仲景之方中，用当归、芎 者，其所主治，不可的知也。今不敢凿从成方而用焉，是阙
如之义也。
辨 误
本草以当归、芎 治血，为产后要药。为则按∶仲景氏治血方中，无此二药者多。而治
他证之方中，亦有此二药。如奔豚汤、当归羊肉汤、酸枣仁汤类是也。由是观之，不可概为
治血之药也。
品 考
当归 江州伊芳 山所产。其味辛、同汉土所产。而和州所产味甘，此以粪土培养之者也，
不可用矣。孙思邈曰∶无当归，以芎 代之。今试尝和州当归，其味大不似芎 也。伊芳 当
归则似焉，故用之也。
芎 出本邦丰后州者上品也。
主治结实而拘挛也。旁治腹痛头痛、身体不仁、疼痛腹满、咳逆下利肿脓。
考 证
桂枝加芍药汤证曰∶腹满时痛。
小建中汤证曰∶腹中急痛。
桂枝加大黄汤证曰∶大实痛。
以上三方，芍药皆六两。
枳实芍药散证曰∶腹痛烦满。
排脓散，证阙。（说在类聚方）
以上二方，芍药一方等分，一方六分。
芍药甘草汤证曰∶脚挛急。
桂枝加芍药生姜人参新加汤证曰∶身疼痛。
芎归胶艾汤证曰∶腹中痛。
以上三方，芍药皆四两。
芍药甘草附子汤，证不具也。（说在互考中）
以上一方，芍药三两，而亦四两之例。
小青龙汤证曰∶咳逆。
大柴胡汤证曰∶心下满痛。又曰∶呕吐而下利。
附子汤证曰∶身体痛。
真武汤证曰∶腹痛。又云∶沉重疼痛、自下利。又云∶咳。
桂枝汤证曰∶头痛。又曰∶身疼痛。
乌头汤证曰∶历节不可屈伸疼痛。又曰∶拘急。
黄 桂枝五物汤证曰；身体不仁。
以上七方，芍药皆三两。
黄芩汤证曰∶自下利。
柴胡桂枝汤证曰∶肢节烦疼。
以上二方，用芍药，或二两，或一两半。而亦三两之例。
上历观此诸方，曰腹痛、曰头痛、曰腹满、曰咳逆、曰下利、曰排脓、曰四肢疼痛、曰
挛急、曰身体不仁，壹是皆结实而所致也。其所谓痛者，拘急也。若夫桂枝加芍药汤、小建
中汤、桂枝加大黄汤，皆以芍药为主药，而其证如此。由是观之，主治结实而拘挛也明矣。
互 考
小建中汤，《伤寒论》不备其证。是以世医不获方意，以为补剂，故其所施也，竟无效
焉？为则按∶此方出自芍药甘草汤，故主治诸病腹拘急而痛者也，学人正焉。芍药甘草附子
汤，其条特举恶寒之证，此附子之所主也，而脱芍药、甘草之所主治也。其用甘草者，治毒
急迫也。其用芍药者，治拘挛也。然则拘挛急迫而恶寒者，此汤主之。
真武汤、附子汤，特有生姜、人参之异。而所主治，则颇异也。真武汤，苓芍为主。而
附子
辨 误
朱震亨曰∶产后不可用芍药，以其酸寒伐生发之气也。李时珍曰∶白芍药益脾，能于土
中泻木，产后肝血已虚，不可更泻，故禁之。夫酸寒之药，盖不少矣。何独避芍药之为？世
医雷同其说，不思之甚矣。诸药皆毒，毒而治毒，毒而不用毒，何治之有？《金匮要略》曰∶
产后腹痛，枳实芍药散主之。《千金方》曰∶产后虚羸、腹中刺痛、当归建中汤主之。此皆
芍药主药，而用之于产后也。且也张仲景芍药甘草汤、芍药甘草附子汤、桂枝加芍药汤，皆
以芍药为主，而于血证无毫关涉焉，特治结实而拘挛已。若乃酸寒伐生发之气，及泻木之说，
此凿空之论，而非疾医之用也。
品 考
芍药 其种有二∶曰木芍药也，曰草芍药也。木芍药是其真也，花容绰约，亦可爱也，
余取之矣；服食家言，白花胜赤花，尝试其功，赤白惟均也。服食家之说，不可从矣。草芍
药，世所谓宇多芍药也，不可用矣。
在张仲景的方剂中，使用当归、川芎的，其主治功效无法确切知晓。如今不敢盲目遵循成方而使用它们，这是遵循“阙如”（保留疑问，不作定论）的原则。
辨误
本草书籍认为当归、川芎用于治疗血证，是产后用药的要药。但我考察发现：张仲景治疗血证的方剂中，没有这两味药的很多。而在治疗其他病证的方剂中，也有这两味药。例如奔豚汤、当归羊肉汤、酸枣仁汤等就是如此。由此看来，不能一概而论地认为它们是治疗血证的药物。
品考
当归产于江州伊芳山。其味道辛，与汉土（中国内地）所产的相同。而和州所产的当归味道甘，这是因为用粪肥培养的缘故，不能使用。孙思邈说：如果没有当归，可以用川芎代替。如今试着品尝和州的当归，其味道与川芎大不相同。伊芳山的当归则与川芎相似，所以使用它。
川芎出产于本邦丰后州的为上品。
主治结实（气血郁结阻滞）以及拘挛（肌肉筋脉拘急痉挛）。旁治腹痛、头痛、身体麻木不仁、疼痛伴腹部胀满、咳逆、下利、肿脓。
考证
桂枝加芍药汤证表现为：腹部胀满，时而疼痛。
小建中汤证表现为：腹中急痛。
桂枝加大黄汤证表现为：剧烈的实痛。
以上三方，芍药用量均为六两。
枳实芍药散证表现为：腹痛，烦闷胀满。
排脓散，证候缺失。（详见《类聚方》）
以上二方，芍药用量为一两等分或六分。
芍药甘草汤证表现为：脚部拘挛紧急。
桂枝加芍药生姜人参新加汤证表现为：身体疼痛。
芎归胶艾汤证表现为：腹中疼痛。
以上三方，芍药用量均为四两。
芍药甘草附子汤，证候不全。（详见《互考》）
以上一方，芍药三两，但也符合四两的惯例。
小青龙汤证表现为：咳逆。
大柴胡汤证表现为：心下痞满疼痛。又说：呕吐而下利。
附子汤证表现为：身体疼痛。
真武汤证表现为：腹痛。又说：沉重疼痛、自发性下利。又说：咳嗽。
桂枝汤证表现为：头痛。又说：身体疼痛。
乌头汤证表现为：历节病，关节不可屈伸且疼痛。又说：拘急。
黄芪桂枝五物汤证表现为：身体麻木不仁。
以上七方，芍药用量均为三两。
黄芩汤证表现为：自发性下利。
柴胡桂枝汤证表现为：肢节烦疼。
以上二方，使用芍药，或二两，或一两半。这也符合三两的惯例。
综上所述，纵观这些方剂，症状包括腹痛、头痛、腹满、咳逆、下利、排脓、四肢疼痛、拘急、身体不仁，这一切都是由“结实”所致。其中所谓的“痛”，就是“拘急”。至于桂枝加芍药汤、小建中汤、桂枝加大黄汤，都以芍药为主药，而其证候如上所述。由此看来，芍药的主治功能确实是治疗结实和拘挛，这已经很明确了。
互考
小建中汤，《伤寒论》中对其证候记载不全。因此后世医生未能领会方义，将其视为补剂，所以施用之后竟然无效？我考察认为：此方出自芍药甘草汤，所以主治各种疾病引起的腹部拘急疼痛，学习者应纠正这一观点。芍药甘草附子汤，其条文特别列举了恶寒的症状，这是附子的主治范围，而脱去了芍药、甘草的主治内容。使用甘草，是为了治疗毒邪引起的急迫症状。使用芍药，是为了治疗拘挛。那么，对于既有拘挛急迫又有恶寒的患者，此汤主治之。
真武汤、附子汤，特有的区别在于生姜、人参的不同。而所主治的病证，则颇有差异。真武汤以茯苓、芍药为主；而附子汤……（原文此处中断）
辨误
朱震亨说：产后不可用芍药，因为它的酸寒性质会伐伤生发之气。李时珍说：白芍药益脾，能在土中泻木气，产后肝血已虚，不能再泻，所以禁止使用。酸寒性质的药物，大概不少见。为何唯独避开芍药呢？后世医生盲从这种说法，思考得太少了。所有药物都有毒性，以毒攻毒，如果不用有毒的药物，又能治疗什么疾病呢？《金匮要略》说：产后腹痛，用枳实芍药散主治。《千金方》说：产后虚弱羸瘦、腹中刺痛，用当归建中汤主治。这些都是以芍药为主药，并用于产后的例子。况且张仲景的芍药甘草汤、芍药甘草附子汤、桂枝加芍药汤，都以芍药为主药，而与血证毫无关系，只是治疗结实和拘挛罢了。至于所谓酸寒伐伤生发之气，以及泻木的说法，这都是凭空捏造的言论，并非临床医生的实用理论。
品考
芍药有两种品种：一种是木芍药，一种是草芍药。木芍药是真正的芍药，花姿优美，也很可爱，我选取的是这种；服食家说，白花胜过赤花，我尝试过它们的功效，发现赤白两者效果相当。服食家的说法，不可听从。草芍药，即世人口中的宇多芍药，不能使用。
In Zhang Zhongjing's prescriptions, the specific therapeutic indications for the use of Danggui (Angelicae Sinensis Radix) and Xiong (Ligustici Chuanxiong Rhizoma) cannot be definitively known. Today, I dare not blindly follow established formulas to use them; this adheres to the principle of "leaving gaps" (preserving uncertainty without making definitive claims).
Correction of Errors
Materia Medica texts state that Danggui and Xiong are essential medicines for treating blood disorders in the postpartum period. However, upon my examination: there are many formulas by Zhang Zhongjing for treating blood disorders that do not contain these two herbs. Conversely, there are also formulas for treating other conditions that contain these two herbs, such as Bentun Tang (Panic Decoction), Danggui Yangrou Tang (Danggui and Mutton Decoction), and Suanzaoren Tang (Sour Jujube Seed Decoction). From this perspective, it is incorrect to generalize them as medicines solely for treating blood disorders.
Product Examination
Danggui produced in Yifang Mountain, Jiangzhou, has a pungent taste, similar to that produced in Hantu (mainland China). However, Danggui from Hezhou has a sweet taste because it is cultivated with manure; it should not be used. Sun Simiao stated: "If Danggui is unavailable, substitute with Xiong." Upon tasting Danggui from Hezhou today, its flavor is significantly different from Xiong. Danggui from Yifang, however, resembles Xiong, hence it is used.
Xiong produced in Bungo Province within our country is of the highest grade.
Primary Indications: Solidity (Qi and Blood stagnation/blockage) and spasm (muscle and tendon contraction). Secondary indications: Abdominal pain, headache, numbness of the body, pain accompanied by abdominal fullness, coughing upward (reverse flow of Qi), diarrhea, swelling, and pus formation.
Textual Verification
The syndrome of Guizhi Jia Shaoyao Tang presents as: abdominal fullness and intermittent pain.
The syndrome of Xiaojianzhong Tang presents as: urgent abdominal pain.
The syndrome of Guizhi Da Huang Tang presents as: severe solid pain.
In the above three formulas, the dosage of Shaoyao (Paeoniae Radix Alba/Rubra) is six liang in each.
The syndrome of Zhishi Shaoyao San presents as: abdominal pain, irritability, and fullness.
The syndrome of Paimon San is missing (see *Leiju Fang*).
In the above two formulas, the dosage of Shaoyao is one part equal or six parts.
The syndrome of Shaoyao Gancao Tang presents as: leg cramps and urgency.
The syndrome of Guizhi Jia Shaoyao Shengjiang Renshen Xinjia Tang presents as: body pain.
The syndrome of Xiong Gui Jiao Ai Tang presents as: abdominal pain.
In the above three formulas, the dosage of Shaoyao is four liang in each.
Shaoyao Gancao Fuzi Tang: the syndrome description is incomplete (see *Hukao*).
In the above single formula, Shaoyao is three liang, which also aligns with the precedent of four liang.
The syndrome of Xiao Qinglong Tang presents as: coughing upward.
The syndrome of Da Chaihu Tang presents as: fullness and pain in the epigastrium. It also states: vomiting and diarrhea.
The syndrome of Fuzi Tang presents as: body pain.
The syndrome of Zhenwu Tang presents as: abdominal pain. It also states: heaviness and pain, spontaneous diarrhea. It also states: cough.
The syndrome of Guizhi Tang presents as: headache. It also states: body pain.
The syndrome of Wutou Tang presents as: Li-jie disease, where joints cannot flex or extend due to pain. It also states: tension and cramping.
The syndrome of Huanggui Zhi Wu Wu Tang presents as: numbness of the body.
In the above seven formulas, the dosage of Shaoyao is three liang in each.
The syndrome of Huangqin Tang presents as: spontaneous diarrhea.
The syndrome of Chaihu Guizhi Tang presents as: painful and irritable limbs and joints.
In the above two formulas, Shaoyao is used, either two liang or one and a half liang. This also aligns with the precedent of three liang.
Having reviewed all these formulas comprehensively, the symptoms mentioned include abdominal pain, headache, abdominal fullness, coughing upward, diarrhea, pus discharge, limb pain, cramping, and body numbness. All of these are caused by "solidity." The so-called "pain" referred to here is essentially "tension/cramping." Regarding Guizhi Jia Shaoyao Tang, Xiaojianzhong Tang, and Guizhi Da Huang Tang, all use Shaoyao as the principal herb, and their syndromes are as described above. From this, it is clear that the primary indication of Shaoyao is to treat solidity and cramping.
Cross-Verification
Xiaojianzhong Tang: The syndrome description in *Shanghan Lun* is incomplete. Therefore, physicians of later generations failed to grasp the intent of the formula, considering it a tonic, and thus its application yielded no effect? My examination suggests: This formula originates from Shaoyao Gancao Tang; therefore, its primary indication is various diseases causing abdominal tension and pain. Students should correct this view. Shaoyao Gancao Fuzi Tang specifically lists aversion to cold as a symptom; this is the domain of Fuzi (Aconiti Lateralis Radix Praeparata), while the indications for Shaoyao and Gancao are omitted. Gancao is used to treat toxicity-induced urgency. Shaoyao is used to treat cramping. Therefore, for patients presenting with cramping, urgency, and aversion to cold, this decoction is indicated.
Zhenwu Tang and Fuzi Tang differ specifically in the presence of Shengjiang (Zingiberis Rhizoma Recens) and Renshen (Ginseng Radix). Their primary indications, however, differ considerably. Zhenwu Tang prioritizes Fuling (Poria) and Shaoyao; whereas Fuzi Tang... (text ends here).
Correction of Errors
Zhu Zhenheng stated: "Shaoyao should not be used postpartum because its sour and cold nature damages the vitalizing Qi." Li Shizhen stated: "White Shaoyao benefits the spleen and drains Wood from Earth. Since Liver Blood is deficient postpartum, further draining is contraindicated, hence it is prohibited." There are many sour and cold medicines. Why single out Shaoyao? Physicians of later generations have blindly followed this saying without much thought. All medicines possess toxicity; we use toxicity to treat toxicity. If we do not use toxic medicines, how can we achieve treatment? *Jingui Yaolue* states: "For postpartum abdominal pain, Zhishi Shaoyao San is indicated." *Qianjin Fang* states: "For postpartum weakness and emaciation, stabbing abdominal pain, Danggui Jianzhong Tang is indicated." These are examples where Shaoyao is the principal herb and is used in the postpartum period. Furthermore, Zhang Zhongjing's Shaoyao Gancao Tang, Shaoyao Gancao Fuzi Tang, and Guizhi Jia Shaoyao Tang all use Shaoyao as the principal herb, yet they have no direct relation to blood disorders; they merely treat solidity and cramping. As for the theories regarding sour-cold damaging vitalizing Qi and draining Wood, these are groundless arguments and not applicable to clinical practice.
Product Examination
There are two varieties of Shaoyao: Mu Shaoyao (Tree Peony Root) and Cao Shaoyao (Herbaceous Peony Root). Mu Shaoyao is the true Shaoyao; its flowers are graceful and lovely, and I select this variety. Practitioners of dietary therapy claim that white flowers are superior to red flowers. Upon testing their efficacy, I found red and white to be equivalent. Thus, the claims of dietary therapy practitioners should not be followed. Cao Shaoyao, commonly known as Uda Shaoyao in the world, should not be used.