泻心胃热毒
微苦咸，大寒。解心胃热毒。
治伤寒，时疾热狂，阳毒发斑（热甚伤血，里实表虚，则发斑。轻如疹子，重如锦纹。
紫黑者，热极而胃烂也，多死。《活人书》∶治赤斑烦痛，有犀角大青汤），黄胆热痢，丹
毒喉痹。
处处有之。高二三尺，茎圆叶长，叶对节生，八月开小红花成簇，实大如椒，色赤。用
茎叶。
大泻气分湿热
辛热有毒，属火善走。入肺经，泻气分之湿热（肺主气，火能平金而泄肺），能达右肾
命门，走精隧，通下焦郁遏。及大肠风秘、气秘，利大小便，逐水消痰，杀虫堕胎。
治水肿喘满 癖气块。若湿、热在血分、胃弱气虚人禁用（东垣曰∶牵牛苦寒误矣，其
味辛辣，久嚼猛烈雄壮，所谓苦寒安在哉？乃泻气之药，比诸辛药泄气尤甚。若湿从下受，
下焦主血，血中之湿，宜苦寒之味。而反用辛热之药，泄上焦之气，是血病泻气，使气血俱
损也。王好古曰∶以气药引，则入气；以大黄引，则入血。时珍曰∶一妇肠结，年几六十，
服养血润燥药，则泥结，服硝黄药，则若罔知。如此三十余年。其人体肥膏梁而多郁，日吐
酸痰乃宽。此乃三焦气滞，有升无降，津液皆化为痰，不能下润肠腑，非血燥也。润剂留滞
，硝、黄入血，不能入气，故无效。用牵牛为末，皂角膏丸，才服便通。外甥素多酒色病，
二便不通，胀痛呻吟七昼夜，用通利药不效。予言此乃湿热之邪在精道，壅隧路，病在二阴
之间。故前阻小便，后阻大便，病不在大肠、膀胱也。用楝实、茴香、穿山甲诸药，倍牵牛
，三服而平。东垣补下焦阳虚天真丹，用牵牛盐水炒黑，佐沉香、杜仲、肉桂、破故纸诸药
，深得补泻兼施之妙）。
有黑、白二种，黑者（亦名黑丑）力速。取子淘去浮者，舂去皮用。得木香、干姜良（此
药汉前未入本草，故仲景方中无此。《别录》始载之，宋后始多用者）。
清泻心、胃的热毒。
味道微苦且咸，性质大寒。能解除心、胃的热毒。
治疗伤寒、时行疫病引起的热盛发狂、阳毒引发的斑疹（热邪极盛损伤血分，里实而表虚，就会发出斑疹。轻的像疹子，重的像锦缎上的花纹。颜色紫黑的，是热毒极盛导致胃烂的表现，大多死亡。《活人书》记载：治疗赤色斑疹伴烦痛，可用犀角大青汤），黄疸、热性痢疾、丹毒、喉痹。
到处都有生长。植株高二三尺，茎圆形，叶子长，叶片在节上对生，八月开小红花成簇，果实大如花椒，颜色红色。药用部位为茎和叶。
强力清泻气分的湿热。
味道辛、热，有毒，属性为火，善于走窜。入肺经，清泻气分的湿热（肺主气，火能平抑金脏并泄除肺热），能通达右肾命门，走窜精隧，疏通下焦的气机郁遏。以及大肠的风秘、气秘，通利大小便，逐水消痰，杀虫堕胎。
治疗水肿、喘满、癖积气块。如果湿热在血分，或者胃弱气虚的人禁用（李东垣说：牵牛味苦寒是错误的，它的味道辛辣，久嚼猛烈雄壮，所谓的苦寒在哪里呢？它是泻气的药，比一般的辛药泄气更厉害。如果湿气从下部受邪，下焦主血，血中的湿气，适宜用苦寒的药。反而用辛热的药，泄上焦之气，这是血病却泻气，使气血都受损。王好古说：用气药做引子，就入气分；用大黄做引子，就入血分。李时珍说：有一个妇人肠道结滞，年纪近六十，服用养血润燥的药，则更加凝滞不通，服用硝石、大黄等药，则毫无感觉。这样三十多年。她身体肥胖，饮食肥甘厚味且多郁结，每天吐酸痰才觉得宽舒。这是三焦气机阻滞，只有升没有降，津液都化为痰，不能向下滋润肠腑，不是血燥。润剂停留滞留，硝、黄入血分，不能入气分，所以无效。用牵牛研末，皂角膏做丸，刚服用就通畅了。外甥平时多酒色致病，二便不通，胀痛呻吟七昼夜，用通利药无效。我说这是湿热邪气在精道，壅塞隧道，病在二阴之间。所以前面阻碍小便，后面阻碍大便，病不在大肠、膀胱。用楝实、茴香、穿山甲等药，加倍使用牵牛，服三剂而平复。李东垣补下焦阳虚的天真丹，用盐水炒黑牵牛，佐以沉香、杜仲、肉桂、破故纸等药，深得补泻兼施的妙处）。
有黑色、白色两种，黑色的（也叫黑丑）效力迅速。取种子淘去浮起的，捣碎去皮后使用。配合木香、干姜效果良好（此药汉代以前未列入本草，所以张仲景方中没有。《名医别录》开始记载，宋代以后才开始多用）。
Clears heat-toxin from the Heart and Stomach.
Slightly bitter, salty, and extremely cold in nature. Resolves heat-toxin in the Heart and Stomach.
Treats *Shanghan* (Cold Damage), epidemic febrile diseases with manic delirium due to heat, Yang-type toxic eruptions manifesting as macules (when heat is extreme and damages blood, interior excess with exterior deficiency leads to eruptions; mild cases resemble rashes, severe cases resemble brocade patterns. Purple-black color indicates extreme heat causing gastric necrosis, often fatal. *Huoren Shu*: Treats red macules with irritability and pain using Xijiao Daqing Tang), jaundice, dysentery with heat, erysipelas, and throat obstruction.
Grows everywhere. The plant is two or three chi tall, with a round stem and long leaves arranged oppositely at nodes. It bears clusters of small red flowers in the eighth month, and fruits the size of peppercorns, which are red. The stems and leaves are used medicinally.
Powerfully drains damp-heat from the Qi level.
Pungent, hot, and toxic; its nature is Fire, making it agile and penetrating. Enters the Lung Meridian, draining damp-heat from the Qi level (the Lung governs Qi; Fire can balance Metal and drain Lung heat). It reaches the Mingmen (Gate of Vitality) of the Right Kidney, travels through the spermatic channels, and unblocks stagnation in the Lower Jiao. It treats wind-obstipation and qi-obstipation of the Large Intestine, promotes urination and defecation, expels water and resolves phlegm, kills parasites, and induces abortion.
Treats edema, wheezing and fullness, and fixed masses (*Pi*). Contraindicated if damp-heat is in the Blood level, or in patients with weak Spleen/Stomach and Qi deficiency (Li Dongyuan stated: "It is wrong to say Qian Niu is bitter and cold; its taste is pungent and spicy, fierce and vigorous upon prolonged chewing, where does the bitterness and cold lie? It is a drug that drains Qi, even more so than other pungent drugs. If dampness enters from below, the Lower Jiao governs Blood, and dampness within Blood should be treated with bitter-cold flavors. Using pungent-hot drugs instead drains Upper Jiao Qi, treating a Blood disease by draining Qi, thereby damaging both Qi and Blood." Wang Haogu stated: "With Qi-class guiding herbs, it enters the Qi level; with Dahuang (Rhubarb Rhizome) as a guide, it enters the Blood level." Li Shizhen recorded: "A woman had intestinal constipation, nearly sixty years old. Taking blood-nourishing and moistening-drying herbs caused further stagnation; taking Xiaoshi (Niter) and Dahuang (Rhubarb Rhizome) had no effect. This persisted for over thirty years. Her body was obese, her diet rich and greasy, and she suffered from much stagnation, finding relief only after vomiting sour phlegm daily. This was stagnation of Qi in the Three Jiao, with ascending but no descending movement, causing fluids to transform into phlegm, unable to moisten the intestines downward; it was not dryness of Blood. Moistening agents remained stagnant; Xiaoshi and Dahuang enter Blood but not Qi, hence ineffective. Using Qian Niu powder made into pills with Zaojiao paste (Gleditsia Sinensis Fruit Paste) resulted in immediate passage. My nephew suffered from excessive alcohol and sexual indulgence, leading to blockage of urination and defecation, with distending pain and groaning for seven days and nights. Promoting drainage medicines were ineffective. I said this was damp-heat pathogen in the spermatic channel, blocking the tunnels, located between the two yin openings. Thus, urine was blocked anteriorly, stool posteriorly; the disease was not in the Large Intestine or Bladder. Using Lianshi (Melia Seed), Huixiang (Fennel Fructus), Chanshunjia (Pangolin Scale), and doubled Qian Niu, three doses resolved it." Li Dongyuan’s Tianzhen Dan, which tonifies Yang deficiency in the Lower Jiao, uses Qian Niu stir-fried with salt water until black, assisted by Chenxiang (Agarwood Wood), Duzhong (Eucommia Bark), Rougui (Cinnamon Bark), and Pugu Zhi (Cibotii Rhizoma), deeply embodying the subtlety of combining tonification and purgation).
There are black and white varieties; the black variety (also called Hei Chou) acts rapidly. Take the seeds, wash away floating ones, pound to remove skins, and use. It works well when combined with Muxiang (Aucklandiae Radix) and Ganjiang (Zingiberis Rhizoma) (This herb was not included in Materia Medica before the Han Dynasty, thus absent in Zhang Zhongjing’s formulas. It first appeared in *Bielu*, and came into widespread use after the Song Dynasty).