（总名秋燥。俗通称风燥）。
【因】秋深初凉。西风肃杀。感之者多病风燥。此属燥凉。较严冬风寒为轻。若久
晴无雨。秋阳以曝。感之者多病温燥。此属燥热。较暮春风温为重。然间有夹暑湿内伏
而发。故其病有肺燥脾湿者。亦有肺燥肠热者。以及胃燥肝热者。脾湿肾燥者。全在临
证者。先其所因。伏其所主。推求其受病之源而已。
【证】凉燥犯肺者。初起头痛身热。恶寒无汗。鼻鸣而塞。状类风寒。惟唇燥嗌干
。干咳连声。胸满气逆。两胁
串疼。皮肤干痛。舌苔白薄而干。扪之戟手。温燥伤肺者。初起头疼身热。干咳无痰。即
咯痰多稀而粘。气逆而喘。咽喉干痛。鼻干唇燥。胸懑胁HT 。心烦口渴。舌苔白薄而燥
。边尖俱红。若秋燥伏暑。当辨其挟湿化火两端。如湿遏热郁者。浅则多肺燥脾湿。一
起即洒淅恶寒。寒已发热。鼻唇先干。咽喉干痛。气逆干咳。肢懈身痛。渴不思饮。饮
水即吐。烦闷不宁。胸胁胀疼。大腹满痛。便泄不爽。溺短赤热。舌苔粗如积粉。两边
白滑。深则多脾湿肾燥。肢懈无力。周身疼重。咳痰咸而稀粘。气喘息短。颧红足冷。
脚心反热。甚则痿厥。后则便泄。泄而后重。前则精滑。溺后余沥。妇女则带多腰酸。
舌圆胖嫩。上罩一层粘苔。边滑根燥。若暑从火化者。浅则多肺燥肠热。上则喉痒干咳
。咳甚则痰粘带血。血色鲜红。胸胁串痰。下则腹热如焚。大便水泄如注。肛门热痛。
甚或腹痛泄泻。泻必艰涩难行。似痢非痢。肠中切痛。有似硬梗。按之痛甚。舌苔干燥
起刺。兼有裂纹。深则多胃燥肝热。大渴引饮。饮不解渴。灼热自汗。四肢虽厥。而心
烦恶热。时而气逆干呕。时而气冲脘痛。筋脉拘疼。不能转侧。甚则手足螈 。状如惊
痫。男子睾丸疝痛。妇人少腹连腰牵疼。脐间动气。按之坚而震手。便多燥结。或便脓
血。或里急欲便而不得。或后重欲圊。欲了而不了。溺短赤涩。或点滴而急痛。
【脉】燥证脉多细涩。虽有因兼证变证。而化浮洪虚大弦数等兼脉。重按则无有不
细不涩也。
【治】凉燥犯肺。以苦温为君。佐以辛甘。香苏葱豉汤去香附。加光杏仁（三钱）
炙百部（二钱）、紫菀（三钱）、白前（二钱）、温润以开通上焦。上焦得通。凉燥自
解。若犹痰多便闭腹痛者。则用五仁橘皮汤。加全栝蒌、（四钱、生姜四分、拌捣极烂）
、干薤白（四枚白酒洗捣）、紫菀（四钱）、前胡（二钱）、辛温以流利气
机。终用归芍异功散加减。（归身二钱、白芍钱半、潞党参、云茯苓、清炙草、蜜炙广
皮。各一钱、金橘 、蜜枣各两枚、切碎）。气血双补以善后。温燥伤肺。以辛凉为
君。佐以苦甘。清燥救肺汤加减。（冬桑叶三钱、光杏仁二钱、冰糖水炒石膏、大麦冬
、真柿霜、南沙参各钱半、生甘草八分、鸡子白两枚。秋梨皮五钱）气喘者加蜜炙苏子
（一钱）、鲜柏子仁（三钱）、鲜茅根（五钱）。痰多者。加川贝（三钱）、淡竹沥（
两瓢冲）、栝蒌仁（五钱、杵）。胸闷者加梨汁（两瓢）、广郁金汁（四匙）。呕逆者。
加芦根汁（两瓢）。鲜淡竹茹（四钱）。炒黄枇杷叶（一两）。凉润以清肃上焦。上焦
既清。若犹烦渴气逆欲呕者。则用竹叶石膏汤去半夏。加蔗浆、梨汁、（各两瓢冲）、
生姜汁（两滴冲）、甘寒以滋养气液。终用清燥养营汤、加霍石斛（三钱）、营阴双补
以善后。肺燥脾湿。先与辛凉解表。轻清化气。葱豉桔梗汤加紫菀、杏仁。辛润利肺以
宣上。上焦得宣。气化湿开。则用加减半夏泻心汤去半夏。加川贝（三钱）芦笋（二两
）。苦辛淡滑以去湿。湿去、则暑无所根据。其热自退。热退而津气两伤。液郁化痰者。
则用二冬二母散加味。（淡天冬、提麦冬、知母各一钱、川贝母、南北沙参各三钱、梨
汁、竹沥各两瓢、姜汁三滴、和匀同冲）。甘润佐辛润。化气生津以活痰。痰少咳减
。终用加减玉竹饮子。（生玉竹、川贝母各三钱、西洋参、浙苓、紫菀各二钱、蜜炙
橘红、桔梗、炙草各八分）。气液双补。兼理余痰以善后。脾湿肾燥。较肺燥脾湿。
病尤深而难疗。必须润燥合宜。始克有济。但须辨其阳虚多湿。湿伤肾气而燥者。阴凝
则燥也。治宜温润。每用《金匮》肾气汤加减。（淡附子八分、拌捣直熟地四钱、紫
桂四分、拌捣山萸肉、一钱二分、生打淮药三钱、南芡实四钱、淡苁蓉三钱、半硫丸一
钱）。温化肾气以流湿润燥。肾气化则阴凝自解。终与黑地黄丸。（制苍术二两、大熟
地四两、黑炮姜二钱、
五味子四钱、先用姜半夏五钱、北秫米一两、煎取浓汁为丸、每服钱半、日二服、砂仁
四分、泡汤送下。）脾肾双补以善后。阴虚多火。湿热耗肾而燥者。阴竭则燥也。治宜
清润。每用知柏地黄汤加减。（知母二钱、川柏五分、陈阿胶钱半、生打山药三钱、泽
泻一钱、南芡实三钱、川连四分、先用生晒术二钱、熟地六钱、切丝、清浆水泡取汁出
代水煎药）。滋养阴液以坚肾燥脾。肾阴坚则液竭可回。终与补阴益气煎去升柴。加春
砂仁（五分捣）、甜石莲（钱半杵）、补中填下以善后。肺燥肠热。则用阿胶黄芩汤。
（陈阿胶、青子芩各三钱、甜杏仁、生桑皮各二钱、生白芍一钱、生甘草八分、鲜
车前草、甘蔗梢。各五钱、先用生糯米一两、开水泡取汁出、代水煎药）、甘凉复酸苦
寒。清润肺燥以坚肠。胃燥肝热。则用清燥养营汤去归橘。加龙胆草（八分、盐水炒）
。生川柏（六分）。东白薇（四钱）。甘寒复咸苦寒。清润胃燥以泄肝。风动螈 者。
加羚角（钱半、先煎）。莹白童便（一杯冲）。大便燥结者。加风化硝（三钱）。净白
蜜（一两。二味煎汤代水。）其余对证方药。已详六淫中燥病药例。随证选用可也。兹
不赘。
【秀按】春月地气动而湿胜。故春分以后。风湿暑湿之证多。秋月天气肃而燥胜。
故秋分以后。风燥凉燥之证多。若天气晴暖。秋阳以曝。温燥之证。反多于凉燥。前哲
沈目南谓《性理大全》。燥属次寒。感其气者。遵《内经》燥淫所胜。平以苦温。佐以
辛甘之法。主用香苏散加味。此治秋伤凉燥之方法也。喻嘉言谓《生气通天论》。秋伤
于燥。上逆而咳。发为痿厥。燥病之要。一言而终。即诸气 郁。皆属于肺。诸痿喘呕
。皆属于上。二条指燥病言明甚。更多属于肺之燥。至左 胁痛。不能转侧。嗌干面尘
。身无膏泽。足外反热。腰痛筋挛。惊骇。丈夫 疝。妇人少腹痛。目 疮。则又燥
病之本于肝而散见不一者也。而要皆秋伤于燥之征也。故治秋
燥病。须分肺肝二脏。遵《内经》燥化于天。热反胜之之旨。一以甘寒为主。发明《内经》燥者
润之之法。自制清燥救肺汤。随证加药。此治秋伤温燥之方法也。张石顽调燥在上必乘
肺经。宜千金麦门冬汤。（大麦冬四钱、生桑皮、鲜生地、紫菀、鲜淡竹茹各三钱、
仙半夏一钱、蜜炙麻黄五分、白桔梗八分、清炙草、生姜一片。）燥于下必乘大肠。须
分邪实、津耗、血枯、三端。邪实者。通幽润燥汤。（油当归二钱五分、桃仁泥、大麻
仁、生川军各一钱、生熟地各钱半、生甘草五分、杜红花一分、蜜炙升麻三分、槟榔汁
二匙冲）津耗者。异功散加减。（潞党参、浙苓、蜜炙广皮、麻仁研各一钱、天麦冬各
钱半、生甘草五分、沉香汁两匙冲。）血枯者。《千金》生地黄汤（鲜生地汁、二合、麦冬
汁、净白蜜各一瓢、淡竹沥两瓢、生姜汁四滴、先用生玉竹、知母、花粉、茯神、鲜
地骨皮各二钱、生石膏四钱、煎取清汁、和入地冬等五汁、重汤煎十余滚服、日三夜
一。）或六味地黄汤加减。（熟地四钱、淡苁蓉、生首乌、当归各三钱、淮药、茯苓、
丹皮、泽泻各钱半。）燥在血脉。多血虚生风证。宜以滋燥养营汤（生熟地各四钱、当
归、白芍各二钱、秦艽、防风各一钱、蜜炙川连六分、生甘草八分。）治外。内补
地黄丸（熟地、归身、白芍、生地、元参、知母、川柏、山药、萸肉、甘杞子、淡苁蓉
、蜜丸、每服三钱、空心盐汤送下。）治内。润燥养营为第一义。燥在阴分。多手足痿
弱证。养阴药中。必加黄柏以坚之。如虎潜丸之类。（盐酒蜜炙黑川柏、炙龟版、熟地
各三两、知母、淮牛膝各二两、白芍、锁阳、归身、炙虎胫骨各一两五钱、炮姜
五钱、醇酒为丸、痿而厥冷、加淡附片五钱、淡盐汤下三钱。）由是三说以推之。燥病
国中末之方药。洵云大备。
【廉勘】凡治燥病。先辨凉温。王孟英曰。以五气而论。则燥为凉邪。阴凝则燥。乃
其本气。但秋承夏后。火之余炎未息。若火即就之。阴竭则燥。是其标气。治分温润凉
润二法。费晋卿曰。燥者干也。对湿言之也。立秋以后。湿气去而燥气来。初秋尚热。
则燥而热。深秋既凉。则燥而凉。以燥为全体。而以热与凉为之用。
兼此二义。方见燥字圆活。法当清润温润。次辨虚实。叶天士先生曰。秋燥一证，颇似
春月风温。温自上受。燥自上伤。均是肺先受病。但春月为病。犹是冬令固密之余。秋
令感伤。恰值夏月发泄之后。其体质之虚实不同。初起治肺为急。当以辛凉甘润之方。
气燥自平而愈。若果有暴凉外束。只宜葱豉汤加杏仁、苏梗、前胡、桔梗之属。延绵日
久。病必入血分、须审体质证候。总之上燥治气。下燥治血。慎勿用苦燥劫烁胃汁也。
又次辨燥湿。石芾南曰。病有燥湿。药有润燥。病有风燥、凉燥、暑燥、燥火、燥郁夹
湿之分。药有辛润、温润、清润、咸润、润燥兼施之别。燥邪初伤肺气。气为邪阻。不
能布津外通毛窍。故身无汗。寒热疼痛。又不能布津上濡清窍。下润胃肠。故口干舌燥
。喉痒干咳。胸懑气逆。二便不调。治者当辨燥湿二气。孰轻孰重。所兼何邪。（如兼
风、兼寒、兼伏暑之类。）所化何邪。（如化火、未化火之分。）所夹何邪。（如夹水
、夹痰、夹食、夹内伤之类。）对病发药。使之开通。（开是由肺外达皮毛，与升散之
直向上行者不同、通是由肺下达胃肠、通润通利、皆谓之通、非专指攻下言。）虽然。
燥病夹湿。用药最要灵活。专润燥。须防其滞湿。专渗湿。须防其益燥。必先诘其已往
。以治其现下。治其现下。须顾其将来。试述其用药要略。凉燥初起。宜用辛润。开达
气机为君。如杏仁、牛蒡、葱白、豆豉、前胡、桔梗之属。寒重者。加以温润。如蔻仁
、橘红、生姜、红枣皮之属。邪机闭遏。在上焦、咳嗽胸懑。痰粘气逆者。加以通润。
宣畅上气。如远志、苏子、紫菀、百部之属。在中焦、脘闷呕恶。嗳腐吞酸者。加以
消降。疏畅中气。如莱菔子、生萝卜汁、蜜炙枳实、鲜佛手之属。在下焦。里气不畅。
大便燥结者。加以辛滑。通畅下气。如炒蒌皮、鲜薤白、春砂仁拌捣郁李净仁之属。气
机一开。大便自解。即汗亦自出。此皆辛中带润。自不伤津。且辛润又能行水。燥郁来
湿者宜之。辛润又能开闭。内外闭遏者宜之。若凉燥之气。搏遏湿热。内蒙清窍。神识
昏迷者。急用辛开淡渗。如赖橘红、炒牛蒡、白芷、白芥子、细辛、鲜石菖蒲、连翘心
、生苡仁、浙苓皮、通草、灯心之属。（查辛开上达之
品、首推细辛、辛润而细、善能开达、用量多至二三分、少则一分、其次芥子牛蒡、芥
子辛润而圆、善能流走、牛蒡辛润而香、善能开透。属子与仁、皆寓生机、又次白芷翘
心、气香味辛、质又极滑、化湿开闭、而不伤津、皆能开表、又能通里、余已历验不爽
、配芦笋鲜冬瓜子尤妙。）以开气闭。气为水母。气开乃能行水。气以养神。气宣则神
自清。如燥已化热。及新感温燥。宜用辛凉甘润。清宣气机。辛凉，如苏薄荷、鲜葱白
、嫩桑芽、青连翘、炒牛蒡、清蒿脑、滁菊花、银花之类。甘润，如鲜茅根、鲜野菰根
、活水芦笋、栝蒌皮、雅梨皮、青蔗皮、梨汁、蔗汁、竹沥、柿霜、西瓜皮、绿豆皮、
生荸荠汁、生藕汁之类。于辛润剂中。酌加三四品。清润轻灵以泄其热。热泄则清肃令
行。气机流利。津液营运。亦必津津化汗而解。阴虚便结者。于辛润剂中。酌加鲜生地
、元参心、鲜柏子仁、大麻仁、黑芝麻、净白蜜、淡海蜇之类。养阴润肠。夹湿而兼有
伏暑者。于辛润剂中。酌加鲜冬瓜皮子、滑石、通草、淡竹叶等之淡滑清渗。生山栀、
青蒿子、霜桑叶、鲜竹叶、丝瓜络、萝卜缨等之轻苦微燥。皆取轻清流利。以解蕴伏之
暑湿。若重者。酌加姜汁、炒木通、芩、连、柏、及绵茵陈、鲜贯众之类。苦降辛通。
开化湿热。其浊热粘腻之伏邪。根据附胃肠渣滓者。则攻下一法。又未可缓施。或用苦泄
。如枳实汁、酒浸生军汁之类。或用咸润。如风化硝、元明粉之类。或用滑降。如泻叶
、炒蒌皮、鲜圆皂仁、郁李净仁之类。但下宜适中。不可太过。且上焦邪气开通。天气
(Total name: Autumn Dryness. Commonly referred to as Wind-Dryness).
[Etiology] In late autumn, when the initial coolness arrives and the west wind is desolate, those who contract this pathogen often suffer from Wind-Dryness. This belongs to Cold-Dryness, which is milder than the Wind-Cold of severe winter. If there has been long sunshine without rain and the autumn sun exposes intensely, those who contract this pathogen often suffer from Warm-Dryness. This belongs to Dry-Heat, which is heavier than the Wind-Warmth of late spring. However, occasionally it may occur with latent Summerheat-Dampness inside, so the diseases may involve Lung Dryness with Spleen Dampness, or Lung Dryness with Intestinal Heat, as well as Stomach Dryness with Liver Heat, and Spleen Dampness with Kidney Dryness. It entirely depends on the clinician to first identify the cause, control the dominant pathology, and deduce the source of the disease.
[Symptoms] When Cold-Dryness invades the Lung, at the onset there is headache, fever, aversion to cold, absence of sweating, nasal congestion with humming sounds, resembling Wind-Cold, except for dry lips and throat, continuous dry cough, chest fullness with rebellious Qi, stitching pain in both hypochondria, dry and painful skin, white and thin but dry tongue coating that feels prickling to the touch. When Warm-Dryness injures the Lung, at the onset there is headache and fever, dry cough without sputum; if sputum is expectorated, it is mostly thin and sticky, with rebellious Qi and wheezing, dry and painful throat, dry nose and lips, chest oppression and hypochondriac pain, vexation and thirst, white and thin but dry tongue coating with red edges and tips. If Autumn Dryness involves latent Summerheat, one must distinguish between two aspects: dampness restraining heat and fire transformation. For dampness restraining heat, superficial cases often present as Lung Dryness with Spleen Dampness, starting with shivering aversion to cold, fever after cold subsides, dry nose and lips, dry and painful throat, rebellious Qi and dry cough, limb flaccidity and body ache, thirst without desire to drink, vomiting immediately after drinking, vexation and restlessness, chest and hypochondriac distending pain, abdominal fullness and pain, unsmooth diarrhea, short and red-hot urine, coarse tongue coating like accumulated powder with white and slippery sides. Deep cases often present as Spleen Dampness with Kidney Dryness, with limb flaccidity and weakness, heavy body ache, salty and thin-sticky sputum, shortness of breath, malar flush and cold feet, hot soles, even Wei-Jue (flaccidity and cold extremities), followed by diarrhea with tenesmus, seminal emission, post-urination dribbling, excessive leukorrhea and sore back in women, round and tender fat tongue covered with a layer of sticky coating, slippery edges and dry root. If Summerheat transforms into Fire, superficial cases often present as Lung Dryness with Intestinal Heat, with upper symptoms of itchy throat and dry cough, sticky blood-tinged sputum with bright red blood upon severe coughing, stitching phlegm pain in chest and hypochondria; lower symptoms include burning abdominal heat, watery diarrhea pouring out, hot and painful anus, even abdominal pain and diarrhea with difficult and hard passage, resembling dysentery but not quite, cutting intestinal pain feeling like a hard obstruction, severe pain upon pressure, dry tongue coating with prickles and cracks. Deep cases often present as Stomach Dryness with Liver Heat, with intense thirst and desire to drink that does not relieve thirst, burning heat with spontaneous sweating, cold extremities despite vexation and aversion to heat, occasional rebellious Qi and dry retching, occasional Qi rushing causing epigastric pain, tendon vessel spasm and pain preventing turning over, even convulsions of hands and feet resembling epilepsy, testicular hernia pain in men, lower abdomen connecting to waist pulling pain in women, pulsating Qi at the umbilicus feeling hard and shaking upon pressure, mostly dry and constipated stool or pus-blood stool, urgency to defecate but inability, or tenesmus wanting to finish but unable, short red and astringent urine or drops with urgent pain.
[Pulse] The pulse of Dryness syndromes is mostly fine and choppy. Although due to complicated and transformed syndromes, combined pulses such as floating, surging, empty, large, string-taut, or rapid may appear, upon heavy pressure they invariably show fine and choppy qualities.
[Treatment] For Cold-Dryness invading the Lung, use Bitter-Warm herbs as the sovereign, assisted by Acrid-Sweet herbs. Use Xiang Su Cong Chi Tang (Perilla and Scallion Decoction) removing Xiang Fu, adding Guang Xing Ren (3 qian), Zhi Bai Bu (2 qian), Zi Wan (3 qian), and Bai Qian (2 qian), to moisten and warm to open the Upper Jiao. Once the Upper Jiao is open, Cold-Dryness resolves naturally. If there is still much phlegm, constipation, and abdominal pain, use Wu Ren Ju Pi Tang (Five Seeds and Tangerina Peel Decoction), adding Quan Gua Lou (4 qian, mashed with 0.5 qian fresh ginger), Gan Xie Bai (4 pieces, washed with white wine and mashed), Zi Wan (4 qian), and Qian Hu (2 qian), to acridly-warm and facilitate Qi mechanism. Finally, use Gui Shao Yi Gong San modified (Gui Shen 2 qian, Bai Shao 1.5 qian, Lu Dang Shen, Yun Fu Ling, Qing Zhi Cao, Mi Zhi Guang Pi each 1 qian, Jin Ju and Mi Zao each 2 pieces, chopped) to tonify both Qi and Blood for recovery. For Warm-Dryness injuring the Lung, use Acrid-Cool herbs as the sovereign, assisted by Bitter-Sweet herbs. Use Qing Zao Jiu Fei Tang (Clear Dryness Rescue Lung Decoction) modified (Dong Sang Ye 3 qian, Guang Xing Ren 2 qian, Shi Gao stir-fried with rock sugar water, Da Mai Dong, Zhen Shi Shuang, Nan Sha Shen each 1.5 qian, Sheng Gan Cao 0.8 fen, Ji Zi Bai 2 eggs, Qiu Li Pi 5 qian). Add Mi Zhi Su Zi (1 qian), Xian Bai Zi Ren (3 qian), and Xian Mao Gen (5 qian) for wheezing. Add Chuan Bei (3 qian), Dan Zhu Li (2 ladles mixed), and Gua Lou Ren (5 qian, pounded) for much phlegm. Add Li Zhi (2 ladles) and Guang Yu Jin Zhi (4 spoons) for chest oppression. Add Lu Gen Zhi (2 ladles), Xian Dan Zhu Ru (4 qian), and Chao Huang Pi Pa Ye (1 liang) for retching. Use Cool-Moistening to clear and purify the Upper Jiao. Once the Upper Jiao is cleared, if there is still vexation, thirst, rebellious Qi, and desire to vomit, use Zhu Ye Shi Gao Tang removing Ban Xia, adding Zhe Jiang and Li Zhi (each 2 ladles mixed), and Sheng Jiang Zhi (2 drops mixed), to Sweet-Cold nourish Qi and fluids. Finally, use Qing Zao Yang Ying Tang adding Huo Shi Hu (3 qian) to tonify both Ying and Yin for recovery. For Lung Dryness with Spleen Dampness, first use Acrid-Cool to release the exterior and lightly-clear Qi transformation. Use Cong Chi Jie Geng Tang adding Zi Wan and Xing Ren, Acrid-Moistening to benefit the Lung and diffuse the Upper. Once the Upper Jiao is diffused, Qi transforms and Dampness opens, then use Jia Jian Ban Xia Xie Xin Tang removing Ban Xia, adding Chuan Bei (3 qian) and Lu Sun (2 liang), Bitter-Acid-Salty-Slippery to eliminate Dampness. Once Dampness is gone, Summerheat has no basis and its heat retreats. After heat retreats, if both Jin and Qi are injured and fluids stagnate transforming into phlegm, use Er Dong Er Mu San added ingredients (Dan Tian Dong, Ti Mai Dong, Zhi Mu each 1 qian, Chuan Bei Mu, Nan Sha Shen, Bei Sha Shen each 3 qian, Li Zhi, Zhu Li each 2 ladles, Jiang Zhi 3 drops, mixed and taken together), Sweet-Moistening assisting Acrid-Moistening, transforming Qi and generating fluids to activate phlegm. When phlegm decreases and cough reduces, finally use Jia Jian Yu Zhu Yin Zi (Sheng Yu Zhu, Chuan Bei Mu each 3 qian, Xi Yang Shen, Zhe Ling, Zi Wan each 2 qian, Mi Zhi Ju Hong, Jie Geng, Zhi Cao each 0.8 fen) to tonify both Qi and fluids and manage residual phlegm for recovery. Spleen Dampness with Kidney Dryness is deeper and harder to treat than Lung Dryness with Spleen Dampness. Moistening Dryness must be appropriate to succeed. One must distinguish Yang deficiency with much Dampness, where Dampness injures Kidney Qi causing Dryness, meaning Yin coagulation leads to Dryness. Treatment should be Warm-Moistening. Often use Jin Gui Shen Qi Tang modified (Dan Fu Zi 0.8 fen, mixed with Zhi Shu Di 4 qian, Zi Gui 0.4 fen, mixed with Shan Yu Rou 1.2 qian, Sheng Da Huai Yao 3 qian, Nan Qian Shi 4 qian, Dan Cong Rong 3 qian, Ban Liu Wan 1 qian) to warm-transform Kidney Qi to flow moisture and moisten Dryness. When Kidney Qi transforms, Yin coagulation resolves naturally, finally give Hei Di Huang Wan (Zhi Cang Zhu 2 liang, Da Shu Di 4 liang, Hei Pao Jiang 2 qian, Wu Wei Zi 4 qian, first decoct Jiang Ban Xia 5 qian and Bei Shu Mi 1 liang to obtain thick juice for pills, take 1.5 qian per dose twice daily, send down with Sha Ren 0.4 fen soaked in water) to tonify both Spleen and Kidney for recovery. Yin deficiency with much Fire, where Damp-Heat consumes Kidney causing Dryness, means Yin exhaustion leads to Dryness. Treatment should be Clear-Moistening. Often use Zhi Bai Di Huang Tang modified (Zhi Mu 2 qian, Chuan Bai 0.5 fen, Chen E Jiao 1.5 qian, Sheng Da Shan Yao 3 qian, Ze Xie 1 qian, Nan Qian Shi 3 qian, Chuan Lian 0.4 fen, first soak Sheng Shai Zhu 2 qian and Shu Di 6 qian sliced in clear浆 water to extract juice to replace water for decocting medicine) to nourish Yin fluids to firm Kidney and dry Spleen. When Kidney Yin is firm, exhausted fluids can return, finally use Bu Yin Yi Qi Jian removing Sheng and Chai, adding Chun Sha Ren (0.5 fen pounded) and Tian Shi Lian (1.5 qian pounded) to tonify middle and fill lower for recovery. For Lung Dryness with Intestinal Heat, use E Huang Huang Qin Tang (Chen E Jiao, Qing Zi Qin each 3 qian, Tian Xing Ren, Sheng Sang Pi each 2 qian, Sheng Bai Shao 1 qian, Sheng Gan Cao 0.8 fen, Xian Che Qian Cao, Gan Zhe Shao each 5 qian, first soak Sheng Nu Mi 1 liang in boiling water to extract juice to replace water for decocting medicine), Sweet-Cool combining Sour-Bitter-Cold, clearing and moistening Lung Dryness to firm Intestines. For Stomach Dryness with Liver Heat, use Qing Zao Yang Ying Tang removing Gui and Ju, adding Long Dan Cao (0.8 fen, stir-fried with salt water), Sheng Chuan Bai (0.6 fen), Dong Bai Wei (4 qian), Sweet-Cold combining Salty-Bitter-Cold, clearing and moistening Stomach Dryness to drain Liver. For Wind stirring convulsions, add Ling Jiao (1.5 qian, decocted first) and Ying Bai Tong Bian (1 cup mixed). For dry and constipated stool, add Feng Hua Xiao (3 qian) and Jing Bai Mi (1 liang, decoct these two with water to replace water). Other syndrome-specific prescriptions are detailed in the examples for Dryness diseases among the Six Excesses; select according to syndrome. No further elaboration here.
[Commentary by Xiu] In spring, earth Qi moves and Dampness prevails, so after Spring Equinox, Wind-Damp and Summerheat-Damp syndromes are common. In autumn, heaven Qi is solemn and Dryness prevails, so after Autumn Equinox, Wind-Dryness and Cold-Dryness syndromes are common. If the weather is sunny and warm, with the autumn sun exposing intensely, Warm-Dryness syndromes are actually more common than Cold-Dryness. Former sage Shen Munan stated in *Xing Li Da Quan* that Dryness belongs to Secondary Cold. Those contracting this Qi follow *Nei Jing*: "When Dryness dominates, soothe with Bitter-Warm, assist with Acrid-Sweet," primarily using Xiang Su San added ingredients. This is the method for treating Autumn injury by Cold-Dryness. Yu Jiayan stated in *Sheng Qi Tong Tian Lun*: "Autumn injury by Dryness causes Qi to rebel upward leading to cough, developing into Wei-Jue." The essence of Dryness disease is concluded in one word: "All Qi stagnation and oppression belong to the Lung," "All Wei, wheezing, and vomiting belong to the Upper." These two lines clearly refer to Dryness disease, mostly involving Lung Dryness. As for left hypochondriac pain, inability to turn, dry throat, dusty face, lack of body luster, heat reversing outward on feet, lower back pain, tendon spasm, fright, male hernia, female lower abdominal pain, eye ulcers, these are manifestations of Dryness originating from the Liver, scattered and varied. Yet all are signs of Autumn injury by Dryness. Therefore, treating Autumn Dryness disease requires distinguishing Lung and Liver organs, following *Nei Jing*: "Dryness transforms from Heaven, Heat counteracts and wins," prioritizing Sweet-Cold, elucidating *Nei Jing*'s method "Dryness implies Moistening," self-formulating Qing Zao Jiu Fei Tang, adding herbs according to syndrome. This is the method for treating Autumn injury by Warm-Dryness. Zhang Shiwen adjusted that Dryness above must invade the Lung Meridian, suitable for Qian Jin Mai Men Dong Tang (Da Mai Dong 4 qian, Sheng Sang Pi, Xian Sheng Di, Zi Wan, Xian Dan Zhu Ru each 3 qian, Xian Ban Xia 1 qian, Mi Zhi Ma Huang 0.5 fen, Bai Jie Geng 0.8 fen, Qing Zhi Cao, Sheng Jiang 1 slice). Dryness below must invade the Large Intestine, requiring distinction into three categories: Pathogen Excess, Fluid Consumption, Blood Withering. For Pathogen Excess, use Tong You Run Zao Tang (You Dang Gui 2.5 qian, Tao Ren Ni, Da Ma Ren, Sheng Chuan Jun each 1 qian, Sheng Shu Di each 1.5 qian, Sheng Gan Cao 0.5 fen, Du Hong Hua 0.1 fen, Mi Zhi Sheng Ma 0.3 fen, Bing Lang Zhi 2 spoons mixed). For Fluid Consumption, use Yi Gong San modified (Lu Dang Shen, Zhe Ling, Mi Zhi Guang Pi, Ma Ren pounded each 1 qian, Tian Mai Dong each 1.5 qian, Sheng Gan Cao 0.5 fen, Chen Xiang Zhi 2 spoons mixed). For Blood Withering, use *Qian Jin* Sheng Di Huang Tang (Xian Sheng Di Zhi 2 he, Mai Dong Zhi, Jing Bai Mi each 1 ladle, Dan Zhu Li 2 ladles, Jiang Zhi 4 drops, first decoct Sheng Yu Zhu, Zhi Mu, Hua Fen, Fu Shen, Xian Di Gu Pi each 2 qian, Sheng Shi Gao 4 qian to obtain clear juice, mix with five juices including Di Dong, decoct heavily for ten boils, take three times day and once night). Or Liu Wei Di Huang Tang modified (Shu Di 4 qian, Dan Cong Rong, Sheng Shou Wu, Dang Gui each 3 qian, Huai Yao, Fu Ling, Dan Pi, Ze Xie each 1.5 qian). Dryness in blood vessels often presents as Blood Deficiency generating Wind, suitable for Zi Zao Yang Ying Tang (Sheng Shu Di each 4 qian, Dang Gui, Bai Shao each 2 qian, Qin Jiao, Fang Feng each 1 qian, Mi Zhi Chuan Lian 0.6 fen, Sheng Gan Cao 0.8 fen) for external treatment, Nei Bu Di Huang Wan (Shu Di, Gui Shen, Bai Shao, Sheng Di, Yuan Shen, Zhi Mu, Chuan Bai, Shan Yao, Yu Rou, Gan Qi Zi, Dan Cong Rong, honey pills, take 3 qian per dose on empty stomach with salt water) for internal treatment, with Moistening Dryness and Nourishing Ying as the primary principle. Dryness in Yin aspect often presents as flaccidity and weakness of hands and feet; in Yin-nourishing medicines, always add Huang Bai to firm them, such as Hu Qian Wan (Salt-wine-honey blackened Chuan Bai, Zhi Gui Ban, Shu Di each 3 liang, Zhi Mu, Huai Niu Xi each 2 liang, Bai Shuo, Suo Yang, Gui Shen, Zhi Hu Jing Gu each 1.5 liang, Pao Jiang 5 qian, pure wine for pills, for flaccidity with cold extremities add Dan Fu Pian 5 qian, take 3 qian with light salt water). From these three theories, the formulas for beginning, middle, and end of Dryness disease are indeed comprehensive.
[Commentary by Lian] Generally, treating Dryness disease requires first distinguishing Cold and Warm. Wang Mengying said: Regarding the Five Qi, Dryness is a Cool pathogen; Yin coagulation leads to Dryness, which is its fundamental Qi. But Autumn follows Summer, and residual heat from Fire has not ceased; if Fire attaches to it, Yin exhaustion leads to Dryness, which is its marked Qi. Treatment divides into Warm-Moistening and Cool-Moistening methods. Fei Jinqing said: Dryness means dryness, spoken in contrast to Dampness. After Start of Autumn, Dampness departs and Dryness arrives; early autumn is still hot, so Dryness is Hot; late autumn is already cool, so Dryness is Cool. Taking Dryness as the whole body, and Heat and Cool as its functions, combining these two meanings makes the character Dryness vivid. Methods should be Clear-Moistening and Warm-Moistening. Next distinguish Empty and Full. Master Ye Tianshi said: Autumn Dryness resembles Spring Wind-Warmth. Warmth enters from above, Dryness injures from above, both initially affect the Lung. But Spring diseases are remnants of Winter's consolidation, while Autumn injuries occur exactly after Summer's dispersal, so their constitutions differ in Empty and Full. Initially treating the Lung is urgent; use Acrid-Cool Sweet-Moistening formulas, and Qi Dryness will naturally level and heal. If there is sudden Cool binding externally, only use Cong Chi Tang adding Xing Ren, Su Geng, Qian Hu, Jie Geng, etc. If lingering for days, the disease must enter the Blood aspect, requiring examination of constitution and symptoms. In summary, treat Qi for Upper Dryness, treat Blood for Lower Dryness, beware of using Bitter-Dry herbs to plunder Stomach juices. Next distinguish Dryness and Dampness. Shi Funan said: Diseases have Dryness and Dampness, medicines have Moistening and Drying. Diseases have Wind-Dryness, Cold-Dryness, Summerheat-Dryness, Dryness-Fire, Dryness-Stagnation with Dampness distinctions; medicines have Acrid-Moistening, Warm-Moistening, Clear-Moistening, Salty-Moistening, Moistening-Drying combined distinctions. When Dryness pathogen initially injairs Lung Qi, Qi is blocked by pathogen, cannot distribute fluids to open hair pores externally, hence no sweat, chills and fever, pain. Cannot distribute fluids to moisten clear orifices above, nourish intestines and stomach below, hence dry mouth and tongue, itchy throat, dry cough, chest oppression, rebellious Qi, abnormal urination and defecation. Clinicians must distinguish Dryness and Dampness, which is lighter or heavier, what pathogen is combined (such as combined with Wind, Cold, latent Summerheat), what pathogen transforms (such as transforming into Fire or not), what pathogen clings (such as clinging to Water, Phlegm, Food, Internal Injury), prescribe medicine against the disease to make it open. (Opening is reaching skin and hair from Lung, different from ascending and scattering straight upward; Opening is descending from Lung to intestines and stomach, moistening and unblocking are all called Opening, not specifically referring to purgation.) Although, treating Dryness disease with Dampness requires flexible medication. Specifically moistening Dryness must prevent stagnating Dampness; specifically draining Dampness must prevent increasing Dryness. Must first inquire about the past to treat the present; treating the present must consider the future. Briefly describing the essentials of medication: For initial Cold-Dryness, use Acrid-Moistening, opening and reaching Qi mechanism as sovereign, such as Xing Ren, Niu Bang, Cong Bai, Dou Chi, Qian Hu, Jie Geng, etc. For heavy cold, add Warm-Moistening, such as Kou Ren, Ju Hong, Sheng Jiang, Hong Zao Pi, etc. For pathogen mechanism closed, in Upper Jiao, cough and chest oppression, sticky phlegm and rebellious Qi, add Unblocking-Moistening to diffuse and smooth Upper Qi, such as Yuan Zhi, Su Zi, Zi Wan, Bai Bu, etc. In Middle Jiao, epigastric oppression, nausea and disgust, belching and acid regurgitation, add Reducing-Digesting to smooth Middle Qi, such as Lai Fu Zi, Sheng Luo Bo Zhi, Mi Zhi Zhi Shi, Xian Fo Shou, etc. In Lower Jiao, interior Qi unsmooth, dry and constipated stool, add Acrid-Slippery to smooth Lower Qi, such as Chao Lou Pi, Xian Xie Bai, Chun Sha Ren mixed pounded Yu Li Jing Ren, etc. Once Qi mechanism opens, stool resolves naturally, and sweat also appears naturally. All these are Acrid containing Moistening, naturally not injuring fluids, and Acrid-Moistening can also move Water, suitable for Dryness-Stagnation with Dampness. Acrid-Moistening can also open closure, suitable for internal and external closure. If Cold-Dryness Qi combats and restrains Damp-Heat, internally clouding clear orifices causing unconsciousness, urgently use Acrid-Opening Light-Draining, such as Lai Ju Hong, Chao Niu Bang, Bai Zhi, Bai Jie Zi, Xi Xin, Xian Shi Chang Pu, Lian Qiao Xin, Sheng Yi Ren, Zhe Ling Pi, Tong Cao, Deng Xin, etc. (Regarding Acrid-Opening ascending products, first recommend Xi Xin, Acrid-Moistening and fine, good at opening and reaching, dosage up to 2-3 fen, minimum 1 fen; next Jie Zi and Niu Bang, Jie Zi is Acrid-Moistening and round, good at flowing and moving, Niu Bang is Acrid-Moistening and fragrant, good at opening and penetrating. Seeds and kernels both contain vitality. Next Bai Zhi and Qiao Xin, qi and flavor are Acrid, substance is very slippery, transform Dampness and open closure without injuring fluids, all can open exterior and connect interior, I have verified accurately, pairing with Lu Sun and Xian Dong Gua Zi is especially good.) To open Qi closure, Qi is the mother of Water, Qi opens then Water can flow, Qi nourishes Spirit, Qi diffuses then Spirit clears. If Dryness has transformed into Heat, and new contraction of Warm-Dryness, use Acrid-Cool Sweet-Moistening to clear and diffuse Qi mechanism. Acrid-Cool, such as Su Bo He, Xian Cong Bai, Nen Sang Ya, Qing Lian Qiao, Chao Niu Bang, Qing Hao Nao, Chu Ju Hua, Yin Hua, etc. Sweet-Moistening, such as Xian Mao Gen, Xian Ye Gu Gen, Huo Shui Lu Sun, Gua Lou Pi, Ya Li Pi, Qing Zhe Pi, Li Zhi, Zhe Zhi, Zhu Li, Shi Shuang, Xi Gua Pi, Lv Dou Pi, Sheng Bi Qi Zhi, Sheng Ou Zhi, etc. In Acrid-Moistening formulas,酌情 add 3-4 items, Clear-Moistening and light-spiritual to drain Heat. Once Heat drains, Clear-Purifying order executes, Qi mechanism flows smoothly, fluids circulate, surely transform into sweat and resolve. For Yin deficiency with constipation, in Acrid-Moistening formulas,酌情 add Xian Sheng Di, Yuan Shen Xin, Xian Bai Zi Ren, Da Ma Ren, Hei Zhi Ma, Jing Bai Mi, Dan Hai Zhe, etc., to nourish Yin and moisten Intestines. For Dampness combined with latent Summerheat, in Acrid-Moistening formulas,酌情 add Xian Dong Gua Pi Zi, Hua Shi, Tong Cao, Dan Zhu Ye, etc., for Light-Slippery Clear-Draining, Sheng Shan Zhi, Qing Hao Zi, Shuang Sang Ye, Xian Zhu Ye, Si Gua Luo, Luo Bo Ying, etc., for Light-Bitter slightly-Drying, all taking Light-Clear and smooth-flowing to resolve latent Summerheat-Dampness. If heavy,酌情 add Jiang Zhi, Chao Mu Tong, Qin, Lian, Bai, and Mian Yin Chen, Xian Guan Zhong, etc., Bitter-Descending Acrid-Opening to open and transform Damp-Heat. For turbid-heat sticky latent pathogens adhering to gastrointestinal dregs, the purgative method cannot be delayed. Or use Bitter-Draining, such as Zhi Shi Zhi, Jiu Jin Sheng Jun Zhi, etc. Or use Salty-Moistening, such as Feng Hua Xiao, Yuan Ming Fen, etc. Or use Slippery-Descending, such as Xie Ye, Chao Lou Pi, Xian Yuan Zao Ren, Yu Li Jing Ren, etc. But purgation should be moderate, not excessive. And once Exterior pathogen Qi is opened, Heavenly Qi