考 证
白头翁汤证曰∶热利下重。又曰∶下利欲饮水。
白头翁加甘草阿胶汤证曰∶下利。
以上二方,白头翁皆三两。
夫仲景用白头翁者,特治热利,而他无所见矣。为则按∶若热利渴而心悸,则用白头翁
汤也,加之血证,及急迫之证,则可用加甘草阿胶汤也。
品 考
白头翁 和、汉无别。
主治心中烦悸也。旁治心下痞、吐下、腹中痛。
考 证
黄连阿胶汤证曰∶心中烦、不得卧。
以上一方,黄连四两。
黄连汤证曰∶胸中有热、腹中痛、欲呕吐。
干姜黄连黄芩人参汤证曰∶吐下。
葛根黄连黄芩汤证曰∶利遂不吐。
白头翁汤证曰∶下利欲饮水。
以上四方,黄连皆三两。
大黄黄连泻心汤证曰∶心下痞、按之濡。
泻心汤证曰∶心气不足。
附子泻心汤证曰∶心下痞。
以上三方,黄连皆一两,而亦三两之例。
上历观此诸方,黄连治心中烦悸也明矣。故心中烦悸而痞者、吐者、利者、腹痛者,用
此皆治也。此外用黄连一两方多,其比余药分量差少,但举心胸之微疾,不足取而征焉!故
不枚举也。
互 考
张仲景用黄连。其证与人参、茯苓,大同而小异。说在人参部。
黄连阿胶汤证曰∶心中烦。此方黄连为君,而有心中烦之证,斯可以见其主治矣。泻心
汤证曰∶心气不足,而吐血衄血者,泻心汤主之。既云不足,又云泻心,此后世论说之所由
起也;然《千金方》不足作不定,斯仲景之古也。而不定者,烦悸之谓也。凡病心中烦悸、
心下痞、按之濡者,用此汤皆治也。由是观之,所谓不定者,烦悸之谓也。
辨 误
夫万物生于天也,故天命之谓性。性唯一也,其能亦唯一也,谓之良能。然其有多能者,
性之所枝而岐也,非性之本也,谓之蠃能。人之眩蠃能,而谓性多能者多矣。余尝读本草,
举其主治甚多。夫主治也者,性之能也。一物一性,岂有此多能哉!今近取譬于人之多能乎?
夫人之性也,有任焉者,有清焉者,有和焉者,有直焉者,虽圣人不可移易也;而有多能焉,
有无能焉,多能非求于天性之外而成焉,无能非求于天性之中而无焉。人其性而用之,则多
能也,是善于用其性者也,非由天性而多能也,故天性任焉者,用而多能,则尽其性之任而
已。任之外,无有其能也。清则清,和则和,直则直,从性之一而贯之,不可移易也。亦有
学而修之,以成其多能者,若天性然,然非去性而然,亦与性成者也。此所以论于人之道,
而非所以论于草根木皮也。夫善于用人性之能者若彼,而况于草根木皮乎?性之外,无有多
能,而一草何多能之有?夫黄连之苦,治心烦也,是性之为能也,张仲景用焉,而治心下痞
呕吐,下利之证也,是性之所枝而岐也,故无心烦之状者,试之无效。如心烦者,其应如响
。仲景治心下痞,呕吐下利,其方用黄连者甚多,斯亦可以征也。由是观之,黄连主治心烦
也,本草之谬也明矣。黄连之能多乎哉,不多也。
品 考
黄连 处处出焉,出于本邦越中者,为上品,世所谓加贺黄连是也。贪利之贾,成以郁
金色之,不可不择也,锉用。
考证
白头翁汤证表现为:热性痢疾且伴有肛门重坠感。又说:下利且想喝水。
白头翁加甘草阿胶汤证表现为:下利。
以上两个方剂,白头翁的用量均为三两。
张仲景使用白头翁,专门治疗热性痢疾,未见其他用途。为则按语:如果是热性痢疾且口渴、心悸,则使用白头翁汤;如果兼有出血症状,以及急迫的症状,则可以使用加甘草阿胶汤。
品考
白头翁:中国和朝鲜半岛没有区别。
主治心中烦闷和心悸。旁治胃脘部痞塞、呕吐腹泻、腹部疼痛。
考证
黄连阿胶汤证表现为:心中烦闷、无法入睡。
以上一个方剂,黄连用量为四两。
黄连汤证表现为:胸中有热、腹部疼痛、想要呕吐。
干姜黄连黄芩人参汤证表现为:呕吐和下利。
葛根黄连黄芩汤证表现为:下利且不呕吐。
白头翁汤证表现为:下利且想喝水。
以上四个方剂,黄连用量均为三两。
大黄黄连泻心汤证表现为:胃脘部痞塞,按压时柔软。
泻心汤证表现为:心气不足。
附子泻心汤证表现为:胃脘部痞塞。
以上三个方剂,黄连用量均为一两,这也是三两用量的先例。
纵观上述各方,黄连主治心中烦闷和心悸是明确的。所以,凡是心中烦闷心悸并伴有胃脘痞塞、呕吐、下利、腹痛者,使用此药都能治愈。此外,使用一两黄连的方剂较多,其相对于其他药物的分量较少,只是列举心胸部位的轻微疾病,不足以作为依据来验证!所以不再一一列举。
互考
张仲景使用黄连。其适应证与人参、茯苓大同小异。说明见人参部。
黄连阿胶汤证表现为:心中烦闷。此方以黄连为君药,且有心中烦闷的症状,由此可以看出其主治功效。泻心汤证表现为:心气不足,若有吐血、鼻衄者,用泻心汤主治。既然说“不足”,又说“泻心”,这是后世理论争论的起源;然而《千金方》中“不足”解释为“不定”,这才是张仲景的古义。“不定”指的是烦悸。凡是有心中烦悸、胃脘痞塞、按压柔软的病症,使用此汤皆能治愈。由此看来,所谓的“不定”,指的就是烦悸。
辨误
万物生于天,所以天命之谓性。本性只有一个,其功能也只有一个,称为良能。然而有的药物有多种功能,是本性的分支和歧出,并非本性的根本,称为羸能(多余的功能)。人们往往迷惑于这种羸能,认为本性具有多种功能的人很多。我曾经阅读本草,发现其中列举的主治功效非常多。所谓主治,就是本性的功能。一物一性,怎么会有这么多功能呢?现在就近取譬于人的多能情况。人的本性,有的刚强,有的清静,有的温和,有的正直,即使是圣人也不能改变;而有的人有多能,有的人无能,多能并非在天性之外求得而成,无能也并非在天性之中缺失。人顺应其本性并使用它,就能表现出多能,这是善于运用本性的人,并非由天性本身产生多能。所以天性刚强者,运用其功能就能表现多能,但这只是尽其刚强之本性罢了。刚强之外,没有其他功能。清则清,和则和,直则直,顺从本性之一端贯穿始终,不可改变。也有通过学习修养而成就多能的,如同天性一样,但并非去除本性而然,也是与本性和谐共成的。这是讨论人的道理,而不是讨论草根树皮的方法。善于运用人性功能的人像这样,何况是草根树皮呢?本性之外,没有多能,一株草哪里会有这么多功能?黄连的苦味,治疗心烦,这是本性所发挥的功能;张仲景用它治疗胃脘痞塞、呕吐、下利的症状,这是本性的分支和歧出。所以,没有心烦症状的患者,试用无效。如有心烦者,疗效如回声般迅速响应。仲景治疗胃脘痞塞、呕吐下利,其方剂中使用黄连的很多,这也足以作为证据。由此看来,黄连主治心烦是明确的,本草书中关于黄连主治众多的说法是错误的。黄连的功能多吗?不多。
品考
黄连到处都有产出,产于本国越中的为上品,世人称之为加贺黄连。贪图利益的商人,将其染成郁金色,不得不仔细挑选。切碎后使用。
Verification
The Bai Tou Weng Tang (Pulsatilla Decoction) syndrome is characterized by: heat-type dysentery with a sensation of rectal heaviness. It also states: diarrhea accompanied by thirst.
The Bai Tou Weng Jia Gan Cao E Jiao Tang (Pulsatilla Decoction with Licorice and Donkey-Hide Gelatin) syndrome is characterized by: diarrhea.
In the above two formulas, the dosage of Pulsatillae Radix (Baitouweng) is three liang in both.
Zhang Zhongjing used Pulsatillae Radix specifically for treating heat-type dysentery, with no other observed indications. Wei Ze's commentary: If there is heat-type dysentery with thirst and palpitations, Bai Tou Weng Tang should be used; if accompanied by bleeding syndromes and urgent symptoms, Bai Tou Weng Jia Gan Cao E Jiao Tang can be used.
Product Verification
Pulsatillae Radix (Baitouweng): No difference between China and Korea/Japan.
Primary indication: Mental restlessness and palpitations. Secondary indications: Epigastric fullness/stuffiness, vomiting and diarrhea, abdominal pain.
Verification
Huang Lian E Jiao Tang (Coptis Decoction with Donkey-Hide Gelatin) syndrome is characterized by: mental restlessness and inability to sleep.
In the above one formula, Coptidis Rhizoma (Huanglian) is four liang.
Huang Lian Tang (Coptis Decoction) syndrome is characterized by: heat in the chest, abdominal pain, and desire to vomit.
Gan Jiang Huang Lian Huang Qin Ren Shen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction) syndrome is characterized by: vomiting and diarrhea.
Ge Gen Huang Lian Huang Qin Tang (Kudzu Root, Coptis, and Scutellaria Decoction) syndrome is characterized by: diarrhea without vomiting.
Bai Tou Weng Tang (Pulsatilla Decoction) syndrome is characterized by: diarrhea with thirst.
In the above four formulas, Coptidis Rhizoma (Huanglian) is three liang in each.
Da Huang Huang Lian Xie Xin Tang (Rhubarb, Coptis, and Heart-Draining Decoction) syndrome is characterized by: epigastric fullness/stuffiness, which is soft upon palpation.
Xie Xin Tang (Heart-Draining Decoction) syndrome is characterized by: insufficiency of Heart Qi.
Fu Zi Xie Xin Tang (Aconite and Heart-Draining Decoction) syndrome is characterized by: epigastric fullness/stuffiness.
In the above three formulas, Coptidis Rhizoma (Huanglian) is one liang in each, which also serves as an example for the three-liang dosage.
Having reviewed these formulas comprehensively, it is clear that Coptidis Rhizoma (Huanglian) treats mental restlessness and palpitations. Therefore, for cases involving mental restlessness and palpitations accompanied by epigastric fullness, vomiting, diarrhea, or abdominal pain, this herb is effective. Furthermore, there are many formulas using one liang of Coptidis Rhizoma; its dosage relative to other herbs is small, merely addressing minor disorders of the chest and heart, which is insufficient to serve as evidence! Thus, they are not enumerated.
Mutual Verification
Zhang Zhongjing used Coptidis Rhizoma (Huanglian). Its indications are largely similar but slightly different from those of Ginseng Radix et Rhizoma (Renshen) and Poria (Fuling). See the section on Ginseng.
Huang Lian E Jiao Tang (Coptis Decoction with Donkey-Hide Gelatin) syndrome is characterized by: mental restlessness. In this formula, Coptidis Rhizoma (Huanglian) is the sovereign herb, and given the symptom of mental restlessness, its primary indication can be seen. Xie Xin Tang (Heart-Draining Decoction) syndrome is characterized by: insufficiency of Heart Qi; if accompanied by hematemesis or epistaxis, Xie Xin Tang (Heart-Draining Decoction) is indicated. The phrase "insufficiency" followed by "draining the Heart" has been the source of later theoretical debates; however, in *Qian Jin Fang*, "insufficiency" is interpreted as "instability," which reflects Zhang Zhongjing's original meaning. "Instability" refers to restlessness and palpitations. For any disease presenting with mental restlessness and palpitations, epigastric fullness/stuffiness, and softness upon palpation, this decoction is effective. From this perspective, what is referred to as "instability" means restlessness and palpitations.
Correction of Errors
All things are born from Heaven; thus, what is endowed by Heaven is called Nature. Nature is singular, and its capacity is singular, termed innate ability. However, some substances possess multiple capacities, which are branches and divergences of nature, not the fundamental nature, termed superfluous abilities. Many people confuse these superfluous abilities and believe that nature possesses multiple capacities. I have read Materia Medica texts where the listed primary indications are numerous. Primary indication refers to the function of nature. One substance, one nature; how can it have so many functions? Let us take a metaphor from human multifaceted abilities. Human nature may be strong, pure, harmonious, or upright; even a sage cannot change this. Some people have multifaceted abilities, while others do not. Multifaceted abilities are not acquired outside of innate nature, nor does lack of ability imply a deficiency within innate nature. When humans align with their nature and utilize it, they exhibit multifaceted abilities; this is being good at utilizing nature, not nature itself generating multifaceted abilities. Therefore, a person with a strong nature utilizes strength to show multifaceted abilities, but this is merely exhausting the capacity of strength. Outside of strength, there is no other ability. Pure remains pure, harmonious remains harmonious, upright remains upright; following one aspect of nature consistently allows for no alteration. Some achieve multifaceted abilities through study and cultivation, resembling nature, but this is not achieved by removing nature, but rather by harmonizing with it. This discusses the way of humanity, not the way of roots and barks. Just as one who is good at utilizing human nature acts thus, how much more so for roots and barks? Outside of nature, there are no multifaceted abilities; how can a single herb have so many functions? The bitterness of Coptidis Rhizoma (Huanglian) treats mental restlessness; this is the function of its nature. Zhang Zhongjing used it to treat epigastric fullness, vomiting, and diarrhea; these are branches and divergences of its nature. Therefore, in patients without mental restlessness, trial use yields no effect. In those with mental restlessness, the response is immediate. Zhang Zhongjing used Coptidis Rhizoma (Huanglian) frequently in formulas for treating epigastric fullness, vomiting, and diarrhea, which serves as evidence. From this, it is clear that Coptidis Rhizoma (Huanglian)'s primary indication is mental restlessness, and the claims in Materia Medica regarding its numerous indications are erroneous. Does Coptidis Rhizoma (Huanglian) have many functions? No.
Product Verification
Coptidis Rhizoma (Huanglian) grows everywhere. Those produced in Echigo Province of our country are considered top grade, known in the world as Kaga Huanglian. Greedy merchants dye them yellow like Turmeric Rhizoma (Yujin), so careful selection is necessary. Cut before use.