Liver Fire: irascible, dizzy and headaches

Angry Man

Like Liver Qi stagnation, Liver Fire is common.

Liver Fire symptoms include:

  • dizziness
  • distending sensation in the head
  • headache on the temples
  • ringing in the ears or sudden deafness
  • red, swollen or painful eyes
  • bitter or dry taste
  • red, flushed face
  • and irascibility, fits of anger.


Also, anxiety: very anxious – and CROSS

That’s not all. Common to this Liver Fire syndrome are other symptoms like:


If it becomes severe, ‘flare up of Fire of Liver’ – ie Liver Fire (that’s the wonderfully flowery way Chinese medicine often describes syndromes!) will damage the Liver’s function of storing the Blood which can lead to nose–bleed (epistaxis) and vomiting of blood (haematemesis).

  • Tongue is often red, with a yellow tongue coating
  • Pulse is wiry and rapid.


Heat rises, so the symptoms of flaring up of Fire of Liver, whether mild or severe, are in the upper body and head.


Fire cracker - what Liver Fire feels like
© Christos Georghiou –

The key feature of Liver Fire is irascibility. The patient often displays this but may complain about it too and if not, you must enquire – it’s important, because another condition – Liver Yang rising – can also have this, but it lacks the irascibility of Liver Fire.


Soon after I began practising acupuncture, my mentor Dr Mary Austin gave me one of her patients.

I now think it was probably a little test, but also I realised later on that perhaps she and he didn’t really get on.

He was in his fifties, grey-haired and, I thought, very self-possessed. He said he had a slight headache.

For me, a slight headache usually gets better overnight, so just needs rest. He said, firmly, this was not the case; sleep did not help.

So I dutifully took his case. Time went by with me enquiring politely about his reaction to the weather (enjoy the sun), his temper (very good), his bowel actions (perfectly regular thank-you), what position he slept in (very comfortably so I tend to forget but thank you for asking), what he felt like during a headache (want to get rid of it), his parents and grandparents and their health (I think he rolled his eyes but out of loyalty to Mary Austin he soldiered on) and lots more like that.

Used as he was to Mary Austin’s immediate diagnoses, he eventually got a little restless.

Looking Back …!

Looking back on it, I’m a bit embarrassed, but that is how I’d been taught and I felt I should leave no stone unturned.

Eventually, with remarkable control, I now realise, he asked me whether he had told me enough about his headache and did I have a diagnosis.

I thought it perhaps time to take his pulses. Now, at that stage of training in the UK we had hardly heard of the huge and sophisticated benefits from Chinese medicine’s contribution to understanding the pulses, and I could just about distinguish between a fast and a slow pulse and between a strong and a weak pulse.

Remembering that he was a mild-mannered man with a slight headache, I took his wrist and approached his radial artery with confidence that his pulse would be a little weak and perhaps slow.

I have to report to you that so strong was his pulse that it nearly knocked my fingers off his wrist. Not just strong, but fast.

Slowly putting things together in my brain, I began asking better questions.

Could he tell me more about his headache?

‘NO HE BLOODY WELL COULD NOT!’ (Those capitals should be quadruple size – he was yelling at me.)

Now I began realising everything I’d missed.
The redness in his eyes which I had thought was due to a little alcohol earlier – but probably was a measure of a lot of alcohol daily.
The colour of his face, which I had thought was a healthy ruddy colour but was much more than that.
Did he take any medication?

YES HE BLOODY WELL DID AND I SHOULD HAVE ASKED BEFORE: FOR INSOMNIA; CONSTIPATION; BLOOD IN HIS URINE; TINNITUS AND DIZZINESS. (Quadruple Capitals, multiplied by now.) (There may have been other medications but I’ve forgotten – this was probably 1980.)

Although I wasn’t familiar with Liver Fire, I certainly knew what to do – call Mary Austin! Together we worked out a treatment plan, using points that, when I learned about it later, I realised benefit Liver Fire.

I’m glad to say they worked, and he became a loyal patient until he retired and moved abroad.

So learn to ask the right questions. Know your theory and syndromes. Be Observant.

And if you’re an acupuncturist and just starting, be very suspicious if you’re sent patients by your mentor.

Aetiology of Liver Fire

Aetiology of Flare-up of Fire of Liver

1/ Liver Fire often appears after long-term Liver qi stagnation.

There’s a saying in Traditional Chinese Medicine, that ‘excessive Qi makes Fire’.

Imagine rubbing your hands together too hard: the friction creates heat and if your hands were wood, they’d catch fire.

Concerning Qi stagnation, see also my book, mentioned below.

2/ Over-indulgence in alcohol and tobacco smoking for long periods exacerbates Liver Fire.

Armagnac - not good for Liver Fire
Armagnac – Copyright

(As you may know, both alcohol and tobacco, in small doses, have a relaxing effect on Liver Qi stagnation. But in large quantities over long periods, they have the opposite effect. The same is true for other substances, herbs and drugs that work the same way. To find out more about this, read my page on Primary and Secondary Actions.)

3/ Irritant foods also give rise to Fire. For example hot pepper, strongly heating spices, chilli, very oily or greasy foods, etc. Most people don’t have a problem with the occasional spicy meal, but some people do, and some people take these foods at every meal, then wonder why they start developing symptoms of flare-up of Fire of Liver.


Greasy food, bad for Liver Fire
Photo by freestocks on Unsplash


You could also get this from eating greasy bacon and eggs for breakfast too often. Here it might first show up simply as a tendency to blepharitis or redness in the margins of your eyelids. 

Hot Foods

These irritant foods are nearly always Hot Foods: read that page for more on this and what to avoid.

Here’s another link to that page! (Yes! I do want you to read it!):

Click here for a list of foods that have a heating effect – to be avoided.

If you ignore these tendencies, they can lead to Liver Wind, which is not such a bed of roses! So enjoy spicy meals in moderation. 

Of course, if you grew up in a culture where spicy food was the norm, your body may have adjusted to it in youth.

From then on you may need more spicy food than others to maintain health. But even so, I would argue, you probably remain more prone to this condition.

Other Liver syndromes

Read about other Liver syndromes by clicking on the following:

Liver Functions in general including Liver Qi Stagnation

Liver Blood Deficiency

Blood Stasis in your Liver

Liver Channel Cold Stagnation

Liver Damp Heat

Fire in your Liver – this page

Liver Wind

Liver Yang rising

Yin deficiency of Liver

Jonathan Brand colours

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