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This condition arises from excessive depletion, leading to the exhaustion of Kidney Water (Jing-Yin), with Ministerial Fire (Xiang Huo, the fire of the Mingmen residing in the Liver and Kidneys) blazing independently. It fails to secure the essence, making it prone to leakage. Alternatively, it may occur after severe vomiting or diarrhea; or when sexual intercourse is indulged recklessly shortly after a new recovery from a Cold Damage syndrome, suddenly causing the collapse of Yang Qi. Symptoms include cold limbs, acute pain and tension in the lower abdomen, retraction and contraction of the external genitalia, shortness of breath that cannot be sustained, cold sweating, and confusion of spirit. Immediate treatment should involve crushing fresh ginger and scallions, stir-frying them until hot, and applying them as a warm compress to the navel and abdomen. Decoct and administer Gushen Tang (Single Ginseng Decoction) or Wuji San (Five Accumulations Powder), or Lizhong Tang (Regulate the Middle Decoction). Additionally, administer hot ginger juice and fine wine orally, and apply moxibustion methods as described in the chapter on Cold Damage to the Middle Jiao.

(Attachment: Chuan Shao - Transmitted Corpse Consumption)
The Classics state: "When there is fatigue and overwork, the physical form weakens and Qi becomes deficient. The Zong Qi (Gathering Qi) is not abundant, the Upper Jiao does not circulate freely, and the Lower Wan (stomach outlet) is blocked. Stomach Qi stagnates and generates heat, which steams upward into the chest, thus causing internal heat." It also states: "Yin Qi is tranquil; when tranquil, the Spirit is stored within; when agitated, the Spirit dissipates." Furthermore: "When the Spirit is tranquil, Yin is generated; when the body is overworked, Yang becomes hyperactive. Yin deficiency generates internal heat, while Yang deficiency generates external cold."

What is referred to as Xu Lao (Deficiency Consumption) encompasses Wu Lao (Five Fatigues), Qi Shang (Seven Injuries), and Liu Ji (Six Extremes).
Wu Lao refers to: Heart fatigue causes palpitations, fearfulness, and forgetfulness, with sores on the mouth and tongue; Liver fatigue causes dark complexion and blurred vision, with the spirit failing to remain anchored; Spleen fatigue causes stiffness at the root of the tongue and difficulty swallowing saliva; Lung fatigue causes shortness of breath and facial edema, with loss of smell; Kidney fatigue causes difficulty bending and extending the back, dribbling urine, penile pain, dampness and sores in the scrotum, and fullness and urgency in the lower abdomen.

Qi Shang refers to: Overeating injures the Spleen, causing belching, lethargy, yellowish complexion; Extreme anger injures the Liver, causing blood loss and dim vision; Lifting heavy weights or sitting long on damp ground injures the Kidney, causing seminal emission, lower back and spine stiffness, and coldness in the lower extremities; Exposure to cold and consumption of cold drinks injure the Lung, causing shortness of breath, cough, and nasal congestion; Worry and excessive thinking injure the Heart, causing distress, palpitations, and forgetfulness; Wind-dampness, cold, and summer-heat injure the physical form, causing withered skin and hair; Unrestrained fear injures the Will (Zhi), causing mental confusion and unhappiness.

Liu Ji refers to: Qi extreme leads to internal emptiness, insufficiency of the Five Zang organs, and reluctance to speak; Blood extreme leads to lack of luster, falling eyebrows and hair; Sinew extreme leads to frequent muscle cramps, pain in fingernails and toenails, and profound fatigue preventing prolonged standing; Bone extreme leads to emaciation, toothache, painful heat in hands and feet, and reluctance to walk; Flesh extreme leads to emaciation, fatigue, lack of luster, and failure to generate flesh; Essence extreme leads to shortness of breath and a sensation of internal emptiness and heat.

The onset of illness must stem from physical weakness and mental exhaustion. Wild movements of the Seven Emotions and Six Desires stir up Yang Fire; sexual excess depletes True Yin. Alternatively, it may evolve from wind-cold, malaria, dysentery, cough, and phlegm-fluid retention over a long period. Gradually, morning chills and night fevers, night sweats, seminal emission, hemoptysis, irritability, and dry throat appear. The pathogenesis is too complex to enumerate fully, but essentially involves Yin deficiency with Yang hyperactivity, where Fire Evil burns and scorches. It is most crucial to abstain from sexual desire, minimize speech, clarify the mind, calm thoughts, and practice introspective self-nourishment, so that Yang can subside and Yin can grow. If the condition progresses to hoarseness and muscle wasting, or amenorrhea due to blood exhaustion in women, even Lu Yi (Bian Que) cannot treat it. If the pulse is洪大 (Hóng Dà, large and forceful), it is still treatable; if the pulse is细数急涩 (Xì Shù Jí Sè, thready, rapid, urgent, and choppy), it is difficult to regulate. Treatment should focus on nourishing Yin to suppress Yang, strengthening Water to control Fire, tonifying Blood and benefiting Qi, and harmonizing the Stomach and strengthening the Spleen. Medicines should avoid cold and cool properties, and diet should exclude raw and cold foods.

Main Formula: Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Sheng Di Huang (Rehmanniae Radix), Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Huang Bo (Phellodendri Cortex, salt-fried), Zhi Mu (Anemarrhenae Rhizoma, raw), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium) are used in equal parts. Gan Cao (Licorice Root) is used in half quantity. Add Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus), decoct, and administer with Zhu Li (Bambusae Caulis in Taeniae Succus) and Tong Bian (Urine of healthy child), each half cup, plus two spoons of Jiang Zhi (Ginger Juice).

For night fever, add Gu Pi (Cortex Lycii Radicis) and Qin Jiao (Gentianae Macrophyllae Radix); for day fever, add Dan Pi (Moutan Cortex); for bloody sputum, add Tian Dong, Zi Wan (Asteris Radix), and E Jiao (Colla Corii Asini); for Lung Fire, add Xuan Shen (Scrophulariae Radix), Pian Qin (Scutellariae Radix), Pi Pa Ye (Loquat Leaf), and Shi Gao (Gypsum Fibrosum); for Kidney deficiency, add Shan Yu Rou (Corni Fructus) and Gou Qi Zi (Lycii Fructus); for chest fullness, add Zhi Ke (Aurantii Fructus Immaturus) and Jie Geng (Platycodonis Radix); for lower back pain and weak knees, add Niu Xi (Achyranthis Bidentatae Radix), Du Zhong (Eucommiae Cortex), Po Gu Zhi (Psoraleae Fructus), Shi Hu (Dendrobii Caulis), and Shan Yao (Dioscoreae Rhizoma); for diarrhea, add Lian Rou (Nelumbinis Semen), Bian Dou (Vigna Semen), Shan Yao, and Yi Yi Ren (Coicis Semen); for difficult urination, add Shi Lian Zi (Nelumbinis Plumula), Che Qian Zi (Plantaginis Semen), and Hua Shi (Talcum); for sore throat, add Gan Cao, Jie Geng, and Shan Dou Gen (Sophorae Tonkinensis Radix); for loss of voice, use He Zi (Terminalia Chebulae Fructus, soaked soft, boiled with honey, held in mouth). These modifications should be used in conjunction with treatments for deficiency consumptions.

Yiyang Wan (Suppress Yang Pill): Suitable for early-stage severe Xu Lao where physical flesh has not yet wasted away. The urgent task is to reduce fever. Even if symptoms like diarrhea exist, they are caused by heat; once heat is removed, diarrhea stops. If the disease persists and drug efficacy slows, heat torments day and night, causing blood depletion, water drying, fluid exhaustion, sudden loss of True Yin, and intensified internal heat—akin to a fierce flame! The Metal of the Lung suffers severely, with profuse phlegm-saliva, gradually hoarse voice, and muscle wasting, leading to inevitable death. Stop taking this pill once fever subsides.

Ren Zhong Huang (Human Waste Yellow), Ren Zhong Bai (Human Waste White, finely ground), Bie Jia (Trionycis Carapax, prepared with child's urine or vinegar and ground extremely fine), Qing Hao (Artemisiae Annuae Herba, seeds used in autumn/winter), Dang Gui (each 2 liang), Mai Men Dong (Ophiopogonis Tuber), Di Gu Pi (Cortex Lycii Radicis, each 1.5 liang).
Grind all into powder. Take juice from ten pig gallbladders, mix with water, and make pills the size of mung beans. Take 100 pills per dose, washed down with plain warm water, three times daily. Combining Bie Jia with Gui Jia (Testudinis Carapax et Plastrum) to make glue, mixed with pig bile for pills, is especially excellent.

Huang Qi Yi Sun Tang (Astragalus Benefit Loss Decoction): For various deficiencies in men, women, boys, and girls; Wu Lao and Qi Shang; bone-steaming night sweats; dry throat with cough; spitting blood streaks; alternating chills and fever with red cheeks; confusion and anorexia. Taking hot medicines causes irritability and distension; taking cold medicines causes diaphragmatic blockage and abdominal pain.
Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix), Shi Hu (Dendrobii Caulis), Bai Zhu, Dang Gui, Fu Ling (Poria), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao, Shu Di Huang (Rehmanniae Radix Preparata), Shan Yao, Dan Pi (Moutan Cortex), Mai Dong (each 6 fen), Mu Xiang (Aucklandiae Radix, ground separately), Rou Gui (Cinnamomi Cortex), Gan Cao (each 2 fen), Wu Wei Zi (Schisandrae Fructus, 5 berries).
Chop ingredients. Decoct with 1.5 cups of water, 3 slices of ginger, 1 jujube, 50 grains of wheat, and 1 dried plum. Decoct to 0.7 portion and take.

Bie Jia San (Softshell Turtle Powder): For deficiency consumption with exogenous heat, muscle wasting, irritability, palpitations, night sweats, poor appetite, excessive thirst, cough, and hemoptysis.
Bie Jia, Huang Qi, Qing Hao (clean leaves), Zhi Mu, Qin Jiao, Zi Wan, Di Gu Pi, Yin Chai Hu (Stellariae Radix), Huai Sheng Di Huang, Chi Shao Yao (Paeoniae Radix Rubra), Jie Geng, Gan Cao (equal parts).
Add 3 loquat leaves (de-haired), decoct in water and take. For deficiency, add Ren Shen, Tian Men Dong (Asparagi Radix), Wu Wei Zi, and Fu Ling.

Taiping Wan (Peaceful World Pill): Treats Yin deficiency cough, vomiting, hemoptysis, bone-steaming deficiency consumption, etc. (Can also be taken mixed with plain warm water).
Tian Men Dong, Mai Men Dong, Zhi Mu, Bei Mu (Fritillariae Bulbus), Dong Hua Hua (Kalanchoes Flos), Xing Ren (Pruni Armeniaci Semen Amarum, each 2 liang), Sheng Di Huang, Shu Di Huang, Dang Gui, Huang Lian (Coptidis Rhizoma), E Jiao (each 1.5 liang), Pu Huang (Typhae Pollen, charred), Jing Mo (Chinese Ink, burnt), Jie Geng, Bo He (Menthae Haplocalycis Herba, each 1 liang), She Xiang (Moschus, optional).
Grind into powder, mix with honey, and make pills the size of a dragon eye. Hold in mouth to dissolve slowly.

Xi Jiao Wan (Rhinoceros Horn Pill): Effective for bone-steaming consumption fever.
Xi Jiao Xie (Rhinoceris Cornu Fragment), Bie Jia (crushed), Zhi Ke, Huang Lian (each 1 liang), Long Dan Cao (Gentianae Radix), Bei Mu, Sheng Ma (Bupleuri Radix, each 3 qian), Wu Mei Rou (Pruni Mume Carnositas, 3 liang), Qin Jiao (2 liang), Ruan Chai Hu (Bupleuri Radix, 1.5 liang).
Grind into powder. Steam Wu Mei until soft, pound into paste, add pig bile (2 he), refine honey, pound together, and make pills the size of paulownia seeds. Take 30 pills per dose, washed down with rice water at any time. Avoid pork and amaranth.

Kan Li Gao (Kan-Li Paste): Treats consumption fever, Yin deficiency with fire movement, cough with hematemesis and epistaxis, hemoptysis, wheezing, and night sweats.
Huang Bo (fried), Zhi Mu (each 4 liang), Sheng Di Huang, Shu Di Huang, Tian Dong, Mai Dong (each 2 liang), Xing Ren (cleaned, pounded, 7 qian), Hu Tao Rou (Walnut Kernel, peeled), Feng Mi (Honey, each 4 liang).
First, decoct Huang Bo and Zhi Mu in 8 bowls of child's urine with Ce Bai Ye (Platycladi Cacumen, 2 liang) until reduced to 4 bowls; strain. Then add Tian Dong, Mai Dong, and Di Huang to the liquid, add 2 bowls of water, and decoct to 2 bowls. Pound the remaining dregs finely, add 2 bowls of water, and decoct to 1 bowl. Total liquid obtained: 3 bowls. Pound Xing Ren and Hu Tao Rou into a paste, mix with honey and the liquid, and simmer slowly over low heat until it becomes a paste. Store in porcelain vessels and soak in water for one day to remove fire toxicity. Take several spoons per dose, washed down with Platycladus tea.

Sheng Jin Zhi Sou Gao (Generate Fluids and Stop Cough Paste): Xi Li Zhi (Pear Juice, 10 zhong), Ou Zhi (Lotus Root Juice), Xian Di Huang Zhi (Fresh Rehmannia Juice), Mao Gen Zhi (Imperatae Rhizoma Juice, each 5 zhong), Mai Men Dong Zhi (Ophiopogon Juice), Luo Bo Zhi (Radish Juice, each 2.5 zhong). Filter cleanly, boil in a new clay pot until reduced by half. Add Bai Mi (White Honey, 8 liang), Yi Tang (Malt Sugar, 4 liang), and Jiang Zhi (Ginger Juice, small amount). If blood is present, add Ce Bai Ye (pounded with child's urine), Jiu Zhi (Leek Juice), and Qian Gen Zhi (Rubiae Radix Juice, each half zhong), and boil into a paste. Take half zhong warm per dose.

Simple Prescription: Removes bone-steaming and dispels evil qi. 5 bowls of child's urine, 5 bowls of Qing Hao juice. Boil in a clay pot to 3 bowls, filter, and simmer slowly to 2 bowls. Add 3 pig gallbladders, boil to about half a bowl. Add Gan Cao powder, pound 1000 times, and make pills the size of paulownia seeds. Take 50 pills per dose on an empty stomach with rice water.
Another prescription: 2 zhong of child's urine, 1 zhong of pure wine. Place in a new porcelain vessel with a pair of pig kidneys. Cook overnight in a double boiler. At dawn (fifth watch), eat the kidneys and drink the juice together; more is better. Cooking chicken eggs is also acceptable.
Another: Hu Huang Lian powder (1 qian), taken with honey water. Or Ling Yang Jiao powder (1 qian), taken with warm water.
Another: 1 jin of Sheng Di Huang juice, 4 liang of honey, boiled until thick. Take frequently. Or Ku Shen powder (1 liang), Mang Xiao (Natrii Sulfas, 3 qian), made into honey pills and taken with water.
For insomnia due to deficiency consumption: Suan Zao Ren (Ziziphi Spinosae Semen, 1 liang, fried and pounded), 2 cups of water, squeeze out juice. Add 1 he of Di Huang juice and 2 he of rice. Cook into porridge and eat.