What does上火 (shànghuǒ) actually mean?

If you have any Chinese friends or colleagues, then you are almost certain to have heard them say at some point, 我上火了(Wǒ shànghuǒ le). But what does this actually mean? Is there any equivalent in English?

The first time I heard this term, as an explanation of why my friend was not feeling very well, I was totally confused and racked my brains to think of a suitable English translation. Since then, I hear it used almost daily, whether it be from the mothers of the children I teach sharing stories about their children’s latest health problems, colleagues who are feeling a little under the weather, or friends who can’t make it out for dinner.

As a term which comes from Chinese medicine, 上火shànghuǒ is certainly a headache for translators. It is often translated as “excessive internal heat”, but to a western audience, this means very little. Apparently there is no real equivalent for the term in western medical terminology, as it is considered too general, with symptoms which correspond to various different medical conditions.

So, if we can’t come up with a good translation, then how can we explain it? What are the causes? What are the symptoms? And how can we get rid of it?

Shànghuǒ in traditional Chinese medicine (TCM)

The TCM explanation of shànghuǒ all hinges on the theory of yin and yang. Yin-yang theory forms the basis of much of Chinese traditional thought, including Chinese medicine, classical Chinese science and philosophy and martial arts. The theory states that yin (阴yīn) and yang (阳yáng) are contradictory yet interdependent forces, which give rise to one another in turn. Everything in the world has to have both yin and yang elements, although some things contain more yang (said to be male, hot, light, high) and others more yin (female, cold, dark, low). The human body, therefore, whether it is male or female, has to maintain a balance between yin and yang elements in order to remain healthy.

Shànghuǒ is caused when a person’s internal fire (yang element) exceeds the normal level (hence the translation “excessive internal heat”), which manifests itself in redness, swelling and pain. Note, this heat is not the same as body temperature and although shànghuǒ can lead to fever (发烧 fāshāo), it is not a fever in itself.

What are the symptoms?

There are a great number of potential symptoms that can be put down to shànghuǒ, and these depend on which part of the body (heart, lungs, stomach, liver are some of the most common) the excessive fire is in.

Some of the most typical symptoms, however, include spots, rashes and sores in the mouth, as well as swellings (of the gums, for example), toothache and coughing. As you can see, many of these symptoms, but not all, are on the face or head. This list is far from exhaustive, but most times I have heard this term used, it has been used to describe coughing, a sore throat or redness in the form of spots or rashes.

How is it caused?

Shànghuǒ is said to be caused by both internal and external factors, although internal factors are believed to be the more crucial of the two. Internal factors inc