Ghost Liver 肝魂 2011 04 28 draft 16A

 

Ghost Liver 肝魂

“In the name of the Father, of the Son, and of the Holy Ghost!”

 

My dear friend was diagnosed with hyperthyroidism 甲亢. 

Traditional Chinese medicine (TCM) calls it Liver fire flaring up 肝火上亢.

I took the Chinese diagnosis in good faith and advised my daughter accordingly.  Being concerned, I checked the physiology of the anatomical liver and the functions of the TCM Liver.  I was shocked.   

The Chinese Liver has abundant physiological functions not found in the anatomical liver.  I can find the anatomical liver with its physiology and functions clearly listed.  But I cannot find the Chinese Liver.  It does not exist as a composite single anatomical organ in the body.  I have searched, and it is not there.  It is a ghost–a ghost Liver!   

Calling it a ghost will upset doctors of traditional Chinese medicine.  We can call it a spirit, a soul, or even a god—the Liver god in our body.[1]  Perhaps it is both a god and a ghost, yang and yin, yang as god and yin as ghost.   In fact traditional Chinese medicine says: “The Heart is the abode of shen 神 (spirit); the Lungs are the abode of po魄 (ghost); the Liver is the abode of hun 魂 (soul); the Spleen is the abode of yi意 (thoughts); the Kidneys are the abode of zhi志 (will).  心藏神, 肺藏魄, 肝藏魂, 脾藏意, 肾藏志.”[2]

 

Comment: Communist materialism and language deny the existence of god, spirit, and soul, all of which they declare as just matter in fine forms.唯物论否定神魂魄存在,只物质精微云耳。       

Question:  How did traditional Chinese medicine come to create this ghost Liver in the human body? 

Conjecture:  Chinese primates saw and understood nature as the sky, the earth, thunder, wind, water, fire, mountains, and lakes, and drew eight trigrams to symbolize them.  Later, a primitive theoretical physicist conceptualised the same nature as the five elements and processes of wood, fire, earth, metal, and water.  Medical scholars accordingly ‘looked’ for the organs and functions of the body, shelving them under five labels: liver-wood, fire-heart, earth-spleen, metal-lungs, and water-kidneys.  They made fantastic ‘mistakes’ forming the wonderful theory of traditional Chinese medicine, alternately known as absurd metaphysical ‘nonsense’ to science-based medicine. 

    The nonsense works! 

 

 

SMPTOMS

 

Graves Disease: Chinese Cure

 

温哥华北京中医学院<中医诊断学>学生问题 Question by a student of the course “Diagnosis in traditional Chinese medicine”, Vancouver Beijing College of Chinese Medicine, July 2010:

 

格雷夫斯氏病 (甲状腺机能亢进) 西医所列症状, 中医诊断学如何代表, 如何八纲辨别, 定其病因为何, 如何定其病症之气血, 津液, 脏腑, 经络, 六经, 营卫病状?

How does traditional Chinese medicine call the symptoms of Graves disease (hyperthyroidism) in terms of the “Eight Types” of disease conditions?  What does it decide as the causes?  How is the patient affected in terms of their qi  (energy) and blood, fluids, storage and transport organs, channels and network vessels, the six-merdians, nutrition and the defence (and immune) system?       

 挚友真實病案問老師 Real case of a dear friend

Symptoms 症状

“Before I took medication 服西藥前:

Symptoms

  • Anxiety?   Yes. 焦慮.
  • Vision affected?   I felt I had a film over my eyes; I found it hard to focus; I felt a glare; and my doctor said I looked as if I was staring. 視力影響: 若眼前有一層膜; 難以聚焦; 覺有強烈光; 醫生說我好像瞪眼看物.
  • Eyeballs that stick out (exophthalmosexophthalmos)?  No. 沒有突眼.
  • Fatigue (exhaustion)?  Extreme極度疲倦.
  • Frequent bowel movements? Diarhea for two weeks瀉了兩星期.
  • GoiterGoiter (possible)?  No. 沒有腫頸.
  • Heat intolerance?  Extreme: sweating all of a sudden.Heat intolerance
  • Increased appetiteIncreased appetite?  No. 不耐熱, 突然大汗.
  • Increased sweating?  (See above.)
  • Insomnia?   Yes. 失眠。
  • Menstrual irregularitiesMenstrual irregularities?  Yes 月經不調
  • Muscle weakness?  In limbs, i.e. arms and legs. 四肢軟弱無力.
  • Nervousness?  Yes. 緊張。
  • Rapid or irregular heartbeat (palpitationspalpitations or arrhythmia)?  Yes. 心跳急速或不平穩。
  • RestlessnessRestlessness and difficulty sleeping?  Yes. 坐立不安。
  • Shortness of breath with exertion ?   Yes. 用力短氣。
  • Tremor?  In hands, a little. 畧微手抖振。
  • Weight loss?  Weight loss Yes Lost 11 lbs no matter how much I ate.  失重。 無論吃多少還是失重了十一英磅,約五公斤多。
  • Late onset, whereas most hyperthyroidism women patients have the disease between 20 and 30.  What does this tell?  此病女性病人多是20-30嵗發病, 我卻中年發病有什麽意義?”
  •  

Recorded by KWAN Lihuen 關理煊

2010-07-23

 

Student’s Diagnosis and Prescription

—– Original Message —–

From: Lihuen Kwan

To: Dr ZHANG Shurong

C.c.: Dr HO Yu-Ping

Sent: Thursday, July 29, 2010 6:32 PM

Subject: Diagnosing and Treating Hyperthyroidism

  老師說我們不在醫院,可常練習診斷治療自己,同學們,和親友.Our teacher said that, since we do not have access to hospitals of traditional Chinese medicine in China, we could practise diagnosis and treatment on ourselves, our schoolmates, and our loved ones, relatives, and friends.

  附件我學習診斷親友甲亢病辯證論治筆記並問題.我翻譯.Attached is my study notes, with my translation, of a loved one’s hyperthyroidism, together with my question to our teacher, my diagnosis in terms of the Eight Types of syndroms, and my recommendation for treatment with physiotherapy and herbs.  

  我的"病人"望,(聼)聞診斷:雖吃西藥一月,得囘吃西藥前所失十一英磅(約六公斤),如前不消廋.唯獨今仍緊張,急躁,不耐煩,易怒,言語急速.思維決斷快捷,知善惡,卻不許問病情.背光不得見其神色,只見其行動敏捷,卻能不動坐沙發五分鐘電話對話,英語異常流利快速,語法無誤,反應對答特快,壓倒對方.兩手不震抖.不得見舌色苔色舌厚薄清膩.電話完畢,我不敢問睡眠等,不敢請就範切脈,免其大怒失控.見面後十分鐘我告別.黃昏卻來電話感謝.

My ‘patient’, judging from my visual and listening diagnosis, though she had taken science-based drugs for a month and has regained her 11 lbs (about 6 kilograms) and is, as months ago before the disease, not skinny at all; is this day still ‘jitteryand and hyperactive’, impatient, irritable, quick in speech, but quick in thinking and decisions, knows right from wrong but would not allow questions about her condition.  She has her back towards the summer sun and I could not see her face colour and spirit.  But could see her movements were swift and decisive.  But she was able to sit still on her sofa without movements or tremor in her hands, conversing intelligently on the phone for five minutes, with quick answers to and ‘winning’ over the other party.  She spoke English very fluently and quickly without grammatical mistakes.  I could not see her tongue for the colour or the coating.  When she finished her phone conversation, I did not dare ask to feel her pulse, so as not to make her lose her temper.  After the 10-minute visit, I said goodbye.  In the evening, she phoned to say thanks.

  斷其仍肝火上冒.宜打坐定神,太極拳也好.肝腎陰虛,可服杞菊地黃丸滋腎養肝.猜其睡不安寧,睡眠不足而煩躁,可服酸棗仁湯片.未知兩中藥與所服西藥有否反忌,可惜暫不能問其西藥藥名.

      My diagnosis is that the patient’s kidney-water is deficient, with her liver-fire ravaging her, making her very irritable.  I should recommend physiotherapy of meditation or Tai Chi to calm mind.  She could take Goji-chrysanthemum Dihuang pills to “moisten the kidney to nourish the liver.”  I guess she has not been sleeping soundly and much, for which I should prescribe Zizyphus semini tablets to relieve her of her irritability and poor sleep.  But I do not know whether the herbs would conflict with her science-based medication.  It is a pity that I could not yet ask her the names of the science-based medication she was taking.       

  請老師,艾格思教授,何譽丙醫師,和同學們慈悲批評錯誤.Please, teachers and schoolmates, be so kind as to criticize my mistakes, for the sake of the patient.

       With best wishes,

Your junior in the discipline,

KWAN Lihuen ‘kowtows’ 

後學關理煊頓首

 

Liver Science

Liver Physiology[3]

 

Liver Function

The liver receives 30% of the resting cardiac output and acts as a giant chemical processing plant in the body. These chemical reactions, called metabolism, are central in the regulation of body homeostasis.

The liver cells, called hepatocytes, contain thousands of enzymes essential to perform vital metabolic functions. They are supermodels in the world of cellular metabolism.

The liver metabolises both beneficial and harmful substances. It stores nutrients and other useful substances, as well as detoxifying or breaking down harmful compounds. These can be then excreted from the body in bile via the liver; in urine via the kidney, or by other means.

 

1.  Nutrient Metabolism

The liver is involved in the metabolism of nutrients. It receives digestive products in the form of glucose, amino acids and fatty acids and glycerol.

The metabolism of carbohydrate, fat and protein takes place in the liver, although specific functions are carried out by fat depots and skeletal muscle. Metabolic end products are often stored in the liver and utilized at a later stage if required.

How the hepatocytes deal with the nutrients depend on whether each nutrient is in abundance or whether levels are low in the body and they are therefore in demand. The hepatocytes alter their metabolic pathways accordingly.

 

2.  Storage

The liver plays an important role as a storage facility. The hepatocytes take up many types of vitamins and minerals from the blood and store them. These include vitamins A, B12, D, E, K and minerals like iron and copper.

Glycogen which is formed from excess glucose is also stored by the liver, although muscle tissue can also store glycogen too.

 

3.  Bile

The liver synthesises bile which is important for fat digestion and is also a route of excretion from the body. Bile consists of water, bile salts, cholesterol, phospholipids, electrolytes and bile pigments which give it its typical yellowy-green colour.

Bile is stored and concentrated in the gall bladder. The presence of fats in the gut during meals stimulates the gall bladder to empty. Bile enters the duodenum emulsifying fats into smaller globules, which can then be broken down further by lipase enzymes.

Metabolic wastes and drug products may form part of the bile which can then be excreted from the body through the digestive tract in the faeces. Bilirubin, the toxic end product of haemoglobin breakdown, is excreted from the body in this way.

 

4.  Detoxification

The liver is vital for the detoxification and destruction of endogenous and exogenous substances that are harmful to the body.

The liver’s own phagocytes which reside within the lobules, known as Kupffer cells, digest and destroy cellular debris and any invading bacteria.

Other exogenous substances such as drugs and alcohol are detoxified by the liver. Endogenous substances (or those produced by the body), are also dealt with by the liver. Amino acids are deaminated, some hormones are inactivated, and bilirubin, a product of the breakdown of old red blood cells, is also detoxified and rendered harmless by liver metabolism.

 

5.  Carbohydrate

Glucose is a vital energy source for cells and levels in the blood stream must remain constant. The liver helps maintain blood glucose levels in response to the pancreatic hormones insulin and glucagon.

After a meal, glucose enters the liver and levels of blood glucose rise. This excess glucose is dealt with by glycogenesis in which the liver converts glucose into glycogen for storage. The glucose that is not stored is used to produce energy by a process called glycolysis. This occurs in every cell in the body.

 

6.  Protein

Amino acids are transported to the liver during digestion and most of the body’s protein is synthesised here.

If protein is in excess, amino acids can be converted into fat and stored in fat depots, or if required, made into glucose for energy by gluconeogenesis which has already been mentioned.

However, before amino acids can be utilized in these ways, the first step is to remove the nitrogen-containing amino group NH2. This very important metabolic process is called deamination.

In the hepatocytes, NH2 (the amino group) quickly changes into ammonia NH3, which is highly toxic to the body. The liver acts fast to convert ammonia into urea that then can be excreted in the urine and eliminated from the body. 

 

7.  Fat

The liver is involved in fat metabolism and synthesises lipoproteins, cholesterol and phospholipids essential for many body functions. Lipids also provide a valuable alternative energy source to glucose and so the metabolic fate of fats and lipids will depend on the levels of intake in the diet and energy expenditure.

If fat is in excess, the liver prepares for storage. Lipogenesis is the metabolic process in which fats, composed of fatty acids and glycerol, are converted for storage in subcutaneous tissue and other storage depots.

If energy and glucose levels are low, stored fat is converted back into glycerol and fatty acids by a process called lipolysis. This occur in adipose cells, but the fatty acids and glycerol are transported to the liver for use as an alternative energy supply.

 

 

 

 

 

 

 

 

 

 

 

 

Traditional Chinese Medicine 中医

Liver Myth

 

Liver 肝 [4]

 

“Its major functions are to govern free flow of qi 主疏泄and store blood 藏血.  The liver and gallbladder form an exterior-interior relationship through affiliation and connection of their meridians.  The liver is associated with tendons in constituent 在体合筋, reflects its brilliance in the nails 其华在爪, and is associated with anger in emotion 在志为怒, with the eye in orifice 在窍为目, and with tear in secretion 在液为泪.  The liver is characterized by ascent and motion of its qi 肝性主升, 主动, and its qi tends to be flourishing and free from obstruction 喜条达而恶抑郁, therefore the liver has its name of ‘resolute organ 刚脏’.

Liver Myth[5]

    Liver [gan 肝][6]

The (ghost) Liver is most closely connected with the Blood and at the same time tempers and “softens” Energy. The (ghost) Liver is exquisitely sensitive to boundaries and demarcations and maintains the smoothness and of movement throughout the body.  The Yellow Emperor’s Inner Classic metaphorically calls the (ghost) Liver “the general of an army”[7] because it ultimately embodies a refined assertiveness that is timely, skilful, and strategic and forcefulness yet remains mobile and flexible.[8]  

 

Liver Metaphysics?

 

Major Functions of the Liver

 

(A) The liver governs free flow of qi 肝主疏泄:  This function connotes that the liver possesses the action to smooth (疏通,畅达)the qi dynamic (气机)of the whole body.  Qi dynamic means the motion of qi.  The function of the liver in governing free flow of qi plays an important regulatory role of ascending, descending, exiting and entering of qi in every viscus and tissue so as to guarantee the freedom of the whole body’s qi dynamic, and in turn to promote the circulation and distribution of essence, blood and body fluid, transformation and transportation by the spleen and stomach, secretion and excretion of bile, smoothness of sentiment, ejaculation in men and menstruation in women, influencing the body extensively.  The major effects of the governing free flow of qi by the liver are as follows.

1.  Smoothing of qi dynamic 调畅气机:  The liver is physiologically characterized by ascent and motion of its qi.  The government of free flow of qi by the liver can both make qi dynamic free from obstruction and avoid qi stagnation.  So when the liver functions normally in government of free flow of qi, the qi dynamic will be smooth, with harmony of qi and blood, smoothness of meridians and collaterals and normal activities of the viscera.  If the liver gets abnormal in government of free flow of qi, it may present with hypofunction in government of qi flow, then the ascent of qi will be insufficient, the qi dynamic will be obstructed, with physiological changes of un-freedom and stagnation of qi dynamic manifesting as distending pain and discomfort of the chest, hypochondria, two breasts, or lateral parts of the lower abdomen; on the other hand it also may present with hyperthyroidism, then the ascent of qi will be hyperactive, with resultant physiological changes of adverse rising of liver qi manifesting as distending pain of the head and eyes red face and eyes, irritability, or even adverse rising of blood following qi with hematemesis and hemoptsis.[9]

Liver Myth

 

“The (ghost)  Liver’s Blood’s ability to temper the Energy has been characterized as “the (ghost)  Liver rules flowing and spreading [shuxie 疏泄][10] A modern Chinese text uses the word sprinkle to describe its gentle touch.[11]  The Yellow Emperor’s Inner Classic says “The (ghost)  Liver is the foundation of curtailing extremes.[12]  One classic herbal formula to restore the (ghost)  Liver’s Blood effect on energy is named “The Free and Easy Wanderer Pill” (also translated as “Rambling Powder)[13] The (ghost)  Liver fosters a relaxed, easygoing internal environment—an even disposition.  Creating this ambience can be thought of as the function of the (ghost)  liver, as well as a basic need of the (ghost)  Liver itself.

        “The (ghost)  Liver’s Blood, by first tempering the (ghost) Liver’s energy and then the entire body’s energy, ensures the smooth movement of energy.  And all activity that depends on energy depends also on the (ghost)  Liver.  Any impairment of the (ghost)  Liver function can influence the circulation of energy and Blood, leading to either Stagnant Energy or Congealed Blood.  The (ghost) Liver energy often becomes stuck and blocked in its own pathways and will then manifest symptoms such as pain or distention in the flanks, swollen or painful breasts and genitals, gas distentoin, or lower abdominal pain.  If the stagnation affects the psyche, a sense of frustration, being hampered, or edginess can easily develop.”[14]  

Comment: Now I understand why traditional Chinese medicine (TCM) diagnoses my daughter’s hyperthyroidism as ‘up-flaring of her (ghost) liver fire 肝火炎上.”  It is not saying that the anatomical liver’s fire is burning her; it is her ghost Liver that is struggling for freedom and growth, like her roots, stem and branches struggling to break through earth and rocks for space, life, air and the sun  .  (Kwan 2010-09-22)

 

Liver Sense or Nonsense?

2.  促进血液与津液的运行 Promoting circulation of blood and body fluid:

Makes sense as myth.

 

3.  促进脾胃的运化功能Promoting transformation and transportation of the spleen and stomach:

So I understand why my daughter had a great appetite but still lost ten pounds.

 

4.  有助于胆汁的分泌排泄Helping secretion and excretion of bile:

 

5.  调畅情志Smoothing emotion:

Makes sense to prescribe the natural herbs Xiakucao (Common Selfheal Fruitspike, Spica Prunellae Vulgaris, prunella vulgaris L.) which is bitter, pungent and medically cold that goes via the meridians of and to the destination of the Liver and the Gallbladder); and wild chrysanthemum which is pungent, sweet, bitter and slightly medically cold and travels along and to the destinations of the Lung and the Liver.     

 

6.  有助于男子排精和女子行经Being conducive to ejaculation in men and menstruation in women:

 

 

(B) The liver stores blood:

 

Liver Myth

    “The (ghost) Liver stores the Blood.”[15] The (ghost) Liver’s Blood is responsible for softening the Energy and ensuring the Energy’s dynamic strength is not too tense, restless, and awkward.  The (ghost) Liver’s Blood is the essential balance for the Energy, especially the (ghost) Spleen’s energy, and the (ghost) Liver’s own energy.  The (ghost) Liver’s Blood is responsible for the repetitive cycles of human life.  A woman’s menstrual cycle depends on the (ghost) Liver’s Blood, and disharmonious (ghost) Liver Blood can make an irregular or painful menstruation.”[16]

 

Liver Nonsense?

 

(C)  肝与体, 志, 窍, 液的关系  Relations of the liver with Constituent, Emotion, Orifice and Secretion

 

(i) The liver is associated with the tendons in constituent 在体合筋,

Comment: nonsense for science-based anatomical liver.

 

(ii)  (The liver) reflects its brilliance in the nails 其华在爪:

Comment: nonsense for science-based anatomical liver.

 

(iii) The liver is associated with anger in emotion 在志为怒:

Comment: So I understand why my daughter was impatient and irritable.  But this is nonsense to the science-based anatomical liver, that it has anything to do with anger: it is the anatomical thyroid in hyperthyroidism that made my daughter impatient and irritable.       

 

(iv) The liver is associated with the eyes in orifice 在窍为目:

Comment: So I understand why my daughter’s doctor said she was staring.  But this is nonsense to the science-based anatomical liver, that it has anything to do with the eyes: it is the anatomical thyroid in hyperthyroidism that causes the staring, not the liver.    

 

(v) The liver is associated with tear in secretion 在液为泪:

 

Summery

 

The science-based anatomical liver has seven functions or aspects:

1.     Nutrient Metabolism            (Ghost Liver function 3.)

2.     Storage                                    (Ghost Liver function (B).)

3.     Bile                                            (Ghost Liver functin 4.)

4.     Detoxification                   (Absent in Ghost Liver functions.)

5.     Carbohydrate                            (Ghost Liver function 3.)

6.     Protein                                      (Ghost Liver function 3.)

7.     Fat                                             (Ghost Liver function 3.)

 

The Chinese ghost Liver has eleven functions

(A)                        肝主疏泄Governs free flow of qi

1.     调畅气机Smoothing of qi dynamic

2.     促进血液与津液的运行 Promoting circulation of blood and body fluid

  1. 促进脾胃的运化功能Promoting transformation and transportation of the spleen and stomach
  2. 有助于胆汁的分泌排泄Helping secretion and excretion of bile
  3. 调畅情志Smoothing emotion
  4. 有助于男子排精和女子行经Being conducive to ejaculation in men and menstruation in women

        

(B)   肝主藏血 The liver stores blood

(C)                          肝与体, 志, 窍, 液 的关系 Relation of the liver with Constituent, Emotion, Orifice and Secretion

7.     在体合筋Associated with the tendons

8.     其华在爪 Reflects its brilliance in the nails

9.     在志为怒Associated with anger

10.   在窍为目Associated with the eyes

11.   在液为泪Associated with tear

The CTM ghost Liver has six of the seven functions of the science-based anatomical liver, short of detoxification. Not bad at all for the legendary ‘Yellow Emperor’ five thousand years ago.

 

The science-based anatomical liver is short of the CTM ghost Liver functions of

(A), 1, 2. 5. 6, 7, 8, 9., 10, 11.   That is a lot short. 

(A), 1, 5, 7, 9, 10 are related to the anatomical thyroid. 

Conclusion:  The ghost Liver includes the anatomical thyroid!       

Conjecture:  The ghost Liver is not a single anatomical ‘organ’ of the body.  It is a system—the Liver system.  It is a process—the Liver process.   This process is the wood process. 

Chinese physiology, i.e. traditional Chinese medical physiology, simply has five processes, viz. wood process, fire process, earth process, metal process, and water process.  Each process is subdivided into yin and yang. 

For example, the yin-wood process is represented by the ghost Liver; the yang-wood process is represented by the ghost gallbladder. 

The ghost Liver includes the anatomical thyroid and its functions. 

Conjecture: Treating the ghost Liver can cure some mal-functions of the anatomical thyroid, e.g. hyperthyroidism or hypothyroidism,

Conjecture: Traditional Chinese medicine, theory and treatments, can cure hyperthyroidism, without the side effects of science-based drugs, radiation, or surgery. 

These conjectures have to be severely tested

Thesis:  Saying that the Liver is responsible for hyperthyroidism is misleading, confusing, and absurd nonsense to and can be easily refuted by science-based medicine.  Saying that the wood process in the body is responsible for hyperthyroidism is a creative theory that can be severely tested as true science or, if not tested, fit is only myth, metaphysics, pseudo-science, or nonsense. 

 

 

 

 

TEST

     —- Original Message —–

From: judith buber agassi and joseph agassi

To: ‘Lihuen Kwan’

Cc: ‘Prof. LI Wenpei 李文沛教授’ ; ‘Dr HO YB 何譽丙中醫師’ ;

Sent: Tuesday, July 27, 2010 3:55 AM

Subject: RE: Hyperthyroidism Chinese diagnosis

My dear Lihuen,

Not being sufficiently familiar with medicine, scientific or traditional, east or west, it is not for me to go into details of what and how much I understand of the material you have kindly sent me. Yet some impressions strike me; allow me to put them as diffidently as possible.

There are always variants; always. So when one goes to test a theory or a cure one has to be clear as to what variant one is testing. This is not always heeded. I have some familiarity with the Freudian literature, and this includes quite a few semi-Freudian, quasi-Freudian, pseudo-Freidan and post-Freudian variants. Since most tests of this theory are not explicit enough, it is not clear what variant is tested and so the tests are all, a priori, of very little value. This seems to me in need of careful specification. Since the traditional etiology is vague and the prescriptions are varied, it is very hard to test a prescription, not to say a theory. This makes specification ever so more important. One has to specify briefly  (1) the theory or the prescription, preferably both, (2) the prediction and only then (3) the observation to compare the prediction with.

Nevertheless, with some commonsense, it may be possible to test the most significant variant. This is a procedure that will take some effort and a lot of money. Do you think you are in position to undertake this? If yes, clearly, the right place to do so is Hong Kong and the first thing to do is to ask for a grant. 

Hoping that this is of some help,

Joseph

Page 18 of 3

Hyperthyroidism Chinese Diagnosis

 

甲亢中医辩证

 

“Etiology 病因

According to Traditional Chinese Medicine, hyperthyroidism is a combination of qi and yin deficiencies, Liver fire uprising, and phlegm stagnation. Qi and yin deficiencies are the fundamental causes, while the symptoms and signs show Liver fire and phlegm stagnation. Correlated with western medicine, Liver fire corresponds to the continuous excitation caused by excessive thyroid hormone; Qi and yin deficiencies represent the weakness and fatigue of the body from prolonged over-stimulation; and phlegm stagnation is illustrated in the enlargement of the thyroid gland. The root of hyperthyroidism is deficiency; the symptoms are excess. Treatment, therefore, must address both the cause and the symptoms simultaneously.

Differential Diagnosis 辩证

It is important to differentiate excess or deficiency in hyperthyroid patients in order to give the most appropriate formula. The three organs involved include the Liver, Heart and Kidney. Besides clearing heat, it is also important to nourish the yin….

1. Liver Fire 肝火

2. Qi and Yin Deficiencies 气与阴虚

3. Qi and Phlegm Stagnation 气与痰滞

4. Liver, Kidney and Heart Yin Deficiencies 肝, 肾, 心阴虚

5. Liver Fire with Phlegm and Underlying Qi and Yin Deficiencies 肝火夹痰, 气与阴虚

 

“I. Liver Fire 肝火

Clinical Manifestation 临床表現

Fidgeting 煩躁坐立不安, irritability 急躁易怒, increased appetite 多食善饥, palpitation 心悸, red tongue 舌红, yellow thin coat 苔黄薄, and wiry rapid pulse 脉弦急.

Herbal Formula 藥方

Zhi Zi Qing Gan Tang清肝汤  (Gardenia Decoction to Clear Liver) – Clears the Liver and purges fire.

Page 19 of 3

“II. Qi and Yin Deficiencies气与阴虚

Clinical Manifestation 临床表现

Fatigue 疲倦, shortness of breath 短气, dry eyes 目干, palpitation 心悸, profuse perspiration 大汗, disturbed sleep 不寐, dry mouth 口干, decreased fluid intake 少喝, hand tremor 手震抖, red tongue 舌红, thin coat 苔薄, deep thready rapid pulse 脉沉弦急.

Herbal Formula

Yi Guan Jian (Linking Decoction) – Tonifies qi and yin, softens the Liver, and calms the Heart.

 

 

“III. Qi and Phlegm Stagnation 气与痰滞

Clinical Manifestation 临床表现

Irritability 烦躁坐立不安, feeling of oppression in the chest 胸觉郁压, plum-seed syndrome, enlargement of the thyroid gland 甲状腺大, red tongue 舌干 thin greasy tongue coat 舌苔薄腻, wiry or slippery-wiry pulse 脉弦或滑弦.

Herbal Formula

Chai Hu Shu Gan Tang 柴胡疏肝汤 (Bupleurum Powder to Spread the Liver) and Ban Xia Hou Po Tang 半夏厚朴汤 (Pinellia and Magnolia Bark Decoction) – Resolve phlegm, regulate qi circulation, and soothe the Liver.

Chai Hu Shu Gan Tang (Bupleurum Powder to Spread the Liver)

Ban Xia Hou Po Tang (Pinellia and Magnolia Bark Decoction)

 

“IV. Liver, Kidney and Heart Yin Deficiences , , 心阴虚

Clinical Manifestation 临床表现

Irritability 烦躁坐立不安, insomnia or light sleep 失眠或睡不熟, tremors 震抖, emaciation 消瘦, dry mouth and throat 口喉干, red tongue 舌红, scanty or no coating 少苔或无苔, thready and rapid pulse 脉弦急.

Herbal Formula

Tian Wang Bu Xin Dan 天王补心丹 (Emperor of Heaven’s Special Pill to Tonify the Heart) and Zhi Bai Di Huang Wan 知柏地黄丸 (Anemarrhena, Phellodendron, and Rehmannia Pills)

 

Page 20 of 3

“V. Liver Fire with Phlegm and Underlying Qi and Yin Deficiencies 肝火夹痰, 气与阴虚

Clinical Manifestation 临床表现

Low-grade fever, tachycardia (90–120 heartbeats per minute), tremors of the tongue and fingers, enlarged thyroid glands, unilateral or bilateral swollen and bulging eyes, palpitations or tachycardia, fatigue, weight loss, fidgeting, irritability, bad temper, aversion to heat, perspiration, hunger and increased appetite, increased blood pressure, etc.  

Herbal Formula

Imperical Formula for Hyperthyroidism

Study notes copied from Cr John CHEN, Ph.D., Pharm.D., O.M.D.., L.Ac.

ABOUT THE AUTHOR:

Dr. John Chen is a recognized authority in both western pharmacology and Chinese Herbal Medicine. He teaches at the USC School of Pharmacy, Emperor’s College, Yo San University of TCM, OCOM, Five Branches, AOMA and ACTCM. Dr. Chen’s most recent published work is Chinese Medical Herbology and Pharmacology (2003, AOM Press) and Chinese Herbal Formulas and Applications (2008, AOM Press) for which he was the lead author.

Copyright © 2010 Lotus Institute of Integrative Medicine. All Rights Reserved. eLOTUS UPDATE January 2010

Student’s study notes copied for discussion with teacher(s) only.  Chinese translation by KWAN Lihuen for his Chinese teacher to read and discuss. 

These notes constitute answers to my question to my teacher in “Diagnosis in Chinese Medicine”: How does traditional Chinese medicine in its own terms ‘diagnose’ hyperthyroidism? 

KWAN Lihuen 关理煊

Canada 2010-07-26 draft 1  

 

 

 

 

 

 

CONSISTENCY?

 

If multiple theories and explanations in traditional Chinese medicine for hyperthyroidism contradict one another, we know that those theories and explanations cannot be all true.

Let us now present here another such theory and diagnosis pattern in traditional Chinese medicine for hyperthyroidism, and see if we shall encounter contradictions with what we have been told so far.  Contradictions mean errors, which have to be eliminated.  Science is the unending elimination of errors.  For traditional Chinese medicine to be science, it must for ever eliminate its errors.      

 

 

 

Hyperthyroidism and Anger

 

Cause

This Chinese word means ‘crowded growth of many trees樹木叢生.’  

It is the nature of trees and plants to grow and spread out in different directions.  It is the same with the Liver wood system in traditional Chinese medicine (CTM).  When this nature is thwarted, depressed, compressed, suppressed, or oppressed, the energy in anger of the Liver system bursts into fire and flares up exuberantly, with symptoms of hyperthyroidism.      

It can be caused by prolonged emotional frustration, or sudden emotional change (shock), resulting in ‘depression and knotting’ of the energy of the Liver system.  長期情志不暢, 或情緒驟變. 致肝氣鬱結. It can be caused by emotional depression 精神抑鬱, or severe emotional hurt 劇烈精神創傷.[17] 

 

 

Therapeutic Drink

 

Ingredients[18]:

1.  Wild crysanthemum flowers 野菊花,’ which ‘clears away liver heat’ and ‘calms the liver’[19]

2.  夏枯草

English name: Common Selfheal Fruitspike

Pharmaceutical name: Spica Prunellae Vulgaris

Botanical name: Prunella vulgaris L.

Functions: ‘clear away liver-fire.’[20]

3.  Add a little honey if you like. 

Drink this beverage any time.

Irritable and sleepless 烦躁不眠?

 

Sunzaoren tablets 酸枣仁汤片

(Available, in bottled tablets, in Chinese herbal stores.  About $2.00.)

 

 

Mental Healing

 

Do your best to stay cheerful.[21]  Hobbies are good, e.g. music, art, gardening, flowers, watch and listen to birds.  It is all right to pursue your goals for a meaningful life, which will give you a positive and cheerful attitude.  The body affects the mind; so does the mind affect the body.    

 

Physiotherapy

 

Tai Chi[22]

 

Question: Pregnancy?

All right six months after being well-healed, for the good of the fetus[23]

KWAN Lihuen 關理煊Canada 2010-08-10 

File: “Hyperthyroidism & Anger” draft 1 稿 308 words 字.

——-ooo0ooo——-

 

 

Epilogue

      —– Original Message —–

From: KWAN Lihuen

Cc:  Prof J Agassi 艾格思教授; Prof. LAM

Sent: Sunday, April 17, 2011 6:16 AM

Subject: “Ghost Liver” draft 12

My dear friend,

    Attached is my paper, with my understanding and findings so far, on your Graves Disease. 

    Our body affects our mind; so does our mind affect our body.  Healing our mind can also heal our body.  I sincerely ask you to consider meditation and Tai Chi to heal your mind, which will heal your thyroid.  Irritability is both mind and body. Meditation heals the mind, and Tai Chi heals the thyroid.  (Please see pages 24-25 of my attached paper.)

    This does not conflict with your Western drugs, which you are right not to mix with Chinese herbs taken at the same time.  You know well the side effects and consequence of your drugs if taken for a long time.

    Meditation and Tai Chi may heal you from dependence on drugs, which may be needed for acute conditions and symptoms.  For example, antibiotics and surgery may be necessary for emergencies, when mild treatments and care may be better for chronic conditions that last for months or years. 

    I do care about your illness.  I pray for you practically every day.  What else can I do for you?

       Wishing you good health and happiness,

               Yours sincerely,

                            Kwan                       

P.S.  I copy my paper and thoughts to my teacher Professor Agassi to check for my mistakes.                         

—– Original Message —–

From: Prof. Joseph Agassi

Sent: Monday, April 18, 2011 1:27 AM

Subject: RE: “Ghost Liver” draft 12

My dear Lihuen,

my ability to examine your paper is very limited, as you have heard me say quite a few times. But your letter to your dear friend is more in my line, so if you want criticism of it, here it is; if not, just skip it.

you presume to know what can provide your dear friend with peace of mind. This is an error. We do not know these things. Even about one’s own self one is too ignorant and one has to observe oneself and judge for oneself what if anything gives one peace of mind. Hopefully your prayers give you peace of mind; it seems walking does too. So let me wish you success in this department.

With best wishes to you and to your dear friend,

Joseph Agassi

Peace of Mind

 —–oo0oo—–

KWAN Lihuen 關理煊 (LH Kwan 关健)

Canada 2011-04-28 draft 16A 稿 for WordPress blog  


[1] Your terminological question seems to me least interesting.  Whether you usegod or demon or spirit does not affect the meaning of your text, so it does not matter at all. Whenever in my experience terminological questions like yours take place, if the meaning is not in question, my disposition is to choose the wrong term. 

As to the view of traditional medicine, Chinese or any other, it does not seem to me possible for me to comment on matters that tradition had obviously no knowledge of. If it were incumbent on me to comment, it would be only after taking seriously the symptoms as seen traditionally and giving them a proper traditional diagnosis.  (Professor Joseph Agassi 2010-09-25.)

 

[2]  <素问. 宣明五氣篇>  The Yellow Emperor’s Inner Classic: Plain Questions  Chapter on the Five Energies.”  The Chinese words have been translated differently, confused as I am: shen 神 as spirit, vitality; hun 魂 as ‘ethereal soul’; po 魄 as ‘corporeal soul’; yi 意 as ‘ideation’; and zhi 志 as will or aspiration. Ultimately, the Chinese interpretations and English translations have to fit the natures of wood-birth, fire-growth, earth-change, metal-harvest, and water-storage.  Wood, or plant life buds like thunder and anger struggling out of winter, bends and straightens to rise and spread its stem and branches 木曰曲直 (wood bends and straightens).  In the case of my daughter’s hyperthyroidism, it describes well her struggle.           

 

[3]  © 2004 School of Nursing and Academic Division of Midwifery, University of Nottingham.  Developer: Dr Viv Rolfe.  Content author: Dr Viv Rolfe   RLO released: 5th October, 2004.  Page last updated: 4 November, 2004

 

[4]  Fundamental Theory of Traditional Chinese Medicine.  CHAI Kefu , compiler-in-chief;  ZHANG Qingrong, translator-in-chief.  Beijing: People’s Medical Publishing House, 2007.  Sections 3.1.4 to 3.1.4.2  Pages 166-169.

[5]  The Web that Has No Weave has made Chinese medical nonsense into wonderful myth, mysterious yet comprehensible in poetic language.  

[6]  The Web that Has No Weave: Understanding Coinese Mecicine.  Ted J. Kaptchuk, O.M.D.  New York: McGraw-Hill, 2000, p. 81.

[7]

[8]  Web, p. 81.

[9] Fundamental…, p. 166.

[10] Web, p. 81.

[11]  Web, p. 100, note 19.

[12] Web, p. 100, note 21: Su Wen, sec. 3, chap. 9, p. 68.

[13]  逍遥散.  Web, p. 101, note 22.

[14] Web, p. 82.

[15]  肝藏血.  Ling Shu, sec. 2, chap. 8, p. 86.  Web, p. 100, note 18.

[16] Web, p. 81.

[17]  Treatment of  Hyperthyroidism in Traditional Chinese Medicine 甲亢中醫療法   Editors-in-chief 主编:  GAO Hansen et al.  高汉森, 林昌松.. Guangzhou 广州: South China University of Science and Technology Press 华南理工大学出版社, 2004, p. 58. 

[18]  Available in Chinese herbal stores, e.g. Chinatown. 

[19]   Chinese Herebal Medicine 中药学.  Beijing 北京: Huaxia Publishing House 华夏出版社, 2001, .p. 42-43.

[20]  Ibid.  P. 149

[21]  Note 1, p. 230-231.

[22]  Note 1, p. 224.

[23]  Note, 1, p. 254.

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3 Responses to “Ghost Liver 肝魂 2011 04 28 draft 16A”

  1. Liver is the Spring! Says:

    Well, I found this very interesting. I have Liver troubles too and am always searching to understand what I can do body and mind to help it. I practise forgiveness for my mind, and for my body i will maybe try the Chrysanthemum flowers, and the Sunzaoren pills for my sleep. Many thanks!! x

    • kwanlihuen Says:

      Thanks for the comment. Kwan

    • kwanlihuen Says:

      Dear Elsspeth,
      Thank you very much for your comment! I am sorry I did not reply earlier, because of my poor skill with the computer. I am learning now to reply to comments. I hope this message reaches you. Wishing you good health, Kwan. 2013.9.9

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