论曰∶古书有五劳、六极、七伤，皆由劳伤过度，或五脏六腑互相克贼，一脏偏损，五
行逆伏，以致尽绝，皆谓之虚劳也。
若日顿羸瘦，短气，腰背牵急，膝胫酸痿，小便或赤或白而浊，夜梦纷纭，或梦鬼交，
翕翕如热，骨肉烦疼，由房劳过度，或思虑过多，皆伤神耗精之由，得之心肾，其脉细促。
大骨枯者不治，微弱者可治，脉大数甚不能食者死，大建中汤主之。
大建中汤（见前发热门）。
论曰∶百病皆生于气，其始必由喜、怒、悲、忧、惊、恐，由是变生，形证不一。若其
气起于一边，或左或右，循行上下，或在肌肉之间，如锥刀所刺，其气不得息，令人腹中满
由惊恐恚怒，或冒寒热，留而不去，为郁伏之气，因气流行，随经上下相搏痛，久久令人
闷，其脉短涩，谓之聚气，七气汤、趁痛散主之。
七气汤 杨仁斋《直指方》云∶治七情相干，阴阳升降，气道壅滞，攻冲作疼。
京三棱 蓬莪术 青橘皮 香附子（去毛） 陈橘皮（洗） 桔梗 藿香叶 桂（取
心）
益智（各一两半） 甘草（炙，三钱。）胡氏（《经效方》有沉香半两，无陈橘皮）
上为散。每服五钱，水二盏，生姜二片，枣二枚，煎至一盏，食前温服。
趁痛散 《可用方》云∶治气搏作痛，肌肉之间如锥刀所刺，胸膈痞闷。
蓬莪术（炮） 桂心（各一两） 槟榔 附子（炮，去皮脐） 细辛（去苗， 各半两）
芫花
（炒，别为末，一钱）
上除芫花外，共为末。每服三大钱，水一盏，煎至七分，去滓，调芫花末一字，温服。
若心下似硬，按之即无，常觉膨胀，多食则吐，气引前后，噫气不除，由思虑过多，气
不以时而行则气结。又曰，思则心有所存，神有所归，正气留而不行，其脉涩滞，谓之结气
参橘丸主之。
参橘丸
橘皮（四两，洗） 人参（一两）
上为细末，炼蜜和丸，如梧桐子大。米饮下三十丸，食前服。
若咽中如核，咽之不下，吐之不出，久不治之，渐妨于食。或由思虑不常，气结不散，
或因饮食之间，气道卒阻，因而留滞。因气者，谓之气噎，其脉缓涩。因食者，谓之食噎，
其脉短涩。气噎，嘉禾散主之。食噎，神曲丸主之。
嘉禾散（方缺）。
神曲丸
神曲（炒，一两） 橘皮（洗，二两）
上为细末，炼蜜和为丸，如鸡豆大。每服一粒，含化咽津。
若痛而游走，上下无常处，脉亦聚散，或促或涩，谓之游气，术香散主之，不止者，
延胡散主之。
术香散
蓬莪术（炮，一两） 人参（一分） 木香（一钱）
上为细末。醋汤调方寸匕。
延胡散
延胡索（炒） 当归（洗，等分）
上为细末。醋汤调方寸匕。
若自咽嗌以下至脐，左右气各不相通，气上奔急攻，右臂痛如斧槌，肌肉日消，浆粥不
下，心中懊闷，由肺经本受寒邪，留于右边，以肺在右，或因以大热药攻寒，寒本在于经而
不能散发，于是火气但逼于肺，肺燥则气上迫。但解药毒，然后理肺，先宜炙肝散，后宜理
气汤。
炙肝散
牡丹皮 柴胡 芍药（各一两） 白术（二两）
上为细末。用猪肝三指许，薄批，掺药末二钱，慢火炙熟，细嚼，米饮下，食前服。
理气汤（疑即前七气汤。）
柏子仁丸 史载之《指南方》多楮实一两。治臂痛不能屈伸，筋脉挛拘。
柏子仁（炒，研） 干地黄（各二两） 茯苓 枳实（麸炒，去瓤） 桂（取心） 五
味子 附
子（炮
香黄
（各
上为细末，炼蜜和丸，如梧桐子大。酒下三十丸，空心服。
若腹胁有块，大小成形，按之不动，推之不移，久久令人寒热如疟，咳嗽，面目浮肿，
动辄微喘，日就羸瘦，由暴怒或惊恐，气上而不下，动伤于肝，气结聚成形，始得之在肝，
其脉牢大而结，不传可治，沉香煎主之。
沉香煎
石斛（五两） 椒（去目，炒出汗） 附子（炮，去皮脐） 秦艽（去土） 鳖甲（煮，
刮去筋
膜，炙） 柴胡（去苗） 沉香 木香 槟榔 黄 （各二两）
上为末，先用枸杞根新者十斤，净洗槌碎，好酒二斗，煮至七升，取出枸杞，别用好酒
三升，拍洗令净，漉去滓，滤过，并于前煎酒内，更入熟蜜四两，再熬成膏，和药末，丸如
梧桐子大。饮下二十丸，食前服。
论述说：古书中有五劳、六极、七伤的说法，这些都是由于过度劳累损伤，或者五脏六腑之间互相克制侵害，导致某一脏器偏颇受损，五行之气逆乱潜伏，最终致使生机断绝，这些都称为虚劳。
如果日渐消瘦羸弱，气短，腰背牵引拘急，膝盖和小腿酸软痿废，小便颜色或红或白且浑浊，夜间梦境纷乱繁杂，或者梦见鬼怪交合，身体忽冷忽热像有热气一样，骨肉烦扰疼痛，这是由于房事过度，或者思虑过多，都是损伤神志、耗竭精气的缘故，病位在心肾，脉象细而急促。
大骨枯槁的属于不治之症，脉象微弱的可以治疗，脉象大而数且不能进食的会死亡，用大建中汤主治。
大建中汤（见前文发热门）。
论述说：百病都产生于气，其起始必然由喜、怒、悲、忧、惊、恐引起，由此变化而生，形体和证候表现不一。如果气从身体的一侧发起，或左或右，循行上下，或在肌肉之间，像被锥刀刺割一样，气机不得舒缓，使人腹部胀满。这是由于惊恐愤怒，或者感受寒热邪气，留滞不去，成为郁伏之气，随着气机的流行，沿着经络上下相搏结而疼痛，久而久之使人感到闷塞，脉象短涩，这称为聚气，用七气汤、趁痛散主治。
七气汤 杨仁斋在《直指方》中说：治疗七情相互干扰，阴阳升降失常，气道壅滞，攻冲作痛。
京三棱 蓬莪术 青橘皮 香附子（去毛） 陈橘皮（洗净） 桔梗 藿香叶 桂（取桂心）
益智仁（各一两半） 甘草（炙，三钱。）胡氏（《经效方》中有沉香半两，无陈橘皮）
以上药物研为散剂。每次服用五钱，用水二盏，生姜两片，大枣两枚，煎煮至一盏，饭前温服。
趁痛散 《可用方》中说：治疗气机搏结作痛，肌肉之间像锥刀刺割，胸膈痞闷。
蓬莪术（炮制） 桂心（各一两） 槟榔 附子（炮制，去皮脐） 细辛（去苗，各半两）
芫花
（炒，另研为末，一钱）
以上除芫花外，共同研为末。每次服用三大钱，用水一盏，煎煮至七分，去渣，调入芫花末一字，温服。
如果心下感觉好像硬实，按压时却无硬块，常觉膨胀，多吃则呕吐，气引动前后（大小便），嗳气不止，这是由于思虑过多，气不按时运行而导致气结。又说，思虑则心神有所存守，正气留滞而不行，脉象涩滞，这称为结气，用参橘丸主治。
参橘丸
橘皮（四两，洗净） 人参（一两）
以上研为细末，用炼蜜调和制成丸药，如梧桐子大小。米饮送下三十丸，饭前服用。
如果咽喉中如有核状物，咽不下去，吐不出来，久治不愈，逐渐妨碍饮食。这可能是由于思虑无常，气结不散，或者是由于饮食之间，气道突然阻塞，因而留滞。因气引起的，称为气噎，脉象缓涩。因食引起的，称为食噎，脉象短涩。气噎，用嘉禾散主治。食噎，用神曲丸主治。
嘉禾散（方剂缺失）。
神曲丸
神曲（炒，一两） 橘皮（洗净，二两）
以上研为细末，用炼蜜调和制成丸药，如鸡豆大小。每次服用一粒，含化咽津。
如果疼痛游走不定，上下没有固定位置，脉象也聚散无常，或促或涩，这称为游气，用术香散主治，无效者，用延胡散主治。
术香散
蓬莪术（炮制，一两） 人参（一分） 木香（一钱）
以上研为细末。用醋汤调服方寸匕。
延胡散
延胡索（炒） 当归（洗净，等分）
以上研为细末。用醋汤调服方寸匕。
如果自咽喉以下至肚脐，左右两侧气机互不相通，气向上奔急攻冲，右臂疼痛如斧槌打击，肌肉日渐消损，浆粥无法下咽，心中懊恼闷乱，这是由于肺经原本受寒邪侵袭，留滞在右边，因为肺位于右侧，或者是由于用大热药攻逐寒邪，寒邪本在于经脉而不能散发，于是火气只逼迫于肺，肺燥则气上迫。只要解除药毒，然后调理肺气，先宜用炙肝散，后宜用理气汤。
炙肝散
牡丹皮 柴胡 芍药（各一两） 白术（二两）
以上研为细末。用猪肝三指许厚薄切片，撒上药末二钱，用慢火烤熟，细细咀嚼，米饮送下，饭前服用。
理气汤（怀疑即前文的七气汤。）
柏子仁丸 史载之在《指南方》中多用楮实子一两。治疗臂痛不能屈伸，筋脉挛急拘紧。
柏子仁（炒，研碎） 干地黄（各二两） 茯苓 枳实（麸炒，去瓤） 桂（取桂心） 五味子 附子（炮制
香黄
（各
以上研为细末，用炼蜜调和制成丸药，如梧桐子大小。酒送下三十丸，空腹服用。
如果腹胁部有肿块，大小成形，按压不动，推之不移，久而久之使人出现寒热如疟疾的症状，咳嗽，面目浮肿，动辄轻微气喘，日渐消瘦羸弱，这是由于暴怒或惊恐，气向上而不向下，动伤肝脏，气结聚形成有形之物，起初病位在肝，脉象牢大而结，若不传变则可治疗，用沉香煎主治。
沉香煎
石斛（五两） 椒（去目，炒出汗） 附子（炮制，去皮脐） 秦艽（去土） 鳖甲（煮，刮去筋膜，炙） 柴胡（去苗） 沉香 木香 槟榔 黄芩（各二两）
以上研为末，先用新的枸杞根十斤，洗净捣碎，用好酒二斗，煮至七升，取出枸杞，另外用好酒三升，拍洗令净，滤去渣滓，过滤后，并入前面的煎酒内，再加入熟蜜四两，再次熬成膏，和入药末，制成如梧桐子大小的丸药。饮送下二十丸，饭前服用。
It is stated: Ancient texts mention five labors (Wu Lao), six extremes (Liu Ji), and seven injuries (Qi Shang). These are all caused by excessive labor and injury, or by mutual overacting among the Zang-Fu organs. When one organ is disproportionately damaged, the Five Elements become reversed and stagnant, leading to exhaustion of vitality. All such conditions are referred to as Deficiency Consumption (Xu Lao).
If a patient becomes increasingly emaciated and weak, suffers from shortness of breath, pulling tension in the lower back, soreness and flaccidity of the knees and calves, turbid urine that may be red or white, vivid and chaotic dreams including nocturnal emissions with dream imagery of sexual intercourse, alternating sensations of heat and chills, and vexing pain in the bones and muscles, these result from excessive sexual activity or excessive mental worry. Such factors damage the Spirit (Shen) and deplete Essence (Jing). The pathology lies in the Heart and Kidney, presenting with a fine and rapid pulse (Xi Cu Mai).
If the large bones are withered, it is incurable; if the pulse is weak but present, it is treatable. If the pulse is large and very rapid and the patient cannot eat, death will ensue. This should be treated with Da Jian Zhong Tang (Greatly Building the Middle Decoction).
Da Jian Zhong Tang (See Fever Chapter above).
It is stated: All diseases arise from Qi. Initially, this stems from joy, anger, sorrow, worry, fright, or fear, which then transform into various physical signs and symptoms. If Qi originates on one side, either left or right, circulating up and down, or residing between the muscles, causing pain like stabbing with an awl or knife, and the Qi feels obstructed, leading to abdominal fullness, this is due to fright, anger, or exposure to cold and heat pathogens that remain stagnant. This forms stagnant Qi. As Qi circulates, it clashes along the meridians up and down, causing pain. Over time, this leads to a feeling of oppression. The pulse is short and choppy. This is called Accumulated Qi (Ju Qi), treated with Qi Qi Tang (Seven Emotions Decoction) or Chen Tong San (Pain-Relieving Powder).
Qi Qi Tang: Yang Renzhai in *Zhi Zhi Fang* states it treats interference among the Seven Emotions, dysfunction of Yin-Yang ascending and descending, obstruction of the Qi pathway, and attacking pain.
San Leng (Rhizoma Sparganii), E Zhu (Rhizoma Curcumae), Qing Ju Pi (Green Tangerine Peel), Xiang Fu Zi (Rhizoma Cyperi, hair removed), Chen Ju Pi (Aged Tangerine Peel, washed), Jie Geng (Radix Platycodi), Huo Xiang Ye (Folium Pogostemonis), Gui (Cortex Cinnamomi, specifically the heart/core).
Yi Zhi Ren (Fructus Alpiniae Oxyphyllae) (each 1 liang 5 qian), Gan Cao (Radix Glycyrrhizae, honey-fried, 3 qian). Hu Shi's formula (*Jing Xiao Fang*) includes Chen Xiang (Lignum Aquilariae Resinae, 0.5 liang) and excludes Chen Ju Pi.
Grind all ingredients into a powder. Take 5 qian per dose, with 2 zhan of water, 2 slices of fresh ginger, and 2 dates. Decoct until 1 zhan remains. Take warm before meals.
Chen Tong San: *Ke Yong Fang* states it treats pain caused by Qi clashing, stabbing pain in the muscles, and chest/epigastric stuffiness.
E Zhu (Rhizoma Curcumae, processed), Gui Xin (Cortex Cinnamomi Cordata) (each 1 liang), Bing Lang (Semen Arecae), Fu Zi (Radix Aconiti Lateralis Preparata, skin and rootlet removed, processed), Xi Xin (Herba Asari, roots removed) (each 0.5 liang).
Yuan Hua (Flos Genkwa, fried, separately ground into powder, 1 qian).
Except for Yuan Hua, grind the remaining ingredients into a powder. Take 3 da qian per dose, with 1 zhan of water. Decoct until 0.7 zhan remains. Strain, mix in the Yuan Hua powder (one zi measure), and take warm.
If there is a sensation of hardness below the heart, but pressure reveals no mass, accompanied by constant distension, vomiting after eating, Qi affecting both anterior and posterior orifices, and persistent belching, this is due to excessive worry causing Qi to stagnate and not flow at the proper times. It is said that thinking causes the mind to fixate and the Spirit to reside, leaving Righteous Qi stagnant and immobile. The pulse is choppy. This is called Knotted Qi (Jie Qi), treated with Shen Ju Wan (Ginseng and Tangerine Pill).
Shen Ju Wan
Chen Pi (Exocarpium Citri Reticulatae, 4 liang, washed), Ren Shen (Radix Ginseng, 1 liang).
Grind into a fine powder. Mix with refined honey to form pills the size of sophora seeds. Take 30 pills with rice broth before meals.
If there is a sensation of a lump in the throat that cannot be swallowed or expectorated, and if untreated for long, it gradually impedes food intake. This may be due to irregular worrying causing Qi knotting, or sudden obstruction of the Qi pathway during eating/digestion. When caused by Qi, it is called Qi Yie (Qi Dysphagia), with a slow and choppy pulse. When caused by food, it is called Shi Yie (Food Dysphagia), with a short and choppy pulse. Qi Yie is treated with Jia He San (Harvesting Grain Powder). Shi Yie is treated with Shen Qu Wan (Medicated Leaven Pill).
Jia He San (Formula missing).
Shen Qu Wan
Shen Qu (Massa Medicata Fermentata, fried, 1 liang), Chen Pi (Exocarpium Citri Reticulatae, washed, 2 liang).
Grind into a fine powder. Mix with refined honey to form pills the size of chicken beans. Take one pill per dose, holding it in the mouth to dissolve and swallow the saliva.
If pain wanders without fixed location, moving up and down, and the pulse gathers and scatters, being either rapid and intermittent or choppy, this is called Wandering Qi (You Qi). Treat with Shu Xiang San (Costus and Cyperus Powder). If ineffective, use Yan Hu San (Corydalis Powder).
Shu Xiang San
E Zhu (Rhizoma Curcumae, processed, 1 liang), Ren Shen (Radix Ginseng, 1 fen), Mu Xiang (Radix Aucklandiae, 1 qian).
Grind into a fine powder. Mix with vinegar decoction using a square-inch spoon measure.
Yan Hu San
Yan Hu Suo (Rhizoma Corydalidis, fried), Dang Gui (Radix Angelicae Sinensis, washed, equal parts).
Grind into a fine powder. Mix with vinegar decoction using a square-inch spoon measure.
If Qi fails to communicate between the left and right sides from the throat down to the umbilicus, with Qi rushing upward aggressively, pain in the right arm like being struck by an axe, daily wasting of muscles, inability to ingest gruel, and inner vexation/oppression, this is because the Lung Meridian originally received Cold pathogen, which remained on the right side (as the Lung resides on the right). Alternatively, it may result from using hot drugs to attack cold; since the Cold was in the meridians and could not be dispersed, Fire Qi merely pressured the Lung. Lung dryness causes Qi to rush upward. First resolve any drug toxicity, then regulate the Lung. Initially use Zhi Gan San (Roasted Liver Powder), followed by Li Qi Tang (Regulate Qi Decoction).
Zhi Gan San
Mu Dan Pi (Cortex Moutan), Chai Hu (Radix Bupleuri), Shao Yao (Radix Paeoniae Alba) (each 1 liang), Bai Zhu (Radix Atractylodis Macrocephalae, 2 liang).
Grind into a fine powder. Slice pork liver thinly (about three fingers thick), sprinkle 2 qian of the powder on it, and slowly roast until cooked. Chew thoroughly and swallow with rice broth before meals.
Li Qi Tang (Suspected to be the same as Qi Qi Tang mentioned earlier).
Bai Zi Ren Wan (Biota Seed Pill): Shi Zaizhi in *Zhi Nan Fang* adds Chu Shi (Fructus Cudraniae Tricuspidae, 1 liang). It treats arm pain preventing flexion and extension, and tendon/muscle spasms.
Bai Zi Ren (Semen Biotae, fried, crushed), Di Huang (Radix Rehmanniae Preparata) (each 2 liang), Fu Ling (Poria), Zhi Shi (Fructus Aurantii Immaturus, bran-fried, pith removed), Gui (Cortex Cinnamomi, core), Wu Wei Zi (Fructus Schisandrae), Fu Zi (Radix Aconiti Lateralis Preparata, processed), Huang Bo (Cortex Phellodendri)... [Text incomplete in source regarding specific weights for some herbs].
Grind into a fine powder. Mix with refined honey to form pills the size of sophora seeds. Take 30 pills with wine on an empty stomach.
If there are masses in the abdomen and hypochondrium, formed and sized, immovable upon pressure and pushing, leading over time to chills and fever resembling malaria, cough, edema of the face and eyes, slight panting upon movement, and progressive emaciation, this is due to sudden anger or fright causing Qi to rise instead of descend, injuring the Liver. Qi knots and aggregates to form a tangible mass. Initially located in the Liver, the pulse is firm, large, and knotted. If it does not transmit, it is treatable. Treat with Chen Xian Jian (Agarwood Decoction).
Chen Xian Jian
Shi Hu (Ramulus Dendrobii, 5 liang), Jiao (Pericarpium Zanthoxyli, remove eyes, fry until sweat appears), Fu Zi (Radix Aconiti Lateralis Preparata, skin and rootlet removed, processed), Qin Jiao (Radix Gentianae Macrophyllae, clean soil), Bie Jia (Carapax et Plastrum Testudinis, boiled, scrape off tendons/membranes, roast), Chai Hu (Radix Bupleuri, remove roots), Chen Xiang (Lignum Aquilariae Resinae), Mu Xiang (Radix Aucklandiae), Bing Lang (Semen Arecae), Huang Qin (Radix Scutellariae) (each 2 liang).
Grind into powder. First, take 10 jin of fresh Goji root, wash clean, and crush. Decoct with 2 dou of good wine until reduced to 7 sheng. Remove the Goji root. Wash another 3 sheng of good wine, filter out dregs, and combine with the previous decoction. Add 4 liang of cooked honey, boil again into an extract. Mix with the herbal powder to form pills the size of sophora seeds. Take 20 pills with water before meals.