The pattern of dampness-heat in the liver meridian refers to the accumulation and stagnation of dampness-heat pathogens in the liver meridian, manifesting symptoms such as hypochondriac pain, bitter taste in the mouth, jaundice, and anorexia. It is often caused by external contraction of dampness-heat pathogens or excessive consumption of rich, greasy, and alcoholic foods.

The main clinical manifestations include: jaundice, distending pain in the hypochondrium, reduced appetite, bitter taste in the mouth, aversion to greasy and fishy foods, and a feeling of heaviness and lack of strength in the body. If dampness is more severe than heat, the tongue coating is white and greasy with a slight yellow tint; if heat is more severe than dampness, the tongue coating is yellow and greasy, with scanty and dark urine, and a soggy, rapid or wiry, slippery, and rapid pulse.

The pattern of dampness-heat in the liver meridian is commonly seen in diseases such as "jaundice," "hypochondriac pain," "tympanites," and "leukorrhea."

This syndrome should be differentiated from the "pattern of dampness and heat in the spleen and stomach," the "pattern of dampness-heat in the liver and gallbladder," and the "pattern of bladder dampness-heat."

bubble_chart Differentiation and Treatment

Dampness-heat invades the liver meridian, stagnating qi movement, and can manifest different disease mechanisms and clinical presentations in various illnesses.

1. For example, in jaundice disease, the pattern of dampness-heat in the liver meridian often presents with generalized yellowing of the body and face, hypochondriac pain, bitter taste in the mouth, aversion to greasy and fishy foods, fatigue, and lack of strength. In cases where dampness is predominant, the yellowing is dull, accompanied by swelling, heavy body sensation, a feeling of heaviness in the head, poor appetite, loose stools, a red tongue with yellow and greasy coating, and a soft but not rapid pulse. In cases where heat is predominant, the yellowing is bright like the color of an orange, accompanied by fever, irritability, constipation, dark urine, a red tongue with yellow and greasy coating at the root, and a deep, wiry, and rapid pulse. The former should be treated by dispersing qi and resolving dampness, clearing heat, using Gizzard-Skin and Lygodium Spore Decoction (Wenbing Tiaobian) with the addition of Virgate Wormwood. The latter should be treated by soothing the liver and promoting bile secretion, clearing and draining damp-heat, using Cold-Limbs Powder (from "Treatise on Cold-Damage Diseases") minus Liquorice Root, combined with Virgate Wormwood Decoction (from "Treatise on Cold-Damage Diseases").
2. If the pattern of dampness-heat in the liver meridian appears in hypochondriac pain, it often manifests as persistent distending pain in the right hypochondrium, or intermittent severe pain radiating to the epigastrium or chest and back, bitter taste in the mouth, dry throat, nausea, or alternating chills and fever, scanty dark urine, and constipation. Treatment should focus on soothing the liver and promoting bile secretion, clearing and resolving dampness-heat, using Major Bupleurum Decoction (from "Treatise on Cold-Damage Diseases") with modifications.
3. If the pattern of dampness-heat in the liver meridian appears in drum distension disease, the clinical manifestations include a large, firm, and full abdomen, attacking pain in the hypochondrium and abdomen, a shallow yellow complexion, a purplish-red tongue with a yellow and greasy coating, and a wiry and rapid pulse. This is due to the accumulation of dampness-heat, stagnation of qi and water retention, damage to both the liver and spleen, involvement of the blood aspect, and obstruction by dampness-heat and stasis. Treatment should focus on clearing heat and promoting urination, invigorating blood and resolving stasis, using Virgate Wormwood Decoction (from "Treatise on Cold-Damage Diseases") combined with Huayu Tang (an empirical formula) with modifications.
4. If the pattern of dampness-heat in the liver meridian appears in leukorrheal disease, it often manifests as pale yellow, sticky, foul-smelling, and copious leukorrhea, or a mixture of red and white discharge, accompanied by itching and pain in the external genitalia, and turbid urine. This is due to the downward flow of dampness-heat in the liver meridian. Treatment should focus on draining liver-gallbladder dampness-heat, using Gentian Liver-Draining Decoction (from Lanshi Micang).

bubble_chart Differentiation of Similar Patterns

1. pattern of dampness and heat in the spleen and stomach and pattern of dampness-heat in liver meridian: The liver and spleen (stomach) are the organs of wood and earth, and they often influence each other pathologically. Although both are diseases of dampness-heat, their clinical manifestations can easily be confused. However, upon careful differentiation, they still have distinct characteristics. The spleen governs transportation and transformation, while the stomach governs reception and descent. If dampness-heat pathogens accumulate in the spleen and stomach, the functions of reception and transformation will be impaired, leading to abnormal ascending and descending. Common symptoms include epigastric stuffiness, nausea, vomiting, and anorexia. Additionally, due to the obstruction and downward pressure of dampness-heat, there may be loose stools, difficulty in defecation, and scanty, dark urine. The liver governs the free flow of qi. If dampness-heat accumulates in the liver meridian, the function of dispersion will be impaired, leading to symptoms such as hypochondriac distending pain, bitter taste in the mouth, and anorexia. Since the liver can affect the spleen, there may also be nausea, abdominal distension, irregular bowel movements, and scanty, dark urine. In summary, the pattern of dampness and heat in the spleen and stomach is mainly characterized by abnormal ascending and descending, while the pattern of dampness-heat in the liver meridian is mainly characterized by depression and stagnation of qi movement. The former typically presents with a soft and rapid pulse, while the latter presents with a wiry and rapid pulse, which can aid in differentiation.
2. pattern of dampness-heat in liver and gallbladder and pattern of dampness-heat in liver meridian: The pattern of dampness-heat in liver and gallbladder and the pattern of dampness-heat in liver meridian are quite similar in terms of disease cause, mechanism of disease, and main symptoms. For example, both can be caused by external contraction of dampness-heat or internal damage from diet, leading to stagnation of dampness-heat and impaired free flow of qi, resulting in symptoms such as hypochondriac pain and bitter taste in the mouth. However, due to differences in the location of disease, the treatment methods differ, and clinical differentiation is essential. In the pattern of dampness-heat in liver and gallbladder, symptoms related to the gallbladder meridian are more prominent, such as deepening jaundice, accompanied by deafness, dry throat, dizzy vision, and vomiting of bitter water. In contrast, in the pattern of dampness-heat in liver meridian, jaundice may or may not be present, or if present, it is usually mild. If the jaundice in the pattern of dampness-heat in liver meridian deepens, it indicates that the location of disease has spread from the liver to the gallbladder, and the dampness-heat pathogen has permeated both the liver and gallbladder meridians. The focus of the two syndromes is different: the former is more related to the gallbladder, while the latter is more related to the liver. This serves as the basis for differentiation.
3. bladder dampness-heat pattern and pattern of dampness-heat in liver meridian: Dampness-heat invading the lower energizer can affect the qi transformation function of the bladder, while dampness-heat invading the middle energizer can affect the free flow of qi in the liver meridian. Both are pathological changes of dampness-heat affecting qi movement. However, the bladder dampness-heat pattern is mainly characterized by difficulty in urination, such as urgency, frequency, scanty urine, painful urination, hematuria, or sand-like particles in the urine, and urethral obstruction. The pattern of dampness-heat in liver meridian is mainly characterized by hypochondriac pain, bitter taste in the mouth, and anorexia. Although dampness-heat in the liver meridian can also descend to the external genitalia and cause painful urination, there is a clear stage of persistent dampness-heat in the liver meridian, where painful urination is not the main symptom. Based on this, the two syndromes can be easily distinguished.

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bubble_chart Documentation

1. Zhubing Yuanhou Lun．Five colors yellow syndrome: "The person has body heat, eyes are greenish-yellow, the pupils appear green, the skin is also green, and the complexion is green. This is due to the transfer of heat from the spleen to the liver, as the liver's color is green."
2. Yuyicao： "When the gallbladder's hot juice overflows and seeps into the meridians, both the body and eyes turn yellow, resulting in alcoholic jaundice."
3. 《Qianzhai Medical Lecture Notes》: "The formation of jaundice is related to the gallbladder... The gallbladder and liver are interconnected, and most liver diseases affect the gallbladder. It is natural for jaundice to appear in liver diseases."