鸡属酉金，又为巽木，具金木之气，本有伐土之长。用其水谷所化之矢白，则尤能化滞
消积，领浊下趋。故脾土职复，则鼓胀以消；风木气平，则转筋自止。利小便并止遗溺者，
以遗溺故小便不利也。用白者，取其得金气多，无白亦可不拘。
圣惠方用原蚕沙治霍乱转筋，是从鸡矢白散脱胎，亦以蚕沙能胜风去湿，领浊下趋耳。
卵白为阳黄为阴，白气轻而黄气重，故白能解散浮阳，疗目热赤痛，与咽中生疮。黄能
涵育真阴，主心中烦不得卧，与百合病吐后，孩子热疮，妊娠胎漏。
本经卵白止小儿下泄一语，最宜体会。小儿热泄，只以气清微寒之卵白治之即效。若丈
夫则宜于苦寒矣。今人治泄，不知有热壅经隧，水谷不能化赤而直趋大肠一证，概从事于淡
渗温燥，读此能无惘然。
伤寒论∶少阴病下利脉微者，与白通汤；利不止、厥逆无脉、干呕烦者，白通加猪胆汁
汤主之。是胆汁明为干呕烦而加。干呕烦者，少阳木火上冲心胃所致。若但寒，则不烦不干
呕也。霍乱下利清谷、里寒外热、汗出而厥者，通脉四逆汤主之。吐已下断、汗出而厥、四
肢拘急不解、脉微欲绝者，通脉四逆加猪胆汁汤主之。于四肢拘急下又益之曰不解，必已依
法治之而犹不解也。以白通加猪胆汁汤之例推之，其所先与，当即为通脉四逆汤，服之而汗
出肢厥如故，更见拘急不解，脉微欲绝，非治之不得其当也。盖四肢为诸阳之本，阴邪充斥
于四肢，则阳被阴缚，欲伸不得，投以姜附热药，则阳拒于内，阴争于外，拘急何自而解。
夫拘急乃筋脉之收引，筋属肝，肝与胆为表里，其姜附之不任受者，胆为之也。相火不治，
君火何能独治。故或为呕烦，或为拘急，此猪胆汁所以并加之也。胆汁苦寒，施于垂绝之微
阳，岂尚能堪此。不知其阴中之火，愤而思竞，正非胆汁不靖，故从治亦即正治。抑仲圣用
此为至慎矣。少阴寒邪直中，乃阳气暴虚非本虚，且内寓元阳，故当其下利而呕烦，可加胆
汁。霍乱亦吐亦下，正中气散乱之际，胆汁甚忌，故必拘急不解，并吐已下断而后加之。且
不解者，如故之谓。拘急之始，何尝不宜胆汁，而仲圣不遽用者，又有可旁通以见之者焉。
在桂枝加附子汤曰四肢微急，在四逆汤曰内拘急、曰四肢拘急，在芍药甘草汤曰微拘急，皆
不用胆汁；独拘急而至不解则用之，非以其苦寒伤正而慎之乎。乃张隐庵谓胆汁能起肾脏之
汁，资心主之血。果尔，则仲圣方当不止一二见矣。何不察之甚哉。
胆脏肝叶，病每相连，医家亦多连称。否则偏注于肝，动云肝气肝阳，鲜有别之为胆病
者。然肝为阴经，胆为阳经；肝为风木，胆为相火。凡见上升与火之证，肝必挟胆，或竟属
胆病。李濒湖谓猪胆去肝胆之火，此即余从治亦正治之说，第与肝并举之耳。成无己则谓通
脉四逆加胆汁，是补肝而和阴，又称肝而不及胆。以两说权之，李自较胜于成。刘潜江却扬
成而抑李。曰∶予见一医治或泻或止，每以猪胆汁炒黄连柴胡和他药用之遂止，不以胆汁炒
则不应。若不有以补肝，令血和而风静，仅如时珍所云平肝胆之火，则黄连辈何以鲜功。甚
矣刘氏之暗也！胆汁与姜附并用，语人以胆汁是正治胆火，人固未必肯信。今以胆汁与柴连
偶，去胆汁即不应，则不啻胆汁自表其功矣。何则？胆汁苦寒而滑，极利大便。若是肝泻，
自应加胆汁而泻作，何以无胆汁则泻反不止，非所谓肝病挟胆者欤。治肝以连，是以寒胜热，
以苦燥湿也。治胆以胆，则平胆中壮火以扶生气，不使随肝下走也。治肝而不治胆，所以无
效。况柴胡为少阳药，显系相协以挽少阳之气。成氏之说，凿空无据，刘氏辄从而和之，医
道诚难言尔。
鸡在五行中属酉金，同时对应八卦中的巽卦（木），兼具金与木的气机特性，原本就具有克制脾土的优势。使用由水谷消化后形成的粪便白色部分（鸡矢白），尤其能够化解积滞、消除食积，引导体内浊气向下排出。因此，当脾土的功能恢复时，鼓胀病证得以消除；当风木之气平和时，转筋症状自然停止。它能通利小便并治疗遗尿症，是因为遗尿往往伴随着小便不利的病理基础。使用鸡矢白的白色部分，是取其获得的金气较多，若不用白色部分也可以不拘泥于此。
《圣惠方》中使用原蚕沙治疗霍乱引起的转筋，是从《鸡矢白散》演变而来，也是因为蚕沙能够胜风祛湿，引导浊气下行。
卵白属阳，卵黄属阴。卵白之气轻清，卵黄之气重浊，所以卵白能解散浮越的阳气，治疗眼睛红肿热痛，以及咽喉部生疮。卵黄能涵育真阴，主治心中烦闷不能安卧，以及百合病呕吐之后、小儿热疮、妊娠期间胎漏下血等症。
《神农本草经》中关于“卵白止小儿下泄”这一句话，最值得深入体会。小儿因热导致的腹泻，只用气味清淡微寒的卵白治疗即可见效。而对于成年人则适合使用苦寒性质的药物。现在的人治疗腹泻，不知道有热邪壅塞经络，导致水谷不能化生为血液而直接冲向大肠这一证型，一概采用淡渗利湿或温燥的方法，读到此处能不感到茫然吗？
《伤寒论》记载：少阴病出现下利且脉象微弱的，给予白通汤；如果下利不止，出现四肢厥冷、无脉、干呕心烦的，以白通加猪胆汁汤为主治。这说明加入胆汁是为了针对干呕和心烦的症状。干呕心烦，是由于少阳相火夹木火上冲心胃所致。如果只是单纯的寒证，就不会出现心烦和干呕。霍乱出现下利清谷（完谷不化）、里寒外热、出汗且四肢厥冷的，以通脉四逆汤主治。如果呕吐和下利停止后，仍然出汗且四肢厥冷，四肢拘急痉挛不能缓解，脉象微弱几乎摸不到，以通脉四逆加猪胆汁汤主治。在“四肢拘急”后面又加上“不解”二字，说明已经按照常规方法治疗过但仍未缓解。根据白通加猪胆汁汤的先例推断，之前先使用的应该是通脉四逆汤，服用后汗出肢厥如故，又出现拘急不缓解、脉微欲绝的情况，这并不是治疗方法不当。因为四肢是诸阳之本，阴邪充斥于四肢，阳气被阴邪束缚，想要伸展却无法做到，此时投用姜附等大热药物，阳气会被拒于内，阴邪争于外，拘急怎么能解除呢？拘急是筋脉的收缩牵引，筋归属于肝，肝与胆互为表里，之所以不能耐受姜附的热性，是因为胆的缘故。相火如果不加控制，君火怎么能单独得到治理？所以有时表现为呕烦，有时表现为拘急，这就是为什么要加入猪胆汁的原因。胆汁味苦性寒，施用于垂危的微阳之上，难道还能承受得住吗？不知道其中的道理是，阴中之火愤激而思抗争，正需要胆汁来平定，所以顺从其性质治疗（从治）也就是正确的治疗（正治）。然而张仲景使用此法是非常谨慎的。少阴寒邪直中人体，是阳气突然虚衰而非根本虚弱，且体内蕴藏元阳，所以在其下利且呕烦时，可以加入胆汁。霍乱既吐又泻，正值中气散乱之际，胆汁是禁忌的，所以必须等到拘急不缓解，并且呕吐下利都停止后才加入。而且“不解”的意思就是像以前一样。拘急刚开始时，何尝不适合用胆汁，但张仲景没有立即使用，这可以通过旁证看出来。在桂枝加附子汤条文中说“四肢微急”，在四逆汤条文中说“内拘急”、“四肢拘急”，在芍药甘草汤条文中说“微拘急”，都没有使用胆汁；只有拘急严重到“不解”的程度才使用，这不是因为担心其苦寒伤正气而慎重吗？张隐庵认为胆汁能激发肾脏的津液，资助心主的血液。果真如此的话，张仲景的方剂中就不止一两次见到这种用法了。为什么不考察得这么清楚呢？
胆脏位于肝脏叶间，病变时常相连，医家也常连称。否则偏重于肝，动不动就说肝气、肝阳，很少将其单独作为胆病来讨论。然而肝是阴经，胆是阳经；肝属风木，胆属相火。凡是见到上升和火热表现的证候，肝必定挟带胆，或者干脆属于胆病。李濒湖认为猪胆能去除肝胆之火，这也就是我所说的“从治即正治”的说法，只是他将其与肝并列提及。成无己则认为通脉四逆加胆汁，是补肝而调和阴气，只提肝而不提胆。权衡这两种说法，李氏比成氏更胜一筹。刘潜江却推崇成氏而贬低李氏。他说：我曾见一位医生治疗时而腹泻时而停止的病证，每次都用猪胆汁炒黄连、柴胡和其他药物配合使用，病就好了；如果不加胆汁炒制，就没有效果。如果不是为了补肝，使血液调和而风邪静止，仅仅像李时珍所说的那样平抑肝胆之火，那么黄连类药物为什么鲜有效果？刘氏对此太糊涂了！胆汁与姜附并用，告诉人们胆汁是正治胆火，人们未必肯相信。现在将胆汁与柴胡、黄连偶合使用，去掉胆汁就没效果，这就好比胆汁自己证明了它的功效。为什么呢？胆汁苦寒而滑利，极利于大便排泄。如果是肝泻，自然应该加入胆汁而使腹泻加重，为什么没有胆汁时腹泻反而不止，这不就是所谓的肝病挟带胆病吗？用黄连治肝，是以寒胜热，以苦燥湿。用胆汁治胆，则是平抑胆中的壮火以扶持生气，不让它随肝气下行。只治肝不治胆，所以无效。况且柴胡是少阳经的药物，明显是协同挽回少阳之气。成氏的说法，凭空捏造没有依据，刘氏却跟着附和，医学之道确实难以言说啊。
The chicken belongs to You Metal in the Five Elements and corresponds to the Xun (Wind/Wood) trigram in the Eight Trigrams, possessing both Metal and Wood qi characteristics. It inherently has the advantage of controlling Spleen Earth. Using its feces, specifically the white part formed from the transformation of water and grain, is particularly effective in resolving stagnation, eliminating accumulations, and guiding turbid qi downward. Therefore, when the function of Spleen Earth is restored, abdominal distension (Gu Zhang) subsides; when the Qi of Wind Wood is pacified, muscle twitching (Zhuan Jin) stops naturally. Its ability to promote urination and treat enuresis (Yi Ni) exists because enuresis is often accompanied by difficulty in urination. Using the white part of the feces is to take advantage of its greater acquisition of Metal qi; using non-white parts is also acceptable without strict adherence.
*Shenghui Fang* uses silkworm sand (Yuancan Sha) to treat convulsions caused by Huoluan (Cholera-like syndrome), which is derived from *Jishi Bai San*, also relying on the ability of silkworm sand to overcome wind and remove dampness, guiding turbidity downward.
Egg white represents Yang, while egg yolk represents Yin. The qi of egg white is light and ascending, while that of egg yolk is heavy and descending. Thus, egg white can dissipate floating Yang and treat eye heat, redness, pain, and sores in the throat. Egg yolk can nourish True Yin and primarily treats vexation in the heart with inability to sleep, as well as conditions following vomiting in Baihe Bing (Lily Disease), infantile heat sores, and fetal leakage during pregnancy.
The statement in *Ben Jing* ("Egg white stops diarrhea in children") deserves careful consideration. For pediatric heat-induced diarrhea, treating it with the clear, slightly cold nature of egg white alone is effective. For adults, bitter-cold herbs are more appropriate. Modern practitioners, unaware of the pattern where heat obstructs the collaterals, preventing water and grain from transforming into blood and causing them to rush directly to the Large Intestine, generally resort to bland-leaching or warm-drying methods. Reading this, one cannot help but feel bewildered.
In *Shanghan Lun*: "In Shaoyin disease, if there is diarrhea and a faint pulse, give Baitong Tang. If diarrhea persists, accompanied by cold limbs, absence of pulse, dry retching, and vexation, Baotong Jia Zhuyedan Tang should be used." This indicates that bile is added specifically for dry retching and vexation. These symptoms arise from the upward rushing of Shaoyang Wood Fire affecting the Heart and Stomach. If it were merely cold, there would be no vexation or dry retching. In Huoluan, if there is diarrhea with undigested food, interior cold with exterior heat, sweating, and cold limbs, Tongmai Sini Tang is indicated. If vomiting and diarrhea cease, yet sweating and cold limbs persist, along with unrelieved limb cramping/tetany and a faint pulse nearly imperceptible, Tongmai Sini Jia Zhuyedan Tang is indicated. The addition of "unrelieved" after "limb cramping" implies that previous treatments failed. By analogy with the case of Baotong Jia Zhuyedan Tang, the initial treatment was likely Tongmai Sini Tang. After administration, sweating and cold limbs remained, and new symptoms of unrelieved cramping and a faint pulse emerged. This does not necessarily indicate incorrect treatment. The limbs are the root of all Yang meridians. When Yin pathogens fill the limbs, Yang is bound by Yin and cannot extend. Administering hot herbs like Ginger and Aconite causes Yang to be rejected internally and Yin to contend externally, making it impossible to resolve cramping. Cramping is the contraction of sinews, which belong to the Liver. Since Liver and Gallbladder are interior-exterior pairs, the intolerance to the heat of Ginger and Aconite is due to the Gallbladder. If Ministerial Fire (Xianghuo) is unchecked, how can Sovereign Fire (Junhuo) be regulated? Hence, sometimes presenting as retching/vexation, sometimes as cramping, this is why Pig Bile is added. Pig bile is bitter and cold; applied to failing Yang, how can it be tolerated? The principle is that the fire within Yin becomes agitated and seeks resolution, which only bile can pacify. Thus, "following the nature" (Congzhi) is effectively "correct treatment" (Zhengzhi). However, Zhang Zhongjing's use of this method was extremely cautious. In Shaoyin cold pathogen direct invasion, Yang qi is suddenly deficient but not fundamentally weak, and Primordial Yang resides within. Thus, when diarrhea is accompanied by retching and vexation, bile can be added. In Huoluan, with simultaneous vomiting and diarrhea, the Middle Qi is scattered, making bile contraindicated. It is only added when cramping is unrelieved and vomiting/diarrhea have ceased. "Unrelieved" means "as before." Why did Zhongjing not use it immediately at the onset of cramping? This can be inferred from other cases. In Guizhi Jia Fuzi Tang, "slight cramping" is mentioned; in Sini Tang, "internal cramping" and "limb cramping"; in Shaoyao Gancao Tang, "slight cramping"—none used bile. Only severe, unrelieved cramping warrants its use, showing caution against its bitter-cold nature damaging healthy Qi. Zhang Yinan claimed bile stimulates Kidney fluids and assists Heart Blood. If true, Zhongjing would have used it more frequently. Why such a lack of scrutiny?
The Gallbladder is located within the Liver lobes, and diseases often co-occur, leading physicians to conflate them. Often, focus is placed solely on the Liver, discussing Liver Qi or Liver Yang, rarely distinguishing Gallbladder disease. However, the Liver is a Yin meridian, while the Gallbladder is a Yang meridian; the Liver corresponds to Wind-Wood, and the Gallbladder to Ministerial Fire. In any condition involving rising or fire, the Liver invariably involves the Gallbladder, or it may even be primarily a Gallbladder disorder. Li Binhu stated that Pig Bile removes Liver-Gallbladder fire, aligning with my view of "conforming treatment as correct treatment," though he grouped them together. Cheng Wuji argued that adding bile to Tongmai Sini Tang tonifies the Liver and harmonizes Yin, mentioning only the Liver. Comparing the two, Li is superior. Liu Qianjiang, however, praised Cheng and criticized Li, stating: "I saw a physician treat intermittent diarrhea using Pinellia-bile fried Coptis and Bupleurum; it worked. Without bile, it failed. If not to tonify the Liver and calm wind, but merely to clear fire as Li Shizhen said, why would Coptis fail?" Liu is profoundly mistaken! When bile is used with Ginger and Aconite, claiming it treats Gallbladder fire directly, people may doubt it. But when paired with Bupleurum and Coptis, removing bile renders it ineffective, proving its efficacy. Why? Bile is bitter, cold, and slippery, promoting bowel movements. If it were purely Liver purgation, adding bile should worsen diarrhea. Yet, without bile, diarrhea persists. This confirms Liver disease involving the Gallbladder. Treating the Liver with Coptis uses cold to overcome heat and bitterness to dry dampness. Treating the Gallbladder with bile pacifies excessive fire to support vital Qi, preventing it from descending with the Liver. Treating only the Liver fails. Moreover, Bupleurum is a Shaoyang herb, clearly assisting in restoring Shaoyang Qi. Cheng’s theory is baseless, and Liu’s endorsement is misguided. Medicine is indeed difficult to discuss.