天津宁氏妇，年近四旬，素病虚劳，偶因劳碌过甚益增剧。
病因 处境不顺，家务劳心，饮食减少，浸成虚劳，已病倒卧懒起床矣。又因讼事，强令
公堂对质，劳苦半日，归家病大加剧。
证候 卧床闭目，昏昏似睡，呼之眼微开不发言语，有若能言而甚懒于言者。其面色似有浮热
，体温38·8℃，问其心中发热乎？觉怔忡乎？皆颔之。其左脉浮而弦硬，右脉浮而芤，皆不任重
按，一息六至。两日之间，惟少饮米汤，大便数日未行，小便亦甚短少。
诊断 即其脉之左弦右芤，且又浮数无根，知系气血亏极有阴阳不相维系之象。是以阳气上浮
而面热，阳气外越而身热，此乃虚劳中极危险之证也。所幸气息似稍促而不至于喘，虽有
咳嗽亦不甚剧，知尤可治。斯当培养其气血，更以收敛气血之药佐之，俾其阴阳互相维系，
即可安然无虞矣。
处方 野台参（四钱） 生怀山药（八钱） 净萸肉（八钱） 生龙骨（八钱捣碎） 大甘枸杞（
六钱） 甘草（二钱） 生怀地黄（六钱） 玄参（五钱） 沙参（五钱） 生赭石（五钱轧细） 生杭芍（四钱）
共煎汤一大盅，分两次温饮下。
复诊 将药连服三剂，已能言语，可进饮食，浮越之热已敛，体温度下降至37.6℃，心中
已不发热，有时微觉怔忡，大便通下一次，小便亦利，遂即原方略为加减俾再服之。
处方 野台参（四钱） 生怀山药（一两） 大甘枸杞（八钱） 净萸肉（六钱）
生怀地黄（五钱） 甘草（二钱） 玄参（五钱） 沙参（五钱） 生赭石（四钱轧细） 生杭
芍（三钱） 生鸡内金（钱半黄色的捣）
共煎汤一大盅，温服。
方解 方中加鸡内金者，因虚劳之证，脉络多瘀，《金匮》所谓血痹虚劳也。用鸡内金以化其
血痹，虚劳可以除根，且与台
参并用，又能运化参之补力不使作胀满也。
效果 将药连服四剂，新得之病全愈，其素日虚劳未能尽愈。俾停服汤药，日用生怀山药
细末煮粥，少加白糖当点心服之。每服时送服生鸡内金细末少许以善其后。
天津宁氏的妇人，年龄接近四十岁，平时患有虚劳病（一种以脏腑亏损、气血阴阳不足为主要病机的慢性虚弱性疾病），偶然因为过度劳累而病情加重。
病因 处境不顺，家务事耗费心神，饮食减少，逐渐形成虚劳病，已经病倒卧床，懒得起床了。又因为诉讼之事，被强行要求在公堂上对质，劳累辛苦了半天，回家后病情大大加剧。
证候 卧床闭目，昏昏沉沉好像要睡着，叫她的话眼睛微微睁开但不说话，像是能说话但非常懒得开口。面色看起来有浮热（虚阳上浮导致的发热感），体温38.8℃，问她心中是否感觉发热？是否感到心悸怔忡（心跳不安）？她都点头表示同意。她的左脉浮取即得且弦硬，右脉浮取即得且芤（中空如葱管），都经不起重按，一息跳动六次（脉搏较快）。两天之间，只少量喝米汤，大便几天没有排解，小便也非常短少。
诊断 根据她脉象左弦右芤，且浮数而无根，知道这是气血极度亏虚，出现阴阳不能互相维系的现象。因此阳气上浮而导致面部发热，阳气外越而导致身体发热，这是虚劳病中极其危险的证候。所幸气息虽然稍促但没有发展到喘逆的程度，虽然有咳嗽也不剧烈，知道还可以治疗。此时应当培养其气血，并辅以收敛气血的药物，使阴阳能够互相维系，就可以安然无恙了。
处方 野台参（四钱） 生怀山药（八钱） 净萸肉（八钱） 生龙骨（八钱捣碎） 大甘枸杞（六钱） 甘草（二钱） 生怀地黄（六钱） 玄参（五钱） 沙参（五钱） 生赭石（五钱轧细） 生杭芍（四钱）
共煎煮成一大盅汤药，分两次温服。
复诊 将药连续服用三剂后，已经能够言语，可以进食，浮越的热气已经收敛，体温下降至37.6℃，心中不再感觉发热，有时轻微感到心悸怔忡，大便通了一次，小便也通畅了，于是就在原方基础上稍作加减让她继续服用。
处方 野台参（四钱） 生怀山药（一两） 大甘枸杞（八钱） 净萸肉（六钱）
生怀地黄（五钱） 甘草（二钱） 玄参（五钱） 沙参（五钱） 生赭石（四钱轧细） 生杭芍（三钱） 生鸡内金（一钱半，黄色的，捣碎）
共煎煮成一大盅汤药，温服。
方解 方中加入鸡内金的原因，是因为虚劳病的患者，脉络多有瘀滞，《金匮要略》中所说的血痹虚劳。使用鸡内金来化解血痹，虚劳就可以除根，而且与台参并用，又能运化人参的补益之力，防止产生胀满的感觉。
效果 将药连续服用四剂后，新得的急性病症完全痊愈，但她平素患有的虚劳病未能完全治愈。嘱咐停止服用汤药，每天用生怀山药细末煮粥，加少许白糖作为点心服用。每次服用时送服少许生鸡内金细末，以巩固疗效。
A woman surnamed Ning from Tianjin, nearly forty years old, had been suffering from Xu Lao (consumptive disease, a chronic weak condition characterized by deficiency of Zang-Fu organs, Qi, Blood, Yin, and Yang). Her condition worsened due to excessive physical exertion.
Etiology: Due to an unfavorable situation and mental strain from household affairs, her dietary intake decreased, gradually leading to Xu Lao. She had already fallen ill, lying in bed unwilling to get up. Additionally, due to a lawsuit, she was forced to undergo cross-examination in court for half a day. Upon returning home, her illness aggravated significantly.
Symptoms: She lay in bed with eyes closed, appearing drowsy as if asleep. When called, she opened her eyes slightly but did not speak, seeming capable of speech but extremely reluctant to do so. Her complexion showed signs of floating heat (a sensation of heat caused by the floating of deficient Yang), with a body temperature of 38.8°C. When asked if she felt heat in the heart or palpitations (Zhen Tong, anxiety with palpitations), she nodded affirmatively. Her left pulse was floating, wiry, and hard; her right pulse was floating and Kou (cork-like, hollow on pressure); neither could withstand heavy pressure. The pulse rate was six beats per breath (tachycardia). Over two days, she only drank small amounts of rice soup. She had not had a bowel movement for several days, and her urine output was very scanty.
Diagnosis: Based on the wiry left pulse and Kou right pulse, which are also floating, rapid, and rootless, it is known that this is a state of extreme deficiency of Qi and Blood, manifesting as a failure of Yin and Yang to sustain each other. Thus, Yang Qi floats upward causing facial heat, and Yang Qi escapes outward causing body heat. This is an extremely critical stage of Xu Lao. Fortunately, although her breathing is slightly hurried, it has not progressed to panting. Although there is coughing, it is not severe. It is known that the case is still treatable. At this point, one should nourish Qi and Blood, assisted by herbs that consolidate Qi and Blood, so that Yin and Yang can mutually sustain each other, ensuring safety and recovery.
Prescription: Ye Tai Shen (Wild Ginseng from Taicang, 4 qian), Sheng Huai Shan Yao (Raw Dioscorea opposita from Huai region, 8 qian), Jing Yu Rou (Cleaned Cornus officinalis fruit, 8 qian), Sheng Long Gu (Raw Dragon Bone, 8 qian, crushed), Da Gan Gou Qi (Large sweet Goji berry, 6 qian), Gan Cao (Licorice root, 2 qian), Sheng Huai Di Huang (Raw Rehmannia glutinosa from Huai region, 6 qian), Xuan Shen (Scrophularia root, 5 qian), Sha Shen (Glehnia or Adenophora root, 5 qian), Sheng Zhe Shi (Raw Hematite, 5 qian, finely ground), Sheng Hang Shao (Raw Paeonia lactiflora from Hangzhou, 4 qian).
Decoct together in a large bowl of water, divide into two doses, and take warm.
Follow-up Visit: After taking the medicine for three consecutive doses, she was able to speak and eat. The floating heat had subsided, and body temperature dropped to 37.6°C. The feeling of heat in the heart ceased. Occasionally, mild palpitations were felt. Bowel movement occurred once, and urination became smooth. Therefore, the original prescription was slightly modified for continued use.
Prescription: Ye Tai Shen (4 qian), Sheng Huai Shan Yao (1 liang), Da Gan Gou Qi (8 qian), Jing Yu Rou (6 qian), Sheng Huai Di Huang (5 qian), Gan Cao (2 qian), Xuan Shen (5 qian), Sha Shen (5 qian), Sheng Zhe Shi (4 qian, finely ground), Sheng Hang Shao (3 qian), Sheng Ji Nei Jin (Raw Chicken Gizzard Lining, 1.5 qian, yellow variety, crushed).
Decoct together in a large bowl of water, take warm.
Formula Analysis: Chicken Gizzard Lining (Ji Nei Jin) was added because patients with Xu Lao often have blood stasis in their collaterals, as described in the *Jin Gui Yao Lue* as "Blood Bi" and Xu Lao. Using Ji Nei Jin resolves Blood Bi, allowing Xu Lao to be eradicated at its root. Furthermore, when used together with Tai Shen (Ginseng), it helps transform and transport the tonifying power of Ginseng, preventing abdominal distension.
Outcome: After taking the medicine for four consecutive doses, the newly acquired acute illness was completely cured, though her chronic underlying Xu Lao was not fully resolved. She was instructed to stop taking decoctions and instead consume porridge made from fine powder of raw Huai Shan Yao daily, with a little white sugar, as a snack. Each time, a small amount of fine powder of raw Ji Nei Jin should be taken with it to consolidate the therapeutic effect.