痰为顽浊之物，一得火势，其性愈劣，甚则阳狂烦躁，语言错乱，清火涤痰汤主之。
清火涤痰汤（自制）
丹参（二钱） 麦冬（二钱） 茯神（二钱） 柏仁（二钱） 贝母（二钱） 化橘红（一钱） 胆星（五分） 姜
蚕（一钱五分炒） 菊花（二钱） 杏仁（三钱） 淡竹沥（半杯） 姜汁（一滴冲服）
绳甫先生云∶火本无质，得痰则实；痰本湿生，得火则燥。由此观之，痰与火结，有不扰其神明者乎。南星
除痰之力，更大于半夏，以牛胆制之，则燥性杀，而兼清肝胆之火矣。化橘红比普通之橘红力大，以产
地适当有礞石也。再以竹沥、姜汁、杏贝佐之，能开而且降，痰火有出路矣。用茯神、丹参、柏仁，顾其灵明
之本也。再以麦冬之生胃津，菊花之清肝风。以狂必由火而起，火必因风而动，风火熄而灵明复，则扰
动者得返其清静之常，真精心架构之方也。祖怡注。
气分偏胜，壮火升腾，发热错语，口燥咽干，阳狂烦躁，加味三黄汤主之。
加味三黄汤（自制）
黄连（五分） 黄芩（一钱） 黄柏（一钱） 连翘（一钱五分） 丹皮（二钱）
薄荷（一钱） 赤芍（一钱） 山栀（一钱五分） 水三钟，煎一钟，热服。
三黄为泻心、肺、肝、肾实火之方。加山栀名黄连解毒汤，见本门后第一张古方。再加薄荷、连翘散心肝，
丹皮、赤芍凉血分，轻扬透发而不抑遏，以发热烦躁，火郁必须发之也。此方见证阳狂烦躁，与痰火同，
而有发热、口燥、咽干，明明是气分之火而不是痰火，从异点上着眼，故此方与痰火方无一味药相同。祖怡注。
痰是顽固浑浊的病理产物，一旦遇到火势，其性质变得更加恶劣，严重时会出现阳气亢盛、狂躁不安、言语错乱的症状，治疗以清火涤痰汤为主。
清火涤痰汤（自制方）
丹参（二钱） 麦冬（二钱） 茯神（二钱） 柏子仁（二钱） 贝母（二钱） 化橘红（一钱） 胆南星（五分） 姜制天竺蚕（一钱五分，炒） 菊花（二钱） 杏仁（三钱） 淡竹沥（半杯） 姜汁（一滴，冲服）
绳甫先生评论道：火原本没有实质形态，遇到痰后变得有形且充实；痰本由湿气滋生，遇到火后变得干燥。由此看来，痰与火结合，难道不会扰乱人的神明（精神意识）吗？胆南星祛除痰浊的力量比半夏更大，用牛胆汁炮制后，其燥性被抑制，同时能清泻肝胆之火。化橘红比普通橘红的药效更强，因为其产地适宜生长有礞石。再加上竹沥、姜汁、杏仁和贝母作为辅助，能够开泄肺气并降逆下行，使痰火有了排出的途径。使用茯神、丹参、柏子仁，是为了顾护心神灵明的根本。再加上麦冬滋养胃中津液，菊花清平肝风。因为发狂必定由火引起，火必定因风而动，风火平息后灵明恢复，那么被扰动的状态就能回归清静的常态，这真是一个精心构思的方剂。祖怡注。
气分邪气偏胜，壮火升腾，出现发热、胡言乱语、口燥咽干、阳气亢盛狂躁烦躁的症状，治疗以加味三黄汤为主。
加味三黄汤（自制方）
黄连（五分） 黄芩（一钱） 黄柏（一钱） 连翘（一钱五分） 牡丹皮（二钱）
薄荷（一钱） 赤芍（一钱） 山栀（一钱五分） 用水三碗，煎取一碗，热服。
三黄（黄连、黄芩、黄柏）是泻心、肺、肝、肾实火的方剂。加入山栀后名为黄连解毒汤，见本章后面第一张古方。再加薄荷、连翘疏散心肝之邪，牡丹皮、赤芍凉血分，药性轻扬透发而不压抑遏阻，因为发热烦躁是由于火郁结所致，必须通过发散来解除。此方见证表现为阳狂烦躁，与痰火证相同，但伴有发热、口燥、咽干，明显是气分之火而不是痰火，从差异点上着眼，因此此方与治痰火的方剂没有一味药相同。祖怡注。
Phlegm is a stubborn and turbid pathological product; once it encounters fire, its nature becomes even more detrimental. In severe cases, it may manifest as Yang hyperactivity, mania, irritability, and disordered speech. The primary treatment is Qinghuo Ditan Tang (Clearing Fire and Scouring Phlegm Decoction).
Qinghuo Ditan Tang (Self-made Formula)
Salviae Miltiorrhizae Radix et Rhizoma (Danshen, 丹参) - 2 qian
Ophiopogonis Tuber (Maidong, 麦冬) - 2 qian
Poria with Hostwood (Fushen, 茯神) - 2 qian
Ziziphi Spinosomi Semen (Bairen, 柏仁) - 2 qian
Fritillariae Bulbus (Beimu, 贝母) - 2 qian
Citri Reticulatae Pericarpium Viride Preparatum (Huajuhong, 化橘红) - 1 qian
Arisaematis Cum Bile Radix (Danning, 胆星) - 5 fen
Bombyx Batryticatus Prepared (Jiangcan, 姜蚕) - 1.5 qian, stir-fried
Chrysanthemi Flos (Juhua, 菊花) - 2 qian
Pruni Armeniacae Semen (Xingren, 杏仁) - 3 qian
Bambusae Succus in Fornice (Danzhuli, 淡竹沥) - half cup
Zingiberis Recens Juice (Jiangzhi, 姜汁) - one drop, taken by mixing
Mr. Shengfu commented: Fire originally has no substantial form; when combined with phlegm, it becomes solid. Phlegm is naturally generated from dampness; when encountering fire, it becomes dry. From this perspective, the combination of phlegm and fire inevitably disturbs the Shen (Spirit/Mind). Arisaema cum Bile (Nanxing) has a stronger phlegm-resolving power than Pinelliae Rhizoma (Banxia). When processed with ox bile, its drying property is suppressed, and it simultaneously clears fire from the Liver and Gallbladder. Huajuhong (Prepared Green Tangerine Peel) is more potent than ordinary Citri Reticulatae Pericarpium (Juhong) because its production area is suitable for the presence of Mengshi (Calamina). Furthermore, assisted by Zhuli (Bamboo Sap), Jiangzhi (Ginger Juice), Xingren (Apricot Kernel), and Beimu (Fritillaria), it can open and descend, providing an exit route for phlegm and fire. The use of Fushen (Poria with Hostwood), Danshen (Salvia Root), and Bairen (Ziziphus Seed) aims to protect the root of the Spirit's clarity. Additionally, Maidong (Ophiopogon) generates Stomach fluids, and Juhua (Chrysanthemum) clears Liver wind. Since mania must arise from fire, and fire must move due to wind, once wind and fire are extinguished, clarity returns, allowing the disturbed state to revert to its normal quietude. This is truly a meticulously structured formula. Note by Zuyi.
When Qi-level pathogenic factors prevail, vigorous fire ascends, manifesting as fever, delirious speech, dry mouth, dry throat, Yang hyperactivity, mania, and irritability. The primary treatment is Jiawei Sanhuang Tang (Modified Three Yellows Decoction).
Jiawei Sanhuang Tang (Self-made Formula)
Coptidis Rhizoma (Huanglian, 黄连) - 5 fen
Scutellariae Radix (Huangqin, 黄芩) - 1 qian
Phellodendri Cortex (Huangbai, 黄柏) - 1 qian
Lonicerae Japonicae Flos (Lianqiao, 连翘) - 1.5 qian
Moutan Cortex (Danpi, 丹皮) - 2 qian
Menthae Haplocalycis Herba (Bohe, 薄荷) - 1 qian
Paeoniae Radix Rubra (Chishao, 赤芍) - 1 qian
Gardeniae Fructus (Shanzhi, 山栀) - 1.5 qian
Decoct three zhong of water to obtain one zhong; take hot.
The "Three Yellows" (Huanglian, Huangqin, Huangbai) constitute a formula for draining excess fire from the Heart, Lung, Liver, and Kidney. Adding Gardeniae Fructus (Shanzhi) creates Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity), seen in the first ancient formula later in this section. By adding Bohe (Mint) and Lianqiao (Honeysuckle Flower) to dissipate Heart and Liver pathogens, and Danpi (Moutan Bark) and Chishao (Red Peony Root) to cool the Blood level, the formula acts lightly and dispersingly without suppressing or obstructing. This is because fever and irritability result from constrained fire, which must be released through dispersion. The manifestations of this formula include Yang hyperactivity, mania, and irritability, which are similar to Phlegm-Fire patterns; however, the presence of fever, dry mouth, and dry throat clearly indicates Qi-level fire rather than Phlegm-Fire. Focusing on these differential points, none of the herbs in this formula overlap with those in the Phlegm-Fire formula. Note by Zuyi.