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Sargassum (Haizao), with a bitter and salty taste, and a cold nature, is non-toxic. The claim that it is toxic is incorrect. It is incompatible with Glycyrrhizae Radix et Rhizoma (Gancao). It enters the Spleen meridian. It treats scrofula (lymph node tuberculosis) in the neck area and goiter (thyroid swelling) under the neck; it promotes urination, treats stranguria caused by urinary retention, drains water qi, eliminates distension and edema, wards off various evil spirits and demons, and alleviates hernia pain characterized by unilateral descent. This substance specializes in dissipating hard and solid pathologies, likely because the salty flavor can soften hardness. However, using this single herb alone often fails to achieve efficacy. By adding guiding herbs (Yinjing zhi pin) appropriate to the specific disease, no solid pathology will remain undissipated.

Someone asked: "Does Sargassum's efficacy in dissipating solidity come from empirical testing?" If medicines must be tested before being described, then what did Shennong test? Nevertheless, speaking without testing is less reliable than testing before speaking. While traveling in the Yan and Zhao regions, I encountered the son of a maternal relative, who mentioned his mother suffered from goiter and sought my treatment. I prescribed Sargassum (Haizao) 5 qian, Poria (Fuling) 5 qian, Pinelliae Rhizoma Preparatum (Banxia) 1 qian, Atractylodis Macrocephalae Rhizoma (Baizhu) 5 qian, Glycyrrhizae Radix et Rhizoma (Gancao) 1 qian, Citri Reticulatae Pericarpium (Chenpi) 0.5 qian, Sinapis Albae Semen (Baijiezi) 1 qian, and Platycodonis Radix (Jiegeng) 1 qian, decocted in water and taken orally. After four doses, the goiter reduced by half; after another four doses, the goiter completely disappeared. Such is the verified efficacy of Sargassum in treating goiter. Can we not trust its other abilities to break up accumulations based on this evidence?

Kansui Radix (Gansui), with a bitter and sweet taste, and a greatly cold nature, is toxic. It is incompatible with Glycyrrhizae Radix et Rhizoma (Gancao). It enters the Stomach, Spleen, Bladder, Large Intestine, and Small Intestine meridians. It miraculously breaks down masses and accumulations (Zhengji), reduces facial and ocular edema, removes fluid retention in the chest, and is particularly effective in promoting diuresis. This herb drains dampness and water slowly, whereas Pharbitidis Semen (Qianniuzi) drains them rapidly. When combined, the slow action becomes efficient, and the rapid action becomes moderated. However, Kansui Radix (Gansui) should not be used lightly. Kansui Radix (Gansui) can only treat true damp-water pathologies, not false ones. Water invading from below upwards constitutes true dampness; water invading from above downwards constitutes false dampness. True dampness can be treated with Kansui Radix (Gansui) to open the water pathways; false dampness should not be treated with it, as it would cause upper leakage. True dampness represents an excess of water pathogens, while false dampness indicates deficiency of primordial Qi. Applying excess-treatment methods to a deficiency condition violates the prohibition against further weakening the deficient. Once drained, death may follow immediately; how can one not be cautious!

Someone asked: "Zhang Zhongjing combined Pharbitidis Semen (Qianniuzi) and Kansui Radix (Gansui) into formulas to treat edema and abdominal distension with miraculous effect. Since Phariitidis Semen (Qianniuzi) promotes diuresis very swiftly, why is Kansui Radix (Gansui) needed to moderate its speed?" Alas! This demonstrates the divine skill of Master Zhang in prescribing, which is beyond the comprehension of those with shallow learning. Have you not observed methods of river management? When floods rise to the sky and the nine provinces are submerged, where does one begin to manage the water? One must start from the upper reaches. If the source is dredged and cleared upstream, managing the downstream becomes easy. If one only opens the downstream outlets, although much water may drain out, the water obstructed and stored in lakes upstream remains abundant. With the tail end leaking but the upstream surging, can the people live in peace? Therefore, water managers must address both upper and lower reaches simultaneously. Is the human body any different? Master Zhang included Kansui Radix (Gansui) among Phariitidis Semen (Qianniuzi) precisely to grasp this principle, thereby facilitating the drainage of dampness. Phariitidis Semen (Qianniuzi) acts swiftly, raising concerns that it might be too aggressive, draining water too urgently so that fluids in the limbs, skin, hair, head, face, hands, and feet might not be as easily expelled as those in the intestines, stomach, and spleen. Adding the moderating influence of Kansui Radix (Gansui) balances harshness and gentleness, ensuring appropriate pacing. Fluids in the upper part become easier to disperse, while fluids in the lower part are not difficult to rapidly discharge. Consequently, fluids in the limbs, skin, head, face, and hands cannot linger; they exit through the Bladder. Even fluids in the Spleen, Stomach, Large Intestine, and Small Intestine are thoroughly evacuated via urine and feces. If only Phariitidis Semen (Qianniuzi) were used without Kansui Radix (Gansui), the action would be too urgent, potentially causing dryness in the lower jiao and panting/fullness in the upper jiao, resulting in an incurable condition. If only Kansui Radix (Gansui) were used without Phariitidis Semen (Qianniuzi), the action would be too sluggish, potentially causing relief in the upper jiao but obstruction in the lower jiao, leading to an unmanageable situation. Master Zhang’s combination achieves miraculous results, gaining efficacy without harm.

Someone asked: "Phariitidis Semen (Qianniuzi) is swift, and Kansui Radix (Gansui) is slow, so their combination succeeds. You have discussed benefits for the upper and lower jiao, but not the middle jiao. Could their combination be detrimental to the middle jiao?" The combination of Phariitidis Semen (Qianniuzi) and Kansui Radix (Gansui), benefiting the upper and lower jiao, actually protects the middle jiao. Obstruction in the lower jiao causes water to reflux into the middle jiao, creating blockage. Panting and fullness in the upper jiao cause water to flow into the middle jiao, forming glomus and distension. Now, using both Phariitidis Semen (Qianniuzi) and Kansui Radix (Gansui) ensures both upper and lower jiao benefit, leaving the middle jiao secure.

Some suspect: "Although Kansui Radix (Gansui) is slow-acting, its expulsion of damp-water is still fierce. Using Phariitidis Semen (Qianniuzi) together with Kansui Radix (Gansui) might exacerbate this fierceness." If it is truly damp-water, why worry about fierceness? If it is not a damp-water condition, even using Kansui Radix (Gansui) alone is inadvisable, let alone adding Phariitidis Semen (Qianniuzi). Precisely because it is true damp-water, they can be used together without conflict.

Someone asked: "'Bifeng Zaxing' records treating urinary retention (Zhuanpao) using 1 qian of Kansui Radix (Gansui) powder, taken with Zhu Ling Tang, resulting in immediate passage. Can this serve as a guideline?" No, it cannot. Urinary retention is mostly due to fire, and since Kansui Radix (Gansui) is greatly cold, draining seems appropriate. However, the 'fire' in urinary retention refers to Kidney fire failing to communicate with the Bladder, where deficient fire is suppressed and unable to flow freely; it is not a true physical twisting of the bladder. If the bladder were truly twisted, death would occur instantly, and survival would not be prolonged.