泻火,燥湿
大苦大寒。入心泻火(王海藏曰∶泻心,实泻脾也。实则泻其子),镇肝凉血(凡治血,
防风为上部之使,黄连为中部之使,地榆为下部之使),燥湿开郁,解渴(单用能治消渴)
除烦,益肝胆,浓肠胃,消心瘀(能去心窍恶血),止盗汗(凉心)。
治肠 泻痢(便血曰 ,有脏连丸。湿热郁而为痢,黄连治痢要药。噤口者,热壅上焦
,同人参煎汤呷之,但得下咽便好。喻嘉言曰∶下痢,必先汗解其外,后调其内。首用辛凉
以解表,次用苦寒以攻里。《机要》云∶后重宜下,腹痛宜和,身重宜除湿,脉弦宜去风,
风邪内结宜汗,身冷自汗宜温,脓血稠粘宜重剂以竭之。下痢,赤属血分,白属气分。戴氏
曰∶俗谓赤热、白寒者,非也。通作湿热处治,但有新久、虚实之分),痞满(燥湿开郁。
张仲景治九种心下痞,五等泻心汤皆用之)腹痛(清热),心痛伏梁(心积),目痛 伤(人
乳浸点或合归、芍等分,煎汤热洗,散热活血),痈疽疮疥(诸痛痒疮,皆属心火),酒毒胎
毒(小儿初生,合甘草为末,蜜调令咽之),明目(《传信方》∶羊肝一具,黄连一两,捣丸,
名羊肝丸,凡是目疾皆治)定惊(镇肝),止汗解毒,除疳(同猪肝蒸为丸)杀蛔(蛔得苦
则伏)。虚寒为病者禁用(久服黄连、苦参反热,从火化也。昂按∶炎上作苦,味苦必燥,
燥则热矣,旦苦寒沉阴肃杀,伐伤生和之气也。韩 曰∶黄连与肉桂同行,能交心肾于顷刻。
时珍曰∶治痢用香连丸,姜连丸用黄连、干姜,姜黄散用黄连、生姜,左金丸用黄连、吴茱
萸,治口疮用黄连、细辛,止下血用黄连、大蒜,一阴一阳,寒因热用,热因寒用,最得制
方之妙)。出宜州者粗肥,出四川者瘦小。状类鹰爪、连珠者良。去毛。治心火生用,虚火
醋炒,肝、胆火猪胆汁炒,上焦火酒炒(有吞酸嘈杂等证,亦有吐酸者名酢心,宜黄连。吴
茱萸降火开郁。酢,音醋),中焦火姜汁炒,下焦火盐水或童便炒,食积火黄士炒,治湿热
在气分,吴茱萸汤炒,在血分干漆水炒,点眼赤人乳浸(时珍曰∶诸法不独为之引导,盖辛
热制其寒苦,咸寒制其燥性,用者详之)。黄芩龙骨为使。恶菊花、玄参、僵蚕、白鲜皮。
畏款冬、牛膝。忌猪肉(时珍曰∶方有脏连丸、黄连猪肚丸,岂忌肉而不忌脏腑乎?)。杀
乌头、巴豆毒。(黄连泻心火,佐以龙胆泻肝、胆火,白芍泻脾火,石膏泻胃火,知母泻肾
火,黄柏泻膀胱火,木通泻小肠火。黄芩泻肺火,栀子佐之;泻大肠火,黄连佐之;柴胡泻
肝胆火,黄连佐之;泻三焦火,黄芩佐之。郑奠一曰∶兀兀欲吐,用黄连数分甚效)。
泻火,燥湿。
黄连味大苦、性大寒。入心经以泻火(王海藏说:泻心火,实际上是泻脾火。因为脾为心之子,实则泻其子),镇肝凉血(凡治疗血证,防风是上部的引经药,黄连是中部的引经药,地榆是下部的引经药),燥湿开郁,解渴(单用能治疗消渴病),除烦,益肝胆,厚肠胃,消除心窍瘀血(能去除心窍中的恶血),止盗汗(通过清心火)。
治疗肠澼、泄痢(便血称为“肠澼”,有脏连丸方。湿热郁结而成痢疾,黄连是治疗痢疾的要药。如果是噤口痢,即患者不能进食,可将黄连与人参同煎汤,少量频服,只要咽下去就会好转。喻嘉言说:治疗痢疾,必须先发汗解除表邪,然后调理内部。首先用辛凉药物解表,其次用苦寒药物攻里。《医学机要》说:里急后重应当通下,腹痛应当调和,身体沉重应当除湿,脉弦应当祛风,风邪内结应当发汗,身体寒冷自汗应当温补,脓血稠粘应当用重剂药力竭尽之。痢疾,红色属血分,白色属气分。戴氏说:世俗认为赤色为热、白色为寒,这是不对的。都按照湿热来治疗,但有新久、虚实的区别),痞满(燥湿开郁。张仲景治疗九种心下痞证,五种泻心汤都用黄连),腹痛(清热),心痛伏梁(心积病),目痛翳障(用人乳浸泡黄连点眼,或配合当归、白芍等分,煎汤热洗,散热活血),痈疽疮疥(各种痛痒疮疡,都属于心火),酒毒胎毒(小儿初生时,将黄连与甘草研为末,蜜调令其咽下),明目(《传信方》记载:羊肝一个,黄连一两,捣烂制成丸药,名为羊肝丸,凡是眼疾都能治疗),定惊(镇肝),止汗解毒,除疳积(同猪肝蒸制为丸),杀蛔虫(蛔虫遇到苦味则潜伏不动)。
虚寒病症者禁用(长期服用黄连、苦参会反热,这是因为化火所致。汪昂按语:炎上作苦,味苦必燥,燥则热矣,况且苦寒沉阴肃杀,会伐伤生和之气。韩祗和说:黄连与肉桂同用,能在顷刻间交通心肾。李时珍说:治痢用香连丸,姜连丸用黄连、干姜,姜黄散用黄连、生姜,左金丸用黄连、吴茱萸,治口疮用黄连、细辛,止下血用黄连、大蒜,一阴一阳,寒因热用,热因寒用,最得制方之妙)。
出产于宜州的黄连粗肥,出产于四川的黄连瘦小。形状像鹰爪、连珠状的是佳品。去毛。治心火生用,虚火醋炒,肝、胆火猪胆汁炒,上焦火酒炒(有吞酸嘈杂等症状,也有吐酸的叫酢心,宜用黄连配吴茱萸降火开郁。酢,音同醋),中焦火姜汁炒,下焦火盐水或童便炒,食积火黄土炒,治湿热在气分用吴茱萸汤炒,在血分用干漆水炒,点眼赤用人乳浸(李时珍说:诸法不独为之引导,盖辛热制其寒苦,咸寒制其燥性,用者详之)。黄芩、龙骨为使药。恶菊花、玄参、僵蚕、白鲜皮。畏款冬、牛膝。忌猪肉(李时珍说:方中有脏连丸、黄连猪肚丸,难道忌肉而不忌脏腑吗?)。杀乌头、巴豆毒。(黄连泻心火,佐以龙胆泻肝、胆火,白芍泻脾火,石膏泻胃火,知母泻肾火,黄柏泻膀胱火,木通泻小肠火。黄芩泻肺火,栀子佐之;泻大肠火,黄连佐之;柴胡泻肝胆火,黄连佐之;泻三焦火,黄芩佐之。郑奠一说:兀兀欲吐,用黄连数分甚效)。
Purging fire, drying dampness.
Extremely bitter and extremely cold. Enters the Heart meridian to purge fire (Wang Haizang said: Purging Heart fire is actually purging Spleen fire. When excess, purge its child), calms the Liver and cools blood (In treating blood disorders, Fangfeng is the guiding herb for the upper part, Huanglian is for the middle part, and Diyü is for the lower part), dries dampness and opens depression, relieves thirst (used alone can treat Xiao Ke [wasting-thirst syndrome]), eliminates vexation, benefits the Liver and Gallbladder, thickens the stomach and intestines, eliminates heart stasis (can remove evil blood from the heart orifices), stops night sweats (by cooling the Heart).
Treats Chang Pi [dysentery with bloody discharge] and diarrhea/dysentery (Bloody stool is called "Chang Pi", there is Zanglian Wan formula. Dysentery caused by damp-heat stagnation; Huanglian is a key herb for treating dysentery. For Jin Kou Li [anorexic dysentery where the patient cannot eat], decoct Huanglian with Renshen and sip slowly; improvement occurs as soon as it is swallowed. Yu Jiayan said: In treating dysentery, one must first resolve the exterior through sweating, then regulate the interior. First use acrid-cool herbs to release the exterior, then use bitter-cold herbs to attack the interior. *Jiyao* states: Tenesmus requires purgation, abdominal pain requires harmonization, heavy body requires dampness removal, wiry pulse requires wind expulsion, internal binding of wind pathogen requires sweating, cold body with spontaneous sweating requires warming, thick sticky pus and blood require heavy dosage to exhaust them. Dysentery: red belongs to the Blood level, white belongs to the Qi level. Dai Shi said: The common belief that red indicates heat and white indicates cold is incorrect. All are treated as damp-heat, but distinguished by new/old onset and deficiency/excess patterns), fullness/stagnation (dries dampness and opens depression. Zhang Zhongjing treated nine types of Xin Xia Pi [subcardiac fullness], using Huanglian in all five Xiexin Tang formulas), abdominal pain (clears heat), heart pain Fu Liang [heart accumulation disease], eye pain and nebula (soak in human milk for eye drops, or combine with Danggui and Baishao in equal parts, decoct and wash hot to dissipate heat and invigorate blood), carbuncles, ulcers, sores, and scabies (all painful, itching sores belong to Heart fire), alcohol toxicity and fetal toxicity (for newborn infants, mix Huanglian with Gancao into powder, blend with honey and let swallow), brightens eyes (*Chuanxin Fang*: one sheep liver, one liang of Huanglian, pound into pills, named Yanggan Wan, treats all eye diseases), settles fright (calms the Liver), stops sweating, detoxifies, eliminates infantile malnutrition (steam with pig liver into pills), kills roundworms (roundworms subside when encountering bitterness).
Contraindicated in deficiency-cold conditions (Long-term consumption of Huanglian and Kushen leads to false heat due to transformation into fire. Note by Ang: Fire flares upward producing bitterness; bitter taste implies dryness; dryness implies heat. Moreover, bitter-cold, sunken, yin, and austere nature damages the vitalizing and harmonizing qi. Han Zhihe said: Huanglian used together with Rougui can communicate Heart and Kidney instantly. Li Shizhen said: For dysentery, Xianglian Wan is used; Jianglian Wan uses Huanglian and Ganjiang; Jianghuang San uses Huanglian and Shengjiang; Zuojin Wan uses Huanglian and Wuzhuyu; for mouth ulcers, Huanglian and Xixin are used; for stopping lower bleeding, Huanglian and Datasuan are used. One yin, one yang; cold utilized via heat, heat utilized via cold; this best exemplifies the ingenuity of formula preparation).
Those produced in Yizhou are coarse and plump; those from Sichuan are thin and small. Those resembling eagle claws or connected beads are superior. Remove hairs. For clearing Heart fire, use raw; for deficient fire, stir-fry with vinegar; for Liver/Gallbladder fire, stir-fry with pig bile; for Upper Jiao fire, stir-fry with wine (symptoms include acid regurgitation and epigastric discomfort; some have vomiting of acid called Zuxin, suitable for Huanglian combined with Wuzhuyu to descend fire and open depression. Zuxi sounds like cu/vinegar); for Middle Jiao fire, stir-fry with ginger juice; for Lower Jiao fire, stir-fry with salt water or child's urine; for food stagnation fire, stir-fry with loess earth; for damp-heat in the Qi level, stir-fry with Wuzhuyu decoction; for damp-heat in the Blood level, stir-fry with Qianxi water; for red eyes, soak in human milk (Li Shizhen said: These methods do not merely serve as guides; spicy-hot herbs restrain its bitter-cold nature, salty-cold herbs restrain its drying property. Users should consider this carefully). Huangqin and Longgu act as assistants. Averse to Juhua, Xuanshen, Jiangcan, and Baixianpi. Feared by Kuandong and Niuxi. Avoid pork (Li Shizhen said: Formulas include Zanglian Wan and Huanglian Zhudu Wan; why avoid meat but not viscera?). Neutralizes the toxicity of Wutou and Badou. (Huanglian purges Heart fire; assisted by Longdan to purge Liver/Gallbladder fire, Baishao to purge Spleen fire, Shigao to purge Stomach fire, Zhimu to purge Kidney fire, Huangbai to purge Bladder fire, Mutong to purge Small Intestine fire. Huangqin purges Lung fire, assisted by Zhizi; purges Large Intestine fire, assisted by Huanglian; Chaihu purges Liver/Gallbladder fire, assisted by Huanglian; purges Sanjiao fire, assisted by Huangqin. Zheng Dianyi said: Feeling nauseous and wanting to vomit, using a few fen of Huanglian is very effective).