凡上升之气，自肝而出。肝木性升散，不受遏郁，郁则经气逆，为嗳，为胀，为呕吐，为暴怒胁痛，为
胸满不食，为飧泄，
为疝，皆肝气横决也。且相火附木，木郁则化火，为吞酸胁痛，为狂，为痿，为厥，为痞，为呃噎，为失
血，皆肝火冲激也。风根据于木，木郁则化风，为眩，为晕，为舌麻，为耳鸣，为痉，为痹，为类中，皆肝
风震动也。故诸病多自肝来，以其犯中宫之土，刚性难驯，挟风火之威，顶巅易到，药不可以刚燥投也。经曰∶
肝苦急，急食甘以缓之；肝欲散，急食辛以散之。用辛补之，酸泻之。古圣治肝，法尽于此。夫肝主藏血，
血燥则肝急。凡肝阴不足，必得肾水以滋之，血液以濡之，味取甘凉，或主辛润，务遂其条畅之性，则郁者舒
矣。凡肝阳有余，必需介属以潜之，柔静以摄之，味取酸收，或佐酸降，务清其营络之热，则升者伏矣。治肝
气，先疏其郁，宜逍遥散。因怒动肝，小柴胡汤加山栀、青皮。嗳而吐沫，代赭旋复汤。呕而胀满，三因七气
汤加枳壳、木香。怒伤胁痛，生白芍、金橘皮、山栀、枳壳、郁金汁、降香末。肠鸣飧泄，则泄木安土，
人参安胃散加半夏曲。 疝肿硬，则导滞和肝，橘核丸加减。若气有余便是火，治肝火实，吞酸胁痛，左金丸、
抑青丸。胁大痛引腰背，汗泄，忌辛燥耗气劫液，宜甘酸化阴，甘草、柏子仁、杞子、枣仁、阿胶、牡蛎、
木瓜、生白芍、五味子、鳖甲、金橘皮。虚痛久痛必入络，宜理营络，旋复花汤加当归须、丹皮、延胡、桃仁。
湿热火盛，胁痛筋痿溲血，龙胆泻肝汤。火盛狂躁，胸痞咽阻便秘，当归龙荟丸。阴虚痿弱，虎潜丸去锁阳。
厥逆，四逆散。痞满，半夏泻心汤。呃噎，橘皮竹茹汤。吐衄失血，犀角地黄汤加山栀、藕汁。至于肝阳化风，
上扰清窍，则巅痛头晕，目眩耳鸣，心悸寤烦，由营液内虚，水不涵木，火动痰升，其实无风可散，宜滋液和
阳。复脉汤去姜、桂，或用熟地、白芍、杞子、茯神、枣仁、炒甘菊、霜桑叶、牡蛎、石斛、五味。其由肾虚
阳浮者，宜填髓补精。阿胶、龟甲、淡菜、青盐、牛膝、萸肉、熟地、磁石。其由土弱木乘者，宜缓肝益胃。
酸枣仁汤去川芎，加人参、山药、小麦。其因怒劳，致舌麻肢痹，筋 肉 ，由五志过极，阳亢阴衰，风从火
出，宜柔润熄风。河间地黄饮子去桂、附、巴戟、菖蒲。其火风上郁，头重脘痹，宜清金肃降。杏仁、鲜菖蒲
根、栝蒌、钩藤、菊叶、薄
荷。其年高水亏，风火易升，头晕便秘，宜壮水滋燥。还少丹去杜仲、巴戟、楮实、茴香，加桑叶、黑芝麻、
柏子仁、炒甘菊、茯神、牡蛎。其阳明络虚，风火易震，食少知饥，宜填实空际。人参、山药、炙草、牡蛎、
枣仁、茯苓、白芍、南枣。大抵肝为刚脏，职司疏泄，用药不宜刚而宜柔，不宜伐而宜和，正仿《内经》治
肝之旨也。
丹溪曰∶病患自言冷气从下而上，非真冷也。此上升之气，自肝而出，中挟相火，自下而上。其热为甚，
自觉冷者，火极似水，积热之甚也。阳亢阴微，故见此症。又曰∶气从左边起，肝火也。宜左金丸。气从脐下
起，阴火也。黄柏丸、坎离丸。气从足下起入腹，虚之极也。滋阴降火汤，外用津调附子末，涂涌泉，引热下行。
凡是上升的气，都是从肝发出的。肝属木，其本性是升发疏散的，不能受到遏制和郁结；一旦郁结，就会导致经络之气逆乱，表现为嗳气、腹胀、呕吐、暴怒引起的胁痛、胸部胀满且食欲不振、完谷不化的泄泻、疝气等，这些都是肝气横逆冲决的表现。况且相火依附于肝木，肝木郁结就会化火，表现为吞酸、胁痛、狂躁、痿证、厥逆、痞块、呃逆噎膈、出血等，这些都是肝火冲激的表现。风根源于木，肝木郁结就会化风，表现为眩晕、头晕、舌头发麻、耳鸣、痉挛、痹证、类中风等，这些都是肝风震动表现。所以各种疾病多由肝引起，因为肝气容易侵犯中焦脾胃（土），肝性刚强难以驯服，又挟带风和火的威势，病邪容易上达头顶，治疗用药不可以使用刚燥的药物。《内经》说：肝苦急，应当吃甘味药来缓和它；肝欲散，应当吃辛味药来发散它。用辛味药补肝，用酸味药泻肝。古代圣人对肝脏的治疗法则都包含在这里了。肝主藏血，血液干燥则肝气急迫。凡是肝阴不足，必须得到肾水的滋润，血液的濡养，口味选取甘凉之品，或者主要使用辛润之法，务必顺应肝气条畅舒展的特性，那么郁结就能舒解了。凡是肝阳有余，必须用介壳类药物来潜降它，用柔和安静的药物来收敛它，口味选取酸收之品，或者辅助酸降之药，务必清除营分和络脉中的热邪，那么上亢的阳气就能潜伏下来。治疗肝气病，先疏解其郁结，适宜用逍遥散。因愤怒触动肝气，用小柴胡汤加山栀、青皮。嗳气并吐沫，用代赭旋复汤。呕吐且腹胀满，用三因七气汤加枳壳、木香。愤怒导致胁痛，用生白芍、金橘皮、山栀、枳壳、郁金汁、降香末。肠鸣且完谷不化的泄泻，则采用泄木安土法，用人参安胃散加半夏曲。疝气肿块坚硬，则采用导滞和肝法，用橘核丸加减。如果气有余就是火，治疗肝火实证，出现吞酸胁痛，用左金丸、抑青丸。胁部剧烈疼痛牵引腰背，出汗，忌用辛燥耗气伤津的药物，适宜用甘酸化阴法，药用甘草、柏子仁、枸杞子、枣仁、阿胶、牡蛎、木瓜、生白芍、五味子、鳖甲、金橘皮。虚痛久痛必然深入络脉，适宜调理营络，用旋复花汤加当归须、丹皮、延胡索、桃仁。湿热火盛，出现胁痛、筋痿、尿血，用龙胆泻肝汤。火盛狂躁，胸中痞闷、咽部阻塞、便秘，用当归龙荟丸。阴虚导致的痿弱，用虎潜丸去掉锁阳。厥逆，用四逆散。痞满，用半夏泻心汤。呃逆噎膈，用橘皮竹茹汤。吐血衄血失血，用犀角地黄汤加山栀、藕汁。至于肝阳化风，上扰清窍，则出现巅顶头痛、头晕、目眩耳鸣、心悸、失眠烦躁，这是由于营液内虚，水不涵木，火动痰升，实际上并没有风可散，适宜滋液和阳。用复脉汤去掉生姜、肉桂，或者用熟地、白芍、枸杞子、茯神、枣仁、炒甘菊、霜桑叶、牡蛎、石斛、五味子。如果是由于肾虚导致阳气浮越的，适宜填髓补精。药用阿胶、龟甲、淡菜、青盐、牛膝、山茱萸、熟地、磁石。如果是由于脾土虚弱被肝木乘克的，适宜缓肝益胃。用酸枣仁汤去掉川芎，加人参、山药、小麦。如果是因愤怒和劳累，导致舌麻肢体痹阻、筋肉跳动，这是由五志过极，阳亢阴衰，风从火出引起的，适宜柔润熄风。用河间地黄饮子去掉桂枝、附子、巴戟天、石菖蒲。如果是火风上郁，头重脘腹痹阻，适宜清金肃降。药用杏仁、鲜菖蒲根、瓜蒌、钩藤、菊花叶、薄荷。如果是年高体弱肾水亏虚，风火容易上升，出现头晕便秘，适宜壮水滋燥。用还少丹去掉杜仲、巴戟天、楮实子、小茴香，加桑叶、黑芝麻、柏子仁、炒甘菊、茯神、牡蛎。如果是阳明络脉空虚，风火容易震动，食少但知饥，适宜填实空际。用人参、山药、炙甘草、牡蛎、枣仁、茯苓、白芍、南枣。大抵来说，肝是刚脏，职能主管疏泄，用药不宜刚猛而宜柔和，不宜攻伐而宜调和，正是效仿《内经》治疗肝的原则。
朱丹溪说：病人自己感觉冷气从下往上冲，并不是真正的寒冷。这是上升的气，从肝发出，中间夹带着相火，自下而上。这种热非常严重，病人自觉冷，是因为火极似水，是积热严重的表现。阳亢阴微，所以出现这种症状。又说：气从左边起来，是肝火。适宜用左金丸。气从脐下起来，是阴火。用黄柏丸、坎离丸。气从足下起进入腹部，是虚损到了极点。用滋阴降火汤，外用唾液调匀附子末，涂抹涌泉穴，引导热邪下行。
Any ascending Qi originates from the Liver. The Liver, belonging to Wood, has a nature of ascending and dispersing; it cannot tolerate obstruction or stagnation. When stagnant, the Qi in the meridians becomes rebellious, manifesting as belching, abdominal distension, vomiting, sudden anger with hypochondriac pain, chest fullness with anorexia, undigested food diarrhea (Sun-xie), hernia, all of which are manifestations of Liver Qi rebelling and bursting forth. Moreover, Ministerial Fire (Xiang-huo) attaches to Liver Wood; when Liver Wood is stagnant, it transforms into Fire, manifesting as acid regurgitation with hypochondriac pain, mania, flaccidity syndrome (Wei), cold limbs (Jue), epigastric fullness (Pi), hiccups and dysphagia, and hemorrhage, all of which are manifestations of Liver Fire rushing and striking. Wind is rooted in Wood; when Liver Wood is stagnant, it transforms into Wind, manifesting as dizziness, vertigo, numbness of the tongue, tinnitus, spasms, Bi-syndrome, and stroke-like syndromes (Lei-zhong), all of which are manifestations of Liver Wind shaking. Therefore, many diseases originate from the Liver, because it invades the Earth of the Middle Jiao (Spleen/Stomach). Its nature is rigid and difficult to tame, carrying the might of Wind and Fire, easily reaching the vertex. Medications should not be harsh and drying. The Classic says: "The Liver suffers from tension; eat sweet flavors to relax it." "The Liver desires dispersion; eat pungent flavors to disperse it." Use pungent flavors to tonify it, and sour flavors to drain it. The ancient sages' methods for treating the Liver are contained within these principles. The Liver stores Blood; when Blood is dry, the Liver becomes tense. Whenever Liver Yin is insufficient, it must be nourished by Kidney Water and moistened by Blood. The flavor should be sweet and cool, or primarily moistening with pungency, striving to follow its free-flowing and smooth nature, so that stagnation will be relieved. Whenever Liver Yang is excessive, it must be anchored by shell-type substances and restrained by gentle and quiet agents. The flavor should be sour and astringent, or assisted by sour and descending agents, striving to clear heat in the Ying (Nutritive) level and collaterals, so that ascending Yang will subside. To treat Liver Qi disorders, first soothe the stagnation; Xiao Yao San (Free and Easy Wanderer Powder) is suitable. If triggered by anger, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Gardenia (Shan Zhi) and Green Tangerine Peel (Qing Pi). For belching with spittle, use Dai Zhe Xuan Fu Tang (Magnetite and Inula Decoction). For vomiting with abdominal distension, use San Yin Qi Qi Tang (Three Causes Seven Qi Decoction) with Aurantium (Zhi Ke) and Costus Root (Mu Xiang). For hypochondriac pain caused by anger, use Raw White Peony Root (Sheng Bai Shao), Golden Orange Peel (Jin Ju Pi), Gardenia (Shan Zhi), Aurantium (Zhi Ke), Curcuma Juice (Yu Jin Zhi), and Agarwood Powder (Xiang Mo). For borborygmus and undigested food diarrhea, employ the method of draining Wood to calm Earth; Ren Shen An Wei San (Ginseng Stomach-Calming Powder) with Pinellia Ferment (Ban Xia Qu) is suitable. For hard and swollen hernias, employ the method of guiding stagnation and harmonizing the Liver; Ju He Wan (Tangerine Seed Pill) with modifications is suitable. If excess Qi becomes Fire, to treat excess Liver Fire with acid regurgitation and hypochondriac pain, use Zuo Jin Wan (Left Metal Pill) or Yi Qing Wan (Suppress Cyan Pill). For severe hypochondriac pain radiating to the back and waist with sweating, avoid pungent-drying drugs that consume Qi and fluids; instead, use the method of sweet-and-sour to generate Yin, with Licorice (Gan Cao), Biota Seed (Bai Zi Ren), Goji Berry (Qi Zi), Jujube Seed (Zao Ren), Donkey-hide Gelatin (E Jiao), Oyster Shell (Mu Li), Quince (Mu Gua), Raw White Peony Root (Sheng Bai Shao), Schisandra (Wu Wei Zi), Turtle Shell (Bie Jia), and Golden Orange Peel (Jin Ju Pi). Chronic pain from deficiency or long-standing pain must enter the collaterals; regulate the Ying collaterals with Xuan Fu Hua Tang (Inula Flower Decoction) plus Dang Gui Xu (Angelica Sinensis Tail), Moutan Bark (Dan Pi), Corydalis (Yan Hu), and Peach Kernel (Tao Ren). For damp-heat and excessive fire causing hypochondriac pain, flaccidity, and hematuria, use Long Dan Xie Gan Tang (Gentian Drain Liver Decoction). For excessive fire causing mania and restlessness, chest oppression, throat obstruction, and constipation, use Dang Gui Long Hui Wan (Angelica Coptis Pill). For Yin-deficiency flaccidity, use Hu Qian Wan (Tiger Crouching Pill) without Suo Yang. For cold limbs (Jue Ni), use Si Ni San (Four Counterflow Powder). For epigastric fullness (Pi Man), use Ban Xia Xie Xin Tang (Pinellia Drain the Epigastrium Decoction). For hiccups and dysphagia, use Ju Pi Zhu Ru Tang (Tangerine Peel and Bamboo Shaving Decoction). For hematemesis, epistaxis, and blood loss, use Xi Jiao Di Huang Tang (Rhinoceros Horn Rehmannia Decoction) with Gardenia (Shan Zhi) and Lotus Root Juice (Ou Zhi). As for Liver Yang transforming into Wind, disturbing the clear orifices upwards, causing vertex headache, dizziness, vertigo, tinnitus, palpitations, and insomnia with irritability, this is due to internal deficiency of Ying fluids, Water failing to nourish Wood, Fire stirring up Phlegm rising. Actually, there is no Wind to disperse; instead, nourish fluids and harmonize Yang. Use Mai Mai Teng Tang (Rehmannia Vine Decoction) minus Ginger and Cinnamon Twig, or use Prepared Rehmannia (Shu Di), White Peony Root (Bai Shao), Goji Berry (Qi Zi), Poria (Fu Shen), Jujube Seed (Zao Ren), Stir-fried Chrysanthemum (Chao Gan Ju), Frost Mulberry Leaf (Shuang Sang Ye), Oyster Shell (Mu Li), Dendrobium (Shi Hu), and Schisandra (Wu Wei Zi). If caused by Kidney deficiency with floating Yang, fill the marrow and tonify essence with Donkey-hide Gelatin (E Jiao), Tortoise Shell (Gui Jia), Edible Mussel (Dan Cai), Blue Salt (Qing Yan), Achyranthes (Niu Xi), Cornus (Yu Rou), Prepared Rehmannia (Shu Di), and Magnetite (Ci Shi). If caused by weak Spleen Earth being overwhelmed by Liver Wood, soothe the Liver and benefit the Stomach with Suan Zao Ren Tang (Sour Jujube Seed Decoction) minus Ligusticum (Chuan Xiong), adding Ginseng (Ren Shen), Yam (Shan Yao), and Wheat (Xiao Mai). If caused by anger and overwork leading to tongue numbness and limb Bi-syndrome, with muscle twitching, this results from extremes of the Five Emotions, hyperactive Yang and deficient Yin, Wind arising from Fire. Soothe and moisten to extinguish wind with He Jian's Di Huang Yin Zi (Rehmannia Drink) minus Cinnamon Twig (Gui Zhi), Aconite (Fu Zi), Morinda (Ba Ji), and Acorus (Chang Pu). If Fire and Wind obstruct upwards, causing heavy head and epigastric Bi-syndrome, clear Metal and descend turbidity with Apricot Seed (Xing Ren), Fresh Acorus Root (Xian Chang Pu Gen), Trichosanthes Fruit (Gua Lou), Uncaria (Gou Teng), Chrysanthemum Leaves (Ju Ye), and Mint (Bo He). If elderly with depleted Water, prone to rising Wind and Fire, causing dizziness and constipation, strengthen Water and moisten dryness with Hai Shao Dan (Little Youth Pill) minus Eucommia (Du Zhong), Morinda (Ba Ji), Celastrus (Chu Shi), and Fennel (Hui Xiang), adding Mulberry Leaf (Sang Ye), Black Sesame (Hei Zhi Ma), Biota Seed (Bai Zi Ren), Stir-fried Chrysanthemum (Chao Gan Ju), Poria (Fu Shen), and Oyster Shell (Mu Li). If the Yangming collaterals are deficient, prone to Wind and Fire shaking, with poor appetite but hunger, fill the emptiness with Ginseng (Ren Shen), Yam (Shan Yao), Roasted Licorice (Zhi Cao), Oyster Shell (Mu Li), Jujube Seed (Zao Ren), Poria (Fu Ling), White Peony Root (Bai Shao), and Southern Date (Nan Zao). Generally, the Liver is a rigid organ responsible for free flow and drainage; medications should not be harsh but gentle, not attacking but harmonizing, truly imitating the principle of treating the Liver in the Neijing.
Zhu Danxi said: Patients say they feel cold Qi rising from below, but it is not true cold. This ascending Qi originates from the Liver, carrying Ministerial Fire (Xiang-huo) internally, rising from below. The heat is severe; the patient feels cold because extreme Fire resembles Water, indicating severe accumulated heat. Hyperactive Yang and deficient Yin cause these symptoms. He also said: Qi rising from the left side is Liver Fire; use Zuo Jin Wan (Left Metal Pill). Qi rising from below the navel is Yin Fire; use Huang Bo Wan (Phellodendron Pill) or Kan Li Wan (Kan-Li Pill). Qi rising from the feet into the abdomen indicates extreme deficiency; use Zi Yin Jiang Huo Tang (Nourish Yin and Descend Fire Decoction), externally apply Aconite powder mixed with saliva to Yongquan (KI 1), to guide heat downward.