Stagnation of the liver qi

Clinical manifestations : Mental depression ; irritability ; distending or wandering pain in the costal and hypochondriac regions ; distension of the breasts ; stuffiness in the chest ; sighing ; epigastric and abdominal distension and pain ; poor appetite ; belching ; or possibly a foreign body sensation in the throat ; irregular menstruation and dysmenorrhea in women ; a thin, white tongue coating and a string - taut pulse. In prolonged cases, there may be pricking pain in the costal and hypochondriac regions or palpable mass may be present. The tongue is purplish dark in color, or there are purplish spots on the tongue.

Etiology and pathology : The syndrome is often due to mental irritation which impairs the function of the liver in promoting the free flow of qi and results in stagnation of the liver qi, leading to retardation of the qi circulation, thus presenting mental depression, irritability, distending pain in the costal and hypochondriac regions and breasts, stuffiness in the chest and sighing. Transverse invasion of the spleen and stomach by the liver qi produces epigastric and abdominal distension and pain, poor appetite and belching. Retardation of the qi circulation allows damp to collect and phlegm may be formed ; the phlegm and qi may accumulate in the throat, resulting in a foreign body sensation in the throat. Affected by dysfunction of qi, the circulation of both qi and blood is retarded and disharmony of the Chong and Ren ( Conception Vessel ) Meridians may result. This can cause irregular menstruation and dysmenorrhea. Long standing obstruction of the liver qi, leading to stagnation of qi and blood, may elicit palpable masses, accompanied by pricking pain in the costal and hypochondriac regions, a purple tongue or a tongue with purplish spots, and a string - taut pulse.