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Liver yīn vacuity

肝阴虚 〔肝陰虛〕gān yīn xū

A disease pattern chiefly characterized by dizziness; dry eyes; rib-side pain; vacuity heat signs.

Description: Dizzy head and flowery vision; dry eyes; blurred vision (loss of visual acuity); tinnitus; dull scorching pain in the rib-side; tidal reddening of the cheeks; dry mouth and pharynx; vexing heat in the five hearts; postmeridian tidal heat effusion; night sweating; red tongue with scant fur and little liquid; a pulse that is stringlike, fine, and rapid; in some cases, wriggling of the extremities.

Diseases: Dizziness; rib-side pain; vacuity taxation; sweating; heat effusion; dry eyes.

Pathogenesis: Depletion of the yīn humor depriving the liver of nourishment and failing to restrain yáng. This may stem from any of the following factors:

Analysis of signs

Comparison: See table.

Comparison Between Liver Blood Vacuity and Liver Yīn Vacuity
Liver Blood Vacuity Liver Yīn Vacuity
Common SignsDizziness
Heat SignsNoneTidal heat effusion, tidal reddening of the cheeks
Other DifferencesBlurred vision, numbness and tingling, tremorDry eyes, wriggling of the extremities
PulseFineFine and rapid

Treatment

Medicinal therapy: Treat by nourishing yīn and emolliating the liver, using All-the-Way-Through Brew (一贯煎 yī guàn jiān). When eye and head signs are prominent, use Lycium Berry, Chrysanthemum, and Rehmannia Pill (杞菊地黄丸 qǐ jú dì huáng wán).

Acumoxatherapy: Base treatment mainly on back transport points, LR, GB, and KI. Select BL-18 (Liver Transport, 肝俞 gān shù), BL-17 (Diaphragm Transport, 膈俞 gé shù), BL-20 (Spleen Transport, 脾俞 pí shù), LR-3 (Supreme Surge, 太冲 tài chōng), BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with supplementation to supplement liver yīn and blood. For ascendant liver yáng, add GV-20 (Hundred Convergences, 百会 bǎi huì), GB-20 (Wind Pool, 风池 fēng chí), GB-43 (Pinched Ravine, 侠溪 xiá xī), and KI-1 (Gushing Spring, 湧泉 yǒng quán); needle with drainage.

Combined pattern: Liver-kidney yīn vacuity, characterized by dizziness, tinnitus, limp aching lumbus and knees, rib-side pain, and insomnia with vacuity heat signs. This pattern is often attributable to kidney disease affecting the liver (water failing to moisten wood).

Further developments: Insufficiency of liver yīn can leave liver yáng unrestrained, causing ascendant hyperactivity of liver yáng, and/or liver wind stirring internally.

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