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In the heat syndromes of cold damage, symptoms such as irritability, dry mouth, deafness, blurred vision, scorched lips, and red tongue appear. In severe cases, macules (skin eruptions) and jaundice may occur, along with delirious speech and madness. All these are caused by fire pathogen. Are not herbs such as Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), and Dahuang (Rhei Radix et Rhizoma) the correct treatments for fire? However, they should not be administered abruptly. If the Taiyang exterior syndrome is unresolved and the pulse is floating and rapid, indicating fire stagnation, it is appropriate to use dispersing methods. If Shaoyang syndrome presents with alternating chills and fever, vomiting, and bitter taste in the mouth, indicating wood qi stagnation, it is appropriate to use unblocking methods. If Yangming stomach excess with heat indicates upward stagnation of heat, purgative methods are appropriate. Only when the evil heat has penetrated deeply, accumulated, and cannot be resolved, and the pulse is surging, rapid, long, and forceful, should treatment be targeted at specific levels: Liangge San (Cooling the Diaphragm Powder) for upper jiao heat, Baihu Tang (White Tiger Decoction) for middle jiao heat, and Huanglian Jiedu Tang (Coptis Decoction to Resolve Toxicity) for triple jiao heat. Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) for deficiency vexation, Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) for macule toxicity, Yinchen Zhizi Tang (Artemisiae Scopariae and Gardeniae Decoction) or Daochi San (Guide Out the Red Powder) for jaundice; all these are formulas treating fire.

Yet one must not ignore the distinction between deficiency fire and excess fire. For upper jiao deficiency thirst, Shengmai San (Generate the Pulse Powder) is used. For middle jiao blood deficiency causing fever, where symptoms resemble those treatable by Baihu Tang, Danggui Buxue Tang (Angelica Sinensis Decoction for Replenishing Blood) is used. When lower jiao true water is exhausted and repeated clearing fails, Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) is used. Zhang Zhongjing feared the drying of kidney water and advocated urgent purgation to preserve body fluids; why not urgently nourish yin? He might even fear it is too late, yet instead uses Chengqi Tang (Chengqi Decoction) to purge? Whenever I treat continuous fever from cold damage with a deficient and rapid pulse, bowel movements that are sometimes loose and sometimes constipated, dry mouth and throat, deafness and blurred vision, and a sensation of hunger in the chest without fullness, I administer large doses of Liuwei Dihuang Tang, which invariably yields immediate results. This is truly a divine formula with hundred percent efficacy. Using the great bitter and cold herbs like Huangqin, Huanglian, Zhizi, and Huangbai would instead damage the true qi. As Zhao Xianke stated, using tangible water to douse intangible fire only suffices to harm life, offering no real benefit.

Regarding clearing fire, there are methods of direct suppression (zhezhe), following the nature of the disease (congzhi), ascending and dispersing, sweet and緩 (gan huan), and strengthening water (zhuangshui). One must observe the patient's complexion, form, pulse, and signs of deficiency or excess, as well as situations where condition worsens after taking cold-cooling herbs; one must know how to adapt. Li Dongyuan's method of ascending yang and dispersing fire, and the Inner Classic's method of guiding fire back to its source, indeed contain subtle wisdom worth adopting.

Liangge San: Dahuang, Poxiao, Gancao, Huangqin, Zhizi, Bohe (each 2 liang); Lianqiao (4 liang). Grind into powder. Take 5–7 qian per dose, decoct in water and take orally.

Baihu Tang: Shigao, Zhimu (each 3 qian); Gancao (0.5 qian, honey-fried); Jingmi (0.5 he). Decoct in water and take orally.

Huanglian Jiedu Tang: Huanglian, Huangqin, Huangbai, Zhizi (equal parts). Decoct in water.

Zhi Zi Chi Tang: Fei Zhizi (4 fruits); Xiangchi (5 qian). Use 2 zhong of water, decoct Zhizi until 1 zhong remains, add Xiangchi, decoct until 0.7 zhong remains, strain and take.

Sanhuang Shigao Tang: Huanglian, Huangqin, Dahuang, Shigao. Decoct in water.

Yinchen Zhizi Tang: Yinchen (3 qian); Zhizi, Dahuang (each 2 qian). Decoct in water.

Daochi San: Shengdihuang, Mutong, Gancao (honey-fried, each 1 qian). Grind into powder. Take 1 qian per dose, mix with Zhu Ye (Bamboo Leaf) decoction.

Shengyang Sanhuo Tang: Shengma, Duohuo, Qianghuo, Fangfeng, Chaihu, Gegen, Renshen, Gancao, Baishao Yao. Decoct in water.

Shengmai San: Renshen (2 qian); Maimendong (1.5 qian); Wuweizi (0.3 fen, crushed). Decoct in water.

Danggui Buxue Tang: Huangqi (6 qian, honey-fried); Danggui (4 qian). Decoct in water.