\r冀州地黄\pj21.bmp\r
\r沂州地黄\pj22.bmp\r
一名 。
味苦、甘，气寒。气薄味浓，沉也，阴也，阴中之阳。无毒。秋深汁
降，根实采收。日干者平，火干者温。蒸干者温补，生干者平宣。地产南北相殊，药力大小
悬隔。江浙种者，（多种肥壤。）受南方阳气，质虽光润力微；怀庆（郡名，属河南。）生者，
（多生深谷。）禀北方纯阴，皮有疙瘩力大。用试寸水，分别三名。浮者天黄，沉者地黄，
半浮沉者人黄。惟地黄独优取
服，余二者并劣检除。畏芜荑，恶贝母，忌三白。咀犯铁器肾消，（竹刀切碎。）食同萝卜发
皓。得麦门冬善为引导，拌
姜汁炒不泥膈痰。（凡饮酒人服此，
必依制之，酒病多痰，恐滞膈作胀满也。）如上达补头脑虚，或外行润皮肤燥。必资酒浸，
方促效臻。入手少阴及手太阳。
凉心火血热，俾去眼疮；泻脾土湿热，使长肌肉。骨蒸劳热可退，五心烦热堪驱。止血溢吐
衄单方，疗伤折金疮要药。
又治妇人月经闭绝，产后血上
攻心。妊娠下血漏胎，崩中下血不止。患人脉洪多热，加用何妨；倘或脾胃有寒，切宜斟酌
。花名地髓，服可延年；实研水调，效与根等。酒润蒸黑，名熟地黄。
性微温稍除寒气，入
手足少厥阴经。大补血衰，倍滋肾水。增气力，明耳目，填骨髓，益真阴。伤寒后，胫股最
痛者殊功；新产后，脐腹急痛者立效。乌髭黑发，悦色驻颜。仲景制八味丸为君，取天下所
生之源，专补肾中元气；（天一生水，故人元气属肾主之。）东垣立四物汤作主，演癸乙同归
一治，兼疗藏血之经。（癸水属肾，乙木属肝，肝为血海，故云藏血经也。）久久服之，明目
益寿。
（谟）按∶丹溪云∶气病补血，虽不中病亦无害也。读之不能无疑焉。夫补血药剂，无
逾地黄、当归，若服过多，
其性缠滞，每于胃气亦有亏尔。尝见胃虚气弱，不能营运，血越上窍者，用此合成四物汤，
以为凉血补血之剂。多服调
治，反致胸膈痞闷，饮食少进，上吐下泻，气喘呕血，日渐危迫，去死几近。此皆因血药伤
其冲和胃气，安得谓无害耶？
大抵血虚固不可专补其气，而气虚亦不可过补其血。所贵认证的真，最剂佐助，庶几不失于
偏损也。
冀州产的地黄
沂州产的地黄
又名。
味苦、甘，性寒。气薄味浓，性质沉降，属阴，为阴中之阳。无毒。深秋时节汁液下降，此时采收根部使其坚实。日晒干燥者药性平和，火烤干燥者药性偏温。蒸制后干燥者具有温补作用，生晒干燥者具有平和宣通的作用。产地南北不同，药效强弱悬殊。江浙地区种植的（多种植于肥沃土壤），受南方阳气影响，质地虽光洁滋润但药力微弱；怀庆府（郡名，隶属河南）出产的（多生长于深谷之中），禀受北方纯阴之气，表皮有疙瘩且药力强大。用试寸水法可以区分三种等级：浮在水面的是天黄，沉入水底的是地黄，半浮半沉的是人黄。只有地黄最为优良适合服用，其余两种均劣等需剔除。畏忌芜荑，厌恶贝母，禁忌“三白”（指白前、白薇、白芷，或泛指白色类药物，此处依古籍常义）。咀嚼时若接触铁器会导致肾消病（竹刀切碎）。食用时若同食萝卜会引发白发。配合麦门冬使用善于起到引导作用，拌姜汁炒制可防止痰湿阻滞胸膈。（凡是饮酒之人服用此药，必须按照上述方法炮制，因为酒病患者多痰，担心滋腻导致胸膈胀满。）如上达头部以补脑髓之虚，或外行肌肤以润皮肤之燥。必须借助酒浸，才能促进疗效迅速达成。归入手少阴心经及手太阳小肠经。
清降心火与血热，使眼疮得以去除；泻除脾土湿热，使肌肉得以生长。骨蒸劳热可以消退，五心烦热可以驱除。是治疗出血、吐血、鼻衄的单方良药，也是治疗跌打损伤和金创的重要药物。
又治疗妇人月经闭止不通，产后恶露上攻于心。妊娠期间下血漏胎，崩中下血不止。患者脉象洪大且多热证，加入使用有何妨碍？倘若脾胃有寒证，务必仔细斟酌。其花名为地髓，服用可延年益寿；果实研碎用水调服，疗效与根部相同。酒润蒸黑后，名为熟地黄。
性微温，稍能祛除寒气，归入手足少阴肾经及手足厥阴肝经。大补血液衰少，加倍滋养肾水。增加气力，明亮耳目，填补骨髓，增益真阴。伤寒病后，小腿和大腿最疼痛者，此药有特殊功效；新近产后，脐腹急痛者，此药立见成效。使胡须变黑，头发乌黑，容光焕发，驻颜不老。张仲景制作八味丸作为君药，取天下所生之源，专门补肾中元气；（天一生水，所以人的元气归属于肾主管）。李东垣创立四物汤作为主方，演绎癸水与乙木同归一治，兼疗藏血的经脉。（癸水属于肾，乙木属于肝，肝为血海，所以说它是藏血之经。）长期服用，明目益寿。
（陈嘉谟）按语：朱丹溪说：气病补血，即使不对症也没有害处。读到这里不能不产生疑问。那补血药剂，没有超过地黄、当归的，如果服用过多，其性质缠滞，往往也会亏损胃气。曾见到胃虚气弱，不能运化，血液溢出上窍的患者，用此药合成四物汤，作为凉血补血的药剂。多服调理，反而导致胸膈痞闷，饮食减少，上吐下泻，气喘呕血，日渐危重紧迫，离死不远。这都是因为血药损伤了冲和的胃气，怎么能说没有害处呢？
大致血虚固然不可专补气，而气虚也不可过补血。可贵之处在于辨证准确，最讲究药物的佐助配合，这样才能不失于偏颇损害。
Rehmanniae Radix from Jizhou
Rehmanniae Radix from Yizhou
Also known as.
Taste: Bitter, Sweet. Nature: Cold. Qi is thin and flavor is strong; it sinks and belongs to Yin, specifically Yang within Yin. Non-toxic. In late autumn, when the juice descends, the roots are harvested and solidified. Sun-dried ones have a neutral nature; fire-dried ones have a warm nature. Steamed and dried ones have warming and tonifying effects; raw-dried ones have neutral and dispersing effects. Due to differences in production areas between north and south, the potency varies greatly. Those planted in Jiangsu and Zhejiang (mostly grown in fertile soil) are influenced by the Yang Qi of the south; although their texture is smooth and moist, their medicinal power is weak. Those produced in Huaiqing Prefecture (a commandery name belonging to Henan) (mostly growing in deep valleys) inherit the pure Yin of the north; their skin has bumps and their power is strong. Using the "inch-water" test method, three grades can be distinguished: those floating on the water surface are Tianhuang (Heavenly Rehmannia); those sinking to the bottom are Dihuang (Earthly Rehmannia); those half-floating and half-sinking are Renhuang (Human Rehmannia). Only Dihuang is superior and suitable for use; the other two are inferior and should be discarded. It fears *Elaeagnus umbellata* (Wuyi), detests *Fritillaria thunbergii* (Beimu), and taboos "Sanbai" (Three Whites). Chewing while contacting iron vessels may cause Shenxiao disease (Kidney Wasting-Thirst) (cut with bamboo knife). Consuming it together with radish may cause hair whitening. Combined with *Ophiopogon japonicus* (Maidong), it serves well as a guiding agent; stir-fried with ginger juice, it prevents phlegm stagnation in the chest and diaphragm. (For those who consume alcohol, this herb must be processed according to these methods, as alcohol-induced diseases often involve phlegm, and there is fear of stagnation causing chest fullness.) If used to reach the upper body to tonify brain marrow deficiency, or to act externally to moisturize dry skin, it must be soaked in wine to promote rapid efficacy. It enters the Hand-Shaoyin Heart Meridian and Hand-Taiyang Small Intestine Meridian.
It cools Heart Fire and Blood Heat, allowing eye sores to heal; it drains Damp-Heat from Spleen Earth, enabling muscle growth. Bone-steaming consumptive fever can be retreated; five-palm heat can be driven away. It is a single-prescription remedy for stopping bleeding, vomiting blood, and epistaxis, and an essential medicine for treating trauma and metal wounds.
It also treats amenorrhea in women, and postpartum blood attacking the heart. For pregnancy-related bleeding and threatened abortion, or metrorrhagia with continuous bleeding: if the patient's pulse is surging and indicates excessive heat, adding it poses no harm; however, if there is Cold in the Spleen and Stomach, careful consideration is required. Its flower is named Disui (Earth Marrow); taking it can prolong life; its seeds ground and mixed with water have efficacy equal to the root. Wine-moistened and steamed until black, it is named Shudihuang (Prepared Rehmannia Root).
Nature: Slightly Warm. It slightly dispels Cold and enters the Foot-Shaoyin Kidney Meridian and Hand-Foot-Jueyin Liver Pericardium Meridians. It greatly tonifies Blood deficiency and doubles nourishes Kidney Water. It increases Qi strength, brightens eyes and ears, fills bone marrow, and benefits True Yin. For post-typhoid leg and thigh pain, it shows special merit; for acute abdominal pain after recent childbirth, it produces immediate effect. It darkens beard and hair, enhances complexion, and preserves youth. Zhang Zhongjing formulated Ba Wei Wan (Eight-Ingredient Pill) using it as the Sovereign drug, drawing from the source of all things born under heaven, specifically to tonify Yuan Qi in the Kidney; (Heaven generates One with Water, so human Yuan Qi is governed by the Kidney). Li Dongyuan established Si Wu Tang (Four Substance Decoction) as the Principal formula, evolving the treatment where Gui Water (Kidney) and Yi Wood (Liver) return to one therapy, simultaneously treating the meridian storing Blood. (Gui Water belongs to the Kidney, Yi Wood belongs to the Liver; the Liver is the Sea of Blood, hence it is called the meridian storing Blood.) Long-term consumption brightens the eyes and extends longevity.
(Chen Jiamo) Commentary: Zhu Danxi said: "Tonifying Blood for Qi diseases causes no harm even if not perfectly indicated." Reading this raises doubts. Among blood-tonifying herbs, none surpass *Rehmanniae Radix* (Dihuang) and *Angelicae Sinensis Radix* (Danggui). If taken in excess, their cloying nature often damages Stomach Qi. I have seen patients with deficient Stomach and weak Qi, unable to circulate, suffering from bleeding from upper orifices. Using this herb to form Si Wu Tang (Four Substance Decoction) as a cooling and blood-tonifying prescription, and administering it frequently for regulation, instead caused chest and diaphragm stuffiness, reduced appetite, vomiting and diarrhea, asthma, hematemesis, worsening daily towards death. This is precisely because blood-tonifying herbs damaged the harmonious Stomach Qi; how can one say it is harmless?
Generally, while Blood deficiency should not be treated solely by tonifying Qi, Qi deficiency should not be over-treated by tonifying Blood. The value lies in accurate syndrome differentiation and appropriate adjuvant assistance, thereby avoiding bias and damage.