脉
虚劳之脉,或浮大,或弦数。大者劳也,弦者亦劳。大弦易治,血气未衰,可敛而正也。弦者难治,血
气已耗而难补。双弦则贼邪侵脾,加数则殆矣。又曰∶骨蒸劳热,脉数而虚,热而涩少,必殒其躯,
加汗加嗽,非药可除。
证
夫劳之为言,言剧也,故以劳瘵为难治之疾。古方虽分六极、六损、五劳、七伤、五尸、九虫、十疰、二
十四蒸之症种种不同,大抵皆由少年之时,嗜欲无节,起居不时,或七情六淫之所伤,或
饮食劳倦之有过,渐至真阴衰虚,相火炽焰,火旺则销烁真阴,而发蒸蒸之燥热也。盖火冲于上焦者,发热
之中,则兼咳嗽喘急,吐
痰吐血,肺痿肺痈等症;其火结于下焦者,发热之中,则兼淋浊结燥,遗精盗汗,惊悸腹痛等症也;妇人则
兼月水不通之类。及其火炽既久,气必伤矣。伤则不能运化水谷,水谷停留,而湿热生虫生积之由也。虫积
日深,变异莫测,啮人心肺,蚀人脏腑精华,殆莫能救矣。况其亲炙之人,熏陶日久,受其恶气,多遭
传染,是曰传尸,即前所谓九虫、十疰、二十四蒸之类是也,得病日浅,犹当施
治,姑息日久,或至发热不休,形体 羸,真气将脱,事不及矣。
治
治之之法,惟滋阴降火,是澄其源也;消痰和血,取积追虫,是洁其流也。及灸膏肓、崔氏四花穴,
无有不效。近世以来,多以紫河车加补肾清心退热之药治之,获效者亦多矣。医者可不以补
虚为主,而兼去邪矣乎!
凡阴虚证,每日午后恶寒发热,至晚亦得微汗而解,脉必虚濡
而数,绝类疟疾。但疟脉弦,而虚脉大,为辨耳。若误作疟疾治之,多致不救。
方
滋阴降火汤 王节斋曰∶男子色欲过度,损伤精血,必致阴虚火动之病,睡中盗汗,午后发热,哈哈
咳嗽,怠倦无力,饮食少思。甚则痰涎带血,咯血唾血,或咳吐衄血,身热,脉沉数,肌肉消瘦,此为劳瘵,
最重难治。轻则用药数十剂,重者期以岁年,然必须病患爱命,坚心定志,绝房室,息妄想,戒恼怒,节
饮食,以自培其根。不则虽服良药,亦无用也。此病治之于早,犹为不易;若到肌肉消尽,沉困着床,六
脉躁疾,则更难为矣。此方治色欲症,先见潮热盗汗,咳嗽倦怠,趁早服之,愈可必矣。
当归身(酒洗,一钱二分) 川芎(一钱) 白芍药(酒炒,一钱) 生地黄(酒洗,
五分) 熟地黄(姜汁炒,一钱) 天门冬(汤泡,去心,一钱) 黄柏(蜜炙,七分) 知
母(蜜炙,一钱) 陈皮(七分) 白术(一钱三分) 干姜(炒黑,三分) 甘草(炙,五分)
一方去干姜,加玄参、贝母、麦门冬、五味子,甚效。
上锉一剂,生姜煎,加竹沥、童便、姜汁同服。若咳嗽甚,加紫菀、款冬花、五味子、杏仁。喘,
加桑白皮。若痰多,加制半夏、贝母、栝蒌仁、白茯苓。若潮热甚,加柴胡、知母、地骨皮。若盗汗多,加酸
枣仁、牡蛎、浮小麦。若遗精梦滑。加龙骨、牡蛎、山茱萸肉。若赤白浊,加白茯苓、黄连。若兼衄血
咳血,出于肺也,加桑白皮、黄芩、山栀子。若兼嗽血痰血,出于脾也,加桑白皮、贝母、黄连、栝蒌仁。
若兼呕吐血,出于胃也,加山栀子、黄连、干姜、蒲黄、韭汁、姜汁。若兼咯唾血,
出于肾也,加桔梗、玄参、侧柏叶。
此症属火,大便多燥,然当愈加撙节爱养,勿令泄泻。若脾
胃一坏,则前项寒凉之药难用矣。倘遇如斯,急服理脾固本健胃之剂。
理脾固本汤
白术(炒,一钱) 白茯苓(一钱) 陈皮(八分) 半夏(制,八分) 神曲(炒,一钱)
麦芽(炒,一钱) 甘草(炙,七分)
上锉一剂,姜、枣煎服。候脾胃气固,然后用前本病药。
清离滋坎汤(云林制)〔批〕(按此方治劳瘵阴虚火动者) 治阴血虚相火旺,
盗汗潮热,咳嗽吐痰,一切虚劳等症,并加治之。
生地黄(二钱) 熟地黄(二钱) 天门冬(一钱) 麦门冬(一钱) 当归(酒洗,一
钱) 白芍(酒炒,一钱) 山茱萸(酒蒸,去核,一钱五分) 干山药(一钱) 白茯苓
(八分) 白术(土炒,一钱) 牡丹皮(一钱二分) 泽泻(八分) 黄柏(蜜炒,八分) 知
母(蜜炒,八分) 甘草(炙,七分)
上锉一剂,水煎服。嗽盛,加紫菀、款冬花。痰盛,加贝母、栝蒌仁。热盛,加地骨皮。心下怔忡,
加远志、酸枣仁。吐血,加山栀子、茅花。鼻衄,加桑白皮、韭汁。
东实两虚泻南补北汤 治酒色过度,妄泄真阴,阴虚火动,火旺痰多,发热咳嗽,咯血唾血等症。
黄连(淡姜汁炒,四两。泻南方火,宽心下痞满,止呕吐之要药也) 黄柏(盐水
炒,六两。补北方水,除热济阴,抑诸火之要药也) 枯芩(生用,二两。清肺滋源) 知
母(去毛,三两。降北方右尺相火,除骨蒸劳热要药) 贝母(去心,四两,用栝蒌仁煮汁
浸一宿。清西方金,消痰解烦) 桔梗(二两,引诸药至西方肺金之地,助子扶母之虚也)
杏仁(去皮尖,三两半。收敛耗散之金,乃降气生津之药也) 五味子(盐水炒,三两。
滋少阴不足之水,收大阴耗散之金) 紫菀(去土,二两半,用沉香煎水浸晒,大降气止
嗽) 当归(童便浸,二两。补血和血之圣药) 赤芍药(生用,二两半。平东方有余之
木,安中央不足之土)生地黄(酒洗,三两。凉血生血,清荣中之伏火) 天门冬(汤
泡,去心,四两。润肺清痰中血,止吐血,清诸经混杂之血) 天花粉(二两,止渴生津
)白术(麸炒,一两半。益脾土以生肺金) 白茯苓(二两,泻诸经火于小便中出)
上锉,每服八钱,乌梅一个,灯心三分,水煎温服。吐衄盛,加茜根、大小蓟、藕节、白茅根、侧柏叶、
京墨。痰盛,加半夏、前胡、竹沥、荆沥。喘急,加栝蒌仁、石膏、葶苈、桑白皮、紫苏子、沉香、枇杷叶。
热甚,加柴胡、地骨皮、连翘、银柴胡。风盛,加防风、荆芥穗、酸枣仁、薄荷、甘菊花、旋复
花。寒盛,加人参、黄 、桂枝。心下怔忡惊悸,加茯神、远志、柏子仁、酸枣仁。胁下气膨,加枳壳、
青皮、白芥子。淋浊,加猪苓、泽泻、木通、车前子。小便涩,加木通、石苇、滑石、海金沙。遗精,加
牡蛎、莲子肉。盗汗,加黄 、牡蛎、麻黄根、浮小麦。热燥,加滑石、石膏、火麻仁、山栀子。
三和汤(云林制) 治咳嗽痰盛,潮热阴虚。
当归(一钱五分) 川芎(五分) 白芍药(一钱) 熟地黄(二钱) 陈皮(八分) 制
半夏(八分) 茯苓(一钱) 黄连(姜汁炒,一钱) 枯芩(八分) 黄柏(炒,八分) 山栀
(炒,八分) 枳壳(八分) 桔梗 杏仁(去皮尖) 桑白皮 五味子(去梗) 知母
(去毛) 贝母(去心) 玄参 白术(土炒) 阿胶(蛤粉炒,或面炒成珠子) 马兜铃
甘草(各等分)
上锉一剂,生姜三片,水二碗,煎八分,空心服。
清肺滋阴散(杜次泉传)〔批〕(按此方治劳瘵阴虚兼有实热者) 治酒色太
过,斫丧真阴,阴火上升,肺金受侮,以致唾痰稠浊,咳嗽咽疮。
川芎(酒洗,一钱) 白芍(炒,一钱半) 生地黄(二钱) 白术(炒,一钱) 陈皮
(一钱) 白茯苓(八分) 黄柏(蜜炒,一钱) 知母(一钱) 贝母(去心,一钱) 紫菀
(八分) 五味子(六分) 款冬花(八分) 麦门冬(一钱) 地骨皮(一钱) 黄连(炒,五
分) 远志(甘草汤泡。八分) 酸枣仁(炒,六分) 甘草(四分)
上锉一剂,生姜一片,竹沥三匙,煎服。心下怔忡,夜卧不寐,加人参八分。心烦躁乱,加枳实六分,竹
茹六分。如痰涎壅盛,加栝蒌仁六分,天花粉一钱。如咽喉有疮,用通嗌散吹之(通嗌散方见咽喉门)
坎离膏(黄宾江传) 治劳瘵阴虚发热,咳吐咯血等症。
川黄柏(四两) 知母(去毛,四两) 生地黄(二两) 熟地黄(二两) 天冬(去
心,二两) 麦冬(去心,二两) 杏仁(去皮,七钱) 胡桃肉(去皮,四两) 白蜜(四两)
上先将黄柏、知母用童便三碗,水三碗,共六碗,侧柏叶一把,煎至三碗,去渣,入天麦冬、生熟地
于汁内,再添水二碗,煎数百沸,滤汁置一边。将天麦冬、生熟地渣捣烂如泥,再用水二碗
另煎,约耗其半,和入前汁,再将杏仁、胡桃仁用水擂烂,滤过汁,再擂再滤,勿混入渣,同蜜入前汁内,
慢火熬成膏子,入水内,去火毒。每服三五匙,侧柏叶煎汤,空心调服,忌犯铜铁器。
宁嗽膏(京师传) 治阴虚咳嗽,火动咯血,服之敛肺。
天冬(去心,半斤) 杏仁(去皮,四两) 贝母(去心,四两) 百部(四两) 百合
(四两) 款冬花(五两) 紫菀(三两) 白术(四两)
上锉,用长流水二十碗,煎五碗,滤渣再煎,如是者三次,共得药汁十五碗,入饴糖半斤,蜜一斤,
再熬,又入阿胶四两,白茯苓细末四两,和匀如膏。每服三五匙。
玄霜悉尼膏(秘方) 生津止渴,除咯血吐血,及治劳心动火,劳嗽久不愈,消痰止嗽,清血归经。
悉尼(六十个,去心,皮,取汁三十钟,酸者不用) 藕汁(十钟) 新鲜生地黄
(捣取汁,十钟) 麦门冬(捣烂煎汁,五钟) 萝卜汁(五钟) 茅根汁(十钟)
上六汁,再重滤去渣,将清汁再入火煎炼,入蜜一斤,饴糖半斤,柿霜半斤,姜汁一盏,入火再熬
如稀糊,则成膏矣。如血不止,咳嗽,加侧柏叶捣汁一钟,韭白汁半钟,茜根汁半钟,俱去渣,
入前汁内,煎成膏服之。
清火永真膏(京师传)
生地黄(四斤,捣汁) 天门冬(六两) 款冬花茸(六两)
上以天冬、款冬水熬,取渣捣烂再熬,然后入地黄汁煎炼成稠,入白蜜一斤再煎,再用五味子一两,另
熬汁半钟,入膏内再煎,至稠粘为度。每日用一二次。
噙化丹(秘方)〔批〕(按此方理劳嗽治标之剂) 治阴虚劳嗽。
天门冬(一两,酒蒸,瓦焙) 麦门冬(一两,酒蒸,瓦焙) 生地(一两五钱) 熟
地(一两五钱) 知母(一两,酒炒) 贝母(一两,炒) 杏仁(一两,炒) 紫菀(一两,炒
)款冬花(二两,水洗,焙干) 阿胶(八钱,蛤粉炒成珠) 当归(一两,酒洗,焙干) 枳
实(一两,炒) 桔梗(一两,炒) 半夏(一两,制) 黄连(一两,炒) 黄芩(一两,炒)
米仁(七钱,炒) 花粉(一两,炒) 青礞石( ,八钱) 薄荷(二两,水洗,焙)
上为极细末,炼蜜丸如弹子大。夜卧口噙化下。
抑心清肺丸(秘方) 治肺热咯血咳嗽,兼治血痢。
黄连(三两) 赤茯苓(三两) 阿胶(二两)
上以上二味为极细末,水熬阿胶和丸,如梧桐子大。每服五六十丸,食后米饮送下。盖连、芩有降心
火之功,阿胶具保肺金之力,则嗽除血止而病自愈矣。
小金丹(方外异人传) 治劳瘵吐痰吐血,发热咳嗽。
哑芙蓉(一钱) 朱砂(三分) 麝香(三分)
上为细末,外用高良姜四两,切碎,烧酒泡三日,去酒,入水十碗,煎至二三碗,滤去渣,慢火熬成膏,
再入乳汁半盏,再熬,入前药为丸,如黄豆大,金箔为衣。每服一丸,先吃梨一片,然后
以药丸嚼下,再吃梨一片,痰嗽顿止,发热即退。
神灸法 治传尸劳虫。
于癸亥日灸两腰眼,低陷中是穴。每穴灸艾七炷,若灸九炷、十炷尤妙。先隔一日前点穴,方睡至半夜
子时,一交癸亥日期,便灸。其虫从大便中出,即用火焚之,弃于江河中。如虫有黑嘴者,则其在内已伤入
肾脏矣,此不可治。虫宜谨避,瘵有数虫,如蜈蚣,如小蛇,如虾蟆,如马尾,如烂面,如乱丝,如苍蝇,如
壁油虫,上紫下白,形锐足细而有口,或如白蚁,孔窍中皆出。此劳瘵根毒,若
传至三人,则如人形,如鬼状。
予观近世阴虚火动之疾,十无一活,何也?盖由色欲劳役之过,七情五味之偏,遂至真元渐耗,虚火
上炎,劳瘵之疾作矣。方履霜之始,饮食如旧,起居如常,惟咳嗽一二声,自谓无恙,且讳疾忌医,灭身无
悟,及蔓延日久,倒卧于床,而坚冰已至矣。良可哀哉!若遇明医,必用滋阴降火健脾之药,以培其本,缓
缓投以数十剂,庶可少济。如求医心亟,效期旦夕,服药未几数剂,遂谓无功,躁急火热而阴火愈动。有等
医者,见其无回生之理,遽用峻药劫之,以纾目前之急,则将不俟终日而死期将至矣。以余意
揆之,方疾之始作,必致谨于三事而后可。三者维何?一要遇明医,二要肯服药,三要能禁戒,三者缺一
不治也。余敬书于方末,以为遘是疾者警云。
脉象
虚劳病的脉象,有的浮大,有的弦数。脉大的属于劳损,脉弦的也属于劳损。脉象既大又弦的容易治疗,因为血气尚未衰败,可以收敛并恢复正常。脉象仅见弦象的难治,因为血气已经耗损且难以补益。若出现双弦脉,则是贼邪侵犯脾脏;若兼见数脉,则病情危殆。又说:骨蒸劳热(一种自觉骨内发热、如潮汐般定时发作的热病),脉象数而虚,身体发热且脉涩、津液不足,必然导致死亡;若再伴有出汗和咳嗽,则非药物所能治愈。
证候
所谓“劳”,意思是剧烈、严重,因此将劳瘵(指具有传染性、以阴虚火旺为主要特征的慢性消耗性疾病)视为难治的疾病。古方虽然分为六极、六损、五劳、七伤、五尸、九虫、十疰、二十四蒸等种种不同的病症,但大体上都是由年轻时嗜欲无度,起居没有规律,或者被七情(喜、怒、忧、思、悲、恐、惊)和六淫(风、寒、暑、湿、燥、火)所伤害,或者是饮食不节、过度劳累所致,逐渐导致真阴(肾中阴精)衰虚,相火(寄居于肝肾之火,生理状态下为动力,病理状态下为邪火)炽盛燃烧。火旺则会销蚀真阴,从而引发蒸蒸的燥热感。如果火气冲于上焦,在发热的同时,会兼见咳嗽气喘急促、吐痰吐血、肺痿(肺部萎弱不用)、肺痈(肺部化脓性病变)等症状;如果火气结于下焦,在发热的同时,会兼见淋浊(小便浑浊或淋漓不尽)、大便干结、遗精盗汗、惊悸腹痛等症状;妇女则兼见月经不通之类。等到火势炽盛日久,气必然受损。气受损则不能运化水谷,水谷停滞,从而产生湿热,进而生虫、形成积滞。虫积日益加深,变化莫测,啃噬人心肺,侵蚀脏腑精华,几乎无法挽救了。况且与其密切接触的人,长期熏陶,受到其恶气影响,大多遭受传染,这叫做传尸(指具有传染性的痨病),就是前面所说的九虫、十疰、二十四蒸之类的疾病。得病时间尚短,还应当施治;姑息拖延日久,可能导致发热不止,形体消瘦羸弱,真气即将脱失,那时就来不及救治了。
治法
治疗的方法,只有滋阴降火,这是澄清源头;消痰和血,消除积滞、驱除寄生虫,这是清洁流弊。以及艾灸膏肓穴、崔氏四花穴,没有不有效的。近代以来,多用紫河车(胎盘)加入补肾、清心、退热的药物治疗,获得疗效的也很多。医生怎能不以补虚为主,同时兼顾祛除邪气呢!
凡是阴虚证,每天午后恶寒发热,到了晚上也能微微出汗而缓解,脉象必定虚濡而数,极像疟疾。但是疟疾的脉象是弦脉,而虚劳的脉象是大脉,以此作为辨别。如果误当作疟疾治疗,多会导致不治。
方剂
滋阴降火汤 王节斋说:男子房事过度,损伤精血,必然导致阴虚火动的疾病,睡中盗汗,午后发热,哈哈咳嗽(形容咳嗽声重浊或频繁),怠倦无力,饮食减少不想吃。严重时痰中带血,咯血唾血,或者咳吐鼻衄血,身体发热,脉沉数,肌肉消瘦,这就是劳瘵,最重且难治。轻症用药几十剂,重症期望以年计算,然而必须病人爱惜生命,坚定心志,断绝房事,平息妄想,戒除恼怒,节制饮食,来自己培养根本。否则,即使服用良药,也没有用处。这个病如果在早期治疗,还算不容易;如果等到肌肉消尽,困顿卧床,六脉躁动急疾,那就更难办了。此方治疗色欲过度的病症,先出现潮热盗汗、咳嗽倦怠,趁早服用,痊愈是可以肯定的。
当归身(酒洗,一钱二分) 川芎(一钱) 白芍药(酒炒,一钱) 生地黄(酒洗,五分) 熟地黄(姜汁炒,一钱) 天门冬(汤泡,去心,一钱) 黄柏(蜜炙,七分) 知母(蜜炙,一钱) 陈皮(七分) 白术(一钱三分) 干姜(炒黑,三分) 甘草(炙,五分)
另一方案去掉干姜,加玄参、贝母、麦门冬、五味子,效果很好。
以上锉成一剂,生姜煎煮,加入竹沥、童便(儿童尿液)、姜汁同服。如果咳嗽严重,加紫菀、款冬花、五味子、杏仁。气喘,加桑白皮。如果痰多,加制半夏、贝母、栝蒌仁、白茯苓。如果潮热严重,加柴胡、知母、地骨皮。如果盗汗多,加酸枣仁、牡蛎、浮小麦。如果遗精梦滑,加龙骨、牡蛎、山茱萸肉。如果赤白浊(小便混浊如米泔或带血色),加白茯苓、黄连。如果兼有鼻衄血、咳血,病出于肺,加桑白皮、黄芩、山栀子。如果兼有嗽血、痰血,病出于脾,加桑白皮、贝母、黄连、栝蒌仁。如果兼有呕吐血,病出于胃,加山栀子、黄连、干姜、蒲黄、韭汁、姜汁。如果兼有咯唾血,病出于肾,加桔梗、玄参、侧柏叶。
此症属火,大便多干燥,然而应当更加节制爱护调养,不要让腹泻发生。如果脾胃一旦败坏,那么前面的那些寒凉药物就难以使用了。如果遇到这种情况,急忙服用理脾固本健胃的药剂。
理脾固本汤
白术(炒,一钱) 白茯苓(一钱) 陈皮(八分) 半夏(制,八分) 神曲(炒,一钱) 麦芽(炒,一钱) 甘草(炙,七分)
以上锉成一剂,生姜、大枣煎服。等待脾胃之气稳固后,然后再用前面治疗本病的药物。
清离滋坎汤(云林制)〔批注〕(按:此方治疗劳瘵阴虚火动者) 治疗阴血虚、相火旺,盗汗潮热,咳嗽吐痰,一切虚劳等症,一并加以治疗。
生地黄(二钱) 熟地黄(二钱) 天门冬(一钱) 麦门冬(一钱) 当归(酒洗,一钱) 白芍(酒炒,一钱) 山茱萸(酒蒸,去核,一钱五分) 干山药(一钱) 白茯苓(八分) 白术(土炒,一钱) 牡丹皮(一钱二分) 泽泻(八分) 黄柏(蜜炒,八分) 知母(蜜炒,八分) 甘草(炙,七分)
以上锉成一剂,水煎服。咳嗽盛,加紫菀、款冬花。痰盛,加贝母、栝蒌仁。热盛,加地骨皮。心下怔忡(心中跳动不安),加远志、酸枣仁。吐血,加山栀子、茅花。鼻衄,加桑白皮、韭汁。
东实两虚泻南补北汤 治疗酒色过度,妄泄真阴,阴虚火动,火旺痰多,发热咳嗽,咯血唾血等症。
黄连(淡姜汁炒,四两。泻南方火,宽解心下痞满,是止呕吐的要药) 黄柏(盐水炒,六两。补北方水,除热济助阴液,是抑制诸火的要药) 枯芩(生用,二两。清肺滋源) 知母(去毛,三两。降北方右尺相火,是除骨蒸劳热的要药) 贝母(去心,四两,用栝蒌仁煮汁浸泡一夜。清西方金,消痰解烦) 桔梗(二两,引诸药至西方肺金之地,助子扶母之虚) 杏仁(去皮尖,三两半。收敛耗散之金,是降气生津的药) 五味子(盐水炒,三两。滋少阴不足之水,收大阴耗散之金) 紫菀(去土,二两半,用沉香煎水浸晒,大降气止咳) 当归(童便浸,二两。补血和血的圣药) 赤芍药(生用,二两半。平东方有余之木,安中央不足之土) 生地黄(酒洗,三两。凉血生血,清荣中之伏火) 天门冬(汤泡,去心,四两。润肺清痰中血,止吐血,清诸经混杂之血) 天花粉(二两,止渴生津) 白术(麸炒,一两半。益脾土以生肺金) 白茯苓(二两,泻诸经火从小便中排出)
以上锉碎,每服八钱,乌梅一个,灯心三分,水煎温服。吐衄盛,加茜根、大小蓟、藕节、白茅根、侧柏叶、京墨。痰盛,加半夏、前胡、竹沥、荆沥。喘急,加栝蒌仁、石膏、葶苈、桑白皮、紫苏子、沉香、枇杷叶。热甚,加柴胡、地骨皮、连翘、银柴胡。风盛,加防风、荆芥穗、酸枣仁、薄荷、甘菊花、旋复花。寒盛,加人参、黄芪、桂枝。心下怔忡惊悸,加茯神、远志、柏子仁、酸枣仁。胁下气膨,加枳壳、青皮、白芥子。淋浊,加猪苓、泽泻、木通、车前子。小便涩,加木通、石苇、滑石、海金沙。遗精,加牡蛎、莲子肉。盗汗,加黄芪、牡蛎、麻黄根、浮小麦。热燥,加滑石、石膏、火麻仁、山栀子。
三和汤(云林制) 治疗咳嗽痰盛,潮热阴虚。
当归(一钱五分) 川芎(五分) 白芍药(一钱) 熟地黄(二钱) 陈皮(八分) 制半夏(八分) 茯苓(一钱) 黄连(姜汁炒,一钱) 枯芩(八分) 黄柏(炒,八分) 山栀(炒,八分) 枳壳(八分) 桔梗 杏仁(去皮尖) 桑白皮 五味子(去梗) 知母(去毛) 贝母(去心) 玄参 白术(土炒) 阿胶(蛤粉炒,或面炒成珠子) 马兜铃 甘草(各等分)
以上锉成一剂,生姜三片,水二碗,煎至八分,空腹服用。
清肺滋阴散(杜次泉传)〔批注〕(按:此方治疗劳瘵阴虚兼有实热者) 治疗酒色太过,斫丧真阴,阴火上升,肺金受侮,以致唾痰稠浊,咳嗽咽疮。
川芎(酒洗,一钱) 白芍(炒,一钱半) 生地黄(二钱) 白术(炒,一钱) 陈皮(一钱) 白茯苓(八分) 黄柏(蜜炒,一钱) 知母(一钱) 贝母(去心,一钱) 紫菀(八分) 五味子(六分) 款冬花(八分) 麦门冬(一钱) 地骨皮(一钱) 黄连(炒,五分) 远志(甘草汤泡,八分) 酸枣仁(炒,六分) 甘草(四分)
以上锉成一剂,生姜一片,竹沥三匙,煎服。心下怔忡,夜卧不寐,加人参八分。心烦躁乱,加枳实六分,竹茹六分。如痰涎壅盛,加栝蒌仁六分,天花粉一钱。如咽喉有疮,用通嗌散吹之(通嗌散方见咽喉门)。
坎离膏(黄宾江传) 治疗劳瘵阴虚发热,咳吐咯血等症。
川黄柏(四两) 知母(去毛,四两) 生地黄(二两) 熟地黄(二两) 天冬(去心,二两) 麦冬(去心,二两) 杏仁(去皮,七钱) 胡桃肉(去皮,四两) 白蜜(四两)
以上先将黄柏、知母用童便三碗,水三碗,共六碗,侧柏叶一把,煎至三碗,去渣,入天冬、麦冬、生地黄、熟地黄于汁内,再添水二碗,煎数百沸,滤汁置一边。将天冬、麦冬、生地黄、熟地黄渣捣烂如泥,再用水二碗另煎,约耗其半,和入前汁,再将杏仁、胡桃仁用水擂烂,滤过汁,再擂再滤,勿混入渣,同蜜入前汁内,慢火熬成膏子,入水内,去火毒。每服三五匙,侧柏叶煎汤,空腹调服,忌犯铜铁器。
宁嗽膏(京师传) 治疗阴虚咳嗽,火动咯血,服之敛肺。
天冬(去心,半斤) 杏仁(去皮,四两) 贝母(去心,四两) 百部(四两) 百合(四两) 款冬花(五两) 紫菀(三两) 白术(四两)
以上锉碎,用长流水二十碗,煎五碗,滤渣再煎,如是者三次,共得药汁十五碗,入饴糖半斤,蜜一斤,再熬,又入阿胶四两,白茯苓细末四两,和匀如膏。每服三五匙。
玄霜悉尼膏(秘方) 生津止渴,除咯血吐血,及治劳心动火,劳嗽久不愈,消痰止咳,清血归经。
悉尼(六十个,去心、皮,取汁三十钟,酸者不用) 藕汁(十钟) 新鲜生地黄(捣取汁,十钟) 麦门冬(捣烂煎汁,五钟) 萝卜汁(五钟) 茅根汁(十钟)
以上六汁,再重滤去渣,将清汁再入火煎炼,入蜜一斤,饴糖半斤,柿霜半斤,姜汁一盏,入火再熬如稀糊,则成膏矣。如血不止,咳嗽,加侧柏叶捣汁一钟,韭白汁半钟,茜根汁半钟,俱去渣,入前汁内,煎成膏服之。
清火永真膏(京师传)
生地黄(四斤,捣汁) 天门冬(六两) 款冬花茸(六两)
以上以天冬、款冬水熬,取渣捣烂再熬,然后入地黄汁煎炼成稠,入白蜜一斤再煎,再用五味子一两,另熬汁半钟,入膏内再煎,至稠粘为度。每日用一二次。
噙化丹(秘方)〔批注〕(按:此方理劳嗽治标之剂) 治疗阴虚劳嗽。
天门冬(一两,酒蒸,瓦焙) 麦门冬(一两,酒蒸,瓦焙) 生地(一两五钱) 熟地(一两五钱) 知母(一两,酒炒) 贝母(一两,炒) 杏仁(一两,炒) 紫菀(一两,炒) 款冬花(二两,水洗,焙干) 阿胶(八钱,蛤粉炒成珠) 当归(一两,酒洗,焙干) 枳实(一两,炒) 桔梗(一两,炒) 半夏(一两,制) 黄连(一两,炒) 黄芩(一两,炒) 米仁(七钱,炒) 花粉(一两,炒) 青礞石(煅,八钱) 薄荷(二两,水洗,焙)
以上为极细末,炼蜜丸如弹子大。夜卧口噙化下。
抑心清肺丸(秘方) 治疗肺热咯血咳嗽,兼治血痢。
黄连(三两) 赤茯苓(三两) 阿胶(二两)
以上二味为极细末,水熬阿胶和丸,如梧桐子大。每服五六十丸,食后米饮送下。盖连、芩有降心火之功,阿胶具保肺金之力,则嗽除血止而病自愈矣。
小金丹(方外异人传) 治疗劳瘵吐痰吐血,发热咳嗽。
哑芙蓉(一钱) 朱砂(三分) 麝香(三分)
以上为细末,外用高良姜四两,切碎,烧酒泡三日,去酒,入水十碗,煎至二三碗,滤去渣,慢火熬成膏,再入乳汁半盏,再熬,入前药为丸,如黄豆大,金箔为衣。每服一丸,先吃梨一片,然后以药丸嚼下,再吃梨一片,痰嗽顿止,发热即退。
神灸法 治疗传尸劳虫。
在癸亥日灸两腰眼,低陷中是穴。每穴灸艾七炷,若灸九炷、十炷尤妙。先隔一日前点穴,才睡至半夜子时,一交癸亥日期,便灸。其虫从大便中出,即用火焚之,弃于江河中。如虫有黑嘴者,则其在内已伤入肾脏矣,此不可治。虫宜谨避,瘵有数虫,如蜈蚣,如小蛇,如虾蟆,如马尾,如烂面,如乱丝,如苍蝇,如壁油虫,上紫下白,形锐足细而有口,或如白蚁,孔窍中皆出。此劳瘵根毒,若传至三人,则如人形,如鬼状。
我看近世阴虚火动的疾病,十个中没有一个是活的,为什么呢?大概是由于色欲和劳役的过错,七情和五味的偏颇,遂致真元逐渐耗损,虚火上炎,劳瘵的疾病发作了。刚开始履霜(比喻病初起)的时候,饮食如旧,起居如常,只是咳嗽一二声,自认为没事,并且讳疾忌医,灭身而无觉悟,等到蔓延日久,倒卧在床上,而坚冰(比喻病重难治)已经到了。实在可悲啊!如果遇到明医,必然用滋阴降火健脾的药物,来培补其根本,缓缓投以几十剂,或许可以稍微救济。如果求医心切,期望效验在旦夕之间,服药没几剂,就说没有功效,急躁火热而阴火更加妄动。有一些医生,见其没有回生之理,就急忙用峻烈药物劫夺正气,以缓解目前的急症,那么将不等一天结束而死期将至了。依我的意思推测,在疾病刚发作时,必须在三件事上谨慎才可以。这三件是什么呢?一要遇到明医,二要肯服药,三要能禁戒,三者缺一就不治了。我恭敬地写在方剂末尾,作为遭遇这种疾病的病人的警戒。
Pulse
The pulse of Xu Lao (Deficiency Consumption) may be floating and large, or wiry and rapid. A large pulse indicates consumption; a wiry pulse also indicates consumption. If the pulse is both large and wiry, it is easy to treat because the Qi and Blood have not yet declined, and can be gathered and restored. If only the wiry pulse is present, it is difficult to treat because the Qi and Blood have already been depleted and are hard to tonify. A double wiry pulse indicates that pathogenic factors invade the Spleen; if accompanied by a rapid pulse, the condition is critical. It is also said: In Gu Zheng Lao Re (Bone-steaming Fever), the pulse is rapid and deficient, the body is hot with a choppy pulse and scanty fluids, leading inevitably to death. If sweating and coughing are added, it cannot be cured by medicine.
Symptoms
The term "Lao" implies severity, hence Lao Zhai (Chronic Consumptive Disease) is considered a difficult-to-treat illness. Although ancient formulas distinguish between Liu Ji (Six Extremes), Liu Sun (Six Damages), Wu Lao (Five Labors), Qi Shang (Seven Injuries), Wu Shi (Five Corpses), Jiu Chong (Nine Worms), Shi Zhu (Ten Taints), and Er Shi Si Zheng (Twenty-four Steams), these conditions generally arise from unrestrained desires in youth, irregular living habits, injuries from the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright) and Six Exogenous Pathogens (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), or improper diet and overexertion. This gradually depletes True Yin (Kidney Yin Essence), causing Xiang Huo (Ministerial Fire) to blaze. Excessive fire consumes True Yin, triggering a steaming dry heat. If fire rushes to the Upper Jiao, fever is accompanied by cough, wheezing, expectoration, hemoptysis, Fei Wei (Lung Atrophy), and Fei Yong (Lung Abscess). If fire knots in the Lower Jiao, fever is accompanied by strangury, turbid urine, constipation, seminal emission, night sweats, palpitations, and abdominal pain. Women may also suffer from amenorrhea. When fire burns for a long time, Qi is inevitably damaged. Damaged Qi fails to transform and transport food and fluids, leading to stagnation, damp-heat generation, worm formation, and accumulation. Deepening worm accumulation leads to unpredictable changes, gnawing at the heart and lungs, eroding the essence of the zang-fu organs, making rescue nearly impossible. Moreover, those in close contact are exposed to this malignant qi over time and often become infected. This is called Chuan Shi (Passing Corpse/Infectious Tuberculosis), referring to the Nine Worms, Ten Taints, and Twenty-four Steams mentioned earlier. If caught early, treatment should be applied; prolonged neglect may lead to unceasing fever, emaciation, and impending collapse of True Qi, at which point it is too late.
Treatment Principles
The method of treatment lies in nourishing Yin and descending fire to clear the source; resolving phlegm, harmonizing blood, eliminating accumulations, and expelling parasites to cleanse the stream. Moxibustion on Gao Huang (BL43) and Cui Shi Si Hua points is invariably effective. In recent times, many use Zi He Che (Placenta Hominis) combined with herbs that tonify the Kidney, clear the Heart, and reduce fever, achieving good results. Physicians must prioritize tonifying deficiency while simultaneously dispelling pathogens.
For all Yin Deficiency syndromes, there is aversion to cold and fever every afternoon, resolving with slight sweating by evening. The pulse is typically deficient, soggy, and rapid, closely resembling Nué (Malaria). However, the Malaria pulse is wiry, whereas the Xu Lao pulse is large; this distinguishes them. Misdiagnosing as Malaria often leads to fatal outcomes.
Formulas
Zi Yin Jiang Huo Tang (Nourish Yin and Descend Fire Decoction)
Wang Jiezhai stated: Excessive sexual activity in men damages Jing and Blood, inevitably leading to Yin Deficiency with Fire Hyperactivity. Symptoms include night sweats during sleep, afternoon fever, heavy/frequent coughing, fatigue, weakness, and poor appetite. Severe cases present with blood-streaked sputum, hemoptysis, epistaxis, body heat, deep rapid pulse, and muscle wasting. This is Lao Zhai, the most severe and difficult to treat. Mild cases require dozens of doses; severe cases may take years. Crucially, the patient must cherish life, strengthen resolve, abstain from sex, cease delusions, avoid anger, and regulate diet to cultivate the root. Otherwise, even good medicine is useless. Early treatment is manageable; once muscles are wasted, bedridden, and pulses are frantic, it is much harder. This formula is best taken early when tidal fever, night sweats, cough, and fatigue first appear to ensure recovery.
* Dang Gui Shen (Radix Angelicae Sinensis Root Section), wine-washed, 1.2 qian
* Chuan Xiong (Rhizoma Chuanxiong), 1 qian
* Bai Shao Yao (Radix Paeoniae Alba), wine-fried, 1 qian
* Sheng Di Huang (Radix Rehmanniae Preparata), wine-washed, 0.5 qian
* Shu Di Huang (Radix Rehmanniae Praeparata), ginger juice-fried, 1 qian
* Tian Men Dong (Herba Asparagi), soaked in water, core removed, 1 qian
* Huang Bo (Cortex Phellodendri), honey-roasted, 0.7 qian
* Zhi Mu (Rhizoma Anemarrhenae), honey-roasted, 1 qian
* Chen Pi (Pericarpium Citri Reticulatae), 0.7 qian
* Bai Zhu (Rhizoma Atractylodis Macrocephalae), 1.3 qian
* Gan Jiang (Rhizoma Zingiberis Recens), charred, 0.3 qian
* Gan Cao (Radix Glycyrrhizae), roasted, 0.5 qian
Alternative: Remove Gan Jiang, add Xuan Shen (Radix Scrophulariae), Bei Mu (Bulbus Fritillariae Cirrhosae), Mai Men Dong (Rhizoma Ophiopogonis), and Wu Wei Zi (Fructus Schisandrae) for excellent effect.
Decoct one dose with fresh ginger. Take with Zhu Li (Nodus Bambusae in Taenia), Tong Bian (Uterine Urine), and Jiang Zhi (Zingiberis Juice). For severe cough, add Zi Wan (Herba Asteris Tatarici), Kuan Dong Hua (Flos Farfarae), Wu Wei Zi, and Xing Ren (Semen Pruni Armeniacae). For wheezing, add Sang Bai Pi (Cortex Mori Radicis). For profuse phlegm, add Zhi Ban Xia (Rhizoma Pinelliae Preparata), Bei Mu, Gua Lou Ren (Semen Benincasae), and Bai Fu Ling (Poria). For severe tidal fever, add Chai Hu (Radix Bupleuri), Zhi Mu, and Di Gu Pi (Cortex Lycii Radicis). For profuse night sweats, add Suan Zao Ren (Semen Ziziphi Spinosae), Mu Li (Concha Ostreae), and Fu Xiao Mai (Frumentum Levigatum). For seminal emission/dream slipping, add Long Gu (Os Draconis), Mu Li, and Shan Zhu Yu (Fructus Corni). For red/white turbid urine, add Bai Fu Ling and Huang Lian (Radix Coptidis). For epistaxis/hemoptysis (from Lung), add Sang Bai Pi, Huang Qin (Radix Scutellariae), and Shan Zhi Zi (Fructus Gardeniae). For coughing blood/sputum blood (from Spleen), add Sang Bai Pi, Bei Mu, Huang Lian, and Gua Lou Ren. For vomiting blood (from Stomach), add Shan Zhi Zi, Huang Lian, Gan Jiang, Pu Huang (Pollinis Typhae), Jiu Zhi (Junci Medulla Juice), and Jiang Zhi. For spitting blood (from Kidney), add Jie Geng (Radix Platycodonis), Xuan Shen, and Ce Bai Ye (Cacumen Platycladi).
This syndrome belongs to Fire; stools are often dry. Restraint and care are essential to prevent diarrhea. If the Spleen and Stomach fail, cold-natured herbs above become unusable. In such cases, immediately administer Li Pi Gu Ben Jian Wei agents.
Li Pi Gu Ben Tang (Regulate Spleen and Solidify Root Decoction)
* Bai Zhu (Rhizoma Atractylodis Macrocephalae), fried, 1 qian
* Bai Fu Ling (Poria), 1 qian
* Chen Pi (Pericarpium Citri Reticulatae), 0.8 qian
* Ban Xia (Rhizoma Pinelliae Preparata), processed, 0.8 qian
* Shen Qu (Massa Medicata Fermentata), fried, 1 qian
* Mai Ya (Frumentum Germinatum), fried, 1 qian
* Gan Cao (Radix Glycyrrhizae), roasted, 0.7 qian
Decoct one dose with ginger and jujube. Once Spleen/Stomach Qi is solidified, proceed with the main disease formula.
Qing Li Zi Kan Tang (Clear Li and Nourish Kan Decoction, formulated by Yun Lin) [Note: Treats Yin Deficiency with Ministerial Fire Hyperactivity in Lao Zhai]
Treats Yin-Blood deficiency, Ministerial Fire hyperactivity, night sweats, tidal fever, cough with phlegm, and all deficiency consumptions.
* Sheng Di Huang (Radix Rehmanniae Preparata), 2 qian
* Shu Di Huang (Radix Rehmanniae Praeparata), 2 qian
* Tian Men Dong (Herba Asparagi), 1 qian
* Mai Men Dong (Rhizoma Ophiopogonis), 1 qian
* Dang Gui (Radix Angelicae Sinensis), wine-washed, 1 qian
* Bai Shao (Radix Paeoniae Alba), wine-fried, 1 qian
* Shan Zhu Yu (Fructus Corni), wine-steamed, pitted, 1.5 qian
* Gan Shan Yao (Rhizoma Dioscoreae), 1 qian
* Bai Fu Ling (Poria), 0.8 qian
* Bai Zhu (Rhizoma Atractylodis Macrocephalae), earth-fried, 1 qian
* Mu Dan Pi (Cortex Moutan), 1.2 qian
* Ze Xie (Rhizoma Alismatis), 0.8 qian
* Huang Bo (Cortex Phellodendri), honey-fried, 0.8 qian
* Zhi Mu (Rhizoma Anemarrhenae), honey-fried, 0.8 qian
* Gan Cao (Radix Glycyrrhizae), roasted, 0.7 qian
Decoct one dose in water. For severe cough, add Zi Wan and Kuan Dong Hua. For profuse phlegm, add Bei Mu and Gua Lou Ren. For severe heat, add Di Gu Pi. For palpitations, add Yuan Zhi (Radix Polygalae) and Suan Zao Ren. For hematemesis, add Shan Zhi Zi and Mao Hua (Flores Imperatae). For epistaxis, add Sang Bai Pi and Jiu Zhi.
Dong Shi Liang Xu Xie Nan Bu Bei Tang (Tonify North and Purge South Decoction for East Excess and Two Deficiencies)
Treats excessive alcohol/sex, reckless depletion of True Yin, Yin Deficiency with Fire Hyperactivity, excessive phlegm due to fire, fever, cough, hemoptysis, and spitting blood.
* Huang Lian (Radix Coptidis), light ginger juice-fried, 4 liang. Purges Southern Fire, relieves epigastric fullness, key for stopping vomiting.
* Huang Bo (Cortex Phellodendri), salt water-fried, 6 liang. Tonifies Northern Water, clears heat to aid Yin, key for suppressing various fires.
* Ku Qin (Radix Scutellariae), raw, 2 liang. Clears Lung and nourishes source.
* Zhi Mu (Rhizoma Anemarrhenae), hairs removed, 3 liang. Descends Ministerial Fire at Right Chi, key for bone-steaming fever.
* Bei Mu (Bulbus Fritillariae Cirrhosae), core removed, 4 liang, soaked overnight in Gua Lou Ren decoction. Clears Western Metal, resolves phlegm and vexation.
* Jie Geng (Radix Platycodonis), 2 liang. Guides herbs to Western Lung Metal, assisting child to support mother's deficiency.
* Xing Ren (Semen Pruni Armeniacae), skin/pits removed, 3.5 liang. Converges scattered Metal, descends Qi and generates fluids.
* Wu Wei Zi (Fructus Schisandrae), salt water-fried, 3 liang. Nourishes insufficient Shaoyin Water, gathers scattered Taiyin Metal.
* Zi Wan (Herba Asteris Tatarici), soil removed, 2.5 liang, soaked/dried in Chenxiang decoction. Greatly descends Qi and stops cough.
* Dang Gui (Radix Angelicae Sinensis), Tong Bian-soaked, 2 liang. Holy herb for tonifying and harmonizing blood.
* Chi Shao Yao (Radix Paeoniae Rubra), raw, 2.5 liang. Levels excess Wood in East, stabilizes deficient Earth in Center.
* Sheng Di Huang (Radix Rehmanniae Preparata), wine-washed, 3 liang. Cools blood, generates blood, clears latent fire in Ying.
* Tian Men Dong (Herba Asparagi), soaked/core removed, 4 liang. Moistens Lung, clears blood in phlegm, stops hemoptysis, clears mixed blood in meridians.
* Tian Hua Fen (Radix Trichosanthis), 2 liang. Stops thirst, generates fluids.
* Bai Zhu (Rhizoma Atractylodis Macrocephalae), bran-fried, 1.5 liang. Benefits Spleen Earth to generate Lung Metal.
* Bai Fu Ling (Poria), 2 liang. Drains fire from meridians via urination.
Decoct together. Take 8 qian per dose with one Wumei (Fructus Mume) and 0.3 qian Deng Xin Cao (Medulla Junci). Warm. For severe hematemesis/epistaxis, add Qian Gen (Radix Rubiae), Da/Xiao Ji (Herba Hieraciae), Ou Jie (Node Nelumbinis), Bai Mao Gen (Rhizoma Imperatae), Ce Bai Ye, and Jing Mo (Chinese Ink). For profuse phlegm, add Ban Xia, Qian Hu (Radix Peucedani), Zhu Li, and Jing Li (Calami Juice). For wheezing, add Gua Lou Ren, Shi Gao (Gypsum Fibrosum), Ting Li (Semen Lepidii), Sang Bai Pi, Zi Su Zi (Fructus Perillae), Chen Xiang (Aquilaria Resin), and Pi Pa Ye (Folium Eriobotryae). For severe heat, add Chai Hu, Di Gu Pi, Lian Qiao (Fructus Forsythiae), and Yin Chai Hu (Radix Stemonae). For wind excess, add Fang Feng (Radix Saposhnikoviae), Jing Jie Sui (Herba Schizonepetae), Suan Zao Ren, Bo He (Herba Menthae), Gan Ju Hua (Flos Chrysanthemi), and Xuan Fu Hua (Capitulum Inulae). For cold excess, add Ren Shen (Radix Ginseng), Huang Qi (Radix Astragali), and Gui Zhi (Ramulus Cinnamomi). For palpitations/fright, add Fu Shen (Poria cum Radice), Yuan Zhi, Bai Zi Ren (Semen Platycladi), and Suan Zao Ren. For distension in hypochondrium, add Zhi Ke (Fructus Aurantii), Qing Pi (Exocarpium Citri Reticulatae Viride), and Bai Jie Zi (Semen Sinapis). For strangury/turbidity, add Zhu Ling (Polyporus), Ze Xie, Mu Tong (Caulis Akebiae), and Che Qian Zi (Semen Plantaginis). For astringent urination, add Mu Tong, Shi Wei (Folium Pyrrosiae), Hua Shi (Talcum), and Hai Jin Sha (Spora Lygodii). For seminal emission, add Mu Li and Lian Zi Rou (Semen Nelumbinis). For night sweats, add Huang Qi, Mu Li, Huang Ma Gen (Radix Ephedrae), and Fu Xiao Mai. For dry heat, add Hua Shi, Shi Gao, Huo Ma Ren (Semen Cannabis), and Shan Zhi Zi.
San He Tang (Harmony Three Decoction, formulated by Yun Lin)
Treats cough with profuse phlegm, tidal fever, and Yin deficiency.
* Dang Gui (Radix Angelicae Sinensis), 1.5 qian
* Chuan Xiong (Rhizoma Chuanxiong), 0.5 qian
* Bai Shao Yao (Radix Paeoniae Alba), 1 qian
* Shu Di Huang (Radix Rehmanniae Praeparata), 2 qian
* Chen Pi (Pericarpium Citri Reticulatae), 0.8 qian
* Zhi Ban Xia (Rhizoma Pinelliae Preparata), 0.8 qian
* Fu Ling (Poria), 1 qian
* Huang Lian (Radix Coptidis), ginger juice-fried, 1 qian
* Ku Qin (Radix Scutellariae), 0.8 qian
* Huang Bo (Cortex Phellodendri), fried, 0.8 qian
* Shan Zhi Zi (Fructus Gardeniae), fried, 0.8 qian
* Zhi Ke (Fructus Aurantii), 0.8 qian
* Jie Geng (Radix Platycodonis)
* Xing Ren (Semen Pruni Armeniacae), skin/pits removed
* Sang Bai Pi (Cortex Mori Radicis)
* Wu Wei Zi (Fructus Schisandrae), stems removed
* Zhi Mu (Rhizoma Anemarrhenae), hairs removed
* Bei Mu (Bulbus Fritillariae Cirrhosae), core removed
* Xuan Shen (Radix Scrophulariae)
* Bai Zhu (Rhizoma Atractylodis Macrocephalae), earth-fried
* E Jiao (Colla Corii Asini), prepared with蛤粉 (Arcae Concha) or flour beads
* Ma Dou Ling (Fructus Aristolochiae)
* Gan Cao (Radix Glycyrrhizae) (All in equal parts)
Decoct one dose with 3 slices of fresh ginger and 2 bowls of water until reduced to 0.8 bowl. Take on an empty stomach.
Qing Fei Zi Yin San (Clear Lung and Nourish Yin Powder, passed down by Du Ci Quan) [Note: Treats Lao Zhai with Yin Deficiency and Excess Heat]
Treats excessive alcohol/sex damaging True Yin, Yin Fire rising, insulting Lung Metal, causing thick turbid sputum, cough, and throat sores.
* Chuan Xiong (Rhizoma Chuanxiong), wine-washed, 1 qian
* Bai Shao (Radix Paeoniae Alba), fried, 1.5 qian
* Sheng Di Huang (Radix Rehmanniae Preparata), 2 qian
* Bai Zhu (Rhizoma Atractylodis Macrocephalae), fried, 1 qian
* Chen Pi (Pericarpium Citri Reticulatae), 1 qian
* Bai Fu Ling (Poria), 0.8 qian
* Huang Bo (Cortex Phellodendri), honey-fried, 1 qian
* Zhi Mu (Rhizoma Anemarrhenae), 1 qian
* Bei Mu (Bulbus Fritillariae Cirrhosae), core removed, 1 qian
* Zi Wan (Herba Asteris Tatarici), 0.8 qian
* Wu Wei Zi (Fructus Schisandrae), 0.6 qian
* Kuan Dong Hua (Flos Farfarae), 0.8 qian
* Mai Men Dong (Rhizoma Ophiopogonis), 1 qian
* Di Gu Pi (Cortex Lycii Radicis), 1 qian
* Huang Lian (Radix Coptidis), fried, 0.5 qian
* Yuan Zhi (Radix Polygalae), soaked in Gan Cao decoction, 0.8 qian
* Suan Zao Ren (Semen Ziziphi Spinosae), fried, 0.6 qian
* Gan Cao (Radix Glycyrrhizae), 0.4 qian
Decoct one dose with 1 slice of fresh ginger and 3 spoons of Zhu Li. For palpitations/insomnia, add Ren Shen 0.8 qian. For restlessness/vexation, add Zhi Shi (Fructus Aurantii Immaturus) 0.6 qian and Zhu Ru (Caulis Bambusae in Taenia) 0.6 qian. For copious phlegm-saliva, add Gua Lou Ren 0.6 qian and Tian Hua Fen 1 qian. For throat sores, use Tong Yi San (see Throat Chapter) insufflated.
Kan Li Gao (Kan-Li Paste, passed down by Huang Binjiang)
Treats Lao Zhai with Yin Deficiency fever, coughing/spitting blood.
* Chuan Huang Bo (Cortex Phellodendri), 4 liang
* Zhi Mu (Rhizoma Anemarrhenae), hairs removed, 4 liang
* Sheng Di Huang (Radix Rehmanniae Preparata), 2 liang
* Shu Di Huang (Radix Rehmanniae Praeparata), 2 liang
* Tian Dong (Herba Asparagi), core removed, 2 liang
* Mai Dong (Rhizoma Ophiopogonis), core removed, 2 liang
* Xing Ren (Semen Pruni Armeniacae), skin removed, 7 qian
* Hu Tao Rou (Semen Juglandis), skin removed, 4 liang
* Bai Mi (Mellis), 4 liang
First, decoct Huang Bo, Zhi Mu, 3 bowls Tong Bian, 3 bowls water, and a handful of Ce Bai Ye in 6 bowls total until reduced to 3 bowls. Strain. Add Tian Dong, Mai Dong, Sheng Di, Shu Di. Add 2 more bowls water, boil hundreds of times. Filter juice and set aside. Pound the dregs into paste. Decoct paste in 2 bowls water until half evaporated. Mix with previous juice. Grind Xing Ren, Hu Tao Ren with water, filter twice without mixing dregs. Combine with honey and previous juice. Simmer slowly into paste. Dip in water to remove fire toxicity. Take 3-5 spoons with Ce Bai Ye decoction on empty stomach. Avoid copper/iron vessels.
Ning Sou Gao (Calm Cough Paste, from Capital)
Treats Yin Deficiency cough, Fire Hyperactivity hemoptysis; astringes Lung.
* Tian Dong (Herba Asparagi), core removed, 0.5 jin
* Xing Ren (Semen Pruni Armeniacae), skin removed, 4 liang
* Bei Mu (Bulbus Fritillariae Cirrhosae), core removed, 4 liang
* Bai Bu (Radix Stemonae), 4 liang
* Bai He (Bulbus Lilii), 4 liang
* Kuan Dong Hua (Flos Farfarae), 5 liang
* Zi Wan (Herba Asteris Tatarici), 3 liang
* Bai Zhu (Rhizoma Atractylodis Macrocephalae), 4 liang
Chop. Decoct in 20 bowls running water until 5 bowls remain. Strain and decoct again. Repeat three times to get 15 bowls juice. Add 0.5 jin Yi Tang (Maltose) and 1 jin Honey. Simmer. Add 4 liang E Jiao and 4 liang fine Bai Fu Ling powder. Mix into paste. Take 3-5 spoons.
Xuan Shuang Xi Ni Gao (Black Frost Xi Ni Paste, Secret Recipe)
Generates fluids, stops thirst, removes hemoptysis/hematemesis, treats Heart Fire from Labor, chronic cough, resolves phlegm, stops cough, clears blood to return to vessels.
* Xi Ni (Fructus Canarii), 60 pcs, core/skin removed, juice 30 zhong (sour ones excluded)
* Ou Zhi (Succus Nelumbinis Rhizomatis), 10 zhong
* Fresh Sheng Di Huang (Radix Rehmanniae Preparata), juice 10 zhong
* Mai Men Dong (Rhizoma Ophiopogonis), mashed/decocted juice 5 zhong
* Luo Bo Zhi (Succus Raphani), 5 zhong
* Mao Gen Zhi (Succus Imperatae), 10 zhong
Filter six juices thoroughly. Re-decoct clear juice. Add 1 jin Honey, 0.5 jin Yi Tang, 0.5 jin Shi Shuang (Persimmon Frost), 1 cup Jiang Zhi. Simmer to thin paste consistency. If bleeding/cough persists, add Ce Bai Ye juice 1 zhong, Jiu Bai Zhi (Succus Allii Fistulosi) 0.5 zhong, Qian Gen Zhi (Succus Rubiae) 0.5 zhong. Strain, mix, decoct into paste.
Qing Huo Yong Zhen Gao (Clear Fire Eternal Truth Paste, from Capital)
* Sheng Di Huang (Radix Rehmanniae Preparata), 4 jin, mashed juice
* Tian Men Dong (Herba Asparagi), 6 liang
* Kuan Dong Hua Rong (Flos Farfarae buds), 6 liang
Decoct Tian Dong, Kuan Dong in water. Take dregs, pound, decoct again. Add Di Huang juice, simmer to thick. Add 1 jin Honey, simmer. Separate decoct 1 liang Wu Wei Zi to 0.5 zhong juice, add to paste, simmer until sticky/thick. Use 1-2 times daily.
Qin Hua Dan (Hold-and-Dissolve Pill, Secret Recipe) [Note: Symptomatic treatment for Labor Cough]
Treats Yin Deficiency Labor Cough.
* Tian Men Dong (Herba Asparagi), 1 liang, wine-steamed, tile-baked
* Mai Men Dong (Rhizoma Ophiopogonis), 1 liang, wine-steamed, tile-baked
* Sheng Di (Radix Rehmanniae Preparata), 1.5 liang
* Shu Di (Radix Rehmanniae Praeparata), 1.5 liang
* Zhi Mu (Rhizoma Anemarrhenae), 1 liang, wine-fried
* Bei Mu (Bulbus Fritillariae Cirrhosae), 1 liang, fried
* Xing Ren (Semen Pruni Armeniacae), 1 liang, fried
* Zi Wan (Herba Asteris Tatarici), 1 liang, fried
* Kuan Dong Hua (Flos Farfarae), 2 liang, washed, dried
* E Jiao (Colla Corii Asini), 8 qian, prepared with蛤粉 beads
* Dang Gui (Radix Angelicae Sinensis), 1 liang, wine-washed, dried
* Zhi Shi (Fructus Aurantii Immaturus), 1 liang, fried
* Jie Geng (Radix Platycodonis), 1 liang, fried
* Ban Xia (Rhizoma Pinelliae Preparata), 1 liang, processed
* Huang Lian (Radix Coptidis), 1 liang, fried
* Huang Qin (Radix Scutellariae), 1 liang, fried
* Mi Yi Ren (Semen Coicis), 7 qian, fried
* Hua Fen (Radix Trichosanthis), 1 liang, fried
* Qing Meng Shi (Lapis Glaucophanitus), calcined, 8 qian
* Bo He (Herba Menthae), 2 liang, washed, dried
Grind to fine powder. Make pills with refined honey, size of bullet. Hold in mouth at night to dissolve.
Yi Xin Qing Fei Wan (Suppress Heart Clear Lung Pill, Secret Recipe)
Treats Lung Heat hemoptysis/cough, also bloody dysentery.
* Huang Lian (Radix Coptidis), 3 liang
* Chi Fu Ling (Poria), 3 liang
* E Jiao (Colla Corii Asini), 2 liang
Grind first two ingredients to fine powder. Decoct E Jiao in water to form pills, size of Sophora seeds. Take 50-60 pills after meals with rice drink. Huang Lian/Qin descend Heart Fire; E Jiao protects Lung Metal. Cough stops, bleeding ceases, disease heals.
Xiao Jin Dan (Little Golden Pill, passed down by Outsider)
Treats Lao Zhai with phlegm/blood vomiting, fever, cough.
* Ya Fu Rong (Corolla Datura Metel), 1 qian
* Zhu Sha (Cinnabaris), 0.3 qian
* She Xiang (Moschus), 0.3 qian
Grind to fine powder. Separately, chop 4 liang Gao Liang Jiang (Rhizoma Alpiniae Officinarum), soak in liquor for 3 days. Discard liquor. Add 10 bowls water, decoct to 2-3 bowls. Strain. Simmer slowly to paste. Add 0.5 cup Milk. Simmer. Mix in powder. Form pills, size of soybean. Coat with Gold Leaf. Take 1 pill. Eat 1 slice pear, chew pill, eat 1 slice pear. Cough/phlegm stops instantly, fever recedes.
Shen Jiu Fa (Divine Moxibustion Method)
Treats Chuan Shi Lao Chong (Infectious Labor Worms).
On Gui Hai day, moxa both Yao Yan (Waist Eyes), located in depressions. Moxa 7 cones per point; 9 or 10 cones is better. Mark point one day prior. Sleep until midnight Zi hour. On Gui Hai day, perform moxa. Worms exit via stool; burn and discard in river. If worm has black mouth, it has entered Kidney; incurable. Avoid worms. Lao Zhai worms resemble centipedes, small snakes, toads, horse tails, rotten noodles, tangled silk, flies, wall oil insects (purple top, white bottom, sharp shape, thin legs, mouth), or termites exiting holes. These are root toxins of Lao Zhai. If transmitted to three people, they take human/demon forms.
I observe that nearly all modern cases of Yin Deficiency Fire Hyperactivity are fatal. Why? Due to excesses in sex/labor, imbalance of Seven Emotions/Five Flavors, leading to gradual depletion of True Yuan, rising deficient fire, and onset of Lao Zhai. Initially (like first frost), diet/sleep are normal, only slight cough; patients ignore illness, fear doctors, and die unaware. By the time bedridden, ice has formed (condition critical). Pitiable! If seen by a wise physician, use Yin-nourishing, fire-descending, Spleen-tonifying herbs to cultivate root, administering dozens of doses slowly for relief. Impatient patients expecting instant cure stop after few doses, claiming failure, agitating fire further. Some physicians, seeing no hope, use harsh drugs to relieve acute symptoms temporarily, hastening death. My advice: At onset, attend to three matters: 1. Find wise physician, 2. Willingness to take medicine, 3. Ability to abstain/restrict. Missing one means untreatable. I write this at the end of formulas as a warning for sufferers.