气味辛平，有毒。主治疟及咳逆寒热，腹中坚症痞结，积聚邪气，蛊毒鬼疰。
（常山之茎，名蜀漆，其功用亦与常山相等。）
蜀漆能通金水之气，以救火逆，又能启太阳之阳，以接助其亡阳，亦从阴出阳之药也。
故《
伤寒·太阳篇》云∶伤寒脉浮，医以火迫劫之，亡阳必惊狂，起卧不安者，桂枝去芍药加蜀
漆牡蛎龙骨救逆汤主之。又，《金匮论》云∶疟多寒者，名曰牝疟。蜀漆散主之。李时珍曰
∶常山、蜀漆有劫痰截疟之功，须在发散表邪，及提出阳分之后，用之得宜，神效立见。用
失其法，真气必伤。
愚谓∶疟乃伏邪，有留于脏腑募原之间，而为三阴疟者；有藏于肾脏，而为先热后寒之
温疟
者；有气藏于心，而为但热不寒之瘅疟者。常山主通少阴太阳之气，从阴出阳，自内而外
，则邪随气出，所谓有故无殒。若邪已提出阳分。而反用攻利之剂，岂不妄伤正气乎。李蕲
阳数十年苦心始成《纲目》，而其间发明议论，有与经旨不合者，长于纂集，而少于参究故
也。
气味辛寒，无毒。主治症瘕积聚，结气，饮食寒热，破坚逐邪，通利水道。
（葶苈子始出 城平泽田野间，汴东、陕西、河北州郡亦有之，近以彭城、曹州者为胜。
春
初生苗，叶高六七寸，似荠，故《别录》名狗荠。根白色，枝茎俱青，三月开花微黄，结角
于扁小，如黍粒微长，黄色，《月令》∶孟夏之月靡草死。许慎、郑元注皆云∶靡草、狗荠
、葶苈之属是也。）
葶苈花实黄色，根白味辛，盖禀土金之气化。禀金气，故主治症瘕积聚之结气。禀土气，
故主治饮食不调之寒热。破坚逐邪，金气盛也。通利水道，土气盛也。
（李杲曰∶《本草十剂》云∶泄可去闭，葶苈、大黄之属二味，皆大苦寒，一泄血闭，
一
味俱浓，不减大黄，又性过于诸药，以泄阳分肺中之闭，亦能泄大便，为体轻象阳故也。《别
录》云∶久服令人虚。朱丹
溪谓∶葶苈属火性急，善遂水，病患稍涉，虚者宜远之，且杀人，甚健何必久服而后虚也。
李时珍曰∶葶苈子有甜苦二
种，正如牵牛黑白二色，急缓不同。又如葫芦甘苦二味，良毒亦异，大抵甜者下泄之性缓，
虽泄肺而不伤胃，苦者下泄
之性急，既泄肺而兼伤胃，故古方多以大枣辅之。若肺中水气 满急者，非
去则止，不可过剂，既不久
服，何至杀人。淮南子云∶大戟去水，葶苈愈胀，用之不节，及反成病，亦在用之有节与不
耳。）
蜀漆的气味辛平，有毒。主治疟疾以及咳嗽气逆、寒热往来，腹中坚硬的积块和痞结，积聚的邪气，蛊毒和鬼疰（一种传染性极强的疾病）。
（常山的茎称为蜀漆，其功效也与常山相当。）
蜀漆能够疏通肺（金）与肾（水）之间的气机，以救治因火法误治导致的气逆，又能激发太阳经的阳气，以接续即将耗竭的阳气，这也是一种从阴分转出阳分的药物。
所以《伤寒论·太阳篇》中说：伤寒脉象浮，医生用火法强迫发汗劫夺津液，导致亡阳，必然出现惊悸狂乱，坐卧不安的症状，应当用桂枝去芍药加蜀漆牡蛎龙骨救逆汤来主治。另外，《金匮要略》中说：疟疾表现为怕冷较多的，名叫牝疟（阴疟），用蜀漆散主治。李时珍说：常山、蜀漆有截断痰饮、制止疟疾发作的功效，必须在发散表邪，并将病邪提出到阳分之后，使用得当，才能神效立现。如果使用方法不当，必然会损伤真气。
我认为：疟疾是潜伏的邪气，有的停留在脏腑募原之间，成为三阴疟；有的藏于肾脏，成为先发热后发冷的温疟；有的气机郁结在心，成为只发热不发冷的瘅疟（但热不寒之疟）。常山主要疏通少阴与太阳经的气机，从阴分出至阳分，使邪气随着气机排出体外，这就是所谓“有病则病受之，不会伤害正气”。如果邪气已经被提出到阳分，反而使用攻下利水的药剂，难道不是妄自损伤正气吗？李时珍花费数十年苦心才完成《本草纲目》，但其中阐发的议论，有些与经典旨意不合，这是因为他在编纂汇集方面擅长，而在深入参悟探究方面不足的缘故。
葶苈子的气味辛寒，无毒。主治症瘕（腹内结块）、积聚，气机郁结，饮食引起的寒热不适，破除坚硬、驱逐邪气，通利水道。
（葶苈子最初生长在京城附近的平原田野间，汴东、陕西、河北各州郡也有生长，近来以彭城、曹州出产的质量最好。春天初生苗，叶子高六七寸，形状像荠菜，所以《名医别录》叫它狗荠。根是白色的，枝茎都是青色的，三月开花呈微黄色，结出的角扁平细小，像黍粒一样稍长，颜色也是黄色的。《礼记·月令》说：孟夏之月靡草枯死。许慎、郑玄注解说：靡草、狗荠、葶苈这类植物就是所谓的靡草。）
葶苈子的花和果实是黄色的，根是白色的，味道辛，这大概是禀受了土和金的气化特性。禀受金气，所以主治症瘕积聚引起的气机郁结。禀受土气，所以主治饮食不调引起的寒热。破除坚硬、驱逐邪气，是因为金气旺盛。通利水道，是因为土气旺盛。
（李杲说：《本草十剂》说：泄法可以去除闭塞，葶苈、大黄这两味药，都是大苦大寒之品，一味能泄血闭，另一味气味浓烈，不亚于大黄，而且药性比其它药物都猛烈，用来泄除阳分肺中的闭塞，也能通便，这是因为它质地轻而象征阳性的缘故。《名医别录》说：长期服用会让人体虚弱。朱丹溪认为：葶苈属于火性且性质急迫，善于逐水，病患稍微涉及，体质虚弱的人应该远离它，况且它能杀人，身体强健的人何必长期服用才会虚弱呢？李时珍说：葶苈子有甜、苦两种，正如牵牛子有黑、白两种颜色，急缓不同。又如同葫芦有甘、苦两种味道，良毒也不同。大致上甜的葶苈子下泄的性质缓和，虽然泄肺但不伤胃；苦的葶苈子下泄的性质急迫，既泄肺又兼伤胃，所以古方多用大枣来辅助它。如果肺中水气充满急迫者，不去除就会停止治疗，不可过量，既然不长期服用，怎么会杀人呢？《淮南子》说：大戟去除水肿，葶苈治愈胀满，如果使用没有节制，反而会成病，这也是在于使用是否有节制的区别罢了。）
The flavor is pungent and neutral, and it is toxic. It treats malaria, as well as cough with reverse flow of Qi, alternating chills and fever, hard masses and epigastric fullness in the abdomen, accumulated pathogenic factors, gu poison (a type of highly contagious disease), and gui zhu (a term for certain infectious diseases).
(The stem of Changshan (Dichroa Radix) is called Shuqi, and its efficacy is also equivalent to that of Changshan.)
Shuqi can unblock the Qi mechanism between Metal (Lung) and Water (Kidney), thereby rescuing from Qi reversal caused by fire therapy errors. It can also stimulate the Yang of the Taiyang (Greater Yang) channel to assist in recovering from depleted Yang; thus, it is a herb that transitions from Yin to Yang.
Therefore, *Shanghan Lun* (Treatise on Cold Damage Disorders), Taiyang Chapter, states: "In cold damage, if the pulse is floating, and the physician uses fire methods to force sweating and deplete fluids, leading to depletion of Yang, there will inevitably be palpitations, mania, restlessness, and inability to lie still or sit comfortably. This should be treated with Guizhi Qu Shaoyao Jia Shuqi Muli Longgu Jiuni Decoction." Additionally, *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: "When malaria presents with predominant chills, it is named Pinmalaria (Yin Malaria). It should be treated with Shuqi San." Li Shizhen said: "Changshan and Shuqi have the merit of resolving phlegm and arresting malaria attacks. They must be used appropriately only after releasing exterior pathogens and drawing the pathogen out to the Yang level. When used correctly, miraculous effects are seen immediately. If used improperly, the True Qi will inevitably be damaged."
I believe: Malaria is a latent pathogen. Some remain between the Zang-Fu organs and the Mu-Yuan (sea of origin), becoming Sanyin Malaria; some hide in the Kidney, becoming Wenmalaria (Warm Malaria) characterized by fever preceding chills; some stagnate in the Heart, becoming Danmalaria (Malaria with Heat Only) characterized by fever without chills. Changshan primarily unblocks the Qi mechanism of Shaoyin and Taiyang, transitioning from Yin to Yang, allowing pathogens to exit along with the Qi. This is what is meant by "when there is a pathology, the pathology receives the treatment, and there is no injury [to healthy tissue]." If the pathogen has already been drawn out to the Yang level, but one instead uses purgative or draining agents, would this not be an unwarranted injury to the Righteous Qi? Li Shizhen spent decades of painstaking effort to complete *Bencao Gangmu* (Compendium of Materia Medica), yet some of his interpretations and discussions do not align with the principles of the classics. This is because he excelled in compilation and collection but lacked sufficient deep contemplation and investigation.
The flavor is pungent and cold, and it is non-toxic. It treats zhizheng (masses and accumulations), qi stagnation, cold-heat disorders arising from diet, breaking hardness, expelling pathogens, and promoting the free flow of water passages.
(Shili Zi (Descurainiae Semen seu Lepidii Semen) originally grew in the plains and fields near the capital. It was also found in regions east of Bian, Shaanxi, and Hebei prefectures. Recently, those from Pengcheng and Caozhou are considered superior. In early spring, seedlings emerge, growing six or seven cun high, with leaves resembling those of Shepherd's Purse (Shepherdia canadensis/Brassica rapa var. parachinensis), hence *Bie Lu* (Newly Added Materia Medica) calls it Gouqi (Dog Mustard). The root is white, branches and stems are green. Flowers bloom in March, pale yellow. Pods form, flat and small, slightly longer than millet seeds, also yellow. *Yueling* (Monthly Ordinances) states: "In the first month of early summer, mi grass dies." Xu Shen and Zheng Xuan's annotations both state: Mi grass, Gouqi, and Shili belong to this category.)
The flowers and fruits of Shili Zi are yellow, and the root is white with a pungent taste. This indicates it inherits the Qi transformation of Earth and Metal. Inheriting Metal Qi, it treats qi stagnation caused by zhizheng and accumulations. Inheriting Earth Qi, it treats cold-heat conditions due to dietary irregularities. Breaking hardness and expelling pathogens is due to abundant Metal Qi. Promoting the free flow of water passages is due to abundant Earth Qi.
(Li Gao stated: *Bencao Shi Ji* (Ten Categories of Materia Medica) says: "Draining methods can remove obstruction. Shili Zi and Dahuang (Rhubarb Root) are two herbs that are greatly bitter and cold. One drains blood obstruction, the other has a strong flavor, comparable to Dahuang, and its nature is more intense than other herbs. It drains obstructions in the Lung within the Yang level and can also promote bowel movements, because its texture is light and corresponds to Yang." *Bie Lu* states: "Long-term use causes deficiency." Zhu Danxi argued: "Shili Zi belongs to Fire in nature and is urgent in action; it effectively eliminates water retention. Patients who are deficient should avoid it. Moreover, it can cause death. Why must one take it for a long time to become deficient?" Li Shizhen said: "Shili Zi comes in sweet and bitter varieties, just as Qian Niu Zi (Pharbitis Seed) comes in black and white varieties, differing in urgency and slowness. Similarly, like gourds having sweet and bitter tastes, their safety and toxicity differ. Generally, sweet Shili Zi has a mild draining nature; although it drains the Lung, it does not injure the Stomach. Bitter Shili Zi has an urgent draining nature; it drains the Lung and simultaneously injures the Stomach. Therefore, ancient formulas often use Da Zao (Jujube Fruit) to assist it. If there is excess water-Qi in the Lung causing fullness and urgency, it must be removed to stop the condition. One should not overdose, nor take it for a long time. How could it cause death under these circumstances?" *Huainanzi* states: "Daji (Euphorbia Root) removes edema; Shili Zi cures distension. If used without moderation, it will cause illness. This depends entirely on whether usage is moderated or not.")