生地性甘大寒。凉血清热。亦惟实热者宜之。故东垣云此药大寒。宜斟酌用之。恐损胃
气。至虚火假热。真
阴枯涸之症。则当以熟地黄为君。盖地黄性本膏赋沉寒。一经蒸晒九炼工夫。火候既足。寒
质自消。始寒
滑而今转为温润。始苦甘相杂。而今转为纯甘无苦。馨香醒鼻。甘美动脾。脾喜甘恶苦。熟
地则味甘者也。
脾喜香恶臭。熟地则气香者也。脾喜燥恶湿。熟地则气燥而味甘润者也。脾喜温恶寒。熟地
则性温平。而
非偏寒偏热之比者也。脾喜补恶泻。熟地则奏功滋补。不失中和者也。擅有五德。何矜九转
。此物初终异
用。可知炉鼎变化。自有妙理。然制炼之要。其地黄大者须蒸晒至十余次。劈开中有黑油如
玉。气味甘
香者方可用。勿拘九数也。亦不必用酒润过方蒸。盖酒经蒸晒。则成酸酢之味。不为佳。俟
临用时。先一夜
切碎如豆大。以酒润之。次早略蒸片晌。使两物匀和。酒气尚存。药气益香。动与胃合。易
于营运。此雷 炮制之微义。不可不留心也。今医者从便酒煮经日即用。大乖古法。有伤中气。停膈为患。岂
药
之咎哉。至于市者不择铜铁物器。煮过待售。非惟损胃。抑且消肾。若辈只知觅利。岂愿害
人。用者忌之。
前药盖消谷克食。决壅宣滞。消胀导痞之功为多也。亦必有宿积为患。元气未亏。病气
太过者。用之有效。
且无伤。若脾气久虚。难运饮食。动触生灾。茫昧误服。适足以取败耳。夫伤米食者谷芽消
之伤面食者麦芽神曲消之伤肉食者砂仁山楂消之。伤果食
者青皮官桂消之。上焦伤者主枳壳。中下
焦伤者主枳实。伤滞气腹痛。则主以浓朴乌药大腹皮。以上皆
治形病有余之实症也。今之医者不管元气虚实。不分积滞有无。动以麦芽山楂神曲浓朴为健
脾之物。
相率成习。孟浪掷服。暗耗真元。遗害非小。岂知宿积留中。伤食恶食用此而攻积宣滞致使
饮食复旧谓
之健脾者以此实非此诸药之能健脾也故东垣谓浓朴有滞气则泄滞气无滞气则泄元气。
又云枳壳
枳实有推墙倒壁之功。立斋亦言麦芽山楂。善消肾气。神曲下胎破血。不宜轻服。诸贤谆谆
告诫。岂应执
迷不返。又立斋治食积诸症。亦必以四君六君为主。而佐以曲麦楂朴攻克之物。庶补泻兼行
。方于脾土无亏。亦即洁古老人创制枳术丸之微意
耳。大都痞满肿胀。病症属实者。则宜投以前药。若虚满虚胀。非参术归苓。直补脾原。无
能奏效是又内经所云塞因塞用者也。
生地黄性味甘、大寒。能凉血清热。只有实热证适合使用它。所以李东垣说此药大寒，应当斟酌使用。恐怕会损伤胃气。至于虚火假热、真阴枯竭涸竭的病症，则应当以熟地黄作为主药（君药）。因为地黄的本性是膏脂状且性质沉寒，经过蒸晒九次炼制工序后，火候充足，寒凉的质地自然消除，开始是寒滑的，现在转为温润；开始是苦甘混杂的，现在转为纯甘无苦，香气醒鼻，甘美动脾。脾喜欢甘味而厌恶苦味，熟地则是味甘的药物；脾喜欢香气而厌恶臭味，熟地则是气香的药物；脾喜欢燥而厌恶湿，熟地则是气燥而味甘润的药物；脾喜欢温而厌恶寒，熟地的性质温和平和，不属于偏寒或偏热的药物；脾喜欢补益而厌恶泻泄，熟地能发挥滋补的功效，不失中和之道。它具备五种德行，何必夸耀九转炼丹之功。这种药物初制与终制用途不同，可知炉鼎变化自有妙理。然而炮制的关键在于：大的地黄须蒸晒十余次，劈开后中间有黑油如玉，气味甘香的才可以服用。不要拘泥于九次的数量。也不必先用酒润透再蒸，因为酒经过蒸晒会变成酸醋的味道，不好。等到临用时，先一夜切碎如豆大，用酒润透，次日早晨稍微蒸片刻，使两者均匀调和，酒气尚存，药气更香，容易与胃相合，易于运化。这是雷敩炮制的精微义理，不可不留意。现在的医生为了方便，用酒煮经日即用，大大违背古法，伤害中气，导致停膈为患，难道是药的过错吗？至于市井卖药的人不选择铜铁器皿，煮过等待出售，不仅损伤胃，而且消耗肾气。这些人只知道谋利，难道愿意害人吗？使用者要忌讳这一点。
前面的药物（指消导药）大概能消谷克食，决壅宣滞，消胀导痞的功效较多。也必须有宿积为患，元气未亏，病气太过的情况，使用才有效且无伤。如果脾气长久虚弱，难以运化饮食，动不动就引发灾难，盲目误服，只足以导致失败罢了。比如损伤米食，用谷芽消除；损伤面食，用麦芽、神曲消除；损伤肉食，用砂仁、山楂消除；损伤果食，用青皮、官桂消除。上焦受伤的主药是枳壳，中下焦受伤的主药是枳实。伤滞气腹痛，则以浓朴、乌药、大腹皮为主。以上都是治疗形病有余的实证。现在的医生不管元气虚实，不分积滞有无，动不动就把麦芽、山楂、神曲、浓朴当作健脾之物，相继成习，轻率投服，暗中耗损真元，遗留的危害不小。哪里知道宿积留中，因伤食恶食用这些药来攻积宣滞，致使饮食恢复旧观，称之为“健脾”的，其实并非如此，这些药物并不能健脾。所以李东垣说浓朴有滞气则泄滞气，无滞气则泄元气。又说枳壳、枳实有推墙倒壁之功。李梴也说麦芽、山楂善于消肾气，神曲下胎破血，不宜轻服。各位贤者谆谆告诫，怎么应该执迷不悟呢？另外李梴治疗食积诸症，也一定以四君子汤、六君子汤为主，而佐以曲、麦、楂、朴等攻克之物，这样补泻兼行，才对脾土没有亏损。这也即张元素创制枳术丸的精微意旨罢了。大多痞满肿胀，病症属实的，则适宜投用前文提到的那些药。如果是虚满虚胀，不用人参、白术、当归、茯苓直接补益脾原，无法奏效。这又是《内经》所说的“塞因塞用”的方法。
Shengdi Huang (Rehmanniae Radix, Raw) is sweet and greatly cold in nature. It cools blood and clears heat. It is suitable only for excess-heat syndromes. Therefore, Li Dongyuan stated that this medicine is greatly cold and should be used with discretion, lest it damage Stomach Qi. For symptoms of deficient fire and false heat, where True Yin is withered and dried up, Shu Di Huang (Rehmanniae Radix, Prepared) should be used as the sovereign drug (Jun Yao). This is because the original nature of Rehmannia is pasty and deeply cold. After undergoing nine cycles of steaming and sun-drying, when the fire and time are sufficient, its cold quality naturally dissipates. It changes from initially cold and slippery to now warm and moist; from initially mixed bitter and sweet to now purely sweet without bitterness. Its fragrance awakens the nose, and its sweetness moves the Spleen. The Spleen likes sweetness and dislikes bitterness; Shu Di Huang is sweet in taste. The Spleen likes fragrance and dislikes foulness; Shu Di Huang is fragrant in odor. The Spleen likes dryness and dislikes dampness; Shu Di Huang has a dry aroma yet is sweet and moist in substance. The Spleen likes warmth and dislikes cold; Shu Di Huang is warm and neutral in nature, not comparable to those that are excessively cold or hot. The Spleen likes tonification and dislikes purgation; Shu Di Huang exerts a tonifying effect without losing the mean. It possesses five virtues; why boast of the nine-fold refining? The use of this material differs from beginning to end, showing that the transformations in the furnace have their own subtle principles. However, the key to processing is: large Rehmannia roots must be steamed and sun-dried more than ten times. When split open, if there is black oil like jade inside, and the smell and taste are sweet and fragrant, it can be used. Do not rigidly adhere to the number nine. It is also not necessary to moisten with wine before steaming, because wine, after steaming and drying, becomes sour and vinegar-like, which is not good. When ready for use, first cut it into pieces the size of beans one night prior, moisten with wine. Early next morning, steam slightly for a short while to make the two substances blend evenly. The wine aroma remains, and the medicinal aroma increases, facilitating harmony with the Stomach and easier transportation and transformation. This is the subtle meaning of Lei Xiao's processing methods, which cannot be overlooked. Today, physicians, for convenience, boil it in wine for days and use it immediately. This greatly deviates from ancient methods, damaging Middle Qi and causing obstruction in the chest as a complication. Is this the fault of the medicine? As for merchants who do not select copper or iron vessels, boiling the herbs for sale, this not only damages the Stomach but also depletes Kidney Qi. These people only know how to seek profit; would they wish to harm people? Users should beware of this.
The aforementioned medicines (referring to digestive aids) generally have the functions of digesting grains and overcoming food stagnation, resolving blockage and promoting stagnation, reducing distension and guiding away fullness. They are effective only when there is old accumulation causing illness, Yuan Qi is not depleted, and pathogenic Qi is excessive. If Spleen Qi has been deficient for a long time, making it difficult to transport and transform food and drink, using them rashly will only bring disaster. Blindly taking them by mistake will only lead to failure. For example, injury from rice food is resolved by Gu Ya (Oryzae Fructus Germinatus); injury from wheat/noodle food is resolved by Mai Ya (Hordei Fructus Germinatus) and Shen Qu (Massa Medicata Fermentata); injury from meat food is resolved by Sha Ren (Amomi Fructus) and Shan Zha (Crataegi Fructus); injury from fruit food is resolved by Qing Pi (Citri Reticulatae Pericarpium Viride) and Guan Gui (Cinnamomi Cortex). For injuries in the Upper Jiao, Zhi Qiao (Aurantii Fructus) is the main herb; for injuries in the Middle and Lower Jiao, Zhi Shi (Aurantii Fructus Immaturus) is the main herb. For pain due to stagnant Qi, Hou Po (Magnoliae Officinalis Cortex), Wu Yao (Linderae Radix), and Da Fu Pi (Arecae Pericarpium) are the main herbs. All of these treat excess syndromes characterized by physical pathology and surplus. Today's physicians, regardless of whether Yuan Qi is deficient or excess, and regardless of whether there is stagnation, indiscriminately regard Mai Ya, Shan Zha, Shen Qu, and Hou Po as spleen-tonifying substances. This habit has become common, leading to reckless administration, secretly depleting True Yuan, and leaving significant harm. How could they know that old accumulation retained in the middle, and food injury treated by using these drugs to attack accumulation and promote stagnation, thereby restoring normal diet, is falsely called "tonifying the Spleen"? In fact, these drugs cannot tonify the Spleen. Therefore, Li Dongyuan said that Hou Po drains stagnant Qi when present, but drains Yuan Qi when absent. He also stated that Zhi Qiao and Zhi Shi have the power to push down walls and overturn battlements. Li Chen also said that Mai Ya and Shan Zha are good at depleting Kidney Qi, and Shen Qu can induce abortion and break blood stasis, so they should not be taken lightly. The earnest warnings of these sages—how can one remain obstinate and refuse to return? Furthermore, when treating various food-stagnation syndromes, Li Chen always used Si Jun Zi Tang (Four Gentlemen Decoction) and Liu Jun Zi Tang (Six Gentlemen Decoction) as the foundation, assisting with attacking substances such as Shen Qu, Mai Ya, Shan Zha, and Hou Po. Thus, tonification and purgation are performed together, ensuring no detriment to the Spleen Earth. This is also the subtle intent behind Zhang Yuansu's creation of Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill). Generally, for bloating, fullness, and swelling, if the syndrome is excess, the aforementioned medicines are appropriate. If it is deficiency-type fullness and deficiency-type distension, without directly tonifying the Spleen's origin with Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Fu Ling (Poria), no effect can be achieved. This is what the *Nei Jing* refers to as "treating obstruction with obstruction" (Se Yin Se Yong).