虚劳客热,枸杞根为末,白汤调服,有痼疾者勿服。
虚劳发热,柴胡、人参各三钱,姜、枣同水煎服。
阴虚发热,麦门冬、竹茹、灯心,时常煎服。
子午潮热,黄柏、知母、地骨皮、麦门冬、灯心、竹茹、木通、北五味,等分制过,
煎服。
一人痰火作热,烦躁不安,此气随火升也。余用滋阴降火汤,加酸枣仁炒山栀、黄连
、竹茹、童便,同煎数服而愈。
夫骨蒸者,病患自觉骨髓中蒸热,扪之皮肤肌肉则无热也。以其火伏于水,燔烁真阴,
煎熬骨髓,是以有此酷证焉。然病固火之所为,而其治亦不可直折,惟滋阴抑阳,以水胜火
,如四物、知、柏、玄参、地骨、丹皮之属,从治可也。若以苦寒正治,以伤其脾,则肌肉
日消,黄泉之境路岂赊乎,哀哉!
圣谓火病骨蒸,真阴亏之极矣。以水伏火中,热侵骨髓,是根本伤而干及枝叶矣。何长
茂而不槁乎?夫水之与火,相背而不相得者也。以水沃其火则灭,火烁其水则枯,然以火置
水中反炽者,非龙雷之火乎?所谓龙雷者,谓其不可水伏,不可直折,如龙潜大海,火光
竟起,得水益燔,雷震虚空,烟焰并炽,以阴愈显。法惟参、 、知、柏、玄参等味之苦甘
温从治,庶几可遏,以温能除大热之义也。若以芩、连之苦寒正治,则阴火愈炽而脾土益
亏,所谓谷神既去,何借以生?噫!病至此而不遇良工,若牵牛已至屠肆,将自就死地,其得
生者几希,人可不知哉。
虚劳伴有外感邪热,将枸杞根研成粉末,用白开水调服,但患有顽固性疾病的人禁止服用。
虚劳引起的发热,取柴胡、人参各三钱,加入生姜、大枣,用水煎煮后服用。
子时和午时出现的潮热,取黄柏、知母、地骨皮、麦门冬、灯心草、竹茹、木通、北五味子,各等分炮制处理后,煎煮服用。
有一人因痰火引发发热,烦躁不安,这是气随火势上逆所致。我使用滋阴降火汤,加入炒酸枣仁、炒山栀、黄连、竹茹、童便(儿童尿液),共同煎煮,服用几剂后痊愈。
所谓骨蒸,是患者自觉骨髓中有蒸腾之热,但触摸皮肤肌肉时却没有热度。这是因为火潜伏在水中,焚烧灼烁真阴,煎熬骨髓,所以出现这种严重的病证。然而,虽然病症确实由火引起,但治疗时也不能直接强行折损火势,只能采用滋阴抑阳的方法,以水来克制火,如使用四物汤、知母、黄柏、玄参、地骨皮、牡丹皮这类药物,顺从病势进行治疗即可。如果用苦寒药物直接清热,会损伤脾胃,导致肌肉日渐消瘦,离死亡就不远了,真是可悲啊!
圣人说,火病中的骨蒸,是真阴亏损到了极点。因为水潜伏在火中,热气侵入骨髓,这是根本受伤进而波及枝叶。怎么能保持茂盛而不枯槁呢?水和火,是相背而不能相容的。用水去浇灭火则灭,火去烧干水则枯,但是把火放在水中反而更旺盛的,不就是龙雷之火吗?所谓的龙雷之火,是指它不能被水压制,不能直接折损,就像龙潜藏在深海中,火光竟然升起,得到水反而更加燃烧;雷震动虚空,烟焰一起炽盛,在阴暗环境中更加显现。治疗方法只有用人参、[原文缺字,推测为熟地黄或类似滋阴药]、知母、黄柏、玄参等味道的苦甘温药物,顺从病势治疗,或许可以遏制,这符合“以温能除大热”的道理。如果用黄芩、黄连的苦寒药物直接清热,那么阴火会更加炽盛,脾土更加亏虚,所谓谷神(胃气)既然离去,还依靠什么来生存呢?唉!病情到了这种地步而遇不到良医,就像牛已经被牵到屠宰场,将要自己走向死地,能够活下来的极少,人们怎么可以不明白这一点呢。
For deficiency consumption (Xu Lao) accompanied by exogenous pathogenic heat, grind the root of *Lycium chinense* (Gouqigen) into powder and take it with warm water. It is contraindicated for those with chronic diseases.
For fever caused by deficiency consumption, use *Bupleuri Radix* (Chaihu) and *Ginseng Radix et Rhizoma* (Renshen), three qian each. Decoct them with ginger and jujube in water and take orally.
For fever due to yin deficiency, decoct *Ophiopogonis Radix* (Maimendong), *Bambusae Caulis in Taeniam* (Zhuru), and *Junci Medulla* (Dengxin) for frequent administration.
For tidal fever occurring at Zi (11 PM–1 AM) and Wu (11 AM–1 PM) hours, take equal parts of *Phellodendri Cortex* (Huangbai), *Anemarrhenae Rhizoma* (Zhimu), *Lycii Cortex* (Digupi), *Ophiopogonis Radix* (Maimendong), *Junci Medulla* (Dengxin), *Bambusae Caulis in Taeniam* (Zhuru), *Akebiae Caulis* (Mutong), and *Schisandrae Fructus* (Beiweizi). Process them equally, decoct, and take orally.
One patient suffered from fever caused by phlegm-fire, with irritability and restlessness. This was due to qi rising along with the fire. I used Ziyin Jianghuo Tang (Nourishing Yin and Descending Fire Decoction), adding stir-fried *Ziziphi Spinosae Semen* (Suanzaoren), stir-fried *Gardeniae Fructus* (Shanzhi), *Coptidis Rhizoma* (Huanglian), *Bambusae Caulis in Taeniam* (Zhuru), and Tongbian (child's urine). After several doses, the patient recovered.
Bone-steaming (Gu Zheng) refers to a condition where the patient feels a steaming heat within the marrow, but upon palpation, the skin and muscles feel cool. This occurs because fire lurks within water, scorching true yin and simmering the marrow, resulting in this severe syndrome. Although the disease is indeed caused by fire, treatment should not directly suppress the fire. Instead, one must nourish yin and restrain yang, using water to overcome fire. Formulas such as Siwu Tang (Four Substances Decoction), along with herbs like *Anemarrhenae Rhizoma* (Zhimu), *Phellodendri Cortex* (Huangbai), *Scrophulariae Radix* (Xuanshen), *Lycii Cortex* (Digupi), and *Paeoniae Rubra* (Danpi), are suitable for treating according to the nature of the disease (concordant treatment). If bitter-cold herbs are used for direct treatment (contrary treatment), they will damage the spleen, causing muscles to waste away daily, bringing death closer. How tragic!
It is said that bone-steaming in fire diseases indicates extreme depletion of true yin. Since water lurks within fire, heat invades the marrow, damaging the root and affecting the branches. How can growth remain lush without withering? Water and fire are opposing and incompatible. Pouring water on fire extinguishes it; fire boiling dry water causes it to wither. However, when fire placed in water becomes more intense, is this not the "Dragon-Thunder Fire"? The term "Dragon-Thunder" implies that it cannot be subdued by water or directly suppressed. Like a dragon hiding in the sea, yet fire rises; getting water makes it burn more fiercely. Like thunder shaking the void, smoke and flames blaze intensely, appearing brighter in darkness. The method is to use bitter, sweet, and warm herbs like *Ginseng Radix et Rhizoma* (Renshen), [text missing, likely Shudihuang], *Anemarrhenae Rhizoma* (Zhimu), *Phellodendri Cortex* (Huangbai), and *Scrophulariae Radix* (Xuanshen) for concordant treatment, which may curb the fire, following the principle that "warmth can remove great heat." If bitter-cold herbs like *Scutellariae Radix* (Huangqin) and *Coptidis Rhizoma* (Huanglian) are used for direct treatment, the yin-fire will become more intense, and the spleen-earth will further decline. Once the "Grain Spirit" (Stomach Qi) is gone, what sustains life? Alas! When the disease reaches this stage without encountering a skilled physician, it is like an ox led to the slaughterhouse, heading towards its own death. Survival is rare. Should people not understand this?