夫六气之中，惟燥治之尤难，盖燥万物莫甚于火。火者，十二经皆有之，当其阴阳
和、脏腑强，荣卫固，寒热调，喜怒平，则诸经各适，火焰不冲，燥从何来？一有所
伤，火乃踵起，如风郁不散，则因风火动而燥者，或热壅不除，因热愈热而燥者，或久
病之后，阴虚火动而燥者，在外则皮毛枯槁，在上则咽干口燥，在中则烦渴不已。
《经》曰∶诸涩枯涸，干劲皴揭，皆属干燥。涸者，无水液也。干者，不滋润也。劲者，
不柔和也。皴揭者，皮肤起裂也。涩者，如诸物润则滑泽，干则涩滞。然干为天而为燥
金，坤为地而为湿土，故涩滞者，皆燥金之化，所以秋脉乃涩。涩者，涩也。皆因燥之
使然。然燥之标由于风与火，而燥之本实根于脾与肾，盖脾精不能转输，而肾阴不能上
奉，所以肺失化源，自见其象耳！治宜生津养血，滋阴润燥，倘寸强尺弱，由乎釜下无
火，而锅盖干燥者，用水中补火之法。
凉膈散
见伤寒门。
黄连 黄柏 山栀（各等分，一方有黄芩） 水煎服。
六味地黄汤
见痨瘵门。
燥干者，肺金之体本燥，金受热化而更
燥涩也。盖风能胜湿，热能耗液，《经》曰∶风热火同，阳也；寒湿燥同，阴也。然燥、
湿，小异也。燥金虽属秋阴，其性异于寒湿，反同于风热火也，加大硬干涩，乃大肠
受热化成燥涩。又如瘫痪中风，皆因火热耗损血液，玄府闭塞，不能浸润，金受火郁不
能发声，《经》云∶肺主声，肢痛 戾者，风湿热相致，而遂以偏枯，言语音涩，手足
不随也。《经》曰∶诸温枯涸，干劲皴揭皆属于燥。夫金为生水之源，生化之源一绝，
则不能溉灌周身，荣养百骸，故枯槁而无润泽也。《经》曰∶金水者，生成之终始；又
曰∶木位之下，金气承之。盖物之化从于生，物之成从于杀，生之重，杀之轻，则气
殚散而不收，杀之重生之轻，则气敛涩而不通，敛涩则伤其分布之政，不惟生气不得
升，而收气亦不得降，所以为燥涩也。更有肺胃肾三经，蕴蓄燥湿之气，而为三消之症
者有焉。喻嘉言曰∶胃中津液干枯，虚火上炎之症，用寒凉药而火反升，徒知与火相
争，用知母、贝母屡施不应，不知胃者，肺之母气也。《金匮》麦门冬汤，用麦冬、人
参、粳米、甘草、大枣，大补中气，大生津液，则火退而津生，何燥之有？
火之累人已甚矣。况至于燥，又深于火之一层，盖由火而至燥也。夫金体本燥，所
以义能生水者，赖坤阴上输，得以水精四布，虽燥体而不至于燥也。迨至脾荣不足，
肾阴又亏，火烁金伤，真脏乃见，生意既穷，化源复竭，金无生水之功，木失涵金之
象，子母不能相生，阴道机关绝灭，由是心主血而血无以生，脾统血而血无以统，肝藏
血而血无以藏，且内地火愈炎，脏腑燥槁甚，理宜重浊味药，峻补真阴，轻扬辛散，
清理郁火，倘系丹田浮越之孤阳，理宜引归而藏纳者，当于补阴汤中，佐以收敛，弗事
清理可也。但燥热之症，虽似有余，实为不足，一至补阴之功得力，则症渐见虚寒，万
勿轻用寒凉，脾胃亦伤，化源之机更绝，所谓土死不救矣。故治火症，尚有当用寒凉，
至于燥症，惟宜投以润剂。治风燥莫如养血，清热燥莫如壮水，奈古哲未之悉何也？
（张）陈一得之管见，高明以为然否？至于更有冷燥一症，虽见便秘燥结，实由阴寒过
极，如阳和之水，遇隆冬而成层冰燥裂也。古方有半硫丸之设，意深远矣。
在六气（风、寒、暑、湿、燥、火）之中，唯独燥邪的诊治最为困难，因为万物中没有比火更干燥的了。火存在于十二经脉中，当人体阴阳调和、脏腑强健、营卫固密、寒热平衡、喜怒平和时，各条经脉都能适应正常状态，火焰不会上冲，燥邪从何而来？一旦有所损伤，火邪便会随之而起。例如：因风邪郁结不散，导致风火相煽而产生燥邪；或因热邪壅盛不除，因热生热而使燥邪加重；或因久病之后，阴虚导致虚火妄动而产生燥邪。在外表现为皮毛枯槁，在上表现为咽干口燥，在中表现为烦渴不止。《黄帝内经》说：“各种涩滞、干枯、涸竭、劲急、皴裂揭起的现象，都属于燥证。”所谓“涸”，是指没有津液；“干”，是指不滋润；“劲”，是指不柔和；“皴揭”，是指皮肤出现裂纹；“涩”，是指像各种物体湿润时则滑泽，干燥时则涩滞一样。然而，“干”对应天，属于燥金；“坤”对应地，属于湿土。所以涩滞的现象，都是燥金的化生结果，因此秋季的脉象呈现涩象。“涩”就是涩滞的意思，这都是由燥邪造成的。但是，燥邪的表现标象源于风与火，而燥邪的根本实质根源于脾与肾。这是因为脾精不能转输，肾阴不能上奉，导致肺失去化源，从而显现出这些症状！治疗应当生津养血，滋阴润燥。如果寸脉强而尺脉弱，这是由于锅底下没有火，导致锅盖干燥的原因，应采用“水中补火”的方法。
燥邪伤人的情况，是因为肺金的本体本来就是燥的，金属受热化后变得更加燥涩。风能胜湿，热能耗损津液，《黄帝内经》说：“风、热、火同属阳；寒、湿、燥同属阴。”然而，燥与湿虽有细微差别，但燥金虽然属于秋天的阴气，其性质不同于寒湿，反而与风、热、火相同，表现为更加坚硬、干燥、涩滞，这是大肠受热化而成燥涩的结果。又如瘫痪中风，都是因为火热耗损血液，玄府（汗孔及毛孔）闭塞，不能浸润，肺受火郁而不能发声，《黄帝内经》说：“肺主声音”，肢体疼痛扭曲的是风湿热共同导致的，进而造成偏枯，言语涩滞，手足不能随意运动。《黄帝内经》说：“各种温热、干枯、涸竭、劲急、皴裂揭起都归属于燥。”金是生水之源，生化之源一旦断绝，就不能灌溉周身，荣养百骸，所以枯槁而没有润泽。《黄帝内经》说：“金和水，是生成的终始；又说：木位的下面，金气承接它。”大概事物的变化顺从于生长，事物的成就顺从于肃杀。如果生的力量重，杀的力量轻，那么气就会消散而不收敛；如果杀的力量重，生的力量轻，那么气就会收敛涩滞而不通。收敛涩滞就会伤害其分布的气机，不仅生气不能上升，而且收气也不能下降，所以成为燥涩。更有肺、胃、肾三经，蕴蓄燥湿之气，而形成消渴症的情况。喻嘉言说：“胃中津液干枯，虚火上炎的病症，使用寒凉药反而使火上升，只知道与火相争，屡次使用知母、贝母无效，不知道胃是肺的母亲之气。《金匮要略》中的麦门冬汤，使用麦冬、人参、粳米、甘草、大枣，大补中气，大生津液，那么火退而津液生成，哪里还有燥呢？”
火对人体的危害已经很大了，况且到了燥的程度，又比火更深一层，这是由火发展到燥。金的形体本来燥，所以能生水的功能，依赖于坤阴上输，得以水精四布，虽然具有燥的形体却不至于真正干燥。等到脾的营血不足，肾阴又亏损，火烁伤金，真脏脉象出现，生机已尽，化源枯竭，金没有生水的功能，木失去涵金的景象，子母不能相生，阴道机关断绝，由此心主血而血无法生成，脾统血而血无法统摄，肝藏血而血无法储藏，且体内之火越炎上，脏腑干燥枯槁越严重，理应使用重浊滋味的药物，峻补真阴，或者使用轻扬辛散的药物，清理郁火。如果是丹田浮越的孤阳，理应引导归藏并收纳，应当在补阴汤中，辅助以收敛的药物，不要从事清理的工作即可。但是燥热的病症，虽然看似有余，实为不足。一旦补阴的功效得力，症状逐渐显现出虚寒，千万不要轻易使用寒凉药，以免损伤脾胃，使化源的机制更加断绝，这就是所谓的“土死不可救”。所以治疗火症，还有应当使用寒凉的时候，至于治疗燥症，只适宜投用润剂。治疗风燥不如养血，治疗清热燥不如壮水，可惜古代哲人未能完全阐明这一点。（张）陈一得的管见，高明者认为如何？至于更有冷燥这一病症，虽然见到便秘燥结，实际上是由阴寒过极所致，就像阳气温和的水，遇到隆冬结成层层冰层而燥裂一样。古方设有半硫丸，用意深远啊。
Among the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), only Dryness is particularly difficult to treat, for nothing is drier than Fire. Fire exists in all twelve meridians. When Yin and Yang are harmonious, Zang-Fu organs are strong, Ying and Wei (Nutritive and Defensive Qi) are solid, Cold and Heat are balanced, and emotions like anger and joy are calm, each meridian functions appropriately, flames do not surge upward, and where would Dryness come from? Once injured, Fire arises subsequently. For instance: if Wind stagnates and does not disperse, Wind and Fire stir up causing Dryness; or if Heat obstructs and remains unresolved, Heat generates more Heat exacerbating Dryness; or after prolonged illness, Yin deficiency causes Deficient Fire to flare up leading to Dryness. Externally, skin and hair become withered; superiorly, the throat becomes dry and the mouth parched; centrally, there is incessant irritability and thirst. The *Classic* states: "All cases of astringency, withering, drying up, stiffness, and cracking belong to Dryness." 'Drying up' means lack of body fluids. 'Dry' means lacking moisture. 'Stiff' means lacking flexibility. 'Cracking' refers to skin fissures. 'Astringent' means that just as various objects are smooth when moist but sticky/astringent when dry. However, 'Dry' corresponds to Heaven and belongs to Metal of Dryness; 'Kun' (Earth) corresponds to Earth and belongs to Soil of Dampness. Therefore, astringency is the transformation of Metal of Dryness, which is why the autumn pulse is astringent. 'Astringent' implies obstruction/stagnation, all caused by Dryness. Yet, the manifest aspect of Dryness stems from Wind and Fire, while its root lies in the Spleen and Kidney. This is because Spleen Essence fails to transport, and Kidney Yin fails to ascend, causing the Lung to lose its source of transformation, thereby revealing these symptoms! Treatment should focus on generating fluids, nourishing blood, nourishing Yin, and moistening Dryness. If the Cun (inch) pulse is strong and the Chi (cubit) pulse is weak, it is due to lack of fire under the pot, causing the lid to dry out; one should employ the method of "tonifying Fire within Water".
Liangge San (Cooling the Diaphragm Powder)
See Shanghan Section.
Coptidis Rhizoma (Huanglian), Phellodendri Cortex (Huangbai), Gardeniae Fructus (Shanzhi) (equal parts, another version includes Scutellariae Radix/Huangqin), decocted in water and taken orally.
Liujun Dihuang Tang (Six-Ingredient Rehmannia Pill)
See Laozai Section.
Regarding Dryness damaging the body, the Lung Metal's nature is inherently dry; when Metal is affected by Heat transformation, it becomes even drier and more astringent. Wind can overcome Dampness, and Heat consumes fluids. The *Classic* states: "Wind, Heat, and Fire are Yang; Cold, Dampness, and Dryness are Yin." However, although Dryness and Dampness differ slightly, Metal of Dryness, though belonging to Autumn Yin, differs in nature from Cold and Dampness, resembling Wind, Heat, and Fire instead, manifesting as increased hardness, dryness, and astringency. This is the Large Intestine undergoing Heat transformation into Dryness and astringency. Similarly, paralysis and stroke often result from Fire-Heat consuming Blood, blocking the Xuanfu (pores/capillaries), preventing infiltration, and causing the Lung to be constrained by Fire unable to produce sound. The *Classic* says: "The Lung governs voice." Limb pain and deformity are caused by the combination of Wind, Dampness, and Heat, leading to hemiplegia, speech impediments, and uncontrolled limbs. The *Classic* states: "All warmth, withering, drying up, stiffness, and cracking belong to Dryness." Metal is the source of generating Water. If this source of generation is cut off, it cannot irrigate the whole body or nourish the bones and tissues, resulting in withering without moisture. The *Classic* states: "Metal and Water are the beginning and end of generation"; also, "Below the position of Wood, Metal Qi succeeds it." Generally, things transform following growth, and things complete following killing/restriction. If the force of growth is heavy and restriction is light, Qi dissipates and fails to gather; if restriction is heavy and growth is light, Qi gathers and becomes astringent/blocking. Astringency damages the distribution of Qi, preventing both ascending Sheng (growth) Qi and descending Shou (gathering) Qi, thus causing Dryness and astringency. Furthermore, accumulation of Dryness/Dampness Qi in the Lung, Stomach, and Kidney meridians can lead to Xiao Ke (Wasting-Thirst syndrome). Yu Jiayan stated: "For conditions where Stomach fluids are dried up and Deficient Fire flares up, using cold/cooling herbs causes Fire to rise further. Merely knowing to contend with Fire, repeatedly using Anemarrhenae Rhizoma (Zhimu) and Fritillariae Bulbus (Beimu) yields no results. One must realize that the Stomach is the Mother Qi of the Lung. In the *Jin Gui Yao Lue*, Maimendong Tang (Ophiopogon Decoction) uses Ophiopogonis Radix (Maidong), Ginseng Radix et Rhizoma (Renshen), Oryza Sativa (Jingmi), Glycyrrhizae Radix et Rhizoma (Gancao), and Jujubae Fructus (Dazao) to greatly tonify Middle Qi and generate fluids. Then Fire retreats, fluids generate, and where is Dryness?"
Fire's damage to humans is already severe; reaching Dryness is even deeper, evolving from Fire. Metal's form is inherently dry, yet its ability to generate Water relies on Kun Yin ascending, allowing Water Essence to distribute widely, so although it has a dry form, it does not become truly dry. When Spleen Ying (Nutritive) blood is insufficient and Kidney Yin is deficient, Fire scorches and injures Metal, True Zang pulses appear, vitality is exhausted, and the source of transformation is depleted. Metal loses its function of generating Water, Wood loses its image of nourishing Metal, mother and child fail to generate each other, and the Yin pathway mechanisms cease. Consequently, the Heart Master of Blood finds no Blood to generate, the Spleen Controller of Blood finds no Blood to control, and the Liver Storehouse of Blood finds no Blood to store. Moreover, internal Fire flares higher, making Zang-Fu organs extremely dry and withered. It is appropriate to use heavy, turbid, flavor-rich medicines to severely tonify True Yin, or light, aromatic, acrid-dispersing medicines to clear constrained Fire. If it is Floating Lone Yang from the Dantian, it should be guided back and stored; one should add astringents to Yin-tonifying decoctions and avoid clearing measures. However, Dryness-Heat syndromes, though appearing excess, are actually deficiency. Once Yin-tonification takes effect, symptoms gradually reveal deficiency-cold. Never lightly use cold/cooling herbs, lest they damage the Spleen and Stomach, further cutting off the mechanism of transformation, which is termed "Earth death, incurable." Thus, treating Fire syndromes may sometimes require cold/cooling herbs, but for Dryness syndromes, only moistening agents are suitable. To treat Wind-Dryness, nothing beats nourishing Blood; to treat Heat-Dryness, nothing beats strengthening Water. Alas, ancient sages did not fully elucidate this. Is Zhang Chen Yide's humble opinion correct, you who are wise? Regarding Cold-Dryness, although constipation and dry blockage are seen, it is actually due to extreme Yin-Cold, like warm water turning into layered ice cracks in deep winter. The ancient formula Banshu Wan (Half-Sulfur Pill) was designed with profound intent.