Liver patterns · Clinician-review draft
Liver Qi Stagnation: symptoms and differentiation
Liver Qi Stagnation is a TCM pattern of constrained movement. The strongest cases are not identified by one symptom, but by a coherent cluster: distension or symptoms that move, emotional reactivity, and findings that change with stress or the menstrual cycle.
Try a Liver Qi Stagnation case- Eight Principles
- Primarily Interior · Excess
- Core mechanism
- Constrained movement of Liver Qi
- High-value clue
- Distension or symptoms linked to stress
- Typical pulse
- Wiry
The presentation to look for
Common findings include hypochondriac or chest distension, frequent sighing, irritability or emotional constraint, and digestive symptoms such as belching or abdominal bloating. In menstrual presentations, premenstrual breast distension, irritability or cycle-linked worsening can strengthen the pattern hypothesis.
The quality and behaviour of the symptom matter. Distending, moving or fluctuating discomfort is more informative than pain alone; worsening with emotional stress is more informative than irritability alone.
- Ask whether pressure or distension changes location or improves after belching, passing gas or movement.
- Establish whether stress reliably precedes or intensifies the complaint.
- For menstrual complaints, ask about breast distension, irritability and symptom timing within the cycle.
- Check appetite, bloating and stool only when the complaint suggests digestive involvement.
Tongue and pulse
The tongue may be unremarkable in uncomplicated Qi stagnation. A wiry pulse is the more characteristic supporting observation. Red sides, a yellow coat or a rapid pulse suggest that constraint may be generating Heat rather than remaining a simple Qi stagnation picture.
Neither the tongue nor pulse should override a contradictory symptom history. Use them as independent evidence that raises or lowers confidence.
Differentiate nearby patterns
| Candidate | What supports it | What shifts away from simple Qi stagnation |
|---|---|---|
| Liver Fire | Severe irritability, red eyes, bitter taste, thirst or dry mouth | Clear Heat signs, red tongue with yellow coat, rapid or forceful pulse |
| Blood Stasis | Fixed, stabbing, localized pain | Purple tongue, dark clots or a choppy/firm quality rather than mainly distension |
| Spleen Qi Deficiency | Fatigue, poor appetite, loose stool, post-meal bloating | Deficiency picture with pale tongue and weak pulse |
| Liver–Spleen disharmony | Stress-linked symptoms plus digestive weakness | Both the constrained Liver cluster and the Spleen deficiency cluster are present |
Move from reading to reasoning
Test the distinctions in an interactive case.
The assistant asks for evidence that can change the ranking and keeps missing observations visible.