河北生者无花子。五六十月采根。曝干用。
味至苦。气寒而沉。纯阴之剂。足少阴肾经君药也。苦燥湿。兼泄气分之热。寒以除血
分之热。热生风。湿生虫。故又能治风杀虫。惟肾水弱而相火旺者。用之相宜。疗时气恶病。
大热狂邪。或结胸壮热。行结热。心腹结气积聚。小腹积热苦痛。利疸热。逐水。治伏热肠
。热毒风。皮肤烦燥。生疮。（古今方治风热疮疹最多）赤癞眉脱。及下部 。（诸本草）
炒存性。米饮服。杀疳虫。渍酒饮。治疥杀虫。又治疠风鼻。方书治消瘅痿厥。中风虚劳。
虚烦盗汗。胀满痰饮。身体痛着痹。滞下痔疮。小便不通及不禁。禀润下之寒化。合从至阴。
对待火热为因。积聚为证者。（之颐）苦参峻补阴气。（子午乃少阴君火对化。故苦参黄柏
之苦寒。皆能补肾。）或得之而致腰重者。因其气降而不升。非伤肾之谓也。（丹溪）本草又
谓苦参养肝胆。平胃气。本经更言补中。盖血热不能养肝胆。则风木自来侮土。而胃气不平。
即以病于中气。三者常相因也。同胡麻刺蒺藜荆芥穗甘菊 白芷当归川芎地黄天冬首乌牛
膝漆叶秦艽龙胆草。治大麻风。同牡蛎粉白术青黛。治童子胃热。羸瘦疳蛔。腊月米醋渍入
瓮中。封固。主一切天行热病。头疼口渴身热。饮碗许。得吐则愈。汗亦如之。热病狂邪。
不避水火。欲杀人。苦参末。蜜丸梧子大。每服十丸。薄荷汤下。亦可为末二钱煎服。天行
病四五日。结胸满痛壮热者。苦参一两。以醋三升。煮取一升二合。饮之取吐。
即愈。小腹热痛。青黑或赤色。不能喘者。苦参一两。醋一升半。煎八合。分二服。遍
身风疹。（胸颈脐腹及近隐处皆然）痒痛不可忍。（始而痒。抓之则痛。渐渐赤烂。遍体无皮。
发肿。流脓水。）作丹毒治愈甚。惟用皂角二两。水一升揉摅取汁。瓦器熬成膏。和苦参末
一两。丸梧子大。温汤下三十丸。仍以苦参煎水洗之。湿烂者末渗之。次日即愈。此味解热
杀虫。治疥洗热疮甚效。大风癞疾。苦参五两切。以好酒三斗渍三十日。每饮一合。日三服。
常服不绝。若觉痹即瘥。又方。苦参末二两。以猪肚盛之。缝合煮熟。取出去药。先饿一
日。次早先饮新水一盏。将猪肚食之。如吐再食。待一二时。以肉汤调无忧散五七钱服。取
出大小虫一二万为效。后以不蛀皂角一斤。去皮子煮汁。入苦参末调糊。下首乌末二两。防
风末一两半。当归末一两。芍药末五钱。人参末三钱。丸梧子大。每服三五十丸。温酒或茶
下。日三服。仍用麻黄苦参荆芥煎水洗之。肾脏风毒。及心肺积热。皮肤生疥癞。瘙痒。时
出黄水。并大风手足坏烂。一切风疾。苦参三十一两。荆芥穗十六两。为末。水糊丸梧子大。
每
〔论〕 苦参味至苦。气复寒。夫苦为火味。肾中原有真阳。故味之苦者入之。况苦味
禀乎寒水之气化。其气味固有专至者。所谓纯阴而气降。止宜于肾水弱而相火旺之人。皆确
论也。其治热毒风之义。更为可参。盖风者阳之淫气。即阳之郁气。气郁化风。渐已化为热
矣。是浅而病乎卫者也。由卫及营以病乎血。积久而热之壅者。更就血中而为毒。热毒之所
化。遂病乎肾肝之真阴而为热毒风。（气郁化风者。即已化热气之热不去。因病乎血热之在
血中者。久而又不去。遂能蚀血。故曰热毒。热毒原是风毒。故曰热毒风。其病变固有浅深
也。）故风热在卫。止散阳郁之邪而清其气。热毒蚀阴。必直驱其伤阴之邪。而用至阴以胜
之。如苦参辈是也。第洁古谓为纯阴。而透以气沉二字。可悟。苦参元参。均之入肾。而却
有迥殊之用存焉。使与病证不相对待。将沉寒直入命门。痼冷大伤元阳矣。其可漫投乎哉。
又生地苦参凉血。一则虑其寒滞于中。一则虑其寒沉于下。若风之化热。热又鼓风。而未至
为热毒风者。则本柴胡四物为用。丹栀翘甘辈颇为适宜。（薛新甫法。血分热者。四物加丹
皮。或小柴胡加山栀芎归。能清肝凉血。又四物加翘甘。能生血清热。如风热则用小柴胡加
防翘。此可以思营卫之分矣。
总之。血热为病。不能舍血药。即芍地虑其滞。而芎归固不可少也。）如苦参犹可需次
以投也。
缪氏云。虽能泄血中之热而除虫疠。然大苦大寒。久服能损肾气。肝肾虚而无大热者。
弗服。火衰精冷。真元不足。及年高之人。不可用。（濒湖）
〔修治〕少入汤剂。多作丸服。用糯米泔浸一宿。蒸三时久。晒干。治疮浸酒。治肠风
炒至烟起为末。
河北出产的苦参没有花和种子。在农历五月、六月和十月采集根部，晒干后使用。
味道极苦，药性寒凉且沉降，属于纯阴性质的药物。它是足少阴肾经的主药。苦参能燥湿，兼清泄气分的热邪；其寒性可以清除血分的热邪。热邪易生风，湿邪易生虫，因此它又能治疗风证并杀虫。只有对于肾水虚弱而相火旺盛的人，使用它才适宜。它可以治疗时行疫病及恶病，如大热、狂躁邪气，或者结胸证伴壮热，能行散结聚之热，治疗心腹部的气滞积聚，以及小腹积热引起的剧烈疼痛。它能利胆退黄以治热疸，逐除水饮，治疗伏热肠痈，热毒风，皮肤烦躁，以及疮疡。（古今方书中用其治疗风热疮疹最多）还能治疗赤癞（麻风病的一种），导致眉毛脱落，以及下部（指前阴或肛门部位）的病变。（出自《诸本草》）。将苦参炒至存性，用米汤送服，可杀灭疳虫；用酒浸泡后饮用，可治疗疥疮并杀虫。此外，它还治疗麻风病导致的鼻柱塌陷。医书记载它能治疗消瘅（类似糖尿病）、痿厥（肢体萎软无力、四肢逆冷）、中风虚劳、虚烦盗汗、胀满痰饮、身体疼痛着痹（痛痹）、痢疾痔疮、小便不通及失禁。苦参禀受润下的寒化之气，合于至阴之性，专门针对因火热为病因、积聚为证候的疾病。（出自李梴《医学入门》）。苦参峻补阴气。（子午之时对应少阴君火的对化，所以苦参、黄柏的苦寒之性，都能补肾。）有人服用后感到腰部沉重，是因为其气机下降而不升发，并非损伤肾脏的意思。（出自朱丹溪）。本草著作又说苦参能养肝胆、平胃气，《本经》更说它能补中气。这是因为血热不能滋养肝胆，则风木之气自然会克制脾土，导致胃气不平，进而影响中气。这三者通常是相互关联的。
苦参可与胡麻、刺蒺藜、荆芥穗、甘菊、白芷、当归、川芎、地黄、天冬、首乌、牛膝、漆叶、秦艽、龙胆草同用，治疗大麻风。与牡蛎、粉、白术、青黛同用，治疗童子胃热、消瘦及疳蛔虫症。腊月时用米醋浸泡放入瓮中，密封保存，主治各种时行热病，头痛、口渴、身热，饮用一碗左右，若呕吐则病愈，出汗亦然。对于热病狂躁邪气，不避水火，欲杀人的情况，可用苦参末，蜂蜜制成梧桐子大小的丸剂，每次服十丸，薄荷汤送下。也可研为末，取二钱煎服。对于时行病四五日，出现结胸、满痛、壮热的情况，用苦参一两，醋三升，煮取一升二合，饮用令其呕吐，即可痊愈。小腹热痛，颜色青黑或赤色，不能喘息的，用苦参一两，醋一升半，煎至八合，分两次服用。对于遍身风疹（胸部、颈部、脐部、腹部及近隐处皆然），瘙痒疼痛不可忍受（起初痒，抓挠后痛，渐渐红肿溃烂，遍体无皮，发肿，流脓水），将其作为丹毒治愈效果很好。只用皂角二两，水一升，揉搓取汁，在瓦器中熬成膏，加入苦参末一两，制成梧桐子大小的丸剂，温开水送服三十丸，仍用苦参煎水清洗患处。湿烂者直接撒粉末，次日即愈。此药解热杀虫，治疗疥疮、洗热疮非常有效。对于大风癞疾，用苦参五两切片，好酒三斗浸泡三十天，每次饮一合，每日三次，常服不断。如果感觉麻木痹痛就会好转。又一方：苦参末二两，装入猪肚中，缝合煮熟，取出弃去药渣，先空腹一天，次日早晨先喝新水一盏，然后吃猪肚。如果呕吐再吃。待一二小时后，用肉汤调服无忧散五七钱，排出大小虫一二万条为见效。之后用不蛀皂角一斤，去皮子煮汁，加入苦参末调成糊状，再加入首乌末二两、防风末一两半、当归末一两、芍药末五钱、人参末三钱，制成梧桐子大小的丸剂，每次服三五十丸，温酒或茶送下，每日三次。仍用麻黄、苦参、荆芥煎水洗患处。对于肾脏风毒，以及心肺积热，皮肤生疥癞，瘙痒，时常流出黄水，以及大风导致手足坏烂，一切风疾，用苦参三十一两，荆芥穗十六两，研为末，水糊丸梧桐子大小，每服适量。
[论] 苦参味道极苦，药性复寒。苦味属火，但肾中原有真阳，所以苦味的药物能入肾。况且苦味禀受寒水之气化，其气味确有专一的作用，所谓纯阴而气机沉降，只适宜于肾水弱而相火旺的人，这都是确切的论述。它治疗热毒风的机理，更值得参考。风是阳气的淫溢之气，也是阳气的郁结之气，气郁化风，逐渐化为热邪。这是病在浅表的卫分。由卫分深入营分而病及血分，积久热邪壅盛，更在血中化为毒。热毒所化，遂病及肾肝的真阴，成为热毒风。（气郁化风者，即已化热气之热不去，因病乎血热之在血中者，久而又不去，遂能蚀血，故曰热毒。热毒原是风毒，故曰热毒风。其病变固有浅深也。）所以风热在卫分，只需疏散阳郁之邪而清气分热；热毒蚀伤阴液，必须直驱其伤阴之邪，并用至阴之品来胜之，如苦参这类药物就是如此。只是洁古谓其为纯阴，而透以“气沉”二字，可以领悟。苦参与玄参，均入肾经，却有截然不同的用途。如果与病证不对应，将沉寒之药直入命门，会严重损伤元阳，岂可随意投用？另外，生地黄与苦参虽都能凉血，但前者顾虑其寒滞于中焦，后者顾虑其寒沉于下焦。如果是风化为热，热又鼓动风，但未至成为热毒风的阶段，则应以柴胡四物汤为基础进行加减，丹皮、栀子、连翘、甘草等颇为适宜。（薛己法：血分热者，四物汤加丹皮，或小柴胡汤加山栀、川芎、当归，能清肝凉血；又四物汤加连翘、甘草，能生血清热；如风热则用小柴胡汤加防风、连翘。这可以思考营卫的区别了。总之，血热为病，不能舍弃血分药，即使芍药、地黄虑其滋腻滞碍，川芎、当归也不可缺少。）在这种情况下，苦参还可以酌情使用。
缪希雍说：苦参虽能泄血中之热而除虫疠，但其大苦大寒，久服能损肾气。肝肾虚而无大热者，不服。火衰精冷、真元不足及年高之人，不可用。（出自李时珍《本草纲目》）
[修治] 少入汤剂，多作丸服。用糯米泔水浸泡一夜，蒸三个时辰，晒干。治疮疡浸酒，治肠风炒至冒烟为末。
The *Kushen* (Radix Sophorae Flavescentis) produced in Hebei has no flowers or seeds. The roots are harvested in the fifth, sixth, and tenth lunar months, dried in the sun, and used.
It tastes extremely bitter, its nature is cold and sinking, and it is a purely Yin agent. It is the sovereign drug for the Foot Shaoyin Kidney Meridian (Foot-Shaoyin Shenshuo Jing). Kushen dries dampness and simultaneously drains heat from the Qi level (Qi Fen). Its cold nature removes heat from the Blood level (Xue Fen). Heat generates wind, and dampness generates parasites; therefore, it can also treat wind syndromes and kill parasites. It is suitable only for those with weak Kidney Water (Shen Shui) and flourishing Ministerial Fire (Xiang Huo). It treats epidemic febrile diseases and malignant conditions, such as high fever, manic delirium, or chest binding syndrome (Jie Xiong) with severe heat. It can dissipate accumulated heat, treat qi stagnation and accumulations in the heart and abdomen, and severe pain caused by accumulated heat in the lower abdomen. It promotes bile flow to treat jaundice-heat, expels water retention, treats latent heat intestinal abscesses, toxic wind, skin irritability, and sores. (It is most frequently used in ancient and modern formulas for wind-heat sores and rashes.) It also treats erythema leprosy (Chi Lai), causing eyebrow loss, and lesions in the lower region (Zhen Bu). (From *Zhong Ben Cao*). When stir-fried until carbonized but retaining its properties and taken with rice water, it kills pinworms. When soaked in wine and drunk, it treats scabies and kills parasites. It also treats rhinomelia (collapse of the nasal bridge) caused by leprosy. Medical texts record that it treats Xiao Dan (wasting-thirst syndrome, similar to diabetes), Wei Jue (limb flaccidity and cold extremities), deficiency-type stroke and consumptive disease, deficiency vexation and night sweats, distension and phlegm-fluid retention, body pain with fixed bi-syndrome (Zhe Bi), dysentery and hemorrhoids, urinary retention, and urinary incontinence. Kushen inherits the cold transformation of moistening and descending, aligning with extreme Yin, and is specifically matched to diseases where fire-heat is the etiology and accumulation is the manifestation. (Li Chan). Kushen powerfully tonifies Yin Qi. (The Zi-Wu period corresponds to the counter-transformation of Shaoyin Ministerial Fire; thus, the bitter-cold nature of Kushen and Huangbai can both tonify the Kidney.) Some individuals feel heavy in the waist after taking it because its Qi descends rather than ascends; this does not mean it damages the Kidney. (Zhu Danxi). Materia Medica texts also state that Kushen nourishes the Liver and Gallbladder and regulates Stomach Qi. The *Shennong Bencao Jing* further states it tonifies the Middle Jiao. This is because blood heat fails to nourish the Liver and Gallbladder, allowing Wind-Wood to overact on Earth, leading to unregulated Stomach Qi and affecting the Middle Qi. These three factors are often interrelated.
Kushen can be combined with Sesame Seed (Huma), Tribulus Fruit (Cijili), Schizonepeta Spike (Jingjie Sui), Chrysanthemum Flower (Ganju), Angelica Dahurica (Baizhi), Chinese Angelica Root (Danggui), Szechuan Lovage Rhizome (Chuanxiong), Rehmannia Root (Dihuang), Asparagus Tuber (Tiandong), Polygonum Multiflorum Root (Shouwu), Achyranthes Root (Niuxi), Lacquer Tree Leaf (Qiyе), Gentian Root (Qinjiao), and Gentiana Scabra Root (Longdan Cao) to treat lepromatous leprosy. Combined with Oyster Shell (Muli), Calamine Powder (Fen), Atractylodes Macrocephala Rhizome (Baizhu), and Indigo Naturalis (Qingdai), it treats childhood stomach heat, emaciation, and pinworms due to deficiency. Soaked in rice vinegar in December and sealed in a jar, it treats all types of epidemic febrile diseases, headache, thirst, and fever. Drinking about one bowl may induce vomiting, which leads to recovery; sweating similarly indicates recovery. For febrile diseases with manic delirium, disregard for hot and cold, and homicidal tendencies, Kushen powder mixed with honey into pills the size of wisteria seeds, ten pills per dose, taken with mint decoction, is effective. Alternatively, two qian of powder can be decocted and taken. For epidemic diseases lasting four to five days with chest binding, fullness, pain, and severe heat, use one liang of Kushen and three sheng of vinegar, decoct to obtain one sheng and two he, and drink to induce vomiting for cure. For lower abdominal heat pain with bluish-black or reddish color and inability to breathe, use one liang of Kushen and one and a half sheng of vinegar, decoct to eight he, and divide into two doses. For generalized wind rashes (affecting the chest, neck, umbilicus, abdomen, and near-genital areas) with unbearable itching and pain (initially itchy, becoming painful upon scratching, gradually turning red and ulcerated, losing skin integrity, swelling, and oozing pus), treating it as erysipelas yields good results. Use two liang of Sichuan Pepper Pod (Zaojiao) and one sheng of water, rub to extract juice, boil in a clay vessel to form a paste, mix with one liang of Kushen powder, make into wisteria-seed-sized pills, take thirty pills with warm water, and wash the area with Kushen decoction. For wet ulcers, apply powder directly; healing occurs the next day. This herb clears heat and kills parasites, being very effective for scabies and washing hot sores. For severe leprosy, cut five liang of Kushen, soak in three dou of good wine for thirty days, drink one he per dose, three times daily, continuously. If numbness or bi-syndrome is felt, improvement will occur. Another prescription: Two liang of Kushen powder stuffed into a pig’s stomach, sewn shut, boiled until cooked, remove the medicine, fast for one day, drink one cup of fresh water early the next morning, then eat the pig’s stomach. If vomiting occurs, eat again. After one or two hours, take five to seven qian of Wuyou San adjusted with meat broth to expel tens of thousands of large and small worms as efficacy. Afterwards, use one jin of non-boring Sichuan Pepper Pod, peel and remove seeds, boil to extract juice, mix with Kushen powder to form a paste, add two liang of Polygonum Multiflorum powder, one and a half liang of Saposhnikovia Root (Fangfeng) powder, one liang of Chinese Angelica Root powder, five qian of White Peony Root powder, and three qian of Ginseng Root powder, make into wisteria-seed-sized pills. Take thirty to fifty pills per dose with warm wine or tea, three times daily. Wash the affected area with a decoction of Ephedra Herb (Mahuang), Kushen, and Schizonepeta. For Kidney wind-toxin, and accumulated heat in the Heart and Lungs, skin sores and leprosy with itching and yellow discharge, and severe leprosy causing hand and foot necrosis, and all wind diseases, use thirty-one liang of Kushen and sixteen liang of Schizonepeta Spike, grind to powder, use water paste to make wisteria-seed-sized pills.
[Discussion] Kushen is extremely bitter and cold. Bitter taste belongs to Fire, yet the Kidney contains original True Yang, so bitter substances enter the Kidney. Moreover, the bitter taste inherits the Qi transformation of Cold Water; its flavor and nature have specific actions. Being purely Yin and sinking in Qi, it is only suitable for those with weak Kidney Water and flourishing Ministerial Fire. These are accurate statements. The principle behind treating toxic wind is worth further study. Wind is the excessive Qi of Yang, or the stagnant Qi of Yang. Qi stagnation transforms into wind, which gradually becomes heat. This affects the superficial Wei Level (Wei Fen). From Wei to Ying (Nutrient) Level, it affects Blood. Over time, stagnant heat becomes toxic within the Blood. The transformation of heat-toxin damages the True Yin of the Kidney and Liver, resulting in toxic wind. (Qi stagnation transforming into wind means the heat from transformed Qi remains, affecting blood heat in the Blood level; prolonged retention erodes blood, hence called heat-toxin. Since heat-toxin originates from wind-toxin, it is called toxic wind. The pathology has varying depths.) Therefore, when wind-heat is at the Wei Level, one should only disperse Yang-stagnant pathogens and clear Qi-level heat. When heat-toxin erodes Yin, one must directly drive out the Yin-damaging pathogen and use extreme Yin agents to overcome it, such as Kushen. However, Zhang Congzheng (Jiegu) described it as purely Yin, and the phrase "sinking Qi" offers insight. Both Kushen and Xuanshen enter the Kidney but have vastly different applications. If mismatched with the syndrome, sinking-cold drugs entering the Gate of Life (Mingmen) would severely damage Original Yang. Can they be administered casually? Furthermore, while Shengdi and Kushen both cool blood, one worries about cold stagnating in the Middle Jiao, the other about cold sinking to the Lower Jiao. If wind transforms into heat, and heat stirs wind, but it has not yet become toxic wind, one should base treatment on Chaihu Siwu Tang. Agents like Danpi, Zhizi, Lianqiao, and Gancao are quite appropriate. (Xue Xinpu’s method: For blood-level heat, Siwu Tang plus Danpi, or Xiaochaihu Tang plus Zhizi, Chuanxiong, and Danggui, clears Liver and cools blood. Siwu Tang plus Lianqiao and Gancao generates blood and clears heat. For wind-heat, Xiaochaihu Tang plus Fangfeng and Lianqiao is used. This allows reflection on the distinction between Ying and Wei. In short, for blood-heat diseases, blood-invigorating herbs cannot be abandoned. Although Shaoyao and Dihuang may cause stagnation, Chuanxiong and Danggui are indispensable.) In such cases, Kushen can be used cautiously.
Miao Xi Yong stated: Although Kushen drains heat from the Blood and eliminates parasites and leprosy, its extreme bitterness and coldness damage Kidney Qi with long-term use. Those with Liver-Kidney deficiency without significant heat should not take it. Those with declining Fire, cold essence, insufficient True Yuan, and the elderly should not use it. (Li Shizhen).
[Processing] Used sparingly in decoctions, mostly in pills. Soak in rice water overnight, steam for three shichen (six hours), dry in the sun. For sores, soak in wine. For intestinal wind, stir-fry until smoking and grind to powder.