今之所谓虚劳，古之所谓蒸也；古之所谓虚劳，今之所谓脱力也。《金匮》必列虚劳者
，以
见伤寒自有因脱力得者也，俗称脱力伤寒本此，知此而《金匮》虚劳诸方能用之矣。（俗称
脱力，不专指疲劳言，凡五劳皆在其中。）脱力有成痼疾者，有在一时者，有着一处者，苟
因劳伤气血不复，皆得称为虚劳。人但泥于弱症损症之不起者为虚劳，而不知彼特其一端也
。若一时一处之虚劳，则或待治而后愈，或不治而自愈，无甚足异。第既有虚劳之因，风寒
随而入之，《金匮》本为风寒尽其变，故浑言之曰虚劳，不复分别其为何劳。推而准之，伤
寒劳复，乃虚劳之在一时者，亦不分别其若者为操作之劳，若者为房室之劳也。根据义本当列
此篇末，编《伤寒论》者，欲其便览，移置如此耳！他如《脉经》云∶病患一臂不随，时复
转移在一臂者，此为微劳，营卫气不周故也，久久自愈。乃虚劳之着一处者，亦不分别有为
何劳，亦以有本病可列故也。此经又有劳疟，《千金》、《外台》有劳嗽、劳聋，凡在一时
及着一处者皆仿此。读古人书，须辨其名，以究其指，医亦如之。诚能知此，何至以建中汤
等方，误投之蒸病也哉？
《外台》始有传尸劳之名，历宋至今，皆着于录。尝欲问其为何病，则诸老医无能言之
者。
及泉习之有年，乃知传尸劳者，合尸、疰、疳、蒸四大症以名之也。初以体虚受邪，入感尸
虫，于是沉沉默默，无处不恶，而不能的言所苦，此时名之为尸可也；甚而发热、喘促、颧
赤，名之为蒸可也；及其项间生块、唇口喉舌皆疮，名之为疳可也；至差而复剧，死而传人
，则为注矣。备此四症，故方法不一，各据见在为言也。古人 、无辜、伏连、尸注等称
，亦各据一端为言也。余幼时，胞姑有病此死者，及长，而嫡妹又病此死，然皆不传染，殆
相似而未的者欤！要之，已备尸、疳、蒸三大症矣。遇是症者，倘能分别论治，其于古方清
热、调胃、杀虫诸法，庶不贻误，特未必其果愈耳！
当今所说的“虚劳”，就是古代所说的“蒸”；古代所说的“虚劳”，就是当今所说的“脱力”。《金匮要略》专门列出“虚劳”这一篇，是为了说明伤寒病中自有因“脱力”而引发的类型，民间俗称的“脱力伤寒”正是源于此理。明白了这一点，才能正确运用《金匮要略》中治疗虚劳的各种方剂。（民间俗称的“脱力”，并不专指身体疲劳而言，凡是五种劳损都包含在内。）“脱力”导致的疾病，有的会形成顽固性疾病，有的仅发生在某一时刻，有的只局限于身体的某一部位。只要是因为劳累损伤气血且无法恢复，都可以称为“虚劳”。人们往往固执地认为只有那些虚弱、亏损导致病情恶化无法治愈的才叫“虚劳”，却不知道那只是其中的一种情况。如果是某一时刻或某一部位的“虚劳”，那么或者经过治疗后才能痊愈，或者不治疗也能自愈，没有什么值得奇怪的。既然已经有了“虚劳”的病因，风寒邪气就会随之侵入，《金匮要略》原本是为了详尽阐述风寒邪气的各种变化，所以笼统地称之为“虚劳”，不再分别它是哪一种具体的劳损。推演并以此为准绳来看，“伤寒劳复”（伤寒病愈后因劳累复发），就是属于“虚劳”中发生在某一时刻的情况，也不再分别它是体力操作之劳还是房事之劳。按照义理本应将此篇列在《伤寒论》末尾，但编纂《伤寒论》的人为了便于查阅，将其移置到了此处！其他如《脉经》中说：病人一只手臂不能随意活动，时常转移到另一只手臂的，这是轻微的劳损，因为营卫之气运行不周所致，久而久之会自行痊愈。这属于“虚劳”中局限于某一部位的情况，也不分别具体是哪一种劳损，也是因为有本病的症状可以列举的缘故。这部经典中还有“劳疟”，《千金方》、《外台秘要》中有“劳嗽”、“劳聋”，凡是在某一时刻发生及局限于某一部位的，都仿照这种情形。阅读古人的书籍，必须辨别名称，以探究其真实含义，医生行医也是如此。如果真的能明白这个道理，怎么会把建中汤等方剂误用于“蒸”病呢？
《外台秘要》开始有了“传尸劳”这个名称，历经宋代直到今天，都被记录在案。我曾经想问这是什么病，但许多老医生都无法说清楚。等到我在泉州习医多年后，才知道“传尸劳”是将“尸”、“疰”、“疳”、“蒸”这四大症候合并起来命名的。起初因为体质虚弱感受邪气，体内感染尸虫，于是精神萎靡沉默寡言，全身各处都不舒服，却无法确切说出痛苦所在，这个时候可以称之为“尸”；严重到出现发热、气喘急促、颧骨发红，可以称之为“蒸”；等到颈部出现肿块、嘴唇口腔咽喉舌头都生疮疡，可以称之为“疳”；等到病愈后又加重，死后传染给别人，就称之为“注”了。具备这四种症候，所以治疗方法不一，都是根据当前显现的症状来说明的。古人所说的“鬼疰”、“无辜”、“伏连”、“尸注”等称呼，也都是各自根据其中一端症状来说明的。我小时候，堂姑患有此病去世，长大后，同父同母的妹妹又患此病去世，然而她们都没有传染性，大概是症状相似但未完全确诊吧！总之，已经具备了“尸”、“疳”、“蒸”三大症候。遇到这种病症的患者，如果能够分别进行辨证论治，对于古方中的清热、调理脾胃、杀虫等方法，或许就不会造成误治，只是未必一定能彻底治愈罢了！
The so-called "Xu Lao" (Deficiency and Emaciation Syndrome) of today is what the ancients called "Zheng" (Steaming Sensation); the "Xu Lao" of the ancients is what is called "Tuo Li" (Collapse of Strength) today. The *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) specifically lists "Xu Lao" to demonstrate that Shang Han (Cold Damage) naturally includes types caused by "Tuo Li"; the common term "Tuo Li Shang Han" originates from this understanding. Grasping this allows one to correctly apply the various formulas for Xu Lao found in the *Jin Gui Yao Lue*. (The common term "Tuo Li" does not refer exclusively to physical fatigue; it encompasses all five types of chronic overstrain.) Diseases resulting from Tuo Li may become entrenched, occur transiently, or be localized to a specific area. As long as Qi and Blood are damaged by exertion and fail to recover, they can all be termed Xu Lao. People often rigidly believe that only those weak and emaciated conditions that deteriorate and prove incurable are called Xu Lao, failing to realize that this is merely one aspect. If the Xu Lao occurs transiently or locally, it may heal after treatment or resolve spontaneously without treatment, which is hardly surprising. Since there is a cause of Xu Lao, Wind-Cold pathogens enter along with it. The *Jin Gui Yao Lue* originally aimed to exhaustively describe the variations of Wind-Cold, thus generally referring to it as Xu Lao without distinguishing the specific type of strain. Extending this logic, "Shang Han Lao Fu" (Relapse of Cold Damage due to Overexertion) belongs to Xu Lao occurring transiently, without distinguishing whether it results from physical labor or sexual activity. According to principle, this section should have been placed at the end of the *Shang Han Lun* (Treatise on Cold Damage), but the compilers moved it here for ease of reference! Similarly, the *Mai Jing* (Pulse Classic) states: "If a patient's arm becomes immobile and the condition shifts between arms, this is minor Laos (overstrain), caused by uneven circulation of Ying and Wei (Nutritive and Defensive Qi). It will heal on its own after a long time." This refers to Xu Lao localized to one area, again without specifying the type of strain, because the underlying disease symptoms allow for classification. This classic also mentions "Lao Nüe" (Malaria due to Overstrain); the *Qian Jin Fang* (Prescriptions Worth a Thousand Gold) and *Wai Tai Mi Yao* (Secret Essentials of the Outer Cabinet) mention "Lao Sou" (Chronic Cough due to Overstrain) and "Lao Er" (Deafness due to Overstrain). All cases occurring transiently or locally follow this pattern. When reading ancient texts, one must distinguish names to investigate their true meanings; physicians must do the same. Only by truly understanding this would one avoid mistakenly applying formulas like Jian Zhong Tang (Middle-Builder Decoction) to treat Zheng diseases?
The name "Chuan Shi Lao" (Transmitting Corpse Consumption) first appeared in the *Wai Tai Mi Yao*, recorded continuously from the Song Dynasty to the present. I once wished to ask what disease this was, but many experienced physicians could not explain it. After practicing medicine in Quanzhou for several years, I came to know that "Chuan Shi Lao" is named by combining four major syndromes: "Shi" (Corpse), "Zhu" (Infectious/Passing On), "Gan" (Ulceration/Emaciation), and "Zheng" (Steaming). Initially, due to constitutional deficiency and pathogenic invasion, infection by "corpse worms" occurs. The patient becomes listless and silent, feeling discomfort everywhere but unable to pinpoint the pain; this stage can be called "Shi". Progressing to fever, panting, and malar flush, it can be called "Zheng". When lumps appear on the neck and ulcers form on the lips, mouth, throat, and tongue, it can be called "Gan". When the disease recurs severely after apparent recovery, or spreads to others after death, it is called "Zhu". Having these four syndromes, treatment methods vary, each addressing the currently manifest symptoms. Ancient terms such as "Gui Zhu" (Ghost Zhu), "Wu Gu" (Gu-Free), "Fu Lian" (Hidden Link), and "Shi Zhu" were also based on specific aspects of the syndrome. In my childhood, my paternal aunt died of this disease, and later my full sister also died of it; however, neither case was infectious, suggesting they were similar but not definitively diagnosed. In summary, they possessed the three major syndromes of "Shi", "Gan", and "Zheng". For patients with this syndrome, if differentiated treatment is applied, utilizing ancient methods such as clearing heat, regulating the Stomach, and eliminating parasites, errors might be avoided, though complete cure is not guaranteed.