（出东垣十书）
张仲景八味丸用泽泻。寇宗 本草衍义云。不过接引桂附等归就肾经。别无他意。王海藏韪之。愚谓八味
丸。以地黄为君而以余药佐之。非止为补血之剂。盖兼补气也。若专为补肾而入肾经。则地黄山茱萸白茯苓牡
丹皮。皆肾经之药。固不待夫泽泻之接引而后至也。其附子乃右命门之药。浮中沉无所不至。又谓通行诸经引
用药。官桂能补下焦相火不足。是亦右肾命门药也。然则桂附。亦不待夫泽泻之接引而后至矣。且泽泻
虽曰咸以泻肾。乃泻肾邪。非泻肾之本也。故五苓散用泽泻者。讵非泻肾邪乎。白茯苓亦伐肾邪。即所以补
正耳。是则八味丸之用泽泻者。非为接引诸药泻肾邪。盖取其养五脏。益气力。起阴气。补虚损、五劳之功。
寇氏又何疑耶。且泽泻固能泻肾。然从于诸补药之中。虽欲泻之。而力莫能施矣。其妙为何如。
余所以谆谆于此方者。盖深知仲景为立方之祖。的认此方为治肾之要。毫不敢私意增减。今人或以脾胃
药杂之。或以寒凉加之。皆不知立方之本意也。余特将仲景立意之奥旨。阐发于各条门下。
坎干水也。气也。即小而井。大而海也。兑坤水也。形也。即
微而露。大而雨也。一阳陷于二阴为坎。坎以水气潜行地中。为万物受命根本。故曰润万物者。莫润乎水。一
阴上彻于二阳为兑。兑以有形之水。普施于万物之上。为资生之利泽。故曰说万物者。莫说乎泽。明此二水。
可以悟治火之道矣。心火者。有形之火也。相火者。无形之火也。无形之火内燥热而津液枯。以五
行有形之兑水制之者。权也。吾身自有上池真水。气也。无形者也。以无形之水沃无形之火。当而可久者也。
是为真水真火。升降既宜。而成既济矣。医家不悟先天太极之真体。不穷无形水
火之妙用。而不能用六味八味之神剂者。其于医理。尚欠太半。
陈希夷正易消息曰。坎干水也。气也。一阳陷于二阴为坎。坎以水气。潜行地中。为万物受命根本。故
曰润万物者。莫润乎水。盖润液也。气之液也。月令于仲秋乃云。杀气浸盛。阳气日衰。水始涸。是水之涸。
地之死也。于仲冬乃云。水泉动。然而是月一阳生。是水之动。地之生也。由斯而观。不过欲人脱死地而求生
地。凡举动先自潜固根本以待。后乃能万应而万举万胜。明其理也。
六味丸（一名地黄丸） 治肾虚作渴。小便淋秘。气壅痰涎。头目眩晕。眼花耳聋。咽燥舌痛齿痛。
腰腿痿软等证。及肾虚发热。自汗盗汗。便血诸血。失音水泛为痰之圣药。血虚发热之神剂。又治肾阴虚弱。
津液不降。败浊为痰。或致咳逆。又治小便不禁。收精气之虚脱。为养气滋肾。制火导水。使机关利而脾土健实。
熟地黄（八两杵膏） 山茱萸肉 山药（各四两） 牡丹皮 白茯苓 泽泻（各三两） 上为细末。和地
黄膏。加炼蜜。丸桐子大。每服七八十丸。空心食前。滚盐汤下。凡服须空腹。服毕少时。便以美
膳压之。使不得停留胃中。直至下元。以泻冲逆也。
（出自李东垣《十书》）
张仲景在八味丸中使用泽泻。寇宗奭在《本草衍义》中说，泽泻的作用不过是引导桂枝、附子等药物归入肾经罢了，没有其他深意。王海藏赞同这一观点。我认为，八味丸以地黄为君药，其他药物为辅佐，它不仅仅是补血剂，同时也兼有补气的作用。如果仅仅是为了补肾而让药物进入肾经，那么地黄、山茱萸、白茯苓、牡丹皮都是入肾经的药物，本来就不需要依靠泽泻来引导才能到达肾经。附子是治疗右命门的药物，其药力浮沉无所不至，又被称为通行各经络的引经药；官桂能补益下焦相火的不足，也是治疗右肾命门的药物。既然如此，桂枝和附子也不需要依靠泽泻的引导就能到达病所。况且泽泻虽然说是用咸味来泻肾，但它是泻除肾中的邪气，而不是泻除肾的本元。所以五苓散中使用泽泻，难道不是为了泻除肾邪吗？白茯苓也能伐除肾邪，这也就是扶助正气的方法。因此，八味丸中使用泽泻，并不是为了引导诸药或泻除肾邪，而是利用它滋养五脏、益气力、起阴气、补虚损以及治疗五劳的功效。寇氏对此又有什么可怀疑的呢？而且泽泻固然能泻肾，但它跟随在诸多补药之中，虽然想要发挥泻的作用，却无力施展了。其中的奥妙多么精妙啊！
我之所以反复强调这个方子，是因为深知张仲景是创立方剂的祖师，确切地认定此方是治疗肾脏疾病的关键，丝毫不敢凭私意增减药物。现在的人有的将脾胃药混杂其中，有的加入寒凉药物，这都是不了解立方的本意。我特意在各条目的门下阐发张仲景立意的高深宗旨。
坎卦代表水，也代表气，即微小的井水和广阔的大海。兑卦和坤卦代表水，也代表形体，即微小的露水和大雨。一个阳爻陷于两个阴爻之间构成坎卦，坎卦以水气的形式潜行于地中，是万物承受生命的根本。所以说，滋润万物的，没有比水更滋润的了。一个阴爻上彻于两个阳爻之间构成兑卦，兑卦以有形的水，普遍施予万物之上，是资助生命利益的恩泽。所以说，喜悦万物的，没有比泽更喜悦的了。明白了这两种水的道理，就可以领悟治疗火病的道法了。心火是有形的火，相火是无形的火。无形的火在内导致燥热而津液枯竭，用五行中有形的兑水来制约它，这是一种权宜之计。我们身体自有上池真水，这是气，是无形的。用无形之水浇灌无形之火，恰当且持久，这就是真水和真火。升降适宜，就形成了既济卦的状态。医生如果不悟解先天太极的真体，不穷尽无形水火的神妙作用，就不能使用六味丸和八味丸这些神效药剂，他们在医理方面还欠缺大半。
陈希夷在《正易消息》中说：坎卦代表水，也代表气。一个阳爻陷于两个阴爻之间构成坎卦，坎卦以水气潜行于地中，是万物承受生命的根本。所以说，滋润万物的，没有比水更滋润的了。盖指润液，即气的液体。《月令》在仲秋时节说：杀气逐渐强盛，阳气日渐衰微，水开始枯竭。水的枯竭，意味着地的死亡。在仲冬时节说：水泉涌动。然而在这个月一阳初生，水的涌动意味着地的生机。由此看来，不过是希望人们脱离死地而求生地。凡是行动都要先暗中巩固根本，然后才能应对万事，做到万举万胜。明白这个道理即可。
六味丸（又名地黄丸），治疗肾虚引起的口渴、小便淋漓闭塞、气壅痰涎、头目眩晕、眼花耳聋、咽喉干燥舌痛齿痛、腰腿痿软等症状，以及肾虚发热、自汗盗汗、便血等各种出血、失音、水泛为痰的圣药，血虚发热的特效剂。又治疗肾阴虚弱，津液不能下降，败浊化为痰饮，或者导致咳嗽气逆。又治疗小便不禁，收敛精气虚脱。具有养气滋肾、制火导水的作用，使机关通利而脾土健实。
熟地黄（八两捣成膏状）、山茱萸肉、山药（各四两）、牡丹皮、白茯苓、泽泻（各三两）。以上药材研成细末，与地黄膏混合，加入炼蜜，制成梧桐子大小的丸药。每次服用七八十丸，空腹或食前，用温盐汤送服。凡服药必须空腹，服完后过一会儿，立即吃美味的饭菜压住药性，使药力不得停留在胃中，一直下行到下元，以泻除冲逆之气。
(From Li Dongyuan's *Ten Books*)
Zhang Zhongjing uses *Alismatis Rhizoma* (Ze Xie, 泽泻) in the *Ba Wei Wan* (Eight-Ingredient Pill with Rehmannia). Kou Zongshi stated in his *Bencao Yan Yi* (Supplement to Materia Medica) that its function is merely to guide herbs such as *Cinnamomi Ramulus* (Gui Zhi, 桂枝) and *Aconiti Lateralis Radix Praeparata* (Fu Zi, 附子) into the Kidney Meridian, with no other profound meaning. Wang Haicang agreed with this view. I argue that in the *Ba Wei Wan*, *Rehmanniae Radix Preparata* (Shu Di Huang, 熟地黄) serves as the sovereign drug, assisted by the remaining herbs. It is not merely a blood-nourishing formula but also possesses Qi-tonifying properties. If the sole purpose were to tonify the Kidney and enter the Kidney Meridian, then *Rehmanniae Radix* (Di Huang, 地黄), *Corni Fructus* (Shan Zhu Yu, 山茱萸), *Poria* (Fu Ling, 茯苓), and *Moutan Cortex* (Mu Dan Pi, 牡丹皮) are all herbs that enter the Kidney Meridian; they would naturally reach the Kidney without needing the guidance of *Alismatis Rhizoma*. *Aconiti Lateralis Radix Praeparata* is a herb for the Right Mingmen (Gate of Life), penetrating through floating, middle, and deep pulses, and is also known as a guiding herb that circulates through all meridians; *Cinnamomi Ramulus* (Gui Zhi, 桂枝) can tonify the deficiency of Ministerial Fire (Xiang Huo, 相火) in the Lower Jiao, making it also a herb for the Right Kidney and Mingmen. Thus, Cinnamon and Aconio do not require the guidance of *Alismatis Rhizoma* to reach their destination. Moreover, although *Alismatis Rhizoma* is said to drain the Kidney using its salty flavor, it drains pathogenic factors from the Kidney, not the Kidney's essence itself. Therefore, the use of *Alismatis Rhizoma* in *Wu Ling San* (Five-Ingredient Powder with Poria) is indeed to drain Kidney pathogens. *Poria* also attacks Kidney pathogens, which is precisely how it supports righteous Qi. Consequently, the use of *Alismatis Rhizoma* in the *Ba Wei Wan* is not to guide other drugs or drain Kidney pathogens, but to utilize its functions of nourishing the Five Viscera, boosting Qi and strength, raising Yin Qi, tonifying deficiencies, and treating the Five Exhaustions. What doubt does Mr. Kou have? Furthermore, although *Alismatis Rhizoma* can drain the Kidney, when combined among numerous tonifying herbs, even if it intends to drain, its power cannot be exerted. How exquisite is this妙 (subtlety)?
I emphasize this formula repeatedly because I deeply understand that Zhang Zhongjing is the ancestor of formula creation and accurately recognize this formula as the key to treating Kidney disorders, daring not to add or subtract ingredients based on personal preference. Nowadays, some people mix in Spleen and Stomach herbs or add cold-cooling herbs, failing to understand the original intent of the formula. I specifically elucidate the profound principles behind Zhang Zhongjing's formulation under each section.
Kan (坎) represents Water and Qi, ranging from small wells to vast seas. Dui (兑) and Kun (坤) represent Water and Form, ranging from dew drops to heavy rain. One Yang line trapped between two Yin lines forms Kan. Kan allows Water Qi to flow secretly underground, serving as the root foundation for all things to receive life. Hence it is said: "Nothing moistens the myriad things like water." One Yin line extending upwards through two Yang lines forms Dui. Dui spreads tangible water over all things above, providing the benefits of sustenance. Hence it is said: "Nothing delights the myriad things like marshes." Understanding these two types of water allows one to comprehend the Dao of treating Fire. Heart Fire is tangible fire; Ministerial Fire is intangible fire. Intangible fire causes internal dryness and heat, leading to withered fluids. Using tangible Dui Water from the Five Elements to restrain it is a provisional measure. Our body possesses True Water from the Upper Pool, which is Qi and intangible. Using intangible Water to irrigate intangible Fire is appropriate and enduring. This constitutes True Water and True Fire. When ascending and descending are harmonious, the state of Ji Ji (Already Crossing/Completion) is achieved. Physicians who fail to comprehend the true substance of the Pre-Heaven Taiji and do not exhaust the miraculous uses of intangible Water and Fire cannot effectively use the divine formulas of Liu Wei Wan (Six-Ingredient Pill) and Ba Wei Wan. Their understanding of medical principles remains deficient by more than half.
Chen Xiyi stated in *Zheng Yi Xiao Xi*: Kan represents Water and Qi. One Yang line trapped between two Yin lines forms Kan. Kan allows Water Qi to flow secretly underground, serving as the root foundation for all things to receive life. Hence it is said: "Nothing moistens the myriad things like water." This refers to moistening fluid, the liquid of Qi. In the *Monthly Ordinances*, during Mid-Autumn, it says: "Killing Qi gradually intensifies, Yang Qi declines daily, and water begins to dry up." The drying of water signifies the death of the earth. In Mid-Winter, it says: "Water springs move." However, in this month, one Yang is born; the movement of water signifies the life of the earth. From this perspective, it is merely intended to help people escape death and seek life. All actions should first secretly consolidate the root before being able to respond to ten thousand matters and achieve victory in every endeavor. Understanding this principle suffices.
*Liu Wei Wan* (Six-Ingredient Pill, also known as *Di Huang Wan*) treats symptoms such as thirst due to Kidney deficiency, dribbling or retention of urine, Qi stagnation with phlegm-saliva, dizziness and vertigo, blurred vision and deafness, dry throat, tongue pain, toothache, flaccidity of the waist and legs, fever due to Kidney deficiency, spontaneous sweating, night sweats, hematochezia, various bleeding disorders, aphonia, edema manifesting as phlegm, and fever due to Blood deficiency. It is a sacred medicine for Kidney deficiency and a divine agent for Blood deficiency fever. It also treats weak Kidney Yin where fluids fail to descend, turning turbid into phlegm, potentially causing cough and rebellious Qi. It treats urinary incontinence and consolidates the virtual collapse of Essence and Qi. It nourishes Qi and tonifies the Kidney, restrains Fire and guides Water, ensuring the smooth functioning of mechanisms and strengthening the Spleen Earth.
Prepared *Rehmanniae Radix* (8 liang, pounded into paste), *Corni Fructus* pulp, *Dioscoreae Rhizoma* (each 4 liang), *Moutan Cortex*, *Poria*, and *Alismatis Rhizoma* (each 3 liang). Grind these into fine powder, mix with the *Rehmanniae* paste, add refined honey, and form pills the size of tung tree seeds. Take 70–80 pills per dose, on an empty stomach or before meals, washed down with warm salted water. Medication must be taken on an empty stomach. After taking the pills, consume a good meal shortly thereafter to suppress the medication, preventing it from lingering in the Stomach, so that it descends directly to the Lower Yuan to drain rebellious Qi.