凡上升之气，自肝而出。肝木性升散，不受遏郁，郁则经气逆，为嗳，为胀，为呕吐，为暴怒胁痛，为
胸满不食，为飧泄，
为疝，皆肝气横决也。且相火附木，木郁则化火，为吞酸胁痛，为狂，为痿，为厥，为痞，为呃噎，为失
血，皆肝火冲激也。风根据于木，木郁则化风，为眩，为晕，为舌麻，为耳鸣，为痉，为痹，为类中，皆肝
风震动也。故诸病多自肝来，以其犯中宫之土，刚性难驯，挟风火之威，顶巅易到，药不可以刚燥投也。经曰∶
肝苦急，急食甘以缓之；肝欲散，急食辛以散之。用辛补之，酸泻之。古圣治肝，法尽于此。夫肝主藏血，
血燥则肝急。凡肝阴不足，必得肾水以滋之，血液以濡之，味取甘凉，或主辛润，务遂其条畅之性，则郁者舒
矣。凡肝阳有余，必需介属以潜之，柔静以摄之，味取酸收，或佐酸降，务清其营络之热，则升者伏矣。治肝
气，先疏其郁，宜逍遥散。因怒动肝，小柴胡汤加山栀、青皮。嗳而吐沫，代赭旋复汤。呕而胀满，三因七气
汤加枳壳、木香。怒伤胁痛，生白芍、金橘皮、山栀、枳壳、郁金汁、降香末。肠鸣飧泄，则泄木安土，
人参安胃散加半夏曲。 疝肿硬，则导滞和肝，橘核丸加减。若气有余便是火，治肝火实，吞酸胁痛，左金丸、
抑青丸。胁大痛引腰背，汗泄，忌辛燥耗气劫液，宜甘酸化阴，甘草、柏子仁、杞子、枣仁、阿胶、牡蛎、
木瓜、生白芍、五味子、鳖甲、金橘皮。虚痛久痛必入络，宜理营络，旋复花汤加当归须、丹皮、延胡、桃仁。
湿热火盛，胁痛筋痿溲血，龙胆泻肝汤。火盛狂躁，胸痞咽阻便秘，当归龙荟丸。阴虚痿弱，虎潜丸去锁阳。
厥逆，四逆散。痞满，半夏泻心汤。呃噎，橘皮竹茹汤。吐衄失血，犀角地黄汤加山栀、藕汁。至于肝阳化风，
上扰清窍，则巅痛头晕，目眩耳鸣，心悸寤烦，由营液内虚，水不涵木，火动痰升，其实无风可散，宜滋液和
阳。复脉汤去姜、桂，或用熟地、白芍、杞子、茯神、枣仁、炒甘菊、霜桑叶、牡蛎、石斛、五味。其由肾虚
阳浮者，宜填髓补精。阿胶、龟甲、淡菜、青盐、牛膝、萸肉、熟地、磁石。其由土弱木乘者，宜缓肝益胃。
酸枣仁汤去川芎，加人参、山药、小麦。其因怒劳，致舌麻肢痹，筋 肉 ，由五志过极，阳亢阴衰，风从火
出，宜柔润熄风。河间地黄饮子去桂、附、巴戟、菖蒲。其火风上郁，头重脘痹，宜清金肃降。杏仁、鲜菖蒲
根、栝蒌、钩藤、菊叶、薄
荷。其年高水亏，风火易升，头晕便秘，宜壮水滋燥。还少丹去杜仲、巴戟、楮实、茴香，加桑叶、黑芝麻、
柏子仁、炒甘菊、茯神、牡蛎。其阳明络虚，风火易震，食少知饥，宜填实空际。人参、山药、炙草、牡蛎、
枣仁、茯苓、白芍、南枣。大抵肝为刚脏，职司疏泄，用药不宜刚而宜柔，不宜伐而宜和，正仿《内经》治
肝之旨也。
丹溪曰∶病患自言冷气从下而上，非真冷也。此上升之气，自肝而出，中挟相火，自下而上。其热为甚，
自觉冷者，火极似水，积热之甚也。阳亢阴微，故见此症。又曰∶气从左边起，肝火也。宜左金丸。气从脐下
起，阴火也。黄柏丸、坎离丸。气从足下起入腹，虚之极也。滋阴降火汤，外用津调附子末，涂涌泉，引热下行。
Any ascending Qi originates from the Liver. The Liver, belonging to Wood, has a nature of ascending and dispersing; it cannot tolerate obstruction or stagnation. When stagnant, the Qi in the meridians becomes rebellious, manifesting as belching, abdominal distension, vomiting, sudden anger with hypochondriac pain, chest fullness with anorexia, undigested food diarrhea (Sun-xie), hernia, all of which are manifestations of Liver Qi rebelling and bursting forth. Moreover, Ministerial Fire (Xiang-huo) attaches to Liver Wood; when Liver Wood is stagnant, it transforms into Fire, manifesting as acid regurgitation with hypochondriac pain, mania, flaccidity syndrome (Wei), cold limbs (Jue), epigastric fullness (Pi), hiccups and dysphagia, and hemorrhage, all of which are manifestations of Liver Fire rushing and striking. Wind is rooted in Wood; when Liver Wood is stagnant, it transforms into Wind, manifesting as dizziness, vertigo, numbness of the tongue, tinnitus, spasms, Bi-syndrome, and stroke-like syndromes (Lei-zhong), all of which are manifestations of Liver Wind shaking. Therefore, many diseases originate from the Liver, because it invades the Earth of the Middle Jiao (Spleen/Stomach). Its nature is rigid and difficult to tame, carrying the might of Wind and Fire, easily reaching the vertex. Medications should not be harsh and drying. The Classic says: "The Liver suffers from tension; eat sweet flavors to relax it." "The Liver desires dispersion; eat pungent flavors to disperse it." Use pungent flavors to tonify it, and sour flavors to drain it. The ancient sages' methods for treating the Liver are contained within these principles. The Liver stores Blood; when Blood is dry, the Liver becomes tense. Whenever Liver Yin is insufficient, it must be nourished by Kidney Water and moistened by Blood. The flavor should be sweet and cool, or primarily moistening with pungency, striving to follow its free-flowing and smooth nature, so that stagnation will be relieved. Whenever Liver Yang is excessive, it must be anchored by shell-type substances and restrained by gentle and quiet agents. The flavor should be sour and astringent, or assisted by sour and descending agents, striving to clear heat in the Ying (Nutritive) level and collaterals, so that ascending Yang will subside. To treat Liver Qi disorders, first soothe the stagnation; Xiao Yao San (Free and Easy Wanderer Powder) is suitable. If triggered by anger, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Gardenia (Shan Zhi) and Green Tangerine Peel (Qing Pi). For belching with spittle, use Dai Zhe Xuan Fu Tang (Magnetite and Inula Decoction). For vomiting with abdominal distension, use San Yin Qi Qi Tang (Three Causes Seven Qi Decoction) with Aurantium (Zhi Ke) and Costus Root (Mu Xiang). For hypochondriac pain caused by anger, use Raw White Peony Root (Sheng Bai Shao), Golden Orange Peel (Jin Ju Pi), Gardenia (Shan Zhi), Aurantium (Zhi Ke), Curcuma Juice (Yu Jin Zhi), and Agarwood Powder (Xiang Mo). For borborygmus and undigested food diarrhea, employ the method of draining Wood to calm Earth; Ren Shen An Wei San (Ginseng Stomach-Calming Powder) with Pinellia Ferment (Ban Xia Qu) is suitable. For hard and swollen hernias, employ the method of guiding stagnation and harmonizing the Liver; Ju He Wan (Tangerine Seed Pill) with modifications is suitable. If excess Qi becomes Fire, to treat excess Liver Fire with acid regurgitation and hypochondriac pain, use Zuo Jin Wan (Left Metal Pill) or Yi Qing Wan (Suppress Cyan Pill). For severe hypochondriac pain radiating to the back and waist with sweating, avoid pungent-drying drugs that consume Qi and fluids; instead, use the method of sweet-and-sour to generate Yin, with Licorice (Gan Cao), Biota Seed (Bai Zi Ren), Goji Berry (Qi Zi), Jujube Seed (Zao Ren), Donkey-hide Gelatin (E Jiao), Oyster Shell (Mu Li), Quince (Mu Gua), Raw White Peony Root (Sheng Bai Shao), Schisandra (Wu Wei Zi), Turtle Shell (Bie Jia), and Golden Orange Peel (Jin Ju Pi). Chronic pain from deficiency or long-standing pain must enter the collaterals; regulate the Ying collaterals with Xuan Fu Hua Tang (Inula Flower Decoction) plus Dang Gui Xu (Angelica Sinensis Tail), Moutan Bark (Dan Pi), Corydalis (Yan Hu), and Peach Kernel (Tao Ren). For damp-heat and excessive fire causing hypochondriac pain, flaccidity, and hematuria, use Long Dan Xie Gan Tang (Gentian Drain Liver Decoction). For excessive fire causing mania and restlessness, chest oppression, throat obstruction, and constipation, use Dang Gui Long Hui Wan (Angelica Coptis Pill). For Yin-deficiency flaccidity, use Hu Qian Wan (Tiger Crouching Pill) without Suo Yang. For cold limbs (Jue Ni), use Si Ni San (Four Counterflow Powder). For epigastric fullness (Pi Man), use Ban Xia Xie Xin Tang (Pinellia Drain the Epigastrium Decoction). For hiccups and dysphagia, use Ju Pi Zhu Ru Tang (Tangerine Peel and Bamboo Shaving Decoction). For hematemesis, epistaxis, and blood loss, use Xi Jiao Di Huang Tang (Rhinoceros Horn Rehmannia Decoction) with Gardenia (Shan Zhi) and Lotus Root Juice (Ou Zhi). As for Liver Yang transforming into Wind, disturbing the clear orifices upwards, causing vertex headache, dizziness, vertigo, tinnitus, palpitations, and insomnia with irritability, this is due to internal deficiency of Ying fluids, Water failing to nourish Wood, Fire stirring up Phlegm rising. Actually, there is no Wind to disperse; instead, nourish fluids and harmonize Yang. Use Mai Mai Teng Tang (Rehmannia Vine Decoction) minus Ginger and Cinnamon Twig, or use Prepared Rehmannia (Shu Di), White Peony Root (Bai Shao), Goji Berry (Qi Zi), Poria (Fu Shen), Jujube Seed (Zao Ren), Stir-fried Chrysanthemum (Chao Gan Ju), Frost Mulberry Leaf (Shuang Sang Ye), Oyster Shell (Mu Li), Dendrobium (Shi Hu), and Schisandra (Wu Wei Zi). If caused by Kidney deficiency with floating Yang, fill the marrow and tonify essence with Donkey-hide Gelatin (E Jiao), Tortoise Shell (Gui Jia), Edible Mussel (Dan Cai), Blue Salt (Qing Yan), Achyranthes (Niu Xi), Cornus (Yu Rou), Prepared Rehmannia (Shu Di), and Magnetite (Ci Shi). If caused by weak Spleen Earth being overwhelmed by Liver Wood, soothe the Liver and benefit the Stomach with Suan Zao Ren Tang (Sour Jujube Seed Decoction) minus Ligusticum (Chuan Xiong), adding Ginseng (Ren Shen), Yam (Shan Yao), and Wheat (Xiao Mai). If caused by anger and overwork leading to tongue numbness and limb Bi-syndrome, with muscle twitching, this results from extremes of the Five Emotions, hyperactive Yang and deficient Yin, Wind arising from Fire. Soothe and moisten to extinguish wind with He Jian's Di Huang Yin Zi (Rehmannia Drink) minus Cinnamon Twig (Gui Zhi), Aconite (Fu Zi), Morinda (Ba Ji), and Acorus (Chang Pu). If Fire and Wind obstruct upwards, causing heavy head and epigastric Bi-syndrome, clear Metal and descend turbidity with Apricot Seed (Xing Ren), Fresh Acorus Root (Xian Chang Pu Gen), Trichosanthes Fruit (Gua Lou), Uncaria (Gou Teng), Chrysanthemum Leaves (Ju Ye), and Mint (Bo He). If elderly with depleted Water, prone to rising Wind and Fire, causing dizziness and constipation, strengthen Water and moisten dryness with Hai Shao Dan (Little Youth Pill) minus Eucommia (Du Zhong), Morinda (Ba Ji), Celastrus (Chu Shi), and Fennel (Hui Xiang), adding Mulberry Leaf (Sang Ye), Black Sesame (Hei Zhi Ma), Biota Seed (Bai Zi Ren), Stir-fried Chrysanthemum (Chao Gan Ju), Poria (Fu Shen), and Oyster Shell (Mu Li). If the Yangming collaterals are deficient, prone to Wind and Fire shaking, with poor appetite but hunger, fill the emptiness with Ginseng (Ren Shen), Yam (Shan Yao), Roasted Licorice (Zhi Cao), Oyster Shell (Mu Li), Jujube Seed (Zao Ren), Poria (Fu Ling), White Peony Root (Bai Shao), and Southern Date (Nan Zao). Generally, the Liver is a rigid organ responsible for free flow and drainage; medications should not be harsh but gentle, not attacking but harmonizing, truly imitating the principle of treating the Liver in the Neijing.
Zhu Danxi said: Patients say they feel cold Qi rising from below, but it is not true cold. This ascending Qi originates from the Liver, carrying Ministerial Fire (Xiang-huo) internally, rising from below. The heat is severe; the patient feels cold because extreme Fire resembles Water, indicating severe accumulated heat. Hyperactive Yang and deficient Yin cause these symptoms. He also said: Qi rising from the left side is Liver Fire; use Zuo Jin Wan (Left Metal Pill). Qi rising from below the navel is Yin Fire; use Huang Bo Wan (Phellodendron Pill) or Kan Li Wan (Kan-Li Pill). Qi rising from the feet into the abdomen indicates extreme deficiency; use Zi Yin Jiang Huo Tang (Nourish Yin and Descend Fire Decoction), externally apply Aconite powder mixed with saliva to Yongquan (KI 1), to guide heat downward.