（山草）大泻脏腑骨髓淫火热邪
胡黄连（专入脏腑骨髓）。出于波斯国。近时秦陇南海亦有。气味功用。亦同黄连。因
以连名
。但此性专达下。大伐脏腑骨髓淫火热邪。凡骨髓劳热。五心烦热。三消五痔。温疟泻痢恶
毒等症。皆得以治。（经曰。心移热于肺为膈消。是渴而多饮。上消肺热症也。又曰。二阳
结而为消。是多食善饥。中消胃热症也。渴而小便数有膏。为下消肾热症也。又按经言痔因
饱食。经脉横解。肠 为痔。又言督脉生病痔漏。又按书言痔有牝痔牡痔脉痔肠痔血痔之分
。皆湿热下流伤于血分。无所施泄。则逼肛门而为痔肿。）故同猪胰。以疗杨梅恶疮。且同
干姜。以治小儿果积。同鸡肝以治小儿疳眼。同乌梅以治小儿血痢。同甘草猪胰以治霉疮。
又治妇人胎蒸。较之黄连治功同而稍异耳。但小儿肾脏不足。脾胃虚寒者。其切忌焉。心黑
外黄。折之尘出如烟者真。畏恶同黄连。
（山草）治肺久伏热邪以清化
知母（专入肺。兼入肾）。辛苦微滑。能佐黄柏以治膀胱热邪。缘人水肿癃闭。本有属
血属气
之分。肺伏热邪。不能生水。膀胱绝其化源。便秘而渴。此当清肺以利水者也。热结膀胱。
真阴干涸。阳无以化。便秘不渴。此当清膀胱以导湿者也。黄柏气味纯寒。虽能下行以除
膀胱湿热。但肺金不肃。则化源无滋。又安能上达于肺而得气分俱肃乎？知母味辛而苦。沉
中有浮。降中有升。既能下佐黄柏以泄肾水。复能上行以润心肺。（汪昂曰。黄柏入二经血
分。故二药必相须而行。）俾气清肺肃。而湿热得解。是以昔人有云。黄柏无知母。犹水母
之无虾。诚以见其金水同源。子母一义。不可或离之义。（震亨曰。小便不通。有热有湿有
气
结于下。宜清宜燥宜升。又有隔二隔三之治。如肺不燥但膀胱热。宜泻膀胱。此正治。如因
肺热不能生水。则清肺。此隔二之治。如因脾湿不运而津不上升。故肺不能生水。则燥胃健
脾。此隔三之治。泻膀胱黄柏知母之类。清肺车前茯苓之类。燥脾二术之类。）故书皆言用
此在上则能清肺止渴。却头痛。润心肺。解虚烦喘嗽。吐血衄血。去喉中腥臭。在中则能退
胃火。平消瘅。在下则能利小水。润大肠。去膀胱肝肾湿热。腰脚肿痛。并治痨瘵内
热。阴火热淋崩渴等症。若谓力能补阴。则大谬矣。（补阴惟地黄为首。）景岳谓此性最沉寒
。本无生气。用以清火则可。（的解）用以补阴。则何补之有。第其阴柔巽顺。似乎有德。
犹
之小人在朝。国家元气受其剥削。而有阴移而莫之觉者。是不可不见之真而辨之早也。读此
可为妄用知母黄柏一箴。得酒良。上行酒浸。下行盐水拌。忌铁。
胡黄连（专门进入脏腑和骨髓）。产于波斯国。近来秦陇、南海等地也有出产。气味和功能，也同黄连相似，因此以“连”命名。但此药性专于下行，能大力清除脏腑骨髓中滞留的淫火、热邪和邪气。凡是骨髓劳热、五心烦热、三消病、五种痔疮、温疟、泻痢、恶毒等症状，都能治疗。（《内经》说：心将热邪移交给肺，称为膈消，表现为口渴且多饮，这是上消，属于肺热证。又说：阳明经气结滞导致消渴，表现为多吃且容易饥饿，这是中消，属于胃热证。口渴且小便频数并伴有膏脂样物质，是下消，属于肾热证。另外按《内经》所言，痔疮因饱食后经脉横解，肠道松弛而形成痔疮。又言督脉生病会导致痔漏。另外按医书所言，痔疮有牝痔、牡痔、脉痔、肠痔、血痔之分，都是湿热下注损伤血分，无法排泄，从而逼迫肛门形成痔肿。）所以常与猪胰同用，来治疗杨梅疮等恶疮；且与干姜同用，来治疗小儿果积；与鸡肝同用，来治疗小儿疳积眼病；与乌梅同用，来治疗小儿血痢；与甘草、猪胰同用，来治疗霉疮。又能治疗妇人胎蒸（产后发热），其治疗功效与黄连相同但略有差异。但是，对于小儿肾脏不足、脾胃虚寒者，必须切忌使用。药材中心黑外表黄，折断时有灰尘如烟雾般冒出的是真品。其畏恶反应与黄连相同。
知母（专门进入肺经，兼入肾经）。味辛、苦，微滑。能辅助黄柏来治疗膀胱热邪。因为人的水肿、小便不通，本就有属于血分病变和气分病变的区别。肺中潜伏热邪，不能生成津液，导致膀胱失去化源，出现便秘和口渴，这种情况应当清肺以利水。若热结在膀胱，真阴干涸，阳气无法气化，出现便秘但不口渴，这种情况应当清膀胱以导湿。黄柏气味纯寒，虽然能下行去除膀胱湿热，但如果肺金不肃降，则化源没有滋润，又怎么能上行到达肺经而使气分都肃降呢？知母味辛而苦，沉降中带有浮升之性，降中有升。既能在下辅助黄柏以泄肾水，又能上行以润养心肺。（汪昂说：黄柏进入二经的血分，所以这两味药必须相互配合使用。）使得气清肺肃，湿热得以解除。所以古人曾说：黄柏如果没有知母，就像水母没有虾一样，确实体现了金水同源、子母相生的道理，二者不可分离。（薛己说：小便不通，有热、有湿、有气结于下部，宜清热、宜燥湿、宜升提。又有隔二、隔三的治法。如肺不燥只是膀胱热，宜泻膀胱，这是正治。如果因肺热不能生水，则清肺，这是隔二的治法。如果因脾湿不运导致津液不能上升，故肺不能生水，则燥湿健脾，这是隔三的治法。泻膀胱用黄柏、知母之类；清肺用车前子、茯苓之类；燥脾用苍术、白术之类。）所以医书都说，此药在上部能清肺止渴，消除头痛，润养心肺，解除虚烦喘嗽，吐血衄血，去除喉中腥臭；在中部能退胃火，平复消瘅；在下部能利小便，润大肠，去除膀胱肝肾湿热，治疗腰脚肿痛，并治疗劳瘵内热、阴火、热淋、崩漏、口渴等症状。如果说它能补阴，那就大错特错了。（补阴以地黄为首选。）张景岳认为此药性最沉寒，本来没有生气，用来清火是可以的。（详解）如果用来补阴，又有什么补益呢？只是它阴柔巽顺，似乎有德行，犹如小人在朝堂之上，国家元气受其剥削，而有阴气转移却无人察觉的情况，这是不能不见到真相而及早辨别啊。读到这里可以作为对妄用知母、黄柏的一剂箴言。用酒制效果良好，酒浸可引药上行，盐水拌可引药下行。忌铁器。
(Mountain Grass) Greatly purges the excessive fire, heat pathogens, and evil qi from the Zang-Fu organs and bone marrow.
*Anemarrhenae Rhizoma* (Hu Huang Lian) (Specifically enters the Zang-Fu organs and bone marrow). It originates from Persia. In recent times, it is also found in Qinlong and Nanhai regions. Its aroma, flavor, and functions are similar to those of *Coptidis Rhizoma* (Huang Lian), hence the name "Lian" (connected/similar). However, this herb's nature specifically directs downwards, greatly reducing the excessive fire, heat pathogens, and evil qi lingering in the Zang-Fu organs and bone marrow. It can treat conditions such as bone marrow deficiency fever, five-palm heat, San Xiao (Three Wasting-Thirst diseases), five types of hemorrhoids, warm malaria, dysentery, and toxic sores. (*The Classic of Difficult Issues* states: "When heart heat transfers to the lung, it is called Ge Xiao [Diaphragm Thirst], characterized by thirst and excessive drinking; this is Upper Xiao, a lung-heat syndrome." It further states: "When the Two Yang meridians bind together leading to Xiao, it is characterized by excessive eating and easy hunger; this is Middle Xiao, a stomach-heat syndrome." And: "Thirst with frequent urination containing paste-like substances is Lower Xiao, a kidney-heat syndrome." Additionally, according to the classics, hemorrhoids arise from overeating causing meridians to loosen transversely and the intestines to become flaccid, forming hemorrhoids. It is also stated that disease of the Du Mai [Governing Vessel] causes hemorrhoids and fistulas. Furthermore, medical texts classify hemorrhoids into Pin Hemorrhoids, Mu Hemorrhoids, Mai Hemorrhoids, Chang Hemorrhoids, and Xue Hemorrhoids. All these result from damp-heat flowing downward, damaging the blood level, where there is no outlet for discharge, forcing the anus to swell and form hemorrhoids.) Therefore, it is used together with *Porcinus Pancreas* (Zhu Yi) to treat severe sores like Yantai Chuang [Kaposi's sarcoma or syphilitic ulcers]. Combined with *Zingiberis Rhizoma Recens* (Gan Jiang), it treats pediatric fruit accumulation. Combined with *Galli Hepatis et Gallbladae* (Ji Gan), it treats pediatric gan eye disease [malnutrition-related eye disorders]. Combined with *Mume Fructus* (Wu Mei), it treats pediatric bloody dysentery. Combined with *Glycyrrhizae Radix et Rhizoma* (Gan Cao) and *Porcinus Pancreas*, it treats meicuang [syphilis]. It also treats taizheng [postpartum fever] in women. Its therapeutic efficacy is similar to but slightly different from *Coptidis Rhizoma*. However, for children with insufficient kidney essence and deficiency-cold of the spleen and stomach, it must be strictly contraindicated. The authentic product has a black center and yellow exterior, and when broken, dust emerges like smoke. Its incompatibilities are the same as those of *Coptidis Rhizoma*.
(Mountain Grass) Treats long-standing latent heat pathogens in the lung to clear and transform them.
*Anemarrhenae Rhizoma* (Zhi Mu) (Specifically enters the Lung Meridian, concurrently entering the Kidney Meridian). Flavor is pungent, bitter, and slightly slippery. It can assist *Phellodendri Cortex* (Huang Bo) to treat heat pathogens in the Bladder. Edema and stranguria [difficulty in urination] in humans can belong to either blood-level or qi-level pathologies. When heat pathogens lie latent in the lung, failing to generate fluids, the Bladder loses its source of transformation, resulting in constipation and thirst. In such cases, one should clear the lung to promote diuresis. If heat binds in the Bladder, depleting true yin, leaving yang without the ability to transform, resulting in constipation without thirst, one should clear the Bladder to guide out dampness. *Phellodendri Cortex* has a purely cold nature and aroma. Although it can descend to remove damp-heat from the Bladder, if Lung Metal does not descend properly, the source of transformation lacks nourishment. How then can it ascend to reach the Lung and ensure the Qi level is fully肃降 (descending and purifying)? *Anemarrhenae Rhizoma* is pungent and bitter, possessing floating properties within its sinking nature, and ascending qualities within its descending action. It can assist *Phellodendri Cortex* downward to drain kidney water, and simultaneously ascend to moisten the Lung and Heart. (Wang Ang stated: "*Phellodendri Cortex* enters the blood level of the two meridians; therefore, these two herbs must be used in conjunction.") This allows the Qi to clear and the Lung to descend, resolving damp-heat. Thus, ancients said: "*Phellodendri Cortex* without *Anemarrhenae Rhizoma* is like a jellyfish without a shrimp," truly reflecting the principle that Metal and Water share the same source, and the mother-child relationship between them cannot be separated. (Xue Ji stated: "Stranguria can be caused by heat, dampness, or qi binding in the lower jiao. Treatment may involve clearing, drying, or ascending. There are also treatments involving 'separated two' and 'separated three' strategies. If the lung is not dry but only the bladder is hot, draining the bladder is the direct treatment. If the lung heat fails to generate water, clearing the lung is the 'separated two' treatment. If spleen dampness fails to transport, preventing fluids from ascending, thus the lung cannot generate water, drying the spleen and strengthening it is the 'separated three' treatment. To drain the bladder, use *Phellodendri Cortex* and *Anemarrhenae Rhizoma*; to clear the lung, use *Plantaginis Semen* (Che Qian Zi) and *Poria* (Fu Ling); to dry the spleen, use *Atractylodis Rhizoma* (Bai Zhu/Cang Zhu).") Therefore, medical texts state that when used in the upper jiao, it clears the lung, stops thirst, relieves headache, moistens the lung and heart, resolves deficiency vexation, wheezing, cough, hematemesis, and epistaxis, and removes foul odor from the throat. When used in the middle jiao, it reduces stomach fire, calms xiao dan [wasting-thirst], and when used in the lower jiao, it promotes urination, moistens the large intestine, removes damp-heat from the bladder, liver, and kidneys, treats swelling and pain in the waist and legs, and manages lao zhai [consumption/tuberculosis] internal heat, yin fire, heat stranguria, metrorrhagia, and thirst. To claim it can tonify yin is a major error. (To tonify yin, *Rehmanniae Radix* (Di Huang) is primary.) Zhang Jingyue stated that this herb is extremely cold and heavy, lacking vital energy. It is suitable for clearing fire. (Detailed Explanation) But what benefit does it offer for tonifying yin? Its yin-nature is soft and compliant, appearing virtuous, yet like a petty person in court, it exploits the nation's primal qi, causing yin to shift imperceptibly. One must see the truth early and distinguish it clearly. Reading this serves as a warning against the reckless use of *Anemarrhenae Rhizoma* and *Phellodendri Cortex*. Processing with wine is beneficial: wine soaking guides the herb upward, while salt-water mixing guides it downward. Avoid iron.