to excrete. Successful expulsion with acupuncture occurs in 70% of cases.

Western Differentiation

Whereas in Chinese medicine both sides of the hypochondrium are related to the Liver channel,
in Western medicine obviously only the right side reflects a possible liver pathology. Thus an
important distinction is that between right and left hypochondrial pain.

Right Hypochondrial Pain

Cholecystitis or Cholelithiasis

Cholecystitis consists in inflammation of the gall-bladder with or without gall-stones. It is more
frequent in women over 25. Cholesterol is maintained in solution in the bile by bile acids. Any
factor which increases cholesterol (obesity, high fat diet) or decreases bile acids (bile stasis, liver
disease) may lead to the formation of stones.

The hypochondrial pain may radiate to the right scapula and may be accompanied by nausea,
vomiting and sweating. The right rectus muscle feels rigid on palpation and the patient is very
restless during an acute attack.

Carcinoma of the Gall-Bladder

Carcinoma of the gall-bladder is more common in women over 50, but it is quite rare in general.
The hypochondrial pain is similar to that of cholecystitis and there may be jaundice. In advanced
cases the patient would be thin and exhausted. The gall-bladder is palpable and tender and its
surface is felt to be irregular. The liver is also enlarged and the glands above the right clavicle
may be enlarged.

Hepatitis

Type A hepatitis may cause a right hypochondrial pain. The liver is enlarged and its surface feels
smooth on palpation.

Carcinoma of the Liver

Carcinoma of the liver causes hypochondrial pain. The liver is enlarged and its surface feels