根味苦辛甘。气温。气浓味薄。沉而升。阴中阳也。足少阴行经气分之药。本经主风
寒所击。金疮止痛。奔豚痫痉。女子疝瘕。治一切风并气。筋骨挛拳。骨节酸痛。中风湿冷
。奔喘逆气。皮肤苦痒。手足挛痛。祛足少阴伏风。百节痛风。（此伏风深入骨节者）凡两
足寒湿痹不能动止。非此不治。与细辛同用。止少阴经头痛。疗劳损风毒齿痛。（诸本草）
独活气浊属阴。善行血分。敛而能舒。沉而能升。缓而善搜。可助表虚。故入太阴肺少阴肾
以理伏风。（士材） 独活细而低。治足少阴伏风而不治太阳。（东垣）
〔羌独活总论〕 羌浮而升。独沉而升。（主治秘诀）羌活气雄。故大无不通。小无不
入。治足太阳风湿相搏。头痛肢节痛。一身尽痛。为却乱反正之主药。独活气细。细者治足
少阴伏风头痛。两足湿痹不能动止。而不治太阳之证。（好古）羌入太阳。独入少阴。一表
一里。似气血之原已分矣。后人用治三时寒疾。以代麻黄桂枝。有孕妇初春外寒。病于足太
阳腑。为头痛骨痛。更病于足少阴脏。为腰痛。表里俱病。气血两伤。此本麻黄桂心所治病。
而药在所禁。但用羌活为君。入太阳。独活为臣。以入肾。一剂便效。同白术苍术秦艽生地
薏仁木瓜石斛黄柏。治下部一切风湿湿热。同生地赤芍甘草丹皮石膏等。治风热上攻牙肿痛。
〔论〕 羌活性温。本地中首出之气。其味始苦。次辛。苦多辛少。辛后又有甘。是首
出之气。本于味苦之入地者以上行。更辛甘合。而上行之气乃畅。所以为手足太阳行经风药。
能大畅寒水之郁而宣其化也。其治督脉为病脊强而厥者。以督为人身之真阳。此品能达真阳
以散寒郁也。又治风湿。（盖肾之真阳不畅。水郁即化湿。羌活从风化以畅水中之阳。正所
以除湿。即举外受之湿。皆能治之也。）而通经络者。以营行脉中。每患于湿以为血病。血
病则邪气恶血住留而经络伤。伤则不能行血气而营阴阳。故患为诸痹。甚且不得濡筋骨。利
关节。致骨节酸痛。屈伸不利而拘挛矣。（即病于脊痛项强。不可回顾。腰似折。项似拔。
皆其由湿以化风者。）羌活本风升之阳。从寒水中达阳以化湿。亦即畅阴以和风。而藏血之
肝。实司风化以主经络者。遂并太阳而效其用焉。（凡便秘属风者。方药中类用羌活。即此
可悟风血相关之义。盖便秘患于燥。燥者血不足。用羌活举阴以升而裕血之用。原非以燥湿
为功。要知风和则血裕。风淫则血燥。羌活不徒达阳以化湿。亦且畅阴以和风。可漫以风剂
例视乎哉。）夫风阳而寒湿阴。羌活固畅阴以达阳矣。乃如防风之冶。反以泻阳实而令阳畅
者何也。盖人身风升之气。与元气无二。畅阴以达阳者。固所以裕元气。俾阳出阴中而上际。
其升之机藉于肝。至泻阳以蓄阴者。更所以裕元气。俾阳依于阴以下蟠。其降之机举在肺。
如肺实不泻。是所谓升降不前气交有变也。至二味之能通经络。防风则自上而达于周身。羌
活则自下而上以及周身。其亦区以别矣。抑先天之元阴。水也。后天之真阴。血也。羌之达
阳以畅阴。与防之泻阳以蓄阴。总乃阳之不离于阴以为用。非泛然谓风剂便通经络也。试观
防风主上部见血。而羌活能治血癞及痈疽败血。则可知斯义之不爽矣。
独活为肾药。肾乃阴中之至阴。独活能 至阴中之阳化。以裕足太阳之气化而上际通
天。言其通经络之功。固不如羌活。第其入至阴之地。即寒水而裕风化。又就风木而达水化。
所谓不争下流者。独活有焉。即本经主治诸证
缪氏云。羌独活本祛风散寒除湿之要品。但本经别录并主中风及诸风。用者宜审。夫真
中风。惟西北高寒之地。表虚者当之。往往猝中。或口眼歪斜。或口噤不语。或手足瘫痪左
右不仁。或刚痉柔痉。（即角弓反张）此药与风药并用可也。若夫吴楚闽越百粤鬼方梁州之
域。从无刚劲之风。多有湿热之患。质脆气虚。多热多痰。其患中风如前等病。外证虽一一
相似。而其中实非。此则内伤虚邪。与外淫实邪。或攻或补。迥若天渊。若误用风药虚虚。
贻祸不小。又有血虚头痛。及遍身疼痛骨痛因而寒热者。此属内证。误用反致作剧。
〔辨治〕 羌活形细而多节。（易简方云须用紫色有蚕头鞭节者）软润。气息极猛烈。
独活色微白。形虚大。（易简云有臼如鬼眼）为用亦相似。而小不如。（陶隐居） 独活自蜀
来者。稍类羌活而极大。气亦芳烈。又有槐叶气者。用之极验。（苏颂）去皮及腐朽者用。
独活易蛀。宜密器藏之。（此亦验真伪之一端）
根的味道苦、辛、甘。药性温。气味浓厚而味道淡薄。作用趋势为沉降中带有上升，属于阴中有阳的药物。它是足少阴肾经行气分层面的药物。《本经》主治风寒邪气侵袭所致之病，金创（金属利器造成的创伤）止痛，奔豚（气从少腹上冲心胸）、癫痫、痉挛，女子疝瘕（腹内结块）。治疗各种风邪及气机阻滞，筋骨拘挛卷曲，骨节酸痛，体内感受风湿冷邪，气喘逆气，皮肤剧烈瘙痒，手足拘挛疼痛。祛除足少阴经潜伏的风邪，治疗各关节痛风。（这种伏风深入骨节的情况）凡是两脚因寒湿痹阻导致不能活动行走的，非用此药不可治疗。与细辛配合使用，可止少阴经头痛，治疗劳损引起的风毒齿痛。（参考诸本草著作）
独活气味浊重，属性属阴，善于通行血分，收敛中兼有舒展之功，沉降中兼有上升之效，缓慢中善于搜剔伏邪，可以辅助表虚证。因此进入太阴肺经和少阴肾经以调理伏风。（引用士材观点）独活质地细小而低矮，治疗足少阴经的伏风，而不治疗太阳经病症。（引用东垣观点）
【羌活与独活总论】
羌活性浮而升散，独活性沉而升提。（引用《主治秘诀》）羌活气味雄烈，故能大无不通，小无不入。治疗足太阳膀胱经受风湿相搏，头痛肢体关节痛，全身疼痛，是纠正紊乱、恢复正常的的主药。独活气味细微，细微者治疗足少阴经伏风头痛，两脚湿痹不能活动，而不治疗太阳经病症。（引用好古观点）羌活入太阳经，独活入少阴经，一表一里，似乎气血本源已分开。后人用于治疗三时（春、夏、秋或泛指四季不同时节）的寒疾，用以代替麻黄、桂枝。如有孕妇在初春感受外寒，病在足太阳腑，表现为头痛骨痛；又病在足少阴脏，表现为腰痛。表里同时患病，气血两伤。这本来是麻黄、桂心所治疗的病证，但麻黄、桂心对于孕妇是禁忌药物。此时只用羌活作为君药，入太阳经；独活作为臣药，入肾经。一剂即可见效。配合白术、苍术、秦艽、生地、薏仁、木瓜、石斛、黄柏，可治疗下部一切风湿湿热证；配合生地、赤芍、甘草、丹皮、石膏等，可治疗风热上攻导致的牙肿痛。
【论述】
羌活性温，禀受大地中首先发出的阳气，其味先苦，后辛，苦味多于辛味，辛味之后又有甘味。这是首先发出的阳气，原本源于苦味入地之气向上运行，再加上辛甘合化，使得上行之气得以通畅，所以成为手足太阳经的行经风药。能够大畅寒水之郁滞并宣发其气化功能。它治疗督脉生病导致的脊背强直而厥逆，因为督脉是人身的真阳，此药能通达真阳以散寒郁。又治疗风湿。（大概是因为肾的真阳不畅，水郁就会化为湿，羌活顺应风化以畅通水中的阳气，正是为了除湿，即使是外感受的湿邪，都能治疗。）至于通经络的作用，因为营气行于脉中，常患湿邪导致血病，血病则邪气恶血停留而损伤经络，损伤后就不能运行血气以营阴阳，所以患各种痹证，甚至不能濡养筋骨，滑利关节，导致骨节酸痛，屈伸不利而拘挛。（即病于脊痛项强，不能回顾，腰像折断一样，脖子像被拔起一样，都是由湿转化为风所致。）羌活本是随风升发的阳气，从寒水中通达阳气以化湿，也就是畅通阴气以调和风邪，而藏血的肝脏，实际主管风化以主导经络，于是便兼取太阳经的功效。（凡便秘属于风邪引起的，方药中经常使用羌活，由此可以领悟风血相关的道理。大概便秘患于燥，燥是因为血不足，用羌活举升阴气以升腾从而充裕血的作用，原本不是为了燥湿。要知道风和平则血充裕，风淫盛则血燥，羌活不仅通达阳气以化湿，也畅通阴气以和风，怎么能简单地把它当作风剂来看待呢？）风属阳，寒湿属阴，羌活固然畅通阴气以通达阳气了，那为什么像防风经过炮制后，反而能泻阳实而使阳气通畅呢？大概人身风气升发之气，与元气没有二致，畅通阴气以通达阳气，固然是为了充裕元气，使阳气出于阴中而上达天际，其上升的机制借助于肝；至于泻阳以蓄积阴气，更是为了充裕元气，使阳气依附于阴气而下潜盘绕，其下降的机制全在于肺。如果肺实不泻，就是所谓的升降不前，气交发生变异。至于这两味药能通经络，防风则是从上往下通达周身，羌活则是从下往上通达周身，它们之间也有区别。再说先天之元阴是水，后天之真阴是血。羌活的通达阳气以畅通阴气，与防风的泻阳以蓄积阴气，总体上是阳气不离阴气以为用的体现，并非泛泛地说风剂就能通经络。试看防风主治上部出血，而羌活能治血癞及痈疽败血，就可以知道这个道理是不差的。
独活是肾经药，肾乃阴中之至阴，独活能到达至阴之中将其化为阳，以充裕足太阳经的气化功能而上达通天。说它通经络的功效，固然不如羌活，但它进入至阴之地，即在寒水中充裕风化，又在风木中通达水化，所谓“不争下流”，独活具备这一点。即《本经》主治的各种证候。
缪氏说：羌活、独活本是祛风散寒除湿的重要药材，但《本经》、《别录》还主治中风及各种风病，使用者应当审慎。真正的中风，只有西北高寒之地，表虚的人才会遭遇，往往突然发病，或者口眼歪斜，或者口噤不语，或者手足瘫痪左右麻木，或者刚痉柔痉。（即角弓反张）此药可以与风药并用。如果是吴楚闽越百粤鬼方梁州等地，从来没有刚劲之风，多有湿热之患，体质脆弱气虚，多热多痰，他们患中风如前述等病，外证虽然一一相似，但其中实质并非如此。这是内伤虚邪，与外淫实邪，或者攻或者补，迥然不同，如同天渊之别。如果误用风药导致虚者更虚，留下的祸患不小。还有血虚头痛，以及遍身疼痛骨痛因而伴有寒热的，这属于内证，误用风药反而会导致病情加剧。
【鉴别与治疗】
羌活形体细长且多节。（《易简方》说必须用紫色、有蚕头鞭节的）质地软润，气息极其猛烈。独活颜色微白，形体虚大。（《易简方》说有臼如鬼眼）功效也相似，但效力稍小。（陶隐居语）产自蜀地的独活，稍微类似羌活但个头极大，气味也芳香猛烈。又有槐叶气味的，使用极有效验。（苏颂语）需去皮及腐朽部分使用。独活容易生虫，应用密闭容器储藏。（这也是验证真伪的一个方面）
The root tastes bitter, acrid, and sweet. Its nature is warm. The qi is strong while the taste is light. Its action tendency is sinking with an ascending quality, belonging to yang within yin. It is a herb that circulates qi in the blood level of the Foot-Shaoyin (Kidney) channel. *Ben Jing* (Classic of Materia Medica) states it treats diseases caused by wind-cold invasion, stops pain from metal wounds (Jinchuang), Ben Tun (gas rushing from lower abdomen to chest), epilepsy, and spasms, and women's Shan Jia (abdominal masses). It treats all types of wind pathogens and qi stagnation, tendon and bone cramping, joint soreness and pain, internal contraction of wind-damp-cold, wheezing and rebellious qi, severe skin itching, and cramping pain in hands and feet. It expels latent wind from the Foot-Shaoyin channel and treats gout in all joints. (This refers to latent wind penetrating deep into the joints.) For cases where both legs are cold-damp bi syndrome causing immobility, this herb is essential for treatment. When used with Xixin (Asari Radix et Rhizoma), it stops Shaoyin channel headaches and treats toothache due to wind-toxin from exhaustion. (Referencing various Materia Medica texts)
Duhuo has a turbid aroma and belongs to yin; it excels at circulating the blood level. It is astringent yet soothing, sinking yet ascending, slow yet good at searching out hidden pathogens. It can assist in treating exterior deficiency. Therefore, it enters the Taiyin Lung and Shaoyin Kidney channels to regulate latent wind. (Citing Shicai) Duhuo is slender and low-growing; it treats latent wind of the Foot-Shaoyin channel but does not treat the Taiyang channel. (Citing Dongyuan)
[General Discussion on Qianghuo and Duhuo]
Qianghuo is floating and ascending; Duhuo is sinking yet ascending. (Citing *Zhi Zhu Mi Jue*) Qianghuo has a vigorous aroma, thus nothing large is not unblocked, and nothing small is not entered. It treats rheumatism-wind combat in the Foot-Taiyang Bladder channel, causing headache, limb and joint pain, and whole-body pain; it is the principal herb for correcting disorder and restoring normalcy. Duhuo has a subtle aroma; subtlety treats latent wind headache of the Foot-Shaoyin channel and damp-bi immobility of both legs, but does not treat Taiyang channel syndromes. (Citing Haogu) Qianghuo enters the Taiyang channel, Duhuo enters the Shaoyin channel; one is exterior, one is interior, seemingly separating the origins of qi and blood. Later practitioners use them to treat cold ailments in three seasons, replacing Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus). For example, if a pregnant woman contracts external cold in early spring, affecting the Foot-Taiyang Fu organ with headache and bone pain, and simultaneously affecting the Foot-Shaoyin Zang organ with lower back pain, presenting as simultaneous exterior-interior disease and qi-blood injury: this was originally treated by Mahuang and Guixin (Cinnamomi Cortex), which are contraindicated for pregnancy. In such cases, use only Qianghuo as the Sovereign herb entering the Taiyang channel, and Duhuo as the Minister herb entering the Kidney. One dose brings efficacy. Combined with Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Shengdi (Rehmanniae Radix), Yiren (Coicis Semen), Mugua (Chaenomelis Fructus), Shihu (Dendrobii Caulis), and Huangbai (Phellodendri Cortex), it treats all lower-body wind-damp-heat syndromes. Combined with Shengdi, Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma), Danpi (Moutan Cortex), and Shigao (Gypsum Fibrosum), it treats tooth swelling and pain caused by wind-heat attacking upward.
[Discussion]
Qianghuo has a warm nature, inheriting the first qi emerging from the earth. Its taste begins bitter, then acrid, with bitterness exceeding acridity, followed by sweetness after the acridity. This first-emerging qi originates from the bitter flavor entering the earth and rising upward; combined with acrid and sweet flavors, the ascending qi becomes smooth. Thus, it serves as a wind-dispelling herb for the Hand and Foot Taiyang channels. It greatly unblocks the depression of Cold-Water and promotes its transformation. It treats diseases of the Du Mai (Governing Vessel) manifesting as spinal rigidity and cold limbs, because the Du Mai is the True Yang of the body; this herb reaches the True Yang to disperse cold depression. It also treats wind-damp. (Presumably, when the True Yang of the Kidney is not smooth, water depression transforms into dampness. Qianghuo follows wind transformation to smooth the yang within water, precisely to eliminate dampness; even externally contracted dampness can be treated.) Regarding its ability to unblock collaterals: Ying Qi (Nutritive Qi) circulates within the vessels and is often afflicted by dampness leading to blood pathology. Blood pathology causes pathogenic qi and evil blood to remain, damaging the collaterals. Damage prevents the circulation of qi and blood to nourish yin and yang, resulting in various Bi syndromes. Severe cases fail to moisten tendons and bones or lubricate joints, causing joint soreness, limited flexion and extension, and cramping. (This includes spinal pain and neck rigidity preventing turning, waist feeling like breaking, and neck feeling like pulling, all arising from damp transforming into wind.) Qianghuo is essentially yang that rises with wind; it reaches yang from cold-water to transform dampness, thereby smoothing yin to harmonize wind. The Liver, which stores blood and governs wind transformation to direct collaterals, consequently shares the function of the Taiyang channel. (For constipation caused by wind, Fang Yaoguang often uses Qianghuo; this reveals the connection between wind and blood. Constipation arises from dryness, which is insufficient blood. Using Qianghuo to lift yin and ascend enriches the function of blood; its purpose is not primarily to dry dampness. Know that when wind is harmonious, blood is abundant; when wind is excessive, blood is dry. Qianghuo not only reaches yang to transform dampness but also smooths yin to harmonize wind. How can it simply be viewed as a standard wind-dispelling agent?) Wind is yang, cold-damp is yin. Qianghuo certainly smooths yin to reach yang. Why, then, does Fangfeng (Saposhnikoviae Radix), after processing, instead drain excess yang to allow yang to flow smoothly? The ascending qi of wind in the human body is no different from Yuan Qi (Source Qi). Smoothing yin to reach yang enriches Yuan Qi, allowing yang to emerge from yin and reach the heavens; its ascending mechanism relies on the Liver. Draining yang to store yin further enriches Yuan Qi, allowing yang to attach to yin and descend; its descending mechanism lies entirely in the Lung. If Lung excess is not drained, it is called "ascending and descending do not proceed, qi intersection changes." Regarding their ability to unblock collaterals: Fangfeng reaches the whole body from top to bottom, while Qianghuo reaches the whole body from bottom to top; there is a distinction. Furthermore, congenital Primary Yin is Water, postnatal True Yin is Blood. Qianghuo reaching yang to smooth yin, and Fangfeng draining yang to store yin, both demonstrate that yang cannot function without yin; it is not merely that wind herbs unblock collaterals. Observe that Fangfeng mainly treats bleeding in the upper body, while Qianghuo treats blood leukoderma and carbuncles with败血 (decaying blood); thus, this principle holds true.
Duhuo is a Kidney herb. The Kidney is the extreme yin within yin. Duhuo can transform the yang within extreme yin, enriching the qi transformation of the Foot-Taiyang channel to reach heaven upwards. Regarding its merit in unblocking collaterals, it is indeed inferior to Qianghuo. However, it enters the realm of extreme yin, enriching wind transformation within cold-water, and reaching water transformation through wind-wood. It embodies the concept of "not competing with the lower flow," which Duhuo possesses. These correspond to the indications in *Ben Jing*.
Mr. Miao stated: Qianghuo and Duhuo are essential herbs for dispelling wind, scattering cold, and removing dampness. However, *Ben Jing* and *Bie Lu* also indicate they treat Zhong Feng (Wind Stroke) and various wind diseases. Practitioners should exercise caution. True Zhong Feng occurs only in the high-cold regions of the Northwest, affecting those with exterior deficiency, often striking suddenly with symptoms such as facial paralysis, locked jaw and inability to speak, hemiplegia or numbness on either side, or Gang Jing (rigid spasm) and Rou Jing (flaccid spasm) (i.e., opisthotonos). This herb can be used in combination with wind-dispelling agents. In contrast, in regions like Wu, Chu, Min, Yue, Baiyue, Guifang, and Liangzhou, there is rarely fierce wind; instead, there are many heat-damp afflictions. People here have fragile constitutions and deficient qi, prone to heat and phlegm. Their Zhong Feng-like illnesses present with similar external signs but differ fundamentally in essence. These are internal injuries with deficiency pathogens versus external invasions with excess pathogens; treatments may involve attack or tonification, differing vastly like heaven and earth. Misusing wind herbs would cause deficiency to become more deficient, leading to serious consequences. Additionally, headache due to blood deficiency and generalized body/bone pain accompanied by alternating chills and fever belong to internal conditions; misusing wind herbs will exacerbate the condition.
[Differentiation and Treatment]
Qianghuo is slender and knotty. (*Yi Jian Fang* states one must use purple varieties with silkworm-heads and whip-joints). It is soft and moist, with an extremely potent aroma. Duhuo is slightly white in color and appears hollow and large. (*Yi Jian Fang* describes nodes resembling ghost eyes). Their effects are similar, but Duhuo is slightly weaker. (Citing Tao Hongjing) Duhuo from Shu resembles Qianghuo but is much larger, with a fragrant and potent aroma. Those with the scent of Sophora leaves are extremely effective. (Citing Su Song) Use the peeled part, excluding rotten portions. Duhuo is prone to insect infestation and should be stored in sealed containers. (This is also a method to verify authenticity.)