一名棘刺棘针。独生而高者为枣。列生而低者为棘。白棘肥盛紫色枝。有皱薄白膜。先
剥起者。厥名取白。义当在此。
气味辛寒。 本经主心腹痛。痈肿溃脓。止痛。决刺结。 别录疗丈夫虚损阴痿。精自
出。补肾气。益精髓。 棘针疗腰痛喉痹不通。
附方 腹胁刺痛不可忍。因肾脏虚冷者。棘针钩子一合焙。槟榔二钱半。水一盏。煎五
分。入好酒半盏。更煎三五沸。分二服。疔疮恶肿。外治棘针倒钩烂者三枚。丁香七枚。同
入瓶烧存性。以月内孩子粪和涂。日三上之。又内服方。曲头棘刺三百枚。陈皮二两。水五
升。煎一升半。分服。
〔论〕 准绳治溲血有鹿茸丸。中用棘刺。且合桂附。是则此味补益。乃有为之前导而
致其功者。抑更行而且补。在诸药味。或未有如斯之兼善者也。
木高丈余。叶似榆。二月开白花如杏。四月实如酸枣。赤色。五月采实。 一种雀儿苏
相似。但其核八棱。须辨之。
味酸平。气微温。阳中之阴。入足厥阴少阴经气分。又为肾之血药。 主温肝脏。助水
脏。强阴益精。补肾气。与阳道。暖腰膝。通九窍。安五脏。秘精气。止小便利。并除一切
风。逐一切气。治肾虚耳鸣耳闭。疗脑骨痛。久服明目。 方书治中风虚劳眩晕。伤燥咳嗽。
消瘅自汗。恐。腰痛胁痛。挛痹着痹。痿。香港脚。遗精浊淋泄泻。大便不通。疝痔。 人身
元气壮盛。由于精气坚固。山萸能闭精。所以壮元气也。（类明） 人身精气。赖温暖而后
充足。况肝肾居至阴之位。非得温暖之气。则孤阴无以生。此药正入二经。气温主补。味酸
主敛。故精气益而阴强也。其他所主之证。皆精气固元气壮之效耳。（仲淳） 仲景八味丸
益阳。以此为君。与六味之君地黄。殊用。 凡久泻。初用参术姜桂罔功。乃舍姜桂而用山
萸芡实。（同参术及黑姜投之）取其收肝肾之阴气。以资脾阴之化源也。 凡心血虚。致虚
火外淫而汗出不止者。不用黄 固表。但君此味以敛于中。使真阴之气不泄。而真阳乃固。
则心血可益。虚火可静也。 同菟丝苁蓉巴戟鹿茸牛膝白胶车前枸杞地黄沙苑麦冬。能添精
固髓。暖腰膝。益阳道。令人有子。 同人参五味牡蛎益智。治老人小便淋沥及遗尿。同人
参熟地人乳牛膝沙苑麦冬甘菊。治脑骨痛。以髓足则脑痛自除。 同石菖蒲甘菊地黄黄柏五
味。治肾虚耳聋。 同杜仲牛膝地黄白胶山药。治肾虚腰痛。
草还丹。用山萸酒浸取肉一斤。补骨脂酒浸焙干八两。当归四两。麝香一钱。为末。炼
蜜丸梧子大。每服八十一丸。临卧盐酒下。纲目谓其益元阳。补元气。固元精。壮元神。乃
延
〔论〕 山茱萸结实于四月。而采于五月。其色赤。是乘乎大火之气以致用也。其味酸。
其气温。是致乎火之用者。尚全乎肝之体也。火用而肝体。则阴为阳守。阳为阴使之元机。
有寓于兹物者焉。夫肝之体云何。曰。风木继寒水之后。以行地道生育之化。使不得春温之
气。则至阴之化郁。然使气温而味辛。即非春温出地之生气。不无近于热浮长之气。将阴亦
逐阳以泄。类明所谓精气不固。元气安得而壮者是矣。惟气温味酸。酸全而辛少者。乃得乎
春温之正令。而肝脏以温。肝体以全。肾阴得少阳之气以生化。而复不泄其真气。此即强阴
益精。暖水脏。补肾气。兴阳道之实诣也。第此味秘精。又言其逐寒湿痹。治效似几相戾。
不知用不离乎体。以固蛰之阴。而达必宣之阳。（如通九窍。逐一切气。逐一切风。）则精之
秘者乃所以为益精起阳之本。而益精起阳者。又所以为通九窍。逐邪气。补风虚之本也。洁
古从其体而言。谓为肾之血药。海藏以其功用言。又属肾之气药。要之涩阴乃裕阳之本。而
固阳又化阴之元。交益相需。乌能较然定其所主哉。故阴耗而滋阴。同于此味。使阴有所育
。阳虚而益阳。同于此味。使阳有所守。即祛阴阳之邪者。亦或投此味于中。以为元阴元阳
之地。山萸之用。大都不外此三例矣。抑肝之喜辛。恶其郁也。兹又取其酸收。何也。须知
结于大火之候。而得此味之涩阴固阳以裕真元。乃仿佛于取坎填离。俾元气之用不匮耳。岂
与肝之喜辛其义相背乎。然则洁古主血分之说较胜。而如补骨脂之益阳而燥者不可同日语矣
。石枣（即山萸）木瓜。同一味酸气温。但石枣全以酸胜。故止于温肝以益肾。木瓜则酸
居强半。而有甘味。故又能行土之用。而和血以去湿。方书言酸甚扶肝。酸多损肾。此语亦
须酌量。如石枣酸胜。六味正用以益肾。何以不如木瓜之多用而损齿及骨也。或亦酸如木瓜
。以其兼行土用。遂因土以制水而肾乃病欤。
缪氏。命门火炽。强阳不痿者。忌。膀胱热结。小便不利者。不宜。阴虚血弱者。不宜。
即用。当与黄柏同加。
〔修治〕 取红润肉浓者。酒拌润。去核取皮。酒蒸一炷香用。
【白棘 / 山茱萸】
别名棘刺、棘针。单独生长且高大的称为枣；成丛生长且低矮的称为棘。白棘枝条肥壮呈紫色，表面有皱缩的薄白膜。先剥去这层白膜的，才配称为“取白”，其含义应当在此处。
气味辛、寒。《本经》主治心腹疼痛、痈肿溃烂流脓、止痛、解除经络中的结滞。《别录》治疗男子虚损、阳痿、精液自出，补肾气，益精髓。棘针治疗腰痛、喉痹不通。
附方：腹胁部刺痛难以忍受，因肾脏虚冷所致者。用棘针钩子一合（计量单位），焙干，槟榔二钱半，水一盏，煎至五分，加入好酒半盏，再煮沸三五次，分两次服用。疔疮恶肿，外用：用棘针倒钩三枚（需烂熟处理），丁香七枚，同放入瓶中烧至存性（保留药性但炭化），用一个月大的婴儿粪便调和涂抹，每日三次。另有内服方：曲头棘刺三百枚，陈皮二两，水五升，煎至一升半，分次服用。
〔论述〕《准绳》治疗尿血有用鹿茸丸，其中含有棘刺，并且配合桂枝、附子，这说明此味药材的补益作用，是有其他药物作为先导而发挥功效的。或者是行气与补益兼施，在诸种药材中，或许没有像这样兼善并美的了。
木高一丈多。叶子像榆树。二月开白花，形状像杏花。四月果实成熟，像酸枣一样，呈赤色。五月采集果实。有一种类似雀儿苏的植物，但其果核有八棱，需要辨别清楚。
味道酸、平。气微温，属于阳中之阴。入足厥阴肝经和足少阴肾经的气分。又是肾的血分药。主要温暖肝脏，助益水脏（肾），强阴益精，补肾气，助长性功能，暖腰膝，通九窍，安五脏，固秘精气，止小便频数，并祛除一切风邪，驱逐一切气滞。治疗肾虚引起的耳鸣、耳闭，疗治脑骨痛。长期服用可明目。医书用于治疗中风、虚劳眩晕、伤燥咳嗽、消渴（糖尿病类症状）、自汗、恐惧感、腰痛胁痛、挛痹、着痹、痿证、脚气、遗精、浊淋、泄泻、大便不通、疝气、痔疮。人身元气壮盛，是由于精气坚固。山茱萸能闭藏精气，所以能壮元气。（出自《类明》）人身精气，依赖温暖之气而后充足。何况肝肾居于至阴之位，不得温暖之气，则孤阴无法生化。此药正入肝肾二经，气温主补，味酸主敛，所以精气得以增益，阴气得以强健。其他所主治的病证，都是精气固摄、元气壮盛的效应罢了。（出自《仲淳》）张仲景的八味丸（金匮肾气丸）旨在益阳，以山茱萸为君药，这与六味地黄丸中以地黄为君药的用法不同。凡是久泻，初用参、术、姜、桂无效时，便舍弃姜、桂而使用山茱萸、芡实（同参、术及黑姜一起投用）。取其收敛肝肾之阴气，以资助脾阴的化源。凡是心血虚，导致虚火外越而汗出不止者，不用黄芪固表，只以此味为君药以收敛于内，使真阴之气不泄露，而真阳才能稳固，那么心血可益，虚火可静。同菟丝子、肉苁蓉、巴戟天、鹿茸、牛膝、白胶、车前子、枸杞、地黄、沙苑子、麦冬同用，能添精固髓，暖腰膝，益阳道，使人能够生育。同人参、五味子、牡蛎、益智仁同用，治疗老人小便淋漓及遗尿。同人参、熟地黄、人乳、牛膝、沙苑子、麦冬、甘菊同用，治疗脑骨痛，因为髓足则脑痛自然消除。同石菖蒲、甘菊、地黄、黄柏、五味子同用，治疗肾虚耳聋。同杜仲、牛膝、地黄、白胶、山药同用，治疗肾虚腰痛。
草还丹：用山茱萸酒浸后取肉一斤，补骨脂酒浸焙干八两，当归四两，麝香一钱，研为细末，炼蜜制成梧桐子大小的丸药。每次服用八十一丸，临睡前用盐酒送下。《纲目》称其益元阳，补元气，固元精，壮元神，乃是延年益寿之方。
〔论述〕山茱萸在四月结实，五月采集，其色赤，这是借助大火之气来发挥作用。其味酸，其气温，这是顺应火的作用，尚且保全了肝的本体。火用而肝体全，则阴为阳守，阳为阴使，其中的玄机寓于这种事物之中。肝的本体是什么？曰：风木继寒水之后，以施行地道生育的变化。如果得不到春温之气，则至阴的变化就会郁结。然而，如果气温而味辛，就不符合春温出地之生气，不免近于热浮长之气，这将导致阴也随着阳而泄散。正如《类明》所说，精气不固，元气怎么能壮盛呢？只有气温而味酸，酸味纯正而辛味少，才符合春温的正令，从而使肝脏得温，肝体得全，肾阴得到少阳之气的生化，而又不再泄露真气。这就是强阴益精、暖水脏、补肾气、兴阳道的实际造诣。只是此味能秘精，又说它能逐寒湿痹，治疗效果似乎有些矛盾。不知道用药不离本体，以固蛰伏之阴，而达必宣之阳（如通九窍、逐一切气、逐一切风），那么秘精正是益精起阳的根本，而益精起阳又正是通九窍、逐邪气、补风虚的根本。洁古从其本体而言，称其为肾之血药；海藏从其功用而言，又属肾之气药。总之，涩阴是裕阳的根本，而固阳又是化阴的源头，二者交相受益，相互需要，怎么能截然确定其主要主治呢？所以阴耗而滋阴，与此味相同；阳虚而益阳，与此味相同；即使是祛阴阳之邪，有时也投以此味于其中，作为元阴元阳的基础。山茱萸的运用，大都不外乎这三条例子。再说肝喜辛，是厌恶其郁结。这里却取其酸收，为什么呢？须知在山火旺盛之时，得到此味之涩阴固阳以充裕真元，这仿佛于取坎填离，使元气之用不匮乏。这难道与肝喜辛的意义相违背吗？然而洁古主张血分之说较为胜一筹，而像补骨脂那样益阳而燥烈的药，不可同日而语。石枣（即山茱萸）与木瓜，同一味酸气温。但石枣完全以酸取胜，所以仅止于温肝以益肾。木瓜则酸占大半，而有甘味，所以又能行土之用，和血以去湿。医书说酸甚扶肝，酸多损肾。这句话也需要斟酌。如石枣酸胜，六味地黄丸正用以益肾，为什么不像木瓜那样多用而损伤牙齿和骨骼呢？或者也是像木瓜那样的酸，因为它兼行土用，遂因土以制水而导致肾病吗？
缪氏指出：命门火炽，强阳不痿者，忌用。膀胱热结，小便不利者，不宜用。阴虚血弱者，不宜用。即使使用，应当与黄柏一同加入。
〔炮制〕选取红润肉厚者，用酒拌润，去核取皮，酒蒸一炷香的时间后使用。
[Baiji / Cornus officinalis]
Also known as Jici (Thorn) and Jinzhen (Needle). The one growing alone and tall is called Zao (Jujube); the ones growing in clusters and low are called Ji (Elaeagnus). Baiji has thick, purple branches with a wrinkled, thin white membrane. Those from which this white membrane is peeled off first are truly named "Qu Bai" (Taking White), and its meaning lies here.
The flavor is Pungent (Acrid), and the nature is Cold. *Ben Jing* states it treats heart and abdominal pain, carbuncles and sores with pus discharge, relieves pain, and resolves stagnation in meridians. *Bie Lu* treats deficiency and emaciation in men, impotence, spontaneous seminal emission, tonifies Kidney Qi, and benefits essence and marrow. Jinzhen treats lower back pain and obstruction of the throat (Hou Bi).
Attached Formulas: For unbearable stabbing pain in the abdomen and hypochondrium due to Kidney deficiency and cold: Use one heaping measure of hooked thorns of Jinzhen, roasted; 2.5 qian of Areca Seed (Binglang); one cup of water, decocted to half a cup; add half a cup of good wine, boil for three to five times, and divide into two doses. For ding sores and malignant swellings, external use: Use three rotten inverted hooks of Jinzhen and seven cloves (Dingxiang), burn them together in a bottle until they retain their properties but are carbonized, mix with feces of a one-month-old infant, apply topically three times daily. Another internal formula: Three hundred curved-head thorns, two liang of Tangerine Peel (Chenpi), five sheng of water, decocted to one and a half sheng, taken in divided doses.
[Discussion] *Zhun Sheng* uses Deer Antler Pill (Lurong Wan) to treat hematuria, containing Jici, combined with Cinnamon Twig (Guizhi) and Aconite Root (Fuzi). This indicates that the tonifying effect of this herb relies on other herbs as guides to achieve its efficacy. It combines moving qi and tonifying. Among various herbs, few possess such comprehensive virtues.
The tree grows over one zhang high. Leaves resemble elm. In the second lunar month, it opens white flowers resembling apricot blossoms. In the fourth month, fruits ripen, resembling sour jujubes, reddish in color. Harvest the fruits in the fifth lunar month. There is a plant similar to Que'er Su, but its seeds have eight ridges; these must be distinguished.
The flavor is Sour, and the nature is Neutral. The qi is slightly warm, belonging to Yin within Yang. It enters the Qi aspect of the Foot Jueyin Liver Meridian and the Foot Shaoyin Kidney Meridian. It is also a blood herb of the Kidney. It primarily warms the Liver, assists the Water Organ (Kidney), strengthens Yin, benefits essence, tonifies Kidney Qi, aids sexual function, warms the waist and knees, unblocks the nine orifices, calms the Five Viscera, secures essence and qi, stops frequent urination, expels all wind pathogens, and drives out all stagnant qi. It treats tinnitus and deafness due to Kidney deficiency, cranial bone pain. Long-term use brightens the eyes. Medical texts treat stroke, consumptive disorders, vertigo, dryness injury cough, xiao-cao (wasting-thirst/diabetes), spontaneous sweating, fear, lower back and hypochondriac pain, spasmodic bi syndrome, fixed bi syndrome, flaccidity syndrome, beriberi, spermatorrhea, turbid strangury, diarrhea, constipation, hernia, and hemorrhoids. Human primal qi is robust because essence and qi are solid. Cornus can close and secure essence, thus strengthening primal qi. (From *Lei Ming*) Human essence and qi rely on warmth to become sufficient. Since the Liver and Kidney reside in the position of extreme Yin, without warm qi, isolated Yin cannot generate. This herb enters both meridians; its warm nature tonifies, and its sour nature astringes, thereby benefiting essence and strengthening Yin. All other treated conditions are effects of secured essence and strengthened primal qi. (From *Zhong Chun*) Zhang Zhongjing's Ba Wei Wan (Eight-Ingredient Pill) benefits Yang, using Cornus as the sovereign herb, distinct from Liu Wei Di Huang Wan where Rehmannia is the sovereign. For chronic diarrhea, if initial treatment with Ginseng, Atractylodes, Ginger, and Cinnamon fails, discard Ginger and Cinnamon and use Cornus and Euryale Seed (Qianshi) (often administered with Ginseng, Atractylodes, and Black Ginger). This takes advantage of its ability to astringe Liver and Kidney Yin to nourish the source of Spleen Yin transformation. For Heart Blood deficiency causing deficient fire to flare outward leading to incessant sweating, instead of using Astragalus to consolidate the exterior, use this herb as the sovereign to astringe internally, preventing leakage of True Yin so that True Yang becomes stable, thereby benefiting Heart Blood and calming deficient fire. Combined with Cuscuta, Cistanche, Morinda, Deer Antler, Achyranthes, Glue, Alisma, Goji, Rehmannia, Astragalus Hairy-rooted Milkvetch, and Ophiopogon, it adds essence, secures marrow, warms waist and knees, benefits Yang, and promotes fertility. Combined with Ginseng, Schisandra, Oyster Shell, and Alpinia Oxyphylla, it treats elderly urinary dribbling and enuresis. Combined with Ginseng, Prepared Rehmannia, Human Milk, Achyranthes, Astragalus Hairy-rooted Milkvetch, Ophiopogon, and Chrysanthemum, it treats cranial bone pain; when marrow is sufficient, brain pain is naturally eliminated. Combined with Acorus, Chrysanthemum, Rehmannia, Phellodendron, and Schisandra, it treats deafness due to Kidney deficiency. Combined with Eucommia, Achyranthes, Rehmannia, Glue, and Chinese Yam, it treats lower back pain due to Kidney deficiency.
Cao Huan Dan: Soak Cornus flesh in wine for one jin, soak Psoralea in wine and roast until dry for eight liang, Angelica Sinensis for four liang, and Musk for one qian. Grind into powder, make pills with refined honey the size of wu zi. Take 81 pills each time before bed, washed down with salt wine. *Ben Cao Gang Mu* states it benefits Yuan Yang, tonifies Yuan Qi, secures Yuan Jing, and strengthens Yuan Shen, serving as an longevity formula.
[Discussion] Cornus fruits set in the fourth lunar month and are harvested in the fifth, appearing red, utilizing the Qi of Great Fire. Its sour flavor and warm nature align with the function of Fire while preserving the form of the Liver. When Fire functions and Liver form is complete, Yin guards Yang, and Yang serves Yin; the mechanism resides in this substance. What is the form of the Liver? It is that Wind-Wood follows Cold-Water to execute the generative changes of the Earth. Without Spring Warmth, the transformation of Extreme Yin becomes stagnant. However, if the qi is warm and the flavor pungent, it does not constitute the vital qi emerging from the earth in spring, resembling hot, floating, and growing qi, causing Yin to follow Yang and leak. As *Lei Ming* states, if essence and qi are not secured, how can primal qi be strong? Only when the qi is warm and the flavor sour, with pure sourness and little pungency, does it conform to the proper command of Spring Warmth, warming the Liver and completing its form. Kidney Yin receives the transformative power of Lesser Yang without leaking true qi. This is the practical achievement of strengthening Yin, benefiting essence, warming the Water Organ, tonifying Kidney Qi, and stimulating Yang. Although this herb secures essence, it is also said to expel cold-damp bi, seeming contradictory. One must understand that usage follows form: securing hibernating Yin allows the necessary Yang to be expressed (such as unblocking nine orifices, expelling all qi and wind). Thus, securing essence is the root of benefiting essence and raising Yang, while benefiting essence and raising Yang is the root of unblocking orifices, expelling pathogens, and treating wind deficiency. Jie Gu spoke of its form, calling it a blood herb of the Kidney; Hai Zang spoke of its function, calling it a qi herb of the Kidney. Essentially, astringing Yin enriches Yang, and consolidating Yang transforms Yin. They mutually benefit and require each other; how can one definitively assign primary indications? Therefore, for Yin consumption and Yin tonification, it is similar to this herb; for Yang deficiency and Yang tonification, it is similar to this herb; even for dispelling Yin and Yang pathogens, this herb may be added as the foundation of Yuan Yin and Yuan Yang. The use of Cornus generally falls into these three categories. Furthermore, the Liver likes Pungent to avoid stagnation. Here we use Sour astringency. Why? Knowing that at the time of Great Fire, obtaining this herb's astringing Yin and consolidating Yang to enrich True Yuan resembles taking Kan to fill Li, ensuring the use of Primal Qi is not depleted. Does this contradict the Liver's liking for Pungent? However, Jie Gu's theory regarding the Blood aspect is superior. Herbs like Psoralea that tonify Yang but are drying cannot be mentioned in the same breath. Shi Zao (Cornus) and Chaenomeles (Mugua) share a sour flavor and warm nature. But Shi Zao wins entirely by sourness, so it only warms the Liver to benefit the Kidney. Mugua is more than half sour but has a sweet taste, allowing it to perform the function of Earth, harmonize blood, and remove dampness. Texts say excessive sourness supports the Liver, but too much sourness damages the Kidney. This statement requires scrutiny. Shi Zao is sour and dominant; Liu Wei Di Huang Wan uses it to benefit the Kidney. Why doesn't it damage teeth and bones like Mugua used in large quantities? Or perhaps, like Mugua, its sourness combined with Earth function leads to Earth controlling Water, causing Kidney disease?
Miao states: Contraindicated for those with blazing Minister Fire and persistent erection without flaccidity. Not suitable for those with heat accumulation in the Bladder and difficult urination. Not suitable for those with Yin deficiency and weak blood. If used, it should be combined with Phellodendron Bark (Huangbai).
[Processing] Select those that are ruddy and fleshy. Mix with wine to moisten, remove the pit, take the skin, steam with wine for the time it takes to burn one incense stick, then use.