By Shihan Mary Bolz
Master of Science Oriental Medicine
Doctoral Fellow, FBU
Master Martial Arts Instructor
Did you know that the liver is the second largest organ, next to the skin, in the body? The liver plays a vital role in maintaining good health via a very intricate network of cells that synthesize and metabolize nutrients and detoxify unwanted chemicals in the blood. The liver is connected by a complex network of blood vessels with the rest of the digestive organs so it can take in nutrition from the food you eat that goes down into the intestines and then transforms the nutrients into essential components of nutrients that the body can use; i.e. proteins, vitamins, fats and minerals. The liver stores nutrients and carbohydrates (glucose that has been broken down into glycogen).
The stored glycogen is release when needed by the muscles and other parts of the body in order for you to perform work. The liver has the very important function of converting iron and other nutrients into heme, which are the oxygen transporting molecules in red blood cells. Knowing this, you can realize how important the liver’s role is in all that occurs in your body: digestion, kidney, brain, cardiovascular functions and even the regulation of sex hormones. Yes, this is dependent on a healthy liver. The liver is very important in the following functions: bile production, fat metabolism, and removal of toxins, blood circulation and filtering of the blood, regulation of blood sugar, synthesizing enzymes important in the digestive process and protein metabolism.
In Traditional Chinese Medicine (TCM) we deal with Organ systems, not necessarily each anatomical organ that allopathic (Western) medicine refers to. These systems in TCM are looked at in terms of function similarly as allopathic medicine, but there is another aspect of the mind body- spirit that is also considered with each organ. There is, in fact, no real separation of the body from the mind or from spiritual and emotional aspects of the live being. This is true of all living beings, not just humans.
Just as allopathic medicine is based on theory, so is TCM. The organ systems are looked at in terms of yin or yang organs relative to each other. Eastern medicine, as well as all Eastern thought is looked at in terms of relationships and patterns. So some organs are yin and some are yang in relationship to each other. Yin organs are interior, prone to deficiencies and vulnerable to the cold. Yang organs are more exterior and prone to excess and more vulnerable to heat. Yin and Yang organs create a balanced whole. In TCM, the liver is considered a yin organ in comparison with its paired organ, the gallbladder.
In Traditional Chinese Medicine, the liver organ system is referred to as the “general,” like the general in an army. The main job of the general is to organize and maintain order among the troops. Similarly, the liver is in charge of maintaining harmony of the Qi (Chinese), Ki (Japanese), Gi (Korean) throughout the body. Qi is the life-force energy. The functions known in TCM (Traditional Chinese Medicine) are similar to those of Western medicine, with the important added duties of : Metabolism of fluid, digestion of nutrients and fluid and the distribution of the energy. The distribution of energy is termed as regulating the smooth flow of Qi in TCM language. The liver organ system controls bile secretion, therefore it cannot maintain the flow of normal liver Qi or Qi of the other organs if the bile production is disrupted.
In TCM the liver stores and regulates blood and other fluids. Blood is known as the mother of Qi in TCM. Since Qi is the life force that circulates all throughout the body, without good blood, good flow of Qi cannot be maintained. The liver system also removes poisons from the blood. The liver system regulates the body by ensuring the smooth flow of Qi throughout the entire channels and other organ systems in the body.
Besides this, the liver balances emotions to protect the organism from frustrations and anger. Emotional stress does disrupt the liver organ system and vice versa; liver disease disrupts the emotions. The emotion most associated with the liver is anger. The Seven emotions in TCM are joy, anger, sadness, fear, sudden fright, grief, and mediation. The liver organ system is connected to the eyes because in supplies nourishment to them, as well as to the tendons and nails. Many times a TCM practitioner will look at the eyes and nails as part of their visual diagnosis. Very closely related to the liver system in TCM is the spleen system, in fact, the spleen is one of the liver’s main partners. In TCM the spleen organ system produces and controls blood. It is responsible for getting the nutrients from the food and transforming it into nutritive substances and blood. In conjunction with the kidney system, it stores Qi that is acquired after birth.
Besides transforming fluids and food into useable substances by the body, it is also responsible for moving the fluids and food throughout the body, actually distributing it properly to other areas. The proper flow of fluid and its movement is needed to lubricate the tissues and joints of the body. This proper balance prevents dryness and keeps fluids from pooling or stagnating inside the body. The spleen organ systems are also associated with muscle mass and tone and with holding the internal organs in their place.
The paired organ of the liver in TCM is the gallbladder. Paired means that there is a mutually dependent relationship between these two organs. The gallbladder stores and secrets the bile that the liver manufactures. If the gallbladder has trouble, the liver, of course, is affected and vice versa. In TCM, it is said that the gallbladder organ system is the decision-maker-it rules the decision-making process of the being. When the gallbladder system is not balanced, decisions become difficult and may have been motivated by anger. In the Chinese language, the phrase, “You have no gallbladder,” means that the person is not courageous and thus cannot make decisions. Saying someone has no gallbladder in Chinese is like telling someone they are a chicken or have no guts, in English.
Hepatitis C can display a variety of symptoms. In fact it is difficult to state a specific list. At the time of initial infection, only 30-40 percent of the people have any symptoms. Some initial symptoms can include malaise, abdominal pain, fatigue and loss of appetite. Chronic symptoms may come and go. Over the course of time, 85 percent of people will have intermittent fatigue, depression, short-term memory loss, digestive disturbances, joint and muscle pain and headache. Progressive stage of the disease can lead to multiple symptoms and to cirrhosis. How is the Hepatitis C virus spread? It is spread through the blood only. The most common routes of infection are: shared IV drug needles, shared cocaine snorting straws, shared personal grooming items such as razors, toothbrushes, scissors, and manicuring equipment, and unprotected sex.
There is no vaccine for the Hepatitis C virus since it mutates often, evading the protective antibodies in the person’s immune system that may be produced by a vaccine. There are also six genotypes which produce different disease patterns of Hepatitis C. In the case of Hepatitis C, a person needs to have specifics on their blood test. A person would need blood tests for liver enzyme levels and for viral forms of the hepatitis: HAV, HBC, and HCV. A test can be done for viral load, which tells how many copies of the virus exist in one milliliter of blood. There are different methods of this, which will not be covered here. The genotype should also be identified if the HCV has been found.
Is there a cure for Hepatitis C? There is no certain cure for it. Some allopathic (Western) medicine treatments reduce the viral load to undetectable levels, keep those levels low, and act as liver-protecting agents. Some would call this a “cure,” but there may still be viruses that are in tissue and organs where it cannot be measured. However, since it cannot be measured, it does offer some feeling that it is suppressed.
Allopathic (Western) medicine treatment consists of interferon or a combination of interferon and ribavirin when a person has antibodies to CV, a measurable viral load and elevated AST and ALT liver enzyme levels, and has had a liver biopsy which reveals evidence of chronic hepatitis that is progressing. People with severe symptoms or a rare condition called cryoglobulinemia are also good candidates for treatment, regardless of their test results.
Some people are not really good candidates for drug therapy. These include those with clinically decompensate cirrhosis (progressive cirrhosis), normal ALT levels, anyone who has received a kidney or heart transplant, anyone with liver cancer, women and men planning to conceive a child, or a pregnant woman, any severe psychiatric or coronary artery diseases.
Treating Hepatitis C and other liver disease in TCM is quite different in approach from Western drug therapy. There are many herbal remedies that can protect the liver from damage of viral inflammation even though these herbs do not reduce the viral load. There are also antiviral herbs that do appear to hold the virus in check. By combining these types of herbs, an effective treatment and protection of the liver and an increase in the quality of life of the person without causing any harmful side effects can be obtained.
Acupuncture is also very powerful to improve the immune system and the entire bodily system in general without any side effects whatsoever. A Traditional Chinese Medicine practitioner will do a complete workup and evaluation using the common methods of TCM: asking, observing, listening, and palpating.
Important methods of diagnosis include pulse diagnosis and tongue diagnosis. Causes of the disharmony are looked at in TCM. Toxic Heat is the primary disease trigger of Hepatitis C according to TCM. Toxic heat is an externally contracted epidemic factor that will produce symptoms like the flu, nausea, fatigue, itchy skin, and a general feeling of toxin in the body. Toxic heat is a cause of many other problems with the spleen, gallbladder, kidneys and heart as well. Some of the other diagnoses associated with Hepatitis C in TCM include liver/gallbladder damp heat, spleen damp heat and spleen damp cold. At the chronic stage of the disease diagnoses can include: liver qi stagnation, spleen qi deficiency, liver yin deficiency, qi deficiency in general, Yin deficiency (general), blood deficiency in general, and blood stagnation.
The great news is that Traditional Chinese Medicine offers great relief and hope for Hepatitis C sufferers. The Eastern doctor’s work can be monitored with the allopathic medicine tests. Many of us practitioners have our work with the patients proven in its effectiveness by these tests. After a course of herbs and acupuncture, the liver enzymes and viral loads will many times show very favorable results. Even cirrhosis of the liver can be managed and improved. We do not claim a cure, but a tremendous help which conventional allopathic (Western) medicine cannot provide. It is important, however, for the Eastern and Western medicine practitioner to work together with Hepatitis C patients because both modalities have a lot to offer. Many times, the overwhelming interferon and ribavirin therapy can be avoided. Next month we will talk more in depth about the symptoms of Hepatitis C and how Oriental medicine approaches treatment.