bubble_chart Concept

Heart fire hyperactivity pattern refers to the symptoms and signs caused by the exuberance of heart fire, which results from the transformation of fire due to extreme stagnation of the five emotions, the transmission of the six excesses into the interior transforming into fire, or excessive consumption of spicy foods, leading to intense heat disturbing the heart-mind.

The main clinical manifestations include: mouth and tongue sores, flushed face, irritability, insomnia, fever, thirst, desire for cold drinks, constipation, yellow urine, and in severe cases, mania or delirium, red tongue with yellow coating, and slippery and rapid pulse.

Heart fire hyperactivity pattern is commonly seen in diseases such as "blood stranguria," "insomnia," and "palpitation."

This pattern should be differentiated from "pattern of heat entering the heart and the nutrient phase" and "pattern of up-flaming liver fire."

bubble_chart Differentiation and Treatment

Heart fire hyperactivity pattern can occur in various diseases, each with its own clinical characteristics.

If heart fire hyperactivity pattern appears in hematuria, the clinical manifestations include hematuria, oral and tongue ulcers, dysphoria with heat in the chest, hematemesis, epistaxis, a red tongue with yellow coating, and a rapid pulse. This is often caused by excessive contemplation, which depletes heart yin. Yin deficiency leads to yang hyperactivity, resulting in exuberance of heart fire. The heart and small intestine are interiorly-exteriorly related, and heart fire transfers to the small intestine, scorching the yin collaterals and causing blood to extravasate from the vessels. Treatment should focus on clearing the heart and reducing fire, cooling blood, and stopping bleeding. The formula Redness-Removing Powder (Xiao'er Yaozheng Zhijue) can be used. For severe hematuria, cooling blood and stopping bleeding, as well as draining heat and purging fire, are recommended. The formula Small Thistle Decoction (Jisheng Fang) can be applied.

If heart fire hyperactivity pattern appears in insomnia, the clinical manifestations often include difficulty falling asleep, oral ulcers, dysphoria, dizziness, tinnitus, a red tongue without coating, and a thin, rapid pulse. This is usually due to kidney yin deficiency failing to nourish the heart, leading to hyperactivity of heart fire and disharmony between the heart and kidney. Treatment should focus on nourishing yin and reducing fire. The formula Anemarrhena, Phellodendron, and Rehmannia Pill (Yifangkao) combined with Harmonic Interacting Pill (Hanshi Yitong) can be used.

If heart fire hyperactivity pattern appears in palpitations, the clinical manifestations often include palpitations, dry mouth, dysphoria, restlessness, constipation, dark urine, a red tongue, and a slippery, rapid pulse. This is often caused by hyperactivity of heart yang, leading to the heart losing its nourishment, or the transformation of the five minds into fire. Treatment should focus on clearing the heart and reducing fire. The formula Heart-Draining Decoction (Jingui Yaolue) or Diaphragm-Cooling Powder (Hejiju Fang) can be applied.

The heart and small intestine are interiorly-exteriorly related and connected by meridians. The small intestine meridian is the exterior, and the heart meridian is the interior. Exuberance of heart fire descending to the small intestine can manifest as short, dark urine and burning pain in the urethra, indicating a pattern of excess-heat in the small intestine, which should not be overlooked.

bubble_chart Differentiation of Similar Patterns

pattern of heat entering the heart and the nutrient phase and heart fire hyperactivity pattern: The pattern of heat entering the heart and the nutrient phase is caused by pathogenic heat damaging the blood vessels, leading to stagnation of nutrient qi, and persistent retention of pathogenic heat. The heart fire hyperactivity pattern is often due to excessive mental strain causing reckless movement of heart fire, or from consuming spicy and hot foods, or from internal stagnation of the six excesses transforming into fire. Internal blazing of heart fire results in vexing heat in the heart, and when fire disturbs the heart spirit, it leads to dysphoria and insomnia. Since the heart is connected to the tongue, up-flaming of heart fire can cause sores or ulceration in the mouth and tongue. Heat scorching body fluids leads to thirst and a desire for cold drinks. As the heart and small intestine are paired, exuberance of heart fire can transfer heat to the small intestine, resulting in reddish and astringent urine with stabbing pain. When the blood vessels are injured by fire, it can cause hematuria. The tongue, being the sprout of the heart, and the heart governing blood and vessels, means that heart heat can manifest as a red tongue and rapid pulse. In the pattern of heat entering the heart and the nutrient phase, heat enters the nutrient-blood, causing internal blazing of heart fire, and symptoms include fever, even mental confusion, floccillation, convulsions, a deep red tongue, and a wiry and rapid pulse. In summary, the pattern of heat entering the heart and the nutrient phase involves warm pathogens entering the nutrient and blood levels, clinically presenting as nutrient aspect pattern. The heart fire hyperactivity pattern, in warm diseases, is part of the manifestation of pathogens at the qi aspect, and in Zabing, there is evidence of reckless movement of heart fire, but without nutrient-blood symptoms. This can be used for differentiation.

pattern of up-flaming liver fire and heart fire hyperactivity pattern: The liver is the viscus of wind and wood, active and prone to change. The pattern of up-flaming liver fire is often caused by emotional imbalance leading to upward flaming of fire, clinically manifesting as headache, dizziness, bitter taste in the mouth, dry stool, and even hematemesis and nosebleeds, with a wiry and rapid pulse. The liver prefers free flow, and when emotions are depressed, it can affect the liver's dispersion, causing liver qi depression, characterized by burning pain in the hypochondriac region, red face and eyes, irritability, and a wiry pulse. The heart fire hyperactivity pattern is often due to the five emotions being extremely depressed and transforming into fire, primarily involving internal damage, clinically presenting with fever, thirst, sores in the mouth and tongue, and even hematuria and painful urination, with a rapid pulse. In summary, the pattern of up-flaming liver fire involves the liver, primarily with qi depression transforming into fire, while the heart fire hyperactivity pattern involves the qi aspect, primarily with excessive heat. This can be used for differentiation.

bubble_chart Documentation

• Zhengzhi Huibu‧Fire Syndrome: "Convulsions, hypochondriac pain, red eyes, liver fire is active. Delirium, mouth and tongue sores, heart fire is active. Abdominal distension and fullness with noise, fetid mouth odor, swollen lips, spleen fire is active. Restless cough, nasal congestion, nosebleeds, lung fire is active. Nocturnal emission, turbid essence (chronic prostatitis), gingival atrophy, kidney fire is active. Yellow eyes, bitter taste in mouth, tinnitus, distending pain, gallbladder fire is active. Frequent abdominal pain, blood stranguria, turbid urine, small intestine fire. Vomiting, epigastric upset, facial swelling, gum swelling, gastrointestinal system fire, fulminant diarrhea, yellow-red stool, constipation, large intestine fire. Ischuria, dribbling, turbid urine, bladder fire. Pharyngitis, dizziness, difficulty eating, triple energizer fire. Frequent male sexual arousal, ejaculation without intercourse, life gate fire."
• Leizheng Zhicai‧Fire Pattern: "Treat real fire, upper energizer heat, middle energizer accumulated heat, thirst, dryness, constipation, triple energizer excessive fire, mania, vomiting, nosebleeds, Yangming tidal fever, lower energizer fire; blood stranguria, urinary retention, all blood aspect fire heat erysipelas."
• "Treat five zang-organs fire: qi depression fire originates from the lungs, great anger fire originates from the liver, drunkenness fire originates from the spleen, fear and overthinking fire originates from the heart; sexual desire fire originates from the kidneys. Treat six fu-organs fire: stomach fire causes toothache and cheek swelling, gallbladder fire causes vertigo and bitter taste in mouth, large intestine fire causes constipation, small intestine fire causes ischuria and dribbling, bladder fire causes abdominal pain and difficult urination, triple energizer fire causes limb heat and body fatigue, pericardium fire causes severe palpitations and restlessness. The wandering fire should be dispersed, cleared, or lowered, each adjusted according to its severity."