痨瘵阴虚虫干血，积热骨蒸咳嗽痰，肌肤甲错目黯黑，始健不泻下为先。
【注】久病痨疾而名曰瘵。瘵者，败也，气血两败之意也。有阴虚干血者，有阴虚积
热者，当以诸补阴药治之。肌肤甲错，谓皮肤干涩也，目黯黑者，谓目黑无光也。始健，
谓初病尚壮；不泻，谓久病不泻也，二者皆可以攻下为先治也。
痨瘵至泻则必死，不泻能食尚可痊，初取利后宜详审，次服柴胡清骨煎，虚用黄
鳖甲散，热衰大补养荣参，皮热柴胡胡连入，骨蒸青蒿鳖甲添，阴虚补阴诸丸剂，阳虚补
阳等汤圆，咳嗽自同咳嗽治，嗽血成方太平丸。
【注】痨瘵之人，病至大便泄泻，则必死矣。若不泻能食，尚堪任药攻治，故可痊也。
初取利后，审其热之微甚，人之强弱。若热甚人强，宜用柴胡清骨散；热不甚人弱，宜
用黄 鳖甲散；热微人弱，宜用十全大补、人参养荣等汤。若皮外发热，加柴胡、胡连。骨
内蒸热，加青蒿、鳖甲。午后阴虚发热，宜用补阴诸丸汤药。阳虚恶寒清瘦，宜用补阳
诸丸汤药。咳嗽不已，同咳门方参而治之。嗽血者，宜用成方太平丸可也。
大黄 虫丸 大黄青蒿煎 传尸将军丸
干血大黄 虫治，积热蒿黄胆便煎，癸亥腰眼灸七壮，后服传尸将军丸。
【注】大黄 虫丸有成方。大黄青蒿煎，即青蒿、大黄、猪胆汁、童便煎。痨瘵日久，
有生恶虫，身死之后，多遭传染，甚而灭门，名曰传尸痨，宜癸亥日灸两腰眼各七壮，后
服传尸将军丸。此方载《丹溪心法》书中。
柴胡清骨散
清骨骨蒸久不痊，热甚秦知草胡连，鳖甲青蒿柴地骨，韭白髓胆童便煎。
【注】此方乃秦艽、知母、炙草、胡连、鳖甲、青蒿、柴胡、地骨皮、韭白、猪脊髓、
猪胆汁、童便也。
黄 鳖甲散
黄 鳖甲虚劳热，骨蒸晡热渴而烦，肌肉消瘦食减少，盗汗咳嗽出血痰，生地赤芍
柴秦草，知 菀骨半苓煎，人参桂桔俱减半，鳖甲天冬桑倍添。
【注】此方即生地、赤芍、柴胡、秦艽、炙草、知母、黄 、紫菀、地骨皮、半夏、茯
苓、人参，桂枝、桔梗、鳖甲、天冬，桑白皮也。
【痨瘵总括】
肺痨（一种以慢性消耗为主要特征的传染病）由阴虚、干血（瘀血日久化热耗伤阴血）、积热、骨蒸（自觉骨内发热，如潮汐般定时发作）、咳嗽、痰多引起。患者肌肤粗糙如鳞甲交错，双目暗黑无光。治疗初期若患者体质尚健且大便不通，应以攻下法为先导。
【注】久病形成的痨疾被称为“瘵”。“瘵”意为败坏，指气血两败的状态。其中有的属于阴虚兼有干血，有的属于阴虚兼有积热，应当使用各类补阴药物进行治疗。“肌肤甲错”，是指皮肤干燥涩滞；“目黯黑”，是指眼睛昏暗无光泽。“始健”，是指初患病时身体尚强壮；“不泻”，是指久病后没有腹泻症状。这两种情况都可以先用攻下法治疗。
【痨瘵治法】
肺痨患者如果发展到出现泄泻（腹泻），则必然死亡；如果不腹泻且能进食，尚可治愈。初次使用通利大便的方法后，应当仔细审察病情。其次服用柴胡清骨煎。虚证使用黄鳖甲散，热势衰退后进行大补，服用养荣参汤。若是体表发热，加入柴胡、胡黄连；若是骨蒸潮热，加入青蒿、鳖甲。阴虚者服用各种补阴丸剂，阳虚者服用各种补阳汤药。咳嗽按照咳嗽病的常规方法治疗，咳血使用成方太平丸。
【注】患有肺痨的人，病情发展到大便泄泻，就必死无疑了。如果不腹泻且能进食，还能承受药物的攻伐治疗，所以可以痊愈。初次使用通利大便的方法后，要审察热邪的轻重和体质的强弱。如果热邪重而体质强，适宜用柴胡清骨散；热邪不重而体质弱，适宜用黄鳖甲散；热邪轻微而体质弱，适宜用十全大补汤、人参养荣汤等。如果是体表外部发热，加用柴胡、胡黄连。如果是骨内蒸热，加用青蒿、鳖甲。午后因阴虚引起的发热，适宜服用补阴类的丸剂和汤药。阳虚导致的恶寒、消瘦，适宜服用补阳类的丸剂和汤药。咳嗽不止，参照咳嗽门的方剂进行治疗。咳血的，适宜使用成方太平丸。
大黄䗪虫丸 大黄青蒿煎 传尸将军丸
干血（瘀血）用大黄䗪虫丸治疗，积热用大黄、青蒿、猪胆汁、童便煎煮治疗。在癸亥日灸两侧腰眼穴各七壮，之后服用传尸将军丸。
【注】大黄䗪虫丸已有现成的方剂。大黄青蒿煎，即由青蒿、大黄、猪胆汁、童便煎煮而成。肺痨日久，体内会产生恶虫，人死后尸体多遭传染，甚至导致全家灭门，称为“传尸痨”。适宜在癸亥日灸两侧腰眼穴各七壮，之后服用传尸将军丸。此方记载于《丹溪心法》一书中。
柴胡清骨散
清骨散用于治疗长期的骨蒸潮热久治不愈。热重者加入秦艽、知母、甘草、胡黄连。方中还有鳖甲、青蒿、柴胡、地骨皮，用韭白、猪脊髓、猪胆汁、童便煎煮。
【注】此方由秦艽、知母、炙甘草、胡黄连、鳖甲、青蒿、柴胡、地骨皮、韭白、猪脊髓、猪胆汁、童便组成。
黄鳖甲散
黄鳖甲散用于治疗虚劳发热、骨蒸潮热、傍晚发热、口渴烦躁。症状包括肌肉消瘦、食欲减少、盗汗、咳嗽、出血、痰多。方中生地、赤芍、柴胡、秦艽、炙甘草、知母、黄芩、紫菀、地骨皮、半夏、茯苓、人参、桂枝、桔梗均减半用量，另加鳖甲、天冬、桑白皮。
【注】此方即生地、赤芍、柴胡、秦艽、炙甘草、知母、黄芩、紫菀、地骨皮、半夏、茯苓、人参、桂枝、桔梗、鳖甲、天冬、桑白皮。
[General Overview of Phthisis]
Phthisis (a contagious disease characterized by chronic consumption) is caused by Yin deficiency, Ganxue (dry blood, where stasis generates heat and consumes Yin over time), accumulated heat, bone-steaming fever (a sensation of heat emanating from the bones, occurring at regular intervals resembling a tide), cough, and excessive phlegm. Patients present with skin roughness resembling fish scales (Jiacuo) and dark, lusterless eyes. In the initial stage, if the patient's constitution is still robust and there is constipation, purgation should be employed as the primary treatment.
[Note] A phthisis resulting from prolonged illness is called "Zhai" (Chai). "Zhai" means decay or ruin, signifying the dual failure of Qi and Blood. Cases may involve Yin deficiency combined with Ganxue (dry blood), or Yin deficiency combined with accumulated heat; in such instances, various Yin-nourishing herbs should be used for treatment. "Skin roughness resembling fish scales" refers to dry and rough skin. "Dark and lusterless eyes" refers to eyes that are dim and lack luster. "Shijian" (initially robust) means the body was strong when the illness first began. "Bu xie" (no diarrhea) means the patient has not experienced diarrhea despite the long duration of the illness. Both these conditions indicate that purgation can be used as the initial treatment.
[Treatment Methods for Phthisis]
If a patient with Phthisis develops diarrhea, death is inevitable. If the patient does not have diarrhea and can eat, they can withstand medicinal treatment and thus can be cured. After initially using methods to promote bowel movement, one must carefully examine the severity of the heat and the strength of the patient's constitution. Subsequently, Chaihu Qinggu Jian (Bupleurum Clearing Bone Decoction) should be administered. For deficiency patterns, Huang Biejia San (Scutellaria and Turtle Shell Powder) is used. Once the heat subsides, vigorous tonification should be performed using Yangrong Shen Tang (Nourishing Prosperity Ginseng Decoction). If there is external skin fever, add Chaihu (Bupleuri Radix) and Hulian (Coptidis Rhizoma); if there is bone-steaming fever, add Qinghao (Artemisiae Annuae Herba) and Biejia (Testudinis Carapax et Plastrum). For Yin deficiency, various Yin-tonifying pills are used; for Yang deficiency, various Yang-tonifying decoctions are used. Coughs are treated according to standard methods for cough diseases. Hemoptysis is treated with the established formula Taiping Wan (Taiping Pill).
[Note] For patients suffering from Phthisis, once the condition progresses to diarrhea, it is fatal. However, if there is no diarrhea and the patient can eat, they can tolerate the attack of medicines, hence recovery is possible. After initially promoting bowel movement, one must assess the intensity of the pathogenic heat and the patient's physical strength. If the heat is severe and the patient is strong, Chaihu Qinggu San (Bupleurum Clearing Bone Powder) is appropriate. If the heat is mild but the patient is weak, Huang Biejia San (Scutellaria and Turtle Shell Powder) is appropriate. If the heat is slight and the patient is weak, Shiquan Dabu Tang (Complete Great Tonification Decoction) or Renshen Yangrong Tang (Ginseng Nourishing Prosperity Decoction) are appropriate. If there is fever on the exterior of the skin, add Chaihu (Bupleuri Radix) and Hulian (Coptidis Rhizoma). If there is steaming heat within the bones, add Qinghao (Artemisiae Annuae Herba) and Biejia (Testudinis Carapax et Plastrum). For afternoon fevers caused by Yin deficiency, Yin-tonifying pills and decoctions are suitable. For chills and emaciation caused by Yang deficiency, Yang-tonifying pills and decoctions are suitable. Persistent coughs should be treated by referring to formulas in the Cough section. For hemoptysis, the established formula Taiping Wan (Taiping Pill) is suitable.
Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill), Dahuang Qinghao Jian (Rhubarb and Artemisia Decoction), Chuanshi Jiangjun Wan (Inherited Phthisis General Pill)
Ganxue (Dry Blood/Stasis) is treated with Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill); accumulated heat is treated with a decoction of Dahuang (Rhei Radix et Rhizoma), Qinghao (Artemisiae Annuae Herba), Zhu Danzhi (Porci Bile), and Tongbian (Infant Urine). On the day of Guihai, moxa is applied to both Yaoyan acupoints (Lumbar Eye points) for seven moxibustion cones, followed by the administration of Chuanshi Jiangjun Wan (Inherited Phthisis General Pill).
[Note] Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) is an existing established formula. Dahuang Qinghao Jian (Rhubarb and Artemisia Decoction) consists of Qinghao (Artemisiae Annuae Herba), Dahuang (Rhei Radix et Rhizoma), Zhu Danzhi (Porci Bile), and Tongbian (Infant Urna) decocted together. After a long duration of Phthisis, malignant parasites may develop in the body. After death, the corpse is often infectious, potentially leading to the demise of the entire family; this is called "Chuanshi Lao" (Inherited Phthisis). It is appropriate to apply moxibustion to both Yaoyan acupoints (Lumbar Eye points) for seven cones on the Guihai day, followed by the administration of Chuanshi Jiangjun Wan (Inherited Phthisis General Pill). This formula is recorded in the book *Danxi Xinfa* (Essential Methods of Master Danxi).
Chaihu Qinggu San (Bupleurum Clearing Bone Powder)
Qinggu San (Clearing Bone Powder) is used to treat persistent bone-steaming fever that has not healed for a long time. For severe heat, add Qinjiao (Gentianae Radix), Zhimu (Anemarrhenae Rhizoma), Cao (Glycyrrhizae Radix et Rhizoma), and Hulian (Coptidis Rhizoma). The formula also includes Biejia (Testudinis Carapax et Plastrum), Qinghao (Artemisiae Annuae Herba), Chaihu (Bupleuri Radix), and Digupi (Lycii Cortex), decocted with Jiubai (Allii Tuberosi Bulbus), Zhu Suishui (Porcine Medulla Spinalis), Zhu Danzhi (Porci Bile), and Tongbian (Infant Urina).
[Note] This formula consists of Qinjiao (Gentianae Radix), Zhimu (Anemarrhenae Rhizoma), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma), Hulian (Coptidis Rhizoma), Biejia (Testudinis Carapax et Plastrum), Qinghao (Artemisiae Annuae Herba), Chaihu (Bupleuri Radix), Digupi (Lycii Cortex), Jiubai (Allii Tuberosi Bulbus), Zhu Suishui (Porcine Medulla Spinalis), Zhu Danzhi (Porci Bile), and Tongbian (Infant Urina).
Huang Biejia San (Scutellaria and Turtle Shell Powder)
Huang Biejia San (Scutellaria and Turtle Shell Powder) is used to treat deficiency-heat from Xu Lao (Deficiency Consumption), bone-steaming fever, evening tidal fever, thirst, and irritability. Symptoms include emaciation, reduced appetite, night sweats, cough, bleeding, and excessive phlegm. The formula contains Shengdi (Rehmanniae Radix), Chishao (Paeoniae Radix Rubra), Chaihu (Bupleuri Radix), Qinjiao (Gentianae Radix), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Ziwan (Astagi Radix), Digupi (Lycii Cortex), Banxia (Pinelliae Rhizoma), Fuling (Poria), Renshen (Ginseng Radix et Rhizoma), Guizhi (Cinnamomi Ramulus), Jiegeng (Platycodonis Radix), Biejia (Testudinis Carapax et Plastrum), Tiandong (Asparagi Radix), and Sangbaipi (Mori Cortex). Note: The dosages of Shengdi, Chishao, Chaihu, Qinjiao, Zhi Cao, Zhimu, Huangqin, Ziwan, Digupi, Banxia, Fuling, Renshen, Guizhi, and Jiegeng are halved. Additional ingredients include Biejia (Testudinis Carapax et Plastrum), Tiandong (Asparagi Radix), and Sangbaipi (Mori Cortex).
[Note] This formula comprises Shengdi (Rehmanniae Radix), Chishao (Paeoniae Radix Rubra), Chaihu (Bupleuri Radix), Qinjiao (Gentianae Radix), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Ziwan (Astagi Radix), Digupi (Lycii Cortex), Banxia (Pinelliae Rhizoma), Fuling (Poria), Renshen (Ginseng Radix et Rhizoma), Guizhi (Cinnamomi Ramulus), Jiegeng (Platycodonis Radix), Biejia (Testudinis Carapax et Plastrum), Tiandong (Asparagi Radix), and Sangbaipi (Mori Cortex).