劳病有似虚损，然虚损起于脾，劳病起于肾。虚损蒸蒸发热，自汗，其热按皮肤间即甚
热，不能饮食而肥，脉豁大，重按无力不清；劳病骨蒸，按皮肤不热，按至筋骨乃热，食多而瘦
，脉紧数。虚损潮热多起于内伤，宜补中益气汤、十全大补汤、四君子汤、八珍汤、参苓白
术散、理中汤之类，丸药亦以此等方调理，大忌补阴药，故虚损而转泄泻，脉短数者不治矣
；劳病阴虚火动，多起于伤风，有似疟状，宜六味汤、八珍汤加黄柏、知母，痰嗽加麦冬、
天冬、贝母、紫菀，随证加减，切忌香燥药，故劳病阴虚火动而转喉痛，脉细数者不治矣。
见证各异，治法迥别。
劳病定无泄泻、多汗之证，必身热、便燥、口干，四物汤加黄柏、知母，以退骨蒸劳热
。阴虚火动，然亦不得已用之，如久服，多患泄泻、喘促而亡。
阴虚火动，生地、丹皮、便制黄柏、杞子、五味子、牛膝、白茯苓，可煎可丸。
劳证退热，青蒿十斤，取自然汁，熬一分，加猪胆汁七分，熬膏，入甘草末为丸，米饮
虚劳欲火，梨汁一斤，胡桃肉一斤，研，牙茶五两，生地六钱，当归末六钱，熬至滴水
成珠，入鸡子清一枚，盛瓷器内，封口勿令出气，冷水浸去火毒，每日清晨服一匙。
劳证脏腑虚损，身体消瘦潮热，建中汤大能生气血、退虚热。
前胡 细辛 当归 白芍 人参 橘红 桂心 麦冬 黄 白茯苓 炙甘草（各一钱）
半夏（七分） 生姜（三片） 大枣（二枚） 不拘时服。
地仙散 治骨蒸肌热，虚劳烦躁。
地骨皮 防风（各一两） 薄荷（一钱五分） 甘草（二钱五分）
为细末，食前生姜、竹叶汤，服三钱。
参 散 治咳嗽吐痰，声哑，潮热盗汗。
人参 柴胡 五味子 杏仁 防风 羌活 款冬花 桑皮（各五分） 白茯苓 黄 紫
菀归身 川芎 半夏 贝母 枳壳 秦艽 桔梗 甘草（各八分） 鳖甲（三钱） 生姜 大枣
水煎服
阿胶丸 治劳证，咳血吐血。
阿胶 生地黄 白茯苓 侧柏 山药 苏叶（各一两） 柏子仁 麦冬 人参 防风（各
蜜丸弹子大，每服一丸，食后细嚼，煎苏梗汤下。
清骨散 治男女五心烦热，欲成劳证。
柴胡 生地黄 熟地黄 人参 赤茯苓 防风 秦艽 薄荷 胡黄连 水煎。
麦冬汤 治心中烦热，惟欲露体，以衣被覆之即闷，惊悸心怯，面无颜色，忘前
失后，妇人患血风气者多成此证，乃是心蒸之状。
青蒿（一小握） 葱白（一寸长，七根） 蓝叶（七片） 苦楝根（七寸）
童便一升半煎取一半，去渣，入安息香、苏合香、阿胶各一钱，朱砂、雄黄、雷丸、枯
矾、硫黄各五分，槟榔末一钱五分，麝香五分。五更初空心进一服，五更五点进一服。午时
前后取出，净桶盛，急入油铫内煮，仍倾盖虫罐内，扎口埋之深山。
五枝散 取传尸劳虫。
桃枝 李枝 梅枝 桑枝 榴枝（各三寸长，七茎取末） 通草 穿山甲 全蝎（炒各一
两） 沉香（八钱五分） 木香 槟榔 灯草（各五钱） 红花（二钱五分）
甘草煎胶为丸，每服三四十丸，空心温酒下。
加减黄 建中汤 治男、妇五劳七伤，骨蒸。
黄 （一两二钱） 秦艽 防风 北柴胡 归身 白芍药 熟地黄 地骨皮 肉豆蔻（煨）
炙甘草 砂仁 槟榔（各五钱） 猪苓（四钱） 桔梗 白茯苓 白术（各三钱） 人参（一钱
为粗末，每服三钱，水一盅，煎七分，不拘时服。老人，黄 加重一两。
再仙丹 治劳证，黄瘦虚损，诸药不效者。
大小茴香（盐水炒，各二两） 麦冬 茯神 地骨皮 防风（各二两） 远志 人参 龙齿
羚羊角 炙甘草 石膏（各三两） 紫石英（一两）
咀片，每三钱，枣一枚，水一盅半，煎七分，食前温服，未差再服，以差为度。甚益心
力，曾经吐血，服之有效。
桑椹膏 治骨蒸。
桑椹不拘多少，取汁入苍术内共熬，去苍术渣成膏。如肾气虚加枸杞子四两研末，肺虚加人参末一两。
验案
一人无大病，但举体不通泰，六脉弦滞。曰∶此从心之郁热不通，又兼力劳、色劳故也。心
郁则神失，力劳则气伤，色劳则精害；神失则火去，气伤则多滞，清害则水衰。若不能多药
，先以橘红、麦冬服几日，再加五味子服之。再将大体常思则心不郁，将小力运动则气滞通
，远色凝神则精自足，如此不但却病，且可长生。
一人病劳半年，虚而欲脱，此证参不可无，亦不可骤用。盖虚极而力不能胜也，只好用
五味
剂，不得顿服，须徐徐呷下，俟神气稍安始可加参。
Lao disease (disease caused by overexertion) symptoms resemble Xu Sun (deficiency and depletion), yet Xu Sun originates from the Spleen, while Lao disease originates from the Kidney. Xu Sun presents with steaming bone fever (fever feeling like steam rising from within), spontaneous sweating, heat felt intensely upon pressing the skin surface, inability to eat but with obesity, a large and hollow pulse that is weak and indistinct upon deep pressure; Lao disease presents with bone-steaming (heat emanating from the bones), no heat upon pressing the skin but heat upon pressing to the sinews and bones, increased appetite but emaciation, and a tight and rapid pulse. Tidal fever (fever occurring at specific times) caused by Xu Sun mostly stems from internal injury, suitable for treating with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction), Si Jun Zi Tang (Four Gentlemen Decoction), Ba Zhen Tang (Eight Treasures Decoction), Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Li Zhong Tang (Regulate the Middle Decoction), etc., and pills should also be regulated using these formulas. It is strictly forbidden to use Yin-nourishing herbs; therefore, if Xu Sun transforms into diarrhea with a short and rapid pulse, it is incurable. Yin deficiency with fire hyperactivity in Lao disease mostly stems from wind-cold invasion, resembling malaria, suitable for Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) or Ba Zhen Tang added with Huang Bo (Phellodendron Bark) and Zhi Mu (Anemarrhena Rhizome); if there is phlegm-cough, add Mai Dong (Ophiopogon Tuber), Tian Dong (Asparagus Tuber), Bei Mu (Fritillaria Bulb), and Zi Wan (Aster Root), adjusting according to symptoms. Fragrant and drying herbs must be avoided; therefore, if Yin deficiency with fire hyperactivity in Lao disease transforms into sore throat with a fine and rapid pulse, it is incurable. The manifestations vary, and the treatment methods are completely different.
Lao disease definitely does not present with diarrhea and excessive sweating; it must present with body heat, dry stool, and dry mouth. Si Wu Tang (Four Substances Decoction) added with Huang Bo and Zhi Mu can be used to dissipate bone-steaming lao heat. Although Yin deficiency with fire hyperactivity exists, these herbs are only used as a last resort; long-term use often leads to diarrhea, panting, and death.
For Yin deficiency with fire hyperactivity, Sheng Di (Rehmannia Root), Dan Pi (Moutan Cortex), Bian Zhi Huang Bo (Phellodendron Bark processed with urine), Qi Zi (Goji Berry), Wu Wei Zi (Schisandra Fruit), Niu Xi (Achyranthes Root), and Bai Fu Ling (Poria) can be decocted or made into pills.
To reduce fever in Lao syndrome, take ten jin of Qing Hao (Artemisia Annua), extract natural juice, concentrate to one part, add seven parts pig bile, boil into an ointment, add Gan Cao (Licorice Root) powder, and make into pills.
For xu lao yu huo (deficiency-lao desire-fire), take one jin of Li Zhi (Pear Juice), one jin of Hu Tao Rou (Walnut Meat), grind them, add five liang of Ya Cha (Tea Leaves), six qian of Sheng Di, and six qian of Dang Gui Mo (Angelica Sinensis Powder), boil until dripping water forms pearls, add one egg white, store in a porcelain vessel, seal tightly to prevent gas escape, soak in cold water to remove fire toxicity, and take one spoonful early every morning.
When Lao syndrome causes visceral deficiency and emaciation with tidal fever, Jian Zhong Tang (Regulate the Middle Decoction) greatly generates Qi and Blood and dissipates deficiency heat.
Qian Hu (Peucedani Radix), Xi Xin (Asari Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Ren Shen (Ginseng Radix et Rhizoma), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Gui Xin (Cinnamomi Ramulus), Mai Dong (Ophiopogonis Tuber), Huang Qi (Astragali Radix), Bai Fu Ling (Poria), Zhi Gan Cao (Prepared Licorice Root) (each 1 qian); Ban Xia (Pinelliae Rhizoma) (0.7 qian); Sheng Jiang (Zingiberis Rhizoma Recens) (3 slices); Da Zao (Jujubae Fructus) (2 pieces). Take at any time.
Di Xian San: Treats bone-steaming muscle heat, deficiency-lao irritability.
Di Gu Pi (Lycii Cortex), Fang Feng (Saposhnikoviae Radix) (each 1 liang); Bo He (Menthae Haplocalycis Herba) (1.5 qian); Gan Cao (Licorice Root) (2.5 qian).
Grind into fine powder, take 3 qian before meals with ginger and bamboo leaf decoction.
Shen San: Treats cough with expectoration, hoarseness, tidal fever, and night sweats.
Ren Shen (Ginseng Radix et Rhizoma), Chai Hu (Bupleuri Radix), Wu Wei Zi (Schisandrae Chinensis Fructus), Xing Ren (Armeniacae Semen Amarum), Fang Feng (Saposhnikoviae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Kuan Dong Hua (Farfarae Flos), Sang Bai Pi (Mori Cortex) (each 0.5 qian); Bai Fu Ling (Poria), Huang Qi (Astragali Radix), Zi Wan (Asteris Radix), Gui Shen (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Ban Xia (Pinelliae Rhizoma), Bei Mu (Fritillariae Bulbus), Zhi Ke (Aurantii Fructus Immaturus), Qin Jiao (Gentianae Macrophyllae Radix), Jie Geng (Platycodonis Radix), Gan Cao (Licorice Root) (each 0.8 qian); Bie Jia (Trionycis Carapax) (3 qian); Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus).
Decoct in water and take.
E Jiao Wan: Treats Lao syndrome, hemoptysis, and hematemesis.
E Jiao (Colla Corii Asini), Sheng Di Huang (Rehmanniae Radix), Bai Fu Ling (Poria), Ce Bai Ye (Biota Top Leaf), Shan Yao (Dioscoreae Rhizoma), Su Ye (Perillae Folium) (each 1 liang); Bai Zi Ren (Biota Seed), Mai Dong (Ophiopogonis Tuber), Ren Shen (Ginseng Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix) (each 1 liang).
Make honey pills the size of bullet seeds, take one pill per dose after meals, chew thoroughly, and swallow with Perilla Stem decoction.
Qing Gu San: Treats five-palm heat (heat in palms, soles, and chest) in men and women, impending Lao syndrome.
Chai Hu (Bupleuri Radix), Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Prepared Rehmanniae Radix), Ren Shen (Ginseng Radix et Rhizoma), Chi Fu Ling (Poria with Red Host), Fang Feng (Saposhnikoviae Radix), Qin Jiao (Gentianae Macrophyllae Radix), Bo He (Menthae Haplocalycis Herba), Hu Huang Lian (Coptidis Rhizoma - *Note: Text says Hu Huang Lian, likely referring to Coptis or similar bitter cold herb, WHO term usually Coptidis Rhizoma or Scutellariae Radix depending on context, here literal translation*).
Decoct in water and take.
Mai Dong Tang: Treats heart vexation and heat, desire to expose the body, stuffiness when covered with clothes, palpitations, timidity, pale complexion, forgetfulness. Women suffering from blood-wind qi often develop this syndrome, which is a sign of Heart Steaming.
Qing Hao (Artemisiae Annuae Herba) (a small handful), Cong Bai (Allii Fistulosi Bulbus) (1 cun long, 7 stalks), Lan Ye (Isatidis Folium) (7 leaves), Ku Lian Gen (Meliae Cortex Radicis) (7 cun).
Decoct one and a half sheng of Tong Bian (Child's Urine) until half remains, strain, add An Xi Xiang (Benzoin Resin), Su He Xiang (Styrax), E Jiao (Colla Corii Asini) (each 1 qian), Zhu Sha (Cinnabar), Xiong Huang (Realgar), Lei Wan (Polyporus Umbellatus - *Note: Lei Wan usually refers to Polyporus or a specific parasite drug, context suggests antiparasitic*), Ku Fan (Alumen), Liu Huang (Sulfur) (each 0.5 qian), Bing Lang Mo (Arecae Semen Preparatum Powder) (1.5 qian), She Xiang (Moschus) (0.5 qian). Take one dose on an empty stomach at the beginning of the fifth watch (early morning), and another dose at the fifth point of the fifth watch. Retrieve residues around noon, place in a clean bucket, boil quickly in an oil wok, pour back into a jar for covering parasites, seal, and bury in a deep mountain. (*Note: This section describes archaic/ritualistic practices.*)
Wu Zhi San: Extracts Chuan Shi Lao Chong (parasites causing infectious Lao).
Tao Zhi (Peach Twig), Li Zhi (Plum Twig), Mei Zhi (Apricot Twig), Sang Zhi (Mulberry Twig), Liu Zhi (Pomegranate Twig) (each 3 cun long, 7 stalks, powdered); Tong Cao (Tetrapanatis Medulla), Chuan Shan Jia (Manis Squama), Quan Xie (Scorpio) (stir-fried, each 1 liang); Chen Xiang (Aquilariae Lignum Resinatum) (8.5 qian); Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Deng Cao (Junci Medulla) (each 5 qian); Hong Hua (Carthami Flos) (2.5 qian).
Make pills with Gan Cao glue, take 30-40 pills per dose with warm wine on an empty stomach.
Jia Jian Huang Qi Jian Zhong Tang: Treats Five Labors and Seven Injuries in men and women, bone-steaming.
Huang Qi (Astragali Radix) (1.2 liang), Qin Jiao (Gentianae Macrophyllae Radix), Fang Feng (Saposhnikoviae Radix), Bei Chai Hu (Bupleuri Radix), Gui Shen (Angelicae Sinensis Radix), Bai Shao Yao (Paeoniae Radix Alba), Shu Di Huang (Prepared Rehmanniae Radix), Di Gu Pi (Lycii Cortex), Rou Dou Kou (Myristicae Semen) (roasted), Zhi Gan Cao (Prepared Licorice Root), Sha Ren (Amomi Fructus), Bing Lang (Arecae Semen) (each 5 qian), Zhu Ling (Polyporus) (4 qian), Jie Geng (Platycodonis Radix), Bai Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (each 3 qian), Ren Shen (Ginseng Radix et Rhizoma) (1 qian).
Grind into coarse powder, take 3 qian per dose with one cup of water, decoct to 0.7 cups, take at any time. For elderly patients, increase Huang Qi by one liang.
Zai Xian Dan: Treats Lao syndrome, yellowish emaciation and deficiency, where other drugs fail.
Da Xiao Hui Xiang (Foeniculi Fructus, stir-fried in salt water, each 2 liang), Mai Dong (Ophiopogonis Tuber), Fu Shen (Poria with Pine Root), Di Gu Pi (Lycii Cortex), Fang Feng (Saposhnikoviae Radix) (each 2 liang), Yuan Zhi (Polygalae Radix), Ren Shen (Ginseng Radix et Rhizoma), Long Chi (Dentis Mammoth), Ling Yang Jiao (Saigae Tataricae Cornu), Zhi Gan Cao (Prepared Licorice Root), Shi Gao (Gypsum Fibrosum) (each 3 liang), Zi Shi Ying (Fluoritum) (1 liang).
Cut into slices, take 3 qian per dose with one jujube and 1.5 cups of water, decoct to 0.7 cups, take warm before meals. Repeat if not cured, stop when cured. Greatly benefits heart strength; effective for those who have previously vomited blood.
Sang Shen Gao: Treats bone-steaming.
Take Sang Shen (Mulberry Fruit) in any amount, extract juice, boil together with Cang Zhu (Atractylodis Rhizoma), remove Cang Zhu residue to form paste. If Kidney Qi is deficient, add 4 liang of Gou Qi Zi (Lycii Fructus) powder; if Lung is deficient, add 1 liang of Ren Shen (Ginseng Radix et Rhizoma) powder.
Case Records
One person had no major illness, but felt general discomfort and stagnation, with string-tight and sluggish pulses in all six positions. I said: This is due to stagnant heat in the Heart not flowing freely, combined with physical overexertion and sexual excess. Heart stagnation causes loss of Shen (Spirit); physical overexertion injures Qi; sexual excess harms Jing (Essence). Loss of Shen means Fire departs; Qi injury causes stagnation; Jing harm causes Water deficiency. If multiple medicines cannot be taken, first take Ju Hong (Citri Reticulatae Pericarpium Rubrum) and Mai Dong (Ophiopogonis Tuber) for a few days, then add Wu Wei Zi (Schisandrae Chinensis Fructus). Generally, thinking calmly prevents Heart stagnation; light exercise unblocks Qi stagnation; avoiding lust and concentrating spirit ensures Jing sufficiency. This not only cures disease but promotes longevity.
One person suffered from Lao disease for half a year, extremely deficient and near collapse. In this condition, Ren Shen (Ginseng Radix et Rhizoma) is indispensable but must not be used abruptly. Extreme deficiency means the body cannot bear strong tonification. One should use a formula primarily based on Wu Wei Zi (Schisandrae Chinensis Fructus), not taking it all at once, but sipping slowly. Wait until Shen Qi (Spirit and Qi) stabilizes before adding Ren Shen.