主治胸膈郁结、痰饮也。
考 证
桔梗白散证曰∶时出浊唾腥臭，久久吐脓。
以上一方，贝母三分。
仲景氏用贝母也，特此一方已然。考之本草，古人用贝母，主治郁结痰饮，旁治咳嗽、
乳汁不下也。乃与仲景氏治浊唾腥臭，其归一也已。其功于桔梗，大同而小异也。
品 考
贝母 用自汉土来者也，锉用焉。今本邦间亦出焉，不异于汉土产也。
主治宿饮停水也。故治水气在心下而咳满、或上逆、或胁痛。
考 证
小青汤证曰∶心下有水气、干呕、发热而咳。
苓甘五味姜辛汤证曰∶咳、胸满。
以上二方，细辛皆三两。
麻黄附子细辛汤，证不具也。（说在互考中）
大黄附子汤证曰∶胁下偏痛。
桂姜草枣黄辛附汤证曰∶心下坚大如盘、边如旋杯。
以上三方，细辛皆二两。
上历观此诸方。其咳者，上逆者，胸满者，胁痛者，心下坚大者，胸胁心下宿饮停水而
所致也，用细辛则水饮去，而其证已。可以见其所主治也。
互 考
麻黄附子细辛汤条，特云少阴病反发热，而不举余证。为则按∶六经也者，是后人之搀
入，而非仲景之古也。所谓少阴病者，蜷卧、小便清利也。蜷卧者，恶寒甚也。恶寒者，水
病也；仲景氏之治恶寒也，其用附子者居多。又其言曰∶术、附并走皮中逐水气也。由是观
之，恶寒之为水气也明矣。其喘而恶寒，有痰饮之变者，此方主之。桂姜草枣黄辛附汤证，
不具也。说在术条下，故不复赘焉。
辨 误
今之为医者，其用药也，瞑眩则栗，遽转其方，何无特操之甚也。书曰∶若药弗瞑眩，
厥疾弗瘳。余每读书到于此，未尝不废书抵掌而欢。圣哲之言，信而有征也。仲景之为方也，
亦有征矣！请举其一二。苓甘五味姜辛夏汤条曰∶咳满即止，而更复渴、冲气复发者，以细
辛干姜也。而仍用细辛干姜，此非审知此毒，而治此疾者，孰能之为？呜呼！仲景哉！术附
汤条曰∶其人如冒状，勿怪。即是术附并走皮中逐水气，未得除故耳，此亦瞑眩之谓也。夫
欲为仲景氏者，其要在知药之瞑眩，而疾乃瘳焉。而后就其方法，审其药功而已。为则从事
于此，审试诸药，本草所谓大毒者，其不彻疾也，不瞑眩。所谓无毒者，亦中肯綮也，必瞑
眩。瞑，眩也，疾斯瘳也；余未见药弗瞑眩，而疾之为瘳者也。呜呼！圣哲之言，信而有征
哉！学人思诸。
品 考
细辛 本邦称云∶真细辛者，即是也，洗去尘土，锉而用之，药铺间以杜衡充细辛也。
不可不辨矣。
考证
桔梗白散证的表现为：时常吐出浑浊且带有腥臭味的唾液，日久之后吐出脓液。
以上一方中，贝母的用量为三分。
张仲景使用贝母，仅见于这一方剂罢了。查阅本草典籍，古人使用贝母，主要治疗郁结和痰饮，兼治咳嗽、乳汁不通等症。这与张仲景治疗浊唾腥臭的功效，本质是一致的。其功效与桔梗大体相同而略有差异。
品考
贝母：源自中国本土（汉土），使用时需切碎。如今我国（日本）也有出产，与中国本土所产无异。
主治宿留的饮邪、停聚的水湿。因此用于治疗水气停留于心下（胃脘部）导致的咳嗽、胀满，或气机上逆，或胁肋疼痛。
考证
小青龙汤证的表现为：心下有 water qi（水气）、干呕、发热并伴有咳嗽。
苓甘五味姜辛汤证的表现为：咳嗽、胸部胀满。
以上二方中，细辛的用量均为三两。
麻黄附子细辛汤，其完整证候描述不详。（说明见互考部分）
大黄附子汤证的表现为：胁下偏侧疼痛。
桂枝去芍药加麻辛附子汤（注：原文“桂姜草枣黄辛附汤”即此方，指桂枝、干姜、甘草、大枣、麻黄、细辛、附子组成的方剂）证的表现为：心下坚硬胀大如盘状，边缘像倒扣的杯子。
以上三方中，细辛的用量均为二两。
综上所述观察这些方剂。那些出现咳嗽的、气机上逆的、胸部胀满的、胁肋疼痛的、心下坚硬胀大的症状，都是由胸胁心下部位宿留的饮邪和水湿所致，使用细辛则水饮得以祛除，症状随之消失。由此可以看出细辛的主治功效。
互考
关于麻黄附子细辛汤条文，特别提到少阴病反见发热，而未列举其他证候。对此进行辨析：六经辨证体系是后人掺入的，并非张仲景原著的古法。所谓的少阴病，表现为身体蜷缩而卧、小便清长通畅。身体蜷缩而卧，是因为恶寒严重。恶寒，是水病的表现；张仲景治疗恶寒，大多使用附子。他又说：“白术、附子共同作用于皮中，驱逐水气。”由此可见，恶寒属于水气致病是很明确的。对于气喘且恶寒，由痰饮变化引起的病症，此方主治。桂枝去芍药加麻辛附子汤的证候，描述不详。说明见白术条下，故不再赘述。
辨误
现在的医生，用药时一旦患者出现瞑眩反应（服药后出现的剧烈反应，预示疾病即将好转），就感到恐惧战栗，立即更改处方，这是多么缺乏坚定操守啊！《尚书》说：“如果服药后没有出现瞑眩反应，严重的疾病就不会痊愈。”我每次读书读到此处，没有不放下书本拍手欢呼的。圣哲的话，确实可信且有证据。张仲景制定方剂，也是有依据的！请举出一两个例子。苓甘五味姜辛夏汤条文说：“咳嗽胀满停止后，如果再次出现口渴、冲气复发，是因为使用了细辛和干姜。”然而仍然继续使用细辛和干姜，如果不是深刻了解这种药物的毒性/烈性，并能针对此疾进行治疗的人，谁能做到呢？唉！真是张仲景啊！术附汤条文说：“病人感觉头昏目眩如被物蒙蔽，不要奇怪。这是因为白术和附子共同在皮中运行以驱逐水气，尚未完全排除的缘故。”这也是瞑眩的表现啊。想要效法张仲景的人，关键在于懂得药物的瞑眩反应，疾病才能痊愈。然后在此基础上研究治疗方法，审慎考察药物功效即可。为此从事于此道，审慎试验各种药物，本草所说的大毒之药，如果不引起彻底的治疗反应（瞑眩），就不能根除疾病。所谓无毒之药，也能切中要害，必然会引起瞑眩。瞑眩发生，疾病才能痊愈；我从未见过不服药产生瞑眩反应而疾病能痊愈的情况。唉！圣哲的话，确实可信且有证据啊！学习者请深思。
It primarily treats stagnation and accumulation in the chest and diaphragm, as well as phlegm-fluid retention (Tan Yin).
Textual Research
The syndrome of Jiegeng Bai San (Platycodon White Powder) is characterized by: frequent expectoration of turbid saliva with a foul odor, and eventually expectoration of pus after a long period.
In the above-mentioned formula, the dosage of Beimu (Fritillaria Bulb) is 3 fen.
Zhang Zhongjing used Beimu only in this single formula. Consulting herbal classics, ancient people used Beimu primarily to treat stagnation and phlegm-fluid retention, and secondarily for cough and insufficient lactation. This aligns with Zhang Zhongjing’s treatment of turbid, foul-smelling saliva. Their efficacy is largely similar to that of Jiegeng (Platycodon Root), with minor differences.
Product Examination
Beimu (Fritillaria Bulb): Sourced from Han territory (China), it is used after being chopped. It is also produced in our country (Japan), and is no different from the Chinese variety.
It treats retained fluid and stagnant water. Therefore, it is used to treat conditions where water qi (pathogenic water) stays under the heart (epigastrium), causing cough and fullness, or upward reversal, or hypochondriac pain.
Textual Research
The syndrome of Xiao Qing Tang (Minor Blue Dragon Decoction, i.e., Xiao Qing Long Tang) is characterized by: water qi under the heart, dry retching, fever accompanied by cough.
The syndrome of Ling Gan Wu Wei Jiang Xin Tang (Poria, Licorice, Schisandra, Ginger, and Asarum Decoction) is characterized by: cough and chest fullness.
In the above two formulas, Xixin (Asarum Root) is used in a dosage of 3 liang.
Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction): The complete syndrome description is not provided. (See Mutual Examination).
Dahuang Fuzi Tang (Rhubarb and Aconite Decoction) is characterized by: pain on one side of the hypochondrium.
Guizhi Qushaoyao Jiama Huang Xixin Fuzi Tang (Cinnamon Twig Decoction minus Peony plus Ephedra, Asarum, and Aconite, referred to in text as Gui Jiang Cao Zao Huang Xin Fu Tang) is characterized by: hardness and distension in the epigastrium as large as a plate, with edges like an inverted cup.
In the above three formulas, Xixin (Asarum Root) is used in a dosage of 2 liang.
Observing these various formulas comprehensively, the symptoms of cough, upward reversal, chest fullness, hypochondriac pain, and hardness/distension in the epigastrium are all caused by retained fluid and stagnant water in the chest, hypochondrium, and epigastrium. Using Xixin (Asarum Root) eliminates the fluid retention, and the symptoms resolve. Thus, its primary indications can be seen.
Mutual Examination
Regarding the clause on Mahuang Fuzi Xixin Tang, it specifically mentions Shaoyin disease with contrary fever, but does not list other symptoms. In analysis: The Six Channels (Liu Jing) system was inserted by later generations and is not the ancient method of Zhang Zhongjing. What is called Shaoyin disease is characterized by curling up while lying down and clear, profuse urination. Curling up indicates severe aversion to cold. Aversion to cold is a sign of water disease; Zhang Zhongjing mostly uses Fuzi (Aconite Root) to treat aversion to cold. He also stated: "Baizhu (Atractylodes Macrocephala Rhizome) and Fuzi act together in the skin to drive out water qi." From this, it is clear that aversion to cold is due to water qi. For panting accompanied by aversion to cold, resulting from phlegm-fluid transformation, this formula is indicated. The syndrome of Guizhi Qushaoyao Jiama Huang Xixin Fuzi Tang is not fully described. See the entry for Baizhu for details, so no further repetition here.
Correction of Errors
Modern physicians, when using medicine, become fearful and trembling upon observing Mingxuan reactions (severe physiological responses indicating impending cure), and hastily change their prescriptions. How lacking in steadfast conviction they are! The Book of Documents states: "If the medicine does not induce a Mingxuan reaction, the serious illness will not be cured." Whenever I read this, I cannot help but put down my book and clap my hands in joy. The words of the sages are indeed credible and evidenced. Zhang Zhongjing’s formulation of prescriptions was also based on evidence! Let me cite one or two examples. The clause on Ling Gan Wu Wei Jiang Xin Xia Tang (Poria, Licorice, Schisandra, Ginger, and Pinellia Decoction) states: "When cough and fullness stop, but thirst recurs and the rebellious qi flares up again, it is because Xixin and Ganjiang (Dried Ginger) were used." Yet, he continues to use Xixin and Ganjiang. Who else but someone who thoroughly understands this 'toxicity' (potency) and treats this disease accordingly could do this? Alas, Zhang Zhongjing! The clause on Shu Fu Tang (Atractylodes and Aconite Decoction) states: "The patient feels as if dizzy or obscured, do not be surprised. This is because Baizhu and Fuzi are moving through the skin to expel water qi, which has not yet been completely removed." This is also what is meant by Mingxuan. Those who wish to emulate Zhang Zhongjing must grasp the concept of medicinal Mingxuan reactions for the disease to be cured. Then, they should study the methods and carefully examine the drug's efficacy. Engaging in this field, one must carefully test various herbs. Herbs classified in Bencao as highly toxic, if they do not cause a thorough Mingxuan reaction, will not eradicate the disease. Herbs classified as non-toxic, if they hit the mark, will inevitably cause a Mingxuan reaction. When Mingxuan occurs, the disease is cured; I have never seen a case where a disease was cured without a Mingxuan reaction. Alas, the words of the sages are indeed credible and evidenced! Students should ponder this.
Product Examination
Xixin (Asarum Root): Our country calls it: True Xixin is this species. It is washed to remove dust and chopped before use. Some pharmacies substitute it with Hengdu (Duheng, Dysosma versipellis). One must not fail to distinguish them.