上汗者，法宜泄火、益湿、补气。脉弦浮沉者同治，以安神丸主之。（方见治虚实。）气不化，小便不利，湿润肌滑，
热蒸阴少，气不化。气走小便利，自汗肌燥涩，为迫津液不能停，离珠丹主之。（方见虚实。）弦数者，阳陷于
内，从外而之内也。弦则带数，甲经于乙。紧则带洪，壬经于丙。若弦虚则无火，细则有水。此二脉，从内之外，
不宜离珠丹。
\r弦数脉图\ps91a6.bmp\r
火令速行而土虚，土虚则长夏不至。《难经》曰∶虚则补其母。资其化源，当泻火于
金中补土是也。
上寸显弦数脉，是东方实，乃乘子势也。既泻其子火，木自虚矣。以寒药泻火，
是补北方水。木既乘火势而来侮金，当金中泻火，火退则木无所恃而自退，是实则泻其子也。
〔仲〕五劳虚极羸瘦，腹满不能饮食，食伤忧伤，饮伤房室伤，饥伤劳伤，经络荣卫气伤，内有干血，肌肤甲
错，两目黯黑，缓中补虚，大黄 虫丸主之。（结在内者，手足脉必相失，宜此方。然必兼大补剂琼玉膏之类服之。）
大黄（十两，蒸） 黄芩（二两） 甘草（三两） 桃仁（一升） 杏仁（一升） 芍药（四两） 地
黄（半两） 干漆（一两，炒） 虻虫（一升） 水蛭（百枚） 蛴螬（一升） 虫（半斤）
上十二味为末，炼蜜丸如小豆大。日三服，酒下五丸。
陈大夫传张仲景百劳丸 治一切劳瘵积滞，疾不经药坏症者宜服。
当归（炒） 乳香 没药（各一钱） 人参（一钱） 大黄（四钱） 虻虫（十四枚，去翅足） 水蛭（
十四枚，制）
上为细末，炼蜜丸如桐子大。都作一服，可百丸，五更百劳水下。取恶物为度，服白粥十日。百劳水，用
杓扬百遍，仲景甘澜水是也。
〔《外台》〕治骨蒸。桃仁一百二十枚，去皮并双仁，留尖，杵和为丸，平旦井花水服令尽。服讫，量性
饮酒，仍须吃水，多效。隔日又服一剂，百日不得食肉。
〔仲〕炙甘草汤（一名复脉汤。） 治虚劳不足，汗出而闷，脉结悸，行动如常，不出百日，急者十一日死。
（方见伤寒。）
〔海〕四物加减汤 治妇人骨蒸。
当归 白芍药 川芎 地黄（以上补血） 地骨皮（泻肾火） 牡丹皮（泻包络火。各等分）
上 咀水煎服。
〔罗〕逍遥散 治血虚劳倦，五心烦蒸，颊赤盗汗，室女血弱阴虚，营卫不和，月水不调，痰嗽潮热，
肌体羸瘦，渐成骨蒸。
茯苓 白术 当归 芍药 柴胡 甘草（炙）
上 咀，生姜一块，煨切破，薄荷少许同煎。
上二方，治妇人骨蒸大法。若夫要处，并同于前阴虚法取之。蒸病治者，宜随各经虚实，内外浅深，用药
加减可也。
〔《古今录验》〕五蒸汤
茯苓 甘草 人参 竹叶 地黄 葛根 知母 黄芩 石膏 粳米（二合）
上 咀，以水三盏，煎小麦二合，至二盏，去麦煎药至一盏，温服、随症加减于后。忌海藻、菘菜、芜荑、
大醋。
实热加黄芩、黄连、黄柏、大黄。虚热，气加乌梅、秦艽、柴胡；血加青蒿、鳖甲、蛤蚧、小麦、牡丹皮。
肺蒸（鼻干）加乌梅、天冬、麦冬、紫菀。大肠（右鼻孔干痛） 加大黄、芒硝。皮蒸（舌白唾血）加石
膏、桑白皮。肤蒸（昏昧嗜卧）加丹皮。气蒸（鼻干喘促，遍身气热。）加人参、黄芩、山栀。
心蒸（舌干） 加黄连、生地。小肠（下唇焦）加赤茯、生地、木通。血蒸（发焦）加生地、当归、桂心、童便。
脉蒸（唾白浪语，脉络溢，脉缓急不调。）加当归、生地。
脾蒸（唇焦）加白芍、木瓜、苦参。胃蒸（舌下痛）加石膏、粳米、大黄、芒硝、干葛。肉蒸（食无味而呕，
烦躁不安。）加白芍。
肝蒸（眼黑）加川芎、当归、前胡。胆蒸（眼白失色）加柴胡、栝蒌。筋蒸（甲焦）加当归、川芎。三焦蒸（乍热
乍寒）加石膏、竹叶。
肾蒸（两耳焦）加生地、石膏、知母、寒水石。膀胱蒸（右耳焦）加泽泻、茯苓、滑石。脑蒸（头眩热闷）加生地、
防风、羌活。髓蒸（髓枯、骨中热）加生地、当归、天门冬、骨蒸（齿黑、腰痛、足逆冷、疳虫食藏）加鳖甲、地骨皮、
丹皮、生地、当归。 蒸（肢细趺肿，腑脏皆热）加石膏、黄柏。胞蒸（小便赤黄）加泽泻、茯苓、生地、沉香、滑
石。
凡此诸症，皆热病后食肥甘油腻，房事饮酒犯之而成。久蒸不除，变成疳病，死期近矣。
牡丹皮治无汗之骨蒸。（能泻阴中之火。）知母治有汗之骨蒸。
〔《衍义》〕治骨蒸劳。用薄荷汁与众药熬成膏。
〔《经验》〕治患劳人。烧香法∶玄参一斤，甘松六两为末，炼蜜一斤，和匀，入瓷瓶内，封闭地中，埋窨
半日，取出。更用炭末六两，炼蜜六两，和匀，入瓶内，封窨五日，取出烧。使鼻中常闻香气，疾自愈矣。
〔《撮要》〕治骨蒸劳热∶膏肓（在四椎下、五椎上各开二寸，灸百壮。详见刺法门）三里。
〔《摘英》〕热劳上气喘满∶肺俞（五分，留七呼，灸七壮）、尺泽。
崔氏治骨热传尸劳。灸四花穴，兼治赤白带。第一次取二穴，令患人正立，取一蜡绳，从足大拇指端（男左女右。）
贴肉量至后跟，上 至委中横纹，绝断为则子。复令患人解发，分两边，令见头缝，却平身正坐，取前则子，
从鼻端贴肉上至头缝，下至项脊骨，以则子尽处为记，用墨点之。（且不是穴）又另取一绳，令患人合口，将绳两头
至口吻，当中钩起至鼻柱根如人字，齐两吻截断，却展直于前则子尽头墨记处，横量开，取两平头是穴。（须左右
当半，高下相平。）第二次取二穴。令平身正坐，又取一绳，绕项向前，双垂与乳头齐，截断。却背翻绳头向项后，以
绳中停于结喉上，其下双垂绳头，尽处当背骨中，用墨点之。（亦不是穴）又取一绳，令病患合口，横量二吻截断，
移于前脊中记处，横量取平，（须左右当中，上下相半。）两头是穴。连前第一次，通取共计四穴。同时上火七
壮至二十壮，灸至百壮。候灸疮瘥，却取三次穴。第三次取二穴，将前第二次量口吻绳子，于第一次双绳头尽处，
墨点记上，当脊骨直上下竖点，令绳子中停中心在墨点处，于上下绳尽处是穴。灸如前法。
〔《标幽》〕体热劳嗽∶魄户（泻）。
〔洁〕治骨蒸热不可治者，或前板齿干燥∶大椎。
〔《撮要》〕又法∶鸠尾（灸二七壮，补之。）
上背俞，取膏肓、肺俞、四花穴、大椎等穴。治劳瘵者，皆为阳气下陷而寒热往来也，若灸之早，百发
百中，累试有效。
〔《玉龙》〕传尸劳∶涌泉（第二足指端量至根尽折中是。针三分，泻六吸。伤寒及劳瘵之症，有血可治，
无血必危。凡欲出血，刺入二分，便须弹指。）丰隆（此穴治痰，针入一寸，泻十吸）、丹田（此穴治气喘，
针入三分，补二呼。）
〔仲〕男子妇人，脉大为劳，极虚亦为劳。男子面色薄者，主渴及亡血卒喘悸，脉浮者，里虚也。劳之
为病，其脉浮大，手足烦，春夏剧，秋冬瘥。阴寒精自出，酸削不能行。脉弦而大，弦则为减，大则为芤。减
则为寒，芤则为虚。虚寒相搏，此名为革。妇人则半产漏下，男子则亡血失精。趺阳脉浮而芤，浮者卫气衰，
芤者荣气伤，其体瘦，肌肉甲错。浮芤相搏，荣气衰微，四属断绝。
上诊脉浮而大，或大而弦，皆为虚劳者，盖阳盛阴虚之症也，暮多见之。
〔仲〕男子妇人，脉虚钿弱者，劳也。男子脉虚沉弦，无寒热，短气里急，小便不利，面色白，时目瞑兼
衄，少腹满，此为劳使之然。脉沉小迟，名脱气，其人疾行则喘喝，手足逆寒，腹满，甚则溏泄，食不消化也。
上诊脉虚微细弦为虚劳者，盖阴阳俱虚之症也，晨多见之。
〔《玄珠〕骨蒸之极，声嘎咽痛，面黧，脉躁，直视，汗出如珠，喘乏气促，出而无入，毛焦唇反，此
皆不治之症。虽有神医，亦无如之何矣。
Sweating: The treatment method should be to drain fire, nourish yin and moisten dryness, and tonify qi. If the pulse is wiry, floating, or deep, treat similarly with Anshen Wan (Calm Spirit Pill). (See "Treating Deficiency and Excess" for the formula.) If qi transformation fails, leading to difficult urination, moist and slippery skin, steaming heat with deficient yin, and impaired qi movement; or if qi moves too fast causing frequent urination, spontaneous sweating, and dry, rough skin, this is due to forced fluids failing to stay. Treat with Lizhu Dan (Pearl Pill). (See "Deficiency and Excess" for the formula.) A wiry and rapid pulse indicates yang sinking inward, moving from exterior to interior. Wiry with rapid indicates Wood transmitting to Wood. Tight with surging indicates Water transmitting to Fire. If wiry and deficient, there is no fire; if fine, there is water. These two pulses indicate disease moving from interior to exterior, and Lizhu Dan is not suitable.
When the fire season acts swiftly but Earth is deficient, long summer dampness fails to arrive. The *Nan Jing* states: "Tonify the mother in deficiency." To nourish the source of transformation, one should drain fire within Metal (Lung) and tonify Earth (Spleen).
If the cun position shows a wiry and rapid pulse, it is an excess of East/Wood, attacking the child element (Fire). Having drained the child fire, Wood becomes deficient. Using cold herbs to drain fire is equivalent to tonifying North/Water. Since Wood has attacked via Fire to insult Metal, draining fire within Metal allows Fire to retreat, leaving Wood without support to naturally recede. This is "draining the child in excess."
[Zhang Zhongjing] Severe deficiency from five labors leads to emaciation, abdominal fullness, and inability to eat. Injuries from diet, sorrow, sexual indulgence, hunger, and labor damage meridians, Ying, Wei, and Qi. Internal dry blood causes skin like scales and dark eyes. Treat by moderating the center and tonifying deficiency with Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill). (For internal accumulation, hand and foot pulses will mismatch; use this formula. However, it must be taken with major tonics such as Qiongyu Gao.)
Ingredients: Dahuang (10 liang, steamed), Huangqin (2 liang), Gancao (3 liang), Taoren (1 sheng), Xingren (1 sheng), Shaoyao (4 liang), Dihuang (0.5 liang), Ganqi (1 liang, stir-fried), Mengchong (1 sheng), Shuizhi (100 pieces), Qicao (1 sheng), E'chong (0.5 jin).
Grind the twelve ingredients into powder, mix with refined honey, and make pills the size of small beans. Take five pills three times daily with wine.
Chen Dafu passed down Zhang Zhongjing's Bailao Wan: For all types of consumption with stagnation and bad conditions resulting from improper medication.
Ingredients: Danggui (stir-fried), Ruxiang, Moyao (each 1 qian), Renshen (1 qian), Dahuang (4 qian), Mengchong (14 pieces, wings and feet removed), Shuizhi (14 pieces, processed).
Grind into fine powder, mix with refined honey, and make pills the size of paulownia seeds. Take all at once, about 100 pills, at dawn with Bailao Water. Stop when foul matter is expelled, then take white rice porridge for ten days. Bailao Water is water stirred vigorously 100 times, also known as Ganlan Water by Zhang Zhongjing.
*[Waitai Miyao]* Treating bone-steaming: 120 Taoren kernels, remove skin and double kernels, keep tips, pound and form pills. Take fully at dawn well-water. After taking, drink alcohol according to tolerance, but continue drinking water. Highly effective. Take another dose every other day. Do not eat meat for 100 days.
[Zhang Zhongjing] Zhi Gancao Tang (also called Fumai Tang): Treats deficiency exhaustion, sweating with chest oppression, knotted and palpitating pulse. Patient moves normally but may die within 100 days, or in severe cases within 11 days. (See "Shanghan" for the formula.)
[Hai Zang] Siwu Jiajian Tang: Treats female bone-steaming.
Danggui, Baishaoyao, Chuanxiong, Dihuang (above four tonify blood); Digupi (drains Kidney fire); Mudanpi (drains Pericardium fire). Equal parts.
Decoct and take.
[Luo Qianfu] Xiaoyao San: Treats blood deficiency with fatigue, five-center heat, red cheeks, night sweats, young women with weak blood and yin deficiency, disharmony of Ying and Wei, irregular menstruation, phlegm-cough with tidal fever, emaciation, gradually forming bone-steaming.
Fuling, Baizhu, Danggui, Shaoyao, Chaihu, Gancao (roasted).
Decoct with ginger (roasted and broken) and mint.
These two formulas are the general methods for treating female bone-steaming. Key points follow the previous yin-deficiency methods. For treating steaming diseases, adjust herbs based on the deficiency/excess of each meridian and the depth of the condition.
*[Gujin Luyan]* Wu Zheng Tang
Fuling, Gancao, Renshen, Zhuye, Dihuang, Gegen, Zhimu, Huangqin, Shigao, Jingsmi (2 he).
Decoct with 3 cups of water. First decoct 2 he of wheat until reduced to 2 cups, remove wheat, then decoct herbs to 1 cup. Take warm. Adjust symptoms below. Avoid Haizao, Songcai, Wuyi, and strong vinegar.
Excess heat: Add Huangqin, Huanglian, Huangbai, Dahuang. Deficient heat, Qi deficiency: Add Wumei, Qinjiao, Chaihu; Blood deficiency: Add Qinghao, Biejia, Gejie, Xiaomai, Mudanpi.
Lung steaming (dry nose): Add Wumei, Tiandong, Maidong, Ziwan. Large Intestine (right nostril dry/painful): Add Dahuang, Mangxiao. Skin steaming (white tongue coating/sputum blood): Add Shigao, Sangbaipi. Flesh steaming (drowsiness): Add Danpi. Qi steaming (dry nose/asthma/body heat): Add Renshen, Huangqin, Shanzhi.
Heart steaming (dry tongue): Add Huanglian, Shengdi. Small Intestine (burnt lower lip): Add Chifu, Shengdi, Mutong. Blood steaming (burnt hair): Add Shengdi, Danggui, Guixin, Tongbian.
Pulse steaming (white sputum/delirium/vessel overflow/irregular pulse): Add Danggui, Shengdi.
Spleen steaming (burnt lips): Add Baishao, Mugua, Kushen. Stomach steaming (pain under tongue): Add Shigao, Jingsmi, Dahuang, Mangxiao, Gange. Meat steaming (loss of taste/vomiting/restlessness): Add Baishao.
Liver steaming (dark vision): Add Chuanxiong, Danggui, Qianhu. Gallbladder steaming (pale whites of eyes): Add Chaihu, Gualou. Tendon steaming (burnt nails): Add Danggui, Chuanxiong. Sanjiao steaming (alternating hot/cold): Add Shigao, Zhuye.
Kidney steaming (burnt ears): Add Shengdi, Shigao, Zhimu, Hanshuishi. Bladder steaming (right ear burnt): Add Zexie, Fuling, Huashi. Brain steaming (dizziness/heat/oppression): Add Shengdi, Fangfeng, Qianghuo. Marrow steaming (marrow dry/bone heat): Add Shengdi, Danggui, Tiandong. Bone steaming (black teeth/lower back pain/cold feet/parasites): Add Biejia, Digupi, Danpi, Shengdi, Danggui. Muscle steaming (thin limbs/swollen instep/internal heat): Add Shigao, Huangbai. Bladder/Viscera steaming (red/yellow urine): Add Zexie, Fuling, Shengdi, Chenxiang, Huashi.
All these conditions result from consuming rich/greasy foods or engaging in sex/alcohol after febrile diseases. Prolonged steaming turns into Guan disease, nearing death.
Mudanpi treats bone-steaming without sweat (drains fire within Yin). Zhimu treats bone-steaming with sweat.
*[Yanyi]* Treating bone-steaming labor: Decoct Bohe juice with other herbs into a paste.
*[Jingyan]* Incense method for labor patients: Xuan Shen (1 jin), Gansong (6 liang) powdered, mixed with 1 jin refined honey, sealed in porcelain bottle, buried for half a day. Then mix Tanmo (6 liang) with Liangmi (6 liang), seal in bottle for five days, then burn. Inhale the aroma for self-healing.
*[Cuoyao]* Treating bone-steaming labor heat: Gaohuang (2 cun lateral to lower border of 4th thoracic vertebra and upper border of 5th, moxa 100 units. See acupuncture section), Zusanli.
*[Zhaoying]* Heat labor with asthma/fullness: Feishu (5 fen, retain 7 breaths, moxa 7 units), Chize.
Cui Shi treats bone-heat transmission corpse-labor: Moxa Sihua acupoints, also treats red/white discharge. First time take 2 points. Patient stands straight. Measure wax string from big toe (left male/right female) to heel, up to popliteal crease. Cut as standard. Patient sits upright, hair parted. Measure from nose tip to head seam, down to neck spine. Mark end with ink. (Not yet a point). Take another string, patient closes mouth, measure corners of mouth, hook up to nose root in 'V' shape, cut at corners. Straighten and place horizontally from previous mark. Ends are points. (Must be symmetrical). Second time take 2 points. Patient sits upright. String around neck forward, hanging level with nipples. Cut. Flip ends back to neck, middle at larynx. Ends at spine. Mark with ink. (Not yet a point). Another string, patient closes mouth, measure corners, move to spine mark, horizontal. Ends are points. Total 4 points. Moxa 7-20 units initially, up to 100 units. Wait for sores to heal, then take third set. Third time take 2 points. Use previous mouth-measuring string on first set's ends. Mark vertically on spine. Middle at mark. Ends are points. Moxa as before.
*[Biaoyou Fu]* Body heat labor cough: Pohu (drain).
[Jie] Treating untreatable bone-steaming heat or dry front incisors: Dazhui.
*[Cuoyao]* Another method: Jiutui (moxa 14 units, tonify).
Back Shu points: Gaohuang, Feishu, Sihua, Dazhui. Treating consumption involves sinking Yang with alternating chills/fever. Early moxibustion is highly effective.
*[Yulong Ge]* Transmission corpse-labor: Yongquan (measure from 2nd toe end to root, halve. Needle 3 fen, drain 6 inhalations. Shanghan and consumption: treatable if blood present, dangerous if absent. To bleed, needle 2 fen, flick finger.) Fenglong (treats phlegm, needle 1 cun, drain 10 inhalations), Dantian (treats asthma, needle 3 fen, tonify 2 exhalations).
[Zhang Zhongjing] Men and women with large pulse have labor; extremely deficient pulse also indicates labor. Pale complexion in men indicates thirst, blood loss, sudden asthma/palpitations. Floating pulse indicates interior deficiency. Labor disease: floating-large pulse, restless hands/feet, worse spring/summer, better autumn/winter. Spontaneous seminal emission, soreness unable to walk. Wiry and large pulse: wiry indicates decline, large indicates hollow. Decline is cold, hollow is deficiency. Deficiency and cold combine, named Ge pulse. Women: miscarriage/bleeding; Men: blood loss/essence loss. Duyang pulse floating-hollow: floating indicates Wei Qi decline, hollow indicates Ying Qi injury. Emaciation, scaly muscle. Floating-hollow combined: Ying Qi weak, four limbs severed.
Floating-large or large-wiry pulse indicates deficiency labor, Yang excess/Yin deficiency, seen more at dusk.
[Zhang Zhongjing] Deficient/fine-weak pulse indicates labor. Men with deficient-deep-wiry pulse, no chills/fever, shortness of breath, interior urgency, difficult urination, pale face, dizziness/epistaxis, lower abdominal fullness, caused by labor. Deep-small-slow pulse named Tuqi: panting when walking fast, cold extremities, abdominal fullness, diarrhea, indigestion.
Deficient-micro-fine-wiry pulse indicates deficiency labor, Yin-Yang both deficient, seen more at dawn.
*[Xuanzhu]* Extreme bone-steaming: hoarse voice/throat pain, dark face, rapid pulse, staring gaze, bead-like sweat, asthmatic shortness of breath, air out but not in, burnt hair/reverted lips. All untreatable. Even divine doctors cannot help.