this is vigorous heart fire injuring the blood and yin. the scorching from heart fire depletes the blood and yin, which in turn deprives the heart of nourishment. the combination of heat and deficiency disturbs the serenity of the spirit, which manifests as insomnia and continuous palpitations.

another way of looking at this is that the uprising of heart fire prevents the heart from rooting in the kidneys, which is necessary to house the spirit. the spirit therefore has no place to reside during the yin time of the day (i.e., the nighttime), and insomnia results.

the internal movement of fire in the heart not only aggravates the palpitations, but also gives rise to a sensation of heat and irritability in the chest, a desire to vomit without result, and a red tongue. this process of heat disturbing the spirit and disrupting the flow of qi in the chest may also lead to the development of a rancorous disposition. the combination of heat and deficiency is clearly reflected in the thin, rapid pulse.