主利水也，旁治掣痛咳烦。
考 证
十枣汤证曰∶引胁下痛。又曰∶咳烦。
互 考
淮南子曰∶大戟去水。
品 考
大戟 汉产有两品，绵大戟为良也，本邦之产，其效较劣。
主利水也，旁治掣痛咳烦、短气、小便难、心下满。
考 证
十枣汤证曰∶引胸下痛、干呕、短气。又曰∶咳烦。
大黄甘遂汤证曰∶小便微难。
甘遂半夏汤证曰∶虽利、心下续坚满。
大陷胸汤证曰∶短气躁烦。又曰∶心下满而硬痛。
以上四方，其用甘遂，或三枚，或二两，或一钱也。
为则按∶芫花、大戟、甘遂，同是利水，而甘遂之效最胜矣。
品 考
甘遂 汉产为胜，本邦所产，其效较劣。
主逐水也；故能治恶寒、身体四肢及骨节疼痛，或沉重，或不仁，或厥冷，而旁治腹痛、
失精、下利。
考 证
大乌头煎证曰∶绕脐痛，若发，则自出汗、手足厥冷。
乌头汤证曰∶历节疼痛、不可屈伸。
乌头桂枝汤证曰∶腹中痛、逆冷、手足不仁。
以上三方，乌头皆五枚而为君药也。
桂枝附子汤证曰∶身体疼痛、不能自转侧。
桂枝附子去桂加术汤证曰∶前证而小便不利。
大黄附子汤证曰∶胁下偏痛。
天雄散，证阙。（说在术部）
以上四方，附子皆三枚。
桂枝甘草附子汤证曰∶疼烦不得伸屈。
附子汤证曰∶背恶寒。又曰∶身体痛、手足寒、骨节痛。
以上二方，附子皆二枚。
四逆汤证曰∶下利清谷不止、身疼痛。又曰∶手足厥冷。
真武汤证曰∶腹痛。又曰∶四肢沉重、疼痛自下利。
桂枝加附子汤证曰∶四肢微急、难以伸屈。
桂枝去芍药加附子汤证曰∶恶寒。
附子粳米汤证曰∶切痛。
麻黄附子甘草汤，证不具也。（说在麻黄部）
麻黄附子细辛汤，证不具也。（说在细辛部）
附子泻心汤证曰∶恶寒。
桂姜草枣黄辛附汤，证不具也。（说在术部）
以上九方，附子皆一枚。
上历观此诸方，其证一是皆水病也。桂枝附子去桂加术汤条曰∶一服觉身痹；半日许再
服，三服都尽，其人如冒状，勿怪；即是术附并走皮中逐水气，未得除故耳。乌头桂枝汤条
曰∶初服二合，不知，即服三合，又不知，复加至五合。其知者，如醉状。得吐者，为中病
也。此二者，言附子逐水瞑眩之状也。凡附子中病，则无不瞑眩。甚者脉绝色变，如死人状。
顷
互 考
凡附子、大戟、甘遂之类，同逐水气。而其用之也，随毒所在。附子主水气，而骨节及
身体
桂枝加附子汤，附子一枚。桂枝附子汤，附子三枚。四肢微急、难以屈伸者，用附子一
枚。身体疼烦、不能自转侧者，用附子三枚。随其痛剧，易附子亦有多少。则附子之功，可
得而知也。
《本草纲目》曰∶天雄散，治失精。其说曰∶暖水脏益精，误矣。仲景以天雄逐水耳。
精也
辨 误
《本草纲目》曰∶附子性大热。又云∶大温。夫味之辛酸苦甘咸，食而可知也。性之寒
热温凉，尝而不可知也。以不可知也为知，一测诸臆，其说纷纷，吾孰适从。夫仲景用附子
以逐水为主，而不拘热之有无也。若麻黄附子细辛汤、大黄附子汤，其证岂得谓之无热乎？
学人察诸。
孔子曰∶名不正，则言不顺。有是哉？今所谓中风者，非古所谓中风也。仲景氏曰∶头
痛发热、恶风有汗者，名曰中风。今所谓中风，则肢体不遂者而其说 于《金匮要略》及《千
金
效也，而设一论。更建曰∶类中风。盖类也者，类似也。而《金匮》、《千金》之所谓中风
，岂类《伤寒论》之所谓中风乎？不类也，宜其不得其治也。为则朝夕苦思，参考仲景氏之
方，今所谓中风者，身体疼痛不仁，而往往附子之证也，今举一二而征焉。乌头桂枝汤证曰
∶手足不仁、身疼痛也。去桂加术汤证曰∶身体疼烦、不能自转侧。桂枝加附子汤证曰∶四
肢微急、难以屈伸。今有此证而用此方，无一不中。中则瞑眩，疾乃瘳。吾故曰∶今所谓中
风者，非古所谓中风。而仲景氏用附子剂者也，不可不知矣。
品 考
附子 今用本邦之乌头也。出于奥州南部津轻松前者，是为上品。今汉客来鬻者，盐藏
而非自然之物也，其功能不与古人所论同也。李时珍曰∶及一两者难得，但得半两以上者皆
良。今汉客来鬻者，大及二两，小不下半两。本邦之乌头，与时珍所说，其轻重只同；而其
效与古人之所用，亦只同也。于是乎吾不用彼而用此也。《博物志》曰∶乌头、附子、天雄，
一物也。《广雅》曰∶奚毒附子也。一年为侧子，二年为乌喙，三年为附子，四年为乌头，
五年为天雄。为则按∶其效皆同，而后世辨别之不可从矣。锉用。
考证：
十枣汤证候描述为：“牵引胁下疼痛”。又说：“咳嗽烦躁”。
互考：
《淮南子》记载：“大戟能去除水饮。”
品考：
大戟：汉代产地有两种，绵大戟品质优良；本国（日本）所产的大戟，药效相对较差。
（甘遂）主要功效是通利水湿，兼治牵引性疼痛、咳嗽烦躁、气短、小便困难、胃脘部胀满。
考证：
十枣汤证候描述为：“牵引胸下疼痛、干呕、气短”。又说：“咳嗽烦躁”。
大黄甘遂汤证候描述为：“小便轻微困难”。
甘遂半夏汤证候描述为：“虽然腹泻，但胃脘部持续坚硬胀满”。
大陷胸汤证候描述为：“气短、躁动烦躁”。又说：“胃脘部胀满且硬痛”。
以上四个方剂，使用甘遂的剂量，或三枚，或二两，或一钱。
为则按语：芫花、大戟、甘遂，都是通利水湿的药物，但甘遂的药效最为显著。
品考：
甘遂：汉代产地品质较好，本国所产的甘遂，药效相对较差。
（附子）主要功效是驱逐水气；因此能治疗恶寒、身体四肢及骨节疼痛，或沉重感，或麻木不仁，或四肢厥冷，并兼治腹痛、遗精、腹泻。
考证：
大乌头煎证候描述为：“绕脐疼痛，若发作，则自汗出、手足厥冷”。
乌头汤证候描述为：“历节疼痛、关节不可屈伸”。
乌头桂枝汤证候描述为：“腹部疼痛、逆冷、手足麻木不仁”。
以上三个方剂，乌头均为五枚，作为君药。
桂枝附子汤证候描述为：“身体疼痛、不能自行翻身转侧”。
桂枝附子去桂加术汤证候描述为：“上述证候而小便不利”。
大黄附子汤证候描述为：“胁下偏侧疼痛”。
天雄散，证候缺失。（详见白术部）
以上四个方剂，附子均为三枚。
桂枝甘草附子汤证候描述为：“疼痛烦躁、不能屈伸”。
附子汤证候描述为：“背部恶寒”。又说：“身体疼痛、手足寒冷、骨节疼痛”。
以上两个方剂，附子均为二枚。
四逆汤证候描述为：“腹泻完谷不化不止、身体疼痛”。又说：“手足厥冷”。
真武汤证候描述为：“腹痛”。又说：“四肢沉重、疼痛伴随腹泻”。
桂枝加附子汤证候描述为：“四肢轻微拘急、难以屈伸”。
桂枝去芍药加附子汤证候描述为：“恶寒”。
附子粳米汤证候描述为：“剧烈疼痛”。
麻黄附子甘草汤，证候不全。（详见麻黄部）
麻黄附子细辛汤，证候不全。（详见细辛部）
附子泻心汤证候描述为：“恶寒”。
桂姜草枣黄辛附汤，证候不全。（详见白术部）
以上九个方剂，附子均为一枚。
纵观上述各方，其证候无一不是水气病。桂枝附子去桂加术汤条文中说：“服药后感觉身体麻痹；约半日后再次服用，三次服完，患者出现如头昏目眩的状态，不要奇怪；这是因为白术和附子共同作用于皮中驱逐水气，尚未完全祛除的缘故。”乌头桂枝汤条文中说：“初次服用二合，若无反应，即服用三合，仍无反应，再加量至五合。若有反应，如同醉酒状态。出现呕吐的，即为中病。”这两处记载，说的是附子驱逐水气时出现的瞑眩反应。凡是附子中病，无不出现瞑眩反应。严重的甚至脉绝、面色改变，像死人一样。
互考：
凡是附子、大戟、甘遂这类药物，都能驱逐水气。但它们的应用，取决于毒性所在部位。附子主治水气，涉及骨节及身体……
桂枝加附子汤，用附子一枚。桂枝附子汤，用附子三枚。四肢轻微拘急、难以屈伸者，用附子一枚。身体疼痛烦躁、不能自行翻身转侧者，用附子三枚。根据疼痛的剧烈程度，附子的用量也有多寡之分。由此可知附子的功效。
《本草纲目》记载：“天雄散，治疗遗精。”其解释说：“温暖水脏以益精”，这是错误的。张仲景使用天雄只是为了驱逐水气罢了。
辨误：
《本草纲目》说：“附子性大热。”又说：“大温。”味道的辛、酸、苦、甘、咸，吃下去就能知道。性质的寒、热、温、凉，尝起来是无法知道的。把无法知道的当作知道的，全凭主观臆测，说法纷纭，我们该听从谁呢？张仲景使用附子主要是为了驱逐水气，而不拘泥于是否有热象。例如麻黄附子细辛汤、大黄附子汤，这些证候难道能说没有热吗？学者们请仔细考察。
孔子说：“名分不正，言语就不顺当。”确实如此吗？现在所谓的“中风”，并非古代所说的“中风”。张仲景说：“头痛发热、恶风有汗者，称为中风。”现在所谓的“中风”，是指肢体瘫痪者，这种说法见于《金匮要略》及《千金方》，并设立了一论。又建立名称叫“类中风”。所谓“类”，就是类似的意思。那么，《金匮要略》、《千金方》中所说的“中风”，难道是类似于《伤寒论》中所说的“中风”吗？并不类似，所以得不到正确的治疗。我朝夕苦苦思考，参考张仲景的方剂，现在所谓的“中风”，表现为身体疼痛麻木不仁，往往属于附子证的范畴，现举一二例来验证。乌头桂枝汤证候描述为：“手足麻木不仁、身体疼痛。”桂枝附子去桂加术汤证候描述为：“身体疼痛烦躁、不能自行翻身转侧。”桂枝加附子汤证候描述为：“四肢轻微拘急、难以屈伸。”现在有这些证候而使用这些方剂，没有不有效的。有效就会出现瞑眩反应，疾病才能痊愈。所以我常说：现在所谓的“中风”，并非古代所说的“中风”，而是张仲景使用附子剂的证候，这一点不可不知。
品考：
附子：现在使用的是本国的乌头。产自奥州南部津轻松前者，为上品。现在来自汉地（中国）客商贩卖的，是用盐腌制的，并非自然之物，其功能与古人论述的不同。李时珍说：“一两重的难得，能得到半两以上的都是好的。”现在汉地客商贩卖的，大的达二两，小的不低于半两。本国的乌头，与李时珍所说的重量相当；但其药效与古人所用的一样。因此我不使用汉地的而使用本国的。《博物志》说：“乌头、附子、天雄，是同一种植物。”《广雅》说：“奚毒就是附子。”生长一年为侧子，二年为乌喙，三年为附子，四年为乌头，五年为天雄。我按语认为：它们的药效相同，而后世对它们的辨别不可从信。使用时需锉碎入药。
(Edulis Radix) Its primary function is to promote diuresis (promote water metabolism), and it also treats pulling pain, cough, and irritability.
Textual Research:
The Shi Zao Tang syndrome describes: "Pulling pain in the hypochondrium." It also states: "Cough and irritability."
Cross-Reference:
Huainanzi records: "Da Ji removes fluid retention."
Product Evaluation:
Edulis Radix: There are two varieties from the Han region; Mian Da Ji is of superior quality. The variety produced locally (in Japan) has inferior efficacy.
(Kansui Radix) Its primary function is to promote diuresis, and it also treats pulling pain, cough, irritability, shortness of breath, difficulty in urination, and fullness in the epigastrium.
Textual Research:
The Shi Zao Tang syndrome describes: "Pulling pain below the chest, dry heaving, shortness of breath." It also states: "Cough and irritability."
Dahuang Gansui Tang syndrome describes: "Slight difficulty in urination."
Gansui Banxia Tang syndrome describes: "Although there is diarrhea, there is persistent hardness and fullness in the epigastrium."
Daxiexiong Tang syndrome describes: "Shortness of breath, restlessness, and irritability." It also states: "Fullness and hard pain in the epigastrium."
In the above four formulas, the dosage of Kansui Radix is either three pieces, two liang, or one qian.
Commentary by Weize: Yuanhua, Edulis Radix, and Kansui Radix all promote diuresis, but Kansui Radix has the most potent effect.
Product Evaluation:
Kansui Radix: The variety from the Han region is superior; the locally produced variety has inferior efficacy.
(Aconiti Lateralis Radix Praeparata) Its primary function is to expel water qi; therefore, it can treat aversion to cold, pain in the body, limbs, and joints, heaviness, numbness, or cold extremities, and also treats abdominal pain, seminal emission, and diarrhea.
Textual Research:
Da Wutou Jian syndrome describes: "Periumbilical pain; if it occurs, spontaneous sweating and cold hands and feet."
Wutou Tang syndrome describes: "Pain in the joints, inability to flex or extend."
Wutou Guizhi Tang syndrome describes: "Abdominal pain, coldness, and numbness in the hands and feet."
In the above three formulas, Aconiti Radix (Wutou) is five pieces and serves as the sovereign herb.
Guizhi Fuzi Tang syndrome describes: "Body pain, inability to turn over independently."
Guizhi Fuzi Qu Guizi Jia Baizhu Tang syndrome describes: "The aforementioned symptoms with ineffective urination."
Dahuang Fuzi Tang syndrome describes: "Pain on one side of the hypochondrium."
Tianxiong San, syndrome description missing. (See Bai Zhu section)
In the above four formulas, Aconiti Lateralis Radix Praeparata (Fuzi) is three pieces.
Guizhi Gancao Fuzi Tang syndrome describes: "Painful irritability, inability to flex or extend."
Fuzi Tang syndrome describes: "Aversion to cold in the back." It also states: "Body pain, cold hands and feet, joint pain."
In the above two formulas, Aconiti Lateralis Radix Praeparata (Fuzi) is two pieces.
Sini Tang syndrome describes: "Continuous diarrhea with undigested food, body pain." It also states: "Cold hands and feet."
Zhenwu Tang syndrome describes: "Abdominal pain." It also states: "Heaviness and pain in the four limbs, accompanied by diarrhea."
Guizhi Jia Fuzi Tang syndrome describes: "Slight stiffness in the four limbs, difficulty in flexion and extension."
Guizhi Qu Shaoyao Jia Fuzi Tang syndrome describes: "Aversion to cold."
Fuzi Xingmi Tang syndrome describes: "Severe pain."
Mahuang Fuzi Gancao Tang, syndrome description incomplete. (See Mahuang section)
Mahuang Fuzi Xixin Tang, syndrome description incomplete. (See Xixin section)
Fuzi Xiexin Tang syndrome describes: "Aversion to cold."
Gui Jiang Cao Zao Huang Xin Fu Tang, syndrome description incomplete. (See Baizhu section)
In the above nine formulas, Aconiti Lateralis Radix Praeparata (Fuzi) is one piece.
Having reviewed these formulas, their syndromes are all related to water disease. In the entry for Guizhi Fuzi Qu Guizi Jia Baizhu Tang, it says: "After taking the medicine, the patient feels numbness in the body; after half a day, take another dose, and after finishing all three doses, the patient may experience a sensation of dizziness or confusion; do not be alarmed; this is because Baizhu and Fuzi are working together in the skin to expel water qi, which has not yet been fully eliminated." In the entry for Wutou Guizhi Tang, it says: "Initially take two he; if there is no effect, take three he; if still no effect, increase to five he. If there is an effect, it resembles a drunken state. Vomiting indicates that the disease is being treated." These two passages describe the mingxuan (medicinal reaction) phenomenon when Fuzi expels water qi. Whenever Fuzi effectively treats the disease, mingxuan reactions occur. In severe cases, the pulse may vanish, complexion may change, resembling death.
Cross-Reference:
Herbs such as Aconiti Lateralis Radix Praeparata, Edulis Radix, and Kansui Radix all expel water qi. However, their application depends on where the toxicity resides. Aconiti Lateralis Radix Praeparata primarily treats water qi affecting the bones, joints, and body...
Guizhi Jia Fuzi Tang uses one piece of Fuzi. Guizhi Fuzi Tang uses three pieces of Fuzi. For slight stiffness in the four limbs and difficulty in flexion and extension, one piece of Fuzi is used. For painful irritability in the body and inability to turn over independently, three pieces of Fuzi are used. Depending on the severity of the pain, the dosage of Fuzi varies accordingly. Thus, the efficacy of Fuzi can be understood.
Bencao Gangmu states: "Tianxiong San treats seminal emission." Its explanation says: "It warms the Water Organ to benefit essence," which is incorrect. Zhang Zhongjing used Tianxiong solely to expel water qi.
Correction of Errors:
Bencao Gangmu states: "Fuzi is extremely hot in nature." It also says: "Greatly warm." The flavors—acrid, sour, bitter, sweet, salty—are known through tasting. The natures—cold, hot, warm, cool—cannot be determined by taste alone. To claim knowledge of what cannot be known is mere speculation, leading to conflicting theories. Whose view should we follow? Zhang Zhongjing used Fuzi primarily to expel water qi, regardless of whether heat was present. For instance, in Mahuang Fuzi Xixin Tang and Dahuang Fuzi Tang, how can the syndromes be described as lacking heat? Scholars should examine this carefully.
Confucius said: "If names are not correct, language is not in accordance with the truth of things." Is this true? What is currently called "Zhong Feng" (Wind Stroke) is not what was anciently called "Zhong Feng." Zhang Zhongjing stated: "Headache, fever, aversion to wind, and sweating is named Zhong Feng." What is currently called "Zhong Feng" refers to limb paralysis. This theory appears in Jingui Yaolue and Qianjin Fang, establishing a discussion. Another term, "Lei Zhong Feng" (Similar Wind Stroke), was coined. "Lei" means similar. Are the "Zhong Feng" mentioned in Jingui Yaolue and Qianjin Fang similar to the "Zhong Feng" in Shanghan Lun? They are not similar, hence the failure to find effective treatments. I have pondered this day and night, referencing Zhang Zhongjing's formulas. What is currently called "Zhong Feng," characterized by body pain and numbness, often falls under the category of Fuzi syndromes. I will cite a few examples to verify this. Wutou Guizhi Tang syndrome describes: "Numbness in hands and feet, body pain." Guizhi Fuzi Qu Guizi Jia Baizhu Tang syndrome describes: "Painful irritability in the body, inability to turn over independently." Guizhi Jia Fuzi Tang syndrome describes: "Slight stiffness in the four limbs, difficulty in flexion and extension." When these syndromes are present and these formulas are used, they are invariably effective. Effectiveness brings about mingxuan reactions, and the disease is cured. Therefore, I say: What is currently called "Zhong Feng" is not the ancient "Zhong Feng," but rather a syndrome treated by Zhang Zhongjing using Fuzi formulas. This must be understood.
Product Evaluation:
Aconiti Lateralis Radix Praeparata: Currently, the local Wutou is used. The variety from Tsugaru in southern Ou Province is of superior quality. The variety sold by merchants from the Han region is salt-preserved and not natural, so its efficacy differs from that discussed by ancients. Li Shizhen said: "One liang is rare; anything above half a liang is good." The current merchandise from Han merchants ranges from two liang down to half a liang. The local Wutou matches Li Shizhen's description in weight, and its efficacy matches that used by the ancients. Therefore, I use the local variety instead of the Han variety. Bowuzhi states: "Wutou, Fuzi, and Tianxiong are the same substance." Guangya states: "Xi Du is Fuzi." One year old is Cizi, two years old is Wu Hui, three years old is Fuzi, four years old is Wutou, five years old is Tianxiong. My commentary: Their efficacies are identical, so subsequent distinctions among them should not be followed. They should be sliced before use.