Liver blood vacuity

A disease pattern chiefly characterized by dizziness; blurred vision (loss of visual acuity); scant menstruation; numbness of the limbs; tremor of the extremities; blood vacuity signs.

Description: Dizzy head and flowery vision; blurred vision (loss of visual acuity); night blindness; tinnitus; numbness and tingling of the limbs, tension in the joints, tremor of the extremities, or jerking sinews and twitching flesh; scant menstruation with pale discharge or in severe cases amenorrhea; lusterless nails; lusterless white complexion; pale tongue; a fine pulse.

Diseases: Dizziness; vacuity taxation; sleeplessness; numbness; blurred vision; sparrow blindness; menstrual irregularities.

Pathogenesis: Depletion of blood depriving the liver of moistening of nourishment. This stems from:

• decreased blood production attributable to spleen vacuity;
• enduring illness wearing the blood;
• excessive blood loss.

Analysis of signs

• Liver signs: Loss of nourishment to the sinews, eyes, nails, and network vessels gives rise to signs such as inhibited bending and stretching of the joints, numbness and tingling of the limbs, dry eyes, blurred vision, dizziness, and lusterless nails.
• General blood vacuity: The general loss of the blood’s nourishing action manifests in a pale-white facial complexion, lips, and tongue, and in clouded head and fatigue and lack of strength.
• Women: When liver blood is depleted, the blood of the thoroughfare (chōng) and controlling (rèn) vessels becomes scant, giving rise to scant menstrual flow or amenorrhea.
• Tongue: Pale.
• Pulse: Fine.

Treatment

Medicinal therapy: Since liver blood and kidney essence are mutually engendering, treatment usually involves dual treatment of liver and kidney. The basic method of treatment is supplementing the blood and nourishing the liver. Commonly used medicinals that supplement both liver and kidney include rehmannia (Rehmanniae Radix, 地黄 dì huáng), white peony (Paeoniae Radix Alba, 白芍药 bái sháo yào), Chinese angelica (Angelicae Sinensis Radix, 当归 dāng guī), lycium berry (Lycii Fructus, 枸杞子 gǒu qǐ zǐ), cornus (Corni Fructus, 山茱萸 shān zhū yú), ligustrum (Ligustri Lucidi Fructus, 女贞子 nǚ zhēn zǐ), eclipta (Ecliptae Herba, 墨旱莲 mò hàn lián), mulberry (Mori Fructus, 桑椹 sāng shèn), flowery knotweed (Polygoni Multiflori Radix, 何首乌 hé shǒu wū), tortoise shell (Testudinis Carapax et Plastrum, 龟版 guī bǎn), and turtle shell (Trionycis Carapax, 鳖甲 biē jiǎ).

For most simple cases of liver blood insufficiency Liver-Supplementing Decoction (补肝汤 bǔ gān tāng) and Four Agents Decoction (四物汤 sì wù tāng) or their variations can be used.

• For blood failing to nourish the sinews or network vessels, characterized by signs such as numbness in the extremities or impaired locomotion, blood-nourishing and network-freeing medicinals such as spatholobus (Spatholobi Caulis, 鸡血藤 jī xuè téng), carthamus (Carthami Flos, 红花 hóng huā), mistletoe (Taxilli Herba, 桑寄生 sāng jì shēng), dipsacus (Dipsaci Radix, 续断 xù duàn), and achyranthes (Achyranthis Bidentatae Radix, 牛膝 niú xī) are indicated.
• Blood failing to nourish the head and eyes, marked by loss of visual acuity and dizziness, can be treated with Lycium Berry, Chrysanthemum, and Rehmannia Pill (杞菊地黄丸 qǐ jú dì huáng wán) or similar formulas.
• Disharmony of the thoroughfare (chōng) and controlling (rèn) vessels due to liver blood vacuity can be treated with Black Free Wanderer Powder (黑逍遥散 hēi xiāo yáo sǎn) (Free Wanderer Powder supplemented with cooked rehmannia) and its variations. Depletion of liver-kidney essence-blood is generally treated with such formulas as Left-Restoring [Kidney Yin] Pill (左归丸 zuǒ guī wán) and its variations which supplement kidney essence and nourish liver blood.

Acumoxatherapy: Base treatment mainly on back transport points, LR, SP, and ST. Select BL-18 (Liver Transport, 肝俞 gān shù), BL-20 (Spleen Transport, 脾俞 pí shù), BL-17 (Diaphragm Transport, 膈俞 gé shù), LR-14 (Cycle Gate, 期门 qī mén), LR-3 (Supreme Surge, 太冲 tài chōng), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ); needle with supplementation. For liver-kidney essence-blood depletion, add BL-23 (Kidney Transport, 肾俞 shèn shù), BL-52 (Will Chamber, 志室 zhì shì), KI-3 (Great Ravine, 太溪 tài xī), and CV-4 (Pass Head, 关元 guān yuán).