从下泄，痢止，余热反走诸络而上溢。否则炮姜、五味之性，何由稍释？其衄也，亦犹伤寒阳明热邪，得红汗而解矣。
尤在泾曰∶评热病论云，劳风法在肺下，其为病也，强上冥视，唾出若涕，恶风而振寒，治之奈何？曰∶
以救俯仰。巨阳引精者三日，中年者五日，不精者七日，咳出清黄涕，其状如脓，大如弹丸，从口中或鼻中出。
不出则伤肺，伤肺者死矣。读此可悟伤风不解成劳之故。劳风者，既劳而又受风也。劳则火起于上，而风又乘
之，风火相搏，气凑于上，故云法在肺下也。肺主气而司呼吸，风热在肺，其液必结，其气必壅，是以俯仰皆
不顺利，故曰当救俯仰也。救俯仰者，即利肺气，散邪气之谓乎。然邪气之散与否，在乎正气之盛与衰。若阳
气旺，而精气引者三日，次五日，又次七日，则青黄之涕从咳而出，出则风热俱出，而肺无恙矣。设不出，则
风火留积于肺中而肺伤。肺伤则喘咳声嘶，渐及五脏而虚劳之病成矣。今人治劳，日用滋养，而不少益者，非
以邪气未出之故欤。而久留之邪，补之固无益，清之亦不解，虚劳病之所以难治也。
徐灵胎曰∶凡人偶感风寒，头痛发热，咳嗽涕出，俗谓之伤风。非《伤寒论》中所云之伤风，乃时行之杂
感也。人皆忽之，不知此乃至难治之疾，生死之所关也。盖伤风之疾，由皮毛以入于肺。肺为娇脏，寒热皆所
不宜。太寒则邪气凝而不出，太热则火烁金而动血，太润则生痰饮，太燥则耗精液，太泄则汗出而阳虚，太涩
则气闭而邪结。并有视为微疾，不避风寒，不慎饮食，经年累月，病机日深。或成血症，或成肺痿，或成哮喘，
或成怯弱，比比皆然。误治之害，不可胜数。谚云∶伤风不解变成劳。至言也。然则治之何如？一驱风，苏叶、
荆芥之类；二消痰，半夏、象贝之类；三降气，苏子、前胡之类；四和营卫，桂枝、白芍之类；五润津液，蒌
仁、元参之类；六养血，当归、阿胶之类；七清火，黄芩、山栀之类；八理肺，桑皮、大力子之类。八者随其
症之轻重而加减之。更加以避风寒，戒辛酸，则庶几渐愈，否则必成大病。又加以升提辛燥之品，如桔梗、干
姜之类，不效即加以酸收，如五味子之类，则必见血。既见血，随用熟地、麦冬以实其肺，即成劳而死。四十
年以来，我见以千计矣。伤哉。
张路玉治姜如农长媳，患风热咳嗽，无痰，灼热自汗，而怀妊七月。先曾服和解清肺药二十余剂，其咳转
剧，胎渐不安。诊之，六脉皆濡大无力，右手寸关独盛而涩，曰∶此热伤肺气也。反与和解药逼汗出，致肺气
益燥，而咳逆愈甚。不得已复用苦寒折之，则火转郁伏而不散也。遂用大剂葳蕤，及川芎、杏仁、白薇、甘草，
取葳蕤汤之半，更以当归、桔梗、五味、黄 益气生津，因以敛肺。二剂，汗止咳减，胎亦向安。更加生诃子
皮，一剂而痊。
郁金岩，劳役后伤风自汗，胸满痰结，咳出青黄涕，大如弹丸。此即《内经》所谓劳风法在肺下也，与茯
苓桂枝白术甘草汤，加姜汁、竹沥，二剂而安。又治宋襄之女，素常多郁，干咳，春间感冒风邪，咳逆愈甚。
以小建中汤用蜜煎生姜，加蜜煎橘皮，外邪即解，而咳不止。次以逍遥散，仍用蜜煎姜、橘，更与异功散，用
蜜制白术、姜、橘而安。
吴佩玉女，伤风咳嗽，自用疏风润肺之药，转加呕渴咽痛。诊之，六脉浮滑应指，作半夏散与之，三啜而
病如失。或问∶咳嗽咽痛而渴，举世咸禁燥剂，而用半夏即效何也？曰∶治病必求其本。此症风寒邪挟饮上攻
之暴迫，故用半夏、桂枝以开通经络，迅扫痰涎，兼甘草之和脾胃，以救津液。风痰散而营卫通，则咽痛燥渴
自己。设用清润，滋其痰湿，经络愈困，津液愈结，燥渴咽痛，愈无宁宇矣。近世治风寒咳嗽，虽用表药，必
兼桑皮、黄芩、花粉，甚则知、柏之类。少年得之，必种吐血虚损之根。中年以后得之，多成痰火喘咳之患。
初时元气未衰，邪热暂伏，似觉稍可。久之真气渐伤，转服转甚。及见吐血，则不问何经脏腑，属火属伤，血
之散结，色之晦鲜，瘀之有无，概以犀角地黄寒凉止截之剂投之，致血蓄成根。向后或两月、一月一发，虽日
服前药不应矣。尝见一人患项肿发热，延伤寒家视之，则曰大头伤寒，以表药发之，并头亦胀，（确然。）大头无
疑矣。病家以其治之益甚，另延杂症家视之，则曰湿热痰火，以里药攻之，则头与项前左半皆消，但项后右侧偏
肿，则又确乎非大头而为杂症矣。病家以肿在偏旁，疑为痈毒，更延痈疽家视之，则曰对口偏疽，以托里兼敷
外药治之，则气血益滞，热不得泄，郁遏竟成溃疡。头本一病也，治之迥异，证亦屡迁。可见病随药变之不诬耳。
邪气从下焦泄出，痢疾停止，但余热反而窜入各条络脉并向上溢出。否则，炮姜和五味子的药性，怎么能稍微得到缓解呢？这种鼻衄（鼻出血），也如同伤寒阳明经的热邪，通过“红汗”（指鼻衄）而得以解除。
尤在泾说：《评热病论》记载，劳风病通常发生在肺的下方。它的症状是：头项强直、视物昏暗，咳唾出的痰液像鼻涕一样粘稠，怕风且伴有寒战。如何治疗呢？回答说：应当救治其呼吸俯仰困难的症状。如果肾气充足能引精气上行的人，三天可愈；中年人五天可愈；精气不充的人七天可愈。期间会咳出清稀或黄色的鼻涕，性状如脓，大小如弹丸，从口中或鼻中排出。如果不排出，就会损伤肺脏，肺脏受损则死亡。读到这里可以领悟到伤风不解演变为虚劳病的缘故。“劳风”，是指既劳累又感受风邪。劳累则虚火上炎，风邪又乘虚而入，风火相互搏结，气机汇聚于上部，所以说病位通常在肺下。肺主气而司呼吸，风热侵袭肺脏，津液必然凝结，气机必然壅滞，因此无论是俯身还是仰面都不顺畅，所以说应当救治俯仰困难。所谓救治俯仰困难，就是宣利肺气、疏散邪气的意思。然而，邪气能否消散，取决于正气的盛衰。如果阳气旺盛，精气能够引导，三天后，接着五天，再后来七天，青黄色的鼻涕就会随着咳嗽排出，一旦排出，风热之邪随之而出，肺脏就能保持无恙。假如不能排出，风火就会留积在肺中而损伤肺脏。肺脏受损就会出现气喘、咳嗽、声音嘶哑，逐渐波及五脏，从而形成虚劳病。现在的人治疗虚劳，每天使用滋补滋养的药物，却不见效果，难道不是因为邪气没有排出的缘故吗？那些久留体内的邪气，用补法固然无益，用清热法也不能解除，这就是虚劳病难以治疗的原因。
徐灵胎说：普通人偶尔感受风寒，出现头痛、发热、咳嗽、流涕等症状，俗称伤风。但这并非《伤寒论》中所说的伤风，而是时行杂感之病。人们往往忽视它，不知道这是极难治疗的疾病，关乎生死。大概伤风之疾，由皮毛侵入肺脏。肺为娇脏，既不耐寒也不耐热。过于寒冷则邪气凝滞而不能外出，过于炎热则火热灼伤肺金而动血，过于滋润则生痰饮，过于干燥则耗损精液，过度发散则出汗导致阳虚，过度收敛则气机闭塞而邪气结聚。并且有人将其视为小病，不避风寒，不慎饮食，经年累月，病机日益加深。有的发展成血症，有的发展成肺痿，有的发展成哮喘，有的发展成怯弱体质，比比皆是。误治的危害，数不胜数。谚语说：“伤风不解变成劳。”这是至理名言。那么如何治疗呢？一是驱风，用苏叶、荆芥之类；二是消痰，用半夏、象贝母之类；三是降气，用苏子、前胡之类；四是调和营卫，用桂枝、白芍之类；五是润养津液，用瓜蒌仁、玄参之类；六是养血，用当归、阿胶之类；七是清火，用黄芩、山栀子之类；八是调理肺气，用桑白皮、牛大力子（牛蒡子）之类。这八种方法根据症状的轻重进行加减。再加上避免风寒，戒食辛辣酸味食物，差不多就能逐渐痊愈，否则必定发展成大病。如果再加以升提、辛燥的药物，如桔梗、干姜之类，无效后又加上酸收药物，如五味子之类，就一定会导致出血。既然已经出血，随即使用熟地黄、麦冬来填补肺阴，就会形成虚劳而死。四十年来，我见到的案例数以千计。真是可悲啊。
张路玉治疗姜如农的长儿媳，患有风热咳嗽，无痰，身体灼热且有自汗，怀孕七个月。先前曾服用和解清肺的药物二十多剂，咳嗽反而加剧，胎儿逐渐不安稳。诊察发现，六脉皆濡大无力，右手寸关部特别盛大而涩。张路玉说：这是热邪损伤了肺气。反而用和解药逼迫出汗，导致肺气更加干燥，咳嗽逆冲更加严重。不得已再用苦寒药物折抑火势，则火邪反而郁伏在内而不能散发。于是使用大剂量的葳蕤（玉竹），以及川芎、杏仁、白薇、甘草，取葳蕤汤的一半剂量，另外加入当归、桔梗、五味子、黄耆以益气生津，借此收敛肺气。服用两剂后，汗止咳嗽减轻，胎儿也趋向安稳。再加生诃子皮，一剂后痊愈。
郁金岩，在劳累役使后伤风自汗，胸满痰结，咳出青色或黄色的鼻涕，大小如弹丸。这就是《内经》所说的劳风病位在肺下的情况。给予茯苓桂枝白术甘草汤，加入姜汁、竹沥，两剂后病情安定。又治疗宋襄的女儿，平时多抑郁，干咳，春季感冒风邪，咳嗽逆冲更加严重。用小建中汤，用蜂蜜煎煮生姜，加入蜂蜜煎煮橘皮，外邪即解，但咳嗽不止。接着使用逍遥散，仍然用蜂蜜煎煮姜、橘，再给予异功散，用蜂蜜炮制的白术、姜、橘，病情才安定。
吴佩玉的女儿，伤风咳嗽，自行服用疏风润肺的药物，反而加重了呕吐、口渴、咽痛。诊察发现，六脉浮滑应指。给予半夏散，服用三次后病如消失。有人问：咳嗽咽痛且口渴，世人都禁止使用燥湿药物，为什么使用半夏就有效呢？回答说：治病必须探究根本。此症是风寒邪气挟带痰饮上攻导致的急迫症状，所以用半夏、桂枝来开通经络，迅速扫除痰涎，兼用甘草调和脾胃，以救津液。风痰散去而营卫通畅，那么咽痛、燥渴自然消除。如果使用清润药物，只会滋助痰湿，使经络更加困阻，津液更加凝结，燥渴咽痛将更加没有安宁之时。近代人治疗风寒咳嗽，虽然使用解表药，必定兼用桑白皮、黄芩、天花粉，甚至知母、黄柏之类。年轻人得了这种治法，必定埋下吐血虚损的病根。中年以后得了这种治法，多成为痰火喘咳的祸患。起初元气未衰，邪热暂时潜伏，似乎觉得还可以。久而久之真气逐渐受伤，越服药病情越重。等到出现吐血，就不问属于哪条经络或脏腑，不论属火还是属伤，不论血液散结与否，色泽晦暗还是鲜明，有无瘀血，一概使用犀角地黄汤等寒凉止血截断的药物投喂，导致血液蓄积成为病根。往后或许两个月、一个月发作一次，即使每天服用前面的药物也不见效了。曾经见过一个人患颈部肿胀发热，请伤寒医生诊治，说是大头伤寒，用解表药发汗，结果头部也肿胀，（确实如此。）大头伤寒无疑了。病人家属因为治疗使病情更重，另请内科杂病医生诊治，说是湿热痰火，用攻里药治疗，则头部和颈前左侧都消退了，但颈后右侧偏肿，则又确实不是大头伤寒而是杂病了。病人家属因为肿块在偏旁，怀疑是痈毒，又请外科痈疽医生诊治，说是对口偏疽，用托里兼敷外药治疗，则气血更加停滞，热邪不得宣泄，郁遏竟成溃疡。头部的病本是一样的，治疗方法迥然不同，证候也多次变迁。可见疾病随药物变化这一说法是不虚假的。
The pathogenic factor exits from the lower jiao, the dysentery stops, but the residual heat instead travels to the various collaterals and overflows upward. Otherwise, how could the properties of Paojiang (Processed Zingiberis Rhizoma) and Wuweizi (Schisandrae Fructus) be slightly relieved? This epistaxis (nosebleed) is also similar to the heat pathogen in the Yangming channel of Shanghan (Cold Damage), which resolves through "red sweat" (referring to nosebleed).
You Zaijing said: The *Ping Re Bing Lun* (Treatise on Evaluating Heat Diseases) states that Laofeng (Labor Wind) typically occurs below the lungs. Its symptoms include stiffness and rigidity of the neck, dim vision, expectoration of viscous sputum resembling mucus, aversion to wind, and chills. How should it be treated? It is answered: One must rescue the difficulty in flexion and extension (breathing difficulties). If the kidney essence is sufficient to guide the Jing (essence) upward, recovery occurs in three days; for middle-aged individuals, in five days; for those with deficient essence, in seven days. During this time, clear or yellow nasal discharge is coughed up, resembling pus, shaped like a pellet, exiting from the mouth or nose. If not discharged, the lungs will be injured, and injury to the lungs leads to death. Reading this allows one to understand why unresolved wind-cold can evolve into consumptive disease (Lao). "Laofeng" refers to contracting wind pathogen while already fatigued. Fatigue causes fire to flare upwards, and wind takes advantage of this, causing wind and fire to contend, with Qi gathering in the upper part; thus, it is said that the pathology lies below the lungs. The Lung governs Qi and respiration. When wind-heat invades the Lung, body fluids inevitably congeal, and Qi inevitably becomes obstructed, making both flexion and extension difficult; hence, it is said that one must rescue the difficulty in flexion and extension. Rescuing flexion and extension means benefiting Lung Qi and dispersing pathogenic factors. However, whether pathogenic factors disperse depends on the strength of Zhengqi (Upright Qi). If Yang Qi is vigorous and Jing essence guides effectively, after three days, then five days, and finally seven days, green-yellow nasal discharge will be coughed out. Once discharged, wind and heat exit together, and the Lung remains unharmed. If not discharged, wind and fire remain accumulated in the Lung, injuring it. Lung injury results in wheezing, coughing, and hoarseness, gradually affecting the five Zang organs, thereby forming consumptive disease. Nowadays, people treat consumptive disease by daily use of nourishing tonics, yet see little benefit. Is this not because the pathogenic factors have not been expelled? For pathogens lingering for a long time, tonification is certainly useless, and clearing heat does not resolve them either; this is why consumptive disease is difficult to treat.
Xu Lingtai said: When ordinary people occasionally contract wind-cold, presenting with headache, fever, cough, and runny nose, it is colloquially called Shangfeng (Wind Cold). This is not the Shangfeng described in the *Shanghan Lun* (Treatise on Cold Damage), but rather a miscellaneous contraction during seasonal epidemics. People often ignore it, unaware that this is a very difficult-to-treat disease concerning life and death. Generally, Shangfeng enters the Lung via the skin and hair. The Lung is a delicate organ, unsuitable for both cold and heat. Too much cold causes pathogenic factors to stagnate without exiting; too much heat scorches Metal (Lung) and moves blood; too much moisture generates phlegm-fluids; too much dryness consumes essence and fluids; excessive dispersion causes sweating leading to Yang deficiency; excessive astringency causes Qi closure and pathogenic binding. Moreover, some regard it as a minor ailment, failing to avoid wind and cold or regulate diet, allowing the pathological mechanism to deepen year after year. Some develop hemorrhagic diseases, some develop Feiwei (Lung Atrophy), some develop asthma, some become frail, all of which are common. The harm of misdiagnosis and mistreatment is countless. The proverb says: "Unresolved wind-cold becomes consumption." This is a profound truth. So, how should it be treated? First, expel wind, using herbs like Suye (Perillae Folium) and Jingjie (Schizonepetae Herba); second, eliminate phlegm, using Banxia (Pinelliae Rhizoma) and Xiangbei (Fritillariae Thunbergii Bulbus); third, direct Qi downward, using Suzi (Perillae Fructus) and Qianhu (Peucedani Radix); fourth, harmonize Ying and Wei (Nutritive and Defensive levels), using Guizhi (Cinnamomi Ramulus) and Baishao (Paeoniae Radix Alba); fifth, moisten fluids, using Louren (Trichosanthis Semen) and Yuan Shen (Scrophulariae Radix); sixth, nourish blood, using Danggui (Angelicae Sinensis Radix) and Ejiao (Asini Corii Colla); seventh, clear fire, using Huangqin (Scutellariae Radix) and Shanzhi (Gardeniae Fructus); eighth, regulate Lung Qi, using Sangpi (Mori Cortex) and Niulizi (Arctii Fructus). These eight methods are added or subtracted according to the severity of symptoms. Additionally, avoiding wind and cold, and abstaining from pungent and sour foods, will likely lead to gradual recovery; otherwise, serious illness will surely develop. If one further adds lifting and pungent-drying agents like Jiegeng (Platycodonis Radix) or Ganjiang (Zingiberis Rhizoma), and if ineffective, adds astringents like Wuweizi (Schisandrae Fructus), bleeding will definitely occur. Once bleeding occurs, if Shudi (Rehmanniae Radix Preparata) and Maidong (Ophiopogonis Radix) are immediately used to fill the Lung, consumptive disease will result in death. In forty years, I have seen thousands of such cases. How tragic.
Zhang Luyu treated the eldest daughter-in-law of Jiang Runong, who suffered from wind-heat cough, absence of sputum, burning sensation, spontaneous sweating, and was seven months pregnant. She had previously taken twenty-plus doses of harmonizing and lung-clearing medicines, but her cough worsened, and the fetus became increasingly unstable. Pulse diagnosis revealed all six pulses were soggy, large, and powerless, with the right Cun and Guan positions particularly full and choppy. Zhang said: This is heat injuring Lung Qi. Using harmonizing medicines forced sweating, causing Lung Qi to become even drier and the cough more severe. Reluctantly using bitter-cold medicines to suppress the fire only caused the fire to become depressed and trapped inside without dissipating. Therefore, he prescribed a large dose of Weirui (Polygonati Odorati Rhizoma), along with Chuanxiong (Ligustici Chuanxiong Rhizoma), Xingren (Armeniacae Semen Amarum), Baiwei (Anemarrhenae Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma), taking half of the Weirui Tang (Jade Decoction). He additionally added Danggui (Angelicae Sinensis Radix), Jiegeng (Platycodonis Radix), Wuweizi (Schisandrae Fructus), and Huangqi (Astragali Radix) to benefit Qi and generate fluids, thereby astringing Lung Qi. After two doses, sweating stopped, cough decreased, and the fetus stabilized. Adding raw Hezi Pi (Terminalia Chebulae Pericarpium), she recovered after one dose.
Yu Jinyan contracted wind-cold with spontaneous sweating after laborious work, experiencing chest fullness and phlegm accumulation, coughing up green or yellow nasal discharge shaped like pellets. This corresponds to the Laofeng pathology located below the lungs mentioned in the *Neijing*. He prescribed Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction), adding Ginger Juice and Bamboo Sap. After two doses, the condition stabilized. He also treated Song Xiang's daughter, who was prone to depression, suffered from dry cough, and caught wind in spring, worsening her cough. He used Xiaojianzhong Tang (Minor Construct the Middle Decoction) prepared with honey-fried ginger, adding honey-fried Chenpi (Citri Reticulatae Pericarpium). The external pathogen resolved, but the cough persisted. Next, he used Xiaoyao San (Free Wanderer Powder), still using honey-fried ginger and orange peel, followed by Yigong San (Extraordinary Merit Powder) using honey-processed Baizhu (Atractylodis Macrocephalae Rhizoma), ginger, and orange peel, which brought stability.
Wu Peiyu's daughter suffered from wind-cold cough. Self-medicating with wind-expelling and lung-moistening drugs aggravated vomiting, thirst, and sore throat. Pulse diagnosis showed floating and slippery pulses responding to pressure. He prescribed Banxia San (Pinellia Powder). After three administrations, the illness vanished as if lost. Someone asked: Cough, sore throat, and thirst usually contraindicate drying agents in the world; why did Banxia prove effective? He replied: Treating disease requires seeking the root. This case involved acute pressure from wind-cold pathogen carrying fluid retention attacking upward. Thus, Banxia and Guizhi were used to open meridians and rapidly sweep away phlegm-saliva, combined with Gancao to harmonize the Spleen and Stomach and rescue fluids. Once wind-phlegm dispersed and Ying and Wei circulated freely, sore throat and dry thirst would naturally subside. If cooling and moistening agents were used, they would nourish phlegm-dampness, further obstructing meridians and condensing fluids, making dry throat and thirst even more persistent. Modern practitioners treating wind-cold cough, although using exterior-releasing drugs, invariably combine them with Sangbai (Mori Cortex), Huangqin (Scutellariae Radix), and Huafen (Trichosanthis Radix), or even Zhimu (Anemarrhenae Rhizoma) and Baipi (Phellodendri Cortex). Young people subjected to this treatment inevitably plant the roots of hemoptysis and deficiency damage. Those past middle age often develop phlegm-fire wheezing and coughing. Initially, when Yuanqi (Original Qi) is not yet depleted and pathogenic heat temporarily latent, it may seem manageable. Over time, true Qi is gradually damaged, and the more medicine taken, the worse the condition becomes. When hemoptysis appears, regardless of the meridian or Zang-Fu involved, whether due to fire or injury, whether blood is scattered or clotted, whether complexion is dull or bright, whether stasis exists, physicians indiscriminately administer cool-cold hemostatic agents like Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), causing blood to accumulate and become entrenched. Later, attacks may occur every month or two; despite daily intake of previous medications, there is no response. I once saw a person with neck swelling and fever. A Shanghan specialist diagnosed it as Datou Shanghan (Big Head Cold) and used exterior-releasing drugs, causing head swelling as well (undeniably so). Big Head Cold seemed certain. However, seeing the treatment worsen the condition, the family consulted a miscellaneous disease specialist, who diagnosed damp-heat and phlegm-fire, using interior-purging drugs. The head and anterior left neck subsided, but posterior right neck remained swollen, proving it was not Big Head Cold but a miscellaneous disease. Suspecting an abscess due to the lateral swelling, the family consulted a surgeon, who diagnosed a lateral Duikou Carbuncle, treating it with internal fortification and external applications. This caused further Qi and Blood stagnation, preventing heat release, leading to郁遏 (depression/obstruction) and eventually ulceration. The head ailment was originally the same, but treatments varied drastically, and symptoms shifted repeatedly. This confirms that diseases change according to the drugs administered.