山萸肉∶味酸性温。大能收敛元气，振作精神，固涩滑脱。因得木气最浓，收涩之中兼具条畅之性，故
又通利九窍，流通血脉，治肝虚自汗，肝虚胁疼腰疼，肝虚内风萌动，且敛正气而不敛邪气，与他酸敛之药不
同，是以《神农本草经》谓其逐寒湿痹也。其核与肉之性相反，用时务须将核去净，近阅医报有言核味涩，性
亦主收敛，服之恒使小便不利，椎破尝之，果有有涩味者，其说或可信。
山茱萸得木气最浓，酸收之中，大具开通之力，以木性喜条达故也。《神农本草经》谓主寒湿痹，诸家
本草，多谓其能通利九窍，其性不但补肝，而兼能利通气血可知，若但视为收涩之品，则浅之乎视山茱萸矣。
【附案】一人年四十余，外感痰喘，愚为治愈。但脉浮力微，按之即无。愚曰∶“脉象无根，当服峻补之
剂，以防意外之变。”病家谓病患从来不受补药，服之则发狂疾，峻补之药，实不敢用。
愚曰∶“既畏补药如是，备用亦可。”病家根据愚言。迟半日忽发喘逆，又似无气以息，汗出遍体，四肢逆冷，
身躯后挺，危在顷刻。急用净萸肉四两，爆火煎一沸，即饮下，汗与喘皆微止。又添水再煎数沸饮下，病又见
愈。复添水将原渣煎透饮下，遂汗止喘定，四肢之厥逆亦回。
邻村李××，年二十余，素伤烟色，偶感风寒，医者用表散药数剂治愈。间日，忽遍身冷汗，心怔忡异常，
自言气息将断，急求为调治。诊其脉浮弱无根，左右皆然。愚曰∶“此证虽危易治，得萸肉数两，可保无虞。”
急取净萸肉四两，人参五钱。先用萸肉二两煎数沸，急服之，心定汗止，气亦接续，又将人参切作小块，用所
余萸肉煎浓汤，送下病若失。
一人年四十八，大汗淋漓，数日不止，衾褥皆湿，势近垂危，询方于愚。俾用净萸肉二两，煎汤饮之，汗
遂止。翌晨，迎愚诊视，其脉沉迟细弱，而右部之沉细尤甚，虽无大汗，遍体犹湿。疑其胸中大气下陷，询之，
果觉胸中气不上升，有类巨石相压，乃恍悟前次之大汗淋漓，实系大气陷后，卫气无所统摄而外泄也，遂用生
黄一两，萸肉、知母各三钱，一剂胸次豁然，汗亦尽止，又服数剂以善其后。
奉天友人田××妻，年五十余，素有心疼证，屡服理气活血之药，未能除根。一日反复甚剧，服药数剂，
病未轻减。田××见既济汤后，载有张××所治心疼医案，心有会悟，遂用其方加没药、五灵脂各数钱，连服数
剂全愈，至此二年，未尝反复。由是观之，萸肉诚得木气最浓，故味虽酸敛，而性仍条畅，凡肝气因虚不能条
畅而作疼者，服之皆可奏效也。
山萸肉之性，又善治内部血管，或肺络破裂，以致咳血吐血久不愈者（补络补管汤下载有医案宜参观）。
山萸肉之性，又善熄内风。族家嫂，产后十余日，周身汗出
不止，且四肢发搐，此因汗出过多而内风动也。急用净萸肉、生山药各二两，俾煎汤服之，两剂愈。
至外感之邪不净而出汗者，亦可重用山萸肉以敛之。邑张××之子，年十八九，因伤寒服表药太过，汗出
不止，心中怔忡，脉洪数不实，大便数日未行。为疏方，用净萸肉、生山药、生石膏各一两，知母、生龙骨、
生牡蛎各六钱，甘草二钱，煎服两剂全愈。
门生万××，曾治一壮年男子，因屡经恼怒之余，腹中常常作疼。他医用通气、活血、消食、祛寒之药，
皆不效。诊其脉左关微弱，知系怒久伤肝，肝虚不能疏泄也。遂用净萸肉二两，佐以当归、丹参、柏子仁各数
钱，连服数剂，腹疼遂愈。后凡遇此等证，投以此方皆效。
山茱萸之核原不可入药，以其能令人小便不利也。而僻处药坊所卖山茱萸，往往核与肉参半，甚或核多于
肉。即方中注明去净核，亦多不为去，误人甚矣。斯编重用山茱萸治险证之处甚多。凡用时愚必自加检点，或
说给病家检点，务要将核去净，而其分量还足，然后不至误事。又山萸肉之功用，长于救脱，而所以能固脱者，
因其味之甚酸，然间有尝之微有酸味者，此等萸肉实不堪用。用以治险证者，必须尝其味极酸者然后用之，方
能立建奇效。
山茱萸：味道酸，性质微温。具有极强的收敛元气、振奋精神、固涩滑脱（防止精气津液无故流失）的功效。因为它禀受木气最为浓厚，在收涩之中兼具条达舒畅的特性，所以又能通利九窍，流通血脉，治疗肝虚引起的自汗、肝虚导致的胁痛和腰痛、肝虚引发的内风萌动。它收敛正气而不敛滞邪气，与其他酸敛性质的药物不同，因此《神农本草经》记载它能驱除寒湿痹阻。它的果核与果肉的性质相反，使用时务必将果核去除干净。近期阅读医报有文章说果核味道涩，性质也主收敛，服用后常常导致小便不利，砸破果核品尝，果然有涩味，这种说法或许可信。
山茱萸禀受木气最浓，在酸收之中，具有强大的开通之力，这是因为木性的特点是喜欢条达舒展的缘故。《神农本草经》记载它主治寒湿痹证，各家本草著作，大多认为它能通利九窍，可知其性质不仅补益肝脏，而且兼能疏通气血。如果仅仅把它视为收涩的药物，那就看轻了山茱萸的作用。
【附案】有一位四十多岁的患者，患有外感痰喘，我将其治愈。但是他的脉象浮取有力而重按即无，显得力量微弱。我说：“脉象没有根基，应当服用峻猛的补益药剂，以防发生意外变化。”病人家属说患者向来不能耐受补药，服用后会发狂病，峻补的药物实在不敢使用。
我说：“既然如此畏惧补药，备用着也可以。”病人家属听从了我的话。过了半天，患者突然发作喘逆，似乎气息将断，全身出汗，四肢厥冷，身体向后挺伸，情况危急，就在顷刻之间。我急忙用净山茱萸四两，猛火煎煮一沸，立即让患者服下，汗出和喘息都稍微停止。又加水再煎煮几沸服下，病情进一步好转。再次加水将原药渣彻底煎透服下，于是汗止喘定，四肢的厥冷也恢复了温暖。
邻村的李某某，二十多岁，平时纵欲吸烟损伤身体，偶然感受风寒，医生用发散表邪的药物几剂治愈。隔日，突然全身冷汗不止，心中惊悸异常，自己说气息将要断绝，急忙请求我为他调治。诊察他的脉象浮弱且无根，左右手都是如此。我说：“这个病症虽然危险但容易治疗，得到几两山茱萸，就可以保证安全。”急忙取净山茱萸四两，人参五钱。先用山茱萸二两煎煮几沸，急服，心定汗止，气息也接续上了，又将人参切成小块，用剩余的山茱萸煎成的浓汤送服，病人大愈。
有一位四十八岁的患者，大汗淋漓，数日不止，被褥都湿了，形势接近垂危，向我咨询方子。让他用净山茱萸二两，煎汤饮用，汗随即停止。第二天早晨，迎请我去诊视，他的脉象沉迟细弱，而右手的沉细尤为严重，虽然没有大汗，但全身仍然潮湿。我怀疑是胸中大气下陷，询问他，果然感觉胸中气不上升，像有巨石压迫一样，这才恍然大悟前次的大汗淋漓，实际上是大气下陷后，卫气无所统摄而外泄所致，于是用生黄芪一两，山茱萸、知母各三钱，一剂后胸中豁然开朗，汗也完全停止，又服用几剂以巩固疗效。
奉天的朋友田某某的妻子，五十多岁，素来有心疼证，多次服用理气活血的药物，未能根治。一日疼痛剧烈反复，服药几剂，病情未减轻。田某某看到《既济汤》后面载有张某某所治心疼的医案，心有领悟，于是用那个方子加没药、五灵脂各几钱，连续服用几剂后痊愈，至此两年，未曾复发。由此看来，山茱萸确实禀受木气最浓，所以味道虽然酸敛，但性质依然条达舒畅，凡是肝气因虚不能条达舒畅而作痛的，服用它都可以奏效。
山茱萸的性质，又善于治疗内部血管，或是肺络破裂，导致咳血吐血久不愈合的情况（《补络补管汤》下方载有医案，适宜参考）。
山茱萸的性质，又善于平息内风。同族家的嫂子，产后十多天，周身汗出不止，并且四肢抽搐，这是因为汗出过多而导致内风动的缘故。急忙用净山茱萸、生山药各二两，让她煎汤服用，两剂后痊愈。
至于外感之邪未尽而出汗的情况，也可以重用山茱萸来收敛它。本邑张某某的儿子，十八九岁，因为伤寒服用解表药太过，汗出不止，心中惊悸，脉象洪数但不实，大便数日未行。我为他开方，用净山茱萸、生山药、生石膏各一两，知母、生龙骨、生牡蛎各六钱，甘草二钱，煎服两剂后痊愈。
门生万某某，曾治疗一位壮年男子，因为屡次在恼怒之后，腹中常常作痛。其他医生用通气、活血、消食、祛寒的药物，都不见效。诊察他的脉象左关微弱，知道是怒气久伤肝脏，肝虚不能疏泄所致。于是用净山茱萸二两，佐以当归、丹参、柏子仁各几钱，连续服用几剂，腹痛遂愈。后来凡遇到此类病症，投以此方皆有效。
山茱萸的果核原本不可入药，因为它会导致人小便不利。而在偏僻地方的药坊所卖的山茱萸，往往果核与果肉参半，甚至果核多于果肉。即使处方中注明去净果核，也多不为去除，误人甚矣。本书中重用山茱萸治疗险证的地方很多。凡是用到山茱萸时，我必定亲自检查，或者嘱咐病人家属检查，务必要将果核去净，而且分量还要充足，然后才不至于误事。另外，山茱萸的功效，长于救脱，而之所以能固脱，是因为它的味道非常酸，然而间或有尝起来微有酸味的，这种山茱萸实在不堪使用。用来治疗险证的，必须尝其味道极酸的然后再使用，才能立刻建立奇效。
Shanzhuyu (Corni Fructus): It has a sour taste and a slightly warm nature. It is highly effective in consolidating Yuan Qi (Original Qi), invigorating the spirit, and securing against slipping and loss (preventing the pathological discharge of essence, fluids, etc.). Because it absorbs the most intense Wood Qi (the energetic quality associated with the Liver system), within its astringent properties lies a characteristic of free flow and smoothness. Therefore, it can also unblock the nine orifices, promote the circulation of blood vessels, treat spontaneous sweating due to Liver deficiency, hypochondriac pain and lower back pain due to Liver deficiency, and the stirring up of internal wind due to Liver deficiency. It consolidates righteous Qi without retaining pathogenic factors, which differs from other astringent herbs; thus, the *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states that it expels cold-damp bi syndrome. Its pit acts contrary to the flesh; when used, one must ensure the pits are completely removed. I recently read in medical journals an article stating that the pit has an astringent taste and nature, primarily astringent, and taking it often causes difficulty in urination. Breaking open the pit and tasting it, indeed, there was an astringent flavor, so this claim may be credible.
Shanzhuyu absorbs the most intense Wood Qi. Within its sour astringency, it possesses great opening power, precisely because the nature of Wood favors free flow and expansion. The *Shennong Bencao Jing* records it as treating cold-damp bi syndrome; various pharmacopoeias mostly state it can unblock the nine orifices. This indicates that its nature not only tonifies the Liver but also promotes the free flow of Qi and Blood. If one merely views it as an astringent agent, then one underestimates Shanzhuyu.
[Attached Cases] A patient over forty years old suffered from external contraction with phlegm and wheezing, which I cured. However, his pulse was floating but weak, disappearing upon heavy pressure. I said, "The pulse lacks a root; you should take strong tonic prescriptions to prevent unexpected changes." The family stated that the patient had never tolerated tonic medicines before; taking them would induce manic behavior, so they dared not use strong tonics.
I said, "Since you fear tonics so much, keeping them on hand for emergency use is acceptable." The family followed my advice. Half a day later, the patient suddenly developed severe wheezing and dyspnea, appearing as if he lacked breath to sustain life. He sweated profusely all over his body, his four limbs became cold, and his body arched backward, facing imminent danger. I urgently prescribed four taels of pure Shanzhuyu, boiled rapidly for one boil, and administered it immediately. Both sweating and wheezing subsided slightly. After adding water and boiling again for several boils, he drank it, and the condition improved further. Adding water once more to thoroughly decoct the original dregs, he drank it, whereupon sweating stopped, wheezing stabilized, and the coldness in his four limbs returned to normal warmth.
Li XX from a neighboring village, in his twenties, had a history of damage from smoking and sexual excess. He accidentally contracted wind-cold, which was cured by a physician using several doses of exterior-releasing drugs. Two days later, he suddenly broke out in cold sweat all over his body, experienced extreme palpitations, and claimed his breath was about to cease. He urgently sought my treatment. His pulse was floating, weak, and rootless on both sides. I said, "Although this condition appears critical, it is easy to treat. Obtaining several taels of Shanzhuyu will ensure safety." I urgently obtained four taels of pure Shanzhuyu and five qian of Renshen (Ginseng). First, I decocted two taels of Shanzhuyu for several boils and administered it urgently. His heart settled, sweating stopped, and his breath resumed. Then, I cut the Renshen into small pieces and delivered it down using the thick decoction made from the remaining Shanzhuyu. The illness vanished as if lost.
A man aged forty-eight suffered from profuse sweating for several days without cessation, wetting his bedding and mattress, approaching a critical state. He consulted me for a prescription. I instructed him to use two taels of pure Shanzhuyu, decocted in water and drunk. The sweating stopped immediately. The next morning, he invited me to examine him. His pulse was deep, slow, fine, and weak, with the deep and fine quality being particularly pronounced in the right position. Although there was no longer profuse sweating, his whole body remained damp. I suspected sinking of the Great Qi in the chest. Upon inquiry, he indeed felt that Qi did not rise in the chest, resembling the pressure of a heavy stone. I suddenly realized that the previous profuse sweating was actually caused by the sinking of Great Qi, leading to the lack of control over Defensive Qi, which leaked outward. Thus, I prescribed one tael of Shenghuang (Raw Astragalus), three qian each of Shanzhuyu and Zhi Mu (Anemarrhena), and after one dose, his chest felt open and clear, and sweating ceased entirely. He took several more doses to consolidate the recovery.
The wife of Tian XX, a friend from Fengtian, was over fifty years old and had a chronic history of heart pain. Multiple treatments with Qi-regulating and Blood-invigorating drugs failed to cure the root cause. One day, the pain recurred severely; after taking several doses of medicine, the condition did not alleviate. Seeing the medical case of Zhang XX treating heart pain recorded after the Jiji Tang (Both Fulfilled Decoction), Tian XX gained insight and used that formula, adding several qian each of Moyao (Myrrh) and Wulingzhi (Trogopterus Dung). After continuous administration for several doses, he was fully cured. For two years since then, there was no recurrence. From this, we can see that Shanzhuyu indeed absorbs the most intense Wood Qi; therefore, although its taste is sour and astringent, its nature remains smooth and flowing. For any pain caused by Liver Qi failing to flow smoothly due to deficiency, taking it can yield effective results.
The nature of Shanzhuyu is also good at treating internal blood vessels, such as cases of hemoptysis or hematemesis resulting from the rupture of lung collaterals that do not heal for a long time (see the attached case in Buchuo Buguan Tang [Decoction for Tonifying Collaterals and Vessels] for reference).
The nature of Shanzhuyu is also good at extinguishing internal wind. The sister-in-law of my clan family suffered from incessant sweating all over her body and twitching of the four limbs more than ten days postpartum. This was due to excessive sweating causing the stirring of internal wind. I urgently prescribed two taels each of pure Shanzhuyu and Shengshanyao (Raw Dioscorea), instructing her to decoct and drink the soup. She recovered after two doses.
In cases where sweating occurs due to incomplete resolution of external pathogens, Shanzhuyu can also be heavily used to astringe it. The son of Zhang XX from our county, aged eighteen or nineteen, suffered from incessant sweating, palpitations, a surging and rapid but empty pulse, and constipation for several days after taking too many exterior-releasing drugs for typhoid fever. I prescribed a formula using one tael each of pure Shanzhuyu, Shengshanyao, and Sheng Shigao (Raw Gypsum); six qian each of Zhi Mu, Sheng Longgu (Raw Dragon Bone), and Sheng Muli (Raw Oyster Shell); and two qian of Gancao (Licorice). After two doses of decoction and ingestion, he was fully cured.
My student Wan XX once treated a vigorous adult male who frequently suffered from abdominal pain following episodes of anger. Other physicians used drugs for promoting Qi flow, invigorating Blood, digesting food stagnation, and dispelling cold, but none were effective. Palpating his pulse, the left Guan position was weak and faint, indicating that prolonged anger had injured the Liver, and Liver deficiency led to an inability to disperse and drain. Thus, I prescribed two taels of pure Shanzhuyu, assisted by several qian each of Danggui (Angelica Sinensis), Danshen (Salvia Miltiorrhiza), and Baiziren (Biota Seed). After continuous administration for several doses, the abdominal pain was cured. Since then, whenever encountering such conditions, administering this formula has always been effective.
The pit of Cornus officinalis should originally not be used in medicine because it can cause difficulty in urination. However, Shanzhuyu sold in pharmacies in remote areas often contains half pits and half flesh, or even more pits than flesh. Even when prescriptions specify removing the pits completely, this is often ignored, causing significant harm to patients. This book extensively uses heavy doses of Shanzhuyu to treat critical conditions. Whenever I use Shanzhuyu, I must personally inspect it or instruct the patient's family to inspect it, ensuring the pits are completely removed and the dosage is sufficient, so as not to cause errors. Furthermore, the function of Shanzhuyu excels in rescuing collapse, and the reason it can secure against collapse is its extremely sour taste. However, occasionally, some samples have only a slight sour taste; such Shanzhuyu is truly unusable. When used to treat critical conditions, one must taste it to ensure it is extremely sour before using it, in order to achieve miraculous effects immediately.