〔《玄》〕虚者，皮毛肌肉筋脉骨髓气血津液不足也。若男女终日劳役，神耗力倦，饥饱越常，喜怒忧思，
形寒饮冷，纵欲恣情。《素问》曰∶今人未及半百而衰者，以酒为浆，以妄为常，醉以入房，以欲竭其精，以耗
散其真，根源从此而虚竭矣。五脏六腑如何不弱，五劳六极七伤从此而始。何谓五劳？心劳血损，肝劳神损，
脾劳食损，肺劳气损，肾劳精损。六极谓筋、脉、肉、皮、毛、骨瘁损，是谓六极。七伤《难经》言之甚详，
伤形与气，谓之七伤。总而言之，为虚是也。大抵五行六气，水特五之一耳。夫一水既亏，岂能胜五火哉，虚劳
等症蜂起矣。其体虚者，最易感于邪气。当先和解，微利微下之，从其缓而治之，次则调之。医者不知邪气加之
于身而未除，便行补剂，邪气得补，遂入经络，致死不治。如此误者，何啻千万。良可悲哉！《内经》中本无劳
症之说，其曰劳者温之，温者温存之义。不足者，补之以味，谷肉菜果，百味珍羞，无非补也。今之医者，不通其
法，唯知大补之道，轻则当归、鹿茸、雄、附，重则乳石、丹砂，加之以灼艾补燥其水，水得热愈涸，生火转
甚。少而成嗽痰血，潮热烦渴喜冷，此则热症明矣。重则失音，断不可救。犹且峻补不已，如此死者，医杀之
耳。及遇良工，治验而以清剂解之，不合病患之意，反行怪责，及闻发表攻里之说，畏而不从，甘死于庸工热
补之手，虽死不悔，深可悯也。夫凉剂能养水清火，热剂能燥水补火，天下之事，无出乎理。理既明，何患疾之
不安。劳为热症明矣，还可补乎。惟无邪无热无积之人，脉举按无力而弱者，方可补之。又必察其胃中及右肾
二火亏而用之。心虚则动悸恍惚，忧烦少色，舌强，宜养荣汤、琥珀定神丸之类，以益其心血。脾虚面黄肌瘦，
吐利清冷，腹胀肠鸣，四肢无力，饮食不进，宜快胃汤、进食丸之类，以调其饮食。肝虚目昏筋脉拘挛，面青
恐惧，如人将捕之状，宜牛膝益中汤、虎骨丹之类，以养助其筋脉。肺虚呼吸少气，喘乏咳嗽，嗌干，宜枳实
汤加人参、黄 、阿胶、苏子，以调其气。肾虚腰背脊膝厥逆而痛，神困耳鸣，小便频数，精漏，宜八味丸加五
味子、鹿茸、去附子，用山药等丸，以生其精。
〔丹〕劳瘵主阴虚、痰与血病。虚劳渐瘦属火，阴火消铄，即是积热，宜照后法治之。
草还丹 治阴虚骨蒸。
用青蒿一斗五升，童便三斗，文武火熬，约童便减至二斗，去蒿，再熬至一升，入猪胆七个，再熬数沸。
用甘草末收和为丸，梧子大，每服五十丸。
治劳病，四物汤加竹沥，入小便。阴虚发热，四物汤加黄柏，降火补阴，甚者加龟板。
〔张文仲〕治骨蒸方。
生地黄一升，捣取汁尽分再服。利则减之，以身凉为度。
上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。此皆阴虚之症，用四物、竹沥，又加炒柏、龟板，皆补阴
降火之剂。又须远嗜欲，薄滋味，静心调养，以助之也。
〔丹〕阴虚发热，四物汤加黄柏。兼气虚者，加参、 、白术。
御院琼玉膏 滋血补气，延年益寿。
人参（三十六两，去芦须，研为净末） 白茯苓（二十四两，去皮，研为细末） 生地黄（十六斤，捣
取汁，以尽为度，去渣） 蜜（六斤）
上和匀，入银石器瓶中。内用油纸，外用竹箬，包以软篾，缚紧瓶口，入重汤内悬胎煮之。用桑柴文武火
不住手三昼夜，入井中浸一日夜出火毒。又煮一日，出阴毒，取出。每早空心用酒或白汤调下。
〔罗〕清神甘露丸 治男子妇人虚劳不足，大骨枯，大肉陷皆治之。
生地汁 白莲藕汁 生乳汁（生用）
上三味等分，用砂石器内，以文武火熬成膏子，用后药。
人参 白术 黄连 黄 五味子 胡黄连
上各等分为细末，以前膏子和剂，丸如桐子大。每服五十丸，人参汤下。
〔海〕黄 膏子煎丸
人参 白术（各一两半） 柴胡 黄芩（各一两） 白芷 知母（各半两） 甘草（半两，炒）
鳖甲（一两，手大者，酥炙） 黄 （半斤，为粗末，用水二斗，熬一斗，去渣再熬，令不住手搅成膏，至半斤，入
白蜜一匙， 一两，再熬令熟，放冷丸药）
上为末，用黄 膏和匀丸，每早白汤服下。呼吸少气，懒言语，无力动作，目无睛光，面色 白，皆兼气虚也。
〔丹〕补天丸 治阴虚骨蒸发热，形羸瘦者。
紫河车洗净，用布绞干，用补肾丸药末捣细焙干，再碾为末，酒煮米糊为丸。梧子大。每服七八十丸，热
汤下。夏月加五味子。紫河车，即初生男子胞衣也。
补肾丸 治阴虚有痰，膈不清者。
龟板（一两半，酥炙） 黄柏（一两半，炒） 牛膝（二两） 干姜（二钱） 陈皮（半两）
上为末，姜汁打糊丸，每服七八十丸。
治酒色过伤少阴。
黄柏（一两半，炒） 黄芩（半两，炒） 地黄（一两） 龟板（五两，酒炒）
夏加砂仁三钱，五味五钱。冬加干姜炒黑三钱。用炊饼为丸，食前白汤服三五十丸。（《丹溪心法》
以地黄作黄柏）
〔洁〕地黄丸 治久新憔悴，寝汗发热，五脏齐损，瘦弱虚烦，肠 下血，骨蒸，痿弱无力，不能运动。东垣云∶治脉沉而虚者。
熟地（八两） 山茱萸（净肉） 山药（各四两） 牡丹皮 茯苓 泽泻（各三两）
上为细末，炼蜜丸，桐子大。空心温酒服五十丸。
〔垣〕或问钱氏地黄丸补肾，又曰补肝，何也？曰∶然，手厥阴心主包络，足厥阴肝经，俱治在下焦。经
云∶不足者滋其化源。故肝肾之病同一治法，此地黄丸补二经之意也。（海藏云∶若加五味为肾气丸，此滋肺之源
以生肾水。）
〔《保》〕黑地黄丸加五味子，为肾气丸治阳盛阴衰，脾胃不足，房室虚损，形瘦无力，面多青黄，而无常色，
此补气益胃。
苍术（一斤，油浸） 熟地（一斤） 五味子（半斤） 干姜（秋冬一两，夏半两，春七钱）
上为细末，枣肉丸梧子大。食前米饮，或酒服百丸。治血虚久痔甚妙。经曰∶肾苦燥，急食辛以润之。此
药开腠理，生津液通气。又五味子酸以收之，此虽阳盛而不燥热，乃是五脏虚损于内，故可益血收气，此药
类象神品方也。
治阳盛心肺不足，宜八味丸。四肢弱无力多困，未知阴阳先损，夏可用地黄丸，春秋宜肾气丸，冬宜八味丸。
〔云岐〕鸡苏丸 治嗽血。（方见咳唾血。）
上治肺肾虚。盖肝心属阳，肺肾属阴，阴虚则肺肾虚矣。肾虚者从房室中来，其症或腰酸腰痛，或足酸
足痿足热，或遗精白浊是也。肺虚者，或咳嗽或吐血是也。治肾虚四方，前二方龟扳、黄柏为君，有痰无
痰皆可用。后二方地黄为君，无痰可用，痰多而膈不清者宜审之。治肺虚咳嗽唾血者，方法浩大，另立咳
嗽唾门也。
〔丹〕虚劳皆积热做成。始健时，可用子和法。后日羸惫，四物汤加减，送消积丸，使热不作也。蒸蒸发
热，积病最多。小陷胸汤，治湿痰发热极妙。（方见伤寒部结胸门。）
退实热劳积痰。
鳖甲 龟板 侧柏 栝蒌仁 半夏 黄连 黄柏
上为末，炊饼丸。
又湿痰发热。
黄芩（炒） 黄连（炒） 香附（生） 苍术。
上为末，栝蒌穣为丸。
青檬石丸（方见咳嗽。） 河间人参半夏丸（方见咳嗽。）
〔丹〕治施官人，年三十余，不可劳动，劳动则发热，脉洪而大在右手，短而涩在左手。予谓此必酒痰成
湿伤血。又问之，遇少劳则喘乏力，小便或赤或白。
当归 黄 人参（各五分） 芍药（一分） 白术（二分半） 川芎（五分） 木通（三分） 黄芩
（三分） 陈皮（五分） 浓朴（五分） 炙甘草（二分）
煎汤下青礞石丸。
〔罗〕柴胡饮子 解一切肌骨蒸热，寒热往来，及伤寒发汗不解，或汗后余热劳复，或妇人经病不快。产后但有
如此之症，并宜服之。
黄芩 甘草（炙） 大黄 芍药 柴胡 人参 当归（各半两）
上 咀，姜三片，煎热服。
〔《保》〕防风当归饮子 治烦热皮肤索泽。食后煎服，空心，宜以此饮下地黄丸。
柴胡 人参 黄芩 甘草 防风 大黄 当归 芍药（各半两） 滑石（二钱）
上 咀每服五钱，水一盏半，姜三片，煎七分，温服。如痰嗽加半夏。如大便黄米谷完出，惊悸，溺血。
淋闭，咳血衄血。自汗头痛，积热肺痿，后与大金花丸。
大金花丸
黄柏 黄芩 黄连 山栀（各八两）
上为细末，水丸小豆大，每服一百丸，温水下，日二三服。或大便实加大黄。自利，如中外热者，此药
作散煎服，名解毒汤。或腹痛呕吐欲作痢者，每服解毒汤半两，加半夏、茯苓、浓朴各三钱，姜三片。如白
脓后重，下痢后重者，加大黄三钱。
麦煎散 治少男室女骨蒸，妇人风血攻疰四肢。
赤茯苓 当归 干漆 鳖甲（醋炙） 常山 大黄（煨） 柴胡 白术 生地 石膏（各一两） 甘草（半两）
上为末，每服三钱，小麦五十粒，水煎，食后临卧服。若有虚汗，加麻黄根一两。东坡云∶此黄州吴判官
疗骨蒸黄瘦，口臭肌热，盗汗极效。吴君宝之，不肯妄传。
当归龙荟丸 治肝有积痰污血，结热而劳瘵者。其太冲脉必与冲阳脉不相应，宜以补阴药吞此丸神效。（方见前。）
上劳瘵兼痰积，其症腹胁常热，手足头面则于寅卯时分乍有凉时者是也。若顽痰胶固难治者，必以吐法
吐之，或沉香滚痰丸、透膈丹之类下之。又甚者，或用倒仓法。若痰积闭塞经脉，则太冲脉与冲阳寸口脉
数而不相应者，极难治。自阴虚条至此，凡六法，但患劳者，罕能脱此六法。自此以后数法，宜审而行之，
无其病，莫妄施也。
〔世〕治骨蒸热，神效。
前胡（一钱） 柴胡（二钱） 胡黄连（一钱） 猪脊髓（一条） 猪胆（一个）
上水煎，入猪胆汁服之。
〔石〕地骨皮枳壳散 治骨蒸壮热，肌肉消瘦，少力多困，夜多盗汗。
地骨皮 秦艽 柴胡 枳壳 知母 当归 鳖甲（醋炙黄）
上等分为末，水一盏，桃柳枝头各七个，姜三片，乌梅一个，去渣临卧服。
〔罗〕秦艽鳖甲散 治骨蒸壮热，肌肉消瘦，舌红颊赤，目倦盗汗。
柴胡 地骨皮（各一两） 秦艽 知母 当归（各半两） 鳖甲（一两，去裙 ，醋炙）
上为粗末，每服五钱，水一盏，入乌梅一个，青蒿五叶，同煎至七分，去渣温服，临卧空心各一服。
人参地骨皮散 治脏中积冷，营中热，按之不足，举之有余，阴不足而阳有余也。
茯苓（半两） 知母 石膏（各一两） 地骨皮 人参 柴胡 生地（各一两五钱）
上 咀，每服一两，生姜三片，水煎细细服。
人参柴胡散 治邪热客于经络，肌热痰嗽，五心烦躁，头目昏痛，夜有盗汗。及妇人虚劳骨蒸尤宜。
白茯苓 人参 白术 柴胡 当归 半夏曲 干葛 甘草（炙） 赤芍药（以上各一两）
上为细末，每服三钱，姜四片，枣三枚，水煎带热服。（许学士云∶但有劳热症皆可服，热退即止。大
抵透肌葛根第一，柴胡次之，其方多黄芩半两。）
上四方，治虚损复受邪热，皆宜用柴胡。《衍义》云∶柴胡《本经》并无一字治劳，今人方中，治劳鲜有
不用者，误人甚多。常原病劳有一种真脏虚损，复受邪热，因虚而致劳。故曰∶劳者牢也，当斟酌之。如
经验方治劳热青蒿煎丸，用柴胡正宜，服之无不效，热去即须急已。若无邪热，得此愈甚，虽至死，人亦
不怨。王海藏云∶苟无实热，医取用之，不死何待？后之用柴胡者，宜审诸。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。
火郁汤（方见前。） 柴胡升阳汤（方见前。）
上二方治重阴覆其阳，火不得伸，或洒洒恶寒，或志意不乐，或脉弦数，或四肢五心烦热是也。病去即
已，不可过剂。服寒凉药，症虽大减，脉反加数者，阳郁也。大忌寒凉，宜升宜补，犯之死速。
〔海〕问两手寸关弦，病脾弱，火胜木旺，土亏金铄，当作何治？答曰∶不治标本，从乎中治。木标也，
土本也，火中也。烁金亏土旺木者，皆火也，钱仲阳安神丸主之，山蓣、麦冬益金之气，金益则气旺而木自平。
寒水石、牙硝，火中添水，使化为湿热也。湿热为季夏之令，非土而何？故用朱砂以坠火下行，将退与子，权
行湿令也，故脉弦得除而土自旺。秋喘，加人参、丹砂等，夏则不加。养气者，加沉香。欲发汗者，临卧先与
白粥一盏，后药之则汗也。寒热神少振摇。小便淋或多，或大便走，完谷不化，口干舌缩，唇吻有疮，心下痞，
大渴引饮，恶干喜湿，目花，四肢无力，怠惰嗜卧，食不入，皮肤燥涩，面色黧黑，肌肉消铄，胸腹中急，额
【《玄》】所谓“虚”，是指皮毛、肌肉、筋脉、骨髓、气血、津液等精微物质的不足。如果男女整日从事繁重的体力劳动，导致精神耗损、体力疲倦，饮食饥饱无常，情绪喜怒忧思过度，身体受寒、饮用冷物，以及纵欲无度、放纵情欲。《素问》说：现在的人不到五十岁就出现衰老迹象，是因为把酒当作浆水般随意饮用，把妄为当作常态，醉酒后行房事，以欲望耗尽精气，以耗散损耗真气，生命的根源从此变得虚弱枯竭。五脏六腑怎能不衰弱？五劳、六极、七伤便由此开始。什么是五劳？心劳导致血损，肝劳导致神损，脾劳导致食损（消化功能受损），肺劳导致气损，肾劳导致精损。六极是指筋、脉、肉、皮、毛、骨的精气极度衰竭，称为六极。七伤在《难经》中解释得很详细，指形体与气的损伤，称为七伤。总而言之，这些都是虚证。大抵五行六气之中，水只是其中之一罢了。既然一水已经亏损，怎么能抵御五火呢？于是虚劳等疾病蜂拥而起。体质虚弱的人，最容易感受邪气。治疗时应当先和解，轻微地通利或攻下，顺着病势缓和地治疗，然后再进行调理。医生不知道邪气加于身上尚未清除，就使用补剂，邪气得到补益，随即深入经络，导致死亡且无法救治。这样的误治，何止千万。实在令人悲哀！《内经》中原本没有“劳症”的说法，其中所说的“劳者温之”，“温”是温存、温和的意思。“不足者，补之以味”，谷物、肉类、蔬菜、水果，各种味道的美味，无非都是补益。现在的医生，不通晓这些方法，只知道大补之道，轻则用当归、鹿茸、雄黄、附子，重则用乳石、丹砂，再加上艾灸来温燥补水，水遇到热更加干枯，生火反而更甚。年少时就出现咳嗽、痰中带血、潮热、烦渴喜冷饮，这显然是热症。严重时失音，断不可救。却仍然峻补不停，像这样死去的，是医生杀死的啊。等到遇到高明的医生，用清剂治疗见效，却不合病患的心意，反而遭到责怪；听到发表攻里的说法，害怕而不听从，甘愿死于庸医的热补之手，即使死了也不后悔，实在令人怜悯。凉剂能养水清火，热剂能燥水补火，天下的事情，没有超出这个道理的。道理既然明白了，还担心疾病不能痊愈吗？劳症明显是热症，还可以补吗？只有无邪、无热、无积滞的人，脉象举按无力而弱，才可以补益。又必须检查其胃中和右肾的相火亏虚，然后才使用。心虚则心悸恍惚，忧愁烦躁面色不佳，舌强，宜用养荣汤、琥珀定神丸之类，来补益心血。脾虚则面色黄、肌肉消瘦，呕吐腹泻清冷，腹胀肠鸣，四肢无力，饮食不进，宜用快胃汤、进食丸之类，来调理饮食。肝虚则目昏、筋脉拘挛，面色青、恐惧，像被人追捕的样子，宜用牛膝益中汤、虎骨丹之类，来滋养辅助筋脉。肺虚则呼吸短气，喘促乏力咳嗽，咽喉干燥，宜用枳实汤加人参、黄芪、阿胶、苏子，来调理肺气。肾虚则腰背脊膝厥冷疼痛，精神困倦耳鸣，小便频数，遗精，宜用八味丸加五味子、鹿茸，去掉附子，用山药等制成丸药，来滋生肾精。
【朱丹溪】劳瘵主要在于阴虚、痰和血的病变。虚劳逐渐消瘦属于火，阴火消烁，就是积热，应该按照后面的方法治疗。
草还丹 治疗阴虚骨蒸。
用青蒿一斗五升，童子尿三斗，用文武火熬煮，大约童子尿减少到二斗，去掉青蒿，再熬至一升，加入七个猪胆，再熬几沸。用甘草末收拢调和做成丸药，梧桐子大小，每次服用五十丸。
治疗劳病，四物汤加竹沥，加入小便。阴虚发热，四物汤加黄柏，降火补阴，严重的加龟板。
【张文仲】治疗骨蒸的方子。
生地黄一升，捣取汁液，分次服完。如果腹泻则减量，以身凉为标准。
以上是丹溪论述劳瘵主乎阴虚的内容。大概从子时到巳时属阳，从午时到亥时属阴，阴虚则热出现在午后子前。醒着属阳，睡觉属阴，阴虚则汗在睡眠时盗出。上升属阳，下降属阴，阴虚则气不下降，气不下降则痰涎上逆，连绵吐出不绝。脉浮属阳，沉属阴，阴虚则浮取洪大，沉取空虚。这些都是阴虚的症状，用四物汤、竹沥，又加炒黄柏、龟板，都是补阴降火的方剂。还必须远离嗜欲，清淡饮食，静心调养，以助恢复。
【朱丹溪】阴虚发热，四物汤加黄柏。兼有气虚的，加人参、黄芪、白术。
御院琼玉膏 滋血补气，延年益寿。
人参（三十六两，去芦须，研为净末） 白茯苓（二十四两，去皮，研为细末） 生地黄（十六斤，捣取汁，以尽为度，去渣） 蜜（六斤）
以上混合均匀，放入银石器瓶中。内部用油纸，外部用竹叶包裹，用软篾扎紧瓶口，放入重汤内悬胎煮制。用桑柴文武火不停地煮三个昼夜，放入井中浸泡一天一夜以去火毒。再煮一天，去除阴毒，取出。每天早晨空腹用酒或白开水调服。
【罗天益】清神甘露丸 治疗男子妇人虚劳不足，大骨枯槁，大肉陷下都治疗。
生地汁 白莲藕汁 生乳汁（生用）
以上三味等分，在砂石器内，用文武火熬成膏状，用以下药物。
人参 白术 黄连 黄芪 五味子 胡黄连
以上各等分为细末，以前面的膏子和剂，做成梧桐子大小的丸药。每次服用五十丸，用人参汤送下。
【李东垣/海藏】黄芪膏子煎丸
人参 白术（各一两半） 柴胡 黄芩（各一两） 白芷 知母（各半两） 甘草（半两，炒） 鳖甲（一两，手掌大的，酥炙） 黄芪（半斤，切成粗末，用水二斗，熬成一斗，去渣再熬，令不停地搅拌成膏，至半斤，加入白蜜一匙，盐一两，再熬熟，放冷后用来和药丸）
以上为末，用黄芪膏和匀做丸，每天早晨白开水送服。呼吸少气，懒言语，无力动作，眼睛无神采，面色㿠白，都是兼有气虚的表现。
【朱丹溪】补天丸 治疗阴虚骨蒸发热，形体羸瘦的人。
紫河车洗净，用布绞干，用补肾丸药末捣细焙干，再碾为末，酒煮米糊为丸。梧桐子大小。每次服用七八十丸，热汤送下。夏季加五味子。紫河车，即初生男子的胞衣。
补肾丸 治疗阴虚有痰，膈间不清爽的人。
龟板（一两半，酥炙） 黄柏（一两半，炒） 牛膝（二两） 干姜（二钱） 陈皮（半两）
以上为末，姜汁打糊为丸，每次服用七八十丸。
治疗因酒色过度损伤少阴。
黄柏（一两半，炒） 黄芩（半两，炒） 地黄（一两） 龟板（五两，酒炒）
夏季加砂仁三钱，五味子五钱。冬季加干姜炒黑三钱。用炊饼为丸，饭前白开水送服三五十丸。（《丹溪心法》中以地黄代替黄柏）
【张洁古】地黄丸 治疗久病新病憔悴，睡中出汗发热，五脏齐损，瘦弱虚烦，肠风下血，骨蒸，痿弱无力，不能运动。东垣说：治疗脉沉而虚的人。
熟地黄（八两） 山茱萸（净肉） 山药（各四两） 牡丹皮 茯苓 泽泻（各三两）
以上为细末，炼蜜为丸，梧桐子大小。空心温酒送服五十丸。
【李东垣】有人问钱乙的地黄丸补肾，又说补肝，为什么呢？回答说：是的，手厥阴心主包络，足厥阴肝经，都治理在下焦。经书说：不足者滋其化源。所以肝肾的疾病治疗方法相同，这就是地黄丸补益这两经的意思。（海藏说：如果加五味子成为肾气丸，这是滋肺之源以生肾水。）
【《保命集》】黑地黄丸加五味子，成为肾气丸，治疗阳盛阴衰，脾胃不足，房室虚损，形体消瘦无力，面色多青黄，而无常色，这是补气益胃。
苍术（一斤，油浸） 熟地黄（一斤） 五味子（半斤） 干姜（秋冬一两，夏半两，春七钱）
以上为细末，枣肉为丸，梧桐子大小。饭前米饮，或酒送服一百丸。治疗血虚久患痔疮非常妙。经书说：肾苦燥，急食辛以润之。此药开腠理，生津液通气。又五味子酸以收敛之，此虽阳盛但不燥热，乃是五脏虚损于内，故可益血收气，此药类象神品方也。
治疗阳盛心肺不足，宜用八味丸。四肢弱无力多困，不知阴阳先损，夏天可用用地黄丸，春秋宜用肾气丸，冬天宜用八味丸。
【云岐子】鸡苏丸 治疗咳血。（方见咳唾血。）
以上治疗肺肾虚。大概肝心属阳，肺肾属阴，阴虚则肺肾虚了。肾虚者从房室中来，其症状或腰酸腰痛，或足酸足痿足热，或遗精白浊是也。肺虚者，或咳嗽或吐血是也。治疗肾虚四方，前二方龟板、黄柏为君药，有痰无痰皆可用。后二方地黄为君药，无痰可用，痰多而膈不清者宜审慎。治疗肺虚咳嗽唾血者，方法浩大，另立咳嗽唾门也。
【朱丹溪】虚劳都是积热造成的。开始时健康，可用子和法。日后羸惫，四物汤加减，送服消积丸，使热不作。蒸蒸发热，积病最多。小陷胸汤，治疗湿痰发热极妙。（方见伤寒部结胸门。）
退实热劳积痰。
鳖甲 龟板 侧柏 栝蒌仁 半夏 黄连 黄柏
以上为末，炊饼为丸。
又有湿痰发热。
黄芩（炒） 黄连（炒） 香附（生） 苍术。
以上为末，栝蒌瓤为丸。
青礞石丸（方见咳嗽。） 河间人参半夏丸（方见咳嗽。）
【朱丹溪】治疗施官人，年三十余，不可劳动，劳动则发热，脉洪而大在右手，短而涩在左手。我说这必定是酒痰成湿伤血。又问，遇少劳则喘乏力，小便或赤或白。
当归 黄芪 人参（各五分） 芍药（一分） 白术（二分半） 川芎（五分） 木通（三分） 黄芩（三分） 陈皮（五分） 浓朴（五分） 炙甘草（二分）
煎汤下青礞石丸。
【罗天益】柴胡饮子 解一切肌骨蒸热，寒热往来，及伤寒发汗不解，或汗后余热劳复，或妇人经病不快。产后但有如此之症，并宜服之。
黄芩 甘草（炙） 大黄 芍药 柴胡 人参 当归（各半两）
以上切碎，姜三片，煎热服。
【《保命集》】防风当归饮子 治疗烦热皮肤索泽。食后煎服，空心，宜以此饮下地黄丸。
柴胡 人参 黄芩 甘草 防风 大黄 当归 芍药（各半两） 滑石（二钱）
以上切碎，每服五钱，水一盏半，姜三片，煎七分，温服。如痰嗽加半夏。如大便黄米谷完出，惊悸，溺血。淋闭，咳血衄血。自汗头痛，积热肺痿，后与大金花丸。
大金花丸
黄柏 黄芩 黄连 山栀（各八两）
以上为细末，水丸小豆大，每次服用一百丸，温水送下，每日二三服。或大便实加大黄。自利，如中外热者，此药作散煎服，名解毒汤。或腹痛呕吐欲作痢者，每服解毒汤半两，加半夏、茯苓、浓朴各三钱，姜三片。如白脓后重，下痢后重者，加大黄三钱。
麦煎散 治疗少男室女骨蒸，妇人风血攻疰四肢。
赤茯苓 当归 干漆 鳖甲（醋炙） 常山 大黄（煨） 柴胡 白术 生地 石膏（各一两） 甘草（半两）
以上为末，每服三钱，小麦五十粒，水煎，食后临卧服。若有虚汗，加麻黄根一两。东坡说：这是黄州吴判官治疗骨蒸黄瘦，口臭肌热，盗汗极效。吴君宝之，不肯妄传。
当归龙荟丸 治疗肝有积痰污血，结热而劳瘵者。其太冲脉必与冲阳脉不相应，宜以补阴药吞此丸神效。（方见前。）
上述劳瘵兼痰积，其症状腹胁常热，手足头面则于寅卯时分乍有凉时者是也。若顽痰胶固难治者，必以吐法吐之，或沉香滚痰丸、透膈丹之类下之。又甚者，或用倒仓法。若痰积闭塞经脉，则太冲脉与冲阳寸口脉数而不相应者，极难治。自阴虚条至此，凡六法，但患劳者，罕能脱此六法。自此以后数法，宜审而行之，无其病，莫妄施也。
【世传】治疗骨蒸热，神效。
前胡（一钱） 柴胡（二钱） 胡黄连（一钱） 猪脊髓（一条） 猪胆（一个）
以上水煎，入猪胆汁服之。
【石学】地骨皮枳壳散 治疗骨蒸壮热，肌肉消瘦，少力多困，夜多盗汗。
地骨皮 秦艽 柴胡 枳壳 知母 当归 鳖甲（醋炙黄）
上等分为末，水一盏，桃柳枝头各七个，姜三片，乌梅一个，去渣临卧服。
【罗天益】秦艽鳖甲散 治疗骨蒸壮热，肌肉消瘦，舌红颊赤，目倦盗汗。
柴胡 地骨皮（各一两） 秦艽 知母 当归（各半两） 鳖甲（一两，去裙襕，醋炙）
以上为粗末，每服五钱，水一盏，入乌梅一个，青蒿五叶，同煎至七分，去渣温服，临卧空心各一服。
人参地骨皮散 治疗脏中积冷，营中热，按之不足，举之有余，阴不足而阳有余也。
茯苓（半两） 知母 石膏（各一两） 地骨皮 人参 柴胡 生地（各一两五钱）
以上切碎，每服一两，生姜三片，水煎细细服。
人参柴胡散 治疗邪热客于经络，肌热痰嗽，五心烦躁，头目昏痛，夜有盗汗。及妇人虚劳骨蒸尤宜。
白茯苓 人参 白术 柴胡 当归 半夏曲 干葛 甘草（炙） 赤芍药（以上各一两）
以上为细末，每服三钱，姜四片，枣三枚，水煎带热服。（许学士说：但有劳热症皆可服，热退即止。大抵透肌葛根第一，柴胡次之，其方多黄芩半两。）
上述四方，治疗虚损复受邪热，皆宜用柴胡。《衍义》说：柴胡《本经》并无一字治劳，今人方中，治劳鲜有不用者，误人甚多。常原病劳有一种真脏虚损，复受邪热，因虚而致劳。故曰：劳者牢也，当斟酌之。如经验方治劳热青蒿煎丸，用柴胡正宜，服之无不效，热去即须急已。若无邪热，得此愈甚，虽至死，人亦不怨。王海藏说：苟无实热，医取用之，不死何待？后之用柴胡者，宜审诸。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。
火郁汤（方见前。） 柴胡升阳汤（方见前。）
上述两方治疗重阴覆其阳，火不得伸，或洒洒恶寒，或志意不乐，或脉弦数，或四肢五心烦热是也。病去即已，不可过剂。服寒凉药，症虽大减，脉反加数者，阳郁也。大忌寒凉，宜升宜补，犯之死速。
【李东垣/海藏】问两手寸关弦，病脾弱，火胜木旺，土亏金铄，当作何治？答曰：不治标本，从乎中治。木标也，土本也，火中也。烁金亏土旺木者，皆火也，钱仲阳安神丸主之，山蓣、麦冬益金之气，金益则气旺而木自平。寒水石、牙硝，火中添水，使化为湿热也。湿热为季夏之令，非土而何？故用朱砂以坠火下行，将退与子，权行湿令也，故脉弦得除而土自旺。秋喘，加人参、丹砂等，夏则不加。养气者，加沉香。欲发汗者，临卧先与白粥一盏，后药之则汗也。寒热神少振摇。小便淋或多，或大便走，完谷不化，口干舌缩，唇吻有疮，心下痞，大渴引饮，恶干喜湿，目花，四肢无力，怠惰嗜卧，食不入，皮肤燥涩，面色黧黑，肌肉消铄，胸腹中急，额
[From "Xuan"] "Deficiency" refers to the insufficiency of skin, hair, muscles, sinews, vessels, bones and marrow, Qi, Blood, and Body Fluids. If men and women engage in heavy labor all day, causing mental exhaustion and physical fatigue, with irregular eating habits (overeating or fasting), excessive emotions (anger, joy, worry, thought), exposure to cold, consumption of cold drinks, and indulgence in sexual desires without restraint. *Su Wen* states: People nowadays show signs of aging before fifty because they treat wine as if it were water, make aberrant behavior their norm, have intercourse while drunk, exhaust their essence through desire, and dissipate their true Qi. The root of life thus becomes deficient and depleted. How can the Five Zang and Six Fu organs not become weak? The Five Exhaustions, Six Extremes, and Seven Injuries begin from here. What are the Five Exhaustions? Heart exhaustion damages Blood; Liver exhaustion damages Spirit (Shen); Spleen exhaustion damages Food digestion; Lung exhaustion damages Qi; Kidney exhaustion damages Essence (Jing). The Six Extremes refer to the extreme depletion of sinews, vessels, flesh, skin, hair, and bones, called the Six Extremes. The Seven Injuries are explained in detail in *Nan Jing*, referring to injuries to form and Qi, called the Seven Injuries. In summary, these are all deficiency patterns. Generally speaking, among the Five Elements and Six Qi, Water is only one part. Since the single Water is already deficient, how can it overcome the Five Fires? Thus, deficiency-lao diseases arise like swarms. Those with a deficient constitution are most susceptible to pathogenic factors. Treatment should first involve harmonization, mild purgation or draining, following the slow progression of the disease, followed by regulation. Physicians who do not realize that pathogenic factors remain on the body and have not been eliminated, but instead use tonifying agents, allow the pathogens to enter the channels and collaterals with the help of tonification, leading to death that cannot be cured. Such errors number in the thousands. It is truly tragic! *Nei Jing* originally had no concept of "Lao syndrome." When it says "For lao, use warmth," "warmth" implies a gentle, nurturing approach. "For insufficiency, tonify with flavor," grains, meats, vegetables, and fruits, all flavors of delicacies, are essentially tonics. Modern physicians, failing to understand this method, only know the way of heavy tonification. Mildly, they use Dang Gui (Angelicae Sinensis Radix), Lu Rong (Cervi Cornu Pantotrichum), Xiong Huang (Realgar), and Fu Zi (Aconiti Lateralis Radix Preparata); heavily, they use Ru Shi (Margarita) and Dan Sha (Cinnabaris), adding moxibustion to dry and warm the Water. Water, when heated, becomes even more dried up, and Fire increases further. Young people develop cough, hemoptysis, tidal fever, irritability, thirst, and preference for cold drinks; this is clearly a Heat pattern. In severe cases, loss of voice occurs, which is incurable. Yet they continue with harsh tonification. Those who die this way are killed by doctors. When encountering skilled physicians who treat effectively with cooling agents, patients may disagree and blame them; hearing of releasing the exterior or purging the interior, they fear and refuse, preferring to die at the hands of mediocre doctors using hot tonification, unrepentant even in death. This is deeply pitiable. Cooling agents nourish Water and clear Fire; heating agents dry Water and supplement Fire. All things in the world follow principles. Once principles are clear, why worry about the disease not healing? Lao is clearly a Heat pattern; can it still be tonified? Only those without pathogens, heat, or stagnation, whose pulse is weak and powerless upon lifting and pressing, can be tonified. One must also examine whether the Stomach and the Ministerial Fire of the Right Kidney are deficient before using tonification. Heart deficiency causes palpitations and confusion, worry, irritability, poor complexion, and stiff tongue; use Yang Rong Tang (Nourish Ying Decoction) or Hu Po Ding Shen Wan (Amber Calming Spirit Pill) to benefit Heart Blood. Spleen deficiency presents with yellow face, emaciation, vomiting and diarrhea of clear/cold nature, abdominal distension, borborygmus, limb weakness, and anorexia; use Kuai Wei Tang (Quick Stomach Decoction) or Jin Shi Wan (Promote Appetite Pill) to regulate diet. Liver deficiency causes blurred vision, sinew spasm, blue complexion, and fear (feeling as if being hunted); use Niu Xi Yi Zhong Tang (Achyranthes Benefit Middle Decoction) or Hu Gu Dan (Tiger Bone Elixir) to nourish sinews. Lung deficiency causes shortness of breath, asthenic cough, dry throat; use Zhi Shi Tang (Immature Bitter Orange Decoction) added with Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), E Jiao (Colla Corii Asini), and Su Zi (Perillae Fructus) to regulate Qi. Kidney deficiency causes cold pain in lower back, spine, knees, and extremities, mental fatigue, tinnitus, frequent urination, and seminal emission; use Ba Wei Wan (Eight-Ingredient Pill) added with Wu Wei Zi (Schisandrae Fructus) and Lu Rong (Cervi Cornu Pantotrichum), removing Fu Zi (Prepared Aconite Root), using Shan Yao (Dioscoreae Rhizoma) etc. as pills to generate Essence.
[Zhu Danxi] Lao Zhai (Consumptive Disease) primarily involves Yin deficiency, Phlegm, and Blood pathology. Deficiency-lao with gradual emaciation belongs to Fire; Yin Fire consumes and melts, constituting accumulated Heat. Treat according to the methods below.
Cao Huan Dan (Grass Returning Pill) treats Yin deficiency with bone-steaming fever.
Use Qing Hao (Artemisiae Annuae Herba) 1.5 dou, and urine from a healthy child 3 dou. Decoct over mild fire until urine reduces to 2 dou, remove Qing Hao, decoct further to 1 sheng. Add 7 pig gallbladders, boil briefly. Use Gan Cao (Glycyrrhizae Radix et Rhizoma) powder to bind into pills, size of wu zi (cibotium seeds). Take 50 pills per dose.
To treat lao disease, Si Wu Tang (Four Substances Decoction) added with Zhu Li (Bambusae Succus) and urine. For Yin deficiency with fever, Si Wu Tang added with Huang Bo (Phellodendri Cortex) to descend Fire and tonify Yin; add Gui Ban (Testudinis Carapax et Plastrum) for severe cases.
[Zhang Wenzhong] Formula for treating bone-steaming.
Sheng Di Huang (Rehmanniae Radix) 1 sheng. Crush to extract juice, divide and take. Reduce dose if diarrhea occurs; stop when body cools.
The above is Danxi's discussion on Lao Zhai being primarily due to Yin deficiency. From Zi hour to Si hour belongs to Yang; from Wu hour to Hai hour belongs to Yin. Yin deficiency leads to heat appearing between Wu and Zi hours. Being awake belongs to Yang, sleeping belongs to Yin; Yin deficiency leads to night sweats during sleep. Ascending belongs to Yang, descending belongs to Yin; Yin deficiency leads to failure of Qi to descend. Failure of Qi to descend leads to counterflow of phlegm-saliva, resulting in continuous spitting. Floating pulse belongs to Yang, deep pulse belongs to Yin; Yin deficiency leads to floating pulse being surging and large, deep pulse being empty. These are all symptoms of Yin deficiency. Using Si Wu Tang, Zhu Li, plus fried Huang Bo and Gui Ban are all formulas that tonify Yin and descend Fire. One must also avoid sexual desires, eat bland food, and rest quietly to assist recovery.
[Zhu Danxi] For Yin deficiency with fever, Si Wu Tang added with Huang Bo. If accompanied by Qi deficiency, add Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), and Bai Zhu (Atractylodis Macrocephalae Rhizoma).
Yu Yuan Qiong Yu Gao (Imperial Court Jade-Jade Paste) nourishes Blood, benefits Qi, prolongs life and health.
Ren Shen (36 liang, remove rhizome and whiskers, grind to fine powder) Bai Fu Ling (Poria) (24 liang, remove skin, grind to fine powder) Sheng Di Huang (16 jin, crush to extract juice until exhausted, remove dregs) Mi (Honey) (6 jin)
Mix well, put into silver or earthenware bottle. Line inside with oil paper, outside with bamboo leaves, tie tightly with soft rattan. Suspend in double-boiler and cook. Use mulberry wood fire (mild to strong) continuously for three days and nights. Soak in a well for one day and night to remove fire toxicity. Cook again for one day to remove yin toxicity. Remove. Take every morning on an empty stomach with wine or plain boiled water.
[Luo Tianyi] Qing Shen Gan Lu Wan (Clear Spirit Sweet Dew Pill) treats deficiency-lao insufficiency in men and women, including skeletal emaciation and muscular wasting.
Sheng Di Zhi (Juice of Rehmannia Root) Bai Lian Ou Zhi (Juice of White Lotus Rhizome) Sheng Niu Nai (Raw Cow's Milk)
Take equal parts of the above three ingredients. Decoct in stone/earthenware vessel over mild fire to form a paste. Use the following herbs.
Ren Shen Bai Zhu Huang Lian Huang Qi Wu Wei Zi Hu Huang Lian
Grind each to fine powder. Mix with the previous paste to form pills the size of tung seeds. Take 50 pills per dose, washed down with Ren Shen decoction.
[Li Dongyuan/Hai Zang] Huang Qi Gao Zi Jian Wan (Astragalus Paste Pill)
Ren Shen Bai Zhu (each 1.5 liang) Chai Hu Huang Qin (each 1 liang) Bai Zhi Zhi Mu (each 0.5 liang) Gan Cao (0.5 liang, stir-fried) Bie Jia (1 liang, palm-sized, pan-fried with butter) Huang Qi (0.5 jin, cut into coarse pieces, decoct in 2 dou water to 1 dou, remove dregs, decoct again stirring constantly until paste forms, reduce to 0.5 jin, add 1 spoonful white honey and 1 liang salt, cook until ready, cool to mix with pills)
Grind above to powder. Mix with Huang Qi paste to form pills. Take every morning with plain boiled water. Shortness of breath, reluctance to speak, lack of strength for movement, dull eyes, pale complexion indicate concurrent Qi deficiency.
[Zhu Danxi] Bu Tian Wan (Heaven-Replenishing Pill) treats Yin deficiency with bone-steaming fever and emaciation.
Zi He Che (Placenta Hominis) wash clean, squeeze dry with cloth. Mix with powder of Bu Shen Wan (Kidney-Tonifying Pill), grind fine, bake dry, grind again. Make pills with rice paste cooked in wine. Size of wu zi. Take 70-80 pills per dose with hot water. Add Wu Wei Zi in summer. Zi He Che is the placenta of a newborn male infant.
Bu Shen Wan (Kidney-Tonifying Pill) treats Yin deficiency with Phlegm and chest oppression.
Gui Ban (1.5 liang, pan-fried with butter) Huang Bo (1.5 liang, stir-fried) Niu Xi (2 liang) Gan Jiang (2 qian) Chen Pi (0.5 liang)
Grind to powder. Make pills with ginger juice paste. Take 70-80 pills per dose.
Treats Shaoyin injury from excessive alcohol and sex.
Huang Bo (1.5 liang, stir-fried) Huang Qin (0.5 liang, stir-fried) Di Huang (1 liang) Gui Ban (5 liang, wine-fried)
Add Sha Ren (3 qian) and Wu Wei Zi (5 qian) in summer. Add Gan Jiang charred black (3 qian) in winter. Make pills with steamed bread dough. Take 30-50 pills before meals with plain boiled water. (*Danxi Xin Fa* uses Di Huang instead of Huang Bo).
[Zhang Congzheng/Jie Gu] Di Huang Wan (Rehmannia Pill) treats chronic or acute emaciation, night sweats with fever, damage to all five Zang, thinness and weakness with vexation, intestinal wind with blood in stool, bone-steaming, flaccidity and weakness unable to move. Dong Yuan said: Treats deep and deficient pulses.
Shu Di Huang (8 liang) Shan Zhu Yu (cleaned flesh) Shan Yao (each 4 liang) Mu Dan Pi Fu Ling Ze Xie (each 3 liang)
Grind to fine powder. Make pills with refined honey, size of tung seeds. Take 50 pills with warm wine on an empty stomach.
[Li Dongyuan] Someone asked: Qian Yi's Di Huang Wan tonifies Kidney, yet also says it tonifies Liver. Why? Answer: Yes. Hand Jueyin Pericardium and Foot Jueyin Liver channel both govern the Lower Jiao. The Classic says: "For insufficiency, nourish its source of transformation." Therefore, Liver and Kidney diseases share the same treatment method. This is the meaning behind Di Huang Wan tonifying these two channels. (Hai Zang said: If Wu Wei Zi is added to become Shen Qi Wan, this nourishes Lung source to generate Kidney Water.)
[Bao Ming Ji] Hei Di Huang Wan (Black Earth Yellow Pill) added with Wu Wei Zi becomes Shen Qi Wan. Treats Yang excess and Yin deficiency, Spleen/Stomach insufficiency, sexual debility, emaciation and weakness, green-yellow complexion without constant color. This benefits Qi and tonifies Stomach.
Cang Zhu (1 jin, soaked in oil) Shu Di Huang (1 jin) Wu Wei Zi (0.5 jin) Gan Jiang (1 liang autumn/winter, 0.5 liang summer, 7 qian spring)
Grind to fine powder. Make pills with jujube flesh, size of wu zi. Take 100 pills before meals with rice drink or wine. Excellent for chronic hemorrhoids due to Blood deficiency. Classic says: "Kidney dislikes dryness; urgently eat pungent to moisten it." This formula opens pores, generates fluids, and moves Qi. Wu Wei Zi is sour to astringe. Although Yang is excess, it is not dry-hot; rather, it is internal deficiency-damage of five Zang. Thus it benefits Blood and gathers Qi. This formula is a divine prescription based on correspondence.
For Yang excess with Heart/Lung insufficiency, use Ba Wei Wan (Eight-Ingredient Pill). Weak limbs, fatigue, unknown initial Yin/Yang damage: Summer use Di Huang Wan; Spring/Autumn use Shen Qi Wan; Winter use Ba Wei Wan.
[Yun Qi Zi] Ji Su Wan (Chicken Mint Pill) treats hemoptysis. (Formula see Cough/Sputum Blood section.)
Above treats Lung/Kidney deficiency. Liver and Heart belong to Yang; Lung and Kidney belong to Yin. Yin deficiency leads to Lung/Kidney deficiency. Kidney deficiency comes from sexual activity; symptoms include sore/lower back pain, sore/weak/hot feet, spermatorrhea, or cloudy urine. Lung deficiency includes cough or hematemesis. Four formulas for Kidney deficiency: First two use Gui Ban and Huang Bo as sovereign herbs, usable with or without Phlegm. Last two use Di Huang as sovereign, usable without Phlegm; for abundant Phlegm and chest obstruction, use with caution. Methods for Lung deficiency cough/hemoptysis are vast; see separate Cough/Sputum section.
[Zhu Danxi] Deficiency-lao is formed by accumulated Heat. Initially healthy, use Hezi's method. Later, when emaciated, modify Si Wu Tang, send Xiao Ji Wan (Accumulation-Dissolving Pill) to prevent heat generation. Steaming fever indicates many accumulation diseases. Xiao Xian Xiong Tang (Minor Trap-in-the-Chest Decoction) is excellent for damp-phlegm fever. (See Shang Han Section, Jie Xiong section.)
Reduce Excess Heat, Lao Accumulation, and Phlegm.
Bie Jia Gui Ban Ce Bai Gua Lou Ren Ban Xia Huang Lian Huang Bo
Grind to powder. Make pills with steamed bread dough.
Also for Damp-Phlegm Fever.
Huang Qin (stir-fried) Huang Lian (stir-fried) Xiang Fu (raw) Cang Zhu.
Grind to powder. Make pills with Gua Lou pulp.
Qing Meng Shi Wan (Green Malachite Pill) (See Cough.) He Jian Ren Shen Ban Xia Wan (He Jian Ginseng Pinellia Pill) (See Cough.)
[Zhu Danxi] Treating Official Shi, over 30 years old, cannot exert himself; exertion causes fever. Pulse surging and large on right hand, short and choppy on left hand. I said this must be Wine-Phlegm forming Dampness injuring Blood. Asked further: slight exertion causes panting and weakness, urine sometimes red, sometimes white.
Dang Gui Huang Qi Ren Shen (each 5 fen) Shao Yao (1 fen) Bai Zhu (2.5 fen) Chuan Xiong (5 fen) Mu Tong (3 fen) Huang Qin (3 fen) Chen Pi (5 fen) Hou Po (5 fen) Zhi Gan Cao (2 fen)
Decoct soup, take with Qing Meng Shi Wan.
[Luo Tianyi] Chai Hu Yin Zi (Bupleurum Drink) resolves all muscle/bone steaming heat, alternating chills/fever, and unresolved sweating from Shang Han, or residual heat/lao relapse after sweating, or menstrual discomfort in women. Postpartum with such symptoms should also take it.
Huang Qin Zhi Gan Cao Da Huang Shao Yao Chai Hu Ren Shen Dang Gui (each 0.5 liang)
Chop. Add 3 slices ginger. Decoct, take hot.
[Bao Ming Ji] Fang Feng Dang Gui Yin Zi (Saposhnikovia Angelica Drink) treats irritability, heat, rough skin. Decoct after meals. On empty stomach, take with Di Huang Wan.
Chai Hu Ren Shen Huang Qin Gan Cao Fang Feng Da Huang Dang Gui Shao Yao (each 0.5 liang) Hua Shi (2 qian)
Chop. Take 5 qian per dose. Add 1.5 cups water, 3 slices ginger. Decoct to 0.7 cup. Take warm. Add Ban Xia for phlegm-cough. For yellow stool with undigested grain, palpitations, hematuria, stranguria, hemoptysis, epistaxis, spontaneous sweating, headache, accumulated heat lung abscess, follow with Da Jin Hua Wan.
Da Jin Hua Wan (Great Golden Flower Pill)
Huang Bo Huang Qin Huang Lian Shan Zhi (each 8 liang)
Grind to fine powder. Make water pills size of mung beans. Take 100 pills per dose with warm water, 2-3 times daily. Add Da Huang if stool is hard. For loose stools with internal/external heat, make powder and decoct, named Jie Du Tang (Detoxifying Decoction). For abdominal pain, vomiting, impending dysentery, take 0.5 liang Jie Du Tang, add Ban Xia, Fu Ling, Hou Po (each 3 qian), 3 slices ginger. For white pus with tenesmus or dysentery tenesmus, add 3 qian Da Huang.
Mai Jian San (Wheat Decoction Powder) treats bone-steaming in young men/women, wind-blood attacking limbs in women.
Chi Fu Ling Dang Gui Gan Qi Bie Jia (vinegar-fried) Chang Shan Da Huang (baked) Chai Hu Bai Zhu Sheng Di Shi Gao (each 1 liang) Gan Cao (0.5 liang)
Grind to powder. Take 3 qian per dose. Add 50 wheat grains. Decoct in water. Take after meals before bed. For deficiency sweating, add Ma Huang Gen (Ephedrae Radix et Rhizoma) 1 liang. Dongpo said: This was used by Judge Wu of Huangzhou to treat bone-steaming, yellow emaciation, foul breath, muscle heat, and night sweats with great effect. Mr. Wu treasured it and did not spread it lightly.
Dang Gui Long Hui Wan (Angelica Gardenia Pill) treats Liver with accumulated phlegm and dirty blood, knotted heat, and lao zhai. Taichong pulse will definitely not correspond with Chongyang pulse. Swallow this pill with Yin-tonifying medicine for miraculous effect. (See previous section.)
Above, Lao Zhai combined with Phlegm-Accumulation: symptoms include constant heat in abdomen/flanks, but coolness in hands/feet/head/face during Yin/Mao hours. For stubborn phlegm that is difficult to treat, induce vomiting, or use Chen Xiang Gun Tan Wan (Agarwood Rolling Phlegm Pill) or Tou Ge Dan (Penetrating Diaphragm Elixir) to purge. For severe cases, use Dao Cang Fa (Inverting Granary Method). If Phlegm-Accumulation blocks meridians, making Taichong and Chongyang/Cunkou pulses rapid and uncorrelated, it is extremely difficult to treat. From the Yin deficiency section to here, there are six methods. Few lao patients escape these six methods. Subsequent methods should be practiced with caution; do not apply blindly without disease.
[World Transmission] Treats bone-steaming heat, miraculous effect.
Qian Hu (1 qian) Chai Hu (2 qian) Hu Huang Lian (1 qian) Zhu Ji Sui (1 strip) Zhu Dan (1 gallbladder)
Decoct in water. Add pig bile and take.
[Shi Xue] Di Gu Pi Zhi Ke San (Groundcherry Bark Aurantium Powder) treats bone-steaming high fever, muscle emaciation, weakness and fatigue, frequent night sweats.
Di Gu Pi Qin Jiao Chai Hu Zhi Mu Zhi Mu Dang Gui Bie Jia (vinegar-fried yellow)
Grind equal parts to powder. Add 1 cup water, 7 peach branch tips, 7 willow branch tips, 3 slices ginger, 1 wumei. Remove dregs. Take before bed.
[Luo Tianyi] Qin Jiao Bie Jia San (Gentian Turtle Shell Powder) treats bone-steaming high fever, muscle emaciation, red tongue and cheeks, tired eyes, night sweats.
Chai Hu Di Gu Pi (each 1 liang) Qin Jiao Zhi Mu Dang Gui (each 0.5 liang) Bie Jia (1 liang, remove skirt, vinegar-fried)
Grind to coarse powder. Take 5 qian per dose. Add 1 cup water, 1 wumei, 5 Qing Hao leaves. Decoct to 0.7 cup. Remove dregs. Take warm. One dose before bed on empty stomach, one dose at bedtime.
Ren Shen Di Gu Pi San (Ginseng Groundcherry Bark Powder) treats accumulated cold in Zang, heat in Ying, insufficient upon pressing, excess upon lifting, Yin insufficiency and Yang excess.
Fu Ling (0.5 liang) Zhi Mu Shi Gao (each 1 liang) Di Gu Pi Ren Shen Chai Hu Sheng Di (each 1.5 liang)
Chop. Take 1 liang per dose. Add 3 slices ginger. Decoct in water. Sip slowly.
Ren Shen Chai Hu San (Ginseng Bupleurum Powder) treats pathogenic heat lodging in channels/collaterals, muscle heat, phlegm-cough, five-palm vexation, dizziness/headache, night sweats. Especially suitable for women's deficiency-lao bone-steaming.
Bai Fu Ling Ren Shen Bai Zhu Chai Hu Dang Gui Ban Xia Qu Gan Ge Zhi Gan Cao Chi Shao Yao (each 1 liang above)
Grind to fine powder. Take 3 qian per dose. Add 4 slices ginger, 3 jujubes. Decoct in water. Take hot. (Xu Xueshi said: Can be taken for any lao-heat syndrome; stop when heat subsides. Generally, Ge Gen (Puerariae Radix) is best for penetrating muscle, Chai Hu second; formulas often contain 0.5 liang Huang Qin.)
The above four formulas treat deficiency-damage complicated by pathogenic heat; all should use Chai Hu. *Yan Yi* says: Ben Jing has no word treating lao with Chai Hu. Modern formulas rarely omit it for lao, misleading many. Originally, lao involves true Zang deficiency complicated by pathogenic heat, leading to lao due to deficiency. Thus it is said: "Lao means firm/solid"; use discretion. For example, Jing Yan Fang's Qing Hao Jian Wan for lao-heat uses Chai Hu appropriately; effective without fail. Stop immediately when heat goes. Without pathogenic heat, taking it worsens condition; even death brings no resentment. Wang Haizang said: If no excess heat, doctor uses it, how can one not die? Future users of Chai Hu should examine carefully. Also strictly avoid Qin, Lian, Bo; sudden use of pure bitter-cold drugs drains Yang. Should use Qiong Yu Gao type to greatly assist Yang Qi, restoring it to Yin/Mao position, slightly adding drugs to drain Yin Fire.
Huo Yu Tang (Fire-Stagnation Decoction) (See previous.) Chai Hu Sheng Yang Tang (Bupleurum Ascending-Yang Decoction) (See previous.)
The above two formulas treat Heavy Yin covering Yang, Fire unable to extend, or chilliness, depression, wiry-rapid pulse, or heat in four limbs and five palms. Stop when disease resolves; do not overdose. Taking cold-cooling drugs reduces symptoms but pulse becomes faster: this is Yang stagnation. Strictly avoid cold-cooling; should ascend and tonify. Violation leads to rapid death.
[Li Dongyuan/Hai Zang] Question: Wiry pulse at Cun/Guan on both hands, Spleen weakness, Fire overcoming Wood, Wood flourishing, Earth deficient, Metal scorched. How to treat? Answer: Do not treat root or branch; treat from the middle. Wood is branch, Earth is root, Fire is middle. Scorched Metal, deficient Earth, flourishing Wood are all Fire. Qian Zhongyang's An Shen Wan (Calming Spirit Pill) is primary. Shan Yao (Dioscoreae Rhizoma) and Mai Dong (Ophiopogonis Radix) benefit Metal Qi. Metal benefited leads to Qi flourishing and Wood naturally levels. Han Shui Shi (Halloysit Rubra) and Ya Xiao (Natrii Sulfas) add Water to Fire, transforming into Damp-Heat. Damp-Heat is the command of late summer; is this not Earth? Thus use Zhu Sha (Cinnabar) to sink Fire downward, yielding to Water, temporarily executing Damp command. Thus wiry pulse removes and Earth flourishes. Autumn asthma: add Ren Shen, Dan Sha, etc.; Summer: do not add. To nourish Qi: add Chen Xiang (Aquilariae Lignum Resinatum). To induce sweating: give a bowl of white porridge before bed, then take medicine, and sweat will occur. Chills/fever with little spirit movement. Stranguria or polyuria, or diarrhea with undigested grain, dry mouth, shriveled tongue, ulcers on lips, epigastric fullness, intense thirst seeking drink, dislike dryness prefer dampness, blurred vision, limb weakness, lethargy, anorexia, dry/rough skin, dark complexion, muscle wasting, tightness in chest/abdomen, forehead...