薄荷∶味辛,气清郁香窜,性平,少用则凉,多用则热(如以鲜薄荷汁外擦皮肤少用殊觉清凉,多用即觉
灼热)。其力能内透筋骨,外达肌表,宣通脏腑,贯串经络,服之能透发凉汗,为温病宜汗解者之要药。若少
用之,亦善调和内伤,治肝气胆火郁结作疼,或肝风内动,忽然痫痉螈 ,头疼目疼,鼻渊鼻塞,齿疼咽喉肿
疼,肢体拘挛作疼,一切风火郁热之疾,皆能治之。痢疾初起挟有外感者,亦宜用之,散外感之邪,即以清肠
中之热,则其痢易愈。又善消毒菌(薄荷冰善消霍乱毒菌薄荷亦善消毒菌可知),逐除恶气,一切霍乱痧证,
亦为要药。为其味辛而凉,又善表疹瘾,愈皮肤瘙痒,为儿科常用之品。
温病发汗用薄荷,犹伤寒发汗用麻黄也。麻黄服后出热汗,热汗能解寒,是以宜于伤寒;薄荷服后出凉汗,
凉汗能清温,是以宜于温病。若以麻黄发温病之汗,薄荷发伤寒之汗,大抵皆不
能出汗,即出汗亦必不能愈病也。
薄荷古原名苛,以之作蔬,不以之作药,《神农本草经》、《名医别录》皆未载之,至唐时始列于药品,
是以《伤寒论》诸方未有用薄荷者。然细审《伤寒论》之方,确有方中当用薄荷,因当时犹未列入药品,即当
用薄荷之方,不得不转用他药者。试取伤寒之方论之,如麻杏甘石汤中之麻黄,宜用薄荷代之,盖麻杏甘石汤,
原治汗出而喘无大热,既云无大热,其仍有热可知,有热而犹用麻黄者,取其泻肺定喘也。然麻黄能泻肺定喘,
薄荷亦能泻肺定喘(薄荷之辛能抑肺气之盛,又善搜肺风),用麻黄以热治热,何如用薄荷以凉治热乎?又如
凡有葛根诸汤中之葛根,亦可以薄荷代之,盖葛根原所以发表阳明在经之热,葛根之凉不如薄荷,而其发表之
力又远不如薄荷,则用葛根又何如用薄荷乎?斯非背古训也,古人当药物未备之时,所制之方原有不能尽善尽
美之处,无他,时势限之也。吾人当药物既备之时,而不能随时化裁与古为新,是仍未会古人制方之意也。医界
之研究伤寒者,尚其深思愚言哉。
薄荷:味辛,气味清香浓郁且窜透,药性平和。少量使用则具凉性,大量使用则显热性(例如将鲜薄荷汁外擦于皮肤,少量使用时感觉特别清凉,大量使用时则感到灼热)。其功效能内透筋骨,外达肌表,宣通脏腑,贯通经络。服用后能促使透出凉爽的汗液,是治疗适宜通过发汗解表的温病的关键药物。如果少量使用,也善于调和内伤,治疗因肝气与胆火郁结引起的疼痛,或肝风内动导致的突然癫痫、抽搐、头痛、眼痛、鼻渊(鼻窦炎)、鼻塞、牙痛、咽喉肿痛、肢体拘挛疼痛等一切风火郁热之疾,均能治疗。痢疾初起兼有外感症状者,也适宜使用薄荷,以疏散外感邪气,同时清除肠道内的热邪,这样痢疾就容易痊愈。此外,薄荷善于消毒杀菌(薄荷冰善于消除霍乱毒菌,由此可知薄荷也能消毒杀菌),驱除恶臭之气,对于各种霍乱和痧证,也是重要药物。因其味辛而凉,又善于透发疹子,治愈皮肤瘙痒,是儿科常用的药材。
在治疗温病需要发汗时,使用薄荷,就像治疗伤寒需要发汗时使用麻黄一样。服用麻黄后排出的是热汗,热汗能够解除寒邪,所以适用于伤寒;服用薄荷后排出的是凉汗,凉汗能够清除温热邪气,所以适用于温病。如果用麻黄来发温病的汗,或用薄荷来发伤寒的汗,大体上都不能出汗,即使出了汗,也必然不能治愈疾病。
薄荷古时候原名“苛”,当时将其作为蔬菜食用,而不作为药物使用,《神农本草经》和《名医别录》中都没有记载它,直到唐代才将其列入药品目录,因此《伤寒论》中的各方没有使用薄荷的。然而仔细审视《伤寒论》中的方剂,确实存在原本应当使用薄荷的情况,只是因为当时薄荷尚未被列入药品,所以在那些本应使用薄荷的方剂中,不得不转而使用其他药物。试举伤寒方的例子来分析,如麻杏甘石汤中的麻黄,可以用薄荷替代。因为麻杏甘石汤原本治疗的是出汗且气喘、没有大热的症状,既然说没有大热,说明体内仍有热邪。在有热邪的情况下仍用麻黄,是取其泻肺定喘的功效。然而麻黄能泻肺定喘,薄荷也能泻肺定喘(薄荷的辛味能抑制肺气过盛,又善于搜剔肺风),用麻黄以热治热,哪里比得上用薄荷以凉治热呢?又如凡是含有葛根的诸种汤剂中的葛根,也可以用薄荷替代。因为葛根原本是用来发表阳明经在经之热,葛根的凉性不如薄荷,而其发表的力量又远不如薄荷,那么使用葛根哪里比得上使用薄荷呢?这并非违背古训。古人在药物种类不完善的时候,所制定的方剂原本就有不能尽善尽美的地方,没有其他原因,只是受限于当时的时代条件罢了。我们在药物种类已经完备的今天,如果不能根据情况灵活变通、推陈出新,那就是还没有领会古人制定方剂的用意。研究伤寒的医学界人士,希望能深思我的这番话。
Bohe (Menthae Haplocalyx, 薄荷): Its taste is pungent; its aroma is clear, rich, and penetrating. Its nature is neutral. In small doses, it is cooling; in large doses, it becomes heating (for instance, when fresh Bohe juice is applied externally to the skin, a small amount feels distinctly cool, while a large amount causes a burning sensation). Its efficacy can penetrate internally into the sinews and bones, reach externally to the muscle layer, unblock the Zang-Fu organs, and traverse the meridians. After ingestion, it induces the excretion of cool sweat, making it a crucial herb for treating Warm Diseases (Wen Bing) that require resolution through sweating. If used in small doses, it is also effective in harmonizing internal injuries, treating pain caused by stagnation of Liver Qi and Gallbladder Fire, or sudden epilepsy and convulsions due to internal stirring of Liver Wind, along with headache, eye pain, nasal sinusitis (Bi Yuan), nasal congestion, toothache, swelling and pain of the throat, and painful stiffness of the limbs. It can treat all disorders characterized by wind-fire stagnation and heat. For dysentery in its early stage accompanied by external contraction, Bohe is also suitable; it disperses the external pathogenic factors and simultaneously clears heat in the intestines, thereby facilitating recovery. Furthermore, Bohe is adept at eliminating bacteria (since Bohe Bing [Borneol] is good at eliminating cholera toxins, it follows that Bohe is also capable of disinfection); it drives away foul odors and is an important herb for various cases of cholera and Sha Zheng (sand syndrome). Due to its pungent and cooling nature, it is also effective in venting rashes and curing skin pruritus, making it a commonly used item in pediatrics.
When treating Warm Diseases requiring diaphoresis, Bohe is used, just as Mahuang (Ephedrae Herba) is used for treating Cold Damage (Shang Han) requiring diaphoresis. After taking Mahuang, hot sweat is produced; this hot sweat resolves cold pathogens, hence it is suitable for Shang Han. After taking Bohe, cool sweat is produced; this cool sweat clears warm pathogens, hence it is suitable for Wen Bing. If Mahuang were used to induce sweating for a Warm Disease, or Bohe for a Cold Damage, generally no sweat would be produced; even if sweat were produced, it would certainly not cure the disease.
In ancient times, Bohe was originally named "Ke" and was used as a vegetable rather than a medicine. It was not recorded in either the *Shennong Bencao Jing* (Divine Farmer's Materia Medica) or the *Mingyi Bielu* (Record of Famous Physicians). It was only listed among medicinal substances during the Tang Dynasty. Therefore, none of the formulas in the *Shanghan Lun* (Treatise on Cold Damage) use Bohe. However, upon careful examination of the formulas in the *Shanghan Lun*, there are indeed instances where Bohe should have been used. Because it was not yet listed as a drug at that time, formulas that required Bohe had to substitute it with other herbs. Let us analyze some Shang Han formulas: for example, Mahuang in the Mahxing Gan Shi Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) could be replaced by Bohe. The Mahxing Gan Shi Tang originally treats symptoms of sweating, wheezing, and absence of high fever. Since there is "no high fever," it implies that heat still exists. The reason Mahuang is used despite the presence of heat is to drain Lung Qi and relieve wheezing. However, since Mahuang can drain Lung Qi and relieve wheezing, Bohe can do so as well (the pungency of Bohe suppresses excessive Lung Qi and is good at searching out Lung Wind). Why use Mahuang to treat heat with heat, when one could use Bohe to treat heat with coolness? Similarly, Gegen (Puerariae Radix) in various formulas containing Gegen could also be replaced by Bohe. Gegen is originally used to release exterior Heat in the Yangming channel. Gegen's cooling property is inferior to Bohe, and its power to release the exterior is far less than that of Bohe. Thus, why use Gegen when Bohe would be superior? This does not contradict ancient teachings. When drugs were not yet comprehensive, the formulas created by the ancients necessarily had imperfections. There is no other reason but the limitations of their time. We, living in an era where medicinal resources are abundant, fail to adapt and innovate according to circumstances, which means we have not truly understood the intent behind the ancients' formulation of medicines. Researchers of Shang Han in the medical field should ponder my words deeply.