张石顽曰∶牡丹皮虽凉,不碍发散也。窃尝丹皮辛膻异常,能通行血分,非性凉之药。
盖平而近温者,功用在归、芎之间,而其气沉降,不致不僭,故为良品。
王孟英曰∶丹皮虽凉血,而气香走泄,能发汗,惟血热有瘀者宜之。又善动呕,胃弱者
勿用。此论已略能不 于旧说矣。动呕一层,亦实有之,但物性终非上升者。
丹皮之苦,不敌其辛;桔梗之辛,不敌其苦。故二药皆以降为用,而敛散不同矣。
昔人谓∶读书须从对面看。此语最有意味。远志、菖蒲,书谓开心气,世遂凡于心虚之
证,
皆避之如砒毒矣。殊不知书谓开心气者,以其味微辛而力缓,止能内开心气,不能外通肤表
也。不然,如麻黄、细辛、桂枝者,岂不大开心气,而何以书绝不言之?以其力不止于此也
。若以此开心气,是病在心,而药力直致之肤表矣,是不可也。惟远志、菖蒲驯静力缓者,
足当开心气耳!且心虚之病,又各不同。如阴虚心燥,是心气已不得阴以养之,其开散已不
可
支,岂可复以此开之?如阳虚心气为痰水所凌,以致怔忡恍惚者,非以此开散痰水,心气何
由得舒?若亦以枣仁、五味滋之,不益之闭乎?
秦艽、柴胡退无汗之骨蒸。此语出于东垣,本不足据。然揆其义,亦不过以其苦能入骨
,辛
凉微散能清泄郁热耳!世遂谓其能发骨中之汗。夫发骨中之汗者,惟细辛、独活可以任之。
麻
黄、桂枝力迅气浮,尚且不能沉搜入骨,而谓秦艽、柴胡之苦辛凉降,能透发骨气,致之
于表而为汗,其谁欺乎?
张石顽说:牡丹皮虽然性凉,但并不妨碍其发散作用。我私下认为,牡丹皮气味辛烈异常,能够通行血分,并非性质寒凉的药物。
它药性平和而接近温性,功效介于当归、川芎之间,且其气机沉降,不会导致气机上逆僭越,因此是优良的药材。
王孟英说:牡丹皮虽然能凉血,但其气香走窜泄散,能发汗,只适用于血热且有瘀滞的情况。此外,它容易引发呕吐,胃气虚弱者不要使用。这种论述已经略微不同于旧有的说法了。“引发呕吐”这一层确实存在,但药物的本性终究不是上升的。
牡丹皮的苦味,抵不过它的辛味;桔梗的辛味,抵不过它的苦味。所以这两味药都以降泄为功用,但在收敛与发散方面有所不同。
古人说:读书必须从反面去看。这句话最有意味。远志、石菖蒲,医书说是“开心气”,世人于是凡是遇到心虚的病症,都把它像避砒毒一样避开。殊不知医书说“开心气”,是因为它们味道微辛且药力缓和,只能向内开通心气,不能向外通达肌肤体表。如果不是这样,像麻黄、细辛、桂枝这些药,难道不是更擅长“开心气”吗?为什么医书中绝口不提它们呢?因为它们的药力不止于此。如果把这些药当作“开心气”之用,那就是病位在心,而药力却直接作用于肌肤体表了,这是不行的。只有像远志、石菖蒲这样性情驯良、药力缓和的药物,才足以担当“开心气”的任务!况且心虚的病证,又各不相同。比如阴虚导致的心烦燥热,这是心气已经得不到阴液的滋养,其开散的状态已经难以承受,怎么可以再用它来开散呢?如果是阳虚心气被痰水所凌犯,以致出现心悸恍惚的症状,不用这些药来开散痰水,心气怎么能得到舒展呢?如果也用酸枣仁、五味子来滋补,岂不是更加闭塞了吗?
秦艽、柴胡能退除无汗的骨蒸潮热。这句话出自李东垣,本来不足以作为依据。然而推究其含义,也不过是因为它们苦味能入骨,辛凉微散能清泄郁热罢了!世人于是认为它们能发出骨头里的汗。所谓能发出骨头里汗的,只有细辛、独活可以胜任。麻黄、桂枝药力迅猛、气机浮越,尚且不能深入搜剔筋骨,何况秦艽、柴胡苦辛凉降,怎么能透发骨中之气,使其到达体表化为汗液呢?这是谁在欺骗谁呢?
Zhang Shiwang stated: Although Moutan Cortex (Mudanpi) is cool in nature, it does not hinder its dispersing action. I have privately observed that Moutan Cortex possesses an unusual pungent and musky aroma, capable of circulating within the Blood level, and is not a drug with a cold nature.
Its medicinal property is neutral and approaches warm; its efficacy lies between Angelicae Sinensis Radix (Danggui) and Chuanxiong Rhizoma (Chuanxiong). Its Qi descends, preventing rebellious upward movement, thus making it a superior herb.
Wang Mengying stated: Although Moutan Cortex cools the Blood, its aromatic and dispersing nature can induce sweating; it is suitable only for cases of Heat in the Blood accompanied by stasis. Furthermore, it tends to provoke vomiting and should be avoided by those with weak Stomach Qi. This discussion differs slightly from older theories regarding the provocation of vomiting, which indeed occurs, though the nature of the substance is ultimately not ascending.
The bitterness of Moutan Cortex cannot outweigh its pungency; the pungency of Platycodonis Radix (Jiegeng) cannot outweigh its bitterness. Therefore, both herbs function primarily through descending, yet differ in their actions of astringing and dispersing.
Ancients said: "When reading books, one must view them from the opposite side." This statement is profound. For Polygala Tenuifolia Radix (Yuanzhi) and Acori Tatarinowii Rhizoma (Shichangpu), texts state they "open Heart Qi," leading the world to avoid them as if they were arsenic in all cases of Heart deficiency. Little do they know that when texts say "open Heart Qi," it is because their taste is slightly pungent and their force is mild, capable only of internally opening Heart Qi, but incapable of externally connecting to the skin and surface. Otherwise, would not Ephedrae Herba (Mahuang), Asari Radix et Rhizoma (Xixin), and Cinnamomi Ramulus (Guizhi) be far more effective at "opening Heart Qi"? Why do texts never mention them? Because their force extends beyond this. If these were used to "open Heart Qi," the disease would be in the Heart, but the medicinal force would directly reach the skin and surface, which is inadmissible. Only herbs like Polygala Tenuifolia Radix and Acori Tatarinowii Rhizoma, which are gentle and mild in force, are sufficient to "open Heart Qi"! Moreover, Heart deficiency diseases vary. In cases of Yin deficiency causing Heart dryness and irritability, the Heart Qi is already unable to receive nourishment from Yin, and its state of dispersion is already unsustainable; how can one use such herbs to further disperse it? In cases of Yang deficiency where Heart Qi is overwhelmed by Phlegm-fluids, leading to palpitations and confusion, if one does not use these herbs to open and disperse the Phlegm-fluids, how can Heart Qi be relieved? If one instead uses Ziziphus Seed (Suanzaoren) and Schisandra Fruit (Wuweizi) to tonify, would this not increase closure?
Gentianae Macrophyllae Radix (Qinjiao) and Bupleuri Radix (Chaihu) are said to relieve bone-steaming fever without sweat. This statement originates from Li Dongyuan and was originally insufficient as evidence. However, examining its meaning, it merely implies that their bitterness enters the bones, and their slight pungency and coolness can clear and drain stagnant Heat. The world then claims they can induce sweating from within the bones. Those capable of inducing sweat from the bones are only Asari Radix et Rhizoma and Angelicae Pubescentis Radix (Duhuo). Ephedrae Herba and Cinnamomi Ramulus have rapid force and floating Qi, yet still cannot penetrate deeply into the bones; how could Gentianae Macrophyllae Radix and Bupleuri Radix, with their bitter, pungent, cool, and descending nature, penetrate the Qi of the bones and bring it to the surface as sweat? Who is deceiving whom?