典藏书目

Regarding Yin deficiency progressing to consumptive disease (Lao) where the pathology is unified under the Lung, there are approximately several types: termed Lao Sou (consumptive cough), termed Hemoptysis (coughing up blood), termed Bone-steaming Fever (a sensation of heat steaming from the bones due to Yin deficiency), and in extreme cases, evolving into Shizhu (a contagious chronic wasting disease). The manifestations of these symptoms include: those accompanied by cough; those that start directly with consumptive cough and are subsequently accompanied by hemoptysis; those that start directly with hemoptysis and are subsequently accompanied by consumptive cough; those that evolve into Shizhu after a long duration; and those who exhibit only one symptom throughout but either recover or die. All such variations are entirely governed by the treatment of the Lung. The reason for this is that although Yin deficiency consumptive diseases have different names such as Five Injuries (Wu Lao) and Seven Damages (Qi Shang), they ultimately adhere to the Lung as the supreme standard. Therefore, before Bone-steaming Fever, consumptive cough, or hemoptysis appear, one should preemptively Clear Metal and Protect the Lung (clear lung heat and protect lung Qi); once Bone-steaming Fever, consumptive cough, or hemoptysis have appeared, one must urgently Clear Metal and Protect the Lung; and for those who have recovered from Bone-steaming Fever, consumptive cough, or hemoptysis, one must never forget to protect the Lung throughout life. This is why the treatment of Yin deficiency should be completely unified under the Lung.

Deficiency syndromes have six causes: congenital causes, acquired causes, causes related to smallpox/rubella and post-illness states, exogenous causes, environmental/psychological causes, and medical error causes.
Congenital causes refer to the initial conception stage. If the parents were elderly and frail, engaged in sexual activity while fatigued, engaged in sexual activity after illness, had improper regulation during pregnancy, or suffered from excessive sexual indulgence, the offspring may easily develop weak consumptive disease around the age of twenty. However, its precursors must manifest first, such as frequent fright-wind in childhood, soft bones and delayed walking; slightly older, inability to vocalize while reading, or trembling hands when writing; excessive phlegm in the throat, Qi stagnation in the chest, head shaking, or eye blinking. These are all signs of congenital insufficiency. Care should be taken before illness occurs, either by preemptively taking tonifying medicines or by conserving mental and physical energy. One cannot assume safety merely because there are no cold or heat symptoms, appetite is normal, and they can handle worldly affairs. Even at the onset of illness, it may merely present as mental and physical fatigue.

Acquired causes primarily involve damage from alcohol, sexual indulgence, overwork, Seven Emotions (joy, anger, worry, thought, sadness, fear, fright), and diet. Sexual indulgence damages the Kidney, leading to weak Kidney essence; mental overwork damages the Heart, leading to Spleen weakness and failure of transportation and transformation. Damage to Qi first inevitably affects Jing (Essence); damage to Jing first inevitably affects Qi. Onset may occur at fifteen or sixteen, around twenty, or near thirty. Although the age of onset varies, the pathological mechanism converges on the same principle.

Causes related to smallpox/rubella and post-illness states: Smallpox is considered congenital Yang toxin, while rubella is congenital Yin toxin. Therefore, smallpox requires boosting Qi and tonifying the Middle Jiao so that the release of Yang toxin is clean, eventually leading to Spleen leakage and Stomach weakness, abdominal pain, shortness of breath, spiritual exhaustion, Essence depletion, pale complexion, lower limb flaccidity, intolerance to labor, and susceptibility to wind-cold. Various symptoms of Qi weakness and Yang decline result from neglecting tonification during smallpox. Rubella-related conditions such as lung wind asthma, hoarseness, and susceptibility to wind-cold coughs represent various symptoms of Yin deficiency and Blood dryness, resulting from neglecting clearing heat during rubella. After illness, if Yuan Qi remains deficient, and the patient disregards their health, engaging in labor to damage Qi and excessive desire to deplete Essence, the five Zang organs may suffer simultaneous damage, often leading to untreatable conditions. Caution is especially required here.

Exogenous causes: As the common saying goes, "A lingering cold turns into consumption." If Yuan Qi is sufficient, it naturally expels pathogens; or if Kidney Essence is originally dense, Water can control Fire, preventing progression to consumption. However, if the person indulges excessively in alcohol and sex, severely damages Heart Blood, has easily stirring Liver Fire, suffers from chronic Yin Blood deficiency, and has latent fire in the Lung, an attack by wind-fire will trigger consumptive cough. Since the Lung governs the skin and hair, once wind-pathogen invades the skin and hair, Lung Qi rebels and causes cough. It may seem like a trivial cold-induced cough, but prolonged coughing stirs latent fire, which ascends to the Metal (Lung). Consequently, water essence fails to distribute, the Kidney source is cut off, and prolonged coughing loses Qi, failing to descend and nourish. When the Water child (Kidney) fails to rescue the Metal mother (Lung), consumptive cough forms.

Environmental/Psychological causes: Without damage from the Seven Emotions, the Five Injuries do not form. Only those truly liberated can achieve a state of detached observation without harm; others rarely escape illness. Distress and unbearable situations disrupt emotions and damage Qi and Blood. Physicians must examine the Seven Emotions before investigating the Five Zang organs, and regulate the Five Wills (emotional states associated with organs) before studying the Five Injuries. It is highly appropriate to use gentle metaphors to untie knots and resolve attachments. For the reckless, warn them of life and death; for the biased, correct them with morality; for the stubborn, guide them toward detachment; for the poor, assist them with material aid. This is the action of benevolent gentlemen.

Medical error causes: Conditions that were originally not consumption become so due to medication errors. Using strong dispersing agents for non-cold-pathogen illnesses, or using harsh purgatives for minor stagnation, causes pathogenic heat to become firmly entrenched and incurable. Such errors can turn false conditions into true ones, and mild conditions into severe ones. Deep discernment is necessary.