（味之浓者阴中之阴味浓则泄酸苦咸气寒是也）
黄连 气寒味苦无毒瓦斯味俱浓可升可降阴中阳也入手少阴经其用有六泻心藏火一也去中焦湿热二也诸疮必用
三也
去风湿四也赤眼暴发五也止中部见血六也张仲景治九种心下痞五等泻心汤皆用之 〔海〕入手少阴苦燥故入心火就
燥也然
泻心其实泻脾也为子能令母实实则泻其子治血防风为上使黄连为中使地榆为下使去须铡细用
黄芩 气寒味苦无毒可升可降阴也阴中微阳入手太阳血分 〔洁〕气凉味苦甘气浓味薄浮而升阳中阴也
入手少阳阳明
经酒炒则上行 〔垣〕黄芩之中枯而飘者泻肺火利气消痰除风热消肌表之热细实而坚者泻大肠火养阴退阳补膀胱寒
水滋其
化源高下之分与枳实枳壳同例 〔洁〕黄芩之用有九泻肺热一也上焦皮肤风热风湿二也去诸热三也利胸中气四也消
痰膈五
也除脾经诸湿六也夏月须用七也妇人产后养阴退阳八也安胎九也酒炒上行主上部积血非此不能除下利脓血腹痛后重身
热久不能止者与芍药甘草同用之凡诸疮痛不可忍者宜黄连苦寒之药详上下分身稍及引经药用之 〔颂〕张仲景治伤
寒心下
痞满泻心汤凡四方皆用黄芩以其主诸热利小肠故也又太阳病下之利不止喘而汗出者有葛根黄芩黄连汤及主妊娠安胎散
亦多用之 〔珍〕洁古老人言黄芩泻肺火治脾湿东垣言片芩治肺火条芩治大肠火丹溪言黄芩治上中二焦火而仲景治
少阳证
小柴胡汤太阳少阳合病下利黄芩汤少阳证下后心下满而不痛泻心汤并用之成无己言黄芩苦而入心泄痞热是黄芩能入手
少阴阳明手足太阴少阳六经矣盖黄芩气寒味苦色黄带绿苦入心寒胜热泻心火治脾之湿热一则金不受刑一则胃火不流入
肺即所以救肺也肺虚不宜者苦寒伤脾胃损其母也少阳之证寒热胸胁痞满默默不欲饮食心烦呕或烦或痞或小便不利虽曰
病在半表半里而胸胁痞满实兼心肺上焦之邪心烦喜呕默默不欲饮食又兼脾胃中焦之证故用黄芩以治手足少阳相火黄芩
亦少阳本经药也成无己注伤寒论但云柴胡黄芩之苦以发传邪之热芍药黄芩之苦以坚敛肠胃之气殊昧其治火之妙杨士瀛
直指方云柴胡退热不及黄芩盖亦不知柴胡之退热乃苦以发之散火之标也黄芩之退热乃寒能胜热折火之本也仲景又云少
阳病腹中痛者去黄芩加芍药心下悸小便不利者去黄芩加茯苓似与别录治少腹绞痛利小肠之文不合成氏言黄芩寒中苦能
坚肾故去之盖亦不然至此当以意逆之辨以脉证可也若因饮寒受寒腹中痛及饮水心下悸小便不利而脉不数者是里无热证
则黄芩不可用也若热厥腹痛肺热而小便不利者黄芩其可不用乎故善观书者先求其理毋徒泥其文去皮并黑腐铡细竹筛齐
用
黄柏 气寒味苦无毒瓦斯味俱浓沉而降阴也苦浓微辛阴中之阳入足少阴经为足太阳引经药 〔垣〕治肾水
膀胱不足诸痿
厥脚膝无力于黄 汤中少加用之使两膝中气力涌出痿即去矣蜜炒此一味为细末治口疮如神瘫痪必用之药泻膀胱之热利
下窍泻膀胱经火补本经及肾不足苦寒安蛔疗下焦虚坚肾经曰苦以坚之足少阴剂肾苦燥故肾停湿也栀子黄芩入肺黄连入
心黄柏入肾燥湿所归各从其类也活人书解毒汤上下内外通治之去皮铡碎生用则降实火熟用酒制则治上盐制则治下蜜制
则治中而不伤胃
栀子 气寒味苦无毒 〔洁〕气薄味浓轻清上行气浮而味降阳中阴也 〔垣〕沉也阴也入手太阴肺
经血分 〔海〕本草不言栀
子能吐仲景用为吐药栀子本非吐药为邪气在上拒而不纳食今上吐则邪因以出所谓其高者因而越之也或用为利小便药实
非利小便乃清肺也肺清则化行而膀胱津液之腑得此气化而出也本草言治大小肠热乃辛与庚合又与丙合又能泄戊先入中
州故也仲景治烦躁用栀子豉汤烦者气也躁者血也气主肺躁主血故用栀子以治肺烦香豉以治肾躁仲景以栀子色赤味苦入
心而治烦香豉色黑味咸入肾而治躁 〔寇〕仲景治伤寒发汗吐下后虚寒不得眠若剧者必反复颠倒心中懊 栀子豉汤
治之因
其虚故不用大黄有寒毒故也栀子虽寒而无毒治胃中热气既亡血亡津液腑藏无润养内生虚热非此物不可去也又治心经留
热小便赤涩用去皮栀子火煨大黄连翘炙甘草等分末之水煎三钱服无不利也凡使须要如雀脑并须长有九路赤色者为上去
心胸中热用仁去肌表热用皮治上焦中焦连壳用下焦去壳治血病炒黑用
石膏 气寒味甘辛无毒入手太阴经少阳经足阳明经 〔洁〕石膏性寒味辛而淡气味俱薄体重而沉降也阴
也乃
阳明经大
寒之药善治本经头痛牙痛止消渴中暑潮热然能寒胃令人不食非腹有极热者不宜轻用又阳明经中热发热恶寒燥热日晡潮
湿肌肉壮热小便浊赤大渴引饮自汗苦头痛之药仲景用白虎汤是也若无以上诸证勿服之多有血虚发热象白虎证及脾胃虚
劳形体病证初得之时与此证同医者不识而误用之不可胜救也 〔垣〕石膏足阳明经也故仲景治伤寒阳明证身热目痛
鼻干不
得卧身以前胃之经也胸前肺之室也邪在阳明肺受火制故用辛寒以清肺气所以有白虎之名又治三焦皮肤大热入手少阳也
凡病脉数不退者宜用之胃弱者不可用按温热病烦热而渴脉洪大而数且长者非用石膏不能取效冬月有此脉证亦宜用之仲
景制白虎汤为正伤寒设也东垣处暑以后勿用之说不可拘泥此即市所谓寒水石者也亦谓之硬石膏细理白泽者良碎之如粟
米大先煮数十沸乃入余药以其气味难出故也
知母 气寒味苦气味俱浓沉而降阴也阴中微阳肾经本药入足阳明手太阴经气分 〔垣〕其用有四泻无根
之肾
火疗有汗
之骨蒸止虚劳之热滋化原之阴仲景用此入白虎汤治不得眠者烦躁也烦出于肺躁出于肾君以石膏佐以知母之苦寒以清肾
之源缓以甘草粳米使不速下也又凡病小便 塞而渴者热在上焦气分肺中伏热不能生水膀胱绝其化源宜用气薄味薄淡渗
之药以泻肺火清肺金而滋水之化源若热在下焦血分而不渴者乃真水不足膀胱干涸乃无阴则阳无以化法当用黄柏知母大
苦寒之药以补肾与膀胱使阴气行而阳自化小便自通凡用拣肥润里白者去毛切引经上行则用酒浸焙干下行则用盐水润焙
（忌铁）
秦皮 气寒味苦无毒沉也降也 〔海〕主热利下重下焦虚经云以苦坚之故用白头翁黄柏秦皮若苦之剂也
治风寒湿痹目
中青翳白膜男子少精妇人带下小儿惊痫宜作汤洗目俗呼为白 木取皮渍水浸出青蓝色与紫草同用以增光晕尤佳大戟为
之使恶吴茱萸 〔珍〕 皮色青气寒味苦性涩乃是厥阴肝少阳胆经药也故治目病惊痫取其平木也治下利崩带取其收
涩也又
能治男子少精益精有子皆取其涩而补也故老子云天道贵涩此药乃服食及惊痫崩利所宜而人止知其治目一节几于废弃良
为可惋
白头翁 气寒味苦辛无毒瓦斯浓味薄可升可降阴中阳也主温疟狂易寒热 瘕积聚逐血止痛张仲景治热利下重用
白头
翁汤主之盖肾欲坚急食苦以坚之利则下焦虚故以纯苦之剂坚之男子阴疝偏坠小儿头秃膻腥鼻衄无此不效毒痢有此获功
亦多 〔吴〕热毒下利紫血鲜血者宜之
大黄 气寒味苦无毒瓦斯味俱浓沉而降阴也用之须酒浸煨熟者寒因热用酒浸入太阳经酒洗入阳明经余经不用酒
〔垣〕
大黄苦峻下走用之于下必生用若邪气在上非酒不至必用酒浸引上至高之分驱热而下如物在高巅必射以取之也若用生者
则遗至高之邪热是以愈后或目赤或喉痹或头肿或膈上热疾生也 〔寇〕仲景治心气不足吐血衄血泻心汤用大黄黄芩
黄连或曰
心气既不足而不用补心汤更用泻心何也答曰若心气独不足则当不吐衄也此乃邪热因不足而客之故令吐衄以苦补其心盖
一举而两得之有是证者用之无不效惟在量其虚实而已 〔丹〕大黄苦寒善泄仲景用之泻心汤者正因少阴经不足本经之
阳亢
甚无辅以致阴血妄行飞越故用大黄泻去亢甚之火使之平和则血归经而自安夫心之阴气不足非一日矣肺与肝俱各受火而
病作故黄芩救肺黄连救肝肺者阴之主肝者心之母血之舍也肝肺之火既退则阴血复其旧矣寇氏不明说而云邪热客之何以
开悟后人也 〔珍〕大黄乃足太阴手足阳明手足厥阴五经血分之药凡病在五经血分者宜用之若在气分用之是谓诛伐
无过矣
泻心汤治心气不足吐血衄血者乃真心之气不足而手厥阴心包络足厥阴肝足太阴脾足阳明胃之邪火有余也虽曰泻心实泻
四经血中之伏火也又仲景治心下痞满按之软者用大黄黄连泻心汤主之此亦泻脾胃之湿热非泻心也病发于阴而反下之则
作痞满乃寒伤荣血邪气乘虚结于上焦胃之上脘在于心故曰泻心实泻脾也素问云太阴所至为痞满又云浊气在上则生 胀
是矣病发于阳而反下之则成结胸乃热邪陷入血分亦在上脘分野仲景大陷胸汤丸皆用大黄亦泻脾胃血分之邪而降其浊气
也若结胸在气分则只用小陷胸汤痞满在气分则用半夏泻心汤矣成成氏注伤寒论亦不知分别此义 〔颂〕本草称大黄
推陈致
新其效最神故古方下积滞多用之张仲景治伤寒用处尤多古人用毒药攻病必随人之虚实寒热而处治非一切轻用也梁武帝
因发热欲服大黄姚僧坦曰大黄乃是快药至尊年高不可轻用帝弗从几至委顿梁元帝常有心腹疾诸医咸谓宜用平药可渐宣
通僧坦曰脉洪而实此有宿积非用大黄无瘥理帝从之遂愈以此言之今医用一毒药而攻众病其偶中便谓此方神奇其差误则
不言用药之失可不戒哉去皮铡碎竹筛齐用
芒硝 气大寒味咸苦辛有小毒 〔成〕内经云咸味下泄为阴又云咸以软之热淫于内治以咸寒气坚者以咸
软之热盛者以
寒消之故张仲景大陷胸汤大承气汤调胃承气汤皆用芒硝以软坚去实热结不至坚者不可用也 〔海〕本草云朴硝味辛
是
辛以
润肾燥也今人不用辛字只用咸字咸能软坚也其义皆是本草言芒硝利小便而堕胎然伤寒妊娠可下者用此兼大黄引之直入
大腹润燥软坚泻热而母子俱安经云有故无殒亦无殒也此之谓欤以在下言之则便溺俱阴以前后言之则前气后血以肾言之
总主大小便难溺涩秘结俱为水少火盛经云热淫于内治以咸寒佐之以苦故用芒硝大黄相须为使也 〔洁〕芒硝气薄味浓沉而
降阴也其用有三去实热一也涤肠中宿垢二也破坚积热块三也 〔珍〕朴硝是初得一煎而成者故力紧急而不和止可施于粗犷
之人及敷涂之剂而已芒硝是朴硝淋过炼成故其性和缓仲景治伤寒多用之以此故也硝禀太阴之精水之子也气寒味咸走血
而润下荡涤三焦肠胃实热阳强之病乃折治火邪药也生用
香豉 气寒味苦无毒阴中之阴也主伤寒头痛烦躁满闷生用 〔珍〕黑豆性平作豉则温既经蒸窨故能升能散得葱则
发汗
得盐则能吐得酒则治风得薤则治痢得蒜则止血炒熟则大能止汗亦麻黄根节之义也
茵陈蒿 气微寒味苦辛无毒阴中微阳入足太阳经除烦热主风湿寒热邪气热结黄胆通身发黄小便不利 〔寇〕
张
仲景治伤寒热甚发黄身面悉黄者用之极效一僧因伤寒后发汗不彻有留热面身皆黄多热期年不愈医作
食治不对而食不减予与此药服五日病减三分之一十日减三分之二二十日病悉去方用山茵陈山栀子各三
分秦艽升麻各四钱为散每用三钱水四合煎二合去滓食后温服以知为度此药以山茵陈为本故书之
〔海〕仲景茵陈栀子大黄汤治湿热也栀子柏皮汤治燥热也如苗涝则湿黄旱则燥黄湿则泻之燥则润之可也
此二药治阳黄也韩祗和李思训治阴黄用茵陈附子汤大抵以茵陈为君主而佐以大黄附子各随其寒热也去
枝用叶手搓碎用
栝蒌实 气寒味甘微苦无毒 〔丹〕栝楼实治胸痹者以其味甘性润甘能补肺润能降气胸中有痰
者乃肺受火逼失其降下之令今得甘缓润下之助则痰自降宜其为治嗽之要药也且又能洗涤胸膈中垢腻郁热
为治消渴之神药 〔珍〕张仲景治胸痹痛引心背咳唾喘息及结胸满痛皆用栝蒌实乃取其甘寒不犯胃气能
降上焦之火使痰气下降也成无己不知此意乃云苦寒以泻热盖不尝其味原不苦而随文傅会尔肥大结实者
连子连皮细切用今人止用核仁非也
栝蒌根（一名天花粉） 气寒味甘微苦酸无毒主消渴身热烦满大热补虚安中通月水消肿毒瘀
血及热狂疮疖 〔垣〕栝蒌根纯阴解烦渴行津液心中枯涸者非此不能除与辛酸同用导肿气
〔珍〕栝蒌根味甘微苦酸其茎叶味酸酸能生津感召之理故能止渴润枯微苦降火甘不伤胃昔人只言其苦寒
似未深察捣细罗过用
土瓜根 气寒味苦有小毒主疗诸邪气热结逐四时骨节中水疗天行热疾酒黄病壮热心烦闷热劳
能吐下人
连轺（连翘根也）气寒味甘苦有小毒主下热气益阴精故仲景治伤寒瘀热在里欲发黄用麻黄连
轺赤小豆汤
竹叶 气寒味甘无毒淡竹为上甘竹次之主胸中痰热咳逆上气 〔寇〕诸笋性皆寒故知其叶
一致也张仲景竹叶汤惟用淡竹 〔洁〕竹叶苦平阴中微阳 〔垣〕竹叶辛苦寒可升可降阳中阴也
其用有二除新久风邪之烦热止喘促气胜之上冲
梓白皮 气寒味苦无毒主热毒去二虫时气温病头痛壮热初得一日用生梓木削去黑皮取里白
（味道浓厚的药材属于阴中之阴，味浓则能泄降，酸、苦、咸味且性寒的药材即属此类）
黄连：气性寒，味道苦，无毒。其药气与药味都非常浓厚，作用趋势既可上升也可下降，属于阴中寓阳之品。归入手少阴心经。它的作用有六方面：一是清泻心火；二是清除中焦的湿热；三是治疗各种疮疡必用此药；四是祛除风湿；五是治疗突发的赤眼红肿；六是止住中部出血。张仲景治疗九种心下痞证的五种泻心汤中都使用它。〔李杲〕认为黄连入足少阴肾经，因其味苦性燥，故能入心火以就燥湿。然而，所谓“泻心”，其实是在泻脾火，因为根据五行理论，“子能令母实”，实则泻其子，所以治血时防风为引经上使，黄连为中使，地榆为下使。使用时需去须，铡细备用。
黄芩：气性寒，味道苦，无毒。作用趋势可升可降，属阴，但阴中微含阳气。归入手太阳小肠经的血分。〔张元素〕认为其气凉味苦甘，气浓味薄，性质浮而升，属于阳中之阴。归入手少阳胆经和手阳明大肠经。酒炒后药力上行。〔李杲〕认为黄芩中空而轻飘者，能清泻肺火，利气消痰，祛除风热，消除肌表的热邪；质地坚实而重者，能清泻大肠火，滋养阴液，退除虚阳，补益膀胱寒水，滋生化之源。其高下之分的使用原则与枳实、枳壳类似。〔张元素〕总结黄芩的功效有九方面：一是清泻肺热；二是清除上焦皮肤的风热、风湿；三是清除各种热邪；四是利胸中气机；五是消除膈间痰饮；六是清除脾经的各种湿气；七是夏季必须使用；八是妇女产后用于养阴退阳；九是安胎。酒炒后上行，主治上部积血，非此药不能清除。若出现下利脓血、腹痛、里急后重、身热长久不止等症状，应与芍药、甘草同用。凡是各种疮疡疼痛难忍者，适宜使用黄连等苦寒药物，需详细辨别上下部位及身体经络，适当加入引经药使用。〔苏颂〕记载张仲景治疗伤寒导致的心下痞满，四个泻心方剂中都使用黄芩，因为它主治各种热邪，通利小肠。另外，太阳病误用攻下法导致腹泻不止、喘息出汗者，可用葛根黄芩黄连汤；治疗妊娠安胎散中也多用黄芩。〔朱震亨〕指出，张元素说黄芩清泻肺火、治疗脾湿；李杲说片芩治肺火，条芩治大肠火；朱震亨说黄芩治上、中二焦之火；而张仲景在治疗少阳证的小柴胡汤、太阳少阳合病下利的黄芩汤、以及少阳证下后心下满而不痛的泻心汤中均使用了它。成无己说黄芩味苦入心，泄除痞热，这说明黄芩能入手少阴、手阳明、足太阴、足少阳六经。大概是因为黄芩气寒味苦，色黄带绿，苦入心，寒胜热，清泻心火，治疗脾的湿热。这样一来，肺金不受心火克制（金不受刑），胃火也不流入肺，这就是救肺的方法。但如果肺虚不宜使用，因为苦寒会损伤脾胃，损害其母脏（土生金）。少阳证的表现为寒热往来、胸胁痞满、神情沉默不欲饮食、心烦或呕，或烦闷，或小便不利。虽然说是病在半表半里，但胸胁痞满实际上兼有心肺上焦的邪气，心烦喜呕、神情沉默不欲饮食又兼有脾胃中焦的证候，所以用黄芩来治疗手足少阳相火。黄芩也是少阳本经的药物。成无己注解《伤寒论》只说柴胡、黄芩之苦以发散传变之邪的热，芍药、黄芩之苦以坚固收敛肠胃之气，这很不明白治疗火邪的奥妙。杨士瀛在《直指方》中说柴胡退热不如黄芩，大概也不知道柴胡退热是靠苦味发散，疏散火的表象；而黄芩退热是靠寒性能胜热，折服火的根本。张仲景又说，少阳病腹中痛者，去掉黄芩加芍药；心下悸、小便不利者，去掉黄芩加茯苓。这似乎与《别录》中治疗少腹绞痛、利小肠的说法不符。成无己说黄芩性寒中苦，能坚肾，所以去掉它。这大概也不对。这里应当通过推究医理，结合脉证来辨别。如果是因饮水受寒导致腹中痛，以及饮水后心下悸、小便不利，且脉象不数，这是里没有热证，那么黄芩不可用。如果是热厥腹痛、肺热导致小便不利，黄芩难道可以不用吗？所以善于读书的人，先要求得其道理，不要仅仅拘泥于文字。使用时去皮及黑腐部分，铡细，过竹筛备用。
黄柏：气性寒，味道苦，无毒。药气与药味都非常浓厚，性质沉降，属阴，味苦浓微辛，属于阴中之阳。归入足少阴肾经，是足太阳膀胱经的引经药。〔李杲〕用于治疗肾水、膀胱不足引起的各种痿证、厥证、脚膝无力，在黄柏汤中少量加入，能使两膝中的气力涌出，痿证即可去除。蜜炒后，将此一味研成细末，治疗口疮如神效，是治疗瘫痪的必用药物。它能泻膀胱热，通利下窍，泻膀胱经火，补益本经及肾的不足。《内经》说：“苦以坚之。”足少阴肾经，肾怕燥，所以肾容易停湿。栀子、黄芩入肺，黄连入心，黄柏入肾，燥湿的作用各归其类。《活人书》中的解毒汤，上下内外通治。使用时去皮，铡碎。生用则降实火，熟用酒制则治上部，盐制则治下部，蜜制则治中部且不伤胃。
栀子：气性寒，味道苦，无毒。〔张元素〕认为其气薄味浓，轻清上行，气浮而味降，属于阳中之阴。〔李杲〕认为其性沉，属阴，归入手太阴肺经的血分。〔李东垣〕《本草》未言栀子能催吐，张仲景将其用作吐药。栀子本身并非吐药，而是因为邪气在上部，拒药不纳，现在上部呕吐，邪气因此而出，这就是所谓“其高者，因而越之”。也有人用它作为利小便的药，其实并非直接利小便，而是清肺。肺清则气化运行，膀胱津液之腑得到气化而排尿。《本草》说它治大小肠热，是因为辛与庚合，又与丙合，又能泄戊土（胃），先入中州的原因。张仲景治疗烦躁用栀子豉汤。烦是气的问题，躁是血的问题。气主肺，躁主血，所以用栀子治肺之烦，香豉治肾之躁。张仲景认为栀子色赤味苦入心而治烦，香豉色黑味咸入肾而治躁。〔寇宗奭〕记载张仲景治疗伤寒发汗、吐、下后，虚寒不得眠，如果严重的一定会反复颠倒、心中懊恼，用栀子豉汤治疗。因为其虚，所以不用大黄，因为大黄有寒毒。栀子虽然寒但无毒，能治胃中热气。既然已经亡血、亡津液，脏腑失去润养，内生虚热，非此物不能去除。另外治疗心经留热、小便赤涩，用去皮栀子、火煨大黄、连翘、炙甘草各等分，研末，每次水煎三钱服用，没有不有效的。凡使用栀子，需要选择像雀脑一样并长有九路纹路、颜色赤红的。治心胸中热用仁，治肌表热用皮，治上焦、中焦连壳用，治下焦去壳，治血病炒黑用。
石膏：气性寒，味道甘、辛，无毒。归入手太阴肺经、手少阳三焦经、足阳明胃经。〔张元素〕认为石膏性寒味辛而淡，气味都薄，体重而沉降，属阴，是阳明经大寒的药物。善于治疗本经头痛、牙痛，止消渴，治中暑、潮热。但它能寒凝胃气，令人不食，如果不是腹部有极热者，不宜轻易使用。另外，阳明经中热发热、恶寒、燥热、日晡潮热、肌肉壮热、小便浊赤、大渴引饮、自汗，是治疗苦头痛的药物。张仲景使用白虎汤即是此意。如果没有以上诸证，不要服用。多有血虚发热像白虎证，以及脾胃虚劳形体病证，初得之时与此证相同，医生不认识而误用，不可胜数地无法挽救。〔李杲〕认为石膏是足阳明经的药物，所以张仲景治疗伤寒阳明证，身热、目痛、鼻干、不得卧，这些是胃的经脉在前，胸前是肺的居室。邪在阳明，肺受火制，所以用辛寒以清肺气，因此有白虎之名。又治疗三焦皮肤大热，归入手少阳经。凡是病脉数不退者适宜使用。胃弱者不可用。按温热病烦热而渴，脉洪大而数且长者，非用石膏不能取效。冬月有此脉证也适宜使用。张仲景制定白虎汤是为正伤寒设立的。李杲处暑以后勿用的说法不可拘泥。这就是市上所卖的寒水石，也称为硬石膏。纹理细致洁白者为良。碎成小米大小，先煮数十沸，再放入其他药物，因为其气味难以析出。
知母：气性寒，味道苦，气味都浓厚，性质沉降，属阴，阴中微含阳气。是肾经的本药，归入足阳明胃经、手太阴肺经的气分。〔李杲〕它的作用有四方面：泻无根的肾火，治疗有汗的骨蒸，止虚劳的热，滋生化之源的阴。张仲景用此药入白虎汤，治疗不得眠的烦躁。烦出于肺，躁出于肾，君药以石膏，佐药以知母之苦寒以清肾之源，缓以甘草、粳米为使，使其不速下。另外，凡是病见小便闭塞而渴者，热在上焦气分，肺中伏热不能生水，膀胱绝其化源，宜用气薄味薄的淡渗药物以泻肺火、清肺金而滋水之化源。若热在下焦血分而不渴者，是真水不足，膀胱干涸，乃无阴则阳无以化，法当用黄柏、知母等大苦寒药物以补肾与膀胱，使阴气行而阳自化，小便自通。凡使用知母，拣选肥润、里面白色的，去毛切。引经上行则用酒浸焙干，下行则用盐水润焙。（忌铁器）
秦皮：气性寒，味道苦，无毒。性质沉，趋势降。〔李东垣〕主治热利下重，下焦虚。《内经》说“以苦坚之”，所以用白头翁、黄柏、秦皮这类苦味药剂。治疗风寒湿痹，目中青翳白膜，男子少精，妇人带下，小儿惊痫。宜作汤洗目，俗称为白木，取皮渍水浸出青蓝色，与紫草同用以增加光晕尤佳。大戟为之使，恶吴茱萸。〔朱震亨〕秦皮色青，气寒味苦，性涩，乃是厥阴肝经、少阳胆经的药物。所以治疗目病、惊痫，取其平肝木之意；治疗下利、崩漏、带下，取其收涩之意。又能治疗男子少精、益精有子，都取其涩而补的意思。所以老子说天道贵涩，此药乃服食及惊痫、崩漏、下利所适宜，而人们只知道它治疗眼睛一节，几乎被废弃，实在令人惋惜。
白头翁：气性寒，味道苦、辛，无毒。药气浓厚，药味较薄，可升可降，属于阴中寓阳。主治温疟、狂易、寒热、瘕积聚，逐血止痛。张仲景治疗热利下重用白头翁汤主治它。大概是因为肾欲坚，急食苦以坚之。利则下焦虚，所以用纯苦的药剂来坚之。男子阴疝偏坠，小儿头秃膻腥，鼻衄，无此药不效。毒痢有此药获功也很多。〔吴球〕热毒下利，紫血鲜血者适宜使用。
大黄：气性寒，味道苦，无毒。药气与药味都非常浓厚，性质沉降，属阴。使用时须酒浸、煨熟者，寒因热用。酒浸入太阳经，酒洗入阳明经，其余经络不用酒。〔李杲〕大黄苦峻下走，用之于下必生用。若邪气在上，非酒不至，必用酒浸，引药至高之分，驱热而下，如同物体在高巅，必射以取之。如果用生的，则会遗留至高之处的邪热，所以愈后可能出现目赤、喉痹、头肿或膈上热疾等症。〔寇宗奭〕张仲景治疗心气不足导致的吐血、衄血，泻心汤中使用大黄、黄芩、黄连。有人问：心气既然不足，为何不用补心汤，反而用泻心汤呢？回答说：如果心气独独不足，则应当不会吐血、衄血。这是邪热因不足而客居于心，所以令吐血、衄血。用苦味补其心，一举两得。有这些证候的使用，无不有效，只在衡量其虚实而已。〔朱震亨〕大黄苦寒，善于泄降。张仲景用它入泻心汤，正是因为少阴经不足，本经之阳亢盛甚，无辅佐以致阴血妄行飞越，所以用大黄泻去亢盛甚的火，使之平和，则血归经而自安。心的阴气不足不是一天了，肺与肝都各自受火而发病，所以黄芩救肺，黄连救肝。肺是阴之主，肝是心之母，血的舍宅。肝肺之火既退，则阴血恢复旧观。寇氏不明说而云邪热客之，何以开悟后人呢？〔朱震亨〕大黄是足太阴、手阳明、足阳明、手厥阴、足厥阴五经血分的药物。凡是病在五经血分者适宜使用。若在气分使用，这叫诛伐无过。
泻心汤治疗心气不足导致的吐血、衄血，乃是真心之气不足，而手厥阴心包络、足厥阴肝、足太阴脾、足阳明胃的邪火有余。虽然叫泻心，实际上是泻四经血中的伏火。另外张仲景治疗心下痞满，按之软者，用大黄黄连泻心汤主治。这也是泻脾胃的湿热，并非泻心。病发于阴而反用攻下法，则作痞满，乃寒伤荣血，邪气乘虚结于上焦胃之上脘，在于心，所以说泻心，实际上是泻脾。《素问》说太阴所至为痞满，又说浊气在上则生胀，就是这个道理。病发于阳而反用攻下法，则成结胸，乃热邪陷入血分，也在上脘分野。张仲景的大陷胸汤丸都用大黄，也是泻脾胃血分之邪而降其浊气。若结胸在气分则只用小陷胸汤，痞满在气分则用半夏泻心汤了。成无己注解《伤寒论》也不知道分别这个意义。〔苏颂〕《本草》称大黄推陈致新，其效果最神奇，所以古方下积滞多用之。张仲景治疗伤寒用处尤其多。古人用毒药攻病，必定随人的虚实寒热而处方治疗，不是一切轻用。梁武帝因发热想服大黄，姚僧坦说：“大黄乃是快药，至尊年高，不可轻用。”武帝不从，几乎至委顿。梁元帝常有心腹疾，诸医都说宜用平药可渐宣通，僧坦说：“脉洪而实，此有宿积，非用大黄无痊愈之理。”武帝从之遂愈。以此言之，今医用一毒药而攻众病，其偶中便谓此方神奇，其差误则不言用药之失，可不戒哉！使用时去皮，铡碎，过竹筛备用。
芒硝：气大寒，味道咸、苦、辛，有小毒。〔成无己〕《内经》说咸味下泄为阴，又说咸以软之。热淫于内，治以咸寒。气坚者以咸软之，热盛者以寒消之。所以张仲景的大陷胸汤、大承气汤、调胃承气汤都用芒硝以软坚去实热结。不至坚者不可用。〔李东垣〕《本草》说朴硝味辛，是辛以润肾燥。今人不用辛字，只用咸字，咸能软坚，其义皆是。《本草》说芒硝利小便而堕胎，然伤寒妊娠可下者用此，兼大黄引之直入大腹，润燥软坚，泻热而母子俱安。《内经》说“有故无殒，亦无殒也”，说的就是这种情况。以在下言之，则便溺俱阴；以前后言之，则前气后血；以肾言之，总主大小便难、溺涩秘结，俱为水少火盛。《内经》说热淫于内，治以咸寒，佐之以苦，所以用芒硝、大黄相须为使。〔张元素〕芒硝气薄味浓，沉降，属阴。它的作用有三方面：去实热，涤肠中宿垢，破坚积热块。〔朱震亨〕朴硝是初次煎成者，所以力紧急而不和，只可施于粗犷之人及敷涂之剂而已。芒硝是朴硝淋过炼成，所以其性和缓，张仲景治疗伤寒多用它，以此缘故。硝禀赋太阴之精，水之子也，气寒味咸，走血而润下，荡涤三焦肠胃实热，阳强之病，乃折治火邪药也。生用。
香豉：气性寒，味道苦，无毒，属于阴中之阴。主治伤寒头痛、烦躁、满闷，生用。〔朱震亨〕黑豆性平，作豉则温，既经蒸窨，故能升能散。得葱则发汗，得盐则能吐，得酒则治风，得薤则治痢，得蒜则止血，炒熟则大能止汗，也是麻黄根节的意义。
茵陈蒿：气微寒，味道苦、辛，无毒，阴中微含阳气。归入足太阳膀胱经。除烦热，主治风湿寒热邪气，热结黄疸，通身发黄，小便不利。〔寇宗奭〕张仲景治疗伤寒热甚发黄，身面悉黄者，用之极效。一僧因伤寒后发汗不彻，有留热，面身皆黄，多热期年不愈，医作食治不对而食不减。予与此药服五日病减三分之一，十日减三分之二，二十日病悉去。方用山茵陈、山栀子各三分，秦艽、升麻各四钱，为散，每用三钱，水四合，煎二合，去滓，食后温服，以知为度。此药以山茵陈为本，故书之。〔李东垣〕张仲景茵陈蒿汤、栀子大黄汤治湿热；栀子柏皮汤治燥热。如苗涝则湿黄，旱则燥黄，湿则泻之，燥则润之，可也。此二药治阳黄。韩祗和、李思训治阴黄用茵陈附子汤。大抵以茵陈为君主，而佐以大黄、附子，各随其寒热。去枝用叶，手搓碎用。
栝蒌实：气性寒，味道甘、微苦，无毒。〔朱震亨〕栝楼实治胸痹，以其味甘性润，甘能补肺，润能降气。胸中有痰者，乃肺受火逼，失其降下之令。今得甘缓润下之助，则痰自降，宜其为治嗽之要药也。且又能洗涤胸膈中垢腻郁热，为治消渴之神药。〔朱震亨〕张仲景治疗胸痹痛引心背、咳唾喘息及结胸满痛，皆用栝蒌实，乃取其甘寒不犯胃气，能降上焦之火，使痰气下降也。成无己不知此意，乃云苦寒以泻热，盖不尝其味，原不苦而随文傅会尔。肥大结实者，连子连皮细切用。今人只用核仁，非也。
栝蒌根（一名天花粉）：气性寒，味道甘、微苦、酸，无毒。主治消渴、身热、烦满、大热，补虚安神，通月水，消肿毒，瘀血及热狂、疮疖。〔李杲〕栝蒌根纯阴，解烦渴，行津液，心中枯涸者非此不能除。与辛酸同用导肿气。〔朱震亨〕栝蒌根味甘微苦酸，其茎叶味酸，酸能生津，感召之理，故能止渴润枯。微苦降火，甘不伤胃。昔人只言其苦寒，似未深察。捣细罗过用。
土瓜根：气性寒，味道苦，有小毒。主治疗诸邪气、热结，逐四时骨节中水，疗天行热疾、酒黄病、壮热心烦、闷热劳，能吐下人。
连轺（连翘根也）：气性寒，味道甘、苦，有小毒。主治下热气，益阴精。所以张仲景治疗伤寒瘀热在里欲发黄，用麻黄连轺赤小豆汤。
竹叶：气性寒，味道甘，无毒。淡竹为上，甘竹次之。主治胸中痰热、咳逆上气。〔寇宗奭〕诸笋性皆寒，故知其叶一致。张仲景竹叶汤惟用淡竹。〔张元素〕竹叶苦平，阴中微阳。〔李杲〕竹叶辛苦寒，可升可降，阳中阴也。它的作用有二方面：除新久风邪之烦热，止喘促气胜之上冲。
(The herbs with strong flavors belong to Yin within Yin. Strong flavors induce purgation. Sour, bitter, and salty flavors combined with cold nature exemplify this category.)
**Coptidis Rhizoma (Huanglian, 黄连):** Nature is cold, flavor is bitter, non-toxic. Its medicinal qi and flavor are both dense; its action can ascend or descend, belonging to Yang within Yin. It enters the Hand-Shaoyin Heart Meridian. Its functions are sixfold: first, it clears and drains Heart Fire; second, it removes damp-heat from the Middle Jiao; third, it is essential for treating various sores and ulcers; fourth, it dispels wind-dampness; fifth, it treats sudden onset of red eyes; sixth, it stops bleeding in the middle region. Zhang Zhongjing used it in all five varieties of Xixin Decoction (Clear the Heart Decoction) for treating nine types of epigastric fullness. [Li Dongyuan] states that Huanglian enters the Foot-Shaoyin Kidney Meridian because its bitter and drying nature allows it to address dryness in Heart Fire. However, "draining the Heart" actually refers to draining the Spleen, based on the principle that "the child can cause the mother to be excess," and thus excess in the child is drained. In treating blood disorders, Saposhnikoviae Radix (Fangfeng, 防风) serves as the ascending guide, Coptidis Rhizoma (Huanglian, 黄连) as the central agent, and Sanguisorbae Radix (Diyu, 地榆) as the descending agent. Remove the rootlets, chop finely, and prepare.
**Scutellariae Radix (Huangqin, 黄芩):** Nature is cold, flavor is bitter, non-toxic. Its action can ascend or descend, belonging to Yin with slight Yang within. It enters the Blood aspect of the Hand-Taiyang Small Intestine Meridian. [Zhang Yuansu] describes its nature as cool, flavor as bitter and sweet, with dense qi and thin flavor, floating and ascending, representing Yin within Yang. It enters the Hand-Shaoyang Gallbladder and Hand-Yangming Large Intestine Meridians. Wine-frying directs its action upward. [Li Dongyuan] notes that Scutellariae Radix which is hollow and light clears Lung Fire, promotes Qi movement, resolves phlegm, dispels wind-heat, and eliminates heat in the muscle layer. Those that are solid and heavy clear Large Intestine Fire, nourish Yin, subdue deficient Yang, tonify Bladder Cold Water, and nourish the source of transformation. The distinction between high and low usage parallels that of Aurantii Fructus Immaturus (Zhishi, 枳实) and Aurantii Fructus (Zhiqiao, 枳壳). [Zhang Yuansu] summarizes nine uses for Scutellariae Radix: first, clears Lung heat; second, removes wind-heat and wind-dampness from the upper Jiao skin; third, clears various heats; fourth, benefits Qi in the chest; fifth, eliminates phlegm in the diaphragm; sixth, removes dampness from the Spleen meridian; seventh, must be used in summer; eighth, nourishes Yin and subdues Yang postpartum in women; ninth, calms the fetus. Wine-fried to ascend, it treats accumulated blood in the upper body, indispensable for clearing such conditions. For dysentery with pus and blood, abdominal pain, tenesmus, and prolonged fever, combine with Paeoniae Radix Alba (Baishao, 白芍) and Glycyrrhizae Radix et Rhizoma (Gancao, 甘草). For painful sores, bitter-cold herbs like Coptidis Rhizoma are suitable; use according to upper/lower body differentiation and add guiding herbs. [Su Song] records that Zhang Zhongjing used Scutellariae Radix in all four Xixin Decoctions for epigastric fullness due to Shaoyin cold damage, as it treats various heats and benefits the Small Intestine. For Taiyang disease treated with purgatives leading to unceasing diarrhea, wheezing, and sweating, Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction) is indicated. It is also widely used in AnTai San (Calming the Fetus Powder) for pregnancy. [Zhu Zhenheng] notes that Zhang Yuansu said Scutellariae Radix clears Lung Fire and treats Spleen dampness; Li Dongyuan said Pian Qin (slice Scutellaria) treats Lung Fire, Tiao Qin (strip Scutellaria) treats Large Intestine Fire; Zhu Zhenheng said it treats Upper and Middle Jiao fire. Zhang Zhongjing used it in Xiao Chaihu Tang (Minor Bupleurum Decoction) for Shaoyang syndrome, Huangqin Tang (Scutellaria Decoction) for Taiyang-Shaoyang combined disease with diarrhea, and Xixin Decoction for Shaoyang syndrome after purgation with epigastric fullness but no pain. Cheng Wuji stated that Scutellariae Radix's bitter taste enters the Heart to drain heat from fullness, indicating it enters the Hand-Shaoyin, Hand-Yangming, Foot-Taiyin, and Foot-Shaoyang meridians. Essentially, its cold nature and bitter flavor, yellow-green color, enter the Heart via bitterness, overcome heat via coldness, clear Heart Fire, and treat Spleen damp-heat. This prevents Metal (Lung) from being controlled by Fire (Heart) and prevents Stomach Fire from flowing into the Lung, thereby saving the Lung. However, it is unsuitable for Lung deficiency as bitter-cold damages the Spleen and Stomach, harming the Mother element. Shaoyang syndrome presents with alternating chills and fever, hypochondriac fullness, silence, lack of appetite, irritability, vomiting, or urinary difficulty. Although located at half-exterior/half-interior, hypochondriac fullness involves Upper Jiao pathogens of Heart and Lung, while irritability, vomiting, and silence involve Middle Jiao Spleen and Stomach symptoms. Thus, Scutellariae Radix treats the Ministerial Fire of Hand and Foot Shaoyang. It is a primary herb for the Shaoyang meridian. Cheng Wuji’s commentary only mentions Bupleuri Radix (Chaihu, 柴胡) and Scutellariae Radix bitterness to disperse transmitted heat, and Paeoniae Radix and Scutellariae Radix bitterness to consolidate intestinal Qi, missing the subtlety of treating Fire. Yang Shiyang claimed Chaihu is inferior to Scutellariae Radix for reducing fever, not realizing Chaihu disperses the branch of fire via bitterness, while Scutellariae Radix conquers the root of fire via coldness. Zhang Zhongjing also stated that for Shaoyang syndrome with abdominal pain, remove Scutellariae Radix and add Paeoniae Radix; for palpitations and urinary difficulty, remove it and add Poria (Fuling, 茯苓). This seems contradictory to Ben Cao regarding treating lower abdominal cramping and benefiting the Small Intestine. Cheng Wuji argued Scutellariae Radix is cold and bitter, hardening the Kidney, hence removed. This is likely incorrect. One must deduce through reasoning and pulse/symptom differentiation. If abdominal pain results from drinking cold water or contracting cold, with palpitations, urinary difficulty, and non-rapid pulse, there is no interior heat, so Scutellariae Radix is contraindicated. However, for heat-jue abdominal pain or Lung heat causing urinary difficulty, Scutellariae Radix is essential. Scholars should seek the underlying principle rather than sticking rigidly to text. Remove peel and black rot, chop finely, sieve with bamboo.
**Phellodendri Cortex (Huangbai, 黄柏):** Nature is cold, flavor is bitter, non-toxic. Medicinal qi and flavor are dense, sinking and descending, belonging to Yin. Bitter and slightly pungent, it represents Yang within Yin. It enters the Foot-Shaoyin Kidney Meridian and serves as a guiding herb for the Foot-Taiyang Bladder Meridian. [Li Dongyuan] treats kidney water and Bladder insufficiency causing various痿 (Wei) syndromes,厥 (Jue) syndromes, and weak knees/legs. Added in small amounts to Huangbai Tang, it generates strength in the knees, resolving Wei. Honey-fried and powdered, it miraculously treats mouth ulcers and is essential for paralysis. It drains Bladder heat, opens the lower orifices, drains Bladder meridian fire, and tonifies the meridian and Kidney insufficiency. The Classic states: "Bitter hardens." The Foot-Shaoyin Kidney fears dryness, leading to dampness retention. Gardenia (Zhizi, 栀子) and Scutellariae Radix enter the Lung; Coptidis Rhizoma enters the Heart; Phellodendri Cortex enters the Kidney; their drying properties follow their respective categories. Huoren Shu’s Jiedu Tang treats internal and external issues. Remove peel, chop. Raw use descends excess fire; wine-processed treats the upper body; salt-processed treats the lower body; honey-processed treats the middle body without damaging the Stomach.
**Gardeniae Fructus (Zhizi, 栀子):** Nature is cold, flavor is bitter, non-toxic. [Zhang Yuansu] describes it as having thin qi and dense flavor, light and clear ascending, floating qi and descending flavor, representing Yin within Yang. [Li Dongyuan] describes it as sinking, Yin, entering the Blood aspect of the Hand-Taiyin Lung Meridian. [Li Dongyuan] Ben Cao does not mention Zhizi as an emetic, but Zhang Zhongjing used it as such. Zhizi is not inherently an emetic; rather, pathogens in the upper region reject the medicine. Vomiting expels the pathogen, following the principle "those high above should be evacuated." Some use it to promote urination, but it actually clears the Lung. Clearing the Lung allows Qi transformation, enabling the Bladder to excrete fluids. Ben Cao says it treats Large and Small Intestine heat because Pungent combines with Geng (Metal), Bing (Fire), and泄 (Xie) Wu (Earth/Stomach), entering the Central State first. Zhang Zhongjing used Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) for irritability. Irritability (Fan) relates to Qi and the Lung; restlessness (Zao) relates to Blood and the Kidney. Zhizi treats Lung-related Fan; Chi Xiao Dou (Fermented Soybean) treats Kidney-related Zao. Zhang Zhongjing noted Zhizi’s red color and bitter taste enter the Heart to treat Fan; Chi Xiao Dou’s black color and salty taste enter the Kidney to treat Zao. [Kou Zongshi] records Zhang Zhongjing using Zhizi Chi Tang for insomnia and mental agitation after sweating, vomiting, or purging for cold damage, avoiding Da Huang (Rhubarb) due to its cold toxicity. Zhizi is cold but non-toxic, treating stomach heat. After loss of blood and fluids, internal deficiency heat arises, requiring Zhizi. For Heart meridian residual heat with dark/scanty urine, combine peeled Zhizi, fire-roasted Da Huang, Forsythiae Fructus (Lianqiao, 连翘), and roasted Glycyrrhizae Radix et Rhizoma in equal parts. Take 3 qian decocted in water. Select Zhizi resembling a sparrow’s brain with nine ridges and red color. Use the kernel for chest heat, the peel for surface heat, whole fruit for Upper/Middle Jiao, shelled for Lower Jiao, and charred for blood disorders.
**Gypsum Fibrosum (Shigao, 石膏):** Nature is cold, flavor is sweet and pungent, non-toxic. Enters the Hand-Taiyin Lung, Hand-Shaoyang Sanjiao, and Foot-Yangming Stomach meridians. [Zhang Yuansu] describes it as cold, sweet-pungent, bland, thin in qi/flavor, heavy, sinking, and Yin. It is a major cold herb for the Yangming meridian, treating headache, toothache, thirst, heatstroke, and tidal fever. However, it can chill the Stomach and suppress appetite, so avoid unless there is extreme interior heat. It treats Yangming heat with fever, aversion to cold, dryness, afternoon tidal fever, muscular fever, turbid/dark urine, intense thirst, spontaneous sweating, and severe headache. Zhang Zhongjing used Baihu Tang (White Tiger Decoction) for this. Do not use if these symptoms are absent. Many cases of blood-deficiency fever mimicking Baihu syndrome, or Spleen-Stomach deficiency, are misdiagnosed and mistreated, leading to untreatable outcomes. [Li Dongyuan] states Gypsum belongs to the Foot-Yangming meridian. Zhang Zhongjing used it for Yangming syndrome with fever, eye pain, nasal dryness, and insomnia. The face/chest area corresponds to the Stomach meridian and Lung residence. Pathogens in Yangming affect the Lung via Fire control, so pungent-cold herbs clear Lung Qi, hence the name White Tiger. It also treats Sanjiao skin heat, entering the Hand-Shaoyang meridian. Use for persistent rapid pulses. Avoid in weak Stomachs. For warm-heat diseases with irritability, thirst, and surging-rapid-long pulses, Gypsum is essential, even in winter. Zhang Zhongjing formulated Baihu Tang for standard cold damage. Li Dongyuan’s advice to avoid it after End of Heat is too rigid. This is the same as Hanshui Shi (Cold Water Stone) or Ying Shigao (Hard Gypsum). Fine white texture is best. Crush to millet size, boil dozens of times before adding other herbs as its essence is hard to extract.
**Anemarrhenae Rhizoma (Zhimu, 知母):** Nature is cold, flavor is bitter, dense in qi/flavor, sinking, Yin with slight Yang. It is a primary herb for the Kidney meridian, entering the Qi aspect of the Foot-Yangming Stomach and Hand-Taiyin Lung meridians. [Li Dongyuan] has four uses: drains rootless Kidney Fire, treats bone-steaming with sweat, stops deficiency heat, and nourishes the Yin of the transformation source. Zhang Zhongjing added it to Baihu Tang for insomnia and irritability. Fan originates from the Lung, Zao from the Kidney. Gypsum is the sovereign, Zhimu the assistant, using bitter-cold to clear the Kidney source. Licorice and Coix Seed slow the descent. For urinary obstruction with thirst, heat is in the Upper Jiao Qi aspect; Lung latent heat fails to generate Water, cutting off the Bladder’s source. Use thin-qi/thin-flavor diuretics to drain Lung Fire and nourish Water. For heat in the Lower Jiao Blood aspect without thirst, true Water is insufficient, Bladder is dry, and Yang cannot transform without Yin. Use Phellodendri Cortex and Anemarrhenae Rhizoma (bitter-cold) to tonify Kidney and Bladder, allowing Yin to move and Yang to transform, restoring urination. Select plump, white-inside rhizomes, remove hairs, slice. For ascending guidance, wine-soak and roast; for descending, salt-water moisten and roast. (Avoid iron).
**Fraxini Cortex (Qinpi, 秦皮):** Nature is cold, flavor is bitter, non-toxic. Sinking and descending. [Li Dongyuan] treats heat-dysentery with heaviness and lower Jiao deficiency. The Classic states "Bitter hardens," hence used with Polygalae Radix (Baitouweng, 白头翁) and Phellodendri Cortex. Treats wind-cold-damp bi, ocular nebula/membrane, male scant sperm, female leukorrhea, pediatric convulsions. Best as a wash for eyes. Known as Bai Mu; soak bark in water for blue color. Combine with Lithospermi Radix (Zicao, 紫草) for better effect. Euphorbiae Humifusa Herba (Daji, 大戟) is its assistant; adverse with Evodiae Fructus (Wuzhuyu, 吴茱萸). [Zhu Zhenheng] Qinpi is green, cold-bitter-astringent, entering the Jueyin Liver and Shaoyang Gallbladder meridians. Treats eye disorders and convulsions by calming Liver Wood; treats dysentery, metrorrhagia, and leukorrhea by astringency. Benefits male fertility via astringent tonification. Laozi said Heaven values astringency. It is suitable for food therapy and convulsions/dysentery, yet often neglected except for eye treatment, which is regrettable.
**Pulsatillae Radix (Baitouweng, 白头翁):** Nature is cold, flavor is bitter-pungent, non-toxic. Dense qi, thin flavor, ascending/descending, Yang within Yin. Treats warm malaria, mania, chills/fever, masses, moves blood, stops pain. Zhang Zhongjing used Baitouweng Tang for heat-dysentery with urgency. The Kidney desires firmness, aided by bitter taste. Dysentery causes lower Jiao deficiency, so pure bitter herbs firm it. Treats hernia, pediatric alopecia/seborrhea, epistaxis, and toxic dysentery effectively. [Wu Qiu] Suitable for heat-toxin dysentery with purple/fresh blood.
**Rhei Radix et Rhizoma (Dahuang, 大黄):** Nature is cold, flavor is bitter, non-toxic. Dense qi/flavor, sinking, Yin. Use wine-soaked and baked versions; "cold treated with heat." Wine infusion enters the Taiyang meridian; wine-washing enters the Yangming meridian. [Li Dongyuan] Rhubarb is bitter,峻 (forceful) in downward movement. Use raw for lower body pathogens. For upper body pathogens, wine is necessary to guide the herb high to drive heat down, like shooting targets high up. Raw use leaves high pathogens, causing post-recovery eye redness, throat bi, head swelling, or diaphragm heat. [Kou Zongshi] Zhang Zhongjing used Rhubarb, Scutellariae Radix, and Coptidis Rhizoma in Xixin Decoction for Heart Qi deficiency causing hematemesis/epistaxis. Question: Why not tonify Heart Qi? Answer: Pure deficiency wouldn’t cause bleeding; it’s pathogenic heat exploiting deficiency. Bitterness tonifies the Heart. Effective if matched to deficiency/excess. [Zhu Zhenheng] Rhubarb is bitter-cold and purgative. Used in Xixin Decoction because Shaoyin deficiency leads to hyperactive Yang and wild bleeding. Rhubarb drains excess fire to restore peace. Heart Yin deficiency is chronic; Lung and Liver suffer from Fire. Scutellaria saves the Lung; Coptis saves the Liver. Once Liver/Lung fire subsides, Yin blood returns to normal. Kou’s explanation of "pathogenic heat" is unclear. [Zhu Zhenheng] Rhubarb enters the Blood aspect of Foot-Taiyin, Hand/Foot-Yangming, and Hand/Foot-Jueyin meridians. Use for Blood aspect disorders; using it for Qi aspect is unjustified punishment.
**Xixin Decoction:** Treats Heart Qi deficiency with bleeding. True Heart Qi is deficient, while Hand-Jueyin Pericardium, Foot-Jueyin Liver, Foot-Taiyin Spleen, and Foot-Yangming Stomach have excess evil fire. "Draining Heart" actually drains latent fire in these four meridians' blood. For epigastric fullness soft to touch, Dahuang Huanglian Xixin Tang is used to drain Spleen-Stomach damp-heat, not the Heart. Yin disease treated with purgatives causes fullness; cold injures Nutritive Blood, pathogens bind in Upper Jiao/Stomach, affecting the Heart. Hence "draining Heart" means draining Spleen. Suwen states Taiyin causes fullness, and turbid Qi rising causes distension. Yang disease treated with purgatives causes Jie Xiong (chest binding); heat enters Blood aspect in Upper Jiao. Daxiexiong Tang/Pills use Rhubarb to drain Spleen-Stomach Blood evil and descend turbid Qi. For Qi-level Jie Xiong, Xiaoxiexiong Tang is used; for Qi-level fullness, Banxia Xiexin Tang is used. Cheng Wuji failed to distinguish this. [Su Song] Ben Cao praises Rhubarb for pushing out old and generating new. Ancients used toxic drugs carefully based on constitution. Emperor Wu of Liang wanted Rhubarb for fever; Yao Shengtan warned against it due to age. Emperor ignored him and nearly collapsed. Emperor Yuan of Liang had abdominal issues; doctors suggested mild herbs, but Yao insisted on Rhubarb for pulse evidence of stagnation, curing him. Modern doctors misuse toxic drugs, claiming success when lucky but hiding errors. Remove peel, chop, sieve.
**Natrii Sulfas (Mangxiao, 芒硝):** Nature is greatly cold, flavor is salty-bitter-pungent, slightly toxic. [Cheng Wuji] Neijing states salty flavor drains downward (Yin) and softens hardness. Heat inside is treated with salty-cold. Hardness is softened by salty; excess heat is cleared by cold. Zhang Zhongjing used Mangxiao in Daxiexiong Tang, Dachengqi Tang, and Tiaowei Chengqi Tang to soften hardness and drain excess heat. Not for non-hard conditions. [Li Dongyuan] Ben Cao says Puxiao (Mirabilite) is pungent to moisten Kidney dryness; now only salty is used to soften hardness. Ben Cao says Mangxiao promotes urination and aborts, but in cold damage/pregnancy requiring purgation, combined with Rhubarb, it moisturizes, softens, and drains heat, protecting mother and fetus. Neijing: "If there is pathology, no injury occurs." Regarding lower body, urination/defecation are Yin; anterior is Qi, posterior is Blood; Kidney governs both. Urinary difficulty/stool constipation result from water deficiency and fire excess. Neijing: treat heat with salty-cold, assisted by bitter. Thus, Mangxiao and Rhubarb are synergistic. [Zhang Yuansu] Mangxiao is thin-qi/dense-flavor, sinking, Yin. Three uses: drains excess heat, cleansse gut residue, breaks heat masses. [Zhu Zhenheng] Puxiao is crude, forceful, for rough constitutions or external use. Mangxiao is refined Puxiao, milder, preferred by Zhang Zhongjing. Mangxiao inherits Taiyin essence, Water’s child, cold-salty, enters Blood, moistens downward, cleanses Sanjiao/Gut excess heat, treats Yang-excess fire. Use raw.
**Fermented Soybean (Xiangchi, 香豉):** Nature is cold, flavor is bitter, non-toxic, Yin within Yin. Treats cold damage headache, irritability, fullness. Use raw. [Zhu Zhenheng] Black bean is neutral; fermented becomes warm. Steaming/fermenting allows ascending/dispersing. With Scallion: induces sweat; with Salt: induces vomiting; with Wine: treats wind; with Allium macrostemon (Xie, 薤): treats dysentery; with Garlic: stops bleeding; cooked: stops sweat significantly. Similar to Ephedrae Caulis (Mahuang Genjie, 麻黄根节).
**Artemisiae Scopariae Herba (Yinchenhao, 茵陈蒿):** Nature is slightly cold, flavor is bitter-pungent, non-toxic, slight Yang within Yin. Enters Foot-Taiyang Bladder meridian. Clears irritability/heat, treats wind-cold-damp-heat, heat-binding jaundice, generalized yellowing, urinary difficulty. [Kou Zongshi] Zhang Zhongjing used it effectively for severe heat jaundice. A monk had lingering heat jaundice after incomplete sweating; dietary therapy failed. Given this herb: 1/3 improvement in 5 days, 2/3 in 10 days, cured in 20 days. Formula: Shan Yinchen and Gardeniae Fructus 3 fen, Qinghao (Qinjiao, 秦艽) and Cimicifugae Rhizoma (Shengma, 升麻) 4 qian. Powder, take 3 qian with water, decoct, take warm after meals. Based on Shan Yinchen. [Li Dongyuan] Yinchenhao Tang/Zhizi Dahuang Tang treat damp-heat; Zhizi Baipi Tang treats dry-heat. Wet yellow requires draining; dry yellow requires moistening. These two treat Yang Jaundice. Han Zhihe and Li Sixun used Yinchen Fuzi Tang for Yin Jaundice. Yinchen is sovereign, assisted by Rhubarb/Aconite per cold/heat. Remove stems, use leaves, crush by hand.
**Trichosanthis Fructus (Gualou Shi, 栝蒌实):** Nature is cold, flavor is sweet-mild bitter, non-toxic. [Zhu Zhenheng] Treats chest bi (pain/oppression) due to sweet-moist nature tonifying Lung and descending Qi. Phlegm caused by Lung Fire losing descending function is resolved by sweet-moist help, making it key for cough. Also washes away greasy郁 (depressed) heat in chest/diaphragm, miraculous for thirst-quenching. [Zhu Zhenheng] Zhang Zhongjing used it for chest bi radiating to back, coughing saliva, wheezing, and chest binding pain. Its sweet-cold nature doesn’t harm Stomach Qi, descends Upper Jiao fire, and moves phlegm-Qi. Cheng Wuji mistakenly called it bitter-cold to drain heat, ignoring its actual sweet taste. Use large, firm fruits with seeds and peel, finely sliced. Using only kernels is incorrect.
**Trichosanthis Radix (Gualou Gen / Tianhuafen, 栝蒌根/天花粉):** Nature is cold, flavor is sweet-mild bitter-sour, non-toxic. Treats thirst, fever, irritability, great heat, deficiency, calms spirit, regulates menstruation, reduces swelling/toxins, blood stasis, heat-manía, sores. [Li Dongyuan] Pure Yin, quenches thirst, moves fluids, cures heart dryness. Combined with pungent-sour to guide swelling Qi. [Zhu Zhenheng] Sweet-mild bitter-sour. Stem/leaf sourness generates fluids, quenching thirst and moistening dryness. Mild bitter drains fire, sweet doesn’t harm Stomach. Past texts calling it merely bitter-cold missed depth. Finely grind and sieve.
**Polypodi Rhizome (Tugua Gen, 土瓜根):** Nature is cold, flavor is bitter, slightly toxic. Treats various pathogens, heat-binding, water in joints across seasons, epidemic fevers, alcohol jaundice, fever/irritability, consumption, induces vomiting/purgation.
**Forsythiae Radix (Lianyao, 连轺):** Nature is cold, flavor is sweet-bitter, slightly toxic. Descends heat, nourishes Yin essence. Zhang Zhongjing used Mahuang Lianyao Chixiaodou Tang for cold damage with trapped heat/jaundice.
**Bambusae Folium (Zhuye, 竹叶):** Nature is cold, flavor is sweet, non-toxic. Bambusa vulgaris (Dan Zhu, 淡竹) is superior; Bambusa textilis (Gan Zhu, 甘竹) secondary. Treats chest phlegm-heat, cough, rebellious Qi. [Kou Zongshi] Bamboo shoots are cold, so leaves share this property. Zhang Zhongjing’s Zhuye Tang uses Dan Zhu. [Zhang Yuansu] Bitter-flat, slight Yang within Yin. [Li Dongyuan] Bitter-pungent-cold, ascending/descending, Yin within Yang. Two uses: clears new/old wind-pathogen heat, stops wheezing/rebellious Qi.
**Morus Cortex (Zibai Pi, 梓白皮):** Nature is cold, flavor is bitter, non-toxic. Treats heat-toxins, expels parasites, seasonal warm diseases, headache, fever. Use fresh Mulberry wood bark (inner white part) on day one.