丹溪论劳瘵主乎阴虚者，盖自子至巳属阳，自午至亥属阴，阴虚则热在午后子前，
寤属阳，寐属阴，阴虚则汗从寐时盗出也。升属阳，降属阴，阴虚则气不降，气不
降则痰涎上逆而连绵吐出不绝也。脉浮属阳，沉属阴，阴虚则浮之洪大，沉之空虚
也。此皆阴虚之证，用四物汤加黄柏、知母主之。然世医遵用治疾，乃百无一效者
何哉？盖阴既虚矣，火必上炎，而川芎、当归皆味辛气大温，非滋虚降火之药。又
川芎上窜，尤非虚炎短乏者所宜。地黄泥膈，非胃弱食少痰多者所宜。黄柏、知母
苦辛大寒，虽曰滋阴，其实燥而损血；虽曰降火，其实苦先入心，久而增气，反能
助火；至其败胃，所不待言，用药如此，乌能奏功也。予每用薏苡仁、百合、天门
冬、麦门冬、桑根白皮、地骨皮、牡丹皮、枇杷叶、五味子、酸枣仁之属，佐以生
地汁、藕汁、乳汁、童子小便等。如咳嗽则多用桑皮、枇杷叶。有痰则增贝母。有
血则多用薏苡仁、百合，增阿胶。热盛则多用地骨皮。食少则用薏苡仁至七八钱。
而麦门冬常为之主，以保肺金而滋生化之源，无不应手而效。盖诸药皆禀燥降收之
气，气之薄者，为阳中之阴，气薄则发泄，辛甘淡平寒凉是也。以施于阴虚火动之
症，犹当溽暑伊芳郁之时，而商 飒然倏动，则炎 如失矣。与治暑热用白虎汤同意。
然彼是外感，外感为有余，故用寒沉藏之药，而后能辅其偏。此是内伤，内伤为不
足，但用燥降收之剂，而已得其平矣。此用药之权衡也。虚劳之疾，百脉空虚，非
粘腻之物填之，不能实也。精血枯涸，非滋湿之物濡之，不能润也。宜用人参、黄
、地黄、天麦门冬、枸杞子、五味子之属，各煎膏，另用青蒿以童便熬膏，及生
地汁、白莲藕汁、人乳汁、薄荷汁，隔汤炼过，酌定多少，并糜角胶、霞天膏，合
和成剂。每用数匙，汤化服之。如欲行瘀血，加入醋制大黄末子、玄明粉、桃仁泥、
韭汁之属。欲止血，加入京墨之属。欲行痰，加入竹沥之属。欲降火，加入童便之
属。凡虚劳之症，大抵心下引胁俱疼，盖滞血不消，新血无以养之也。尤宜用膏子，
加韭汁、桃仁泥。呼吸少气，懒言语，无力动作，目无精光，面色 白，皆兼气虚，
用麦门冬、人参各三钱，橘红、桔梗、炙甘草各半两，五味子二十一粒，为极细末，
水浸油饼为丸，如鸡头子大。每服一丸，细嚼津唾咽下，名补气丸。气虚则生脉散，
不言白术。血虚则三才丸，不言四物。大略前言薏苡仁之属治肺虚，后言参 地黄
膏子之类治肾虚。盖肝心属阳，肺肾属阴，阴虚则肺肾虚矣。故补肺肾即是补阴，
非四物、黄柏、知母之谓也。劳瘵兼痰积，其证腹胁常热，头面手足则于寅卯时分
乍有凉时者是也。宜以霞天膏入竹沥、加少姜汁，调玄明粉行之。若顽痰在膈上胶
固难治者，必以吐法吐之，或沉香滚痰丸、透膈丹之类下之，甚则用倒仓法。若肝
有积痰污血结热而劳瘵者，其太冲脉必与冲阳脉不相应，宜以补阴药吞当归龙荟丸。
古方柴胡饮子、防风当归饮子、麦煎散皆用大黄，盖能折炎上之势而引之下行，莫
速乎此。然惟大便实者乃可。若溏泄则虽地黄之属亦不宜，况大黄乎。透肌解热，
柴胡、干葛为要剂，故治骨蒸方中多用之。如秦艽鳖甲散、人参地骨皮散、人参柴
胡散，皆退热之剂，然非常用多服之药也。《衍义》云∶柴胡，《本经》并无一字治
劳，今治劳方中鲜有不用者，凡此误世甚多。尝原病劳有一种真藏虚损，复受邪热
者，如《经验方》治劳热，青蒿煎丸用柴胡，正合宜耳，服之无不效。热去即须急
已。若无邪热，不死何待。又大忌芩、连、柏，骤用纯苦寒药，反泻其阳。但当用
琼玉膏之类，大助阳气，使其复还寅卯之位，微加泻阴火之药是也。有重阴覆其阳，
火不得伸，或洒洒恶寒，或志意不乐，或脉弦数，四肢五心烦热者，火郁汤、柴胡
升麻汤，病去即已，不可过剂。服寒凉药，证虽大减，脉反加数者，阳郁也。宜升
宜补，大忌寒凉，犯之必死。男子肌瘦，气弱咳嗽，渐成劳瘵，用猪肚丸，服之即
肥。有面色如故，肌体自充，外看如无病，内实虚损，俗呼为桃花蛀，当看有何证
候，于前项诸药审而用之。上所列五劳六极二十三蒸诸治法，亦略备矣。然当以脾
肾二脏为要，何以言之，肾乃系元气者也，脾乃养形体者也。经曰∶形不足温之以
气者也。谓真气有少火之温，以生育形体。然此火不可使之热，热则壮，壮则反耗
真气也。候其火之壮少，皆在两肾间，经又曰∶精不足补之以味。五味入胃，各从
所喜之脏而归之，以生津液，输纳于肾者。若五味一有过节，反成其脏有余，胜克
之祸起矣。候其五味之寒热，初在脾胃，次在其所归之脏，即当补其不足，泻其有
余。谨守精气，调其阴阳，使神五内。夫如是，则天枢开发，而胃和脉生，故荣卫
以周于内外，无不被滋养而病愈矣。劳疾久而嗽血，咽疼无声，此为自下传上；若
不嗽不疼，久而溺浊脱精，此为自上传下，皆死证也。骨蒸之极，声嗄咽痛，面黧
脉躁，汗出如珠，喘乏气促，出而无入，毛焦唇反，皆死证也。又骨肉相失，声散
呕血，阳事不禁，昼凉夜热者死。
附水丘先生紫庭治瘵秘方 人有传尸、 、伏连、五劳、七伤、二十六蒸，其
候各异，其源不同，世医不明根本，妄投药石，可胜叹哉。予休心云水，远绝人
事，遂以所传枢要精微，以示世医，使之明晓。夫传尸劳者，男子自肾传心，心而
肺，肺而肝，肝而脾；女子自心传肺，肺而肝，肝而脾，脾而肾，五脏复传六腑而
死矣。或连及亲族，至于灭门，其源皆由房室、饮食过度，冷热不时，忧思悲伤，
有欲不遂，惊悸喜惧。或大病后行房，或临尸哭泣，尸气所感。邪气一生，流传五
脏，蠹食伤心，虽有诸候，其实不离乎心阳肾阴也。若明阴阳用药，可以返魂夺命，
起死回生。人知劳之名，未知其理。人生以血为荣，气为卫，二者运转而无壅滞，
劳何由生。故劳者倦也，血气倦则不运，凝滞疏漏，邪气相乘。心受之为盗汗虚汗，
忧悲恐惧，恍惚不安。肾受之为骨蒸，为鬼交，阳虚好色愈甚。肝受之为瘰 ，胁
满痞聚，拳挛拘急，风气乘之为疼痛。脾受之为多思虑慕，清凉不食，多食无味。
肺受之为气喘痰涎，睡卧不安，毛发焦枯。至于六腑，亦各有证。今人多用凉药则
损胃气，虽卢扁亦难矣。予之所论，但在开关把胃，何则？劳病者，血气不运，遂
致干枯，此关脉闭也。故先用开关药通其血脉，既开关则须起胃。盖五脏皆有胃气，
邪气附之则五脏衰弱，若不把胃，则他药何由而行，故开关把胃乃治劳妙法也。然
必须明阴阳，且如起胃，阳病药不可过暖，阴病药不可过凉。今人言丁香、浓朴、
肉桂、苁蓉可补五脏，不知用之则喘息闭嗽，如火益热。或以治鬼为先务，要当法
药相济，道力资扶，然后鬼尸可逐也。此论上合黄帝、岐、扁，下明脏腑阴阳，非
患人有福，亦不遭逢，宝之。
总论病证 如夜梦鬼交，遗精自泄。梦魂不安，常见先亡，恐怖鬼神。思量饮食，
食至不进。目睛失白，骨节疼痛。五心烦热，头发作滞。面脸时红，如敷胭脂。
唇红异常，肌肤不润，言语气短。大便秘涩，或时溏利。小便黄赤，或时白浊。项
生瘰 ，腹中气块。鼻口生疮，口舌干燥，咽喉不利，仰卧不得。或时气喘，涕唾
稠粘，上气愤满，痰吐恶心，腹胁妨闷。阴中冷痛，阴痒生疮，多湿转筋拘急。或
忿怒悲啼，舌直苦痛，目睛时疼，盗汗，抬肩喘息，阳道虚刚。如手足心烦疼，口
干舌疮，小便黄赤，大便难，及热多咽喉痛，涎唾黄粘，及兼前项一二证，即是阳
病。当用阳病开关散，为泻阳而补阴。如大便溏利，小便白浊，饮食不化，胃逆口
恶，虽有热，痰唾白色及小便多，仍兼前项数症，即是阴病。当用阴病开关药。凡
劳病虚极，亦多令人烦躁，大小便不利，宜兼诸脉证审之。阴阳二症，皆用起胃散。
又歌诀云∶水丘道人年一百，炼得龙精并虎魄。流传此法在人间，聊向三天助阴德。
扶危起死莫蹉跎，此药于人有效多。不问阴阳与冷热，先将脾胃与安和。脾经虚冷
易生寒，最是难将热药攻。闭却大便并上气，为多浓朴与苁蓉。此法精关两道方，
病患入口便知良。但须仔细看形候，莫向阴中错用阳。涕唾稠粘小便赤，干枯四体
无筋力。乌龙膏子二十丸，便似焦枯得甘滴。遗精梦泄腹膨高，咳嗽阴疼为患劳。
此病是阴须识认，盒饭急下玉龙膏。嗽里痰涎仰卧难，阴阳交并候多端。却须兼服
诃黎散，治取根源病自安。
七宝丸、泻骨蒸传尸邪气，阳病可服。黄连四两，为细末，用猪肚一个洗
净，入药末，线缝之。用童便五升，文火煮令烂干为度。以肚细切同药烂研，置
风中吹干，丸如桐子大，朱砂、麝香作衣。空心麦门冬水下，或用阳病开关散咽
下。无朱砂亦可。
阳病开关散，北柴胡，去芦桔梗炒，秦艽、麦门冬去心各半两，芍药、木香、
泽泻各一两，木通半两，甘草一钱炙，当归、桑白皮蜜炙、地骨皮各一两， 咀。
每服三钱，水一盏，姜三片，煎六分，空心服。小便多即病去也。
阴病开关散，当归、赤芍药、肉桂、白芷、甘草炙各半两，木香二钱，制枳壳
三钱，天南星一钱，去皮姜汁浸一宿焙， 咀。每服三钱，姜三片，煎七分，入无
灰酒三分盏，童便三分盏，又煎七分温服。先服此起胃散一二日后，不问退否，兼
玉龙膏服之。
起胃散，阴阳二候皆用。黄 炙二两，白术炒一两，白芷半两，人参半两，山
药一两， 咀。每服三钱，加木瓜煎。或加沉香、茯苓、甘草各半两。
乌龙膏，乌梅去核，柴胡、紫菀、生干地黄、木香各一两，秦艽实好者、贝母
面炒去心、防风各三钱，杏仁五两面炒为末，皂角六十片，二十片去黑皮醋炙为末，
二十片烧灰存性，二十片汤浸去黑皮，用精猪肉剁烂如泥，同皂角一处，入水五升
细揉汁，入童便三升，无灰酒一升，并熬如膏，和前药末为丸，如梧桐子大。每服
二十丸，空心麦门冬汤下，甚者二十日效。
玉龙膏，青蒿子、柴胡、白槟榔各二两，制鳖甲、白术、赤茯苓、木香、牡蛎
各半两，地骨皮半两，人参一两，生干地黄一两，当归三钱，朱砂一钱，豆豉心二
合，虎头骨斫开酒炙黄赤色一两，肉苁蓉酒浸一宿炙一两，鳖甲汤煮去皮裙，酒浸
炙黄赤，皆为末。又加乌梅肉、枳壳。上前件末成，却以杏仁五升，壮者，以童便浸，
春夏七日，秋冬十日，和瓶日中晒，每日一换新者，日数足，以清水淘去皮尖焙干，
别以童便一升，于银石器内，以文火煎至随手烂，倾入砂盆，用柳木槌研烂为膏，
细布滤过，入酥一两，薄荷自然汁二合搅匀，和药用槌捣五百下，丸如梧桐子大。
空心汤下十五丸，加至三十丸。如觉热减丸数服，热少还添。加减经月日，诸证皆
退，进食安卧，面有血色，乃药行也。当勤服无怠。忌苋菜、白粥、冷水、生血、
雀、鸽等物。
诃黎散，治劳嗽上气。赤茯苓二两，诃黎勒皮二两，木香半两，槟榔一两，当
归一两炒，大黄一两炒，吴茱萸汤泡七次半两， 咀。每服三钱，生姜三片，水一
盏，煎六分，温服。
Zhu Danxi discussed that the main pathology of Lao Zhai (a chronic consumptive disease primarily characterized by Yin deficiency) lies in Yin deficiency. This is because from Zi hour to Si hour belongs to Yang, and from Wu hour to Hai hour belongs to Yin; when Yin is deficient, heat appears in the afternoon and before Zi hour. Being awake belongs to Yang, and sleeping belongs to Yin; when Yin is deficient, sweat escapes during sleep (night sweats). Qi ascending belongs to Yang, and descending belongs to Yin; when Yin is deficient, Qi does not descend. When Qi does not descend, phlegm and saliva reverse upward, leading to continuous, unceasing coughing. A floating pulse belongs to Yang, and a deep pulse belongs to Yin; when Yin is deficient, the pulse is large and forceful on superficial palpation but empty on deep palpation. These are all signs of Yin deficiency, for which Siwu Tang (Four Substances Decoction) added with Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma) should be used as the primary treatment. However, why do physicians today follow this method yet achieve no effect in one hundred cases? It is because when Yin is already deficient, Fire must flare upward. Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix) are both acrid in flavor and greatly warm in nature; they are not herbs that nourish deficiency or descend ministerial fire. Moreover, Chuanxiong has an ascending and dispersing nature, making it particularly unsuitable for patients with deficient flaming fire and shortness of breath/weakness. Dihuang (Rehmanniae Radix) is cloying and obstructs the stomach, making it unsuitable for patients with weak spleen/stomach, poor appetite, and abundant phlegm. Huangbai and Zhimu are bitter, acrid, and greatly cold. Although said to nourish Yin, they are actually drying and damage blood; although said to descend Fire, bitterness first enters the Heart, and long-term use increases Heart Qi, which can actually assist Fire. As for damaging the Stomach, it goes without saying. With such medication, how can efficacy be achieved?
I often use herbs such as Yiyiren (Coicis Semen), Baihe (Lilii Bulbus), Tianmendong (Asparagi Radix), Maimendong (Ophiopogonis Radix), Sanggenbaipi (Mori Cortex), Digupi (Lycii Cortex), Mudanpi (Moutan Cortex), Pipaye (Eriobotryae Folium), Wweizi (Schisandrae Fructus), and Szaoren (Ziziphi Spinosae Semen), assisted by fresh Shengdihuang juice, Ou juice, milk, and Tongzi Xiaobian (urine of a healthy prepubescent boy). If there is cough, I mostly use Sangbaipi (Mori Cortex) and Pipaye. If there is phlegm, I add Beimu (Fritillariae Bulbus). If there is hemoptysis, I mostly use Yiyiren and Baihe, adding Ejiao (Colla Corii Asini). If heat is excessive, I mostly use Digupi. If appetite is low, I use Yiyiren up to 2-3 qian (approx. 6-9g). Maimendong is often used as the chief herb to protect Lung Metal and nourish the source of transformation and generation, achieving immediate results. This is because these herbs possess the qi of dryness, descent, and astringency. Herbs with thin qi belong to Yin within Yang; thin qi has a dispersing action, which applies to acrid, sweet, bland, neutral, cool, and cold herbs. Applying them to symptoms of Yin deficiency with moving fire is like experiencing a sudden cool breeze during muggy, stagnant summer heat, causing the heat to vanish instantly. This is consistent with the principle of using Baihu Tang (White Tiger Decoction) to treat summerheat-warmth. However, external contraction diseases involve excess pathogenic factors, so cold and sinking herbs are used to correct the bias. Internal injury diseases involve deficiency, so only using dry, descending, and astringent agents restores balance. This is the weighing of medication strategies. In Luolao (consumptive weakness), the hundred vessels are empty; without sticky and moist substances to fill them, they cannot become solid. Essence and blood are dried up; without moistening substances to nourish them, they cannot become lubricated. It is appropriate to use Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Dihuang, Tianmendong, Maimendong, Gouqizi (Lycii Fructus), and Wweizi, decocted separately into pastes. Additionally, Qinghao (Artemisiae Annuae Herba) is decocted with Tongzi Xiaobian into a paste, along with fresh Shengdihuang juice, white lotus root juice, human milk, and Bohe juice (Menthae Haplocalycis Herba). These are refined over water, and the dosage is adjusted. They are mixed with Lujiaojiao (Colla Cornus Cervi) and Xiatiangao, and formed into pills. Each dose consists of several spoons, dissolved in warm water and taken orally. To move blood stasis, add Cuzhi Dahuang (Rhubarb processed with vinegar), Xuanmingfen (Mirabilite), Taoren ni (Persicae Semen paste), and Jiujiu (Allii Tuberosi Juice). To stop bleeding, add Jingmo (Chinese Ink). To resolve phlegm, add Zhuli (Bambusa Textilis Caulis juice). To descend fire, add Tongzi Xiaobian. Generally, in Luolao syndromes, pain radiates from the epigastrium to the hypochondrium because stagnant blood is not resolved, preventing new blood from nourishing the tissues. Pastes are especially suitable, added with Jiujiu and Taoren ni. Shortness of breath, reluctance to speak, lack of strength for movement, dull eyes, and pale complexion indicate concurrent Qi deficiency. Use Maimendong and Renshen, each 1 qian (approx. 3g); Juhong (Citri Reticulatae Pericarpium Rubrum), Jiegeng (Platycodonis Radix), and Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), each half liang (approx. 15g); and 21 Wweizi. Grind into an extremely fine powder, mix with water-soaked oil cakes to form pills the size of a corn kernel. Take one pill per dose, chew thoroughly with saliva, and swallow. This is named Buqi Wan (Qi-Nourishing Pill). For Qi deficiency, use Shaoyang San (Pulse-Generating Powder), omitting Baizhu (Atractylodis Macrocephalae Rhizoma). For Blood deficiency, use Santian Wan (Three Heaven Pill), omitting Siwu Tang. Broadly speaking, the previously mentioned Yiyiren group treats Lung deficiency, while the latter mentioned Renshen, Huangqi, and Dihuang pastes treat Kidney deficiency. Because Liver and Heart belong to Yang, and Lung and Kidney belong to Yin; Yin deficiency leads to Lung and Kidney deficiency. Therefore, tonifying Lung and Kidney is equivalent to tonifying Yin, referring not to Siwu Tang, Huangbai, or Zhimu. When Lao Zhai is complicated by phlegm accumulation, the syndrome involves constant heat in the abdomen and hypochondrium, with occasional coolness in the head, face, hands, and feet during the Yin-Mao hours (5:00-7:00 AM). It is appropriate to use Xiatiangao added with Zhuli and a small amount of Jiangzhi (Ginger juice), mixed with Xuanmingfen to promote movement. If stubborn phlegm is firmly lodged in the diaphragm and difficult to treat, emesis must be induced, or drugs like Chenxiang Guntan Wan (Agarwood Rolling Phlegm Pill) or Touge Dan (Diaphragm-Penetrating Elixir) should be used to purge downwards. In severe cases, the Daocang Fa (Stomach-Clearing Method) may be employed. If Liver has accumulated phlegm, dirty blood, and结热 (congealed heat) causing Lao Zhai, the Taichong pulse will likely not correspond with the Chongyang pulse. It is appropriate to swallow Danggui Longhui Wan (Angelica and Gardeniae Pill) with Yin-nourishing medicines. Ancient formulas such as Chaihu Yinzi, Fangfeng Danggui Yinzi, and Maijian San all use Dahuang, likely because it can curb the upward-flaring tendency of Fire and guide it downward, nothing being faster. However, this is only suitable for those with solid stools. If there is diarrhea, even Dihuang is unsuitable, let alone Dahuang. To penetrate the muscle layer and resolve heat, Chaihu (Bupleuri Radix) and Gange (Puerariae Lobatae Radix) are essential, hence frequently used in formulas treating bone-steaming fever. Such as Qinjiao Biejia San, Renshen Digupi San, and Renshen Chaihu San are all antipyretic agents, but not for frequent or long-term use. Yan Yi states: "Chaihu is not mentioned in Ben Jing for treating Lao." Yet nowadays, few Lao formulas omit it, misleading many. I have traced the pathology: there is a type of true Zang-Fu deficiency where pathogenic heat is superimposed. For example, in the Jingyan Fang treating Lao heat, Qinghao Jian Wan uses Chaihu, which is perfectly appropriate, and is invariably effective. Once heat is gone, the drug must be stopped immediately. Without pathogenic heat, death is inevitable. One must strictly avoid Qin (Scutellariae Radix), Lian (Coptidis Rhizoma), and Bai (Phellodendri Cortex); suddenly using pure bitter-cold drugs reversely drains Yang Qi. Instead, Qiongyu Gao (Jade Nourishing Paste) should be used to strongly support Yang Qi, allowing it to return to its proper position (Yin-Mao hours), with only a slight addition of drugs that drain ministerial fire. In cases of heavy Yin covering Yang, preventing Fire from extending, presenting with aversion to cold, depression, wiry-rapid pulse, and five-palm heat, Huoyu Tang (Fire-Stagnation Decoction) or Chaihu Shengma Tang should be used until the illness passes; overdosing must be avoided. If taking cold-cooling drugs reduces symptoms but the pulse becomes more rapid, it indicates Yang stagnation. Ascending and tonifying are indicated; cold-cooling drugs are strictly contraindicated, and violating this leads to death. Men with emaciation, weak Qi, and cough gradually developing into Lao Zhai can use Zhudu Wan (Pork Stomach Pill), which causes weight gain upon administration. Some present with normal facial color and self-sufficient physique, appearing healthy externally but suffering internal deficiency, commonly called "Peach Wood Moth." Their specific symptoms should be assessed to select from the aforementioned medications. The treatments listed above for Five Labors, Six Extremes, and Twenty-Three Steamings are roughly complete. However, the Spleen and Kidney are paramount. Why? The Kidney sustains Yuan Qi (Original Qi), and the Spleen nourishes the physical form. The Classics state: "For insufficiency of form, warm with Qi." This refers to the warming of Shao Huo (Lesser Fire) by True Qi to generate the form. However, this Fire must not become too hot; if it becomes strong, it consumes True Qi. Observe the intensity of this Fire, located between the two Kidneys. The Classics also state: "For insufficiency of essence, tonify with flavor." The five flavors enter the Stomach and歸 (return) to their preferred Zang organs, generating body fluids and transporting them to the Kidneys. If any of the five flavors is excessive, it causes surplus in that organ, leading to destructive overcoming relationships. Observe the cold/heat of the five flavors, initially in the Spleen/Stomach, then in the target organ; tonify deficiency and drain surplus accordingly. Carefully guard Essence and Qi, harmonize Yin and Yang, and calm the Spirit within the Five Viscera. Thus, Tianshu opens, Stomach Qi harmonizes, and pulses generate, allowing Ying and Wei to circulate internally and externally, nourishing all and curing the disease. If Lao disease persists with hemoptysis, sore throat, and loss of voice, it transmits from below to above; if without cough/pain but with turbid urine and seminal emission over time, it transmits from above to below; both are fatal signs. Extreme bone-steaming with hoarseness, sore throat, dark complexion, restless pulse, pearl-like sweat, panting with shortness of breath, exhalation exceeding inhalation, brittle hair, and everted lips are all fatal. Loss of flesh-bone connection, scattered voice, hematemesis, inability to control erections, and day-cool/night-hot are also fatal.
Appendix: Mr. Shuiqiu's Secret Formula from Ziting for Treating Lao Zhai: People suffer from Chuanshi, Fulian, Five Labors, Seven Injuries, and Twenty-Three Steamings. Symptoms vary, origins differ. Physicians ignorant of the root blindly administer drugs—how lamentable! I, resting in clouds and water, far from worldly affairs, share these essential secrets with physicians to enlighten them. Chuanshi Lao (Transmitted Corpse Labor) in men transmits from Kidney to Heart, Heart to Lung, Lung to Liver, Liver to Spleen; in women, from Heart to Lung, Lung to Liver, Liver to Spleen, Spleen to Kidney. After traversing the Five Zang, it moves to the Six Fu, leading to death. It may spread to relatives, causing family extinction. Origins include excessive sexual activity/diet, irregular temperature exposure, worry/sorrow, unfulfilled desires, fright/startle. Or intercourse after major illness, weeping over corpses, infection by corpse Qi. Once pathogenic Qi arises, it spreads through the Five Zang, consuming the Heart. Despite varied symptoms, it essentially involves Heart Yang and Kidney Yin. Understanding Yin-Yang in medication can restore life. People know the name "Lao" but not the principle. Humans rely on Blood as Ying (Nutrient) and Qi as Wei (Defensive). When they circulate without obstruction, how does Lao arise? Lao means fatigue; when Blood and Qi are fatigued, they fail to circulate, becoming stagnant and leaky, allowing pathogenic Qi to invade. Heart involvement causes night sweats/virtual sweats, sorrow/fear, restlessness. Kidney involvement causes bone-steaming, nocturnal emissions ("ghost intercourse"), worsening with Yang deficiency and lust. Liver involvement causes scrofula, hypochondriac fullness, cramping/spasms, pain from Wind. Spleen involvement causes excessive thinking, aversion to food, tastelessness. Lung involvement causes asthma/phlegm, restlessness, brittle hair. The Six Fu also have specific signs. Modern use of cooling drugs damages Stomach Qi, making cure difficult even for Lu Bian. My discussion focuses on opening the gate and securing the Stomach. Why? Lao patients have non-circulating Blood/Qi, leading to dryness—this is closed Guan Mai (Gate Pulse). Thus, open the gate first to unblock vessels, then revive Stomach Qi. All Five Zang depend on Stomach Qi; if pathogenic Qi attaches, Zang Qi weakens. Without securing Stomach Qi, other drugs cannot act. Hence, opening the gate and securing the Stomach is the subtle method for Lao. However, Yin-Yang must be distinguished. For reviving Stomach Qi, Yang disease drugs must not be too warm, Yin disease drugs must not be too cold. People claim Dingxiang (Caryophylli Flos), Houpo (Magnoliae Officinalis Cortex), Rougui (Cinnamomi Cortex), and Rongrong (Cynomorii Fructus) tonify the Five Zang, but using them causes wheezing/cough, adding fire to heat. Exorcism should combine medicine and Daoist power to expel ghost corpses. This theory aligns with Yellow Emperor, Qibo, and Bian Que, clarifying Zang-Fu Yin-Yang. Treasure it.
General Discussion of Syndromes: Night dreams of ghost intercourse, spontaneous seminal emission. Restless spirit, seeing deceased ancestors, fear of ghosts. Desire food but cannot eat. Pale eyes, joint pain. Five-palm heat, brittle hair. Flushing cheeks like rouge. Abnormally red lips, dry skin, shortness of breath. Constipation or loose stools. Yellow/red urine or turbid white urine. Scrofula on neck, abdominal masses. Sores in nose/mouth, dry tongue/throat, difficulty lying supine. Asthma, thick sputum, chest oppression, nausea. Cold/pain in genitals, itching/sores, dampness/cramps. Anger/sorrow, stiff painful tongue, eye pain, night sweats, shoulder-lifting breathing, impotence. If five-palm heat, dry mouth/tongue ulcers, yellow/red urine, difficult defecation, sore throat, yellow sticky sputum, plus some prior symptoms, it is a Yang disease. Use Yang Disease Kaiguan San to drain Yang and tonify Yin. If loose stools, turbid white urine, indigestion, gastric reversal/bad taste, despite heat, white sputum, and polyuria, plus prior symptoms, it is a Yin disease. Use Yin Disease Kaiguan Medicine. Severe Lao deficiency causes irritability and urinary/fecal retention; assess with pulses and signs. Both Yin/Yang syndromes use Qiwai San. Verse: Water Hill Daoist lived to 100, refining Dragon Essence and Tiger Soul. This method passed to humans, aiding Yin Virtue. Save the dying, do not delay; this drug is highly effective. Regardless of Yin/Yang or cold/heat, first harmonize Spleen/Stomach. Spleen deficiency/cold easily generates cold, hard to treat with hot drugs. Constipation and Qi rebellion require more Houpo and Rongrong. This precise method works instantly; examine signs carefully, do not misuse Yang in Yin. Thick sputum, red urine, dry limbs, no strength. Twenty Wulong Pills resemble rain on parched earth. Nocturnal emission, distended abdomen, cough/genital pain constitute Lao. Recognize this Yin disease; urgently apply Yulong Gao. Phlegm in cough, difficulty lying supine, complex Yin/Yang signs. Also take Helisan to treat the root and ensure peace.
Qibao Wan: Drains bone-steaming and transmitted corpse pathogenic Qi; suitable for Yang diseases. Huanglian (Coptidis Rhizoma) 4 liang, ground fine. Wash one pig stomach, insert powder, sew with thread. Cook in 5 sheng of Tongzi Xiaobian over gentle heat until dry and tender. Slice stomach finely, grind with medicine, dry in wind, form pills like sesame seeds, coat with Zhusha (Cinnabar) and Shexiang (Moschus). Take on empty stomach with Maimendong water, or swallow with Yang Disease Kaiguan San. Zhusha is optional.
Yang Disease Kaiguan San: Chaihu (deprived of radicle), fried Jiegeng, Qinjiao, Maimendong (deprived of heart) each half liang; Shaoyao, Muxiang, Zexie each 1 liang; Mutong half liang; Zhigancao (fried) 1 qian; Danggui, honey-fried Sangbaipi, Digupi each 1 liang. Cut into pieces. Take 3 qian, decoct in 1 sheng water with 3 slices of ginger until reduced to 0.6 sheng. Take on empty stomach. Abundant urination indicates cure.
Yin Disease Kaiguan San: Danggui, Chishaoyao (Red Peony Root), Rougui, Baizhi, Zhigancao (fried) each half liang; Muxiang 2 qian; Zhizhi (processed) 3 qian; Tiannanxing 1 qian (peeled, soaked overnight in ginger juice, baked). Cut into pieces. Take 3 qian, decoct in 1 sheng water with 3 slices of ginger until reduced to 0.7 sheng. Add 0.3 sheng Wuhuijiu (unadulterated wine) and 0.3 sheng Tongzi Xiaobian, decoct again to 0.7 sheng, and take warm. After taking Qiwai San for 1-2 days, regardless of improvement, also take Yulong Gao.
Qiwai San: Used for both Yin and Yang conditions. Zhuhuangqi (fried) 2 liang, fried Baizhu 1 liang, Baizhi half liang, Renshen half liang, Shanyao 1 liang. Cut into pieces. Take 3 qian, decoct with Mugua (Chaenomeles Fruit). Alternatively, add Chenxiang, Fuling, Zhigancao each half liang.
Wulong Gao: Remove pits from Wumei (Mume Fructus). Chaihu, Ziwan (Herba Asteris Tatarici), Sheng Gan Dihuang (Fresh Dried Rehmannia), Muxiang each 1 liang; high-quality Qinjiao, Beimu (pan-fried with flour, deprived of heart), Fangfeng each 3 qian; Xingren (pan-fried with flour, ground) 5 liang. 60 pods of Zhaojiao (Gleditsiae Spina): 20 pods remove black skin, process with vinegar, grind; 20 pods burn to ash retaining character; 20 pods soak in water, remove black skin. Mince lean pork into paste, mix with Zhaojiao, add 5 sheng water, knead to extract juice. Add 3 sheng Tongzi Xiaobian, 1 sheng Wuhuijiu, boil into paste. Mix with previous powders, form pills like paulownia seeds. Take 20 pills on empty stomach with Maimendong decoction; severe cases show effect in 20 days.
Yulong Gao: Qinghaozi (Artemisiae Annuae Semen), Chaihu, Bai Binglang (Arecae Semen) each 2 liang; Zhi Biejia (Processed Turtle Shell), Baizhu, Chifuling (Polyporus), Muxiang, Muli (Ostrea Concha) each half liang; Digupi half liang; Renshen 1 liang; Sheng Gan Dihuang 1 liang; Danggui 3 qian; Zhusha 1 qian; Douchi Xin (Fermented Soybean Heart) 2 he. Hu tou gu (Tiger skull bone) split, roasted in wine until yellow-red, 1 liang. Rongrong soaked in wine overnight, roasted, 1 liang. Biejia boiled to remove skirt, soaked in wine, roasted yellow-red. All ground to powder. Add Wumei meat and Zhike. Prepare Almond paste: 5 sheng almonds for robust individuals, soaked in Tongzi Xiaobian. Spring/Summer 7 days, Autumn/Winter 10 days. Sun-dry daily, changing liquid. When days are complete, wash clean, remove skins/spikes, bake dry. Separately, decoct 1 sheng Tongzi Xiaobian in silver/ceramic pot over gentle heat until soft. Pour into clay basin, grind with willow pestle into paste. Filter through fine cloth. Add 1 liang Su (Butyrum) and 2 he Bohe natural juice, mix well. Combine with medicine, pound 500 times with pestle, form pills like paulownia seeds. Take 15 pills on empty stomach with warm water, increase to 30. Reduce dose if heat decreases, increase if heat remains. Adjust over months until all symptoms recede, appetite returns, sleep improves, complexion gains color—indicating drug action. Take diligently without neglect. Avoid Amaranth, white porridge, cold water, raw blood, sparrow, pigeon, etc.
Helisan: Treats Lao cough with Qi rebellion. Chifuling 2 liang, Helile Pi (Terminalia Chebula Peel) 2 liang, Muxiang half liang, Binglang 1 liang, Danggui (fried) 1 liang, Dahuang (fried) 1 liang, Wuzhuyu (soaked in water 7 times) half liang. Cut into pieces. Take 3 qian, decoct in 1 sheng water with 3 slices of ginger until reduced to 0.6 sheng. Take warm.