The syndrome of Liver-Yang rising is caused by Liver-Yin deficiency. It is often seen in people over 50 years old or who are suffering from certain chronic diseases that injure the Liver-Yin. As soon as the Liver-Yin fails to control the Liver-Yang, the Yang rises. The manifestations are dizziness with a slightly tight sensation in the head, headache, blurred vision and tinnitus. In a severe case, there is irritability, dream-disturbed sleep and a distending pain in the hypochondriac region and the patient prefers a quiet and relaxing environment. If the Liver-Yang and Heat disturb the Stomach, patients may have a red face, a dry and bitter taste in the mouth, nausea or belching. The tongue body is red, or red only on the border, and the coating is thin, dry and yellow. The pulse is thready and wiry, or thready, wiry and rapid. In clinical practice, this syndrome is often seen in hypertension, menopausal syndrome, neurotinnitus, nervous deafness and glaucoma.

If the Liver-Yang is not controlled with proper treatment, it may turn to Liver-Wind, especially in those with a Yang constitution, or in conditions of rage, high stress, eating too much spicy food or taking certain medications. At that moment, the Liver-Yang rises rapidly and stirs up the Wind. This is called ‘Liver-Yang stirs up the Wind’ or ‘Liver-Yang turns to Wind’. Since the Liver controls all the tendons, the symptoms of Liver-Wind are characterized by tremors or spasms of the limbs, severe dizziness, nausea, vomiting, tingling or numbness of the limbs, and loss of balance in standing or walking. In severe cases, Liver-Wind may disturb the normal circulation of Qi and Blood, and rebellious Qi and Blood, as well as Fire and Phlegm, attack the head, block the meridians and cover the Mind. The patient may suddenly lose consciousness and afterwards will have hemiplegia and deviation of the eyes and mouth. In this case, the tongue body is red, the coating is yellow and dry, or yellow and sticky, and the pulse is wiry, forceful and rapid. In clinical practice, this syndrome is often seen in epilepsy, convulsions in infectious disease, severe cases of hypertension and glaucoma, facial paralysis, facial spasms and cerebrovascular accident and its sequelae.

Since the syndrome of Liver-Yang rising is the result of Liver-Yin deficiency, one of the treatment principles is to nourish the Liver-Yin so as to control the Liver-Yang, and this is especially necessary in the mild, chronic cases of Liver-Yang rising. However, because the Liver-Yang has already left its original place, the Lower Jiao, it is not so easy to get it to return to its place quickly by means of nourishing the Yin. So a second principle of the treatment is to anchor the Yang and sedate the Liver so as to build up a new balance between the Liver-Yin and Liver-Yang, especially in acute cases. In a severe case of Liver-Yang rising, the procedure of anchoring the Yang should be carried out at once so as to stop the development of the pathological changes and prevent the occurrence of Liver-Wind syndrome.

If the Liver-Wind has already been stirred up by the suddenly rising Liver-Yang, the treatment principles mentioned above are not enough to handle the Wind, so methods that strongly direct the Liver-Yang to descend, pacify the Liver and extinguish Wind should be applied immediately.

In the treatment of Liver-Yang rising or Liver-Wind, it is important to make a clear differentiation of the stage of the disorder and the primary and secondary steps of treatment. If a patient has family history of hypertension, is over 50 years old and feels quite stressed, and the blood pressure is slightly higher than normal, treatment should be given to nourish the Liver-Yin and calm the Liver-Yang. If, at certain moments, such as in the springtime, when under high stress or in a rage, the patient’s blood pressure rises quickly, and there are all the obvious symptoms of Liver-Yang rising, then the treatment to anchor the Yang and sedate the Liver should be given immediately. If the patient not only has the symptoms of Liver-Yang rising, but also feels tingling in the fingers or limbs, and loses balance in walking, then treatment to extinguish Liver-Wind and anchor the Yang must be given immediately.

To treat patients with a syndrome of Liver-Yang rising and Liver Wind, it is also important to advise the patient to avoid all the factors that may contribute to the Liver-Yang rising, such as herbs that move upwards and outwards, alcohol, spicy food, stress and rage.

The substances that sedate and anchor the Liver-Yang and extinguish Liver-Wind are used for acute and subacute conditions of Liver-Yang rising or Liver-Wind and they have the following characteristics.