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Liver fire flaming upward
肝火上炎 〔肝火上炎〕gān huǒ shàng yán
Also:
- Liver fire (肝火 gān huǒ)
- Intense liver fire (肝火炽盛 gān huǒ chì shèng)
- Iiver channel repletion fire (肝经实火 gān jīng shí huǒ)
Key signs: Dizziness; distension in the head; scorching rib-side pain; impatience, agitation, and irascibility; repletion heat signs.
Description: Dizzy head; stabbing headache; distension in the head; red face and eyes; bitter taste in the mouth; dry mouth; impatience, agitation, and irascibility; tinnitus with ringing in the ears like the sound of the ocean, in severe cases, sudden deafness; insomnia; profuse nightmares; scorching pain in the rib-side; vomiting of blood; nosebleed; short voidings of yellow urine; constipation; red tongue with yellow fur; a pulse that is stringlike and rapid.
Diseases: Sleeplessness; dizziness; tinnitus; deafness; ear pain.
Pathogenesis: Exuberant fire-heat harassing the liver and ascending counterflow and causing excessive free coursing. This is a repletion pattern stemming from:
- depressed liver qì transforming into fire;
- spleen-stomach damp-heat stemming from dietary irregularities, alcohol consumption, and smoking (alcohol and smoking cause heat);
- externally contracted heat;
- liver yīn vacuity.
Analysis of signs
- Upper body heat signs: Red face and eyes, dizziness, distension in the head, bitter taste in the mouth, and dry pharynx.
- Other heat signs: Constipation or reddish urine may be present.
- Spirit: Impatience, agitation, and irascibility; insomnia and sometimes nightmares.
- Ears: When the liver fire affects the ears, there may be ringing in the ears like the sound of the sea on the shore (耳鸣如潮 ěr míng rú cháo), sudden deafness, or pain in the ear with purulent discharge.
- Cross-counterflow: Liver fire can run cross-counterflow into the stomach, stirring the blood, and giving rise to retching of blood (
blood running counterflow with qì
). - Tongue: Red with yellow fur.
- Pulse: Rapid and stringlike.
Treatment
Medicinal therapy: Clear the liver and drain fire. Use
Acumoxatherapy: Base treatment mainly on GB and LR. Select
Combined pattern: Liver fire invading the lung, characterized by cough (in some cases with coughing of blood); scorching pain in the chest and rib-side; impatience, agitation, and irascibility; and repletion heat signs.
Further developments: When liver fire scorches the network vessels of the lung, there may be coughing of blood, or nosebleed. This is called liver fire invading the lung (肝火犯肺 gān huǒ fàn fèi) or wood fire tormenting metal (木火刑金 mù huǒ xíng jīn). It can also run cross-counterflow to scorch the network vessels of the stomach, giving rise to vomiting of blood. This is called liver fire invading the stomach.
Clinical sketch: A 39-year-old male complains of splitting headaches. On examination, he was found to display a red face, vexation and agitation, dry mouth, bitter taste in the mouth, insomnia, and susceptibility to fright. The tongue was red with yellow fur. The pulse was stringlike and rapid. He was diagnosed with liver fire transforming into fire and flaming upward to harass the clear orifices.