Liver-calming wind-extinguishing agents

Liver-calming wind-extinguishing medicinals are medicinals that either calm liver yáng in the treatment of hyperactivity of liver yáng or extinguish wind and check tetany in the treatment of liver wind stirring internally.

Liver-yáng–calming medicinals, also called liver-calming yáng-subduing medicinals, treat ascendant hyperactivity of liver yáng is a yīn-yáng imbalance. This arises when insufficiency of liver-kidney yīn fails to counteract liver yáng. It is characterized by dizziness, tinnitus, distension and pain in the head, and red face and eyes.

Wind-extinguishing tetany-checking medicinals treat liver wind stirring internally, which manifests in tetany (a generic term for various forms of severe spasm). Liver wind stirring internally can result from ascendant hyperactivity of liver yáng (referred to as liver yáng transforming into wind). It can also arise as a result of exuberant heat in febrile disease (extreme heat engendering wind).

Most liver-calming wind-extinguishing medicinals are cold or slightly cold in nature. Liver-yáng–calming medicinals are mostly bitter or salty, while wind-extinguishing tetany-checking agents are mostly acrid, sweet, or salty. All liver-calming wind-extinguishing medicinals enter the liver channel, and some enter the heart channel. They all have a downbearing action. Only quán xiē (Scorpio) and wú gōng (Scolopendra) are toxic.

Subcategories

• Liver-calming yáng-subduing agents
• Wind-extinguishing tetany-relieving agents

Properties

Nature: Most are cold or slightly cold. Some wind-extinguishing tetany-checking medicinals are balanced. Wú gōng (Scolopendra) is warm.

Flavor: Liver-calming yáng-subduing medicinals are mostly bitter or salty; wind-extinguishing tetany-checking medicinals are mostly acrid, sweet, or salty.

Channel entry: All enter the liver channel; some enter the heart channel.

Bearing: All have a downbearing action.

Toxicity: All are nontoxic except for quán xiē (Scorpio) and wú gōng (Scolopendra).

Actions

Liver-yáng–calming agents are also called liver-yáng–calming medicinals. Most are shells or minerals, and are conventionally described as calming the liver and subduing yáng. Vegetable and animal products other than shells are referred to as repressing liver yáng or calming the liver. However, this distinction has little significance. More significant are functional distinctions. Some clear liver heat, and are used for hyperactivity of liver yáng with pronounced liver fire signs; these are called heat-clearing liver-calming medicinals. Some also have a spirit-calming effect or an eye-brightening action.

Wind-extinguishing tetany-checking agents check tetany (various forms of severe spasm), which is attributed to liver wind stirring internally. Some have a heat-clearing action and treat exuberant heat stirring wind. These are called heat-clearing wind-extinguishing medicinals. Most wind-extinguishing tetany-checking medicinals also have a liver-calming yáng-subduing action, a heat-clearing toxin-resolving action, or an eye-brightening action.

Indications

Liver-calming wind-extinguishing agents treat ascendant hyperactivity of liver yáng (ascendant liver yáng) and liver wind stirring internally (liver wind).

Liver-calming yáng-subduing agents specifically treat ascendant liver yáng, which is a yīn-yáng imbalance resulting from liver-kidney yīn vacuity. Ascendant liver yáng is a repletion pattern arising from vacuity.

Wind-extinguishing tetany-checking agents specifically treat liver wind stirring internally. Liver wind can result from ascendant hyperactivity of liver yáng, from extreme heat in febrile disease, from blood vacuity, and from yīn vacuity. These conditions are known as liver yáng transforming into wind, extreme heat engendering wind, blood vacuity engendering wind, and yīn vacuity stirring wind. Wind-extinguishing tetany checking medicinals are mostly for the first two of these, which are repletion patterns.

Ascendant Hyperactivity of Liver Yáng (Ascendant Liver Yáng)

Pathomechanisms: Ascendant liver yáng is hyperactivity of yáng due to yīn vacuity, specifically liver-kidney vacuity, which arises by any of numerous factors, including liver depression transforming into fire that damages liver and kidney yīn. When in such cases water fails to moisten wood (kidney yīn fails to nourish liver yīn), yīn can no longer restrain yáng. While there is yīn vacuity in the lower body, yáng becomes hyperactive in the upper body, with qì and blood surging upward. This is a pattern of lower body vacuity and upper body repletion.

Signs: Dizziness, tinnitus, distension and pain in the head, red face and eyes. In some cases there is heavy body and light feet (a feeling of top-heaviness), and limp aching lumbus and knees. There is also impatience, agitation, and irascibility, heart palpitation, and insomnia. The tongue is red. The pulse is stringlike, fine, and rapid, or stringlike and forceful. Note that patients diagnosed as having ascendant hyperactivity of liver yáng often have high blood pressure, hyperthyroidism, Menière’s disease, or climacteric syndrome. However, it would be wrong to equate ascendant liver yáng rigidly with these diseases.

Treatment method: Calm the liver and subdue yáng. Also enrich yīn to address the underlying yīn vacuity.

Liver Yáng Transforming into Wind

Pathomechanism: This is a development of ascendant hyperactivity of liver yáng in which which the liver’s upbearing and effusing action becomes excessive and transforms into wind.

Signs: Dizziness that threatens collapse, headache, shaking head, tremor of the limbs, inhibited speech, and unsteady gait.

When wind is complicated by phlegm, a wind-phlegm pattern may arise. This is characterized by sudden clouding collapse that leaves the patient unconscious with deviated eyes and mouth, hemiplegia, stiffness of the tongue preventing speech, and the sound of phlegm in the throat. This is the classical type of wind stroke, which in many cases corresponds to cerebrovascular accident in Western medicine.

Treatment method: Calm the liver and extinguish wind. Also enrich yīn to address the underlying yīn vacuity.

Wind stroke patterns often involve phlegm, which has to be addressed in the treatment. Orifice-opening medicinals are often used to revive the patient.

Extreme Heat Engendering Wind (Exuberant Heat Engendering Wind)

Pathomechanism: Severe heat entering provisioning-blood in warm-heat disease or exuberant liver heat scorching the liver channel and depriving the sinews of nourishment, causing yáng qì to become unconstrained and transform into wind.

Signs: The chief signs are convulsions of the limbs, upward staring, and clenched jaw.

Treatment method: Clear heat, cool the liver, and extinguish wind.

Note that liver-calming yáng-subduing medicinals are only used for the above internal wind patterns. Yīn vacuity stirring wind, blood vacuity engendering wind, and blood dryness engendering wind are forms of internal wind that are essentially vacuity patterns and hence should be treated by supplementation rather than with liver-calming wind-extinguishing medicinals.

Combinations With Other Categories

Liver-Yáng–Calming Agents

Yīn vacuity: Because hyperactivity of liver yáng is a yīn-yáng disharmony, liver-calming yáng-subduing medicinals are invariably combined with agents that enrich and nourish liver and kidney yīn.

Liver yáng transforming into wind: Ascendant liver yáng easily transforms into wind, in which case wind-extinguishing tetany-checking medicinals are also used.

impatience, agitation, and irascibility: When liver fire is exuberant and gives rise to signs of this nature, agents that clear heat and drain liver fire are often used.

Disquieted heart spirit: When ascendant hyperactivity of liver yáng disquiets the heart spirit, giving rise to insomnia and palpitations, it is appropriate to use agents that quiet the heart spirit.

Wind-Extinguishing Tetany-Checking Agents

Ascendant hyperactivity of liver yáng: When liver wind stirring internally is due to ascendant hyperactivity of liver yáng, wind-extinguishing tetany-checking medicinals should be combined with ones that calm liver yáng.

Extreme heat engendering wind: Select medicinals that both clear the liver and extinguish wind, and combine them with medicinals that clear heat, drain fire, and resolve toxin.

Lockjaw: lockjaw is attributed to wind evil and manifests in signs of the kind associated with liver wind stirring internally. It is treated with wind-dispelling tetany-checking medicinals, which are combined with wind-dispelling agents.

Epilepsy with clouded spirit and convulsions due to phlegm turbidity: Combine wind-extinguishing tetany-checking medicinals with phlegm-transforming medicinals and orifice-opening medicinals .

Method Of Use And Warnings

Liver-Yáng–Calming Agents

Shells and minerals:The majority of liver-yáng–calming medicinals are shells and minerals. These are used in larger dosages than other medicinals, and they should be crushed before use. Very often they are calcined before use. Because they are difficult to digest, shells and minerals are often combined with medicinals that fortify the spleen and stomach. They should not be used for too long.

Wind-Extinguishing Tetany-Checking Agents

Some are toxic: Some wind-extinguishing tetany-checking medicinals are toxic and should not be used in excessively large quantities or in pregnancy.

Internal wind due to yīn vacuity or blood vacuity should be treated mainly by supplementing yīn or supplementing the blood, not with medicinals of this category.

Chronic fright wind due to spleen vacuity should not be treated with wind-extinguishing tetany-checking medicinals that are cold in nature.