肾中阳虚之人,水上泛而为痰涎,火上升而为喘逆。沉香质坚色黑而沉,故能举在上之
水与火,悉摄而返之于肾。其气香性温,则能温肾以理气,即小便气淋,大肠虚闭,亦得以
通之,而要非以宣泄为通也。
沉香之用以气,虽功在降摄,而凡气分中之病,仍能运转于中而不留滞。若滚痰丸以沉
香佐礞石大黄黄芩,治实热老痰,则其知沉香也深矣。
乌药色黑味辛,气温而香,其主膀胱肾间冷气攻冲背膂宜矣。而寇宗 谓与沉香同磨作
汤点服,治胸腹冷气甚稳当者何故?盖其根如车毂纹横生,非降亦非升,故凡病之属气而涉
寒
缩泉丸治小便频数,温肾固气,惟恃益智山药,佐乌药则以散冷气耳。
黄柏为五脏肠胃清湿热之药,表里上下俱到。表有热可治,表不热而里热亦可治。色黄
入肠胃,皮入肺,微辛亦入肺,气味俱浓,性寒而沉入肝肾,入胃则亦入脾,入肾则亦入心。
本经所以主五脏肠胃中结热也。性寒已热,燥则除湿,故本经所列黄胆、肠痔、泄痢、女子
漏下赤白、阴伤蚀疮,皆属湿热之 别录又补出惊气在皮间、肌肤热赤起、目热赤痛、口疮,
则所谓五脏肠胃者悉备矣。大抵湿下溜而火上出,别录所主虽不属湿,而其因未始非湿。观
仲圣栀子柏皮汤、大黄硝石汤治黄胆,为阳明病。白头翁汤治热痢,乌梅丸治呕吐久痢,为
阳明兼厥阴病。外台大黄汤,更治天行壮热,黄柏一味,实赅五脏肠胃,故其用颇广。若以
治少阴与萸地知母为伍,则肾中不必有湿,否则如其分以施之,必得如二妙散为当。盖苦燥
之物,无不劫阴,以黄柏为滋阴之剂者非也。
In individuals with Kidney Yang deficiency, water fluids float upward to become phlegm and saliva, while fire ascends leading to panting and counterflow. Chenxiang (Aquilariae Lignum) has a firm texture, black color, and heavy weight; thus, it can lift the floating water and fire above and gather them back into the Kidney. Its fragrance and warm nature allow it to warm the Kidney and regulate Qi. Even in cases of Qi-type strangury (dysuria due to Qi stagnation) or deficiency-cold constipation of the Large Intestine, it can facilitate unblocking, yet this is not achieved through purgative drainage.
The efficacy of Chenxiang lies in its Qi aspect. Although its function is descending and gathering, it can still circulate within the middle Jiao for various diseases involving the Qi level without causing stagnation. For instance, in Tansuan Wan (Phlegm-Expelling Pill), Chenxiang assists Mengshi (Lapis Malachitis), Dahuang (Rhei Radix et Rhizoma), and Huangqin (Scutellariae Radix) to treat old phlegm caused by excess heat, demonstrating a profound understanding of Chenxiang's properties.
Wuyao (Litseae Fructus) is black in color, pungent in taste, warm in nature, and fragrant. It is suitable for treating cold Qi attacking from between the Bladder and Kidney towards the back and spine. Why does Kou Zongshi state that grinding Wuyao together with Chenxiang to make a decoction taken orally is very effective for treating cold Qi in the chest and abdomen? This is likely because the root of Wuyao resembles the radial spokes of a cart hub, growing horizontally; it is neither purely descending nor ascending. Therefore, for diseases belonging to Qi stagnation involving cold... Suoquan Wan (Bladder-Retaining Pill) treats frequent urination by relying on Yizhiren (Alpiniae Oxyphyllae Semen) and Shanyao (Dioscoreae Rhizoma) to warm the Kidney and consolidate Qi, while assisting with Wuyao serves only to disperse cold Qi.
Huangbai (Phellodendri Cortex) is a herb that clears damp-heat from the Five Zang organs and the intestines and stomach, reaching both interior and exterior, upper and lower. It can treat heat at the exterior; if there is no exterior heat but interior heat exists, it can also be treated. The yellow color enters the intestines and stomach; the bark enters the Lung; its slight pungency also enters the Lung. With strong aroma and flavor, its nature is cold and heavy, sinking into the Liver and Kidney. Entering the Stomach, it also enters the Splen; entering the Kidney, it also enters the Heart. Hence, the *Shennong Bencao Jing* states it governs accumulated heat in the Five Zang organs and intestines/stomach. Its cold nature clears heat, and its dryness removes dampness. Thus, the conditions listed in the *Bencao Jing* such as jaundice, intestinal hemorrhoids, diarrhea and dysentery, leukorrhea (red and white discharge) in women, and erosive sores of the genitals all belong to damp-heat categories. The *Bielu* further adds symptoms like frightful Qi lodged in the skin, hot and red skin eruptions, hot and red painful eyes, and mouth ulcers, thereby fully covering the aspects of the Five Zang organs and intestines/stomach. Generally, dampness flows downward while fire flares upward. Although the conditions governed by the *Bielu* do not explicitly belong to dampness, their origin may indeed stem from dampness. Observing Zhang Zhongjing's Zhizi Bopi Tang (Gardenia and Phellodendron Decoction) and Dahuang Xiaoshi Tang (Rhubarb and Niter Decoction) for treating jaundice as Yangming disease; Baitouweng Tang (Pulsatilla Decoction) for treating heat-dysentery; and Wu Mei Wan (Mume Pill) for treating vomiting and chronic dysentery as Yangming combined with Jueyin disease; and the Dahuang Tang (Rhubarb Decoction) from *Waitai Miyao* for treating epidemic high fever. Huangbai alone essentially encompasses the Five Zang organs and intestines/stomach, so its applications are quite broad. If used to treat Shaoyin disease in combination with Roupuzhuyu (Corni Fructus), Dihuang (Rehmanniae Radix), and Zhimu (Anemarrhenae Rhizoma), then there need not be dampness in the Kidney; otherwise, it should be administered proportionally, ideally resembling Er Miao San (Two Marvels Powder). Since bitter and drying substances invariably deplete Yin, regarding Huangbai as an agent for nourishing Yin is incorrect.