Liver patterns · Clinician-review draft
Liver Yang Rising vs Liver Fire
Both patterns can produce temporal headache, irritability, dizziness and a wiry pulse. The useful distinction is not the shared symptom list; it is whether the case shows ascending Yang on a deficient root or a pronounced full-Heat blaze.
Try the headache differentiation flow- Shared branch
- Upward disturbance
- Yang Rising
- Often a deficient root with an excess branch
- Liver Fire
- Full-Heat excess
- Best separator
- Intensity and unmistakable Heat signs
Side-by-side differentiation
| Finding | Liver Yang Rising | Liver Fire |
|---|---|---|
| Headache | Distending or throbbing; temples or vertex; often stress-aggravated | Often severe and throbbing, with a more forceful Heat presentation |
| Heat signs | May have red face or bitter taste, but the blaze is incomplete | Red eyes, pronounced thirst or dry mouth, bitter taste and marked irritability |
| Root | Look for Liver/Kidney Yin deficiency context | Primarily a full excess pattern |
| Tongue | Red sides may support the upward Liver picture | Red tongue, often with a yellow coat |
| Pulse | Wiry | Wiry and rapid; may be forceful or flooding |
Questions with the highest information value
- How severe and forceful is the headache, and is it distending or throbbing?
- Are the eyes distinctly red, and is there marked thirst or dry mouth?
- Is there a longer-standing Yin deficiency context such as night symptoms or dryness?
- What do the tongue body, coating and pulse rate add independently?
- Does emotional stress trigger the episode, or are strong Heat signs present regardless of stress?
How to reason without overcalling
A stress-triggered headache with a wiry pulse does not by itself distinguish these patterns. Strong red-eye, thirst, yellow-coat and rapid-forceful-pulse evidence shifts the hypothesis toward Liver Fire. A longer deficiency background with fewer full-Heat signs supports Liver Yang Rising.
Mixed presentations are possible. The diagnostic record should show which findings support the root, which support the active branch, and which expected findings were not established.
Move from reading to reasoning
Test the distinctions in an interactive case.
The assistant asks for evidence that can change the ranking and keeps missing observations visible.