Liver and gall bladder syndromes
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| The liver meridian |
The liver resides under the right lower ribcage. 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 meridian creating an exterior and interior relationship. Thus, these organs influence each other closely.
The important signs in liver diseases are pain in the ribcage 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 |
| Syndromes |
Presentations |
Reference with Western medicine |
| Deficiency of liver yin and blood |
Dizziness, ear ringing, dry eyes, blurred vision or night blindness, dull pain in ribcage sides where the liver meridian passes, pale face, brittle and pale nails, limb numbness, 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 |
A depressed mood, irritability, distending pain in the ribcage, chest tightness, a tendency to sigh, poor appetite, belching, abdominal distention, a lump feeling in the throat, menstrual disorders, menstrual pain, or breast tenderness before menstruation. On examination, the tongue coating is white and thin, and the pulse is taut. |
Neurosis, gastroenteritis, menstrual problems |
| Flare up of liver fire |
Headache, dizziness, ear ringing, flushed face, bloodshot eyes, irritability, burning pain in the ribcage, a bitter taste in the mouth or mouth dryness, insomnia or dream-disturbed sleep, constipation, and yellowish urine. In serious situations, there may even have nose bleeding, vomiting blood, and deafness. On examination, the tongue is red and covered with yellow or dry coating, the pulse is rapid and taut. |
Hypertension, neurasthenia |
| Damp-heat in liver and gall bladder |
Distending pain or burning sensation in the ribcage, a bitter taste in the mouth, poor appetite, nausea, constipation, and scanty and yellowish urine. In addition, there may also have yellow tinted eyes and skin, alternating chills and fever, scrotum eczema, swelling and burning pain in the testes, yellow foul leucorrhoea (sticky vaginal discharge) and itchy vulva. On examination, the tongue is red and covered by yellow and greasy coating, and the pulse is taut and rapid. |
Acute hepatitis, eczema in vulva |
| Hyperactivity of liver yang |
Dizziness, ear ringing or hearing loss, headache with a distending nature, distending pain or dryness in the eyes bloodshot eyes, flushed face, irritability, palpitations, poor memory, insomnia or dream-disturbed sleep, soreness and weakness in knees and lower back region. On examination, the tongue is red and dry, and the pulse is taut and forceful, or taut, thready and rapid. |
Hypertension, neurasthenia |
| Liver yang transforming into wind |
Severe dizziness, headache, limb numbness or limb trembling. In severe cases, there may even have tongue stiffness, speech difficulty, abnormal gait, sudden loss of consciousness (syncope), convulsions, distorted mouth and eyes, and paralysis on one side of the body. On examination, the tongue is red with a white greasy coating, and the pulse is taut and rapid and forceful. |
Blood pressure diseases, stroke |
| Extreme heat of liver stirring wind |
High fever, limb spasms, upward turning of the eyes, tightly closed jaw, a stiff back and neck, delirium or coma. On examination, the tongue is deep-red with yellow coating. The pulse is taut and rapid and forceful. |
High fever convulsions |
| Blood deficiency creating wind |
Dizziness, ear ringing, blurred vision, sallow face, brittle and pale nails, limb numbness, muscular spasms or limb trembling, and joint dysfunction. On examination the tongue is pale, and the pulse is taut and thready. |
Severe anemia |
| Cold coagulating in liver meridian |
Retracting pain in both sides of the lower abdomen, cold pain or heavy sensation in the scrotum, sensitive to low temperatures and cold limbs. Symptoms typically are relieved by warmth. On examination, the tongue coating is white and glossy, and the pulse is deep and taut, or slow. |
Hernia |
| Phlegm disturbing the gall bladder |
Dizziness, vertigo, ear ringing, a bitter taste in the mouth, nausea, vomiting, irritability, insomnia, a tendency to be frightened, chest tightness and sighing. On examination, the tongue coating is yellow and greasy, and the pulse is taut and rolling. |
Neurasthenia |
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