仙茅，味辛，气温，有毒。入肾。治心腹冷气，疗腰膝挛痹，不能行走，男子虚损劳伤，
老
人失溺，无子，益肌肤，明耳目，助阳道，长精神，久服通神强记。中仙茅毒者，含大黄一
片即解，不须多用大黄也。此种药近人最喜用之，以《本草》载其能助阳也。然全然不能兴
阳。盖仙茅气温，而又入肾，且能去阴寒之气，以止老人之失溺，苟非助阳，焉能如此。而
子独谓全不兴阳者，以仙茅之性，与附子、肉桂迥异。仙茅虽温，而无发扬之气，长于闭精
，而短于动火。闭精，则精不易泄，止溺，则气不外走，无子者自然有子，非因其兴阳善战
，而始能种玉也。子辨明其故，使世之欲闭其精者，用之以固守其精。而元阳衰惫，痿弱而
不举者，不可惑于助阳之说，错用仙茅，归咎于药之不灵也。
或问仙茅闭精，而不能兴阳，其说甚创，然子论之甚辨，岂亦有试之而云然乎？曰∶余
论其
性耳，何试为然，而余亦曾自试之矣。予平日之阳，亦未甚衰也，服仙茅半年，全然如故。
余不得其意，后遇岐天师之指示，而始爽然自失也。仙茅闭精，而不兴阳，实身试而有验
，乃阅历之语，非猜度之辞也。
附子，味辛，气温、大热，浮也，阳中之阳，有大毒。大者为天雄，小者为川乌。天雄
过热
，不可用；川乌热太劣，不若附子之适于用也。制法∶每个用甘草五钱，煮水一碗，将附子
泡透，不必去皮脐尖子，正要全用为佳。取甘草至仁，以制不仁也。无经不达，走而不守，
但可为臣使，佐群药通行诸经，以斩关夺门，而不可恃之安抚镇静也。去四肢阙逆，祛五脏
阴寒，暖脚膝而健筋骨，温脾胃而通腰肾，真夺命之灵丹，回春之仙药也。用之当，则立刻
重生；用之不当，则片时可死。畏之而不敢用，因循观望，必有失救之悲；轻之而敢于用，
孟浪狂妄，又有误杀之叹。要在人辨寒热阴阳，而慎用之也。夫附子，阳药也，以阳治阴，
最为相宜，以阳治阳，自然相恶。阳主热，而阴主寒，有如冰炭，何至错误。惟阳似阴，而
阴似阳，以假乱真，往往杀人，惨于刀刀也。我今辨阴阳寒热之殊，使用附子者尽生人，而
不再误杀人也。阴热之症，乃肾水之耗，而肾守之火不能下安于肾宫，上冲于咽喉口齿之间
，其舌必滑者也。论理大补其真阴之水，水旺而火又不归。然而，徒补其水，火虽少衰，终
不能一时骤降，少用附子，同肉桂入于六味地黄汤中，大剂冷服，下喉而火即消，归下肾内
，上焦之热，尽化为清凉矣，此用附子以治阴热之秘法也，阳热之症，乃心火之盛，移于其
热
胃中，发狂而大叫，或失神而谵语，手足反现冰冷，而胸前膈上多有发斑者，必大渴呼水，
而舌苔或红、或黄、或灰黑，必燥而峭，开裂成绫者也。论理不必从治，竟用三黄石膏直治
其火，火泻而肾水不干，可免亡阳祸。然火过于旺盛，用大
寒之药，恐致格拒，尚不入加附子一片，重一分，入于三黄石膏汤中，以火从火，引苦寒之
药下行，而不相背，热性过而寒性发，自能泻火邪于顷刻矣，此用附子以治阳热之秘法也。
阴寒之病，乃寒邪直中于肾经，此伤寒之卒病也。肾受寒邪，命门之火自不能藏，欲遁出于
躯壳之外，而寒乘胜追逐，犯于脾则腹痛，犯于肝乃胁痛，犯于心则心痛，或手足青者有之
，或筋骨拘挛者有之，或呕或吐，或泻或利，甚则身青袋缩，死生悬于反掌，真危急存亡之
秋也。探其舌必滑，急用附子二三钱、人参五六钱或一二两、白术一二两、干姜二钱，同煎
服之，下喉而阳回寒散矣，此阴寒用附子之法有如此，阳寒之病，平素伤其脾胃之气，不能
荣卫于一身，以致风寒但犯，发热恶寒，喜卧而不喜语言，喜静而不喜纷扰，与之饮食，又
能知味，身虽热，而神思甚清，脉必细微，气必甚怯，此阳气不足，而邪乃中之也，其舌虽
干而必滑，急用理中汤加附子一钱治之，正气足而邪自散矣。甘温除大热，非此之谓欤。阳
寒用附子之法，又如此。知此四治，触类旁通，断无误用之失矣。
或问附子有毒，用之得当，可以一服即回阳，有毒者固如是乎？附子之妙，正取其有毒
也。
斩关而入，夺门而进，非藉其刚烈之毒瓦斯，何能祛除阴寒之毒哉。夫天下至热者，阳毒也，
至寒者，阴毒也。人感阴寒之气，往往至手足一身之青黑而死，正感阴毒之深也。阴毒非阳
毒不能祛，而阳毒非附子不胜任。以毒治毒，而毒不留，故一祛寒而阳回，是附子正有毒以
祛毒，非无毒以治有毒也。
或问附子入之于三生饮中，救中风之垂绝，何以必生用之乎？此实有妙义存焉。夫中风，
非
风也，乃气虚而痰塞于心中，故一时卒中，有似乎风之吹倒也。若作风治，十死九矣。必须
用人参为君，附子为佐，加之生南星、生半夏、生姜，而后可以开其心窍，祛逐其痰涎，使
死者重生也。世人皆以为人参之功也。苟非附子，何以推荡而奠宁哉？然此时用熟附子，正
恐未必神效，往往有缓不济事之忧。必生用之者，取其无所牵制，则斩关突围而入，自能破
劲敌于须臾也。药中用霸气而成功者，此类是欤。
或问参附汤之治阴寒直中，又救一时之垂绝者，何以又不用生附子耶？夫熟附子之治直
中阴
寒也，欲救其回阳也。阴寒入于至阴之肾中，祛命门之火出外，而不敢归宫，真火越出，而
阴寒乘势祛逐，元阳几无可藏之地，此时而不大用人参，则元阳飞出于躯壳之外矣。然而徒
用人参，不佐之以附子，则阴寒大盛，人参何能直入于腹中，以生元阳于无何有之乡？既用
附子，而不制其猛悍之气，则过逐阴寒，一往罔顾，未必乘胜长驱，随阴寒而尽散热，必元
阳无可归，而气又遽亡。故必须用熟者，同入于人参之中。既能逐阴寒之外出，又且引元阳
之内归，得附子之益，去附子之损，所谓大勇而成其大仁也。
或问附子阳药，宜随阳药以祛除，何以偏用之阴药以滋补乎？盖附子大热之品也，入于
阳药
之中者，所以救一时之急；入于阴药之中者，所以治久滞之 。凡阳虚之症，宜用阳药救之
，故附子可多用以出奇；阴虚之病，宜用阳药养之，故附子可少用以济胜。阳得阴而功速，
阴得阳而功迟，各有妙用也。
或疑附子之功，有以少而成功者，又是何故？夫急症宜多，而缓症宜少，此用附子之法
也。
但古人有用附子只一片而成功，非藉其斩关夺门之神也。盖附子无经不达，得其气而不必得
其味，入于经而不必留于脏，转能补气以生气，助补血而生血，而不至有增火增热之虞，反
成其健土关胃之效也。
或问附子何以必得人参以成功，岂他药独不可制之乎？夫人参得附子则直前，无坚不破；
附
子得人参则功成，血脉不伤。至于他药，未尝不可兼投。然终不知人参与附子，实有水乳之
合也。
或问缪仲醇论附子之害，其言又可采否？噫。仲醇之心则仁矣，而论证尚未尽善也。如
言外寒
，脾阴不足，以致饮食无味，喜饮冷浆及鲜果，血虚腹痛，按之即止，火炎欲呕，或干霍乱
，或大疟寒热并盛，老人精绝，阳痿，少年纵欲伤精，阴精不守，精滑，脑漏，妇人血枯无
子，血枯经闭，肾虚小便余沥，梦寐纷纭，行履重滞，痹症，中风僵仆不语，中风口眼歪斜
，中风言语蹇涩，中风半身不遂，中风痰多神昏，阴症痈疽未溃，其三十一症，皆必须附子
，十补阴，三补阳，始能夺命奏功。仲醇一概戒人勿用，庸医执滞不通，坚信不用附子以回
阳，又何以生阴以续命乎？虽仲醇过于谨慎，与其乱用杀人于顷刻，不若烦用以听其自生。
然病实可生，任其悠忽，因循失救，而奄奄坐已，又行医之过也。铎所以将仲醇所忌七十二
症之中，摘其宜用附子者，表而出之，以亦其救病之延生，勿坐视听死也。
或问缪仲醇之过慎，未必非全生之道，吾子以其所忌者，摘出以交之，必自万一杀人，
过不
在子乎？嗟乎！仲醇之所慎者，正病所不必慎者也。岂独不必慎，实症之不可慎者也。宜慎
而
不慎，与不可慎而又慎者，非至中之道也。
仙茅，味道辛，性质温，有毒性。归入肾经。治疗心腹部的冷气，治愈腰膝部位的拘挛痹痛，导致无法行走的症状；治疗男子因虚损劳伤引起的病症，以及老人尿失禁、无子嗣的情况；能够滋补肌肤，使耳目明亮，辅助阳气之道，增长精神，长期服用可以通神益智、增强记忆力。误服仙茅中毒的人，含服一片大黄即可解毒，不需要使用过多的大黄。这种药现代人最喜欢使用，因为《本草》记载它能辅助阳气。然而它实际上完全不能兴起阳气。大概是因为仙茅性质温和，且归入肾经，并且能去除阴寒之气，从而止住老人的尿失禁，如果不是辅助阳气，怎么能做到这样呢？而你却认为它完全不能兴起阳气，是因为仙茅的药性与附子、肉桂截然不同。仙茅虽然温热，但没有升发张扬的气机，擅长闭藏精气，而短于动火。闭藏精气，则精气不易泄漏；止住尿失禁，则气机不向外耗散，没有子嗣的人自然会有子嗣，并不是因为它能兴起阳气、善于作战，才始能生育子女。我辨明其中的缘故，是让世上想要闭藏精气的人，用它来固守精气。而对于元阳衰败疲惫，阳痿软弱而不能勃起的人，不可被辅助阳气的说法所迷惑，错误地误用仙茅，进而归咎于药物不灵验。
有人问：仙茅闭藏精气而不能兴起阳气，这个说法很新颖，然而你论述得很详尽，难道也是经过尝试后才知道的吗？回答说：我论述的是它的药性罢了，何必一定要尝试呢？不过我也曾经亲自尝试过。我平时的阳气，也没有特别衰弱，服用仙茅半年，身体情况完全和以前一样。我没有领悟其中的意旨，后来遇到岐天师指点，才恍然大悟感到自愧不如。仙茅闭藏精气而不兴起阳气，确实是亲身尝试而有验证的，这是阅历之语，不是猜测之辞。
附子，味道辛，性质温、大热，性浮，属于阳中之阳，有大毒性。大的称为天雄，小的称为川乌。天雄过热，不能使用；川乌热性太劣，不如附子适合使用。炮制方法：每个附子用甘草五钱，煮水一碗，将附子泡透，不必去皮、脐、尖，正要用全株为佳。选取甘草这味至仁厚的药，用来制约附子的不仁厚（毒烈）。附子无经不达，走窜而不守静，只能作为臣药或使药，佐助群药通行各条经脉，以斩关夺门（比喻破除阻滞），而不能依靠它来安抚镇静。它能去除四肢厥冷，祛除五脏阴寒，温暖脚膝并强健筋骨，温补脾胃并通达腰肾，真是夺命的灵丹，回春的仙药啊。使用得当，立刻就能起死回生；使用不当，片刻就会死亡。畏惧它而不敢使用，犹豫观望，必定会有错失救治的悲哀；轻视它而敢于使用，鲁莽狂妄，又有误杀的叹息。关键在于人要辨别寒热阴阳，谨慎地使用它。夫附子是阳药，以阳治阴，最为适宜；以阳治阳，自然相恶。阳主热，阴主寒，如同冰炭不相容，怎么会出错呢？只有阳似阴，而阴似阳，以假乱真，往往杀人，比刀杀还惨。我现在辨明阴阳寒热的区别，让使用附子的人都能救人，而不再误杀人。
阴热之症，是肾水消耗，而肾中守持之火不能下安于肾宫，上冲到咽喉口齿之间，其舌苔一定是滑润的。按理应该大补真阴之水，水旺了而火又不回归。然而，单纯补水，火虽然稍微衰减，终究不能一时骤降，少量使用附子，同肉桂加入六味地黄汤中，大剂量冷服，下喉后火即消除，回归到下肾内，上焦的热，全部化为清凉了，这是用附子治疗阴热症的秘法。
阳热之症，是心火旺盛，移热到胃中，发狂大叫，或者神志不清胡言乱语，手足反而呈现冰冷，而胸前膈上多有发斑的，一定大渴呼水，而舌苔或者红、或者黄、或者灰黑，一定干燥而粗糙，开裂成绫纹状。按理不必从治，竟直接用三黄石膏汤直治其火，火泻了而肾水不干，可避免亡阳的祸患。然而火过于旺盛，用大寒的药，恐怕导致格拒（排斥），尚不如加附子一片，重一分，加入三黄石膏汤中，以火从火，引导苦寒的药下行，而不相违背，热性过了而寒性发作，自然能在顷刻间泻去火邪了，这是用附子治疗阳热症的秘法。
阴寒之病，是寒邪直接中于肾经，这是伤寒的卒病。肾受到寒邪，命门之火自然不能藏匿，想要遁出躯壳之外，而寒邪乘胜追逐，侵犯脾则腹痛，侵犯肝则胁痛，侵犯心则心痛，或者手足青紫的有这种情况，或者筋骨拘挛的有这种情况，或者呕吐或者腹泻，甚至身体青紫、阴囊收缩，生死悬于反掌之间，真是危急存亡的时刻。探察其舌苔一定是滑润的，急用附子二三钱、人参五六钱或一二两、白术一二两、干姜二钱，同煎服用，下喉后阳气回复寒气消散了，这就是阴寒症用附子的方法。
阳寒之病，平素损伤了脾胃之气，不能在周身荣卫，以致风寒一犯，就发热恶寒，喜欢躺卧而不喜欢说话，喜欢安静而不喜欢纷扰，给他饮食，又能知道味道，身体虽然热，但神思很清醒，脉象一定细微，气息一定很怯弱，这是阳气不足，而邪气乘虚而入，其舌虽然干但一定滑润，急用理中汤加附子一钱治疗它，正气充足而邪气自然消散了。甘温除大热，说的不就是这个吗？阳寒症用附子的方法，又如此。懂得这四种治法，触类旁通，断然不会有误用的失误了。
有人问：附子有毒，使用得当，可以一服药就回阳，有毒的药本来就是这样吗？附子的妙处，正是利用它的毒性。斩关而入，夺门而进，不凭借它刚烈的毒瓦斯，怎么能祛除阴寒的毒呢？天下最热的，是阳毒；最冷的，是阴毒。人感受阴寒之气，往往导致手足一身青黑而死，正是感受阴毒很深。阴毒非阳毒不能祛除，而阳毒非附子不胜任。以毒治毒，而毒不留存，所以一祛除寒邪而阳气回复，这是附子正有毒以祛毒，不是无毒以治有毒。
有人问：附子放入三生饮中，救中风垂危绝症，为什么一定要生用呢？这实在有妙义存在。夫中风，不是风，是气虚而痰堵塞在心中，所以一时卒中，有像风吹倒的样子。如果按风症治疗，十死九活不了。必须用人参为君药，附子为佐药，加上生南星、生半夏、生姜，然后才能开通心窍，祛除痰涎，使死者重生。世人都认为是人参的功效。如果不是附子，怎么能推荡痰浊而奠宁呢？然而此时如果用熟附子，正恐怕未必有神效，往往有缓不济事的担忧。必须生用的，是取它无所牵制，就能斩关突围而入，自然能在须臾间攻破劲敌。药物中使用霸气而成功的，这类就是吧。
有人问：参附汤治疗阴寒直中，又救一时的垂危绝症，为什么又不用生附子呢？夫熟附子治疗直中阴寒，是想救回阳气。阴寒进入至阴的肾中，驱逐命门之火出外，而不敢归宫，真火越出，而阴寒乘势驱逐，元阳几乎没有可藏之地，此时如果不大量用人参，则元阳飞出于躯壳之外了。然而单纯用人参，不佐以附子，则阴寒大盛，人参怎么能直入腹中，在无何有之乡生出元阳？既然用了附子，而不制约它猛悍的气性，则过度驱逐阴寒，一往无前不顾后果，未必能乘胜长驱，随着阴寒尽数散热，必致元阳无可归依，而气又突然亡失。所以必须用熟的，同入于人参之中。既能驱逐阴寒外出，又引导元阳内归，得到附子的益处，去掉附子的损害，所谓大勇而成其大仁。
有人问：附子是阳药，应该随阳药一起祛除，为什么偏用它在阴药中来滋补呢？盖附子是大热之品，入于阳药之中的，是用来救一时的急症；入于阴药之中的，是用来治久滞之症。凡阳虚之症，宜用阳药救之，故附子可多用以出奇制胜；阴虚之病，宜用阳药养之（此处原文逻辑稍显矛盾，意指在滋阴基础上少佐阳药），故附子可少用以济胜。阳得阴而功效迅速，阴得阳而功效迟缓，各有妙用。
有人怀疑附子的功效，有以少而成功的，又是什么缘故？夫急症宜多，缓症宜少，这是使用附子的法则。但古人有用附子只一片而成功的，并非凭借它斩关夺门的神力。大概附子无经不达，得到它的“气”而不必得到它的“味”，进入经脉而不必留在脏腑，反而能补气以生气，助补血而生血，而不至于有增火增热的忧虑，反而成就健土关胃的效果。
有人问：附子为什么必须得到人参才能成功，难道其他药单独不可以制约它吗？夫人参得到附子则直前，无坚不破；附子得到人参则功成，血脉不伤。至于其他药，未尝不可以兼投。然而终究不知道人参与附子，实有水乳交融的结合。
有人问：缪仲醇论述附子的害处，他的话又可以采纳吗？噫。仲醇的心肠是仁慈的，而论证尚未尽善。如说外寒，脾阴不足，导致饮食无味，喜欢喝冷饮及鲜果，血虚腹痛，按之即止，火炎欲呕，或者干霍乱，或者大疟寒热并盛，老人精绝，阳痿，少年纵欲伤精，阴精不守，精滑，脑漏，妇人血枯无子，血枯经闭，肾虚小便余沥，梦寐纷纭，行履重滞，痹症，中风僵仆不语，中风口眼歪斜，中风言语蹇涩，中风半身不遂，中风痰多神昏，阴症痈疽未溃，这三十一症，都必须用附子，十补阴，三补阳，始能夺命奏功。仲醇一概告诫人不要用，庸医执滞不通，坚信不用附子来回阳，又怎么能生阴以续命呢？虽然仲醇过于谨慎，与其乱用杀人于顷刻，不如烦用听其自然生存。然而病确实可生，任由其疏忽，因循失救，而奄奄一息坐以待毙，又是行医的过错。陈士铎所以将仲醇所忌七十二症之中，摘出其中宜用附子的，表而出之，以延长病人的生命，不要坐视死亡。
有人问：缪仲醇的过分谨慎，未必不是保全生命的道理，我把他所忌讳的摘出来交给你，万一杀人，过错不在你吗？唉！仲醇所谨慎的，正是病症所不必谨慎的。岂独不必谨慎，实在是病症不可谨慎的。应当谨慎而不谨慎，与不可谨慎而又谨慎的，都不是至中的道理。
Curculiginis Rhizoma (Xian Mao), pungent in flavor, warm in nature, toxic. Enters the Kidney meridian. Treats cold qi in the heart and abdomen; cures spasmodic bi-syndrome of the waist and knees, rendering walking impossible; treats deficiency and exhaustion injuries in men; treats urinary incontinence in the elderly; aids conception for those without offspring; nourishes the skin and muscles; brightens the ears and eyes; assists the Dao of Yang; enhances spirit; long-term use promotes spiritual clarity and strong memory. Those poisoned by Curculiginis Rhizoma can be detoxified by holding a slice of Rheum Radix et Rhizoma (Dahuang, 大黄) in the mouth; excessive use of Rheum is unnecessary. This herb is currently most favored by people because the *Bencao* records its ability to assist Yang. However, it completely fails to arouse Yang. Presumably, because Curculiginis Rhizoma is warm and enters the Kidney, and can dispel Yin-cold qi to stop urinary incontinence in the elderly; if it did not assist Yang, how could it achieve this? Your claim that it entirely fails to arouse Yang stems from the fact that the nature of Curculiginis Rhizoma is radically different from that of Aconiti Lateralis Radix Praeparata (Fuzi, 附子) and Cinnamomi Cortex (Rougui, 肉桂). Although Curculiginis Rhizoma is warm, it lacks an ascending and expansive Qi; it excels at consolidating Essence but is deficient in stirring Fire. Consolidating Essence means Essence does not easily leak; stopping urinary incontinence means Qi does not scatter outward. Thus, those without offspring naturally acquire offspring, not because it arouses Yang and fights well, but to enable reproduction. I have clarified this reason so that those wishing to consolidate their Essence may use it to firmly guard their Jing. For those with exhausted Yuan-Yang, impotence, and failure to erect, one must not be confused by the theory of assisting Yang and mistakenly use Curculiginis Rhizoma, then blame the drug for ineffectiveness.
Someone asked: "Curculiginis Rhizoma consolidates Essence but does not arouse Yang; this theory is novel, yet your discussion is very detailed. Did you verify this through trial?" I replied: "I am discussing its properties; why must there be trial? Yet I have indeed tried it myself. My Yang was not particularly weak normally. After taking Curculiginis Rhizoma for half a year, my condition remained exactly as before. I failed to grasp its meaning until Teacher Qi guided me, whereupon I felt enlightened and ashamed. That Curculiginis Rhizoma consolidates Essence without arousing Yang is verified by personal experience; these are words of experience, not speculation."
Aconiti Lateralis Radix Praeparata (Fuzi, 附子), pungent in flavor, warm and extremely hot in nature, floating, Yang within Yang, highly toxic. The large ones are called Tianxiong, the small ones Chuanwu. Tianxiong is too hot and should not be used; Chuanwu's heat is inferior, making it less suitable than Fuzi. Processing method: For each piece, use 5 qian of Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), boil in one bowl of water, soak the Fuzi thoroughly. There is no need to remove the skin, umbilicus, or tip; using the whole piece is best. Select Gancao, the most benevolent herb, to restrain the non-benevolent (toxicity) of Fuzi. Fuzi penetrates all meridians, moves freely without staying put, and can only serve as a minister or envoy herb, assisting other drugs to circulate through all meridians, breaking through barriers like cutting gates and seizing doors, but cannot be relied upon for calming and sedating. It removes cold limbs and reversal cold, dispels Yin-cold in the five Zang organs, warms the feet and knees while strengthening sinews and bones, warms the Spleen and Stomach while unblocking the waist and Kidneys. It is truly a miraculous elixir for saving lives and a fairy medicine for restoring youth. Used correctly, one can instantly regain life; used incorrectly, death can occur in a moment. Fearing it and daring not to use it, leading to hesitation and observation, inevitably results in the sorrow of missed rescue; despising it and daring to use it rashly leads to the sigh of mistaken killing. The key lies in distinguishing cold, heat, Yin, and Yang, and using it cautiously. Fuzi is a Yang drug; treating Yin with Yang is most appropriate, while treating Yang with Yang is naturally repulsive. Yang governs heat, Yin governs cold, like ice and charcoal, how could errors arise? Only when Yang resembles Yin, and Yin resembles Yang, deceiving reality with falsehood, do deaths often occur, more tragic than knife wounds. I now distinguish the differences between Yin/Yang and cold/heat, so that users of Fuzi may save lives and no longer kill by mistake.
Yin-Heat syndrome is caused by depletion of Kidney Water, causing the Fire guarding the Kidney to fail to settle in the Kidney palace, rushing up to the throat and teeth. The tongue coating will necessarily be slippery. Logically, one should greatly tonify True Yin Water; when Water is abundant, Fire returns. However, merely tonifying Water, although Fire slightly declines, cannot drop suddenly in an instant. Use a small amount of Fuzi, combined with Cinnamomi Cortex (Rougui, 肉桂) into Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), taken in large doses cold. Upon swallowing, Fire dissipates immediately, returning to the lower Kidney, and heat in the Upper Jiao transforms into coolness. This is the secret method of using Fuzi to treat Yin-Heat.
Yang-Heat syndrome is caused by excess Heart Fire transferring to the Stomach, manifesting as madness and loud shouting, or loss of spirit with delirious speech. Hands and feet may appear cold, and macules often appear on the chest and diaphragm. There is extreme thirst calling for water, and the tongue coating may be red, yellow, or gray-black, necessarily dry, rough, and cracked like silk patterns. Logically, one should not follow the counter-treatment method but directly use Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) to clear Fire. If Fire is drained and Kidney Water is not dried, one can avoid the disaster of Yang collapse. However, if Fire is excessively vigorous, using extremely cold herbs may cause rejection (geju). It is better to add one piece of Fuzi, increasing the dose slightly, into Sanhuang Shigao Tang. Using Fire to follow Fire guides the bitter-cold herbs downward without opposition. Once the hot nature passes and the cold nature emerges, Fire pathogenic factors are drained instantly. This is the secret method of using Fuzi to treat Yang-Heat.
Yin-Cold disease occurs when Cold pathogenic factors strike directly into the Kidney meridian, which is an acute stage of Shanghan (Cold Damage). When the Kidney receives Cold pathogenic factors, the Fire of the Gate of Vitality cannot hide and attempts to escape the body shell. Cold chases victoriously; invading the Spleen causes abdominal pain, invading the Liver causes hypochondriac pain, invading the Heart causes heart pain. Hands and feet may turn blue; sinews and bones may contract. Vomiting or diarrhea may occur. In severe cases, the body turns blue and the scrotum retracts. Life and death hang in the balance of turning a palm over; this is truly a critical moment of survival or extinction. Examining the tongue reveals a slippery coating. Urgently use 2-3 qian of Fuzi, 5-6 qian or 1-2 liang of Ginseng Radix et Rhizoma (Renshen, 人参), 1-2 liang of Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), and 2 qian of Zingiberis Rhizoma (Ganjiang, 干姜), decocted together and taken orally. Upon swallowing, Yang returns and Cold disperses. This is the method of using Fuzi for Yin-Cold.
Yang-Cold disease arises from chronic damage to Spleen and Stomach Qi, failing to nourish and defend the body, so that Wind-Cold invasion causes fever and aversion to cold. The patient prefers lying down and dislikes speaking, prefers quiet and dislikes disturbance. They retain taste for food. Although the body is hot, mental clarity remains high. The pulse is necessarily fine and minute, and Qi is very timid. This indicates insufficient Yang allowing pathogenic factors to invade. The tongue, though dry, is necessarily slippery. Urgently treat with Lizhong Tang (Regulate the Middle Decoction) plus 1 qian of Fuzi. When Righteous Qi is sufficient, pathogenic factors disperse naturally. "Sweet and warm eliminates great heat"—does this not refer to this? This is the method of using Fuzi for Yang-Cold. Understanding these four treatments allows for analogical reasoning, ensuring no misuse.
Someone asked: "Fuzi is toxic. When used correctly, it can restore Yang in one dose. Is it true that toxic drugs work this way?" The wonder of Fuzi lies precisely in its toxicity. Breaking through gates and seizing doors, without relying on its fierce toxic vapor, how can it dispel the toxicity of Yin-Cold? The hottest thing in the world is Yang-Toxin; the coldest is Yin-Toxin. Humans infected with Yin-Cold qi often die with blue-black hands, feet, and body, indicating deep infection with Yin-Toxin. Yin-Toxin cannot be dispelled without Yang-Toxin, and Yang-Toxin is ineffective unless handled by Fuzi. Treating toxin with toxin leaves no residue; thus, once Cold is dispelled, Yang returns. Fuzi uses its toxicity to dispel toxicity, not non-toxicity to treat toxicity.
Someone asked: "When Fuzi is added to Sansheng Yin (Three-Life Decoction) to save critical stroke patients, why must it be used raw?" This contains profound meaning. Stroke is not Wind; it is Qi deficiency with Phlegm blocking the Heart, causing sudden collapse resembling being blown down by wind. If treated as Wind disease, nine out of ten will die. One must use Ginseng as the Sovereign herb, Fuzi as the Assistant herb, plus raw Arisaema Cum Bile (Sheng Nananxing, 生南星), raw Pinelliae Rhizoma (Sheng Banxia, 生半夏), and fresh Zingiberis Rhizoma (Sheng Jiang, 生姜), to open the Heart orifices and expel Phlegm, bringing the dying back to life. People attribute this to Ginseng. Without Fuzi, how could turbidity be pushed away and stability restored? However, using processed Fuzi at this time might lack divine efficacy, often suffering from slowness failing to meet emergencies. Raw usage is necessary to take advantage of its lack of restraint, allowing it to break through barriers and突围 (break out), defeating strong enemies instantly. Drugs achieving success through 'domineering Qi' are of this type.
Someone asked: "Canfu Tang (Ginseng and Aconite Decoction) treats direct invasion of Yin-Cold and saves critical conditions, yet why is raw Fuzi not used?" Processed Fuzi treats direct invasion of Yin-Cold to restore Yang. Yin-Cold enters the ultimate Yin Kidney, driving the Fire of the Gate of Vitality out, preventing it from returning to the palace. True Fire escapes, and Yin-Cold drives it further. Yuan-Yang has almost nowhere to hide. At this moment, if large amounts of Ginseng are not used, Yuan-Yang will fly out of the body shell. However, using only Ginseng without Fuzi means Yin-Cold is overwhelmingly strong, and Ginseng cannot enter the abdomen directly to generate Yuan-Yang in the void. Since Fuzi is used, its fierce nature must be restrained; otherwise, it will chase Yin-Cold relentlessly, possibly driving off Heat but leaving Yuan-Yang with no return path, causing sudden Qi collapse. Therefore, processed Fuzi must be used together with Ginseng. It can drive Yin-Cold outward and guide Yuan-Yang inward, gaining the benefits of Fuzi while removing its harms—great courage achieving great benevolence.
Someone asked: "Fuzi is a Yang drug, suited for removal with Yang drugs. Why is it biasedly used in Yin drugs for tonification?" Fuzi is a highly hot substance. When entered into Yang drugs, it saves urgent situations; when entered into Yin drugs, it treats chronic stagnation. For Yang deficiency syndromes, Yang drugs should be used to save them, so Fuzi can be used in larger amounts to achieve surprise effects. For Yin deficiency diseases, Yang drugs should be used to nourish (support Yin), so Fuzi can be used in small amounts to aid victory. Yang gains speed with Yin; Yin gains effect slowly with Yang. Each has its subtle utility.
Some doubt the efficacy of Fuzi, asking why it sometimes succeeds with small doses? Urgent conditions require large doses; chronic conditions require small doses. This is the rule for using Fuzi. However, ancients succeeded with just one piece of Fuzi, not relying on its barrier-breaking power. Perhaps Fuzi penetrates all meridians; obtaining its Qi without needing its Flavor, entering meridians without staying in Zang organs, it can tonify Qi to generate Qi, assist Blood to generate Blood, avoiding increased Fire and Heat, instead achieving the effect of strengthening Earth and regulating the Stomach.
Someone asked: "Why must Fuzi rely on Ginseng to succeed? Can't other drugs control it?" Ginseng with Fuzi advances forward, breaking everything; Fuzi with Ginseng achieves success without damaging blood vessels. Other drugs can certainly be combined. However, the combination of Ginseng and Fuzi is truly like milk and water blending perfectly.
Someone asked: "Miao Zhongchun discusses the harms of Fuzi. Are his words acceptable?" Alas. Miao's heart is benevolent, but his argument is not fully sound. He states that for exterior Cold due to Spleen Yin deficiency, causing loss of appetite, preference for cold drinks and fresh fruits, blood-deficiency abdominal pain relieved by pressure, Fire flaring causing nausea, dry Huoluan, severe malaria with alternating chills and fever, elderly essence exhaustion, impotence, young men injuring essence through lust, insecure Yin Essence, seminal emission, nasal discharge, women with blood dryness and infertility, amenorrhea due to blood dryness, Kidney deficiency with dribbling urine, chaotic dreams, heavy gait, Bi-syndrome, stroke with rigidity and silence, facial deviation, slurred speech, hemiplegia, excessive phlegm and coma in stroke, and un-ulcerated Yin-type carbuncles—these 31 syndromes all require Fuzi. Ten parts tonifying Yin, three parts tonifying Yang, to save lives. Miao universally warns against using it. Quack doctors are rigid and inflexible, firmly believing not to use Fuzi to restore Yang. How then can they generate Yin to prolong life? Although Miao is overly cautious, rather than using indiscriminately and killing instantly, it is better to use it frequently and let nature take its course. However, if the disease is curable, neglecting it due to carelessness and missing the rescue, letting the patient sit and die, is also a fault of the physician. Chen Shiduo therefore extracts from Miao's 72 contraindicated syndromes those suitable for Fuzi, highlighting them to extend patients' lives, rather than sitting idly watching them die.
Someone asked: "Miao's excessive caution may well be a way to preserve life. By extracting what he forbids, if you cause death by mistake, is the fault not yours?" Alas! What Miao cautions against is precisely what need not be cautioned against. Not only need not be cautioned, but actually must not be cautioned. Being cautious where caution is needed, and being cautious where caution is not needed, is not the doctrine of the Mean.