Liver yīn vacuity

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:

• damage to yīn caused by liver fire flaming upward (often arising by depressed liver qì transforming into fire) or occurring in advanced-stage warm heat disease;
• enduring illness;
• kidney yīn vacuity (water failing to moisten wood).

Analysis of signs

• Liver signs: Dry eyes, dizzy head and vision; and dull scorching pain in the rib-side.
• Vacuity heat signs: Slight heat effusion; tidal heat effusion; vexing heat in the five hearts; night sweating; tidal reddening of the cheeks; emaciation, and dry mouth and pharynx.
• Tongue: Red with scant fur and little liquid. Pulse: Fine and rapid.

Comparison: See table.

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.