（味之浓者阴中之阴味浓则泄酸苦咸气寒是也）
黄连 气寒味苦无毒瓦斯味俱浓可升可降阴中阳也入手少阴经其用有六泻心藏火一也去中焦湿热二也诸疮必用
三也
去风湿四也赤眼暴发五也止中部见血六也张仲景治九种心下痞五等泻心汤皆用之〔海〕入手少阴苦燥故入心火就
燥也然
泻心其实泻脾也为子能令母实实则泻其子治血防风为上使黄连为中使地榆为下使去须铡细用
黄芩 气寒味苦无毒可升可降阴也阴中微阳入手太阳血分〔洁〕气凉味苦甘气浓味薄浮而升阳中阴也
入手少阳阳明
经酒炒则上行〔垣〕黄芩之中枯而飘者泻肺火利气消痰除风热消肌表之热细实而坚者泻大肠火养阴退阳补膀胱寒
水滋其
化源高下之分与枳实枳壳同例〔洁〕黄芩之用有九泻肺热一也上焦皮肤风热风湿二也去诸热三也利胸中气四也消
痰膈五
也除脾经诸湿六也夏月须用七也妇人产后养阴退阳八也安胎九也酒炒上行主上部积血非此不能除下利脓血腹痛后重身
热久不能止者与芍药甘草同用之凡诸疮痛不可忍者宜黄连苦寒之药详上下分身稍及引经药用之〔颂〕张仲景治伤
寒心下
痞满泻心汤凡四方皆用黄芩以其主诸热利小肠故也又太阳病下之利不止喘而汗出者有葛根黄芩黄连汤及主妊娠安胎散
亦多用之〔珍〕洁古老人言黄芩泻肺火治脾湿东垣言片芩治肺火条芩治大肠火丹溪言黄芩治上中二焦火而仲景治
少阳证
小柴胡汤太阳少阳合病下利黄芩汤少阳证下后心下满而不痛泻心汤并用之成无己言黄芩苦而入心泄痞热是黄芩能入手
少阴阳明手足太阴少阳六经矣盖黄芩气寒味苦色黄带绿苦入心寒胜热泻心火治脾之湿热一则金不受刑一则胃火不流入
肺即所以救肺也肺虚不宜者苦寒伤脾胃损其母也少阳之证寒热胸胁痞满默默不欲饮食心烦呕或烦或痞或小便不利虽曰
病在半表半里而胸胁痞满实兼心肺上焦之邪心烦喜呕默默不欲饮食又兼脾胃中焦之证故用黄芩以治手足少阳相火黄芩
亦少阳本经药也成无己注伤寒论但云柴胡黄芩之苦以发传邪之热芍药黄芩之苦以坚敛肠胃之气殊昧其治火之妙杨士瀛
直指方云柴胡退热不及黄芩盖亦不知柴胡之退热乃苦以发之散火之标也黄芩之退热乃寒能胜热折火之本也仲景又云少
阳病腹中痛者去黄芩加芍药心下悸小便不利者去黄芩加茯苓似与别录治少腹绞痛利小肠之文不合成氏言黄芩寒中苦能
坚肾故去之盖亦不然至此当以意逆之辨以脉证可也若因饮寒受寒腹中痛及饮水心下悸小便不利而脉不数者是里无热证
则黄芩不可用也若热厥腹痛肺热而小便不利者黄芩其可不用乎故善观书者先求其理毋徒泥其文去皮并黑腐铡细竹筛齐
用
黄柏 气寒味苦无毒瓦斯味俱浓沉而降阴也苦浓微辛阴中之阳入足少阴经为足太阳引经药〔垣〕治肾水
膀胱不足诸痿
厥脚膝无力于黄 汤中少加用之使两膝中气力涌出痿即去矣蜜炒此一味为细末治口疮如神瘫痪必用之药泻膀胱之热利
下窍泻膀胱经火补本经及肾不足苦寒安蛔疗下焦虚坚肾经曰苦以坚之足少阴剂肾苦燥故肾停湿也栀子黄芩入肺黄连入
心黄柏入肾燥湿所归各从其类也活人书解毒汤上下内外通治之去皮铡碎生用则降实火熟用酒制则治上盐制则治下蜜制
则治中而不伤胃
栀子 气寒味苦无毒〔洁〕气薄味浓轻清上行气浮而味降阳中阴也〔垣〕沉也阴也入手太阴肺
经血分〔海〕本草不言栀
子能吐仲景用为吐药栀子本非吐药为邪气在上拒而不纳食今上吐则邪因以出所谓其高者因而越之也或用为利小便药实
非利小便乃清肺也肺清则化行而膀胱津液之腑得此气化而出也本草言治大小肠热乃辛与庚合又与丙合又能泄戊先入中
州故也仲景治烦躁用栀子豉汤烦者气也躁者血也气主肺躁主血故用栀子以治肺烦香豉以治肾躁仲景以栀子色赤味苦入
心而治烦香豉色黑味咸入肾而治躁〔寇〕仲景治伤寒发汗吐下后虚寒不得眠若剧者必反复颠倒心中懊 栀子豉汤
治之因
其虚故不用大黄有寒毒故也栀子虽寒而无毒治胃中热气既亡血亡津液腑藏无润养内生虚热非此物不可去也又治心经留
热小便赤涩用去皮栀子火煨大黄连翘炙甘草等分末之水煎三钱服无不利也凡使须要如雀脑并须长有九路赤色者为上去
心胸中热用仁去肌表热用皮治上焦中焦连壳用下焦去壳治血病炒黑用
石膏 气寒味甘辛无毒入手太阴经少阳经足阳明经〔洁〕石膏性寒味辛而淡气味俱薄体重而沉降也阴
也乃
阳明经大
寒之药善治本经头痛牙痛止消渴中暑潮热然能寒胃令人不食非腹有极热者不宜轻用又阳明经中热发热恶寒燥热日晡潮
湿肌肉壮热小便浊赤大渴引饮自汗苦头痛之药仲景用白虎汤是也若无以上诸证勿服之多有血虚发热象白虎证及脾胃虚
劳形体病证初得之时与此证同医者不识而误用之不可胜救也〔垣〕石膏足阳明经也故仲景治伤寒阳明证身热目痛
鼻干不
得卧身以前胃之经也胸前肺之室也邪在阳明肺受火制故用辛寒以清肺气所以有白虎之名又治三焦皮肤大热入手少阳也
凡病脉数不退者宜用之胃弱者不可用按温热病烦热而渴脉洪大而数且长者非用石膏不能取效冬月有此脉证亦宜用之仲
景制白虎汤为正伤寒设也东垣处暑以后勿用之说不可拘泥此即市所谓寒水石者也亦谓之硬石膏细理白泽者良碎之如粟
米大先煮数十沸乃入余药以其气味难出故也
知母 气寒味苦气味俱浓沉而降阴也阴中微阳肾经本药入足阳明手太阴经气分〔垣〕其用有四泻无根
之肾
火疗有汗
之骨蒸止虚劳之热滋化原之阴仲景用此入白虎汤治不得眠者烦躁也烦出于肺躁出于肾君以石膏佐以知母之苦寒以清肾
之源缓以甘草粳米使不速下也又凡病小便 塞而渴者热在上焦气分肺中伏热不能生水膀胱绝其化源宜用气薄味薄淡渗
之药以泻肺火清肺金而滋水之化源若热在下焦血分而不渴者乃真水不足膀胱干涸乃无阴则阳无以化法当用黄柏知母大
苦寒之药以补肾与膀胱使阴气行而阳自化小便自通凡用拣肥润里白者去毛切引经上行则用酒浸焙干下行则用盐水润焙
（忌铁）
秦皮 气寒味苦无毒沉也降也〔海〕主热利下重下焦虚经云以苦坚之故用白头翁黄柏秦皮若苦之剂也
治风寒湿痹目
中青翳白膜男子少精妇人带下小儿惊痫宜作汤洗目俗呼为白 木取皮渍水浸出青蓝色与紫草同用以增光晕尤佳大戟为
之使恶吴茱萸〔珍〕 皮色青气寒味苦性涩乃是厥阴肝少阳胆经药也故治目病惊痫取其平木也治下利崩带取其收
涩也又
能治男子少精益精有子皆取其涩而补也故老子云天道贵涩此药乃服食及惊痫崩利所宜而人止知其治目一节几于废弃良
为可惋
白头翁 气寒味苦辛无毒瓦斯浓味薄可升可降阴中阳也主温疟狂易寒热 瘕积聚逐血止痛张仲景治热利下重用
白头
翁汤主之盖肾欲坚急食苦以坚之利则下焦虚故以纯苦之剂坚之男子阴疝偏坠小儿头秃膻腥鼻衄无此不效毒痢有此获功
亦多〔吴〕热毒下利紫血鲜血者宜之
大黄 气寒味苦无毒瓦斯味俱浓沉而降阴也用之须酒浸煨熟者寒因热用酒浸入太阳经酒洗入阳明经余经不用酒
〔垣〕
大黄苦峻下走用之于下必生用若邪气在上非酒不至必用酒浸引上至高之分驱热而下如物在高巅必射以取之也若用生者
则遗至高之邪热是以愈后或目赤或喉痹或头肿或膈上热疾生也〔寇〕仲景治心气不足吐血衄血泻心汤用大黄黄芩
黄连或曰
心气既不足而不用补心汤更用泻心何也答曰若心气独不足则当不吐衄也此乃邪热因不足而客之故令吐衄以苦补其心盖
一举而两得之有是证者用之无不效惟在量其虚实而已〔丹〕大黄苦寒善泄仲景用之泻心汤者正因少阴经不足本经
之阳亢
甚无辅以致阴血妄行飞越故用大黄泻去亢甚之火使之平和则血归经而自安夫心之阴气不足非一日矣肺与肝俱各受火而
病作故黄芩救肺黄连救肝肺者阴之主肝者心之母血之舍也肝肺之火既退则阴血复其旧矣寇氏不明说而云邪热客之何以
开悟后人也〔珍〕大黄乃足太阴手足阳明手足厥阴五经血分之药凡病在五经血分者宜用之若在气分用之是谓诛伐
无过矣
泻心汤治心气不足吐血衄血者乃真心之气不足而手厥阴心包络足厥阴肝足太阴脾足阳明胃之邪火有余也虽曰泻心实泻
四经血中之伏火也又仲景治心下痞满按之软者用大黄黄连泻心汤主之此亦泻脾胃之湿热非泻心也病发于阴而反下之则
作痞满乃寒伤荣血邪气乘虚结于上焦胃之上脘在于心故曰泻心实泻脾也素问云太阴所至为痞满又云浊气在上则生 胀
是矣病发于阳而反下之则成结胸乃热邪陷入血分亦在上脘分野仲景大陷胸汤丸皆用大黄亦泻脾胃血分之邪而降其浊气
也若结胸在气分则只用小陷胸汤痞满在气分则用半夏泻心汤矣成成氏注伤寒论亦不知分别此义〔颂〕本草称大黄
推陈致
新其效最神故古方下积滞多用之张仲景治伤寒用处尤多古人用毒药攻病必随人之虚实寒热而处治非一切轻用也梁武帝
因发热欲服大黄姚僧坦曰大黄乃是快药至尊年高不可轻用帝弗从几至委顿梁元帝常有心腹疾诸医咸谓宜用平药可渐宣
通僧坦曰脉洪而实此有宿积非用大黄无瘥理帝从之遂愈以此言之今医用一毒药而攻众病其偶中便谓此方神奇其差误则
不言用药之失可不戒哉去皮铡碎竹筛齐用
芒硝 气大寒味咸苦辛有小毒〔成〕内经云咸味下泄为阴又云咸以软之热淫于内治以咸寒气坚者以咸
软之热盛者以
寒消之故张仲景大陷胸汤大承气汤调胃承气汤皆用芒硝以软坚去实热结不至坚者不可用也〔海〕本草云朴硝味辛
是
辛以
润肾燥也今人不用辛字只用咸字咸能软坚也其义皆是本草言芒硝利小便而堕胎然伤寒妊娠可下者用此兼大黄引之直入
大腹润燥软坚泻热而母子俱安经云有故无殒亦无殒也此之谓欤以在下言之则便溺俱阴以前后言之则前气后血以肾言之
总主大小便难溺涩秘结俱为水少火盛经云热淫于内治以咸寒佐之以苦故用芒硝大黄相须为使也〔洁〕芒硝气薄味
浓沉而
降阴也其用有三去实热一也涤肠中宿垢二也破坚积热块三也〔珍〕朴硝是初得一煎而成者故力紧急而不和止可施
于粗犷
之人及敷涂之剂而已芒硝是朴硝淋过炼成故其性和缓仲景治伤寒多用之以此故也硝禀太阴之精水之子也气寒味咸走血
而润下荡涤三焦肠胃实热阳强之病乃折治火邪药也生用
香豉 气寒味苦无毒阴中之阴也主伤寒头痛烦躁满闷生用〔珍〕黑豆性平作豉则温既经蒸窨故能升能散
得葱则发汗得盐则能吐得酒则治风得薤则治痢得蒜则止血炒熟则大能止汗亦麻黄根节之义也
茵陈蒿 气微寒味苦辛无毒阴中微阳入足太阳经除烦热主风湿寒热邪气热结黄胆通身发黄小便不利〔寇〕
张仲景治伤寒热甚发黄身面悉黄者用之极效一僧因伤寒后发汗不彻有留热面身皆黄多热期年不愈医作
食治不对而食不减予与此药服五日病减三分之一十日减三分之二二十日病悉去方用山茵陈山栀子各三
分秦艽升麻各四钱为散每用三钱水四合煎二合去滓食后温服以知为度此药以山茵陈为本故书之
〔海〕仲景茵陈栀子大黄汤治湿热也栀子柏皮汤治燥热也如苗涝则湿黄旱则燥黄湿则泻之燥则润之可也
此二药治阳黄也韩祗和李思训治阴黄用茵陈附子汤大抵以茵陈为君主而佐以大黄附子各随其寒热也去
枝用叶手搓碎用
栝蒌实 气寒味甘微苦无毒〔丹〕栝楼实治胸痹者以其味甘性润甘能补肺润能降气胸中有痰
者乃肺受火逼失其降下之令今得甘缓润下之助则痰自降宜其为治嗽之要药也且又能洗涤胸膈中垢腻郁热
为治消渴之神药〔珍〕张仲景治胸痹痛引心背咳唾喘息及结胸满痛皆用栝蒌实乃取其甘寒不犯胃气能
降上焦之火使痰气下降也成无己不知此意乃云苦寒以泻热盖不尝其味原不苦而随文傅会尔肥大结实者
连子连皮细切用今人止用核仁非也
栝蒌根（一名天花粉） 气寒味甘微苦酸无毒主消渴身热烦满大热补虚安中通月水消肿毒瘀
血及热狂疮疖〔垣〕栝蒌根纯阴解烦渴行津液心中枯涸者非此不能除与辛酸同用导肿气
〔珍〕栝蒌根味甘微苦酸其茎叶味酸酸能生津感召之理故能止渴润枯微苦降火甘不伤胃昔人只言其苦寒
似未深察捣细罗过用
土瓜根 气寒味苦有小毒主疗诸邪气热结逐四时骨节中水疗天行热疾酒黄病壮热心烦闷热劳
能吐下人
连轺（连翘根也）气寒味甘苦有小毒主下热气益阴精故仲景治伤寒瘀热在里欲发黄用麻黄连
轺赤小豆汤
竹叶 气寒味甘无毒淡竹为上甘竹次之主胸中痰热咳逆上气〔寇〕诸笋性皆寒故知其叶
一致也张仲景竹叶汤惟用淡竹〔洁〕竹叶苦平阴中微阳〔垣〕竹叶辛苦寒可升可降阳中阴也
其用有二除新久风邪之烦热止喘促气胜之上冲
梓白皮 气寒味苦无毒主热毒去二虫时气温病头痛壮热初得一日用生梓木削去黑皮取里白
者切一升水二升五合煎汁每服八合取瘥折热之剂必以苦为主又曰大热之气寒以取之是也
（味道浓厚的药材属于阴中之阴，味浓则具有泄降作用。酸、苦、咸味且气寒的药材即属此类。）
黄连：气寒，味苦，无毒，药力与气味都非常浓厚，既能上升又能下降，属于阴中阳。归入手少阴心经。其功效有六方面：一是泻心火；二是清除中焦湿热；三是治疗各种疮疡必用；四是祛除风湿；五是治疗突发赤眼；六是止住中部出血。张仲景治疗九种心下痞证的五种泻心汤中都使用它。李东垣认为：黄连入足少阴肾经，因其苦燥，故能入心火以就燥。然而，所谓“泻心”，其实是在泻脾火。这是因为根据五行理论，“子能令母实”，实则泻其子。在治疗血证时，防风为上行引导药，黄连为中间引导药，地榆为下行引导药。使用时需去须，铡细备用。
黄芩：气寒，味苦，无毒，可升可降，属阴，是阴中的微阳。归入手太阳小肠经的血分。李杲认为：其气凉，味苦甘，气浓味薄，性浮而升，属于阳中之阴。归入手少阳胆经和手阳明大肠经。酒炒后药性上行。李杲又言：黄芩中空而轻飘者，能泻肺火，利气消痰，除风热，消除肌表之热；质地坚实而重者，能泻大肠火，养阴退阳，补膀胱寒水，滋养化源。这与枳实、枳壳的应用道理相同。李杲总结黄芩的功效有九方面：一是泻肺热；二是清除上焦皮肤的风热、风湿；三是清除各种热邪；四是利胸中气机；五是消除膈间痰浊；六是清除脾经的各种湿气；七是夏季必须使用；八是妇女产后用于养阴退阳；九是安胎。酒炒后上行，主治上部积血，非此药不能清除。若出现下利脓血、腹痛、里急后重、身热久不止等症状，应与芍药、甘草同用。凡是各种疮疡疼痛难忍者，宜用黄连等苦寒药物，需详细辨别上下部位及引经药的使用。苏颂记载：张仲景治疗伤寒心下痞满的泻心汤，四个方剂都用了黄芩，因为它能主理各种热邪，利小肠。另外，太阳病误下后导致腹泻不止、喘息出汗者，可用葛根黄芩黄连汤；治疗妊娠安胎的散剂也多用黄芩。李时珍记载：洁古老人说黄芩泻肺火、治脾湿；东垣说片芩治肺火，条芩治大肠火；丹溪说黄芩治上、中二焦之火。而张仲景治疗少阳证的小柴胡汤、太阳少阳合病下利的黄芩汤、少阳证下后心下满而不痛的泻心汤，都使用了黄芩。成无己说黄芩苦入心，泄痞热，说明黄芩能入手少阴、手阳明、足太阴、足少阳六经。大概因为黄芩气寒味苦，色黄带绿，苦入心，寒胜热，泻心火，治脾之湿热。一则使肺金不受心火刑克，二则使胃火不流入肺，这就是救肺的方法。肺虚不宜使用者，是因为苦寒伤脾胃，损及其母脏。少阳证的表现为寒热往来、胸胁痞满、默默不欲饮食、心烦或呕，或烦或痞，或小便不利。虽然说是病在半表半里，但胸胁痞满实际上兼有心肺上焦之邪，心烦喜呕、默默不欲饮食又兼有脾胃中焦之证，所以用黄芩来治疗手足少阳相火。黄芩也是少阳本经的药。成无己注《伤寒论》只说柴胡、黄芩之苦以发散传变之邪的热，芍药、黄芩之苦以坚固收敛肠胃之气，这殊不明其治疗火的奥妙。杨士瀛《直指方》说柴胡退热不及黄芩，大概也是不知道柴胡退热乃是苦以发之，散火之标；黄芩退热乃是寒能胜热，折火之本。张仲景又说：少阳病腹中痛者，去黄芩加芍药；心下悸、小便不利者，去黄芩加茯苓。这似乎与《别录》治疗少腹绞痛、利小肠的文字不符。成氏说黄芩寒中，苦能坚肾，所以去掉它。这大概也不对。对此应当以意逆志，通过脉证来辨别。如果是因饮冷受寒导致腹中痛，以及饮水后心下悸、小便不利而脉不数的，这是里没有热证，那么黄芩不可用。如果是热厥腹痛、肺热而小便不利的，黄芩岂可不用？所以善于读书的人，先要探求其中的道理，不要仅仅拘泥于文字。使用时去皮并去除黑腐部分，铡细，用竹筛筛齐备用。
黄柏：气寒，味苦，无毒，药力与气味都非常浓厚，性质沉降，属阴，是苦味浓而微辛，属于阴中之阳。归入足少阴肾经，为足太阳膀胱经的引经药。李杲认为：治疗肾水、膀胱不足引起的各种痿证、厥证、脚膝无力，在黄柏汤中少量加入，能使两膝中气力涌出，痿证即可痊愈。蜜炒这一味药研成细末，治疗口疮如神，是治疗瘫痪必用的药。它能泻膀胱之热，利下窍，泻膀胱经火，补本经及肾之不足。《内经》说：“苦以坚之。”足少阴肾经，肾恶燥，故肾易停湿。栀子、黄芩入肺，黄连入心，黄柏入肾，燥湿所归，各从其类。《活人书》解毒汤上下内外通治。使用时去皮，铡碎。生用则降实火，熟用酒制则治上部，盐制则治下部，蜜制则治中部且不伤胃。
栀子：气寒，味苦，无毒。李杲认为：其气薄味浓，轻清上行，气浮而味降，属于阳中之阴。李东垣认为：性质沉降，属阴。归入手太阴肺经的血分。李时珍认为：《本草》不说栀子能催吐，张仲景用它作为吐药。栀子本来不是吐药，是因为邪气在上，拒而不纳食物，现在向上呕吐，邪气因此而出，这就是所谓“其高者，因而越之”。也有人用它作为利小便的药，其实并非直接利小便，而是清肺。肺清则气化运行，膀胱津液之腑得到此气化而排出尿液。《本草》说治疗大小肠热，是因为辛与庚合，又与丙合，又能泄戊土，先入中州的原因。张仲景治疗烦躁用栀子豉汤。烦是气的问题，躁是血的问题。气主肺，躁主血，所以用栀子治肺之烦，香豉治肾之躁。张仲景认为栀子色赤味苦入心而治烦，香豉色黑味咸入肾而治躁。寇宗奭认为：张仲景治疗伤寒发汗、吐、下后，虚寒不得眠，如果严重的一定会反复颠倒、心中懊憹，用栀子豉汤治疗。因为其虚，所以不用大黄，因为大黄有寒毒。栀子虽然寒但无毒，治疗胃中热气。既然已经亡血、亡津液，脏腑失去润养，内生虚热，非此物不能去除。又治疗心经留热、小便赤涩，用去皮栀子、火煨大黄、连翘、炙甘草各等分，研末，水煎三钱服用，没有不有效的。凡是用栀子，必须要像雀脑一样，并且长有九路纹路、赤色的为好。去心胸中热用仁，去肌表热用皮，治上焦、中焦连壳用，治下焦去壳，治血病炒黑用。
石膏：气寒，味甘辛，无毒。归入手太阴肺经、少阳经、足阳明胃经。李杲认为：石膏性寒，味辛而淡，气味俱薄，体重而沉降，属阴，是阳明经大寒的药物。善于治疗本经头痛、牙痛，止消渴，中暑，潮热。然而它能寒胃，令人不食，如果不是腹部有极热者，不宜轻用。又是阳明经中热、发热恶寒、燥热、日晡潮热、肌肉壮热、小便浊赤、大渴引饮、自汗、苦头痛的药物。张仲景用白虎汤就是针对这种情况。如果没有以上诸证，不要服用。多有血虚发热像白虎证，以及脾胃虚劳形体病证，初得之时与此证相同，医者不认识而误用，不可胜数地无法挽救。李杲认为：石膏是足阳明经的药，所以张仲景治疗伤寒阳明证，身热、目痛、鼻干、不得卧，身体前面是胃的经络，胸前是肺的居室，邪在阳明，肺受火制，所以用辛寒以清肺气，因此有白虎之名。又治疗三焦皮肤大热，入手少阳经。凡是病脉数不退者适宜用之，胃弱者不可用。按温热病烦热而渴，脉洪大而数且长者，非用石膏不能取效，冬月有此脉证也适宜用之。张仲景制白虎汤是为正伤寒设立的。东垣说处暑以后不要用，这种说法不可拘泥。这就是市场上所谓的寒水石，也叫做硬石膏。纹理细致洁白的为好，碎成粟米大小，先煮数十沸，再放入其他药物，因为其气味难以析出。
知母：气寒，味苦，气味俱浓，沉降，属阴，是阴中的微阳。是肾经的本药，归入足阳明、手太阴经的气分。李杲认为：其功效有四方面：一是泻无根之肾火；二是治疗有汗之骨蒸；三是止虚劳之热；四是滋化原之阴。张仲景用此药入白虎汤，治疗不得眠的烦躁。烦出于肺，躁出于肾，君药以石膏，佐药以知母之苦寒以清肾之源，缓药以甘草、粳米为使，使其不速下。另外，凡是病见小便闭塞而渴者，是热在上焦气分，肺中伏热不能生水，膀胱绝其化源，宜用气薄味薄、淡渗的药物以泻肺火、清肺金而滋水之化源。若热在下焦血分而不渴者，乃真水不足，膀胱干涸，乃无阴则阳无以化，法当用黄柏、知母等大苦寒之药以补肾与膀胱，使阴气行而阳自化，小便自通。凡是用知母，拣选肥润、里面白的，去毛切。引经上行则用酒浸焙干，下行则用盐水润焙。（忌铁器）
秦皮：气寒，味苦，无毒，性质沉降。李时珍认为：主治热利下重，下焦虚。《内经》说“以苦坚之”，所以用白头翁、黄柏、秦皮这类苦味药剂。治疗风寒湿痹，目中青翳白膜，男子少精，妇人带下，小儿惊痫。宜作汤洗目，俗呼为白XX木，取皮渍水浸出青蓝色，与紫草同用以增加光晕尤佳。大戟为之使，恶吴茱萸。李时珍又言：秦皮色青，气寒味苦，性涩，乃是厥阴肝、少阳胆经的药。所以治目病、惊痫，取其平木；治下利、崩漏带下，取其收涩。又能治男子少精、益精有子，皆取其涩而补。所以老子云天道贵涩，此药乃服食及惊痫、崩利所宜，而人只知道它治目一节，几乎被废弃，良为可惋。
白头翁：气寒，味苦辛，无毒，药力浓味薄，可升可降，属阴中阳。主治温疟、狂易、寒热、瘕积聚、逐血止痛。张仲景治疗热利下重用白头翁汤主之。盖因肾欲坚，急食苦以坚之。利则下焦虚，故以纯苦之剂坚之。男子阴疝偏坠、小儿头秃、膻腥、鼻衄，无此不效。毒痢有此获功亦多。吴谦认为：热毒下利，紫血鲜血者适宜用之。
大黄：气寒，味苦，无毒，药力与气味都非常浓厚，沉降，属阴。使用时须酒浸、煨熟者，寒因热用。酒浸入太阳经，酒洗入阳明经，其余经不用酒。李杲认为：大黄苦峻下走，用之于下必生用。若邪气在上，非酒不至，必用酒浸引上至高之分，驱热而下，如物在高巅必射以取之也。若用生者，则遗至高之邪热，是以愈后或目赤、或喉痹、或头肿、或膈上热疾生也。寇宗奭记载：张仲景治疗心气不足、吐血、衄血，泻心汤用大黄、黄芩、黄连。有人问：心气既不足，而不用补心汤，更用泻心何也？答曰：若心气独不足，则当不吐衄也。此乃邪热因不足而客之，故令吐衄。以苦补其心，盖一举而两得之。有是证者用之无不效，惟在量其虚实而已。朱丹溪认为：大黄苦寒善泄。张仲景用之泻心汤者，正因少阴经不足，本经之阳亢甚，无辅以致阴血妄行飞越，故用大黄泻去亢甚之火，使之平和，则血归经而自安。夫心之阴气不足非一日矣，肺与肝俱各受火而病作，故黄芩救肺，黄连救肝。肺者阴之主，肝者心之母，血之舍也。肝肺之火既退，则阴血复其旧矣。寇氏不明说而云邪热客之，何以开悟后人呢？李时珍认为：大黄乃足太阴、手足阳明、手足厥阴五经血分之药。凡病在五经血分者宜用之。若在气分用之，是谓诛伐无过矣。泻心汤治心气不足、吐血、衄血者，乃真心之气不足，而手厥阴心包络、足厥阴肝、足太阴脾、足阳明胃之邪火有余也。虽曰泻心，实泻四经血中之伏火也。又张仲景治疗心下痞满、按之软者，用大黄黄连泻心汤主之。此亦泻脾胃之湿热，非泻心也。病发于阴而反下之，则作痞满，乃寒伤荣血，邪气乘虚结于上焦胃之上脘，在于心，故曰泻心，实泻脾也。《素问》云太阴所至为痞满，又云浊气在上则生䐜胀，是矣。病发于阳而反下之，则成结胸，乃热邪陷入血分，亦在上脘分野。张仲景大陷胸汤丸皆用大黄，亦泻脾胃血分之邪而降其浊气也。若结胸在气分，则只用小陷胸汤；痞满在气分，则用半夏泻心汤矣。成无己注《伤寒论》亦不知分别此义。苏颂记载：《本草》称大黄推陈致新，其效最神，故古方下积滞多用之。张仲景治伤寒用处尤多。古人用毒药攻病，必随人之虚实寒热而处治，非一切轻用也。梁武帝因发热欲服大黄，姚僧坦曰：“大黄乃是快药，至尊年高，不可轻用。”帝弗从，几至委顿。梁元帝常有心腹疾，诸医咸谓宜用平药，可渐宣通。僧坦曰：“脉洪而实，此有宿积，非用大黄无瘥理。”帝从之，遂愈。以此言之，今医用一毒药而攻众病，其偶中便谓此方神奇，其差误则不言用药之失，可不戒哉！使用时去皮，铡碎，竹筛齐用。
芒硝：气大寒，味咸苦辛，有小毒。成无己引《内经》云：咸味下泄为阴，又云咸以软之。热淫于内，治以咸寒。气坚者以咸软之，热盛者以寒消之。故张仲景大陷胸汤、大承气汤、调胃承气汤皆用芒硝，以软坚去实热结。不至坚者不可用也。李时珍认为：《本草》云朴硝味辛，是辛以润肾燥也。今人不用辛字，只用咸字，咸能软坚也，其义皆是。《本草》言芒硝利小便而堕胎，然伤寒妊娠可下者用此，兼大黄引之，直入大腹，润燥软坚，泻热而母子俱安。《经》云有故无殒，亦无殒也，此之谓欤。以在下言之，则便溺俱阴；以前后言之，则前气后血；以肾言之，总主大小便难、溺涩秘结，俱为水少火盛。《经》云热淫于内，治以咸寒，佐之以苦，故用芒硝、大黄相须为使也。李杲认为：芒硝气薄味浓，沉而降，属阴。其用有三：去实热一也，涤肠中宿垢二也，破坚积热块三也。李时珍认为：朴硝是初得一煎而成者，故力紧急而不和，止可施于粗犷之人及敷涂之剂而已。芒硝是朴硝淋过炼成，故其性和缓，张仲景治伤寒多用之，以此故也。硝禀太阴之精，水之子也，气寒味咸，走血而润下，荡涤三焦肠胃实热，阳强之病，乃折治火邪药也。生用。
香豉：气寒，味苦，无毒，属阴中之阴。主治伤寒头痛、烦躁、满闷，生用。李时珍认为：黑豆性平，作豉则温。既经蒸窨，故能升能散。得葱则发汗，得盐则能吐，得酒则治风，得薤则治痢，得蒜则止血，炒熟则大能止汗，亦麻黄根节之义也。
茵陈蒿：气微寒，味苦辛，无毒，属阴中微阳。入足太阳经。除烦热，主风湿寒热邪气，热结黄疸，通身发黄，小便不利。寇宗奭记载：张仲景治疗伤寒热甚发黄，身面悉黄者，用之极效。一僧因伤寒后发汗不彻，有留热，面身皆黄，多热期年不愈，医作食治不对而食不减。予与此药，服五日病减三分之一，十日减三分之二，二十日病悉去。方用山茵陈、山栀子各三分，秦艽、升麻各四钱，为散，每用三钱，水四合，煎二合，去滓，食后温服，以知为度。此药以山茵陈为本，故书之。李时珍认为：张仲景茵陈蒿汤、栀子大黄汤治湿热也；栀子柏皮汤治燥热也。如苗涝则湿黄，旱则燥黄，湿则泻之，燥则润之，可也。此二药治阳黄也。韩祗和、李思训治阴黄用茵陈附子汤。大抵以茵陈为君主，而佐以大黄、附子，各随其寒热也。去枝用叶，手搓碎用。
栝蒌实：气寒，味甘微苦，无毒。朱丹溪认为：栝楼实治胸痹者，以其味甘性润，甘能补肺，润能降气。胸中有痰者，乃肺受火逼，失其降下之令。今得甘缓润下之助，则痰自降，宜其为治嗽之要药也。且又能洗涤胸膈中垢腻郁热，为治消渴之神药。李时珍记载：张仲景治疗胸痹痛引心背、咳唾喘息及结胸满痛，皆用栝蒌实，乃取其甘寒不犯胃气，能降上焦之火，使痰气下降也。成无己不知此意，乃云苦寒以泻热，盖不尝其味，原不苦而随文傅会尔。肥大结实者，连子连皮细切用。今人只用核仁，非也。
栝蒌根（一名天花粉）：气寒，味甘微苦酸，无毒。主治消渴、身热、烦满、大热、补虚、安中、通月水、消肿毒、瘀血及热狂、疮疖。李杲认为：栝蒌根纯阴，解烦渴，行津液，心中枯涸者非此不能除。与辛酸同用，导肿气。李时珍认为：栝蒌根味甘微苦酸，其茎叶味酸，酸能生津，感召之理，故能止渴润枯。微苦降火，甘不伤胃。昔人只言其苦寒，似未深察。捣细罗过用。
土瓜根：气寒，味苦，有小毒。主治疗诸邪气、热结、逐四时骨节中水、疗天行热疾、酒黄病、壮热心烦、闷热劳、能吐下人。
连轺（连翘根也）：气寒，味甘苦，有小毒。主下热气，益阴精。故张仲景治疗伤寒瘀热在里欲发黄，用麻黄连轺赤小豆汤。
竹叶：气寒，味甘，无毒。淡竹为上，甘竹次。主胸中痰热、咳逆上气。寇宗奭认为：诸笋性皆寒，故知其叶一致也。张仲景竹叶汤惟用淡竹。李杲认为：竹叶苦平，阴中微阳。李东垣认为：竹叶辛苦寒，可升可降，阳中阴也。其用有二：除新久风邪之烦热，止喘促气胜之上冲。
梓白皮：气寒，味苦，无毒。主热毒，去二虫，时气温病，头痛，壮热。初得一日用生梓木，削去黑皮，取里白者，切一升，水二升五合，煎汁，每服八合，取瘥。折热之剂必以苦为主，又曰大热之气寒以取之，是也。
(Those with strong flavors belong to Yin within Yin. Strong flavors have a purgative/descending effect. Sour, bitter, and salty flavors with cold qi belong to this category.)
*Scutellariae Radix* (Huanglian, 黄连): Cold in nature, bitter in taste, non-toxic. Its medicinal force and flavor are both strong; it can ascend and descend, belonging to Yang within Yin. It enters the Hand-Shaoyin Heart Meridian. Its functions include six aspects: first, clearing Heart Fire; second, removing damp-heat from the Middle Jiao; third, essential for treating various sores; fourth, dispelling wind-dampness; fifth, treating sudden onset of red eyes; sixth, stopping bleeding in the middle region. Zhang Zhongjing uses it in all five varieties of Xixin Decoction (Cordis Dispersing Decoction) for treating nine types of epigastric fullness. Li Dongyuan states: *Scutellariae Radix* enters the Foot-Shaoyin Kidney Meridian; due to its bitter dryness, it enters Heart Fire to address dryness. However, "clearing the Heart" actually clears Spleen Fire. According to Five Elements theory, "the child can make the mother full"; when excess occurs, drain the child. In treating blood disorders, Saposhnikoviae Radix (Fangfeng, 防风) acts as the ascending guide, *Scutellariae Radix* as the middle guide, and Sanguisorbae Radix (Diyu, 地榆) as the descending guide. Remove roots and fine-cut for use.
*Scutellariae Radix* (Huangqin, 黄芩): Cold in nature, bitter in taste, non-toxic. It can ascend and descend, belongs to Yin, specifically slight Yang within Yin. Enters the Blood aspect of the Hand-Taiyang Small Intestine Meridian. Li Guo states: Its qi is cool, taste bitter-sweet, qi is strong while flavor is thin, floating and ascending, belonging to Yin within Yang. Enters the Hand-Shaoyang Gallbladder and Hand-Yangming Large Intestine Meridians. Wine-fried to direct action upward. Li Dongyuan further notes: The hollow and light variety clears Lung Fire, benefits Qi, resolves phlegm, dispels wind-heat, and eliminates heat in the muscle layer. The solid and heavy variety clears Large Intestine Fire, nourishes Yin, reduces Yang, supplements Bladder cold water, and nourishes the source of transformation. This parallels the usage of Atractylodis Fructus (Zhishi, 枳实) and Aurantii Fructus (Zhiqiao, 枳壳). Li Guo summarizes nine uses: first, clearing Lung heat; second, resolving wind-heat and wind-dampness in the Upper Jiao skin; third, clearing various heat pathogens; fourth, benefiting Qi in the chest; fifth, eliminating phlegm in the diaphragm; sixth, removing dampness in the Spleen meridian; seventh, essential for summer use; eighth, nourishing Yin and reducing Yang postpartum; ninth, calming the fetus. Wine-fried to ascend, treating upper accumulation of blood. For dysentery with pus and blood, abdominal pain, tenesmus, and persistent fever, combine with Paeoniae Radix Alba (Baishao, 白芍) and Glycyrrhizae Radix (Gancao, 甘草). For painful sores, use bitter-cold herbs like *Scutellariae Radix*, distinguishing upper/lower regions and using guiding herbs. Su Song records: Zhang Zhongjing uses *Scutellariae Radix* in all four Xixin Decoctions for epigastric fullness because it treats various heats and benefits the Small Intestine. Ge Gen Huang Qin Huang Lian Tang (Kudzu, Scutellaria, and Coptis Decoction) is used for diarrhea, wheezing, and sweating after incorrect purgation in Taiyang disease. Sanmu An Tai San (Sanmu Calming Fetus Powder) also frequently uses it. Li Shizhen records: Li Guojie states *Scutellariae Radix* clears Lung Fire and treats Spleen dampness; Dongyuan states Pian Qin (slice form) treats Lung Fire, Tiao Qin (strip form) treats Large Intestine Fire; Danxi states it treats Upper and Middle Jiao fire. Zhang Zhongjing uses it in Xiao Chaihu Tang (Minor Bupleurum Decoction) for Shaoyang syndrome, Huang Qin Tang for Taiyang-Shaoyang combined disease with diarrhea, and Xixin Decoction for post-purgation epigastric fullness without pain. Cheng Wuji states *Scutellariae Radix* enters the Heart via bitterness to clear fullness heat, indicating it enters the Hand-Shaoyin, Hand-Yangming, Foot-Taiyin, and Foot-Shaoyang meridians. Generally, its cold nature and bitter taste enter the Heart to clear heat and treat Spleen damp-heat. This prevents Metal from being controlled by Fire and stops Stomach Fire from entering the Lung, thereby saving the Lung. It is unsuitable for Lung deficiency as bitter-cold damages the Spleen and Stomach (the Mother organ). Shaoyang syndrome presents with alternating chills and fever, hypochondriac fullness, silent desire not to eat, irritability, or vomiting. Although located half-exterior half-interior, hypochondriac fullness involves Upper Jiao pathogens of Heart and Lung, while irritability and aversion to food involve Middle Jiao Spleen and Stomach. Thus, *Scutellariae Radix* treats the Ministerial Fire of Shaoyang. Cheng Wuji’s commentary only mentions dispersing transmitted heat, missing the subtlety of treating Fire. Yang Shiying claims Bupleuri Radix (Chaihu, 柴胡) is inferior to *Scutellariae Radix* for reducing fever, not realizing Chaihu disperses the branch of fire, while *Scutellariae Radix* conquers heat to break the root. Zhang Zhongjing advises removing *Scutellariae Radix* for abdominal pain or adding Fu Ling (Poria) for palpitations and difficult urination, seemingly contradicting *Ben Cao* statements on treating lower abdominal cramps. Cheng Shi attributes this to *Scutellariae Radix* hardening the Kidney via bitterness, but this is likely incorrect. One must differentiate via pulse and symptoms: if caused by cold/drink with non-rapid pulse, avoid it; if caused by heat-jue or Lung heat, use it. Skilled readers seek principles rather than literal text. Remove skin and black rot, fine-cut, and sieve.
*Coptidis Rhizoma* (Huangbai, 黄柏): Cold in nature, bitter in taste, non-toxic. Strong medicinal force and flavor, sinking and descending, belonging to Yin, slightly pungent among Yin, thus Yang within Yin. Enters the Foot-Shaoyin Kidney Meridian, serving as a guiding herb for the Foot-Taiyang Bladder Meridian. Li Dongyuan states: Treats Wei syndrome, Jue syndrome, and weak knees/legs due to Kidney Water and Bladder insufficiency. Add small amounts to Huang Bai Tang to restore strength. Honey-fried powder treats mouth ulcers miraculously and is essential for paralysis. It clears Bladder heat, benefits the lower orifice, clears Bladder meridian fire, and supplements Kidney insufficiency. *Neijing* states: "Bitterness hardens." The Kidney dislikes dryness and retains dampness. Zhi Zi (Gardeniae Fructus) and Huang Qin enter the Lung, Huang Lian enters the Heart, Huang Bai enters the Kidney; each addresses dryness according to its affinity. Huoren Shu’s Jiedu Tang treats internally and externally. Use raw for descending real fire; wine-processed for upper body; salt-processed for lower body; honey-processed for middle body without damaging Stomach.
*Gardeniae Fructus* (Zhizi, 栀子): Cold in nature, bitter in taste, non-toxic. Li Guo states: Thin qi, strong flavor, light and clear ascending, floating qi, descending flavor, Yang within Yin. Li Dongyuan states: Sinking, Yin. Enters the Blood aspect of the Hand-Taiyin Lung Meridian. Li Shizhen notes: *Ben Cao* does not mention emetic properties, but Zhang Zhongjing used it as an emetic. It is not inherently emetic; rather, pathogenic factors in the upper region reject food, causing vomiting to expel pathogens ("The high ones, cause them to vomit"). Some use it to promote urination, but it actually clears the Lung. Clearing the Lung allows Qi transformation, enabling the Bladder to excrete fluids. *Ben Cao* mentions treating Large and Small Intestine heat due to elemental combinations. Zhang Zhongjing uses Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) for irritability (Qi/Lung) and restlessness (Blood/Kidney). Red color/bitter taste enters Heart for irritability; black color/salty taste enters Kidney for restlessness. Kou Zongshi records: Used after sweating/vomiting/purging for insomnia and mental agitation due to deficiency, avoiding Da Huang (Rhei Radix et Rhizoma) due to its cold toxicity. Zhizi treats internal empty heat from fluid/blood loss. For Heart heat and dark urine, combine with processed Da Huang, Forsythiae Fructus (Lianqiao, 连翘), and roasted Glycyrrhizae Radix. Select grains resembling quail brains with nine ridges and red color. Kernel for chest heat; peel for surface heat; whole shell for Upper/Middle Jiao; peeled for Lower Jiao; charred for blood disorders.
*Gypsum Fibrosum* (Shigao, 石膏): Cold in nature, sweet-pungent, non-toxic. Enters Hand-Taiyin Lung, Shaoyang, and Foot-Yangming Stomach meridians. Li Guo states: Cold, pungent-bland, thin qi/flavor, heavy and sinking, Yin. Major cold herb for Yangming Meridian. Treats headache, toothache, thirst, heatstroke, and tidal fever. However, it may chill the Stomach and suppress appetite; avoid unless extreme heat exists. Also treats Yangming heat, fever with aversion to cold, dryness, afternoon tidal fever, muscle fever, turbid urine, intense thirst, spontaneous sweating, and severe headache. Baihu Tang (White Tiger Decoction) addresses this. Avoid if these signs are absent; misdiagnosis of blood-deficiency fever or Spleen-Stomach deficiency can be fatal. Li Dongyuan adds: It clears Lung heat constrained by Yangming fire. For rapid pulse, use it; avoid in weak Stomach. Effective for warm diseases with thirst and surging pulse, even in winter. Do not strictly follow Dongyuan’s advice to avoid it after End of Heat. It is also known as Hanshui Shi (Cold Water Stone) or Ying Shigao (Hard Gypsum). Fine white texture is best. Crush to millet size, boil first before adding other herbs.
*Anemarrhenae Rhizoma* (Zhimu, 知母): Cold in nature, bitter in taste, strong qi/flavor, sinking, Yin, slight Yang within Yin. Primary herb for Kidney Meridian, entering Foot-Yangming and Hand-Taiyin Qi aspects. Li Dongyuan states: Four uses: clearing rootless Kidney fire, treating bone-steaming with sweat, stopping deficiency heat, and nourishing the source of Yin. Zhang Zhongjing combines it with Shigao in Baihu Tang for restlessness. Fang Feng guides up, Zhimu clears Kidney source, Gancao and Jing Mi (Coix Seed) slow descent. For urinary obstruction with thirst (Upper Jiao heat blocking Water generation), use bland-draining herbs to clear Lung fire. For urinary obstruction without thirst (Lower Jiao blood heat/Yin deficiency), use Huangbai and Zhimu to tonify Kidney/Bladder, allowing Yang to transform and urine to flow. Select plump, white interior, remove hairs. Wine-processed for ascending; salt-water processed for descending. (Avoid iron).
*Fraxini Cortex* (Qinpi, 秦皮): Cold in nature, bitter in taste, non-toxic, sinking. Treats heat-dysentery with heaviness and lower Jiao deficiency. *Neijing* states "bitterness hardens," hence used with Weitou Wang and Huangbai. Treats wind-cold-damp bi, eye opacities, male infertility, female leukorrhea, and pediatric convulsions. Wash eyes with decoction. Extract blue-green juice, mix with Lithospermi Radix (Zicao, 紫草) for better effect. Guided by Euphorbiae Humifusa Herba (Daji, 大戟); incompatible with Evodiae Fructus (Wuzhuyu, 吴茱萸). Li Shizhen adds: Green color, cold/bitter/astringent nature targets Liver/Gallbladder meridians. Treats eye disorders and convulsions by pacifying Wood; treats dysentery and leukorrhea by astringency; treats infertility by astringent tonification. Often overlooked except for eye treatments.
*Pulsatillae Radix* (Baitouweng, 白头翁): Cold in nature, bitter-pungent, non-toxic, thick qi/thin flavor, ascending/descending, Yang within Yin. Treats warm malaria, mania, cold-heat alternations, masses, blood stasis, and pain. Zhang Zhongjing uses Baitouweng Tang for heat-dysentery with urgency. Hardens lower Jiao via bitter taste. Treats hernia, alopecia, fetid discharge, and epistaxis. Effective for toxic dysentery. Wu Qian states: Suitable for heat-toxin dysentery with purple/fresh blood.
*Rhei Radix et Rhizoma* (Dahuang, 大黄): Cold in nature, bitter in taste, non-toxic, strong qi/flavor, sinking, Yin. Use wine-soaked/roasted for "cold treated with heat." Wine directs to Taiyang; washing directs to Yangming. Li Dongyuan states: Bitter and峻 (severe) downward movement. Raw for lower body; wine-processed for upper body to drive heat down ("shooting at high targets"). Raw use leaves upper heat, causing post-recovery eye/throat/head issues. Kou Zongshi records: Zhang Zhongjing uses Dahuang in Xixin Decoction for hematemesis/epistaxis due to deficient Heart Qi invaded by heat. Bitterness tonifies Heart by clearing pathogenic heat. Zhu Danxi states: Dahuang clears excessive Yang fire causing blood rebellion. Huang Qin saves Lung, Huang Lian saves Liver. Li Shizhen states: Dahuang enters Blood aspect of Taiyin, Yangming, and Jueyin meridians. Use for blood disorders; avoid for Qi disorders. Xixin Decoction treats excess fire in Pericardium, Liver, Spleen, and Stomach. Epigastric fullness after incorrect purgation involves Cold injuring Nutritive Blood and pathogenic factors in Upper Jiao; "clearing Heart" actually clears Spleen. Chest binding involves Heat entering Blood aspect. Dahuang descends turbid Qi. Su Song records: Dahuang pushes out old and generates new. Ancient physicians used toxic herbs cautiously based on deficiency/excess. Yaoengt Tan advised against Dahuang for Emperor Wu of Liang due to age, but he refused and nearly died. For Emperor Yuan of Liang, Yaoingt Tan correctly diagnosed stagnation requiring Dahuang. Physicians should beware of indiscriminate use. Remove skin, cut, sieve.
*Natrii Sulfas* (Mangxiao, 芒硝): Very cold, salty-bitter-pungent, slightly toxic. *Neijing*: Salty drains downward and softens hardness. Cold dissipates heat. Zhang Zhongjing uses it in Daxiexiong Tang, Dachengqi Tang, and Tiaoweichengqi Tang to soften hardness and clear heat. Not for non-hard accumulations. Li Shizhen notes: Puxiao (Mirabilite) has pungent property to moisten Kidney dryness; modern texts emphasize salty property to soften. Safe in pregnancy with Dahuang for heat constipation ("If there is pathology, no harm"). Promotes urination and bowel movements. Li Guo states: Three uses: clearing real heat, cleansing intestinal residue, breaking hard heat masses. Li Shizhen distinguishes Puxiao (initial extraction, harsh) from Mangxiao (refined, mild). Mangxiao derives from Taiyin essence, enters Blood, moistens downward, clears Sanjiao/Stomach-Intestine real heat, and treats Yang-excess fire. Use raw.
*Dietary Fermented Soybean* (Xiangchi, 香豉): Cold in nature, bitter in taste, non-toxic, Yin within Yin. Treats cold damage headache, irritability, and oppression. Use raw. Li Shizhen notes: Black beans are neutral; fermentation makes them warm, capable of ascending and dispersing. Combined with Congei Caulis (scallion) induces sweating; with Sal (salt) induces vomiting; with Alcohol treats wind; with Allii Macrostemonis Bulbus (leek) treats dysentery; with Allii Sativi Bulbus (garlic) stops bleeding; cooked stops sweating.
*Artemisiae Scopariae Herba* (Yinchen Hao, 茵陈蒿): Slightly cold, bitter-pungent, non-toxic, slight Yang within Yin. Enters Foot-Taiyang Meridian. Clears irritability, treats wind-cold-damp-heat, heat-binding jaundice, generalized yellowing, and difficult urination. Kou Zongshi records: Effective for severe jaundice. Case study: Monk with lingering heat jaundice cured over 20 days using Yinchen, Zhizi, Qin Jiao, and Shengma. Li Shizhen notes: Yinchen Hao Tang treats damp-heat; Zhizi Baipi Tang treats dry-heat. Differentiate wet vs. dry jaundice. Han Zhihe and Li Sixun use Yinchen Fuzi Tang for cold jaundice. Remove stems, use leaves, crush by hand.
*Trichosanthis Fructus* (Gualou Shi, 栝蒌实): Cold in nature, sweet-mildly bitter, non-toxic. Zhu Danxi states: Sweet and moistening, tonifies Lung, directs Qi downward. Resolves phlegm in chest caused by Fire constraining Lung. Cleanses chest heat, treating thirst. Li Shizhen records: Zhang Zhongjing uses it for chest bi pain, coughing saliva, asthma, and chest binding. Its sweet-cold nature does not damage Stomach Qi, directs upper heat down, and moves phlegm. Cheng Wuji mistakenly called it bitter-cold. Use large, firm fruits with seed and skin, finely cut. Using only kernel is incorrect.
*Trichosanthis Radix* (Tianhuafen, 栝蒌根): Cold in nature, sweet-mildly bitter-sour, non-toxic. Treats thirst, fever, irritability, emptiness, regulates menstruation, reduces swelling, detoxifies, treats blood stasis, mania, and sores. Li Dongyuan states: Pure Yin, relieves thirst, moves fluids. Essential for dry heart. Combine with pungent-sour to guide swelling. Li Shizhen adds: Sour generates fluids; mild bitter clears heat; sweet does not damage Stomach. Past texts focusing only on bitter-cold missed this. Sift finely.
*Polypodi Rhizoma* (Tugua Gen, 土瓜根): Cold in nature, bitter, slightly toxic. Treats various pathogens, heat binding, water retention in joints, epidemic fevers, alcohol jaundice, fever, irritability, and consumption. Can induce vomiting or purging.
*Forsythiae Radix* (Lianyao, 连轺): Cold in nature, sweet-bitter, slightly toxic. Descends heat, benefits Yin essence. Zhang Zhongjing uses Ma Huang Lian Qiao Chi Dou Tang for heat-toxin jaundice.
*Bambusae Folium* (Zhuye, 竹叶): Cold in nature, sweet, non-toxic. Light bamboo is superior. Treats chest phlegm-heat, cough, and rebellious Qi. Kou Zongshi notes: Bamboo shoots are cold, so leaves are too. Zhang Zhongjing’s Zhuye Tang uses light bamboo. Li Guo states: Bitter-flat, slight Yang within Yin. Li Dongyuan states: Pungent-bitter-cold, ascending/descending, Yin within Yang. Two uses: clears new/old wind-heat irritability; stops wheezing and rebellious Qi.
*Broussonetiae Cortex* (Zibai Pi, 梓白皮): Cold in nature, bitter, non-toxic. Treats heat-toxin, parasites, seasonal warm diseases, headache, and fever. Use fresh inner bark boiled. Bitter is primary for clearing heat; cold nature conquers heat.