痨瘵之证。咯血痰嗽。遗精泄泻。潮热盗汗。瘦削疲倦。梦与鬼交。或梦亡先。喜见人过。常怀忿怨。平旦病减。
午后病增。发热心烦。口燥鼻干。脸红唇赤。骨蒸肺痿。咽痛失音。若泻不止。则不治矣。其原得于酒色损伤。
以及失血之后。瘀血郁热。化生痨虫。蚀人脏腑之精血。变生诸般怪证。病患死后。虫气传染家人。名曰传
尸。又名尸疰。谓其自上注下。见证与前死之人相似故也。辨虫之法。或腹中有块。或脑后两边有小结核。
或用乳香熏手背。以帛覆手心。良久手上出毛长寸许。白黄者可治。红者稍难。青黑者死。若熏手无毛。非
痨虫证也。又或用真安息香。烧烟吸之。不嗽者非传尸。烟入即嗽。真传尸也。痨虫之形。或似蜣螂。或似红
丝马尾。或似虾蟆 鼠。或似鞠面。或有足无头。或有头无足。或化精血归于元气之内。若传至三人者。其
虫灵怪不可治。凡用药治虫。勿令病者知之。恐虫觉悟。难取效也。
夫痨虫何由而生哉。木必先腐。而后虫生之。人身亦必先有瘀血。虚热郁蒸。乃生痨虫。虫者。风木之气所
化。人身肝主风。木又主藏血。肝脏之血。若有瘀积。是犹木之先腐也。于是肝脏之风气。郁遏蒸煽。将瘀血
化生为虫。既化为虫。即从虫治之。宜天灵盖散治之。然天灵盖不易得。且不宜用。可用虎头骨代。或金蟾
丸亦可。余每用干漆明雄川椒楝根皮白颈蚯蚓升麻郁金。共为末。白汤五更时服。其虫不吐即下。义固
取于杀虫。而尤在干漆郁金。兼治瘀血。以痨虫是瘀血所化。杀虫是治其标。去瘀是治其本也。诸书但言
杀虫。而不知虫之所自生。宜乎未得其治也。吾为指出。痨虫是瘀血所化。治瘀血是治其本也。辨证录用
移尸灭怪汤。治痨虫传尸。方以去瘀为主。故效。
痨虫之生。由瘀血所化。而痨虫既生。蚀人精血。人之正气。日以消耗。不治其虚。但杀其虫。病终不能愈也。
月华丸主之。义取补虚。而去瘀杀虫兼施。其治乃万全之策。鳗鱼肉常食亦佳。或鳗鱼骨鳖甲知母山茱
萸柴胡当归青黛桃枭为丸。人参汤下。亦攻补兼行之术。
又凡湿热积痰。皆能生虫。与小儿疳虫无异。用金蟾丸即愈。不比血化之虫。灵怪难治也。
既杀虫后。但当滋补其虚。阴虚者十居八九。琼玉膏主之。加黄柏知母紫河车更佳。阳虚者。十之二三。六
君子汤主之。
痨瘵这一病证，表现为咯血、痰多咳嗽、遗精、泄泻、潮热、盗汗、身体消瘦疲倦、梦见与鬼交合或梦见已故祖先、喜欢挑剔别人的过错、心中常怀愤怒怨恨。清晨时病情减轻，午后时病情加重，伴有发热、心烦、口燥、鼻干、脸红、唇赤、骨蒸（阴虚内热感）、肺痿、咽痛、失音。如果腹泻不止，则属于不治之症。
其病因源于酒色过度损伤，以及失血之后，瘀血郁结化热，化生出“痨虫”，侵蚀人体的脏腑精血，从而变生各种怪异的证候。患者死后，虫气传染给家人，称为“传尸”，又名“尸疰”。之所以这样命名，是因为病症自上而下注染，且见证与前死之人相似。
辨别是否有痨虫的方法：或者腹部有肿块，或者脑后两边有小结核；或者用乳香熏烤手背，用布覆盖手心，过一段时间后手上长出约一寸长的毛发，白色或黄色的可以治疗，红色的稍难治疗，青黑色的预后不良（主死）。如果熏手没有长毛，就不是痨虫证。又或者使用真安息香，燃烧烟雾吸入，不咳嗽的不是传尸病，吸入烟雾即咳嗽的，才是真正的传尸病。
痨虫的形状，有的像蜣螂（屎壳郎），有的像红丝马尾，有的像虾蟆鼠，有的像鞠面（一种面食形状），有的有足无头，有的有头无足。有的化为精血回归到元气之中。如果传染到第三个人，这种虫子灵怪异常，难以治愈。凡是用药治疗痨虫，不要让病人知道，恐怕虫子觉悟后，难以取效。
那么痨虫是如何产生的呢？树木必须先腐烂，然后才会生虫。人体也必然是先有瘀血，虚热郁结蒸腾，才产生痨虫。虫是由风木之气所化生的。人体中肝主风，木又主藏血。肝脏的血如果有瘀积，就像树木先腐烂一样。于是肝脏的风气被郁遏蒸煽，将瘀血化生为虫。既然已经化为虫，就应当从治虫的角度入手。适宜用天灵盖散来治疗。然而天灵盖不易得到，且不宜使用，可以用虎头骨代替，或者金蟾丸也可以。我平时常用干漆、明雄黄、川椒、楝根皮、白颈蚯蚓、升麻、郁金，共研为末，在五更时用白开水送服。虫子要么吐出来，要么排下去。这道理固然在于杀虫，但尤其在于干漆和郁金兼治瘀血，因为痨虫是瘀血所化，杀虫是治其标，去瘀是治其本。许多医书只说杀虫，而不知道虫是从哪里生出来的，所以没能找到正确的治疗方法。我在此指出，痨虫是瘀血所化，治疗瘀血才是治本。辨证选用移尸灭怪汤，治疗痨虫传尸。该方以去除瘀血为主，所以有效。
痨虫的产生，是由瘀血所化；而痨虫既已产生，就会侵蚀人的精血，导致人的正气日益消耗。如果不治疗其虚损，只是杀灭虫子，病终究不能痊愈。应当以月华丸为主方。其义理在于补虚，同时兼顾去瘀和杀虫，这才是万全的治疗策略。经常食用鳗鱼肉也很好。或者用鳗鱼骨、鳖甲、知母、山茱萸、柴胡、当归、青黛、桃枭制成丸剂，用人参汤送下，这也是攻补兼施的方法。
另外，凡湿热积痰，都能生虫，这与小儿疳虫没有区别，用金蟾丸即可痊愈，不像由血化生的虫子那样灵怪难治。
在杀灭虫子之后，只应当滋补其虚损。阴虚者占十分之八九，以琼玉膏为主方，加入黄柏、知母、紫河车效果更好。阳虚者占十分之二三，以六君子汤为主方。
The syndrome of Lao Zhai (Consumption Disease) manifests as hemoptysis, cough with phlegm, spermatorrhea, diarrhea, tidal fever, night sweats, emaciation and fatigue, dreams of copulating with ghosts or deceased ancestors, a tendency to find fault with others, and constant resentment. The condition alleviates in the early morning but worsens in the afternoon, accompanied by fever, irritability, dry mouth, dry nose, flushed face, red lips, bone-steaming sensation (a sensation of heat coming from within the bones due to Yin deficiency), pulmonary atrophy, sore throat, and loss of voice. If diarrhea persists without cessation, it is considered incurable.
The etiology stems from damage caused by excessive alcohol and sexual indulgence, and following hemorrhage, where blood stasis stagnates and transforms into heat, giving rise to "Lao worms" (parasitic pathogens associated with consumption). These worms erode the essence and blood of the internal organs, generating various bizarre manifestations. After the patient's death, the pathogenic energy of the worm infects family members, termed "Chuan Shi" (Transmitting Corpse), also known as "Shi Zhu." It is so named because the disease transmits downward from person to person, and the clinical manifestations resemble those of the previously deceased individual.
Methods to identify the presence of Lao worms include: palpating for abdominal masses or small nodules on both sides behind the neck; or fumigating the back of the hand with Ru Xiang (Frankincense), covering the palm with cloth, and after some time observing if hair about one cun long grows on the hand. White or yellow hair indicates a treatable condition; red hair indicates a slightly difficult case; green or black hair indicates death. If no hair grows upon fumigation, it is not a Lao worm syndrome. Alternatively, burning genuine An Xi Xiang (Benzoin Resin) and inhaling the smoke: non-coughing indicates it is not Chuan Shi; immediate coughing upon inhalation confirms true Chuan Shi.
The morphology of Lao worms varies: resembling dung beetles, red silk horse tails, toad-mice, or shaped like Ju Mian (a type of dough ball); some have feet but no head, some have heads but no feet. Some transform into essence and blood returning to Yuan Qi (Original Qi). If transmitted to a third person, the worm becomes spiritually anomalous and difficult to cure. When administering medicine to treat the worm, the patient should not be informed, lest the worm become aware and resist treatment.
How are these Lao worms generated? Trees must rot first before worms arise. Similarly, the human body must first have blood stasis, with deficient heat stagnating and steaming, to generate Lao worms. Worms are transformed from the Qi of Wind and Wood. In the human body, the Liver governs Wind, and Wood governs Blood storage. If there is blood stasis accumulation in the Liver, it is akin to wood rotting first. Consequently, the Liver's Wind Qi becomes stagnant and steaming, transforming the blood stasis into worms. Once transformed into worms, treatment should target the worm directly. Tian Ling Gai San (Human Skull Powder) is suitable for treatment. However, Tian Ling Gai is hard to obtain and inappropriate to use; Hu Tou Gu (Tiger Head Bone) can be used as a substitute, or Jin Chan Wan (Toad Pill) is also acceptable. I commonly use Gan Xi (Dried Resin of Toxicodendron vernicifluum), Ming Xiong Huang (Realgar), Chuan Jiao (Sichuan Pepper), Liu Gen Pi (Cinchona Bark/Litchi Root Bark - *Note: Context implies a specific root bark, often interpreted as Toosendan Fructus or similar in modern contexts, but literal translation is Root Bark of Li tree*), Bai Jing Qiu Yin Chong (White-necked Earthworm), Sheng Ma (Cimicifugae Rhizoma), and Yu Jin (Curcumae Radix), ground into powder, taken at dawn with warm water. The worm will either be vomited or excreted. The rationale lies not only in killing the worm but particularly in Gan Xi and Yu Jin treating blood stasis simultaneously, because Lao worms are generated from blood stasis. Killing the worm treats the branch (symptom), while removing stasis treats the root (cause). Many medical texts only mention killing the worm without understanding its origin, hence failing to find the correct treatment. I point out here that Lao worms are generated from blood stasis, and treating blood stasis is treating the root. For differentiation and prescription, Yi Shi Mie Guai Tang (Transfer Corpse Eliminate Strange Pill) is selected to treat Lao worm transmission. This formula focuses on removing blood stasis, thus proving effective.
Lao worms are generated from blood stasis; once generated, they erode human essence and blood, causing daily depletion of Zheng Qi (Upright Qi). If deficiency is not treated and only the worm is killed, the illness cannot be cured. Yue Hua Wan (Moon Radiance Pill) is the primary formula. Its principle is tonifying deficiency while simultaneously removing stasis and killing worms, representing a comprehensive strategy. Regular consumption of Eel meat is also beneficial. Alternatively, form pills using Eel Bone, Bie Jia (Testudinis Carapax et Plastrum), Zhi Mu (Anemarrhenae Rhizoma), Shan Zhu Yu (Corni Fructus), Chai Hu (Bupleuri Radix), Dang Gui (Angelicae Sinensis Radix), Qing Dai (Indici Folium), and Tao Xiao (Peach Kernel processed with alum), taken with Ren Shen Tang (Ginseng Decoction). This is also a method of combining attack and tonification.
Furthermore, damp-heat and accumulated phlegm can also generate worms, indistinguishable from pediatric Guan worms (malnutrition parasites). Jin Chan Wan resolves this easily, unlike worms generated from blood which are spiritually anomalous and difficult to treat.
After eliminating the worms, one should solely tonify the deficiency. Yin deficiency accounts for eight or nine out of ten cases; Qiong Yu Gao (Jade Dew Paste) is the primary formula, adding Huang Bo (Phellodendri Cortex), Zhi Mu, and Zi He Che (Placentae Humanae) yields better results. Yang deficiency accounts for two or three out of ten cases; Liu Jun Zi Tang (Six Gentlemen Decoction) is the primary formula.