Formulas · Text · Donguibogam 東醫寶鑑

Fire

Hwa

한글 화 · Pinyin Huo

Sovereign fire and ministerial fire — and a method for locating heat by the depth at which the hand feels it

火

The longest chapter in the volume and the one that most rewards careful reading. Of the five phases each has one nature, it opens, and fire alone has two: sovereign fire, which is the fire of man, and ministerial fire, which is the fire of heaven. What follows is the most sustained treatment of heat in the book. Zhu Zhenheng's argument sits at its centre — ministerial fire rises easily, and when the five natures are fanned by desire it stirs recklessly, boiling the true yin away. From that come the sections a practitioner actually uses. There is a way to tell which organ is hot by pressing: light at the skin is the lung, a little deeper the heart, midway the spleen, deeper again the liver, and at the bone the kidney. There is a way to tell repletion heat from vacuity heat by whether the patient can eat. There is heat by day and heat by night, and the two are treated in different aspects. Steaming bone gets the longest section in the chapter, with twenty-eight passages and its own list of signs that cannot be treated; and the section on what organs to drain runs to twenty-eight more. The chapter closes with methods for subduing fire, forty-four simples and the acupuncture points.

5.1 Fire Is of Two Kinds, Sovereign and Ministerial 火有君相之二

5.1.1

Source원문

五行各一其性, 惟火有二, 曰君火, 人火也. 曰相火, 天火也. 火內陰而外陽, 主乎動者也. 以名而言, 形質相生, 配於五行, 故謂之君. 以位而言, 生於虛無, 守位稟命, 因其動而可見, 故謂之相. 天主生物, 故恒於動, 人有此生, 亦恒於動. 其所以恒於動者, 皆相火之所爲也. 《東垣》

Translation영역

Of the five phases each has one nature, and fire alone has two: sovereign fire, which is the fire of man, and ministerial fire, which is the fire of heaven. Fire is yin within and yang without, and it governs movement. Speaking by name, form and substance engender one another and are matched to the five phases, and so it is called sovereign. Speaking by position, it arises from the void, keeps its station and receives the mandate, and is seen only by its movement, and so it is called ministerial. Heaven governs the engendering of things and is therefore constant in movement; a person having this life is likewise constant in movement — and what makes them constant in movement is all the work of the ministerial fire.

Clinical note임상 주석

The chapter's first claim and the one everything else rests on. Sovereign fire is the fire that belongs to the five-phase scheme and sits in the heart; ministerial fire arises from the void, has no fixed substance and is known only by what it does. 恒於動 — constant in movement — is the key. Ministerial fire is not a pathology but the power that keeps a living body moving, which is why 5.2 can call fire the thief of the origin qi without contradiction. The same force that sustains life consumes it.

Dongwon 東垣

5.1.2

Source원문

君火者, 乃眞心小腸之氣所爲也. 相火者, 乃心包絡三焦之氣所爲也. 《丹心》

Translation영역

Sovereign fire is the work of the qi of the true heart and the small intestine. Ministerial fire is the work of the qi of the pericardium and the three burners.

Clinical note임상 주석

The anatomical assignment, and it is what makes the distinction usable. Sovereign fire belongs to the heart and small intestine; ministerial fire to the pericardium and three burners — the two channel pairs that have no organ of their own.

Dansim 丹心

5.2 Fire Is the Thief of the Origin Qi 火爲元氣之賊

5.2.1

Source원문

火能消物. 凡爍金, 虧土, 旺木, 涸水者皆火也. 《丹心》

Translation영역

Fire can consume things. Whatever melts metal, wastes earth, makes wood exuberant or dries up water is all fire.

Dansim 丹心

5.2.2

Source원문

火之爲病, 其害甚大, 其變甚速, 其勢甚彰, 其死甚暴. 人身有二火. 曰君火, 猶人火也. 曰相火, 猶龍火也. 在氣交之中, 多動少靜, 凡動皆屬火化, 動之極也, 病則死矣. 《河間》

Translation영역

As a disease, fire's harm is very great, its change very swift, its force very manifest, and its death very sudden. The human body has two fires: sovereign fire, which is like the fire of man, and ministerial fire, which is like the fire of the dragon. Standing in the exchange of qi, they move much and rest little; all movement belongs to the transformation of fire, and where the movement reaches its extreme, the disease ends in death.

Clinical note임상 주석

龍火, dragon fire, is the tradition's name for a fire that water does not quench — it rises from the deep and burns in the wet. The image is used throughout for ministerial fire out of its station, and the Fire chapter's treatment sections turn on it: such a fire is led back down rather than extinguished.

Hagan 河間

5.2.3

Source원문

相火易起, 五性厥陽之火相扇, 則妄動矣. 火起於妄, 變化莫測, 無時不有, 煎熬眞陰, 陰虛則病, 陰絶則死. 《東垣》

Translation영역

Ministerial fire rises easily; when the reverting yang fire of the five natures fans it, it stirs recklessly. Fire arising from recklessness changes beyond reckoning and is never absent; it boils and parches the true yin, and where the yin is vacuous there is disease, where the yin is cut off there is death.

Clinical note임상 주석

The passage Danxi's whole system is built on, and the mechanism it states — 煎熬眞陰, boiling and parching the true yin — is why he held that his contemporaries were yin-deficient and should not be treated as though they were yang-deficient. The Internal Damage chapter records his complaint about meat at 1.2.2 from the same premise.

Dongwon 東垣

5.2.4

Source원문

又有藏府厥陽之火, 根於五志之內, 六慾七情激之, 其火隨起. 大怒則火起於肝, 醉飽則火起於胃, 房勞則火起於腎, 悲哀則火起於肺, 心爲君主, 自焚則死矣. 《河間》

Translation영역

There is also the reverting yang fire of the viscera and bowels, rooted within the five minds; the six desires and seven affects stir it, and the fire rises accordingly. Great anger makes fire rise from the liver; drunkenness and repletion make fire rise from the stomach; sexual taxation makes fire rise from the kidney; grief and sorrow make fire rise from the lung. The heart is the sovereign, and where it burns itself there is death.

Clinical note임상 주석

Four causes with four organs, and they can be checked against a history: anger and the liver, drink and the stomach, sex and the kidney, grief and the lung. Each of those chapters treats the same association from its own side — the Internal Damage chapter at 1.10.2 for drink, the Uterus chapter at 13.15.2 for grief. 心爲君主, 自焚則死 is the exception: the heart has no organ above it to take the fire, so when it burns there is nowhere for the heat to go.

Hagan 河間

5.2.5

Source원문

火者, 元氣ㆍ穀氣ㆍ眞氣之賊也. 《東垣》

Translation영역

Fire is the thief of the origin qi, the grain qi and the true qi.

Dongwon 東垣

5.3 Pulse Method 脉法

5.3.1

Source원문

火脉洪數, 虛則浮. 《脉訣》

Translation영역

The fire pulse is surging and rapid; where there is vacuity it is floating.

Maekgyeol 脉訣

5.3.2

Source원문

脉實數者有實熱. 《丹心》

Translation영역

Where the pulse is replete and rapid there is repletion heat.

Dansim 丹心

5.3.3

Source원문

脉浮而洪數爲虛火.

Translation영역

A pulse floating, surging and rapid is vacuity fire.

Jeongjeon 正傳

5.3.4

Source원문

脉沈而實大爲實火.

Translation영역

A pulse sunken, replete and large is repletion fire.

Jeongjeon 正傳

5.3.5

Source원문

洪數見於左寸爲心火.

Translation영역

Surging and rapid at the left inch is heart fire.

Jeongjeon 正傳

5.3.6

Source원문

見於右寸爲肺火.

Translation영역

At the right inch it is lung fire.

Jeongjeon 正傳

5.3.7

Source원문

見於左關爲肝火.

Translation영역

At the left bar it is liver fire.

Jeongjeon 正傳

5.3.8

Source원문

見於右關爲脾火.

Translation영역

At the right bar it is spleen fire.

Jeongjeon 正傳

5.3.9

Source원문

見於兩尺爲腎經命門之火.

Translation영역

At both cubits it is the fire of the kidney channel and the gate of life.

Jeongjeon 正傳

5.3.10

Source원문

男子兩尺洪大者, 必遺精, 陰火盛也. 《正傳》

Translation영역

In a man whose cubit pulses on both sides are surging and large, there must be seminal emission — the yin fire is exuberant.

Jeongjeon 正傳

5.3.11

Source원문

骨蒸勞熱, 脉數而虛. 熱而澁小, 必損其軀, 加汗加咳, 非藥可治. 《脉訣》

Translation영역

In steaming bone with taxation heat the pulse is rapid and vacuous. Hot with a rough small pulse, the body must be detrimented; add sweating and add cough, and no medicine can treat it.

Clinical note임상 주석

Fever, night sweats and cough together in a wasting patient is pulmonary tuberculosis, and the chapter says plainly that at this stage medicine cannot reach it. The long section at 5.11 gives the formulas for the earlier stages, and 5.11.1 lists the signs past which they are not attempted. **Tuberculosis requires modern antibiotic treatment.**

Maekgyeol 脉訣

5.3.12

Source원문

虛火浮數, 實火沈大, 隨其所見, 細數爲害. 《回春》

Translation영역

Vacuity fire is floating and rapid; repletion fire is sunken and large. Whatever appears, a fine and rapid pulse is the harmful one.

Clinical note임상 주석

Twelve lines and eight of them locate fire by position, which is the section's practical content: left inch for the heart, right inch for the lung, left bar for the liver, right bar for the spleen, both cubits for the kidney. The repletion-vacuity rule runs against intuition — vacuity fire floats and repletion fire sinks — because a fire with substance behind it drives the pulse down into the flesh while an empty one flares at the surface.

Hoechun 回春

5.4 Distinguishing the Heat Patterns of the Five Viscera 辨五臟熱證

5.4.1

Source원문

身熱有五, 而其狀各異. 《東垣》

Translation영역

Heat of the body is of five kinds, and their forms differ from one another.

Clinical note임상 주석

The heading for the five subsections that follow, and what makes them a single method is the hand. Each organ's heat is felt at a different depth under the same pressing finger, so one manoeuvre distinguishes five conditions.

Dongwon 東垣

5.4.1 Liver Heat 肝熱

5.4.1.1

Source원문

肝熱者, 按之肌肉之下至骨之上, 乃肝之熱也. 寅卯間尤甚. 其證四肢滿悶, 便難, 轉筋, 多怒多驚, 筋痿不能起於床. 宜瀉靑丸方見五藏ㆍ柴胡飮子. 《東垣》

Translation영역

In liver heat, pressing below the flesh and above the bone, this is the heat of the liver. It is worst in the in and myo hours. Its pattern is the four limbs full and oppressed, difficult stool, cramping of the sinews, much anger and much fright, and the sinews wilting so that the patient cannot rise from bed. Drain the Green Pill formula in the Five Viscera chapter and Bupleurum Drink are appropriate.

Clinical note임상 주석

Each of the five subsections gives a depth, an hour and a set of signs. Here the depth is between flesh and bone, and the hour is before dawn — the liver's own time in the daily cycle.

Dongwon 東垣

5.4.2 Heart Heat 心熱

5.4.2.1

Source원문

心熱者, 微按至皮膚之下肌肉之上, 輕手乃得. 微按至皮毛之下則熱, 少加力按之則全不熱. 是熱在血脉也. 日中太甚, 其證煩心心痛, 掌中熱而啘. 宜導赤散方見五藏ㆍ黃連瀉心湯方見神部. 《東垣》

Translation영역

In heart heat, pressing lightly to below the skin and above the flesh, it is got with a light hand. Pressing lightly to below the skin and hair there is heat, and adding a little force there is no heat at all. This is heat in the blood vessels. It is at its worst at midday, and its pattern is vexation of the heart with heart pain, heat in the palms, and retching. Guide Out the Red Powder formula in the Five Viscera chapter and Coptis Drain the Heart Decoction formula in the Spirit chapter are appropriate.

Clinical note임상 주석

少加力按之則全不熱 — adding a little force, there is no heat at all — is the discriminating test. Heart heat is found only at the lightest pressure and disappears under a firmer hand, which is the opposite of kidney heat at 5.4.5.

Dongwon 東垣

5.4.3 Spleen Heat 脾熱

5.4.3.1

Source원문

脾熱者, 輕手捫之不熱, 重按至筋骨亦不熱, 不輕不重在輕手重手之間. 此熱在肌肉, 遇夜尤甚. 其證必怠惰嗜臥, 四肢不收, 無氣以動. 實熱, 則用瀉黃散方見五藏ㆍ調胃承氣湯方見寒門, 虛熱, 則用人參黃芪散方見虛勞ㆍ補中益氣湯方見內傷. 《東垣》

Translation영역

In spleen heat, stroking with a light hand there is no heat, and pressing heavily to the sinews and bone there is likewise no heat; it lies neither light nor heavy, between the light hand and the heavy hand. This heat is in the flesh and is worst at night. Its pattern is necessarily indolence and a liking for lying down, the four limbs not gathering themselves, and no qi to move with. For repletion heat use Drain the Yellow Powder formula in the Five Viscera chapter and Regulate the Stomach and Order the Qi Decoction formula in the Cold Damage chapter; for vacuity heat use Ginseng and Astragalus Powder formula in the Vacuity Taxation chapter and Supplement the Centre and Boost the Qi Decoction formula in the Internal Damage chapter.

Clinical note임상 주석

The only one of the five defined by absence at both ends: no heat light, no heat deep, heat in between. That makes it the hardest to find and the easiest to miss. It is also the only one split into repletion and vacuity with separate formularies, which reflects Dongwon's own concern — spleen heat from depletion is the condition his whole method was built for.

Dongwon 東垣

5.4.4 Lung Heat 肺熱

5.4.4.1

Source원문

肺熱者, 輕手乃得, 微按全無, 瞥瞥然見於皮毛上, 日西尤甚, 乃皮毛之熱也. 其證必見喘咳, 洒淅寒熱. 輕者, 宜瀉白散方見五藏ㆍ人參地骨皮散, 重者, 白虎湯方見寒門ㆍ涼膈散. 《東垣》

Translation영역

In lung heat it is got with a light hand and is wholly absent under the slightest pressure, appearing fleetingly on the skin and hair; it is worst as the sun goes west, and it is the heat of the skin and hair. Its pattern necessarily shows panting and cough, with shivering chills and fever. In light cases Drain the White Powder formula in the Five Viscera chapter and Ginseng and Lycium Root Bark Powder are appropriate; in severe cases White Tiger Decoction formula in the Cold Damage chapter and Cool the Diaphragm Powder.

Clinical note임상 주석

The shallowest of the five — 瞥瞥然, fleetingly, is a heat that is gone before the finger settles. Worst at sunset, which is the lung's hour.

Dongwon 東垣

5.4.5 Kidney Heat 腎熱

5.4.5.1

Source원문

腎熱者, 輕按之不熱, 重按至骨, 其熱蒸手如火如灸. 其證骨蘇蘇然如蟲蝕其骨, 困熱不任, 亦不能起於床. 滋腎丸方見小便ㆍ六味地黃丸方見虛勞主之. 《東垣》

Translation영역

In kidney heat, pressing lightly there is no heat, but pressing heavily to the bone the heat steams the hand as though from a fire or a moxa. Its pattern is the bones feeling loose and crumbling as though worms were eating them, fatigue and heat that cannot be borne, and likewise an inability to rise from bed. Enrich the Kidney Pill formula in the Urine chapter and Six Flavours Rehmannia Pill formula in the Vacuity Taxation chapter govern it.

Clinical note임상 주석

骨蘇蘇然如蟲蝕其骨 — the bones feeling loose and crumbling as though worms were eating them — is the most vivid sensation described in the chapter, and it is what patients with bone pain of deep origin actually report. The five together make a usable scheme, and it is worth setting out as one: skin for the lung, just below the skin for the heart, mid-flesh for the spleen, below the flesh for the liver, at the bone for the kidney. The hours run with them — sunset, midday, night, before dawn — and each has its own formulary.

Dongwon 東垣

5.5 Distinguishing the Depth of Heat by Pressing with the Hand 手按辨熱深淺

5.5.1

Source원문

以手捫摸有三法. 輕手捫之則熱, 重按之則不熱, 是熱在皮毛血脉也. 《東垣》

Translation영역

In stroking and feeling with the hand there are three methods. Stroking with a light hand there is heat, and pressing heavily there is none — this is heat in the skin, hair and blood vessels.

Dongwon 東垣

5.5.2

Source원문

重按至筋骨之分, 則熱蒸手極甚, 輕摸之則不熱, 是熱在筋骨間也. 《東垣》

Translation영역

Pressing heavily to the division of the sinews and bone, the heat steams the hand most severely, and stroking lightly there is no heat — this is heat between the sinews and bone.

Dongwon 東垣

5.5.3

Source원문

輕手捫之不熱, 重手按之亦不熱, 不輕不重按之則熱, 是熱在筋骨之上, 皮毛血脉之下, 乃熱在肌肉也. 以三黃丸通治之. 《東垣》

Translation영역

Stroking with a light hand there is no heat, pressing with a heavy hand likewise no heat, and pressing neither light nor heavy there is heat — this is heat above the sinews and bone and below the skin, hair and blood vessels, that is, heat in the flesh. Three Yellows Pill treats it generally.

Dongwon 東垣

5.5.4

Source원문

輕手按之熱甚, 重手按之不甚熱, 此熱在肌表, 宜淸之. 重手按之熱甚而烙手, 輕手按之不覺熱, 此熱在肌肉之內, 宜發之. 《正傳》

Translation영역

Pressing with a light hand the heat is severe and pressing with a heavy hand it is not — this heat is at the surface of the flesh, and clearing is appropriate. Pressing with a heavy hand the heat is severe and sears the hand, and pressing with a light hand no heat is felt — this heat is within the flesh, and effusing is appropriate.

Clinical note임상 주석

The five-organ scheme of 5.4 reduced to three depths and then to a rule of treatment: shallow heat is cleared, deep heat is effused. That last pairing is counterintuitive and worth keeping. Heat at the surface is drained downward with cold medicinals; heat locked deep is driven outward, because clearing it where it sits would only bind it further.

Jeongjeon 正傳

5.6 Examining the Regions of Visceral and Bowel Heat 審臟腑熱之部分

5.6.1

Source원문

內經曰, 心熱病者, 顔先赤顔卽額也. 脾熱病者, 鼻先赤. 肝熱病者, 左頰先赤. 肺熱病者, 右頰先赤. 腎熱病者, 頤先赤.

Translation영역

The Neijing says: in heart heat disease the forehead reddens first an here means the forehead; in spleen heat disease the nose reddens first; in liver heat disease the left cheek reddens first; in lung heat disease the right cheek reddens first; in kidney heat disease the chin reddens first.

Clinical note임상 주석

Five regions of the face, one for each organ, and the assignment follows the five-phase directions: liver to the left because wood rises in the east, lung to the right because metal belongs to the west. Whether or not the correspondences hold, the habit they encode is sound — looking at where the colour sits rather than only noting that the face is red.

Naegyeong 內經

5.6.2

Source원문

心肺居胸背, 心熱則胸熱, 肺熱則背熱.

Translation영역

The heart and lung lie at the chest and back; heart heat brings heat in the chest, lung heat brings heat in the back.

Gangmok 綱目

5.6.3

Source원문

肝膽居脇, 肝膽熱則當脇亦熱.

Translation영역

The liver and gallbladder lie at the ribside; where the liver and gallbladder are hot, the ribside is hot to match.

Gangmok 綱目

5.6.4

Source원문

腎居腰, 腎熱則當腰亦熱.

Translation영역

The kidney lies at the lumbus; where the kidney is hot, the lumbus is hot to match.

Gangmok 綱目

5.6.5

Source원문

胃居臍上, 故胃熱則臍以上熱.

Translation영역

The stomach lies above the navel, and so stomach heat brings heat above the navel.

Gangmok 綱目

5.6.6

Source원문

腸居臍下, 故腸熱則臍以下熱. 《綱目》

Translation영역

The intestines lie below the navel, and so intestinal heat brings heat below the navel.

Clinical note임상 주석

The second half of the section drops the five-phase scheme entirely and reads by position: the organ is hot where the organ is. Chest for the heart, back for the lung, ribside for the liver, lumbus for the kidney, above and below the navel for stomach and intestines. Taken with 5.4 and 5.5, the chapter now has three independent ways to locate heat — by depth under the finger, by the hour it worsens, and by where on the body it is felt. A practitioner who agrees on two of the three has a reading.

Gangmok 綱目

5.7 Fire Heat Has Repletion and Vacuity 火熱有實有虛

5.7.1

Source원문

能食而熱, 口舌乾燥, 大便難者, 實熱也. 以辛苦大寒之劑下之, 瀉熱補陰. 脉洪盛而有力者, 是已. 《東垣》

Translation영역

Where the patient can eat and is hot, the mouth and tongue dry and the stool difficult, this is repletion heat. Purge it with acrid, bitter and greatly cold preparations, draining the heat and supplementing the yin. The pulse surging, exuberant and forceful — that is it.

Dongwon 東垣

5.7.2

Source원문

不能食而熱, 自汗氣短者, 虛熱也. 以甘寒之劑, 瀉熱補氣, 脉虛弱無力者, 是已. 《東垣》

Translation영역

Where the patient cannot eat and is hot, with spontaneous sweating and shortness of breath, this is vacuity heat. Drain the heat and supplement the qi with sweet and cold preparations. The pulse vacuous, weak and without strength — that is it.

Clinical note임상 주석

One question separates the two: can the patient eat? The same test the Internal Damage chapter uses at 1.4.5 and the Wasting Thirst chapter at 4.4.1. The treatments diverge completely from that answer — bitter cold purging on one side, sweet cold supplementing on the other — so getting it wrong is not a matter of degree.

Dongwon 東垣

5.7.3

Source원문

五藏陰也, 所主皆有形, 骨肉筋血皮毛是也. 此五藏皆陰足, 陰足而熱反勝之, 是爲實熱. 若骨痿, 肉爍, 筋緩, 血枯, 皮聚, 毛落者, 陰不足而有熱疾, 是虛熱也. 《海藏》

Translation영역

The five viscera are yin, and what they govern all has form — bone, flesh, sinew, blood, skin and hair. Where these five viscera all have yin sufficient, and the heat nonetheless prevails over it, this is repletion heat. But where the bones wilt, the flesh melts away, the sinews slacken, the blood withers, the skin gathers and the hair falls, the yin is insufficient and there is a heat disease — this is vacuity heat.

Clinical note임상 주석

Six signs of substance lost — bone, flesh, sinew, blood, skin, hair — and any of them makes the heat a vacuity heat whatever else the picture shows. This is the visible test that matches the one-question test above.

Haejang 海藏

5.7.4

Source원문

脉實數者, 實熱也. 《丹心》

Translation영역

Where the pulse is replete and rapid, it is repletion heat.

Dansim 丹心

5.7.5

Source원문

實火, 內外皆熱, 口渴, 日夜潮熱, 大小便閉. 熱在表, 宜羌活冲和湯方見寒門, 熱入裏, 宜調胃承氣湯方見寒門, 燥渴者, 宜白虎湯方見寒門.

Translation영역

In repletion fire there is heat within and without, thirst, tidal fever by day and night, and stool and urine blocked. Where the heat is in the exterior, Notopterygium Harmonize the Centre Decoction formula in the Cold Damage chapter is appropriate; where the heat has entered the interior, Regulate the Stomach and Order the Qi Decoction formula in the Cold Damage chapter; where there is dryness and thirst, White Tiger Decoction formula in the Cold Damage chapter.

Immun 入門

5.7.6

Source원문

虛火, 潮熱有間, 口燥不渴, 宜人參地骨皮散方見上, 或補中益氣湯, 加芍藥ㆍ黃柏. 《入門》

Translation영역

In vacuity fire the tidal fever comes with intervals and the mouth is dry without thirst. Ginseng and Lycium Root Bark Powder formula above is appropriate, or Supplement the Centre and Boost the Qi Decoction with peony and phellodendron added.

Clinical note임상 주석

口燥不渴 — the mouth dry without thirst — is the single sign that most reliably marks vacuity fire. A patient with real heat drinks; one whose mouth is dry from want of fluid does not want water in quantity. 潮熱有間, tidal fever with intervals, is the other half: heat that comes and goes rather than burning steadily.

Immun 入門

5.7.7

Source원문

實火可瀉, 黃連解毒湯之類. 虛火可補, 參ㆍ朮ㆍ(生)甘草之類. 《丹心》

Translation영역

Repletion fire may be drained — Coptis Resolve Toxin Decoction and its kind. Vacuity fire may be supplemented — ginseng, atractylodes, raw licorice and their kind.

Dansim 丹心

5.8 Heat Divides into Day and Night 熱有晝夜之分

5.8.1

Source원문

晝熱, 則行陽二十五度, 宜柴胡飮子方見上. 夜熱, 則行陰二十五度, 宜四順淸涼飮. 《海藏》

Translation영역

Heat by day travels the yang twenty-five circuits, and Bupleurum Drink formula above is appropriate. Heat by night travels the yin twenty-five circuits, and Four Compliances Clear and Cool Drink is appropriate.

Clinical note임상 주석

The defence qi makes twenty-five circuits of the yang by day and twenty-five of the yin by night, and heat is read as travelling with it. Fever that keeps to daylight is in the qi aspect; fever that comes after dark has gone deeper.

Haejang 海藏

5.8.2

Source원문

晝則發熱, 夜則安靜, 是陽氣自旺於陽分也. 晝則安靜, 夜則發熱煩躁, 是陽氣下陷入陰中也, 名曰熱入血室. 晝夜俱發熱煩躁, 是重陽無陰也, 當亟瀉其陽, 峻補其陰. 《東垣》

Translation영역

Where fever breaks out by day and there is quiet at night, the yang qi is exuberant of itself in the yang division. Where there is quiet by day and at night fever with vexed agitation, the yang qi has sunk down and entered among the yin — this is called heat entering the blood chamber. Where fever with vexed agitation breaks out both day and night, this is doubled yang without yin; the yang must be drained urgently and the yin supplemented forcefully.

Clinical note임상 주석

Three patterns from one question — when does the fever come? Day only, night only, or both. The third is the grave one, and the instruction for it is unusually urgent: 亟瀉其陽, 峻補其陰, drain the yang urgently and supplement the yin forcefully. 熱入血室 is borrowed here from the Shanghan tradition, where it describes heat entering while the menses are open; the Uterus chapter treats that sense at 13.21. Dongwon uses it more broadly for heat that has sunk into the blood.

Dongwon 東垣

5.8.3

Source원문

夜熱, 是陽陷入陰中也. 宜擧其熱, 使上行陽分, 宜升陽散火湯. 《綱目》

Translation영역

Heat at night is the yang fallen and entered among the yin. Its heat should be raised so that it travels upward into the yang division, and Raise the Yang and Scatter Fire Decoction is appropriate.

Gangmok 綱目

5.8.4

Source원문

晝則明了, 夜則譫語, 熱入血室也. 宜瀉血湯ㆍ退熱湯.

Translation영역

Where the patient is clear-headed by day and delirious at night, heat has entered the blood chamber. Drain the Blood Decoction and Abate the Heat Decoction are appropriate.

Clinical note임상 주석

The diurnal pattern that the Uterus chapter gives at 13.21 as the classic sign — lucid by day, delirious after dark. There it is read as heat entering while the menses are open; here the chapter generalizes it. **Fever with confusion requires urgent medical assessment; sepsis and encephalitis must be excluded.**

Dongwon 東垣

5.8.5

Source원문

夜發多者, 是邪氣下陷之深, 當從熱入血室而論之, 宜瀉血湯ㆍ退熱湯. 《東垣》

Translation영역

Where the fever breaks out mostly at night, the evil qi has sunk deep, and it should be discussed under heat entering the blood chamber; Drain the Blood Decoction and Abate the Heat Decoction are appropriate.

Dongwon 東垣

5.8.6

Source원문

血虛而熱, 午後陽中之陰虛, 宜四物湯, 加知母ㆍ黃柏之類. 《丹心》

Translation영역

Where there is heat from blood vacuity, it is the yin within the yang being vacuous in the afternoon; Four Substances Decoction with anemarrhena and phellodendron and their kind added is appropriate.

Dansim 丹心

5.9 Fire Differs in the Upper, Middle and Lower Burners 火有上中下三焦之異

5.9.1

Source원문

熱在上焦者, 因咳爲肺痿. 熱在中焦者, 爲堅謂大便堅也. 熱在下焦者, 爲尿血淋閉. 《仲景》

Translation영역

Where heat is in the upper burner, cough brings on lung wilting. Where heat is in the middle burner, there is hardness meaning hard stool. Where heat is in the lower burner, there is bloody urine with dribbling blockage.

Junggyeong 仲景

5.9.2

Source원문

上焦有熱, 眼目赤腫, 頭項腫痛, 口舌生瘡.

Translation영역

Where the upper burner has heat, the eyes are red and swollen, the head and nape swollen and painful, and sores arise in the mouth and on the tongue.

Seonmyeongnon 宣明

5.9.3

Source원문

中焦有熱, 胸膈煩躁, 飮食不美.

Translation영역

Where the middle burner has heat, the chest and diaphragm are vexed and agitated and food has no savour.

Seonmyeongnon 宣明

5.9.4

Source원문

下焦有熱, 小便赤澁, 大便秘結.

Translation영역

Where the lower burner has heat, the urine is red and rough and the stool is bound.

Seonmyeongnon 宣明

5.9.5

Source원문

五藏俱熱, 乃三焦熱也. 卽生癰癤瘡痍, 及五般痔疾. 《宣明》

Translation영역

Where all five viscera are hot, this is heat of the three burners; it engenders welling abscesses, boils and sores, and the five kinds of haemorrhoid.

Clinical note임상 주석

A third way of locating heat, after depth at 5.5 and region at 5.6. Here it is by burner, and the signs are ordinary enough to be checked at once: eyes and mouth above, appetite and chest in the middle, urine and stool below. The four subsections that follow give a formulary for each, which makes this the chapter's most directly usable scheme.

Seonmyeongnon 宣明

5.9.1 Upper Burner Heat 上焦熱

5.9.1.1

Source원문

宜用涼膈散方見下ㆍ龍腦飮子ㆍ抑靑丸ㆍ淸心湯ㆍ黃芩湯ㆍ淸金丸ㆍ朱砂凉膈丸ㆍ九味淸心元ㆍ黃連淸膈丸ㆍ上淸元ㆍ淸金降火丹ㆍ子芩散ㆍ旣濟解毒湯方見瘟疫ㆍ加減凉膈散.

Translation영역

Cool the Diaphragm Powder formula below, Borneol Drink, Restrain the Green Pill, Clear the Heart Decoction, Scutellaria Decoction, Clear the Metal Pill, Cinnabar Cool the Diaphragm Pill, Nine Ingredients Clear the Heart Pill, Coptis Clear the Diaphragm Pill, Upper Clearing Pill, Clear the Metal and Downbear Fire Elixir, Child Scutellaria Powder, Already Fording Resolve Toxin Decoction formula in the Epidemic chapter and Modified Cool the Diaphragm Powder are used.

Donguibogam · Hwa

5.9.2 Middle Burner Heat 中焦熱

5.9.2.1

Source원문

宜用調胃承氣湯方見寒門ㆍ洗心散ㆍ四順淸涼飮方見上ㆍ當歸龍薈丸方見五藏ㆍ桃仁承氣湯方見寒門ㆍ白朮除濕湯ㆍ旣濟淸神散.

Translation영역

Regulate the Stomach and Order the Qi Decoction formula in the Cold Damage chapter, Wash the Heart Powder, Four Compliances Clear and Cool Drink formula above, Angelica, Gentiana and Aloe Pill formula in the Five Viscera chapter, Peach Kernel Order the Qi Decoction formula in the Cold Damage chapter, White Atractylodes Eliminate Dampness Decoction and Already Fording Clear the Spirit Powder are used.

Donguibogam · Hwa

5.9.3 Lower Burner Heat 下焦熱

5.9.3.1

Source원문

宜用大承氣湯方見寒門ㆍ立效散ㆍ八正散方見小便ㆍ五苓散方見寒門ㆍ防風當歸飮子ㆍ黃柏丸ㆍ回金丸ㆍ佐金丸.

Translation영역

Major Order the Qi Decoction formula in the Cold Damage chapter, Established Effect Powder, Eight Corrections Powder formula in the Urine chapter, Five Ingredients Powder with Poria formula in the Cold Damage chapter, Saposhnikovia and Angelica Drink, Phellodendron Pill, Return the Metal Pill and Assist the Metal Pill are used.

Donguibogam · Hwa

5.9.4 General Treatment of Fire in the Three Burners 通治三焦火

5.9.4.1

Source원문

宜用三黃湯ㆍ三黃元方見下ㆍ三補丸ㆍ加味金花丸ㆍ淸心丸ㆍ大金花丸ㆍ黃連解毒湯方見寒門ㆍ防風通聖散方見風門ㆍ淸火湯.

Translation영역

Three Yellows Decoction, Three Yellows Pill formula below, Three Supplements Pill, Augmented Golden Flower Pill, Clear the Heart Pill, Major Golden Flower Pill, Coptis Resolve Toxin Decoction formula in the Cold Damage chapter, Saposhnikovia Sage-Inspired Powder formula in the Wind chapter and Clear Fire Decoction are used.

Clinical note임상 주석

Thirty-three formulas across the four subsections, and the arrangement is the chapter's most practical contribution: decide which burner is hot, then take the list. The three yellows run through all four — scutellaria above, coptis in the middle, phellodendron below — and the general section simply uses all three together.

Donguibogam · Hwa

5.10 Accumulated Heat 積熱

5.10.1

Source원문

藏府積熱, 頰赤煩渴, 口舌生瘡, 五心煩躁, 便尿秘澁, 或溫壯連滯, 致生瘡癤癰疽. 《得效》

Translation영역

In accumulated heat of the viscera and bowels the cheeks are red with vexing thirst, sores arise in the mouth and on the tongue, the five hearts are vexed and agitated, stool and urine are bound and rough; or a warm strong fever persists and brings on sores, boils and welling abscesses.

Deukhyo 得效

5.10.2

Source원문

欲去積熱, 三黃湯ㆍ三黃元第一藥耳. 凡熱皆出於心, 熱甚則能傷血. 熱出於心, 洗心散方見上所不可闕, 熱能傷血, 四順淸涼飮方見上又不可無也. 若酒後之麪, 飯後之酒, 最易生熱, 又當防於未然. 《直指》

Translation영역

To remove accumulated heat, the Three Yellows Decoction and Three Yellows Pill are the first medicines. All heat issues from the heart, and where the heat is severe it can damage the blood. Heat issuing from the heart, Wash the Heart Powder formula above cannot be dispensed with; heat being able to damage the blood, Four Compliances Clear and Cool Drink formula above likewise cannot be done without. As for wheat food after wine and wine after a meal, these most readily engender heat, and should be guarded against before they arise.

Clinical note임상 주석

酒後之麪, 飯後之酒 — wheat food after wine, wine after a meal. A dietary caution stated as prevention rather than treatment, and the Internal Damage chapter's alcohol sections make the same pairing at 1.11.2.

Jikji 直指

5.10.3

Source원문

積熱, 宜用三黃湯ㆍ三黃元ㆍ加減三黃元方見消渴ㆍ涼膈散ㆍ紫雪ㆍ紅雪通中散ㆍ妙香丸.

Translation영역

For accumulated heat, Three Yellows Decoction, Three Yellows Pill, Modified Three Yellows Pill formula in the Wasting Thirst chapter, Cool the Diaphragm Powder, Purple Snow, Red Snow Free the Centre Powder and Wondrous Fragrance Pill are used.

Donguibogam · Hwa

5.11 Steaming Bone Heat 骨蒸熱

5.11.1

Source원문

蒸病有五. 一曰骨蒸, 其根在腎. 二曰脉蒸, 其根在心. 三曰皮蒸, 其根在肺. 四曰外蒸, 其根在脾. 五曰內蒸, 其根在五藏六府. 蒸病皆因陰氣不足, 血氣不榮, 骨髓枯竭而得之. 腎主骨, 以其先從骨熱, 故曰骨蒸. 《類聚》

Translation영역

Steaming disease is of five kinds. The first is bone steaming, rooted in the kidney; the second is vessel steaming, rooted in the heart; the third is skin steaming, rooted in the lung; the fourth is outer steaming, rooted in the spleen; the fifth is inner steaming, rooted in the five viscera and six bowels. All steaming diseases come of the yin qi being insufficient, the blood and qi not nourishing, and the bone marrow withering and drying up. The kidney governs the bones, and because the heat begins from the bones it is called bone steaming.

Yuchwi 類聚

5.11.2

Source원문

凡人嗜慾無節, 勞傷過度, 眞水枯竭, 陰火上炎, 而發蒸蒸之燥熱, 古方名曰蒸病. 其證咳嗽發熱, 咯血吐痰, 白濁白淫, 遺精盜汗, 精神恍惚, 日漸尫羸, 漸成勞瘵. 《正傳》

Translation영역

Where a person's appetites and desires have no measure and taxation damage passes all bounds, the true water withers and dries up, the yin fire flames upward, and a steaming dryness and heat breaks out — the old formularies call it steaming disease. Its pattern is cough with fever, hawking blood and spitting phlegm, white turbidity and white overflow, seminal emission and night sweating, the spirit confused, and a wasting that grows thinner by the day until it becomes taxation consumption.

Clinical note임상 주석

The clinical picture of pulmonary tuberculosis: cough, fever, haemoptysis, night sweats and progressive wasting. 勞瘵, taxation consumption, is the tradition's name for it, and the Vacuity Taxation chapter treats the same condition from the depletion side. **Tuberculosis requires modern antibiotic treatment. Cough with blood, night sweats and weight loss requires urgent investigation.**

Jeongjeon 正傳

5.11.3

Source원문

肺蒸, 鼻乾.

Translation영역

Lung steaming: the nose dry.

Yuchwi 類聚

5.11.4

Source원문

大腸蒸, 右鼻孔痛.

Translation영역

Large intestine steaming: the right nostril painful.

Yuchwi 類聚

5.11.5

Source원문

皮蒸, 舌白唾血.

Translation영역

Skin steaming: the tongue white, spitting blood.

Yuchwi 類聚

5.11.6

Source원문

膚蒸, 昏昧嗜臥.

Translation영역

Flesh-surface steaming: clouded and dull, with a liking for lying down.

Yuchwi 類聚

5.11.7

Source원문

氣蒸, 鼻乾喘促氣熱.

Translation영역

Qi steaming: the nose dry, panting and hurried, the qi hot.

Yuchwi 類聚

5.11.8

Source원문

心蒸, 舌乾.

Translation영역

Heart steaming: the tongue dry.

Yuchwi 類聚

5.11.9

Source원문

小腸蒸, 下脣焦.

Translation영역

Small intestine steaming: the lower lip parched.

Yuchwi 類聚

5.11.10

Source원문

血蒸, 髮焦.

Translation영역

Blood steaming: the hair parched.

Yuchwi 類聚

5.11.11

Source원문

脉蒸, 唾白浪語, 脉緩急不調.

Translation영역

Vessel steaming: spitting white, wandering speech, the pulse slack and urgent by turns and out of order.

Yuchwi 類聚

5.11.12

Source원문

脾蒸, 脣焦.

Translation영역

Spleen steaming: the lips parched.

Yuchwi 類聚

5.11.13

Source원문

胃蒸, 舌下痛.

Translation영역

Stomach steaming: pain beneath the tongue.

Yuchwi 類聚

5.11.14

Source원문

肉蒸, 食無味而嘔, 煩躁不安.

Translation영역

Flesh steaming: food without savour and retching, vexed agitation without ease.

Yuchwi 類聚

5.11.15

Source원문

肝蒸, 眼黑.

Translation영역

Liver steaming: the eyes darkened.

Yuchwi 類聚

5.11.16

Source원문

膽蒸, 眼白失色.

Translation영역

Gallbladder steaming: the whites of the eyes losing their colour.

Yuchwi 類聚

5.11.17

Source원문

筋蒸, 爪甲焦.

Translation영역

Sinew steaming: the nails parched.

Yuchwi 類聚

5.11.18

Source원문

三焦蒸, 乍熱乍寒.

Translation영역

Three burner steaming: now hot and now cold.

Yuchwi 類聚

5.11.19

Source원문

腎蒸, 兩耳焦.

Translation영역

Kidney steaming: both ears parched.

Yuchwi 類聚

5.11.20

Source원문

膀胱蒸, 右耳焦.

Translation영역

Bladder steaming: the right ear parched.

Yuchwi 類聚

5.11.21

Source원문

腦蒸, 頭眩熱悶.

Translation영역

Brain steaming: the head swimming, hot and oppressed.

Yuchwi 類聚

5.11.22

Source원문

髓蒸, 髓枯骨中熱.

Translation영역

Marrow steaming: the marrow withered, heat within the bones.

Yuchwi 類聚

5.11.23

Source원문

骨蒸, 齒黑腰痛, 足逆冷.

Translation영역

Bone steaming: the teeth blackened, the lumbus painful, the feet reverse-cold.

Yuchwi 類聚

5.11.24

Source원문

臀蒸, 肢細趺腫, 藏府皆熱. 胞蒸, 小便黃赤. 《類聚》

Translation영역

Buttock steaming: the limbs thin and the insteps swollen, the viscera and bowels all hot. Uterus steaming: the urine yellow and red.

Clinical note임상 주석

Twenty-four steamings named in a row, each with one or two signs. The organizing idea is that the same wasting heat shows differently according to where it is rooted, and the sign given for each is where the drying first appears — nose, tongue, lip, hair, nail, ear, tooth. Read as a whole the list describes one disease: progressive drying from the surface inward, with the extremities parching first. That is what chronic fever and wasting look like, and the tradition read the twenty-four as stages and locations rather than as separate illnesses.

Yuchwi 類聚

5.11.25

Source원문

骨蒸發熱, 積病最多. 先服荊蓬煎元方見積聚, 後服淸骨散, 暗合妙理. 《丹心》

Translation영역

In steaming bone with fever, accumulation diseases are the most numerous. First take Schizonepeta and Curcuma Decoct Pill formula in the Accumulations chapter, and afterwards Clear the Bone Powder — this quietly accords with the subtle principle.

Clinical note임상 주석

The order matters: break the accumulation first, clear the bone heat after. Danxi's claim is that steaming bone usually has an accumulation behind it, and clearing the heat while the accumulation stands leaves the cause in place.

Dansim 丹心

5.11.26

Source원문

婦人骨蒸, 四物湯, 加地骨皮ㆍ牡丹皮煎服. 牡丹皮瀉包絡火, 地骨皮瀉腎火.

Translation영역

In steaming bone in a woman, Four Substances Decoction with lycium root bark and moutan bark added, decocted and taken. Moutan bark drains the fire of the pericardium and lycium root bark drains the fire of the kidney.

Clinical note임상 주석

The pairing is worth keeping and the reason is given: moutan bark for the pericardium, lycium root bark for the kidney. Both clear heat from the blood aspect rather than from the qi, which is why they go into a blood formula.

Dansim 丹心

5.11.27

Source원문

骨蒸, 用柴前梅連散ㆍ人參淸肌散. 《丹心》

Translation영역

For steaming bone, Bupleurum, Peucedanum, Mume and Coptis Powder and Ginseng Clear the Flesh Powder are used.

Dansim 丹心

5.11.28

Source원문

氣血虛甚, 發熱成勞, 補天丸, 加骨蒸藥佐之, 知母ㆍ黃柏ㆍ地骨皮ㆍ麥門冬ㆍ秦芃ㆍ靑蒿ㆍ鱉甲ㆍ石膏ㆍ竹葉ㆍ烏梅之類, 是也. 《正傳》

Translation영역

Where qi and blood are severely vacuous and the fever has become taxation, Supplement Heaven Pill with steaming bone medicines added as assistants — anemarrhena, phellodendron, lycium root bark, ophiopogon, large gentian, sweet wormwood, turtle carapace, gypsum, bamboo leaf and mume and their kind.

Clinical note임상 주석

The ten medicinals listed here are the chapter's standing group for steaming bone, and they recur across its formulas. Sweet wormwood and turtle carapace are the pair most specific to it; both clear heat from the bone and blood rather than from the surface.

Jeongjeon 正傳

5.11.1 Signs in Steaming Bone That Cannot Be Treated 骨蒸不治證

5.11.1.1

Source원문

骨蒸之極, 聲嗄, 咽痛, 面黧, 脉躁, 直視, 汗出如珠, 喘乏氣促, 皮焦, 脣反, 皆爲不治之證. 《玄珠》

Translation영역

In steaming bone at its extreme — the voice hoarse, the throat painful, the face darkened, the pulse agitated, the gaze fixed, sweat standing out like beads, panting and exhausted with hurried breath, the skin parched, the lips drawn back — all are signs that cannot be treated.

Clinical note임상 주석

Nine signs, and together they describe the end of advanced tuberculosis: hoarseness from laryngeal involvement, fixed gaze, beaded sweat, air hunger, the lips retracted over the teeth. 汗出如珠 — sweat standing out like beads — is used across the tradition for the sweat of dying, and it appears in the Distension and Oedema chapters in the same position.

Hyeonju 玄珠

5.11.1.2

Source원문

其或骨間有熱, 以至四肢緩弱不擧, 此則骨痿. 欲斯疾之有瘳也, 艱哉. 《直指》

Translation영역

Where there is heat between the bones reaching the point that the four limbs are slack and weak and will not lift, this is bone wilting. To wish for a cure of this disease — how hard it is.

Jikji 直指

5.12 Heat of the Five Hearts 五心熱

5.12.1

Source원문

五心煩熱者, 是火鬱於地中也. 四肢者, 脾土也. 心火下陷於脾土之中, 鬱而不得伸故也. 火鬱則發之, 是也. 《東垣》

Translation영역

Vexing heat of the five hearts is fire depressed within the earth. The four limbs are the spleen earth; the heart fire has sunk down into the spleen earth and is depressed and cannot stretch out. Where fire is depressed, effuse it — this is that.

Clinical note임상 주석

五心 are the palms, the soles and the centre of the chest — the five places that burn. The reading is that heart fire has fallen into the limbs and cannot get out, which is why the treatment raises and scatters rather than cools. 火鬱則發之 is from the Suwen and is the rule the whole section turns on. It is the same reasoning as 5.5.4: heat locked deep is driven out, not damped down.

Dongwon 東垣

5.12.2

Source원문

凡男女四肢熱, 肌熱, 筋熱, 骨髓中熱如燎, 捫之烙手, 此熱伏土中, 由血虛而得, 或過食冷物, 抑遏陽氣於脾土之中. 火鬱則發之, 宜升陽散火湯ㆍ火鬱湯. 《東垣》

Translation영역

In men and women alike, where the four limbs are hot, the flesh hot, the sinews hot, and the heat within the bone marrow as though scorching so that it sears the hand on touching, this heat lies hidden within the earth. It comes of blood vacuity, or of eating too much cold food so that the yang qi is repressed within the spleen earth. Where fire is depressed, effuse it: Raise the Yang and Scatter Fire Decoction and Depressed Fire Decoction are appropriate.

Clinical note임상 주석

過食冷物 — eating too much cold food — as a cause of burning heat is the passage's most useful turn. Cold food represses the yang, the repressed yang becomes fire, and the patient burns. Cooling such a patient further makes it worse.

Dongwon 東垣

5.12.3

Source원문

虛損, 手心脚心發熱不可當, 宜淸骨散. 《醫鑑》

Translation영역

In vacuity detriment where the palms and soles are hot past bearing, Clear the Bone Powder is appropriate.

Uigam 醫鑑

5.12.4

Source원문

兩手大熱如火, 是爲骨厥. 見鍼灸

Translation영역

Where both hands are greatly hot as with fire, this is bone reversal. see the acupuncture section

Donguibogam · Hwa

5.12.5

Source원문

五心之熱, 小兒傷食證也. 大人亦然. 《資生》

Translation영역

Heat of the five hearts is the pattern of food damage in a child; in adults it is likewise.

Clinical note임상 주석

A different reading from the four passages above: burning palms and soles as a sign of food accumulation rather than of depression or depletion. The Internal Damage chapter's test at 1.4.5 settles which is which — press the epigastrium. Pain means food.

Jasaenggyeong 資生

5.13 Tidal Fever 潮熱

5.13.1

Source원문

潮熱者, 有時而熱, 不失其時. 寒熱者, 寒已而熱相繼而發. 至於發熱, 則無時而熱也. 《醫鑑》

Translation영역

Tidal fever is heat at a fixed time, not missing its hour. Cold and heat is cold ending and heat following on after it. As for plain fever, it is heat at no fixed time.

Clinical note임상 주석

Three kinds of fever separated by timing alone: tidal comes at its appointed hour, cold-heat alternates, plain fever is constant. That is the distinction the rest of the section works from.

Uigam 醫鑑

5.13.2

Source원문

潮熱有時, 爲內傷, 爲虛. 潮熱無時, 爲外感, 爲實. 《入門》

Translation영역

Tidal fever at a fixed time is internal damage and vacuity; tidal fever at no fixed time is external contraction and repletion.

Immun 入門

5.13.3

Source원문

平朝潮熱者, 熱在行陽之分, 肺氣主之, 故用白虎湯方見寒門, 以瀉氣中之火.

Translation영역

Where the tidal fever comes at daybreak, the heat is in the division travelling the yang and the lung qi governs it; therefore White Tiger Decoction formula in the Cold Damage chapter is used, to drain the fire within the qi.

Jeongjeon 正傳

5.13.4

Source원문

日晡潮熱者, 熱在行陰之分, 腎氣主之, 故用地骨皮飮卽上東垣方地骨皮散也, 以瀉血中之火. 《正傳》

Translation영역

Where the tidal fever comes toward dusk, the heat is in the division travelling the yin and the kidney qi governs it; therefore Lycium Root Bark Drink that is, Dongwon's Lycium Root Bark Powder above is used, to drain the fire within the blood.

Clinical note임상 주석

Morning fever is drained from the qi and evening fever from the blood, which applies the day-night rule of 5.8 to a finer division of the day. 日晡, toward dusk, is the classic hour of tidal fever in the Shanghan tradition and is when the fever of tuberculosis characteristically rises.

Jeongjeon 正傳

5.13.5

Source원문

氣虛, 有汗潮熱, 宜補中益氣湯方見內傷.

Translation영역

In qi vacuity with sweating and tidal fever, Supplement the Centre and Boost the Qi Decoction formula in the Internal Damage chapter is appropriate.

Immun 入門

5.13.6

Source원문

氣虛, 無汗潮熱, 宜人參淸肌散方見上.

Translation영역

In qi vacuity without sweating and with tidal fever, Ginseng Clear the Flesh Powder formula above is appropriate.

Immun 入門

5.13.7

Source원문

血虛, 有汗潮熱, 宜人參養榮湯方見虛勞.

Translation영역

In blood vacuity with sweating and tidal fever, Ginseng Nourish the Construction Decoction formula in the Vacuity Taxation chapter is appropriate.

Immun 入門

5.13.8

Source원문

血虛, 無汗潮熱, 宜茯苓補心湯方見血門.

Translation영역

In blood vacuity without sweating and with tidal fever, Poria Supplement the Heart Decoction formula in the Blood chapter is appropriate.

Immun 入門

5.13.9

Source원문

氣血兩虛, 無汗潮熱, 宜茯苓補心湯.

Translation영역

Where qi and blood are both vacuous, without sweating and with tidal fever, Poria Supplement the Heart Decoction is appropriate.

Immun 入門

5.13.10

Source원문

氣血兩虛, 有汗潮熱, 宜加減逍遙散.

Translation영역

Where qi and blood are both vacuous, with sweating and tidal fever, Modified Free Wanderer Powder is appropriate.

Clinical note임상 주석

Six lines making a two-by-two table and then a fifth case: qi or blood or both, with sweat or without. The reader is meant to run the two questions and take the answer. Sweating marks which side is failing — with sweat the surface cannot hold, without it the fluid is already spent — and the formulas differ accordingly.

Immun 入門

5.13.11

Source원문

血虛, 夜分潮熱, 宜四物二連湯.

Translation영역

In blood vacuity with tidal fever in the night watches, Four Substances Two Coptis Decoction is appropriate.

Immun 入門

5.13.12

Source원문

參蘇飮, 大解潮熱, 將欲成勞, 痰咳喘熱最效. 方見寒門《醫鑑》

Translation영역

Ginseng and Perilla Drink greatly resolves tidal fever, and where it is about to become taxation, with phlegm, cough, panting and heat, it is most effective. formula in the Cold Damage chapter

Uigam 醫鑑

5.14 Vacuity Vexation 虛煩

5.14.1

Source원문

心虛則煩心. 又肝腎脾虛, 亦煩心. 經曰, 夏脉者, 心也, 不及則令人煩心. 又云, 肝虛腎虛脾虛, 皆令人體重煩寃. 是知煩多生於虛也. 盖金攻肝虛, 土攻腎虛, 木攻脾虛, 而爲煩也. 《綱目》

Translation영역

Where the heart is vacuous there is vexation of the heart; and where liver, kidney or spleen are vacuous there is likewise vexation of the heart. The classic says: the summer pulse is the heart, and where it falls short it makes a person vexed at heart. It also says: liver vacuity, kidney vacuity and spleen vacuity all make the body heavy and vexed and oppressed. By this it is known that vexation mostly arises from vacuity. For metal attacks where the liver is vacuous, earth attacks where the kidney is vacuous, and wood attacks where the spleen is vacuous — and so there is vexation.

Gangmok 綱目

5.14.2

Source원문

虛煩者, 心胸煩擾而不寧也. 內經曰, 陰虛則內熱. 今之虛煩, 多是陰虛生內熱所致. 虛勞之人, 腎虛心旺, 及傷寒吐下後, 霍亂吐瀉後, 津液枯竭, 多有虛煩之證. 《醫鑑》

Translation영역

Vacuity vexation is the heart and chest disturbed and vexed without ease. The Neijing says: where the yin is vacuous there is internal heat. The vacuity vexation of today is mostly brought about by yin vacuity engendering internal heat. In those with vacuity taxation, the kidney vacuous and the heart effulgent; and after vomiting or purging in cold damage, and after vomiting and diarrhoea in sudden turmoil, the fluids withering and drying up — in these there is often the pattern of vacuity vexation.

Clinical note임상 주석

The causes named are all states of fluid loss: chronic depletion, or the aftermath of treatment by vomiting or purging, or severe gastroenteritis. The Vomiting and Purging chapters both warn of it in their own terms at To 6.10 and Ha 8.5.

Uigam 醫鑑

5.14.3

Source원문

獨熱者, 虛煩也. 與傷寒相似, 但頭身不痛, 脉不緊數爲異. 宜竹葉石膏湯方見寒門. 《保命》

Translation영역

Heat alone is vacuity vexation. It resembles cold damage, but the head and body not aching and the pulse not tight and rapid are what distinguish it. Bamboo Leaf and Gypsum Decoction formula in the Cold Damage chapter is appropriate.

Clinical note임상 주석

獨熱 — heat alone, without the body ache and tight pulse of an exterior contraction. The Internal Damage chapter uses the same discriminator at 1.6.5: 但身不痛爲異, the body not aching is what distinguishes it.

Bomyeongjip (保命集)

5.14.4

Source원문

虛煩自利, 手足冷, 宜用旣濟湯. 《入門》

Translation영역

In vacuity vexation with spontaneous diarrhoea and cold hands and feet, Already Fording Decoction is appropriate.

Immun 入門

5.14.5

Source원문

虛煩, 宜橘皮湯ㆍ人參竹葉湯ㆍ淡竹茹湯.

Translation영역

For vacuity vexation, Tangerine Peel Decoction, Ginseng and Bamboo Leaf Decoction and Bland Bamboo Shavings Decoction are appropriate.

Donguibogam · Hwa

5.15 Qi That Rises Belongs to Fire 上升之氣屬火

5.15.1

Source원문

病人自言, 冷氣從下而上者, 非眞冷氣也. 此上升之氣, 自肝而出, 中挾相火, 自下而上, 其熱爲甚. 自覺其冷者, 此火極似水, 積熱之甚也. 陽亢陰微, 故見此證. 冷生氣者, 出於高陽生之謬言也. 《丹心》

Translation영역

Where a patient says of themselves that a cold qi rises from below, it is not truly a cold qi. This rising qi issues from the liver, carrying the ministerial fire with it, and passes from below upward, and its heat is severe. That they feel it as cold is fire at its extreme resembling water — accumulated heat at its worst. The yang is hyperactive and the yin faint, and so this pattern appears. That cold engenders qi comes of Gao Yangsheng's mistaken saying.

Clinical note임상 주석

火極似水 — fire at its extreme resembling water — is the chapter's most important warning and it recurs at 5.16.5. A patient who reports cold rising through them is describing heat, and warming them makes it worse. The phrase names a general problem: at its extreme, a condition presents as its opposite. Danxi returns to it wherever the patient's own account would mislead.

Dansim 丹心

5.15.2

Source원문

氣從左邊起者, 肝火也. 氣從臍下起者, 陰火也. 氣從脚下起入腹如火者, 乃虛之極也. 盖火起于九泉之下, 十不救一. 《丹心》

Translation영역

Where the qi rises from the left side, it is liver fire. Where it rises from below the navel, it is yin fire. Where it rises from below the feet and enters the abdomen like fire, this is vacuity at its extreme — for the fire is rising from beneath the nine springs, and not one in ten is saved.

Clinical note임상 주석

Three origins with three prognoses, worsening as the starting point drops: the left side is treatable, below the navel less so, from the feet almost never. 九泉, the nine springs, is the underworld, and the image is of fire coming up from the grave.

Dansim 丹心

5.15.3

Source원문

凡氣有餘便是火, 不足者是氣虛. 《丹心》

Translation영역

Wherever the qi is in surplus it is fire; where it is insufficient it is qi vacuity.

Dansim 丹心

5.15.4

Source원문

氣從左邊起, 宜回金丸方見上ㆍ當歸龍薈丸方見五藏. 氣從臍下起, 宜黃柏丸方見上ㆍ坎离丸方見下. 氣從脚下起, 宜用四物湯, 加黃柏ㆍ知母幷鹽炒, 或滋陰降火湯方見下. 外用附子末, 津調罯涌泉穴, 引下其熱. 《丹心》

Translation영역

Where the qi rises from the left side, Return the Metal Pill formula above and Angelica, Gentiana and Aloe Pill formula in the Five Viscera chapter are appropriate. Where it rises from below the navel, Phellodendron Pill formula above and Kan and Li Pill formula below. Where it rises from below the feet, Four Substances Decoction with phellodendron and anemarrhena both salt-fried added, or Enrich the Yin and Downbear Fire Decoction formula below. Externally, powdered aconite mixed with saliva and applied to Yongcheon (涌泉, KI1) draws the heat downward.

Clinical note임상 주석

The external application is the part worth keeping. Aconite powder paste on Yongcheon, the point at the sole, is used across the tradition to lead rising fire back down — the medicinal is hot, and the reasoning is that like draws like rather than that cold opposes heat. **Aconite is toxic even applied externally, and is absorbed through skin.**

Dansim 丹心

5.16 Aversion to Heat and Aversion to Cold 惡熱惡寒

5.16.1

Source원문

惡熱非熱, 明是虛證. 惡寒非寒, 明是熱證. 《丹心》

Translation영역

Aversion to heat is not heat — it is plainly a vacuity pattern. Aversion to cold is not cold — it is plainly a heat pattern.

Clinical note임상 주석

Two inversions in one line, and they are the section's whole content. A patient who cannot bear heat is empty rather than hot; a patient who cannot bear cold is hot rather than cold. Both run against what the patient reports and what a physician would assume, which is why the chapter states them first and then argues them.

Dansim 丹心

5.16.2

Source원문

經曰, 陰虛則發熱. 夫陽在外, 爲陰之衛, 陰在內, 爲陽之守. 精神外馳, 嗜慾無節, 陰氣耗散, 陽無所附, 遂致浮散於肌表之間而惡熱, 當作陰虛治之. 《內經》

Translation영역

The classic says: where the yin is vacuous there is fever. The yang lies without as the defence of the yin, and the yin lies within as the guard of the yang. Where the essence and spirit race outward and appetites have no measure, the yin qi is wasted and scattered and the yang has nothing to attach to; it comes to float and scatter between the flesh and the surface, and there is aversion to heat — it should be treated as yin vacuity.

Naegyeong 內經

5.16.3

Source원문

經曰, 惡寒戰慄, 皆屬於熱. 原病式曰, 實非寒也. 古人遇戰慄之證, 有以大承氣下燥糞而愈者, 明是病熱而反覺自冷, 熱證耳. 《內經》

Translation영역

The classic says: aversion to cold with shivering all belongs to heat. The Yuanbingshi says: it is truly not cold. When the ancients met a pattern of shivering, there were cases cured by purging dry stool with Major Order the Qi Decoction — which makes it plain that the disease is heat and the patient feels cold on the contrary; it is a heat pattern.

Clinical note임상 주석

The proof offered is from treatment: a shivering patient purged with a cold draining formula and cured. If a heat treatment resolves it, the condition was heat whatever the patient felt. That inference — from what works back to what it was — is the same one the Wasting Thirst chapter uses for worm thirst at 4.11.

Naegyeong 內經

5.16.4

Source원문

惡寒者, 雖當炎月, 若遇風霜, 重綿在身, 自覺凜凜戰慄, 惡寒之甚也. 《內經》

Translation영역

One with aversion to cold, though it be in the hottest month, is as though meeting wind and frost; with layers of padding on the body they still feel a chill and shiver — this is aversion to cold at its severest.

Naegyeong 內經

5.16.5

Source원문

痼冷之病, 豈非身惡寒而口喜熱之病耶. 殊不知濕痰積中, 抑遏陽氣不得外泄, 身必惡寒. 劉河間曰, 火極似水, 故見此證也. 宜吐出痰涎. 苦參ㆍ赤小豆爲末, 虀水調服, 探吐之. 後用川芎ㆍ南星ㆍ蒼朮ㆍ酒芩爲末, 神麴糊丸服. 《丹心》

Translation영역

Is not the disease of entrenched cold one where the body has aversion to cold and the mouth favours hot things? What is not understood is that damp phlegm has accumulated within and represses the yang qi so that it cannot discharge outward, and the body must then have aversion to cold. Liu Hejian said: fire at its extreme resembles water, and so this pattern appears. The phlegm drool should be ejected: powder sophora root and adzuki bean, take it stirred into pickle water, and probe to induce vomiting. Afterwards use chuanxiong, arisaema, atractylodes lancea and wine-fried scutellaria, powdered and made into pills with medicated leaven paste.

Clinical note임상 주석

The mechanism that makes the inversion intelligible: phlegm blocks the yang from reaching the surface, so the surface is cold while the interior is hot. Treating it by ejecting rather than by warming is the practical consequence, and the Vomiting chapter carries the same pairing of sophora and adzuki bean at 6.5.4.

Dansim 丹心

5.16.6

Source원문

陽虛惡寒, 四君子湯方見氣門, 減茯苓, 倍加黃芪ㆍ桂枝, 或加附子少許. 陰虛惡寒發熱, 二陳湯合四物湯, 加知母ㆍ黃柏ㆍ地骨皮. 《入門》

Translation영역

In yang vacuity with aversion to cold, Four Gentlemen Decoction formula in the Qi chapter with the poria reduced, astragalus and cinnamon twig doubled, or a little aconite added. In yin vacuity with aversion to cold and fever, Two Matured Ingredients Decoction combined with Four Substances Decoction, with anemarrhena, phellodendron and lycium root bark added.

Immun 入門

5.16.7

Source원문

一人脚自踝以下常覺熱, 冬不可加綿於上, 常誇稟質壯, 不怕冷. 予曰, 此足三陰之虛, 宜早斷慾事, 以補養陰血, 庶乎可免. 彼笑而不答. 年近五十, 患痿而死. 《丹心》

Translation영역

A man's legs from the ankles down were always felt to be hot, and in winter he could put no padding over them; he constantly boasted that his constitution was strong and that he did not fear the cold. I said: this is vacuity of the three yin of the foot, and he should break off sexual matters early and supplement and nourish the yin blood, and then he might escape it. He laughed and did not answer. Near fifty he fell ill of wilting and died.

Clinical note임상 주석

A case recorded for its ending. Heat in the legs taken as proof of strength, advice refused, and death from wilting disease twenty years later. Danxi includes it because the sign was read backwards by the patient himself — persistent heat in the lower limbs is yin depletion, not vigour.

Dansim 丹心

5.16.2 Accumulated Heat with Aversion to Cold 積熱惡寒

5.16.2.1

Source원문

一婦人, 身冷惡寒, 六月重裘猶覺寒, 泄注不止, 脉如橫繩有力. 予以凉布熨心, 以新汲水淋之, 其人呼呌殺人, 猶不止, 連灌三四十桶, 大戰汗出, 昏困一二日而所苦皆除. 漢華佗ㆍ北齊徐文伯, 亦治痼寒人, 候冬寒月, 以冷水發之, 此其法也. 《子和》

Translation영역

A woman's body was cold with aversion to cold; in the sixth month she still felt cold under heavy furs, and diarrhoea poured without stopping; her pulse was like a rope laid crosswise and had force. I pressed cool cloths to her heart and poured newly drawn water over her. She cried out that I was killing her, and still I did not stop — pouring on thirty or forty buckets in succession. She shivered violently and sweat came out; after a day or two of clouded exhaustion all her suffering was gone. Hua Tuo of the Han and Xu Wenbo of the Northern Qi likewise treated people with entrenched cold by waiting for the cold months of winter and effusing them with cold water — this is that method.

Clinical note임상 주석

The chapter's most extreme case and the one that shows what 火極似水 meant in practice. A woman in furs in midsummer, doused with thirty or forty buckets of cold water over her protests, and recovering. 脉如橫繩有力 — a pulse like a rope laid crosswise, with force — is the finding that told Zhang Congzheng the cold was counterfeit. A genuinely cold patient has no such pulse. **Cold-water immersion in a shivering patient causes hypothermia and cardiac arrhythmia. This is recorded as a historical case and must not be attempted.**

Jahwa 子和

5.16.3 Loss of Blood Causing Aversion to Cold and Fever 亡血致惡寒發熱

5.16.3.1

Source원문

病人脉微而澁者, 其人亡血. 病當惡寒, 後乃發熱, 無休止時. 夏月盛熱, 欲着複衣, 冬月盛寒, 欲裸其身. 所以然者, 陽微則惡寒, 陰弱則發熱. 此醫發其汗, 令陽氣微, 又大下之, 令陰氣弱. 五月之時, 陽氣在表, 胃中虛冷, 以陽氣內微, 不能勝冷, 故欲着複衣. 十一月之時, 陽氣在裏, 胃中煩熱, 以陰氣內弱, 不能勝熱, 故欲裸其身. 又陰脉遲澁, 故知亡血也. 《仲景》

Translation영역

Where a patient's pulse is faint and rough, that person has lost blood. The disease should be aversion to cold, and afterwards fever, with no time of remission. In the height of summer's heat they wish to put on layered clothing; in the depth of winter's cold they wish to strip themselves bare. The reason is this: where the yang is faint there is aversion to cold, and where the yin is weak there is fever. Here the physician effused their sweat, making the yang qi faint, and then purged them heavily, making the yin qi weak. In the fifth month the yang qi is at the exterior and the stomach is vacuous and cold within; the yang qi being faint within, it cannot overcome the cold, and so they wish to put on layered clothing. In the eleventh month the yang qi is in the interior and the stomach is vexed and hot within; the yin qi being weak within, it cannot overcome the heat, and so they wish to strip themselves bare. Further, the yin pulse being slow and rough, it is known that blood has been lost.

Clinical note임상 주석

A patient bundled up in July and stripped in December, and Zhongjing names the cause: 此醫發其汗 ... 又大下之 — the physician sweated them and then purged them heavily. Both treatments were wrong and the second compounded the first, leaving yang and yin simultaneously depleted. The chapter records the mechanism so that the error can be recognized rather than repeated, as the Internal Damage chapter does at 1.22.3.

Junggyeong 仲景

5.17 Yang Vacuity Brings Cold Without, Yang Exuberance Brings Heat Without 陽虛外寒陽盛外熱

5.17.1

Source원문

黃帝問曰, 陽虛生外寒, 奈何. 岐伯曰, 陽受氣於上焦, 以溫皮膚分肉之間. 今寒氣在外, 則上焦不通, 上焦不通, 則寒氣獨留于外, 故寒慄.

Translation영역

The Yellow Emperor asked: yang vacuity engendering cold without — how so? Qi Bo said: the yang receives qi at the upper burner and thereby warms between the skin and the divisions of the flesh. Now where cold qi lies without, the upper burner does not communicate; the upper burner not communicating, the cold qi lodges alone without, and hence there is shivering with cold.

Naegyeong 內經

5.17.2

Source원문

帝曰, 陽盛生外熱, 奈何. 岐伯曰, 上焦不通利, 則皮膚緻密, 腠理閉塞, 玄府不通, 衛氣不得泄越, 故外熱. 《內經》

Translation영역

The Emperor said: yang exuberance engendering heat without — how so? Qi Bo said: where the upper burner is not free and disinhibited, the skin is close and dense, the interstices are blocked and shut, the mysterious mansions do not open, and the defence qi cannot discharge and pass beyond — hence heat without.

Clinical note임상 주석

The same fault — the upper burner failing to communicate — produces cold in one case and heat in the other, according to which side is in surplus. 玄府, the mysterious mansions, are the pores.

Naegyeong 內經

5.18 Yin Vacuity Brings Heat Within, Yin Exuberance Brings Cold Within 陰虛內熱陰盛內寒

5.18.1

Source원문

黃帝問曰, 陰虛生內熱, 奈何. 岐伯曰, 有所勞倦, 形氣衰少, 穀氣不盛, 上焦不行, 下脘不通, 胃氣熱, 熱氣熏胸中, 故內熱.

Translation영역

The Yellow Emperor asked: yin vacuity engendering heat within — how so? Qi Bo said: where there has been taxation and fatigue, the form and qi decline and diminish, the grain qi is not exuberant, the upper burner does not move, the lower venter is not free, the stomach qi becomes hot and the hot qi steams the chest — hence heat within.

Clinical note임상 주석

The passage the Internal Damage chapter opens its taxation section with at 1.15.1, and the Immun's gloss there is worth carrying here too: the 陰虛 of this passage means the substantial part of the body kept up by food, not the kidney yin of the Vacuity Taxation chapter.

Naegyeong 內經

5.18.2

Source원문

帝曰, 陰盛生內寒, 奈何. 岐伯曰, 厥氣上逆, 寒氣積於胸中而不瀉, 不瀉則溫氣去. 寒獨留則血凝澁, 凝則脉不通, 其脉盛大以濇, 故中寒. 《內經》

Translation영역

The Emperor said: yin exuberance engendering cold within — how so? Qi Bo said: reverting qi counterflows upward and cold qi accumulates in the chest without draining; not draining, the warm qi departs. The cold lodging alone, the blood congeals and roughens; congealed, the vessels do not pass through, and the pulse is exuberant and large yet rough — hence cold in the centre.

Naegyeong 內經

5.19 Distinguishing the Two Patterns of Yang Vacuity and Yin Vacuity 辨陽虛陰虛二證

5.19.1

Source원문

陽虛陰虛二證, 丹溪辨之明矣. 何則, 晝夜發熱, 晝重夜輕, 口中無味, 陽虛之證也. 午後發熱, 夜半則止, 口中有味, 陰虛之證也. 陽全陰半, 陽得以兼陰, 陰不得以兼陽, 自然之理也. 陽虛之證, 責在胃, 陰虛之證, 責在腎. 盖飢飽傷胃, 則陽氣虛矣, 房勞傷腎, 則陰血虛矣. 古人以飮食男女爲切要, 厥有旨哉. 以藥論之, 甘溫則能補陽氣, 苦寒則能補陰血. 如以四君子補氣, 四物補血, 是也. 《入門》

Translation영역

The two patterns of yang vacuity and yin vacuity were clearly distinguished by Danxi. How so? Fever by day and night, heavier by day and lighter by night, with no taste in the mouth — this is the pattern of yang vacuity. Fever after noon, stopping at midnight, with taste in the mouth — this is the pattern of yin vacuity. The yang is whole and the yin is half; the yang can encompass the yin and the yin cannot encompass the yang, and this is the natural principle. The pattern of yang vacuity is charged to the stomach, and the pattern of yin vacuity to the kidney. For hunger and repletion damage the stomach and the yang qi becomes vacuous; sexual taxation damages the kidney and the yin blood becomes vacuous. That the ancients took food and drink and the relations of man and woman for the essentials — there was point in it. Speaking of medicines: the sweet and warm can supplement the yang qi, and the bitter and cold can supplement the yin blood, as Four Gentlemen supplements the qi and Four Substances supplements the blood.

Clinical note임상 주석

Two questions settle it: when does the fever come, and can the patient taste their food? Yang vacuity is worse by day with no taste; yin vacuity comes after noon and stops at midnight, with taste preserved. 口中無味 as a marker of yang vacuity is the same test the Internal Damage chapter uses at 1.16.10 to separate internal damage from external contraction, and at 1.19.4 it is stated as a rule: yin vacuous, there is taste; yang vacuous, there is none.

Immun 入門

5.19.2

Source원문

氣虛熱, 升陽以散之, 四君子湯ㆍ補中益氣湯, 或益胃升陽湯. 幷見內傷

Translation영역

In qi vacuity heat, raise the yang to scatter it: Four Gentlemen Decoction, Supplement the Centre and Boost the Qi Decoction, or Boost the Stomach and Raise the Yang Decoction. all in the Internal Damage chapter

Immun 入門

5.19.3

Source원문

血虛熱, 滋陰以降之, 四物湯, 加芩ㆍ連ㆍ梔子, 或滋陰降火湯ㆍ坎离丸.

Translation영역

In blood vacuity heat, enrich the yin to downbear it: Four Substances Decoction with scutellaria, coptis and gardenia added, or Enrich the Yin and Downbear Fire Decoction and Kan and Li Pill.

Immun 入門

5.19.4

Source원문

氣血俱虛熱, 升陽滋陰兼用, 十全大補湯ㆍ人參養榮湯, 加知母ㆍ黃柏. 幷見虛勞《入門》

Translation영역

Where qi and blood are both vacuous with heat, use raising the yang and enriching the yin together: Perfect Major Supplementation Decoction and Ginseng Nourish the Construction Decoction, with anemarrhena and phellodendron added. both in the Vacuity Taxation chapter

Immun 入門

5.19.5

Source원문

血虛發熱, 宜當歸補血湯. 《東垣》

Translation영역

In fever from blood vacuity, Angelica Supplement the Blood Decoction is appropriate.

Clinical note임상 주석

Dongwon's own formula, and its entry records the case it was made for: a patient burning and flushed with a surging pulse that vanishes under a firm hand. Emptiness counterfeiting fullness, which is the chapter's constant theme.

Dongwon 東垣

5.20 Fever from Drinking 飮酒發熱

5.20.1

Source원문

飮酒發熱, 黃連解毒湯, 加葛根主之. 方見寒門《仲景》

Translation영역

For fever from drinking, Coptis Resolve Toxin Decoction with pueraria added governs it. formula in the Cold Damage chapter

Junggyeong 仲景

5.20.2

Source원문

因酒發熱, 用靑黛ㆍ瓜蔞仁爲末, 入薑汁, 每日服數匙, 三日而安. 《丹心》

Translation영역

For fever arising from wine, powder indigo and trichosanthes seed, put in ginger juice, take several spoonfuls a day, and in three days there is ease.

Dansim 丹心

5.20.3

Source원문

酒熱內鬱而惡寒者, 黃芪一兩, 葛根五錢, 水煎服, 大汗而愈. 《入門》

Translation영역

Where the heat of wine is depressed within and there is aversion to cold, astragalus 1 nyang and pueraria 5 don decocted in water and taken; a great sweat, and recovery.

Immun 入門

5.20.4

Source원문

凡發熱人, 極忌飮酒. 《入門》

Translation영역

Anyone with fever must absolutely avoid drinking.

Immun 入門

5.20.5

Source원문

飮酒人發熱者難治, 不飮酒人因酒發熱者, 亦難治. 《丹心》

Translation영역

Fever in a drinker is hard to treat; and fever arising from wine in one who does not drink is likewise hard to treat.

Clinical note임상 주석

Both halves are hard, and for opposite reasons: a habitual drinker's fever has a cause that will not be removed, and a non-drinker who is made feverish by a little wine has no tolerance to fall back on.

Dansim 丹心

5.21 Fever from Stagnant Blood 滯血發熱

5.21.1

Source원문

其人脉澁, 必有漱水之證, 必有嘔惡痰涎之證, 必有兩脚厥冷之證, 亦有小腹結急之證, 或唾紅或鼻衄. 宜以柴胡ㆍ黃芩, 佐以川芎ㆍ白芷ㆍ桃仁ㆍ五靈脂, 更加大黃ㆍ濃蜜, 使滯血一通, 黑物流利, 則熱不復作矣. 《直指》

Translation영역

Such a person's pulse is rough; there must be the sign of rinsing the mouth with water, the sign of retching and nausea with phlegm drool, the sign of both legs reverse-cold, and also the sign of the lower abdomen bound and urgent; and there may be red spittle or nosebleed. Bupleurum and scutellaria should be used, with chuanxiong, angelica dahurica, peach kernel and flying squirrel faeces as assistants, and rhubarb and thick honey added besides — so that the stagnant blood passes through at once and the black matter flows freely, and then the fever does not arise again.

Clinical note임상 주석

漱水 — rinsing the mouth with water without swallowing — is the classic sign of blood stasis rather than of thirst, and it is the one that identifies this pattern. The patient wants their mouth wet and does not want to drink. 黑物流利, the black matter flowing freely, is the endpoint: old blood passed as dark stool.

Jikji 直指

5.22 Yin Vacuity with Fire Stirring 陰虛火動

5.22.1

Source원문

凡發熱, 咳嗽, 吐痰, 咯血, 午後至夜發熱, 面赤, 脣紅, 小便赤澁, 便是陰虛火動也. 《回春》

Translation영역

Wherever there is fever, cough, spitting phlegm and hawking blood, with fever from after noon into the night, the face red, the lips scarlet and the urine red and rough — this is yin vacuity with fire stirring.

Hoechun 回春

5.22.2

Source원문

潮熱, 盜汗, 咳嗽痰盛, 咯唾血, 氣力困怠, 形容消瘦, 腰痛脚痿, 遺精夢泄, 皆陰虛火動之證也. 《入門》

Translation영역

Tidal fever, night sweating, cough with abundant phlegm, hawking and spitting blood, strength fatigued, the form wasted and thin, lumbar pain with wilting legs, seminal emission and dream emission — all are patterns of yin vacuity with fire stirring.

Clinical note임상 주석

The same picture as steaming bone at 5.11.2, read from the yin-vacuity side rather than the heat side. Both describe advanced pulmonary tuberculosis. **Cough with blood, night sweats and weight loss requires urgent medical investigation.**

Immun 入門

5.22.3

Source원문

陰虛火動, 宜滋陰降火湯ㆍ淸离滋坎湯. 後服滋陰淸化膏方見咳嗽ㆍ六味地黃丸方見五藏. 愈後用坎离旣濟丸, 乃收功保後之藥也.

Translation영역

In yin vacuity with fire stirring, Enrich the Yin and Downbear Fire Decoction and Clear the Li and Enrich the Kan Decoction are appropriate. Afterwards take Enrich the Yin and Clear Transformation Paste formula in the Cough chapter and Six Flavours Rehmannia Pill formula in the Five Viscera chapter. After recovery use Kan and Li Already Fording Pill, which is the medicine for securing the gain and protecting what follows.

Immun 入門

5.22.4

Source원문

四物湯, 加知母ㆍ黃柏幷鹽水炒, 是降火補陰之妙劑. 甚者, 加龜板. 《丹心》

Translation영역

Four Substances Decoction with anemarrhena and phellodendron both salt-water fried added is the marvellous preparation for downbearing fire and supplementing the yin; in severe cases add tortoise plastron.

Clinical note임상 주석

The formula Danxi is most identified with, and the salt-water frying is what sends the two cold medicinals to the kidney. Tortoise plastron in severe cases is the heaviest yin-enriching substance in the materia medica.

Dansim 丹心

5.22.5

Source원문

陰虛火動, 宜滋陰降火湯ㆍ淸离滋坎湯ㆍ淸肺滋陰散ㆍ陰虛生內熱湯ㆍ補陰瀉火湯ㆍ補陰丸ㆍ六味地黃丸方見虛勞ㆍ坎离膏ㆍ先坎离丸ㆍ後坎离丸ㆍ坎离旣濟丸.

Translation영역

For yin vacuity with fire stirring: Enrich the Yin and Downbear Fire Decoction, Clear the Li and Enrich the Kan Decoction, Clear the Lung and Enrich the Yin Powder, Yin Vacuity Engendering Internal Heat Decoction, Supplement the Yin and Drain Fire Decoction, Supplement the Yin Pill, Six Flavours Rehmannia Pill formula in the Vacuity Taxation chapter, Kan and Li Paste, Earlier Kan and Li Pill, Later Kan and Li Pill and Kan and Li Already Fording Pill.

Donguibogam · Hwa

5.22.11 Yin Vacuity with Fire Stirring Is Hard to Treat 陰虛火動者難治

5.22.11.1

Source원문

近世陰虛火動之疾, 十無一活, 何也. 盖其始也, 飮食如舊, 起居如常, 惟痰嗽一二聲, 自謂無恙, 諱疾忌醫, 滅身無悟. 及蔓延日久, 倒臥於床, 而堅氷已至, 不可復救. 余意揆之, 方疾之始, 必致謹於三事而後可. 三者維何. 一要遇明醫, 二要肯服藥, 三要守禁戒. 三者缺一, 不可治也. 《醫鑑》

Translation영역

In recent times, of those with the disease of yin vacuity with fire stirring, not one in ten lives — why is this? At its beginning food and drink are as before and activity and rest as usual, with only a phlegmy cough of one or two sounds; the patient tells himself there is nothing wrong, conceals the illness and shuns the physician, and destroys himself without understanding. By the time it has spread over long days and he lies down on his bed, the solid ice has already come and he cannot be rescued. Reckoning it in my own mind: at the very beginning of the disease, care must be taken in three things and then it may be done. What are the three? First, to meet a clear-sighted physician. Second, to be willing to take the medicine. Third, to keep the prohibitions. Lacking one of the three, it cannot be treated.

Clinical note임상 주석

The chapter's most humane passage and its most quotable. The disease is lost not at its end but at its beginning — 諱疾忌醫, concealing the illness and shunning the physician, while the only sign is a slight cough. 堅氷已至 — the solid ice has already come — is from the Yi's first hexagram: treading on frost, solid ice is not far off. The point is that the outcome was set long before it appeared. The three requirements are worth keeping as stated: a competent physician, a patient willing to take the medicine, and prohibitions kept. Two out of three is not enough.

Uigam 醫鑑

5.23 There Is a Method for Subduing Fire 制火有方

5.23.1

Source원문

儒者立敎, 曰正心, 收心, 養心, 皆所以防此火之動於妄也. 醫者立敎, 曰恬澹虛無, 精神內守, 亦所以遏此火之動於妄也. 《丹溪》

Translation영역

The Confucians in their teaching speak of rectifying the heart, gathering in the heart and nourishing the heart — all so as to guard against this fire stirring recklessly. The physicians in their teaching speak of calm detachment and emptiness, and the essence and spirit kept within — likewise so as to check this fire stirring recklessly.

Clinical note임상 주석

Danxi puts the two traditions side by side and finds them saying one thing. The medical half is from the opening of the Suwen, 恬澹虛無, 眞氣從之, and this chapter reads it as a treatment rather than as a counsel.

Dansim 丹溪

5.23.2

Source원문

火不妄動, 動由於心. 靜之一字, 其心中之水乎. 《入門》

Translation영역

Fire does not stir of itself; its stirring comes of the heart. The single word stillness — is it not the water within the heart?

Immun 入門

5.23.3

Source원문

神靜則心火自降, 慾斷則腎水自升. 《入門》

Translation영역

Where the spirit is still, the heart fire descends of itself; where desire is cut off, the kidney water rises of itself.

Clinical note임상 주석

The whole chapter in one sentence. Everything from 5.1 onward has been about fire rising when it should stay down and water failing to rise to meet it, and here the correction is given without any medicine in it.

Immun 入門

5.24 There Is a Method for Abating Heat 退熱有法

5.24.1

Source원문

退熱之法, 全在淸心, 必用麥門冬ㆍ燈心草ㆍ白朮ㆍ茯苓. 盖心者, 一身之主宰, 而萬事之本根, 萬令從心. 心不淸則妄動而熱不退. 然熱能傷血, 血滯則氣鬱, 而熱愈不退. 退熱之法, 又在調血, 法用川芎ㆍ當歸. 若夫陽浮於外, 則當斂以降之, 法用參苓白朮散方見內傷, 薑ㆍ棗煎服. 《丹心》

Translation영역

The method of abating heat lies wholly in clearing the heart, and ophiopogon, juncus, white atractylodes and poria must be used. The heart is the ruler of the whole body and the root of the ten thousand affairs, and all commands follow the heart. Where the heart is not clear it stirs recklessly and the heat does not abate. But heat can damage the blood, and where the blood stagnates the qi is depressed and the heat abates still less. The method of abating heat lies further in regulating the blood, and the method uses chuanxiong and angelica. As for the yang floating without, it should be gathered in and downborne; the method uses Ginseng and Poria White Atractylodes Powder formula in the Internal Damage chapter, decocted with ginger and jujube.

Clinical note임상 주석

Three methods in order — clear the heart, regulate the blood, gather in the floating yang — and none of them is a cold draining formula. The chapter's position throughout is that fire is led rather than fought.

Dansim 丹心

5.24.2

Source원문

凡熱皆出於心, 心血不可不淸, 麥門冬不可缺也. 以燈心草爲引子. 《丹心》

Translation영역

All heat issues from the heart; the heart blood must be cleared, and ophiopogon cannot be dispensed with. Juncus serves as the conductor.

Dansim 丹心

5.24.3

Source원문

凡壯熱煩躁, 用柴胡ㆍ黃芩ㆍ大黃解利之. 其熱不退, 宜用黃芩ㆍ川芎ㆍ甘草ㆍ烏梅作劑, 入黃連ㆍ生地黃ㆍ赤茯苓, 入燈心一捻煎服, 其效甚速. 盖川芎ㆍ生地黃, 皆能調血, 心血一調, 其熱自退. 《直指》

Translation영역

Wherever there is vigorous heat with vexed agitation, use bupleurum, scutellaria and rhubarb to resolve and disinhibit it. If the heat does not abate, make a preparation of scutellaria, chuanxiong, licorice and mume, put in coptis, fresh rehmannia and red poria, add a pinch of juncus, decoct and take — the effect is very quick. Chuanxiong and fresh rehmannia can both regulate the blood, and the heart blood once regulated, the heat abates of itself.

Jikji 直指

5.24.4

Source원문

駱隆吉曰, 風火旣熾, 當滋腎水. 《東垣》

Translation영역

Luo Longji said: where wind and fire are already blazing, the kidney water should be enriched.

Clinical note임상 주석

Eight graphs that state the chapter's therapeutic principle in full. A blazing fire is not put out from above but answered from below, by supplying the water that should have held it down.

Dongwon 東垣

5.25 Medicines That Drain Fire from the Viscera and Bowels 臟腑瀉火藥

5.25.1

Source원문

君火者, 心火也, 可以濕伏, 可以水滅, 黃連之屬可以制之. 相火者, 龍火也, 不可以水滅, 惟從其性而伏之, 黃柏之屬可以降之. 《丹心》

Translation영역

Sovereign fire is heart fire; it may be subdued with damp and extinguished with water, and coptis and its kind can control it. Ministerial fire is dragon fire; it cannot be extinguished with water, and only by following its nature can it be subdued — phellodendron and its kind can downbear it.

Clinical note임상 주석

The distinction of 5.1 turned into a rule of prescribing, and it is the single most useful line in the chapter. Heart fire is put out; ministerial fire is followed and led down. 惟從其性而伏之 — only by following its nature can it be subdued — is why phellodendron rather than coptis, and why 5.15.4 puts hot aconite on the sole to draw fire downward.

Dansim 丹心

5.25.2

Source원문

上焦熱, 用梔子ㆍ片芩.

Translation영역

For upper burner heat, use gardenia and sliced scutellaria.

Haejang 海藏

5.25.3

Source원문

中焦熱, 用黃連ㆍ芍藥.

Translation영역

For middle burner heat, use coptis and peony.

Haejang 海藏

5.25.4

Source원문

下焦熱, 用黃柏ㆍ大黃. 《海藏》

Translation영역

For lower burner heat, use phellodendron and rhubarb.

Haejang 海藏

5.25.5

Source원문

黃連瀉心火, 白芍藥瀉脾火, 柴胡瀉肝火黃連佐之, 知母瀉腎火.

Translation영역

Coptis drains heart fire; white peony drains spleen fire; bupleurum drains liver fire with coptis as assistant; anemarrhena drains kidney fire.

Dongwon 東垣

5.25.6

Source원문

木通瀉小腸火, 條芩瀉大腸火, 柴胡瀉膽火黃連佐之, 石膏瀉胃火, 黃柏瀉膀胱火. 《東垣》

Translation영역

Akebia drains small intestine fire; slender scutellaria drains large intestine fire; bupleurum drains gallbladder fire with coptis as assistant; gypsum drains stomach fire; phellodendron drains bladder fire.

Clinical note임상 주석

Nine organs with one medicinal each, and it is the passage most often lifted from this chapter. Learned as a set it gives a starting point for any organ named as hot.

Dongwon 東垣

5.25.7

Source원문

主治各經熱藥. 肝, 氣柴胡, 血黃芩.

Translation영역

Medicines governing the heat of each channel. Liver: for the qi, bupleurum; for the blood, scutellaria.

Immun 入門

5.25.8

Source원문

心, 氣麥門冬, 血黃連.

Translation영역

Heart: for the qi, ophiopogon; for the blood, coptis.

Immun 入門

5.25.9

Source원문

脾, 氣白芍藥, 血大黃.

Translation영역

Spleen: for the qi, white peony; for the blood, rhubarb.

Immun 入門

5.25.10

Source원문

肺, 氣石膏, 血梔子.

Translation영역

Lung: for the qi, gypsum; for the blood, gardenia.

Immun 入門

5.25.11

Source원문

腎, 氣玄參, 血黃柏.

Translation영역

Kidney: for the qi, scrophularia; for the blood, phellodendron.

Immun 入門

5.25.12

Source원문

膽, 氣連翹, 血柴胡.

Translation영역

Gallbladder: for the qi, forsythia; for the blood, bupleurum.

Immun 入門

5.25.13

Source원문

胃, 氣葛根, 血大黃.

Translation영역

Stomach: for the qi, pueraria; for the blood, rhubarb.

Immun 入門

5.25.14

Source원문

大腸, 氣連翹, 血大黃.

Translation영역

Large intestine: for the qi, forsythia; for the blood, rhubarb.

Immun 入門

5.25.15

Source원문

小腸, 氣赤茯苓, 血木通.

Translation영역

Small intestine: for the qi, red poria; for the blood, akebia.

Immun 入門

5.25.16

Source원문

膀胱, 氣滑石, 血黃柏.

Translation영역

Bladder: for the qi, talc; for the blood, phellodendron.

Immun 入門

5.25.17

Source원문

包絡, 氣麥門冬, 血牡丹皮. 三焦, 氣連翹, 血地骨皮. 《入門》

Translation영역

Pericardium: for the qi, ophiopogon; for the blood, moutan bark. Three burners: for the qi, forsythia; for the blood, lycium root bark.

Clinical note임상 주석

Twelve channels, each split into qi and blood, and a medicinal for each half — twenty-four assignments in all. Taken with the nine-organ list above it makes this the chapter's reference section, and it is meant to be consulted rather than read through. The pairs that recur are worth noting: rhubarb for the blood of spleen, stomach and large intestine; forsythia for the qi of gallbladder, large intestine and three burners.

Immun 入門

5.26 Method of Medicines for Treating Fire and Heat Generally 通治火熱藥法

5.26.1

Source원문

除熱瀉火, 非甘寒不可也. 有大熱脉洪大, 服苦寒劑而熱不退者, 加石膏. 《東垣》

Translation영역

To remove heat and drain fire, nothing but the sweet and cold will do. Where there is great heat with a surging large pulse and a bitter cold preparation has been taken without the heat abating, add gypsum.

Dongwon 東垣

5.26.2

Source원문

火妄動夏月, 用益元散方見暑門鎭墜之妙. 《丹心》

Translation영역

Where fire stirs recklessly in the summer months, Boost the Origin Powder formula in the Summerheat chapter settles and weighs it down marvellously.

Dansim 丹心

5.26.3

Source원문

虛熱, 用荊芥ㆍ薄荷ㆍ梔子ㆍ黃芩. 實熱, 用大黃ㆍ芒硝. 《得效》

Translation영역

For vacuity heat use schizonepeta, mint, gardenia and scutellaria; for repletion heat use rhubarb and mirabilite.

Deukhyo 得效

5.26.4

Source원문

實火可瀉, 黃連解毒湯之類. 虛火可補, 參ㆍ朮ㆍ(生)甘草之類. 《丹心》

Translation영역

Repletion fire may be drained — Coptis Resolve Toxin Decoction and its kind. Vacuity fire may be supplemented — ginseng, atractylodes, raw licorice and their kind.

Dansim 丹心

5.26.5

Source원문

火盛者, 不可驟用寒涼, 必兼溫散. 《丹心》

Translation영역

Where fire is exuberant, cold and cooling medicines must not be used abruptly; warming and scattering must go with them.

Clinical note임상 주석

不可驟用寒涼 — cold medicines must not be used abruptly — is the caution that governs the whole section. A fire met head-on with cold is driven inward; warm scattering medicines open a way out for it. The formularies of 5.9 all carry an aromatic or two for this reason, and Yongnoe-eumja at 5.9.1.1 is the clearest instance.

Dansim 丹心

5.26.6

Source원문

火急甚者, 必緩之, (生)甘草兼瀉兼緩. 參ㆍ朮亦可. 《丹心》

Translation영역

Where the fire is urgent and severe it must be moderated; raw licorice both drains and moderates, and ginseng and atractylodes will also serve.

Dansim 丹心

5.26.7

Source원문

火盛癲狂, 人壯氣實者, 可用正治, 氷水之類飮之. 人虛者, 飮以生薑湯. 若投氷水, 正致立死. 《丹心》

Translation영역

In mania and withdrawal from exuberant fire, where the person is strong and the qi replete, straight treatment may be used and iced water and the like given to drink. Where the person is depleted, give ginger decoction to drink; if iced water is thrown at them, it brings death on the spot.

Clinical note임상 주석

正致立死 — it brings death on the spot — is as blunt as the chapter gets, and the distinction it turns on is the patient's constitution rather than the presentation. The same mania gets iced water in a strong patient and hot ginger in a weak one. The case at 5.16.2 is the first of these; this passage is the warning attached to it.

Dansim 丹心

5.26.8

Source원문

補陰則火自降, 炒黃柏ㆍ生地黃之類. 《丹心》

Translation영역

Supplement the yin and the fire descends of itself — fried phellodendron and fresh rehmannia and their kind.

Dansim 丹心

5.26.9

Source원문

膀胱有火邪, 幷下焦有濕熱, 用防己ㆍ草龍膽ㆍ黃柏ㆍ知母之類. 《正傳》

Translation영역

Where the bladder has a fire evil and the lower burner has damp heat together with it, use stephania, gentian, phellodendron and anemarrhena and their kind.

Jeongjeon 正傳

5.26.10

Source원문

黃連ㆍ黃芩ㆍ白芍藥ㆍ柴胡ㆍ知母, 此皆苦寒之味, 能瀉五藏有餘之火耳. 若內傷勞倦, 爲陽虛之病, 以甘溫之劑除之, 如參ㆍ芪ㆍ甘草之屬. 若相火熾盛, 日漸煎熬, 爲血虛之病, 以甘寒之劑降之, 如當歸ㆍ地黃之屬. 若心火亢極, 爲陽强之病, 以醎冷之劑折之, 如大黃ㆍ朴硝之屬. 若腎水受傷, 眞陰失守, 爲陰虛之病, 以壯水之主制之, 如生地黃ㆍ玄參之屬. 《丹心》

Translation영역

Coptis, scutellaria, white peony, bupleurum and anemarrhena are all bitter and cold in flavour and can drain the surplus fire of the five viscera — no more than that. Where internal damage and taxation fatigue have made a disease of yang vacuity, remove it with sweet and warm preparations, such as ginseng, astragalus and licorice. Where ministerial fire blazes and parches by the day and has made a disease of blood vacuity, downbear it with sweet and cold preparations, such as angelica and rehmannia. Where heart fire is hyperactive in the extreme and has made a disease of yang hyperactivity, break it with salty and cold preparations, such as rhubarb and crude mirabilite. Where the kidney water has been damaged and the true yin has lost its guard, making a disease of yin vacuity, control it by strengthening the ruler of water, such as fresh rehmannia and scrophularia.

Clinical note임상 주석

Four conditions with four classes of medicine — sweet-warm, sweet-cold, salty-cold, and water-strengthening — and the opening clause is the point: bitter cold drains surplus fire and nothing else. That single restriction is what the whole chapter has been building toward. Most of the heat a physician meets is not surplus, and reaching for coptis by reflex treats the smallest of the four cases.

Dansim 丹心

5.26.11

Source원문

火熱通治, 宜防風通聖散ㆍ黃連解毒湯.

Translation영역

For general treatment of fire and heat, Saposhnikovia Sage-Inspired Powder and Coptis Resolve Toxin Decoction are appropriate.

Donguibogam · Hwa

5.27 Simple Medicinals 單方

5.27.1

Source원문

凡四十四種. 石膏ㆍ生地黃ㆍ柴胡ㆍ薄荷ㆍ知母ㆍ黃芩ㆍ黃連ㆍ大黃ㆍ靑蒿ㆍ地骨皮ㆍ桑椹ㆍ黃柏ㆍ梔子ㆍ牡蠣ㆍ蜆肉ㆍ蚌肉ㆍ田螺ㆍ鼃ㆍ鱉ㆍ蟹ㆍ烏梅ㆍ藕ㆍ梨ㆍ獼猴桃ㆍ脂麻油ㆍ黑豆ㆍ菉豆ㆍ甛瓜ㆍ西瓜ㆍ冬瓜ㆍ菘菜ㆍ苦菜ㆍ蕨ㆍ水芹ㆍ蜜ㆍ白鵝ㆍ白鴨ㆍ人屎ㆍ人尿ㆍ雞子ㆍ牛乳ㆍ猪肚ㆍ獺肉ㆍ鼠肉.

Translation영역

Forty-four kinds in all: gypsum, fresh rehmannia, bupleurum, mint, anemarrhena, scutellaria, coptis, rhubarb, sweet wormwood, lycium root bark, mulberry fruit, phellodendron, gardenia, oyster shell, freshwater clam flesh, freshwater mussel flesh, river snail, frog, soft-shelled turtle, crab, mume, lotus root, pear, hardy kiwi, sesame oil, black soybean, mung bean, oriental melon, watermelon, wax gourd, Chinese cabbage, bitter lettuce, bracken, water dropwort, honey, white goose, white duck, human faeces, human urine, hen's egg, cow's milk, pig stomach, otter flesh and rat flesh.

Clinical note임상 주석

Forty-four, and more than half are ordinary food — melon, watermelon, pear, kiwi, mulberry, lotus root, mung bean, cabbage, bracken, honey, milk, egg. For a chapter whose treatment sections keep saying that fire is led rather than fought, a list made mostly of cooling foods is consistent. The cold water creatures are the other group: clam, mussel, snail, frog, turtle, crab. All are yin-enriching in the tradition's reckoning and all are eaten rather than decocted. **Human faeces and urine are recorded here as historical materia medica. Ingesting them carries a serious infection risk.**

Donguibogam · Hwa

5.28 Acupuncture and Moxibustion Methods 鍼灸法

5.28.1

Source원문

骨蒸勞熱, 取膏肓ㆍ三里. 《綱目》

Translation영역

For steaming bone with taxation heat, take Gohwang (膏肓, BL43) and Samni (三里, ST36).

Gangmok 綱目

5.28.2

Source원문

骨蒸勞熱, 形氣未脫者, 灸崔氏四花穴, 無有不安. 《正傳》

Translation영역

For steaming bone with taxation heat, where the form and qi have not yet deserted, moxa Choe's four flowers points, and there is none who is not eased.

Clinical note임상 주석

形氣未脫者 — where the form and qi have not yet deserted — marks the window, and it is the same caution as 5.11.1: once the signs of desertion appear, treatment is not attempted. The four flowers points appear in the Uterus chapter at 13.24.6 for a different complaint, and the same name for the same set.

Jeongjeon 正傳

5.28.3

Source원문

體熱勞瘦, 取魄戶. 《綱目》

Translation영역

For heat of the body with taxation and wasting, take Baekho (魄戶, BL42).

Gangmok 綱目

5.28.4

Source원문

兩手大熱爲骨厥, 如在火中, 可灸涌泉三壯或五壯, 立安. 《海藏》

Translation영역

Where both hands are greatly hot — this is bone reversal, as though they were in a fire — three or five cones of moxa at Yongcheon (涌泉, KI1) may be burnt, and there is ease at once.

Clinical note임상 주석

The same point 5.15.4 treats with aconite paste, and for the same purpose: heat at the hands drawn down to the soles. Moxa is fire, and using it to treat burning heat follows the ministerial-fire rule at 5.25.1 — follow its nature and lead it down.

Haejang 海藏

5.28.5

Source원문

骨蒸熱, 板齒乾燥, 取大顀, 灸之. 《綱目》

Translation영역

For steaming bone heat with the front teeth dry and parched, take Daechu (大椎, GV14) and moxa it.

Gangmok 綱目

5.28.6

Source원문

身熱如火, 足冷如氷, 灸陽輔. 《易老》

Translation영역

Where the body is hot as fire and the feet cold as ice, moxa Yangbo (陽輔, GB38).

Clinical note임상 주석

The chapter closes on the presentation it has returned to throughout — heat above and cold below, the two ends of the body out of communication. Yangbo is on the gallbladder channel above the ankle, and moxa there works on the same principle as Yongcheon: bring the fire down to where the cold is rather than cool the part that burns.

Yeokro 易老

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 3, Fire chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.