When we talk about the functions of the liver in traditional Chinese medicine, we always mention three concepts, liver-Qi, liver-Yang and liver-Yin.
The Qi of an internal organ always acts the main role of performing the functions of the organ. You may understand the Qi of an internal organ as energy. In Chinese medicine, there is a saying, “The disharmony of Qi and blood can lead to a hundred diseases.” Heart-Qi maintains the function of the heart in pumping blood, while lung-Qi promotes the flow of blood. Spleen-Qi transports nutrients for the forming of blood, and keeps blood in vessels. The main function of liver-Qi is to unblock the movement of Qi and blood of the body.
Liver-Yin and live-Yang constitute two physical natures of the liver. Liver-Yin makes the liver soft, calm and cool, while liver-Yang warms the liver and supports the upward movement of liver-Qi.
Liver Qi unblocks the Qi of the body, making the Qi of the internal organs and meridians run smoothly to maintain the normal activities of the body’s internal organs, meridians, limbs, and orifices.
Qi pushes and regulates the dispersion of body fluid. In the case of the stasis of liver-Qi, the Qi of the body can’t run smoothly. It causes the stasis of body fluid, leading to the generation of pathological factors such as phlegm and dampness. Phlegm and dampness may cause the sensation of something obstructive in the throat, lumps in the neck, the breast or the skin, oedema or even abdominal dropsy.
Unblocking liver and regulating Qi is a common method for treating the stasis of phlegm and dampness inside the body.
The circulation of blood depends on the pushing and regulating of Qi. Dysfunction of liver-Qi in unblocking the Qi of the body may affect the flow of the blood.
In the case of the stasis of liver-Qi, blood does not flow smoothly, and may stagnate as blood stasis, resulting in delayed menstruation, dysmenorrhoea, amenorrhoea, or lumps.
In the case of excessive upward movement of liver-Qi, blood follows the abnormal movement of Qi and is not restrained by blood vessels, resulting in vomiting blood, haemoptysis, early menstruation, or metrorrhagia.
In the case of the deficiency of liver-Qi, blood does not flow smoothly, and it may cause irregular menstruation.
For treating blood stasis inside the body and hemorrhages, regulating liver-Qi is a common method.
In the case of the stasis of liver-Qi, the person is depressed, sighs easily, and feels a swelling pain in the chest, hypochondriac regions, breasts, or lower abdomen.
In the case of the excess of liver-Qi, the person is impatient and irritable, and has a swelling pain in the head. He has a flushed face and bloodshot eyes. He feels a swelling pain in the chest, the hypochondriac regions, or breasts, and the pain area is not fixed. In the severe case of hyperactivity of liver-Qi, blood follows liver-Qi move upwards, leading to vomiting of blood, haemoptysis, or even sudden fainting.
In the case of the deficiency of liver-Qi, the person is depressed, timid, sluggish, and lacking in strength. He suffers from dizziness, and his hypochondriac regions feel dull discomfort. His pulse is weak.
The excess of liver-Yang is always together with the excessive movement of liver-Qi and the deficiency of liver-Yin, leading to the generation of liver-fire.
On the other hand, the deficiency of liver-Yang makes liver-Yin dominates the liver. Meanwhile, the upward movement of liver-Qi lacks support, leading to the cold stasis of Qi in the meridian of liver.
The main difference between the deficiency of liver-Qi and the deficiency of liver-Yang is that the deficiency of Yang causes cold and stasis, but the deficiency of Qi causes weakness. As Ling Shu says, the deficiency of liver-Qi causes fear, while the excess of liver-Qi causes anger.
In modern medical science, the liver is the largest digestive gland and can store abundant blood for keeping normal blood circulation. In traditional Chinese medicine, the liver also has the function of storing blood. And liver is called the sea of blood.
In the theory of traditional Chinese medicine, the activity or inactivity of a person leads to the reallocation of the body’s blood. When a person is quiet or sleeping, a lot of blood is stored in the liver. When the person starts being physically active, the liver releases blood for satisfying the needs of the body.
The blood in the liver can nourish the liver and the organs which are related to the liver. The eyes, tendons, ligaments, fingernails and toenails are related to the liver, and all of them are nourished by the blood which is stored in the liver.
Su Wen, one of theoretical books of traditional Chinese medicine, says, “The liver receives blood, so eyes can see. Feet receive blood, so they can walk. A palm receives blood, so it can hold. Fingers receive blood, so they can grasp.”
If the blood in the liver is deficient, the person may suffer from dry eyes, dim eyesight, brittle nails, muscle spasm, or convulsion of limbs.
The blood in the liver is the source of menstrual blood of a woman. The deficiency of blood in the liver leads to the decreased menstrual discharge or amenorrhea.
The moving direction of liver-Qi is upward. Meanwhile, liver-Qi makes the running of the Qi of the body smooth and unobstructed. Qi pushes blood forward to flow, and keep blood in vessels. Therefore, when liver functions normally, the Qi of the body controls blood normally.
The excess of liver-Yang and the deficiency of liver-Yin are two of common disorders of the liver. Liver-Qi and liver-Yang always become excessive together. There are two kinds of pathogenic fire, which are called external fire and internal fire. The excess of liver-Yang or the deficiency of liver-Yin causes the fire of liver, which belongs to internal fire.
The moving excessively of liver-Qi and liver-Yang, or the spread of liver-fire, can cause various kinds of hemorrhages, like cerebral hemorrhage, vomitting blood, nasal bleeding, or uterine bleeding.
In the process of food digestion, spleen-Qi moves upwards, stomach-Qi moves downwards, and liver-Qi plays a coordinating role in promoting food digestion, nutrient absorption and waste excretion. If liver-Qi is not functioning properly, the function of the spleen and the stomach will be disturbed. The condition is called “wood excessively limiting earth” in the theory of five elements.
The dysfunction of liver-Qi disturbs the upward movement of Spleen-Qi. The syndrome is called “disharmony between the liver and spleen” or “liver-Qi offending the spleen”. Because the transforming and transporting functions of the spleen are disturbed, the person feels abdominal swelling, and may suffer from diarrhoea.
The dysfunction of liver-Qi disturbs the downward movement of stomach-Qi. The syndrome is called “disharmony between the liver and the stomach” or “liver-Qi offending the stomach”. The abnormal upward movement of stomach-Qi leads to loss of appetite, feeling of gastric swelling, belching, vomiting and constipation.
Bile is transformed from the essential Qi of the liver, converges in the gallbladder, and is released into the small intestine to participate in the digestion of food. The secreting and releasing of bile is regulated by the unblocking function of liver-Qi.
Stagnation of liver-Qi can cause a disorder in the secreting and releasing of bile. It disturbs the normal movements of spleen-Qi and stomach-Qi, leading to loss of appetite and a feeling of abdominal swelling. Moreover, stagnation of liver-Qi may lead to stagnation of bile, and then cause the formation of gallstones, making the person suffer from the pain of the right hypochondriac region or jaundice.
If liver-Qi moves upwards excessively together with the fire of the liver and the gallbladder, it can lead to the upward flowing of bile. The person may feel bitter taste in the mouth, and bitter water may flow into the mouth and even cause vomitting.
In Chinese medicine, the reproductive function of the body is closely related to the kidneys. Jing-Qi, Essential Qi which is stored in kidneys includes original essential Qi which is inherited from parents and essential Qi which is acquired from nutrients. Essential Qi of the kidneys generates sperm and ova. The smooth discharge of sperm and an ovum needs the participation of the unblocking function of liver Qi.
In the case of the stasis of liver Qi, sperm discharge may be obstructed.
In the case of the excess of liver-Qi with the liver-fire, there may be nocturnal emission.
In the case of the stasis of liver Qi, there may be delayed menstruation or low menstrual flow. Mentruation is not smooth, and the woman may suffer from dysmenorrhea.
In the case of the excess of liver-Qi or liver-fire, there may be early menstruation or heavy menstrual flow. The woman may suffer from metrorrhagia.
In Chinese medicine, regulating the unblocking function of liver-Qi is very important for improving the disorders related to menstruation, vaginal discharge, pregnancy and postnatal period.
The functions of the eyes depend on the nourishing of the blood of the liver and the unblocking of liver-Qi. In the two classical theoretical books of Chinese medicine, Su Wen says “the liver stores blood so the person can see”, and Ling Shu says “the liver-Qi is open to the eyes. When the liver is in harmony, the eyes can distinguish colors correctly”.
If the liver-Yin and liver-blood is deficient, the eyes will suffer from dryness, unclear vision, whirling sensation, and orbit pain.
If the external pathogenic factors, wind and heat, invade the liver meridian, the eyes will be bloodshot, itchy and painful.
The severe excess of liver-Yang or the severe deficiency of liver-Yin may cause the uncontrolled movement of the liver-Yang, leading to the internal wind. It is called the wind of the liver. In this case, the person may stiffly stare upwords or sideways. Moreover, the person may suffer from dizziness, convulsion of muscles, numbness and tremor of limbs. In a severe case, he may suffer from a lopsided corner of the mouth and hemiplegia, or may even suddenly faint and remain unconscious.
The depression may cause the stagnation of the liver-Qi, and the long-term stagnation liver-Qi may be transformed into fire. Moreover, due to the stagnation, the liver-Qi can’t unblock body fluid, so pathogenic phlegm is formed. The combination of the two pathogenic factors, fire and phlegm, can make the vision dimmed and blurred. Because of the close relations between the liver and eyes, in Chinese medicine the common treatment method of eye diseases is to treat the liver. And this is why Chinese people think that eating the liver of an animal is helpful to improve the vision of a person.
Though the liver acts a main role in sustaining the function of eyes, the eyes actually are nourished by the essential Qi from all internal organs. Ling Shu says, “The essential Qi of internal organs are upwards infused into eyes and form the essence of eyes. The place where the essence stays is eyeballs; the essence from bones is the pupil; the essence from tendons is black iris; the essence from blood is small vessels; the essence from the Qi is white sclera; the essence from muscles controls eyeballs.”
Based on the words of Ling Shu, ancient Chinese medical practitioners developed the theory of five wheels, which recognizes the disorders of internal organs according to the changes of different parts of eyes. The parts of eyes are called wheels, because they are round.
The small vessels of medial corner and lateral corner of an eye are related to the heart, called “blood wheel”; iris is related to the liver, called “wind wheel”; white sclera is related to the lungs, called “Qi wheel”; the pupil is related to the kidneys, called “water wheel”; upper and lower eyelids are related to the spleen, called “flesh wheel”. The concepts of five wheels constitute the theoretical foundation for diagnosis and treatment of eye diseases in Chinese medicine.
In Chinese medicine, the forming of tears depends on the nourishing of liver-Yin and the unblocking of liver-Qi. If the liver-Yin or the liver blood is deficient, eyes will be dry and uncomfortable. If the external pathogenic factors, wind with heat or dampness with heat, invade the liver meridian, the secretions of eyes will increase, and tears will be secreted when facing the wind.
Su Wen says, “All of Jin is attached to joints.” The concept Jin includes tissues that are attached to joints and sustain the motion of joints. Therefore, the concept Jin mainly indicates tendons, and also indicates articular ligaments. In Chinese medicine, tendons are nourished by the Qi and blood of the liver so that Su Wen says, “the liver generates Jin”. When the Qi and blood of the liver are deficient, tendons are not nourished, the ability to move will be weakened. This is why elderly people are unable to move easily, and they get tired easily. Su Wen says, “When a man is at the age of 56, the Qi of the liver is weak, so Jin can’t work.”
There is a saying, “nails are the extensions of Jin”. As tendons, nails are also nourished by the Qi and blood of the liver. The conditions of nails, including colour and shape, can show the conditions of the liver. The deficiency of the liver’s blood may causes nails to become soft and pale, or become brittle or even deformed.
In traditional Chinese medicine, liver is an internal organ that is related to consciousness and dreaming. Meanwhile, it is related to anger.
Mental activities, from instincts to emotions, are related to five internal organs in traditional Chinese medicine. Su Wen, a theoretical book of traditional Chinese medicine, divides fundamental mental activities into five kinds, including Shen, Po, Yi, Hun, and Zhi.
Shen means spirit, which stays in the heart. In traditional Chinese medicine, the heart governs all organs and all mental activities.
Po means Yin-soul, which stays in the lungs. Po is the innate instinct for behaving and sensation.
Yi means mind, which stays in the spleen. Yi is the ability of thinking and remembering.
Hun means Yang-soul, which stays in the liver. Hun is not only related to consciousness, but also related to dreaming.
Zhi means will and memory, which stays in the kidneys.
Hun is a fundamental mental activity related to liver. Zhang Jingyue, a famous therapist of the Ming Dynasty, pointed out that dreams are generated by Hun.
Ling Shu, a theoretical book of traditional Chinese medicine, says, “Liver stores blood, and blood keeps Hun.” Blood is the physical base of mental activities. When the blood of the liver is sufficient, the person has a normal consciousness and sleeps well.
However, when the blood of the liver is deficient, the person is difficult to fall asleep. He frequently dreams, and may have nightmares, sleep talking and sleepwalking. He may even have hallucination.
The fire of liver may harass Hun, leading to restless sleep, fidgeting and even mania.
In traditional Chinese medicine, liver is related to anger. The excess or stasis of liver-Qi, the excess of liver-Yang, or the deficiency of liver-Yin, may cause irritability.
On the other hand, if a person is furious, liver-Qi may move upwards excessively. If a person feels angry and depressed, it may cause the stasis of liver-Qi, leading to the obstruction of the Qi of the body. Therefore, there is a phrase: “Anger harms liver”.
Yike Jiang
Article category: Chinese Medicine