Diseases of the Liver in General

Picture A. Lobes of the Liver. B. Gall Bladder. C. Liver Artery. D, G. Portal Vein
Der gantzen Artzenei
, Dryander, 1542

The Liver can be argued to be the most important organ in the body, both in Traditional Medicine, and in modern medicine. This is because of the wide range of activity the Liver has in the body. Cleansing the blood, manufacturing and storing various nutrients and blood factors, and the synthesis of hormones are among its primary activities in modern medicine.

The Liver in Traditional Medicine makes the Blood which includes the manufacture of the Humors, which go to make up the blood. This is manufactured in what was called ‘Second Digestion’ where the raw nutrient digested by the stomach (‘First Digestion’) and absorbed by the Intestines is taken to the Liver via the Portal Vein for processing into Blood and Humors. In Traditional Medicine the blood cleansing role of the Liver has been long known, and its importance in the treatment of women’s diseases suggests an understood role of the connection of the Liver with the female reproductive system and cycle.

The Liver is also the source of ‘Internal Wind’ in TCM, Internal Wind being responsible for Wind (Nervous) disorders as opposed to External Wind which comes from Wind exposure and is acute in nature. The connection between Liver and Wind is noted in the Western Tradition with the connection of the Liver to ‘Air Element’.

Due to its importance, the Liver is subject to a variety of conditions.
  • Liver Heat/Excess Bile: noted in all Traditions: red eyes and face, headache, anger or irritable, red tongue with yellow coat and a strong or fast pulse.
  • Liver Damp-Heat: this is similar to the above, only there is fluid involved. Cholecystitis, UTI’s and Diarrhea associated with the Liver are examples.
  • Liver Cold/Blood Deficiency: what was termed Liver Cold in the West equates closely to Blood Deficiency in TCM. Face and Lips are pale, pulse is weak, feels the Cold, Dizziness and Headache
  • Liver Obstruction/ Liver Qi Stagnation: The Liver controls the ‘Free flow of Qi’ which helps regulate the nervous system. Liver Obstruction of the West and Liver Qi Stagnation of TCM are effectively the same, excepting that TCM sees Qi stagnation as being far reaching and associated with conditions including Depression and PMS, as examples. The Liver and Gall Bladder may be obstructed due to Heat, Phlegm, Cold, Blood Stagnation etc. Obstruction causes a dull or heavy ache over the Liver, Gall Bladder inflammation or obstruction, masses in the Liver etc. When the symptoms are more energetic, Qi is obstructed. But as the condition develops, chronic obstructions causes Blood Stagnation which can develop into a tumor or mass.
  • Liver Wind: what is termed Liver Wind in TCM is regarded as a Wind disorder in the other Traditions. Liver or ‘Internal’ Wind is used in TCM to differentiate from ‘External’ (Acute) Wind diseases. This may include Headache, Migraine, Dizziness, Vertigo, Tinnitus, Epilepsy, etc. It requires medicines to Settle Wind while treating the underlying condition which may include Liver Heat, Yin Deficiency, excess Phlegm or Damp etc.
  • Liver Deficiency: being a hot organ, the Liver Yin can easily be damaged. Nourishing Liver Yin usually occurs in addition to Nourishing Liver Blood, especially in women. Liver Yin Deficiency is similar to Dryness of the Liver mentioned in western texts. Skin is dry and dull, eyes are blurry and the hair may be greying prematurely.

Herbs with proven Hepatoprotective effects include:
Milk Thistle seed
Chicory
Sage
Gentian
Licorice
Wormwood
Fumitory
Turmeric
Black Nightshade
Agrimony
Dandelion
Rosemary
Swertia
Peony
Celandine
Dodder
Madder
Caper root-bark
Astragalus Huang Qi
Peony Bai Shao
Salvia Dan Shen
Lycium Gou Qi Zi
Chebulic Myrobalan


Withania
Dang Gui
Schisandra Wu Wei Zi
Cuscuta Tu Si Zi
Phyllanthus amarus

Western Tradition

Simples
Agrimony
Sandalwood
Barberry
Gentian
Madder
Wormwood
Rose
Maidenhair
Rhubarb
Turmeric

Hepar mundificant–Cleanse the Liver
Stomach Pills
Pilulae Aggregative (Mesue)



General for Liver Disease
Decoction of Fruits and Flowers
Decoction of Fumitory (Mesue)
Decoction for Hepatitis

Opening Hepatic Decoction
Decoction for the Liver (Hoffman)
Syrup of Thyme
Syrup of Wormwood
Syrup of Calamint

Syrup of Wormwood (Mesue)
Powder of Three Sandalwoods (Diatriasantalum)
Troches of Anise (Dianisum) (Mesue)
Troches for the Liver and Jaundice (Nicholas)
Tryphera Saracenica
Troches for the Liver and Jaundice (Nicolas)
Lesser Pills of Agrimony (Mesue)

Safflower 7 (Gur gum 7)


Hepatis percussioni conferunt–
Liver injury (‘striking’)-Liver Blood Stagnation

Pills of Agrimony Greater (Mesue)

Powder for the Liver (Unani)
Troches of Rhubarb
Troches of Gum Lacca
Electuary of Saffron (Diacrocum) (Mesue)

Safflower 13 (Gur gum bcu gsum)


Chronic Liver Disease
Troches of Agrimony
Troches of Rhubarb (Mesue)
Troches of Lacca (Mesue)
Troches of Rose and Agrimony (Mesue)
Powder of Three Sandalwoods (Diatriasantalum)
Diamorusia

Electuary of Saffron Lesser (Diacrocon Minus) (Mesue)
Electuary of Saffron Greater (Diacrocus) (Mesue)
Greater Pills of Agrimony (Mesue)

Safflower 13 (Gur gum bcu gsum) (Tibetan)
Safflower Supreme 7 (Gur gum mchog bdun) (Tibetan)


Liver Abscess / Cyst
1. Diarrhodon Abbatis with Rhubarb

Troches of Agrimony
Troches of Rhubarb (Mesue)

Cerate of Hyssop


Great Decoction 25 (Thang chen nyer lnga)


Liver Tumors
Troches of Rhubarb (Mesue)
Troches of Lacca (Mesue)

Great Decoction 25 (Thang chen nyer lnga)


Liver Ulcers
Troches for Liver Ulcers (Andromachus)

TCM Classification

Liver Heat
Irritable, anger, red eyes, headache, bitter taste, yellow urine, red tongue with yellow coating, rapid pulse
Long Dan Xie Gan Tang
Dan Gui Long Hui Wan



Diatriasantalum
Diarrhodon Abbatis
Damp-Heat of the Liver
Fullness in abdomen or hypochondrium, poor appetite, bitter taste, heaviness, yellow vaginal discharge, skin rashes or itchiness, difficult or burning urine, red tongue with a sticky yellow coat, rapid or rapid and slippery pulse
Long Dan Xie Gan Tang


Troches of Barberry
Liver Qi Stagnation
Pain  or distention in hypochondrium, irritable, dizzy, chills and fever, headache, low appetite, irregular menstruation, breast tenderness, PMS, emotional or stressed, blurred vision, dry mouth, pale tongue with a weak or wiry pulse.

Xiao Yao San
Chai Hu Shu Gan San



Letificans
Diatriasantalum
Liver Qi Stagnation with Phlegm
Nausea, vomiting, coughing of phlegm, feeling of something stuck in the throat, fullness in hypochondria, stifling sensation in the chest; emotional or paranoid
Ban Xia Hou Po Tang


Liver Blood Stagnation
Hypochondriac or abdominal pain, abdominal masses, purplish nails, lips and tongue, dull or dark complexion, dry skin, irregular or painful periods with dark or clotted blood, purplish on sides or whole tongue, wiry pulse
Tao Hong Si Wu Tang
Ge Xia Zhu Yu Tang


Trochisci de Lacca
Pills of Rhubarb
Diacrocum Majores

Liver Heat and Wind / Liver Yang Rising
Fever, irritability, restless, dizzy, vertigo, muscle twitches or spasms; severe cases may have loss of consciousness, deep red tongue, rapid pulse
Tian Ma Gou Teng Tang
Ling Jiao Gou Teng Tang



Liver Yin Deficiency
Dizziness, numbness, insomnia, blurred vision, floaters, dry eyes, poor night vision, dull, lusterless complexion, dry hair and skin, brittle nails
Liu Wei Di Huang Wan
Qi Ju Di Huang Wan


Diatragacanth Frigidum
Liver Blood Deficiency
Dizziness, blurred vision or floaters, tired, feels the cold, pale face and nails, low and weak pulse, muscular weakness, dry skin and hair, dull or pale complexion, cramps, fine or weak pulse, pale tongue
Si Wu Tang
Bu Gan Tang



Special Formula

A GOOD DRINK FOR ALL DISEASES OF THE LIVER
Take 4 Chicory root (2 if large) and boil in a quart of water until one third is wasted. Drink a cupful on an empty stomach.
  Despite being regarded as cooling, Chicory has been regarded as beneficial for all diseases of the Liver by some authors. (Brunschwig, 1561)

‘FAULTY OR UNCLEAN LIVER’
    Sandalwood Water
    Endive Water
    Chervil Water                 1 ½ oz. each
Mix, divide into 3 portions and take one each morning. ‘It is experimented and proved’. (Brunschwig, 1561)

ELECTUARY OF RHUBARB FOR THE LIVER
    Rhubarb
    Wormwood                  10 drams each
    Parsnip seed
    Aloe                                5 drams each
    Gum Arabic
    Rue seed
    Parsley seed
    Saffron
    Spikenard                      2 drams each
    Indian leaf
    Myrrh
    Musk                               1 dram each
    Castoreum                     4 denke
    Honey                             sufficient
Form an Electuary. Used for ‘every ailment of the Liver and Stomach, and for Obstructions’.
Dose: 1 dram in infusion of Fenugreek (Syrian “Book of Medicine“, trans. by Wallis Budge, 1913)

HEPATIC DECOCTION OF HOFFMAN
    Chicory root
    Dandelion root
    Asparagus root             6 drams ea.
    4 Great Cold seeds      2 drams ea.
    Scabious leaf
    Chicory leaf
    Endive leaf                    ½ handful ea.
    Licorice                          2 drams
    Raisin                              1 oz

HEPATIC TROCHES OF ASCLEPIADIS (GALEN)
    Annis
    Celery seed
    Asarum
    Bitter Almond
    Wormwood                   ½ oz.
    Rain Water                     qs
Form Troches; helps Liver, cleanse by Urine, taken with Wine, or water if there is Fever. Some versions omitted Asarum.

MIRACULOUS HEPATIC POTION
    Gentian
    Amomum
    Wormwood
    Costus
    Agrimony
    Bitter Almond             2 drams
    Pepper
    Annis                            1 dram
(Medicamentorum Opus Nicolai Myrepsus 1625)


See also:
Liver Heat   
Liver Cold   
Liver Weakness   
Liver Pain  
Jaundice   
Liver Obstruction   
Hepatitis & Liver Inflammation   
Liver Hardness, Cirrhosis


Research

1. Natural Medicines Used in the Traditional Tibetan Medical System for the Treatment of Liver Diseases