bubble_chart Concept

Head heat refers to a subjective sensation of fever in the head.

Suwen．Tongping Xushi Lun contains records of "head heat." Later generations often mention it together with "facial heat," collectively referred to as "head and facial heat."

Head heat can occur alongside headache, dizziness, and head distension. This section focuses on cases where head heat is the primary symptom. As for symptoms such as redness, swelling, heat, and pain caused by excessive Yangming heat in external-contraction febrile diseases or the upward congestion of epidemic toxin, these are not within the scope of this section. For more details, please refer to the relevant content on "redness and swelling of the head and face."

bubble_chart Pattern Analysis

1. Up-flaming of Liver Fire︰Head hot and face red, irritability and susceptibility to anger, restless sleep, hypochondriac pain and bitter taste in the mouth, red tongue with thin coating, wiry and forceful pulse. Mostly caused by habitual emotional depression or resentment and anger, {|###|}liver qi{|###|} failing to flow freely, stagnating and transforming into fire. The nature of fire is to flare upward, hence the head hot and face red; when {|###|}liver fire{|###|} is exuberant, heart fire becomes excessive, disturbing the heart spirit, leading to {|###|}failure of mind to keep to its abode{|###|}, hence restless sleep and bitter taste in the mouth; the hypochondrium is the domain of the liver, stagnation of {|###|}liver qi{|###|} causes hypochondriac pain, thin coating and wiry pulse. Treatment should aim to calm the liver and drain fire, the formula chosen is {|###|}Gentian Liver-Draining Decoction{|###|} with modifications.
2. Kidney Yin Deficiency︰Head heat, tinnitus, accompanied by vertigo, soreness and weakness in the lower back and knees, vexing heat in the chest, palms, and soles; if yin impairment affects yang, leading to deficiency of both yin and yang, symptoms may include flushing heat in the face, sweating, cold limbs, a red tongue with scant coating, and a thready, rapid pulse. This is often caused by constitutional yin deficiency or excessive sexual activity depleting kidney yin. Kidney yin deficiency results in yin deficiency with effulgent fire, manifesting as head heat; kidney deficiency below leads to water failing to nourish wood, causing ascendant hyperactivity of liver yang, hence vertigo and tinnitus; the lower back is the residence of the kidney, so kidney deficiency results in emptiness in the lumbar region, leading to soreness; yin deficiency generates internal heat, hence vexing heat in the chest, palms, and soles, a red tongue with scant coating, and a thready, rapid pulse. Treatment should focus on nourishing yin and subduing yang, with the formula selection being Wolfberry and Chrysanthemum Rehmannia Pill plus Gastrodia Tuber, Uncaria, and Abalone Shell, among others. For women nearing the exhaustion of reproduction-stimulating essence, with deficiency of the thoroughfare and conception vessels and yin deficiency with effulgent fire, symptoms may include flushing heat in the face, while yang deficiency and weakened qi lead to sweating and cold limbs. Treatment should aim to nourish yin and support yang, using formulas such as Two Plus Fossil Bone Decoction or Curculigo and Epimedium Decoction with modifications. Jingui Yaolue·"Treatment of Blood Impediment, Deficiency Fatigue, and Abnormal Pulse Syndromes" discusses Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell, citing the "Xiao Pin" as follows: "For those with deficiency weakness, floating heat, and sweating, remove cinnamon twig and add Blackend Swallowwort Root and Aconite Lateral Root, three fen each, hence the name Two Plus Fossil Bone Decoction."
3. Exuberant Yin Repelling Yang︰Feverish head and flushed cheeks, sore throat with restlessness, diarrhea with undigested food, cold limbs, pale tongue with white coating, and deep faint pulse on the verge of disappearing. Mostly seen in the late stage [third stage] of external-contraction febrile disease, Shaoyin pattern, with severe internal cold, exuberant yin repelling yang, leading to floating of deficient yang, hence feverish head, flushed cheeks, sore throat, and restlessness; exuberant yin and declined yang result in diarrhea with undigested food, cold limbs, and deep faint pulse on the verge of disappearing. Treatment should focus on treating yin for yang, restoring yang to save from collapse, using Bai Tong Jia Zhu Dan Zhi Tang (White Communication Plus Pig Gallbladder Decoction).

Key points for differentiation of head heat syndrome: In cases of up-flaming of liver fire, head heat often occurs with emotional fluctuations, accompanied by irritability and a tendency to anger. In cases of kidney yin deficiency, characterized by upper excess and lower deficiency, the upper excess manifests as head heat and vertigo, while the lower deficiency presents as soreness and weakness in the lower back and knees, which is distinctly different from the up-flaming of liver fire that only shows upper excess symptoms. In women with depletion of reproduction-stimulating essence, yin impairment affects yang, leading to deficiency of both yin and yang, resulting in sudden heat, flushed face, sweating, and cold limbs, which differs from simple kidney yin deficiency. In cases of exuberant yin repelling yang, true cold with false heat is present, where yang qi decline leads to internal true cold, manifesting as diarrhea, cold limbs, and a faint pulse; while floating yang at the surface causes external false heat, presenting as head heat and flushed cheeks. This can be distinguished from head heat due to kidney yin deficiency, which is characterized by yin deficiency with yang hyperactivity, and vexing heat in the chest, palms, and soles.

bubble_chart Documentation

1. Suwen-Tongping Xushi Lun: "The pulse is full and solid, the hands and feet are cold, the head is hot, ... in spring and autumn one survives, in winter and summer one dies.
2. Huangdi Neijing Suwen Collected Annotations: "The head being hot indicates that the taiyang qi is exuberant and rising above."
3. Linzheng Zhinan Yi'an．Summer: "The head is hot, the eyes are closed, the breath is short, and the spirit is confused, this is the correct deficiency-type pathogen obstruction."