9. Syndrome of Liver-Yin deficiency
Manifestations
Main symptoms
Dizziness or chronic lingering headache, blurred vision, dry and tired sensation of the eyes, weakness and stiffness of the joints, especially the knees, irritability, dream-disturbed sleep, tinnitus with a high tone.
Secondary symptoms
Hypochondriac pain, chest pain, epigastric and abdominal distension, a bitter taste in the mouth, heartburn, tiredness, and irregular or scanty menstruation. Some symptoms may exist in stress and emotional situations, such as anger, severe headache, red face, dizziness, vertigo and tingling of the limbs.
Tongue
Red and dry, often with a thin, yellow and dry coating.
Pulse
Thready and wiry; in some cases also rapid.
Associated disorders in western medicine
Hypertension, hepatitis, cirrhosis, peptic ulcer, glaucoma, mental disorders, menopausal syndrome and Parkinson’s disease.
Analysis of the syndrome
The Liver is located in the Lower-Jiao. It belongs to wood in the Five-Element theory. It houses the soul and regulates the Qi movement and the blood circulation. The syndrome of Liver-Yin deficiency is often observed in chronic diseases, people over 50 years old or people with a constitution of Yin deficiency.
• When the Liver-Yin is too weak to nourish its orifice and support the head, the Qi movement and the blood circulation, dizziness, headache, blurred vision and a dry and tired sensation of the eyes may present.
• If the Liver-Yin is too weak to nourish the tendons, the joints become stiff and the knees are weak.
• The Liver-Yin deficiency often follows Liver-blood deficiency. In conditions where Yin and blood are both deficient, they are unable to house the soul, to spread the Qi and to regulate the blood, dream-disturbed sleep, depression, irregular menstruation and tiredness may arise.
Liver-Yin deficiency may bring about the following consequences:
• First of all, Qi stagnation shows in pain and distension of the hypochondriac regions, chest and abdomen. It also shows in changes of mood and irritability.
• Second, Yin deficiency and Qi stagnation may produce heat, which is manifested as a bitter taste in the mouth, heartburn and a quick temper.
• Third, Yin deficiency may trigger a tendency of Yang ascending that causes severe headache, a red face, dizziness, vertigo and tingling of the limbs. If the condition is not treated in time, it may develop into Liver-wind syndrome.
• A red and dry tongue with a thin and yellow coating indicates Yin deficiency with heat. A thready, wiry and rapid pulse represents Yin deficiency with stagnation of Qi and heat.
Treatment principle: Tonify the Liver-Yin
Herb selection principles and formula composition strategies
• First, herbs that enter the Liver and Kidney meridians and are able to nourish the Liver-Yin and tonify the Liver-blood or Kidney-essence are selected.
• Second, herbs that enter the Liver and Kidney meridians, and are able to relax the tendons are selected, along with herbs that reduce the Liver heat and descend the Liver-Yang.
• Third, herbs that regulate the Liver-Qi are selected.
Structure of the formula and selection of herbs
Chief: Nourish the Liver-Yin
E Jiao ( Asini corii colla)
E Jiao is sweet and neutral, and enters the Liver and Kidney meridians. It is able to tonify the Liver-blood and the Kidney-essence. This substance is moistening in nature and can nourish the Yin as well as moisten the dryness. It is particularly suitable for use where the Yin, blood and essence are all deficient, which manifests as dry skin, cracked nails, lusterless hair, scanty menstruation and constipation.
Gou Qi Zi ( Lycii fructus)
Gou Qi Zi is sweet and neutral, and enters the Liver, Kidney and Lung meridians. It is able to tonify the Yin, the essence and the blood. It is particularly selected in the formula to treat eye problems due to Yin and essence deficiency, such as dry and tired eyes, blurred vision and decreased vision.
Bai Shao Yao ( Paeoniae radix lactiflora)
Bai Shao Yao is bitter, sour and slightly cold, and enters the Liver and Spleen meridians. It is able to nourish the Yin and therefore soften the Liver. In addition, it can reduce the empty-heat from the Liver, which is often caused by Yin deficiency. Thus it is considered an effective herb to soften and pacify the Liver, and is used to treat cramping pain due to Yin deficiency that fails to nourish the tendons and muscles. It is also selected in emotional disturbances such as stress, anger, frustration, resentment and irritability.
Nu Zhen Zi ( Ligustri lucidi fructus)
Nu Zhen Zi is sweet, cold and bitter, and enters the Liver and Kidney meridians. The characteristic of this herb is that it can nourish the Yin and reduce the empty-heat without any cloying side effect, which arises in many of the herbs that nourish the Yin. It is particularly suitable for use in the formula for patients who suffer from Yin deficiency when the Stomach is too weak to bear the heavy herbs. It is often used for heavy menstruation in the menopause due to empty-heat in the Liver and Kidney meridians and organs. It is also selected in formulas to treat dry eyes, blurred vision and tinnitus.
Deputy: Nourish the Kidney-Yin in order to tonify the Liver-Yin
Shu Di Huang ( Rehmanniae radix praeparata)
Shu Di Huang
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