论
《内经》曰∶诸涩枯涸干劲皴揭，皆属于燥。原病式曰∶经云风、热、火同阳也，寒、燥、湿同阴也，又燥、湿少
异也。然燥金虽属秋阴，而异乎寒湿，故反同其风热也。故火热胜，则金衰而风生，缘风能胜湿，热能耗液而反寒，阳
实阴虚，则风热胜于水湿而为燥也。凡人风病多因热甚，而风燥者为其兼化，以热为其主也。盖肝主于筋，而风气自甚，
又燥热加之，则筋大燥也。燥金主于收敛，其脉紧涩，故为病劲强紧急而口噤也。或病燥热太甚而脾胃干涸成消渴者，
或风热燥甚怫郁在表而里气平者，或善伸数欠筋脉拘急，或时恶寒筋惕而搐，又或风热燥并而郁甚于里，故烦满而或秘
结也。及风痫之发作者，由热甚而风燥为其兼化，涎溢胸膈，燥烁而螈 昏冒僵仆也。凡此诸证，皆由热甚而生风燥，
病各有异者，由风热燥各微甚不等故也。所谓中风筋缓者，因其风热胜湿而为燥之甚也。然筋缓不收而痿痹，故诸 郁
病痿皆属于肺金，乃燥之化也。如秋深燥甚，则草木萎落而不收，病之象也。是以掌得血而能握，足得
血而能步。夫燥之为病者，血液衰少，不能荣养百骸，故若是也，学人不可不知。
脉法
脉紧而涩，或浮而弦，或芤而虚。
方法
丹溪曰∶皮肤皴揭拆裂，血出大痛，或肌肤燥痒，皆火烁肺金，燥之甚也，宜以四物汤去川芎，加麦门冬、人参、
天花粉、黄柏、五味子之类治之。
（以上丹溪方法凡一条）
（以下皆 仙方）
琼脂膏 治血虚、皮肤枯燥及消渴等证。
鹿角胶（一斤） 生地黄（二十斤，洗净细捣，取真汁去渣） 白沙蜜（二斤，煎一、二沸，掠去上沫净而止） 真
酥油（一斤） 生姜（二两，捣取真汁）
上先以文武火熬地黄汁数沸，以绢滤取净汁，又煎二十沸，下鹿角胶，次下酥油及蜜同煎，良久候稠如饧，以瓷器
收贮，每服一、二匙，空心温酒调下。
琼玉膏 治证同前，及肺热咳嗽甚者。（方见咳嗽门。）
天门冬膏 治血虚肺燥，皮肤折裂，及肺痿咳脓血证。
天门冬（新掘者不拘多少）
上一味，净洗，去皮心，细捣，绞取汁，澄清，以布滤去渣滓，用银锅或沙锅，慢火熬成膏，每用一、二匙，空心
温酒调服。
地仙煎 治诸燥证。
山药（杵细，一斤） 杏仁（去皮尖，一升） 生牛乳汁（二斤）
上件将杏仁研细，入牛乳、山药拌匀，绞取汁，用新瓷瓶密封，重汤煮一日，每服一、二匙，空心温酒或汤调下。
和血益气汤（东垣） 治口燥舌干便数，舌上赤脉。此药生津液，除干燥，生肌肉。（方见消渴门。）
当归润燥汤（东垣） 治消渴，大便秘涩干燥结硬，兼喜温饮，阴头退缩，舌燥口干，眼涩难开等证。（方见消
渴门。）
生津甘露汤（一名清凉饮子。东垣） 治消中，能食而瘦，口舌干燥，自汗，大便结燥，小便频数。（方见消渴
门。）
生津甘露饮子（东垣） 治消渴，诸燥证。（方见消渴门。）
辛润缓肌汤（东垣） 治诸燥肌渴，及皮肤燥涩等证。（方见消渴门。）
润燥汤（东垣） 治大便燥结，肠胃枯涸等证。
润肠丸（东垣） 治大便干燥，闭结不通。润燥和血。
活血润燥丸（东垣） 治大便风秘、血秘，常常燥结。
润肠汤（东垣） 治大便结燥不通。（以上四方，并见大便结燥门。）
通幽汤 治大便结燥，治在幽门，以辛润之。
甘草（炙） 红花（各一分） 生地黄 熟地黄（各一钱） 升麻 桃仁泥 当归身（各一钱）
上锉，水煎，调槟榔末五分，稍热服之。
（医案）
予仲兄怀德处士，年四十五，平生体瘦弱血少，值庚子年岁金太过，至秋深燥金用事，久晴不雨，得燥证，皮肤折
裂，手足枯燥，搔之屑起血出痛楚，十指甲浓，反而莫能搔痒。予制一方，名生血润肤饮，服数十帖，其病如脱，后治
十数人皆验。
（祖传方）
生血润肤饮
川归身（酒洗） 生地黄 熟地黄（酒洗） 黄 （蜜炙，各一钱） 天门冬（一钱五分） 麦门冬（去心，一钱）
五味子（九粒） 片芩（去朽，酒洗，五分） 栝蒌仁（五分） 桃仁泥（五分） 酒红花（一分） 升麻（二分）
上细切，作一服，水二盏，煎至一盏，温服。如大便结燥，加麻仁、郁李仁各一钱。
论
《黄帝内经》说：凡是出现涩滞、干枯、涸竭、干硬、皮肤皱缩揭起等症状，都属于燥邪致病。刘完素在《原病式》中说：经典记载风、热、火同属阳，寒、燥、湿同属阴，而燥与湿仅有细微差别。然而，燥金虽然属于秋季的阴气，却不同于寒湿，反而与风热相似。因此，当火热偏胜时，会导致金气衰弱而生风，因为风能胜湿，热能耗伤津液而导致类似寒象（此处指津亏之象），阳气实而阴气虚，风热胜于水湿从而形成燥证。大凡风病多因热盛所致，而风燥是热盛的兼化表现，以热为主因。肝主筋，若风气极盛，再加上燥热侵袭，就会导致筋脉极度干燥。燥金主收敛，其脉象紧涩，所以发病时表现为筋脉劲强紧急、口噤不开。或者因燥热太甚，导致脾胃干涸而成消渴病；或者因风热燥邪郁结在体表而体内气机平和；或者表现为喜欢伸展、频繁打哈欠、筋脉拘急；或者时而恶寒、肌肉跳动抽搐；又或者风热燥邪并至且郁结于体内深处，导致烦闷胀满或大便秘结。以及风痫发作时，也是由热盛而生风燥作为兼化，导致涎液溢出胸膈，燥热灼烁身体而出现抽搐、昏迷、僵仆倒地等症状。以上这些证候，都是由热盛而生风燥引起的，病症各有不同，是因为风、热、燥三者偏盛程度不等所致。所谓中风导致的筋脉弛缓，是因为风热胜湿转化为极度的燥邪所致。然而筋脉弛缓不收导致痿痹，所以各种郁病和痿证都归属于肺金，这是燥邪转化的结果。就像深秋时节燥气极盛，草木枯萎凋落而无法收敛，这是疾病的征象。因此手掌得到血液濡养才能握持，脚得到血液濡养才能行走。燥邪致病，是由于血液衰少，不能荣养全身骨骼肢体，所以才出现上述情况，学习中医的人不可不知道。
脉法
脉象紧而涩，或者浮而弦，或者芤而虚。
方法
朱丹溪说：皮肤皱缩裂开出血剧痛，或者肌肤干燥瘙痒，都是火邪灼伤肺金，燥邪严重的表现，适宜用四物汤去掉川芎，加入麦门冬、人参、天花粉、黄柏、五味子等药物治疗。
（以上是丹溪的方法共一条）
（以下皆为祖传方剂）
琼脂膏 治疗血虚、皮肤枯燥以及消渴等证候。
鹿角胶（一斤） 生地黄（二十斤，洗净细捣，取真汁去渣） 白沙蜜（二斤，煎煮一两次沸腾，撇去上面泡沫干净为止） 真酥油（一斤） 生姜（二两，捣取真汁）
以上药物先用文火武火交替熬煮地黄汁数沸，用绢布过滤取得净汁，再煎煮二十沸，加入鹿角胶，接着加入酥油和蜂蜜一同煎煮，许久后等待药液浓稠如饴糖状，用瓷器收贮，每次服用一至二匙，空腹用温酒调服。
琼玉膏 治疗证候同上，以及肺热咳嗽严重者。（方剂见咳嗽门。）
天门冬膏 治疗血虚肺燥，皮肤折裂，以及肺痿咳脓血证候。
天门冬（新挖掘的不限多少）
以上一味药，洗净，去皮去心，细捣，绞取汁液，澄清，用布过滤去除渣滓，用银锅或沙锅，慢火熬成膏状，每次用一至二匙，空腹用温酒调服。
地仙煎 治疗各种燥证。
山药（杵碎成细末，一斤） 杏仁（去皮尖，一升） 生牛乳汁（二斤）
以上药材将杏仁研细，加入牛乳、山药拌匀，绞取汁液，用新瓷瓶密封，隔水蒸煮一天，每次服用一至二匙，空腹用温酒或温水调服。
和血益气汤（李东垣） 治疗口燥舌干、大便频数、舌上有赤色脉络。此药能生津液，消除干燥，生长肌肉。（方剂见消渴门。）
当归润燥汤（李东垣） 治疗消渴，大便秘涩干燥结硬，兼有喜喝温水，阴头退缩，舌燥口干，眼涩难开等证候。（方剂见消渴门。）
生津甘露汤（一名清凉饮子。李东垣） 治疗消中，能吃但消瘦，口舌干燥，自汗，大便结燥，小便频数。（方剂见消渴门。）
生津甘露饮子（李东垣） 治疗消渴，各种燥证。（方剂见消渴门。）
辛润缓肌汤（李东垣） 治疗各种燥肌渴，以及皮肤燥涩等证候。（方剂见消渴门。）
润肠丸（李东垣） 治疗大便干燥，闭结不通。具有润燥和血功效。
润肠汤（李东垣） 治疗大便结燥不通。（以上四方，均见大便结燥门。）
通幽汤 治疗大便结燥，治疗部位在幽门，采用辛润之法。
甘草（炙） 红花（各一分） 生地黄 熟地黄（各一钱） 升麻 桃仁泥 当归身（各一钱）
以上切碎，水煎，调入槟榔末五分，稍热时服用。
（医案）
我的二哥怀德处士，年龄四十五岁，平生体质瘦弱血少，正值庚子年岁金太过，到了深秋燥金当令，久晴不雨，得了燥证，皮肤折裂，手足枯燥，搔抓后皮屑起落出血疼痛，十指甲增厚，反而无法搔痒。我配制一方，名为生血润肤饮，服用几十帖后，病情痊愈，后来治疗十几人都有效验。
（祖传方）
生血润肤饮
川归身（酒洗） 生地黄 熟地黄（酒洗） 黄芪（蜜炙，各一钱） 天门冬（一钱五分） 麦门冬（去心，一钱）
五味子（九粒） 片芩（去朽，酒洗，五分） 栝蒌仁（五分） 桃仁泥（五分） 酒红花（一分） 升麻（二分）
以上细切，作一服药量，用水二盏，煎至一盏，温服。如果大便结燥，加麻仁、郁李仁各一钱。
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "All cases of stagnation, dryness, withering, dehydration, rigidity, and skin cracking/shedding belong to Dryness." Liu Wansu in the *Yuanbing Shi* (Treatise on Original Causes of Diseases) says: "The classics state that Wind, Heat, and Fire are all Yang; Cold, Dryness, and Dampness are all Yin. However, Dryness differs slightly from Dampness. Although Dryness Metal belongs to Autumn Yin, it is distinct from Cold-Dampness and thus resembles Wind-Heat. Therefore, when Fire-Heat prevails, Metal Qi declines and Wind arises, because Wind can overcome Dampness, and Heat consumes fluids leading to a condition resembling Cold (due to fluid depletion). When Yang is Excess and Yin is Deficient, Wind-Heat overcomes Water-Dampness, resulting in Dryness. Generally, Wind diseases often arise from excessive Heat, and Wind-Dryness is a secondary transformation of Heat, with Heat as the primary cause. The Liver governs the sinews; if Wind Qi becomes extreme and is compounded by Dryness-Heat, the sinews become severely dry. Dryness Metal governs contraction, and its pulse is tight and choppy; therefore, disease manifests as sinew rigidity, tension, and lockjaw. Alternatively, severe Dryness-Heat may cause the Spleen and Stomach to become dehydrated, resulting in Xiao Ke (Wasting-Thirst Syndrome); or Wind-Heat-Dryness may be constrained at the exterior while interior Qi remains peaceful; or one may experience frequent stretching and yawning, sinew cramping; or occasional aversion to cold, muscle twitching, and convulsions; or Wind-Heat-Dryness may combine and constrain deeply within the interior, causing irritability, fullness, or constipation. In the onset of Feng Xian (Wind Epilepsy), it is also due to Heat generating Wind-Dryness as a secondary transformation, causing saliva to overflow in the chest and diaphragm, with Dryness-Heat scorching the body, leading to spasms, coma, stiffness, and collapse. All these syndromes arise from Heat generating Wind-Dryness; the variations in symptoms are due to the unequal degrees of Wind, Heat, and Dryness. The so-called 'sinew flaccidity' in Zhong Feng (Wind Stroke) occurs because Wind-Heat overcoming Dampness transforms into extreme Dryness. However, since sinew flaccidity leads to Wei Bi (Flaccidity and Obstruction), various Yu Bing (Constraint Diseases) and Wei Zheng (Flaccidity Syndromes) are attributed to Lung Metal, which is the transformation of Dryness. Just as in late autumn when Dryness is severe, plants wither and fall without retaining leaves, this is the image of disease. Thus, the palm can grasp only when nourished by Blood, and the foot can walk only when nourished by Blood. Disease caused by Dryness results from the deficiency of Blood, which fails to nourish the hundred bones and limbs; hence such manifestations occur. Students of medicine must not ignore this."
Pulse Diagnosis
The pulse may be tight and choppy, or floating and wiry, or hollow and deficient.
Methods
Zhu Danxi said: "Skin wrinkling, cracking, bleeding with severe pain, or dry and itchy skin, are all signs of Fire scorching Lung Metal and severe Dryness. It is appropriate to treat with Si Wu Tang (Four Substances Decoction) removing Chuanxiong Rhizoma (Chuanxiong), and adding Ophiopogonis Radix (Maidong), Ginseng Radix et Rhizoma (Renshen), Trichosanthis Radix (Tianguafen), Phellodendri Cortex (Huangbai), and Schisandrae Fructus (Wuweizi)."
(Above is Zhu Danxi's method, one entry total)
(Below are all ancestral prescriptions)
Qiong Zhi Gao (Jade Fat Paste) Treats Blood Deficiency, dry and rough skin, and Xiao Ke (Wasting-Thirst Syndrome).
Deer Antler Glue (Lu Jiao Jiao) (1 jin) Raw Rehmanniae Radix (Sheng Dihuang) (20 jin, washed, finely pounded, true juice extracted, dregs removed) White Sand Honey (Bai Sha Mi) (2 jin, boiled until bubbling once or twice, upper foam skimmed off until clean) True Butter Oil (Zhen Su You) (1 jin) Fresh Ginger (Sheng Jiang) (2 liang, pounded to extract true juice)
First, boil the Raw Rehmanniae juice over alternating mild and strong heat for several boils, filter through silk cloth to obtain clear juice, then boil for twenty more boils. Add Deer Antler Glue, then add butter oil and honey, boiling together for a long time until thick like malt syrup. Store in porcelain vessels. Take 1-2 spoons per dose, mixed with warm wine on an empty stomach.
Qiong Yu Gao (Jade Jade Paste) Treats the same syndromes as above, and severe cough due to Lung Heat. (Formula see Cough Section.)
Tian Men Dong Gao (Asparagus Fern Paste) Treats Blood Deficiency and Lung Dryness, skin cracking, and Fei Wei (Lung Flaccidity) with coughing of pus and blood.
Asparagus Fern Root (Tian Men Dong) (Freshly dug, amount不拘)
Cleanse the single herb, peel, remove heart, pound finely, squeeze to extract juice, clarify, filter dregs with cloth. Use a silver or clay pot, simmer slowly over low heat until paste forms. Take 1-2 spoons per dose, mixed with warm wine on an empty stomach.
Di Xian Jian (Immortal Earth Decoction) Treats various Dryness syndromes.
Chinese Yam (Shan Yao) (pounded fine, 1 jin) Apricot Kernel (Xing Ren) (peeled and tip removed, 1 sheng) Raw Cow Milk (Sheng Niu Nai Zhi) (2 jin)
Grind the Apricot Kernels finely, mix with cow milk and Chinese Yam, squeeze to extract juice. Seal in a new porcelain bottle, steam over water for one day. Take 1-2 spoons per dose, mixed with warm wine or water on an empty stomach.
He Xue Yi Qi Tang (Harmonize Blood and Boost Qi Decoction) (Li Dongyuan) Treats dry mouth and tongue, frequent defecation, red veins on the tongue. This medicine generates fluids, eliminates dryness, and promotes flesh growth. (Formula see Xiao Ke Section.)
Dang Gui Run Zao Tang (Angelica Moisten Dryness Decoction) (Li Dongyuan) Treats Xiao Ke (Wasting-Thirst Syndrome), hard and dry constipation, preference for warm drinks, retraction of the penis, dry tongue and mouth, dry eyes difficult to open. (Formula see Xiao Ke Section.)
Sheng Jin Gan Lu Tang (Generating Fluids Sweet Dew Decoction) (Also known as Qing Liang Yin Zi. Li Dongyuan) Treats Xiao Zhong (Consuming Middle), ability to eat but emaciation, dry mouth and tongue, spontaneous sweating, dry constipation, frequent urination. (Formula see Xiao Ke Section.)
Sheng Jin Gan Lu Yin Zi (Generating Fluids Sweet Dew Drink) (Li Dongyuan) Treats Xiao Ke (Wasting-Thirst Syndrome), various Dryness syndromes. (Formula see Xiao Ke Section.)
Xin Run Huan Ji Tang (Acid-Moisten Muscle Relaxing Decoction) (Li Dongyuan) Treats various dry skin thirst, and dry/rough skin syndromes. (Formula see Xiao Ke Section.)
Run Zao Tang (Moisten Dryness Decoction) (Li Dongyuan) Treats dry constipation, withered intestines and stomach.
Run Chang Wan (Moisten Intestine Pill) (Li Dongyuan) Treats dry stool, obstruction and inability to pass. Moistens dryness and harmonizes blood.
Huo Xue Run Zao Wan (Invigorate Blood Moisten Dryness Pill) (Li Dongyuan) Treats Wind Constipation and Blood Constipation, frequent dry hard stools.
Run Chang Tang (Moisten Intestine Decoction) (Li Dongyuan) Treats dry hard stool obstruction. (The above four formulas are all found in the Dry Hard Stool Section.)
Tong You Tang (Unblock the Hidden Decoction) Treats dry hard stool, targeting the幽门 (Hiemen/Pylorus), using Acrid-Moistening method.
Licorice Root (Gan Cao) (roasted) Safflower Flower (Hong Hua) (each 1 fen) Raw Rehmanniae Radix (Sheng Di Huang) Prepared Rehmanniae Radix (Shu Di Huang) (each 1 qian) Cimicifugae Rhizoma (Sheng Ma) Peach Kernel Paste (Tao Ren Ni) Angelica Sinensis Radix (Dang Gui Shen) (each 1 qian)
Cut into pieces, decoct in water, mix with 5 fen of Areca Seed Powder (Bing Lang), take while slightly warm.
(Medical Case)
My second brother, Huai De, a scholar-official, was forty-five years old. He had always been thin, weak, and deficient in Blood. In the year Gengzi, the Metal Qi of the year was excessive. By late autumn, Dryness Metal was in command. After a long period of sunny weather without rain, he contracted a Dryness syndrome: skin cracking, dry and rough hands and feet, scratching produced flakes and bleeding with pain, fingernails became thick, and he could no longer scratch the itch. I formulated a prescription named Sheng Xue Run Fu Yin (Generate Blood Moisten Skin Decoction). After taking dozens of doses, his illness vanished like shedding skin. Later, I treated over ten people with the same result.
(Ancestral Prescription)
Sheng Xue Run Fu Yin (Generate Blood Moisten Skin Decoction)
Angelica Sinensis Radix (Chuan Gui Shen) (wine-washed) Raw Rehmanniae Radix (Sheng Di Huang) Prepared Rehmanniae Radix (Shu Di Huang) (wine-washed) Astragalus Membranaceus Root (Huang Qi) (honey-roasted, each 1 qian) Asparagus Fern Root (Tian Men Dong) (1.5 qian) Ophiopogonis Radix (Mai Men Dong) (heart removed, 1 qian)
Schisandrae Fructus (Wu Wei Zi) (9 grains) Scutellaria Baikalensis Root (Kuan Huang Qin) (remove rotten parts, wine-washed, 5 fen) Trichosanthis Semen (Gua Lou Ren) (5 fen) Peach Kernel Paste (Tao Ren Ni) (5 fen) Safflower Flower (Hong Hua) (wine-treated, 1 fen) Cimicifugae Rhizoma (Sheng Ma) (2 fen)
Finely cut, prepare as one dose. Add two cups of water, decoct until one cup remains. Take warm. If there is dry hard stool, add Hemp Seed (Ma Ren) and Brume Plum Seed (Yu Li Ren), each 1 qian.