Abstract: This study, with a focused analysis of “Shanghuo”—a core TCM concept embodying heat pathologies, critically explores the efficacy of digital semiotic systems in illustrating TCM metaphorical concepts. Through a framework integrating principles for effective multimodal metaphor application from Conceptual Metaphor Theory, Multimodal Metaphor Theory, Visual Grammar Theory, and Multimodal Interaction Analysis Theory, this study examines the pattern of multimodal representation of metaphors and performance of four modes—written signs, pictorial signs, sounds, and gestures in translating this metaphorical concept across 20 relevant Douyin videos. The findings reveal that among the current cases of multimodal representation of metaphor of “Shanghuo”, strategies combining three or more target modes are more prevalent compared to simple 1–2 modes combinations. However, an examination of their limitations exposes challenges in balancing richness and coherence across different modes. While multimodal integration significantly stimulates viewers’ interest, issues like incomplete and contradictory mapping to the target domain—particularly mismatched color schemes in written signs, lack of dynamic design in pictorial signs, and irrelevant audio-gestural cues—not only hinder accurate demonstration of “Shanghuo” but also induce cognitive fatigue in viewers. These findings collectively emphasize the need for optimizing cross-modal consistency and coordination in the multimodal representation of the metaphor of “Shanghuo”. Specific recommendations for optimization can be made in two key areas: 1) strengthen the visual, auditory, gestural mapping of fire-associated features to “Shanghuo” in corresponding Zang-organs; 2) enhance cross-modal coordination and complementarity in mirroring the pathological progression of “heat” evolving from the five Zang-organs to the body’s surface.
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