俗名马蚂蟥。生于阴湿之处，味咸，苦，气平，有大毒。其用与虻虫相似，故方中与之并施。咸
入血，走血，苦泄结，故治妇人月闭，血瘕积聚，无子者及血蓄膀胱水道不通者。因破血之功，
故能堕胎。然 之存性，见水复能化生，啮人肠脏，破瘀之药甚多，何必用此？如犯之者，黄泥作丸
，吞之必入泥而出。
水蛭，即马蝗蜞，活者堪吮肿毒恶血，名为蜞针，炒者能去积瘀坚 ，抵当丸是治
折伤，利水道，通月信，堕妊娠。麝香酒调下，治蓄血神效，盖苦走血，咸胜血耳，染
须药中，能引药力倒上至根。
一名推车客，禀阴湿之气以生，味咸，气寒，有毒。入足厥阴，手足阳明经。以咸
寒软坚降下之性，故为惊痫癫疾奔痔 疔肿之锡。大肠脱肛，螳螂烧存性，为末入冰
片研匀，掺上托之即入。肠漏出水，用蜣螂一枚，阴干入冰片少许，为末，纸捻蘸末，
入孔内渐渐生肉，药自退出即愈。附骨疽疮，蜣螂七枚，同大麦捣敷。无名恶疮。不
识者，用蜣螂杵汁涂之。刘禹蚀救三死方云，得疔疮十四日，益笃善药敷之莫救，贾
方伯数月蜣螂心一夕百苦皆已。明年正月食羊肉又大作，再用如神验，其蜣螂心在腹下
度取之，其肉稍白是也，贴疮半日许，再易，血尽根出即愈。蜣螂畏羊肉，故食之即
发，出葛洪肘后方。箭镞入骨不可移者，用巴豆微炒，同蜣螂捣涂，斯须痛定，必微
痒忍之待极痒不可忍，乃撼动拔之立出，凡诸疮皆可疗也。捣为丸塞下部，引痔虫出尽永瘥。
蜣螂主小儿惊痫螈 ，腹胀寒热，大人癫疾狂易，手足端寒，支满奔豚等症，皆咸
寒软坚降下之功，故又治一切痔屡，及疔肿疽疮，出箭镞之用也。但性有毒，外用易臻
厥功，内服非虚人所宜。
俗名马蚂蟥。生长于阴暗潮湿的地方，味道咸、苦，气性平，有大毒。其功效与虻虫相似，因此在药方中常与虻虫配合使用。咸味入血分，能行血，苦味能泄散结聚，因此用于治疗妇女月经闭止、血瘕积聚导致的不孕症，以及血液蓄积在膀胱导致水道不通的情况。因其具有破血的功效，所以能够堕胎。然而，水蛭即使炒制存性，遇水又能化生，会咬噬人的肠脏。破瘀的药物很多，何必一定要用这种药呢？如果误服了，可以用黄泥做成丸剂吞下，它必定会进入泥中排出体外。
水蛭，也就是马蝗蜞，活体可以吮吸肿毒恶血，被称为“蜞针”。炒制后的水蛭能够去除积滞的瘀血坚块。抵当丸就是用来治疗跌打损伤、通利水道、疏通月经、堕胎妊娠的。用麝香酒调服，治疗蓄血证效果极佳，这是因为苦味走血分，咸味能胜血（克制血邪）。将其加入染发药物中，能引导药力倒向上行至发根。
另一种名为推车客（即屎壳郎），禀受阴湿之气而生，味道咸，气性寒，有毒。归足厥阴肝经、手阳明大肠经和足阳明胃经。凭借其咸寒软坚、降逆下行的药性，因此是治疗惊痫癫疾、奔豚痔疮、疔疮肿毒的良药。对于大肠脱肛，将螳螂烧制成炭存性，研成粉末加入冰片研磨均匀，撒在患处并用手托举，即可复位。肠道漏管流水，取一只蜣螂，阴干后加入少许冰片，研成粉末，用纸捻蘸取药粉，插入孔内，随着新肉逐渐生长，药粉自然退出，病即痊愈。治疗附骨疽疮，取七只蜣螂，与大麦一起捣烂敷贴。对于无名恶疮，如果不认识此药，可用蜣螂捣汁涂抹。刘禹锡《传信方》记载救治三死的方法说：患疔疮十四天，病情加重，用好药敷治也无法挽救，贾方伯连续几个月用蜣螂心治疗，一夜之间百苦皆消。次年正月吃羊肉后又发作，再次使用如神般灵验。蜣螂心位于腹部下方度量处取得，肉质稍白。贴在疮口约半天，再更换一次，待血尽根出即愈。蜣螂畏惧羊肉，所以吃了羊肉就会发病，此说法出自葛洪的《肘后方》。箭头射入骨头无法移动者，用微炒的巴豆同蜣螂捣烂外涂，片刻后疼痛停止，必然会有轻微瘙痒，忍耐直到极度瘙痒不可忍受时，晃动即可拔出，凡各种疮疡皆可治疗。捣碎做成丸剂塞入下部，引出痔虫排尽则永远痊愈。
蜣螂主治小儿惊痫抽搐、腹胀寒热，大人癫狂易志、手足末端寒冷、胸胁胀满、奔豚等症状，这都是因为咸寒软坚、降逆下行的功效。因此又用于治疗各种痔疮，以及疔疮肿毒疽疮，还有取出箭镞的作用。但性味有毒，外用容易达到显著疗效，内服则不适合身体虚弱的人。
Commonly known as the horse leech. It grows in dark and damp places, tastes salty and bitter, has a neutral qi nature, and possesses great toxicity. Its effects are similar to those of *Machong* (Tabanidae insect), hence they are often used together in prescriptions. Salty flavors enter the blood level and promote blood circulation; bitter flavors drain and dissipate accumulations. Therefore, it is used to treat amenorrhea in women, blood masses (*Xuejia*) and accumulations causing infertility, as well as cases where blood stagnates in the bladder leading to obstruction of the urinary tract. Due to its potent blood-breaking power, it can induce abortion. However, even if preserved by calcination (*Cunxing*), it can regenerate upon contact with water and bite into human intestines and viscera. There are many drugs that break stasis; why must one use this? If ingested accidentally, one can swallow a pill made of yellow mud, which will guide the leech out through the mud.
The leech, also called the horse leech, when alive, can suck out toxic swelling and evil blood, known as "Qi Zhen" (Leech needle). When stir-fried, it can remove stagnant and hardened blood stasis. *Didang Wan* (Thoroughgoing Pill) is used to treat traumatic injuries, promote urination, regulate menstruation, and induce abortion. Administered with musk wine, it is miraculously effective for treating blood retention syndromes, because bitter flavors navigate the blood, and salty flavors overcome blood pathologies. When added to hair-dyeing preparations, it guides medicinal power upward to the roots of the hair.
Another name is "Tui Che Ke" (Cart-pushing Guest), referring to the dung beetle. Born from yin-damp qi, it tastes salty, has a cold qi nature, and is toxic. It enters the Foot Jueyin Liver Meridian, Hand Yangming Large Intestine Meridian, and Foot Yangming Stomach Meridian. Utilizing its salty-cold property to soften hardness and descend, it serves as a valuable agent for treating convulsions, epilepsy, manic depression, Ben Tun (rushing pig syndrome), hemorrhoids, and carbuncles. For rectal prolapse, burn the Mantis Ootheca (*Tanglang*) until carbonized but retaining its efficacy, grind into powder, mix evenly with Borneol (*Bingpian*), apply to the area, and manually reduce the prolapse. For intestinal fistulas discharging fluid, take one dung beetle, dry it in shade, add a little Borneol, grind into powder, dip a paper wick in the powder, insert it into the orifice; as new flesh grows, the medicine naturally exits, curing the condition. For deep-seated abscesses (*Fugu Ju*), crush seven dung beetles with large barley and apply externally. For nameless malignant sores, if unrecognized, crush dung beetles and apply the juice. Liu Yuxi's *Chuanxin Fang* records a method to save three deaths: after fourteen days of a carbuncle, the condition worsens despite good treatments. Official Jia used dung beetle hearts for several months, relieving all pains overnight. The next January, eating mutton caused a recurrence; using it again proved miraculous. The heart is located under the abdomen; the meat is slightly white. Apply to the sore for half a day, then replace. Once the blood is exhausted and the root emerges, it heals. Dung beetles fear mutton; thus, consuming mutton triggers relapse. This comes from Ge Hong's *Zhouhou Beiji Fang*. For arrowheads embedded in bone that cannot be moved, lightly stir-fried Croton Seed (*Badou*) crushed with dung beetle and applied externally stops pain quickly. Slight itching follows; endure until unbearable itching occurs, then shake and pull out immediately. This treats various sores. Crush into pills and insert into the lower orifice to expel hemorrhoid worms completely, ensuring permanent cure.
Dung beetles primarily treat pediatric convulsions and spasms, abdominal distension with alternating cold and fever, adult mania and erratic behavior, cold extremities, chest fullness, and Ben Tun syndrome. These effects stem from their salty-cold ability to soften hardness and descend. Thus, they also treat all types of hemorrhoids, carbuncles, and sores, and assist in removing arrowheads. However, they are toxic. External use easily achieves remarkable results, but internal administration is not suitable for individuals with deficiency.