牛膝，味甘酸，气平，无毒。蜀产者佳。善走十二经络，宽筋骨，补中绝续，益阴壮阳，
除
腰膝酸疼，最能通尿管涩痛，引诸药下走。近人多用此药以治血症血瘕，绝无一效，亦未取
其功用而一思之也。夫血症血瘕，乃脾经之病。牛膝能走于经络之中，而不能走于肠腹之内
。况症瘕之结痰包血也。牛膝乃阴分之药，总能逐血而不能逐痰，此所以终岁而无效耳。至
于血晕血虚，儿枕作痛，尤不宜轻用，而近人用之，往往变生不测，亦未悟用牛膝之误也。
牛膝善走而不善守，产晕，血虚之极也，无血以养心，所以生晕。不用归芎以补血，反用牛
膝以走血，不更下之石乎。虽儿枕作痛，似乎有瘀血在腹，然而产后气血大亏，多有阴寒之
变，万一不是瘀血，而亦疑是儿枕之作痛，妄用牛膝以逐瘀，去生远矣。故必手按之而痛甚
者，始可少用牛膝于归芎之内。否则勿轻用耳。
或问牛膝最善堕胎，是非补剂，似产前均宜忌之。然前人间用于产前，而胎安然不损者
何
耶？夫牛膝岂堕胎药哉，乃补损药也。凡有断续者，尚可再接，岂未损者而反使之堕乎。古
人有用牛膝，合之麝香之中，外治以堕胎，取其性走之意。然而堕胎实麝香之故，而非牛膝
也。从未闻用牛膝内治而能堕胎者，但性既善走，在胎产亦不宜多用，而终不可谓牛膝是堕
胎之物也。
或问牛膝乃下部之药，用之以补两膝，往往未见功效，岂牛膝非健步之药乎。夫牛膝治
下部
，前人言之未可尽非，但膝之坚实，非牛膝之可能独健也。膝之所以健者，由于骨中之髓满
，
髓空斯足弱矣。故欲膝之健者，必须补髓，然而髓之所以满者，又由于肾水之足，肾水不足
，则骨中之髓何由满。故欲补骨中之髓者，又须补肾中之精也。虽牛膝亦补精之味，而终不
能大补其精，则单用牛膝以治肾虚之膝，又何易奏效哉。
或问牛膝健足之药，近人见下部之病辄用之，而取效甚少，得毋止可健膝而不可健足耶？
不
知健膝即所以健足，而健膝不可徒健夫膝也。凡足之所以能步者，气充之也。不补气以运足
，而徒用牛膝以健膝，膝且不能健，又何以健足哉。（〔批〕健足由于健膝，膝健由于气充
，至论也。）
或疑牛膝血分之药，入气分药中转易成功，其故何也？盖牛膝性善走，气亦善走，两相
合则
气无止遏，而血无凝滞，自然血易生而气易旺，又安有不成功者哉。
或疑牛膝乃补中续绝之圣药，何子反略而不谈？曰∶牛膝补中续绝，前人已言之矣，何
必再
论。惟是补中续绝，实别有说。盖牛膝走而不守，能行血于断续之间，而不能补血于断续之
内，必须用牛膝于补气补血之中，而后能收其续绝之效。此补中续绝之义，实前人所未及也
。
牛膝，味道甘酸，气性平和，没有毒性。四川出产的质量最好。它善于通行十二经络，舒展筋骨，接续断裂的筋骨，滋养阴液并壮阳，消除腰部和膝盖的酸痛，最能通利小便时的涩痛感，并能引导其他药物向下行走。近来的人多用此药治疗血症和血瘕（体内形成的肿块），却毫无效果，这是因为没有探究其功用而加以思考的缘故。那血症和血瘕，是脾经的疾病。牛膝能行走在经络之中，却不能进入肠腹之内。况且症瘕是由于痰浊包裹血液凝结而成的。牛膝属于阴分的药物，总能驱逐瘀血却不能驱逐痰浊，这就是为什么整年使用都无效的原因。至于血晕（产后因失血过多引起的头晕目眩）和血虚，以及儿枕痛（产后子宫收缩引起的腹痛），尤其不应当轻易使用，而近来的人使用它，往往导致病情发生不可预测的变化，这也是没有领悟到使用牛膝的错误所在。
牛膝善于走窜而不善于固守。血晕、血虚是极度亏虚的状态，没有血液来滋养心脏，所以产生晕厥。如果不使用当归、川芎来补血，反而使用牛膝来走散血液，这不是更加雪上加霜吗？虽然儿枕作痛，似乎腹部有瘀血，然而产后气血大亏，多有阴寒的变化，万一不是瘀血，而也怀疑是儿枕痛，妄用牛膝来逐瘀，那就离生路很远了。所以必须用手按压时疼痛剧烈的，才可以在当归、川芎中加入少量牛膝。否则不要轻易使用。
有人问：牛膝最善于堕胎，不是补益的药物，似乎产前都应该禁忌使用。然而以前的人用于产前，而胎儿安然无损的情况为什么呢？牛膝难道是堕胎药吗？它是补损（修复损伤）的药物。凡是能够接续断骨的地方，还可以再接续，难道没有受损的反面使它堕落吗？古人有用牛膝配合麝香，外用治疗以堕胎，是取其性善走窜的意思。然而堕胎实际上是麝香的作用，而不是牛膝。从未听说过用牛膝内服治疗能堕胎的，只是既然它的性质善于走窜，在胎产期间也不宜多用，但最终不能称牛膝是堕胎之物。
有人问：牛膝是下部的药物，用它来补益两膝，往往不见功效，难道牛膝不是健步的药物吗？治疗下部疾病，前人的说法并非完全错误，但膝盖的坚实有力，不是单靠牛膝就能做到的。膝盖之所以强健，是因为骨髓充盈；骨髓空虚则脚力软弱。所以想要膝盖强健，必须补髓。然而骨髓之所以充盈，又依赖于肾水的充足，肾水不足，那么骨头中的骨髓从哪里充盈呢？所以想要补益骨头中的骨髓，又必须补肾中的精液。虽然牛膝也是补精味的药物，但最终不能大量补精，那么单用牛膝来治疗肾虚导致的膝盖问题，又怎么容易见效呢？
有人问：牛膝是健足的药物，近来的人见到下部的病就用它，而取得的效果很少，莫非只能健膝而不能健足吗？不知道健膝就是用来健足的，而健膝不能仅仅让膝盖强壮。凡是可以行走的足，是靠气充盈推动的。不补气来运化双足，而只使用牛膝来健膝，膝盖尚且不能强健，又凭什么来健足呢？（批注：健足源于健膝，膝健源于气充，这是至理名言。）
有人怀疑：牛膝是血分的药物，加入气分药物中反而容易成功，这是什么原因呢？大概因为牛膝的性质善于走窜，气也善于走窜，两者结合则气没有阻滞，血没有凝滞，自然血容易生成而气容易旺盛，又怎么会不成功呢？
有人怀疑：牛膝是补中续绝（补益中气、接续断绝）的圣药，为什么你反而简略不谈？回答说：牛膝补中续绝，前人已经说过了，何必再论述。只是这“补中续绝”，实在另有说法。盖因牛膝走窜而不固守，能在断续之间行血，但不能在断续之内补血，必须在补气补血的方剂中使用牛膝，然后才能收到续绝的效果。这“补中续绝”的含义，实在是前人所未曾涉及到的。
Horseherb (Niuxi), with a sweet and sour taste, neutral in nature, and non-toxic. The variety produced in Shu (Sichuan) is of superior quality. It excels at circulating through the twelve meridians, relaxing the sinews and bones, reconnecting severed tissues, nourishing Yin, and strengthening Yang. It eliminates soreness and pain in the lower back and knees, effectively relieves painful and difficult urination, and guides other herbs downward. In recent times, many people use this herb to treat blood disorders and abdominal masses (Xue Zha), yet achieve no effect. This is because they have not pondered its specific functions. Blood disorders and abdominal masses are diseases of the Spleen Meridian. Horseherb can circulate within the meridians but cannot penetrate into the intestines and abdomen. Moreover, these masses are formed by phlegm encasing blood. Horseherb belongs to the Yin aspect; it can expel blood stasis but cannot expel phlegm. This is why it remains ineffective throughout the year. Regarding syncope due to blood loss (Xue Yun), blood deficiency, and postpartum uterine contraction pain (Erzhen Tong), it is especially inadvisable to use lightly. Recent practitioners who use it often cause unpredictable adverse changes, failing to realize the error in using Horseherb.
Horseherb excels at moving but lacks the ability to consolidate. Syncope and blood deficiency represent extreme depletion; without blood to nourish the Heart, syncope occurs. If one does not use Danggui (Angelicae Sinensis Radix) and Chuanxiong (Chuanxiong Rhizoma) to tonify blood, but instead uses Horseherb to move blood, this is adding insult to injury. Although postpartum uterine contraction pain seems to indicate blood stasis in the abdomen, postpartum conditions involve significant depletion of Qi and Blood and are prone to cold transformations. If it is not actually blood stasis, but mistakenly suspected as Erzhen Tong, the reckless use of Horseherb to dispel stasis will lead far from recovery. Therefore, only when severe pain upon palpation is present should a small amount of Horseherb be added to Danggui and Chuanxiong. Otherwise, do not use it lightly.
One might ask: Horseherb is known for inducing abortion and is not a tonic, so shouldn't it be contraindicated during pregnancy? Yet, historically, some used it during pregnancy without harming the fetus. Why? Is Horseherb an abortifacient? No, it is a herb for repairing damage. Where fractures can be reconnected, how could undamaged tissue be caused to abort? Ancient practitioners combined Horseherb with Moschus (Shexiang) for external application to induce abortion, utilizing its moving property. However, the abortifacient effect is due to Moschus, not Horseherb. There is no record of internal use of Horseherb causing abortion. Nevertheless, since its nature is moving, it should not be used excessively during pregnancy and childbirth, but it cannot be definitively classified as an abortifacient.
One might ask: Horseherb is a herb for the lower body; when used to tonify the knees, efficacy is often lacking. Is Horseherb not a herb for improving gait? The predecessors' statements on treating the lower body are not entirely incorrect, but knee strength cannot be achieved by Horseherb alone. Knee strength depends on full marrow in the bones; empty marrow leads to weak legs. To strengthen the knees, one must tonify the marrow. Marrow fullness relies on sufficient Kidney Water (Jing-Yin). If Kidney Water is insufficient, how can bone marrow fill? Thus, to tonify bone marrow, one must tonify Kidney Essence. Although Horseherb also tonifies essence, it cannot significantly tonify essence. Therefore, using Horseherb alone to treat knee issues due to Kidney deficiency is unlikely to yield quick results.
One might ask: Horseherb is a herb for strengthening the feet. Recently, people use it for lower body ailments with little success. Can it only strengthen the knees but not the feet? Strengthening the knees is the means to strengthen the feet, but strengthening the knees cannot be done merely by targeting the knee joint. Feet walk because Qi fills them. Without tonifying Qi to power the feet, and relying solely on Horseherb to strengthen the knees, the knees themselves may not even become strong, let alone the feet. (Commentary: Strong feet stem from strong knees; strong knees stem from abundant Qi. This is a profound truth.)
One might suspect: Horseherb acts on the Blood level; why does it succeed more easily when combined with Qi-level herbs? This is because Horseherb's nature is moving, and Qi also moves. When combined, Qi faces no obstruction, and Blood faces no stagnation. Naturally, Blood generates easily and Qi prospers, ensuring success.
One might suspect: Horseherb is a supreme herb for tonifying the center and reconnecting severances. Why did you omit discussing it? I reply: Predecessors have already discussed Horseherb's ability to tonify the center and reconnect severances; why repeat? However, the meaning of "tonifying the center and reconnecting severances" has a deeper explanation. Horseherb moves without consolidating; it can promote blood circulation between severed parts but cannot tonify blood within those parts. It must be used within formulas that tonify Qi and Blood to achieve the effect of reconnecting severances. This interpretation of "tonifying the center and reconnecting severances" was indeed overlooked by predecessors.