按古方书,无秋燥之病。近代以来,惟喻嘉言始补《燥气论》,其方用甘润微寒。叶氏亦有燥气化火之论,其方用
辛凉甘润。乃《素问》所谓燥化于天,热反胜之,治以辛凉,佐以苦甘法也。
春月地气动而湿胜,故春分以后,风湿暑湿之证多;秋月天气肃而燥胜,故秋分以后,风燥凉燥之证多;若天气晴
暖,秋阳以曝,温燥之证反多于凉燥。前哲沈氏目南,谓《性理大全》燥属次寒,感其气者,遵《内经》燥淫所胜,平
以苦温,佐以辛甘之法,主用香苏散(香附、紫苏、陈皮、甘草)加味,此治秋伤凉燥之方法也。
喻氏嘉言,谓《生气通天论》,秋伤于燥,上逆而咳,发为痿厥。燥病之要,一言而终,即诸气 郁,皆属于肺,
诸痿喘呕,皆属于上,二条指燥病言明甚,更多属于肺之燥。至左 胁痛、不能转侧、嗌干面尘、身无膏泽、足外反热、
腰痛、筋挛、惊骇、丈夫 疝、妇人少腹痛、目眯 疮、则又燥病之本于肝而散见不一者也,而要皆秋伤于燥之征也。
故治秋燥病,须分肺肝二脏,遵《内经》燥化于天,热反胜之之旨,一以甘寒为主,发明《内经》燥者润之之法,自制
清燥救肺汤,用桑叶、石膏、甘草、人参、胡麻仁、真阿胶、麦门冬、杏仁、枇杷叶。痰多加贝母、栝蒌;血枯加生地
黄;热甚加犀角、羚羊角、或牛黄。随证加药。此治秋伤温燥之方法也。
根据古代医方书籍,没有关于“秋燥”这种疾病的记载。近代以来,只有喻嘉言开始补充撰写了《燥气论》,他使用的方剂性质为甘润且微寒。叶天士也有燥气化火的论述,他使用的方剂性质为辛凉且甘润。这正是《素问》中所说的:燥气由天时引起,若热气反而偏胜,治疗应以辛凉为主,辅以苦甘之法。
春季地气升动而湿气偏胜,所以春分以后,风湿和暑湿的病证较多;秋季天气肃杀而燥气偏胜,所以秋分以后,风燥和凉燥的病证较多;如果天气晴朗温暖,秋阳暴晒,温燥的病证反而比凉燥多。前贤沈目南认为,《性理大全》中称燥属于次寒,感受这种邪气的人,应遵循《内经》中“燥淫所胜,平以苦温,佐以辛甘”的原则,主用香苏散(由香附、紫苏、陈皮、甘草组成)进行加味,这是治疗秋季损伤于凉燥的方法。
喻氏嘉言认为,《生气通天论》中提到:“秋伤于燥,上逆而咳,发为痿厥。”燥病的要点,可以用一句话概括,即“诸气郁,皆属于肺”、“诸痿喘呕,皆属于上”,这两条明确指出了燥病,更多是指归属于肺的燥病。至于左胁痛、不能转侧、咽喉干燥、面色如蒙尘、身体缺乏润泽、足外侧反热、腰痛、筋脉拘挛、惊骇、男子疝气、女子少腹痛、眼睑痉挛生疮等,则是燥病根源在肝而表现不一的情况,但这些都是秋季损伤于燥气的征象。因此,治疗秋燥病,必须区分肺和肝两脏,遵循《内经》中“燥化于天,热反胜之”的宗旨,一概以甘寒为主,阐发《内经》“燥者润之”的方法,自创清燥救肺汤,使用桑叶、石膏、甘草、人参、胡麻仁、真阿胶、麦门冬、杏仁、枇杷叶。痰多加贝母、栝蒌;血枯加生地黄;热甚加犀角、羚羊角,或牛黄。随证加减药物。这是治疗秋季损伤于温燥的方法。
According to ancient medical formularies, there is no record of the disease "Autumn Dryness" (Qiū Zào). Since modern times, only Yu Jiayan (Yu Chang) began to supplement with his treatise *Lùn Zào Qì* (Treatise on Dryness Qi), using formulas that are sweet, moistening, and slightly cold. Ye Tianshi also discussed the transformation of dryness into fire, using formulas that are acrid-cool and sweet-moistening. This aligns with the principle in *Sù Wèn* (Basic Questions): when dryness originates from heaven and heat counteracts it excessively, treatment should employ acrid-cool agents as primary, assisted by bitter-sweet agents.
In spring, earth qi rises and dampness prevails; thus, after the Spring Equinox, patterns of wind-dampness and summerheat-dampness are common. In autumn, heavenly qi becomes solemn and dryness prevails; thus, after the Autumn Equinox, patterns of wind-dryness and cool-dryness are common. However, if the weather is sunny and warm, with the autumn sun exposing the earth, patterns of warm-dryness may actually outnumber those of cool-dryness. The former scholar Shen Munan stated that according to *Xìng Lǐ Dà Quán*, dryness belongs to secondary cold. Those affected by this qi should follow the *Nèi Jīng* principle: "When dryness invades and prevails, level it with bitter-warm, assisted by acrid-sweet." The main formula used is Xiāng Sū Sǎn (Fragrant Perilla Powder, composed of Xiangfu, Zisu, Chenpi, Gancao) with modifications. This is the method for treating autumn injury by cool-dryness.
Yu Jiayan cited the *Shēng Qì Tōng Tiān Lùn* chapter, which states: "Autumn injury by dryness causes upward rebellion and cough, leading to flaccidity syndromes and cold extremities." The essence of dryness diseases can be summarized in one phrase: "All qi stagnations belong to the Lung," and "All flaccidity, wheezing, and vomiting belong to the upper jiao." These two statements clearly refer to dryness diseases, specifically emphasizing dryness belonging to the Lung. As for left hypochondriac pain, inability to turn the body, dry throat, dusty complexion, lack of bodily luster, heat in the outer sole of the foot, lower back pain, tendon cramping, fright, male hernia, female lower abdominal pain, eyelid spasms with sores—these are manifestations where the root of dryness lies in the Liver but presents variably. Nevertheless, they are all signs of autumn injury by dryness. Therefore, treating autumn dryness diseases requires distinguishing between the Lung and Liver organs. Following the *Nèi Jīng* principle that "when dryness originates from heaven and heat counteracts it," treatment should primarily use sweet-cold agents, elucidating the *Nèi Jīng* method "for dryness, use moistening." Yu created the Qīng Zào Jiù Fèi Tāng (Clear Dryness Rescue Lung Decoction), using Sangye, Shigao, Gancao, Renshen, Humaoren, Zhen Ejiao, Maimendong, Xingren, and Pipaye. If phlegm is excessive, add Beimu and Gualou; if blood is depleted, add Shengdihuang; if heat is severe, add Xijiao, Lingyangjiao, or Niuhuang. Adjust herbs according to symptoms. This is the method for treating autumn injury by warm-dryness.