In this pattern there is both unformed heat above and formed accumulation below, which requires a strategy of simultaneously draining the heat and reducing the accumulation. The use of only one of these strategies will not alleviate the condition. This pattern is one of formed or accumulated heat in the middle burner, and unformed or blazing heat in the upper burner. Heat in the chest and diaphragmatic regions produces a sensation of heat and irritability that, in severe cases, may cause delirious speech. Heat in the Stomach and Intestines injures the fluids and prevents them from rising to the mouth, which causes thirst. Dryness due to heat clumping in the yang organs interrupts the smooth flow of qi and causes constipation and dark, scanty urine. Heart fire blazing upward produces a flushed face, red lips, mouth and tongue sores, sore throat, and a swollen tongue. Heat in the Lungs, Heart, Spleen, and Liver manifests as signs of inflammtion in their corresponding sensory organs (the nose, tongue, mouth, and eyes respectively). Red tongue edges with a white coating indicates that heat is lodged primarily in the upper burner; redness covering the body of the tongue and a yellow coating indicates that heat is firmly established in both the upper and middle burners. A dry coating indicates dryness. A rapid pulse indicates heat, while a slippery pulse indicates clumping due to the accumulation of heat and dryness in the interior. --Bensky: Chinese Herbal Medicine Formulas & Strategies.