按前所序之秋燥方论，乃燥之复气也，标气也。盖燥属金而克木，木之子，少阳相火也，火气
来复，故现燥热干燥之证。又《灵枢》谓∶丙丁为手之两阳合明，辰巳为足之两阳合明，阳明本燥，标
阳也。前人谓燥气化火，经谓燥金之下，火气承之，皆谓是也。案古方书，无秋燥之病。近代以来，惟喻氏始补
燥气论，其方用甘润微寒；叶氏亦
有燥气化火之论，其方用辛凉甘润；乃《素问》所谓燥化于天，热反胜之，治以辛凉，佐以苦甘法也。
瑭袭前人之旧，故但叙燥证复气如前。书已告成，窃思与《素问》燥淫所胜不合，故杂说篇中，特着燥
论一条，详言正化、对化、胜气、复气以补之。其于燥病胜气之现于三焦者，究未出方论，乃不全之
书，心终不安。嗣得沈目南先生《医征》温热病论，内有秋燥一篇，议论通达正大，兹采而录之于后，
间有偏胜不园之处，又详辨之，并特补燥证胜气治法如下。再按胜复之理，与正化对化，从本从标之
道，近代以来，多不深求，注释之家，亦不甚考。如仲景《伤寒论》中之麻桂、姜附，治寒之胜气也，治
寒之正化也，治寒之本病也。白虎、承气，治寒之复气也，治寒之对化也，治寒之标病也。余气俱可
从此类推。（太阳本寒标热，对化为火，盖水胜必克火。故经载太阳司天，心病为多。末总结之曰∶
病本于心，心火受病必克金。白虎所以救金也。金受病，则坚刚牢固，滞塞不通，复气为土，土性壅
塞，反来克本身之真水。承气，所以泄金与土而救水也。再经谓∶寒淫所胜，以咸泻之。从来注释
家，不过随文释义，其所以用方之故，究未达出。本论不能遍注伤寒，偶举一端，以例其余。明者得
此门经，熟玩《内经》，自可迎刃而解；能解伤寒，其
于本论，自无难解者矣。由是推之，六气皆然耳）。
沈目南《燥病论》曰∶《天元纪大论》云∶天以六为节，地以五为制。盖六乃风寒暑湿燥火为节，五
即木火土金水为制。然天气主外，而一气司六十日有奇；地运主内，而一运主七十二日有奇。故五
运六气合行而终一岁，乃天然不易之道也。《内经》失去长夏伤于湿、秋伤于燥，所以燥证湮没，
至今不明。先哲虽有言之，皆是内伤津血干枯之证，非谓外感清凉时气之燥。然燥气起于秋分以
后，小雪以前，阳明燥金凉气司令。经云∶阳明之胜，清发于中，左 胁痛，溏泄，内为嗌塞，外
发疝。大凉肃杀，华英改容，毛虫乃殃。胸中不便，嗌塞而咳。据此经文，燥令必有凉气感人，
肝木受邪而为燥也。惟近代喻嘉言昂然表出，可为后世苍生之幸；奈以诸气 郁，诸痿喘呕，咳不
止而出白血死，谓之燥病，此乃伤于内者而言，诚与外感燥证不相及也。更自制清燥救肺汤，皆
以滋阴清凉之品，施于火热刑金，肺气受热者宜之。若治燥病，则以凉投凉，必反增病剧。殊不知
燥病属凉，谓之次寒，病与感寒同类。经以寒淫所胜，治以甘热，此但燥淫所胜，平以苦温，乃外用
苦温辛温解表，与冬月寒冷而用麻桂姜附，其法不
同，其和中攻里则一，故不立方。盖《内经》六气，但分阴阳主治，以风热火三气属阳同治，但药有辛凉
苦寒咸寒之异；湿燥寒三气属阴同治，但药有苦热苦温甘热之不同。仲景所以立伤寒温病二论为大纲也。盖《性
理大全》谓燥属次寒，奈后贤悉谓属热，大相径庭。如盛夏暑热熏蒸，则人身汗出 ，肌肉潮润而不燥也；
冬月寒凝肃杀，而人身干槁燥冽。故深秋燥令气行，人体肺金应之，肌肤亦燥，乃火令无权，故燥属凉，前人谓
热非矣。
按先生此论，可谓独具只眼，不为流俗所 没者。其责喻氏补燥论用甘寒滋阴之品，殊失燥
淫所胜，平以苦温之法，亦甚有理。但谓诸气 郁，诸痿喘呕，咳不止出白血，尽属内伤，则于理欠
园。盖因内伤而致此证者固多，由外感余邪在络，转化转热而致此证者，亦复不少。瑭前于风温咳
嗽条下，驳杏苏散，补桑菊饮，方论内极言咳久留邪致损之故，与此证同一理也。谓清燥救肺汤治燥
之复气，断非治燥之胜气，喻氏自无从致辨；若谓竟与燥不相及，未免各就一边谈理。盖喻氏之清
燥救肺汤，即《伤寒论》中后半截之复脉汤也。伤寒必兼母气之燥，故初用辛温甘热，继用辛凉苦
寒，终用甘润，因其气化之所至而然也。至谓仲景立伤寒温病二大纲，如《素问》所云，寒暑六入，暑
统风火，寒统燥湿，一切外感，皆包于内，其说尤不尽然，盖尊信仲景太过而失之矣。若然，则
仲景之书，当名六气论，或外感论矣，何以独名伤寒论哉！盖仲景当日着书，原为伤寒而设，并
未遍着外感，其论温、论暑、论湿，偶一及之也。即先生亦补《医征》温热病论，若系全书，何容又补
哉！瑭非好辨，恐后学眉目不清，尊信前辈太过，反将一切外感，总混入《伤寒论》中，此近代以来之大
弊，祸未消灭，尚敢如此立论哉！
一、秋燥之气，轻则为燥，重则为寒，化气为湿，复气为火。
揭燥气之大纲，兼叙其子母之气、胜复之气，而燥气自明。重则为寒者，寒水为燥金之子也；化
气为湿者，土生金，湿土其母气也。《至真要大论》曰∶阳明厥阴，不从标本，从乎中也。又曰∶从本者，
化生于本；从标本者，有标本之化；从中者，以中气为化也。按阳明之上，燥气治之，中见太阴。故本论
初未着燥金本气方论，而于疟疝等证，附见于寒湿条下。叶氏医案谓伏暑内发，新凉外加，多见于伏
暑类中；仲景《金匮》，多见于腹痛疟疝门中。
二、燥伤本脏，头微痛，恶寒，咳嗽稀痰，鼻塞，嗌塞，脉弦，无汗，杏苏散主之。
本脏者，肺胃也。经有嗌塞而咳之明文，故上焦之病自此始。燥伤皮毛，故头微痛恶寒也，微痛
者，不似伤寒之痛甚也。阳明之脉，上行头角，故头亦痛也。咳嗽稀痰者，肺恶寒，古人谓燥为小寒
也；肺为燥气所搏，不能通调水道，故寒饮停而咳也。鼻塞者，鼻为肺窍。嗌寒者，嗌为肺系也。脉
弦者，寒兼饮也。无汗者，凉搏皮毛也。按杏苏散，减小青龙一等。此条当与下焦篇所补之痰饮
数条参看。再杏苏散乃时人统治四时伤风咳嗽通用之方，本论前于风温门中已驳之矣；若伤燥凉之
咳，治以苦温，佐以甘辛，正为合拍。若受重寒夹饮之咳，则有青龙；若伤春风，与燥已化火无痰之
证，则仍从桑菊饮、桑杏汤例。
杏苏散方
苏叶 半夏 茯苓 前胡 苦桔梗 枳壳 甘草 生姜 大枣（去核） 桔皮 杏仁
〔加减法〕无汗，脉弦甚或紧，加羌活，微透汗。汗后咳不止，去苏叶、羌活，加苏梗。兼泄泻腹满
者，加苍术、浓朴。头痛兼眉棱骨痛者，加白芷。热甚加黄芩，泄泻腹满者不用。
〔方论〕此苦温甘辛法也。外感燥凉，故以苏叶、前胡辛温之轻者达表；无汗脉紧，故加羌活辛
温之重者，微发其汗。甘、桔从上开，枳、杏、前、芩从下降，则嗌塞鼻塞宣通而咳可止。桔、半、茯苓，
逐饮而补肺胃之阳。以白芷易原方之白术者，白术中焦脾药也，白芷肺胃本经之药也，且能温肌肉而
达皮毛。姜、枣为调和营卫之用。若表凉退而里
邪未除，咳不止者，则去走表之苏叶，加降里之苏梗。泄泻腹满，金气太实之里证也，故去黄芩之苦
寒，加术、朴之苦辛温也。
三、伤燥，如伤寒太阳证，有汗，不咳，不呕，不痛者，桂枝汤小和之。
如伤寒太阳证者，指头痛、身痛、恶风寒而言也。有汗不得再发其汗，亦如伤寒例，但燥较寒为
轻，故少与桂枝小和之也。
桂枝汤方（见前）
四、燥金司令，头痛，身寒热，胸胁痛，甚则疝瘕痛者，桂枝柴胡各半汤加吴萸楝子茴香木香汤
主之。
此金胜克木也。本病与金病并见，表里齐病，故以柴胡达少阳之气，即所达肝木之气，合桂枝而
外出太阳，加芳香定痛，苦温通降也。湿燥寒同为阴邪，故仍从足经例。
桂枝柴胡各半汤加吴萸楝子茴香木香汤方（治以苦温，佐以甘辛法）
桂枝 吴茱萸 黄芩 柴胡 人参 广木香 生姜 白芍 大枣（去核） 川楝子 小茴香 半
夏炙甘草
五、燥淫传入中焦，脉短而涩，无表证，无下证，胸痛，腹胁胀痛，或呕，或泄，苦温甘辛以和之。
燥虽传入中焦，既无表里证，不得误汗、误下，但以苦温甘辛和之足矣。脉短而涩者，长为木，短
为金，滑为润，涩为燥也。胸痛者，肝脉络胸也。腹痛者，金气克木，木病克土也。胁痛者，肝木之
本位也。呕者，亦金克木病也。泄者，阳明之上，燥气治之，中见太阴也。或者，不定之辞；有痛而
兼呕与泄者，有不呕而但泄者，有不泄而但呕者，有不兼呕与泄而但痛者。病情有定，病势无定，故
但出法而不立方，学人随证化裁可也。药用苦温甘辛者，经谓燥淫所胜，治以苦温，佐以甘辛，以苦
下之。盖苦温从火化以克金，甘辛从阳化以胜阴也。以苦下之者，金性坚刚，介然成块，病深坚结。
非下不可。下文即言下之证。
六、阳明燥证，里实而坚，未从热化，下之以苦温；已从热化，下之以苦寒。
燥证阳明里实而坚满，经统言以苦下之，以苦泄之。今人用下法，多以苦寒。不知此证当别已化
未化，用温下寒下两法，随证施治，方为的确。未从热化之脉，必仍短涩，涩即兼紧也，面必青黄。
苦温下法，如《金匮》大黄附子细辛汤，新方天台乌药散（见下焦篇寒湿门）加巴豆霜之类。已从热化
之脉，必数而坚，面必赤，舌必黄，再以他证参之。苦寒下法，如三承气之类，而小承气无芒硝，轻用
大黄或酒炒，重用枳、朴，则微兼温矣。
〔附治验〕丙辰年，瑭治一山阴幕友车姓，年五十五岁，须发已白
大半。脐左坚大如盘，隐隐微痛，不大便数十日。先延外科治之，外科以大承气
下之三，四次，终不通。延余诊视，按之坚冷如石，面色青黄，脉短涩而迟。先尚能食，屡下之后，糜
粥不进，不大便已四十九日。余曰∶此症也，金气之所结也。以肝本抑郁，又感秋金燥气，小邪中
里，久而结成，愈久愈坚，非下不可，然寒下非其治也。以天台乌药散二钱，加巴豆霜一分，姜汤和
服。设三伏以待之，如不通，第二次加巴豆霜分半；再不通，第三次加巴豆霜二分。服至三次后，
始下黑亮球四十九枚，坚莫能破。继以苦温甘辛之法调理，渐次能食。又十五日不大便，余如前法
下，至第二次而通，下黑亮球十五枚，虽亦坚结，然破之能碎，但燥极耳。外以香油熬川椒，熨其坚
处；内服苦温芳香透络，月余化尽。于此证，方知燥金气伤人如此，而温下寒下之法，断不容紊也。
乙丑年，治通廷尉，久疝不愈。时年六十八
岁。先是通廷尉外任时，每发疝，医者必用人参，故留邪在络，久不得愈。至乙丑季夏，受凉复发，坚
结肛门，坐卧不得，胀痛不可忍，汗如雨下，七日不大便。余曰∶疝本寒邪，凡结坚牢固，皆属金象，况
现下势甚危急，非温下不可。亦用天台乌药散一钱，巴豆霜分许。下至三次始通，通后痛渐定。调
以倭硫黄丸，兼用《金匮》蜘蛛散，渐次化净。以上治验二条，俱系下焦证，以出阳明坚结下法，连类
而及。
七、燥气延入下焦，搏于血分，而成 者，无论男妇，化 回生丹主之。
大邪中表之燥证，感而激发者，诚如目南先生所云，与伤寒同法，学人衡其轻重可耳。前所补数
条，除减伤寒法等差二条，胸胁腹痛一条，与伤寒微有不同，余俱兼疝瘕者，以经有燥淫所胜，男子
疝，女子少腹痛之明文。疝瘕已多见寒湿门中，疟证、泄泻、呕吐已多见于寒湿、湿温门中，此特补小
邪中里，深入下焦血分，坚结不散之痼疾。若不知络病宜缓通治法，或妄用急攻，必犯瘕散为蛊之戒。
此蛊乃血蛊也，在妇人更多，为极重难治之证，学人不可不预防之也。化 回生丹法，系燥淫于内，
治以苦温，佐以甘辛，以苦下之也。方从《金匮》鳖
甲煎丸与回生丹脱化而出。此方以参、桂、椒、姜通补阳气，白芍、熟地，守补阴液，益母膏通补阴气，
而消水气，鳖甲胶通补肝气，而消 瘕，余俱芳香入络而化浊。且以食血之虫，飞者走络中气分，走
者走络中血分，可谓无微不入，无坚不破。又以醋熬大黄三次，约入病所，不伤他脏，久病坚结不
散者，非此不可。或者病其药味太多，不知用药之道，少用独用，则力大而急；多用众用，则功分而
缓。古人缓化之方皆然，所谓有制之师不畏多，无制之师少亦乱也。此方合醋与蜜共三十六味，得
四九之数，金气生成之数也。
化 回生丹方
人参（六两） 安南桂（二两） 两头尖（二两） 麝香（二两） 片子姜黄（二两） 公丁香（三两）
川椒炭（二两） 虻虫（二两） 京三棱（二两） 蒲黄炭（一两） 藏红花（二两） 苏木（三两）
按：前文所论述的秋燥方剂与理论，针对的是燥气的“复气”（报复之气）和“标气”（表象之气）。因为燥在五行中属金，金克木，而木之子为少阳相火，当火气来复时，就会出现燥热、干燥的症状。另外，《灵枢》中说：丙丁日对应手部的两阳合明（阳明经），辰巳时对应足部的两阳合明（阳明经），阳明本气为燥，标气为阳。前人认为燥气化火，经文说“燥金之下，火气承之”，说的都是这个意思。考察古方书，没有专门论述秋燥病的。近代以来，只有喻嘉言开始补充燥气论，他的方子用甘润微寒的药物；叶天士也有燥气化火的论述，他的方子用辛凉甘润的药物；这正是《素问》所说的“燥化于天，热反胜之，治以辛凉，佐以苦甘”的方法。我吴瑭沿袭前人的旧说，所以只像前面那样叙述燥证的复气。本书已经写成，但我私下思考这与《素问》中“燥淫所胜”的理论不合，所以在杂说篇中特别写了一条燥论，详细阐述正化、对化、胜气、复气来加以补充。至于燥病胜气表现于三焦的情况，还没有出具体方论，这是一部不完整的书，我心里始终不安。后来得到沈目南先生的《医征》温热病论，其中有一篇关于秋燥的议论通达正大，于是采纳并记录在后面，其中有偏颇不完备的地方，又详细辨析了，并特别补充燥证胜气的治法如下。再按胜复的道理，以及正化对化、从本从标的道理，近代以来，很少有人深入探究，注释家也不甚考证。比如张仲景《伤寒论》中的麻黄汤、桂枝汤，干姜、附子类方，是治疗寒邪的胜气，也是治疗寒的正化和本病。白虎汤、承气汤，是治疗寒的复气，也是治疗寒的对化和标病。其余六气都可以从此类推。（太阳本气为寒，标气为热，对化为火，大概是因为水胜必克火。所以经文记载太阳司天时，心病较多。最后总结说：病本于心，心火受病必然克制金。白虎汤所以能救金。金受病，则坚刚牢固，滞塞不通，复气为土，土性壅塞，反而来克本身的真水。承气汤所以能泄金与土而救水。另外经文说：寒淫所胜，以咸泻之。从来注释家，不过随文释义，对方药使用的根本原因，终究没有透彻阐明。本论不能遍注《伤寒论》，偶然举一端为例来推及其他。高明的人得到这个门径，熟读《内经》，自然可以迎刃而解；能理解《伤寒论》，对本论自然也没有难以理解的了。由此推之，六气都是这样的）。
沈目南《燥病论》说：《天元纪大论》说：天以六为节，地以五为制。大概六是指风寒暑湿燥火作为节律，五即木火土金水作为制约。然而天气主外，一气主管六十多天；地运主内，一运主管七十多天。所以五运六气合行而终一岁，这是天然不易的道理。《内经》原文丢失了“长夏伤于湿、秋伤于燥”的内容，所以燥证湮没，至今不明。先哲虽然有提及，但都是指内伤津血干枯的证候，不是指外感清凉时气的燥。然而燥气起于秋分以后，小雪以前，此时阳明燥金凉气当令。经文说：阳明之胜，清发于中，左胁痛，溏泄，内为咽喉阻塞，外发疝气。大凉肃杀，花草凋零，毛虫受灾。胸中不便，咽喉阻塞而咳。根据这段经文，燥令必有凉气感人，肝木受邪而化为燥。只有近代喻嘉言公然提出，可为后世苍生之幸；无奈他将“诸气郁，诸痿喘呕，咳不止而出白血死”称为燥病，这是从内伤而言的，确实与外感燥证不相干。更自制清燥救肺汤，都用滋阴清凉的药物，适用于火热刑金，肺气受热者。如果治疗燥病，用凉药去治凉燥，必定反而加重病情。殊不知燥病属于凉，称为次寒，病与感寒同类。经文说寒淫所胜，治以甘热，这里只是燥淫所胜，平以苦温，这是外用苦温辛温解表，与冬月寒冷而用麻黄、桂枝、干姜、附子的方法不同，但和中攻里的原则是一致的，所以没有列出方剂。大概《内经》六气，只分阴阳主治，风、热、火三气属阳同治，只是药物有辛凉、苦寒、咸寒的区别；湿、燥、寒三气属阴同治，只是药物有苦热、苦温、甘热的不同。张仲景所以立伤寒、温病二论为大纲。大概《性理大全》说燥属次寒，但后辈贤人全都说属热，大相径庭。如盛夏暑热熏蒸，则人身汗出，肌肉潮润而不燥；冬月寒凝肃杀，而人身干槁燥冽。所以深秋燥令气行，人体肺金应之，肌肤亦燥，这是火令无权，所以燥属凉，前人说是热是不对的。
按先生这篇论述，可谓独具只眼，不被流俗淹没。他指责喻氏补燥论用甘寒滋阴之品，殊失“燥淫所胜，平以苦温”的方法，也很有道理。但说“诸气郁，诸痿喘呕，咳不止出白血”尽属内伤，则在理论上不够圆满。因为因内伤而导致这些证候的固然多，由外感余邪在络脉，转化转热而导致这些证候的，也不少。我吴瑭先前在风温咳嗽条下，驳斥杏苏散，补充桑菊饮，方论内极言咳嗽久留邪导致虚损的缘故，与此证同一道理。说清燥救肺汤治疗燥的复气，绝不是治疗燥的胜气，喻氏自然无从辩解；如果说竟与燥不相干，未免各就一边谈理。大概喻氏的清燥救肺汤，就是《伤寒论》中后半截的复脉汤。伤寒必然兼有母气的燥，所以初用辛温甘热，继用辛凉苦寒，终用甘润，这是随着气化之所至而然的。至于说张仲景立伤寒、温病二大纲，像《素问》所说，寒暑六入，暑统风火，寒统燥湿，一切外感，都包于内，这种说法尤其不完全正确，大概是尊信张仲景太过而失之偏颇了。如果是这样，那么仲景的书，应当叫六气论，或外感论了，为什么独名伤寒论呢！大概仲景当日著书，原是为伤寒而设，并未遍述外感，其论温、论暑、论湿，只是偶尔提及罢了。即使先生也补充《医征》温热病论，如果是全书，何必又补充呢！我吴瑭并非好辩论，恐怕后学眉目不清，尊信前辈太过，反而将一切外感，总混入《伤寒论》中，这是近代以来的大弊病，祸患未消，怎敢如此立论呢！
一、秋燥之气，轻则为燥，重则为寒，化气为湿，复气为火。
揭示燥气的大纲，兼叙其子母之气、胜复之气，而燥气自然明了。重则为寒的，是因为寒水是燥金之子；化气为湿的，是因为土生金，湿土是其母气。《至真要大论》说：阳明厥阴，不从标本，从乎中也。又说：从本者，化生于本；从标本者，有标本之化；从中者，以中气为化也。按阳明之上，燥气治之，中见太阴。所以本论起初未着墨于燥金本气的方论，而在疟疾、疝气等证中，附见于寒湿条下。叶天士医案说伏暑内发，新凉外加，多见于伏暑类中风；张仲景《金匮要略》，多见于腹痛疟疝门中。
二、燥伤本脏，头微痛，恶寒，咳嗽稀痰，鼻塞，咽喉阻塞，脉弦，无汗，杏苏散主之。
本脏，指肺胃。经文有咽喉阻塞而咳的明文，所以上焦之病自此始。燥伤皮毛，所以头微痛恶寒；微痛，不像伤寒那样痛得厉害。阳明经脉，上行头角，所以头也痛。咳嗽稀痰，是因为肺恶寒，古人说燥为小寒；肺为燥气所搏，不能通调水道，所以寒饮停聚而咳。鼻塞，是因为鼻为肺窍。咽喉寒，是因为咽为肺系。脉弦，是寒兼饮。无汗，是凉气搏击皮毛。按杏苏散，比小青龙汤轻一等。此条应当与下焦篇所补的痰饮数条参看。另外杏苏散是当时人统治四时伤风咳嗽通用的方子，本论前于风温门中已驳斥过它了；如果伤燥凉之咳，治以苦温，佐以甘辛，正是合拍。如果受重寒夹饮之咳，则有青龙汤；如果伤春风，与燥已化火无痰之证，则仍从桑菊饮、桑杏汤例。
杏苏散方
苏叶 半夏 茯苓 前胡 苦桔梗 枳壳 甘草 生姜 大枣（去核） 桔皮 杏仁
〔加减法〕无汗，脉弦甚或紧，加羌活，微透汗。汗后咳不止，去苏叶、羌活，加苏梗。兼泄泻腹满者，加苍术、浓朴。头痛兼眉棱骨痛者，加白芷。热甚加黄芩，泄泻腹满者不用。
〔方论〕这是苦温甘辛法。外感燥凉，所以用苏叶、前胡辛温之轻者达表；无汗脉紧，所以加羌活辛温之重者，微发其汗。甘、桔从上开，枳、杏、前、芩从下降，则咽喉阻塞鼻塞宣通而咳可止。桔、半、茯苓，逐饮而补肺胃之阳。用白芷替换原方中的白术，因为白术是中焦脾药，白芷是肺胃本经之药，且能温肌肉而达皮毛。姜、枣为调和营卫之用。如果表凉退而里邪未除，咳不止者，则去掉走表的苏叶，加入降里的苏梗。泄泻腹满，是金气太实之里证，所以去掉黄芩之苦寒，加术、朴之苦辛温。
三、伤燥，如伤寒太阳证，有汗，不咳，不呕，不痛者，桂枝汤小和之。
如伤寒太阳证，指头痛、身痛、恶风寒而言。有汗不得再发其汗，也像伤寒例，但燥较寒为轻，所以少与桂枝汤小和之。
桂枝汤方（见前）
四、燥金司令，头痛，身寒热，胸胁痛，甚则疝瘕痛者，桂枝柴胡各半汤加吴萸楝子茴香木香汤主之。
这是金胜克木。本病与金病并见，表里齐病，所以用柴胡达少阳之气，即所达肝木之气，合桂枝而外出太阳，加芳香定痛，苦温通降。湿燥寒同为阴邪，所以仍从足经例。
桂枝柴胡各半汤加吴萸楝子茴香木香汤方（治以苦温，佐以甘辛法）
桂枝 吴茱萸 黄芩 柴胡 人参 广木香 生姜 白芍 大枣（去核） 川楝子 小茴香 半夏炙甘草
五、燥淫传入中焦，脉短而涩，无表证，无下证，胸痛，腹胁胀痛，或呕，或泄，苦温甘辛以和之。
燥虽传入中焦，既无表里证，不得误汗、误下，但以苦温甘辛和之足矣。脉短而涩，长为木，短为金，滑为润，涩为燥。胸痛，是肝脉络胸。腹痛，是金气克木，木病克土。胁痛，是肝木之本位。呕，也是金克木病。泄，是阳明之上，燥气治之，中见太阴。或者，是不定之辞；有痛而兼呕与泄者，有不呕而但泄者，有不泄而但呕者，有不兼呕与泄而但痛者。病情有定，病势无定，所以只出法而不立方，学人随证化裁即可。药用苦温甘辛，经文说燥淫所胜，治以苦温，佐以甘辛，以苦下之。盖苦温从火化以克金，甘辛从阳化以胜阴。以苦下之，是因为金性坚刚，介然成块，病深坚结，非下不可。下文即言下之证。
六、阳明燥证，里实而坚，未从热化，下之以苦温；已从热化，下之以苦寒。
燥证阳明里实而坚满，经文统言以苦下之，以苦泄之。今人用下法，多以苦寒。不知此证当别已化未化，用温下寒下两法，随证施治，方为确切。未从热化的脉，必仍短涩，涩即兼紧，面必青黄。苦温下法，如《金匮》大黄附子细辛汤，新方天台乌药散（见下焦篇寒湿门）加巴豆霜之类。已从热化的脉，必数而坚，面必赤，舌必黄，再以他证参之。苦寒下法，如三承气之类，而小承气无芒硝，轻用大黄或酒炒，重用枳、朴，则微兼温矣。
〔附治验〕丙辰年，我吴瑭治一山阴幕友车姓，年五十五岁，须发已白大半。脐左坚大如盘，隐隐微痛，不大便数十日。先延外科治之，外科以大承气汤下之三、四次，终不通。延余诊视，按之坚冷如石，面色青黄，脉短涩而迟。先尚能食，屡下之后，糜粥不进，不大便已四十九日。我说：此症也，金气之所结也。以肝本抑郁，又感秋金燥气，小邪中里，久而结成，愈久愈坚，非下不可，然寒下非其治也。以天台乌药散二钱，加巴豆霜一分，姜汤和服。设三伏以待之，如不通，第二次加巴豆霜分半；再不通，第三次加巴豆霜二分。服至三次后，始下黑亮球四十九枚，坚莫能破。继以苦温甘辛之法调理，渐次能食。又十五日不大便，余如前法下，至第二次而通，下黑亮球十五枚，虽亦坚结，然破之能碎，但燥极耳。外以香油熬川椒，熨其坚处；内服苦温芳香透络，月余化尽。于此证，方知燥金气伤人如此，而温下寒下之法，断不容紊也。
乙丑年，治通廷尉，久疝不愈。时年六十八岁。先是通廷尉外任时，每发疝，医者必用人参，故留邪在络，久不得愈。至乙丑季夏，受凉复发，坚结肛门，坐卧不得，胀痛不可忍，汗如雨下，七日不大便。我说：疝本寒邪，凡结坚牢固，皆属金象，况现下势甚危急，非温下不可。亦用天台乌药散一钱，巴豆霜分许。下至三次始通，通后痛渐定。调以倭硫黄丸，兼用《金匮》蜘蛛散，渐次化净。以上治验二条，俱系下焦证，以出阳明坚结下法，连类而及。
七、燥气延入下焦，搏于血分，而成癥瘕者，无论男妇，化癥回生丹主之。
大邪中表之燥证，感而激发者，诚如目南先生所说，与伤寒同法，学人衡其轻重即可。前所补数条，除减伤寒法等差二条，胸胁腹痛一条，与伤寒微有不同，余俱兼疝瘕者，以经文有“燥淫所胜，男子疝，女子少腹痛”的明文。疝瘕已多见寒湿门中，疟证、泄泻、呕吐已多见于寒湿、湿温门中，此特补小邪中里，深入下焦血分，坚结不散之痼疾。若不知络病宜缓通治法，或妄用急攻，必犯瘕散为蛊之戒。此蛊乃血蛊也，在妇人更多，为极重难治之证，学人不可不预防之也。化癥回生丹法，系燥淫于内，治以苦温，佐以甘辛，以苦下之也。方从《金匮》鳖甲煎丸与回生丹脱化而出。此方以参、桂、椒、姜通补阳气，白芍、熟地，守补阴液，益母膏通补阴气，而消水气，鳖甲胶通补肝气，而消癥瘕，余俱芳香入络而化浊。且以食血之虫，飞者走络中气分，走者走络中血分，可谓无微不入，无坚不破。又以醋熬大黄三次，约入病所，不伤他脏，久病坚结不散者，非此不可。或者病其药味太多，不知用药之道，少用独用，则力大而急；多用众用，则功分而缓。古人缓化之方皆然，所谓有制之师不畏多，无制之师少亦乱也。此方合醋与蜜共三十六味，得四九之数，金气生成之数也。
化癥回生丹方
人参（六两） 安南桂（二两） 两头尖（二两） 麝香（二两） 片子姜黄（二两） 公丁香（三两） 川椒炭（二两） 虻虫（二两） 京三棱（二两） 蒲黄炭（一两） 藏红花（二两） 苏木（三两）
Note: The formulas and theories of autumn dryness discussed previously refer to the "rebound qi" (compensatory reaction) and "superficial qi" (manifestation) of dryness. Since dryness belongs to Metal in the Five Elements, and Metal overcomes Wood, while Wood's son is Shaoyang Ministerial Fire, when Fire qi rebounds, symptoms of dry-heat and dryness appear. Furthermore, the *Ling Shu* states that Bing-Ding days correspond to the Two Yangs Combining for Brightness in the hand (Yangming Meridian), and Chen-Si hours correspond to the Two Yangs Combining for Brightness in the foot (Yangming Meridian). Yangming's root qi is Dryness, and its superficial qi is Yang. Predecessors stated that Dryness transforms into Fire; the classics say "beneath Dryness Metal, Fire qi supports it," which refers to this phenomenon. Examining ancient medical texts, there are no specific discussions on diseases of autumn dryness. Since modern times, only Yu Jiayan began to supplement the theory of Dryness Qi, using sweet, moistening, and slightly cold herbs in his formulas; Ye Tianshi also had the theory that Dryness transforms into Fire, using pungent-cool and sweet-moistening herbs in his formulas. This aligns with the method in the *Su Wen*: "When Dryness transformation occurs due to Heaven, Heat may counter-vanquish it; treat with Pungent-Cool, assist with Bitter-Sweet." I, Wu Tang, have followed the precedents of predecessors, thus only narrating the rebound qi of Dryness syndromes as before. Although this book is completed, I privately reflect that it does not fully accord with the *Su Wen*'s discussion on "Excess of Dryness," so in the miscellaneous essays section, I specifically added a treatise on Dryness, detailing proper transformation, opposite transformation, vanquishing qi, and rebound qi to supplement this. Regarding the manifestation of Dryness disease's vanquishing qi in the Triple Burner, specific formulas were not provided, making this an incomplete work, leaving my mind uneasy. Later, I obtained Shen Munan's *Yi Zheng* Treatise on Warm Diseases, which contains an essay on Autumn Dryness with thorough and upright arguments. I adopted and recorded it hereafter, clarifying and distinguishing any partial or imperfect points, and specifically supplemented the treatment methods for the vanquishing qi of Dryness syndromes as follows. Furthermore, regarding the principles of vanquishing and rebound, proper and opposite transformations, and following the root or superficial aspect, few have sought deep understanding since modern times, and commentators have not investigated much. For instance, in Zhang Zhongjing's *Shang Han Lun*, Mahuang Tang and Guizhi Tang, along with Ganjiang and Fuzi formulas, treat the vanquishing qi of Cold, the proper transformation of Cold, and the root disease of Cold. Baihu Tang and Chengqi Tang treat the rebound qi of Cold, the opposite transformation of Cold, and the superficial disease of Cold. The other five Qi can be inferred from this. (Taiyang's root qi is Cold, superficial qi is Heat, opposite transformation is Fire; generally, Water excess must overcome Fire. Thus, the classics state that when Taiyang governs the year, Heart diseases are frequent. It concludes: The disease originates in the Heart; when Heart Fire is diseased, it must overcome Metal. Baihu Tang saves Metal. When Metal is diseased, it becomes hard and rigid, obstructed and unflowing; the rebound qi is Earth, whose nature is obstruction, counter-overcoming the true Water of itself. Chengqi Tang drains Metal and Earth to save Water. Additionally, the classics say: "For excess Cold, use Salty to drain." Commentators throughout history merely explained the text literally, failing to thoroughly explain the rationale behind the formula usage. This treatise cannot annotate all of *Shang Han Lun*; I briefly cite one end as an example for the rest. Those with clarity, obtaining this key and studying the *Nei Jing* thoroughly, will naturally solve problems easily; understanding *Shang Han Lun* makes understanding this treatise easy. By extension, this applies to all Six Qi.)
Shen Munan in *Zao Bing Lun* says: The *Tian Yuan Ji Da Lun* states: "Heaven uses Six as the rhythm, Earth uses Five as the system." Generally, Six refers to Wind, Cold, Summer-Heat, Dampness, Dryness, and Fire as rhythms; Five refers to Wood, Fire, Earth, Metal, and Water as systems. However, Heaven's Qi governs externally, with one Qi governing for over sixty days; Earth's movement governs internally, with one Yun governing for over seventy-two days. Thus, the combination of Five Yun and Six Qi completes a year, which is the unchangeable way of nature. The *Nei Jing* lost the phrases "Summer-Heat season injured by Dampness, Autumn injured by Dryness," causing Dryness syndromes to be obscured and unclear to this day. Although ancient sages mentioned it, they referred to internal injuries causing dryness of fluids and blood, not external contraction of cool-dry seasonal Qi. However, Dryness Qi arises after the Autumn Equinox and before Minor Snow, when Yangming Dryness Metal Cool Qi commands. The classics say: "Victory of Yangming, Clearness erupts within, left hypochondriac pain, loose stools, internal throat obstruction, external hernia. Great Cool desiccation, flowers and leaves change appearance, hair-bearing creatures suffer. Chest discomfort, throat obstruction and cough." Based on this scripture, the Dryness command must involve Cool Qi affecting humans, causing Liver Wood to be invaded and transform into Dryness. Only in modern times did Yu Jiayan openly propose this, bringing fortune to future generations; unfortunately, he called "all Qi stagnation, all flaccidity, wheezing, vomiting, persistent cough with white blood death" as Dryness disease, which speaks of internal injury, indeed unrelated to external Dryness syndromes. He further created Qingzao Jiufei Tang, using yin-nourishing and cool-clearing herbs, suitable for Fire scorching Metal and Lung Qi受热. If treating Dryness disease, using Cool to treat Cool will surely worsen the condition. Little do they know that Dryness disease belongs to Cool, termed Secondary Cold, similar to contracting Cold. The classics say for excess Cold, treat with Sweet-Hot; here for excess Dryness, level with Bitter-Warm. This involves external use of Bitter-Warm and Pungent-Warm to release the exterior, differing from winter cold treated with Mahuang, Guizhi, Ganjiang, Fuzi, though the principle of harmonizing middle and attacking interior remains the same, hence no formula was listed. Generally, the *Nei Jing* divides Six Qi into Yin-Yang for main treatment: Wind, Heat, Fire three Qi belong to Yang and are treated similarly, differing only in herbs being Pungent-Cool, Bitter-Cold, or Salty-Cold; Dampness, Dryness, Cold three Qi belong to Yin and are treated similarly, differing only in herbs being Bitter-Hot, Bitter-Warm, or Sweet-Hot. Zhang Zhongjing established Shanghan and Wenbing two treatises as the outline. The *Xingli Daquan* states Dryness belongs to Secondary Cold, but later scholars all say it belongs to Heat, a vast discrepancy. In midsummer heat steaming, the body sweats, muscles are moist, not dry; in winter cold condensation and desiccation, the body is dry and brittle. Thus, in late autumn when Dryness Qi acts, human Lung Metal responds, skin becomes dry, because Fire command lacks power, so Dryness belongs to Cool; predecessors saying it is Heat is incorrect.
Regarding Mr. Shen's argument, it shows unique insight, not submerged by vulgar trends. His criticism of Yu's Dryness supplementation using Sweet-Cold yin-nourishing herbs, missing the method "for excess Dryness, level with Bitter-Warm," is very reasonable. But stating that "all Qi stagnation, flaccidity, wheezing, vomiting, persistent cough with white blood" are entirely internal injuries is theoretically incomplete. While many such syndromes result from internal injury, many others arise from residual pathogenic factors in collaterals from external contraction, transforming into heat. Previously, under Wind-Warm cough sections, I refuted Xingsu San and supplemented Sangju Yin, extensively discussing how prolonged cough retains pathogens leading to damage, which shares the same logic as this syndrome. Saying Qingzao Jiufei Tang treats the rebound qi of Dryness, definitely not the vanquishing qi of Dryness, Yu has no grounds to argue; saying it is completely unrelated to Dryness is discussing from one side only. Essentially, Yu's Qingzao Jiufei Tang is the latter half of Fumai Tang in *Shang Han Lun*. Shanghan necessarily involves the dryness of the mother organ, so initially using Pungent-Warm Sweet-Hot, then Pungent-Cool Bitter-Cold, finally Sweet-Moist, following the progression of Qi transformation. As for Zhang Zhongjing establishing Shanghan and Wenbing as two outlines, like the *Su Wen* says "Cold and Summer-Heat enter six times, Summer-Heat unifies Wind and Fire, Cold unifies Dryness and Dampness," encompassing all external contractions, this view is particularly incomplete, likely due to excessive reverence for Zhang Zhongjing. If so, Zhongjing's book should be named Treatise on Six Qi or External Contractions, why solely name it Treatise on Cold Damage! Zhongjing wrote originally for Cold Damage, not comprehensively covering external contractions; his discussions on Warm, Summer-Heat, and Dampness were occasional mentions. Even Mr. Shen supplemented *Yi Zheng* Warm Disease Treatise; if it were a complete work, why supplement again! I am not arguing for the sake of arguing, fearing students will be confused, reverting to elders too much, mixing all external contractions into *Shang Han Lun*, a major flaw since modern times. How dare I stand such a theory amidst such dangers!
1. Autumn Dryness Qi, light is Dryness, heavy is Cold, transformed qi is Dampness, rebound qi is Fire.
This reveals the outline of Dryness Qi, including its mother-son qi and vanquishing-rebound qi, making Dryness Qi clear. Heavy becoming Cold is because Cold Water is the son of Dryness Metal; transformed qi becoming Dampness is because Earth generates Metal, Wet Earth is its mother qi. *Zhi Zhen Yao Da Lun* says: Yangming and Jueyin do not follow root/superficial, but follow the middle. Also: Following root means transformation born from root; following root/superficial means transformation of root/superficial; following middle means transformation by middle qi. According to above Yangming, Dryness Qi governs, middle sees Taiyin. Thus, this treatise initially did not elaborate on Dryness Metal root qi formulas, but attached malaria and hernia syndromes under Cold-Damp sections. Ye Tianshi's medical cases mention latent Summer-Heat erupting internally, new Cool externally, often seen in latent Summer-Heat stroke-like syndromes; Zhang Zhongjing's *Jin Gui*, often seen in abdominal pain and malaria-hernia sections.
2. Dryness injuring the root organ, slight head pain, aversion to cold, cough with thin phlegm, nasal congestion, throat obstruction, wiry pulse, no sweat, Xingsu San governs.
Root organ refers to Lung and Stomach. The classics explicitly mention throat obstruction and cough, so Upper Jiao diseases start here. Dryness injures skin and hair, hence slight head pain and aversion to cold; slight pain differs from severe pain in Shanghan. Yangming meridian ascends to head corners, hence head pain. Cough with thin phlegm occurs because Lung dislikes Cold, ancients called Dryness Small Cold; Lung constrained by Dryness Qi cannot regulate water passages, so Cold-fluid stagnates causing cough. Nasal congestion because nose is Lung orifice. Throat cold because throat is Lung connection. Wiry pulse indicates Cold combined with fluid retention. No sweat indicates Cool confronting skin and hair. Xingsu San is one grade lighter than Xiao Qinglong Tang. This section should be read together with several phlegm-fluid sections supplemented in Lower Jiao chapter. Also, Xingsu San is a general formula used by contemporaries for wind-cold coughs in four seasons, already refuted in this treatise's Wind-Warm section; for coughs injured by Dryness-Cool, treating with Bitter-Warm assisted by Sweet-Pungent is appropriate. For coughs with severe Cold and fluid retention, Qinglong Tang is used; for spring wind injury or Dryness transformed into Fire without phlegm, follow Sangju Yin or Sangxing Tang examples.
Xingsu San Formula
Suyu, Banxia, Fuling, Qianhu, Ku Jiegeng, Zhike, Gancao, Shengjiang, Dazao (pitted), Jupi, Xingren
[Modifications] No sweat, wiry or tight pulse, add Qianghuo to induce slight sweating. Cough persists after sweating, remove Suyu, Qianghuo, add Sugeng. With diarrhea and abdominal fullness, add Cangzhu, Houpo. Headache with supraorbital pain, add Baizhi. Severe heat add Huangqin, not used with diarrhea/abdominal fullness.
[Formula Analysis] This is Bitter-Warm Sweet-Pungent method. External contraction of Dryness-Cool, so use light Pungent-Warm Suyu, Qianhu to reach exterior; no sweat tight pulse, so add heavy Pungent-Warm Qianghuo to induce slight sweating. Gan, Jiegeng open from above, Zhike, Xingren, Qian, Qin descend from below, thus throat/nasal obstruction clears and cough stops. Jiegeng, Banxia, Fuling drain fluid and tonify Lung-Stomach Yang. Replacing Baizhu with Baizhi because Baizhu is Middle Jiao Spleen herb, Baizhi is Lung-Stomach meridian herb, and warms muscle/reaches skin. Jiang, Zao harmonize Ying and Wei. If exterior Cool recedes but interior pathogen remains, cough persists, remove exterior-reaching Suyu, add interior-descending Sugeng. Diarrhea/abdominal fullness is excessive Metal interior syndrome, so remove bitter-cold Huangqin, add bitter-pungent-warm Baizhu, Houpo.
3. Injury by Dryness, resembling Shanghan Taiyang syndrome, with sweat, no cough, no vomiting, no pain, Guizhi Tang harmonizes slightly.
Resembling Shanghan Taiyang syndrome refers to headache, body ache, aversion to wind-cold. With sweat, do not induce sweating again, similar to Shanghan rules, but Dryness is lighter than Cold, so give Guizhi Tang slightly to harmonize.
Guizhi Tang Formula (see previous)
4. Dryness Metal commanding, headache, alternating chills and fever, chest/hypochondriac pain, even hernia/mass pain, Guizhi Chaihu Ge Ban Tang plus Wuzhuyu, Lianzi, Huixiang, Muxiang Tang governs.
This is Metal overcoming Wood. Root disease and Metal disease appear together, exterior-interior simultaneously diseased, so use Chaihu to reach Shaoyang Qi, i.e., Liver Wood Qi, combined with Guizhi to exit Taiyang, adding aromatic pain-calming, bitter-warm descending agents. Dampness, Dryness, Cold are all Yin pathogens, so still follow Foot meridian examples.
Guizhi Chaihu Ge Ban Tang plus Wuzhuyu, Lianzi, Huixiang, Muxiang Tang Formula (Treat with Bitter-Warm, assist with Sweet-Pungent)
Guizhi, Wuzhuyu, Huangqin, Chaihu, Renshen, Guangmuxiang, Shengjiang, Baishao, Dazao (pitted), Chuanlianzi, Xiaohuixiang, Banxia, Zhigancao
5. Dryness invading Middle Jiao, short and choppy pulse, no exterior syndrome, no interior excess syndrome, chest pain, abdominal/hypochondriac distending pain, or vomiting, or diarrhea, Bitter-Warm Sweet-Pungent to harmonize.
Although Dryness invades Middle Jiao, lacking exterior-interior syndromes, do not mistakenly sweat or purge, but harmonizing with Bitter-Warm Sweet-Pungent suffices. Short-choppy pulse: Long is Wood, Short is Metal, Slippery is Moist, Choppy is Dry. Chest pain is Liver meridian passing through chest. Abdominal pain is Metal overcoming Wood, Wood disease overcoming Earth. Hypochondriac pain is Liver Wood's original position. Vomiting is also Metal overcoming Wood disease. Diarrhea is above Yangming, Dryness Qi governs, middle sees Taiyin. "Or" is indefinite; some have pain with vomiting/diarrhea, some vomiting only, some diarrhea only, some pain only. Disease nature is fixed, disease trend is variable, so only provide method not formula, students adjust according to syndrome. Herbs Bitter-Warm Sweet-Pungent: Classics say for excess Dryness, treat with Bitter-Warm, assist with Sweet-Pungent, drain with Bitter. Bitter-Warm transforms via Fire to overcome Metal, Sweet-Pungent transforms via Yang to overcome Yin. Draining with Bitter is because Metal nature is hard/rigid, forming clumps, deep-seated firmness requires purging. Next section discusses purging syndromes.
6. Yangming Dryness syndrome, interior excess and firm, not yet transformed into Heat, purge with Bitter-Warm; already transformed into Heat, purge with Bitter-Cold.
Yangming Dryness interior excess firm/full, classics generally say purge with Bitter, drain with Bitter. Modern practitioners mostly use Bitter-Cold purging. Not knowing this syndrome distinguishes transformed/untransformed, using Warm-Purge and Cold-Purge methods according to syndrome is accurate. Untransformed pulse remains short/choppy, choppy implies tight, face green-yellow. Bitter-Warm purge method: e.g., *Jin Gui* Dahuang Fuzi Xixin Tang, new Fang Tian Tai Wuyao San (see Lower Jiao Cold-Damp section) plus Radix Crotonis seed powder. Transformed pulse rapid/firm, face red, tongue yellow, cross-reference other syndromes. Bitter-Cold purge method: e.g., Three Chengqi formulas, Xiao Chengqi without Mangxiao, light Dahuang or wine-fried, heavy Zhike/Houpo, slightly warm.
[Attached Treatment Cases] In Bingchen year, I treated a幕友 (secretary) named Che from Shanyin, age 55, hair/beard mostly white. Firm mass like plate left of umbilicus, dull slight pain, no bowel movement for dozens of days. Initially treated by surgeons, who purged with Dachengqi Tang three-four times, still blocked. Consulted me, palpated firm/cold like stone, face green-yellow, pulse short/choppy/slow. Initially could eat, after repeated purging, refused porridge, no bowel movement for 49 days. I said: This syndrome is knotting of Metal Qi. Liver originally depressed, contracted Autumn Metal Dryness, minor pathogen entered interior, long-term knotting, harder over time, requires purging, but Cold-Purge is not the treatment. Use Tian Tai Wuyao San 2 qian, add Radix Crotonis seed powder 1 fen, mix with Ginger Decoction. Wait for Sanfu period, if not passed, second dose add 1.5 fen; if still not, third dose add 2 fen. After three doses, passed 49 black shiny balls, extremely hard. Then regulated with Bitter-Warm Sweet-Pungent method, gradually ate. Another 15 days no bowel movement, purged again as before, passed on second dose, 15 black shiny balls, also firm but breakable, just extreme dryness. Externally fried Sichuan Pepper in Sesame Oil, applied to firm area; internally took Bitter-Warm aromatic collateral-penetrating herbs, resolved in over a month. From this case, we see how Dryness Metal Qi harms people, and Warm-Purge/Cold-Purge methods must not be confused.
In Yichou year, treated Tong Tingwei, chronic hernia unresolved. Age 68. Previously when Tong served outside, every hernia attack, doctors used Renshen, thus retaining pathogen in collaterals, never healing. In late summer of Yichou, caught cold, relapsed, firm knot at anus, unable to sit/lie, unbearable distending pain, sweating like rain, no bowel movement for 7 days. I said: Hernia is originally Cold pathogen, all firm knots belong to Metal image, especially now critical situation, requires Warm-Purge. Used Tian Tai Wuyao San 1 qian, Radix Crotonis seed powder approx 1 fen. Passed after three doses, pain settled. Regulated with Wo Liuhuang Wan, combined with *Jin Gui* Zhizhu San, gradually resolved. Above two cases are Lower Jiao syndromes, illustrating Yangming firm knot purging method, included by association.
7. Dryness Qi extending to Lower Jiao, contending in Blood division, forming masses, regardless of gender, Huazheng Huisheng Dan governs.
Major pathogen affecting exterior Dryness syndrome, triggered by infection, truly as Mr. Munan said, same method as Shanghan, students judge severity. Previous supplemented sections, except two reducing Shanghan differentiation steps, one chest/hypochondriac/abdominal pain section slightly different from Shanghan, others all accompanied by hernia/masses, because classics have explicit text "excess Dryness, men hernia, women lower abdominal pain." Hernia/masses seen in Cold-Damp section, malaria/diarrhea/vomiting in Cold-Damp/Warm-Damp sections, this specifically supplements minor pathogen entering interior, deeply invading Lower Jiao Blood division, firm knotting unresolving chronic disease. If not knowing collaterals disease requires slow unblocking method, or recklessly using urgent attack, must violate warning of mass dispersing into gu. This gu is Blood Gu, more common in women, extremely serious difficult-to-treat syndrome, students must prevent. Huazheng Huisheng Dan method: Dryness inside, treat with Bitter-Warm, assist with Sweet-Pungent, drain with Bitter. Formula derived from *Jin Gui* Biejia Jian Wan and Huisheng Dan. This formula uses Renshen, Guizhi, Jiaojiao, Shengjiang to pass-tonify Yang Qi, Baishao, Shudi to guard-tonify Yin Fluid, Yimuao Paste to pass-tonify Yin Qi and drain water Qi, Biejia Jiao to pass-tonify Liver Qi and resolve masses, remaining herbs aromatic entering collaterals to transform turbidity. Moreover, blood-eating insects, flying ones traverse Qi division in collaterals, walking ones traverse Blood division in collaterals, penetrating every micro, breaking every firmness. Vinegar-boiled Dahuang three times, concentrates on disease site, sparing other organs, long-standing firm knots require this. Some complain too many herbs, not knowing medication way: single/few herbs strong/fast; many/herbs weak/slow. Ancient slow-resolution formulas are all like this, "disciplined army fears not numbers, undisciplined army chaotic even with few." This formula combines vinegar and honey totaling 36 ingredients, achieving number 49, Metal generation number.
Huazheng Huisheng Dan Formula
Renshen (6 liang), Annan Guizhi (2 liang), Liangtoujian (2 liang), Shexiang (2 liang), Pianzi Jianghuang (2 liang), Gong Dingxiang (3 liang), Chuanjiao Tan (2 liang), Mengchong (2 liang), Jingsanleng (2 liang), Puhuang Tan (1 liang), Zanghonghua (2 liang), Sumu (3 liang)