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(Attachment: Newly Prescribed Hepatone-Regulating Pill)

The Liver belongs to the Jueyin (Terminal Yin) channel, its Qi transformation manifests in conjunction with the Shaoyang (Lesser Yang) channel, and it houses Ministerial Fire (Xiang Huo, a type of physiological fire associated with the Liver and Gallbladder). Therefore, the *Neijing* (Classic of Internal Medicine) calls it the "General Officer," indicating its nature is extremely rigid. Due to this rigidity, when disease occurs, it often overacts upon (Wu, an excessive controlling relationship in Five Phase theory) what it normally controls, namely the Spleen and Stomach, leading to Spleen-Stomach pathology manifesting as distension, pain, diarrhea, and various other symptoms. Consequently, medical texts speak of "Pacifying the Liver," asserting that pacifying the Liver is equivalent to supporting the Spleen. In cases where Liver Qi is rampant and unbridled, this method may be used temporarily but not for long-term use. Since the Liver corresponds to the Spring season, marking the beginning of Qi generation and sprouting, excessive pacification will inevitably damage the body's Qi transformation.

Some argue that in the Five Phases (Wu Xing), the Liver belongs to Wood, and Wood's nature is inherently capable of free flow and spreading. Thus, the method for treating the Liver should be to "scatter" as a form of tonification (medical texts state: "For the Liver, astringency is purging, scattering is tonifying"). "Scattering" refers to ascending and promoting free flow. However, frequent use of ascending and scattering methods actually damages Qi and Blood, and secretly injures Kidney Water, thereby damaging the root of Liver Wood.

Others state: The Liver dislikes dryness and prefers moisture. Dryness makes the Liver substance rigid, causing Liver Fire and Liver Qi to move recklessly; moisture makes the Liver substance soft and gentle, allowing Liver Fire and Liver Qi to remain tranquil. Hence, medical texts advocate using moistening herbs to soften the Liver. However, repeated use of moistening herbs actually hinders the Spleen and Stomach; this method can also only be used temporarily, not long-term. So, what is the appropriate method for treating the Liver?

The *Neijing* states: "If Jueyin cannot be treated, seek treatment in Yangming." The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: "Knowing Liver disease, one must first strengthen the Spleen." The sages of old and the sages of later times share the same principle; this is indeed the infallible method for treating Liver diseases. Regrettably, since the Han and Tang dynasties, no one has elucidated this principle. It was not until Huang Kunzai that the principle was deeply understood: "Liver Qi should ascend, Gallbladder Fire should descend. However, without the ascent of Spleen Qi, Liver Qi cannot ascend; without the descent of Stomach Qi, Gallbladder Fire cannot descend." This statement is profound, truly penetrating the essence of the *Neijing* and *Jingui Yaolue*. From this perspective, to treat Liver disease, one ought to raise Spleen Qi and lower Stomach Qi, cultivating the Middle Jiao (Central Pivot). By making the Qi transformation of the Middle Jiao thick and abundant, one allows Liver Wood to regulate itself. Even if some Liver-regulating herbs are occasionally used in small amounts, they serve merely as adjuvants in formulas regulating the Spleen and Stomach. This is because Earth in the Five Phases encompasses Metal, Wood, Water, and Fire. The human Spleen and Stomach belong to Earth; their Qi transformation distribution encompasses the organs of Metal, Wood, Water, and Fire. Therefore, when Spleen Qi ascends, Liver Qi naturally follows upward; when Stomach Qi descends, Gallbladder Fire naturally follows downward.

Furthermore, the *Neijing*, discussing Jueyin treatment, mentions "regulate the Middle Qi, making it peaceful." Regulating the Middle Qi refers to raising Spleen Qi and lowering Stomach Qi. Making it peaceful refers to the natural peace of Liver Qi achieved through raising Spleen Qi and lowering Stomach Qi. Zhang Zhongjing, in writing the *Shanghan Lun* (Treatise on Cold Damage Pathogens), deeply grasped the intent of the *Neijing*. His Jueyin treatment includes Wuzhuyu Decoction (Evodiae Fructus Decoction); since Jueyin and Shaoyang organs are interconnected, extending from Jueyin to Shaoyang treatment yields Xiaochaihu Decoction (Minor Bupleurum Decoction). The Ginseng Radix et Rhizoma (Renshen), Pinelliae Tuber (Banxia), Zizyphi Fructus (Dazao), Zingiberis Rhizoma Recens (Shengjiang), and Glycyrrhizae Radix et Rhizoma (Gancao) in these two formulas are all key herbs for harmonizing the Spleen and Stomach. Moreover, Xiaochaihu Decoction uses Chaihu (Bupleuri Radix) as the chief herb. The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states it treats knotting Qi in the intestines and stomach, food accumulation, and cold-heat pathogenic factors, pushing out the old and bringing forth the new. Repeatedly studying the text of the *Shennong Bencao Jing*, one sees that Chaihu is essentially a herb for the Yangming Stomach organ, while also treating Shaoyang. Those wishing to treat Gallbladder and Liver diseases would do well to follow the *Neijing* and emulate Zhang Zhongjing!

However, Liver pathology not only disadvantages the Spleen; conditions such as fright epilepsy, mania, dizziness, and cerebral congestion (referred to by Westerners as cerebrospinal nerve diseases) all involve the Liver channel. Generally, human cerebrospinal nerves originate from the Kidneys and branch into the Du Mai (Governing Vessel), appearing as pale gray fine tendons. The Liver governs tendons, and the Liver moves Qi for the Kidneys; thus, cerebrospinal nerve diseases are closely related to the Liver organ. To treat such conditions, one should apply the principle that Metal controls Wood in the Five Phases, using many metallic substances to anchor and suppress, such as Ferrugo (Iron Rust), Plumbum Cinis (Lead Ash), Aurum Folium (Gold Leaf), and Haematitum (Ochre/Hematite - Ochre is an iron oxide compound containing metal). These should be supplemented with herbs that clear and moisten the Liver, such as Antelopis Cornu (Antelope Horn), Indigo Naturalis (Qingdai), Paeoniae Radix Alba (Shaoyao), Gentianae Radix (Longdancao), and Achyranthis Bidentatae Radix (Niuxi - Niuxi enters the Liver via sour taste, excels at guiding blood and fire downward, and is a crucial herb for treating cerebral congestion, but requires heavy dosage for miraculous effects). This ensures wind settles and fire extinguishes in the Liver channel, allowing cerebrospinal nerves to return to normal limits, preventing various diseases. If immediate cure is not possible, one should also supplement with herbs that regulate and tonify the Spleen and Stomach, after which metallic and cold/cool substances can be taken long-term without harm. Furthermore, these conditions often involve phlegm-fluids; once Spleen-Stomach ascending and descending functions normalize, phlegm-fluids dissipate spontaneously.

There is a critical condition where the cause is not entirely in the Liver, but due to urgent symptom management, attention must first focus on the Liver: this is deficiency of Yuan Qi (Primal Qi) threatening upward collapse. Symptoms include profuse sweating that does not stop, or stops briefly then resumes, with alternating chills and fever. Or extreme danger with eyes fixed upward, showing no black pupil; or no sweat but palpitations and inner restlessness requiring someone to press upon the chest; or accompanied by panting. At this time, heavily dose astringent Liver herbs to prevent Liver from dispersing, thereby blocking the path of Yuan Qi collapse. Once sweating stops, palpitations cease, and panting subsides temporarily, one can slowly plan other treatments. Heavily dose purified Cornus Officinalis Fructus (Shanzhuyu) up to 2 liang (*Shennong Bencao Jing* states Shanzhuyu treats cold-heat, referring to this condition). Astringing the Liver is equivalent to tonifying the Liver, assisted by Ren Shen (Ginseng), Haematitum (Ochre), Longgu (Fossilized Bones), and Muli (Oyster Shell). My work *Laifu Tang* records several cases rescued using this method; readers may refer to them.

Ultimately, the function of the Gallbladder and Liver actually assists the Spleen and Stomach in regulation. According to Five Phase theory, Wood can overact upon Earth, but Wood can also loosen Earth. I once treated a patient with indigestion who took 100 doses of Spleen-fortifying and Stomach-warming herbs without effect. Palpation revealed a very weak pulse at the Left Guan position, indicating Liver Yang depression. I prescribed Huangqi (Astragali Radix - its warm, ascending nature matches the Liver Wood's ascending quality, embodying the principle of similar energies seeking each other, making it the chief herb for tonifying the Liver) 1 liang, and Guizhi Jian (Cinnamon Twig Tip) 3 qian. After a few doses, the patient recovered. I also treated jaundice; palpation showed a particularly weak Left Guan pulse. I heavily decocted Huangqi and used the liquid to swallow Xiaoshi Jiushisan (Magneti Ostreae and Alum Powder) from the Jaundice chapter of *Jingui Yaolue*, resulting in recovery. These are clear proofs. Furthermore, bile enters the Small Intestine, aiding digestion, illustrating Wood loosening Earth. Although the Small Intestine belongs to Fire, it is physically connected to the Stomach, so it can also be discussed as Earth. Bile originates from blood in the hepatic veins, is poured into the Gallbladder, and fully embodies the Qi of Jia-Yi Wood. Thus, in the Small Intestine, it digests food the Stomach cannot, showing swift efficacy in loosening Earth.

Western medicine posits the Liver as a convergence point for venous return; if the Liver enlarges or heats up, vessels become stagnant and swollen. From this, we know that herbs that soothe Liver stagnation, such as Chaihu (Bupleuri Radix), Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), Hordei Fructus Germinatus (ShengMaiya), Boswelliae Resina (Ruxiang), and Myrrha Resina (Moyao), can be selected. These should be assisted by blood-invigorating herbs like Taoren (Persicae Semen), Carthami Flos (Honghua), Buprestidis (Chuangji), and Eupolyphaga Steleophaga (Zhechong). Additionally, heat-purging herbs should be added, but sudden use of large-cold herbs is avoided lest stagnant blood congeal upon cooling, becoming harder to dissipate. Instead, select Lonicerae Japonicae Flos (Lianqiao), Yin Chen Hao (Artemisiae Scopariae Herba), Toosendan Fructus (Chuanlianzi), and Gardeniae Fructus (Zhizi - Zhizi powder mixed with rice wine treats bruising/swelling/pain from trauma, proving its ability to resolve stasis). These are cool yet dispersing, fitting the syndrome perfectly.

The Liver substance is hard like wood; softening methods are suitable. Softening herbs include Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Baidao Ren (Platycladi Semen), Xuanshen (Scrophulariae Radix), Gouqi (Lycii Fructus), Ejiao (Asini Corii Colla), and Biejiia (Testudinis Carapax et Plastrum). These can be selected, assisted by blood-invigorating herbs. Among blood-invigorators, Sanqi (Notoginseng Radix et Rhizoma) is most crucial for resolving stasis and generating new tissue. Besides decoctions, take Sanqi fine powder separately, three times daily, 1.5 qian to 2 qian per dose. Then the hard Liver substance will become soft soon.

The *Neijing* states: "The Liver suffers from tension; urgently eat sweet things to relax it." "Suffering from tension" means Qi and Blood suddenly merge into the Liver, creating an urgent, hard-to-relax pressure, causing loss of normal function. During acute tension, the Liver substance may be hard, but returns to normal afterward. Treatment involves heavily dosing sweet, relaxing herbs to alleviate tension, curing the disease spontaneously. This differs from treating chronic Liver hardness. I read Vol. 24 of *Shanxi Medical Journal*: a patient overdosed on hot, acrid, harsh herbs, suddenly developing spasms, opisthotonos, and vomiting blood/froth. Dr. Qiao followed the *Neijing*, using only Gancao (Glycyrrhizae Radix et Rhizoma) heavily, decocted and taken continuously, recovering in days. This shows mastery of the *Neijing*. If this method fails, add cool-moistening herbs like Antelopis Cornu (Antelope Horn) or Baishao (White Peony Root), or heavy anchoring herbs like Cinnabar (Zhu Sha - finely ground and swallowed) or Iron Rust.

[Newly Prescribed Hepatone-Regulating Pill] Treats Liver hardness, Liver Qi stagnation, Liver vessel occlusion, and Liver Wood rampant overacting on Spleen Earth. Symptoms include hypochondriac distension/pain, wandering limb pain, reduced appetite, vomiting/hiccups, acid regurgitation, persistent belching, continuous hiccups, headache/eye distension, dizziness, spasms/epilepsy, etc.

Powdered Gancao (Glycyrrhizae Radix et Rhizoma) (5 liang, fine powder)
Raw Hangshaoyao (Paeoniae Radix Alba) (3 liang, fine powder)
Green Lianqiao (Lonicerae Japonicae Flos) (3 liang, fine powder)
Guang Rougui (Cinnamomi Cortex) (1.5 liang, remove bark, fine powder)
Bingpian (Borneolum Syntheticum) (3 qian, fine powder)
Bohebing (Menthae Haplocalycis Herba Ice/Menthol) (4 qian, fine powder)
Pian Zhusha (Cinnabar) (3 liang, fine powder)

Mix the first six ingredients evenly, pill with water to size of Sophora japonica seeds, dry in shade (do not sun-dry). Coat with Zhusha (Cinnabar). Ensure pills are solid and smooth to prevent flavor loss. Take 20-30 pills one hour after meals, twice daily. For acute cases, take on an empty stomach; or take an extra dose before bed after the initial two doses. For healthy individuals using it as a digestive aid, take 10 pills one hour after meals.

In recent years, Liver diseases are common, especially in women. Doctors habitually use Xiangfu (Cyperi Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Zhike (Aurantii Fructus), and Yanhusuo (Corydalis Rhizoma) to move Qi, and Chaihu (Bupleuri Radix), Chuanxiong (Chuanxiong Rhizoma) to raise Qi. Continuous use often leaves Liver disease unresolved while Yuan Qi is weakened beyond support; even good doctors find rescue difficult. This is lamentable.

This formula uses Gancao's sweetness to relax the Liver; Shaoyao's moisture to soften the Liver; Lianqiao to scatter Qi-level knots (used alone for Liver Qi stagnation with special effect); Bingpian and Bohebing to open vessel closures; Rougui (Cinnamomi Cortex) to restrain Liver rampantness; Zhusha (Cinnabar) to control reckless Ministerial Fire in the Liver. Combined as pills, the sweet-aromatic taste awakens the Spleen and strengthens the Stomach, increasing appetite. The properties are mild: clearing above, warming below (feels cool initially, becomes warm in the Lower Jiao). Thus, for any Liver disease unresponsive to other drugs, slow administration of this pill will yield results.