Liver/GB Functions in Traditional Chinese Medicine

Liver Functions

Stores Blood
- Regulates blood volume
  - Blood flows to muscles and sinews during activity
  - Blood flows back to the Liver at rest
  - Influences resistance to external pathogens
- Moistens eyes and sinews
  - Deficiency: Dry eyes or blurred vision
  - Excess heat: Red and burning
  - Poor nourishment of sinews may lead to muscle cramps and poor tendon functioning
  - Internal Wind may cause muscle tremors
- Regulates menstruation
  - Deficiency can lead to amenorrhea or light bleeding
  - Excess heat can lead to heavier bleeding
  - Stagnation can lead to pain, cramping, and PMS
  - Influences the Conception (Ren Mai) and Penetrating vessels (Chong Mai), which are connected to the uterus
Ensures the smooth flow of Qi
- Relates to emotions
  - Essential to balanced emotions
  - Reduced flow → Obstructed Qi → Irritability/frustration/anger
  - Repressed emotion → Obstructed Qi
- Aids in digestion
  - Assists in the normal movement of Qi for each organ
  - Descending for Stomach, ascending for Spleen
  - Obstructed Qi → blocked movement of Qi → symptoms
  - Liver directs Qi traffic in the middle burner
- Regulates secretion of bile
  - Obstructed Qi → poor bile secretion → poor digestion
Controls the Sinews
- Nourishes the tendons, ligaments, and cartilage
- An extension of the Liver
- Related to Liver Blood levels
- Muscles are under control of the Spleen
- GB 34 is the Influential point for tendons and sinews
Manifests in the Nails
- Nails are a byproduct of sinews in TCM
- Related to Liver Blood
- Deficient = dry, brittle, cracked
- Stagnation = dark or purple
Opens into the Eyes
- Related to Liver Blood
  - Proper vision requires adequate Liver Blood
  - Blood Deficient = blurred vision, myopia, floaters
  - Yin Deficient = dry, gritty eyes
  - Excess Heat = burning, painful, redness
  - Stagnation = painful eyeball (or behind the eye)
  - Liver Wind = moving eyeball
  - Kidney Essence and Heart Qi/Blood required for vision
Controls Tears
- Tears are the fluid related to the Liver
- Mainly for moistening and clearing of foreign bodies
- Not linked to emotional tears
- Necessary for proper functioning of the eyes
- Deficiency of Blood or Yin can lead to dry eyes
- Liver Yang Rising may cause watery eyes
House the Hun (Ethereal Soul)
- Linked to “Spirits” and “Demons”
- Yang in nature
- Planning life and giving life a sense of direction
  - Affected by Liver function
- Linked to the Corporeal Soul (Po) of the Lung
  - The Po closes with death
  - The Hun continues to the next life
Controls Planning
- Gives life direction and meaning
- Organizes functions to ensure smooth flow of Liver Qi

Liver Pathologies

Excess
- Liver Blood Stasis
- Liver Fire
- Stagnation of Cold
Deficiency
- Liver Qi stagnation
- Internal Wind
- Liver Blood Deficiency
- Liver Yin Deficiency
- Liver Yang Rising

Key Liver Actions

Promotes the smooth flow of Liver Qi
Subdues Liver Yang
Moves stagnation
Benefits the genitals
Benefits the breasts

Key Liver Acupuncture Points

POINT | USES
Liver 3 | Source point, moves Qi, regulates emotions, nourishes Blood/Yin
LI 4 | Regulates ascending and descending of Qi, subdues Liver Yang
CV 6 | Moves Qi, moves stagnation
GB 34 | Promotes the smooth flow of Liver Qi
UB 18 | Back Shu point; good for deficiency conditions
Liver 14 | Front-Mu point, moves Blood; good for excess conditions
Liver 2 | Clears Liver Fire, subdues Liver Yang, stops bleeding
GV 20 | Subdues Liver Yang
Pc 6 | Moves Liver Qi, subdues Qi in upper and middle burners
GB 21 | Promotes the smooth flow of Liver Qi
Sp 6 | Regulates the Liver, promotes the smooth flow of Liver Qi, nourishes Blood

Gall Bladder Functions

Stores and excretes bile
- Aids the digestive functions of the spleen and stomach
- Affected by Liver’s circulation of Qi
- Only Yang organ to store a “pure” substance
- Depends on flow of Liver Qi
Controls Decisions
- Works with Liver’s control of planning
- Other organs depend on Gall Bladder’s decision-making capabilities
  - Seen as a motivator for others
- Courage and initiative (“Drive”)
Controls the Sinews
- Like the Liver but less nourishing and more qi distribution to the sinews

W3C1 Patient Info

45 y.o. male, accountant
CC: Heartburn
Symptoms began 5 years ago
- Feeling of burning in the chest after eating pepperoni pizza, pasta with tomato sauce, red wine, coffee, or pineapples.
- Burning sensation is present when lying down at bedtime, exercising, and soon after waking in the morning.
- Uses Pantoprazole (40mg bid) which helps the symptoms, but he has been on the medication for 2 years and wants a change.
- Appetite was high but has decreased since starting the medication.
- Belching (after meals)
- Hiccups (1-2x/wk)
- Infrequent bowel movements (1 q3-4d)
- Distending pain in the epigastrium
Job is stressful at times with tax deadlines, RRSP deadlines, and corporate year-end
- Irritable
- Low libido (some erectile dysfunction)
- Headaches (distending pressure behind both eyes)
- Difficulty sleeping
- Dry eyes
Admits to drinking more alcohol when he feels stressed (2-4 oz of scotch, whiskey, or bourbon)
Denies chest pain, palpitations, hearing loss, anger, low back pain, urination concerns, or feelings of heaviness.
Pulse: Strong, wiry, rapid.
Tongue: Red body with light purple edges, and med purple in the center of the tongue. Moderately thick, dry, yellow coating

W3C2 Patient Info

51 y.o. female, Firefighter
CC: Hot flashes
- Experiences 4-5 hot flashes everyday
  - More common in the afternoon and early evening
- Described as feeling hot in the distal extremities, and centrally around the chest, then radiates up toward the head.
- Cheeks get red and needs to fan herself or remove layers of clothing until the episode ends after 30-60 seconds.
- Triggered by coffee, red wine, nervous situations, and spicy food.
Night sweats every 2-3 nights
- Wakes her up from sleep and needs to change the sheets and her pyjamas.
No menstrual cycle for 1 year
Associated intermittent symptoms
- Tinnitus (low pitch)
- Dry eyes
- Insomnia
- Dry mouth/throat
- Vaginal dryness
- Increased libido
- Thinning hair
- Low back and knee pain
- Dull headaches behind the eyes
In the past 2 weeks she has had multiple episodes of vertigo, her face is turning red with hot flashes, she has more random bouts of anger, more difficulty falling and staying asleep, high-pitched tinnitus, and a vertex headache.
Pulse: Rapid, thready overall. Weak left Chi pulse.
Tongue: Red body with peeled areas on the sides and root. Dry coating.