人身之内，凡火有五。心火、阳明燥火、三焦壮火、雷火、龙火是也。心火宜清，燥火
宜润，壮火宜寒以泻之，雷火微则敛以平之，甚则温以和之，龙火宜从其性，以热导之。
古人治火，用石膏、川连两许者，势不得不用也。盖人身惟火为患最毒，火之毒莫甚于
命门相火，相火在下为少火，少火生气，逆而在上则为壮火，壮火食气。然命门之火起，一因于
君不主令，相火横逆，一因于阳明接引，而燥金化为烈火，与肝木相并而焚，则一身上下三
焦无非火矣。倘少用寒药，如以一杯水，倾入红锅，不惟无益，且将立破其锅，非多用何能
救？盖用川连者，治君相合横也；用石膏者，治燥金合木也。头上有火，清阳不升，火炎于
上也。高者治宜越之，补中益气汤加荆芥三分，蔓荆子五分。
验案
一人头不痛，身不热，无表症，但火郁懊 ，无可奈何，大便或闭或痢。方用川连一钱
泻其火，枳实一钱损至高之滞气，白术一钱扶其胃，三味煎服遂愈。
一女人六月间昏睡不言，身热不动，两手脉上盛下涩。涩者阳气有余，盛大为火，火证
也。冷水调益元散主之。
一人七月病，上辰昏晕，下午不言，昏睡一日不醒，人叫不应，身凉不食，不寒不热，
皆曰阴证。议用附子理中汤、四逆汤。诊其脉，沉小滞伏，内有火邪，小便一二日不解，此火证
也。不从，又延至夜不醒，曰∶此真火也。其妻曰∶前日房事，如何是火？予曰∶夜有房事
内虚，又劳热甚，天干热从虚入，则阳气将绝，以水救之则可。取冷水一桶，饮至五碗，病
者曰渴，饮至七碗，大汗如雨，病者曰饿，要吃粥一碗，用补中益气汤加炮姜、泽泻，温中
一妇五月间，身凉，自言内热，水泻二月，一日数次，小水绝无，大便皆水。自言上热
极、下冻死，腰腿足俱冷，腹痛如冰，或一时发热，不欲近衣，或一时怕冷，遍身尽热，夜至天
明，面目红肿，药之不愈。自小至大，六脉洪大，此伏火也。火性炎上，故上热下冷耳！用
四物汤加柴胡、葛根、升麻、甘草、栀子、黄柏、黄芩二帖。小水行泻止，复发牙疼，三日
不愈，用黄 建中汤加附子，一服愈。
一妇四十余岁，身体肥大，病后渐瘦，内觉火热外如冰冷，自汗出，手见冷水即麻木不
仁，头面筋搐而痛，骨节疼痛手不可近，牙根出脓血，舌强硬，右手不能举动， 臂肘皆强痛，
饥不欲食，小便如饴，嗳气作酸，坐卧不安，恶风便难。脉浮候细涩，中脉缓弱，左手弱于
右手。病已五、六年，病症多端，由阴精不奉，阳精不降，上盛下虚，阳中阴虚也。宜补阳
中之阴，六味汤主之。
一人胸前常跳，头耳左边鸣，肺脉紧数。此肺虚不能生肾水，木火妄动，气血不归原也
。血不归原，心火妄动，故心跳；气不归原，肝木动，故耳鸣。左右者，阴阳之道路也。在左，
木火为阳也，宜用归脾汤养心血，敛火下行，心血足则心火不刑金，金能平木，肝气自平也
一妇左三脉洪滑有力，右三脉短涩，呕吐胸饱，小便痛而泄，经水乃至，不通不泄，经
水不至。此肝木有余，火行土位，故经、泻并行也。用白芍二两，泻土中之木；甘草一两以缓肝
；香附三钱，木香一钱，理痛止吐；益母草、延胡索各一两以行血滞；山药糊丸以补脾。肝
气有余，脾气不足，故肝气动而脾受克也。经水未行属少阴，已行属厥阴，行后属太阴。经
、泻并行，肝气动也；肝之动，土受克也；克则不能运湿而泻，克则气血不调而痛。故平肝
一妇六月卒死，遍身冷而无汗，六脉俱伏，三日不醒，但未气绝耳。众用四逆、理中亦
纳。四日后诊之，仍无脉验。人一、二日无脉立死，今三日不死，此脉伏也，热极似寒耳。
用水湿青布放身上一时许，身热，内吃冷水五、六碗。反言渴，又一碗，大汗出，出后，用
补中益气汤加黄柏十帖愈。
人体之内，凡火有五种。分别是心火、阳明燥火、三焦壮火、雷火、龙火。心火适宜用清热法，燥火适宜用滋润法，壮火适宜用寒凉药以泻其势，雷火轻微时用收敛法以平抑它，严重时则用温和方法来调和它，龙火适宜顺从其本性，用热性药物引导它（引火归元）。古人治疗火证，使用石膏、黄连各二两的情况，是形势所迫不得不这样做的。大概人身之中只有火为患最为毒烈，火的毒性没有比命门相火更甚的。相火在下位称为少火，少火能生气；若逆乱而上行则成为壮火，壮火会消耗元气。然而命门之火的发动，一方面是因为君主之火不主令，导致相火横逆；另一方面是因为阳明经接引，使燥金化为烈火，与肝木相合并焚烧，那么一身上下三焦便无处不是火了。如果稍微使用寒凉药，就像把一杯水倒入烧红的铁锅中，不仅无益，而且会立刻打破锅，除非大量使用，否则怎能挽救？使用黄连，是为了治疗君火与相火合而横逆；使用石膏，是为了治疗燥金与肝木合邪。头部有火，是因为清阳之气不能上升，火炎于上所致。对于高处的病邪，治疗宜用发散越邪的方法，可用补中益气汤加荆芥三分、蔓荆子五分。
验案
有一人头部不痛，身体不发热，没有表证，只是火郁懊恼，无可奈何，大便有时闭塞有时痢疾。方剂用黄连一钱以泻火，枳实一钱以损去至高部位的滞气，白术一钱以扶助胃气，三味药煎服后痊愈。
有一位女性在六月间昏睡不语，身体发热但不想动，两手脉象上部盛大下部涩滞。涩脉代表阳气有余，盛大代表火，这是火证。用冷水调服益元散主治。
有一人在七月生病，上午辰时昏晕，下午不说话，昏睡一天不醒，叫他不答应，身体凉爽不想吃东西，不冷也不热，大家都说是阴证。商议使用附子理中汤、四逆汤。诊察他的脉象，沉小滞伏，体内有火邪，小便一两天不通畅，这是火证。家属不听，又拖延到夜晚不醒，我说：这是真火证。他的妻子说：前几天有过房事，怎么说是火？我说：夜间房事导致内虚，加上劳累热气很重，天干的热邪从虚处侵入，阳气将绝，用水来救是可以的。取一桶冷水，喝到五碗，病人说渴，喝到七碗，大汗如雨，病人说饿，要吃一碗粥，用补中益气汤加炮姜、泽泻，温中……（原文此处中断）
有一位女性在五月间，身体凉爽，自己感觉内部发热，腹泻两个月，一天数次，小便完全没有，大便全是水。自己感觉上部热极、下部冻死，腰腿脚都冷，腹痛如冰，有时一时发热，不喜欢穿衣，有时一时怕冷，遍身尽热，直到天亮，面目红肿，用药治不好。从小到大的六脉洪大，这是伏火。火性炎上，所以上热下冷！用四物汤加柴胡、葛根、升麻、甘草、栀子、黄柏、黄芩，两帖后。小便通利腹泻停止，但复发牙疼，三天不好，用黄芪建中汤加附子，一服即愈。
有一位四十多岁的妇女，身体肥大，病后逐渐消瘦，内部觉得火热外部像冰冷一样，自汗出，手碰到冷水就麻木不仁，头面部筋脉抽搐而痛，骨节疼痛手不能靠近，牙根出脓血，舌头强硬，右手不能举动，手臂肘部都强痛，饥饿但不想吃东西，小便像糖浆一样黏稠，嗳气带酸味，坐卧不安，恶风且排便困难。脉象浮取细涩，中取缓弱，左手脉弱于右手。病已五六年，病症多端，由于阴精不能奉养，阳精不能下降，上盛下虚，属于阳中阴虚。应当补阳中之阴，用六味地黄丸主治。
有一人胸前常跳动，头耳左边鸣响，肺脉紧数。这是肺虚不能生肾水，木火妄动，气血不归原。血不归原，心火妄动，所以心跳；气不归原，肝木动，所以耳鸣。左右，是阴阳的道路。在左侧，木火属阳，适宜用归脾汤滋养心血，收敛火下行，心血充足则心火不克肺金，金能平木，肝气自然平和。
有一位妇女左三部脉洪滑有力，右三部脉短涩，呕吐胸满，小便痛且泄，月经来了，不通也不泄，月经不来。这是肝木有余，火行土位，所以经血、泄泻并行。用白芍二两，泻土中之木；甘草一两以缓和肝急；香附三钱，木香一钱，理气止痛止吐；益母草、延胡索各一两以行血滞；山药糊丸以补脾。肝气有余，脾气不足，所以肝气动而脾受克。经血未行属少阴，已行属厥阴，行后属太阴。经血、泄泻并行，是肝气动；肝之动，土受克；克则不能运湿而致泻，克则气血不调而痛。所以平肝……（原文此处中断）
有一位女性在六月突然死亡，遍身冷而无汗，六脉俱伏，三天不醒，但尚未气绝。众人用四逆汤、理中汤也无效。四天后诊察，仍然无脉可验。人一两天无脉就会立即死亡，现在三天不死，这是脉伏，热极似寒罢了。用冷水浸湿的青布放在身上约一小时，身体变热，内部吃冷水五、六碗。反而说渴，再喝一碗，大汗出，汗出后，用补中益气汤加黄柏，十帖痊愈。
Within the human body, there are five types of fire. They are Heart Fire, Yangming Dryness Fire, Sanjiao Vigorous Fire, Thunder Fire, and Dragon Fire. Heart Fire is suitable for clearing; Dryness Fire is suitable for moistening; Vigorous Fire should be purged with cold-natured herbs; Thunder Fire, when mild, should be pacified with astringents, and when severe, harmonized with warm methods; Dragon Fire should follow its nature and be guided using hot-natured substances (to guide fire back to its source). In ancient times, when treating fire syndromes, the use of two liang each of Shigao (Gypsum Fibrosum) and Chuanlian (Coptidis Rhizoma) was employed only when circumstances necessitated it. Generally, among all pathogens in the human body, fire is the most toxic. The toxicity of fire is most severe in the Ministerial Fire of the Mingmen (Gate of Life). When Ministerial Fire resides below, it is called Shaohuo (Lesser Fire), which generates Qi; if it rebels and moves upward, it becomes Zhuanghuo (Vigorous Fire), which consumes Qi. However, the arising of Mingmen Fire occurs for two reasons: first, because the Sovereign Fire (Heart Fire) fails to govern, causing Ministerial Fire to rebel horizontally; second, due to the connection of the Yangming channel, transforming Dry Metal into fierce fire, which combines with Liver Wood to burn, resulting in fire everywhere throughout the upper, lower, and middle Jiao. If one uses only a small amount of cold herbs, it is like pouring a cup of water into a red-hot pot; not only is it useless, but it will also break the pot immediately. How can it be saved unless a large amount is used? Using Chuanlian treats the combination of Sovereign and Ministerial Fire rebelling horizontally; using Shigao treats the combination of Dry Metal and Liver Wood. Fire in the head indicates that Clear Yang fails to ascend, with fire flaming upward. For conditions located high, treatment should involve dispersing and venting. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with 3 fen of Jingjie (Schizonepetae Herba) and 5 fen of Manjingzi (Vitex Fruit) is indicated.
Case Records
One patient had no headache, no fever, and no exterior syndrome, but suffered from stifling oppression due to constrained fire, with bowel movements alternating between constipation and dysentery. The prescription consisted of 1 qian of Chuanlian to purge fire, 1 qian of Zhishi (Immature Bitter Orange) to reduce stagnant Qi at the highest level, and 1 qian of Baizhu (Atractodis Rhizoma) to support the Stomach. After decocting and taking these three ingredients, the patient recovered.
A woman in June fell into a coma, sleeping without speaking, with a hot body but immobility. Her pulses in both hands were vigorous at the superficial position and choppy at the deep position. A choppy pulse indicates excess Yang; vigor indicates fire. This is a fire syndrome. It was treated with Yi Yuan San (Benefit Origin Powder) mixed with cold water.
Another patient became ill in July. At Chen hour (7-9 AM), he fainted; in the afternoon, he did not speak, slept comatose for a day without waking, and did not respond to calls. His body was cool, he refused food, felt neither cold nor hot. Everyone diagnosed it as a Yin syndrome. It was proposed to use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) and Sini Tang (Reverse the Cold Decoction). Upon palpation, his pulse was deep, small, sluggish, and hidden, indicating internal fire pathogen. Urine output had ceased for one or two days. This is a fire syndrome. The family did not comply. He remained unconscious until nightfall. I said, "This is true fire." His wife asked, "We had intercourse the previous day; how can this be fire?" I replied, "Nighttime intercourse causes internal deficiency. Combined with labor and intense heat, dry heavenly heat enters through the deficiency. Yang Qi is about to perish. Saving it with water is feasible." One bucket of cold water was taken. After drinking five bowls, the patient said he was thirsty. After seven bowls, he sweated profusely like rain. He then said he was hungry and wanted a bowl of porridge. Buzhong Yiqi Tang was used with Paojiang (Prepared Ginger) and Zexie (Alisma Rhizome) to warm the middle... [Text cuts off here].
A woman in May had a cool body but felt internal heat internally. She had watery diarrhea for two months, several times a day, with absolutely no urine output, and her stool was entirely liquid. She felt extreme heat above and freezing cold below. Her waist, legs, and feet were cold, and abdominal pain felt like ice. Sometimes she felt hot temporarily and disliked clothing; sometimes she feared cold with heat all over her body. Until dawn, her face and eyes were swollen and red, unresponsive to medication. Her six pulses (three on each hand) were always large and vigorous. This is concealed fire. Since fire nature flares upward, this results in upper heat and lower cold. Siwu Tang (Four Substances Decoction) was used with Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), Gancao (Licorice Root), Zhizi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), and Huangqin (Scutellariae Radix). After two doses, urination resumed and diarrhea stopped. However, toothache recurred and persisted for three days. Huangqi Jianzhong Tang (Astragalus Establish the Middle Decoction) with Fuzi (Aconiti Lateralis Radix Praeparata) was administered, curing it in one dose.
A woman in her forties, previously obese, gradually lost weight after illness. She felt internal heat while her exterior felt icy cold. She had spontaneous sweating, and her hands became numb and insensible upon contact with cold water. Tendons in her head and face spasmed and hurt; bone joints ached so much that her hands could not approach them. Pus and blood exuded from her gums. Her tongue was stiff and rigid. Her right hand could not move; her arms and elbows were stiff and painful. She felt hunger but had no appetite. Her urine was viscous like syrup. She belched with an acidic taste, was restless sitting or lying down, feared wind, and had difficulty defecating. The floating pulse was fine and choppy; the moderate pulse was slow and weak; the left hand pulse was weaker than the right. The illness had lasted five or six years with diverse symptoms. It arose because Yin Essence failed to nourish and Yang Essence failed to descend, resulting in upper excess and lower deficiency, specifically Yin deficiency within Yang. Treatment should tonify Yin within Yang. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) was prescribed.
One patient often experienced jumping sensations in his chest and ringing in the left side of his head and ears. His Lung pulse was tight and rapid. This indicates Lung deficiency failing to generate Kidney Water, leading to reckless movement of Wood and Fire, and Qi and Blood failing to return to their origin. When Blood does not return to its origin, Heart Fire moves recklessly, causing heart palpitations. When Qi does not return to its origin, Liver Wood moves, causing tinnitus. The left and right sides are the pathways of Yin and Yang. On the left, Wood and Fire belong to Yang. Guipi Tang (Restore the Spleen Decoction) should be used to nourish Heart Blood and gather Fire to move downward. When Heart Blood is sufficient, Heart Fire will not insult Lung Metal. Metal can then calm Wood, and Liver Qi will naturally level out.
A woman had vigorous, slippery, and forceful pulses on the left three positions, and short, choppy pulses on the right three positions. She vomited and had chest fullness. Her urination was painful accompanied by discharge. Her menstruation arrived but was obstructed and not discharged properly, or failed to arrive. This indicates Liver Wood excess, with Fire operating in the Earth position, causing menstruation and discharge to occur simultaneously. Bai Shao (White Peony Root) 2 liang was used to drain Wood from Earth; Gancao (Licorice Root) 1 liang to soothe the Liver; Xiangfu (Cyperi Rhizoma) 3 qian and Muxiang (Aucklandiae Radix) 1 qian to regulate Qi, stop pain, and arrest vomiting; Yimucao (Leonurus Herba) and Yanhusuo (Corydalis Rhizoma) 1 liang each to move Blood stasis; and Shanyao (Dioscoreae Rhizoma) paste pills to tonify the Spleen. Liver Qi was excessive, while Spleen Qi was deficient, so Liver Qi moved and oppressed the Spleen. Menstruation before flow belongs to Shaoyin; during flow to Jueyin; after flow to Taiyin. Simultaneous menstruation and discharge indicate Liver Qi movement. Liver movement oppresses Earth. Oppression prevents the transformation of Dampness, leading to diarrhea; it also disrupts Qi and Blood harmony, leading to pain. Therefore, calming the Liver... [Text cuts off here].
A woman suddenly died in June. Her whole body was cold and sweatless. All six pulses were hidden. She did not wake for three days, but her vital Qi had not yet completely severed. Others used Sini Tang and Lizhong Tang without effect. Four days later, upon examination, there were still no detectable pulses. Usually, a person dies immediately if pulses are absent for one or two days. The fact that she survived three days indicates hidden pulses, where extreme heat mimics cold. A green cloth soaked in cold water was placed on her body for about an hour. Her body became warm. Internally, she drank five or six bowls of cold water. She complained of thirst and drank another bowl. Profuse sweating ensued. Afterward, Buzhong Yiqi Tang with Huangbai (Phellodendri Cortex) was administered for ten doses, resulting in recovery.