1.痨瘵阴虚虫干血, 积热骨蒸咳嗽痰, 肌肤甲错目黯黑, 始健不泻
下为先.
【注】久病痨疾而名曰瘵. 瘵者, 败也, 气血两败之意也. 有阴虚干
血者, 有阴虚积热者, 当以诸补阴药治之. 肌肤甲错, 谓皮肤干涩也
.目黯黑者, 谓目黑无光也. 始健, 谓初病尚壮; 不泻, 谓久病不泻
也,二者皆可以攻下为先治也.
2.痨瘵至泻则必死, 不泻能食尚可痊, 初取利后宜详审, 次服柴胡
清骨煎, 虚用黄耆鳖甲散, 热衰大补养荣参, 皮热柴胡胡连入, 骨蒸
青蒿鳖甲添, 阴虚补阴诸丸剂, 阳虚补阳等汤圆, 咳嗽自同咳嗽治,
嗽血成方太平丸.
【注】痨瘵之人, 病至大便泄泻, 则必死矣. 若不泻能食, 尚堪任药
攻治, 故可痊也. 初取利后, 审其热之微甚, 人之强弱, 若热甚人强
,宜用柴胡清骨散. 热不甚人弱, 宜用黄耆鄨甲散. 热微人弱, 宜用
十全大补, 人参养荣等汤. 若皮外发热, 加柴胡, 胡连. 骨内蒸热,
加青蒿, 鳖甲. 午后阴虚发热, 宜用补阴诸丸汤药. 阳虚恶寒清瘦,
宜用补阳诸丸汤药. 咳嗽不巳, 同咳门方参而治之. 嗽血者, 宜用成
方太平丸可也.
大黄?? 虫丸 大黄青蒿煎 传尸将军丸
3.干血大黄?? 虫治, 积热蒿黄胆便煎, 癸亥腰眼炙七壮, 后服传尸
将军丸.
【注】大黄?? 虫丸有成方. 大黄青蒿煎, 即青蒿, 大黄, 猪胆汁,
童便煎. 痨瘵日久, 有生恶虫, 身死之后, 多遭传染, 甚而灭门, 名
曰传尸痨, 宜癸亥日炙两腰眼各七壮, 后服传尸将军丸. 此方载『丹
溪心法』书中.
柴胡清骨散
4.清骨骨蒸久不痊, 热甚秦知草胡连, 鳖甲青蒿柴地骨, 韭白髓胆
童便煎.
【注】此方乃秦艽, 知母, 炙草, 胡连, 鄨甲, 青蒿, 柴胡, 地骨皮
,韭白, 猪脊髓, 猪胆汁, 童便也.
黄耆鳖甲散
5.黄耆鳖甲虚劳热, 骨蒸晡热渴而烦, 肌肉消瘦食减少, 盗汗咳嗽
出血痰, 生地赤芍柴秦草, 知耆菀骨半苓煎, 人参桂桔俱减半, 鳖甲
天冬桑倍添.
【注】此方即生地, 赤芍, 柴胡, 秦艽, 炙草, 知母, 黄耆, 紫菀,
地骨皮, 半夏, 茯苓, 人参, 桂枝, 桔梗, 鳖甲, 天冬, 桑白皮也.
1. 痨瘵（慢性消耗性疾病）由阴虚、虫蚀干血所致，伴有积热、骨蒸（热自骨髓向外透发）、咳嗽及痰多。患者肌肤粗糙如鳞甲交错，双目黯淡无光。若患者初起时身体尚健壮且大便不通，治疗应以攻下法为先。
【注】久患痨疾称为“瘵”。“瘵”意为败坏，指气血两败。其中有阴虚导致干血内结的，有阴虚导致积热的，应当用各种补阴药物来治疗。“肌肤甲错”，是指皮肤干燥涩滞；“目黯黑”，是指眼睛昏暗无光泽。“始健”，是指初病时体质尚壮实；“不泻”，是指久病后大便并不泄泻。这两种情况（指初病体壮且便秘者），都可以先用攻下法治疗。
2. 痨瘵发展到出现泄泻则必死无疑，若不泄泻且能进食，尚可治愈。初期若需通便，之后应详细审察病情，随后服用柴胡清骨煎。虚证用黄耆鳖甲散，热势衰退后宜大补，使用养荣参汤。若体表发热，加入柴胡、胡黄连；若为骨蒸潮热，加入青蒿、鳖甲。阴虚者服用各类补阴丸剂，阳虚者服用各类补阳汤丸。咳嗽按咳嗽常规治疗，咳血者使用太平丸这一成方。
大黄䗪虫丸、大黄青蒿煎、传尸将军丸
3. 干血证用大黄䗪虫丸治疗，积热证用大黄、青蒿、猪胆汁及童便煎煮的大黄青蒿煎治疗。在癸亥日灸两侧腰眼穴各七壮，随后服用传尸将军丸。
【注】大黄䗪虫丸是有现成的方剂。大黄青蒿煎，即由青蒿、大黄、猪胆汁、童便煎煮而成。痨瘵日久，体内生出恶虫，人死后尸体多遭传染，甚至导致全家灭门，这种病称为“传尸痨”。适宜在癸亥日灸两侧腰眼穴各七壮，随后服用传尸将军丸。此方记载于《丹溪心法》一书中。
柴胡清骨散
4. 骨蒸潮热经久不愈的清骨散，含有秦艽、知母、甘草、胡黄连、鳖甲、青蒿、柴胡、地骨皮。用韭白、猪脊髓、猪胆汁和童便煎煮。
【注】此方由秦艽、知母、炙甘草、胡黄连、鳖甲、青蒿、柴胡、地骨皮、韭白、猪脊髓、猪胆汁、童便组成。
黄耆鳖甲散
5. 黄耆鳖甲散治疗虚劳发热、骨蒸潮热、午后发热、口渴烦躁、肌肉消瘦、食欲减退、盗汗、咳嗽及痰中带血。方中含有生地、赤芍、柴胡、秦艽、甘草、知母、黄耆、紫菀、地骨皮、半夏、茯苓。人参、桂枝、桔梗用量减半，再加入鳖甲、天冬、桑白皮煎服。
【注】此方即由生地、赤芍、柴胡、秦艽、炙甘草、知母、黄耆、紫菀、地骨皮、半夏、茯苓、人参、桂枝、桔梗、鳖甲、天冬、桑白皮组成。
1. Laozai (chronic consumptive disease) is caused by Yin deficiency and dry blood consumed by parasites, accompanied by accumulated heat, bone-steaming fever (heat radiating from the bone marrow to the exterior), cough, and excessive phlegm. The patient's skin is rough and scaly like fish scales, and the eyes are dull and dark. If the patient was initially robust and suffers from constipation, treatment should prioritize purgation (attacking downward).
[Note] A chronic Lao disease is called "Zhai". "Zhai" means decay or ruin, referring to the dual failure of Qi and Blood. Cases may involve dry blood accumulation due to Yin deficiency, or accumulated heat due to Yin deficiency; in such cases, various Yin-nourishing herbs should be used for treatment. "Skin like fish scales" refers to dry and rough skin. "Dull and dark eyes" refers to eyes lacking luster. "Initially robust" means the constitution was strong at the onset of the disease; "no diarrhea" means there is no loose stool despite the long duration of illness. Both conditions (specifically referring to initial robustness combined with constipation) can be treated first with purgative methods.
2. When Laozai progresses to diarrhea, death is inevitable. If there is no diarrhea and the patient can eat, recovery is possible as they can tolerate medicinal attacks. After using laxatives initially, one must carefully examine the condition, then administer Chaihu Qinggu Decoction. For deficiency patterns, use Huangqi Biejia San; after the heat subsides, major tonification should be applied using Yangrong Shen Tang. If there is external skin fever, add Chaihu and Hualian. For bone-steaming heat, add Qinghao and Biejia. For Yin deficiency, various Yin-tonifying pills are used; for Yang deficiency, various Yang-tonifying decoctions and pills are used. Cough is treated according to standard cough protocols; hemoptysis is treated with the established formula Taiping Wan.
Dahuang Zhechong Wan, Dahuang Qinghao Jian, Chuanshen Jiangjun Wan
3. Dry blood patterns are treated with Dahuang Zhechong Wan; accumulated heat patterns are treated with Dahuang Qinghao Jian, which consists of Da Huang, Qing Hao, Pig Bile, and Child's Urine boiled together. On a Guihai day, moxibustion should be applied to both Yao Yan points (lower back/kidney area) seven times each, followed by the administration of Chuanshen Jiangjun Wan.
[Note] Dahuang Zhechong Wan is an existing formula. Dahuang Qinghao Jian is made by boiling Qinghao, Dahuang, Pig Bile, and Child's Urine. Long-standing Laozai may generate evil parasites; after death, the corpse often causes infection, potentially wiping out the entire family. This disease is called "Chuanshen Lao" (Passing-Shadow Consumption). It is suitable to apply moxibustion to both lower back areas seven times each on a Guihai day, followed by Chuanshen Jiangjun Wan. This formula is recorded in the book *Danxi Xinfa*.
Chaihu Qinggu San
4. Qinggu San treats persistent bone-steaming fever. It contains Qin Jiao, Zhi Mu, Gan Cao, Hu Lian, Bie Jia, Qing Hao, Chai Hu, and Di Gu Pi. It is decocted with Jiu Bai (leek white), Pig Marrow, Pig Bile, and Child's Urine.
[Note] This formula consists of Qin Jiao, Zhi Mu, Zhi Gan Cao, Hu Lian, Bie Jia, Qing Hao, Chai Hu, Di Gu Pi, Jiu Bai, Pig Marrow, Pig Bile, and Child's Urine.
Huangqi Biejia San
5. Huangqi Biejia San treats Xu Lao (deficiency exhaustion) with fever, bone-steaming afternoon fever, thirst, irritability, emaciation, reduced appetite, night sweats, cough, and bloody sputum. The formula includes Sheng Di, Chi Shao, Chai Hu, Qin Jiao, Gan Cao, Zhi Mu, Huang Qi, Zi Wan, Di Gu Pi, Ban Xia, Fu Ling. The dosages of Ren Shen, Gui Zhi, and Jie Geng are halved, and additional ingredients include Bie Jia, Tian Dong, and Sang Bai Pi.
[Note] This formula consists of Sheng Di, Chi Shao, Chai Hu, Qin Jiao, Zhi Gan Cao, Zhi Mu, Huang Qi, Zi Wan, Di Gu Pi, Ban Xia, Fu Ling, Ren Shen, Gui Zhi, Jie Geng, Bie Jia, Tian Dong, and Sang Bai Pi.