脉∶虚大浮数、实大洪大，随其所见，细数为害。火症者有君火、相火。君火者。心火也。心为君主之官，
配于五行守位而不动。相火者，辅助之火也，生于虚无，寄于肝肾之间，听命而行。凡动皆是相火。五脏皆有火
，相火易起，五火相扇动矣。相火乃元气之贼，无时而不煎熬真阴。阴虚则病，阴绝则死，阴虚火动者难治。
凡人发热咳嗽吐痰血者，午后至夜发热、面颊唇红、小便赤涩者，便是阴虚火动也。
脉数无力者，阴虚火动也，滋阴降火汤（方见劳瘵），治肾经阴虚火动。
左寸脉洪数者，心火也。
黄连汤 治心火舌上生疮，或舌上肿，燥裂，或舌尖出血，或舌硬。
黄连 山栀 生地黄 麦门冬（去心） 当归 芍药（各一钱） 薄荷 犀角 甘草（各五分）
上锉一剂，水煎，食后频服。
左关脉洪数者，肝火也。
柴胡汤 治肝火盛，水气实，或胁痛，或气从左边起者，或目红肿痛，俱肝火也。
柴胡 芍药 龙胆草 当归 青皮 山栀 连翘（各一钱） 甘草（五分）
上锉一剂，水煎，食后服。
右寸脉洪数者，肺火也。
黄芩汤 治肺火咳嗽，吐血、痰血、鼻血、咽喉肿痛干燥生疮，或鼻孔干燥生疮，或鼻肿痛。
黄芩 山栀 桔梗 芍药 桑白皮 麦门冬 荆芥 薄荷 连翘（各一钱） 甘草（三分）
上锉一剂，水煎，食后服。
右关脉洪数者，脾火也。
芍药汤 治脾火或消谷易饥，或胃热口燥烦渴，或唇生疮。
芍药 栀子 黄连 石膏 连翘 薄荷（各一钱） 甘草（三分）
上锉一剂，水煎，食后服。
脉沉而实大者，实火也。
黄连解毒汤 治三焦实火，内外皆热，烦渴、小便赤、口生疮。
黄连 黄芩 桅子 黄柏 连翘 芍药 柴胡（各等分）
上锉一剂，水煎，食前服。
凉膈散 治三焦实火，烦渴、舌生疮、小水赤、大便结。
大黄 芒硝 桔梗 连翘 桅子 黄芩（各一钱） 薄荷（五分） 甘草（三分）
上锉一剂，水煎，食后服。
三黄解毒汤 治内外诸邪热毒，痈肿疮疽，筋脉拘挛，切牙惊悸，一切热毒并五淋便浊、痔漏。
黑丑（四两） 滑石（四两） 大黄 黄芩 黄连 桅子（各二两）
上为末，滴水丸，如梧桐子大。每服四十丸，温水送下。
脏腑积热，三焦火盛，口舌生疮、咽痛牙疼，用六味丸加黄连、黄芩、黄柏、桅子、知母、生地黄。
通府志斋徐公，因酷好烧酒及五香，药酒过度，患吐血痰唾、气喘咳嗽。一医与参苏饮，一医以败毒散，
一医以滋阴降火汤，俱无寸效。予见六脉急数，乃酒毒积热入于骨髓，不受滋补。以黄连解毒汤加知母、贝母、
石膏、连翘、玄参、
天花粉、葛根、栝萎、桔梗、酒蒸大黄，早晚而服。至百日外，以六味地黄丸加解毒药入内，与前汤药并进，
又服至百日始瘳。后归田逾年，为陈酒所犯而卒。
脉象：若见虚大、浮数，或实大、洪大的脉象，可根据具体所见进行判断；但若脉细数，则危害较大。火证分为君火和相火。君火，即心火。心被称为君主之官，在五行中守其位而不动。相火，是辅助之火，生于虚无之中，寄居于肝肾之间，听从命令而运行。凡是运动变化都属于相火的作用。五脏都有火，相火容易兴起，导致五火相互煽动。相火是元气的贼寇，无时无刻不在煎熬真阴。阴虚就会生病，阴气枯竭就会死亡，阴虚火旺者难以治疗。凡人出现发热、咳嗽、咳痰带血，午后到夜间发热，面颊嘴唇发红，小便赤涩的，就是阴虚火旺的表现。脉数而无力者，也是阴虚火旺，用滋阴降火汤（方剂见劳瘵篇），治疗肾经阴虚火旺。左寸脉洪数者，是心火。黄连汤，治疗心火导致舌上生疮，或者舌头肿胀，干燥裂口，或者舌尖出血，或者舌头僵硬。药材：黄连、山栀、生地黄、麦门冬（去心）、当归、芍药（各一钱）、薄荷、犀角、甘草（各五分）。以上药物锉碎为一剂，用水煎煮，饭后频繁服用。左关脉洪数者，是肝火。柴胡汤，治疗肝火旺盛，水气实证，或者胁痛，或者气从左边升起，或者眼睛红肿疼痛，这些都是肝火所致。药材：柴胡、芍药、龙胆草、当归、青皮、山栀、连翘（各一钱）、甘草（五分）。以上药物锉碎为一剂，用水煎煮，饭后服用。右寸脉洪数者，是肺火。黄芩汤，治疗肺火引起的咳嗽，吐血、痰中带血、鼻出血，咽喉肿痛干燥生疮，或者鼻孔干燥生疮，或者鼻子肿痛。药材：黄芩、山栀、桔梗、芍药、桑白皮、麦门冬、荆芥、薄荷、连翘（各一钱）、甘草（三分）。以上药物锉碎为一剂，用水煎煮，饭后服用。右关脉洪数者，是脾火。芍药汤，治疗脾火，或者消谷善饥（吃得多饿得快），或者胃热口干烦躁口渴，或者嘴唇生疮。药材：芍药、栀子、黄连、石膏、连翘、薄荷（各一钱）、甘草（三分）。以上药物锉碎为一剂，用水煎煮，饭后服用。脉象沉而实大者，是实火。黄连解毒汤，治疗三焦实火，内外皆热，烦渴、小便赤色、口内生疮。药材：黄连、黄芩、栀子、黄柏、连翘、芍药、柴胡（各等分）。以上药物锉碎为一剂，用水煎煮，饭前服用。凉膈散，治疗三焦实火，烦渴、舌内生疮、小便赤色、大便干结。药材：大黄、芒硝、桔梗、连翘、栀子、黄芩（各一钱）、薄荷（五分）、甘草（三分）。以上药物锉碎为一剂，用水煎煮，饭后服用。三黄解毒汤，治疗内外各种邪热毒气，痈肿疮疽，筋脉拘挛，咬牙惊悸，一切热毒以及五淋便浊、痔漏。药材：黑丑（四两）、滑石（四两）、大黄、黄芩、黄连、栀子（各二两）。以上药物研为粉末，滴水泛丸，如梧桐子大小。每次服用四十丸，温水送下。脏腑积热，三焦火盛，口舌生疮、咽痛牙疼，用六味丸加黄连、黄芩、黄柏、栀子、知母、生地黄。通府志斋徐公，因为酷爱喝烧酒及五香药酒过度，患吐血、咳痰唾、气喘咳嗽。一位医生给参苏饮，一位医生用败毒散，一位医生用滋阴降火汤，都没有丝毫效果。我诊察发现六脉急数，这是酒毒积热深入骨髓，不能接受滋补。于是用黄连解毒汤加知母、贝母、石膏、连翘、玄参、天花粉、葛根、栝萎、桔梗、酒蒸大黄，早晚服用。到了百日之后，用六味地黄丸加入解毒药内服，与前方的汤药同时并进，又服用百日才痊愈。后来辞官归田一年多，因再次饮酒而去世。
Pulse: If the pulse is deficient and large, floating and rapid, or excess and large, and surging, judgment must be made according to the specific presentation; however, a fine and rapid pulse indicates greater harm. Fire syndromes are divided into Ministerial Fire (Jun Huo) and Assistant Fire (Xiang Huo). Ministerial Fire refers to Heart Fire. The Heart acts as the Sovereign Ruler, aligns with the Five Elements, remains in its proper position, and does not move recklessly. Assistant Fire is the auxiliary fire, born from emptiness, residing between the Liver and Kidney, acting upon command. All movement in the body is the function of Assistant Fire. Each of the Five Zang organs contains fire; Assistant Fire rises easily, causing the fires of the five organs to fan each other. Assistant Fire is the thief of Yuan Qi (Original Qi), constantly burning True Yin without rest. Yin deficiency leads to disease; exhaustion of Yin leads to death; cases of Yin deficiency with hyperactive fire are difficult to treat.
When a person presents with fever, cough, expectoration of blood-stained sputum, fever from afternoon to night, redness of the malar region and lips, and dark, scanty, or painful urination, this indicates Yin deficiency with hyperactive fire. A rapid but forceless pulse also indicates Yin deficiency with hyperactive fire; it should be treated with Ziyin Jianghuo Tang (Nourish Yin and Descend Fire Decoction) (see Formula for Lao Zhai/Tuberculosis) to treat Kidney channel Yin deficiency with hyperactive fire.
A surging and rapid pulse at the left Cun position indicates Heart Fire. Huanglian Tang (Coptis Decoction) treats Heart Fire causing sores on the tongue, swelling of the tongue, dryness and cracking, bleeding from the tip of the tongue, or stiffness of the tongue. Ingredients: Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Sheng Dihuang (Rehmanniae Radix), Maidong (Ophiopogonis Tuber) (heart removed), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba) (each 1 qian); Bohe (Menthae Haplocalycis Herba), Xijiao (Rhinocerotis Cornu), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 qian). The above ingredients are coarsely crushed for one dose, decocted in water, and taken frequently after meals.
A surging and rapid pulse at the left Guan position indicates Liver Fire. Chaihu Tang (Bupleurum Decoction) treats excessive Liver Fire with excess Water Qi, hypochondriac pain, Qi rising from the left side, or red, swollen, and painful eyes; all these are caused by Liver Fire. Ingredients: Chaihu (Bupleuri Radix), Shaoyao (Paeoniae Radix Alba), Longdancao (Gentianae Radix), Danggui (Angelicae Sinensis Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Shanzhi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus) (each 1 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 qian). The above ingredients are coarsely crushed for one dose, decocted in water, and taken after meals.
A surging and rapid pulse at the right Cun position indicates Lung Fire. Huangqin Tang (Scutellaria Decoction) treats Lung Fire causing cough, hemoptysis, blood-tinged sputum, epistaxis, sore throat with swelling, dryness, and sores, dryness and sores in the nostrils, or nasal swelling and pain. Ingredients: Huangqin (Scutellariae Radix), Shanzhi (Gardeniae Fructus), Jiegeng (Platycodonis Radix), Shaoyao (Paeoniae Radix Alba), Sangbaipi (Mori Cortex), Maidong (Ophiopogonis Tuber), Jingjie (Schizonepetae Spica), Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus) (each 1 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.3 qian). The above ingredients are coarsely crushed for one dose, decocted in water, and taken after meals.
A surging and rapid pulse at the right Guan position indicates Spleen Fire. Shaoyao Tang (Peony Decoction) treats Spleen Fire causing excessive hunger despite normal digestion (Xiaogu Yiji), stomach heat with dry mouth and thirst, or sores on the lips. Ingredients: Shaoyao (Paeoniae Radix Alba), Zhizi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), Shigao (Gypsum Fibrosum), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba) (each 1 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.3 qian). The above ingredients are coarsely crushed for one dose, decocted in water, and taken after meals.
A deep, excess, and large pulse indicates Excess Fire. Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) treats Excess Fire of the Triple Burner, internal and external heat, irritability and thirst, dark urine, and oral sores. Ingredients: Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), Lianqiao (Forsythiae Fructus), Shaoyao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix) (equal parts). The above ingredients are coarsely crushed for one dose, decocted in water, and taken before meals.
Liangge San (Cool the Diaphragm Powder) treats Excess Fire of the Triple Burner, irritability and thirst, oral sores, dark urine, and constipation. Ingredients: Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Jiegeng (Platycodonis Radix), Lianqiao (Forsythiae Fructus), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix) (each 1 qian); Bohe (Menthae Haplocalycis Herba) (0.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.3 qian). The above ingredients are coarsely crushed for one dose, decocted in water, and taken after meals.
Sanhuang Jiedu Tang (Three Yellows Decoction to Relieve Toxicity) treats various internal and external pathogenic heat toxins, carbuncles and sores, muscle spasms, teeth grinding, palpitations due to fright, all heat toxins, Wulin (Five Strangury syndromes), turbid urination, and hemorrhoids with fistulas. Ingredients: Heiqiu (Semen Cassiae Cum Semen Strychnos) (4 liang), Huashi (Talcum) (4 liang), Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus) (each 2 liang). The above ingredients are powdered, mixed with water to form pills the size of Sophora seeds. Take 40 pills per dose, washed down with warm water.
For accumulated heat in the Zang-Fu organs and excessive Fire in the Triple Burner causing oral and lingual sores, sore throat, and toothache, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) added with Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), and Shengdihuang (Rehmanniae Radix).
Mr. Xu from Tongfu Zhizhai suffered from hemoptysis, expectoration of phlegm and saliva, asthma, and cough due to excessive consumption of distilled liquor and five-spice medicinal wines. One physician prescribed Shen Su Yin (Ginseng and Bupleurum Decoction), another used Baidu San (Defeat Toxin Powder), and a third used Ziyin Jianghuo Tang (Nourish Yin and Descend Fire Decoction), but none had any effect. Upon examination, I found the pulses in all six positions to be urgent and rapid, indicating that alcohol toxin and accumulated heat had penetrated into the bone marrow, making the patient intolerant to tonification. Therefore, I prescribed Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) added with Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Bulbus), Shigao (Gypsum Fibrosum), Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), Tianhuafen (Trichosanthis Radix), Gegen (Puerariae Lobatae Radix), Gualou (Trichosanthis Fructus), Jiegeng (Platycodonis Radix), and Jiuzheng Dahuang (Alcohol-steamed Rhubarb), administered morning and evening. After more than a hundred days, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with detoxifying herbs was combined with the previous decoction. After another hundred days of treatment, the illness finally subsided. Later, after retiring to his hometown for over a year, he died due to relapse triggered by aged wine.