When speaking about menstruation, it is essential to talk about pathology of the Internal organs. In this blog we will be speaking about the Kidneys’ and the Liver’s Pathology.
Kidney deficiency is a major pathology in women’s gynecological health since these organs have a strong relationship between Blood and the Uterus. For instance, deficiency in Blood would cause an overlap with deficiency in the Kidneys and disrupt the Uterus. In Pathology, the Kidneys have both a Yin and Yang aspects. In Kidney-Yang deficiency, the tongue has a pale aspect, but in Kidney-Yin deficiency, the tongue will not have a coat. Kidney-Yin and Kidney-Yang deficiency will happen at once if three events happen.
The Pathology of the Kidneys
The first event is pathology between the interconnected Penetrating Vessel, Blood, the Uterus, and the Kidneys. Kidney-Yang deficiency influences the Penetrating Vessel and consequently affects Blood, and Yin. As a result, Yin becomes deficient which then affects the Uterus and the Uterus affects Blood. This affects the Penetrating Vessel which is the Sea of Blood that rises from the Uterus and comes from the area within the Kidneys called the Motive Force or Dong Qi. Dong Qi originates from this area and contains the Fire of the Gate of Life and the end result is Kidney-Yang deficiency.
The Minister fire is the origin of Fire and Water. Water is necessary to form menstrual blood Therefore, the second event is the deficiency in Water and Fire due to the Minister Fire.
The third reason Kidney-Yin and Kidney-Yang are deficient at the same time is because they are connect within the body. If one is deficient, the other will also become deficient. Deficiency of Kidney-Yin and Kidney-Yang is most common after 40 years of age. Both the Kidney-Yin and the Kidney-Yang may be deficient simultaneously in women which causes Hot and Cold symptoms. In Heat and Cold due to Kidney deficiency, symptoms include cold or hot feet at night, and the face may feel hot, but not cold. Yin-deficiency could influence the rise of Empty-Heat even with the dominance of Yang deficiency. In Kidney-Yang deficiency, women may experience back pains, frequent/ pale urination, swollen ankles, cold feet, pale tongue and hot rushes. Similarly, Kidney-Yin deficiency manifests the same symptoms with the exclusion of cold feet and frequent urination, and the inclusion of a red peeled tongue, dizziness, and night sweats.
Treating Kidney Yin and Yang
Before the age of 40, pathology lasts for a short period of time and can be identified as one form of pathology, such as Kidney-Yin or Kidney-Yang deficiency. As age increases, the Kidneys start to lose energy and Blood pathology begins to affect the body. Pathology within the Yin of the Kidney triggers pathology in the Yang of the Kidney and vice versa. Once people are the age of 60, the primary deficiency will dominate over the other pathologies.
Because the deficiency of Kidney-Yin or Kidney-Yang means the deficiency of the other, both are tonified. Since the waxing and waning of both aid the path of the menstrual cycle, both are tonified to treat infertility. Treatment for infertility involves adding Yin Yang Hup Herba Epimedii within the tonics for Kidney-Yin, adding Nu Zhen Zi Fructus Ligustri lucidi and Han Lian Cao Herba Ecliptae within the tonics for Kidney-Yang. To tonify Kidney-Yang, the formula used is You Gui Wan Restoring the Right Kidney Pill. Even though it tonifies the Kidney-Yang, it contains Gou Qi Zi Fructus Lycii which nourishes the Kidney-Yin. In order to tonify the Kidney-Yin the formulae Zuo Gui Wan Restoring the Left Kidney Pill is used. Even though it tonifies the Kidney-Yin it contains Tu Si Zi Semen Cuscutae and Lu Jiao Colla Cornu Cervi which both tonify the Kidney-Yang.
The Liver is another important organ; pathology within the Liver such as deficiency of Liver-Qi and Liver-Blood is common within women. Within the Liver there can be many patterns that can happen at once such as deficiency of Liver-Qi, Liver-Blood, Liver-Fire, and Liver-Yang rising.
The reason behind this is that Liver deficiencies trigger other Liver deficiencies. Liver-Blood deficiency can potentially cause Liver-Qi stagnation. Liver-Qi stagnation could lead to either Liver-Heat and trigger Liver-Yang rising, or lead to Liver-Blood stasis.
Stagnation of Liver-Qi
Liver-Qi stagnation is common within pathology of women. Liver-Qi is a major Yang process in menstruation since it moves Qi and Blood within the 4th phase. There are two types of Liver-Qi stagnation.
The primary type or main causes of Liver-Qi stagnation are emotional stresses such as anger, worry, shame, guilt and resentment. The effects of this pathology manifest through the premenstrual phase with symptoms of irritability, and depression. Stagnation produces bloating and swelling symptoms of the abdomen, the epigastrium and/ or the breasts. However, not all are a symptom of Liver-Qi stagnation. It may also cause irregular and painful periods. There will be no signs of stagnation on the tongue, but it will appear to be red in severe cases. The pulse will appear to be wiry on the left side. Liver Yang rising creates headaches before or during menstruation. If stagnation is prolonged, it could turn into heat and may lead to the rise of Liver-Heat, then lead to Liver-Fire. The heat could then cause Blood to heat up and conclude with Blood-Heat or the Fire could damage Yin, therefore causing Empty-Heat. Stagnation may also lead to Liver-Blood stasis that causes large and dark blood clots.
The secondary type is Liver-Blood deficiency, Liver-Qi represents the Yang of the Liver and Liver-Blood represents the Yin. As stated in the blog The Concepts of Yin and Yang, the Yin and Yang should be balanced. If Yin is deficient, which is the Liver-Blood, then it will not contain or root the Yang, which is the Liver-Qi. A combination of Liver Blood deficiency and emotional distress will cause Liver-Qi to stagnate. If the tongue appears pale and the pulse is lightly wiry or not at all wiry, then Liver Stagnation is second to Liver-Qi. Liver-Qi stagnation manifests as purple on the sides of the tongue.
Women are prone to Liver-Blood deficiency because of the blood loss in menstruation, emotional stresses and diet. The Liver provides storage for Blood and distribution to the Uterus, and because of its connection to the Penetrating Vessel. Symptoms of Liver-Blood deficiency are infertility, scanty periods, delayed cycles and amenorrhoea. It is important to note that the Liver is responsible for the connection between Tian Gui and ordinary Blood. Therefore, the symptoms of Liver-Blood deficiency can be a reflection of Blood deficiency as well. Because Liver-Blood nourishes the hair, eyes, skin, and the sinews, in deficiency, the hair would be dry, the nails would be brittle, with cramps, alongside a choppy pulse and a pale tongue.
Liver-Blood deficiency leads to other pathologies. An example of this is the triggering of the Liver-Yang rising, mainly common within women. Liver-Blood deficiency could cause Wind-Heat in the skin since Liver-Blood produces moisture and maintains the skin. A symptom in menopause for women is the manifestation of itching and the lack of rashes. Treatment includes Subduing Wind Decoction and YangXue Ding Feng Tang Nourishing Blood or Yang Xue Run Fu Yin Nourishing Blood alongside Moistening the Skin Decoction. Glorious Sea is able to nourish Liver-Blood and discard Wind-Heat.
Blood and Qi are connected with one another, since Qi is the child of Blood. Therefore, if Liver-Blood is deficient, then so could Liver-Qi. Treatment includes Ba Zhen Tang Eight Precious Decoction. The Precious Sea tonifies Qi and nourishes Blood.
Liver Affecting The Heart and Kidney
Liver-Blood deficiency can also cause Heart-Blood deficiency since they both govern blood and they have a natural bond within the Five Elements. Treatment includes Gui Pi Tang Restoring the Spleen Decoction.
There is a connection between Kidney-Yin and Liver-Blood since Kidney-Yin nourishes essence and Blood. Therefore, if Liver-Blood is in deficiency, Kidney Yin is at risk of being deficient too. Treatment includes Dang Gui Di Huang Yin Angelica-Rehmannia Decoction and Ba Wei Di Huang Wan Eight Ingredients Rehmannia Pills and the variations of Liu Wei Di Huang Wan Six Ingredients Rehmannia Pills. Kidney-Yang deficiency is connected with Liver-Blood deficiency since it is linked with the Penetrating Vessel, the Uterus, Blood and the Liver. Treatment includes You Gui Wan Restoring the Right Kidney Pill or Zan Yu Dan Aiding fertility Pill.
Liver-Blood Deficiency Hot and Cold Pathology
Another pathology caused by Liver-Blood includes Empty-Heat which usually originates from Yin deficiency, but is developed from Blood-deficiency as well. It causes hot flushes and a pale tongue. Treatments include Qin Lian Si Wu Tan Scutellaria-Coptis Four Substances Decoction.
Liver-Blood may also cause Cold to manifest in many areas. The Limbs are susceptible to this pathology mainly in women. For Cold in the limbs caused by Blood deficiency in women, treatment includes Dang Gui Si Ni Tang Angelica Four Rebellious Decoction.
Deficiency in Liver-Blood will cause the Uterus to be Empty and susceptible to Cold. Cold in the Uterus will prevent the storage of Blood and therefore will cause Liver-Blood deficiency. Treatment includes Wen Jing Tang Warming the Menses Decoction. There should be warmth within the Menses, the Palace, the Mansion, and the Uterus; the nourishment of the Blood is necessary.
Liver-Blood Deficiency Leading Into Liver-Blood stasis
Liver-Blood deficiency leads to Liver-Blood stasis because it will not travel properly. Treatment includes Tao Hong Si Wu Tang Persica-Carthamus Four Substances Decoction and the Stir Fields of Elixir which invigorates Liver-Blood and eliminates stasis. Liver-Qi and Liver-Blood are the Yin and Yang of the Liver. When one is in pathology, it fails to aid the other. Therefore when Liver-Blood is deficient, Liver-Qi will stagnate. It is very evident in gynecological problems and treatment includes Xiao Yao San Free and Easy Wanderer Powder and freeing the moon which sustains Liver-Blood and allows Liver-Qi to move.
Liver-Blood stasis is most apparent in women because the Uterus stores Blood and can easily stagnate in the lower abdomen. Liver-Qi stagnation is the cause for Liver-Blood stasis which may cause dark blood and clots, painful periods, cysts, endometriosis or myomas. Blood stasis is one of the main culprits of most gynecological conditions. Liver-Blood stasis can lead to serious diseases including endometriosis, cervical cancer, uterine cancer, polycystic ovary syndrome and myomas.
Liver-Blood is responsible for heavier menstrual bleeding. Within the uterus, the blood vessels become obstructed because of the Blood stagnation. The body constantly produces new blood and must spill out of the Uterus in Liver Blood stasis since the stagnant blood in the blood vessels block the uterus. Both Liver-Qi and Liver-Blood stasis affect the Mind and cause insomnia, dreaming, mental restlessness, and in severe cases may cause Mind Obstructions including Post-Natal Psychosis. A wiry, firm or choppy pulse and a purple tongue signifies Liver-Blood. However, the purple tongue may signify Blood stasis in the Uterus more than the Liver itself.
Treatment for Liver-Blood stasis includes SP-Gongsun to the right alongside P-6 Neiguan to the left, alongside KI-14 Siman, SP-10 Xuehai and LIV-3 Taichong.
Three major factors cause Liver-Blood Heat. If Liver-Qi remains stagnant over a long period of time, Liver-Blood is heated. The causes of Blood-Heat may also cause Liver-Blood Heat where emotional stresses remain and diets are not balanced. The third factor is the minister’s fire. Instead of drying water, the minister’s fire produces water. In problems with the emotions, the Minister Fire becomes pathological and Its effects manifest on the Liver easily. The balances Minister Fire will produce Qi, but when Minister Fire is in excess, the fire eats qi. Wood represents the Liver within the Five Elements. Because of its nature, if fire is in excess, the wood would burn and therefore, causing pathology in Liver-Blood. When fire reaches the Liver, it also reaches the Heart and the Pericardium because they connect with the Terminal Yin. Because of this, the Minister Fire also affects the Pericardium. Menorrhagia is a cause of pathology within Liver-Blood Heat and in such a case, Blood is pushing out of the blood vessels and there will be a fast shift in pulse occurring within the Middle position.
Damp-Heat in the Liver channel
Damp-Heat in the presence of genital symptoms confirms that the presence of Damp Heat is within the Live as opposed to the Gallbladder. The effects of its manifestation in the Liver channel of women include urination symptoms, gential symptoms, difficult and painful urination, excessive vaginal discharge, vaginal itching, and soreness. To treat Dampness within the Liver channel when it affects the urinary and genital areas, the points LIV-5 Ligou, SP-9 Yinlingquan, Ren-3 Zhongji, ST-28 Shuidao and BL-22 Sanjiaoshu.
Liver-Yang rising manifests as menstrual headaches at one of the sides of the head, nausea, vomiting and/or visual disturbances. Menstrual headaches may also arise due to Liver-Yin and Kidney-Yin deficiency, however, it is more common to manifest due to Liver-Yang deficiency. The tongue will be pale and thin and the body will have a choppy pulse. Treatment involves the Tian Ma Gou Teng Yin Gastrodia Uncaria Decoction or Bu Gan Tang Tonifying the Liver Decoction. Bend Bamboo is able to nourish Liver-Blood and subdue Liver-Yang.
Liver-Wind is pathology during pregnancy. It is mainly present within eclampsia and pre- eclampsia. This ends up giving the patients dizziness, tremors, tics and a stiff neck. It is imperative to treat Liver-Wind especially within pregnancy.