人之五脏，惟肝易动而难静。其他脏有病，不过自病，亦或延及别脏，乃病久而生克失
常所
致。惟肝一病，即延及他脏。肝位于左，其用在右。肝气一动，即乘脾土，作痛作胀，甚则
作泻。又或上犯胃土，气逆作呕，两胁痛胀。肝之大脉，布于两胁，而胃之大络，亦在两胁
也。又成上而冲心，致心跳不安。又或上而侮肺，肺属金，原以制肝木，而肝气太旺，不受
金制，反来侮金，致肺之清肃不行，而呛咳不已，所谓木击金鸣也。又或火化为风，眩晕非
常。又或上及巅顶，疼痛难忍。又或血不荣肝，因不荣筋，四肢搐搦，周身抽掣。又或疏泄
太过，致肾不闭藏，而二便不调。又或胀及背心，痛及头项。其变幻不测，不能尽述；其往
来无常，不可思议。总之，肝为将军之官，如象棋之车，任其纵横，无敢当之者。五脏之病
，肝气居多，而妇人尤甚。治病能治肝气，则思过半矣。《内经》治肝有三法∶辛以散之，
酸以敛之，甘以缓之。后人立方，合三法为一方，谓之逍遥散。用柴胡为君，以为辛散；用
白芍以为酸敛，用炙草以为甘缓。因肝气必有肝火，又加丹皮、山栀，谓之加味逍遥散。今
之医者，一见肝气，即投以逍遥；不应，即投以加味逍遥；再不应，则束手无策矣。不知《
内经》论治肝，不过言其大概，临证则变幻无常，而治法甚多，岂能拘于三法?
予尝深思详考，治肝竟有十法焉。心为肝之子，实则泻其子，一法也；肾为肝之母，虚
则补
其母，二法也；肺为气之主，肝气上逆，清金降肺以平之，三法也；胆在肝叶之下，肝气上
逆，必挟胆火而来，其犯胃也，呕吐夹酸、夹苦酸者，肝火苦，则胆火宜用温胆法，平其胆
火，则肝气亦随之而平，所谓平甲木以和乙木者，四法也；肝阳太旺，养阴以潜之，不应，
则用牡蛎、玄武版介类以潜之，所谓介以潜阳，五法也；肝病实脾，则仲景之老法，六法也
；亦有肝有实火，轻则用左金丸，重则用龙胆泻肝汤，亦应手而愈，七法也。合之《内经》
三法，岂非十法乎?若夫专用破气，纵一时较快，而旋即胀痛，且愈发愈重，此粗工之所为
，不足以言法也。然而庸庸者，大抵以破气为先，否则投以逍遥散，至不应，则以为病重难
治，岂不冤乎?予故特作肝气之论。
或问逍遥散一方，集方书者，无不取之，如子言，其方竟不可用欤?予应之曰∶逍遥散
本是
良方，奈粗工不善用，遂觉不灵耳!其方以柴胡为君，主于散郁，所谓木郁达之也。果病者
肝气郁结，或为人所制，有气不能发泄，郁而生火，作痛作胀，脉虽弦数而见沉意，投以逍
遥，辛以散之，自然获效。若其人并无所制，而善于动怒，性不平和，愈怒愈甚，以致肝气
肆横，胀痛交作，不时上火，头疼头晕，脉来弦数而无沉意，此乃肝火化风，平之不及，而
犹治以辛散，譬如一盆炭火，势已炎炎，而更以扇扇之，岂有火不愈炽，而病不加甚耶?故
逍遥散非不可用也，奈用之者，自不求甚解耳!
人的五脏中，只有肝脏容易激动而难以安静。其他脏腑生病，通常只是本脏自病，或者病情日久后波及到其他脏腑，这是由于疾病长期发展导致五行生克关系失常所致。唯独肝脏一旦发病，就会立即波及到其他脏腑。肝位于身体左侧，但其功能作用体现在右侧。肝气一旦发动，就会克制脾土，导致腹部疼痛、胀满，严重时甚至引起腹泻。或者向上侵犯胃土，导致气机上逆而呕吐，两胁部位疼痛胀满。肝的主要经脉分布在两胁，而胃的大络脉也分布在两胁。又或者肝气向上冲犯心脏，导致心跳不安。或者向上反侮肺金，肺属金，原本是用来制约肝木的，但肝气太旺盛，不受金的制约，反而来欺侮肺金，导致肺的清肃功能不能正常行使，从而出现呛咳不止，这就是所谓的“木击金鸣”。又或者肝气化火生风，导致严重的眩晕。或者病气上达头顶，疼痛难忍。或者肝血不足不能濡养肝脏，进而不能濡养筋脉，导致四肢抽搐痉挛，全身肌肉抽动。或者肝的疏泄功能太过，导致肾的闭藏功能失职，从而大小便不调。或者胀满波及到背心，疼痛放射到头项。其变化莫测，无法一一陈述；其往来无常，不可思议。总之，肝被称为“将军之官”，就像象棋中的车一样，纵横驰骋，无人敢挡。五脏的疾病中，肝气为患占大多数，而妇女尤为严重。治病如果能治好肝气病，那么治疗就成功了一半。《内经》治疗肝的方法有三种：用辛味药来疏散它，用酸味药来收敛它，用甘味药来缓和它。后人创立方剂，将这三种方法合为一个方子，称为逍遥散（Xiaoyao San）。以柴胡为君药，取其辛散之功；用白芍作为酸敛之用，用炙甘草作为甘缓之用。因为肝气郁滞必然伴有肝火，所以又加入丹皮、山栀，称为加味逍遥散（Jiawei Xiaoyao San）。现在的医生，一见到肝气病，就投用逍遥散；如果无效，就投用加味逍遥散；再无效，就束手无策了。不知道《内经》论述治肝，不过是说个大概，临证时病情变幻无常，治疗方法很多，怎么能拘泥于这三种方法呢？
我曾经深思详考，发现治疗肝竟有十种方法。心是肝的子脏，实证则泻其子，这是第一种方法；肾是肝的母脏，虚证则补其母，这是第二种方法；肺主气，肝气上逆，通过清肃肺气来平抑它，这是第三种方法；胆在肝叶之下，肝气上逆，必然挟带胆火而来，当它侵犯胃时，呕吐物夹杂酸水或苦水，肝火表现为苦味，则胆火宜用温胆法（Wendan Method），平息胆火，肝气也随之平息，这就是所谓“平甲木（胆）以和乙木（肝）”，这是第四种方法；肝阳太旺，用滋阴的方法来潜降它，如果无效，则用牡蛎、龟板等介类药物来潜降，这就是所谓“介以潜阳”，这是第五种方法；肝病实脾，这是张仲景的老办法，这是第六种方法；也有肝有实火的，轻则用左金丸（Zuojin Wan），重则用龙胆泻肝汤（Longdan Xiegan Tang），也能应手而愈，这是第七种方法。加上《内经》的三种方法，难道不是十种方法吗？至于专门使用破气药，虽然一时痛快，但随即又会胀痛，而且越发越重，这是粗劣医生的做法，不足以称之为法。然而平庸的医生，大抵都以破气为先，否则就投用逍遥散，到了无效时，就认为病重难治，这岂不是冤枉吗？所以我特意撰写这篇关于肝气的论述。
有人问：逍遥散这一方，收集方书的无不采用，像您说的，这个方子竟然不能用吗？我回答说：逍遥散本是良方，无奈粗劣的医生不善于使用，所以才觉得不灵验！这个方子以柴胡为君药，主要在于疏散郁结，也就是所谓“木郁达之”（若肝气郁结，应予以疏导发散）。如果病人确实是肝气郁结，或者是被人压制，有气不能发泄，郁积而生火，导致疼痛胀满，脉象虽然弦数但带有沉意，此时投用逍遥散，用辛味药来疏散它，自然能获效。如果这个人并没有受到压制，而是善于发怒，性情不平和不顺，越怒越厉害，以致肝气肆意横行，胀痛交替发作，不时上火，头疼头晕，脉来弦数但没有沉意，这是肝火化风，需要平抑都来不及，却还用辛散的方法治疗，这就好比一盆炭火，火势已经炎炎，却还要用扇子去扇它，难道不是火更旺、病更重吗？所以逍遥散并非不能用，无奈使用者自己不求甚解罢了！
Among the five zang organs of the human body, only the Liver is prone to agitation and difficult to remain calm. When other zang organs are diseased, they typically suffer from their own illness alone, or the disease may spread to other organs after a long duration due to the dysfunction of the generation and restriction cycles (Sheng-Ke relationships) caused by prolonged illness. However, once the Liver is diseased, it immediately affects other organs. The Liver is located on the left, but its functional manifestation is on the right. Once Liver Qi moves, it overacts on Spleen Earth, causing pain and distension, and in severe cases, diarrhea. Alternatively, it may invade Stomach Earth upward, causing rebellious Qi leading to vomiting, and pain and distension in both hypochondriac regions. The main meridian of the Liver distributes through the hypochondriac regions, as does the large collateral of the Stomach. Furthermore, it may rush upward to attack the Heart, resulting in palpitations and restlessness. Or it may insult Lung Metal upward; Lung belongs to Metal, which originally controls Liver Wood, but when Liver Qi is too vigorous, it resists Metal's control and insults Metal instead, causing the Lung's descending and purifying function to fail, leading to incessant dry coughing, known as "Wood striking Metal ringing." Additionally, Fire may transform into Wind, causing severe vertigo. Or the pathogenic factor may reach the vertex, causing unbearable pain. If Blood fails to nourish the Liver, it consequently fails to nourish the sinews, leading to spasms and convulsions of the four limbs and twitching of the whole body. Excessive dispersal may cause Kidney to fail in its storing function, resulting in irregular urination and defecation. Distension may extend to the back, and pain to the head and neck. Its changes are unpredictable and cannot be fully described; its coming and going are capricious and inconceivable. In short, the Liver is called the "General Officer," like the Chariot in Chinese chess, moving freely纵横 without anyone daring to oppose it. Among diseases of the five zang organs, Liver Qi disorders account for the majority, especially in women. If one can treat Liver Qi disorders, then half of the treatment success is achieved. *Neijing* (The Inner Canon) proposes three methods for treating the Liver: use Pungent flavors to disperse it, Sour flavors to astringe it, and Sweet flavors to moderate it. Later physicians created formulas combining these three methods into one prescription, called Xiaoyao San (Free and Easy Wanderer Powder). Using Chai Hu (Bupleuri Radix) as the sovereign herb for its pungent dispersing action; using Bai Shao (Paeoniae Radix Alba) for sour astringency, and Zhi Gan Cao (Prepared Licorice Root) for sweet moderation. Since Liver Qi stagnation inevitably involves Liver Fire, Dan Pi (Moutan Cortex) and Shan Zhi (Gardeniae Fructus) are added, creating Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Modern physicians, upon seeing Liver Qi disorders, immediately administer Xiaoyao San; if ineffective, they administer Jiawei Xiaoyao San; if still ineffective, they are at a loss. They do not realize that *Neijing*'s discussion on treating the Liver is merely a general principle; clinically, conditions change unpredictably, and there are many treatment methods, so how can one be confined to just these three methods?
I have deeply pondered and examined, and found ten methods for treating the Liver. The Heart is the child organ of the Liver; for excess patterns, drain the child—this is the first method. The Kidney is the mother organ of the Liver; for deficiency patterns, tonify the mother—this is the second method. The Lung governs Qi; when Liver Qi rebels upward, clear and descend Lung Qi to pacify it—this is the third method. The Gallbladder lies beneath the liver lobes; when Liver Qi rebels upward, it must carry Gallbladder Fire with it. When attacking the Stomach, vomiting may contain acid or bitter fluids. Liver Fire manifests as bitter taste; thus, Gallbladder Fire should be treated with Wendan Method (Warm the Gallbladder Method) to calm Gallbladder Fire, thereby calming Liver Qi as well. This is what is meant by "pacifying Jia Wood (Gallbladder) to harmonize Yi Wood (Liver)"—this is the fourth method. When Liver Yang is too vigorous, nourish Yin to subdue it; if ineffective, use Oyster Shell (Muli), Turtle Shell (Guiban), and other shell-type herbs to subdue it. This is "using shells to subdue Yang"—this is the fifth method. Strengthening the Spleen to treat Liver disease is an old method of Zhang Zhongjing—this is the sixth method. For Liver Excess Fire, mild cases use Zuojin Wan (Left Metal Pill), and severe cases use Longdan Xiegan Tang (Gentian Liver-Draining Decoction), both effective—this is the seventh method. Combined with the three methods from *Neijing*, are these not ten methods? As for exclusively using Qi-breaking herbs, although providing temporary relief, pain and distension return quickly, worsening with each use; this is the practice of incompetent physicians and does not constitute a proper method. However, mediocre physicians generally prioritize Qi-breaking herbs, or otherwise prescribe Xiaoyao San. When it fails, they deem the disease severe and incurable, which is unjust! Therefore, I specifically wrote this treatise on Liver Qi.
Someone asked: "Xiaoyao San is collected in all formularies and universally adopted. According to your words, is this formula unusable?" I replied: "Xiaoyao San is indeed a good formula, but incompetent physicians do not know how to use it properly, hence it seems ineffective! The formula uses Chai Hu as the sovereign herb, primarily to disperse stagnation, which corresponds to 'when Wood is stagnant, unblock it.' If the patient truly has Liver Qi stagnation, or is suppressed by external factors, unable to vent Qi, leading to stagnation generating Fire, causing pain and distension, with a pulse that is Wiry and Rapid but feels Deep, administering Xiaoyao San to disperse with Pungent flavors will naturally yield results. However, if the person is not suppressed but prone to anger, has an unstable temperament, becomes angrier and more intense, causing Liver Qi to run rampant, alternating pain and distension, frequent heat sensations, headache, dizziness, with a Wiry and Rapid pulse lacking a Deep quality, this indicates Liver Fire transforming into Wind. It is already insufficient to merely pacify it, yet treating with Pungent dispersal is like fanning a blazing charcoal fire; surely the fire will intensify and the disease worsen. Thus, Xiaoyao San is not unusable; the problem lies in users who do not seek deep understanding!"