《内经》无痨瘵之名，而有痨瘵之因。凡外感六淫，内伤七情。其邪展转乘于五脏，遂至大骨枯槁，
大肉陷下，各见所合衰惫之症，真脏脉见则有死期。二阳之病，则为风消、息贲。三阳为病，其传为索泽
瘅，成为消中。大肠移热于胃，胃移热于膀胱，胆则体养
而瘦。尝贵后贱，病从内生，名曰脱营，尝富后贫，名曰失精。暴乐后苦，皆伤精气，精气竭尽，形体
毁沮。离绝菀结，忧恐喜怒，五脏空虚，血气离守。《灵枢》曰∶怵惕思虑则伤神，神伤则恐惧自失，
破脱肉，毛瘁色夭，死于冬。又诸在肤肉脉筋骨之间者，各索所合之本脏，不得索于所不胜。后世张仲景
立虚劳门，本于此也。巢元方有虚劳，有蒸病，有注病，皆推于此也。虚劳者，五劳六极七伤是也。五劳
者，志劳，思劳，忧劳，心劳，瘦劳；六极者，气极，血极，筋极，骨极，肌极，精极也；七伤者，曰阴寒，
曰阴萎，曰里急，曰精连，曰精少阴下湿，曰精滑，曰小便苦数，临事不举。又曰∶大饱伤脾，大怒气逆伤
肝，强力举重，久坐湿地伤肾，形寒饮冷伤肺，忧愁思虑伤心，风雨寒暑伤形，大恐惧不节伤志。又五蒸病
者，骨蒸，脉蒸，皮蒸，肉蒸，内蒸。遍身热多，又因热病愈后，食牛肉，或饮酒，或房欲而成。诸注候者，
谓邪气居住人身之内，故名为注。此由阴阳失守，经络空虚，风寒暑湿劳役之所致也。或伤寒传诸阴不时
除，瘥而留滞，或宿食冷热不调而流注，或乍感生死之气，卒犯鬼物之精，皆能成病，变状多端。凡此注
之为言住也，言其连滞停住，死又注易傍人也。以上虚劳蒸注等候，近世方论所列之药众矣，未有一言以
归其要者。盖人之生气与形耳，气为阳，形为阴，偏于阳则热，偏于阴则寒，况消万物莫甚于火。夫痨瘵未
有形不瘠肉不消也，皆由精血不胜气之热火，当用寒凉以和之，益水以济之耳！乃谓形不足须温之以气，岂
知，“温”乃“温存”。非温热也。气本阳而复得温则成亢阳矣，已涸之精血而加之以温热，天真何由而生
耶？又有一等胎生骨细质弱者，精血必亏，此天癸已至而阴不能全盛与阳为配，及情欲动中，或劳役所使，
则君、相二火相扇而起，其亏少之阴水莫能制之，故内蒸五脏，外连四属，如是者，以禀赋夭短，岂药所能
治哉！
《黄帝内经》中没有“痨瘵”这个病名，但阐述了导致痨瘵的病因。凡是外感六淫（风、寒、暑、湿、燥、火六种外邪），内伤七情（喜、怒、忧、思、悲、恐、惊七种情志）。病邪辗转传变侵犯五脏，最终导致大骨枯槁，大肉陷下，出现各脏腑所合部位衰败虚弱的症状，如果出现真脏脉（无胃气的脉象）则预示死期将至。阳明经（二阳）发病，会导致风消（因风热耗损津液而消瘦）、息贲（呼吸急促胸满）。太阳经（三阳）发病，其传变为索泽瘅（皮肤干枯焦黑的热病），形成消中（多食易饥的病证）。大肠的热邪移注于胃，胃的热邪移注于膀胱，胆受邪则身体失养而消瘦。曾经尊贵后来卑贱，病从内生，名叫脱营；曾经富有后来贫穷，名叫失精。突然快乐之后转为痛苦，都会损伤精气，精气竭尽，形体毁坏沮丧。离别断绝、郁结不解，忧愁恐惧喜怒无常，导致五脏空虚，血气离散失守。《灵枢》说：惊恐思虑会损伤神志，神志受损则恐惧自我丧失，肌肉破败脱落，毛发憔悴面色枯夭，死于冬季。另外，凡是在皮肤、肌肉、血脉、筋骨之间的病变，都要寻找其所对应的本脏根源，不能去求索于所不胜（相克）之脏。后世张仲景设立虚劳门，就是基于此理。巢元方论述了虚劳、蒸病、注病，都是推演于此。虚劳，指的是五劳、六极、七伤。五劳，指志劳、思劳、忧劳、心劳、瘦劳；六极，指气极、血极、筋极、骨极、肌极、精极；七伤，指阴寒、阴萎、里急、精连、精少阴下湿、精滑、小便频数苦痛、行房时举而不坚。又说：饱食过度损伤脾，大怒气逆损伤肝，强力举重、久坐湿地损伤肾，形体受寒、饮用冷物损伤肺，忧愁思虑损伤心，风雨寒暑损伤形体，大惊恐惧且不知节制损伤志。另外五种蒸病，指骨蒸、脉蒸、皮蒸、肉蒸、内蒸。遍身发热较多，又因为热病痊愈后，吃牛肉，或饮酒，或进行房事而导致。各种注病的候象，是指邪气居住在人身体内部，所以叫作注。这是由于阴阳失守，经络空虚，由风寒暑湿及劳役所致。或者伤寒传入诸阴经未能及时清除，病愈后邪气留滞，或者宿食冷热不调而流注，或者突然感受生死之气，猝然触犯鬼物之精，都能成病，变化症状多种多样。大凡这种“注”，说的就是“住”，指其连续滞留停住，死后又会传染转移给旁人。以上虚劳、蒸病、注病等候象，近代方论所列的药物很多，但没有一句话能归结其要点。大概人的生气与形体罢了，气属于阳，形属于阴，偏于阳则热，偏于阴则寒，何况没有比火更能消耗万物的了。痨瘵患者没有不形体消瘦、肌肉消减的，这都是由于精血不能制约气的火热，应当用寒凉药来调和它，滋益肾水来济助它！却说形体不足需要用温补阳气的方法，哪里知道，“温”乃是“温存”之意，并非温热也。气本来属阳，如果再得到温热就会变成亢盛的阳热，对于已经枯竭的精血再加以温热，天真之气从哪里产生呢？又有一类天生骨骼细小体质虚弱的人，精血必然亏损，这是天癸（促进性发育的物质）已至但阴气不能完全盛壮以与阳气配合，加上情欲动于中，或劳役所使，则君火、相火相互煽动而起，亏少的阴水不能制约它们，所以内蒸五脏，外连四肢肌肉。像这样的人，由于禀赋先天短少，难道药物所能治愈的吗！
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) does not use the term "Lao Zhai" (Consumption/Tuberculosis), but it discusses its etiology. Any external contraction of the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and internal injury from the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright). The pathogenic factors circulate and invade the Five Viscera, eventually leading to withering of the large bones and sinking of the large muscles, presenting symptoms of decline and exhaustion corresponding to each organ. If True Visceral Pulses (pulse signs indicating the absence of Stomach Qi and imminent death) appear, there is a deadline for death. Disease of the Yangming Channel (Second Yang) leads to Feng Xiao (wasting due to wind-heat consuming fluids) and Xi Ben (shortness of breath and chest fullness). Disease of the Taiyang Channel (Third Yang) transmits into Suo Ze Dan (a heat disease causing dry and dark skin) and becomes Xiao Zhong (polyphagia). Heat from the Large Intestine transfers to the Stomach; heat from the Stomach transfers to the Bladder; if the Gallbladder is affected, the body loses nourishment and emaciates. One who was once noble but became lowly develops an internal disease named Tuo Ying (Depletion of Ying); one who was once rich but became poor develops Shi Jing (Loss of Essence). Sudden joy followed by suffering both injure Jing-Qi; when Jing-Qi is exhausted, the physical form is ruined and collapsed. Separation, isolation, frustration, worry, fear, anger, and joy cause the Five Viscera to become empty, and Blood and Qi to scatter and lose their residence. The *Lingshu* states: "Terror and overthinking injure Shen (Spirit); when Shen is injured, fear and self-loss occur, muscles break down and fall away, hair becomes brittle, complexion turns lifeless, and death occurs in Winter." Furthermore, lesions in the skin, flesh, vessels, sinews, and bones should be traced to their root in the corresponding primary Viscera, not sought in the Viscera that overcomes them (the overcoming element). Later, Zhang Zhongjing established the section on Deficiency Consumption (Xu Lao), based on this principle. Chao Yuanfang discussed Xu Lao, Zheng Bing (Steaming Disorder), and Zhu Bing (Imparted/Transmitted Disease), all deduced from this. Xu Lao refers to Wu Lao (Five Labors), Liu Ji (Six Extremities), and Qi Shang (Seven Injuries). Wu Lao refers to Zhi Lao (Mental Labor), Si Lao (Pensiveness Labor), You Lao (Worry Labor), Xin Lao (Heart Labor), and Shou Lao (Emaciation Labor - *Note: Text says 'Shou', likely referring to labor leading to emaciation or specific mental strain*). Liu Ji refers to Qi Ji (Qi Exhaustion), Xue Ji (Blood Exhaustion), Jin Ji (Sinew Exhaustion), Gu Ji (Bone Exhaustion), Ji Ji (Flesh Exhaustion), and Jing Ji (Essence Exhaustion). Qi Shang includes: Yin Han (Yin Cold), Yin Wei (Yimpotence), Li Ji (Internal Urgency/Discomfort), Jing Lian (Continuous Essence Loss), Jing Shao Yin Xia Shi (Scanty Essence with Yin Dampness), Jing Hua (Spermatorrhea), Xiao Bian Ku Shu (Bitter frequency/dysuria in urination), and Lin Shi Bu Ju (Failure to erect during intercourse). It also states: Overeating injures the Spleen; great anger with reversed Qi injures the Liver; forceful lifting and long sitting on damp ground injure the Kidney; cold exposure and drinking cold beverages injure the Lung; worry and overthinking injure the Heart; wind, rain, cold, and summerheat injure the Form; great fear without moderation injures Zhi (Will). Additionally, the five types of Steaming Disorders are: Gu Zheng (Bone Steaming), Mai Zheng (Vessel Steaming), Pi Zheng (Skin Steaming), Rou Zheng (Flesh Steaming), and Nei Zheng (Internal Steaming). These involve widespread heat, often occurring after recovery from a heat disease, triggered by eating beef, drinking alcohol, or sexual activity. The manifestations of Zhu Bing (Imparted Disease) refer to pathogenic factors residing within the human body, hence the name "Zhu" (Imparting/Transmitting). This results from the loss of balance between Yin and Yang, emptiness of the meridians, caused by Wind, Cold, Summerheat, Dampness, and overexertion. Or, Shaoyang diseases transmitted to the Yin channels are not cleared in time, leaving lingering pathogens after recovery; or undigested food with unbalanced hot/cold qualities flows and stagnates; or sudden contact with qi of life and death, or abrupt encounter with evil spirits' essences, can all cause disease, with varied and complex symptoms. The term "Zhu" implies "stopping" or "residing," indicating continuous stagnation and retention; after death, it may transmit to others. Regarding the above patterns of Xu Lao, Zheng Bing, and Zhu Bing, although modern formularies list many herbs, none summarize the essential principle. Essentially, human vitality consists of Qi and Form. Qi belongs to Yang, Form belongs to Yin. Bias toward Yang causes Heat; bias toward Yin causes Cold. Moreover, nothing consumes things more than Fire. Patients with Lao Zhai invariably suffer from emaciated forms and wasted muscles. This is because Jing and Blood cannot control the fiery heat of Qi. Therefore, one should use Cool/Cold herbs to harmonize it and tonify Water (Kidney Yin) to assist it! To claim that deficiency of Form requires warming with Qi methods misunderstands the concept; "Wen" (Warm) here means "gentle care/nourishment," not Hot/Warm temperature. Qi is inherently Yang, and adding warmth creates Hyperactive Yang. Adding Hot/Warm properties to already depleted Jing and Blood, how can Tian Zhen (Heavenly Truth/Vital Essence) arise? There is another category: those born with fine bones and weak constitutions inevitably have deficient Jing and Blood. Their Tian Gui (Menstrual/Essential fluid promoting reproduction) has arrived, but Yin cannot fully flourish to match Yang. When desires stir internally, or due to overexertion, Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo) fan each other into flame. The deficient Yin Water cannot restrain them, thus steaming the Five Viscera internally and connecting to the four limbs externally. Such individuals, due to congenital insufficiency, are hardly curable by medicine!