凡热病之作，亦自有内外之辨。如感风寒而传化为热，或因时气而火盛为热，此皆外来
之热，即伤寒、瘟疫、时毒、咳疟之属也。至若内生之热，则有因饮食而致者，有因劳
倦而致者，有因酒色而致者，有因七情而致者，有因药饵而致者，有因过暖而致者，有因阴
虚而致者，有偶感而致者，有累积而致者。虽其所因不同，而病候无过表里。故在外者，但
当察经络之深浅；在内者，但当察脏腑之阴阳。凡此诸证，在各门具有方论者，兹不再赘。
且热即火也。故治热之法，即当于火证门通融用之。其有未尽之义，仍列于后。
一、治热之法，凡微热之气，宜凉以和之。大热之气，宜寒以制之。郁热在经络者，宜
疏之、发之。结热在脏腑者，宜通之、利之。阴虚之热者，宜壮水以平之。无根之热者，宜
益火以培之。此其中有宜降者，所谓高者抑之也。有宜散者，所谓下者举之也。有相类者，
所谓逆者正治也。有相反者，所谓从者反治也。治热之法，不过如此，而鲜有得其善者，岂
亦由学力之未至乎。
一、五脏之热证有可据者。如肺气上通于鼻，而下主于皮毛。心气上通于舌，而下主于
血脉。脾气上通于口，而下主于四肢。胃气上通于头面牙龈，而下主于肌肉。肝气上通于目
，而下主于筋节。肾气上通于喉、耳，而下主于二阴。而六腑之气，亦可因表里以察之，此
皆病在形体也。凡有诸中者必形诸外，故必有热证可据，方可以热论治，医中关系，惟此为
最。
一、治五脏之热，当察微甚。如心经之微热者，宜二阴煎、安神丸、天王补心丹、导赤
散之类，皆可随证酌用；其热甚者，如泻心汤、黄连解毒汤、八正散、《直指》黄芩汤，及
犀角地黄汤三方，皆其类也。肺经微热者，宜加减一阴煎、《正传》麦门冬汤、泻白散之类
主之；其热甚者，宜黄芩清肺饮、黄芩知母汤之类主之。肝经微热者，宜化肝煎、保阴煎；
热甚者，宜加味龙胆泻肝汤、芍药清肝散、七正散。脾胃微热者，清化饮、黄芩芍药汤。阳
明热甚者，白虎汤、太清饮、泻黄散、玉泉散。肾经微热者，一阴煎、滋阴八味丸。热甚者
，正气汤、丹溪大补阴丸。肾虚兼胃火者，玉女煎。膀胱微热者，五淋散；热甚者，大厘清
饮、化阴煎。三焦微热者，徙薪饮；热甚者，抽薪饮、大连翘饮、凉膈散、三补丸、大金花
丸之类，择宜用之。凡清火退热方论甚多，此亦言其约耳。欲尽其义，当详考寒阵二类。
凡是热病的发生，自然有外感和内生的区别。比如感受风寒而传变化为热邪，或者因时行疫气导致火盛而发热，这些都属于外来的热邪，即包括伤寒、瘟疫、时毒、咳嗽疟疾等病症。至于内生的热邪，则有因为饮食不当引起的，有因为劳累过度引起的，有因为酒色过度引起的，有因为七情（喜、怒、忧、思、悲、恐、惊）失调引起的，有因为药物误用引起的，有因为环境过热引起的，有因为阴虚引起的，有偶然感邪引起的，有长期积累引起的。虽然致病原因不同，但病候表现不出表证和里证两类。所以在外的，只需观察经络的深浅；在内的，只需观察脏腑的阴阳虚实。以上各种证候，在各门类中已有方论记载的，这里不再赘述。而且热就是火。所以治疗热的方法，应当在火证门中融会贯通地使用。其中未尽的含义，仍列在后面。
第一条：治疗热邪的方法，凡是轻微的热邪，适宜用凉性药物来调和它。严重的大热邪气，适宜用寒性药物来制约它。郁结在经络中的热邪，适宜疏通它、发散它。结聚在脏腑中的热邪，适宜通利它、疏导它。阴虚产生的热邪，适宜壮水（滋补肾阴）来平抑它。无根之火（虚阳外越）产生的热邪，适宜益火（温补命门）来培补它。这其中有的适宜降逆，所谓“高者抑之”；有的适宜升散，所谓“下者举之”；有的属于同类相求，所谓“逆者正治”；有的属于相反相成，所谓“从者反治”。治疗热邪的方法，不过如此而已，但很少有人能掌握得恰到好处，难道也是因为学问功夫还没达到境界吗？
第二条：五脏的热证是有依据可循的。比如肺气上通于鼻，而下主司皮毛。心气上通于舌，而下主司血脉。脾气上通于口，而下主司四肢。胃气上通于头面牙龈，而下主司肌肉。肝气上通于目，而下主司筋节。肾气上通于喉、耳，而下主司前后二阴。六腑的气机，也可以通过表里关系来察知，这些都是病在形体方面的表现。凡内部有病变必然反映在外在表现上，所以必须有具体的热证作为依据，才能按照热证来论治，这在医学中关系最为重大。
第三条：治疗五脏的热证，应当考察其程度的轻重。比如心经的微热，适宜使用二阴煎、安神丸、天王补心丹、导赤散之类的方剂，都可以随证斟酌选用；如果热势严重，如泻心汤、黄连解毒汤、八正散、《直指方》黄芩汤，以及犀角地黄汤这三个方子，都属于这一类。肺经微热，适宜加减一阴煎、《正传》麦门冬汤、泻白散之类的主治；如果热势严重，适宜黄芩清肺饮、黄芩知母汤之类的主治。肝经微热，适宜化肝煎、保阴煎；热势严重，适宜加味龙胆泻肝汤、芍药清肝散、七正散。脾胃微热，适宜清化饮、黄芩芍药汤。阳明经热势严重，适宜白虎汤、太清饮、泻黄散、玉泉散。肾经微热，适宜一阴煎、滋阴八味丸。热势严重，适宜正气汤、丹溪大补阴丸。肾虚兼有胃火的，适宜玉女煎。膀胱微热，适宜五淋散；热势严重，适宜大厘清饮、化阴煎。三焦微热，适宜徙薪饮；热势严重，适宜抽薪饮、大连翘饮、凉膈散、三补丸、大金花丸之类，选择适宜的使用。凡是清热退火的方论非常多，这里也只是概括地说一下。想要穷尽其义理，应当详细考证《寒阵》这两类书籍。
Any onset of heat disease naturally involves a distinction between external and internal origins. For instance, when wind-cold is contracted and transforms into heat, or when seasonal epidemic qi causes excessive fire leading to fever, these are all external heat pathogens, belonging to categories such as Cold Damage (Shanghan), Plague (Wenyi), Seasonal Toxins (Shidu), and Cough-Malaria (Kemu). As for internally generated heat, it may arise from dietary irregularities, overexertion, excess in alcohol and sexual activity, emotional disturbances (Seven Emotions: Joy, Anger, Worry, Thought, Sorrow, Fear, Fright), improper medication, exposure to excessive warmth, Yin deficiency, accidental pathogenic invasion, or gradual accumulation. Although the etiologies differ, the clinical manifestations do not exceed the two categories of Exterior (Biao) and Interior (Li). Therefore, for exterior conditions, one should observe the depth of the meridians; for interior conditions, one should examine the Yin-Yang balance of the Zang-Fu organs. Regarding these various syndromes, formulas and discussions provided in other sections need not be repeated here. Moreover, heat is essentially fire. Thus, the methods for treating heat should be applied comprehensively within the section on Fire Syndromes. Additional nuances are listed below.
First: Methods for treating heat. For mild heat pathogens, cooling agents should be used to harmonize them. For severe heat pathogens, cold-natured agents should be used to control them. For heat constrained within the meridians, dispersing and venting methods are appropriate. For heat knotted within the Zang-Fu organs, purging and draining methods are appropriate. For heat due to Yin deficiency, nourishing Water (Kidney Yin) should be employed to pacify it. For rootless heat (deficiency fire floating outward), tonifying Fire (Mingmen Fire) should be employed to support it. Among these, some cases require descending, following the principle "suppress that which is high"; some require ascending and dispersing, following the principle "lift that which is low"; some involve similar pathogens treated with contrary methods, known as "orthodox treatment" (Zhengzhi); others involve opposite appearances treated with compliant methods, known as "compliant treatment" (FanZhi). The methods for treating heat are limited to this, yet few achieve mastery. Is this perhaps due to insufficient scholarly cultivation?
Second: There are reliable indicators for heat syndromes of the Five Zang organs. Lung Qi connects upward to the nose and governs the skin and hair downward. Heart Qi connects upward to the tongue and governs the blood vessels downward. Spleen Qi connects upward to the mouth and governs the four limbs downward. Stomach Qi connects upward to the head, face, and gums, and governs the muscles downward. Liver Qi connects upward to the eyes and governs the sinews and joints downward. Kidney Qi connects upward to the throat and ears, and governs the two yin openings (urethra and anus) downward. The Qi of the Six Fu organs can also be examined through their exterior-interior relationships. These represent diseases manifesting in the physical form. Since internal pathology must manifest externally, there must be observable heat signs to justify treating according to heat principles. This aspect is of paramount importance in medicine.
Third: When treating heat syndromes of the Five Zang organs, one must assess their severity. For mild Heat of the Heart Channel, formulas such as Er Yin Decoction (Two Yin Decoction), An Shen Wan (Spirit-Calming Pill), Tian Wang Bu Xin Dan (Emperor of Heaven's Special Pill to Tonify the Heart), and Dao Chi San (Direct Red Powder) may be selected according to the syndrome. For severe heat, formulas such as Xie Xin Tang (Drain the Epigastrium Decoction), Huang Lian Jie Du Tang (Coptis Detoxification Decoction), Ba Zheng San (Eight Upright Powder), Huang Qin Tang (Scutellaria Decoction) from *Zhizhi Fang*, and Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) are appropriate. For mild Heat of the Lung Channel, formulas such as Jia Jian Yi Yin Jian (Modified One Yin Decoction), Mai Men Dong Tang (Ophiopogon Decoction) from *Zheng Chuan*, and Xie Bai San (Drain White Powder) are indicated. For severe heat, Huang Qin Qing Fei Yin (Scutellaria Lung-Clearing Infusion) and Huang Qin Zhi Mu Tang (Scutellaria and Anemarrhena Decoction) are indicated. For mild Heat of the Liver Channel, Hua Gan Jian (Transform Liver Decoction) and Bao Yin Jian (Protect Yin Decoction) are used; for severe heat, Jia Wei Long Dan Xie Gan Tang (Modified Gentiana Drain Liver Decoction), Shao Yao Qing Gan San (Peony Liver-Clearing Powder), and Qi Zheng San are used. For mild Spleen-Stomach heat, Qing Hua Yin (Clear Transformation Infusion) and Huang Qin Shao Yao Tang (Scutellaria and Peony Decoction) are used. For severe Yangming heat, Bai Hu Tang (White Tiger Decoction), Tai Qing Yin, Xie Huang San (Drain Yellow Powder), and Yu Quan San (Jade Spring Powder) are used. For mild Kidney channel heat, Yi Yin Jian (One Yin Decoction) and Zi Yin Ba Wei Wan (Nourish Yin Eight-Ingredient Pill) are used; for severe heat, Zheng Qi Tang and Danxi Da Bu Yin Wan (Danxi's Great Yin-Tonifying Pill) are used. For Kidney deficiency combined with Stomach fire, Yu Nu Jian (Jade Woman Decoction) is used. For mild Bladder heat, Wu Lin San (Five Strangury Powder) is used; for severe heat, Da Li Qing Yin and Hua Yin Jian are used. For mild Sanjiao (Triple Burner) heat, Xi Xin Yin (Remove Firewood Infusion) is used; for severe heat, Chou Xin Yin (Draw Firewood Infusion), Da Lian Qiao Yin, Liang Ge San (Cool Diaphragm Powder), San Bu Wan (Three Tonify Pills), and Da Jin Hua Wan (Great Golden Flower Pill) are selected as appropriate. There are many formulas for clearing fire and reducing heat; this text merely summarizes them. To fully understand the principles, one should consult the two volumes of *Han Zhen* (Cold Arsenal).