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Scrophulariae Radix (Xuanshen, 玄参), with a bitter and salty taste, and a slightly cold nature, is non-toxic. It should not be decocted in copper vessels, as doing so may damage the throat causing dysphagia and impair vision. It enters the Lung, Kidney, and Stomach meridians. It strengthens Yin, benefits essence, tonifies the Kidney, and improves vision. It treats body heat and chest/hypochondriac fullness caused by Shanghan (Cold Damage) syndrome, accompanied by a trance-like state resembling unconsciousness; it treats alternating chills and fever with frequent shivering caused by Wen Nue (Warm Malaria); it eliminates residual diseases after childbirth in women; it dispels bone-steaming consumption and infectious tuberculosis in men; it drives out intestinal wind and blood stasis manifesting as hard masses; and it dissipates phlegm nodules and carbuncles/swellings below the head. It is an agent that regulates the pivot mechanism, directing Qi up and down, clearing turbidity without causing cloudiness, treating the misty Qi in the void, and dispersing rootless floating fire; no other herb is more suitable for this. This was the view of predecessors. Recently, some have despised it and do not use it, or if used, dare not use large doses. How could they know that Scrophulariae Radix is a sovereign drug, truly capable of saving lives? The most difficult conditions to treat under heaven are Fire syndromes. Among Fire syndromes, the most difficult to subdue are the Fire of the Stomach and the Fire of the Kidney. When Kidney Fire boils, it is Dragon-Lei Fire (Fire of the Dragon and Thunder), which is particularly fierce. Using bitter-cold herbs to suppress it may actually increase the flame, burning forests and splitting wood. This often occurs during cold rainy times or in the intense heat of summer; once cool winds and white dew appear, the Dragon-Lei Fire hides and stores itself. Therefore, directly treating with bitter-cold herbs is inferior to treating with slightly cold herbs following the disease's trend. Scrophulariae Radix is precisely such a slightly cold herb, and it excels at dispersing floating fire, making it perfectly suited for treatment. As for the rise of Stomach Fire, its momentum is like a prairie fire, unceasing until consumed, often with rising hot air, sparks from the mouth/nose, singing while climbing high, running naked, and jumping into water. If one does not immediately rescue with pungent-cool and greatly cold herbs, madness and collapse of Yang will occur, leading to immediate death; this requires the urgent use of Baihu Tang (White Tiger Decoction). However, Shigao (Gypsum Fibrosum) is overly cold, and excessive use damages the Stomach Qi. Although it can save emergencies temporarily, it cannot be used for follow-up care. Scrophulariae Radix treats misty Qi in the void, and its strength lies in purging fire. Following Gypsum Fibrosum, continuing with Scrophulariae Radix allows Yang Fire to naturally subside while Yin Fire grows, avoiding the fear of Yang collapse. This is essential for treating Stomach Fire. But a spoonful of water cannot extinguish a great fire; it may even intensify it. If Stomach Fire is Yang Fire, Scrophulariae Radix must be used in large doses to curb its momentum; and since Kidney Fire is Yin Fire, it also requires large doses of Scrophulariae Radix to extinguish its intensity. Moreover, as Scrophulariae Radix is originally a sovereign drug, large doses facilitate success, while small doses may cause failure. One might as well use from 1 liang to 5-6 liang to achieve victory through surprise. If one is timid and dares not use large doses, allowing patients to die without rescue, hoping to avoid blame, this is extremely difficult. I hope practitioners, hearing my words, will heavily rely on Scrophulariae Radix to treat the Fire of the Stomach and Kidney, is this not feasible?

Someone asked: Scrophulariae Radix retreats the Fire of the Stomach and Kidney, neither damaging the Stomach nor failing to nourish Yin, but it must be used in large doses, from 1 liang to 5-6 liang. Is this too much? Could the Spleen and Stomach find it hard to bear? What if symptoms of fullness, oppression, and loss of appetite arise? Alas! This is unnecessary worry. The rising of Stomach and Kidney Fire is due to the lack of Water below. Extreme Fire prosperity indicates extreme Water deficiency; if Water is not deficient, Fire is not prosperous. The way of Heaven and Earth is the Way of Yin and Yang; Yin and Yang root each other. In the human body, Water and Fire summon each other. With Water to control Fire, Fire remains peaceful, and Lower Jiao (Lower Burner) absolutely does not boil over into Upper Jiao (Upper Burner). Thus, Fire ceases when it lacks Water, and becomes peaceful upon obtaining Water, retracting swiftly and miraculously. However, when Fire rises into the sky, it desperately seeks Water, fearing that slight amounts of Water are insufficient to resolve its arid and fierce heat atmosphere. There is no logic where abundant rain causes disgust or harm. Therefore, entering the Stomach revives it, entering the Spleen pleases it. Furthermore, when Stomach and Kidney Fire flare upwards, Water in all meridians is scorched. Even with torrential rain, one might still fear insufficient distribution. How could there be stagnation in tonification, difficulty for the Stomach to bear, leading to fullness and anorexia? This is impossible. Use it boldly. Yet I still consider the dose small. It is better to assist with Maidong (Ophiopogonis Radix), add Shengdi Huang (Rehmanniae Radix), and Ganju (Chrysanthemi Flos), so that they help each other, bringing the joy of sufficient dew.

Some suspect that Scrophulariae Radix retreats floating fire and empty fire in the Upper Jiao, but not empty fire in the Lower Jiao. You praise its efficacy highly; is this not a misidentification of Kidney Fire ascending? It is not a mistake. Floating fire is indeed Lower Jiao Fire, not Upper Jiao Fire. Fire in the Upper Jiao is easy to eliminate when prosperous; Fire in the Lower Jiao is hard to extinguish when blazing. Scrophulariae Radix resolves Lower Jiao Fire, hence it requires large doses to succeed. Upper Jiao Fire consists of Lung Fire and Heart Fire. For Lung Fire, Huangqin (Scutellariae Radix) is used; for Heart Fire, Huanglian (Coptidis Rhizoma) is used. This is an unchangeable method. Even if Lung Fire is strong, 2 qian of Huangqin clears it; even if Heart Fire is fierce, 3 qian of Huanglian eliminates it. This is because Upper Jiao Fire tends to flare upwards and is easily resolved. If Lower Jiao Fire originates from Liver Wood or Kidney Water, both Liver and Kidney Fires are Dragon-Lei Fires. They suddenly ascend and suddenly descend, their floating and不定 (uncertain) nature being hard to grasp. Without large doses of Scrophulariae Radix, the insufficiency of Water to support Fire leads to indescribable destructive power. People see that Scrophulariae Radix fails to lower fire, unaware that it is because the dose is too small to benefit Water. In summary, Excess Fire can be purged, while Deficient Fire can be tonified. To purge Excess Fire, small doses of cold herbs suffice; to purge Deficient Fire, large doses of moistening herbs are necessary. Thus, Scrophulariae Radix to retreat Liver and Kidney Deficient Fire must be used in large doses to stabilize floating fire. Small doses are strictly forbidden as they increase ferocity.

Some suspect that after Scrophulariae Radix retreats floating fire, what medicine should be used to prevent recurrence? Should Scrophulariae Radix continue to be used for follow-up? Scrophulariae Radix can retreat temporary fire, but not long-standing fire. Fire nature flares upward; without Water, it cannot meet temporary urgency. Fire nature also loves to hide; without Water, it cannot save from myriad fires' blaze. Use Scrophulariae Radix to lower fire, then immediately use Rougui (Cinnamomi Cortex) to calm fire. Use large doses of Scrophulariae Radix and small doses of Rougui, or assist with pure True Yin tonics. Naturally, Fire is controlled by Water, and Fire hides in Water, preventing further floating.

Some suspect that using Scrophulariae Radix with Rougui may be unsuitable due to cold and heat conflicts. This shows ignorance of the subtleties of Yin and Yang. Yin and Yang root each other; without Yin, how can Yang arise? Without Yang, how can Yin grow? Scrophulariae Radix with Rougui facilitates Yin generation; Rougui with Scrophulariae Radix facilitates Yang growth. Only after Yang grows does Yin diminish; Yin diminishing below prevents Fire from flaming above. The combination of these two herbs embodies the wonderful application of Yin and Yang.

Some suspect that after Yin and Yang are balanced, there is no disease. Now using Scrophulariae Radix and Rougui, one in large dose and one in small, I fear imbalance due to differing weights. Yin-Yang imbalance has existed for a long time. Observing Heaven and Earth, Yin always exceeds Yang. Among many Yins, one Yang brings peace; if Yang exceeded Yin, the world would be cruel and fierce. In the human body, Zang-Fu organs are full of Fire Qi. Without ample Water Qi, the body would become scorched. Therefore, Yin-tonifying herbs should not be few, while Yang-tonifying herbs should not be many. When Yin prospers, Fire can control Fire; if Yang prospers, Fire burns Water. Scrophulariae Radix for tonification should be used in large doses. Rougui for benefiting Yang should be used in small doses. These two, one large and one small, seem imbalanced, yet Yin exceeding Yang achieves balance for both Yin and Yang.

Some suspect that Scrophulariae Radix lowers fire, similar to Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex). You warn against lightly using Zhimu and Huangbai, yet advise heavy use of Scrophulariae Radix for floating fire. Is this contradictory? It is not. Scrophulariae Radix is slightly cold, not greatly cold. In greatly cold places, plants do not grow; in slightly cold places, plants flourish. Hence, discard Zhimu and Huangbai, and use Scrophulariae Radix and Digupi (Lycii Cortex). Moreover, Scrophulariae Radix and Digupi possess tonifying qualities within their slight coldness, far different from Huangbai and Zhimu. How can they be equated?

Some suspect that since cold herbs damage Spleen and Stomach, do not slightly cold herbs also cause damage? Treating disease involves removing severe pathogens, but not necessarily eliminating all cold herbs entirely. My concern is that Zhimu and Huangbai are overly cold; I do not say cold herbs are unusable. If Zhimu and Huangbai are effective and usable, why discard Scrophulariae Radix and Digupi, which are only slightly cold? Furthermore, Scrophulariae Radix and Digupi have special merits in treating internal heat from Deficient Fire ascending. Why should I not hasten to praise them and urge their use?

Someone asks: Scrophulariae Radix is slightly cold; why can it purge floating fire? Fire is divided into Excess and Deficient. Excess Fire suits greatly cold herbs to reduce its blazing momentum; Deficient Fire suits slightly cold flavors to guide it towards retraction. Scrophulariae Radix purges while tonifying, making it suitable for Deficient Fire. Floating fire is indeed Deficient Fire, hence it is urgently needed.

Someone asks: Why is Xuanshen suitable for the Kidney? Answer: When Kidney Water is deficient, it becomes cold and damp, requiring warm herbs to tonify. When Kidney Fire is deficient, it becomes hot and dry, requiring cool herbs to tonify. Thus, Xuanshen alone serves as the sovereign herb for the Kidney organ.