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The four basic aspects of the liver. Liver qì and liver yáng, physiologically speaking, form a single entity, but the term liver yīn is considerably broader in meaning, including the essence referred to in Plain Questions (素问 sù wèn), which states, Food qì enters the stomach and sends essence to the liver. The liver’s yáng-qì and its yīn-blood under normal circumstances are interdependent and mutually counterbalancing. Liver yīn and liver blood nourish liver yáng qì, and also prevent it from stirring upward excessively, and when they fail to, a condition that easily develops is ascendant liver yáng. At the same time, liver yīn and liver blood are dependent on the liver qì’s function of governing free coursing to be able to nourish the limbs, the sinews and vessels, the eyes, and the thoroughfare (chōng) and controlling (rèn) vessels.

Diseases of the liver are most clearly understood in terms of the duality of yīn and yáng. The yáng qualities of the liver are seen in the phrases the liver thrives by orderly reaching and is prone to upbearing and stirring, for which reasons it is said to be the unyielding viscus. The diseases on the yáng side, liver qì depression and ascendant liver yáng, can both affect the yīn side. Liver qì depression can lead to liver blood stasis or qì can also transform into fire, damaging liver yīn and liver blood. Diseases on the yīn side can affect the yáng side. If liver yīn or liver blood are insufficient, the yáng qì of the liver is no longer kept in check and bears upward. Two other liver diseases demonstrate the yīn-yáng duality. Liver fire is the result of a transformation of depressed liver qì or else it occurs when damp-heat becomes depressed internally. Liver fire tends to affect the blood storage function, causing vomiting of blood, nosebleed, and profuse menstruation. The other of the two diseases, liver wind, is regarded as a movement of yáng qì due to severe yīn-yáng or qì-blood imbalance. Ascendant liver yáng, liver fire flaming, and insufficiency of liver yīn-blood (yīn, blood or both) can all give rise to liver wind.

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