中医内科学

3. Scope of Symptoms: Clinically pathological changes of the liver and gall-
bladder mainly are apoplexy, dizziness, headache, spasm, epilepsy, syncope,
abdominal mass , deafness , tinnitus , hernia , hematemesis, apostaxis, panic, in-
somnia, numbness and tremor.
4. Classification of Syndromes
(1) Excess Syndrome
(a) Stagnation of the Liver-qi
Summary of Pathogenesis: impairment of the liver due to depression and
anger, dysfunction of the liver, transverse invasion by the hyperactive liver-qi,
obstruction and stagnation of the liver-qi, pain, abdominal mass, obstruction of
blood circulation due to blood stasis , blockage of channels, and hypochondriac
lump.
Main Pulse Conditions and Symptoms: hypochondriac pain, vomiting, ab-
dominal pain, diarrhea, abdominal mass, thin fur and taut pulse are main symp-
toms. Hypochondriac pain is characterized by uncomfortable oppressed feeling in
the chest, wandering pain and inability of turning round. Vomiting is character-
ized by adverse flow of qi, regurgitation of acid, and vomiting of yellow, green
and bitter watery fluid. Abdominal pain and diarrhea are characterized by un-
comfortable pain in the lower abdomen without alleviation after diarrhea. Ab-
dominal mass is under the hypochondria and hypochondriac lump moves left or
right, converges or diverges uncertainly, with distending pain or prickling pain.
In addition, there are other symptoms of liability to anger and anorexia.
Treatment: Chai Hu Shu Gan Powder or Xue Yu Pill and their like are used
to sooth the liver and regulate the circulation of qi, and to dissolve lump and re-
solve mass.
(b) Flaming-up of the Liver-fire
Summary of Pathogenesis: dysfunction of the liver and gallbladder, fire-
syndrome caused by stagnation of qi, scurry of fire with qi, upward invasion of
the vertex by the liver-fire.
Main Pulse Conditions and Symptoms: hypochondriac pain, vomiting, dizzi-
ness, headache, fury, deafness, tinnitus, conjunctival congestion, hemateme-
sis, apostaxis, red smooth tongue, yellow or dry greasy fur, and taut and rapid
pulse are main symptoms. Hypochondriac pain is characterized by burning pain
and vexation. Vomiting is characterized by bitter or yellow watery fluid. Dizzi-
ness and headache are characterized by intolerable dizziness, pulse feeling of ten-
don and muscle, heat in the forehead with chopping pain or distending pain. Tin-
nitus and deafness are characterized by sudden fits with tidal sound in the ear
without alleviation under massage. Conjunctival congestion is characterized by a-
cute pain and swelling. Hematemesis and apostaxis are characterized by sudden
fits with a large amount of blood gushed from the mouth. In addition, there are
other symptoms of difficulty in micturition with hot dark urine, hot red face,
and dry mouth with bitter taste.
Treatment: Long Dan Xie Gan Decoction and its like are used to clear away
heat from the liver and gallbladder.
(c) Hyperactivity of the Liver-yang
Summary of Pathogenesis: fire-syndrome caused by hyperactivity of the liv-
er-qi, sudden expansion of yang-qi, scurry of fire with qi, transverse invasion of
channels and collaterals by the hyperactive liver-qi? blood ascending with qi to
the vertex.