My Liver is What?

The first in a series demystifying Chinese Medicine Theory
    for Patients and the General Public

Traditional Chinese Medicine (TCM) uses a variety of unique terminology to diagnose and treat a broad range of health issues. In this series of articles I am going to discuss some of the more common TCM diagnoses and their meanings in the hopes of demystifying the world of acupuncture. This, the first article in the series, will discuss the "Liver" system.

Many become concerned when their acupuncturist or herbalist tells them they have "Liver Qi Stagnation" or "Liver Blood Deficiency"... They often assume that this means there is something wrong with their physical liver and may go to their western doctor asking for Liver Blood tests or other exams. They may also think their Liver is "toxic" and try any variety of detoxifying diets or supplements. Or, as is often the case, they may just stare at you and wonder what it is, exactly, that you are talking about....

Chinese Medicine theory uses the names of the organs to help illustrate a pattern of related physical and psychological issues. When a practitioner says you have a "liver" issue they are generally speaking of the "liver system" from a Chinese Perspective. This system involves the physical liver, the liver acupuncture meridian, liver related disharmonies (or patterns), western medicine liver diseases such as hepatitis and cirrhosis, and a range of health issues that arise from the liver related disharmonies from a TCM perspective.

About The Liver:

From a western perspective the physical liver is a very important organ that stores our blood, processes toxins and poisons, helps us store energy, and aids in our overall immunity. General signs of physical liver problems can be yellowish skin and eyes (jaundice), abdominal pain and swelling and fatigue and/or loss of appetite. We cannot live without a liver so fostering the health of our liver is very important to our overall wellbeing.

 

The "Liver" in Chinese Medicine:

• Stores the blood and aids in the proper circulation of the blood during movement:

A dysfunction here can result in muscle spasms, numbness in the limbs, blurred vision, or menstrual issues.
 

• Controls the flow of "qi," or "energy", in the body:

This means the circulation of blood and energy for movement and digestion (secretion of bile, for example), but also the smooth flow of emotions (which are also a form of "qi" or "energy"). A dysfunction in this role can result in depression, insomnia, anger and/or frustration. On the digestive side symptoms such as nausea and vomiting may indicate "liver" system issues.
 

• "Controls" the tendons and manifests in the nails:

This has to do with the smooth circulation of blood (in actuality nourishment) to the muscles and tendons. A dysfunction here can result in joint and tendon problems anywhere in the body, knee pain and/or brittle nails.
 

• Is said to "Open into the eyes":

The connection here also has to do with that idea of nourishment from the blood coupled with the path of the liver meridian. Symptoms of a disharmony here can be night blindness, dry or red and irritated eyes.

From a Chinese Perspective the following list of symptoms and conditions are some of the signs of a liver imbalance:

Headaches, irritability, tinnitus (ringing in the ears), insomnia, muscle spasms, dizziness, stroke, bitter taste in the mouth, vomiting, purple lips, abdominal pain, depression, anxiety, PMS, and menstrual issues.

As you can see the Chinese Medicine perspective contains a host of symptoms and relationships that do not exist in Western Medicine and are not necessarily connected with the physical functioning of the liver. So when you are told that you have Liver Qi Stagnation, a western exam would likely find nothing wrong with your physical liver.

As with most things in Chinese Medicine the terminology we use is to categorize and make sense of natural functions and relationships in the body that have been observed over time. Chinese Medicine is first and foremost an observational form of medicine and over the thousands of years of its existence the theory, terminology, and relationships have been observed and cataloged and treated. Some of these findings map up with modern western medical understandings, others may do so in the future, and yet others will never be "understood" from a western medical paradigm.

So What Do These Patterns Mean?

As I've written about before, Chinese Medicine treats "patterns" and not "conditions". When you visit with a practitioner they often ask many questions and ultimately find and use relationships among a variety of symptoms that from a western perspective may seem unrelated. From a Chinese perspective, however, treating the root pattern can lead to the elimination of all of the related symptoms that you are experiencing. This opposed to treating each symptom individually as is often the case in western medicine.

Take for example the TCM diagnosis of "Liver Qi Stagnation". A person who has this pattern may experience any or all of the following symptoms: Chest distention, hypochondriac pain a/or distention, sighing, nausea, vomiting, poor appetite, diarrhea, depression, moodiness, plum pit qi (a feeling of something stuck in your throat), PMS, breast tenderness, painful a/or irregular menstruation.

As you can see there is quite a range of conditions that fall within this single pattern. Certainly the nausea, vomiting and poor appetite are also western diagnostic signs for physical liver problems, but depression, PMS and moodiness are a unique relationship to the livers role in the smooth circulation of blood and energy (qi) in the body from a Chinese Medicine perspective.

For a full list of all of the Liver related conditions and their symptoms, you can see the "Liver Related Disharmonies" page.

How Does My Lifestyle and Diet Effect These Patterns?

This question leads into the idea of toxicity of the liver which is a term that is thrown around far too freely in alternative medicine circles. Certainly if all you eat is fried foods and all you drink is beer and you work 20 hours a day in a high stress environment you are going to develop a liver pattern from a Chinese perspective and quite likely physical liver problems as well. That said, most people are not as "toxic" as they may think and even minor changes in their diet and lifestyle can make a huge impact on their overall health.

From a TCM dietary perspective the following foods are harmful to the liver system: fried foods, fatty foods, alcohol, excessive caffeine and excessive dairy particularly milk. A diet focused on these foods will foster many of the symptoms of a liver system imbalance from a Chinese perspective. Examples of foods which are beneficial are: oatmeal, rye bread, lima beans, cashews, zucchini, green beans, lemons, limes and avocados. For a full discussion of dietary change from a Chinese Medicine perspective see the article TCM dietary therapy.

Lifestyle wise the liver is associated with the emotions of anger and frustration. An excessive expression (or repression) of these emotions can indicate and/or foster a liver system imbalance. Also generally high stress levels will create an imbalance in this system. As the liver system enjoys and fosters movement, exercise (walking, tai chi, jogging, etc.) along with dietary change will help to resolve the stagnation that is caused by stress and emotions such as frustration.

So if you have any of the symptoms listed above working to improve the functioning of the liver system is in your best interest. With a free flowing liver system your joints will be smooth, your eyes bright, and the energy in your body (both physical and emotional) will flow freely. Liver Qi Stagnation in particular is a very common imbalance found in our modern western society. Being aware of the more mild signs of the imbalance and working now to correct them can avoid more serious issues later and help us to live better in the present.