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Huanglian (Coptidis Rhizoma) is bitter, drying, and extremely cold. It treats various heat syndromes, damp-heat syndromes, and toxic dysentery. For hematemesis originating from the Stomach Meridian and lower bleeding caused by internal toxin accumulation, when used in combination with other herbs, it yields significant merit.

However, it should only be used when the patient suffers from excess heat syndrome and their Yuan Qi (Original Qi) and Stomach Qi have not yet been damaged. It is appropriate to stop using it once the disease is cured; it should not be taken for a long time. Since the statement in the Materia Medica regarding "thickening the intestines and stomach" was published, physicians worldwide, without distinguishing between excess and deficiency, have rigidly adhered to this text and applied treatments indiscriminately. They fail to realize that this statement originally referred to cases where toxic dysentery and accumulated heat steamed and scorched the intestines and stomach, causing intestinal mucus to scrape off and discharge. Using Huanglian to clear heat, once the heat subsides, the intestines and stomach contract and naturally become thicker; thus, "thickening the intestines and stomach" refers to this mechanism. If a person's constitution is deficient, even if there are heat symptoms, using Huanglian will instead damage the Stomach Qi and gradually deplete True Yang. There are even cases of Fire decline and Deficient Fire syndromes where it is recklessly used. Why is this so? Therefore, Li Dongyuan stated: Excess Fire can be purged using herbs like Huangqin (Scutellariae Radix) and Huanglian; Deficient Fire can be tonified using herbs like Renshen (Ginseng Radix et Rhizoma). In Xue Lizhai's medical case records, those who died due to misusing the bitter-cold formulas of Huangqin and Huanglian are too numerous to recount. Nevertheless, when treating Excess Fire, did Xue Lizhai ever abandon the use of Huangqin and Huanglian? The value of Xue Lizhai lies in his distinction from Liu Wansu and Zhu Danji, specifically his skill in differentiating between true and false, excess and deficiency. Thus, his prescription logic is seamless, and his curative effects are increasingly remarkable. The Classics state: "Yang generates, Yin grows"; without Yang, Yin cannot grow. It also states: "Lesser Fire generates Qi." There has never been an entity of profound Yin without Fire capable of generating all things. Awakened by this classic teaching, one should no longer remain obstinate and deluded as before.

For excess heat in any meridian, bitter-cold herbs are suitable. When the condition improves slightly, administration must cease; otherwise, it may hinder Stomach Qi. Medication requires identifying the affected meridian. For instance, Huangqin and Zhizi (Gardeniae Fructus) purge Lung Fire. [Contextual correction based on flow]: If one fails to warm and nourish Yang Qi and diligently cultivate the Earth element (Spleen/Stomach, the mother of Metal), vitality will flourish daily until Essence is abundant, Blood is rich, and True Yin recovers fully, causing False Heat and Deficient Fire to extinguish spontaneously. However, if one indiscriminately administers herbs like Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma), Yin Blood will not be generated while Spleen Yang collapses first, making the False Heat more intense and endangering the body. This is not tonifying Yin but robbing Yin. Wang Taipu said: "Extreme heat that does not respond to cold treatment indicates Water deficiency." One should use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to strengthen the master of Water to control the Sunlight. Xue Lizhai stated: Regarding the general discussion of Yin and Yang syndromes, although there are distinctions among Yin, Yang, Qi, and Blood, they are essentially caused by insufficient Yang Qi of the Spleen and Stomach. If one uses sinking-yin substances like Huangbai and Zhimu, it will further drain True Yang, often leading to untreatable conditions. Therefore, bitter-cold herbs are indeed unsuitable for Yin deficiency. Assuming Yin is not deficient but Excess Heat is the problem, what harm is there in temporary use? Alas! Zhu Danxi was a renowned philosopher of his generation, yet he failed to examine the root of the disease and conflated his theories, harming the people, which is truly lamentable.