治骨蒸。
人参 黄芩 知母 地黄 葛根 石膏 粳米 麦冬 甘草
浮小麦一撮，水煎。
二十四种蒸病用药法。以下方法，俱从五蒸汤见症加减。
所谓劳蒸者，毛折发焦，肌肤甲错，其蒸在皮。又症舌白唾血。加石膏、桑白皮。
外热内寒，身振肉 ，其蒸在肉。又症食无味而呕，烦躁不安。加芍药。
发焦，鼻衄，或复尿血，其蒸在血。加生地、当归、童子小便。
身热烦躁，痛如针刺，其蒸在脉。又症唾白，浪语，脉络乱，缓急不调。加生地、当
归、童便。（痛如针刺，血滞而散，不能融活故也。）
爪甲焦枯，眼黑胁痛，其蒸在髓。又症髓沸骨中热。加天门冬、当归、生地。
头眩，热闷，涎浊，眵泪，其蒸在脑，加生地、防风。
男子失精，女子白淫，其蒸在玉房。加知母、黄柏、当归、芍药。
乍寒乍热，中脘烦闷，其蒸在三焦，加竹叶、石膏。
小便赤黄，凝浊如胶，其蒸在膀胱。又症右耳焦。加泽泻、滑石。
大便秘泄，腹中雷鸣，其蒸在小腹。又症下唇焦。加赤茯苓、木通、生地。
大腹阴痛，口舌干疼，其蒸在大肠。又症右鼻孔干痛。加大黄、芒硝。
口鼻干燥，腹胀自汗，睡卧不安，其蒸在胃。又症舌下痛。加石膏、粳米、大黄、芒硝、干葛。
口苦耳聋，两胁下痛，其蒸在胆。又症眼色白。加柴胡、栝蒌。
里急后重，肛门闭涩，其蒸在广肠。加（缺）
小腹 痛，筋脉纵缓，阴器自强，其蒸在宗筋。加（缺）
眩晕下泪，躁怒不常，其蒸在肝。又症眼黑。加川芎、当归、前胡。
舌黑气短，烦闷洒淅，其蒸在心。又症舌干。加黄连、生地、当归。
唇干口疮，胸腹胀满，畏寒不食，其蒸在脾。加芍药、木瓜、苦参。
咳嗽喘满，咯痰吐血，声嘶音哑，其蒸在肺。又症鼻干，加天冬，桔梗、紫菀、乌梅肉。
耳叶焦枯，香港脚酸痛，其蒸在肾。加生姜、石膏、知母、寒水石、 本。
情想不宁，精物时下，其蒸在右肾。加（缺）
心膈噎塞，攻击疼痛，俯仰烦冤，其蒸在膈。加（缺。）
上气喘促，鼻干，身热不安，其蒸在气。加人参、黄芩、栀子。
以上共二十三种加减，系立斋先生引《医林集》。
胞蒸，小便赤。用泽泻、茯苓、生地、沉香、滑石。
膀胱蒸，右耳焦。用泽泻、滑石。
骨蒸，齿黑腹痛，足胫瘦。用鳖甲、地骨皮、丹皮、当归、生地。
臀蒸，腿细，肢肿，腑脏俱热。用石膏、滑石。
肤蒸，肌肉热。用牡丹皮。实热。加黄芩、黄连、黄柏、大黄。虚热，加乌梅、柴胡、蛤蚧、青蒿、鳖甲、丹皮。
以上出《体仁汇编》。
薛立斋云∶凡此诸症，虚劳热病，皆由食肉与油腻、房劳、饮酒而成者，久蒸不除，变
为疳症，即死。亦有疟久不愈，以致咳嗽失治，渐成骨蒸劳瘵，当推标本而治之。
按∶薛立斋云∶蒸病二十四种，止简得二十三种。《体仁汇编》言蒸病亦二十三种，且蒸病
各异，各蒸下注，或有或无。可见病之险难，人罕传师，所以阙漏无凭，前后不一，俟博观
者补之。
海藏云∶以上诸蒸，或脏病，或腑病，或腑脏俱病，脉络气血，交经相属，用药皆当合
而用之。君臣佐使，上下奇偶，表里虚实，逆从通塞，汗下补吐，咸在其中。
凡蒸病不已，骨节间阴有干血，用行血丸。（凡血实能令肌肉实肿，血虚亦能令腠理膜
络虚肿。肿则升降开合失常不能循环接济，而遗溺滑精诸证先见，久则枯萎挛缩幻证迭出，故治
虚
中，缓中者内膜筋舒，气活而无胀急也，静参大黄 虫丸当有悟入。）
治疗骨蒸（一种以午后或夜间发热、热自骨髓向外透发为特征的虚劳病证）。
人参 黄芩 知母 地黄 葛根 石膏 粳米 麦冬 甘草
取浮小麦一撮，加水煎煮服用。
二十四种蒸病（指因五邪久留体内化热，导致身体内部发热如蒸的病症）的用药法则。以下方法，均根据五蒸汤（治疗五种蒸病的方剂）所见的症状进行加减。
所谓劳蒸（由劳损引起的蒸热），表现为毛发枯折、头发焦黄、肌肤干燥粗糙如鳞甲交错，这种蒸热在皮肤。又见舌苔白、唾血症状。加入石膏、桑白皮。
外感热象而内里寒凉，身体震颤、肌肉跳动，这种蒸热在肌肉。又见饮食无味且呕吐、烦躁不安的症状。加入芍药。
头发焦黄、鼻出血，或者再次出现尿血，这种蒸热在血液。加入生地黄、当归、童便（健康男童的小便）。
身体发热烦躁，疼痛如同针刺，这种蒸热在血脉。又见唾出白色泡沫、胡言乱语、脉络紊乱、脉象缓急不调的症状。加入生地黄、当归、童便。（疼痛如针刺，是因为血行瘀滞而散漫，不能融汇流通的缘故。）
指甲焦枯、眼睛发黑、胁肋疼痛，这种蒸热在骨髓。又见骨髓沸腾、骨头中发热的症状。加入天门冬、当归、生地黄。
头晕目眩、头热闷胀、唾液浑浊、眼屎多流泪，这种蒸热在脑髓。加入生地黄、防风。
男子遗精、女子白带过多（白淫），这种蒸热在生殖器部位（玉房）。加入知母、黄柏、当归、芍药。
忽冷忽热、胃脘部烦闷，这种蒸热在三焦（人体上、中、下三个部位的气机通道）。加入竹叶、石膏。
小便颜色赤黄、浑浊如胶冻状，这种蒸热在膀胱。又见右耳廓焦枯的症状。加入泽泻、滑石。
大便时而干结时而泄泻、腹中肠鸣如雷，这种蒸热在小腹。又见下唇焦枯的症状。加入赤茯苓、木通、生地黄。
大腹部及阴部疼痛、口舌干燥疼痛，这种蒸热在大肠。又见右鼻孔干燥疼痛的症状。加入大黄、芒硝。
口鼻干燥、腹胀、自汗、睡眠不安稳，这种蒸热在胃。又见舌下疼痛的症状。加入石膏、粳米、大黄、芒硝、干葛（即葛根）。
口苦、耳聋、两胁下疼痛，这种蒸热在胆。又见眼色发白的症状。加入柴胡、栝蒌。
里急后重（想排便但排不出或排不尽的感觉）、肛门闭塞涩痛，这种蒸热在广肠（直肠下部）。加入（原文缺失药物名）
小腹部疼痛、筋脉松弛无力、阴茎异常勃起（阴器自强），这种蒸热在宗筋（前阴部位）。加入（原文缺失药物名）
眩晕、流泪不止、急躁易怒、情绪无常，这种蒸热在肝。又见眼睛发黑的症状。加入川芎、当归、前胡。
舌色发黑、气短、烦闷怕冷（洒淅），这种蒸热在心。又见舌面干燥的症状。加入黄连、生地黄、当归。
嘴唇干燥、口舌生疮、胸腹胀满、畏寒不想进食，这种蒸热在脾。加入芍药、木瓜、苦参。
咳嗽气喘、胸部胀满、咳痰吐血、声音嘶哑失音，这种蒸热在肺。又见鼻子干燥的症状，加入天冬、桔梗、紫菀、乌梅肉。
耳廓焦枯、脚气酸痛，这种蒸热在肾。加入生姜、石膏、知母、寒水石、藁本。
思虑不宁、精液不时滑出，这种蒸热在右肾。加入（原文缺失药物名）
心膈部噎塞不通、攻冲作痛、俯仰之间感到烦冤痛苦，这种蒸热在膈膜。加入（原文缺失药物名）
上气喘促、鼻子干燥、身体发热不安，这种蒸热在气分。加入人参、黄芩、栀子。
以上共计二十三种加减法，系立斋先生（薛己）引用《医林集》的内容。
胞蒸（此处指胞宫或相关部位的蒸热），小便赤红。使用泽泻、茯苓、生地黄、沉香、滑石。
骨蒸，牙齿发黑、腹痛、小腿消瘦。使用鳖甲、地骨皮、丹皮、当归、生地黄。
肤蒸，肌肉发热。使用牡丹皮。若是实热，加入黄芩、黄连、黄柏、大黄。若是虚热，加入乌梅、柴胡、蛤蚧、青蒿、鳖甲、丹皮。
以上内容出自《体仁汇编》。
薛立斋说：凡是这些症状，虚劳热病，都是由吃肉与油腻食物、房事过度、饮酒等原因造成的。长期蒸热不除，会转变为疳症（一种小儿慢性消耗性疾病，此处泛指严重虚损），最终致死。也有因为疟疾久治不愈，导致咳嗽失治，逐渐形成骨蒸劳瘵（肺结核等慢性消耗性疾病的统称），应当推究病因标本进行治疗。
按语：薛立斋说：蒸病有二十四种，这里只简要列出了二十三种。《体仁汇编》中说蒸病也是二十三种，而且各种蒸病各不相同，每种蒸病下的注释，有的有内容，有的缺失。可见病情险恶难治，医生很少传授师承，所以存在缺漏没有依据，前后内容不一致，等待博学的人来补充。
海藏（张元素）说：以上各种蒸病，或者是脏病，或者是腑病，或者是脏腑同时患病，脉络气血，相互贯通关联，用药都应当综合使用。君臣佐使的配伍原则，上下、奇偶的配合，表里、虚实的辨别，逆从、通塞的处理，汗法、下法、补法、吐法，都包含在其中。
凡是蒸病经久不愈，骨节之间有阴分的干血（陈旧性瘀血），使用行血丸。（凡是血实证能使肌肉坚实肿胀，血虚证也能使腠理膜络虚肿。肿胀则升降开合功能失常，不能循环接济，于是遗尿、滑精等症状先出现，时间久了则枯萎挛缩、幻证迭出，所以治疗虚证中，缓和其中的急迫，使内膜筋舒展，气机通畅而没有胀急之感，静参大黄䗪虫丸的道理应当由此领悟。）
Treat Gu Zheng (Bone-steaming, a type of consumptive disease characterized by fever emanating from the bone marrow).
Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Dihuang (Rehmanniae Radix), Gegen (Puerariae Lobatae Radix), Shigao (Gypsum Fibrosum), Jingsmi (Oryzae Semen), Maidong (Ophiopogonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Take a handful of Fuxiaomai (Tritici Levis Fructus), decoct in water and take.
Medication methods for twenty-four types of Zheng diseases (conditions where internal heat feels like steaming due to lingering pathogens). The following methods are all modified based on the symptoms seen in Wu Zheng Tang (Decoction for Five Steams).
The so-called Lao Zheng (Steaming caused by overwork/consumption) presents with brittle hair, scorched hair, and skin rough and scaly like fish scales; this steaming is in the skin. Additionally, there are symptoms of white tongue coating and spitting blood. Add Shigao (Gypsum Fibrosum) and Sangbaipi (Morus Cortex).
External heat with internal cold, body tremors, and muscle twitching; this steaming is in the muscle. Additionally, there are symptoms of loss of taste, vomiting, and restlessness. Add Shaoyao (Paeoniae Radix).
Scorched hair, epistaxis (nosebleed), or recurrent hematuria (blood in urine); this steaming is in the blood. Add Shengdihuang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix), and Tongzi Xiaobian (Urine of healthy young boys).
Body heat and restlessness, pain like needle pricks; this steaming is in the vessels. Additionally, there are symptoms of spitting white foam, delirious speech, chaotic pulse qualities, and irregular pulse rhythm. Add Shengdihuang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix), and Tongzi Xiaobian (Urine of healthy young boys). (Pain like needle pricks occurs because blood stasis is scattered and cannot flow smoothly.)
Brittle nails, dark eyes, and hypochondriac pain; this steaming is in the marrow. Additionally, there are symptoms of boiling marrow and heat within the bones. Add Tiantongdong (Asparagi Radix), Danggui (Angelicae Sinensis Radix), and Shengdihuang (Rehmanniae Radix Preparata).
Dizziness, head heat and stuffiness, turbid saliva, excessive eye discharge and tearing; this steaming is in the brain. Add Shengdihuang (Rehmanniae Radix Preparata) and Fangfeng (Saposhnikoviae Radix).
Seminal emission in men, leukorrhea (white vaginal discharge) in women; this steaming is in the genital organs (Yu Fang). Add Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Danggui (Angelicae Sinensis Radix), and Shaoyao (Paeoniae Radix).
Alternating chills and fever, epigastric fullness and oppression; this steaming is in the San Jiao (Triple Burner). Add Zhuye (Bambusae Folium) and Shigao (Gypsum Fibrosum).
Red and yellow urine, turbid like glue; this steaming is in the Bladder. Additionally, there is a symptom of a scorched right ear. Add Zexie (Alismatis Rhizoma) and Huashi (Talcum).
Constipation alternating with diarrhea, borborygmus (rumbling in the abdomen); this steaming is in the lower abdomen. Additionally, there is a symptom of a scorched lower lip. Add Chi Fuling (Polyporus), Mutong (Akebiae Caulis), and Shengdihuang (Rehmanniae Radix Preparata).
Pain in the great abdomen and yin region, dry and painful mouth and tongue; this steaming is in the Large Intestine. Additionally, there is a symptom of dry and painful right nostril. Add Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas).
Dry mouth and nose, abdominal distension, spontaneous sweating, restless sleep; this steaming is in the Stomach. Additionally, there is a symptom of pain under the tongue. Add Shigao (Gypsum Fibrosum), Jingsmi (Oryzae Semen), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), and Gange (Puerariae Lobatae Radix).
Bitter taste, deafness, pain under both hypochondria; this steaming is in the Gallbladder. Additionally, there is a symptom of white-colored eyes. Add Chaihu (Bupleuri Radix) and Gualou (Trichosanthis Fructus).
Tenesmus (urgent need to defecate with little result), anal obstruction and涩 (roughness); this steaming is in the Changchang (Lower part of the rectum). Add [Missing].
Abdominal pain, flaccid sinews and vessels, involuntary erection of the penis (Yin Qi Zi Qiang); this steaming is in the Zong Jin (Genital tendons). Add [Missing].
Dizziness, profuse tearing, irritability and anger, emotional instability; this steaming is in the Liver. Additionally, there is a symptom of dark eyes. Add Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Qianhu (Peucedani Radix).
Black tongue, shortness of breath, restlessness and aversion to cold (Sa Xi); this steaming is in the Heart. Additionally, there is a symptom of a dry tongue. Add Huanglian (Coptidis Rhizoma), Shengdihuang (Rehmanniae Radix Preparata), and Danggui (Angelicae Sinensis Radix).
Dry lips, oral ulcers, chest and abdominal fullness, aversion to cold and anorexia; this steaming is in the Spleen. Add Shaoyao (Paeoniae Radix), Mugua (Chaenomelis Fructus), and Kushen (Sophorae Flavescentis Radix).
Cough, wheezing, chest fullness, expectoration of phlegm and blood, hoarseness and aphonia; this steaming is in the Lung. Additionally, there is a symptom of dry nose. Add Tiandong (Asparagi Radix), Jiegeng (Platycodonis Radix), Ziwan (Asternis Radix), and Wumei Rou (Mume Fructus Flesh).
Scorched earlobes, Hongjiao (Foot-qi/beriberi) causing soreness and pain; this steaming is in the Kidney. Add Shengjiang (Zingiberis Rhizoma Recens), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Hanshuishi (Halloysit Rubrum), and Bencao (Ligustici Wallichii Rhizoma).
Restless thoughts, frequent seminal emission; this steaming is in the Right Kidney. Add [Missing].
Throat and diaphragm obstruction, attacking pain, distress during flexion and extension; this steaming is in the Diaphragm. Add [Missing].
Upper asthma and rapid breathing, dry nose, body heat and restlessness; this steaming is in the Qi level. Add Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix), and Zhizi (Gardeniae Fructus).
The above total twenty-three modifications, cited by Mr. Lizhai (Xue Ji) from *Yi Lin Ji*.
Bao Zheng (Steaming of the Bao/Uterus), red urine. Use Zexie (Alismatis Rhizoma), Fuling (Poria), Shengdihuang (Rehmanniae Radix Preparata), Chenxiang (Aquilariae Lignum Resinatum), and Huashi (Talcum).
Bladder Zheng, scorched right ear. Use Zexie (Alismatis Rhizoma) and Huashi (Talcum).
Gu Zheng (Bone-steaming), black teeth, abdominal pain, emaciated calves. Use Biejia (Testudinis Carapax et Plastrum), Digupi (Lygodii Radix), Danpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix), and Shengdihuang (Rehmanniae Radix Preparata).
Buttock Zheng, thin legs, limb swelling, heat in all zang-fu organs. Use Shigao (Gypsum Fibrosum) and Huashi (Talcum).
Fu Zheng (Skin-steaming), hot muscles. Use Mudanpi (Moutan Cortex). For excess heat, add Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), and Dahuang (Rhei Radix et Rhizoma). For deficiency heat, add Wumei (Mume Fructus), Chaihu (Bupleuri Radix), Gejie (Geckus), Qinghao (Artemisiae Annuae Herba), Biejia (Testudinis Carapax et Plastrum), and Danpi (Moutan Cortex).
The above content comes from *Ti Ren Hui Bian*.
Mr. Xue Lizhai said: All these symptoms, being consumptive heat diseases, are caused by eating meat and greasy foods, sexual indiscretion, and drinking alcohol. If long-term steaming is not eliminated, it transforms into Gan syndrome (a chronic wasting condition), leading to death. There are also cases where prolonged malaria, left untreated, leads to coughing, gradually forming Gu Zheng Lao Zhai (consumptive tuberculosis-like disease), which should be treated by addressing both root and branch causes.
Note: Mr. Xue Lizhai stated that there are twenty-four types of Zheng diseases, but only twenty-three were briefly listed here. *Ti Ren Hui Bian* also states there are twenty-three types of Zheng diseases, and each type varies, with some annotations present and others missing under each Zheng. This shows that the diseases are dangerous and difficult, and knowledge is rarely transmitted by masters, resulting in omissions and inconsistencies. We await scholars to supplement these gaps.
Mr. Haizang (Zhang Yuansu) said: Regarding the various Zheng diseases mentioned above, whether they affect the Zang organs, Fu organs, or both, the meridians and qi-blood are interconnected. Medications should be used in combination. The principles of Sovereign, Minister, Assistant, and Courier (Jun-Chen-Zuo-Shi), upper-lower, odd-even, exterior-interior, deficiency-excess, counter-following, unblocking-obstruction, sweating-purgation-tonification-vomiting, are all included within them.
If Zheng diseases persist and do not resolve, and there is dried blood (old blood stasis) in the interosseous spaces between bone joints, use Xingxue Wan (Blood-Moving Pill). (Excess blood conditions can cause solid muscle swelling, while blood deficiency can cause vacuous swelling of the pores and membrane networks. Swelling disrupts ascending-descending and opening-closing functions, preventing circulation and mutual support, leading first to symptoms like enuresis and seminal emission. Over time, withering, spasms, and phantom symptoms emerge. Therefore, in treating deficiency, one must gently relax the interior, allowing membranes and tendons to stretch and qi to move freely without distension and urgency. One should gain insight from Jingcan Dahuang Zhechong Wan (Quietly Refining Rhubarb and Ground Beetle Pill).)