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Chapter 8 of 27
金匮要略
🌿 Opening Explanation: This chapter in the upper volume of the Essentials from the Golden Cabinet specifically discusses two categories of deficiency-wasting diseases—Blood Bi (a condition of body numbness and lack of sensation due to impaired flow of nutritive and defensive qi and blood, with failure of the limbs and flesh to be nourished) and Consumptive Labor (a chronic debilitating condition caused by various factors leading to deficiency of viscera, qi, blood, yin, and yang—not a disease of a single viscus, but a systemic deficiency and impairment). The entire chapter contains nine clauses on pulse manifestations and syndromes, and nine formulas, systematically discussing the etiologies, pulse manifestations, syndromes, and treatment methods of both disease categories.
🌿 Blood Bi Dialogue: Someone asked: How does Blood Bi disease develop? The teacher replied: Those distinguished persons (those who lead a life of ease and comfort with little physical labor), with weak bones but abundant flesh (weak sinews and bones yet corpulent flesh), inherently have insufficient defensive function at the exterior. This, combined with sweating after fatigue, opening of the pores, and restless sleeping with frequent turning and exposure to wind—even merely a slight wind pathogen—is sufficient to take advantage of the deficiency and enter, giving rise to Blood Bi. The pulse manifestation shows Cun-kou slightly sluggish (the pulse arrives weak and hesitant, indicating insufficiency of qi and blood with impaired circulation), and Guan slightly tight (the Guan position pulse carries a slightly tight quality, indicating slight invasion of wind-cold and yang qi that fails to spread). Treatment should use acupuncture to activate yang qi, allowing yang qi to flow freely and the pulse pathways to harmonize; when the tight pulse recedes, the disease can be cured.
🌿 Huangqi Guizhi Wuwu Tang Pattern: In Blood Bi disease, if the pulse shows both Cun-kou and Guan being faint, with Chi position slightly tight, and the body surface manifests numbness of the body (skin numbness with loss of sensation to pain and itching), resembling Wind Bi (a bi disorder primarily characterized by wandering pain)—this results from insufficiency of yang qi and stagnation of yin blood. Treat with Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction).
Huangqi Guizhi Wuwu Tang Formula: Astragalus root 3 liang, Peony root 3 liang, Cinnamon twig 3 liang, Fresh ginger 6 liang, Red dates 12 pieces. Decoct these five herbs in 6 sheng of water to obtain 2 sheng. Take 7 he warm, three times daily. This formula is derived from Guizhi Tang (Cinnamon Twig Decoction) with licorice removed, ginger doubled, and astragalus added, serving to boost qi, unblock yang, harmonize the nutritive level, and move through bi obstruction.
⚠️ The above formula was established by the ancients for the pathogenesis of Blood Bi. It is presented here solely as academic theory and principle explanation, not as medication guidance.
🌿 General Pulse Manifestations of Consumptive Labor: Generally speaking, if a man appears outwardly normal but the pulse is large (floating and large but without strength, indicating yin deficiency with yang floating), this belongs to consumptive labor; if the pulse is extremely vacuous (the pulse arrives extremely soft and without strength, indicating interior depletion of essence qi), this also belongs to consumptive labor.
🌿 Pulse Manifestations of Various Consumptive Labor Patterns: In a man with thin complexion (pale and lusterless complexion), there is predominance of thirst and loss of blood (hemorrhage); if there is sudden wheezing, palpitations, and a floating pulse, this indicates interior vacuity (deficiency of qi and blood within the body, with yang qi floating externally). In a man whose pulse is vacuously deep and stringlike (soft on floating palpation, stringlike on deep palpation—the stringlike quality indicating vacuity-cold), without aversion to cold or fever, yet presenting with shortness of breath and inner tension (short, rapid breathing with abdominal gripping discomfort), difficult urination, a pale complexion, frequent closure of the eyes with dizziness, occasional nosebleeds, and lower abdominal fullness—this is caused by consumptive labor. In consumptive labor as a disease, the pulse is floating and large (large but without strength on floating palpation), with feverishness of the hands and feet, aggravation in spring and summer, and alleviation in autumn and winter, with cold genitals and spontaneous emission of essence (coldness of the genital area with spontaneous seminal discharge), and acidic soreness and atrophy with inability to walk (sore, atrophied legs with inability to walk with strength). In a man whose pulse is floating, weak, and hesitant (weak on floating palpation, with rough and hesitant movement), this indicates inability to have children (infertility), because his essence qi is cold and clear (sperm is thin, cold, and lacking warm vitality).
🌿 Treatment of the “Seminal Emission Sufferer”: For those who have long suffered from loss of essence (nocturnal emission and spermatorrhea), there is lower abdominal stringlike tension (tight, pulling sensation in the lower abdomen), cold glans penis, dizziness, and hair loss. The pulse is extremely vacuous, hollow, and slow (extremely soft, hollow like a scallion stalk, and slow)—this is the sign of undigested grains in the stool, loss of blood, and loss of essence. Wherever the pulse shows hollow, stirring, faint, and slightly tight qualities (hollow indicating vacuity, stirring indicating restless throbbing, faint indicating insufficiency of yang qi, tight indicating cold)—in men this indicates loss of essence, and in women it indicates dream intercourse (dreaming of intercourse with the opposite sex with resulting seminal emission or vaginal discharge). Treat with Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell).
Guizhi Jia Longgu Muli Tang Formula: Cinnamon twig, Peony root, Fresh ginger—each 3 liang; Licorice 2 liang; Red dates 12 pieces; Dragon bone, Oyster shell—each 3 liang. Decoct all seven herbs in 7 sheng of water to obtain 3 sheng. Take warm in three divided doses. This formula is Guizhi Tang with dragon bone and oyster shell added, serving to harmonize yin and yang, and to suppress and stabilize.
The ancients considered this formula to treat seminal loss and dream intercourse, embodying the therapeutic approach of harmonizing yin and yang, and suppressing and securing. For study purposes only, not as medication guidance.
Tianxiong San Formula: Processed aconite root (Tianxiong) 3 liang (pao), Atractylodes 8 liang, Cinnamon twig 6 liang, Dragon bone 3 liang. Grind all four herbs into powder. Take half a qian spoon with wine, three times daily; if the effect is not evident, the dose may be slightly increased. The ancients used this formula to warm yang and secure essence, for the pattern of yang deficiency with seminal loss. For study purposes only, not as medication guidance.
🌿 Night Sweating Pulse Pattern: In a man who appears outwardly normal, with a pulse that is weak, faint, and fine (the pulse arrives soft, faint, and thin), this is mostly the night sweating (sweating after falling asleep at night, stopping upon waking) type of person—caused by deficiency of both yin and yang, with failure of the nutritive and defensive systems to secure the exterior.
🌿 Geriatric Consumptive Labor Pattern: In people aged fifty to sixty, if the pulse is instead large, this is a consumptive labor pulse, commonly presenting with bi along the back (numbness and discomfort along both sides of the back, as if a bi disorder travels along the spine); if there is also intestinal rumbling, saber-shaped swellings (lymph node tuberculosis under the armpits, shaped like a saber), and beaded goiter (cervical lymph nodes enlarged in a string, like a tassel)—all are caused by consumptive labor.
🌿 Qi Collapse Pattern: If the pulse is deep, small, and slow (deep in position, small in form, slow in rate), this is called qi collapse (extreme deficiency of yang qi with qi sinking due to deficiency)—such a person will pant and wheeze upon rapid walking (shortness of breath with audible sounds when walking quickly), have cold hands and feet, abdominal fullness, and in severe cases, loose stools with undigested food.
🌿 Leather Pulse Indicating Disease: If the pulse is stringlike and large, with stringlike indicating reduction (attenuation of yang qi) and large indicating hollow (emptiness of yin blood); reduction indicates cold, hollow indicates vacuity; when vacuity and cold mutually combine, this is called the leather pulse (the pulse arrives stringlike and large but hollow within, like pressing on a drumskin—hard externally, hollow within). In women, this pulse indicates miscarriage and vaginal bleeding (miscarriage or flooding and spotting); in men, it indicates loss of blood and seminal loss.
🌿 Xiao Jianzhong Tang Pattern: In consumptive labor presenting with inner tension (gripping and painful tension in the abdomen), palpitations, nosebleeds, abdominal pain, dreams with seminal emission, soreness and pain in the four limbs, feverishness of the hands and feet, and dry throat and mouth—this results from deficiency of both yin and yang, failure of the middle burner to thrive, and depletion of the source of qi and blood transformation. Treat with Xiao Jianzhong Tang (Minor Build the Middle Decoction).
Xiao Jianzhong Tang Formula: Cinnamon twig 3 liang (peeled), Licorice 3 liang (honey-fried), Red dates 12 pieces, Peony root 6 liang, Fresh ginger 3 liang, Malt sugar (yi tang, i.e., maltose) 1 sheng. Decoct the six herbs in 7 sheng of water to obtain 3 sheng. Remove the dregs, then add the malt sugar and dissolve over gentle heat. Take 1 sheng warm, three times daily. This formula is Guizhi Tang with doubled peony plus malt sugar, serving to sweetly warm and build the middle burner, and harmonize yin and yang.
The ancients considered this formula to treat consumptive labor with inner tension and abdominal pain, embodying the therapeutic approach of sweetly warming and building the middle, and harmonizing yin and yang. Those with vomiting should not take it, as the sweetness of malt sugar tends to promote dampness. For study purposes only, not as medication guidance.
Huangqi Jianzhong Tang Formula: For consumptive labor with inner tension and various insufficiencies, use Huangqi Jianzhong Tang (Astragalus Build the Middle Decoction) as the primary treatment. This is Xiao Jianzhong Tang with 1.5 liang of astragalus added; the rest of the administration method is the same. If there is shortness of breath and chest fullness, add fresh ginger; if there is abdominal fullness, remove the red dates and add Poria 1.5 liang; it also treats deficiency and insufficiency of the lung, adding Pinellia 3 liang to boost qi. This formula sweetly warms and boosts qi, building the middle and supplementing vacuity.
For study purposes only, not as medication guidance.
🌿 Bawei Shenqi Wan Pattern: In consumptive labor presenting with lumbar pain, lower abdominal gripping tension (tight, uncomfortable sensation in the lower abdomen), and difficult urination, use Bawei Shenqi Wan (Eight-Ingredient Kidney Qi Pill) as the primary treatment. This formula is the Shenqi Wan (Kidney Qi Pill) (containing dried rehmannia, Chinese yam, Cornus, Alisma, Poria, Moutan bark, cinnamon twig, and prepared aconite), serving to warmly supplement kidney qi and transform qi to move water.
The ancients considered this formula to treat lumbar pain and difficult urination due to deficiency of kidney qi. For study purposes only, not as medication guidance.
🌿 Shuyu Wan Pattern: In consumptive labor with various insufficiencies (deficiency of all aspects—qi, blood, yin, and yang), complicated by wind-qì with hundred maladies (multiple deficiency-wasting disorders triggered by external wind pathogen invasion), use Shuyu Wan (Dioscorea Pill) as the primary treatment.
Shuyu Wan Formula: Dioscorea 30 parts; Dang gui, Cinnamon twig, Dried rehmannia, Medicated leaven, Fermented soybean卷—each 10 parts; Licorice 28 parts; Chuanxiong, Ophiopogon, Peony root, Atractylodes, Apricot kernel—each 6 parts; Ginseng 7 parts; Bupleurum, Platycodon, Poria—each 5 parts; Ejiao 7 parts; Dried ginger 3 parts; Ampelopsis 2 parts; Ledebouriella 6 parts; Red dates 100 pieces (made into a paste). Grind all twenty-one ingredients into powder, mix with refined honey into pills the size of a marble. Take one pill on an empty stomach with wine, with one hundred pills constituting one course of treatment. This formula supplements the middle while dispersing, supporting the upright and dispelling evil—a restorative formula for consumptive labor complicated by external wind.
For study purposes only, not as medication guidance.
🌿 Suanzao Tang Pattern: In consumptive labor presenting with vexation and inability to sleep (vexation due to deficiency, restless unease in the heart, and difficulty falling asleep), use Suanzao Tang (Sour Jujube Decoction) as the primary treatment.
Suanzao Tang Formula: Sour jujube kernel (Ziziphus) 2 sheng, Licorice 1 liang, Anemarrhena 2 liang, Poria 2 liang, Chuanxiong 2 liang. First decoct sour jujube kernel in 8 sheng of water until 6 sheng remain, then add the remaining herbs and decoct to obtain 3 sheng. Take warm in three divided doses. This formula nourishes liver blood, clears vacuous heat, and calms the spirit.
For study purposes only, not as medication guidance.
🌿 Dahuang Zhechong Wan Pattern: In the five exhaustions (prolonged looking harms blood, prolonged lying harms qi, prolonged sitting harms flesh, prolonged standing harms bones, prolonged walking harms sinews)–induced extreme vacuity and emaciation (extreme thinness and wasting), with abdominal fullness and inability to eat or drink, the causes implicate injury by food (dietary irregularity), injury by worry (excessive grief and anxiety), injury by drinking (excessive alcohol consumption), injury by sexual intemperance (excessive sexual activity), injury by hunger (irregular hunger and satiety), injury by overexertion (excessive fatigue from labor), and injury to the channels, collaterals, nutritive, and defensive qi—resulting in internal stagnant blood (static blood coagulated internally, dry and unyielding). This manifests as skin coarseness like fish scales and dark, dull eyes (dark and lusterless area around both eyes). Treat with the method of relaxing the middle and supplementing vacuity (dispersing stasis to relax the middle, removing stasis to generate new blood), using Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) as the primary treatment.
Dahuang Zhechong Wan Formula: Rhubarb 10 parts (steamed), Scutellaria 2 liang, Licorice 3 liang, Peach kernel 1 sheng, Apricot kernel 1 sheng, Peony root 4 liang, Dried rehmannia 10 liang, Dried lacquer 1 liang, Tabanus 1 sheng, Leech 100 pieces, Grub 1 sheng, Ground beetle (Eupolyphaga) half a sheng. Grind all twelve ingredients into powder, mix with honey into pills the size of small red beans. Take 5 pills with wine or water, three times daily. This formula breaks blood and expels stasis, relaxes the middle and supplements vacuity—the representative formula for the method of "removing stasis to generate the new."
For study purposes only, not as medication guidance.
🌿 Attached Formula One: Zhigancao Tang (from the Qianjin Yi, also known as Pulse-Restoring Decoction): The ancients considered that in consumptive labor with insufficiency, sweating with oppressive chest, and knotted pulse with palpitations (intermittent pulse with palpitations of the heart), in individuals who otherwise act normally, crisis occurs within one hundred days; if the pulse is at a critical state, death occurs on the eleventh day. Formula: Licorice 4 liang (honey-fried), Cinnamon twig and Fresh ginger—each 3 liang, Ophiopogon 1 half-sheng, Hemp seed 1 half-sheng, Ginseng and Ejiao—each 2 liang, Red dates 30 pieces, Raw rehmannia 1 jin. Use 7 sheng of wine and 8 sheng of water, first decoct the eight other ingredients to obtain 3 sheng, remove the dregs, then add Ejiao to dissolve. Take 1 sheng warm, three times daily. This formula boosts qi and nourishes blood, frees yang and restores the pulse.
For study purposes only, not as medication guidance.
Attached Formula Two: Tà gān Sǎn (Otter Liver Powder) (from the Zhouhou Bei Ji Fang): The ancients considered it to treat cold consumptive labor (consumptive labor presenting with cold signs), and also to treat ghost infection (the ancient term for certain infectious diseases) that afflicts one household by contagion (mutual transmission within the same family). Formula: One otter liver, dried over fire, ground into powder. Take one square spoon with water, three times daily.
⚠️ This clause pertains to the ancient practice of using animal organs in medication, as well as the disease designation “ghost infection”—these are understandings under historical conditions, bearing clear limitations of their era. The description of “one household afflicted by contagion” suggests that the ancients had observed that certain diseases exhibit familial clustering and transmission, yet attributing this to “ghost infection” is a non-scientific conceptualization. This is an ancient formula; presented here only as academic theory and principle explanation, not as medication guidance.
1. The “Distinguished Person” Constitution in Blood Bi—The Sprouting of the “Sedentary Disease” Concept
“The distinguished person, with weak bones and abundant flesh” represents an important paradigm of constitution differentiation in Chinese medicine. Those who lead lives of ease and comfort may appear corpulent externally, but their internal sinews and bones are not strong—akin to “strong outside, weak inside.” Because they engage in little physical exertion, their defensive yang fails to be vigorous; once fatigue leads to sweating, even slight wind is sufficient to cause disease. Zhang Zhongjing uses acupuncture to mobilize yang qi rather than simply dispel wind, revealing that the core pathogenesis of Blood Bi is failure of yang qi to circulate and sluggishness of blood movement—not the vigor of the pathogen itself. The therapeutic focus lies in “causing the pulse to become harmonious,” restoring the natural rhythm of qi and blood movement.
This concept of “illness from idleness” (excessive ease and comfort can also cause disease) aligns with the Suwen statement “prolonged lying harms qi,” and is highly unique in the history of Chinese medicine, deserving deep consideration.
2. The Pulse-Learning Framework for Differentiating Consumptive Labor
This chapter establishes the definitive pronouncement: “A large pulse indicates consumptive labor; an extremely vacuous pulse also indicates consumptive labor.” A large but powerless pulse indicates yin deficiency with yang floating and yang qi expanding outwardly; an extremely vacuous pulse indicates scarcity and depletion of essence qi, with the pulse failing to fill. The two—one floating, one deep, one external, one internal—encapsulate both the yin and yang ends of consumptive labor. Thereafter, the layers unfold: the hollow pulse indicates loss of blood and essence (the vessel is empty like a scallion stalk), the leather pulse indicates mutual contention of vacuity and cold (stringlike and large yet hollow like a drumskin), deep, small, and slow indicates qi collapse, and floating, weak, and hesitant indicates cold essence with infertility—each pulse manifestation corresponds to a specific mechanism of qi-blood deficiency, constituting a rigorous diagnostic logic integrating pulse–pattern–pathogenesis.
3. The Central Position of the “Build the Middle” Method
Among the numerous formulas for supplementing vacuity, Xiao Jianzhong Tang and Huangqi Jianzhong Tang occupy a pivotal, connecting position. The key lies in making the middle burner and spleen-stomach the pivotal axis: although consumptive labor involves damage to the five viscera, all the body's qi and blood are generated by the middle burner; if the middle burner is not thriving, a hundred supplements will be ineffective. Sweet-warm building of the middle establishes the middle qi so that the nutritive and defensive levels become harmonious and yin and yang become balanced. Thus, even the seemingly contradictory manifestations of “inner tension, palpitations, nosebleeds, abdominal pain, dreams with seminal emission, soreness of the four limbs, and feverishness of the hands and feet” (qi-blood deficiency with mixed cold and heat) can all be resolved through this approach. The intellectual roots of later earth-supplementing schools (such as that of Li Dongyuan) lie precisely herein.
4. Supplementing Vacuity Without Neglecting Treating Excess—“Stagnant Blood” and “Wind-Qi”
Consumptive labor is not treated with pure supplementation alone; there are also the two approaches of Shuyu Wan (primarily supplementing vacuity while also dispelling wind, supporting the upright and dispelling evil in parallel) and Dahuang Zhechong Wan (primarily breaking blood and expelling stasis, with the rationale that “relaxing the middle and supplementing vacuity”—removing static blood clears the way for generating new blood). This profoundly reflects Zhang Zhongjing's view of vacuity with superimposed excess: in protracted consumptive labor, stagnation of qi and blood circulation may give rise to “dry blood” (static blood); deficiency of upright qi may invite external wind. Therefore, treatment is “supplementing without causing blockage, attacking without being drastic,” at every turn protecting the upright qi.
5. The “Seminal Emission Sufferer” and Non-Intercourse of Heart and Kidney
For the seminal loss and dream intercourse treated by Guizhi Jia Longgu Muli Tang, the key pathology lies in disharmony of yin and yang, failure of the heart-spirit to be secured, and failure of the essence gate to be firm. This is not simply kidney deficiency but rather disharmony between the nutritive and defensive levels (the Guizhi Tang pattern) combined with floating of the heart-spirit and failure of the kidney essence to be stored (what the dragon bone and oyster shell suppress and secure). This holistic view connects reproductive-system “seminal loss” and “dream intercourse” with superficial nutritive-defensive patterns and instability of the heart-spirit, embodying the unity of body and mind paradigm in Chinese medical thinking.
Regarding “Blood Bi” and “Numbness”
"Body numbness" describes a sensation of skin tingling or numbness, which in modern medicine can be seen in peripheral neuropathy (such as diabetic peripheral neuropathy, vitamin B12 deficiency, cervical spondylosis with nerve compression, etc.), peripheral circulatory disorders, and other conditions. The ancients attributed this to "impaired circulation of yang qi and sluggish blood flow," which bears a certain correspondence to the modern medical emphasis on microcirculatory perfusion and neural conduction at two levels. As a classic formula for supplementing qi, unblocking yang, and harmonizing the nutritive system, Huangqi Guizhi Wuwu Decoction (Astragalus and Cinnamon Twig Five-Substance Decoction) has been recorded in ancient and modern case histories as having some therapeutic effect on limb numbness. Modern pharmacological research also suggests that its ingredients—such as Astragalus, Cinnamon Twig, and Peony—may improve microcirculation, exert anti-inflammatory effects, and provide analgesia. However, it must be pointed out: the causes of numbness are complex and diverse, involving multiple systems including nervous, vascular, metabolic, and immune systems, and must not be treated solely with a single formula or method without proper differentiation.
Regarding the description of the "one who suffers seminal loss" (shijing jia)
The original text's depiction of the seminal-loss patient—lower abdominal tautness and urgency, cold glans penis, dizziness, hair loss, and an extremely deficient, hollow, and slow pulse—overlaps with modern descriptions of chronic wasting diseases or neurasthenia symptom complexes. In particular, "dizziness and hair loss" align with manifestations of malnutrition and endocrine disorders. The logic behind the composition of Guizhi Jia Longgu Muli Tang (Cinnamon Twig plus Dragon Bone and Oyster Shell Decoction)—harmonizing the nutritive and defensive qi while anchoring and calming the spirit—has been applied in some modern clinical studies for conditions such as anxiety, insomnia, and autonomic nervous system dysfunction, though the level of evidence is limited and should be regarded only as reference.
Regarding "a large pulse indicates exhaustion; an extremely deficient pulse likewise indicates exhaustion"
From a modern medical perspective, a "large pulse" in traditional Chinese medicine (TCM) pulse diagnosis often corresponds to a state of increased cardiac output with decreased vascular tone, observable in chronic wasting conditions, anemia, hyperthyroidism, and the like. An "extremely deficient" pulse corresponds to a weakened state of reduced stroke volume and low blood pressure. The ancients' inference of "consumptive exhaustion" (xulao) from pulse findings is essentially a functional description of the body's overall state, not a "pulse diagnosis that can confirm disease" in the modern sense. These pulse descriptions may serve as clinical reference clues but cannot be equated with modern laboratory or imaging examinations.
Regarding "skin resembling fish scales" and "desiccated blood"
The description of "skin resembling fish scales and dark lusterless eyes" in the Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) pattern is understood in modern medicine as a manifestation of chronic wasting, microcirculatory disturbance, and abnormal skin nutritional metabolism. The formula contains numerous insect-derived medicines (gadfly, leech, worm grub, and ground beetle), all with blood-breaking and stasis-dispelling actions. Modern pharmacological studies have shown that their active components (such as hirudin) have anticoagulant and microcirculation-improving effects. However, this formula is an attacking and expelling preparation, by no means suitable for casual use in ordinary "consumptive exhaustion" conditions—it should only be considered under the strict pattern differentiation of a qualified professional physician.
Regarding "Tahan Liver Powder" and "ghost affliction" (guizhu)
"Ghost affliction should be transmitted within the same household" represents the ancients' rudimentary observation of infectious diseases, and invoking "ghosts" as the cause belongs to the historical limitations of their era. Otter liver as a medicinal substance is rarely used in modern practice, and its therapeutic efficacy lacks support from modern evidence-based medicine. Such appended formulas primarily reflect the ancients' medicinal philosophy of "tonifying viscera with viscera" and "using blood-and-flesh substances of sentient beings," as well as their exploratory responses to unidentified infectious diseases. They should be viewed rationally and not followed blindly.
Regarding "knotted pulse with palpitations" and Zhi Gan Cao Tang (Licorice Decoction)
The description in the Zhi Gan Cao Tang pattern—"sweating with chest oppression, knotted pulse with palpitations, yet normal ambulation"—closely matches the manifestations of cardiac arrhythmias (premature beats, atrial fibrillation, etc.) in modern medicine. A "knotted or intermittent pulse" in TCM pulse theory refers precisely to irregular heart rhythm. As a renowned "pulse-restoring" formula, modern research has confirmed that some of its ingredients (such as Ginseng, Cinnamon Twig, and Licorice) may have a role in improving heart rhythm. However, arrhythmias have diverse etiologies and widely varying degrees of danger—one must never self-diagnose or self-manage based solely on a "knotted pulse with palpitations."
Although this chapter consists of disease-specific passages, the health preservation principles contained within are profound and actionable. The following are general maintenance insights and do not target any specific disease:
1. Moderate exertion; avoid "excessive idleness"
"The honored and prosperous, with weak bones and flourishing flesh" serves as a warning: excessive ease and inactivity can harm the body just as much as overexertion. Modern people who sit for prolonged periods and lack exercise are the very epitome of "weak bones and flourishing flesh." We should consciously maintain regular exercise (such as walking, Baduanjin, Taiji Quan, and other gentle activities) to promote the free flow of qi and blood, strengthen muscles and bones, and prevent the protective yang from becoming depleted and sluggish.
2. Regulate daily routine; cautiously avoid deficient pathogenic influences
"Exacerbated by fatigue and sweating, restless tossing in bed, then lightly exposed to wind"—after sweating from fatigue, the pores are open and the body is susceptible to invasion by external pathogens. Similarly, if modern people are directly exposed to cold air from air conditioning after exercise, after bathing, or during nighttime sleep, there is an equivalent risk of damaging the yang. One should wipe the body dry after sweating, avoid sleeping in a draft, keep nighttime air-conditioning temperatures not too low, and cover the abdomen with a light blanket.
3. Eat and drink with moderation; nourish the spleen and stomach
In this chapter, Xiaojianzhong Tang uses maltose as its core to strengthen the middle burner, and Shuyu Wan uses jujubes in its paste base—both emphasize the spleen and stomach as the foundation of acquired constitution. Daily life should include regular meals, avoiding extremes of hunger or overeating, maintaining appropriate food temperature, and limiting raw, cold, greasy, and sweet foods, so that the middle burner's transformation and transportation remain vigorous.
4. Moderate sexual activity; preserve essence and nurture spirit
"Sexual excess" is listed among the five overexertions and seven injuries, and the various weakened manifestations of the "seminal-loss patient" point directly to the harm of depleting essence through indulgence. The ancients advocated "restraining desire to preserve essence" and "maintaining regularity in daily life without undue exertion," which is especially relevant for modern people—keeping regular schedules, ensuring quality sleep, and moderating sexual desire are fundamental practices for maintaining essence, qi, and spirit.
5. Keep the mind calm and peaceful; avoid restless overexertion
"Restless agitation with inability to sleep" suggests that when the spirit is unsettled, the body is unwell. The core of the Suan Zao Tang (Sour Jujube Decoction) pattern lies in "deficient restlessness"—restlessness arising from deficiency, and insomnia arising from restlessness. Modern people under work pressure with racing thoughts should, before bed, gather and calm the spirit (such as through quiet sitting, deep breathing, and distancing from electronic screens), giving the mind a time to "return to camp."
6. Heed the signals of "exhaustion" and adjust promptly
Descriptions such as "panting when walking quickly," "emaciated and unable to walk," and "pallid complexion" warn us: signs such as persistent fatigue, a lackluster complexion, and shortness of breath upon slight exertion are early manifestations of "overexhaustion." One should adjust one's pace of life promptly and seek medical evaluation when necessary, rather than pushing through.
Associated Concepts
Further Reading
The pharmaceutical and therapeutic content above is derived from the TCM classical text Jingui Yaolue and is provided solely for the study and research of traditional culture. It does not constitute any medical diagnosis, medication recommendation, or treatment advice; specific syndromes should be addressed through pattern differentiation by a licensed TCM practitioner or physician in conjunction with modern medical examinations.
This content is based on a classical traditional Chinese medicine text and is provided solely for cultural study and reference. It does not constitute any medical diagnosis, medication, or treatment advice. If you feel unwell, please seek medical attention promptly.