白藓之根作羊毡气,毡属风,宜治在下之风矣。而其根于四五月花开之后,即虚恶无用
,是未花之前,其气上注必力,且采于二月风木司令,自于治头风极合。至味苦化燥,气寒
已热,又能于湿热大展其用,治淋沥阴肿者,根走极下之验也。治黄胆湿痹者,皮走肌肉之
验也。治四肢不安腹中大热饮水者,皮黄白入肺胃之验也。用之于湿热,不必挟风,用之于
风,不必挟湿而必挟热,否则于是物无当矣。
黄芩主少阳之经热,竹茹主少阳之腑热,龙胆则主由少阳入厥阴之热。其味苦中有涩,
苦主发,涩主收,即发即收,其用在少阳者少,在厥阴者多,故用龙胆者皆取其泻肝。凡肝
之热,有本脏挟胆而热者,有为胆所侵侮而热者。龙胆治胆侮肝之热,能内极于骨间,谓之
治肝
芍药十月生芽,正月出土,夏初开花,花大而荣,正似少阳渐入阳明,故得木气最盛。
根外黄内白,则为具木气于土中而土生其金,金主攻利,又气味苦平,故能入脾破血中之气
结,又能敛外散之表气以返于里。凡仲圣方用芍药,不越此二义,以此求之方得。
芍药别录酸微寒,隐庵辈多议其非。今取嚼之,却带微涩,涩者酸辛之变味。况同一物
而气质有浓薄,安知古之不异于今。即本经之苦平与酸微寒并体之,皆不外敛之与破。识得
芍药
邹氏于仲圣方之有芍药,处处以破阴结解之,支离殊甚。桂枝汤因卫气外泄不与营合,
故于桂甘温经驱风之中,用芍药摄卫气就营气,营气本未尝结,何待于破,此敛之义也。当
归芍药散治腹中 痛,此破之义也。桂枝加芍药汤治腹满时痛,此敛与破兼者也(满须敛,
痛
腹痛为太阴血中之气结,芍药以木疏土而破结,故为腹痛专药(谓于土中泻水者,犹属
膈膜之论)。下利乃阴气下溜,土德有惭,岂堪更从而破之,故下利断非所宜。若滞下之利,
则
仲圣黄芩汤治下利何以有芍药,盖太少合病,邪已近里,无用葛根汤之理,治之宜从里
和。黄芩清少阳之热而其气轻,加芍药以敛之,甘枣以固之,则里和而利止。且太少合病,
则病气未肯骤下,欲其里和,焉得不敛,芍药之不可少如是。
甘遂半夏汤证,曰脉伏,欲自利,利反快,虽利心下续坚满。脉伏者,有留饮在内。欲
自利利反快者,利不即利,既利则快。心下续坚满者,利后满减,过时又续,显系内有停阻
,与滞下无异。芍药能破坚积,正其所宜。且以甘遂逐在上之留饮,而又以芍药敛而降之,
则上
芍药甘草附子汤证,曰发汗病不解,反恶寒者,虚故也。虚者阳虚,汗后气已外散,故
以附子扶阳,炙甘草补中,芍药敛其外散之气,方义易见。而邹氏以芍药甘草为得桂枝汤之
半,
芍药为太阴血中之气药,不能破血中之血结,且味涩则破而不泄,故凡下瘀血之方,芍
药得
芍药若用为补剂,必配合得宜,如四物汤之类,方能获益。辛 之患消渴九年,止而复
作,苏朴授以芍药甘草等分为末煎服,七日顿愈。陈日华谓古人处方,殆不可晓。实则无不
可晓也,殆善师成无己酸以收之,甘以缓之,酸甘相合,用补阴血、敛逆气、除肺燥之意耳
。此最得用补之妙法,单用讵能即补。洁古谓入脾经补中焦,东垣谓色在西方故补,皆足贻
误后人。洄溪又但以为养肝之圣药,其亦昧之至矣。
古有减芍药以避中寒之说,寇氏然之,谓气虚禁用。此亦仲圣早有以示人者。伤寒太阴
篇云∶太阴病脉弱,其人续自便利,设当行大黄芍药者宜减之,以其人胃气弱易动故也。以
芍药与大黄并称,即可知芍药之为芍药,胃弱宜减。更可知应用而尚不可多用,何后人直以
为补
胃弱既宜慎矣,乃防己黄 汤下云,胃中不和者,加芍药三分,则何以解之?夫芍药者
,能敛外散之气以返于里者也。风湿脉浮身重汗出恶风,气之外散为何如,故其证有兼喘者
,有兼气上冲者。和胃非他,敛胃气使下降耳,岂芍药而有和胃之专长。又肺与肠胃皆一气
直下
白鲜的根具有类似羊毡的气味,羊毡属风邪范畴,因此适宜治疗位于下部的风邪。然而,它的根在四五月花开之后就会变得空虚恶劣而无用,这说明在花开放之前,其药气向上注力非常强劲,且多在二月(风木当令之时)采收,这与治疗头风病极为契合。至于它味苦能化燥,性寒能清热,又能在湿热证中发挥巨大作用,治疗淋沥不尽、阴部肿胀等症,这是根部药力直达极下部位的验证。治疗黄疸、湿痹,是皮部药力作用于肌肉的验证。治疗四肢不安、腹中大热并想喝水的症状,是皮色黄白入肺胃经的验证。使用白鲜皮治疗湿热时,不一定非要兼夹风邪;但用于治疗风邪时,则必须兼夹热邪,否则此药便不对证了。
黄芩主要清解少阳经的热邪,竹茹主要清解少阳腑的热邪,而龙胆草则主要清解由少阳传入厥阴的热邪。龙胆草的味道苦中带涩,苦味主发散,涩味主收敛,即散即收,其在少阳经的作用较小,而在厥阴经的作用较大,所以使用龙胆草的人都是取其泻肝火的功效。凡是肝脏有热,有的是本脏兼带胆热,有的是被胆热所侵侮而产生热象。龙胆草治疗因胆热侵侮肝脏而产生的热邪,药力能深入骨间,这被称为治疗肝病。
芍药在十月生芽,正月出土,夏初开花,花朵大而繁盛,正像少阳之气逐渐转入阳明,因此它所禀受的木气最旺盛。其根外部黄色内部白色,意味着它在土中具备木气,而土能生金,金主攻破利导,加上气味苦平,所以它能进入脾脏,破除血中的气结,又能收敛向外散失的表气使其返回体内。凡是张仲景方剂中使用芍药,不出这两层含义,据此去理解方义就能得到真谛。
《名医别录》记载芍药酸、微寒,隐庵等人多对此提出异议。如今取来咀嚼,却带有微涩的味道,涩是酸和辛的变化之味。况且即使是同一种药物,气质也有浓淡厚薄之分,怎知古代的药性与今天不同呢?即使将《神农本草经》记载的苦平与酸微寒两种性质结合起来看,都不外乎“收敛”与“破结”两个方面。认清了芍药的这一特性……
邹氏对于张仲景方剂中含有芍药的情况,处处都用“破除阴结”来解释,显得支离破碎。桂枝汤是因为卫气外泄不能与营气相合,所以在桂枝、甘草温经驱风的方子中,用芍药来摄纳卫气以就合营气,既然营气本身并没有郁结,哪里需要破除呢?这正是“收敛”的含义。当归芍药散治疗腹中疼痛,这是“破结”的含义。桂枝加芍药汤治疗腹满、时时腹痛,这是“收敛”与“破结”兼用的情况(腹满需用收敛,腹痛需用破结)。
腹痛属于太阴血中的气结,芍药通过疏理木气来疏通脾土从而破除气结,所以它是治疗腹痛的专药(如果说它是通过泻脾土中的水湿,那还属于隔膜的见解)。腹泻是由于阴气下溜,脾土德性亏损,哪里还能承受进一步的破泄呢?所以腹泻绝对不是芍药的适应症。如果是痢疾导致的下利,那么……
张仲景的黄芩汤治疗下利为什么含有芍药?这是因为少阳与太阴合病,邪气已经接近里部,不再适用葛根汤的道理,治疗应当从调和里气入手。黄芩清解少阳热邪而其气轻扬,加入芍药以收敛之,甘枣以固护之,这样里气调和而腹泻停止。而且既然是太少合病,病气不肯骤然下行,想要里气调和,怎么能不收敛呢?芍药在此不可或缺,就是这样重要。
甘遂半夏汤的证候描述为:脉伏,想要自利,利后反而感觉畅快,虽然有利下,但心下部位持续坚硬胀满。脉伏说明体内有留饮停滞。想要自利且利后反快,说明利下并不顺畅,一旦利下则感觉爽快。心下持续坚满,利后满减,过段时间又续发,明显显示内有停阻,与痢疾无异。芍药能破除坚积,正是其所宜。并且用甘遂驱逐在上部的留饮,同时又用芍药收敛并引导其下降,这样上……
芍药甘草附子汤的证候描述为:发汗后病不解,反而恶寒,这是虚证。虚是指阳虚,发汗后阳气已向外散失,所以用附子扶助阳气,炙甘草补益中气,芍药收敛向外散失的阳气,方义容易理解。而邹氏认为芍药甘草汤是得到了桂枝汤的一半……
芍药是太阴血中的气药,不能破除血中的血结,且味道涩,所以破而不泄,因此凡是攻下瘀血的方剂,芍药得……
芍药如果用作补剂,必须配合得当,如四物汤之类,才能获益。辛某患消渴症九年,停药后复发,苏朴传授给他将芍药、甘草等分为末煎服,七日痊愈。陈日华说古人的处方大概不可理解。其实没有什么不可理解的,大概是善于效法成无己“酸以收之,甘以缓之”的理论,酸甘相合,用意在于补阴血、敛逆气、除肺燥。这是最得用补法的妙处,单用怎么可能立即见效?洁古说芍药入脾经补中焦,东垣说因为它色白属西方所以补,这些都足以误导后人。洄溪又只把它当作养肝的圣药,这也糊涂到了极点。
古人有减少芍药用量以避免伤及中阳的说法,寇宗奭赞同此说,认为气虚者禁用。这也是张仲景早有示人的道理。《伤寒论·太阴篇》说:“太阴病脉弱,其人继续自行便利,假如应当使用大黄、芍药的,应该减量,因为此人胃气虚弱,容易动扰。”将芍药与大黄并列提及,就可以知道芍药作为芍药,胃弱者宜减量。更可以知道即使应用也不宜多用,为何后人直接把它当作补药呢?
胃弱既然已经谨慎对待了,那么在防己黄芪汤下面又说:“胃中不和者,加芍药三分”,这怎么解释呢?夫芍药,是能收敛向外散失的气使其返回体内的药物。风湿证见脉浮、身重、汗出、恶风,气之外散到了什么程度呢?所以该证有兼喘的,有兼气上冲的。所谓和胃并非其他,就是收敛胃气使其下降罢了,难道芍药有和胃的专长吗?另外肺与肠胃皆一气直下……
The root of *Dictamni Cortex* (Bai Xian Pi, White Bark) has an odor resembling sheep felt. Since felt is associated with wind pathogenic factors, it is suitable for treating wind located in the lower part of the body. However, its root becomes hollow and useless after flowering in the fourth or fifth lunar month. This indicates that before flowering, its medicinal qi ascends with great force. Furthermore, since it is harvested in the second lunar month when the Wood phase governs, it is highly compatible with treating cephalic wind (head wind). Its bitter taste transforms dryness, and its cold nature clears heat. It can also exert significant effects on damp-heat, treating conditions such as dribbling dysuria and genital swelling; this demonstrates that the root's efficacy reaches the extreme lower parts. Treating jaundice and bi-syndrome caused by dampness demonstrates that the bark acts on the muscles. Treating restlessness of the four limbs, intense internal heat in the abdomen, and thirst demonstrates that the yellowish-white bark enters the Lung and Stomach meridians. When used for damp-heat, it does not necessarily need to be combined with wind pathogens; but when used for wind pathogens, it must be combined with heat, otherwise, it would be inappropriate for this substance.
*Scutellariae Radix* (Huang Qin, Scutellaria Root) primarily clears heat from the Shaoyang meridian. *Ziziphi Fructus* (Zhuru, Bamboo Shavings - Note: Text says Zhu Ru, usually Bamboo Shavings, but context implies Shaoyang Fu heat) primarily clears heat from the Shaoyang fu organs. *Gentianae Radix* (Long Dan Cao, Gentian Root) primarily clears heat transmitted from the Shaoyang to the Jueyin. Its taste is bitter with astringency. Bitterness promotes dispersion, while astringency promotes consolidation. Thus, it disperses and consolidates simultaneously. Its application in the Shaoyang is minor, whereas its application in the Jueyin is major. Therefore, those who use *Gentianae Radix* do so to drain Liver fire. Heat in the Liver may arise from the organ itself accompanied by Gallbladder heat, or from Gallbladder heat invading and bullying the Liver. *Gentianae Radix* treats heat caused by Gallbladder bullying the Liver, penetrating deeply into the interstices of the bones, which is referred to as treating Liver disease.
*Paeoniae Radix Alba* (Shaoyao, White Peony Root) sprouts in the tenth lunar month, emerges from the soil in the first lunar month, and flowers in early summer. The large and lush flowers resemble the gradual transition from Shaoyang to Yangming, indicating that it absorbs the strongest Wood qi. The root is yellow outside and white inside, meaning it possesses Wood qi within Earth, and Earth generates Metal. Metal governs breaking and purging. Combined with its bitter and neutral taste, it can enter the Spleen to break Qi stagnation in the blood. It can also consolidate external-dispersed Wei Qi (Defensive Qi) and return it inward. In Zhang Zhongjing's formulas, the use of *Paeoniae Radix* never exceeds these two principles; understanding them allows one to grasp the formula logic correctly.
*Naming of Famous Physicians* records *Paeoniae Radix* as sour and slightly cold. Yin'an and others often dispute this. Tasting it now reveals a slight astringency. Astringency is a transformed flavor of sour and pungent. Moreover, even for the same herb, the density and thickness of its properties vary. How can we know ancient herbs were not different from modern ones? Even combining the *Shennong Bencao Jing*'s description of bitter/neutral with sour/slightly cold, both aspects ultimately relate to "consolidation" and "breaking." Recognizing these characteristics...
Zou interpreted every use of *Paeoniae Radix* in Zhang Zhongjing's formulas as "breaking Yin stagnation," which is fragmented and inconsistent. In *Guizhi Tang* (Cinnamon Twig Decoction), because Wei Qi leaks outward and fails to harmonize with Ying Qi (Nutritive Qi), *Paeoniae Radix* is used to gather Wei Qi to join Ying Qi. Since Ying Qi itself is not stagnant, there is no need to "break"; this illustrates the principle of "consolidation." *Danggui Shaoyao San* (Angelica and Peony Powder) treats abdominal pain, illustrating the principle of "breaking." *Guizhi Jia Shaoyao Tang* (Cinnamon Twig Decoction with Added Peony) treats abdominal fullness and intermittent pain, illustrating the combination of "consolidation" and "breaking" (fullness requires consolidation, pain requires breaking).
Abdominal pain is Qi stagnation in the Blood of the Taiyin. *Paeoniae Radix* soothes Wood to unblock Earth and breaks stagnation, making it a specific medicine for abdominal pain (Saying it drains water from Earth is still a superficial view). Diarrhea results from Yin Qi sinking downward and deficient Spleen virtue; it cannot withstand further breaking/draining. Thus, diarrhea is absolutely not indicated for *Paeoniae Radix*. However, if the diarrhea is due to tenesmus (dysentery-like)...
Why does Zhang Zhongjing's *Huangqin Tang* (Scutellaria Decoction) for diarrhea contain *Paeoniae Radix*? Because it is a combined disease of Shaoyang and Taiyin, with pathogens near the interior, making *Ge Gen Tang* (Kudzu Decoction) inappropriate. Treatment should focus on harmonizing the interior. *Scutellariae Radix* clears Shaoyang heat with its light quality; adding *Paeoniae Radix* consolidates it, and Gan Zao (Licorice and Jujube) secures it. Thus, the interior harmonizes and diarrhea stops. In Shaoyang-Taiyin combined disease, the pathogenic qi does not descend abruptly. To harmonize the interior, one must consolidate. Hence, *Paeoniae Radix* is indispensable.
In the syndrome of *Gansui Banxia Tang* (Mustard Seed and Pinellia Decoction), the pulse is hidden (Fu), there is a desire for spontaneous diarrhea, and relief follows diarrhea, yet the epigastrium remains persistently hard and full. A hidden pulse indicates retained fluid (Liu Yin) inside. Relief after diarrhea suggests incomplete evacuation. Persistent epigastric hardness indicates internal obstruction, similar to dysentery. *Paeoniae Radix* can break firm accumulations, making it appropriate. Using *Gansui* to expel upper retained fluid, while using *Paeoniae Radix* to consolidate and guide downward...
In the syndrome of *Shaoyao Gancao Fuzi Tang* (Peony, Licorice, and Aconite Decoction), sweating fails to resolve the disease, and aversion to cold worsens, indicating deficiency. Deficiency here refers to Yang deficiency. After sweating, Qi has dispersed outward. Thus, *Fuzi* (Aconite) supports Yang, *Zhi Gancao* (Honey-fried Licorice) tonifies the Middle, and *Paeoniae Radix* consolidates the dispersed outward Qi. The formula logic is clear. However, Zou claimed *Shaoyao Gancao Tang* represents half of *Guizhi Tang*...
*Paeoniae Radix* is the Qi medicine in Taiyin Blood. It cannot break Blood stasis in the Blood, and its astringent taste means it breaks but does not purge. Therefore, in formulas for purging blood stasis, *Paeoniae Radix*...
If *Paeoniae Radix* is used as a tonic, it must be paired appropriately, such as in *Siwu Tang* (Four Substance Decoction), to benefit. Xin suffered from Xiao Ke (Wasting-Thirst) for nine years, recurring after cessation. Su Pu prescribed equal parts of *Paeoniae Radix* and *Gancao* powdered and decocted, curing him in seven days. Chen Rihua said ancient prescriptions are inexplicable. In fact, nothing is inexplicable. It likely follows Cheng Wuji's principle: "Sour to consolidate, Sweet to relax." Sour and Sweet combined intend to tonify Yin Blood, consolidate rebellious Qi, and remove Lung dryness. This is the subtle art of tonification; single use cannot achieve immediate tonification. Jiegu said it enters the Spleen meridian to tonify the Middle; Dongyuan said it tonifies because its color is white (West). Both mislead later generations. Huixi regarded it solely as a sacred medicine for nourishing the Liver, which is extremely ignorant.
Ancient texts mention reducing *Paeoniae Radix* to avoid damaging Middle Cold. Kou Zongshi agreed, stating it is contraindicated for Qi deficiency. This was shown by Zhang Zhongjing long ago. The *Taiyin Chapter* of *Shanghan Lun* states: "In Taiyin disease, if the pulse is weak and the person continues to have spontaneous loose stools, if Da Huang (Rhubarb) and Shaoyao are indicated, they should be reduced because the person's Stomach Qi is weak and easily disturbed." Mentioning *Paeoniae Radix* alongside Da Huang shows that for weak Stomach Qi, reduction is needed. It further shows that even when indicated, it should not be overused. Why did later generations treat it directly as a tonic?
Since weak Stomach Qi requires caution, how do we explain the note in *Fangji Huangqi Tang* (Stephania and Astragalus Decoction): "For disharmony in the Stomach, add three fen of Shaoyao"? *Paeoniae Radix* consolidates externally dispersed Qi and returns it inward. In Wind-Dampness with floating pulse, heavy body, sweating, and aversion to wind, Qi dispersion is severe. Hence, complications include wheezing or Qi rushing upward. "Harmonizing the Stomach" here means consolidating Stomach Qi to direct it downward. Does *Paeoniae Radix* specialize in harmonizing the Stomach? Furthermore, the Lung and intestines/stomach share one continuous downward flow...