The liver is situated in the right hypochondriac region below the diaphragm in the abdomen. It is the house of mood, the storehouse of blood, and the controller of tendons. It corresponds to wood in the five elements and is characterized by ascending-spreading movement.
Its main physiological functions include the control of normal flow ofqi and the storage of blood. It opens into the eyes and controls the tendons with its outward manifestations reflected on the nails. It has its specific emotion in anger and its associated secretion in tears. Moreover, the liver and gallbladder are exteriorly-interiorly related due to inter-connecting of the liver channel of foot- jueyin and the gallbladder channel of foot- shaoyang .
Normal Flow ofQi Governed by the Liver. The liver is a solid visceral organ responsible for ascending-spreading movement, which is regarded as the physiological basis for its control of the normal flow of qi . This function of the liver is an important link in the regulatory functional activities ofqi and promoting circulation of blood and body fluids. The liver governs normal flow of qi in a threefold action.
1. It regulates functional activities ofqi , which refers to the lifting-lowering and entering-exiting movements of the liver.
When the liver functions properly in this respect,qi andqi -blood function normally, channels flow freely, and thezang - fu organs and other structures perform normally. Conversely, dysfunction of the liver may manifest itself by two kinds of morbid conditions: hyperactivity and hypoactivity. In the case of hyperactivity of the liver, the following pathological changes may occur:
• Upward adverse flow of liver-qi , characterized by distend-ing pain of head and eyes, flushed face with congested eyes, irritability, restlessness, and so on.
• Upward overflow of blood due to adverse flow ofqi , marked by hemoptysis and even sudden syncope with unconsciousness.
.In the case of hypoactivity, the functioning ofqi is impeded and may cause mental depression, distending pain in the chest,
Chapter 4: Phase of Viscera
2. The liver promotes the transporting-transforming function of the spleen and stomach. When the liver functions properly, it governs a normal flow ofqi and greatly influences the lifting-lowering function of the spleen and stomach. For instance, dysfunction of the liver can impair the function of the spleen and stomach in lifting clearqi and lowering turbidqi . This dysfunction results in symptoms attributed to an attack of the spleen or stomach by the hyperactive liver-qi . Since bile is the aggregation of the surplus liver-essence, when the liver func-tions normally, it promotes the regular secretion and excretion of bile. Stagnation of liver-qi promotes irregular secretion and excretion of the bile and further impairs the function of the spleen and stomach in transportation and transformation.
3. The liver adjusts emotional activities. Whereas the heart primarily dominates emotional activities, the liver also closely relates to the activities of emotions. A normally functioning liver leads to normal functionalqi activities, harmony of qi -blood, and proper functioning of the fivezangorgans, thus resulting in normal emotional activities. Conversely, hypofunc-tion of the liver may lead to depression of liver-qi , manifested as a tendency toward melancholy and gloominess from even slight stimulation; hyperfunction of the liver results in adverse ascension of yang -qi and manifests as restlessness and irascibili-ty after a slight stimulation. Repeated or persistent emotional abnormality, in turn, impairs the function of the liver and results in morbid changes such as stagnation of liver-qi or hyperactivity of liver- yang .
The Liver Stores Blood.This function is concerned with the liver’s capability to store blood and regulate the volume of circulating blood. First, a certain amount of blood stored in the liver can restrain liver- yang from rising excessively. If the liver fails to function properly in storing blood, pathological changes such as deficient liver-blood or bleeding ensues. When liver-blood is not adequate enough to nourish the eyes, dryness and discomfort of the eyes with blurred vision or night blindness is likely to occur. If liver-blood fails to nourish the tendons, numbness of limbs and inflexible joints appears; if liver-blood is unable to replenish the reservoir of blood, scanty menstruation or even amenor-rhea may occur in women. To sum up, the failure of the liver to store blood may give rise to such symptoms as menorrhagia or even metror-rhagia and metrostaxis.
Regulating the volume of blood circulating in the body is the principal role the liver plays. Under normal conditions, the volume of
The Liver
circulating blood in every part of the body, especially the extremities, remains relatively constant but varies based on:
• The amount of activities in which the body engages
• Emotional changes
• Climactic changes, etc.
During strenuous activity or intense excitement, the liver releases stored blood to the peripheral portion of the body to meet its demands;
during states of rest and calmness some of the circulating blood returns to the liver to be stored. In this case, the reduced activity of the body requires a relatively diminished demand for the peripheral blood.
Mood srcinates from the mind. Only when the liver functions properly in storing blood, can it house the mood properly. If the liver suffers a shortage of blood, the liver will be unable to control mood, and symptoms such as dreaminess with a tendency to be frightened, insom-nia with restlessness, somnanbulism, somniloquy, etc., ensue.
The Liver Is Responsible for Anger.Anger is an emotional response of the human body to an unfavorable stimulation. With regard to its action on ability of theqi of the body to function properly, anger can make yang -qi , and henceqi -blood, ascend adversely. Since the normal flow ofqi and the ascension of yang -qi are governed and promot-ed respectively by the liver, anger is referrpromot-ed to as the emotion of the liver. On the one hand, rage can cause excessive ascension of liver- yang and result in illness. “Excessive anger impairs the liver.” On the other hand, deficient liver- yin or liver-blood in conjunction with hyperactivity of liver- yang leads to irascibility after a slight stimulation.
The Liver Related to Tendons with Its Outward
Manifestations on the Nails.The tendons, attached to the bones and aggregating around the joints, join muscles to the joints. The tendons rely upon the liver for blood supply. Replete liver-blood nourishes the tendons, which, in turn, make the body move actively and nimbly. On the contrary, insufficientqi -blood of the liver leads to failure of the tendons to obtain sufficient nutrients and thus brings about such symptoms as tremors of hand and foot, numbness of limbs, difficulty in extension and flexion, convulsion, and so on.
The nails of both hands and feet are actually an extension of the tendons, so they are spoken of as “the remainders of the tendons.” The amount of liver-blood directly affects the property and appearance of the nails. For example, sufficient liver-blood leads to tough and sturdy nails with ruddiness and luster. Conversely, insufficient liver-blood results in thin and frail nails with pallor dryness and without luster—and even
Chapter 4: Phase of Viscera
Tears Are the Secretion Derived from the Liver.Tears come from the eyes, which are the specific body openings of the liver.
Therefore, tears are derived from the liver. Tears moisten and protect the eyes. Under normal physiological conditions, the lacrimal secretion just performs a moistening action inside the eyes but do not cause tears.
Once a foreign object enters the eye, tears develop to clean the eyes and get rid of the foreign object. Under pathological conditions, however, abnormal secretion of the tears may occur. For instance, deficient yin or liver-blood leads to insufficient lacrimal secretion, resulting in
dryness and uncomfortable feeling of the eyes, while the liver channel’s damp-heat leads to increased secretion in the eyes, epiphora induced by the wind, etc. Additionally, extreme grief can also greatly increase lacrimal secretion.
The Liver Has Its Specific Body Opening in the Eyes. As the liver channel connects upward with the ocular connectors and vision depends on the normal flow of liver-qi and the nutritive function of liver-blood, the liver is said “to open into the eyes.” In addition, the essence andqi of the fivezangorgans and six fuorgans all flow upward into the eyes, so an intrinsic relationship exists between the eyes and the zang - fu organs.
Owing to the extremely close relationship between the liver and the eyes, the former’s functional state is usually reflected on the latter. For example, inadequacy of liver- yin or liver-blood leads to dryness and uncomfortable feeling of the eyes, blurred vision, or night blindness;
wind-heat in the liver channel promotes conjunctival congestion and itching and pain in the eye and flaming-up of the liver-fire leads to conjunctivitis with nebula. Additionally, hyperactivity of liver- yang results in dizziness with dim eyesight and an “up-stirring” of the liver brings strabismus or squinting upward, etc.