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Module 4   Lesson 2   Gan and Dan

Liver and Gall-Bladder

Red, pale or purple sides, a yellow strip on one side, a pulse like a string: which pattern of the Liver or Gall-Bladder do you read, and what tells the neighbours apart?

After this lesson you know where to read the Liver and Gall-Bladder (the sides of the tongue and left guan), you know the tongue and pulse of every Liver and Gall-Bladder pattern, you read the wiry pulse in its variants, you separate the tricky pairs, you know which tongues and pulses go to a doctor first, and you read a recurring headache from finding to principle.

stagnation
Schematic: Liver-Qi stagnation. Often a normal tongue.
warm
Schematic: stagnation turning into Heat. Red sides, thin yellowish coating.
Fire
Schematic: Liver-Fire. Red, redder sides, yellow coating, dry.
Damp-Heat
Schematic: Damp-Heat in Liver and Gall-Bladder. Red, sticky yellow coating, thickest on one side.
stasis
Schematic: Liver-Blood stasis. Purple, especially the sides.
Cold
Schematic: Cold in the Liver channel. Pale, wet, white coating.
Blood
Schematic: Liver-Blood deficiency. Pale and Thin, the sides palest.
Yin
Schematic: Liver-Yin deficiency. Red without coating, redder sides, dry.
Wind
Schematic: Liver-Yang rising to Wind. Red without coating, Quivering.
Gall-Bladder
Schematic: Phlegm-Heat disturbing the Gall-Bladder. Sticky yellow coating.

Know by heart

  • Where you read the Liver. On the tongue, the sides (Liver and Gall-Bladder); at the wrist, left guan. The pulse of the Liver is wiry: taut and straight like a string; mnemonic: the sides are the flanks, the string is the Liver.
  • From still to Fire. Liver-Qi stagnation: tongue often normal; wiry. Stagnation turning into Heat: redder sides, thin yellowish coating; wiry, slightly rapid. Liver-Fire: Red, redder sides, yellow coating, dry; wiry-rapid; mnemonic: first the edge colours, then the whole tongue, then the coating.
  • Dampness, stasis and Cold. Damp-Heat in Liver and Gall-Bladder: Red, sticky yellow coating, on one or both sides; slippery-wiry-rapid. Liver-Blood stasis: purple sides; wiry or choppy. Cold in the Liver channel: Pale, wet, white; deep, wiry, slow; mnemonic: yellow sticks, purple stands still, white and wet is cold.
  • Deficiency. Liver-Blood deficiency: Pale and Thin, the sides palest, orange when severe; choppy or thin. Liver-Yin deficiency: Red without coating, especially the sides, dry; thin or thin-rapid; mnemonic: a pale edge lacks Blood, a red bare edge lacks Yin.
  • Yang and Wind. Liver-Yang rising: the tongue shows the root (Red without coating with Yin deficiency, Pale with Blood deficiency); wiry. Wind makes the tongue move: Quivering, Deviated or Stiff. Extreme Heat: Deep-Red, dry; wiry-rapid. Yang rising to Wind: Red; wiry, often thin. Blood deficiency giving rise to Wind: Pale, Thin; choppy or thin; mnemonic: the colour names the source, the movement names the Wind.
  • Gall-Bladder. Damp-Heat: sticky yellow, often on the right or in two strips; slippery, wiry, rapid. Gall-Bladder deficiency: Pale or normal; weak. Phlegm-Heat disturbing the Gall-Bladder: sticky yellow; slippery and wiry.
  • Red flags. Deviated or Stiff tongue with loss of speech or strength: emergency services (112 in Europe, 999 in the UK, 911 in North America). Fever with convulsions or neck stiffness: emergency services (112). Yellow whites of the eyes, or fever with pain in the upper right abdomen: the same day. Suddenly the worst headache ever: emergency services (112).

The rest of this lesson is reference.

Three practice questions from this lesson

Where do you read the Liver and Gall-Bladder on the tongue and at the wrist?
  1. The tip of the tongue and left cun
  2. The centre of the tongue and right guan
  3. The sides of the tongue and left guan

Answer: The sides of the tongue and left guan. The sides are the zone of the Liver and Gall-Bladder, left guan the position of the Liver. The tip and left cun belong to the Heart, the centre and right guan to the Spleen and Stomach.

How does a wiry pulse feel, and how does it differ from tight?
  1. Like a taut string; tight like a twisted rope
  2. Smooth and rolling like pearls under the finger; tight is halting
  3. Big and soft, gives way under pressure; tight is small and hard

Answer: Like a taut string; tight like a twisted rope. Wiry is taut, long and straight, like a string that does not give: the string of the Liver. Tight is the rope of Cold and pain. Smooth and rolling is slippery, big and soft is empty.

Case. Student, 24, exam weeks: a pressing feeling under the ribs and tense breasts before her period, sighs often, irritable; it changes with her mood. Tongue normal in colour, thin white coating. Pulse taut like a string, clearest at left guan.
  1. Liver-Fire
  2. Liver-Qi stagnation
  3. Liver-Blood deficiency

Answer: Liver-Qi stagnation. Stagnant Qi without Heat and without deficiency: the tongue stays normal, the pulse is wiry. Liver-Fire gives a Red tongue with yellow coating; Liver-Blood deficiency pale sides and a thin pulse.

The rest of this lesson

In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 16 case-based practice questions, 19 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 4: Organ by organ.

Try two lessons freeSee Tongue and Pulse