〔害〕能坠诸气，至于下极，气虚下陷者，所当远避。如脾胃虚，虽有积滞者不宜用。
下利
非后重者不宜用。心腹痛无留结及非虫积者勿用。疟非山岚瘴气者不宜用。凡病属阴阳两虚
，
中气不足，而非肠胃壅滞，宿食胀满者，悉在所忌。多食亦发热。岭南多瘴，以槟榔代茶，
损泄真气，所以居人多病少寿。
〔利〕苦辛温，入脾、胃、大肠三经。降至高之气，疏后重之急，攻痰癖，去肿胀，消
食积
而治疟，疗香港脚而杀虫，辛能破气，苦能杀虫。
〔修治〕浸透切片，近时方药，亦有以火煨焙用。然出生白槟榔，须本境可得，若他处
者，
必经煮薰，安得生者耶？
〔害〕经曰∶实则泻之。此大苦大寒峻利之性，猛烈之气，长驱直捣，一往直前，苟非
血分
热结，六脉沉实者，切勿轻与推荡。大黄乃血分之药，病在气分，及胃寒血虚，并胎产而用
之者，是为诛伐无过矣。凡病血闭由于血枯，而不由于热积；寒热由于阴虚，而不由于血积
；症瘕由于脾胃虚弱，而不由于积滞停留；便秘由于血瘀、血燥、肠燥，而不由于饮食停滞
；女子少腹痛，由于厥阴血虚，而不由于经阻老血，瘀结滞下者不宜用。初起即属胃虚，当
以补养胃气，清消湿热为本，而不可妄加推荡，当谨慎分别。若轻发误投，损伤胃气，多至
危殆，戒之戒之！
〔利〕大苦大寒，入脾、胃、心、肝、大肠五经。泻有形积滞，水食痰结者宜之。有拨
乱反
正之功，得峻快将军之名。清血分实热，血瘀血逆者宜之。
仲圣泻心汤，治心气不足而吐衄，乃心气不足而包络肝胆与胃之邪火有余，虽曰泻心，实泻
经血中伏火也。又心下痞满，按之濡者，用大黄黄连泻心汤，亦泻脾胃湿热，非泻心也。病
发于阴，下之则痞满，乃寒伤营血，邪气乘虚结于上焦。胃之上脘当心，故曰泻心，实泻胃
也。病发于阳，下之则结胸，乃热邪陷入血分，亦在上脘，大陷胸汤丸皆用大黄，亦泻脾胃
血分之邪。若结胸在气分，只用小陷胸汤，痞满在气分，只用半夏泻心汤。
〔修治〕川产如锦纹者良。洗切片，浸取汁，冲入药。制用酒浸，或酒拌蒸，则性缓而
能上
行。邪热之在上者，借酒行之，以成勋也。生熟之力不同，生用更峻。欲取通利者，不得骤
进谷食。大黄得谷食，不能通利也。
【危害】槟榔能导致各种气机下坠，甚至达到极深处，对于气虚下陷的患者，应当远离避免。如果脾胃虚弱，即使有积滞也不宜使用。
对于腹泻：如果不是伴有里急后重（想拉拉不出，肛门坠胀感），不宜使用。心腹痛如果没有实邪结聚以及不是虫积引起的，不要使用。疟疾如果不是由山岚瘴气引起的，不宜使用。凡是疾病属于阴阳两虚、中气不足，而不是肠胃壅滞、宿食胀满的，都在禁忌之列。多吃也会引起发热。岭南地区多瘴气，人们用槟榔代替茶喝，会损耗泄泻真气，所以当地人多生病且寿命短。
【功效】味苦、辛，性温，入脾、胃、大肠三经。能下降至高处的逆气，迅速缓解里急后重，攻逐痰癖，消除肿胀，消化食积并治疗疟疾，疗治香港脚（脚气病）并杀虫，辛味能破气，苦味能杀虫。
【炮制】浸泡透后切片，近代的方药中，也有用火煨焙后使用的。然而出产自本地的生槟榔，必须在本地才能获取，如果是其他地方的，必定经过煮和熏蒸处理，哪里还能得到生的呢？
【危害】《内经》说：实证要用泻法。大黄是大苦大寒、峻猛利下的药物，气势猛烈，长驱直入，一往直前，如果不是血分热结、六脉沉实的患者，千万不要轻易给予推荡攻下。大黄是作用于血分的药物，如果病在气分，以及胃寒血虚，还有孕妇和产后妇女使用它，这就叫做诛伐无罪之人（误伤正气）。凡是血闭是由于血枯（血液枯竭）而不是由于热积引起的；寒热症状是由于阴虚而不是由于血积引起的；症瘕（腹内结块）是由于脾胃虚弱而不是由于积滞停留引起的；便秘是由于血瘀、血燥、肠燥而不是由于饮食停滞引起的；女子少腹痛是由于厥阴肝经血虚而不是由于经阻老血瘀结引起的，都不宜使用。初起就属于胃虚的，应当以补养胃气、清消湿热为本，而不可妄加推荡攻下，应当谨慎分辨。如果轻率误投，损伤胃气，多会导致危殆，务必戒慎！
【功效】大苦大寒，入脾、胃、心、肝、大肠五经。能泻除有形的积滞，水湿、食物、痰浊结聚的情况适宜使用。它有拨乱反正的功效，因此得名“将军”。能清解血分实热，血瘀血逆的情况适宜使用。
张仲景的泻心汤，治疗心气不足导致的吐血、衄血，其实是心气不足导致包络、肝胆与胃的邪火有余，虽然叫泻心，实际上是泻除经络血分中的伏火。另外，心下痞满，按之柔软的，使用大黄黄连泻心汤，也是泻除脾胃湿热，并非泻心。疾病发于阴证，误用下法则导致痞满，这是寒邪伤了营血，邪气乘虚结于上焦。胃的上脘正当心脏位置，所以说泻心，实际上是泻胃。疾病发于阳证，误用下法则导致结胸，这是热邪陷入血分，也在上脘部位，大陷胸汤丸都使用大黄，也是泻除脾胃血分中的邪气。如果结胸在气分，只用小陷胸汤；痞满在气分，只用半夏泻心汤。
【炮制】四川产的带有锦纹的大黄品质优良。洗净切片，浸泡取汁，冲入药液中服用。炮制时用酒浸泡，或用酒拌蒸，则药性缓和并能上行。对于在上部的邪热，借助酒的升提作用来发挥作用，以此建立功勋。生大黄和熟大黄的力量不同，生用的更峻猛。想要通过大黄取得通利效果时，不能立即进食谷物食物。大黄遇到谷物食物，就不能起到通利的作用了。
[Harm] Areca nut (Binglang) can cause the descent of various Qi mechanisms, reaching to the extreme lower part. For patients with Qi deficiency and sinking, it should be avoided. If the Spleen and Stomach are deficient, even if there is food stagnation, it is not suitable for use.
For diarrhea: It is not suitable for use if there is no tenesmus (a feeling of incomplete defecation with straining). Do not use for heart and abdominal pain without solid accumulation or non-parasitic accumulation. It is not suitable for malaria not caused by mountainous miasma. Any disease belonging to dual deficiency of Yin and Yang, insufficiency of Middle Qi, rather than gastrointestinal congestion or distension from retained food, is strictly contraindicated. Excessive consumption can also cause fever. In Lingnan, where miasma is prevalent, people drink Areca nut as tea, which depletes true Qi; therefore, locals suffer from frequent illness and short lifespans.
[Benefits] Bitter, pungent, warm in nature. Enters the Spleen, Stomach, and Large Intestine meridians. It descends rebellious Qi from the upper body, rapidly relieves tenesmus, attacks phlegm masses, removes swelling, digests food stagnation, treats malaria, cures Hong Kong foot (Beriberi), and kills parasites. Pungency breaks Qi, bitterness kills parasites.
[Processing] Soak until permeable, then slice. In recent prescriptions, some are roasted over fire. However, raw Areca nut produced locally must be obtained within the local region. Those from other places have necessarily been boiled and fumigated; how can they be considered raw?
[Harm] The *Neijing* states: "Excess conditions require purgation." Da Huang (Rhubarb Root and Rhizome) has a strongly bitter, cold, and drastic purgative nature, with fierce momentum, driving straight through. Unless there is heat accumulation in the Blood level and deep, solid pulses in all six positions, do not lightly administer its purgative action. Da Huang acts on the Blood level. If the disease is in the Qi level, or in cases of Stomach cold and Blood deficiency, or during pregnancy and postpartum, using it constitutes punishing the innocent (damaging healthy Qi unnecessarily). Whenever blood obstruction is due to Blood exhaustion rather than heat accumulation; chills and fever due to Yin deficiency rather than Blood accumulation; masses (Zheng Jia) due to Spleen and Stomach weakness rather than stagnation; constipation due to Blood stasis, dryness, or intestinal dryness rather than food stagnation; lower abdominal pain in women due to Liver channel Blood deficiency rather than menstrual obstruction or old blood stasis, it is not suitable for use. If the initial stage belongs to Stomach deficiency, the treatment should focus on tonifying Stomach Qi and clearing damp-heat, avoiding reckless purgation. Careful differentiation is essential. Reckless misprescription damages Stomach Qi and may lead to critical danger. Beware!
[Benefits] Strongly bitter and cold. Enters the Spleen, Stomach, Heart, Liver, and Large Intestine meridians. It purges有形 (solid) accumulations; suitable for water, food, and phlegm knotting. It has the power to restore order from chaos, earning the name "General" for its swift and drastic action. It clears excess heat in the Blood level; suitable for Blood stasis and rebellious Blood.
Zhang Zhongjing's Xiexin Tang (Drain the Epigastrium Decoction) treats vomiting and epistaxis due to insufficient Heart Qi. This actually refers to excess pathogenic fire in the Pericardium, Gallbladder, and Stomach due to insufficient Heart Qi. Although called "Draining the Heart," it actually drains latent fire in the meridian Blood. Furthermore, for epigastric fullness that is soft upon pressure, Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Decoction to Drain the Epigastrium) is used to drain Spleen and Stomach damp-heat, not the Heart itself. When a disease originates from a Yin pattern, purgation leads to fullness; this is cold injuring the Ying-Blood, with pathogenic Qi binding in the Upper Jiao. The upper Stomach corresponds to the Heart area, so it is called "Draining the Heart," but it actually drains the Stomach. When a disease originates from a Yang pattern, purgation leads to chest bind (Jie Xiong); this is heat pathogen sinking into the Blood level, also located at the upper Stomach. Both Daxianxiong Tang Wan (Major Draining the Chest Decoction Pills) use Da Huang to drain pathogenic factors in the Spleen and Stomach Blood level. If the chest bind is in the Qi level, only Xiaoxianxiong Tang (Minor Draining the Chest Decoction) is used. If fullness is in the Qi level, only Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is used.
[Processing] Sichuan-produced varieties with brocade-like patterns are superior. Wash, slice, soak to extract juice, and mix into other medicines. For processed use, soak in wine or steam with wine mixed, which moderates the nature and allows upward movement. For pathogenic heat located in the upper body, the ascending property of wine helps achieve efficacy. Raw and cooked Da Huang differ in strength; raw is more drastic. To achieve purgation, one must not consume grain food immediately after administration. Da Huang cannot promote purgation when combined with grain food.