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Yellow Emperor asked: Why does a person, after being injured by cold pathogenic factors, transmit into a heat syndrome? Qi Bo answered: This is due to the principle of cold qi condensing externally and stagnating internally. If the cou li (skin texture and interstices) are firm and dense, and the xuan fu (sweat pores) are closed and tight, then the qi cannot be disseminated and unblocked. Dampness knots internally, and the interior and exterior clash with each other. When cold is excessive, heat is generated. From this, we know that the origin of heat is entirely due to external pathogens entering inward. This is essentially the body's own primordial yang being obstructed by pathogens, step by step unable to vent, thus transforming into heat. However, if one does not take advantage of the momentum to eliminate it, the heat will have a tendency to advance further and contend with the righteous qi. Therefore, the ancients used Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction), or Da Chengqi Tang (Major Order the Qi Decoction) and Xiao Chengqi Tang (Minor Order the Qi Decoction), nothing more than to allow the heat to be purged.

I examine the use of purging methods for heat diseases; consulting medical formularies, there are many drugs involved. But the main principles are: For heat in the Lung, only Huangqin (Scutellariae Radix) and Zhimu (Anemarrhenae Rhizoma) should be used; for heat in the Stomach, only Shigao (Gypsum Fibrosum), Dahuang (Rhei Radix et Rhizoma), and Puxiao (Natrii Sulfas) should be used; for heat in the Heart, only Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), and Mutong (Akebiae Caulis) should be used; for heat in the Liver, only Qingdai (Indigo Naturalis) and Longdancao (Gentianae Radix) should be used; for heat in the Kidney, only Tongbian (Child’s Urine) and Qingyan (Green Salt) should be used; for heat in the Spleen, only Shihu (Dendrobii Caulis) and Baishao (Paeoniae Radix Alba) should be used. These are the primary formulas for clearing heat from the various zang organs.

As for the Lung, there are other agents to purge heat. Because when heat pathogen is initially formed and not yet vigorous, one may use Baihe (Lilii Bulbus), Bubu (Stemonae Radix), and Madouling (Aristolochiae Fructus). If toxic vapors are concurrent, one may use Jinyinhua (Lonicerae Japonicae Flos) and Niubangzi (Arctii Fructus). For chronic cough leading to fei wei (lung atrophy/withering), one may use Shashen (Glehniae Radix). If jiaoxie (foot disease/gout) is concurrent, one may use Yiyiren (Coicis Semen). For yan chuang (throat sores) and zhi lou (hemorrhoids and fistulas), one may use Shigan (Dried Persimmon) and Shishuang (Persimmon Frost). If heat carries qi attacking upward, one may use Qianniu (Pharbitidis Semen). If sanjiao (Triple Burner) heat merges, one may use Zhizi (Gardeniae Fructus). If there is vexation, thirst, and vomiting, one may use Zhuru (Bambusae Caulis in Taenia). If heat is accompanied by phlegm, one may use Beimu (Fritillariae Bulbus). If heat causes qi rebellion and discomfort, one may use Qingmuxiang (Aquilariae Lignum). If heat causes urinary retention, one may use Cheqianzi (Plantaginis Semen) and Shiwei (Pyrosiae Folium). For chronic cough with collapse, one may use Wubeizi (Gallae Chinensis) and Baiyaojian (Fermented Tea Brick). For milk water blockage, one may use Tongcao (Tetrapanacis Medulla). If additionally there is blood heat, then Shengdi (Rehmanniae Radix) and Ziwan (Adenophorae Radix) should be used. This is the general overview of purging Lung heat.

For the Stomach, there are also other agents to purge heat. Because if heat is combined with blood dryness, Xijiao (Rhinocerotis Cornu) is suitable. If toxicity is excessive and heat is blazing, Lüdou (Phaseoli Semen) is suitable. If middle deficiency causes vexation, Jingmi (Oryzae Semen) is suitable. If summerheat causes thirst, Xigua (Citrullus Lanatus) is suitable. If epidemic irregular qi prevails, Guanzhong (Cyathulae Radix) is suitable. If epidemic heat toxicity is excessive, Renzhonghuang (Hominis Excrementum Carbonisatum), Jinzhi (Human Gold Juice), and Xueshui (Snow Water) are suitable. For throat sores and hemorrhoidal fistulas, Shidi (Persimmoni Calyx) and Shigan are suitable. For constipation with hard stools, Xuanmingfen (Mirabilitum Depuratum) is suitable. For ru yong (mastitis) with constipation, Loulu (Euphorbiae Humifusae Radix) is suitable. For gu ji (parasitic accumulation) not resolving, Leiwan (Holoscoziae Sporangium) is suitable. For excessive heat causing hiccups, Zhuru and Lugeng (Phragmitis Rhizoma) are suitable. For intestinal toxins not cleared, Baitouweng (Pulsatillae Radix) and Ci Pi (Zanthoxyli Cortex) are suitable. For unceasing thirst, Zhuye (Bambusae Folium) is suitable. If additionally there is blood heat, then Diyü (Sanguisorbae Radix), Huaijiao (Gleditsiae Sinensis Fructus), Huaihua (Sophorae Flos), Sumu (Pterocarpi Santalinus), Sanqi (Notoginseng Radix), Ganqi (Drynariae Rhizoma) are suitable. This is the general overview of purging Stomach heat. As for large intestine heat knot, it still does not go beyond Xiaoshi (Natrii Sulfas), Dahuang, Baitouweng, Huangqin, Lüdou, Woniu (Helix), and Shengdi.

For the Heart, there are also other agents to purge heat. Such as using Qumai (Dianthi Herba) and Mutong for urinary retention; using Zhesi (Hematitum) for qi rebellion; using Beimu and Tianzhuhuang (Calami Tuber) for phlegm closure; using Xigua for summerheat thirst; using Lianxu (Nelumbinis Plumula) for essence leakage; using Gouteng (Uncariae Ramulus cum Uncis) for twitching; using Baihe for cough; using Chuanlianzu (Toosendan Fructus) for hernia and masses. And for blood heat, additionally using Xijiao, Shegan (Belamcandae Radix), Tongbian, Xuyutan (Calces Capillis Humanis), Honghua (Carthami Flos), Chencha (Cinnabar), Zicao (Arnebiae Radix et Rhizoma), Shengdi, Yujin (Curcumae Radix), Tao Ren (Persicae Semen), Qiancao (Rubiae Radix), Sumu, Danshen (Salviae Miltiorrhizae Radix), Moyao (Myrrha), Ou Lian (Lotus Rhizome), Yimucao (Leonuri Herba), Xiongdan (Ursi Fel) and other drugs. One can also investigate based on flavors to seek understanding. This is the general overview of purging Heart heat.

For the Liver, there are also other agents to purge heat. Such as for liver channel qi rebellion, using Zhesi to calm it; for kidney qi insecurity, using Shinanye (Acanthopanacis Trifolii Caulis) to consolidate it; for urinary obstruction, using Cheqianzi to guide it; for phlegm closure with unconsciousness, using Niuhuang (Bovis Calculus) to open it; for eye nebula and unclear vision, using Qinpi (Fraxini Cortex), Kongqing (Azurite), Menghua (Chrysanthemi Indici Flos), Shiyan (Fossilia Osseum), Qingxiangzi (Vernoniae Semen), and Shijueming (Haemitecti Shell) to treat it; for cough with phlegm and rebellion, using Quan Huhu (Full Huhu/Isatis Root) to descend it; for parasitic accumulation not resolving, using Lusuo (Aloe) to kill it; for damp stagnation and fright, using Hupo (Succinum) to calm it; for mental confusion, using Zaoren (Ziziphi Spinosomi Semen) to clear it. If heat is in the blood, the drugs are numerous. Generally, those entering the liver to cool blood include Chishao (Paeoniae Radix Rubra), Zhesi, Pugongying (Taraxaci Herba), Qingyudan (Green Fish Gallbladder), Honghua, Diyü, Huaihua, Huaijiao, Cebeiye (Platycladi Cacumen), Juanbai (Selaginellae Herba), Wumingyi (Chalcanthitum), Lingxiaohua (Campsis Grandiflorae Flos), Zhuweixue (Porcine Tail Blood), Zicao, Yemingsha (Phalaenopsidis Semen), Toutou (Rabito Carnis), Hanliancao (Ecliptae Herba), Maogen (Imperatae Rhizoma), Wugong (Scolopendra), Shanjiā (Manis Squama), Hupo, Furonghua (Hibisci Mutabilis Flos), Kujiu (Vinegar), Xiongdan, etc. Those entering the liver to break blood include Ezhu (Curcumae Rhizoma), Zi Bei (Amethyst), Lingzhi (Ganoderma), Zican (Codonopsis Radix - *Note: Context implies a different herb often confused or specific local name, but literal translation provided*), Yimucao, Puhuang (Pollen Typhae), Xuexie (Dracaenae Sanguis), Ou Lian, Guwenqian (Ancient Coin), Zao Fan (Melanteritum), Gui Wei (Angelicae Sinensis Radix), Biejia (Trionycis Carapax), Guanzhong, Qiancao, Tao Ren, etc. Those entering the liver to disintegrate blood include Sanqi, Mengchong (Blatta Orientalis - *Note: Text says 虫 likely referring to insect like Mengchong or similar, context implies blood-breaking insects*), Chong (*Text has missing character or typo, likely another insect*), Pangxie (Crab), Walengzi (Arcae Shell), Shuizhi (Hirudo), Hua Ruishi (Flowers Roushi/Stalactite?), etc. All must be administered after examining excess conditions. This is the general overview of purging Liver heat. And for purging Gallbladder heat, are there any flavors outside Kong Qingtong, Lü Qingtong, Xiongdan, Danfan (Alumen), and Qianhu (Peucedani Radix)?

For the Kidney, there are also other agents to purge heat. Such as Longdancao and Fangji (Stephaniae Tetrandrae Radix) are suitable for excessive kidney heat with urinary retention; Qiushi (Ashes of Dogwood Fruit) is necessary for excessive kidney heat with deficiency cough and urinary retention; Hanshuishi (Halloysitum Rubrum) is necessary for excessive kidney heat with thirst and edema; Digupi (Lycii Cortex) is necessary for excessive kidney heat with sweating and bone-steaming fever; Yan Yan (Salt) is necessary for excessive kidney heat with constipation; Hupo and Haishi (Fossilia Calcitum) are necessary for excessive kidney heat with blood stasis and urinary retention. If heat is in the blood, the drugs do not exceed Tongbian, Digupi, Xuyutan, Yin Chaihu (Stellariae Radix), Pugongying, Sheng Niu Xi (Achyranthis Bidentatae Radix), Hanliancao, Chishizhi (Kaolin), Ziran Tong (Natural Copper), Guwenqian, and Qingyan. And for purging bladder heat knot, using Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Difuzi (Kochiae Fructus), Yinchen (Artemisiae Scopariae Herba), Huangbai (Phellodendri Cortex), Huangqin, Longdancao, and Chuanlianzu, one can again investigate according to symptoms and treatment. This is the general overview of purging Kidney heat.

There are few spleen heat purging drugs. Only for spleen channel blood heat, books record the use of Yuli Ren (Prunus Armeniacae Semen Amarum), Shegan, Zi Bei, Jiang Huang (Curcumae Longae Rhizoma), Ou Lian, Zao Fan, and Qiuyin (Earthworm). However, one must distinguish drug and syndrome for treatment. In essence, treating diseases and using drugs requires distinguishing the zang-fu organs. However, whether their action is upper or lower, in minute details, one cannot be completely rigid. For example, once a drug enters the Lung, it inevitably enters the Heart; once it enters the Liver, it inevitably enters the Spleen; once it enters the Kidney, it inevitably enters the Bladder. Moreover, drugs with light and clear qi float upward, while those with heavy and turbid qi sink downward. How could there be floating to the left but not to the right, or heavy here but not there? As long as the form, color, and flavor are clearly compared here, the drugs naturally possess the charm of flexibility. Why must one be pedantic about measuring in millimeters, thereby limiting the wisdom of the practitioner?