LIVER Patterns Flashcards
Internal Liver Wind: BLOOD DEFICIENCY
ETIOLOGY
When Blood is vacuous, wind can take up the empty space left in the Blood vessels.
Internal Liver Wind: BLOOD DEFICIENCY
S/SX
Parkinsons; numbness of limbs, tic, shaking of head, tremor of limbs, trouble swallowing
t: pale, deviated
P hesistant
Fine tremors, facial tic ✴Dizziness, blurred vision, poor memory, insomnia ✴Numbness and tingling of the limbs ✴Scanty periods
wind in excess causes blood defficiency
Internal Liver Wind: BLOOD DEFICIENCY
TMT
Extinguish wind, Nourish LV Blood
LV 8 invigorates blood; benefits genitals & uterus; nourishes blood & yin; HE SEA
LIV-3 (Taichong)
Regulates Liver Qi and Blood
SP-6 (SanYinjiao)
Needle to regulate Blood and the three Yin of the lower limb
KD 3 nourishes KD yin & clears deficiency heat; anchors qi ; strengthens lumbar spine; shu stream, yuan source
BL-18 (Ganshu)
Regulates Liver Blood
BL-17 (Geshu)
Influential Point of Blood, regulates Blood when needled
UB 20 ?????back shu spleen
UB23 ??????back shu kd
LI-4 (Hegu)
Regulates channels, stops pain and spasm
GB 20 eliminates wind; benefits head & eyes; activates channel & alleviates pain “wind pool”
DU 16 eliminates wind; nourishes the sea of marrow & benefits the head & neck; calms spirit; windstroke; “palace of wind”
DU 20 pacifies wind & subdues yand raises yand counters prolapse; nourishes sea of marrow; benefits brain & calms the spirit
Internal Liver Wind: HEAT
etiology
This may be due to pathogenic heat, febrile disease or LV fire. Heat, a Yang pathogen, can generate wind. Pathogenic heat is more likely to be acute, while LV fire is more likely to be chronic and in the elderly
NOTE:
Internal wind is movement of the body’s Yang Qi” and is the result of “depleted stocks of Yin in the viscera.” Etiology: Wind is a Yang pathogen. Internal wind is the excessive movement of then body’s Yang Qi. A vacuity of Yin substances allows internal wind to be engendered. Exuberant Yang can also damage Yin and create movement of wind stirring internally. LV patterns that can engender internal wind are: LV Yang Rising; LV Fire; LV/KI Yin vacuity; and LV Blood vacuity
Internal Liver Wind: HEAT
s/sx
High fever convulsions, tremor of limbs, neck rigidity, upward staring of eyes, in sever case, opsthotonus (backwards arching convulsion) coma, lock jaw
t: deep red tongue P string taut rapid
there can be:
Temporal headache, dizziness, red face/eyes ✴Bitter taste in mouth, dry throat, constipation
Internal Liver Wind: HEAT
tmt
Nourish Yin, Extinguish wind (Heat: Cool Blood; Fire: Clear LV, drain fire)
LIV-2 (Xingjian)
Clears Liver Fire
LIV-3 (Taichong)
Sedates the Liver
Shixuan - on the tips of all 10 fingers you prick to bleed and then maybe moxa; Open portals & revives conscious ness drains heat and pacifies wind.
SI 3 benefits occiput, neck & back; activates channels clears wind & heat & treats epilepsy; shu stream confluent point
DU 20 pacifies wind & subdues yang, good for windstoke: opisthtonos, lock jaw, epilespysy; benefits head; sea of marrow; mtg point of du, UB GB LIV
DU 16 eliminates wind nourishes sea of marrow & benefits the head & neck;
GB-20 (Fengchi)
Subdues Liver Yang, use as local pt for headache in occiput or headache around eye
Internal Liver Wind: YANG RISING
ETIOLOGY
Long term LV Yang rising can lead to LV wind.; the yin cant control the yang
It is more common in elderly.
As with other LV Yang rising patterns, symptoms are differentiated by the combination patterns of Yin and Blood vacuity.
S&S are generally those of LV wind plus:
Hypertension ✴Dry throat ✴Blurred vision, poor memory ✴Insomnia
Internal Liver Wind: YANG RISING
S/SX
this can occur post wind stroke
dizziness & vertido, headache, numbness or tremor of the limbs, convustions, in severe case, sudden collapese , coma, stiffness of the tongue, dysphasia, aphasia or difficult speech, deviation of the mouth & eyes Y hemiplegia
t: red & tremoulous tongue P: string-taut, rapid;
S&S are generally those of LV wind plus:
Hypertension ✴Dry throat ✴Blurred vision, poor memory ✴Insomnia
Internal Liver Wind: YANG RISING
TMT
Extinguish wind, Subdue LV Yang, Nourish Yin/Blood
LIV-3 (Taichong)
Subdues Liver Yang
KID-3 (Taixi)
Tonify Kidney Yin
LIV-8 (Ququan)
Tonify Liver Yin
UB 18 pacifies wind; cools fire; regulates & nourishes lv blood; BACK SHU LV
DU 16 eliminates wind; nourishes the sea of marrow & benefits head & neck; calms spirit; called “the palace of wind)
GB 20 “called wind pool”; eliminates wind
Liver BLOOD DEFICIENCY
ETIOLOGY
can be called Liver Blood Vacuity
Very common pattern, especially in women.
The LV stores Blood and any form of Blood vacuity affects the LV. Blood moistens the LV.
Etiology: When the LV is dry it can impede the function of regulating Qi.
The eyes are dependent on LV Blood to see clearly, and the sinews need LV blood for nourishment. The KI are the mother of the LV. LV Blood contributes to the formation of KI Essence. LV Blood vacuity can lead to general Blood vacuity and it can therefore affect the HT, and the Chong and Ren Mai. There are many causes of LV Blood vacuity, including, Poor diet, Emotional stress, Excessive exercise, and Blood loss.
Liver BLOOD DEFICIENCY
S/SX
Liver BLOOD DEFICIENCY
TREATMENT
Nourish LV Blood (or Tonify the Liver and Nourish Blood)
BL-18 (Ganshu)
Tonifies Liver and Liver Blood
BL-20 (Pishu)
Tonifies Spleen to produce Blood
BL-23 (Shenshu)
Tonifies Kidneys to produce Blood
BL-17 (Geshu)
Direct moxa to tonify Blood
LIV-8 (Ququan)
Tonifies Liver Yin and Blood
ST-36 (Zusanli)
Tonify Qi of Middle Burner to produce Blood
SP-6 (SanYinjiao)
Tonify Qi of Middle Burner to produce Blood
REN-4 (Guanyuan)
Direct moxa to tonify Blood
Liver BLOOD STASIS
etiology
?????
Liver BLOOD STASIS
TMT
invigorate blood, alleviate pain and dispel blood stasis; Disperse the Liver, regulate Blood
LIV-3 (Taichong)
Regulates Liver Qi and Blood
GB-34 (Yanglingquan)
Regulates Liver Qi to regulate Blood
BL-18 (Ganshu)
Regulates Liver Blood
BL-17 (Geshu)
Influential Point of Blood, regulates Blood when needled
SP-10 (Xuehai)
Regulates Blood
REN-6 (Qihai)
Regulates Qi and moves Blood in the abdomen, especially where there is abdominal pain
Liver BLOOD STASIS
S/SX
lv qi stag can lead to this…..
prickling pain in hypochondriac regions or palpable mass, vomiting of blood, epistaxis, Pain is fixed, patient can say I have pain right here
painful periods, irrecgular periods, mentrual blood dark & clotted; abdominal pain, “masses in abdomen fixed not movable; accumulations possilbe fibroids
purple nails, purple lips, purple complexion
dry skin (in severe cases) petechiae
t: purple dark in color especially on the sides, purplish spots on the tongue
P string - taut
Liver COLD STAGNATION
etiology
can be called: Cold Stagnating in the Liver Etiology:
This is an excess pattern of exterior cold invasion into the LV channel.
Cold contracts and stagnates Qi causing pain along the LV channel, particularly in the area of the lower abdomen radiating down to the genitals.
Preexisting LV Qi stagnation may predispose a patient to this condition.
Liver COLD STAGNATION
s/sx
Lower abdominal (hypogastrium = just over the bladder), distending pain w/ bearing down sensation in the testes, the scrotum may be contracted, in women there can be shrinking of vagina, pain is aggravated by cold & alleviated by warmth
t: white coating
P rolling, deep, string -taut
Liver COLD STAGNATION
tmt
Tx: Clear LV, expel cold (or Sedate Liver, Disperse Cold)
Points
REN-3 (Zhongji)
Moxa to disperse Cold from Lower Burner
LIV-5 (Ligou)
Connecting (Lo) point; opens Lo channel which flows around genitals: can disperse Cold from the channel
LIV-1 (Dadun)
Clears Liver channel and removes obstruction of Cold from Lower Burner
Liver FIRE
ETILOLOGY
LV Qi stagnation can transform into heat.
Damp-heat can also depress/stagnate the flow of Qi. In this pattern Yin vacuity is not necessary because when there is enough heat it will overwhelm even sufficient Yin and rise to the upper body.
However, over time heat can burn off the Yin causing it to become vacuous.
✴Similar to LV Yang rising, plus heat signs.
Liver FIRE
S/SX
this is an excess ptn
Distending pain in head, temporal headache, dizziness & vertigo,
redness swelling, pain of eyes, tinnitus like the sound of waves,
irritability propensity to outbursts of anger, dream distubed sleep,
thirst bitter taste, dryness in mouth,
intercostal / hypochandriac burning pain, rib cage
dark yellow urine & constipation w dry stools,
hematemsis, hemoptyosis, cough or vomit blood, epitasis; the heat speeds the blood & causes it to break out of the vessels
t: red w yellow coating
p strong taut, rapid
Liver FIRE
TMT
sedate liver & clear fire
LIV-2 (Xingjian)
Clears Liver Fire
LIV-3 (Taichong)
Sedates the Liver
GB-20 (Fengchi)
Clear Liver Fire, pacify rising Liver Yang. Especially useful where eye problems or headache
TaiYang (Extra Point)
Clear Liver Fire and treats temporal headache
GB 13 (Benshen) Subdue ascending Liver Yang and calms the Mind
LI 11 clears heat; cools blood; regulates qi & blood; he sea
Liver QI STAGNATION
etiology
Most common LV pattern.
Impaired Qi movement results in LV Qi stagnation.
Many conditions interfere with Qi movement but the most common causes are emotional disorders, dampness, and Yin & Blood vacuity.
Emotional disharmony, especially repressed anger, resentment, frustration, over a long time, which impairs the circulation of Liver Qi.
Women during the premenstrual time are naturally more prone to stagnation-related problems, since at this time Blood is collecting in the uterus and Qi levels are diminishing.
Stagnation of Liver Qi over a long time induces stasis of Liver Blood
Liver QI STAGNATION
s/sx
Remember there is always a mental /emotional aspect and that there is some kind of disregulation of QI
mental depression, melancholoy, moodiness, fluctuating mental state, unhappieness, “feeling wound up”, irritability, sighing,
chest stuffiness distending or wandering pain in costal & hypochndriac regions; the pain is diffuse, come & go kind of pain; patient will sometimes say better with movement
stuffiness in stomach, belching, poor appetite, borborygumus diarhea,
possibly a foreign body sensation in throast, difficulty swallowing, plum pit qi
breast distension irregular menstruation & dysmenorrhea, prementrual tension & irritability; Women during the premenstrual time are naturally more prone to stagnation-related problems, since at this time Blood is collecting in the uterus and Qi levels are diminishing.
Liver QI STAGNATION
tmt
Disperse (course) the Liver and regulate (rectify) Qi
LIV-3 (Taichong)
Regulates Liver Qi and especially effective when the throat is involved
GB-34 (Yanglingquan)
Regulates Liver Qi and especially useful when the hypochondriac region in involved
LIV-13 (Zhangmen)
Regulates Liver Qi in Middle Jiao, especially when it affects the Stomach
LIV-14 (Qimen)
Regulates Liver Qi in the Middle Jiao, especially when it invades the Spleen
SJ-6 (Zhigou)
Regulates Liver Qi and especially affects the sides
P-6 (Neiguan)
Regulates Liver Qi and is especially good when emotional problems are major symptoms
Liver Yang Rising (is deficiency & excess)
- etiology*
- can also be called* . Ascendant Hyperactivity of Liver Yang/
This is a complex pattern of excess and vacuity causing Yin Yang imbalance. Yang always tends to move upwards and is dependent on Yin to hold it down. When LV Qi (Yang) becomes exuberant and Yin is vacuous, LV Yang will rise causing disturbances in the upper body, especially along the GB channel in the head or in the eyes. LV Yang exuberance is generally due to the excess condition of LV Qi stagnation (stress), but is also dependent on the vacuity of Yin that allows the Yang to rise. LV Qi stagnation, over time, will wear on the Yin substances causing Yin vacuity and leading to this pattern.
Liver Yang Rising (is deficiency & excess)
s/sx
headache in temples, eyes or lateral side of the head, distending sensation in head
dizziness & vertigo tinnitus, flushed fae & red eyes, dry mouth & throat,
irritability, feeling worked up, shouting in anger, poor memory, sore & weak lower bak & knees
t: red
P: string taut, thready & rapid
insomnia & dream disturved sleep
palpitation,
Liver Yang Rising (is deficiency & excess)
tmt
Liver DAMP HEAT
ETIOLOGY
Can be called Damp-Heat (brewing) in the Liver/Gallbladder Etiology:
Etiology: External or internal dampness can enter the LV and GB channels and combine with heat to interfere with the free coursing of Qi, resulting in Qi stagnation and S&S along the channels and in related organs.
NOTE: INTRESTING
This pattern is a combination of Heat in Liver and Dampness in Spleen. There must be Dampness in Spleen for the pattern to manifest.
Dampness in Liver and Gallbladder channel causes Liver Qi to stagnate by obstructing the smooth flow of Liver Qi. This results in distention/pain of hypochondrium and chest. Then the Liver Qi invades Stomach, with symptoms such as (nausea, vomiting, loss of Appetite and abdominal distention.
Accumulation of Dampness can obstruct the flow of bile and cause jaundice.
Damp-Heat causes low grade continuous fever. Dampness can flow down and settles in Lower Burner and give rise to symptoms such as vaginal discharge and itching or pain/swelling and redness of scrotum
Internal: Spleen Deficiency (irregular eating habits, excessive consumption of Cold and raw foods, protein deficient diet, excessive thinking or mental strain). Liver Qi stagnation over long time (excessive emotional frustration, repressed anger, etc.) causes Liver Heat, which combines with dampness to obstruct the Liver and Gallbladder
External:
Invasion of exogenous Damp-Heat.
Common in tropics, less common in temperate climates.
Liver DAMP HEAT
S/SX
Hypochondriac distension & pain,
bitter taste in the mouth, poor appetite, nausea,
vomiting abdominal distension,
scanty & dark yellow urine, ther may be yellow sclera & skin of the entire body (jaundice) or fever
eczema of scrotum, swelling & burning pain in the testes,, also
vaginal itch, yellow foul leukorrhea w/ pruitus vulvae
t: yellow sticky coating P: string - taut, rapid
Note it smells, its yellow - accumulation its a channel pattern
Liver DAMP HEAT
TMT
tx: Drain damp-heat, clear LV/GB
Resolve Dampness, Clear Heat, Disperse Liver and Gallbladder
LIV-14 (Qimen)
Regulates Liver Qi in hypochondrium/epigastrium
GB-24 (Riyue)
Regulates Liver Qi, soothes Gallbladder, Resolves Damp
GB-34 (Yanglingquan)
Move stagnant Liver Qi and resolve Dampness
BL-18 (Ganshu)
Move stagnant Liver Qi and resolve Dampness
BL-19 ( Danshu)
Move stagnant Liver Qi and resolve Dampness
DU-9 (ZhiYang)
Resolves Dampness from Gallbladder
REN-12 (Zhongwan)
Tonifies Spleen to resolve Dampness
SP-9 (Yinlingquan)
Resolve Dampness in Lower Burner
SP-6 (SanYinjiao)
Resolve Dampness in Lower Burner
SP-3 (Taibai)
Resolve Dampness
LI-11 (Quchi)
Clear Heat, resolve Dampness
LIV-2 (Xingjian)
Clear Heat in Liver
