Welcome to Chinese Medicine Bristol's official blog! Here, Acupuncture and TCM pracitioner Sandra Arbelaez will share information about Acupuncture and Chinese Herbal Medicine, how they work, and the latest research and developments related to TCM. You will also find knowledge and ideas on how to enjoy a full, healthy life that she has picked up over the course of 15 years of exploring the world of natural health

Friday 13 April 2012

The organs in Traditional Chinese Medicine: The Liver

This post is part of a series dedicated to TCM concepts of the organs. Although this is the first official post of the series, I have already covered the Heart in a previous post which you can read here. I will cover each organ’s functions, possible symptoms arising from its lack of balance, and how to look after it.

TCM Yin organs and their corresponding elements
In TCM, organs are not necessarily defined by their anatomical positioning or their quantifiable workings. Instead, the concepts associated with an organ are determined by a series of functional activities and relationships with other organs, tissues, fluids, sense organs, and environmental influences. This is part of a sophisticated theory of the human body as an integrated whole which comprises not only physical functions but also emotional, mental, sensorial, and even spiritual aspects. Understanding the relationship and inter-dependence between organs is just as important as understanding the role that each organ is playing in the development of symptoms and in the maintenance of our health at every level.

The two main types of organs are Yin (Zang) and Yang (Fu) organs. Yin organs are considered to be deeper both in terms of location and function, and more fundamental to life. The Yin organs are: Liver, Spleen, Heart, Kidney, and Lung.

The Liver (Gan):

The Liver is the organ of the Wood element and is regarded both energetically and physically as a large, expansive and, when out of balance, invasive organ. In ancient texts, it is compared to an army general due to its roles as regulator and coordinator of the flow of Qi and Blood throughout the whole system. In addition, the Liver is paired with the Gall Bladder and has a reciprocated influence over this organ and its functioning.

The Liver is in charge of regulating and harmonising the whole system, through its main functions:

1.  Rules the free flow of Qi: Much depends on the smooth movement of Qi throughout the body. Without it, obstruction, blockage, and irregular functioning of other substances and organs can ensue.
    This function of the Liver particularly influences the following aspects:
  • Our emotional state: Our emotions are as much an expression of our energy as the physical functions of our body so a harmonious flow of Qi results in equally harmonious emotions reflected in a relaxed disposition and an ability to cope and let things go when appropriate.
  •  The efficiency of our digestion: The Liver plays an important part in the digestive process both physically and energetically. Appropriate flow of Liver Qi is needed to ensure the smooth passage of food through the digestive system from ingestion through to evacuation.
  • The adequate secretion of bile: As part of the digestive process, bile needs to be released in adequate amounts. This is a Gall Bladder function that depends on the adequate flow of Liver Qi.
  •  The smooth flow of menstruation: The Liver organ and its channel have an intimate relationship with the reproductive system. As Qi flows, so does the Blood so an obstruction in the flow of Qi may result in stagnant Blood and in symptoms both before and during menstruation. On the other hand, the Liver channel runs through the reproductive system, which makes the flow of Qi in the Liver even more important for reproductive health.

2.  Stores the Blood (Xue): When we are active, the Liver ensures that enough Blood is circulating through the body so that the sinews and muscles are nourished and moistened.  When at rest, the Blood is collected and stored in the Liver so that our energy is restored during our sleep.

3. Rules the tendons and sinews: The Liver, mostly through the Liver Blood, is the organ that enables the muscles, tendons and ligaments to contract and relax and to move in a co-ordinated, responsive manner.

4. Opens into the eyes and manifests in the nails: In TCM, each Yin organ is in charge of nourishing a specific sense organ. The health of each Yin organ is also said to be reflected in the quality of a particular tissue of the body. The eyes are the sense organs that are influenced by the Liver in terms of their moisture and freshness as well as the quality of vision. The health of the Liver is also reflected in the quality and strength of the nails.

5. Houses the Ethereal soul (Hun): In the Taoist roots of TCM, our Soul or Spirit is thought to be comprised by smaller parts which represent specific human behaviours and tendencies. Each of these smaller spirits is in turn closely associated to a specific Yin organ.

The Hun or Ethereal soul is the spirit of the Liver and it is understood to be the part of us that “lives on” after our bodies have passed. The Hun is the part of us that both holds and enables our life purpose to be fulfilled. In order to achieve this, the Hun gives us confidence and drive as well as the ability to establish boundaries and to feel the compassion that inspires us to perform acts of kindness.

Symptoms of Liver imbalance

The Western life-style tends to badly affect the energy of the Liver. Stress, lack of down-time, over-consumption of stimulants, being on the run all the time, and a diet consisting of heavy foods that make the body work harder are common causes of Liver imbalance. In terms of emotions, issues such as unresolved anger and resentment, frustration with work or relationships, and feeling that there are too many demands on our time and energy also take a toll on Liver energy. Indeed, the most common cause of Liver imbalance seen in Acupuncture practices is stress due to work demands, family/relationship difficulties, and feeling that one has no choice and is trapped in a situation.

The most common symptoms associated with a Liver imbalance are shown in the table below:

Liver Function
Signs of Liver imbalance
Rules the free-flow of Qi
Physical and emotional tension
Pain around the rib cage
Tightness in the chest
A sensation of a lump in the throat
Abdominal distension
Affecting the emotions:
Emotional frustration, depression, anger, irritability, moodiness, feeling “on edge”.
Affecting digestion:
Belching, abdominal pain, acid reflux, nausea, vomiting, intermittent constipation and loose stools.
Affecting the flow of bile:
Bitter taste in the mouth, belching, jaundice, indigestion, nausea.
Affecting menstruation:
Pre-menstrual tension, depression, distension in the breasts, irritability and menstrual pain.
Stores the Blood
Stiffness and difficult mobility
Non-restorative sleep
Very heavy, very light, or clotty periods
Stabbing period pains
Rules the Tendons and Sinews
Cramps, spasms, tremors, stiffness and excessive contraction or flaccidity of the muscles, tendons and ligaments.
Opens into the eyes and manifests in the nails
Tired, dry, gritty, red, or burning eyes
Blurred vision and/or floaters in the visual field
Dry, pale, brittle nails
Houses the Hun
A tendency to being unkind to oneself or others
Overwhelming anger, envy, jealousy and hatred
Lack of self-worth
Numbness towards the suffering of others
A sense of “absence”, depression


 How to look after your Liver energy

The Liver is an organ that possesses great power and, like with anything powerful, it needs to be both nourished and softened so that this power does not get out of hand. As stress is the factor with the most negative influence on the Liver, much of what I mentioned in my post about coping with stress is highly relevant for Liver health. In addition, the following tips may help:

  • Keep calm and let go Many of us feel stuck in the wrong job, relationship, and even in the wrong family. In most cases it is difficult to walk out of these commitments because of the complexity of our circumstances so this may not be an option. However hard we try not to think about it, our frustration and resentment always ends up resurfacing at the wrong time and often at the wrong person. This is because we are forcibly not allowing our emotions to “flow”, we’re in effect blocking the normal flow of Liver Qi which results in a “pressure cooker” effect where Qi will end up finding an escape route and often releasing itself with an “explosion”.  Meditation, Yoga (but the gentle types not Ashtanga or Bikram!), Qi Gong and Tai Chi are all good ways to acquire tools that will help us handle our stress and frustrations. Learning to let go of those things that offend us or annoy us rather than holding on to them is really important. Feeling anger is not in itself harmful- all our emotions are an expression of our humanity- what is harmful is to carry on being angry long after the events have passed. We need to learn not to take everything personally and realise that other people do what they do because they too are confused and stressed.
  • Exercise Exercise is very important to encourage the Liver to move the Qi. Gentle to moderate exercise -such as walking, swimming, or cycling- is best to keep everything flowing, provided we are not using more energy than we have got. However, excessive exercise can and does result in Liver Qi stagnation. This is especially true in people who are already under stress and use heavy exercise as a way of venting this stress. This of course works straight after a work-out when endorphins are flooding the blood stream but, as many an exercise addict secretly knows, the sensation of wiriness and inability to relax returns with a vengeance when these effects have worn off.
    • Diet All recommendations made for stress are relevant here as well, so you can refer to my previous post on stress. We also need to keep the Liver soft by avoiding overwhelming it with rich foods, excessive amounts of food, and toxicity from chemical additives, alcohol, or drugs. Sour foods help detoxify the Liver: a cup of hot water with the juice of half a lime, lemon or cider vinegar first thing in the morning helps stimulate the release of toxins.
    • Nourishing the Blood also helps keep a smooth Liver flow. To do this we need to consume adequate amounts of protein, as well as plenty of dark leafy green vegetables, and sweet, dark, unrefined foods such as dates and unsulfured apricots.


    Chinese Medicine Treatment 

    Liver imbalances are the most common syndromes seen at the Acupuncture clinic. Treating Acupuncture points on the Liver channel helps restore the flow of Liver Qi and resolve symptoms associated stagnation of Liver Qi. In addition, there are specific combinations of points that can induce a relaxed state and encourage the body and mind to rest and restore, thus helping relieve symptoms associated with stress. 

    Several Chinese Herbal Medicine classical formulae have been designed to treat specific types of Liver dysharmony. The most common formula amongst these is Xiao Yao Wan, or "free and easy wanderer", with restores the flow of Liver Qi and helps resolve many of the symptoms listed under that category in the table above.

    Chinese Medicine treatment will also include appropriate dietary and life-style advice that will help improve symptoms and promote Liver balance so that further symptoms will be prevented.

     Key thoughts for the Liver 
    •  Forgive and you will be forgiven: Every time something makes you angry, chances are it is something you have yourself done at some point in your life.
    • Feel for others: Put yourself in other people's shoes so that you can be compassionate and tolerant.
    • Accept what life brings you:  Most of the time there is no point fighting against your circumstances. You will end up frustrated and exhausted and will most likely remain stuck in one spot until you decide to let go. 



    1. Thank you so much for this article!

      1. Thank you for your comment Marta, I hope you found it useful!

    2. Hello. This article is very interesting!! Thank you!
      In addition to the treatments above, does panax ginseng help with the liver?

      1. Thank you for reading my blog Pet, I'm glad you enjoyed the article.

        Panax Ginseng is not a herb used for Liver issues in Chinese Herbal medicine. In addition, Chinese herbs are not generally used as single herbs but as part of a formula that can address both a symptom and its cause. I would recommend that you consult a herbalist before taking any herbs as they can cause problems is used wrongly. I hope this helps!

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