一名棠 子。禀木气而生，味酸，气平。入足阳明、太阴经，为健脾胃、消渍
滞、行结气之需。又能散宿血，化肉积。儿枕痛之用。然脾虚不能运化者，多服久服。
愈伤脾胃生生之气，益增其滞也。宜同参术兼施，则脾元不损，积滞自消。然山楂即非
戡乱之能，臣复非培元之良相，止堪暂为佐助，化食宿血之需，岂可用为君主，长服摄
生之药，何近世小儿药中动辄必投何也！
山楂，益幼稚，消食积聚，扶产妇，除儿枕痛，消滞血，理疮疡，行结气，健脾
胃，祛膨胀。消宿滞。用之者以味酸属甲。甘则属己，甲己化土，所以入补脾药，助其
运化也。消血块肉积者，以酸能入肝，去其肝藏之血滞也。肉积者，亦血液之化类耳。
核主催生疝气。
主治（痘疹合参） 解毒发痘，消食健胃，化痰行结气，催疮疡。消滞血，有制参
之功。痘疹用之者，以毒由血热气滞，藉酸味入肝。溶化其血毒为脓水也。然性散血
解结，多用则内虚。若气虚便溏者切忌，宜去核用，盖核仁能使作泻耳。
按∶山楂，善去腥膻肉食之积，与麦芽消谷积者不同，仲景治伤寒一百十三方，未
尝用麦芽山楂何也？为其性缓，非乱世之能臣，故但用大小承气耳。近世不问肉食积滞
有无，一概用之，以为稳当，恐无益即有小害也。
山楂，又名棠子。禀受木气而生，味道酸，气性平。归入足阳明胃经和足太阴脾经，是强健脾胃、消除食积停滞、疏通郁结之气的必需药物。又能消散陈旧的血瘀，化解肉类积滞。用于治疗产后儿枕痛（产后子宫复旧不全引起的腹痛）。然而，对于脾气虚弱不能运化水谷的人，如果多服或久服，反而会进一步损伤脾胃生生不息之气，更加增加体内的停滞。应当与人参、白术等补气健脾药配合使用，这样脾元不致受损，积滞自然消除。
然而，山楂并非能够平定乱局的猛将，也不是培育元气的好宰相，只堪作为辅助药物，用于化解宿食和陈旧血瘀的需求，怎么能把它当作君药（主药），长期服用作为养生之药呢？为什么近代小儿药方中动不动就加入它呢！
山楂，有益于婴幼儿，能消除食物积聚；扶助产妇，消除儿枕痛；消散滞留的血块；调理疮疡；疏通郁结之气；健脾益胃；祛除腹胀。使用山楂是因为它的味酸归属于甲（天干属木，对应肝），甘味归属于己（天干属土，对应脾），甲己相合化为土气，所以将其加入补脾的药物中，以助其运化功能。消除血块和肉积，是因为酸味能入肝，去除肝脏所藏的血瘀。所谓的肉积，也是血液转化的一类产物。山楂核主要用于催生和治疗疝气。
主治（参考《痘疹合参》）：解毒促使痘疹发出，消食健胃，化痰并疏通郁结之气，促进疮疡愈合。消散滞留的血块，具有类似炮制后的人参的功效。治疗痘疹时使用它，是因为痘毒由血热和气滞引起，借助酸味入肝，溶解化解血中的毒素成为脓水排出。然而山楂性质发散破血、解结，多用会导致体内虚弱。如果是气虚且大便溏稀的患者切忌使用。宜去掉果核使用，因为核仁可能导致腹泻。
按语：山楂善于消除腥膻肉食造成的积滞，与麦芽消除谷物积滞不同。张仲景在治疗伤寒的一百一十三首方剂中，从未使用过麦芽和山楂，为什么呢？因为它们的药性缓和，不是处理紧急复杂病证（乱世）的能臣，所以只用大承气汤和小承气汤等峻下之剂。近代医生不问是否有肉食积滞，一概使用山楂，认为这样稳妥，恐怕不仅无益，反而会有小害。
Shanzha (Crataegi Fructus), also known as Tangzi, is generated by inheriting the Qi of Wood. Its taste is sour, and its nature is neutral. It enters the Foot-Yangming Stomach Meridian and the Foot-Taiyin Spleen Meridian. It is essential for strengthening the Spleen and Stomach, eliminating food stagnation, and moving stagnant Qi. It can also dissipate old blood stasis and resolve meat accumulation. It is used to treat Erzhen Tong (postpartum uterine pain due to lochia retention). However, for those with Spleen deficiency unable to transform and transport nutrients, excessive or long-term use will further damage the vital Qi of the Spleen and Stomach, thereby increasing stagnation. It should be administered in combination with Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) so that the Yuan Qi of the Spleen is not damaged, and the stagnation will naturally resolve.
However, Shanzha is not a general capable of quelling chaos, nor is it a good minister assisting in nourishing the Yuan Qi; it is only suitable as an adjuvant to help resolve food retention and old blood stasis. How can it be used as the Sovereign herb (principal ingredient) or taken long-term as a health-preserving medicine? Why do modern pediatric prescriptions frequently include it?
Shanzha benefits infants and young children, eliminates food accumulation, supports postpartum women, removes Erzhen Tong, resolves stagnant blood, regulates sores and ulcers, moves stagnant Qi, strengthens the Spleen and Stomach, and dispels abdominal distension. The reason for using Shanzha is that its sour taste belongs to Jia (Wood/Heavenly Stem corresponding to Liver), while sweet taste belongs to Ji (Earth/Heavenly Stem corresponding to Spleen). When Jia and Ji combine, they transform into Earth. Therefore, it is added to formulas tonifying the Spleen to assist its transformative and transporting functions. To eliminate blood clots and meat accumulation, it is because the sour taste enters the Liver, removing blood stasis stored in the Liver. Meat accumulation is essentially a type of transformation of blood. The core is mainly used to induce labor and treat hernia.
Main Indications (referencing *Douzhen Hecan*): Detoxifies and promotes the eruption of smallpox/rashes, aids digestion and strengthens the stomach, transforms phlegm and moves stagnant Qi, promotes healing of sores and ulcers, and resolves stagnant blood. It possesses efficacy similar to processed Renshen (Ginseng Radix). It is used for smallpox/rashes because the toxin arises from Blood heat and Qi stagnation; relying on the sour taste entering the Liver helps dissolve and transform blood toxins into pus and fluid for discharge. However, its nature scatters Blood and resolves knots; excessive use leads to internal deficiency. It is strictly contraindicated for patients with Qi deficiency and loose stools. The core should be removed before use, as the kernel may cause diarrhea.
Commentary: Shanzha is good at resolving accumulation caused by greasy and gamey meat, which differs from Maiya (Hordei Fructus Germinatus) that resolves grain accumulation. Zhang Zhongjing did not use Maiya or Shanzha in his 113 formulas for treating Cold Damage (Shanghan). Why? Because their properties are mild, and they are not capable ministers for handling chaotic/critical conditions; thus, he only used Da Chengqi Tang (Major Order the Qi Decoction) and Xiao Chengqi Tang (Minor Order the Qi Decoction). Modern practitioners indiscriminately use Shanzha regardless of whether there is meat accumulation, considering it safe, but this may be of no benefit and even cause minor harm.