虚损之脉，凡甚急、甚数、甚细、甚弱、甚涩、甚滑、甚短、甚长、甚浮、甚沉、甚弦
、甚紧、甚洪、甚实者，皆劳伤之脉。然无论浮沉大小，但渐缓则渐有生意。若弦甚者病必
甚，数甚者病必危，若以弦细而再加紧数，则百无一生矣。
《要略》曰∶脉芤者为血虚，沉迟而小者为脱气。大而无力为阳虚，数而无力为阴虚。
脉大而芤者为脱血。平人脉大为劳。虚极亦为劳。脉微细者盗汗。寸弱而软为上虚。尺弱软
涩为下虚。尺软滑疾为血虚。两关沉细为胃虚。
《脉经》曰∶脉来软者为虚，缓者为虚。微弱者为虚。弦者为中虚。细而弱小者，气血
俱虚。
凡劳损之病，本属阴虚，阴虚必血少。而指爪为精血之余，故凡于诊候之际，但见其指
爪干黄，觉有枯槁之色，则其发肤营气，具在吾目中矣。此于脉色之外，便可知其有虚损之
候，而损之微甚，亦可因之以辨也。
病之虚损，变态不同。因有五劳七伤，证有营卫脏腑，然总之则人赖以生者，惟此精气
，而病为虚损者，亦惟此精气。气虚者，即阳虚也；精虚者，即阴虚也。凡病有火盛水亏，
而见营卫燥津液枯者，即阴虚之证也；有水盛火亏，而见脏腑寒脾肾败者，即阳虚之证也。
此惟阴阳偏困所以致然。凡治此者，但当培其不足，不可伐其有余。夫既缘虚损，而再去所
余，则两败俱伤矣，岂不殆哉！惟是阴阳之辨，犹有不易，谓其阴阳之中，复有阴阳，其有
似阳非阳，似阴非阴者，使非确有真见，最易惑人，此不可不详察也。且复有阴阳俱虚者，
则阳为有生之本，而所重者，又单在阳气耳。知乎此，则虚损之治，如指诸掌矣。
一、阳虚者多寒，非谓外来之寒，但阳气不足，则寒生于中也，若待既寒，则阳已败矣
。而不知病见虚弱，而别无热证者，便是阳虚之候，即当温补元气，使阳气渐回，则真元自
复矣。盖阳虚之候，多得之愁忧思虑以伤神，或劳役不节以伤力，或色欲过度而气随精去，
或素禀元阳不足而寒凉致伤等，病皆阳气受损之所由也。欲补阳气，惟辛甘温燥之剂为宜，
万勿兼清凉寒滑之品，以残此发生之气，如生地、芍药、天麦门冬、沙参之属，皆非所宜，
而石斛、玄参、知、柏、芩、连、龟胶之类，则又切不可用。若气血俱虚者，宜大补元煎，
或八珍汤，或十全大补汤。五脏俱虚，宜平补者，五福饮。命门阴分不足者，左归饮、左归
丸。命门阳分不足者，右归饮、右归丸。气分虚寒者，六气煎。脾肾阴分虚寒，诸变不一者
，理阴煎。三焦阳气大虚者，六味回阳饮。气虚脾寒者，一气丹。胃气虚寒者，温胃饮、理
中汤。血虚寒滞者，五物煎。
一、阴虚者多热，以水不济火而阴虚生热也。此病多得于酒色嗜欲，或愤怒邪思，流荡
狂劳，以动五脏之火，而先天元阴不足者，尤多此病。凡患虚损而多热多燥，不宜热食者，
便是阴虚之候。欲滋其阴，惟宜甘凉醇静之物。凡阴中有火者，大忌辛温，如干姜、桂、附
、破故纸、白术、苍术、半夏之属，皆不可轻用；即如人参、黄 、枸杞、当归、杜仲之类
，是皆阴中有阳，亦当酌宜而用之，盖恐阳旺则阴愈消，热增则水益涸耳。然阴虚者，因其
水亏，而水亏者，又忌寒凉，盖苦劣之流，断非资补之物。其有火盛之甚，不得不从清凉者
，亦当兼壮水之剂，相机间用，而可止即止，以防其败，斯得滋补之大法。诸治如下∶
一、虚损夜热，或午后发热，或喜冷便实者，此皆阴虚生热，水不制火也，宜加减一阴
煎。若火在心肾，而惊悸失志者，宜二阴煎。若外热不已，而内不甚热，则但宜补阴，不可
清火，宜一阴煎，或六味地黄汤。其有元气不足，而虚热不已者，必用大补元煎，庶乎久之
自愈。寒热门论治尤详，所当参阅。
一、虚损咳嗽，虽五脏皆有所病，然专主则在肺肾。盖肺为金脏，金之所畏者，火也，
金之化邪者，燥也，燥则必痒，痒则必嗽，正以肾水不能制火，所以克金，阴精不能化气，
所以病燥，故为咳嗽、喘促、咽痛、喉疮、声哑等证。凡治此者，只宜甘凉至静之剂，滋养
金水，使肺肾相生，不受火制，则真阴渐复，而嗽可渐愈。火盛者，宜四阴煎加减主之。火
微者，宜一阴煎，六味地黄汤，或左归饮。兼受风寒而嗽者，宜金水六君煎。贝母丸治嗽最
佳。
一、虚损吐血者，伤其阴也，故或吐或衄，所不能免，但当察其有火无火，及火之微甚
而治之。凡火之盛者，以火载血上，而脉证之间自有热证可辨。急则治标，此不得不暂用芩
、连、栀、柏、竹叶、童便之属，或单以抽薪饮、徙薪饮之类主之。若阴虚而兼微火者，宜
保阴煎，或清化饮，或加减一阴煎主之。血止即当养血，不宜过用寒凉也。若无实火而全属
伤阴，则阴虚水亏，血由伤动而为吐为衄者，此宜甘纯养阴之品，以静制动，以和治伤，使
阴气安静得养，则血自归经。宜一阴煎，六味地黄汤，或小营煎之类主之。若阴虚连肺而兼
嗽兼血者，宜四阴煎加减主之。若因劳役，别无火证，心脾肾三阴受伤而动血者，宜五阴煎
、五福饮、六味地黄丸之类主之。若阴虚于下，格阳于上，六脉无根而大吐大衄者，此火不
归源，真阳失守而然，宜右归饮加减主之，或八味地黄汤亦可。此惟思虑劳倦过伤者，多有
此证。若因劳倦而素易呕泻，多有脾不摄血，而为吐血下血者，宜六味回阳饮大加白术主之
，万不可用凉药。若大吐大衄，而六脉细脱，手足厥冷，危在倾刻，而血犹不止者，速宜用
镇阴煎，其血自止。若血脱至甚，气亦随之，因至厥逆昏愦者，速当益气以固生机，宜六味
回阳饮，或四味四阳饮主之，若再用寒凉即死。总之，失血吐血，必其阴分大伤，使非加意
元气，培养真阴，而或专用寒凉，则其阴气愈损，血虽得止，而病必日败矣。
一、虚损伤阴，本由五脏，虽五脏各有所主，然五脏证治，有可分者，有不可分者。如
诸气之损，其治在肺；神明之损，其治在心；饮食肌肉之损，其治在脾；诸血筋膜之损，其
治在肝；精髓之损，其治在肾，此其可分者也。然气主于肺，而化于精；神主于心，而化于
气；肌肉主于脾，而土生于火；诸血藏于肝，而血化于脾胃；精髓主于肾，而受之于五脏，
此其不可分者也。及乎既甚，则标本相传，连及脏腑，此又方之不可执言也。故凡补虚之法
，但当明其阴阳升降，寒热温凉之性，精中有气，气中有精之因。且凡上焦阳气不足者，必
下陷于肾也，当取之至阴之下。下焦真阴不足者，多飞越于上也，可不引之归源乎？所以治
必求本，方为尽善。然余用补之法，则悉在新方八略、八阵中，惟细察之可得其概。其有诸
证未备者，如遗精、梦泄、声哑、盗汗，及妇人血枯经断等证，但于各门求之，则无不俱有
照应。
虚损病的脉象，凡是极急、极数、极细、极弱、极涩、极滑、极短、极长、极浮、极沉、极弦、极紧、极洪、极实的，都属于劳伤之脉。然而无论脉象是浮是沉、是大是小，只要逐渐变得缓和，就说明病情有生机。如果脉象极弦，说明病势必然严重；脉象极数，说明病情必然危急；如果脉象既弦细又兼见紧数，那就百无一生（无法治愈）了。
《金匮要略》说：脉象芤（中空如葱管）的是血虚，脉象沉迟而小的是气脱。脉象大而无力的属于阳虚，脉象数而无力的属于阴虚。脉象大而芤的是失血。正常人的脉象大，是因为劳损。极度虚弱也是劳损的表现。脉象微细的会出现盗汗。寸口脉弱而软的是上焦虚。尺部脉弱软涩的是下焦虚。尺部脉软滑疾数是血虚。两关部脉沉细是胃虚。
《脉经》说：脉来柔软的是虚，缓怠的是虚。微弱的是虚。弦的是中焦虚。细而弱小的是气血俱虚。
凡是劳损的病，本来属于阴虚，阴虚必然导致血少。而手指和指甲是精血的余气所生，所以在诊察时，只要看到指爪干枯发黄，显现出枯槁的神色，那么他的头发、皮肤和营气状况，就都在我眼中清楚了。这在脉象和面色之外，就能知道他有虚损的症状，而且损伤的程度轻重，也可以据此来辨别。
疾病的虚损，变化形态各不相同。病因有五劳七伤，证候涉及营卫脏腑，但总而言之，人赖以生存的东西，只有精气，而因病成为虚损的，也仅仅是精气。气虚，就是阳虚；精虚，就是阴虚。凡是病有火盛水亏，出现营卫燥热、津液枯竭的，就是阴虚的证候；有水盛火亏，出现脏腑寒凉、脾肾衰败的，就是阳虚的证候。这仅仅是因为阴阳偏颇困顿所以导致这样。凡是治疗这种情况的，只应当培补不足，不可攻伐有余。既然已经是虚损，如果再去除所谓的“有余”，就会两败俱伤，难道不危险吗！只是阴阳的辨别，还有不容易的地方，说是阴阳之中，又有阴阳，那些似阳非阳、似阴非阴的情况，如果不是确有真知灼见，最容易迷惑人，这是不可不详加考察的。况且还有阴阳俱虚的情况，那么阳气是有生命的根本，所重视的，又单在阳气罢了。懂得这一点，那么治疗虚损的方法，就像看手掌一样清楚明了。
一、阳虚的人多怕冷，不是说外来的寒气，只是阳气不足，寒气就会从体内产生，如果等到已经感到寒冷，那么阳气就已经败坏了。却不知道病见虚弱，而没有其他热证的，就是阳虚的征候，就应当温补元气，使阳气逐渐恢复，那么真元自然就会复原了。大概阳虚的征候，大多得之于忧愁思虑损伤心神，或劳累役使不节制损伤体力，或色欲过度导致气随精流失，或素来禀赋元阳不足因寒凉药物导致受伤等等，这些都是阳气受损的原因。想要补益阳气，只有辛甘温燥的药物适宜，千万不要兼用清凉寒滑的药物，以残害这种发生之气，像生地、芍药、天冬、麦冬、沙参这一类，都不适宜，而石斛、玄参、知母、黄柏、黄芩、黄连、龟板胶之类，则更是绝对不可用的。如果气血都虚，宜用大补元煎，或八珍汤，或十全大补汤。五脏都虚，宜平补的，用五福饮。命门阴分不足的，用左归饮、左归丸。命门阳分不足的，用右归饮、右归丸。气分虚寒的，用六气煎。脾肾阴分虚寒，各种变化不一的，用理阴煎。三焦阳气大虚的，用六味回阳饮。气虚脾寒的，用一气丹。胃气虚寒的，用温胃饮、理中汤。血虚寒滞的，用五物煎。
一、阴虚的人多发热，是因为水不能济助火，从而阴虚生热。这个病大多得之于酒色嗜欲，或愤怒邪思，流荡狂劳，从而扰动五脏之火，而先天元阴不足的，尤其多有此病。凡是患虚损而多热多燥，不宜吃热食的，就是阴虚的征候。想要滋补肾阴，只宜用甘凉醇静性质的药物。凡是阴中有火的，严禁使用辛温药物，如干姜、桂枝、附子、破故纸、白术、苍术、半夏这一类，都不可轻率使用；就像人参、黄芪、枸杞、当归、杜仲这一类，都是阴中有阳，也应当斟酌适宜而使用，大概是担心阳气旺盛则阴液更加消减，热增加则水源更加枯竭罢了。然而阴虚的人，因为水亏，而水亏的人，又忌讳寒凉，因为苦劣的药物，绝对不是滋补之物。如果有火盛得非常厉害，不得不从清凉治疗的，也应当兼用壮水的药物，相机间杂使用，而可以停止时就停止，以防败坏正气，这才是滋补的大法。各种治法如下：
一、虚损夜间发热，或午后发热，或喜欢冷饮、大便干燥的，这都是阴虚生热，水不能制约火，宜用加减一阴煎。如果火在心肾，而出现惊悸、神志失常的，宜用二阴煎。如果外表发热不止，而内部不甚热，那么就只宜补阴，不可清火，宜用一阴煎，或六味地黄汤。如果有元气不足，而虚热不止的，必须用大补元煎，久而久之自然会痊愈。寒热门论治尤为详细，应当参阅。
一、虚损咳嗽，虽然五脏都有病变，但专门主治则在肺肾。盖肺为金脏，金所畏惧的是火，金转化邪气的因素是燥，燥则必然发痒，痒则必然咳嗽，正因为肾水不能制约火，所以火克金，阴精不能化气，所以病燥，因此出现咳嗽、喘促、咽痛、喉疮、声音嘶哑等证候。凡是治疗这些的，只宜用甘凉至静的药物，滋养金水，使肺肾相生，不受火制，那么真阴逐渐恢复，而咳嗽就可以逐渐痊愈。火盛的，宜用四阴煎加减主治。火轻微的，宜用一阴煎，六味地黄汤，或左归饮。兼受风寒而咳嗽的，宜用金水六君煎。贝母丸治疗咳嗽最佳。
一、虚损吐血，是损伤了阴分，所以或吐或鼻衄，在所难免，但应当观察有火无火，以及火的轻微严重而进行治疗。凡是火盛的，因为火载着血上行，而在脉证之间自然有热证可辨。急则治标，这里不得不暂时用黄芩、黄连、栀子、黄柏、竹叶、童便这一类，或单用抽薪饮、徙薪饮之类主治。如果阴虚而兼有微火的，宜用保阴煎，或清化饮，或加减一阴煎主治。血止之后就当养血，不宜过用寒凉药物。如果没有实火而全属伤阴，那么阴虚水亏，血因受伤而动而为吐为衄的，这宜用甘纯养阴的药物，以静制动，以和治伤，使阴气安静得到滋养，那么血自然回归经脉。宜用一阴煎，六味地黄汤，或小营煎之类主治。如果阴虚连及肺而兼咳嗽兼出血的，宜用四阴煎加减主治。如果因劳累役使，没有其他火证，心脾肾三阴受伤而动血的，宜用五阴煎、五福饮、六味地黄丸之类主治。如果阴虚于下，格阳于上，六脉无根而大吐大衄的，这是火不归源，真阳失守而导致的，宜用右归饮加减主治，或八味地黄汤也可以。这只有思虑劳倦过度损伤的，多有此证。如果因劳倦而素易呕吐腹泻，多有脾不摄血，而为吐血下血的，宜用六味回阳饮大加白术主治，万万不可用凉药。如果大吐大衄，而六脉细弱欲绝，手足厥冷，危在顷刻，而血仍不止的，速宜用镇阴煎，其血自止。如果血脱非常严重，气也随之耗散，因而导致厥逆昏愦的，速当益气以固护生机，宜用六味回阳饮，或四味四阳饮主治，若再用寒凉药物就会死亡。总之，失血吐血，必然是阴分大伤，如果不加意保护元气，培养真阴，而或者专用寒凉药物，那么阴气更加受损，血虽然得以止住，但病情必定日益败坏。
一、虚损伤阴，本来由五脏引起，虽然五脏各有所主，但五脏的证治，有可以区分的，有不可以区分的。比如诸气的损伤，治疗在肺；神明的损伤，治疗在心；饮食肌肉的损伤，治疗在脾；诸血筋膜的损伤，治疗在肝；精髓的损伤，治疗在肾，这是可以区分的。然而气主于肺，而化生于精；神主于心，而化生于气；肌肉主于脾，而土生于火；诸血藏于肝，而血化生于脾胃；精髓主于肾，而受之于五脏，这是不可以区分的。等到病情严重时，则标本相传，连及脏腑，这又是方剂不可拘执言说的地方。所以凡是补虚的方法，只应当明白其阴阳升降，寒热温凉的性质，精中有气，气中有精的原因。而且凡上焦阳气不足的，必然下陷于肾，应当取穴至阴之下。下焦真阴不足的，多飞越于上，可不引之归源吗？所以治疗必须求本，方为尽善。然而我使用的补法，都包含在新方八略、八阵中，只有仔细考察才能得到大概。其中有各种证候未备的，如遗精、梦泄、声哑、盗汗，及妇人血枯经断等证，只要在各自门类中寻求，就没有不互相照应的。
The pulse of deficiency and damage (Xu Sun), whether extremely rapid, extremely frequent, extremely fine, extremely weak, extremely choppy, extremely slippery, extremely short, extremely long, extremely floating, extremely deep, extremely wiry, extremely tight, extremely surging, or extremely excess, all belong to the pulse of labor injury. However, regardless of whether the pulse is floating or deep, large or small, as long as it gradually becomes relaxed and slow, it indicates that there is vitality in the condition. If the pulse is extremely wiry, the disease must be severe; if the pulse is extremely frequent, the disease must be critical; if the pulse is both wiry and fine, and additionally tight and frequent, then there is no chance of survival (it is incurable).
*Jingui Yaolue* states: A knotted pulse (Kou Mai, hollow like a scallion stalk) indicates blood deficiency; a deep, slow, and small pulse indicates qi depletion. A large but forceless pulse indicates yang deficiency; a frequent but forceless pulse indicates yin deficiency. A large and knotted pulse indicates loss of blood. In a healthy person, a large pulse is due to labor. Extreme weakness is also a sign of labor. A minute and fine pulse indicates night sweating. A weak and soft pulse at the Cun position indicates upper jiao deficiency. A weak, soft, and choppy pulse at the Chi position indicates lower jiao deficiency. A soft, slippery, and rapid pulse at the Chi position indicates blood deficiency. A deep and fine pulse at both Guan positions indicates stomach deficiency.
*Mai Jing* states: A soft pulse indicates deficiency; a slack pulse indicates deficiency. A minute and weak pulse indicates deficiency. A wiry pulse indicates middle jiao deficiency. A fine, small, and weak pulse indicates simultaneous deficiency of qi and blood.
Diseases of labor damage essentially belong to yin deficiency, and yin deficiency inevitably leads to blood insufficiency. Fingers and nails are the surplus of essence and blood; therefore, during diagnosis, if one observes dry, yellow, withered, and lifeless nails, the condition of hair, skin, and Ying Qi is evident before us. Beyond pulse and complexion, this allows us to identify signs of deficiency and damage, and to distinguish the severity of the damage.
The manifestations of deficiency diseases vary. Etiologically, there are five labors and seven injuries; clinically, they involve Ying-Wei, Zang-Fu organs. However, fundamentally, what sustains life is only Essence and Qi, and what constitutes deficiency damage is also only Essence and Qi. Qi deficiency is yang deficiency; Essence deficiency is yin deficiency. Diseases characterized by excessive fire and deficient water, presenting with dry Ying-Wei and withered body fluids, are yin deficiency syndromes. Diseases characterized by excessive water and deficient fire, presenting with cold viscera and failure of spleen and kidney, are yang deficiency syndromes. This results solely from the bias and distress of yin and yang. Treatment should focus on tonifying insufficiency and never attacking excess. Since the condition is already deficient, attacking any perceived "excess" would lead to mutual destruction of both sides, which is dangerous! The differentiation of yin and yang is difficult because within yin and yang, there is further yin and yang. Cases that appear yang but are not truly yang, or appear yin but are not truly yin, can easily confuse practitioners unless one possesses true insight. This requires careful examination. Furthermore, there are cases of simultaneous yin and yang deficiency. Yang is the root of life, so emphasis is placed solely on yang qi. Understanding this makes the treatment of deficiency damage clear as day.
1. Those with yang deficiency often feel cold. This does not refer to external cold, but rather cold generated internally due to insufficient yang qi. If one waits until cold symptoms manifest, the yang qi has already failed. One should recognize that weakness without other heat signs indicates yang deficiency, requiring warming and tonification of primordial qi to gradually restore it. Yang deficiency often arises from sorrow and worry damaging the spirit, overwork damaging physical strength, excessive sexual activity causing qi to depart with essence, or constitutional lack of primordial yang damaged by cold medicines. To tonify yang, acrid-sweet-warm-dry agents are suitable. Cool-cold-slippery substances must be avoided to prevent damaging generative qi. Substances such as Sheng Di Huang (Rehmanniae Radix), Bai Shao (Paeoniae Radix Alba), Tian Men Dong (Asparagi Rhizoma), Mai Men Dong (Ophiopogonis Rhizoma), and Sha Shen (Glehniae Radix) are unsuitable. Shi Hu (Dendrobii Caulis), Xuan Shen (Scrophulariae Radix), Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Huang Qin (Scutellariae Radix), Lian Zi (Nelumbinis Semen - *Note: Context implies Lian Qiao or similar, but text says Lian, likely Huang Lian based on context of cold herbs*), Gui Jiao (Testudinis et Chelonis Carapax et Plastrum) are absolutely contraindicated. For simultaneous qi and blood deficiency, Da Bu Yuan Jian (Great Tonify Origin Decoction), Ba Zhen Tang (Eight Treasures Decoction), or Shi Quan Da Bu Tang (Ten Significant Great Tonify Decoction) are appropriate. For simultaneous five-viscera deficiency requiring mild tonification, Wu Fu Yin (Five Blessings Drink) is used. For insufficiency of the Mingmen yin component, Zuo Gui Yin (Left Return Drink) and Zuo Gui Wan (Left Return Pill) are used. For insufficiency of the Mingmen yang component, You Gui Yin (Right Return Drink) and You Gui Wan (Right Return Pill) are used. For qi-component cold deficiency, Liu Qi Jian (Six Qi Decoction) is used. For spleen-kidney yin-component cold deficiency with varied manifestations, Li Yin Jian (Regulate Yin Decoction) is used. For significant deficiency of sanjiao yang qi, Liu Wei Hui Yang Yin (Six Ingredient Restore Yang Drink) is used. For qi deficiency and spleen cold, Yi Qi Dan (One Qi Elixir) is used. For stomach qi deficiency and cold, Wen Wei Yin (Warm Stomach Drink) and Li Zhong Tang (Regulate Middle Decoction) are used. For blood deficiency and cold stagnation, Wu Wu Jian (Five Elements Decoction) is used.
2. Those with yin deficiency often experience heat, due to water failing to assist fire, leading to yin-deficiency heat. This disease often arises from indulgence in alcohol, sex, and desires, or anger and evil thoughts causing wild exertion, stirring up fire in the five viscera, especially in those with congenital primordial yin insufficiency. Patients with deficiency damage who experience much heat and dryness, and dislike hot food, show yin deficiency signs. To nourish yin, sweet-cool-pure-still substances are suitable. For yin with internal fire, acrid-warm agents are strictly forbidden, such as Gan Jiang (Zingiberis Rhizoma), Gui Zhi (Cinnamomi Ramulus), Fu Zi (Aconiti Lateralis Radix Praeparata), Po Gu Zhi (Psoraleae Fructus), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cang Zhu (Atractylodis Rhizoma), and Ban Xia (Pinelliae Tuber). Even Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Gou Qi Zi (Lycii Fructus), Dang Gui (Angelicae Sinensis Radix), and Du Zhong (Eucommiae Cortex), which contain yang within yin, should be used cautiously, fearing that strong yang will consume yin further and increased heat will dry up water sources. However, yin-deficient patients, due to water insufficiency, must avoid cold-bitter substances, as these are not nourishing. If fire is excessively strong and cooling is necessary, it must be combined with water-nourishing agents, used intermittently, and stopped when possible to prevent damage. This is the major principle of tonification. Treatments include:
3. For night fever or afternoon fever in deficiency damage, or preference for cold drinks and solid stools, indicating yin-deficiency heat where water fails to control fire, use Jia Jian Yi Yin Jian (Modified One Yin Decoction). If fire affects heart and kidney, causing palpitations and mental instability, use Er Yin Jian (Two Yins Decoction). If external heat persists but internal heat is slight, only tonify yin, do not clear fire; use Yi Yin Jian (One Yin Decoction) or Liu Wei Di Huang Tang (Six Ingredient Rehmannia Pill Decoction). If primordial qi is insufficient and deficiency heat persists, Da Bu Yuan Jian must be used for gradual self-recovery. Refer to the chapter on Cold and Heat for detailed treatments.
4. Deficiency damage cough involves all five viscera, but primarily focuses on lung and kidney. Lung is the metal organ, feared by fire, transformed by dryness. Dryness causes itching, which causes cough. Because kidney water fails to control fire, fire attacks metal; because yin essence fails to transform into qi, dryness occurs. Symptoms include cough, panting, sore throat, throat sores, and hoarseness. Treatment requires sweet-cool-still agents to nourish metal and water, allowing lung and kidney to generate each other without fire constraint, restoring true yin and curing cough. For strong fire, use Si Yin Jian (Four Yins Decoction) modified. For slight fire, use Yi Yin Jian, Liu Wei Di Huang Tang, or Zuo Gui Yin. For cough complicated by wind-cold, use Jin Shui Liu Jun Jian (Metal-Water Six Gentlemen Decoction). Bei Mu Wan (Fritillaria Pill) is best for cough.
5. Deficiency damage hematemesis damages yin, leading to vomiting blood or epistaxis. Treatment depends on the presence and severity of fire. For strong fire carrying blood upward, with heat signs in pulse and symptoms, treat the branch urgently using temporary clearing agents like Huang Qin, Huang Lian, Zhi Zi, Huang Bo, Zhu Ye, and Tong Bian (Child's Urine), or single prescriptions like Chou Xin Yin (Draw Firewood Drink) or Xi Xin Yin (Remove Firewood Drink). For yin deficiency with slight fire, use Bao Yin Jian (Protect Yin Decoction), Qing Hua Yin (Clear Transformation Drink), or Jia Jian Yi Yin Jian. After bleeding stops, tonify blood; avoid excessive cold. For no excess fire but pure yin injury, where yin-water deficiency causes blood movement and bleeding, use purely sweet-yin-nourishing agents to calm movement with stillness and heal injury with harmony, allowing yin qi to rest and blood to return to vessels. Use Yi Yin Jian, Liu Wei Di Huang Tang, or Xiao Ying Jian (Small Nourish Decoction). For yin deficiency involving lung with cough and blood, use Si Yin Jian modified. For labor injury without fire signs, damaging heart-spleen-kidney yin and moving blood, use Wu Yin Jian (Five Yins Decoction), Wu Fu Yin, or Liu Wei Di Huang Wan. For lower yin deficiency with floating yang above, rootless six pulses, and massive hematemesis/epistaxis, indicating fire not returning to source and loss of true yang, use You Gui Yin modified or Ba Wei Di Huang Tang (Eight Ingredient Rehmannia Pill). This occurs mostly in cases of excessive thought and fatigue. For fatigue-induced vomiting/diarrhea with spleen failing to control blood, use Liu Wei Hui Yang Yin with heavy Bai Zhu; cool medicines are forbidden. For massive bleeding, thready/dead pulses, cold limbs, and imminent death, use Zhen Yin Jian (Settle Yin Decoction) immediately to stop bleeding. For severe blood loss with qi collapse causing fainting, tonify qi to secure life using Liu Wei Hui Yang Yin or Si Wei Si Yang Yin; cool medicines will cause death. In summary, blood loss indicates major yin injury. Without protecting primordial qi and cultivating true yin, and using only cool medicines, yin will further deplete. Although bleeding may stop, the disease will deteriorate daily.
6. Deficiency damaging yin originates in the five viscera. While each viscus has its domain, treatment can be differentiated or undifferentiated. Qi damage treats lung; spirit damage treats heart; diet/muscle damage treats spleen; blood/tendon damage treats liver; essence/marrow damage treats kidney. This is differentiable. However, qi governs lung but transforms from essence; spirit governs heart but transforms from qi; muscle governs spleen but earth generates from fire; blood stores in liver but transforms from spleen/stomach; essence/marrow governs kidney but receives from five viscera. This is undifferentiable. When severe, root and branch transmit, affecting viscera, making rigid formulas inappropriate. Therefore, tonification methods must understand yin-yang ascent/descent and cold-hot-warm-cool natures, and the interplay of essence and qi. Upper jiao yang deficiency sinks to kidney, requiring stimulation of extreme yin points. Lower jiao true yin deficiency flies upward, requiring guidance back to source. Treatment must seek the root. My tonification methods are detailed in the New Formulas' Eight Strategies and Eight Arrays. For unlisted symptoms like spermatorrhea, nocturnal emission, hoarseness, night sweats, or female amenorrhea due to blood dryness, consult respective sections for corresponding treatments.