论曰夫劳瘵一证。为人之大患。凡受此病者。传变不一。积年疰易。甚至灭门。可胜叹
哉。大抵合而言之。曰传尸。别而言之。曰骨蒸 。复连尸疰、劳疰、虫疰、毒疰、热疰、
冷疰、食疰、鬼疰是也。夫疰者注也。自上疰下。病源无异。是之谓疰。又其变则有二十二
种。或三十六种。或九十九种。又有所谓五尸者。曰蜚尸、遁尸、寒尸、丧尸、注尸是也。
其名不同。传变尤不一。感此疾而获安者。十无一二也。大凡五脏所传。皆令人憎寒发热。
其证状各异。有如传之于肝。则面白目枯。口苦自汗。心烦惊怪。传之于心。则面黑鼻干。
口疮喜忘。大便或秘或泻。传之于脾。则面青唇黄。舌强喉哽吐涎。体瘦。饮食无味。传之
于肺。则面赤鼻白。吐痰咯血。嗽喘毛枯。传之于肾。则面黄耳枯。胸满膈痛。白浊遗沥。
又有二十四种劳蒸者。亦可因证验之。蒸在心也。少气烦闷。舌必焦黑。蒸在小肠也。腹内
雷鸣。大肠或秘泄。蒸在肝也。目昏眩晕。躁怒无时。蒸在胆也。耳聋口苦。胁下坚痛。蒸
在肾也。耳叶焦枯。腰脚酸痛。蒸在右肾也。情意不定。泄精白絮。蒸在肺也。喘嗽咯血。
声音嘶远。蒸在大肠也。右鼻干疼。大肠隐痛。蒸在脾也。唇口干燥。腹胁胀满。畏寒不食。
蒸在胃也。鼻口干燥。腹膨自汗。睡卧不宁。蒸在膀胱也。小便黄赤。凝滑如膏。蒸在三焦
也。或寒或热。中腕膻中时觉烦闷。蒸在膈也。心胸噎塞。疼痛不舒。蒸在宗筋也。筋脉纵
缓。小腹隐痛。阴气自强。蒸在回肠也。肛门秘泄。传道之时。里急后重。蒸在玉房也。男
子遗精。女子白淫。蒸在脑也。眼眵头眩。口吐浊涎。蒸在皮也。肌肤鳞起。毛折发焦。蒸
在骨也。版齿黑燥。大杼酸痛。蒸在髓也。肩背疼倦。 骨酸疼。蒸在筋也。眼昏胁痛。爪
甲焦枯。蒸在脉也。心烦体热。痛刺如针。蒸在肉也。自觉身热。多不奈何。四体 动。蒸
在血也。毛发焦枯。有时鼻血。或复尿血。详诸病证。大略如斯。若究其根。惟心肺受虫啮
祸之甚也。治法先宜去根。次须摄养。亦有早灸膏肓崔氏穴。而得愈者。若待其根深蒂固而
治之。则无及矣。平时得三五方用之颇验。漫录于左。以为备治。
论曰传尸劳者骨蒸之病。流传五脏也。其证 。半卧半起。旦即醒。然午后微蒸。情
常不悦。心多惊悸。夜即盗汗。梦与鬼交。两颊红赤。唇如血色。欲睡不得眠。欲食不能食。
或
。时或微利。鼻口干燥。渐至 羸。虽死在须臾。精神尚爽。是其候也。治之若缓。犹如水
涸。不觉其死。
近世以来。童男室女。丈夫妇人。月水不调。脐腹冷痛。五心烦热。医者一见。便作骨
蒸劳证治之。病者闻之。莫不惊骇。殊不知人本无劳证。皆原禀受怯弱。血气不足。治之不
得其法。用药不善。遂成此疾。且多以柴胡地骨皮青蒿知母藕节鳖甲紫菀麦门冬为退热之剂。
已服之后。热虽渐退。未久复来。医者便究本原。不详医书所谓虚热语。再用前件等药。愈
进而血气愈虚。疾势愈甚矣。况前药性冷。必伤脾胃。日复一日。不思饭食。以致伤胃滑泄。
肢体瘦悴。以致不救。此乃柴胡等药误之矣。深可怜悯。盖柴胡等药。乃伤寒表解之剂。若
血气虚者。非所宜服。向来必用方中。亦曾言之。但其辞文隐而难晓。今明言其略。庶几易
知。若受病之人。未曾服前件药。犹为易治。已曾服后。倘或过多。真气表尽。难以收救。
宜服宜神饮。
凡患骨蒸之人。坐卧居处。不宜伤冷。亦不得伤热。冷甚则药气难通。兼之胀满。食不
消化。或腹气上热。甚则血脉拥塞。头眩目疼。唇干口燥。心胸烦闷。渴欲饮水。此等皆是
将息过度之状。深可诫也。将养之法。须寒温得所。先热而脱。先寒而着。若背伤冷。即令
咳嗽。若手足伤热即令心烦。若覆衣伤浓。即眠卧盗汗。若覆衣过薄。即心腹胀满。所以饮
食不限时节。宁可少食。保无宿注。数数进之。助药势也。必须软。易消故也。不宜生硬。
恐损胃气。致不消也。此皆以易消食之为瘥。骨蒸之病。无问男女。忌房室举动劳作。有所
不宜。陈臭酸咸粘食不消。牛马驴羊大小二豆猪鱼油腻酒面瓜果野鸟之属。葵笋蒜蕨及生冷
等。并不得餐。自必平复。一月以后。乃渐开也。大略如此。触类而长之。此病宜餐煮。饭
盐豉豆酱姜葱韭枸杞苜蓿苦菜地黄牛膝并须煮烂食之。候病稍退。恐肌肤虚弱。可时食干鹿
脯。
论述说：劳瘵这一病症，是人类的重大祸患。凡是感染此病的人，病情传变不一，经年累月相互传染，甚至导致全家灭亡，怎能不令人叹息呢？大体上合起来说，称为“传尸”；分开来说，有骨蒸、复连尸疰、劳疰、虫疰、毒疰、热疰、冷疰、食疰、鬼疰等。所谓“疰”，就是“注”的意思，病气自上注下，病源相同，这就叫做疰。其变化又有二十二种、三十六种或九十九种之分。还有所谓的“五尸”，即蜚尸、遁尸、寒尸、丧尸、注尸。名称不同，传变更加复杂。感染这种疾病而能痊愈的，十人中无一二人。大凡五脏受邪传变，都会让人憎恶寒冷、发热，但症状各异。如传之于肝，则面色苍白、眼睛干枯、口苦、自汗、心烦、易受惊吓；传之于心，则面色发黑、鼻干、口舌生疮、健忘、大便或秘结或泄泻；传之于脾，则面色青黄、嘴唇发黄、舌强喉哽、吐涎、身体消瘦、饮食无味；传之于肺，则面色赤红、鼻部色白、吐痰咯血、咳嗽气喘、毛发枯槁；传之于肾，则面色发黄、耳朵干枯、胸满膈痛、小便浑浊、遗精沥漏。
又有二十四种“劳蒸”之证，也可根据症状来验证。蒸热在心，表现为少气烦闷、舌头焦黑；蒸热在小肠，表现为腹内雷鸣、大肠或秘结或泄泻；蒸热在肝，表现为目昏眩晕、烦躁易怒无定时；蒸热在胆，表现为耳聋口苦、胁下坚硬疼痛；蒸热在肾，表现为耳叶焦枯、腰脚酸痛；蒸热在右肾，表现为情意不定、泄精如白絮；蒸热在肺，表现为喘嗽咯血、声音嘶哑遥远；蒸热在大肠，表现为右鼻干疼、大肠隐痛；蒸热在脾，表现为唇口干燥、腹胁胀满、畏寒不想进食；蒸热在胃，表现为鼻口干燥、腹部膨隆自汗、睡卧不宁；蒸热在膀胱，表现为小便黄赤、凝滑如膏状；蒸热在三焦，表现为忽冷忽热、中脘及膻中部位时常觉得烦闷；蒸热在膈，表现为心胸噎塞、疼痛不适；蒸热在宗筋，表现为筋脉纵缓、小腹隐痛、阴气自强；蒸热在回肠，表现为肛门秘结或泄泻、排便时里急后重；蒸热在玉房（生殖器官），表现为男子遗精、女子白带过多；蒸热在脑，表现为眼屎多头晕、口吐浊涎；蒸热在皮，表现为肌肤起鳞屑、毛发折断头发焦枯；蒸热在骨，表现为门齿黑燥、大杼穴处酸痛；蒸热在髓，表现为肩背疼痛疲倦、骨骼酸痛；蒸热在筋，表现为眼昏胁痛、爪甲焦枯；蒸热在脉，表现为心烦体热、疼痛如针刺；蒸热在肉，表现为自觉身热、四肢难以忍受地躁动；蒸热在血，表现为毛发焦枯、有时鼻出血、有时尿血。详查各种病证，大致如此。若追究根源，主要是心肺受到虫类啃噬，祸害最严重。治疗方法应先去除病根，其次需要调养摄生。也有早期艾灸膏肓穴和崔氏穴而痊愈的。如果等到病根深固再治疗，就来不及了。平时收集几个方子使用颇为有效，随意记录如下，以备治疗参考。
论述说：传尸劳是骨蒸的病证，会流传于五脏。其症状是半卧半坐，早晨醒来，但午后微微发热，情绪常不愉快，心中多惊悸，夜间盗汗，梦见与鬼交合，两颊红赤，嘴唇像血色一样红润，想睡睡不着，想吃吃不下，或者腹泻，时而轻微泄利，鼻口干燥，逐渐变得瘦弱羸乏，虽然死亡在即，精神尚且清爽，这就是它的征候。治疗如果迟缓，就像水干涸一样，不知不觉就死了。
近代以来，童男童女、丈夫妇人，出现月经不调、脐腹冷痛、五心烦热的症状，医生一见，便当作骨蒸劳证来治疗。病人听到后，无不惊恐骇异。殊不知人本来没有劳证，都是由于先天禀赋怯弱，血气不足，治疗不得法，用药不善，才形成这种疾病。况且多以柴胡、地骨皮、青蒿、知母、藕节、鳖甲、紫菀、麦门冬作为退热的药剂。服用之后，热虽渐渐退去，但未过多久又复发。医生便探究本源，不详察医书中所谓的“虚热”理论，再次使用前几种药物，结果越治血气越虚，病情越严重。况且前几种药性寒凉，必然损伤脾胃，日复一日，不思饮食，以致伤胃滑泄，肢体瘦弱憔悴，最终无法救治。这都是柴胡等药物误事啊，实在可怜悯。因为柴胡等药，是伤寒表证已解后的药剂，对于血气虚弱的人，并不适宜服用。向来必用方剂中也曾提到过，只是言辞隐晦难懂，现在明确说明大概意思，以便容易知晓。如果患病之人未曾服用前几种药物，还比较容易治疗；如果已经服用过，倘若过量，真气耗竭，外表虚脱，就难以挽救了。应当服用宜神饮。
凡是患有骨蒸的人，坐卧居处，不宜受冷，也不宜受热。受冷太甚，则药气难以通达，兼有胀满，食物不消化；或者腹气上逆发热，甚则血脉拥塞，头晕目眩、眼睛疼痛、嘴唇干燥、口舌干燥、心胸烦闷、口渴想喝水。这些全都是调养过度不当的状况，深可警戒。调养的方法，必须寒温适宜，先热时适当减衣，先寒时适当添衣。如果背部受冷，就会引起咳嗽；如果手足受热，就会引起心烦；如果覆盖衣物过厚，就会引起睡眠中盗汗；如果覆盖衣物过薄，就会引起心腹胀满。所以饮食不限定时间，宁可少吃，保证没有宿食停滞，多次少量进食，以助药势。食物必须软烂，容易消化。不宜生硬，恐怕损伤胃气，导致不消化。这些都是以容易消化的食物为主才能痊愈。骨蒸之病，无论男女，都忌房事、举动和劳作，有所不宜。陈腐、酸咸、粘腻不易消化的食物，牛马驴羊、大小豆、猪鱼、油腻、酒面、瓜果、野鸟之类，葵菜、笋、蒜、蕨菜以及生冷等，都不得食用。自然必定平复，一个月以后，才逐渐放开饮食。大致如此，触类旁通。此病适宜食用煮熟的米饭、盐豉、豆酱、姜、葱、韭、枸杞、苜蓿、苦菜、地黄、牛膝，都必须煮烂食用。等到病情稍退，恐怕肌肤虚弱，可以适时食用干鹿肉脯。
Translation:
It is said that Lao Zhai (Consumption Disease) is a major affliction for humans. Those who contract this disease undergo various transformations, spreading over years and infecting others, even leading to the extinction of entire families. How can one not sigh at this? Generally speaking, it is collectively called Chuan Shi (Transmitting Corpse), while specifically distinguished, it includes Gu Zheng (Bone Steaming), Fu Lian Shi Zhu (Reconnecting Corpse Transmission), Lao Zhu (Labor Transmission), Chong Zhu (Insect Transmission), Du Zhu (Poison Transmission), Re Zhu (Heat Transmission), Leng Zhu (Cold Transmission), Shi Zhu (Food Transmission), and Gui Zhu (Ghost Transmission). The term "Zhu" implies "Zhu" (to pour/transfer); the pathogen transfers from above to below, with identical origins, hence termed Zhu. Its variations include twenty-two types, thirty-six types, or ninety-nine types. There are also so-called "Five Corpses": Fei Shi (Flying Corpse), Dun Shi (Escaping Corpse), Han Shi (Cold Corpse), Sang Shi (Mourning Corpse), and Zhu Shi (Transmission Corpse). Although names differ, their transmission is even more complex. Among those infected, only one or two out of ten recover. Generally, when the five viscera transmit pathogens, it causes aversion to cold and fever, but symptoms vary. If transmitted to the Liver, there is pale complexion, dry eyes, bitter taste, spontaneous sweating, mental restlessness, and fright. If transmitted to the Heart, there is dark complexion, dry nose, mouth ulcers, forgetfulness, and constipation or diarrhea. If transmitted to the Spleen, there is greenish-yellow complexion, yellow lips, stiff tongue, throat obstruction, salivation, emaciation, and loss of appetite. If transmitted to the Lung, there is reddish complexion, white nose, expectoration of blood, coughing and wheezing, and dry hair. If transmitted to the Kidney, there is sallow complexion, dry ears, chest fullness, diaphragmatic pain, cloudy urine, and seminal emission.
There are also twenty-four types of "Lao Zheng" (Labor Steaming), which can be verified by symptoms. Steaming in the Heart manifests as shortness of breath, mental oppression, and a blackened, scorched tongue. Steaming in the Small Intestine manifests as borborygmus within the abdomen, and constipation or diarrhea in the Large Intestine. Steaming in the Liver manifests as blurred vision, dizziness, and intermittent irritability. Steaming in the Gallbladder manifests as deafness, bitter taste, and hardness/pain under the ribs. Steaming in the Kidney manifests withered earlobes and sore, aching waist and legs. Steaming in the Right Kidney manifests as emotional instability and emission of semen resembling white絮 (cotton-like substance). Steaming in the Lung manifests as coughing, expectorating blood, hoarse and distant voice. Steaming in the Large Intestine manifests as dryness and pain in the right nostril and dull pain in the Large Intestine. Steaming in the Spleen manifests as dry lips and mouth, abdominal and hypochondriac distension, aversion to cold, and anorexia. Steaming in the Stomach manifests as dry nose and mouth, abdominal distension with spontaneous sweating, and restless sleep. Steaming in the Bladder manifests as yellow-red urine, thick and slippery like paste. Steaming in the San Jiao (Triple Burner) manifests as alternating chills and fever, with frequent mental oppression in the Zhong Wan and Dan Zhong regions. Steaming in the Diaphragm manifests as chest and heart blockage, painful discomfort. Steaming in the Zong Jin (Major Sinew) manifests as flaccid sinews and tendons, dull lower abdominal pain, and hyperactive Yin Qi. Steaming in the Hui Chang (Returning Intestine) manifests as constipation or diarrhea, with tenesmus during defecation. Steaming in the Yu Fang (Jade Chamber/Genitals) manifests as seminal emission in men and leukorrhea in women. Steaming in the Brain manifests as excessive eye discharge, dizziness, and spitting of turbid saliva. Steaming in the Skin manifests as scaly skin, broken hairs, and scorched scalp hair. Steaming in the Bone manifests as blackened and dry incisors, and soreness at the Da Shu acupoint. Steaming in the Marrow manifests as shoulder and back pain and fatigue, and bone soreness. Steaming in the Tendons manifests as blurred vision, hypochondriac pain, and scorched, brittle nails. Steaming in the Vessels manifests as mental restlessness, body heat, and stabbing pain like needles. Steaming in the Flesh manifests as subjective body heat and unbearable restlessness of the four limbs. Steaming in the Blood manifests as scorched hair, occasional epistaxis, or hematuria. Detailed examination of these diseases reveals they are roughly as described. Investigating the root cause, the damage caused by insects gnawing the Heart and Lungs is most severe. Treatment should first aim to eliminate the root, followed by nursing care. Some have recovered by moxibustion on the Gao Huang and Cui Shi acupoints early on. If treatment is delayed until the disease takes deep root, it is too late. A few effective prescriptions collected for routine use are recorded below for reference.
It is said that Chuan Shi Lao is a disease of Gu Zheng (Bone Steaming) that spreads through the five viscera. Symptoms include lying and sitting half-upright, waking in the morning, but slight steaming fever in the afternoon, constant dissatisfaction, frequent palpitations, night sweats, dreams of intercourse with ghosts, red cheeks, lips looking bloody, inability to sleep despite wanting to, inability to eat despite wanting to, occasional mild diarrhea, dry nose and mouth, progressing to emaciation. Although death is imminent, the spirit remains clear; this is its characteristic. If treatment is slow, it is like water drying up, leading to death unnoticed.
In recent times, for young men and women, husbands and wives, presenting with irregular menstruation, cold pain in the umbilical and abdominal region, and five-palm heat, physicians immediately treat them as Gu Zheng Lao. Patients hear this and are terrified. They do not realize that people originally do not have Lao Zheng; it stems from weak congenital constitution and insufficient Qi and Blood. Improper treatment and poor medication lead to this illness. Often, herbs such as Chai Hu (Bupleuri Radix), Di Gu Pi (Lycii Cortex), Qing Hao (Artemisiae Annuae Herba), Zhi Mu (Anemarrhenae Rhizoma), Ou Jie (Nelumbinis Node), Bie Jia (Testudinis Carapax et Plastrum), Zi Wan (Asteris Radix), and Mai Men Dong (Ophiopogonis Tuber) are used as antipyretics. After taking them, fever subsides slightly but returns soon. Physicians then investigate the origin, failing to consult medical texts regarding "Deficiency Heat," and reuse these drugs, causing Qi and Blood to become increasingly deficient and the disease to worsen. Moreover, these drugs are cold in nature, inevitably damaging the Spleen and Stomach. Day after day, lack of appetite leads to gastric injury and loose stools, resulting in emaciation and untreatable condition. This error is due to Chai Hu and other drugs. It is truly pitiable. Chai Hu and similar herbs are formulas for resolving exterior syndromes in Shang Han (Cold Damage); they are unsuitable for those with deficient Qi and Blood. Previous formularies mentioned this, though the language was obscure. Now, I clarify briefly for easier understanding. If the patient has not taken these drugs, it is easier to treat; if already taken excessively, depleting True Qi and exhausting the exterior, rescue is difficult. One should take Yi Shen Yin (Benefit Spirit Drink).
For those suffering from Gu Zheng, sitting, lying, and living environments should avoid both cold and heat. Excessive cold hinders the passage of medicinal energy, causing distension and indigestion; or abdominal Qi rises causing heat, potentially blocking blood vessels, leading to dizziness, eye pain, dry lips and mouth, and mental oppression with thirst. These are all signs of improper nursing, which should be strictly avoided. Nursing methods must ensure appropriate warmth and coolness: remove clothes if hot, add clothes if cold. Cold injury to the back causes coughing; heat injury to hands and feet causes mental restlessness; covering too thickly causes night sweats; covering too thinly causes abdominal distension. Therefore, meal times are flexible; better to eat less frequently in small amounts to avoid food stagnation, aiding medicinal action. Food must be soft and easy to digest. Avoid raw and hard foods to prevent damaging Stomach Qi and causing indigestion. Recovery depends on easily digestible foods. For Gu Zheng, regardless of gender, sexual activity, physical exertion, and labor are contraindicated. Old, sour, salty, sticky, and indigestible foods, beef, horse, donkey, sheep, beans, pork, fish, greasy foods, alcohol, wheat noodles, fruits, wild birds, okra, bamboo shoots, garlic, ferns, and cold/raw foods must be avoided. Recovery will naturally occur, and diet can gradually expand after one month. Generally, cooked rice, salted fermented soybeans, bean paste, ginger, scallions, leeks, goji berries, alfalfa, bitter vegetables, Rehmanniae Radix (Di Huang), and Achyranthis Bidentatae Radix (Niu Xi) should be boiled thoroughly and eaten. As the disease recedes, fearing weak skin and flesh, dried venison jerky may be consumed occasionally.