(足厥阴属脏)
肝与胆相附。东方木也。其性刚。赖血以养。自两胁以下及少腹阴囊之地。皆其部位。最易动
气作痛。其风又能上至巅顶而痛于头。色属青。常现于左颧目 。于妇人为尤甚。肝无表
症。皆属于里。
肝之虚。肾水不能涵木而血少也。脉左关必弱或空大。其症为胁痛。为头眩。为目干。为眉棱
骨眼眶痛。为心悸。为口渴。为烦躁发热。
胁痛者。血不营筋也。四物汤主之。头眩者。血虚风动也。逍遥散主之。目干者。水不养木也。
六味地黄丸主之。眉棱骨眼眶痛者。肝血虚。见光则痛。逍遥散主之。心悸者。血少而虚火煽也。
七福饮主之。口渴者。血虚液燥也。甘露饮主之。烦躁发热者。虚火亢也。六味地黄丸主之。
肝之实。气与内风充之也。脉左关必弦而洪。其症为左胁痛。为头痛。为腹痛。为小腹痛。为积
聚。为疝气。为咳嗽。为泄泻。为呕吐。为呃逆。
左胁痛。肝气不和也。柴胡疏肝散、栝蒌散并主之。头痛者。风热也。清空膏主之。或柴胡疏肝散。腹
痛者。肝木乘脾也。芍药甘草汤主之。小腹痛者。 瘕之气聚也。奔豚丸主之。有热者去附桂。积聚
者。肝积在左胁下。名曰肥气。和中丸加柴胡、鳖甲、青皮、莪术主之。疝气者。气结聚于下也。橘核丸主
之。寒则加吴茱萸、肉桂。咳嗽者。木火刑金也。止嗽散加柴胡、枳壳、赤芍主之。泄泻者。木旺克土也。
四君子汤加柴胡、木香主之。呕吐者。木火凌胃也。二陈汤加炒黄连主之。呃逆者。气郁火冲也。橘
皮竹茹汤主之。
肝寒之症。脉左关必沉迟。其症为小腹痛。为疝瘕。为囊缩。为寒热往来。
小腹痛者。寒结下焦也。暖肝煎、奔豚丸主之。疝瘕者。寒气结聚也。橘核丸加吴茱萸、肉桂主之。囊
缩者。寒主敛。故缩也。奔豚丸、四逆汤主之。寒热往来者。欲化疟也。小柴胡汤主之。
肝热之症。脉左关必弦数。其症为眩晕。为目赤肿痛。为口苦。为消渴。为头痛。为胁痛。为瘰 。
为耳。为筋痿拘挛。为气上冲心。为偏坠。为舌卷囊缩。为小便不禁。
眩晕者。风热上升也。逍遥散主之。目赤肿痛者。风热入目也。蝉花无比散主之。口苦者。胆味苦。肝
热胆亦热也。小柴胡汤主之。消渴者。风燥其液也。一柴胡饮主之。头痛者。火上冲也。柴芩煎主之。
胁痛者。肝火郁也。柴胡疏肝散加栝蒌霜主之。左金丸亦可。瘰 者。血燥筋急而生也。消瘰丸主
之。兼服逍遥散。 耳者。风热相搏。津液凝聚而痒痛也。逍遥散去白术。加荷叶、木耳、贝母、香附、菖蒲
主之。筋痿拘挛者。血气热也。五痿汤加黄芩、丹皮、牛膝主之。气上冲心者。火逆也。柴芩煎主之。甚
则小承气汤。偏坠者。热而睾丸舒纵也。柴胡疏肝散主之。舌卷囊缩者。邪入厥阴。血涸也。大承气
汤主之。小便不禁者。肝气热。阴挺。失职也。逍遥散主之。
(足厥阴肝经属于脏)
肝脏与胆腑相互依附。在五行中,肝属东方之木。其性质刚强,依赖血液来滋养。从两胁以下直到小腹及阴囊的区域,都是肝经所主的部位,最容易因气机郁滞而产生疼痛。肝风还能上达头顶,导致头部疼痛。肝对应的颜色是青色,常显现于左颧和眼睛部位,在女性身上表现得尤为明显。肝没有表证,所有的病变都属于里证。
肝虚证,是由于肾水不能涵养肝木,导致肝血不足。脉象表现为左关部必弱或空大。症状包括胁痛、头晕目眩、眼睛干涩、眉棱骨及眼眶疼痛、心悸、口渴、烦躁发热。
出现胁痛,是因为血液不能濡养筋脉。主治方剂为四物汤。
出现头晕目眩,是因为血虚导致内风扰动。主治方剂为逍遥散。
出现眼睛干涩,是因为肾水不能滋养肝木。主治方剂为六味地黄丸。
出现眉棱骨及眼眶疼痛,是因为肝血虚,见光则痛。主治方剂为逍遥散。
出现心悸,是因为血少导致虚火煽动。主治方剂为七福饮。
出现口渴,是因为血虚导致津液干燥。主治方剂为甘露饮。
出现烦躁发热,是因为虚火亢盛。主治方剂为六味地黄丸。
肝实证,是由气滞和内风充盛所致。脉象表现为左关部必弦而洪大。症状包括左侧胁痛、头痛、腹痛、小腹痛、积聚、疝气、咳嗽、泄泻、呕吐、呃逆。
左侧胁痛,是肝气不和所致。主治方剂为柴胡疏肝散或栝蒌散。
头痛,是风热所致。主治方剂为清空膏,或者柴胡疏肝散。
腹痛,是肝木乘克脾土所致。主治方剂为芍药甘草汤。
小腹痛,是瘕聚之气聚集所致。主治方剂为奔豚丸。若有热象,去掉附子、肉桂。
积聚,指肝积位于左胁下,名为肥气。主治方剂为和中丸,加柴胡、鳖甲、青皮、莪术。
疝气,是气结聚于下部所致。主治方剂为橘核丸。若属寒证,加吴茱萸、肉桂。
咳嗽,是木火刑金(肝火犯肺)所致。主治方剂为止嗽散,加柴胡、枳壳、赤芍。
泄泻,是木旺克土(肝旺乘脾)所致。主治方剂为四君子汤,加柴胡、木香。
呕吐,是木火凌胃(肝火犯胃)所致。主治方剂为二陈汤,加炒黄连。
呃逆,是气郁化火冲逆所致。主治方剂为橘皮竹茹汤。
肝寒证,脉象左关部必沉迟。症状包括小腹痛、疝瘕、阴囊收缩、寒热往来。
小腹痛,是寒邪结聚于下焦所致。主治方剂为暖肝煎或奔豚丸。
疝瘕,是寒气结聚所致。主治方剂为橘核丸,加吴茱萸、肉桂。
阴囊收缩,是因为寒性主收敛,所以导致收缩。主治方剂为奔豚丸或四逆汤。
寒热往来,是欲转化为疟疾的表现。主治方剂为小柴胡汤。
肝热证,脉象左关部必弦数。症状包括眩晕、眼睛红肿疼痛、口苦、消渴、头痛、胁痛、瘰疬、耳聋、筋痿拘挛、气上冲心、偏坠(睾丸肿胀下垂)、舌卷缩、阴囊收缩、小便失禁。
眩晕,是风热上升所致。主治方剂为逍遥散。
眼睛红肿疼痛,是风热入目所致。主治方剂为蝉花无比散。
口苦,是因为胆汁味苦,肝热则胆亦热。主治方剂为小柴胡汤。
消渴,是风燥耗伤津液所致。主治方剂为一柴胡饮。
头痛,是火上冲所致。主治方剂为柴芩煎。
胁痛,是肝火郁结所致。主治方剂为柴胡疏肝散加栝蒌霜,也可用左金丸。
瘰疬,是因血燥筋急而生。主治方剂为消瘰丸,兼服逍遥散。
耳聋,是风热相搏,津液凝聚而致痒痛。主治方剂为逍遥散去白术,加荷叶、木耳、贝母、香附、石菖蒲。
筋痿拘挛,是气血热盛所致。主治方剂为五痿汤,加黄芩、牡丹皮、牛膝。
气上冲心,是火气逆乱所致。主治方剂为柴芩煎,严重者用小承气汤。
偏坠,是热邪导致睾丸松弛下垂。主治方剂为柴胡疏肝散。
舌卷缩、阴囊收缩,是邪气侵入厥阴经,血枯涸所致。主治方剂为大承气汤。
小便失禁,是肝气热盛,导致阴器挺出,功能失职。主治方剂为逍遥散。
(Liver Meridian of Foot-Jueyin belongs to the Zang organs)
The Liver and Gallbladder are mutually attached. In the Five Elements, the Liver corresponds to Wood of the East. Its nature is rigid, relying on Blood for nourishment. The area from both hypochondriac regions downwards to the lower abdomen and scrotum constitutes its domain, where it is most prone to Qi stagnation causing pain. Liver Wind can also ascend to the vertex, causing headache. The color associated with the Liver is Green, often manifesting in the left cheekbone and eyes; this is particularly pronounced in women. The Liver has no exterior syndromes; all pathologies belong to the interior.
Liver Deficiency Syndrome arises when Kidney Water fails to nourish Liver Wood, resulting in Blood deficiency. The pulse at the Left Guan position must be weak or hollow and large. Symptoms include hypochondriac pain, dizziness, dry eyes, pain in the supraorbital ridge and eye sockets, palpitations, thirst, irritability, and fever.
Hypochondriac pain occurs because Blood fails to nourish the sinews. It is primarily treated with Siwu Tang (Four Substances Decoction). Dizziness occurs due to internal wind stirring from Blood deficiency. It is primarily treated with Xiaoyao San (Free and Easy Wanderer Powder). Dry eyes occur because Water fails to nourish Wood. It is primarily treated with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). Pain in the supraorbital ridge and eye sockets occurs due to Liver Blood deficiency, exacerbated by light exposure. It is primarily treated with Xiaoyao San (Free and Easy Wanderer Powder). Palpitations occur because insufficient Blood allows deficient fire to flare up. It is primarily treated with Qifu Yin (Seven Blessings Decoction). Thirst occurs because Blood deficiency leads to fluid dryness. It is primarily treated with Ganlu Yin (Sweet Dew Decoction). Irritability and fever occur due to hyperactive deficient fire. It is primarily treated with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
Liver Excess Syndrome is caused by Qi stagnation and internal wind filling the channels. The pulse at the Left Guan position must be wiry and surging. Symptoms include pain in the left hypochondrium, headache, abdominal pain, lower abdominal pain, accumulations, hernia, cough, diarrhea, vomiting, and hiccups.
Pain in the left hypochondrium is due to Disharmony of Liver Qi. It is primarily treated with Chaihu Shugan San (Bupleurum Powder to Soothe the Liver) or Gualou San (Trichosanthes Powder). Headache is due to Wind-Heat. It is primarily treated with Qingkong Gao (Clear the Crown Paste), or Chaihu Shugan San (Bupleurum Powder to Soothe the Liver). Abdominal pain is due to Liver Wood overacting on Spleen Earth. It is primarily treated with Shaoyao Gancao Tang (Peony and Licorice Decoction). Lower abdominal pain is due to the aggregation of Qi in Jia masses. It is primarily treated with Bentun Wan (Rushing Pig Pill). If heat signs are present, remove Fuzi (Prepared Aconite Root) and Rougui (Cinnamon Bark). Accumulation refers to a Liver accumulation located under the left hypochondrium, named Feiqi (Fat Qi). It is primarily treated with Hezhong Wan (Harmonize the Middle Pill) added with Chaihu (Bupleurum Root), Biejia (Turtle Shell), Qingpi (Green Tangerina Peel), and Ezhu (Curcuma Rhizome). Hernia is due to Qi knotting and aggregating in the lower region. It is primarily treated with Juhe Wan (Citrus Seed Pill). If cold, add Wuzhuyu (Evodia Fruit) and Rougui (Cinnamon Bark). Cough is due to Wood-Fire punishing Metal (Liver Fire invading the Lungs). It is primarily treated with Zhisou San (Stop Cough Powder) added with Chaihu (Bupleurum Root), Zhike (Aurantii Fructus), and Chishao (Red Peony Root). Diarrhea is due to Hyperactive Wood overcoming Earth (Liver Overacting on Spleen). It is primarily treated with Sijunzi Tang (Four Gentlemen Decoction) added with Chaihu (Bupleurum Root) and Muxiang (Aucklandiae Radix). Vomiting is due to Wood-Fire insulting Stomach (Liver Fire invading the Stomach). It is primarily treated with Erchen Tang (Two-Aged Decoction) added with fried Huanglian (Coptidis Rhizoma). Hiccups are due to Qi stagnation transforming into fire rushing upward. It is primarily treated with Jupi Zhuru Tang (Tangerina Peel and Bamboo Shaving Decoction).
Liver Cold Syndrome presents with a pulse at the Left Guan position that is deep and slow. Symptoms include lower abdominal pain, hernia and Jia masses, retraction of the scrotum, and alternating chills and fever.
Lower abdominal pain is due to Cold knotting in the Lower Jiao. It is primarily treated with Nuangan Jian (Warming the Liver Decoction) or Bentun Wan (Rushing Pig Pill). Hernia and Jia masses are due to Cold Qi knotting and aggregating. It is primarily treated with Juhe Wan (Citrus Seed Pill) added with Wuzhuyu (Evodia Fruit) and Rougui (Cinnamon Bark). Retraction of the scrotum occurs because Cold has the nature of contraction. It is primarily treated with Bentun Wan (Rushing Pig Pill) or Sini Tang (Recover the Initial Decoction). Alternating chills and fever indicate an impending transformation into malaria. It is primarily treated with Xiao Chaihu Tang (Minor Bupleurum Decoction).
Liver Heat Syndrome presents with a pulse at the Left Guan position that is wiry and rapid. Symptoms include vertigo, red and swollen painful eyes, bitter taste, Xiao Ke (wasting-thirst), headache, hypochondriac pain, Luoli (scrofula), deafness, sinew atrophy and spasms, Qi rushing up to the heart, unilateral testicular swelling, tongue curling and scrotal retraction, and urinary incontinence.
Vertigo is due to Wind-Heat ascending. It is primarily treated with Xiaoyao San (Free and Easy Wanderer Powder). Red and swollen painful eyes are due to Wind-Heat entering the eyes. It is primarily treated with Chanhua Wubi San (Cicada Flower Peerless Powder). Bitter taste occurs because bile is bitter; if the Liver is hot, the Gallbladder is also hot. It is primarily treated with Xiao Chaihu Tang (Minor Bupleurum Decoction). Xiao Ke (wasting-thirst) is due to Wind-Dryness consuming fluids. It is primarily treated with Yi Chaihu Yin (First Bupleurum Decoction). Headache is due to Fire rushing upward. It is primarily treated with Chaiqin Jian (Bupleurum and Scutellaria Decoction). Hypochondriac pain is due to Liver Fire stagnation. It is primarily treated with Chaihu Shugan San (Bupleurum Powder to Soothe the Liver) added with Gualou Shuang (Trichosanthes Powder), or Zuojin Wan (Left Metal Pill). Luoli (scrofula) arises from Blood dryness and tense sinews. It is primarily treated with Xiaoluo Wan (Eliminate Scrofula Pill), taken concurrently with Xiaoyao San (Free and Easy Wanderer Powder). Deafness is due to Wind-Heat clashing, condensing body fluids and causing itching and pain. It is primarily treated with Xiaoyao San (Free and Easy Wanderer Powder) without Baizhu (Atractylodis Macrocephalae Rhizoma), added with Heye (Lotus Leaf), Mu'er (Wood Ear Mushroom), Beimu (Fritillariae Bulbus), Xiangfu (Cyperi Rhizoma), and Changpu (Acori Tatarinowii Rhizoma). Sinew atrophy and spasms are due to Heat in Qi and Blood. It is primarily treated with Wu Wei Tang (Five Atrophy Decoction) added with Huangqin (Scutellariae Radix), Danpi (Moutan Cortex), and Niuxi (Achyranthis Bidentatae Radix). Qi rushing up to the heart is due to rebellious Fire. It is primarily treated with Chaiqin Jian (Bupleurum and Scutellaria Decoction); in severe cases, use Xiaochengqi Tang (Minor Order the Yellow Decoction). Unilateral testicular swelling is due to Heat causing the testicles to relax and descend. It is primarily treated with Chaihu Shugan San (Bupleurum Powder to Soothe the Liver). Tongue curling and scrotal retraction occur when pathogenic factors invade the Jueyin channel and Blood becomes depleted. It is primarily treated with Dachengqi Tang (Major Order the Yellow Decoction). Urinary incontinence is due to Heat in Liver Qi causing prolapse of the genitalia and loss of function. It is primarily treated with Xiaoyao San (Free and Easy Wanderer Powder).