荆襄江淮济南河陕皆有之。茎花叶实。俱有三棱。故名。苗下有魁。初生成块如附子。
亦有扁者。从旁横贯一根。复连数魁。魁上亦出苗叶。其魁皆扁。长须。皮色黄褐。削去须
皮。宛如鲫状。体重者荆三棱。圆小如梅者黑三棱。钩曲如爪者。鸡爪三棱。方书又有石三
味苦甘平。气温。阴中之阳。入足厥阴。亦入足太阴。从血药则治血。从气药则治气。
主治老癖症瘕。积聚结块。破积气。通肝经积血。治疮肿坚硬。疗心膈痛饮食不消。妇人产
后恶血血结。（诸本草）三棱色白属金。破血中之气。其治积块疮硬。乃坚者削之也。（好古）
昔有患症癖死者。遗言开腹取视。得病块干硬如石。文理五色。后作刀柄。因刈三棱而柄忽
有病症癖腹胀。用三棱蓬术酒煎服之。下黑物如鱼而愈。老症
宿瘕。皆由血瘀气结食停所致。此味苦辛泄散。甘和入脾。血属阴而有形。所以治一切停结
香附延胡肉桂牡蛎人参鳖甲。消一切坚症老癖之积聚。同四物桂
治产后恶血停结。及经阻
腹痛不可按。同青皮陈皮砂仁肉蔻山
治心积起于脐。上至心。
大如臂。
久则心烦身体髀股皆肿。环脐而痛。其脉沉而芤者。人参白术茯苓半夏浓朴枳壳三棱各等分。
食远用米饮下五十丸。三棱汤。治症瘕 癖。坚满痞膈。妨食腹胀。
三棱二两。白术一两。蓬术当归各半两。槟榔木香各七钱半。为末。每服三钱。沸汤调下。
加减四物汤。治妇人血积。芎归芍地棱术桂心干漆炒烟尽各等分。为粗末。每煎服二钱。三
方皆以补味同三棱用者。举以类推。
〔三棱蓬术合论〕蓬术色黑属血能破气中之血。三棱色白属气。能破血中之气。夫气中
之血。谓气所凝结之血也。阳困其阴。非泛用破血诸药可效。惟蓬术阳中之阴。能从气入而
破血。先开其气。而后效其破血之用。（故又入气药。发诸香。且以治气不能接续。）为疏气
如霍乱冷气及心腹痛。亦犹可用也。若血中之气。则血所壅遏之
破气诸药可除。三棱乃阴中
之阳。从血入而破气。先决其血。而
坚。所须何遽至此。盖阴为
阳之依。
凡用三棱。不惟伤血。而更损真气。虚者切戒。能破有形之积。如因外淫泣滞其气血而
饮食痰沫裹之者。须以此除之。若夫七情久结。致成有形。则必善用补运以壮其脾胃。脾胃
〔修治〕消积须用醋浸一日炒。或煮熟焙干入药。
荆襄、江淮、济南、河陕等地都有出产。它的茎、花、叶、果实，都具有三个棱面，因此得名。幼苗下方有块根（魁），初生时结成块状，形状像附子。也有扁平的，从旁边横贯一根主根，又连接着多个块根。块根上也长出苗叶。这些块根都是扁平的，带有长长的须根，皮色黄褐色。削去须根和表皮后，形状宛如鲫鱼。体重的是荆三棱，圆小如梅子的是黑三棱，钩曲如爪子的是鸡爪三棱。医方书中还有石三棱，味苦甘，性平，气温，属于阴中之阳。入足厥阴肝经，也入足太阴脾经。跟随血分药使用则治疗血病，跟随气分药使用则治疗气病。主要治疗老癖症瘕（腹内结块）、积聚结块，破除积滞之气，疏通肝经瘀血，治疗疮肿坚硬，疗治心膈疼痛、饮食不消，以及妇人产后恶露不尽、血结等症。（出自诸本草）三棱色白属金，能破血中之气。它治疗积块、疮硬，属于“坚者削之”的治疗方法。（李杲/好古语）从前有人患症癖而死，临终前嘱咐开腹查看，发现病块干硬如石头，纹理五色斑斓，后来被做成刀柄。因为割切三棱时，刀柄忽然感到病症癖腹胀。用三棱、蓬术酒煎服，排出黑色物体如鱼状而痊愈。老症宿瘕，都是由血瘀、气结、食停所致。此药味苦辛能泄散，味甘能和入脾。血属阴而有形，所以能治疗一切停结之症。香附、延胡索、肉桂、牡蛎、人参、鳖甲，能消除一切坚症、老癖之积聚。同四物汤、桂枝等配伍，治疗产后恶血停结，以及经闭腹痛不可按压。同青皮、陈皮、砂仁、肉豆蔻等配伍，治疗心积起于脐部，上至心口，大如手臂。日久则心烦，身体髀股皆肿，环脐而痛，脉象沉而芤者，用人参、白术、茯苓、半夏、浓朴、枳壳、三棱各等分。饭后用米饮送下五十丸。三棱汤，治疗症瘕癖，坚满痞膈，妨碍进食，腹胀。三棱二两，白术一两，蓬术、当归各半两，槟榔、木香各七钱半，研为末。每服三钱，沸水调下。加减四物汤，治疗妇人血积。川芎、当归、芍药、地黄、三棱、白术、桂心、干漆（炒至烟尽）各等分，研为粗末。每煎服二钱。这三方都是以补益药同三棱配合使用，可以举一反三。
【三棱蓬术合论】蓬术色黑属血，能破气中之血。三棱色白属气，能破血中之气。所谓气中之血，是指气所凝结的血。阳气困阻阴血，不是泛用破血诸药所能奏效的。只有蓬术作为阳中之阴，能从气分进入而破血，先开通气机，而后发挥其破血的作用。（所以又入气药，发散诸香气，且用于治疗气不能接续的情况。）对于疏理气机，如霍乱冷气及心腹痛，也仍然可以使用。若血中之气，则是血所壅遏的气，破气诸药可以去除。三棱乃阴中之阳，从血分进入而破气，先决通血分，而……（原文此处似有缺漏或断句不清，依文意推测：先决其血，而后破其气）。坚积所需时间何遽至此？盖阴为阳之依托。凡使用三棱，不仅伤血，而且更损真气，虚证者切忌。能破有形之积，如因外邪淫泣滞其气血，而饮食痰沫包裹之者，须以此除之。若因七情久结，致成有形之积，则必善用补运之法以壮其脾胃。脾胃（健运则积自消）。
Jingxiang, Jianghuai, Jinan, Heshan, and other regions all produce it. Its stem, flowers, leaves, and fruits all possess three edges, hence the name. Below the seedling is a tuber (Kui). Initially formed into lumps like Fuzi (Aconiti Lateralis Radix Praeparata), they can also be flat. A single root runs horizontally from the side, connecting several tubers. Seedlings and leaves also sprout from these tubers. These tubers are all flat with long roots, yellowish-brown in skin color. After removing the roots and peel, they resemble crucian carp. Those with heavy weight are Jing Sanleng; those round and small like plums are Hei Sanleng; those hooked like claws are Jizhao Sanleng. Medical formularies also mention Shisanleng, which is bitter and sweet in taste, neutral in nature, warm in temperature, belonging to Yang within Yin. It enters the Foot-Jueyin Liver Meridian and also the Foot-Taiyin Spleen Meridian. When used with blood-invigorating herbs, it treats blood disorders; when used with qi-regulating herbs, it treats qi disorders. It mainly treats Lao Pi Zhengjia (chronic abdominal masses), accumulations and lump formations, breaks stagnant Qi, unblocks accumulated blood in the Liver Meridian, treats hard swelling sores, alleviates chest and diaphragm pain and indigestion, and addresses postpartum lochia retention and blood stasis in women. (From various Materia Medica) Sanleng is white and belongs to Metal, breaking Qi within Blood. Its treatment of accumulations and hard sores follows the principle of "scraping what is hard" (Jian Zhe Xiao Zhi). (Haogao's commentary) In the past, someone died of Zhengpi (abdominal masses). Before death, he instructed that his abdomen be opened for examination. A dry, stone-hard mass was found, with five-colored textures, later made into a knife handle. Because cutting Sanleng caused sudden abdominal distension due to Zhengpi. Using Sanleng and Pengzhu decocted in wine, black substances like fish were excreted, leading to recovery. Old symptoms and chronic accumulations are all caused by blood stasis, Qi stagnation, and food retention. This herb is bitter and pungent to drain and disperse, sweet to harmonize and enter the Spleen. Blood belongs to Yin and has form, thus treating all types of stagnation and accumulation. Xiangfu (Cyperi Rhizoma), Yanhusuo (Corydalis Rhizoma), Rougui (Cinnamomi Cortex), Muli (Ostreae Concha), Renshen (Ginseng Radix et Rhizoma), Biejia (Trionycis Carapax) can eliminate all hard conditions and old accumulations. Combined with Siwu Tang (Four Substances Decoction) and Guizhi (Cinnamon Twig), it treats postpartum lochia retention and amenorrhea with abdominal pain intolerable to pressure. Combined with Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus), Roudoukou (Myristicae Semen), it treats Xinji (Heart Accumulation) starting from the umbilicus up to the heart, as large as an arm. Over time, it causes irritability, swelling of the body, thighs, and legs, pain around the umbilicus, with a deep and hollow pulse. Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma), Nongpu (Magnoliae Officinalis Cortex), Zhike (Aurantii Fructus Immaturus), Sanleng each in equal parts. Take 50 pills with rice water after meals. Sanleng Tang (Sanleng Decoction) treats Zhengjia, Pi, hardness, fullness, epigastric oppression, difficulty eating, and abdominal distension. Sanleng 2 liang, Baizhu 1 liang, Pengzhu (Curcumae Rhizoma), Danggui (Angelicae Sinensis Radix) each 0.5 liang, Binglang (Arecae Semen), Muxiang (Aucklandiae Radix) each 7.5 qian. Grind into powder. Take 3 qian per dose, mixed with boiling water. Jiawei Siwu Tang (Modified Four Substances Decoction) treats female blood accumulation. Xiong (Ligustici Chuanxiong Rhizoma), Gui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba), Dihuang (Rehmanniae Radix), Leng (Sanleng Rhizoma), Zhu (Baizhu Rhizoma), Guixin (Cinnamomi Ramulus), Ganqi (Drynariae Rhizoma stir-fried until smoke ceases) each in equal parts. Grind into coarse powder. Decoct and take 2 qian per dose. All three formulas combine tonifying herbs with Sanleng; this illustrates the principle of analogy.
[Discussion on Sanleng and Pengzhu] Pengzhu is black and belongs to Blood, able to break Blood within Qi. Sanleng is white and belongs to Qi, able to break Qi within Blood. What is called "Blood within Qi" refers to blood condensed by Qi. When Yang is trapped by Yin, general blood-breaking herbs are ineffective. Only Pengzhu, being Yin within Yang, can enter through Qi to break Blood, first opening Qi, then exerting its blood-breaking effect. (Thus it is also used with Qi herbs to disperse aromatic qualities and treat discontinuous Qi.) For regulating Qi, such as Huoluan cold Qi and heart/abdominal pain, it can still be used. As for "Qi within Blood," which is Qi obstructed by blood, Qi-breaking herbs can remove it. Sanleng is Yang within Yin, entering through Blood to break Qi, first resolving Blood... (Text fragmentary). Hard accumulations do not arise suddenly. Yin is the foundation of Yang. Whenever Sanleng is used, it not only damages Blood but also depletes True Qi; deficiency patterns must strictly avoid it. It can break tangible accumulations caused by external pathogens stagnating Qi and Blood, wrapped by food, phlegm, and saliva. However, if tangible accumulations result from long-term emotional constraint, one must skillfully use tonification and movement to strengthen the Spleen and Stomach. The Spleen and Stomach...
[Processing] To resolve accumulations, soak in vinegar for one day and stir-fry, or boil thoroughly and bake dry before use.