火之为病，其害甚大，甚变甚速，其形甚彰，其死甚暴，而其症甚多，难以枚举，试以大略言
之。夫脏腑皆有气，气不得其平，则为火，所谓气有余便是火，气即火，火即气，譬诸水结为冰，解则复
常，非二物也。但火在诸经，或一经之自病，或别经之相克，或二经之遗病，或数经之合病。然亦有实火
有虚火，有相火，有燥火，有湿火，有郁火，有猛烈之火，有无名之火，不可不知。‘常见焦思生心
火，忧愁生肺火，劳倦生脾火，忿怒生肝火，思想无穷生肾
火，此皆本经之自病，治在本经。心火太过，必克肺金，清肃之令将衰；肺火太过，必克旺木，发生之
气将萎；脾火太过，必克肾水，津液之源将涸；肝火太过，必克脾土，化生之源将绝，肾火太过，反
助心火，君主之功将夺，皆别经之相克，治在别经，而兼用本经之药。其二经之遗病，如心火过旺，必
遗热于小肠，则小便淋秘；如肺有火，咳嗽日久，必遗热于大肠，则成泄泻；如脾有火，唇口干燥，必
遗热于胃，则成胀满；如肝有火，胁痛日久，必遗热于胆，则汁溢口苦，如肾有火，盗汗遗精，必
遗热于膀胱，则白淫淋沥；此皆脏遗热于腑之症，治在脏而腑病自消焉。然经又有脾移热于肝，肾移热
于脾，此移于已所不胜之脏也。肺移热于肾，此移于已生之子也。肝移于心则死。移己生之脏而死
者，以木火相燔，犯及君主故也。脏腑互相移热，是在临症者之神明，以察其病变之无穷焉。又有数经
之合病者，端绪难寻，攻伐未易，此当择其尤重者而治之，审其先发者而责之，或病在上而下取之，或
病在下而上取之之类是也。实火虚火、五脏皆有。脉浮大或数，重按无力，为虚火；滑数而举按皆有
力，为实火。见于两寸，为心肺之火，两关，为脾胃肝胆之火；两尺，为肾与膀胱之火。黄连泻心火，黄
芩泻肺火，大黄泻脾火，龙胆泻肝火，知柏泻肾火，此皆苦寒之
味，以泻有余之火，中病即止，不可过剂。若肺经虚火。则投二冬、桑皮、百合、童便之属，心经
虚火，则投竹叶、麦冬、辰砂、犀角之属；脾胃虚火，则投白芍、石斛、芦根、蔗浆、梨汁之属；肝
经虚火，则投白芍、甘菊、钩藤、鳖甲、羚羊角之属，肾经虚火，则投生地、元参、骨皮、女
贞、龟甲之属，此皆本经之的药也。丹溪曰，相火最易妄动，因五志之火相煽故也。火起于妄，变
化不测，无时不有，煎熬真阴，阴虚则病，阴绝则死。暴悍酷烈，甚于君火，四时随触而动，而于
芒种以后六十日，相火司令，热暑湿三气交合，尤为易动。治斯火者，但宜滋其阴，则火自降，非苦
来之剂，不能胜也。燥火则起于血衰，脏腑不润，大小便秘，苦寒之剂，转增其燥，须用甘寒滋润之
品，则燥可泽而火可熄矣。湿有生于热者，热亦有由于湿者，湿热每多相生。如大便久秘，及更衣则
又溏甚，以热在肠胃之外故秘，湿在肠胃之中故溏，湿热兼理，斯得之耳。郁，火一症，东垣
谓胃虚过食冷物，抑遏阳气于脾土，为郁火之病，宜用升阳之剂，所谓火郁发之者是也。若真阴虚，真
元惫，毋妄用之。其师尼寡妇室女愆期，多有郁火之病，是当以逍遥散合甘寒滋阴之药治之则善。若猛
烈之火，丹溪谓火盛不可骤
用寒凉，盖恐扑之而愈焰，须以生甘草兼泻兼缓，则猖狂自定，此妙论也。所谓无名之火，一发即不
识人，或直视狂言，或闭目无语，或手足螈 ，或发数日而终，或一发便脱，或卧枕而逝，人不及知，
既无络经之可寻，又无脉症之可凭，即经所谓暴病暴死皆属于火者是也。余观世人之病，惟火十居
八、九，能辨明此类，而参以散见各门之火症，其于治火庶无虚虚实实之误矣。今只以五脏实火虚火
之方，阐发于左，聊为后学之准绳，神而明之，扩而充之，是所望也。
导赤散 治心热而烦，小便赤涩。〔心与小肠为表里故也。〕
生地〔凉心血。〕木通〔泻心火。〕甘草〔生用泻火。〕加灯心、叶竹。
此方导心火，由小肠溺泄。如系虚火，加麦冬、茯神、朱砂之属，实火加犀角、黄连。连翘之属。
古方但用黄连名泻心汤，芩、连、大黄名三黄泻心汤。
天王补心丹〔见虚劳。〕此治心经虚火之方，对症加减用之。
泻白散 治肺热咳嗽，喘满气急。〔火乘肺则为咳，为气急，气上逆则喘满。〕
桑皮 皮骨〔皆祛肺中伏火。〕甘草〔润肺除热。〕如火郁于肺，鼻不利，加甘菊、薄
荷，〔清散上焦之郁火。〕面肿身热亦用之。如肺移热于大肠而泄泻，加米仁〔清肺益脾。〕茯苓。〔
导气平火。〕
此方专泻肺经之火。如右寸或洪或数，重按无力为虚火，加二冬、百合、甘寒之品；右寸或洪或
数，举按有力为实火，加黄芩、知母苦寒之品，或再加石膏治之。
归脾汤 资生丸〔俱见虚劳。〕此皆治脾胃之方，对症加减用之。
承气汤 茵陈蒿汤 竹叶石膏汤〔俱见伤寒。〕此皆治脾胃实火之方，对症加减用之。
加味逍遥散〔见虚劳。〕
此治肝经郁火之方。宜去香燥加滋阴。辛散甘缓，滋阴养血，是即为补肝也。
龙胆泻肝汤 左金丸〔俱见胁痛。〕
此治肝胆实火之方。古方有当归龙荟丸，用龙胆、芦荟、青黛泻肝，栀、芩泻肺，黄连泻心，黄
柏泻肾，大黄泻脾，当归养血，木香、射香〔少许〕利气，炼蜜丸服。治肝火太盛之要药，量症
用之。按昔人所言肝脏有泻无补，然肝亦有虚火，肝血亏少，则木燥火炎，是但当滋阴养血为治。
海藏泻肾丸 治肾中相火过旺，左尺脉洪实者。
六味地黄丸去肉萸。〔以子能令母实，去山萸不欲强木以补其子，是即为泻，盖肾有补而无泻
故也。〕
此方仍是壮水之剂。赵氏云∶火之有余，缘水之不足也，毫不敢祛火，只补水以配火，若果相火旺
甚，宜六味加知柏，以泻肾家有余之火。古方有滋肾丸，用知母〔六两〕黄柏，〔十两〕以肉桂〔五
钱〕为反佐。治肾经火旺，热自足心直冲股内，上入腹中，然不如六味加知柏之为稳。
凉膈散 治上焦实火，面红目赤，头昏心烦，喉舌肿痛，口疮燥渴，溺赤便秘。
薄荷〔辛凉，有功于头目咽喉口齿诸病。〕黑山栀〔轻飘上达而清肺，屈曲下行而泻
火。〕枯黄芩〔轻飘者上行也。〕连翘〔主泻心火。〕甘草〔缓其速下。各钱许。〕大
黄、芒硝〔润其大便，所谓上病而下取之，以缓其炎上之势。各五分。〕可加犀角、黄连、石膏、
知母、生鸡子。
此治上焦实火之方。东垣云∶去硝、黄加桔梗，为舟楫之剂，浮而上之。淡竹叶利其小便，使心肺
之火下行，治上焦胸膈之热最妙。
黄连解毒汤〔见伤寒。〕
此治上中下三焦实火之方，另再加对症药用之。
防风通圣散〔加减〕治表里客热，三焦实火。
防风 荆芥 薄荷〔使表热由汗而泄。〕大黄 芒硝〔使里热由下而泄。〕滑石 山
栀〔由溺而泄。〕连翘 黄芩〔祛诸经之热。〕石膏 桔梗〔清肺胃之热。〕麦冬〔救
热伤之津液。〕白芍〔救热伤之营血。〕甘草〔调和诸药。〕本方去硝黄名双解散。
此方清火热，开鬼门，洁净府，通传导，内外分消其势，亦治火之良法。外科以此方治里有实热，疥
疮满身者。余每加生地，用金银花一、二两、绿豆一、二合，煎汤煎药，饮之殊效。
清热渗湿汤 凉血祛湿汤〔俱见湿门。〕
此俱治湿热之方，但一燥一润，迥然不同，须分别采用
火邪致病，危害极大，病情变化迅速且剧烈，症状表现明显，死亡往往突然，而且症状繁多，难以一一列举，这里尝试用简略的方式来说明。
脏腑都有气，如果气失去平衡，就会化火，这就是所谓的“气有余便是火”，气和火本质上是同一回事，就像水结成冰，融化后又恢复常态，并不是两种不同的物质。但是火存在于各条经络中，可能是某一经络自身的病变，也可能是其他经络的克制影响，或者是两条经络遗留的病证，又或者是多条经络同时发病。然而也有实火、虚火之分，还有相火、燥火、湿火、郁火，以及猛烈之火和无名之火等，这些都不能不知道。
常见因过度思虑产生心火，忧愁产生肺火，劳累倦怠产生脾火，愤怒产生肝火，无休止的思想活动产生肾火，这些都是本经自身的病变，治疗应针对本经。心火过盛，必然克制肺金，导致肺的清肃功能衰退；肺火过盛，必然克制肝木，导致肝的生发之气萎靡；脾火过盛，必然克制肾水，导致津液之源枯竭；肝火过盛，必然克制脾土，导致生化之源断绝；肾火过盛，反而助长心火，导致君主（心）的功能被夺走，这些都是其他经络对它的克制，治疗应在其他经络，并兼用本经的药物。至于两条经络之间的遗留病证，比如心火过旺，必然将热邪遗留给小肠，导致小便淋漓不通；如果肺有火，咳嗽日久，必然将热邪遗留给大肠，导致变成泄泻；如果脾有火，嘴唇口腔干燥，必然将热邪遗留给胃，导致变成胀满；如果肝有火，胁痛日久，必然将热邪遗留给胆，导致胆汁溢出口苦；如果肾有火，盗汗遗精，必然将热邪遗留给膀胱，导致白浊淋沥不尽；这些都是脏将热邪遗留给腑的症状，治疗在脏，腑的病自然消除。
然而经络之间又有脾将热移交给肝，肾将热移交给脾，这是移交给自己所不胜（即被克）的脏。肺将热移交给肾，这是移交给自己所生（即子）的脏。肝将热移交给心则会导致死亡。移交给自己所生的脏却导致死亡的，是因为木火相互燃烧，侵犯了君主（心）。脏腑之间互相转移热邪，在于临症医生要具备神妙的洞察力，以观察其无穷变化的病变。又有数条经络同时发病的情况，头绪难寻，攻伐不易，这时应当选择最严重的来治疗，审查最先发作的来追究责任，或者病在上部而从下部取治，或者病在下部而从上部取治，等等。
实火和虚火，五脏都有。脉象浮大或数，重按无力，是虚火；脉象滑数，轻按重按都有力，是实火。脉象出现在两寸部位，是心和肺的火；两关部位，是脾胃肝胆的火；两尺部位，是肾与膀胱的火。黄连泻心火，黄芩泻肺火，大黄泻脾火，龙胆草泻肝火，知母、黄柏泻肾火，这些都是苦寒的药味，用来泻除有余的实火，中病即止，不可过量。如果是肺经虚火，则使用天冬、麦冬、桑白皮、百合、童便之类的药物；心经虚火，则使用竹叶、麦冬、辰砂、犀角之类的药物；脾胃虚火，则使用白芍、石斛、芦根、蔗浆、梨汁之类的药物；肝经虚火，则使用白芍、甘菊、钩藤、鳖甲、羚羊角之类的药物；肾经虚火，则使用生地、玄参、地骨皮、女贞子、龟甲之类的药物，这些都是本经对症的药物。
朱丹溪说，相火最容易妄动，是因为五志之火相互煽动的缘故。火起于妄动，变化莫测，无时无刻不在，煎熬真阴，阴虚就会生病，阴绝就会死亡。相火暴悍酷烈，比君火更甚，四时随触而动，而在芒种以后六十天，相火当令，热、暑、湿三气交合，尤其容易妄动。治疗这种火，只宜滋养其阴，火自然下降，非苦寒之剂不能胜任。燥火则起于血衰，脏腑不滋润，大小便秘结，如果用苦寒之剂，反而会加重燥热，必须使用甘寒滋润的药物，才能使燥得到润泽而火得以熄灭。湿有因热而生者，热也有因湿而起者，湿热往往互相滋生。比如大便长期秘结，但上厕所时却又稀溏严重，这是因为热在肠胃之外所以秘结，湿在肠胃之中所以稀溏，湿热兼顾调理，才能治愈。
郁火这一病症，李东垣认为由于胃虚过食冷物，压抑遏制阳气于脾土，形成郁火病，适宜使用升阳之剂，这就是所谓“火郁发之”的道理。如果是真阴虚、真元疲惫，不要妄用此法。那些尼姑、寡妇、未婚女子月经延期，多有郁火之病，这应当用逍遥散配合甘寒滋阴的药物来治疗才好。至于猛烈之火，丹溪说火势旺盛不可骤然使用寒凉药，恐怕扑灭后火势更旺，必须用生甘草兼施泻火和缓急的作用，那么猖狂的火势自然平定，这是妙论。所谓无名之火，一发即不识人，或者直视胡言乱语，或者闭目不语，或者手足抽搐，或者发作数日后死亡，或者一发就脱证，或者睡在枕头上就去世，人们来不及知道，这就是经书所说的“暴病暴死皆属于火”的情况。
我观察世人的疾病，十有八九是火邪引起的，能辨明这类情况，并结合散见于各门类的火症，那么在治疗火邪时大概就不会有虚虚实实的错误了。现在只将五脏实火虚火的方剂，阐述如下，暂作为后学的准则，若能神妙地理解它，扩大并充实它，这就是我所期望的。
导赤散：治疗心热烦躁，小便赤涩。（因为心与小肠互为表里。）
生地（凉心血），木通（泻心火），甘草（生用泻火），加灯心草、淡竹叶。
此方引导心火，从小便排出。如果是虚火，加麦冬、茯神、朱砂之类；实火加犀角、黄连、连翘之类。
古方只用黄连名为泻心汤，黄芩、黄连、大黄名为三黄泻心汤。
天王补心丹（见虚劳篇）：这是治疗心经虚火的方剂，根据症状加减使用。
泻白散：治疗肺热咳嗽，气喘胸闷气急。（火乘袭肺则咳嗽、气急，气上逆则喘满。）
桑白皮、地骨皮（都能祛除肺中伏火），甘草（润肺除热）。如果火郁于肺，鼻窍不利，加甘菊、薄荷（清散上焦郁火）。面肿身热也适用。如果肺将热移交给大肠导致泄泻，加薏苡仁（清肺益脾）、茯苓（导气平火）。
此方专门泻肺经之火。如果右寸脉洪大或数，重按无力为虚火，加天冬、麦冬、百合、甘寒类药物；右寸脉洪大或数，举按有力为实火，加黄芩、知母苦寒类药物，或者再加石膏治疗。
归脾汤、资生丸（均见虚劳篇）：这些都是治疗脾胃的方剂，根据症状加减使用。
承气汤、茵陈蒿汤、竹叶石膏汤（均见伤寒篇）：这些都是治疗脾胃实火的方剂，根据症状加减使用。
加味逍遥散（见虚劳篇）：这是治疗肝经郁火的方剂。适宜去掉香燥药物，加入滋阴药物。辛散甘缓，滋阴养血，这就是补肝的方法。
龙胆泻肝汤、左金丸（均见胁痛篇）：这是治疗肝胆实火的方剂。古方有当归龙荟丸，用龙胆草、芦荟、青黛泻肝，栀子、黄芩泻肺，黄连泻心，黄柏泻肾，大黄泻脾，当归养血，木香、麝香（少许）理气，炼蜜为丸服用。这是治疗肝火太盛的要药，根据症状用量使用。按古人所说肝脏只有泻没有补，然而肝也有虚火，肝血亏少，则木燥火炎，这时只应当滋阴养血来治疗。
海藏泻肾丸：治疗肾中相火过旺，左尺脉洪实者。
六味地黄丸去掉山茱萸。（因为子能令母实，去掉山茱萸是不想通过强补肝木来补其子，这就是泻的意思，因为肾有补而无泻的缘故。）
此方仍然是壮水制火的药剂。赵献可说：火有余，是因为水不足，丝毫不敢祛火，只补水以配火，如果确实相火旺盛得很，适宜六味地黄丸加知母、黄柏，以泻肾家有余之火。古方有滋肾丸，用知母（六两）、黄柏（十两），以肉桂（五钱）作为反佐。治疗肾经火旺，热自足心直冲大腿内侧，上入腹中，然而不如六味地黄丸加知母、黄柏稳妥。
凉膈散：治疗上焦实火，面红目赤，头晕心烦，咽喉舌肿痛，口疮燥渴，小便赤涩便秘。
薄荷（辛凉，对头目咽喉口齿诸病有功），黑山栀（轻飘上达而清肺，屈曲下行而泻火），枯黄芩（轻飘者上行），连翘（主泻心火），甘草（缓其速下，各一钱左右），大黄、芒硝（润其大便，所谓上病而下取之，以缓和其炎上之势，各五分）。可加犀角、黄连、石膏、知母、生鸡蛋黄。
此方治疗上焦实火。李东垣说：去掉硝石、大黄，加桔梗，成为舟楫之剂，浮而上行。淡竹叶利其小便，使心肺之火下行，治疗上焦胸膈之热最为巧妙。
黄连解毒汤（见伤寒篇）：这是治疗上中下三焦实火的方剂，另外再加对症药物使用。
防风通圣散（加减）：治疗表里客热，三焦实火。
防风、荆芥、薄荷（使表热由汗而泄），大黄、芒硝（使里热由下而泄），滑石、山栀（由小便而泄），连翘、黄芩（祛诸经之热），石膏、桔梗（清肺胃之热），麦冬（救热伤之津液），白芍（救热伤之营血），甘草（调和诸药）。本方去掉硝石、大黄名为双解散。
此方清热泻火，开鬼门（发汗），洁净府（利小便），通传导，内外分消其势，也是治疗火邪的良好方法。外科以此方治疗里有实热，满身疥疮者。我每次加生地，用金银花一、二两、绿豆一、二合，煎汤煎药，饮用效果显著。
Pathogenic Fire as a Disease: The harm is significant, changes are rapid and drastic, symptoms are obvious, death can be sudden, and manifestations are numerous, difficult to enumerate. Here, I will attempt to explain briefly.
Every Zang-Fu organ possesses Qi. When Qi loses its balance, it transforms into Fire. This is what is meant by "excess Qi becomes Fire"; Qi and Fire are essentially the same entity, just as water freezes into ice and melts back to normal; they are not two different substances. However, Fire exists within the meridians. It may be a disease originating in one meridian itself, or caused by the overcoming influence of another meridian, or a residual condition from two meridians, or a simultaneous disease of several meridians. Furthermore, there are Excess Fire and Deficiency Fire, Ministerial Fire (Xiang Huo), Dryness Fire, Dampness Fire, Stagnant Fire, fierce Fire, and nameless Fire, all of which must be understood.
Commonly, excessive worry generates Heart Fire, sorrow generates Lung Fire, fatigue and overwork generate Spleen Fire, anger generates Liver Fire, and endless mental activity generates Kidney Fire. These are diseases originating in their respective meridians, and treatment should target the specific meridian. If Heart Fire is excessive, it inevitably overcomes Lung Metal, causing the Lung's descending and purifying function to decline; if Lung Fire is excessive, it inevitably overcomes Liver Wood, causing the Liver's generating energy to wither; if Spleen Fire is excessive, it inevitably overcomes Kidney Water, causing the source of fluids to dry up; if Liver Fire is excessive, it inevitably overcomes Spleen Earth, causing the source of transformation and generation to cease; if Kidney Fire is excessive, it assists Heart Fire, usurping the function of the Sovereign (Heart). These are cases where other meridians overcome this meridian; treatment should focus on the other meridians while simultaneously using herbs for the affected meridian. Regarding residual conditions between two meridians: if Heart Fire is too vigorous, it inevitably transmits heat to the Small Intestine, resulting in dysuria; if the Lung has Fire and cough persists for a long time, it inevitably transmits heat to the Large Intestine, leading to diarrhea; if the Spleen has Fire, causing dry lips and mouth, it inevitably transmits heat to the Stomach, leading to distension; if the Liver has Fire, causing chronic hypochondriac pain, it inevitably transmits heat to the Gallbladder, causing bile overflow and bitter taste; if the Kidney has Fire, causing night sweats and seminal emission, it inevitably transmits heat to the Bladder, causing leukorrhea and dribbling. These are symptoms where Zang organs transmit heat to Fu organs; treating the Zang organ resolves the Fu organ disease naturally.
However, among meridians, Spleen may transmit heat to the Liver, and Kidney to the Spleen; this is transmitting to the organ that overcomes it (the conquered element). Lung may transmit heat to the Kidney; this is transmitting to its offspring (the generated element). If Liver transmits heat to the Heart, death ensues. Transmitting to the offspring yet resulting in death occurs because Wood and Fire burn each other, invading the Sovereign. The mutual transmission of heat among Zang-Fu organs requires the physician to possess divine insight to observe the infinite variations of pathological changes. There are also cases of simultaneous disease in multiple meridians, where clues are hard to find and attack is difficult. In such cases, one should treat the most severe aspect first, investigate the initial onset, or treat upper diseases by accessing lower points, or treat lower diseases by accessing upper points, etc.
Excess Fire and Deficiency Fire exist in all five Zang organs. A pulse that is floating, large, or rapid but weak upon heavy pressure indicates Deficiency Fire; a pulse that is slippery and rapid, strong upon both light and heavy pressure, indicates Excess Fire. Pulse findings at the Cun position (both sides) indicate Heart and Lung Fire; at the Guan position, Spleen, Stomach, Liver, and Gallbladder Fire; at the Chi position, Kidney and Bladder Fire. Coptis Rhizome (Huang Lian) drains Heart Fire, Scutellaria Root (Huang Qin) drains Lung Fire, Rhubarb (Da Huang) drains Spleen Fire, Gentian Root (Long Dan) drains Liver Fire, Anemarrhena Rhizome (Zhi Mu) and Phellodendron Bark (Huang Bo) drain Kidney Fire. These are all bitter-cold substances used to drain excess Fire; stop when the illness is cured, do not overdose. For Lung Meridian Deficiency Fire, use Tianshuoluo (Dong Bei Liu Jun Zi Tang ingredients like Asparagi Radix and Ophiopogonis Radix), Mulberry Bark (Sang Bai Pi), Lily Bulb (Bai He), and child urine. For Heart Meridian Deficiency Fire, use Bamboo Leaf (Zhu Ye), Ophiopogon (Mai Dong), Cinnabar (Zhen Zhu Sha), and Rhino Horn (Xi Jiao). For Spleen/Stomach Deficiency Fire, use White Peony Root (Bai Shao), Dendrobium (Shi Hu), Reed Rhizome (Lu Gen), Sugarcane Juice, and Pear Juice. For Liver Meridian Deficiency Fire, use White Peony Root, Chrysanthemum (Gan Ju), Uncaria (Gou Teng), Turtle Shell (Bie Jia), and Antelope Horn (Ling Yang Jiao). For Kidney Meridian Deficiency Fire, use Rehmannia Root (Sheng Di), Scrophularia Root (Xuan Shen), Cortex Moutan (Mu Dan Pi), Ligustrum Lucidum Fruit (Nv Zhen Zi), and Tortoise Shell (Gui Jia). These are appropriate herbs for their respective meridians.
Zhu Danxi stated: Ministerial Fire (Xiang Huo) moves wildly easily due to the stirring effect of the Five Emotions' Fire. Fire arises from recklessness, changes unpredictably, exists at all times, and boils down True Yin. Yin deficiency leads to disease; Yin exhaustion leads to death. Ministerial Fire is violent and cruel, worse than Sovereign Fire. It moves with every trigger throughout the four seasons, especially after the Start of Summer (Mang Zhong) for sixty days, when Ministerial Fire commands, and Heat, Summer-heat, and Dampness combine, making it particularly prone to movement. To treat this Fire, one should only nourish Yin, and the Fire will subside; bitter-cold agents alone cannot overcome it. Dryness Fire arises from blood deficiency, causing organs and vessels to lack moisture, leading to constipation. Bitter-cold agents will worsen dryness; sweet-cold moistening substances must be used to moisten dryness and extinguish Fire. Dampness can arise from Heat, and Heat can arise from Dampness; Damp-Heat often generates each other. For example, prolonged constipation followed by loose stools during defecation occurs because Heat is outside the intestines/stomach causing constipation, while Dampness is inside causing looseness; treating both Dampness and Heat together achieves cure.
Stagnant Fire (Yu Huo): Li Dongyuan attributed it to Spleen-Stomach deficiency and excessive consumption of cold foods, suppressing Yang Qi in Spleen Earth. Treatment requires ascending-Yang agents, following the principle "stagnant Fire should be dispersed." If True Yin is deficient and True Yuan exhausted, do not use this method. Nuns, widows, and unmarried women with delayed menstruation often suffer from Stagnant Fire; treat with Xiao Yao San combined with sweet-cold Yin-nourishing herbs. For Fierce Fire, Danxi said: Do not abruptly use cold/cool herbs when Fire is excessive, lest suppression causes rebound flare-up. Use Raw Licorice Root (Sheng Gan Cao) to drain and moderate; the rampant Fire will settle. This is a profound insight. Nameless Fire manifests suddenly with loss of consciousness, staring blankly, delirious speech, closed eyes without speech, convulsions, death after days, immediate collapse, or death while sleeping. No meridian pathway or pulse/symptom pattern can identify it. This corresponds to the Classic statement: "Sudden illnesses and sudden deaths all belong to Fire."
I observe that eight or nine out of ten diseases in the world are caused by Fire. If one can distinguish these types and refer to scattered Fire syndromes in other chapters, treatment errors of "tonifying excess" or "draining deficiency" can be avoided. Below, I elaborate on formulas for Excess and Deficiency Fire of the Five Zang organs, serving as a guideline for students. May they understand it divinely and expand upon it.
Dao Chi San (Guide Out the Red Powder): Treats Heart Heat with irritability and red, scanty urination. [Since Heart and Small Intestine are exterior-interior pairs.]
Rehmannia Root (Sheng Di) [cools Heart Blood], Akebia Stem (Mu Tong) [drains Heart Fire], Licorice Root (Gan Cao) [raw form drains Fire], add Juncus Effusus (Deng Xin) and Bambusa Leaves (Ye Zhu).
This formula guides Heart Fire out via Small Intestine urination. For Deficiency Fire, add Ophiopogon (Mai Dong), Poria (Fu Shen), Cinnabar (Zhu Sha). For Excess Fire, add Rhino Horn (Xi Jiao), Coptis (Huang Lian), Forsythia (Lian Qiao).
Ancient formulas: Huang Lian alone is called Xie Xin Tang; Huang Qin, Huang Lian, Da Huang together are San Huang Xie Xin Tang.
Tian Wang Bu Xin Dan (Heavenly Emperor Heart-Nourishing Pill) [see Xu Lao]: Formula for Heart Meridian Deficiency Fire; modify according to symptoms.
Xie Bai San (Drain White Powder): Treats Lung Heat cough, wheezing, chest fullness, and急促 breathing. [Fire attacking Lung causes cough and急促 breathing; rebellious Qi causes wheezing and fullness.]
Mulberry Bark (Sang Bai Pi), Dogwood Bark (Di Gu Pi - *Note: Text says Pi Gu, likely Di Gu Pi*) [both remove latent Fire in Lung], Licorice Root (Gan Cao) [moistens Lung, clears Heat]. If Fire stagnates in Lung causing nasal obstruction, add Chrysanthemum (Gan Ju), Mint (Bo He) [clears/disperses Upper Jiao stagnant Fire]. Also used for facial swelling and fever. If Lung transmits heat to Large Intestine causing diarrhea, add Coix Seed (Yi Yi Ren) [clears Lung, benefits Spleen], Poria (Fu Ling) [guides Qi, calms Fire].
This formula specifically drains Lung Meridian Fire. If Right Cun pulse is flooding or rapid but weak on heavy pressure, it is Deficiency Fire; add Tianshuoluo, Lily Bulb, sweet-cold herbs. If Right Cun pulse is flooding or rapid and strong on light/heavy pressure, it is Excess Fire; add Scutellaria (Huang Qin), Anemarrhena (Zhi Mu) bitter-cold herbs, or add Gypsum (Shi Gao).
Gui Pi Tang (Restore the Spleen Decoction), Zi Sheng Wan (Life-Nourishing Pill) [see Xu Lao]: Both treat Spleen/Stomach; modify according to symptoms.
Cheng Qi Tang (Descending Qi Decoction), Yin Chen Hao Tang (Artemisia Capillaris Decoction), Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) [see Shang Han]: All treat Spleen/Stomach Excess Fire; modify according to symptoms.
Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) [see Xu Lao]: Formula for Liver Meridian Stagnant Fire. Remove aromatic-drying herbs, add Yin-nourishing herbs. Acrid-dispersing and sweet-moderating actions, nourishing Yin and Blood, constitute tonifying the Liver.
Long Dan Xie Gan Tang (Gentian Drain Liver Decoction), Zuo Jin Wan (Left Metal Pill) [see Xiong Tong]: Formulas for Liver/Gallbladder Excess Fire. Ancient formula Dang Gui Long Hui Wan uses Gentian (Long Dan), Aloe (Lu Hui), Indigo Naturalis (Qing Dai) to drain Liver; Gardenia (Zhi Zi), Scutellaria (Huang Qin) to drain Lung; Coptis (Huang Lian) to drain Heart; Phellodendron (Huang Bo) to drain Kidney; Rhubarb (Da Huang) to drain Spleen; Angelica Sinensis (Dang Gui) to nourish Blood; Aucklandia (Mu Xiang), Musk (She Xiang - small amount) to move Qi; honey pills. Essential herb for severe Liver Fire, dose according to syndrome. Note: Ancients said Liver has draining but no tonifying methods. However, Liver has Deficiency Fire; Liver Blood deficiency leads to Wood dryness and Fire flaring; thus, only nourish Yin and Blood for treatment.
Hai Zang Xie Shen Wan (Hai Zang Kidney-Draining Pill): Treats excessive Ministerial Fire in Kidney with flooding/excess Left Chi pulse.
Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) minus Cornus Officinalis Fruit (Shan Yu Rou). [Since Child strengthens Mother, removing Shan Yu Rou avoids strengthening Wood to boost its Child; this constitutes draining, as Kidney has tonification but no draining.]
This formula still strengthens Water. Zhao Xike said: Excess Fire stems from insufficient Water. Dare not drain Fire directly; only tonify Water to harmonize Fire. If Ministerial Fire is very strong, use Liu Wei Di Huang Wan plus Zhi Mu and Huang Bo to drain excess Kidney Fire. Ancient formula Zi Shen Wan uses Anemarrhena (Zhi Mu, 6 liang), Phellodendron (Huang Bo, 10 liang), with Cinnamon Bark (Rou Gui, 5 qian) as counter-agent. Treats Kidney Fire excess with heat rushing from soles up thighs to abdomen. However, Liu Wei Di Huang Wan plus Zhi Mu/Huang Bo is more stable.
Liang Ge San (Cool the Diaphragm Powder): Treats Upper Jiao Excess Fire, red face/eyes, dizziness, irritability, throat/tongue swelling/pain, mouth ulcers, dry thirst, red urine, constipation.
Mint (Bo He) [acrid-cool, beneficial for head/eyes/throat/teeth], Gardenia (Shan Zhi) [light/floating reaches up to clear Lung, winding goes down to drain Fire], Scutellaria (Huang Qin) [light/floating ascends], Forsythia (Lian Qiao) [mainly drains Heart Fire], Licorice (Gan Cao) [moderates rapid descent, approx. 1 qian each], Rhubarb (Da Huang), Mirabilite (Mang Xiao) [moistens stool, treating upper disease by accessing lower, slowing upward flaming tendency, approx. 5 fen each). Can add Rhino Horn, Coptis, Gypsum, Anemarrhena, Raw Egg Yolk.
Treats Upper Jiao Excess Fire. Li Dongyuan said: Remove Mang Xiao/Da Huang, add Platycodon (Jie Geng) to create a boat-like agent that floats upward. Bambusa Leaves (Dan Zhu Ye) promotes urination, guiding Heart/Lung Fire downward; excellent for Upper Jiao chest/diaphragm heat.
Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity) [see Shang Han]: Treats Excess Fire in Upper, Middle, and Lower Jiao; add symptomatic herbs.
Fang Feng Tong Sheng San (Saposhnikovia Universal Protector Powder) [modified]: Treats exterior-interior pathogenic Heat, Three Jiao Excess Fire.
Saposhnikovia (Fang Feng), Schizonepeta (Jing Jie), Mint (Bo He) [release exterior Heat via sweat], Rhubarb (Da Huang), Mirabilite (Mang Xiao) [release interior Heat via bowels], Talcum (Hua Shi), Gardenia (Shan Zhi) [release via urine], Forsythia (Lian Qiao), Scutellaria (Huang Qin) [dispel Heat in various meridians], Gypsum (Shi Gao), Platycodon (Jie Geng) [clear Lung/Stomach Heat], Ophiopogon (Mai Dong) [rescue fluids injured by Heat], White Peony (Bai Shao) [rescue Ying-Blood injured by Heat], Licorice (Gan Cao) [harmonize herbs]. Removing Mang Xiao/Da Huang yields Shuang Jie San.
This formula clears Heat/Fire, opens pores (sweat), cleansse bladder (urine), unblocks transmission, dispersing intensity internally and externally. Good method for Fire. Surgery uses this for interior Excess Heat with widespread scabies. I often add Rehmannia (Sheng Di), honeysuckle (Jin Yin Hua, 1-2 liang), mung beans (Lu Dou, 1-2 he), decoct in water to cook medicine; drinking yields remarkable effects.
Qing Re Shen Shi Tang (Clear Heat and Percolate Dampness Decoction), Liang Xue Qu Shi Tang (Cool Blood and Remove Dampness Decoction) [see Shi Men]: Both treat Damp-Heat. One is drying, one is moistening; they differ significantly. Select accordingly.