DONGUIBOGAM; Internal Bodily Elements-13. Treatment Methods for Liver Disease

picture of the liver 간장도

Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)

01 The Shape of the Liver 肝形象 간의 형상

  • The liver has two wide leaves and one narrow leaf. It resembles the sprouting buds of a tree. Each leaf has a stem in the center, so it spreads out harmonized yang qi. The liver stores the ethereal soul.
  • The liver has two big leaves and one small leaf. The left side of the liver has three lobes and the right side has four lobes. The lobes are distributed to both sides. This resembles many leaves budding from a tree.
  • It weighs 4 geun 4 nyang. It has a total of 7 leaves, 3 leaves in the left lobe, and 4 leaves in the right. It stores the ethereal soul.

02 Areas of the Liver 肝部位 간의 부위

  • The liver is engendered from the left side.
  • The liver system starts from underneath the diaphragm and sticks to the left ribcage then passes through the diaphragm to enter the lungs. It is connected to the diaphragm.
  • LR14 is the liver’s alarm point. It is located 1.5 chon underneath the nipples. The liver’s transport point is underneath the ninth vertebra. These are the locations of the liver.

03 Day and Time When the Liver Governs 肝主時日 간이 주관하는 시간과 날짜

  • The liver governs spring, foot reverting yin, foot lesser yang, and the day of Gab and Eul (甲乙日).
  • East engenders wind, wind engenders Wood, Wood engenders a sour taste, and a sour taste engenders the liver.
  • The liver is lesser yang of yin and corresponds to spring.

04 Things Belonging to the Liver 肝屬物類 간에 속하는 것들

It becomes wind in heaven and Wood on the earth. It is sinew in the body and the liver among the five viscera. It is color blue among the five colors, Gak sound (角) among the five sounds, roaring sound among the five voices, and grasping among the five changes. It is the eyes among the five orifices, the sour taste among the five tastes, anger among the five minds, tears among the five humors, and the state of this organ is manifested in the nails. It is the smell of fat in the five fats, and Jin trigram (its engendering number is three and complete number is eight) among the trigrams in the Book of Changes. Its grain is sesame (or barley), and its animal is a dog (or chicken). Its animal belongs to the category of furred animal, and the number is eight. Its fruit is the plum, and its vegetable is chives. Its meridian is foot reverting yin.

05 Size of the Liver 肝臟大小 간장의 대소

  • The liver performs a role of a general. It controls the outside. To see whether it is strong, check the size of the eyes.
  • The person with a bluish color and dense interstices has a small liver while the person with sparse interstices has a big liver. The person who has a broad chest with a big angle below the sternum has the liver in a higher place. The person who has the small angle below the sternum has the liver in a lower place. The person with a stable ribcage has a stable liver. The person with a weak ribcage has a weak liver. The person with a harmonized chest and back has a stable liver. The person with a slanted ribcage has a slanted liver.
  • If the liver is small, it is stable and there is no disease. However, if the liver is big, it presses the stomach and throat to cause dysphagia and pain under the ribcage. If the liver is placed in the higher place, it presses the diaphragm up and pushes the ribcage outwards, causing lung stagnation. If the liver is placed in the lower place, it presses the stomach and makes an empty space below the ribcage, providing susceptibility to pathogens. If the liver is strong, it is stable, and hardly receives the pathogen. If the liver is weak, it may cause wasting-thirst and the liver is more likely to be hurt. If the liver is in the stable place, it is harmonized so it usually does not get hurt. If the liver is slanted, the ribcage may be painful.

06 Syndromes Due to Damage to the Liver 肝傷證 간상증

  • The liver can be hurt from the accumulation of bad blood in the body due to falling down from a high place o qi from excessive anger. Also, if qi counterflows upward due to rage, it can damage the liver.
  • Excessive fury causes the upflow of qi. If it does not return down to its place, it will damage the liver.

07 Liver Diseases 肝病證 간병증

  • When the pathogen is in the liver, the insides of both sides of the ribcage are painful and cold with the accumulation of bad blood.
  • When the liver is diseased, the ribcage are painful with pulling pain from the lower abdomen, and the person will get angry easily.
  • When the pathogen in the lungs is transferred to the liver, it is called a liver impediment. It is also called reverting disease. It causes ribcage pain and vomiting.
  • Heat in the liver makes the face bluish and nails dried.
  • Outer symptoms when a patient has liver disease are that he or she will pursue cleanliness with a bluish face and hot temper. Inner symptoms are moving qi on the left of the umbilicus with tenderness and pain on pressure. The person with liver disease may not be able to freely move his or her limbs and may suffer from difficulty in urination, constipation and muscle cramps. If these symptoms do not appear, it is not a liver disease.
  • Thinning of the thighs, chest discomfort, abdominal pain, fever over the shoulders, neck, and the body, thinning of the calf, hollow eyes, true visceral pulse, and a loss of vision are signs of immediate death. If the person’s vision is still maintained, the person will die reaching the time when he or she cannot win over. It is said in the Annotation, “it refers to the liver. Time which one cannot win over refers to the day of Gyeong and Sin (庚辛日) month.”

08 Deficiency and Excess of Liver Disease 肝病虛實 간병의 허실

  • The liver stores blood and blood keeps the ethereal soul inside. When liver qi is deficient, the person tends to be fearful; when liver qi is excessive, the person tends to get angry.
  • If the liver is excessive, there will be ribcage pain, pulling pain in the lower abdomen, and a hot temper. If the liver is
    deficient, there will be blurry vision with weakened eyes, hearing difficulties, and fear as if someone is chasing the person.
  • The liver stores blood. When blood is sufficient, the person will easily get angry, and when blood is deficient, the person will easily be fearful.
  • When a person moves, blood flows into various meridians and collaterals; when a person stays calm, blood returns to the liver. This is because the liver governs the sea of blood.

09 When Liver Disease Is Relieved or Becomes Worse 肝病間甚 간병이 낫거나 심해지는 때

  • When disease is in the liver, it is relieved in summer; if not, it becomes worse in autumn. If the person does not die in autumn, the desease maintains in winter and arises in spring.
  • liver disease is relieved on the day of Byeong Jeong (丙丁日); if not, it becomes worse on the day of Gyeong Sin (庚辛日). If the person does not die on the day of Gyeong Sin (庚辛日), it maintains on the day of Yim and Gye (壬癸日) and arises on the day of Gab and Eul (甲乙日).
  • A liver disease is relieved at dawn, becomes worse at dusk and becomes stable at night.

10 Treatment Methods for Liver Disease 肝病治法 간병 치료법

  • The liver dislikes contracture, so one must quickly relieve it with a sweet taste. Therefore, use Glycyrrhizae Radix (甘草) and eat nonglutinous rice, dates, beef and curled mallow. The Annotation says, “The liver disliking contracture
    means the excess of liver qi.” The liver tends to spread out, so spread it with a hot taste like Cnidii Rhizoma (川芎). Tonify a liver deficiency with Zingiberis Rhizoma Crudus (生薑) and Citrus Unshius Pericarpium (陳皮).
  • Eat a sweet taste for a liver disease. Take the sweet taste from nonglutinous rice, beef, dates and curled mallow to relieve contracture.
  • Take the sour taste for a liver disease such as sesame, dog meat, plum and chives. This method is taking the original taste of the organ.
  • Use a decoction of the four drugs, a Clear Liver Decoction or Tonify Liver Pill for a Liver deficiency. Use a Drain Green Pill, Cleanse Liver Powder, or Angelica, Gentian and Aloe Pill (當歸龍薈丸) for a Liver excess.
  • Do not face the wind in a liver disease.
    -Clear Liver Decoction 淸肝湯 청간탕: It treats anger Fire due to a blood deficiency of the liver meridian. Prepare 1.5
    don of Paeoniae Radix Alba (白芍藥), 1 don of Cnidii Rhizoma (川芎) and Angelica Gigantis Radix (當歸), 8 pun of Bupleuri Radix (柴胡), and 4 pun of Gardeniae Fructus (梔子) and Moutan Cortex (牧丹皮). Cut these herbs and boil in water.
    -Tonify Liver Pill 補肝丸 보간환: It treats a liver deficiency, made of a Four Substances Decoction (四物湯) with the addition of Saposhnikoviae Radix (防風) and Osterici Radix (羌活) in honeyed pills.
    -Drain Green Pill 瀉靑丸 사청환: ① It treats a liver excess. Put the same amounts of Angelica Gigantis Radix (當
    歸), Gentianae Radix (草龍膽), Cnidii Rhizoma (川芎), Gardeniae Fructus (梔子), Rhei Radix et Rhizoma (大黃) (roasted under an ash Fire), Osterici Radix (羌活) and Saposhnikoviae Radix (防風) and mix with honey and make pills to the size of an Euryales Semen (芡實). Take one pill with water boiled with Phyllostachys Folium (竹葉) and warm sugar water. ② This is also called a Cool Liver Pill.
    -Cleanse Liver Powder 洗肝散 세간산: It treats a liver excess. Prepare 1 don of Osterici Radix (羌活), Angelica Gigantis Radix (當歸), Menthae Herba (薄荷), Saposhnikoviae Radix (防風), Rhei Radix et Rhizoma (大黃), Cnidii Rhizoma (川芎), Gardeniae Fructus (梔子) (stir-fried), and Glycyrrhizae Radix (甘草) (roasted) and boil in water. Adding 1 don of Gentianae Radix (草龍膽) will bring more dramatic effects.
    -Angelica, Gentian, and Aloe Pill 當歸龍薈丸 당귀용회환: It treats ribcage pain due to excess heat in the liver. Prepare 1 nyang of Angelica Gigantis Radix (當歸), Gentianae Radix (草龍膽), Gardeniae Fructus (梔子), Coptidis Rhizoma (黃連), Phellodendri Cortex (黃柏) and Scutellariae Radix (黃芩), 5 don of Rhei Radix et Rhizoma (大黃), Aloe (盧薈), and Polygoni Tinctori Fructus (靑黛), 2.5 don of Aucklandiae Radix (木香), and 0.5 don of Moschus (麝香). Grind these herbs and mix with honey and make pills to the size of a red bean. Take 20 – 30 pills with water boiled with ginger.