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Liver fire flaming upward

肝火上炎 〔肝火上炎〕gān huǒ shàng yán

Also:

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:

Analysis of signs

Treatment

Medicinal therapy: Clear the liver and drain fire. Use Gentian Liver-Draining Decoction (龙胆泻肝汤 lóng dǎn xiè gān tāng) or Chinese Angelica, Gentian, and Aloe Pill (当归龙荟丸 dāng guī lóng huì wán).

Acumoxatherapy: Base treatment mainly on GB and LR. Select LR-3 (Supreme Surge, 太冲 tài chōng), GB-43 (Pinched Ravine, 侠溪 xiá xī), LR-2 (Moving Between, 行间 xíng jiān), GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán), and TB-6 (Branch Ditch, 支沟 zhī gōu); needle with drainage.

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.

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