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In fire syndromes, those caused by Yin deficiency leading to hyperactive fire are difficult to treat. For Fire Stagnation (Huo Yu), dispersing methods should be employed; one must identify the affected meridian. In mild cases, descending methods can be used; in severe cases, one should follow the nature of the fire and use ascending/dispersing methods. Excess Fire (Shi Huo) can be purged, using formulas such as Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity); Deficient Fire (Xu Huo) can be tonified, and unobstructed urination rapidly reduces fire. Whenever Qi is in excess, it transforms into Fire; when Qi is insufficient, it is Qi Deficiency. For cases where Fire is urgent and severe, raw Gancao (Glycyrrhizae Radix et Rhizoma) must be used to moderate the action, combining purging and moderating effects; Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) may also be used. For robust individuals with abundant Qi and excessive Fire presenting with mania or epilepsy, direct treatment (Zheng Zhi, using cold/cooling agents to subdue heat) can be applied, or substances like Xiaoshi (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), and Bing Shui (Ice Water) may be used. However, for patients with excessive Deficient Fire causing mania, Ginger Decoction (Shengjiang Tang) should be administered; if ice water is mistakenly used for direct treatment, death will occur immediately. By nourishing Yin, Fire naturally descends; this can be achieved with Chao Huangbai (Fried Phellodendri Cortex) and Shengdihuang (Rehmanniae Radix). In cases of vigorous Fire, cooling drugs should not be used abruptly; warming and dispersing methods must be combined.

There are two indications for dispersing: external contraction of Wind-Cold can be dispersed, and internal Fire Stagnation can also be dispersed. If Qi rises from the left side, it is Liver Fire; if Qi rises from below the navel, it is Yin Fire; if Qi rises from the feet and enters the abdomen feeling like fire, it indicates extreme Deficiency. Such Fire rising from the "Nine Springs" (extreme depths) often leads to death. (Alternative method): Use Fuzi powder (Aconiti Lateralis Radix Preparata), mixed with saliva, and apply it to Yongquan acupoint (KI 1); simultaneously administer Siwu Tang (Four Substances Decoction) added with Fire-descending herbs, which is effective. Yin Deficiency syndromes are inherently difficult to treat; Siwu Tang (Four Substances Decoction) added with fried Huangbai (Phellodendri Cortex) can descend Fire and tonify Yin. Guiban (Testudinis Carapax et Plastrum) tonifies Yin and belongs to the "Supreme Yin within Yin." Siwu Tang (Four Substances Decoction) added with Baima Jinggu (Equini Tibia Bone) can descend Fire within Yin, serving as a substitute for Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Dahuang (Rhei Radix et Rhizoma), and Huangbai (Phellodendri Cortex); however, these bitter-cold herbs should only be used for Fire within Yin. Raw Gancao (Glycyrrhizae Radix et Rhizoma) moderates Fire pathogenic factors; Mutong (Akebiae Caulis) directs heat downward and drains Small Intestine Fire; Renzhongbai (Calcinatus Urinae Hominis) drains Liver Fire and should be exposed to wind and dew for two to three years; Renzhonghuang (Carbonized Human Faeces) is extremely cooling and is best used for treating Epidemic Diseases (Yi Bing) if aged for many years.

For patients with insufficient Middle Qi, flavors should be sweet and cold. Shan Zhizi Ren (Gardeniae Semen) greatly descends Fire and excretes it via urine; its property allows it to descend through twists and turns, a fact unknown to many, and it also treats Fire pathogens in Pi Kuai (Plaque masses).

[Formulas]
Zuojin Wan (Left Metal Pill): Treats Liver Fire. Also known as Huiling Wan.
Ingredients: Huanglian (Coptidis Rhizoma) (6 liang, another version says Huangqin [Scutellariae Radix]), Wuzhuyu (Evodiae Fructus) (1 liang or half liang).
Preparation and Administration: Grind into powder, make pills with water or steamed bread dough. Take 50 pills with warm water.

[Appendix] Various heat syndromes causing dizziness and confusion (Mao), sudden aphonia, coma, restlessness, mania, cursing, fright, swelling, pain, soreness, rebellious Qi rushing upward, trembling and fear as if losing spiritual control, sneezing, vomiting, sores and ulcers, throat obstruction (Hou Bi), tinnitus, and deafness, vomiting and overflow, inability to eat, blurred vision, acute diarrhea, sudden sores, sudden death, and the extreme excess of the Five Emotions and Seven Affects all belong to Fire. Fire is categorized into two types: Jun Huo (Ministerial Fire/Imperial Fire), which is Human Fire; and Xiang Huo (Assistant Fire), which is Heavenly Fire. Fire is Yin inside and Yang outside, primarily governing movement. Therefore, anything involving movement belongs to Fire. In terms of name, form and substance generate each other, corresponding to the Five Elements, hence called Jun (Emperor); in terms of position, it arises from emptiness, maintains its station receiving commands, and manifests through movement, hence called Xiang (Minister). The Yin of the Kidney and Liver both contain Xiang Huo (Assistant Fire). Li Dongyuan stated: Assistant Fire is the thief of Yuan Qi (Original Qi); Fire and Yuan Qi are incompatible; when one wins, the other loses. So how can we prevent this rivalry? Zhou Dunyi said: Spirit gives rise to consciousness. When the Five Natures are moved by external things, they cannot remain still. This movement refers to the Five Fires mentioned in the Neijing. Assistant Fire easily arises; when coupled with Jue Yang Fire of the Five Natures, it moves recklessly. Fire arises from delusion, changes unpredictably, exists at all times, and fries True Yin. Yin deficiency leads to disease, and Yin exhaustion leads to death. The Qi of Jun Huo (Imperial Fire) is described in classics as Summer Heat and Heat. The Qi of Xiang Huo (Assistant Fire) is described simply as Fire, indicating its violent, fierce, and cruel nature, which is more severe than Imperial Fire. Thus it is said: Assistant Fire is the thief of Original Qi. Zhou Dunyi further said: The Sage establishes correctness, justice, benevolence, and righteousness, and emphasizes Stillness. Zhu Xi also said: One must ensure that Dao Xin (Mind of the Way) is always the master of the body, while Ren Xin (Human Mind) obeys it; this is how to properly manage Fire. When the Human Mind obeys the Mind of the Way and is governed by Stillness, the Five Fires will become silent. Then Assistant Fire will only assist creation, functioning in endless generation, having no thieving nature.

[Attached Formulas]
Dongyuan Xie Yin Huo Sheng Yang Tang (Dongyuan's Decoction to Drain Yin Fire and Raise Yang): Treats muscle fever, vexatious heat, red face, poor appetite, asthma, cough, and profuse phlegm.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), Cangzhu (Atractylodis Rhizoma) (each 1 liang), Shengma ( Cimicifugae Rhizoma) (8 qian), Chaihu (Bupleuri Radix) (1.5 liang), Renshen (Ginseng Radix), Huangqin (Scutellariae Radix) (each 7 qian), Huanglian (Coptidis Rhizoma) (wine-fried, 0.5 liang), Shigao (Gypsum Fibrosum) (0.5 liang, do not use in late autumn).
Preparation and Administration: Cut into pieces. Take 1 liang or 0.5 liang per dose, decoct in water. This formula disperses Spleen and Stomach Fire pathogens; it also acts on the Heart, Gallbladder, Liver, Lung, and Bladder. It drains Yin Fire, raises and disperses Yang Qi, and nourishes Qi and Blood.

Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction): Treats fever in the four limbs of men and women, muscle fever, heat in tendon bi, heat in bone marrow, and oppressive heat like burning, where touching feels scalding. This condition often results from Blood Deficiency, or from Stomach Deficiency and overconsumption of cold foods, which suppresses Yang Qi in the Spleen Earth, causing Fire Stagnation; thus, dispersing is used.
Ingredients: Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Duhuo (Angelicae Pubescentis Radix), Qianghuo (Notopterygii Rhizoma et Radix) (each 0.5 liang), Fangfeng (Saposhnikoviae Radix) (2.5 qian), Chaihu (Bupleuri Radix) (8 qian), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (3 qian), Renshen (Ginseng Radix), Baishao (Paeoniae Radix Alba) (each 0.5 liang), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) (2 qian).
Preparation and Administration: Cut into pieces. Take 0.5 liang or 1 liang per dose, decoct in water, and take slightly warm.

Digupi San (Digut皮的 Powder): Treats whole-body high fever, long and slippery pulse, Yang Toxin with blazing Fire causing thirst.
Ingredients: Digupi (Lycii Cortex), Fuling (Poria) (each 0.5 liang), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Shengdihuang (Rehmanniae Radix), Zhimu (Anemarrhenae Rhizoma) (each 1 liang), Shigao (Gypsum Fibrosum) (2 liang), Qianghuo (Notopterygii Rhizoma et Radix), Mahuang (Ephedrae Herba) (each 7.5 qian, remove Mahuang if sweating is present).
Preparation and Administration: Cut into pieces. Take 1 liang per dose, decoct with ginger.

Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity): See section on Summer Heat.