一名瓜蒌
〔害〕寒胃滑肠，胃虚少食，脾虚泄泻，勿投。畏牛膝、干漆，恶干姜，反乌头。
〔利〕苦甘，润肺疏肝，滑肠凉脾，为治肺热咳嗽要药。清上焦之火，使痰气下降，止
一切
血热，又能荡涤胸中郁热垢腻，生津，止渴，清咽良剂，亦能治结胸，为脾热之主药。
〔修治〕九月采取，栝圆黄皮浓蒂小，蒌则形长赤皮蒂粗。阴人服蒌，阳人服栝，并去
壳皮
革膜及油。土瓜蒌，功用相仿，惟实热壅滞者宜之。稍挟虚切勿妄投。去油捣霜，润肺之性
减，而凉脾之功胜，利水泻热，行血堕胎。
〔害〕细审其质性，不过泻气破血之品。故能堕胎。古方俱用以为补肾者，乃误传也。
愚按
补肾者，系潼关蒺藜，今肆中所用，盖不分也。
〔利〕苦辛而温，泻肺疏肝，散风胜湿，破血催生，通乳闭，消症瘕。
〔修治〕七八月采子，酒炒研，去刺用。
〔害〕单用多用，亦损正气。
〔利〕辛苦温、性中和，理上焦肺气而平呕，健中州脾运而进食，疏气平肝，除痰止嗽。
〔修治〕去白或炒，鲜者尤佳。产闽广，古方枸椽，或蒸露用。
〔害〕但性稍寒，无火者勿服。除惊痫、眩晕，平息肝风相火之外，他无所长。凡病风
温，
邪未入营，尚在上中二焦卫分者，误服之恐致昏谵。以其轻扬入肝，未免激动肝阳上升，升
则浊邪上蒙清窍故也。
〔利〕甘寒，舒筋，除眩晕，心热、烦躁，下气宽中，治小儿惊痫、客忤胎风，祛肝风
而不
燥，庶几和中。今去梗，纯用钩，功加倍。
〔修治〕三月采，有刺类钓钩，古方多用皮，久煎则无力。俟他药煎就，方入钩藤，三
沸
即起，颇得力也。时珍曰∶苦寒过服，恐伤胃中生发之气，反取火邪。亦久服黄连，反从火
化之义也。
**Trichosanthes Fruit (Gualou)**
[Contraindications] Cold in nature, it injures the stomach and causes loose stools. It should not be used for those with weak stomach qi and poor appetite, or for those with spleen deficiency leading to diarrhea. It is incompatible with Achyranthis Bidentatae Radix (Niuxi) and Drynariae Rhizoma with Ferulae Resin (Ganqi), adverse to Zingiberis Radix Exsiccata (Ganjiang), and contrary to Aconiti Lateralis Radix Prepara (Wutou).
[Benefits] Bitter and sweet in taste, it moistens the lungs and soothes the liver, lubricates the intestines and cools the spleen. It is a key herb for treating cough due to lung heat. It clears fire from the Upper Jiao, directs phlegm-qi downward, stops all types of blood-heat, and can also purge stagnant heat and greasiness from the chest. It generates fluids, relieves thirst, and is an excellent remedy for clearing the throat. It also treats Jie Xiong (chest binding syndrome) and is a principal herb for spleen heat.
[Processing] Harvested in the ninth lunar month. "Gua" refers to round fruits with thick yellow skin and small stalks, while "Lou" refers to elongated fruits with red skin and thick stalks. Women should consume Lou, and men should consume Gua. The shell, peel, membranous layer, and oil must be removed. Trichosanthes Kirilowii Root (Tugualou) has similar functions but is suitable only for cases of excess heat stagnation. It should not be administered indiscriminately if there is any deficiency. When the oil is removed and the root is pounded into a paste, its lung-moistening property decreases, but its spleen-cooling effect increases. It promotes urination, drains heat, invigorates blood, and induces abortion.
**Tribulus Fruit (Jili)**
[Note: The original text lacks a specific heading here, but based on the context of "removing thorns" and the comparison with "Tongguan Jili", this section refers to Tribulus Terrestris.]
[Contraindications] Upon careful examination of its nature, it is merely a substance that dissipates qi and breaks blood stasis; hence, it can induce abortion. Ancient formulas used it to tonify the kidney, which is a misinterpretation. I believe the reference to "tonifying the kidney" actually pertains to Tribulus from Tongguan. Currently, what is sold in markets is often not distinguished properly.
[Benefits] Bitter, pungent, and warm. It drains lung heat, soothes the liver, disperses wind and overcomes dampness, breaks blood stasis to facilitate childbirth, unblocks milk obstruction, and resolves masses and accumulations (Zheng Jia).
[Processing] Seeds are harvested in the seventh and eighth lunar months, stir-fried with wine, ground, and the thorns are removed before use.
**Aurantii Fructus Immaturus / Mature (Zhike/Zhishi)**
[Note: Based on "removing the white pith", "regulating upper jiao lung qi", "strengthening middle jiao spleen transport", and association with Citrus medica (Gouyuan), this refers to Aurantii Fructus.]
[Contraindications] Used alone or in large doses, it may also damage healthy qi.
[Benefits] Pungent, bitter, and warm. Its nature is neutral. It regulates lung qi in the Upper Jiao to stop vomiting, strengthens the spleen's transport function in the Middle Jiao to promote appetite, moves qi to calm the liver, eliminates phlegm, and stops coughing.
[Processing] Remove the white pith or stir-fry. Fresh ones are particularly good. Produced in Fujian and Guangdong. In ancient formulas, Citrus medica (Gouyuan) was sometimes steamed or prepared as a dew.
**Uncaria Ramulus cum Uncis (Gouteng)**
[Contraindications] Its nature is slightly cold; it should not be taken by those without internal heat. Apart from treating epilepsy and dizziness, and calming liver wind and ministerial fire, it has few other merits. For patients with Wind-Warmth disease, where the pathogenic factor has not yet entered the Ying (Nutrient) level but remains in the Wei (Defensive) level of the Upper and Middle Jiao, mistaken use may lead to coma and delirium. This is because its light and ascending nature enters the Liver, inevitably stirring up Liver Yang to rise. When Yang rises, turbid pathogens ascend and cloud the clear orifices.
[Benefits] Sweet and cold. It relaxes tendons, alleviates dizziness, clears heart heat and irritability, directs qi downward and expands the middle, and treats pediatric epilepsy, sudden shock, and fetal wind. It dispels liver wind without being drying, thus harmonizing the middle. Today, removing the stems and using only the hooks doubles the efficacy.
[Processing] Harvested in the third lunar month. The stems have thorns resembling fishing hooks. Ancient formulas often used the bark, which loses potency if decocted for too long. Add Gouteng after other herbs have finished decocting. Boil three times and remove immediately; this method yields significant efficacy. Li Shizhen stated: Overconsumption of bitter-cold herbs may damage the generating qi of the stomach, potentially attracting fire pathogens. This is analogous to the principle that long-term consumption of Coptidis Rhizoma (Huanglian) may transform into fire.