Liver Syndromes

Liver syndromes are commonly seen in clinical practice, since the stress and toxicity of modern life (poor diet, chemicals in our food and environment, stress, overwork, etc.) take a toll on the liver. Since the liver plays the central role in the smooth flow of qi and emotion in the body, disharmony of the liver can affect any of the other organs. Typically, disorders of the menstrual cycle or stress-related ailments indicate a problem with the liver.

Liver Qi Stagnation: This is one of the most common diagnoses in traditional Chinese medicine. When the qi of the liver is stuck, symptoms of frustration, irritability, depression, anxiety, fullness in the chest, menstrual disorders, and indigestion can occur. This excess condition can also arise in a person who has experienced long-term depression or frustrations, creating a vicious cycle of cause and effect. Some Western conditions that fit this pattern are premenstrual syndrome, depression, hepatitis, or chronic fatigue. Treatment with acupuncture often has an immediate effect in relieving the symptoms. A classic formula known as Xiao Yao Wan ("Free and Easy Wanderer Pills") is also very effective in rectifying this liver syndrome.

Liver Fire Uprising: This excess heat pattern mainly affects the upper body, since heat rises naturally. The entire face is red, with additional signs and symptoms of red eyes, anger, headache, ringing in the ears (tinnitus), bitter taste in the mouth, insomnia, constipation, dark urine, red tongue with a yellow coat, and a full, rapid pulse. The condition can arise from long-term stagnation of qi due to anger, alcoholism, or chronic liver imbalances that develop into heat patterns. Some corresponding Western diagnoses are hypertension, alcoholism, hyperthyroidism, acute hepatitis, gallbladder infection, ear infection, and conjunctivitis. Treatment involves clearing heat and regulating the liver with acupuncture and herbal formulas such as Long Dan Xie Gan Wan.

Liver and Gallbladder Damp Heat: When dampness accumulates in the body and combines with heat in the liver and gallbladder, this excess syndrome develops. Its symptoms are jaundice and dark urine, which are caused by a stagnation of yellow bile that backs up and is excreted through the skin and urine. Additional symptoms include a lack of appetite, an aversion to greasy food, digestive problems, bitter taste in the mouth, nausea, vomiting, burning diarrhea, a red tongue with a thick, greasy yellow coat, and a slippery, rapid pulse. In Western medicine, most of these symptoms are typical of acute hepatitis or gallbladder infections, but this pattern can also correspond to herpes, vaginal discharges, testicular pain, and eczema. The treatment principle is to clear heat and drain dampness with herbs such as rhubarb root (da huang), gentian (long dan cao), and Artemisia (yin chen hao).

Liver Wind Moving Internally: Since the liver is in charge of the smooth flow of qi, any abnormal body movements are typically related to liver imbalances due to wind. This internal wind is considered an excess pattern, but it can arise from a variety of causes, such as blood deficiency, excess heat, or liver yin deficiency. The cardinal symptoms involve abnormal movements such as shaking, spasms, tics, rigidity, and convulsions. Dizziness, headache, and difficulty in speaking may also occur. The tongue and pulse signs depend on which underlying pattern has caused the stirring of wind, but the pulse is usually wiry, a typical sign of liver imbalance. This pattern is seen in stroke patients and those with Parkinson disease and cases of seizures associated with a high fever, tetanus, and hypertension. Acupunc­ture can be a very effective treatment, as are herbs that clear liver wind and heat, such as Gastrodia (tian ma), Uncaria (gou teng), and Chrysanthemum (jua hua). If the problem is caused by depletion, the underlying deficiency must be tonified. For example, if wind is due to deficient liver yin, treatment must both tonify the liver yin and subdue the wind.

Cold Stagnation in the Liver Channel: The liver meridian encircles the genital area, so localized disorders in the reproductive organs are often traced to a blockage in that meridian. This syndrome is characterized by pain in the groin, lower abdomen, and testicles and is relieved by application of heat. This pattern typically corresponds to a hernia but may also be present in cold-type menstrual disorders and infertility. Treatment involves warming with moxa and using herbs that regulate qi and warm the liver meridian, such as Galangal (gao liang jiang) and lychee seed (li zhi he).

Liver Blood Deficiency: This syndrome has the typical symptoms of blood deficiency: pale face and tongue, dizziness, dry skin, and thin pulse. The condition of the eyes and nails are clues to the state of the liver, so symptoms may include pale, cracked nails, blurred vision, itchy eyes, night blindness, and visual distortions such as spots and floaters. Menstrual flow may be scanty or nonexistent, and lack of nourishment to the tendons from liver blood deficiency can lead to pain, numbness, or cramping in the legs. Possible Western diagnoses are anemia, malnutrition, hypertension, menstrual disorders, and eye problems. Treatment involves tonifying the blood with standard blood tonics such as Angelica sinensis (dang gui), cooked Rehmannia (shu di huang), and Polygonum multiflorum (he shou wu), along with herbs that specifically nourish the liver such as Lycium fruit (gou qi zi).

Liver Yin Deficiency: This syndrome exhibits the usual signs of "five palm heat": red cheeks, night sweats, red tongue with no coat, and a thin, rapid pulse. Additional symptoms specific to the liver are dizziness, irritability, and dry, irritated eyes. Treatment involves tonifying liver yin and clearing heat with formulas such as Chrysanthemum, Lycium, and Rehmannia Pills (Qi Ju Di Huang Wan).

Liver Yang Rising: If liver yin deficiency continues without treatment, the deficiency heat rises to the head. Known as liver yang rising, it produces additional symptoms of headache and anger. It is an intermediate syndrome -- more severe than a simple yin deficiency but less severe than liver fire. Some Western diagnoses are anemia, chronic hepatitis, hypertension, eye problems, menopause, and menstrual disorders. Treatment involves sedating the excess liver yang with formulas such as Gastrodia and Uncaria Combination (Tian Ma Gou Teng Yin). If the yang rising symptoms are especially severe, heavy herbs that settle yang, such as oyster shell (mu li), are added.

Life Out of Balance
Joe is a 40-year-old executive with a high-stress lifestyle, often working overtime. He drinks coffee frequently to "keep up his energy," and his meals often consist of pastries from a vending machine. His colleagues complain he is prone to bouts of sudden anger for no good reason, so they keep their distance.

He always seems to have a stiff neck, and his face and eyes are often red. His doctor is very concerned about his high blood pressure, and his wife has warned him that she will leave him if he doesn't stop yelling at her at the slightest provocation.
This is a classic case of excess liver yang or fire, caused by Joe's lifestyle and diet.

The symptoms can be alleviated with acupuncture and herbal therapy. However, to achieve lasting healing, Joe's life needs a major overhaul. In addition to working less, the most important change he must make is to eliminate coffee, since it directly overheats the liver. Since caffeine withdrawal can also cause similar symptoms, green tea is a good substitute at first. Although it still has some caffeine, green tea has a cooling energy that disturbs the liver far less. And it can be decreased or eliminated later without causing discomfort.

A well-balanced diet is also essential, since a deficient diet harms the liver and also leads to qi deficiency and a consequent craving for stimulants. Exercise and stress-reduction techniques will also help lower blood pressure and create an appetite for good food.

Once Joe's liver cools down with lifestyle changes, acupuncture, and herbal therapy, he will be much less prone to outbursts of anger. He can then take cooling tonics such as American ginseng, which will give him extra energy without creating all the side effects of coffee.

On the next page, find out about kidney syndromes, which can manifest themselves anywhere in the body but are exclusively of a deficient nature.

For more about traditional Chinese medicine, treatments, cures, beliefs, and other interesting topics, see:

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.