心，匠意造方，以博裙带之乐，夭人天年，为可痛伤也。我特传此方以救之。以火之有余
者，水之不足，故用熟地、麦冬以大益其肾水，又恐熟地、麦冬不足以息燎原之火，又益玄
参、甘菊以平其胃中之炎。泻火仍是滋阴之味，则火息而正又无亏。火既上行非引而下之，
则水不济而火恐上腾，加之牛膝之润下，使火下降而不上升也。肾水既久枯竭，所
补之水，仅可供肾中之自用，安得分余膏而养肝木之子，复佐之白芍以滋肝，则肝
木既平，不必取给于肾水，自气还本宫而不至走下而外泄。然而火焚既久，则火毒
将成，虽现下之火为水所克，而从前之火毒安能遽消，故又辅之金银花，以消其毒，
而更能益阴，是消火之毒，而不消阴之气也。又虑阳火非至阴之味，不能消化于无
形，乃少用黄柏以折之，虽黄柏乃大寒之药，然入之大补阴水之中，反能解火之毒，
引补水之药，直入于至阴之中，而泻其虚阳之火耳。此方除黄柏不可多用外，其余
诸药，必宜如此多用，始能补水之不足，泻火之有余，否则火炽而不可救也。夫救
焚之道，刻不可缓，非滂沱大雨，不能止其遍野燎原之火。况火既升腾，胃中得水，
不啻如甘露之止渴，大料煎饮，正足以快其所欲，不必虑其多而难受也。
此症用定狂汤亦神效。
熟地（三两） 知母（一两） 荆芥（五钱） 水煎服。一剂即愈。
眼目红肿，口舌尽烂，咽喉微痛，两胁胀满，人以为肝火之旺，谁知是肾火之
旺乎。夫眼目属肝，两胁亦肝之位，明是肝火之旺，而谓是肾火者何居？以咽喉、
口舌之痛烂而知之也。第口舌属心，咽喉属肺，与肾绝不相干，何统以肾火名之？
不知肾火龙雷之火也。雷火由地而冲于天，肾火亦由下而升于上，入于胁则胁胀，
入于喉则喉痛，入于口舌则口舌烂，入于眼目则眼目肿矣。火无定位，随火之所至
而病乃生。今四处尽病，乃肾火之大炽耳。盖各经之火，止流连于一处，断不能口
舌、咽喉、眼目、两胁一齐受病也。似乎治法未可独治一经矣。然而各经不可分治，
而肾经实可专治，治其肾火，而各经之火尽散也。方用六味地黄汤加味治之。
熟地（一两） 山药（五钱） 茯苓（三钱） 丹皮（五钱） 泽泻（三钱） 山茱萸（四钱）
麦冬 白芍（各一两）
水煎服。一剂两胁之胀满除，二剂眼目之红肿愈，三剂咽喉之痛解，四剂口舌
之烂痊也。
六味汤原是纯补真水之药，水足而火自息。又有白芍之舒肝以平木，麦冬之养
肺以益金，金生水而水不必去生肝，则水尤易足，而火尤易平也。盖龙雷之火，乃
虚火也。虚火得水而即伏，何必泻火以激其怒哉。或曰∶用六味之方而不遵分两进
退加减者何也？曰∶夫药投其病，虽佐使之味可多用，病忌其药，虽君主之品自当
少减。轻重少殊，又何虑哉。
此症用止沸汤亦佳。
熟地（三两） 麦冬（二两） 地骨皮（一两） 水煎服。
寒热时止时发，一日四、五次以为常，热来时躁不可当，寒来时颤不能已，人
以为寒邪在阴阳之间也，谁知是火热在心肾之内乎。夫肾与心本相克而相交者也，
倘相克而不相交，必至寒热止发之无定。盖心喜寒而不喜热，肾喜热而不喜寒，然
而热为肾之所喜，必为心之所恶，寒为心之所喜，必为肾之所恶。肾恶心寒，恐寒
气犯肾，远避之而不敢交于心；心恶肾热，恐热气犯心，坚却之而不肯交于肾。然
而肾恶心寒，而又恶其不下交于肾，必欲交心而心不受，反以热而凌心矣；心恶肾
热而不上交于心，必思交肾而肾又不受，反以寒而犯肾矣。两相犯而相凌，于是因
寒热之盛衰，分止发之时候矣。夫心肾原无时不交也，一日之间，寒热之止发无常，
因交而发，因不交而即止，又何足怪。惟热来时躁不可当，寒来时颤不能已，实有
秘义也。夫热来之时，乃肾气之升腾也。心虽恶热，而心中正寒，宜不发躁，而何
以躁？盖寒则心气大虚，虚则惟恐肾气之来攻，乃惧而躁，非热而躁也。寒来之时，
乃心气之下降也，肾虽恶寒，而肾中正热，宜不发颤，而何以颤？盖热则肾水大乏，
乏则惟恐心气之来夺，乃吝而颤，非寒而颤也。然则欲心之不躁，必须使其不寒，
欲肾之不颤，必须使其不热。方用解围汤∶
人参（五钱） 熟地（一两） 山茱萸（五钱） 当归（一两） 茯神（五钱） 生枣仁（五钱）
柴胡（一钱） 白芍（一两） 远志（二钱） 半夏（二钱） 玄参（三钱） 菖蒲（一钱） 水煎服。二
剂寒热减半，躁颤亦减半，再服二剂，前症顿愈。再服二剂，不再发。
此方心肝肾三部均治之药也。欲心肾之交，必须借重肝木为介绍，分往来之寒
热，止彼此之躁颤，方能奏功。方中虽止肾热而散心寒，倘肝气不通何能调剂？所
以加入柴胡、白芍以大舒其肝中之郁气。盖祖孙不至间隔，而为子为父者，自然愉
快矣。宁尚至热躁寒颤之乖离哉。
此症用玄荆汤亦效。
玄参（二两） 荆芥（三钱） 水煎服。
热极止在心头上一块出汗，不啻如雨，四肢他处又复无汗，人以为心热之极也，
谁知是小肠之热极乎。夫小肠在脾胃之下，何以火能犯心而出汗乎？不知小肠与心
为表里，小肠热而心亦热矣。然而心中无液取给于肾水以养心。倘汗是心中所出，
竟同大雨之淋漓，则发汗亡阳，宜立时而化为灰烬，胡能心神守舍，而不发狂哉。
明是小肠之热，水不下行而上出也。第小肠之水便于下行，何故不走阴器，而反走
心前之窍耶？正以表里关切，心因小肠而热，小肠即升水以救心，而心无窍可入，
遂走于心外之毛窍而出也。然则治法不必治心，仍治小肠，利水以分消其火气，则
水自归源，而汗亦不从心头外出也。方用返汗化水汤∶
茯苓（一两） 猪苓（三钱） 刘寄奴（三钱） 水煎服。一剂而汗止，不必再剂也。
茯苓、猪苓俱是利水之药，加入刘寄奴则能止汗，又善利水，其性又甚速，同
茯苓、猪苓从心而直趋于膀胱，由阴器以下泄。因水去之急，而火亦随水而去急也，
正不必再泄其火，以伤损夫脏腑耳。
此症用苓连汤亦神。
茯苓（二两） 黄连（一钱） 水煎服。
口舌红肿，不能言语，胃中又觉饥渴之甚，人以为胃火之上升也，第胃火不可
动，一动则其势炎上而不可止，非发汗亡阳，必成躁妄发狂矣，安能仅红肿于口舌，
不能言语之小症乎？故此火乃心包之火，而非胃火也。夫舌乃心之苗，亦心包之窍
也。若心包无火，无非清气上升，则喉舌安闲，语言响亮，迨心包火动，而喉舌无
权。况心包之火，乃相火也，相火易于作祟，譬如权臣多欲，欲立威示权，必先从
传递喉舌之人始；今相火妄动，而口舌红肿，势所必至。又譬如主人之友，为其仆
轻辱，则友亦缄默以求容，若不投以货财，则不能餍其仆之所求，此饥渴之所以来
也。治法清其心包之火，而不必泻其胃中之土，恐泻胃而土衰，则心包之火转来生胃，
其火愈旺也。方用清火安胃汤∶
麦冬（一两） 石斛（三钱） 丹参（三钱） 生地（三钱） 炒枣仁（五钱） 竹叶（一百片）
水煎服。一剂语言出，再剂红肿消，三剂而胃中之饥渴亦愈矣。
此方全去消心包之火，而又不泻心中之气，心包火息而胃气自安矣。
此症用玄丹麦冬汤亦效。
玄参 丹参 麦冬（各一两） 水煎服。
热症满身皮窍如刺之钻，又复疼痛于骨节之内外，以冷水拍之少止，人以为火
出于皮肤也，谁知是火郁于脏腑，乃欲出而不得出之兆也。盖火性原欲炎上，从皮
肤而旁出，本非所宜，其人内火既盛，而阳气又旺，火欲外泄，而皮肤坚固，火本
郁而又拂其意，遂鼓其勇往之气，而外攻其皮肤，思夺门而出，无如毛窍不可遽开，
火不得已仍返于脏腑之内，而作痛，以凉水拍之而少止者。喜其水之润肤，而反相
忘其水之能克火矣，非因水之外击，足以散火，而能止痛也。然则治法，亦先泻其
脾胃之火，而余火不泻而自泻也。方用攻火汤∶
大黄（三钱） 石膏（五钱） 炒栀子（三钱） 当归（一两） 浓朴（一钱） 甘草（一钱）
柴胡（一钱） 白芍（三钱） 水煎服。一剂火泻，二剂痛除。
此方直泻脾胃之火，又不损脾胃之气，兼舒其肝木之郁，则火尤易消，乃扼要
争奇，治火实有秘奥，何必腑腑而清之、脏脏而发之哉。
此症用宣扬散亦佳。
柴胡（一钱） 荆芥（二钱） 当归（一两） 麦冬（一两） 天花粉（三钱） 水煎服。
人有心中火热如焚，自觉火起，即入小肠之经，辄欲小便，急去遗溺，大便随
时而出，人以为心火下行，谁知是心与心包二火之作祟乎。夫心包之火，代君司化，
君火盛而相火宁，君火衰而相火动。然亦有君火盛而相火亦动者，第君、相二火，
不可齐动，齐动而君、相不两立。相火见君火之旺，不敢上夺君权，乃让君而下行，
而君火既动无可发泄，心与小肠为表里，自必移其热于小肠，相火随辅君火下行，
既入小肠而更引入大肠矣，此二便所以同遗也。治法安二火之动，而热焰自消。方
用四物汤加味治之。
熟地（一两） 川芎（二钱） 当归（一两） 白芍（五钱） 黄连（二钱） 玄参（一两） 黄柏（一钱）
车前子（二钱） 水煎服。二剂少安，四剂全愈。
四物汤补血之神剂也。火动由于血燥，补其血而脏腑无干涸之虞，凉其血而火
焰无浮游之害。况黄连入心以清君火，黄柏入心包以清相火。加车前利水，引二火
直走膀胱，从水化而尽泄之，又何乱经之虑哉。
此症用二地汤亦佳。
生地 熟地 当归（各一两） 人参（三钱） 黄连（一钱） 肉桂（五分） 水煎服。
人有大怒之后，周身百节俱疼，胸腹且胀，两目紧闭，逆冷，手指甲青黑色，
人以为阴症伤寒也。谁知是火热之病乎。夫阴症似阳，阳症似阴，最宜分辨，此病
乃阳症似阴也。手指甲现青黑色，阴症之外象也。逆冷非寒极乎，不知内热之极，
反见外寒，乃似寒而非寒也。大怒不解，必伤其肝，肝气甚急，肝叶极张。一怒而
肝之气更急，而肝之叶更张，血沸而火起，有不可止拂之势。肝主筋，火起而筋乃
挛束作痛。火欲外焚，而痰又内结，痰火相搏，湿气无可散之路，乃走其湿于手足
之四末。指甲者，筋之余也，故现青黑之色。手足逆冷，而胸腹正大热也。治法平
其肝气，散其内热，而外寒之象自散矣。方用平肝舒筋汤∶
柴胡（一钱） 白芍（一两） 牛膝 生地 丹皮 炒栀子（各三钱） 当归（五钱）
陈皮 甘草（各一钱） 神曲（五分） 秦艽 乌药（各一钱） 防风（三分） 水煎服。一剂目
开，二剂痛止，三剂胀除，四剂诸症尽愈。
此方所用之药，俱入肝经以解其怒气也。怒气解而火自平矣，火平而筋舒，必
至之理也。人见此等之症，往往信之不深，不敢轻用此等之药，遂至杀人，以阴阳
之难辨也。然我更有辨之之法∶与水探之，饮水而不吐者，乃阳症；饮水而即吐者，
乃阴症。倘饮水不吐即以此方投之，何至有误哉。
此症用息怒汤亦效。
白芍（三两） 柴胡（二钱） 丹皮（五钱） 炒栀子（三钱） 天花粉（三钱） 水煎服。
心（心脏）工匠般精心构思方剂，以博取裙带间的欢愉，导致他人折损寿命，实在令人痛心。我特意传授此方以救治他们。由于火气有余而肾水不足，所以使用熟地黄、麦冬来大补益肾水；又担心熟地黄、麦冬不足以平息燎原般的烈火，于是增加玄参、甘菊以平抑胃中的炎症。泻火仍用滋阴的药物，则火熄灭而正气又不受亏损。火既然上行，若不引导其下行，则肾水无法上济而火恐继续上腾，因此加入牛膝的润下之性，使火下降而不升。肾水既然长期枯竭，所补充的水仅够肾自用，怎能分出多余的膏脂来滋养肝木之子呢？于是辅助白芍以滋润肝脏，则肝木得以平和，不必再向肾水索取，自然气归本宫而不至于走泄于下并外散。然而火焚烧时间既久，火毒将形成，虽然现在的火被水克制，但以前的火毒怎能立刻消除？因此又辅助金银花，以消除其毒，而且更能益阴，这是消解火的毒，而不损伤阴的气。又担心阳火不是至阴性质的药物，不能在无形之中消化，于是少量使用黄柏以折服它，虽然黄柏是大寒之药，但放入大补阴水的方剂中，反而能解火的毒，引导补水之药直入至阴之中，从而泻去虚阳之火罢了。此方除了黄柏不可多用外，其余诸药，必须如此多用，才能补足水的不足，泻去火的有余，否则火势炽盛而不可救药了。拯救火灾的道理，片刻不能迟缓，不是滂沱大雨，不能止住遍野燎原的火势。况且火已经升腾，胃中得到水，不啻如甘露止渴，大量煎煮饮用，正足以满足其欲望，不必担心太多而难以承受。
此症使用定狂汤也有神效。
熟地黄（三两） 知母（一两） 荆芥（五钱） 水煎服。一剂即愈。
眼睛红肿，口舌全部溃烂，咽喉微痛，两胁胀满，人们认为是肝火旺盛，谁知道是肾火旺盛呢？眼睛属于肝，两胁也是肝的部位，明明是肝火旺盛，为什么说它是肾火呢？从咽喉、口舌的疼痛溃烂来判断。只是口舌属于心，咽喉属于肺，与肾绝不相干，为什么统称为肾火呢？不知道肾火是龙雷之火。雷火由地冲向天，肾火也由下升于上，进入胁部则胁胀，进入喉咙则喉痛，进入口舌则口舌烂，进入眼目则眼目肿。火没有固定位置，随着火到达的地方病就产生。现在四处都生病，是肾火的大炽盛罢了。大概各经的火，只流连于一处，断不能口舌、咽喉、眼目、两胁一齐受病。似乎治法不可以单独治疗一经了。然而各经不可以分开治疗，而肾经确实可以专门治疗，治疗肾火，则各经的火都消散。方剂使用六味地黄汤加味治疗。
熟地黄（一两） 山药（五钱） 茯苓（三钱） 丹皮（五钱） 泽泻（三钱） 山茱萸（四钱） 麦冬 白芍（各一两）
水煎服。一剂后两胁的胀满消除，二剂后眼睛的红肿痊愈，三剂后咽喉的疼痛解除，四剂后口舌的溃烂痊愈。
六味汤原本是纯补真水的药物，水充足而火自然平息。又有白芍舒缓肝脏以平抑肝木，麦冬滋养肺部以益金，金生水而水不必去生肝，则水更容易充足，而火更容易平息。大概龙雷之火，是虚火。虚火得到水就潜伏，何必泻火来激怒它呢？有人说：使用六味方的方剂而不遵循分量进退加减的原因是什么？回答说：药物投合病症，即使是佐使之味也可以多用，病症忌讳药物，即使是君主之品也应当减少。轻重稍微不同，又有什么可忧虑的呢？
此症使用止沸汤也很好。
熟地黄（三两） 麦冬（二两） 地骨皮（一两） 水煎服。
寒热症状时停时发，一天四五次成为常态，热来时躁动不可抵挡，寒来时颤抖不能停止，人们认为寒邪在阴阳之间，谁知道是火热在心肾之内呢？肾与心本来相克而又相交，倘若相克而不相交，必然导致寒热发作没有定时。大概心喜欢寒而不喜欢热，肾喜欢热而不喜欢寒，然而热是肾所喜欢的，必定是心所厌恶的；寒是心所喜欢的，必定是肾所厌恶的。肾厌恶寒，恐怕寒气侵犯肾，远远避开而不敢与心相交；心厌恶肾热，恐怕热气侵犯心，坚决拒绝而不肯与肾相交。然而肾厌恶寒，又厌恶其不下交于肾，一定要与心相交而心不接受，反而以热来凌犯心；心厌恶肾热而不上交于心，一定想与肾相交而肾又不接受，反而以寒来侵犯肾。两者互相侵犯和凌犯，于是根据寒热的盛衰，区分发作的时间。心肾原本无时无刻不交合，一天之中，寒热发作无常，因为交合而发作，因为不交合就停止，这有什么奇怪。只有热来时躁动不可抵挡，寒来时颤抖不能停止，确实有深奥的意义。热来的时候，是肾气升腾的时候。心虽然厌恶热，而心中正是寒，应该不躁动，为什么躁动？大概寒则心气大虚，虚则惟恐肾气来攻，于是恐惧而躁动，不是因为热而躁动。寒来的时候，是心气下降的时候，肾虽然厌恶寒，而肾中正热，应该不颤抖，为什么颤抖？大概热则肾水大乏，乏则惟恐心气来夺取，于是吝惜而颤抖，不是因为寒而颤抖。既然如此，想要心不躁动，必须使其不寒；想要肾不颤抖，必须使其不热。方剂使用解围汤：
人参（五钱） 熟地黄（一两） 山茱萸（五钱） 当归（一两） 茯神（五钱） 生枣仁（五钱） 柴胡（一钱） 白芍（一两） 远志（二钱） 半夏（二钱） 玄参（三钱） 菖蒲（一钱） 水煎服。二剂后寒热减半，躁动颤抖也减半，再服二剂，前面的症状顿时痊愈。再服二剂，不再发作。
此方是心、肝、肾三部均治疗的药物。想要心肾相交，必须借助肝木作为介绍，分往来的寒热，停止彼此的躁动颤抖，才能奏效。方中虽然只清肾热而散心寒，倘若肝气不通畅怎么能调剂？所以加入柴胡、白芍以大舒肝中的郁气。大概祖孙不至间隔，而为子为父者，自然愉快了。哪里还会至于热躁寒颤的乖离呢？
热极只在心头上一块出汗，不啻如雨，四肢其他地方又没有汗，人们认为是心热到了极点，谁知道是小肠热到了极点呢？小肠在脾胃之下，为什么火能犯心而出汗呢？不知道小肠与心互为表里，小肠热而心也热了。然而心中无液，取给于肾水以养心。倘若汗是心中所出，竟同大雨淋漓，则发汗亡阳，应该立时化为灰烬，怎么能心神守舍，而不发狂呢？明显是小肠的热，水不下行而上出。只是小肠的水便于下行，为什么不走阴器，反而走心前的窍道呢？正因为表里关切，心因小肠而热，小肠就升水来救心，而心无窍可入，遂走于心外的毛窍而出。那么治法不必治心，仍治小肠，利水以分消其火气，则水自然归源，而汗也不从心头外出。方剂使用返汗化水汤：
茯苓（一两） 猪苓（三钱） 刘寄奴（三钱） 水煎服。一剂而汗止，不必再服。
茯苓、猪苓都是利水的药物，加入刘寄奴则能止汗，又善于利水，其性质又很快，同茯苓、猪苓从心直趋于膀胱，由阴器以下泄。因为水去得急，而火也随水而去得急，正不必再泄其火，以损伤脏腑。
此症使用苓连汤也很神奇。
茯苓（二两） 黄连（一钱） 水煎服。
口舌红肿，不能言语，胃中又觉得饥渴得很，人们认为是胃火上升，只是胃火不可动，一动则其势炎上而不可止，不是发汗亡阳，必成躁妄发狂，怎么能仅仅红肿于口舌，不能言语的小症呢？故此火是心包之火，而非胃火。舌头乃心的苗窍，也是心包的窍道。若心包无火，无非清气上升，则喉舌安闲，语言响亮，等到心包火动，而喉舌失去控制。况且心包之火，是相火，相火易于作祟，譬如权臣多欲，想要立威示权，必定先从传递喉舌的人开始；现在相火妄动，而口舌红肿，是势所必至。又譬如主人的朋友，被仆人轻辱，则朋友也缄默以求容，如果不投以货财，则不能满足仆人的要求，这就是饥渴到来的原因。治法清其心包之火，而不必泻其胃中之土，恐怕泻胃而土衰，则心包之火转来生胃，其火更旺。方剂使用清火安胃汤：
麦冬（一两） 石斛（三钱） 丹参（三钱） 生地（三钱） 炒枣仁（五钱） 竹叶（一百片）
水煎服。一剂后语言出，二剂后红肿消，三剂后胃中的饥渴也痊愈。
此方全去消心包之火，而不泻心中之气，心包火息而胃气自然安定了。
此症使用玄丹麦冬汤也有效。
玄参 丹参 麦冬（各一两） 水煎服。
热症满身皮窍如刺之钻，又复疼痛于骨节之内外，用冷水拍之稍止，人们认为火出于皮肤，谁知道是火郁于脏腑，是想出而不得出的征兆。大概火的性质原欲炎上，从皮肤旁出，本非适宜，其人内火既盛，而阳气又旺，火欲外泄，而皮肤坚固，火本郁而又拂逆其意，于是鼓动其勇往之气，而外攻其皮肤，想夺门而出，无奈毛窍不可遽开，火不得已仍返回脏腑之内，而作痛，用凉水拍之而稍止，是喜欢水之润肤，反而忘记水能克火，并非因为水之外击，足以散火，而能止痛。那么治法，也先泻其脾胃之火，而余火不泻而自泻。方剂使用攻火汤：
大黄（三钱） 石膏（五钱） 炒栀子（三钱） 当归（一两） 浓朴（一钱） 甘草（一钱） 柴胡（一钱） 白芍（三钱） 水煎服。一剂火泻，二剂痛除。
此方直泻脾胃之火，又不损脾胃之气，兼舒其肝木之郁，则火更容易消，是扼要争奇，治火实有秘奥，何必腑腑而清之、脏脏而发之呢？
此症使用宣扬散也很好。
柴胡（一钱） 荆芥（二钱） 当归（一两） 麦冬（一两） 天花粉（三钱） 水煎服。
有人心中火热如焚，自觉火起，随即进入小肠之经，就想小便，急忙遗尿，大便随时而出，人们认为心火下行，谁知道是心与心包二火作祟呢？心包之火，代君主持化育，君火盛而相火安宁，君火衰而相火动。然而也有君火盛而相火也动的，只是君、相二火，不可齐动，齐动而君、相不两立。相火见君火之旺，不敢上夺君权，于是让君而下行，而君火既动无可发泄，心与小肠为表里，自然必移其热于小肠，相火随辅君火下行，既入小肠而更引入大肠，这就是二便同时遗出的原因。治法安二火之动，而热焰自然消。方剂使用四物汤加味治疗。
熟地黄（一两） 川芎（二钱） 当归（一两） 白芍（五钱） 黄连（二钱） 玄参（一两） 黄柏（一钱） 车前子（二钱） 水煎服。二剂后稍安，四剂后全愈。
四物汤是补血的神剂。火动由于血燥，补其血而脏腑无干涸之虞，凉其血而火焰无浮游之害。况且黄连入心以清君火，黄柏入心包以清相火。加车前利水，引二火直走膀胱，从水化而尽泄之，又有什么乱经的忧虑呢？
此症使用二地汤也很好。
生地 熟地 当归（各一两） 人参（三钱） 黄连（一钱） 肉桂（五分） 水煎服。
人有大怒之后，周身百节俱疼，胸腹且胀，两目紧闭，逆冷，手指甲青黑色，人们认为是阴症伤寒，谁知道是火热之病呢？阴症似阳，阳症似阴，最宜分辨，此病乃阳症似阴。手指甲现青黑色，是阴症之外象。逆冷不是寒极吗？不知道内热之极，反见外寒，乃是似寒而非寒。大怒不解，必伤其肝，肝气甚急，肝叶极张。一怒而肝之气更急，而肝之叶更张，血沸而火起，有不可止拂之势。肝主筋，火起而筋乃挛束作痛。火欲外焚，而痰又内结，痰火相搏，湿气无可散之路，乃走其湿于手足之四末。指甲者，筋之余也，故现青黑之色。手足逆冷，而胸腹正大热。治法平其肝气，散其内热，而外寒之象自然散。方剂使用平肝舒筋汤：
柴胡（一钱） 白芍（一两） 牛膝 生地 丹皮 炒栀子（各三钱） 当归（五钱） 陈皮 甘草（各一钱） 神曲（五分） 秦艽 乌药（各一钱） 防风（三分） 水煎服。一剂后目开，二剂后痛止，三剂后胀除，四剂后诸症尽愈。
此方所用之药，都入肝经以解其怒气。怒气解而火自然平，火平而筋舒，是必然之理。人见此等之症，往往信之不深，不敢轻用此等之药，遂至杀人，因为阴阳难辨。然而我更有辨别之法：给水试探，饮水而不吐的，是阳症；饮水而即吐的，是阴症。倘若饮水不吐即用此方投之，何至有误呢？
The heart (Zang organ) crafts formulas with meticulous design to seek pleasure in intimate relations, causing others to lose their natural lifespan, which is truly heartbreaking. I specifically transmit this formula to save them. Since fire is excessive and kidney water is insufficient, Shu Di Huang (Prepared Rehmannia Root) and Mai Dong (Ophiopogon Tuber) are used to greatly tonify kidney water. Fearing that Shu Di Huang and Mai Dong are insufficient to extinguish the raging fire, Xuan Shen (Scrophularia Root) and Gan Ju (Chrysanthemum Indicum Flower) are added to calm the inflammation in the stomach. To purge fire using yin-nourishing herbs ensures that fire subsides without damaging righteous qi. Since fire ascends, if not guided downward, kidney water cannot ascend to nourish it, and fire may continue to rise; therefore, Niu Xi (Achyranthes Root), with its moistening and descending nature, is added to make fire descend rather than ascend. Since kidney water has been depleted for a long time, the supplemented water is only sufficient for the kidney's own use; how can surplus essence be distributed to nourish the liver wood? Thus, Bai Shao (White Peony Root) is assisted to moisten the liver, so that liver wood becomes balanced and no longer needs to draw from kidney water, allowing qi to return to its origin palace without leaking downward or dispersing outward. However, since fire has burned for a long time, fire toxin will form. Although current fire is controlled by water, how can previous fire toxins disappear immediately? Therefore, Jin Yin Hua (Honeysuckle Flower) is added to eliminate toxins while further nourishing yin; this eliminates fire toxin without damaging yin qi. Furthermore, yang fire cannot be digested in the formless realm by non-yin substances, so a small amount of Huang Bo (Phellodendron Bark) is used to subdue it. Although Huang Bo is a great cold herb, when placed in a formula that greatly tonifies yin water, it instead resolves fire toxin and guides water-tonifying herbs directly into the deepest yin to drain deficient yang fire. Except for Huang Bo, which should not be used in large doses, all other herbs must be used in large quantities to sufficiently replenish water deficiency and drain fire excess; otherwise, the blazing fire will be incurable. The way to rescue a fire requires no delay; only torrential rain can stop the widespread flames. Moreover, since fire has risen, water entering the stomach is like sweet dew quenching thirst; brewing and drinking large amounts fully satisfies the desire, and there is no need to worry about intolerance due to volume.
This condition treated with Ding Kuang Tang (Calm Madness Decoction) also yields miraculous effects.
Shu Di Huang (3 liang), Zhi Mu (Anemarrhena Rhizome, 1 liang), Jing Jie (Schizonepeta Spike, 5 qian). Decoct in water and take orally. One dose results in cure.
Eyes are red and swollen, mouth and tongue are completely ulcerated, throat is slightly painful, and both hypochondria are distended. People assume this is due to hyperactive liver fire, but who would guess it is actually hyperactive kidney fire? Eyes belong to the liver, and the hypochondria are also the domain of the liver; clearly, it appears to be liver fire, yet why call it kidney fire? This is known from the pain and ulceration of the throat and mouth/tongue. Although the mouth and tongue belong to the heart, and the throat belongs to the lung, seemingly unrelated to the kidney, why is it collectively named kidney fire? It is unknown that kidney fire is "Dragon and Thunder Fire." Thunder fire rushes from earth to heaven; similarly, kidney fire rises from below to above. Entering the hypochondria causes distension; entering the throat causes pain; entering the mouth and tongue causes ulceration; entering the eyes causes swelling. Fire has no fixed location; disease arises where fire arrives. Now that all four areas are affected, it indicates intense kidney fire. Generally, fire in each meridian stays in one place and cannot simultaneously affect the mouth/tongue, throat, eyes, and hypochondria. Thus, treatment cannot focus on just one meridian. However, since meridians cannot be treated separately, the kidney meridian can indeed be treated specifically; treating kidney fire dissipates fire in all meridians. Use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) with modifications.
Shu Di Huang (1 liang), Shan Yao (Chinese Yam, 5 qian), Fu Ling (Poria, 3 qian), Dan Pi (Moutan Cortex, 5 qian), Ze Xie (Alisma Rhizome, 3 qian), Shan Zhu Yu (Cornus Fruit, 4 qian), Mai Dong (1 liang), Bai Shao (1 liang).
Decoct in water and take orally. After one dose, hypochondriac distension resolves; after two doses, eye redness and swelling heal; after three doses, throat pain ceases; after four doses, mouth and tongue ulcers recover.
Liu Wei Tang originally consists purely of herbs that tonify true water; when water is sufficient, fire naturally subsides. Additionally, Bai Shao soothes the liver to pacify wood, and Mai Dong nourishes the lung to benefit metal. Metal generates water, so water does not need to generate liver wood, making water easier to suffice and fire easier to pacify. Dragon and Thunder fire is essentially deficient fire. Deficient fire lies dormant upon contact with water; why purge fire to provoke its anger? Some ask: Why use Liu Wei Fang without adjusting dosages according to progression? The answer is: When medicine matches the disease, even assistant/herald herbs can be used in larger doses; when the disease resists the medicine, even sovereign herbs should be reduced. Slight differences in weight and quantity need no concern.
This condition treated with Zhi Fei Tang (Stop Boiling Decoction) is also excellent.
Shu Di Huang (3 liang), Mai Dong (2 liang), Di Gu Pi (Cortex Lycii, 1 liang). Decoct in water and take orally.
Chills and fever come and go intermittently, occurring four or five times a day as usual. During heat episodes, restlessness is unbearable; during chills, trembling cannot cease. People believe cold pathogen resides between yin and yang, but who knows it is actually heat-fire within the heart and kidney? Kidney and heart normally overcome and interact with each other. If they overcome but do not interact, chills and fever will occur irregularly. Heart prefers cold and dislikes heat; kidney prefers heat and dislikes cold. Heat, though preferred by kidney, is disliked by heart; cold, though preferred by heart, is disliked by kidney. Kidney dislikes cold, fearing cold qi invading, thus avoiding interaction with heart; heart dislikes kidney heat, fearing hot qi invading, thus refusing interaction with kidney. However, kidney dislikes cold yet also dislikes lack of downward interaction, desiring to interact with heart but heart refuses, leading to heat harassing heart; heart dislikes kidney heat yet desires upward interaction, but kidney refuses, leading to cold invading kidney. Mutual harassment leads to timing of chills and fever based on their intensity. Heart and kidney should always interact; irregular occurrence is due to interaction causing flare-ups and non-interaction causing cessation, which is not strange. Only the unbearable restlessness during heat and uncontrollable trembling during chills hold secret meanings. Heat arrival signifies kidney qi rising. Though heart dislikes heat, the heart center is cold, so restlessness should not occur; why does it happen? Cold causes severe heart qi deficiency; deficiency fears kidney qi attack, causing fear-induced restlessness, not heat-induced. Cold arrival signifies heart qi descending. Though kidney dislikes cold, the kidney center is hot, so trembling should not occur; why does it happen? Heat causes severe kidney water depletion; depletion fears heart qi takeover, causing stingy trembling, not cold-induced. Therefore, to prevent heart restlessness, one must prevent cold; to prevent kidney trembling, one must prevent heat. Use Jie Wei Tang (Resolve Siege Decoction):
Ren Shen (Ginseng Root, 5 qian), Shu Di Huang (1 liang), Shan Zhu Yu (5 qian), Dang Gui (Angelica Sinensis Root, 1 liang), Fu Shen (Poria with Hostwood, 5 qian), Sheng Zao Ren (Raw Ziziphus Seed, 5 qian), Chai Hu (Bupleurum Root, 1 qian), Bai Shao (1 liang), Yuan Zhi (Polygala Root, 2 qian), Ban Xia (Pinellia Tuber, 2 qian), Xuan Shen (3 qian), Chang Pu (Acorus Rhizome, 1 qian). Decoct in water and take orally. After two doses, chills/fever reduce by half, and restlessness/trembling halve; take two more doses, previous symptoms resolve instantly; take two more doses, recurrence stops.
This formula treats heart, liver, and kidney simultaneously. For heart-kidney interaction, liver wood is needed as an intermediary to distribute incoming/outgoing chills/fever and stop mutual restlessness/trembling for efficacy. Although the formula clears kidney heat and dispels heart cold, without smooth liver qi, regulation fails. Hence, Chai Hu and Bai Shao are added to strongly soothe liver depression. Just as grandparents remain close, parents naturally feel joyful, preventing extreme heat-restlessness and cold-trembling separation.
This condition treated with Xuan Jing Tang (Xuan Shen and Schizonepeta Decoction) is also effective.
Xuan Shen (2 liang), Jing Jie (3 qian). Decoct in water and take orally.
Extreme heat causes sweating only on a patch over the heart, profuse as rain, while limbs and other parts have no sweat. People assume extreme heart heat, but who knows it is extreme small intestine heat? Small intestine is below spleen/stomach; how can fire invade heart to cause sweating? Small intestine and heart are exterior-interior pairs; small intestine heat implies heart heat. However, heart lacks fluid and relies on kidney water to nourish itself. If sweat originated from heart, it would be like heavy rain, causing collapse of yang through sweating, turning to ash instantly, yet spirit remains housed without madness. Clearly, it is small intestine heat where water does not descend but flows upward. Small intestine water prefers descending; why not exit via yin organs but instead via orifices before the heart? Due to exterior-interior connection, heart heats due to small intestine; small intestine raises water to save heart, but heart has no entry orifice, so water exits via skin pores outside the heart. Treatment need not target heart but should target small intestine; promoting urination disperses fire qi, returning water to source and stopping sweat from exiting heart area. Use Fan Han Hua Shui Tang (Return Sweat Transform Water Decoction):
Fu Ling (1 liang), Zhu Ling (Polyporus, 3 qian), Liu Ji Nu (Vaccinium Bracteatum Stem, 3 qian). Decoct in water and take orally. One dose stops sweat; no further doses needed.
Fu Ling and Zhu Ling are diuretic herbs; adding Liu Ji Nu stops sweat and promotes urination rapidly. Together with Fu Ling and Zhu Ling, they move directly from heart to bladder, exiting via yin organs. Rapid water loss causes rapid fire loss, eliminating need to purge fire and damage zang-fu.
This condition treated with Ling Lian Tang (Poria and Coptis Decoction) is also miraculous.
Fu Ling (2 liang), Huang Lian (Coptis Rhizome, 1 qian). Decoct in water and take orally.
Mouth and tongue are red and swollen, unable to speak, and stomach feels extremely hungry and thirsty. People assume stomach fire ascending. However, stomach fire should not be moved; once moved, its flame rises uncontrollably, potentially causing yang collapse through sweating or mania/madness, not merely mild mouth/tongue swelling and speechlessness. Thus, this is pericardium fire, not stomach fire. Tongue is the sprout of heart and orifice of pericardium. Without pericardium fire, clear qi ascends, throat/tongue are calm, speech is loud. When pericardium fire moves, throat/tongue lose control. Pericardium fire is ministerial fire, prone to mischief. Like a powerful minister seeking authority, he starts with messengers; here, ministerial fire moves wildly, causing mouth/tongue swelling inevitably. Like a friend humiliated by a servant, silence seeks tolerance; without bribes, servant demands aren't met, explaining hunger/thirst. Treatment clears pericardium fire without purging stomach earth; purging stomach weakens earth, causing pericardium fire to generate more stomach fire. Use Qing Huo An Wei Tang (Clear Fire Pacify Stomach Decoction):
Mai Dong (1 liang), Shi Hu (Dendrobium Stem, 3 qian), Dan Shen (Salvia Root, 3 qian), Sheng Di (Rehmannia Root, 3 qian), Chao Zao Ren (Fried Ziziphus Seed, 5 qian), Zhu Ye (Bamboo Leaf, 100 pieces). Decoct in water and take orally. One dose restores speech; two doses reduce swelling; three doses resolve stomach hunger/thirst.
This formula entirely clears pericardium fire without draining heart qi; once pericardium fire rests, stomach qi naturally calms.
This condition treated with Xuan Dan Mai Dong Tang (Xuan Shen, Dan Shen, and Mai Dong Decoction) is also effective.
Xuan Shen, Dan Shen, Mai Dong (1 liang each). Decoct in water and take orally.
Heat syndrome causes body pores to feel like piercing needles, with pain inside and outside joints. Cold water application provides slight relief. People think fire originates from skin, but who knows it is fire depressed in zang-fu, wanting to exit but unable to? Fire nature tends to blaze upward and exit sideways through skin, which is inappropriate. Internal fire is strong, yang qi is vigorous; fire wants to escape externally, but skin is firm. Depressed fire, frustrated, gathers courage to attack skin, trying to break out. Pores cannot open suddenly; fire returns internally, causing pain. Cold water application helps slightly because it moisturizes skin, forgetting water controls fire. Pain relief is not due to external water scattering fire. Treatment should first purge spleen/stomach fire; remaining fire will purge itself. Use Gong Huo Tang (Attack Fire Decoction):
Da Huang (Rhubarb Root, 3 qian), Shi Gao (Gypsum Fibrosum, 5 qian), Chao Zhi Zi (Fried Gardenia Fruit, 3 qian), Dang Gui (1 liang), Hou Po (Magnolia Bark, 1 qian), Gan Cao (Licorice Root, 1 qian), Chai Hu (1 qian), Bai Shao (3 qian). Decoct in water and take orally. One dose purges fire; two doses remove pain.
This formula directly purges spleen/stomach fire without damaging spleen/stomach qi, and soothes liver wood depression, making fire easier to消. This is the key to treating fire; why clear every fu and treat every zang separately?
This condition treated with Xuan Yang San (Promote Yang Powder) is also good.
Chai Hu (1 qian), Jing Jie (2 qian), Dang Gui (1 liang), Mai Dong (1 liang), Tian Hua Fen (Trichosanthes Root, 3 qian). Decoct in water and take orally.
Some feel heart burning like fire, sensing fire rising, then entering small intestine meridian, urging urination, leading to involuntary urine loss, followed by stool discharge. People think heart fire descends, but who knows it is heart and pericardium fire acting up? Pericardium fire acts as deputy for sovereign fire. Sovereign fire strong means ministerial fire calm; sovereign fire weak means ministerial fire moves. Sometimes sovereign fire is strong yet ministerial fire also moves. Sovereign and ministerial fire cannot move together; they are incompatible. Seeing sovereign fire strong, ministerial fire dares not usurp power, yielding downward movement. Sovereign fire, having nowhere to vent, transfers heat to small intestine (exterior-interior pair). Ministerial fire assists sovereign fire downward, entering small intestine then large intestine, causing simultaneous urinary and fecal incontinence. Treatment stabilizes both fires, extinguishing flame. Use Si Wu Tang (Four Substances Decoction) with modifications:
Shu Di Huang (1 liang), Chuan Xiong (Ligusticum Rhizome, 2 qian), Dang Gui (1 liang), Bai Shao (5 qian), Huang Lian (2 qian), Xuan Shen (1 liang), Huang Bo (1 qian), Che Qian Zi (Plantago Seed, 2 qian). Decoct in water and take orally. Two doses bring slight relief; four doses result in full recovery.
Si Wu Tang is a divine blood-tonifying agent. Fire movement stems from blood dryness; tonifying blood prevents zang-fu dehydration, cooling blood prevents floating fire harm. Huang Lian enters heart to clear sovereign fire; Huang Bo enters pericardium to clear ministerial fire. Adding Che Qian promotes urination, guiding both fires to bladder for excretion via water transformation, avoiding meridian disruption.
This condition treated with Er Di Tang (Two Rehmannies Decoction) is also good.
Sheng Di, Shu Di, Dang Gui (1 liang each), Ren Shen (3 qian), Huang Lian (1 qian), Rou Gui (Cinnamon Bark, 5 fen). Decoct in water and take orally.
After severe anger, whole body joints ache, chest/abdomen distend, eyes close tightly, extremities turn cold, fingernails turn blue-black. People assume yin-pattern cold damage, but who knows it is heat-fire disease? Yin patterns mimic yang, yang patterns mimic yin; distinction is crucial. This is a yang pattern mimicking yin. Blue-black nails are yin exterior signs. Cold extremities seem extreme cold, but extreme internal heat manifests as external cold, appearing cold but not being cold. Unresolved anger injures liver; liver qi becomes urgent, liver lobes expand. Anger makes liver qi more urgent and lobes more expanded, boiling blood and raising fire, unstoppable. Liver governs sinews; fire causes sinew contraction and pain. Fire wants to burn externally, but phlegm knots internally; phlegm-fire struggle leaves dampness无处 to scatter, moving dampness to four extremities. Nails are remnants of sinews, hence blue-black color. Extremities are cold, but chest/abdomen are intensely hot. Treatment pacifies liver qi and disperses internal heat, resolving external cold signs. Use Ping Gan Shu Jin Tang (Pacify Liver Soothe Sinew Decoction):
Chai Hu (1 qian), Bai Shao (1 liang), Niu Xi, Sheng Di, Dan Pi, Chao Zhi Zi (3 qian each), Dang Gui (5 qian), Chen Pi (Tangerine Peel, 1 qian), Gan Cao (1 qian), Shen Qu (Medicated Leaven, 5 fen), Qin Jiao (Gentiana Macrophylla Root, 1 qian), Wu Yao (Lindera Root, 1 qian), Fang Feng (Saposhnikovia Root, 3 fen). Decoct in water and take orally. One dose opens eyes; two doses stop pain; three doses remove distension; four doses resolve all symptoms.
Herbs in this formula enter liver meridian to resolve anger. Anger resolved, fire calms; fire calmed, sinews relax, a necessary principle. People seeing such symptoms often lack confidence, afraid to use these herbs, leading to death due to yin/yang confusion. However, I have another method: Offer water to test. Drinking without vomiting indicates yang pattern; vomiting immediately indicates yin pattern. If drinking without vomiting, using this formula causes no error.
This condition treated with Xi Nu Tang (Calm Anger Decoction) is also effective.
Bai Shao (3 liang), Chai Hu (2 qian), Dan Pi (5 qian), Chao Zhi Zi (3 qian), Tian Hua Fen (3 qian). Decoct in water and take orally.