Liver Syndromes Flashcards
Liver Blood Deficiency
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Postural dizziness, numbness or tingling of limbs, scanty periods or amenorrhoea, blurred vision.
AccompanYing symptoms: Insomnia characterised by frequent waking during the night, floaters, diminished night vision, dull pale complexion, pale lips, dry hair and skin, muscular weakness, cramps, withered and brittle nails, a feeling of aimlessness, feeling low.
2)
Pulse: Thin or Choppy, especially left, middle position.
Tongue Body: Pale, especially on sides, and Dry. In extreme cases, Orange sides and Thin.
3)
Pathology: The Liver opens into the eyes therefore if Liver Blood is deficient the eyes will lack nourishment causing any of above eye symptoms. The Liver controls the sinews which will not be properly nourished if Liver Blood is weak, leading to numbness, tingling, weakness or cramps. As the Liver manifests in the nails, when Liver Blood is deficient they will become withered and brittle. The Directing and Penetrating Vessels (Ren Mai and Chong Mai respectively) rely on the Liver to supply them with Blood. If they are not properly filled because Liver Blood is weak, periods will be scanty or missed altogether. If Liver Blood is deficient, the Ethereal Soul (Hun) will not be properly anchored at night leading to insomnia. Similarly, if the Ethereal Soul (Hun) is not properly anchored, the person may feel aimless and low because its capacity for planning will be diminished.
4)
Aetiology: a) Poor diet – irregular eating habits and not enough Blood nourishing foods. b) Heavy blood loss. c) Excessive physical exercise. d) Emotional stress. e) Kidney deficiency.
5)
Treatment Principle: Nourish Blood. Tonify Liver.
Examples of Points: Bl 18, Bl 20, Bl 23, Bl 17, Liv 3, Liv 8, Sp 6, St 36, Ren 4. Needle technique: Tonification.
Other applicable techniques: Moxa.
Liver Yin Deficiency
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Insomnia, dry eyes, restlessness, irritability.
AccompanYing symptoms: Very dry hair and skin, muscular weakness, a feeling of aimlessness, dull- pale complexion without lustre, malar flush, feeling of heat in the afternoon and evening, 5-palm heat, night-sweating, thirst with desire to drink in small sips, depression, scanty periods or amenorrhoea (although menstrual bleeding may be heavy if there is a lot of Empty Heat).
2)
Pulse: Wiry, Floating, Empty, especially left, middle position, and Rapid.
Tongue Body: Red, may be partially Peeled or Peeled.
3)
Pathology: Very closely related to Liver Blood deficiency. Dry eyes are due to deficient Liver Yin not nourishing and moistening the eyes. Empty Heat agitates the Ethereal Soul (Hun) which is not rooted because the Yin is deficient, so that it ‘comes and goes’ too much causing anxiety, insomnia, mental restlessness and irritability. All other signs are due to Empty Heat arising from Yin deficiency.
4)
Aetiology: a) Poor diet – too many heating foods. b) Heavy blood loss. c) Excessive physical exercise. d) Excessive sexual activity. d) Emotional stress. e) Kidney deficiency.
5)
Treatment Principles: Nourish Liver Yin. Clear Empty Heat if necessary.
Examples of Points: Liv 3, Liv 8, Bl 18, Kid 3, Kid 6, Sp 6, Ren 4. Needle Technique: Tonification.
Liver Yang Rising
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Headaches on the temples, eyes or lateral side of head, irritability, dizziness, propensity to outburst of anger.
AccompanYing symptoms: Tinnitus, deafness, blurred vision, dry mouth and throat, insomnia, feeling worked up, stiff neck.
2)
Pulse: Wiry, especially left, middle position.
Tongue Body: May be slightly Red on the sides.
3)
Pathology: Symptoms are all due to the rising of Liver Yang to the head. This may stem from Yin deficiency of the Liver and/or Kidneys, or Liver Blood deficiency. In practice, the above symptoms usually occur alongside symptoms of either Yin or Blood deficiency. The headache, which is usually unilateral, affects the Gall-Bladder channel.
4)
Aetiology: a) Emotional problems such as anger, frustration and resentment over a long period of time. b) Diet – eating in a hurry or when angry. c) Alcohol, some recreational drugs and medications.
5)
Treatment Principles: Subdue Liver Yang. Tonify Liver and/or Kidney Yin or Liver Blood.
Examples of Points: a) Liv 3, Liv 2, TB 5, P 6, LI 4, GB 43, GB 38, Bl 2, GB 20, GB 9, GB 8, GB 6. b) Kid 3, Liv 8, Sp 6.
Needle Technique: a) Even or Reduction. b) Tonification.
Liver Qi Stagnation
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Moodiness, pre-menstrual tension, irritability.
AccompanYing symptoms:
Melancholy, depression, anger without a cause, fluctuation of mental state, feeling ‘wound up’. Feeling of distension in hypochondrium, chest, epigastrium or abdomen, sighing.
Nausea, vomiting, epigastric pain, poor appetite, sour regurgitation, belching, feeling of pulsation in epigastrium, churning feeling in stomach, abdominal distension, flatulence, diarrhoea.
Feeling of lump (‘Plum Stone’) in throat, difficulty swallowing.
Irregular periods, pre-menstrual breast distension.
2)
Pulse: Wiry, especially left, middle position.
Tongue Body: Normal, or possibly slightly Purple, or slightly Red on the sides.
3)
Pathology: Most symptoms are due to Liver Qi Stagnating in different areas of the body. Nausea, vomiting, epigastric pain, no appetite etc. due to Liver Qi Invading the Stomach and Spleen. Symptoms connected to menstruation are due to Liver Qi Stagnation impairing the movement of Blood in the Penetrating (Chong Mai) and Directing (Ren Mai) Vessels and affecting the Uterus. Emotional symptoms are due to the Liver failing to ensure the smooth flow of Qi in relation to the mind, which impedes the “coming and going” of the Ethereal Soul (Hun). The Liver channel runs through the throat so if Liver Qi stagnates there may be a feeling of lump in the throat or difficulty swallowing.
4)
Aetiology: Long-term emotional problems such as anger, frustration and resentment.
5)
Treatment Principles: Disperse the Liver. Regulate Qi.
Examples of Points: GB 34, Liv 3, Liv 1, Liv 13, Liv 14, TB 6, Pc 6. Needle technique: Even or Reduction.
NB: Because stagnation can easily turn to Heat it is common to see patients with a further development of this syndrome called Liver Qi Stagnation Turns to Heat. In this case patients will have many of the signs and symptoms above and also have more signs of heat such as red sides to tongue, overflowing pulse, a tendency to feel hot some of the time and more a tendency to more extreme emotional volatility.
Liver Blood Stagnation
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Very painful periods, dark and clotted menstrual blood, hypochondrial or abdominal
pain.
AccompanYing symptoms: Haematemesis, epistaxis, irregular periods, abdominal masses, purple petechiae, purple nails, purple lips, purple or dark complexion, dry skin (in severe cases).
2)
Pulse: Wiry, Choppy or Firm, especially left, middle position.
Tongue Body: Purple, especially on sides. In severe cases, there may be Purple spots on the sides.
3)
Pathology: All symptoms are due to Stagnation of Liver Blood. As the Liver stores Blood, it is particularly affected by stagnation of Blood. When Liver Blood stagnates, Blood in the Directing (Ren Mai)and Penetrating (Chong Mai) Vessels will also stagnate, causing menstrual symptoms. Vomiting of blood and epistaxis are caused by stagnation of Blood in the Liver channel. As the Liver manifests in the nails, Liver Blood stagnation may cause purple nails. General stagnation of Blood causes purple lips and complexion. In severe cases, stagnant Blood obstructs the circulation of fluids and the skin becomes dry. Purple petechiae are due to bleeding under the skin caused by Blood stagnation in the Blood Connecting channels.
4)
Aetiology: a) Chronic Liver Qi stagnation (deriving from long-term emotional problems, b) Cold, c) Heat.
5)
Treatment Principles: Disperse the Liver. Regulate Blood.
Examples of Points: GB 34, Liv 3, Bl 18, Bl 17, Sp 10, Ren 6. Needle technique: Even or Reduction.
Liver Fire Blazing Upwards
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Irritability, propensity to outbursts of anger, dream-disturbed sleep, red face and eyes.
AccompanYing symptoms: Tinnitus, deafness, temporal headache, dizziness, thirst, bitter taste, dream-disturbed sleep, constipation with dry stools, dark yellow urine, epistaxis, haematemesis, haemoptysis.
2)
Pulse: Overflowing, Wiry, especially left middle position, Rapid. Tongue Body: Red, Redder on sides.
Tongue Coat: Yellow, Dry.
3)
Pathology: Liver Fire has a natural tendency to flare upwards, and all signs in the head are a reflection of this. Fire agitates the Mind, causing all the mental-emotional symptoms. Liver Fire dries up Body Fluids resulting in constipation with dry stools and dark, concentrated urine. In severe cases, Liver Fire heats the Blood causing it to leak out of the blood vessels which may lead to nose bleed, vomiting or coughing of blood.
4)
Aetiology: a) Long-standing anger. b) Poor diet – too many heating foods. c) Alcohol, some recreational drugs and medications.
5)
Treatment Principles: Sedate the Liver. Clear Fire.
Examples of Points: Liv 2, Liv 3, Liv 1, GB 20, GB 13, LI 11, Taiyang (extra). Needle Technique: Even or Reduction.
Liver Blood Deficiency Causing Wind Agitating Within
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Mild tremor of limbs, facial tic, numbness of limbs, shaking of head.
AccompanYing symptoms: Insomnia, scanty periods or amenorrhoea, floaters, blurred vision, diminished night vision, dull pale complexion, pale lips, dry hair and skin, muscular weakness, cramps, withered and brittle nails, a feeling of aimlessness, feeling low.
2)
Pulse: Choppy, Wiry, esp. left, middle position. Tongue Body: Pale, especially on sides, Dry.
3)
Pathology: The mild tremor, facial tic (which will be mild) and shaking of head are caused by Internal Wind. This has stemmed from Liver Blood Deficiency, which has created emptiness in the blood vessels which has been ‘filled’ by Internal Wind.
4)
Aetiology: a) Poor diet – irregular eating habits and not enough Blood nourishing foods. b) Heavy blood loss. c) Excessive physical exercise d) Emotional stress e) Kidney deficiency.
5)
Treatment Principles: Nourish Liver Blood. Subdue Wind.
Examples of Points: a) Liv 3, GB 20, LI 4, TB 5, Du 19. b)Liv8,Ki3,Sp6,Bl17,Bl18,Bl20,Bl23,Ren4.
Needle technique: a) Even or Reduction. b) Tonification.
Extreme Heat generating Liver-Wind
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: High temperature, convulsions, rigidity of the neck, tremor of the limbs,
opisthotonos.
AccompanYing symptoms: Coma (in severe cases).
2)
Pulse: Rapid and Wiry, especially left, middle position. Tongue Body: Deep Red, Stiff.
Tongue Coat: Thick, Yellow, Dry.
3)
Pathology: Seen as a complication in acute febrile diseases e.g. measles, encephalitis and meningitis. Heat reaches the Blood level and injures Yin. Yin deficiency then gives rise to internal Wind which causes all the above symptoms.
4)
Aetiology: Invasion of Exterior Heat or Wind-Heat penetrating to the Blood level.
5)
Treatment Principles: Cool Blood. Disperse the Liver. Subdue Wind. Nourish Yin.
Examples of Points: Liv 3, Liv 2, SI 3, Du 20, Du 16, Du 14, Du 8, GB 20, Shixuan (extra).
Needle technique: Even or Reduction.
Other applicable techniques: Bleeding needle (on Shixuan).
Liver Yang Rising Generating Wind:
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Headache, hypertension, severe dizziness, sudden unconsciousness, convulsions,
deviation of eye and mouth, hemiplegia, aphasia or difficult speech, severe tremor.
AccompanYing symptoms: Dry throat, dry eyes, blurred vision, numbness or tingling of limbs, facial tic, tinnitus, scanty urination, night-sweating, insomnia, poor memory.
2)
Pulse: Floating, Wiry, Thin, especially left, middle position, and Rapid. Tongue Body: Pale or Red, partially Peeled or Peeled, Deviated.
3)
Pathology: Symptoms are due to Internal Wind generated from Liver Yang Rising (which itself may stem from Liver or Kidney Yin Deficiency, or Liver Blood deficiency). Wind is a Yang pathogenic factor which “agitates”, therefore causing involuntary movements such as convulsions, tremors and tics within the body. Deviation of eye and mouth, hemiplegia and aphasia are also due to Wind in the channels. Tinnitus, headache, hypertension and dizziness are all due to Liver Yang rising to the head. Dry throat and eyes, scanty urination and nightsweating are all indicative of underlYing Yin deficiency, whilst blurred vision, numbness or tingling of limbs and poor memory are a sign of underlYing Blood deficiency.
4)
Aetiology: Liver Yin Deficiency a) Excess sex. b) Excess exercise. c) Excessive physical work. d) Liver Blood Deficiency (in women). Liver Yang Rising Long-term emotional problems such as anger, frustration and resentment.
5)
Treatment Principles: Subdue Liver Yang. Subdue Wind. Nourish Liver Yin, Kidney Yin or Liver Blood.
xamples of Points: (a) Liv 3, Du 16, GB 20 LI 4, Bl 18, Liv 2. (b) Liv 8, Sp 6, Kid 3.
Needle technique: (a) Even or Reduction. (b) Tonification.
Damp-Heat in the Liver and Gall Bladder
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Nausea, a feeling of fullness and heaviness of the chest, abdomen or
hypochondrium, vaginal discharge and itching.
AccompanYing symptoms: Jaundice, bitter or sticky taste, loss of appetite, pain, redness and swelling of scrotum, difficulty in passing urine, dark urine, pain and burning on urination, papular or vesicular skin rashes.
2)
Pulse: Wiry or Slippery, especially in left middle position, and may be Rapid. Tongue Body: Red.
Tongue Coat: Sticky, Yellow.
3)
Pathology: All symptoms due to Damp-Heat. Dampness is heavy and infuses downwards causing various genital and urinary symptoms. Dampness may also obstruct the Middle Burner impairing the descending of Stomach Qi and leading to nausea and poor appetite. Dampness may cause a heavy feeling anywhere in the body.
4)
Aetiology: a) Dampness (from Spleen Qi deficiency). b) Long-term Liver Qi Stagnation. c) External climatic Damp or Damp-Heat
5)
Treatment Principles: Resolve Dampness. Disperse the Liver. Clear Heat.
Examples of Points: Liv 14, Liv 13, Liv 5, GB 34,GB 24, Bl 18, Bl 19, Du 9, Sp 9, Sp 6, Sp 3, LI 11, Liv 2, Ren 12.
Needle technique: Even or Reduction.
Stagnation of Cold in the Liver Channel
1) Symptoms
2) Pulse and Tongue
3) Pathology
4) Aetiology
5) Treatment
1)
Key symptoms: Fullness and distension of the hypogastrium with pain that refers to the scrotum and
testes and upwards to the hypochondrium, pain alleviated by warmth.
AccompanYing symptoms: Straining of the testes or contraction of the scrotum, vertex headache, feeling of cold, cold hands and feet, vomiting of clear watery fluid or dry vomiting. In women there may be shrinking of the vagina.
2)
Pulse: Wiry, Deep, especially left, middle position, and Slow.
Tongue Body: Pale, Wet.
Tongue Coat: White.
3)
Pathology: The Liver channel flows around the external genitalia. Cold contracts, hence the pain and contraction of the scrotum.
4)
Aetiology: Invasion of Exterior Cold.
5)
Treatment Principles: Sedate the Liver. Expel Cold.
Examples of Points: Ren 3, Liv 5, Liv 1, Liv 3. Needle Technique: Even or Reduction. Other applicable techniques: Moxa.
Examples of Points: Ren 3, Liv 5, Liv 1, Liv 3. Needle Technique: Even or Reduction. Other applicable techniques: Moxa.
Other Liver syndromes
- Rebellious Liver Qi
