人年五、六十，其病脉大者，痹挟背行，〔若肠鸣，〕马刀挟「瘰」〔瘿〕者，皆为
劳得之。
【按】
「若肠鸣」三字，与上下文不属，必是错简，当删之。挟瘿之「瘿」字，当是「瘰」
字，且先劳后瘰、先瘰后劳者有之，从未见劳、瘿先后病也，当改之。
劳之为病，其脉浮大，手足烦，春夏剧，秋冬差，阴「虚」〔寒〕精自出，酸削不能
行。
【按】
阴寒精自出之「寒」字，应是「虚」字，当改之。
男子面色白者，主渴及亡血，卒喘悸。〔脉浮者，里虚也。〕
【按】
「脉浮者，里虚也」句，当是衍文。
夫失精家，少腹弦急，阴头寒，目眩，发落，脉极虚、芤、迟，为清谷亡血失精。〔
脉得诸芤动微紧，男子失精，女子梦交，桂枝龙骨牡蛎汤主之。〕
【按】
此条「脉得诸芤…」五句，与上文义不属，衍文也。另分一条，在本门十二条之次。
脉弦而大，弦则为减，大则为芤，减则为寒，芤则为虚，虚寒相搏，此名为革，妇人
则半产漏下，男子则亡血失精。
【按】
此条注详见『伤寒论·办脉篇』内，故不复释。
五荣极虚，羸瘦，腹满，不能饮食，「缓中补虚」。食伤、忧伤、饮伤、房室伤、饥
伤、劳伤、经络荣卫气伤，内有干血，肌肤甲错，两目黯黑，〔缓中补虚，〕大黄□
虫圆主之。
【按】
两目黯黑句下「缓中补虚」四字，当在不能饮食之下，必是传写之□，当移之。
人到了五六十岁，如果患病且脉象宏大，出现痹证伴随背部疼痛，或者出现马刀侠瘿（一种颈部淋巴结结核或甲状腺肿大的病症），这些都是由于虚劳引起的。
【按语】
“若肠鸣”这三个字，与上下文不连贯，必定是竹简错乱所致，应当删除。“挟瘿”的“瘿”字，应当是“瘰”字，而且先患虚劳后患瘰疬、先患瘰疬后患虚劳的情况都有，从未见过虚劳和瘿病先后发病的情况，应当改正。
虚劳这种病，脉象浮大，手足烦热，春夏季节病情加重，秋冬季节减轻，阴精因阴虚而自行滑脱，身体消瘦酸软不能行走。
【按语】
“阴寒精自出”中的“寒”字，应该是“虚”字，应当改正。
男子面色苍白，主诉口渴及失血，突然气喘心悸。（脉象浮，说明里气虚弱。）
【按语】
“脉浮者，里虚也”这一句，应当是衍文（多余的文字）。
凡是经常失精的人，小腹部拘急紧绷，阴头寒冷，头晕目眩，头发脱落，脉象极虚、芤（如按葱管）、迟，这是清谷（完谷不化）、失血、失精的表现。（脉象出现各种芤、动、微、紧的特征，男子失精，女子梦交，用桂枝加龙骨牡蛎汤主治。）
【按语】
这一条中“脉得诸芤…”这五句，与上文意义不连贯，是衍文。应单独列为一条，放在本门第十二条之后。
脉象弦而大，弦脉表示阳气减损，大脉表示中空如芤，减损则生寒，中空则为虚，虚与寒相互搏结，这种脉象称为革脉，妇女表现为半产（流产）漏下，男子表现为亡血失精。
【按语】
这一条的注解详见《伤寒论·辨脉篇》内，所以不再解释。
五脏荣气极度虚弱，身体瘦弱，腹部胀满，不能饮食，（治疗原则为缓中补虚。）饮食损伤、忧思损伤、饮水损伤、房事损伤、饥饿损伤、劳累损伤、经络营卫之气损伤，体内有干血（瘀血日久），肌肤粗糙如鳞甲交错，两眼暗黑，（治疗原则为缓中补虚，）用大黄䗪虫丸主治。
At the age of fifty or sixty, if a person is ill with a large pulse, experiencing bi-syndrome (obstruction syndrome) accompanied by back pain, or developing "mad knife and jia luo" (a condition resembling cervical lymphadenitis or goiter), all these are caused by lao-disease (consumptive disease).
[Note]
The three characters "ruo chang ming" (if there is intestinal borborygmus) do not belong to the context here; it must be a textual error due to bamboo slips being out of order, and should be deleted. The character "ying" (goiter) in "jia ying" should be "luo" (scrofula/lymph node tuberculosis). There are cases where lao-disease precedes luo, or luo precedes lao, but never have we seen lao and ying occurring sequentially as diseases; this should be corrected.
In lao-disease, the pulse is floating and large, the hands and feet are vexed and hot, the condition worsens in spring and summer, and improves in autumn and winter. Due to yin deficiency, essence escapes spontaneously, and the body becomes emaciated and sore, unable to walk.
[Note]
The character "han" (cold) in "yin han jing zi chu" (yin cold causes spontaneous essence discharge) should be "xu" (deficiency); this should be corrected.
If a man has a pale complexion, it indicates thirst and blood loss, sudden panting, and palpitations. [A floating pulse indicates interior deficiency.]
[Note]
The sentence "mai fu zhe, li xu ye" (a floating pulse indicates interior deficiency) is likely an interpolation and should be omitted.
Those who habitually lose essence often present with tension and urgency in the lower abdomen, coldness at the glans penis, dizziness, hair loss, and a pulse that is extremely deficient, kōu (hollow), and slow. This indicates clear stool (undigested food in feces), blood loss, and essence loss. [When the pulse presents various characteristics of kōu, moving, fine, and tight, and the patient suffers from seminal emission or nocturnal emissions, Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell) is the primary treatment.]
[Note]
The five sentences starting with "mai de zhu kou..." (when the pulse presents various kōu...) do not align with the preceding text in meaning and are interpolations. They should be separated into a new clause, placed after the twelfth clause in this section.
A pulse that is xian (wiry) and da (large): xian indicates reduction (of yang), da indicates kōu (hollowness). Reduction implies cold, and hollowness implies deficiency. When deficiency and cold interact, this is named ge-pulse (drum-taut pulse). In women, this manifests as miscarriage and persistent uterine bleeding; in men, it manifests as blood loss and essence loss.
[Note]
The annotation for this clause can be found in detail in the "Bian Mai Pian" (Chapter on Pulse Differentiation) of *Shanghan Lun* (Treatise on Cold Damage), so no further explanation is provided here.
When the qi of the five zang-organs is extremely deficient, the body is emaciated, the abdomen is full, and there is an inability to eat. [The treatment principle is to soothe the middle and tonify deficiency.] Whether caused by dietary injury, emotional distress, excessive drinking, sexual excess, hunger, overwork, or damage to the meridians, ying-qi, and wei-qi, if dry blood (chronic blood stasis) accumulates internally, the skin becomes rough like fish scales, and the eyes appear dark. [The treatment principle is to soothe the middle and tonify deficiency.] Da Huang Zhe Chong Wan (Rhubarb and Ground Beetle Pill) is the primary treatment.
[Note]
The four characters "huan zhong bu xu" (soothe the middle and tonify deficiency) appearing after the phrase "liang mu an hei" (eyes appear dark) should actually follow "bu neng yin shi" (unable to eat). This is likely a transcription error and should be moved.