（毒草）大泻里结水湿
芫花叶尖如柳。花紫似荆。
荛花苗
茎无刺。花细色黄。至其性味芫花辛苦而温。此则辛苦而寒。若论主治则芫花辛温。多有达
表行水之力。此则气寒。多有入里走泄之效。故书载能治利。（宗 曰。张仲景伤寒论以荛
花治利者。取其行水也。水去则利止。其意如此。今用之当斟酌。不可过使。恐不及也。须
有是症乃用之。）然要皆属破结逐水之品。未可分途而别视也。但药肆混收。亦可见效。以
其主治差同故耳。
（毒草）大泻经隧水湿
甘遂（专入脾胃肺肾膀胱）。皮赤。肉白味苦。气寒有毒。其性纯阴。故书皆载能于肾
经。及
或
隧道水气所结之处奔涌直决。使之尽从谷道而出。为下水湿第一要药。（元素曰。水结胸
中。非此不能除。故仲景大陷胸汤用之。但有毒。不可轻用。）喻嘉言曰。胃为水谷之海。
五脏六腑之源。脾不散胃之水精于肺。而病于中。肺不能通胃之水道于膀胱。而病于上。肾
不能司胃之关。时其蓄泄。而病于下。以致积水浸淫。无所底止。（水肿有风水皮水正水石
水黄汗五种。水郁于心。则心烦气短。卧不克安。水郁于肺。则虚满喘咳。水郁于肝。则胁
下痞满痛引少腹。水郁于脾。则四肢烦 体重不能衣。水郁于肾。则腹痛引背央央。腰髀痛
楚。水肿与气肿不同。水肿其色明润。其皮光薄。其肿不速。每自下而上。按肉如泥。肿有
分界。气则色苍黄。其皮不薄。其肿暴起。肿无分界。其胀或连胸胁。其痛或及脏腑。或倏
如浮肿。或肿自上及下。或通身尽肿。按则随起。但仲景所论水肿。多以外邪为主。而内伤
兼及。究之水为至阴。其本在肾。肾气既虚。则水无所主而妄行。使不温肾补脾。但以行气
利水。终非引水归肾之理。犹之土在雨中则为泥。必得和风暖日。则湿气转为阳和。自得万
物消长矣！）故凡因实邪。元气壮实。（必壮实方可用以甘遂。）而致隧道阻寒。见为水肿蛊
胀。疝瘕腹痛。无不仗此迅利以为开决水道之首。如仲景大陷胸汤之类。然非症属有余。只
因中气衰弱。小便不通。水液妄行。脾莫能制。误用泄之之品益虚其虚。水虽暂去。大命必
随。甘草书言与此相反。何以二物同用而功偏见。亦以甘行而下益急。（又按刘河间云。凡
水
肿服药未全消者。以甘遂末涂腹绕脐令满。内服甘草水。其肿便去。二物相反。而感应如
此。）非深于斯道者。未易语此。皮赤肉白。根作连珠重实者良。面裹。煨熟用。（用甘草荠
汁浸三日。其水如墨。以清为度。再面裹煨。）瓜蒂为使。恶远志。
【毒草】能强力泻除体内积聚的水湿
芫花的叶子尖端像柳叶。花朵紫色类似荆条花。
荛花的幼苗
茎干没有刺。花朵细小且颜色发黄。至于它们的药性，芫花味辛、苦，性温；而荛花则是味辛、苦，性寒。如果讨论主治功效，芫花因辛温之性，多有通达体表、行散水气的作用；而荛花因气寒，多有深入体内、泄下积滞的效果。所以医书记载它能治疗痢疾。（雷敩说：张仲景在《伤寒论》中用荛花治疗痢疾，是取其行水利尿的作用。水湿去除了，痢疾自然停止。他的用意如此。现在使用它应当仔细斟酌，不可过量使用，恐怕会有副作用。必须有相应的症状才可使用。）然而它们都属于攻破结聚、逐除水饮的药物，不可以分开来看待。只是药店里经常混淆收进这两种药，也能看到疗效，因为它们的主治功能大致相同的原因。
【毒草】能强力泻除经络隧道中的水湿
甘遂（专门进入脾、胃、肺、肾、膀胱经）。外皮红色，肉质白色，味道苦，气寒，有毒。它的性质纯阴，所以医书都记载它能于肾经以及或有的隧道水气凝结之处，如洪水奔涌般直接决堤，使水湿全部从肛门排出。它是下行水湿的第一要药。（李杲说：水邪结聚在胸中，不用此药不能消除。所以张仲景的大陷胸汤中使用它。但它有毒，不可轻易使用。）喻嘉言说：胃是水谷的海洋，五脏六腑的源头。脾不能将胃吸收的水谷精微散布到肺，就会在中焦生病；肺不能将胃的水道通调至膀胱，就会在上焦生病；肾不能主管胃的关隘，调节其蓄积与排泄，就会在下焦生病。从而导致积水浸淫漫延，没有止境。（水肿分为风水、皮水、正水、石水、黄汗五种。水邪郁结在心，则心烦气短，躺卧不安；水邪郁结在肺，则虚满喘咳；水邪郁结在肝，则胁下痞满疼痛牵引少腹；水邪郁结在脾，则四肢沉重烦扰，身体困重不能穿衣；水邪郁结在肾，则腹痛牵引背部，腰部和大腿疼痛难忍。水肿和气肿不同。水肿肤色明润，皮肤光薄，肿胀发生较慢，通常自下而上发展，按压肌肉像泥一样凹陷不起，肿胀有分界；气肿则面色苍黄，皮肤不薄，肿胀突然兴起，无分界，胀感有时连及胸胁，疼痛有时涉及脏腑，或者突然像浮肿，或者肿胀自上而下，或者全身尽肿，按压后随即弹起。但张仲景所论述的水肿，多以外邪为主，内伤兼及。究其根本，水为至阴之物，其本源在肾。肾气既然虚弱，则水无所主而妄行。如果不温补肾阳、补益脾气，仅仅使用行气利水的药物，终究不是引导水液回归肾脏的道理。这就好比泥土在雨中变成泥浆，必须得到和风暖日，湿气才能转为阳和之气，万物自然消长恢复！）所以凡是因实邪导致元气壮实的人（必须体质壮实才可以用来服用甘遂），而出现经络阻塞寒冷，表现为水肿、蛊胀、疝气瘕聚腹痛等症状，无不依靠这种迅利之药作为开通决泄水道的首选。如张仲景的大陷胸汤之类。然而如果不是实证有余，只是因为中气衰弱，小便不通，水液妄行，脾脏不能制约，误用泄下的药物会进一步损伤正气，水湿虽然暂时去除，但性命必随之丧失。甘草书中记载它与甘遂相反，为什么这两味药同用而功效偏向？也是因为甘遂行气向下作用更加急切。（另外按刘完素所说：凡水肿服药后未完全消退的，用甘遂末涂抹腹部环绕肚脐令其充满，内服甘草水，其肿便去。两药相反，而感应如此。）不是深谙此道的人，不容易与此谈论。外皮红色肉质白色，根部呈连珠状重叠坚实的为佳。用面粉包裹，煨熟后使用。（用甘草荠汁浸泡三天，水变黑，以水变清为度，再用面粉包裹煨制。）瓜蒂为使药。忌远志。
[Poisonous Herb] Strongly purges internal accumulation of water and dampness
The leaves of Genkwa Flos (Yuanhua) are pointed like willow leaves. The flowers are purple, resembling those of Vitex negundo (Jing).
Stem of Wikstroemia indica (Raohua)
The stem has no thorns. The flowers are fine and yellow in color. Regarding their properties, Yuanhua is acrid, bitter, and warm; whereas Raohua is acrid, bitter, and cold. In terms of therapeutic indications, due to its acrid-warm nature, Yuanhua has the power to reach the exterior and move water. Raohua, being cold in qi, has the effect of entering the interior and draining downward. Therefore, medical texts record that it can treat dysentery. (Lei Xiao stated: Zhang Zhongjing used Raohua to treat dysentery in *Shanghan Lun* (Treatise on Cold Damage), taking advantage of its ability to promote urination. Once the water is removed, the dysentery stops. This was his intent. When using it now, one must exercise caution and not overuse it, lest adverse effects occur. It should only be used when specific symptoms are present.) However, they all belong to substances that break up accumulations and drive out fluid retention, and should not be viewed separately. It is merely that pharmacies often mix them up, yet efficacy can still be seen, because their main therapeutic functions are similar.
[Poisonous Herb] Strongly purges water and dampness from the meridians and collaterals
Kansui Radix (Gansui) (Specifically enters the Spleen, Stomach, Lung, Kidney, and Bladder channels). The skin is red, the flesh is white, the taste is bitter, the qi is cold, and it is toxic. Its nature is purely yin. Therefore, medical texts all record that it can act upon the Kidney channel and places where water qi condenses in the tunnels or collaterals, surging forth and breaking through directly, causing all water-dampness to exit through the anus. It is the primary herb for descending water-dampness. (Li Gao stated: When water pathogen knots in the chest, this herb cannot be omitted. Hence, Zhang Zhongjing uses it in Da Xianxiong Tang (Major Intractable Chest Decoction). But it is toxic and should not be used lightly.) Yu Jiayan said: The Stomach is the sea of water and grain, the source of the five zang and six fu organs. If the Spleen fails to scatter the water essence from the Stomach to the Lung, disease arises in the middle; if the Lung fails to regulate the water pathway from the Stomach to the Bladder, disease arises in the upper; if the Kidney fails to manage the gate of the Stomach and control its storage and discharge, disease arises in the lower. This leads to accumulating water overflowing without limit. (Edema is divided into five types: Fengshui (Wind Edema), Pishui (Skin Edema), Zhengshui (True Water Edema), Shishui (Stone Water Edema), and Huanghan (Yellow Sweat). When water stagnates in the Heart, there is heart vexation, shortness of breath, and inability to lie comfortably. When water stagnates in the Lung, there is distension, wheezing, and coughing. When water stagnates in the Liver, there is fullness and pain under the ribs radiating to the lower abdomen. When water stagnates in the Spleen, there is heaviness and discomfort in the four limbs, making it difficult to wear clothes. When water stagnates in the Kidney, there is abdominal pain radiating to the back, and pain in the waist and thighs. Edema differs from Qi edema. Edema has a bright luster, thin and smooth skin, develops slowly, usually rising from below, feels like mud when pressed, and has clear boundaries. Qi edema has a sallow-yellow complexion, thick skin, rises suddenly, has no clear boundaries, distension may extend to the chest and hypochondrium, pain may involve the zang-fu, or appear suddenly like swelling, or rise from top to bottom, or cover the whole body, rebounding immediately after pressing. However, the edema discussed by Zhang Zhongjing is mostly caused by external pathogens with internal injury as a secondary factor. Ultimately, water is extreme yin, and its root lies in the Kidney. If Kidney qi is deficient, water lacks mastery and acts recklessly. If one does not warm the Kidney and tonify the Spleen, but merely uses herbs to move qi and promote urination, this is ultimately not the principle of guiding water back to the Kidney. It is like soil turning to mud in rain; only with gentle wind and warm sun can dampness transform into harmonious yang, allowing the natural cycle of growth and decline of all things to resume!) Therefore, whenever real pathogenic factors cause obstruction in the meridians due to cold, presenting as edema, gu-zhang (abdominal distension with visible veins), hernia, masses, and abdominal pain, in patients whose primal qi is robust (only those who are robust can use Kansui), one relies on this swift and potent herb as the first choice to open and drain the water pathways, such as in Zhang Zhongjing's Da Xianxiong Tang. However, if the condition is not excess but rather deficiency of Middle Qi, leading to urinary retention, reckless flow of fluids, and the Spleen's inability to control them, mistakenly using draining substances will further deplete the deficiency. Although water may temporarily leave, life will surely follow. Gancao (Licorice Root) texts state it is contrary to this herb. Why are they used together yet have biased effects? It is also because Gansui's action of moving downward is extremely urgent. (Additionally, Liu Hejian noted: For edema that has not fully resolved after medication, apply Kansui powder around the navel on the abdomen, and internally administer Gancao water. The edema then subsides. Though these two herbs are contrary, their interaction is thus.) Those not deeply versed in this way find it hard to discuss this. The best quality has red skin, white flesh, and roots that are bead-like and heavy. Wrap in flour and roast until cooked. (Soak in Gancao and Qiji juice for three days until the water turns black, then clear. Then wrap in flour and roast.) Digiti Melonis Fructus Seed (Gua Di) serves as the guide drug. Avoids Polygala tenuifolia (Yuan Zhi).