This month I would like to discuss some more reasons why the liver is so important in neural therapy. I have in previous e-newsletters emphasized that the liver is the most common organ interference field and that it is often involved in depression. However liver interference fields can have other manifestations, some of them obvious and others relatively subtle.
First a little neuroanatomical review: The liver’s pre-ganglionic sympathetic nerves derive from segments (approximately) T6 to T11, enter the abdominal cavity through the splanchnic nerves and synapse in the celiac plexus. Post-ganglionic fibers follow hepatic branches of the celiac trunk to the liver. Parasympathetic preganglionic fibers derive from the vagus nerve, pass through the celiac region and follow the blood supply to the liver.
A significant proportion of the nerve fibers in these nerves are actually afferent in nature – approximately 90% of the vagus and 50% of the splanchnic nerve fibers. Many of the vagus afferent fibers carry regulatory information such as plasma glucose concentration, osmotic pressure and temperature. The splanchnic nerves carry pain sensation from stretch receptors and bradykinin stimulation. Apparently the vagus nerve does not carry pain sensation.
Most authorities say simply that “little is known about autonomic nervous system effects on liver function” except that sympathetic activation increases the output of glucose. Some intriguing recent research at the University of Manitoba http://umanitoba.ca/faculties/medicine/units/pharmacology/1833.htm indicates that the autonomic nervous system’s regulation of liver function is more complex than that. A new hormone, called “HISS” or “hepatic insulin sensitizing substance” has been found to be released by parasympathetic fibers in the liver in response to elevated insulin levels. HISS activates glucose uptake by skeletal muscle. Failure of this mechanism may explain the insulin resistance found in liver disease and obesity, and of course may also occur when the liver becomes an interference field (speculation on my part!).
Now let us get back to less speculative knowledge of the effects of a liver interference field: It has long been known that liver problems can refer pain to the right interscapular area and/or the right C4 dermatome (or upper shoulder area). Less well known is a somato-visceral reflex from the liver disturbing the mechanics of the lower thoracic spine. In osteopathic language, a liver interference field may cause “somatic dysfunction” in the lower thoracic spine. This may in turn cause low backache.
A simple screening test for lower thoracic spine somatic dysfunction is to assess the patient’s ability to rotate the upper trunk to the right and to the left while in the sitting position. If limitation of range of motion is present in one direction but not the other, there is a good chance that a somatic dysfunction is present. But if the underlying cause is a liver interference field, manipulation of the spine will either not work, or will provide only temporary benefit.
Look for the usual signs of low grade liver dysfunction: depression, fatigue, malaise, loss of appetite etc. and if an interference field is found, treat it with neural therapy. Of course, it goes without saying that any concurrent cause(s) of the liver interference field, such as organic solvent toxicity, hepatitis C, medication adverse effects, etc. should be treated as well.
The practical application of this lesson: In patients with low back pain, if spinal manipulation of the lower thoracic spine is not working, consider the liver as a possible interference field.