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What does it mean to have excess of the liver (is it excess of

yin/yang, or chi); and what would cause this type of problem. Can

Liver excess cause pain in the tendons(in the feet, behind the knee

etc.) How would you treat a case of liver excess combined with

spleen chi deficiency (teeth marks around the edge of the tongue).

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>What does it mean to have excess of the liver (is it excess of

>yin/yang, or chi); and what would cause this type of problem. Can

>Liver excess cause pain in the tendons(in the feet, behind the knee

>etc.) How would you treat a case of liver excess combined with

>spleen chi deficiency (teeth marks around the edge of the tongue).

 

A brief review for those new to TCM: When problems are created by there

being too much of something, this is called Excess. For example, Yang or

Yin can be in Excess. When Yang (which activates and warms) is in Excess,

the person will be too active and too hot. When Yin (which cools and calms)

is in Excess, the person will be too sluggish and too cold. (I'm

simplifying things here.) Likewise, Deficiency problems are caused by there

being too little of something. Too little Yang means the person and

physiology will be too cold and too sluggish because there is not enough

Yang to warm and activate the body properly. Too little Yin means the

person will be too hot and too agitated because there's not enough Yin to

cool and calm the body properly. A person also can be Qi Deficient or Blood

Deficient.

 

In addition, other conditions are classified as Excess or Deficiency. Qi

Stagnation (Qi not flowing smoothly or even blocked), Blood Stasis (Blood

not flowing properly), and Phlegm are classified as Excess because any Qi

Stagnation, Blood Stasis, or Phlegm is too much and creates problems.

 

In addition to these, problems with the direction of the flow of Qi also are

classified as Excess or Deficiency. There is a proper direction of flow of

Qi. For example, Stomach Qi is supposed to descend. When it doesn't, when

it Rebels (ascends) instead and causes problems like belching, nausea,

vomiting, etc., this is called Stomach Qi Rebelling, and Rebellious Qi is

classified as an Excess pattern. Stomach Qi is supposed to descend, but

Spleen Qi is supposed to ascend. When Spleen Qi descends instead of

ascending, this is called Spleen Qi Sinking, and this is classified as a

Deficiency problem.

 

The reason TCM healers pay attention to Excess and Deficiency

classifications is because this will dictate healing strategies. In

general, one supplements or tonifies what is missing in the case of

Deficiency. In general one disperses, sedates, or gets rid of what is in

Excess.

 

Although problems with Qi Stagnation and proper direction of flow can occur

anywhere in the body and from different causes, one Organ system in

particular is linked to Qi Stagnation and flow problems. " The main function

of the Liver is that of ensuring the smooth flow of Qi. " (Giovanni

Maciocia, The Foundations of , p. 215.) The Liver " ensures

the smooth flow of Qi. This is the most important of all the Liver

functions and it is central to nearly all Liver disharmonies. The

impairment of this funciton is one of the most common patterns seen in

practice. " (Foundations, p. 78.)

 

" The normal direction of movement of Liver-Qi is upwards and outwards in all

directions to ensure the smooth and unimpeded flow of Qi everywhere This

explains the importance of this function, as it involves all parts of the

body and can affect all organs. " (Foundations, pp. 78-79.) For example,

one of the possible causes of Stomach Qi Rebelling is the Liver Invades the

Stomach. Sometimes the Stomach is invaded because it is weak; sometimes the

Stomach is invaded because the Liver is in Excess. The Liver Qi has been

blocked, dammed up, etc. (The number one cause of this is emotional though

other things like infection, trauma, surgery, diet, inappropriate herbs,

parasites, misalignment of the spine, and toxins also can cause this to

happen.)

 

What writers usually are talking about when they speak of Liver Excess are

problems with the smooth and proper flow of Qi

 

It is common to see mixed patterns of Excess and Deficiency. For example,

when the Liver Invades the Spleen because the Liver is in Excess, this may

be a pure Excess pattern. But when the Liver Invades the Spleen because the

Spleen is weak, this may be a mixed Deficiency (the Spleen weakness) and

Excess (the Invasion by the Liver Qi) pattern. (I want to point out that

sometimes the Primary Root of the Qi Stagnation problems are in the Liver -

usually with an emotional basis. But, it's also possible for the Primary

Root of the Qi Stanation problems in the Liver to be elsewhere. For

example, when Spleen Qi is Deficient, this can trigger Dampness

accumulation, and the Dampness accumulation can in turn cause Liver Qi

Stagnation problems. The Qi can't flow properly because of the Dampness.)

 

Liver imbalance most definitely can affect the tendons. " The state of the

sinews (including tendons) affeccts our capacity for movement and physical

activity. The contraction and relaxation of sinews ensures the movement of

joints. The sinews' capacity for contraction and relaxation depends on the

nourishment and moistening of the Blood from the Liver. The 'Simple

Questions' in chapter 21 says: 'The Qi of food enters the Stomach, the

essence extracted from food goes to the Liver and the excess Qi from the

Liver overflows into the sinews' " (Foundations, p. 79)

 

" If Liver-Blood is abundant, the sinews will be moistened and nourished,

ensuring smooth movement of joints and good muscle action. If Liver_Blood

is deficient, the sinews will lack moistening and nourishment which may

cause contractions and spasms or impaired extension / flexion, numbness of

limbs, muscle cramps, tremors, tetany or lack of strength of the limbs.

This is why the 'Simple Questions' in cahpter 1 says: 'When Liver-Qi

declines, the sinews cannot move.' " (Foundations, p. 79) Qi Stagnation

problems can trigger Blood Stasis problems. If the Blood is not flowing

properly to a part of the body because of Blood Stasis problems, this means

that the Blood is not performing the proper moistening and nourishing

function for that part of the body.

 

In considering pain (or other sensations such as unusual cold, heat,

numbness, redness, etc.), also consider if it is occuring along the course

of a meridian. You didn't mention specifically where the pain in the

tendons of the feet is. All of the tendons or in just one area of the foot?

There are a number of channels which run through the feet and legs,

including the Liver channel. The one that runs down the back of the leg and

behind the knee is the Bladder channel. The Bladder channel also runs down

the outside of the feet and ends at the little toes. I mention this because

sometimes channel problems will worsen Interior problems.

 

For those new to TCM, sometimes the tongue will be so swollen it will be

teeth-marked from pressing against the teeth. This is also called a

" scalloped tongue. " When a tongue is scalloped, this usually is a sign that

the person is Qi or Yang Deficient. " A survey in China of 425 patients with

tooth-marked tongues found that 345 suffered from qi or yang deficiency. "

(Giovanni Maciocia, Tongue Diagnosis in , p. 83, citing Qian

Xin-Ru, " Analysis of Clinical Observation of Patients with Tooth-marked

Tongue " , Journal of Traditional 32, no. 1 (1991): 33.)

 

The reason why a swollen or even scalloped tongue shows up so often in

people who are Qi or Yang Deficient is because one of the functions of Qi is

to transport and transform fluids. If Qi is in short supply, fluids tend to

accumulate. This is especially true if Yang Deficiency also is present as

then there is the added factor of Deficiency Cold slowing things down even

more.

 

Victoria

 

 

 

 

 

 

 

 

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