肝胆火盛，肋痛耳聋，口苦筋痿，阴痛，或淋浊溺血，加味丹栀汤主之。
加味丹栀汤（自制）
丹皮（二钱） 山栀（一钱五分） 赤芍（一钱） 龙胆草（一钱） 夏枯草（一钱五分）
当归（一钱五分） 生地（四钱） 柴胡（一钱） 木通（一钱） 车前（二钱） 灯芯（三尺）
此条见证，与本门后附见龙胆泻肝汤相仿佛，而去黄芩、泽泻、甘草，加丹皮、山栀、赤芍、夏枯草、灯芯，同
样能去肝胆实火。方虽小异，效力则大致相同。二方皆用当归、生地、补血凉血，以肝乃藏血之脏，泻其
腑必须顾其脏，且以舒其筋也。祖怡注。
脾有伏火，口燥唇干，烦渴易饥，热在肌肉，加味泻黄散主之。
加味泻黄散（自制）
防风（一钱） 葛根（二钱） 石膏（四钱） 石斛（三钱） 山栀（一钱五分）
茯苓（三钱） 甘草（四分） 荷叶（一角） 粳米（一撮煎汤代水）
本方用泻黄散去藿香而加葛根、石斛、茯苓、荷叶、粳米；从白虎汤法，去知母而添升阳散火意，清中有
发，发中有清，阳升火散，而无抑遏之患。此条当与先生《医方论》泻黄散对比观之，更易明白。祖怡注。
肾火者，龙火也。龙不蛰藏，飞腾于上，口燥咽干，面红目赤，耳流脓血，不闻人声，加味肾热汤主之。
加味肾热汤（自制）
磁石（四钱） 牡蛎（四钱） 生地（四钱） 白术（一钱） 白芍（一钱）
人参（一钱） 元参（二钱） 甘草（五分） 猪肾（二枚煎汤代水）
生地、元参、白芍、猪肾，养阴益肾，显而易见。加磁石以镇之，牡蛎以潜之，二味肾家药，亦显而易见。用参、
术、草等中州药者，龙火上腾，必是脾胃砥柱失守所致；中州有砥柱，龙火必无由而上腾矣。祖怡注。
阳火可泻，阴火不可泻，况龙性难驯，逆而折之，反肆冲激。故丹溪滋肾丸，于滋阴药中，加肉桂一味，导龙
归海，从治之法，最为精当。兹更推展其意，制潜龙汤主之。
潜龙汤（自制）
龙齿（二钱） 龟版（八钱） 生地（五钱） 龙骨（二钱） 知母（一钱）
黄柏（一钱） 人参（一钱） 元参（二钱） 蛤粉（四钱） 肉桂（四分） 鲍鱼（一两切片煎汤代水）
黄柏、知母、肉桂，取一阳居二阴之中，成为坎象。不用肉桂，则龙不肯归海。既用肉桂，尚恐知、柏之力不
足以驾驭，故加人参、元参、生地以佐之。再用龙骨涩而兼镇，龙齿但镇不涩；龟版、蛤粉、鲍鱼，则潜阳即
所以潜龙。而一味肉桂，处于群阴之中，当亦驯服，而潜藏不显矣。祖怡注。
肝胆火盛，出现胁痛、耳聋、口苦、筋脉痿软、阴部疼痛，或淋证、尿浊、尿血等症状，以加味丹栀汤为主治方剂。
加味丹栀汤（自制方）
牡丹皮（二钱） 山栀子（一钱五分） 赤芍药（一钱） 龙胆草（一钱） 夏枯草（一钱五分）
当归（一钱五分） 生地黄（四钱） 柴胡（一钱） 木通（一钱） 车前子（二钱） 灯心草（三尺）
本条所述证候，与本门后附载的龙胆泻肝汤相类似，但去掉了黄芩、泽泻、甘草，加入了牡丹皮、山栀子、赤芍药、夏枯草、灯心草，同样能够清除肝胆实火。方剂虽略有差异，效力则大致相同。两方均使用当归、生地黄来补血凉血，因为肝脏是藏血的脏器，清泻其腑必须顾护其脏，并且以此来舒缓筋脉。祖怡注。
脾脏有伏火，表现为口燥唇干、烦躁口渴、容易饥饿，热邪在肌肉层面，以加味泻黄散为主治方剂。
加味泻黄散（自制方）
防风（一钱） 葛根（二钱） 石膏（四钱） 石斛（三钱） 山栀子（一钱五分）
茯苓（三钱） 甘草（四分） 荷叶（一角） 粳米（一撮，煎汤代水）
本方用泻黄散去掉藿香，而加入葛根、石斛、茯苓、荷叶、粳米；遵循白虎汤的法度，去掉知母而增添升阳散火的意蕴，清中有发，发中有清，阳气上升则火邪消散，而没有压抑遏制的隐患。此条应当与先生《医方论》中的泻黄散对比阅读，更容易明白。祖怡注。
肾火，就是龙火。龙如果不潜藏蛰伏，就会飞腾于上，出现口燥咽干、面色红赤、双目发红、耳朵流脓血、听不见人声等症状，以加味肾热汤为主治方剂。
加味肾热汤（自制方）
磁石（四钱） 牡蛎（四钱） 生地黄（四钱） 白术（一钱） 白芍药（一钱）
人参（一钱） 玄参（二钱） 甘草（五分） 猪肾（二枚，煎汤代水）
生地黄、玄参、白芍药、猪肾，滋养阴液补益肾脏，显而易见。加入磁石以镇摄，牡蛎以潜降，这两味是肾脏的药物，也显而易见。使用人参、白术、甘草等中焦脾胃药物，是因为龙火上腾，必然是因为脾胃这个“中州砥柱”失守所致；如果中焦有砥柱支撑，龙火就没有理由向上飞腾了。祖怡注。
阳火可以清泻，阴火不可以清泻，况且龙性难以驯服，如果逆其势而折之，反而会导致其更加猛烈冲激。所以朱丹溪的滋肾丸，在滋阴药中加入肉桂一味，引导龙火回归大海，这是从治法，最为精当。现在进一步推展其意旨，制作潜龙汤为主治方剂。
潜龙汤（自制方）
龙齿（二钱） 龟板（八钱） 生地黄（五钱） 龙骨（二钱） 知母（一钱）
黄柏（一钱） 人参（一钱） 玄参（二钱） 蛤粉（四钱） 肉桂（四分） 鲍鱼（一两，切片煎汤代水）
黄柏、知母、肉桂，取一阳爻居于二阴爻之中，形成坎卦之象。如果不使用肉桂，龙就不肯回归大海。既然使用了肉桂，还担心知母、黄柏的力量不足以驾驭龙火，所以加入人参、玄参、生地黄来辅助它。再用龙骨，既收敛又镇摄；龙齿只镇摄不收敛；龟板、蛤粉、鲍鱼，则是通过潜降阳气来达到潜降龙火的目的。而那一味肉桂，处于众多阴药之中，应当也会被驯服，从而潜藏而不显露。祖怡注。
When Liver and Gallbladder Fire is excessive, symptoms such as hypochondriac pain (肋痛), deafness (耳聋), bitter taste in the mouth (口苦), flaccidity of tendons (筋痿), genital pain (阴痛), or stranguria (淋证), turbid urine (溺浊), and hematuria (溺血) may occur. Jiawei Danzhi Tang (Modified Cinnamon Twig and Gardenia Decoction) is the principal formula.
Jiawei Danzhi Tang (Self-made Formula)
* *Moutan Cortex* (Danpi, 2 qian)
* *Gardeniae Fructus* (Shanzhi, 1.5 qian)
* *Paeoniae Radix Rubra* (Chishao, 1 qian)
* *Gentianae Radix* (Longdancao, 1 qian)
* *Prunellae Spica* (Xiakucao, 1.5 qian)
* *Angelicae Sinensis Radix* (Danggui, 1.5 qian)
* *Rehmanniae Radix Recens* (Shengdi, 4 qian)
* *Bupleuri Radix* (Chaihu, 1 qian)
* *Akebiae Caulis* (Mutong, 1 qian)
* *Plantaginis Semen* (Cheqian, 2 qian)
* *Junci Medulla* (Dengxin, 3 chi)
The manifestations described in this section are similar to those of Longdan Xiegan Tang (Gentian Liver-Draining Decoction) attached later in this chapter, but with Huangqin (Scutellariae Radix), Zexie (Alismatis Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma) removed, and Danpi, Shanzhi, Chishao, Xiakucao, and Dengxin added. It similarly clears Excess Fire from the Liver and Gallbladder. Although the formulas differ slightly, their efficacy is roughly the same. Both formulas use Danggui and Shengdi to nourish Blood and cool Blood, because the Liver is the organ that stores Blood; when draining its Fu organ, one must protect its Zang organ, and thereby soothe the tendons. Annotation by Zuyi.
When Spleen has latent Fire, symptoms such as dry mouth and lips (口燥唇干), irritability and thirst (烦渴), easy hunger (易饥), and heat in the muscles (热在肌肉) may appear. Jiawei Xiehuang San (Modified Yellow-Draining Powder) is the principal formula.
Jiawei Xiehuang San (Self-made Formula)
* *Saposhnikoviae Radix* (Fangfeng, 1 qian)
* *Puerariae Lobatae Radix* (Gegen, 2 qian)
* *Gypsum Fibrosum* (Shigao, 4 qian)
* *Dendrobii Caulis* (Shihu, 3 qian)
* *Gardeniae Fructus* (Shanzhi, 1.5 qian)
* *Poria* (Fuling, 3 qian)
* *Glycyrrhizae Radix et Rhizoma* (Gancao, 0.4 qian)
* *Nelumbinis Folium* (Heye, 1 jiao)
* *Oryza Sativa* (Jingmi, 1 pinch, decocted in water instead of plain water)
This formula uses Xiehuang San but removes Huoxiang (Agastaches Herba) and adds Gegen, Shihu, Fuling, Heye, and Jingmi; it follows the method of Baihu Tang (White Tiger Decoction), removing Zhimu (Anemarrhenae Rhizoma) while adding the intent of raising Yang and dispersing Fire. There is clearing within dispersing, and dispersing within clearing; as Yang rises, Fire dissipates, without the risk of suppression and stagnation. This section should be compared with Mr.'s *Yifang Lun* (Discussion on Medical Formulas) regarding Xiehuang San for easier understanding. Annotation by Zuyi.
Kidney Fire is Dragon Fire. If the Dragon does not hibernate and store, it flies upward, causing dry mouth and throat (口燥咽干), red face (面红), red eyes (目赤), purulent and bloody discharge from the ears (耳流脓血), and inability to hear human voices (不闻人声). Jiawei Shenre Tang (Modified Kidney-Heat Decoction) is the principal formula.
Jiawei Shenre Tang (Self-made Formula)
* *Magnetitum* (Cishi, 4 qian)
* *Concha Ostreae* (Muli, 4 qian)
* *Rehmanniae Radix Recens* (Shengdi, 4 qian)
* *Atractylodis Macrocephalae Rhizoma* (Baizhu, 1 qian)
* *Paeoniae Radix Alba* (Baishao, 1 qian)
* *Ginseng Radix* (Renshen, 1 qian)
* *Scrophulariae Radix* (Yuanshen, 2 qian)
* *Glycyrrhizae Radix et Rhizoma* (Gancao, 0.5 qian)
* *Sus Ren* (Zhu shen, 2 pieces, decocted in water instead of plain water)
Shengdi, Yuanshen, Baishao, and Zhu shen nourish Yin and benefit the Kidney, which is obvious. Adding Cishi to suppress and Muli to subdue, these two are Kidney herbs, which is also obvious. Using Renshen, Baizhu, Gancao, etc., which are Middle Jiao herbs, is because when Dragon Fire ascends, it is necessarily due to the failure of the "Middle Jiao Pillar" (Spleen and Stomach); if there is a pillar in the Middle Jiao, Dragon Fire has no way to ascend. Annotation by Zuyi.
Yang Fire can be drained, but Yin Fire cannot be drained. Moreover, the nature of the Dragon is difficult to tame; opposing it directly causes it to surge more violently. Therefore, Danxi Zishui Wan (Nourishing Kidney Pill) adds a single herb, Rougui (Cinnamomi Cortex), among the Yin-nourishing herbs to guide the Dragon back to the sea. This is the method of treating according to the disease's nature (concordant treatment), which is most precise. Here, we further expand upon this intent and create Qianlong Tang (Subduing Dragon Decoction) as the principal formula.
Qianlong Tang (Self-made Formula)
* *Dent Draconis* (Longchi, 2 qian)
* *Carapax et Plastrum Testudinis* (Guiban, 8 qian)
* *Rehmanniae Radix Recens* (Shengdi, 5 qian)
* *Os Draconis* (Longgu, 2 qian)
* *Anemarrhenae Rhizoma* (Zhimu, 1 qian)
* *Phellodendri Cortex* (Huangbai, 1 qian)
* *Ginseng Radix* (Renshen, 1 qian)
* *Scrophulariae Radix* (Yuanshen, 2 qian)
* *Concha Meretricis et Cyclinae* (Gafen, 4 qian)
* *Cinnamomi Cortex* (Rougui, 0.4 qian)
* *Balneum* (Baoyu, 1 liang, sliced and decocted in water instead of plain water)
Huangbai, Zhimu, and Rougui take one Yang line situated between two Yin lines, forming the Kan trigram (Water). Without Rougui, the Dragon will not return to the sea. Since Rougui is used, there is still fear that the power of Zhimu and Huangbai is insufficient to control the Dragon, so Renshen, Yuanshen, and Shengdi are added to assist. Then, using Longgu, which is both astringent and sedating; Longchi only sedates but does not astringe; Guiban, Gafen, and Baoyu subdue Yang, which is thereby subduing the Dragon. And that single portion of Rougui, amidst a group of Yin herbs, should also be tamed, thus hiding and remaining inconspicuous. Annotation by Zuyi.