甲
味咸。气平。足厥阴血分药也。主治益阴补气。除老疟疟母。疗劳瘦骨热。骨节间劳
结实壅塞。除心腹症瘕。坚积寒热。血瘕腰痛。劳复女劳复。小儿胁下坚及惊痫。斑痘
妇人产后阴脱。去息肉阴蚀。痔核恶肉。方书更治香港脚。嗽血盗汗。中风痞证。咳嗽
消瘅。小便不禁。虚劳证多用之。但不可过剂。（宗 ）鳖色青入肝。故所主疟劳寒
瘕惊痫。经水痈肿阴疮。皆厥阴血分病。水龟色黑入肾。故其甲所主阴虚精弱。腰脚
阴疟泻痢。皆少阴血分病。（濒湖）鳖甲味咸。润下益阴何疑。本经之主症瘕坚积息肉
殆本于益阴。而咸以软坚之故欤。（仲淳）疟疾类病于阴虚之人。暑邪深入阴分。出
阳而热。入并于阴而寒。至元气虚羸。邪始内陷而结为疟母。鳖甲益阴除热而能消散。故为
治疟要药。即是退劳热及阴虚寒热往来之上品。（又）得牛膝当归橘皮首乌知母麦冬。治久
疟
若
黄
少
至
腹
久
服
寸
甲烧存性。研末。酒服方寸匕。
服。石出瘥。吐血不止。鳖甲蛤
食后茶下。斑痘发喘。小便不利
小便有血者。中坏也。黑靥无脓
〔论〕 鳖甲益阴。丹溪更云补气。夫气有阳气阴气之殊。其说本于内经。经曰。阴虚
则无
别录甄
要矣。
竭血燥
臭盗汗
痛。皆滞血
为滋补也。
块为言。固
阳不降耳。
阳之归。则三
而不能升。致
香港脚心腹胀满
乎。小便不利
皆用鳖甲以和
脏伤则阴虚
要领也。方
统以鳖甲为之
（黄 鳖甲
子漏下。皆用
亦阴气虚而不
简误云。妊娠禁用。凡阴虚胃弱泄泻。产后泄泻。饮食不消。不思食。及呕恶等证。咸
忌。
〔辨治〕 凡使。要绿色。九肋多裙。重七两者。为上。用六一泥固瓶子底。待干。安
甲于
用。
取东
浸一
肉
气味甘平。主治伤中益气。补不足。去血热。益阴补虚。作丸服。治虚劳 癖香港脚
人带下。血瘕腰痛。
头
主脱肛。 皮散。治肛门脱出不收。 皮磁石桂心鳖头为细末服。伏龙肝散。治阴
肛。（阳证另用他药）伏龙肝鳖头骨百药煎为末。紫苏汤温洗。清油调涂。
头血
治风中血脉。口眼 僻。涂脱肛。疗小儿疳劳潮湿。千金方目 唇动口 。皆风入
急服小续命汤。外用鳖血或鸡冠血。调伏龙肝散涂之。干则再上。甚妙。盖鳖血之性
血。故治口 肛脱之病。小儿疳劳。潮热往来。五心烦躁。盗汗咳嗽。鳖血丸主之。
黄连各二两。以鳖血一盏。吴萸一两。同二连浸。经宿。去萸血。炒干研末。入柴胡
荑各一两。人参五钱。使君子二十个。为末。煮粟米粉糊和丸。如粟米大。每用熟水
小。日三服。
心入肾以滋阴
之运阴以会阳
之颐所谓金互
是达乎真阴
鳖之用焉。
为其本于
督脉会于
静。大有
【鳖甲】
味咸。气平。是足厥阴肝经血分的药物。主治功效为滋养阴液、补益元气，消除久疟及疟母（脾脏肿大），治疗虚劳消瘦、骨蒸潮热，以及骨节间的劳损结实、壅塞不通。能消除心腹部的症瘕积聚、坚积寒热、血瘕腰痛，治疗因劳累或房劳引起的复发症状。用于小儿胁下坚硬及惊痫。在斑疹痘疮方面，可用于妇人产后子宫脱垂，去除息肉、阴部蚀烂，以及痔核和恶肉。医方书籍还记载其治疗脚气病、咳血盗汗、中风痞证、咳嗽、消渴、小便失禁等证。虚劳证常多用此药。但不可过量使用。（李时珍之父李建元按：）鳖色青入肝，所以它主治的疟疾、劳热、寒瘕、惊痫、月经病、痈肿、阴疮等，都属于厥阴肝经血分的疾病。水龟色黑入肾，所以龟甲主治的阴虚精弱、腰脚疼痛、阴疟、泻痢等，都属于少阴肾经血分的疾病。（李时珍按：）鳖甲味咸，滋润下行以益阴，有何可疑？《神农本草经》中记载的主治症瘕、坚积、息肉等症状，大概正是基于其益阴的作用，以及咸味能软坚散结的缘故吧。（陈实功按：）疟疾在阴虚之人身上表现类似，暑邪深入阴分，出于阳则发热，并入于阴则发冷。等到元气虚弱羸瘦，邪气才内陷凝结成为疟母。鳖甲能益阴除热并消散结块，所以是治疗疟疾的要药，也是退除劳热及阴虚寒热往来的上品。（又按：）配合牛膝、当归、橘皮、首乌、知母、麦冬，可治疗久疟。
若将鳖甲烧存性，研成末，用酒送服一方寸匕。
若服用后石出而病愈。吐血不止者，用鳖甲配蛤粉，饭后茶送下。斑疹痘疮发作气喘、小便不利者，小便有血者，属于病情恶化。黑靥无脓者……
〔论述〕 鳖甲能益阴，丹溪先生更说它能补气。气分为阳气与阴气，这种说法本源于《内经》。经文说：“阴虚则无阳”，导致阳气不能下降。
〔别录、甄权补充〕 臭秽盗汗、疼痛，都是滞血所致；作为滋补药，固然是为了调理阴阳之归，使三焦通畅，而不能升提，导致香港脚心腹胀满，小便不利等，都用鳖甲来调和。五脏受伤则阴虚，这是要领。方剂统以鳖甲为主。
（黄宫绣按：）鳖甲子漏下，都用它。也是阴气虚而不固的表现。
〔简误〕 云：妊娠禁用。凡是阴虚胃弱泄泻、产后泄泻、饮食不消、不思食，以及呕恶等证，都忌用。
〔炮制与鉴别〕 凡使用鳖甲，要选绿色的，九肋多裙边，重七两的为上品。用六一泥固定瓶底，待干后，将甲放入瓶中煅烧使用。
取东壁土浸一宿……
【鳖肉】
气味甘平。主治伤中益气，补不足，去血热，益阴补虚。做成丸药服用，治疗虚劳、癖块、香港脚、妇人带下、血瘕腰痛。
【鳖头】
主脱肛。鳖皮散，治疗肛门脱出不收。鳖皮、磁石、桂心、鳖头研为细末服用。伏龙肝散，治疗阴肛。（阳证另用他药）。伏龙肝、鳖头骨、百药煎研为末，紫苏汤温洗，清油调涂。
【鳖血】
治疗风中血脉，口眼歪斜。涂治脱肛。治疗小儿疳劳潮湿。千金方中目瞤唇动口僻，都是风入血脉所致。急服小续命汤，外用鳖血或鸡冠血，调伏龙肝散涂之，干了再上，甚妙。这是因为鳖血的性质……
心入肾以滋阴，运阴以会阳，颐所谓金互是达乎真阴，鳖之用焉。为其本于督脉会于静，大有……
[Guiji (Tartar Turtle Shell)]
Taste: Salty. Nature: Neutral. It is a medicine entering the blood aspect of the Foot Jueyin Liver Meridian. Its main indications include nourishing Yin, supplementing Qi, eliminating chronic malaria and Mamo (splenomegaly associated with malaria), treating consumptive disease with emaciation, bone-steaming tidal fever, and labor-related stiffness, obstruction, and blockage in the bone joints. It eliminates Zhengjia (masses) and Jianji (hard accumulations) in the heart and abdomen, Xuejia (blood masses) with lower back pain, and recurrence due to overexertion or sexual indulgence. It is used for hardness under the hypochondrium and epilepsy in children. In cases of smallpox and measles, it treats uterine prolapse postpartum in women, removes polyps, erosions of the yin, hemorrhoidal nodes, and malignant flesh. Medical texts also record its use for treating Hongjiaojiao (beriberi/leg qi), hemoptysis, night sweats, stroke with pi syndrome (abdominal masses), cough, xiaodan (wasting-thirst), and urinary incontinence. It is frequently used in Xu Lao (deficiency consumption) syndromes. However, it should not be overdosed. (Li Zhiyuan's note:) The green color of Guiji enters the Liver; therefore, its indications for malaria, lao heat, cold zhajia, epilepsy, menstrual disorders, sores, and yin ulcers all belong to diseases of the Jueyin blood aspect. Water turtles are black and enter the Kidney; thus, their shells treat Yin deficiency with essence weakness, lower back and leg pain, yin malaria, and dysentery, which all belong to diseases of the Shaoyin blood aspect. (Li Shizhen's note:) Guiji tastes salty, moistens downward, and benefits Yin; what doubt is there? The indications in the *Shennong Bencao Jing* for zhajia, hard accumulations, and polyps likely stem from its ability to benefit Yin, combined with the property of saltiness to soften hardness. (Chen Shigong's note:) Malaria in patients with Yin deficiency resembles this pattern. Summer-heat pathogens penetrate deeply into the Yin aspect; emerging to Yang causes fever, while merging into Yin causes chills. When Yuanqi becomes deficient and emaciated, the pathogen sinks inward and knots to form Mamo. Guiji benefits Yin, clears heat, and dissipates accumulation, making it an essential herb for treating malaria and a superior agent for relieving lao heat and alternating chills and fever due to Yin deficiency. (Further note:) Combined with Niuxi (Achyranthis Bidentatae Radix), Danggui (Angelicae Sinensis Radix), Ju Pi (Citri Reticulatae Pericarpium), Shouwu (Polygoni Multiflori Radix), Zhimu (Anemarrhenae Rhizoma), and Maidong (Ophiopogonis Radix), it treats chronic malaria.
If Guiji is calcined until carbonized but retains its nature, ground into powder, and taken with wine in a dose of one cun bi (a measure roughly equivalent to a teaspoon).
If taken after stones have passed and the illness has resolved. For unceasing hemoptysis, combine Guiji with Gege (Puerariae Lobatae Radix), taken after meals with tea. For wheezing during the eruption of smallpox/measles and difficult urination; if blood appears in urine, it indicates severe deterioration. If black crusts appear without pus...
[Discussion] Guiji benefits Yin; Danxi further stated it supplements Qi. Qi is distinguished into Yang Qi and Yin Qi; this theory originates from the *Neijing*. The classic states: "Yin deficiency leads to [Yang] exhaustion," causing Yang Qi to fail to descend.
[Supplements from *Bielu* and *Zhenwan*:] Foul-smelling night sweats and pain are caused by stagnant blood. As a tonic, it serves to regulate the return of Yin and Yang, ensuring the smooth flow of the Triple Burner, preventing failure to ascend, thereby addressing Hongjiaojiao with abdominal distension and fullness, and difficult urination. All these conditions utilize Guiji to harmonize. Injury to the five zang organs results in Yin deficiency; this is the key principle. Formulas generally take Guiji as the principal ingredient.
(Huang Gongxiu's note:) For leukorrhea with leakage due to Guiji deficiency, it is used. This reflects Yin Qi deficiency failing to secure.
[Contraindications & Errors] It is stated: Contraindicated in pregnancy. It is contraindicated in cases of Yin deficiency with weak stomach and diarrhea, postpartum diarrhea, indigestion, loss of appetite, and vomiting/nausea.
[Precipitation and Identification] When using Guiji, select those that are green, have nine ribs and abundant skirt-like edges, weighing seven liang, considered superior. Fix the bottom of the bottle with Liuyi泥 (a mixture of kaolin and flux), let it dry, place the shell inside, and calcine for use.
Take earth from the east wall, soak overnight...
[Gui Rou (Turtle Meat)]
Taste and Nature: Sweet and neutral. Main indications: Treats injury to the middle jiao, supplements Qi, fills deficiencies, clears blood heat, benefits Yin, and tonifies deficiency. Made into pills to treat Xu Lao (deficiency consumption), piku (abdominal masses), Hongjiaojiao (leg qi), leukorrhea in women, Xuejia with lower back pain.
[Gui Tou (Turtle Head)]
Main indication: Rectal prolapse. Gui Pi San (Turtle Skin Powder) treats irreducible rectal prolapse. A powder of Gui Pi (Turtle Skin), Cishi (Magnetitum), Guixin (Cinnamomi Cortex), and Gui Tou (Testudinis Caput) is taken orally. Fulonggan San (Powder of Dragon's House Earth) treats yin anal conditions. (For Yang syndromes, use other medicines separately.) Fulonggan (Dragon's House Earth), Gui Tou Gu (Testudinis Carapax et Plastrum - head part), and Baiyaojian (Galla Chinensis) are ground into powder. Wash warmly with Zisu Tang (Perillae Decoction), then apply mixed with clear sesame oil.
[Gui Xue (Turtle Blood)]
Treats wind invading the blood vessels, causing deviation of the mouth and eye. Applied to rectal prolapse. Treats pediatric gan lao (malnutrition) with dampness. The *Qianjin Fang* mentions twitching eyes, moving lips, and deviation of the mouth, all caused by wind entering the blood vessels. Take Xiaoxuming Tang (Minor Continue Life Decoction) urgently. Externally, mix Gui Xue (Turtle Blood) or Jiguan Xue (Rooster Comb Blood) with Fulonggan San and apply. Reapply when dry; this is excellent. This is because of the nature of turtle blood...
The heart enters the Kidney to nourish Yin; transporting Yin to meet Yang. As Yi described, metal and water interact to reach True Yin; this is the application of Gui. Because it originates from the Du Mai meeting stillness, it has great...