Danxi stated that cases of deficiency fire arising from yin deficiency are difficult to treat. For constrained fire, diaphoresis may be employed, depending on the affected meridian; mild cases can be treated by descending fire, while severe cases should be resolved by following its nature. Excess fire can be purged, and deficiency fire can be tonified. Descending fire through urination is extremely rapid.

First, when fire is excessive, cold and cool medicines must not be used abruptly; instead, warm medicines should be used to disperse it.

Second, fever in individuals who consume alcohol is difficult to treat; similarly, fever caused by alcohol consumption in those who do not normally drink is also difficult to treat.

Third, if heat is intense upon light palpation but less so upon heavy pressure, the heat is located in the muscle layer (muscular tissue). In such cases, herbs such as Cortex Lycii (Digupi) and Radix Ophiopogonis (Maimendong) are suitable.

Fourth, if heat is intense and scalding upon heavy pressure but not felt upon light palpation, the pathology lies within the muscles. Diaphoresis is indicated, using formulas such as Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction) by Dongyuan, or Huoyu Tang (Fire Constrained Decoction).

Fifth, for fever due to yin deficiency, Siwu Tang (Four Substances Decoction) added with stir-fried Phellodendri Cortex (Huangbai) is a superb formula for descending fire and tonifying yin; Buyin Wan (Tonify Yin Pill) may also be used.

Sixth, heat in the palms indicates fire constrained in the spleen earth. Huoyu Tang (Fire Constrained Decoction) added with stir-fried Gardenia Fruit (Zhizi) is appropriate.

Seventh, excess fire can be purged using Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) or Sanhuang Wan (Three Yellows Pill), which utilize bitter-cold herbs to purge excess fire.

Eighth, deficiency fire can be addressed by tonification using Ginseng Radix (Renshen), Atractylodis Rhizoma (Baizhu), Astragali Radix (Huangqi), and Glycyrrhizae Radix et Rhizoma (Gancao); sweet-warm herbs can effectively clear deficiency fire.

Ninth, when the four limbs feel hot, and the muscles, marrow, and tendons are trapped in heat like burning, feeling scalding to the touch, this indicates yang qi constrained in the spleen earth. Since fire is constrained, it should be dispersed. Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction) or Xieyin Huoshengyang Tang (Draining Yin Fire and Ascending Yang Decoction) are indicated.

To drain heart fire: Coptidis Rhizoma (Huanglian).
To drain liver fire: Coptidis Rhizoma (Huanglian), Numinis Albus (Renzhongbai), Bupleuri Radix (Chaihu).
To drain spleen fire: Paeoniae Radix Alba (Baishao).
To drain lung fire: Gardeniae Fructus (Shanzhi), Scutellariae Radix Scorched (Kuhuangqin), Radix Ophiopogonis (Maimendong).
To drain stomach fire: Gypsum Fibrosum Soft (Ruanshigao).
To drain kidney fire: Phellodendri Cortex (Huangbai).
To drain small intestine fire: Akebiae Caulis (Mutong).
To drain bladder fire: Phellodendri Cortex (Huangbai), Asari Radix et Rhizoma (Xixin).
To drain gallbladder and liver fire: Coptidis Rhizoma (Huanglian), stir-fried with pig bile.
To drain constrained fire of the five zang organs: Indigo Naturalis (Qingdai).
To drain rootless wandering fire: Scrophulariae Radix (Xuanshen), Gardeniae Fructus (Shanzhiren) [stir-fried to descend fire and excrete it via urine, possessing a property that descends obliquely].

For men and women suffering from heat in the four limbs, with muscles feeling hot as if burning and scalding to the touch, this is fire constrained in the spleen earth.
Prescription: Cimicifugae Rhizoma (Shengma), Puerariae Lobatae Radix (Gange), Angelicae Dahuricae Radix (Duhuo), Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Bupleuri Radix (Chaihu), Glycyrrhizae Radix et Rhizoma (Gancao), Panacis Ginseng Radix (Renshen), Paeoniae Radix (Shaoyao). No guiding herb is needed; take at any time without restriction.