Rebellious Liver Qi invading the Spleen
Rebellious Liver Qi invading the Spleen
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Diagnostic Signs
Normal-coloured or slightly Red on the sides
Weak (Ruo), Wiry (Xian)
Diagnostic Considerations
Alternation of constipation and loose stools and a Wiry pulse is enough in and of itself to diagnose Rebellious Liver Qi invading the Spleen.
Causes & Pathology
Common Causes
Anger, frustration or resentment are all emotions that affect the Liver and which, if felt for a prolonged period of time (or very intensively over a short period), cause Liver Qi to stagnate. Stagnant Liver Qi may become Rebellious, accentuating its horizontal movement towards the Spleen. This disturbs the Spleen function of transformation and transportation and it prevents Spleen Qi from rising.
Irregular eating, eating in a hurry, when worried, when angry or while working can cause Liver Qi to rebel towards the Spleen.
Pathological Mechanism
Liver Qi is said to be rebellious when its horizontal movement is accentuated. This impairs the Spleen's function of transformation and transportation and prevents Spleen Qi from rising.
It is a pattern of mixed Deficiency and Excess: Excess of the Liver (Rebellious Qi) and Deficiency of Spleen Qi. In the Five-Phases theory, it corresponds to Wood overacting on Earth.
There are typically two types of presentations for this pattern.
The first is when the Excess of the Liver is more important than the Spleen's Deficiency. It is said that the Liver's overactivity invades the Spleen. In this presentation there is constipation (with stools that are dry, difficult and often in small pieces) more frequently than diarrhea and the abdominal distension and pain are quite marked.
In the second presentation the Spleen Qi Deficiency is more pronounced. This means the Spleen is weak and ‘allows’ itself to be invaded by the Liver, even when the Liver Excess is relatively mild. In this scenario there are loose stools, even diarrhea, more often than constipation and the abdominal pain is only slight.
Those two presentations are the reason why the tongue can either be Red on the sides (first presentation) or normal coloured (second presentation).
Treatment Approach
Treatment Principle
Subdue rebellious Liver Qi, tonify the Spleen.
Recommended Herbal Formulas
Diet & Lifestyle Recommendations
Adopting good eating habits are very important to prevent this pattern. Eat at regular intervals and take the time to eat. Avoid working or other stressful activities while eating.
To prevent or mitigate Spleen Qi Deficiency, it's also important to favor eating cooked foods only, including rice, meat (especially beef), vegetables, congee and warm or room temperature drinks such as warm milk. Avoid anything too cold in temperature (e.g. ice cream or cold drinks), raw ingredients and the excessive use of sugar and other sweeteners.
To calm the Liver work with the emotions of anger, frustration and resentment by finding constructive outlets to express and release them. Above all, do not repress or stuff your emotions. Avoid excessive physical activity, such as sex or exercise. Regularity of habits helps to regulate Liver Qi.
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