假火者，内虚寒而外见火证也。脉必微细，即见洪大，内必空虚。皆宜温补，八味、十
验案
一人眼痛，大便闭，已服大黄半斤，眼痛稍减，大便或溏或闭，以为真火，清凉二月，
口干
之，曰∶此内伤不足，再用寒凉必死矣。病者曰∶吾乃火也，不从而返。六月复邀予诊视，
余仍前说。病者曰∶吾真火也，又返。未几，又邀余诊，其病已危，予再仍前说，病者姑试
之。用保元汤加附子、炮姜、肉桂、白术、当归四五帖，微汗，身稍疏畅，乃信服不疑。至
三十帖，用参半斤，便润身凉，反觉畏寒，更加鹿茸。服参三斤，桂、附、姜各斤余而愈。
盖已经下之，自汗自吐，非虚而何？宜大温大补无疑矣。
一妇气从丹田冲上，遂吐清水。此因恼怒劳碌，火起上逆，丹田虚寒也。用白术二两，
白蔻五钱，共末。早饭后每次白水送下一钱。一以补脾克水，一以温肺生水，金水相生，其病自
愈。（张东扶曰∶全从吐清水立方，不可概治丹田虚寒也。）
一人日发寒热，热甚不可当，闭目而处，脐下胀滞，肛门火烧。此清气下陷，阴气化火
也。用补中益气汤加小茴、益智各五分，吴萸三厘，神效。
一妇内伤似疟，医用八珍加麦冬，二月不愈。一医作疟治截之，即形如死尸，音哑身热
，大便燥结，小便尿血。此阳陷而阴绝，宜举阳而阴自生。用附子理中汤三帖，身发流火，痛即
皮破，用保元汤加姜、桂二三月，上身肉长，下体脚伸不直，又以牛膝、防己、五苓散利之
，再以十全大补补之而愈。
一人身大热，眼红出火，口干舌燥，脚浸水中，骂詈不避亲疏。服黄连解毒汤一二帖，
其病愈甚。诊脉豁大无力，此心之脾胃虚也。其人素有淫欲，心气耗散，必非寒凉所能制。用白
术、炮姜各一钱，人参三钱，三味煎服，不超时引被自盖，战汗而愈。
假火，是指体内虚寒而体表出现火热证候的病证。其脉象必定微细，即使表面看似洪大，内部也必然是空虚的。此类病证都适宜采用温补法治疗，如八味丸、十味参苏饮等方剂。
验案一：
有一人眼睛疼痛，大便闭塞不通，已经服用了半斤大黄，眼痛症状稍减，但大便时而溏泄时而闭塞。旁人认为这是真火（实热），于是使用清凉药物调理了两个月，导致患者口干。我诊断后说：“这是内伤不足之证，如果再继续使用寒凉药物，必然致死。”病人说：“我是火证，你不听从我的判断反而反驳我。”六月时，病人再次邀请我为他诊视，我仍然坚持之前的说法。病人说：“我确实是真火，你又反驳我。”不久后，病人再次邀请我诊治，此时病情已经危急，我再次坚持之前的观点，病人姑且尝试服用我的药方。处方用保元汤加附子、炮姜、肉桂、白术、当归，服用四五帖后，微微出汗，身体稍微感到通畅舒展，于是信服不再怀疑。至服用三十帖时，用人参半斤，大便滋润，身体凉爽，反而觉得畏寒，于是更加鹿茸。最终服用人参三斤，肉桂、附子、干姜各一斤余，病愈。这是因为已经经过泻下治疗，又有自汗、自吐的症状，如果不是虚证是什么？显然应该大温大补，毫无疑问。
验案二：
有一位妇女，气从丹田向上冲逆，随即吐出清水。这是因为恼怒和劳碌，导致火气上逆，而丹田虚寒所致。处方用白术二两，白豆蔻五钱，共研为末。早饭后每次用白开水送服一钱。一方意在补脾以制约水湿，另一方意在温肺以滋生肾水，金水相生，疾病自然痊愈。（张东扶评论说：此方完全是针对“吐清水”这一症状设立的，不能一概用于治疗所有丹田虚寒证。）
验案三：
有一人每天发作寒热往来，热势甚盛难以抵挡，闭目独处，脐下胀满停滞，肛门有火烧感。这是清气下陷，阴气化火所致。处方用补中益气汤加小茴香、益智仁各五分，吴茱萸三厘，效果神效。
验案四：
有一位妇女内伤症状类似疟疾，医生使用八珍汤加麦冬，两个月未愈。另一位医生按疟疾治疗并强行截断病程，结果病人形同死尸，声音嘶哑，身体发热，大便燥结，小便尿血。这是阳气下陷而阴液枯竭，应当升举阳气，阴液自然生成。处方用附子理中汤三帖，身体发出流火（游走性疼痛或红肿），疼痛处皮肤破裂，随后用保元汤加干姜、肉桂调理两三个月，上身肌肉生长，下肢脚部伸直不直，又用牛膝、防己、五苓散利水渗湿，最后再用十全大补汤补益气血而痊愈。
验案五：
有一人身大热，眼睛发红似要出火，口干舌燥，双脚浸泡在水中，骂詈不分亲疏。服用黄连解毒汤一二帖后，病情加重。诊察脉象豁大无力，这是心脾两脏虚损所致。此人平素纵欲过度，心气耗散，必然不是寒凉药物所能控制的。处方用白术、炮姜各一钱，人参三钱，三味药煎服，不超过一时辰，患者主动拉被子盖住自己，通过战汗而痊愈。
Jia Huo (False Fire) refers to a pathological condition characterized by internal deficiency-cold manifesting as external heat symptoms. The pulse must be fine and minute; even if it appears large and forceful superficially, the interior is necessarily empty. Such conditions are all suitable for warming and tonifying treatments, such as Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) or Shi Wei Shen Su Yin (Ten-Ingredient Ginseng and Perilla Decoction).
Case Record 1:
A patient suffered from eye pain and fecal impaction. After ingesting half a jin (approx. 500g) of Da Huang (Rhei Radix et Rhizoma), the eye pain slightly decreased, but his bowel movements alternated between loose stools and constipation. Others believed this was Zhen Huo (True Fire/Excess Heat) and administered cooling medications for two months, resulting in dry mouth. I diagnosed and stated, "This is an internal injury due to insufficiency; continuing with cold-natured drugs will certainly cause death." The patient retorted, "I have fire; you do not follow my assertion but refute me." In June, the patient invited me again for consultation. I maintained my previous stance. The patient said, "I truly have fire, and you still refute me." Shortly thereafter, the patient invited me again; the condition had become critical. I reiterated my previous opinion. The patient agreed to try my prescription tentatively. The formula consisted of Bao Yuan Tang (Preserve the Origin Decoction) supplemented with Fu Zi (Aconiti Lateralis Radix Praeparata), Pao Jiang (Zingiberis Rhizoma Praeparatum), Rou Gui (Cinnamomi Cortex), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Dang Gui (Angelicae Sinensis Radix). After four to five doses, slight sweating occurred, and the body felt somewhat unblocked and comfortable, leading to the patient's trust and lack of doubt. Upon reaching thirty doses, half a jin of Ren Shen (Ginseng Radix et Rhizoma) was used; the bowels became moist, the body cooled, and the patient subsequently felt aversion to cold, prompting the addition of Lu Rong (Cervi Cornu Pantotrichum). Ultimately, three jin of Ren Shen, and over one jin each of Rou Gui, Fu Zi, and Sheng Jiang (Zingiberis Rhizoma Recens) were consumed before recovery. Since the patient had already undergone purgation, experienced spontaneous sweating, and vomiting, how could this not be a deficiency? It is undoubtedly appropriate to apply strong warming and tonification.
Case Record 2:
A female patient experienced qi rushing upward from the Dan Tian (Elixir Field/Lower Abdomen), followed by vomiting clear fluid. This was caused by anger and overwork, leading to fire rising counterflow while the Dan Tian remained deficient and cold. The prescription used Bai Zhu (Atractylodis Macrocephalae Rhizoma) two liang (approx. 60g) and Bai Kou Ren (Amomi Fructus Rotundus) five qian (approx. 15g), ground into powder. One qian was taken with plain water after breakfast. One herb aims to tonify the Spleen to control Water, while the other warms the Lung to generate Kidney Water; through the mutual generation of Metal and Water, the disease healed spontaneously. (Zhang Dongfu commented: This prescription was formulated entirely based on the symptom of vomiting clear fluid and cannot be generalized for all cases of Dan Tian deficiency-cold.)
Case Record 3:
A patient experienced daily episodes of alternating chills and fever, with intense heat that was unbearable. He kept his eyes closed and stayed alone, suffering from distension and stagnation below the umbilicus and a burning sensation in the anus. This indicated sinking of Clear Qi and transformation of Yin into Fire. The prescription used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) supplemented with Xiao Hui Xiang (Foeniculi Fructus) and Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), each 5 fen (approx. 1.5g), and Wu Zhu Yu (Evodiae Fructus) 3 li (approx. 0.9g). The effect was miraculous.
Case Record 4:
A female patient presented with internal injury symptoms resembling Malaria (Nue Ji). A physician prescribed Ba Zhen Tang (Eight-Treasure Decoction) plus Mai Dong (Ophiopogonis Radix), which failed to cure her after two months. Another physician treated it as malaria and attempted to arrest the paroxysm, resulting in the patient appearing like a corpse, with hoarseness, fever, dry stool, and hematuria. This indicated sinking of Yang and exhaustion of Yin; thus, raising Yang would naturally regenerate Yin. Three doses of Fu Zi Li Zhong Tang (Aconite Decoction to Regulate the Middle) were administered. The body developed "flowing fire" (wandering pain or redness), causing skin rupture at painful sites. Subsequently, Bao Yuan Tang (Preserve the Origin Decoction) supplemented with Jiang (Ginger) and Gui (Cinnamon Bark) was used for two to three months. Upper body muscle mass increased, and although the lower limbs' feet remained unable to straighten fully, Niu Xi (Achyranthis Bidentatae Radix), Fang Ji (Stephaniae Tetrandrae Radix), and Wu Ling San (Five-Ingredient Powder with Poria) were used to promote urination and leach out dampness. Finally, Shi Quan Da Bu Tang (Great Tonifying Decoction of Ten Ingredients) was used to tonify Qi and Blood, leading to recovery.
Case Record 5:
A patient exhibited high fever, red eyes seeming to emit fire, dry mouth and tongue, immersed his feet in water, and cursed without distinguishing relatives from strangers. After taking one or two doses of Huang Lian Jie Du Tang (Coptis Decoction to Resolve Toxicity), the condition worsened. The pulse was found to be wide and empty without strength, indicating deficiency of both Heart and Spleen/Stomach. This person had a history of excessive sexual indulgence, leading to consumption and dispersion of Heart Qi; thus, cold-natured drugs could not control it. The prescription used Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Pao Jiang (Prepared Ginger Rhizome), each 1 qian (approx. 3g), and Ren Shen (Ginseng Radix et Rhizoma) 3 qian (approx. 9g). These three herbs were decocted and taken. Within less than one shichen (two hours), the patient actively pulled the quilt to cover himself, underwent a battle-sweat (Zhan Han), and recovered.