火症之真假宜辨也火症本为大热之病热极则火势炎天自宜显现火热之症如何有真假之分
不知
火原有二有真火有假火真火者实邪也假火者相火也然而真火每见假寒以欺人假火每见真热以
欺世少若用药之误顷刻杀人矣真火之见假寒奈何身热而手足反凉脉反沉细而口渴心作懊 而
身反战栗此阳症似阴热极假作冰凉也法当用大寒之药以凉解之方用攻真散一剂而手足之凉反
作如火之热慎勿疑寒药之多用也盖病是热极之症见假寒以骗人吾以真寒之药攻其至坚假象破
而真状乃显故手足凉者而转为火热也再以此汤少减一半与之则胸腹一身之热尽去倘疑前方过
峻改用他方又且热变为寒以成危亡之症矣又何可不知复为所误乎行医者当于此等之病着眼留
心则生死之权不在阎罗而在医者之手操之矣假火而见真热之象奈何此乃肾水涸竭肾火无制上
腾而作热也肾火者少阴之虚火也肾火得肾水以相资则为真火肾火离肾水以相制则成虚火矣相
制者忽而相离则火无所养忽然冲地而出如霆如雷劈木焚林震天轰地者龙雷之火也人身少阴
之火亦然有一发而不可止遏由脾而胃由心而肺无脏不烧无肤不害咽喉方寸之地安能止遏自然
火星奔越目痛喉干咳嗽吐痰身热心烦头痛耳鸣诸症蜂起矣看其症候绝是火之有余谁知是水之
不足哉若错认作白虎汤症而大用寒凉石膏知母肆情多用下口即便灭亡不知其故而用吾攻真之
汤祸亦同之然则治之奈何当用六味地黄汤加麦冬五味大肆吞饮水足而火自归原盖龙雷之火
原喜水也寒凉之味亦水也何以以水投水而龙雷之火愈加飞越其故何哉盖水非真水故龙雷之火
愈为猖獗耳六味地黄汤乃至阴之水也阳水以制阴火则阴火不能伏阴水以制阴火则阴火自能归
倘药中再加入肉桂少许尤为得宜盖龙雷之火不特喜阴水之相济而更喜阴火之相宜肉桂亦至阴
之火以火引火原为妙法而更加入至阴之水中水中引火火自退藏消归乌有矣此种议论实惊世人
然实有至理存焉非故作幽奇之论能知此等治法医道自然神异而治病又何有棘手哉
攻真散
黄连（三钱） 栀子（五钱） 柴胡（二钱） 白芍（一两） 茯苓（五钱） 枳壳（一钱） 浓朴（一钱）
甘草（一钱） 天花粉（五钱） 黄芩（一钱）水煎服
火证的真假是需要辨别的。火证本来是大热之病，热到了极点，火势就像炎天一样，自然应该显现出火热的症状，怎么会有真假之分呢？
不知道的是，火原本有两种：有真火，有假火。真火属于实邪，假火属于相火。然而，真火常常表现出假寒的症状来欺骗人，假火常常表现出真热的症状来迷惑世人。如果用药失误，顷刻间就会致人死亡。
真火表现为假寒的情况是怎样的呢？身体发热，但手脚反而发凉；脉象反而沉细；口渴，心中烦闷懊恼，身体反而战栗。这是阳证似阴，热极而假装冰凉。治疗方法应当使用大寒的药物来清热解表。方剂用攻真散，服用一剂后，手脚的凉感反而会转变为像火一样的热感。千万不要怀疑寒性药用得太多。因为这是热极之症，它用假寒的现象来欺骗人，我用真寒性质的药物去攻克它最坚固的假象，假象破除后，真实的病情才会显露出来，所以手脚由凉转为火热。再用此汤减半剂量给予患者，则胸腹及全身的余热尽除。倘若怀疑前方过于峻猛，改用其他方剂，又会使热证变为寒证，从而造成危亡的后果。这怎么可以不知道而再次被误导呢？行医的人应当在这种疾病上着眼留心，那么生死的权柄就不在阎罗王手中，而在医者手中操持了。
假火表现为真热现象的情况是怎样的呢？这是由于肾水枯竭，肾火失去制约，向上腾越而产生热象。肾火是少阴经的虚火。肾火得到肾水的资助就成为真火，肾火脱离肾水的制约就变成虚火。所谓“相制”，是指忽而相互分离，火就失去了滋养，忽然冲地而出，如同雷霆、劈木焚林、震天轰地一般，这就是龙雷之火。人身少阴之火也是如此，一旦发作便不可遏制，由脾传至胃，由心传至肺，没有哪个脏腑不燃烧，没有哪处肌肤不受害。咽喉和心胸部位怎么能止遏得住呢？自然火星奔逸，出现目痛、喉干、咳嗽吐痰、身热心烦、头痛耳鸣等各种症状蜂拥而起。看这些症候，绝对是火有余的表现，谁知其实是水不足呢？如果错认为白虎汤证而大量使用寒凉的石膏、知母，肆意多用，一入口便会立即死亡。如果不明白这个道理而使用我的攻真汤，祸患也是一样的。那么该怎么治疗呢？应当使用六味地黄汤加入麦冬、五味子，大肆吞服饮水。水充足了，火自然回归本源。盖龙雷之火原本喜欢水，寒凉的味道也是水，为什么以水投水，龙雷之火却更加飞越呢？这是什么缘故呢？这是因为所用的不是真水，所以龙雷之火越发猖獗。六味地黄汤是至阴之水，用阳水来制约阴火，阴火就不能潜伏；用阴水来制约阴火，阴火自然能归原。如果在药中加入少许肉桂，尤为适宜。因为龙雷之火不仅喜欢阴水的相助，更喜欢阴火的相宜。肉桂也是至阴之火，以火引火原本是妙法，再加上至阴的水中引火，火自然会退藏消归于无。这种议论确实令人震惊，但其中实在有至理存在，并非故意故作幽深奇特之论。能懂得这种治法的医生，医术自然神异，治病又有什么棘手难办的呢？
攻真散
黄连（三钱） 栀子（五钱） 柴胡（二钱） 白芍（一两） 茯苓（五钱） 枳壳（一钱） 浓朴（一钱） 甘草（一钱） 天花粉（五钱） 黄芩（一钱） 水煎服
The authenticity and falsity of Fire Syndromes (Huo Zheng) must be distinguished. A Fire Syndrome is fundamentally a disease of excessive heat. When heat reaches its extreme, the fire's momentum resembles the scorching sun, naturally manifesting symptoms of heat and fire. How can there be a distinction between authenticity and falsity?
It is unknown that Fire originally exists in two forms: True Fire (Zhen Huo) and False Fire (Jia Huo). True Fire constitutes an Excess Pathogen (Shi Xie), while False Fire constitutes Ministerial Fire (Xiang Huo). However, True Fire often presents with Fake Cold (Jia Han) to deceive people, and False Fire often presents with Real Heat (Zhen Re) to confuse the world. If medication is administered incorrectly, death can occur within moments.
How does True Fire present as Fake Cold? The body is hot, yet the hands and feet are cold; the pulse is unexpectedly deep and fine; there is thirst, mental restlessness and vexation (Ao Nao), and the body trembles. This is a Yang Syndrome resembling Yin, where extreme heat feigns ice-coldness. The treatment method should employ majorly cold-natured herbs to clear heat and resolve the condition. The formula used is Gongzhen San (Attack True Powder). After one dose, the coldness of the hands and feet will transform into heat akin to fire. Do not hesitate regarding the extensive use of cold-natured herbs. This is because the disease is of extreme heat, using fake cold to deceive; I use true cold-natured medicine to attack its most solidified false appearance. Once the false appearance is broken, the true state is revealed, so the cold hands and feet turn to heat. Administer half the dose of this decoction subsequently, and all residual heat in the chest, abdomen, and whole body will be eliminated. If one suspects the previous prescription was too harsh and switches to another formula, the heat may transform into cold, leading to critical danger. How can one ignore this and be misled again? Physicians must pay close attention to such diseases; thus, the power over life and death lies not with Yama (the King of Hell) but in the hands of the physician.
How does False Fire present with Real Heat phenomena? This arises from the depletion of Kidney Water (Shen Shui), causing Kidney Fire to lose control and ascend, generating heat. Kidney Fire is Deficient Fire (Xu Huo) of the Shaoyin (Lesser Yin) channel. When Kidney Fire is supported by Kidney Water, it becomes True Fire; when detached from the restraint of Kidney Water, it becomes Deficient Fire. "Mutual restraint" implies that when they suddenly separate, the fire loses nourishment and erupts from the earth like thunder, splitting wood, burning forests, and shaking the heavens—this is Dragon-Thunder Fire (Long Lei Zhi Huo). The Fire of the Shaoyin in the human body is similar; once ignited, it cannot be restrained, spreading from the Spleen to the Stomach, from the Heart to the Lung, burning every organ and harming every skin area. How can the throat and the heart region restrain it? Naturally, sparks fly, resulting in symptoms such as painful eyes, dry throat, coughing with phlegm, fever, mental restlessness, headache, and tinnitus arising simultaneously. Observing these symptoms, it appears absolutely as an excess of Fire, who would guess it is actually a deficiency of Water? If mistakenly diagnosed as a Baihu Tang (White Tiger Decoction) syndrome and large doses of cold-natured Shi Gao (Gypsum Fibrosum) and Zhi Mu (Anemarrhenae Rhizoma) are used indiscriminately, death will follow immediately upon ingestion. If one uses my Gongzhen San without understanding the cause, the disaster is the same. So, how should it be treated? One should use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Mai Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Fructus), encouraging copious water intake. When water is sufficient, Fire returns to its origin. Dragon-Thunder Fire naturally favors Water. Cold-natured flavors are also Water. Why does pouring water on water make Dragon-Thunder Fire fly higher? The reason is that the water used is not True Water, causing Dragon-Thunder Fire to become even more rampant. Liuwei Dihuang Wan is Water of Extreme Yin. Using Yang Water to restrain Yin Fire prevents Yin Fire from hiding; using Yin Water to restrain Yin Fire allows Yin Fire to return to its source. Adding a small amount of Rou Gui (Cinnamomi Cortex) to the prescription is particularly appropriate. Dragon-Thunder Fire not only favors the assistance of Yin Water but also the suitability of Yin Fire. Rou Gui is Fire of Extreme Yin. Using Fire to attract Fire is indeed a wonderful method, and adding it to Water of Extreme Yin to guide Fire causes Fire to retreat, hide, and vanish completely. This discussion is truly startling to the world, yet it contains profound truth, not merely intended to be obscure or bizarre. A physician who understands such treatments possesses divine medical skills, making difficult diseases manageable.
Gongzhen San (Attack True Powder)
Huang Lian (Coptidis Rhizoma) (3 qian)
Zhi Zi (Gardeniae Fructus) (5 qian)
Chai Hu (Bupleuri Radix) (2 qian)
Bai Shao (Paeoniae Radix Alba) (1 liang)
Fu Ling (Poria) (5 qian)
Zhi Ke (Aurantii Fructus Immaturus) (1 qian)
Nong Po (Magnoliae Officinalis Cortex) (1 qian)
Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 qian)
Tian Hua Fen (Trichosanthis Radix) (5 qian)
Huang Qin (Scutellariae Radix) (1 qian)
Decoct in water and take orally.