肉苁蓉，味甘温而咸、酸，无毒。入肾。最善兴阳，止崩漏。久用令男女有子，暖腰膝。
但
专补肾中之水火，余无他用。若多用之，能滑大肠。古人所以治虚人大便结者，用苁蓉一两
，水洗出盐味，另用净水煮服，即下大便，正取其补虚而滑肠也。然虽补肾，而不可专用，
佐人参、白术、熟地、山茱萸诸补阴阳之药，实有利益。使人阳道修伟，与驴鞭同用更奇，
但不可用琐阳。盖琐阳非苁蓉可比，苁蓉，乃马精所化，故功性能神；琐阳，非马精所化之
物，虽能补阴兴阳，而功效甚薄，故神农薄而不取。近人舍苁蓉，而用琐阳，余所以分辨之
也。至于草苁蓉，尤不可用。凡用肉苁蓉，必须拣其肥大而有鳞甲者，始可用。否则，皆草
苁蓉而假充之者，买时必宜详察。
或问肉苁蓉既大补，又性温无毒，多用之正足补肾，何以反动大便？不知肉苁蓉肉，乃
马精
所化之物，马性最淫，故能兴阳。马精原系肾中所出，故又益阴。然而马性又最动，故骤用
之多，易动大便，非其味滑也。（〔批〕近情切理之言。）
或问肉苁蓉之动大便，恐是攻剂，而非补药也？夫苁蓉，乃有形之精所生，实补而非泻。
试
观老人不能大便者，用之以通大便。夫老人之闭结，乃精血之不足，非邪火之有余也，不可
以悟其是补而非攻乎。
或疑肉苁蓉性滑而动大便，凡大肠滑者，可用乎，抑不可用乎？夫大肠滑者，多由于肾
中之
无火，肉苁蓉兴阳，是补火之物也，补火而独不能坚大肠乎。故骤用之而滑者，久用之而自
涩矣。
或疑肉苁蓉，未必是马精所生，此物出之边塞沙土中，岁岁如草之生，安得如许之马精
耶？
曰∶肉苁蓉，是马精所生，非马精所生，吾何由定。但此说，实出于神农之《本草》，非后
人之私臆也，肉苁蓉不得马精之气，而生于苦寒边塞之外，又何能兴阳而补水火哉。
或问王好古曾云∶“服苁蓉以治肾，必妨于心”，何子未识也？曰∶此好古不知苁蓉，而妄
诫之也。凡补肾之药，必上通于心，心得肾之精，而后无焦枯之患。苁蓉大补肾之精，即补
心之气也，又何妨之有。（〔批〕实是。）
肉苁蓉，味道甘温且带咸、酸味，没有毒性。归入肾经。最擅长振奋阳气，治疗崩漏（非经期大量出血或淋漓不尽）。长期服用能使男女获得子嗣，温暖腰部和膝盖。
但是，它专门补益肾中的阴精与阳气，没有其他用途。如果大量使用，会导致大肠滑利。古人治疗虚人便秘时，使用一两肉苁蓉，用水洗去盐分味道，另用净水煮服，就能排出大便，正是利用它补虚而润滑肠道的特性。然而虽然补肾，却不可单独专用，需配合人参、白术、熟地黄、山茱萸等补益阴阳的药物，确实有益处。使人阳道强健雄伟，若与驴鞭同用效果更神奇，但不可使用锁阳。因为锁阳无法与肉苁蓉相比，肉苁蓉是由马精所化，所以功效神奇；锁阳不是由马精所化的东西，虽然也能补阴兴阳，但功效很薄弱，所以《神农本草经》轻视而不收录。近代人舍弃肉苁蓉而使用锁阳，所以我对此进行辨析。至于草苁蓉，更加不能使用。凡是使用肉苁蓉，必须挑选肥大且有鳞甲的，才可以药用。否则，都是草苁蓉假冒充数的，购买时务必仔细考察。
有人问：肉苁蓉既然大补，又性温无毒，多服用正好补肾，为什么反而导致大便滑泄？不知道肉苁蓉的肉，是马精所化的物质，马的性质最淫欲旺盛，所以能振奋阳气。马精原本是从肾脏中产生的，所以又能益阴。然而马的性质又最躁动，所以突然大量使用，容易扰动大便，并不是因为它的味道滑利。（〔批注〕这是合乎情理、切中事理的话。）
有人问：肉苁蓉导致大便滑泄，恐怕是攻下剂，而不是补药吧？夫肉苁蓉，是有形的精气所生，确实是补益而非泻下。试看老年人不能排便的，用它来通大便。老年人的便秘闭塞，是由于精血不足，并非邪火有余，难道不能由此明白它是补益而非攻伐吗？
有人怀疑肉苁蓉性质滑利而动大便，凡是肠道滑泄的人，可以使用吗，还是不可以使用？那些肠道滑泄的人，大多由于肾中没有阳气（命门火衰），肉苁蓉能振奋阳气，是补火的东西，补火难道还不能使大肠固涩吗？所以突然使用它会导致滑泄，长期服用自然就会变得固涩了。
有人怀疑肉苁蓉未必是马精所生，这种物产出于边塞沙土中，每年像草一样生长，哪里会有那么多马精呢？
回答说：肉苁蓉是马精所生，如果不是马精所生，我怎么能断定呢。但这种说法，实际上出自神农的《本草经》，不是后人的私意臆测。肉苁蓉如果没有得到马精的气，生长在苦寒的边塞之外，又怎么能振奋阳气并补益水火（阴阳）呢？
有人问王好古曾说：“服用肉苁蓉治疗肾脏疾病，必定妨害心脏”，为什么你没有意识到这一点呢？回答说：这是王好古不了解肉苁蓉，而胡乱告诫罢了。凡是用药补肾，必然上通于心，心得到了肾的精气，然后才不会有焦枯的祸患。肉苁蓉大补肾之精气，也就是补心之气，又有什么妨害呢。（〔批注〕确实是这样的。）
Cistanche (Rou Cong Rong), with a sweet, warm flavor and notes of salty and sour, is non-toxic. It enters the Kidney meridian. It excels at invigorating Yang and stopping metrorrhagia and metrostaxis (abnormal uterine bleeding). Long-term use enables men and women to conceive offspring and warms the waist and knees.
However, it specifically tonifies the water and fire (Yin and Yang) within the Kidney, having no other uses. If used in large doses, it can cause lubrication of the Large Intestine. The ancients treated constipation in deficient patients by using one liang of Cistanche, washing off the saline taste, boiling it in clean water, and administering it orally, which would induce bowel movement; this precisely utilizes its ability to tonify deficiency while lubricating the intestines. Nevertheless, although it tonifies the Kidney, it should not be used exclusively. When combined with herbs such as Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Rehmanniae Radix Praeparata (Shudi), and Corni Fructus (Shanzhuyu)—herbs that tonify Yin and Yang—it yields substantial benefits. It makes the male organ robust and magnificent; when used together with Donkey Penis (Lv Bian), the effect is even more remarkable. However, Euryale Seed (Suo Yang) should not be used. This is because Suo Yang cannot compare to Cistanche; Cistanche is transformed from horse essence, thus possessing miraculous efficacy, whereas Suo Yang is not derived from horse essence. Although it can tonify Yin and invigorate Yang, its efficacy is very weak, so it was despised and excluded by Shennong in the *Shennong Bencao Jing*. In recent times, people have abandoned Cistanche in favor of Suo Yang, which is why I distinguish between them. As for Grass Cistanche (Cao Rou Cong Rong), it must absolutely not be used. Whenever using Cistanche, one must select specimens that are plump and possess scales; only then are they suitable for medicinal use. Otherwise, they are likely Grass Cistanche passed off as genuine, so careful inspection is necessary at the time of purchase.
A question arises: Since Cistanche is highly tonifying, warm in nature, and non-toxic, why does excessive use, which should benefit the Kidney, instead cause loose stools? One must understand that the fleshy part of Cistanche is a substance transformed from horse essence. Horses have a most lustful nature, hence Cistanche can invigorate Yang. Horse essence originates from the Kidney, hence it also nourishes Yin. However, the nature of horses is also most active/restless; therefore, sudden and heavy use easily disturbs the bowels, not because of its slippery taste. ([Commentary] This is a statement consistent with human nature and logical reasoning.)
Another question: Does Cistanche’s tendency to loosen the bowels suggest it is a purgative rather than a tonic? Cistanche is born from tangible essence, truly tonifying rather than draining. Observe elderly patients suffering from constipation; using Cistanche to unblock their bowels reveals that their obstruction stems from insufficiency of essence and blood, not from an excess of pathogenic fire. Can we not deduce from this that it is a tonic and not an attack?
Another doubt: Given that Cistanche is slippery and moves the bowels, can it be used for those with already slippery intestines, or is it contraindicated? Those with slippery intestines often suffer from a lack of Fire in the Kidney. Cistanche invigorates Yang and is a substance that tonifies Fire. How could tonifying Fire fail to firm up the Large Intestine? Thus, while sudden use may cause slipperiness, long-term use will naturally lead to astringency.
Another skepticism: Is Cistanche necessarily produced from horse essence? This herb grows in the sandy soil of border regions year after year like grass; how can there be enough horse essence for this?
The answer is: Cistanche is generated from horse essence. Whether it is or not, how could I determine it? But this theory actually originates from Shennong’s *Bencao Jing*, not from later personal speculation. If Cistanche did not receive the Qi of horse essence, growing in the bitter cold beyond the borders, how could it invigorate Yang and tonify Water and Fire?
A question asks: Wang Haogu once said, “Taking Cistanche to treat the Kidney will inevitably hinder the Heart.” Why have you overlooked this? The response is: This is Wang Haogu’s ignorant and reckless warning due to his lack of understanding of Cistanche. Any herb that tonifies the Kidney must communicate upward to the Heart. Only when the Heart receives the essence of the Kidney can it avoid the affliction of dryness and withering. Cistanche greatly tonifies the essence of the Kidney, which is equivalent to tonifying the Qi of the Heart. What hindrance could there possibly be? ([Commentary] Indeed true.)