何首乌种分赤白,故气血兼益。藤夜交昼疏,故具阖辟之长。味浓入肾,涩入肝,苦则
坚,温则补。陈修园但知其为苦涩,而于益气血具阖辟之所以然,则未之见,其必有施之不
当而为所误者矣。
修园于首乌能止久疟久痢则韪之,而一归于少阳,则知犹未知。夫久疟不止,势必损及
于肝,肝病肾亦病。肾者三阴之枢也,欲枢转而止疟,自当补肝与肾。肝主疏泄,久痢则疏
泄太过,肾亦失蛰封之职,亦必以补肝肾为要。修园既以首乌苦涩而短之,安得更有直折之
威
刘潜江以开宝主瘰 、痈肿、头面风疮、五痔、心痛,为效在气血之结而经脉为壅。黑
髭发、悦颜色、长筋骨、益精髓,为效在气血之劣而形器有损。二者证绝相悬,而首乌并建
厥功。正与阖辟之理相合,可知开宝非浪许也。
首乌之用,生熟迥殊,其已久疟消肿毒,皆是用生者。又消肿毒用赤不用白,补肝肾则
以黑
张石顽云∶今人治津血枯燥,大肠风秘,鲜首乌数钱煎服即通。其滋水之速,与肉苁蓉
润燥
萆 用根,取其入肾。茎叶俱青,叶作三叉,则入肝。根黄白色,则入肺胃。根多节而
虚软,则能化阴伸阳而治痹。风寒湿之在腰背骨节而痛强者,阴不化也,以萆 达之而阴化
。风寒湿之为阴痿、为失溺、为老人五缓者,阳不伸也,以萆 导之而阳伸。后世以萆 为
厘清
化阴非能益阴,伸阳非能助阳。盖萆 者,所以驱风寒湿也。
萆 味苦则发,气平则降。力能外拓而性复下趋,故驱风寒湿而解之于至卑。此所以谓
萆
何首乌的品种分为赤色和白色,因此能够同时补益气血。其藤蔓夜间交合、白天舒展,所以具备收敛与发散的双重功效。味道浓厚能入肾经,涩味能入肝经,苦味能使组织坚实,温性能起到补益作用。陈修园只知道它是苦涩之品,却未能洞察它补益气血以及具备收敛发散功能的根本原理,这必然导致他在临床应用中因使用不当而犯错。
陈修园认可何首乌能治疗长期的疟疾和痢疾,但将其病机完全归结为少阳经病变,这说明他的认识仍然不够透彻。长期的疟疾不止,势必会损伤肝脏,肝病则累及肾脏。肾是三阴经的枢纽,想要通过调节枢纽来停止疟疾,自然应当补益肝肾。肝主疏泄功能,长期痢疾会导致疏泄过度,肾也会失去封藏固摄的职责,因此必须以补益肝肾为关键。陈修园既然因为何首乌的苦涩特性而贬低它,又怎能理解它直折病势的威力呢?
刘潜江认为《开宝本草》记载何首乌主治瘰疬、痈肿、头面风疮、五痔、心痛,是因为其疗效在于化解气血的郁结和经络的壅滞;记载其能黑髭发、悦颜色、长筋骨、益精髓,是因为其疗效在于改善气血的亏虚和形体的损伤。这两种证候截然不同,而何首乌都能建立卓越的功劳。这正符合“阖辟”(收敛与发散)的道理,可知《开宝本草》的评价并非随意许与。
何首乌的生用和熟用功效迥然不同,无论是治疗久疟还是消肿毒,都是使用生何首乌。另外,在消肿毒时多用赤何首乌而不白何首乌,而在补益肝肾时则以黑色何首乌为主。
张石顽说:如今人们治疗津液血液干枯、大肠风秘,取鲜何首乌数钱煎服即可通便。其滋补肾水的速度,与肉苁蓉润燥的功效相似。
萆薢使用根部,取其入肾经的特性。茎叶都是青色,叶子呈三叉状,说明入肝经。根呈黄白色,说明入肺胃经。根部多节且质地虚软,因此能化阴气、伸阳气,从而治疗痹证。风寒湿邪侵袭腰背骨节导致疼痛强直,是因为阴气不能化散,用萆薢通达它而使阴气化散。风寒湿邪导致阳痿、失禁、老人肢体缓纵无力的情况,是因为阳气不能伸展,用萆薢引导它而使阳气伸展。后世将萆薢作为厘清汤的主要成分。
化阴并不是能补益阴精,伸阳也不是能助长阳气。大概萆薢的作用,是用来驱除风寒湿邪的。
萆薢味苦能发散,气平能下降。力量能向外开拓而性质又向下趋行,因此能驱除风寒湿邪并将其解于身体下部。这就是为什么说萆薢……
The varieties of Polygonum multiflorum (He Shou Wu) are divided into red and white, thus it benefits both Qi and Blood. Its vines intertwine at night and separate during the day, endowing it with the virtues of closing (He, constriction/consolidation) and opening (Pi, dispersion/releasing). The strong flavor enters the Kidney channel; the astringent nature enters the Liver channel; bitterness solidifies tissues; warmth tonifies deficiency. Chen Xiuyuan only knew it as bitter and astringent, but failed to see the rationale behind its ability to benefit Qi and Blood and possess opening/closing functions. Consequently, he must have made errors due to improper application.
Chen Xiuyuan agreed that He Shou Wu can cure chronic malaria and chronic dysentery, but attributing them solely to Shaoyang disease indicates his understanding was still incomplete. Chronic malaria that does not cease will inevitably damage the Liver; Liver pathology affects the Kidney. The Kidney is the pivot of the Three Yin channels. To turn this pivot to stop malaria, one must naturally tonify the Liver and Kidney. The Liver governs Shuxie (free flow and discharge); chronic dysentery leads to excessive Shuxie, and the Kidney loses its function of Zhenfeng (storing and sealing). Therefore, tonifying the Liver and Kidney is essential. Since Chen Xiuyuan disparaged He Shou Wu for its bitterness and astringency, how could he appreciate its power to directly overcome pathogenic factors?
Liu Qianjiang stated that *Kaibao Bencao* records He Shou Wu treating scrofula (Luoli), carbuncles, wind sores on the head and face, five types of hemorrhoids, and heart pain, because its efficacy lies in resolving stagnation of Qi and Blood and unblocking meridians. It records blackening beard and hair, beautifying complexion, strengthening bones and sinews, and benefiting essence and marrow, because its efficacy lies in improving deficient Qi and Blood and repairing damaged physical structures. These two types of syndromes are vastly different, yet He Shou Wu achieves merit in both. This perfectly aligns with the principle of He and Pi (closing and opening), showing that *Kaibao Bencao*'s endorsements were not arbitrary.
The use of raw versus cooked He Shou Wu differs significantly. Both curing chronic malaria and reducing swelling/toxins involve using the raw herb. Furthermore, for reducing swelling/toxins, red He Shou Wu is used rather than white; for tonifying the Liver and Kidney, black He Shou Wu is preferred.
Zhang Shiweng said: Nowadays, when treating dryness of body fluids and Blood, or wind-constipation of the Large Intestine, decocting a few qian of fresh He Shou Wu promotes bowel movement quickly. Its rapid ability to nourish Water (Kidney Yin) is comparable to the moistening action of Cistanche (Rou Cong Rong).
Dioscorea hypoglauca (Bi Xie) uses the root, taking advantage of its entry into the Kidney channel. The stems and leaves are green, and the leaves are trifid, indicating entry into the Liver channel. The root is yellowish-white, indicating entry into the Lung and Stomach channels. The root has many nodes and is spongy/soft, enabling it to transform Yin and extend Yang, thereby treating Bi syndrome (painful obstruction). When Wind-Cold-Dampness invades the lower back, back, bones, and joints causing pain and stiffness, it is because Yin cannot be transformed; using Bi Xie to reach these areas transforms the Yin. When Wind-Cold-Dampness causes impotence, urinary incontinence, or the "five slacknesses" in the elderly, it is because Yang cannot be extended; using Bi Xie to guide these areas extends the Yang. Later generations used Bi Xie as a key ingredient in Liqing Decoction.
Transforming Yin does not mean tonifying Yin essence; extending Yang does not mean assisting Yang qi. Essentially, Bi Xie serves to expel Wind-Cold-Dampness.
Bi Xie is bitter, which induces dispersal; its qi is neutral, which induces descent. Its force can expand outward, and its nature tends downward, thus expelling Wind-Cold-Dampness and resolving it in the lowest parts of the body. This is why Bi Xie is described as...