黄芩∶味苦性凉。中空,最善清肺经气分之热,由脾而下通三焦,达于膀胱以利小便。又善入脾胃清热,
由胃而下及于肠,以治肠 下利脓血。又善入肝胆清热,治少阳寒热往来(大小柴胡汤皆用之)。兼能调气,
无论何脏腑,其气郁而作热者,皆能宣通之。又善清躯壳之热,凡热之伏藏于经络散漫于腠理者,皆能消除之。
治肺病、肝胆病、躯壳病,宜用枯芩(即中空之芩);治肠胃病宜用条芩(即嫩时中不空者亦名子芩)。究之,
皆为黄芩,其功用原无甚差池也。
李濒湖曰∶“有人素多酒欲,病少腹绞痛不可忍,小便如淋诸药不效,偶用黄芩、木通、甘草三味,煎服
遂止。”按∶黄芩治少腹绞痛,《名医别录》原明载之,由此见古人审药之精非后人所能及也。然必因热气所
迫致少腹绞痛者始可用,非可概以之治腹痛也。又须知太阴腹痛无热证,必少阳腹痛始有热证,《名医别录》
明标之曰“少腹绞痛”,是尤其立言精细处。
濒湖又曰∶“余年二十时,因感冒咳嗽既久,且犯戒,遂病骨蒸发热,肤如火燎,每日吐痰碗许,暑月烦
渴,寝食俱废,六脉浮洪,遍服柴胡、麦冬、荆沥诸药,月余益剧,皆以为必死矣。先君偶思李东垣治肺热如
火燎,烦躁引饮而昼盛者气分热也,宜一味黄芩汤,以泻肺经气分之火。遂按方用片芩一两,水二盅煎一盅顿
服,次日身热尽退,而痰嗽皆愈,药中肯 ,如鼓应桴,医中之妙有如此哉。”观濒湖二段云云,其善清气分
之热,可为黄芩独具之良能矣。
黄芩:味苦,性凉。药体质地中空,最善于清除肺经气分的郁热,其药力由脾脏下行贯通三焦,直达膀胱以通利小便。又善于进入脾胃清除热邪,从胃下行波及肠道,用于治疗肠道下利脓血之症。又善于进入肝胆清除热邪,治疗少阳病寒热往来的症状(小柴胡汤和大柴胡汤中均使用此药)。兼能调理气机,无论哪个脏腑,若因气机郁滞而化热,黄芩都能宣散疏通。又善于清除体表的发热,凡是热邪伏藏于经络、散漫于腠理之间的,都能消除。
治疗肺病、肝胆病、体表疾病时,宜使用枯芩(即中间空心的黄芩);治疗肠胃病时,宜使用条芩(即嫩茎部分中间不空的,也称为子芩)。究其实质,二者皆为黄芩,其基本功效原本没有太大差别。
李濒湖说:“有人平素酒色过度,患少腹绞痛难以忍受,小便如同淋证,服用多种药物无效,偶然使用黄芩、木通、甘草三味药,煎服后疼痛随即停止。”按语:黄芩治疗少腹绞痛,《名医别录》中原本就有明确记载,由此可以看出古人审视药性的精微之处是后人难以企及的。然而,必须是因为热邪逼迫导致少腹绞痛的情况才可以应用,不能一概用它来治疗所有腹痛。另外需要知道,太阴病的腹痛没有热证,只有少阳病的腹痛才有热证,《名医别录》明确标注为“少腹绞痛”,这正是它立言精细的地方。
李濒湖又说:“我二十多岁时,因感冒咳嗽日久,且违反了房事禁忌,于是患上骨蒸潮热,皮肤像火燎一样灼热,每天吐痰约一碗,夏季感到烦躁口渴,睡觉和吃饭都废弛了,六脉浮洪,遍服柴胡、麦冬、荆沥等药物,一个多月病情反而加重,大家都认为必死无疑。家父偶然想起李东垣治疗肺热如火燎,烦躁引饮且白天加重的属于气分热,应当用一味黄芩汤,以泻肺经气分之火。于是按照方子使用片芩一两,水两盅煎成一盅,一次性顿服,第二天身体热势尽退,痰嗽全部痊愈,药力击中要害,如击鼓应声般迅速,医学中的奥妙竟有如此神效啊。”观察李濒湖这两段论述,黄芩善于清除气分之热,可以说是黄芩独具的特殊良能。
Huangqin (Radix Scutellariae): Bitter in taste, cool in nature. Its texture is hollow in the center, making it particularly effective at clearing heat from the Qi level of the Lung Meridian. Its action descends from the Spleen to penetrate the Sanjiao (Triple Burner) and reach the Bladder to promote urination. It is also effective at entering the Stomach and Spleen to clear heat, descending from the Stomach to the Intestines to treat dysentery with pus and blood. Furthermore, it enters the Liver and Gallbladder to clear heat, treating the alternating chills and fever characteristic of Shaoyang disease (used in both Xiaochaihu Tang [Minor Bupleurum Decoction] and Dachaihu Tang [Major Bupleurum Decoction]). It can also regulate Qi; for any Zang-Fu organ where Qi stagnation leads to heat, Huangqin can disperse and unblock it. It is also effective at clearing heat from the exterior shell of the body, eliminating heat that is latent in the meridians or scattered in the Couli (interstices).
For treating Lung diseases, Liver and Gallbladder diseases, and exterior diseases, Kuqin (hollow Huangqin) should be used; for treating Stomach and Intestine diseases, Tiaoqin (tender, non-hollow Huangqin, also known as Ziqin) should be used. Ultimately, both are Huangqin, and their fundamental functions have little difference.
Li Binhu stated: "There was a person who indulged excessively in alcohol and sexual desires, suffering from unbearable colic pain in the lower abdomen and urinary symptoms resembling strangury. Various medicines were ineffective. Accidentally using a decoction of Huangqin, Mutong [Akebiae Caulis], and Gancao [Licorice Root], the pain stopped after ingestion." Commentary: The treatment of lower abdominal colic by Huangqin is clearly recorded in the Mingyi Bielu [Secret Records of Famous Physicians]. This demonstrates that the ancient physicians' precision in evaluating medicinal properties was beyond the reach of later generations. However, it can only be used when the lower abdominal colic is caused by heat forcing the Qi; it cannot be generally applied to all abdominal pains. One must also understand that Taiyin abdominal pain does not present with heat syndromes, whereas Shaoyang abdominal pain does present with heat. The Mingyi Bielu explicitly labels this as "lower abdominal colic," which highlights its precise terminology.
Li Binhu further stated: "When I was in my twenties, due to prolonged cold-induced coughing and violating dietary/sexual restrictions, I developed bone-steaming fever, with skin feeling like burning embers. I expectorated about a bowl of phlegm daily, felt irritable and thirsty during summer months, and lost my appetite and sleep. My six pulses were floating and surging. After taking Chaihu [Bupleuri Radix], Maidong [Ophiopogonis Radix], Jingli [Phyllostachys Nigra Juice], and other medicines for over a month, my condition worsened, and everyone believed I would certainly die. My father occasionally recalled Li Dongyuan's treatment for lung heat resembling fire blazing, with irritability, excessive thirst, and worsening during the day, identifying it as heat in the Qi level. He recommended Yiwu Huangqin Tang [Single-Huangqin Decoction] to purge the fire from the Qi level of the Lung Meridian. Following this prescription, I took one liang of Pianqin [sliced Huangqin], boiled in two cups of water until reduced to one cup, and drank it in one dose. The next day, the fever completely subsided, and the cough with phlegm healed. The medicine hit the mark precisely, responding as quickly as a drumbeat. Such is the wonder of medicine." Observing these two passages by Li Binhu, his proficiency in clearing heat from the Qi level demonstrates the unique capability of Huangqin.