By Enzo Ilander
Liver Wind, also referred as Liver Wind stirring internally, is internal Wind arising from extreme Yin/Yang and Qi/Blood imbalance when excessive depletion of Liver and kidney Yin humor deprives the Liver's Yang Qi of its nourishment and counterbalancing. The result of this is an erratic movement of Liver-Qi manifesting sings characterized by movement or by the absence of it, like for example tremor and convulsions or paralysis.
The main signs are dizziness, headache with a pulling sensation, tensions and stiffness in the neck, tremor, tic, convulsions, paralysis, tingling or numbness in the limbs, seizures, and sudden loss of consciousness.
There are three main causes of Liver- Wind: Extreme Heat with upflaming of Liver-Fire generating Wind, Deficiency of Liver-Yin with raising of Liver-Yang and Deficiency of Liver-Blood.
Extreme heat generating Wind is an excess pattern related to acute febrile diseases in which the exterior Heat penetrates deeply into the Blood level. Liver is the viscera of Wind and trees, it governs the sinews and stores blood, when Blood Heat scorches the Liver channel, the sinews and vessels lose nourishment and Wind is stirred.
Evil heat is internally exuberant. It causes a vigorous fever. Extreme fever engenders Wind, which rises and harasses the clear openings resulting in dizziness and distending pain in the heart. Transverse penetration of the channel vessels results in vexation of the hands and feet and in convulsions. Rigidity of the limbs, tightly closed jaw, upward gazing eyes and arched back and rigidity are also manifestations of stirred Wind. When heat attacks the spirit brightness, mania results.
Internal Wind signs are characterized by movements hence the tremor of limbs and convulsions. It also prevents the Liver from moistening the sinews, causing rigidity. The main signs are high fever with thirst, red face and eyes, ringing in the ears, convulsions, hypertonicity, upward staring eyes, rigidity of neck and back and clenched jaw. Other signs are short inhibited voidings of urine, constipation. In severe cases, when entering the pericardium, the extreme Heat and Wind can cloud the Mind causing clouded spirit, delirious speech and coma.
The tongue will be deep-red, stiff and with a thick, yellow coating. The Pulse will be wiry, rapid and full.
The method will be clearing. The treatment will be clear Heat, disperse the Liver and subdue Wind.
Useful herbs for this type of pattern are: Ling Yang Jiao (Cornus Antelopis), Niu Xi (Acyranthes) and Gou Teng (Uncaria).
Formulas: Ling Jiao Gou Teng Tang (Antelope Horn and Uncaria Decoction) or An Gong Niu Huang Wan (Peaceful Palace Bovine Bezoar pill).
Extreme heat generating Wind it is more common in children, Fright Wind, as a complication of febrile diseases like measles, encephalitis and meningitis. In such cases, patients need urgent Western medical treatment.
Liver-Yang rising causing Wind arises when Liver-Kidney Yin depletion makes Yin unable to constrain Yang, and Liver Yang becomes hyperactive causing Wind to stir and Fire Qi to float upwards.
This pattern is a combination of deficiency and excess, usually caused by emotional factors, especially due to a continuous state of anger, resentment, frustration, etcÖ It may include symptoms of Liver Wind by extreme Heat (Headache, dizziness, anger, red eyes,Ö) and signs of Liver and Kidney Yin deficiency. The Yin and Blood of the Liver depend on the nourishment of Kidney-Yin and Essence because the Kidneys correspond to the water element, which should nourish wood, the Liver element. Thus, if Kidney fails to nourish, Liver-Yang upbears and stirs unchecked.
The signs are dizziness that upsets balance, shaking head, trembling of the limbs, sluggish speech or stiff tongue preventing speech, sudden collapse and unconsciousness, convulsions, deviation of eyes and mouth, headache, rigidity of the neck, numbness of the extremities and unsteady gait.
The tongue is red-peeled, deviated. The pulse is floating-empty or wiry-fine and rapid.
The method is combined (supplement Yin-subdue Wind). The treatment principles are: Extinguish Liver-Wind, subdue Liver-Yang, nourish Yin, regulate Liver.
The herbs to use: Tian Ma (Gastrodia), Gou Teng (Uncaria).
The formulas: Tian Ma Gou Teng Yin (Gastrodia and Uncaria Decoction) or Zhen Gan Xi Feng Tang (Liver Settling Wind Extinguishing Decoction)
Deficiency of Liver-Blood is a pattern where a vacuity of Liver-Blood creates an emptiness in the blood vessels that is filled by internal Wind. This is a deficient type of internal Wind.
Two main causes for Liver Blood vacuity are commonly observed: damage to Yin-Blood during the course of an enduring illness which deprives the Liver of blood for storage and adequate nourishment; and an excessive loss of blood due to an acute or chronic hemorrhage or other type of bleeding. That insufficiency of Liver Blood deprives the sinews of nourishment and gives rise to spasm.
Among the main signs, itchy rashes that change location, shaking of the head, tic and tremor are due to internal Wind. The numbness of limbs is due to deficient Blood not nourishing muscles and sinews. There are also tremors, but in this case they are much softer than in the other two types, where real convulsions will be found.
Besides the main signs due to Liver-Wind the pattern will present the general Blood vacuity signs with symptoms getting worst as day goes on: functional weakness, dryness, difficulty sleeping, malar flush, night sweats, 5 hearts fever. Since Blood is insufficient it cannot ascend to nourish the head and face, manifesting in dizziness, tinnitus, lusterless complexion and pale tongue, unclear vision, dry eyes, night blindness, and scant menstrual flow or menstrual block.
The tongue is pale and deviated. The pulse is fine, choppy (because blood is scanty and vessels are empty).
The method of treatment is combined. The principles are nourishing Blood and subdue Liver-Wind.
Herbs: Tian Ma, Gou tong and Liver-Blood Tonics.
Formula: Ding Zhen Wan (Tremor-Stabilizing Pill)