This syndrome is mainly caused by emotional upsets and transformation of fire from liver depression; or by exogenous pathogenic heat and fire; or by exuberant fire in the other organs that involves the liver.

Clinical manifestations:
Dizziness, distending headache, flushed face and red eyes, bitter taste and dryness of mouth, irritability and susceptibility to rage, tinnitus and deafness, insomnia or nightmare, or scorching pain in the hypochondria, or hematemesis and epistaxis, constipation, scanty and yellow urine, red tongue, yellow fur and taut and rapid pulse. These symptoms are usually seen in hypertension, hyperthyroidism,neurasthenia, manic depression, migraine, cerebral arteriosclerosis and climacteric syndrome.

Analysis of the symptoms:
Dizziness, distending headache, flushed face and red eyes, bitter taste and dryness of mouth are caused by pathogenic heat and fire disturbing the upper part of the body along the liver meridian; insomnia or nightmare is caused by mental distraction due to internal disturbance of heat and fire; irritability and susceptibility to rage are caused by liver depression; scorching pain in the hypochondria is caused by stagnation of qi and fire in the liver meridian; hematemesis and epistaxis with fresh blood are caused by extravasation of blood due to upward adverse rise of qi and fire; constipation, scanty yellowish urine, reddish tongue with yellowish fur and taut and rapid pulse are caused by fire scorching body fluid.

Key points for syndrome differentiation:
The diagnostic evidences of this syndrome are irritability and susceptibility to rage, insomnia or nightmare, dizziness, distending headache, flushed cheeks and red eyes, bitter taste and dryness of the mouth and scorching pain in the?hypochondria and sides.