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(Liang essays, thirty-one rules and methods, ten prohibitions)

Yu Chang said: The syndrome of Xu Lao (Consumptive Disease), as narrated in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) following Xue Bi (Blood Bi Syndrome), shows that overwork inevitably damages Jing (Essence) and Xue (Blood). When Ying Blood (Nutritive Blood) is injured, internal heat arises; the five centers (both palms, both soles, and the chest) are often hot; one sees flashes or fire in the eyes; there is a buzzing sound like frogs and cicadas in the ears; the mouth and tongue are ulcerated; the flavors of the five tastes are not perceived; the nostrils are dry; respiration is difficult; even food cannot transform into muscle and flesh; the body is lethargic and lazy, prone to sleep; bones are soft, and feet are fatigued. Ying Qi (Nutritive Qi) moves slowly day by day, while Wei Qi (Defensive Qi) moves rapidly day by day. Ying Blood is forced by Wei Qi, unable to remain within, and escapes outward, resulting in hematemesis (vomiting blood), epistaxis (nosebleed), or bleeding from the anterior and posterior orifices. Once blood loss is significant, pathogenic fire bursts in, forcing and simmering without cessation. Ying Blood will be exhausted immediately; why wait for death! Furthermore, when overwork reaches its extreme, causing Xue Bi (Blood Bi Syndrome), blood does not escape outward but accumulates internally. After accumulating for a long time, all the tunnels through which blood flows in the entire body become bi-zu (blocked and stagnant), tending toward dryness. The skin lacks moisture, and the face loses luster. Thus, where Qi passes, blood does not move, merely steaming the blood into heat. This may occur at dusk (Shen and You hours) or at midnight and noon (Zi and Wu hours). Initially, it is dry heat; only after vapor dissipates with slight sweating does the heat resolve. If steaming continues unceasingly, Zhai Bing (Tuberculous Disease) forms; why wait for death! There are also cases starting with blood loss, later leading to Xue Bi. Due to blood deficiency and scarcity, circulation is difficult; fever causes bi-zu, which is very easy to happen. The *Nei Jing* (Inner Canon) generally states that Xu diseases do not involve overwork. However, if large muscles are withered, large bones are sunken, Qi rises high in the chest, and each of the Five Zang Organs shows critical signs, this has indeed been discussed. There is no case of extreme overwork without the appearance of Zhen Zang Mai (True Organ Pulse). Yet, if withering is extreme, even if Zhen Zang Mai does not appear, can one expect survival? Qin Yue Ren (Bian Que) first proposed the theory of Xu Sun (Deficiency Damage), stating that deficiency with cold invasion damages Yang; Yang deficiency leads to Yin excess, and damage proceeds from top to bottom. First damage affects the Lung, causing skin contraction and hair loss; second damage affects the Heart, preventing blood vessels from nourishing the Zang-Fu organs; third damage affects the Stomach, preventing food from forming flesh. Deficiency with heat invasion damages Yin; Yin deficiency leads to Yang excess, and damage proceeds from bottom to top. First damage affects the Kidney, causing bone flaccidity inability to rise from bed; second damage affects the Liver, causing tendon laxity inability to hold oneself; third damage affects the Spleen, preventing food digestion. Damage proceeding from top to bottom becomes incurable once it exceeds the Stomach. Damage proceeding from bottom to top becomes incurable once it exceeds the Spleen. Generally, abundant diet naturally generates blood; scant diet fails to generate blood. Without blood generation, Yin cannot balance Yang, inevitably leading to damage of all Five Zang Organs. Yue Ren emphasized the Spleen and Stomach; his words were profound. Regarding Zhong Jing’s text in *Jin Gui*, I carefully grasped its main idea: Essence is generated from grain. If grain intake is low and blood is not generated, blood cannot transform essence. The *Nei Jing* states that for insufficiency of essence, one must supplement with flavor. Flavor refers to the taste of the five grains. Supplementing with flavor and regulating overwork allows accumulation to gradually enrich, and life will not collapse. If what enters is small like a chicken’s beak, and what exits is large like a cow’s anus, how could it not become Xu Lao? Therefore, the ten admonitions all speak of healthy men with dual deficiency of Jing and Xue, making the signs of Xu Lao clear as pointing to the palm. Healthy men know only to indulge in desire and overwork essence, but who knows that Yin Essence is daily damaged, food loses flavor, turning overwork into deficiency and deficiency into overwork? The pulse changes internally, color lacks external brilliance, fluids decline causing thirst and scanty urination. Severely, eyes dim and nosebleeds occur; Yin Essence fails to interact and leaks spontaneously; night sweats drench the body; the body trembles; heart and gallbladder are fearful—such cases are common. Thus, if blood fails to transform essence, Xue Bi occurs. With Xue Bi, new blood is not born, and existing blood also stagnates and fails to flow. Blood stasis leads to Ying deficiency; Ying deficiency leads to fever; prolonged fever steams the stagnant blood, transforming it into worms, thus forming Chuan Shi Zhai Zheng (Infectious Tuberculosis). Extremely vicious, it exhausts human Shen Qi (Spiritual Energy) to nourish the worm’s Shen Qi. When the person dies, the worm also dies. Those wandering souls that do not die transmit to a close relative, attaching to blood tunnels, seeming present yet absent. Later, worms grow prosperous, humans wither. After three transmissions, the worm’s spirituality cannot be controlled by talismans or medicines. Yi He diagnosed Duke Ping of Jin’s illness, saying: “This is due to proximity to women, generating internal heat and confusion in darkness. It is neither ghost nor food, and is incurable.” ‘Huo’ refers to sores on the lower lip, worms eating the anus, named Huo Gu. The character Gu implies three worms carried in one vessel, neither ghost nor food, clearly pointing to worms as the cause, not hiding it for the honorable. Therefore, Hu Huo syndrome features hoarseness, and Zhai Lao syndrome also features hoarseness. Thus, hoarseness clearly indicates tracheal erosion by worms. The lessons of men before us number thousands and millions in ancient and modern times. *Chao Shi Bing Yuan* (Source of Diseases by Master Chao) failed to investigate, claiming there is Xu Lao, Zheng Bing (Steaming Disease), Zhu Bing (Transmitting Disease); Lao has Wu Lao Liu Ji Qi Shang (Five Overworks, Six Extremes, Seven Injuries); Zheng has Wu Zheng Er Shi Si Zheng (Five Steams, Twenty-Four Steams); Zhu has Thirty-Six Types and Ninety-Nine Types, each classified separately for treatment. Later generations, confused by many divergent paths, did not know where to turn, and tabooed the name, calling it Tan Huo (Phlegm-Fire). Ignorant people then claimed Phlegm-Fire has Xu and Shi aspects. Consequently, bookshelves full of prescriptions recklessly stated: for Lung Xu use this herb, for Lung Shi use that herb, and for Heart, Liver, Spleen, Kidney, all provided two treatments for Xu and Shi. This added Shi Sun and Shi Lao to Xu Sun and Xu Lao; how baseless and vulgar! Zhong Jing earnestly warned healthy men, emphasizing that the way of Ying and Wei treasures grain intake. Usually regulating Ying and Wei to settle grain is the root of longevity; accumulating essence makes one naturally strong. Usually restraining desires generates essence. When disease just begins, and pulse shows only hints, relying solely on Jian Zhong Tang (Middle-Building Decoction) and Fu Mai Tang (Pulse-Recovering Decoction) as main treatments. Both Jian Zhong and Fu Mai are excellent herbs of “Jia Se Zuo Gan” (Earth’s nature is sweet), strictly following the principle of supplementing essence with flavor. How can one say that when a spring is exhausted, one should not seek to replenish it from within? Later generations’ kidney-tonifying formulas, taking myriad paths to treat Xu Lao, why are they rarely successful? Is this not copying the gourd, merely providing material for gossip? When Xue Bi sets in, Zhong Jing urgently expels the old and generates the new, acting almost between the formation and non-formation of Lao Zhai. This is truly a unique sage method, only unusable by those clinging to convention. Observe children: their Zang-Fu are fragile. Even slight cold-heat stagnation easily forms masses and malnutrition. Wait until Xue Bi occurs, Qi evaporates causing fever, and it is incurable. Women with dried blood and amenorrhea, continuous fever, have more signs of Lao Zhai. Wait until the condition forms, and even with good methods, treatment is too late. If one could heed Zhong Jing’s foresight, exert effort on men, children, and women at the threshold of Zhai Bing formation, the merit of saving lives would be raising the dead back to life, favored by Heaven.