纲目称其行水泻肾。仲景地黄丸用茯苓泽泻者。取其泻膀胱之邪气。古人用补药必兼
泻邪。邪去则补药得力。后世不知此理。一意用补。故久服有偏胜之患。是泽泻但长于利水
。未可专任。扁鹊云。多服病患眼。盖小便利。肾气虚。故昏目也。本草久服云云。扬之太
过。用者审之。
开宝首云风痹淋痹。下云大胁风。纲目诸刻皆同。惟汤液本作风痒麻痹。下作大肠风
。盖以枳壳胜湿化痰。疏泄肺与大肠之气也。解要因之。愚意当是风痹淋闭。大胁痛。原误
二字。故不可解。淋闭多郁热。胁痛多气逆。淋闭者清阳不升则浊阴不降。壳主高主气。用
以理上。患自除矣。气逆刺痛。亦皆近上。胁言大者。别于下之季胁也。散留结乃统言。胸
膈痰滞其一耳。盖用实治下主血。用壳治高主气。洁古东垣皆如此。非臆说也。
竹类极繁。本草陶苏二家云。入药宜 竹淡竹。又谓甘竹似篁而茂。即淡竹也。六地
多竹。此所指似俗呼水黄连者。余庭前旧植数十竿。邻近每采用。今医家好言淡竹叶。伧父
谬以鸭跖草当之。本草草部另载淡竹叶云。苗高数寸。似竹米落地所生。甘寒无毒。叶去烦
热。利小便清心。今六之西山有一种草。高不盈尺。茎中空有节。叶亦全肖竹而稍薄。生丛
棘间。凌冬不凋。仅一痘医识之云。其师江右人也。指授此为真淡竹。用之已数十年。尝贻
余合他药浸酒。未知是否。汤液本草。竹淡竹俱载木部。于淡竹引日华子并用根茎。所主痰
热惊痫等症也。按诗绿竹。郑笺绿为王刍。竹为篇竹。郭璞云。篇亦作扁。似小藜。陆玑云
。绿竹乃一草。高数尺。可磨治器物。俗呼木贼。以上皆指草。惟班彪志云。淇园殷纣竹箭
园也。朱子云。淇上多竹。汉世犹然。此则实指今竹。盖竹即多种难辨。又有草木混之。故
迄无定论。记此质诸博雅君子。
《本草纲目》称泽泻能行水并泻肾中相火。张仲景在六味地黄丸中使用茯苓和泽泻,是取其能够泻除膀胱中的邪气。古人使用补益药时,必定兼用泻邪之品,因为邪气去除后,补药才能发挥效力。后世医者不了解这一道理,一味地使用补药,所以长期服用会导致阴阳偏胜的祸患。因此,泽泻只擅长利水渗湿,不可单独重用。扁鹊曾说,多服泽泻会使患者眼睛昏花,这是因为小便过多导致肾气虚弱,从而引起视力模糊。《本草》中说久服泽泻有益的说法,被过分夸大了,使用者应当审慎对待。
《开宝本草》首先记载枳壳治疗风痹、淋痹,后面又提到治疗大胁部的风邪。《本草纲目》的各种刻本都与此相同,只有《汤液本草》将“风痹”写作“风痒麻痹”,将“大胁风”写作“大肠风”。这大概是认为枳壳能胜湿化痰,疏泄肺与大肠的气机。我对此加以解释,我认为原本应该是“风痹淋闭”和“大胁痛”,原文可能误脱了两个字,所以难以解释。淋证和闭证多由郁热引起,胁痛多由气逆引起。淋闭病患者,如果清阳不升,则浊阴不降;枳壳主高、主气,用于调理上焦,病患自然消除。气逆引起的刺痛,也大多位于上部。“大胁”是指区别于下部季胁的部位。所谓“散留结”是总括而言,胸膈痰滞只是其中一种情况。大概是因为实性药物治下焦主血,而枳壳治上焦主气。洁古(张元素)和东垣(李杲)都是这样认识的,并非我的臆测。
竹类非常繁多,《本草》中陶弘景和苏颂两位医家说,入药适宜选用淡竹。又有人说甘竹类似篁竹且茂盛,指的就是淡竹。六地(泛指多地)多产竹子,这里所指的似乎俗称为“水黄连”的植物。我家庭院前旧植有几十竿竹子,邻居经常采摘使用。现在的医家喜欢谈论淡竹叶,粗鄙之人错误地用鸭跖草来代替它。《本草》草部另外记载了淡竹叶:苗高数寸,像竹子种子落地后生长出来的样子,味甘寒无毒,叶子能去除烦热,通利小便,清心火。现在六地的西山有一种草,高度不满一尺,茎中空且有节,叶子完全像竹叶但稍薄,生长在丛棘之间,冬天也不凋谢。只有一个痘医认识它,他说他的老师是江西人,指点这是真正的淡竹,他使用了几十年,曾经赠送给我和其他药一起浸泡药酒,不知道是否准确。《汤液本草》中,竹和淡竹都记载在木部,对于淡竹引用日华子的说法,并用其根茎,主治痰热惊痫等症状。按《诗经》中的“绿竹”,郑玄笺注说“绿”是王刍,“竹”是篇竹。郭璞说,篇也写作扁,类似小藜。陆玑说,绿竹是一种草,高数尺,可以磨治器物,俗称木贼。以上这些指的都是草。只有班彪的《志》说,淇园是殷纣王的竹箭园。朱熹说,淇水上游多竹,汉代还是这样。这才是真正指现在的竹子。大概因为竹子品种众多难以辨别,又有草木混淆的情况,所以至今没有定论。记录于此,以请教博学雅正的君子。
Bencao Gangmu (Compendium of Materia Medica) states that Zexie (Rhizoma Alismatis) promotes water metabolism and drains Kidney fire. Zhang Zhongjing uses Fuling (Poria) and Zexie in Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to take advantage of their ability to drain pathogenic factors from the Bladder. Ancient physicians, when using tonic herbs, invariably combined them with herbs that drain pathogens; once the pathogens are eliminated, the tonics can exert their effect effectively. Later physicians did not understand this principle and used tonics exclusively, thus causing harm due to excessive bias from long-term use. Therefore, Zexie is only proficient in promoting diuresis and should not be used alone or in high doses. Bian Que stated that excessive consumption of Zexie causes eye problems in patients. This is because excessive urination leads to Kidney Qi deficiency, resulting in blurred vision. The claim in Bencao texts that long-term use of Zexie is beneficial is exaggerated; practitioners should exercise caution.
Kaibao Bencao first records Zhike (Pericarpium Citri Reticulatae) for treating Wind-Bi (Wind-Dampness Obstruction Syndrome) and Lin-Bi (Damp-Heat Urinary Disorder). It later mentions treating "Da Xie Feng" (Wind affecting the large hypochondrium). All editions of Bencao Gangmu agree with this, whereas Tangye Bencao (Materia Medica of Decoctions) writes "Feng Yang Ma Bi" (Wind-induced Itching and Numbness) and "Da Chang Feng" (Wind affecting the Large Intestine). This is likely based on the view that Zhike overcomes dampness and transforms phlegm, thereby venting the Qi of the Lung and Large Intestine. I provide an explanation for this: I believe the original text should have been "Feng Bi Lin Bi" (Wind-Bi and Lin-Bi) and "Da Xie Tong" (Large Hypochondriac Pain), and two characters were erroneously omitted, making it difficult to interpret. Lin and Bi syndromes often involve stagnant heat, while hypochondriac pain often involves rebellious Qi. In Lin and Bi cases, if Clear Yang fails to ascend, Turbid Yin fails to descend. Zhike governs the upper body and Qi; using it to regulate the Upper Jiao resolves the illness naturally. Rebellious Qi causing stabbing pain also tends to occur in the upper regions. "Da Xie" refers to distinguishing the main hypochondrium from the lower Ji Xie (lateral costal margin). "San Liu Jie" (Scattering Stagnant Accumulations) is a general term, with Phlegm-Stasis in the Chest and Diaphragm being just one aspect. Generally, solid substances treat the Lower Jiao and govern Blood, while Zhike treats the Upper Jiao and governs Qi. Jiegu (Zhang Yuansu) and Dongyuan (Li Gao) held this view; it is not my speculation.
Bamboo species are extremely numerous. Tao Hongjing and Su Song in Bencao state that Dan Zhu (Dendrocalamus oldhamii) is suitable for medicinal use. They also mention that Gan Zhu resembles Huang Zhu and is lush, referring to Dan Zhu. Many places produce bamboo; what is referred to here seems to be the plant commonly called Shui Huanglian (Hydrocotyle javanica). Dozens of bamboo stalks were formerly planted in front of my courtyard, and neighbors frequently harvested them. Modern physicians often discuss Dan Zhu Ye (Leaf of Dendrocalamus oldhamii), but uneducated people mistakenly substitute it with Ya Zhi Cao (Commelina communis). The Grass Section of Bencao separately records Dan Zhu Ye: the seedling is several inches high, resembling growth from fallen bamboo seeds; it is sweet, cold, non-toxic; its leaves remove irritability and heat, promote urination, and clear Heart Fire. Currently, in the Western Hills of Liudi, there is a herb less than one chi tall, with a hollow stem with nodes, leaves resembling bamboo but thinner, growing among thorny bushes, remaining evergreen in winter. Only one smallpox physician recognizes it; he said his teacher, from Jiangxi, identified it as true Dan Zhu Ye, which he has used for decades. He once gave it to me to steep in wine with other herbs; I do not know if it is correct. Tangye Bencao lists both Zhu and Dan Zhu in the Wood Section, citing Ri Huazi regarding the use of roots and stems to treat Phlegm-Heat,惊痫 (Convulsions and Epilepsy), etc. According to the Shi Jing (Classic of Poetry), "Green Bamboo," Zheng Xuan's commentary says "Green" is Wang Chu (Plantago asiatica) and "Bamboo" is Pian Zhu. Guo Pu says Pian is also written as Bian, resembling Xiao Li (Chenopodium album). Lu Ji says Green Bamboo is a grass, several chi high, usable for polishing vessels, commonly called Mu Zei (Equisetum ramosissimum). All the above refer to grasses. Only Ban Biao's Zhi states that Qiyuan was the Bamboo Arrow Garden of King Zhou of Yin. Zhu Xi said there were many bamboos upstream of the Qi River, even in Han times. This truly refers to modern bamboo. Since bamboo varieties are numerous and hard to distinguish, and are often confused with herbs, there is no definitive conclusion. I record this to consult learned scholars.