A 46-year-old woman presents with a 1-year history of episodic headaches. The pain is distending and worsens with emotional stress. Recently, she has experienced dizziness, tinnitus, irritability, and difficulty sleeping. She denies strong thirst. Tongue is red on the sides with scanty coating. Pulse is wiry and slightly rapid. What is the most likely diagnosis?
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Scanty Coating
A scanty coating often suggests fluid or Yin deficiency and is an important clue to a deficiency-rooted pattern.
Wiry Pulse
A wiry pulse is commonly associated with Liver patterns, pain, and phlegm-fluid disorders. It feels taut and straight, like a tightened string.
Red Tongue
A red tongue usually indicates heat, but whether that heat is excess or deficiency must be determined from the coating and pulse.
Liver Yang Rising
Liver Yang Rising is usually a mixed root-branch pattern: the root is Yin deficiency, while the branch is upward disturbance of Yang. In exam stems it often appears with headache, dizziness, tinnitus, irritability, a red tongue, scanty coating, and a wiry pulse.