LIVER

LIVER

Chapter contents

LIVER-QI STAGNATION PATTERNS

Stagnation of Liver-Qi

Stagnant Liver-Qi turning into Heat

Liver-Qi stagnation with Phlegm

REBELLIOUS LIVER-QI

LIVER-YANG RISING

LIVER-BLOOD STASIS

LIVER-FIRE BLAZING UPWARDS

Damp-Heat in the Liver

Damp-Heat in the Liver and Gall-Bladder

Extreme Heat generating Wind

Liver-Yang rising generating Wind

Liver-Fire generating Wind

Liver-Blood deficiency giving rise to Wind

Liver-Wind harbouring Phlegm

LIVER-BLOOD DEFICIENCY PATTERNS

Liver-Blood deficiency

Liver-Blood deficiency with Phlegm

STAGNATION OF COLD IN THE LIVER CHANNEL

LIVER-YIN DEFICIENCY PATTERNS

Liver-Yin deficiency

Liver-Yin deficiency with Empty-Heat

LIVER-QI DEFICIENCY

LIVER PHLEGM-FIRE

LIVER-YANG DEFICIENCY

COMBINED PATTERNS

Rebellious Liver-Qi invading the Spleen

Rebellious Liver-Qi invading the Stomach

Liver-Fire insulting the Lungs

Liver- and Heart-Blood deficiency

LIVER-QI STAGNATION PATTERNS

Stagnation of Liver-Qi

Clinical manifestations

Hypochondrial or epigastric distension, a slight feeling of oppression of the chest, irritability, melancholy, depression, moodiness, premenstrual tension, irregular periods, premenstrual breast distension, a feeling of a lump in the throat.

Tongue

In light cases the tongue-body colour may not change; in severe cases the sides will be red.

Pulse

Wiry, especially on the left side.

Acupuncture

P-6 Neiguan, GB-34 Yanglingquan, LIV-13 Zhangmen, LIV-14 Qimen, LIV-3 Taichong, TB-6 Zhigou.

Prescription

Yue Ju Wan Gardenia-Ligusticum Pill

Xiao Yao San Free and Easy Wanderer Powder.

Stagnant Liver-Qi turning into Heat

Clinical manifestations

Hypochondrial or epigastric distension, a slight feeling of oppression of the chest, irritability, melancholy, depression, moodiness, premenstrual tension, irregular periods, premenstrual breast distension, a feeling of a lump in the throat, a feeling of heat, red face, thirst, propensity to outbursts of anger, heavy periods.

Tongue

Red on the sides.

Pulse

Wiry, especially on the left side and slightly Rapid.

Acupuncture

P-6 Neiguan, GB-34 Yanglingquan, LIV-13 Zhangmen, LIV-14 Qimen, LIV-3 Taichong, TB-6 Zhigou, LIV-2 Xingjian.

Prescription

Dan Zhi Xiao Yao San Moutan-Gardenia Free and Easy Wanderer Powder.

Liver-Qi stagnation with Phlegm

Clinical manifestations

Mental depression, irritability, moodiness, a feeling of oppression of the chest, a feeling of a lump in the throat, difficulty in swallowing, sighing, cough with expectoration of phlegm, hypochondrial distension, premenstrual breast distension, swelling and pain.

Tongue

Swollen with a sticky coating.

Pulse

Acupuncture

LIV-3 Taichong, ST-40 Fenglong, LI-4 Hegu, Du-24 Shenting, GB-13 Benshen, P-7 Daling, P-6 Neiguan.

Prescription

Yue Ju Wan Gardenia-Ligusticum Pill

Ban Xia Hou Po Tang Pinellia-Magnolia Decoction

Ju He Wan Citrus Seed Pill

Si Hai Shu Yu Wan Fours Seas Soothe Stagnation Pill (specific for goitre from Qi stagnation and Phlegm).

REBELLIOUS LIVER-QI

Clinical manifestations

Hypochondrial or epigastric distension, hiccup, sighing, nausea, vomiting, belching, ‘churning feeling in the stomach’, irritability, breast distension in women.

Tongue

In light cases the tongue-body colour may not change; in severe cases the sides will be Red.

Pulse

Wiry. It may be particularly Wiry on the Liver and Stomach positions.

Acupuncture

LIV-14 Qimen, P-6 Neiguan, GB-34 Yanglingquan, LIV-3 Taichong, TB-6 Zhigou, LI-4 Hegu, ST-21 Liangmen, ST-19 Burong.

Prescription

Chai Hu Shu Gan Tang Bupleurum Soothing the Liver Decoction

Yi Gan San Restrain the Liver Powder.

LIVER-YANG RISING

Clinical manifestations

Headache which may be on the temples, eyes or lateral side of the head, dizziness, tinnitus, deafness, blurred vision, dry mouth and throat, insomnia, irritability, a feeling of being worked-up, propensity to outbursts of anger, stiff neck.

Tongue

The tongue presentation may vary widely depending on the underlying condition causing Liver-Yang rising. If this derives from Liver-Blood deficiency the tongue-body colour will be Pale; if it derives from Liver-Yin deficiency the tongue-body colour will be slightly Red on the sides and without coating. In some cases, Liver-Yang rising may develop from rebellious Liver-Qi; in this case the tongue-body colour may be normal or slightly red on the sides.

Pulse

Wiry. However, if there is a background of Liver-Blood or Liver-Yin deficiency, the pulse may be Wiry only on one side, or it may also be Wiry but Fine.

Acupuncture

LIV-3 Taichong, TB-5 Waiguan, P-6 Neiguan, LI-4 Hegu, GB-43 Xiaxi, GB-38 Yangfu, BL-2 Zanzhu, Taiyang extra point, GB-20 Fengchi, GB-9 Tianchong, GB-8 Shuaigu, GB-6 Xuanli. In cases of Liver-Blood or Liver-Yin deficiency: SP-6 Sanyinjiao, KI-3 Taixi, LIV-8 Ququan, ST-36 Zusanli.

Prescription

Tian Ma Gou Teng Yin Gastrodia-Uncaria Decoction

Ling Jiao Gou Teng Tang Cornu Antelopis-Uncaria Decoction.

LIVER-BLOOD STASIS

Clinical manifestations

Hypochondrial pain, abdominal pain, vomiting of blood, epistaxis, painful periods, irregular periods, dark and clotted menstrual blood, infertility, masses in the abdomen, purple nails, purple lips, purple or dark complexion, dry skin (in severe cases), purple petechiae.

Tongue

Purple especially, or only, on the sides. In severe cases, there will be purple spots on the sides.

Pulse

Acupuncture

GB-34 Yanglingquan, LIV-3 Taichong, BL-18 Ganshu, BL-17 Geshu, SP-10 Xuehai, Ren-6 Qihai, SP-4 Gongsun and P-6 Neiguan (opening points of the Penetrating Vessel), ST-29 Guilai, KI-14 Siman, LIV-5 Ligou, LIV-6 Zhongdu.

Prescription

Ge Xia Zhu Yu Tang Eliminating Stasis below the Diaphragm Decoction

Shi Xiao San Breaking into a Smile Powder

Yan Hu Suo Tang Corydalis Decoction.

LIVER-FIRE BLAZING UPWARDS

Clinical manifestations

Irritability, propensity to outbursts of anger, tinnitus/deafness (with sudden onset), temporal headache, dizziness, red face and eyes, thirst, bitter taste, dream-disturbed sleep, constipation with dry stools, dark-yellow urine, epistaxis, haematemesis, haemoptysis.

Tongue

Red with redder sides and dry yellow coating.

Pulse

Acupuncture

LIV-2 Xingjian, LIV-3 Taichong, GB-20 Fengchi, Taiyang extra point, GB-13 Benshen, LI-11 Quchi, GB-1 Tongziliao, GB-9 Tianchong, GB-8 Shuaigu, GB-6 Xuanli, Du-24 Shenting, SP-6 Sanyinjiao, LIV-1 Dadun.

Prescription

Long Dan Xie Gan Tang Gentiana Draining the Liver Decoction

Dang Gui Long Hui Tang Angelica-Gentiana-Aloe Decoction.

DAMP-HEAT

Damp-Heat in the Liver

Clinical manifestations

Fullness of the hypochondrium, abdomen or hypogastrium, bitter taste, poor appetite, nausea, a feeling of heaviness of the body, yellow vaginal discharge, vaginal itching, vulvar eczema or sores, mid-cycle bleeding/pain, pain, redness and swelling of the scrotum, genital, papular or vesicular skin rashes and itching, urinary difficulty, burning on urination, dark urine.

Tongue

Red body with redder sides, sticky-yellow coating.

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Tags: Diagnosis in Chinese Medicine A Comprehensive Guide

Apr 15, 2017 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off

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