岳父年逾花甲，形体瘦瘠，早岁辛苦劳碌，调养失宜。是以赢弱之质，时患肢节疼痛，劳伤内损固有之，风寒外入亦有之，因病小而忽诸。久而不治，厥疾乃甚。浸至二年前春夏之交，一身肢节尽疼，痛如虎咬，手指关节既肿且大。饮食起居，艰于自理，是为历节风痛也，西医断为类风湿性关节炎。久经中西医迭治，汤丸并进，而又举凡针灸、导引、按摩、运动之法，靡不施行，终鲜效机。及至盛夏，病不少减，行动困惫，肌肉尽削。暑本湿热之气，常人受之，犹汗流不辍，而岳父滴汗不淌，浑身不适，难可名状。因思风邪闭于腠理，不开鬼门，病何以祛?遂投《金匮》乌头汤(乌头、麻黄、芍药、甘草、黄芪、白蜜)，汗仍不露。方中加入桂枝，助麻黄以迫汗，各用3g亦不知，渐次递加至麻黄12g、桂枝9g，始得通身津润，病势由是而顿挫。却见肌肤亢热，夜剧昼轻，脉弦而细，乃是阴伤血燥之征。频进养血祛风，虚热除而痹痛不瘥，节肿不消。旋因公返回外地，在彼所服近百剂，率皆独活防风灵仙秦艽之属，一派祛风辛燥之品。虽稍益参术，总是杯水车薪。嗣即膺胸大痛，俯仰维艰。石顽云：“上虚而痛者，心脾伤也。”得无为此说法乎?彼医以葡萄糖静脉滴注，持续旬余始趋安可。继而仍服益气祛风之剂，痹痛稍减，但心悸怔忡、足跟疼痛不可着地之病生。赢瘦少气，纳谷不馨。越数月回沪，视脉弦大挺劲，察舌胖大淡嫩，苔薄腻而略干。窃思病逾年半有奇，今已伤及先天，纵观症情脉舌，显然肝肾亏损，此张景岳论之详矣。更参孙一奎《生生子医案》治法，拟方子服：
党参12g熟地12g枸杞子30g炙龟板12g鹿角胶9g五加皮6g苍耳子6g黄柏4．5g生苡仁12g淮牛膝12g杜红花3g
以地杞龟鹿滋肾而扶本。党参益气而助之；加皮苍膝强筋骨而祛风；黄柏苡仁清消肢节之肿；红花一味通利血脉之痹。以此加减，药未兼旬，而病愈强半。复因公务紧要，返回办事，徒步跋涉数十里，足踵居然不痛。事竟返沪，照服前方，至今尽三十余剂，痹痛又减，除十指小关节晨起略有肿胀外，余处皆舒。胃纳也开，心悸亦宁。舌象虽未复常，而六脉逐现柔和。此先天之真元渐充，后天之胃气来复，是佳兆也明矣。倘能不违前方之意，不离前方之法，随症情而略加增损，则沉疴除去之日，可克期而待也。
按：岳父之病，以彼医固执己见，用药始终不离羌独灵仙，而“沉疴除去之日”终未来到。服药愈多，病势愈甚。患难症而遇不学无术却又刚愎自用之辈，不亦悲夫!罗谦甫《卫生宝鉴》有句云：“活人之道将与相，一旦在己权非轻。”古人又云：“不为良相，宁为良医。”是以医虽小道，而重任独肩，尤其患者危急之际，医操生杀之权，故临证之时切切不可师心自用也。余不敏，时时识此以为鉴戒，不敢放任自流。
甲状腺机能亢进一症，为现代西医病名，中医归入“瘿病”范畴。典型症状可见甲状腺肿大、突眼症、心律加速，有时可见心律失常，多食易饥，部分患者大便次数增多，但常挟不消化食物，易消瘦及营养不良：中医对此症之认识，为多与气郁痰结有关。疾病初起，证多属实，每见心肝火炽症状。如头痛、眩晕、心烦易怒，目涩口干、失眠多梦。后期证多属虚，而虚中挟实。以阴虚内热症状为多见，如两颊潮红，心悸盗汗、五心烦热，健忘失眠，形体消瘦，舌红苔净，脉形细数等。至其治法，心肝火炽者当清泄郁火；肝肾阴虚者宜滋肾养肝；阴虚内热者则养阴清热；痰气郁结者参以化痰散结。依据患者之病证，随证施治。余于临证之中，恒见患者肝肾精血亏虚、心肝郁热与痰气凝滞等证每多挟杂并见，且又相因为病。尚兼有脾肺气虚之象。于症状则多见疲倦乏力及自汗频频。对于此类患者，祝谌予先生用当归六黄汤加味治疗，颇为合宜。
祝谌予先生曰：“此方为我在临床治疗甲亢之首选方剂，口干、自汗、肌肉痉挛时加生牡蛎、木瓜、五味子；手颤甚用白头翁；甲状腺肿大加橘核、荔枝核、夏枯草。”余用先生此法治疗数例，均获良效，今录一例于下。
友人徐君之侄女，昔年在沪业个体服装，后赴阿根廷经营饭店，亦甚顺利。但乍到异国他乡，人地生疏，语言不通，于斯创业，辛苦倍尝。加之急躁郁闷，日以为常。两年后渐觉乏力、短气、汗出、心悸。彼国医院诊断“甲亢”，建议终身服药。于是返沪求治，以冀痊愈。途中病发甚重，甫下飞机舷梯，即晕厥于地。家属送至某医院，诊断与境外一致：“甲状腺机能亢进症。”住院一月，病情得以控制，后即出院。彼昔年在沪时，常患肠胃不和，每每由余调治。故出院伊始，即向余问药。时在1993年12月27日也。
当时所见主症为乏力特甚，汗出极多。稍稍行动则疲惫不支，而汗冒如珠。兼见胸闷、烦躁、口干、头痛、纳食不振、夜寐欠安、前额胀疼、两目不适、面目虚浮、持物手颤、眩晕泛恶、两耳蝉鸣，情绪稍有波动即心慌心跳。诊脉左小，右小滑，舌淡红，苔薄黄。据此脉证，是气血两亏于内，心肝痰火郁伏于中。治法宗祝谌予先生，用当归六黄汤化裁，以益气养血，软坚消痰清火为法，即书一方：
生黄芪24g当归9g炒白芍9g黄柏9g黄连3g黄芩9g生熟地各15g生牡蛎30g枸杞子9g党参9g麦门冬9g瓜蒌仁9g五味子3g海藻9g昆布9g
以上方为基础，用药随证加减。曾用之药有：白头翁、枣仁、夜交藤、石决明、甘菊花、白蒺藜、桑叶、茯苓、远志、牛膝、火麻仁、生晒参、淮山药等。至来年三月中旬，服药七十帖，病体渐愈，症状相继消失，化验基本正常。未久返回阿根廷，二年后曾来电相告：健康一如畴昔。
风痨臌膈素称四大难症，其中肺痨由瘵虫传染而成，于人类健康危害尤烈，因而历代医家无不潜心钻研，究其治法，虽各有所得，而终乏出类拔萃之方。考前贤之治疗方药中，《医学心悟》之“月华丸”滋柔清润、补虚抗痨，为治肺痨之良方。其方养阴、清肝、化瘀、杀虫，用意周匝，药简而精，颇切实用。然全方偏重养阴，治病之力尚嫌不足。至若瘵虫始嚣，邪气方张、咳嗽剧作、失血频频，骨蒸如潮、盗汗淋漓、遗精无度、气促嘘吸之时，斯方犹觉鞭长莫及，尚难左右逢原。
近贤唐容川别出心裁，倡议以小柴胡汤治肺痨咳嗽。盖虚痨之病见症虽多，而咳嗽为其最为突出之主症。故治虚痨咳嗽之方，亦多能治虚痨本病。唐容川于《血证论》中曰：“夫虚痨咳嗽，原于火克金、水乘肺，而切究其故，则病皆在于胃。胃为水谷之海，化生津血。血不足则火旺；津不生则肺燥；水气不化，则饮邪上干。”又曰：“兹有一方可以统治肺胃者，则莫如小柴胡汤。”“盖小柴胡能通水津、散郁火、升清降浊、左宜右有，加减合法，则曲尽其妙。”
或曰：小柴胡汤乃治伤寒邪在少阳之主方，何以能治肺痨?对此唐氏有其极为精辟之见解，其于小柴胡汤下释曰：“人身之表，腠理实营卫之枢机；人身之里，三焦实脏腑之总管。惟少阳内主三焦，外主腠理。论少阳之体，则为相火之气，根于胆腑。论少阳之用，则为清阳之气，寄在胃中。方以参、枣、甘草以培养其胃，则用黄芩、半夏降其浊火；柴胡、生姜升其清阳。是以其气和畅；则腠理、三焦罔不调治。”此即小柴胡汤能治人身内、外、妇、儿等各科许多疾病之机理，而肺痨之病岂能越此?其实肺痨之成，多由情志郁勃，肝郁既久，内热必盛，肝热肺火相因为病。热炽津伤，痰浊内生。病久之体，不仅易损津液，且能伤及脾肺气分。此方以参、草、姜、枣益气扶中、和胃致津。半夏、黄芩清热、消痰而降浊。柴胡合黄芩疏肝而散肺肝郁热。诸药之组合，深契肺痨之病机，故用治肺痨，别具手眼，独树一帜。
唐氏之论，发聋振聩，犹如严冬将过，春雷萌动。实为肺痨之治法，继程氏之后又开新宇。余据唐氏之论，以小柴胡汤治肺痨，但须辨证明确，化裁得宜，每获良效。今举二例为证。
例一肺结核
某局金科长，六十三岁，男性。于1996年2月7日来诊。自诉疲乏无力，精神委靡、咳嗽无痰、有时吐红、呼吸不畅，盗汗频作，时发寒热、腰脊酸软已经数月。初起未予介意，自服解热、止咳、消炎等药，病情时轻时重，缠绵未已。经由铁道大学附属甘泉医院胸片检查，片示“右上肺斑片状影多处”诊断为“肺结核，部分为陈旧性，”并伴肺气肿。余诊其脉，左手小弦，右手浮大。舌体瘦小，略偏暗红，苔薄白。据其四诊，诊断为“肺肾阴亏。”治拟滋阴润肺，敛火清金，拟用百合固金汤加减：
太子参12g百合9g生熟地各9g川贝母6g桔梗3g甘草3g麦门冬9g桑叶15g炒白芍9g炙百部9g五味子1g红枣30g
上方服用十七剂，自觉精神好转，盗汗不作，而余症如初。且午后三时许(即中医所谓“日晡”之时)必发低烧，两颊蒸热，夜间则干咳剧烈。偶有痰浊，多带血丝。视脉左弦，右弦细而软，舌苔如前。证属阴亏火炽、气虚痨热。经再三推敲，改拟小柴胡汤加味，方为：
党参24g柴胡3g甘草9g姜半夏4．5g黄芩9g杏仁9g炒白芍20g天门冬9g百部9g生姜一片大枣5枚
此方一药见效，共加减服用近百剂而诸症渐解。治疗期间因于胸痛咳甚时，曾加川贝母、丹参、桃仁、平地木；脾肺气虚明显时，酌加黄芪、苡仁；眩晕则加龙牡。其余诸药则随其脉症而变动不居。
此外，服小柴胡汤加减方五十剂后，适当辅以狼毒蛋内服，以加强杀虫之力。
至6月7日，自觉症状皆已消失，请在老年医院担任领导之亲戚为之复查，告以病灶消失。为巩固疗效，增强体质，又以首次之方随证加减，服五十余剂，滋养肺脾肾，固本扶正。药后精神益佳，神采奕奕，不耐静养而外出发挥余热矣。
诊后小记：此方疗效之佳，事实已经证明，而佳效的获得，固仗小柴胡汤之大力。然益入数品，亦非等闲之辈，皆为祛邪抗痨之猛将。天冬合百部，润肺燥、杀痨虫、止咳逆独具专长。《津门医粹》阐述古今人医师治肺痨经验云：“常用药为天冬、百部二味，谓《千金方》记载百部一味能治三十年久咳，且能杀虫。根据本草记载天冬亦能杀三虫去伏尸。”故其自制之肺活素亦以此二味为之主药。此外，就余经验所得，天门冬养阴退蒸及和络脉、止胸痛功效可靠而非虚语。芍药、甘草重用之可平肝解痉而治肺痨之顽固咳嗽，且能有效消除胸痛。惟白芍善泻木于土中，其性酸敛，因而不无克伐消削之嫌而虑其抑制中阳，凡痨病经久、中土受戕者用之宜慎。
狼毒蛋治肺痨方，余首先于70年代之《新中医》杂志报道，作者位于东北，故一次制作一月量(红壳蛋二十余枚)。上海地处长江流域，气温较高，因而稍稍变通其方法。上例治于春日，每次以狼毒10g加水适量，烧煮一小时后加入洗净之红壳鸡蛋8枚，煮之蛋熟即离火，让蛋浸没于狼毒液中，过两小时后取蛋食第一枚，随即存入冰箱保藏，以后每日取食一枚，食时可用微波炉加热，或放碗中隔水蒸热。如在夏季天气炎热，宜于每日制作，当日服食。其法每日以狼毒3g，放于底窄之小锅内，加水煮就后浸泡4小时食用，每日一枚。余曾以此法治一刘姓女子，系食堂炊事员，年近40岁。因乏力、低热骨蒸，至区结防所检查，诊断为右上肺浸润型结核，嘱其须耐心服药数年，以观后效。余授以狼毒蛋方，服法如上。服用数日后低热骨蒸即消失，由是信心坚定，每日坚持服一枚，经治四个月，摄片复查则结核病灶全部钙化。愈后至今已十余年，向来康健无病，肺痨亦未复发，
又：狼毒为有毒之品，余曾以一片煮水饮服，旋即咽喉疼痛，咽后壁滤泡丛生，经多日始消。医书有以狼毒加水烧煮，上置蒸笼，内放红枣，蒸二小时后取枣晒干食用，每日10～15枚，其法似较每日煮蛋为简便。余曾试作而亲尝之，然食后即见明显泛恶及眩晕，虽经数小时可自行解除，但总是药物毒性反应，难免有损于患者之病体。而狼毒蛋则绝无不良反应，余亦曾尝试多次，蛋壳煮破者食之亦无妨。且曾饮服少量与蛋同煮之狼毒液汁，亦未见任何副反应。是否蛋白质对狼毒具有解毒功能，有待研究。鸡蛋以红壳者为优，红壳蛋壳厚而致密，滤毒功能当较白壳者更佳也。
例二结核性胸膜炎
孙某，女，于43岁孟冬，渐见疲乏无力，右胸上部疼痛，进行性加重，下午潮热，两颧骨蒸，铁道大学附属甘泉医院摄片，诊断为“右侧中量胸腔积液”及“右上肺结核”。由区中心医院予以雷米封及利福平内服，三月后仍无明显好转。患者素信中医中药，因而同时要求服用中药。余诊其脉左弦，右小而不耐寻按，右寸细弱。舌质淡，苔薄白。症如上述。据此脉症，显属脾肺气虚、肝胆热蕴。木火刑金则咳，灼络则痛，入于阴分，内蒸骨髓则潮热。治法当清疏少阳之热，益气和中以培土生金，兼以杀虫抗痨、化痰止咳。同时开降肺气，以利水道。拟方以小柴胡汤合葶苈大枣泻肺汤加味：
岳父年过六十，身体消瘦，早年辛苦劳碌，调养不当。因此体质虚弱，时常患肢体关节疼痛，这既有劳累内伤的因素，也有风寒外袭的原因，因为病情看似轻微而被忽视。长期不治疗，旧病加重。直到两年前春夏之交，全身关节都疼痛，痛如虎咬，手指关节既肿胀又变大。饮食起居难以自理，这就是历节风痛，西医诊断为类风湿性关节炎。经过中西医多次治疗，汤药丸药并用，以及针灸、导引、按摩、运动等方法都用过了，始终没有明显疗效。到了盛夏，病情没有减轻，行动疲惫，肌肉消瘦。暑天本是湿热之气，常人感受它，还会汗流不止，而岳父却一滴汗不出，浑身不适，难以形容。我想风邪闭阻在腠理（皮肤毛孔），如果不发汗，病怎么能祛除？于是投用《金匮要略》中的乌头汤（含乌头、麻黄、芍药、甘草、黄芪、白蜜），仍然不出汗。方中加入桂枝，帮助麻黄强行发汗，各用3克也不见效，逐渐增加到麻黄12克、桂枝9克，才使得全身湿润出汗，病情由此得到遏制。但随后出现肌肤高热，夜间重白天轻，脉象弦细，这是阴液受伤、血液干燥的征象。频繁服用养血祛风的药物，虚热消除了但痹痛未愈，关节肿胀未消。后来因公返回外地，在那里服用的近百剂药，都是独活、防风、威灵仙、秦艽这类药物，一派祛风辛燥之品。虽然稍微加入人参、白术，总是杯水车薪。随即出现胸膺部剧烈疼痛，俯仰困难。石顽（明代医家李中梓号）说：“上焦虚损而疼痛的，是心脾受伤。”难道就是这种情况吗？那位医生用葡萄糖静脉滴注，持续十几天才趋于安定。接着继续服用益气祛风的药剂，痹痛稍减，但又出现了心悸怔忡、足跟疼痛不能着地的新病。身体赢瘦少气，食欲不佳。几个月后回到上海，诊脉弦大挺劲，察舌胖大淡嫩，苔薄腻而略干。我思考病人患病一年多，现在已经损伤了先天之本，纵观症状、脉象和舌象，显然是肝肾亏损，这在张景岳的论述中很详细。再参考孙一奎《生生子医案》的治疗方法，拟定方子服用：
党参12g 熟地黄12g 枸杞子30g 炙龟板12g 鹿角胶9g 五加皮6g 苍耳子6g 黄柏4.5g 生薏苡仁12g 淮牛膝12g 杜红花3g
用地黄、枸杞、龟板、鹿角胶滋补肾精以扶助根本。党参益气并辅助它；五加皮、苍耳子、牛膝强健筋骨并祛风；黄柏、薏苡仁清除消退肢节的肿胀；红花一味通利血脉的痹阻。以此加减，用药不到十天，病情好了大半。后来又因公务紧急，回去办事，徒步跋涉几十里，脚后跟竟然不痛。事情办完回上海，继续服用前方，至今共服三十多剂，痹痛又减轻，除了十个手指小关节早晨起床略有肿胀外，其余部位都舒适。胃纳也开了，心悸也安宁了。舌象虽然没恢复正常，但六脉逐渐显现柔和。这是先天真元逐渐充盛，后天胃气恢复，这是明显的吉兆。如果能不违背前方的意思，不离前方的方法，根据病情略微增减，那么沉疴除去的日子，可以期待很快到来。
按语：岳父的病，因为那位医生固执己见，用药始终不离羌活、独活、威灵仙，而“沉疴除去之日”终究没来。服药越多，病情越重。患难症遇到不学无术却又刚愎自用的人，不也是可悲吗！罗谦甫《卫生宝鉴》有句话：“行医之道如同将相，一旦掌握在自己手中，责任不轻。”古人又说：“不做良相，宁做良医。”所以医学虽然是小道，但重任独自承担，尤其在患者危急时刻，医生操有生杀大权，所以临证时切切不可自以为是。我不才，时时记住这个作为警戒，不敢放任自流。
甲状腺功能亢进是现代西医病名，中医归入“瘿病”范畴。典型症状可见甲状腺肿大、突眼症、心律加速，有时可见心律失常，多食易饥，部分患者大便次数增多，但常夹杂不消化食物，易消瘦及营养不良；中医对此症的认识，认为多与气郁痰结有关。疾病初起，证多属实，常见心肝火炽的症状。如头痛、眩晕、心烦易怒，目涩口干、失眠多梦。后期证多属虚，而虚中夹实。以阴虚内热症状为多见，如两颊潮红，心悸盗汗、五心烦热，健忘失眠，形体消瘦，舌红苔净，脉形细数等。至于治法，心肝火炽者应当清泄郁火；肝肾阴虚者宜滋肾养肝；阴虚内热者则养阴清热；痰气郁结者参以化痰散结。依据患者的病证，随证施治。我在临证中，常看到患者肝肾精血亏虚、心肝郁热与痰气凝滞等证往往夹杂并见，且相互致病。还兼有脾肺气虚的现象。在症状上则多见疲倦乏力及自汗频频。对于此类患者，祝谌予先生用当归六黄汤加味治疗，颇为合适。
祝谌予先生说：“此方是我临床治疗甲亢的首选方剂，口干、自汗、肌肉痉挛时加生牡蛎、木瓜、五味子；手颤甚用白头翁；甲状腺肿大加橘核、荔枝核、夏枯草。”我用先生的这种方法治疗几例，均获良效，现记录一例如下。
友人徐君的侄女，昔年在上海从事个体服装生意，后去阿根廷经营饭店，也很顺利。但刚到异国他乡，人地生疏，语言不通，在此创业，辛苦加倍。加之急躁郁闷，习以为常。两年后渐渐觉得乏力、短气、出汗、心悸。该国医院诊断“甲亢”，建议终身服药。于是返回上海求治，希望痊愈。途中病情发作严重，刚下飞机舷梯，就晕厥在地。家属送到某医院，诊断与境外一致：“甲状腺功能亢进症。”住院一个月，病情得以控制，后即出院。她昔年在上海时，常患肠胃不和，每每由我调治。所以出院伊始，就向我问药。时在1993年12月27日。
当时所见主症为乏力特别严重，出汗极多。稍稍行动则疲惫不堪，而汗冒如珠。兼见胸闷、烦躁、口干、头痛、纳食不振、夜寐欠安、前额胀疼、两目不适、面目虚浮、持物手颤、眩晕泛恶、两耳蝉鸣，情绪稍有波动即心慌心跳。诊脉左小，右小滑，舌淡红，苔薄黄。据此脉证，是气血两亏于内，心肝痰火郁伏于中。治法遵循祝谌予先生，用当归六黄汤化裁，以益气养血，软坚消痰清火为法，即开一方：
生黄芪24g 当归9g 炒白芍9g 黄柏9g 黄连3g 黄芩9g 生熟地黄各15g 生牡蛎30g 枸杞子9g 党参9g 麦门冬9g 瓜蒌仁9g 五味子3g 海藻9g 昆布9g
以上方为基础，用药随证加减。曾用过的药有：白头翁、枣仁、夜交藤、石决明、甘菊花、白蒺藜、桑叶、茯苓、远志、牛膝、火麻仁、生晒参、淮山药等。至来年三月中旬，服药七十帖，病体渐愈，症状相继消失，化验基本正常。不久返回阿根廷，二年后曾来电告知：健康一如往昔。
风痨臌膈素称四大难症，其中肺痨由瘵虫传染而成，对人类健康危害尤烈，因而历代医家无不潜心钻研，探究其治法，虽各有所得，但终乏出类拔萃之方。考察前贤的治疗方药中，《医学心悟》的“月华丸”滋柔清润、补虚抗痨，为治肺痨之良方。其方养阴、清肝、化瘀、杀虫，用意周全，药简而精，颇切实用。然而全方偏重养阴，治病之力尚嫌不足。至于瘵虫始嚣，邪气方张、咳嗽剧作、失血频频，骨蒸如潮、盗汗淋漓、遗精无度、气促嘘吸之时，此方犹觉鞭长莫及，尚难左右逢源。
近贤唐容川别出心裁，倡议以小柴胡汤治肺痨咳嗽。盖虚痨之病见症虽多，而咳嗽为其最为突出之主症。故治虚痨咳嗽之方，亦多能治虚痨本病。唐容川于《血证论》中说：“夫虚痨咳嗽，原于火克金、水乘肺，而切究其故，则病皆在于胃。胃为水谷之海，化生津血。血不足则火旺；津不生则肺燥；水气不化，则饮邪上干。”又说：“兹有一方可以统治肺胃者，则莫如小柴胡汤。”“盖小柴胡能通水津、散郁火、升清降浊、左宜右有，加减合法，则曲尽其妙。”
有人说：小柴胡汤乃治伤寒邪在少阳之主方，何以能治肺痨？对此唐氏有其极为精辟之见解，其于小柴胡汤下解释曰：“人身之表，腠理实营卫之枢机；人身之里，三焦实脏腑之总管。惟少阳内主三焦，外主腠理。论少阳之体，则为相火之气，根于胆腑。论少阳之用，则为清阳之气，寄在胃中。方以参、枣、甘草以培养其胃，则用黄芩、半夏降其浊火；柴胡、生姜升其清阳。是以其气和畅；则腠理、三焦罔不调治。”此即小柴胡汤能治人身内、外、妇、儿等各科许多疾病之机理，而肺痨之病岂能越此？其实肺痨之成，多由情志郁勃，肝郁既久，内热必盛，肝热肺火相因为病。热炽津伤，痰浊内生。病久之体，不仅易损津液，且能伤及脾肺气分。此方以参、草、姜、枣益气扶中、和胃致津。半夏、黄芩清热、消痰而降浊。柴胡合黄芩疏肝而散肺肝郁热。诸药之组合，深契肺痨之病机，故用治肺痨，别具手眼，独树一帜。
唐氏之论，发聋振聩，犹如严冬将过，春雷萌动。实为肺痨之治法，继程氏之后又开新宇。余据唐氏之论，以小柴胡汤治肺痨，但须辨证明确，化裁得宜，每获良效。今举二例为证。
例一 肺结核
某局金科长，六十三岁，男性。于1996年2月7日来诊。自诉疲乏无力，精神委靡、咳嗽无痰、有时吐红、呼吸不畅，盗汗频作，时发寒热、腰脊酸软已经数月。初起未予介意，自服解热、止咳、消炎等药，病情时轻时重，缠绵未已。经由铁道大学附属甘泉医院胸片检查，片示“右上肺斑片状影多处”诊断为“肺结核，部分为陈旧性，”并伴肺气肿。余诊其脉，左手小弦，右手浮大。舌体瘦小，略偏暗红，苔薄白。据其四诊，诊断为“肺肾阴亏。”治拟滋阴润肺，敛火清金，拟用百合固金汤加减：
太子参12g 百合9g 生熟地黄各9g 川贝母6g 桔梗3g 甘草3g 麦门冬9g 桑叶15g 炒白芍9g 炙百部9g 五味子1g 红枣30g
上方服用十七剂，自觉精神好转，盗汗不作，而余症如初。且午后三时许（即中医所谓“日晡”之时）必发低烧，两颊蒸热，夜间则干咳剧烈。偶有痰浊，多带血丝。视脉左弦，右弦细而软，舌苔如前。证属阴亏火炽、气虚痨热。经再三推敲，改拟小柴胡汤加味，方为：
党参24g 柴胡3g 甘草9g 姜半夏4.5g 黄芩9g 杏仁9g 炒白芍20g 天门冬9g 百部9g 生姜一片 大枣5枚
此方一药见效，共加减服用近百剂而诸症渐解。治疗期间因于胸痛咳甚时，曾加川贝母、丹参、桃仁、平地木；脾肺气虚明显时，酌加黄芪、苡仁；眩晕则加龙牡。其余诸药则随其脉症而变动不居。
此外，服小柴胡汤加减方五十剂后，适当辅以狼毒蛋内服，以加强杀虫之力。
至6月7日，自觉症状皆已消失，请在老年医院担任领导之亲戚为之复查，告以病灶消失。为巩固疗效，增强体质，又以首次之方随证加减，服五十余剂，滋养肺脾肾，固本扶正。药后精神益佳，神采奕奕，不耐静养而外出发挥余热矣。
诊后小记：此方疗效之佳，事实已经证明，而佳效的获得，固仗小柴胡汤之大力。然益入数品，亦非等闲之辈，皆为祛邪抗痨之猛将。天冬合百部，润肺燥、杀痨虫、止咳逆独具专长。《津门医粹》阐述古今人医师治肺痨经验云：“常用药为天冬、百部二味，谓《千金方》记载百部一味能治三十年久咳，且能杀虫。根据本草记载天冬亦能杀三虫去伏尸。”故其自制之肺活素亦以此二味为之主药。此外，就余经验所得，天门冬养阴退蒸及和络脉、止胸痛功效可靠而非虚语。芍药、甘草重用之可平肝解痉而治肺痨之顽固咳嗽，且能有效消除胸痛。惟白芍善泻木于土中，其性酸敛，因而不无克伐消削之嫌而虑其抑制中阳，凡痨病经久、中土受戕者用之宜慎。
狼毒蛋治肺痨方，余首先于70年代之《新中医》杂志报道，作者位于东北，故一次制作一月量（红壳蛋二十余枚）。上海地处长江流域，气温较高，因而稍稍变通其方法。上例治于春日，每次以狼毒10g加水适量，烧煮一小时后加入洗净之红壳鸡蛋8枚，煮之蛋熟即离火，让蛋浸没于狼毒液中，过两小时后取蛋食第一枚，随即存入冰箱保藏，以后每日取食一枚，食时可用微波炉加热，或放碗中隔水蒸热。如在夏季天气炎热，宜于每日制作，当日服食。其法每日以狼毒3g，放于底窄之小锅内，加水煮就后浸泡4小时食用，每日一枚。余曾以此法治一刘姓女子，系食堂炊事员，年近40岁。因乏力、低热骨蒸，至区结防所检查，诊断为右上肺浸润型结核，嘱其须耐心服药数年，以观后效。余授以狼毒蛋方，服法如上。服用数日后低热骨蒸即消失，由是信心坚定，每日坚持服一枚，经治四个月，摄片复查则结核病灶全部钙化。愈后至今已十余年，向来康健无病，肺痨亦未复发，
又：狼毒为有毒之品，余曾以一片煮水饮服，旋即咽喉疼痛，咽后壁滤泡丛生，经多日始消。医书有以狼毒加水烧煮，上置蒸笼，内放红枣，蒸二小时后取枣晒干食用，每日10～15枚，其法似较每日煮蛋为简便。余曾试作而亲尝之，然食后即见明显泛恶及眩晕，虽经数小时可自行解除，但总是药物毒性反应，难免有损于患者之病体。而狼毒蛋则绝无不良反应，余亦曾尝试多次，蛋壳煮破者食之亦无妨。且曾饮服少量与蛋同煮之狼毒液汁，亦未见任何副反应。是否蛋白质对狼毒具有解毒功能，有待研究。鸡蛋以红壳者为优，红壳蛋壳厚而致密，滤毒功能当较白壳者更佳也。
例二 结核性胸膜炎
孙某，女，于43岁孟冬，渐见疲乏无力，右胸上部疼痛，进行性加重，下午潮热，两颧骨蒸，铁道大学附属甘泉医院摄片，诊断为“右侧中量胸腔积液”及“右上肺结核”。由区中心医院予以雷米封及利福平内服，三月后仍无明显好转。患者素信中医中药，因而同时要求服用中药。余诊其脉左弦，右小而不耐寻按，右寸细弱。舌质淡，苔薄白。症如上述。据此脉症，显属脾肺气虚、肝胆热蕴。木火刑金则咳，灼络则痛，入于阴分，内蒸骨髓则潮热。治法当清疏少阳之热，益气和中以培土生金，兼以杀虫抗痨、化痰止咳。同时开降肺气，以利水道。拟方以小柴胡汤合葶苈大枣泻肺汤加味：
Uncle-in-law was over sixty years old, with a thin and emaciated physique. Having worked hard and tirelessly in his early years and lacking proper care, his constitution became weak. Consequently, he frequently suffered from pain in the limbs and joints. This condition stemmed both from internal injury due to overexertion and external invasion of wind-cold. Because the symptoms seemed minor, they were neglected. Without long-term treatment, the chronic illness worsened. By the transition between spring and summer two years ago, pain affected all his joints, feeling as if bitten by tigers, with swelling and enlargement of the finger joints. Daily activities such as eating and dressing became difficult. This is known as "Li Jie Feng Tong" (Joint Bi Pain), diagnosed by Western medicine as Rheumatoid Arthritis. Despite repeated treatments by both Chinese and Western medicine, including decoctions, pills, acupuncture, Dao Yin (guiding and pulling exercises), massage, and exercise, there was little efficacy. Even in midsummer, when the pathogenic heat-dampness is prevalent, causing normal people to sweat profusely, my uncle-in-law did not sweat at all, suffering from indescribable discomfort throughout his body. I reasoned that wind-pathogen was closed within the Cou Li (skin pores and interstices); without opening the "ghost gate" (sweat pores) to induce sweating, how could the disease be expelled? Thus, I prescribed Wutou Tang (Cock's Foot Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), containing Chuanwu (Aconitum carmichaelii), Mahuang (Ephedrae Herba), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), and Bai Mi (Honey). However, no sweat appeared. I added Guizhi (Cinnamomi Ramulus) to assist Mahuang in forcing sweat, using 3g each, but it remained ineffective. Gradually, the dosage was increased to Mahuang 12g and Guizhi 9g, until finally, the whole body became moist with sweat, and the disease trend was checked.
However, subsequent symptoms included intense skin heat, worse at night and lighter during the day, with a wiry and fine pulse. These are signs of Yin injury and blood dryness. Frequent administration of formulas for nourishing blood and dispelling wind eliminated the deficient heat but failed to relieve the Bi pain or reduce joint swelling. Later, due to official duties, he returned to another location. The nearly one hundred doses taken there consisted mainly of Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Lingxian (Syneilesis Aconitifoliae Herba), and Qinjiao (Gentianae Macrophyllae Radix)—a batch of acrid-warm herbs for dispelling wind. Although some Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) were added, it was like pouring a cup of water on a burning cartload of fuel. Subsequently, severe chest pain occurred, making bending and stretching difficult. Shiwan (Li Zhongzi) stated: "Pain in the upper jiao due to deficiency indicates injury to the Heart and Spleen." Could this have been the case? The attending physician used intravenous glucose infusion for over ten days before stability was achieved. He then continued taking Qi-nourishing and wind-dispelling agents. While Bi pain slightly decreased, new symptoms emerged: palpitations, restlessness, and heel pain preventing him from standing on his feet. He remained emaciated with shortness of breath and poor appetite. Months later, upon returning to Shanghai, his pulse was wiry, large, and stiff; his tongue was fat, pale, and tender, with a thin, greasy, and slightly dry coating. Reflecting on the illness lasting over a year and a half, I concluded that the congenital foundation had been damaged. Observing the symptoms, pulse, and tongue, it was clearly Liver and Kidney deficiency, as detailed by Zhang Jingyue. Referencing Sun Yikui’s *Sheng Sheng Zi Yi An* (Medical Cases of Sheng Sheng Zi), I formulated the following prescription:
Dangshen (Codonopsis Radix) 12g, Shudi (Rehmanniae Radix Preparata) 12g, Gouqizi (Lycii Fructus) 30g, Zhi Guiban (Testudinis Carapax et Plastrum Preparatum) 12g, Lu Jiaojiao (Cervi Cornus Colla) 9g, Wujiapi (Acanthopanacis Cortex) 6g, Cangerzi (Xanthii Fructus) 6g, Huangbai (Phellodendri Cortex) 4.5g, Sheng Yiren (Coicis Semen) 12g, Huai Niuxi (Achyranthis Bidentatae Radix) 12g, Du Honghua (Carthami Flos) 3g.
Using Rehmannia, Goji, Tortoise Shell, and Deer Antler Gelatin to nourish the Kidneys and support the root. Dangshen tonifies Qi to assist; Wujiapi, Cangerzi, and Niuxi strengthen sinews and bones while dispelling wind; Huangbai and Yiren clear and resolve joint swelling; Honghua unblocks blood vessel obstruction. With these modifications, within ten days, the illness improved by more than half. Due to urgent official business, he traveled tens of kilometers on foot, and surprisingly, his heels did not hurt. Upon returning to Shanghai, he continued the previous formula. After thirty-plus doses, Bi pain decreased further. Except for slight morning swelling in the small joints of the ten fingers, all other areas felt comfortable. Appetite improved, and palpitations subsided. Although the tongue appearance had not fully normalized, the six pulses gradually became soft. This indicated that the primordial essence of the congenital foundation was replenishing, and the Stomach Qi of the acquired foundation was recovering—a favorable sign. If one adheres to the principles and methods of the previous formula, adjusting slightly according to symptoms, the removal of this chronic ailment can be expected soon.
Note: My uncle-in-law’s illness did not resolve because the attending doctor was stubborn, sticking exclusively to Qianghuo, Duhuo, and Lingxian. The more he took medicine, the worse the condition became. It is tragic to encounter incompetent yet arrogant physicians for difficult diseases. Luo Qianfu’s *Wei Sheng Bao Jian* states: "The way of saving lives is like that of generals and ministers; once power lies in one's hands, the responsibility is not light." The ancients said, "If one cannot be a good minister, one should strive to be a good physician." Medicine may seem a minor art, but it bears heavy responsibility. Especially in critical moments, doctors hold the power of life and death. Therefore, one must never be self-opinionated during clinical practice. I keep this in mind as a warning and dare not let things drift.
Effective Formula for Hyperthyroidism: Danggui Liu Huang Tang
Hyperthyroidism is a modern Western medical term, categorized in Traditional Chinese Medicine (TCM) under "Ying Bing" (Goiter). Typical symptoms include thyroid enlargement, exophthalmos, accelerated heart rate, sometimes arrhythmia, polyphagia with easy hunger, increased bowel movements often containing undigested food, weight loss, and malnutrition. TCM views this condition as largely related to Qi stagnation and Phlegm accumulation. Early stages are typically excess patterns, often showing Heart and Liver Fire blazing, such as headache, dizziness, irritability, dry eyes and mouth, insomnia, and vivid dreams. Later stages tend toward deficiency mixed with excess, commonly presenting Yin deficiency with internal heat, such as malar flush, palpitations, night sweats, five-palm heat, forgetfulness, insomnia, emaciation, red tongue with scant coating, and fine-rapid pulse. Treatment depends on the pattern: clearing stagnant fire for Heart-Liver Fire; nourishing Kidney and Liver for Yin deficiency; nourishing Yin and clearing heat for Yin deficiency with internal heat; and resolving Phlegm and dissipating nodules for Phlegm-Qi stagnation. In my clinical experience, patients often present with mixed patterns of Liver-Kidney Essence and Blood deficiency, Heart-Liver depressed heat, and Phlegm-Qi stagnation, often accompanied by Spleen-Lung Qi deficiency. Symptoms frequently include fatigue and spontaneous sweating. For such patients, Mr. Zhu Chenyu’s modified Danggui Liu Huang Tang is quite appropriate.
Mr. Zhu Chenyu stated: "This is my first-choice formula for treating hyperthyroidism clinically. Add Sheng Muli (Ostreae Concha), Mugua (Chaenomelis Fructus), and Wuweizi (Schisandrae Fructus) for dry mouth, spontaneous sweating, and muscle spasms; use Baitouweng (Pulsatillae Radix) for severe hand tremors; add Juhe (Citri Reticulatae Pericarpium), Lizhihe (Litchis Semen), and Xiakucao (Prunellae Spica) for thyroid enlargement." I applied this method to several cases with good results. One case is recorded below.
The niece of my friend, Mr. Xu, worked in the garment industry in Shanghai before moving to Argentina to run a restaurant successfully. However, facing unfamiliar surroundings and language barriers abroad, she endured great hardship. Combined with irritability and depression, which became daily occurrences, two years later she began experiencing fatigue, shortness of breath, sweating, and palpitations. A hospital in that country diagnosed "Hyperthyroidism" and recommended lifelong medication. She returned to Shanghai seeking a cure. On the journey, her condition worsened significantly; she fainted immediately upon stepping off the airplane stairs. Family members took her to a hospital where the diagnosis matched the overseas report: "Hyperthyroidism." After one month of hospitalization, her condition stabilized, and she was discharged. Previously in Shanghai, she often suffered from gastrointestinal disharmony, which I treated. Thus, upon discharge, she consulted me. This was on December 27, 1993.
Her main symptoms were severe fatigue and profuse sweating. Any slight movement led to exhaustion and bead-like sweating. Accompanying symptoms included chest tightness, irritability, dry mouth, headache, poor appetite, restless sleep, frontal distension and pain, eye discomfort, puffy face and eyes, hand tremors when holding objects, dizziness, nausea, tinnitus, and palpitations triggered by emotional fluctuations. Her left pulse was small; right pulse was small and slippery. The tongue was pale-red with a thin yellow coating. Based on these signs, there was dual deficiency of Qi and Blood internally, with Phlegm-Fire of the Heart and Liver constrained within. Following Mr. Zhu Chenyu’s approach, I used a modified Danggui Liu Huang Tang to tonify Qi and nourish Blood, soften hardness, resolve Phlegm, and clear Fire. The prescription was:
Sheng Huangqi (Astragali Radix) 24g, Danggui (Angelicae Sinensis Radix) 9g, Chao Baishao (Paeoniae Radix Alba Preparata) 9g, Huangbai (Phellodendri Cortex) 9g, Huanglian (Coptidis Rhizoma) 3g, Huangqin (Scutellariae Radix) 9g, Sheng Shu Dihuang (Rehmanniae Radix) 15g each, Sheng Muli (Ostreae Concha) 30g, Gouqizi (Lycii Fructus) 9g, Dangshen (Codonopsis Radix) 9g, Maidong (Ophiopogonis Radix) 9g, Gualouren (Trichosanthis Semen) 9g, Wuweizi (Schisandrae Fructus) 3g, Haizao (Sargassum) 9g, Kunbu (Eckloniae Thallus) 9g.
Modifications were made based on symptoms. Additional herbs used included Baitouweng (Pulsatillae Radix), Zaoren (Ziziphi Spinosae Semen), Yejiaoteng (Polygoni Multiflori Caulis), Shijueming (Haliotidis Squama), Gan Juhua (Chrysanthemi Flos), Bai Jili (Tribuli Fructus), Sangye (Mori Folium), Fuling (Poria), Yuanzhi (Polygalae Radix), Niuxi (Achyranthis Bidentatae Radix), Huomaren (Cannabis Semen), Sheng Shaishen (Ginseng Radix), and Huaishanyao (Dioscoreae Rhizoma). By mid-March of the following year, after seventy doses, her health gradually improved, symptoms disappeared, and lab tests normalized. She returned to Argentina shortly after and reported being healthy as before two years later.
Xiao Chai Hu Tang Cures Pulmonary Tuberculosis
Wind, Lao (Consumption), Gu (Distension), and Ge (Diaphragmatic Obstruction) are traditionally known as the four difficult syndromes. Pulmonary Tuberculosis (PTB), caused by "Zhai Chong" (TB bacilli), poses a severe threat to human health. Historically, physicians have studied its treatment extensively. While various methods exist, few stand out as exceptional. Among ancient prescriptions, "Yuehua Wan" (Moonlight Pill) from *Yi Xue Xin Wu* (New Insights into Medicine) is an excellent formula for PTB. It nourishes Yin, clears Liver, resolves stasis, and kills parasites. Its design is comprehensive, with simple yet precise ingredients. However, it focuses heavily on nourishing Yin, lacking sufficient strength to combat active disease. When TB bacilli are rampant, with severe coughing, frequent hemoptysis, tidal fever resembling bone-steaming, profuse night sweats, seminal emissions, and dyspnea, Yuehua Wan is insufficient.
Modern scholar Tang Rongchuan innovatively proposed using Xiao Chai Hu Tang (Minor Bupleurum Decoction) to treat PTB cough. Although PTB presents many symptoms, cough is the most prominent. Thus, formulas treating PTB cough often address the root disease. Tang Rongchuan wrote in *Xue Zheng Lun* (Treatise on Blood Disorders): "PTB cough originates from Fire overcoming Metal and Water attacking Lung. Investigating closely, the pathology lies in the Stomach. The Stomach is the sea of grain and water, transforming fluids and blood. Insufficient blood leads to blazing fire; lack of fluids causes Lung dryness; failure to transform water vapor allows fluid retention to harass upward." He further stated: "No formula governs Lung and Stomach better than Xiao Chai Hu Tang." "Xiao Chai Hu Tang can circulate fluids, disperse constrained fire, raise clear Yang, and descend turbid Yin. With appropriate modifications, it achieves perfection."
Some ask: Xiao Chai Hu Tang is the primary formula for Shaoyang syndrome in Shanghan (Cold Damage) theory; how can it treat PTB? Tang provided profound insights: "The exterior of the body relies on Cou Li as the pivot of Ying and Wei; the interior relies on San Jiao as the manager of Zang-Fu. Shaoyang governs San Jiao internally and Cou Li externally. Structurally, Shaoyang is Ministerial Fire rooted in the Gallbladder; functionally, it is Clear Yang residing in the Stomach. The formula uses Ginseng, Jujube, and Licorice to nourish the Stomach; Scutellaria and Pinellia to descend turbid fire; Bupleurum and Ginger to raise clear Yang. Thus, Qi flows smoothly, regulating Cou Li and San Jiao." This explains why Xiao Chai Hu Tang treats numerous diseases across specialties. PTB formation often stems from emotional depression leading to Liver stagnation, generating internal heat. Liver heat and Lung fire interact. Heat consumes fluids, generating Phlegm. Long-standing illness damages fluids and injures Spleen-Lung Qi. This formula tonifies Middle Jiao with Ginseng, Licorice, Ginger, and Jujube; clears heat and transforms Phlegm with Pinellia and Scutellaria; and soothes Liver and disperses Lung-Liver constrained heat with Bupleurum and Scutellaria. This combination fits the PTB pathogenesis perfectly.
Tang’s theory is enlightening, opening new horizons for PTB treatment after Cheng’s school. Based on Tang’s theory, I use Xiao Chai Hu Tang for PTB, ensuring accurate differentiation and appropriate modification, achieving good results. Two cases follow.
Case 1: Pulmonary Tuberculosis
Section Chief Jin, male, 63 years old, visited on February 7, 1996. He complained of fatigue, listlessness, dry cough, occasional hemoptysis, breathing difficulty, frequent night sweats, alternating chills and fever, and lower back soreness for months. Initially ignoring it, he self-medicated with antipyretics, antitussives, and antibiotics, with fluctuating severity. Chest X-ray at Ganquan Hospital affiliated to Railway University showed "multiple patchy shadows in the right upper lung," diagnosing "Pulmonary Tuberculosis, partially old," accompanied by emphysema. His pulse was wiry-small on the left and floating-large on the right. The tongue was thin, slightly dark-red, with a thin white coating. Diagnosis: Lung-Kidney Yin Deficiency. Treatment: Nourish Yin, moisten Lung, restrain fire, clear Metal. Prescription: Baihe Gujin Tang modified.
Taizishen (Codonopsis Radix) 12g, Baihe (Lilii Bulbus) 9g, Sheng Shu Dihuang (Rehmanniae Radix) 9g each, Chuan Beimu (Fritillariae Cirrhosae Bulbus) 6g, Jiegeng (Platycodonis Radix) 3g, Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Maidong (Ophiopogonis Radix) 9g, Sangye (Mori Folium) 15g, Chao Baishao (Paeoniae Radix Alba Preparata) 9g, Zhi Baibu (Stemonae Radix) 9g, Wuweizi (Schisandrae Fructus) 1g, Hongzao (Jujubae Fructus) 30g.
After seventeen doses, spirit improved, night sweats stopped, but other symptoms persisted. Low-grade fever occurred around 3 PM (Shi hour), with malar flushing and severe dry cough at night. Sputum occasionally contained blood streaks. Pulse was wiry-left, wiry-fine-soft-right; tongue coating unchanged. Pattern: Yin deficiency with blazing fire and Qi deficiency with consumption heat. After careful consideration, I switched to Xiao Chai Hu Tang modified:
Dangshen (Codonopsis Radix) 24g, Chaihu (Bupleuri Radix) 3g, Gancao (Glycyrrhizae Radix et Rhizoma) 9g, Jiang Banxia (Pinelliae Rhizoma Preparatum) 4.5g, Huangqin (Scutellariae Radix) 9g, Xingren (Armeniacae Semen Amarum) 9g, Chao Baishao (Paeoniae Radix Alba Preparata) 20g, Tianmendong (Asparagi Radix) 9g, Baibu (Stemonae Radix) 9g, Shengjiang (Zingiberis Rhizoma Recens) 1 slice, Dazao (Jujubae Fructus) 5 pieces.
One dose showed effect. After nearly one hundred modified doses, symptoms gradually resolved. During treatment, Chuan Beimu, Danshen, Taoren, and Pingdimu were added for chest pain and severe cough; Huangqi and Yiren were added for obvious Spleen-Lung Qi deficiency; Longgu and Muli were added for dizziness. Other herbs varied with pulse and symptoms.
Additionally, after fifty doses of modified Xiao Chai Hu Tang, Langdu Dan (Wolfberry Egg) was administered orally to enhance anti-parasitic effects.
By June 7, subjective symptoms disappeared. A relative working as a leader in an elderly hospital conducted a re-examination, reporting lesion disappearance. To consolidate efficacy and strengthen constitution, the initial formula was modified and taken for fifty-plus doses to nourish Lung, Spleen, and Kidney, securing the root and supporting Righteous Qi. Spirit improved greatly, radiating vitality, unable to stay idle, he went out to contribute further.
Post-diagnosis Note: The efficacy is proven, relying heavily on Xiao Chai Hu Tang. Added herbs are also potent agents against pathogens and TB. Tianmen Dong combined with Baibu specializes in moistening Lung dryness, killing TB worms, and stopping cough. *Jin Men Yi Cui* records: "Commonly used herbs are Tianmen Dong and Baibu. *Qian Jin Fang* records Baibu alone cures thirty-year chronic cough and kills parasites. Materia Medica states Tianmen Dong also kills three parasites and removes latent corpses." Thus, their homemade "Lung Vitality Element" uses these two as main ingredients. From my experience, Tianmen Dong reliably nourishes Yin, reduces steaming bone sensation, harmonizes collaterals, and stops chest pain. Heavy use of Baishao and Gancao soothes Liver, relieves spasms, treats stubborn PTB cough, and eliminates chest pain. However, Baishao drains Wood from Earth; its sour-astringent nature may suppress Middle Yang. Use cautiously in long-standing TB with damaged Spleen Earth.
Langdu Dan formula was first reported in *New Chinese Medicine* in the 1970s by an author in Northeast China, producing one month’s supply (over twenty red-shell eggs) at once. Shanghai, located in the Yangtze River basin with higher temperatures, requires slight modification. In the above case treated in spring, 10g Langdu was boiled with water for one hour, then eight washed red-shell eggs were added. Once eggs were cooked, heat was removed, and eggs soaked in the Langdu liquid for two hours. The first egg was eaten, and others stored in the refrigerator. One egg per day thereafter, heated in a microwave or steamed in a bowl. In summer, prepare daily and consume same-day. Method: 3g Langdu in a narrow-bottomed pot, boil, soak for 4 hours, eat one daily. I treated a female cafeteria worker, nearly 40, with fatigue and low-grade bone-steaming fever. Diagnosed with right upper lung infiltrative tuberculosis, advised years of medication. I gave her the Langdu Dan method. After a few days, fever vanished. Confident, she ate one daily. After four months, X-ray showed complete calcification of TB lesions. Over ten years post-cure, she remains healthy with no recurrence.
Note: Langdu is toxic. I once boiled a piece and drank the water, resulting in immediate throat pain and posterior pharyngeal follicles, which took days to subside. Some books suggest boiling Langdu with water, steaming red dates inside for two hours, drying, and eating 10-15 dates daily. This seems simpler. I tried it and tasted it, but experienced immediate nausea and dizziness, though self-resolving. Still, it is a toxic reaction harming the patient. Langdu Dan has no adverse reactions. I tried it multiple times; even broken shells were harmless. Drinking small amounts of the broth caused no side effects. Whether protein detoxifies Langdu needs study. Red-shell eggs are superior; their thick, dense shells filter toxins better than white ones.
Case 2: Tuberculous Pleurisy
Ms. Sun, female, age 43, in early winter, gradually developed fatigue, right upper chest pain worsening progressively, afternoon tidal fever, and malar bone-steaming. X-ray at Ganquan Hospital diagnosed "moderate right pleural effusion" and "right upper lung tuberculosis." Treated with Rifampicin and Isoniazid at the district central hospital for three months with no obvious improvement. Believing in TCM, she requested herbal medicine. Left pulse was wiry; right pulse was small, faint, and difficult to locate; right Cun position was fine and weak. Tongue was pale with thin white coating. Symptoms as above. Pattern: Spleen-Lung Qi deficiency with Liver-Gallbladder heat accumulation. Wood-fire insulting Metal causes cough; burning collaterals causes pain; entering Yin level steams marrow causing tidal fever. Treatment: Clear and diffuse Shaoyang heat, tonify Qi and harmonize Middle to generate Earth to produce Metal, kill parasites and treat TB, transform Phlegm and stop cough. Simultaneously open and descend Lung Qi to benefit water passages. Prescription: Xiao Chai Hu Tang combined with Tingli Dazao Xie Fei Tang modified: