论治痨病 论虚痨 论治痨虫
天师曰∶全治者，乃人病痨瘵之症也。痨病用不得霸药，宜用通身清火之味治之。（〔批〕痨症与虚损
症，外症大相似而治实不同。虚损者，阴阳两虚∶痨症阴虚阳亢，故虚损可用温补，痨症用清补，而忌用
温也。辨证法不必凭脉，只看人着复衣，此着单衣者为痨；人着单衣，此着复衣者为虚损。一骨蒸而热，
一营卫虚而热故也。李子永识。）方用熟地五钱，地骨皮五钱，药虽多而功用平和也，丹皮
二钱，元参一钱，人参
三钱，白术三分，桑叶五片，麦冬二钱，北五味五粒，茯苓二钱，芡实五
钱，山茱萸一钱，白芥子三分，枣仁五分，沙参二钱，水煎服。（〔批〕首方实平补
神丹）。此方妙在地骨皮为君，以入阴中平其虚火，而又不损其脾胃之气；余又加芡实、茯苓，以利其
湿气，则熟地专能生阴中之水；少加人参，以补微阳而不助火，则肺金有养矣；又益之麦冬、五味，补
其肺金，则金能生水。水生自能制虚火，而相火下伏，不夺心主之权。则一身安宁。此全治之法也。
更有一法，治人虚劳而未成痨瘵之症。方用熟地一两，山药一两，山茱萸三钱，麦
冬三钱，枣仁一钱，人参一钱，茯苓二钱，陈皮一钱，甘草一钱，沙参三
钱，白芥子一钱。芡实五钱，白芍三钱，远志八分，丹皮一钱，水煎服。此方
亦通身补其气血之方也，不寒不热，不多不少，不偏不倚，乃至中之方，当以此为主，治初起之痨役
也。盖痨役之方，当世推尊补中益气。其方原无不利，但补中益气汤治饮食内伤，兼带风邪者最妙，不能
治无有风邪而兼痨役内伤之症也。吾今立方名为和平散，以治内伤而无外感者神效。亦全治之一法也。
痨病前方妙矣。如前方服之不见起色者，必有痨虫尸气，当用一方。用鬼箭三钱，鳖甲一两，
地栗粉半斤，生何首乌半斤，熟地半斤，神曲二两，白薇三两，人参五钱，柴
胡五钱，鹿角霜六两，地骨皮五两，沙参五两，各为细末，蜜为丸。每日服前汤后，送
下五钱，一日二次。（〔批〕断虫神丹。）此方善能杀虫，又不伤耗真阴之气，真全治之巧者。因远公善
心，余不吝罄传，天下无痨虫尸气之忧矣，大约此药可服半料即止，不必尽也。此丸服半料后，当改用
六味地黄丸，加
麦冬三两，五味一两足矣，不必另立方矣。骨蒸有汗者，宜用丹皮；无汗者，宜用沙参；若地骨
皮，则有汗无汗俱宜服之。
张公曰∶痨病最难治，非偏于热，则偏于寒；非多于清，即多于补。正以当世无可遵之方，今岐天
师酌定此三方，煎、丸并用，平补无奇，实有鬼神难测之机，余又安敢以鄙浅而参间之。然而至神之中，
不妨少益至微之语。前方可服五剂，即当服吾地黄丸汤一剂，再服前汤五剂，又服余地黄汤一剂。如此
间服，则水胜于火，阳胜于阴，不至有偏旺之虞。虽岐天师方中补阴之品多于补阳，然而阳常有余，阴常
不足，似乎多服补肾水之剂，尤为无弊也。方用熟地一两，山茱萸四钱，泽泻一钱五分，丹
皮一钱五分，山药三钱，茯苓三钱，麦冬三钱，北五味五分，水煎服。此方即六味地
黄汤，加麦冬、五味者也。余特另酌分两，以示世之善用六味地黄汤者。
华君曰∶此未传予之法也，无可谈。
雷公曰∶我亦有方传子。痨病已成，人最难治。盖有虫生之，以食人之气血也。若徒补其气血，而
不知入杀虫之品。则饮食入胃，止荫虫而不生气血矣。但止杀虫而不补气血，则五脏尽伤，又何有生
理哉。予方于大补气血之中，加入杀虫之药，则元气既全，真阴未散，虫死而身安矣。方用人参三
两，熟地八两，何首乌生用八两；地栗粉八两，鳖甲醋炙一斤，神曲五两、麦
冬五两，桑叶八两，白薇三两，山药一斤，为末，打成糊；前药各为末，为丸。每日白
滚水送下五钱，半年而虫俱从大便中出。予方与天师方，各有妙理，可并传之。
孙真君曰∶未成痨病而将成痨病者，用熟地一两，地骨皮五钱，人参五分，麦冬五
钱，北五味三分，白术一钱，山
药三钱，白芥子一钱，水煎服。此方妙在平补而无偏胜之弊，虽熟地多用，然有参、术以行
气，自易制其腻滞，故转能奏功，倘谓参、木助阳，熟地过湿，举世皆不知其妙也。
更有一方，治痨虫神效。榧子半斤，鳖甲一斤，地栗粉八两，獭肝一付，白薇
四两，生何首乌一斤，各为细末，蜜为丸。每日临睡，空腹白滚水送下五钱。服半料，腹中似
虫非虫，尽行便出。天师乃治痨虫已成之圣方，而予乃治痨虫将成之妙药也，（妙）。
【背景信息】
书名：石室秘录 作者：陈士铎 朝代：清 章节：全治法 类别：综合
论治痨病（肺结核类慢性消耗性疾病） 论虚痨（以虚损为主的痨病） 论治痨虫（导致痨病的寄生虫/病原体）
天师说：所谓“全治”，是指治疗人的痨瘵（一种严重的慢性消耗性传染病）病症。治疗痨病不能使用猛烈峻烈的药物，适宜使用能清泻全身虚火的药物来治疗。（批注：痨症与虚损症，外在症状非常相似但治疗方法截然不同。虚损症是阴阳两虚；痨症则是阴虚阳亢，所以虚损症可以用温补法，痨症要用清补法，而忌讳使用温补。辨证的方法不必依赖脉诊，只看穿衣习惯即可判断：如果别人穿厚衣，此人却穿单衣，这是痨症；如果别人穿单衣，此人却穿厚衣，这是虚损症。前者是骨蒸潮热，后者是营卫虚弱导致的发热。李子永识。）方剂用熟地黄五钱，地骨皮五钱，药味虽多但功效平和。丹皮二钱，玄参一钱，人参三钱，白术三分，桑叶五片，麦冬二钱，北五味子五粒，茯苓二钱，芡实五钱，山茱萸一钱，白芥子三分，枣仁五分，沙参二钱，加水煎服。（批注：第一个方子实际上是平补的神丹妙药。）这个方子的妙处在于以地骨皮为君药，它能深入阴分平息虚火，同时不损伤脾胃之气；我又加入芡实、茯苓，用来利湿，这样熟地黄就能专门滋养阴中之水；稍加人参，以补微弱的阳气而不助长火势，那么肺金就得到了滋养；再辅以麦冬、五味子，补益肺金，那么金就能生水。水产生后自然能制约虚火，使相火潜伏下行，不再抢夺心主（心神）的权柄。这样全身就能安宁。这就是全治的方法。
还有一种方法，用于治疗那些处于虚劳状态但尚未形成严重痨瘵病症的人。方剂用熟地黄一两，山药一两，山茱萸三钱，麦冬三钱，枣仁一钱，人参一钱，茯苓二钱，陈皮一钱，甘草一钱，沙参三钱，白芥子一钱，芡实五钱，白芍三钱，远志八分，丹皮一钱，加水煎服。这个方子也是通身补益气血的方剂，不寒不热，剂量不多不少，不偏不倚，是符合中庸之道的方子，应当以此为主方，治疗初起阶段的痨役（痨病）。大概当时世人推崇补中益气汤。这个方子原本没有不好，但补中益气汤治疗饮食内伤兼带风邪的情况最为巧妙，不能治疗没有外感风邪而仅有内伤痨役病症的情况。我现在创立的这个方子名为“和平散”，用于治疗内伤而无外感的情况，效果神奇。这也是全治的一种方法。
前面的治疗痨病的方子已经很好了。如果服用前面的方子不见起色，那必定是有痨虫和尸气作祟，应当使用另一个方子。用鬼箭羽三钱，鳖甲一两，地栗粉（荸荠粉）半斤，生何首乌半斤，熟地黄半斤，神曲二两，白薇三两，人参五钱，柴胡五钱，鹿角霜六两，地骨皮五两，沙参五两，各研成细末，用蜂蜜制成丸药。每天在服用前面的汤药之后，送服此丸药五钱，一天两次。（批注：断除痨虫的神丹。）这个方子善于杀虫，又不伤害耗损真阴之气，真是全治中的巧方。因为远公心存善念，我不吝惜全部传授，天下就没有患痨虫尸气的忧虑了。大约这药服用半料就可以停止，不必全部吃完。服用完这半料丸药后，应当改用六味地黄丸，加上麦冬三两，五味子一两就可以了，不必另外立方的。如果有骨蒸潮热且伴有出汗的，适宜用丹皮；无汗的，适宜用沙参；至于地骨皮，则有汗无汗都适宜服用。
张公说：痨病最难治疗，不是偏于热证，就是偏于寒证；不是多用清热药，就是多用补益药。正因为当今世上没有可以遵循的固定方剂，现在岐天师斟酌制定了这三个方子，汤剂和丸剂并用，平补而无奇特之处，实在有鬼神都难以测度的机理，我又怎敢以我浅陋的意见来插足其间呢？然而，在至高神妙的医术之中，不妨补充一些细微的话语。前面的汤药可以服用五剂，接着就应当服用我的地黄丸汤一剂，再服用前面的汤药五剂，又服用地黄汤一剂。如此交替服用，那么水就能胜过火，阳就能胜于阴，不至于有偏旺的担忧。虽然岐天师的方子中补阴的药物多于补阳的药物，但是阳气常有余，阴精常不足，似乎多服用补肾水的药剂，尤其没有弊端。方剂用熟地黄一两，山茱萸四钱，泽泻一钱五分，丹皮一钱五分，山药三钱，茯苓三钱，麦冬三钱，北五味子五分，加水煎服。这个方子就是六味地黄汤，加上麦冬、五味子而成的。我特意另外斟酌了分量，以向世间展示如何善用六味地黄汤。
华君说：这不是他传授给我的方法，没什么可谈的。
雷公说：我也有方子传授给您。痨病一旦形成，人就很难治疗。大概是因为有虫子滋生，以吃人的气血为生。如果只是单纯补益气血，而不知道加入杀虫的药物，那么饮食进入胃中，只会滋养虫子而不能生成气血了。但如果只杀虫而不补气血，那么五脏都会受伤，又有什么生机呢？我的方子在大力补益气血之中，加入杀虫的药物，那么元气既已完备，真阴未散，虫子死了身体也就安好了。方剂用人参三两，熟地黄八两，生何首乌八两；地栗粉八两，醋炙鳖甲一斤，神曲五两，麦冬五两，桑叶八两，白薇三两，山药一斤，研成细末，打成糊状；前面的药物各研成细末，混合制成丸药。每天用白开水送服五钱，半年后虫子都会从大便中排出。我的方子和天师的方子，各有妙理，可以一起传授。
孙真君说：对于尚未形成痨病但即将形成痨病的人，用熟地黄一两，地骨皮五钱，人参五分，麦冬五钱，北五味子三分，白术一钱，山药三钱，白芥子一钱，加水煎服。这个方子的妙处在于平补而没有偏胜的弊病，虽然熟地黄用量较多，但有参、术来行气，自然容易制约其腻滞，所以反而能奏效。倘若认为参、术助阳，熟地黄过湿，举世之人都不知道其中的奥妙啊。
还有另一个方子，治疗痨虫效果神奇。榧子半斤，鳖甲一斤，地栗粉八两，獭肝一副，白薇四两，生何首乌一斤，各研成细末，用蜂蜜制成丸药。每天临睡前，空腹用白开水送服五钱。服用半料后，腹中会出现似虫非虫的东西，全部排出体外。天师的是治疗已成痨虫的圣方，而我的是治疗将成痨虫的妙药啊。（妙）
[Background Information]
Book: Shishi Milu (Secret Records of the Stone Chamber)
Author: Chen Shiduo (Chen Shi Duo)
Dynasty: Qing Dynasty
Chapter: Quan Zhi Fa (Methods for Complete Cure)
Category: Comprehensive
On Treating Lao Disease (Tuberculosis-like Chronic Consumptive Diseases), On Xu Lao (Lao Disease Dominated by Deficiency), On Treating Lao Chong (Parasites/Pathogens Causing Lao Disease)
The Heavenly Master said: What is referred to as "Complete Cure" pertains to treating a person's symptoms of Lao Zhai (a severe chronic consumptive infectious disease). One must not use harsh or drastic medicines for treating Lao disease; instead, it is appropriate to use substances that clear heat and fire from the entire body. (Commentary: The symptoms of Lao syndrome and Xu Sun (Deficiency Injury) are externally very similar, but their treatments differ significantly. Xu Sun involves deficiency of both Yin and Yang; whereas Lao syndrome involves Yin deficiency with Yang hyperactivity. Therefore, Xu Sun can be treated with warming tonification, while Lao syndrome requires clearing and tonifying, avoiding warming methods. Differentiation does not rely on pulse diagnosis; one only needs to observe clothing habits: if others wear thick clothes and this patient wears thin ones, it is Lao syndrome; if others wear thin clothes and this patient wears thick ones, it is Xu Sun. The former is due to bone-steaming tidal fever, the latter due to heat from deficiency of Ying and Wei (Nutritive and Defensive Qi). Recorded by Li Ziyong.) The prescription uses Shudi (Rehmanniae Radix Praeparata) 5 qian, Digupi (Lycii Cortex) 5 qian. Although there are many ingredients, the efficacy is mild. Danpi (Moutan Cortex) 2 qian, Yuan Shen (Scrophulariae Radix) 1 qian, Renshen (Ginseng Radix et Rhizoma) 3 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 0.3 qian, Sangye (Mori Folium) 5 leaves, Maidong (Ophiopogonis Radix) 2 qian, Bei Wuwei Zi (Schisandrae Chinensis Fructus) 5 grains, Fuling (Poria) 2 qian, Qianshi (Nelumbinis Semen) 5 qian, Shanzhuyu (Corni Fructus) 1 qian, Baijiezi (Sinapis Semen) 0.3 qian, Zaoren (Ziziphi Spinosae Semen) 0.5 qian, Shashen (Glehniae Radix) 2 qian. Decoct in water and take orally. (Commentary: This first formula is essentially a Divine Elixir for gentle tonification.) The brilliance of this formula lies in using Digupi as the sovereign herb to enter the Yin level and calm deficient fire without damaging Spleen and Stomach Qi; I additionally added Qianshi and Fuling to promote dampness drainage, allowing Shudi to specifically generate Water within Yin; adding a small amount of Renshen to tonify slight Yang without aiding fire, thereby nourishing Lung Metal; further assisting with Maidong and Wuwei Zi to tonify Lung Metal, so that Metal can generate Water. Once Water is generated, it naturally controls deficient fire, causing Ministerial Fire to subside downward, no longer usurping the authority of the Heart Master (Shen/Spirit). Thus, the whole body remains peaceful. This is the method of complete cure.
There is another method for treating individuals in a state of Xu Lao (Deficiency Labor) who have not yet developed serious Lao Zhai symptoms. The prescription uses Shudi 1 liang, Shanyao (Dioscoreae Rhizoma) 1 liang, Shanzhuyu 3 qian, Maidong 3 qian, Zaoren 1 qian, Renshen 1 qian, Fuling 2 qian, Chenpi (Citri Reticulatae Pericarpium) 1 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian, Shashen 3 qian, Baijiezi 1 qian, Qianshi 5 qian, Baishao (Paeoniae Radix Alba) 3 qian, Yuanzhi (Polygalae Radix) 0.8 fen, Danpi 1 qian. Decoct in water and take orally. This formula also tonifies Qi and Blood throughout the body; it is neither cold nor hot, neither excessive nor insufficient, neither biased nor leaning, representing the formula of the Mean (Zhong Yong). It should serve as the primary formula for treating early-stage Lao Yi (Lao disease). Generally, people today revere Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting Qi). While this formula has its merits, Buzhong Yiqi Tang is most excellent for treating internal injury from diet accompanied by Wind pathogen, but it cannot treat cases of internal injury from Lao Yi without external Wind pathogen. I now created this formula named Heping San (Peaceful Powder) to treat internal injury without external contraction, showing miraculous effects. This is also a method of complete cure.
The previous formulas for treating Lao disease are excellent. If there is no improvement after taking them, there must be Lao Chong (parasites) and Shi Qi (corpse qi/toxicity). In such cases, use another formula: Guijianyu (Arisaematis Cum Bile / Arisaema with gallbladder bile - *Note: Context implies a specific antiparasitic herb, often interpreted as Arisaema or similar, here translated as Guijianyu*) 3 qian, Biejia (Testudinis Carapax et Plastrum) 1 liang, Dili Fen (Heptapodi Medullam / Water Chestnut Starch) half jin, Sheng Heshouwu (Polygoni Multiflori Radix Cruda) half jin, Shudi half jin, Shenqu (Massa Medicata Fermentata) 2 liang, Baiwei (Cynanchi Atrati Radix) 3 liang, Renshen 5 qian, Chaihu (Bupleuri Radix) 5 qian, Lujiaoshuang (Cervi Cornus Degelatinatum) 6 liang, Digupi 5 liang, Shashen 5 liang. Grind each into fine powder, mix with honey to form pills. After taking the previous decoction daily, swallow 5 qian of these pills, twice a day. (Commentary: Divine Elixir for Eradicating Parasites.) This formula effectively kills parasites without damaging True Yin Qi, truly a skillful method of complete cure. Due to the benevolence of Yuan Gong, I do not hesitate to transmit this completely. There will be no worry about Lao Chong and Shi Qi in the world. Approximately, half a dose of this medicine is sufficient to stop; it is not necessary to finish it all. After taking half a dose of these pills, switch to Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), adding Maidong 3 liang and Wuwei Zi 1 liang. There is no need to create another formula. For those with bone-steaming fever and sweating, Danpi is suitable; for those without sweating, Shashen is suitable; however, Digupi is suitable for both with or without sweating.
Lord Zhang said: Lao disease is the most difficult to treat. It is either biased towards Heat or biased towards Cold; either it uses more clearing herbs or more tonifying herbs. Precisely because there is no standard formula to follow in the current era, Lord Qi Tian Shi has carefully determined these three formulas, combining decoctions and pills. They gently tonify without being extraordinary, possessing mechanisms difficult even for ghosts and gods to fathom. How dare I intrude with my shallow views? However, within supreme divinity, it is acceptable to add some subtle words. The previous decoction can be taken for five doses, then take one dose of my Dihuang Wan Tang (Decoction), then five doses of the previous decoction again, followed by one dose of the remaining Dihuang Tang. By alternating like this, Water will overcome Fire, and Yang will overcome Yin, avoiding the risk of hyperactivity. Although Lord Qi Tian Shi's formula contains more Yin-tonifying than Yang-tonifying herbs, Yang is often in excess and Yin is often deficient. It seems particularly harmless to take more Kidney Water-tonifying agents. The formula uses Shudi 1 liang, Shanzhuyu 4 qian, Zexie (Alismatis Rhizoma) 1.5 qian, Danpi 1.5 qian, Shanyao 3 qian, Fuling 3 qian, Maidong 3 qian, Bei Wuwei Zi 0.5 fen. Decoct in water and take orally. This formula is Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) plus Maidong and Wuwei Zi. I specially adjusted the dosages to demonstrate to the world how to skillfully use Liuwei Dihuang Tang.
Lord Hua said: This is not the method transmitted to me; there is nothing to discuss.
Lord Lei said: I also have a formula to transmit. Once Lao disease has formed, the person is hardest to treat. This is because parasites breed, feeding on the person's Qi and Blood. If one merely tonifies Qi and Blood without knowing to add anti-parasitic ingredients, food entering the stomach will only nourish the parasites rather than generate Qi and Blood. But if one only kills parasites without tonifying Qi and Blood, the Five Viscera will be entirely damaged, leaving no room for life. My formula adds anti-parasitic drugs within strong Qi and Blood tonification. Thus, Yuan Qi (Original Qi) becomes complete, True Yin remains intact, parasites die, and the body becomes safe. The formula uses Renshen 3 liang, Shudi 8 liang, raw Heshouwu 8 liang; Dili Fen 8 liang, Vinegar-fried Biejia 1 jin, Shenqu 5 liang, Maidong 5 liang, Sangye 8 liang, Baiwei 3 liang, Shanyao 1 jin. Grind into fine powder, make into paste; mix with other powdered herbs to form pills. Take 5 qian daily with plain boiled water. After half a year, all parasites will be excreted through stool. My formula and the Heavenly Master's formula each have profound principles; they can be transmitted together.
Master Sun said: For those who have not yet developed Lao disease but are about to, use Shudi 1 liang, Digupi 5 qian, Renshen 0.5 fen, Maidong 5 qian, Bei Wuwei Zi 0.3 fen, Baizhu 1 qian, Shanyao 3 qian, Baijiezi 1 qian. Decoct in water and take orally. The brilliance of this formula lies in gentle tonification without bias. Although Shudi is used in large amounts, Renshen and Baizhu move Qi, easily controlling its cloying nature, thus achieving efficacy. If one claims Renshen and Baizhu aid Yang and Shudi is too damp/wet, the world fails to understand its subtlety.
There is another formula, extremely effective for treating Lao Chong: Feizi (Torreya Seed) half jin, Biejia 1 jin, Dili Fen 8 liang, Ta Gan (Leporis Hepat / Rabbit Liver) one piece, Baiwei 4 liang, raw Heshouwu 1 jin. Grind each into fine powder, mix with honey to form pills. Every night before sleep, take 5 qian on an empty stomach with plain boiled water. After half a dose, strange worm-like substances will appear in the abdomen and be completely excreted. The Heavenly Master's formula is a sacred prescription for treating established Lao Chong, while mine is a wonderful remedy for preventing impending Lao Chong. (Wonderful)