内经帝曰。人伤于寒而传为热。何也。岐伯曰。寒气外凝内郁之理。腠理坚致。玄府闭
密
。则气不宣通。湿气内结。中外相薄。寒盛热生。观此则知热之由作。悉皆外邪内入而热。
是即本身元阳为邪所遏。一步一步而不得泄。故尔变而为热耳。然不乘势以除。则热更有
进而相争之势。所以古人有用三黄石膏。及或大小承气。无非使其热泻之谓。余按热病用泻
。考之方书。其药甚众。然大要在肺则止用以黄芩知母。在胃则止用以石膏大黄朴硝。在心
则止用以黄连山栀连翘木通。在肝则止用以青黛龙胆。在肾则止用以童便青盐。在脾则止用
以石斛白芍。此为诸脏泻热首剂。至于在肺。又有他剂以泻。盖以热邪初成未盛。则或用以
百合百部马兜铃。毒瓦斯兼见。则或用以金银花牛蒡子。久嗽肺痿。则或用以沙参。香港脚兼见
。则或用以薏苡仁。咽疮痔漏。则或用以柿干柿霜。热挟气攻。则或用以牵牛。三焦热并。
则或用以栀子。烦渴而呕。则或用以竹茹。热而有痰。则或用以贝母。热而气逆不舒。则或
用以青木香。热而溺闭。则或用以车前石苇。久嗽兼脱。则或用以五倍子百药煎。乳水不通
。则或用以通草。若更兼有血热。则又当用生地紫菀。此泻肺热之大概也。在胃又有他剂以
泻。盖以热兼血燥。犀角宜矣。毒盛热炽。绿豆宜矣！中虚烦起。粳米宜矣。暑热渴生。西
瓜宜矣。时行不正。贯众宜矣。疫热毒盛。人中黄金汁雪水宜矣。咽疮痔漏。柿蒂柿干宜矣
。便结不软。玄明粉宜矣。乳痈便闭。漏芦宜矣。蛊积不消。雷丸宜矣。热盛呃逆。竹茹芦
根宜矣。肠毒不清。白头翁刺 皮宜矣。口渴不止。竹叶宜矣。若更兼有血热。则又宜于地
榆槐角槐花苏木三七干漆。此泻胃热之大概也。而大肠热结。仍不外乎硝黄白头翁黄芩绿豆
蜗牛生地之药矣。在心又有他剂以泻。则或因其溺闭。而用瞿麦木通。气逆而用赭石。痰闭
而用贝母天竺黄。暑渴而用西瓜。精遗而用莲须。抽掣而用钩藤。咳嗽而用百合。疝瘕而
用川楝。与夫血热而更用以犀角射干童便血余红花辰砂紫草生地郁金桃仁茜草苏木丹参没药
莲藕益母草熊胆等药。又可按味以考求矣。此泻心热之大概也。在肝又有他剂以泻。则如肝
经气逆。宜用赭石以镇之。肾气不固。则用石南叶以坚之。溺闭不通。则用车前子以导之。
痰闭不醒。则用牛黄以开之。目翳不明。则用秦皮空青蒙花石燕青葙子石决明以治之。咳嗽
痰逆。则用全胡以降之。蛊积不消。则用芦荟以杀之。湿郁惊恐。宜用琥珀以镇之。神志昏
冒。宜用枣仁以清之。若使热在于血。其药众多。大约入肝凉血。则有赤芍赭石蒲公英青鱼
胆红花地榆槐花槐角侧柏叶卷柏无名异凌霄花猪尾血紫草夜明砂兔肉旱莲草茅根蜈蚣山甲琥
珀芙蓉花苦酒熊胆之类。入肝破血。则有莪术紫贝灵芝紫参益母草蒲黄血竭莲藕古文钱皂
矾归尾鳖甲贯众茜草桃仁之类。入肝败血。则有三七虻虫 虫螃蟹瓦楞子水蛭花蕊石之类。
皆当审实以投。此泻肝热之大概也。而泻胆热之味。又岂有外空青铜绿铜青熊胆胆矾前胡等
药者乎？在肾又有他剂以泻。如龙胆防己。为肾热盛溺闭者所宜用也。秋石为肾热盛虚咳嗽
溺闭者所必用也。寒水石为肾热盛口渴水肿者所必用也。地骨皮为肾热盛有汗骨蒸者所必用
也。食盐为肾热盛便闭者所必用也。琥珀海石为肾热盛血瘀溺秘者所必用也。若使热在于血
。则药亦不出乎童便地骨皮血余银柴胡蒲公英生牛膝旱莲草赤石脂自然铜古文钱青盐之类。
而泻膀胱热结。其用猪苓泽泻地肤子茵陈黄柏黄芩龙胆川楝子药者。又可按其症治以考求矣
。此泻肾热之大概也。脾热泻药无多。惟有脾经血热。考书有用郁李射干紫贝姜黄莲藕皂矾
蚯蚓。然亦须辨药症以治。要之治病用药。须当分其脏腑。然其是上是下。毫微之处。未可
尽拘。如药既入于肺者。未有不入于心。入于肝者。未有不入于脾。入于肾者。未有不入于
膀胱。且药气质轻清者上浮。重浊者下降。岂有浮左而不浮右。重此而不重彼者乎？但于形
色气味重此。比较明确。则药自有圆通之趣。又奚必拘拘于毫茫间互为较衡。而致局其神
智者乎？
黄帝问：人受寒邪侵袭后，为什么会转化为热证？岐伯回答：这是因为寒气在体表凝结，导致体内气机郁滞。如果腠理（皮肤纹理及汗孔）致密坚固，玄府（汗孔）闭塞紧密，那么体内的气就无法宣通发散。湿气在体内结聚，内外之气相互搏结，寒邪盛极则化生热邪。由此可知，热证的产生，都是因为外邪内入所致。这其实是人体原本的元阳之气被邪气遏制，一步步无法宣泄，所以变生为热证。然而如果不趁势祛除邪热，那么热邪就会有进一步加剧、与正气相争的趋势。所以古人使用三黄石膏汤，或者大承气汤、小承气汤等方剂，无非是为了使热邪得以泻除。
我考察热病使用泻法，查阅医方书籍，相关的药物非常多。但大致的原则是：热在肺脏，只宜用黄芩、知母；热在胃腑，只宜用石膏、大黄、朴硝；热在心经，只宜用黄连、山栀、连翘、木通；热在肝脏，只宜用青黛、龙胆草；热在肾脏，只宜用童便、青盐；热在脾脏，只宜用石斛、白芍。这是各脏腑清泻热邪的首选药物。
至于肺脏，还有其他方药可以泻热。因为热邪初成且未盛时，可用百合、百部、马兜铃；若兼有毒瓦斯（毒邪），可用金银花、牛蒡子；久嗽导致肺痿，可用沙参；脚气兼见，可用薏苡仁；咽喉疮疡、痔疮漏管，可用柿干、柿霜；热邪挟带气机上攻，可用牵牛子；三焦热邪并盛，可用栀子；心烦口渴且呕吐，可用竹茹；热邪伴有痰湿，可用贝母；热邪导致气逆不舒，可用青木香；热邪导致小便闭塞，可用车前子、石苇；久嗽兼有虚脱，可用五倍子、百药煎；乳汁不通，可用通草。如果再兼有血热，则又应当用地黄、紫菀。这是清泻肺热的大概情况。
在胃腑，也有其他方药可以泻热。因为热邪兼有血燥，适宜用水牛角；毒盛热炽，适宜用绿豆；中气虚弱而生烦热，适宜用粳米；暑热导致口渴，适宜用西瓜；时行不正之气（瘟疫），适宜用贯众；疫疠热毒盛，适宜用人中黄、金汁、雪水；咽喉疮疡、痔疮漏管，适宜用柿蒂、柿干；大便干结不软，适宜用玄明粉；乳痈伴有大便闭塞，适宜用漏芦；蛊积（寄生虫或积聚）不消，适宜用雷丸；热盛导致呃逆，适宜用竹茹、芦根；肠道毒邪不清，适宜用白头翁、刺皮；口渴不止，适宜用竹叶。如果再兼有血热，则又适宜用地榆、槐角、槐花、苏木、三七、干漆。这是清泻胃热的大概情况。而大肠热结，仍然离不开硝石、大黄、白头翁、黄芩、绿豆、蜗牛、地黄等药物。
在心经，也有其他方药可以泻热。如因为小便闭塞，就用瞿麦、木通；气逆就用代赭石；痰闭就用贝母、天竺黄；暑热口渴就用西瓜；精遗就用莲须；抽搐掣动就用钩藤；咳嗽就用百合；疝瘕就用川楝子。以及血热更用水牛角、射干、童便、血余炭、红花、辰砂、紫草、地黄、郁金、桃仁、茜草、苏木、丹参、没药、莲藕、益母草、熊胆等药物。又可以按药物的性味来考究寻求。这是清泻心热的大概情况。
在肝脏，也有其他方药可以泻热。如肝经气逆，适宜用代赭石以镇降之；肾气不固，就用石南叶以固涩之；小便闭塞不通，就用车前子以引导之；痰闭神昏不醒，就用牛黄以开窍之；目生翳膜不明，就用秦皮、空青、蒙花、石燕、青葙子、石决明来治疗；咳嗽痰逆，就用全胡（胡黄连）以降逆之；蛊积不消，就用芦荟以杀虫之；湿郁惊恐，适宜用琥珀以镇惊之；神志昏冒，适宜用酸枣仁以清心安神之。如果热邪在于血分，药物众多。大致入肝凉血的，有赤芍、代赭石、蒲公英、青鱼胆、红花、地榆、槐花、槐角、侧柏叶、卷柏、无名异、凌霄花、猪尾血、紫草、夜明砂、兔肉、旱莲草、茅根、蜈蚣、穿山甲、琥珀、芙蓉花、苦酒、熊胆之类；入肝破血的，有莪术、紫贝、灵芝、紫参、益母草、蒲黄、血竭、莲藕、古文钱、皂矾、当归尾、鳖甲、贯众、茜草、桃仁之类；入肝败血的，有三七、虻虫、水蛭、螃蟹、瓦楞子、花蕊石之类。这些都应当审察实证后投药。这是清泻肝热的大概情况。而清泻胆热的药物，难道还有超出空青铜、绿铜青、熊胆、胆矾、前胡等药物吗？
在肾脏，也有其他方药可以泻热。如龙胆草、防己，是肾热盛且小便闭塞者所适宜用的；秋石，是肾热盛且虚咳、小便闭塞者所必须用的；寒水石，是肾热盛且口渴、水肿者所必须用的；地骨皮，是肾热盛且有汗、骨蒸者所必须用的；食盐，是肾热盛且大便闭塞者所必须用的；琥珀、海浮石，是肾热盛且血瘀、小便秘结者所必须用的。如果热邪在于血分，药物也不出童便、地骨皮、血余炭、银柴胡、蒲公英、生牛膝、旱莲草、赤石脂、自然铜、古文钱、青盐之类。而清泻膀胱热结，使用猪苓、泽泻、地肤子、茵陈、黄柏、黄芩、龙胆草、川楝子等药物，又可以按照症状治疗来考究寻求。这是清泻肾热的大概情况。
脾热泻药不多，只有脾经血热，查考书籍有用郁李仁、射干、紫贝、姜黄、莲藕、皂矾、蚯蚓的。但也必须辨别药症以治疗。总之治病用药，必须分清脏腑。然而其作用在上还是在下，细微之处，不可完全拘泥。比如药物既然进入肺脏，没有不进入心脏的；进入肝脏的，没有不进入脾脏的；进入肾脏的，没有不进入膀胱的。况且药气质地轻清的上浮，重浊的下沉，哪有向左浮而不向右浮，向此重而不向彼重的道理呢？只要在形色气味上对此比较明确，那么药物自有圆通变化的趣味。又何必拘泥于毫厘之间互相较衡，从而局限了医生的智慧呢？
Yellow Emperor asked: Why does a person, after being injured by cold pathogenic factors, transmit into a heat syndrome? Qi Bo answered: This is due to the principle of cold qi condensing externally and stagnating internally. If the cou li (skin texture and interstices) are firm and dense, and the xuan fu (sweat pores) are closed and tight, then the qi cannot be disseminated and unblocked. Dampness knots internally, and the interior and exterior clash with each other. When cold is excessive, heat is generated. From this, we know that the origin of heat is entirely due to external pathogens entering inward. This is essentially the body's own primordial yang being obstructed by pathogens, step by step unable to vent, thus transforming into heat. However, if one does not take advantage of the momentum to eliminate it, the heat will have a tendency to advance further and contend with the righteous qi. Therefore, the ancients used Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction), or Da Chengqi Tang (Major Order the Qi Decoction) and Xiao Chengqi Tang (Minor Order the Qi Decoction), nothing more than to allow the heat to be purged.
I examine the use of purging methods for heat diseases; consulting medical formularies, there are many drugs involved. But the main principles are: For heat in the Lung, only Huangqin (Scutellariae Radix) and Zhimu (Anemarrhenae Rhizoma) should be used; for heat in the Stomach, only Shigao (Gypsum Fibrosum), Dahuang (Rhei Radix et Rhizoma), and Puxiao (Natrii Sulfas) should be used; for heat in the Heart, only Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), and Mutong (Akebiae Caulis) should be used; for heat in the Liver, only Qingdai (Indigo Naturalis) and Longdancao (Gentianae Radix) should be used; for heat in the Kidney, only Tongbian (Child’s Urine) and Qingyan (Green Salt) should be used; for heat in the Spleen, only Shihu (Dendrobii Caulis) and Baishao (Paeoniae Radix Alba) should be used. These are the primary formulas for clearing heat from the various zang organs.
As for the Lung, there are other agents to purge heat. Because when heat pathogen is initially formed and not yet vigorous, one may use Baihe (Lilii Bulbus), Bubu (Stemonae Radix), and Madouling (Aristolochiae Fructus). If toxic vapors are concurrent, one may use Jinyinhua (Lonicerae Japonicae Flos) and Niubangzi (Arctii Fructus). For chronic cough leading to fei wei (lung atrophy/withering), one may use Shashen (Glehniae Radix). If jiaoxie (foot disease/gout) is concurrent, one may use Yiyiren (Coicis Semen). For yan chuang (throat sores) and zhi lou (hemorrhoids and fistulas), one may use Shigan (Dried Persimmon) and Shishuang (Persimmon Frost). If heat carries qi attacking upward, one may use Qianniu (Pharbitidis Semen). If sanjiao (Triple Burner) heat merges, one may use Zhizi (Gardeniae Fructus). If there is vexation, thirst, and vomiting, one may use Zhuru (Bambusae Caulis in Taenia). If heat is accompanied by phlegm, one may use Beimu (Fritillariae Bulbus). If heat causes qi rebellion and discomfort, one may use Qingmuxiang (Aquilariae Lignum). If heat causes urinary retention, one may use Cheqianzi (Plantaginis Semen) and Shiwei (Pyrosiae Folium). For chronic cough with collapse, one may use Wubeizi (Gallae Chinensis) and Baiyaojian (Fermented Tea Brick). For milk water blockage, one may use Tongcao (Tetrapanacis Medulla). If additionally there is blood heat, then Shengdi (Rehmanniae Radix) and Ziwan (Adenophorae Radix) should be used. This is the general overview of purging Lung heat.
For the Stomach, there are also other agents to purge heat. Because if heat is combined with blood dryness, Xijiao (Rhinocerotis Cornu) is suitable. If toxicity is excessive and heat is blazing, Lüdou (Phaseoli Semen) is suitable. If middle deficiency causes vexation, Jingmi (Oryzae Semen) is suitable. If summerheat causes thirst, Xigua (Citrullus Lanatus) is suitable. If epidemic irregular qi prevails, Guanzhong (Cyathulae Radix) is suitable. If epidemic heat toxicity is excessive, Renzhonghuang (Hominis Excrementum Carbonisatum), Jinzhi (Human Gold Juice), and Xueshui (Snow Water) are suitable. For throat sores and hemorrhoidal fistulas, Shidi (Persimmoni Calyx) and Shigan are suitable. For constipation with hard stools, Xuanmingfen (Mirabilitum Depuratum) is suitable. For ru yong (mastitis) with constipation, Loulu (Euphorbiae Humifusae Radix) is suitable. For gu ji (parasitic accumulation) not resolving, Leiwan (Holoscoziae Sporangium) is suitable. For excessive heat causing hiccups, Zhuru and Lugeng (Phragmitis Rhizoma) are suitable. For intestinal toxins not cleared, Baitouweng (Pulsatillae Radix) and Ci Pi (Zanthoxyli Cortex) are suitable. For unceasing thirst, Zhuye (Bambusae Folium) is suitable. If additionally there is blood heat, then Diyü (Sanguisorbae Radix), Huaijiao (Gleditsiae Sinensis Fructus), Huaihua (Sophorae Flos), Sumu (Pterocarpi Santalinus), Sanqi (Notoginseng Radix), Ganqi (Drynariae Rhizoma) are suitable. This is the general overview of purging Stomach heat. As for large intestine heat knot, it still does not go beyond Xiaoshi (Natrii Sulfas), Dahuang, Baitouweng, Huangqin, Lüdou, Woniu (Helix), and Shengdi.
For the Heart, there are also other agents to purge heat. Such as using Qumai (Dianthi Herba) and Mutong for urinary retention; using Zhesi (Hematitum) for qi rebellion; using Beimu and Tianzhuhuang (Calami Tuber) for phlegm closure; using Xigua for summerheat thirst; using Lianxu (Nelumbinis Plumula) for essence leakage; using Gouteng (Uncariae Ramulus cum Uncis) for twitching; using Baihe for cough; using Chuanlianzu (Toosendan Fructus) for hernia and masses. And for blood heat, additionally using Xijiao, Shegan (Belamcandae Radix), Tongbian, Xuyutan (Calces Capillis Humanis), Honghua (Carthami Flos), Chencha (Cinnabar), Zicao (Arnebiae Radix et Rhizoma), Shengdi, Yujin (Curcumae Radix), Tao Ren (Persicae Semen), Qiancao (Rubiae Radix), Sumu, Danshen (Salviae Miltiorrhizae Radix), Moyao (Myrrha), Ou Lian (Lotus Rhizome), Yimucao (Leonuri Herba), Xiongdan (Ursi Fel) and other drugs. One can also investigate based on flavors to seek understanding. This is the general overview of purging Heart heat.
For the Liver, there are also other agents to purge heat. Such as for liver channel qi rebellion, using Zhesi to calm it; for kidney qi insecurity, using Shinanye (Acanthopanacis Trifolii Caulis) to consolidate it; for urinary obstruction, using Cheqianzi to guide it; for phlegm closure with unconsciousness, using Niuhuang (Bovis Calculus) to open it; for eye nebula and unclear vision, using Qinpi (Fraxini Cortex), Kongqing (Azurite), Menghua (Chrysanthemi Indici Flos), Shiyan (Fossilia Osseum), Qingxiangzi (Vernoniae Semen), and Shijueming (Haemitecti Shell) to treat it; for cough with phlegm and rebellion, using Quan Huhu (Full Huhu/Isatis Root) to descend it; for parasitic accumulation not resolving, using Lusuo (Aloe) to kill it; for damp stagnation and fright, using Hupo (Succinum) to calm it; for mental confusion, using Zaoren (Ziziphi Spinosomi Semen) to clear it. If heat is in the blood, the drugs are numerous. Generally, those entering the liver to cool blood include Chishao (Paeoniae Radix Rubra), Zhesi, Pugongying (Taraxaci Herba), Qingyudan (Green Fish Gallbladder), Honghua, Diyü, Huaihua, Huaijiao, Cebeiye (Platycladi Cacumen), Juanbai (Selaginellae Herba), Wumingyi (Chalcanthitum), Lingxiaohua (Campsis Grandiflorae Flos), Zhuweixue (Porcine Tail Blood), Zicao, Yemingsha (Phalaenopsidis Semen), Toutou (Rabito Carnis), Hanliancao (Ecliptae Herba), Maogen (Imperatae Rhizoma), Wugong (Scolopendra), Shanjiā (Manis Squama), Hupo, Furonghua (Hibisci Mutabilis Flos), Kujiu (Vinegar), Xiongdan, etc. Those entering the liver to break blood include Ezhu (Curcumae Rhizoma), Zi Bei (Amethyst), Lingzhi (Ganoderma), Zican (Codonopsis Radix - *Note: Context implies a different herb often confused or specific local name, but literal translation provided*), Yimucao, Puhuang (Pollen Typhae), Xuexie (Dracaenae Sanguis), Ou Lian, Guwenqian (Ancient Coin), Zao Fan (Melanteritum), Gui Wei (Angelicae Sinensis Radix), Biejia (Trionycis Carapax), Guanzhong, Qiancao, Tao Ren, etc. Those entering the liver to disintegrate blood include Sanqi, Mengchong (Blatta Orientalis - *Note: Text says 虫 likely referring to insect like Mengchong or similar, context implies blood-breaking insects*), Chong (*Text has missing character or typo, likely another insect*), Pangxie (Crab), Walengzi (Arcae Shell), Shuizhi (Hirudo), Hua Ruishi (Flowers Roushi/Stalactite?), etc. All must be administered after examining excess conditions. This is the general overview of purging Liver heat. And for purging Gallbladder heat, are there any flavors outside Kong Qingtong, Lü Qingtong, Xiongdan, Danfan (Alumen), and Qianhu (Peucedani Radix)?
For the Kidney, there are also other agents to purge heat. Such as Longdancao and Fangji (Stephaniae Tetrandrae Radix) are suitable for excessive kidney heat with urinary retention; Qiushi (Ashes of Dogwood Fruit) is necessary for excessive kidney heat with deficiency cough and urinary retention; Hanshuishi (Halloysitum Rubrum) is necessary for excessive kidney heat with thirst and edema; Digupi (Lycii Cortex) is necessary for excessive kidney heat with sweating and bone-steaming fever; Yan Yan (Salt) is necessary for excessive kidney heat with constipation; Hupo and Haishi (Fossilia Calcitum) are necessary for excessive kidney heat with blood stasis and urinary retention. If heat is in the blood, the drugs do not exceed Tongbian, Digupi, Xuyutan, Yin Chaihu (Stellariae Radix), Pugongying, Sheng Niu Xi (Achyranthis Bidentatae Radix), Hanliancao, Chishizhi (Kaolin), Ziran Tong (Natural Copper), Guwenqian, and Qingyan. And for purging bladder heat knot, using Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Difuzi (Kochiae Fructus), Yinchen (Artemisiae Scopariae Herba), Huangbai (Phellodendri Cortex), Huangqin, Longdancao, and Chuanlianzu, one can again investigate according to symptoms and treatment. This is the general overview of purging Kidney heat.
There are few spleen heat purging drugs. Only for spleen channel blood heat, books record the use of Yuli Ren (Prunus Armeniacae Semen Amarum), Shegan, Zi Bei, Jiang Huang (Curcumae Longae Rhizoma), Ou Lian, Zao Fan, and Qiuyin (Earthworm). However, one must distinguish drug and syndrome for treatment. In essence, treating diseases and using drugs requires distinguishing the zang-fu organs. However, whether their action is upper or lower, in minute details, one cannot be completely rigid. For example, once a drug enters the Lung, it inevitably enters the Heart; once it enters the Liver, it inevitably enters the Spleen; once it enters the Kidney, it inevitably enters the Bladder. Moreover, drugs with light and clear qi float upward, while those with heavy and turbid qi sink downward. How could there be floating to the left but not to the right, or heavy here but not there? As long as the form, color, and flavor are clearly compared here, the drugs naturally possess the charm of flexibility. Why must one be pedantic about measuring in millimeters, thereby limiting the wisdom of the practitioner?