补肝肾，涩精气
辛温酸涩。补肾温肝（入二经气分）。固精秘气，强阴助阳，安五脏，通九窍（《圣济》
云∶如何涩剂以通九窍？《经疏》云∶精气充则九窍通利。昂按∶山茱萸通九窍，古今疑之
，得《经疏》一言，而意旨豁然。始叹前人识见深远，不易测识，多有如此类者，即《经疏
》一语而扩充之，实可发医人之慧悟也），暖腰膝，缩小便。
治风寒湿痹（温肝故能逐风），鼻塞目黄（肝虚邪客，则目黄），耳鸣耳聋（肾虚则耳鸣
耳聋，皆固精通窍之功。王好古曰∶滑则气脱，涩剂所以收之，仲景八味丸用之为君，其性
味可知矣。昂按∶《别录》、甄权皆云能发汗，恐属误文。酸剂敛涩，何以反发？仲景亦安取
发汗之药为君乎？李士材曰∶酸属东方，而功多在北方者，乙癸同源也。肝为乙木，肾为癸
水），去核（核能滑精）用。恶桔梗、防风、防己。
补而润，敛汗，宁心
甘酸而润（凡仁皆润）。专补肝胆。炒熟酸温而香，亦能醒脾（故归脾汤用之）。助阴气，
坚筋骨，除烦止渴（敛阴生津），敛汗（《经疏》曰∶凡服固表药，而汗不止者，用枣仁炒研
，同生地、白芍、五味，麦冬、竹叶、龙眼肉煎服多效。汗为心液故也）宁心（心君易动，
皆由胆怯所致。经曰∶凡十一官皆取决于胆也）。
疗胆虚不眠（温胆汤中或用之。肝虚则胆也虚，肝不藏魂，故不寐。血不归脾，卧亦不
安。《金匮》治虚劳烦不眠，用酸枣仁汤。枣仁二升，甘草一两炙，知母、茯苓、芎 各二
两，深师加生姜二两，此补肝之剂。经曰∶卧则血归于肝。苏颂曰∶一方加桂一两，二方枣
仁并生用，治不得眠，岂得以煮过便为熟乎？），酸痹久泻（酸收涩，香舒脾）。
生用酸平，疗胆热好眠（时珍曰∶今人专以为心家药，殊昧此理。昂按∶胆热必有心烦
口苦之证，何以反能好眠乎？温胆汤治不眠，用二陈加竹茹、枳实，二味皆凉药，乃以凉肺
、胃之热，非以温胆经之寒也。其以温胆名汤者，以胆欲不寒不燥，当温为候耳。胆热好眠
四字，不能无疑也）。
炒，研用。恶防己。
补益肝肾，固涩精气。
（山茱萸）味辛、温，性酸涩。能补肾并温养肝脏（作用于肝、肾两经的气分）。具有固摄精微、秘藏气机、强壮阴精、辅助阳气、安定五脏、通畅九窍的功效（《圣济总录》问道：为何收敛固涩的药物能够通畅九窍？《医宗金鉴·经疏》回答：精气充盈则九窍自然通利。汪昂按语：对于山茱萸能通九窍的说法，古今之人多有怀疑，直到读到《经疏》的这句话，才豁然开朗其意旨。这才感叹前人的见识深远，难以轻易测度，类似的情况还有很多。仅凭《经疏》这一句话加以扩充阐释，确实足以启发医者的智慧与领悟），温暖腰膝，缩小便。
治疗风寒湿痹（因温养肝脏故能驱逐风邪），鼻塞、目黄（肝虚而邪气客居，则导致目黄），耳鸣耳聋（肾虚则导致耳鸣耳聋，这都是固精和通窍的功效。王好古说：滑泄则气机脱失，涩剂的作用在于收敛它。张仲景在八味丸中将其作为君药，其性味可知了。汪昂按语：《名医别录》和甄权都记载它能发汗，恐怕是传抄错误的文字。酸味药物具有收敛固涩的特性，怎么会反而发汗呢？张仲景又怎会选用发汗的药物作为君药呢？李士材说：酸味属东方木，但其功效多在北方水，这是因为乙癸同源。肝为乙木，肾为癸水），使用时需去除果核（果核会导致滑精）。忌与桔梗、防风、防己同用。
（酸枣仁）性质补益且滋润，能收敛止汗，宁心安神。
（酸枣仁）味甘、酸，质地滋润（凡是种子仁类皆具润性）。专门补益肝胆。炒熟后呈酸温之性且香气浓郁，也能醒脾（因此归脾汤中使用它）。辅助阴气，坚固筋骨，消除烦热、止渴（通过收敛阴液以生津液），收敛止汗（《经疏》说：凡是服用固表药物后，汗仍不止者，将酸枣仁炒研，同生地、白芍、五味子、麦冬、竹叶、龙眼肉煎服，多有效验。因为汗为心之液，故也），宁心安神（心主神明易受扰动，皆由胆怯所致。经文说：凡十一脏腑的功能发挥，皆取决于胆）。
治疗胆虚导致的失眠（温胆汤中有时使用它。肝虚则胆亦虚，肝不藏魂，所以失眠。血液不能回归于脾，卧睡也不安宁。《金匮要略》治疗虚劳烦闷不得眠，使用酸枣仁汤。方中酸枣仁二升，炙甘草一两，知母、茯苓、川芎各二两，《深师方》加生姜二两，这是补肝的方剂。经文说：卧则血归于肝。苏颂说：一方加桂枝一两，另一方酸枣仁生用，治疗不得眠，怎么能认为煮过就算熟了呢？），治疗酸痹及久泻（酸味收敛涩滞，香气舒展脾气）。
生用时味酸平，治疗胆热导致的嗜睡（李时珍说：现在的人专门把它当作治心的药物，很不明白这个道理。汪昂按语：胆热必然伴有心烦口苦的症状，怎么反而会嗜睡呢？温胆汤治疗不眠，使用二陈汤加竹茹、枳实，这两味都是凉药，是用来清肺、胃的热，而不是用来温胆经的寒。之所以叫温胆汤，是因为胆气应当不寒不燥，以“温”为适宜状态罢了。“胆热好眠”这四个字，实在令人怀疑）。
使用时需炒制、研碎。忌与防己同用。
Tonifies the Liver and Kidney, astringes Essence and Qi.
Acrid, warm, sour, and astringent. Tonifies the Kidney and warms the Liver (acting on the Qi level of these two meridians). Secures Jing (Essence) and consolidates Qi, strengthens Yin and assists Yang, calms the Five Zang organs, and unblocks the Nine Orifices (The *Shengji Zonglu* asks: How can astringent agents unblock the Nine Orifices? The *Jingshu* replies: When Jing and Qi are abundant, the Nine Orifices become smooth and patent. Wang Ang notes: The claim that Cornus officinalis (Shanzhuyu) unblocks the Nine Orifices has been doubted since ancient times until reading this statement from the *Jingshu*, which clarifies its meaning. One sighs at the profound insight of predecessors, which is not easily fathomed; there are many such cases. Expanding upon this single phrase from the *Jingshu* truly awakens the wisdom of physicians), warms the waist and knees, reduces urination frequency.
Treats Bi syndrome caused by Wind-Cold-Dampness (by warming the Liver, it expels Wind), nasal congestion and yellowing of the eyes (Liver deficiency with pathogenic invasion leads to yellowing of the eyes), tinnitus and deafness (Kidney deficiency leads to tinnitus and deafness, both being effects of securing Essence and unblocking orifices. Wang Haogu states: Slippage implies Qi depletion, so astringents are used to gather it. Zhang Zhongjing uses it as the Sovereign herb in Ba Wei Wan [Eight-Ingredient Pill], revealing its nature and flavor. Wang Ang notes: *Bielu* and Zhen Quan both record it induces sweating, which is likely a textual error. Sour herbs are收敛 (astringent/consolidating); how could they induce sweating? Why would Zhang Zhongjing use a diaphoretic as the Sovereign herb? Li Shicai says: Sour belongs to the East Wood, but its efficacy often lies in the North Water, because Yi and Gui share the same source. The Liver is Yi Wood, the Kidney is Gui Water). Use after removing the pit (the pit causes seminal emission). Avoid using with Platycodon root (Jiegeng), Saposhnikovia root (Fangfeng), and Stephania root (Fangji).
Nourishing and moistening, arrests sweating, calms the Heart.
Sweet, sour, and moist (all seeds/nuts are moistening). Specifically tonifies the Liver and Gallbladder. When stir-fried, it becomes sour-warm and fragrant, also awakening the Spleen (therefore used in Guipi Tang). Assists Yin Qi, strengthens sinews and bones, eliminates vexation and stops thirst (by astringing Yin to generate fluids), arrests sweating (*Jingshu* states: For those taking exterior-consolidating medicines whose sweating does not cease, stir-fried and ground Suanzaoren, decocted with Rehmannia root (Shengdi), White Peony root (Baishao), Schisandra fruit (Wuweizi), Ophiopogon tuber (Maidong), Bamboo leaf (Zhuye), and Longan aril (Longyanrou) is often effective. Since sweat is the fluid of the Heart, this applies), calms the Heart (The Heart Mind is prone to agitation, all due to Gallbladder timidity. The Classics state: All eleven organs depend on the Gallbladder for decision-making).
Treats insomnia due to Gallbladder deficiency (sometimes used in Wendan Tang. Liver deficiency leads to Gallbladder deficiency; if the Liver does not store Hun (Ethereal Soul), one cannot sleep. If blood does not return to the Spleen, restlessness occurs during sleep. *Jinkui Yaolue* treats deficiency exhaustion with vexation and insomnia using Suanzaoren Tang. Formula: 2 sheng of Suanzaoren, 1 liang of roasted Licorice root (Gancao), 2 liang each of Anemarrhena rhizome (Zhimu), Poria sclerotium (Fuling), and Ligusticum rhizome (Chuanxiong). *Shenshi Fang* adds 2 liang of Fresh Ginger. This is a Liver-tonifying formula. The Classics state: When lying down, blood returns to the Liver. Su Song says: One formula adds 1 liang of Cinnamon twig (Guizhi); another uses raw Suanzaoren to treat insomnia. How can one assume that boiled means cooked/processed?). Treats acid-Bi syndrome and chronic diarrhea (Sourness gathers and astringes; fragrance soothes the Spleen).
Raw form is sour and neutral, treats lethargy/sleepiness due to Gallbladder Heat (Li Shizhen says: People today exclusively treat it as a Heart herb, missing this principle. Wang Ang notes: Gallbladder Heat must present with vexation and bitter taste in the mouth; how could it cause excessive sleepiness? Wendan Tang treats insomnia using Er Chen Tang plus Zhu Ru and Zhi Shi, both cooling herbs, to clear Lung and Stomach heat, not to warm Cold in the Gallbladder meridian. It is named Wendan Tang because the Gallbladder should be neither cold nor dry, with "warmth" being the ideal state. The phrase "Gallbladder Heat causing sleepiness" is highly questionable).
Use after stir-frying and grinding. Avoid using with Stephania root (Fangji).