即诃子出波斯。今岭南广州亦有之。其木作实似栀子橄榄状。七八月成熟。实棱只具六
路。或多或少者非。肉浓者佳。曝干收之。益小为胜。 毗黎勒个个毗头。一种勒圆而文露。
或八路至十二三路。号榔精勒。味涩不堪。为害殊甚。
味涩而苦。微酸有甘。气温味浓。苦重。阴也。降也。入肺大肠二经。 主治冷气心腹
胀满。消痰。（海舶遇大鱼放涎滑。数里船不能通。乃煮此洗其涎滑。寻化为水。其消痰功
力可知。）下气。疗上气喘急。破胸膈结气。敛肺止久嗽。利咽喉。通津液。疗肾气奔豚。
及大便不通。实大肠。止肠癖久泄。并患痢人肛门急痛。产妇阴痛。（和蜡烧烟熏之。或煎
汤熏洗。） 肺苦气上逆。急食苦以泄之。以酸补之。诃子苦重泻气。酸轻不能补肺。（东垣）
味苦而性急。肺苦急。急食苦以泻之。谓降而下走也。故诃子下气。惟气实者宜之。气虚似
难轻服。（丹溪）气虚人宜缓缓煨熟少服。兹物苦涩。虽涩肠。又泻肺气故耳。（宗 ） 同
乌梅五倍子用。则收敛。同橘皮浓朴用。则下气。同人参用。则能补肺。治咳嗽。但咳未
久者。不可骤用。 同人参肉豆蔻。则实大肠。 得人参。治肺虚受寒喘嗽。得陈皮砂仁。
主冷气入内。心腹胀满。及因寒食不下。 得益智。止虚寒小水不禁。 佐樗根白皮。止肠
癖泻血。佐白术莲实。止久泻因于虚寒。 同蛇床五味山萸杜仲续断。止虚寒带下。 劳嗽。
（即火郁嗽）肺气因火伤极。遂郁遏胀满。不得眠一边。用诃子海浮石瓜蒌杏仁青黛童便浸
香附半夏曲等。姜蜜调噙化服。此证必以补阴为主。而取诃味酸苦。有收敛降火之功。 下
痢赤白久不瘥。转为白脓。用诃子三枚。两炮一生。并取皮末之。以沸浆水一合服之效。若
只水痢。加甘草末一钱匕。若微有脓血。加三匕。血多亦加三匕。
〔论〕 诃子产于炎土。七八月结实。禀金气以告成。而金随从火以为用。故其味初尝
之涩。次苦。苦居胜。又次酸。酸微有甘。夫苦从火化。酸者阳气之不尽宣。而涩乃阴气之
不尽畅也。昔贤谓血得酸则敛。得苦则涩。是阴持于阳之中不能尽畅而为涩也。诃子之先涩
者金。次苦者火。禀金气而反从火以为用。故其金从火以降。而火又由金以敛。所以同于降
泻。则奏降泻之功。同于收敛。则致收敛之效。大约具降收之全性。与他药之擅一长者有异
也。 方书于诃子有止用皮者。有止用肉者。其肉先涩次苦。而涩不敌苦。又次酸及甘。乃
甚微。是肉之为用。降泻居多。而泻中犹有收义。更合于中土之气而不尽泻也。其皮涩与苦
等。次止有甘。亦甚微。是皮之涩能敌苦。泻犹未极。又止带甘。则泻中尤有缓也。二者须
索其味之有异以施治。乃为得之。 再按诃子下逆气。泻结气。通积聚。利咽喉。历考成方。
如息贲之枳实散。伏梁之半夏散。奔豚之木香槟榔散。便闭之七宣丸。又声喑之诃子汤。梅
核气之清咽屑。或止同于降泻。从邪之实者论治。或更同于寒凉之降泻。从实邪之有热者论
治也。又如胸痞气滞胁肋刺痛之沉香升降散。胸痹喘息之利膈散。息贲之半夏汤。喘证之苏
杏散。或兼补剂。从虚中有实者论治。或更兼温补。从虚中有寒者论治也。是其降泻为功。
岂得畏气虚而不用乎。至又有用其酸与涩者。义固非与降泻相戾也。人身肺气犹天。其职司
降。而有降即有收。自飞门至于魄门。皆一气之所贯。（若有降无收。有收无降。则升降息
而气立孤危矣。） 经故曰魄门亦为五脏使。言脏腑糟粕。固由其泻。而脏气升降。亦借以
调。诃子入手太阴阳明。其味始于涩苦。终于酸甘。降与收随所合而为用。是以丹溪治久嗽
劫剂。则同于百药煎荆芥穗。河间治失音发声。则同于桔梗木通童便。东垣以止久痢。则同
于御米壳干姜陈皮。宝鉴则合于椿白皮母丁香。其通便闭也。合杏仁麻仁枳壳为二仁丸。协
柴胡枳实桃仁大黄木香为七宣丸。绎此不可以识诃子之长技。亦惟我所使欤。总之。用以降
泻。宜于气实。实者邪气实。用以收涩。则宜于气虚。虚者正气虚。此中后先主辅。惟当适
事为故耳。至缪氏致慎于火嗽湿热痢。立论良是。第丹溪治火嗽久病。有同杏仁青黛海粉皂
角胆星而用者。又治湿热久痢。（地榆丸）有同地榆当归木香黄连阿胶乌梅而用者。正可推
此类以尽变也。又如滑泻之治。有诃子散以治热。更有诃子丸以治寒。举寒热而皆宜。其故
可思矣。再河间治热滑诃子散。用诃子木香黄连甘草。其云腹痛渐止。泻下渐少。宜此药止
之。如止之不已。宜因其归而送之。加浓朴一两。竭其邪气也。玩此。则主辅应有合宜之味。
而火嗽
凡咳嗽因于肺有实热滞下。湿热正盛。法并忌之。（仲淳）
〔修事〕 水泡。面包煨熟去核。或酒浸蒸去核。焙干。 清痰生用。止泻煨用。
诃子产于波斯。如今岭南广州也有出产。它的果实形状像栀子或橄榄。在七八月成熟。果实表面只有六条棱路。如果棱路数量多或少于六条的都不是正品。果肉厚实的为佳。晒干后收藏。个头小的更好。
毗黎勒（诃子的别名）个个都有蒂头。有一种勒圆且纹理显露的，或者棱路有八路到十二三路的，号称“榔精勒”，味道涩得难以下咽，危害很大。
诃子味道涩而苦，微酸带甘。药性温，气味浓厚，苦味较重，属阴，主降。归入肺、大肠二经。主治冷气引起的心腹胀满，消除痰饮。（海外商船遇到大鱼吐出的涎液滑腻，几里长的船都被堵塞，于是煮这种药清洗涎液，很快化为水，由此可知它消除痰饮的功效。）下气，治疗上气喘急，破除胸膈间郁结之气，收敛肺气以止久咳，利咽喉，通津液，治疗肾气奔豚（气从少腹上冲心胸），以及大便不通，固涩大肠，止住肠癖和长期泄泻，并缓解患痢疾者的肛门急痛，产妇阴道疼痛。（可与蜡一起烧烟熏蒸，或煎汤熏洗。）
《内经》说：肺苦气上逆，应急食苦味以泄之；用酸味来补之。诃子苦味重，能泻气；酸味轻，不能补肺。（李东垣语）
诃子味苦而药性急峻。肺病苦于气急，急食苦味以泻之，意思是使其下降并向下走。所以诃子能下气，只适用于气实之人，气虚的人似乎难以轻易服用。（朱丹溪语）气虚的人宜慢慢煨熟后少量服用。此物苦涩，虽然能涩肠，但也泻肺气的原因罢了。（张宗语）
与乌梅、五倍子同用，则具有收敛作用；与橘皮、浓朴同用，则能下气；与人参同用，则能补肺，治疗咳嗽。但咳嗽时间不长的，不可突然使用。
与人参、肉豆蔻同用，则能实大肠。
得到人参配合，可治肺虚受寒引起的喘咳。
得到陈皮、砂仁配合，主治冷气入内导致的心腹胀满，以及因寒凉饮食导致的食欲不振。
得到益智仁配合，可止住虚寒引起的小便不禁。
佐以樗根白皮，可止住肠癖便血。
佐以白术、莲实，可止住因虚寒引起的长期腹泻。
与蛇床子、五味子、山萸肉、杜仲、续断同用，可止住虚寒引起的带下病。
劳嗽（即火郁嗽）。肺气因火热损伤至极，遂致郁遏胀满，无法侧卧睡眠。可用诃子、海浮石、瓜蒌、杏仁、青黛、童便浸香附、半夏曲等药，加姜蜜调匀噙化服用。此证必须以滋阴为主，取诃子酸苦之味，发挥其收敛降火的功效。
下痢赤白，日久不愈，转为白脓。用诃子三枚，一半炮制一半生用，并将果皮研成粉末，用沸浆水一合送服，效果显著。如果只是水样腹泻，加甘草末一钱匕。如果微有脓血，加三匕。如果血多，也加三匕。
【论】
诃子产于炎热之地，七八月结实，禀受金气以告完成，而金随从火来发挥作用。所以它的味道初尝是涩的，其次是苦的，苦味占优势，再次是酸的，酸味中微带甘味。苦味从火化，酸味是阳气未能完全宣发的表现，而涩味是阴气未能完全畅达的表现。古人说血得酸则收敛，得苦则涩滞，这是阴气处于阳气之中不能完全畅达而表现为涩。诃子先涩是因为金，次苦是因为火，禀受金气却反而随从火来发挥作用，所以它的金随火而降，而火又由金来收敛。因此，它与降泻药同类，就能奏降泻之功；与收敛药同类，就能致收敛之效。大体上具备降收的全性，与其他药物擅长某一方面的特点不同。
方书中对于诃子，有用皮者，有用肉者。诃子的肉先涩后苦，而涩不敌苦，再次是酸及甘，但非常微弱。所以肉的作用，降泻居多，而在泻中还有收敛之意，更合乎中土之气而不尽泻。诃子的皮，涩与苦相等，其次只有甘，也非常微弱。所以皮的涩能抵得住苦，泻力尚未至极，又带有甘味，则在泻中更有缓急之意。这两者必须根据味道的差异来施治，才算得当。
再按诃子能下逆气，泻结气，通积聚，利咽喉。历考成方，如治疗息贲病的枳实散，治疗伏梁病的半夏散，治疗奔豚病的木香槟榔散，治疗便秘的七宣丸，治疗失音的诃子汤，治疗梅核气的清咽屑。有的是同于降泻，从邪气实证论治；有的更是同于寒凉的降泻，从实邪有热者论治。又如治疗胸痞气滞胁肋刺痛的沉香升降散，治疗胸痹喘息的利膈散，治疗息贲病的半夏汤，治疗喘证的苏杏散。有的兼用补剂，从虚中有实者论治；有的更兼用温补，从虚中有寒者论治。由此可见，它的降泻功效，怎么能因为气虚就畏惧不用呢？至于又有用其酸涩作用的，意义固然不与降泻相违背。人身肺气犹如天，其职能主降，而有降就有收，从飞门（口唇）至于魄门（肛门），都是一气所贯通。（如果有降无收，有收无降，那么升降停止，气机就会孤立危险了。）所以经书说魄门也为五脏役使，意思是脏腑糟粕，固然由其排泄，而脏气升降，也借此来调节。诃子入手太阴肺经和手阳明大肠经，其味道始于涩苦，终于酸甘，降与收随着配伍不同而发挥作用。因此，丹溪治疗久咳的劫剂，就同百药煎、荆芥穗同用；河间治疗失音发声，就同桔梗、木通、童便同用；东垣用来止久痢，就同御米壳、干姜、陈皮同用；宝鉴则合椿白皮、母丁香。用来通便闭时，合杏仁、麻仁、枳壳为二仁丸；协同柴胡、枳实、桃仁、大黄、木香为七宣丸。推究这些，不可以认识诃子的特长吗？也是看我们如何使用罢了。总之，用来降泻，适宜于气实之人，实是指邪气实；用来收涩，则适宜于气虚之人，虚是指正气虚。其中的主次先后，只应当根据具体情况而定。至于缪氏对火嗽、湿热痢提出谨慎使用的观点，立论确实正确。只是丹溪治疗火嗽久病，有用同杏仁、青黛、海粉、皂角、胆南星的情况；又治疗湿热久痢（地榆丸），有用同地榆、当归、木香、黄连、阿胶、乌梅的情况。正可以类推此类以穷尽其变化。又如治疗滑泻，有诃子散治疗热证，更有诃子丸治疗寒证，举凡寒热都适宜，其中的道理值得深思。再如河间治疗热滑的诃子散，用诃子、木香、黄连、甘草，他说腹痛逐渐停止，泻下逐渐减少，宜用此药止住。如果止不住，宜因其归经而送之，加浓朴一两，以竭尽邪气。玩味这段话，则主次应有合适的味道搭配，而火嗽……
凡是咳嗽因于肺有实热、滞下、湿热正盛时，法度上都忌讳使用。（仲淳语）
【修事】
水泡，面包煨熟去核。或用酒浸蒸去核，焙干。清痰生用，止泻煨用。
Hezi (Chebulae Fructus) originates from Persia. It is now also produced in Guangzhou, Lingnan region. The fruit resembles the shape of Gardenia or Olive. It matures in July and August. The fruit has only six ridges; those with more or fewer than six are not authentic. Thick flesh is preferred. It is sun-dried for storage. Smaller fruits are superior.
Pili Le (a synonym for Hezi) each has a calyx remnant. One variety is round with exposed texture, or has eight to twelve or thirteen ridges, known as "Langjing Le". Its taste is excessively astringent and unbearable, causing significant harm.
The taste is astringent and bitter, slightly sour with a hint of sweet. The nature is warm, and the qi/flavor is strong, with bitterness being predominant. It belongs to Yin and descends. It enters the Lung and Large Intestine meridians. It mainly treats cold qi causing abdominal distension and fullness, and eliminates phlegm. (When overseas merchant ships encounter fish slime that is slippery and blocks the ship for miles, boiling this herb to wash away the slime quickly turns it into water, indicating its efficacy in eliminating phlegm.) It directs Qi downward, treats upper jiao asthma and急促 breathing, breaks up stagnant Qi in the chest and diaphragm, astringes Lung Qi to stop chronic cough, benefits the throat, promotes fluid secretion, treats Kidney Qi Ben Tun (Qi rushing upward from the lower abdomen to the heart/chest), and constipation. It consolidates the Large Intestine, stops dysentery and chronic diarrhea, and relieves acute pain in the anus of patients with dysentery, as well as vaginal pain in postpartum women. (It can be smoked with wax or decocted for fumigation/washing.)
The *Neijing* states: When the Lung suffers from rebellious Qi, urgently consume bitter substances to drain it; use sour substances to tonify it. Hezi has heavy bitterness which drains Qi, and light sourness which cannot tonify the Lung. (Li Dongyuan)
Hezi is bitter and has an urgent/potent nature. When the Lung suffers from urgency, urgently consuming bitter substances drains it, meaning it descends and moves downward. Therefore, Hezi directs Qi downward and is suitable only for those with Qi excess; those with Qi deficiency should not easily take it. (Zhu Danxi) Those with Qi deficiency should slowly roast/char it and take small amounts. This substance is bitter and astringent; although it astringes the intestines, it also drains Lung Qi. (Zhang Zong)
When used together with Wumei (Mume Fructus) and Wubeizi (Galla Chinensis), it has an astringent effect. When used together with Jupi (Citri Reticulatae Pericarpium) and Nongpo (Magnoliae Officinalis Cortex), it directs Qi downward. When used together with Renshen (Ginseng Radix et Rhizoma), it tonifies the Lung and treats cough. However, it should not be used abruptly for coughs that have not lasted long.
When used together with Renshen and Roudoukou (Myristicae Semen), it consolidates the Large Intestine.
Combined with Renshen, it treats asthma and cough due to Lung deficiency and cold invasion.
Combined with Chenpi (Citri Reticulatae Pericarpium) and Sharen (Amomi Fructus), it mainly treats cold qi entering the interior causing abdominal distension and fullness, and loss of appetite due to cold food.
Combined with Yizhi (Alpiniae Oxyphyllae Fructus), it stops involuntary urination due to deficiency-cold.
Adjuvanted with Chugenbaipi (Bignoniae Radicis Cortex), it stops bloody dysentery.
Adjuvanted with Baizhu (Atractylodis Macrocephalae Rhizoma) and Lianshi (Nelumbinis Semen), it stops chronic diarrhea due to deficiency-cold.
Used together with Shechuangzi (Cnidii Fructus), Wuweizi (Schisandrae Fructus), Shanyuzhuyu (Corni Fructus), Duzhong (Eucommiae Cortex), and Xuduan (Dianthi Radix), it stops leukorrhea due to deficiency-cold.
Lao Sou (Laborious Cough, i.e., Fire-stagnation Cough). Lung Qi is extremely damaged by fire, leading to stagnation and fullness, preventing sleep on either side. Use Hezi, Haifushi (Pumex), Gualou (Trichosanthis Fructus), Xingren (Armeniacae Semen Amarum), Qingdai (Indigo Naturalis), Tongbian (Infantis Urine) soaked Xiangfu (Cyperi Rhizoma), Banxia (Pinelliae Rhizoma Qu), etc. Mix with ginger and honey, hold in mouth to dissolve and swallow. This condition must primarily focus on nourishing Yin, taking advantage of Hezi's sour and bitter flavors to achieve astringency and descending fire.
For chronic dysentery with red and white discharge that does not heal and turns into white pus, use three Hezi fruits, half roasted and half raw, grind the peel into powder, and take with one he of boiling grain water. Effective. If it is only watery diarrhea, add one qianbi of Gancao (Glycyrrhizae Radix et Rhizoma) powder. If there is slight pus and blood, add three qianbi. If there is much blood, also add three qianbi.
[Discussion]
Hezi is produced in hot lands, bearing fruit in July and August, inheriting Metal Qi to complete its formation, but Metal follows Fire to exert its function. Thus, its initial taste is astringent, followed by bitter, with bitterness prevailing, then sour, with a slight hint of sweet. Bitterness transforms from Fire; Sourness is the manifestation of Yang Qi not fully disseminated; Astringency is the manifestation of Yin Qi not fully unblocked. Ancient sages said blood gathers with Sourness and becomes astringent with Bitterness. This means Yin holds within Yang but cannot flow freely, resulting in astringency. Hezi is first astringent due to Metal, then bitter due to Fire. Inheriting Metal Qi, it反而 (instead) follows Fire for its function. Thus, its Metal descends with Fire, and Fire is gathered by Metal. Therefore, when combined with descending-draining herbs, it achieves descending-draining effects; when combined with astringent herbs, it achieves astringent effects. Generally, it possesses the complete nature of both descending and gathering, differing from other herbs that excel in only one aspect.
Medical texts vary on using only the peel or only the flesh of Hezi. The flesh is first astringent, then bitter, but astringency does not overcome bitterness, followed by sour and sweet, which are very faint. Thus, the flesh's function is mostly descending-draining, yet within draining, there is still gathering intent, making it more compatible with Central Earth Qi and not purely draining. The peel's astringency equals its bitterness, followed only by faint sweetness. Thus, the peel's astringency can counteract bitterness, so draining is not extreme, and it carries sweetness, implying moderation within draining. Both must be treated according to their flavor differences to be effective.
Furthermore, Hezi directs rebellious Qi downward, drains stagnant Qi, unblocks accumulations, and benefits the throat. Examining established formulas: Zhishi San for Xiben (accumulation in chest), Banxia San for Fuliang (abdominal mass), Muxiang Binglang San for Bentun, Qixuan Wan for constipation, Hezi Tang for aphonia, Qingyan Xie for Plum-pit Qi. Some align with descending-draining, treating based on pathogenic excess; some align with cold-descending-draining, treating based on excess pathogens with heat. Others like Chenxiang Shengjiang San for chest oppression and Qi stagnation with rib-side stabbing pain, Lige San for chest bi with panting, Banxia Tang for Xiben, Suxing San for wheezing. Some combine tonics, treating deficiency with excess; some combine warming-tonics, treating deficiency with cold. Thus, regarding its descending-draining merit, how can one fear Qi deficiency and avoid using it? As for using its sour/astringent properties, this does not contradict descending-draining. Human Lung Qi is like Heaven, its function is descending, and where there is descending, there is gathering. From Feimen (mouth/lips) to Pomen (anus), all are connected by one Qi. (If there is descending without gathering, or gathering without descending, ascending/descending ceases, and Qi stands isolated and in danger.) Hence, the Classics say Pomen serves the Five Zang organs. Waste from Zang-Fu is indeed excreted through it, but Zang-Qi ascending/descending is also regulated by it. Hezi enters Hand-Taiyin Lung and Hand-Yangming Large Intestine meridians. Its taste starts with astringent/bitter and ends with sour/sweet. Descending and gathering function according to combination. Thus, Danxi used it with Baiyaojian and Jingjiesui for chronic cough; Hejian used it with Jiegeng, Mutong, and Tongbian for aphonia; Dongyuan used it with Yumiqiao, Ganjiang, and Chenpi for chronic dysentery; Baojian combined it with Chunbaipi and Mudingxiang. For constipation, it was combined with Xingren, Renren, Zhike for Erren Wan; coordinated with Chaihu, Zhishi, Taoren, Dahuang, Muxiang for Qixuan Wan. Studying these, can we not recognize Hezi's specialties? It depends on our usage. In summary, for descending-draining, it suits Qi Excess (pathogenic excess); for astringing, it suits Qi Deficiency (healthy Qi deficiency). The priority and assistance depend on the specific situation. Miu's caution regarding Fire Cough and Damp-Heat Dysentery is correct. However, Danxi treated Fire Cough with Xingren, Qingdai, Haifen, Zhaojiao, Dansheng; and Damp-Heat Dysentery (Diyu Wan) with Diyu, Danggui, Muxiang, Huanglian, Ejiao, Wumei. These allow us to infer variations. Regarding slippery diarrhea, Hezi San treats Heat, while Hezi Wan treats Cold, suitable for both, a point worth pondering. Hejian's Heat-Slippery Hezi San uses Hezi, Muxiang, Huanglian, Gancao. He stated: if abdominal pain stops and diarrhea decreases, use this to stop it. If stopping fails, follow its meridian entry and send it out, adding Nongpo 1 liang to exhaust pathogenic Qi. Observing this, primary and secondary ingredients should be appropriately matched.
[Cough Contraindication]
Whenever cough is due to Lung Excess Heat, stagnation-downward, or flourishing Damp-Heat, it is contraindicated by method. (Zhongchun)
[Processing]
Soak in water, wrap in flour, roast until cooked, remove core. Or soak in wine, steam, remove core, dry by baking. Raw for clearing phlegm; roasted/charred for stopping diarrhea.