Rebellious Liver Qi invading the Spleen

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Pattern factsheet

Chinese name: 肝气逆侵脾

Pinyin name: Gān Qì Nì Qīn Pí

Associated TCM concepts: Liver Qi Spleen

Diagnosis

Common symptoms: Tiredness Flatulence Irritability Abdominal pain Abdominal distension and two other symptoms

Pulse type(s): Weak (Ruo), Wiry (Xian)

Tongue description: Normal-coloured or slightly Red on the sides

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).

Diagnosing Rebellious Liver Qi invading the Spleen

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

Pulse type(s): Weak (Ruo) or wiry (Xian)

Tongue description: Normal-coloured or slightly Red on the sides

Possible symptoms: Tiredness Flatulence Irritability Abdominal pain Abdominal distension Alternating constipation and diarrhea Stools sometimes dry and in small pieces

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 Rebellious Liver Qi invading the Spleen will tend to exhibit weak (Ruo) or wiry (Xian) pulses.

Practitioners also learn to read from a long list of seemingly unrelated symptoms. Here patients with Rebellious Liver Qi invading the Spleen might experience symptoms like irritability, abdominal distension, abdominal pain and alternating constipation and diarrhea (full list here above).

Herbal formulas used to treat Rebellious Liver Qi invading the Spleen

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

Read more about Xiao Yao San

Diet 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.

Most important herbs used to treat Rebellious Liver Qi invading the Spleen