Liver Qi Stagnation

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Pattern factsheet

Chinese name: 肝气郁结

Pinyin name: Gān Qì Yù Jié

Associated TCM concepts: Liver Qi Stagnation

Related conditions: Mastitis Hepatitis Peptic ulcers and seven other conditions

Diagnosis

Common symptoms: Fever Anger Blister Belching Moodiness and forty three other symptoms

Pulse type(s): Wiry (Xian)

Tongue color: Normal (light red)

When Liver Qi does not flow smoothly or regularly, it becomes Stagnant and in Excess. This leads to Heat accumulating in the Liver. This affects not only the Liver, but other connected Organs too as well as the Seven Emotions.

Liver Qi Stagnation is not only the most seen Liver disharmony, but also one of the most common TCM patterns in general. Many things can cause Liver Qi Stagnation, such as suppressed or overly expressed anger, resentment and frustration, or a diet rich in stimulants, drugs, fatty and oily foods, recreational drugs, alcohol, coffee, black tea, or overwork without sufficient rest.

The feeling of ‘Distension’ (zhang 胀) is the main symptom of Liver Qi Stagnation, especially distention in the hypochondrium, chest, epigastrium or abdomen. To describe this feeling, the term ‘bloating’ is also often used in English-speaking countries. Emotionally speaking, patients are often depressed, moody and irritable. For women, they often have painful and irregular periods as well as breasts distension. Wiry pulse can also be used to diagnose this pattern. 

To treat Qi Stagnation, it is important to avoid using tonifying herbal ingredients as they create Excess and thus Stagnation worsens, like putting more cars to a bad traffic jam. Therefore, it is recommended to give herbals that Regulating Qi and Blood together with Herbs that clear Heat. 

Related conditions

Abnormal vaginal discharge Irregular menstruation Breast engorgement Mastitis Low breast milk supply Chronic gastritis Peptic ulcers Hepatitis Chronic cholecystitis Intercostal neuralgia

Diagnosing Liver Qi Stagnation

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Diagnosing a pattern in Chinese Medicine is no easy feat and should be left to professional practitioners.

In particular one has to know how to differentiate between different types of pulses and tongue coatings, shapes and colors. Here patients with Liver Qi Stagnation will tend to exhibit wiry (Xian) pulses as well as a normal (light red) tongue.

Practitioners also learn to read from a long list of seemingly unrelated symptoms. Here patients with Liver Qi Stagnation might experience symptoms like depression, irregular menstruation, menstrual cramps and irritability (full list here above).

Herbal formulas used to treat Liver Qi Stagnation

Xiao Yao San

Source date: 1107 AD

Number of ingredients: 6 herbs

Key actions: Harmonizes the function of Liver and Spleen. Relieves Liver Qi stagnation. Nourishes the Blood.

Formula summary

Xiao Yao San is a 6-ingredient Chinese Medicine formula with Bupleurum Roots (Chai Hu) as a principal ingredient. Invented in 1107 AD, it belongs to the category of formulas that harmonize Liver-Spleen.

Besides Liver Qi Stagnation, Xiao Yao San is also used to treat Liver Blood Stagnation or Rebellious Liver Qi invading the Spleen.

Read more about Xiao Yao San

Chai Hu Shu Gan San

Source date: 1602

Number of ingredients: 7 herbs

Key actions: Disperses Stagnant Liver Qi and Blood. Alleviates pain. Harmonizes Blood.

Formula summary

Chai Hu Shu Gan San is a 7-ingredient Chinese Medicine formula with Bupleurum Roots (Chai Hu) as a principal ingredient. Invented in 1602, it belongs to the category of formulas that promote Qi movement.

Besides Liver Qi Stagnation, Chai Hu Shu Gan San is also used to treat Liver Blood Stagnation or Heart Vessel obstructed.

Read more about Chai Hu Shu Gan San

Jia Wei Xiao Yao San

Source date: Ming dynasty

Number of ingredients: 10 herbs

Key actions: Clears Liver and Spleen Qi Stagnation. Tonifies Spleen. Clears Deficient Heat. Nourishes the blood.

Formula summary

Jia Wei Xiao Yao San is a 10-ingredient Chinese Medicine formula with Bupleurum Roots (Chai Hu) as a principal ingredient. Invented in Ming dynasty, it belongs to the category of formulas that harmonize Liver-Spleen.

Besides Liver Qi Stagnation, Jia Wei Xiao Yao San is also used to treat Stagnant Liver-Qi turning into Fire or Heat in the Blood.

Read more about Jia Wei Xiao Yao San

Yue Ju Wan

Source date: 1481 AD

Number of ingredients: 5 herbs

Key actions: Promotes the movement of Qi. Releases all types of Stagnation (Qi, Blood, Phlegm, Fire, Food and Dampness).

Formula summary

Yue Ju Wan is a 5-ingredient Chinese Medicine formula with Atractylodes Rhizomes (Bai Zhu) and Szechuan Lovage Roots (Chuan Xiong) as principal ingredients. Invented in 1481 AD, it belongs to the category of formulas that promote Qi movement.

Besides Liver Qi Stagnation, Yue Ju Wan is also used to treat Phlegm or Qi Stagnation.

Read more about Yue Ju Wan

Wu Yao Tang

Source date: 1336 AD

Number of ingredients: 9 herbs

Key actions: Pacifies the Liver. Moves Qi. Stops pain. Nourishes Liver Blood. Eliminates Stagnation.

Formula summary

Wu Yao Tang is a 9-ingredient Chinese Medicine formula with Lindera Roots (Wu Yao) as a principal ingredient. Invented in 1336 AD, it belongs to the category of formulas that promote Qi movement.

Besides Liver Qi Stagnation, Wu Yao Tang is also used to treat Qi Stagnation or Qi and Blood Stagnation.

Read more about Wu Yao Tang

Gua Lou San

Source date: 1826 AD

Number of ingredients: 8 herbs

Key actions: Remove breast carbuncle (mastitis) after birth giving.

Formula summary

Gua Lou San is a 8-ingredient Chinese Medicine formula with Snake Gourds (Gua Lou) as a principal ingredient. Invented in 1826 AD, it belongs to the category of formulas that clear Heat and resolve toxicity.

Besides Liver Qi Stagnation, Gua Lou San is also used to treat Stomach Fire or Stomach Heat.

Read more about Gua Lou San

Xia Ru Yong Quan San

Source date: 1840 AD

Number of ingredients: 11 herbs

Key actions: Nourishes Blood. Increases breast milk supply.

Formula summary

Xia Ru Yong Quan San is a 11-ingredient Chinese Medicine formula with Dong Quai (Dang Gui) as a principal ingredient. Invented in 1840 AD, it belongs to the category of formulas that invigorate Blood and dispel Blood Stagnation.

Read more about Xia Ru Yong Quan San

Diet recommendations

Avoid fried and fatty foods, nuts and nut butters, avocados, cheese and dairy, chips of all kinds, turkey and red meats, alcohol, hot and spicy foods, chocolate, caffeinated foods, drugs and stimulants. Avoid drinks such as coffee, black tea, cocoa and colas. Eat plenty of grains, legumes, vegetables and dark leafy greens, such as kale, collards, dandelion, mustard, beet and mustard greens. Lemon juice also helps decongest the Liver

Special highlight: the link between low breast milk supply and Liver Qi Stagnation

Dong Quai (Dang Gui) is the key herb for Xia Ru Yong Quan San, a formula used for low breast milk supply caused by Liver Qi Stagnation

Low levels of milk supply is often due to Liver Qi Stagnation, an issue where Qi gets blocked in the Liver and cannot flow freely to the breasts.

The Liver and nipples are connected through the Liver Channel. To deal with low lactation due to this specific pattern, the Liver needs to be pacified and Qi needs to be moved by eliminating Stagnation. Only when the Stagnation is removed from the Liver Channel that connects to the breasts can the new mum can be encouraged to promote lactation.

A...Read more about low breast milk supply

Special highlight: the link between mastitis and Liver Qi Stagnation

Snake Gourds (Gua Lou) is the key herb for Gua Lou San, a formula used for mastitis caused by Liver Qi Stagnation

If a nursing mother is easily impacted by anger and her emotions are repressed, her Qi will rebel upwards and stagnate in the Liver, which connects to the nipples through the Liver Channel. This leads the milk ducts or nipple orifices to clog, milk cannot come out and thus forms lumps or nodules in the breasts. The nursing mother feels swelling and hardness in the breasts and a strong sharp pain during breastfeeding. Sometimes, only one of the breasts' nipples are clogged and it leads to an...Read more about mastitis