邹氏论附子天雄乌头之性用颇精，为节其说曰，乌头老阴之生育已竟者也，天雄孤阳之
不能生育者也，附子即乌头天雄之种，含阴包阳者也。老阴生育已竟者，其中空，以气为用
。孤阳不能生育者，其中实，以精为用。气主发散，精主敛藏。发散者能外达腠理，敛藏者
能内入筋骨。附子则兼备二气，内充实，外强健，且其物不假系属，以气相贯而生，故上下
表理无乎不到。惟其中蓄二物之精，斯能兼擅二物之长，其用较二物为广尔。
本经附子主风寒咳逆邪气，后世缘此多以为治风之药，其实经文深奥，义别有在也。夫
风有伤与中之分，伤者伤于营卫，中者中于经络脏腑。伤营卫者，寒郁于表而易化热，宜麻
桂决不宜附子。中经络脏腑者，寒根于里而阳本虚，用麻桂又贵用附子。附子非风药，而本
经之主风寒，盖指中风之风寒言，非指伤风之风寒言也。
外台谓中风多从热起，故中风有寒亦有热。风引汤治热之方也，热不用附子，固不待言
。小续命汤治寒之方也，若附子即以驱风，何以附子外不少风药。其有附子无风药，如近效
术附汤治风虚者有之，未闻能散外入之邪风也。邹氏谓附子之治风寒，是阳气不荣，风寒侵
侮，阳振而风寒自退。似非不知附子治风寒之理者。乃又谓仲圣用生附子之方，皆兼有表证
，而其所引白通汤附子汤，则并无未解之表邪。夫白通所以用葱白者，因少阴下利一往不返
，失地道上行之德，葱白能入少阴而升之，非以表汗。附子汤证，是少阴受寒，而阳气不能
四周。表何尝有风，脉沉固不当汗，且其方伍以参术之补，苓芍之降，又岂足胜解表之任。
至仲圣附子生用，非属汗后，即是下利脉沉，汗后宜补表阳，下利脉沉宜挽其气，生用自胜
熟用，
或难予曰∶恶风加附子，越婢汤非明证乎？何说之 也！曰∶大青龙汗出恶风者不可服
，越婢汤加附子，则证为汗出恶风，若附子又从而汗之，独不畏厥逆筋惕肉 耶，盖加附子
正以其汗出。赵氏云∶恶风者阳虚，故加附子以入阳。然则舍附子则有亡阳之祸，岂果为驱
风哉。
用附子于中风风寒，原可不过分，故三生饮无风药，以阳气一充而邪即自消也。若他风
寒证，则定须分治。邹氏亦颇以附子与表药对举，暗中逗出，足见附子外尚有表药，其所引
桂枝加附子汤等八方皆是也。惟其中桂枝附子、白术附子、甘草附子，则为治风湿之方；桂
甘姜枣麻辛附子，则为治气分之方。夫风为阳邪，附子阳药，以其人阳虚而寒重，非扶阳则
风不能以徒驱，故扶阳与驱风并行。寒为阴邪，湿亦为阴邪，风湿之风，与伤风之风，亦致
不同，非阳虚不尔，故亦需附子。气分者，水寒之气，结于心下，证由少阴阳虚而来。故麻
辛附子，温少阴而发汗；桂甘姜枣，化上焦之阳而开结，此从表解。枳术汤则从中泄，病同
而治不同。水饮所作四字，赵氏本上下条皆有之，极是。又麻黄附子汤，以麻黄发表而少阴
脉沉用之，正赖有附子温少阴也，否则脉沉无发汗之理矣。
附子为温少阴专药，凡少阴病之宜温者，固取效甚捷。然如理中汤治腹满，黄土汤治下
血，附子泻心汤治心痞，甚至薏苡附子败酱散治肠痈，如此之类，亦无往不利。惟其挟纯阳
之性，奋至大之力，而阴寒遇之辄解，无他道也。
天雄，仲圣惟天雄散一方，附于桂枝加龙骨牡蛎汤后，不言所主何病。按此与上节离合
之间，必有窜乱，今细绎其文，自夫失精家至为清谷亡血失精，当是以天雄散主之，下以桂
枝加龙骨牡蛎汤主之，正为合宜。何以言之？两方于失精家原可通用。但脉为极虚芤迟，证
见清谷亡血失精，则已肾损及脾，不补脾则生精之源绝。故白术用至八两，少腹弦急、阴头
寒、目眩、发落，种种肾病，自非他补肾药所能胜任，故选用精气充实不外泄之天雄，而以
天雄名方。至其佐使之桂枝龙骨，尤微妙难言。桂枝汤桂枝只三两，而此乃倍之，欲其于太
阳之经府俱到以化气。其证阴既下泄，阳自上浮，而脾肾咸虚之阳，不当潜以咸寒之牡蛎；
得龙骨，则引火归土而亦不损其阳。且桂枝辅天雄则入肾释阴，辅白术则入脾温土；龙骨辅
天雄则固肾涩精，辅白术则固脾祛湿。以天雄散隶于是证，义实至精至确。若脉得诸芤动微
紧，虽天雄散亦可服，要不如桂枝加龙骨牡蛎汤为尤中 。盖脉芤动为阳，微紧为阴，阴阳
气争则表里失和。治之以此汤，桂枝生姜甘枣为阳，芍药为阴；龙骨为阳，牡蛎为阴；于祛
邪涩精之中，有表里相得阴阳互维之妙。此二方是于小建中汤肾气丸外，又别出良法者。就
天雄
乌头治风，亦惟阳虚而挟寒挟湿者宜之。以其中空以气为用，开发腠理，过于附子。故
古方中风证用乌头，较多于附子；抉壅通痹，亦过于附子。故仲圣治历节不可屈伸疼痛，及
逆冷手足不仁身疼痛灸刺诸药不能治，皆用乌头不用附子。乌头与附子，同为少阴药，而补
益以附子为优，发散以乌头为胜。故肾气丸有附子无乌头，大乌头煎有乌头无附子。因乌头
气散不收，故不解表之方，皆去滓纳蜜更煮以节其性。仲圣之用乌头附子，可谓各极其妙矣
。乃乌头赤石脂丸更二物并用，以治心痛彻背背痛彻心，取其母子相感以除内外之邪，此岂
寻常思议所及哉。
邹氏对附子、天雄、乌头的药性论述颇为精辟，他总结说道：乌头是老阴完成生育功能的产物；天雄是孤阳无法进行生育的形态；附子则是乌头和天雄的种子，内含阴而外涵阳。老阴完成生育功能后，其内部中空，以“气”发挥效用；孤阳无法生育，其内部充实，以“精”发挥效用。“气”主要主发散，“精”主要主敛藏。发散的特性能够向外通达腠理（皮肤纹理及汗孔），敛藏的特性能够向内深入筋骨。附子则兼备这两种气，内部充实，外部强健，且这种药物不依赖其他依附关系，而是通过气的贯通而生长，因此上下表里无处不到。正因为其中蓄积了上述两种药物的精华，所以能兼取两者的长处，其应用范围比两者更广。
《神农本草经》记载附子主治风寒引起的咳嗽气逆和邪气，后世因此多将其视为治疗风病的药物。其实经文含义深奥，另有深意。风病有“伤”与“中”的区别：“伤”是指损伤营卫（运行于体表的气血），“中”是指邪气侵入经络脏腑。损伤营卫者，寒邪郁结在体表容易化热，适宜用麻黄汤或桂枝汤，绝不宜用附子。侵入经络脏腑者，寒根源于体内且阳气本虚，此时使用麻黄汤或桂枝汤又必须配合使用附子。附子并非专门的风药，但《神农本草经》说它主治风寒，这里指的是“中风”（中脏腑之风寒），而非“伤风”（感冒之风寒）。
《外台秘要》认为中风多从热证开始，所以中风既有寒证也有热证。风引汤是治疗热证的方剂，热证不用附子，这是不言而喻的。小续命汤是治疗寒证的方剂，如果附子是驱风药，为什么附子方中很少配伍其他风药？虽然有附子而无风药的例子，如近效术附汤治疗风虚证，但未听说它能疏散外入的邪风。邹氏认为附子治疗风寒，是因为阳气不能荣养，风寒乘虚侵袭，阳气振奋则风寒自然退去。这似乎不是不懂附子治风寒道理的人能说出的。但他又说张仲景使用生附子的方剂，都兼有表证，而他引用的白通汤和附子汤，却并没有未解除的表邪。白通汤之所以用葱白，是因为少阴病下利不止，失去了地道上升的功能，葱白能入少阴经并升提阳气，并非用于发汗解表。附子汤证，是少阴经受寒，阳气不能周流全身。哪里有什么风邪在表？脉象沉伏本来就不应当发汗，而且该方配伍了人参、白术的补益，茯苓、芍药的降泄，又怎能胜任解表的任务呢？至于张仲景使用生附子，如果不是发汗之后，就是下利且脉象沉伏。发汗后宜补表阳，下利脉沉宜挽回元气，生用自然胜过熟用。
有人反驳我说：“恶风加附子，越婢汤不就是明证吗？你作何解释？”我说：“大青龙汤证中，若出现汗出恶风则不可服用。越婢汤加附子，说明症状已是汗出恶风，如果附子还能发汗，难道不怕出现四肢厥冷、筋惕肉瞤（肌肉跳动）的危候吗？加入附子正是因为患者已经汗出。赵氏说：恶风是因为阳虚，所以加附子以温阳。既然如此，舍弃附子就会有亡阳的危险，这难道是仅仅为了驱风吗？”
在治疗中风风寒时，使用附子原本可以不过分，所以三生饮中没有风药，因为阳气一旦充盛，邪气自然消除。如果是其他风寒证，则必须区分治疗。邹氏也将附子与解表药并列提及，暗中点出附子之外还有解表药，他所引用的桂枝加附子汤等八个方剂都是例证。其中桂枝附子汤、白术附子汤、甘草附子汤，是治疗风湿的方剂；桂枝附子去桂加白术汤（注：原文指桂甘姜枣麻辛附子汤，即甘草附子汤或类似变方，此处依原文直译）则是治疗气分病的方剂。风为阳邪，附子为阳药，因为患者阳虚且寒重，不扶助阳气则风邪不能单纯驱除，所以扶阳与驱风并行。寒为阴邪，湿也为阴邪，风湿中的“风”，与伤风中的“风”，成因截然不同，若非阳虚不会如此，所以也需要附子。所谓气分病，是水寒之气结聚在心下，病症源于少阴阳虚。所以麻黄附子细辛汤，温补少阴并发汗；桂枝甘草干姜大枣汤，化上焦之阳以开结，这是从表解。枳术汤则是从中焦泄浊，病相同但治法不同。赵氏在上下条文中都提到“水饮所作”四个字，非常正确。另外，麻黄附子汤，用麻黄发表而少阴脉沉时使用，正是依靠附子温补少阴，否则脉沉就没有发汗的道理了。
附子是温补少阴的专用药，凡是少阴病需要温补的，确实见效很快。然而像理中汤治疗腹满，黄土汤治疗便血，附子泻心汤治疗心下痞塞，甚至薏苡附子败酱散治疗肠痈，这类情况，没有不奏效的。只是因为它具有纯阳的性质，爆发巨大的力量，阴寒遇到它就消散，没有其他途径能做到这样。
天雄，张仲景只有天雄散一方，附在桂枝加龙骨牡蛎汤之后，没有说明主治什么病。按此与上一节离合之间，必有错乱，现在仔细推敲其文义，从“失精家”到“清谷亡血失精”，应当是用天雄散来主治，下面用桂枝加龙骨牡蛎汤主治，这才是合适的。为什么这么说呢？两个方子对于失精家原本都可以通用。但如果脉象极虚芤迟，症状出现完谷不化、亡血、失精，则已经是肾损及脾，不补脾则生精之源断绝。所以白术用到八两，针对小腹弦急、阴头寒、目眩、脱发等种种肾病，绝非其他补肾药所能胜任，所以选用精气充实不外泄的天雄，并以天雄命名方剂。至于作为佐使药的桂枝和龙骨，尤其微妙难以言表。桂枝汤中桂枝只用三两，而此方加倍，是想让它到达太阳经和腑以化气。既然阴液在下部泄漏，阳气自然上浮，而脾肾两虚的阳气，不应当用咸寒的牡蛎来潜降；得到龙骨，则能引火归土且不损伤阳气。而且桂枝辅助天雄则入肾化解阴寒，辅助白术则入脾温补脾土；龙骨辅助天雄则固肾涩精，辅助白术则固脾祛湿。将天雄散归属于此类病症，义理确实精当确切。如果脉象出现诸芤动微紧，虽然也可以服用天雄散，但不如桂枝加龙骨牡蛎汤更为对症。因为脉芤动属阳，微紧属阴，阴阳气相争则表里不和。用这个方子治疗，桂枝、生姜、甘草、大枣属阳，芍药属阴；龙骨属阳，牡蛎属阴；在祛邪涩精之中，有着表里相得、阴阳互维的妙处。这两个方子是在小建中汤和肾气丸之外，又别出心裁的好方法。
就天雄和乌头治疗风病而言，也只适合阳虚兼夹寒湿的患者。因为它们内部中空，以气为用，开发腠理的作用超过附子。所以古方中风证使用乌头，多于附子；破除壅滞、通利痹阻，也超过附子。所以张仲景治疗历节病（关节疼痛不可屈伸）、以及手足逆冷麻木身疼痛、灸刺诸药不能治愈的情况，都用乌头而不用附子。乌头和附子同为少阴经药，但在补益方面附子更优，在发散方面乌头更胜。所以肾气丸中有附子无乌头，大乌头煎中有乌头无附子。因为乌头气散不收，所以在不解表的方剂中，都去掉药渣加入蜂蜜再煮以节制其药性。张仲景使用乌头和附子，可谓各尽其妙。至于乌头赤石脂丸更是两种药物并用，以治疗心痛彻背、背痛彻心，取其母子相感以去除内外邪气，这难道是寻常思虑所能达到的境界吗？
Zou’s discussion on the properties and uses of Fuzi (Prepared Aconite Lateralis Radix), Tianxiong (Radix Aconiti Lateralis Preparata), and Wutou (Radix Aconiti) is quite refined. He summarized his view as follows: Wutou is the product of Old Yin after its reproductive function has been completed; Tianxiong is the form of Solitary Yang that cannot reproduce; Fuzi is the seed of both Wutou and Tianxiong, containing Yin within and encompassing Yang externally. The one where Old Yin has completed reproduction is hollow inside and functions through Qi (Vital Energy); the one where Solitary Yang cannot reproduce is solid inside and functions through Jing (Essence). Qi primarily governs dispersion, while Jing primarily governs storage. The dispersive nature can reach outward to the Cou Li (interstitial spaces of the skin and muscles), and the storing nature can penetrate inward to the sinews and bones. Fuzi possesses both these energies; it is solid internally and robust externally. Moreover, this herb does not rely on external attachment but grows through the continuity of Qi, thus reaching everywhere from top to bottom and interior to exterior. Precisely because it accumulates the essence of both aforementioned herbs, it excels in both their strengths, making its scope of application broader than either alone.
The *Shennong Bencao Jing* records that Fuzi treats cough, counterflow qi, evil qi, and pathogenic factors caused by Wind-Cold. Later generations, based on this, often regarded it as a medicine for treating Wind diseases. In fact, the scriptural meaning is profound, with a different implication. Wind diseases are distinguished into "injury" (Shang) and "penetration" (Zhong). Injury refers to damage to Ying and Wei (Nutritive and Defensive Qi); penetration refers to pathogens entering the meridians and zang-fu organs. When Ying and Wei are injured, Cold stagnates at the exterior and easily transforms into Heat; Mahuang Tang or Guizhi Tang are appropriate, and Fuzi is strictly contraindicated. When meridians and zang-fu organs are penetrated, Cold roots in the interior and Yang is inherently deficient; using Mahuang Tang or Guizhi Tang requires the addition of Fuzi. Fuzi is not specifically a Wind-dispelling drug, yet the *Shennong Bencao Jing* states it treats Wind-Cold; here, "Wind" refers to Zhong Feng (Wind Stroke/Invasion of Organs), not Shang Feng (Common Cold/Injury of Surface).
The *Waitai Miyao* states that Zhong Feng often originates from Heat, so Zhong Feng can be either Cold or Heat patterns. Fengyin Tang is a formula for Heat patterns; Heat patterns do not use Fuzi, which goes without saying. Xiaoxuting Tang is a formula for Cold patterns. If Fuzi were a Wind-dispelling drug, why are there few Wind-dispelling herbs in formulas containing Fuzi? There are cases with Fuzi but no Wind-dispelling herbs, such as Jinxiao Shufu Tang treating Wind-Deficiency, but it is unheard of that it can disperse exogenous Wind pathogens. Zou stated that Fuzi treats Wind-Cold because Yang Qi fails to nourish, allowing Wind-Cold to invade; when Yang is revitalized, Wind-Cold recedes naturally. This seems to indicate an understanding of the principle behind Fuzi's treatment of Wind-Cold. However, he further claimed that all Zhang Zhongjing’s formulas using raw Fuzi involve exterior syndromes, whereas the Baitong Tang and Fuzi Tang he cited have no unresolved exterior pathogens. The reason Congbai (Scallion White) is used in Baitong Tang is that Shaoyin syndrome with unceasing diarrhea loses the virtue of Earth’s ascending function; Congbai enters the Shaoyin meridian to lift Qi, not to induce sweating for exterior release. The Fuzi Tang syndrome involves Shaoyin meridian cold invasion where Yang Qi cannot circulate throughout the body. Where is the Wind on the exterior? A deep pulse definitely does not warrant sweating. Furthermore, the formula combines the tonifying properties of Renshen and Baizhu with the descending properties of Fuling and Shaoyao; how could it suffice for the task of releasing the exterior? Regarding Zhang Zhongjing’s use of raw Fuzi, if not after sweating, then it is for diarrhea with a deep pulse. After sweating, tonifying exterior Yang is indicated; for diarrhea with a deep pulse, rescuing Qi is indicated. Raw usage naturally surpasses cooked usage.
A skeptic asked: "Adding Fuzi for aversion to wind—does not Yueshi Tang serve as clear proof? What is your explanation?" I replied: "For Da Qinglong Tang syndrome, if sweating and aversion to wind occur, it must not be taken. In Yueshi Tang plus Fuzi, the symptoms are already sweating and aversion to wind. If Fuzi were to induce further sweating, would one not fear Jue Ni (cold extremities) and Jin Ti Rou Yu (muscle twitching)? Adding Fuzi is precisely because sweating has already occurred. Zhao stated: 'Aversion to wind indicates Yang deficiency, hence Fuzi is added to warm Yang.' If so, abandoning Fuzi leads to Wang Yang (collapse of Yang); is this truly merely for dispelling Wind?"
Using Fuzi for Zhong Feng or Wind-Cold need not be excessive; thus, Sansheng Yin contains no Wind-dispelling herbs, as once Yang Qi is充盈 (replenished), pathogens dissipate spontaneously. For other Wind-Cold syndromes, distinct treatments are required. Zou also juxtaposed Fuzi with exterior-releasing drugs, subtly implying that besides Fuzi, there are exterior drugs; the eight formulas he cited, such as Guizhi Jia Fuzi Tang, are examples. Among them, Guizhi Fuzi Tang, Baizhu Fuzi Tang, and Gancao Fuzi Tang are formulas for treating Wind-Dampness; Guizhi Gancao Jiangzao Maxing Fuzi Tang (referring to a variation involving Ma Huang, Xi Xin, etc.) is a formula for treating Qi Fen (Qi Division/Water-Cold accumulation). Wind is a Yang pathogen, and Fuzi is a Yang drug. Because the patient has Yang deficiency and severe Cold, if Yang is not supported, Wind cannot be driven away merely by dispersing; thus, supporting Yang and dispelling Wind proceed together. Cold is a Yin pathogen, and Dampness is also a Yin pathogen. The "Wind" in Wind-Dampness differs significantly from the "Wind" in common cold; unless there is Yang deficiency, this pattern does not arise, hence Fuzi is needed. Qi Fen disease refers to Water-Cold Qi knotting below the heart, originating from Shaoyin Yang deficiency. Therefore, Mahuang Fuzi Xixin Tang warms Shaoyin and induces sweating; Guizhi Gancao Jiangzao Tang transforms Upper Jiao Yang to open knots, resolving from the exterior. Zhizhu Tang drains from the middle; although the disease is similar, the treatment differs. Zhao’s mention of "caused by water retention" in both upper and lower sections is highly accurate. Additionally, Mahuang Fuzi Tang uses Mahuang to release the exterior while the Shaoyin pulse is deep; this relies entirely on Fuzi warming Shaoyin. Otherwise, there is no rationale for sweating with a deep pulse.
Fuzi is the dedicated drug for warming Shaoyin. For any Shaoyin syndrome requiring warming, it indeed yields rapid results. However, formulas like Lizhong Tang for abdominal fullness, Huangtu Tang for hematochezia, Fuzi Xie Xin Tang for epigastric stuffiness, and even Yiyi Fuzi Baijiang San for intestinal abscess—all these prove effective. It is solely due to its pure Yang nature and immense power that Yin-Cold dissolves upon contact; no other method achieves this.
Tianxiong: Zhang Zhongjing only has one formula, Tianxiong San, appended after Guizhi Jia Longgu Muli Tang, without stating its primary indication. Considering the transition between the previous section, there must be textual corruption. Careful analysis suggests that from "those prone to seminal emission" to "clear stool, blood loss, and seminal emission," Tianxiong San should be the primary treatment, followed by Guizhi Jia Longgu Muli Tang, which is appropriate. Why? Both formulas can generally be used for those prone to seminal emission. But if the pulse is extremely deficient, knotted, and slow, and symptoms include clear stool, blood loss, and seminal emission, Kidney damage has extended to Spleen. Without tonifying Spleen, the source of Essence generation is cut off. Hence, Baizhu is used up to eight liang. For various Kidney diseases such as tension in the lower abdomen, cold in the genital area, dizziness, and hair loss, no other Kidney-tonifying drug can胜任 (handle) this case. Thus, Tianxiong, whose essence is solid and does not leak, is selected, and the formula is named after it. The assistant ministers Guizhi and Longgu are particularly subtle. In Guizhi Tang, Guizhi is only three liang, but here it is doubled to ensure it reaches both the Taiyang meridian and fu organs to transform Qi. Since Yin leaks downward, Yang floats upward; the Yang of both Spleen and Kidney, being deficient, should not be anchored with salty-cold Muli. With Longgu, Fire returns to Earth without damaging Yang. Furthermore, Guizhi assisting Tianxiong enters the Kidney to resolve Yin; assisting Baizhu enters the Spleen to warm Earth. Longgu assisting Tianxiong secures the Kidney and astringes Essence; assisting Baizhu secures the Spleen and expels Dampness. Classifying Tianxiong San under this syndrome is truly precise and accurate. If the pulse shows knotted, moving, fine, and tight qualities, Tianxiong San may still be taken, but Guizhi Jia Longgu Muli Tang is more targeted. Knotted and moving pulses indicate Yang; fine and tight pulses indicate Yin. Conflict between Yin and Yang Qi leads to disharmony between interior and exterior. Treating with this formula, Guizhi, Shengjiang, Gancao, and Dazao are Yang; Shaoyao is Yin; Longgu is Yang; Muli is Yin. Within dispelling pathogens and astringing Essence, there is the subtlety of interior-exterior harmony and mutual support of Yin and Yang. These two formulas represent another excellent method alongside Xiaojianzhong Tang and Shenqi Wan.
Regarding Tianxiong and Wutou treating Wind, they are suitable only for Yang deficiency with accompanying Cold and Dampness. Because they are hollow inside and function through Qi, their ability to open Cou Li exceeds that of Fuzi. Therefore, ancient formulas for Wind stroke used Wutou more frequently than Fuzi; for breaking stagnation and unblocking Bi obstruction, Wutou also surpasses Fuzi. Thus, Zhang Zhongjing used Wutou instead of Fuzi for Lijie syndrome (painful joint disease with immobility), and for cold extremities, numbness, body pain, and conditions unresponsive to moxibustion and acupuncture. Although Wutou and Fuzi are both Shaoyin drugs, Fuzi is superior for tonification, while Wutou excels in dispersion. Hence, Shenqi Wan contains Fuzu but no Wutou, while Dawutou Jian contains Wutou but no Fuzi. Because Wutou’s Qi scatters and does not retain, in formulas not intended for exterior release, the dregs are removed, honey is added, and it is boiled again to moderate its properties. Zhang Zhongjing’s use of Wutou and Fuzi was truly masterful. Wu Tou Chi Shi Zhi Wan uses both substances together to treat chest pain radiating to the back and back pain radiating to the chest, utilizing the mutual influence of mother and child elements to eliminate internal and external pathogens. This transcends ordinary reasoning.