（《本经》下品）
【释名】 （与蜞同。《尔雅》作虮）。至掌（《别录》），大者名马蜞（《唐本》）、马蛭（《
唐本》）、马蟥（《衍义》）、马鳖（《衍义》）。
时珍曰∶方音讹蛭为痴，故俗有水痴、草痴之称。
宗 曰∶汴人谓大者为马鳖，腹黄者为马蟥。
【集解】《别录》曰∶水蛭生雷泽池泽。五月、六月采，曝干。
弘景曰∶处处河池有之， 有数种，以水中马
及诸小者，皆
恭曰∶有水蛭、草蛭，大者长尺许，并能咂牛、马、人血。今俗多取水中小者，用之大
效，不必食人血满腹者。其草蛭在深山草上，人行即着胫股，不觉入于肉中，产育为害，山
人自有疗法。
保升曰∶惟采水中小者用之。别有石蛭生石上，泥蛭生泥中，二蛭头尖腰粗色赤。
误食之，令人眼中如生烟，渐致枯损。
时珍曰∶李石《续博物志》云∶南方水痴似鼻涕，闻人气闪闪而动，就人体成疮，惟以
麝香、朱砂涂之即愈。此即草蛭也。
【修治】保升曰∶采得，以 竹筒盛；待干，用米泔浸一夜
然后用之。
藏器曰∶收干蛭，当展其身令长，腹中有子者去之。性最难死，虽以火炙，亦如鱼子烟
熏经年，得水犹活也。
大明曰∶此物极难修治，须细锉，以微火炒，色黄乃熟。不尔，入腹生子为害。
时珍曰∶昔有途行饮水，及食水菜，误吞水蛭入腹，生子为害，啖咂脏血，肠痛黄瘦者
惟以田泥或擂黄土水饮数升，则必尽下出也。盖蛭在人腹，忽得土气而下尔。或以牛、羊热
血一二升，同猪脂饮之，亦下也。
【气味】咸、苦，平，有毒。
《别录》曰∶微寒。畏锻石、食盐。
【主治】逐恶血瘀血月闭，破血症积聚，无子，利水道（《本经》）。
治女子月闭，欲成血劳（《药性》
（寇宗 ）。
【发明】成无己曰∶咸走血，苦胜血。水蛭之咸苦，以除蓄血，乃肝经血分药，故能通
肝经聚血。
弘景曰∶楚王食寒菹，见蛭吞之，果能去结积。虽曰阴 ，亦是物性兼然。
藏器曰∶此物难死，故为楚王之病也。
时珍曰∶按∶贾谊《新书》云∶楚惠王食寒菹得蛭，恐监食当死，遂吞之，腹有疾而不
能食。令尹曰∶天道无亲，惟德是辅。王有仁德，病不为伤。王果病愈。此楚王吞蛭之事也。
王充《论
【附方】旧四，新八。
漏血不止∶水蛭，炒为末，酒服一钱，日二服，恶血消即愈。（《千金》）。
产后血晕∶血结聚于胸中，或偏于少腹，或连于胁肋。用水蛭（炒）、虻虫（去翅、足，
炒）、没药、麝香各一钱，为末，以四物
折伤疼痛∶水蛭，新瓦焙为细末。酒服一钱。食顷作痛，可更一服。痛止，便将折骨药
封，以物夹定，调理。（《经验方
跌扑损伤，瘀血凝滞，心腹胀痛，大小便不通，气绝欲死∶用红蛭（锻石炒黄）半两，
大
黄、牵牛头末各二两，为末。每服二钱，热酒调下。当下恶血，以尽为度。名夺命散。（《济
生》）
坠跌打击∶内伤神效方∶水蛭、麝香各一两锉碎，烧令烟出，为末。酒服一钱，当下蓄
血。未止再服，其效如神。（《古今录验方》）
杖疮肿痛∶水蛭，炒研，同朴硝等分。研末，水调敷之。（周密《志雅堂杂抄》）
赤白丹肿∶藏器曰∶以水蛭十余枚，令咂病处，取皮皱肉白为效。冬月无蛭，地中掘取，
暖水养之令动。先净人皮肤，以竹筒盛蛭合之，须臾咬咂，血满自脱，更用饥者。
痈肿初起∶同上方法。
纫染白须∶谈野翁方∶用水蛭为极细末，以龟尿调，捻须梢，自行入根也。一用白乌骨
鸡一只，杀血入瓶中，纳活水蛭数十于内，待化成水，以猪胆皮包指，蘸捻须梢，自黑入根
也。《普济》∶用大水蛭七枚为
深埋马粪中。四十九日取出，化为黑油。以鱼脬笼指，每蘸少许捻须上，其油自然倒行至根，
变为黑色也。又黑须倒卷帘方∶用
以鸡冠血磨京墨与食，过四五次
盐泥涂之。干时放地上，火 五寸香；二次，退开三寸火，又五寸香；三次，再退远火，又
五寸香，取出为末。将猪胆皮包指，承末搽须梢，即倒上也。
（收录于《神农本草经》下品）
【释名】（与水蛭同义。《尔雅》中写作“虮”）。至掌（出自《名医别录》），大的称为马蜞（出自《新修本草》）、马蛭（出自《新修本草》）、马蟥（出自《证类本草·衍义》）、马鳖（出自《证类本草·衍义》）。
李时珍说：由于方言读音将“蛭”讹传为“痴”，所以民间有水痴、草痴的称呼。
寇宗奭说：汴京人把大的叫作马鳖，腹部黄色的叫作马蟥。
【集解】《名医别录》说：水蛭生长在雷泽的池塘沼泽中。五月、六月采集，晒干。
陶弘景说：各地的河池都有，有好几种，以水中的马蛭以及诸多种类的小者为主。
苏恭说：有水蛭和草蛭，大的长约一尺左右，都能吸食牛、马、人的血。现在民间多取水中较小的使用，效果显著，不必非要取吸饱人血的那种。草蛭生活在深山的草丛上，人走过就会附着在小腿和大腿上，不知不觉钻入肉中，繁殖造成危害，山中有自己的治疗方法。
郑保升说：只采集水中较小的使用。另有石蛭生在石头上，泥蛭生在泥土中，这两种蛭头尖腰粗，颜色发红。
误食它们，会让人眼中感觉像有烟生起，逐渐导致视力枯损。
李时珍说：李石在《续博物志》中记载：南方的水痴像鼻涕一样，闻到人气就会闪动，接触人体形成疮疡，只用麝香、朱砂涂抹即可痊愈。这就是草蛭。
【修治】郑保升说：采集后，用竹筒盛放；待其干燥，用米泔水浸泡一夜，然后使用。
陈藏器说：收藏干蛭，应当将其身体展开拉长，腹中有卵的要去除。这种药性极难杀死，即使用火烤，也像鱼子被烟熏了一年一样，遇到水仍然存活。
孙思邈说：此物极难处理，必须细细切碎，用微火炒，颜色变黄才算熟透。否则，进入腹中会生子为害。
李时珍说：过去有人赶路饮水，或吃水生蔬菜，误吞水蛭入腹，生子为害，吸食脏腑血液，导致肠痛、面色萎黄消瘦，只有服用田泥或研磨黄土水数升，则必定全部排出。大概是因为蛭在人腹中，忽然得到土气而下行排出。也有人用一二升温热的牛羊血，混合猪脂饮用，也能排出。
【气味】咸味、苦味，平性，有毒。
《名医别录》说：微寒。畏锻石、食盐。
【主治】驱逐恶血、瘀血、闭经，破除症瘕积聚，治疗不孕，通利水道（出自《神农本草经》）。
治疗女子闭经，预防发展为血劳病（出自《药性论》，寇宗奭补充）。
【发明】成无己说：咸味入血分，苦味能胜血。水蛭的咸苦之性，用来消除蓄积之血，是肝经血分的药物，所以能疏通肝经聚积之血。
陶弘景说：楚王吃了腌菜，看见水蛭并吞下它，果然能去除体内的结块积聚。虽然说是阴德感召，也是事物本性如此。
陈藏器说：此物难以死亡，所以成为楚王的病症（指吞蛭治病之事）。
李时珍说：按：贾谊《新书》记载：楚惠王吃腌菜时得到水蛭，担心监食官因此获罪处死，于是吞下了它，腹中有疾但不能进食。令尹说：天道无私，只辅助有德行的人。大王有仁德，疾病不会造成伤害。大王果然病愈。这就是楚王吞蛭的故事。王充在《论衡》……
【附方】旧方四首，新方八首。
漏血不止：水蛭，炒研为末，酒送服一钱，每日两次，恶血消除即愈。（出自《千金方》）。
产后血晕：血结聚于胸中，或偏于少腹，或连于胁肋。用水蛭（炒）、虻虫（去翅足，炒）、没药、麝香各一钱，研为末，以四物汤调服。
折伤疼痛：水蛭，在新瓦上焙干研为细末。酒送服一钱。过一会儿感到疼痛，可以再服一次。疼痛停止后，立即用接骨药封贴，并用物品夹定固定，进行调理。（出自《经验方》）。
跌扑损伤，瘀血凝滞，心腹胀痛，大小便不通，气息微弱欲死：用红蛭（用锻石炒黄）半两，大黄、牵牛子头末各二两，研为末。每次服二钱，用热酒调下。当下出恶血，以排尽为度。名为夺命散。（出自《济生方》）。
坠跌打击：内伤神效方：水蛭、麝香各一两，锉碎，烧至冒烟，研为末。酒送服一钱，当下出蓄血。未止再服，效果如神。（出自《古今录验方》）。
杖疮肿痛：水蛭，炒研，与朴硝等分。研为末，水调敷患处。（周密《志雅堂杂抄》）。
赤白丹肿：陈藏器说：用十余枚水蛭，令其叮咬患处，直到皮肤起皱、肌肉变白为有效。冬季没有蛭，从地中掘取，用暖水养使其活动。先清洁人皮肤，用竹筒扣住蛭使其吸附，片刻后咬咂，吸满血自动脱落，再用饥饿的蛭继续。
痈肿初起：同上方法。
染白须：谈野翁方：用水蛭为极细末，用龟尿调和，捻擦须梢，黑色自然渗入根部。另一种方法：用一只白乌骨鸡，杀鸡取血放入瓶中，放入数十条活水蛭在内，等待化成水，用猪胆皮包裹手指，蘸取擦拭须梢，黑色自然渗入根部。《普济方》：用大水蛭七枚……
深埋在马粪中。四十九天后取出，化为黑油。用鱼鳔包裹手指，每次蘸少许涂抹须上，油自然倒行至根部，变为黑色。又一种黑须倒卷帘方：用……
以鸡冠血磨京墨食用，经过四五次……
盐泥涂之。干燥时放在地上，距离火五寸香远；第二次，退开三寸火远，又五寸香；第三次，再退远火，又五寸香，取出研为末。将猪胆皮包裹手指，承接药末涂抹须梢，即可倒转变黑。
(Recorded in the Lower Grade of *Shennong Bencao Jing*)
**[Names]** (Synonymous with Shizhi [Leech]. Written as "Ji" in *Erya*). Zhizhang (recorded in *Mingyi Bielu*); large ones are named Maqi (recorded in *Xinxiu Bencao*), Mazhi (recorded in *Xinxiu Bencao*), Mahuang (recorded in *Yanyi* of *Zhenglei Bencao*), and Mabie (recorded in *Yanyi* of *Zhenglei Bencao*).
Li Shizhen states: Due to dialectal pronunciation errors where "Zhi" is misread as "Chi", common names include Shuichi [Water Chi] and Caochi [Grass Chi].
Kou Zongshi states: People in Bianjing call large ones Mabie, and those with yellow abdomens Mahuang.
**[Collection and Description]** *Mingyi Bielu* states: Shizhi [Leech] grows in the ponds and marshes of Leize. Collected in May and June, then dried in the sun.
Tao Hongjing states: They are found in rivers and ponds everywhere, with several varieties; those in water, such as Mazhi and other small types, are primarily used.
Su Gong states: There are Shizhi [Water Leech] and Caozhi [Grass Leech]. Large ones are about one chi long and can suck blood from cattle, horses, and humans. Currently, people mostly use smaller ones from water, which are highly effective; it is not necessary to use those that have sucked human blood until their bellies are full. Caozhi [Grass Leech] lives on grass in deep mountains; when a person walks by, they attach to the calves and thighs, unknowingly burrowing into the flesh. Their reproduction causes harm, but mountain dwellers have their own treatments.
Zheng Baosheng states: Only smaller ones from water are collected for use. There are also Shizhi [Stone Leech] living on stones and Nizhi [Mud Leech] living in mud; these two types have pointed heads, thick waists, and red coloration.
Accidental ingestion causes a sensation of smoke in the eyes, gradually leading to vision loss.
Li Shizhen states: Li Shi records in *Xu Bowuzhi*: Southern Shuichi [Water Chi] resembles mucus; it moves upon smelling human breath and forms sores upon contact with the body. It heals only when applied with Mosiang [Musk] and Zhusha [Cinnabar]. This is Caozhi [Grass Leech].
**[Processing]** Zheng Baosheng states: After collection, store in a bamboo tube; once dry, soak in rice washing water overnight before use.
Chen Cangqi states: When storing dried leeches, stretch their bodies out. Remove those with eggs in the abdomen. Their nature is extremely difficult to kill; even if roasted by fire, like fish roe smoked for a year, they remain alive when exposed to water.
Sun Simiao states: This substance is very difficult to process. It must be finely chopped and stir-fried over low heat until yellow, indicating it is cooked. Otherwise, it may produce offspring in the abdomen causing harm.
Li Shizhen states: In the past, someone drinking water or eating aquatic vegetables accidentally swallowed a leech, which produced offspring and harmed them by sucking organ blood, causing intestinal pain, jaundice, and emaciation. Drinking several sheng of field mud water or ground yellow earth water would cause them to be completely expelled. This is likely because the leech in the abdomen descends upon encountering the qi of earth. Alternatively, drinking one or two sheng of warm ox or sheep blood mixed with pig lard can also expel them.
**[Flavor and Nature]** Salty, Bitter, Neutral, Toxic.
*Mingyi Bielu* states: Slightly Cold. Averse to Duanshi [Calamine/Smelted Iron Ore] and Shiyen [Salt].
**[Indications]** Expels evil blood, stasis blood, and amenorrhea; breaks up mass formations and accumulations; treats infertility; promotes urination (*Shennong Bencao Jing*).
Treats female amenorrhea, preventing progression to Xuelao [Blood Consumption Disease] (*Yaoxing Lun*, supplemented by Kou Zongshi).
**[Elucidation]** Cheng Wuji states: Salty flavors enter the blood level, and Bitter flavors overcome blood. The salty and bitter properties of Shizhi [Leech] eliminate accumulated blood; it is a medicine for the Liver Meridian blood level, thus capable of unblocking stagnant blood in the Liver Meridian.
Tao Hongjing states: King Chu ate pickled vegetables, saw a leech, and swallowed it, successfully removing internal stagnation. Although attributed to Yin virtue, it is also due to the nature of the substance.
Chen Cangqi states: Because this creature is hard to kill, it became the subject of King Chu's illness [treatment story].
Li Shizhen states: According to Jia Yi's *Xinshu*: King Hui of Chu found a leech in his pickled vegetables. Fearing the official in charge of food would be executed, he swallowed it. He had abdominal discomfort and could not eat. The Lingyin [Prime Minister] said: "The Way of Heaven has no favorites; it assists only the virtuous." The King had benevolent virtue, so the disease would not harm him. The King indeed recovered. This is the story of King Chu swallowing the leech. Wang Chong in *Lunheng*...
**[Attached Prescriptions]** Four old prescriptions, eight new prescriptions.
**Leaking Blood Unstoppable:** Shizhi [Leech], stir-fried and powdered. Take 1 qian with wine, twice daily. Stops when evil blood dissipates (*Qianjin Fang*).
**Postpartum Blood Dizziness:** Blood stagnates in the chest, or偏向 the lower abdomen, or extends to the hypochondrium. Use Shizhi [Leech] (stir-fried), Mengchong [Dragonfly Larva] (remove wings and feet, stir-fried), Moyao [Myrrh], and Mushixiang [Musk], each 1 qian. Powder them and take with Siwu Tang [Four Substances Decoction].
**Fracture and Injury Pain:** Shizhi [Leech], baked on a new tile and powdered finely. Take 1 qian with wine. If pain occurs after a meal, take another dose. Once pain stops, apply bone-setting medicine immediately, fix with splints, and regulate (*Jingyan Fang*).
**Falls and Trauma, Stagnant Blood Accumulation, Abdominal Distension and Pain, Constipation and Urinary Retention, Critical Condition:** Use Hongzhi [Red Leech] (stir-fried with Duanshi until yellow) 0.5 liang, Dahuang [Rhubarb Root], and Qiuniu Toumo [First-run Pulverized Pharbitis Seed] each 2 liang. Powder them. Take 2 qian per dose, mixed with hot wine. Evacuate evil blood until complete. Named Duoming San [Life-Grabbing Powder] (*Jisheng Fang*).
**Falls and Blows:** Internal Injury Divine Efficacy Prescription: Shizhi [Leech] and Mushixiang [Musk] each 1 liang. Chop and burn until smoke appears, then powder. Take 1 qian with wine to evacuate stagnant blood. Repeat if necessary; efficacy is divine (*Gujin Luyuan Fang*).
**Stick Wound Swelling and Pain:** Shizhi [Leech], stir-fried and ground, equal parts Puxiao [Mirabilite]. Powder and mix with water for external application (*Zhiyatang Zacahao* by Zhou Mi).
**Red and White Dan Swelling:** Chen Cangqi says: Use over ten Shizhi [Leeches] to bite the affected area until the skin wrinkles and flesh turns white. In winter, dig them up, keep in warm water to activate. Clean the skin, cover with a bamboo tube to attach the leech. After biting and filling with blood, it detaches naturally. Use hungry leeches subsequently.
**Early Stage Carbuncle and Swelling:** Same method as above.
**Dyeing White Beard:** Tan Yeweng's Prescription: Use extremely fine Shizhi [Leech] powder, mix with Guiyu [Turtle Urine], rub onto beard tips to naturally darken roots. Another method: Use one white black-bone chicken, slaughter and collect blood in a bottle. Add dozens of live Shizhi [Leeches]. Wait until dissolved into water. Wrap finger in pig bladder skin, dip and rub beard tips to naturally darken roots. *Puji Fang*: Use seven large Shizhi [Leeches]...
Bury deeply in horse manure. After 49 days, remove and transform into black oil. Wrap finger in fish swim bladder, dip sparingly and rub on beard; the oil naturally travels to the root, turning black. Another Black Beard Rolling Upward Prescription: Use...
Grind Jingmo [Beijing Inkstick] with Chicken Comb Blood and consume; after four or five times...
Coat with salt mud. When dry, place on ground, distance from fire 5 cun incense length; second time, retreat fire 3 cun, another 5 cun incense length; third time, retreat further, another 5 cun incense length. Remove and powder. Wrap finger in pig bladder skin, hold powder and rub on beard tips to reverse direction.