味苦。性平。一云微寒。无毒。禀仲冬之气。兼得地之辛味以生。升也。阴中阳也。
半夏为使。恶皂荚。畏藜芦。
【主治】主伤寒邪热。痰热结实。虚劳肌热。呕吐心烦。诸疟寒热。头眩目赤。胸痞胁
气。口苦耳聋。女人热入血室。胎前产后诸热。小儿痘疹。五疳羸热。散十二经疮疽血凝气
聚。功同连翘。（备要）肠胃心腹中结气。五脏间游气。胸中邪气。大肠停积水胀。及湿痹
拘挛肩背疼痛。脾痹。阳气下陷。平肝胆心包三焦相火。及头痛眩晕。（本
【归经】入肝胆心包三焦四经。为表散之品。（四经引经药 少阳经表药其功发表和里
退
热升
【前论】东垣曰。柴胡能引清气行阳道。伤寒外诸有热病则加之。无热不必加之。能引
胃气上行。升腾而行春令。时珍曰。痨有五。痨在肝胆心心包有热。则柴胡乃此四经必用之
药。痨在脾胃有热。或阳气下陷。则柴胡为升清退热必用之药。惟痨在肺肾。当斟酌用之。
然亦非必禁用也。孙琳曰。凡疟痨热从髓出。若加刚剂。气血愈亏。热有在皮肤。在脏腑。
在骨髓。在骨髓者。非柴胡不可。若得真银柴胡。一服可愈。南方者力减。必三服乃可愈。
汪昂曰。凡胁痛。多是肝木有余。宜小柴胡汤加青皮、川芎、白芍。又左胁痛。宜活血行气。
右胁痛。宜消食行痰。又热入血室。男女皆有之。柴胡在脏主血。在经主气。
鳌按、今人治疟。必用柴胡。若非柴胡即不足以为治者。故致辗转淹滞。变生不测。竟
能殒
阳。
正气
而医家犹曰柴胡为治疟要药。吾开手即用之。不知其何以死。病家亦曰以柴胡治疟而竟不效。
此其命之
是在古
为治痨
乏羸瘦
当须
但真
【禁忌】经疏曰。凡虚人气升呕吐。及阴虚火炽炎上。法所同忌。疟非少阳经者勿入。
【炮制】备要曰。产银州者色白黄而大。北产者色微黑而细。并良。南产者强硬不堪用。
外
【性味】味道苦。性质平和。另一种说法认为微寒。没有毒性。禀受仲冬（农历十一月）的气候之气，同时兼得地气的辛味而生长。药性主升，属于阴中之阳。
【主治功效】主要治疗伤寒邪热、痰热结实、虚劳引起的肌肉发热、呕吐心烦、各种疟疾的寒热往来、头晕目眩、眼睛发红、胸膈痞满胁肋气滞、口苦耳聋。女性热邪陷入血室，产前产后各种热证，小儿痘疹，五种疳积引起的羸弱发热。能消散十二经络中的疮疽、血凝和气聚，功效类似于连翘。（《本草备要》补充：治疗肠胃心腹中结聚的气机、五脏间的游移之气、胸中的邪气、大肠停积水肿胀满，以及湿痹导致的肩背疼痛拘挛、脾痹、阳气下陷。能平抑肝胆、心包、三焦的相火，以及头痛眩晕。）
【归经】入肝、胆、心包、三焦四经。属于发表散邪的药物。（是这四经的引经药，少阳经的表药，其功效在于发表和里、退热、升提。）
【前人论述】李东垣说：柴胡能引导清气运行于阳道。伤寒等外感热病则加入使用，无热证不必加入。能引导胃气上行，升腾而行春生之令。李时珍说：痨病有五种，若痨热在肝、胆、心、心包，则柴胡是这四经必用的药物。若痨热在脾胃，或阳气下陷，则柴胡是升清退热必用的药物。只有痨在肺肾时，应当斟酌使用。然而也并非绝对禁用。孙琳说：凡是疟疾、痨病的热从骨髓发出，如果加入刚烈燥热的药剂，气血会更加亏损。热邪有的在皮肤，有的在脏腑，有的在骨髓。在骨髓的热邪，非柴胡不可用。如果得到真正的银柴胡，服用一次即可痊愈。南方产的柴胡药力减弱，必须服用三次才能痊愈。汪昂说：凡是胁痛，多是肝木有余，宜用小柴胡汤加青皮、川芎、白芍。又左胁痛，宜活血行气；右胁痛，宜消食行痰。还有热入血室，男女都有此病。柴胡在脏分主血，在经分主气。
【按语】现在的人治疗疟疾，必定使用柴胡。如果不是柴胡就觉得不足以治疗，导致病情辗转拖延，变生不测，竟然能损伤阳气正气，而医家仍然说柴胡是治疗疟疾的要药。我刚开始用药就用它，不知道病人为什么死亡。病人家属也说用柴胡治疟疾竟然无效。这其中的命运……古时候治疗痨病……虚弱消瘦……应当需要……但是真正的……
【禁忌】缪希雍《本草经疏》说：凡是虚人气机上逆呕吐，以及阴虚火旺炎上者，依法都应当忌用。疟疾不属于少阳经的不要使用。
【炮制】《本草备要》说：产于银州的柴胡颜色白黄且个大，北地产的颜色微黑且细，都是好的。南产的品质强硬不堪使用。
[Properties and Flavor] Bitter in taste. Neutral in nature. Another view holds it to be slightly cold. Non-toxic. It inherits the qi of Mid-Winter (the 11th lunar month) and, while growing, also acquires the pungent flavor of the earth. Its action is ascending; it belongs to Yang within Yin.
[Combinations and Contraindications] Banxia (Pinelliae Rhizoma) serves as its guiding agent. It is incompatible with Zaojia (Gleditsiae Sinensis Spina) and fears Liliu (Veratri Rhizoma).
[Indications and Actions] Primarily treats pathogenic heat from Shanghan (Cold Damage), phlegm-heat accumulation, deficiency consumption with muscle fever, vomiting with irritability, various types of malaria with alternating chills and fever, dizziness, red eyes, chest oppression with hypochondriac Qi stagnation, bitter taste in the mouth, and deafness. For women, it treats heat entering the Blood Chamber (Xueshi), various febrile conditions before and after childbirth, pediatric smallpox/rash, and emaciated fever caused by the five kinds of Ganic syndrome (childhood malnutrition syndromes). It dissipates carbuncles and sores, blood stasis, and Qi aggregation in the twelve meridians, with effects similar to those of Lianqiao (Forsythiae Fructus). (Supplement from *Bencao Beiyao*): Treats Qi knotting in the intestines, stomach, and abdomen; wandering Qi among the five Zang organs; pathogenic Qi in the chest; water retention and distension in the large intestine; and wet Bi syndrome causing shoulder and back pain with stiffness and spasms, Pi Bi syndrome, and sinking of Yang Qi. It pacifies the Ministerial Fire (Xianghuo) of the Liver, Gallbladder, Pericardium, and Sanjiao, as well as headache and vertigo.
[Meridian Tropism] Enters the Liver, Gallbladder, Pericardium, and Sanjiao meridians. It is a drug for releasing the exterior. (It is a guiding herb for these four meridians and a superficial-releasing herb for the Shaoyang Meridian; its functions include releasing the exterior, harmonizing the interior, reducing fever, and lifting.)
[Preceding Discussions] Li Dongyuan stated: Chaihu can guide clear Qi to circulate through the Yang pathways. It should be added for exogenous febrile diseases such as Shanghan, but not if there is no heat. It can guide Stomach Qi upward, ascending to enact the Spring generation. Li Shizhen stated: There are five types of consumption diseases. If the heat of consumption lies in the Liver, Gallbladder, Heart, or Pericardium, Chaihu is an essential herb for these four meridians. If the heat of consumption lies in the Spleen and Stomach, or if Yang Qi is sinking, Chaihu is an essential herb for clearing the clear and reducing fever. Only when the consumption lies in the Lung and Kidney should one exercise caution in its use. However, it is not absolutely contraindicated. Sun Lin stated: Whenever malaria or consumption fever originates from the marrow, adding harsh agents will further deplete Qi and Blood. Heat may reside in the skin, Zang organs, or marrow. For heat residing in the marrow, only Chaihu is effective. If genuine Yinchaihu (Stellariae Radix) is obtained, one dose can cure it. The southern variety has reduced potency and requires three doses for a cure. Wang Ang stated: Hypochondriac pain is mostly due to excess Liver Wood; Xiao Chaihu Tang (Minor Bupleurum Decoction) with Qingpi (Aurantii Fructus Pericarpium), Chuanxiong (Ligustici Chuanxiong Rhizoma), and Baishao (Paeoniae Radix Alba) is appropriate. Left-sided hypochondriac pain calls for invigorating blood and moving Qi; right-sided hypochondriac pain calls for resolving food stagnation and transforming phlegm. Furthermore, heat entering the Blood Chamber occurs in both men and women. In the Zang organs, Chaihu governs Blood; in the meridians, it governs Qi.
[Commentary] Nowadays, practitioners invariably use Chaihu for treating malaria. They believe treatment is insufficient without it, leading to prolonged and lingering illness with unpredictable complications, potentially damaging Yang Qi and Zheng Qi (Upright Qi). Yet physicians still claim Chaihu is the key herb for malaria. I used it at the onset of treatment, unaware of why the patient died. Patients' families also complain that Chaihu failed to treat the malaria. This reflects fate... In ancient times, treating consumption... emaciation... one must... but genuine...
[Contraindications] According to *Bencao Jing Shulü* by Mi Huanyong: It is contraindicated in cases of deficiency with rebellious Qi and vomiting, and in cases of Yin deficiency with blazing fire rising. It should not be used for malaria not involving the Shaoyang Meridian.
[Processing] *Bencao Beiyao* states: The variety produced in Yinzhou is white-yellow and large; the northern variety is slightly black and fine; both are good quality. The southern variety is hard and tough, making it unsuitable for use.