（论一首 法十一条 律五条）
喻昌曰∶燥之与湿，有霄壤之殊。燥者，天之气也；湿者，地之气也。水流湿，火就燥，各从其类，此胜彼负，两
不相谋。春月地气动而湿胜，斯草木畅茂。秋月天气肃而燥胜，斯草木黄落。故春分以后之湿，秋分以后之燥，各司其
政。今指秋月之燥为湿，是必指夏月之热为寒然后可，奈何《内经》病机一十九条，独遗燥气。他凡秋伤于燥，皆谓秋
伤于湿，历代诸贤，随文作解，弗察其讹。昌特正之，大意谓春伤于风，夏伤于暑，长夏伤于湿，秋伤于燥，冬伤于寒。
觉六气配四时之旨，与五运不相背戾，而千古之大疑始一决也。然则秋燥可无论乎？夫秋不遽燥也，大热之后，继以凉
生，凉生而热解，渐至大凉，而燥令乃行焉。《经》谓阳明所至，始为燥终为凉者，亦误文也。岂有新秋月华露湛，星
润
渊澄，天香遍野，万宝垂实，归之燥政？迨至山空月小，水落石出，天降繁霜，地凝白卤，一往坚急劲切之化，反谓凉
生，不谓燥乎？或者疑燥从火化，故先燥而后凉，此非理也。深乎！深乎！《上古脉要》曰∶春不沉，夏不弦，秋不数，
冬不涩，是谓四塞。谓脉之从四时者，不循序渐进，则四塞而不退也。所以春夏秋冬孟月之脉，仍循冬春夏秋季月之常，
不改其度。俟二分二至以后，始转而从本令之王气，乃为平人顺脉也。故天道春不分不温，夏不至不热，自然之运，悠
久无疆。使在人之脉，方春即以弦应，方夏即以数应，躁促所加，不三时而岁度终矣。其能长世乎？即是推之，秋月之
所以忌数脉者，以其新秋为燥所胜，故忌之也。若不病之人，新秋而脉带微数，乃天真之脉，何反忌之耶？且夫始为燥，
终为凉，凉已即当寒矣。何至十月而反温耶？凉已反温，失时之序，天道不几顿乎。不知十月之温，不从凉转，正从燥
生，盖金位之下，火气承之，以故初冬常温，其脉之应，仍从乎金之涩耳。由涩而沉，其涩也，为生水之金；其沉也，
即为水中之金矣。珠辉玉映，伤燥云乎哉？然新秋之凉，方以却暑也，而夏月所受暑邪，即从凉发。《经》云∶当暑汗不
出者，秋成风疟。举一疟，而凡当风取凉，以水灌汗，乃至不复汗而伤其内者，病发皆当如疟之例治之矣。其内伤生冷
成滞下者，并可从疟而比例矣。以其原来皆暑湿之邪，外内所主虽不同，同从秋风发之耳。若夫深秋燥金主病，则大异
焉。经曰∶燥胜则干。夫干之为害，非遽赤地千里也。有干于外而皮肤皱揭者；有干于内而精血枯涸者；有干于津液而
荣卫气衰，肉烁而皮着于骨者。随其大经小络，所属上下中外前后，各为病所，燥之所胜；亦云 矣。至所伤则更厉，
燥金所伤，本摧肝木，甚则自戕肺金。盖肺金主气，而治节行焉，此惟土生之金，坚刚不挠，故能生杀自由，纪纲不紊。
若病起于秋而伤其燥，金受火刑，化刚为柔，方圆且随型埴，欲仍清肃之旧，其可得耶？《经》谓咳不止而出白血者死，
白血谓色浅红，而似肉似肺者，非肺金自削。何以有此？试观草木菁英可掬，一乘金气，忽焉改容，焦其上首，而燥
气先伤上焦华盖，岂不明耶。详此则病机之诸气 郁，皆属于肺；诸痿喘呕，皆属于上。二条明指燥病言矣。生气通天
论谓秋伤于燥，上逆而咳，发为痿厥。燥病之要，一言而终。与病机二条适相吻合。只以误传伤燥为伤湿，解者竞指燥
病为湿病，遂至经旨不明。今一论之，而燥病之机，了无余义矣。其左 胁痛，不能转侧，嗌干面尘，身无膏泽，足外
反热，腰痛惊骇筋挛，丈夫 疝，妇人少腹痛，目昧皆疮，则燥病之本于肝，而散见不一者也。《内经》燥淫所胜，其主
治必以苦温者，用火之气味而制其胜也。其佐以或酸或辛者，临病制宜，宜补则佐酸，宜泻则佐辛也。其下之亦以苦温
者，如清甚生寒，留而不去，则不当用寒下，宜以苦温下之。即气有余，亦但以辛泻之，不以寒也。要知金性畏热，燥
复畏寒，有宜用平寒而佐以苦甘者，必以冷热和平为方，制乃尽善也。又六气凡见下承之气，方制即宜少变。如金位之
下，火气承之，则苦温之属宜减，恐其以火济火也。即用下，亦当变苦温而从寒下也。此《内经》治燥淫之旨，可赞一
辞者也。至于肺气 郁，痿喘呕咳，皆伤燥之剧病，又非制胜一法所能理也。兹并入燥门，细商良治，学人精心求之，
罔不获矣。若但以润治燥，不求病情，不适病所，犹未免涉于粗疏耳。
《痹论》云∶阴气者，静则神藏，躁则消亡。下文但言饮食自倍，肠胃乃伤，曾不及于肺也。其所以致燥而令阴气
消亡之故，引而未发也。至《灵枢》云∶形寒饮冷则伤肺，始知伤肺关于寒冷矣。可见肺气外达皮毛，内行水道，形寒
则外寒从皮毛内入，饮冷则水冷从肺中上溢，遏抑肺气，不令外扬下达。其治节不行，周身之气，无所禀仰，而肺病矣。
究竟肺为娇脏，寒冷所伤者，十之二三。火热所伤者，十之七八。寒冷所伤，不过裹束其外。火热所伤，则更消烁
其中，所以为害倍烈也。然火热伤肺，以致诸气 郁，诸痿喘呕而成燥病，百道方中，率皆依样葫芦。如乌药、香附、
紫苏、半夏、茯苓、浓朴、丁、沉、诃、蔻、姜、桂、蓬、棱、槟榔、益智之属，方方取足。只因《内经》脱遗燥证，
后之无识者，竞皆以燥治燥，恬于操刃，曾罔顾阴气之消亡耳。
虽以东垣之大贤，其治燥诸方，但养荣血，及补肝肾亏损，二便闭结而已，初不论及于肺也。是非谓中下二焦有燥
病，而上焦独无也。不过阙经旨伤湿之疑，遂因仍不察耳。夫诸气 郁之属于肺者，属于肺之燥，非属于肺之湿也。苟
肺气不燥，则诸气禀清肃之令，而周身四达，亦胡致 郁耶。诸痿喘呕之属于上者，上亦指肺，不指心也。若统上焦心
肺并言，则心病不主痿喘及呕也，惟肺燥甚，则肺叶痿而不用，肺气逆而喘鸣，食难过膈而呕出，三者皆燥证之极者也。
经文原有逆秋气，则太阴不收，肺气焦满之文，其可称为湿病乎。更考东垣治肺消方中，引用白豆蔻、荜澄茄，及治诸
气方中，杂用辛香行气之药，觉于伤燥一途，有未悉耳。又如丹溪折衷杂证，为后代所宗，亦无一方一论及于肺燥。但
于热郁汤下云∶有阴虚而得之者；有胃虚食冷物，抑遏阳气于脾土中而得之者；其治法皆见发热条中，此治非阴虚非阳
陷，亦不发热，而常自蒸蒸不解者。夫蒸蒸不解，非肺气为热所内蒸，而不能外达耶。方用连翘、薄荷叶、黄芩、山栀
仁、麦门冬、甘草、郁金、栝蒌皮穣八味，竹叶为引。方后复设为问答云∶何不用苍术、香附、抚芎？曰∶火就燥，燥
药皆能助火，故不用也。似此一方，示不欲以燥助火之意，于热郁之条，其不敢以燥益燥，重伤肺金，隐然可会。何为
不立燥病一门，畅发其义耶？又如缪仲醇治病，所用者，无非四君、四物、二冬、二母、沙参、玄参、黄 、山药、苏
子、橘红、桑叶、枇杷叶、杏仁、枣仁、扁豆、莲心、栝蒌、五味、升、葛、柴、前、芩、莲、栀、柏、滑石、石膏、
菊花、枸杞、牛膝、续断、薏苡、木瓜、胡麻、首乌、豆豉、霜梅、胶饴之属，千方一律，不过选择于此。增入对证一
二味，自成一家。识者称其不尽用方书所载，投之辄效，盖独开门户者也。又有称其精于本草，择用五六十种无过之药，
屡获奇验，无以多为者。昌谓不然，世之患燥病者多，仲醇喜用润剂，于治燥似乎独开门户，然亦聪明偶合，未有发明，
可以治内伤之燥，不可以治外感之燥。何况风寒暑湿哉，节取其长可矣！
《内经》云∶心移热于肺，传为膈消，肺燥之繇来者远矣。苟其人肾水足以上升而交于心，则心火下降而交于肾，
不传于肺矣。心火不传于肺，曾何伤燥之虞哉？即肾水或见不足，其肠胃津血足以协济上供，肺亦不致过伤也。若夫中
下之泽尽竭，而高源之水，犹得措于不倾，则必无之事矣。所以经文又云∶二阳结，谓之消。手阳明大肠，热结而津不
润。足阳明胃，热结而血不荣，证成消渴。舌上赤裂，大渴引饮，与心移热于肺，传为膈消，文虽异而义则一也。治膈
消者，用白虎加人参汤颛救其肺，以施于诸气 郁，诸痿喘呕，罔不合矣。学人可不知引伸触类，以求坐进此道耶。
《阴阳别论》云∶二阳之病发心脾，有不得隐曲，男子少精，女子不月，其传为风消，其传为息贲，死不治。此亦
肺燥所繇来，而未经揭出者，夫燥而令男子精液衰少，女子津血枯闭，亦云极矣。然其始，但不利于隐曲之事耳。其
继则胃之燥传入于脾而为风消，风消者，风热炽而肌肉消削也。大肠之燥，传入于肺而为息贲，息贲者，息有音而上奔
不下也。是则胃肠合心脾以共成肺金之燥，三藏二府，阴气消亡殆尽，尚可救疗者乎？夫由心之肺，已为死阴之属。然
脾气散二阳之精，上输于肺，犹得少苏涸鲋。今以燥之为害，令生我者尽转而浚我之生，故直断为死不治也。从前愦愦，
特绎明之。
病机十九条内云∶诸涩枯涸，干劲皴揭，皆属于燥。燥金虽为秋令，虽属阴经，然异于寒湿，同于火热。火热胜则
金衰，火热胜则风炽，风能胜湿，热能耗液，转令阳实阴虚，故风火热之气，胜于水土而为燥也。
肝主于筋，风气自甚；燥热加之，则液聚于胸膈，不荣于筋脉而筋燥。故劲强紧急而口噤，或螈 昏冒僵仆也。
风热燥甚，怫郁在表而里气平者，善伸数欠，筋脉拘急，或时恶寒，或筋惕而搐，脉浮数而弦。若风热燥并郁甚于
里，则必为烦满，必为闷结，故燥有表里气血之分也。
至于筋缓不收，痿痹不仁，因其风热胜湿，为燥日久，乃燥病之甚者也。至于诸气 郁，诸痿喘呕，皆属于肺。金
从燥化，金且自病，而肺气日见消亡，又何论痿痹乎？
五脏五志之火，皆有真液以养之，故凝聚不动，而真液尤赖肾之阴精，胃之津液，交灌于不竭。若肾胃之水不继，
则五脏之真阴随耗，五志之火，翕然内动，而下上中三消之病作矣。河间云∶燥太甚而脾胃干涸，则成消渴，亦其一也。
燥病必渴，而渴之所属各不同，有心肺气厥而渴；有肝痹而渴；有脾热而渴；有肾热而渴；有胃与大肠结热而渴；
有小肠痹热而渴；有因病疟而渴；有原素食肥甘而渴；有因醉饮入房而渴；有因远行劳倦，遇大热而渴；有因伤害胃，
干而渴；有因风而渴。五脏部分不同，病之所遇各异，其为燥热亡液则一也。另详消渴门。
治燥病者，补肾水阴寒之虚，而泻心火阳热之实；除肠中燥热之甚，济胃中津液之衰；使道路散而不结，津液生而
不枯，气血利而不涩，则病日已矣。
肾恶燥，急食辛以润之。故肾主五液，津则大便如常。若饥饱劳逸，损伤胃气，及食辛热味浓之物，而助火邪，伏
于血中，耗散真阴，津液亏少，故大便结燥。仲景云∶小便利，大便硬，不可攻下，以脾约丸润之。戒轻下而重伤津
液也。然藏结复有阳结阴结之不同，阳结者以辛凉润之，阴结者以辛温润之，其辨又在微芒之间矣。
【律五条】
凡秋月燥病，误以为湿治者，操刃之事也。从前未明，咎犹可诿。今明知故犯，伤人必多，孽镜当前，悔之无及。
凡治燥病，燥在气而治血，燥在血而治气，燥在表而治里，燥在里而治表，药不适病，医之过也。
凡治杂病，有兼带燥证者，误用燥药，转成其燥，因致危困者，医之罪也。
凡治燥病，须分肝肺二藏见证。肝藏见证，治其肺燥可也。若肺藏见证，反治其肝，则坐误矣！医之罪也。肝藏见
燥证，固当急救肝叶，勿令焦损。然清其肺金，除其燥本，尤为先务。若肺金自病，不及于肝，即颛力救肺。焦枯且恐
立至，尚可分功缓图乎？
凡治燥病，不深达治燥之旨，但用润剂润燥，虽不重伤，亦误时日，只名粗工，所当戒也。
（论一首 法十一条 律五条）
喻昌说：燥与湿，有着天壤之别。燥，是天的气；湿，是地的气。水向湿处流，火向燥处燃，各自顺应其类，此胜彼负，互不干涉。春季大地之气发动而湿气胜，所以草木茂盛。秋季天气肃杀而燥气胜，所以草木枯黄凋落。因此，春分以后的湿气，秋分以后的燥气，各自掌管其时令。如今将秋季的燥认定为湿，那必定也要把夏季的热认定为寒才可以，为什么《黄帝内经》病机十九条中，唯独遗漏了燥气？其他凡是提到“秋伤于燥”的，都说是“秋伤于湿”，历代各位贤人，顺着文字进行解释，没有察觉其中的错误。我特意纠正这一点，大意是说：春伤于风，夏伤于暑，长夏伤于湿，秋伤于燥，冬伤于寒。这样六气配合四时的宗旨，与五运不相违背，千古的大疑团这才得以解决。那么，秋燥可以不论吗？秋天不会突然就干燥，大热之后，接着产生凉意，凉意产生而热气消散，逐渐达到大凉，然后燥令才施行。《内经》说“阳明所至，始为燥终为凉”，这也是误文。难道新秋时节花露晶莹，星光润泽，深渊澄澈，天香遍野，万物丰收，能归咎于燥政吗？等到山空月小，水落石出，天降繁霜，地凝白卤，那种一贯坚急劲切的转化，反而说是凉生，不说燥吗？或许有人怀疑燥从火化，所以先燥而后凉，这不符合道理。深奥啊！深奥啊！《上古脉要》说：春脉不沉，夏脉不弦，秋脉不数，冬脉不涩，这叫四塞。说的是脉象顺应四时，如果不循序渐进，就会四塞而不退。所以春夏秋冬孟月的脉象，仍然遵循冬春夏秋季月的常规，不改变其度数。等到二分二至以后，才开始转变而顺应当令的王气，这才是平人的顺脉。所以天道春不分则不温，夏不至则不热，这是自然的运行，悠久无疆。如果人的脉象，刚春就以弦应，刚夏就以数应，躁促相加，不到三个季节岁度的终结就到了。还能长寿吗？由此推之，秋月之所以忌讳数脉，是因为新秋被燥所胜，所以忌讳它。如果不是病人，新秋脉带微数，那是天真的脉象，为什么反而忌讳呢？况且始为燥，终为凉，凉后本该寒了。为什么到了十月反而温暖呢？凉后反温，失去了时序，天道岂不是停顿了吗？不知道十月的温，不是从凉转来，正是从燥生，大概金位之下，火气承之，所以初冬常温，其脉的应象，仍从乎金的涩。由涩而沉，其涩，是为生水之金；其沉，就是水中之金了。珠辉玉映，难道是伤燥吗？然而新秋的凉，本是用来驱除暑热的，而夏季所受暑邪，就从凉而发。《内经》说：“当暑汗不出者，秋成风疟。”举一个疟疾为例，凡是在风中取凉，用水冲洗汗水，乃至不再出汗而损伤内部的，发病都应当像疟疾一样治疗。那些内伤生冷导致滞下的，也可以从疟疾类推。因为它们原来都是暑湿之邪，外内所主虽然不同，但都从秋风而发。至于深秋燥金主病，那就大不相同了。经说：燥胜则干。干的危害，并不是立刻赤地千里。有干于外而皮肤皱揭的；有干于内而精血枯涸的；有干于津液而营卫气衰，肉消而皮着于骨的。随着其大经小络，所属上下中外前后，各成为病所，燥之所胜；也够厉害的了。至于所伤则更严重，燥金所伤，本来摧折肝木，甚则自伤肺金。盖肺金主气，而治节行焉，这只有土生之金，坚刚不挠，所以能生杀自由，纪纲不紊。如果病起于秋而伤其燥，金受火刑，化刚为柔，方圆且随型埴，想要恢复清肃的旧貌，怎么可能呢？《内经》说咳不止而出白血者死，白血谓色浅红，而似肉似肺者，不是肺金自削，怎么会有这个？试看草木菁英可掬，一乘金气，忽焉改容，焦其上首，而燥气先伤上焦华盖，岂不明显吗。详查此，则病机的诸气郁，皆属于肺；诸痿喘呕，皆属于上。这两条明确指燥病而言了。生气通天论说秋伤于燥，上逆而咳，发为痿厥。燥病的要点，一言而终。与病机两条适相吻合。只因为误传伤燥为伤湿，解者竞指燥病为湿病，遂至经旨不明。现在一论之，而燥病的机理，了无余义了。其左胁痛，不能转侧，嗌干面尘，身无膏泽，足外反热，腰痛惊骇筋挛，丈夫疝，妇人少腹痛，目昧皆疮，则是燥病之本于肝，而散见不一者也。《内经》燥淫所胜，其主治必以苦温者，用火的气味而制其胜也。其佐以或酸或辛者，临病制宜，宜补则佐酸，宜泻则佐辛也。其下之亦以苦温者，如清甚生寒，留而不去，则不当用寒下，宜以苦温下之。即气有余，亦但以辛泻之，不以寒也。要知道金性畏热，燥复畏寒，有宜用平寒而佐以苦甘者，必以冷热和平为方，制乃尽善也。又六气凡见下承之气，方制即宜少变。如金位之下，火气承之，则苦温之属宜减，恐其以火济火也。即用下，亦当变苦温而从寒下也。这是《内经》治燥淫的宗旨，可赞一词也。至于肺气郁，痿喘呕咳，都是伤燥的重病，又不是制胜一法所能理也。兹并入燥门，细商良治，学人精心求之，罔不获矣。若但以润治燥，不求病情，不适病所，犹未免涉于粗疏耳。
《痹论》说：阴气者，静则神藏，躁则消亡。下文只说饮食自倍，肠胃乃伤，曾不及于肺。其所以致燥而令阴气消亡的缘故，引而未发也。至《灵枢》说：形寒饮冷则伤肺，才知道伤肺关于寒冷了。可见肺气外达皮毛，内行水道，形寒则外寒从皮毛内入，饮冷则水冷从肺中上溢，遏抑肺气，不令外扬下达。其治节不行，周身之气，无所禀仰，而肺病矣。究竟肺为娇脏，寒冷所伤的，十之二三。火热所伤的，十之七八。寒冷所伤，不过裹束其外。火热所伤，则更消烁其中，所以为害倍烈也。然而火热伤肺，以致诸气郁，诸痿喘呕而成燥病，百道方中，率皆依样葫芦。如乌药、香附、紫苏、半夏、茯苓、浓朴、丁香、沉香、诃子、蔻仁、姜、桂、蓬术、莪棱、槟榔、益智之属，方方取足。只因《内经》脱遗燥证，后之无识者，竞皆以燥治燥，恬于操刃，曾罔顾阴气之消亡耳。
虽然以东垣之大贤，其治燥诸方，但养荣血，及补肝肾亏损，二便闭结而已，初不论及于肺也。是非谓中下二焦有燥病，而上焦独无也。不过阙经旨伤湿之疑，遂因仍不察耳。夫诸气郁之属于肺者，属于肺之燥，非属于肺之湿也。苟肺气不燥，则诸气禀清肃之令，而周身四达，亦胡致郁耶。诸痿喘呕之属于上者，上亦指肺，不指心也。若统上焦心肺并言，则心病不主痿喘及呕也，惟肺燥甚，则肺叶痿而不用，肺气逆而喘鸣，食难过膈而呕出，三者皆燥证之极者也。经文原有逆秋气，则太阴不收，肺气焦满之文，其可称为湿病乎。更考东垣治肺消方中，引用白豆蔻、荜澄茄，及治诸气方中，杂用辛香行气之药，觉于伤燥一途，有未悉耳。又如丹溪折衷杂证，为后代所宗，亦无一方一论及于肺燥。但于热郁汤下云：有阴虚而得之者；有胃虚食冷物，抑遏阳气于脾土中而得之者；其治法皆见发热条中，此治非阴虚非阳陷，亦不发热，而常自蒸蒸不解者。夫蒸蒸不解，非肺气为热所内蒸，而不能外达耶。方用连翘、薄荷叶、黄芩、山栀仁、麦门冬、甘草、郁金、栝蒌皮穣八味，竹叶为引。方后复设为问答云：何不用苍术、香附、抚芎？曰：火就燥，燥药皆能助火，故不用也。似此一方，示不欲以燥助火之意，于热郁之条，其不敢以燥益燥，重伤肺金，隐然可会。何为不立燥病一门，畅发其义耶？又如缪仲醇治病，所用者，无非四君、四物、二冬、二母、沙参、玄参、黄芪、山药、苏子、橘红、桑叶、枇杷叶、杏仁、枣仁、扁豆、莲心、栝蒌、五味、升麻、葛根、柴胡、前胡、黄芩、莲子、栀子、黄柏、滑石、石膏、菊花、枸杞、牛膝、续断、薏苡、木瓜、胡麻、首乌、豆豉、霜梅、胶饴之属，千方一律，不过选择于此。增入对证一二味，自成一家。识者称其不尽用方书所载，投之辄效，盖独开门户者也。又有称其精于本草，择用五六十种无过之药，屡获奇验，无以多为者。昌谓不然，世之患燥病者多，仲醇喜用润剂，于治燥似乎独开门户，然亦聪明偶合，未有发明，可以治内伤之燥，不可以治外感之燥。何况风寒暑湿哉，节取其长可矣！
《内经》说：心移热于肺，传为膈消，肺燥的由来者远矣。假如其人肾水足以上升而交于心，则心火下降而交于肾，不传于肺矣。心火不传于肺，曾何伤燥之虞哉？即使肾水或见不足，其肠胃津血足以协济上供，肺亦不致过伤也。若夫中下之泽尽竭，而高源之水，犹得措于不倾，则必无之事矣。所以经文又说：二阳结，谓之消。手阳明大肠，热结而津不润。足阳明胃，热结而血不荣，证成消渴。舌上赤裂，大渴引饮，与心移热于肺，传为膈消，文虽异而义则一也。治膈消者，用白虎加人参汤专救其肺，以施于诸气郁，诸痿喘呕，罔不合矣。学人可不知引伸触类，以求坐进此道耶。
《阴阳别论》说：二阳之病发心脾，有不得隐曲，男子少精，女子不月，其传为风消，其传为息贲，死不治。这也是肺燥的由来，而未经揭出的，夫燥而令男子精液衰少，女子津血枯闭，也够极了。然而其始，但不利于隐曲之事耳。其继则胃之燥传入于脾而为风消，风消者，风热炽而肌肉消削也。大肠之燥，传入于肺而为息贲，息贲者，息有音而上奔不下也。是则胃肠合心脾以共成肺金之燥，三藏二府，阴气消亡殆尽，尚可救疗者乎？夫由心之肺，已为死阴之属。然脾气散二阳之精，上输于肺，犹得少苏涸鲋。今以燥之为害，令生我者尽转而浚我之生，故直断为死不治也。从前愦愦，特绎明之。
病机十九条内说：诸涩枯涸，干劲皴揭，皆属于燥。燥金虽为秋令，虽属阴经，然异于寒湿，同于火热。火热胜则金衰，火热胜则风炽，风能胜湿，热能耗液，转令阳实阴虚，故风火热之气，胜于水土而为燥也。
肝主于筋，风气自甚；燥热加之，则液聚于胸膈，不荣于筋脉而筋燥。故劲强紧急而口噤，或抽搐昏冒僵仆也。
风热燥甚，怫郁在表而里气平者，善伸数欠，筋脉拘急，或时恶寒，或筋惕而搐，脉浮数而弦。若风热燥并郁甚于里，则必为烦满，必为闷结，故燥有表里气血之分也。
至于筋缓不收，痿痹不仁，因其风热胜湿，为燥日久，乃燥病之甚者也。至于诸气郁，诸痿喘呕，皆属于肺。金从燥化，金且自病，而肺气日见消亡，又何论痿痹乎？
五脏五志之火，皆有真液以养之，故凝聚不动，而真液尤赖肾之阴精，胃之津液，交灌于不竭。若肾胃之水不继，则五脏之真阴随耗，五志之火，翕然内动，而下上中三消之病作矣。河间说：燥太甚而脾胃干涸，则成消渴，亦其一也。
燥病必渴，而渴之所属各不同，有心肺气厥而渴；有肝痹而渴；有脾热而渴；有肾热而渴；有胃与大肠结热而渴；有小肠痹热而渴；有因病疟而渴；有原素食肥甘而渴；有因醉饮入房而渴；有因远行劳倦，遇大热而渴；有因伤害胃，干而渴；有因风而渴。五脏部分不同，病之所遇各异，其为燥热亡液则一也。另详消渴门。
治燥病者，补肾水阴寒之虚，而泻心火阳热之实；除肠中燥热之甚，济胃中津液之衰；使道路散而不结，津液生而不枯，气血利而不涩，则病日已矣。
肾恶燥，急食辛以润之。故肾主五液，津则大便如常。若饥饱劳逸，损伤胃气，及食辛热味浓之物，而助火邪，伏于血中，耗散真阴，津液亏少，故大便结燥。仲景说：小便利，大便硬，不可攻下，以脾约丸润之。戒轻下而重伤津液也。然而藏结复有阳结阴结之不同，阳结者以辛凉润之，阴结者以辛温润之，其辨又在微芒之间矣。
【律五条】
凡是秋月燥病，误以为湿治的，是拿刀杀人般的事。从前不明白，过错还可以推委。现在明知故犯，伤人必多，孽镜当前，悔之无及。
凡是治燥病，燥在气而治血，燥在血而治气，燥在表而治里，燥在里而治表，药不适病，是医生的过错。
凡是治杂病，有兼带燥证的，误用燥药，转成其燥，因而导致危困的，是医生的罪过。
凡是治燥病，须分肝肺二脏见证。肝脏见证，治其肺燥就可以了。如果肺脏见证，反治其肝，那就是坐误了！是医生的罪过。肝脏见燥证，固然应当急救肝叶，勿令焦损。然而清其肺金，除其燥本，尤为先务。如果肺金自病，不及于肝，即全力救肺。焦枯且恐立至，还可以分功缓图吗？
(One Treatise, Eleven Methods, Five Laws)
Yu Chang said: Dryness and dampness differ as much as heaven and earth. Dryness is the Qi of Heaven; dampness is the Qi of Earth. Water flows to dampness, fire moves toward dryness; each follows its kind. One prevails while the other yields, and they do not conspire with each other. In spring, the Qi of the Earth stirs and dampness prevails, so that grass and trees flourish luxuriantly. In autumn, the Qi of Heaven becomes solemn and dryness prevails, so that grass and trees turn yellow and fall. Therefore, the dampness after the Spring Equinox and the dryness after the Autumn Equinox each govern their respective seasons. To now identify the dryness of autumn as dampness would be tantamount to identifying the heat of summer as cold. Why does the *Pathogenic Mechanisms* (Bing Ji) section of nineteen items in the *Nei Jing* (Inner Canon) omit dryness Qi? All instances elsewhere stating "autumn injury by dryness" have been stated as "autumn injury by dampness." Sages of past generations interpreted the text accordingly without noticing the error. I specifically correct this. The main idea is: Spring injury by wind, Summer injury by summer-heat, Late Summer injury by dampness, Autumn injury by dryness, Winter injury by cold. With this, the principle of matching the Six Qi (Liu Qi) to the Four Seasons aligns with the Five Movements (Wu Yun), resolving a millennium-old great doubt. Then, can autumn dryness be ignored? Autumn does not become dry abruptly. After intense heat, coolness arises; as coolness arises, heat dissipates, gradually reaching intense coolness, and only then does the command of dryness operate. The *Jing* states "where Yangming arrives, it begins as dryness and ends as coolness," which is also an erroneous text. Could it be that in early autumn, when flowers are dewy, starlight is moist, abysses are clear, heavenly fragrance fills the fields, and all treasures hang heavy on branches, we attribute this to the administration of dryness? When mountains are empty, the moon small, waters recede revealing stones, heavy frost falls from heaven, and white salt condenses on the ground, creating a transformation that is firm, urgent, strong, and cutting—could we call this coolness arising rather than dryness? Some suspect that dryness transforms from fire, hence dryness first and coolness later; this is illogical. Profound! Profound! The *Shang Gu Mai Yao* (Ancient Pulse Essentials) states: "In spring, the pulse should not be deep; in summer, not wiry; in autumn, not rapid; in winter, not choppy. This is called 'Four Obstructions'." It refers to pulses conforming to the four seasons. If they do not advance step by step, the Four Obstructions occur and do not retreat. Thus, the pulses in the first month of spring, summer, autumn, and winter still follow the norms of winter, spring, summer, and autumn months respectively, without changing their degree. Only after the Equinoxes and Solstices do they begin to transform and accord with the ruling Qi of the current season; this constitutes the smooth pulse of a healthy person. Therefore, according to the Way of Heaven, if there is no Spring Equinox, there is no warmth; if there is no Summer Solstice, there is no heat. This is natural operation, enduring and boundless. If human pulses were wiry in early spring and rapid in early summer, aggravated by restlessness and haste, the annual cycle would end before three seasons passed. How could one live long? By this reasoning, the reason why rapid pulses are taboo in autumn is that early autumn is overcome by dryness, hence it is taboo. If a non-sick person has a slightly rapid pulse in early autumn, this is the pulse of innate truth; why is it taboo? Moreover, beginning as dryness and ending as coolness, coolness should immediately lead to cold. Why is it warm in the tenth month instead? Coolness turning back to warmth violates the order of time; would not the Way of Heaven come to a halt? The warmth of the tenth month does not transform from coolness but arises from dryness. Generally, below the position of Metal, Fire Qi succeeds it. Hence, early winter is often warm, and the corresponding pulse still follows the choppy quality of Metal. From choppy to deep: the choppy quality represents Metal generating Water; the deep quality represents Metal within Water. Like shining pearls and reflecting jade, is this injury by dryness? However, the coolness of early autumn serves to dispel summer-heat, and the summer-heat pathogen received in summer emerges through this coolness. The *Jing* says: "Those who suffer summer-heat but do not sweat will develop wind-malaria in autumn." Taking malaria as one example, anyone who cools themselves in the wind, washes off sweat with water, or fails to sweat thereby injuring the interior, their illness onset should be treated according to the principles for malaria. Those whose internal injury from raw/cold food leads to dysentery can also be inferred from malaria. Because originally they are all summer-heat and dampness pathogens; although the external and internal dominances differ, they all manifest via autumn wind. As for diseases governed by autumn-deep Metal-Dryness, they are vastly different. The Classic says: "Dryness prevailing causes dryness." The harm of dryness is not necessarily an immediate barren land. There is dryness externally causing skin wrinkling and peeling; dryness internally causing withering of essence and blood; dryness affecting fluids causing decline of Ying and Wei Qi, flesh wasting away until skin adheres to bone. Following the major and minor meridians, belonging to upper/lower, inside/outside, front/back, each becomes a site of disease where dryness prevails; this is indeed severe. The injury caused is even more serious. Metal-Dryness injury originally destroys Wood-Liver; severely, it injures Metal-Lung itself. Lung-Metal governs Qi and executes regulation. Only Earth-generated Metal is firm and unyielding, thus able to control life and death freely and maintain order without confusion. If illness originates in autumn and injures dryness, Metal suffers Fire punishment, transforming rigidity into flexibility, becoming malleable like clay. Can it still restore its original state of clarity and purity? Impossible. The *Jing* states: "Cough persisting with expulsion of white blood indicates death." White blood refers to pale red color, resembling meat or lung tissue. Without self-depletion of Lung-Metal, how could this occur? Observe lush vegetation; upon encountering Metal Qi, it suddenly changes appearance, scorching its top. Thus, Dryness Qi first injures the Upper Jiao Hua Gai (Lung). Is this not clear? Detailed examination shows that among the Pathogenic Mechanisms, "All Qi stagnation belongs to Lung; all flaccidity, wheezing, and vomiting belong to Upper." These two clauses explicitly refer to dryness disease. The *Sheng Qi Tong Tian Lun* states: "Autumn injury by dryness causes upward reversal and cough, developing into flaccidity and cold extremities." The essence of dryness disease is concluded in one sentence. This coincides perfectly with the two clauses in Pathogenic Mechanisms. Only due to transmission error mistaking dryness injury for dampness injury, interpreters competed to label dryness disease as dampness disease, leading to unclear canonical meaning. Now, with this treatise, the mechanism of dryness disease is fully elucidated. Left hypochondriac pain, inability to turn sides, dry throat, dusty face, lack of body luster, heat on outer feet, lower back pain, fright, tendon spasms, hernia in men, lower abdominal pain in women, blurred vision and ulcers—these are dryness disease originating from Liver, appearing variously. The *Nei Jing* states regarding Dryness Overwhelming: treatment must use Bitter-Warm herbs, utilizing the flavor and nature of Fire to control the prevailing condition. Adjuvants may be Sour or Acrid depending on clinical needs: Sour for tonification, Acrid for purgation. Purgatives should also be Bitter-Warm. If extreme cooling generates cold that remains unresolved, cold purgatives should not be used; Bitter-Warm purgatives are appropriate. Even if Qi is excessive, purge with Acrid, not Cold. Know that Metal nature fears heat, and Dryness fears cold. For cases suitable for Neutral-Cold with Bitter-Sweet adjuvants, formulas must balance hot and cold to be perfect. Furthermore, for the Six Qi, whenever there is succeeding Qi below, formula composition should vary slightly. E.g., below Metal position, Fire Qi succeeds; thus, Bitter-Warm categories should be reduced to avoid adding fire to fire. Even if using purgatives, change from Bitter-Warm to Cold-Purgative. This is the gist of treating Dryness Overwhelming in the *Nei Jing*, worthy of praise. As for Lung Qi stagnation, flaccidity, wheezing, vomiting, and cough—all are severe injuries by dryness—not resolvable by mere controlling methods. These are included in the Dryness Section for careful discussion of good treatments. Students seeking diligently will surely succeed. Merely using moistening to treat dryness without investigating pathology or fitting the disease site is still crude.
The *Bi Lun* (Treatise on Bi Syndrome) states: "Yin Qi, when quiet, stores the Spirit; when restless, it perishes." The following text mentions only "diet doubling damages intestines and stomach," omitting Lung. The reason for inducing dryness and causing Yin Qi to perish is hinted at but not fully expounded. Until the *Ling Shu* states: "External cold and cold drinks injure Lung," we realize Lung injury relates to cold. Thus, Lung Qi extends outward to skin/hair and inward manages water passages. External cold enters from skin/hair; cold drinks cause water to overflow upward from Lung, suppressing Lung Qi, preventing it from rising outward and descending downward. Regulation fails, whole-body Qi lacks reliance, and Lung disease occurs. Ultimately, Lung is a delicate organ; cold injury accounts for 20-30%, while heat-fire injury accounts for 70-80%. Cold injury merely wraps/constricts externally. Heat-fire injury consumes internally, causing twice the harm. Yet, heat-fire injuring Lung leads to Qi stagnation, flaccidity, wheezing, vomiting, forming dryness disease. Among hundreds of prescriptions, most are copied blindly. Such as Wu Yao, Xiang Fu, Zi Su, Ban Xia, Fu Ling, Hou Po, Ding Xiang, Chen Xiang, He Zi, Dou Kou, Ginger, Cinnamon, Peng Ze, E Zhu, Bing Lang, Yi Zhi, etc., are fully utilized in every formula. Simply because the *Nei Jing* omitted dryness syndromes, later ignorant people competed to treat dryness with drying methods, casually wielding knives, disregarding the consumption of Yin Qi.
Even Dong Yuan, a great sage, in his formulas for dryness, only nourished Ying-Blood and supplemented Liver/Kidney deficiency, addressing constipation of urine/feces, never mentioning Lung. This does not mean Middle/Lower Jiao have dryness disease while Upper Jiao alone lacks it. It is merely due to the ambiguity of canonical texts on dampness injury, leading to uncritical continuation. Regarding "Qi stagnation belonging to Lung," it belongs to Lung-Dryness, not Lung-Dampness. If Lung Qi is not dry, it receives clear/pure commands and spreads throughout the body; how could stagnation occur? Regarding "flaccidity, wheezing, vomiting belonging to Upper," "Upper" refers to Lung, not Heart. If speaking generally of Upper Jiao Heart/Lung, Heart disease does not primarily cause flaccidity, wheezing, or vomiting. Only when Lung-Dryness is severe do Lung lobes become flaccid and unusable, Lung Qi reverses causing wheezing sounds, food struggles to pass diaphragm causing vomiting. These three are extremes of dryness syndrome. The classic text originally states: "Reversing Autumn Qi causes Taiyin not to收 (receive/consolidate), Lung Qi becomes scorched and full." How can this be called dampness disease? Further examining Dong Yuan's formulas for Lung Xiao (Consumption), citing Bai Dou Kou, Bi Cheng Qie, and mixing acrid-aromatic Qi-moving herbs in Qi-stagnation formulas, suggests he was unaware of the path of dryness injury. Similarly, Dan Xi's *Zhe Zhong Za Zheng* (Compromise Miscellaneous Diseases), revered by later generations, contains no single formula or theory regarding Lung-Dryness. Only under Re Yu Tang (Heat Stagnation Decoction) does it say: "Some obtain it via Yin deficiency; some via Stomach deficiency eating cold food, suppressing Yang Qi in Spleen Earth." Their treatments appear in the Fever clause. This treatment is neither Yin deficiency nor Yang sinking, nor feverish, yet constantly steaming without resolution. Steaming without resolution implies Lung Qi is steamed internally by heat and cannot reach exterior. Formula uses Lian Qiao, Bo He Ye, Huang Qin, Shan Zhi Ren, Mai Men Dong, Gan Cao, Yu Jin, Gua Lou Pi/Rang (eight herbs), with Zhu Ye as guide. Post-formula Q&A asks: "Why not Cang Zhu, Xiang Fu, Fu Xiong?" Answer: "Fire moves to dryness; drying herbs assist fire, hence not used." This single formula shows intent not to use dryness to aid fire. Under Heat Stagnation clause, the reluctance to add dryness to dryness, severely injuring Lung Metal, is implicitly understood. Why not establish a Dryness Disease section to fully expound its meaning? Furthermore, Miao Zhong Chun's treatments used nothing but Si Jun Zi, Si Wu, Er Dong, Er Mu, Sha Shen, Xuan Shen, Huang Qi, Shan Yao, Su Zi, Ju Hong, Sang Ye, Pi Pa Ye, Xing Ren, Zao Ren, Bian Dou, Lian Xin, Gua Lou, Wu Wei, Sheng Ma, Ge Gen, Chai Hu, Qian Hu, Huang Qin, Lian Zi, Zhi Zi, Huang Bo, Hua Shi, Shi Gao, Ju Hua, Gou Qi, Niu Xi, Xu Duan, Yi Yi, Mu Gua, Hu Ma, Shou Wu, Dou Chi, Shuang Mei, Jiao Yi, etc. A thousand formulas follow one pattern, merely selecting from here. Adding one or two symptom-specific herbs creates a unique school. Experts praised him for not blindly using recorded formulas, achieving efficacy instantly, opening new doors. Others claimed mastery of Materia Medica, selecting 50-60 harmless herbs, achieving miraculous results frequently, arguing quantity isn't the issue. I disagree. Many suffer dryness disease today. Zhong Chun likes using moistening agents, seemingly opening a new door for treating dryness, but this is accidental cleverness, lacking theoretical innovation. It can treat internal-injury dryness, not external-contracted dryness. What about Wind-Cold, Summer-Heat, Dampness? Selecting strengths is sufficient.
The *Nei Jing* states: "Heart transfers heat to Lung, transmitting as Ge Xiao (Diaphragmatic Consumption)." The origin of Lung-Dryness is ancient. If Kidney Water ascends sufficiently to interact with Heart, Heart Fire descends to interact with Kidney, not transferring to Lung. If Heart Fire doesn't transfer to Lung, what fear of dryness injury? Even if Kidney Water is insufficient, intestinal/stomach fluids/blood suffice to assist upper supply, preventing excessive Lung injury. If Middle/Lower pools are exhausted, yet High Source Water remains stable, this is impossible. Hence the Classic adds: "Two Yang knotting is called Xiao." Hand-Yangming Large Intestine, heat knots causing fluid non-moistening. Foot-Yangming Stomach, heat knots causing blood non-nourishing, resulting in Xiao Ke (Consumption-Thirst). Red cracks on tongue, extreme thirst drinking large amounts. Though wording differs from "Heart transfers heat to Lung... Ge Xiao," meaning is identical. Treating Ge Xiao uses Bai Hu Jia Ren Shen Tang to exclusively save Lung, applicable to all Qi stagnation, flaccidity, wheezing, vomiting, fitting perfectly. Should students not extend this logic to master this path?
The *Yin Yang Bie Lun* states: "Disease of Two Yang originates in Heart/Spleen, involving hidden difficulties, scanty essence in men, amenorrhea in women. Transmission becomes Feng Xiao (Wind Consumption), transmission becomes Xi Ben (Breath Bulge), death untreatable." This is also an unexposed origin of Lung-Dryness. Dryness causing male essence depletion and female fluid/blood closure is extreme. Initially, it only hinders intimate acts. Subsequently, Stomach-Dryness transmits to Spleen as Feng Xiao (Wind-Heat blazing, muscle wasting). Large Intestine-Dryness transmits to Lung as Xi Ben (breathing noisy, rushing up not down). Thus, Stomach/Intestines combine with Heart/Spleen to complete Lung-Metal-Dryness. Three Zang and two Fu organs, Yin Qi nearly exhausted, can it be saved? From Heart to Lung is already Dead Yin category. Although Spleen Qi scatters Two Yang essence, uploading to Lung, it might briefly revive dried fish. Now, due to dryness harm, the one generating me turns to drain my life source, hence directly judged dead untreatable. Formerly confused, now clarified.
Within Pathogenic Mechanisms Nineteen Items: "All astringency, withering, dryness, hardness, wrinkling, and peeling belong to Dryness." Although Metal-Dryness is Autumn Command and Yin Channel, it differs from Cold-Dampness, resembling Fire-Heat. Fire-Heat prevailing causes Metal decline; Fire-Heat prevailing causes Wind blazing. Wind overcomes dampness; Heat consumes fluids, turning to Yang-excess/Yin-deficiency. Thus, Wind-Fire-Heat Qi surpasses Earth/Water to create Dryness.
Liver governs tendons; Wind Qi is naturally excessive. Adding Dryness-Heat, fluids gather in chest/diaphragm, failing to nourish tendons/vessels, causing tendon-dryness. Hence stiffness, urgency, locked jaw, or convulsions, fainting, stiff collapse.
If Wind-Heat-Dryness is severe, stagnant in Exterior while Interior Qi is calm, patient stretches frequently yawns, tendons/vessels contract, occasional chills, or muscle twitching/spasms, pulse floating-rapid-wiry. If Wind-Heat-Dryness stagnates severely in Interior,必有烦满 (must have vexation/fullness), must have oppression/knotting. Thus, Dryness has Exterior/Interior and Qi/Blood distinctions.
As for tendon laxity/unretractability, flaccidity/numbness, due to Wind-Heat overcoming dampness, being dry for long periods, this is severe dryness disease. Regarding "All Qi stagnation, all flaccidity, wheezing, vomiting belong to Lung." Metal transforms via Dryness; Metal itself sickens, Lung Qi daily declines. What talk of flaccidity/numbness?
Fire of Five Zang and Five Wills all have True Fluids to nourish them, thus remaining condensed/motionless. True Fluids especially rely on Kidney Yin-Essence and Stomach Fluids, intermixing endlessly. If Kidney/Stomach Water fails to continue, Five Zang True Yin depletes accordingly, Five Wills Fire moves internally suddenly, and Lower/Middle/Upper San Xiao diseases arise. He Jian said: "Extreme Dryness causing Spleen/Stomach aridity leads to Xiao Ke," which is one aspect.
Dryness disease must involve thirst, but thirst origins vary: Heart/Lung Qi rebellion causing thirst; Liver Bi causing thirst; Spleen Heat causing thirst; Kidney Heat causing thirst; Stomach/Large Intestine knot-heat causing thirst; Small Intestine Bi-heat causing thirst; Thirst due to malaria; Thirst from habitual rich/sweet diet; Thirst from drunken sex; Thirst from long travel fatigue meeting intense heat; Thirst from Stomach injury causing dryness; Thirst from Wind. Five Zang regions differ, disease encounters vary, but all involve Dryness-Heat consuming fluids. See Xiao Ke Section for details.
Treating Dryness Disease: Tonify Kidney Water Yin-Cold deficiency, purge Heart Fire Yang-Heat excess; remove extreme Dryness-Heat in intestines, supplement Stomach Fluid decline; ensure pathways scatter without knotting, fluids generate without withering, Qi/Blood flow smoothly without astringency, then disease heals daily.
Kidney dislikes Dryness; urgently eat Acrid to moisten. Kidney governs Five Fluids; fluids result in normal stool. If hunger/fullness, work/rest imbalance damages Stomach Qi, or eating Acrid-Hot strong-flavored foods assists Fire Pathogen, hiding in Blood, consuming True Yin, fluid deficiency causes hard/dry stool. Zhang Zhong Jing said: "Clear urination, hard stool, do not attack with purgatives; moisten with Pi Yue Wan." Warn against light purgation severely injuring fluids. However, Zang Knotting has Yang-Knot and Yin-Knot differences. Yang-Knot moisten with Acrid-Cool; Yin-Knot moisten with Acrid-Warm. Distinction lies in subtle nuances.
[Five Laws]
1. Any Autumn Dryness disease mistakenly treated as Dampness is akin to wielding a knife to kill. Previously unknown, blame could be shifted. Now knowingly committing it, harming many, facing the Mirror of Karma, regret comes too late.
2. Any treating Dryness Disease: Dryness in Qi treating Blood, Dryness in Blood treating Qi, Dryness in Exterior treating Interior, Dryness in Interior treating Exterior, medicine not fitting disease—this is doctor's fault.
3. Any treating miscellaneous diseases with accompanying Dryness Syndrome: Mistakenly using drying herbs, exacerbating dryness, leading to critical danger—this is doctor's sin.
4. Any treating Dryness Disease must distinguish Liver/Lung Zang manifestations. Liver Zang manifestation, treating Lung-Dryness is acceptable. If Lung Zang manifestation, conversely treating Liver is sitting in error! Doctor's sin. Liver Zang seeing Dryness Syndrome, certainly should urgently save Liver Lobe, prevent scorching damage. However, clearing Lung Metal, removing Dryness root, is especially primary task. If Lung Metal sickens itself, not affecting Liver, exert full force saving Lung. Scorching/withering may arrive instantly; can one divide effort and plan slowly?
5. Any treating Dryness Disease, not deeply understanding the gist of treating Dryness, merely using moistening agents to moisten dryness, although not severely injuring, also wastes time, named only crude artisan, must be warned against.