寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Liver

Ganjang

한글 간장  ·  Pinyin Gan Zang

The general among the officials — seven lobes on the left, ruling spring and wood, anger and the eyes, sinews and nails, and the blood that returns to it at rest

肝臟

The first of the twelve organ chapters, and the pattern the others follow. Each has fourteen sections in the same order: the organ's shape and weight, where it sits, the season and days it rules, everything in the world that belongs to its phase, the sizes and shapes it can take and what each means, how it is injured, what its disease looks like, what its vacuity and repletion are, when its disease eases and worsens, how it is treated, the signs of its qi expiring, the breathing practice for it, the stretch for it, and the simples. The liver is the general. It has seven lobes and sits on the left; it rules spring and the days gap and eul, wood and wind and the colour green, the eyes and the nails and the sinews, anger and tears; and it stores the blood, which runs out to the channels when a person moves and comes home to the liver when they rest. The liver's injury is rage, and a fall; its disease is pain under the ribs and readiness to anger; its vacuity is fear and dim eyes, its repletion anger; it eases in summer and worsens in autumn. It is treated with sweetness to relax it and acridity to disperse it, and the signs of its end are green lips, a curled tongue and the testicles drawn up. The chapter's five formulas are registered under their own entries, three to drain the liver and two to supplement it.

2.1 The Form of the Liver 肝形象

2.1.1
Source원문

肝有二布葉, 一小葉, 如木甲拆之象. 各有支絡脉居中, 以宣發陽和之氣, 魂之宮也. 《內經註》

Translation영역
The liver has two spreading lobes and one small lobe, in the image of a tree's bud-scales splitting open. Each has branching vessels within, by which it diffuses the harmonious yang qi. It is the palace of the ethereal soul.
Clinical note임상 주석
如木甲拆之象 — like bud-scales splitting. The liver is wood, and its lobes are described as a bud opening in spring, which is the season it rules. The image does the work of the whole chapter.

Naegyeong-ju 內經註

2.1.2
Source원문

肝有二大葉, 一小葉, 左三葉, 右四葉, 分兩如木甲拆之多葉也. 《入門》

Translation영역
The liver has two large lobes and one small lobe — three on the left and four on the right, divided into two sides like the many leaves of a tree's bud-scales splitting.

Immun 入門

2.1.3
Source원문

肝重四斤四兩, 左三葉, 右四葉, 凡七葉, 主藏魂. 《難經》

Translation영역
The liver weighs four geun four nyang, three lobes on the left and four on the right, seven in all, and governs the storing of the ethereal soul.
Clinical note임상 주석
Four geun four nyang is about two and three-quarter kilos, and the Nanjing's forty-second difficulty gives every organ a weight. The real liver is near a kilo and a half; the seven lobes are a count the tradition kept from the Nanjing without dissecting.

Nangyeong 難經

2.2 The Position of the Liver 肝部位

2.2.1
Source원문

肝生於左. 《內經》

Translation영역
The liver is born on the left.
Clinical note임상 주석
The Suwen's line, and the one that every reader of the tradition has to reckon with: the liver is on the right. 肝生於左 is read as the liver's qi rising on the left — the left is where yang ascends — rather than as anatomy, and the Body chapter's 1.9 and 1.10 gave the left-up, right-down circuit that the reading depends on.

Naegyeong 內經

2.2.2
Source원문

肝之系者, 自膈下着左脇肋, 上貫膈, 入肺中, 與膈膜相連也. 《入門》

Translation영역
The liver's cords attach below the diaphragm to the left ribs, pass up through the diaphragm, enter the lung, and connect with the diaphragm's membrane.

Immun 入門

2.2.3
Source원문

期門二穴, 肝之募也. 在兩乳直下一寸半, 在背則肝兪在九顀下, 是肝之分也. 《銅人》

Translation영역
The two points Gimun (期門, LR14) are the liver's alarm points, one and a half chon straight below the two nipples; on the back, Gansu (肝兪, BL18) is below the ninth vertebra. These are the liver's territory.
Clinical note임상 주석
Front and back: the alarm point under the nipple and the transport point beside the ninth vertebra. Every organ chapter gives its pair, and they are the points the tradition uses to reach the organ directly.

Dongin 銅人

2.3 The Season and Days the Liver Rules 肝主時日

2.3.1
Source원문

肝主春, 足厥陰少陽主治, 其日甲乙.

Translation영역
The liver rules spring; the foot reverting yin and lesser yang govern its treatment; its days are gap and eul.

Naegyeong 內經

2.3.2
Source원문

東方生風, 風生木, 木生酸, 酸生肝.

Translation영역
The east engenders wind, wind engenders wood, wood engenders sourness, and sourness engenders the liver.

Naegyeong 內經

2.3.3
Source원문

肝爲陰中之少陽, 通於春氣. 《內經》

Translation영역
The liver is the lesser yang within yin, and communicates with the qi of spring.
Clinical note임상 주석
Spring, east, wind, wood, sour — the liver's set from the Suwen's fifth chapter, and 2.4 gives the rest of it. Gap and eul are the two wood stems, and 2.9.2 will use them to say which days the liver's disease eases.

Naegyeong 內經

2.4 The Things That Belong to the Liver 肝屬物類

2.4.1
Source원문

在天爲風, 在地爲木, 在體爲筋, 在藏爲肝, 在色爲蒼, 在音爲角, 在聲爲呼, 在變動爲握, 在竅爲目, 在味爲酸, 在志爲怒, 其液爲淚, 其榮爲爪, 其臭爲臊, 其卦爲震生數三, 成數八, 其穀爲麻一作麥, 其畜爲犬一作雞, 其蟲爲毛, 其數爲八, 其果爲李, 其菜爲韭, 其脉爲足厥陰. 《內經》

Translation영역
In heaven it is wind, on earth wood, in the body the sinews, among the viscera the liver, in colour green, in the notes gak, in sounds shouting, in change grasping, in the orifices the eyes, in flavours sour, in the minds anger; its fluid is tears, its bloom the nails, its odour rank, its trigram jin its engendering number three and completing number eight, its grain hemp one version says wheat, its animal the dog one version says the fowl, its creatures the furred, its number eight, its fruit the plum, its vegetable the leek, and its channel the foot reverting yin.
Clinical note임상 주석
The liver's column in the five-phase table, and every organ chapter has one. Two of the entries matter clinically: 在變動爲握, grasping — the liver's disease is spasm and clenching, which the Wind chapter treats — and 其液爲淚, tears, which the Eye chapter reads. The plum and the leek are the last two of the chapter's simples at 2.14.

Naegyeong 內經

2.5 The Size of the Liver 肝臟大小

2.5.1
Source원문

肝者主爲將, 使之候外, 欲知堅固, 視目大小.

Translation영역
The liver is the general, sent to keep watch without; to know whether it is firm, look at the size of the eyes.

Yeongchu 靈樞

2.5.2
Source원문

靑色小理者肝小, 麄理者肝大. 廣胸反骹者肝高, 合脇兎骹者肝下. 胸脇好者肝堅, 脇骨弱者肝脆. 膺背好相得者肝端正, 脇骨偏擧者肝偏傾也.

Translation영역
A green complexion with fine skin-grain means a small liver, with coarse grain a large one. A broad chest with the ribs flaring back means a high liver; ribs drawn in with the lower ribs low, a low liver. A good chest and flank mean a firm liver; weak rib-bones, a brittle one. Chest and back well matched mean an upright liver; rib-bones raised on one side, a tilted one.
Clinical note임상 주석
The liver read from the rib cage — flaring, drawn in, weak, lopsided. The Lingshu's rule that the organ's shape shows on the bones over it, and 2.5.3 says what each shape costs.

Yeongchu 靈樞

2.5.3
Source원문

肝小則藏安, 無脇下之病, 肝大則逼胃, 迫咽, 苦膈中, 且脇下痛. 肝高則上支賁, 切脇, 悗爲息賁, 肝下則逼胃, 脇下空, 易受邪. 肝堅則藏安難傷, 肝脆則善病消癉易傷. 肝端正則和利難傷, 肝偏傾則脇下痛也. 《靈樞》

Translation영역
A small liver means the viscus is at ease and there is no disease under the ribs; a large one presses on the stomach and crowds the throat, troubles the diaphragm, and pains under the ribs. A high liver props up against the diaphragm, cuts at the ribs, and oppresses into rushing breath; a low one presses on the stomach and leaves the flank hollow, easily invaded by evil. A firm liver is at ease and hard to injure; a brittle one is prone to wasting thirst and easily injured. An upright liver is harmonious and hard to injure; a tilted one pains under the ribs.
Clinical note임상 주석
A liver that is large or high presses on the stomach and the diaphragm — which is what an enlarged liver does — and the Lingshu has the mechanism though not the cause. 消癉, wasting thirst, for the brittle liver is the Wasting Thirst chapter's diabetes.

Yeongchu 靈樞

2.6 The Patterns of Liver Injury 肝傷證

2.6.1
Source원문

有所墜墮, 惡血留內, 有所大怒, 氣上不下, 積於脇下則傷肝. 又曰, 大怒氣逆則傷肝. 《靈樞》

Translation영역
A fall from a height, with bad blood lodging within, or a great rage with the qi rising and not descending, accumulating under the ribs, injures the liver. It also says: great rage with the qi counterflowing injures the liver.

Yeongchu 靈樞

2.6.2
Source원문

恚怒, 氣逆上而不下則傷肝. 《難經》

Translation영역
Resentment and rage, with the qi counterflowing upward and not descending, injure the liver.
Clinical note임상 주석
Two injuries, a fall and a rage, and the Ojangyukbu chapter's 1.11 and 1.12 gave them among the five organs' causes. Blood lodged under the ribs after a fall is a liver injury in both senses, and the tradition put the organ of anger there because that is where anger is felt.

Nangyeong 難經

2.7 The Patterns of Liver Disease 肝病證

2.7.1
Source원문

邪在肝, 則兩脇中痛, 寒中, 惡血在內. 《靈樞》

Translation영역
Where the evil is in the liver, there is pain within both flanks, cold in the centre, and bad blood within.

Yeongchu 靈樞

2.7.2
Source원문

肝病者, 兩脇下痛, 引小腹, 令人善怒.

Translation영역
In liver disease there is pain under both ribs drawing into the lower abdomen, and the person is quick to anger.
Clinical note임상 주석
The liver's signature — flank pain reaching the groin, and a short temper. The Suwen's twenty-second chapter, and the two signs together are what the tradition means by a liver pattern.

Naegyeong 內經

2.7.3
Source원문

肺傳之肝, 病名曰肝痺, 一名曰厥, 脇痛出食.

Translation영역
Where the lung passes it to the liver, the disease is named liver impediment, also called reversal — flank pain and food brought up.
Clinical note임상 주석
Metal overcoming wood: the lung's disease passing to the liver along the control cycle, which the Ojangyukbu chapter's 1.15 said was the fatal direction. 肝痺, liver impediment, is the name for it.

Naegyeong 內經

2.7.4
Source원문

肝熱者, 色蒼而爪枯. 《內經》

Translation영역
Where the liver is hot, the complexion is green and the nails withered.

Naegyeong 內經

2.7.5
Source원문

外證, 善潔, 面靑, 善怒, 內證, 臍左有動氣, 按之牢若痛. 其病四肢滿閉, 淋澁便難, 轉筋, 有是者肝也, 無是者非也. 《難經》

Translation영역
The outer signs are fastidiousness about cleanliness, a green face and quickness to anger; the inner sign is stirring qi to the left of the navel, firm under pressure and painful. Its disease is fullness and blockage of the four limbs, dribbling and difficult urination, and cramping of the sinews. Where these are present it is the liver; where they are absent it is not.
Clinical note임상 주석
The Nanjing's sixteenth difficulty, with the test at the end: 有是者肝也, 無是者非也. The pulsation to the left of the navel is the abdominal sign, and the tradition palpated the belly for it. 善潔, fastidiousness, is the one temperamental sign, and it is a good observation.

Nangyeong 難經

2.7.6
Source원문

大骨枯槁, 大肉陷下, 胸中氣滿, 腹內痛, 心中不便, 肩項身熱, 破䐃脫肉, 目眶陷, 眞藏見, 目不見人立死, 其見人者, 至其所不勝之時則死. 註曰, 此肝之藏也. 所不勝之時, 謂庚辛之月也. 《內經》

Translation영역
The great bones withered, the great muscles sunken, the chest full of qi, pain within the abdomen, the heart uneasy, heat in shoulders, neck and body, the muscle-masses broken and the flesh deserting, the eye sockets sunken — the true viscus appearing; where the eyes do not see people, death at once, and where they still do, death when the time the organ cannot overcome arrives. The commentary says: this is the liver as a viscus, and the time it cannot overcome means the months of gyeong and sin.
Clinical note임상 주석
The Suwen's picture of the end of a liver disease — wasting, sunken eyes, fever — and the date it will kill: the metal months, which overcome wood. The Pulse Diagnosis chapter's 4.4 true-viscus pulse is the same 眞藏見, felt rather than seen.

Naegyeong 內經

2.8 Vacuity and Repletion in Liver Disease 肝病虛實

2.8.1
Source원문

肝藏血, 血舍魂, 肝氣虛則恐, 實則怒.

Translation영역
The liver stores blood, and the blood houses the ethereal soul; where the liver qi is vacuous there is fear, and where it is replete, anger.
Clinical note임상 주석
Fear or anger — the one sign that sorts a liver disease into empty and full. The Qi chapter's 4.15.1 sent anger's qi up and fear's down, and the liver is where the two meet.

Yeongchu 靈樞

2.8.2
Source원문

肝實則兩脇下痛, 引小腹, 善怒, 虛則目𥆨𥆨無所見, 耳無所聞, 善恐如人將捕之. 《靈樞》

Translation영역
Where the liver is replete there is pain under both ribs drawing into the lower abdomen and quickness to anger; where it is vacuous the eyes are dim and see nothing, the ears hear nothing, and there is fear as though someone were about to seize one.
Clinical note임상 주석
善恐如人將捕之 — fear as though about to be arrested. The Lingshu's phrase for the anxiety of liver vacuity, and it names the feeling exactly.

Yeongchu 靈樞

2.8.3
Source원문

肝藏血, 血有餘則怒, 不足則恐. 《內經》

Translation영역
The liver stores blood; where the blood is in surplus there is anger, and where it is insufficient, fear.

Naegyeong 內經

2.8.4
Source원문

人動則血運於諸經, 靜則血歸於肝藏, 肝主血海故也. 《入門》

Translation영역
When a person moves the blood runs out to the channels, and when they rest the blood returns to the liver, because the liver rules the sea of blood.
Clinical note임상 주석
The liver as reservoir — blood goes out to the limbs in action and comes home at rest. The claim is physiological and roughly right: the liver's blood volume does change with activity. The Blood chapter's 1.2.2 gave the liver the storing of blood on this basis.

Immun 入門

2.9 Remission and Worsening of Liver Disease 肝病間甚

2.9.1
Source원문

病在肝, 愈於夏, 夏不愈, 甚於秋, 秋不死, 持於冬, 起於春.

Translation영역
Where the disease is in the liver it heals in summer; if it does not heal in summer it worsens in autumn; if it does not kill in autumn it holds in winter and rises in spring.

Naegyeong 內經

2.9.2
Source원문

肝病者, 愈在丙丁, 丙丁不愈, 加於庚辛, 庚辛不死, 持於壬癸, 起於甲乙.

Translation영역
Liver disease heals on byeong and jeong days; if it does not heal on byeong and jeong it worsens on gyeong and sin; if it does not kill on gyeong and sin it holds on im and gye and rises on gap and eul.

Naegyeong 內經

2.9.3
Source원문

肝病者, 平朝慧, 下晡甚, 夜半靜. 《內經》

Translation영역
Liver disease is clear at dawn, worse in the late afternoon, and quiet at midnight.
Clinical note임상 주석
Three clocks — the year, the ten-day week, the day — all running on the same five-phase rule. Fire days ease the liver, metal days worsen it, water days hold it, wood days stir it. The Ojangyukbu chapter's 1.17 gave the rule; this is the liver's table.

Naegyeong 內經

2.10 The Treatment of Liver Disease 肝病治法

2.10.1
Source원문

肝苦急, 急食甘以緩之, 甘草, 宜食粳米ㆍ牛肉ㆍ棗ㆍ葵. 註曰, 肝苦急, 是其氣有餘也. 肝欲散, 急食辛以散之, 川芎. 肝虛以生薑ㆍ陳皮之類補之. 《內經》《東垣》

Translation영역
The liver suffers from tension; quickly eat sweet things to relax it — licorice — and rice, beef, jujube and mallow are suitable. The commentary says: the liver suffering from tension is its qi in surplus. The liver wishes to disperse; quickly eat acrid things to disperse it — chuanxiong. Where the liver is vacuous, supplement it with fresh ginger, tangerine peel and their kind.
Clinical note임상 주석
Sweet to relax, acrid to disperse — the Suwen's two rules for the liver, with Dongwon's medicinals attached. 肝欲散, the liver wishes to disperse: the organ of wood wants to spread, and what it hates is constraint. The Medicine Use chapter's 5.32 gave the same rule for the affects.

Naegyeong 內經 · Dongwon 東垣

2.10.2
Source원문

肝病, 宜食甘, 粳米ㆍ牛肉ㆍ棗ㆍ葵, 取其甘, 能緩急也. 《內經》

Translation영역
In liver disease it is suitable to eat sweet things — rice, beef, jujube and mallow — taking their sweetness, which can relax tension.

Naegyeong 內經

2.10.3
Source원문

肝病, 宜食麻ㆍ犬肉ㆍ李ㆍ韭, 皆酸, 取本味也. 《甲乙經》

Translation영역
In liver disease it is suitable to eat hemp, dog meat, plum and leek, all sour, taking the organ's own flavour.
Clinical note임상 주석
Two food lists and two theories: the Suwen feeds the liver the flavour that relaxes it, the Jiayi feeds it its own. The Bogam gives both, and the four sour foods are the four from 2.4's table.

Gabeulgyeong 甲乙經

2.10.4
Source원문

肝虛, 宜四物湯方見血門ㆍ淸肝湯, 或補肝丸. 肝實, 宜瀉靑丸ㆍ洗肝散ㆍ當歸龍薈丸. 《海藏》

Translation영역
For liver vacuity, Four Substances Decoction formula in the Blood chapter, Clear the Liver Decoction, or Supplement the Liver Pill. For liver repletion, Drain the Green Pill, Wash the Liver Powder and Angelica, Gentian and Aloe Pill.
Clinical note임상 주석
Six formulas, three each way, and all six registered. Sacheong-hwan is Qian Yi's — 靑, green, is the liver's colour and the pill drains it — and Danggwiyonghoe-hwan is the strongest liver purge in the book, with aloe and gentian. Samul-tang for the empty liver is the Blood chapter's rule that the liver stores blood.

Haejang 海藏

2.10.5
Source원문

肝病, 禁當風. 《內經》

Translation영역
In liver disease, facing the wind is forbidden.
Clinical note임상 주석
Wind is the liver's climate, and the sick liver cannot bear its own element. Each organ chapter ends its treatment with one prohibition, and the liver's is the wind.

Naegyeong 內經

2.11 The Signs of the Liver Expiring 肝絶候

2.11.1
Source원문

足厥陰氣絶, 則筋絶. 厥陰者, 肝脉也. 肝者, 筋之合也. 筋者, 聚于陰器而絡于舌本也. 故脉不榮則筋急, 筋急則引舌與卵. 故脣靑, 舌卷, 卵縮, 則筋先死. 庚日篤, 辛日死.

Translation영역
Where the foot reverting yin's qi is cut off, the sinews are cut off. The reverting yin is the liver's channel, and the liver is what the sinews join with; the sinews gather at the genitals and network to the root of the tongue. So where the channel does not nourish, the sinews tighten, and the tightened sinews draw on the tongue and the testicles. Hence green lips, a curled tongue and drawn-up testicles mean the sinews have died first. Grave on a gyeong day, death on a sin day.
Clinical note임상 주석
Three signs — green lips, curled tongue, retracted testicles — and the mechanism: the sinews the liver rules run to the tongue and the genitals, and when the liver fails they contract. Death on a metal day, which overcomes wood.

Yeongchu 靈樞

2.11.2
Source원문

厥陰終者, 中熱, 嗌乾, 善尿, 心煩, 甚則舌卷, 卵上縮而終矣. 《靈樞》

Translation영역
Where the reverting yin ends, there is heat in the centre, a dry throat, frequent urination and vexation of the heart; at the worst the tongue curls and the testicles draw up, and it ends.

Yeongchu 靈樞

2.11.3
Source원문

脣吻反靑, 四肢漐習伸縮也, 汗出者, 此爲肝絶也. 《仲景》

Translation영역
Where the lips and mouth turn green, the four limbs twitch and stretch and contract, and sweat comes out — this is the liver expiring.

Junggyeong 仲景

2.11.4
Source원문

肝絶八日死, 何以知之. 面靑, 但欲伏眠, 目示而不見人, 汗出如水不止八一作三. 《脉經》

Translation영역
The liver expiring, death in eight days — how is it known? The face green, wanting only to lie prone and sleep, the eyes open but not seeing people, and sweat running like water without stopping one version says three days for eight.
Clinical note임상 주석
Four sources on the same death, and the signs agree: green, twitching, sweating, the eyes open and blind. The Qi chapter's 4.25 gave the general signs of expiry; this is the liver's own.

Maekgyeong 脉經

2.12 The Method of Cultivating the Liver 肝臟修養法

2.12.1
Source원문

常以正月二月三月朔旦, 東面平坐叩齒三通, 吸震宮靑氣入口, 九呑之, 閉氣九十息. 《養性書》

Translation영역
Always on the first day of the first, second and third months at dawn, sit level facing east, click the teeth three times, breathe the green qi of the jin palace in through the mouth, swallow it nine times, and hold the breath for ninety breaths.
Clinical note임상 주석
The liver's breathing: spring, east, the trigram jin, the colour green, nine swallowings. Every organ chapter has one, keyed to its own season and direction, and the Qi chapter's 4.30 gave the six-syllable version.

Yangseongseo 養性書

2.13 The Guided Stretch for the Liver 肝臟導引法

2.13.1
Source원문

可正坐, 以兩手相重, 按䏶下, 徐緩身左右各三五度, 又可正坐, 兩手拽相叉, 翻覆向胸三五度. 此能去肝家積聚, 風邪毒氣. 《臞仙》

Translation영역
Sit upright, lay the two hands one on the other and press below the thigh, and slowly turn the body left and right three to five times each. Or sit upright, interlace the fingers of both hands, and turn them over toward the chest three to five times. This can remove accumulations in the liver and the toxic qi of the wind evil.
Clinical note임상 주석
Twisting from the waist — the stretch for the organ under the ribs — and Zhu Quan's claim is that it clears what has gathered there. The Body chapter's 1.20.4 gave his full set; this is the liver's part.

Guseon 臞仙

2.14 Simple Medicinals 單方

2.14.1
Source원문

凡二十一種.

Translation영역
Twenty-one kinds in all.
Clinical note임상 주석
Twenty-one simples for the liver — gentian, azurite, coptis, asarum, cassia seed, plantain seed, shepherd's purse seed, rubus, celosia, jujube kernel, cornus, adenophora, xanthium, peony, sophora root, green tangerine peel, chaenomeles, wheat, scallion, leek and plum. Half are for the eyes, which is where the liver shows, and the last two are 2.4's plum and leek. The green tangerine peel entry says it plainly: 肝氣不達, 用靑皮以疏之 — where the liver's qi does not reach, use green peel to open it.

Donguibogam · Gan

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 3, The Liver chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.