3．吐血，肺痨之咯血或吐血，最足惹起病者之惶恐，此症虽非绝对危险，然往往患者精神感动太剧烈，因而增加不良之影响者不少。故止血方法，在治疗上，功；非常重要，尤其在大吐血时，更宜特别重视。医者凡遇轻微之咯血，即应明白告知咯血之病理，使其加意预防，免致日后之大吐血。若遇大吐血病者，极端惊慌时，医者必须设法安慰之，务使患者及其家族，格外镇静，而后施以对症之药品，以期止血。在大吐血时，若以暂求速效为目的，当然以注射西药麦角剂为宜，内服亦可。用麦角及阿片等剂，均有止血之速效，以余之经验，麦角一药，虽有止血之效？然隔若干时，或数月、或数年之后，患者若再吐血时，其数量必更大。此或为——般医者所不知意者此药有刺激血管、收缩神经中枢之作用，因收缩血管之力过强，或致该部郁血，故积之日久，反致大吐血欤，至此药之易于中毒，及不宜于怀孕之妇人，收缩子宫种种缺点，中医更不可不知。余在完全崇信西医时期，每遇吐血症，几无不用此药，后则渐渐发现其缺点，即只以暂时止血而论，亦不能尽如药物学上所载之效验。成药贩卖之宣传刊物，更不必论。余实遇有数例，在肺病大吐血时，连续适用麦角剂之极大量，约五、六日，竟不能完全止血，仅仅止其大吐，然——日之间，尤其于早晨，必吐二、三口，或数十口。（一日药量用至一·○克，此药用大量至五、六日，原非所宜，乃竟不能收效。此外尚用可阿古连注射皮下，同时尝用麦角剂内服，并不能收完全止血之效。此例甚多，故余现在对于吐血，不主张纯用此类西药矣。咯血少量时，更不可用麦角剂，以免后患。
中药中之白芍，其止血之效力，乃至神妙而不可思议。上述数例，于麦角及其他西药，不能完全止血时．或再发更大吐血时，竟以白芍四钱至—两佐以藕节—两、汉三七一钱、生地四钱至八钱等药，而完全止血，且止血后均经过数年或数十年，亦未见再发。或根本不用西药，一遇吐血或咯血，即以白芍为主药与之，率皆一剂即有奇效。有时以白芍之方，与麦角之方，每星期掉换令患者试服，十分之十无疑地皆于服麦角时期，复发吐血，病势反复此例亦不下数十。故余至今废止麦角剂，并以余之确实试验与比较成绩，坦白说明于此。愿中医坚信白芍为止血神晶，放胆用之，愿西医注意白芍止血，千真万确，毫无流弊，迥出于麦角等止血西药之上也。
白茅根、天花粉二药，于初起之咯血，或骤然大吐血不论肺、胃出血用之良效。然此药只宜在体气未衰，偶尔吐血者用之，万不可施用于二、三期肺痨之吐血，倘或妄用，必致病势加重。喘促、失音，即以此二药媒介，与麦冬、五味子及其他温补药，同一流弊，久用必失音不可不知，此亦屡经实验者也。
大蓟、小蓟二药，止血亦有良效？此药自春至秋，鲜者极多，吾乡俗名曲曲菜、青青菜、蓟菜，遍地野生，可作馅，可作汤，可作咸菜，以之佐餐，常常食之。尽可令病者以此为常食品，不必加入药中也。
4．汗，肺痨既有顽固难退之虚热缠绵日久，消耗体内有用之津液，（然并非如实热之消耗津液，此热因虚弱浮游于外，不能与气血含合，互生互长，以致津液失其来源而干枯，此余对肺痨热一贯之主张，愿学者深信此言也。）皮肤肌肉，因而不健全，自汗、盗汗，亦相继而至，愈热愈汗，愈汗愈弱，病者之危期至矣。根本止汗，必重用中药滋阴，例如生地、白芍、元参、阿胶等，其中最有奇效者，首推白芍、生地，再佐以收涩滋阴之生牡蛎、生鳖甲等，用之必能止汗，但此种药量，用之均宜在一两左右生地可用五、六钱方能有效。西药止汗剂多剧烈，且非根本治法，不可用也，其他中药止汗类，例如浮小麦等，亦不必用，间有用人参、当归于此症者，余不主张之。
5，失音，此症在肺痨第三期，或误服不对症之药，往往如此，偶尔风寒咳嗽失音，不在此例，不可误解。喉头结核时，亦有此症状，肺痨之败象也。此症有效中药，例如生扁豆、怀山药、莲子、苡仁、沙参等，佐以白芍、牡蛎、炙桑皮、炙枇把叶、地骨皮、杏仁、橘红、远志根等味，不公皆用，可以选择、不难收效。此中医虚则补母之说，以睥胃属土，以肺属金，失音之症，责在肺气太虚，补土所以生金也。余不愿谈此理，然补睥胃药，试之良验，盖强壮治法，实治肺痨之上规也。治失音颇有良效。西药对此症无良药盖中药补养脾胃，即合于西医治疗肺痨之原则，身体强壮，渚症自愈，然服龟肝油、帕勒托等，则绝无效。所以身体稍健，而声音恢复，亦有定理。试验极确但中药之温性补药，例如肉桂、干姜、人参等及种种凉性药、例如天花粉、金银花、白茅根、麦冬、天冬等。收涩药、例如五味广、乌梅等。则实不宜于失音之症。此类药品，未失音前误服之，可致失音，既失音后，再误服之，则不可救药矣，慎之慎之。张妪年四十八岁，通州城南车里坟人，余家之女仆也。患极重之产宫瘤，因出血过多，身体渐弱。又以伊本乡妇，不惯烧煤，前在姚姓家佣；工，-—家四、五个煤炉，由伊一人掌管，（自云曾受煤气）遂有气管支炎之习惯病。每至冬徒，一添煤火，必患咳嗽气短，（俗名憋气）有时呼吸阻滞，夜不能卧。戊寅春，忽失音，（前亦有失音，以此次为甚。）月余不愈。经某医用桔梗五钱，法夏五钱，麦冬五钱，河于肉三钱、化红二钱、元参五钱，甘草五钱、蒌仁二钱，生地四钱，知母三钱、贝母二钱、枳实三钱、香附三钱、灯笼三钱、银花三钱．五味子一钱。（药名均照原方抄录）服数剂，更其，丝毫不能发音矣。余乃以苏子二钱、法半夏一钱，金银花一钱、鲜芦根五钱，沙参二钱、炒生地二钱、生百合三钱、旋覆花—二钱、甜杏仁一钱、炒粳米引，煎服，共服七剂而愈。此例本不足录，只以此病用药与此章本沦相抵触，而亦有效，则以其原因为煤毒，并非结核，故此等药，竟能收效。若在第三期之肺痨失音，则绝不可用，录以此见医者认症及读书，均须有灵活之眼光，不可拘板，此道之所以难也。
6．烦躁，此症并非必要主征，以精神的疗法，求其安慰，自然症候消失。此外环境之改造，余曾因此症而辞官职，三期之肺痨竞获痊愈。职业之选择，肺痨愈重，烦躁亦愈甚，普通人认为肝气，即是此症。均有良效。药品方面，不过平肝滋阴之品，白芍、生地等肺痨渐减，此症亦必随之而去也。
7．喘，肺痨病在未至十分衰弱时，若有喘症．或病者自觉气短，稍稍与以中药之旋覆花、桑白皮、杏仁、熟地少用、沙参、白芍、首乌、阿胶、建莲、山药、苡仁等，或间接治喘，或直接治喘，均能有效。然至肺痨末期，肺之本体己崩溃殆尽，发现真性喘息时，则无法挽回，必不得已而用西药之麻醉剂，亦属饮鸩止渴，绝非善策。麻黄素绝不可用于此种喘息。近有用樟脑制剂者，比较稳健，然须绝对避免酒精。屋克沙福之调制，多添加酒精，橙皮糖浆，虽为调味药，然内有酒精，不可不知。中药内之紫河车真有根治虚痨喘促之效，但制法宜格外洁净耳。
8．贫血，因肺痨而致贫血万不可用西药之铁制剂，及中药之当归等补血药。此症不必专治，只要肺痨得脾胃调和，饮食增加，身体强壮，则贫血自愈。若在肺痨药中，加入补血之品，十之八九，愈补愈热，不但无益，而反害之，此余历试不爽者也。
余曾亲见有因服帕勒托自来血等，反致诱起吐血者。
9，怔忡，此为中医病名，肺痨大吐血后，往往见之。患者自觉，心脏忐忑不宁，每隔数分钟，或数刻钟，即宋一次，为心血不足之危象。有此现象，无沦如何，万不可用西药之退热剂及麻醉剂。然在普通人，往往不甚注意，实则大吐血后，顷刻之间，因而失劫生命者，即由于此。余在治疗肺痨中，甚不主张用参、芪、当归等，然遇此症剧烈时，深知性命有不保之危险，轻微之怔忡不在此例故必重用大剂台参、炙黄芪、当归身、白芍、柏子二、炒枣仁、龙眼肉、炙甘草，以上药味，不町增减，以末治之，唯大吐血尚未全止时，若患此症甚急，不可骤用大剂参、芪，反致大吐，此时可以西药樟脑酸内服，若有虚脱之虑时，可注射强心剂，例如哥罗那金，实芰答利斯等，以暂救一时之危险。（中药可以暂停）此种西药，持续时间，不如中药之长，可暂用之，以资急救，若根治心脏衰弱之左方，仍以中药为准也。以资挽救不可拘泥。
10.泄泻，此症为肺痨病末期临危之现象，每伴浮肿以俱宋，盖其肠内，已满布结核菌，完全失其吸收之作用，血液来源，既渐减少，血行障碍，势所必致也。以中医说，则为脾肾虚弱已极之现象，总之病者滋养缺乏，已成难治之症，若再加以泄泻，则所进些微食物，完全在肠内不能吸收，养源断绝，不死何待？故善治肺痨者，在病人尚未十分衰弱之时，即当先顾脾胃，此是要诀以预防此症之演变。不幸病者发现此症，此时万不可服鱼肝油等若欲求一时速效，则阿片末、次硝酸苍铅、单那而并等西药，均有确效。凡肺痨病者，饮食下咽后，既觉腹痛，即是泄泻之预兆，不可不防。然中药之莲子、山药、苡仁等亦有效，但力缓耳，病势至此，十之八九，不能挽回矣。
肺痨病治法总论余既认定虚弱为肺痨原因，结核为肺痨结果，故余治此症专注于脾胃及肾之清补，使病者脾胃强壮饮食增加，自然气血渐旺，肾阴潜和自然虚阳归纳，可以根本限制结核菌之繁殖。此症不适用补气、（参、芪）补血（当归及铁剂）等药，盖以此病例有一种虚无飘渺之热，游离于肌肉皮肤之间，稍加燥补，则热更升高，而肺之炎症部，受其灼烁溃烂更甚，无益有损也。是以蒺藜、熟地、山药，白芍、莲子、扁豆、苡仁、茯苓等品，看似清淡，然补养脾胃及肾，不温不燥，适合于有虚热之病体也。夫虚热何由来？盖因病者气血太弱，失其温煦涵润之正规，不能抵抗菌毒，遂致生此惨败热象，此热并非由毒素产生，乃人体内抗毒力量，勉强挣扎，不肯受死于菌毒，而发生筋疲力竭自救之呼声。西医退热药，乃多半退实热，用之于此，是将此些微挣扎之自救力，而又加以解除也。是以因用退热药，诱起自汗者实多，不但无益，而反害之，此种虚热，恍惚迷离，如因风之游丝，不可捉摸。盖热之正当生理，本应涵蓄于吾入气血之中，气血若无此热之温煦，则不能生长，此热若无气血之含吸，则亦失其附丽。此症气血与热，因身体太弱，愈离愈远，则愈虚愈热，愈热愈汗，愈汗愈虚，阴阳脱钮，日久抱合愈难，势必消耗灼烁，使人体之内无丝毫自救能力而后已，故肺痨临危，反不热不咳矣，若只认为菌毒，犹浅见也。在稍有生活力病者，常服此种健脾养胃补肾之药，使其真阴渐固，消化容易，纳食健全，得一分食物即多一分气血，久久自能气血渐旺，抵抗力增加，此种无着之虚热，即渐渐与气血濡合，而归于平靖，故气血畅旺，未有不退热者。然用此等中药，必合大剂养阴之品用之，白芍、生地、阿胶、地骨皮、牡蛎等以促其阴阳之拢合，一面兼顾肺痨。唯一目的，必先止嗽，盖不震动肺体，而后可望减少炎症产出物，不令其为害于血液，希望游离之热，不再受其扰动，而后安静含濡，容易潜藏入阴，则健脾药亦有用武之余地，使肺之病灶不再扩大。有数日不咳，则脾胃药得其机会，大见功效，渐渐生长，气血调和，自然不咳不热。其初虽系药力强制，其后即成自然向愈，身体日强，病灶日渐缩小，即是此症唯一向愈道路。止嗽之药以重用白芍、杏仁、炙桑皮等最有效，必不得巳时，可兼用西药之止嗽剂，然西药不过一时用之，以补中药之不足，亦经验谈也。此症绝对不可用中药之五味子等敛肺药及其他中药，不但无益而反害之。肺痨之热，最不易退，然若认定此理，坚信不疑，未有不奏效者，病人自觉手足心发热，或胸内热灼，皆是此热，万不可用苦寒药也。若用西药麻醉剂止嗽，病人嗽止更觉痛苦者不宜过用麻醉药，此时已入危境矣。
余曾治有极凶险之肺病，参看医验无不以此法而退热，唯此种立论，理想上与西医说不能吻合，而排除中医说法之处亦不少。
余实不敢只凭理想，凭空结篆，贻误后人，致蹈以前中医著述之罪恶，余只知治病有效，即为有价值之学说，既由实验得来，因而恣谈之，以告同好。此章可与前论阳虚发热，阴虚发热参看。然肺痨者，则阴虚者多，不可误用补阳药也。又中药内补药最多，凡本论未载之补药，万不可用，即其他止嗽止血退热等中药，未经此论表出者，均不可用。以余对此症，历试中西药，已四十余年，临症何止干百，试之又试，煞费苦心，一字一句，皆实验谈也。余治此症，实有独得之妙，颇饶兴趣也。
3. Hematemesis (vomiting blood) and hemoptysis (coughing up blood) caused by Pulmonary Tuberculosis (Lung Consumption) are most likely to cause panic in patients. Although this condition is not absolutely dangerous, there are many cases where the patient's spirit is severely disturbed, thereby increasing adverse effects. Therefore, hemostatic methods play a very important role in treatment; especially during massive hematemesis, special attention should be paid. Whenever a physician encounters slight hemoptysis, they should clearly explain the pathology of hemoptysis to the patient, urging them to take precautions to prevent massive hematemesis in the future. If encountering a patient with massive hematemesis who is extremely panicked, the physician must find ways to comfort them, ensuring that both the patient and their family remain exceptionally calm, before administering symptomatic medication to achieve hemostasis. During massive hematemesis, if the goal is to seek rapid temporary effect, it is certainly appropriate to use Western medicine ergot injections, which can also be taken orally. Both ergot and opium preparations have rapid hemostatic effects. Based on my experience, although Ergota (Ergot) has hemostatic efficacy, after a certain period—whether months or years—if the patient experiences hematemesis again, the volume will inevitably be greater. This may be a principle unknown to general physicians: this drug stimulates blood vessels and contracts the central nervous system. Because its power to contract blood vessels is too strong, it may cause congestion in that area; thus, accumulating over time, it反而 leads to massive hematemesis. Regarding its tendency to cause poisoning, its unsuitability for pregnant women, and its uterine contraction side effects, these are disadvantages that Traditional Chinese Medicine (TCM) practitioners must know. During my period of complete faith in Western medicine, I almost invariably used this drug for hematemesis cases, but later gradually discovered its drawbacks. Even regarding temporary hemostasis alone, it did not always yield results as recorded in pharmacology texts. Advertisements for proprietary medicines are even less reliable. I indeed encountered several cases where, during massive hematemesis from lung disease, extremely large doses of Ergot were applied continuously for about five or six days, yet could not completely stop the bleeding. It only stopped the massive vomiting of blood, but within one day, especially in the morning, two or three mouthfuls, or dozens of mouthfuls, would still be vomited. (The daily dosage reached 1.0 gram; using such large doses for five to six days was originally inadvisable, yet it still failed to produce results. Additionally, subcutaneous injections of Cocaine were used simultaneously with oral Ergot, but complete hemostasis was not achieved. There are many such cases, so now I do not advocate pure use of such Western drugs for hematemesis. When hemoptysis is slight, Ergot must not be used to avoid future complications.
Among TCM herbs, Bai Shao (Radix Paeoniae Alba) has a hemostatic efficacy that is truly miraculous and inconceivable. In the aforementioned cases, when Ergot and other Western drugs could not completely stop bleeding, or when larger volumes of blood were vomited again, simply using Bai Shao (4 qian to 1 liang), assisted by Ou Jie (Nodus Nelumbinis Rhizomatis, Lotus Node, 1 liang), Han San Qi (Radix Notoginseng, 1 qian), and Sheng Di Huang (Radix Rehmanniae Preparata, 4-8 qian), completely stopped the bleeding. Furthermore, after hemostasis, several or even decades passed without recurrence. Or, using no Western drugs at all, whenever hematemesis or hemoptysis occurred, Bai Shao was used as the principal herb, usually yielding miraculous effects with just one dose. Sometimes, alternating weekly between formulas containing Bai Shao and those containing Ergot for patients to try, ten out of ten undoubtedly relapsed with hematemesis during the periods taking Ergot, with fluctuating conditions. Such examples number no less than dozens. Therefore, I have abolished the use of Ergot preparations to this day, and frankly state this based on my actual experimental and comparative results. I wish TCM practitioners firmly believe that Bai Shao is a divine product for stopping bleeding and use it boldly; I wish Western medicine practitioners note that Bai Shao's hemostatic effect is absolutely true, free from adverse reactions, far surpassing Western hemostatic drugs like Ergot.
Bai Mao Gen (Rhizoma Imperatae) and Tian Hua Fen (Radix Trichosanthis) are highly effective for initial hemoptysis or sudden massive hematemesis, regardless of whether the bleeding originates from the lungs or stomach. However, these two herbs are only suitable for patients whose constitution has not declined and who occasionally bleed; they must never be applied to hematemesis in stage II or III Pulmonary Tuberculosis. If used recklessly, the disease condition will surely worsen. Dyspnea (asthma/shortness of breath) and aphonia (loss of voice), often mediated by these two herbs combined with Mai Dong (Radix Ophiopogonis), Wu Wei Zi (Fructus Schisandrae), and other warming and tonifying drugs, share similar detrimental outcomes; long-term use inevitably leads to aphonia, which must be known, as confirmed by repeated experiments.
Da Ji (Herba Cirsii Japonici) and Xiao Ji (Herba Cirsii) also have good hemostatic effects. These herbs are abundant in fresh form from spring to autumn. In our hometown, they are commonly known as Ququ Cai, Qingqing Cai, and Ji Cai, growing wild everywhere. They can be used as fillings, in soups, or as pickles. Used as accompaniments to meals and consumed regularly, they can serve as regular food for patients without necessarily being added to medicinal formulas.
4. Sweating: Since Pulmonary Tuberculosis involves stubborn, difficult-to-reduce deficient heat lingering for a long time, consuming useful body fluids (however, this is not like excess heat consuming fluids; this heat floats on the exterior due to weakness and cannot combine with Qi and Blood to mutually generate and grow, causing fluids to lose their source and dry up. This is my consistent view on heat in Pulmonary Tuberculosis, and I hope scholars believe this statement). The skin and muscles become unhealthy, and spontaneous sweating (Zihan) and night sweats (Daohan) follow sequentially. The hotter it gets, the more one sweats; the more one sweats, the weaker one becomes, marking the critical phase for the patient. To fundamentally stop sweating, heavy doses of TCM Yin-nourishing herbs must be used, such as Sheng Di Huang (Radix Rehmanniae Preparata), Bai Shao (Radix Paeoniae Alba), Xuan Shen (Radix Scrophulariae), and E Jiao (Colla Corii Asini). Among these, Bai Shao and Sheng Di Huang are most efficacious, assisted by astringent and Yin-nourishing Shi Mu Li (Concha Ostreae) and Shi Bie Jia (Carapax et Plastrum Testudinis). Their use will surely stop sweating. However, the dosages for such herbs should generally be around 1 liang; Sheng Di Huang requires 5-6 qian to be effective. Western antiperspirants are often harsh and do not address the root cause, so they should not be used. Other TCM antiperspirants, such as Fu Xiao Mai (Frumentum Semimaturum), are also unnecessary. I do not advocate the occasional use of Ren Shen (Radix Ginseng) or Dang Gui (Radix Angelicae Sinensis) for this condition.
5. Aphonia: This symptom often occurs in stage III Pulmonary Tuberculosis or due to taking inappropriate medications. Occasional aphonia due to wind-cold cough is excluded here; do not misunderstand. Laryngeal tuberculosis also presents this symptom, indicating a decline in Pulmonary Tuberculosis. Effective TCM herbs for this condition include Sheng Bian Dou (Semens Phaseoli Umbellati), Huai Shan Yao (Rhizoma Dioscoreae Hypoglaucae), Lian Zi (Semens Nelumbinis), Yi Yi Ren (Semen Coicis), and Sha Shen (Radix Glehniae or Radix Adenophorae), assisted by Bai Shao (Radix Paeoniae Alba), Mu Li (Concha Ostreae), Zhi Sang Pi (Cortex Mori Praeparatus), Zhi Pi Pa Ye (Folium Eriobotryae Praeparatus), Di Gu Pi (Cortex Lycii), Xing Ren (Semen Armeniacae Amarum), Ju Hong (Pericarpium Citri Reticulatae), and Yuan Zhi Gen (Radix Polygalae). Not all need to be used; selection is possible, and efficacy is easily achieved. This aligns with the TCM theory of "tonifying the mother when deficient." Since Spleen and Stomach belong to Earth and Lung belongs to Metal, aphonia is attributed to excessive deficiency of Lung Qi; tonifying Earth generates Metal. I am reluctant to discuss this theory, but spleen and stomach tonics have proven effective. Strengthening therapy is actually the superior approach for treating Pulmonary Tuberculosis. Treatment of aphonia yields good results. Western medicine lacks effective drugs for this condition. Tonifying Spleen and Stomach with TCM aligns with Western principles for treating Pulmonary Tuberculosis; as the body strengthens, various symptoms resolve spontaneously. However, cod liver oil and Palto are absolutely ineffective. Thus, slight physical improvement leading to voice recovery follows established laws. Experiments confirm this. However, warm-tonic TCM herbs such as Rou Gui (Cortex Cinnamomi), Gan Jiang (Rhizoma Zingiberis), and Ren Shen (Radix Ginseng), as well as cooling herbs like Tian Hua Fen (Radix Trichosanthis), Jin Yin Hua (Flos Lonicerae), Bai Mao Gen (Rhizoma Imperatae), Mai Dong (Radix Ophiopogonis), and Tian Dong (Radix Asparagi), and astringents like Wu Wei Zi (Fructus Schisandrae) and Wu Mei (Fructus Mume), are truly unsuitable for aphonia. Misusing these before aphonia occurs can cause it; misusing them after aphonia sets in makes the condition incurable. Be extremely cautious. Mrs. Zhang, aged 48, from Che Lifan, south of Tongzhou City, was a maid in my home. She suffered from a severe uterine fibroid and became progressively weak due to excessive bleeding. Being a local woman, she was unaccustomed to burning coal. While working for the Yao family, managing four or five coal stoves alone, (she stated she was exposed to coal gas), she developed chronic bronchitis. Every winter, adding coal fire triggered coughing and shortness of breath (colloquially called "breath-holding"), sometimes causing respiratory obstruction and inability to sleep at night. In the spring of the Wuyin year, she suddenly lost her voice (she had lost her voice before, but this episode was worse). It persisted for over a month without healing. A certain doctor prescribed Jie Geng (Radix Platycodonis) 5 qian, Fa Ban Xia (Rhizoma Pinelliae Preparatum) 5 qian, Mai Dong (Radix Ophiopogonis) 5 qian, He Zi Rou (Endocarpus Terminaliae Chebulae) 3 qian, Hua Hong 2 qian, Xuan Shen (Radix Scrophulariae) 5 qian, Gan Cao (Radix Glycyrrhizae) 5 qian, Lou Ren (Semen Benincasae) 2 qian, Sheng Di Huang (Radix Rehmanniae Preparata) 4 qian, Zhi Mu (Rhizoma Anemarrhenae) 3 qian, Bei Mu (Bulbus Fritillariae Cirrhosae) 2 qian, Zhi Shi (Fructus Aurantii Immaturus) 3 qian, Xiang Fu (Rhizoma Cyperi) 3 qian, Deng Long 3 qian, Yin Hua (Flos Lonicerae) 3 qian, and Wu Wei Zi (Fructus Schisandrae) 1 qian. (Drug names copied exactly from the original formula). After several doses, her condition worsened, and she could not produce any sound at all. I prescribed Su Zi (Fructus Lepidii seu Descurainiae) 2 qian, Fa Ban Xia (Rhizoma Pinelliae Preparatum) 1 qian, Jin Yin Hua (Flos Lonicerae) 1 qian, Xian Lu Gen (Rhizoma Phragmitis Recens) 5 qian, Sha Shen (Radix Glehniae) 2 qian, Chao Sheng Di Huang (Radix Rehmanniae Preparata Stir-fried) 2 qian, Sheng Bai He (Bulbus Lilii) 3 qian, Xuan Fu Hua (Capitulum Inulae) 2 qian, Tian Xing Ren (Semen Armeniacae Amarum Sweet) 1 qian, using Chao Jing Mi (Semen Oryzae Sativae Stir-fried) as a guide, decocted and taken orally. After seven doses, she recovered. This case is hardly worth recording, except that the medication contradicts the main argument of this chapter yet proved effective because the cause was coal toxicity, not tuberculosis. Therefore, these drugs worked. For aphonia in stage III Pulmonary Tuberculosis, however, they must absolutely not be used. I record this to show that physicians must have flexible insight in diagnosing and studying, avoiding rigidity; this is why the medical path is difficult.
6. Irritability: This symptom is not a necessary primary sign. Spiritual therapy to provide comfort naturally causes symptoms to disappear. Additionally, environmental modification helped me resign from my official post, resulting in the complete cure of stage III Pulmonary Tuberculosis. Career choice matters; the heavier the Pulmonary Tuberculosis, the more severe the irritability. Ordinary people attribute this to Liver Qi stagnation, which also yields good results. Regarding medication, items that soothe the Liver and nourish Yin, such as Bai Shao (Radix Paeoniae Alba) and Sheng Di Huang (Radix Rehmanniae Preparata), are used. As Pulmonary Tuberculosis diminishes, this symptom will inevitably recede.
7. Asthma/Dyspnea: When Pulmonary Tuberculosis has not reached extreme debility, if asthma occurs or the patient feels short of breath, slightly administering TCM herbs such as Xuan Fu Hua (Capitulum Inulae), Sang Bai Pi (Cortex Mori), Xing Ren (Semen Armeniacae Amarum), small doses of Shu Di Huang (Radix Rehmanniae Preparata), Sha Shen (Radix Glehniae), Bai Shao (Radix Paeoniae Alba), Shou Wu (Radix Polygoni Multiflori), E Jiao (Colla Corii Asini), Jian Lian (Semens Nelumbinis), Shan Yao (Rhizoma Dioscoreae Hypoglaucae), and Yi Yi Ren (Semen Coicis) can be effective, whether indirectly or directly treating asthma. However, in the terminal stage of Pulmonary Tuberculosis, when the lung tissue itself has collapsed and true dyspnea appears, it cannot be reversed. Using Western anesthetic agents as a last resort is drinking poison to quench thirst and is definitely not a good strategy. Ephedra alkaloids (Ma Huang Su) must absolutely not be used for this type of dyspnea. Recently, camphor preparations have been used, which are relatively stable, but alcohol must be absolutely avoided. Ulexin formulations often contain added alcohol. Orange peel syrup, though a flavoring agent, contains alcohol, which must be noted. Zhe He Che (Placenta Humana) in TCM truly has the effect of fundamentally treating deficiency-type asthma, but its preparation method must be exceptionally clean.
8. Anemia: Anemia caused by Pulmonary Tuberculosis must never be treated with Western iron preparations or TCM blood-tonifying herbs like Dang Gui (Radix Angelicae Sinensis). This condition does not require specific treatment; as long as the Spleen and Stomach are harmonized in Pulmonary Tuberculosis, diet increases, and the body strengthens, anemia will heal spontaneously. Adding blood-tonifying substances to Pulmonary Tuberculosis prescriptions will, nine times out of ten, increase heat further, doing no good and causing harm instead. This is an experience of mine that has never failed.
I have personally witnessed cases where taking Palto or Zi Lai Xue induced hematemesis.
9. Palpitations (Zheng Tong): This is a TCM disease name, often seen after massive hematemesis in Pulmonary Tuberculosis. The patient feels their heart fluttering uneasily, occurring every few minutes or quarters of an hour. This is a critical sign of insufficient Heart Blood. Regardless of circumstances, Western antipyretics and anesthetics must absolutely not be used when this phenomenon occurs. However, ordinary people often pay little attention to it. In reality, death can occur moments after massive hematemesis due to this. In my treatment of Pulmonary Tuberculosis, I generally do not advocate using Ren Shen (Radix Ginseng), Huang Qi (Radix Astragali), or Dang Gui (Radix Angelicae Sinensis). However, when this symptom is severe, knowing the life is in danger, mild palpitations are excluded. Therefore, heavy doses of Tai Shen (Ginseng), Zhi Huang Qi (Radix Astragali Praeparatus), Dang Gui Shen (Radix Angelicae Sinensis Root Tip), Bai Shao (Radix Paeoniae Alba), Bai Zi Ren (Semen Platycladi) 2 qian, Chao Zao Ren (Semen Ziziphi Spinosae Stir-fried), Long Yan Rou (Arillus Longan), and Zhi Gan Cao (Radix Glycyrrhizae Praeparatus) must be used. The above herbs should not be altered. They should be powdered and taken. Only when massive hematemesis has not fully stopped and this symptom is urgent should large doses of Ren Shen and Huang Qi not be used abruptly, as this may trigger massive bleeding. At this time, oral Camphoric Acid (Zhang Nao Suan) can be used. If collapse is feared, cardiac stimulants such as Coronarin or Strychnine can be injected to temporarily save the immediate danger. (TCM can be paused). These Western drugs do not last as long as TCM but can be used temporarily for emergency rescue. For fundamentally treating cardiac weakness, TCM remains the standard. Rescue efforts should not be rigid.
10. Diarrhea: This symptom is a pre-terminal phenomenon in Pulmonary Tuberculosis, often accompanied by edema. This is because the intestines are covered with tubercle bacilli, completely losing their absorption function. As blood sources gradually decrease, blood circulation obstacles are inevitable. From a TCM perspective, this is a sign of extreme Spleen and Kidney deficiency. In short, the patient lacks nourishment and the condition is difficult to treat. If diarrhea is added, the small amount of food ingested cannot be absorbed in the intestines, cutting off the source of nourishment. How can death not follow? Therefore, skilled practitioners of Pulmonary Tuberculosis must first protect the Spleen and Stomach before the patient becomes extremely weak; this is the key to preventing the evolution of this symptom. Unfortunately, if the patient develops this symptom, fish liver oil and similar substances must absolutely not be taken. If seeking temporary rapid effect, Opium powder, Bismuth Subnitrate, or Tanalin have definite effects. For any Pulmonary Tuberculosis patient, abdominal pain felt immediately after swallowing food is a precursor to diarrhea and must be prevented. However, TCM herbs like Lian Zi (Semens Nelumbinis), Shan Yao (Rhizoma Dioscoreae Hypoglaucae), and Yi Yi Ren (Semen Coicis) are also effective, though their action is slow. Once the disease reaches this stage, nine times out of ten, it cannot be reversed.
General Discussion on Treating Pulmonary Tuberculosis: Since I determine that weakness is the cause of Pulmonary Tuberculosis and tuberculosis is the result, my treatment focuses on clearing and tonifying the Spleen, Stomach, and Kidneys. Making the patient's Spleen and Stomach strong and increasing diet naturally leads to gradual abundance of Qi and Blood. With Kidney Yin harmonizing, deficient Yang naturally returns to its source, fundamentally limiting the reproduction of tubercle bacilli. This condition is not suitable for Qi-tonifying (Ren Shen, Huang Qi) or Blood-tonifying (Dang Gui, iron agents) drugs. This is because these cases involve a vague, floating heat游离 between muscles and skin. Slightly adding drying tonics raises the heat further, causing the inflamed parts of the lung to suffer more scorching and ulceration, doing more harm than good. Therefore, items like Ji Li (Fructus Tribuli), Shu Di Huang (Radix Rehmanniae Preparata), Shan Yao (Rhizoma Dioscoreae Hypoglaucae), Bai Shao (Radix Paeoniae Alba), Lian Zi (Semens Nelumbinis), Bian Dou (Semens Phaseoli Umbellati), Yi Yi Ren (Semen Coicis), and Fu Ling (Poria) appear light, but they tonify the Spleen, Stomach, and Kidneys without being warming or drying, suiting bodies with deficient heat. Where does this deficient heat come from? Because the patient's Qi and Blood are too weak, losing their normal warming and moistening functions, they cannot resist bacterial toxins, leading to this tragic heat manifestation. This heat is not produced by toxins but is the body's anti-toxic strength struggling reluctantly, refusing to die to the bacteria, a cry of exhaustion in self-rescue. Western antipyretics mostly reduce excess heat; using them here removes this slight struggling self-rescue force. Thus, using antipyretics often induces spontaneous sweating, doing no good and causing harm. This deficient heat is elusive, like spider silk in the wind, ungraspable. Physiologically, heat should be contained within Qi and Blood. Without this heat's warmth, Qi and Blood cannot grow; without Qi and Blood's containment, heat loses its attachment. In this condition, due to extreme bodily weakness, Qi, Blood, and Heat drift further apart. The weaker it gets, the hotter it becomes; the hotter it gets, the more one sweats; the more one sweats, the weaker it gets. Yin and Yang disconnect, making reunion increasingly difficult over time. It inevitably consumes and scorches until the body has no self-rescue ability left. Thus, in critical Pulmonary Tuberculosis, heat and cough cease. Viewing it solely as bacterial toxin is superficial. For patients with some vitality, frequently taking these Spleen-strengthening, Stomach-nourishing, and Kidney-tonifying herbs solidifies True Yin, aids digestion, improves appetite, and converts food into Qi and Blood. Over time, Qi and Blood gradually abound, resistance increases, and this rootless deficient heat gradually merges with Qi and Blood, returning to tranquility. Thus, with abundant Qi and Blood, heat does not retreat. However, using such TCM herbs must be combined with large doses of Yin-nourishing agents like Bai Shao (Radix Paeoniae Alba), Sheng Di Huang (Radix Rehmanniae Preparata), E Jiao (Colla Corii Asini), Di Gu Pi (Cortex Lycii), and Mu Li (Concha Ostreae) to promote Yin-Yang union, while addressing Pulmonary Tuberculosis. The sole objective must be to stop coughing first. By not agitating the lung tissue, we hope to reduce inflammatory exudates, preventing harm to the blood, hoping the floating heat is no longer disturbed, becoming quiet and moist, easily hiding into Yin. Then, Spleen-tonifying drugs have room to work, preventing lung lesions from expanding. If coughing stops for several days, Spleen-stomach drugs get the opportunity to show great efficacy, gradually growing, harmonizing Qi and Blood, naturally stopping cough and heat. Initially, this may be forced by drug power, but later it becomes natural recovery. The body strengthens daily, lesions shrink daily; this is the only path to recovery for this condition. For stopping cough, heavy use of Bai Shao (Radix Paeoniae Alba), Xing Ren (Semen Armeniacae Amarum), and Zhi Sang Pi (Cortex Mori Praeparatus) is most effective. As a last resort, Western antitussives can be used concurrently, but Western drugs are only for temporary use to supplement TCM deficiencies, based on experience. This condition absolutely forbids using TCM Lung-astringents like Wu Wei Zi (Fructus Schisandrae) or other such herbs, as they do no good and cause harm. Heat in Pulmonary Tuberculosis is hardest to retreat, but if this principle is recognized and believed without doubt, no one fails to respond. Patients feeling heat in palms/soles or burning in the chest are experiencing this heat; bitter-cold drugs must absolutely not be used. If Western anesthetics are used to stop coughing and the patient feels more painful after coughing stops, anesthetics should not be overused; the patient has entered a critical state.
I once treated extremely dangerous lung diseases; reviewing medical records, all retreated heat using this method. However, this theoretical stance does not align with Western medicine ideals, and excludes many TCM explanations.
I dare not base myself solely on ideals, construct theories out of thin air, mislead future generations, or repeat the sins of previous TCM writings. I only know that effective treatment constitutes a valuable theory. Since it comes from experimentation, I speak freely to inform enthusiasts. This chapter can be read alongside previous discussions on Yang-deficiency heat and Yin-deficiency heat. However, in Pulmonary Tuberculosis, Yin deficiency is more common; Yang-tonifying drugs must not be mistakenly used. Furthermore, among TCM tonics, there are many types. Any tonic not recorded in this discussion must absolutely not be used. Similarly, other TCM herbs for stopping cough, bleeding, or reducing heat, not expressed in this discussion, must not be used. Having tested Chinese and Western medicines for this condition for over forty years, and seeing thousands of cases, testing again and again with great effort, every word and sentence is based on experiment. My treatment of this condition possesses unique subtleties and considerable interest.