Library

[Background Information]
Book: Bian Zheng Lu (Record of Syndrome Differentiation)
Author: Chen Shiduo
Dynasty: Qing
Chapter: Lao Zhai Men (Diseases of Consumption and Tuberculosis, 17 Cases) (1/3)
Category: Comprehensive

[English Translation]

There are cases where excessive indulgence in sexual activity damages the Kidney essence, leading to soreness and pain in both calves, stiffness and tightness in the waist and back, weakness when walking and standing, nocturnal emission during sleep, sweating in the genital area with flaccidity and impotence, mental fatigue and lassitude, reduced appetite, and a whistling sound in the ears as if hearing the wind. People consider this to be "Chuan Shi" (a contagious chronic wasting disease) causing Lao Zhai (consumption/tuberculosis), but who would know that this is self-injury to the Kidney, representing the initial stage of Lao Zhai?

Generally, people's greed for lust involves various improper practices: engaging in intercourse while standing, indulging after labor, continuing ejaculation before the first has ceased, exerting oneself again without rest after fatigue, forcing union when desire has not yet arisen, seeking pleasure despite exhaustion, taking aphrodisiacs due to varying constitutions, learning techniques to entertain the mind despite inadequate sexual capacity, engaging in intercourse after suffering from epidemics or hard labor, or using sex to forget worries caused by mental exhaustion. A single night of joy can result in a lifelong illness. This originates not from having many partners or frequent emissions, but from a lack of moderation, which immediately leads to consumption. It inevitably results in blood loss, accompanied by expectoration, cough, night sweats with fever, aversion to cold and heat, symptoms resembling malaria but not being malaria, a sensation in the chest that feels like hunger but is not, and pain that feels real but is not. Regarding diet, one cannot eat much, nor can one digest food properly. Emotional instability and disordered thoughts lead to bone-steaming fever (heat emanating from the bones) and internal fire movement. The patient may seek to vent the fire through sexual desire, becoming aroused by sights, experiencing nocturnal emissions with dreams of sexual intercourse with spirits ("Gui Jiao"), and losing control. Thus, chills and fever occur, and "Lao worms" (pathogenic factors associated with tuberculosis) are generated within the bone marrow. Procrastination leads to death, which is deeply sorrowful.

The treatment method should replenish the deficiency of true essence, strengthen the decline of Stomach Qi, and add herbs that kill parasites. How could a dying person not be curable?

Prescription: Jiu Zhai Tang (Rescue Consumption Decoction)
Prepared Rehmannia Root (Shu Di Huang) - 5 qian
White Peony Root (Bai Shao) - 2 qian
Chinese Yam (Shan Yao) - 2 qian
Glehnia Root (Sha Shen) - 3 qian
Lycium Bark (Di Gu Pi) - 5 qian
Ophiopogon Tuber (Mai Dong) - 2 qian
Schisandra Berry (Bei Wu Wei Zi) - 10 berries
Codonopsis Root (Ren Shen) - 5 fen
Anemone Root (Bai Wei) - 5 fen
White Mustard Seed (Bai Jie Zi) - 1 qian
Tartar Shell (Bie Jia) - 1 qian
Poria (Fu Ling) - 1 qian

Decoct in water and take orally. After ten doses, the worms die; after twenty doses, Stomach Qi opens significantly. Continuous administration for two months gradually restores vitality. Cure is achieved after one year of use, provided sexual desires are completely abstained from.

This formula primarily nourishes Yin, with a small amount of Codonopsis to assist Stomach Qi, thus avoiding the cloying nature of Yin-nourishing herbs. Even the anti-parasitic herbs used are not comparable to toxic substances like wolf or tiger parts; they eliminate pathogens invisibly, offering benefit without harm. Although the formula appears ordinary, its combination is exquisite, possessing miraculous efficacy for treating initial-stage consumption.

For this syndrome, Jiu Bai Tang (Rescue Failure Decoction) is also effective.
Lycium Bark (Di Gu Pi)
Moutan Cortex (Dan Pi) - 5 qian each
Codonopsis Root (Ren Shen) - 3 fen
White Peony Root (Bai Shao) - 3 qian
Chinese Yam (Shan Yao) - 1 liang
Licorice Root (Gan Cao) - 2 fen

Decoct in water and take orally.

While the previous formula is excellent for the prior condition, many people suffer from kidney injury leading to such diseases. One formula may not suffice for all cases. I have received transmission from an unusual master, who provided another highly effective formula for these conditions, which I record here. The master stated that for kidney injury causing Lao worms, one must first kill the worms, then use kidney-tonifying herbs. Otherwise, merely tonifying essence is futile. If the worms remain, the generated essence only serves the worms, enhancing their power. Therefore, killing worms first and then nourishing Yin is superior. However, most anti-parasitic herbs damage Yin further. My formula differs: it kills worms without damaging Yin and aids the stomach.

Formula Name: Qu Sui Dan (Expel Evil Spirits Pill)
Eel (one piece, weighing 6 liang)
Huai Chinese Yam (Huai Shan Yao) - 3 liang
Euryale Seed (Qian Shi) - 1 liang

Boil in water until extremely soft. Add a little green salt and consume. Do not eat rice afterward. Finish the entire portion in one day, including the broth. After one course, repeat every seven days according to the same method. After three courses, worms in the bones will die. Then, use Qi Zhai Tang (Rise Consumption Decoction):
Codonopsis Root (Ren Shen) - 1 qian
Poria (Fu Ling) - 3 qian
Ophiopogon Tuber (Mai Dong) - 3 qian
Schisandra Berry (Bei Wu Wei Zi) - 10 berries
Raw Sour Jujube Seed (Sheng Zao Ren) - 2 qian
Prepared Rehmannia Root (Shu Di Huang) - 5 qian
Cornus Fruit (Shan Zhu Yu) - 2 qian
Morinda Root (Ba Ji Tian) - 2 qian
White Peony Root (Bai Shao) - 1 qian
White Mustard Seed (Bai Jie Zi) - 5 fen
Glehnia Root (Sha Shen) - 1 qian

Decoct in water and take orally. After one month, essence gradually strengthens. After another month, full recovery occurs.

This formula is plain yet extraordinary. The previous formula was extraordinary yet plain. Both were transmitted by the unusual master. I dare not conceal them and wish to share them with the world to save those with initial kidney consumption.

Some patients experience frequent waking with fright at night, constant fear, a feeling of insecurity in the heart, weak breathing as if about to cease, frequent erotic dreams, increasing night sweats, tasteless food, mouth ulcers, chest irritability, general weakness, desire for sleep, lips appearing red like vermilion, malar flush like rouge, hot palms and soles, dry fluids and parched saliva. People believe this is Kidney Meridian consumption, but who knows it is Kidney disease transmitting to the Heart, where the Heart initially suffers?

When the Heart Palace is tranquil, evil cannot invade. If evil invades the Heart, the Spirit escapes outward. Kidney consumption generates worms; invisible evil qi invading the Heart is incurable, let alone有形 (tangible) worms penetrating deeply. Although worms are tangible, their Qi is intangible. Since Kidney Qi communicates with the Heart, how can Kidney worm Qi not ascend to the Heart? Worm Qi differs from Kidney Qi. Kidney Qi benefiting the Heart brings advantage; Worm Qi harming the Heart brings damage. Why must worms enter the Heart for it to become diseased? Treatment need not focus on the Heart; treating the Kidney suffices. However, if only the Kidney is treated while worms remain, Worm Qi persists in the Kidney, and the Heart still suffers. Thus, saving the Heart requires nourishing the Kidney, and nourishing the Kidney requires killing worms.

Prescription: Qi Zhai Zhi Shen Tang (Extraordinary Efficacy Decoction for Rising Consumption)
Prepared Rehmannia Root (Shu Di Huang) - 1 liang
Cornus Fruit (Shan Zhu Yu) - 5 qian
Ophiopogon Tuber (Mai Dong) - 1 liang
Poria (Fu Ling) - 5 qian
Chinese Yam (Shan Yao) - 5 qian
Euryale Seed (Qian Shi) - 3 qian
Cinnamon Twig (Rou Gui) - 3 fen
Atractylodes Macrocephala Rhizome (Bai Zhu) - 3 qian
Eucommia Bark (Du Zhong) - 1 qian
Tartar Shell (Bie Jia) - 5 qian
Stemona Root (Bai Bu) - 2 qian

Decoct in water and take orally. After ten consecutive doses, Lao worms die. After one more month, Kidney Qi flourishes and Heart Qi calms. After another month, full recovery is achieved.

This formula entirely tonifies the Kidney and calms the Heart. Only Tartar Shell and Stemona Root kill worms. Tartar Shell penetrates deeply, guiding Stemona into the deepest Yin levels. It nourishes Yin without damaging marrow. Worms perceive it as nourishment, unaware it is lethal. Once worms die, no abnormal Qi remains in the Kidney, benefiting the Heart. Supported by Ophiopogon, Poria, and Atractylodes, peace and stability are established in the Heart Palace.

For this syndrome, An Yang Tang (Peace and Nourish Decoction) is also effective.
Codonopsis Root (Ren Shen)
Stemona Root (Bai Bu) - 1 qian each
Chinese Yam (Shan Yao) - 1 liang
Licorice Root (Gan Cao) - 3 fen
Ophiopogon Tuber (Mai Dong) - 5 qian
Schisandra Berry (Bei Wu Wei Zi) - 10 berries
Atractylodes Macrocephala Rhizome (Bai Zhu) - 2 qian
Poria with Hostwood (Fu Shen) - 3 qian

Decoct in water and take orally.

Some patients suffer from coughing with phlegm, rebellious Qi causing asthma, worsening when lying down, dry nose and mouth unable to detect odors, occasional detection of even fragrant smells as putrid, nausea, dry skin, intermittent pain, sensation of worms crawling in lung tubes, fine scaling skin resembling bran. People believe this is Lung Meridian consumption, but who knows it is Heart consumption transmitting to the Lung?

The Lung is a delicate organ, most averse to Qi restriction. If Heart Fire normally restricts the Lung, the Lung suffers; how much more so if corpse-worm Qi transfers to restrict the Lung? Lung Qi injury stems from Heart Fire. When the Heart is injured by Worm Qi, it cannot spare Worm Qi to attack the Lung. Instead, despising Worm Qi invasion, the Heart transfers Worm Qi to the Lung to avoid toxicity. Furthermore, the Lung is the Mother of the Kidney; since Lung naturally communicates with the Kidney, why shouldn't Kidney Worm Qi communicate with the Lung? This mutual invasion between Heart and Kidney makes consumption more severe than Kidney-to-Heart transmission. Eliminating Worm Qi in the Heart is less effective than eliminating it at its source in the Kidney. However, with both Heart and Kidney injured, eliminating worms in both meridians requires medicine passing through the Stomach first. If Stomach Qi fails before worms are killed, Lung Metal loses its source of transformation, which is poor treatment. The method should strengthen the Stomach to distribute fluids, benefiting Heart and Kidney without harming the Stomach, allowing worms to be eradicated.

Prescription: Jian Tu Sha Chong Tang (Strengthen Earth Kill Worms Decoction)
Atractylodes Macrocephala Rhizome (Bai Zhu) - 5 qian
Codonopsis Root (Ren Shen) - 2 qian
Anemone Root (Bai Wei) - 2 qian
Wannianqing (Periwinkle/Vinca herb) - 1 slice
Prepared Rehmannia Root (Shu Di Huang) - 1 liang
Ophiopogon Tuber (Mai Dong) - 1 liang
Cornus Fruit (Shan Zhu Yu) - 3 qian
Raw Sour Jujube Seed (Sheng Zao Ren) - 3 qian
Plantago Seed (Che Qian Zi) - 2 qian
Fritillaria Bulb (Bei Mu) - 1 qian

Decoct in water and take orally. After two doses, asthma stabilizes slightly. After two more doses, cough lightens. After two more doses, sense of smell returns. After two more doses, pain stops. Full recovery after three months.

This formula tonifies Stomach Qi without aiding Yang, eliminates Worm Qi without damaging fluids. Kidney controls Heart, preventing Heart Fire from attacking the Lung. It is a superb method for treating consumption transmitting to the Lung.

For this syndrome, Hu Fei Yin (Protect Lung Infusion) is also good.
Atractylodes Macrocephala Rhizome (Bai Zhu)
Codonopsis Root (Ren Shen)
Lily Bulb (Bai He) - 2 qian each
Anemone Root (Bai Wei)
Asparagus Tuber (Tian Dong) - 1 qian each
Ophiopogon Tuber (Mai Dong) - 3 qian
Winter Flower Bud (Kuan Dong Hua) - 5 fen
Trichosanthes Root (Tian Hua Fen)
Platycodon Root (Jie Geng) - 6 fen each

Decoct in water and take orally.

Some patients have dim vision, pale complexion, dull pain in both hypochondriac regions, acid regurgitation when hot, vomiting when cold, phlegm resembling nasal discharge (clear or yellow) with foul odor, dry and gritty eyes, desire to keep eyes closed, restless sleep, frequent fright and terror. People believe this is Liver Meridian consumption, but who knows it is Lung consumption transmitting sequentially to the Liver?

Metal restricts Wood. If Liver Wood is strong, Lung Metal cannot restrict it. However, after Kidney consumption, Liver Wood lacks nourishment and becomes weak. Lung takes advantage of this weakness, transferring Worm Qi to the Liver. Unable to resist, the Liver accepts the Worm Qi. As the Child of the Kidney, when the Kidney sees its child infected, fearing Liver Qi insufficiency, it transfers Kidney Qi to generate Liver Qi. Worm Qi follows this transfer into the Liver. Worms erode Liver Blood, leaving the Liver unable to nourish itself. Treatment must rescue the Kidney to generate the Liver, and generate the Liver to kill worms.

Prescription: Yuan Zhai Tang (Support Consumption Decoction)
White Peony Root (Bai Shao) - 1 liang
Angelica Sinensis Root (Dang Gui) - 1 liang
Prepared Rehmannia Root (Shu Di Huang) - 1 liang
Cornus Fruit (Shan Zhu Yu) - 5 qian
Poria (Fu Ling) - 5 qian
Tartar Shell (Bie Jia) - 5 qian
Anemone Root (Bai Wei) - 2 qian

Decoct in water and take orally. After ten doses, slight recovery. After twenty doses, greater recovery. Full recovery after three months.

This is a formula treating both Liver and Kidney. Only Tartar Shell and Anemone Root kill worms; they are neither cold nor hot, avoiding bias, capable of tonification and attack, achieving completeness. They kill worms invisibly, reviving the nearly dead. Some argue that green-yellow phlegm requires expectorants. However, if worms enter Kidney and Liver, merely rescuing these meridians is insufficient to save life. Moreover, expectorants damage Spleen and Stomach. With Liver already invaded by worms, intending to transmit to Spleen, further damage invites worms into the Middle Jiao (Spleen/Stomach). Therefore, it is better to strongly tonify Liver and Kidney, allowing phlegm to resolve naturally, rather than lightly using expectorants to re-injure the Spleen and Stomach.

For this syndrome, Liao Zhai Tang (Treat Consumption Decoction) is also good.
White Peony Root (Bai Shao)
Prepared Rehmannia Root (Shu Di Huang) - 5 qian each
Angelica Sinensis Root (Dang Gui) - 4 qian
Tartar Shell (Bie Jia) - 3 qian
Eel Bone (burned to ash) - 3 fen
Schisandra Berry (Bei Wu Wei Zi) - 10 berries

Decoct in water and take orally.

Some patients experience chest fullness and oppression, indigestion, continuous phlegm production, frequent loose stools, abdominal pain and distension, borborygmus when empty, dry and cracked lips and mouth, dry and bristly hair, yellow-black complexion, slight shortness of breath with difficulty continuing, black stool resembling juice, green phlegm resembling nasal discharge. People believe this is Spleen Meridian consumption, but who knows it is Liver consumption transmitting to the Spleen?

Consumption transmitting to the Spleen among the five Zang organs is generally incurable, and no specific method for Spleen consumption is usually established. However, if a thread of Stomach Qi remains, survival is possible in an instant. Spleen and Stomach are exterior-interior pairs; Stomach failure means Spleen failure, leaving no hope. But if Spleen fails while Stomach remains, there is still vitality. One should not attribute this to fate just because Liver worms enter the Spleen. Since beginning practice, I saved a woman with this syndrome. Her pulse was thready and rapid. Doctors deemed it terminal consumption transmitting to Spleen. Her husband abandoned her. Seeing she could still taste food, I told her husband: "Your wife has a thread of hope; how can you bear to watch her die without helping?" He replied: "Doctors gave up; it is not that I do not want her to live." I advised single administration of Er Bai San (Two Whites Powder):
Chinese Yam (Shan Yao)
Euryale Seed (Qian Shi) - equal parts, approx. 4 jin each
Wannianqing (Periwinkle/Vinca herb) - 4 large slices

Stir-fry separately, grind to fine powder, mix with 1 jin white sugar, and take with boiling water.
Use whenever hungry, regardless of frequency. The woman happily followed the method, consuming five large bowls on the first day. For about five months, daily usage restored Spleen Qi gradually, resulting in survival. Asked total consumption, it was approx. 100 jin. She later thanked me. I recorded this to aid medical methods. These two herbs strengthen Spleen and especially Kidney. Treating both yields success. Wannianqing kills worms invisibly; mixed with them, worms perish unknowingly. This formula treats Spleen consumption specifically but requires patience for delayed results. Adding 2 liang Codonopsis to boost Stomach Qi would make Stomach Qi stronger and Spleen Qi easier to rescue.

For this syndrome, Yuan Que Tang (Support Timidity Decoction) is also wonderful.
Atractylodes Macrocephala Rhizome (Bai Zhu)
Chinese Yam (Shan Yao) - 1 liang each
Poria (Fu Ling) - 3 qian
Codonopsis Root (Ren Shen) - 3 qian
Euryale Seed (Qian Shi) - 5 qian
Anemone Root (Bai Wei) - 1 qian
Eel Bone Powder - 5 fen
Cinnamon Twig (Rou Gui) - 3 fen

Decoct and take mixed.

Some patients with Yin deficiency and fire movement experience nightly fever like fire, cooling by dawn, intermittent sweating, sensation of internal inflammation in bone marrow, reduced appetite, frothy white phlegm. People believe this is bone-steaming consumption, but who knows it is Kidney Water failing to control Fire?

Water and Fire in the Kidney must be balanced. Excess Fire indicates Insufficient Water. Bone-steaming disease arises precisely from Fire flourishing and Water declining. Treatment need not drain Kidney Fire; simply tonify Kidney Water. When Water is sufficient to balance Fire, the Kidney is not hot, and bone marrow内外 (inside and outside) cannot be hot.

Prescription: Liang Sui Dan (Cool Marrow Pill)
Lycium Bark (Di Gu Pi) - 1 liang
Moutan Cortex (Dan Pi) - 1 liang
Ophiopogon Tuber (Mai Dong) - 5 qian
Dendrobium Stem (Jin Cha Shi Hu) - 3 qian
Achyranthes Root (Niu Xi) - 2 qian
Poria (Fu Ling) - 2 qian

Decoct in water and take orally. After four consecutive doses, internal heat lightens. After four more doses, internal heat disappears. Full recovery after one month.

This formula uses Lycium Bark and Moutan Cortex not only to tonify Kidney Water but also to cool bone marrow and clear bone-external blood. Heat in bone marrow consumes external blood; heat in external blood scorches bone marrow. Using both treats marrow and blood simultaneously, avoiding excessive heat. Dendrobium and Achyranthes tonify Kidney Yin. When Yin flourishes, Yang balances; when Water prevails, Fire retreats. Bone-steaming ceases, and consumption cannot form.

For this syndrome, Chun Yin Tang (Pure Yin Decoction) is also good.
Scrophularia Root (Xuan Shen)
Ophiopogon Tuber (Mai Dong)
Moutan Cortex (Dan Pi)
Lycium Bark (Di Gu Pi)
Prepared Rehmannia Root (Shu Di Huang) - 3 qian each

Decoct in water and take orally.

Some patients with Qi deficiency experience shortness of breath insufficient for respiration, distinct from physical exertion-induced急促 (rapid breathing). They are reluctant to speak, find food tasteless, feel body heaviness and fatigue. People believe this is Qi consumption, but who knows it is Yang deficiency sinking due to internal injury to Primordial Qi?

Primordial Qi resides in Guan Yuan, connecting upward to the Lung and downward to the Kidney. If uninjured, True Yang rises to the Lung, strengthening Lung Qi, executing clearing and descending functions, distributing among Five Zang and Seven Fu organs. If injured, True Yang cannot rise and sinks into extreme Yin, generating heat. This is Deficiency Heat, not Excess Heat. Excess Heat is purged; Deficiency Heat is tonified. Thus, sweet-warm herbs are used to reduce deficiency heat. However, using only sweet-warm herbs without lifting herbs to raise sinking Yang causes Yang to sink into Yin, making Qi unlifted; tonifying Qi is useless. Even with lifting herbs, without tonifying Qi, lifting force is weak, and Qi cannot be easily raised.

Prescription: Bu Zhong Yi Qi Tang (Tonify Middle and Augment Qi Decoction)
Codonopsis Root (Ren Shen) - 5 qian
Atractylodes Macrocephala Rhizome (Bai Zhu) - 5 qian
Prepared Astragalus Root (Zhi Huang Qi) - 3 qian
Angelica Sinensis Root (Dang Gui) - 3 qian
Tangerine Peel (Chen Pi) - 5 fen
Licorice Root (Gan Cao) - 5 fen
Cimicifuga Rhizome (Sheng Ma) - 2 fen
Bupleurum Root (Chai Hu) - 3 fen
Add Fritillaria Bulb (Bei Mu) - 1 qian

Decoct in water and take orally. After one dose, Qi rises. After two doses, Qi flourishes. After ten doses, strength returns, Stomach Qi opens, and previous illness vanishes instantly.

Bu Zhong Yi Qi Tang embodies Li Dongyuan's lifelong scholarship. Its brilliance lies in using Bupleurum and Cimicifuga within Codonopsis, Atractylodes, Astragalus, and Angelica. One rotates left to lift Heart, Liver, and Kidney Qi; one rotates right to lift Lung, Spleen, Stomach, and Mingmen Qi. It does not merely lift Upper and Middle Jiao Qi.

For this syndrome, Ti Xian Tang (Raise Sunken Decoction) is also effective.
Astragalus Root (Huang Qi)
Ophiopogon Tuber (Mai Dong) - 5 qian each
Atractylodes Macrocephala Rhizome (Bai Zhu)
Codonopsis Root (Ren Shen) - 2 qian each
Licorice Root (Gan Cao) - 3 fen
Platycodon Root (Jie Geng) - 1 qian
Medicated Leaven (Shen Qu) - 5 fen

Decoct in water and take orally.

Some patients with Blood deficiency present with pale complexion, burnt/dried muscles, dry large intestine, palpitations, forgetfulness, insomnia, poor appetite, emaciation, night fever without sweat. People believe this is Blood consumption, but who knows it is Liver dryness generating Fire?

Liver Fire flourishing often leads to self-burning, ultimately due to Kidney Water failing to generate Wood. It is either blood loss externally or blood consumption internally. Liver dryness generates Fire within Wood. While Fire in Heart benefits from Liver Wood, Fire in Liver burns itself. Thus, Fire in Heart draws support from Liver, but Fire in Liver is preoccupied with self-preservation. Treatment must first address the Kidney, and addressing the Kidney requires tonifying Water.

Prescription:
Scrophularia Root (Xuan Shen) - 1 liang
Moutan Cortex (Dan Pi) - 5 qian
Glehnia Root (Sha Shen) - 5 qian
White Peony Root (Bai Shao) - 1 liang
Angelica Sinensis Root (Dang Gui) - 5 qian
Chrysanthemum Flower (Gan Ju Hua) - 3 qian
Poria (Fu Ling) - 3 qian
Ophiopogon Tuber (Mai Dong) - 5 qian

Decoct in water and take orally. After ten doses, night fever resolves. After twenty doses, dryness clears. After thirty doses, all illnesses heal.

Named Zi Gan Yin (Nourish Liver Infusion), it actually tonifies Kidney to nourish Liver. With Kidney Water nourishment, Liver Wood Fire does not flare, preventing self-burning and consumption.

For this syndrome, Jia Jian Si Wu Tang (Modified Four Substances Decoction) is used:
White Peony Root (Bai Shao)
Angelica Sinensis Root (Dang Gui)
Rehmannia Root (Sheng Di Huang) - 5 qian each
Prepared Rehmannia Root (Shu Di Huang) - 1 liang
Moutan Cortex (Dan Pi) - 3 qian

Decoct in water and take orally.

Some patients excessively indulge in roasted, fried, and grilled foods, fragrant and fatty items, eating indiscriminately, leading to indigestion, chest fullness, prolonged...