桔梗，味苦，气微温，阳中阴也，有小毒。入手足肺、胆二经。润胸膈，除上气壅闭，
清头
目，散表寒邪，祛胁下刺痛，通鼻中窒塞，治咽喉肿痛，消肺热有神，消肺痈殊效，能消恚
怒，真舟楫之需，引诸药上升，解小儿惊痫，提男子血气，为药中必用之品，而不可多用者
也。盖少用，则攻补之药，恃之上行以去病；多用，则攻补之药，借之上行而生殃。惟咽喉
疼痛，与甘草多用，可以立时解氛，余则戒多用也。
或问桔梗乃舟楫之需，毋论攻补之药，俱宜载之而上行矣，然亦有不能载之者，何故？
曰∶
桔梗之性上行，安有不能载之者乎。其不能载者，必用药之误也。夫桔梗上行之药，用下行
之药于攻补之中，则桔梗欲上而不能上，势必下行之药，欲下而不能下矣。余犹记在襄武先
辈徐叔岩，闻余论医，阴虚者宜用六味地黄汤，阳虚者宜用补中益气汤。徐君曰∶余正阴阳
两虚也。余劝其夜服地黄汤，日服补中益气汤，服旬日，而精神健旺矣。别二年复聚，惊其
精神不复似昔，问曾服前二汤否，徐君曰∶子以二汤治予病，得愈后，因客中无仆，不能朝
夕煎饮消息子之二方，而合为丸服，后气闭于胸膈之间，医者俱言二方之不可长服，予久谢
绝。今幸再晤，幸为我治之。予仍以前二方，令其朝夕分服，精神如旧。徐君曰∶何药经吾
子之手，而病即去也，非夫医而何？余曰∶非余之能，君自误耳。徐问故。余曰∶六味地黄
汤，补阴精之药，下降者也；补中益气汤，补阳气之药，上升者也。二汤分早晚服之，使两
不相妨，而两有益也。今君合而为一，则阳欲升，阴又欲降，彼此势均力敌，两相持，而两
无升降，所以饱闷于中焦，不上不下也。徐君谢曰∶医道之渊微也如此。夫桔梗与升麻、柴
胡，同是升举之味，而升麻、柴胡用之于六味汤丸之内，其不能升举如此，然则桔梗之不能
载药上行，又何独不然哉。正可比类而共观也。
或问桔梗散邪，而不耗正气，何以戒多用也？曰∶桔梗亦有多用而成功。少阴风邪，致
喉痛
如破者，多用之而邪散如响。是邪在上者，宜多用；而邪在下者，即不宜多用。
或问《古今录验方》中载桔梗治中蛊毒。下血如鸡肝片者血块石余
，服方寸匕，七日三服而愈，其信然乎？曰∶此失其治蛊之神方，止记其引导之味也。中蛊
必须消毒，下血必须生血，一定之理也。桔梗既非消毒之品，又非生血之药，乌能治蛊而止
血乎。盖当时必有神奇之丸，以酒调化，同桔梗汤送之奏功，而误传为桔梗，《古今录》遂
志之也。
或问桔梗不可多用，而吾子又谓可以多用，何言之相背也？曰∶邪在上者宜多，邪在下
者宜
少，余已先辨之，未尝相背也。虽然，用药贵得其宜，要在临症斟酌。有邪在上，多用桔梗
而转甚；有邪在下，少用桔梗而更危。盖邪有虚实之不同，而桔梗非多寡之可定，故实邪可
用桔梗，而虚邪断不可用桔梗也。（〔批〕寒邪者，实邪也，热邪者，虚邪也，又不可不知
。）
桔梗，味道苦，气微温，属于阳中阴的药材，有小毒。归入手经和足经的肺、胆二经。它能滋润胸膈，消除上焦气机壅塞闭阻，清利头目，疏散体表寒邪，祛除胁下的刺痛，通利鼻中的窒塞，治疗咽喉肿痛，消除肺热功效显著，消除肺痈效果极佳，能消除愤怒情绪，确实是像舟楫一样重要的药物，能引导其他药物向上运行，解除小儿惊风癫痫，提升男子的血气，是药方中必须使用的品种，但是不能多用的药材。因为少用，那么攻邪或补益的药物，依靠它向上运行以去除疾病；多用，那么攻邪或补益的药物，借助它向上运行反而产生祸殃。只有咽喉疼痛，与甘草大量同用，可以立即缓解症状，其余情况都告诫不要多用。
有人问：桔梗既然是舟楫之需，不论攻邪还是补益的药物，都应该载引它们上行，然而也有不能被载引的，这是什么原因？
回答说：桔梗的药性是上行的，怎么会有不能被载引的呢？那些不能被载引的，一定是用药的错误。凡是桔梗作为上行引导的药物，如果在攻补之中使用了下行的药物，那么桔梗想要上行却不能上行，势必导致下行的药物想要下行也不能下行了。我还记得在襄武的前辈徐叔岩，听我论述医学，说阴虚的人适宜用六味地黄汤，阳虚的人适宜用补中益气汤。徐君说：我正适合阴阳两虚的治疗。我劝他晚上服用地黄汤，白天服用补中益气汤，服用十天后，精神变得健旺了。分别两年后再次聚会，惊讶他的精神不再像从前那样好，问他是否服用了前两种汤剂，徐君说：您用这两种汤剂治疗我的病，痊愈后，因为客居他乡没有仆人，不能早晚煎煮饮用并斟酌调理您的两个方子，于是将它们合在一起做成丸药服用，后来气机闭塞在胸膈之间，医生们都说是这两个方子不可以长期服用，我就长久地停用了。现在有幸再见面，希望您为我治疗。我仍然用前两种方子，让他早晚分开服用，精神恢复如旧。徐君说：什么药经过您的手，病就消除了呢？如果不是医生又能怎样呢？我说：不是我的能力，是您自己误治罢了。徐君询问缘故。我说：六味地黄汤，是补阴精的药物，性质是下降的；补中益气汤，是补阳气的药物，性质是上升的。这两种汤剂分早晚服用，使两者互不干扰，而都有益处。现在您将它们合为一处，那么阳气想要升发，阴精又想要下降，彼此势力相当，互相牵制，而两者都没有升降，所以感到饱闷在中焦，不上不下。徐君谢罪说：医道的深奥微妙竟然到了这种地步。桔梗与升麻、柴胡，同样是升举性质的药物，而升麻、柴胡用在六味地黄汤丸之内，尚且不能升举如此，那么桔梗不能载药上行，又有什么单独例外的呢？正可以类比共同观察。
有人问：桔梗疏散邪气，而不耗损正气，为什么告诫不要多用呢？回答说：桔梗也有多用的时候并能成功。少阴经受风邪侵袭，导致喉咙痛得像破溃一样的，多用桔梗则邪气消散得很快。这是邪气在上部的，适宜多用；而邪气在下部的，就不适宜多用了。
有人问：《古今录验方》中记载桔梗治疗中蛊毒。出现下血像鸡肝片一样的血块一两多，服用方寸匕大小的量，七天服药三次而痊愈，这真的可信吗？回答说：这是丢失了治疗蛊毒的神奇方剂，只记录了引导性的药物。中蛊毒必须消毒，下血必须生血，这是确定的道理。桔梗既然不是消毒的物品，也不是生血的药物，怎么能治疗蛊毒并止血呢？大概当时一定有神奇的丸药，用酒调化，同桔梗汤一起送服才奏效，而误传为桔梗，《古今录》于是就记录下来了。
有人问：桔梗不可多用，而您又说可以多用，为什么言论相违背呢？回答说：邪气在上部适宜多用，邪气在下部适宜少用，我已经先辨析过了，并没有相违背。虽然这样，用药贵在得当，关键在于临症时斟酌。有邪气在上部，多用桔梗反而加重病情；有邪气在下部，少用桔梗反而更加危险。大概邪气有虚实不同，而桔梗的使用多少不能一概而定，所以实邪可以用桔梗，而虚邪绝对不可以用桔梗。（〔批注〕寒邪属于实邪，热邪属于虚邪，又不可不知道。）
Jiegeng (Platycodonis Radix), with a bitter taste and slightly warm nature, belongs to the category of "Yin within Yang" and possesses slight toxicity. It enters the Lung and Gallbladder meridians of both the Hand and Foot. It moistens the chest and diaphragm, eliminates upper jiao qi stagnation and obstruction, clears the head and eyes, disperses exterior cold pathogens, removes stabbing pain in the hypochondrium, unblocks nasal congestion, treats sore throat and swelling, effectively clears lung heat, and is remarkably effective in resolving lung abscesses. It can dissipate anger and resentment. It is truly an indispensable "vessel" (zhoudi) that guides other herbs upward, relieves pediatric convulsions and epilepsy, and lifts men's blood and qi. It is an essential herb in prescriptions but should not be used in large doses. For when used in small amounts, attacking or tonifying herbs rely on it to ascend and eliminate disease; when used in large amounts, attacking or tonifying herbs borrow its ascending property and may instead cause harm. Only in cases of sore throat, when used in large amounts together with Gancao (Licorice Root), can symptoms be relieved immediately. In other cases, one must caution against using it in large doses.
Someone asked: Since Jiegeng serves as a vessel to guide herbs upward, shouldn't all attacking and tonifying herbs be carried by it to ascend? Yet there are instances where it cannot carry them. Why is this?
I replied: The nature of Jiegeng is to ascend; how could there be anything it cannot carry? Those cases where it fails to carry are due to errors in prescription. When Jiegeng is intended to guide herbs upward, if descending herbs are included within an attacking or tonifying formula, Jiegeng will desire to ascend but fail to do so, and inevitably, the descending herbs will desire to descend but also fail. I still remember Xu Shuyan, a senior from Xiangwu, listening to my medical discussions. He stated that those with Yin deficiency should use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction), and those with Yang deficiency should use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Mr. Xu said, "I suffer from both Yin and Yang deficiency." I advised him to take Dihuang Tang at night and Buzhong Yiqi Tang during the day. After ten days, his spirit became vigorous. Two years later, we met again, and I was surprised that his spirit had declined. I asked if he had taken the previous two decoctions. Mr. Xu replied, "You treated my illness with these two decoctions, and after recovery, lacking servants while traveling, I could not prepare and drink them morning and evening as prescribed. Instead, I combined them into pills. Later, qi became obstructed in the chest and diaphragm. Physicians said these two formulas were unsuitable for long-term use, so I discontinued them. Now, fortunate to meet you again, please treat me." I once again prescribed the two formulas, instructing him to take them separately in the morning and evening. His spirit returned to normal. Mr. Xu said, "What medicine passes through your hands only to cure the illness? If not a physician, then what?" I said, "It is not my ability; you erred yourself." Mr. Xu asked for the reason. I said, "Liuwei Dihuang Tang is a Yin-nourishing formula with a descending nature; Buzhong Yiqi Tang is a Yang-tonifying formula with an ascending nature. Taking them separately at different times allows them to benefit without interfering. By combining them, the Yang desires to ascend while the Yin desires to descend. Their forces are equal, leading to a stalemate where neither ascends nor descends, resulting in fullness and distension in the middle jiao, stuck neither up nor down." Mr. Xu apologized, saying, "The profundity of medicine is indeed such. Jiegeng, along with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), shares the property of lifting. Yet even Shengma and Chaihu, when placed within Liuwei Dihuang Wan (Pills), fail to lift in this manner. Therefore, why would Jiegeng's inability to carry herbs upward be any different? They can be understood by analogy."
Someone asked: Jiegeng disperses pathogens without consuming healthy qi. Why caution against large doses?
I replied: There are occasions where large doses of Jiegeng succeed. In Shaoyin wind-pathogen invasion causing severe throat pain resembling rupture, large doses disperse the pathogen rapidly. Thus, for pathogens located in the upper body, large doses are appropriate; for pathogens in the lower body, large doses are inappropriate.
Someone asked: The *Gujin Luyuan Fang* records Jiegeng treating gu-poison (gu-toxin). It mentions hematochezia resembling chicken liver slices, with over one tael of blood clots. Taking one fangcun bi (a measure of volume) three times over seven days resulted in a cure. Is this credible?
I replied: This reflects a loss of the miraculous formula for treating gu-poison, recording only the guiding ingredient. Treating gu-poison requires detoxification; stopping bleeding requires generating blood—this is a fixed principle. Since Jiegeng is neither a detoxifying agent nor a blood-generating herb, how could it treat gu-poison and stop bleeding? Likely, there was a miraculous pill at that time, dissolved in wine and taken alongside Jiegeng Tang to achieve efficacy, but it was mistakenly attributed solely to Jiegeng, which led to its recording in the *Gujin Lu*.
Someone asked: You state Jiegeng should not be used in large doses, yet elsewhere you say it can be. Why the contradiction?
I replied: I have already clarified that large doses are suitable for pathogens in the upper body, while small doses are for the lower body; there is no contradiction. Nevertheless, the key lies in appropriateness and clinical judgment. There are cases where pathogens are in the upper body, yet large doses of Jiegeng worsen the condition; there are cases where pathogens are in the lower body, yet small doses of Jiegeng exacerbate the danger. Pathogens differ in excess (shi) and deficiency (xu). The dosage of Jiegeng cannot be determined merely by quantity. Excess pathogens may utilize Jiegeng, but deficiency pathogens absolutely must not use Jiegeng. ([Comment] Cold pathogens are excess patterns; heat pathogens are deficiency patterns. This must not be overlooked.)