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There may have been situations when the patient goes to the Chinese Medicine doctor and is diagnosed with having a liver problem. He then goes to his Western doctor, and does tests that show nothing abnormal with his liver. To understand why the Chinese Medicine doctor said what he said, we have to clarify the differences between the Chinese Medicine liver and what we all know as the liver now.

Let’s begin with the what we know as the liver:

The liver is the biggest known “non-hollow” organ in the body. It takes up the entire right side of our upper abdomen and part of the upper left side. Its upper border is usually slightly below our right nipple (around the 5th or 6th intercostal), its lower border sort of follows the lower edge of our ribs. So most of the liver is shielded by the ribs.

Many events happen in the liver. It’s a crucial organ that does complicated things. The nutrients we receive or already have need to pass through the liver’s machinery to become stuff that the body really can use. For example,

• the plasma protein（血浆蛋白） in the blood, the glucose（葡萄糖）that we need, the fat（脂类）that we also need, the vitamins（维生素）we really need, and the blood coagulating factors（凝血因子）that keeps the blood in the vessels - all of them need to be produced by the liver machinery.
• bile is created in the liver; bile pigments are excreted via the liver to the intestines
• the liver can detoxify poisonous substances, medicines we eat and othe metabolites in the body, to be excreted via the intestines or kidney.
• the liver participates in the regulation of enzyme levels in the body, as well as the metabolism of hormones, water and electrolytes.
• The liver is closely linked with immune function. For example, in the embryonic stage, it is the main producer of blood and lymphocytes. Although it looses this role after the baby is born, we know that it’s closely tied to immune function because when the liver is not working well, both cellular and humoral immune function is compensated.

Liver inflammation (hepatitis) is very often virus-induced, so we often talk  of viral-hepatitis.
Chinese Medicine’s Liver:

The liver we mentioned above is also spoken of in Chinese Medicine. The classics talk of this organ with two lobes, its weight, even the fact that the gall bladder resides within the smaller lobe. So there is an anatomical liver to speak of, however, more important to the Chinese Medicine theorists of a time long past were the physiological and pathological expressions of the liver.

Although there are more, the three main ideas (simplified) we need to know about Chinese Medicine’s liver are listed below:

1. Stress（from “肝主疏泄”）: Stress will cause “liver problems.” So the liver is as much a mental/psychological concept as it is a physiological concept. If a certain manifestation of stress appears in you, beyond what your body can comfortably handle, you’ll manifest “liver problems.” Many time, this will express as digestive problems that affect the smooth functioning of your stomach, intestines and even gall bladder.
2. Endocrine Imbalances（from “肝主藏血）: Although the ancients saw it as the liver not storing blood as it should, this may once again be related to stress. All of a sudden your endocrine system starts going awry, causing for example ladies’ menstrual issues or lack thereof.
3. Tissue and tendon quality（from “肝主身之筋膜”）: This is perhaps related to blood and the healthy portioning of nutrient throughout the body, especially glucose.
4. Your eyes （from “肝受血而能视”）: When we see eye problems, especially those manifesting heat or dryness, we related it to the liver.

In any case, we can either think of it as excessive stress, or some constitutional insufficiency in the liver function (to produce and regulate as it should).

“Liver Problems” and Hepatitis:

In Chinese medicine, liver problems can present as the following:

1. Liver Qi stuck
2. Liver fire burning upward
3. Liver yang excess
4. Liver wind causing internal chaos
5. Liver blood deficiency
6. Liver blood not being stored and running elsewhere

Although some of these might be related to the digestive, endocrine, blood-related, musculo-skeletal problems we assocaited with hepatitis, it’s not exactly the same. Moreover, we often consider Chinese Medicine’s spleen and kidney when trying to solve hepatitis. So Liver inflammation (hepatitis) can often be a problem with the liver, spleen and kidney if using a Chinese Medicine perspective.