枳壳乃枳实之老而壳薄者,既名枳壳,须去穣核用之。壳实古原不分,性用亦无所异。
若治胸膈痞塞,枳壳较枳实少胜。然何如以枳实协辛温轻扬之橘皮桂枝,为奏功尤大乎。惟
本经主大风在皮肤中如麻豆苦痒、除寒热结,则惟去穣核之枳壳为宜。盖痒为风,寒热结为
痹。于皮肤中除风除痹,用枳实则易走里,难与枳壳争能。此证类本草枳壳所以主风痒麻痹
也。
栀子花白蕊黄仁赤,其树最喜灌溉,意在条达其性体,为心肺肝胃三脏一腑之药。惟花
时不采,而采者为黄赤之实,体轻入气,而性阴又入血,其治在心肝胃者多,在肺者少。苦
寒涤热,而所涤为瘀郁之热,非浮散之热,亦非坚结之热。能解郁不能攻坚,亦不能平逆,
故阳明之腹满有燥屎,肺病之表热咳逆,皆非其所司。独取其秉肃降之气以敷条达之用,善
治心烦与黄胆耳。心烦或懊 或结痛,黄胆或寒热不食或腹满便赤,皆郁也。心烦心下濡者
为虚,胸中窒者为实。实与虚皆汗吐下后余邪留踞,皆宜吐去其邪。栀子解郁而性终下行,
何以能吐?协以香豉,则一升一降,邪不任受则吐。黄胆之瘀热在表,其本在胃,栀子入胃
涤热下行,更以走表利便之茵陈辅之,则瘀消热解而疸以愈。然则栀子于肺无与乎?仲圣云∶
凡用栀子汤病患旧微溏者不可与服之。肺与大肠相表里,服栀子则益其大肠之寒,此可为秉
金气之一证。至治肝则古方不可胜举,总不离乎解郁火。凡肝郁则火生,胆火外扬,肝火内
伏,栀子解郁火,故不治胆而治肝,古方如泻青丸、凉肝汤、越鞠丸、加味逍遥散之用栀子
皆是。凉膈散有栀子,以治心也。泻黄散有栀子,以治胃也。而泻白散不遴入,则以肺中气
热而不涉血者,栀子不与也。本经主胃中热气,朱丹溪谓最清胃脘之血,究栀子之治,气血
皆有而血分为多。然不能逐瘀血与丹皮桃仁分功;其解血中之郁热,只在上中焦而不在下焦
;亦不入足太阳与手足少阳;不入足太阳,故不利小便。茵陈蒿汤所以必先煮茵陈,许学士
之治酒 鼻,朱丹溪之治热厥心痛,集简方之敷折伤肿痛,皆属血中郁热。其余之治,悉可
类推。
枳壳是枳实中成熟且果皮较薄的部分,既然名为枳壳,使用时必须去除中间的瓤和核。在古代,枳壳与枳实的名称原本没有区分,它们的药性和功效也没有太大差异。
如果是治疗胸膈部位的痞闷堵塞感,枳壳比枳实稍微更有优势。然而,怎么能不如用枳实配合辛温、轻扬升散的橘皮和桂枝,这样发挥的功效会更大呢?只有《神农本草经》中提到主治皮肤中有大风邪引起的如麻豆般苦痒的症状,以及消除寒热互结的病证时,才适合使用去除了瓤核的枳壳。因为瘙痒属于风邪,寒热互结属于痹证。要在皮肤中祛除风邪和痹阻,如果使用枳实则容易深入体内,难以在体表发挥作用,所以无法与枳壳争胜。这类病症在《本草》中记载枳壳主要治疗风邪引起的瘙痒和麻痹。
栀子的花白色,花蕊黄色,果实红色,这种树最喜欢灌溉,意在疏通条达其本性体质,它是心、肺、肝、胃四个脏腑的药物。只是在花开时不采摘,而是采摘黄红色的果实,质地轻浮能入气分,但性质阴寒又能入血分,它治疗心、肝、胃的疾病较多,治疗肺的疾病较少。栀子味苦性寒,能清除热邪,但所清除的是瘀滞郁结的热邪,而不是浮散的热邪,也不是坚结的热邪。它能解除郁结但不能攻逐坚积,也不能平降逆气,所以阳明腑实证中的腹部胀满有燥屎,以及肺病引起的表热咳嗽气逆,都不在它的职权范围内。唯独利用它具备肃降的气机来施展条达的作用,善于治疗心烦和黄胆病。心烦可能表现为懊恼或结痛,黄胆病可能表现为寒热往来、不能进食或腹部胀满、小便赤红,这些都属于郁证。如果心烦且心下柔软,属于虚证;如果胸闷窒塞,属于实证。实证和虚证都是发汗、催吐、泻下之后残留的病邪停留占据所致,都适宜用涌吐的方法祛除病邪。栀子能解郁但性质终究下行,为什么能引起呕吐?配合香豉(淡豆豉),一升一降,病邪无法承受则引发呕吐。黄胆病的瘀热在体表,根本在于胃,栀子进入胃中清除热邪并向下行,再配合走表利小便的茵陈辅助,那么瘀血消散、热邪解除,黄疸就会痊愈。那么栀子和肺没有关系吗?张仲景说:“凡是使用栀子汤的病人,如果平时大便稀溏,不可服用。”肺与大肠相表里,服用栀子会增加大肠的寒凉,这可以作为栀子秉受金气(肺气)的一个证据。至于治疗肝脏,古代方剂不胜枚举,总离不开解除郁火。凡是肝气郁结则生火,胆火向外张扬,肝火向内潜伏,栀子能解除郁火,所以虽然不治胆而治肝,古代方剂如泻青丸、凉肝汤、越鞠丸、加味逍遥散中使用栀子都是这个原因。凉膈散中含有栀子,是用来治疗心脏疾病的。泻黄散中含有栀子,是用来治疗胃脏疾病的。而泻白散不选用栀子,是因为肺中的气热不涉及血分,栀子不与气分单纯的热邪打交道。《神农本草经》主治胃中热气,朱丹溪认为栀子最擅长清泄胃脘的血分热,研究栀子的治疗作用,气血都能治疗但侧重于血分。然而它不能像牡丹皮、桃仁那样逐除瘀血;它解除血中的郁热,只在上焦和中焦起作用,而不在下焦;也不进入足太阳膀胱经和手足少阳经;不进入足太阳经,所以不利小便。茵陈蒿汤之所以必须先煮茵陈,许学士治疗酒齄鼻,朱丹溪治疗热厥心痛,集简方外敷治疗跌打损伤肿痛,都属于血中郁热。其余的治疗作用,都可以据此类推。
Zhiqiao (Aurantii Fructus) is the mature fruit of Zhishi (Immature Bitter Orange) with thinner peel. Since it is named Zhiqiao, the pulp and seeds must be removed before use. In ancient times, Zhiqiao and Zhishi were not distinguished by name, nor were their properties and uses significantly different.
If treating chest and diaphragm fullness and obstruction, Zhiqiao has a slight advantage over Zhishi. However, would it not be more effective to combine Zhishi with acrid-warm and light-ascending herbs such as Chenpi (Tangerine Peel) and Guizhi (Cinnamon Twig), thereby achieving greater efficacy? Only when treating conditions described in the *Shennong Bencao Jing* (*Divine Farmer's Materia Medica*)—such as severe wind pathogen in the skin causing itching like millet grains, or eliminating cold-heat clumping—is it appropriate to use Zhiqiao with pulp and seeds removed. This is because itching is attributed to wind, and cold-heat clumping constitutes Bi syndrome (obstruction). To dispel wind and resolve Bi in the skin, using Zhishi tends to penetrate deeply into the interior, making it less capable than Zhiqiao in acting on the exterior. This explains why *Bencao* texts state that Zhiqiao primarily treats wind-induced itching and numbness.
Zhizi (Gardeniae Fructus) has white flowers, yellow stamens, and red fruits. The tree thrives with ample irrigation, which aligns with its nature to promote free flow and unblocking. It acts as a herb for the Heart, Lung, Liver, and Stomach. Harvesting occurs not during flowering but when the fruits turn yellow-red. Its texture is light, entering the Qi level, yet its Yin-cold nature also enters the Blood level. It treats diseases of the Heart, Liver, and Stomach more frequently than those of the Lung. Bitter and cold, it clears heat, specifically targeting stagnant and constrained heat, rather than floating/scattered heat or solidified/clumped heat. It can resolve constraint but cannot attack solid accumulations nor pacify rebellious Qi. Therefore, it is not indicated for Yangming Fu organ syndrome characterized by abdominal fullness with dry feces, nor for lung diseases presenting with exterior heat, cough, and rebellious Qi. It uniquely utilizes its descending nature to facilitate free flow, effectively treating mental restlessness (Xin Fan) and jaundice (Huang Dan). Mental restlessness may present as vexation (Ao Nan) or painful constriction; jaundice may present with alternating chills and fever, anorexia, abdominal fullness, and reddish urine, all indicating constraint. If mental restlessness is accompanied by softness below the heart, it is a deficiency pattern; if there is chest oppression, it is an excess pattern. Both excess and deficiency patterns result from residual pathogens lingering after sweating, vomiting, or purging therapies, and both are suitable for treatment via emesis (inducing vomiting) to expel pathogens. Zhizi resolves constraint but its nature ultimately descends; how can it induce vomiting? When combined with Chidouchi (Prepared Soybean), one ascends and one descends; the pathogen cannot withstand this dynamic and is expelled via vomiting. For jaundice where stagnant heat is on the exterior but rooted in the Stomach, Zhizi enters the Stomach to clear heat and descend, assisted by Yinchen (Artemisiae Scopariae Herba), which moves to the exterior and promotes urination. Thus, stagnation dissipates, heat resolves, and jaundice heals. Does Zhizi have no relation to the Lung? Zhang Zhongjing stated: "For patients using Zhizi Tang who have a history of loose stools, it should not be administered." The Lung and Large Intestine are exterior-interior related; administering Zhizi increases cold in the Large Intestine, which serves as evidence of Zhizi inheriting Metal Qi (Lung energy). Regarding liver treatment, ancient formulas are numerous, generally focusing on resolving constrained fire. Whenever Liver Qi is constrained, fire generates; Gallbladder fire flares outward, while Liver fire lingers inward. Zhizi resolves constrained fire. Although it does not directly treat the Gallbladder, it treats the Liver. Ancient formulas such as Xieqing Wan (Drain Green Pill), Lianggan Tang (Cool Liver Decoction), Yueju Wan (Regulate Six Pills), and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) all use Zhizi for this reason. Liangge San contains Zhizi to treat Heart disorders. Xiehuang San contains Zhizi to treat Stomach disorders. Xiebai San does not include Zhizi because Lung Qi heat does not involve the Blood level, and Zhizi does not address pure Qi-level heat. The *Shennong Bencao Jing* states it treats Stomach heat; Zhu Danxi claimed it best clears Heat in the Stomach's Blood level. Investigating Zhizi's actions, it treats both Qi and Blood but focuses more on Blood. However, it cannot eliminate blood stasis like Mudan Pi (Moutan Cortex) or Taoren (Persicae Semen); its resolution of constrained heat in the Blood is limited to the Upper and Middle Jiao, not the Lower Jiao; it does not enter the Foot-Taiyang Bladder Meridian or the Hand-Foot-Shaoyang Gallbladder/Triple Burner Meridians. Because it does not enter the Foot-Taiyang, it does not promote urination. In Yinchenshao Tang (Artemisia and Coix Seed Decoction), Yinchen must be boiled first. Xu Xueshi's treatment of rhinophyma (Jiu Zabi), Zhu Danxi's treatment of heat-jue heart pain, and the external application in *Jijian Fang* for traumatic swelling and pain all relate to constrained heat in the Blood. Other therapeutic applications can be inferred analogously.