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According to the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet): "Five labors" (Wu Lao, referring to injuries caused by prolonged visual strain damaging blood, prolonged lying down damaging Qi, prolonged sitting damaging flesh, prolonged standing damaging bones, and prolonged walking damaging sinews) lead to extreme deficiency and emaciation. The classic text states: "The injuries caused by the five labors..." Emaciation is severe, with large muscles about to atrophy. Abdominal fullness is due to the Spleen's failure in transportation and transformation. Inability to eat is due to the Stomach's loss of reception and containment. Injuries from improper diet, excessive drinking, excessive worry, sexual exhaustion, hunger, and physical overwork damage the meridians, Ying-Qi, Wei-Qi, and Qi-Blood. Although the origins of disease differ, they can all gradually progress to an extreme state. There is dry blood inside the body. Various injuries to the Zang-Fu organs prevent True Qi from governing the circulation of blood throughout the body; Ying-Blood becomes bi-stagnant and fails to circulate in the meridians, resulting in accumulated stasis that does not disperse, forming dry blood internally. The skin is rough like fish scales (jia cuo), and the area around both eyes is dark. The Liver stores blood and opens into the eyes; the qi of dry blood invades the Liver internally and steams upward to the eyes, causing darkness. This pill treats this condition by "soothing the center and tonifying deficiency." Once the blood stasis is removed, appetite naturally returns, and Qi-Blood recovers, hence it is called "soothing the center and tonifying deficiency."

Da Huang (Rhizoma Rhei Palmati, steamed with wine, 3 liang), E Chong (Whole Ground Beetle, 3 liang), Shui Zhi (Leech, stir-fried until crisp), Meng Chong (Male Blowfly, feet and wings removed, stir-fried), Qi Qiao (Larva of Cockchafer, roasted until scorched), Gan Xi (Resina Semecarpis Anacardii, [Note: Text implies description here]), Huang Qin (Radix Scutellariae Baicalensis, clears heat because long-standing stasis generates heat; stir-fried with wine, 1 liang), Xing Ren (Seed of Apricot, promotes Qi movement because Qi stagnation impedes flow; skin and tips removed, 3 liang), Sheng Di Huang (Radix Rehmanniae Preparata, 4 liang), Shao Yao (Radix Paeoniae Alba, nourishes and collects Yin-Blood; stir-fried with wine, 2 liang), Gan Cao (Radix Glycyrrhizae Uralensis, harmonizes the various herbs, 1 liang).

Grind the above thirteen ingredients into powder, make pills using honey, sized like small beans. Take 5 pills each time, delivered with wine, three times daily.

This formula breaks blood and moves stasis; it is an excellent treatment for what is commonly known as "Dry Blood Labor" (Gan Xue Lao). The internal accumulation of dry blood stasis has persisted for a long time and is firmly entrenched, difficult to eradicate. New blood cannot circulate throughout the body. Therefore, harsh medicines are used for slow results, gradually eliminating the stasis successively. Once the stasis is removed, the consumptive disorder may recover; this is a prescription for survival from death. Jiayan (Yu Chang) stated: In cases of extreme labor injury, blood stagnates and fails to move, eventually becoming dry. The skin may appear fresh and smooth, and the face lacks luster. Wherever Qi passes, blood no longer moves, merely steaming the blood to generate heat. This may occur in the afternoon (Shi hour) or at Zi/Wu hours. Initially, there is dry steaming fever; after the steaming dissipates, slight sweating resolves the heat. If the steaming heat continues incessantly, how can one avoid death? Furthermore, prolonged heat steaming can transform the stagnant blood into parasites, leading to "Chuan Shi Zhai" (Infectious Consumption Disease/Tuberculosis). He also said: Children have fragile and tender Zang-Fu organs. When cold-heat and stagnation first appear, it is easy to form masses and become pediatric malnutrition (Gan syndrome). By the time blood bi-stagnation occurs and Qi evaporation causes fever, similar to women with dried blood and amenorrhea with continuous fever, these are signs of labor consumption. Once the condition develops, even with good methods, treatment will be too late. If one could heed Zhongjing's foresight, for children and adults with consumption diseases in the pre-manifest stage, where Stomach Qi can still withstand medication, one should urgently guide the blood, administering it together with Ren Shen (Radix Ginseng) to promote its movement. For example, add Tao Ren (Semen Persicae) paste and Da Huang powder to Qiong Yu Gao (Jade Essence Paste), or use this pill, delivering it with the nourishing Qiong Yu Gao. Moving stasis and reducing fever, preserving life, is of great importance; however, ordinary people are unable to do so. My commentary: This formula is an attacking agent, designed specifically for dry blood, not a common formula for general consumption disorders. If the diagnosis is not clear and it is mistakenly administered, it will instead accelerate death.