阳在上不与阴化而为风,阴遂变为痰涎。皂荚以金胜木,通气利窍,风无不搜,斯湿无
不去,故凡痰涎涌塞而为中风为喉痹者,胥倚以奏功。阳在下不与阴化而为风,阴遂被劫而
生燥,皂荚气浮而子较沉,故子能祛在下之风,风去则阴得伸其津润之权,而大肠之燥结以
通。凡风药必燥而皂荚以多脂为佳。皂子之仁又粘而韧,其能利大便,亦兼得辛润之力也。
诃黎勒苦温能开,酸涩能收。开则化痰涎,消胀满,下宿食,发音声;收则止喘息,已
泻痢。然苦多酸少,虽涩肠而终泄气,古方用是物皆极有斟酌。仲圣诃黎勒散治气利。气利
者,气与矢俱失也,必有痰涎阻于肠中。诃黎勒既涩肠而又化痰涎,最于是证相得。又以粥
饮和服,安其中气。是诃黎勒之泄,亦有功无过矣。千金诃黎勒丸治气满闭塞,不能食喘息。
不
岂能即返,诃黎勒能一物而两治之。两治之物,无冲和之性,蜜丸又所以和之也。与仲圣用
诃黎勒之意正复无异。若诃子清音汤治中风不语,是但用其泄矣;协以甘桔,则不至过泄而
音可开。真人养脏汤治久痢脱肛,是但用其涩矣;协以参术归芍诸药,则不至徒涩而痢可止
肛可收。凡此皆用药之权衡,不可不知者也。
桑根白皮甘辛入脾肺,而气寒复入膀胱,能驱脾肺中之水气从小便出,故水肿腹满胪胀
胥治之。咳嗽惟肺有水气及伏火者宜之。肺虚无火,因风寒而嗽者,服之则锢闭邪气而成久
嗽。此仲圣于王不留行散,所以谓风寒勿取也。
阳气在上部不能与阴气交化,从而转化为风邪,阴气随即转变为痰涎。皂荚凭借金性克制木性(风),能够通利气道和孔窍,凡是有风邪之处无不搜剔清除,这样湿气也就没有不除去的了。因此,凡是因痰涎涌塞导致中风或喉痹的病症,都依靠它来取得疗效。
阳气在下部不能与阴气交化而转化为风邪,阴气随即被劫夺而产生燥热。皂荚的气味上浮而其子相对沉降,所以皂子能够祛除下部的风邪,风邪去除后,阴气得以施展其津液滋润的功能,大肠的燥结因此得以通畅。凡是风药大多性质燥烈,但皂荚以富含油脂者为佳。皂子的仁又黏腻且坚韧,它能通利大便,也是兼得了辛散润下的力量。
诃黎勒(诃子)味苦性温具有开泄作用,味酸涩具有收敛作用。开泄则能化痰涎、消除胀满、排出积食、恢复声音;收敛则能平定喘息、止住泻痢。然而它苦味多而酸味少,虽然能涩肠止泻,但最终会耗泄正气,古方中使用此物都非常讲究斟酌。张仲景在《伤寒论》中的诃黎勒散用于治疗“气利”。“气利”是指排气与大便同时失禁,这必然有痰涎阻滞在肠道中。诃黎勒既能涩肠又能化痰涎,最适宜于这种证候。再用米粥调服,可以安护中焦脾胃之气。这样看来,诃黎勒的“泄”的作用,也是有功效而无弊端的。
《千金方》中的诃黎勒丸用于治疗气滞胀满闭塞、不能进食及喘息。病情难道能立刻逆转吗?诃黎勒能一药两用(既开又收)。具有双重治疗作用的药物,如果没有冲和的性质,用蜜制丸剂又是为了调和药性。这与张仲景使用诃黎勒的用意完全相同。如果像诃子清音汤治疗中风不语,这是只利用了它的开泄作用;配合甘草、桔梗,就不会导致过度开泄,声音即可开启。真人养脏汤治疗久痢脱肛,这是只利用了它的收敛作用;配合人参、白术、当归、芍药等药物,就不会导致单纯收敛而痢疾可止、肛门可收。这些都是用药权衡的关键,不可不知道。
桑根白皮味甘辛,入脾肺经,因其气寒,又入膀胱经,能够驱除脾肺中的水气从小便排出,所以水肿、腹部胀满、皮肤肿胀都能治疗。咳嗽只有当肺中有水气及潜伏火热时才适宜使用。如果肺气虚弱无火,因风寒引起的咳嗽,服用它则会封闭邪气,形成久咳不愈。这就是张仲景在王不留行散中特别注明“风寒勿取”的原因。
When Yang Qi in the upper part fails to interact and transform with Yin, it turns into Wind pathogen, causing Yin to subsequently transform into Phlegm-Saliva. Saponaria Fructus (Zaojia) utilizes Metal nature to overcome Wood (Wind), unblocking the airways and orifices. It searches out all Wind pathogens, thereby ensuring that Dampness is eliminated. Thus, for conditions such as Stroke (Zhongfeng) or Throat Bi (Houbi) caused by surging and obstructing Phlegm-Saliva, this herb is relied upon for its efficacy. When Yang Qi in the lower part fails to interact and transform with Yin, it turns into Wind, which then coerces Yin, generating Dryness. The aromatic quality of Saponaria Fructus floats upward, while its seed sinks relatively; therefore, the seed can dispel Wind in the lower body. Once Wind is removed, Yin can exert its moistening power, thereby relieving dryness and constipation of the Large Intestine. Generally, Wind-dispelling herbs are drying, but Saponaria Fructus is best when rich in oil. The kernel of the seed is sticky and tough; its ability to promote bowel movements also derives from its acrid and moistening properties.
Cheqiele (Terminalia chebula Retz., Hele) is bitter and warm, possessing opening properties, and sour and astringent, possessing consolidating properties. Its opening action resolves Phlegm-Saliva, reduces distension and fullness, expels retained food, and restores voice; its astringent action stops wheezing and halts diarrhea and dysentery. However, since its bitterness outweighs its sourness, although it astringes the intestines, it ultimately leaks Qi. Ancient formulas use this substance with great deliberation. Zhang Zhongjing’s Cheqiele San (Terminalia Chebula Powder) treats "Qi Li" (flatus with stool). "Qi Li" refers to the simultaneous loss of flatus and feces, indicating that Phlegm-Saliva must be obstructing the intestines. Terminalia chebula Retz. both astringes the intestines and resolves Phlegm-Saliva, making it highly suitable for this syndrome. Taking it mixed with rice gruel stabilizes the Middle Jiao Qi. Thus, the "draining" aspect of Terminalia chebula Retz. has merit without fault.
The Qianjin Cheqiele Wan (Million Gold Formula Terminalia Chebula Pill) treats Qi stagnation with fullness and obstruction, inability to eat, and wheezing. How can the condition reverse immediately? Terminalia chebula Retz. achieves dual treatment (opening and closing). For substances with dual actions, lacking a harmonious nature, honey-pilleting serves to harmonize them. This aligns perfectly with Zhang Zhongjing’s intent in using Terminalia chebula Retz. If used in Hezi Qingyin Tang (Terminalia Voice-Clearing Decoction) to treat aphasia due to Stroke, only its draining/opening property is utilized; combined with Licorice and Platycodon, it prevents excessive draining, allowing the voice to open. In Zhenren Yangzang Tang (True Person Nourishing the Viscera Decoction) treating chronic dysentery with rectal prolapse, only its astringent property is utilized; combined with Ginseng, Atractylodes, Angelica Sinensis, and Paeonia Lactiflora, it prevents mere astringency, stopping dysentery and retracting the prolapse. These are all matters of therapeutic balance that must be understood.
Sangbaipi (Morus Alba Root Bark, Sanggenbaipidan) is sweet and acrid, entering the Spleen and Lung meridians, and due to its cold nature, it also enters the Bladder meridian. It drives out Water-Qi from the Spleen and Lungs, excreting it via urination; thus, it treats edema, abdominal fullness, and skin swelling. Cough is suitable for treatment with this herb only when there is Water-Qi and latent Fire in the Lungs. If Lung Qi is deficient without Fire, and cough is caused by Wind-Cold, taking this herb will trap the pathogenic factors, leading to chronic cough. This is why Zhang Zhongjing specified "avoid if Wind-Cold" in Wangbuliuxing San (Vaccaria Seed Powder).