\r知母\pj47.bmp\r
味苦、辛,气寒,气味俱浓。沉而降,阴也,阴中微阳。无毒。多生徐解二州,(并
属南直隶。)形类菖蒲;柔软肥白有力,枯黯无功。去净皮毛,忌犯铁器。引经上颈,酒炒
才升。益肾滋阴,盐炒便入。乃足少阴本药,而又入足阳明、入手太阴也。补肾水,泻去无
根火邪;消浮肿,为利小便佐使。初痢脐下痛者能却,久疟烦热甚者除。治有汗骨蒸热痨,
疗往来传尸疰病。润燥解渴,(患人虚热口干,宜倍用之。)止咳消痰。久服不宜,令人作泻
。仍治溪毒,河润澡洗,先以药末,投水上流,自无患矣。
(谟)按∶东垣云∶仲景用此为白虎汤,治不得眠者烦燥也。盖烦者肺,燥者肾,以石
膏为君
,佐以知母之苦寒,以清肾之燥。缓以甘草、粳米之甘,使不速下也。经云∶胸中有寒者瓜
蒂散,表热里寒者白虎汤。瓜蒂、知母味皆苦寒,何谓治胸中寒也?曰∶读者当逆识之,如
言乱臣十人,乱当作治。仲景言寒,举其效言之,热在其中矣。若果为寒,安得复用苦寒之
剂?且白虎汤证,脉尺寸俱长,其热明矣。岂可因其辞而害其意乎?
\r肉丛蓉\pj48.bmp\r
味甘、酸、咸,气微温。无毒。陕西州郡俱有,马沥落地所生。端午采干,用先
酒浸。刷去身外浮甲,劈除心内膜筋。或酥炙酒蒸,仍碎掐入剂。忌轻铁器,切勿犯之。治
男
子绝阳不兴,泄精尿血遗沥;疗女人绝阴不产,血崩带下阴疼。助相火补益劳伤,暖腰膝坚
强筋骨。丹溪云∶虽能峻补精血,骤用反动大便。又种琐阳,(亦产陕西。)味甘可啖。
以酥涂炙,代用亦宜。煮粥弥佳,入药尤效。润大便燥结,(若溏泻者,切忌服之。)补阴血
虚羸。兴阳固精,强阴益髓。但《本经》原缺未载,此丹溪续补为云。 又草苁蓉,岩石多
产。根类初生莲藕,《本经》一名列当。温补略同,功力殊劣,或压扁假充前药,(肉苁蓉
罕得真者,市多以此压扁假充。又以金莲草根盐润充卖,误服之反有损也。)凡用者务审精
详。
知母
味苦、辛,性寒,气味浓厚。药性沉降,属阴,阴中微含阳气。无毒。多产于徐州、解州两地,(均属于南直隶地区。)外形类似菖蒲;质地柔软、肥白且有力者佳,干枯黯淡者无效。需去除尽净表面的绒毛和表皮,忌接触铁器。作为引经药可上行至颈部,经酒炒后药性才能上升。益肾滋阴,经盐炒后药力能入肾经。它是足少阴肾经的本经药,同时也进入足阳明胃经和手太阴肺经。补益肾水,清除无根之火邪;消除浮肿,作为利小便的辅助药物。初患痢疾且脐下疼痛者,它能缓解;久疟疾且烦热严重者,它能消除。治疗有汗的骨蒸劳热,疗治往来传尸疰病。润燥解渴,(患者因虚热导致口干时,宜加倍使用。)止咳消痰。长期服用不宜,会导致腹泻。还能治疗溪毒,用河水润泽并洗浴,先将药末投入河流上游,自然就不会有祸患了。
(陈嘉谟)按语:李东垣说:张仲景将此药用于白虎汤,治疗因烦躁不得安眠的症状。大概烦躁与肺有关,干燥与肾有关,以石膏为君药,佐以知母的苦寒之性,以清泻肾中的燥热。再用甘草、粳米的甘缓之性,使药力不致过快下行。经文说:“胸中有寒者用瓜蒂散,表热里寒者用白虎汤。”瓜蒂、知母味道都是苦寒的,为什么说能治疗胸中的寒证呢?回答说:读者应当逆向理解,就像说“乱臣十人”,这里的“乱”字应理解为“治”。张仲景说“寒”,是列举其表象而言,其实热象在其中了。如果真的是寒证,怎么能再次使用苦寒的药物呢?况且白虎汤证的脉象尺寸两部都长,其热象是很明显的。难道可以因为文字表面意思而损害其真实意旨吗?
肉苁蓉
味甘、酸、咸,气微温。无毒。陕西各州郡都有出产,生长在马尿淋湿落地之处。端午节采收晒干,使用前先用酒浸泡。刷去体外的浮甲,劈除内部的内膜筋络。或用酥油炙烤、酒蒸,然后捣碎掐断入药。忌轻率接触铁器,千万不要触犯。治疗男子阳绝不起、泄精、尿血、遗沥;疗治女子阴绝不孕、血崩、带下、阴部疼痛。助相火,补益劳伤,温暖腰膝,坚固筋骨。朱丹溪说:虽然能峻补精血,但骤用反而会引起大便泄泻。还有一种琐阳,(也产于陕西。)味道甘甜可以食用。用酥油涂抹炙烤,代替肉苁蓉使用也很适宜。煮粥吃很好,入药效果更佳。润通大便燥结,(如果是溏泻者,切忌服用。)补益阴血虚损消瘦。兴阳固精,强阴益髓。但是《神农本草经》原本缺失未记载,这是朱丹溪后续补充所说的。另外还有草苁蓉,岩石上多产。根部像初生的莲藕,《神农本草经》中一名列为“列当”。温补作用大致相同,但功力远不如肉苁蓉,有人将其压扁假冒前药,(肉苁蓉很难得到真品,市场上多用此法压扁假冒。又用金莲草根盐渍润湿冒充售卖,误服反而有害。)凡是用者务必仔细审查辨别。
Rhizoma Anemarrhenae (Zhimu)
Bitter, acrid, cold in nature; the flavor and qi are dense. It sinks and descends, belonging to Yin, with a slight Yang within Yin. Non-toxic. It grows abundantly in Xuzhou and Jiezhou prefectures (both belonging to Southern Zhili). Its shape resembles Calamus Rhizome (Changpu); it should be soft, plump, white, and vigorous, while dry and dull ones are ineffective. The down and skin must be completely removed, avoiding contact with iron vessels. As a guiding herb, it can ascend to the neck; only after being stir-fried with wine does its action rise. It benefits the Kidney and nourishes Yin; when stir-fried with salt, its efficacy enters the Kidney meridian. It is the primary herb for the Foot-Shaoyin (Kidney) meridian, but also enters the Foot-Yangming (Stomach) and Hand-Taiyin (Lung) meridians. It tonifies Kidney Water and clears rootless fire pathogens; reduces edema, serving as an assistant and envoy for promoting urination. It can alleviate pain below the umbilicus in initial dysentery and remove severe irritability and heat in chronic malaria. It treats bone-steaming consumption with sweating, and cures transmissible phthisis (Zhubing). It moistens dryness and relieves thirst (for patients with deficiency-heat causing dry mouth, it should be doubled in dosage). It stops coughing and eliminates phlegm. Long-term use is not advisable as it causes diarrhea. It also treats stream toxins; by bathing with river water enriched with the drug, if the powdered medicine is thrown into the upstream of the river, no harm will occur.
(Chen Jiamo) Commentary: Li Dongyuan stated: Zhang Zhongjing used this herb in Baihu Tang (White Tiger Decoction) to treat insomnia caused by irritability. Irrability relates to the Lung, and dryness relates to the Kidney. Gypsum (Shigao) is used as the sovereign herb, assisted by the bitter-cold nature of Rhizoma Anemarrhenae (Zhimu) to clear Kidney dryness. Licorice Root (Gancao) and Rice (Jingsmi) are used for their sweet and緩 (slow/relaxing) properties to prevent the medicine from descending too quickly. The Classics state: "For cold in the chest, use Gou Ti San (Melon Seed Powder); for exterior heat and interior cold, use Baihu Tang." Both Melon Seeds (Goudi) and Rhizoma Anemarrhenae (Zhimu) are bitter and cold. Why is it said to treat cold in the chest? I say: Readers should interpret this inversely. Just as "rebellious ministers" might imply "governing ministers," when Zhang Zhongjing says "cold," he refers to the apparent symptom, while heat lies within. If it were truly cold, how could bitter-cold agents be reused? Moreover, in Baihu Tang syndrome, the pulse at both Cun and Chi positions is long, indicating obvious heat. How can one allow the literal words to obscure the true meaning?
Cistanche Deserticola (Roucongrong)
Sweet, sour, salty; slightly warm in nature. Non-toxic. It is found in all prefectures of Shaanxi, growing where horse urine falls on the ground. It is harvested and dried on the Dragon Boat Festival (Duanwu). Before use, it must be soaked in wine. Brush off the floating scales on the surface, split open to remove the inner membrane and tendons. It may be roasted with su (animal fat) or steamed with wine, then crushed and broken into pieces for decoction. Avoid light iron vessels; do not let them touch the herb. It treats male impotence due to absolute Yang deficiency, seminal emission, hematuria, and dribbling urine; it heals female infertility due to absolute Yin deficiency, metrorrhagia, leukorrhea, and genital pain. It assists Ministerial Fire, tonifies labor injuries, warms the waist and knees, and strengthens bones and sinews. Zhu Danxi said: Although it can vigorously tonify essence and blood, sudden use may reverse effect and cause diarrhea. There is also Suoyang (Astragali Complanati Semen), (also produced in Shaanxi). It is sweet and edible. Roasted with su, it is suitable as a substitute. Cooking it in porridge is excellent, and using it in medicine is particularly effective. It moistens and unblocks dry fecal impaction (if loose stools exist, it is strictly forbidden to take it). It tonifies Yin-blood deficiency and emaciation. It promotes Yang, secures essence, strengthens Yin, and benefits marrow. However, it was originally missing and not recorded in Shen Nong Ben Cao Jing (Divine Farmer's Materia Medica); this addition was made by Zhu Danxi. Additionally, there is Caorongrong (Grass Cistanche), which grows abundantly on rocks. Its root resembles newly born lotus roots. In Shen Nong Ben Cao Jing, it is listed under the name Lidang (Pedicularis Resupinatae Herba). Its warming and tonifying effects are similar, but its potency is significantly inferior. Some flatten it to pass it off as the former herb (True Cistanche is rare; the market often flattens this to fake it. Also, roots of Nelumbinis Rhizoma (Jinliangen) are salted and sold as substitutes; taking them by mistake causes harm). Users must examine carefully and thoroughly.