Liver fire invading the lung

Also wood fire tormenting metal (木火刑金 mù huǒ xíng jīn).

A disease pattern chiefly characterized by cough (in some cases with coughing of blood); scorching pain in the chest and rib-side; impatience, agitation, and irascibility; repletion heat signs.

Description: Scorching pain in the chest and rib-side; impatience, agitation, and irascibility; distension in the head; dizziness; red face and eyes; dry mouth; bitter taste in the mouth; bouts of coughing; thick sticky yellow phlegm; in severe cases, coughing of blood; a red tongue with thin yellow fur; a pulse that is stringlike and rapid.

Diseases: Cough; expectoration of blood.

Pathogenesis: Affect-mind damage causing depressed liver qì, which transforms into fire and ascends the liver channel to attack the lung.

The relationship between the lung and liver mainly concerns the upward and downward bearing of qì. The lung governs downbearing, while the liver governs upbearing. These mutually complementary actions coordinate to ensure a regulated qì dynamic throughout the body. If the liver’s upbearing action is excessive or the lung’s downbearing action is deficient, the result can be counterflow ascent of qì and fire, which manifests in cough and counterflow ascent of qì, in some cases with expectoration of blood. This is called liver fire invading the lung.

Analysis of signs

• Liver fire impairing depurative downbearing: Bouts of coughing with expectoration of thick yellow phlegm; in severe cases, expectoration of blood when the network vessels of the lung are scorched.
• Liver fire: Scorching pain in the chest and rib-side; impatience, agitation, and irascibility; distension in the head and dizziness; dry mouth; bitter taste in the mouth; and red face and eyes.
• Repletion heat: Heat vexation and thirst.
• Tongue: Red with yellow fur.
• Pulse: Stringlike and rapid.

Treatment

Medicinal therapy: Clear heat and drain fire; moisten the lung and transform phlegm. Use Indigo and Clamshell Pill (青蛤丸 qīng gé wán) combined with Metal-Clearing Phlegm-Transforming Decoction (清金化痰汤 qīng jīn huà tán tāng).

Acumoxatherapy: Base treatment mainly on LU and LR. Select BL-13 (Lung Transport, 肺俞 fèi shù), LU-10 (Fish Border, 鱼际 yú jì), LR-2 (Moving Between, 行间 xíng jiān), and GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán); needle with drainage.