4. Syndrome of Liver-blood deficiency
Manifestations
Main symptoms
Dizziness, dry eyes, blurred vision, cramping and stiffness of muscles and joints, tingling or numbness of limbs, insomnia, dream-disturbed sleep and dull-pale complexion.
Secondary symptoms
Thin and brittle nails, dry and itchy skin, dry nasal cavities, constipation, scanty menstruation, amenorrhea or irregular menstruation, infertility, anger and depression.
Tongue
Pale with a thin white coating.
Pulse
Thready, or thready and wiry, particularly on the left side.
Associated disorders in western medicine
Various types of anemia, malnutrition, hypotension, dysfunctional uterine bleeding, infertility, thrombocytopenia, heavy blood loss after a surgical operation or delivery of a baby, mental disorders.
Analysis of the syndrome
• The Liver stores blood and regulates the quantity of blood in the blood circulation. If the Liver-blood is too weak to nourish its orifice, dizziness, dry eyes and blurred vision may exist.
• When the blood is too weak to circulate and nourish the tendons, numbness, tingling of the muscles, stiffness or cramp of the joints and thin and brittle nails may present.
• When the blood is unable to nourish the skin, the mucus and the intestines, dry and itchy skin, dry nasal cavities and constipation may occur.
• The Liver houses the Hun (soul), which is active in sleep. If the Liver-blood is deficient, restless sleep and dream-disturbed sleep often exist.
• Menstruation is supported by sufficient blood. If the blood is deficient, scanty menstruation, amenorrhea or irregular menstruation may present. If the blood is too weak to nourish the fetus, infertility and miscarriage may occur.
• If the blood cannot flow vigorously, there may be a thready pulse. When the blood is too weak to move, Qi stagnation is often present – the pulse is then not only thready, but also wiry. Patients may suffer from emotional disturbances such as depression, anger and irritability, or hypochondriac distension and pain.
(See Figure 5.4 on page 189 .)
Treatment principle: Nourish the Liver-blood; promote the free flow of Liver-Qi and the smooth circulation of blood
Herb selection principles and formula composition strategies
• First, herbs that enter the Liver meridian and are able to tonify the Liver-blood directly are selected.
• Second, herbs that enter the Kidney meridian and tonify the Kidney-essence in order to tonify the Liver-blood indirectly are often selected.
• Third, sour and astringent herbs which can soften the Liver, relax the tendons and moisten the dryness are selected.
• Finally, herbs that promote the Qi and blood circulation are selected.
Structure of the formula and selection of herbs
Chief: Tonify the Liver-blood directly
Dang Gui ( Angelicae sinensis radix) and Bai Shao Yao ( Paeoniae radix lactiflora)
Dang Gui is sweet, pungent and warm, and enters the Liver meridian. It is the commonly used herb to tonify the Liver-blood as it enters the Liver meridian primarily and tonifies the blood directly. Along with herbs that tonify the Kidney-essence, its function of tonifying the Liver-blood becomes stronger. The strong point of this herb is that it not only tonifies the blood, but also promotes the blood circulation as it has pungent and warm properties. It matches the nature of blood, which prefers warmth and must always be moving.
Bai Shao Yao is bitter, sour and slightly cold. It enters the Liver and Spleen meridians. Its sour and cold property can nourish the Yin directly and generate the substantial part of the blood. It is particularly effective for softening the Liver, thereby relieving cramp of the muscles and tendons. It can also effectively moisten the internal organs and the orifices, so it can treat the symptoms of dryness of skin and eyes caused by Liver-blood deficiency.
Dang Gui and Bai Shao Yao are very often used together as a pair of herbs in the formula, as Dang Gui concerns the functional aspect of blood and Bai Shao Yao concerns the substantial aspect of blood. The former is called a Yang herb and the latter a Yin herb in this situation. They can effectively treat Liver-blood deficiency.
Shu Di Huang ( Rehmanniae radix praeparata)
Shu Di Huang is sweet and slightly warm, and enters the Kidney and Liver meridians. As it is able to tonify the Kidney-essence and the Liver-blood directly, the function of tonifying the blood is quite strong. It is often used as chief in the formula for serious conditions of blood and essence deficiency, such as in those with a poor constitution, retardation of children and degeneration in elderly people. In the formula, this herb should be used with some herbs that regulate the Qi in the Middle- and Lower-Jiao to reduce its rich and heavy nature.
Deputy: Nourish the Kidney-essence
Gou Qi Zi ( Lycii fructus) and He Shou Wu ( Polygoni multiflori radix)
These two herbs enter the Kidney and Liver meridians. They are able to tonify the Kidney-essence and Liver-blood. Unlike Shu Di Huang ( Rehmanniae radix praeparata) they are not heavy and cloying in nature, thus they may not bring about the problem of digestion. For this reason, they are often used in formulas to enhance the ability of the chief herb to tonify the Liver-blood.
Assistant: Treat the symptoms caused directly by blood deficiency
Ji Xue Teng ( Spatholobi caulis et radix)
Ji Xue Teng is bitter, slightly sweet and warm, and enters the Kidney and Liver meridians. It is a special herb for tonifying the blood as it is also able to promote the blood circulation and relax the tendons. It is therefore selected in formulas to relieve stiffness, tingling, numbness, pain and an uneasy feeling in the body, such as in Bi syndrome and in restless leg disorder due to blood deficiency with Qi and blood stagnation.
Mu Gua ( Chaenomelis fructus)
Mu Gua is sour and warm, and enters the Liver and Spleen meridians. It has no function to tonify the blood, but is able to nourish the tendons, expel dampness and open the meridians. It is selected in formulas to relieve spasm and stiffness of the limbs due to Yin and Liver-blood deficiency.
Suan Zao Ren ( Ziziphi spinosae semen)
Suan Zao Ren
Buy Membership for Complementary Medicine Category to continue reading. Learn more here
