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Classical Five-Element Acupuncture

By Neil Gumenick, MAc (UK), LAc, Dipl. Ac

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The Liver: The Official of Planning

The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season. Yet, this exuberance is neither chaotic nor random, but takes place within precise existing natural laws.

The early Chinese referred to the twelve organs and functions as "Officials." As such, they were metaphorically seen as ministers of an Imperial court. There was a King or Queen – the Supreme Controller, and eleven ministers, each of which had specific tasks to perform in service to the King and the Kingdom. The Kingdom, in fact, is the body, mind, and spirit of each and every person. Each Official has the innate ability to perform its own natural functions – physically, mentally, and spiritually for the  benefit of all. No minister can effectively replace another, and if one falls sick, all will feel the effects.

The Physical Level

Physically, the Liver weighs about three pounds and is located in the upper right aspect of the abdomen, below the diaphragm, to the right of the stomach, under the rib cage. Among its many functions is the production of bile, needed to emulsify and digest fats. From the digestive tract, the Liver receives about 1.5 quarts of blood per minute, which it filters, removing toxins such as alcohol, drugs, and harmful chemicals. The Liver makes many kinds of substances for use throughout the body. It makes and stores glucose as a carbohydrate, glycogen, which is converted back to functional sugar, glucose, when the body's sugar level drops below normal, maintaining homeostasis and providing an immediate source of energy. Liver cells make proteins required for numerous functions including blood clotting and the maintenance of proper fluidity in the circulatory system. The Liver manufactures cholesterol and triglycerides. It breaks down hemoglobin, insulin, and other hormones, and converts ammonia to urea, which is a vital component of metabolism.

The Function of Planning

As can be seen from the above, the Liver Official is very much concerned with the function of regulation, providing harmony and order within precise known parameters. These parameters are natural laws upon which the body/mind/spirit functions and which govern every facet of our being. All of our functions, from the smallest cellular activities to our grandest expressions, are not random, but follow specific internal ordered plans for their unfolding. The proper release of hormones, for example, follows an intricate order and logic. Food is digested according to a plan; the rhythms of the menstrual cycle follow a plan, as do the functions of every organ and process. It is easy to see how an imbalance in the Liver could disrupt the functioning of any organ or function as the plan for its healthy operation breaks down.

Every conscious and unconscious process contains a design or "blueprint" for its occurrence. Before any process can begin, there must always an internal plan. The Chinese considered the Liver Official to be the grand architect who has the vision and sets the plan, as in a "blueprint". The Gall Bladder Official (Acupuncture Today, March 2016, Vol 17, Issue 03), like a good and reliable construction supervisor, carries out the plans, deciding when, where, and how the plans will be implemented. When these Officials are healthy, everything functions and flows like clockwork: smoothly and well coordinated, with everything arriving in the right amount, at the right place, and at the right time.

The Mental Level

At the mental level, we are continually making plans – for the next moment, hour, day, year, as well as the distant future. A healthy Planner enables us to see our goals and organize our lives so as to stay on track, reach them, and give birth to new objectives. Our powers of reason and logic are largely due to the health of the Liver Official, which enables us to "see" with the eyes of the mind. When we say, "I see what you mean," we are speaking of seeing with the mind's eye. The Planning Official also provides us with contingency plans – the ability to see from other points of view, to adapt and rearrange according to changing circumstances. Thus, we can deal with obstacles without losing sight of the goal.

Without such flexibility or tolerance for the plans of others with different ideas or points of view, we tend to become bossy, close-minded, and prejudiced. What was, in fact, "my" plan becomes "the" plan to which everyone must agree. It is easy to see how the emotion of anger and the sound of shouting arise out of the nature of this Element and Official. We have an idea – a plan; some obstacle thwarts our plan; we feel anger and frustration. To someone primarily imbalanced in the Wood Element, any interaction is prone to be perceived as a confrontation and cause for anger. In the opposite extreme, the Wood imbalance can manifest as one who cannot self-assert, who easily caves in to the ideas of others, surrendering his/her own vision. Thus, we can see two major diagnostic correspondences pointing to a diagnosis of a primary Wood imbalance: excess anger or lack of anger (the emotion repressed), and excess or lack of shouting (the sound repressed).

The Spirit Level

Without a plan or spiritual purpose for our lives, there is no sense of a worthwhile future. Instead, we often feel aimless, wandering without direction, ready to give up. Without a healthy Liver, we do not see the promise of a renewal, a new beginning, and a fresh start.

Spiritual goals are the highest of our aspirations, as evidenced by the religious and spiritual paths and practices found at the core of every culture since the dawn of time. Hope, vision, and optimism are spiritual gifts of the Wood Element and give our lives a sense of purpose and the ability to stay on our spiritual path and bring its wisdom into our daily lives. Even in the inevitable presence of obstacles, distractions, and temptations, we can keep focused on what will fulfill our inner essential being and be of service to others. A healthy Liver also allows us to see the value in the practices of others, even those with which we differ. The unhealthy antitheses manifest as spiritual intolerance and religious fanaticism. There is an old, and true, saying, "There are many paths up the mountain. The view from the top is the same for all."

As there is an intrinsic plan for the unfolding of every process, so there is a "higher purpose" for each of us – something for which we strive that is bigger than our individual self-interest. Helen Keller said, "Many persons have a wrong idea of what constitutes true happiness. It is not attained through self-gratification but through fidelity to a worthy purpose." When our individual plans are in alignment with a worthy higher purpose, they are suffused with strength and confidence - gifts of the Wood Element.

The Diagnostics

Every person is born with a primary imbalance (AKA Causative Factor or CF) in one of the Five Elements. Over time, this imbalance will spread, via the creative cycle (AKA Sheng cycle) and the control cycle (AKA K'e cycle), and will imbalance all other Elements and Officials. Thus, by the time a patient comes for treatment, it is not uncommon to find all twelve pulses imbalanced and symptoms coming from everywhere. The Causative Factor element becomes the focus of treatment, as it is in this element that the original imbalance arose. Once the Causative Factor is identified, balanced and harmonized, not only does it regain its own health, but the healing will also manifest throughout the other Elements and their associated Officials.

Each element has an odor, color, vocal sound, and emotion associated with it. In the case of the Wood Element, when it is the primary imbalance, as we have seen, the emotion of anger and the sound of shouting will be present beyond what we would consider "normal." There are times when a healthy expression of self-assertion, self-direction, and anger are appropriate. For example, when we know that our vision is sound and we are ready to take action and someone or something comes along and says, essentially, "No, you can't," we must not be shaken or derailed, but assert ourselves (firmly if needed) and stay our course. In nature, the season of spring – the season of Wood – itself manifests with force. A spring bud that bursts free of its husk, or a dandelion that cracks a cement sidewalk in its reach for the sun, demonstrate the force of new growth. This is quite natural. When Wood is imbalanced, however, the sound and emotion will either over or under express. This is no longer natural, in a healthy sense. It is unnatural in the sense that it becomes inappropriate. When assessing whether a patient is, in fact, a Wood CF, we must consider whether his/her anger or shouting is appropriate or not. Is it present when there is no real need for its expression, or absent when it should be present? These inappropriate expressions of sound and emotion will manifest in virtually everything the patient says and does.

The diagnostic indicators of a Wood CF also include its odor and color. Rancid is the odor emitted by a primary Wood imbalanced patient. The smell is akin to old butter, oil, or the fur of animals such as goats and sheep. The color, best-seen lateral to the eyes, on the skin, is green. Green is the color of things young and not yet ripe. Even in colloquial language, we refer to someone who is new, or a beginner, as being "green." Spring is the time of youth, not only chronologically, but in the sense of a new vision, a new plan, the beginning of a new cycle of growth - young, eager, optimistic, and "raring to go."

For a discussion of acupuncture points on the Liver meridian, please refer to The Spirits of the Points: The Liver Meridian, Parts I and II (Acupuncture Today, February 2012 Vol 13, Issue 02 and June 2012 Vol 13, Issue 06).

The Questions

The following questions are useful for self-observation and can appropriately be modified to inquire about the state of a patient's Liver Official, particularly at the mental and spirit levels. It is important to remember that the presence of a problem in this Official's functioning does not necessarily make a patient a Wood Causative Factor, nor does it mean that the major underlying problem is the Liver Official.

As we have seen, any symptom can come from imbalance in any element, as imbalance spreads from one official and element to the next. We determine the source of the trouble, the CF, only through odor, color, sound and emotion. Yet, if you suspect a problem in a patient's Wood element and specifically with the Liver Official, here are some questions to consider in assessing its state:

  1. When have your plans been thwarted?
  2. When have you been unable to come with a satisfactory plan?
  3. What do you envision for yourself in the future?
  4. When have you lost hope?
  5. When have you felt frustrated at not being able to make up your mind?
  6. When have you been upset when plans were changed at the last minute?
  7. When have you become bossy and close-minded?
  8. When have you been angry at not being able to figure out how something worked?
  9. When have you sensed that your actions were aligned with a higher purpose?
  10. When have you felt ready to open a new chapter in your life?

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