this is primarily a liver qi stagnation pattern, often accompanied by a disharmony of the liver and spleen.

the distending pain in the hypochondria and chest, sensation of fullness or oppression, frequent sighing, irritability, and wiry pulse are indicative of liver qi stagnation. these symptoms reflect the failure of the liver to ensure the free flow of qi.

the emotional depression or irritability further illustrates liver involvement, as emotional stress readily constrains liver qi and disrupts the overall movement of qi in the body.

the abdominal pain, bloating, indigestion, constipation or irregular bowel movements point to secondary impairment of the spleen. this occurs when stagnant liver qi overacts on the spleen, disturbing its functions of transformation and transportation.

when liver qi stagnation persists, it may transform into heat, reflected in a bitter taste in the mouth, dry mouth, red tongue sides, and a wiry or slightly rapid pulse.

this is yang- or hot-type collapse (yáng jué), which is commonly due to heat entering the interior where it constrains the yang qi. this inhibits the spreading of yang qi to the extremities, causing cold fingers and toes (in contrast to depleted yang, where the entire limb is cold), and a warm body. the tongue signs reflect the presence of heat. the wiry pulse and the sensation of irritabilty and fullness in the chest and abdomen reflect interior constraint.

nowadays this formula is used to treat rebellious liver qi attacking the stomach and spleen, characterized by hypochondriac pain and distention, sometimes with epigastric pain and fullness, a bitter taste in the mouth, belching, reduced appetite, and a wiry, forceful pulse.

(bensky & barolet)