稼穑作甘，为土之正味。不似他物之甘，独有所偏。粳米平调五脏，补益中气，有时
委顿乏力，一饭之后，便舒适异常，真有人参不逮者，可以想其功能矣。
粳米得金水之气多，于益气之中兼能养阴，故补剂寒剂，无不可赞助成功。
谷为人生至宝，而霍乱痧胀，与夫欲吐不吐，欲泻不泻之证，周时内咽米饮一口，即不
可救。盖暑湿秽恶之邪，充斥隧络，而米饮入胃输脾归肺，又适以恢张之，使无一隙之余，
所以告危如是之速。
李濒湖云∶薏苡仁属土，阳明药也，故能健脾益胃。刘氏驳之，则云∶胃为五脏六腑之
海，其清气上注于肺，所以能注于肺者，实由于脾。脾气合于肾以至肺，肺气合于心以归肾，
此三阴之气，谓之元气，即中气也。然若胃阳虚，则脾之地气不升于天，势必湿盛化热凑于
胃脘之阳以伤气。胃阳亢，则肺之天气不降于地，亦必热盛化湿，还迫于脾脏之阴以伤血。
伤气者肺受之，为胸痹偏缓；甚或肺阴大损，为肺痿肺痈；更因伤气而病乎藏血之肝，为筋
急拘挛。伤血者脾受之，为肠胃不利，甚或脾气大虚，为水肿为久风湿痹，且移患于下部为
疝。凡此皆胃气之病于上下者也。薏苡生于平泽，气寒味甘，水土合德，乃实结于盛夏，则
润下之气，还就炎上；而采实在于秋末，则热浮之气，又归凉降。有合于胃达地气而不病于
湿之化热，更合于胃达天气而不病于热之化湿。举前证胥能治之。夫中气不病于湿，即不病
于热，除湿而即能清热者，非胃之专功而胃第为之枢也。如李氏言，泛泛与燥湿健脾者同论
，将所谓清热、疗痿、和血、润筋者，归于何地乎。然薏苡为益中气之要药，而其味淡，其
力缓，如不合群以济，浓集以投，亦不能奏的然之效。又云∶此言筋挛，乃湿热伤血而病于
筋膜干者。经所谓大筋 短是也。肝脏血而主筋，湿热固血分之病也。按李说固未中肯綮，
而刘氏张皇幽眇，致多委折。微论脏腑阴阳升降出入，不尽如其言。而即其言复之，实亦有
自呈其阙者，不能为讳焉。伤气之内，插入更因伤气一句，是以筋急拘挛，为尽属伤气之传
变。伤血宁无真正血证，而猥以肠胃不利等四项当之。皆意为牵合，无与实理。薏苡能使胃
阳不虚，胃阳不亢，又能使脾合肾以至肺，肺合心以归肾，宜乎用处至赜，如四物四君子之
类，何以古方选入者，如晨星之落落！？况云须合群以济，浓集以投，则固知薏苡不能兼揽
众长，而又何为滥许之乎！？薏苡能使湿不化热，热不化湿，自是除湿而亦清热，乃又云除
湿而即能清热，岂并薏苡之气寒而亦忘之乎！？即以薏苡为除湿，而又云薏苡润筋，是视薏
苡与牛膝无二矣。牛膝治筋膜干之四肢拘挛不可屈伸，以其根柔润而中有白汁也。润筋者不
能除湿，除湿者不能润筋，理固然也。肝藏血而主筋，然筋病不得竟指为血病，此亦不容不
辨者矣。
本经一书，原有汉人羼入之句，其精奥处，则字字金玉，决非圣人不作。如薏苡仁主筋
急拘挛、不可屈伸、久风湿痹、下气数语，真万世矩 。自千金外台以及后相传之佳方，凡
用薏苡仁者，必兼有筋急拘挛、不可屈伸之证，寒挛用为佐使，亦取其能舒筋。古方小续命
汤注云∶中风、筋急拘挛、语迟、脉弦者加薏苡仁。李氏以加薏苡为扶脾益肝，不知其有舒
筋之妙可谓愦愦。又薏苡仁丸治胁痛，胁痛非肝病耶。妊妇禁服薏苡，非以其泻肝堕胎耶。
然则肝之合筋，薏苡安得非肝药。不解金元以来，竟无一人阐及。天门冬主暴风湿痹，薏苡
仁主久风湿痹。久字固大有义在。盖风湿痹非寒药所宜，风湿久而不解，则寒将化热。如金
匮麻黄杏仁薏苡甘草汤，汗出当风久伤取冷是寒，发热日晡所剧是寒化之热，麻黄所以驱寒，
薏苡所以除热。无热非薏苡责也。凡此所治，悉与本经符合。再以薏苡体之，纲目载马志云∶
薏苡取青白色者良。苏颂云∶薏苡结实青白色。雷 云∶薏苡颗小色青味甘。据此，薏苡决
非纯白。苗发于仲春与色青，得木气为多。实采于九秋与色白，得金气亦多。色青兼白，则
为金木相媾。味甘而淡，则入胃不入脾。主疏泄者肝，司肃降者肺，胃亦传化下行之腑，是
肺肝挟金木之威，直走而下，由胃而小肠而膀胱，皆其所顺由之路，且气寒复归于肾，湿何
能不去。后人以利小便治疝，皆深得此意。刘氏以实结盛夏，为润下之气还就炎上。不知实
结盛夏，是水不畏火，不畏火则制火。水自就水，奚肯就火。本经下气二字，又包有至理如
此。
刘氏以此之筋挛为筋膜干，余既略驳之矣。考刘氏此篇宗 曰一段加注云∶受湿则筋缓，
然湿即化热，湿合于热则伤血，血不能养筋则又挛缩。筋挛固有因血虚者，而此则不然。邹
氏云∶筋之为物，寒则坚劲，坚劲则短缩；热而 缓， 缓则弛长。此为不挟湿者言也。若
挟湿则大筋横胀，横胀则 短；小筋纵伸，纵伸则弛长。凡物皆然。特能短而不能劲，与因
寒而缩者有异。按横胀之说，未经人道，较刘氏自胜。然灵枢湿热不攘，大筋 短，小筋弛
长。是 短时湿已化热。盖初虽横胀，不致短缩，惟化热之后，所谓食气入胃，散精于肝，
淫气于筋者，遂渐被其烁，筋为之缩。云不攘，则热由湿化，已非一日，与本经之言如出一
辙。薏苡止泄热驱湿而筋即舒，试之屡验。若伤血而待养血，则不能如是易矣。
本经久风湿痹，系于筋急拘挛不可屈伸之下，明其病之属筋，而上下文若断若续，几索
解不得。金匮胸痹缓急一条，正为本经点睛。胸痹即风湿痹，在手足为不可屈伸，在胸为一
缓一急，皆久而后成，皆筋病也。缓急二字，前人注多支吾，惟邹氏于灵素之言阴跷阳跷与
足阳明颊筋，推类以求，并绎巢元方之论胸痹，谓五脏六腑之寒气，因虚而上冲胸膈者，寒
冲于左，则逼热于右；寒冲于右，则逼热于左。寒者急，热者缓。可谓今日发 旷然已昭矣。
或问寒湿热湿，各有专药。湿既化热，乃舍治热湿之专药而用薏苡，不名之为热湿，其亦有
说乎？曰∶痹无热痹，湿化之热，终不离寒。故不曰湿热风热，而曰久风湿痹。证为热中有
寒，缓急自非专由于热，此理惟寇宗 及之。曰∶受寒使人筋急，寒热使人筋挛；若但受热
不曾受寒，则不至筋挛。虽与邹说微异，然缓急实惟薏苡一物治之。何则？寒即是湿，湿去
寒亦去，薏苡治筋有专长也。然则仲圣何为又加附子乎？曰∶胸痹由于阳虚，本非辛温药不
治，用附子不用薤桂者，以薏苡有损阳之虞，附子足以敌薏苡而舍短取长。非以薏苡治热，
附
李氏谓∶薏苡健脾益胃，虚则补母，故肺痿肺痈用之。刘氏谓∶治痿独取阳明。阳明湿
热盛则成肺痿肺痈。大肠与胃之湿热散，则肺痿肺痈自愈。噫，二家之言，粗疏甚矣！夫治
痿独取阳明者，为痿 言之也。与肺痿之痿，讵得同论。且薏苡肺药而肺痿不治，肺痿而至
吐脓成肺痈则治之，肺痈之中，又以胸中甲错为最宜。何则？胸中甲错，乃肺热烁液所致。
虽在肌肤而与筋膜联属，肝与有责。薏苡泄肺热而能疏筋膜中干涩，故为妙药。如千金苇茎
汤可征也。肺痿何以不治？肺痿之因有二∶属虚冷者无论矣；即肺由热烁而津液已枯，筋膜
无故，薏苡不能润液而且竭液，奚借此为。肠痈何以治之？则亦以身甲错故。甲错虽不在胸，
而其为痈脓则一，痈脓亦不能专任薏苡，而因痈脓而甲错，则非薏苡不任，与胸痹之专治缓
急无二义。尤氏谓此肠痈为小肠痈，与余薏苡由胃而小肠而膀胱之说适合。或疑肺药多入大
肠，薏苡何独不然。曰∶此正金木相媾，肝主疏泄而薏苡为肝药之据也。薏苡之主治，肝居
首，肺次之，胃以下皆其所递及。方书胃病无治以薏苡者。盖其补土，止补肝中之土，所谓
五脏皆有土也。前人惟视薏苡为补中土之药，故谓其力和缓，然用之中的，为效极速，何和
缓之有哉。
“稼穑作甘，为土之正味。”（《尚书·洪范》：种植和收割作物产生甜味，这是土的纯正味道。）粳米不像其他具有甜味的物品那样偏颇。它能平和地调理五脏，补益中气。有时感到疲倦乏力，吃一顿饭后，便感到异常舒适，这种功效甚至有人参所不及之处，由此可以推想它的功能了。
粳米多得金（肺）和水（肾）之气，在益气之中兼能滋养阴液，所以在补益剂或寒凉剂中，没有不能辅助其成功的。
谷物是人生的至宝，但在霍乱、痧胀，以及想要呕吐却吐不出来、想要腹泻却泻不出来的证候中，如果在发作时咽下一口米汤，就不可救治了。这是因为暑湿秽恶的邪气充斥在经络隧道中，而米汤进入胃后输布到脾，再归注于肺，反而助长了邪气的张势，使体内没有一丝空隙剩余，所以病情危重得如此迅速。
李时珍说：“薏苡仁属土，是阳明经的药物，所以能健脾益胃。”刘氏反驳说：“胃是五脏六腑的海，其中的清气上注于肺，之所以能注于肺，实际上是由于脾的作用。脾气结合肾气以达于肺，肺气结合心气以归于肾，这三阴之气，称为元气，也就是中气。然而如果胃阳虚，那么脾的地气就不能升腾于天，势必导致湿气盛极而化热，凑集于胃脘的阳气处以损伤气。如果胃阳亢盛，那么肺的天气就不能下降于地，也必然导致热盛而化湿，反过来逼迫脾脏的阴液以损伤血。损伤气的，肺受其害，表现为胸痹、脉象偏缓；严重时甚至肺阴大损，形成肺痿、肺痈；更因为伤气而波及藏血的肝，表现为筋急拘挛。损伤血的，脾受其害，表现为肠胃不利；严重时甚至脾气大虚，形成水肿、久风湿痹，并且病邪移于下部形成疝气。这些都是胃气病变影响上下部的情况。薏苡生长在平泽之地，气寒味甘，水土合德，果实结于盛夏，此时润下的水气，转而趋向炎上的火气；采摘果实在于秋末，此时浮散的热气，又回归于凉降的金气。这符合胃通达地气而不因湿化热的变化，也符合胃通达天气而不因热化湿的变化。上述各种证候都能治疗。中气不因湿而病，即不因热而病，除湿的同时就能清热，这不是胃的专属功能，而是胃作为枢纽的作用。如果像李氏所说，将其泛泛地与燥湿健脾的药物同等看待，那么所谓清热、治疗痿证、调和血液、滋润筋膜的功效，该归入何处呢？然而薏苡是补益中气的重要药物，但它的味道淡，药力缓和，如果不配合群药来济助它，不集中大量投用，也不能奏效。又说：这里的筋挛，是湿热损伤血液而导致筋膜干枯所致。就是《内经》所说的“大筋短缩”。肝藏血而主筋，湿热确实是血分的病证。按李氏的说法固然未击中要害，而刘氏则夸大深奥之理，导致许多曲折牵强。且不说脏腑阴阳升降出入的道理，并不完全如他所说。即使仅就他的话回复，实际上也有显露其缺陷的地方，不能掩饰。在“伤气”之内，插入“更因伤气”一句，使得筋急拘挛被归结为全是伤气的传变。损伤血难道没有真正的血证吗？却勉强用肠胃不利等四项来当之。这都是主观牵合，不符合实理。薏苡能使胃阳不虚，胃阳不亢，又能使脾合肾以至肺，肺合心以归肾，用处应该非常深奥复杂，像四物汤、四君子汤之类，为什么古方中选用的，却像晨星一样稀疏呢？况且说必须配合群药济助，集中大量投用，那就本来知道薏苡不能兼揽众长，又何必滥加赞誉呢！薏苡能使湿不化热，热不化湿，自然是除湿同时也清热，却又说除湿即能清热，难道连薏苡气寒的特性也忘记了吗！既然认为薏苡是除湿的，又说薏苡润筋，这是把薏苡与牛膝看作没有区别了。牛膝治疗筋膜干枯导致的四肢拘挛不可屈伸，是因为它的根柔润且中间有白色汁液。润筋的药物不能除湿，除湿的药物不能润筋，道理本来就是这样的。肝藏血而主筋，但是筋的病不能竟指为血病，这也是不容不辨别的。
《本经》一书中，原本有汉代人的窜入之句，其中精奥之处，则字字如金玉，决非圣人不会撰写。如薏苡仁主治筋急拘挛、不可屈伸、久风湿痹、下气这几句话，真是万世的准则。自《千金方》、《外台秘要》以及后世相传的佳方，凡是使用薏苡仁的，必定兼有筋急拘挛、不可屈伸的证候，对于寒性筋挛用作佐使药，也是取其能舒筋的作用。古方小续命汤的注释说：“中风、筋急拘挛、言语迟缓、脉弦者，加薏苡仁。”李氏认为加薏苡是为了扶脾益肝，不知道它有舒筋的妙处，可谓糊涂。又有薏苡仁丸治疗胁痛，胁痛不是肝病吗？孕妇禁服薏苡，不是因为它泻肝堕胎吗？既然如此，肝与筋相合，薏苡怎么能不是肝药呢？不解从金元以来，竟然没有一个人阐发这一点。天门冬主治暴风湿痹，薏苡仁主治久风湿痹。“久”字确实大有深意。因为风湿痹证并非寒药所适宜，风湿久而不解，则寒将化为热。如《金匮要略》中的麻黄杏仁薏苡甘草汤，汗出当风、久伤取冷是寒邪，发热在日晡时分加剧是寒邪化生的热邪，麻黄用来驱寒，薏苡用来除热。如果没有热，就不是薏苡的责任了。凡此所治疗的，都与《本经》相符。再以薏苡的形体来考察，《本草纲目》记载马志说：“薏苡取青白色的为好。”苏颂说：“薏苡结实呈青白色。”雷斅说：“薏苡颗粒小、色青、味甘。”据此，薏苡绝不是纯白色的。苗发于仲春且色青，多得木气；果实采于九秋且色白，多得金气。色青兼白，则是金木相媾（交融）。味甘而淡，则入胃而不入脾。主疏泄的是肝，司肃降的是肺，胃也是传化下行的腑，因此肺肝挟带金木之势，直走而下，经由胃而小肠而膀胱，都是它所顺行的道路，而且气寒最终归于肾，湿气怎么能不去除呢？后人用利小便的方法治疗疝气，都深得此意。刘氏认为果实结于盛夏，是润下的水气还就炎上的火气。不知道果实结于盛夏，是水不畏火，不畏火则能制火。水自然就水，怎么会肯就火呢？《本经》中“下气”二字，又包含如此深刻的道理。
刘氏将此处的筋挛解释为筋膜干枯，我刚才已经略微驳斥了他。考证刘氏在此篇引用《灵枢》的一段加注说：“受湿则筋缓，然而湿即化热，湿合于热则伤血，血不能养筋则又挛缩。”筋挛固然有因血虚引起的，但此处不是这样。邹氏说：“筋这种东西，寒冷则坚劲，坚劲则短缩；热则弛缓，弛缓则弛长。”这是针对不挟湿的情况而言的。如果挟湿，则大筋横胀，横胀则短缩；小筋纵伸，纵伸则弛长。所有事物都是这样。只是能短缩而不能坚劲，与因寒冷而缩者有所不同。按横胀的说法，前人未曾提及，比刘氏的说法高明。然而《灵枢》说“湿热不攘，大筋软短，小筋弛长”，是说短缩时湿已化热。大概起初虽然横胀，不至于短缩，只有化热之后，所谓饮食之气入胃，散布精气于肝，淫溢之气于筋，逐渐被热邪灼烁，筋为之收缩。说不攘除，则热由湿化，已非一日，与《本经》的说法如出一辙。薏苡只止泄热驱湿而筋即舒展，试验多次验证有效。如果是伤血而等待养血，则不可能如此容易见效。
《本经》中“久风湿痹”列在“筋急拘挛、不可屈伸”之下，明确表明病属于筋，上下文若断若续，几乎难以索解。《金匮要略》胸痹缓急一条，正是为《本经》点睛。胸痹即风湿痹，在手足表现为不可屈伸，在胸部表现为一缓一急，都是久病而成，都是筋的病。关于“缓急”二字，前人的注解大多含糊其辞，只有邹氏根据《灵枢》、《素问》中关于阴跷脉、阳跷脉与足阳明颊筋的理论，推类以求，并阐释巢元方关于胸痹的论述，认为五脏六腑的寒气，因虚而上冲胸膈的，寒冲于左，则逼热于右；寒冲于右，则逼热于左。寒者急，热者缓。可以说是今日豁然开朗，已经昭然若揭了。
有人问：寒湿、湿热各有专药。湿既已化热，为何舍弃治疗热湿的专药而用薏苡，不称之为热湿，这其中也有说法吗？回答说：痹证没有所谓的“热痹”，湿化之热，终究不离寒。所以不叫湿热风热，而叫久风湿痹。证候是热中有寒，缓急自然不是专由于热，这个道理只有寇宗奭提到了。他说：“受寒使人筋急，寒热使人筋挛；如果只受热不曾受寒，则不至筋挛。”虽然与邹氏的说法略有不同，然而缓急确实只有薏苡这一味药能治。为什么呢？寒即是湿，湿去寒亦去，薏苡治疗筋病有专长。那么张仲景为什么又加附子呢？回答说：胸痹由于阳虚，本来非辛温药不治，用附子不用薤白、桂枝，是因为薏苡有损伤阳气的虞虑，附子足以抵销薏苡的副作用而舍短取长。并不是说薏苡治热，附子……
李时珍说：薏苡健脾益胃，虚则补母，所以肺痿、肺痈用它。刘氏说：治痿独取阳明。阳明湿热盛则成肺痿肺痈。大肠与胃的湿热散，则肺痿肺痈自愈。唉，这两家的言论，粗疏得很啊！所谓“治痿独取阳明”，是针对痿证的痿躄而言的。与肺痿的“痿”，岂能同论。况且薏苡是肺药，而肺痿不治，肺痿发展到吐脓成肺痈时才治它，在肺痈之中，又以胸中皮肤甲错为最适宜。为什么呢？胸中甲错，乃肺热灼烁津液所致。虽然在肌肤，但与筋膜联属，肝也负有责任。薏苡泄肺热而能疏解筋膜中的干涩，所以是妙药。如《千金方》苇茎汤就可以证明。肺痿为什么不治？肺痿的原因有二：属虚冷的不用说；即使是肺由热灼而津液已枯，筋膜无故（失去濡养），薏苡不能润液而且竭液，哪里需要借助它呢？肠痈为什么治呢？也是因为身体甲错的原因。甲错虽然不在胸部，但其为痈脓则是一样的，痈脓也不能单靠薏苡，但因为痈脓而导致甲错，则非薏苡不能胜任，这与胸痹专门治疗缓急没有二义。尤在泾认为此肠痈为小肠痈，与我说的薏苡由胃而小肠而膀胱的说法吻合。有人怀疑肺药多入大肠，薏苡何独不然。回答说：这正是金木相媾，肝主疏泄而薏苡为肝药的依据。薏苡的主治，肝居首位，肺次之，胃以下皆是其所递及。方书中胃病没有用薏苡治疗的。大概它补土，只补肝中之土，所谓“五脏皆有土”。前人只视薏苡为补中土之药，所以说它药力和缓，然而用得恰当，疗效极速，哪里有什么和缓呢？
"Jia Se Zuo Gan, Wei Tu De Zheng Wei." (From *Shangshu - Hong Fan*: Planting and harvesting crops produce sweetness; this is the pure flavor of Earth.) Jingmi (Coix Seed, specifically the glutinous variety) differs from other sweet substances in that it is not biased. It harmoniously regulates the Five Zang Organs and tonifies the Middle Qi (Central Energy). When one feels fatigued and weak, a single meal brings exceptional comfort; its efficacy surpasses even that of Renshen (Ginseng), which allows us to infer its functions.
Jingmi absorbs abundant Metal (Lung) and Water (Kidney) energies. While it tonifies Qi, it simultaneously nourishes Yin. Therefore, it can assist successfully in both tonifying formulas and cooling formulas.
Grains are treasures for human life. However, in cases of Huoluan (Cholera-like disorder with vomiting and diarrhea), Shazhang (Sha poisoning and distension), or conditions where there is an urge to vomit but nothing comes out, or an urge to defecate but nothing comes out, if a mouthful of rice water is swallowed during the onset, the condition becomes incurable. This is because pathogenic factors such as Summer-heat, Dampness, and foul turbidity fill the meridians and collaterals. When rice water enters the Stomach, it transmits to the Spleen and returns to the Lungs, inadvertently expanding these pathways and leaving no room for escape, causing the critical state to arise so rapidly.
Li Shizhen stated: "Yiyiren (Coicis Semen, Coix Seed) belongs to Earth and is a medicine of the Yangming channel, thus it can strengthen the Spleen and benefit the Stomach." Liu Shi refuted this, stating: "The Stomach is the sea of the Five Zang and Six Fu organs. Its clear Qi ascends to the Lungs. The reason it can ascend to the Lungs is actually due to the Spleen. Spleen Qi combines with Kidney Qi to reach the Lungs, and Lung Qi combines with Heart Qi to return to the Kidneys. These three Yin energies are called Yuan Qi (Original Qi), which is also Zhong Qi (Middle Qi). However, if Stomach Yang is deficient, the Earth Qi of the Spleen cannot ascend to Heaven, inevitably leading to excessive Dampness transforming into Heat, which gathers at the Yang of the Epigastrium to damage Qi. If Stomach Yang is hyperactive, the Heaven Qi of the Lungs cannot descend to Earth, inevitably leading to excessive Heat transforming into Dampness, which presses back against the Yin of the Spleen to damage Blood. Damage to Qi affects the Lungs, manifesting as Xiongbi (Chest Bi/Pain) and a slow pulse; severely, it damages Lung Yin, resulting in Feiwei (Flaccid Atrophy of the Lung) and Feibing (Lung Abscess); further, damaging Qi affects the Liver, which stores Blood, resulting in Jinji Juluan (Tendon Spasm and Cramping). Damage to Blood affects the Spleen, manifesting as intestinal and stomach dysfunction; severely, it causes severe Spleen Qi deficiency, leading to Edema and chronic Wind-Damp Bi, and the pathology shifts to the lower body causing Shan (Hernia). All these are diseases of Stomach Qi affecting the upper and lower parts. Yiyi grows in flat marshes, has a cold nature and sweet taste, combining the virtues of Water and Earth. Its fruit forms in midsummer, when the descending nature of Water turns toward the ascending nature of Fire; it is harvested in late autumn, when the floating heat returns to the cool descent of Metal. This aligns with the Stomach's ability to access Earth Qi without being damaged by Dampness transforming into Heat, and to access Heaven Qi without being damaged by Heat transforming into Dampness. It can treat all the aforementioned syndromes. Since the Middle Qi is not diseased by Dampness, it is not diseased by Heat either. Removing Dampness inherently clears Heat. This is not solely the function of the Stomach, but rather the Stomach acts as the pivot. If one discusses Yiyi merely as a drug for drying Dampness and strengthening the Spleen like Li suggested, where would the effects of clearing Heat, treating Wei syndrome, harmonizing Blood, and moistening tendons be categorized? However, Yiyi is a key herb for tonifying Middle Qi, yet its taste is bland and its action is mild. Without combining it with other herbs to aid it, or administering it in concentrated doses, it cannot achieve precise results. Furthermore, regarding tendon spasms caused by Damp-Heat damaging Blood and drying the fascia, as mentioned in the Classics ("Large tendons become short"), the Liver stores Blood and governs tendons, so Damp-Heat is indeed a disease of the Blood level. While Li's view missed the mark, Liu Shi exaggerated profound mysteries, leading to convoluted reasoning. Not only do his explanations of Zang-Fu organ Yin-Yang ascent and descent not fully align with reality, but even within his own logic, flaws are evident and cannot be concealed. By inserting "further due to Qi damage" under "Qi damage," tendon spasm is attributed entirely to the transmission of Qi damage. Are there no true Blood disorders among Blood damage, yet forced into categories like intestinal dysfunction? This is subjective forcing, lacking factual basis. Yiyi can prevent Stomach Yang from being deficient or hyperactive, and facilitate the cycle of Spleen-Kidney-Lung and Lung-Heart-Kidney. Its applications should be as profound and complex as Siwu Tang or Sijunzi Tang. Why are prescriptions using it so rare, like morning stars? Moreover, if it requires combination and high dosage, it admits Yiyi cannot handle everything alone, so why praise it indiscriminately? Yiyi prevents Dampness from turning to Heat and Heat from turning to Dampness; naturally, removing Dampness clears Heat. To say "removing Dampness immediately clears Heat" ignores its cold nature! Equating Yiyi's tendon-moistening effect with Niuxi (Achyranthis Bidentatae Radix) is erroneous. Niuxi treats limb spasms due to dry fascia because its root is soft, moist, and contains white juice. Moistening tendons does not remove Dampness, and removing Dampness does not moisten tendons; this is logical. The Liver stores Blood and governs tendons, but tendon diseases cannot simply be labeled as Blood diseases; this distinction must be made.
The *Shennong Bencao Jing* contains some Han dynasty interpolations, but its profound passages are golden and jade, surely written by sages. Phrases like "Yiyiren treats tendon spasm, inability to flex/extend, chronic Wind-Damp Bi, and directs Qi downward" are eternal standards. From *Qianjin Fang*, *Waitai Miyao*, and later excellent formulas, Yiyiren is always used for tendon spasm and immobility. For cold-induced spasms, it serves as an assistant to relax tendons. The annotation for *Xiao Xuming Tang* states: "For stroke with tendon spasm, slurred speech, and wiry pulse, add Yiyiren." Li Shizhen claimed adding Yiyiri tonifies Spleen and Liver, missing its tendon-relaxing miracle—how ignorant! Another formula, Yiyiren Wan, treats hypochondriac pain. Is hypochondriac pain not a Liver disease? Pregnant women are forbidden Yiyi because it drains Liver Qi and induces abortion. Thus, since the Liver connects to tendons, how can Yiyi not be a Liver herb? It is inexplicable that no one since the Jin-Yuan dynasties elaborated on this. *Tianmendong* (Asparagi Radix) treats acute Wind-Damp Bi; *Yiyiren* treats chronic Wind-Damp Bi. The word "chronic" is significant. Wind-Damp Bi is not suitable for cold medicines; if chronic, Cold transforms to Heat. In *Jinkui Yaolue*'s *Mahuang Xingren Yiyi Gancao Tang*, sweating after wind exposure and seeking cold is Cold; worsening fever at dusk is Heat generated from Cold. Mahuang expels Cold; Yiyi clears Heat. Without Heat, Yiyi is unnecessary. All these treatments align with the *Benjing*. Regarding Yiyi's physical properties: Ma Zhi noted "greenish-white is best"; Su Song said "fruits are greenish-white"; Lei Xiao said "small grains, green color, sweet taste." Thus, Yiyi is not purely white. Sprouts emerge in mid-spring and are green, absorbing much Wood Qi. Fruits are harvested in late autumn and are white, absorbing much Metal Qi. Green mixed with white represents the interaction of Metal and Wood. Sweet and bland taste enters the Stomach, not the Spleen. The Liver governs dispersing and draining; the Lungs govern descending and purifying; the Stomach is a fu organ for transmission and descent. Thus, Lung and Liver, leveraging Metal and Wood, move directly downward through the Stomach, Small Intestine, and Bladder. With its cold nature returning to the Kidney, how can Dampness remain? Later practitioners using diuresis to treat Hernia understood this well. Liu Shi claimed fruit formation in summer means Water Qi seeks Fire Qi. Ignorance! Fruit formation in summer shows Water fears no Fire and controls Fire. Water stays Water; why seek Fire? The phrase "directs Qi downward" in the *Benjing* holds such profound truth.
I previously refuted Liu Shi's claim that tendon spasm is due to dry fascia. Liu Shi annotated *Lingshu*: "Dampness makes tendons lax; if Dampness transforms to Heat and combines with it, it damages Blood; Blood fails to nourish tendons, causing contraction." While some spasms are due to Blood deficiency, this case is different. Zou Shi stated: "Tendons become firm and short when cold; they become lax and long when hot." This applies to non-Damp cases. With Dampness, large tendons swell transversely and shorten; small tendons stretch longitudinally and lengthen. This is universal. They shorten but do not become firm, differing from cold-induced shortening. Zou's theory of transverse swelling is superior to Liu's. However, *Lingshu* says "If Damp-Heat is not dispelled, large tendons become soft and short, small tendons become lax and long." Shortening implies Dampness has already transformed to Heat. Initially swollen, they don't shorten until Heat scorches the essence dispersed by the Liver to the tendons. "Not dispelled" implies Heat from Dampness has persisted, matching the *Benjing*. Yiyi stops Heat leakage and drives out Dampness, relaxing tendons instantly upon trial. If it were Blood damage requiring tonification, relief wouldn't be so easy.
In the *Benjing*, "Chronic Wind-Damp Bi" follows "Tendon spasm, inability to flex/extend," clearly indicating the disease involves tendons. The text seems disjointed. *Jinkui Yaolue*'s section on "Chest Bi with alternating tension and relaxation" illuminates this. Chest Bi is Wind-Damp Bi; in limbs, it manifests as immobility; in the chest, as alternating tension and relaxation. Both are chronic tendon diseases. Previous commentators struggled with "alternating tension and relaxation." Only Zou Shi, referencing Yin/Qiao vessels and Foot Yangming cheek tendons, and interpreting Chao Yuanfang's theory on Chest Bi, explained that Cold Qi rushing up due to deficiency creates Heat on the opposite side. Cold causes tension; Heat causes relaxation. This clarifies the matter brilliantly.
Question: Cold-Damp and Damp-Heat have specific drugs. If Dampness transforms to Heat, why use Yiyi instead of specific Damp-Heat drugs, and why not call it Damp-Heat? Answer: There is no such thing as "Heat Bi." Heat derived from Dampness ultimately retains Cold characteristics. Hence, it is called Chronic Wind-Damp Bi, not Damp-Heat Wind-Heat. The syndrome is Heat containing Cold; alternation is not solely due to Heat. Kou Zongshi noted: "Cold causes tendon tension; Cold-Heat causes spasm; heat alone does not cause spasm." Though slightly different from Zou, only Yiyi treats alternation. Why? Cold is essentially Damp; removing Damp removes Cold. Yiyi specializes in treating tendons. Then why did Zhang Zhongjing add Fuzi (Aconiti Lateralis Radix Praeparata)? Answer: Chest Bi stems from Yang deficiency, requiring acrid-warm drugs. Fuzi is used instead of Xiebai or Guizhi because Yiyi may damage Yang; Fuzi counteracts this, taking the long and discarding the short. It is not that Yiyi treats Heat...
Li Shizhen said: Yiyi strengthens Spleen/Stomach; tonifying the mother treats deficiency, hence used for Feiwei and Feibing. Liu Shi said: Treat Wei by focusing on Yangming. Excess Yangming Damp-Heat causes Feiwei/Feibing. Clearing Damp-Heat from Large Intestine/Stomach cures them. Alas, both views are crude! "Treat Wei by focusing on Yangming" refers to Wei syndrome (flaccidity paralysis), not Feiwei (lung flaccidity). Can they be equated? Yiyi is a Lung herb, yet it doesn't treat Feiwei. It treats Feibing (lung abscess) when pus is expectorated, especially when "chest skin resembles fish scales" (Xiongzhong Jiacuo). Why? Fish-scale skin results from Lung Heat scorching fluids. Though on the skin, it connects to fascia, involving the Liver. Yiyi clears Lung Heat and resolves fascia dryness, making it excellent. *Qianjin Fang*'s Weijing Tang proves this. Why not treat Feiwei? Causes of Feiwei: 1. Deficiency-Cold (ignored here); 2. Heat scorching fluids causing dryness. In the latter, Yiyi cannot moisten and may deplete fluids further. Why treat Changbing (Intestinal Abscess)? Also due to body-wide skin scaling. Scaling indicates abscess; Yiyi is essential here, just as it is for Chest Bi's tension/relaxation. You Zaijing identified this Intestinal Abscess as Small Intestine Abscess, aligning with my theory of Yiyi moving from Stomach to Small Intestine to Bladder. Some doubt Lung herbs enter Large Intestine; why not Yiyi? Answer: This confirms Metal-Wood interaction; Liver governs drainage, making Yiyi a Liver herb. Yiyi's primary target is Liver, secondary Lung, then Stomach below. Formulas rarely use Yiyi for Stomach disease. Its "tonifying Earth" only supplements the Earth within the Liver ("All five Zang contain Earth"). Predecessors viewed Yiyi merely as a mild Middle Earth tonic, calling it gentle. But when used correctly, its effect is rapid; where is the gentleness?