（蔓草）泻心经小肠湿热
木通（专入心。兼入小肠。古名通草。今之通草。即古所名通脱木）。甘淡轻虚。据书
开载治
效甚多。然究不外清火通窍利水数端而已。缘人一身上下。外无风寒暑湿六淫郁而为热。内
无火气熏蒸。则水道顺畅。一身安养。上自咽喉以迄心胸。下自大腹以迄二便。而无膈结不
通之弊矣。东垣曰。凡人肺受热邪。津液气化之源绝。（肺为水源。）则泉水断流。（源绝则
流断。）膀胱受湿热癃闭约束。则小便不通。（湿热为害。）朱二允曰。火在上则口燥眼赤鼻
干。在中则心烦呕哕。在下则淋闭足肿。木通藤细有孔。两头皆通。体轻质浮。味淡气渗。
能泻君火。火退则小便自利。（心与小肠相表里。）便利。则诸经火邪皆从心水而下降矣。是
以行经下乳。（火不内亢则经调乳通。）破血除蒸。（热除则血破。血破则蒸除。）止烦住痛。
（心热清则烦除痛止。）排脓生肌。（心热除则气血得养而肌肉生。）开关利节。（心窍通则
经络流行。故关节亦通。）并凡因于湿热而成者。无不借此以为开导。此虽类泽泻同为渗利
。但君火动则宜木通。相火动则宜泽泻也。惟神气亏损。汗多外出。及虚弱孕妇者切忌。以
性通利故耳。
（隰草）清肝肺风热以道膀胱水邪
车前子（专入肝肺。）甘咸性寒。据书皆载能治膀胱湿热。以通水道。然余谓膀胱之清。
由于
肝肺之肃。凡人泻利暴作。小水不通。并湿痹五淋。暑热泻利。难产目赤。虽有膀胱水涸不
能
化阳。然亦有为肝肺感受风热。以致水不克生。故须用此以清肝肺。兼咸下降以清水道。（
圣惠方风热目暗。用车前子宣州黄连各一钱为末。食后温服效。又景驻丸治肝肾俱虚。眼目
昏花。或生障翳。迎风有泪。久服补肝肾。增目力。车前子熟地黄酒蒸三两。菟丝子酒浸五
两。
蜜丸。时珍曰。服此治目。须佐他药。如六味地黄丸之用泽泻也。若单用。则走泄太过。恐
非久服之物。又欧阳公常得暴下病。国医不能治。夫人买市人药一帖进之而愈。方叩其方
。则车前子一味为末。饮服二钱匕云。此药利水而不动气。水道利则清浊分。各藏自止矣！
）是以五子衍宗丸。用此以为四子之佐。（五子衍宗丸。枸杞菟丝各八两。五味复盆各四两。
车前二两。蜜丸。遗泄者。车前易莲子。）金匮肾气丸。用此以为诸药之助。且此肝肺既清
。风热悉去。则肺不受热而化源有自。肝不破风而疏泄如常。精与溺二窍。本不相兼。水得
气而通。精得火而泄。故水去而火益盛。精盛而气益固。所谓服此令人有子。（明医杂录云
。服固精药日久。须服此行房。即有子。）及渗利而不走气。（冯兆张曰。利膀胱水窍而不及
命门精窍。故浊阴去而肾愈固。热去而目自明也。）与茯苓同功者。正谓此也。但气虚下陷
。肾气虚脱。切勿服耳。酒蒸捣饼焙研用。
木通（主要入心经，兼入小肠经。古称通草，现在的通草即古代所称的通脱木）。味甘、淡，质地轻虚。据书籍记载，其治疗功效很多，但究其根本，不外乎清热泻火、通利窍道、利尿渗湿这几方面罢了。因为人体上下内外，如果没有风寒暑湿等六淫邪气郁结化热，内部也没有火热之气熏蒸，那么水道就会顺畅，身体得以安宁调养。从上至咽喉直至心胸，下自大腹直至大小便，就不会出现膈间结滞不通的弊病。李东垣说：凡是人的肺受到热邪侵袭，津液和气化的源头就会断绝。（肺为水之上源。）那么泉水就会断流。（源头断绝则水流停止。）膀胱受到湿热困扰导致癃闭约束，就会出现小便不通。（这是湿热为害所致。）朱丹溪说：火邪在上则口燥、眼红、鼻干；在中则心烦、呕吐呃逆；在下则淋证、闭尿、足部肿胀。木通藤细且有孔，两头皆通，体质轻而质浮，味道淡而气味渗透，能清泻君火（心火），火退则小便自然通利。（心与小肠互为表里。）小便通利，则各条经络的火邪都能随着心水下行排出。因此它能通行经脉、催生下乳。（火不内亢则月经调畅、乳汁通畅。）破血除蒸。（热除则瘀血消散，瘀血消散则骨蒸潮热除去。）止烦止痛。（心热清除则烦躁消除、疼痛停止。）排脓生肌。（心热去除则气血得到滋养而肌肉生长。）开通关窍、利节通络。（心窍通则经络流行，所以关节也通畅。）以及凡是因湿热引起的病症，无不借此药来开导疏通。这虽然与泽泻同类，同为渗湿利水之品，但君火（心火）动则适宜用木通，相火（命门之火/肾火）动则适宜用泽泻。只有神气亏损、汗出过多外出，以及虚弱孕妇者切忌使用，因为其性味通利故耳。
车前子（主要入肝、肺二经）。味甘、咸，性寒。据书籍记载，都能治疗膀胱湿热，以通利水道。然而我认为膀胱的清利，依赖于肝肺的肃降功能。凡人突然发生腹泻痢疾，小便不通，以及湿痹、五淋、暑热泻利、难产、目赤等症状，虽然有膀胱水涸不能化阳的情况，但也有因肝肺感受风热，导致水液代谢失常（金不生水）的缘故，所以必须用此药来清肝肺，兼以咸味下降以清水道。（《圣惠方》治风热导致的目暗不明，用车前子和宣州黄连各一钱研为末，饭后温服有效。又《景驻丸》治疗肝肾俱虚，眼睛昏花，或生障翳，迎风流泪，久服可补肝肾、增视力，配方为车前子三两经黄酒蒸制，菟丝子五两酒浸，蜜丸。李时珍说：服用此药治疗眼疾，须配合其他药物，如六味地黄丸中用泽泻一样。如果单用，则走泄太过，恐怕不是久服之物。另外欧阳修常患暴泻病，国医不能治愈，他的夫人买市井药农的一帖药进献给他而痊愈。询问药方，则是车前子一味研为末，饮水送服二钱匕。此药利水而不耗气，水道通利则清浊分离，各脏腑自安！）因此《五子衍宗丸》用此药作为四子（枸杞、菟丝、五味、覆盆）的佐使。（《五子衍宗丸》配方：枸杞、菟丝子各八两，五味子、覆盆子各四两，车前子二两，蜜丸。遗精滑泄者，将车前子替换为莲子。）《金匮肾气丸》用此药作为诸药的辅助。况且肝肺既已清利，风热悉去，则肺不受热而化源自有，肝不破伤风邪而疏泄功能如常。精窍与溺窍本不相兼，水得气而通，精得火而泄，所以水去则火益盛，精盛则气益固。所谓服用此药能令人有子。（《明医杂录》云：服用固精药日久，须服用此药行房事，即可有子。）以及渗湿利水而不耗散正气。（冯兆张说：利膀胱水窍而不涉及命门精窍，所以浊阴去而肾愈固，热去而眼睛自然明亮。）这与茯苓功效相同，正是说的这一点。但是气虚下陷、肾气虚脱者，切勿服用。需经酒蒸、捣饼、焙干后研粉使用。
(Mutong) Drains Damp-Heat from the Heart and Small Intestine Meridians
Mutong (Akebiae Caulis, 木通) primarily enters the Heart meridian and also the Small Intestine meridian. In ancient times known as Tongcao, the current Tongcao corresponds to Tetrapanacis Medulla (Tongtuomu, 通脱木). It is sweet, bland, light, and void in nature. According to texts, its therapeutic effects are numerous, but fundamentally, they do not exceed clearing fire, unblocking orifices, and promoting urination. This is because if the human body, both internally and externally, is free from the stagnation of Wind, Cold, Summerheat, and Dampness transforming into heat, and there is no internal steaming by Fire Qi, then the water passages will flow smoothly, allowing the body to be nourished and at peace. From the throat down to the chest and heart, and from the great abdomen down to the bowel movements and urination, there will be no obstruction or blockage. Li Dongyuan stated: When the Lungs are affected by Heat Evil, the source of Body Fluids and Qi transformation is cut off. (The Lung is the upper source of water.) Then the spring water ceases to flow. (When the source is cut off, the flow stops.) If the Bladder is constrained by Damp-Heat causing strangury, urination will be obstructed. (This is due to the harm caused by Damp-Heat.) Zhu Danxi said: Fire above causes dry mouth, red eyes, and dry nose; in the middle causes mental restlessness, vomiting, and hiccups; below causes strangury, retention of urine, and swollen feet. Mutong vines are slender with pores, open at both ends, light in texture and floating in nature, bland in taste and penetrating in aroma. It can drain Ministerial Fire (Heart Fire); when Fire recedes, urination becomes smooth naturally. (The Heart and Small Intestine are exterior-interior related.) With smooth urination, Fire Evil from all meridians descends via Heart Water. Therefore, it can unblock meridians and promote lactation. (When Fire does not surge internally, menstruation regulates and milk flows.) It breaks blood stasis and removes bone-steaming fever. (When heat is removed, blood stasis dissipates; when stasis dissipates, steaming fever is eliminated.) It relieves irritability and pain. (When Heart Heat clears, irritability vanishes and pain stops.) It expels pus and generates flesh. (When Heart Heat is removed, Qi and Blood are nourished, and muscles grow.) It opens orifices and benefits joints. (When Heart orifices are clear, meridians circulate freely, so joints also become unobstructed.) For any condition caused by Damp-Heat, this herb serves as an effective guide for unblocking. Although similar to Ze Xie (Alismatis Rhizoma, 泽泻) in being a diuretic, when Ministerial Fire (Heart Fire) moves, Mutong is indicated; when Deputy Fire (Kidney/Mingmen Fire) moves, Ze Xie is indicated. It is strictly contraindicated for those with depleted Shen Qi, excessive sweating, and weak pregnant women, due to its penetrating and draining nature.
(Xiqianzi) Clears Wind-Heat from Liver and Lungs to guide Bladder Water Pathogens
Xiqianzi (Plantaginis Semen, 车前子) primarily enters the Liver and Lung meridians. It is sweet, salty, and cold in nature. Texts record that it treats Damp-Heat in the Bladder to unblock water passages. However, I believe the clarity of the Bladder depends on the descending function of the Liver and Lungs. When sudden diarrhea or dysentery occurs with obstructed urination, as well as in cases of Damp Bi, Five Stranguries, Summerheat-induced diarrhea, difficult labor, and red eyes, although these may stem from Bladder fluid depletion failing to transform Yang, they can also result from Liver and Lungs contracting Wind-Heat, leading to failure of Metal generating Water. Thus, this herb must be used to clear the Liver and Lungs, combined with its salty descending property to clear water passages. (Shenghui Fang treats dim vision due to Wind-Heat using one qian each of Xiqianzi and Huanglian from Xuanzhou, powdered and taken warm after meals for efficacy. Jingzhu Pill treats deficiency of both Liver and Kidney causing blurry vision, cataracts, and tearing in wind, improving vision with long-term use; formula includes three liang of Xiqianzi steamed in yellow wine, five liang of Tusizi soaked in wine, formed into honey pills. Li Shizhen noted: To treat eye conditions with this herb, it must be assisted by other drugs, just as Ze Xie is used in Liuwei Dihuang Wan. Used alone, it drains too excessively and is not suitable for long-term use. Additionally, Ouyang Xiu suffered from acute diarrhea that imperial physicians could not cure; his wife bought a packet of medicine from a market herbalist which cured him. Upon inquiry, the formula was simply Xiqianzi powder, two qianbi taken with water. This herb promotes urination without moving Qi; when water passages are clear, turbidity and clarity separate, and organs settle.) Therefore, Wuzi Yanzong Wan uses it as an assistant to the four seeds. (Wuzi Yanzong Wan formula: Gouqizi and Tusizi eight liang each, Wuweizi and Fupenzi four liang each, Xiqianzi two liang, honey pills. For seminal emission, replace Xiqianzi with Lianzi.) Jin Gui Shenqi Wan uses it to assist the other herbs. Moreover, once the Liver and Lungs are cleared and Wind-Heat eliminated, the Lungs are not affected by Heat, ensuring the source of transformation remains intact; the Liver is not damaged by Wind, maintaining normal dispersing and descending functions. The orifices for essence and urine are distinct; water flows with Qi, while essence releases with Fire. Thus, as water leaves, Fire becomes stronger; as essence accumulates, Qi becomes more secure. Hence, taking this herb enables conception. (Mingyi Zalu states: After long-term use of essence-consolidating medicines, one should take this herb during intercourse to achieve conception.) It promotes diuresis without depleting Qi. (Feng Zhaozhang said: It benefits the Bladder's water orifice without affecting the Mingmen's essence orifice, so turbid Yin departs and the Kidney becomes more secure; Heat leaves and vision clarifies.) Its efficacy is equivalent to that of Fu Ling (Poria, 茯苓), which is precisely what is meant here. However, it must be strictly avoided in cases of Qi sinking and Kidney Qi collapse. It should be steamed in wine, pounded into cakes, baked, and then powdered.