Liver overactivity

This formula is able to free the constrained Liver-Qi and regulate the Spleen. It is a formula devised for stagnation of Liver-Qi, which may happen in a stressful situation. When Qi stagnates, the patient has fullness in the chest and distension of the hypochondria and abdomen. When Qi is not able to reach the extremities, the patient has cold fingers. If the Liver overacts on the Spleen, abdominal pain may also present. The patient may have a wiry pulse. 

Zhi Gan Cao is used as deputy to strengthen the Spleen and protect the Middle-Jiao. It is particularly useful when the Liver overacts on the Spleen. 

Among these herbs, Ban Xia can soothe the Stomach-Qi and Chen Pi can promote the Qi movement in the Upper- and Middle-Jiao. Both can remove the dampness, phlegm and food accumulation that often arises in the same syndrome. Xiang Yuan and Fo Shou are able to harmonize the Qi of the Liver and Stomach, and are particularly used in the condition where the Liver overacts on the Stomach. Xiang Fu is the most commonly used herb... 

Once the Liver-Qi stagnates, it easily overacts or insults the other organs. 

Dang Shen and Bai Zhu are able to tonify the Qi and strengthen the function of the Spleen. They are often used as assistants in a formula that treats Liver-Qi stagnation with Spleen-Qi deficiency. Another reason to use herbs which tonify the Spleen is that, as in a chronic condition of Liver-Qi stagnation, the Liver is almost always overacting on the Spleen. It is wise therefore to tonify the Spleen before it is badly weakened. 

Xiang Yuan and Fo Shou are bitter, sour and slightly warm, and enter the Liver, Spleen and Stomach meridians. They can effectively promote Liver-Qi movement, as well as soothing the Stomach-Qi. They are particularly used to treat the syndrome where Liver-Qi overacts on the Stomach and leads to distension in the gastric and hypochondriac regions, reduced appetite, vomiting and belching. 

Alternating diarrhea and constipation due to Liver-Qi overacting on the Stomach and Spleen use Bai Zhu [Atractylodis macrocephalae rhizoma) and Bai Shao Yao (Paeoniae radix lactiflora) to harmonize the Spleen and Liver use Fang Feng (Saposhnikoviae radix) and Chen Pi (Citri reticulatae pericarpium) to regulate the Qi. 

This formula can harmonize the functions of the Liver and the Spleen and can treat a condition of Liver-Qi overacting on the Spleen with disturbance of Qi movement in the Middle-Jiao. The manifestations are borborygmi, abdominal pain, an urge to defecate, and diarrhea with abdominal pain subsiding after completion. The tongue coating is thin and white and the pulse is wiry. 

It suggests the basic strategies in the case of the Liver-Qi overacting on the Spleen - to strengthen the Spleen, to reduce the Liver and to soothe the Qi. 

At the same time, the Kidney-Qi descends due to fear and shock, and the connection between the Kidney and the Heart is broken. The Liver-Qi overacts on the Spleen and the Qi in the Middle-Jiao is blocked. The Liver-fire and Heart-fire often flare up attacking the lung. These result in anxiety, rapid breathing, vigilance, night sweats, insomnia and poor concentration - even panic attacks and hyperventilation. 

This syndrome is generally referred to as disharmony between the Liver and Spleen. In fact, it can be divided into several sub-syndromes besides disharmony between the Liver and Spleen, such as disharmony between the Liver and Stomach, and disharmony between the Liver and Large Intestine. Since the Stomach and Large Intestine are directly finked to the transportation function of the Spleen, and both belong to Earth in the Five-Element theory, the liver often attacks these organs if it overacts on the Spleen. Hence they are often considered and discussed as one syndrome under the name of disharmony between the Liver and Spleen. 

As soon as the Spleen becomes weak, it becomes vulnerable to attack from the Liver. When the Liver-Qi overacts on the Spleen, the Qi is blocked in the Middle-Jiao. The Stomach-Qi cannot descend, thus fullness in the stomach, nausea and vomiting may occur the Spleen-Qi is unable to ascend, thus giving rise to diarrhea. 

If Liver-Qi overacts on the Spleen and Stomach, a thick coating can be found on the tongue, showing that the digestion is impaired. 

In clinical practice, this formula is used not only to relieve Shao Yang syndrome, but also to treat Qi stagnation in the Liver and Gall Bladder meridians when Liver-Qi overacts on the Stomach, impairing digestion and weakening the body s resistance. 

Tc-albumin microcolloid is metabolized in the Kupffer cells by proteolytic enzymes and eliminated from the liver (Reske et al. 1981 Taplin et al. 1964 a). In the case of Tc-albumin millimicrospheres, biological half-times of 10 min and 4.7 h were measured (Reske et al. 1981). In patients with overactive digestive function, RES " Tc-labeled degradation products have been observed in the bile, accumulating in the gallbladder during the first 2-3 h post-intravenous injection (Kitani and Taplin 1972). 

First-pass acetylation in the Gl mucosa and liver is related to genetic acetylator phenotype (8). Acetylation phenotype is an important determinant of the plasma concentrations of hydralazine when the same dose of hydralazine is administered orally. Slow acetylators have an autosomal recessive trait that results in a relative deficiency of the hepatic enzyme N-acetyl transferase, thus prolonging the elimination half-life of hydralazine (see Chapter 10). This population of hypertensive patients will require an adjustment in dose to reduce the increased overactive response. Approximately 50% of African Americans and Caucasians, and the majority of American Indians, Eskimos, and Orientals are rapid acetylators of hydralazine. This population of patients will have subtherapeutic plasma concentrations of hydralazine because of its rapid metabolism to inactive metabolites and shorter elimination times. Patients with hydralazine-induced systemic lupus erythematosus frequently are slow acetylators. 

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