脉数而虚。又兼紧涩。骨蒸劳热。盗汗咳嗽。必殒其躯。非药可除。
夫阴虚火动。劳瘵之疾。由相火上乘肺金而成之也。伤其精则阴虚而火动。耗其血则火
亢而
金亏。人身之血犹水也。血之英华最浓者精也。不谨者。纵其欲而快其心。则精血渗涸。故
脏腑津液渐燥。则火动熏肺而生痰。因其燥则痰结肺管。不利于出。故咳而声干。原乎精乏
则阴虚。阴虚则相火行于胃。而变为涎也。二火熏膈。则痰涎逆上。胃脘不利。则多嗽声。
盖痰因火动。嗽因痰起。痰之黄浓者为有气。可治。状如鱼涎白沫者。为无元气。难痊然斯
病之起。非止过欲而已。或五味之偏。或七情之极。或劳役之过。耗散元气。损伤脾胃。气
血亏损。脏腑虚弱。六脉沉细。微涩而数。百病由是次第而生。盖肾水一虚。则相火旺动相
火上炎
则克肺金。肺受火邪所克。所以为咳为嗽。为热为痰。为喘息。为盗汗。为吐血。为衄血
为便血尿血。为四肢倦怠。为五心烦热。为咽干声
哑。为耳鸣眼花。为遗精便浊。为虫胀肿满。为一应难状之症。治者宜滋肾水。养心血
元气。健脾胃。以培其本。降相火。清湿热。化痰涎。润肺金。以治其标。宜以清离滋坎汤
补中益气汤、河车地黄汤、太平丸、瑞莲丸、宁嗽膏、白雪膏之类。宜对症选用。慎毋执泥
盖此病
功不可以间断。效有难于速期。久则肾水上升。相火下降。火降则
痰消嗽止。水升则气足神完。水火既济。又何疾之不愈哉。又须病者坚心爱命。绝房劳。戒
恼怒。息妄想。节饮食。广服药。以自培其根可也。万一毫分不谨。则诸症迭起。纵庐扁复
生。亦难为矣。可不慎乎。
一论因房欲过度。而成阴虚火动劳瘵之症。发热咳嗽。吐痰喘急。盗汗。五心烦热。吐
血衄血。咽喉声哑。夜梦泄精。耳鸣眼花。六脉沉数而涩。
清离滋坎汤
怀生地黄（一钱） 熟地（一钱） 麦门冬（去心一钱） 当归（酒洗一钱） 白芍（酒炒一钱）
怀
山药（一钱） 牡丹皮（六分） 炙甘草（三分） 天门冬（去心一钱） 白茯苓（去皮一钱）
山茱
萸（酒蒸去核一钱） 白术（去芦土炒一钱） 泽泻（炒五分） 黄柏（蜜炒五分） 知母（五
分）
上锉。姜枣煎。温服。痰盛。加竹沥、姜汁。热盛。加童便、人乳同服。盗汗。加黄
蜜水
炒、酸枣仁炒。嗽甚。加五味子。痰盛。加贝母、栝蒌仁。热盛。加骨皮。心下怔忡。恍惚
不寐。加远志去心、酸枣仁炒。遗精。加龙骨、牡蛎 。
胸中不爽。加陈皮。泄泻。加莲肉、陈皮。去知母、黄柏。吐血衄。加犀角、玄参。气
虚。加人参。阳虚。加熟附子。咽疮喉痛。加桔梗、玄参。
一论虚劳发热。口干咳嗽。吐痰喘急。自汗。四肢困倦无力不思饮食。大便泄泻。肚腹
蛊胀肿。六脉浮数无力是也。
加减补中益气汤
黄 （蜜炒一钱） 人参（一钱） 白术（去油芦炒一钱五分） 当归（酒洗一钱） 白茯苓（
去皮一钱） 陈皮（六分） 白芍（酒炒一钱） 莲肉（一钱） 怀山药（一钱） 甘草（炙三分
半）
上锉。姜、枣煎服。痰盛。加姜制半夏。嗽甚。加五味子。口渴。加麦门冬。腹胀。加
浓朴
、姜炒。胸痞。加枳实麸炒。泄泻。加炒黑干姜。呕吐。加姜炒半夏。肿满。加猪苓、泽泻
、木通。憎寒发热。加柴胡。元气下陷。加升麻。元气虚惫。加熟附子、肉桂。
一论年少之人。禀赋薄弱。不能谨慎。斫丧太过。以致肾水枯竭。相火妄动。而成阴虚
火动
之症。浑身发热。咳嗽吐痰。喘急上壅。夜多盗汗。五心烦热。日轻夜重。吐血衄血。尿血
便血。咯血唾血。肺痈肺痿。咽疮声哑。口干发渴。耳鸣眼黑。头眩昏沉蛊胀肿满。小
便淋沥。夜梦遗精。足膝酸软。肌肉消瘦。四肢困倦。饮食少思。血虚发热之圣药也。
河车地黄丸
怀生地黄（先将酒洗令净再入酒拌匀。粗碗盛坐放砂锅内重汤蒸半日取出加酒再蒸至极
黑为
度再入生姜汁拌匀慢火焙干八两） 山茱萸（酒蒸去复选肉四两） 怀山药（四两） 白茯苓（去
皮筋膜乳汁浸晒三次） 牡丹皮（去骨） 泽泻（各三两）
上忌铁器。为最细末。用头生胞衣一具。男用男胎。女用女胎。长流水洗净。瓷碗盛放
砂锅
内。用文武火蒸一日。极烂入臼内杵如泥。入药。再杵千余下。为丸如梧桐子大。每服百丸
空心。白汤送下。肾水不能摄养脾土。多吐痰唾。姜汤送下。或用斑龙胶酒化开为丸尤妙
如病患大便干燥。口干作渴。此相火太旺。加黄柏酒炒、知母酒炒、麦门冬去心、五味子
各一两。同丸服。
一论虚劳。久嗽红痰。肺痿肺痈。卧不倒床。嗽声不绝者。宜用
噙化太平丸
天门冬（去心） 麦门冬（去心） 知母（去毛） 贝母（去心） 款冬花 杏仁（去皮各二两）
梗（去芦一两） 麝香（少许） 白蜜（四两） 南薄荷叶（一两）
上为细末。炼蜜为丸。如弹子大。临卧。浓煎薄荷汤。先灌漱喉中。细嚼一丸。津液送
下。
一论阴虚火动。吐血咯血。咳嗽痰涎喘急。大敛肺气。止咳化痰。定喘之圣药也。
如神宁嗽膏
天门冬（去心八两） 杏仁（泡去皮尖四两） 贝母（去心四两） 百部（四两） 百合（四两）
款冬花（五两） 紫菀（三两）
上以上俱为细末。长流水煎三次。入饴糖八两。蜜一斤。再熬。又入阿胶四两。白茯苓
水飞去筋膜四两。晒干。二味入前汁内。调匀如糊成膏。每服三五匙。
一论治虚劳。脾胃虚弱。不思饮食。泄泻等症。宜参苓白术散。
理气健脾丸（方见饮食） 治男妇虚劳。肚腹胀痛。泄泻不止。咳嗽吐痰。上喘痞闷。
阳春白雪糕（方见内伤） 治虚劳百病。可兼前汤丸进之。大有补益。
一论虚劳发热。痰咳喘汗。泄泻腹痛。脾虚虚弱。饮食少思。骨瘦如柴。宜
瑞莲丸
干山药（炒二两） 莲肉（去心膜皮二两） 白术（去芦土炒三两） 芡实（去壳炒二两）
参（二两） 白茯苓（去皮一两） 陈皮（一两） 白芍（火煨酒炒一两） 粉草（炙五钱）
上锉细末。用公猪肚一个。洗净。水煮烂。捣和为丸。如梧桐了大。每服百丸。米汤送
下。
一论此膏能治五劳七伤。诸虚劳极。元气虚损。脾胃亏弱。养血和中。宁嗽化痰。退热
定喘。止泻除渴。真王道之剂也。
调元百补膏 张尚书传。
当归身（酒洗四两） 怀生地黄（二斤） 怀熟地黄（四两） 甘枸杞子（一斤） 白芍（一斤
用
米粉炒） 人参（四两） 辽五味子（一两） 麦门冬（去心五两） 地骨皮（四两） 白术（去芦四
两） 白茯苓（去皮十二两） 莲肉（四两） 怀山药（五两） 贝母（去心三两） 甘草（三两
）琥珀（一钱三分） 薏苡仁（用米粉炒八两）
上锉细末。和足水十斤。微火煎干。再加水十斤。如此四次。滤去渣。取汁。文武火熬
之
待减去三分。每斤拣净熟蜜四两。春五两。夏六两。共熬成膏。每服三匙。白汤调下。吐
血。加牡丹皮二两。骨蒸。加青蒿汁、童便各二碗。同热服之。一人足热口干。吐痰头晕。
服四物、黄连、黄柏。饮食即减。痰涎益甚。用十全大补加麦门冬、五味、山药、山茱而愈
一男子年十六。夏月作渴。发热吐痰。唇燥。遍体生疥。两腿尤多。色暗作痒。日晡愈
炽。
仲冬腿患疮。尺脉洪数。余曰。疥。肾疳也。疮骨疽也。皆肾经虚症。针之脓出。其气氤氲
余谓火旺之际。必患瘵症。遂用六味地黄、十全大补。不二旬而诸症愈。瘵症俱用前药而
愈。抵冬娶妻。至春其症复作。父母忧之。俾其外寝。虽其年少谨疾。亦服地黄丸数斤。煎
药三百余剂而愈也。
一余尝闻士子读书。作文辛苦。最宜节欲。盖劳心而不节欲则火动。火动则肾水日耗。
水耗
则火炽。火炽则肺金受害。传变为劳。此固深知读书之苦。洞得病情之由。而患者不可不知
所预防也。
一阴虚火动。发热烦躁。服诸药不效者。非童便不能奏效。益气汤去柴、升。加生地、
赤茯苓、白茯苓、天冬、麦冬、赤芍、五味、黄柏、地骨皮、知母、贝母、银花、柴胡、龟板。
一若热来复去。昼见夜伏。夜见昼伏。不时而动。或无定处。而作口舌生疮者。若从脚
起。乃无根之火也。以八味丸、十全大补汤。加麦门冬、五味子。
一治阴虚火动。五心烦热。用七八岁无病童子小便。去头尾。用白色者一盏。或食前。
或食
后服之。每日二三次服之。降火滋阴最速。童便红黄者。勿用。若误服。伤脾胃而作泄泻。
慎之。
一儒者形体魁伟。冬日饮水。自喜壮实。余曰。此阴虚也。不信。一日。口舌生疮。或
用寒凉之剂。肢体倦怠。发热恶寒。余用六味地黄、补中益气而愈。
一治劳瘵阳旺不倒。用皮硝不拘多少。放劳宫。即手掌心内。两手合住。自化。其阳自
痿。病愈。用起阳法。好烧酒和黄泥。涂阴毛际处一日。其阳即起。
一方。治阳旺用丝瓜小藤捣烂。敷玉茎。阳即倒矣。
一方。痿阳。用经霜丝瓜。不拘大小。白马尿浸一日。阴干为末。每服三钱。空心白酒
送下。
一方。缩阳法。
马蝗蜞一曰马鳖。寻起九条。入水养之。至七月七日。取之阴干。称有多少。入麝香并
合
衣香。三样一般多。研为细末。用蜜少许为饼。遇阳旺时。即将少许擦左脚心。实时阳痿过
日复旺。又擦。
一论劳者劳于神气。伤者伤于形容。饥饱过度则伤脾。思虑过度则伤心。色欲过度则伤
肾。
起居过常则伤肝。喜怒悲愁则伤肺。又风寒暑湿则伤外。饥饱劳役则伤内。昼感之则伤荣。
夜感之则伤卫。荣卫经行。内外交运。而各从其昼夜。始劳于一。一起为二。二传于三。三
通于四。四干其五。五复犯一。一至于五。邪乃深藏。真气自失。使人肌肉消。神气弱。饮
食减。行步难。及其如此。则虽有命。亦不能久也。
脉象数而虚弱，又兼见紧涩之象。出现骨蒸劳热、盗汗、咳嗽等症状，必然导致身体衰败死亡，此时已非药物所能治愈。
阴虚火动所致的劳瘵疾病，是由相火上冲克制肺金而形成的。损伤精气则导致阴虚而火动；耗损血液则导致火亢盛而肺金亏损。人身之血犹如水，血中精华最浓郁的部分即为精。如果不谨慎节制，放纵欲望以图一时快意，就会导致精血枯竭。因此脏腑津液逐渐干燥，火热内动熏蒸肺部而生痰。因为肺部干燥，痰结于肺管，不利于排出，所以咳嗽且声音干哑。根源在于精乏导致阴虚，阴虚则相火行于胃，转化为涎。二火熏蒸膈膜，导致痰涎逆上。胃脘气机不利，则多发出嗽声。大概痰因火动而起，嗽因痰生所致。痰色黄浓的属于有气，可以治疗；状如鱼涎白沫的，属于无元气，难以痊愈。然而这种病的起因，不仅仅是房事过度。或者是五味偏嗜，或者是七情过极，或者是劳役过度，耗散元气，损伤脾胃，导致气血亏损，脏腑虚弱。六脉沉细、微涩而数，百病由此次第产生。大概肾水一虚，则相火旺动；相火上炎则克伐肺金。肺受火邪克制，所以出现咳嗽、发热、生痰、喘息、盗汗、吐血、衄血、便血、尿血、四肢倦怠、五心烦热、咽干声哑、耳鸣眼花、遗精、便浊、虫胀肿满等一系列难以名状的病症。治疗者应当滋补肾水，养心血，补元气，健脾胃，以培补其根本；降相火，清湿热，化痰涎，润肺金，以治疗其标症。适宜选用清离滋坎汤、补中益气汤、河车地黄汤、太平丸、瑞莲丸、宁嗽膏、白雪膏等方剂。应当对症选用，切勿固执拘泥。盖此病功效不可以间断，疗效难以迅速预期。日久则肾水上升，相火下降。火降则痰消嗽止，水升则气足神完。水火既济，又有什么疾病不能痊愈呢？又必须患者坚定心志爱惜生命，断绝房劳，戒除恼怒，平息妄想，节制饮食，广泛服药，以自我培补根基。万一有一毫一分不谨慎，则各种症状迭起，即使卢医扁鹊再生，也难以救治了。能不谨慎吗？
第一种论述：因房欲过度，而成阴虚火动劳瘵之症。表现为发热咳嗽，吐痰喘急，盗汗，五心烦热，吐血衄血，咽喉声哑，夜梦泄精，耳鸣眼花，六脉沉数而涩。
清离滋坎汤
怀生地黄（一钱） 熟地黄（一钱） 麦门冬（去心一钱） 当归（酒洗一钱） 白芍（酒炒一钱）
怀山药（一钱） 牡丹皮（六分） 炙甘草（三分） 天门冬（去心一钱） 白茯苓（去皮一钱）
山茱萸（酒蒸去核一钱） 白术（去芦土炒一钱） 泽泻（炒五分） 黄柏（蜜炒五分） 知母（五分）
以上药材切碎，加生姜、大枣煎煮，温服。痰多者，加竹沥、姜汁。热盛者，加童便、人乳同服。盗汗者，加黄芩（原文“黄”疑为黄芩或黄芪，结合语境清热宜黄芩，但此处保留原文用字或推测，通常黄芩清热，黄芪补气，若指黄芩则写黄芩，若指黄芪则写黄芪，原文仅“黄”，根据后文“蜜水炒”及清热语境，常指黄芩或黄芪，此处依原文“黄”字，暂译为黄[药]，但在中医常规中，治盗汗多用黄芪或黄柏，前文已有黄柏，此处可能指黄芪或黄芩。鉴于原文可能有脱漏，按常见配伍，治盗汗多用黄芪固表，或黄芩清热。此处依原文直译“黄”）。酸枣仁（炒）。咳嗽严重者，加五味子。痰多者，加贝母、栝蒌仁。热盛者，加地骨皮。心中怔忡，恍惚失眠者，加远志（去心）、酸枣仁（炒）。遗精者，加龙骨、牡蛎。胸中不畅者，加陈皮。泄泻者，加莲肉、陈皮，去掉知母、黄柏。吐血衄血者，加犀角、玄参。气虚者，加人参。阳虚者，加熟附子。咽疮喉痛者，加桔梗、玄参。
第二种论述：虚劳发热，口干咳嗽，吐痰喘急，自汗，四肢困倦无力，不思饮食，大便泄泻，肚腹蛊胀肿满，六脉浮数无力，即是此证。
加减补中益气汤
黄芪（蜜炒一钱） 人参（一钱） 白术（去油芦炒一钱五分） 当归（酒洗一钱） 白茯苓（去皮一钱） 陈皮（六分） 白芍（酒炒一钱） 莲肉（一钱） 怀山药（一钱） 甘草（炙三分半）
以上药材切碎，加姜、枣煎服。痰多者，加姜制半夏。咳嗽严重者，加五味子。口渴者，加麦门冬。腹胀者，加厚朴（姜炒）。胸痞者，加枳实（麸炒）。泄泻者，加炒黑干姜。呕吐者，加姜炒半夏。肿满者，加猪苓、泽泻、木通。憎寒发热者，加柴胡。元气下陷者，加升麻。元气虚惫者，加熟附子、肉桂。
第三种论述：年少之人，禀赋薄弱，不能谨慎，斫丧太过，以致肾水枯竭，相火妄动，而成阴虚火动之症。浑身发热，咳嗽吐痰，喘急上壅，夜间多盗汗，五心烦热，日轻夜重，吐血衄血，尿血便血，咯血唾血，肺痈肺痿，咽疮声哑，口干发渴，耳鸣眼黑，头眩昏沉，蛊胀肿满，小便淋沥，夜梦遗精，足膝酸软，肌肉消瘦，四肢困倦，饮食少思。这是治疗血虚发热的圣药。
河车地黄丸
怀生地黄（先将酒洗令净再入酒拌匀，粗碗盛放砂锅内重汤蒸半日取出加酒再蒸至极黑为度，再入生姜汁拌匀慢火焙干，八两） 山茱萸（酒蒸去复选肉四两） 怀山药（四两） 白茯苓（去皮筋膜乳汁浸晒三次） 牡丹皮（去骨） 泽泻（各三两）
以上药材忌用铁器，研为最细末。用初生胞衣一具，男用男胎，女用女胎，长流水洗净，瓷碗盛放砂锅内，用文武火蒸一日，极烂后入臼内杵如泥，加入药末，再杵千余下，制成梧桐子大小的丸药。每服一百丸，空心时白开水送下。若肾水不能摄养脾土，多吐痰唾，可用姜汤送下。或者用斑龙胶酒化开制作丸药尤其妙。如果病患大便干燥，口干作渴，这是相火太旺，加黄柏（酒炒）、知母（酒炒）、麦门冬（去心）、五味子各一两，同丸服用。
第四种论述：虚劳，久嗽红痰，肺痿肺痈，卧床不起，咳嗽声不绝者，适宜使用噙化太平丸。
噙化太平丸
天门冬（去心） 麦门冬（去心） 知母（去毛） 贝母（去心） 款冬花 杏仁（去皮各二两） 桔梗（去芦一两） 麝香（少许） 白蜜（四两） 南薄荷叶（一两）
以上药材研为细末，炼蜜为丸，如弹子大小。临睡前，浓煎薄荷汤，先含漱喉中，细嚼一丸，津液送下。
第五种论述：阴虚火动，吐血咯血，咳嗽痰涎喘急，大敛肺气，止咳化痰，定喘的圣药。
如神宁嗽膏
天门冬（去心八两） 杏仁（泡去皮尖四两） 贝母（去心四两） 百部（四两） 百合（四两） 款冬花（五两） 紫菀（三两）
以上药材均研为细末，长流水煎煮三次，加入饴糖八两，蜜一斤，再熬。又加入阿胶四两，白茯苓（水飞去筋膜四两，晒干），将这两味加入前面的药汁内，调匀如糊状成膏。每服三五匙。
第六种论述：治疗虚劳，脾胃虚弱，不思饮食，泄泻等症，适宜参苓白术散。
理气健脾丸（方见饮食篇） 治疗男女虚劳，肚腹胀痛，泄泻不止，咳嗽吐痰，上喘痞闷。
阳春白雪糕（方见内伤篇） 治疗虚劳百病，可兼与前汤丸并进，大有补益。
第七种论述：虚劳发热，痰咳喘汗，泄泻腹痛，脾虚虚弱，饮食少思，骨瘦如柴，适宜瑞莲丸。
瑞莲丸
干山药（炒二两） 莲肉（去心膜皮二两） 白术（去芦土炒三两） 芡实（去壳炒二两） 人参（二两） 白茯苓（去皮一两） 陈皮（一两） 白芍（火煨酒炒一两） 粉草（炙五钱）
以上药材锉细末，用公猪肚一个，洗净，水煮烂，捣和为丸，如梧桐子大小。每服一百丸，米汤送下。
第八种论述：此膏能治五劳七伤，诸虚劳极，元气虚损，脾胃亏弱，养血和中，宁嗽化痰，退热定喘，止泻除渴，真是王道的药剂。
调元百补膏 （张尚书传）
当归身（酒洗四两） 怀生地黄（二斤） 怀熟地黄（四两） 甘枸杞子（一斤） 白芍（一斤用米粉炒） 人参（四两） 辽五味子（一两） 麦门冬（去心五两） 地骨皮（四两） 白术（去芦四两） 白茯苓（去皮十二两） 莲肉（四两） 怀山药（五两） 贝母（去心三两） 甘草（三两） 琥珀（一钱三分） 薏苡仁（用米粉炒八两）
以上药材锉细末，和足水十斤，微火煎干，再加水十斤，如此四次，滤去渣，取汁。用文武火熬之，待减去三分之一。每斤药汁拣净熟蜜四两，春季五两，夏季六两，共熬成膏。每服三匙，白开水调下。吐血者，加牡丹皮二两。骨蒸者，加青蒿汁、童便各二碗，同热服之。一人足热口干，吐痰头晕，服用四物汤、黄连、黄柏后，饮食即减少，痰涎更严重。用十全大补汤加麦门冬、五味子、山药、山茱萸而痊愈。
一男子十六岁，夏月作渴，发热吐痰，唇燥，遍体生疥，两腿尤多，色暗作痒，日晡愈炽。仲冬腿患疮，尺脉洪数。我说：疥是肾疳，疮是骨疽，都是肾经虚症。针刺后脓出，其气氤氲。我谓火旺之际，必患瘵症。遂用六味地黄丸、十全大补汤，不到二十天诸症痊愈。瘵症俱用前药而愈。等到冬天娶妻，到春天其症复发。父母担忧，让他分居外寝。虽然他年少谨疾，也服用地黄丸数斤，煎药三百余剂而痊愈。
我曾听说士子读书，作文辛苦，最宜节欲。大概劳心而不节欲则火动，火动则肾水日耗，水耗则火炽，火炽则肺金受害，传变为劳。这固然深知读书之苦，洞得病情之由，而患者不可不知道预防。
阴虚火动，发热烦躁，服诸药不效者，非童便不能奏效。益气汤去掉柴胡、升麻，加生地、赤茯苓、白茯苓、天冬、麦冬、赤芍、五味子、黄柏、地骨皮、知母、贝母、银花、柴胡、龟板。
若热来复去，昼见夜伏，夜见昼伏，不时而动，或无定处，而作口舌生疮者，若从脚起，乃无根之火也。以八味丸、十全大补汤，加麦门冬、五味子。
治疗阴虚火动，五心烦热，用七八岁无病童子小便，去头尾，用白色者一盏，或食前，或食后服之。每日二三次服之，降火滋阴最速。童便红黄者，勿用。若误服，伤脾胃而作泄泻，慎之。
一儒者形体魁伟，冬日饮水，自喜壮实。我说：这是阴虚。他不信。一日，口舌生疮，或用寒凉之剂，肢体倦怠，发热恶寒。我用六味地黄丸、补中益气汤而愈。
治疗劳瘵阳旺不倒，用皮硝不拘多少，放劳宫穴（即手掌心内），两手合住，自化，其阳自痿，病愈。用起阳法，好烧酒和黄泥，涂阴毛际处一日，其阳即起。
一方，治疗阳旺，用丝瓜小藤捣烂，敷玉茎，阳即倒矣。
一方，治疗阳痿，用经霜丝瓜，不拘大小，白马尿浸一日，阴干为末，每服三钱，空心白酒送下。
一方，缩阳法。
马蝗蜞（一曰马鳖），寻起九条，入水养之，至七月七日，取之阴干，称有多少，入麝香并合衣香，三样一般多，研为细末，用蜜少许为饼，遇阳旺时，即将少许擦左脚心，实时阳痿，过日复旺，又擦。
第一种论述：劳者劳于神气，伤者伤于形容。饥饱过度则伤脾，思虑过度则伤心，色欲过度则伤肾，起居过常则伤肝，喜怒悲愁则伤肺。又风寒暑湿则伤外，饥饱劳役则伤内。昼感之则伤荣，夜感之则伤卫。荣卫经行，内外交运，而各从其昼夜，始劳于一，一起为二，二传于三，三通于四，四干其五，五复犯一，一至于五，邪乃深藏，真气自失，使人肌肉消，神气弱，饮食减，行步难。及其如此，则虽有命，亦不能久也。
Pulse is rapid and deficient, accompanied by tightness and choppy qualities. Symptoms include bone-steaming tidal fever, night sweats, and coughing, inevitably leading to physical decline and death; at this stage, it cannot be cured by medicine alone.
The disease of *Lao Zhai* (Consumption/Tuberculosis) caused by Yin deficiency with hyperactive fire arises from the ministerial fire ascending to oppress Lung Metal. Injury to essence leads to Yin deficiency and hyperactive fire; consumption of blood leads to excessive fire and depletion of Lung Metal. Blood in the human body is like water, and the most concentrated essence of blood is essence (*Jing*). If one is not prudent, indulging desires for temporary gratification causes essence and blood to dry up. Consequently, the fluids of the zang-fu organs gradually become dry, internal fire moves and steams the lungs generating phlegm. Due to lung dryness, phlegm knots in the bronchial tubes, hindering expulsion, resulting in coughing with a hoarse voice. The root lies in essence depletion causing Yin deficiency; Yin deficiency allows ministerial fire to move in the stomach, transforming into saliva. The dual fires steam the diaphragm, causing phlegm and saliva to rebel upward. Stomach disharmony leads to frequent coughing. Generally, phlegm arises from fire movement, and coughing arises from phlegm. Phlegm that is yellow and thick indicates the presence of Qi and is treatable; phlegm resembling fish mucus or white foam indicates a lack of True Qi and is difficult to cure. However, the onset of this disease is not solely due to excessive sexual activity. It may also result from dietary imbalances, extreme emotional fluctuations, or overexertion, which dissipate True Qi and damage the Spleen and Stomach, leading to Qi and Blood deficiency and weak zang-fu organs. The six pulses are deep, fine, slightly choppy, and rapid, giving rise to various diseases sequentially. When Kidney Water is deficient, ministerial fire becomes hyperactive; ascending ministerial fire attacks Lung Metal. The Lung, oppressed by fire pathogenic factors, manifests as coughing, heat, phlegm, panting, night sweats, hemoptysis, epistaxis, hematochezia, hematuria, limb fatigue, five-palm heat, dry throat with hoarseness, tinnitus, blurred vision, spermatorrhea, turbid urine, abdominal distension, and swelling—a series of intractable symptoms. Treatment should nourish Kidney Water, nourish Heart Blood, tonify True Qi, strengthen the Spleen and Stomach to cultivate the root; descend ministerial fire, clear damp-heat, resolve phlegm and saliva, and moisten Lung Metal to treat the branch. Suitable formulas include Qing Li Zi Kan Tang (Clear the South and Nourish the North Decoction), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), He Che Di Huang Tang (Placenta Rehmannia Decoction), Tai Ping Wan (Great Peace Pill), Rui Lian Wan (Lotus Seed Pill), Ning Sou Gao (Cough-Calming Paste), and Bai Xue Gao (White Snow Paste). Select according to symptoms; do not adhere rigidly. The efficacy of this disease requires continuous treatment, and quick results are hard to expect. Over time, Kidney Water ascends and ministerial fire descends. As fire descends, phlegm dissipates and coughing stops; as water ascends, Qi becomes sufficient and Spirit complete. With the interaction of Fire and Water, what disease would not heal? Furthermore, the patient must firmly cherish life, abstain from sexual labor, avoid anger, cease delusions, regulate diet, and take medicines extensively to self-cultivate the root. If there is even the slightest negligence, symptoms will arise successively; even if Luque and Bian Que were reborn, they would find it difficult to help. How can one not be cautious?
First discussion: Caused by excessive sexual desire, leading to Yin deficiency with hyperactive fire and *Lao Zhai*. Symptoms include fever and coughing, expectoration with panting, night sweats, five-palm heat, hemoptysis and epistaxis, hoarse throat, nocturnal emission during dreams, tinnitus, blurred vision, and a pulse that is deep, rapid, and choppy in all six positions.
Qing Li Zi Kan Tang (Clear the South and Nourish the North Decoction)
Huai Sheng Di Huang (Rehmanniae Radix Preparata, 1 qian)
Shu Di Huang (Prepared Rehmanniae Radix, 1 qian)
Mai Men Dong (Ophiopogonis Radix, decentered, 1 qian)
Dang Gui (Angelicae Sinensis Radix, wine-washed, 1 qian)
Bai Shao (Paeoniae Radix Alba, wine-fried, 1 qian)
Huai Shan Yao (Dioscoreae Rhizoma, 1 qian)
Mu Dan Pi (Moutan Cortex, 6 fen)
Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 3 fen)
Tian Men Dong (Asparagi Radix, decentered, 1 qian)
Bai Fu Ling (Poria, peeled, 1 qian)
Shan Zhu Yu (Corni Fructus, wine-steamed, pitted, 1 qian)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, de-rhizome, earth-fried, 1 qian)
Ze Xie (Alismatis Rhizoma, fried, 5 fen)
Huang Bo (Phellodendri Cortex, honey-fried, 5 fen)
Zhi Mu (Anemarrhenae Rhizoma, 5 fen)
Decoct these ingredients with fresh ginger and jujube, take warm. For abundant phlegm, add Zhu Li (Bamboo Sap) and Jiang Zhi (Fresh Ginger Juice). For severe heat, add Tong Bian (Child's Urine) and Ren Ru (Human Milk) to take together. For night sweats, add Huang [Yao] (likely Huang Qi or Huang Qin, text ambiguous) fried with honey water and Chao Suan Zao Ren (Ziziphi Spinosae Semen, fried). For severe cough, add Wu Wei Zi (Schisandrae Fructus). For abundant phlegm, add Bei Mu (Fritillariae Bulbus) and Gua Lou Ren (Trichosanthis Semen). For severe heat, add Gu Pi (Lycii Cortex). For palpitations, restlessness, and insomnia, add Yuan Zhi (Polygalae Radix, decentered) and Chao Suan Zao Ren (Ziziphi Spinosae Semen, fried). For spermatorrhea, add Long Gu (Fossilia Ossis Mastodi) and Mu Li (Ostreae Concha). For chest discomfort, add Chen Pi (Citri Reticulatae Pericarpium). For diarrhea, add Lian Rou (Nelumbinis Semen) and Chen Pi (Citri Reticulatae Pericarpium); remove Zhi Mu (Anemarrhenae Rhizoma) and Huang Bo (Phellodendri Cortex). For hemoptysis and epistaxis, add Xi Jiao (Rhinocerotis Cornu) and Xuan Shen (Scrophulariae Radix). For Qi deficiency, add Ren Shen (Ginseng Radix et Rhizoma). For Yang deficiency, add Shu Fu Zi (Aconiti Lateralis Radix Preparata). For throat sores and pain, add Jie Geng (Platycodonis Radix) and Xuan Shen (Scrophulariae Radix).
Second discussion: Deficiency consumption with fever, dry mouth and coughing, expectoration with panting, spontaneous sweating, limb fatigue and weakness, loss of appetite, loose stools, abdominal distension and swelling, and a pulse that is floating, rapid, and powerless.
Modified Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)
Huang Qi (Astragali Radix, honey-fried, 1 qian)
Ren Shen (Ginseng Radix et Rhizoma, 1 qian)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, de-oiled rhizome, fried, 1.5 qian)
Dang Gui (Angelicae Sinensis Radix, wine-washed, 1 qian)
Bai Fu Ling (Poria, peeled, 1 qian)
Chen Pi (Citri Reticulatae Pericarpium, 6 fen)
Bai Shao (Paeoniae Radix Alba, wine-fried, 1 qian)
Lian Rou (Nelumbinis Semen, 1 qian)
Huai Shan Yao (Dioscoreae Rhizoma, 1 qian)
Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 qian)
Decoct with ginger and jujube. For abundant phlegm, add Ban Xia (Pinelliae Tuber, ginger-processed). For severe cough, add Wu Wei Zi (Schisandrae Fructus). For thirst, add Mai Men Dong (Ophiopogonis Radix). For abdominal distension, add Hou Po (Magnoliae Officinalis Cortex, ginger-fried). For chest fullness, add Zhi Shi (Aurantii Fructus Immaturus, bran-fried). For diarrhea, add Gan Jiang (Zingiberis Rhizoma, charred). For vomiting, add Ban Xia (Pinelliae Tuber, ginger-fried). For swelling, add Zhu Ling (Polyporus, 1 qian), Ze Xie (Alismatis Rhizoma, fried, 5 fen), and Mu Tong (Akebiae Caulis). For aversion to cold and fever, add Chai Hu (Bupleuri Radix). For sinking of True Qi, add Sheng Ma (Cimicifugae Rhizoma). For extreme Qi deficiency and exhaustion, add Shu Fu Zi (Aconiti Lateralis Radix Preparata) and Rou Gui (Cinnamomi Cortex).
Third discussion: Young people with weak constitution who fail to be prudent and indulge excessively cause Kidney Water to dry up and ministerial fire to move recklessly, resulting in Yin deficiency with hyperactive fire. Symptoms include whole-body fever, coughing with expectoration, upper congestion with panting, frequent night sweats, five-palm heat, mild during the day and severe at night, hemoptysis, epistaxis, hematuria, hematochezia, spitting blood, lung abscess, lung flaccidity, throat sores with hoarseness, dry mouth with thirst, tinnitus, blackened vision, dizziness, heavy head, abdominal distension and swelling, dysuria, nocturnal emission dreams, soreness and weakness of feet and knees, muscle emaciation, limb fatigue, poor appetite. This is the sacred medicine for treating blood deficiency fever.
He Che Di Huang Wan (Placenta Rehmannia Pill)
Huai Sheng Di Huang (Rehmanniae Radix Preparata, 8 liang): Wash clean with wine, mix with wine, place in a coarse bowl inside a clay pot, steam over boiling water for half a day, remove, add wine, steam again until extremely black, mix with fresh ginger juice, dry slowly over low fire.
Shan Zhu Yu (Corni Fructus, 4 liang): Wine-steamed, pitted, selected flesh.
Huai Shan Yao (Dioscoreae Rhizoma, 4 liang).
Bai Fu Ling (Poria, 4 liang): Peel fascia, soak in milk, sun-dry three times.
Mu Dan Pi (Moutan Cortex, 4 liang): Remove woody core.
Ze Xie (Alismatis Rhizoma, 3 liang).
Avoid iron vessels. Grind into finest powder. Use one placenta (male fetus for male, female fetus for female), wash clean with running water, place in a porcelain bowl inside a clay pot, steam over gentle fire for one day until extremely soft, pound in a mortar into paste, mix with medicine, pound over a thousand times, form pills the size of paulownia seeds. Take 100 pills on an empty stomach with plain water. If Kidney Water fails to nourish Spleen Earth causing excessive phlegm and saliva, take with ginger soup. Alternatively, dissolve Ban Long Jiao (Cervi Cornus Colla) in wine to form pills, which is excellent. If the patient has dry stool and dry mouth with thirst, indicating excessive ministerial fire, add Huang Bo (Phellodendri Cortex, wine-fried), Zhi Mu (Anemarrhenae Rhizoma, wine-fried), Mai Men Dong (Ophiopogonis Radix, decentered), and Wu Wei Zi (Schisandrae Fructus), each 1 liang, and pill together.
Fourth discussion: For deficiency consumption with chronic cough producing bloody sputum, lung flaccidity, lung abscess, inability to lie flat, and incessant coughing, use Qin Hua Tai Ping Wan (Swallowing Pacifying Great Peace Pill).
Qin Hua Tai Ping Wan (Swallowing Pacifying Great Peace Pill)
Tian Men Dong (Asparagi Radix, decentered)
Mai Men Dong (Ophiopogonis Radix, decentered)
Zhi Mu (Anemarrhenae Rhizoma, de-hair)
Bei Mu (Fritillariae Bulbus, decentered)
Kuan Dong Hua (Farfarae Flos)
Xing Ren (Armeniacae Semen, peeled, each 2 liang)
Jie Geng (Platycodonis Radix, de-rhizome, 1 liang)
She Xiang (Moschus, a little)
Bai Mi (White Honey, 4 liang)
Nan Bo He Ye (Menthae Haplocalycis Folium, 1 liang)
Grind into fine powder, make pills with refined honey, size of a bullet. Before sleep, decoct strong mint tea, gargle throat first, chew one pill finely, swallow with saliva.
Fifth discussion: For Yin deficiency with hyperactive fire, hemoptysis, spitting blood, coughing with phlegm and panting, this is the sacred medicine to greatly astringe Lung Qi, stop coughing, resolve phlegm, and calm panting.
Ru Shen Ning Sou Gao (Miraculous Cough-Calming Paste)
Tian Men Dong (Asparagi Radix, decentered, 8 liang)
Xing Ren (Armeniacae Semen, soaked, peeled, pointed removed, 4 liang)
Bei Mu (Fritillariae Bulbus, decentered, 4 liang)
Bai Bu (Stemonae Radix, 4 liang)
Bai He (Lilii Bulbus, 4 liang)
Kuan Dong Hua (Farfarae Flos, 5 liang)
Zi Wan (Periplocae Radix, 3 liang)
Grind all into fine powder, decoct three times with running water, add Yi Tang (Maltose, 8 liang) and Mi (Honey, 1 jin), boil again. Add E Jiao (Colla Corii Asini, 4 liang) and Bai Fu Ling (Poria, water-washed, fascia removed, dried, 4 liang), mix into the previous liquid until uniform like paste. Take 3-5 spoons per dose.
Sixth discussion: To treat deficiency consumption with weak Spleen and Stomach, loss of appetite, and diarrhea, Can Ling Bai Zhu San (Codonopsis, Poria, and Atractylodes Macrocephala Powder) is suitable.
Li Qi Jian Pi Wan (Regulate Qi and Strengthen Spleen Pill) (Formula seen in Diet section): Treats deficiency consumption in men and women, abdominal distension and pain, incessant diarrhea, coughing with expectoration, upper panting and chest fullness.
Yang Chun Bai Xue Gao (Spring White Snow Cake) (Formula seen in Internal Injury section): Treats various diseases of deficiency consumption, can be taken concurrently with the aforementioned decoctions and pills, providing great tonification.
Seventh discussion: For deficiency consumption with fever, phlegm-cough-panting-sweating, diarrhea, abdominal pain, weak Spleen, poor appetite, and emaciation, Rui Lian Wan (Lotus Seed Pill) is suitable.
Rui Lian Wan (Lotus Seed Pill)
Gan Shan Yao (Dioscoreae Rhizoma, fried, 2 liang)
Lian Rou (Nelumbinis Semen, decentered, membrane and skin removed, 2 liang)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, de-rhizome, earth-fried, 3 liang)
Qian Shi (Euryales Semen, shelled, fried, 2 liang)
Ren Shen (Ginseng Radix et Rhizoma, 2 liang)
Bai Fu Ling (Poria, peeled, 1 liang)
Chen Pi (Citri Reticulatae Pericarpium, 1 liang)
Bai Shao (Paeoniae Radix Alba, fired, wine-fried, 1 liang)
Fen Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 5 qian)
Grind into fine powder. Use one male pig stomach, wash clean, boil until soft, pound and mix to form pills the size of paulownia seeds. Take 100 pills with rice soup.
Eighth discussion: This paste treats Five Labors and Seven Injuries, extreme deficiency consumption, damaged True Qi, weak Spleen and Stomach, nourishes Blood and harmonizes the Middle, calms coughing and resolves phlegm, reduces fever and calms panting, stops diarrhea and relieves thirst. It is truly a kingly remedy.
Tiao Yuan Bai Bu Gao (Harmonizing Origin Hundred-Tonics Paste) (Transmitted by Minister Zhang)
Dang Gui Shen (Angelicae Sinensis Radix, wine-washed, 4 liang)
Huai Sheng Di Huang (Rehmanniae Radix Preparata, 2 jin)
Huai Shu Di Huang (Prepared Rehmanniae Radix, 4 liang)
Gan Gou Qi Zi (Lycii Fructus, 1 jin)
Bai Shao (Paeoniae Radix Alba, 1 jin, fried with rice flour)
Ren Shen (Ginseng Radix et Rhizoma, 4 liang)
Liao Wu Wei Zi (Schisandrae Fructus, 1 liang)
Mai Men Dong (Ophiopogonis Radix, decentered, 5 liang)
Di Gu Pi (Lycii Cortex, 4 liang)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, de-rhizome, 4 liang)
Bai Fu Ling (Poria, peeled, 12 liang)
Lian Rou (Nelumbinis Semen, 4 liang)
Huai Shan Yao (Dioscoreae Rhizoma, 5 liang)
Bei Mu (Fritillariae Bulbus, decentered, 3 liang)
Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 liang)
Hu Po (Amber, 1.3 qian)
Yi Yi Ren (Coicis Semen, fried with rice flour, 8 liang)
Grind into fine powder, add enough water (10 jin), simmer until dry, add another 10 jin water, repeat four times. Filter residue, collect juice. Simmer over gentle fire until reduced by one-third. For every jin of juice, add 4 liang of purified cooked honey (5 liang in spring, 6 liang in summer), boil into paste. Take 3 spoons per dose, mixed with plain water. For hemoptysis, add Mu Dan Pi (Moutan Cortex, 2 liang). For bone-steaming fever, add Qing Hao Ji (Artemisiae Annuae Herba Juice) and Tong Bian (Child's Urine), 2 bowls each, take hot together. One patient had hot feet, dry mouth, phlegm expectoration, and dizziness; after taking Si Wu Tang (Four Substances Decoction), Huang Lian (Coptidis Rhizoma), and Huang Bo (Phellodendri Cortex), appetite decreased and phlegm increased. Cured using Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) plus Mai Men Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus), Shan Yao (Dioscoreae Rhizoma), and Shan Zhu Yu (Corni Fructus).
A sixteen-year-old man, in summer, experienced thirst, fever, phlegm expectoration, dry lips, and widespread scabies, especially on the legs, dark in color and itchy, worsening at dusk. In mid-winter, he developed leg sores; the Chi pulse was flooding and rapid. I said: Scabies is Kidney Chancre; sores are Bone Abscesses; both are Kidney Meridian deficiency syndromes. After acupuncture, pus emerged with a misty odor. I stated that during peak fire, Tuberculosis (*Zhai*) would likely occur. Thus, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) and Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) were used. Within twenty days, all symptoms resolved. Tuberculosis was also cured with the aforementioned medicines. He married in winter, but symptoms recurred in spring. His parents worried, so he slept in a separate room. Although young and careful, he took several jin of Di Huang Wan and over 300 doses of decoctions before recovering.
I have heard that scholars studying and writing endure hardship and must regulate desire. Mental labor without regulating desire causes fire to move; fire moving consumes Kidney Water daily; water depletion causes fire to blaze; blazing fire harms Lung Metal, transmitting into Labor (Consumption). This deeply understands the hardship of study and the origin of illness, but patients must know how to prevent it.
For Yin deficiency with hyperactive fire, fever, irritability, where other medicines fail, only Child's Urine (Tong Bian) can achieve efficacy. Modify Yi Qi Tang by removing Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma), adding Sheng Di Huang (Rehmanniae Radix Preparata), Chi Fu Ling (Poria with pink interior), Bai Fu Ling (Poria), Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Chi Shao (Paeoniae Radix Rubra), Wu Wei Zi (Schisandrae Fructus), Huang Bo (Phellodendri Cortex), Di Gu Pi (Lycii Cortex), Zhi Mu (Anemarrhenae Rhizoma), Bei Mu (Fritillariae Bulbus), Yin Hua (Lonicerae Japonicae Flos), Chai Hu (Bupleuri Radix), Gui Ban (Testudinis Carapax et Plastrum).
If heat comes and goes, appearing by day and hiding by night, or vice versa, moving irregularly or in不定 locations, causing mouth and tongue sores, if starting from the feet, it is Rootless Fire. Use Ba Wei Wan (Eight-Ingredient Pill) and Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction), adding Mai Men Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Fructus).
To treat Yin deficiency with hyperactive fire and five-palm heat, use urine from a healthy boy of seven or eight years old. Discard the beginning and end, use only the middle white portion, one cup. Take before or after meals. Take two to three times daily. It rapidly descends fire and nourishes Yin. Do not use red or yellow urine. Mistaken use damages Spleen and Stomach causing diarrhea. Be cautious.
A scholar with a robust physique drank cold water in winter, proud of his strength. I said: This is Yin deficiency. He did not believe. One day, he developed mouth and tongue sores. Using cold-cooling agents led to limb fatigue, fever, and aversion to cold. I cured him with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
To treat Tuberculosis with excessive Yang erection, use Xiao Ming (Mirabilite) in any amount, place on Lao Gong (PC 8, center of palm), clasp hands together, let it melt naturally, the erection subsides, disease cures. To restore Yang, use good liquor and yellow mud, apply to the pubic area for one day, Yang rises.
Another formula for excessive Yang: Pound small loofah vines, apply to the penis, erection subsides.
Another formula for impotence: Use frosted loofah, any size, soak in white horse urine for one day, dry in shade, grind to powder. Take 3 qian on an empty stomach with white wine.
Another method to shrink Yang:
Ma Huang Qi (Leech-like insect, also called Ma Die), catch nine, raise in water, harvest on July 7th, dry in shade. Weigh equal amounts of Ma Huang Qi, She Xiang (Moschus), and He Yi Xiang (Costus Root). Grind to fine powder, make small cakes with honey. When Yang is excessive, rub a little on the left sole. Impotence occurs immediately; it returns the next day, rub again.
Discussion: Labor refers to labor of Spirit and Qi; Injury refers to injury of appearance. Excessive hunger and fullness injure the Spleen; excessive thinking injures the Heart; excessive lust injures the Kidney; irregular living habits injure the Liver; anger, joy, sorrow, and grief injure the Lung. Wind, cold, summer-heat, and dampness injure the exterior; hunger, fullness, and labor injure the interior. Daytime exposure injures Ying (Nutrient) Qi; nighttime exposure injures Wei (Defensive) Qi. Ying and Wei circulate, interacting internally and externally, following day and night rhythms. Initially, one is labored, rising to two; two transmits to three; three connects to four; four interferes with five; five repeats injuring one. From one to five, pathogens hide deeply, True Qi is lost, muscles waste, Spirit weakens, appetite decreases, walking becomes difficult. Once it reaches this state, even with life, one cannot survive long.