准绳云∶劳倦所伤,用补中益气汤调治(补中益气,是治劳倦内伤之剂,乃初治法,非
久病劳瘵骨蒸所宜)。乃暴病也,失治而有发热潮热,盗汗咳嗽,诸证出焉,谓之虚劳。又复
失治,而有皮聚毛落,饮食不为肌肤,骨髓中热,经闭不行,诸证出焉,谓之瘵骨蒸热。至于
传尸之疾,别自一种,其源不起于劳欲,其流或至于灭门。余于杂病首册,则既条分而备列
矣。然男以精为主,女以血为主,其致病既殊,其施治亦异,故应别着方法(精血虽殊,而虚
劳形症不远,治亦不异,宜与杂症参看)。而陈氏《良方》,分劳瘵、骨蒸劳、血风劳、气虚劳、
风劳、冷劳、热劳、客热等门,未免惑乱,后人靡所适从,今厘正如左,医者更参杂病虚劳传
尸劳二门而用之,则无道少之患矣。(按血风劳者,肝血虚而风热成劳也;风劳、冷劳,因虚
乘袭,日久变成劳热。气虚者,气不足。热劳者,血不足至骨蒸劳瘵,大都难治矣)
保命集云∶治妇人虚劳,《局方》中谓首尾六合,如大圣散、熟地黄丸,是治无热虚劳也;
中道药,牡丹煎丸,空心食前,人参荆芥散,临卧食后,是治有热虚也。
戴氏曰∶有病后血虚者,有本体血虚者,其人往来寒热,或五心发热,言语无力,面色
萎黄,头目昏晕,变生诸疾。芎归汤加羊肉少许,或十全大补汤、四物汤、养荣汤服之,血虚
而气旺者,宜抑气汤,即香附末。
《医学准绳六要》中说:因劳累和过度疲劳所致的损伤,使用补中益气汤进行调理(补中益气汤是治疗劳倦内伤的方剂,属于初期治疗方法,并不适宜用于久病形成的虚劳、骨蒸痨热等重症)。这原本属于暴发性疾病,如果失治误治,就会出现发热、潮热、盗汗、咳嗽等症状,这就称为“虚劳”。如果再继续失治,就会出现皮肤干枯聚缩、毛发脱落、饮食不能转化为肌肉营养、骨髓中感觉燥热、月经闭止不行等症状,这就称为“瘵骨蒸热”。至于“传尸”这种疾病,则是另一种类型,其病因并非起于劳累和房事过度,但其后果严重,甚至可能导致全家灭门。我在杂病卷首册中已经详细分类并列举了这些内容。然而,男子以精气为本,女子以血液为本,二者致病原因既然不同,施治方法也应当有所区别,因此应当单独撰写治疗方法(虽然精与血有所不同,但虚劳的形态和症状相差不远,治疗原则也不完全相异,应当与杂病部分参考对照阅读)。而陈氏的《良方》,将劳瘵、骨蒸劳、血风劳、气虚劳、风劳、冷劳、热劳、客热等分为不同的门类,未免让人感到混乱,后人无所适从。现在将其整理校正如下,医生们再参考杂病中的虚劳、传尸劳两个门类来运用,就不会有遗漏之患了。(按语:所谓血风劳,是指肝血亏虚导致风热形成劳损;风劳、冷劳,是因为正气虚弱遭受外邪侵袭,日久转变为劳热。气虚者,即气不足。热劳者,即血不足发展到骨蒸劳瘵的程度,大多难以治愈。)
《保命集》中说:治疗妇女虚劳,《太平惠民和剂局方》中认为从头到尾都适用六合法,如大圣散、熟地黄丸,这是治疗没有热象的虚劳;中途用药,如牡丹煎丸,空腹或饭前服用,人参荆芥散,睡前饭后服用,这是治疗有热象的虚劳。
戴氏说:有病后导致血虚的,也有先天体质血虚的,这类人会出现忽冷忽热的症状,或者五心(两手心、两足心及心胸)发热,说话无力,面色萎黄,头晕目眩,进而引发各种疾病。可以使用芎归汤加入少许羊肉,或者服用十全大补汤、四物汤、养荣汤。如果是血虚但气机旺盛的情况,适宜使用抑气汤,也就是香附末。
*Zhuansheng* (Standard of Medicine) states: For injuries caused by fatigue and overexertion, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for regulation (Buzhong Yiqi Tang is a formula for treating internal injury due to fatigue and overexertion; it is an initial treatment method and not suitable for chronic consumptive diseases such as Xu Lao [Deficiency Consumption] or Gu Zheng Re [Bone-steaming Fever]). This originally belongs to acute illness. If left untreated or mistreated, symptoms such as fever, tidal fever, night sweats, and cough will emerge, which is termed Xu Lao (Deficiency Consumption). If treatment is further delayed, symptoms such as dry and shriveled skin, falling hair, inability of food intake to nourish muscles, heat in the bone marrow, and amenorrhea will appear, which is termed Zhai Gu Zheng Re (Consumptive Bone-steaming Fever). As for the disease known as Chuan Shi (Transmitting Corpse), it is a distinct category. Its origin does not lie in fatigue or sexual excess, but its progression may lead to the extinction of the entire family. In the first volume of miscellaneous diseases, I have already itemized and listed them in detail. However, men take Jing (Essence) as their foundation, while women take Xue (Blood) as their foundation. Since the causes of disease differ, the therapeutic methods must also differ; therefore, specific methods should be documented separately (Although Essence and Blood differ, the manifestations and symptoms of deficiency consumption are not far apart, and the treatments are not entirely different; they should be consulted alongside the miscellaneous diseases section). Chen’s *Liangfang* (Good Prescriptions) divides Lu Zhai (Consumptive Disease), Gu Zheng Lao (Bone-steaming Consumption), Xue Feng Lao (Blood Wind Consumption), Qi Xu Lao (Qi Deficiency Consumption), Feng Lao (Wind Consumption), Leng Lao (Cold Consumption), Re Lao (Heat Consumption), and Ke Re (Guest Heat) into separate categories, which inevitably causes confusion, leaving later generations unsure of what to follow. Now, these are corrected and organized as follows. Physicians should refer to the sections on Xu Lao (Deficiency Consumption) and Chuan Shi Lao (Transmitting Corpse Consumption) in the miscellaneous diseases section when applying these methods, thus avoiding omissions. (Note: Xue Feng Lao refers to consumption resulting from Liver Blood deficiency leading to Wind-Heat; Feng Lao and Leng Lao arise when deficiency allows pathogenic invasion, gradually transforming into consumption-heat over time. Qi Xu refers to insufficiency of Qi. Re Lao refers to Blood deficiency progressing to bone-steaming consumptive disease, which is generally difficult to treat.)
*Bao Ming Ji* (Collection for Preserving Life) states: To treat female deficiency consumption, *Ju Fang* (Formulary of the Bureau) suggests that throughout the course of treatment, one may use formulas such as Da Sheng San (Great Sage Powder) and Shu Di Huang Wan (Prepared Rehmannia Pill), which are used to treat deficiency consumption without heat; for mid-course medication, Mu Dan Jian Wan (Moutan Decoction Pill) is taken on an empty stomach or before meals, and Ren Shen Jing Jie San (Ginseng and Schizonepeta Powder) is taken before sleep or after meals, which are used to treat deficiency consumption with heat.
Dai states: There are cases of Blood deficiency following illness, and cases of constitutional Blood deficiency. Patients present with alternating chills and fever, or heat in the five centers (palms, soles, and chest), weakness in speech, sallow complexion, dizziness, and vertigo, subsequently developing various diseases. One may use Xiong Gui Tang (Ligusticum and Angelica Decoction) with a small amount of mutton, or administer Shiquan Dabu Tang (Ten Complete Tonifying Decoction), Si Wu Tang (Four Substance Decoction), or Yang Rong Tang (Nourish the Vigor Decoction). In cases of Blood deficiency with vigorous Qi, Yi Qi Tang (Suppress Qi Decoction), which consists of Cyperi Rhizoma powder, is appropriate.