主治肌表之水也。故能治黄汗、盗汗、皮水。又旁治身体肿或不仁者。
考 证
芍桂枝苦酒汤证曰∶身体肿、发热汗出而渴。又云∶汗沾衣、色正黄加 汁；防己黄
汤证曰∶身重、汗出恶风。
以上二方，黄 皆五两。
防己茯苓汤证曰∶四肢肿，水气在皮肤中。
黄 桂枝五物汤证曰∶身体不仁。
以上二方，黄 皆三两。
桂枝加黄 汤证曰∶身常暮盗汗出者。又云∶从腰以上必汗出、下无汗、腰 弛痛、如
有物在皮中状。
以上一方，黄 二两。
黄 建中汤证，不具也。
以上一方，黄 一两半。
上历观此诸方，黄 主治肌表之水也。故能治黄汗、盗汗、皮水。又能治身体肿或不仁
者，是肿与不仁，亦皆肌表之水也。
互 考
芍桂枝苦酒汤、桂枝加黄 汤，同治黄汗也。而 芍桂枝苦酒汤证曰∶汗沾衣，是汗
甚多也。桂枝加黄 汤证曰∶腰以上必汗出、下无汗，是汗少也。以此考之，汗之多少，即
用黄 多少，则其功的然可知矣。
防己黄 汤、防己茯苓汤。同治肌肤水肿也。而黄 有多少。防己黄 汤证曰∶身重汗
出。防己茯苓汤证曰∶水气在皮肤中，此随水气多少，而黄 亦有多少。则黄 治肌表之水
明矣。故 芍桂枝苦酒汤、桂枝加黄 汤，随汗之多少，而用黄 亦有多少也。
黄 桂枝五物汤证曰∶身体不仁。为则按∶仲景之治不仁，虽随其所在，处方不同。而
历观其药，皆是治水也。然则不仁，是水病也。故小腹不仁、小便不利者，用八味丸以利小
便，则不仁自治。是不仁者，水也。学人思诸。
防己黄 汤，《金匮要略》载其分量与《外台秘要》异。为则夷考其得失，《外台秘要》
古，而《金匮要略》不古矣。故今从其古者也。
辨 误
余尝读本草载黄 之功。陶弘景曰∶补丈夫虚损、五劳羸瘦、益气。甄权曰∶主虚喘，
肾衰耳聋，内补。嘉谟曰∶人参补中，黄 实表也。余亦尝读《金匮要略》，审仲景之处方，
皆以黄 治皮肤水气，未尝言补虚实表也。为则尝闻之，周分置医，职四焉∶曰食医、曰疾
医、曰疡医、曰兽医。夫张仲景者，盖古疾医之流也。夫陶弘景尊信仙方之人也。故仲景动
言疾病，而弘景动论养气，谈延命，未尝论疾病。后世之喜医方者，皆眩其俊杰，而不知其
有害于疾医也。彼所尊信而我尊信之，滔滔者天下皆是也。岂不亦悲哉？夫逐奔兽者，不见
大山。嗜欲在外，则聪明所蔽。故其见物同，而用物之异。仲景主疾病者也，弘景主延命者
也；仲景以黄 治水气，弘景以之补虚。夫药者，毒也。毒药何补之为，是以不补而为补，
以不补而为补，是其聪明为延命之欲所蔽也。古语曰∶邪气盛则实，精气夺则虚。夫古所谓
虚实者，以其常而言之也。昔者常无者，今则有之，则是实也。昔者常有者，今则无之，则
是虚也。邪者，常无者也；精者，常有者也。故古所谓实者，病也。而虚者，精也。因病而
虚，则毒药以解其病毒而复其故也。非病而虚，则非毒药之所治也，以谷肉养之。故曰攻病
以毒药，养精以谷肉果菜。今试论之。天寒肌肤粟起，当此时服黄 而不已也。以衣衾则已，
以衣衾而不已也，啜粥而已，无他。是非病而精虚也。若乃手足拘急恶寒，是与衣衾而不已
也，啜粥而不已也，与毒药而已也。无他，是邪实也。呜呼？仲景氏哉？信而有征，此孔子
所以非法言不敢道也，甄权、嘉谟不言疾医之法言也，抑亦弘景祸之矣。言必以仙方，必以
阴阳，此 功之所以不着也。
品 考
黄 汉土、朝鲜、本邦皆产也。汉土出绵上者，以为上品，其他皆下品也。其出朝
鲜、本邦者，亦皆下品也。今华舶之所载而来者，多是下品，不可不择也。凡黄 之品，柔
软、肉中白色，润泽味甘，是为上品也，锉用。
主治肌表的水湿之邪。因此能够治疗黄汗、盗汗、皮水。又兼治身体浮肿或肢体麻木不仁者。
考证
芍药桂枝苦酒汤证表现为：身体浮肿、发热、出汗且口渴。又说：汗液沾湿衣物，颜色正黄如汁；防己黄芪汤证表现为：身体沉重、出汗且怕风。
以上两个方剂中，黄芪都用五两。
防己茯苓汤证表现为：四肢浮肿，水气停留在皮肤之中。
黄芪桂枝五物汤证表现为：身体麻木不仁。
以上两个方剂中，黄芪都用三两。
桂枝加黄芪汤证表现为：经常夜间盗汗。又说：腰部以上必然出汗，腰部以下无汗，腰部弛缓疼痛，感觉像有东西在皮肤中一样。
以上一个方剂中，黄芪用二两。
黄芪建中汤的条文内容不全。
以上一个方剂中，黄芪用一两半。
综上所述观察这些方剂，黄芪主治肌表的水湿之邪。因此能治疗黄汗、盗汗、皮水。又能治疗身体浮肿或麻木不仁，这说明浮肿和麻木不仁，也都是肌表的水湿之邪所致。
互考
芍药桂枝苦酒汤、桂枝加黄芪汤，都治疗黄汗。但芍药桂枝苦酒汤证说：汗液沾湿衣物，这是汗出很多的表现。桂枝加黄芪汤证说：腰部以上必然出汗，腰部以下无汗，这是汗出较少的表现。据此考证，汗出的多少，即对应使用黄芪的多少，其功效确实可以知晓了。
防己黄芪汤、防己茯苓汤，都治疗肌肤水肿。但黄芪的用量不同。防己黄芪汤证说：身体沉重、出汗。防己茯苓汤证说：水气在皮肤中，这是随着水气的多少，而决定黄芪用量的多少。那么黄芪治疗肌表水湿是明确的。所以芍药桂枝苦酒汤、桂枝加黄芪汤，也是随着汗出的多少，而决定黄芪用量的多少。
黄芪桂枝五物汤证说：身体麻木不仁。为则按：张仲景治疗麻木不仁，虽然根据病变部位不同，处方也不同。但纵观其用药，都是治疗水湿。既然这样，麻木不仁就是水湿病。所以小腹麻木不仁、小便不利者，用八味丸来利小便，则麻木不仁自然痊愈。可见麻木不仁是水湿所致。学者请深思。
防己黄芪汤，《金匮要略》记载的分量与《外台秘要》不同。为则详细考察其得失，《外台秘要》更古老，而《金匮要略》不够古老。所以现在遵循《外台秘要》的古本。
辨误
我曾经阅读本草书中记载黄芪的功效。陶弘景说：补益男子的虚损、五劳羸瘦、益气。甄权说：主治虚喘，肾衰耳聋，内补。嘉谟说：人参补中焦，黄芪实肌表。我也曾阅读《金匮要略》，仔细审查张仲景的处方，都是用黄芪治疗皮肤水气，从未说过补虚、实表。为则曾经听说，周朝分设医生，职责分为四类：叫食医、疾医、疡医、兽医。张仲景，大概是古代疾医这一类人。陶弘景是尊崇信奉仙方的人。所以张仲景动不动就谈论疾病，而陶弘景动不动就谈论养气、谈延命，从未谈论疾病。后世喜欢医方的人，都被他们的杰出所迷惑，却不知道这对疾医有害。他们所尊信而我尊信的，天下到处都是，这难道不可悲吗？追逐奔跑的野兽，看不见大山。欲望在外，就会遮蔽聪明。所以他们看到的物体相同，但使用物体的方法却不同。张仲景主治疾病，陶弘景主治延命；张仲景用黄芪治水气，陶弘景用它补虚。药物，是有毒性的。毒药有什么可补的呢？把不补当作补，以不补为补，是因为他们的聪明被延命的欲望所遮蔽了。古语说：邪气盛则实，精气夺则虚。古人所说的虚实，是从常态来说的。过去常没有的，现在有了，这就是实。过去常有的，现在没有了，这就是虚。邪，是过去常没有的；精，是过去常有的。所以古人所说的实，是指病。而虚，是指精。因病而虚，就用毒药解除病毒并恢复原来的状态。不是病而虚，就不是毒药所能治疗的，要用谷肉来滋养。所以说攻病用毒药，养精用谷肉果菜。现在试着论述一下。天冷时肌肤起粟粒，在这个时候服用黄芪而不能止住。盖上衣服被子就能止住，盖上衣服被子还不能止住，喝热粥就能止住，没有其他原因。这不是病而是精虚。如果是手足拘急恶寒，这与盖衣被不能止住，喝热粥也不能止住，只有用毒药才能止住。没有其他原因，这是邪实。唉！张仲景啊！真实而有证据，这就是孔子所以不说非礼之言的原因。甄权、嘉谟说的不是疾医的法言，这也是陶弘景造成的祸害。说话必以仙方，必以阴阳，这就是黄芪的功效之所以不显著的原因。
品考
黄芪汉地、朝鲜、日本都有出产。汉地出产绵上的，作为上品，其他的都是下品。出产于朝鲜、日本的，也都是下品。现在中国商船运来的，多是下品，不得不选择。凡是黄芪的品种，柔软、肉质中白色，润泽味甘，这就是上品，切碎使用。
It governs the water-dampness at the muscle and surface level. Therefore, it can treat Huanghan (Yellow Sweat), Daohan (Night Sweats), and Pishui (Skin Edema). It also treats body swelling or numbness (loss of sensation).
Evidence Examination
The syndrome of Shaoyao Guizhi Kujiu Tang (Peony and Cinnamon Twig Vinegar Decoction) presents with: body swelling, fever, sweating, and thirst. It is also stated that: sweat stains clothes yellow like juice; the syndrome of Fangji Huangqi Tang (Stephania and Astragalus Decoction) presents with: heavy body, sweating, and aversion to wind.
In the above two formulas, Huangqi (Astragalus Root) is used in the amount of five liang.
The syndrome of Fangji Fuling Tang (Stephania and Poria Decoction) presents with: swelling of the four limbs, with water-qi residing in the skin.
The syndrome of Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction) presents with: body numbness.
In the above two formulas, Huangqi (Astragalus Root) is used in the amount of three liang.
The syndrome of Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction with Added Astragalus) presents with: frequent night sweating. It is also stated that: sweating must occur from the waist up, while there is no sweating below the waist; the waist feels flaccid and painful, as if there were an object within the skin.
In the above one formula, Huangqi (Astragalus Root) is used in the amount of two liang.
The text for Huangqi Jianzhong Tang (Astragalus and Middle-Warming Decoction) is incomplete.
In the above one formula, Huangqi (Astragalus Root) is used in the amount of one and a half liang.
Having observed these formulas comprehensively, Huangqi (Astragalus Root) governs water-dampness at the muscle and surface level. Thus, it can treat Huanghan (Yellow Sweat), Daohan (Night Sweats), and Pishui (Skin Edema). It can also treat body swelling or numbness, indicating that swelling and numbness are both caused by water-dampness at the muscle and surface level.
Cross-Examination
Shaoyao Guizhi Kujiu Tang (Peony and Cinnamon Twig Vinegar Decoction) and Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction with Added Astragalus) both treat Huanghan (Yellow Sweat). However, the syndrome of Shaoyao Guizhi Kujiu Tang states: "sweat stains clothes," indicating profuse sweating. The syndrome of Guizhi Jia Huangqi Tang states: "sweating must occur from the waist up, while there is no sweating below the waist," indicating scanty sweating. Based on this examination, the amount of sweating corresponds to the dosage of Huangqi (Astragalus Root); thus, its efficacy is clearly discernible.
Fangji Huangqi Tang (Stephania and Astragalus Decoction) and Fangji Fuling Tang (Stephania and Poria Decoction) both treat edema of the skin and muscles. However, the dosage of Huangqi (Astragalus Root) differs. The syndrome of Fangji Huangqi Tang states: "heavy body, sweating." The syndrome of Fangji Fuling Tang states: "water-qi in the skin." This indicates that the dosage of Huangqi (Astragalus Root) varies according to the amount of water-qi. Therefore, it is clear that Huangqi (Astragalus Root) treats water-dampness at the muscle and surface level. Consequently, in Shaoyao Guizhi Kujiu Tang (Peony and Cinnamon Twig Vinegar Decoction) and Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction with Added Astragalus), the dosage of Huangqi (Astragalus Root) varies according to the amount of sweating.
The syndrome of Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction) states: "body numbness." Weierze notes: Zhang Zhongjing's treatment of numbness varies the prescription according to the location. However, observing his herbs, they all treat water-dampness. Thus, numbness is a disease of water. Therefore, for numbness in the lower abdomen accompanied by difficult urination, using Bajian Wan (Eight-Ingredient Pill) to promote urination will cure the numbness naturally. Numbness is caused by water. Scholars should ponder this.
For Fangji Huangqi Tang (Stephania and Astragalus Decoction), the dosages recorded in *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) differ from those in *Waitai Miyao* (Secret Essentials of the Outer Palace). Weierze examined their merits and demerits; *Waitai Miyao* is older, whereas *Jingui Yaolue* is not as old. Therefore, we now follow the older version.
Correction of Errors
I once read in herbal texts about the efficacy of Huangqi (Astragalus Root). Tao Hongjing said: "Tonifies deficiency injuries in men, five labors, emaciation, and benefits qi." Zhen Quan said: "Treats deficiency wheezing, kidney decline, deafness, and provides internal tonification." Jiamo said: "Renshen (Ginseng) tonifies the middle, while Huangqi (Astragalus Root) solidifies the exterior." I have also read *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) and carefully examined Zhang Zhongjing's prescriptions; he always used Huangqi (Astragalus Root) to treat skin water-qi, never mentioning tonifying deficiency or solidifying the exterior. Weierze once heard that in the Zhou Dynasty, physicians were divided into four categories: Shi Yi (Dietary Physician), Ji Yi (Physician for Diseases), Yang Yi (Surgeon), and Shou Yi (Veterinarian). Zhang Zhongjing was likely a practitioner of the ancient Ji Yi (Physician for Diseases). Tao Hongjing was a person who revered and believed in immortal prescriptions. Thus, Zhang Zhongjing frequently discussed diseases, while Tao Hongjing frequently discussed nourishing qi and prolonging life, never discussing diseases. Later generations who favored medical prescriptions were dazzled by their brilliance but did not realize the harm done to the practice of Ji Yi (Physician for Diseases). What they revered, I also revere; this trend is ubiquitous under heaven. Is this not tragic? One chasing a fleeing beast does not see the great mountains. Desires external to oneself obscure wisdom. Thus, although they see the same objects, their use of them differs. Zhang Zhongjing focused on diseases, Tao Hongjing on prolonging life; Zhang Zhongjing used Huangqi (Astragalus Root) to treat water-qi, while Tao Hongjing used it to tonify deficiency. Medicines are toxic. How can toxic substances provide tonification? To treat non-deficiency as deficiency, and to claim tonification where there is none, is because their wisdom was obscured by the desire to prolong life. An ancient saying goes: "When pathogenic qi is exuberant, it is excess; when essential qi is depleted, it is deficiency." The ancient concepts of excess and deficiency were based on normalcy. What was normally absent but is now present constitutes excess. What was normally present but is now absent constitutes deficiency. Pathogens are what is normally absent; essence is what is normally present. Therefore, what the ancients called "excess" refers to disease, and "deficiency" refers to essence. When deficiency arises from disease, toxic medicines are used to resolve the pathogen and restore the original state. When deficiency is not due to disease, it is not treated with toxic medicines but nourished with grains and meats. Hence, it is said: "Attack disease with toxic medicines; nourish essence with grains, meats, fruits, and vegetables." Let us discuss this further. When the weather is cold and gooseflesh appears on the skin, taking Huangqi (Astragalus Root) at this time will not stop it. Covering oneself with clothes and quilts will stop it. If covering with clothes and quilts does not stop it, drinking hot porridge will stop it. There is no other reason. This is not disease but essence deficiency. However, if there are contracted limbs, aversion to cold, which do not improve with clothes and quilts or hot porridge, but only improve with toxic medicines, there is no other reason; this is pathogenic excess. Alas, Master Zhongjing! His records are true and verifiable. This is why Confucius said he would not speak words that were not proper. Zhen Quan and Jiamo did not speak the laws of the Ji Yi (Physician for Diseases); this disaster was indeed caused by Tao Hongjing. Speaking only of immortal prescriptions and yin-yang theory is why the efficacy of Huangqi (Astragalus Root) remains obscure.
Product Examination
Huangqi (Astragalus Root) is produced in Han lands, Korea, and our own country (Japan). Those produced in Mianshang of Han lands are considered superior grade, while others are inferior grade. Those produced in Korea and our own country are also inferior grade. Most of what is brought by Chinese merchant ships today is inferior grade, so selection is necessary. For all grades of Huangqi (Astragalus Root), those that are soft, white in the flesh, moist, and sweet-tasting are considered superior grade. They should be sliced before use.