bubble_chart Concept

Irritability refers to the symptom of being easily agitated and prone to anger without reason, and being unable to control oneself. It is also known as "moodiness" or "quick temper."

bubble_chart Pattern Analysis

1. Liver Qi Depression︰Distending or wandering pain in the chest and hypochondrium, frequent sighing, irritability, emotional distress, and a wiry, forceful pulse. Suwen. Linglan Midian Lun "The liver is the organ of a general, responsible for planning and deliberation." The nature of wood is inherently straight, and its tendency is to extend. Slight depression can hinder its free-flowing nature, leading to agitation and anger. Thus, unfulfilled emotions, excessive contemplation, or unmet desires can all result in liver depression and discomfort, with liver qi rebelling upward, giving rise to anger. Suwen. Sishici Nicong Lun: "When blood rises with qi rebellion, it causes frequent anger." The key clinical diagnostic points are: frequent anger accompanied by distension and fullness in both hypochondria, a tendency to sigh, and other signs of disordered qi movement. This often arises from sudden emotional triggers, leading to uncontrollable rage and sudden fainting. Suwen. Shengqi Tongtian Lun: "Great anger causes the body's qi to cut off, and blood to stagnate upward, leading to emotional syncope." The pulse is wiry and forceful. Treatment should focus on soothing the liver and regulating qi, in accordance with Suwen. "Discussion on the Six Pathogenic Factors and Healthy Qi": "Depressed wood should be freed." Recommended formulas include Dayu Tang and Jienu Pinggan Tang.
2. Excessive Liver and Gallbladder Fire︰Chest and hypochondriac fullness and oppression, bitter taste in the mouth and thirst, excessive dreams during sleep, dysphoria and irritability, red tongue, wiry and rapid forceful pulse. The liver and gallbladder belong to wood and govern ministerial fire. If liver depression transforms into fire, or excessive alcohol consumption and indulgence in spicy foods lead to stagnation and heat transformation into fire, all can stir up exuberant liver-gallbladder fire, resulting in impaired liver dispersion and gallbladder fire flaring upward, thus causing irritability. The key points for clinical pattern differentiation are: irritability accompanied by symptoms such as qi-fire flaming upward, emetic therapy, red eyes, dizzy vision, tinnitus like tides or head distending pain, bitter taste in the mouth, and red face. Additionally, because the liver channel encircles the external genitalia, exuberant liver-gallbladder fire may manifest symptoms such as swelling of the vulva, reddish urine, turbidity, constipation, wiry and rapid forceful pulse, etc. Treatment should focus on clearing and purging the liver and gallbladder, and the formula selected is Gentian Liver-Draining Decoction.
3. Liver Overacting on Spleen Due to Spleen Deficienc︰Fatigue, lack of strength, poor appetite, lienteric diarrhea, abdominal distension and fullness, abdominal pain, distension and fullness in both flanks, irritability, and a weak, wiry pulse. The spleen belongs to earth, and the liver belongs to wood. The spleen-earth relies on the free-flowing function of the liver-wood to maintain normal digestion and transformation. However, excessive liver-wood can easily over-restrict the spleen, leading to impaired spleen function. If spleen deficiency occurs, it is more prone to being overacted upon by liver-wood, resulting in a condition of earth deficiency and Scouring Rush Herb. The key points of clinical differentiation are: irritability coexisting with spleen deficiency symptoms such as poor appetite, loose stools, abdominal distension and fullness, lack of strength, as well as symptoms of liver-wood transverse invasion such as distension and fullness in both flanks, epigastric stuffiness with nausea, abdominal pain, and bitter taste in the mouth. The treatment should focus on strengthening the earth and restraining the wood. Recommended formulas include Cyperus, Amomum and Six Gentlemen Decoction, Pain and Diarrhea Vital Formula, and Jingyue Quanshu. Discussion on treatment: "...the qi of liver-wood inevitably invades spleen-earth, injuring stomach qi and impairing digestion... Therefore, the focus should not be overly on the liver but rather on the spleen."
4. Liver-kidney Yin Deficiency︰Soreness and weakness of the waist and knees, tidal fever night sweat, vexing heat in the chest, palms and soles, insomnia dreamfulness, discomfort in the chest and hypochondrium, red tongue with scant coating, thin and rapid pulse. Yi (liver) and Gui (kidney) share the same source. If the body inherently suffers from kidney yin deficiency, water failing to nourish wood, and yin failing to subdue yang, it leads to ascendant hyperactivity of liver yang, causing vertigo and irritability. The key points for clinical pattern identification are: irritability accompanied by soreness and weakness of the waist and knees, tidal fever night sweat, vexing heat in the chest, palms and soles, thin and rapid pulse, red tongue with scant coating, and other symptoms of kidney yin deficiency. The treatment should focus on nourishing water to moisten wood, and the prescription recommended is Wolfberry and Chrysanthemum Rehmannia Pill.

Nanjing "If the liver pulse is obtained, the external symptoms are a clean face, a greenish complexion, and a tendency to anger." Therefore, all those who are prone to anger are related to liver disease, but in clinical treatment, attention should be paid to distinguishing between deficiency and excess, and the root and branch.

bubble_chart Documentation

1. Suwen-Tiaojing Lun: "liver storing blood，when blood is excessive, it causes anger." "When blood accumulates in the upper part and qi in the lower part, it leads to heart vexation and frequent anger."
2. Lingshu-Benshen chapter: "When the kidney is excessively angry and does not stop, it harms the will."
3. Suwen-Qijiaobian Da Lun"When the year's wood is excessive, people suffer from frequent anger."