蜀川者佳。根如蒿。多须而紫黑细小。极坚。削去皮。青绿色者谓之鸡骨升麻。功力
殊胜。虚大黄白色者。不堪用。一种外黑里白。质虽紧实。谓之鬼脸升麻。一种纯青色。质
亦坚。功力俱逊。川产青绿者。
根味微苦甘。气平性温。气味俱薄。浮而升。阳也。为足阳明太阴引经的药。得葱白白
芷。亦入手阳明太阴经。升清阳。奉生气。治阳陷眩晕。举久泄下痢后重。遗浊带下崩中。
血淋下血。并发散本经风邪。解肌肉风热。消斑疹及游风肿毒。辟时气毒疠邪气。蛊毒入口
皆吐。疗喉痛口疮。牙龈烂臭。又治小儿热壅惊痫。（诸本草）其用有四。手足阳明引经。
一也。升阳气于至阴之下。二也。去至高之上及皮肤风邪。三也。治阳明头痛。四也。补脾
胃药非此引用不效。治脾痹非其梢不能除。（洁古）引参 上行。补卫气之散而实其表。又
缓带脉之缩急。又凡胃虚伤冷。郁遏阳气于脾土者。宜升麻葛根以升散其火郁。（东垣）凡
醉饱房劳。阳气致陷于至下之乡。或呕吐下痢过伤。而小腹急痛。或大小便难腰滞。而后重
窘迫。或疮肿下陷黑紫。并湿盛脾痹者。非此无以升提发散。扶正而驱邪也。（能）升麻葛
根汤。本发散阳明风寒药也。用治阳气郁遏。及元气下陷诸病。时行赤眼。殊效。一人寒月
哭母受冷。遂病寒中。食无姜蒜。不能一啜。至夏酷暑。又多饮水。兼怀怫郁。因病右腰一
点胀痛。牵引右胁。上至胸口。则必卧下。大便里急后重。频欲登圊。小便长而数。或吞酸
吐水。或作泻。厥逆阳痿。得酒得热。病亦稍止。但受寒食寒。或入房劳役。或怒或饥。即
时举发。一止则诸证泯然。甚则日发数次。服温脾胜湿滋补消导诸药。皆微止随发。此乃饥
饱劳逸。内伤元气。清阳陷遏不能上升所致也。遂用升麻葛根汤合四君加柴胡苍术黄 煎服。
仍饮酒一二杯助之。其药入腹。即觉清气上行。胸膈爽快。手足和暖。头目精明。诸证如扫。
每发一服即止。若减升葛。或不饮酒。则效便迟。大抵人年五十以后。其气消者多。长者少。
降者多。升者少。秋冬之令多。春夏之令少。若禀受弱而有前诸证者。并宜此药活法治之。
同郁金服。治蛊毒。不吐则下。（毒在上用升麻吐之。在腹用郁金下之。或合二物服之。）君
人参莲肉。拣绿色升麻醋炒。治噤口痢有神。同石膏知母麦冬竹叶。治阳明热极发斑。头疼
口渴。同荆防芩甘白芷。去皮肤风邪。同葛根荆芥菊花甘草。解肌肉间风热。兼发浮汗。同
生地麦冬元参连翘甘草葛根。治牙根浮烂恶臭。同生地麦冬牛膝蒲黄。治小儿尿血。同黄连
红曲滑石白芍莲肉甘草。治一切滞下为要药。升麻葛根汤。散胃经热邪。发斑疹。及天行豌
豆疮。（水煎棉沾湿之）引葱白。散手阳明风邪。引石膏。止阳明齿痛。或加生地麦冬知母
丹皮黄柏连翘元参弥良。入升阳散火汤。治阳气郁遏。及元气不足。阳气下陷。为小儿斑疹
及痘疮圣药。未见点时可用。见标后不可用。
〔论〕 升麻禀春阳之气以生。华于夏。（四月）实于季夏后。（六月）是气畅于火而宿
于土也。其实黑色。其根紫黑色。是畅于火宿于土者。归根于至阴之水也。本水土合德以立
地。然后火土合德以际天。即其气味之薄。先苦后甘者。非从下而上。毕达其升浮之功乎。
夫升阳气于至阴之下。何以与中土相关。盖胃之阳根于脾之阴。而脾与肝肾同会于关元。（经
云。脐下三寸。关元也。三结交者。阳明太阴也。）升麻直入阳明太阴之元。引清气以上行。
即
缪氏云。凡吐衄咳嗽。阴虚火动。气逆呕吐。及惊悸怔忡。癫狂等病。咸忌。
〔辨治〕质轻而坚。色黑者佳。发散生用。补中酒炒。止咳汗蜜炒。治滞下醋拌炒。
产自蜀地（四川）的升麻品质最佳。其根部形状像蒿草，须根多且呈紫黑色、细小，质地极其坚硬。削去外皮后，呈现青绿色的称为“鸡骨升麻”，药效特别显著；虚胖、大黄白色者，不堪使用。还有一种外黑内白，质地虽然紧实，但被称为“鬼脸升麻”；另一种纯青色，质地也坚硬，但药效都较差。产于川地的青绿色升麻最好。
根部味道微苦甘，气平性温，气味都很淡薄，药势浮而上升，属于阳。它是足阳明胃经和足太阴脾经的引经药。配合葱白和白芷，也能进入手阳明大肠经和手太阴肺经。它能提升清阳之气，奉养生气，治疗阳气下陷引起的眩晕，提升中气以治疗久泻、痢疾后的里急后重，治疗遗精、白带过多及崩漏，治疗血淋和下血。同时发散本经的风邪，解除肌肉层面的风热，消除斑疹以及游走性的风肿毒气，辟除时行疫疠邪气。蛊毒入口会引起呕吐。治疗喉痛、口疮、牙龈腐烂发臭。又治疗小儿因热壅导致的惊痫。（出自《诸本草》）它的作用有四个方面：一是作为手足阳明经的引经药；二是将阳气从至阴之下提升上来；三是去除至高之处及皮肤的风邪；四是治疗阳明头痛。补充脾胃的药物如果不加此药作为引导则无效。治疗脾痹不用它的梢部不能祛除病邪。（出自张洁古）它能引导人参上行，补益卫气的散失并充实肌表。又能缓解带脉的收缩紧急。此外，凡是胃虚受冷，导致阳气被郁遏在脾土中的情况，适宜用升麻葛根汤来升散其火郁。（出自李东垣）凡是醉酒饱食或房劳过度，导致阳气陷入最下方的部位，或者呕吐腹泻过度损伤，出现小腹急痛，或者大小便困难腰部滞涩，以及里急后重窘迫感，或者疮肿下陷呈黑紫色，以及湿盛导致的脾痹等情况，非用此药无法升提发散，扶正驱邪。（出自王好古/能始）
升麻葛根汤，原本是发散阳明风寒的药。用于治疗阳气郁遏及元气下陷的各种疾病，对时行赤眼有特效。有一人寒冬月为母亲哭丧受寒，于是患上寒中症，吃姜蒜等辛辣食物都无法下咽。到了夏天酷暑，又大量饮水，兼有抑郁情绪，因而患病，表现为右腰部一点胀痛，牵引至右胁，上至胸口就必须躺下。大便里急后重，频繁想上厕所。小便长而频数。有时吞酸吐水，有时腹泻。出现厥逆和阳痿。得到酒或热物后，病情稍止。但只要受寒、吃寒凉食物，或进行房事劳累，或发怒或饥饿，病情立即发作。一次停止后，所有症状消失。严重时一天发作数次。服用温脾、胜湿、滋补、消导等各种药物，都只是轻微缓解随即复发。这是因饥饱劳逸不当，内伤元气，清阳下陷被遏不能上升所致。于是用升麻葛根汤合四君子汤，加柴胡、苍术、黄芩煎服。仍让患者饮用一二杯酒以助药力。药入腹中，即感觉清气上行，胸膈爽快，手足温暖，头目清明，诸证如扫。每发作时服用一剂即可停止。如果减少升麻和葛根的用量，或不饮酒，则疗效变慢。大抵人年过五十以后，消耗的气多，生长的气少；下降的气多，上升的气少；秋冬的时令多，春夏的时令少。如果禀赋虚弱而有上述各种症状的人，都适宜用这种药物的活法来治疗。与郁金同服，可治蛊毒，不引起呕吐则通过下行排出。（蛊毒在上部用升麻催吐，在腹部用郁金攻下，或将两物合用。）与人参、莲肉同用，拣选绿色升麻用醋炒，治疗噤口痢有神奇效果。与石膏、知母、麦冬、竹叶同用，治疗阳明热极引发的发斑、头疼、口渴。与荆芥、防风、黄芩、甘草、白芷同用，去除皮肤风邪。与葛根、荆芥、菊花、甘草同用，解除肌肉间的风热，兼发浮汗。与生地、麦冬、元参、连翘、甘草、葛根同用，治疗牙根浮烂恶臭。与生地、麦冬、牛膝、蒲黄同用，治疗小儿尿血。与黄连、红曲、滑石、白芍、莲肉、甘草同用，是治疗一切痢疾的要药。升麻葛根汤，散发胃经热邪，发出斑疹，以及天行豌豆疮。（用水煎煮，用棉沾湿敷之）。引导葱白，散发手阳明风邪。引导石膏，止阳明齿痛。或者加入生地、麦冬、知母、丹皮、黄柏、连翘、元参，效果更好。加入升阳散火汤，治疗阳气郁遏及元气不足、阳气下陷，是治疗小儿斑疹及痘疮的圣药。在未见皮疹点时可用，见到皮疹标象后不可再用。
〔论〕 升麻禀受春阳之气而生，在夏季开花（四月），在季夏之后结果（六月）。这说明其气畅达于火而归宿于土。其实色黑，其根紫黑色，说明其畅达于火而归宿于土，归根于至阴之水。它本乎水土合德而立地，然后火土合德以接天。从其气味淡薄，先苦后甘来看，不正体现了从下而上，毕达其升浮之功吗？将阳气从至阴之下提升上来，为何与中土相关？因为胃的阳根源于脾的阴，而脾与肝肾同会于关元。（经文说：脐下三寸为关元。三结交者，指阳明和太阴。）升麻直入阳明太阴之元，引导清气以上行。正如缪希雍所说：凡是吐血、衄血、咳嗽、阴虚火动、气逆呕吐，以及惊悸怔忡、癫狂等疾病，都应忌用。
〔辨治〕 质地轻而坚，颜色黑者佳。发散功效生用，补中益气酒炒，止咳止汗蜜炒，治疗痢疾醋拌炒。
The Shengma (Rhizoma Cimicifugae) produced in Shu (Sichuan) is of the best quality. The root resembles Artemisia, with numerous fine, purplish-black, and slender fibrous roots; it is extremely hard. After peeling off the skin, those that are bluish-green are called "Chicken Bone Shengma" (Cimicifugae Rhizoma cum Radice), which possesses superior efficacy. Those that are hollow, yellowish-white, and large are unsuitable for use. There is a variety that is black on the outside and white on the inside; although firm, it is called "Ghost Face Shengma". Another variety is purely green and also hard, but both have inferior efficacy. Among those produced in Sichuan, the bluish-green ones are best.
The root tastes slightly bitter and sweet, has a neutral qi and warm nature. Its scent and taste are both faint; its action floats and ascends, belonging to Yang. It serves as a guiding herb for the Foot-Yangming Stomach Meridian and Foot-Taiyin Spleen Meridian. When combined with Congbai (Scallion White) and Baizhi (Radix Angelicae Dahuricae), it also enters the Hand-Yangming Large Intestine Meridian and Hand-Taiyin Lung Meridian. It raises clear Yang, nourishes vital Qi, treats vertigo caused by sinking of Yang, lifts middle Qi to treat chronic diarrhea and tenesmus following dysentery, treats spermatorrhea, leukorrhea, and metrorrhagia, treats hematuria and lower gastrointestinal bleeding. Simultaneously, it disperses wind pathogens from these meridians, resolves wind-heat at the muscle level, eliminates macules/rash and migratory wind-swelling/toxins, wards off seasonal epidemic toxins and pestilential evils, and induces vomiting when gu poison enters the mouth. It treats sore throat, oral ulcers, and putrid, rotting gums. It also treats infantile convulsions due to heat obstruction. (From *Zhu Bencao*) Its functions are fourfold: first, it acts as a guiding herb for the Hand and Foot Yangming meridians; second, it raises Yang Qi from below the Supreme Yin; third, it removes wind pathogens from the highest regions and the skin; fourth, it treats Yangming headaches. Tonifying spleen and stomach formulas are ineffective without this herb as a guide. To treat Pi Bi (Spleen Obstruction), one must not use anything other than its tip. (From Zhang Jiegu) It guides Renshen (Ginseng Root) upward, supplements the dispersion of Wei Qi (Defensive Qi) and solidifies the exterior. It also relieves the contraction and urgency of the Dai Mai (Girdle Vessel). Furthermore, in cases of Stomach deficiency with cold injury, where Yang Qi is constrained within the Spleen Earth, it is appropriate to use Shengma Gegen Tang (Cimicifuga and Kudzu Decoction) to raise and disperse Fire Depression. (From Li Dongyuan) In cases of drunkenness, overeating, or sexual exhaustion causing Yang Qi to sink to the lowest region, or excessive vomiting and diarrhea damaging the body, resulting in acute pain in the lower abdomen, difficulty in urination and defecation with waist stagnation, and severe tenesmus, or carbuncles/swellings that sink and turn dark purple, or dampness-heavy Pi Bi, only this herb can lift and disperse, support righteousness, and expel evil. (From Wang Haogu)
Shengma Gegen Tang (Cimicifuga and Kudzu Decoction) was originally a formula to disperse Wind-Cold of the Yangming channel. It is used to treat various diseases of constrained Yang Qi and sinking Yuan Qi (Primal Qi); it is particularly effective for epidemic red eyes. A patient who suffered cold exposure while mourning his mother in winter developed "Han Zhong" (Cold Middle Syndrome), unable to consume even ginger or garlic. In the summer heat, he drank much water and harbored depression, leading to a disease characterized by a painful swelling point in the right lumbar region radiating to the right hypochondrium and chest, requiring him to lie down. He experienced tenesmus, frequent urges to defecate, long and frequent urination, acid regurgitation, vomiting of water, or diarrhea. He presented with cold limbs (Jue Ni) and impotence. Symptoms subsided slightly with wine or heat but flared immediately upon cold exposure, cold food, sexual activity, labor, anger, or hunger. Each episode lasted briefly before all symptoms vanished. Severe cases occurred several times daily. Treatments with herbs to warm the spleen, overcome dampness, tonify, or aid digestion provided only temporary relief. This was due to internal injury to Yuan Qi from irregular diet and labor, causing Clear Yang to sink and be constrained, unable to ascend. Thus, Shengma Gegen Tang was combined with Sijunzi Tang (Four Gentlemen Decoction), adding Chaihu (Bupleuri Radix), Cangzhu (Atractylodis Rhizoma), and Huangqin (Scutellariae Radix), decocted and taken. The patient was advised to drink one or two cups of wine to assist the medicine. Upon ingestion, he felt clear Qi ascending, chest and diaphragm becoming comfortable, hands and feet warming, head and eyes becoming bright, and all symptoms swept away. One dose stopped each flare. Reducing Shengma and Gegen, or omitting wine, delayed efficacy. Generally, after age fifty, people have more consumption than growth, more descent than ascent, and more of autumn/winter qualities than spring/summer. Those with weak constitution presenting such symptoms should be treated with this flexible approach. Combined with Yujin (Curcumae Radix), it treats Gu Poison; if it does not induce vomiting, it causes downward expulsion. (If Gu poison is upper, use Shengma to induce vomiting; if abdominal, use Yujin to purge; or combine both.) With Renshen and Lianrou (Lotus Seed Endosperm), using vinegar-fried green Shengma, it treats Jin Kou Li (Anorectic Dysentery) with miraculous effect. With Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix), and Zhuye (Phyllostachys Folium), it treats macules due to extreme Yangming Heat, headache, and thirst. With Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Huangqin, Gancao (Glycyrrhizae Radix et Rhizoma), and Baizhi, it removes skin wind pathogens. With Gegen, Jingjie, Juhua (Chrysanthemi Flos), and Gancao, it resolves muscle-level wind-heat and induces slight sweating. With Shengdi (Rehmanniae Radix), Maidong, Yuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), Gancao, and Gegen, it treats floating, rotting, and foul-smelling gums. With Shengdi, Maidong, Niuxi (Achyranthis Bidentatae Radix), and Puhuang (Typhae Pollen), it treats pediatric hematuria. With Huanglian (Coptidis Rhizoma), Hongqu (Red Yeast Rice), Huashi (Kaolin), Shaoyao (Paeoniae Radix Alba), Lianrou, and Gancao, it is a key drug for all types of Li Xia (Dysentery). Shengma Gegen Tang disperses Stomach meridian heat pathogens, brings out macules/rash, and treats epidemic pea pox. (Decoct in water, soak cotton, and apply.) Guiding Congbai disperses Hand-Yangming wind pathogens. Guiding Shigao stops Yangming toothache. Adding Shengdi, Maidong, Zhimu, Danpi (Moutan Cortex), Huangbai (Phellodendri Cortex), Lianqiao, and Yuanshen improves efficacy. Added to Shengyang Sanhuo Tang (Raise Yang and Disperse Fire Decoction), it treats constrained Yang Qi, insufficient Yuan Qi, and sinking Yang Qi; it is a sacred medicine for pediatric macules/rash and smallpox. It can be used before spots appear, but not after they manifest.
[Discussion] Shengma grows by inheriting Spring Yang Qi, flowers in Summer (April), and fruits in late Summer (June). This indicates its Qi flows freely through Fire and resides in Earth. Its fruit is black, and its root is purplish-black, indicating it flows through Fire, resides in Earth, and returns to Supreme Yin Water. It establishes itself on earth through the virtue of Water and Earth combining, then meets heaven through the virtue of Fire and Earth combining. From its faint scent and taste, starting bitter and ending sweet, does it not demonstrate its ascending and floating function from below to above? Why does raising Yang Qi from below Supreme Yin relate to Central Earth? Because the Yang of the Stomach is rooted in the Yin of the Spleen, and the Spleen converges with the Liver and Kidneys at Guan Yuan (Guanyuan CV4). (The Classic states: Three cun below the navel is Guan Yuan. The "Three Intersections" refer to the Yangming and Taiyin meridians.) Shengma directly enters the origin of the Yangming and Taiyin meridians, guiding Clear Qi upward. As Mu Xi said: For conditions such as hematemesis, epistaxis, cough, Yin deficiency with Fire hyperactivity, rebellious Qi with vomiting, as well as palpitations, fright, mania, etc., it is strictly contraindicated.
[Differentiation and Treatment] Light and firm texture, black color is best. Use raw for dispersing; wine-fry for tonifying the middle; honey-fry for stopping cough and sweat; vinegar-stir-fry for treating dysentery.