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[Song] Among the Five Elements, each has one Fire, but there are two Fires: Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo), corresponding to the Heart (Xin) and Kidney (Shen). If caused by emotions such as joy, anger, worry, fear, and grief, disturbing the mind and causing reckless movement, this is named "Five Emotions Fire" (Wu Zhi Zhi Huo). How can the single Water of the Kidney Meridian (Shen Jing) overcome the surging of seven Fires? Thus, Yang becomes excessive while Yin is often deficient; therefore, Zhu Danxi advocated nourishing Yin to balance Yang. The methods for treating Fire are not limited to one approach; one must tonify deficiency, drain excess, and disperse stagnation. There are also distinctions between Yang Fire and Yin Fire, hence establishing direct treatment (Zheng Zhi) and indirect treatment (Cong Zhi). He Jian extensively elaborated on the mechanism of Fire, revealing the ancient secrets of Qibo.

[Discussion] Each of the Five Elements has its own nature, but Fire has two types: Sovereign Fire and Ministerial Fire, which arise from natural formation. Additionally, when the Five Emotions reach their extreme, they disturb the mind and cause reckless movement, giving rise to Fire in the Five Zang Organs, known as "Fire of the Five Emotions," which arises from human factors. As Zhu Danxi stated, "One Water cannot overcome Seven Fires," thus diseases caused by Fire are numerous. In the Nineteen Pathogenesis Patterns of the *Nei Jing*, five belong to Fire. He Jian further expanded on this theory, providing a detailed account of diseases caused by Fire. For example: panting, coughing, vomiting, acute diarrhea with tenesmus, muscle spasms, turbid urine, abdominal distension sounding like a drum upon percussion, carbuncles, ulcers, sores, rashes, goiters, lymph node swellings, vomiting and diarrhea resembling cholera, mental confusion and depression, swelling, nasal congestion, rhinorrhea, epistaxis, hemorrhage, dysuria and retention, fever, aversion to cold with shivering, fright, confusion, sadness, laughter, delirium, and diseases involving blood leakage or filth all belong to diseases of the Hand Shaoyin Sovereign Fire. For example: mental confusion, convulsions, sudden aphonia, dizziness, restlessness, mania, cursing, fright, swelling, soreness, pain, rebellious Qi rushing upward, trembling and fear as if losing spiritual control, sneezing, vomiting, sores, throat obstruction, tinnitus, deafness, violent vomiting, inability to eat, blurred vision, acute diarrhea, sudden illness, and sudden death all belong to diseases of the Hand Shaoyang Ministerial Fire. However, since Fire diseases are not of a single origin, treatment methods cannot be confined to one principle. One must examine the signs of deficiency and excess, investigate the cause of the disease, and adapt to the nature of Yin and Yang to treat it carefully; then Fire will easily subside. Otherwise, provoking and weakening its nature may lead to blazing fire that cannot be controlled.

[Pulse] Deficient Fire presents with a floating and rapid pulse; Excess Fire presents with a deep and large pulse. According to the symptoms seen, a fine and rapid pulse indicates greater harm.

**Sovereign Fire (Jun Huo)**
Sovereign Fire is Heart Fire. It can be subdued by dampness, extinguished by water, or directly reduced. Formulas include Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity), Sanhuang Wan (Three Yellows Pill), and Zhizi Jinhua Wan (Gardenia Golden Flower Pill). In cases of excess, direct treatment with Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), or ice water is appropriate. If Sovereign Fire is extremely intense and using cold herbs to directly reduce it causes the Fire to worsen, one must use herbs processed with ginger juice or wine; then the Fire will naturally subside. This is the method of "treating cold with heat." Furthermore, the Heart is the Monarch; if it burns itself, death ensues, hence there are many cases of sudden death.

**Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity)**
Indicated for Excess Fire of the Triple Burner (San Jiao), heat inside and out, irritability, thirst, red urine, mouth and tongue sores, constipation, and rapid pulse.
Huanglian (Coptidis Rhizoma, stir-fried), Huangqin (Scutellariae Radix, stir-fried), Huangbai (Phellodendri Cortex, stir-fried), Zhizi (Gardeniae Fructus, stir-fried), equal parts.
Decoct in water and take hot. If made into pills with water, it is named Zhizi Jinhua Wan; swallow with tea broth.

**Sanhuang Wan (Three Yellows Pill)**
Also known as Sanbu Wan (Three Tonics Pill), this formula is the above prescription minus Zhizi.
Note: The classics state: "Strong Fire consumes Qi, Mild Fire generates Qi." Mild Fire promotes growth in all things; Strong Fire consumes all things. Therefore, Mild Fire should be ascending, and Strong Fire should be descending. Thus, Huangqin clears the Upper Jiao, Huanglian clears the Middle Jiao, and Huangbai clears the Lower Jiao, so the Strong Fire of the Triple Burner naturally subsides, Qi is generated, and Blood is nourished; hence it is called "Three Tonics." Although so, Fire has deficiency and excess; this formula treats only Excess Fire. If used for Deficiency Fire, the Fire will反而 increase due to excessive draining leading to loss of Yin.

**Ministerial Fire (Xiang Huo)**
Ministerial Fire is Dragon Fire. It cannot be directly reduced; only Huangbai can treat it by subduing it according to its nature. If treated directly with ice water or cold herbs, death will occur immediately. Suitable formulas include Dabu Yin Wan (Great Tonification of Yin Pill) and Kanli Wan (Kan-Li Pill). If Qi rushes upward from below, carrying internal Ministerial Fire because Kidney Water is deficient and cannot control it, use Shudi (Rehmanniae Radix Preparata), Mudanpi (Moutan Cortex), Xuanshen (Scrophulariae Radix), and Zhimu (Anemarrhenae Rhizoma) to strengthen Water.

**Dabu Yin Wan (Great Tonification of Yin Pill)** (See Deficiency Damage section.)

**Kanli Wan (Kan-Li Pill)**
Also known as Zishen Wan (Kidney Nourishing Pill), treating Kidney Fire arising below the Yongquan point (KI1).
Huangbai (Phellodendri Cortex, 10 liang, soaked in wine), Zhimu (Anemarrhenae Rhizoma, 6 liang, soaked in wine), Rougui (Cinnamomi Cortex, 5 qian).
Make into water pills; take on an empty stomach with light salt water.
Note: Zhimu and Huangbai are bitter and cold, belonging to Water, thus they can nourish Kidney Water. Rougui is acrid and hot, belonging to Fire, thus it serves as an adjuvant (fan zuo). This embodies the interaction of Kan and Li, achieving Ji Ji (successful transition).

**Stagnant Fire (Yu Huo)**
Stagnant Fire can be dispersed; one must determine which meridian is involved. Fever in the four limbs, heat in muscle bi, heat in the bone marrow feeling like burning, hot to the touch, is caused by Blood deficiency. Or, if the Stomach is deficient and one eats too much cold food, suppressing Yang Qi in the Spleen Earth, use Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction). Heat in the palms belongs to Heat Stagnation; use Huoyu Tang (Fire Stagnation Decoction), or make pills with Zhizi, Xiangfu, Baizhi, Banxia, and Chuanxiong using Qu paste. If caused by rich wine and strong flavors, accumulating heat from rich foods, use Qingwei San (Clear the Stomach Powder).

**Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction)**
Treating overconsumption of cold food, suppressing Shaoyang Fire, stagnating in the Spleen region.
Shengma (Cimicifugae Rhizoma), Gange (Puerariae Radix), Duhuo (Angelicae Pubescentis Radix), Qianghuo (Notopterygii Rhizoma et Radix) (each 5 qian), Fangfeng (Saposhnikoviae Radix, 2.5 qian), Chaihu (Bupleuri Radix, 3 qian), Renshen (Ginseng Radix), Shaoyao (Paeoniae Radix Alba, 5 qian), Gancao (Glycyrrhizae Radix, half raw half roasted, 6 fen).
Take 5 qian per dose, decoct in water, take hot.
Note: Shengma, Chaihu, Qianghuo, Duhuo, Gange, and Fangfeng are all acrid-warm substances that ascend; they are used to ascend Shaoyang Qi. Once Clear Yang exits the upper orifices, Turbid Yin naturally returns to the lower orifices, and food transmission proceeds without suppression. Shaoyao is sour and can drain Liver Wood within Spleen Earth. Renshen is sweet and can tonify Qi in the Central Region. Raw Gancao can drain Stagnant Fire in the Spleen; roasting it strengthens the Stomach and harmonizes the Middle.

**Huoyu Tang (Fire Stagnation Decoction)**
This is Shengyang Sanhuo Tang minus Duhuo, plus Congbai (Allii Fistulosi Bulbus).

**Qingwei San (Clear the Stomach Powder)**
Treating lip and tooth pain, or gum ulceration, or pain extending to the head, face, and neck caused by rich wine and strong flavors.
Shengma (Cimicifugae Rhizoma, 2 qian), Shengdi (Rehmanniae Radix), Mudanpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix) (each 1 qian), Huanglian (Coptidis Rhizoma, stir-fried, 1.5 qian).
Decoct in water and take. Adding Xijiao (Rhinocerotis Cornu), Lianqiao (Forsythiae Fructus), and Gancao (Glycyrrhizae Radix) creates Jia Wei Qingwei San (Modified Clear the Stomach Powder).

**Fire of the Five Emotions (Wu Zhi Zhi Huo)**
Qi stagnation belongs to the rising of Lung Fire. Also, sorrow moving internally causes Fire to arise in the Lung. The classics say: "The Lung dislikes rebellious Qi; urgently eat bitter to drain it." Huangqin, Tinglizi, and Kujiu are examples; treat with Xiebai San (Drain White Powder) and Qingjin Wan (Clear Metal Pill).
Wind symptoms with shaking and vertigo belong to the rising of Liver Fire. Also, great anger causes Fire to arise in the Liver. Drain with Chaihu, Huanglian, and Longdancao; or use Huiling Wan.
Dampness symptoms with swelling and fullness belong to the movement of Spleen Fire. Fire arising after drunkenness or overeating should be drained with Shaoyao, Huangqin, and Shigao.
Pain, itching, sores, and ulcers belong to the movement of Heart Fire. Also, fright and overthinking cause Fire to arise in the Heart. Drain with Xiexin Tang (Drain Heart Decoction) and Daochi San (Guide Out Redness Powder).
Rebellious Qi rushing upward belongs to the rising of Kidney Fire. Also, sexual exhaustion causes Fire to arise in the Kidney. Only Huangbai and Zhimu should be used to subdue it according to its nature.

**Xiebai San (Drain White Powder)**
Treating Lung Fire causing panting, fullness, and急促 breathing.
Sangbaipi (Mori Cortex, 1 liang), Digupi (Lygodii Radix, 1 liang), Gancao (Glycyrrhizae Radix, 5 qian).
Grind into coarse powder; take 2 qian per dose, add one cup of water, decoct to 0.6 cups, take warm before meals.

**Qingjin Wan (Clear Metal Pill)**
Treating Lung Fire.
Huangqin (Scutellariae Radix) as needed, stir-fried, ground into powder, made into water pills the size of mung beans; take 1 qian per dose.

**Xieqing Wan (Drain Green Pill)**
Treating Wind-Heat Excess Fire of the Liver Meridian.
Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Zhizi (Gardeniae Fructus, wine-fried), Longdancao (Gentianae Radix, wine-mixed, steamed, dried), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Dahuang (Rhei Radix et Rhizoma, wine-mixed, steamed, dried).
Equal parts, grind into powder, make honey pills the size of bullet seeds; take with Bamboo Leaf Decoction mixed with rock sugar.

**Huiling Wan (Huiling Pill)**
Also known as Zuojin Wan (Left Metal Pill), treating Liver Fire.
Huanglian (Coptidis Rhizoma, 6 liang), Wuzhuyu (Evodiae Fructus, 1 liang, boiled briefly in water).
Grind into powder, make pills with congee; take with Baizhu and Chenpi decoction, 1 qian per dose.

**Xiexin Tang (Drain Heart Decoction)**
Treating Heart Heat.
Huanglian (Coptidis Rhizoma) ground into powder, taken with water.

**Sanhuang Xiexin Tang (Three Yellows Drain Heart Decoction)**
This is the above formula plus Dahuang and Huangqin in equal parts, decocted and taken.

**Daochi San (Guide Out Redness Powder)**
Treating Excess Heat of the Small Intestine.
Shengdi (Rehmanniae Radix), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix) in equal parts.
Decoct with Zhuye (Bambusae Folium), take warm.

**Deficient Fire (Xu Huo)**
Deficient Fire can be tonified. If diet and fatigue injure Yuan Qi internally, Fire and Yuan Qi cannot coexist; this is a Yang Deficiency disease. Use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), a sweet-warm agent, to eliminate it, as the classics state: "Warmth can remove great heat." If Yin is weak and Yang is strong, with intense Ministerial Fire invading Yin positions and slowly consuming, this is a Blood Deficiency disease. Use sweet-cold agents to descend it; use Siwu Tang (Four Substances Decoction) plus Huangbai and Zhimu. Add a little ginger juice to process the herbs; this is the method of indirect treatment. If sexual exhaustion injures internally, True Yin is lost, Rootless Fire floats upward, Qi rises from the feet; this is a Yin Deficiency disease. If it arises from the sole of the foot, it is extreme deficiency and difficult to treat. Must greatly tonify Qi and Blood, combined with warming and dispersing agents; use Danxi's Dabu Yin Wan and Dabu Wan (Great Tonification Pill). Apply Fuzi (Aconiti Lateralis Radix Preparata) powder to the Yongquan point (KI1) to guide Fire downward.

**Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction)** (See Internal Injury section.)

**Siwu Tang (Four Substances Decoction)** (See Blood Deficiency section.)

**Dabu Wan (Great Tonification Pill)**
Treating Yin Fire.
Huangbai (Phellodendri Cortex) stir-fried until brown, ground into powder, made into pills with congee (or water pills).

**Excess Fire (Shi Huo)**
Excess Fire can be purged. If organs accumulate heat, this is a Yang Excess disease. For mouth and tongue sores, phlegm obstruction, irritability, thirst, constipation, and difficult urination, use Liangge San (Cool the Diaphragm Powder). For robust individuals with strong Qi, intense Fire, mania, and severe constipation, use Heinu Wan (Black Slave Pill). For intense Yangming Fire with irritability, thirst, and dryness, use Baihu Tang (White Tiger Decoction). For intense Fire, add a small amount of warming agents to cold herbs, or process with wine, so the pathogen is easily subdued.

**Liangge San (Cool the Diaphragm Powder)**
Treating Fire stagnating in the Upper Jiao with high fever and red face.
Dahuang (Rhei Radix et Rhizoma), Puxiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix) (each 2 liang), Lianqiao (Forsythiae Fructus, 4 liang), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Bohe (Menthae Haplocalycis Herba) (each 1 liang).
Grind into powder; take 2 qian per dose, add 7 bamboo leaves and a little honey, decoct and take.
Note: The classics state: "Heat rampant inside is treated with salty-cold, assisted by bitter-sweet." Thus, Mangxiao (Natrii Sulfas) is the Sovereign herb, Dahuang is the Minister herb, and Huangqin, Zhizi, Lianqiao, Bohe, and Gancao are the Assistant herbs. It is made into a powder rather than a decoction to target the diaphragm and achieve success in the Upper Jiao.

**Heinu Wan (Black Slave Pill)**
Treating Yang Toxin with macules, irritability, and extreme thirst. Epidemic febrile diseases where no sweat has occurred after six or seven days, with a洪大 or rapid pulse, red face, swollen eyes, body pain, high fever, irritability, delirious speech, desire to run, and extreme thirst. Also for unresolved heat in the chest after five or six days, locked jaw unable to speak, considered damaged typhoid, untreatable by doctors, abandoned as dead, with exhausted spirit and soul, but warmth remaining at the heart; open the mouth and pour medicine down to revive.
Huangqin (Scutellariae Radix), Fudimei (Carbon from pot bottom), Mangxiao (Natrii Sulfas), Mahuang (Ephedrae Herba), Zaotumo (Carbon from chimney), Liangshangchen (Dust from beam), Xiaomai Nu (Wheat Sprouts) (each 1 liang), Dahuang (Rhei Radix et Rhizoma, 1.2 liang).
Grind into fine powder, make pills with refined honey the size of bullet seeds; dissolve in fresh well water and take. After drinking all the water, the feet should feel cold; after the cold passes, sweating occurs and recovery follows. If still not sweating, take another pill; slight diarrhea should occur. Do not use if there is no extreme thirst.

**Baihu Tang (White Tiger Decoction)**
Shigao (Gypsum Fibrosum, 4 qian, crushed and ground), Zhimu (Anemarrhenae Rhizoma, 1.5 qian), Gancao (Glycyrrhizae Radix, roasted, 1 qian), Jingsmi (Oryza Sativa, a pinch).
Decoct in water, take warm, at any time.