治积热结滞脏腑，大便秘结，心膈烦燥。
黄连 黄芩 大黄（煨，各等分） 水煎服。
治心肺蕴热，口疮咽痛膈闷，小便淋浊不利。
黄连 栀子仁 黄芩 麦门冬 木通 生地黄 泽泻 甘草（各等分） 水煎服。
治一切积热丹毒，并喉咙热痛。
当归 甘草（炙） 赤芍药 大黄（各等分） 水煎服。
夫火之为病，其害甚大，其变甚速，其势甚彰，其死甚暴，盖以火性疾速，燔灼焚
焰，飞走狂越，消铄于物，莫能御之。游行乎三焦，虚实有两途，曰君火者，犹人火
也，曰相火者，犹龙火也。凡火性不妄动，不违于道，则禀位听命营运，造化生存之机
得矣。奈何人在气交之中，多动少静，欲不妄动，其可得乎？故凡动者，皆属火化。火
一妄行，元气受伤，势不两立，偏胜则病，移害他经，事非细，故动之极也，病则死
矣。《经》所谓∶一水不胜二火之火，然出于天造，君相之外，又有厥阳脏腑之火，根
于五志之内，无因六欲七情激之，其火随起者，如大怒则火起于肝，醉饱则火起于胃，
房劳则火起于肾，悲哀动中，则火起于肺，心为君主，自焚则死矣。故丹溪曰∶火出五
脏。《经》所谓∶一水不胜五火之火，盖五脏各有火，五志激之，其火随起，诸寒为
病，必身犯寒气，口食寒物而得，非若诸火为病，皆自内作者也。凡脉虚则浮大，实则
洪数，药之所主，各因其属，如君火者，心火也，可以湿伏，可以水灭，可以直折，黄
连之属，可以制之。相火者，龙火也，不可以水湿折之，从其性而伏之，惟黄柏之属，
可以降之。虽然泻火之法，岂止如此，虚实多端，不可不察。以脏气司之，黄连泻心
火，黄芩泻肺火，芍药泻脾火，柴胡泻肝火，知母泻肾火，此皆苦寒之味，能泻有余
之火耳。若饮食劳倦，内伤元气，火不两立，为阳虚之病者，宜以甘温之剂除之，如
黄、人参、甘草之属。若阴微阳强，相火炽盛，以乘阴位，日渐煎熬，为血虚之病
者，宜以甘寒之剂降之，如当归、地黄之属。或心火亢极，郁热内实，为阳强之病
者，宜以咸冷之剂折之，如大黄、朴硝之属。若肾水受伤，真阴失守，无根之火，为
阴虚之病者，宜以壮水之剂制之，如生地黄、玄参之属，若右肾命门之衰，为阳脱之
病者，宜以温热之剂济之，如附子、干姜之属。若胃虚过食冷物，逼退阳气于脾土、而
为火郁之病者，宜以升散之剂发之，如升麻、葛根之属。倘不明此，而治之。难免实
实虚虚之祸矣。
夫火与元气，势不两立，故火之盛者，即气之衰也。是以元气者，水火之根，气血
之母，虽为有生之本，实为无形之虚。凡有所伤皆患不足，故有余之疾病，皆正气之衰
微，盖人身五脏六腑、十二经络、三焦包络，皆一气之流行，安有所谓火哉？火者即
气之不得其平，而为之也，故曰捍卫冲和不息之谓气，扰乱变动之谓火。五行各一，惟
火有二，曰君火、人火也；相火、天火也。凡动皆属火，而其所以易于动者，皆相火之
助也。相火寄于肾肝，见于天者，犹之龙雷，东垣谓为元气之贼，以其暴悍酷烈，有
甚于君火也。使善处而制之以静，则元阳蓄焉。五火寂然不作，惟有补脾，造化生生不
息之用，有何贼之患哉！所以六气之序，君火在前，相火在后，前者肇物之生，后者成
物之实，此乃君相二火之用也。若夫所谓火与元气，势不两立，一胜一负，此论壮火而
非少火也。然阳火利于正治，阴火利于从治，凡自劳役辛苦及感冒而致者，皆为伤其
阳火也，补中汤。自劳心思虑及房欲而得者，皆为伤其阴火也，地黄汤。有谓阳盛则
阴衰，火盛则水衰，故用大苦大寒之药，抑阳而扶阴，泻其亢甚之火者，而救其欲绝之
水也。然非实热不可轻投，盖有根之火，有病病以当之，无根之火，元气受伤而立败，
故曰，误服寒凉者立死。此治阴阳二火之大略，实至当不易之经纶也。
火郁当发，兼宜审看何经？如轻者可降，重者则从其性而治之，丹溪云∶实火可
泻，如黄连解毒汤之类。虚火可补，如四物汤之类。气有余便是火，不足者是气虚。人
壮气实火盛颠狂者，可用正治，人虚火盛狂者，若投正治即死，宜补阴火即自降。凡火
盛者不可骤用凉药，必兼温散。有可发者，如风寒外束者可发。郁火可发，气从左边起
者乃肝火也，气从脐下起者乃阴火也。气从脚下起入腹如火者，乃虚之极也。盖火起于
九泉之下，其症多死，倘能清心绝欲，养阴滋肾，使真阴得复，亦可挽回。若徒事服
药，而不能禁忌，多致不救，外用附子末津调敷涌泉穴，乃引火下行之义也。阴虚火动
者难治。凡小便降火最速。龟板补阴，乃阴中之至阴也。生甘草缓火邪，木通下行，泻
小肠火。人中白泻肝火，须风露中二三年者佳，人中黄大凉，治疾病须多年者佳。山栀
子仁大能降郁火，从小便泄去，其性能屈曲下降，亦能治痞块中火邪。
治疗脏腑积热结滞，大便秘结，心胸膈部烦闷燥热。
黄连、黄芩、大黄（煨制，各等分），水煎服。
治疗心肺蕴积热邪，口舌生疮，咽喉疼痛，胸膈痞闷，小便淋沥浑浊不利。
黄连、栀子仁、黄芩、麦门冬、木通、生地黄、泽泻、甘草（各等分），水煎服。
治疗各种积热引起的丹毒，以及喉咙热痛。
当归、甘草（炙）、赤芍药、大黄（各等分），水煎服。
火这种致病因素，其危害非常大，变化非常迅速，病势非常明显，死亡往往很突然。这是因为火的性质疾速猛烈，像燃烧火焰一样，飞走狂越，销蚀万物，没有人能抵御它。火在三焦中游行，虚实有两种途径：所谓君火，就像人间的火；所谓相火，就像龙火。凡是火的性质如果不妄动，不违背正道，就会安守本位，听从命令进行运化，从而获得造化生存的机会。奈何人处在天地气交之中，多动少静，想要不妄动，怎么可能呢？所以凡是动的，都属于火化。火一旦妄行，元气就会受伤，两者势不两立，偏胜就会导致疾病，并移害其他经络，事情并不小，如果动到极点，生病就会死亡。《内经》所说的“一水不胜二火”，是指出于天造、在君相之外的厥阳脏腑之火，根源于五志之内，如果没有六欲七情的激发，火不会随起。比如大怒则火起于肝，醉饱则火起于胃，房劳过度则火起于肾，悲哀伤及内心则火起于肺，心为君主之官，如果自焚就会死亡。所以朱丹溪说：“火出于五脏。”《内经》所说的“一水不胜五火”，是因为五脏各有火，五志激发它们，火就随之而起。各种寒性疾病，一定是身体遭受寒气、口中食用寒物而得的，不像各种火性疾病，都是发自内部的。凡是脉象虚的则浮大，实的则洪数，用药的主次，各自根据其属性而定。如君火，就是心火，可以用湿伏法，可以用水灭法，可以直折其势，用黄连这类药物，可以制约它。相火，就是龙火，不可以用水湿来折服，要顺着它的性质来伏制它，只有黄柏这类药物，可以降伏它。虽然泻火的方法，难道只有这些吗？虚实情况多种多样，不可不仔细考察。从脏气主治来看，黄连泻心火，黄芩泻肺火，芍药泻脾火，柴胡泻肝火，知母泻肾火，这些都是苦寒的味道，能够泻除有余的火邪罢了。如果是饮食劳倦，内伤元气，火与元气势不两立，属于阳虚的疾病，适宜用甘温的药剂来消除，如黄芪、人参、甘草这类药物。如果是阴微阳强，相火炽盛，侵犯阴位，日渐煎熬，属于血虚的疾病，适宜用甘寒的药剂来降伏，如当归、地黄这类药物。或者是心火亢极，郁热内实，属于阳强的疾病，适宜用咸冷的药剂来折服，如大黄、朴硝这类药物。如果是肾水受伤，真阴失守，无根之火，属于阴虚的疾病，适宜用壮水的药剂来制约，如生地黄、玄参这类药物。如果是右肾命门衰败，属于阳脱的疾病，适宜用温热的药剂来救助，如附子、干姜这类药物。如果是胃虚过食冷物，逼迫阳气退避到脾土，而形成火郁的疾病，适宜用升散的药剂来发散，如升麻、葛根这类药物。如果不明白这些道理而去治疗，难免犯下“实实虚虚”（使实证更实，虚证更虚）的祸患。
火与元气，势不两立，所以火盛的，就是气的衰弱。因此元气是水火之根，气血之母，虽然是有生命的根本，实际上是无形之虚。凡是有损伤都会导致不足，所以有余的疾病，都是正气的衰微。大概人身五脏六腑、十二经络、三焦包络，都是一气的流行，哪里有所谓的火呢？火就是气不得平衡而产生的，所以说捍卫冲和不息的叫做气，扰乱变动的叫做火。五行各有一个，只有火有两个：君火，是人火；相火，是天火。凡是动都属火，而其所以容易动的，都是相火的帮助。相火寄居于肾肝，表现在天上，就像龙雷一样，李东垣称之为元气的贼，因为它暴悍酷烈，比君火更厉害。如果能妥善处置并用静来制约它，那么元阳就能蓄积。五火寂然不作，只有补脾，发挥造化生生不息的作用，有什么贼的祸患呢！所以六气的次序，君火在前，相火在后，前者开启万物的生长，后者成就万物的结实，这是君相二火的作用。至于所谓火与元气势不两立，一胜一负，这是论述壮火，而不是少火。然而阳火利于正治，阴火利于从治。凡是因劳役辛苦及感冒而导致的，都是伤了阳火，用补中益气汤。凡是因劳心思虑及房事欲望而得的，都是伤了阴火，用地黄丸。有人说阳盛则阴衰，火盛则水衰，所以用大苦大寒的药物，抑制阳而扶持阴，泻其亢盛的火，来救其将绝的水。然而如果不是实热，不可轻易投用，因为有根的火，有病邪来抵挡它；无根的火，元气受伤就会立即败亡，所以说误服寒凉药会立即死亡。这是治疗阴阳二火的大略，确实是恰当且不可改变的准则。
火郁应当发散，同时适宜审察是哪一经？如轻症可以降，重症则顺从其性质来治疗。朱丹溪说：实火可泻，如黄连解毒汤之类。虚火可补，如四物汤之类。气有余便是火，气不足则是气虚。人体壮实、气盛、火盛、癫狂的人，可以用正治法；人体虚弱、火盛、狂乱的人，如果投用正治法就会死亡，适宜补阴火，火自然下降。凡是火盛的，不可骤然使用凉药，必须兼用温散。有可以发散的，如风寒外束的可以发散。郁火可以发散，气从左边起的乃是肝火，气从脐下起的乃是阴火。气从脚下起进入腹部如火烧般的，乃是虚到了极点。大概火起于九泉之下，这种症状大多死亡，如果能清心绝欲，养阴滋肾，使真阴得以恢复，也可以挽回。如果只致力于服药，而不能禁忌，多导致无法救治。外用附子末，用唾液调敷涌泉穴，这是引火下行的意思。阴虚火动的难治。凡是小便降火最快。龟板补阴，是阴中的至阴药。生甘草缓减火邪，木通下行，泻小肠火。人中白泻肝火，须在风露中存放二三年的为佳，人中黄大凉，治疗疾病须多年的为佳。山栀子仁大能降郁火，从小便泄去，其性能屈曲下降，也能治疗痞块中的火邪。
Treats accumulated heat and stagnation in the Zang-Fu organs, constipation, and irritability with restlessness in the heart and diaphragm.
Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Rhei Radix et Rhizoma (Dahuang) [stir-fried until charred], equal parts. Decoct in water and take orally.
Treats heat accumulation in the Heart and Lungs, mouth ulcers, sore throat, chest oppression, and dysuria with turbid urine.
Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Zhizi Ren), Scutellariae Radix (Huangqin), Ophiopogonis Radix (Maimendong), Akebiae Caulis (Mutong), Rehmanniae Radix (Shengdihuang), Alismatis Rhizoma (Zexie), Glycyrrhizae Radix et Rhizoma (Gancao), equal parts. Decoct in water and take orally.
Treats various types of accumulated heat causing erysipelas (Dan Du), and hot pain in the throat.
Angelicae Sinensis Radix (Danggui), Glycyrrhizae Radix et Rhizoma (Gancao) [roasted], Paeoniae Radix Rubra (Chishaoyao), Rhei Radix et Rhizoma (Dahuang), equal parts. Decoct in water and take orally.
Fire as a pathogenic factor causes great harm, changes rapidly, manifests prominently, and leads to sudden death. This is because fire has a swift and fierce nature, burning like flames, flying wildly, consuming all things, and nothing can resist it. Fire circulates through the San Jiao (Triple Burner), presenting two pathways of deficiency and excess: Jun Huo (Monarch Fire) is like human fire; Xiang Huo (Minister Fire) is like dragon fire. When fire does not move recklessly and follows the Dao, it obeys its position and commands, facilitating the mechanisms of creation and survival. However, humans exist within the intersection of Qi, moving more than staying still; how can one avoid reckless movement? Therefore, all movement belongs to fire transformation. Once fire moves recklessly, Yuan Qi (Original Qi) is injured, and the two are incompatible. Excess leads to disease, affecting other meridians, which is no small matter. If movement reaches its extreme, illness leads to death. The *Classic* states: "One water cannot overcome two fires." This refers to the Ju Yang (Jue-Yang) fire of the Zang-Fu organs, which arises from heaven and exists outside of Jun and Xiang fire. It roots within the Five Emotions (Wu Zhi). Without stimulation by the Six Desires or Seven Emotions, fire does not arise spontaneously. For example, anger causes fire to rise in the Liver; drunkenness and overeating cause fire to rise in the Stomach; sexual exhaustion causes fire to rise in the Kidneys; sorrow and grief injuring the interior cause fire to rise in the Lungs. The Heart is the Monarch; if it burns itself, death ensues. Thus, Zhu Danxi said: "Fire originates from the Five Zang Organs." The *Classic* also states: "One water cannot overcome five fires." Since each Zang organ has fire, when stimulated by the Five Emotions, fire arises accordingly. Diseases caused by cold must result from exposure to cold air or consumption of cold foods, unlike diseases caused by fire, which originate internally.
Regarding pulse diagnosis: deficiency pulses are floating and large; excess pulses are surging and rapid. Medication should be chosen according to the specific nature. Jun Huo is Heart Fire; it can be subdued by dampness, extinguished by water, or directly reduced using bitter-cold herbs like Coptidis Rhizoma (Huanglian). Xiang Huo is Dragon Fire; it cannot be subdued by water or dampness but must be controlled by following its nature, using herbs like Phellodendri Cortex (Huangbai) to descend it. Although these are methods for purging fire, they are not exhaustive; deficiency and excess present in many ways and must be carefully examined. From the perspective of Zang organ governance: Coptidis Rhizoma (Huanglian) purges Heart Fire; Scutellariae Radix (Huangqin) purges Lung Fire; Paeoniae Radix (Shaoyao) purges Spleen Fire; Bupleuri Radix (Chaihu) purges Liver Fire; Anemarrhenae Rhizoma (Zhimu) purges Kidney Fire. These are all bitter-cold substances that purge excess fire.
If dietary irregularities or fatigue injure Yuan Qi, leading to a conflict between fire and Qi, resulting in Yang deficiency disease, sweet-warm formulas such as Astragali Radix (Huangqi), Ginseng Radix (Renshen), and Glycyrrhizae Radix et Rhizoma (Gancao) should be used. If Yin is weak and Yang is strong, with vigorous Xiang Huo invading Yin positions and slowly consuming fluids, causing blood deficiency disease, sweet-cold formulas such as Angelicae Sinensis Radix (Danggui) and Rehmanniae Radix (Dihuang) should be used to descend fire. If Heart Fire is hyperactive with internal stagnant heat, causing Yang excess disease, salty-cold formulas such as Rhei Radix et Rhizoma (Dahuang) and Natrii Sulfas (Puxiao) should be used to reduce fire. If Kidney Water is injured and True Yin is lost, resulting in rootless fire and Yin deficiency disease, formulas that strengthen Water, such as Rehmanniae Radix (Shengdihuang) and Scrophulariae Radix (Xuanshen), should be used. If the Gate of Vitality (Ming Men) of the Right Kidney declines, causing Yang collapse disease, warm-hot formulas such as Aconiti Lateralis Radix Praeparata (Fuzi) and Zingiberis Rhizoma (Ganjiang) should be used to rescue Yang. If Stomach deficiency leads to excessive consumption of cold items, forcing Yang Qi to retreat into the Spleen Earth, causing Fire Stagnation disease, ascending and dispersing formulas such as Cimicifugae Rhizoma (Shengma) and Puerariae Radix (Gegen) should be used to vent the fire. Failure to understand these principles may lead to the disaster of reinforcing excess and depleting deficiency.
Fire and Yuan Qi are incompatible; thus, abundant fire indicates deficient Qi. Yuan Qi is the root of Water and Fire, and the mother of Qi and Blood. Although it is the foundation of life, it is essentially an invisible emptiness. Any injury leads to insufficiency; therefore, diseases of excess are actually due to the decline of righteous Qi. The Five Zang, Six Fu, Twelve Meridians, and San Jiao Bao Luo are all flows of a single Qi; where does fire come from? Fire is simply Qi losing its balance. Thus, what maintains harmony and unceasingly protects is called Qi; what disturbs and changes is called Fire. Among the Five Elements, there is only one of each, except for Fire, which has two: Jun Huo (Human Fire) and Xiang Huo (Heavenly Fire). All movement belongs to fire, facilitated by Xiang Huo. Xiang Huo resides in the Kidneys and Liver; in nature, it resembles dragon thunder. Li Dongyuan called it the "thief of Yuan Qi" because it is violent and cruel, worse than Jun Huo. If managed well and controlled by stillness, Yuan Yang is stored. If the Five Fires remain silent and the Spleen is tonified, the creative function continues without theft. In the sequence of the Six Qi, Jun Huo comes first, initiating growth; Xiang Huo comes second, completing fruition. This is the function of Jun and Xiang Fire. The statement that "Fire and Yuan Qi are incompatible, one wins while the other loses" refers to Zhuang Huo (Blazing Fire), not Shao Huo (Lesser Fire). Yang Fire responds to orthodox treatment; Yin Fire responds to contrary treatment. Diseases caused by labor, hardship, or wind-cold damage Yang Fire; treat with Buzhong Yiqi Tang. Diseases caused by mental strain or sexual desire damage Yin Fire; treat with Dihuang Wan. Some say Yang excess leads to Yin deficiency, and fire excess leads to water deficiency. Therefore, use bitter-cold drugs to suppress Yang and support Yin, purging hyperactive fire to save impending water. However, do not use them lightly unless there is real heat. Rooted fire has pathology to absorb it; rootless fire causes immediate collapse upon injuring Yuan Qi. Hence, mistakenly taking cold-cooling drugs leads to immediate death. This is the general principle for treating Yin and Yang Fire, an immutable canon.
For Fire Stagnation, dispersion is indicated, but one must determine the affected meridian. Mild cases can be descended; severe cases follow their nature. Zhu Danxi said: Real fire can be purged, e.g., Huanglian Jiedu Tang; Deficient fire can be tonified, e.g., Siwu Tang. Excess Qi becomes fire; deficient Qi is Qi deficiency. Strong individuals with excess Qi, fire, and mania can undergo orthodox treatment. Weak individuals with excess fire and mania will die if treated orthodoxy; instead, tonify Yin fire to let it descend naturally. Do not abruptly use cooling drugs for high fire; combine with warm dispersants. Cases with external wind-cold binding can be dispersed. Stagnant fire can be dispersed. Qi rising from the left side indicates Liver Fire; Qi rising from below the navel indicates Yin Fire. Qi rising from the feet into the abdomen like fire indicates extreme deficiency. Fire arising from the "nine springs" (deep depths) often results in death. However, if one clears the mind, abandons desires, nourishes Yin, and moistens the Kidneys to restore True Yin, recovery is possible. Mere medication without lifestyle restrictions often leads to untreatable conditions. Topically, apply Fuzi powder mixed with saliva to Yongquan (KI 1) to guide fire downward. Yin deficiency with fire agitation is difficult to treat. Urination reduces fire fastest. Guiban (Testudinis Carapax et Plastrum) tonifies Yin and is the ultimate Yin substance. Gancao (raw) moderates fire pathogens; Mutong descends and purges Small Intestine fire. Renzhongbai (Urinae Hominis Depuratum) purges Liver fire; aged two to three years in wind and dew is best. Renzhonghuang is very cooling; aged years are best for treating diseases. Zhizi Ren greatly descends stagnant fire via urination; its nature descends curvingly and can also treat fire pathogens in abdominal masses.