断不敢用。岂但伤寒一证，即痘疹初发，疟痢初发，中风中痰，中寒中暑，及痈疽产后，初时概不敢用，而虚
人之遇重病，一切可生之机，悉置之矣。古方表汗用参苏饮、败毒散；和解用小柴胡汤、白虎汤、竹叶石膏汤
等方，皆用人参，皆藉参力领出内邪，不使久留，乃得速愈。何世
俗不察耶？每见感入体虚之人，大热呻吟，数日间烁尽津液，身如枯柴，初非不汗之，汗之热不退；后非不和
之、下之，和之、下之热亦不退。倘起先药中用人参数分，领药深入驱邪，何至汗下不应耶？况古今时势不同，
膏粱、藜藿异体，东垣治内伤兼外感者，用补中益气，加表药而散外邪，有功千古。伤寒专科，从仲景至今，
方书每用人参，何为今日医家单除人参不用，其治体虚病感，百无一活矣。乃不知医者，又交口劝病患不宜服
参，目睹亲族死亡，曾不悟旁操鄙见害之也。谨剖心沥血相告，且誓之曰∶今后有以表和药内不宜用人参之言
误人者，死入犁耕地狱。盖不当用参而用之杀人者，皆是与 、术、当归、干姜、桂、附等药，同行温补之
误所致；不与羌、独、柴、前、芎、桔、芷、芩、膏、半等药，同行汗和之法所致也。汗和药中兼用人参，从
古至今，不曾伤人性命，安得视为砒鸠，固执不思耶？（《寓意草》）
天下之害人者，杀其身，未必破其家；破其家，未必杀其身。先破人之家，而后杀其身者，人参也。夫人
参用之而当，实能补元气，拯危险，然不可谓天下之死人皆能生之也。其为物，气盛力浓，不论风、寒、暑、
湿、痰、火、郁、结，皆能补塞。病果邪去正衰，用之固宜。或邪微而正惫，或邪深而正弱，不能逐之于外，
则于除邪药中投之以为驱邪之助，自有扶危定倾之功。若不察其有邪无邪，是虚是实，又佐以纯补温热之品，
将邪气补住，轻者邪不复出，重者即死矣。夫医者之所以遇疾即用人参，而病家服之死而无悔者，何也？盖愚
人之心，皆以价贵为良药，价贱为劣药；而常人之情，无不好补而恶攻，故服参而死，即使明知其误，然以为
医者之力已竭，人子之心已尽，此命数使然，可以无恨；若服攻药而死，即使用药不误，病实难治，而医者之
罪，已不可胜诛矣。故人参者，乃医家邀功避罪之圣药也。病家如此，医家如此，而害人无窍矣。更可骇者，
或以用人参为冠冕，或以用人参为有力量，又因其贵重，深信以为必能挽回造化，故毅然
用之。孰知人参一用，凡病之有邪者即死；其不死者，亦终身不得愈矣。其破家之故何也？盖向日之人参不过
一、二换，多者三，四换，今则其价十倍于前，且所服又非一、二钱而止。小康之家服二、三两，家已荡然。
夫人情于死生之际，何求不得，安恤破家乎？医者全不一念，轻将人参立方，用而不遵，在父为不慈，在子为
不孝，在夫妇昆弟为忍心害理。亲戚朋友责罚痛骂，即使明知无益，姑以此塞责。又有孝子慈父，幸其或生，
竭力谋之，遂使贫窭之家，病或稍愈，一家终身冻馁。若仍不救，棺殓俱无，卖妻鬻子，全家覆败。医者误治，
杀人可恕，而害人破家，其恶甚于盗贼，可不慎哉！吾愿天下之人，断不可以人参为起死回生之药，而必服之。
医者必审其病实系纯虚，非参不治，服必万全，然后用之。又必量其家业尚可支持，不至用参之后，死生无靠，
然后节省用之。一以惜物力，一以全人之命，一以保人之家。如此存心，自然天降之福。若如近日之医，杀人
破家于人不知之地，恐天之降祸，亦在人不知之地也。（徐灵胎）
药之治病，临时变通，非调补之有赖于丸也。以时行之风痰壅闭，理当随时用药，自制丸散，尚不可服，
而何有于蜡丸？蜡丸制于粤东，射利者货之四方，愚夫愚妇误服受害，不知凡几。医家执而从误，是诚何心！
孔子云∶未达不敢尝。予尝语送药之家，必系以方，若无方之药，有识之士其肯服乎？（《小儿诸热辨》）
凡用药太过不及，皆非适中。而不及尚可加，太过则病去药存，为害更烈，医之过也。（《医门法律》）
药解
人参之用甚多。其大纲有四∶一参 ，二参麦，三参附，四参连。临证变通，用之的当，其功未可尽述。
（《怡堂散记》）
人参之用有三∶补气也；止渴也；生津也。补气不必言，何为能生津止渴？盖脾气输于肺，肺气下降，津
液乃生。犹蒸物然，热气熏蒸，旋即成液。故气不足则渴，补其气则津生，而渴自止
矣。（王宇泰）
参者，参也。与元气为参赞者也。不特气虚宜用，即血虚亦宜用。内伤宜用，外感亦宜用。盖烦渴由乎
火邪，得人参而阴津自长；肿胀本乎气壅，得人参而痞闷全消。以至食不欲入，食入反胀，或胃反噎隔，泄利
亡阴，洒淅恶寒，多汗漏风等证，无不赖人参之大力，作元气之藩篱。而妄谓肺热伤肺，参能作饱。不知肺虚
之冤热，非参莫救；脾虚之中满，非参、术何由健运？此所以功冠群草也。（赵羽皇）
人参得升麻，补上焦泻肺火；得茯苓，补下焦泻肾火；得麦冬，泻火而生脉；得黄 、甘草，乃甘温退
大热。○东垣理脾胃，泻阴火，交泰丸用人参、皂荚，是恶而不恶也；古方疗月闭，四物汤加人参、五灵脂，
是畏而不畏也。又疗痰在胸膈，人参、藜芦同用，而取其涌越，是激其怒性也，非洞奥达权者不能知。（汪 庵）
参、 、甘草，泻火之圣药。盖烦劳则虚而生热，得甘温以补元气，而虚热自退。故亦谓之泻。（李东垣）
人知参、 能止汗，而不知其能发汗。以在表药队中，则助表药而解散也。东垣治虚人感冒，用补中益
气汤，即同此意。（陶节庵）
补气药多，补血药亦从而朴气；补血药多，补气药亦从而补血。益气汤虽加当归，因势寡被参、 所据；
补血汤黄 数倍于当归，亦从当归所引而补血。（汪 庵）
甘令人满，有甘草生用为泻者，以其能引诸药至于满所。《经》云∶以甘补之，以甘泻之。故仲景治痞
满有甘草泻心汤。又甘草得茯苓，则不资满而反泻满。○古方用甘草皆倚为君，必须重用方效。时师每用不过
二、三分而止，不知始自何人？相习成风，殊属可笑。（汪 庵）
叶时可先生，一日观钓鱼而悟甘草之用。谓余曰∶鱼竿在手，
所用者丝与钩也。投竿于水，丝浮钩沉。腰间必系一泛子，留于水面，能使浮者不浮，沉者不沉，钓者之心，
视为准则。是钓鱼无需于泛子，然非泛子竟不能得鱼。药中之甘草似之，以其味长于甘而守中也。古称甘草能
和百药，药留于胃，则从容分布，升者循经，降者入腑，非甘草所治之病，而药之得力，皆赖其停顿之功。无
用之用，大矣哉！（《怡堂散记》）
或问附子理中、调胃承气皆用甘草，如何是调和之意？答曰∶附子理中用甘草者，恐其僭上也；调胃承气
用甘草者，恐其速下也。非和也，皆缓也。小柴胡用甘草，则有调和之意。中不满而用甘为之补，中满者而用
甘为之泻。《经》云∶以甘补之，以甘泻之，以甘缓之。（王好古）
附子有斩关夺门之勇。引补气药行十二经，以追散失之元阳；引补血药入血分，蒸动不足之真阴；引发散
药开腠理，以驱在表之风寒；引温暖药达下焦，以逐在里之寒湿。（赵羽皇）
熟附配麻黄，发中有补。仲景麻黄附子细辛汤、麻黄附子甘草汤是也。生附配干姜，补中有发。仲景干姜
附子汤、通脉四逆汤是也。（赵以德）
附子用阴药为君，则惟有回阴制火之力。尚何存辛热强阳之性哉！故药云饵者，是饵其火之下归也。古云∶
附子无干姜不热之语，可进思矣。（《冯氏锦囊》）
用附子补火，必防涸水。如阴虚之人久服补阳之药，则虚阳益炽，真阴愈耗，精血日枯，气无所附，遂成
不救者多矣。（王好古）
桂、附除蒸热，硝、黄解寒战。（高鼓峰）
人身有气中之阳，有血中之阳。气中之阳，走而不守；血中之阳，守而不走。凡药之气胜者，往往补气中
之阳；质胜者，往往补血中之阳。如附子暖血，肉桂暖气，一定之理也。然气之阳胜，则能动血；血之阳胜，
则能益气。又相因之理也。桂，气分
药也，而其验则见于血，其义不晓然乎？（徐灵胎）
白术既燥湿，而又生津，何也？盖脾恶湿，湿胜则气不得施化，津何由生？用白术以除湿，气得周流，
津自生矣。○胸膈逆满，由中气不足而作胀者，宜补之，而胀自除。《经》云∶塞因塞用是也。俗医泥于作饱，
而不敢用参、术，不知少用反滋壅，多服则宣通，补之正所以导之也。（汪 庵）
今人动云白术性燥，冤杀白术矣。盖脾喜燥而恶湿，脾旺则燥，脾虚则湿。白术补脾，湿去则脾旺而燥矣。
非白术之性燥也。且今人动云补阴，绝不知真补阴之法，用白术正所以补阴也。脾乃太阴，补脾之太阴，独非
补阴乎？（吴天士）
地黄产于中州，色黄味甘，得土气最浓。惟是生者性凉，脾阳不足，所当慎用；熟则性平，能补五脏之真
阴，尤有益于多血之脏，得非脾胃药耶？犹有妙者，以之兼散，则能发汗，以汗化于血也；以之兼温，则能回
阳，以阳生于下也。然阳性速，故人参少用，亦可成功；阴性缓，熟地非多，难以奏效。有畏其滞腻者，何肾
气丸用治痰浮？有畏其滑湿者，何八味丸用医肾泻？又若制法用姜汁者，必中寒兼呕；用砂仁者，必胀满不行；
用酒者，必经络壅滞。使无此而强制之，是欲用其静，而反乱其性，何异蛇足乎？（张景岳）
当归之用有三∶一，心经本药；二，和血；三，治诸药夜甚。凡血病必用之。（张洁古）
黄麻发汗，驶不能御。根、节止汗，效如影响。物理不测如此。（汪 庵）
桂枝本营分药，得麻黄、生姜，则令营气外发而为汗，从辛也；得芍药，则收敛营气而止汗，从酸也；
得甘草则补营气而养血，从甘也。（柯韵伯）
仲景桂枝汤，用桂枝者，盖取桂之枝梢细薄者耳。非若肉桂之肉浓也。盖肉桂浓实，治五脏用之者，取
其镇重也；桂枝轻扬，治伤寒用之者，取其发散也。今人例用之，是以见功者寡矣。（《发微论》）
按∶柴胡为少阳药，因伤寒少阳证之用柴胡汤也。夫邪入少阳，将有表邪渐解，里邪渐着之势。方以柴、
芩对峙，解表清里，的为少阳和解之法。而柴胡实未印定少阳药也。盖以柴胡之性，苦平微寒，味薄气升，与
少阳半表之邪，适合其用耳。乃有病在太阳，服之太早，则引贼入门；若病入阴经，复服柴胡，则重虚其表之
说。此恐后人认病未清，模糊混用，故设此二端以晓之也。不观景岳新方中，诸柴胡饮、柴芩煎、柴胡白虎煎
诸方，信手拈来，头头是道，是诚知柴胡之用，而先得我心之所同然矣。再古方有逍遥散之疏解郁热；归柴饮
之和营散邪；补中益气汤之升发清阳，提邪下陷；疏肝益肾汤之疏肝清热，养阴透邪。其妙难于仆数。何至重
虚其表乎？余于风邪初感之轻证，及邪气淹留表热不解之久病，用之并臻神效。奈何将此有用之良品，拘泥成
说而畏之？即用亦准之以分数，竟至相沿成习，不得不为置辨。（《吴医汇讲》）
有言治疟疾不可用柴胡，试问之∶疟疾不在少阳在何经？少阳不用柴胡用何药？不识彼将何以应我。○余治
疟疾用柴胡，每以青蒿佐之。青蒿得少阳之令最早，有芳香之气。（《散记续编》）
黄芩之退热，乃寒能胜热，折火之本也；柴胡之退热，乃苦以发之，散火之标也。（《直指方》）
地骨皮能退内潮，人所知也；能退外潮，人实不知。病或风寒，散而未尽，潮热往来，非柴、葛所能治，
用地骨皮走表又走里之药，消其浮游之邪，服之未有不愈。（朱二允）
地骨皮泻肾火，牡丹皮泻包络火，总治热在外，无汗之骨蒸；知母泻肾火，治热在内，有汗之骨蒸。（李东垣）
古云∶黄柏无知母，故纸无胡桃，犹水母之无虾也。（汪 庵）
后重之用木香、槟榔，行燥金之郁也；癃秘之用知母、黄柏，散相火之炽也。（滑伯仁）
肝火逆行，上乘脾位，用吴萸炒黄连以制之。黄连泻火，吴萸引肝气达下归于其位，所谓木沉则火降也。
（周慎斋）
热药多秘，惟硫黄性缓而通；冷药多泄，惟黄连浓肠止泄。（张洁古）
人有真阳虚衰，桂、附所不能补者，非硫黄不能补之。今人以为燥毒，弃而不用，不知硫黄性虽燥而疏利，
与燥涩者不同。本草称为救危妙药，道家以之服食，尊之为金液丹，固人所可常服。且硝与黄，一阴一阳，皆
同类之物。今人惟知用硝，而不敢用黄，可见今人之不逮古人矣。（吴鹤皋）
硝者，消也。朴硝乃至阴之精，而乘阳以出，其本水也，其标火也。遇湿则化为水，遇火则升为火，体最
清而用最变。故丹家重之。（徐灵胎）
阳起石得火不燃，得日而飞；硫黄得日无焰，得火而发。皆为火之精，而各不同。盖阳起石禀日之阳气
不敢轻易使用。不仅仅是伤寒这一种病症，即使是痘疹初发、疟疾和痢疾初起、中风或中痰、中寒或中暑，以及痈疽和产后初期，一概都不敢使用（人参）。而对于体质虚弱的人遇到重病时，所有能够恢复生机的机会，都被置之不理了。古代方剂中，解表发汗用参苏饮、败毒散；和解用小柴胡汤、白虎汤、竹叶石膏汤等方，都用人参，都是借助人参的力量引导体内邪气排出，不让它久留，这样才能迅速痊愈。为什么世俗之人不加考察呢？常常看到感受外邪且体质虚弱的人，高热呻吟，几天之内津液被烧干，身体像枯柴一样，起初并非没有发汗，但发汗后热不退；后来并非没有和解或攻下，但和解、攻下后热也不退。如果一开始用药时加入人参，引导药力深入驱除邪气，怎么会到发汗和攻下都不见效的地步呢？况且古今时势不同，富贵人家与贫苦人家体质各异，李东垣治疗内伤兼外感者，用补中益气汤，加入解表药以发散外邪，功效流传千古。伤寒专科，从张仲景至今，方书中常用人参，为什么现在的医生单单排除人参不用，导致治疗体虚受邪的病人，百无一活呢？那些不懂医术的人，又众口一词劝告病人不宜服用人参，亲眼目睹亲族死亡，竟然不明白是旁人的偏见害了他们。我恳切地剖白心迹相告，并发誓说：今后如果有人用“解表和中药内不宜用人参”的话误导人，死后将堕入犁耕地狱。大概不当用人参而用了导致杀人的，都是因为与人参同用的如苍术、白术、当归、干姜、桂枝、附子等药物，同行温补之误所致；而不是因为与人参同用的羌活、独活、柴胡、前胡、川芎、桔梗、白芷、黄芩、石膏、半夏等药物，同行汗法和和解法所致。在发汗和解的药中加入人参，从古至今，不曾伤害人命，怎么能把它视为砒霜鸠酒，固执不知变通呢？
天下害人的人，杀死他的身体，未必能破坏他的家庭；破坏他的家庭，未必能杀死他的身体。先破坏别人的家庭，然后再杀死他身体的，就是人参啊。人参如果使用得当，确实能补益元气，挽救危险，但不能说天下所有的死人用它都能救活。这种药，气盛力浓，不论风、寒、暑、湿、痰、火、郁结，都能补塞。如果病果真是邪气已去正气衰弱，使用它固然适宜。或者邪气微弱而正气疲惫，或者邪气深重而正气虚弱，不能将其驱逐于体外，那么在祛除邪气的药物中加入它作为驱邪的辅助，自然有扶危定倾的功效。如果不察辨是否有邪气、是虚是实，又佐以纯补温热的药物，将邪气补住，轻的病邪不再外出，重的就会死亡。医生之所以遇到疾病就用人参，而病人服用后死了也不后悔，为什么呢？大概愚笨的人的心，都认为价格贵的是良药，价格贱的是劣药；而普通人的情感，没有不喜欢补益而厌恶攻伐的，所以服用参而死，即使明知是错误的，然而认为医生的力量已经竭尽，为人子女的心意已经尽到，这是命运使然，可以没有遗憾；如果服用攻伐药而死，即使用药没有错误，病情确实难治，而医生的罪过，就已经不可胜数了。所以人参，是医生邀功避罪的圣药。病人如此，医生如此，害人就没有窍隙可寻了。更令人惊骇的是，有人把用人参当作荣耀，有人把用人参当作有力量，又因为它贵重，深信以为一定能挽回造化，所以毅然使用它。谁知道人参一用，凡是病中有邪气的立即死亡；那些没死的，也终身不得痊愈了。它破坏家庭的原因是什么呢？过去的人参不过一两二钱，多的三两四两，现在价格却是以前的十倍，而且所服的又不止一两二钱。小康之家服用二两三两，家产就已经荡然无存了。人之常情在生死关头，有什么要求得不到满足，哪里还顾得上破坏家庭呢？医生完全不动念考虑，轻易地将人参列入处方，如果不使用，在父亲是不慈爱，在儿子是不孝顺，在夫妇兄弟是忍心违背伦理。亲戚朋友责罚痛骂，即使明知没有益处，姑且以此来搪塞责任。又有孝子慈父，希望病人或许能活，竭力谋求，于是使得贫穷的家庭，病人或许稍微好转，全家终身受冻挨饿。如果仍然救不活，连棺材殓具都没有，卖妻卖子，全家覆灭。医生误治杀人尚可宽恕，而害人破家，其罪恶甚于盗贼，能不谨慎吗！我希望天下的人，绝对不可以把人参加作起死回生的药，而一定要服用。医生必须审察病人的病确实是纯虚无邪，非人参不能治疗，服用必定万全，然后才使用。又必须估量其家业还可以支持，不至于用人参之后，生死无靠，然后节省使用。一来爱惜物力，二来保全人的生命，三来保护人的家庭。这样存心，自然上天降福。如果像近日的医生，在人不知的地方杀人破家，恐怕上天降下的祸患，也在人不知的地方。（徐灵胎）
药物治病，临时变通，并不是调补就依赖于丸药。对于时行风痰壅闭的情况，理应当随时间变化用药，自制丸散，尚且不可以服用，何况蜡丸呢？蜡丸制于粤东，逐利者在四方贩卖，愚夫愚妇误服受害，不知有多少。医生执着跟随这种错误，这到底是什么用心！孔子说：不理解的不敢尝试。我曾经告诉送药的人，必须附上药方，如果没有药方的药，有见识的人肯服用吗？（《小儿诸热辨》）
凡是用药太过或不及，都不是适中。而不及还可以增加剂量，太过则病去药存，危害更猛烈，这是医生的过错。（《医门法律》）
药解
人参的用途很多。其大纲有四类：一是参芪（人参配黄芪），二是参麦（人参配麦冬），三是参附（人参配附子），四是参连（人参配黄连）。临证变通，用得恰当，它的功效无法全部述说。（《怡堂散记》）
人参的作用有三点：补气；止渴；生津。补气不必多说，为什么能生津止渴？因为脾气输送给肺，肺气下降，津液才得以产生。就像蒸东西一样，热气熏蒸，随即变成液体。所以气不足就会口渴，补其气则津液生成，口渴自然停止。（王宇泰）
参，就是参赞的意思。它是帮助元气的。不仅气虚适宜使用，血虚也适宜使用。内伤适宜使用，外感也适宜使用。大概烦渴由于火邪，得到人参而阴津自然增长；肿胀本乎气机壅滞，得到人参而痞闷全消。以至于不想吃东西，吃进去反而胀满，或者胃反噎隔，泄利亡失阴液，洒淅恶寒，多汗漏风等证候，无不依赖人参的大力，作为元气的屏障。而荒谬地说肺热伤肺，人参能造成饱胀。不知道肺虚的冤热，非人参不能救治；脾虚的中满，非人参、白术如何能健运？这就是它功效冠绝群草的原因。（赵羽皇）
人参得升麻，补上焦泻肺火；得茯苓，补下焦泻肾火；得麦冬，泻火而生脉；得黄芪、甘草，乃甘温退大热。○李东垣调理脾胃，泻阴火，交泰丸用人参、皂荚，是恶而不恶（看似相恶实则不相恶）；古方治疗月经闭止，四物汤加人参、五灵脂，是畏而不畏（看似相畏实则不相畏）。又治疗痰在胸膈，人参、藜芦同用，而取其涌吐作用，是激发它的怒性，不是深奥通达权变的人不能知道。（汪昂）
人参、黄芪、甘草，是泻火的圣药。大概烦劳则虚而生热，得到甘温的药物以补元气，而虚热自然消退。所以也称为泻。（李东垣）
人们知道人参、黄芪能止汗，却不知道它们能发汗。因为在解表药的队伍中，则助解表药而解散。李东垣治疗体虚感冒，用补中益气汤，就是同样的意思。（陶节庵）
补气药多，补血药也随之充实气；补血药多，补气药也随之补血。益气汤虽然加了当归，但因为势单力薄被人参、黄芪占据主导；补血汤中黄芪数倍于当归，也从当归的引导下而补血。（汪昂）
甘味令人胀满，有甘草生用为泻的，因为它能引诸药到达胀满之处。《内经》说：以甘补之，以甘泻之。所以张仲景治疗痞满有甘草泻心汤。另外甘草得茯苓，则不助满反而泻满。○古方用甘草都倚仗它作为君药，必须重用才有效。时医每用不过二三分就停止了，不知道始自何人？相习成风，实在可笑。（汪昂）
叶时可先生，有一天看钓鱼而悟出甘草的用处。对我说：鱼竿在手，所用的是丝线和鱼钩。投竿于水，丝浮钩沉。腰间必系一个浮子，留在水面，能使浮的不浮，沉的不沉，钓鱼者的心，视其为准则。是钓鱼不需要浮子，然而没有浮子竟不能得鱼。药中的甘草类似这个，因为它味长于甘而守中。古称甘草能和百药，药留在胃里，则从容分布，升的循经，降的入腑，不是甘草治疗的病，而药物的得力，都依赖它的停顿之功。无用之用，太伟大了！（《怡堂散记》）
有人问附子理中汤、调胃承气汤都用甘草，怎么说是调和的意思？回答说：附子理中汤用甘草，是担心它僭越上行；调胃承气汤用甘草，是担心它泻下太快。不是调和，都是缓急。小柴胡汤用甘草，则有调和之意。中焦不满而用甘为之补，中焦满而用甘为之泻。《内经》说：以甘补之，以甘泻之，以甘缓之。（王好古）
附子有斩关夺门的勇猛。引导补气药行于十二经，以追回散失的元阳；引导补血药入血分，蒸动不足的真阴；引导发散药开腠理，以驱除在表的风寒；引导温暖药达下焦，以驱逐在里的寒湿。（赵羽皇）
熟附子配麻黄，发中有补。张仲景的麻黄附子细辛汤、麻黄附子甘草汤就是这样的。生附子配干姜，补中有发。张仲景的干姜附子汤、通脉四逆汤就是这样的。（赵以德）
附子用阴药为君，就只有回阳制火的力量。还有什么辛热强阳的性质呢！所以药书上说“饵”，是诱引其火之下归。古语说：附子无干姜不热，这句话可以深思了。（《冯氏锦囊》）
用附子补火，必须防止耗竭肾水。如阴虚之人久服补阳的药，则虚阳更加炽盛，真阴更加耗损，精血日渐枯竭，气无所依附，遂成不治的多矣。（王好古）
人身有气中之阳，有血中之阳。气中之阳，走而不守；血中之阳，守而不走。凡药气味胜的，往往补气中之阳；质地胜的，往往补血中之阳。如附子暖血，肉桂暖气，是一定的道理。然而气之阳胜，则能动血；血之阳胜，则能益气。又是相互关联的道理。桂枝，是气分药，而它的验效却见于血，其中的道理不是很明显吗？（徐灵胎）
白术既燥湿，而又生津，为什么呢？大概脾恶湿，湿胜则气不得施化，津液从何而生？用白术以除湿，气得周流，津液自然产生了。○胸膈逆满，由中气不足而作胀的，宜补之，而胀自然消除。《内经》说：塞因塞用就是这样。俗医拘泥于造成饱胀的说法，而不敢用人参、白术，不知道少用反而滋腻壅滞，多用则宣通，补正是为了导引。（汪昂）
今人动不动就说白术性燥，冤枉了白术啊。大概脾喜燥而恶湿，脾旺则燥，脾虚则湿。白术补脾，湿去则脾旺而燥了。不是白术的性燥。而且今人动不动就说补阴，完全不知道真正补阴的方法，用白术正是补阴啊。脾乃太阴，补脾的太阴，难道不是补阴吗？（吴天士）
地黄产于中州，色黄味甘，得土气最浓。只是生的性凉，脾阳不足，应当慎用；熟则性平，能补五脏的真阴，尤其有益于多血的脏器，这不是脾胃药吗？还有妙处，用它兼散，则能发汗，因为汗化生于血；用它兼温，则能回阳，因为阳生于下。然而阳性速，所以人参少用，也可成功；阴性缓，熟地非多用，难以奏效。有畏惧它滞腻的，为什么肾气丸用来治痰浮？有畏惧它滑湿的，为什么八味丸用来医肾泻？又如制法用姜汁的，必是中寒兼呕吐；用砂仁的，必有胀满不行；用酒的，必有经络壅滞。如果没有这些而强制使用，是想用它的静，反而乱了它的本性，这和画蛇添足有什么区别呢？（张景岳）
当归的用处有三点：一，是心经的本药；二，和血；三，治诸药夜甚（夜间症状加重）。凡是血病必用。（张洁古）
黄芪、麻黄发汗，迅猛不能抵御。根、节止汗，效验如影响。物理不可测度如此。（汪昂）
桂枝本是营分药，得麻黄、生姜，则令营气外发而为汗，从辛也；得芍药，则收敛营气而止汗，从酸也；得甘草则补营气而养血，从甘也。（柯韵伯）
张仲景的桂枝汤，用桂枝的，大概是取桂的枝梢细薄者罢了。不像肉桂的肉厚。大概肉桂浓实，治五脏病用的，取它镇重；桂枝轻扬，治伤寒用的，取它发散。今人一律使用，所以见效的很少了。（《发微论》）
按：柴胡为少阳药，因伤寒少阳证之用柴胡汤也。邪入少阳，将有表邪渐解，里邪渐着的趋势。方中以柴胡、黄芩对峙，解表清里，确实是少阳和解之法。而柴胡实际上并未限定为少阳药。大概因为柴胡的性质，苦平微寒，味薄气升，与少阳半表之邪，适合其用罢了。于是有病在太阳，服之太早，则引贼入门；若病入阴经，复服柴胡，则重虚其表的说法。这恐怕是后人认病未清，模糊混用，所以设立这两端来晓谕他们。不观景岳新方中，诸柴胡饮、柴芩煎、柴胡白虎煎诸方，信手拈来，头头是道，这确实是知道柴胡的用处，而先得我心之所同然了。再古方有逍遥散的疏解郁热；归柴饮的和营散邪；补中益气汤的升发清阳，提邪下陷；疏肝益肾汤的疏肝清热，养阴透邪。其中奥妙难于我数说。怎么会重虚其表呢？我在风邪初感的轻证，及邪气淹留表热不解的久病，用之并臻神效。奈何将此有用的良品，拘泥成说而畏惧它？即用也是准之以分数，竟至相沿成习，不得不为此辩驳。（《吴医汇讲》）
有人说治疟疾不可用柴胡，试问：疟疾不在少阳在何经？少阳不用柴胡用什么药？不知道他将如何回答我。○我治疟疾用柴胡，每以青蒿佐之。青蒿得少阳之令最早，有芳香之气。（《散记续编》）
黄芩的退热，是寒能胜热，折火之本；柴胡的退热，是苦以发之，散火之标。（《直指方》）
地骨皮能退内潮，人所知也；能退外潮，人实不知。病或风寒，散而未尽，潮热往来，非柴胡、葛根所能治，用地骨皮走表又走里的药，消其浮游之邪，服之没有不愈的。（朱二允）
地骨皮泻肾火，牡丹皮泻包络火，总治热在外，无汗之骨蒸；知母泻肾火，治热在内，有汗之骨蒸。（李东垣）
后重之用木香、槟榔，行燥金之郁也；癃秘之用知母、黄柏，散相火之炽也。（滑伯仁）
肝火逆行，上乘脾位，用吴茱萸炒黄连以制之。黄连泻火，吴茱萸引肝气达下归于其位，所谓木沉则火降也。（周慎斋）
热药多便秘，惟硫黄性缓而通；冷药多泄泻，惟黄连浓肠止泄。（张洁古）
人有真阳虚衰，桂枝、附子所不能补的，非硫黄不能补之。今人以为燥毒，弃而不用，不知道硫黄性虽燥而疏利，与燥涩的不同。本草称为救危妙药，道家以之服食，尊之为金液丹，固然是人可以常服的。且硝石与硫黄，一阴一阳，皆同类之物。今人只知道用硝石，而不敢用硫黄，可见今人的不如古人了。（吴鹤皋）
硝者，消也。朴硝乃至阴之精，而乘阳以出，其本水也，其标火也。遇湿则化为水，遇火则升为火，体最清而用最变。所以炼丹家重视它。（徐灵胎）
Dare not use it lightly. It is not only for Taiyang disease (disease of the Taiyang channel), but also when mumps and chickenpox first appear, malaria and dysentery first onset, wind-stroke or phlegm-stroke, cold-stroke or heat-stroke, as well as in the early stages of carbuncles and postpartum conditions, one dare not use (Ginseng) at all. And for people with weak constitutions encountering serious illnesses, all chances of recovery are left unattended. In ancient prescriptions, for releasing the exterior through sweating, Shen Su Yin (Ginseng and Perilla Decoction) and Bai Du San (White Antidote Powder); for harmonizing, Xiao Chai Hu Tang (Minor Bupleurum Decoction), Bai Hu Tang (White Tiger Decoction), Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) etc., all use Ginseng. They all rely on the power of Ginseng to guide internal pathogens out, preventing them from lingering, thus achieving a rapid cure. Why do worldly people fail to examine this? I often see those who have contracted external pathogens and have weak constitutions, suffering from high fever and groaning, their body fluids burned away in a few days, their bodies like withered firewood. Initially, they were not without sweating treatment, but the fever did not recede after sweating; later, they were not without harmonizing or purging treatments, but the fever did not recede after harmonizing or purging. If Ginseng had been added to the medicine at the beginning to guide the medicinal power deep into the body to drive out pathogens, how could it reach the point where both sweating and purging were ineffective? Moreover, times and circumstances differ between ancient and modern days; the constitutions of those living in luxury differ from those living in poverty. Li Dongyuan treated internal injury complicated by external contraction using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), adding exterior-releasing herbs to disperse external pathogens, a merit that has lasted for millennia. The specialized school of Shanghan (Cold Damage) has used Ginseng in prescriptions from Zhang Zhongjing to the present day. Why do doctors today single out Ginseng and refuse to use it, resulting in nearly all patients with weak constitutions contracting illness dying? Those ignorant of medicine advise patients against taking Ginseng, yet having witnessed the death of relatives, they fail to realize that it is their biased opinions that caused harm. I earnestly pour out my heart and blood to inform you, and swear: From now on, anyone who misleads others with the words "Ginseng should not be used in exterior-harmonizing medicines" shall fall into the hell of plowing fields after death. Generally, those who kill by using Ginseng when inappropriate do so because of errors in concurrent warm-tonifying herbs such as Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Gan Jiang (Zingiberis Rhizoma), Gui Zhi (Cinnamomi Ramulus), Fu Zi (Aconiti Lateralis Radix Praeparata), etc.; it is not due to concurrent sweating and harmonizing herbs such as Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Xiong Qiong (Ligustici Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix), Bai Zhi (Angelicae Dahuricae Radix), Huang Qin (Scutellariae Radix), Shi Gao (Gypsi Fibrosus), Ban Xia (Pinelliae Rhizoma), etc. Adding Ginseng to sweating and harmonizing medicines has never harmed human life from ancient times to the present. How can it be regarded as arsenic or poison, held fast without thought?
Those who harm the world may kill the body without destroying the family; destroy the family without killing the body. But the one who destroys the family first and then kills the body is Ginseng. Although Ginseng, when used appropriately, can indeed tonify Yuan Qi (Original Qi) and rescue danger, it cannot be said that it can revive every dead person in the world. This substance has strong qi and potent force; regardless of wind, cold, summer-heat, dampness, phlegm, fire, stagnation, or knotting, it can tonify and block. If the pathology is truly pathogen elimination and righteous qi decline, using it is appropriate. Or if pathogens are slight but righteous qi is exhausted, or pathogens are deep but righteous qi is weak, unable to expel them externally, then adding it to pathogen-expelling medicines as an aid to driving out pathogens will naturally have the merit of rescuing critical situations. If one does not observe whether there are pathogens or not, whether it is deficiency or excess, and further assists with purely tonifying and warming-hot substances, the pathogens will be tonified and trapped; mild cases will not expel pathogens again, severe cases will die. Why do doctors use Ginseng upon encountering disease, and why do patients take it until death without regret? The hearts of foolish people generally consider expensive drugs to be good and cheap drugs to be inferior; and the emotions of ordinary people generally prefer tonification and dislike attack. Thus, even if they know taking Ginseng was a mistake, they think the doctor's effort has been exhausted, and the child's filial piety has been fulfilled; this is destiny, so there is no resentment. If they die after taking attacking medicines, even if the medication was correct and the disease truly difficult to treat, the doctor's sin is unpardonable. Therefore, Ginseng is the holy medicine for doctors to claim credit and avoid blame. Patients are like this, doctors are like this, and harming people leaves no loophole. What is more shocking is that some regard using Ginseng as honor, some regard it as showing strength, and because it is expensive, they deeply believe it can surely reverse fate, so they resolutely use it. Who knows that once Ginseng is used, any disease with pathogens will immediately result in death; those who do not die will never recover for life. What is the reason for destroying families? Previously, Ginseng cost one or two qian, at most three or four qian; now its price is ten times higher, and the amount taken is not just one or two qian. A moderately wealthy family taking two or three liang will have its assets completely depleted. Human nature at the moment of life and death seeks anything it desires, caring little for family destruction. Doctors do not think about this at all, easily prescribing Ginseng. Not using it makes a father unfilial, a son unfilial, and spouses/siblings cruel and unethical. Relatives and friends scold and curse; even knowing it is useless, they use it merely to shirk responsibility. Filial sons and loving fathers, hoping for survival, strive to procure it, causing poor families whose patients might slightly recover to suffer lifelong freezing and hunger. If still not saved, there is no money for coffins or burial clothes, leading to selling wives and children, and total family ruin. Doctor's mis-treatment killing people can be forgiven, but harming people and destroying families is worse than thieves and robbers; must one not be cautious! I wish all people in the world absolutely would not regard Ginseng as a drug that brings the dead back to life and must take it. Doctors must carefully examine if the disease is purely deficient without pathogens, non-Ginseng cannot treat, and taking it guarantees safety, before using it. They must also estimate if the family wealth can support it, ensuring that after using Ginseng, life and death are not left without reliance, before sparingly using it. This preserves material resources, preserves human life, and protects human families. With such intention, natural blessings from heaven will descend. If like recent doctors, killing and destroying families in places unknown to people, perhaps the disasters sent by heaven will also be in places unknown to people. (Xu Lingtai)
Medicines treating diseases require temporary adaptation; tonification and regulation do not necessarily depend on pills. For epidemic wind-phlegm obstruction, one should use medicines according to time changes; homemade pills and powders should not even be taken, let alone wax pills. Wax pills are manufactured in Guangdong, sold everywhere by profit-seekers, and countless foolish men and women suffer from mistaken use. Doctors adhering to and following this error, what is their mindset! Confucius said: "Do not taste what you do not understand." I have told those delivering medicines that they must attach a prescription; without a prescription, would knowledgeable people dare to take it? (from *Differentiation of Various Fevers in Children*)
Using medicines excessively or insufficiently is not moderate. Insufficiency can be increased, but excess means the disease is gone while the medicine remains, causing greater harm; this is the doctor's fault. (from *Medical Laws*)
**Drug Analysis**
Ginseng has many uses. Its main categories are four: one is Ginseng-Huangqi (Ginseng and Astragalus), two is Ginseng-Maidong (Ginseng and Ophiopogon), three is Ginseng-Fuzi (Ginseng and Prepared Aconite), four is Ginseng-Helian (Ginseng and Coptis). Adapting to clinical conditions and using them appropriately, its merits cannot be fully described. (from *Yitang Sanji*)
Ginseng has three functions: tonifying Qi; stopping thirst; generating fluids. Tonifying Qi needs no explanation. Why can it generate fluids and stop thirst? Because Spleen Qi transmits to the Lung, Lung Qi descends, and then body fluids are generated. It is like steaming things; heat vaporizes and immediately becomes liquid. Therefore, Qi insufficiency causes thirst; tonifying Qi generates fluids, and thirst stops naturally. (Wang Yutai)
Shen (Ginseng) means assisting. It assists Yuan Qi (Original Qi). Not only is it suitable for Qi deficiency, but also for Blood deficiency. Suitable for internal injury, and also for external contraction. Generally, vexation and thirst arise from Fire pathogens; with Ginseng, Yin fluids naturally grow. Swelling stems from Qi stagnation; with Ginseng, fullness and oppression disappear entirely. Even symptoms like loss of appetite, bloating after eating, vomiting/regurgitation, diarrhea losing Yin fluids, chills/shivering, profuse sweating, and wind leakage all rely on the great power of Ginseng to act as a barrier for Yuan Qi. Those absurdly claiming Lung Heat damages the Lung and Ginseng causes fullness do not know that Lung deficiency's unjust heat cannot be saved except by Ginseng; Spleen deficiency's central fullness cannot be transported and transformed except by Ginseng and Bai Zhu (Atractylodis Macrocephalae Rhizoma). This is why its merit tops all herbs. (Zhao Yuhuang)
Ginseng combined with Sheng Ma (Cimicifugae Rhizoma) tonifies the Upper Jiao and drains Lung Fire; combined with Fu Ling (Poria), tonifies the Lower Jiao and drains Kidney Fire; combined with Mai Dong (Ophiopogonis Radix), drains Fire and generates the Mai Pulse; combined with Huang Qi (Astragali Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma), it is sweet-warm to reduce high fever. ○ Li Dongyuan regulated the Spleen and Stomach and drained Yin Fire; Jiao Tai Wan used Ginseng and Gleditsia Sinensis Thorn, which is "dislike but not dislike"; ancient formulas for amenorrhea used Si Wu Tang (Four Substances Decoction) plus Ginseng and Trogopteri Dung, which is "fear but not fear". Also, for phlegm in the chest and diaphragm, Ginseng and Veratrum nigrum are used together to induce vomiting, stimulating its angry nature; only those who penetrate mysteries and understand flexibility can know this. (Wang Ang)
Ginseng, Huang Qi (Astragali Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma) are sacred medicines for draining Fire. Generally, fatigue leads to deficiency and generates heat; obtaining sweet-warm substances to tonify Yuan Qi causes deficiency-heat to retreat naturally. Hence it is also called "draining". (Li Dongyuan)
People know Ginseng and Huang Qi (Astragali Radix) can stop sweating, but do not know they can induce sweating. When in the company of exterior-releasing medicines, they assist exterior medicines to disperse. Li Dongyuan treated weak people with common colds using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), which follows this same idea. (Tao Jian'an)
When there are many Qi-tonifying medicines, Blood-tonifying medicines follow to solidify Qi; when there are many Blood-tonifying medicines, Qi-tonifying medicines follow to tonify Blood. Although Yi Qi Tang adds Dang Gui (Angelicae Sinensis Radix), because its force is weak, it is dominated by Ginseng and Huang Qi (Astragali Radix); in Bu Xue Tang, Huang Qi (Astragali Radix) is several times that of Dang Gui (Angelicae Sinensis Radix), and also follows Dang Gui (Angelicae Sinensis Radix) to tonify Blood. (Wang Ang)
Sweet causes fullness. There are cases where raw Gan Cao (Glycyrrhizae Radix et Rhizoma) is used for draining because it can guide various medicines to the site of fullness. The *Classic* says: "Tonify with sweet, drain with sweet." Therefore, Zhang Zhongjing treated fullness with Gan Cao Xie Xin Tang (Licorice Decoction for Draining the Epigastrium). Furthermore, Gan Cao (Glycyrrhizae Radix et Rhizoma) combined with Fu Ling (Poria) does not aid fullness but instead drains it. ○ Ancient formulas relied on Gan Cao (Glycyrrhizae Radix et Rhizoma) as the Sovereign herb, requiring heavy doses for efficacy. Contemporary physicians use only two or three fen, not knowing who started this; it has become a custom, which is quite laughable. (Wang Ang)
Mr. Ye Shike, while watching fishing one day, realized the use of Gan Cao (Glycyrrhizae Radix et Rhizoma). He said to me: The fishing rod is in hand, but what is used is the line and hook. Casting into water, the line floats and the hook sinks. A float must be tied to the waist, remaining on the water surface, making floating things not float too high and sinking things not sink too deep; the fisherman's mind regards it as the standard. Fishing does not need the float, yet without the float, one cannot catch fish. Gan Cao (Glycyrrhizae Radix et Rhizoma) in medicines is similar; because its flavor is long-lasting sweet and it guards the center. Ancient texts say Gan Cao (Glycyrrhizae Radix et Rhizoma) harmonizes hundred medicines. Medicines stay in the stomach, distributing leisurely; ascending ones follow meridians, descending ones enter fu organs. For diseases not treated by Gan Cao (Glycyrrhizae Radix et Rhizoma), the effectiveness of medicines relies on its pausing function. The utility of the useless is great! (from *Yitang Sanji*)
Someone asked: Both Fuzi Lizhong Tang (Aconite Decoction for Regulating the Middle) and Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct to the Interior Decoction) use Gan Cao (Glycyrrhizae Radix et Rhizoma); how is this the meaning of harmonizing? Answer: In Fuzi Lizhong Tang (Aconite Decoction for Regulating the Middle), Gan Cao (Glycyrrhizae Radix et Rhizoma) is used fearing rebellion upward; in Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct to the Interior Decoction), Gan Cao (Glycyrrhizae Radix et Rhizoma) is used fearing rapid purging. It is not harmonizing, but slowing down. Xiao Chai Hu Tang (Minor Bupleurum Decoction) using Gan Cao (Glycyrrhizae Radix et Rhizoma) has the meaning of harmonizing. If the middle is not full, sweet tonifies; if the middle is full, sweet drains. The *Classic* says: "Tonify with sweet, drain with sweet, slow with sweet." (Wang Haogu)
Fu Zi (Aconiti Lateralis Radix Praeparata) has the courage to break through gates and seize doors. It guides Qi-tonifying medicines through the twelve channels to pursue scattered Yuan Yang (Original Yang); guides Blood-tonifying medicines into the blood level to steam insufficient True Yin; guides dispersing medicines to open cou-li (pores) to drive wind-cold in the exterior; guides warming medicines to the Lower Jiao to chase cold-dampness in the interior. (Zhao Yuhuang)
Shu Fu Zi (Prepared Aconite) paired with Ma Huang (Ephedrae Herba): releasing with tonification. Zhang Zhongjing's Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Cimicifuga Decoction) and Ma Huang Fu Zi Gan Cao Tang (Ephedra, Aconite, and Licorice Decoction) are examples. Sheng Fu Zi (Raw Aconite) paired with Gan Jiang (Zingiberis Rhizoma): tonifying with releasing. Zhang Zhongjing's Gan Jiang Fu Zi Tang (Zingiber and Aconite Decoction) and Tong Mai Si Ni Tang (Pulse-Unblocking Four Reversals Decoction) are examples. (Zhao Yi De)
If Fu Zi (Aconiti Lateralis Radix Praeparata) uses Yin medicines as Sovereign, it only has the power to restore Yin and control Fire. What remains of its acrid-hot strong Yang nature! Thus, the term "take" (er) in medicine implies baiting its fire to return downward. Ancient saying: "Fu Zi (Aconiti Lateralis Radix Praeparata) is not hot without Gan Jiang (Zingiberis Rhizoma)"—this phrase deserves deep thought. (from *Fengshi Jinang*)
When using Fu Zi (Aconiti Lateralis Radix Praeparata) to tonify Fire, one must prevent drying up Water. If Yin-deficient people take Yang-tonifying medicines for a long time, deficient Yang becomes more blazing, True Yin is more consumed, essence and blood dry up daily, Qi has nothing to attach to, and many become incurable. (Wang Haogu)
Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Praeparata) remove steaming heat; Xiao Shi (Natrii Sulfas) and Da Huang (Rhei Radix et Rhizoma) resolve chills. (Gao Gufeng)
The human body has Yang within Qi and Yang within Blood. Yang within Qi moves without staying; Yang within Blood stays without moving. Medicines with strong aroma often tonify Yang within Qi; medicines with strong substance often tonify Yang within Blood. For example, Fu Zi (Aconiti Lateralis Radix Praeparata) warms Blood, Rou Gui (Cinnamomi Cortex) warms Qi; this is a fixed principle. However, if Yang within Qi is excessive, it can move Blood; if Yang within Blood is excessive, it can benefit Qi. This is another interconnected principle. Gui Zhi (Cinnamomi Ramulus) is a Qi-level medicine, but its verification appears in Blood; is its meaning not clear? (Xu Lingtai)
Bai Zhu (Atractylodis Macrocephalae Rhizoma) dries dampness yet generates fluids; why? The Spleen dislikes dampness; when dampness is excessive, Qi cannot transform, so how can fluids be generated? Using Bai Zhu (Atractylodis Macrocephalae Rhizoma) to remove dampness allows Qi to circulate freely, and fluids are generated naturally. ○ Reverse fullness in the chest and diaphragm, caused by insufficient Middle Qi leading to distension, should be tonified, and the distension will naturally disappear. The *Classic* says: "Use blocking for blocking" applies here. Vulgar doctors stick to the idea of causing fullness and dare not use Ren Shen (Ginseng) and Bai Zhu (Atractylodis Macrocephalae Rhizoma); they do not know that small doses cause stagnation, while large doses promote circulation. Tonifying is precisely guiding. (Wang Ang)
Modern people always say Bai Zhu (Atractylodis Macrocephalae Rhizoma) is drying; this wrongs Bai Zhu (Atractylodis Macrocephalae Rhizoma)! The Spleen likes dryness and dislikes dampness; when Spleen is prosperous, it is dry; when Spleen is deficient, it is damp. Bai Zhu (Atractylodis Macrocephalae Rhizoma) tonifies the Spleen; when dampness is removed, the Spleen becomes prosperous and dry. It is not that Bai Zhu (Atractylodis Macrocephalae Rhizoma) is drying. Moreover, modern people always talk about tonifying Yin, completely unaware of the true method of tonifying Yin. Using Bai Zhu (Atractylodis Macrocephalae Rhizoma) is precisely tonifying Yin. The Spleen is Taiyin; tonifying the Taiyin of the Spleen, is it not tonifying Yin? (Wu Tianshi)
Di Huang (Rehmanniae Radix) is produced in the Central Plains, yellow in color and sweet in taste, receiving the strongest Earth Qi. However, raw Di Huang (Rehmanniae Radix) is cool in nature; for insufficient Spleen Yang, it should be used cautiously. Cooked Di Huang (Rehmanniae Radix Preparata) is neutral in nature, able to tonify the True Yin of the five Zang organs, especially benefiting blood-rich organs; is it not a Spleen-Stomach medicine? There is a subtlety: combined with dispersing agents, it can induce sweating because sweat transforms from blood; combined with warming agents, it can restore Yang because Yang is born from below. However, Yang nature is rapid, so small doses of Ren Shen (Ginseng) can succeed; Yin nature is slow, so cooked Di Huang (Rehmanniae Radix Preparata) requires large doses to be effective. Some fear its cloying nature; why is Shen Qi Wan (Kidney Qi Pill) used to treat floating phlegm? Some fear its slippery/wet nature; why is Ba Wei Wan (Eight-Ingredient Pill) used to treat Kidney diarrhea? Furthermore, processing with Ginger Juice indicates Cold in the Middle with vomiting; processing with Sha Ren (Amomi Fructus Rotundus) indicates abdominal distension and stagnation; processing with Wine indicates meridian congestion. Without these, forcing the preparation is wanting to use its stillness but disturbing its nature, akin to drawing legs on a snake. (Zhang Jingyue)
Dang Gui (Angelicae Sinensis Radix) has three uses: one, it is the principal herb of the Heart Channel; two, harmonizes Blood; three, treats worsening of symptoms at night. All Blood diseases must use it. (Zhang Jiegou)
Huang Qi (Astragali Radix) and Ma Huang (Ephedrae Herba) induce sweating, swift and uncontrollable. Roots and nodes stop sweating, effective as an echo. Physical principles are unpredictable thus. (Wang Ang)
Gui Zhi (Cinnamomi Ramulus) is originally a Ying (Nutritive) level medicine. Combined with Ma Huang (Ephedrae Herba) and Sheng Jiang (Zingiberis Rhizoma Recens), it causes Ying Qi to emerge externally as sweat, following Acridity; combined with Shao Yao (Paeoniae Radix Alba), it收敛 (astringes) Ying Qi and stops sweating, following Sourness; combined with Gan Cao (Glycyrrhizae Radix et Rhizoma), it tonifies Ying Qi and nourishes Blood, following Sweetness. (Ke Yunbo)
Zhang Zhongjing's Gui Zhi Tang (Cinnamon Twig Decoction) uses Gui Zhi (Cinnamomi Ramulus), likely taking the thin tips of the cinnamon branch. Unlike Rou Gui (Cinnamomi Cortex) which is thick flesh. Rou Gui (Cinnamomi Cortex) is dense and solid, used for treating the five Zang organs, taking its heaviness; Gui Zhi (Cinnamomi Ramulus) is light and rising, used for treating Shanghan (Cold Damage), taking its dispersing property. Modern people use it uniformly, so few achieve success. (from *Fawei Lun*)
Note: Chai Hu (Bupleuri Radix) is a Shaoyang herb, used in Chai Hu Tang (Bupleurum Decoction) for Shaoyang syndrome of Shanghan (Cold Damage). When pathogens enter Shaoyang, there is a trend of exterior pathogens gradually resolving and interior pathogens gradually intensifying. The formula uses Chai Hu (Bupleuri Radix) and Huang Qin (Scutellariae Radix) in opposition, releasing exterior and clearing interior, truly the harmonizing method for Shaoyang. However, Chai Hu (Bupleuri Radix) is not strictly defined as a Shaoyang herb. Generally, because Chai Hu (Bupleuri Radix) is bitter, neutral, slightly cold, with thin flavor and ascending qi, it fits the half-exterior pathogens of Shaoyang. Thus, some say if used too early for Taiyang disease, it invites the thief indoors; if used for Yin channel diseases, it doubly defies the exterior. This is likely to warn later generations against unclear diagnosis and confused use, setting these two points to clarify. Looking at Jingyue's new formulas, such as various Chai Hu Yin (Bupleurum Drinks), Chai Qin Jian (Bupleurum and Scutellaria Decoction), Chai Hu Bai Hu Jian (Bupleurum and White Tiger Decoction), they come naturally and logically; this truly knows the use of Chai Hu (Bupleuri Radix) and aligns with my own thoughts. Furthermore, ancient formulas include Xiao Yao San (Free and Easy Wanderer Powder) for soothing and resolving stagnant heat; Gui Chai Yin (Angelica and Bupleurum Drink) for harmonizing Ying and dispersing pathogens; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) for raising clear Yang and lifting sunken pathogens; Shu Gan Yi Shen Tang (Soothe Liver and Benefit Kidney Decoction) for soothing Liver, clearing heat, nourishing Yin, and penetrating pathogens. Their subtleties are hard for me to enumerate. How could it double-defy the exterior? I use it with divine effect for mild initial wind-pathogen infections and chronic diseases where pathogens linger with unresolved exterior heat. Why fear this useful fine product by sticking to established theories? Even when used, limiting it by dosage has become a habit, necessitating this clarification. (from *Wu Yi Hui Jiang*)
Some say Chai Hu (Bupleuri Radix) cannot be used for malaria. Let me ask: If malaria is not in Shaoyang, which channel is it? If Shaoyang does not use Chai Hu (Bupleuri Radix), what medicine is used? I wonder how they will answer me. ○ I treat malaria using Chai Hu (Bupleuri Radix), often assisting with Qing Hao (Artemisiae Annuae Herba). Qing Hao (Artemisiae Annuae Herba) receives the command of Shaoyang earliest and has an aromatic qi. (from *Sanji Xu Bian*)
Huang Qin (Scutellariae Radix) reduces heat because cold overcomes heat, breaking the root of Fire; Chai Hu (Bupleuri Radix) reduces heat because bitterness releases it, scattering the branch of Fire. (from *Zhizhi Fang*)
Di Gu Pi (Lycii Cortex) can reduce internal tidal fever, which people know; reducing external tidal fever, people truly do not know. If the disease is wind-cold, dispersed but not fully resolved, with alternating tidal fever, Chai Hu (Bupleuri Radix) and Ge Gen (Puerariae Lobatae Radix) cannot treat it. Using Di Gu Pi (Lycii Cortex), a medicine that travels both exterior and interior, eliminates floating pathogens; taking it results in recovery without exception. (Zhu Eryun)
Di Gu Pi (Lycii Cortex) drains Kidney Fire; Mu Dan Pi (Moutan Cortex) drains Pericardium Fire; both treat bone-steaming with heat outside and no sweat; Zhi Mu (Anemarrhenae Rhizoma) drains Kidney Fire, treating bone-steaming with heat inside and sweat. (Li Dongyuan)
Ancient saying: Huang Bo (Phellodendri Cortex) without Zhi Mu (Anemarrhenae Rhizoma), and Tu Si Zi (Cuscutae Semen) without Hu Tao Ren (Juglandis Semen), is like a jellyfish without shrimp. (Wang Ang)
For tenesmus, Mu Xiang (Aucklandiae Radix) and Bing Lang (Arecae Semen) move the stagnation of Dry Metal; for strangury and constipation, Zhi Mu (Anemarrhenae Rhizoma) and Huang Bo (Phellodendri Cortex) scatter the blazing Minister Fire. (Hua Borren)
Liver Fire reversing upward, attacking the Spleen position, use Wu Zhu Yu (Evodiae Fructus) stir-fried with Huang Lian (Coptidis Rhizoma) to control it. Huang Lian (Coptidis Rhizoma) drains fire, Wu Zhu Yu (Evodiae Fructus) guides Liver Qi down to return to its position, so-called "Wood sinks then Fire descends". (Zhou Shenzhai)
Hot medicines often cause constipation, only Liu Huang (Sulfur) is gentle and unblocking; Cold medicines often cause diarrhea, only Huang Lian (Coptidis Rhizoma) thickens intestines and stops diarrhea. (Zhang Jiegou)
People with True Yang deficiency and collapse, whom Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Praeparata) cannot tonify, require Liu Huang (Sulfur) to tonify. Modern people consider it dry and toxic, discarding it; they do not know Liu Huang (Sulfur) is dry yet unblocking, different from dry/astringent substances. Materia Medica calls it a miraculous medicine for saving crises; Daoists use it for ingestion, honoring it as Golden Liquid Pill, certainly something people can take regularly. Moreover, Xiao Shi (Natrii Sulfas) and Liu Huang (Sulfur) are Yin and Yang respectively, both similar substances. Modern people only know how to use Xiao Shi (Natrii Sulfas) and dare not use Liu Huang (Sulfur), showing modern people are inferior to ancients. (Wu Hegao)
Xiao Shi (Natrii Sulfas) means eliminating. Pu Xiao Shi (Mirabilite) is the essence of extreme Yin, emerging riding Yang; its root is Water, its branch is Fire. Meeting moisture turns it to water, meeting fire raises it to fire; its body is clearest and its use most variable. Hence alchemists value it. (Xu Lingtai)
Yang Qi Shi (Salpetra) does not burn when meeting fire, flies when meeting the sun; Liu Huang (Sulfur) has no flame when meeting the sun, ignites when meeting fire. Both are essences of Fire, yet different. Generally, Yang Qi Shi (Salpetra) inherits the Yang Qi of the Sun