一 一人正月间骤发齿痛，十余日而愈。四月间焦劳过多，齿痛大发。医用石膏、知母等药治之。
不效。用刀去齿间紫血，满口痛不可忍，齿俱摇动。至六、七月间，饮食益多，小便如膏，肌肉尽削。
至十一月，身不能起。冬末用黄 、地黄等药，稍能起立。然食易饥如故，小便如膏，亦如故。翌年二、
三月愈甚，亦不服药，齿痛如故，当门二齿脱落，复加口渴，昼夜不止。此中、下二消症也。仲淳用生地
〔六钱。〕麦冬〔五两。〕天冬〔一两。〕五味子〔三钱。〕芦根〔五两。〕黄连〔三钱。〕黄
〔五钱。〕以缲丝汤十碗煎二碗不拘时服。未数数剂而愈。丸药即于前方中，加五味子〔六两。〕枸
杞〔四两。〕牛膝〔五两。〕黄柏〔三两。〕沙参〔六两。〕蜜丸常服，遂不复发。
二 一人服热药而病消渴，坚令服六味地黄汤千剂，果效。盖得于壮水之主，以制阳光之旨也。
虚劳之病，无外邪相干，皆由内伤脏腑所致。如酒伤肺，湿热熏蒸，则肺阴消灼。色伤肾，精室空
虚，则相火无制。思虑伤心，神伤血耗，血耗则火易上炎。劳倦伤脾，最能生热，热盛则内伐真阴。忿
怒伤肝，郁怒则肝火内炽而灼血，大怒则肝火上冲而吐血。此五者，皆能劳其精血。《道经》云∶涕、
唾、精、津、汗、血、液，七般灵物总属阴。阴虚则内热生，而成虚劳之症。大抵因酒色成劳者为多
耳，然有童子未室，而亦患此症者，此则由于先天禀受之不足，而禀于母气者尤多。如母阴虚者，生子
必多弱症也。其师、尼。寡妇、室女愆期，思欲不遂，气血郁结，以致寒热如疟，朝凉暮热，饮食不
思，经期不准，或致闭绝，成此病症者甚多，多由郁火内蒸所致。方书之言虚劳，皆以气虚、血虚、阴
虚、阳虚，混同论治，是以学人漫无指归。不知气虚者，面白无神，语言轻微，四肢无力，脉来微弱，阳
虚者，体冷畏寒，手足逆冷，溺清溏泄，脉沉小迟，可投温补。故谓虚劳之能服参、 ，为受补可治者，
气虚、附虚之症也。虚劳之不能服参、 ，为不受补不治者，血虚、阴虚
之症也。虽血脱有补气之法，此指卒暴失血，素非血虚之人，如新产之类，非所论于血因火燥致虚
之症，其致使火之燥血者，水虚无以制之也。故经曰∶一水不能胜五火。五火者，五志之火也，一水
者，肾中真阴之水也。水即精也。观经言∶女子二七而天癸至，男子二八而天癸至。非阴生在后，而
阴成之难乎？又言，人年四十，而阴气自半也。非阴衰在前，而阴之易凋乎？所谓阴者，即我之精而
造我之形者也。人生全盛之数，前后止二十余年，而形体渐衰。故丹溪引日月之盈亏，以为阳常有余，阴
常不足。而王节斋则以为阴虚成病者，十之八、九，阳虚成病者，百无一、二。盖以节欲者少，纵欲
者多耳。夫人但知纵欲劳精，抑孰知阴精日损，饮食无味，转劳转虚，转虚转劳，脉从内变，色不外
华。其为病也，在肾则为腰脊腿胫酸软，或悠隐而痛，为骨蒸内热盗汗，或至夜发热，为遍身骨酸，或
疼痛如折，为梦交失精，或自遗滑泻，为耳中呜，为足心热。在心则为惊悸怔忡，为掌中干热，为虚烦
无寐或梦魇不宁，为口苦舌干，或口舌糜烂。在肺则为咳嗽多痰，或干咳少痰，为胸满气逆，或喘息
促急，为两颧红若胭脂，为鼻中气如火热，为咳血，为衄血，甚则吐涎如白沫，一边不能睡，咽疼喉
烂，声嘶音哑。在于肝则为寒热如疟，为颈项瘰疠，为胁作胀作疼，为两目或涩或痛，为头晕，为眼花，
为多怒，为吐血。在脾则为饮食少思，为恶心呕吐，为胀满腹痛，食不消化，为肠鸣泄泻，肌。
肉消瘦。此皆五脏虚劳之本症。经曰∶治病必求其本。须审其因何致损，何脏受伤。如因于色者，则
知其伤在肾，纵有他经现症，亦当以补肾为本，而兼治他经之症。其因于酒者，又当以清肺为先。标本
即审，然病之传变无穷，不可不察。如肾传心、心传肺、肺传肝、肝传脾、脾再传肾，此传其所胜之
脏，侮而乘之，谓之贼克，大凶之兆。经云∶诸病以次相传者死。谓五脏以次相传而克遍也。《难
经》云∶七传者死，谓如病始于肾，而脾复传肾，是谓六传，已尽一脏，不可再伤也。如肾病不传心而
传肺，此间一脏，而传于生我之母，以母子气通，子病及母也。如肾病不传心传肺，而传肝，此间二脏
而传于己生之子，母病及子也。如肾病不传心、传肺、传肝，而传脾，此间三脏而传己所不胜之脏，
经所谓轻而侮之也。传乘不明，岂能治病。虚劳一症，世之偏于阴虚者，比比皆是，而医者每不深晰气
血阴阳，模糊调治，甚为夭亡者，何可数哉！试详言之，其误有七。一曰∶引火归元之误。命门之火，
谓之龙火，亦谓之真阳。如果衰弱，肾中阴盛，龙火不能安其位，浮越于上，而为上焦假热，面赤烦躁
口渴，甚者舌苔等症。但口虽渴而不欲饮水，苔虽有而舌必滑软，足冷过膝，小便清长，其右尺脉必
沉小而迟，或浮大无根。此阴盛于下，逼阳于上之假症。如夏至一阴生，水底冷而天上热，龙为阳物，
故随阳而上升，此正宜用八味之属，冰冷与饮，假寒之药，骗之下咽之后，冷性既除，热性始发，浮游
之火，可得引之归原，如冬至一阳来
复，地中水暖，而龙归大海也。至若虚劳之症，是因肾水真阴虚极，水不摄火，火因上炎。而致面赤
唇红，口鼻出血。齿痛齿衄，种种上焦虚热之症，虽亦龙火上炎，与虚阳上浮不同，纵有下部恶寒足
冷，此因虚火上升所致，非真阳衰而然。故其小便必黄赤，其脉必带数，有内热的症之可据。设误用
桂、附引火归原之法，是抱薪救火，上焦愈热，而咳喘燥渴益甚，咽痛喉烂诸症至矣。二曰∶理中温
补之误。理中者，理中焦之虚寒也。虚寒腹痛，绵绵痛而无增减，喜热手按，热饮食，虚寒泄泻，水
谷不化，而澄澈清冷，必有虚寒之症脉可凭，然后用之有效。今人一见胀满腹痛，食不消化，肠鸣泄泻
等症，便认为虚寒，而投以白术之香燥，又济以干姜之辛热，甚者更加桂、附；殊不知虚劳患在伤
阴，再补其阳，则阳益亢，而阴益竭，诸热悉加，是促之死也。更有见其胀满泄泻，遂引经文清气在
下，则生飧泄，浊气在上，则生 胀，而用补中益气汤，以升清降浊，误施升柴，反提阴火上逆，以
致咳喘频增，吐衄交至，而危亡见矣。然使其温补得售者，亦病家不明有以致之耳。盖助阳之药，能
使胃气一时暂壮，饮食增加，彼此夸功，固执不改，至死不悟，良为可悯。三曰∶参、 助火之误。
夫虚劳之可受参、 者，肺必无热者也，肺脉按之而虚必不数者也。故有土旺
而金生，勿拘拘于保肺之说，古人每用之而奏功。而今则火已灼金而咳矣，火蒸津液而化为浓痰
矣，君相亢甚，而血随之上逆矣，犹引无阳则阴无以生，虚火可补，参、 之属，富贵之家，大剂
投之。因之阳火愈旺，而金益受伤。所以好古有肺热还伤肺，节斋有服参必死之叮咛也。四曰∶苦
寒泻火之误。实火为病，可以苦寒直折之，然当热去即止，不可过用。虚火为病，阴之亏也，岂
知、柏苦寒之剂可能清之！服之者，非惟不能清热，抑且有损其阴，徒败胃气，食少泻多，将何疗
治。甚者，见其大便燥结，肆用硝、黄以通之。不知肾主二便，肾主五液，肾之津液既亏，自然
不能濡润，滋其阴，润其燥，而便自通。彼既虚之阴，岂能胜硝黄之攻代乎？故士材之论，昧者
徒从其温补，自明者观之，知其深戒苦寒之不可妄用也。五曰∶二陈消痰之误。痰在脾经者，名曰
湿痰。其痰滑而易出，或稀如饮水者，名曰痰饮。湿者燥之，半夏为正治之药。若阴水不足，阴火
上升，肺受火侮，不得清肃下行，由是津液凝浊，不生血而生痰，此当以润剂滋其阴，使上逆之火，
得返其宅而息焉，则痰自清矣，投以二陈，立见其殆。六曰∶辛剂发散之误。世之真阴虚而发热者，
十之六、七，亦与外感无异。火逆冲上，则头胀微痛；火升壅肺，则有时鼻塞∶阴虚阳陷入里，则
洒淅恶寒；阴虚阳无所附，则浮越肌表发热。但其发时，必在午
后，先洒淅恶寒，少顷发热，热至鸡鸣寅卯时分，盗汗出而身凉。或无微寒，而但午后发热，必现前
列肾虚诸症。或兼唇红颧赤，口渴烦躁，六脉弦数，或虚数无力。此宜大剂补阴，如保阴、六味之
属。若认为外感，而用风药以表散之，则魄汗淋漓，诸虚蜂起。或有失血之人，表之无汗，经所谓
夺血者无汗也，再强发之，血必从耳目口鼻中出，为上厥下竭，难治之症。今人一见发热，便用表
散，更以为邪尚未尽，禁其饮食，以致胃气馁惫，至于死亡，可不寒心。七曰∶治疗过时之误。上古
圣人不治已病而治未病。如劳神者，常养其心；劳倦者，常补其脾，多怒者，常滋其肝血；多饮
者，常清其肺热；好色者，峻补其肾水。及病之方萌，即为补救。仲景曰∶凡人有病，不时即治，隐
忍冀瘥，必成锢疾。所以虚劳终罕得愈者，以内热之症，人多易忽，虚症渐见，犹不求治，自恃饮食
起居如常，面颜如旧，仍纵恣酒色，且讳言虚劳，而医者又逢迎迁就，致病日深。迨至咳嗽痰红，吐
血寒热，饮食少思，病已成而后药之，譬之渴而穿井，斗而铸兵，不亦晚乎！然而治之最难，有三大
要法，不可不讲也，一曰，补肾水。经云∶肾者主水，受五脏六腑之精而藏之。故五液皆归乎精，而
五精皆统乎肾，肾有精室，是曰命门，精藏于此，气化于此，精即阴中之火也。故命门
之水火，为十二脏之化源。心赖之，则君主以明；肺赖之，则治节以行；脾胃赖之，济仓廪之富；肝
胆赖之，资谋虑之本；膀胱赖之，则三焦气化，大小肠赖之，则传导自分。故水火之功，缺一不
可。然火衰者甚少，而水虚者恒多。王节斋云∶少年肾水正旺，似不必补，然施泄过度，岂能充满。
中年欲心虽减，然少年斫丧既多，焉得复实。既至老年，天真渐绝，只有孤阳。故人自少至老，所生疾
病，靡不由于真阴不足。即童子禀赋弱者，从幼填补真阴，亦有可复之天。所以补阴之药，亦自少至
老，不可或缺，况虚劳因入房太甚而得者乎？故保阴、六味、左归之属，皆甘寒滋水添精之品，补阴以
配阳，正王太朴所谓壮水之主，以制阳光，丹溪所谓滋其阴则火自降，譬之灯残火焰，添油则焰光自
小也。然须制大剂，长久服之。盖益阴之药，必无旦夕之效，以阴无速补之法也。至若因于酒者，清
金润燥为主，而保阴之属，仍不可废。何则？好饮之人，仍有不患虚劳者，以肾水虚也。虚则必寡于
畏，而复灼久伤之肺，焉得不病！补北方正所以泻南方而救肺也。因于思虑者，清心养血为主，而保
阴之属，仍不可缺，所谓水壮而火熄，勿亟亟于泻心是也。因于劳倦者，培补脾阴为主，而佐以保阴
之剂。经曰∶有所远行劳倦，逢大热而渴，渴则阳气内伐，内伐则热舍于肾。故知劳倦伤脾，内热者必
及于肾也。若忿怒伤肝动血，保阴、六味丸为正治之剂。盖水旺则龙水不炎，而雷火亦
不能发，乃肾肝同治之法也。二曰，培脾土。脾胃为后天之根本，经曰，安谷则昌。盖精生于谷，
饮食多，自能生血化精，精血渐生，虽有邪热，药得以制之消之，久则火自降而阴自复。若脾胃一弱，
则饮食少而血不生，血不生则阴不足以配阳，而五脏齐损。故曰，又归重于脾胃。而言一损损于
肺，皮聚而毛落∶二损损于心，血脉不能荣养脏腑；三损损于脾，饮食不为肌肤，四损损于肝，筋缓
不能自收持，五损损于肾，骨痿不能起于床。从上而下者，过于胃则不治，至骨痿不能起于床者死；
从下而上者，过于脾则不治，至皮聚而毛落者死。所以仲景治虚劳，惟用甘药，创建中气，以生血
化精，充溢脏腑，为复虚劳诸症之良法。一遵精不足者，补之以味之旨也。味非独药也，五谷之味
皆味也，补以味而节其劳，则积贮渐富，大命不倾。经云∶阴阳形气俱不足者，调以甘药。盖药食之
入，必先脾胃，而后五脏得禀其气。脾胃强，则五脏俱盛，脾胃弱，则五脏俱衰。故中气不足者，非甘
不可。况土强则金旺，金旺则水充。又男子以脾胃为生身之本，女子以心脾为主命之根。故治虚劳
者，毋论何脏致损，皆当以调养脾胃为主。三曰，慎调摄。虚劳之因，因于酒色者最多，其因于忧愁思
虑，抑郁多怒者，复亦不少。所以童子、室女不生欢笑，及鳏、寡、僧、尼易犯此病者，谓非针药之可
治，必须消遣情怀，随遇皆安，然后疗治，庶能愈病，乃今之患此症者，徒仗诸草木，奉为撤消之
品，外则疲劳形体，内则沉湎七清，酒色不屏，辛热不戒，此乃自趋死径，间有知戒酒色，节劳逸，
而于七情多所难释。不知心有妄动，气随心散，气散不聚，精逐气亡。故广成子曰∶必静必清，无
一、有一人正月间突然发作牙痛，十多天后痊愈。四月间因过度劳累焦灼，牙痛剧烈复发。医生用石膏、知母等药物治疗，无效。用刀刺破牙齿间的紫血，满口疼痛难忍，牙齿全部松动。到了六、七月间，饮食增多，小便像膏脂一样浑浊，肌肉完全消瘦。到了十一月，身体无法起床。冬末使用黄柏、地黄等药物，稍微能够站立。然而食欲容易饥饿如旧，小便像膏脂一样，也如旧。第二年二、三月病情更加严重，也不服药，牙痛依旧，门牙两颗脱落，又加上口渴，昼夜不停。这是中消、下消两种症状。仲淳用生地黄（六钱）、麦冬（五两）、天冬（一两）、五味子（三钱）、芦根（五两）、黄连（三钱）、黄柏（五钱），用煮丝茧的汤十碗煎成两碗，不拘时间服用。没有几剂就痊愈了。丸药即在前方基础上，加五味子（六两）、枸杞（四两）、牛膝（五两）、黄柏（三两）、沙参（六两），炼蜜为丸常服，于是不再复发。
二、有一人服用热性药物后患上消渴病，坚持让他服用六味地黄汤一千剂，果然有效。这是因为得到了“壮水之主，以制阳光”的宗旨。
虚劳病，没有外邪干扰，都是由内伤脏腑所致。比如饮酒损伤肺，湿热熏蒸，则肺阴被消灼；房事损伤肾，精室空虚，则相火失去制约；思虑损伤心，神伤血耗，血耗则火容易上炎；劳倦损伤脾，最能生热，热盛则内部伐害真阴；愤怒损伤肝，郁怒则肝火在内炽盛而灼烧血液，大怒则肝火上冲而吐血。这五种情况，都能使精血劳损。《道经》说：涕、唾、精、津、汗、血、液，七种灵物总属阴。阴虚则内生热，形成虚劳病症。大抵因酒色导致虚劳的人居多，但也有未婚童子也患此病的，这是由于先天禀赋不足，且受母亲体质影响更多。如果母亲阴虚，生子必然多弱症。那些僧侣、尼姑、寡妇、处女月经延期，思欲不得满足，气血郁结，以致寒热像疟疾一样，早晨凉晚上热，不想饮食，经期不准，或者导致闭经绝经，形成这种病症的很多，多由郁火在内蒸腾所致。医书关于虚劳的论述，都把气虚、血虚、阴虚、阳虚混同论治，所以学习者漫无目标。不知道气虚的人，面色白无神，语言轻微，四肢无力，脉来微弱；阳虚的人，身体冷畏寒，手足逆冷，小便清长大便溏泄，脉沉小迟，可以投用温补。所以说虚劳中能服用人参、黄芪，属于能受补可治的，是气虚、阳虚的症状。虚劳中不能服用人参、黄芪，属于不受补不治的，是血虚、阴虚的症状。虽然血脱有补气的方法，但这指的是突然大量失血，平时并非血虚之人，比如新产后之类，不适用于因火燥导致血虚的症状，致使火燥血的，是因为水虚无以制约它。所以经文说：一水不能胜五火。五火，是指五志之火；一水，是指肾中真阴之水。水即精。看经文说：女子十四岁天癸至，男子十六岁天癸至。不是阴在后生成，而且阴很难成就吗？又说，人四十岁，阴气自半。不是阴在前衰退，而且阴很容易凋谢吗？所谓阴，就是我的精，造就我的形体。人生全盛的时期，前后只有二十多年，形体逐渐衰败。所以丹溪引用月亮的盈亏，认为阳常有余，阴常不足。而王节斋则认为阴虚成病的占十分之八、九，阳虚成病的百无一、二。大概因为节制欲望的人少，放纵欲望的人多罢了。人们只知道纵欲劳精，又有谁知道阴精日渐损耗，饮食无味，越劳累越虚，越虚越劳累，脉象从内部变化，面色不显荣华。其发病时，在肾则为腰脊腿胫酸软，或隐隐作痛，为骨蒸内热盗汗，或到夜间发热，为全身骨酸，或疼痛如折断，为梦交遗精，或自遗滑泻，为耳中鸣响，为足心热。在心则为惊悸怔忡，为手掌干热，为虚烦失眠或梦魇不宁，为口苦舌干，或口舌糜烂。在肺则为咳嗽多痰，或干咳少痰，为胸满气逆，或喘息急促，为两颧红若胭脂，为鼻中气如火热，为咳血，为鼻衄，甚至吐涎如白沫，一边不能睡，咽疼喉烂，声嘶音哑。在肝则为寒热像疟疾，为颈部瘰疬，为胁肋胀疼，为两眼或涩或痛，为头晕，为眼花，为多怒，为吐血。在脾则为饮食少思，为恶心呕吐，为胀满腹痛，食不消化，为肠鸣泄泻，肌肉消瘦。这都是五脏虚劳的本症。经文说：治病必求其本。必须审查因何致损，哪脏受伤。如因房事导致的，就知道伤在肾，纵然有其他经络现症，也当以补肾为本，兼治其他经络症状。如因饮酒导致的，又当以清肺为先。标本既已审察，但病的传变无穷，不可不察。比如肾传心、心传肺、肺传肝、肝传脾、脾再传肾，这是传其所胜之脏，侮而乘之，称为贼克，是大凶之兆。经文说：诸病以次相传者死。指五脏依次相传而克遍。《难经》说：七传者死，指如病始于肾，而脾复传肾，这叫六传，已尽一脏，不可再伤。如肾病不传心而传肺，中间隔一脏，传于生我之母，因母子气通，子病及母。如肾病不传心传肺，而传肝，中间隔二脏，传于己生之子，母病及子。如肾病不传心、传肺、传肝，而传脾，中间隔三脏，传于己所不胜之脏，经文所谓轻而侮之。传乘不明，怎能治病。虚劳一症，世上偏于阴虚者比比皆是，而医者每不深晰气血阴阳，模糊调治，甚为夭亡者，何可数哉！试详言之，其误有七。一曰：引火归元之误。命门之火，称为龙火，也称为真阳。如果衰弱，肾中阴盛，龙火不能安其位，浮越于上，而为上焦假热，面赤烦躁口渴，甚者舌苔等症状。但口虽渴而不欲饮水，苔虽有而舌必滑软，足冷过膝，小便清长，其右尺脉必沉小而迟，或浮大无根。这是阴盛于下，逼阳于上的假症。如夏至一阴生，水底冷而天上热，龙为阳物，故随阳而上升，这正是适宜用八味丸之类的，冰冷与饮，假寒之药，骗之下咽之后，冷性既除，热性始发，浮游之火，可得引之归原，如冬至一阳来复，地中水暖，而龙归大海也。至于虚劳之症，是因肾水真阴虚极，水不摄火，火因上炎。而致面赤唇红，口鼻出血。齿痛齿衄，种种上焦虚热之症，虽亦龙火上炎，与虚阳上浮不同，纵有下部恶寒足冷，此因虚火上升所致，非真阳衰而然。故其小便必黄赤，其脉必带数，有内热的症之可据。设误用桂枝、附子引火归原之法，是抱薪救火，上焦愈热，而咳喘燥渴益甚，咽痛喉烂诸症至矣。二曰：理中温补之误。理中者，理中焦之虚寒也。虚寒腹痛，绵绵痛而无增减，喜热手按，热饮食，虚寒泄泻，水谷不化，而澄澈清冷，必有虚寒之症脉可凭，然后用之有效。今人一见胀满腹痛，食不消化，肠鸣泄泻等症，便认为虚寒，而投以白术之香燥，又济以干姜之辛热，甚者更加桂枝、附子；殊不知虚劳患在伤阴，再补其阳，则阳益亢，而阴益竭，诸热悉加，是促之死也。更有见其胀满泄泻，遂引经文清气在下，则生飧泄，浊气在上，则生痞胀，而用补中益气汤，以升清降浊，误施升麻、柴胡，反提阴火上逆，以致咳喘频增，吐衄交至，而危亡见矣。然使其温补得售者，亦病家不明有以致之耳。盖助阳之药，能使胃气一时暂壮，饮食增加，彼此夸功，固执不改，至死不悟，良为可悯。三曰：参、芪助火之误。夫虚劳之可受参、芪者，肺必无热者也，肺脉按之而虚必不数者也。故有土旺而金生，勿拘拘于保肺之说，古人每用之而奏功。而今则火已灼金而咳矣，火蒸津液而化为浓痰矣，君相亢甚，而血随之上逆矣，犹引无阳则阴无以生，虚火可补，参、芪之属，富贵之家，大剂投之。因之阳火愈旺，而金益受伤。所以好古有肺热还伤肺，节斋有服参必死之叮咛也。四曰：苦寒泻火之误。实火为病，可以苦寒直折之，然当热去即止，不可过用。虚火为病，阴之亏也，岂知、柏苦寒之剂可能清之！服之者，非惟不能清热，抑且有损其阴，徒败胃气，食少泻多，将何疗治。甚者，见其大便燥结，肆用硝、黄以通之。不知肾主二便，肾主五液，肾之津液既亏，自然不能濡润，滋其阴，润其燥，而便自通。彼既虚之阴，岂能胜硝黄之攻代乎？故士材之论，昧者徒从其温补，自明者观之，知其深戒苦寒之不可妄用也。五曰：二陈消痰之误。痰在脾经者，名曰湿痰。其痰滑而易出，或稀如饮水者，名曰痰饮。湿者燥之，半夏为正治之药。若阴水不足，阴火上升，肺受火侮，不得清肃下行，由是津液凝浊，不生血而生痰，此当以润剂滋其阴，使上逆之火，得返其宅而息焉，则痰自清矣，投以二陈，立见其殆。六曰：辛剂发散之误。世之真阴虚而发热者，十之六、七，亦与外感无异。火逆冲上，则头胀微痛；火升壅肺，则有时鼻塞∶阴虚阳陷入里，则洒淅恶寒；阴虚阳无所附，则浮越肌表发热。但其发时，必在午后，先洒淅恶寒，少顷发热，热至鸡鸣寅卯时分，盗汗出而身凉。或无微寒，而但午后发热，必现前列腺肾虚诸症。或兼唇红颧赤，口渴烦躁，六脉弦数，或虚数无力。此宜大剂补阴，如保阴、六味之属。若认为外感，而用风药以表散之，则魄汗淋漓，诸虚蜂起。或有失血之人，表之无汗，经所谓夺血者无汗也，再强发之，血必从耳目口鼻中出，为上厥下竭，难治之症。今人一见发热，便用表散，更以为邪尚未尽，禁其饮食，以致胃气馁惫，至于死亡，可不寒心。七曰：治疗过时之误。上古圣人不治已病而治未病。如劳神者，常养其心；劳倦者，常补其脾，多怒者，常滋其肝血；多饮者，常清其肺热；好色者，峻补其肾水。及病之方萌，即为补救。仲景曰：凡人有病，不时即治，隐忍冀瘥，必成锢疾。所以虚劳终罕得愈者，以内热之症，人多易忽，虚症渐见，犹不求治，自恃饮食起居如常，面颜如旧，仍纵恣酒色，且讳言虚劳，而医者又逢迎迁就，致病日深。迨至咳嗽痰红，吐血寒热，饮食少思，病已成而后药之，譬之渴而穿井，斗而铸兵，不亦晚乎！然而治之最难，有三大要法，不可不讲也，一曰，补肾水。经云：肾者主水，受五脏六腑之精而藏之。故五液皆归乎精，而五精皆统乎肾，肾有精室，是曰命门，精藏于此，气化于此，精即阴中之火也。故命门之水火，为十二脏之化源。心赖之，则君主以明；肺赖之，则治节以行；脾胃赖之，济仓廪之富；肝胆赖之，资谋虑之本；膀胱赖之，则三焦气化，大小肠赖之，则传导自分。故水火之功，缺一不可。然火衰者甚少，而水虚者恒多。王节斋云：少年肾水正旺，似不必补，然施泄过度，岂能充满。中年欲心虽减，然少年斫丧既多，焉得复实。既至老年，天真渐绝，只有孤阳。故人自少至老，所生疾病，靡不由于真阴不足。即童子禀赋弱者，从幼填补真阴，亦有可复之天。所以补阴之药，亦自少至老，不可或缺，况虚劳因入房太甚而得者乎？故保阴、六味、左归之属，皆甘寒滋水添精之品，补阴以配阳，正王太朴所谓壮水之主，以制阳光，丹溪所谓滋其阴则火自降，譬之灯残火焰，添油则焰光自小也。然须制大剂，长久服之。盖益阴之药，必无旦夕之效，以阴无速补之法也。至若因于酒者，清金润燥为主，而保阴之属，仍不可废。何则？好饮之人，仍有不患虚劳者，以肾水虚也。虚则必寡于畏，而复灼久伤之肺，焉得不病！补北方正所以泻南方而救肺也。因于思虑者，清心养血为主，而保阴之属，仍不可缺，所谓水壮而火熄，勿亟亟于泻心是也。因于劳倦者，培补脾阴为主，而佐以保阴之剂。经曰：有所远行劳倦，逢大热而渴，渴则阳气内伐，内伐则热舍于肾。故知劳倦伤脾，内热者必及于肾也。若忿怒伤肝动血，保阴、六味丸为正治之剂。盖水旺则龙水不炎，而雷火亦不能发，乃肾肝同治之法也。二曰，培脾土。脾胃为后天之根本，经曰，安谷则昌。盖精生于谷，饮食多，自能生血化精，精血渐生，虽有邪热，药得以制之消之，久则火自降而阴自复。若脾胃一弱，则饮食少而血不生，血不生则阴不足以配阳，而五脏齐损。故曰，又归重于脾胃。而言一损损于肺，皮聚而毛落∶二损损于心，血脉不能荣养脏腑；三损损于脾，饮食不为肌肤，四损损于肝，筋缓不能自收持，五损损于肾，骨痿不能起于床。从上而下者，过于胃则不治，至骨痿不能起于床者死；从下而上者，过于脾则不治，至皮聚而毛落者死。所以仲景治虚劳，惟用甘药，创建中气，以生血化精，充溢脏腑，为复虚劳诸症之良法。一遵精不足者，补之以味之旨也。味非独药也，五谷之味皆味也，补以味而节其劳，则积贮渐富，大命不倾。经云：阴阳形气俱不足者，调以甘药。盖药食之入，必先脾胃，而后五脏得禀其气。脾胃强，则五脏俱盛，脾胃弱，则五脏俱衰。故中气不足者，非甘不可。况土强则金旺，金旺则水充。又男子以脾胃为生身之本，女子以心脾为主命之根。故治虚劳者，毋论何脏致损，皆当以调养脾胃为主。三曰，慎调摄。虚劳之因，因于酒色者最多，其因于忧愁思虑，抑郁多怒者，复亦不少。所以童子、室女不生欢笑，及鳏、寡、僧、尼易犯此病者，谓非针药之可治，必须消遣情怀，随遇皆安，然后疗治，庶能愈病，乃今之患此症者，徒仗诸草木，奉为撤消之品，外则疲劳形体，内则沉湎七情，酒色不屏，辛热不戒，此乃自趋死径，间有知戒酒色，节劳逸，而于七情多所难释。不知心有妄动，气随心散，气散不聚，精逐气亡。故广成子曰：必静必清，无
1. A person suddenly developed toothache in the first lunar month, which healed after more than ten days. In the fourth lunar month, due to excessive mental anxiety and fatigue, the toothache flared up severely. The physician prescribed drugs such as Gypsum Fibrosum (Shigao) and Anemarrhenae Rhizoma (Zhimu), but with no effect. Using a knife to drain purple blood from between the teeth caused unbearable pain throughout the mouth, and all teeth became loose. By the sixth and seventh lunar months, food intake increased, urine became thick like paste, and muscles wasted away completely. By the eleventh lunar month, the body could not rise. At the end of winter, using Phellodendri Cortex (Huangbai) and Rehmanniae Radix (Dihuang) allowed him to stand slightly. However, appetite remained easily hungry as before, and urine remained thick like paste. In the second and third lunar months of the following year, the condition worsened further; he took no medicine, toothache persisted, two central incisors fell out, and thirst was added, unceasing day and night. This is a case of Middle Xiao (Middle Wasting-Thirst) and Lower Xiao (Lower Wasting-Thirst). Zhongchun used Sheng Dihuang (Liu qian), Maidong (Wu liang), Tiandong (Yi liang), Wuweizi (San qian), Lugen (Wu liang), Huanglian (San qian), and Huangbai (Wu qian), decocted in ten bowls of silk-boiling water until two bowls remained, taken at any time. After a few doses, he recovered. For pills, add Wuweizi (Liu liang), Gouqi (Si liang), Niuxi (Wu liang), Huangbai (San liang), and Shashen (Liu liang) to the above prescription, made into honey pills for regular use, so it did not recur.
2. A person developed Xiao Ke (Wasting-Thirst) after taking hot-natured drugs. He was insisted upon taking Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) for a thousand doses, and it was indeed effective. This aligns with the principle of "strengthening the master of Water to control the glare of Fire."
The disease of Xu Lao (Consumptive Disease) involves no external pathogens interfering; it is caused entirely by internal injury to the Zang-Fu organs. For instance, alcohol damages the Lung; damp-heat steaming and熏蒸 (fuming) consumes Lung Yin. Sexual activity damages the Kidney; emptiness of the essence chamber leads to unrestrained Ministerial Fire. Overthinking damages the Heart; spirit injury and blood consumption lead to easy flaming-up of Fire. Fatigue damages the Spleen; it generates heat most readily, and excessive heat internally attacks True Yin. Anger damages the Liver; constrained anger causes Liver Fire to blaze internally and scorch blood, while great anger causes Liver Fire to rush upward leading to hematemesis. These five conditions can all exhaust Essence and Blood. The Daoist Canon states: Nasal mucus, saliva, essence, fluids, sweat, blood, and body fluids—the seven spiritual substances—all belong to Yin. When Yin is deficient, internal heat arises, forming the syndrome of Xu Lao. Generally, those who develop Xu Lao due to alcohol and sex are numerous, yet there are also unmarried youths suffering from this, due to congenital insufficiency, particularly influenced by the mother's constitution. If the mother has Yin deficiency, her children will likely have many weak syndromes. Monks, nuns, widows, and unmarried women with delayed menstruation, whose desires are unfulfilled, suffer from Qi and Blood stagnation, leading to chills and fever resembling malaria, morning coolness and evening heat, loss of appetite, irregular menstruation, or amenorrhea, forming this syndrome frequently, mostly due to internal steaming of constrained Fire. Medical texts discuss Xu Lao, confusingly treating Qi deficiency, Blood deficiency, Yin deficiency, and Yang deficiency together, leaving learners without direction. One must know that those with Qi deficiency present with pale, lifeless complexion, faint speech, weakness in limbs, and a faint pulse; those with Yang deficiency present with cold body and aversion to cold, cold extremities, clear urine and loose stools, and a deep, small, slow pulse; warm tonification can be administered. Thus, those Xu Lao patients who can tolerate Renshen (Ginseng Root) and Huangqi (Astragali Radix) are those capable of receiving tonification, indicating Qi or Yang deficiency syndromes. Those who cannot tolerate Renshen and Huangqi are those incapable of receiving tonification, indicating Blood or Yin deficiency syndromes. Although there is a method of tonifying Qi for Blood loss, this refers to sudden massive hemorrhage in persons not previously Blood-deficient, such as postpartum cases, and does not apply to Blood deficiency caused by Fire dryness, where the cause of Fire drying Blood is the inability of Water (Yin) to restrain it. Hence, the Classic says: "One Water cannot overcome Five Fires." The Five Fires refer to the fires of the Five Emotions; One Water refers to the True Yin Water of the Kidney. Water is Essence. Observing the Classic: "At fourteen, girls' Tian Gui arrives; at sixteen, boys' Tian Gui arrives." Does this not show that Yin forms later and is difficult to achieve? It also says, "At forty, Yin Qi is halved." Does this not show that Yin declines earlier and is easily withered? What is called Yin is my Essence, which shapes my form. The period of peak vitality lasts only about twenty years, after which the form gradually declines. Therefore, Danxi cited the waxing and waning of the moon to argue that Yang is often in excess, while Yin is often insufficient. Wang Jiezhai believed that eight or nine out of ten diseases are due to Yin deficiency, while one or two out of a hundred are due to Yang deficiency. This is because few restrain desires, while many indulge them. People only know that indulging desires exhausts Essence, but who knows that daily loss of Yin Essence leads to tasteless food, turning fatigue into deficiency, and deficiency into fatigue, with pulses changing internally and complexion losing luster. When illness occurs: in the Kidney, it manifests as soreness and weakness of the lower back, spine, legs, and calves, or dull pain; bone-steaming internal heat with night sweats; fever at night; generalized bone soreness or pain as if broken; nocturnal emission during dreams or spontaneous slipping; tinnitus; hot soles. In the Heart, it manifests as palpitations and fright; dry heat in palms; empty vexation and insomnia or restless dreaming; bitter taste and dry tongue, or oral ulcers. In the Lung, it manifests as cough with much phlegm, or dry cough with little phlegm; chest fullness and rebellious Qi, or rapid panting; red cheeks like rouge; hot breath from nose; hemoptysis; epistaxis; even vomiting white foam; inability to lie on one side; sore throat and rotten gums; hoarseness. In the Liver, it manifests as chills and fever like malaria; scrofula on the neck; distension and pain in the hypochondrium; dry or painful eyes; dizziness; blurred vision; irritability; hematemesis. In the Spleen, it manifests as poor appetite; nausea and vomiting; distension and abdominal pain; indigestion; borborygmus and diarrhea; muscle wasting. These are the fundamental symptoms of the five Zang organs in Xu Lao. The Classic says: "In treating disease, one must seek the root." One must examine what caused the damage and which organ was injured. If caused by sex, the injury is in the Kidney; even if other meridians show symptoms, tonifying the Kidney should be the root, treating other meridian symptoms concurrently. If caused by alcohol, clearing the Lung should be prioritized. Once root and branch are examined, one must observe that disease transmission is infinite. For example, Kidney transmitting to Heart, Heart to Lung, Lung to Liver, Liver to Spleen, Spleen back to Kidney—this is transmitting to the organ it overcomes, insulting and attacking, called "Thief Restriction," a sign of great misfortune. The Classic says: "Diseases transmitted sequentially die." This means the five Zang organs transmit in sequence until all are overcome. The Nan Jing says: "Seven transmissions mean death." This means if disease starts in the Kidney and transmits to the Spleen and back to the Kidney, this is six transmissions, exhausting one organ, which cannot be injured again. If Kidney disease does not transmit to the Heart but to the Lung, skipping one organ, it transmits to the Mother that generated me; since Mother and Son Qi connect, Son disease affects Mother. If Kidney disease does not transmit to the Heart or Lung, but to the Liver, skipping two organs, it transmits to the Son I generated; Mother disease affects Son. If Kidney disease does not transmit to the Heart, Lung, or Liver, but to the Spleen, skipping three organs, it transmits to the organ I cannot overcome; this is what the Classic calls "light insult." If transmission and attack are unclear, how can one treat disease? In Xu Lao, those biased toward Yin deficiency are everywhere, yet physicians often fail to deeply understand Qi, Blood, Yin, and Yang, treating vaguely, leading to premature death, which is countless! Let us explain in detail; there are seven errors. First: Error of Guiding Fire Back to its Source. The Fire of Mingmen is called Dragon Fire, also True Yang. If it is weak, Yin abundance in the Kidney prevents Dragon Fire from settling, causing it to float upward, creating false heat in the Upper Jiao: red face, vexation, thirst, and even tongue coating symptoms. But although thirsty, there is no desire to drink; although there is coating, the tongue is slippery and soft; feet are cold past the knees; urine is clear and long; the Right Chi pulse is necessarily deep, small, and slow, or floating, large, and rootless. This is false heat caused by Yin abundance below forcing Yang upward. Like the generation of Yin at Summer Solstice, cold at the bottom of water and hot in the sky; Dragon is a Yang creature, so it rises with Yang. This is precisely when one should use formulas like Bawei Wan (Eight-Ingredient Pill); drinking cold, falsely cold medicines deceives it down the throat; once the cold nature is removed, the hot nature begins, and floating fire can be guided back to its source, like the return of Yang at Winter Solstice, warming the water underground, and the Dragon returns to the sea. However, in Xu Lao, the cause is extreme deficiency of Kidney Water and True Yin; Water fails to control Fire, and Fire flares upward. This causes red face and lips, bleeding from mouth and nose, toothache and gingival bleeding, various upper Jiao deficiency heat symptoms. Although this is also Dragon Fire flaming upward, it differs from floating False Yang. Even if there is aversion to cold and cold feet below, this is caused by deficiency Fire rising, not True Yang decline. Thus, urine must be yellow-red, pulse must be rapid, with evidence of internal heat. If mistakenly using Guizhi (Cinnamon Twig) and Fuzi (Aconite Root) to guide fire back to source, it is like adding firewood to save a fire; upper Jiao heat increases, cough, panting, dryness, and thirst worsen, and sore throat and rotten gums appear. Second: Error of Lizhong Warm Tonification. Lizhong regulates middle Jiao deficiency-cold. Deficiency-cold abdominal pain is continuous without increase or decrease, prefers hot hand pressure and hot drinks; deficiency-cold diarrhea involves undigested food, clear and cold. There must be deficiency-cold symptoms and pulse basis before using it effectively. Now, people see distension, abdominal pain, indigestion, borborygmus, and diarrhea, and immediately assume deficiency-cold, administering Xiangzao (fragrant-dry) Baizhu and Xinre (pungent-hot) Ganjiang, or even adding Guizhi and Fuzi; they do not know that Xu Lao suffers from Yin injury; tonifying Yang again makes Yang more hyperactive and Yin more exhausted, adding all heats, hastening death. Some see distension and diarrhea, cite the Classic "Clear Qi below generates sundew diarrhea, Turbid Qi above generates fullness," and use Buzhong Yiqi Tang to raise Clear and descend Turbid, mistakenly using Shengma and Chaihu, instead raising Ministerial Fire rebellion, causing frequent cough and panting, alternating hematemesis and epistaxis, leading to danger and death. Yet those whose warm tonification succeeds do so because the patient is ignorant, bringing it upon themselves. Yang-assisting drugs temporarily strengthen Stomach Qi and increase food intake; both sides claim merit, sticking stubbornly, not realizing until death, truly pitiable. Third: Error of Renshen and Huangqi assisting Fire. Those Xu Lao patients who can accept Renshen and Huangqi must have no Lung Heat, and their Lung pulse, though deficient, must not be rapid. Thus, when Earth is prosperous and generates Metal, one need not strictly adhere to protecting the Lung; ancients often used these with success. But now, Fire has scorched Metal causing cough, steamed fluids into thick phlegm, Ministerial and Sovereign Fire are extremely hyperactive, and Blood rebels upward; still citing "Without Yang, Yin cannot generate" and "Deficiency Fire can be tonified," wealthy families administer large doses of Renshen and Huangqi. Consequently, Yang Fire becomes stronger, and Metal is further injured. Hence, Haogu warned "Lung heat injures the Lung again," and Jiezhai cautioned "Taking Ginseng leads to death." Fourth: Error of Bitter-Cold Draining Fire. Real Fire disease can be directly subdued with bitter-cold, but stop when heat goes; do not overuse. Deficiency Fire disease is Yin deficiency; how can Zhimu and Huangbai, bitter-cold agents, clear it! Those taking them not only fail to clear heat but also damage Yin, vainly destroying Stomach Qi, leading to poor appetite and more diarrhea; how to treat then? Worse, seeing dry stool, they recklessly use Xiaoshi (Mirabilite) and Dahuang (Rhubarb) to purge. They do not know the Kidney governs the two openings and five fluids; since Kidney fluids are deficient, natural lubrication is lost; nourish Yin, moisten dryness, and stool will pass naturally. How can deficient Yin withstand the attack of Xiaoshi and Dahuang? Thus, Shicai's argument: the ignorant follow warm tonification, while the enlightened know to deeply warn against reckless use of bitter-cold. Fifth: Error of Erchen Phlegm Resolution. Phlegm in the Spleen Meridian is called Damp Phlegm. Slippery and easy to expectorate, or thin like water, is called Fluid Retention. Dampness requires drying; Banxia is the correct drug. If Yin Water is insufficient, Yin Fire rises, Lung suffers Fire insult, cannot descend clearly and turbidly, thus fluids condense turbidly, failing to generate Blood and generating Phlegm instead. This requires moistening agents to nourish Yin, allowing rebelling Fire to return home and rest, then Phlegm clears itself; administering Erchen leads to immediate danger. Sixth: Error of Pungent Dispersants. Six or seven out of ten cases of true Yin deficiency with fever are indistinguishable from external contraction. Fire rebellion rushing up causes head distension and slight pain; Fire rising obstructing Lung causes occasional nasal congestion; Yin deficiency with Yang sinking inward causes shivering aversion to cold; Yin deficiency with Yang having no attachment causes floating heat on the skin surface. But onset is always in the afternoon, first shivering aversion to cold, then fever shortly after; fever peaks at chicken-crow hour (3-7 AM), night sweats occur, and body cools. Or no slight cold, but only afternoon fever, necessarily presenting preceding Kidney deficiency symptoms. Or accompanied by red lips and cheekbones, thirst and vexation, string-taut and rapid pulse, or deficient and rapid/weak pulse. This requires large doses of Yin tonification, such as Baoyin or Liuwei. If mistaken for external contraction and treated with wind drugs to disperse, profuse sweating ensues, and all deficiencies arise. For those with blood loss, dispersing yields no sweat; the Classic says "Those who lose blood should not sweat"; forcing it further causes blood to flow from ears, eyes, mouth, and nose, leading to upper rebellion and lower exhaustion, a difficult-to-treat syndrome. Now, people see fever and immediately use dispersants, further believing pathogen remains, restricting diet, leading to Stomach Qi exhaustion and death; is this not chilling? Seventh: Error of Delayed Treatment. Ancient sages treated disease before it arose. For those exhausting spirit, constantly nourish Heart; for those fatigued, constantly tonify Spleen; for those angry, constantly nourish Liver Blood; for those drinking much, constantly clear Lung Heat; for those lustful, vigorously tonify Kidney Water. When disease just sprouts, remedy it. Zhang Zhongjing said: "When people have disease, treat it promptly; enduring hoping for recovery creates entrenched disease." Thus, Xu Lao rarely heals because internal heat is easily ignored; as deficiency symptoms gradually appear, treatment is still sought; relying on normal diet and sleep, unchanged complexion, one continues indulging in alcohol and sex, and hides the term Xu Lao, while physicians accommodate, letting disease deepen. Until cough, bloody phlegm, hematemesis, chills and fever, poor appetite occur, and disease is formed before medicating, it is like digging a well when thirsty or forging weapons when fighting, is it not too late! However, treating it is hardest, requiring three major essential methods. First: Tonify Kidney Water. The Classic says: "The Kidney governs Water, receiving and storing Essence of the five Zang and six Fu organs." Thus, five fluids return to Essence, and five Essences are governed by the Kidney. The Kidney has an Essence Chamber, called Mingmen; Essence is stored here, Qi transforms here; Essence is Fire within Yin. Thus, Water and Fire of Mingmen are the transformation sources of the twelve organs. Heart relies on it to clarify the Sovereign; Lung relies on it to execute regulation; Spleen and Stomach rely on it for granary richness; Liver and Gallbladder rely on it for strategic foundation; Bladder relies on it for Sanjiao Qi transformation; Large and Small Intestines rely on it for separate transmission. Thus, Water and Fire functions are indispensable. Yet Fire decline is rare, while Water deficiency is constant. Wang Jiezhai said: "In youth, Kidney Water is vigorous, seemingly no need to tonify, but excessive release cannot maintain fullness. In middle age, desire decreases, but since youth was squandered much, how can it recover? In old age, innate truth gradually ends, leaving only solitary Yang." Thus, from youth to old age, diseases arise from True Yin insufficiency. Even youths with weak constitution can recover by tonifying True Yin from childhood. Therefore, Yin-tonifying drugs are indispensable from youth to old age, especially for Xu Lao caused by excessive intercourse. Thus, Baoyin, Liuwei, Zuogui belong to sweet-cold agents that nourish Water and add Essence; tonifying Yin to match Yang, exactly as Wang Taipu said "Strengthen the master of Water to control the glare of Fire," and Danxi said "Nourish Yin then Fire descends naturally," like adding oil to a dying lamp flame, making light smaller. Must prepare large doses and take long-term. Indeed, Yin-benefiting drugs have no overnight effect, as there is no quick way to tonify Yin. For those caused by alcohol, clearing Metal and moistening dryness is primary, but Baoyin agents cannot be abandoned. Why? Drinkers who do not get Xu Lao do so because Kidney Water is deficient. Deficiency leads to lack of fear, re-scorching the long-injured Lung; how can one not get sick! Tonifying North (Water) is precisely to drain South (Fire) and save the Lung. For those caused by overthinking, clearing Heart and nourishing Blood is primary, but Baoyin agents remain indispensable, meaning "When Water is strong, Fire extinguishes; do not rush to drain Heart." For those caused by fatigue, cultivating Spleen Yin is primary, assisted by Baoyin agents. The Classic says: "Traveling far and being fatigued, encountering great heat and thirst; thirst causes Yang Qi to attack internally; internal attack causes heat to lodge in Kidney." Thus, knowing fatigue damages Spleen, internal heat inevitably reaches Kidney. If anger damages Liver and moves Blood, Baoyin and Liuwei Wan are correct treatments. Because when Water is vigorous, Dragon Water does not flare, and Thunder Fire cannot erupt; this is simultaneous treatment of Kidney and Liver. Second: Cultivate Spleen Earth. Spleen and Stomach are the root of acquired constitution. The Classic says: "Abundant grain leads to prosperity." Essence is born from grain; abundant diet naturally generates Blood and transforms Essence; as Blood and Essence gradually grow, even if evil heat exists, drugs can control and eliminate it; over time, Fire descends and Yin recovers. If Spleen and Stomach weaken, diet decreases and Blood is not generated; if Blood is not generated, Yin is insufficient to match Yang, and five Zang organs are damaged together. Thus, emphasis returns to Spleen and Stomach. It says: First damage is Lung, skin gathers and hair falls; second damage is Heart, blood vessels cannot nourish organs; third damage is Spleen, food does not become flesh; fourth damage is Liver, tendons relax and cannot hold; fifth damage is Kidney, bones wither and cannot rise from bed. From top to bottom, exceeding Stomach means untreatable; reaching bone withering and inability to rise means death. From bottom to top, exceeding Spleen means untreatable; reaching skin gathering and hair falling means death. Thus, Zhongjing treats Xu Lao only with sweet drugs, establishing Middle Qi to generate Blood and transform Essence, filling organs, a good method for recovering from Xu Lao. Following the principle: "For insufficiency of Essence, tonify with flavor." Flavor is not just drugs; flavors of five grains are also flavors. Tonifying with flavor and regulating labor leads to gradual accumulation and preservation of life. The Classic says: "When Yin, Yang, Form, and Qi are all insufficient, regulate with sweet drugs." Since drugs and food enter, they must pass through Spleen and Stomach first, then five Zang receive their Qi. Strong Spleen and Stomach mean flourishing five Zang; weak Spleen and Stomach mean declining five Zang. Thus, Middle Qi insufficiency requires sweetness. Moreover, strong Earth makes Metal prosperous; prosperous Metal fills Water. Men regard Spleen and Stomach as the root of life; women regard Heart and Spleen as the root of destiny. Thus, treating Xu Lao, regardless of which organ is damaged, one must prioritize regulating Spleen and Stomach. Third: Carefully regulate lifestyle. The cause of Xu Lao is mostly alcohol and sex; causes from sorrow, overthinking, depression, and anger are also not few. Thus, youths and unmarried women lacking laughter, and widowers, widows, monks, and nuns easily contracting this disease—if not treatable by needles and drugs, one must relieve emotions, find peace in every situation, then treat, so that disease may heal. Now, sufferers rely solely on herbs, regarding them as remedies, externally exhausting the body, internally indulging in Seven Emotions, not abstaining from alcohol and sex, not avoiding pungent-hot foods; this is walking the path to death oneself. Occasionally, some know to戒 (abstain) from alcohol and sex, regulate labor and rest, but find it hard to release Seven Emotions. Not knowing that when Heart moves妄 (wildly), Qi scatters with Heart; scattered Qi does not gather, Essence flees with Qi. Thus, Guangchengzi said: "Must be quiet and clear, no..."