（无热虚劳，乃阳虚症，其病自上而下，损之脉也，法宜温补，惟东垣、元礼、立斋先生，
独得其治，宜宗之。气虚易补，宜早为妙，不比有热虚劳之难疗理也）
大全云∶妇人冷劳，属血气不足，脏腑虚寒，以致脐下冷痛，手足时寒，月经失常，饮食
不消，或时呕吐，恶寒发热，骨节酸疼，肌肤羸瘦，面色萎黄也。
薛氏曰∶前证有内外真寒，有内外真热，有内真热而外假寒，有内真寒而外假热者。若
饮食难化，大便不实，肠鸣腹痛，饮食畏寒，手足逆冷，面黄呕吐，畏见风寒，此内外真寒之
证也，宜用附子理中汤以回阳，八味地黄丸以壮火若饮食如常，大便坚实，胸腹痞胀，饮食
喜冷，手足烦热，面赤呕吐，不畏风寒，此内外真热之证也（有热无热，可以占气血虚实矣。
立斋证治方法，可补前论不足），宜用黄连解毒汤以消阳，六味地黄丸以壮水。若饮食如
常，大便坚实，胸腹痞胀，饮食喜寒，手足逆冷，面黄呕吐，畏见风寒，此内真热而外假寒
也，亦用解毒汤、六味丸。若饮食少思，大便不实，吞酸嗳气，胸腹痞满，手足逆冷，面赤呕
吐，畏见风寒，此内真寒而外假热也，亦用附子理中汤与八味丸，当求其属而治之。经曰∶
益火之源，以消阴翳，壮水之主，以制阳光。使不知真水火之不足，泛以寒热药治之，则旧疾
未去，新病复生矣。夫所谓属者，犹主也，谓心肾也，求其属也者，言水火不足而求之于心肾
也，火之源者，阳气之根，即心是也，水之主者，阴气之根，即肾是也，非谓火为心源为肝，
水为肾主为肺也。
一妇食少作呕，口吐痰涎，面黄腹痛，月经不调，手足逆冷，此内外俱寒之证（以内外
俱寒而不用附子、理中，何也），以六君加香附、木香，治之而愈。
一妇忽呕吐酸水，内热作渴，饮食不进，惟喜冷水，面色青赤，投之以药，入口即吐，此
内外真热之症，积十余日，以黄连一味，煎汤饮之，徐加白术、茯苓，仍加陈皮、当归、炙草，
至月余，始进米饮稀粥，调理而愈。（以内外真热，不用三黄解毒，而以一味黄连者，泻火之
源也，其余加白术等药者，抑恐苦寒伤胃耳）
一妇内热作渴，大便秘结，畏恶风寒，手足逆冷，此内真热而外假寒，先用黄连解毒
汤，后用六味丸而愈。（有热渴、便秘二症，故虽逆冷，亦是假寒。然亦有可下者，后用六味
丸，求其属也。然须以脉有力无力分虚实）
一妇初患痰喘热渴，医以降火散气治之，肌日削而气日索，延至甲辰，木旺痰盛，身热
口腐，腹胀神昏，绝食几死，此虚热无火，投以壮火生土之剂，随服随效。越数岁，夏初，坐则
头坠，不能起视，卧则背冷，觉风透体，烦热晕眩，咳呕痰涌，手足麻冷，此内真寒而外假热
之证也，遂以大补姜附之剂投之，不三四服而大势已平，仍以前药加减而愈。（此得热因寒
用之法从之）
韩懋治其嫂年三十余（此案系重出，然不删去者，存之以备遗亡也），十八胎，九 八
夭，会家难作，惊忧过甚，遂昏昏不省人事，口唇舌皆疮，或至封喉，下部虚脱，白带如注，如
此四十余日，或时少苏，至欲自缢，悲不能堪，医或投凉剂解其上，则下部疾愈甚，或投热
剂，及以汤药熏蒸其下，则热晕欲绝，此亡阳证也（明是上实下虚，得热因寒用），急以盐煮
大附子九钱为君，制以薄荷、防风，佐以芎、归、姜、桂之属，水煎，入井水冷与之，未尽剂，
鼾睡通宵，觉即能识人。或曰∶此何谓也？曰∶方书有之，假对假，真对真尔，上乃假热，故以
假冷之药从之，下乃真冷，故以真热之药反之，斯上下和而病解矣，继以女金丹。错综以
三二方，不但去其疾，且调治元气，无何连生二子。
以上论及治验，有无当于虚劳者，而实治寒与热变通之大法尔，不可不察也。
（无热虚劳，乃阳虚症，其病自上而下，损之脉也，法宜温补，惟东垣、元礼、立斋先生，独得其治，宜宗之。气虚易补，宜早为妙，不比有热虚劳之难疗理也）
无热虚劳，属于阳虚证候，其病情由上向下发展，属于元气亏损的脉象规律，治疗法则应当采用温补法。只有李东垣、薛己（号元礼）、薛立斋三位先生，独自掌握了这种治疗方法，值得效法。气虚容易补益，应当尽早治疗为妙，不像有热虚劳那样难以调理治愈。
《女科百问》中说：妇人冷劳，属于气血不足，脏腑虚寒，导致脐下冷痛，手足时常发凉，月经失调，饮食不消化，有时呕吐，恶寒发热，骨节酸痛，肌肤消瘦，面色萎黄。
薛氏说：上述证候有内外皆真寒的，有内外皆真热的，有内里真热而外部假寒的，有内里真寒而外部假热的。如果饮食难以消化，大便不成形，肠鸣腹痛，饮食怕冷，手足逆冷，面色发黄呕吐，害怕风吹和寒冷，这是内外皆真寒的证候，适宜使用附子理中汤来回阳救逆，八味地黄丸来壮命门之火。如果饮食正常，大便干结，胸腹痞满胀闷，饮食喜欢冷饮，手足烦热，面色发红呕吐，不怕风吹和寒冷，这是内外皆真热的证候（通过有无热象可以判断气血的虚实。薛立斋的证治方法，可以补充前面论述的不足），适宜使用黄连解毒汤来清泻实火，六味地黄丸来滋补肾阴。如果饮食正常，大便干结，胸腹痞满胀闷，饮食喜欢冷食，手足逆冷，面色发黄呕吐，害怕风吹和寒冷，这是内里真热而外部假寒的证候，也使用黄连解毒汤、六味地黄丸。如果饮食减少不想吃，大便不成形，吞酸嗳气，胸腹痞满，手足逆冷，面色发红呕吐，害怕风吹和寒冷，这是内里真寒而外部假热的证候，也使用附子理中汤与八味地黄丸，应当探究疾病的根本属性而进行治疗。《内经》说：补益火的源头，以消除阴寒之邪；壮大水的根本，以制约阳热之气。如果不了解真水真火的不足，泛泛地使用寒热药物治疗，那么旧疾未去，新病又会产生。所谓“属”，就是“主”的意思，指心和肾。探究其所属，是说水火不足而从心肾求治。火的源头，是阳气的根本，即心；水的根本，是阴气的根本，即肾。并不是说火归属于心、源归属于肝，水归属于肾、主归属于肺。
一位妇女饮食少且作呕，口吐痰涎，面色发黄腹痛，月经不调，手足逆冷，这是内外俱寒的证候（既然内外俱寒为何不用附子、理中？），用六君子汤加入香附、木香，治疗而痊愈。
一位妇女忽然呕吐酸水，内热作渴，饮食不进，只喜欢冷水，面色青赤，给药后入口即吐，这是内外真热的症状，持续十余日，只用黄连一味，煎汤饮用，慢慢加入白术、茯苓，随后再加入陈皮、当归、炙甘草，直到一个多月后，才开始喝米饮稀粥，调理而痊愈。（既然是内外真热，为何不用三黄解毒汤，而只用一味黄连？这是因为要直泻火之源。其余加入白术等药，是恐怕苦寒药物损伤胃气罢了。）
一位妇女内热作渴，大便秘结，畏恶风寒，手足逆冷，这是内里真热而外部假寒，先用黄连解毒汤，后用六味地黄丸而痊愈。（有热渴、便秘两个症状，所以虽然手足逆冷，也是假寒。然而也有可以使用攻下法的，后来用六味地黄丸，是为了探究疾病的根本属性。然而必须通过脉象的有力无力来区分虚实。）
一位妇女起初患痰喘热渴，医生用降火散气的方法治疗，肌肉日渐消瘦，正气日渐衰弱，拖延到甲辰年，木气旺盛痰湿盛，身体发热，口腔腐烂，腹胀神志昏迷，绝食几乎死亡，这是虚热无火（此处指阴虚火旺或真寒假热之误用导致的虚损，原文意指此前误治导致真阳受损或阴液枯竭，此处按原文语境理解为因误治导致的虚损状态，需壮火生土），投以壮火生土的药剂，随服随效。过了几年，夏初，坐着时头重坠不能抬起视物，躺着时背部发冷，感觉风透入体内，烦热晕眩，咳嗽呕吐痰涌，手足麻木发冷，这是内里真寒而外部假热的证候，于是用大剂量姜附的药剂投予，不到三四服大势已平，仍以前方加减而痊愈。（这是得到了“热因寒用”的反治法，顺从其假象而治。）
韩懋治疗他的嫂子，三十多岁（此案系重复出现，但不删去，是为了保存以备遗忘），生育十八胎，九个夭折，遭遇家庭变故，惊忧过度，于是昏昏沉沉不省人事，口唇舌头都生疮，甚至堵塞咽喉，下部虚脱，白带如注，如此四十多天，有时稍微清醒，甚至想要自缢，悲痛不堪。医生有的投凉剂解除上部症状，则下部疾病更严重；有的投热剂，并用汤药熏蒸下部，则热晕欲绝，这是亡阳证候（明明是上实下虚，符合热因寒用的原则），急忙用盐煮的大附子九钱为君药，配伍薄荷、防风，佐以川芎、当归、生姜、肉桂等属，水煎，放入井水中冷却后给她服用，药未尽，便鼾睡通宵，醒来就能认人。有人说：这是什么意思？回答说：医书上有记载，假对假，真对真罢了。上部是假热，所以用假冷的药物顺从它；下部是真冷，所以用真热的药物对抗它，这样上下调和而病解了。随后用女金丹。错综使用两三个方剂，不但去除了疾病，而且调理元气，不久接连生了两个儿子。
以上论述及治疗验证，是否有适合虚劳的，其实是治疗寒与热变化通融的大法，不可不仔细考察。
(Wu Re Xu Lao, being Yang Deficiency Syndrome, its pathology proceeds from above downward, representing the pulse pattern of depletion. The treatment principle should be warming and tonifying. Only Mr. Dongyuan (Li Dongyuan), Yuanli (Xue Ji), and Lizhai (Xue Li) independently mastered this treatment method, which is worthy of emulation. Qi deficiency is easy to tonify; it is best to treat early, unlike Heat-type Xu Lao which is difficult to manage.)
Wu Re Xu Lao (Deficiency Consumption without Heat) belongs to Yang Deficiency Syndrome. Its pathology progresses from the upper body to the lower body, reflecting the pulse pattern of organ depletion. The therapeutic principle should employ Warming and Tonification (Wen Bu). Only Master Li Dongyuan, Xue Ji (courtesy name Yuanli), and Xue Li (courtesy name Lizhai) uniquely grasped the correct treatment for this condition, and their methods should be emulated. Qi Deficiency (Qi Xu) is relatively easy to tonify, so early intervention is ideal, unlike Heat-type Xu Lao which is more difficult to treat.
*Da Quan* states: Women's Cold Lao (Cold Consumption) belongs to Blood and Qi Insufficiency, with deficiency-cold in the Zang-Fu organs, leading to cold pain below the umbilicus, intermittent coldness in the hands and feet, irregular menstruation, indigestion, occasional vomiting, aversion to cold with fever, soreness and pain in bone joints, emaciation of the skin and muscles, and sallow complexion.
Master Xue stated: The aforementioned syndromes include those with true cold internally and externally, true heat internally and externally, true heat internally with false cold externally, and true cold internally with false heat externally. If digestion is difficult, stools are unformed, there is borborygmus and abdominal pain, food intake is feared due to cold, hands and feet are cold up to the elbows/knees, the face is yellow with vomiting, and there is aversion to wind and cold, this is a syndrome of True Cold Internally and Externally. It is appropriate to use Fuzi Lizhong Tang (Aconite Decoction for Regulating the Middle) to restore Yang, and Bawei Dihuang Wan (Eight-Ingredient Pill with Rehmannia) to strengthen the Fire of the Gate of Vitality. If diet is normal, stools are firm, there is chest and abdominal fullness and distension, preference for cold drinks, hot sensations in the hands and feet, red face with vomiting, and no aversion to wind or cold, this is a syndrome of True Heat Internally and Externally. (The presence or absence of heat can indicate the deficiency or excess of Qi and Blood. The diagnostic and treatment methods of Lizhai can supplement the preceding discussion.) It is appropriate to use Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) to clear Yang-Heat, and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish Water. If diet is normal, stools are firm, there is chest and abdominal fullness and distension, preference for cold food, cold hands and feet, yellow face with vomiting, and aversion to wind and cold, this is a syndrome of True Heat Internally with False Cold Externally. One should also use Jiedu Tang (Decoction for Resolving Toxicity) and Liuwei Wan (Six-Ingredient Pill). If appetite is poor, stools are unformed, there is acid regurgitation and belching, chest and abdominal fullness, cold hands and feet, red face with vomiting, and aversion to wind and cold, this is a syndrome of True Cold Internally with False Heat Externally. One should also use Fuzi Lizhong Tang and Bawei Wan (Eight-Ingredient Pill), seeking the root cause (Shu) to treat it. The Classics state: "Enrich the source of Fire to dissipate Yin shadows; strengthen the master of Water to control Solar brilliance." If one does not understand the insufficiency of True Water and True Fire, and indiscriminately uses cold or hot medicines, old diseases will not leave, and new diseases will arise. The term "Shu" (Affiliation/Root) refers to "Zhu" (Master), meaning Heart and Kidney. Seeking the Shu means addressing insufficiency of Water and Fire by treating the Heart and Kidney. The Source of Fire is the root of Yang Qi, which is the Heart. The Master of Water is the root of Yin Qi, which is the Kidney. It does not mean that Fire belongs to the Heart and Source to the Liver, nor that Water belongs to the Kidney and Master to the Lung.
A woman had poor appetite and vomiting, spat out phlegm-saliva, had a yellow face, abdominal pain, irregular menstruation, and cold hands and feet. This was a syndrome of Cold both Internally and Externally. (Why were Fuzi and Lizhong not used given the internal and external cold?) She was treated with Liujun Zi Tang (Six-Gentlemen Decoction) added with Xiangfu (Cyperus Rhizome) and Muxiang (Aucklandiae Radix), and she recovered.
A woman suddenly vomited sour fluid, felt internal heat and thirst, could not eat, only desired cold water, had a bluish-red complexion, and vomited immediately after taking medicine. This was a syndrome of True Heat Internally and Externally. After more than ten days, she drank a decoction of a single herb, Huanglian (Coptidis Rhizoma), slowly adding Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria), followed by Chenpi (Citri Reticulatae Pericarpium), Danggui (Angelicae Sinensis Radix), and Zhigancao (Prepared Licorice Root). After more than a month, she could finally consume rice water and thin porridge, and recovered through regulation. (Since it was True Heat Internally and Externally, why was Sanhuang Jiedu Tang not used, but only a single dose of Huanglian? To directly drain the source of fire. The addition of Baizhu and other herbs was to prevent bitter-cold medicines from damaging the Stomach.)
A woman had internal heat, thirst, constipation, aversion to wind and cold, and cold hands and feet. This was True Heat Internally with False Cold Externally. She first used Huanglian Jiedu Tang, then Liuwei Dihuang Wan, and recovered. (Due to symptoms of heat-thirst and constipation, even though her limbs were cold, it was false cold. However, purgatives might also be applicable in some cases. Later using Liuwei Dihuang Wan was to seek the root. One must distinguish deficiency and excess by whether the pulse is forceful or weak.)
A woman initially suffered from phlegm-wheezing, heat, and thirst. A doctor treated her with clearing-fire and dispersing-Qi methods. Her muscles wasted away daily, and her Qi declined. By the year Jiachen, Wood Qi was prosperous, Phlegm was abundant, she had body heat, oral ulcers, abdominal distension, and coma, nearly dying from starvation. This was a case of Deficient Heat without Fire (referring to the aftermath of mis-treatment leading to severe deficiency), and she was administered formulas to Strengthen Fire to Generate Earth (Zhuang Huo Sheng Tu). She responded immediately. Years later, in early summer, when sitting her head felt heavy and she could not lift it to look around; when lying down her back felt cold, as if wind penetrated her body; she experienced irritability, heat, dizziness, coughing, vomiting, profuse phlegm, and numb, cold hands and feet. This was a syndrome of True Cold Internally with False Heat Externally. She was then administered a large-dose formula containing Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata). Within three to four doses, the major symptoms subsided. She continued with modified versions of the previous prescription and recovered. (This obtained the method of "Treating Heat with Cold" [Reversal Treatment], following the false presentation.)
Han Mao treated his sister-in-law, who was over thirty years old. (This case is repeated, but retained to preserve potential lost knowledge.) She had eighteen pregnancies, nine ended in infant death. Due to family difficulties, excessive shock and worry led to unconsciousness, sores on lips, tongue, and throat blocking the airway, lower body collapse, and leukorrhea like a gush. For over forty days, she occasionally regained consciousness, contemplated suicide, and was unbearable in grief. Doctors who administered cooling agents to resolve upper symptoms caused lower symptoms to worsen. Those who administered heating agents or steamed the lower body with herbal decoctions caused heat-induced fainting. This was a syndrome of Yang Collapse (Clearly Upper Excess and Lower Deficiency, fitting the principle of Heat due to Cold usage). Urgently, he used Yan Zhu Da Fu Zi (Salt-prepared Large Aconite) 9 qian as the sovereign herb, processed with Bohe (Menthae Haplocalycis Herba) and Fangfeng (Saposhnikoviae Radix), assisted by Xiong (Chuanxiong Rhizoma), Gui (Angelicae Sinensis Radix), Jiang (Zingiberis Rhizoma), and Rougui (Cinnamomi Cortex). It was decocted in water, cooled in a well, and administered. Before the dose was finished, she slept soundly all night and woke up recognizing people. Someone asked: What is this? He replied: Medical texts state, "Treat the false with the false, the true with the true." The upper part presented False Heat, so false-cold medicines were used to follow it. The lower part presented True Cold, so true-hot medicines were used to oppose it. Thus, the upper and lower harmonized, and the disease resolved. Subsequently, Nvjin Dan (Women's Golden Pill) was used. By intricately combining two or three formulas, not only was the disease removed, but Yuan Qi (Primal Qi) was regulated. Soon after, she gave birth to two sons.
The above discussions and verified treatments address whether they apply to Xu Lao, but essentially they are the great principles of flexibly treating Cold and Heat variations. They must not fail to be examined carefully.