〔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 Yi] The Liver governs Wind. In excess conditions, symptoms include eyes staring straight, loud crying, yawning, neck stiffness, and sudden oppression. In deficiency conditions, symptoms include teeth grinding and frequent yawning. Heat in Qi generates external wind, while warmth (internal heat) generates internal wind. In Liver disease, the child cries and calls, stares with eyes fixed, yawns, feels sudden oppression, and has a stiff neck. If caused by external contraction of Wind, presenting with yawning, sudden oppression, and hot breath from the mouth, dispersing treatment should be applied, primarily using Da Qing Gao (Great Blue Paste). If the child can eat but drinks incessantly, minor purgation should be applied using Da Huang Wan (Rhubarb Pill). Other conditions should not be purged. For Liver Heat, manifesting as hands grasping at clothing collars and randomly rubbing objects, Xie Qing Wan (Drain Green Pill) is indicated. For high fever, drinking water, wheezing, and oppression, Xie Bai San (Drain White Powder) is indicated. When there is Wind in the Liver, the eyes twitch without convulsions; if Heart Heat is also present, convulsions occur. Treat the Liver with Xie Qing Wan and the Heart with Dao Chi San (Guide Out Red Powder). When there is Heat in the Liver, the eyes stare straight without convulsions; if Heart Heat is also present, convulsions occur. Treat the Liver with Xie Qing Wan and the Heart with Dao Chi San. When Liver Wind is severe, causing the body to arch backward and become rigid without convulsions, it indicates the Heart is not affected by heat. One should tonify the Kidney and treat the Liver: use Di Huang Wan (Rehmannia Pill) for the Kidney and Xie Qing Wan for the Liver. 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, the child cannot bear it, resulting in eye twitching. If Heat enters the eyes, pulling on the sinews, both eyes become tight and unable to turn, resulting in staring eyes. If Heart Heat is present, convulsions occur because both mother (Liver) and son (Heart) organs have excess heat, and Wind and Fire struggle together. [Zhang Yuansu said: The Liver governs strategy and courage. Heat causes seeking clothes, rubbing objects, eye twitching, and staring inability to turn. Extremes cause body arching 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 says late afternoon), Liver strength overcomes Lung, Lung weakness cannot overcome Liver. Tonify Spleen and Lung, treat Liver. Tonifying Spleen follows the principle "Mother makes Son solid." Use Yi Huang San (Benefit Yellow Powder) for Spleen and Xie Qing Wan for Liver. Liver disease appearing in Spring (or one says morning), Lung overcomes Liver. Tonify Kidney and Liver, treat Lung. Liver is weak and diseased. Tonify Kidney and Liver with Di Huang Wan; treat Lung with Xie Bai San. Regarding the weight of Five Zang overcoming each other: Liver disease seen in Autumn indicates Wood prosperity and Liver overcoming Lung. Benefit Lung and drain Liver. Mild cases resolve; severe cases result in white lips and death. [Lou Quanshan] The overcoming of Five Zangs and diseases following seasonal timing expands upon the principles of the *Nei Jing* regarding organ qi and time. This truly develops insights not previously expressed. For example, Liver disease appearing in Spring and morning indicates self-disease in its own position. If it appears in Autumn and late afternoon (Lung's time), it indicates extreme Lung deficiency allowing Liver to overcome it. Thus, tonify Spleen and Lung, drain Liver. Apply this logic to others.
[Zhang Yuansu] The Liver governs Wind. Self-disease causes wind convulsions and stiffness. Urgently use sweet flavors to relax, assist with sour and bitter flavors, and disperse with pungent flavors. Excess wind convulsions are forceful; treat with Xie Qing Wan. Deficiency wind convulsions are weak; treat with Di Huang Wan. Heart overcoming Liver is an Excess pathogen: high fever and convulsions, treat with Li Jing Wan (Relieve Shock Pill) and Liang Jing Wan (Cool Shock Pill). Lung overcoming Liver is a Robber pathogen: excessive Qi leads to stretching forward, yawning, and slight convulsions. Method dictates draining Lung, first tonifying the home organ. Tonify Liver with Di Huang Wan; drain Lung with Xie Bai San. Spleen overcoming Liver is a Minor pathogen: excessive sleep, heavy body, and convulsions. First stop convulsions with Xie Qing Wan. After convulsions stop, observe subsequent syndromes and establish separate treatments. Kidney overcoming Liver is a Deficient pathogen: increased cold, yawning, and convulsions, treat with Qiang Huo Gao (Notopterygium Paste). [Liu Wansu] Whenever the Liver is diseased, first examine the Lung and Kidney to trace the origin of the disease, then assess the excess or deficiency of the Liver itself before treating. The Kidney is the Mother of the Liver; Metal (Lung) is the Ghost (Robber) of Wood (Liver). If the Liver is diseased, unless it is due to Kidney Water failing to generate, it must be Lung Metal attacking. Detailed examination is necessary. If the source is Lung, treat Lung first to attack the Ghost. If the source is Kidney, tonify Kidney first to nourish the Root. Then assess Liver excess/deficiency and apply cold/warm therapies. [Xue Ji] If Liver channel excess heat generates external wind, use Da Qing Gao to disperse. If symptoms persist or worsen after administration, the pathogen is gone but Spleen Qi is damaged; use Yi Gong San (Extraordinary Efficacy Powder) plus Chuan Xiong and Dang Gui to tonify. If Liver channel deficiency heat or internal wind generated by harsh treatment occurs, use Yi Gong San and Di Huang Wan to tonify. If Wind pathogen enters the Zang, with ability to eat, desire for cold drinks, and constipation, this is internal excess; use Da Huang Wan to purge. If after purging, food intake decreases, desire for warm soup increases, or abdominal distension occurs, this is internal Spleen Qi deficiency; use Bai Zhu San (Atractylodes Powder) to tonify. If Qi and Blood are inherently weak, or post-illness, or after harsh drugs, presenting with hand grasping collar, teeth grinding, yawning, and pale blue eyes, this is extreme Liver deficiency; urgently use Di Huang Wan to tonify Kidney and Liver. Gagging, shortness of breath, sighing indicate extreme Lung deficiency; urgently use Yi Gong San to tonify Spleen and Lung. Crying, staring, yawning, sudden oppression, neck stiffness, palpitations, limb shaking, fever, and thirst during Shen/You hours (3-7 PM) indicate Wind-Fire struggling and overcoming Lung Metal. Use Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder) to treat Liver Fire and generate Liver Blood. Use Yi Gong San to tonify Spleen Earth and generate Lung Metal. White lips indicate Spleen exhaustion, which is incurable.
[Hai Zang] The Liver suffers from urgency; urgently eat sweet to relax, Licorice. The Liver desires dispersion; urgently eat pungent to disperse, Chuan Xiong. Tonify with pungent, Xi Xin. Drain with sour, Shaoyao. Tonify Liver deficiency with Sheng Jiang and Chen Pi. Deficiency tonifies the Mother; Kidney is the Mother of Liver. Use Shu Di and Huang Bo to tonify Kidney. Without other symptoms, Qian's Di Huang Wan tonifies. Bu Gan Wan (Tonify Liver Pill) is Si Wu Tang plus Fang Feng and Qiang Huo in equal parts, powdered and honey-pilled. Zhen Gan Wan (Calm Liver Pill) is Xie Qing Wan minus Zhi Zi and Da Huang. To treat Liver deficiency, Qian's Bu Shen Di Huang Wan. Liver excess is drained by Bai Shao. Without other symptoms, Qian's Xie Qing Wan is primary. Excess drains the Son; Heart is the Son of Liver, drain Heart with Gan Cao.
Xie Qing Wan (Qian's Formula) Also known as Xie Gan Wan
Dang Gui (remove radicle, bake) Long Dan (bake) Chuan Xiong Shan Zhi Zi (kernel) Chuan Da Huang (wrapped in wet paper, baked) Qiang Huo Fang Feng (remove radicle. Equal parts)
Powdered above, mixed with refined honey into pills the size of a quail egg. Take half to one pill per dose, decoct Zhu Ye (Bamboo Leaf) soup, dissolve with brown sugar and warm water.
[Xue Ji] The previous formula is for the Foot Jueyin channel to disperse muscle-surface and unblock internal heat. If constipation, irritability/thirst for cold drinks, and normal appetite exist, it is Form and Disease both excess; use this to drain. If stool is harmonious, irritability/thirst for cold drinks, and pale blue eyes exist, it is Pathogen Qi excess but Body Qi deficiency; use Yi Gan San (Suppress Liver Powder) to calm. If loose stools, thirst for warm drinks, poor appetite, and limb fatigue exist, it is Form and Disease both deficiency; use Di Huang Wan to tonify.
Yi Gan San Treats Liver channel deficiency heat causing convulsions, or fever with teeth grinding, or palpitations with alternating chills/fever, or Wood overcoming Earth causing vomiting phlegm/saliva, abdominal distension, poor food intake, and restless sleep.
Ruan Chai Hu Gan Cao (each 5 fen) Chuan Xiong (8 fen) Dang Gui Bai Zhu (stir-fried) Fu Ling Diao Teng Gou (each 1 qian)
Decoct in water. Child and mother take together. If honey-pilled, named Yi Qing Wan.
Da Qing Gao (Formula seen in Convulsions section) Da Huang Wan (Formula seen in Abdominal Distension section) Yi Gong San (Formula seen in Vomiting/Diarrhea section) Bai Zhu San (Formula seen in Thirst section) Chai Hu Zhi Zi San (Formula seen in Various Fevers section) Li Jing Wan Liang Jing Wan Qiang Huo Gao (Three formulas seen in Convulsions section) Xi Xin San