At the later stage of liver disease, the common consequence of the exuberance of yang (vital function) of the liver would be :
(i) The deficiency of yin (vital essence) of liver & kidneys;
(ii) The exuberance of yang due to deficiency of yin; and
(iii) The deficiency of both yin and yang.

The deficiency of yin (vital essence) of the liver and kidney

It is a morbid condition typically marked by the following symptoms : heat sensation in the chest, palms and soles, dizziness, tinnitus, impairment of hearing, insomnia, palpitation, aching of the loins and weakness of the knees and legs, red and dry tongue with scanty or no coating, dry throat and mouth, swollen and tender gum, reddened tongue with little coating or even cracks, halitosis, ulcer of mucous membrane, dull color of the hair, dull face, thready and rapid pulse.

The exuberance of yang due to the deficiency of yin

It is a morbid condition which incorporate the symptoms of deficiency of yin and the exuberance of yang of the liver.

The deficiency of yin and yang

It is a morbid condition built on the basis of the first condition – the deficiency of yin (vital essence) of the liver and kidney as a result of lost of treatment in time or not taking continuous care of the liver (for example taking anti-liver drugs, alcoholic drinks, infection, or other course of treatment) which increase the mal-functioning of the liver and further the development of liver disease. Clinically, patients are found to have symptoms of both the deficiency of yin and yang of the liver and kidney. In addition to that, patients would increase in weight within a short period of time, known as edema, which can be easily seen on the face, lower limbs, and marked by tiredness, short of breath, somnolence, aching all over the body and the loins (e.g. bony spur, stubborn pain around the waist, gout, rheumatoid arthritis, osteoporostic arthritis). For some serious cases, patients would have difficulty in walking, urine at night, impotence, tongue substance is soft and plump and marked with teeth prints around the border, shedding of loose teeth, thin and heavy pulse.

Patients with poor functioning of the heart and lungs may even have “black jaundice”, with dark face, skin colour and colour pigment at the forelimbs (for the elder, it is known as “senile plaques” and would increase and grow in size).
Such situation would then progress to cirrhosis and even liver cancer later.

(translated by QC in February 2002)

The nature of the liver is rigid and firm. According to the theory of the Five Evolutive Phases[1], it corresponds to wood and stores the ministerial fire (versus the king fire from the heart). It favors moistness but is intolerant of dryness. It avoids or abstains from pathogenic heat and scorching hot. If the pathogenic heat already hides in the liver, it will be difficult to get rid of. The deficiency syndrome of the kidney would mean a deficiency of yin (vital essence) and yang (vital function) of the kidney and is caused by the consumption of fluid and the essence of the kidney in chronic diseases. This results in the deficiency of yang in the liver and flaming-up of the liver fire. The exuberance of yang (vital function) of the liver would lead to the deficiency of yin (vital essence) of liver and kidney, the exuberance of yang due to deficiency of yin and deficiency of both yin and yang.

The clinical symptoms of this form vary and it depends on the damages of the internal organs caused by the hepatitis viruses. In fact, as the symptoms are interchangeable at different stages, it is difficult to diagnose exactly the pathogensis of the disease. But as the principles of treatment for the deficiency of yin and exuberance of yang and the deficiency of yin and yang are basically the same, therefore, it is necessary to observe the reaction result of treatment in order to determine the ways of recuperation.

The exuberance of yang (vital function) of the liver is a morbid condition due to hyperactivity of the liver. It is further manifested by dizziness, distending pain in the head, headache, sudden break out migraine, fidgety, mental irritability, weakening of memory, dislike heat and like cold, insomnia, dreamfulness. Patients may have difficulties in getting asleep, easily awake, scarlet red sides of the tongue with yellow or little coating, flushed face, blood-shot eyes, high blood pressure, spider nevus, liver palm, taut and rapid pulse, with scanty dark urine and dry stools. When the patients approach the age of 55-65 for male and 45-55 for female, the above symptoms would be more severe.
　

(translated by QC in February 2002)