燥症大意
诸涩枯涸。干劲皴揭。皆属于燥。（经文）燥万物者。莫 乎火。（易经）火气一 。五液皆枯。故燥之为病。血液
衰少。而又气血不能通畅。（原病式）
燥症内因
燥者。阳明金气所化。金受火制。木旺风生。风火相合。胜湿损津。（原病式）亦有天时久晴。黄埃蔽空。风热怫郁
而成者。此属外邪。（六要）其内因所致者。病端不一。有减气而枯。有减血而枯。（好古）或大病而攻伐太过。或
吐泻而津液顿亡。或饥饿劳倦。损伤胃液。或思虑劳神。心血耗散。或房劳太过。肾水干枯。或金石刚剂。预
求峻补。或膏粱浓味。炙爆太多。皆能助火烁阴而为燥。（良方）总之。金为水源。金受火克。不能生水而源绝
于上。则无以荣肤泽毛。而诸燥作矣。（六要）
燥症外候
在外则皮肤皴揭。在上则咽鼻焦干。在中则水液衰少而烦渴。在下则肠胃枯涸而便难。（良方）
燥病变症
风燥。由肝血不能荣筋。故筋痛爪裂。火燥。由脾多伏火。故唇揭便秘。血燥。由心血失散。故头多白屑。发脱
须落。虚燥。由肾阴虚涸。故小便数。咽干喉肿。此皆燥之初因也。濡润自愈。若不加啬养。使真水涸竭。为消
渴噎膈。为痿痹经闭。为干咳声哑。筋脉劲强。口噤拳挛。筋缓不收。而千 竞起。虽欲静摄。则燎原不可遏
矣。（汇补）
燥症脉法
脉紧而涩。或浮而弦。或芤而虚。皆属燥症。（正传）
燥症治法
治燥须先清热。清热须先养血。养血须先滋阴。（绳墨）宜甘寒之品。滋润荣卫。甘能生血。寒能胜热。阴得滋
而火杀。液得润而燥除。故曰。莫治风。莫治燥。治得火时风燥了。（子和）
虚燥宜补
若病后曾服汗下药。及吐后产后。老年瘦羸人。见诸燥症。脉细涩或洪数者。俱属血液不足。当濡润之。纵
欲人发燥者。多肾虚。以肾主五液也。（汇补）
燥症禁戒
切忌香燥动火。及发汗渗湿利便通导之药。（入门）损伤津液。至于苦寒辛凉。亦逐末而忘本。世多此弊。其
燥愈增。（汇补）
燥症用药
主以四物汤加减。如皮肤皴揭。加秦艽、防风。咽鼻焦干。加知母、黄芩。烦渴。加麦冬、花粉。便难。加麻仁、
牛膝。痰燥。加贝母、栝蒌。血燥。加天冬、熟地。火燥。壮实者。用清凉饮子以治上焦之燥。用脾约麻仁丸以治中下
之燥。虚燥。在肾经者。用地黄汤丸。加天麦冬。在肝脾经者。用加味逍遥散。加麦冬。或枯梗。或生地。随症加
减。不可胶泥其说也。
燥症选方
清凉饮子 治上焦积热。口舌咽干鼻燥。
黄芩 黄连 薄荷 玄参 当归 芍药（各一钱半） 甘草（一钱）
便燥。加大黄。水煎服。
脾约麻仁丸（和剂） 治脾家伏火。血液燥。大便闭结。
浓朴 枳实 芍药（各二两） 大黄（蒸四两） 杏仁 麻仁（各一两半）
蜜丸。温水下。
地黄汤 加味逍遥散 四物汤（三方俱见中风）
大补地黄丸 治下焦虚火。精血枯燥。因而便闭。
熟地（四两） 当归 山药 枸杞（各三两） 知母 黄柏（各二两） 山萸肉 白芍药（二两） 生地（二两五
钱） 肉苁蓉 玄参（各一两半）
炼蜜丸。盐汤下。
新制通幽汤 治幽门不通。大便闭结。上冲吸门。呕食不下。肠燥胃闭。将成噎塞之症。
当归 红花 桃仁 韭汁 香附 牡丹皮 苏子 桔梗 陈皮
水煎。磨槟榔五分。调和服。
朱砂芦荟丸 治大便不通。
朱砂（研如飞面五钱） 真芦荟（研细七钱）
滴好酒少许为丸。每服一钱二分。好酒服。朝服暮通。暮服朝通。须天晴时修合。
General Principles of Dryness Syndrome
Various conditions of dryness, witheredness, exhaustion, skin tightness, and scaling all belong to Dryness Syndrome (Zao Zheng). That which dries up all things is fire; nothing surpasses it. (From the Classic Texts) When Fire Qi becomes excessive, the Five Fluids all wither. Therefore, the occurrence of Dryness Syndrome is due to the depletion of Blood and the failure of Qi and Blood to circulate smoothly. (From *Yuan Bing Shi*)
Internal Causes of Dryness Syndrome
Dryness Syndrome is transformed from the Metal Qi of Yangming. When Metal is controlled by Fire, Wood becomes hyperactive generating Wind; Wind and Fire combine to overcome Dampness and damage Body Fluids. (From *Yuan Bing Shi*) There are also cases caused by prolonged sunny weather, where yellow dust obscures the sky, leading to the formation of Wind-Heat stagnation; this belongs to External Pathogens. (From *Liu Yao*) Regarding those caused by internal factors, the origins vary: there is withering due to Qi deficiency and withering due to Blood deficiency. (From Haogu) Or, after a major illness, excessive purgative or attacking treatments may be used; or vomiting and diarrhea may cause sudden loss of Body Fluids; or hunger and fatigue may damage Stomach Yin; or excessive mental labor and overthinking may dissipate Heart Blood; or excessive sexual activity may dry up Kidney Water; or the premeditated use of harsh mineral drugs for strong tonification may occur; or excessive consumption of rich foods and fried/grilled items may generate heat. All these can assist Fire to scorch Yin and cause Dryness Syndrome. (From *Liang Fang*) In summary, Metal is the source of Water. If Metal is overcome by Fire and cannot generate Water, the source is cut off in the Upper Jiao, failing to nourish the skin and moisten hair, thus various Dryness Syndromes arise. (From *Liu Yao*)
External Manifestations of Dryness Syndrome
Externally, the skin becomes tight and scales; superiorly, the throat and nose become scorched and dry; centrally, body fluids decrease causing irritability and thirst; inferiorly, the intestines and stomach become withered causing difficulty in defecation. (From *Liang Fang*)
Complications of Dryness Syndrome
Wind-Dryness arises when Liver Blood fails to nourish the sinews, resulting in sinus pain and cracked nails. Fire-Dryness arises when Spleen has latent Fire, resulting in peeling lips and constipation. Blood-Dryness arises when Heart Blood is scattered, resulting in dandruff on the head, hair loss, and beard falling out. Deficiency-Dryness arises from Kidney Yin exhaustion, resulting in frequent urination, dry throat, and swollen larynx. These are all initial causes of Dryness. If moistened, they heal spontaneously. If not conserved and nourished, allowing True Water to exhaust, it leads to Xiao Ke (Wasting-Thirst), Ye Ge (Dysphagia), Wei Bi (Flaccidity and Obstruction), Amenorrhea, dry cough with hoarseness, stiff and rigid sinews and vessels, locked jaw and clenched fists, or loose sinews that cannot hold. Various diseases emerge competitively. Even if one wishes to rest and preserve health, it is like a prairie fire that cannot be contained. (From *Hui Bu*)
Pulse Diagnosis of Dryness Syndrome
A pulse that is tight and choppy, or floating and wiry, or hollow and deficient, all belong to Dryness Syndrome. (From *Zheng Zhuan*)
Treatment Methods for Dryness Syndrome
To treat Dryness, one must first Clear Heat; to Clear Heat, one must first Nourish Blood; to Nourish Blood, one must first Nourish Yin. (From *Sheng Mo*) It is appropriate to use Sweet-Cold substances to moisten Ying and Wei. Sweetness generates Blood, Coldness overcomes Heat. When Yin is nourished, Fire is subdued; when fluids are moistened, Dryness is removed. Thus it is said: Do not directly treat Wind, do not directly treat Dryness; when you treat the Fire, both Wind and Dryness are resolved. (From Hezi)
Deficiency-Dryness Should Be Tonified
If after an illness, sweating or purgative medicines were taken, or after vomiting, postpartum states, or in elderly emaciated individuals, various Dryness symptoms appear with fine-choppy or rapid-hong pulses, these all belong to Blood insufficiency and should be treated with moistening methods. Those whose bodies become dry due to excessive desire are mostly due to Kidney Deficiency, as the Kidney governs the Five Fluids. (From *Hui Bu*)
Contraindications for Dryness Syndrome
Strictly avoid aromatic-drying and Fire-moving herbs, as well as herbs that induce sweating, promote diuresis, or unblock bowels. (From *Ru Men*) These damage Body Fluids. As for Bitter-Cold and Acrid-Cool herbs, they address the branch while forgetting the root; this is a common flaw in the world, resulting in increased Dryness. (From *Hui Bu*)
Medication for Dryness Syndrome
The main formula is Si Wu Tang (Four Substance Decoction) with modifications. For tight/scaly skin, add Qin Jiao (Gentian Root) and Fang Feng (Saposhnikovia Root). For scorched/dry throat and nose, add Zhi Mu (Anemarrhena Rhizome) and Huang Qin (Scutellaria Root). For irritability/thirst, add Mai Dong (Ophiopogon Tuber) and Hua Fen (Trichosanthes Root). For difficult defecation, add Ma Ren (Hemp Seed) and Niu Xi (Achyranthes Root). For Phlegm-Dryness, add Bei Mu (Fritillaria Bulb) and Gua Lou (Trichosanthes Fruit). For Blood-Dryness, add Tian Dong (Asparagus Tuber) and Shu Di (Rehmannia Root). For Fire-Dryness in robust constitutions, use Qing Liang Yin Zi (Cooling Drink Substitution) to treat Upper Jiao Dryness, and Pi Yue Ma Ren Wan (Splee-Restricting Hemp Pill) to treat Middle/Lower Jiao Dryness. For Deficiency-Dryness in the Kidney Meridian, use Di Huang Wan (Rehmannia Pill) with added Tian Dong and Mai Dong. For Liver/Spleen Meridians, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) with added Mai Dong, Jie Geng (Platycodon Root), or Sheng Di (Raw Rehmannia Root). Modify according to symptoms; do not adhere rigidly to fixed theories.
Selected Formulas for Dryness Syndrome
Qing Liang Yin Zi (Cooling Drink Substitution): Treats accumulated Heat in the Upper Jiao, dry mouth/tongue/throat/nose.
Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Bo He (Mint Herb), Xuan Shen (Scrophularia Root), Dang Gui (Angelica Sinensis Root), Shao Yao (Peony Root) (each 1.5 qian); Gan Cao (Licorice Root) (1 qian).
For dry stool, add Da Huang (Rhubarb Root). Decoct in water and take orally.
Pi Yue Ma Ren Wan (Splee-Restricting Hemp Pill) (From *He Ji Ju Fang*): Treats latent Fire in the Spleen, Blood Dryness, and constipation.
Hou Po (Magnolia Bark), Zhi Shi (Immature Bitter Orange), Shao Yao (Peony Root) (each 2 liang); Da Huang (Rhubarb Root, steamed) (4 liang); Xing Ren (Apricot Seed), Ma Ren (Hemp Seed) (each 1.5 liang).
Make pills with refined honey, take with warm water.
Di Huang Tang (Rehmannia Decoction), Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder), Si Wu Tang (Four Substance Decoction) (All three formulas are described under Stroke).
Da Bu Di Huang Wan (Great Tonifying Rehmannia Pill): Treats Empty Fire in the Lower Jiao, exhaustion of Essence and Blood, leading to constipation.
Shu Di (Prepared Rehmannia Root) (4 liang); Dang Gui (Angelica Sinensis Root), Shan Yao (Dioscorea Rhizome), Gou Qi (Goji Berry) (each 3 liang); Zhi Mu (Anemarrhena Rhizome), Huang Bai (Phellodendron Bark) (each 2 liang); Shan Zhu Yu (Cornus Fruit), Bai Shao Yao (White Peony Root) (2 liang); Sheng Di (Raw Rehmannia Root) (2.5 liang); Rou Cong Rong (Cistanche Stem), Xuan Shen (Scrophularia Root) (each 1.5 liang).
Make pills with refined honey, take with salt water.
Xin Zhi Tong You Tang (New Regulated Unblocking Soup): Treats obstruction of the幽门 (Pylorus), constipation, qi rushing upward to the吸门 (Glottis), vomiting food inability, intestinal dryness and Stomach closure, impending Dysphagia.
Dang Gui (Angelica Sinensis Root), Hong Hua (Safflower Flower), Tao Ren (Peach Kernel), Jiu Zhi (Leek Juice), Xiang Fu (Cyperus Rhizome), Mu Dan Pi (Moutan Cortex), Su Zi (Perilla Fruit), Jie Geng (Platycodon Root), Chen Pi (Tangerine Peel).
Decoct in water, grind Bin Lang (Areca Seed) 0.5 qian, mix and take orally.
Zhu Sha Lu Hui Wan (Cinnabar Aloe Pill): Treats complete constipation.
Zhu Sha (Cinnabar, ground to fine powder) (5 qian); Zhen Lu Hui (True Aloe Resin, finely ground) (7 qian).
Add a few drops of good wine to form pills. Take 1.2 qian per dose with good wine. Morning intake leads to evening evacuation; evening intake leads to morning evacuation. Must be prepared on sunny days.