One of the most frequent mistakes we have all made is to see a very red face on a patient, and immediately diagnose them as Fire. A flushed face, with an even red spread over the whole of the face is, I have found, never Fire, but either Wood or Earth.
Fire’s red tends to appear in blotches, interspersed with a much paler colour, particularly around the mouth and eyes. Its red also tends to come and go, as happens when we flush, one minute making the face very red and then dying away so that the face looks pale and drained of colour. I always see this as the Heart, and particularly its devoted servant, the Heart Protector, pumping away to try and bring a good blood supply to the face, but not having enough energy to keep the blood flow consistent.
Both Wood and Earth can have very red faces when they are out of balance, but their red does not come and go in flushes, but stays there all the time, placing a layer of red over the whole face which almost submerges the elemental colour of green or yellow beneath it. In the case of Wood, the red is a result of the weakness of the mother (Wood) causing distress in the child (Fire). In the case of Earth, the reverse is true, even though there is the same effect of flushing. Here Fire, the mother, is unable to pass on sufficient energy to its child (Earth), causing a build-up of Fire in the mother.
The red of a Wood imbalance comes from its child crying out for help, and the red of an Earth imbalance comes from its mother showing distress. The kind of red which appears will obviously be very different in either case, but will, misleadingly, appear to be the dominant colour. So beware of any snap decision about Fire when you see red!