（症候）此病大约分三期，第一期，本期初起多徐缓，往往易于忽略，此期大率肺尖部稍有结核，病者或有干咳或无，常年羸瘦脱力酸软，不思饮食，失眠，精神过敏，或抑郁善怒，女子多有月经不调、贫血等症，普通人往往以为虚弱，漫不经意。第二期，病灶日益扩大，怯弱证象，一律皆现，患部呈结核性浸润，于是咳嗽，吐痰，咯血多量则为肺出血，自汗，盗汗，怔仲，喘促，失音，咽干，寒热，两颊微红等症相继而来，此时期已决无与他病误认之虞矣确定期。第三期，以上诸症加重，体温亦高，衰弱愈甚，则浸润部分崩溃而成空洞，患部糜烂已甚，生活力全失，尪瘠衰弱，已近鬼趣，更甚则手足浮肿，泄泻频频不能行动，遂致毕命。然此症不侵害脑神经，故至临死而精神清醒。余对此症，有特别之见解，认为因虚弱而肺痨，非因肺痨而虚弱；因虚弱而发热，非因发热而虚弱，故西医消耗热之名词，余不取之。
以上概述本病之过程，约分三期，兹再分述其各症之现象于下。
1．热，本病第一关键，全在此热，病加则热高，病退则热减，故医者可以热之消长，而视病之进退。但初起之肺痨患者，气血尚未大损，阴阳尚能含合，故其热脱出于气血之外者尚少，热度不甚高，摄氏表三十八度左右，病者只微觉酸懒无力。若此等微热，常年累月，浮游虚冒，无所归着，一如将失躯壳之灵魂，不能煦育含和温润气血，反致焦灼枯燥干耗津液，则热之功用既失养人之物，反成害人之物矣。中医诊察，此时绝难知其有热，以用检温器为宜以此时两手脉，尚多不能现虚数象故也。
病者恒自觉手足心发热，每有劳动，热即上升；故常觉疲倦、喘促、头晕、眼花，此时期，即中医所谓虚弱，或肾虚、阴虚等症是也。虚弱病势前进，正当之体温与气血之吸着力更薄弱，则此热更无所附丽，脱出愈多，故热度亦渐高，以手们之可以察知表皮之热度愈高，气血内之温愈少，每日午后，由三十八度渐渐高升至三十九度以上，有时但觉胸内有灼热之感且其热绵绵不断，西医谓之消耗热一若日暮途穷之人，徘徊哀求，希望救援，顽固缠绵，至可忧虑之热型也。本病脉多虚细而数，发热时或觉寒凛。本病经过中之合并症，例如肋膜炎，腹膜炎及续发症，例如肠结核、喉头结核均由热可以推定，故热之观察，于测料肺痨患者之轻重，为最确实之标准。大率疾病全停止，或变为慢性症时，则不发热。若有微热存在，病势虽为一时的徐缓，然阴阳维系，暂合仍离，必为将来进行之征。若系绵绵不断之热，则为病势不良之征。此段应与前论阴虚发热、阳虚发热参看。一言以蔽之，愈虚弱愈发热也。津液渐枯，阳气无所附丽之现象也。
2．咳嗽、咯痰，为本病之要征，然亦有时咳嗽甚少，或全无，亦或有剧烈咳嗽，概以喉头及气管被侵害时为甚。痰量视病状而异，初起率多干咳，日愈久，痰愈多，至肺浸润期，多为稀痰或白沫，至肺生空洞时，痰则更多为脓性，或粘液脓性，内乏空气之痰，吐于充满清水之唾壶中，多沉降水底，而为货钱状。然病至极重时，往往反不发热，不咳嗽，不吐痰血，此时盖去死期不远矣。
3．吐血，本症初起，痰中常混有血液，血点或血丝，在轻微之咯血，虽不足虑，然有时多为大出血之先驱，不可不防。咯血分二种，①初期咯血，②空洞咯血。初期咯血，则发于肺痨之初期，空洞咯血，则因存在空洞内之肺动脉枝上之细小脉破裂而发。故肺痨初期，不过痰中混有血丝或血点，亦有始终不吐血而死者迨后或至狂吐鲜红之大量血液。常见有若干年潜伏之肺痨，初起吐血，往往每晨略于痰中夹杂血丝、血点，或日常如此，或至大吐血，立时致命。凡吐血复发，恒觉口内有腥臭之味。
然亦有肺痨极重，始终并不咯血者，故咯血并非肺痨之主要征象也。
4．汗，肺痨病因热而致自汗、盗汗，此种虚汗，以夜间为甚，西医亦名盗汗。但虚汗甚者，不分昼夜，往往自出，自汗、盗汗且有因此失眠者，衰弱原因，多在于此。
5．失音，肺痨病人之失音有二种，一为喉头结核，即声门痨疮，一为崩溃期，肺之空洞太大，致肺气衰弱，不能发音，风寒咳嗽，偶尔失音，不在此例。为肺痨已深之征象，然治疗得法，病势渐退，失音亦能渐愈，此非主要症候也。
6．烦躁，肺痨患者，精神抑郁，最易忿怒，此症状与环境最有关系，宜设法改变之。往往以不相干之事，认为重大，而起激怒，中医谓之肝气病益进行，此症状亦益显著。病减此现象亦减，不必专治此症。
7．喘息，肺痨患者，因身体衰弱，稍有劳动，辄好喘急，若日久病深，觉胸际气闷、气短，皆肺痨已生空洞之征，但轻微之喘息，则无关紧要也。肺痨感觉胸内有疼痛或痒者亦有之，乃肋膜被侵害之征，并非宅征，以肺之本体，并无痛感故也。
8．贫血，肺病痨菌在体内，破坏一切，血液受此影响，因而全身呈中毒西医血液中毒解释为血液内混合菌之毒质，不可作中医中毒解。现象，故病者面黄肌瘦，特别现枯槁苍白之色，此一般肺痨患者，共同之现象，女子多有月经闭止者皆由虚弱来也。
9．怔忡，此为中医病名，心脏衰弱之征象，肺痨病于大失血后，多有此症，患者常觉心内忐忑不宁，为一危险之症状。此症多不注意，然实危险。
10.泄泻，此亦中医病名，肺痨病最后之危险现象也，俗名泻肚此时肠之结核已形成，衰弱已极，食物不能吸收，滋养之来源断绝，为一般肺痨病患者之收场，浮肿现象，亦多于末期见之，尤以下利（泻）患者为显著。至可虑也。
西医对肺痨之认症，可为确实明了，较之中医劳伤，虚损、痨瘵、肺痿等说，踏实可取，惟论此症之脉，不如中医明显。盖此症至二期，脉必虚细而数，或只虚细，或现结代（失血后）绝无可疑。若在第一期，气血尚未大衰，或有弦细、弦数，及稍觉浮洪（右手居多）之脉，失血过多，则脉虚大无力（芤脉之类）者亦有之。此皆余由经验得来，并非抄袭古说，故以上论症，概取西医，独缺略脉搏一项，特录中医脉理于此，以补西医之缺点，希望医者详细参考，据此认症，似较显明。再肺痨症，虽如上述，其症状大多数固然一律，然以余之经验，亦有例外患者，不必各症皆具，即主要症状，亦大半皆无（不咳嗽，不吐血，不发热），缠绵日久，（或仅有吐血）中西医均认定为肺痨病，并经爱可斯光照诊，毫无疑义者，而主要症候，竟缺如，或时一发现，即便消失，如此迁延，终归不治者有之。又有肺痨断定千真万确，经有名各医院照诊，有名中医诊断毫无疑义，然中西医一用治肺痨之方法，则立时加重，绝非误诊，亦绝非误治，而绝对不适用中西治肺痨之药品，反而恣用大凉药，例如生地、石膏等，而渐减轻者，亦有之，此例外，实属奇特，皆余亲历，因附录于此。须知西医论症，固属确实，然纸上谈兵，尚不能尽此症之变态，此外是否尚有特例，亦未可知，是以吾辈医者，要虚心也。（与肺结核类似之症颇多，但以二例外，绝非误认。）正治法）治疗肺结核，以愈早愈妙，最好是预防法之讲求，然普通患者，往往缺乏此种常识，不幸而罹本病，乃又以其为慢性疾患，恒被视为无关重要，倏然失其容易治疗之时期，最为可惜，迨至患者自觉危险，遍访良医，十之八、九，已入于不易疗治第二、三期之阶段中，于此时期，若再误于中西医药，治法不善，反致增加病势也。则自入岐途，未有不断送生命者。此症大概应注意事项，均载入余著之肺痨病自疗法一书中，可以参看。自疗法全文，列阴虚发热节下。此仅将对症疗法，比较中西治法及药物之优劣，分述如下，以资印证。此皆根据余数十年之实验，一字一句，不知经过若干次之苦心体察，反复试验，始敢公诸社会，愿研究此症者，根据余之报告，再作进一步之探讨，更愿肺痨患者，注意余之著述，以作访求良医之指南针，自不致误入岐途，早脱病苦，是则著者之本意也。
1．热以下与前列症候次序相同之一症，为肺痨病中最要之征象，亦最难疗治之一端，欲使此症急速退热，除服用西药安基比林、规尼涅、别拉密童等退热剂外，绝少速效。然此等西药，往往诱起自汗、盗汗，在心脏衰弱者，且恐骤致心脏停止之大危险，故以不用为是。规尼涅虽无发汗之副作用，然用之多不能退热，且能诱起呕吐、眩晕，亦非适应此症之良药，近世多用爱儿邦药片者，然其效极缓，价又极昂，非多日继续服之不可。而亦不能十分准确退热，不过比较安基比林等，为和平耳。以樟脑酸佐别拉密童伍用，以防出汗过多，心脏停止，亦是—法。中医称此种热为阴虚发热，实含至理，故滋阴药中，实有一、二味有确效者。中药滋阴药，品类极多，不可滥试。例如白芍、此药不但养阴，且能敛汗，又能敛肺止嗽，为治肺痨病不可多得之品。生地、丹皮、地骨皮、女贞子、牡蛎、鳖甲、龟板、桑寄生，均有相当效验。白芍用量，须在一两以上，馀药须在六、七钱以上。其馀中药内所列滋阴退热之药多无效，不必试验，佘已历试多年矣尤以麦冬、五味子、吴茱萸、白术、当归、肉桂肉桂一味中医有引火归元之说，西医亦用肉桂酸，然多无效。等药，万不可用。以习惯用者颇多，故特别申明禁用，人参虽非绝对禁用，然流弊颇大，不可不慎。以上所列有效之中药，若在第二期，或第三期，尚未至十二分衰弱者。十之八、九，可以退热，且其效力和平永久，不似西药之急遽退热，效力持续时间甚短，故比较优良。其中药唯一优点，即绝无发汗之副作用，对于衰弱者之心脏，绝无丝毫危险，且与止咳、止汗、止血等药，更有相得益彰之美，可以放胆用之也。西药注射剂，关于肺痨者，晶目极多，试验多次，均无良效，不可滥用。一般西药宣传刊物，多不直实，不可尽信。
余以为正常之热（平温）在人体内，乃最宝贵之物。惟肺痨病者，阴血不足，不能含濡此热，使其潜静融合，以发挥其温暖人体之正当作用，反而浮游灼烁，不得其所，酿成亢旱干枯之病态。医者宜设法令其归纳、中和、吸收，自然热退。若以西药退热剂解除此热，是将人身宝贵之生活力，加以斧削，一时虽觉热退，而其馀幸未全离阴血之热，必又浮出，故仍发热也。若屡屡用西药退热，则必致剥夺净尽，一毫热气皆无，此热退尽之日，即人体内生活力耗尽之日，心脏不停何待乎？故余主张治肺痨之热，可以使热收缩，不可使热放散，自以为颇有精义。盖一部分西药退热，是使热放散于体外，故病人虽觉暂时轻快，实则等于剥夺其生活力一次，默默中反使肺痨病患者，更受莫大之损失。本此主张，故余用中药退热，只是使热收敛，保存含濡，绝不令其外散。西医认此热为有害，故退热之药，与治实热（例如温症）之药同，余认此热为人体内极宝之物，人之所以能恢复健康者，全赖此热。若此热用西药或中药内之发散药，强制使其放散，则旋散旋热，去一分热，即去—分生活力，生活力尽，而人死矣。故余主张必使此热收敛于气血之内，不可排除于人体之外；必使此热退回于气血之中，不可放散于皮肤之外。
西医患此热之多，余恐此热之少也，余本此主张，历试多年，实有奇效，此论与西医说正相反，与中医说亦不尽同，然余治病重实际，既不敢空谈误人，（古医书多有此弊）亦不敢盲从新说，愿有心人一试之。
2．咳嗽，亦为本病主要之征候，此种极顽固之咳嗽，虽一般患者，不必尽有，然咳嗽一症，治疗上实感困难，且愈咳则肺愈震动，愈震动则炎症部愈大，而痰亦愈多，肺内侵润部分，更易扩充，故止嗽之法，在本病过程中，与退热方法，同一重要。
盖本病之咳嗽与热，相辅而行，愈咳则愈弱，愈弱则愈热，热减咳亦减，热加咳亦加也。止嗽之药，中药之白芍，应居首位，凡日期稍久有肺痨嫌疑者之咳嗽，以白芍为主药五、六钱，佐以杏仁、贝母、紫菀、桑白皮、枇把叶等作煎剂或加梨引，三、五剂后，无不大效者。稀痰过多，茯苓为必用之品六钱以上，若系稠痰，则橘红、远志根，必须加入，三期之末，病人有痰极稠，不易吐出者更危险。皆中药之有卓效者。然以余之经验，中药止咳，效力常久，是其优点，但大多数只能缓缓减轻咳嗽，若令病者完全不咳，则殊感困难。西药止嗽之品，有特效者，例如盐酸歇鲁因、莫尔比涅阿片，哥罗仿等，凡阿片制剂，对于小儿，非常危险，万不可用，慎之慎之。皆不外麻醉之类，不可滥用。其比较和平者，则有拕汹儿氏散。此药虽亦含有阿片，但含量甚少，对于小儿尚可用，然亦必须小量。是以单论止咳药之效力，中药固不及西药之有速效，然西药麻醉晶，并非真能治疗本病不过麻醉作用所致，故药力一经消失，仍然咳嗽，较中药之对于咳嗽，确能根本减轻之现象，似属各有短长。然医者如能于相当场合，利用西药以济中药之所短，则相辅而行，实有不可思议之妙，是在医者运用得当耳。
(Symptoms) This disease is roughly divided into three stages. The first stage usually begins slowly and is often easily overlooked. In this stage, there is typically slight tuberculosis at the apex of the lung. The patient may have a dry cough or no cough, suffering from chronic emaciation, fatigue, soreness and weakness, poor appetite, insomnia, mental sensitivity, or depression with irritability. Female patients often have menstrual irregularities and anemia. Ordinary people often mistake it for general physical weakness and pay little attention to it. In the second stage, the lesion expands day by day, and all signs of debility appear. The affected area shows tuberculous infiltration. Consequently, symptoms such as cough, expectoration, massive hemoptysis (pulmonary hemorrhage), spontaneous sweating, night sweats, palpitations, dyspnea, aphonia, dry throat, alternating chills and fever, and slightly red malar flush appear successively. By this stage, there is absolutely no risk of misdiagnosis with other diseases; this is the confirmed stage. In the third stage, the aforementioned symptoms worsen, body temperature rises, and debility becomes more severe. The infiltrated areas collapse to form cavities, and the affected tissue is severely ulcerated, losing vitality completely. The patient becomes extremely emaciated and weak, nearing death. More severely, edema of the hands and feet occurs, frequent diarrhea makes movement impossible, leading eventually to death. However, since this disease does not affect the cranial nerves, the patient remains mentally clear until death. I have special insights into this disease: I believe that tuberculosis results from physical weakness, not that weakness results from tuberculosis; fever results from weakness, not that weakness results from fever. Therefore, I do not adopt the Western medical term "consumptive fever."
The above outlines the course of the disease, roughly divided into three stages. Below, I will describe the phenomena of each symptom in detail.
1. Fever is the first key point of this disease. The entire issue lies in this "fever": when the condition worsens, the temperature rises; when it improves, the temperature drops. Thus, physicians can observe the progression or regression of the disease by monitoring the fluctuation of fever. However, in early-stage tuberculosis patients, Qi and Blood are not yet severely damaged, and Yin and Yang can still maintain balance. Therefore, very little heat escapes from the Qi and Blood, and the temperature is not very high, around 38°C. Patients only feel slight soreness, lassitude, and weakness. If this slight fever persists year after month, floating and unsettled without a root, like a soul about to leave the body, it fails to warm, nourish, and harmonize Qi and Blood. Instead, it causes scorching dryness and consumes body fluids. Thus, having lost its function of nourishing the person, it becomes harmful. During TCM diagnosis, it is difficult to detect fever at this stage; using a thermometer is appropriate because the pulse in both wrists often does not yet show a deficiency-rapid (Xu Shu) pattern.
Patients often feel their palms and soles are hot. After any labor, the heat rises; thus, they often feel fatigued, short of breath, dizzy, and have blurred vision. This period corresponds to what TCM calls debility, or Kidney deficiency, Yin deficiency, etc. As the debility progresses, the normal body temperature and the adhesive force of Qi and Blood become weaker. Consequently, this heat has less to attach to, escapes more, and the temperature gradually rises. Touching the skin reveals higher surface temperature but less internal warmth within the Qi and Blood. Every afternoon, the temperature gradually rises from 38°C to over 39°C. Sometimes, there is only a burning sensation in the chest, and the heat is continuous. Western medicine calls this "consumptive fever," a type of fever that is stubborn and lingering, like a person at the end of their journey wandering and begging for help, causing great worry. The pulse in this disease is mostly deficiency-thin and rapid. During fever, the patient may sometimes feel cold and shivering. Complications during the course of this disease, such as pleurisy and peritonitis, and secondary conditions such as intestinal tuberculosis and laryngeal tuberculosis, can be inferred from the fever. Therefore, observing fever is the most reliable standard for estimating the severity of tuberculosis. Generally, when the disease stops completely or becomes chronic, there is no fever. If slight fever exists, although the disease progress is temporarily slow, Yin and Yang are temporarily united but soon separate again, indicating future progression. Continuous fever is a sign of poor prognosis. This section should be read in conjunction with the previous discussion on Yin-deficiency fever and Yang-deficiency fever. In short, the more deficient one is, the more feverish one becomes. This is a phenomenon of gradually drying up of body fluids and Yang Qi having nothing to attach to.
2. Cough and expectoration are important signs of this disease. However, sometimes there is little or no cough, or there may be severe coughing, which is most severe when the larynx and trachea are involved. The amount of sputum varies with the condition. Initially, it is mostly a dry cough. The longer the duration, the more sputum. During the pulmonary infiltration stage, it is mostly thin sputum or white foam. When lung cavities form, the sputum increases and becomes purulent or mucopurulent. Sputum lacking air, when spat into a spittoon filled with clear water, sinks to the bottom and appears coin-shaped. However, when the disease is extremely severe, there is often no fever, no cough, and no hemoptysis. At this time, death is near.
3. Hematemesis/Hemoptysis. In the early stage of this disease, blood is often mixed with sputum, appearing as blood spots or streaks. While slight hemoptysis may not be worrying, it can sometimes be a precursor to massive hemorrhage and must be guarded against. Hemoptysis is divided into two types: ① Early-stage hemoptysis, and ② Cavity-related hemoptysis. Early-stage hemoptysis occurs in the initial phase of tuberculosis. Cavity-related hemoptysis occurs due to the rupture of small vessels on the branches of the pulmonary artery existing within the cavity. Thus, in the early stage of tuberculosis, there is merely blood streaks or spots in the sputum. Some die without ever vomiting blood, while later others may vomit large amounts of bright red blood. It is common to see latent tuberculosis for several years where initial hemoptysis involves mixing blood streaks or spots with sputum every morning, or daily, progressing to massive hemoptysis that is immediately fatal. Whenever hemoptysis recurs, the patient often perceives a fishy odor in the mouth.
However, some tuberculosis patients are extremely severe and never hemoptysis. Thus, hemoptysis is not a primary sign of tuberculosis.
4. Sweating. Tuberculosis causes spontaneous sweating and night sweats due to heat. This type of deficiency sweat is worse at night, also called night sweats in Western medicine. But in cases of severe deficiency sweat, it occurs regardless of day or night. Spontaneous and night sweats can also cause insomnia. Debility often stems from this.
5. Aphonia. There are two types of aphonia in tuberculosis patients: one is laryngeal tuberculosis, i.e., glottic tuberculous ulcer; the other is in the collapse stage, where the lung cavity is too large, causing Lung Qi deficiency and inability to produce sound. Occasional aphonia due to wind-cold cough is not included here. This is a sign of deep-seated tuberculosis. However, with proper treatment and gradual regression of the disease, aphonia can also gradually heal. This is not a primary symptom.
6. Irritability. Tuberculosis patients are mentally depressed and easily angered. This symptom is closely related to the environment and should be addressed by changing circumstances. Patients often consider irrelevant matters significant and become enraged. TCM calls this Liver Qi disorder. As the disease progresses, this symptom becomes more prominent. As the disease subsides, this phenomenon decreases, and specific treatment for this symptom is not necessary.
7. Dyspnea/Asthma. Due to physical debility, tuberculosis patients pant easily with slight exertion. If the disease is long-standing and deep, feeling chest oppression and shortness of breath are signs that lung cavities have formed. However, slight dyspnea is insignificant. Some tuberculosis patients feel pain or itching in the chest, which is a sign of pleural involvement, not a sign of the lung itself, as the lung parenchyma has no pain sensation.
8. Anemia. Tuberculosis bacilli destroy everything in the body. Affected by this, the whole body presents a toxic state. Western medicine explains blood poisoning as the mixture of bacterial toxins in the blood; this should not be interpreted as TCM toxicity. Consequently, patients have yellow faces and emaciated muscles, presenting a particularly withered and pale complexion. This is a common phenomenon among general tuberculosis patients. Women often have amenorrhea, all caused by debility.
9. Palpitations (Zheng Chong). This is a TCM disease name, a sign of heart weakness. After massive blood loss in tuberculosis, patients often have this symptom. They often feel uneasy and restless in the heart. It is a dangerous symptom. It is often ignored but is actually dangerous.
10. Diarrhea. This is also a TCM disease name, the final dangerous phenomenon of tuberculosis, commonly known as "loose stools." At this time, intestinal tuberculosis has formed, and debility is extreme. Food cannot be absorbed, and the source of nutrition is cut off. This is the outcome for general tuberculosis patients. Edema is also seen in the late stage, especially prominent in patients with diarrhea. It is very worrying.
Western medicine's recognition of tuberculosis is indeed clear and accurate, more practical than TCM concepts of Lao Shang, Xu Sun, Lao Zhai, and Fei Wei. However, its description of the pulse is not as clear as TCM. Generally, in the second stage, the pulse must be deficiency-thin and rapid, or only deficiency-thin, or show knotted/intermittent pulses (after blood loss), leaving no doubt. In the first stage, if Qi and Blood are not yet severely depleted, the pulse may be wiry-thin, wiry-rapid, or slightly floating-full (mostly on the right hand). With excessive blood loss, the pulse may be deficiency-large and powerless (similar to Kou pulse). These are derived from my experience, not copied from ancient texts. Therefore, in the above discussion of symptoms, I generally adopt Western medicine, except for the omission of pulse diagnosis. I specifically record TCM pulse theory here to supplement Western medicine's shortcomings. I hope physicians refer to this carefully. Diagnosing based on this seems clearer. Furthermore, although the symptoms of tuberculosis are generally uniform as described above, in my experience, there are exceptional cases where not all symptoms are present, and even major symptoms are largely absent (no cough, no hemoptysis, no fever). Lingering for a long time (or only with hemoptysis), recognized as tuberculosis by both Chinese and Western medicine, confirmed by X-ray examination without doubt, yet the main symptoms are missing or appear briefly and then disappear. Such cases linger and ultimately prove untreatable. There are also cases where tuberculosis is definitely diagnosed by famous hospitals and renowned TCM doctors. However, when treated with standard Chinese or Western methods for tuberculosis, the condition immediately worsens. This is neither misdiagnosis nor mistreatment, but rather an absolute incompatibility with standard drugs. Conversely, patients who recklessly use strong cooling herbs, such as Sheng Di Huang (Rehmanniae Radix) and Shi Gao (Gypsum Fibrosum), gradually improve. These exceptions are truly peculiar, personally witnessed by me, and appended here. One must know that while Western medicine's symptom analysis is accurate, theoretical discussion alone cannot fully capture the variations of this disease. Whether there are other special cases is unknown. Therefore, we physicians must remain humble. (There are many symptoms similar to pulmonary tuberculosis, but these two exceptions are certainly not misidentifications.)
Correct Treatment Method) Treating pulmonary tuberculosis is best done as early as possible; ideally, prevention should be emphasized. However, ordinary patients often lack this common sense. Unfortunately contracting the disease, they view it as a chronic illness and consider it unimportant, suddenly missing the easy-to-treat period, which is most regrettable. By the time patients realize the danger and seek good doctors, eight or nine out of ten have entered the difficult-to-treat second or third stages. In this period, if further misled by Chinese or Western medicine and treated improperly, the disease will worsen. Straying onto the wrong path inevitably leads to death. General precautions for this disease are recorded in my book *Self-Therapy for Pulmonary Tuberculosis*, which can be consulted. The full text of self-therapy is listed under the section on Yin-deficiency fever. Here, I only compare the advantages and disadvantages of symptomatic treatments and drugs between Chinese and Western medicine, describing them below for verification. All this is based on my decades of experimentation. Every word and sentence has undergone countless careful observations and repeated trials before being made public. I hope researchers explore further based on my report. I also hope tuberculosis patients pay attention to my writings as a guide to finding good doctors, thereby avoiding wrong paths and escaping suffering early. This is the author's original intention.
1. Fever. This symptom, following the order of the previously listed symptoms, is the most important sign in tuberculosis and also one of the most difficult to treat. To rapidly reduce fever, apart from taking Western antipyretics such as Antipyrine, Phenacetin, and Pyramidon, few achieve quick results. However, these Western drugs often induce spontaneous and night sweats. In patients with heart weakness, they pose a great danger of sudden cardiac arrest, so they should be avoided. Although Phenacetin has no sweating side effects, excessive use fails to reduce fever and induces vomiting and dizziness, making it not a good drug for this condition. Recently, Euphorbium tablets are widely used, but their effect is very slow and expensive, requiring continuous administration for many days. Moreover, they cannot reduce fever accurately; they are just comparatively gentler than Antipyrine, etc. Using Camphoric Acid with Pyramidon to prevent excessive sweating and cardiac arrest is another method. TCM calls this type of fever "Yin-deficiency fever," which contains profound truth. Therefore, among Yin-nourishing herbs, there are indeed one or two with definite effects. There are many types of TCM Yin-nourishing herbs, and they should not be tried indiscriminately. For example, Bai Shao (Paeoniae Radix Alba): this herb not only nourishes Yin but also arrests sweating and astringes the Lung to stop cough. It is an invaluable product for treating tuberculosis. Sheng Di Huang (Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), Di Gu Pi (Cortex Lycii), Nu Zhen Zi (Ligustri Lucidi Fructus), Mu Li (Ostrea Concha), Bie Jia (Testudinis Carapax et Plastrum), Gui Ban (Plastrum Testudinis), Sang Ji Sheng (Taxilli Herba) all have considerable efficacy. The dosage of Bai Shao must be above 30g (one tael), and the rest above 18-21g (six to seven qian). Most other TCM herbs listed for nourishing Yin and reducing fever are ineffective and need not be tested; I have tried them for many years. Especially Mai Dong (Ophiopogonis Tuber), Wu Wei Zi (Schisandrae Fructus), Wu Zhu Yu (Evodiae Fructus), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Rou Gui (Cinnamomi Cortex) should absolutely not be used. Since many habitually use them, I specially declare them forbidden. Although Ren Shen (Ginseng Radix) is not absolutely forbidden, its drawbacks are significant, so caution is required. Among the effective TCM herbs listed above, for patients in the second or third stage who are not yet twelve parts weak, eight or nine out of ten can reduce fever. Their efficacy is gentle and lasting, unlike Western drugs that reduce fever abruptly with short duration, so they are comparatively superior. The unique advantage of these TCM herbs is the complete absence of sweating side effects, posing no danger to the weakened heart, and complementing cough-stopping, sweat-arresting, and bleeding-stopping herbs beautifully. They can be used boldly. Regarding Western injectables for tuberculosis, there are many varieties, but multiple trials showed no good effects; they should not be abused. General Western pharmaceutical promotional materials are often untrue and should not be fully trusted.
I believe that normal body temperature (normothermia) in the human body is the most precious thing. Only tuberculosis patients, with insufficient Yin and Blood, cannot contain and moisten this heat, allowing it to settle and merge to perform its proper function of warming the body. Instead, it floats and scorches, going astray,酿成 (breeding) a pathological state of drought and dryness. Physicians should find ways to guide it to gather, neutralize, and absorb, so that fever naturally subsides. If Western antipyretics are used to eliminate this heat, it is like hacking away at the precious vital energy of the body. Although fever seems to subside temporarily, the remaining heat, fortunately not fully separated from Yin and Blood, will float out again, so fever returns. If Western antipyretics are used repeatedly, vital energy will be completely depleted, leaving not a trace of warmth. The day this heat is completely gone is the day vital energy in the body is exhausted. Why wait for the heart to stop? Therefore, I advocate that in treating tuberculosis fever, heat should be contracted, not dispersed. I believe this has profound meaning. Part of Western antipyretic action disperses heat outside the body. Although the patient feels temporarily relieved, it essentially deprives them of vital energy once, silently causing greater loss to tuberculosis patients. Based on this advocacy, my use of TCM to reduce fever only converges heat, preserving and containing it, never letting it escape outward. Western medicine considers this heat harmful, so antipyretic drugs are the same as those treating excess heat (e.g., warm diseases). I consider this heat extremely precious within the body; human recovery of health relies entirely on this heat. If this heat is forcibly dispersed using Western drugs or dispersing TCM herbs, it will scatter and return as heat. Removing one part of heat removes one part of vital energy. When vital energy is exhausted, the person dies. Therefore, I advocate that this heat must be converged within Qi and Blood, not expelled from the body; it must be returned to the center of Qi and Blood, not dispersed to the skin.
Western medicine fears the abundance of this heat; I fear its scarcity. Based on this advocacy, I have tested it for years with miraculous effects. This theory contradicts Western medicine and differs somewhat from TCM. However, I value practice in treating diseases. I dare not talk empty words and mislead people (a flaw in many ancient medical books), nor blindly follow new theories. I invite interested parties to try it.
2. Cough. This is also a main symptom of this disease. Although not all general patients necessarily have this extremely stubborn cough, treating cough is genuinely difficult. The more one coughs, the more the lungs vibrate; the more they vibrate, the larger the inflammatory area becomes, and the more sputum is produced. The infiltrated parts inside the lungs are more easily expanded. Therefore, the method of stopping cough is as important in the course of this disease as the method of reducing fever.
The cough and fever in this disease act together. The more one coughs, the weaker one becomes; the weaker one becomes, the hotter one gets. As fever decreases, cough decreases; as fever increases, cough increases. Among cough-stopping herbs, Bai Shao (Paeoniae Radix Alba) should take the first place. For coughs in patients suspected of tuberculosis for a relatively long time, use Bai Shao as the main herb (15-18g), assisted by Xing Ren (Armeniacae Semen Amarum), Bei Mu (Fritillariae Bulbus), Zi Wan (Asteris Radix), Sang Bai Pi (Mori Cortex), and Pi Pa Ye (Loquat Leaf) as a decoction, or add Pear as a guide. After three to five doses, great efficacy is invariably achieved. If there is excessive thin sputum, Fu Ling (Poria) is essential (above 18g). If the sputum is thick, Ju Hong (Citri Reticulatae Pericarpium Rubrum) and Yuan Zhi Gen (Polygalae Radix) must be added. At the end of the third stage, patients with extremely thick sputum that is difficult to expectorate are in more danger. These are all TCM herbs with outstanding efficacy. However, in my experience, the advantage of TCM cough-stopping herbs is their long-lasting effect, but most can only slowly reduce cough. Making the patient stop coughing completely is quite difficult. Western cough-stopping drugs with special effects include Hydrochloride Esculin (likely referring to a specific alkaloid preparation, contextually likely Codeine/Eserine derivative mistranslation or specific brand), Morphinum (Morphine), Chloroform, etc. All opium preparations are very dangerous for children and must absolutely not be used. Be cautious. They are all anesthetics and should not be abused. The comparatively gentler one is Troponil powder (likely a transliteration of a specific proprietary mix). Although this drug also contains opium, the content is very small, so it can be used for children, but in small doses. Therefore, discussing solely the efficacy of cough-stopping drugs, TCM certainly does not match the speed of Western drugs. However, Western anesthetic products do not truly treat the disease; they only provide anesthesia. Once the drug effect disappears, coughing resumes. Compared to TCM, which can indeed fundamentally reduce cough, it seems each has its strengths and weaknesses. However, if physicians can utilize Western drugs to make up for the shortcomings of TCM in appropriate situations, then assisting each other creates unimaginable wonders. It depends on the physician's skillful application.