典藏书目

Fire is the state of Qi losing its balance. If the five Zang and six Fu organs each maintain their balance, then Ying (Nutritive) and Wei (Defensive) Qi will be harmonious, and meridians will flow smoothly; how could there be fire?

(It is said that this formula originated from the fire agent of Tai Cang Gong, Cui used it to treat Commander Liu, and it is also claimed to be self-made by him.)
It treats all kinds of heat-fire syndromes where both exterior and interior heat are flourishing, characterized by mania, restlessness, vexation, dry mouth and throat, high fever with dry retching, confused speech, insomnia, hematemesis, epistaxis, and macules due to extreme heat toxicity (Toxicity refers to fire pathogen. When pathogen enters Yang channels, mania occurs; when the Heart is disturbed by heat, vexation arises; restlessness is severe vexation; dry mouth and throat indicate excessive fire depleting body fluids; dry retching indicates upward reversal of heat toxin; confused speech indicates heat clouding the spirit; insomnia indicates Yin failing to restore; in Shanghan [Cold Damage] cases with hematemesis or epistaxis, it is because sweating was indicated but not performed, causing accumulated heat to force blood upward; macules indicate heat toxin entering the Stomach). Minister Cui stated: Dry feces in the Stomach can cause confused speech, and excessive pathogenic heat can also cause confused speech; if confused speech is due to constipation, Chengqi Tang is appropriate; if it persists after bowel movement, Huanglian Jiedu Tang is appropriate.

Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus), in equal proportions.
These are herbs for the Hand and Foot Yangming meridians and the Hand Shaoyang meridian. With accumulated heat in the Sanjiao [Triple Burner] and reckless wandering of pathogenic fire, Huangqin is used to clear Lung fire in the Upper Jiao, Huanglian to clear Spleen fire in the Middle Jiao (Wang Haicang said: Huanglian clears Heart fire, but actually clears Spleen fire, as the child can make the mother full, and excess should be drained by treating the child), Huangbai to clear Kidney fire in the Lower Jiao, and Zhizi to unblock and drain... [Text fragmentary here, context implies draining fire from the three Jiaos].

Removing Zhizi from this formula yields Bopi Tang: It treats solid heat in the Sanjiao. Made into pills with congee, it is called Sanbu Wan: It treats fire in the Sanjiao causing dry throat and difficulty in urination and defecation, as well as night fever due to damp-phlegm (The Classic states: Vigorous fire consumes Qi, mild fire generates Qi. Therefore, mild fire should be ascending, while vigorous fire should be descending. Now, using Huangqin to clear the upper, Huanglian to clear the middle, and Huangbai to clear the lower allows vigorous fire to descend and mild fire to ascend, Qi to generate, Blood to nourish, benefiting all three Jiaos).

Removing Huangqin and Huanglian and adding Gancao (Licorice Root) yields Zhizi Bapi Tang (Formula by Zhang Zhongjing): It treats yellowing of the skin and fever in Shanghan [Yellow Fever/Jaundice due to Cold Damage] (Yellowing is due to stagnant heat in the Stomach, requiring purgation. Fever indicates the heat has not yet formed a solid mass. In cold-damp syndromes, heat is hard to obtain; once obtained, the pathogenic tendency moves outward rather than inward, so sweating and diuresis are unnecessary. Zhizi clears heat from the muscle layer, Huangbai drains the Bladder to harmonize. Note: Jaundice in Shanghan may involve the Taiyang Bladder channel or Yangming stagnant heat in the Stomach, which are different. Thus, Zhang Zhongjing also stated that some cases cannot be purged and should be sought within cold-damp treatments; if stagnant heat is in the interior, formulas like Mahuang Lianqiao Chixiaodou Tang for sweating and diuresis may be used, see Shanghan Lun).

Removing Huangbai and Zhizi and adding Dahuang (Rhei Radix et Rhizoma) soaked in wine yields Sanhuang Xiexin Tang (from Jin Gui Yao Lue): It treats epigastric fullness and heat, insufficiency of Heart Qi, hematemesis, and epistaxis. Dahuang steamed and sun-dried nine times in wine, made into honeyed pills, is called Sanhuang Wan: It treats accumulated heat in the Sanjiao, swelling and pain of the head and neck, red eyes and mouth ulcers, chest irritability, constipation, dark scanty urine, and Xiao Ke [Wasting-Thirst] with emaciation (Xiao Ke and emaciation result from fire flaring and water drying up). A question arose: Why drain the Heart instead of tonifying it when Heart Qi is insufficient leading to bleeding? Zhu Danxi said: Insufficiency of Shaoyin leads to unrestrained Yang lacking support, causing reckless movement of Yin Blood; thus Dahuang is used to drain the harmful fire. Since the Heart is originally insufficient and the Lung and Liver suffer from fire pathogens, Huangqin saves the Lung and Huanglian saves the Liver. The Lung is the master of Yin, and the Liver is the Mother of the Heart and the residence of Blood. When Lung and Liver fire recede, blood returns to its vessels and settles naturally. Kou Zongshi said: Using bitter herbs to drain heat is also using them to tonify the Heart, achieving two goals with one move. Wu Hegao said: Treating disease requires seeking the root. For bleeding caused by Yang toxin attacking upward, heat is the root and blood is the branch; removing heat allows blood to return to vessels without specific hemostatic treatment. Li Shicai said: The ancients' use of Dahuang for consumptive hematemesis was profound, because if turbid Yin does not descend, clear Yang cannot transform; if stasis does not resolve, new blood cannot generate. Wang Ang notes: This applies to bleeding from external contraction transferring heat; if used mistakenly for internal deficiency-cold bleeding, it would be fatal. Yang Renzhai said: Blood flows freely when heated, so cooling herbs are often used for hemostasis; however, there are cases of Qi deficiency with cold, or deficient and scattered Ying Qi causing erratic blood flow, known as Yang deficiency leading to Yin loss. The method should be warming the Middle to let blood return to vessels naturally, suitable formulas include Lizhong Tang plus Muxiang, Qi Qi Tang plus Chuanxiong, or Gancao Ganjiang Tang, which are very effective.

Adding Shigao (Gypsum Fibrosum), Danshi (Fermented Soybean), and Mahuang (Ephedrae Herba) to this formula yields Sanhuang Shigao Tang (See Exterior-Interior section).
Making pills with water yields Sanhuang Jinhua Wan: It treats various internal and external heat syndromes, night sweats, teeth grinding, dream-disturbed speech, palpitations, hematemesis, stranguria, retention, chronic cough, and bone-steaming consumption.
Adding Dahuang yields Zhizi Jinhua Wan; removing Zhizi and adding Dahuang yields Da Jinhua Wan: It treats similar symptoms.