The Liver in Chinese medicine

The Liver (Gan, 肝) is called the “General” of the organs in Chinese medicine. Its two great functions are storing Blood (resting in the Liver at night and released when active) and ensuring the smooth, unobstructed flow of Qi throughout the entire body. Almost every dimension of clinical complaint — from menstrual irregularity to migraine, irritability, digestive cramping, eye disorders and tendon stiffness — involves the Liver in some way. Paired with the Gallbladder; element Wood; season Spring; sense organ the eyes; emotion anger / frustration; tissue sinews and tendons; houses the Hun (Ethereal Soul).

Functions of the Liver

1. Stores Blood — the Liver is the principal reservoir of Blood; at rest Blood returns to the Liver, during activity it is released to nourish muscles. Liver Blood nourishes the eyes, sinews, nails and (in women) the menstrual cycle.
2. Ensures the smooth flow of Qi — the Liver maintains free circulation of Qi throughout the channels. When obstructed, the result is Liver Qi stagnation — the single commonest pattern in modern clinical practice.
3. Controls the sinews — flexibility, range of motion and freedom from cramps depend on Liver Blood nourishing the sinews
4. Manifests in the nails — strong, healthy nails reflect adequate Liver Blood; brittle, ridged nails reflect deficiency
5. Opens into the eyes — visual sharpness, dryness, floaters and night vision relate to Liver function. Dry eye syndrome typically reflects Liver Blood/Yin deficiency.
6. Houses the Hun (Ethereal Soul) — the aspect of consciousness concerned with planning, dreaming, vision and life direction

Liver and Gallbladder pair

The Liver is paired with the Gallbladder. Liver produces bile; Gallbladder stores and excretes it. The Gallbladder also governs decision-making and courage in TCM; its weakness produces indecisiveness, timidity and being easily startled.

Common patterns of Liver disharmony

1. Liver Qi stagnation — irritability, sighing, premenstrual tension, breast tenderness, hypochondriac fullness, alternating loose/constipated stools; the foundational modern pattern of chronic stress
2. Liver Fire blazing upward — intense anger outbursts, red eyes, bitter taste, throbbing temporal headache, tinnitus, insomnia, dream-disturbed sleep
3. Liver Yang rising — the underlying pattern in much hypertension: throbbing headache, dizziness, irritability, often on a background of Kidney Yin deficiency
4. Liver Wind moving inward — tremor, twitches, dizziness, post-stroke contractures, sometimes seizures; can arise from Liver Yang rising or from Blood deficiency
5. Liver Blood deficiency — dull headache, dry eyes, floaters, scant or absent periods, brittle nails, muscle cramps, insomnia with vivid dreams
6. Liver Yin deficiency — combined with Kidney Yin deficiency: dry eyes, night sweats, hot flushes, irritability, restless sleep
7. Damp-Heat in Liver-Gallbladder — jaundice, bitter taste, hypochondriac pain, urinary burning, vaginal discharge with itching, headaches
8. Liver overacting on Spleen — stress-triggered IBS: cramping pain with bowel motion, alternating loose and hard stools
9. Liver Qi invading Stomach — acid reflux, nausea, hiccups, epigastric tension with stress

Conditions on this site relating to Liver disharmony

Stress, anxiety, depression, premenstrual tension, painful periods, irregular cycles, endometriosis, menopausal symptoms, hypertension, insomnia, migraines, acid reflux, IBS, tinnitus, dry eye and many tension-related pain presentations.

Treatment principles for the Liver

Core acupuncture points include LV 3 (Taichong) (Yuan-source; moves Liver Qi; the most-used Liver point), LI 4 (Hegu) (combined with LV 3 as the “Four Gates” to move stagnant Qi throughout the body), LV 14 (Qimen) as the Front-Mu, BL 18 (Ganshu) as the Back-Shu, GB 34 (Yanglingquan) for sinews. Foundational formulas include Xiao Yao San (Liver Qi stagnation with Spleen deficiency — the single most-prescribed Liver formula), Long Dan Xie Gan Tang (Liver Fire / Damp-Heat), Tian Ma Gou Teng Yin (Liver Yang rising with hypertension), Si Wu Tang (Liver Blood deficiency).

Return to Zang-Fu organ overview or read about the Heart, Lung, Spleen and Kidney.