（《局方》）
治肝胆经实火湿热，胁痛耳聋，胆溢口苦，筋痿阴汗，阴肿阴痛，白浊溲血（胁者，肝
胆之部也，火盛故作痛；胆脉络于耳，故聋；肝者，将军之官也，谋虑出焉。胆者，中正之
官也，决断出焉。胆虚故谋虑而不能决；胆气上溢，故口为之苦；肝主筋，湿热胜故筋痿；
肝脉络
龙胆草（酒炒） 黄芩（炒） 栀子（酒炒） 泽泻 木通 车前子 当归（酒洗） 生
地黄（
此足厥阴、少阳药也。龙胆泻厥阴之热（肝），柴胡平少阳之热（胆），黄芩、栀子清肺
与三焦之热以佐之；泽泻泻肾经之湿，木通、车前泻小肠、膀胱之湿以佐之；然皆苦寒下泻
之药，故用
东垣∶无黄芩、栀子、甘草，亦名龙胆泻肝汤∶治前阴热痒臊（臭此因饮酒，风湿热合
于下焦为邪，厥阴肝脉络于阴器，柴胡入肝为引，泽泻、车前、木通利小便，亦除臊气，所
谓在下
一方除当归、生地、木通、泽泻、车前，加人参、五味、天冬、麦冬、黄连、知母，亦
名龙胆泻肝汤∶治筋痿挛急，口苦爪枯；亦治前证（加人参者，扶土所以抑木；用二冬、五
味者，清金亦以平木，润燥所以养筋；用黄连、知母者，上以泻心火，下以泻肾火，一为肝
子，一
（又名茱连丸）
治肝火燥盛，左胁作痛，吞酸吐酸，筋疝痞结（肝火盛，则胁痛；吞酸吐酸，亦由肝火上
干肺
厥阴之脉络阴器，寒湿干之，则成筋疝；肝木过盛，克制脾土，
则成痞结）；亦治噤口痢，汤药入口即吐（本方加糯米一撮，浓煎，但得三匙下咽，即不得
吐矣）。
黄连（六两，姜汁炒） 吴茱萸（一两，盐水泡。）水丸。
此足厥阴药也。肝实则作痛，心者，肝之子，实则泻其子，故用黄连泻心清火，为君，
使火不
以为反佐；一寒一热，寒者正治，热者从治（以热治热，从其性而治之，亦曰反治），故能
相济以立功也。肝居于左，肺处于右，左金者，谓使金令得行于左而平肝也李（东垣曰∶病
机曰∶诸呕吐酸，皆属于热。此上焦受外来客邪也。以杂病论之，呕吐酸水者，甚则酸水浸
其心，次令牙酸不能相对，以大辛热剂疗之必减，若以病机作热攻之，误矣。或问吞酸《素
问》以为热，东垣以为寒，何也，丹溪曰∶吐酸与吞酸不同，吐酸，吐出酸水如醋，平时津
液随上升之气郁而成积，湿中生热，故随木化，遂作酸味，非热而何；其有郁之久伏于肠胃
之间，咯不得上，咽不得下，肌表得风寒，则内热愈郁，而酸味刺心，肌表温暖，腠理开发，
或得香热汤丸，津液得行，亦可暂解，非寒而何。《素问》言热，言其本也；东垣言寒，言
其末也。余尝治吞酸用黄连茱萸制炒，随时令选为佐使，苍术、茯苓为辅，汤浸蒸饼为丸吞
之，仍教 食蔬果自养，则病易安。丹溪之论，亦未畅尽，总之，此证有寒有热，不可执一。
戴氏曰∶房劳肾虚之人，胸膈多有隐痛，此肾虚不能纳气，气虚不能生血之故，气与血犹水
也，盛则流畅，虚则鲜有不滞者，所以作痛，宜破故纸之类补肾，芎归之类补血，若作寻常
胁痛治，则殆矣）。
本方加炒芩、苍术、陈皮，亦名茱连丸∶治同。本方加芍药等分，为丸，名戊己丸∶治
热痢热泻（热泻者，粪黄肛涩也。戊为胃土，己为脾土，加芍药伐肝泻木，使不克脾土）。
本方除吴茱萸，加附子一两，名连附六一汤∶治胃脘痛，寒因热用也。本方用黄连一味，吴
茱萸汤浸
（出自《太平惠民和剂局方》）
治疗肝胆经实火湿热证，症状包括胁痛、耳聋、胆气上溢导致口苦、筋痿、阴部出汗、阴囊肿痛、白浊、尿血。（胁部是肝胆所在的部位，火热旺盛所以产生疼痛；胆的经络联络耳朵，所以耳聋；肝被称为将军之官，主谋虑。胆被称为中正之官，主决断。胆虚则虽有谋虑但不能决断；胆气上溢，所以口中发苦；肝主筋，湿热胜则导致筋痿；肝的经络……[原文此处中断]
龙胆草（酒炒）、黄芩（炒）、栀子（酒炒）、泽泻、木通、车前子、当归（酒洗）、生地黄（……[原文此处中断]
这是足厥阴肝经和足少阳胆经的药。龙胆草泻厥阴肝经的热（肝），柴胡平少阳胆经的热（胆），黄芩、栀子清肺与三焦的热来辅助；泽泻泻肾经的湿，木通、车前子泻小肠、膀胱的湿来辅助；然而这些都是苦寒下泻的药物，所以用……[原文此处中断]
李东垣：没有黄芩、栀子、甘草，也叫龙胆泻肝汤：治疗前阴热痒臊臭（这是因为饮酒，风湿热合于下焦成为邪气，厥阴肝经的经络联络阴器，柴胡入肝作为引经药，泽泻、车前子、木通利小便，也能去除臊气，所谓在下……[原文此处中断]
另一方去掉当归、生地、木通、泽泻、车前子，加入人参、五味子、天冬、麦冬、黄连、知母，也叫龙胆泻肝汤：治疗筋痿挛急、口苦指甲枯槁；也治疗上述症状（加入人参，是为了扶持脾土从而抑制肝木；使用天冬、麦冬、五味子，是为了清金从而平抑肝木，润燥以养筋；使用黄连、知母，是为了上泻心火，下泻肾火，一个是肝之子……[原文此处中断]
治疗肝火燥盛，左侧胁肋作痛，吞酸吐酸，筋疝痞结（肝火旺盛，则胁痛；吞酸吐酸，也是由于肝火上干肺……[原文此处中断]
厥阴肝经的经络联络阴器，寒湿侵犯它，则形成筋疝；肝木过盛，克制脾土，则形成痞结）；也治疗噤口痢，汤药入口即吐（本方加糯米一撮，浓煎，只要得三匙咽下，就不会再吐了）。
这是足厥阴肝经的药。肝实则作痛，心是肝之子，实证泻其子，所以用黄连泻心清火，作为君药，使火不……[原文此处中断]
作为反佐；一寒一热，寒者是正治，热者是从治（以热治热，顺从其性质而治疗，也称为反治），所以能相互济助而立功。肝居于左边，肺处于右边，左金的意思是，使金的令行得以运行于左而平抑肝木。李东垣说：病机论中说：各种呕吐酸水，都属于热。这是上焦受外来客邪所致。从杂病角度论述，呕吐酸水的，严重时酸水浸渍心脏，其次导致牙齿酸软不能相对，用大辛热的药剂治疗必定减轻，如果按照病机论当作热证来攻伐，就错了。有人问吞酸，《素问》认为是热，李东垣认为是寒，为什么呢？朱丹溪说：吐酸与吞酸不同，吐酸，吐出酸水像醋一样，平时津液随着上升之气郁结而成积，湿中生热，所以随木化，遂作酸味，这不是热是什么；有的郁结日久潜伏在肠胃之间，咯不得上，咽不得下，肌表受风寒，则内热更加郁结，而酸味刺心，肌表温暖，腠理开发，或者得到香热汤丸，津液得以运行，也可以暂时缓解，这不是寒是什么。《素问》说热，说的是本质；李东垣说寒，说的是表象。我曾经治疗吞酸用黄连茱萸制炒，根据时令选择为佐使，苍术、茯苓为辅，汤浸蒸饼为丸吞服，仍教导食用蔬果自我调养，则病容易安宁。丹溪的论述，也没有详尽无遗，总之，此证有寒有热，不可固执一端。戴氏说：房劳肾虚之人，胸膈多有隐痛，这是肾虚不能纳气，气虚不能生血的缘故，气与血就像水一样，盛则流畅，虚则鲜有不滞者，所以作痛，宜用破故纸之类补肾，芎归之类补血，如果当作寻常胁痛治疗，那就危险了）。
本方加炒黄芩、苍术、陈皮，也叫茱连丸：治疗同症。本方加芍药等分，制成丸，名戊己丸：治疗热痢热泻（热泻者，粪便黄肛门涩滞。戊为胃土，己为脾土，加芍药伐肝泻木，使不克脾土）。
(From *Tai Ping Hui Min He Ji Ju Fang*)
Treats excess fire and damp-heat in the Liver-Gallbladder meridians, with symptoms including hypochondriac pain (胁痛), deafness (耳聋), bitter taste in the mouth due to Gallbladder Qi reflux (胆溢口苦), sinew atrophy (筋痿), sweating in the genital area (阴汗), swelling and pain of the genitals (阴肿阴痛), white turbidity (白浊), and hematuria (溲血). (The hypochondrium is the region of the Liver and Gallbladder; excess fire causes pain; the Gallbladder meridian connects to the ear, hence deafness; the Liver is called the General, governing strategy and planning. The Gallbladder is called the Official of Justice, governing decision-making. Deficiency of the Gallbladder leads to inability to decide despite having plans; upward reflux of Gallbladder Qi causes bitterness in the mouth; the Liver governs the sinews; damp-heat dominance leads to sinew atrophy; the Liver meridian... [text interrupted here])
Long Dan Cao (Gentianae Radix, wine-fried), Huang Qin (Scutellariae Radix, fried), Zhi Zi (Gardeniae Fructus, wine-fried), Ze Xie (Alismatis Rhizoma), Mu Tong (Akebiae Caulis), Che Qian Zi (Plantaginis Semen), Dang Gui (Angelicae Sinensis Radix, wine-washed), Sheng Di Huang (Rehmanniae Radix Recens)... [text interrupted here]
This acts on the Foot-Jueyin Liver meridian and Foot-Shaoyang Gallbladder meridian. Long Dan Cao drains heat from the Jueyin Liver (Liver); Chai Hu pacifies heat in the Shaoyang Gallbladder (Gallbladder); Huang Qin and Zhi Zi clear heat from the Lung and Sanjiao to assist; Ze Xie drains dampness from the Kidney meridian; Mu Tong and Che Qian Zi drain dampness from the Small Intestine and Bladder to assist; however, these are all bitter-cold purgative drugs, so use... [text interrupted here]
Li Dongyuan: Without Huang Qin, Zhi Zi, and Gan Cao, it is also named Long Dan Xie Gan Tang: Treats itching and foul odor in the anterior yin (This is caused by drinking alcohol, where wind-damp-heat combines in the Lower Jiao as pathogenic factors; the Foot-Jueyin Liver meridian connects to the genital organs; Chai Hu enters the Liver as a guiding herb; Ze Xie, Che Qian Zi, and Mu Tong promote urination, also removing the foul odor, as stated in "Below"... [text interrupted here])
Another prescription removes Dang Gui, Sheng Di Huang, Mu Tong, Ze Xie, and Che Qian Zi, adding Ren Shen, Wu Wei Zi, Tian Dong, Mai Dong, Huang Lian, and Zhi Mu, also named Long Dan Xie Gan Tang: Treats sinew atrophy with spasms and tightness, bitter taste in the mouth, and withered nails; also treats the above conditions (Adding Ren Shen supports Earth to suppress Wood; using Tian Dong, Mai Dong, and Wu Wei Zi clears Metal to level Wood, moistens dryness to nourish sinews; using Huang Lian and Zhi Mu clears Heart Fire upwards and Kidney Fire downwards; one is the Son of the Liver, one... [text interrupted here])
(Also known as Zuo Jin Wan / Zhu Lian Wan)
Treats excessive dryness and heat of Liver Fire, pain in the left hypochondrium, acid regurgitation (吞酸吐酸), sinew hernia (筋疝), and epigastric fullness/mass (痞结) (Excess Liver Fire causes hypochondriac pain; acid regurgitation is also due to Liver Fire harassing the Lung... [text interrupted here]).
The Jueyin Liver meridian connects to the genital organs; invasion by cold-dampness leads to sinew hernia; excessive Liver Wood overacting on Spleen Earth leads to epigastric fullness/mass); also treats dysentery with inability to swallow food (Jin Kou Li), where decoctions are vomited immediately upon entry (Add a pinch of glutinous rice to this formula, decoct strongly; if three spoonfuls can be swallowed without vomiting, it will stop).
Huang Lian (6 liang, stir-fried with ginger juice), Wu Zhu Yu (1 liang, soaked in salt water). Make into water pills.
This acts on the Foot-Jueyin Liver meridian. Liver excess causes pain; the Heart is the Son of the Liver; for excess syndromes, drain the Son; thus, Huang Lian is used to drain Heart and clear fire, serving as the Sovereign herb, preventing fire from... [text interrupted here]
As a counter-agent; one cold and one hot, cold is the direct treatment, hot is the contrary treatment (treating heat with heat, following its nature to treat it, also called contrary treatment), so they can assist each other to achieve efficacy. The Liver resides on the left, the Lung is on the right; "Zuo Jin" means enabling the Metal command to circulate on the left to pacify the Liver. Li Dongyuan said: The *Nei Jing* states that various types of vomiting acid belong to heat. This is due to external pathogens affecting the Upper Jiao. Discussing from the perspective of miscellaneous diseases, severe cases of vomiting acid involve acid soaking the Heart, followed by sour teeth unable to meet; treating with large acrid-hot agents reduces it. If treated as heat according to the *Bing Ji*, it is an error. Someone asked why *Su Wen* considers acid regurgitation as heat, while Li Dongyuan considers it cold? Zhu Danxi said: Vomiting acid (Tu Suan) differs from swallowing acid (Tun Suan). Vomiting acid involves expelling sour fluid like vinegar; normally, body fluids accumulate due to rising Qi stagnation, generating heat within dampness, transforming via Wood, thus becoming sour—is this not heat? In some cases, stagnation lies deep in the intestines and stomach for a long time, unable to be coughed up or swallowed; when the skin surface is affected by wind-cold, internal heat becomes more stagnant, and the sour taste pierces the heart; when the skin surface is warm and pores open, or after consuming aromatic-hot soups/pills, body fluids move, providing temporary relief—is this not cold? *Su Wen* speaks of heat regarding the root; Li Dongyuan speaks of cold regarding the branch. I once treated swallowing acid using Huang Lian and Zhu Yu prepared by stir-frying, selecting assistants according to seasons, with Cang Zhu and Fu Ling as辅 (supporting herbs), made into pills with steamed dough soaked in soup, and advised eating vegetables and fruits for self-care, leading to easier recovery. Danxi's discussion was not exhaustive; ultimately, this syndrome has both cold and heat aspects, and one should not adhere rigidly to one view. Dai Shi said: People with Kidney deficiency due to sexual exhaustion often have dull pain in the chest and diaphragm; this is because Kidney deficiency fails to grasp Qi, and Qi deficiency fails to generate Blood. Qi and Blood are like water; when abundant, they flow smoothly; when deficient, stagnation is inevitable, causing pain. It is appropriate to use Gu Bu Zhi to tonify the Kidney, and Xiong Gui to tonify Blood. If treated as ordinary hypochondriac pain, it would be dangerous.)
Adding Chao Huang Qin, Cang Zhu, and Chen Pi to this formula is also named Zhu Lian Wan: Treats the same condition. Adding equal parts of Bai Shao to this formula and making pills is named Wu Ji Wan: Treats heat dysentery and heat diarrhea (Heat diarrhea features yellow stool and a涩 sensation in the anus. Wu represents Stomach Earth, Ji represents Spleen Earth; adding Bai Shao attacks Liver and drains Wood, preventing it from overacting on Spleen Earth).
Removing Wu Zhu Yu and adding 1 liang of Fu Zi to this formula is named Lian Fu Liu Yi Tang: Treats epigastric pain, utilizing heat to treat cold (Han Yin Re Yong). Using only Huang Lian from this formula, soaked in Wu Zhu Yu Tang... [text interrupted here]