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Liver Patterns

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Functions of the Liver

-It stores Blood.

-It ensures the smooth flow of Qi. influences all

organs and many different parts of the
body(Does not take part in actual production
and supply of Qi)
-It controls the sinews.
-It manifests in the nails.
-It opens into the eyes.
-It controls tears.
-It houses the Ethereal Soul (Hun).
-It is affected by anger.
A feel for liver pathology

sinew related (physical tiredness/ weakness or

contraction of tendons)
Rapid changes (e.g. in skin diseases)
Up and down fluctuation (e.g. level of energy,
mood)
Emotionally up and down
Moodiness, irritability
Pain
Eye problems
A feeling of 'distension'
Gynaecological problems
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Liver stores blood-blood

-scanty periods

deficiency

-Liver Blood stagnanation as consequence of

Liver-Qi stagnation (Qi is commander of blood,

Qi stagnates, Blood congeals)
General Aetiology - Exterior

-Wind and Dampness

pathogenic factors

-Wind does not attack Liver directly (invades

lung's defensive Qi portion) but

-External Wind can aggravate an interior Liver
disharmony (e.g. Liver-Yang rising, Liver-Wind).
-Exterior Wind may affect Liver-Blood and either
cause or aggravate skin diseases.
General Aetiology -Emotions

Emotion and organ has mutual affecting

relationship
'Anger' includes frustration and resentment,
irritation, repressed anger
Anger may cause Liver-Qi stagnation or LiverYang rising
Anger makes Qi rise and is a frequent cause of
headaches from Liver-Yang rising
-Stagnation of Qi over a long period of time can
lead to Heat as the implosion of Qi caused by
emotional
constraint generates Heat. This situation is often
manifested
on the tongue with red sides and tip, possibly
with red points on the tip.
- Worry mostly affects Lungs but can also cause
Liver-Qi stagnation and maybe cause Liver Yang
to rise
-Sadness can affect Liver especially in women
"injure the Ethereal Soul."
General Aetiology- Diet

-Excessive consumption of hot-energy foods eg.

red meat, spices, alcohol can lead to Liver- Fire.

-Excessive greasy food can lead to Dampness
-inadequate consumption of warming and Blood-

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nourishing foods eg. meat and grains can lead to

Blood deficiency, Liver- Blood deficiency
especially in women
General Aetiology- Blood loss

A severe blood loss, such as one occurring after

childbirth, can lead to deficiency of Liver-Blood.

Full Patterns (Liver Qi

1. Feeling of DISTENTION of hypochondrium,

Stagnation) - Clinical

chest,

manifestations

epigastrium or abdomen, sighing.

2. Melancholy, DEPRESSION, MOODINESS,

fluctuation of
mental state, 'feeling wound-up', feeling of a
lump
in the throat.
3. Irregular periods, distension of breasts before
the periods, premenstrual tension and irritability
(Fig. 34.1).
Tongue: the body colour may be normal. In
severe
cases, it may be slightly Red on the sides.
Pulse: WIRY, especially on the left side.
*A feeling of distension and a Wiry pulse by
themselves are enough to diagnose Liver-Qi
stagnation.
Full Patterns (Liver Qi

- Emotional stress - a state of frustration,

Stagnation) - Aetiology

repressed anger or resentment over a long

period of
time can cause the flow of Qi to be impeded so
that Qi
does not flow smoothly and it becomes stuck
Full Patterns (Liver Qi

1. 'Distension' (zhang) is the chief symptom of Qi

Stagnation) - Pathhology

stagnation. Most English-speaking patients would

say 'bloating'. Sighing releases stagnant Qi

2. Emotional manifestations due to lack of flow of
Qi at psychic level, impeding coming and going
of the Ethereal Soul, leading to depression and
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irritability.
3. Stagnation of Liver-Qi can impair the
movement
of Qi and Blood in the Directing and Penetrating
Vessels (Ren Mai and Chong Mai), thus affecting
the
Uterus, resulting in irregular periods and
premenstrual
tension with distension of the breasts
Full Patterns (Liver Qi

-The tongue in Qi stagnation may be normal

Stagnation) - Tongue

coloured; it is not purple (blood stasis). In severe

appearance, and Pulse

cases it may be

red on the sides.

-Wiry pulse
*In women, Liver-Qi stagnation often derives
from or
is associated with Liver-Blood deficiency:
The symptoms and signs will be slightly different
and generally of the Deficient type
There will be depression rather than irritability
The pulse may be generally Fine and only
slightly
Wiry on the left
Xiao Yao San is for Liver-Qi stagnation deriving
from or associated with Liver-Blood deficiency
Yue Ju Wan is for 'pure' Liver-Qi stagnation.
Full Patterns (Liver Qi

-May arise as a secondary consequence of

Stagnation) - Pathological

Liver-Blood deficiency (Yin Yang mutually

precursors of and

influencing each other)

developments from the

-Kidneys are the Mother of the Liver in the

pattern

Five-Element scheme, a deficiency of the Kidneys

may
induce a secondary Liver-Qi stagnation.
-Qi 'is the commander of Blood' and 'when Qi
stagnates Blood congeals', stagnation of Liver-Qi
over a long period of time can easily induce
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stasis of LiverBlood
Full Patterns (Liver Qi

Principle of treatment: smooth the Liver and

Stagnation) - Treatment

move Qi

...

...

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