薏苡仁，味甘，气微寒，无毒。入脾、肾二经，兼入肺。疗湿痹有神，舒筋骨拘挛，止
骨中
疼痛，消肿胀，利小便，开胃气，亦治肺痈。但必须用至一、二两，始易有功，少亦须用五
钱之外，否则，力薄味单耳。薏仁最善利水，又不损耗真阴之气。凡湿感在下体者，最宜用
之。视病之轻重，准用药之多寡，则阴阳不伤，而湿病易去。人见用药之多，动生物议，原
未知药性，无怪其然。余今特为阐明，原世人勿再疑也。凡利水之药，俱宜多用，但多用利
水之药，必损真阴之气，水未利，而阴且虚矣，所以他利水之药，不敢多用。惟薏仁利水，
而又不损真阴之气，诸利水药所不及者也。可以多用，而反不用，与不可多用，而反大用者
，
安得有利乎。故凡遇水湿之症，用薏仁一、二两为君，而佐之健脾去湿之味，未有不速于奏
效者也。倘薄其气味之平和而轻用之，无益也。（〔批〕薏仁利水而不走气，与茯苓同功。）
或问薏仁味薄而气轻，何以利水之功犹胜？盖薏仁感土气而生，故利气又不损阴。所以
可多
用以出奇，而不必节用以畏缩也。
或问薏仁有取之酿酒者，亦可藉为利湿之需乎？夫薏仁性善利湿，似乎所酿之酒，亦可
以利
湿也。然用薏酒以治湿，而湿不能去，非特湿不能去，而湿且更重，其故何哉？酒性大热，
薏仁既化为酒，则薏仁之气味亦化为热矣，既化为热，独不可化为湿乎，湿热以治湿热，又
何宜哉。此薏仁之酒，断不可取之，以治湿热之病也。
或问薏仁可以消瘴气，而未言及，岂忘之耶？非忘也。薏仁只能消湿气之瘴，而不能消
岚气
之瘴。虽岚气即湿气之类，然而湿气从下受，而岚气从上感，又各不同。薏仁消下部之湿，
安能消上部之湿哉。（〔批〕薏仁消下湿，而不消上湿，确论不磨。）
或问薏仁得地之燥气，兼禀乎天之秋气，似与治痿相宜，何子忘之也？亦未曾忘也。经
曰∶
治痿独取阳明。阳明者，胃与大肠也。二经湿热则成痿，湿去则热亦随解。故治痿者，必去
湿也。吾前言用薏仁至一、二两者，正言治痿病也。天下惟痿病最难治，非多用薏仁，则水
不易消，水不消，则热不能解，故治痿病断须多用耳。推之而凡有诸湿之症，无不宜多用。
正不可因铎之未言，即疑而不用也。
或问薏仁功用甚薄，何不用猪苓、泽泻，可以少用见功，而必多用薏仁，何为乎？不知
利水
之药，必多耗气，薏仁妙在利水而又不耗真气，故可重用之耳。
薏苡仁，味道甘甜，性质微寒，没有毒性。进入脾、肾二经，同时也进入肺经。治疗湿痹（因湿邪阻滞经络引起的关节疼痛重着）有显著疗效，能舒缓筋骨拘挛，停止骨中疼痛，消除肿胀，通利小便，开胃气，也能治疗肺痈（肺部化脓性病变）。但是必须用到一两到二两的剂量，才容易见效，最少也要用五钱以上，否则药力薄弱、药味单一罢了。薏仁最擅长利水，又不会损耗真阴之气。凡是湿气感受在下半身的，最适合使用它。根据病情的轻重，确定用药的多寡，那么阴阳就不会受伤，而湿病也容易去除。人们看到用药量大，就动辄产生非议，原本是不了解药性，这也难怪他们如此。我今天特意阐明这一点，希望世人不要再怀疑了。凡是利水的药物，都适宜多用，但是多用其他利水的药物，必然会损伤真阴之气，水还没利掉，阴气反而虚弱了，所以其他的利水药不敢多用。只有薏仁利水，却不损伤真阴之气，这是其他利水药所比不上的。可以多用却反而不用，与不可多用却反而大用的情况相比，怎么能起到利水的作用呢？所以凡是遇到水湿病症，用薏仁一两到二两作为主药，再配合健脾去湿的药物，没有不迅速见效的。如果轻视它气味平和而轻率地少量使用，是没有益处的。（批注：薏仁利水而不耗散正气，功效与茯苓相同。）
有人问：薏仁味道淡薄而气轻，为什么利水的功效还能胜过其他药物？大概是因为薏仁感应土气而生，所以能利气又不损伤阴气。因此可以多用来出奇制胜，而不必因为害怕副作用而节制用量、畏缩不前。
有人问：薏仁有用来酿酒的，也可以借它来作为利湿的需求吗？薏仁性质善于利湿，似乎所酿成的酒，也可以用来利湿。然而用薏仁酒来治疗湿证，湿邪不能去除，不仅湿邪不能去除，湿邪反而会加重，这是什么原因呢？酒性大热，薏仁既然变成了酒，那么薏仁的气味也就转化为热性了，既然转化为热性，难道不能转化为湿邪吗？用湿热之性去治疗湿热之病，又有什么适宜的呢？这种薏仁酒，绝对不可以拿来治疗湿热病症。
有人问：薏仁可以消除瘴气，文中却没有提及，难道是忘记了吗？不是忘记。薏仁只能消除湿气引起的瘴气，而不能消除岚气（山间雾气）引起的瘴气。虽然岚气属于湿气的一类，然而湿气是从下部受入，而岚气是从上部感受，两者又各不相同。薏仁消除下部的湿气，怎么能消除上部的湿气呢？（批注：薏仁消除下湿，而不消除上湿，确实是确凿不移的论断。）
有人问：薏仁得到地的燥气，兼禀受天的秋气，似乎与治疗痿证（肢体萎软无力）相适宜，为什么你忘记提了呢？也未曾忘记。医经说：治疗痿证独取阳明经。阳明经，指的是胃和大肠。这两条经脉如果有湿热就会形成痿证，湿气去除则热邪也随之解除。所以治疗痿证，必须去湿。我前面说用薏仁一到二两，正是指治疗痿病而言。天下只有痿病最难治疗，如果不是多用薏仁，那么水湿就不容易消除，水湿不消除，热邪就不能解除，所以治疗痿病断然必须多用薏仁。推而言之，凡是各种湿症，都适宜多用。千万不要因为我陈士铎没有特别言及，就怀疑而不敢使用。
有人问：薏仁的功效很薄，为什么不使用猪苓、泽泻，这样可以少量使用就能见效，而一定要多用薏仁，是为什么呢？不知道利水的药物，必然多会耗气，薏仁妙在利水而不耗损真气，所以可以重用它的缘故。
Coix Seed (Yiyiren), with a sweet taste and slightly cold nature, is non-toxic. It enters the Spleen and Kidney meridians, and also the Lung meridian. It is effective in treating Bi syndrome due to dampness (joint pain and heaviness caused by damp pathogen obstruction), relaxing tendon and bone spasms, relieving bone pain, reducing swelling, promoting urination, opening the stomach qi, and treating lung abscess (purulent lesions in the lungs). However, a dosage of one to two taels is required for efficacy; even the minimum dose should be five qian, otherwise the medicinal power is weak and the flavor too simple. Coix seed excels at promoting water metabolism without depleting True Yin Qi. It is most suitable for cases where dampness affects the lower body. By adjusting the dosage according to the severity of the illness, Yin and Yang remain undamaged, and damp diseases are easily resolved. People often criticize high dosages because they do not understand the properties of herbs, which is understandable. I hereby clarify this point so that people will no longer doubt it. Generally, diuretic herbs are suitable for high doses, but using large amounts of other diuretics inevitably damages True Yin Qi; before the water is eliminated, Yin becomes deficient. Therefore, other diuretics cannot be used in large quantities. Only Coix seed promotes water metabolism without damaging True Yin Qi, surpassing other diuretic herbs. If one can use more but does not, compared to those who use excessively when they should not, how can there be any benefit? Thus, for any water-dampness condition, using one to two taels of Coix seed as the sovereign herb, assisted by herbs that strengthen the Spleen and eliminate dampness, will invariably produce rapid effects. If its mild nature leads to underdosing, it will be of no benefit. (Comment: Coix seed promotes water metabolism without dispersing Zheng Qi, functioning similarly to Poria.)
A question arises: Since Coix seed has a light taste and mild aroma, why is its diuretic effect superior? This is likely because Coix seed grows by absorbing Earth Qi, thus benefiting Qi without damaging Yin. Therefore, it can be used in larger amounts for unexpected results, without the need for restraint or hesitation.
Another question: Can Coix seed wine be used for eliminating dampness? Although Coix seed is good at resolving dampness, the wine made from it may not necessarily resolve dampness effectively. Using Coix seed wine to treat dampness fails to remove the dampness and may even exacerbate it. Why? Wine has a hot nature. Once Coix seed is fermented into wine, its nature transforms into heat. Heat can transform into dampness. Using heat-dampness to treat heat-dampness is inappropriate. Therefore, Coix seed wine must not be used to treat heat-dampness conditions.
Another question: Coix seed can dissipate miasma, yet this was not mentioned. Was it forgotten? No. Coix seed can only dissipate miasma caused by dampness, not miasma caused by mountain mist (Lan Qi). Although mountain mist is a type of dampness, dampness typically enters from below, while mountain mist is contracted from above; they differ significantly. Coix seed eliminates dampness in the lower part of the body; how can it eliminate dampness in the upper part? (Comment: Coix seed eliminates lower dampness but not upper dampness; this is an irrefutable argument.)
Another question: Coix seed absorbs dry Qi from the earth and Autumn Qi from heaven, seemingly suitable for treating Wei syndrome (limb flaccidity). Why did you omit it? It was not omitted. The Classics state: "In treating Wei syndrome, focus solely on the Yangming." Yangming refers to the Stomach and Large Intestine meridians. Damp-heat in these two meridians causes Wei syndrome; removing dampness resolves the heat. Therefore, treating Wei syndrome requires removing dampness. When I previously mentioned using one to two taels of Coix seed, I was referring specifically to treating Wei syndrome. Wei syndrome is the most difficult to treat worldwide. Without using large amounts of Coix seed, water retention is hard to resolve; if water is not resolved, heat cannot be cleared. Thus, large doses are essential for Wei syndrome. By extension, large doses are appropriate for all damp-related conditions. Do not hesitate to use it simply because I did not explicitly emphasize it earlier.
Another question: Coix seed's efficacy seems mild. Why not use Polyporus (Zhuling) or Alisma (Zexie), which show effects at lower doses, instead of heavily relying on Coix seed? One must realize that diuretic herbs tend to consume Qi. The brilliance of Coix seed lies in promoting water metabolism without consuming True Qi, which allows for heavy usage.