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Internal Medicine – Liver Disorders

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Dizziness

Headache

Hypochondriac Pain

Jaundice

Important: as with all items posted on TCM Health-info, it is very strongly recommended that you seek proper advise from your healthcare professional before administering any form of treatment to yourself.  This website is for informational purposes and does not replace the proper diagnosis of your physician. 

Overview Of Liver Function:

The liver has many important functions dealing with blood and maintaining the smooth flowing of Qi within the body.  The liver stores blood and regulates blood volume within the body depending on the amount of physical activity of the individual.  It also plays a major role in menstruation and pms.  The liver ensures that Qi is moving smoothly throughout the body.  If Qi movement is disturbed then this can be reflected upon  the emotional state, digestive disorders and the secretion of bile.  The liver controls the sinews and tendons throughout the body giving rise to such symptoms as  soreness and stiffness inhibiting movement.

Dizziness – Xuan Yun

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Xuan translates to blurred vision and Yun translates to dizziness or ‘off balance’.  This pattern of disease will have the symptoms of blurred vision, dizziness, black outs, viritgo, nausea, vomiting, un-balanced feeling, spinning, tinnitus, deafness, cold sweats, fatigue and possibly shaking.  It is most commonly due to three factors, wind, phlegm or deficiency.

May be caused by:

            Liver Yang Rising: excess or deficiency

                                    Excess: brings internal wind causing dizziness

                                    Liver/Kidney Yin deficiency: 

            Kidney Essence Deficiency:  can’t nourish marrow & brain

            Qi/Blood Deficiency: clear Qi is unable to ascent to brain

Accumiliation Of Turbid Phlegm: phlegm blocks channels and collaterals, clear Qi is  unable to ascend.  Phlegm may turn to Phlegm Fire

Blood Stasis: due to injury or chronic illness, blocks Heart and Mind

Hyperactive Liver Yang

Dizziness, tinnitus, severe distended H/A, dysphoria, scanty dark urine, insomnia with excess dreams, bitter taste in mouth, constipation

            T – red, yellow coat                              P – rapid, wiry

Treatment:        Soothe hyperactive liver Yang

Formula            Tian Ma Gou Teng Yin

Liver Yin Deficiency Causing Hyperactive Yang

Dizziness, tinnitus, distended H/A, angry, scanty dark  urine, insomnia with dreams, weakness of lower back and knees with possible pain. Seminal emission

            T -  red, thin yellow coat                       P – Thin, rapid, wiry

Treatment:        Soothe hyperactive liver Yang and Nourish Liver Yin

Formula            Tian Ma Gou Teng Yin + Shou Di/Gui Ban

Liver Wind

            Dizziness, numbness, shaking limbs, nausea, severe vomiting, can’t stand up

                        T - red                                                 P – wiry

            Treatment:        soothe liver to extinguish wind

            Formula            Tian Ma Gou Teng Yin + Ling Yang Jiao (heavy minerals)

Qi & Blood Deficiency

Dizziness with tiredness and fatigue, pale complexion, insomnia, palpitation, poor appetite, loose stools

            T – pale, puffy                                      P – thin, weak

Treatment:        nourish Qi and blood and strengthen spleen and stomach

Formula            Ba Zhen Tang

                        Bu Zhong Yi Qi YTang (spleen Qi sinking)

                        Gui Pi Tang (heart)

Kidney Essence Deficiency

Lower back & knee pain, lack of concentration, poor memory, loosing hair, dry hair, reproductive system disorders

            T – Pale, puffy                                      P – deep, weak

Treatment:        nourish kidney essence

Formula            He Che Da Zao Wan

                        Zou Gui Wan (heat signs - yin def.)

                        You Gui Wan   (cold signs – yang def.)

Turbid Phlegm Accumilation

Heaviness of head, nautious, vomiting, fullness in chest, poor appetite, sleepiness, tired

            T – swollen, greasy, thick, dirty coat                 P – slippery

Treatment:        dry dampness, elimin ate phlegm, invigorate spleen and stomach

Formula            Ban Xia Bai Zhu Tian Ma Tang

                        Wen Dai Tang (phlegm heat)

Blood Stasis

            History of injury, fixed H/A, poor memory, palpitation, stabbing pain

                        T – purple                                            P – uneven

            Treatment:        remove blood stasis and promote circulation to treat dizziness

            Formula            Tong Qiao Huo Xue Tang

                                    Xue Fu Zhu Yu Tang (opens chest)

Headache – Tou Tong

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Pain in the head due to many causes.  Symptoms include sudden sharp pain on one side of the head, top of the head (vertex), back of the head (occipital), temporal area and possible spreading too facial area, neck area, and tearing with pain.

Western Medicine:

            Epidemic febrile disease, common cold, influenza, neurological disorders,             hypertension, brain tumor, brain blood vessel disorder … … …

May be caused by:

            Exterior Pathogenic Invasion -wind attacks head blocking other meridian             channels – clear yang Qi is unable to ascend – turbid Qi is unable to descend

Exterior Pathogenic Invasion

Wind Cold

            Occipital headache with stiff neck and shoulders, aversion to cold, shivering,             cough, runny nose, clear discharge, no fever, no sweating, no thirst

                        T – thin white coat                                            P – tight, floating

            Treatment:        expel wind cold to relieve head ache

            Formula            Chuan Xiong Cha Tiao San

                                    (take with green tea)           

Shao Yin Cold

            Cold limbs/upper back

                        T – thin white coat                                            P – deep/thin

            Treatment:        warm cold and remove blockage to ShaoYin meridian

            Formula            Ma Huang Fu Zi Xi Xin Tang

Jue Yin

            Vertex headache, painful behind eyes

                        T – white coat                                                  P – wiry

            Treatment: expel cold pathogen and remove obstruction from JueYin meridian

            Formula            Wu Zhu Yu Tang

Wind heat

            Distended headache, aversion to cold, cough, runny nose, yellow mucus, fever,    slight sweat, itchy sore throat, thirsty, slight constipation

                        T – red tip/sides                                                P – rapid, floating

            Treatment:        expel wind heat to relieve headache

            Formula            Xiong Zhi Shi Gao Tang

                                    severe constipation  +  Da Huang

Toxic Wind Damp

            Pounding headache with swollen head

            Treatment:        expel wind, dry dampness, clear heat and detoxify

            Formula            Qing Zhen Tang  +  Pu Ji Xiao Du Yin

Wind Damp

            Heavy head, poor appetite, heavy limbs, fullness in chest, soft stools

                        T – white greasy coat, swollen body                  P – soft

            Treatment:        expel wind damp to relieve headache

            Formula            Qiang Huo Sheng shi Tang

                                    Summer heat with dampness – Huang Lian Xiang Pu Yin

Interior Injuries

Hyperactive Liver Yang

            Temporal headache, complicated with dizziness, pulsing/pounding temples,             dysphoria, bitter taste, hypochondriac pain

                        T – red, yellow coat                                          P – rapid wiry

            Treatment:        calm liver and suppress hyperactive yang to relieve headache

            Formula            Tian Ma Go Tang Yin (mild)

                                    Zhi Zi Qing Gan San (severe)

                                    Qi Jue Di Huang Wan (due to Liver/kidney yin Deficiency)

Qi Deficiency

            Chronic dull/mild headache, aggravated by activity, easily fatigued, easily catch    cold, pale complexion, spontaneous sweat

                        T – pale/normal                                                P – weak

            Treatment:        nourish Qi, ascend nutrients to head to relieve headache

            Formula            Shun Qi He Zhong Tang

Blood Deficiency

History of loss of blood, chronic illness, generally blood deficient, dull headache,         complicated with light headedness, dull yellow complexion, palpitations, insomnia

                        T – pale                                                            P – thin

            Treatment:        nourish blood to relieve headache

            Formula            Jia Wei Si Wu Tang

                                    Ren Shen Yang Ying Tang (Qi & Blood Deficiency)

Kidney Yang Deficiency

            Empty headache, dizziness, tinnitus, cold hands/feet, weak/cold lower back/knees, reproductive disorders, abundant clear urination

                        T – pale, swollen, wet                                       P – deep, weak

            Treatment:        nourish kidney essence to relieve headache

            Formula            Da Bu Yuan Jian

Kidney Qi Deficiency

            Turbid yin up surging

            Sore/weak lower back, clear frequent urination, dribbling after urination, frequent            urination, reproductive disorders          

                        T – pale                                                            P – deep, weak           

            Treatment: nourish and stabilize kidney Qi while descending up surging yin

            Formula            yu Zhen Wan

Turbid Phlegm

            Heavy headache, cloudy head, poor concentration, nauseous, distended chest

                        T – white, greasy                                              P – wiry, slippery

            Treatment:        resolve phlegm, descend turbid yin

            Formula            Ban Xia Bai Zhu tian Ma Tang

Blood Stasis

            Fixed headache in one area

                        T – purple                                                        P – thin, uneven

            Treatment:        promote blood circulation and remove stasis

            Formula            Tong Qiao Huo Xue Tang

Hypochondriac Pain

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Pain in the hypochondriac region usually due to blood stasis, liver yin deficiency or  external pathogen invasions.  The pain can be on one or both sides of the abdomen and have a distended, stabbing, fixed or dull quality.

Liver Qi Stagnation

            Hypochondriac pain which moves, pain aggravated by stress and emotion

                        T – red                                                             P – wiry

            Treatment:        spread liver qi, harmonize the blood and alleviate pain

            Formula            Chai Hu Shu Gan Tang

Blood Stasis

            Hypochondriac pain which is fixed and is aggravated at night

                        T – purple                                            P – wiry

            Treatment:        promote blood circulation and remove stasis in collaterals

            Formula            Xuan Fu Hua Tang

Liver Yin Deficiency

Hypochondriac pain which is dull and chronic, blurred vision, dull/pale complexion

            T – pale                                                P – thin, rapid

Treatment:        nourish liver Qi

Formula            Yi Guan Jian

Damp Heat Invasion

Hypochondria pain with bitter taste, aversion to cold, fever, fullness in chest, nauseous, vomit, possible jaundice

            T – red, yellow greasy  coat                 P – rapid

Treatment:        clear liver heat, induce diresis to eliminate dampness

Formula            Long Dan Xie Gan Tang

Jaundice – Huang Dan

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A yellow discolouring of the skin, yellow mucous membranes, yellow eyes and yellow urine caused by too much bile in the blood.  May be accompanied by nausea, vomiting, poor appetite and stomach pain.  The primary factor in Jaundice is damp heat due to internal or external disease.

May be caused by:

Accumulation of  Damp Heat   -impairs liver soothing function pushing bile out of its tract.

Stagnated Heat in Liver & Gall Bladder   - due t long term stress or sudden shock, bile turns to stones blocking bile tract.

Deficient Cold in Middle Jiao:   Spleen Deficiency complicated with cold – can’t transform damp blocking bile tract

   Spleen & Stomach Deficiency – can’t produce enough Qi & Blood

Toxic Heat Accumulation   - invades Ying & Xue levels injuring Liver and

Kidney

            Abdominal Mass (Ji Ju)   - stagnation in abdomen blocks Gall Bladder            channel pushing bile out

Yang Jaundice

Damp Heat With Superficial Symptoms

Yellow eyes, yellow skin, yellow urine, aversion to cold, fever heaviness of head and body, fatigue, no appetite

            T – thin, greasy coat                                         P – floating, wiry, rapid

Treatment:        clear heat, transform dampness, relieve superficial area

Formula            Ma Huang Lian Qiao Chi Xiao Dou Tang

                        + Gan Lu Xiao Du Dan

Accumulation of Damp HEAT

Yellow eyes, yellow skin, yellow scanty urine, fresh, bright yellow jaundice color, fever, thirst, nauseous, fullness in abdomen, poor appetite, dry stools

                        T – red, yellow greasy coat                   P – soft, rapid, slippery

            Treatment:        induce diresis to eliminate damp and clear heat

            Formula            Yin Chen Hao Tang

Accumulation of DAMP Heat

Yellow eyes, yellow skin, yellow urine, recessive fever, heaviness and fullness of chest/abdomen, thirst with no desire to drink, soft sticky stool

                        T – mixed yellow/greasy                                   P – soft

            Treatment:        induce diresis to eliminate damp and clear heat

            Formula            Yin Chen Si Ling Tang

Liver And Gall Bladder Heat Stagnation

Yellow eyes, yellow skin, yellow scanty urine, hypochondriac pain, irritability, bitter taste in mouth, thirst, nauseous, vomiting, poor appetite, dry stools, fullness in abdomen

            T – red, yellow/dry coat                        P – wiry, slippery, rapid

Treatment:        Clear Liver and Gall Bladder to transform dampness

Formula            Qing Dan Tang

Yin Jaundice

Accumulation of Damp Cold

Yellow eyes, dark yellow skin, yellow urine,  fatigue, poor appetite, bloating, aversion to cold, soft stools

            T – swollen/pale, greasy white coat       P – deep, thin, retarded

Treatment:        strengthen spleen and stomach to warm cold and transform damp

Formula            Yin Chen Zhu Fu Tang

Liver Blood Stasis

Yellow eyes, dark yellow skin, yellow urine, distended pain in hypogastrium, spider veins

            T – purple                                            P – wiry, thin, uneven

Treatment: promote blood circulation, remove blood stasis to soothe liver

Formula            Bie Jia Jian Wan

Blood Deficiency

Yellow eyes, yellow skin, yellow urine, poor appetite, shortness of breath, fatigue, soft stools

            T – pale, thin coat                                             P – thin, soft

Treatment:        strengthen spleen, nourish Qi/Blood, warm middle jiao

Formula            Xiao Jian Zhong Tang

Severe Jaundice

Excess Toxic Heat

Yellow eyes, yellow skin, yellow scanty urine, acute onset, turns to deep yellow with excessive fever, severe nauseous and vomiting, abdomen distension with pain, constipation, irritable

            T – dry/red, yellow coat                                    P – wiry, rapid, surging

Treatment:        Clear heat and detoxify

Formula            Huang Lian Jie Du Tang

                        Wu Wei Xiao Du Yin

Toxic Heat Invades Ying And Xue Levels

Yellow eyes, golden skin, yellow urine, retention of urine, excessive fever, bleeding, irritability, delirium, spasm of limbs

                        T – deep red, turbid coat                                  P – wiry/thin, rapid

            Treatment:        clear heat, detoxify, cool blood and rescue yin

            Formula            Xi Jiao San

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