痨瘵脉，酉、戌时洪盛，寅、卯时细弱者，阳气虚陷也。忌服苦寒，损其阳气，当以助
剂，复其寅卯之位，微加泻阴火而已。若服寒凉，证虽大减，脉反加数者，阳郁也。（朝暮
异脉，而朝细暮洪者，振阳分之阳，滋阴分之阴；朝洪暮细者，敛阳分之阴，温阴分之阳。）
右脉大，用保元汤；左脉大，用六味汤。不减，若燥者，以栝蒌、生甘草散润之。
久病咳嗽、气喘，若脉洪数，不可即用补药。如服之，虚火一退，多令人痿倦不起。（
下文意测之，补药二字，当作泻火。此证本不宜泻火，肺体已痿，一泻不返，治法不外宣阳
纳阴。阳郁由于湿痹，阴浮由于血虚及燥热，宜以龟板、牡蛎清滋。又有下寒上冲而然者，
是实邪也，以法逐之化之。）须先用独参汤以接其气，数日后，数脉渐退，方与调理为是。
夫痨者劳也，非一端可尽，或若心竭其心脾之神志，或酒色竭其肝肾之阴精，或久痢、久疟
、伤寒、伤暑诸证，治之不当，损其气血，伤其脾胃，五脏干枯而火起，以致发热，则金受
克，大肠先结燥，而水之源先涸矣，宜见脉见症，用药果当，无不愈者。若初热未甚，继以
治法之非，久之即成蒸病。蒸病者，如甑之蒸，热之极也。然使初病，元气尚强，脉气尚旺
，照古方用五蒸汤加减二十三蒸之法，亦无不验。治蒸法服之，病稍退，又当察症清心，参
用痨病治方，不可造次。蒸或病十日、半月热极，致骨中血凝，便化为虫，张仲景立祛血之
法，不使凝血化虫， 虫丸、百劳丸是也。倘治之不得其序，不能祛血，血化为虫，是时病
人脉气尚充，精神尚充，犹可救也。如声哑、喉痛、寒热大作、脉细而数、不思饮食、精神
视听俱不能支，皆属不治。又有火郁、痰凝、气滞、咳嗽、发热、气喘，葛先生保和汤、保
真汤次序用之。火散痰开热退，总归八珍汤调理。又有吐红、咳嗽，脉虽数，有神，不致于
蒸极作虫者。脉洪、脉数，虚虚实实，通变在乎心灵矣。
骨蒸由气虚不能化血，血干则火自沸腾，内如针刺，骨热烦疼。或五心俱热，或两肋如火，
或子午相应。或昼微恶寒，而夜反大热。虽肾经所主，传变不常。蒸上则喘咳、痰血、舌黑
、耳鸣、目眩等症；蒸下则见梦遗，淋浊、泄泻、腰疼、脚疼等症；蒸中则见腹胀、胁痛、四肢倦怠等症。
不问阴病阳病，日久皆能传变，男子自肾传心、肺、肝、脾，女子自心传肺、肝、脾、
肾，五脏复传六腑而死矣。有始终只传一经者，有专着心肾而不传者，大要以脉为证验。
凡气血劳倦不运，则凝滞疏漏，邪气得以相乘，又饮食劳倦所伤，则上焦不行，下脘不通，
热极蒸胸中，而内热生矣。凡颈上有核，肠中有块，或当脐冰冷，或无力言动，皆痰涎结聚
，气血凝滞之所致，故以开关启胃为先。盖关脉闭则气血干竭，胃气弱则药无由行。但阳虚
不可偏用辛、香、丁、附之类，阴虚不可用苦寒，古方有开关定胃散，今亦难用，窃其意推之。
虫为气血凝滞瘀血化成，但平补气血为主，加以乌梅、青蒿、朱砂之类，而虫自亡矣。紫河
车丹、紫河车丸、青蒿膏、蛤蚧散选用，惟度其虚实为主。
凡体虚者，宜先用补法，补其元气，然后用王道之药，佐之以杀虫之剂，如化虫丸，使
君子丸之类。或追虫后，而继以温补亦可，不然则虫去而元气亦散。
传尸之说，不必深泥，历观痨瘵，皆因酒色之类，损伤心血，以致虚火妄动。医者不分阴阳
用药，病者不思疾由自取，往往归咎前因，甚者疑及房室、器皿、坟墓及冤业、飞尸，递相
传疰。古人云∶痨瘵三十六种，惟阴德可以断之。不幸患此疾者，或入山林，或居静室，清
心戒欲，专意保养，庶乎病可除根。不然，即服药不效。
痨虫须分五脏，常居肺间，正所谓膏之上，肓之下，针之不得，药之不行，只宜早灸膏肓、
四花为佳。若蚀肺系，则咯血、吐痰、声嘶、思食无厌。病恚至此，未易疗治，当参究古法
九虫及一十八种虫名之异，并紫庭取虫诸法。
昼热，行阴二十五度，大抵柴胡饮子；夜热，行阴二十五度，四顺饮子；平旦发热，热在行
阳之分，肺气主之，故用白虎汤，以泻气中之火；日晡潮热，热在行阴之分，肾气主之，故
用地骨皮散，以泻血中之火。
肝症发热，肉下骨上，寅卯尤甚，泻青丸、人中白散；心症发热，在血脉，日中则甚，单泻
心汤、导赤散、朱砂安神丸；脾症发热，在肌肉，遇夜尤甚，泻黄散、三白汤；肺症发热，
在皮毛，日西则甚，泻白散，甚者凉膈散；肾证发热，在骨，亥子尤甚，两手足心如火，滋肾丸。
尸注一症，予尝治之，先癸亥夜二更，六神皆聚之时，灸腰眼穴七壮，然后用药。倘不
，先用药亦可。注病亦似劳症，但两足无力，行则痿疲是也，其治法∶六脉洪数，八物汤；
脾肺不足，补中益气汤；睡不稳，归脾汤；不思食，六君子汤，随症推类。但煎剂中，须加
忍冬叶三钱同煎，《本草》以其叶能治尸注也。
凡治劳症，或男或妇，若淫火不退者，虽治不治。
The pulse of Lao Zhai (chronic consumptive disease) is surging and vigorous during the You and Xu hours (5 PM - 9 PM), but thin and weak during the Yin and Mao hours (3 AM - 7 AM); this indicates deficiency and sinking of Yang Qi. It is contraindicated to take bitter-cold herbs, as they damage Yang Qi. One should use tonifying agents to restore its position in the Yin and Mao hours, adding only a slight amount to drain Yin Fire. If cold-cooling herbs are taken, although symptoms may greatly decrease, the pulse becomes faster instead; this indicates constrained Yang. (When morning and evening pulses differ: if the pulse is thin in the morning and surging in the evening, one should rouse Yang of the Yang aspect and nourish Yin of the Yin aspect; if it is surging in the morning and thin in the evening, one should gather Yin of the Yang aspect and warm Yang of the Yin aspect.) For a large pulse on the right side, use Baoyuan Tang (Preserve the Origin Decoction); for a large pulse on the left side, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If symptoms do not subside and the body is dry, use Gualou San (Trichosanthes Powder) and raw Licorice Powder to moisten.
For chronic cough and asthma, if the pulse is surging and rapid, tonifying medicines should not be used immediately. If taken, once the deficient fire recedes, it often leads to flaccidity and fatigue, making the patient unable to rise. (Inferring from the following text, "tonifying medicine" should likely read "fire-draining medicine". This condition is originally unsuitable for draining fire because the Lung tissue is already flaccid; one drainage cannot reverse it. The treatment method lies in venting Yang and gathering Yin. Yang constraint is due to dampness obstructing the collaterals; Yin floating is due to blood deficiency and dryness-heat. It is appropriate to use Gui Ban (Tortoise Shell) and Mu Li (Oyster Shell) to clear heat and nourish. There are also cases caused by lower-jiao cold evil rushing upward, which is an excess pathogen; it should be treated by expelling and transforming it.) One must first use Dushen Tang (Single Ginseng Decoction) to connect the Qi. After several days, when the rapid pulse gradually recedes, then proceed with regulation.
"Lao" means labor or exhaustion, and causes are manifold. Some exhaust the spirit and will of the Heart and Spleen; some exhaust the Yin essence of the Liver and Kidneys due to alcohol and sexual indulgence; some result from improper treatment of chronic dysentery, chronic malaria, Cold Damage, or Heat Damage, damaging Qi and Blood, injuring the Spleen and Stomach, causing the five Zang organs to become dry and internal fire to arise, leading to fever. Consequently, Metal (Lung) is overcome, the Large Intestine becomes dry and constipated first, and the source of Water dries up. If the pulse and symptoms correspond, and medication is appropriate, there is no case that will not heal. If initial fever is not severe, but subsequent treatment methods are incorrect, over time it becomes Zheng Bing (Steaming Disorder). Zheng Bing is like steam in a steamer, representing extreme heat. However, if at the onset Yuan Qi is still strong and Pulse Qi is robust, using Wu Zheng Tang (Five Steaming Decoction) modified according to the method of treating Twenty-Three Steaming Disorders, as per ancient formulas, will invariably be effective. After taking treatment for Steaming Disorder, when the illness slightly recedes, one must observe symptoms and clear the Heart, referring to Lao disease treatment protocols, without being hasty. If steaming lasts ten days or half a month with extreme heat, causing blood coagulation in bones which transforms into worms, Zhang Zhongjing established methods to remove blood stasis to prevent coagulated blood from turning into worms, such as Qu Xue Wan (Remove Blood Pill) and Bailao Wan (Hundred Fatigue Pill). If treatment is disordered and blood stasis is not removed, blood turns into worms. At this time, if the patient's Pulse Qi and Spirit are still sufficient, it can still be saved. However, hoarseness, sore throat, severe chills and fever, thin and rapid pulse, loss of appetite, and inability to support mental and visual functions all indicate incurable conditions. There are also cases of Fire Constraint, Phlegm Coagulation, Qi Stagnation, cough, fever, and asthma; Mr. Ge advocates using Baohe Tang (Harmonize the Interior Decoction) and Baozhen Tang (Preserve the Authenticity Decoction) in sequence. Once Fire disperses, Phlegm opens, and Heat recedes, total regulation is achieved with Bazhen Tang (Eight-Treasure Decoction). There are also cases of hemoptysis and cough where the pulse is rapid but Shen (Spirit) is present, not progressing to extreme steaming and worm formation. Surging and rapid pulses involve both deficiency and excess; adaptation depends on the physician's insight.
Bone Steaming arises from Qi deficiency failing to transform Blood; when Blood is dry, Fire boils spontaneously, feeling like needle pricks internally, with hot and painful bones. Or all five centers (both palms, both soles, and heart) are hot, or ribs feel like fire, or symptoms correspond to Zi and Wu hours. Or slight aversion to cold during the day, but high fever at night. Although governed by the Kidney Meridian, transmission is irregular. Upward steaming manifests as wheezing, cough, bloody sputum, black tongue, tinnitus, and vertigo; downward steaming shows nocturnal emission, stranguria, diarrhea, lower back pain, and leg pain; middle steaming presents abdominal distension, hypochondriac pain, and limb fatigue.
Regardless of Yin or Yang disease, long duration allows transmission. In men, it transmits from Kidney to Heart, Lung, Liver, and Spleen; in women, from Heart to Lung, Liver, Spleen, and Kidney. After five Zang organs transmit to six Fu organs, death ensues. Some transmit only through one meridian throughout; some focus solely on Heart and Kidney without transmitting. Generally, pulse serves as the verification.
Whenever Qi and Blood are exhausted by labor and cannot circulate, stagnation and leakage occur, allowing pathogenic factors to invade. Coupled with injury from diet and labor, Upper Jiao fails to descend, Lower Wan fails to open, extreme heat steams the chest, generating internal heat. Any lumps in the neck, masses in the intestines, cold navel, or weakness in speech and movement are caused by phlegm-saliva accumulation and Qi-Blood stagnation. Therefore, opening orifices and awakening Stomach Qi comes first. If Guan pulse is closed, Qi and Blood dry up; if Stomach Qi is weak, drugs cannot act. However, for Yang deficiency, one must not excessively use acrid-aromatic herbs like Dingxiang (Clove) and Fuzi (Aconite Root); for Yin deficiency, bitter-cold herbs must not be used. Ancient formulas include Kaiguan Dingwei San (Open Passages Stabilize Stomach Powder), though difficult to use now; one may borrow its intent and deduce accordingly.
Worms are formed from Qi-Blood stagnation and blood stasis. By primarily balancing and tonifying Qi and Blood, plus adding Wumei (Mume Fruit), Qinghao (Sweet Wormwood), and Zhusha (Cinnabar), the worms will perish. Zijieche Dan (Placenta Pill), Zijieche Wan (Placenta Pill), Qinghao Gao (Sweet Wormwood Paste), and Hejie San (Gecko Powder) can be selected, primarily based on assessing deficiency and excess.
For those with weak constitutions, tonification should be used first to replenish Yuan Qi, followed by gentle "King's Way" medicines, assisted by vermifuge agents like Huachong Wan (Vermifuge Pill) or Shijunzi Wan (Quisqualis Pill). Alternatively, after expelling worms, warming and tonifying can follow; otherwise, while worms are expelled, Yuan Qi also dissipates.
The theory of "Chuan Shi" (Transmitting Corpse) need not be rigidly adhered to. Observing Lao Zhai, it is generally caused by alcohol and sexual indulgence damaging Heart Blood, leading to erratic deficient fire. Physicians who do not distinguish Yin and Yang in prescribing, and patients who do not reflect on self-inflicted causes, often blame past karma. Severe cases even suspect bedrooms, utensils, graves, grudges, or flying corpses, passing infection to each other. Ancients said: "There are thirty-six types of Lao Zhai, only Yin Virtue can cut them off." Those unfortunate enough to suffer this disease should enter mountains or dwell in quiet rooms, clear the mind, abstain from desires, and focus on preservation, hoping to eradicate the root. Otherwise, even medication will be ineffective.
Lao worms must be categorized by the five Zang organs. They usually reside in the Lung area, precisely above the Gao and below the Huang, where acupuncture cannot reach and medicine cannot act. It is best to moxa the Gaohuang points and Sihua points early. If eroding the Lung system, symptoms include hemoptysis, expectoration, hoarseness, and insatiable appetite. When anger reaches this point, treatment is difficult. One should study ancient methods regarding the nine worms and eighteen types of worm names, and various methods from Zitings to extract worms.
Daytime fever, circulating in Yin twenty-five degrees, generally uses Chaihu Yinzi (Bupleurum Drink); nighttime fever, circulating in Yin twenty-five degrees, uses Sishun Yinzi (Four Smoothness Drink); dawn fever, heat in the Yang circulation phase, governed by Lung Qi, thus Baihu Tang (White Tiger Decoction) is used to drain Fire in Qi; afternoon tidal fever, heat in the Yin circulation phase, governed by Kidney Qi, thus Digupi San (Phellodendron Bark Powder) is used to drain Fire in Blood.
Liver symptom fever, located under flesh and above bone, worse during Yin-Mao hours, uses Xieqing Wan (Drain Green Pill) and Renzhongbai San (Human Midst White Powder); Heart symptom fever, in blood vessels, worse at noon, uses Dan Xixin Tang (Single Draining Heart Decoction), Daochi San (Direct Red Powder), and Zhusha Anshen Wan (Cinnabar Calming Spirit Pill); Spleen symptom fever, in muscles, worse at night, uses Xiehuang San (Drain Yellow Powder) and Sanbai Tang (Three Whites Decoction); Lung symptom fever, in skin and hair, worse in late afternoon, uses Xiebai San (Drain White Powder), or Liangge San (Cool Diaphragm Powder) for severe cases; Kidney symptom fever, in bones, worse during Hai-Zi hours, with hot palms and soles, uses Zishen Wan (Nourish Kidney Pill).
Regarding Shizhu (Corpse Injection) syndrome, I once treated it. First, at the second watch of Guihai night, when the six spirits gather, moxa the Yaoyan points seven times, then administer medicine. If not possible, medicine first is acceptable. Zhu disease resembles Lao syndrome, characterized by weak legs and fatigue upon walking. Its treatment: Six pulses surging and rapid, use Bawu Tang (Eight Medicines Decoction); Spleen-Lung insufficiency, use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction); restless sleep, use Guipi Tang (Restore the Spleen Decoction); poor appetite, use Liujunzi Tang (Six Gentlemen Decoction), adapting to symptoms. However, add Sandorsye (Honeysuckle Leaf) three qian to the decoction, as Bencao states its leaves treat Shizhu.
In treating Lao syndrome, whether male or female, if Lust Fire does not recede, treatment is futile.