半夏、橘红皆为利痰之药，然宜于湿寒之痰，不宜于燥热之痰，至阴虚生热有痰，外感温热有痰，尤所
当忌。究之伍药得宜，半夏或犹可用，是以《伤寒论》竹叶石膏汤、《金匮》麦门冬汤皆用之。至橘红则无
论伍以何药，皆不宜用。试略举数案于下以明之。
本邑于姓媪，劳热喘嗽，医治数月，病益加剧，不能起床，脉搏近七至，心中热而且干，喘嗽连连，势
极危险。所服之方，积三十余纸，曾经六七医生之手，而方中皆有橘红。其余若玄参、沙参、枸杞、天冬、
贝母、牛蒡、生熟地黄诸药，大致皆对证，而其心中若是之热而干者，显系橘红之弊也。愚投以生怀山药一
两，玄参、沙参、枸杞、龙眼肉、熟地黄各五钱，川贝、甘草各二钱，生鸡内金钱半。煎服一剂，即不觉干。
即其方略为加减，又服十余剂，全愈。
又∶治奉天李××，得风温证，发热、头疼、咳嗽。延医服药一剂，头疼益剧，热嗽亦
不少减。其脉浮洪而长，知其阳明经
府皆热也。视所服方，有薄荷、连翘诸药以解表，知母、玄参诸药以清里，而杂以橘红三钱，诸药之功尽为
橘红所掩矣。为即原方去橘红，加生石膏一两，一剂而愈。
又∶治沧州孙××肺脏受风，咳嗽吐痰。医者投以散风利痰之剂，中有毛橘红二钱，服后即大口吐血，
咳嗽益甚。其脉浮而微数，右部寸关皆有力。投以《伤寒论》麻杏甘石汤，方中生石膏用一两，麻黄用一钱，
煎汤送服旱三七细末二钱。一剂血止。又去三七，加丹参三钱，再服一剂，痰嗽亦愈。方中加丹参者，
恐其经络中留有瘀血，酿成异日虚劳之证，故加丹参以化之。
统观以上三案，橘红为虚劳温病之禁药，不彰彰可考哉！而
医者习惯用之，既不能研究其性于平素，至用之病势增进，仍不知为误用橘红所致，不将梦梦终身哉！
半夏和橘红都是化痰的药物，然而它们适用于湿寒性质的痰，不适用于燥热性质的痰。至于因阴虚生内热而有痰，或外感温热邪气而有痰的情况，更是应当禁忌使用。仔细推敲起来，如果药物配伍得当，半夏或许还可以使用，因此《伤寒论》中的竹叶石膏汤、《金匮要略》中的麦门冬汤都使用了半夏。至于橘红，无论与什么药物配伍，都不适宜使用。下面试举几个医案来说明这一点。
本县有一位姓于的老妇人，患有虚劳发热、气喘咳嗽，经过几个月治疗，病情反而加剧，无法起床，脉搏接近七至（每呼吸一次脉跳七次），心中感觉灼热且干燥，气喘咳嗽连续不断，形势极其危险。所服用的药方，累积了三十多张纸，经过六七位医生之手，但每个方子中都有橘红。其余如玄参、沙参、枸杞、天冬、贝母、牛蒡、生地黄、熟地黄等药物，大致上都对症，但她心中如此严重的灼热和干燥，显然是橘红造成的弊端。我给她投以生怀山药一两，玄参、沙参、枸杞、龙眼肉、熟地黄各五钱，川贝、甘草各二钱，生鸡内金钱半。煎服一剂后，就不觉得干燥了。按照这个方略稍作加减，又服用了十余剂，完全痊愈。
另外：治疗奉天的李某某，得了风温证，出现发热、头痛、咳嗽。请医生服药一剂后，头痛更加剧烈，热咳也没有多少减轻。他的脉象浮洪而长，可知阳明经和腑都有热。查看他所服用的方子，有薄荷、连翘等药物来解表，知母、玄参等药物来清里，却混杂了橘红三钱，导致其他药物的功效全被橘红抵消了。于是我在原方中去掉橘红，加入生石膏一两，服用一剂就痊愈了。
另外：治疗沧州的孙某某，肺脏受风邪侵袭，咳嗽吐痰。医生投用疏散风邪、利化痰浊的药剂，其中含有毛橘红二钱，服用后立即大口吐血，咳嗽更加严重。他的脉象浮而微数，右手的寸部和关部都有力。我投用《伤寒论》中的麻杏甘石汤，方中生石膏用一两，麻黄用一钱，煎汤送服旱三七细末二钱。服用一剂后血止住了。后来又去掉三七，加入丹参三钱，再服用一剂，痰嗽也好了。方中加入丹参的原因，是担心经络中留有瘀血，日后酿成虚劳病证，所以加入丹参来化解它。
综合以上三个医案来看，橘红是虚劳和温病的禁忌药物，这不是非常明显确凿的吗！然而医生们习惯使用它，平时既不能研究它的药性，等到用药后病情加重，仍然不知道是误用橘红导致的，这不就要糊里糊涂地度过一生吗！
Pinellia Rhizome (Banxia, 半夏) and Exocarpium Citri Reticulatae Viride (Juhong, 橘红) are both medicines for promoting the discharge of phlegm. However, they are suitable for phlegm caused by damp-cold, but not for phlegm caused by dryness-heat. In cases where Yin deficiency generates internal heat with phlegm, or where external warm-heat pathogens cause phlegm, their use is particularly contraindicated. Upon careful consideration, if the combination of medicines is appropriate, Pinellia Rhizome (Banxia, 半夏) might still be usable; therefore, Zhu Ye Shi Gao Tang (Bamboo Leaf and Ginseng Decoction) in *Shang Han Lun* (Treatise on Cold Pathogenic Diseases) and Mai Men Dong Tang (Ophiopogon Decoction) in *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) both employ it. As for Exocarpium Citri Reticulatae Viride (Juhong, 橘红), regardless of what other medicines it is combined with, it should not be used. The following few cases are briefly presented to illustrate this point.
An elderly woman surnamed Yu in our county suffered from consumptive fever, panting, and coughing. After several months of medical treatment, her condition worsened, rendering her bedridden. Her pulse was nearly seven beats per breath, and she felt intense heat and dryness in her heart region, with continuous panting and coughing, presenting a critical situation. The accumulated prescriptions she had taken amounted to over thirty sheets, handled by six or seven physicians, yet every prescription contained Exocarpium Citri Reticulatae Viride (Juhong, 橘红). Other herbs such as Scrophulariae Radix (Xuanshen, 玄参), Glehniae Radix (Shashen, 沙参), Lycii Fructus (Gouqi, 枸杞), Asparagi Radix (Tiandong, 天冬), Fritillariae Bulbus (Beimu, 贝母), Arctii Fructus (Niubang, 牛蒡), Rehmanniae Radix Recens (Sheng Dihuang, 生地黄), and Rehmanniae Radix Preparata (Shu Dihuang, 熟地黄) were generally appropriate for her syndrome. However, the severe heat and dryness in her heart region were evidently the detrimental effect of Exocarpium Citri Reticulatae Viride (Juhong, 橘红). I prescribed Dioscoreae Hypoglaucae Rhizoma (Sheng Huai Shanyao, 生怀山药) 1 liang, Scrophulariae Radix (Xuanshen, 玄参), Glehniae Radix (Shashen, 沙参), Lycii Fructus (Gouqi, 枸杞), Longan Aril (Longyanrou, 龙眼肉), and Rehmanniae Radix Preparata (Shu Dihuang, 熟地黄) each 5 qian, Fritillariae Bulbus (Chuan Bei, 川贝) and Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) each 2 qian, and Aves' Gizzard-membrane (Sheng Jineijin, 生鸡内金) half a qian. After one dose decocted and taken orally, the dryness disappeared. By slightly modifying this formula and taking more than ten additional doses, she made a complete recovery.
Another case: I treated Mr. Li XX from Fengtian who contracted Wind-Warmth syndrome, presenting with fever, headache, and coughing. After one dose of medicine prescribed by a physician, his headache intensified, and the hot cough did not decrease significantly. His pulse was floating, surging, and long, indicating heat in both the Yangming Channel and its associated Fu organs. Reviewing the prescribed formula, it contained Menthae Haplocalycis Herba (Bohe, 薄荷) and Forsythiae Fructus (Lianqiao, 连翘) to release the exterior, Anemarrhenae Rhizoma (Zhimu, 知母) and Scrophulariae Radix (Xuanshen, 玄参) to clear the interior, but was mixed with Exocarpium Citri Reticulatae Viride (Juhong, 橘红) 3 qian. This mixture negated the efficacy of all other herbs. I immediately removed Exocarpium Citri Reticulatae Viride (Juhong, 橘红) from the original formula and added Pectinitum (Sheng Shigao, 生石膏) 1 liang. One dose resulted in a cure.
Another case: I treated Mr. Sun XX from Cangzhou, whose lungs were affected by wind, causing coughing and expectoration. The physician administered a formula to disperse wind and promote phlegm discharge, which included Citri Reticulatae Pericarpium Viride (Mao Juhong, 毛橘红) 2 qian. Immediately after ingestion, he vomited large amounts of blood, and the cough worsened. His pulse was floating and slightly rapid, with strength in the Cun and Guan positions on the right side. I administered Ma Xing Gan Shi Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) from *Shang Han Lun*, using Pectinitum (Sheng Shigao, 生石膏) 1 liang and Ephedrae Herba (Mahuang, 麻黄) 1 qian, decocted in water to administer with 2 qian of fine powder prepared from Panax Notoginseng Root (Han Sanqi, 旱三七). One dose stopped the bleeding. Subsequently, Panax Notoginseng Root (Sanqi, 三七) was removed, and Notoginseng Radix (Danshen, 丹参) 3 qian was added. After another dose, the phlegm and cough also resolved. Danshen Radix et Rhizoma (Danshen, 丹参) was added to the formula because I feared that residual blood stasis in the channels and collaterals might develop into a consumptive disease later; thus, Danshen Radix et Rhizoma (Danshen, 丹参) was added to resolve the stasis.
Reviewing these three cases collectively, it is undeniably evident that Exocarpium Citri Reticulatae Viride (Juhong, 橘红) is a prohibited medicine for consumptive diseases and warm-pathogen diseases. Yet, physicians habitually use it. Since they fail to study its properties beforehand, and when the disease worsens after its use, they remain unaware that it is due to the misuse of Exocarpium Citri Reticulatae Viride (Juhong, 橘红), will they not live their lives in perpetual ignorance!