下降。地气自随之以营运。又何必峻下为能乎。其有燥热窜入肌肉皮肤。发 发疹。隐
隐不现者。宜用辛凉开达。轻清芳透。如牛蒡、连翘、银花、丹皮、栝蒌皮、青蒿脑、
紫草尖、鲜大青、鲜茅根、活水芦笋、鲜卷心竹叶、灯心、青箬叶之类。其有燥热伤
阴。邪闭心宫。舌绛无苔。神昏谵妄者。宜用清润开透。用药最要空灵。如犀角尖、鲜
生地、连翘心、银花、鲜石菖薄、芦笋、梨汁、竹沥、和姜汁少许之类。凉药热饮。取
其流通。此治新感秋燥。国中末用药之大法也。张禾芬曰。燥气搏湿之病。即吴鞠通所
谓肺感燥气。脾伏湿邪是也。但不如喻氏燥
湿二字为简当。（嘉言曰、湿统四时、春曰风湿、夏曰暑湿、秋曰燥湿、冬曰寒湿。）
其病秋深时最多。如秋分后天久不雨。最易剧发。人烟稠密之处尤广。若兼伏暑。病尤
深重。一起即烦躁昏谵。燥渴恣饮。或闭闷无汗。或汗虽泄而邪不解。或咳血。或泄血
。甚则血热肝燥。火旺生风。筋脉螈 。肢臂强直。目瞪口噤。舌卷囊缩。便多干结。
或 似痢。或初虽水泻。暴注下迫。旋即干秘。溲多赤涩。脉多沉部弦数。按之细涩
。证虽险变百出。大纲亦只数端。在上焦有二。一肺之化源绝。二热闭神昏。中焦亦有
二。一胃络脉绝。二脏结下痢。下焦只有一。男则精竭髓枯。女则血枯肝绝。选药制方。
莫如鲜药之取效较速。其次花露。如鲜苇茎、鲜菊叶、鲜忍冬藤叶、鲜枇杷叶、鲜淡竹
叶、鲜大青叶、鲜桑芽、鲜梨皮、鲜橘叶、鲜青箬叶等之轻清气燥。生萝卜汁、生梨汁
、淡竹沥、鲜石菖蒲汁等之清化燥痰。辛润开闭。鲜茅根、鲜大青、鲜益母草、鲜生地
、鲜马鞭草、生藕汁、西瓜汁、金汁、童便等之凉血通瘀。解毒透 。鲜石斛、蔗浆、
鲜稻穗露、鸡肉露、熟地露等之滋养胃汁。生地栗、淡海蜇等之咸润肠燥。皆燥热病中
有利无病之品。至若燥气夹湿。是湿为地气。燥为天气。天气能包地气。先当以治燥为
急。燥邪一解。湿开热透。自然随出。惟虚损体复感燥邪。势尤危险。初治以润肺养液
清络泄热为主。既不能过事透表。亦不得径投滋补。继进甘润养胃。以存阴液。虚甚者
。气结津枯。清润又非所宜。必得温润甘燥。如淡苁蓉、熟玉竹、菟丝子、枸杞、熟地
、阿胶、鹿胶之类。方为中 。虚燥治法。大率类此。燥门述此诸法。方药洵云全备。
中惟脾湿肾燥一证。外感夹内伤者居多。外感、多由于湿热未尽。阴液先伤。内伤、多
由于酒湿伤脾。色欲伤肾。外感已属难治。其证口干不渴。饮亦不能滋干。骨节隐痛不
舒。溺亦赤涩不利。此时渗湿则劫阴。救阴则助湿。治必养阴逐湿。润燥合宜。予每参
用薛王两法。以元米煎合参斛冬瓜汤。（北沙参六钱、黄草川斛四钱、炒麦冬钱半、炒
香枇杷叶四钱、带子丝瓜络、建兰叶各三钱、先用糯米泔水泡生于术三钱、隔六小时、
去术、取米泔水、煎鲜冬瓜皮子各二两、熬取清汤、
代水煎药。）尚多应手。内伤尤为难治。有脾湿下流。阳损及阴者。其证肢懈气堕。肠
鸣肾泄。夜发内热。腰酸溺少。每用仲淳脾肾双补法奏功。（潞党参、炒莲肉、淮山药
、炒扁豆、煨肉果、带壳春砂、炒白芍、炒车前、盐水炒补骨脂、五味子、菟丝子、巴
戟肉、为丸如绿豆大、每服八分至一钱、空心临卧服。）有肾燥不合。阴损及阳者。其
证泄泻如注。里急后重。头晕气促。六脉两尺白无神。舌色淡红而干。每用慎斋润肾固
气法取效。（淡苁蓉三钱、太子参、生芍各一钱、归身、五味子各八分、炙草六分
、炮姜二分。）又有湿袭精窍。阴虚多火者。其证腰酸背热。脚跟热痛。两足痿弱难行
。男子精热自遗。女子带多稠粘。每用虎潜丸及加味二妙丸。以渐图功。更有纵恣酒色
。湿热酿痰。虚火时升。上实下虚者。其证头晕面赤。痰嗽喘逆。胸胁虚痞。周身酸痛
。腰足尤疼。甚则痿厥。每用六味地黄汤加生捣左牡蛎。冲竹沥、姜汁、童便。送下猴
枣（二三分）或吞黑锡丹（一二分）缓图收功。更有阴虚气滞。脾湿肝火。酿痰上壅者
。其证嗽痰白粘。气逆胸闷。口渴善呕。四肢倦懈。舌绛似干。上罩垢浊薄苔。脉左细
数。每用自制七汁饮。（人乳、梨汁、竹沥、广郁金汁、甜酱油、茄楠香汁、解KT 草根
子捣汁、其根下子、形似麦冬、色白味甘、性凉质润、滋养肺胃、较麦冬为优。）屡收
敏效。总之阳虚多湿。气不化津。由阴结而致肾燥者。证多食少脉微。大便闭结。俞氏
《金匮》肾气汤加减。曾用有验。然不多见。惟阴虚挟湿。因燥利太过。湿竭化燥。肾
水亏而肝火鸱张。上则烁肺咳血。下则逼动冲任。男子遗精梦泄。女子带多髓枯。酿成
下损痿厥重证。数见不鲜。多由外感而做成内伤。非柔润静药。及血肉有情之品。大剂
滋填不可。
【荣斋按】本节（秋燥伤寒）证治，俞氏分“凉燥犯肺”“温燥伤肺”“肺燥脾湿
”“脾湿肾燥”“肺燥肠热”“胃燥肝热”六个类型。秀山先生更补出沈目南“治秋伤
凉燥”法，喻嘉言“治秋伤温燥”法，张石顽治“燥病国中末”方法。廉臣先生又补出
∶叶天士、石芾南、张禾芬及他自己等的经验治法。这样的集思广益，
去芜存菁，在当时可以说是一秋燥证治”的一篇总结会报。根据廉臣先生晚年实验，他
对于“燥夹伏暑”（即俞氏所谓肺燥脾湿）的理解，认为∶“秋日暑湿踞于内，新凉燥
气加于外，燥湿兼至，最难界限清楚，稍不确当，其败坏不可胜言。盖燥有寒化热化，
先将暑、湿、燥分开，再将寒热辨明，自有准的。治法∶先用苦温发表，辛润宣上，以
解凉燥外搏之新邪；俟凉燥外解，湿开热透，然后整肃其伏热，或用芳透清化，或用缓
下清利，必俟伏邪去净，如发现津液两亏，则改用增液育阴以善后。”他归纳秋燥的治
法，也很简单扼要，他说∶“六气之中，惟燥气难明，盖燥有凉燥、温燥、上燥、下燥
之分。凉燥者，燥之胜气也，治以温润；杏苏散主之。温燥者、燥之复气也，治以清润
；清燥救肺汤主之。上燥治气，吴氏桑杏汤主之。下燥治血，滋燥养营汤主之。”这些
中心学说的提供我们记取，对我们研究祖国医学的过程中是有帮助的。
(Heat-dryness pathogen) descends. Earth qi follows it to circulate and operate. Why is it necessary to use drastic purgation as a feat? For those cases where heat-dryness invades muscles and skin, causing rashes that are faint and indistinct, it is appropriate to use acrid-cool opening and unblocking agents with light, clear, aromatic penetration. Such as Bullarum Seed (Niu Bang Zi), Forsythia Fruit (Lian Qiao), Honeysuckle Flower (Jin Yin Hua), Moutan Cortex (Mu Dan Pi), Trichosanthes Peel (Gua Lou Pi), Artemisia Annua Brain (Qing Hao Nao), Arnebia Root Tip (Zi Cao Jian), Fresh Isatis Root (Xian Da Qing), Fresh Imperata Rhizome (Xian Mao Gen), Living Reed Shoots (Huo Shu Lu Sun), Fresh Heart-shaped Bamboo Leaves (Xian Juan Xin Zhu Ye), Juncus Effusus (Deng Xin), and Blue Bamboo Leaf (Qing Ruo Ye). In cases where heat-dryness damages yin fluids, and pathogens close the Heart Palace, presenting with crimson tongue without coating, coma, and delirium, it is appropriate to use clearing, moistening, opening, and penetrating methods. The key to medication lies in being ethereal and agile. Such as Rhinoceros Horn Tip (Xi Jiao Jian - *Note: Substitute with synthetic alternatives or Buffalo Horn in modern practice*), Fresh Rehmannia Root (Xian Sheng Di), Forsythia Heart (Lian Qiao Xin), Honeysuckle Flower (Jin Yin Hua), Fresh Acorus Tatarinowii Slices (Xian Shi Chang Pu Bo), Reed Shoots (Lu Sun), Pear Juice (Li Zhi), Bamboo Sap (Zhu Li), mixed with a small amount of Ginger Juice (Jiang Zhi). Cool medicines taken hot, to promote circulation. This is the general principle for treating new-onset autumn dryness in its initial and intermediate stages. Zhang Hefen stated: Diseases where dryness qi combats dampness qi are what Wu Jutong referred to as the Lung affected by dryness qi and the Spleen harboring latent dampness. However, this is not as concise as Yu Jiayan's two characters "Dryness" and "Dampness". (Yu Jiayan said: Dampness governs all four seasons; Spring is Wind-Damp, Summer is Heat-Damp, Autumn is Dryness-Damp, Winter is Cold-Damp.) This disease is most common in late autumn. For instance, after the Autumn Equinox, if there has been no rain for many days, it easily erupts severely. It is particularly widespread in densely populated areas. If complicated by latent summerheat, the condition is even more severe. Upon onset, there is irritability, coma, and delirium; extreme thirst with excessive drinking; or closure, stuffiness, and anhidrosis; or sweating occurs but pathogens do not resolve; or hemoptysis; or hematochezia/hematuria. Even worse, blood-heat and Liver dryness arise, fire flares generating wind, tendons and vessels spasm and contract, limbs and arms become rigid, eyes stare wide, mouth clenches shut, tongue curls, testicles retract, stools are mostly dry and constipated. Or tenesmus resembling dysentery; or initially watery diarrhea with sudden violent urging, quickly turning into dry constipation; urine is mostly red and scanty/difficult. Pulse is mostly wiry and rapid in the deep position, fine and choppy upon pressure. Although symptoms present myriad dangerous variations, the main outlines are only a few. In the Upper Jiao, there are two types: one is the exhaustion of the Lung's source of transformation; the other is heat closing leading to spirit confusion. In the Middle Jiao, there are also two: one is the exhaustion of Stomach collaterals; the other is organ binding leading to dysentery. In the Lower Jiao, there is only one type: in males, essence depletion and marrow drying up; in females, blood exhaustion and Liver failure. When selecting herbs and formulating prescriptions, nothing takes effect faster than fresh herbs. Next are flower dew extracts, such as fresh Reed Shoots (Xian Wei Jing), fresh Chrysanthemum Leaves (Xian Ju Ye), fresh Honeysuckle Vine Leaves (Xian Ren Dong Teng Ye), fresh Loquat Leaves (Xian Pi Pa Ye), fresh Light Bamboo Leaves (Xian Dan Zhu Ye), fresh Isatis Leaves (Xian Da Qing Ye), fresh Mulberry Buds (Xian Sang Ya), fresh Pear Skins (Xian Li Pi), fresh Tangerine Leaves (Xian Ju Ye), fresh Blue Bamboo Leaves (Xian Qing Ruo Ye), etc., for light clearing and resolving dryness; raw Radish Juice (Sheng Luo Bo Zhi), raw Pear Juice (Sheng Li Zhi), Light Bamboo Sap (Dan Zhu Li), fresh Acorus Juice (Xian Shi Chang Pu Zhi), etc., for clearing and transforming dryness-phlegm; acrid-moistening opening of closure, using fresh Imperata Root (Xian Mao Gen), fresh Isatis Root (Xian Da Qing), fresh Motherwort Herb (Xian Yi Mu Cao), fresh Rehmannia Root (Xian Sheng Di), fresh Verbena Herb (Xian Ma Bian Cao), raw Lotus Root Juice (Sheng Ou Zhi), Watermelon Juice (Xi Gua Zhi), Gold Juice (Jin Zhi - *historical term for fermented human feces extract*), and Child's Urine (Tong Bian), etc., for cooling blood, promoting blood circulation, detoxifying, and expelling pathogens; fresh Dendrobium Stem (Xian Shi Hu), Sugarcane Syrup (Zhe Jiang), fresh Rice Ear Dew (Xian Dao Sui Lu), Chicken Meat Dew (Ji Rou Lu), Prepared Rehmannia Dew (Shu Di Lu), etc., for nourishing Stomach juices; raw Chestnuts (Sheng Di Li), pale Jellyfish (Dan Hai Zhe), etc., for salty-moistening intestinal dryness. All these are beneficial items in heat-dryness diseases. As for dryness combined with dampness, dampness is Earth Qi, dryness is Heaven Qi; Heaven Qi can encompass Earth Qi. One should prioritize treating dryness first. Once dryness resolves, dampness opens and heat penetrates, naturally following out. Only when a deficient constitution contracts dryness pathogen is the situation particularly dangerous. Initial treatment focuses on moistening the Lung, nourishing fluids, clearing collaterals, and draining heat. One must neither excessively induce sweating nor directly administer tonics. Subsequently, advance to sweet-moistening nourishment of the Stomach to preserve yin fluids. In severe deficiency, with qi stagnation and fluid exhaustion, clearing and moistening is unsuitable; one must obtain warm-moistening and sweet-drying herbs, such as Cistanche Stem (Dan Cong Rong), Prepared Polygonatum Rhizome (Shu Yu Zhu), Dodder Seed (Tu Si Zi), Goji Berry (Gou Qi), Prepared Rehmannia Root (Shu Di Huang), Donkey-hide Gelatin (E Jiao), Deer Antler Gelatin (Lu Jiao Jiao), which are appropriate methods. The treatment of deficiency-dryness is generally similar to this. The Dryness chapter describes these methods, and the formulas and drugs are indeed comprehensive. Among them, only the syndrome of Spleen Dampness and Kidney Dryness is mostly due to external contraction complicating internal injury. External contraction often results from unresolved damp-heat injuring yin fluids first; internal injury often results from alcohol-damp damaging the Spleen and sexual excess damaging the Kidney. External contraction is already difficult to treat; symptoms include dry mouth without thirst, drinking cannot moisten the dryness, hidden pain in bone joints with discomfort, and urine red/scanty/difficult. At this time, promoting urination to drain dampness will rob yin, while saving yin will assist dampness. Treatment must nourish yin and drive out dampness, combining moistening and drying appropriately. I often combine the methods of Xue Ji and Wang Lun, using Yuan Mi Decoction combined with Ginseng and Dendrobium Winter Melon Soup. (Bei Sha Shen 6 qian, Huang Cao Chuan Hu 4 qian, Fried Ophiopogon 1.5 qian, Fried Fragrant Loquat Leaf 4 qian, Silk Gourd Network with seeds, Jian Lan Ye each 3 qian; first soak raw Atractylodes Macrocephala Rhizome 3 qian in rice water for 6 hours, remove Atractylodes, take rice water, decoct fresh Winter Melon Peel and Seeds each 2 liang, boil to extract clear soup, use as water to decoct medicine.) It is mostly effective. Internal injury is even more difficult to treat. There are cases of Spleen dampness flowing downward, yang damage affecting yin, with symptoms of limb flaccidity and qi sinking, borborygmus and renal diarrhea, night fever, sore back, and scanty urine. I often use Zhong Chun's Spleen-Kidney Dual Tonification Method with success. (Lu Dang Shen, Fried Lotus Seed, Huai Shan Yao, Fried Coix Seed, Baked Myrobalan, Spring Cardamom with shell, Fried White Peony Root, Fried Alisma Seed, Salt-fried Psoralea Fruit, Schisandra Berry, Dodder Seed, Morinda Root, made into pills the size of mung beans, take 0.8-1 qian empty stomach or before sleep.) There are cases of Kidney dryness failing to harmonize, yin damage affecting yang, with symptoms of profuse diarrhea, tenesmus, dizziness, shortness of breath, six pulses showing empty and spiritless Chi positions, pale-red dry tongue. I often use Shen Zhai's Moistening Kidney and Consolidating Qi Method with success. (Cistanche 3 qian, Pseudoginseng Root, Raw White Peony Root each 1 qian, Angelica Sinensis Root, Schisandra Berry each 0.8 fen, Roasted Licorice 0.6 fen, Processed Ginger 0.2 fen.) There are also cases of dampness invading the essence orifices, yin deficiency with much fire, with symptoms of sore back and back heat, heel heat and pain, weak and difficult-to-walk legs. Men have spontaneous emission of hot semen; women have excessive sticky leukorrhea. I often use Tiger-Hide Pill (Hu Qian Wan) and Modified Er Miao Pill, gradually seeking results. There are further cases of indulging in alcohol and sex, damp-heat brewing phlegm, deficiency fire rising intermittently, upper excess and lower deficiency, with symptoms of dizziness and red face, phlegmy cough and wheezing, chest and hypochondriac fullness, generalized body ache, especially waist and foot pain, even leading to flaccidity and cold extremities. I often use Liu Wei Di Huang Tang added with raw-ground Left Oyster Shell, mixed with Bamboo Sap, Ginger Juice, Child's Urine, administered with Monkey Pearl (Hou Zao 2-3 fen) or swallowed Black Tin Pill (Hei Xi Dan 1-2 fen), slowly seeking recovery. There are yet cases of yin deficiency with qi stagnation, Spleen dampness and Liver fire brewing phlegm obstructing upwards, with symptoms of white-sticky phlegm cough, qi reversal and chest stuffiness, thirst and frequent vomiting, limb fatigue, crimson tongue seeming dry covered with turbid thin coating, left pulse fine and rapid. I often use Self-made Seven-Juice Drink. (Human Milk, Pear Juice, Bamboo Sap, Curcuma Aromatica Juice, Sweet Soy Sauce, Aquilaria Wood Juice, Jie KT Grass Root Seed crushed juice; the seed under the root resembles Ophiopogon, white color, sweet taste, cool nature, moist texture, nourishes Lung and Stomach, superior to Ophiopogon.) It frequently achieves agile results. In summary, yang deficiency leads to much dampness, qi fails to transform fluids, leading to Kidney dryness via yin knotting; symptoms often include poor appetite and faint pulse, bowel obstruction. Yu's modification of Jin Gui Shen Qi Tang has been used with verified efficacy. However, this is rare. Only yin deficiency with dampness, due to excessive drying/purging, dampness exhausting and transforming into dryness, Kidney water deficient and Liver fire rampant, burning Lung causing hemoptysis above, forcing Chong and Ren below, men having seminal emissions and nocturnal pollutions, women having excessive leukorrhea and marrow drying,酿成 (brewing into) severe lower damage and flaccidity-cold syndromes, is seen frequently. This mostly arises from external contraction evolving into internal injury. It requires soft-moist quiet herbs, and products of flesh and blood with affectionate properties, in large doses to fill and nourish.
[Rong Zhai's Note] The syndrome and treatment of this section (Autumn Dryness Cold Damage) divides Yu's classification into six types: "Cool Dryness Attacking Lung", "Warm Dryness Damaging Lung", "Lung Dryness Spleen Dampness", "Spleen Dampness Kidney Dryness", "Lung Dryness Intestinal Heat", "Stomach Dryness Liver Heat". Mr. Xiushan further supplemented Shen Munan's "Treating Autumn Injury by Cool Dryness" method, Yu Jiayan's "Treating Autumn Injury by Warm Dryness" method, and Zhang Shiweng's method for "Dryness Disease Initial and Terminal Stages". Mr. Lianchen further supplemented the empirical treatment methods of Ye Tianshi, Shi Feinan, Zhang Hefen, and himself. This gathering of wisdom, discarding the dross and retaining the essence, can be said at that time to be a summary report on "Autumn Dryness Syndrome and Treatment". Based on Mr. Lianchen's experiments in his later years, his understanding of "Dryness Combined with Latent Summerheat" (i.e., Yu's so-called Lung Dryness Spleen Dampness) believes: "In autumn, summer-dampness occupies the interior, new cool-dryness adds to the exterior; dryness and dampness arrive together, making it hardest to delineate boundaries clearly. If slightly inaccurate, the deterioration is indescribable. Since dryness can transform into cold or heat, first separate summerheat, dampness, and dryness, then clarify cold and heat, and there will be accurate targets. Treatment: First use bitter-warm releasing of the exterior and acrid-moistening dispersing of the upper jiao to resolve the new evil of cool-dryness attacking externally; wait until cool-dryness is resolved externally, dampness opens and heat penetrates, then rectify the latent heat, either using aromatic-penetrating clearing-transforming, or gentle purgation clearing-draining, must wait until latent pathogens are completely removed; if yin-fluid dual deficiency is discovered, then switch to Zeng Ye Yu Yin (Increase Fluids Nourish Yin) for consolidation." His summary of autumn dryness treatment methods is also simple and concise. He said: "Among the Six Qi, only Dryness Qi is difficult to understand, because dryness has divisions of Cool Dryness, Warm Dryness, Upper Dryness, and Lower Dryness. Cool Dryness is the dominant energy of dryness, treated with warm-moistening; Xing Su San is the main formula. Warm Dryness is the rebound energy of dryness, treated with clearing-moistening; Qing Zao Jiu Fei Tang is the main formula. Upper Dryness treats Qi, Wu's Sang Xing Tang is the main formula. Lower Dryness treats Blood, Zi Zao Yang Ying Tang is the main formula." Remembering these central theories helps us in our study of traditional Chinese medicine."