Hyperactive heart fire

Also:

• Intense heart fire (心火炽盛 xīn huǒ chì shèng)
• Exuberant heart fire (心火盛 xīn huǒ shèng
• Heart fire flaming upward (心火上炎 xīn huǒ shàng yán), used when there are pronounced upper body signs, such as mouth and tongue sores and vomiting or nosebleed

A disease pattern chiefly characterized by vexation and agitation; insomnia; mouth and tongue sores; repletion heat signs; in some cases, vomiting of blood or nosebleed.

Description: Heart vexation; insomnia; red facial complexion; thirst; generalized heat effusion; yellow urine and possibly constipation; red or crimson tongue; yellow tongue; rapid pulse. In some cases, there may be the following:

• mouth and tongue sores;
• vomiting of blood or nosebleed;
• painful voidings of reddish urine;
• in severe cases, manic agitation, delirious speech, and unclear spirit-mind.

Diseases: Insomnia; bleeding.

Pathogenesis: Fire-heat harassing the heart spirit, in some cases damaging yīn and stirring the blood. This results from:

• imbalance of the affects, which causes qì to become depressed and transform into fire;
• excessive consumption of rich, fatty and hot spicy foods;
• external fire invading the interior.

Analysis of signs

• Heart fire harassing the heart spirit: Vexing heat in the heart and chest, insomnia, and in severe cases manic agitation, delirious speech, and unclear spirit-mind.
• Repletion heat: Heat effusion, thirst with desire for cold drinks, short voidings of reddish urine, and in some cases constipation.
• Frenetic movement of blood: Vomiting of blood or nosebleed.
• Tongue: Red or crimson, especially at the tip, with yellow tongue fur. Mouth and tongue sores. These signs are all attributable to heat.
• Pulse: Rapid and forceful.

Comparison: See table.

Treatment

Medicinal therapy: Clear the heart and drain fire. Use Heart-Draining Decoction (泻心汤 xiè xīn tāng) or Palace-Clearing Decoction (清宫汤 qīng gōng tāng). Heat spreading from the heart to the small intestine can be treated with Red-Abducting Powder (导赤散 dǎo chì sǎn), which abducts the heat downward and out through the bowels.

Acumoxatherapy: Base treatment mainly on PC and HT. Select PC-8 (Palace of Toil, 劳宫 láo gōng), HT-8 (Lesser Mansion, 少府 shào fǔ), and CV-14 (Great Tower Gate, 巨阙 jù què), needling with drainage and prick PC-9 (Central Hub, 中冲 zhōng chōng), and HT-9 (Lesser Surge, 少冲 shào chōng) to bleed.

Point selection according to signs: For mouth sores, add KI-2 (Blazing Valley, 然谷 rán gǔ). For vexation and agitation, add KI-1 (Gushing Spring, 湧泉 yǒng quán), and PC-5 (Intermediary Courier, 间使 jiān shǐ). For insomnia, add HT-7 (Spirit Gate, 神门 shén mén), BL-15 (Heart Transport, 心俞 xīn shù), and HT-5 (Connecting Lǐ, 通里 tōng lǐ). For thirst, add TB-2 (Humor Gate, 液门 yè mén), CV-23 (Ridge Spring, 廉泉 lián quán), KI-6 (Shining Sea, 照海 zhào hǎi), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo). For dry stool, add LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), ST-37 (Upper Great Hollow, 上巨虚 shàng jù xū), and TB-6 (Branch Ditch, 支沟 zhī gōu). For blood ejection, add ST-44 (Inner Court, 内庭 nèi tíng), and PC-4 (Cleft Gate, 郄门 xī mén). For heart fire spreading to the small intestine, add CV-4 (Pass Head, 关元 guān yuán), ST-39 (Lower Great Hollow, 下巨虚 xià jù xū), and SI-2 (Front Valley, 前谷 qián gǔ), needling with drainage. Compare heart fire flaming upward, intense internal heart fire, and heart heat.

Combined pattern: Noninteraction of the heart and kidney, characterized by heart vexation, heart palpitation, insomnia, profuse dreaming, limp aching lumbus and knees, seminal emission, and yīn vacuity signs.

Further developments: Small intestine repletion heat.