主逐水也。旁治咳掣痛。
考 证
十枣汤证曰∶引胁下痛。又曰∶咳。
张仲景氏用芫花，莫过于十枣汤也。为则试服芫花一味，必大泻水。则其逐水也明矣。
辨 误
本草芫花条。慎微曰∶《三国志》云∶魏初平中，有青牛先生常服芫花，年百余岁，常
如五六十。时珍曰∶芫花乃下品毒物，岂堪久服，此方外迂怪之言，不足信也。为则曰∶方
外迂怪之说，固无论于疾医之道也。下品毒物，岂堪久服，时珍过矣！时珍过矣！有病毒而
毒药以攻之，岂不堪久服邪？学人勿眩焉。
品 考
芫花 汉产为良。本邦亦出焉。本邦所产，今之所鬻者，颇多伪也，不可不正矣。本邦
俗称志计武志，是真芫花也。
主治咳而冒者也。
考 证
小青龙汤证曰∶咳。
苓桂五味甘草汤证曰∶时复冒。
以上二方，五味子皆半升。
上观此二方。则五味子所主治也，咳而冒者明矣。
互 考
五味子、泽泻，皆主治冒者，而有其别。五味子治咳而冒者，泽泻治眩而冒者也。
辨 误
余尝读本草，有五味子收肺补肾之言，是非疾医之言也。原其为说，由五脏生克而来也。
夫
品 考
五味子 朝鲜之产，是为上品，汉次之。本邦之产，其品稍劣，锉用。
主治胸痹也，旁治痰饮。
考 证
小陷胸汤证曰∶结胸。
栝蒌薤白白酒汤证曰∶胸痹、喘息咳唾。
栝蒌薤白半夏汤证曰∶胸痹、不得卧。
枳实薤白桂枝汤证曰∶胸痹。
以上四方，栝蒌实皆一枚。
上历观诸方。其治胸痹及痰饮也明矣；所谓胸痹者，胸膈痞塞是也。
互 考
枳实薤白桂枝汤条曰∶胸痹云云。枳实薤白桂枝汤主之，人参汤亦主之。《金匮要略》，
往
喘息咳唾，则枳实薤白桂枝汤主之。胸痹而心下痞硬，则人参汤主之。此所以不可相代也，
学人思诸。
品 考
栝蒌实 颂曰∶其形有正圆者，有锐而长者，功用皆同。今用世所谓玉章者，李时珍曰∶
栝
考证：
十枣汤证候表现为牵引胁下疼痛，又说有咳嗽症状。
张仲景使用芫花，没有超过十枣汤的。如果尝试单独服用芫花，必然会导致大量泻下水液。那么它驱逐水饮的功效就明确了。
辨误：
本草书中芫花条目下，慎微说：“《三国志》记载：魏朝初平年间，有位青牛先生常年服用芫花，年龄一百多岁，看起来却像五六十岁。”李时珍说：“芫花属于下品有毒之物，怎么能长期服用呢？这是方外之人迂腐怪诞的说法，不值得相信。”为则（作者吉益东洞）说：“方外迂怪之说，本来就不在疾医（临床医生）的道理范围内讨论。下品毒物，难道就不能长期服用吗？李时珍错了！李时珍错了！如果有病邪积聚，就用毒药来攻伐它，难道就不能长期服用吗？学习者不要迷惑。”
品考：
芫花：以汉代产地者为良。本国（日本）也有出产。本国所产的，现在市面上售卖的，很多都是伪品，不可不加以纠正。本国俗称“志计武志”，这才是真正的芫花。
考证：
小青龙汤证候表现为咳嗽。
苓桂五味甘草汤证候表现为时常感到头目昏眩。
以上两个方剂中，五味子的用量都是半升。
观察上述两个方剂，那么五味子所主治的是咳嗽且伴有头目昏眩的情况，这就明确了。
互考：
五味子和泽泻，都主治头目昏眩，但有所区别。五味子主治咳嗽且伴有头目昏眩，泽泻主治眩晕且伴有头目昏眩。
辨误：
我曾经读本草书，其中有说五味子能收敛肺气、补肾的说法，这不是临床医生的说法。推究这种说法的来源，是由五脏相生相克的理论推导而来的。
品考：
五味子：朝鲜出产的为上品，汉代产地次之。本国出产的，品质稍差，需切碎使用。
考证：
小陷胸汤证候表现为结胸。
栝蒌薤白白酒汤证候表现为胸痹、喘息、咳嗽吐涎沫。
栝蒌薤白半夏汤证候表现为胸痹、不能平卧。
枳实薤白桂枝汤证候表现为胸痹。
以上四个方剂中，栝蒌实的用量都是一枚。
纵观上述各方，它治疗胸痹及痰饮的功效就明确了；所谓的胸痹，是指胸膈部痞塞不通的感觉。
互考：
枳实薤白桂枝汤条文中说：“胸痹……用枳实薤白桂枝汤主治，人参汤也主治。”《金匮要略》中……
出现喘息、咳嗽吐涎沫的症状，则用枳实薤白桂枝汤主治。胸痹且伴有心下部痞硬的症状，则用人参汤主治。这就是两者不可互相替代的原因，学习者请深思。
品考：
栝蒌实：苏颂说：“它的形状有的正圆，有的尖锐而长，功用都相同。”现在世面上使用的所谓“玉章”（指瓜蒌），李时珍说：“栝……”
The primary action of *Genkwa Flos* (Yuanhua, 芫花) is to expel water retention. It also treats cough with pulling pain in the hypochondrium.
Evidence:
In the syndrome of *Shizao Tang* (Ten Jujube Decoction), it states: "pulling pain under the ribs." It also states: "cough."
Zhang Zhongjing's use of *Genkwa Flos* does not exceed that in *Shizao Tang*. If one attempts to take *Genkwa Flos* alone, it will inevitably cause severe purgation of water. Thus, its action of expelling water is clear.
Correction of Errors:
In the entry for *Genkwa Flos* in the Materia Medica, Shen Wei states: "According to *Records of the Three Kingdoms*, during the early Ping era of Wei, there was a Master Green Ox who frequently took *Genkwa Flos*, lived over a hundred years old, yet appeared as if he were only fifty or sixty." Li Shizhen states: "*Genkwa Flos* is a lower-grade toxic substance; how can it be taken for a long time? This is a bizarre and eccentric statement from outside the medical field, unworthy of belief." Weize (the author, Yoshimasa Dodo) states: "Eccentric statements from outside the medical field are indeed irrelevant to the principles of clinical medicine. Lower-grade toxic substances—how can they not be taken for a long time? Li Shizhen is wrong! Li Shizhen is wrong! If there is pathogenic accumulation, using toxic drugs to attack it—is it not suitable for long-term use? Students should not be confused."
Product Examination:
*Genkwa Flos*: Those produced in the Han region are superior. They are also produced in our country (Japan). The ones sold in the market today from our country are often counterfeit and must be corrected. The local common name is "Shikibushi," which is the true *Genkwa Flos*.
The primary action of *Schisandrae Fructus* (Wuweizi, 五味子) is to treat cough accompanied by dizziness/vertigo.
Evidence:
In the syndrome of *Xiao Qinglong Tang* (Minor Blue Dragon Decoction), it states: "cough."
In the syndrome of *Linggui Wuzhi Gancao Tang* (Poria, Cinnamon, Schisandra, and Licorice Decoction), it states: "frequently experiencing dizziness/vertigo."
In the above two formulas, the dosage of *Schisandrae Fructus* is both half sheng.
Observing these two formulas, it is clear that *Schisandrae Fructus* primarily treats cough accompanied by dizziness/vertigo.
Mutual Examination:
*Schisandrae Fructus* and *Alismatis Rhizoma* (Zexie, 泽泻) both treat dizziness/vertigo, but there are distinctions. *Schisandrae Fructus* treats cough accompanied by dizziness/vertigo, while *Alismatis Rhizoma* treats vertigo accompanied by dizziness/vertigo.
Correction of Errors:
I once read in the Materia Medica that *Schisandrae Fructus* can astringe the Lung and tonify the Kidney. This is not the language of clinical physicians. Tracing the origin of this theory, it stems from the generation and restriction cycles of the Five Zang Organs.
Product Examination:
*Schisandrae Fructus*: Those produced in Korea are of the highest grade, followed by those from the Han region. Those produced in our country are of slightly inferior quality and should be sliced before use.
The primary action of *Trichosanthis Fructus* (Gualou Shi, 栝蒌实) is to treat Chest Bi (obstruction), and secondarily to treat Phlegm-Fluid retention.
Evidence:
In the syndrome of *Xiao Xianxiong Tang* (Minor Sinking into the Chest Decoction), it states: "Chest Binding" (Jie Xiong).
In the syndrome of *Gualou Xiebai Baijiu Tang* (Trichosanthes, Macrostemon, and White Wine Decoction), it states: "Chest Bi, wheezing, coughing, and spitting."
In the syndrome of *Gualou Xiebai Banxia Tang* (Trichosanthes, Macrostemon, and Pinellia Decoction), it states: "Chest Bi, inability to lie flat."
In the syndrome of *Zhishi Xiebai Guizhi Tang* (Aurantium, Macrostemon, and Cinnamon Twig Decoction), it states: "Chest Bi."
In the above four formulas, the dosage of *Trichosanthis Fructus* is all one fruit.
Reviewing these formulas, it is clear that it treats Chest Bi and Phlegm-Fluid retention; what is referred to as Chest Bi is a sensation of fullness and obstruction in the chest and diaphragm.
Mutual Examination:
The entry for *Zhishi Xiebai Guizhi Tang* states: "Chest Bi... treated by *Zhishi Xiebai Guizhi Tang*; *Renshen Tang* (Ginseng Decoction) also treats it." In *Jin Gui Yao Lue*...
When there is wheezing, coughing, and spitting, *Zhishi Xiebai Guizhi Tang* is indicated. When there is Chest Bi accompanied by hardness and fullness below the heart, *Renshen Tang* is indicated. This is why they cannot be substituted for each other; students should ponder this.
Product Examination:
*Trichosanthis Fructus*: Song states: "Its shape is either perfectly round or sharp and elongated; their functions are identical." What is currently used in the world as "Yuzhang" refers to the Trichosanthes fruit. Li Shizhen states: "Trichosanthes..."