根名檀桓
苦寒，无毒。生用降实火。酒制治阴火上炎。盐制治下焦之火。姜制
治中焦痰火，姜汁炒黑治湿热。盐酒炒黑治虚火。阴虚火盛，面赤戴阳，附子汁制。
《本经》主五脏肠胃中结热，黄瘅肠痔，止泄痢，女子漏下赤白，阴伤蚀疮。檀桓主心
腹百病，安魂魄，不饥渴，久服轻身延年通神。
发明 黄柏苦燥，为治三阴湿热之专药。详《本经》主治皆湿热伤阴之候，即漏下赤白
，亦必因热邪伤阴，火气有余之患，非崩中久漏之比。其根治心腹百病，魂魄不安，皆火内
亢之候。仲景栀子柏皮汤治身黄发热得其旨矣。按∶黄柏味浓而降，入肾经血分。凡肾水膀
胱不足，诸痿厥无力，于黄 汤中加用，使两足膝中气力涌出，痿弱即愈。黄柏、苍术乃治
痿要药。凡下焦湿热肿痛，并膀胱火邪，小便不利及黄涩者并宜，黄柏、知母为君，茯苓、
泽泻为佐。凡小便不通而渴者，邪热在气分，主治在肺不能生水。不渴者，邪热在血分，主
治在膀胱不能化气，亦宜黄柏、知母。昔人病小便不通，腹坚如石，脚腿裂水，双睛凸出，
遍服治满利小便药不效，此高粱积热损伤肾水，致膀胱不化火气，上逆而为呕哕，遂以滋肾
丸主之。方用黄柏、知母，入桂为引导，服少时，前阴如火烧，溺即涌出，顾盼肿消。《金
匮》治误食自死，六畜肉中毒，用黄柏屑捣服方寸匕解之，不特治高粱积热。盖苦以解毒，
寒以泄热也。大抵苦寒之性利于实热，不利于虚热。凡脾虚少食，或呕或泻或好热恶寒，或
肾虚五更泄泻，小便不禁，少腹冷痛，阳虚发热，瘀血停止，产后血虚发热，痈疽肿后发热
，阴虚小便不利，痘后脾虚小便不利，血虚烦躁不眠等证，法皆忌之。一种小而实如酸石榴
者名曰小柏。性亦不甚相远，《千金翼》阿伽佗丸用之。
黄柏的根名为檀桓。
味苦，性寒，无毒。生用能清降实火。酒制可治疗阴火上炎。盐制可治疗下焦之火。姜制可治疗中焦痰火，姜汁炒黑可治疗湿热。盐酒炒黑可治疗虚火。阴虚火盛，面赤戴阳（虚阳上浮），用附子汁炮制。
《神农本草经》记载其主治五脏肠胃中的结热，黄疸、肠痔，止泄痢，女子漏下赤白带下，阴部损伤蚀疮。檀桓主治心腹各种疾病，安定魂魄，消除饥渴感，长期服用可轻身延年，通神。
发明：黄柏味苦而燥，是治疗三阴经湿热的专用药物。详细分析《本经》的主治功效，都是湿热伤阴的表现，即使是漏下赤白，也必定是因为热邪伤阴，火气有余所致，并非崩中久漏（虚寒性出血）的情况。其根治心腹百病，魂魄不安，都是火气内亢的表现。张仲景的栀子柏皮汤治疗身黄发热，就抓住了这一主旨。按语：黄柏气味浓厚而沉降，入肾经血分。凡是肾水、膀胱不足，各种痿证厥逆无力，在黄柏汤中加入使用，能使两足膝中的气力涌出，痿弱即可痊愈。黄柏、苍术是治疗痿证的要药。凡是下焦湿热肿痛，以及膀胱火邪，小便不利及尿色黄涩者都适宜，以黄柏、知母为君药，茯苓、泽泻为佐药。凡是小便不通且口渴的，邪热在气分，主治在于肺不能生水；不口渴的，邪热在血分，主治在于膀胱不能化气，也适宜用黄柏、知母。过去有人患小便不通，腹部坚硬如石，脚腿渗出水液，双眼凸出，遍服治疗胀满、利小便的药物无效，这是高梁厚味积热损伤肾水，导致膀胱不化火气，上逆而为呕吐呃逆，于是用滋肾丸主治。方中用黄柏、知母，加入肉桂作为引导，服用片刻后，前阴如火烧般感觉，尿液随即涌出，转眼之间肿胀消退。《金匮要略》治疗误食自死的六畜肉类中毒，用黄柏屑捣碎服用一方寸匕来解毒，不仅用于治疗高梁积热。大概是因为苦味可以解毒，寒性可以泄热。大抵苦寒的性质有利于实热，不利于虚热。凡是脾虚少食，或呕吐或腹泻或喜热恶寒，或肾虚五更泄泻，小便不禁，少腹冷痛，阳虚发热，瘀血停滞，产后血虚发热，痈疽肿后发热，阴虚小便不利，痘后脾虚小便不利，血虚烦躁不眠等证候，法度上都忌讳使用。一种小而坚实像酸石榴一样的叫作小柏。药性也相差不远，《千金翼方》中的阿伽佗丸中使用它。
The root is named Tanhuan.
Bitter, cold, non-toxic. Used raw to descend and clear excess fire. Processed with wine to treat flaming fire of the Yin. Processed with salt to treat fire in the Lower Jiao (Lower Burner). Processed with ginger to treat phlegm-fire in the Middle Jiao (Middle Burner); stir-fried with ginger juice until black to treat damp-heat. Stir-fried with salt and wine until black to treat deficient fire. For excessive fire due to Yin deficiency, with a red face and floating Yang (deficient Yang floating upward), process with decoction of Fuzi (Aconiti Lateralis Radix Praeparata).
*Shennong Bencao Jing* states it primarily treats internal knotting of heat in the five Zang organs and intestines/stomach, jaundice, hemorrhoids, stops dysentery and diarrhea, treats leukorrhea with red and white discharge in women, and sores/ulcers on the genitals. Tanhuan treats various diseases of the heart and abdomen, calms the Hun and Po spirits, eliminates hunger and thirst, and long-term use lightens the body, prolongs life, and enhances spiritual clarity.
Invention: Huangbai is bitter and drying, serving as a specialized herb for treating damp-heat in the three Yin meridians. A detailed examination of the indications in *Shennong Bencao Jing* reveals they are all conditions where damp-heat injures Yin. Even leukorrhea with red and white discharge must be caused by pathogenic heat injuring Yin and an excess of fire energy, which differs from chronic metrorrhagia or prolonged spotting due to deficiency-cold. Its ability to cure various heart and abdominal diseases and restless Hun and Po spirits stems from hyperactive internal fire. Zhang Zhongjing’s Zhizi Bopi Tang (Gardenia and Phellodendron Decoction) for treating yellowing of the body with fever captures this essence accurately. Note: Huangbai has a strong flavor and descending nature, entering the Kidney meridian and blood level. In cases of insufficiency of Kidney water and Bladder Qi, manifesting as various Wei syndrome (flaccidity syndromes) and Jue syndrome (cold extremities) with weakness, adding it to Huangbai Tang causes Qi strength to surge in the knees and legs, curing flaccidity. Huangbai and Cangzhu (Atractylodis Rhizoma) are essential herbs for treating Wei syndrome. It is suitable for damp-heat swelling and pain in the Lower Jiao, Bladder fire pathogenic factors, difficult urination, and yellow, turbid urine. The formula uses Huangbai and Zhimu (Anemarrhenae Rhizoma) as Sovereign herbs, with Fuling (Poria) and Zexie (Alismatis Rhizoma) as Assistant herbs. For urinary retention accompanied by thirst, the pathogenic heat is in the Qi level; treatment focuses on the Lung’s failure to generate water. For urinary retention without thirst, the pathogenic heat is in the Blood level; treatment focuses on the Bladder’s failure to transform Qi; Huangbai and Zhimu are also appropriate. Historically, a patient suffered from urinary retention, an abdomen hard as stone, edema oozing from the legs, and protruding eyes. After failing numerous treatments for distension and diuresis, it was diagnosed that rich food accumulated heat injured Kidney water, causing the Bladder to fail to transform fire Qi, which reversed upward causing vomiting and hiccups. Thus, Zishen Wan (Kidney-Nourishing Pill) was used. The formula employed Huangbai and Zhimu, with Rougui (Cinnamomi Cortex) as a guiding agent. Upon taking a small amount, the external genitalia felt like burning, and urine gushed out; within moments, the swelling subsided. *Jingui Yaolue* treats poisoning from accidentally consuming meat of animals that died naturally using crushed Huangbai bark taken as one Cunbi (a traditional measure) to detoxify, not merely for clearing rich-food accumulated heat. This is because bitterness detoxifies and coldness drains heat. Generally, the bitter-cold nature benefits excess heat but harms deficient heat. It is contraindicated in cases of Spleen deficiency with poor appetite, vomiting, diarrhea, preference for warmth and aversion to cold, Kidney deficiency with dawn diarrhea, urinary incontinence, cold pain in the lower abdomen, Yang deficiency with fever, stagnant blood stasis, postpartum blood deficiency with fever, fever after carbuncles/sores have swollen, Yin deficiency with difficult urination, Spleen deficiency with difficult urination after smallpox, and blood deficiency with irritability and insomnia. One variety, small and solid like a sour pomegranate, is called Xiaobai. Its properties are not significantly different; it is used in Ajituo Wan (Ajituo Pill) from *Qianjin Yifang*.