（附∶新拟和肝丸）
肝为厥阴，中见少阳，且有相火寄其中，故《内经》名为将军之官，其性至刚也。为其性刚，当有
病时恒侮其所胜，以致脾胃受病，至有胀满、疼痛、泄泻种种诸证。因此方书有平肝之
说，谓平肝即所以扶脾。若遇肝气横恣者，或可暂用而不可长用。因肝应春令，为气化发生之始，过平
则人身之气化必有所伤损也。有谓肝于五行属木，木性原善条达，所以治肝之法当以散为补（方书谓肝以敛为
泻以散为补）。散者即升发条达之也，然升散常用，实能伤气耗血，且又暗伤肾水以损肝木之根也。
有谓∶肝恶燥喜润。燥则肝体板硬，而肝火肝气即妄动；润则肝体柔和，而肝火肝气长宁静。是以方书
有以润药柔肝之法。然润药屡用，实与脾胃有碍，其法亦可暂用而不可长用。然则治肝之法将恶乎宜哉？
《内经》谓∶“厥阴不治，求之阳明”。《金匮》谓∶“知肝之病，当先实脾。”先圣后圣，其揆
如一，此诚为治肝者之不二法门也。惜自汉、唐以还，未有发明其理者。独至黄坤载，深明其理谓∶“肝气
宜升，胆火宜降。然非脾气之上行，则肝气不升，非胃气之下行，则胆火不降。”旨哉此言，诚窥《内经》、
《金匮》之精奥矣。由斯观之，欲治肝者，原当升脾降胃，培养中宫，俾中宫气化敦浓，以听肝木之自理。
即有时少用理肝之药，亦不过为调理脾胃剂中辅佐之品。所以然者，五行之土原能包括金木水火四行，人之脾
胃属土，其气化之敷布，亦能包括金木水火诸脏腑。所以脾气上行则肝气自随之上升，胃气下行则胆火自
随之下降也。又《内经》论厥阴治法，有“调其中气，使之和平”之语。所谓调其中气者，即升脾降胃
之谓也。所谓使之和平者，即升脾降胃而肝气自和平也。至仲景着《伤寒论》，深悟《内经》之旨，其厥阴
治法有吴茱萸汤；厥阴与少阳脏腑相根据，乃由厥阴而推之少阳治法，有小柴胡汤。二方中之人参、半夏、大
枣、生姜、甘草，皆调和脾胃之要药也。且小柴胡汤以柴胡为主药，而《神农本草经》谓其主肠胃中结气，
饮食积聚，寒热邪气，推陈致新。三复《神农本草经》之文，则柴胡实亦为阳明胃府之药，而兼治少
阳耳。欲治肝胆之病者，易弗祖《内经》而师仲景哉！
独是，肝之为病不但不利于脾，举凡惊痫、癫狂、眩晕、脑充血诸证西人所谓脑气筋病者，皆与肝经有
涉。盖人之脑气筋发源于肾，而分派于督脉，系淡灰色之细筋。肝原主筋，肝又为肾行气，故脑气筋之病实与
肝脏有密切之关系也。治此等证者，当取五行金能制木之理，而多用五金之品以镇之，如铁锈、铅灰、
金银箔、赭石（赭石铁养化合亦含有金属）之类，而佐以清肝润肝之品，若羚羊角、青黛、芍药、龙胆草、牛膝
（牛膝味酸入肝，善引血火下行，为治脑充血之要药，然须重用方见奇效）诸药，俾肝经风定火熄，而
脑气筋亦自循其常度，不至有种种诸病也。若目前不能速愈者，亦宜调补脾胃之药佐之，而后金属及寒
凉之品可久服无弊。且诸证多系挟有痰涎，脾胃之升降自若而痰涎自消也。
有至要之证，其病因不尽在肝，而急则治标，宜先注意于肝者，元气之虚而欲上脱者是也。其病状多大
汗不止，或少止复汗，而有寒热往来之象。或危极至于戴眼，不露黑睛；或无汗而心中摇摇，需人按住；或
兼喘促。此时宜重用敛肝之品，使肝不疏泄，即能杜塞元气将脱之路。至汗止、怔忡、喘促诸疾暂愈，
而后徐图他治法。宜重用山茱萸净肉至二两（《神农本草经》山萸肉主治寒热即指此证），
敛肝即以补肝，而以人参、赭石、龙骨、牡蛎诸药辅之。拙着来复汤后载有本此法挽回垂绝之证数则，可参阅也。
究之肝胆之为用，实能与脾胃相助为理。因五行之理，木能侮土，木亦能疏土也。曾治有饮食不能
消化，服健脾暖胃之药百剂不效。诊其左关太弱，知系肝阳不振，投以黄 （其性温升肝木之性亦温升有同气
相求之义，故为补肝之主药）一两，桂枝尖三钱，数剂而愈。又治黄胆，诊其左关特弱，重用黄 煎汤，送
服《金匮》黄胆门硝石矾石散而愈。若是皆其明征也。且胆汁入于小肠，能助小肠消化食物，此亦木
能疏土之理。盖小肠虽属火，而实与胃腑一体相连，故亦可作土
论。胆汁者，原由肝中回血管之血化出，而注之于胆，实得甲乙木气之全，是以在小肠中能化胃中不能化
之食，其疏土之效愈捷也。又西人谓肝中为回血管会合之处，或肝体发大，或肝内有热，各管即多凝滞壅胀。
由斯知疏达肝郁之药，若柴胡、川芎、香附、生麦芽、乳香、没药皆可选用；而又宜佐以活血之品，若
桃仁、红花、樗鸡、 虫之类，且又宜佐以泻热之品，然不可骤用大凉之药，恐其所瘀之血得凉而凝，转
不易消散，宜选用连翘、茵陈、川楝子、栀子（栀子为末，烧酒调敷，善治跌打处青红肿疼，能消瘀血可知）
诸药，凉而能散，方为对证。
肝体木硬，宜用柔肝之法。至柔肝之药，若当归、芍药、柏子仁、玄参、枸杞、阿胶、鳖甲皆可选用，而
亦宜用活血之品佐之。而活血药中尤以三七之化瘀生新者为最紧要之品，宜煎服汤药之外，另服此药细末日
三次，每次钱半或至二钱。则肝体之木硬者，指日可柔也。
《内经》谓∶“肝苦急，急食甘以缓之。”所谓苦急者，乃气血忽然相并于肝中，致肝脏有急迫难缓
之势，因之失其常司。当其急迫之时，肝体亦或木硬，而过其时又能复常。故其治法，宜重用甘缓之药以缓
其急，其病自愈，与治肝体长此木硬者有异。曾阅《山西医志》二十四期，有人过服燥热峻烈之药，骤发痉
厥，角弓反张，口吐血沫。乔××遵《内经》之旨，但重用甘草一味，连煎服，数日全愈，可谓善读《内经》
者矣。然此证若如此治法仍不愈者，或加以凉润之品，若羚羊角、白芍，或再加镇重之品，若朱砂（研细送服）
、铁锈，皆可也。
【新拟和肝丸】治肝体木硬，肝气郁结，肝中血管闭塞，及肝木横恣侮克脾土。其现病或胁下胀疼，或
肢体串疼，或饮食减少，呕哕，吞酸，或噫气不除，或呃逆连连，或头疼目胀、眩晕、痉痫，种种诸证。
粉甘草（五两细末） 生杭芍（三两细末） 青连翘（三两细末） 广肉桂（两半去粗皮细末）
冰片（三钱细末） 薄荷冰（四钱细末） 片朱砂（三两细末）
上药七味，将前六味和匀，水泛为丸，梧桐子大，晾干（不宜晒），用朱砂为衣，勿余剩。务令坚实光
滑始不走味。每于饭后一点钟服二十粒至三十粒，日再服。病急剧者，宜空心服；或于服两次
之后，临睡时又服一次更佳。若无病者，但以为健胃消食药，则每饭后一点钟服十粒即可。
数年来肝之为病颇多，而在女子为尤甚。医者习用香附、青皮、枳壳、延胡开气之品，及柴胡、川芎升
气之品。连连服之，恒有肝病未除，元气已弱，不能支持，后遇良医，亦殊难为之挽救，若斯者良可慨也。
此方用甘草之甘以缓肝；芍药之润以柔肝；连翘以散其气分之结（尝单用以治肝气郁结有殊效）；冰片、
薄荷冰以通其血管之闭；肉桂以抑肝木之横恣；朱砂以制肝中之相火妄行。且合之为丸，其味辛香甘美，能
醒脾健胃，使饮食加增。又其药性平和，在上能清，在下能温（此药初服下觉凉及行至下焦则又变为温性）。
故凡一切肝之为病，服他药不愈者，徐服此药，自能奏效。
（附：新拟定的和肝丸）
肝脏属于厥阴经，其气化表现与少阳经相通，且体内寄居着相火，因此《内经》称它为“将军之官”，其性质极其刚强。正因为它的性质刚强，一旦发病，常常克制它所胜的脏腑（即脾胃），导致脾胃受病，出现胀满、疼痛、泄泻等各种症状。因此医书中有“平肝”的说法，认为平抑肝气就是扶持脾土的方法。如果遇到肝气横逆猖獗的情况，或许可以暂时使用这种方法，但不能长期服用。因为肝脏对应春季，是气化生发的开始，如果过度平抑，人体的气化功能必然受到损伤。
有人说，肝脏在五行中属木，木的本性原本善于条达舒展，所以治疗肝脏的方法应当以“散”为补（医书说“肝以敛为泻，以散为补”）。所谓“散”，就是升发条达的意思，然而经常使用升散之法，实际上会耗伤气和血，并且暗中损伤肾水，从而损害肝木的根本。
有人说：肝脏厌恶干燥而喜欢滋润。干燥则肝体变得板硬，肝火和肝气就会妄动；滋润则肝体变得柔和，肝火和肝气就会长久保持宁静。因此医书中有用滋润药物来柔养肝脏的方法。然而多次使用滋润药物，实际上会对脾胃造成妨碍，这种方法也只能暂时使用，不可长期服用。那么，治疗肝脏的方法究竟什么才适宜呢？
《内经》说：“厥阴病治不好，要从阳明胃经去求治。”《金匮要略》说：“知道肝病，应当先充实脾土。”前代圣人和后代圣人，他们的道理是一致的，这确实是治疗肝病的不二法门。可惜从汉代、唐代以来，没有人阐明其中的原理。直到黄坤载，深刻明白其中的道理，他说：“肝气宜于上升，胆火宜于下降。但是如果不是脾气上行，肝气就不能上升；如果不是胃气下行，胆火就不能下降。”这句话意义深远，确实窥探到了《内经》和《金匮要略》的精妙奥义。由此看来，想要治疗肝病，原本应当提升脾气、降下胃气，培养中焦脾胃之气，使中焦的气化功能深厚浓郁，从而听任肝木自行调理。即使有时少量使用调理肝脏的药物，也不过是作为调理脾胃方剂中的辅助药物。之所以这样，是因为五行中的土原本能够涵盖金、木、水、火四行，人的脾胃属土，其气化功能的敷布，也能涵盖金、木、水、火各脏腑。所以脾气上行，肝气自然随之上升；胃气下行，胆火自然随之下降。
另外，《内经》论述厥阴治法时，有“调和中气，使之平和”的话。所谓调和中气，就是指提升脾气、降下胃气。所谓使之平和，就是通过提升脾气、降下胃气，使肝气自然平和。至于张仲景撰写《伤寒论》，深刻领悟了《内经》的宗旨，其厥阴治法中有吴茱萸汤；厥阴与少阳脏腑相互依存，由厥阴推演到少阳治法，有小柴胡汤。这两个方子中的人参、半夏、大枣、生姜、甘草，都是调和脾胃的重要药物。而且小柴胡汤以柴胡为主药，《神农本草经》说它主治肠胃中的结气、饮食积聚、寒热邪气，推陈出新。反复研读《神农本草经》的文字，可知柴胡实际上是治疗阳明胃腑的药物，兼治少阳。想要治疗肝胆疾病的人，何不效法《内经》并师承张仲景呢！
只是，肝脏致病不仅不利于脾，凡是惊痫、癫狂、眩晕、脑充血等病症（西医称为脑神经病），都与肝经有关。大概人的脑神经发源于肾，分派于督脉，是淡灰色的细筋。肝脏原本主管筋脉，肝脏又为肾脏运行气机，所以脑神经的疾病实际上与肝脏有密切的关系。治疗这些病症，应当取五行中金能克木的道理，多用五金类的物品来镇摄，如铁锈、铅灰、金银箔、赭石（赭石是铁的氧化物，也含有金属成分）之类，并辅以清肝、润肝的药物，如羚羊角、青黛、芍药、龙胆草、牛膝（牛膝味酸入肝，善于引导血火下行，是治疗脑充血的重要药物，但必须重用才能见到奇效）等药物，使肝经的风定火熄，脑神经自然遵循正常规律，不至于产生各种疾病。如果目前不能迅速痊愈的，也应当用调补脾胃的药物辅助，之后金属及寒凉性质的药物才可以长期服用而无弊端。况且这些病症多夹杂有痰涎，脾胃升降功能恢复正常，痰涎自然消除。
有至关重要的病症，其病因不全部在肝脏，但急则治标，应当先注意肝脏的是：元气虚弱即将上脱的情况。这种病症的表现大多是大汗不止，或者稍止后又出汗，并有寒热往来的现象。或者危险至极，出现两眼上翻，黑睛不露；或者无汗而心中悸动不安，需要人按住；或者兼有气喘急促。此时应当重用收敛肝脏的药物，使肝不疏泄，就能堵塞元气将脱的路径。等到汗止、心悸、气喘等疾病暂时痊愈后，再慢慢图谋其他治疗方法。应当重用净山茱萸肉至二两（《神农本草经》中山茱萸主治寒热，指的就是此证），收敛肝气即是补肝，并用人参、赭石、龙骨、牡蛎等药物辅助。拙著《来复汤》后记载有几例运用此法挽回垂危病例的记录，可以参考。
究其根本，肝胆的作用，实际上能与脾胃相助治理。因为五行的道理，木能侮土，木也能疏土。曾经治疗过饮食不能消化，服用健脾暖胃的药物一百剂都不见效的患者。诊察其左关脉特别弱，知道是肝阳不振，投用黄芪（其性温升，能提升肝木的性质，也有同气相求的意义，所以是补肝的主药）一两，桂枝尖三钱，几剂药后就痊愈了。又治疗黄疸病，诊察其左关脉特别弱，重用黄芪煎汤，送服《金匮要略》黄疸门中的硝石矾石散而痊愈。这些都是明显的证据。而且胆汁进入小肠，能帮助小肠消化食物，这也是木能疏土的道理。大概小肠虽然属火，但实际上与胃腑一体相连，所以也可以按土来论述。胆汁，原本是由肝脏回血管中的血液化出，注入到胆中，真正具备了甲乙木气的完整特性，所以在小肠中能化解胃中不能消化的食物，其疏土的效果更加快捷。
另外，西方人认为肝脏是回血管汇合之处，如果肝体肿大，或肝内有热，各管道就会多凝滞壅胀。由此可知，疏达肝郁的药物，如柴胡、川芎、香附、生麦芽、乳香、没药都可以选用；并且应当辅以活血的药物，如桃仁、红花、樗鸡、䗪虫之类；并且还应当辅以泻热的药物，然而不可突然使用大寒凉的药，恐怕所瘀积的血遇到寒凉而凝固，反而不容易消散，宜选用连翘、茵陈、川楝子、栀子（栀子研成末，用烧酒调敷，善于治疗跌打损伤处的青红肿痛，能消除瘀血，由此可知）等药物，凉而能散，才是对症的。
肝体木质坚硬，宜用柔肝的方法。至于柔肝的药物，如当归、芍药、柏子仁、玄参、枸杞、阿胶、鳖甲都可以选用，并且也应当用活血的药物辅助。而在活血药中，尤其以三七化瘀生新的作用最为紧要，应当在煎服汤药之外，另服此药细末，每日三次，每次一钱半至二钱。那么肝体的木质坚硬，很快就能变柔和。
《内经》说：“肝苦急，急食甘以缓之。”所谓“苦急”，是指气血忽然合并于肝脏中，导致肝脏有急迫难缓之势，因而失去正常的职能。当它急迫的时候，肝体也可能木质坚硬，而过了这个时期又能恢复正常。所以其治疗方法，应当重用甘缓的药物来缓解其急迫，病自然会好，这与治疗肝体长期木质坚硬的情况不同。曾经阅读《山西医志》第二十四期，有人过服燥热峻烈的药物，突然发作痉厥，角弓反张，口吐血沫。乔某某遵循《内经》的宗旨，只重用甘草一味，连续煎服，几天就全愈了，这可以说是善于阅读《内经》的人了。然而如果这种病症用这种方法仍然不愈，可以加上凉润的药物，如羚羊角、白芍，或者再加镇重的药物，如朱砂（研细送服）、铁锈，也都是可以的。
【新拟和肝丸】治疗肝体木质坚硬，肝气郁结，肝中血管闭塞，以及肝木横逆克制脾土。出现的病症或是胁下胀痛，或是肢体窜痛，或是饮食减少，呕吐呃逆，吞酸，或是嗳气不止，或是呃逆连连，或是头痛目胀、眩晕、痉痫等各种症状。
粉甘草（五两，研成细末） 生杭芍（三两，研成细末） 青连翘（三两，研成细末） 广肉桂（一两半，去掉粗皮，研成细末）
冰片（三钱，研成细末） 薄荷冰（四钱，研成细末） 片朱砂（三两，研成细末）
以上七味药，将前六味混合均匀，用水泛为丸，大小如梧桐子，晾干（不宜日晒），用朱砂做外衣，不要有剩余。务必使其坚实光滑，以免走味。每于饭后一小时服用二十粒至三十粒，每天两次。病情急剧者，宜空腹服用；或者在服用两次之后，临睡前再服用一次更好。如果没有病，仅将其作为健胃消食药，那么每饭后一小时服用十粒即可。
近年来肝病很多，而在女子中更为严重。医生习惯使用香附、青皮、枳壳、延胡索等开气药物，以及柴胡、川芎等升气药物。接连服用，常常导致肝病未除，元气已弱，无法支撑，后来遇到良医，也很难挽救，像这样的情况真是令人感慨。
此方用甘草的甘味来缓和肝气；用芍药的滋润来柔养肝体；用连翘来疏散气分的郁结（曾单独使用治疗肝气郁结有殊效）；用冰片、薄荷冰来疏通血管的闭塞；用肉桂来抑制肝木的横逆；用朱砂来制约肝中相火的妄行。并且合起来做成丸药，味道辛香甘美，能醒脾健胃，使饮食增加。而且药性平和，在上能清热，在下能温煦（此药初服下觉得凉，行至下焦则又变为温性）。所以凡是所有肝脏的病症，服用其他药物不愈的，慢慢服用此药，自然能奏效。
(Attachment: Newly Prescribed Hepatone-Regulating Pill)
The Liver belongs to the Jueyin (Terminal Yin) channel, its Qi transformation manifests in conjunction with the Shaoyang (Lesser Yang) channel, and it houses Ministerial Fire (Xiang Huo, a type of physiological fire associated with the Liver and Gallbladder). Therefore, the *Neijing* (Classic of Internal Medicine) calls it the "General Officer," indicating its nature is extremely rigid. Due to this rigidity, when disease occurs, it often overacts upon (Wu, an excessive controlling relationship in Five Phase theory) what it normally controls, namely the Spleen and Stomach, leading to Spleen-Stomach pathology manifesting as distension, pain, diarrhea, and various other symptoms. Consequently, medical texts speak of "Pacifying the Liver," asserting that pacifying the Liver is equivalent to supporting the Spleen. In cases where Liver Qi is rampant and unbridled, this method may be used temporarily but not for long-term use. Since the Liver corresponds to the Spring season, marking the beginning of Qi generation and sprouting, excessive pacification will inevitably damage the body's Qi transformation.
Some argue that in the Five Phases (Wu Xing), the Liver belongs to Wood, and Wood's nature is inherently capable of free flow and spreading. Thus, the method for treating the Liver should be to "scatter" as a form of tonification (medical texts state: "For the Liver, astringency is purging, scattering is tonifying"). "Scattering" refers to ascending and promoting free flow. However, frequent use of ascending and scattering methods actually damages Qi and Blood, and secretly injures Kidney Water, thereby damaging the root of Liver Wood.
Others state: The Liver dislikes dryness and prefers moisture. Dryness makes the Liver substance rigid, causing Liver Fire and Liver Qi to move recklessly; moisture makes the Liver substance soft and gentle, allowing Liver Fire and Liver Qi to remain tranquil. Hence, medical texts advocate using moistening herbs to soften the Liver. However, repeated use of moistening herbs actually hinders the Spleen and Stomach; this method can also only be used temporarily, not long-term. So, what is the appropriate method for treating the Liver?
The *Neijing* states: "If Jueyin cannot be treated, seek treatment in Yangming." The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: "Knowing Liver disease, one must first strengthen the Spleen." The sages of old and the sages of later times share the same principle; this is indeed the infallible method for treating Liver diseases. Regrettably, since the Han and Tang dynasties, no one has elucidated this principle. It was not until Huang Kunzai that the principle was deeply understood: "Liver Qi should ascend, Gallbladder Fire should descend. However, without the ascent of Spleen Qi, Liver Qi cannot ascend; without the descent of Stomach Qi, Gallbladder Fire cannot descend." This statement is profound, truly penetrating the essence of the *Neijing* and *Jingui Yaolue*. From this perspective, to treat Liver disease, one ought to raise Spleen Qi and lower Stomach Qi, cultivating the Middle Jiao (Central Pivot). By making the Qi transformation of the Middle Jiao thick and abundant, one allows Liver Wood to regulate itself. Even if some Liver-regulating herbs are occasionally used in small amounts, they serve merely as adjuvants in formulas regulating the Spleen and Stomach. This is because Earth in the Five Phases encompasses Metal, Wood, Water, and Fire. The human Spleen and Stomach belong to Earth; their Qi transformation distribution encompasses the organs of Metal, Wood, Water, and Fire. Therefore, when Spleen Qi ascends, Liver Qi naturally follows upward; when Stomach Qi descends, Gallbladder Fire naturally follows downward.
Furthermore, the *Neijing*, discussing Jueyin treatment, mentions "regulate the Middle Qi, making it peaceful." Regulating the Middle Qi refers to raising Spleen Qi and lowering Stomach Qi. Making it peaceful refers to the natural peace of Liver Qi achieved through raising Spleen Qi and lowering Stomach Qi. Zhang Zhongjing, in writing the *Shanghan Lun* (Treatise on Cold Damage Pathogens), deeply grasped the intent of the *Neijing*. His Jueyin treatment includes Wuzhuyu Decoction (Evodiae Fructus Decoction); since Jueyin and Shaoyang organs are interconnected, extending from Jueyin to Shaoyang treatment yields Xiaochaihu Decoction (Minor Bupleurum Decoction). The Ginseng Radix et Rhizoma (Renshen), Pinelliae Tuber (Banxia), Zizyphi Fructus (Dazao), Zingiberis Rhizoma Recens (Shengjiang), and Glycyrrhizae Radix et Rhizoma (Gancao) in these two formulas are all key herbs for harmonizing the Spleen and Stomach. Moreover, Xiaochaihu Decoction uses Chaihu (Bupleuri Radix) as the chief herb. The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states it treats knotting Qi in the intestines and stomach, food accumulation, and cold-heat pathogenic factors, pushing out the old and bringing forth the new. Repeatedly studying the text of the *Shennong Bencao Jing*, one sees that Chaihu is essentially a herb for the Yangming Stomach organ, while also treating Shaoyang. Those wishing to treat Gallbladder and Liver diseases would do well to follow the *Neijing* and emulate Zhang Zhongjing!
However, Liver pathology not only disadvantages the Spleen; conditions such as fright epilepsy, mania, dizziness, and cerebral congestion (referred to by Westerners as cerebrospinal nerve diseases) all involve the Liver channel. Generally, human cerebrospinal nerves originate from the Kidneys and branch into the Du Mai (Governing Vessel), appearing as pale gray fine tendons. The Liver governs tendons, and the Liver moves Qi for the Kidneys; thus, cerebrospinal nerve diseases are closely related to the Liver organ. To treat such conditions, one should apply the principle that Metal controls Wood in the Five Phases, using many metallic substances to anchor and suppress, such as Ferrugo (Iron Rust), Plumbum Cinis (Lead Ash), Aurum Folium (Gold Leaf), and Haematitum (Ochre/Hematite - Ochre is an iron oxide compound containing metal). These should be supplemented with herbs that clear and moisten the Liver, such as Antelopis Cornu (Antelope Horn), Indigo Naturalis (Qingdai), Paeoniae Radix Alba (Shaoyao), Gentianae Radix (Longdancao), and Achyranthis Bidentatae Radix (Niuxi - Niuxi enters the Liver via sour taste, excels at guiding blood and fire downward, and is a crucial herb for treating cerebral congestion, but requires heavy dosage for miraculous effects). This ensures wind settles and fire extinguishes in the Liver channel, allowing cerebrospinal nerves to return to normal limits, preventing various diseases. If immediate cure is not possible, one should also supplement with herbs that regulate and tonify the Spleen and Stomach, after which metallic and cold/cool substances can be taken long-term without harm. Furthermore, these conditions often involve phlegm-fluids; once Spleen-Stomach ascending and descending functions normalize, phlegm-fluids dissipate spontaneously.
There is a critical condition where the cause is not entirely in the Liver, but due to urgent symptom management, attention must first focus on the Liver: this is deficiency of Yuan Qi (Primal Qi) threatening upward collapse. Symptoms include profuse sweating that does not stop, or stops briefly then resumes, with alternating chills and fever. Or extreme danger with eyes fixed upward, showing no black pupil; or no sweat but palpitations and inner restlessness requiring someone to press upon the chest; or accompanied by panting. At this time, heavily dose astringent Liver herbs to prevent Liver from dispersing, thereby blocking the path of Yuan Qi collapse. Once sweating stops, palpitations cease, and panting subsides temporarily, one can slowly plan other treatments. Heavily dose purified Cornus Officinalis Fructus (Shanzhuyu) up to 2 liang (*Shennong Bencao Jing* states Shanzhuyu treats cold-heat, referring to this condition). Astringing the Liver is equivalent to tonifying the Liver, assisted by Ren Shen (Ginseng), Haematitum (Ochre), Longgu (Fossilized Bones), and Muli (Oyster Shell). My work *Laifu Tang* records several cases rescued using this method; readers may refer to them.
Ultimately, the function of the Gallbladder and Liver actually assists the Spleen and Stomach in regulation. According to Five Phase theory, Wood can overact upon Earth, but Wood can also loosen Earth. I once treated a patient with indigestion who took 100 doses of Spleen-fortifying and Stomach-warming herbs without effect. Palpation revealed a very weak pulse at the Left Guan position, indicating Liver Yang depression. I prescribed Huangqi (Astragali Radix - its warm, ascending nature matches the Liver Wood's ascending quality, embodying the principle of similar energies seeking each other, making it the chief herb for tonifying the Liver) 1 liang, and Guizhi Jian (Cinnamon Twig Tip) 3 qian. After a few doses, the patient recovered. I also treated jaundice; palpation showed a particularly weak Left Guan pulse. I heavily decocted Huangqi and used the liquid to swallow Xiaoshi Jiushisan (Magneti Ostreae and Alum Powder) from the Jaundice chapter of *Jingui Yaolue*, resulting in recovery. These are clear proofs. Furthermore, bile enters the Small Intestine, aiding digestion, illustrating Wood loosening Earth. Although the Small Intestine belongs to Fire, it is physically connected to the Stomach, so it can also be discussed as Earth. Bile originates from blood in the hepatic veins, is poured into the Gallbladder, and fully embodies the Qi of Jia-Yi Wood. Thus, in the Small Intestine, it digests food the Stomach cannot, showing swift efficacy in loosening Earth.
Western medicine posits the Liver as a convergence point for venous return; if the Liver enlarges or heats up, vessels become stagnant and swollen. From this, we know that herbs that soothe Liver stagnation, such as Chaihu (Bupleuri Radix), Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), Hordei Fructus Germinatus (ShengMaiya), Boswelliae Resina (Ruxiang), and Myrrha Resina (Moyao), can be selected. These should be assisted by blood-invigorating herbs like Taoren (Persicae Semen), Carthami Flos (Honghua), Buprestidis (Chuangji), and Eupolyphaga Steleophaga (Zhechong). Additionally, heat-purging herbs should be added, but sudden use of large-cold herbs is avoided lest stagnant blood congeal upon cooling, becoming harder to dissipate. Instead, select Lonicerae Japonicae Flos (Lianqiao), Yin Chen Hao (Artemisiae Scopariae Herba), Toosendan Fructus (Chuanlianzi), and Gardeniae Fructus (Zhizi - Zhizi powder mixed with rice wine treats bruising/swelling/pain from trauma, proving its ability to resolve stasis). These are cool yet dispersing, fitting the syndrome perfectly.
The Liver substance is hard like wood; softening methods are suitable. Softening herbs include Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Baidao Ren (Platycladi Semen), Xuanshen (Scrophulariae Radix), Gouqi (Lycii Fructus), Ejiao (Asini Corii Colla), and Biejiia (Testudinis Carapax et Plastrum). These can be selected, assisted by blood-invigorating herbs. Among blood-invigorators, Sanqi (Notoginseng Radix et Rhizoma) is most crucial for resolving stasis and generating new tissue. Besides decoctions, take Sanqi fine powder separately, three times daily, 1.5 qian to 2 qian per dose. Then the hard Liver substance will become soft soon.
The *Neijing* states: "The Liver suffers from tension; urgently eat sweet things to relax it." "Suffering from tension" means Qi and Blood suddenly merge into the Liver, creating an urgent, hard-to-relax pressure, causing loss of normal function. During acute tension, the Liver substance may be hard, but returns to normal afterward. Treatment involves heavily dosing sweet, relaxing herbs to alleviate tension, curing the disease spontaneously. This differs from treating chronic Liver hardness. I read Vol. 24 of *Shanxi Medical Journal*: a patient overdosed on hot, acrid, harsh herbs, suddenly developing spasms, opisthotonos, and vomiting blood/froth. Dr. Qiao followed the *Neijing*, using only Gancao (Glycyrrhizae Radix et Rhizoma) heavily, decocted and taken continuously, recovering in days. This shows mastery of the *Neijing*. If this method fails, add cool-moistening herbs like Antelopis Cornu (Antelope Horn) or Baishao (White Peony Root), or heavy anchoring herbs like Cinnabar (Zhu Sha - finely ground and swallowed) or Iron Rust.
[Newly Prescribed Hepatone-Regulating Pill] Treats Liver hardness, Liver Qi stagnation, Liver vessel occlusion, and Liver Wood rampant overacting on Spleen Earth. Symptoms include hypochondriac distension/pain, wandering limb pain, reduced appetite, vomiting/hiccups, acid regurgitation, persistent belching, continuous hiccups, headache/eye distension, dizziness, spasms/epilepsy, etc.
Powdered Gancao (Glycyrrhizae Radix et Rhizoma) (5 liang, fine powder)
Raw Hangshaoyao (Paeoniae Radix Alba) (3 liang, fine powder)
Green Lianqiao (Lonicerae Japonicae Flos) (3 liang, fine powder)
Guang Rougui (Cinnamomi Cortex) (1.5 liang, remove bark, fine powder)
Bingpian (Borneolum Syntheticum) (3 qian, fine powder)
Bohebing (Menthae Haplocalycis Herba Ice/Menthol) (4 qian, fine powder)
Pian Zhusha (Cinnabar) (3 liang, fine powder)
Mix the first six ingredients evenly, pill with water to size of Sophora japonica seeds, dry in shade (do not sun-dry). Coat with Zhusha (Cinnabar). Ensure pills are solid and smooth to prevent flavor loss. Take 20-30 pills one hour after meals, twice daily. For acute cases, take on an empty stomach; or take an extra dose before bed after the initial two doses. For healthy individuals using it as a digestive aid, take 10 pills one hour after meals.
In recent years, Liver diseases are common, especially in women. Doctors habitually use Xiangfu (Cyperi Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Zhike (Aurantii Fructus), and Yanhusuo (Corydalis Rhizoma) to move Qi, and Chaihu (Bupleuri Radix), Chuanxiong (Chuanxiong Rhizoma) to raise Qi. Continuous use often leaves Liver disease unresolved while Yuan Qi is weakened beyond support; even good doctors find rescue difficult. This is lamentable.
This formula uses Gancao's sweetness to relax the Liver; Shaoyao's moisture to soften the Liver; Lianqiao to scatter Qi-level knots (used alone for Liver Qi stagnation with special effect); Bingpian and Bohebing to open vessel closures; Rougui (Cinnamomi Cortex) to restrain Liver rampantness; Zhusha (Cinnabar) to control reckless Ministerial Fire in the Liver. Combined as pills, the sweet-aromatic taste awakens the Spleen and strengthens the Stomach, increasing appetite. The properties are mild: clearing above, warming below (feels cool initially, becomes warm in the Lower Jiao). Thus, for any Liver disease unresponsive to other drugs, slow administration of this pill will yield results.