An impediment (bì) pattern arising when in enduring impediment further contraction of evils or damage to the liver by anger causes depressed liver qì. Liver impediment is characterized by fright during sleep at night, thirst with increased fluid intake, frequent urination, rib-side pain, and enlarged abdomen.
Medicinal therapy: Course the liver and dispel the evil using Five Impediments Decoction (五痹汤wǔ bì tāng) with the addition of spiny jujube (Ziziphi Spinosi Semen, 酸枣仁suān zǎo rén) and bupleurum (Bupleuri Radix, 柴胡chái hú) or with Bupleurum Liver-Coursing Powder (柴胡疏肝散chái hú shū gān sǎn). For vacuity patterns, use Liver-Supplementing Powder (补肝散bǔ gān sǎn), whereas for fire patterns, use Green-Blue–Draining Pill (泻青丸xiè qīng wán) or Gentian Liver-Draining Decoction (龙胆泻肝汤lóng dǎn xiè gān tāng).
Acumoxatherapy: Base treatment mainly on back transport points, LR, GB, and SP. Select BL-18 (Liver Transport, 肝俞 gān shù), LR-3 (Supreme Surge, 太冲 tài chōng), PC-6 (Inner Pass, 内关 nèi guān), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), GB-20 (Wind Pool, 风池 fēng chí), SP-10 (Sea of Blood, 血海 xuè hǎi), BL-23 (Kidney Transport, 肾俞 shèn shù), GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán), SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and SP-5 (Shang Hill, 商丘 shāng qiū); needle with drainage. For vacuity patterns, supplement BL-20 (Spleen Transport, 脾俞 pí shù), BL-21 (Stomach Transport, 胃俞 wèi shù), and BL-17 (Diaphragm Transport, 膈俞 gé shù). For fire patterns, drain LR-2 (Moving Between, 行间 xíng jiān), GB-43 (Pinched Ravine, 侠溪 xiá xī), and TB-6 (Branch Ditch, 支沟 zhī gōu).