经曰数而无力为阴虚火动之脉
又曰失血之脉芤而且涩
平人脉大为劳极虚亦为劳
脉诀云骨蒸劳热脉数而虚热而涩小必损其躯加汗加嗽非药可医
一治瘵病先当补养气血降心火滋肾水清其骨热保肺化痰追虫凉血此其大法也更灸膏肓四
花诸穴多有可效者
一痨瘵初起发热咳嗽呕血宜用 滋阴保肺汤加减用
一痨瘵初起潮热盗汗咳嗽倦怠宜用 柴胡饮子或补阴丸
一因忧思损伤心气咳嗽潮热痰中有血恍惚倦怠宜用 劫痨散 门冬地黄汤 加减扶羸汤
一痨极骨蒸盗汗肌瘦食减宜用 黄 鳖甲汤
一虚痨日久咳嗽发热精神短少夜梦遗精盗汗宜用 保和汤 保真汤 蛤蚧散 和肺饮
太平丸 白凤膏
一虫痨面唇红时或腹痛宜早服 神授丹
主方
知母 黄柏 当归 麦门冬 陈皮 甘草 白芍药
水二钟姜三片煎八分食远服
○若咳嗽盛加 桔梗 桑白皮
○若痰盛加 半夏 蒌实 马兜苓
○若痰不清去 半夏 加贝母 款冬花
○若潮热加 沙参 地骨皮 柴胡
○若盗汗多出加 牡蛎 黄 浮麦
○若梦遗精滑加 牡蛎 茯苓
○若衄血咳血出于肺也加 桑皮 炒栀子 阿胶珠 天门冬
○若咳血痰血出于脾也加 贝母 黄连 蒌实
○若呕血吐血出于胃也加 蒲黄 桃仁 炒栀子 韭汁
○若咯血唾血出于肾也加 侧柏叶 五味子
○若大便泄泻去 当归 黄柏 加山药 薏苡仁
○若胁痛加 青黛 柴胡梢
○若咽不利加 玄参 诃子
○若咳久痰稠见血加 紫菀 百合
○若久嗽不宜用燥药盖肺喜润而恶燥
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: A pulse that is rapid and forceless indicates Yin deficiency with hyperactive fire.
It also states: The pulse of patients with blood loss is cun-kou (floating and hollow like a bamboo tube, known as "Kou" pulse) and choppy.
In healthy individuals, a large pulse indicates exhaustion; extreme weakness also indicates exhaustion.
The *Mai Jue* (Pulse Classic) states: In cases of bone-steaming consumption (a type of chronic consumptive disease characterized by tidal fever and night sweats), the pulse is rapid and deficient. If accompanied by heat and a fine, choppy pulse, the body will inevitably be damaged. If sweating and coughing are added, it cannot be cured by medicine alone.
First rule: To treat Zhai disease (chronic consumptive diseases such as pulmonary tuberculosis), one must first tonify Qi and Blood, descend Heart Fire, nourish Kidney Water, clear bone heat, protect the Lungs and resolve phlegm, expel parasites, and cool the Blood. This is the general principle. Additionally, moxibustion on points such as Gao Huang (BL 43) and Si Hua often yields effective results.
Second rule: For early-stage Lao Zhai presenting with fever, cough, and hematemesis, use Zi Yin Bao Fei Tang (Nourish Yin and Protect Lung Decoction) with modifications.
Third rule: For early-stage Lao Zhai presenting with tidal fever, night sweats, cough, and fatigue, use Chai Hu Yin Zi (Bupleurum Decoction) or Bu Yin Wan (Tonify Yin Pill).
Fourth rule: For damage to Heart Qi due to excessive worry and overthinking, presenting with cough, tidal fever, blood in sputum, mental confusion, and fatigue, use Jie Lao San (Paralysis-Consumption Powder), Men Dong Di Huang Tang (Ophiopogon and Rehmannia Decoction), or Jia Jian Fu Lei Tang (Modified Strengthening Emaciation Decoction).
Fifth rule: For severe consumption presenting with bone-steaming, night sweats, emaciation, and anorexia, use Huang Bie Jia Tang (Coptis and Turtle Shell Decoction).
Sixth rule: For chronic deficiency consumption presenting with cough, fever, shortness of spirit, nocturnal emission during dreams, spermatorrhea, and night sweats, use Bao He Tang (Preserve Harmony Decoction), Bao Zhen Tang (Preserve Authenticity Decoction), Ge Jie San (Gecko Powder), He Fei Yin (Harmonize Lung Drink), Tai Ping Wan (Great Peace Pill), or Bai Feng Gao (White Phoenix Paste).
Seventh rule: For worm consumption (consumption caused by parasites) presenting with red face and lips and occasional abdominal pain, administer Shen Shou Dan (Divine Bestowal Pill) early.
Main Formula Composition:
Anemarrhenae Rhizoma (Zhi Mu), Phellodendri Cortex (Huang Bo), Angelicae Sinensis Radix (Dang Gui), Ophiopogonis Radix (Mai Men Dong), Citri Reticulatae Pericarpium (Chen Pi), Glycyrrhizae Radix et Rhizoma (Gan Cao), Paeoniae Radix Alba (Bai Shao Yao).
Add two zhong (approx. 400-500 ml) of water and three slices of Zingiberis Rhizoma Recens (Sheng Jiang). Decoct until eight fen (approx. 300-400 ml) remains. Take after meals.
○ If cough is severe, add Platycodonis Radix (Jie Geng) and Morus Alba Cortex (Sang Bai Pi).
○ If phlegm is profuse, add Pinelliae Rhizoma Preparatum (Ban Xia), Trichosanthis Fructus (Lou Shi), and Aristolochiae Fructus (Ma Dou Ling).
○ If phlegm is turbid and thick, remove Ban Xia and add Radix Bupleuri (Bei Mu) and Farflos Flos (Kuan Dong Hua).
○ If tidal fever occurs, add Radix Adenophorae (Sha Shen), Cortex Lycii (Di Gu Pi), and Radix Bupleuri (Chai Hu).
○ If night sweats are profuse, add Concha Ostreae (Mu Li), Radix Astragali (Huang Qi), and Frumen Tritici Levis (Fu Mai).
○ If nocturnal emission and spermatorrhea occur, add Mu Li and Poria (Fu Ling).
○ If epistaxis or hemoptysis occurs (originating from the Lungs), add Sang Bai Pi, Gardeniae Fructus Preparatus (Chao Zhi Zi), Asini Corii Colla (E Jiao Zhu), and Asparagi Radix (Tian Men Dong).
○ If hemoptysis or blood-streaked sputum occurs (originating from the Spleen), add Bei Mu, Coptidis Rhizoma (Huang Lian), and Lou Shi.
○ If hematemesis or vomiting of blood occurs (originating from the Stomach), add Polygoni Multiflori Caulis (Pu Huang), Persicae Semen (Tao Ren), Chao Zhi Zi, and Juice of Allii Tuberosi (Jiu Zhi).
○ If spitting of blood occurs (originating from the Kidneys), add Platycladi Cacumen (Ce Bai Ye) and Schisandrae Fructus (Wu Wei Zi).
○ If diarrhea occurs, remove Dang Gui and Huang Bo, and add Dioscoreae Rhizoma (Shan Yao) and Coicis Semen (Yi Yi Ren).
○ If hypochondriac pain occurs, add Indigo Naturalis (Qing Dai) and the tip of Chai Hu.
○ If throat discomfort occurs, add Scrophulariae Radix (Xuan Shen) and Terminalia Chebula Retzii Fructus (He Zi).
○ If chronic cough persists with thick phlegm and blood, add Asteris Radix (Zi Wan) and Lilii Bulbus (Bai He).
○ In cases of chronic cough, drying herbs should not be used, because the Lungs prefer moisture and dislike dryness.