Chapter 6, Xuebi and Exhausting syndrome, their symptoms, pulse

Chapter 6, Xuebi and Exhausting syndrome, their symptoms, pulse and treatment

问曰：血痹病从何得之？师曰：夫尊荣人，骨弱肌肤盛重，因疲劳，汗出，卧不时动摇，加被微风，遂得之。但以脉自微涩，在寸口关上小紧，宜针引阳气，令脉和紧去则愈。

Asked: how can a person get Xuebi disease? Master: for a person with rich life condition, he/shi is weak in bone, but overweigh in muscles. Whenever exhausted with labor or mental work, he has sweat, shaking in the body during sleep. Then, he is exposed to and attacked by the slight wind during the sweat and lying. The person with the Xuebi disease has slight harsh, and slight tight pulse in the Chun position. For the treatment, use acupuncture to guide the Yangqi, to release the tight pulse. [1]

血痹，阴阳俱微，寸口关上微，尺中小紧，外证身体不仁，如风痹状，黄耆桂枝五物汤主之。(注：这里的临床症状出现在上症未得到有效治疗之后)．　

For person with the Xuebi disease[2], the pulse is weak when touch slightly or deeply. In addition, his pulse is mild on the Guan position, and slight tight on the Chun position. He feels discomfort　(similar to a kind of numb) in the body here and there but not typical pain or numb or tight or spasm or itch, a condition similar to a Fengbi disease[3]. In this case, use Huangqi Guizhi Wuwo Tang.

黄耆桂枝五物汤方

Huangqi 45 gram, Shaoyao 45 gram, Guizhi 45 gram, fresh ginger 90 gram, Chinese date 12 badges.

右五味，以水六升，煮取二升，温服七合，日三服。（一方有人参）

Add the herbs and 1500 ml water into a herbal pot. Bring to boil and keep in mild boiling until the liquid in the pot is about 500 ml. Drink one third of the herbal tea each time, three times a day. (in another formula version,, there is Renshen in it).

For a person seems healthy, but his pulse is big, the big pulse[4] suggests his exhausting working history, which is called exhausting disease. Very weak pulse also suggests an exhausting disease. (this is a condition in which the pulse is ill but the person has not been ill.)

人年五、六十，其病脉大者，痹侠背行。若马刀、侠瘰者，皆为劳得之。

For a person aged between 50 to 60 and with the big pulse, he will have tissue lamp or enlarged tissue mass[5] in the body, all of which is the symptoms of the exhausting disease.

劳之为病，其脉浮大，手足烦(热)[6]，春夏剧，秋冬差，阴虚精自出，酸削不能行。

For exhausting disease, the pulse of the person is floating and big. He feels annoying (hot) feeling in the hands or feet, which is more severe in the spring and summer, but less so in fall or winter. Since the Yin is not sufficient to hold libido, so the libido leaks. The Yin is not sufficient to be save in the Kidney system. The Kidney system is weak, and fails to nourish the bones, so the leg is skinny and difficult to walk.
男子脉虚沉弦，无寒热，短气里急，小便不利，面色白，时目瞑兼衄[7]，少腹满[8]，此为劳使之然。(凡此脉证，皆因劳而病也)

For a male, if his pulse is deep, weak and string[9], he has no hot or cold[10], but has short of breath, spasm inside of the body, difficult in urine, pale face, eye blurring form time to time and nose bleeding, bloating in lower abdomen, it is called exhausting disease.

For a male, if he is thin and pale in the face, it suggests thirsty[11] and loss of blood, sudden asthma[12] and palpitation[13].

For a male, if his pulse is floating and weak and harsh, the condition indicates Cold in his libido, so he may have hard to have a baby.

夫失精家，少腹弦急，阴头寒，目眩，发落，脉极虚，芤迟，为清谷亡血失精。

For person with lose of fine[14], he feels spasm in lower abdomen, cold in the head of penis, dizzy in eyes, loss of hair. His pulse is very weak, hollow[15] and slow[16]. He also has non-digested food in the stool, loss of blood, or depletion of fine.

脉得诸芤动微紧，男子失精，女子梦交，桂枝龙骨牡蛎汤主之。

For person with blood loss or depletion of the fine, his pulse is hollow, slight tight and weak. For a male to lose fine, and for a women to dream sexual activity, use Guizhi Longgu Muli Tang.

For a male with weak, soft, thin and mild pulse, he is easy to have night sweat.

脉弦而大，弦则为减，大则为芤，减则为寒，芤则为虚，虚寒相搏，此名为革，妇人则半产漏下，男子则亡血失精。

Guizhi 45 gram, Shaoyao 45 gram, Fresh ginger 45 gram, Gancao 30 gram, Chinese date 12 badges, Longgu 45 gram, Muli 45 gram.

Add the herbs and 1750 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml liquid left. Drink one third of the tea each time, three times a day.

虚劳里急，悸衄，腹中痛，梦失精，四肢酸疼，手足烦热，咽干口燥，小建中汤主之。

For person with the exhausting condition, has spasm in the abdomen, palpitation, nose bleeding, pain in the abdomen, dream the loss of fine, feels sour in arms and legs, annoying hot in the hands and feet, dry mouth and throat, use Xiao Jianzhong Tang.

桂枝　三两，甘草（炙）三两，大枣　十二枚，芍药　六两，生姜　二两，胶饴　一升

Guizhi 45 gram, Gancao (processed) 45 gram, Chinese date 12 badges, fresh ginger 30 gram, Jiaoyi 250 ml.

右六味，以水七升，煮取三升，去滓，内胶饴，更上微火消解，温服一升，日三服。

Add the herbs (except the Jiaoyi) and 1750 ml of water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml liquid left in the pot. Remove the residue, add the Jiaoyi in, continue boiling for a while until the Jiaoyi is melted in the herbal tea. Drink one third of the tea each time, three times a day.

If a person is easy to vomiting, do not use the Xiao Jianzhong Tang to him, since this herb tea is sweet and it may create nausea and vomit.

For all kinds of exhausting conditions, weakness conditions, use Huangqi Jianzhong Tang.[17]

Add Huangqi 23 gram into the above Xiao Jiangzhong Tang. Cook and drink the tea the same way.

若气短胸满者，加生姜；腹满者，去枣加茯苓一两半；及疗肺虚损不足补气，加半夏三两。

If there is short of breath, add fresh ginger; fullness in abdomen, remove Chinese date but add Fuling 23 gram; for Lung weakness, add Banxia 45 gram.

For exhausting condition with lower back pain, spasm in the lower abdomen and difficulty in urine, use Bawei Shenqi Wan.

For exhausting condition with more annoying impatience so that it is hard to fall into sleep, use Suanzaoren Tang

Suanzaoren 80 gram, Gancao 15 gram, Zhimu 30 gram, Fuling 30 gram, Chuangqun 30 gram.

右五味，以水八升，煮酸枣仁，得六升，内诸药，煮取三升，分温三服。

Add the Suanzaoren and 1800 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 1500 ml liquid left in the pot. Add remaining herbs in, continue to boiling until there is 750 ml herbal tea left. Collect it. Drink one third of the tea each time, three times a day.

五劳极虚，羸瘦腹满，不能饮食，食伤、忧伤、饮伤、房室伤、饥伤、劳伤，经络荣卫气伤，内有干血，肌肤甲错，两目黯黑，缓中补虚，大黄虫丸主之。(本条以热伤干血为言)

If the exhausting condition is very severe, the person is very wasting, skinny, fullness in abdomen, hard to eat, and the conditions are caused by improper eating, depression, drinking, sexual activity, hungry, extreme labor work, and his Weiwi, Rongqi and meridian systems have been damaged. He has dead blood[18] inside of the body, dry skin which looks as a fish skin, dark around the eyes. To adjust, balance the body inside and nourish the body inside, use Dahuang Zhechong Wan.

大黄（蒸）十分,，黄芩二两，甘草三两，桃仁一升，杏仁一升，芍药四两，干漆一两，汒虫一升，水蛭百枚，蟅虫半升，蛴螬一升，干地黄十两

Dahuang, Huangqin, Gancao, Taoren, Xinren, Shaoyao, Ganqi, Mangchong, Shuizhi, Zhechong, Qicao, Shendihuang

右十二味，末之，炼蜜为丸，小豆大，酒饮服五丸，日三服。

Prepare the herbs into pills as 0.5 cm in diameter. Drink five pills each time with the help of wine to swallow. Three times a day.

虚劳诸不足，风气百疾，薯蓣圆方主之。（此条以风气百疾立论）

For various exhausting conditions, the body is usually with Wind damage inside. If the Wind hurts the upper blood part, causing cough and pus formation in the lung; if it damages blood in the lower part of the body, it causes accumulation of dead blood there. In such cases, use Shuyuyuan. (For the treatment, it should not be urgent to treat the Wind, but should pay much attention first to nourish the Zhengqi inside. The Master use Sijungzi Tang, Siwu Tang to nourish the Qi and Blood in the body. When the Zhengqi is sufficient, the Wind should be depleted automatically.)

Shuyu, Danggui, Guizhi, Shengqu, Shendi, Douhuangjuan, Gancao, Renshen, Chuangqun, Shaoyao, Baishu, Maimendong, Xinren, Chaihu, Jiegen, Fuling, Ajiao, Ganjiang, Baiji, Fangfeng, Chinese date.

右二十一味，末之，炼蜜和丸，如弹子大，空腹酒服一丸，一百丸为剂。

Prepare the herbs with honey into pills of 1 cm in diameter. Drink one pill each time with the help of wine for swallow.

[1] The paragraph tells that, some person, though looks strong and have big size in the body, is easy to be affected by the Wind during the sleeping (with sweat). He looks strong from outside, but weak inside of the body. Harsh pulse suggests the Xieqi is stick in the blood.

[2] Xuebi, Xue means blood. Bi means tightness or pain when refers to joints.

[3] For Fengbi disease, the person has moving pain in the small joints. The Xuebi disease has no such joint pain, but discomfort feeling in whole body. Fengbi, here Feng means wind.

[4] The pulse is big, but soft, not tight or strong.

[5] Such as lymph enlargement, or fibrosis, skin ulcer, etc.

[6] Because the exhausting labor or mental work exhausts the Yinqi or Yinye of the body, the less Yin can not hold the Yangqi, so the Yangqi is floating. In the spring and summer, the Yangqi in the nature vibrates and helps the Yangqi in the body to float so the condition is worse. In the fall and winter, the Yinqi in the nature helps the Yinye in the body to hold the Yangqi inside of the body, so the symptoms are less severe.

[7] Pale face and eye blurring, and nose bleeding suggests the upper part of the body is weak.

[8] Fullness in the lower abdomen and difficult in urine: weakness in the lower part of the body.

[9] The weak, deep and string pulse suggests the depletion of body Yin and Yangqi in the body.

[10] Though the Yin and Yang are both depleted, but no one is relatively more than the another.

[11] This thirsty is due to deficiency in the Jingye, the weakness of the Yinye.

[12] Sudden asthma: Lung weakness.

[13] Sudden palpitation: Heart weakness in blood.

[14] This is a condition in which the Kidney Yangqi is not enough to hold the Yin – the fine.

[15] Hollow pulse: blood depletion.

[16] Slow pulse: Cold condition.

[17] For the Guizhi jia Longgu Muli Tang, it is the Guizhi Tang plus Longgu and Muli; the Xiao Jiangzhong Tang is the Guizhi Tang plus Jiaoyi; and the Huangqi Jiangzhong Tang is the Guizhi Tang plus Huangqi and Jiaoyi. Here the readers should remember that the Guizhi Tang is used for a weat therapy for Taiyang Wind-invasion condition, but it is also used for the nourishing therapy for various exhausting conditions too.

[18] Dead blood: TCM concept. It refers to those of blood that does not participate in the normal blood circulation.