八月采根。如指大。边白中微黄。有心。味苦而辛。苦为胜。若无心味甜者。荠
耳。有一种木梗真同桔梗。只是咬之腥涩不堪为异。
根苦辛甘平。微温。味浓气轻。入手太阴肺经气分及少阴经。兼入足阳明经。主治喉咽
痛。肺热气促嗽逆。除鼻塞。清利头目。口舌生疮。赤目肿痛。肺部风热。胸膈滞气及痛。
疗胸胁痛如刀刺。胸腹胀满。肠鸣幽幽。惊恐悸气。下一切气。（肺金得令则浊气自下行）
破血积气。消聚痰涎。治肺痈养血排脓。补内漏。桔梗利胸中之气。能开提气血。盖中焦为
气所从出之处。如有痰水饮食压在气上。惟用桔梗开通壅塞之道。升提其气上行。能使痰水
饮食降下也。干咳嗽。由痰火之邪郁在肺中。宜苦桔以开之。痢疾腹痛。乃肺金之气郁在大
肠。亦宜苦桔开之。后用痢药。（丹溪）与甘草同行。为舟楫之剂。诸药有此一味。不能下
沉。（洁古）胸中痞满不通。同枳壳用。取其通肺利膈下气也。寒实结胸。同贝母巴豆用。
取其温中消谷破积也。肺痈唾脓。同甘草用。取其苦辛清肺。甘温泻火。又能排脓血补内漏
也。少阴咽痛。亦用甘桔。取其苦辛散寒。甘平除热。合用能调寒热也。后人通治咽喉口舌
诸病。加荆防连翘。名如圣汤。（濒湖） 与牡蛎远志同用。疗恚怒。与石膏葱白同用。能
升气于至阴之下。与硝黄同用。能引至胸中至高之分。利五脏肠胃。
〔论〕 桔梗色白。而心微黄。质禀金气。其味先苦后辛。化火者仍归于金。是苦而胜
者。正金气之归元。乃还而大畅其横遍之用耳。盖由辛宣而苦泻。以至于地。使无有壅阏
。旋归辛宣者。统其气化而至于天。故能开提气血。为诸药之任载。惟兼升降而尽其功于辛
宣。与上升之剂不同。所主咽痛鼻塞肺热咳逆奔促。乃其专功。至如余证。由其能行上行表。
使气血流通耳。海藏谓入足少阴者。以桔梗固气分药。而肾为气之元。苦则至下也。（方书
治香港脚剂中。有桔梗。须空心服。益证此味之入肾矣。丹溪云。香港脚湿者。须先升提之。不
用升柴。而以此代。其义可思。）桔梗与紫菀。味俱先苦后辛。苦胜辛劣。而紫菀之苦尤胜。
但桔梗质白属金。从金化火。仍归于金。是金能用火。金为主也。紫菀色紫属火。即从火生
苦。苦为胜而终之以微金。是火为金用。火又主也。若诃子止有涩而无辛。其苦味最胜。则
是金从火为用也。
下虚及怒气上升。（嵩）又凡气逆不得下降者。弗用。攻补下焦药中。勿入。（仲淳）
〔修治〕 去头及两畔附枝。米泔浸一宿。焙干。
八月采集根部。粗细如手指。外皮白色，中心微黄。中间有芯。味道苦而辛，以苦味为主。如果没有芯且味道甜的，是荠耳（一种伪品）。有一种名为“木梗”的植物，外形与桔梗完全相同，只是咬起来有腥涩味，不堪入药，以此作为区别。
根味苦、辛、甘，性平，微温。气味浓郁但质地轻清。归入手太阴肺经的气分以及足少阴肾经，兼入足阳明胃经。主治咽喉疼痛，肺热引起的呼吸急促、咳嗽气逆，消除鼻塞，清利头目，口舌生疮，眼睛红肿疼痛，肺部风热，胸膈部气机阻滞及疼痛，治疗胸胁疼痛如刀刺一般，胸腹胀满，肠鸣音低沉，惊恐心悸气乱，通降一切气滞。（当肺金之气当令时，浊气自然下行）破散血积和气滞，消散积聚的痰涎，治疗肺痈（肺部化脓性疾病），养血排脓，补益内脏漏泄之症。桔梗能疏通胸中之气，能够升提气血。因为中焦是气机升降出入的关键部位，如果有痰饮、水湿或饮食停滞压迫在气机上，只有使用桔梗来开通壅塞的道路，升提其气上行，才能使痰饮水食随之降下。对于干咳，是由痰火邪气郁结在肺中引起，适宜用苦桔梗来开宣肺气。痢疾腹痛，是由于肺金之气郁结在大肠所致，也适宜用苦桔梗来开宣肺气，之后再使用治痢的药物。（朱丹溪观点）桔梗与甘草同用，成为“舟楫之剂”，其他药物若有此一味配合，便不会下沉。（张元素观点）治疗胸中痞闷胀满不通，可与枳壳同用，取其通利肺气、宽胸利膈、降气的作用。寒实结胸证，可与贝母、巴豆同用，取其温中消谷、破积散结的作用。肺痈咳吐脓血，可与甘草同用，取其苦辛清肺、甘温泻火，又能排脓血、补内漏的功效。少阴经咽痛，也使用甘草和桔梗，取其苦辛散寒、甘平除热，合用能调和寒热。后人通治咽喉口舌各种疾病，加入荆芥、防风、连翘，命名为如圣汤。（李时珍观点）桔梗与牡蛎、远志同用，可治疗因愤怒导致的情志病；与石膏、葱白同用，能将气机升提至至阴之下；与大黄、芒硝同用，能引导药力到达胸中至高之处。它能利五脏肠胃。
【论述】 桔梗颜色白，心微黄，质地禀受金气。其味道先苦后辛，化火后仍归于金，这是苦味胜出的表现，正是金气回归本源，从而使其横向遍布的功能得以畅达。大概是因为辛能宣散，苦能泻下，作用下达于地，使体内没有壅塞阻滞。随后又回归辛宣，统摄气化功能上达于天。所以能开提气血，作为诸药的载体。它只有在兼具升降功能并充分发挥辛宣作用时才能建功，这与单纯上升的药剂不同。它所主治的咽痛、鼻塞、肺热咳嗽气急奔促，是其专长。至于其他病症，是因为它能行于上部和体表，使气血流通的缘故。王海藏认为桔梗入足少阴肾经，是因为桔梗确实是气分药，而肾为元气之根，苦味能引药下行。（方书中治疗脚气病的方剂里有桔梗，必须空腹服用，更加证实了该药入肾的特性。朱丹溪说，湿热型脚气病，必须先升提气机，不使用升麻、柴胡，而用桔梗代替，其中的道理值得深思。）桔梗与紫菀，味道都是先苦后辛，苦味胜出，辛味较弱，而紫菀的苦味尤其强盛。但桔梗质白属金，从金化火，最终仍归于金，这是金能利用火，金为主宰。紫菀色紫属火，即从火生苦，苦味胜出，最终带有微弱的金性，这是火被金所用，火为主宰。如果诃子只有涩味而没有辛味，其苦味最胜，那就是金从属于火发挥作用。
下元虚损及怒气上冲者禁用。（高鼓峰观点）凡是气逆不能下降的情况，都不宜使用。在攻补下焦的药物中，不要加入。（陈实功观点）
In the eighth month, harvest the roots. They are as thick as a finger. The outer layer is white, and the center is slightly yellow. There is a core in the middle. The taste is bitter and acrid, with bitterness prevailing. If there is no core and the taste is sweet, it is *Ji'er* (a type of adulterant). There is a plant called "Mugeng" that looks exactly like Jiegeng, but it has an unpleasant fishy and astringent taste when chewed, which serves as a distinction.
The root tastes bitter, acrid, and sweet; its nature is neutral, slightly warm. Its flavor is strong, but its qi is light. It enters the Qi aspect of the Hand-Taiyin Lung Meridian and the Foot-Shaoyin Kidney Meridian, and also enters the Foot-Yangming Stomach Meridian. It mainly treats sore throat, lung heat causing rapid breathing, cough, and rebellious qi; removes nasal congestion; clears and benefits the head and eyes; treats sores on the mouth and tongue; red, swollen, and painful eyes; wind-heat in the lungs; stagnation of qi in the chest and diaphragm accompanied by pain; treats stabbing pain in the chest and hypochondrium; chest and abdominal fullness; low-pitched borborygmi; fright, palpitations, and chaotic qi; and descends all types of qi stagnation. (When Lung Metal qi is in command, turbid qi naturally descends.) It breaks up blood stasis and qi accumulation, dissipates accumulated phlegm and saliva, treats Lung Abscess (pulmonary suppurative disease), nourishes blood, expels pus, and supplements internal leakage. Jiegeng unblocks the qi in the chest and can elevate blood and qi. Since the Middle Jiao is the source from which qi emerges, if phlegm-fluids, water-dampness, or food retention presses upon the qi, only by using Jiegeng to open the pathways of obstruction and elevate its qi upward can the phlegm-fluids and food be caused to descend. For dry cough caused by phlegm-fire pathogenic factors depressed in the lungs, bitter Jiegeng should be used to open the lung qi. For dysentery with abdominal pain, which results from Lung Metal qi being depressed in the Large Intestine, bitter Jiegeng should also be used to open the lung qi, followed by the administration of dysentery remedies. (View of Zhu Danxi) When used together with Gancao (Licorice Root), it forms a "boat-like agent"; other medicines, with this one ingredient, cannot sink. (View of Zhang Yuansu) To treat chest stuffiness and fullness with blockage, use it together with Zhike (Aurantium Fructus), taking advantage of its ability to unblock the Lung, benefit the diaphragm, and direct qi downward. For Cold-Excess Jiechest (cold-phlegm binding in the chest), use it together with Beimu (Fritillaria Bulb) and Badou (Croton Seed), taking advantage of its ability to warm the middle, digest food, and break up accumulations. For Lung Abscess with expectoration of pus and blood, use it together with Gancao, taking advantage of its bitter-acrid property to clear the Lung, its sweet-warm property to drain fire, and its ability to expel pus and blood and supplement internal leakage. For Shaoyin meridian sore throat, Gancao and Jiegeng are also used, taking advantage of their bitter-acrid property to disperse cold and their sweet-neutral property to clear heat; combined, they can harmonize cold and heat. Later generations generally treated various diseases of the throat and mouth with it, adding Jingjie (Schizonepeta Herb), Fangfeng (Saposhnikovia Root), and Lianqiao (Forsythia Fruit), naming it Rusheng Tang (Like-Sage Decoction). (View of Li Shizhen) Used together with Muli (Oyster Shell) and Yuanzhi (Polygala Root), it treats emotional disorders caused by anger. Used together with Shigao (Gypsum Fibrosum) and Congbai (Scallion White), it can elevate qi to the lowest Yin region. Used together with Xiaoshi (Natrii Sulfas) and Huanglian/Huangqin (though text says Huang, likely implying purgatives like Dahuang/Mangxiao contextually, here translated as purgatives), it can guide medicinal power to the highest part of the chest. It benefits the five Zang organs and intestines and stomach.
[Discussion] Jiegeng is white in color with a slightly yellow heart, and its substance embodies Metal qi. Its taste is first bitter then acrid; after transforming into fire, it still returns to Metal. This prevalence of bitterness represents the return of Metal qi to its origin, thereby greatly facilitating its lateral and pervasive function. Generally, because Acridity disperses and Bitterness drains, the effect reaches the earth, ensuring no obstruction remains. Then it returns to Acrid dispersion, governing the transformation of qi to reach the heaven. Thus, it can open and elevate blood and qi, serving as a carrier for other herbs. It achieves its merit only by combining ascending and descending functions and fully exerting the power of Acrid dispersion; it differs from agents that merely ascend. Its main indications—sore throat, nasal congestion, lung heat, cough, and rapid breathing—are its specialized merits. As for other symptoms, it works because it travels to the upper body and exterior, allowing blood and qi to circulate freely. Haizang stated that Jiegeng enters the Foot-Shaoyin Kidney Meridian because Jiegeng is indeed a Qi-regulating herb, and the Kidney is the root of Qi; Bitterness leads downward. (In prescriptions for Hongjiao [foot swelling/weakness] found in medical books, Jiegeng is included and must be taken on an empty stomach, further confirming this herb's entry into the Kidney. Danxi said that for damp-type Hongjiao, one must first elevate and lift the qi; without using Shengma or Chaihu, one uses this herb instead. The principle is worth pondering.) Jiegeng and Ziwan (Aster Root) both have tastes that are first bitter then acrid, with bitterness prevailing over acridity, and Ziwan's bitterness is even stronger. However, Jiegeng is white in quality and belongs to Metal; it transforms from Metal to Fire and still returns to Metal. This means Metal utilizes Fire, with Metal as the master. Ziwan is purple in color and belongs to Fire; it generates Bitterness from Fire. Bitterness prevails, ultimately ending with slight Metal characteristics. This means Fire is utilized by Metal, with Fire as the master. If Hezi (Terminalia Chebula Fruit) has only astringency without acridity, and its bitterness is most prevalent, then Metal acts under the influence of Fire.
Contraindicated in deficiency of the lower Jiao and cases where angry qi rises upward. (View of Song) Furthermore, do not use it in cases where rebellious qi fails to descend. Do not include it in formulas that attack or tonify the lower Jiao. (View of Zhongchun)
[Processing] Remove the head and side branches. Soak in rice washing water overnight, then bake dry.