(谦甫) 治风劳骨蒸,午后壮热,咳嗽肌瘦,颊赤盗汗,脉来细数。(风阳邪也
表则表热,在里则里热,附骨则骨蒸,午后甚者,阴虚也。风火相搏则咳嗽,蒸久血枯
瘦,虚火上炎则颊赤,睡而汗出曰盗汗,阴虚也。脉细为虚,脉数为热。)
鳖甲(炙) 柴胡 地骨皮(一两) 秦艽 知母 当归(五钱) 乌梅(一个) 青
篙(五叶) 汗
风生热而热生风,非柴胡秦艽不能驱之使出。鳖阴类,用甲者,骨以及骨之义。乌梅酸
涩,
气。
血,
(谦甫) 治男女虚劳客热,五心烦热,四肢怠惰,咳嗽咽干,自汗食少,或日哺
(五心,心窝手心足心也。脾主四肢,五心烦热,是心火陷于脾土之中,宜升发火郁
怠惰,脾虚也。咳嗽,肺火也。咽干,肾水不足相火上炎也。自汗,阳虚也。食少,
也。日西潮热,肺虚也。)
黄 (蜜炙) 鳖甲(炙) 天冬(五钱) 柴胡 秦艽 地骨皮 茯苓(三钱) 桑
白皮 紫菀
半) 每一两,加姜
鳖甲天冬芍地知母,滋肾水而泻肺肝之火以养阴。(地黄知母滋肾水,天冬泻肺火,鳖
甲芍
半
辛
之
(直指) 治肺痿骨蒸,或寒或热,成劳咳嗽,声嗄不出,体虚自汗,四肢倦怠。
痿,有火热伤肺而得之者,有肺气虚寒而得之者。骨蒸,骨里蒸蒸然热,阴虚也。咳嗽
火乘肺也。或寒或热,阴阳不和也。声嗄,火郁在肺也。自汗倦怠,心脾虚而卫气不充
柴胡(二钱) 秦艽 人参 当归 鳖甲(炙) 地骨皮(钱半) 甘草(炙) 紫菀 半
夏(一钱)
柴胡秦艽,散表邪兼清里热。(柴胡解肌热,秦艽退骨蒸。)鳖甲地骨,滋血而退骨蒸。
(地
发声
(李谦甫)治疗风劳骨蒸,午后高热,咳嗽且身体消瘦,两颊发红、睡中盗汗,脉象细而数。(风为阳邪,在表则表现为表热,在里则表现为里热,深入骨骼则导致骨蒸;午后症状加重,是因为阴虚。风火相互搏结则引发咳嗽,蒸灼日久导致血液枯竭、身体消瘦,虚火上炎则两颊发红,睡着时出汗称为盗汗,这也是阴虚的表现。脉细表示虚证,脉数表示热证。)
鳖甲(炙)、柴胡、地骨皮(各一两)、秦艽、知母、当归(各五钱)、乌梅(一个)、青蒿(五叶)。煎服法:加水煎煮,去渣取汁温服。
风产生热,热又生风,如果不是柴胡和秦艽,就不能将风邪驱除出体外。鳖甲属于阴类药材,使用其甲壳,寓意能入骨以治骨中之热。乌梅味酸涩,能收敛气与血。
(李谦甫)治疗男女虚劳客热,五心烦热,四肢倦怠无力,咳嗽咽干,自汗、食欲减退,或傍晚时分潮热。(五心指心窝、手心、足心。脾主四肢,五心烦热,是心火郁陷于脾土之中,应当升发被郁之火;四肢倦怠,是脾虚的表现。咳嗽,是肺火所致。咽干,是肾水不足、相火上炎所致。自汗,是阳虚所致。食欲减退,是脾气虚弱所致。傍晚潮热,是肺虚所致。)
黄耆(蜜炙)、鳖甲(炙)、天冬(各五钱)、柴胡、秦艽、地骨皮、茯苓(各三钱)、桑白皮、紫菀、半夏(半两)。每服用一两药量,加入生姜半个。
鳖甲、天冬、芍药、地黄、知母,这些药物能滋补肾水并清泻肺肝之火以滋养阴液。(地黄和知母滋补肾水,天冬清泻肺火,鳖甲和芍药……)
(《直指方》)治疗肺痿骨蒸,或恶寒或发热,形成劳损性咳嗽,声音嘶哑甚至失音,身体虚弱自汗,四肢倦怠。肺痿,有的是因火热伤肺所致,有的是因肺气虚寒所致。骨蒸,感觉骨头里热气蒸腾,这是阴虚。咳嗽,是火邪乘袭肺脏所致。或寒或热,是阴阳不和所致。声音嘶哑,是火郁结在肺中。自汗和倦怠,是心脾两虚且卫气不充足所致。
柴胡(二钱)、秦艽、人参、当归、鳖甲(炙)、地骨皮(一钱半)、甘草(炙)、紫菀、半夏(一钱)。
柴胡和秦艽,能疏散表邪兼清里热。(柴胡解除肌表之热,秦艽退除骨蒸之热。)鳖甲和地骨皮,能滋养血液并退除骨蒸。(地骨皮……)
(Li Qianfu) Treats wind-lao (consumptive disease due to wind) and bone-steaming, with high fever in the afternoon, coughing and emaciation, red cheeks, night sweats, and a fine and rapid pulse. (Wind is a yang pathogen; when in the exterior, it causes exterior heat; when in the interior, it causes interior heat; when attaching to the bones, it causes bone-steaming. Symptoms worsening in the afternoon indicate yin deficiency. Wind and fire combusting together cause coughing; prolonged steaming leads to blood exhaustion and emaciation; deficient fire flaming upward causes red cheeks; sweating during sleep is called night sweats, also indicating yin deficiency. A fine pulse indicates deficiency; a rapid pulse indicates heat.)
Bie Jia (Tortoise Shell, calcined), Chai Hu (Bupleuri Radix), Di Gu Pi (Lycii Cortex), Qin Jiao (Gentianae Macrophyllae Radix), Zhi Mu (Anemarrhenae Rhizoma), Dang Gui (Angelicae Sinensis Radix) [dosages: Bie Jia, Chai Hu, Di Gu Pi 1 liang each; Qin Jiao, Zhi Mu, Dang Gui 5 qian each], Wu Mei (Mume Fructus, 1 piece), Qing Hao (Artemisiae Annuae Herba, 5 leaves). Decoct in water, strain, and take warm.
Wind generates heat, and heat generates wind; without Chai Hu and Qin Jiao, it is impossible to drive them out. Bie Jia belongs to the yin category; using its shell implies entering the bone to treat heat within the bone. Wu Mei is sour and astringent, capable of consolidating qi and blood.
(Li Qianfu) Treats deficiency-lao (consumptive disease) with guest-heat in both men and women, characterized by five-palm heat (heat in the chest, palms, and soles), lassitude of the four limbs, coughing, dry throat, spontaneous sweating, poor appetite, or tidal fever in the late afternoon. (The "five hearts" refer to the epigastrium, palms, and soles. The spleen governs the four limbs; five-palm heat indicates heart-fire sunken into spleen-earth, requiring the raising and dispersal of constrained fire; lassitude indicates spleen deficiency. Coughing indicates lung-fire. Dry throat indicates insufficient kidney-water and flaming upward of ministerial fire. Spontaneous sweating indicates yang deficiency. Poor appetite indicates spleen-qi deficiency. Tidal fever in the evening indicates lung deficiency.)
Huang Qi (Astragali Radix, honey-fried), Bie Jia (Tortoise Shell, calcined), Tian Dong (Asparagi Radix) [dosages: Huang Qi, Bie Jia, Tian Dong 5 qian each], Chai Hu (Bupleuri Radix), Qin Jiao (Gentianae Macrophyllae Radix), Di Gu Pi (Lycii Cortex), Fu Ling (Poria), Sang Bai Pi (Mori Cortex), Zi Wan (Asteris Radix), Ban Xia (Pinelliae Rhizoma) [dosages: Fu Ling 3 qian; Sang Bai Pi, Zi Wan, Ban Xia 0.5 liang]. For every 1 liang of this formula, add half a slice of fresh ginger.
Bie Jia, Tian Dong, Shao Yao (Paeoniae Radix), Di Huang (Rehmanniae Radix), and Zhi Mu nourish kidney-water and drain fire from the lungs and liver to nourish yin. (Di Huang and Zhi Mu nourish kidney-water; Tian Dong drains lung-fire; Bie Jia and Shao Yao...)
(Zhi Zhi Fang) Treats fei wei (lung atrophy) with bone-steaming, alternating chills and fever, consumptive coughing, hoarseness or loss of voice, physical weakness with spontaneous sweating, and lassitude of the four limbs. Fei wei can result from fire-heat injuring the lung or from deficiency-cold of lung-qi. Bone-steaming refers to the sensation of steaming heat from within the bones, indicating yin deficiency. Coughing indicates fire invading the lung. Alternating chills and fever indicate disharmony of yin and yang. Hoarseness indicates fire constrained in the lung. Spontaneous sweating and lassitude indicate deficiency of heart and spleen with insufficiency of defensive qi.
Chai Hu (Bupleuri Radix, 2 qian), Qin Jiao (Gentianae Macrophyllae Radix), Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Bie Jia (Tortoise Shell, calcined), Di Gu Pi (Lycii Cortex, 1.5 qian), Gan Cao (Licorice Root, fried), Zi Wan (Asteris Radix), Ban Xia (Pinelliae Rhizoma, 1 qian).
Chai Hu and Qin Jiao disperse exterior pathogens and simultaneously clear interior heat. (Chai Hu resolves muscle-layer heat; Qin Jiao reduces bone-steaming.) Bie Jia and Di Gu Pi nourish blood and reduce bone-steaming. (Di Gu Pi...)