（山草）清上中二焦火热与湿
黄芩（专入心脾肺。兼入肝大肠膀胱）。书载味苦入心。又载入肺泻火。入脾除湿。入
大肠以
治肠 腹痛。（痢为肠 。凡痢有寒有热。痢属于热。则其形气坚强。脉必滑实有力。身则
畏
热喜冷。不欲衣被。渴则恣好冷水。愈凉愈快。随饮随消。小便热赤涩痛不堪。下痢纯红
。
痛则便硬拒按。并或头疼身热。筋骨酸痛。此其症之实者也。痢属于寒。则其形体薄弱。颜
色清白。脉虽紧数。而无力无神。脉即真弦。而中虚似实。血则微红不鲜。及或杂有紫红紫
白屋漏水形。所下之物。或浅黄色淡。不甚臭秽。痛则不实不坚。或喜揉按。或喜暖熨。
或胸腹如饥而不欲食。或胃脘作呕而多吞酸。或数至圊欲出不出。或口虽渴而不欲饮冷。饮
冷而不欲咽。此其症之虚者也。）入小肠膀胱以治淋闭。且治中焦实火。及邪在少阳胆经。
得此以为清理。一药而上下表里皆治。其功力之泛涉。殆有难为专主者耳。不知内火冲激。
外邪传入。皆能恣害。上如胸膈咽喉。下如肚腹二便。中如表里之所。阴阳之界。无不病症
悉形。以故腹痛肠 。（痢）寒热往来。（疟）黄胆淋闭。胸高气喘。痈疽疮疡。火嗽喉腥。
经
闭胎漏。口渴津枯。一皆湿之所淫。热之所侵。火之所胜。（提出湿热与火。为诸病之要。）
黄芩味苦性寒。枯而大者轻飘上升以清肺。肺清则痰自理矣。（汪昂曰。痰因火动。当先
降火。）实而细者沉重下降以利便。便利则肠 自去。酒炒则膈热可除。而肝胆火熄。生用
则实热堪投。而腹痛斯愈。（时珍曰。仲景治少阳症小柴胡汤。太阳少阳合病下痢黄芩汤。
少阳症下后心下满而不痛泻心汤并用之。盖黄芩味苦气寒。色黄而绿。泻心火而除脾湿。俾
金不受胃火上刑。故能救肺。少阳之症。虽曰病在半表半里。为胸胁痞满。实兼心肺上焦之
邪。心烦喜呕。默默不欲饮食。又兼脾胃中焦之症。故用黄芩以治手足少阳相火。黄芩亦少
阳本经药也。杨士瀛直指方云。柴胡退热。不及黄芩。盖亦不知柴胡之退热。乃苦以发之。
散火之标也。黄芩之退热。乃寒能胜热。折火之本也。）且得白术砂仁以安胎。得浓朴黄连
以除腹痛。得芍药以治痢。得柴胡以治寒热往来。此虽合上与下。表里皆治。而究止为上中
二焦泻火除热与湿之味矣。（东垣治肺热。身如火燎。烦燥引饮而昼盛者。宜一味黄芩汤以
泻肺经气分之火。方用黄芩一两。）但肺虚腹痛属寒者切忌。（时珍曰。肺虚不宜者。苦寒伤
脾胃。损其母也。）黄明者良。中虚者为枯芩。即片芩。内实者名条芩。即子芩。上行酒炒
。泻肝胆火。猪胆汁炒。山药龙骨为使。畏丹皮丹砂。
黄芩（主要归入心、脾、肺经，兼入肝、大肠、膀胱经）。医书记载其味苦入心经。又记载其入肺经以泻火，入脾经以除湿，入大肠经以治疗肠中腹痛。（痢疾即肠中腹痛。凡痢疾有寒证和热证之分。若痢疾属于热证，则患者形体气色坚强，脉象必定滑实有力，身体畏热喜冷，不喜欢衣被覆盖，口渴时大量饮用冷水，越凉越觉爽快，随饮随消，小便灼热赤涩疼痛难忍，下痢纯红色，腹痛且大便干硬拒按，或者伴有头痛身热、筋骨酸痛。这是痢疾实证的表现。若痢疾属于寒证，则患者形体薄弱，面色清白，脉象虽然紧数，但无力无神，脉象即使呈现真弦脉，也是中气虚弱而看似实证，血色微红不鲜亮，或者夹杂紫红、紫白如屋漏水样的颜色，所下的粪便，或者浅黄色淡，气味不甚臭秽，腹痛但不实不坚，或者喜欢揉按，或者喜欢热敷，或者胸腹感觉像饥饿一样却不想吃东西，或者胃脘作呕且多吞酸水，或者多次想上厕所却欲出不出，或者口虽渴却不想要喝冷水，喝了冷水也不愿咽下。这是痢疾虚证的表现。）入小肠和膀胱经以治疗淋证和小便不通。并且能治疗中焦的实火，以及邪气在少阳胆经的情况。得到黄芩作为清理之药，一药能上下表里皆治。其功效广泛涉猎，几乎难以指定单一主治。不知道内火冲激，外邪传入，都能肆意为害。上至胸膈咽喉，下至肚腹二便，中至表里之间、阴阳交界之处，无不病症显现。因此出现腹痛肠中痢疾、寒热往来（疟疾）、黄疸、淋证小便不通、胸高气喘、痈疽疮疡、火咳喉腥、闭经胎漏、口渴津液枯竭等症，全都是湿邪淫溢、热邪侵袭、火邪亢盛所致。（提出湿热与火，是各种疾病的关键。）黄芩味苦性寒，枯老粗大的部分轻飘上升以清肺热，肺热清则痰自然理顺。（汪昂说：痰因火动，应当先降火。）坚实细小的部分沉重下降以利小便，小便通利则肠中痢疾自然去除。酒炒后则可消除膈部热邪，使肝胆之火熄灭；生用则可投用于实热证，腹痛因而痊愈。（李时珍说：张仲景治疗少阳证用小柴胡汤，太阳少阳合病下痢用黄芩汤，少阳证下后心下满而不痛用泻心汤，都使用了黄芩。大概黄芩味苦气寒，色黄而绿，能泻心火而除脾湿，使肺金不受胃火上刑，所以能救肺。少阳证，虽说病在半表半里，表现为胸胁痞满，实则兼有心肺上焦之邪，心烦喜呕，默默不欲饮食，又兼有脾胃中焦之症，所以用黄芩来治疗手足少阳相火。黄芩也是少阳本经的药物。杨士瀛《直指方》说：柴胡退热，不如黄芩。这大概是不知柴胡退热，乃是苦味发散之法，疏散火的表象；黄芩退热，乃是寒能胜热，折服火的根本。）并且配合白术、砂仁可以安胎，配合厚朴、黄连可以消除腹痛，配合芍药可以治疗痢疾，配合柴胡可以治疗寒热往来。这虽然结合上与下，表里皆治，但究其本质，只是上中二焦泻火、除热与湿的药物罢了。（李东垣治疗肺热，身体如火烧般，烦躁引饮且白天加重者，宜用一味黄芩汤以泻肺经气分之火。方用黄芩一两。）但是肺虚腹痛属于寒证的切忌使用。（李时珍说：肺虚不宜使用黄芩，因为苦寒伤脾胃，损伤了肺之母脏。）黄明者为佳。中间空虚的为枯芩，即片芩。内部坚实的名为条芩，即子芩。上行需酒炒。泻肝胆火可用猪胆汁炒，山药、龙骨为使药。畏丹皮、丹砂。
(Mountain Grass Category) Clears Heat-Fire and Dampness in the Upper and Middle Jiao
Huangqin (Coptidis Rhizoma, Huang Qin) [Radix Scutellariae] primarily enters the Heart, Spleen, and Lung meridians, and additionally enters the Liver, Large Intestine, and Bladder meridians. Medical texts record that its bitter flavor enters the Heart meridian. It is also recorded to enter the Lung meridian to drain Fire, enter the Spleen meridian to remove Dampness, and enter the Large Intestine meridian to treat abdominal pain within the intestines. (Dysentery refers to abdominal pain in the intestines. Dysentery can be classified into Cold and Heat patterns. If dysentery belongs to the Heat pattern, the patient's physique and Qi appear robust, the pulse is necessarily slippery, solid, and forceful, the body fears heat and prefers cold, dislikes clothing and bedding, feels thirsty and desires copious consumption of cold water, finding it increasingly refreshing as it cools, digesting immediately upon drinking, urine is hot, red, scanty, and painful to pass, stool is purely red, abdominal pain is accompanied by hard stool that refuses pressure, or there may be headache, fever, and soreness of bones and sinews. These are manifestations of excess syndrome in dysentery. If dysentery belongs to the Cold pattern, the patient's physique is frail, complexion is pale and clear, although the pulse is tight and rapid, it lacks strength and spirit; even if the pulse appears truly wiry, it indicates deficiency in the middle with an appearance of excess. The blood color is faint red and not bright, or mixed with purple-red or purple-white resembling roof-leakage water. The discharged matter may be light yellow and pale, not particularly foul-smelling. Abdominal pain is not firm or hard, or the patient prefers rubbing/massage or warm compresses. There may be a sensation of hunger in the chest and abdomen without desire to eat, epigastric nausea with much acid regurgitation, frequent urges to defecate with difficulty in passing stool, or thirst without desire to drink cold water, or inability to swallow cold water despite drinking. These are manifestations of deficiency syndrome in dysentery.) It enters the Small Intestine and Bladder meridians to treat strangury and urinary retention. Furthermore, it treats excess Fire in the Middle Jiao and pathogens located in the Shaoyang Gallbladder meridian. With Huangqin as a clearing agent, one herb treats both upper/lower and interior/exterior aspects. Its efficacy is broad, making it difficult to assign a single primary indication. One must realize that internal Fire surging and external pathogens invading can both cause widespread harm. From the upper regions like the chest, diaphragm, and throat, to the lower regions like the abdomen and bowels/bladder, to the middle regions between exterior/interior and Yin/Yang boundaries, all manner of symptoms manifest. Thus, conditions such as abdominal pain and intestinal dysentery, alternating chills and fever (Malaria), jaundice, strangury and urinary retention, chest fullness with asthma, carbuncles and sores, fire-cough with foul breath, amenorrhea and fetal bleeding, thirst with fluid exhaustion—all are caused by the inundation of Dampness, invasion of Heat, and dominance of Fire. (This highlights Damp-Heat and Fire as key factors in various diseases.) Huangqin has a bitter taste and cold nature. The older, larger parts are light and floating, ascending to clear Lung Heat; when Lung Heat is cleared, phlegm is naturally regulated. (Wang Ang stated: Phlegm moves due to Fire; one should first descend Fire.) The solid, slender parts are heavy and sinking, descending to promote urination; when urination is unobstructed, intestinal dysentery naturally resolves. Wine-fried Huangqin removes Heat from the diaphragm and extinguishes Liver-Gallbladder Fire. Raw Huangqin is suitable for excess Heat patterns, thereby relieving abdominal pain. (Li Shizhen stated: Zhang Zhongjing used Huangqin in Xiao Chai Hu Tang for Shaoyang syndrome, Huangqin Tang for dysentery in Taiyang-Shaoyang combined syndrome, and Xie Xin Tang for post-purging epigastric fullness without pain in Shaoyang syndrome. This is because Huangqin is bitter and cold, yellow-green in color, drains Heart Fire and removes Spleen Dampness, preventing Metal from being punished by Stomach Fire, thus saving the Lungs. Shaoyang syndrome, though located half-exterior half-interior presenting with chest and hypochondriac fullness, actually involves pathogens in the Heart-Lung Upper Jiao, irritability, vomiting, silence, and lack of appetite, alongside Middle Jiao Spleen-Stomach symptoms. Therefore, Huangqin is used to treat the Ministerial Fire of Hand and Foot Shaoyang. Huangqin is also a primary herb of the Shaoyang channel. Yang Shiying's *Zhizhi Fang* stated: Chaihu's ability to reduce fever is inferior to Huangqin. This likely stems from ignorance that Chaihu reduces fever by dispersing via bitter flavor, addressing the branch of Fire, whereas Huangqin reduces fever by using cold to overcome heat, breaking the root of Fire.) Additionally, combined with Baizhu (Atractylodis Macrocephalae Rhizoma) and Sharen (Amomi Fructus Rotundus), it calms the fetus; combined with Houpo (Magnoliae Officinalis Cortex) and Huanglian (Coptidis Rhizoma), it eliminates abdominal pain; combined with Shaoyao (Paeoniae Radix Alba/Rubra), it treats dysentery; combined with Chaihu (Bupleuri Radix), it treats alternating chills and fever. Although this combines upper/lower and interior/exterior treatments, ultimately it remains an herb for draining Fire, removing Heat, and eliminating Dampness in the Upper and Middle Jiao. (Li Dongyuan treated Lung Heat where the body felt like burning, with irritability, excessive thirst, and worsening during the day, recommending Yi Wei Huangqin Tang to drain Qi-level Fire in the Lung meridian, using one ounce of Huangqin.) However, it is strictly contraindicated for Lung deficiency with abdominal pain of the Cold pattern. (Li Shizhen stated: Unsuitable for Lung deficiency because bitter-cold damages the Spleen-Stomach, injuring the Mother organ.) The yellowish ones are superior. Those with hollow centers are called Ku Huangqin (Withered Coptis), also known as Pian Huangqin. Those with solid interiors are called Tiao Huangqin (Strip Coptis), also known as Zi Huangqin. For ascending action, wine-fry. To drain Liver-Gallbladder Fire, fry with Pig Bile. Yam (Shanyao) and Dragon Bone (Longgu) serve as guides. It is incompatible with Danpi (Moutan Cortex) and Dansha (Cinnabar).