以北庭山（即今西域火州）出者为上。故名北庭砂。火焰山（即北庭）中常有烟气涌起。
而无云雾。至夕光焰若炬火。照见禽鼠皆赤色。采 砂者。乘木屐取之。若皮底即焦矣。（
行程记）临洮兰县有洞出 砂。（一统志）今西凉夏国。及河东陕西近边州郡亦有之。西戎
来者颗块光明。大者如拳。重三五两。小者如指面入药最紧。边界出者。杂碎如麻豆粒。又
夹砂石。用之须水飞。澄去土石讫。亦无力。彼人谓之气砂。（颂）
味酸咸苦辛。气大热。有大毒。能消五金八石。腐坏人肠胃。中其毒者。生绿豆研汁饮
一二升解之。畏浆水。忌羊血。（权）
主治男妇羸瘦。痰气郁结。坚积。噎膈症瘕。积痢骨鲠。去目翳 肉。及恶疮 肉。除
痣疣赘。（诸本草）凡噎膈反胃。积块内症。多由七情饮食所致。痰气郁结。遂成有形。
妨碍道路。吐食痛胀。非用 砂消化。岂能去之。其性善烂金银铜锡。 人煮硬肉。入
少许即烂。所谓化人心为血者。亦甚言其不可多服耳。（濒湖） 砂破坚癖。不可独用。须
辅入群队药中。作散外治。亦须与牛黄龙脑铅华象牙末等同用。（洁古仲淳）虽能攻化有形
癖结。然多食坏人肠胃。惟去恶肉及恶疮 肉目翳 肉。是其所长。（仲淳）损目生瘀。赤
不退。杏仁百粒。蒸熟去皮尖。研。滤取净汁。入 砂末一分。水煮化。日点一二次自落。
鼻中 肉。 砂合明矾牛黄铅粉真珠象牙末点之即落。面上疣目。 砂少许。硼砂铁锈麝香
等分。研搽三次自落。惫以甘草汁浸洗。
〔论〕 北庭砂秉阴石之气。含阳毒之精。（所云有毒皆指阳毒）凡沉冷结积诸证。由
阴之不化以为痼病者。非此不能透入痼阴而致阳之化也。濒湖言此乃卤汁所结。出于青海。
与月华相射而生。附盐以成质者。彼人淋炼成之。果如此则又为至阴之精。其毒属阴矣。何
以治诸沉冷之疾哉。窃意西人用以当盐者。即彼中淋炼之卤汁。而阳毒能腐人肠胃者。乃北
庭所产之砂也。其性味阴阳迥殊。而施治有若冰炭。因未亲履其地。当俟后以确见而实证者
云。
〔修治〕 用黄丹锻石作柜。 赤使用。并无毒。（黄丹乃铅炼就者。铅属至阴故可解
之阳毒。）世人自疑烂肉。然刀刃所伤。以之罨敷。当时生痂。（日华子） 砂透物。又号
透骨将军。用黝罐盛悬火上则常干。或加干姜同收亦良。若近冷及得湿。即化为水。或渗湿
也。此亦阳极遇阴即化之义。
以产自北庭山（即今天的西域火州）的为上品。因此得名“北庭砂”。火焰山（即北庭地区）中常有烟气升腾，却没有云雾。到了傍晚，光芒像火炬一样，照亮飞禽和老鼠都呈现红色。采集砂的人，穿着木屐去取砂，如果是皮底鞋就会烧焦。（出自《行程记》）临洮兰县有洞穴出产砂。（出自《一统志》）现在的西凉夏国，以及河东、陕西靠近边境的州郡也有出产。从西戎来的砂呈块状且光亮，大的像拳头，重三到五两；小的像指面大小，入药最为紧要。边界出产的砂，杂乱细碎如麻豆粒，又夹杂砂石，使用时必须经过水飞法处理，澄清去除土石后，药效也微弱。当地人称之为“气砂”。（出自苏颂《本草图经》）
味道酸、咸、苦、辛。性质大热，有大毒。能溶解五金八石，腐蚀人的肠胃。中毒者，生绿豆研成汁饮用一二升可以解毒。畏忌浆水，忌食羊血。（出自李珣《海药本草》）
主治男女身体消瘦，痰气郁结，坚硬积聚，噎膈症瘕，积痢骨鲠，去除目翳息肉，以及恶疮息肉，除去痣疣赘生物。（出自历代诸本草）凡是噎膈反胃，体内积块病症，多由七情饮食所致。痰气郁结，遂形成有形之物，阻碍道路，导致吐食疼痛胀满，如果不使用硇砂消化，怎么能去除它呢？它的性质善于腐烂金银铜锡，人们煮硬肉时，放入少许就能煮烂。所谓“化人心为血”，也是极言其不可多服罢了。（出自李时珍《本草纲目》）硇砂破除坚癖，不可单独使用，必须辅助加入群队药物中，制成散剂外用治疗。也必须与牛黄、龙脑、铅华、象牙末等同用。（出自张元素洁古、缪希雍仲淳）虽然能攻伐化解有形的癖结，但多吃会损坏人的肠胃。只有去除恶肉及恶疮息肉、目翳息肉，是它的长处。（出自缪希雍仲淳）损伤眼睛产生瘀血，红赤不退，用杏仁一百粒，蒸熟去皮尖，研磨，过滤取得纯净汁液，加入一分硇砂粉末，用水煮化，每天点眼一两次，瘀血自落。鼻中息肉，用硇砂配合明矾、牛黄、铅粉、真珠、象牙末点涂，息肉自落。面上疣目，用少许硇砂，与硼砂、铁锈、麝香等分，研磨后搽抹，三次后自落。感到疲惫时用甘草汁浸洗。
〔论〕 北庭砂秉承阴石之气，含有阳毒之精。（所说的有毒皆指阳毒）凡是沉冷结积诸证，由于阴气不化而成为痼疾的，不用此药不能透入痼阴而促使阳气转化。李时珍说这是卤汁凝结而成，出于青海，与月光照射而生，依附盐分形成质地。如果真是这样，那它就是至阴之精，其毒属阴了。为什么能治疗各种沉冷疾病呢？我私下认为，西人用来当盐食用的，就是他们那里淋炼出来的卤汁，而北庭所产的砂，其性味阴阳截然不同，施治效果如同冰炭般相反。因为未曾亲自踏足其地，应当等待后来有确切见闻的人来证实。
〔修治〕 用黄丹、锻石制作柜子，使其变红使用，并无毒性。（黄丹是铅炼制而成的，铅属至阴，所以可以解阳毒。）世人担心它烂肉，然而刀刃所伤，用它敷贴，当时就能生痂。（出自日华子）硇砂穿透物体，又号称“透骨将军”。用黑色罐子盛装悬挂在火上则常保持干燥，或者加干姜一同收藏也很好。如果接近寒冷或受潮，就会化为水。这也是阳极遇阴即化的道理。
The best quality comes from Beitingshan (i.e., Huozhou in the Western Regions today). Hence it is named "Beiting Sha" (Nao Stone from Beitingshan). In Huoyanshan (i.e., Beitingshan), smoke and vapor often rise, but there are no clouds or mist. By evening, the light resembles torches, illuminating birds and mice so that they appear red. Collectors wear wooden clogs to gather the stone; if they wore leather-soled shoes, the soles would burn. (From *Xingcheng Ji* / *Record of Travel*) Lancheng County inLintao has caves producing Sha. (From *Yitong Zhi* / *Comprehensive Gazetteer*) It is also found in the modern Xiliang Xia Kingdom and in bordering prefectures of Hedong and Shaanxi. Sha imported from the Western Barbarians appears as bright lumps; large ones are fist-sized, weighing three to five taels; small ones are finger-nail sized and are most essential for medicinal use. Sha from border areas is mixed and fragmented like hemp seeds or beans, often夹杂着 sand and gravel. It must be processed by "water flying" (trituration with water) and clarified to remove earth and stones; otherwise, its efficacy is weak. Locals call this "Qi Sha" (Vapor Sha). (From Su Song's *Bencao Tujing* / *Illustrated Materia Medica*)
It tastes sour, salty, bitter, and pungent. Its nature is extremely hot, and it possesses great toxicity. It can dissolve the "five metals and eight minerals," corroding human intestines and stomachs. For poisoning, drinking one to two sheng of juice made from raw, ground mung beans can detoxify it. It is incompatible with Jiangshui (fermented grain liquid) and sheep blood. (From Li Xun's *Haiyao Bencao* / *Materia Medica of Foreign Drugs*)
It treats emaciation in men and women, phlegm-qi stagnation, hard accumulations, dysphagia (Ya Ge) and regurgitation, abdominal masses (Zheng Jia), chronic dysentery, and fish bones stuck in the throat. It removes corneal opacities (Mu Yi) and fleshy growths (Rou), and eliminates moles, warts, and skin tags. (From various ancient materia medicas) Dysphagia, regurgitation, and internal masses are mostly caused by emotional disturbances and dietary irregularities. Phlegm and qi stagnate and form tangible obstructions, blocking pathways, leading to vomiting, pain, and distension. Without using Nao Sha to digest these, how could they be removed? Its nature is capable of rotting gold, silver, copper, and tin. When people cook tough meat, adding a small amount makes it tender quickly. The saying that it "transforms the heart into blood" is merely an exaggeration warning against excessive consumption. (From Li Shizhen's *Bencao Gangmu* / *Compendium of Materia Medica*) Nao Sha breaks down hard accumulations and should not be used alone. It must be combined with other herbs in compound prescriptions and used externally as powders. It should also be used together with Realgar (Niuhuang - *Note: Context implies Realgar or similar mineral, though Niuhuang is typically Musk Deer Gallstone, here likely referring to a mineral powder context or specific formulation*), Borneol (Longnao), Lead White (Qianhua), and Ivory Powder. (From Zhang Yuansu [Jiegu] and Miao Xichong [Zhongchun]) Although it can attack and resolve tangible accumulations, excessive intake damages the intestines and stomach. Its strength lies only in removing foul flesh, malignant ulcerations, corneal opacities, and fleshy growths. (From Miao Xiong [Zhongchun]) For eye injury causing stasis and persistent redness, take 100 almonds, steam until cooked, remove skins and tips, grind, filter to obtain pure juice, add one fen of Nao Sha powder, boil in water, and apply to the eyes once or twice daily until the stasis falls off. For nasal polyps, apply Nao Sha combined with Alum (Mingfan), Realgar (Niuhuang - *Note: Likely typo in original for Realgar or another mineral, usually Niuhuang is Musk Deer Gallstone, but in external polyp treatments, minerals are common*), Lead Powder, Pearl (Zhenzhu), and Ivory Powder until they fall off. For facial warts, mix a small amount of Nao Sha with equal parts Borax (Pengsha), Iron Rust (Tiexiu), and Musk (Shexiang), grind, and apply; after three applications, they will fall off. Wash with licorice root decoction when fatigued.
[Discussion] Beiting Sha inherits the qi of yin stones and contains the essence of yang toxicity. (The term "toxic" here refers to yang toxicity.) For conditions of deep cold and accumulated stagnation caused by the failure of yin to transform into pathology, this herb is necessary to penetrate the entrenched yin and induce yang transformation. Li Shizhen stated that this forms from brine condensation, originating from Qinghai, generated by interaction with moonlight, and solidifying with salt. If this were true, it would be the essence of extreme yin, and its toxicity would belong to yin. How then could it treat various deep-cold diseases? I suspect that what Westerners use as salt is the brine they leach and refine, whereas the Nao Sha produced in Beitingshan has a completely different yin-yang nature and therapeutic effect, acting like ice and charcoal in opposition. Since I have not personally visited the region, I await future observations with certainty to verify this.
[Processing] Use cages made of Minium (Huandan) and Calcined Alumen (Duanshi) to heat it until it turns red for use; this renders it non-toxic. (Minium is refined from lead; lead belongs to extreme yin and thus can resolve yang toxicity.) People worry about its flesh-rotting property, yet for knife wounds, applying it causes scabs to form immediately. (From Ri Huaizi) Nao Sha penetrates objects and is also known as "Bone-Penetrating General." Store it in black jars suspended over fire to keep it dry, or store it with dried ginger, which is also effective. If exposed to cold or moisture, it dissolves into water. This illustrates the principle that extreme yang transforms upon encountering yin.