TCM Syndrome Differentiation and Classification of "Shanghuo" (Internal Heat)
1. Heart Fire: Divided into deficiency and excess types. Deficiency fire manifests as low-grade fever, night sweats, vexation, and dry mouth. Excess fire manifests as recurrent mouth ulcers, dry mouth, scanty and dark urine, irritability, and easy anger.
2. Lung Fire: Mainly manifests as a dry cough without phlegm, blood-streaked sputum, sore throat, hoarseness, tidal fever, and night sweats.
3. Stomach Fire: Divided into deficiency and excess types. Deficiency fire manifests as a mild cough, reduced appetite, constipation, abdominal bloating, a red tongue with little coating. Excess fire manifests as discomfort in the upper abdomen, dry mouth with a bitter taste, and hard, dry stools.
4. Liver Fire: Manifests as headache, flushed face and red eyes, dry mouth and sore throat, pain in the ribs and hypochondria, yellow urine, constipation, and in severe cases, vomiting blood.
5. Kidney Fire: Mainly manifests as dizziness and vertigo, tinnitus and hearing loss, hair loss and loose teeth, disturbed sleep, vexation with heat in the five centers (palms, soles, chest), emaciation, and pain in the lower back and legs.
"Huǒ" (fire) can be divided into excess fire and deficiency fire. Excess fire refers to a syndrome of excessive yang heat and excess heat. It is most commonly seen in the liver, gallbladder, stomach, and intestines. Symptoms include high fever, headache, red eyes, a preference for cold drinks, restlessness, abdominal distension and pain, constipation, yellow urine, a red tongue with a yellow, dry coating or a prickly surface, and a rapid, forceful pulse. In severe cases, it may lead to vomiting blood or nosebleeds. Treatment principles and methods include using bitter and cold herbs to control fire, clearing heat and resolving toxins, and purging excess fire to eliminate it. Deficiency fire is mostly caused by internal damage from chronic illness or overstrain, which can lead to disharmony and weakness of the zang-fu organs, generating internal heat that further transforms into deficiency fire.
Depending on the pathogenesis, deficiency fire is further divided into two conditions: yin-deficiency fire and qi-deficiency fire. Yin-deficiency fire is often characterized by general tidal fever, night sweats, emaciation, dry mouth and throat, vexation with heat in the five centers, restlessness, a red tongue with no coating, and a thin, rapid pulse. Treatment should be based on the principles of generating fluids and nourishing blood, and nourishing yin to reduce fire. Qi-deficiency fire manifests as general dry heat, which is more pronounced in the morning, aversion to cold and wind, preference for heat over cold, fatigue and listlessness, shortness of breath and reluctance to speak, spontaneous sweating, clear urine and loose stools, a large but weak pulse, and a pale tongue with a thin coating. Treatment should be based on the principles of tonifying the middle jiao and qi, strengthening the kidneys and promoting yang, and using sweet and warm herbs to eliminate heat.
It is very important to analyze whether the "shanghuo" is of excess or deficiency type for targeted medication. Additionally, some foods that can reduce fire can be tried, but they must be appropriate for the specific syndrome. For example, drink lotus seed soup to clear heart fire, eat pork liver to clear lung fire, drink mung bean congee to clear stomach fire, drink pear water to clear liver fire, and eat pig kidneys to clear kidney fire.