燥为阳明秋金之化，金燥则水源竭，而灌溉不周，兼以风生燥，火化燥，《原病式》所谓诸涩枯涸，
干劲皴揭，皆属于燥也。燥有外因，有内因。因于外者，天气肃而燥胜，或风热致伤气分，则津液不腾，宜甘润
以滋肺胃，佐以气味辛通；因乎内者，精血夺而燥生，或服饵偏助阳火，则化源日涸，宜柔腻以养肾肝，尤
资血肉填补。叶氏以上燥治气，下燥治血二语括之，最为简当。今析言之，燥在上，必乘肺，为燥嗽。喻氏
清燥救肺汤加减。肺中有火，为干咳。申先生琼玉膏主之。外内合邪，千金麦门冬汤。肺痿咳唾，心中温温液
液者，仲景炙甘草汤。燥在中，必伤脾胃之阴，为热壅，食不下，金匮麦门冬汤。胃脘有死血，干燥枯槁，
食下痛，胃翻便秘，丹溪韭汁牛乳饮。胃热善消水谷，丹溪消渴方。燥在下，必乘大肠，为大便燥结，其气秘，浊
阴不降者，东垣通幽汤、润燥汤、玉函麻仁丸。风秘血燥，东垣润肠丸加郁李仁、防风。津枯秘结，丹溪
润燥生津汤加麻仁，或蜜煎导。血枯膈噎，便结如栗，生料六味丸去山萸，加首乌、当归，或加肉苁蓉、桃
仁捣。水煎服。兼食人乳酥蜜。此燥在脏腑者也。若燥在血脉，多见风症，宜滋燥养营汤治外，大补地黄汤
治内。血虚外燥，皮肤皴揭，筋急爪枯，滋燥养营汤。诸痿由于肺热，热亢则液耗，百骸无所荣养，故手足痿
弱，不能自收持，反似痹湿之症，养阴药中，加黄柏以坚之，如虎潜丸之类，切忌用风药。又妇人脏燥，肺脏
也。悲伤欲泣，仲景甘麦大枣汤以生肺津。凡诸燥症，多火灼真阴，血液衰少，故其脉皆细微而涩也。通治
滋燥饮，生血润肤饮。
燥是阳明秋金之气化的表现，金气燥盛则导致水源枯竭，灌溉功能不周全，再加上风邪生燥、火邪化燥，正如《原病式》所说：各种涩滞枯涸、皮肤干裂起皱的现象，都属于燥证。燥证有外因和内因两种。由外因引起的，是天气肃杀而燥气偏胜，或者风热之邪损伤气分，导致津液不能上腾，治疗宜用甘润之品以滋养肺胃，佐以气味辛通的药物；由内因引起的，是精血耗夺而生燥，或者长期服用助阳火的药物，导致化源日渐枯竭，治疗宜用柔腻之品以滋养肾肝，尤其需要借助血肉有情之品来填补。叶天士先生用“上燥治气，下燥治血”两句话概括了燥证的治法，最为简明恰当。现在分别论述：燥邪在上焦，必然侵犯肺脏，表现为燥咳。可用喻嘉言的清燥救肺汤加减治疗。若肺中有火，表现为干咳，由申先生主张用琼玉膏主治。若内外邪气合而为病，用千金方中的麦门冬汤。若出现肺痿、咳嗽吐涎沫、心中感觉温温液液不适者，用张仲景的炙甘草汤治疗。燥邪在中焦，必然损伤脾胃之阴，表现为热邪壅滞、饮食不下，用《金匮要略》中的麦门冬汤治疗。若胃脘有死血停滞，表现为干燥枯槁、进食后疼痛、胃气上翻、便秘，用朱丹溪的韭汁牛乳饮治疗。若胃热善于消烁水谷，表现为消渴症，用朱丹溪的消渴方治疗。燥邪在下焦，必然侵犯大肠，表现为大便燥结，气机闭塞，浊阴之气不能下降，可用李东垣的通幽汤、润燥汤或玉函麻仁丸治疗。若是风秘或血燥导致的便秘，用李东垣的润肠丸加郁李仁、防风。若是津液枯竭导致的便秘，用朱丹溪的润燥生津汤加麻仁，或者用蜜煎导法。若是血枯导致的膈噎、大便干结如栗，用生料六味丸去掉山茱萸，加何首乌、当归，或者加肉苁蓉、桃仁捣碎煎服，同时兼食人乳、酥油、蜂蜜。这是燥邪在脏腑的情况。如果燥邪在血脉，多表现为风症，宜外用滋燥养营汤治疗，内服大补地黄汤治疗。若是血虚导致的外燥，表现为皮肤干裂、筋脉拘急、指甲枯槁，用滋燥养营汤治疗。各种痿证由于肺热引起，热势亢盛则津液消耗，全身骨骼肌肉得不到荣养，所以手足痿弱，不能自主收持，反而类似痹湿的症状，在滋阴药中加入黄柏以坚阴，如虎潜丸之类，切忌使用风药。另外，妇女的脏燥证，病位也在肺脏。表现为悲伤欲哭，用张仲景的甘麦大枣汤以滋生肺津。凡是各种燥证，多是火邪灼伤真阴，血液衰少，所以其脉象都是细微而涩的。通治燥证的方剂有滋燥饮、生血润肤饮。
Dryness is the transformation of Yangming and Autumn Metal Qi. When Metal Qi is dry, the source of water is exhausted, and irrigation is incomplete. Additionally, wind generates dryness, and fire transforms into dryness. As stated in *Yuan Bing Shi* (Treatise on the Original Causes of Diseases): "All astringency, withering, drying, stiffness, and cracking belong to Dryness." Dryness has external causes and internal causes. External causes involve the weather becoming solemn and dryness prevailing, or wind-heat injuring the Qi level, causing body fluids to fail to ascend. Treatment should use sweet and moistening agents to nourish the Lung and Stomach, assisted by herbs with pungent and penetrating aromas. Internal causes involve the depletion of essence and blood generating dryness, or the long-term intake of drugs that excessively assist Yang fire, causing the source of transformation to gradually dry up. Treatment should use soft and viscous agents to nourish the Liver and Kidney, especially relying on substances of flesh and blood for filling. Mr. Ye Tianshi summarized this with the phrase "treat Qi for upper dryness, treat Blood for lower dryness," which is most concise. Now, analyzing separately: Dryness in the Upper Jiao inevitably attacks the Lung, manifesting as dry cough. Yu's Qingzao Jiufei Tang (Clear Dryness Rescue Lung Decoction) modified may be used. If there is fire in the Lung, manifesting as dry hacking cough, Mr. Shen advocated using Qiongyu Gao (Jade Jade Paste). If external and internal pathogens combine, Qianjin's Maidong Tang (Ophiopogon Decoction) from the Thousand Golden Formulas is used. For lung atrophy with coughing and spitting saliva, accompanied by a warm, fluid sensation in the heart, Zhang Zhongjing's Zhi Gancao Tang (Honey-Fried Licorice Decoction) is used. Dryness in the Middle Jiao inevitably injures the Yin of the Spleen and Stomach, manifesting as heat obstruction and inability to eat. Maidong Tang (Ophiopogon Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) is used. If there is dead blood in the epigastrium, manifesting as dryness and emaciation, pain after eating, stomach reflux, and constipation, Zhu Danxi's Jiu Zhi Niu Nai Yin (Leek Juice and Cow Milk Drink) is used. If stomach heat rapidly consumes food and drink, manifesting as Xiao Ke (Wasting-Thirst), Zhu Danxi's Xiaoke Fang (Eliminate Thirst Formula) is used. Dryness in the Lower Jiao inevitably attacks the Large Intestine, manifesting as dry fecal impaction, qi stagnation, and failure of turbid Yin to descend. Li Dongyuan's Tongyou Tang (Unblocking the Hidden Decoction), Runzao Tang (Moistening Dryness Decoction), or Yukan Mahuang Wan (Jade Container Hemp Seed Pill) may be used. For constipation due to wind or dry blood, Li Dongyuan's Runchang Wan (Moisten Intestine Pill) added with Xingren (Apricot Kernel) and Fangfeng (Saposhnikovia Root) is used. For constipation due to fluid exhaustion, Zhu Danxi's Runzao Shengjin Tang (Moisten Dryness Generate Fluids Decoction) added with Mahuang (Ephedra) or honey suppositories are used. For blood exhaustion causing ge ye (diaphragmatic dysphagia) and stool hard as chestnuts, Shengli Liuwei Wan (Raw Six-Ingredient Pill) without Shanzhuyu (Cornus Fruit), added with Shouwu (Polygonum Multiflorum) and Danggui (Angelica Sinensis), or added with Rongzhurong (Cistanche) and Taoren (Peach Seed) pounded and decocted, is used, taken with human milk, butter, and honey. This describes dryness in the Zang-Fu organs. If dryness is in the blood vessels, it often manifests as wind symptoms. It should be treated externally with Zizao Yangying Tang (Nourish Dryness Nourish Ying Decoction) and internally with Dabu Dihuang Tang (Great Tonify Rehmannia Decoction). For exterior dryness due to blood deficiency, manifesting as cracked skin, tendon tension, and withered nails, Zizao Yangying Tang (Nourish Dryness Nourish Ying Decoction) is used. Various Wei syndromes (Flaccidity Syndromes) result from Lung heat. Excessive heat consumes fluids, leaving the bones and muscles without nourishment, resulting in flaccid weakness of the limbs and inability to hold oneself, resembling Bi syndrome (Obstruction Syndrome) with dampness. In Yin-nourishing medicines, Huangbai (Phellodendron Bark) is added to firm the Yin, such as in Hujian Wan (Tiger Lock Pill). Wind medicines must strictly be avoided. Furthermore, Zang Zao (Visceral Dryness) in women involves the Lung organ. Manifesting as sadness and desire to weep, Zhang Zhongjing's Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction) is used to generate Lung fluids. Generally, various dryness syndromes involve fire scorching true Yin and declining blood, so their pulses are all fine, minute, and choppy. General treatments for dryness include Zizao Yin (Moisten Dryness Drink) and Shengxue Runfu Yin (Generate Blood Moisturize Skin Drink).