Deficiency fire is a problem that many people encounter but find difficult to address. It differs from the "excess fire" we commonly talk about—excess fire is often temporary, such as sore throat and mouth ulcers after consuming too many spicy or fried foods, which can be quickly relieved with some heat-clearing and detoxifying herbs. However, deficiency fire tends to recur and is often accompanied by some "cold signs," such as feeling both hot and cold, or having mouth ulcers but being afraid to drink cold water. The root of this condition actually lies not in "too much fire" but in "fire going to the wrong place."

In Traditional Chinese Medicine theory, kidney yang is the foundation of the body's yang qi. It should be stably stored in the kidneys, warming the entire body. However, if due to fatigue, aging, or prolonged illness that depletes the body, kidney yang becomes insufficient, the kidneys' ability to store qi weakens, and yang qi loses its foundation, floating upwards, forming the "deficiency fire" of upper heat and lower cold. At this time, if one uses cold and cool herbs to clear heat unilaterally, it will further damage yang qi, leading to even more intense deficiency fire, creating a vicious cycle where the more you clear the fire, the bigger it becomes.

The correct approach is not to clear fire, but to redirect it—to guide the floating and excessive yang energy back to its proper place. "Qianyang Dan" (Yang-Subduing Elixir), created by the Qing Dynasty Fire Spirit School physician Zheng Qin'an, is a classic formula specifically designed for this pathological mechanism. The entire formula contains only four ingredients, yet its combination is precise and well-conceived, aiming to subdue floating yang and redirect fire back to its origin.

In the formula, Aconitum carmichaelii (Fuzi) is extremely pungent and hot, excelling at warming and tonifying kidney yang, stabilizing the fire of the Shengmen (Duancheng), and providing the driving force for the floating yang to return. Amomum villosum (Sharen) promotes qi movement and harmonizes the stomach, helping to guide the floating yang downward to return to the kidneys. Carapax testudinis (Gui ban) is salty and cold, nourishing yin, controlling the dryness of Aconitum carmichaelii, and aiding kidney water to consolidate yang. Cinnamomi glabrii (Zhi gan cao) tonifies the spleen and harmonizes the stomach, not only harmonizing the herbs but also "subduing fire with earth" to help the yang qi subside.

When these four herbs are combined, they not only guide the externally overflowing yang qi back to its proper place but also strengthen the kidney's sealing function, transforming the floating "fire qi" back into usable "qi," fundamentally improving the issue of virtual fire.

I once treated a middle-aged woman in her fifties who had chronic recurrent oral ulcers, dry throat with aversion to cold and cold limbs, sore waist and knees, and frequent nighttime urination. Despite multiple attempts to use heat-clearing herbs, her condition worsened and she became even more afraid of cold. Her syndrome was diagnosed as insufficient kidney yang with floating virtual fire. The original formula of Qianyang Dan was slightly modified and prescribed. After one week of medication, her ulcers significantly improved, and her aversion to cold 减轻 ed. Continued treatment for half a month further alleviated her virtual fire symptoms.

It should be noted that Qianyang Dan is specifically prescribed for the exact syndrome of yang deficiency with floating fire, and is not suitable for all cases of "up-rising fire." It is not recommended for those accompanied by damp-heat, excess heat, or yin deficiency with hyperactivity of fire. It is advised to use it under the guidance of a professional physician for syndrome differentiation to safely and effectively address the problem.