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By Henryk Dancygier

Medical Hepatology – rules and perform of Hepatobiliary illnesses presents transparent and accomplished assurance of the etiology, mechanisms of illness, prognosis, and sensible administration of the total spectrum of liver and biliary problems. It additionally presents a good, evidence-based assessment of the speedily increasing box of hepatobiliary ailments.

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CLINICAL NOTE Women are very prone to Blood stasis. In complicated, chronic gynecological problems, always suspect Blood stasis. 8 Section 1: Physiology and Pathology In order to understand women’s physiology, it may be helpful to compare and contrast it with men’s physiology. Women pertain to Yin but some aspects of their physiology are Yang; men pertain to Yang but some aspects of their physiology are Yin. Women’s physiology is rooted in Blood, men’s in Qi; men store Essence, women store the Uterus, Blood and fetus.

However, the Heart also plays a role. If Heart-Qi does not descend to the Uterus, this may also cause amenorrhoea. 4 shows the connection between the Uterus and the internal organs. ‘Uterus’ has a broad definition in Chinese medicine, encompassing structures beyond the uterus itself, Interestingly, in Western medicine too there is a connection between the uterus and ovaries. There is evidence that hysterectomy with conservation of the ovaries is associated with earlier ovarian failure and this may be due to a reduction in the blood supply to the ovaries following surgical clamping of the uterine arteries.

In men, the LH which is secreted by the pituitary gland in response to a GnRH signal acts on the Leydig cells in the testes. Once stimulated with LH, the Leydig cells in the testes produce testosterone. FSH is also secreted by the pituitary gland in men. Together with testosterone, FSH stimulates Sertoli cells (located in the seminiferous tubules of the testes) to support the developing sperm (Fig. 12). SUMMARY Hypothalamus–pituitary–ovarian axis • The menstrual cycle is the result of a complex and delicate interplay among the hypothalamus, pituitary and ovaries • The hypothalamus secretes gonadotropin releasing hormone (GnRH) which in turn stimulates the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by the pituitary • FSH stimulates follicle development in the ovaries during the follicular phase while LH stimulates the corpus luteum during the luteal phase • The hypothalamus–pituitary–ovarian axis has its correspondent in the Du/Ren axis in Chinese medicine • Both the Governing and Directing Vessels originate in the ‘Kidneys’ (which includes the ovaries).

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