夫骨蒸 ，半卧半起之谓复连，内传五脏之谓尸注、劳注、虫注、热注、冷注、食注
、鬼注。疰者，注也。自上注下，与前人相似，故曰注，（注、疰皆蛀也，如虫之蛀，即谷飞为
虫之义也。注易之说本于巢氏，似为协。）言其变有二十二种，或三十六种，或九十八种，
令人沉沉默默，寒热盗汗，梦与鬼交，遗泄白浊，或腹中有块，或脑后两边有结核，咳嗽脓
血，下痢羸瘦，死而传注，甚至灭门。更有飞尸、遁尸、寒尸、丧尸、尸疰，谓之五尸。人
为其疰者，不自知所苦，虽有狸骨、獭肝、天灵盖等方，未尝效也。惟崔氏灸法，早用有济
。
若寒热自汗，面白目干，口苦，神昏，善恐，不能独卧，传在肝也。若寒热面黑，鼻燥
，善忘，大便秘泻，口舌生疮，传在心也。若寒热面青，唇黄，舌本硬强，言语不出，饮食无味
，羸瘦吐涎，传在脾也。若寒热面赤，鼻白，干燥毛折，咯嗽喘急，吐涎脓血，传在肺也。
若寒热面黄，耳焦，脚 酸痛，小便白浊遗沥，腹痛，传在肾也。以上陈临川先生，未有治
法。
立斋云∶前证诚然有之，故葛仙翁用獭肝一具，阴干，杵末，水下方寸匕，日三服，未
愈再服。宋宣和间，一法师善考讯鬼怪，时一妇以疾投状，既而如有鬼
祟所附曰∶非我为患，乃病患命自衰耳，渠今已成虫食肺，
故令吐血、声嘶。又屡讯彼所畏何物，云以獭爪为末，酒服之，则去矣。患家如其言，则愈
。獭爪即獭肝之类与？元珠云∶虫瘵多有互相传染，甚至绝户，此乃冤业相缠及风水所致，
虽有符文法水下虫之方，虫去而人亦亡。但能平素保养，或可希免。《救生微旨》云∶益气
补肺，益精补肾，皆资其化源也。盖人之精血常不足，加之数夺其精，资化失常，则胃气不
固，精气滑脱，不能上接阳气，故头重，或气弱食少，元气下陷，脉微外散欲绝而虚洪，或
见损脉，总属元气不足，非有外感贼邪之证也。
立斋尝治一妇，素勤苦，因丧子（肺病），饮食少思（脾病，）忽吐血甚多（心病）而自止，此后
每劳则吐数口。瘵症已具，形体甚倦。午前以补中益气汤滋其脾肺，午后以归脾汤养其心脾
，送地黄丸滋肾而愈。（肺病、脾病、心病六字原注。）
又一女子患前症，反其唇，视有白点，此虫蚀肺也。余曰∶急寻獭肝治之。不相信，果
咯脓而殁。反闻其兄弟三人皆夭于此症。大凡久嗽，当视其两唇，若上唇有点，虫蚀上部，下唇
有点，虫蚀下部。
所谓骨蒸（一种以骨骼发热为特征的虚劳病证），半卧半起的状态称为“复连”，病邪内传五脏则称为尸注、劳注、虫注、热注、冷注、食注、鬼注。“疰”字，就是“注”的意思。病气自上而下传染，且症状与前人相似，所以称为“注”。（注和疰都含有蛀蚀之意，如同虫子蛀蚀物体，即谷物飞化生虫的含义。关于注易的说法源于巢元方，似乎较为恰当。）这里指其变化有二十二种、三十六种或九十八种，使人精神萎靡沉默，出现寒热往来、盗汗、梦中与鬼交合、遗精白浊等症状，或者腹中有肿块，脑后两侧有结核，咳嗽脓血，下痢消瘦，死后还能传染他人，甚至导致全家灭门。还有飞尸、遁尸、寒尸、丧尸、尸疰，这五种称为“五尸”。人被这种疰病所害，自己不知道痛苦所在，虽然有使用狸骨、獭肝、天灵盖等方剂，但从未见效。只有崔氏的灸法，如果早期使用会有帮助。
如果表现为寒热往来、自汗、面色苍白、眼睛干涩、口苦、神志昏沉、容易恐惧、不能独自卧床，这是病邪传到了肝脏。如果表现为寒热往来、面色发黑、鼻干、健忘、大便秘结或腹泻、口舌生疮，这是病邪传到了心脏。如果表现为寒热往来、面色发青、嘴唇发黄、舌根僵硬强硬、言语不出、饮食无味、消瘦流涎，这是病邪传到了脾脏。如果表现为寒热往来、面色发红、鼻色白、毛发干枯折断、咳吐脓血、气喘急促，这是病邪传到了肺脏。如果表现为寒热往来、面色发黄、耳朵焦枯、脚部酸痛、小便白浊淋漓、腹痛，这是病邪传到了肾脏。以上这些是陈临川先生的论述，但没有提出治疗方法。
薛立斋说：前面的病症确实存在，所以葛仙翁使用一整具獭肝，阴干后捣成粉末，用水送服一方寸匕，每天服用三次，如果未痊愈再服用。宋宣和年间，有一位法师擅长审讯鬼怪，当时有一位妇人因病提起诉讼，后来好像有鬼魂附体说道：“不是我作祟，而是病人生命自然衰败罢了，他现在已经变成虫子吃肺了，所以导致吐血、声音嘶哑。”又多次审讯它害怕什么东西，回答说用獭爪磨成粉末，用酒送服，就能去除。患者家属照此办理，果然痊愈。獭爪大概和獭肝是同类吧？元珠说：虫瘵（由虫引起的虚劳病）多有互相传染，甚至导致绝户，这是由于冤业纠缠以及风水所致，虽然有符文法水驱除虫子的方子，但虫子去除了人也死了。只要平时注意保养，或许可以侥幸避免。《救生微旨》说：益气补肺、益精补肾，都是资助其化源。大概人的精血常常不足，加上多次耗夺精气，资助化生的功能失常，那么胃气不固，精气滑脱流失，不能向上接续阳气，所以头部沉重，或者气弱食少，元气下陷，脉象微弱外散似将断绝而显得虚洪，或者见到损脉，总属于元气不足，并不是有外感贼邪的证候。
薛立斋曾经治疗一位妇人，平素勤劳辛苦，因为丧子（肺病），饮食减少思虑（脾病），忽然吐血很多（心病）然后自行停止，此后每次劳累就会吐出几口。虚劳病的症状已经具备，形体非常疲倦。午前服用补中益气汤来滋养脾肺，午后服用归脾汤来养护心脾，送服地黄丸滋补肾肾而痊愈。（肺病、脾病、心病六字为原书注释。）
又有一位女子患上述病症，嘴唇反卷，观察发现有白点，这是虫子侵蚀肺部的表现。我说：急忙寻找獭肝来治疗。她不相信，果然咳出脓血而死。后来听说她的三个兄弟也都夭折于这种病症。大凡久咳的人，应当观察他的双唇，如果上唇有点，说明虫子侵蚀上部；下唇有点，说明虫子侵蚀下部。
Regarding bone-steaming (a consumptive disease characterized by heat sensation in the bones), the state of lying half-upright is called "Fu Lian" (Repeating Link). When the pathogenic factor transmits internally to the Five Zang Organs, it is referred to as Shi Zhu (Corpse Transmission), Lao Zhu (Consumptive Transmission), Chong Zhu (Worm Transmission), Re Zhu (Heat Transmission), Leng Zhu (Cold Transmission), Shi Zhu (Food Transmission), and Gui Zhu (Ghost Transmission). The term "Zhu" (Transmission) implies "Zhu" (to pour/transfer). The pathogenic qi transfers from above downwards, and the symptoms resemble those of previous sufferers, hence it is called "Zhu". (Note: Both Zhu and Diao imply a boring or corroding action, similar to insects boring into objects, which relates to the meaning of grain transforming into insects. The theory of transmission originates from Chao Yuanfang, which seems appropriate.) This refers to its variations, which may number twenty-two, thirty-six, or ninety-eight types, causing the patient to become listless and silent, experiencing alternating chills and fever, night sweats, dreams of sexual intercourse with ghosts, seminal emission with turbid urine, abdominal masses, or lymph node swellings on both sides of the back of the head, coughing up pus and blood, dysentery, emaciation, and even transmitting after death, potentially wiping out an entire family. There are also Fei Shi (Flying Corpse), Dun Shi (Escaping Corpse), Han Shi (Cold Corpse), Sang Shi (Dead Corpse), and Shi Zhu (Corpse Transmission), collectively known as the "Five Corpses." Those afflicted by this transmission do not realize their own suffering; although formulas using fox bone, otter liver, and human skull cap are employed, they have never been effective. Only Cui's moxibustion method, if applied early, can be beneficial.
If the presentation includes alternating chills and fever, spontaneous sweating, pale complexion, dry eyes, bitter taste in the mouth, mental confusion, excessive fearfulness, and inability to sleep alone, the transmission has reached the Liver. If it presents with alternating chills and fever, dark complexion, dry nose, forgetfulness, constipation or diarrhea, sores on the mouth and tongue, the transmission has reached the Heart. If it presents with alternating chills and fever, greenish complexion, yellow lips, stiff tongue root, aphasia, loss of appetite, emaciation, and drooling, the transmission has reached the Spleen. If it presents with alternating chills and fever, red complexion, white nasal color, dry and brittle hair, coughing up pus and blood, and wheezing, the transmission has reached the Lung. If it presents with alternating chills and fever, sallow complexion, scorched ears, soreness and pain in the legs, turbid urine with dribbling, and abdominal pain, the transmission has reached the Kidney. These descriptions are from Mr. Chen Linchuan, but no treatment methods were provided.
Xue Lizhai stated: The aforementioned conditions indeed exist. Therefore, Ge Xianweng used one whole otter liver, dried in the shade, pounded into powder, administered with water as one cubic inch spoonful, three times a day. If not cured, continue administration. During the Xuanhe era of the Song Dynasty, a monk skilled in interrogating spirits was consulted when a woman filed a complaint due to illness. Later, it seemed as if possessed by a spirit who said, "It is not me causing harm, but the patient's life force naturally declining. He has already become worms eating his lungs, thus causing hemoptysis and hoarseness." Upon repeatedly asking what the spirit feared, it replied that consuming powdered otter claws with wine would drive it away. The patient's family followed this advice, and she recovered. Are otter claws similar to otter liver? Yuanzhu stated: Worm consumption often spreads contagiously, even leading to the extinction of households, caused by karmic entanglement and wind-water factors. Although there are talismans and ritual waters to expel worms, once the worms are gone, the person also dies. However, if one maintains proper preservation and care, one might escape this fate. *Jiusheng Weizhi* states: Tonifying Qi and benefiting the Lung, tonifying Essence and benefiting the Kidney, all serve to nourish the source of transformation. Generally, human Essence and Blood are often insufficient; compounded by frequent depletion of Essence, the mechanism of transformation becomes abnormal. Consequently, Stomach Qi fails to consolidate, Essence and Qi slip and leak, failing to connect upward with Yang Qi. This results in heavy head, weak Qi, poor appetite, sinking of Yuan Qi, pulse appearing faint, scattered, nearly absent yet falsely full and large, or showing Sun pulses. All these belong to insufficiency of Yuan Qi, not evidence of external pathogenic thieves.
Xue Lizhai once treated a woman who was diligent and hardworking since youth. After losing her child (Lung disease), she had little desire for food (Spleen disease) and suddenly experienced severe hemoptysis (Heart disease) which stopped spontaneously. Afterwards, every time she exerted herself, she would cough up a few mouthfuls of blood. The consumptive symptoms were fully present, and her physical form was extremely fatigued. In the morning, she took Buzhong Yiqi Tang to nourish the Spleen and Lung; in the afternoon, she took Guipi Tang to nurture the Heart and Spleen, followed by Dihuang Wan to nourish the Kidneys, and she recovered. (The characters Lung disease, Spleen disease, Heart disease are original annotations.)
Another young woman suffered from the aforementioned condition, with her lips everted, revealing white spots upon observation, indicating worms eroding the Lung. I said: urgently seek otter liver for treatment. She did not believe it, and indeed died after coughing up pus. It was later heard that her three brothers also perished from this same condition. Generally, for chronic cough, one should observe the lips. If there are spots on the upper lip, it indicates worms eroding the upper part; if there are spots on the lower lip, it indicates worms eroding the lower part.