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Heart fire flaming upward

心火上炎 〔心火上炎〕xīn huǒ shàng yán

Also upflaming heart fire. A disease pattern of heat ascending the heart channel to the upper body, manifesting in red-tipped tongue, erosion of the mouth and tongue, heart vexation, insomnia, and a pulse that is rapid. Heart fire flaming upward is the result of hyperactive heart fire or heart yīn vacuity. It may occur with liver fire in effulgent heart-liver fire, which is a repletion pattern, or with kidney yīn vacuity in noninteraction between the heart and kidney, which is an yīn vacuity with effulgent fire pattern. Sometimes, heart fire may also spread downward to the small intestine. Signs associated with effulgent heart-liver fire include headache, reddening of the eyes, agitation, and irascibility, in addition to the general signs of heart fire flaming upward. Noninteraction of the heart and kidney is characterized by vexation, insomnia, and occasionally by dryness of the pharynx and mouth, upbearing fire flush, a red, mirror tongue, and a fine, rapid pulse.

Medicinal therapy: Clear heat and drain fire. Use coptis (Coptidis Rhizoma, 黄连 huáng lián), lotus embryo (Nelumbinis Plumula, 莲子心 lián zǐ xīn), forsythia (Forsythiae Fructus, 连翘 lián qiào), licorice (Glycyrrhizae Radix, 甘草 gān cǎo), raw licorice (Glycyrrhizae Radix Cruda, 生甘草 shēng gān cǎo), lophatherum (Lophatheri Herba, 淡竹叶 dàn zhú yè), trifoliate akebia (Akebiae Trifoliatae Caulis, 木通 mù tōng), and juncus (Junci Medulla, 灯心草 dēng xīn cǎo). Formulas that treat heart fire flaming upward include variations of Heart-Draining Decoction (泻心汤 xiè xīn tāng) combined with Red-Abducting Powder (导赤散 dǎo chì sǎn) to abduct heart fire downward. Noninteraction of the heart and kidney can be treated with Coptis and Ass Hide Glue Decoction (黄连阿胶汤 huáng lián ē jiāo tāng) supplemented with medicinals that quiet heart and spirit. Where signs of effulgent heart-liver fire are pronounced, heart-clearing fire-draining can be used with the judicious addition of liver-clearing medicinals such as moutan (Moutan Cortex, 牡丹皮 mǔ dān pí), gardenia (Gardeniae Fructus, 山栀子 shān zhī zǐ), large gentian (Gentianae Macrophyllae Radix, 秦艽 qín jiāo), and mulberry twig (Mori Ramulus, 桑枝 sāng zhī).

Acumoxatherapy: Base treatment mainly on HT, PC, and GV. PC-8 (Palace of Toil, 劳宫 láo gōng), HT-8 (Lesser Mansion, 少府 shào fǔ), PC-9 (Central Hub, 中冲 zhōng chōng), HT-9 (Lesser Surge, 少冲 shào chōng), and GV-26 (Water Trough, 水沟 shuǐ gōu) can all be used to treat heart fire flaming upward. Select two or three of these points and needle with drainage or prick to bleed with a three-edged needle.

Point selection according to concurrent patterns: For effulgent heart-liver fire, add LR-2 (Moving Between, 行间 xíng jiān), GB-43 (Pinched Ravine, 侠溪 xiá xī), and GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán), needling with drainage. For noninteraction of the heart and kidney, add BL-15 (Heart Transport, 心俞 xīn shù), BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), HT-7 (Spirit Gate, 神门 shén mén), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), needling with supplementation. Compare hyperactive heart fire; heart heat; stirring of the ministerial fire.

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