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Gu Lao (Grain Fatigue) refers to a condition where the Stomach receives food and water, but due to deficient Qi, it fails to transform and transport. When grain accumulates while Qi is deficient, it causes lethargy, drowsiness, heaviness and discomfort in the limbs, abdominal fullness, frequent hunger, yet an inability to eat; symptoms worsen after eating. This is caused by the stagnation of Grain Qi.

Chenxiang Tang (Agarwood Decoction)
Herbs: Chen Xiang (Aquilariae Lignum Resinatum), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria, white part), Zinongpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice, each 1 liang), Banxia (Pinelliae Rhizoma, processed with ginger), Ganjiang (Zingiberis Rhizoma).
Usage: Add Shengjiang (Zingiberis Recens Rhizoma) and Dazao (Jujubae Fructus), decoct with water, take 3 qian of the liquid, warm administration, twice daily.
The *Zhou Hou Bei Ji Fang* states: Lying down immediately after a full meal leads to Gu Lao disease, causing heaviness and discomfort in the four limbs, silence, and desire to sleep; symptoms intensify after eating. The treatment uses one sheng of Damai (Hordei Fructus Germinatus), one liang of Jiaojiao (Zanthoxyli Pericarpium), stir-fried together, plus three liang of Ganjiang (Zingiberis Rhizoma), pounded into powder. Each dose is one fangcun bi (a square-inch scoop), taken three times daily.

The *Nei Jing* says: When heat from the Large Intestine transfers to the Stomach, causing excessive appetite with emaciation, it is called Shi Yi (Eating Similarly). The Stomach is the sea of water and grain, responsible for transforming food into qi essence to generate Ying (Nutritive Qi) and Wei (Defensive Qi). If Stomach Qi is harmonious and diet is regulated, blood and qi will be abundant, and skin and flesh will be plump. However, if the Stomach is invaded by pathogenic heat, consuming grain qi and failing to transform food into essence and blood, it results in excessive eating with emaciation. The name "Shi Yi" implies that although one eats, one feels as if hungry. Furthermore, when heat from the Stomach transfers to the Gallbladder, it is also named Shi Yi. Since the Gallbladder belongs to Yang Wood, when heat invades it...

Ganlu Yin (Sweet Dew Decoction) treats Stomach heat causing excessive appetite and failure to generate muscle tissue.
Herbs: Shengdi (Rehmanniae Radix), Shudi (Rehmanniae Radix Preparata), Tiantong (Asparagi Radix), Maimendong (Ophiopogonis Radix), Pianqin (Scutellariae Radix), Shihu (Dendrobii Caulis), Pipaye (Loquat Leaf), Gancao (Glycyrrhizae Radix et Rhizoma), Zhike (Aurantii Fructus Immaturus), Yichen (Artemisiae Scopariae Herba, each 1 liang).
Usage: Decoct these ten herbs with water, take 3 qian of the liquid.

Various hemorrhagic syndromes: If blood rebels upward, it manifests as hematemesis or epistaxis; if depleted internally, it forms Xu Lao (Deficiency Consumption); if flowing backward downward, it presents as hematochezia or hematuria; if heat accumulates in the Bladder, it causes stranguria or bloody urine; if heat penetrates the intestines, it becomes Chang Feng (Intestinal Wind); if Yin deficiency with vigorous Yang pulse, it causes Beng Zhong (Metrorrhagia); if damp-heat steams and stasis occurs, it becomes Li Xia (Dysentery); if extreme heat causes putrefaction, pus and blood appear; if fire reaches its extremity resembling water, the blood color becomes purple-black; if heat surpasses Yin, sores and ulcers develop; if dampness obstructs the blood vessels, painful Bi syndrome occurs; if urticaria appears on the skin, it becomes Cold Bi; if blood stasis accumulates in the upper body, the person tends toward mania; if blood stasis accumulates in the lower body, the person tends toward forgetfulness.
Bleeding from the seven orifices above is called Xue Yi (Blood Overflow); bleeding from the large and small intestines is called Xue Xie (Blood Leakage). However, the *Nei Jing* states: "Overflow leads to posterior blood," meaning blood exiting from below can also be termed "Yi"; one should not be rigidly bound by terminology.
If bleeding appears first, followed by phlegm-cough, it is mostly due to Yin deficiency. If phlegm-cough appears first, followed by bleeding, it is mostly due to Phlegm-Fire accumulation and heat.
For severe hematemesis or epistaxis that does not stop, one must prevent syncope due to blood loss. Burn Maogen (Imperatae Rhizoma) to produce smoke, sprinkle vinegar, and let the patient inhale the vapor to curb the flow. Or, if sudden syncope occurs due to blood deficiency and vertigo, moxibustion is contraindicated, nor should the patient be startled or cry out, as agitation will exploit the deficiency and lead to death. One should decoct Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Shudihuang (Rehmanniae Radix Preparata), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Jingjiesui (Schizonepetae Spica), Gancao (Glycyrrhizae Radix et Rhizoma) each 7 fen, two dates, and one Wumei (Mume Fructus), decoct together and administer.
When using blood-regulating herbs, do not use them singly for stopping or moving blood, nor use purely cold-natured herbs. One must add acrid-warm ascending herbs. If cold herbs are used, they should be decocted or stir-fried with wine, which is the method of "using cold with heat." For chronic hemorrhagic conditions where blood fails to return to its source and long-term medication is ineffective, using Chuanxiong (Ligustici Chuanxiong Rhizoma) as the chief herb yields efficacy. (Danxi.)
For vomiting blood, if the volume is small, there is likely blood stasis in the chest and diaphragm, which should be eliminated first. Sudden use of tonification methods causes blood to become stagnant and hot, often leading to adverse outcomes. My teacher, Mr. Xue Yupiao, treated Lu Yuanbin for hematemesis due to labor injury. Later, the patient became increasingly emaciated, experienced intermittent chills and fever, reduced appetite, slight dry cough, weakness in the four limbs, and reluctance to speak. The teacher prescribed one large Danggui (Angelicae Sinensis Radix), weighing 2 liang, pounded loose with a wooden tool, decocted with aged wine, administered for three doses. Since the patient did not usually drink alcohol, the teacher changed to a half-wine, half-water decoction. Indeed, after three doses, all diseases were cured.