阳明火起发狂，腹满不得卧，面赤而热，妄见妄言，人皆谓内热之极也。然而
阳明属土，而不属火，何以火出于土，谓是外邪之助乎？既非暑气之侵，又非寒气
之变，乃一旦火起，以致发狂，人多不解。不知土中之火，乃心中之火也，心火起
而阳明之火翕然而发。阳明胃经乃多气多血之腑，火不发则已，一发而反不可制，
往往卷土而来，火焰升腾，其光烛天，而旁且沿烧于四境，有不尽不已之势，非惟
焚尽于胃，而且上烧于心，心君不宁，且有下堂而走者，神既外越，自然妄有所见，
既有妄见安能止其妄言？此谵语之所以生也。然则阳明之火乃内因而成，非外邪所
致也。治法宜与伤寒之狂，伤暑之狂俱不可同日而论矣。然而阳明之火，其由来虽
有内外之殊，而治阳明之火，其方法实无彼此之异。必须急灭其火，以救燎原之势，
而不可因循观望，长其火焰之腾，以致延烧各脏腑也。方用人参竹叶石膏汤治
之。
人参（五钱） 石膏（一两） 麦冬（一两） 竹叶（三百片） 知母（三钱） 甘草（一钱）
糯米（一撮） 水煎服。一剂狂定，再剂腹满不能卧之病除，而妄见妄言之症亦
去矣，不必三剂。
此方退胃火之神剂也，凡有胃热之病，用之皆宜。然止可救一时之急，而不可
泻长久之火。论理内热之火既起于心，宜泻心，而反泻胃者，恐胃火太盛，必致变
生不测也。盖心火不止，不过增胃火之炎；而胃火不止，实有犯心火之祸。所以治
心火者，必先泻胃也。胃既泻矣，而后减去石膏、知母加入黄连一钱，玄参一两，
再服二剂，不特胃火全消，而心火亦息也。
此症用苦龙汤亦神。
地龙（二十条，捣烂） 苦参（五钱） 水煎服之。一剂既止狂，不必再服。
热病有完谷不化，奔迫直泻者，人以为大肠之火也，谁知是胃火太盛乎。夫胃
火上腾而不下降，胡为直下于大肠而作泻耶？盖胃为肾之关，肾虚则胃之关门不守，
胃乃挟水谷之气而下行矣。第肾虚为寒而胃何以反能热耶？不知肾虚者水虚也。水
虚则火无所制，而命门龙雷之火下无可藏之地，直冲于胃，见胃火之盛，亦共相附
会，不上腾而下泄矣。胃火既盛，又得龙雷之火，则火势更猛，以龙雷之性甚急，
传于大肠不及传导，故奔迫而直泻也。治法似宜先治肾矣，然而胃火不泻，则肾火
断不肯回，但遽泻胃火，则胃土因火而崩，胃水随土而泄，又不能底止，必须先健其
土，而分利其水，则水清而土可健，火可安，而龙雷之火亦易于收藏也。方用缓流
汤∶
茯苓（一两） 芡实 山药（各三两） 车前子（五钱） 薏仁（一两） 甘草（一钱）
人参（一两） 五味子（一钱）
此方无一味非健土之药，又无一味非利水之品。然利水之中不走其气，下气不
走而上火自升矣。况健土之品，无非补肾之味，肾得补而真阴生，龙雷之火自仍归
于肾脏。肾火既安，则胃火失党，而胃土又健，则水谷之气，更易分消，自然火衰
而泻止也。
此症用滑苓汤亦甚效。
滑石 茯苓（各一两，同研为末，井水调服即止。）
人有口干舌燥，面目红赤，易喜易笑者，人以为心火热极也，谁知是心包膻中
之火炽甚乎。夫心包之火，相火也，相火者，虚火也。膻中为臣使之官，喜乐出焉，
是膻中乃心之辅佐，代心而行其赏罚者也。喜怒者，赏罚之所出也，心内神明则赏
罚正；心内拂乱，则赏罚移。譬如下人专擅借上之赏罚，以行其一己之喜怒，久
则忘其为下，以一己之喜怒，为在下之赏罚矣。治法宜泻心包之火。然而泻心包必
至有损于心，心虚而心包之气更虚，必至心包之火更盛。不如专补其心，心气足而
心包之火自安其位，何至上炎于口、舌、面、目，而成喜笑不节之病乎。方用归脾汤∶
人参（三钱） 茯神（三钱） 炒枣仁（五钱） 远志（一钱） 麦冬（三钱） 山药（三钱） 当归（三钱）
广木香末（三分） 黄 （二钱） 甘草（三分） 水煎调服。一剂面目之红赤减，二剂口舌之干
燥除，三剂易喜易笑之症亦平矣。
此方补心气之虚，仍是补心包之火，何以火得之而反息也？不知心火宜泻以为
补，而心包之火宜补以为泻。心包之火旺，由于心君之气衰，补其心而心包不敢夺
心之权，何敢喜笑自若，僭我君王哉。
此症用参术二仁汤亦效。
人参 茯神 炒枣仁（各三钱） 白术（五钱） 远志 半夏（各一钱） 砂仁（二粒）水煎服。
鼻中出黑血不止，名曰衄 ，乃心热之极，火刑肺金也。夫肺金为心火所克，
宜出红血，不宜出黑血矣，得毋疑为肾火之刑母乎。夫肾为肺金之子，安有子杀
其母者？然而黑血实肾之色也。心火太盛移其热于肺，而肺受火刑，必求救于肾，
肾恶心火之克母，乃出其全力以制心，而心已移热于肺矣，肾即随火而奔入于肺，
怒心火之肆恶，并力以相战，肺无可藏之地，肾即逐血而出于鼻，红血而变为黑色。
真有不共戴天之仇，焦头烂额，白日俱昏者矣。治法单泻心中之火，不必泻肾中之水。
盖火息而金安，金安而肾水何至与心相斗哉。方用救 丹∶
黄连（二钱） 丹皮（三钱） 茯苓（二钱） 麦冬（五钱） 玄参（一两） 生枣仁（三钱）
生地（三钱） 柏子仁（一钱） 水煎服。连用二剂黑血即止，四剂不再衄。
此方制心火之有余，不损心气之不足，肾见君火之衰，肺金之旺，则报仇之恨
已泄，复国之谋已成，自然返兵旋旅，何至穷寇之再追哉。或谓心君已为肾子所 ，则
心气必伤，自宜急泻肾气，毋使追奔为是，何反泻心以助其虐耶？不知肾水原非有余，
不过因肺母之难，故奋罔顾身，因心火之起舋？而转伐肾子，非理也。况方中虽泻
心火，而正未尝少损心气，名为泻心而实补心也。不过少解其炎氛，以泄肾子之愤，
而火即解矣。且肾有补而无泻，何若泻心火之为得哉。
此症用生地冬芩汤
麦冬 生地（各二两） 黄芩（三钱） 水煎服。
人有热极发斑，身中如红云一片者，人以为内热之极而外发于皮肤矣，孰知此
热郁于内，而不能外发之故乎。此等之病，寒热之药，两不宜施。夫火热宜用凉药，
内火未有不从外泄者。但火得寒则又闭，微火可以寒解，而盛火不可以寒折，往往
得寒凉之味，反遏其外出之机，闭塞而不得泄，有成为发狂而不能治者。若用热药投
之，则火以济火，其势必加酷烈，欲不变为亡阳而不可得矣。治法必须和解为得。
第火盛者，水必衰，徒解其火而不益之以水，未必火之遽散也。宜用补水之中而行
其散火之法，则火无干燥之虞，而有发越之易也。方用风水散斑汤∶
玄参（二两） 当归（二两） 荆芥（三钱） 升麻（一钱） 生地（一两） 水煎服。一剂
斑少消，二剂斑又消，三剂斑全消。
此方玄参补阴，以解其浮游之火，当归、生地以补其心胃之血，多用荆芥、升
麻风药以解散郁热，则火得水而相制，亦火得风而易扬，全无泻火之品，而已获泻火
之效，实有深义耳。
此症用化云汤亦神。
黄连（三钱） 当归（一两） 玄参（二两） 升麻（二钱） 水煎服。
热极发斑，目睛突出，两手冰冷，此心火内热，所谓亢则害也，而不知又有肝
火以助之耳。夫热病宜现热象，何反见寒冷之证乎？盖火极似水耳。热极于心，则
四肢之血齐来救心，转无血以养手足，故手足反寒；如冰之冷者，外寒之极，实由
于内热之极也。至于目睛突出者，肝开窍于目，而目之大 又心之窍也。心火既盛，
又得木中之火相助，则火更添焰而炎上，所以直奔其窍而出，但目中之窍细小，不
足以畅泄其火，怒气触睛，故突而出也。治法宜泻心火，而更平肝木，木气既舒，
心火自散。方用风水散斑汤加减，而症自愈也。
玄参（一两） 当归（一两） 黄连（三钱） 荆芥（三钱） 升麻（三钱） 白芍（一两）
生地（五钱） 水煎服。
此方加白芍、黄连，以黄连泻心火，而白芍平肝火也。又得荆芥、升麻引群药共
入于腠理之间，则上下四旁之余热尽消，且不至遏抑其火，有经络未达之虞。此方
补多于攻，散火而不耗损真气，庶几有既济之美也。
此症用玄丹升麻汤亦神效。
玄参（半斤） 丹皮（三两） 升麻（三钱） 水煎一碗，一剂饮愈。
热极不能睡熟，日夜两眼不闭，人以为心肾不交，火盛之故，谁知是水火两衰
之故乎。夫心火最畏肾水之克，而又最爱肾水之生，盖火非水不养也；肾水又最爱
心火之生，而又最恶心火之烧，盖水非火不干也。是心肾相爱则相交，心肾相恶则
相背，求闭目而神游于华胥之国，自不可得矣。治法补其心中之液，以下降于肾；
补其肾中之精，以上滋于心；并调其肝气，以相引于心肾之间，俾相恶者仍至相爱，
则相背者自相交矣。方用引交汤∶
熟地 麦冬（各一两） 炒枣仁 山茱萸 沙参（各五钱） 茯神（三钱） 玄参（五钱）
白芍（二两） 炒栀子（三钱） 菖蒲 破故纸（各五分） 水煎服。连服二剂即目闭而酣睡矣。
此方心肾双补，而平其肝气，以清木中之火。盖肝火泻则心火自平，肾水亦旺，
势必心气通于肝，而肾气亦通于肝也。心肾既通于肝，而又有菖蒲以引心，破故纸
以引肾，介绍同心，自能欢好如初，重结寤寐之交矣。
此症用水火两滋汤亦效。
熟地（三两） 肉桂（二钱） 菟丝子（一两） 水煎服。
人肝火内郁结而不伸，闷烦躁急，吐痰黄块者，人以为火郁宜达也，然达之而
火愈炽，此乃未尝兼肝肾而同治也。夫肝木有火，火郁而不宣者，虽是外邪蒙之，
亦因内无水以润之也。木无水润，则木郁更甚，倘徒用风药，以解肝中之火，不用
润剂以荫肝中之水，则熬干肝血，而火益盛矣。倘徒用润剂，以益其肝中之水，不
用风剂以舒其肝中之火，则拂抑肝气而郁更深矣。郁深则烦闷于心，火盛则躁急于
腹，欲其痰涎之化得乎。治法舒其肝以解火，复补其肾以济水，自然郁结伸而诸症
愈也。方用肝肾两舒汤∶
熟地 玄参（各一两） 茯苓（三钱） 白芍（一两） 柴胡（一钱） 当归（五钱） 甘草炒
栀子（各一钱） 丹皮（三钱）水煎服。二剂渐轻，四剂全愈。
此方归、芍、柴、栀所以舒肝者，风以吹之也；熟地、玄、丹所以补肾者，雨
以溉之也。茯苓、甘草又调和于二者之中，使风雨无太过不及之虞耳。譬如夏令炎
蒸，郁极而热，树木枯槁，忽得金风习习，大雨滂沱，则从前郁闷燔燥之气，尽快
如扫，而枯槁者倏变为青葱，爽气迎人，岂犹有烦闷躁急等症哉。
此症用快膈汤亦效。
白芍 当归 熟地（各一两） 柴胡 甘草（各一钱） 生地 麦冬（各三钱） 枳壳 半
夏（各三钱） 水煎服。
人头面红肿，下体自脐以下又现青色，口渴殊甚，似欲发狂，人以为下寒而上
热也，谁知是下热之极，而假现风象以欺人乎。若作上热下寒治之，立时发狂而死，
必至皮肉尽腐也。此种之病，乃误听方士之言，服金石之药，以助命门之火，强阳
善斗，助乐旦夕。而金石之药，必经火 ，其性燥烈，加之鼓勇浪战，又自动其火，
战久则乐极情浓，必然大泄其精，倍于寻常。火极原已耗精，复倍泄精以竭其水，
一而再，再而三，必有阴虚火动之忧。无如世人迷而不悟，以秘方为足恃，以杀人
之药为灵丹，日日吞咽而不知止，则脏腑无非火气，虽所用饮食未尝不多，然而火
极易消，不及生精化水。于是火无水制，自然上腾头面，其头面初犹微红，久则纯
红而作肿。然自脐以下，不现红而现青者，以青乃风木之色也。脐下之部位属肾，
肾火旺而肾水干，则肝木无所养，于是肝气不自安，乃下求于肾，而肾又作强，火
炽肝气欲返于本宫，而燥极不能自还，遂走肾之部位，而外现青色矣。此等症候《内
经》亦未尝言及，无怪世人之不识也。夫肝气之逆如此，而火愈上升，欲口之不渴
得乎？口渴饮水，止可救胃中之干燥，而不能救五脏之焦枯。势且饮水而口愈渴，
安得不发狂哉。治法必须大补其水，而不可大泻其火。盖泻其火，则火息而水竭，
亦必死之道也。方用救焚解毒汤∶
熟地（四两） 玄参（二两） 麦冬（三两） 白芍（三两） 金银花（三两） 甘菊花（五钱）
牛膝（一两） 黄柏（一钱）
水煎服。一连数剂，下体之青色除，再服数剂，头面之红肿亦渐愈。此方减半，
必再服一月，始无痈疽之害。
盖热极发红，乃是至恶之兆，况现青色，尤为恶之极者。幸脐之上不青，若一见青
色，则脏腑肠胃内烂，疮疡痈毒外生，安有性命哉。前古医圣不论及者，以上古之人恬澹冲
和，未尝服金石之毒药也。后世人情放荡，觅春药如饴糖，而方士之辈，但知逢迎贵介之欢
When fire flares up in the Yangming channel, causing madness, abdominal fullness preventing sleep, a red and hot face, hallucinations, and delirious speech, people all consider it to be extreme internal heat. However, the Yangming channel belongs to Earth and not to Fire; why does fire emerge from Earth? Is it because of the assistance of external pathogens? Since it is neither an invasion by summerheat nor a transformation of cold pathogen, but rather sudden onset of fire leading to madness, many do not understand. They do not know that the fire within Earth is actually the Heart Fire (fire of the Heart organ). When Heart Fire arises, the fire of the Yangming channel erupts vigorously. The Stomach meridian of Yangming is a fu-organ abundant in Qi and Blood. If fire does not flare up, fine; but once it does, it becomes uncontrollable. It often returns with force, flames soaring, light illuminating the sky, spreading and burning along the four boundaries, with a momentum that seems endless. It not only burns the Stomach but also scorches upward to the Heart. The Heart Sovereign is unsettled, and there may even be a desire for the Spirit to flee the body. Since the Spirit has wandered outward, naturally hallucinations occur; given these hallucinations, how can delirious speech cease? This is why delirium arises. Thus, the fire in the Yangming channel is caused by internal factors, not external pathogens. The treatment method should be discussed differently from madness caused by Cold Damage or Summerheat injury. However, although the origin of Yangming fire may differ internally or externally, the method for treating Yangming fire is essentially the same. One must urgently extinguish the fire to save the prairie-fire situation, without hesitating or waiting, allowing the flames to soar and burn various zang-fu organs. Use Ren Shen Zhu Ye Shi Gao Tang (Ginseng, Bamboo Leaf, and Gypsum Decoction) to treat it.
Ren Shen (5 qian) Shi Gao (1 liang) Mai Dong (1 liang) Zhu Ye (300 leaves) Zhi Mu (3 qian) Gan Cao (1 qian)
Nuomi (a pinch) Decoct in water and take orally. After one dose, madness stabilizes; after two doses, the abdominal fullness and inability to sleep are cured, and symptoms of hallucinations and delirious speech disappear; no need for a third dose.
This formula is a divine agent for clearing Stomach fire; it is suitable for any disease involving Stomach heat. However, it can only rescue acute conditions temporarily and cannot be used to drain chronic fire. Theoretically, since internal heat fire originates in the Heart, one should drain the Heart, yet we drain the Stomach instead, fearing that excessive Stomach fire will inevitably lead to unpredictable complications. Generally, if Heart fire persists, it merely increases the blaze of Stomach fire; but if Stomach fire persists, it truly poses a disaster of invading the Heart. Therefore, those who treat Heart fire must first drain Stomach fire. Once Stomach fire is cleared, remove Shi Gao and Zhi Mu, add Huang Lian (2 qian) and Xuan Shen (1 liang), and take for another two doses. Not only will Stomach fire be completely eliminated, but Heart fire will also subside.
Using Ku Long Tang (Bitter Dragon Decoction) for this condition is also miraculous.
Di Long (20 earthworms, crushed) Ku Shen (5 qian) Decoct in water and take. Madness stops after one dose; no further administration needed.
In febrile diseases, if undigested food appears in stool and there is urgent, direct diarrhea, people assume it is Large Intestine fire, unaware that it is actually excessive Stomach fire. Why does Stomach fire, which rises upward and does not descend, go directly down to the Large Intestine to cause diarrhea? The Stomach serves as the gate for the Kidney. When Kidney deficiency occurs, the gate of the Stomach fails to hold, and the Stomach carries the Qi of water and grain downward. But Kidney deficiency is typically cold; why can the Stomach become hot? One must realize that Kidney deficiency implies Water deficiency. When Water is deficient, Fire has no restraint, and the Mingmen Dragon-Lei Fire (Ministerial Fire originating from the Gate of Life) has nowhere to hide below, rushing straight to the Stomach. Seeing the abundance of Stomach fire, it joins forces, descending rather than ascending. With both Stomach fire and Dragon-Lei fire present, the flame intensifies. Due to the urgent nature of Dragon-Lei fire, transmission to the Large Intestine lacks time for conduction, resulting in urgent, direct diarrhea. Treatment seems to require addressing the Kidney first; however, unless Stomach fire is drained, Kidney fire will never retreat. If one hastily drains Stomach fire, the Earth of the Stomach collapses due to fire, and Stomach Water drains with the Earth, unable to reach a stopping point. One must first strengthen the Earth and separate/drain the Water. Then, clear Water strengthens Earth, Fire calms, and Dragon-Lei fire becomes easier to store. Use Huan Liu Tang (Slow Flow Decoction):
Fu Ling (1 liang) Qian Shi Shan Yao (each 3 liang) Che Qian Zi (5 qian) Yi Yi Ren (1 liang) Gan Cao (1 qian)
Ren Shen (1 liang) Wu Wei Zi (1 qian)
Every herb in this formula strengthens Earth, and every herb promotes water drainage. Yet, within water drainage, Qi is not dispersed; lower-moving Qi does not scatter, and upper fire naturally rises and dissipates. Moreover, herbs that strengthen Earth are essentially tonifying the Kidney. Tonifying the Kidney generates True Yin, and Dragon-Lei fire naturally returns to the Kidney. Once Kidney fire is calm, Stomach fire loses its allies; with strong Stomach Earth, water and grain Qi are easily separated and transformed, naturally leading to reduced fire and stopped diarrhea.
Using Hua Ling Tang (Slippery Talcum Decoction) for this condition is also very effective.
Hua Shi Fu Ling (each 1 liang, ground into powder together, taken mixed with well water to stop immediately.)
A person with dry mouth and tongue, red face and eyes, prone to joy and laughter, is assumed by others to have extreme Heart fire. Who knows it is actually intense fire in the Pericardium and Danzhong (Conception Vessel source area)? Fire in the Pericardium is Ministerial Fire, which is Deficient Fire. Danzhong is the official of the messenger, where joy originates; thus, Danzhong is the assistant to the Heart, executing rewards and punishments on behalf of the Heart. Joy and anger are manifestations of rewards and punishments. If the Heart's spirit is bright, rewards and punishments are just; if the Heart is chaotic, rewards and punishments shift. It is like a subordinate usurping the superior's authority to execute personal joys and angers. Over time, forgetting their lower status, they use personal emotions as judgments for those below. Treatment should drain Pericardium fire. However, draining Pericardium fire inevitably damages the Heart. Heart deficiency leads to weaker Pericardium Qi, causing Pericardium fire to surge further. It is better to specifically tonify the Heart. When Heart Qi is sufficient, Pericardium fire naturally stays in its position and does not flare up to the mouth, tongue, face, and eyes, causing uncontrolled laughter. Use Gui Pi Tang (Restore the Spleen Decoction):
Ren Shen (3 qian) Fu Shen (3 qian) Chao Zao Ren (5 qian) Yuan Zhi (1 qian) Mai Dong (3 qian) Shan Yao (3 qian) Dang Gui (3 qian)
Guang Mu Xiang powder (3 fen) Huang Qi (2 qian) Gan Cao (3 fen) Decoct in water and take. After one dose, facial redness decreases; after two doses, mouth and tongue dryness disappears; after three doses, symptoms of easy joy and laughter subside.
This formula tonifies Heart Qi deficiency, which still addresses Pericardium fire. Why does fire subside when supplemented? One must know that Heart fire is treated by draining to achieve tonification, while Pericardium fire is treated by tonifying to achieve draining. Pericardium fire surges due to the decline of Heart Sovereign Qi. Tonifying the Heart prevents the Pericardium from usurping power, so how dare it laugh and act arrogantly, infringing upon the Monarch?
Using Shen Shu Er Ren Tang (Ginseng, Atractylodes, and Two Seeds Decoction) for this condition is also effective.
Ren Shen Fu Shen Chao Zao Ren (each 3 qian) Bai Zhu (5 qian) Yuan Zhi Ban Xia (each 1 qian) Sha Ren (2 grains) Decoct in water and take.
Black blood flowing continuously from the nose is called Nu Xue (epistaxis), indicating extreme Heart heat, where Fire punishes Lung Metal. Lung Metal is controlled by Heart Fire, so red blood should appear, not black. Could it be suspected as Kidney Fire punishing the Mother (Lung)? The Kidney is the child of Lung Metal; how can a child kill its mother? However, black blood is indeed the color of the Kidney. Excessive Heart Fire transfers heat to the Lung; suffering fire punishment, the Lung seeks help from the Kidney. Disliking Heart Fire's attack on its mother, the Kidney exerts full strength to control Heart Fire. But Heart Heat has already moved to the Lung. The Kidney follows the fire into the Lung, angry at Heart Fire's cruelty, fighting together. The Lung has nowhere to hide; the Kidney drives blood out through the nose, turning red blood black. It resembles an irreconcilable hatred, scorching heads and broken foreheads, darkening the day. Treatment requires solely draining Heart Fire, not draining Kidney Water. When fire subsides, Metal is safe; when Metal is safe, why would Kidney Water fight the Heart? Use Jiu Nu Dan (Save Epistaxis Pill):
Huang Lian (2 qian) Dan Pi (3 qian) Fu Ling (2 qian) Mai Dong (5 qian) Xuan Shen (1 liang) Sheng Zao Ren (3 qian)
Sheng Di (3 qian) Bai Zi Ren (1 qian) Decoct in water and take. Using for two consecutive doses stops black blood; four doses prevent recurrence.
This formula controls excess Heart Fire without damaging insufficient Heart Qi. Seeing the decline of Sovereign Fire and the prosperity of Lung Metal, the Kidney's revenge is satisfied, and restoration plans are formed. Naturally, troops return; why pursue the desperate enemy again? Some argue that since the Heart Sovereign was injured by the Kidney child, Heart Qi must be damaged, requiring urgent draining of Kidney Qi to prevent pursuit. Why drain Heart to aid tyranny? One must know Kidney Water is originally not in excess; it acted recklessly due to the distress of Lung Mother. Attacking the Kidney child due to Heart Fire's provocation is unreasonable. Moreover, although this formula drains Heart Fire, it does not diminish Heart Qi; named "draining Heart" but actually "tonifying Heart." It merely alleviates inflammation to vent Kidney child's resentment, resolving the fire. Since the Kidney is only tonified, never drained, is it not better to drain Heart Fire?
Using Sheng Di Dong Qin Tang (Rehmannia, Ophiopogon, and Scutellaria Decoction) for this condition:
Mai Dong Sheng Di (each 2 liang) Huang Qin (3 qian) Decoct in water and take.
A person with extreme heat causing macules, resembling a patch of red clouds on the body, is thought to be extreme internal heat manifesting on the skin. Who knows this heat is stagnated internally and cannot vent outward? For such diseases, neither cold nor hot medicines are appropriate. Heat-Fire suits cool medicines; internal fire usually vents outward. But fire closed by cold prevents slight fire from being resolved by cold, and strong fire cannot be broken by cold. Often, obtaining cold flavors suppresses the mechanism of outward venting, causing blockage and failure to vent, potentially leading to untreatable madness. Using hot medicine feeds fire with fire, intensifying severity, inevitably leading to collapse of Yang. Treatment must employ harmonization.
Since excessive fire implies deficient Water, merely resolving fire without supplementing Water may not disperse fire quickly. One should use methods to disperse fire within water-supplementing formulas, avoiding dryness and facilitating venting. Use Feng Shui San Ban Tang (Wind-Water Macule-Dispersing Decoction):
Xuan Shen (2 liang) Dang Gui (2 liang) Jing Jie (3 qian) Sheng Ma (1 qian) Sheng Di (1 liang) Decoct in water and take. After one dose, macules decrease slightly; after two, more decrease; after three, completely gone.
Xuan Shen nourishes Yin to resolve floating fire; Dang Gui and Sheng Di nourish Heart and Stomach blood. Using more Jing Jie and Sheng Ma (wind herbs) to disperse stagnant heat allows fire to be controlled by water and easily dispersed by wind. Without any fire-draining herbs, fire-draining effects are achieved, holding profound meaning.
Using Hua Yun Tang (Cloud-Dissolving Decoction) for this condition is also miraculous.
Huang Lian (3 qian) Dang Gui (1 liang) Xuan Shen (2 liang) Sheng Ma (2 qian) Decoct in water and take.
Extreme heat causing macules, protruding eyes, and cold hands indicates internal Heart heat, known as "excess causes harm," unaware that Liver Fire assists it. Febrile diseases should show heat signs; why cold symptoms? Because extreme fire resembles water. Extreme heat in the Heart draws blood from limbs to rescue the Heart, leaving no blood to nourish hands and feet, hence cold extremities. Extreme external cold stems from extreme internal heat. Protruding eyes occur because the Liver opens into the eyes, and the outer canthus is the opening of the Heart. With盛 Heart Fire assisted by Wood fire, flames rise, rushing to the openings. Since eye openings are small and cannot vent fire fully, anger touches the eyes, causing protrusion. Treatment should drain Heart Fire and calm Liver Wood. Once Wood Qi is relaxed, Heart Fire disperses. Modify Feng Shui San Ban Tang, and the condition heals itself.
Xuan Shen (1 liang) Dang Gui (1 liang) Huang Lian (3 qian) Jing Jie (3 qian) Sheng Ma (3 qian) Bai Shao (1 liang)
Sheng Di (5 qian) Decoct in water and take.
Adding Bai Shao and Huang Lian: Huang Lian drains Heart Fire, Bai Shao calms Liver Fire. Jing Jie and Sheng Ma guide herbs into the interstices, eliminating residual heat above, below, and around, without suppressing fire or risking unattained meridians. This formula emphasizes tonification over attacking, dispersing fire without depleting True Qi, achieving balance.
Using Xuan Dan Sheng Ma Tang (Xuan Shen, Moutan, and Cimicifuga Decoction) for this condition is also highly effective.
Xuan Shen (8 liang) Dan Pi (3 liang) Sheng Ma (3 qian) Decoct in one bowl of water; cure after one dose.
Extreme heat preventing deep sleep, eyes open day and night, is assumed to be Heart-Kidney non-interaction due to excess fire. Who knows it is due to dual deficiency of Water and Fire? Heart Fire fears Kidney Water's control but loves Kidney Water's generation, as Fire needs Water to nourish it. Kidney Water loves Heart Fire's generation but dislikes Heart Fire's burning, as Water needs Fire to dry it. When Heart and Kidney love each other, they interact; when they dislike each other, they oppose. Seeking sleep with spirit wandering in dreams becomes impossible. Treatment should tonify Heart fluids to descend to Kidney; tonify Kidney essence to ascend to Heart; regulate Liver Qi to mediate between Heart and Kidney, turning dislike into love, so opposition turns to interaction. Use Yin Jiao Tang (Guide Interaction Decoction):
Shu Di Mai Dong (each 1 liang) Chao Zao Ren Shan Zhu Yu Sha Shen (each 5 qian) Fu Shen (3 qian) Xuan Shen (5 qian)
Bai Shao (2 liang) Chao Zhi Zi (3 qian) Shi Pu Po Gu Zhi (each 5 fen) Decoct in water and take. Sleeping soundly with eyes closed after two consecutive doses.
This formula tonifies both Heart and Kidney, calms Liver Qi, and clears Wood fire. Draining Liver Fire calms Heart Fire and boosts Kidney Water. Heart Qi connects to Liver, and Kidney Qi connects to Liver. With Shi Pu guiding Heart and Po Gu Zhi guiding Kidney, introducing them together restores harmony, re-establishing the connection between wakefulness and sleep.
Using Shui Huo Liang Zi Tang (Water and Fire Dual-Nourishing Decoction) for this condition is also effective.
Shu Di (3 liang) Rou Gui (2 qian) Tu Si Zi (1 liang) Decoct in water and take.
Liver Fire stagnated internally, causing oppression, irritability, and vomiting yellow phlegm clumps, is assumed to require dispersion of stagnant fire. Yet dispersion makes fire fiercer because Liver and Kidney were not treated simultaneously. Liver Wood has fire; stagnant fire not released is due to external pathogens covering it or internal lack of Water to moisten it. Without Water moisture, Wood stagnation worsens. Using only wind herbs to resolve Liver fire without moistening agents dries Liver Blood, increasing fire. Using only moistening agents to benefit Liver Water without wind herbs to soothe Liver fire suppresses Liver Qi, deepening stagnation. Deep stagnation causes mental oppression; excess fire causes abdominal restlessness. How can phlegm transform? Treatment should soothe Liver to resolve fire and tonify Kidney to assist Water. Naturally, stagnation resolves and symptoms heal. Use Gan Shen Liang Shu Tang (Liver-Kidney Dual-Soothing Decoction):
Shu Di Xuan Shen (each 1 liang) Fu Ling (3 qian) Bai Shao (1 liang) Chai Hu (1 qian) Dang Gui (5 qian) Gan Cao Chao Zhi Zi (each 1 qian) Dan Pi (3 qian) Decoct in water and take. Symptoms lighten after two doses, fully healed after four.
Dang Gui, Bai Shao, Chai Hu, Zhi Zi soothe Liver (wind blows); Shu Di, Xuan Shen, Dan Pi tonify Kidney (rain irrigates). Fu Ling and Gan Cao harmonize both, ensuring wind and rain are neither excessive nor insufficient. Like summer heat causing extreme depression and heat, trees withering, suddenly receiving gentle breeze and heavy rain, previous oppressive, scorching air is swept away, withered trees turn green instantly, refreshing air greets people. How could oppression and irritability remain?
Using Kuai Ge Tang (Rapid Diaphragm Decoction) for this condition is also effective.
Bai Shao Dang Gui Shu Di (each 1 liang) Chai Hu Gan Cao (each 1 qian) Sheng Di Mai Dong (each 3 qian) Zhi Ke Ban Xia (each 3 qian) Decoct in water and take.
Red and swollen head and face, with cyan color appearing below the navel, extreme thirst, seeming madness, is assumed to be upper heat and lower cold. Who knows it is extreme lower heat pretending to be wind phenomena to deceive? Treating as upper heat/lower cold causes immediate madness and death, with flesh rotting. This disease results from mistakenly listening to alchemists, taking mineral drugs (Stone/Metal pills) to boost Mingmen Fire, promoting strong yang combat and fleeting pleasure. Mineral drugs undergo firing, possessing dry and fierce nature. Coupled with vigorous sexual activity, fire moves. Prolonged struggle leads to extreme pleasure and intense emotion, causing massive semen loss, double the normal amount. Extreme fire consumes essence; doubling semen loss exhausts Water. Repeatedly doing this brings worry of Yin deficiency and Fire movement. People, lost and unawakened, rely on secret recipes, treating killing drugs as elixirs, swallowing daily without stop. Organs become pure Fire Qi. Although diet is abundant, Fire easily consumes, failing to generate essence and transform water. Thus, Fire without Water restraint rises to the head and face. Initially slightly red, eventually purely red and swollen. Below the navel, showing cyan instead of red: cyan is the color of Wind-Wood. The area below the navel belongs to Kidney. Kidney Fire prosperous and Kidney Water dry means Liver Wood has no nourishment. Liver Qi becomes uneasy, seeking below in Kidney. But Kidney is strong; with blazing fire, Liver Qi wants to return to its palace but is too dry to return, wandering to Kidney area, manifesting cyan externally. Such symptoms are not mentioned in *Neijing*, no wonder people don't recognize them. With such rebellious Liver Qi and rising Fire, how can thirst not exist? Drinking water saves Stomach dryness but cannot save Five Zang dehydration. Drinking makes thirst worse; how can one not go mad? Treatment must greatly tonify Water, not greatly drain Fire. Draining Fire extinguishes Fire but exhausts Water, leading to death. Use Jiu Fen Jie Du Tang (Save Burning Detoxifying Decoction):
Shu Di (4 liang) Xuan Shen (2 liang) Mai Dong (3 liang) Bai Shao (3 liang) Jin Yin Hua (3 liang) Gan Ju Hua (5 qian)
Niu Xi (1 liang) Huang Bo (1 qian)
Decoct in water and take. Several consecutive doses remove cyan color below; several more doses gradually heal red/swollen head/face. Halving the dose requires one month of continued intake to avoid carbuncle dangers.
Extreme heat turning red is a dire omen; showing cyan is extremely dire. Fortunately, above the navel is not cyan. If cyan appears, internal organs and intestines rot, external sores and toxins arise; life is impossible. Ancient sages did not discuss this because ancient people were tranquil and mild, never taking mineral poisons. Later generations are licentious, seeking aphrodisiacs like candy, while alchemists only know how to please the wealthy.