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[Dissertation] The so-called "Xu Lao Gu Zheng" (Bone-steaming due to Deficiency and Emaciation) originates from the pathogenic qi of Heat-Lao (Chronic Febrile Disease with Emaciation), which adheres to the Qi and Blood, penetrates deeply into the Marrow, and invades and damages the Zang-Fu organs. If left untreated for a long time, it steams and boils according to the deficiency of each organ's Qi, forming the disease.

Gu Zheng (Bone-steaming) originates in the Kidney. Its symptoms include feeling cool in the morning and feverish in the evening, irritability, restless sleep, loss of taste, scanty dark urine, weak panting, lower back pain, cold feet, and constant heat in the palms. During severe steaming episodes, internal injury transforms into Gan accumulation (Pediatric malnutrition syndrome), eroding the five Zang organs.

Mai Zheng (Pulse-steaming) originates in the Heart. Symptoms include daily worsening of irritability and oppression, tossing hands and feet, thirst with desire to drink, spitting white foam, talking in sleep with fear and panic, and a rapid pulse. During severe steaming, it also transforms into Gan accumulation, with oppression below the umbilicus or violent, unceasing diarrhea.

Pi Zheng (Skin-steaming) originates in the Lung. Symptoms include severe panting, dry nose and mouth, white coating on the tongue, and blood-like urine. During severe steaming, there is chest fullness and distension under both hypochondria, severe cough with back and shoulder blade pain, and restless lying. Toxic damage to the organs causes hemoptysis.

Rou Zheng (Flesh-steaming) originates in the Spleen. Symptoms include body heat like fire, irritability without sweat, abdominal distension, nausea after eating, blood-like urine, and constipation with difficulty. During severe steaming, the body swells, eyes become red, and lying is restless.

Xue Zheng (Blood-steaming) is caused by Liver Qi deficiency. When the Liver is deficient, Blood has nowhere to store; when Blood has nowhere to store, it has nowhere to nourish. This leads to the exhaustion of Ying Qi (Nutritive Qi) and the internal accumulation of Deficient Yang. Symptoms include exterior cold and interior heat, also known as Nei Zheng (Internal steaming). Pressing to the bone reveals intense internal heat, emaciation of flesh and bone, loss of taste, and dry, lusterless skin. During severe steaming, vision dims, anger arises easily with frequent fright, limbs gradually thin, and the dorsum of the foot swells.

These five types of Zheng diseases are largely similar to but differ slightly in treatment from Heat-Lao. This is because Zheng diseases attach internally to the marrow and manifest externally on the skin. Ancients discussed twenty-three types of Zheng. Upon careful deduction, organ diseases have myriad variations. All diseases arise from deficiency; one should not rigidly adhere to twenty-three types. Such an explanation is too brief.

For Gu Zheng Xu Lao, Chuan Shi (Infectious consumption), Fei Wei (Lung atrophy), incessant cough, heaviness and emaciation, high fever or sudden aversion to cold, cold abdominal distension, painful limbs, loss of appetite, headache, dry mouth, thick sticky sputum and nasal discharge, and unquenchable thirst, use Zhu Du Huang Lian Wan (Pig Stomach and Coptis Pill).

Zhu Du (One pig stomach, boiled in child's urine until cooked, finely cut, dried, and powdered) Zhi Mu (Crushed and dried) Wuyi Ren (Stir-fried, two liang each) Zi Wan (Remove seedlings and soil) Da Huang (Crushed and lightly stir-fried) Bie Jia (Remove skirt edge, soaked in vinegar and roasted) Bing Lang (Roasted) Cang Zhu (Soaked in rice wash water, cut and dried) Bai Bu (Remove seedlings) Huang Lian (Remove whiskers).

The above nineteen ingredients are crushed and sifted into powder, mixed with refined honey to form pills the size of Sophora seeds. Take twenty pills per dose with warm wine on an empty stomach.

For heart heat causing irritability, desire to expose the body, oppression and irritability upon covering, palpitations, pale complexion, memory loss, and women suffering from Xue Feng (Blood wind) often developing this condition, indicating Xin Zheng (Heart steaming), use Mai Men Dong Tang (Ophiopogon Decoction).

Mai Men Dong (Remove heart and dry) Fu Shen (Remove wood core) Fang Feng (Remove forked branches) Di Gu Pi (Remove soil, three liang each) Ren Shen Long Chi Yuan Zhi.

The above eleven ingredients are crushed to the size of hemp seeds. Take three qian bi per dose with one and a half sheng of water and two dates. Decoct to half a sheng, strain, and take warm. After one dose, if not fully relieved, prepare another. Continue until cured. This formula greatly benefits heart power and is especially good for those who have previously vomited blood. If one fears mineral drugs, omitting Zi Shi Ying (Purple Quartz) is also fine.

For treating the Five Zhengs, use Di Gu Pi Tang (Cortex Lycii Decoction).

Di Gu Pi Bai Fu Ling (Remove black skin) Mai Men Dong (Remove heart and dry) Chai Hu (Remove seedlings, one and a half liang each) Chi Shao Yao Gan Cao (Roasted until red, one liang each).

The above six ingredients are coarsely crushed and sieved. Take five qian bi per dose with one and a half sheng of water. Decoct to one sheng, strain, and take warm in two divided doses after meals.

For treating the Five Zhengs, use Ge Gen Tang (Kudzu Root Decoction).

Ge Gen (Roasted yellow and crushed, three liang) Shi Gao (Ground, five liang) Gan Cao (Roasted until red, one liang) Zhi Mu (Crushed and dried) Huang Qin (Remove black heart) Jing Mi (One he).

The above ten ingredients are coarsely crushed and sieved. Take five qian bi per dose with one and a half sheng of water and five bamboo leaves. Decoct to one sheng, strain, and take warm in two divided doses. Using juice from boiling half a sheng of wheat in three sheng of water to decoct the herbs is even better.

For Gu Zheng with body heat, vexatious heat in hands and feet, mental restlessness, progressive emaciation and inability to eat, use Long Dan Wan (Gentian Pill).

Long Dan (One liang and one fen) Huang Lian (Remove whiskers) Huang Bo (Remove rough bark and roast) Da Huang (Crushed and lightly stir-fried) Chi Shao Yao Ren Shen.

The above nine ingredients are crushed and sifted into powder, mixed with refined honey to form pills the size of Sophora seeds. Take fifteen pills with grain drink after meals, and again at noon.

For Gu Zheng Re Lao, Fei Wei, cough, Chuan Shi emaciation, night sweats, weakness, sore limbs, Gui Qi (Ghost energy) and Pi Ku (Masses), use Qing Hao Wan (Artemisia Annua Pill).

Qing Hao (Soaked in child's urine for seven days, sun-dried, three liang) Tian Men Dong (Remove heart and dry) Chai Hu (Remove seedlings) Di Gu Pi Bai Fu Ling (Remove shell) Gui (Remove rough bark and stir-fry with bran) Sheng [Bie Jia?] Tian Ling Gai (Three fen, ground) She Xiang (One fen).

The above eighteen ingredients are crushed and sifted into powder, mixed with refined honey to form pills the size of Sophora seeds. Take twenty pills on an empty stomach with warm water, and again at noon.

For Xin Zheng causing distress, fear, and trembling, men damaging Heart Qi through reading and excessive thought, severe damage leading to hematemesis, mental restlessness, forgetfulness, loss of spirit, body itching with wind plaques, or chest Qi fullness, use Fu Ling Tang (Poria Decoction).

Bai Fu Ling (Remove black skin) Mai Men Dong (Remove heart and dry) Kuan Dong Hua Du Huo (Remove rhizome head) Bing Lang (Crushed, six liang each) Gui (Remove rough bark) Di Gu Pi (Remove soil, ten liang).

The above eleven ingredients are crushed to the size of hemp seeds. Take five qian bi per dose with two sheng of water. First decoct Shan Ze Yin, take one and a half sheng of liquid. Add herbs, half a slice of ginger, and three cracked dates. Decoct to one sheng, strain, and take warm. Once in the morning and once at night.

For Gu Zheng heat, emaciation, sallow complexion, vomiting and rebellious Qi, oppression, shortness of breath, worsening in the evening, and inability to eat, use Long Dan San (Gentian Powder).

[Ingredients missing in source text]

The above ten ingredients are crushed and ground into powder. Take two qian bi per dose with grain drink, three times daily.

For Xu Lao Gu Zheng with body heat, vexatious pain in hands, mental anguish, emaciation and inability to eat, use Long Dan Wan (Gentian Pill).

Long Dan (One liang and one fen) Huang Bo (Remove rough bark from thick pieces) Huang Qin (Remove black heart) Ren Shen Zhi Zi Ren Huang Lian (Remove whiskers) Bai [Shao Yao?].

The above eight ingredients are crushed and sifted into powder, mixed with refined honey to form pills the size of Sophora seeds. Take fifteen pills with porridge drink, once on an empty stomach and once before bed, until effective.

For Xin Zheng with heart irritability, hot painful hands and feet, desire to expose the body, palpitations, fear, dry throat with false thirst, sallow complexion, memory loss, and women with weak Qi and Blood often transmitting this disease, use Mai Men Dong Yin (Ophiopogon Drink).

Mai Men Dong (Remove heart and dry, two liang) Bai Fu Ling (Remove black skin) Ren Shen Long Chi Yuan Zhi (Remove heart and dry, three liang each) Gan Cao [Roasted?].

The above nine ingredients are crushed to the size of hemp seeds. Use five qian bi per dose with two sheng of water and one fen of Shan Ze Yin. Add two cracked dates. Decoct to one sheng, strain, and take warm in two divided doses. For severe heat, irritability, and thirst, add one he of Dan Zhu Li (Bamboo sap) and decoct. Also treats previous hematemesis. Follow other methods above. One dose will surely cure.

For men and women with Gu Zheng Re Lao, emaciated skin and flesh, sallow complexion, loss of appetite, nighttime cough, thick sticky sputum, joint pain, aversion to cold with high fever, abdominal Qi distension, restlessness, malaria-like attacks, women's Xue Feng Lao, and all Lao diseases, use Bie Jia Tang (Softshell Turtle Decoction).

Bie Jia (Remove skirt edge, vinegar-roasted until yellow, three liang) Qin Jiao (Remove seedlings and soil, two liang) Zi Wan (Remove soil, one and a half liang) Chai Hu (Remove seedlings, three liang) [Missing ingredients] Roast) Sheng Ma Gan Cao [Roasted?] Bai Pi (Crushed) Da Huang (Stir-fried) Huang Lian (One liang each).

The above twenty-four ingredients are coarsely crushed and sieved. Take three qian bi per dose with one sheng of water, one cracked date, one sour plum, and three slices of ginger. Decoct for three to five boils, strain, and take slightly warm at any time.

For Gu Zheng Re Lao, use Qin Jiao Tang (Qin Jiao Decoction).

Qin Jiao (Remove seedlings and soil, four liang) Qing Hao Zi (Soaked in child's urine overnight, washed, dried, and roasted) Zhi Mu (Roasted) Bei Mu (Remove heart) Chang Shan (Wash and roast) Gan Cao (Salt water-soaked and roasted yellow, two liang each) Bie Jia (Remove skirt edge, vinegar-soaked and roasted) Zhi Ke (Remove pulp and stir-fry with bran) Chai Hu (Remove seedlings).

The above twelve ingredients are coarsely crushed and sieved. Take two qian bi per dose with one sheng of water, one cracked sour plum, and three slices of ginger. Decoct to seven parts, strain, and take warm. If whole-body high fever occurs, take two doses.

For Xu Lao Gu Zheng with muscle emaciation, night sweats and tidal fever, cough possibly with hemoptysis, limb fatigue, inability to eat, and virgins with Lao Re, amenorrhea, occasional tidal irritability and false thirst, use Bie Jia Tang (Softshell Turtle Decoction).

Bie Jia (Nine-rib large one, soaked in vinegar overnight, remove skirt edge, spine dipped in vinegar and roasted red, use two and a half liang) Ren Shen Chai Hu (Remove seedlings, each [missing amount]) Zhi Ke (Remove pulp) Dang Gui (Cut and roast) Jie Geng Zi Wan (Wash and roast) Bai Zhu Gui (Remove rough bark) Gan Cao (Roasted, half liang each) Jing San Leng (One and a half liang).

The above thirty ingredients are crushed into coarse powder. Take five qian bi per dose with two sheng of water, half a slice of ginger, and three cracked dates. Decoct to one sheng, strain, and take slightly warm on an empty stomach and before bed.

For boys and virgins with Gu Zheng Re transforming into Lao, loss of appetite, tasteless food, bodily pain, increasing Yang heat, reddish face, use Qing Hao Wan (Artemisia Annua Pill).

Qing Hao (Crushed, four liang) Gan Cao (Crushed, one liang) Tao Ren Xing Ren (Two liang each, remove skins, tips, and double kernels).

The above four ingredients are placed in a porcelain bottle with five sheng of child's urine. Place bricks underneath and burn with chaff heads overnight. Remove Tao Ren and Xing Ren, grind separately into paste. Add [other herbs] Shao Yao Zhi Mu Tian Ling Gai (Roasted) Che Qian Zi Zi Wan (Remove soil) Wei Yu Dang Gui (Cut and roast) Zhi Ke (Remove pulp and stir-fry with bran) Chai Hu (Remove seedlings) Xu [Duan?].

The above twenty-two ingredients, excluding the first four, are crushed and sifted into powder. Mix with Tao Ren and Xing Ren, pound one to two thousand times. Gradually add the decocted child's urine. Pound wetly one to two thousand times. If hard, add one and a half liang of refined honey and pound more. Form pills with multiple hands, size of Sophora seeds. Take thirty pills with cooked water daily at any time. For cough, add Ban Xia half liang. For female menstrual obstruction, add Mu Dan Pi and Yan Hu Suo, one fen each. For five-center irritability, add Di Gu Pi and Fu Ling. For bad dreams, add Fu Shen and Ling Yang Jiao. For early stage not yet transmitted to organs, take four doses with wine to cure. For abdominal masses, Pi Ku, aversion to cold, headache, sallow face, and dry brittle hair, cure after taking.

For Gu Zheng with red lips and cheeks, coarse breathing, dry mouth, whole-body high fever, or excessive spontaneous sweating, constipation, dark yellow urine, and minimal diet, use Bie Jia Zhu Du Wan (Softshell Turtle and Pig Stomach Pill).

Bie Jia (Remove skirt edge, vinegar-roasted) Chai Hu (Remove seedlings) Mu Xiang Qing Hao Sheng Gan Di Huang (Roast, one liang each) Huang Lian (Remove whiskers, two liang).

The above seven ingredients are crushed and sifted into powder. Take one pig stomach, remove fat membrane, wash clean, insert herb powder inside, tie securely, and steam until soft. Pound in mortar hundreds of times to form pills the size of mung beans. Take fifteen pills with warm water before meals, at noon, and before bed, three times daily.

For Gu Zheng Re Lao, use Chai Hu Tang (Bupleurum Decoction).

Chai Hu (Remove seedlings, one liang) Hu Huang Lian (Half liang) Zi Wan (Remove soil) Zhi Mu (Three fen each) Bie Jia (Small half piece, soaked in child's urine) Ren (Remove skins, tips, double [kernels?]).

The above ten ingredients are coarsely crushed and sieved. Take two qian bi per dose with one sheng of water and a little Qing Hao. Decoct to seven parts. Leave outdoors overnight. Strain at dawn and take warm on an empty stomach.

For Gu Zheng, plague, epidemic fevers, alternating cold and heat malaria, Wu Shi (Five Corpses), Jiu Zhu (Nine Pours), stabbing abdominal pain, Gu Du (Poisonous ghosts), all heat toxins, Hong Zhang Jiao (Podagra/Gout), confusion and attacking Qi, oral ulcers from heat, mania and running away, resolving all poisons, including mineral and herbal heat toxins, jaundice, irritability, pain, and all heat diseases, use Zi Xue Wan (Purple Snow Pill).

Jin (Gold, fifteen liang) Yin (Silver, fifteen liang) Han Shui Shi Shi Gao Ci Shi Hua Shi (Each three jin).

The above four stone drugs are crushed together. With Jin and Yin, total six items, boil in one shi of water to obtain one dou. Remove Jin, Yin, and stone dregs. Add following herb powders.

Mu Xiang (One liang) Xi Jiao (Sliced, five liang) Ding Xiang (Four liang) Chen Xiang (Five liang) Gan Cao (Roasted, eight liang) Sheng Ma Xuan Shen ([Amount missing]).

The above thirteen ingredients, excluding the first six, are boiled in three dou of water to obtain one dou. Strain cleanly and mix with previous liquid. Add five sheng of finely ground Mang Xiao (Mirabilite) to the liquid. Simmer slowly, stirring constantly, until slightly over one dou remains. Pour into a vessel. To solidify, add three liang of water-flushed Dan Sha (Cinnabar) powder and one liang and one fen of She Xiang (Musk) powder. Grind together into powder, mix with dough, cover, and let stand for two days until frost-snow forms. Dry in sun, seal tightly in new jar or bottle. Take when ill. Strong adults take one qian bi mixed with cold water, adjusting dosage based on strength. For Hong Zhang Jiao or toxicity from mineral drugs, take half qian bi mixed with water like magic. After taking, lie supine with waist elevated to direct medicine to chest and abdomen. For red hot eyes, mix with cold water and apply to eye corners. Initial slight pain, then tears flow and settle. Use three to five times daily and at night, always effective. For oral heat ulcers, hold almond-sized amount in mouth to dissolve, swallow slowly until stopped.

For Gu Zheng swelling Qi, aversion to cold and high fever in the evening, red cheeks, inability to eat, and progressive emaciation, use Xiang Chi Yin (Fermented Soybean Drink).

Xiang Chi (One fen) Sheng Di Huang (One liang) Cong Bai (Three stalks).

The above three ingredients are finely crushed and mixed. Soak in two and a half sheng of child's urine overnight. Decoct at dawn to eight parts. Strain and take warm in two divided doses on an empty stomach and at noon.

For men and women with Gu Zheng Lao Qi, emaciated body, weak limbs, red cheeks and sallow face, five-center heat, fatigue and palpitations, excessive night sweats, abdominal and hypochondriac masses, and loss of appetite, use Bie Jia Tang (Softshell Turtle Decoction).

Bie Jia (Remove skirt edge, vinegar-roasted) Chai Hu (Remove seedlings, three liang each) Jie Geng (Stir-fried) Gan Cao (Roasted yellow, one and a half liang each) Qin Jiao (Remove seedlings [Amount missing]).

The above six ingredients are coarsely crushed and sieved. Take three qian bi per dose with one sheng of water and one cracked sour plum. Decoct to six parts, strain, and take warm after meals.

For men and women with all Lao diseases, Gu Zheng, Feng Qi, etc., adjust according to seasons, use Qing Hao Wan (Artemisia Annua Pill). This medicine has seven names: 1. Xing Ren Wan, treats cough; 2. Mu Xiang Wan, treats Shi Zhu (Corpse transmission) and ghost energy, nine types of heart pain, three types of insect-bitten heart pain; 3. Xi Jiao Wan, treats seasonal heat epidemics; 4. Long Nao Wan, treats children's innocent Gan dysentery; 5. Wan Bing Wan, treats all deficiencies; 6. Dan Sha Wan, treats toxic evil and Pi Qi; 7. Qing Hao Wan, treats all Lao Qi in men and women. Carrying it in forests, fields, pits, or graves keeps ghosts away. Crush one pill and apply to snake bites or harmful injuries for immediate effect.

Qing Hao Xin (Three pieces, finely cut) Tong Zi Xiao Shui (Three large dou) Sheng Di Huang (Three stalks, cut with bamboo knife and pounded) Dong Yin Tao Zhi (Half handful, finely pounded [?]).

The above five ingredients are placed in a new urn, soaked in urine for seven days. Boil urine and herbs for three to five hundred boils. Strain out herbs, dry, and crush into powder. Clarify urine, put in pot, refine with mulberry wood fire, stirring constantly with a comb. Refine three dou of urine to three sheng. Store in non-leaking vessel. Mix with following herbs.

Xing Ren Tao Ren (Remove double kernels and skins, stir-fry until yellow) Jie Geng (Stir-fried) Wei Yu Zhi Ke (Stir-fry with bran, remove pulp) Da Huang (Roast [?]) [Replace with Hu Gu?] Gan [Cao?] Rough Bark) Chen Ju Pi (Remove white part and roast) Zhu Yu (Soak in soup and stir-fry) Dan Sha (Grind separately) She [Xiang?] Ling Yang Jiao (Shreds, two liang and one fen).

The above twenty-seven ingredients are crushed to fine powder. Decoct with previous urine, mix well, pound in mortar five hundred times. If not sticky, add refined honey, knead into pills the size of Sophora seeds. Take thirty pills with warm water after meals. For severe illness, take twice daily. Unblocks San Jiao, calms five Zang. Daily use prevents Xu Lao. Seasonal miasma malaria cannot harm. For rebellious Qi, cough, regardless of sputum, dry cough, or cough with blood (named Lung Heat, heat toxin congestion causing nasal blockage, hoarse voice, chest pain), if not treated quickly, becomes Fei Wei and Lao emaciation. Take five liang of this medicine to calm the disease. For hands/feet hot as fire, oral ulcers, tongue rot, night terrors, dental pain, throat obstruction, take five liang. Roots emerge from Large Intestine like rotten tendons/flesh, frog skin, cherry knots, strange foul smell. If Lu Li (Scrofula) erupts, failing to treat root attacks five Zang, resembling vines wrapping trees, causing neck destruction and death. Taking five liang of this medicine is effective. For seasonal Qi headache wanting death, body heat, constipation, unconsciousness, inability to eat, take fifty pills with fresh drawn water to cure. Men/women who took excess hot medicines, though drug effects faded, Qi still rises to head/face causing eye pain, dizziness, heat, heart/stomach irritability, bad breath, ulcers. Take three pills with warm water, not exceeding one to two liang. Infant innocent disease is same as adult Lao, caused by prenatal essence/blood damage leading to dry lips/mouth, diarrhea/dysentery, abdominal masses, eye membranes. Taking cures it. As child grows, follow adult dosage. For women with irregular menstruation, early/late, varying amounts, green/black mixed colors, clotted/scattered, progressing to Lao emaciation, take one to two liang to cure.

Spring add: Long Dan Long Gu Chai Hu (Remove seedlings) Huang Lian (Remove whiskers, lightly stir-fried, one fen each).

Summer add: Zhi Mu Shi Chang Pu Mai Men Dong (Remove heart) Bai Fu Ling (Remove black skin, one liang each).

Autumn add: He Li Le (Skin) Qin Jiao Xuan Fu Hua (One liang each).

Winter add: Zi Wan (Remove soil) Shao Yao Wu Wei Zi Huang Qin (Remove black heart, one liang each).

For Gu Zheng heat disease, all Lao miasma toxins, excessive phlegm, shortness of breath, headache, dry mouth, dry eyes, poor appetite, progressive emaciation, use Long Dan Wan (Gentian Pill).