Liver and gall bladder syndromes
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| The liver meridian |
The liver resides under the right lower ribs. Its main physiological functions are storing and regulating blood, creating unrestrained conditions for qi (vital energy) flow. The body movement, emotions and menstruation are also associated with it. The eyes and nails are important external checking parameters for assessing its condition. The gall bladder stores bile, which aids digestion, and in TCM, it also rules decision and is related to bravery. The liver meridian communicates with the gall bladder creating an exterior and interior relationship. Thus, these organs influence each other closely.
The important signs in liver diseases are pain in the ribs where the liver meridian passes, irritability, being easily angered, dizziness, distending headache, blurred vision or eye discomfort, menstrual problems, convulsions, trembling limbs and distending pain in the testes of males.
| Liver and gall bladder syndromes |
| Syndrome |
Presentations |
Reference with Western medicine |
| Deficiency of liver yin and blood |
Dizziness, vertigo, dry eyes, blurred vision or night blindness, dull pain in rib sides where the liver meridian passes, lusterless face, dry and white nails, numbness in the limbs, tendon and muscle spasms and menstrual problems. On examination, the tongue is red with little coating, and the pulse is taut and thready. |
Hypertension, neurasthenia night blindness |
| Stagnation of liver qi |
Palpitations, dull pain in the cardiac region, shortness of breath,which all may be worse on exertion, fullness in the chest, pale face, spontaneous sweating, fatigue, aversion of cold temperatures and cold limbs. On examination, the tongue is purple and moist with a white coating and the pulse is thready or knotted and intermittent. |
Neurosis, gastroenteritis, menstral problems |
| Flare up of liver fire |
Palpitations, a tendency to be frightened, chest oppression, insomnia, nightmares, poor memory, a lusterless complexion, dizziness and pale lips and nails. On examination, the tongue is pale white, and the pulse is thready and weak. |
Hypertension, neurasthenia |
| Damp-heat in liver and gall bladder |
Damp-heat in liver and gall bladder Distension and pain in the rib sides where the liver meridain passes, bitter taste in the mouth, poor appetite, nausea, vomiting, abdominal distension, consitpation, scanty and yellow urine. In addition there may be yellow eyes and yellow discoloration of the skin and alternating chills or fever. The occurrence of eczema in the scrotum, swelling and burning pain in the testes or yellow foul leucorrhoea(sticky viginal discharge) with an itchy vulvae suggests damp heat in the Liver Meridian. On examination, the tongue is covered by yellow, sticky coating, and the pulse is taut and rapid. |
Acute hepatitis, eczema in vulva |
| Hyperactivity of liver yang |
Dizziness, ringing in the ears, deafness, headache, distending pain and dryness in the eyes, irritability, papitations, poor memory, insomnia, nightmares, soreness and weakness in knees and lower back regions. On examination, the tongue is red and dry, the pulse is taut, thready and rapid. |
Hypertension, neurasthenia |
| Liver yang transforming into wind |
Severe dizziness, headache, limb numbness, or limb trembling. In serious cases, speech difficulty, abnormal gait, loss of consciousness (syncope), convulsions, deviated mouth and eyes and paralysis on one side of the body appears. On examination, the tongue is red with a white greasy coating, and the pulse is taut and rapid. |
Blood pressure diseases, stroke |
| Extreme heat of liver stirring wind |
High fever, stupor, upward turning of the eyes, tightly closed jaw, a stiff back and neck, agitation or convulsions. On examination, the tongue is red and dry, or there is a deep red tongue with yellow or black and dry coating. The pulse is taut and rapid. |
High fever convulsions |
| Defficient blood creating wind |
Dizziness, ringing in the ears, blurred vision, withering face, dry and white nails, limb numbness, muscle spasms or limb trembling and joint dysfunction. On examination the tongue is pale, and the pulse is taut and thready. |
Severe anemia |
| Cold coagulating the liver meridian |
Retracting pain in the lower abdomen, cold pain or heavy sensation in the scrotum, aversion to cold temperatures and cold limbs. Symptoms typically are relieved by warmth. On examination,the tongue coating is white and slimy, and a deep taut pulse. |
Hernia |
| Phlegm disturbing the gall bladder |
Dizziness, vertigo, ringing in the ears, bitter taste in the mouth, nausea, vomiting, irritability, insomnia, a tendency to be frightened, fullness in the chest and sighing. On examiantion there is a yellow and greasy tongue coating and a taut and rolling pulse. |
Neurasthenia |
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