大意
火乃天地间真阳之气。天非此火。不能生物。人非此火。不能有生。故凡腐熟五谷。化精气神。皆赖此真阳
之火。名曰少火。及情窦既开。动过乎静。动始阳生。动极阳亢。亢则火爆。偏胜而病者。皆亢阳之火。名曰壮
火。（汇补）壮火食气。少火生气。（内经）所以少火之火。无物不生。壮火之火。无物不耗。可见火与元气。势不两
立。一胜则一负。故曰。火为元气之贼。（东垣）
内因
恚怒则火起于肝。忧思则火起于脾。醉饱则火起于胃。房劳则火起于肾。悲哀则火起于肺。过喜则火起
于心。心为君主。自焚则死矣。（内经）
外候
诸痛疮疡。诸腹胀大。诸病有声。鼓之如鼓。诸呕吐酸。暴注下迫。皆属于热。诸热瞀螈。诸逆冲上。诸躁狂越。
诸禁鼓栗。如丧神守。诸病 肿。疼酸惊骇。诸转反戾。水液混浊。皆属于火。（内经）言属热者。君火之病。属火
者。相火之症。不可不辨。
火分各经
掉眩螈 。胁痛目赤。肝火动也。悲笑谵妄。口舌疮疡。心火动也。腹胀有声。口臭唇肿。脾火动也。喘咳烦闷。
鼻塞鼽衄。肺火动也。梦遗精浊。躁扰牙宣。肾火动也。目黄口苦。耳鸣胀痛。胆火动也。多作腹痛。血淋溺浊。
小肠火也。呕吐嘈杂。面浮龈肿。胃家火也。暴泻黄赤。便结不通。大肠火也。癃闭淋沥。遗溺混浊。膀胱火也。
喉痹昏昧。头眩格食。三焦火也。阳事频举。不交精泄。命门火也。（六要）大概属肝者。诸风之火。属脾胃者。诸
湿痰火。属心肺者。诸热实火。属肾者。诸虚阴火。散于各经。浮游之火。入气分。无根之火。入血分。消阴伏火。
故曰。诸病寻痰火。痰火生异症。（入门）
火升有三
气从左边起者。肝火也。气从脐下起者。阴火也。气从涌泉穴起者。虚之甚也。（丹溪）要知上升之气。自肝而
出。中抉相火。自觉冷者。非真冷也。乃火极似水耳。（原病式）
虚火有五
有劳倦内伤。身热无力。为气虚火者。有失血之后。阴分转剧。为血虚火者。有遇事烦冗。心火焦灼。为阳强
病者。有房室过度。肾水不足。阳光上亢。为阴虚火者。有老弱病后。吐泻脱元。上热下寒。为阳虚火者。（汇补）
郁火有三
有平素内热。外感风寒。腠理闭塞而为郁热者。有恚怒不发。谋虑不遂。肝风屈曲而为郁火者。有胃虚食
冷。抑遏阳气于脾土之中。四肢发热。扪之烙手而为火郁症者。（汇补）
虚实分辨
大约实火之热。日夜无间。口渴能饮。大便坚闭。虚火之热。向夜潮热。口燥不饮。大便不闭。（入门）然实火亦
有日晡潮热者。如外感阳明里症是也。虚火亦有昼夜俱热者。如气血两虚之症也。实火亦有大便泄泻
者。如暑湿气食之症也。虚火亦有大便干燥者。如产后病后及老弱血枯便燥是也。当合兼症脉息辨之。
（汇补）
脉法
脉浮虚数为虚火。脉沉实数为实火。各随部位以断何经之火。（汇补）
死候
卒病暴死。皆属于火。（内经）盖因喜怒悲恐惊五者。偶有过中。心火暴甚。肾水不能救之。则阳亢阴竭。卒然
不省。故曰。五志之火动极。不治。（丹溪）
又有多谋多怒多欲之人。厥阳之火。无时不动。既已有病。尚尔不息。煎熬真阴。渐致危殆。阴虚则惫。阴绝
则死。盖一水不能胜五火也。（丹溪）
火宜静养
火之为物。静则退藏。动则亢上。不拘五脏六腑十二经中。动皆属火。当恬惮虚无。镇之以静。使道心常为
一身之主。而人心听命焉。彼诸火者。将寂然不动。何酷烈暴悍之有。（六要）
总治
火之性不同。在心者位尊丽上。主宰一身。谓之君火。在肾肝者。感心而动。代君行令。谓之相火。君火正治。
相火反治。故虚火补之。实火泻之。郁火发之。浮火敛之。又曰。降有余之火。在于破气。降不足之火。在于滋
阴。（汇补）
分治
心火者。譬诸柴薪之火。可以湿伏。可以水灭。可以直折。宜苦寒凉剂。逆其性而正治之。所谓热淫所胜。治
以咸寒也。三黄汤、当归六黄汤、天王补心丹之类。命门火者。譬诸亢龙之火。遇雨则焚。得湿则燔。人身阳
虚之火。不可以寒凉直折。宜辛温之品。随其性以反佐之。所谓据其窟穴而招之也。八味丸、附子理中汤
之类。肝火者。譬诸雷电之火。郁蒸愈发。阴湿愈炎。或出地而上升。或与龙而并见。人身肝家之火。挟气郁
者。宜顺气以导之。所谓气降则火自降也。挟血燥者。宜养血以濡润之。所谓肝气为阳为火。肝血为阴为
水也。逍遥散之类。挟湿热者。宜清湿以解之。所谓湿病多自热生。热去而湿自除也。左金丸、当归芦荟丸
之类。挟脾虚者。宜培脾以调肝火。所谓木来侮土。则当培土以泻水也。六君子加黄连、白芍之类。肝自虚
者。宜补肝以胜其火。所谓肝气太旺。肝亦自伤。则当敦土以培木也。六君子加当归、白芍。挟肾虚者。宜滋
肾以抑肝。所谓乙癸同源。肾肝同治也。地黄汤加当归、白芍。或加柴胡、山栀之类。肾火者。譬诸灯烛之火。
得水则燥。添火则竭。惟以膏油加之。则光明不绝。人身下焦阴火上炎。得苦寒之品则真水愈虚。宜滋其
精液。所谓壮水之主以制阳光也。地黄丸加麦冬、五味之类。脾火者。譬诸红炉之火。得湿则灭。得木则烟。
以灰覆之则温暖长存。人身脾家之火。得苦寒之剂。则食少泻多。得恼怒之气。则面青口苦。故劳倦伤脾
发热者。宜培补中气。养其化源。所谓甘温能除大热也。补中益气加减。生冷滞脾发热者。宜升阳开胃。佐
以舒脾。所谓火郁发之也。（火郁汤）
用药总法
大率肝火用柴胡、赤芍。胆火用柴胡、胆草。心火用黄连、连翘。肺火用黄芩、山栀。脾火用黄连、白芍。肾火用
黄柏、知母。大肠火用条芩、大黄。小肠火用木通、灯心。胃火加石膏、花粉。膀胱火用山栀、泽泻。三焦火用玄
参、山栀。此皆治热淫邪胜实火之药也。若稍涉虚者。不拘此法。凡君火炽盛。尺寸脉俱大。用诸寒药直折
其火转甚者。须用姜汁炒药。或酒制炒。则火自伏。此寒因热用之法也。凡相火炽盛。两尺俱大。寸脉反静
者。不可用寒凉。惟黄柏同肉桂并用。随其性而下行。使心肾之火交于顷刻。然左尺脉独大者。不可用黄
柏。右尺脉独大者。不可用肉桂。又两手尺寸脉不大。但微无力。或浮数无伦者。亦不可用黄柏。虽有烦燥
火盛。乃虚阳发露。宜用肉桂、附子同诸补药。煎成冷服。则无拒格之患。此热因寒用之法也。如误用寒药
者死。凡火症左尺脉微细者。宜地黄汤丸。加麦冬、五味。右尺脉微细者。八味地黄汤丸。左关肝脉无力者。
宜逍遥散。或加人参、麦冬、生地、陈皮。右关脾脉无力者。宜补中益气汤。加白芍、丹皮、麦冬。左寸心脉无力
者。宜归脾汤。右寸肺脉无力者。宜生脉散。其出入加减。于各方中与病合宜者采用之。凡火过盛。必缓之
以生甘草。童便降火甚速。火症见血者宜之。人中白降龙雷之火。阴虚者宜丸药中用之。火起脐下。小腹
唧唧有声者。阴火也。败龟板主之。火从足底涌泉穴起。用附子末津调抹足心下。加蓖麻子尤验。
火症选方
三黄汤（东垣） 治膏粱醇酒太过。积热上中二焦。变诸火症。
黄连 黄芩 黄柏（各一钱） 炒山栀 玄参（各八两） 知母（一钱半） 石膏（二钱） 甘草（七分）
灯心水煎服。
单用前四味。名解毒汤。为丸。名栀子金花丸。去栀子。又名三补丸。一名三黄丸。
泻白散（钱氏） 治肺火实盛。
桑白皮（炒） 地骨皮（各一两） 甘草（炒五钱）
王海藏加黄芩、山栀。
泻青丸 治肝火实盛生风之症。
当归（焙秤） 川芎 山栀 龙胆草（焙秤） 羌活 防风 大黄（煨）
各等分。末之。蜜丸鸡豆大。每服一丸。煎竹叶汤同砂糖温水化下。
清胃散 治胃火。
生地（三分） 当归（三分） 丹皮（五分） 黄连（三分） 升麻（一钱）
加连翘、甘草、赤芍药。水煎。
回令丸（丹溪） 治肝火。
黄连（六两） 吴茱萸（一两）
为末。粥丸。
导赤散（钱氏） 治小肠火。
生地 木通 甘草（等分）
为末。每用三钱。入竹叶七片。煎服。
泻心汤（钱氏） 治心火。
黄连一味。酒炒。加大黄、黄芩、名三黄泻心汤。
凉膈散 治火郁上焦。
大黄 朴硝（各五钱） 甘草 连翘 栀子 黄芩 薄荷（各一两半）
为末。每服一两。水二盏。竹叶七片。煎服。
白虎汤（方见发热）
黑奴丸 治热毒发斑。烦燥大渴倍常。时行热病。六七日未得汗。脉洪大而数。面赤目胀。身痛大热。狂躁
欲走。又五六日已上不解。热在胸中。口噤不能言。为坏伤寒病。医所不治。弃为死人。精魂已竭。心下才
暖。拨开其口。灌药下咽即活。
黄芩 釜底煤 芒硝 麻黄 灶突墨 梁上尘 小麦奴（各一两） 大黄（一两二钱）
为末。蜜丸如弹子大。新汲水化下。饮尽当足寒汗出乃瘥。若时顷不汗出。再服一丸。见微利。若不大渴。
不可与此药。以上诸方。皆治实火之剂。
大补阴丸 治下焦相火。
黄柏一味。炒褐色。粥丸。或水丸。
坎离丸（丹溪） 一名滋肾丸。治相火上炎。
黄柏 知母 肉桂
逍遥散（易简） 治肝脾二经血虚火症。
当归 白芍药 白术 白茯苓 柴胡（各一钱） 甘草（五分）
水煎。薛立斋加牡丹皮、山栀。名加味逍遥散。古方逍遥散。即前方。中无牡丹皮、山栀。有薄荷、陈皮、地骨皮。
地黄汤 治肾虚火症。用此壮水之主以制阳光。（方见中风）
上渴足冷者。方中加肉桂、五味子。上渴足暖者。加麦冬、五味。
四物汤 治血虚火症。
四君子汤 治气虚火症。
补中益气汤 治元气下陷。阴火上炎。
十全大补汤 治火症气血两虚者。
人参养荣汤 治心脾肾三经俱虚火症。（五方俱见中风）
火郁汤（东垣）治火郁于中。不得舒散。因内伤生冷。抑遏阳气于脾土中而发热者。
升麻 葛根 白芍药 柴胡（各一钱） 甘草 防风（各五分）
加独活。名升阳散火汤。每服三四钱。水二盏。加连须葱白三寸。煎服。
防风通圣散（河间） 治郁火症。因内有积热。外为风寒所束而发热者。
防风 川芎 当归 赤芍药 连翘 薄荷 麻黄 大黄 芒硝（各半两） 桔梗 石膏 黄芩（各一两） 白术 山
栀荆芥（各二钱半） 滑石（三两） 甘草（二两）
上为末。每服二钱。水一盏。姜三片。煎服。又名双解散。
【大意】
火，是天地间的真阳之气。天如果没有这火，就不能化生万物；人如果没有这火，就不能维持生命。所以凡是腐熟五谷、化生精气神，都依赖这真阳之火，称之为“少火”。等到情欲萌动，活动超过了静守，动则阳气生发，动极则阳气亢盛，亢盛则如火爆发，偏胜而致病，这些都是亢阳之火，称之为“壮火”。（《证治汇补》引用）壮火消耗元气，少火滋生元气。（《黄帝内经》）所以少火之火，无物不能生长；壮火之火，无物不致耗损。可见火与元气，势不两立，一方胜则另一方负。所以说：火是元气的贼寇。（李东垣）
【内因】
愤怒则火起于肝，忧思则火起于脾，醉饱则火起于胃，房劳则火起于肾，悲哀则火起于肺，过喜则火起于心。心为君主之官，若自焚则死矣。（《黄帝内经》）
【外候】
各种疼痛疮疡，各种腹部胀大，各种病证伴有声响，叩击如鼓声，各种呕吐酸水，急骤腹泻伴肛门重坠感，都属于热证。各种发热昏闷抽搐，各种气逆冲上，各种烦躁狂乱超越常态，各种口禁鼓栗，如同失掉神志主宰，各种病证肿胀，疼痛酸痛惊骇，各种筋脉转侧反折拘挛，津液混浊，都属于火证。（《黄帝内经》）说属于热的，是君火的病证；属于火的，是相火的病症，不可不辨别清楚。
【火分各经】
肢体震颤眩晕抽搐，胁痛目赤，是肝火发动。悲笑谵妄，口舌生疮，是心火发动。腹胀有声，口臭唇肿，是脾火发动。喘咳烦闷，鼻塞流涕鼻衄，是肺火发动。梦遗精浊，躁扰牙宣（牙龈出血），是肾火发动。目黄口苦，耳鸣胀痛，是胆火发动。多作腹痛，血淋尿浊，是小肠火。呕吐嘈杂，面浮龈肿，是胃家火。暴泻黄赤，大便干结不通，是大肠火。小便癃闭淋漓，遗尿混浊，是膀胱火。喉痹昏昧，头眩格食（吞咽困难），是三焦火。性功能频繁勃起但不交合泄精，是命门火。（《医宗六要》）大概属肝的，是诸风之火；属脾胃的，是诸湿痰火；属心肺的，是诸热实火；属肾的，是诸虚阴火。散在于各经的，是浮游之火；入于血分的，是无根之火。消解阴伏之火，所以说：各种病证寻找痰火，痰火能产生奇异病症。（《医学入门》）
【火升有三】
气从左边起来的，是肝火。气从脐下起来的，是阴火。气从涌泉穴起来的，是虚损至极。（朱丹溪）要知道上升之气，出自肝，中间挟持相火，自觉冷的，不是真冷，乃是火极似水罢了。（《原病式》）
【虚火有五】
有因劳倦内伤，身体发热无力，称为气虚火。有因失血之后，阴分症状加重，称为血虚火。有因遇事烦冗，心火焦灼，称为阳强病（此处指阴虚阳亢之实证表现）。有因房室过度，肾水不足，阳光上亢，称为阴虚火。有因老弱病后，吐泻脱元，上热下寒，称为阳虚火。（《证治汇补》）
【郁火有三】
有平素内热，又外感风寒，腠理闭塞而形成的郁热。有恚怒不发，谋虑不遂，肝气屈曲而形成的郁火。有胃虚食冷，抑遏阳气于脾土之中，四肢发热，摸上去烫手而形成的火郁症。（《证治汇补》）
【虚实分辨】
大致实火的热象，日夜不间断，口渴能饮水，大便坚硬闭塞。虚火的热象，夜间潮热，口干但不欲饮，大便不闭塞。（《医学入门》）然而实火也有日晡时潮热的，如外感阳明里证就是。虚火也有昼夜都热的，如气血两虚的证候就是。实火也有大便泄泻的，如暑湿气食积滞的证候就是。虚火也有大便干燥的，如产后病后及老弱血枯便燥就是。应当结合兼症和脉息来辨别。（《证治汇补》）
【脉法】
脉浮虚数为虚火，脉沉实数为实火。各自根据脉位来判断是哪一经的火。（《证治汇补》）
【死候】
突然患病暴死，都属于火。（《黄帝内经》）这是因为喜怒悲恐惊五种情绪，偶尔有过度的，导致心火暴甚，肾水不能救助，于是阳亢阴竭，突然不省人事。所以说：五志之火动极，难以治愈。（朱丹溪）
又有谋略多、易怒、欲望多的人，厥阳之火，无时无刻不在动。既然已经生病，还不休止，煎熬真阴，逐渐导致危殆。阴虚则疲惫，阴绝则死亡。盖因一水不能胜五火也。（朱丹溪）
【火宜静养】
火这种东西，静则退藏，动则亢上。不拘泥于五脏六腑十二经中，动皆属于火。应当恬淡虚无，以静镇之，使道心常为一身之主，而人心听命于它。那些诸火，将寂然不动，还有什么酷烈暴悍的呢？（《医宗六要》）
【总治】
火的性质不同。在心者，位置尊贵且位于上部，主宰一身，称为君火。在肾肝者，受心感召而动，代君行使命令，称为相火。君火用正治法，相火用反治法。所以虚火用补法，实火用泻法，郁火用发散法，浮火用收敛法。又说：降有余之火，在于破气；降不足之火，在于滋阴。（《证治汇补》）
【分治】
心火，好比柴薪之火，可以用湿伏灭，用水扑灭，可以直折其势。宜用苦寒凉剂，逆其性而正治之。所谓热淫所胜，治以咸寒。三黄汤、当归六黄汤、天王补心丹之类。
命门火，好比亢龙之火，遇雨则焚，得湿则燃烧。人身阳虚之火，不可以用寒凉药直折。宜用辛温之品，随其性以反佐之。所谓据其窟穴而招引它。八味丸、附子理中汤之类。
肝火，好比雷电之火，郁蒸愈发，阴湿愈炎。或出地而上升，或与龙并见。人身肝家之火，挟气郁的，宜顺气以导之。所谓气降则火自降。挟血燥的，宜养血以濡润之。所谓肝气为阳为火，肝血为阴为水。逍遥散之类。挟湿热的，宜清湿以解之。所谓湿病多自热生，热去而湿自除。左金丸、当归芦荟丸之类。挟脾虚的，宜培脾以调肝火。所谓木来侮土，则当培土以泻水。六君子汤加黄连、白芍之类。肝自虚的，宜补肝以胜其火。所谓肝气太旺，肝亦自伤，则当敦土以培木。六君子汤加当归、白芍。挟肾虚的，宜滋肾以抑肝。所谓乙癸同源，肾肝同治。地黄汤加当归、白芍。或加柴胡、山栀之类。
肾火，好比灯烛之火，得水则燥，添火则竭。惟以膏油加之，则光明不绝。人身下焦阴火上炎，得苦寒之品则真水愈虚。宜滋其精液。所谓壮水之主以制阳光。地黄丸加麦冬、五味子之类。
脾火，好比红炉之火，得湿则灭，得木则烟，以灰覆之则温暖长存。人身脾家之火，得苦寒之剂，则食少泻多；得恼怒之气，则面青口苦。所以劳倦伤脾发热者，宜培补中气，养其化源。所谓甘温能除大热。补中益气汤加减。生冷滞脾发热者，宜升阳开胃，佐以舒脾。所谓火郁发之。（火郁汤）
【用药总法】
大率肝火用柴胡、赤芍。胆火用柴胡、龙胆草。心火用黄连、连翘。肺火用黄芩、山栀。脾火用黄连、白芍。肾火用黄柏、知母。大肠火用条芩、大黄。小肠火用木通、灯心草。胃火加石膏、天花粉。膀胱火用山栀、泽泻。三焦火用玄参、山栀。这些都是治疗热淫邪胜实火的药物。如果稍涉虚证，不拘泥于此法。凡君火炽盛，寸关尺脉俱大，用诸寒药直折其火反而更重的，须用姜汁炒药，或酒制炒，则火自伏。这是寒因热用的方法。凡相火炽盛，两尺脉俱大，寸脉反静的，不可用寒凉药。惟有用黄柏同肉桂并用，随其性而下行，使心肾之火交于顷刻。然而左尺脉独大的，不可用黄柏；右尺脉独大的，不可用肉桂。又两手尺寸脉不大，但微无力，或浮数无伦的，也不可再用黄柏。虽有烦躁火盛，乃是虚阳发露，宜用肉桂、附子同诸补药，煎成冷服，则无拒格之患。这是热因寒用的方法。如误用寒药者死。凡火症左尺脉微细的，宜用地黄汤丸，加麦冬、五味子。右尺脉微细的，用八味地黄汤丸。左关肝脉无力的，宜用逍遥散，或加人参、麦冬、生地、陈皮。右关脾脉无力的，宜用补中益气汤，加白芍、丹皮、麦冬。左寸心脉无力的，宜用归脾汤。右寸肺脉无力的，宜用生脉散。其出入加减，于各方中与病合宜者采用之。凡火过盛，必缓之以生甘草。童便降火甚速，火症见血者适宜。人中白降龙雷之火，阴虚者适宜在丸药中使用。火起脐下，小腹唧唧有声的，是阴火，败龟板主之。火从足底涌泉穴起，用附子末津液调抹足心下，加蓖麻子尤其有效。
【火症选方】
三黄汤（李东垣） 治疗膏粱醇酒太过，积热上中二焦，变生诸火症。
黄连、黄芩、黄柏（各一钱），炒山栀、玄参（各八两），知母（一钱半），石膏（二钱），甘草（七分）。灯心水煎服。
单用前四味，名解毒汤，制成丸剂，名栀子金花丸。去掉栀子，又名三补丸，一名三黄丸。
泻白散（钱乙） 治疗肺火实盛。
桑白皮（炒）、地骨皮（各一两），甘草（炒五钱）。
王海藏加黄芩、山栀。
泻青丸 治疗肝火实盛生风的证候。
当归（焙称量）、川芎、山栀、龙胆草（焙称量）、羌活、防风、大黄（煨）。
各等分。研末，蜜丸如鸡豆大。每服一丸，煎竹叶汤同砂糖温水化下。
清胃散 治疗胃火。
生地（三分）、当归（三分）、丹皮（五分）、黄连（三分）、升麻（一钱）。
加连翘、甘草、赤芍药。水煎。
回令丸（朱丹溪） 治疗肝火。
黄连（六两）、吴茱萸（一两）。
为末，粥丸。
导赤散（钱乙） 治疗小肠火。
生地、木通、甘草（等分）。
为末。每用三钱，入竹叶七片，煎服。
泻心汤（钱乙） 治疗心火。
黄连一味，酒炒。加大黄、黄芩，名三黄泻心汤。
凉膈散 治疗火郁上焦。
大黄、朴硝（各五钱），甘草、连翘、栀子、黄芩、薄荷（各一两半）。
为末。每服一两，水二盏，竹叶七片，煎服。
黑奴丸 治疗热毒发斑，烦躁大渴倍常，时行热病，六七日未得汗，脉洪大而数，面赤目胀，身痛大热，狂躁欲走。又五六日以上不解，热在胸中，口噤不能言，为坏伤寒病，医所不治，弃为死人，精魂已竭，心下才暖，拨开其口，灌药下咽即活。
黄芩、釜底煤、芒硝、麻黄、灶突墨、梁上尘、小麦奴（各一两），大黄（一两二钱）。
为末，蜜丸如弹子大，新汲水化下。饮尽当足寒汗出乃瘥。若片刻不汗出，再服一丸。见微利。若不大渴，不可与此药。以上诸方，皆治实火之剂。
坎离丸（朱丹溪） 一名滋肾丸。治疗相火上炎。
黄柏、知母、肉桂。
逍遥散（《济生方》/易简方） 治疗肝脾二经血虚火症。
当归、白芍药、白术、白茯苓、柴胡（各一钱），甘草（五分）。
水煎。薛立斋加牡丹皮、山栀，名加味逍遥散。古方逍遥散，即前方，中无牡丹皮、山栀，有薄荷、陈皮、地骨皮。
地黄汤 治疗肾虚火症。用此壮水之主以制阳光。（方见中风篇）
上渴足冷者，方中加肉桂、五味子。上渴足暖者，加麦冬、五味。
火郁汤（李东垣）治疗火郁于中，不得舒散。因内伤生冷，抑遏阳气于脾土中而发热者。
升麻、葛根、白芍药、柴胡（各一钱），甘草、防风（各五分）。
加独活，名升阳散火汤。每服三四钱，水二盏，加连须葱白三寸，煎服。
防风通圣散（刘河间） 治疗郁火症。因内有积热，外为风寒所束而发热者。
防风、川芎、当归、赤芍药、连翘、薄荷、麻黄、大黄、芒硝（各半两），桔梗、石膏、黄芩（各一两），白术、山栀、荆芥（各二钱半），滑石（三两），甘草（二两）。
上为末。每服二钱，水一盏，姜三片，煎服。又名双解散。
[General Principle]
Fire is the true Yang Qi of heaven and earth. Without this fire, heaven cannot generate all things; without this fire, humans cannot maintain life. Therefore, whatever processes such as the digestion of grains and the transformation of essence, Qi, and spirit all rely on this true Yang fire, which is called "Shao Huo" (Lesser Fire). Once emotional desires awaken, movement exceeds stillness; movement generates Yang, and extreme movement leads to Yang hyperactivity. Hyperactivity results in fiery explosion; when it becomes excessive and causes disease, these are all fires of hyperactive Yang, called "Zhuang Huo" (Greater Fire). (*Zhengzhi Huibu* cites:) "Zhuang Huo consumes Qi, Shao Huo generates Qi." (*Huangdi Neijing*) Thus, Shao Huo allows nothing not to grow, while Zhuang Huo causes nothing not to be consumed. It can be seen that fire and Yuan Qi (Original Qi) are incompatible; when one prevails, the other declines. Hence it is said: "Fire is the thief of Yuan Qi." (Li Dongyuan)
[Internal Causes]
Anger causes fire to arise in the Liver; worry and overthinking cause fire to arise in the Spleen; drunkenness and overeating cause fire to arise in the Stomach; sexual exhaustion causes fire to arise in the Kidney; grief causes fire to arise in the Lung; excessive joy causes fire to arise in the Heart. The Heart is the Monarch organ; if it burns itself, death ensues. (*Huangdi Neijing*)
[External Manifestations]
Various pains and sores, various abdominal distensions, various diseases with sounds, drum-like upon percussion, various vomiting of acid fluids, sudden diarrhea with tenesmus, all belong to Heat. Various fevers with dizziness and convulsions, various rebellious Qi rushing upward, various restlessness and mania exceeding normal limits, various mouth closure and shivering as if losing spiritual control, various swellings, painful soreness, and fright, various tendon contractions and spasms, turbid body fluids, all belong to Fire. (*Huangdi Neijing*) Those stated to belong to Heat refer to the pathology of Jun Huo (Monarch Fire); those stated to belong to Fire refer to the syndrome of Xiang Huo (Minister Fire), which must be distinguished carefully.
[Fire by Meridian]
Tremors, vertigo, and convulsions, hypochondriac pain and red eyes indicate Liver Fire activation. Sadness, laughter, delirium, and mouth/tongue ulcers indicate Heart Fire activation. Abdominal distension with sounds, bad breath, and swollen lips indicate Spleen Fire activation. Wheezing, cough, chest oppression, nasal congestion, epistaxis, and rhinorrhea indicate Lung Fire activation. Nocturnal emissions, turbid urine, restlessness, and bleeding gums indicate Kidney Fire activation. Yellow eyes, bitter taste, tinnitus, and distending pain indicate Gallbladder Fire activation. Frequent abdominal pain, hematuria, and turbid urine indicate Small Intestine Fire. Vomiting and heartburn, facial edema, and swollen gums indicate Stomach Fire. Sudden yellow-red diarrhea and constipation indicate Large Intestine Fire. Urinary retention, dribbling, enuresis, and turbid urine indicate Bladder Fire. Throat obstruction, mental confusion, vertigo, and dysphagia indicate San Jiao (Triple Burner) Fire. Frequent erections without ejaculation indicates Ming Men (Gate of Life) Fire. (*Yizong Liuyao*) Generally, those belonging to the Liver are winds-fire; those belonging to the Spleen and Stomach are dampness-phlegm-fire; those belonging to the Heart and Lung are heat-excess fire; those belonging to the Kidney are deficiency-yin fire. Scattered among the meridians is floating-wandering fire; entering the Blood level is rootless fire. To resolve yin-entrenched fire, it is said: "In various diseases, seek phlegm-fire; phlegm-fire generates strange syndromes." (*Yixue Rumen*)
[Three Types of Rising Fire]
Qi rising from the left side is Liver Fire. Qi rising from below the navel is Yin Fire. Qi rising from the Yongquan point (KI1) indicates extreme deficiency. (Zhu Danxi) One must know that rising Qi originates from the Liver, carrying Minister Fire internally. Feeling cold is not true cold, but rather fire extreme resembling water. (*Yuanbing Shi*)
[Five Types of Deficiency Fire]
There is Qi-deficiency fire due to fatigue and internal injury, characterized by fever and weakness. There is Blood-deficiency fire after blood loss, where Yin symptoms worsen. There is Yang-excess syndrome due to mental agitation and burning Heart Fire. There is Yin-deficiency fire due to excessive sexual activity and insufficient Kidney Water, leading to Sunlight (Yang) soaring upward. There is Yang-deficiency fire in the elderly or post-illness, characterized by vomiting/diarrhea depleting Yuan Qi, upper heat and lower cold. (*Zhengzhi Huibu*)
[Three Types of Stagnant Fire]
There is stagnant heat due to chronic internal heat combined with external Wind-Cold obstructing the interstices. There is stagnant fire due to suppressed anger or unfulfilled plans, causing Liver Qi to twist. There is fire-stagnation syndrome due to Spleen-Stomach deficiency and cold food, suppressing Yang Qi within the Spleen Earth, causing hot limbs that feel burning to the touch. (*Zhengzhi Huibu*)
[Distinguishing Excess and Deficiency]
Generally, excess fire heat is continuous day and night, accompanied by thirst and desire to drink, and hard constipation. Deficiency fire heat is tidal fever at night, dry mouth without desire to drink, and no constipation. (*Yixue Rumen*) However, excess fire can also present with afternoon tidal fever, such as in Exterior-Interior Yangming syndrome. Deficiency fire can also present with heat day and night, such as in Qi and Blood dual deficiency. Excess fire can also present with diarrhea, such as in Summerheat-dampness or food stagnation. Deficiency fire can also present with dry stool, such as postpartum, post-illness, or in the elderly with blood depletion. Differentiation must be made by combining accompanying symptoms and pulse diagnosis. (*Zhengzhi Huibu*)
[Pulse Method]
Floating, deficient, and rapid pulses indicate deficiency fire; deep, solid, and rapid pulses indicate excess fire. Diagnosis of which meridian's fire depends on the pulse position. (*Zhengzhi Huibu*)
[Signs of Death]
Sudden illness and violent death all belong to fire. (*Huangdi Neijing*) This is because the five emotions—joy, anger, sorrow, fear, and shock—when excessive, cause Heart Fire to flare violently. If Kidney Water cannot rescue it, Yang hyperactivity and Yin exhaustion occur, leading to sudden unconsciousness. Hence it is said: "When fire from the five zhi moves to extremes, it is incurable." (Zhu Danxi)
People who are overly calculating, angry, or desirous have Jue Yang fire moving constantly. Even after illness begins, if it does not cease, it fries the True Yin, gradually leading to critical danger. Yin deficiency leads to exhaustion; Yin extinction leads to death. For one water cannot overcome five fires. (Zhu Danxi)
[Fire Should Be Nourished by Stillness]
Fire, as a substance, retreats when still and rises hyperactively when moving. Regardless of the Zang-Fu organs or twelve meridians, movement belongs to fire. One should remain tranquil and empty, suppressing fire with stillness, making Dao Xin (Dao Mind) the master of the body, so that Ren Xin (Human Mind) obeys. Then these various fires will remain motionless; what酷烈暴悍 (cruelty and ferocity) would there be? (*Yizong Liuyao*)
[General Treatment]
The nature of fire differs. In the Heart, it is noble and superior, governing the whole body, called Jun Huo (Monarch Fire). In the Kidneys and Liver, it moves in response to the Heart, acting on behalf of the Monarch, called Xiang Huo (Minister Fire). Jun Huo is treated with orthodox methods; Xiang Huo is treated with reverse methods. Thus, deficiency fire is tonified, excess fire is purged, stagnant fire is dispersed, and floating fire is astringed. It is also said: To descend surplus fire, break Qi; to descend insufficient fire, nourish Yin. (*Zhengzhi Huibu*)
[Specific Treatments]
Heart fire is like wood fire; it can be smothered with wetness, extinguished with water, or directly broken. Use bitter-cold cooling agents to treat it orthodoxy against its nature. As stated: "For heat invading excessively, treat with salty-cold." Examples include San Huang Tang (Three Yellows Decoction), Danggui Liu Huang Tang (Angelica Six-Yellow Decoction), Tianwang Buxin Dan (Heavenly Emperor Heart-Nourishing Pill).
Ming Men fire is like the fire of an arrogant dragon; it burns when meeting rain and ignites when getting wet. Human Yang-deficiency fire cannot be directly broken with cold-cool herbs. Use acrid-warm substances to assist according to its nature (reverse assistance). As stated: "Attract it from its lair." Examples include Ba Wei Wan (Eight-Ingredient Pill), Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction).
Liver fire is like thunder and lightning fire; it increases with stagnation and inflammation with dampness. It rises from the earth or appears with dragons. Liver fire in the human body, if accompanied by Qi stagnation, should be guided by regulating Qi. As stated: "When Qi descends, fire naturally descends." If accompanied by Blood dryness, nourish Blood to moisten. As stated: "Liver Qi is Yang/Fire; Liver Blood is Yin/Water." Examples include Xiaoyao San (Free and Easy Wanderer Powder). If accompanied by Damp-Heat, clear dampness to resolve it. As stated: "Damp diseases often arise from heat; when heat goes, dampness removes itself." Examples include Zuojin Wan (Left Metal Pill), Danggui Lvhua Wan (Angelica Green-Alum Pill). If accompanied by Spleen deficiency, cultivate the Spleen to regulate Liver fire. As stated: "When Wood insults Earth, cultivate Earth to drain Water." Examples include Liujunzi Tang (Six-Gentlemen Decoction) plus Huanglian and Baishao. If the Liver itself is deficient, tonify the Liver to overcome its fire. As stated: "If Liver Qi is too vigorous, the Liver harms itself; thus cultivate Earth to nurture Wood." Examples include Liujunzi Tang plus Danggui and Baishao. If accompanied by Kidney deficiency, nourish the Kidney to suppress the Liver. As stated: "Yi and Gui share the same source; Kidney and Liver are treated together." Examples include Dihuang Tang (Rehmannia Decoction) plus Danggui and Baishao, or Chaihu and Zhizi.
Kidney fire is like lamp/candle fire; it dries with water and exhausts with added fire. Only by adding oil does the light last forever. Lower Jiao Yin fire flaming upward, if treated with bitter-cold, makes True Water more deficient. Nourish essence/fluids. As stated: "Strengthen the master of Water to control Sunlight." Examples include Dihuang Wan (Rehmannia Pill) plus Maidong and Wuweizi.
Spleen fire is like a red furnace fire; it extinguishes with dampness, smokes with wood, and stays warm long under ash. Spleen fire in the human body, if treated with bitter-cold, causes poor appetite and diarrhea; if provoked by anger, causes green face and bitter taste. For fever due to fatigue injuring the Spleen, cultivate and tonify Middle Qi to nourish the source of transformation. As stated: "Sweet-warm can remove great heat." Examples include Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) modified. For fever due to cold/raw food stagnating the Spleen, raise Yang and open the stomach, assisting with soothing the Spleen. As stated: "Disperse stagnant fire." (Huoyu Tang)
[General Principles of Medication]
Generally, Liver fire uses Chaihu and Chishao; Gallbladder fire uses Chaihu and Longdancao; Heart fire uses Huanglian and Lianqiao; Lung fire uses Huangqin and Zhizi; Spleen fire uses Huanglian and Baishao; Kidney fire uses Huangbai and Zhimu; Large Intestine fire uses Tiaohuangqin and Dahuang; Small Intestine fire uses Mutong and Dengxincao; Stomach fire adds Shigao and Huafen; Bladder fire uses Zhizi and Zexie; San Jiao fire uses Xuanshen and Zhizi. These are all herbs for treating heat-invasion and excess fire. If slightly deficient, do not stick to this method. If Jun Huo is blazing and pulses at Cun, Guan, Chi are all large, using cold herbs to directly break the fire may make it worse; use herbs fried in ginger juice or wine-processed instead, so the fire settles. This is the method of "cold used for heat." If Xiang Huo is blazing, both Chi pulses are large while Cun is quiet, do not use cold-cool herbs. Only use Huangbai together with Rougui, allowing them to descend according to their nature, causing Heart and Kidney fire to interact instantly. However, if only the Left Chi pulse is large, do not use Huangbai; if only the Right Chi pulse is large, do not use Rougui. Furthermore, if neither Cun nor Chi pulses are large but are slightly weak or floating-rapid without order, do not use Huangbai. Even with irritability and fire excess, this is revealed deficient Yang. Use Rougui and Fuzi with tonifying herbs, decocted and taken cold to avoid rejection. This is the method of "heat used for cold." Misusing cold herbs leads to death. For fire syndromes with fine/weak Left Chi pulse, use Dihuang Wan/Tang plus Maidong and Wuweizi. With fine/weak Right Chi pulse, use Ba Wei Dihuang Wan/Tang. With weak Left Guan Liver pulse, use Xiaoyao San, or add Renshen, Maidong, Shengdi, and Chenpi. With weak Right Guan Spleen pulse, use Buzhong Yiqi Tang, plus Baishao, Danpi, and Maidong. With weak Left Cun Heart pulse, use Guipi Tang. With weak Right Cun Lung pulse, use Shengmai San. Modify these formulas appropriately based on the syndrome. For excessive fire, always soothe with raw Gancao. Tongbian (Child's urine) reduces fire rapidly and is suitable for fire syndromes with bleeding. Renzhongbai (Ash from human feces) lowers Dragon/Thunder fire and is suitable for Yin deficiency in pill form. Fire arising below the navel with bubbling sounds in the lower abdomen is Yin fire; Baiguiban (Tortoise Shell) is the main herb. Fire arising from Yongquan (KI1) at the sole of the foot: apply powder of Fuzi mixed with saliva to the sole; adding Bamazi (Castor Seed) is especially effective.
[Selected Formulas for Fire Syndromes]
San Huang Tang (Li Dongyuan) Treats excessive rich food and alcohol, accumulating heat in Upper/Middle Jiao, transforming into various fire syndromes.
Huanglian, Huangqin, Huangbai (1 qian each), Fried Zhizi, Xuanshen (8 liang each), Zhimu (1.5 qian), Shigao (2 qian), Gancao (0.7 fen). Decoct with Dengxincao (Juncus effusus stem) and water.
Using only the first four ingredients is named Jiedu Tang (Detoxification Decoction); made into pills, it is Zhizi Jinhua Wan (Gardenia Golden Flower Pill). Removing Zhizi, it is also called Sanbu Wan (Three Tonics Pill) or Sanhuang Wan (Three Yellows Pill).
Xie Bai San (Qian Yi) Treats excess-full Lung fire.
Sangbaipi (fried), Gubopi (1 liang each), Gancao (fried, 5 qian).
Wang Haicang adds Huangqin and Zhizi.
Xie Qing Wan Treats Liver fire excess generating wind.
Danggui (roasted and weighed), Chuanxiong, Zhizi, Longdancao (roasted and weighed), Qianghuo, Fangfeng, Dahuang (roasted).
Equal parts. Powder, honey pills size of chicken beans. Take one pill per dose, dissolve in warm water with sugar, taken with Zhu Ye (Bamboo Leaf) decoction.
Qingwei San Treats Stomach fire.
Shengdi (3 fen), Danggui (3 fen), Danpi (5 fen), Huanglian (3 fen), Shengma (1 qian).
Add Lianqiao, Gancao, Chishao. Decoct with water.
Hui Ling Wan (Zhu Danxi) Treats Liver fire.
Huanglian (6 liang), Wuzhuyu (1 liang).
Powder, pill with congee.
Dao Chi San (Qian Yi) Treats Small Intestine fire.
Shengdi, Mutong, Gancao (equal parts).
Powder. Take 3 qian per dose, add 7 Zhu Ye leaves, decoct and take.
Xie Xin Tang (Qian Yi) Treats Heart fire.
Huanglian alone, wine-fried. Adding Dahuang and Huangqin makes San Huang Xie Xin Tang (Three Yellows Draining Heart Decoction).
Liang Ge San Treats stagnant fire in Upper Jiao.
Dahuang, Piao Xiao (5 qian each), Gancao, Lianqiao, Zhizi, Huangqin, Bohe (1.5 liang each).
Powder. Take 1 liang per dose, decoct with 2 cups water and 7 Zhu Ye leaves.
Baihu Tang (See Fever chapter)
Hei Nu Wan Treats heat-toxin causing macules, severe irritability and thirst, epidemic febrile disease. If no sweat after 6-7 days, pulse is surging-large and rapid, face red, eyes distended, body pain, high fever, mania wanting to run. Or unresolved after 5-6 days, heat in chest, jaw locked unable to speak, termed 'bad伤寒' (complicated cold damage), untreatable by doctors, abandoned as dead, soul exhausted, only warmth remaining in the heart area. Open mouth and pour medicine down; life returns immediately.
Huangqin, Fudi Mei (soot from pot bottom), Mangxiao, Mahuang, Zaotu Mo (soot from chimney flue), Liangshang Chen (dust from beam), Xiaomai Nu (wheat sprouts) (1 liang each), Dahuang (1.2 liang).
Powder, honey pills size of bullet. Dissolve in fresh well water. Drink until feet become cold and sweat appears for cure. If no sweat shortly, take another pill. Mild diarrhea is expected. Do not use if not extremely thirsty. All above formulas treat excess fire.
Da Bu Yin Wan Treats Lower Jiao Minister fire.
Huangbai alone, fried brown, pill with congee or water.
Kan Li Wan (Zhu Danxi) Also known as Zishen Wan. Treats Minister fire flaming upward.
Huangbai, Zhimu, Rougui.
Xiaoyao San (Yijian) Treats Blood-deficiency fire in Liver and Spleen meridians.
Danggui, Baishao, Baizhu, Baifuling, Chaihu (1 qian each), Gancao (0.5 qian).
Decoct with water. Xue Lizhai adds Mudanpi and Zhizi, named Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Ancient Xiaoyao San is the above formula without Mudanpi/Zhizi, but includes Bohe, Chenpi, and Gubopi.
Dihuang Tang Treats Kidney deficiency fire. Use this to strengthen the master of Water to control Sunlight. (See Stroke chapter)
For thirst above and cold feet, add Rougui and Wuweizi. For thirst above and warm feet, add Maidong and Wuweizi.
Siwu Tang Treats Blood-deficiency fire.
Sijunzi Tang Treats Qi-deficiency fire.
Buzhong Yiqi Tang Treats sinking of Yuan Qi and flaming up of Yin fire.
Shiquan Dabu Tang Treats fire syndromes with dual Qi and Blood deficiency.
Renshen Yangrong Tang Treats dual deficiency fire in Heart, Spleen, and Kidney meridians. (All five formulas see Stroke chapter)
Huoyu Tang (Li Dongyuan) Treats fire stagnant in the middle, unable to disperse. Caused by internal injury from cold/raw food, suppressing Yang Qi in Spleen Earth leading to fever.
Shengma, Gegen, Baishao, Chaihu (1 qian each), Gancao, Fangfeng (0.5 qian each).
Add Duohuo, named Shengyang Sanhuo Tang (Raise Yang Disperse Fire Decoction). Take 3-4 qian per dose, decoct with 2 cups water and 3 cun of scallion white with roots.
Fangfeng Tongsheng San (Liu Hejian) Treats stagnant fire syndrome. Caused by internal accumulated heat bound externally by Wind-Cold leading to fever.
Fangfeng, Chuanxiong, Danggui, Chishaoyao, Lianqiao, Bohe, Mahuang, Dahuang, Mangxiao (0.5 liang each), Jiegeng, Shigao, Huangqin (1 liang each), Baizhu, Zhizi, Jingjie (2.5 qian each), Huashi (3 liang), Gancao (2 liang).
Powder. Take 2 qian per dose, decoct with 1 cup water and 3 slices of ginger. Also known as Shuangjie San (Double Resolution Decoction).