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[Verse]
Dietary indiscretion and physical overexertion constitute internal injury, sometimes also caused by hunger, overeating, or excessive sexual activity. The presentation resembles cold damage (Shanghan); misusing sweating therapy will cause the patient to become bedridden.

[Dissertation]
For syndromes caused by dietary indiscretion and labor, tonification should be employed rather than purgation. For external contraction of wind-cold pathogenic factors, purgation (dispersing) should be employed rather than tonification; the difference between the two is as vast as heaven and earth. Internal injury syndromes may also present with headache and fever. Incompetent physicians often treat them as external contractions and induce heavy sweating, a grave error! Disaster follows swiftly. Li Dongyuan stated: When the Renying pulse (located at the neck, reflecting Yang meridians) is larger than the Qikou pulse (located at the radial artery of the wrist, reflecting Yin meridians and Spleen/Stomach), it indicates external injury. When the Qikou pulse is larger than the Renying pulse, it indicates internal injury. In external injuries, aversion to cold and fever occur simultaneously without interval; in internal injuries, they occur alternately and irregularly. In external injuries, aversion to cold persists even near intense heat; in internal injuries, aversion to cold resolves upon seeking warmth. In external injuries, aversion to wind implies intolerance to all winds; in internal injuries, aversion to wind is only to slight drafts. External injury symptoms manifest prominently in the nose, causing nasal congestion with forceful breathing; internal injury symptoms manifest prominently in the mouth, causing loss of taste and abdominal discomfort. External injuries involve excess pathogenic factors, so speech is loud and vigorous, with severity increasing from light to heavy; internal injuries involve deficiency of Yuan Qi (Original Qi), so speech is lazy and timid, with severity decreasing from heavy to light. In external injuries, the back of the hand is hot while the palm is not; in internal injuries, the palm is hot while the back of the hand is not. Internal injury headaches come and go; external injury headaches are constant until the pathogen transmits to the interior. Internal injury presents with lethargy and desire to lie down, with limbs unable to hold themselves up; external injury causes the patient to be bedridden on the day of onset, unable to rise without support, with muscle spasms and bone pain. In external injuries, appetite is lost but taste remains normal and there is no disgust for food; in internal injuries, there is disgust for food and loss of taste. After three days of external injury, grain is digested and fluids metabolized, pathogenic factors transmit to the interior, and thirst inevitably occurs; in internal injury, pathogenic factors remain in excess in the blood vessels, so there is no thirst. If the internal injury is due to hunger or excessive sexual activity, it represents a deficiency within deficiency compared to dietary internal injury. Major tonification to restore Yang is required, and one still fears delay. If mistakenly treated as an external contraction and heavy sweating is induced again, death is inevitable.

[Pulse Diagnosis]
Internal injury from labor presents with a wide, loose pulse that lacks constraint. If Stomach Qi is damaged, the pulse becomes hidden and difficult to locate. Internal injury from cold food presents with a slippery, rapid, and deep pulse. Internal injury from hot food presents with a rapid, large, and choppy pulse.

Overeating Injury
For injury from overeating, use Baohe Wan (Preserve Harmony Pill) or Qu Nie Zhi Zhu Wan (Malt and Immature Bitter Orange and Atractylodes Macrocephala Pill). For injury from hot foods, use San Huang Zhi Shi Tang (Three Yellows and Immature Bitter Orange Decoction). For injury from cold foods, use Muxiang Jian Yuan Wan (Costus Root Round Pill).
Baohe Wan (Formula see Food Injury section.)
Qu Nie Zhi Zhu Wan (Formula see Spleen and Stomach section.)
San Huang Zhi Shi Tang (Formula see Food Injury section.)
Muxiang Jian Yuan Wan (Formula see Food Injury section.)

Hunger Injury
In years of famine or prolonged starvation due to excessive work, damaging the Spleen and Stomach and weakening Yuan Qi, use Sijunzi Tang (Four Gentlemen Decoction), or Huangqi Jianzhong Tang (Astragalus Middle-Nourishing Decoction), or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Shanyao added and Chaihu removed.
Sijunzi Tang
Treats Spleen and Stomach weakness, poor appetite, or loose stools, emaciation with sallow complexion, or empty fullness in the chest and diaphragm, phlegm cough with acid regurgitation, or Spleen and Stomach weakness prone to malaria and dysentery.
Renshen (Ginseng Radix et Rhizoma, remove rhizome) Baizhu (Atractylodis Macrocephalae Rhizoma, remove rhizome and oil) Fuling (Poria, remove skin) each 2 qian Gancao (Licorice Root, honey-fried) 1 qian
Crush these into pieces. For one dose, add 3 slices of fresh ginger and 1 jujube, decoct in water, and take warm.
Adding Chenpi (Citri Reticulatae Pericarpium) creates Yigong San (Different Merit Powder). Adding Banxia (Pinelliae Rhizoma) creates Liujunzi Tang (Six Gentlemen Decoction).

Huangqi Jianzhong Tang
Used for profuse sweating leading to Yang collapse with a weak Chi pulse (at the wrist).
Huangqi (Astragali Radix) Shaoyao (Paeoniae Radix Alba) Guizhi (Cinnamomi Ramulus) Gancao (Licorice Root)
Decoct with water and ginger. Add Yi (Maltose) before administration.
If Yuan Qi is extremely deficient, add Renshen.

Labor Internal Injury
Heavy lifting and labor damage Yuan Qi. Use Buzhong Yiqi Tang, Tiaozhong Yiqi Tang, or Huangqi Jianzhong Tang, Liujunzi Tang. "Those who are fatigued should be warmed" does not refer to hot-warm herbs, but rather to warming and nourishing methods. In summer, after labor-induced internal injury with heatstroke and sweating, presenting with weakness and a faint pulse, use Qingshu Yiqi Tang (Clear Summerheat and Augment Qi Decoction).
Buzhong Yiqi Tang
Treats physical and mental fatigue combined with dietary irregularity, exhaustion and deficiency, fever with irritability, a洪大 (surging-large) yet empty pulse, headache, or aversion to cold with thirst, spontaneous sweating with weakness, Qi rebellion with asthma.
Huangqi (Astragali Radix, honey-fried) 1.5 qian Renshen (Ginseng Radix et Rhizoma) 1 qian Gancao (Licorice Root, fried) 0.5 qian Dangguishen (Angelicae Sinensis Radix, body only, wine-rinsed) 1 qian Chenpi (Citri Reticulatae Pericarpium, keep white pith) 0.5 qian Baizhu (Atractylodis Macrocephalae Rhizoma) 0.5 qian Chaihu (Bupleuri Radix) 0.3 qian Shengma (Cimicifugae Rhizoma) 0.3 qian
Crush these into pieces. For one dose, add 3 slices of fresh ginger and 2 jujubes, decoct in water, and take warm.
Note: The Classics state: "The five flavors enter the mouth; sweet flavor first enters the Spleen." This formula contains Renshen, Huangqi, Danggui, Baizhu, and Gancao, all sweet substances, thus entering the Spleen to tonify Middle Qi. Middle Qi refers to the Qi of the Spleen and Stomach. Shengma guides Stomach Qi upward to restore its proper position. Chaihu guides Shaoyang Qi upward to assist the spring-like ascending function. Chenpi is used to unblock the Spleen and Stomach and to move the stagnation of sweet-warm herbs.
If there is profuse sweating, remove Shengma and Chaihu, add Suanzaoren (Ziziphi Spinosae Semen). For insomnia at night, do likewise. For headache, add Manjingzi (Vittariae Spora) and Chuanxiong (Ligustici Chuanxiong Rhizoma). If prone to sneezing, indicating loose interstices and external pathogen invasion, add Baizhi (Angelicae Dahuricae Radix) and Chuanxiong. For brain pain or vertex pain, add Gaoben (Ligustici Wallichii Rhizoma et Radix) and Xixin (Asari Radix et Rhizoma). For dry mouth or thirst, add Gegen (Puerariae Lobatae Radix). For phlegm, add Beimu (Fritillariae Thunbergii Bulbus) and Qianhu (Peucedani Radix). For diarrhea, add Baishao (Paeoniae Radix Alba), Zexie (Alismatis Rhizoma), and Fuling. For chest/epigastric fullness/stuffiness, remove Huangqi, Shengma, and Chaihu, add Zhishi (Aurantii Fructus Immaturus) and Huanglian (Coptidis Rhizoma, stir-fried with ginger). For cough, add Sangbaipi (Mori Cortex) and Wuweizi (Schisandrae Chinensis Fructus). For excessive mental exertion, restlessness, palpitations, or fright, add Fushen (Poria cum Pinodi), Yuanzhi (Polygalae Radix), Suanzaoren, Shichangpu (Acori Tatarinowii Rhizoma), and Baiziren (Platycladi Semen). For poor appetite or food injury, add Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus), Shanzha (Crataegi Fructus), and Zhishi. For damp-phlegm in the Stomach, add Banxia. For post-illness incomplete recovery of Yuan Qi with chest fullness and shortness of breath, add Jupi (Citri Reticulatae Pericarpium), Zhishi, and Baishao. For heat, add Huangqin (Scutellariae Radix) and Huanglian.

Tiaozhong Yiqi Tang
Indications are the same as above.
It is Buzhong Yiqi Tang minus Dangguishen and Baizhu, plus Cangzhu (Atractylodis Rhizoma), Huangbai (Phellodendri Chinensis Cortex), and Muxiang (Aucklandiae Radix).

Liujunzi Tang
Renshen Baizhu Fuling Gancao
This is Sijunzi Tang plus Chenpi and Banxia, decocted with ginger and jujube.

Qingshu Yiqi Tang
Treats long summer damp-heat steaming people. Upon contraction, symptoms include limb fatigue, reduced spirit, reluctance to move, chest fullness and shortness of breath, joint pain, or Qi rebellion with asthma, fever with irritability, epigastric distension, yellow and frequent urination, loose and frequent stools, or diarrhea with thirst, poor appetite, spontaneous sweating, and body weakness.
Huangqi (Astragali Radix, honey-fried) Cangzhu (Atractylodis Rhizoma, rice-water processed) Shengma (Cimicifugae Rhizoma) each 1 qian Renshen Baizhu (Atractylodis Macrocephalae Rhizoma, soil-fried) Chenpi (Citri Reticulatae Pericarpium, fried) Shenqu (Massa Medicata Fermentata, fried) Zexie (Alismatis Rhizoma) Huangbai (Phellodendri Chinensis Cortex, wine-fried) Danggui (Angelicae Sinensis Radix) Qingpi (Citri Reticulatae Pericarpium Viride, remove pith) Maidong (Ophiopogonis Radix, remove heart) Gegen (Puerariae Lobatae Radix) Gancao (Licorice Root) each 0.3 qian Wuweizi (Schisandrae Chinensis Fructus) 9 grains
Crush these into pieces. For one dose, decoct in water and take warm.

Sexual Activity Internal Injury
Excessive sexual activity damages Yuan Qi, causing spontaneous sweating and weakness. Use Renshen Yangrong Tang (Ginseng Nourishing Grace Decoction) or Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction). If Yang collapses, use Sanjian Tang (Three Jian Decoction), urgently moxa Guanyuan (CV4) and Qihai (CV6) for 100 moxa cones each, to restore Yuan Qi.
Renshen Yangrong Tang
Treats accumulated fatigue, deficiency and damage of Qi and Blood, muscle wasting, and limb lethargy.
Renshen Huangqi (Astragali Radix, honey-fried) Chenpi Baishao (Paeoniae Radix Alba, wine-fried) Danggui (Angelicae Sinensis Radix, wine-rinsed) Gancao (Licorice Root, fried) Fuling (Poria) Wuweizi Yuanzhi Baizhu Guixin (Cinnamomi Cortex) Shudihuang (Rehmanniae Radix Praeparata)
Decoct with ginger and jujube.

Shiquan Dabu Tang
This is Bazhen Tang (Eight Treasures Decoction) plus Huangqi and Rougui (Cinnamomi Cortex).

Sanjian Tang (Formula see Cold Damage to Interior section.)

Alcohol Injury
Wine is formless, greatly hot and toxic. Excessive drinking damages the Stomach causing vomiting. Use Gehua Jie Cheng Tang (Kudzu Flower Relieving Intoxication Decoction). For indulging in hot wine causing irritability and alcohol toxicity, Huanglian Jiedu Tang (Coptis Detoxification Decoction) is indicated.
Gehua Jie Cheng Tang
Treats excessive drinking, vomiting with phlegm reversal, mental confusion, chest/diaphragm stuffiness, trembling hands and feet, reduced appetite, and difficult urination.
Gehua (Puerariae Flos) Sharen (Amomi Fructus Rotundus) Muxiang Aucklandiae Radix Baidoukou (Cardamomi Fructus) Renshen Fuling Chenpi (Citri Reticulatae Pericarpium) each 0.5 qian Shenqu (Massa Medicata Fermentata, fried) Baizhu (Atractylodis Macrocephalae Rhizoma, fried) Qingpi (Citri Reticulatae Pericarpium Viride) Zexie Ganshengjiang (Zingiberis Rhizoma Recens, dried ginger) each 0.3 qian
Note: Gehua is cold in nature and can resolve alcohol toxicity. Zexie and Fuling are bland in flavor and can drain dampness from alcohol. Sharen, Doukou, Muxiang, Qingpi, and Chenpi have pungent flavors that move stagnation of alcohol and food. Ginger opens the Stomach and stops vomiting. Shenqu dissolves greasy foods. The sweetness of Renshen and Baizhu benefits the damaged Yuan Qi.

Huanglian Jiedu Tang (Formula see Fire Syndromes section.)