〔钱〕肝，主风。实则目直大叫，呵欠项急顿闷。虚则切牙多欠。气热则外
生，气温则内生。肝病，哭叫目直视，呵欠顿闷项急。外生感风，呵欠顿闷，
口中气热，当发散，大青膏主之。若能食，饮水不止，当大黄丸微下之。余不可下。
肝热，手寻衣领，及乱捻物，泻青丸主之。壮热饮水喘闷，泻白散主之。肝有风，
目连札，不搐，得心热则搐，治肝泻青丸，治心导赤散。肝有热，目直视，不搐，
得心热则搐，治肝泻青丸，治心导赤散。肝有风甚，身反折强直，不搐，心不受
热也，当补肾治肝，补肾，地黄丸；治肝，泻青丸。凡病或新或久，皆引肝风，
风动而上于头目，目属肝，风入于目，上下左右如风吹不定，儿不能任，故目连札
也。若热入于目，牵其筋脉，两 俱紧，不能转视，故目直也。若得心热则搐，以
其子母俱有实热，风火相搏故也。（洁古曰，肝主谋勇，热则寻衣捻物、目连札、直视不能转视，或
极则身反强直折，皆风热也，目者肝之窍，属木，木性急，故如是。）肝病秋见（一作日晡，）
肝强胜肺，肺怯不能胜肝，当补脾肺，治肝。益脾者，母令子实故也。补脾，益黄散；治肝，泻
青丸主之。肝病春见（一作早晨），肺胜肝，当补肾肝，治肺脏，肝怯者受病也。补肝肾、地黄丸，治
肺、泻白散，主之。五脏相胜轻重，肝病见秋，木旺肝胜肺也，宜补肺泻肝，轻者肝病退，重者唇
白而死。〔娄〕五脏相胜，病随时令，乃钱氏扩充《内经》藏气法时论之旨，实发前人所未发者也，
假如肝病见于春及早晨，乃肝自病于本位也，今反见于秋及日晡肺之位，知肺虚极，肝往胜之，故
当补脾肺泻肝也，余仿此。
〔洁〕肝主风，自病则风搐拘急，急食甘以缓之，佐以酸苦，以辛散之。实则风搐力大，泻青
丸主之。虚则风搐力小，地黄丸主之。心乘肝，实邪，壮热而搐，利惊丸、凉惊丸主之。肺乘肝，贼
邪，气盛则前伸呵欠微搐，法当泻肺，先补本脏，补肝，地黄丸主之；泻肺，泻白散主之。脾乘肝，
微邪，多睡体重而搐，先当定搐，泻青丸主之，搐止，再见后证，则别立法治之。肾乘肝，虚邪，增寒
呵欠而搐，羌活膏主之。〔刘〕凡肝得病，必先察其肺肾两脏，根其病之所起，然
后审其肝家本脏之虚实，方可治疗，然肾者肝之母，金者木之贼，今肝之得病，若
非肾水之不能相生，必是肺金之鬼来相攻击，不得不详审而求之，故其来在肺，
先治其肺，攻其鬼也。其来在肾，先补其肾，滋其根也。然后审其肝家本脏之虚实
而寒温之。〔薛〕若肝经实热而外生风者，宜用大青膏散之。若既服而前证仍作，
或益甚者，此邪气已去，而脾气亏损也，宜用异功散加芎、归补之。若肝经虚热，
或因克伐而内生风者，宜用异功散、地黄丸补之。若风邪入脏，能食饮冷、大便
秘结者，此邪气内实也，宜用大黄丸下之。若既下而食少饮汤，或腹作胀者，此脾
气内虚也，宜用白术散补之。气血素弱，或因病后，或服攻伐之剂，而手寻衣领，
切牙呵欠，目淡青者，乃肝经虚甚也，急用地黄丸以补肾肝。哽气，短气，长出气，
乃肺经虚甚也，急用异功散以补脾肺。若申酉时叫哭直视，呵欠顿闷，项急惊悸，
手足摇动，发热饮水者，此风火相搏而胜肺金也，用柴胡栀子散以治肝火，生肝血。
用异功散补脾土，生肺金。若唇白者，为脾绝不治。
〔海〕肝苦急，急食甘以缓之，廿草。肝欲散，急食辛以散之，川芎。以辛
补之，细辛。以酸泻之，芍药。肝虚以生姜、陈皮之类补之。虚则补其母，
肾者肝之母也，以熟地、黄柏、补肾，如无他证，钱氏地黄丸补之。补肝丸，四
物汤内加防风、羌活等分，为细末，炼蜜为丸是也。镇肝丸，即泻青丸去栀子、
大黄是也。治肝虚，钱氏补肾地黄丸 肝实，以白芍药泻之。如无他证，钱氏
泻青丸主之。实则泻其子，心乃肝之子，以甘草泻心。
泻青丸（钱氏） 又名泻肝丸
当归（去芦，焙） 龙胆（焙） 川芎 山栀子（仁） 川大黄（湿纸裹，煨） 羌活
防风（去芦。各等分）
上为末，炼蜜和丸，芡实大。每服半丸至一丸，煎竹叶汤、同沙糖温水化下。
〔薛〕前方，足厥阴经解散肌表，疏通内热之药也，若大便秘结，烦渴饮冷，
饮食如常者，属形病俱实，宜用此以泻之。若大便调和，烦渴饮冷，目淡青色，
属病气实而形气虚，宜用抑肝散平之。若大便不实，作渴饮汤，饮食少思，肢体
倦怠者，属形病俱虚，宜用地黄丸补之。
抑肝散 治肝经虚热发搐，或发热切牙，或惊悸寒热，或木乘土而呕吐痰涎，腹胀
少食，睡卧不安。
软柴胡 甘草（各五分） 川芎（八分） 当归 白术（炒） 茯苓 钓藤钩（各一钱）
上水煎。子、母同服。如蜜丸，名抑青丸。
大青膏（方见惊搐） 大黄丸（方见腹胀） 异功散（方见吐泻） 白术散（方见渴） 柴
胡栀子散（方见诸热） 利惊丸 凉惊丸 羌活膏（三方俱见惊搐） 洗心散
[Qian] The Liver governs Wind. In excess, symptoms include eyes staring straight, loud crying, yawning, neck stiffness, and sudden chest oppression. In deficiency, symptoms include teeth grinding and frequent yawning. Heat in Qi generates external Wind, while warmth in Qi generates internal Wind. Liver disease manifests as crying and shouting, eyes staring straight, yawning, sudden chest oppression, and neck stiffness. If caused by external Wind invasion, with yawning, sudden chest oppression, and hot breath from the mouth, dispersing treatment is indicated, primarily using Daqing Gao (Great Blue Ointment). If the patient can eat but drinks incessantly, mild purgation with Dahuang Wan (Rhubarb Pill) is indicated. Other conditions should not be treated with purgation. For Liver Heat, manifesting as hands grasping at clothes collars and randomly fidgeting, Xieqing Wan (Drain the Green Pill) is primarily used. For high fever, thirst for water, wheezing, and chest oppression, Xiebai San (Drain White Powder) is primarily used. When there is Wind in the Liver, eyelids twitch without convulsions; if Heart Heat is involved, convulsions occur. Treat the Liver with Xieqing Wan, treat the Heart with Daochi San (Guide Out Red Powder). When there is Heat in the Liver, eyes stare straight without convulsions; if Heart Heat is involved, convulsions occur. Treat the Liver with Xieqing Wan, treat the Heart with Daochi San. When Liver Wind is severe, causing body opisthotonos and rigidity without convulsions, it indicates the Heart is not affected by heat; tonify the Kidney and treat the Liver. Tonify the Kidney with Dihuang Wan (Rehmannia Pill); treat the Liver with Xieqing Wan. Any disease, whether new or chronic, can draw out Liver Wind. Wind moves upward to the head and eyes. Since the eyes belong to the Liver, when Wind enters the eyes, moving up, down, left, and right like wind blowing uncontrollably, the child cannot bear it, hence the eyelid twitching. If Heat enters the eyes, pulling on the sinews, making both eyes tight and unable to turn, thus the eyes stare straight. If Heart Heat is involved, convulsions occur because both the mother (Liver/Wood) and son (Heart/Fire) have excess heat, and Wind and Fire struggle together. [Jiegong said: The Liver governs strategy and courage. Heat causes seeking clothes, fidgeting, eyelid twitching, staring eyes unable to turn, or extreme cases of body opisthotonos and rigidity, all due to Wind-Heat. The eyes are the opening of the Liver, belonging to Wood. Wood nature is urgent, hence such symptoms.] Liver disease appearing in Autumn (or one version says late afternoon), Liver strength overcomes Lung, Lung qi is weak and cannot overcome Liver, so tonify Spleen and Lung, treat Liver. Benefiting the Spleen follows the principle that "the mother makes the son full." Tonify Spleen with Yihuang San; treat Liver with Xieqing Wan. Liver disease appearing in Spring (or one version says morning), Lung overcomes Liver, so tonify Kidney and Liver, treat Lung organ. The Liver is weak and diseased. Tonify Kidney and Liver with Dihuang Wan; treat Lung with Xiebai San. Regarding the weight of mutual overcoming among the Five Zang organs: Liver disease seen in Autumn indicates Wood prosperity, Liver overcoming Lung. It is appropriate to tonify Lung and drain Liver. Mild cases see Liver disease recede; severe cases result in white lips and death. [Lou Quanshan] Mutual overcoming among the Five Zang organs, diseases following seasonal timing, is Qian's expansion of the principles in the *Neijing* regarding organ qi laws and time. It truly developed theories not previously expressed. For example, Liver disease appearing in Spring and morning is the Liver being diseased in its own position. Now appearing instead in Autumn and late afternoon (Lung's position), it indicates extreme Lung deficiency, allowing Liver to overcome it. Thus, tonify Spleen and Lung, drain Liver. Others follow this pattern.
[Zhang Yuansu] The Liver governs Wind. Self-disease results in Wind convulsions and stiffness. Urgently use sweet flavors to relax, assist with sour and bitter, and disperse with pungent flavors. Excess Wind convulsions are forceful; use Xieqing Wan. Deficient Wind convulsions are weak; use Dihuang Wan. Heart overcoming Liver is an Excess pathogen, causing high fever and convulsions; use Lijing Wan and Liangjing Wan. Lung overcoming Liver is a Robber pathogen. With excessive Qi, arms extend forward, yawning, slight convulsions. Method dictates draining Lung, first tonifying the original organ. Tonify Liver with Dihuang Wan; drain Lung with Xiebai San. Spleen overcoming Liver is a Minor pathogen, causing sleepiness, heavy body, and convulsions. First stabilize convulsions with Xieqing Wan. After convulsions stop, if subsequent symptoms appear, establish other treatments. Kidney overcoming Liver is a Deficient pathogen, causing increased cold, yawning, and convulsions; use Huoqi Gao. [Liu Wansu] Whenever the Liver becomes diseased, first examine the Lung and Kidney organs, trace the origin of the disease, then assess the excess or deficiency of the Liver organ itself before treating. However, Kidney is the Mother of Liver, Metal (Lung) is the Ghost (Overcomer) of Wood (Liver). If the Liver is diseased, unless Kidney Water fails to generate it, it must be Lung Metal attacking. One must carefully investigate. If the cause is in the Lung, treat the Lung first to attack the Ghost. If the cause is in the Kidney, tonify the Kidney first to nourish the Root. Then assess the Liver's excess or deficiency and apply cold or warm methods. [Xue Ji] If Liver Meridian Excess Heat generates external Wind, use Daqing Gao to disperse. If symptoms persist or worsen after administration, this indicates pathogens are gone but Spleen Qi is damaged; use Yigong San plus Chuanxiong and Danggui to tonify. If Liver Meridian Deficient Heat, or internal Wind generated by harsh purgation, use Yigong San and Dihuang Wan to tonify. If Wind pathogen enters the Zang, with ability to eat, desire for cold drinks, and constipation, this is internal excess pathogen; use Dahuang Wan to purge. If after purging, food intake is low, drinking only soup, or abdominal distension occurs, this is internal Spleen Qi deficiency; use Baizhu San to tonify. If Qi and Blood are inherently weak, or post-illness, or after taking purgative agents, with hands grasping clothes collars, teeth grinding, yawning, and pale blue eyes, this is extreme Liver Meridian deficiency; urgently use Dihuang Wan to tonify Kidney and Liver. Gagging, shortness of breath, long sighing, indicate extreme Lung Meridian deficiency; urgently use Yigong San to tonify Spleen and Lung. If crying, staring, yawning, sudden chest oppression, neck stiffness, palpitations, hand/foot trembling, fever, and thirst occur during Shen and You hours (3-7 PM), this is Wind-Fire struggling and overcoming Lung Metal. Use Chaihu Zhizi San to treat Liver Fire and generate Liver Blood. Use Yigong San to tonify Spleen Earth and generate Lung Metal. If lips are white, it indicates Spleen exhaustion and is untreatable.
[Chen Ziming] The Liver suffers from urgency; urgently eat sweet to relax it, Gancao (Licorice). The Liver desires dispersion; urgently eat pungent to disperse it, Chuanxiong. Pungent tonifies it, Xixin (Asarum). Sour drains it, Shaoyao (Peony). Tonify Liver deficiency with Shengjiang (Ginger) and Chenpi (Tangerine Peel). Deficiency tonifies its Mother; Kidney is the Mother of Liver. Tonify with Shudi (Prepared Rehmannia) and Huangbo (Phellodendron). If no other symptoms, Qian's Dihuang Wan is used. Bu Gan Wan (Tonify Liver Pill) is Siwu Tang plus Fangfeng and Qianghuo in equal parts, ground to powder, honey-pilled. Zhen Gan Wan (Calm Liver Pill) is Xieqing Wan minus Zhizi and Dahuang. To treat Liver deficiency, Qian's Bushen Dihuang Wan. Liver excess, drain with Baishaoyao (White Peony). If no other symptoms, Qian's Xieqing Wan is primary. Excess drains its Son; Heart is the Son of Liver, drain Heart with Gancao.
Xieqing Wan (Qian's) Also known as Xiegan Wan
Danggui (remove radicle, roast) Longdan (roast) Chuanxiong Shanzhizi (kernel) Chuan Dahuang (wrapped in wet paper, roasted) Qianghuo Fangfeng (remove radicle. Equal parts each)
Grind to powder, mix with refined honey into pills the size of Euryale seed. Each dose half to one pill, decoct Zhu Ye (Bamboo Leaf) soup, dissolve with brown sugar and warm water.
[Xue Ji] The above formula is for the Foot Jueyin Meridian to disperse muscle surface and unblock internal heat. If constipation, vexation/thirst for cold drinks, normal diet, it belongs to form and disease both excess; use this to drain. If stool is harmonious, vexation/thirst for cold drinks, pale blue eyes, it belongs to disease Qi excess but Form Qi deficiency; use Yigan San to calm. If loose stools, thirst for hot drinks, poor appetite, limb fatigue, it belongs to form and disease both deficiency; use Dihuang Wan to tonify.
Yigan San Treats Liver Meridian Deficient Heat causing convulsions, or fever with teeth grinding, or palpitations with alternating chills/fever, or Wood overcoming Earth causing vomiting of phlegm-saliva, abdominal distension, poor food intake, restless sleep.
Ruan Chaihu Gancao (each 5 fen) Chuanxiong (8 fen) Danggui Baizhu (stir-fried) Fuling Diaotenggou (each 1 qian)
Decoct in water. Child and mother take together. If honey pills, named Yiqing Wan.
Daqing Gao (Formula seen in Convulsions) Dahuang Wan (Formula seen in Abdominal Distension) Yigong San (Formula seen in Vomiting/Diarrhea) Baizhu San (Formula seen in Thirst) Chaihu Zhizi San (Formula seen in Various Fevers) Lijing Wan Liangjing Wan Huoqi Gao (Three formulas all seen in Convulsions) Xixin San