The clinical application of the theory of “The liver is born on the left and the lung is hidden on the right” in Huangdi Neijing

The theory of “the liver is born on the left and the lung is hidden on the right” originates from the Yellow Emperor’s Classic of Internal Medicine, which states that the rising of the liver and lowering of the lung play an important role in maintaining the body’s qi flow. The theory has an important guiding significance for the clinical evidence of TCM practitioners. The theory originates from the Yellow Emperor’s Classic of Internal Medicine (Huangdi Neijing), which states that among the movements of Qi in the organism, it is especially important for the liver to rise and the lung to descend. The liver rises to the left and the lung descends to the right. The theory originates from the Yellow Emperor’s Classic of Internal Medicine, as the Su Wen – Theory of Thorns and Forbidden says: “The important thing is to hide, so we must not ignore it. The liver is born on the left, the lungs are hidden on the right, the heart is on the surface, the kidneys are ruled by the lining, the spleen is the make …… From the blessing, the rebellion has blame.” The liver is the source of vital energy, which rises on the left, and the lung is the source of purifying energy, which descends on the right. The liver is the lesser yang of the yin, with the image of wood qi rushing and, the owner of the body’s vitality, vigorous upward, prosperous in the east, the east is on the left, so its qi rises from the left, the so-called liver is born in the left, this is also called; lung is gold, the lesser yin of the yang, the owner of the body to collect the killing qi, prosperous in the west, the west is on the right, so its qi descends from the right, the so-called lung hidden in the right is also. As the Su Wen says: “The person faces south, left east and right west, the liver is the master of the Qi of spring, located in the east, so the liver is born on the left; the lung is the master of the Qi of autumn harvest, located in the west, so the lung is hidden on the right. The liver rises and the lung descends. The liver rises and the lung descends are important for maintaining the body’s qi flow. The liver is a rigid organ and is the main organ of drainage, with ascending being the norm; the lung is a delicate organ and is the main organ of propagation and purification, with descending being the order of the day. The liver is located in the lower jiao, which is the yin of the yang organs, and its meridians go through the diaphragm from the bottom to the lungs and up to the brain, so that the wood Qi can rise and fall to drain the blood and make it rise to the heart and lungs and go up to the head and face and circulate throughout the body; the lung is located in the upper jiao, which is the yin of the yang organs, and its Qi can descend to make the clear Qi of breathing and the essence of the spleen to spread throughout the body and down to the liver and kidneys. The normal ascension of the liver and the normal descent of the lung, the left ascending and right descending, are actually related to the up and down movement of the human qi. The liver rises and the lung descends in this way, promoting the physiological activities of the internal organs, meridians, yin and yang qi and blood of the human body, so that the qi and blood are regulated and the internal organs are in harmony. The pathological effect of the liver rising and lung descending. When the liver and lung ascending and descending are not normal, it will lead to Qi rebellion and change of evidence. Due to depression, sudden mental stimulation, or other disturbances, it affects the circulation of the liver, resulting in liver depression and stagnation of qi, which leads to liver depression and failure to rise. Due to uncomfortable mood, unrestrained emotions, liver qi stagnation, depression and fire, or kidney water deficiency, water does not contain wood, every cause of the liver’s yang hyper-retrograde upward, fire upward rushing and cause the liver to rise too much. External internal injuries cause the lung qi to rise without descending, and the lung loses its power to descend. The above shows that the reference of “liver is born on the left and lung is hidden on the right” in Huang Di Nei Jing is not a modern anatomical concept, but a high summary of the physiopathological functions of liver and lung, which are closely related to the rise and fall of the two organs. There are many reasons for the malfunction of liver and lung in clinical practice, such as external infection, internal injury, and disharmony of internal organs, all of which can lead to disorders of liver and lung functions. At the time of clinical evidence, we should be flexible in identifying the evidence according to the specific situation, identifying the priority of liver and lung elevation and the nature of the disease evil and disease evidence, so as to decide the specific treatment method and medicine. The following are two cases of clinical evidence of the theory of liver rising and lung falling. 1, de-stress the liver and do not forget to promote the lung to lower the qi Patient, Li, 52 years old, was first diagnosed on March 6, 2013. He has been suffering from irritability and hot flashes for 2 months and has been aggravated for 1 week. At the first consultation, she was irritable and restless, and if she was bothered, she immediately went out and walked, regardless of day and night, with hot flashes and sweating, five heartburn, chest tightness and palpitations, dry mouth and tongue, fatigue, poor sleep, and a dry stool, with 1 line per day, and urine regulation. The tongue is red, with little coating, and the pulse is thin and stringy. Chinese medicine diagnosis: depression (dirty dryness), this is due to liver depression and qi stagnation, yin deficiency and fire, the method should be to dredge the liver to relieve depression, nourish yin and clear heat, the formula is Chai Hu plus Dragon Bone and Oyster Soup with Artemisia annua and Turtle Nail Soup plus reduction treatment: Chai Hu 6g, Han Xia 9g, Fu Ling 10g, Dragon Bone (first decoction) 30g, Oyster (first decoction) 30g, Roasted Turtle Nail (first decoction) 15g, Artemisia annua 12g, Zhi Mu 6g, Dan Pi 10g, Prince Ginseng 15g, Gui Zhi 3g, Radix et Rhizoma Rhei 6g, Radix et Rhizoma Huai Shan 30g, Radix et Rhizoma Glycyrrhizae 3g. 7 doses in water, one dose a day. In the second diagnosis, all the symptoms improved, but there is still heart trouble, sometimes not stretching, the theory of liver ascending and lung descending, in the front to remove Zhi Mu, Huai Shan Yao, add Bai Qian 10g to promote the lung and lower the Qi, 10 doses. All the symptoms were removed in the third diagnosis, and the disease was cured. According to: dirty dryness for the Chinese medicine depression disease of a type of evidence, treatment to dredge the liver to relieve depression and Qi, as “where the depression must first Qi disease, Qi get unblocked, depression in what? As the saying goes, “Every depression disease must be preceded by a qi disease. The movement of Qi and blood in the body is closely related to the operation of Lung Qi. If the lung qi is not smooth, the liver qi will become more depressed; if the liver qi is stagnant, the lung will lose the promotion and descent; if the liver and lung qi are regulated, all the qi will be regulated; if the liver and lung qi are disordered, all the qi will be disordered. The patient’s initial treatment was not effective, and then with the lung and lowering of Bai Qian and effective, it can be seen that the liver and lung in the gas disease often affect each other, which is the specific embodiment of the theory of “liver and lung down”, so the evidence of liver stagnation not only to dredge the liver to relieve depression, but also to promote the lowering of lung qi. The patient, Wang Moumou, female, 31 years old, a teacher, was first diagnosed on September 17, 2012. Cough for 4 weeks, aggravated for 2 days. On initial examination, she has frequent dry cough with little sputum, chest pain, itching and hoarseness, dry mouth and throat, nasal congestion, poor sleep, and a dry stool with one line per day, and spontaneous urination. The tongue is red, the coating is thin, and the pulse is fine. The examination of leukocytes is 6.1×109/L, CRP 1.8 mg/l, and the chest X-ray shows that the texture of both lungs is slightly thickened. TCM diagnosis: cough, which is caused by wind-dryness injuring the lung and deficiency of lung yin, the method should be to nourish yin, moisten the lung, promote the lung and stop cough. 5 doses, decoction in water, one dose a day. In the second diagnosis, the symptoms improved slightly, but the cough was still frequent, so the theory of ascending the liver and descending the lung was adopted, and Xin Yi was removed from the front, and 10g of Buddha’s Hand and 10g of Citrus aurantium were added. At the third diagnosis, the cough was slightly relieved, and the patient was treated with the previous formula with additional reduction for 1 week. Note: The patient has been coughing for 4 weeks, so it is a prolonged cough that is difficult to resolve. The lung is the main cause of coughing, just as in “The Three Character Classic of Medicine – Coughing”: “Coughing is not only in the lung, but also in the lung.” Therefore, the lungs should be the mainstay of cough treatment. However, the liver and lungs are closely related and are the pivot of the qi flow. A prolonged cough will injure the liver, and gold will grind wood and wood will insult gold, so the liver and lungs should be treated together. This is a concrete manifestation of the theory that “the liver rises and the lung descends”. Therefore, for diseases in which the lung loses sufficiency, it is more effective to treat the lung while adding two to three liver meridians to make the liver qi rise while the lung qi descends. I have learned from my clinical experience that for people with liver depression or other illnesses with obvious symptoms of liver depression, when the effect of relieving liver depression is not good, we can use products that promote the lung and lower the qi; and for lung diseases, such as prolonged cough or frequent asthma, when the effect of treating the lung is not good, we can use products that regulate the liver and qi, or clear the liver and lower the fire, or nourish yin and soften the liver, which is often more effective.