凡劳伤虚损，五脏各有所主，而惟心脏最多，且心为君主之官，一身生气所系，最不可
伤，而人多忽而不知也，何也？夫五脏之神皆禀于心，故忧生于心，肺必应之，忧之不已，
而戚戚幽幽，则阳气日索，营卫日消，劳伤及肺，弗亡弗已。如经曰∶尝贵后贱，虽不中邪
，病从内生，名曰脱营。尝富后贫，名曰失精。五气留连，病有所并，暴乐暴苦，始乐后苦
，皆伤精气，精气竭绝，形体毁沮。故贵脱势，虽不中邪，精神内伤，身必败亡之类，无非
虑竭将来，追穷已往，而二阳并伤。第其潜消暗烁于冥冥之中，人所不觉，而不知五脏之伤
，惟心为本，凡值此者，速宜舒情知命，力挽先天。要知人生在世，喜一日则得一日，忧一
日则失一日，但使灵明常醒，尚何尘魔敢犯哉！及其既病，而用参、 、归、术、益气汤之
类，亦不过后天之末着耳，知者当知所先也。
一、喜因欲遂而发，若乎无伤，而经曰∶喜伤心。又曰∶暴喜伤阳。又曰∶喜乐者，神
惮散而不藏。又曰∶肺喜乐无极则伤魄，魄伤则狂，狂者意不存人，皮革焦，毛悴色夭，死
于夏。盖心藏神，肺藏气，二阳脏也。故暴喜过甚则伤阳，而神气因以耗散。或纵喜无节，
则淫荡流亡，以致精神疲竭，不可救药。或偶尔得志，则气盈载满，每多骄恣傲慢，自取败
亡，而莫知其然者多矣。然则喜为人所忽，而犹有不可忽者如此。
一、思本乎心。经曰∶心怵惕思虑则伤神，神伤则恐惧自失，破 脱肉，毛悴色夭
，死于冬。此伤心则然也。然思生于心，脾必应之，故思之不已，则劳伤在脾。经曰∶思伤
脾。又曰∶思则心有所存，神有所归，正气留而不行，故气结矣。凡此为病，脾气结则为噎
膈，为呕吐，而饮食不能运，食不运则血气日消，肌肉日削，精神日减，四肢不为用，而生
胀满泄泻等证，此伤心脾之阳也。夫人孰无思？而苦思难释，则劳伤至此，此养生者所当戒
也。然思本伤脾，而忧亦伤脾。经曰∶脾愁忧而不解则伤意，意伤则 乱，四肢不举，
毛悴色夭，死于春。盖人之忧思，本多兼用，而心脾肺所以并伤，故致损上焦阳气。而二阳
之病发自心脾，以渐成虚劳之证者，断由乎此。
一、淫欲邪思又与忧思不同，而损惟在肾。盖心耽欲念，肾必应之，凡君火动于上，则
相火应于下。夫相火者，水中之火也，静而守位则为阳气，炽而无制则为龙雷，而涸泽燎原
，无所不至。故其在肾，则为遗淋带浊，而水液渐以干枯。炎上入肝，则逼血妄行，而为吐
为衄，或为营虚筋骨疼痛。又上入脾，则脾阴受伤，或为发热，而饮食悉化痰涎。再上至肺
，则皮毛无以扃固，而亡阳喘嗽，甚至喑哑声嘶。是皆无根虚火，阳不守舍，而光焰诣天，
自下而上，由肾而肺，本源渐槁，上实下虚，是诚剥极之象也。凡师尼室女，失偶之辈，虽
非房室之劳，而私情系恋，思想无穷，或对面千里，所愿不得，则欲火摇心，真阴日削，遂
致虚损不救。凡五劳之中，莫此为甚，苟知重命，慎毋蹈之。
一、七情伤肾，恐亦居多。盖恐畏在心，肾则受之，故经曰∶恐伤肾。又曰∶恐则精却
。又曰∶恐惧而不解则伤精，精伤则骨酸痿厥，精时自下。余尝诊一在官少年，因恐而致
病，病稍愈而阳痿，及其病复，终不可疗。又尝见猝恐者，必阴缩或遗尿，是皆伤肾之征也
。然恐固伤肾，而怒亦伤肾。经曰∶肾盛怒而不止则伤志，志伤则喜忘其前言，腰背不可以
俯仰屈伸，毛悴色夭，死于季夏。是知盛怒不惟伤肝，而肾亦受其害也。
一、怒生于心，肝必应之，怒不知节，则劳伤在肝。经曰∶怒伤肝。又曰∶怒则气逆，
甚则呕血及飧泄，故气上矣。盖肝为阴中之阳脏，故肝之为病，有在阴者，有在阳者。如火
因怒动而逼血妄行，以致气逆于上，而胀痛、喘急者，此伤其阴者也。又或气以怒伤，而木
郁无伸，以致侵脾气陷，而为呕为胀，为泄为痛，为食饮不行者，此伤其阳者也。然随怒随
消者，未必致病，脏气坚固者，未必致病，惟先天禀弱，而三阴易损者，使不知节，则东方
之实，多致西方之败也。然怒本伤肝，而悲哀亦最易伤肝。经曰∶肝悲哀动中则伤魂，魂伤
则狂妄不精，不精则不正，当人阴缩而挛筋，两胁骨不举，毛悴色夭，死于秋。盖怒盛伤肝
，肝气实也；悲哀伤肝，肝气虚也。但实不终实，而虚则终虚耳，虚而罔顾，则必至劳损
。而治当察其邪正也。
一、惊气本以入心，而实通于肝胆。经曰∶惊则心无所根据，神无所归，虑无所定，故气
乱矣。又曰∶东方色青，入通于肝，其病发惊骇。此所以惊能动心，而尤能伤及肝胆。心为
君主，固不可伤，而胆以中正之官，实少阳生气所居，故十一脏阳刚之气皆取决于胆，若或
损之，则诸脏生气，因皆消索致败，其危立见。尝见微惊致病者，惟养心安神，神复则病自
却。若惊畏日积，或一时大惊损胆，或致胆汁泄而通身发黄，默默无言者，皆不可救。（胆
黄证，论详黄胆门）
一、色欲过度者，多成劳损。盖人自有生以后，惟赖后天精气以为立命之本，故精强神
亦强，神强必多寿；精虚气亦虚，气虚必多夭。其有先天所禀原不甚浓者，但知自珍，而培
以后天，则无不获寿。设禀赋本薄，而且恣情纵欲，再伐后天，则必成虚损，此而伤生，咎
将谁委？又有年将未冠，壬水方生，保养萌芽，正在此日，而无知孺子，遽摇女精。余见苞
萼未成而蜉蝣旦暮者多矣，良可悲也。此其责水在孺子，而在父师，使不先有明诲，俾知保
生之道，则彼以童心，岂识利害？而徒临期恳祷，号呼悲戚，将何济于事哉。
一、劳倦罔顾者，多成劳损。夫劳之于人，孰能免之，如奔走食力之夫，终日营营，而
未闻其劳者，岂非劳乎？但劳有不同耳。盖贫贱之劳，作息有度，无关荣辱，习以为常，何
病之有？惟安闲柔脆之辈，而苦竭心力，斯为害矣。故或劳于名利，而不知寒暑之伤形；或
劳于色欲，而不知旦暮之疲困；或劳于游荡，而忍饥竭力于呼卢驰骤之场；或劳于疾病，而
剥削伤残于无术庸医之手，或为诗书困厄，每缘萤雪成灾；或以好勇逞强，遂致绝筋乏力。
总之，不知自量，而务从勉强，则一应妄作妄为，皆能致损。凡劳倦之伤，虽曰在脾，而若
此诸劳不同，则凡伤筋伤骨，伤气伤血，伤精伤神，伤皮毛肌肉，则实兼之五脏矣。呜呼！
嗜欲迷人，其害至此。此其故，则在但知有彼，而忘其有我耳。广成子曰∶无劳女形，无摇
女精，乃可以长生。若此二言者，人因其简，故多易之，而不知养生之道，于此八字而尽之
矣，顾可以忽之也耶！
一、少年纵酒者多成劳损。夫酒本狂药，大损真阴，惟少饮之未必无益，多饮之难免无
伤，而耽饮之，则受其害者十之八九矣。且凡人之禀赋，脏有阴阳，而酒之性质，亦有阴阳
。盖酒成于酿，其性则热，汁化于水，其质则寒。若以阴虚者纵饮之，则质不足以滋阴，而
性偏动火，故热者愈热，而病为吐血、衄血、便血、尿血、喘嗽、躁烦、狂悖等证，此酒性
伤阴而然也。若阳虚者纵饮之，则性不足以扶阳，而质留为水，故寒者愈寒，而病为臌胀、
泄泻、腹痛、吞酸、少食、亡阳、暴脱等证，此酒质伤阳而然也。故纵酒者，既能伤阴，尤
能伤阳，害有如此，人果知否？矧酒能乱性，每致因酒妄为，则凡伤精竭力，动气失机，及
遇病不胜等事，无所不至，而阴受其损，多罔觉也。夫纵酒之时，固不虑其害之若此，及病
至沉危，犹不知为酒困之若此。故余详明于此，以为纵酒者之先觉云。（泄泻、肿胀二门俱
有酒论。）
一、疾病误治及失于调理者，病后多成虚损。盖病有虚实，治有补泻，必补泻得宜，斯
为上工。余见世俗之医，固不知神理为何物，而且并邪正缓急，俱不知之，故每致伐人元气
，败人生机。而随药随毙者，已无从诉，其有幸而得免，而受其残剥，以致病后多成虚损而
不能复振者，此何以故也？故凡医有未明，万毋轻率，是诚仁人积德之一端也。至若失于调
治，致不能起，则俗云∶小孔不补，大孔叫冤，苦亦自作之而自受之耳，又何尤焉。
凡是劳伤虚损，五脏各有其主导，但其中以心脏最为多见。而且心是君主之官，关乎一身生气的根本，最不可受伤，然而人们往往忽视而不知道其中的原因。为什么呢？因为五脏的神志都禀受于心，所以忧愁产生于心，肺必然随之响应；如果忧愁不止，就会变得忧郁悲伤，导致阳气日渐消索，营卫之气日渐消耗，劳伤波及肺部，不致死不休。正如经典所说：“曾经尊贵后来卑贱，虽然未受外邪侵袭，病从内生，名叫脱营。”“曾经富有后来贫穷，名叫失精。”五气滞留不去，疾病相互合并，突然的大乐或大苦，开始快乐后来痛苦，都会损伤精气；精气枯竭断绝，形体就会毁坏败坏。所以权贵失去权势，虽然未受外邪，精神内伤，身体必然败亡之类，无非是因为忧虑未来、追悔过去，导致二阳（大肠、胃）同时受伤。只是这种损伤在暗中悄然发生，人们并不察觉，却不知道五脏的损伤，以心脏为根本。凡遇到这种情况，应当迅速舒展情怀、安知天命，努力挽回先天的元气。要知道人生在世，高兴一天就得到一天的益处，忧愁一天就损失一天的生机，只要让灵明之心常醒，还有什么尘世的魔障敢来侵犯呢！等到已经生病，再用参、[白术]、当归、白术、益气汤之类的药物，也不过是补救后天的下策罢了，明智的人应当知道治本为先。
一、喜悦因欲望满足而产生，似乎没有伤害，但经典说：“喜伤心。”又说：“暴喜伤阳。”又说：“喜乐过度，则神志涣散而不能收敛。”又说：“肺喜乐无极则伤魄，魄伤则发狂，狂者心中无人，皮肤干枯，毛发憔悴，面色枯槁，死于夏季。”这是因为心藏神，肺藏气，二者都属于阳脏。所以暴喜过甚会损伤阳气，导致神气因此耗散。或者纵情欢笑无节制，就会淫荡流亡，以致精神疲竭，不可救药。或者偶尔得志，就会气盈志满，常常骄傲恣肆傲慢，自取败亡，而不知道其中道理的人很多了。然而喜悦被人忽视，却有如此不可忽视的地方。
一、思虑本乎于心。经典说：“心怵惕思虑则伤神，神伤则恐惧自失，肌肉消瘦脱肉，毛发憔悴，面色枯槁，死于冬季。”这是伤心导致的后果。然而思虑产生于心，脾必然随之响应，所以思虑不止，就会劳伤在脾。经典说：“思伤脾。”又说：“思虑则心神有所存留，神志有所归着，正气停留而不运行，所以气机郁结。”凡是这类疾病，脾气郁结就会导致噎膈、呕吐，饮食不能运化，食物不运化则血气日渐消耗，肌肉日渐消瘦，精神日渐减少，四肢不能运用，并出现胀满、泄泻等症状，这是伤心脾之阳气。人谁没有思虑？但如果苦苦思虑难以释怀，就会劳伤到这种地步，这是养生者应当警惕的。然而思虑本伤脾，而忧愁也伤脾。经典说：“脾愁忧而不解则伤意，意伤则思维混乱，四肢不能举动，毛发憔悴，面色枯槁，死于春季。”大概人的忧和思，本来多兼用，而心、脾、肺因此一并受伤，导致上焦阳气受损。而二阳的疾病发自心脾，逐渐形成虚劳证候的，断然由此而来。
一、淫欲邪思又与忧思不同，其损伤主要在肾。因为心沉迷于欲念，肾必然随之响应。凡君火动于上，则相火应于下。所谓相火，是水中之火，安静守位则为阳气，炽热而无制约则为龙雷之火，干涸沼泽，燎原大火，无所不至。所以在肾，就会导致遗精、淋浊、带下，水液逐渐干枯。炎上入肝，则逼迫血液妄行，导致吐血、衄血，或者营血亏虚筋骨疼痛。再向上入脾，则脾阴受伤，或者发热，饮食全部化为痰涎。再向上至肺，则皮毛无法固密，导致亡阳喘咳，甚至声音嘶哑。这些都是无根虚火，阳气不能守舍，光焰冲天，自下而上，由肾传肺，本源逐渐枯竭，上实下虚，这确实是剥卦极致的象义。凡是僧尼、处女、寡妇等辈，虽然不是房室之劳，但私情系恋，思想无穷，或者对面千里，愿望不得实现，则欲火摇动心神，真阴日渐削减，最终导致虚损不可救治。在五劳之中，没有比这更严重的了，如果懂得重视生命，千万不要重蹈覆辙。
一、七情伤肾，恐惧也占多数。因为恐惧在心，肾则承受它，所以经典说：“恐伤肾。”又说：“恐则精却（精气退缩）。”又说：“恐惧而不解则伤精，精伤则骨酸痿厥，精气自行滑脱。”我曾经诊治一位在任官员的少年，因恐惧而致病，病稍愈后出现阳痿，等到病情复发，最终无法治疗。又曾见过猝然受惊的人，必然出现阴茎内缩或遗尿，这都是伤肾的征象。然而恐惧固然伤肾，愤怒也伤肾。经典说：“肾盛怒而不止则伤志，志伤则喜欢忘记前言，腰背不能俯仰屈伸，毛发憔悴，面色枯槁，死于季夏。”由此可知，盛怒不仅伤肝，肾也受害。
一、愤怒产生于心，肝必然随之响应，愤怒不知节制，就会劳伤在肝。经典说：“怒伤肝。”又说：“怒则气逆，严重时呕血及完谷不化的泄泻，所以气机上逆。”因为肝是阴中之阳脏，所以肝病有在阴分的，有在阳分的。如火因怒动而逼迫血液妄行，导致气逆于上，出现胀痛、喘急，这是损伤其阴分。又或者气因怒而受伤，木气郁结不得伸展，以致侵犯脾气下陷，出现呕吐、胀满、泄泻、疼痛、饮食不行的症状，这是损伤其阳分。然而随怒随消的，未必致病，脏气坚固的，未必致病，只有先天禀赋虚弱，三阴易损的人，如果不加节制，那么东方（肝）的实证，多会导致西方（肺）的败坏。然而愤怒本伤肝，悲哀也最容易伤肝。经典说：“肝悲哀动中则伤魂，魂伤则狂妄不精明，不精明则行为不正，应当出现阴器收缩而筋脉拘挛，两胁骨骼不能举起，毛发憔悴，面色枯槁，死于秋季。”大概愤怒盛则伤肝，肝气实；悲哀伤肝，肝气虚。但实不会一直实，虚则会一直虚，虚而不顾惜，则必然导致劳损。治疗时应当察辨邪正。
一、惊气本以入心，实则通于肝胆。经典说：“惊则心无所根据，神无所归，虑无所定，所以气乱。”又说：“东方色青，入通于肝，其病发惊骇。”这就是为什么惊动能动心，尤其能伤及肝胆。心为君主，固然不可伤，而胆作为中正之官，实际上是少阳生气所居之处，所以十一脏的阳刚之气都取决于胆，如果损伤了胆，那么各脏的生气，因此都消索导致败坏，危险立刻显现。曾见轻微受惊致病的，只需养心安神，神复则病自然退去。如果惊恐畏惧日积月累，或者一时大惊损伤胆气，或者导致胆汁外泄而全身发黄，沉默不言的，都不可救治。（胆黄证，论述详见黄疸门）
一、色欲过度者，多成劳损。大概人自从出生以后，只依赖后天的精气作为立命的根本，所以精气强盛神气也强盛，神气强盛必定长寿；精气虚弱气也虚弱，气虚必定多夭折。那些先天禀赋原本不浓厚的人，只知道自我珍重，而培补后天，则无不获得长寿。假如禀赋本来就薄弱，而且放纵情欲，再伐害后天，则必然成为虚损，这样伤害生命，责任归于谁呢？又有年纪不到二十岁，壬水（肾水）方生，保养萌芽，正是在这个时候，而无知的孩童，竟然动摇女精。我见到花苞未开而像蜉蝣一样朝生暮死的例子很多了，实在可悲。这责任在于孩童，也在于父师，如果不事先有明确的教诲，使他们知道保生的道理，那么他们凭着童心，哪里认识利害？而只是临时恳切祈祷，号呼悲戚，对事情有什么帮助呢？
一、不顾劳累倦怠者，多成劳损。劳倦对于人，谁能避免呢？比如奔走食力的劳工，终日忙碌，却没听说他们生病的，这难道不是劳吗？只是劳有不同的罢了。大概贫贱之劳，作息有度，无关荣辱，习以为常，有什么病呢？只有安闲柔脆之辈，苦竭心力，这才是危害。所以有的为名利所劳，不知道寒暑对形体的伤害；有的为色欲所劳，不知道旦暮的疲困；有的为游荡所劳，在赌博驰骋的场面上忍饥竭力；有的为疾病所劳，在无术庸医手中被剥削伤残；有的为诗书所困，常常因刻苦读书而成灾；有的因好勇逞强，导致断筋乏力。总之，不知道自我估量，而务求勉强，那么一切妄作妄为，都能导致损伤。凡是劳倦的损伤，虽然说主要在脾，但像这些各种不同性质的劳，那么凡是伤筋伤骨，伤气伤血，伤精伤神，伤皮毛肌肉的，实际上兼涉五脏了。唉！嗜欲迷惑人心，危害到了这种地步。这个缘故，就在于只知道有外物，而忘记了自己的存在啊。广成子说：“不要使你的形体劳累，不要动摇你的精气，这样就可以长生。”像这两句话，人们因为文字简略，所以大多轻视它，却不知道养生之道，在这八个字里就穷尽了，怎么可以忽视呢！
一、少年纵酒者多成劳损。酒本是狂药，大损真阴，只有少量饮用未必无益，多饮难免无伤，而沉溺饮酒的，十之八九要受到危害。而且人的禀赋，脏腑有阴阳，酒的性质，也有阴阳。大概酒酿成，其性则热，汁液化于水，其质则寒。如果用阴虚的人放纵饮酒，则质地不足以滋阴，而性质偏于动火，所以热者更热，而病表现为吐血、衄血、便血、尿血、喘咳、烦躁、狂悖等症状，这是酒性伤阴造成的。如果用阳虚的人放纵饮酒，则性质不足以扶阳，而质地留滞为水湿，所以寒者更寒，而病表现为鼓胀、泄泻、腹痛、吞酸、少食、亡阳、暴脱等症状，这是酒质伤阳造成的。所以纵酒的人，既能伤阴，尤能伤阳，危害有如此之大，人们果真知道吗？况且酒能乱性，常常导致因酒妄为，那么凡是伤精竭力，动气失机，以及遇病不胜等情况，无所不至，而阴受其损，大多没有察觉。在纵酒的时候，固然不考虑危害有如此之大，等到病至沉危，还不知道是被酒所困到如此地步。所以我在此详细阐明，作为纵酒者的预先觉悟。（泄泻、肿胀二门中都有关于酒的论述。）
一、疾病误治及失于调理者，病后多成虚损。大概病有虚实，治有补泻，必须补泻得当，这才是上工。我看见世俗的医生，本来不知道神理是什么东西，而且连邪正缓急都不知道，所以常常导致伐害人的元气，败坏人的生机。随着服药随即死亡的，已无处申诉，那些有幸免于一死，而遭受残害剥蚀，以致病后多成虚损而不能恢复振作的，这是什么原因呢？所以凡是医术不明，千万不要轻率，这确实是仁人积德的一个方面。至于因为失于调治，导致不能痊愈，则俗话常说：“小孔不补，大孔叫冤”，苦也是自作自受罢了，又有什么可抱怨的呢？
In cases of exhaustion and deficiency, each of the Five Zang organs has its specific dominance, yet the Heart is most frequently involved. The Heart is the Sovereign Official (Zhu Jun), the root of vital Qi for the entire body, and is most susceptible to injury; however, people often overlook this ignorance. Why is this? The spiritual activities of all five Zang organs are derived from the Heart. Thus, sorrow originates in the Heart, and the Lung necessarily responds. If sorrow persists, leading to melancholy and gloom, Yang Qi will gradually diminish, and Ying (Nutritive) and Wei (Defensive) Qi will deplete. Exhaustion then affects the Lung, persisting until death. As stated in the classics: "One who was once noble but became humble, though not struck by external pathogens, develops disease from within, named Tuoying (Depletion of Ying Qi)." "One who was once wealthy but became poor, is named Shijing (Loss of Jing Essence)." When the Five Qi linger without resolving, diseases merge. Sudden joy or sudden suffering, starting with happiness and ending in sorrow, all damage Jing Qi. When Jing Qi is exhausted, the physical form decays. Therefore, nobles losing power, though not affected by external pathogens, suffer internal spiritual injury, leading to physical decline. This is essentially due to worrying about the future and regretting the past, injuring both Yang channels (Large Intestine and Stomach). However, this consumption occurs silently and invisibly, unnoticed by people. They do not realize that among injuries to the Five Zang organs, the Heart is the root. For those experiencing this, one should promptly relax the mind, accept destiny, and strive to preserve congenital essence. One must understand that in life, enjoying a day yields benefits for that day, while worrying a day results in loss for that day. If the luminous spirit remains awake, what worldly illusions would dare to invade? Once illness has set in, using herbs like Ginseng, [Atractylodes], Angelica Sinensis, Atractylodes Macrocephala, and Yiqi Tang are merely inferior measures to support acquired essence. Wise individuals know to prioritize treating the root.
1. Joy arises from the fulfillment of desires and seems harmless, yet the classics state: "Joy injures the Heart." Also: "Sudden joy injures Yang." Also: "Excessive joy causes the Spirit (Shen) to scatter and fail to consolidate." Also: "If the Lung experiences boundless joy, it injures the Po (Corporeal Soul); if the Po is injured, madness ensues. The mad person disregards others, skin becomes dry, hair deteriorates, complexion fades, and death occurs in summer." This is because the Heart stores Shen, and the Lung stores Qi; both are Yang organs. Thus, excessive sudden joy damages Yang, causing Shen and Qi to dissipate. Unrestrained laughter leads to licentiousness and wandering, resulting in spiritual exhaustion beyond remedy. Occasional success may lead to arrogance and self-destruction, often without understanding why. Thus, although joy is often overlooked, it has aspects that cannot be ignored.
2. Thought (Si) originates in the Heart. The classics state: "Frightened and thoughtful states injure Shen; when Shen is injured, fear and loss of control arise, muscles waste away, hair deteriorates, complexion fades, and death occurs in winter." This is the result of injuring the Heart. Since thought originates in the Heart, the Spleen necessarily responds. Persistent thought injures the Spleen. The classics state: "Thought injures the Spleen." Also: "Thought causes the mind to focus and Shen to reside, causing Zheng Qi to stagnate and not move, leading to Qi knotting." Diseases arising from this involve Spleen Qi stagnation, resulting in dysphagia (Yege), vomiting, and inability to digest food. Poor digestion leads to daily depletion of Blood and Qi, wasting of muscles, reduction of spirit, paralysis of limbs, and symptoms like distension and diarrhea. This injures the Yang of the Heart and Spleen. Everyone thinks, but苦思 (bitter/persistent thinking) causes such severe injury, which health preservers must beware of. Although thought primarily injures the Spleen, worry also injures the Spleen. The classics state: "If the Spleen is troubled by worry and unresolved, Yi (Intellect) is injured; if Yi is injured, thoughts become chaotic, limbs cannot move, hair deteriorates, complexion fades, and death occurs in spring." Human worry and thought often occur together, injuring Heart, Spleen, and Lung, thereby damaging Upper Jiao Yang Qi. Diseases of the two Yang channels originating from Heart and Spleen, gradually forming consumptive disorders, definitely stem from this.
3. Lustful and evil thoughts differ from worry and thought, causing damage primarily to the Kidney. When the Heart indulges in desire, the Kidney responds. When Ministerial Fire (Xiang Huo) moves upward, it resonates downward. Ministerial Fire is fire within water; when calm and stationary, it is Yang Qi; when blazing and uncontrolled, it resembles dragon-thunder fire, drying swamps and burning plains everywhere. In the Kidney, it causes seminal emission, stranguria, leukorrhea, and gradual drying of fluids. Rising into the Liver, it forces blood to move recklessly, causing hematemesis, epistaxis, or deficient Ying Qi with bone and tendon pain. Ascending to the Spleen, it injures Spleen Yin, causing fever and transforming diet into phlegm-saliva. Reaching the Lung, it fails to secure skin and hair, causing Yang collapse with wheezing and cough, even aphonia. These are all rootless deficient fire, with Yang failing to reside, flames reaching heaven, moving upward from Kidney to Lung, draining the source, resulting in upper excess and lower deficiency, a sign of extreme peeling (B Gua). Nuns, virgins, and widows, though not engaging in sexual intercourse, may have lingering private attachments and endless thoughts. If separated by distance or unfulfilled desires, desire-fire shakes the Heart, daily depleting True Yin, leading to incurable deficiency. Among the Five Exhausters, none is more severe. Those valuing life must avoid this.
4. Among the Seven Emotions, Fear (Kong) frequently injures the Kidney. Fear resides in the Heart, and the Kidney receives it. The classics state: "Fear injures the Kidney." Also: "Fear causes Jing Essence to retreat." Also: "Unresolved fear injures Jing; injured Jing causes bone soreness, flaccidity, coldness of extremities, and spontaneous leakage of essence." I once treated a young official whose illness stemmed from fear; after slight recovery, he suffered impotence, and upon relapse, it was incurable. I have also seen those suddenly frightened experience penile retraction or enuresis, signs of Kidney injury. However, anger also injures the Kidney. The classics state: "Unrestrained excessive anger injures Zhi (Will); injured Zhi causes forgetfulness, inability to bend/extend back/waist, hair deterioration, fading complexion, and death in late summer." Thus, excessive anger harms not only the Liver but also the Kidney.
5. Anger originates in the Heart, and the Liver responds. Unrestrained anger injures the Liver. The classics state: "Anger injures the Liver." Also: "Anger causes Qi to reverse; severely, it causes hematemesis and undigested stool diarrhea, so Qi ascends." The Liver is a Yang organ within Yin. Liver diseases can affect Yin or Yang. If fire moves due to anger, forcing blood recklessly and causing Qi reversal with distension, pain, and wheezing, this injures Yin. If Qi is injured by anger, Wood stagnation fails to extend, invading Spleen Qi and causing sinking, leading to vomiting, distension, diarrhea, pain, and food stagnation, this injures Yang. Mild anger that subsides quickly may not cause disease, nor will robust constitution easily fall ill. Only those with weak congenital endowment and vulnerable Three Yin channels, lacking restraint, will see Liver (East) excess leading to Lung (West) failure. Although anger primarily injures the Liver, grief/sorrow also easily injures the Liver. The classics state: "Liver grief moving internally injures Hun (Ethereal Soul); injured Hun causes madness and lack of clarity, leading to improper behavior, penile retraction, tendon contraction, inability to lift costal bones, hair deterioration, fading complexion, and death in autumn." Excessive anger injures Liver with excess Qi; grief injures Liver with deficient Qi. Excess does not remain excess forever, but deficiency remains deficient. Neglecting deficiency leads to consumptive damage. Treatment must distinguish pathogenic factors from healthy Qi.
6. Fright (Jing) enters the Heart but connects to Liver and Gallbladder. The classics state: "Fright causes the Heart to have no foundation, Shen no refuge, and thoughts no certainty, leading to Qi chaos." Also: "The East corresponds to Green color, connecting to the Liver; its disease manifests as fright and horror." Thus, fright agitates the Heart and especially injures Liver and Gallbladder. The Heart, as Sovereign, must not be injured. The Gallbladder, as the Official of Justice, houses Shaoyang Sheng Qi. The Yang-Qiang Qi of all eleven organs depends on the Gallbladder. Injury here causes immediate decline of vitality in all organs. Mild fright causing illness requires nourishing Heart and calming Shen; once Shen recovers, the disease retreats. Accumulated fear or sudden severe fright damaging the Gallbladder may cause bile leakage and jaundice, or silence, which are incurable. (Gallbladder Jaundice is discussed in the Jaundice chapter.)
7. Excessive sexual desire often leads to consumptive damage. After birth, humans rely on acquired Essence and Qi for survival. Strong Essence leads to strong Shen and longevity; deficient Essence leads to weak Qi and early death. Those with weak congenital endowment who cherish themselves and nurture acquired essence will likely live long. Those with thin endowment indulging in lust further deplete acquired essence will inevitably develop deficiency. Such self-harm invites blame. Youth under twenty, where Kidney Water (Ren Shui) is just generating, need protection of their budding vitality. Ignorant youths squandering female essence are like mayflies dying at dawn; this is tragic. Responsibility lies with the youth and their parents/teachers. Without prior instruction on preserving life, children acting on innocent curiosity cannot understand pros and cons. Late prayers and wailing are useless.
8. Neglecting fatigue often leads to consumptive damage. Labor is unavoidable. Manual laborers working all day rarely get sick; is this not labor? But labor differs. Poor laborers with regulated rest and no concern for status rarely get sick. Harm comes to the idle and fragile who exhaust their mental and physical strength. Labor for fame/profit ignores climate damage to the body; labor for lust ignores daily fatigue; labor for dissipation involves hunger and exertion in gambling/racing; labor from illness involves harm from incompetent doctors; labor from study involves disaster from hard work; labor from bravado leads to tendon rupture and weakness. Ultimately, failing to self-assess and forcing oneself leads to damage through reckless actions. Fatigue primarily injures the Spleen, but various labors injure tendons, bones, Qi, Blood, Essence, Shen, skin, and muscle, affecting all Five Zang organs. Alas! Desires confuse people, causing such harm. The cause is focusing on externals while forgetting the self. Guangchengzi said: "Do not weary your form, do not shake your essence, and you may attain longevity." People ignore these brief words, not realizing the Way of Health Preservation is contained within them. How can they be neglected?
9. Young men indulging in alcohol often develop consumptive damage. Alcohol is a wild drug, severely damaging True Yin. Moderate drinking may have benefits, but excess causes harm. Addicts suffer 80-90% harm. Human constitutions have Yin/Yang, and alcohol has Yin/Yang properties. Brewed wine is hot in nature but cold in substance (water-based). Indulging in wine with Yin deficiency: substance fails to nourish Yin, nature stirs fire, worsening heat, causing hematemesis, epistaxis, hematochezia, hematuria, wheezing, irritability, and madness. This is wine nature injuring Yin. Indulging in wine with Yang deficiency: nature fails to support Yang, substance retains as dampness, worsening cold, causing abdominal distension, diarrhea, abdominal pain, acid regurgitation, anorexia, Yang collapse, and sudden collapse. This is wine substance injuring Yang. Thus, wine injures both Yin and Yang. Wine confuses nature, leading to reckless acts, exhausting Essence and Qi, and failing to withstand disease, often unnoticed Yin damage. At the time of drinking, harm is ignored; only when critically ill is the cause recognized. I clarify this to awaken drinkers. (Discussions on wine appear in Diarrhea and Distension chapters.)
10. Misdiagnosis/mistreatment and neglect of post-illness care often lead to post-illness deficiency. Illnesses have Deficiency/Excess patterns; treatments have Tonifying/Reducing methods. Proper application makes a superior physician. Secular doctors often ignore Divine Principles and fail to distinguish Pathogenic/Healthy Qi and urgency, thus damaging Yuan Qi and destroying vitality. Deaths following medication go unreported. Survivors often suffer residual damage, leading to chronic deficiency unable to recover. Why? Physicians must not act rashly without clear understanding; this is a way of accumulating virtue. Regarding neglect of regulation leading to failure to recover: as the saying goes, "If small leaks are not patched, big holes cry injustice." Suffering is self-inflicted; what is there to complain about?