寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Vacuity Taxation

Heoro

한글 허로  ·  Pinyin Xu Lao

the Donguibogam chapter in translation — origins, signs, and pulse of depletion illness

虛勞

Modern correspondence: chronic fatigue and burnout syndromes · convalescent debility · wasting and frailty · anemia and hypofunction states

This page presents the Donguibogam's Heoro (虛勞, vacuity taxation) chapter — the classical system of depletion illness: how the body is worn down layer by layer, how the five taxations, six extremes, and seven damages are distinguished, and how each viscus's vacuity is supplemented. Formula names link to their pages in this site's formula database. Sections will be added in order.

Origin of vacuity taxation 虛勞病源

損脉之爲病奈何. 然一損損於皮毛, 皮聚而毛落. 二損損於血脉, 血脉虛少, 不能榮於藏府. 三損損於肌肉, 肌肉消瘦, 飮食不爲肌膚. 四損損於筋, 筋緩不能自收持. 五損損於骨, 骨痿不能起於床. 反此者, 至脉之病也. 損脉從上下, 骨痿不能起於床者死, 至脉從下上, 皮聚而毛落者亦死. 《難經》

What are the diseases of the detriment pulse (損脉)? The first detriment is detriment to the skin and body hair: the skin shrivels and the hair falls out. The second is detriment to the blood vessels: the blood vessels grow vacuous and scant and cannot nourish the viscera and bowels. The third is detriment to the flesh: the flesh wastes and grows thin, and food and drink no longer build flesh and skin. The fourth is detriment to the sinews: the sinews slacken and cannot hold the body up. The fifth is detriment to the bones: the bones wilt and one cannot rise from bed. The reverse of this is the disease of the racing pulse (至脉). Detriment-pulse disease proceeds from above downward — when the bones wilt and one cannot rise from bed, death. Racing-pulse disease proceeds from below upward — when the skin shrivels and the hair falls out, likewise death.
Clinical note The chapter opens with the Nanjing's staging system: depletion advances through five anatomical layers — skin, vessels, flesh, sinews, bone — and the direction of travel is prognostic. Death is defined at either terminus: the yang disease that reaches the bones, or the yin disease that reaches the surface. Everything that follows in the chapter is an attempt to intercept this progression mid-course.

Nangyeong 難經 — Classic of Difficult Issues, Issue 14

虛損之疾, 寒熱, 因虛而感也. 感寒則損陽, 陽虛則陰盛. 故損自上而下. 治之宜辛甘淡, 過於胃, 則不可治也. 感熱則損陰, 陰虛則陽盛. 故損自下而上. 治之宜以苦酸醎, 過於脾, 則不可治也. 自上而下者, 一損損於肺, 皮聚而毛落. 二損損於心, 血脉虛少, 不能榮於藏府, 婦人則月水不通. 三損損於胃, 飮食不爲肌膚. 自下而上者, 一損損於腎, 骨痿不能起於床. 二損損於肝, 筋緩不能自收持. 三損損於脾, 飮食不能消化. 論曰, 心肺損而色敗, 肝腎損而形痿, 穀不能消而脾損. 感此病者, 皆損之病, 漸漬之深, 皆虛勞之疾也. 《綱目》

In the illness of vacuity detriment, cold and heat gain entry because of vacuity. Contracting cold damages yang; with yang vacuous, yin exuberates — hence the detriment travels from above downward. Treat with acrid, sweet, and bland; once it passes the stomach, it cannot be treated. Contracting heat damages yin; with yin vacuous, yang exuberates — hence the detriment travels from below upward. Treat with bitter, sour, and salty; once it passes the spleen, it cannot be treated. Traveling from above downward: the first detriment strikes the lung — the skin shrivels and the hair falls; the second strikes the heart — the vessels grow vacuous and cannot nourish the viscera, and in women the menses cease; the third strikes the stomach — food no longer builds flesh. Traveling from below upward: the first detriment strikes the kidney — the bones wilt and one cannot rise from bed; the second strikes the liver — the sinews slacken and cannot hold; the third strikes the spleen — food cannot be transformed. The discourse says: when heart and lung are damaged, the complexion is ruined; when liver and kidney are damaged, the physical form wilts; when grain cannot be transformed, the spleen is damaged. All who contract these are diseases of detriment; as the soaking deepens, all become the illness of vacuity taxation.
Clinical note The Gangmok maps the Nanjing's layers onto the viscera and adds the therapeutic corollary: the middle burner is the watershed. Whether the disease descends from the lung or ascends from the kidney, it becomes untreatable when it crosses the spleen-stomach — the reason the chapter's supplementation strategy so often runs through the center (Samul-tang and Sagunja-tang lineages, Bojungikgi logic) rather than attacking the end organ directly.

Gangmok 綱目 — Yixue gangmu

夫衆病積聚, 皆起於虛, 虛生百病. 《本草》

Now, the many diseases and the accumulations and gatherings all arise from vacuity; vacuity engenders the hundred diseases.
Clinical note The chapter's thesis in eight characters — depletion as the common soil of disease, including the concretions (積聚) treated elsewhere in this volume.

Boncho 本草

Signs of vacuity taxation 虛勞證

虛者, 皮毛肌肉, 筋脉骨髓, 氣血津液不足, 是也. 《綱目》

Vacuity means insufficiency of the skin and hair, the flesh, the sinews and vessels, the bones and marrow, and of qi, blood, and liquid and humor.

Gangmok 綱目

凡飮食減少, 精神昏短, 遺精夢泄, 腰背胸脇筋骨引痛, 潮熱自汗, 痰盛咳嗽, 是虛勞常證也. 《入門》

Reduced food intake, clouded and flagging spirit, seminal loss and dream emission, pulling pain in the sinews and bones of the lumbus, back, chest, and rib-sides, tidal heat and spontaneous sweating, copious phlegm and cough — these are the usual signs of vacuity taxation.
Clinical note The clinical checklist: appetite, mentation, seminal securing, musculoskeletal pain, heat pattern, sweat pattern, phlegm and cough. A serviceable intake template for chronic fatigue presentations to this day.

Immun 入門

皮虛則熱, 脉虛則驚, 肉虛則重, 筋虛則急, 骨虛則痛, 髓虛則墮, 腸虛則泄. 三陽實, 三陰虛, 汗不出, 三陰實, 三陽虛, 汗不止. 《直指》

When the skin is vacuous, heat; when the vessels are vacuous, fright; when the flesh is vacuous, heaviness; when the sinews are vacuous, tension; when the bones are vacuous, pain; when the marrow is vacuous, limpness; when the intestines are vacuous, diarrhea. When the three yang are replete and the three yin vacuous, sweat does not issue; when the three yin are replete and the three yang vacuous, sweat does not cease.

Jikji 直指

諸虛不足, 榮衛俱竭, 五勞七傷, 骨蒸潮熱, 腰背拘急, 百節痠疼, 夜多盜汗, 心常驚惕, 咽燥脣焦, 嗜臥少力, 肌膚瘦悴, 咳嗽多痰, 咯唾血絲, 寒熱往來, 頰赤神昏, 專不進食. 服熱藥則煩躁上衝, 服涼藥則膈滿腹痛, 最難爲治. 《得效》

All the vacuities and insufficiencies with construction and defense both exhausted: the five taxations and seven damages; steaming bone and tidal heat; hypertonicity of the lumbus and back; aching soreness in the hundred joints; frequent night sweating; a heart constantly frightened and jumpy; dry throat and scorched lips; craving to lie down, with little strength; emaciated, haggard flesh; cough with copious phlegm; threads of blood in the expectorate; alternating cold and heat; red cheeks and clouded spirit; refusing food altogether. If hot medicinals are taken, vexation and agitation surge upward; if cool medicinals are taken, the diaphragm feels full and the abdomen aches — this is the hardest of all to treat.
Clinical note The advanced picture — and the therapeutic trap that defines it: too hot for warm supplementation, too depleted for cold clearing. The chapter's answer is the balanced-supplementation class (Ssanghwa-tang, Sipjeondaebo-tang lineages) and slow-built paste and pill formulas rather than decisive one-direction treatment.

Deukhyo 得效

Pulse 脉法

平人脉大爲勞, 脉極虛亦爲勞. 《仲景》 ○氣虛則脉弦, 血虛則脉大. 《靈樞》 ○凡人脉虛細弱者, 勞也.

In a seemingly healthy person, a large pulse means taxation; an extremely vacuous pulse likewise means taxation. — With qi vacuity the pulse is stringlike; with blood vacuity the pulse is large. — In anyone, a vacuous, fine, weak pulse means taxation.
Clinical note Both extremes convict: the pulse too large for the person's state (yin failing to restrain) and the pulse nearly absent (qi failing to fill). Zhongjing's opening line warns against reading a big pulse as robustness in a tired patient.

Jungyeong 仲景 · Yeongchu 靈樞

脉弦而大, 弦則爲減, 大則爲芤, 減則爲寒, 芤則爲虛, 虛寒相搏, 此名爲革, 婦人則半産漏下, 男子則亡血失精. 《仲景》

A pulse stringlike and large: the stringlike quality means diminishment, the largeness means scallion-stalk hollowness; diminishment means cold, hollowness means vacuity. When vacuity and cold beat against each other, this is called the drumskin pulse (革) — in women, miscarriage and flooding; in men, blood collapse and seminal loss.

Jungyeong 仲景

寸口脉微而澁, 微者, 衛氣衰, 澁者, 榮氣不足, 衛氣衰, 面色黃, 榮氣不足, 面色靑. 榮爲根, 衛爲葉, 榮衛俱微, 則根葉枯槁, 而寒慄咳逆, 唾腥吐涎沫. 《仲景》

When the inch-opening pulse is faint and rough: faintness means the defense qi is debilitated; roughness means the construction qi is insufficient. With defense debilitated, the complexion yellows; with construction insufficient, the complexion turns green-blue. Construction is the root and defense the leaves; when construction and defense are both faint, root and leaves wither — shivering cold, cough and counterflow, fishy-smelling spittle, and drooling of foam.

Jungyeong 仲景

脉來軟者爲虛. ○緩者爲虛. ○微者爲虛. ○弱者爲虛. ○弦者爲中虛. ○脉細而微者, 血氣俱虛, 脉小者, 血氣俱少. ○脉大而芤者, 脫血, 血虛, 脉大如葱管. ○脉沈者遲者, 脫氣. 《脉經》 ○平脉弦大, 勞損而虛, 大而無力, 陽衰易扶, 數而無力, 陰火難除, 寸弱上損, 浮大裏枯, 尺寸俱微, 五勞之軀, 血羸左濡, 氣惟右推, 左右微小, 氣血無餘. 《回春》

A soft-arriving pulse means vacuity; moderate — vacuity; faint — vacuity; weak — vacuity; stringlike — vacuity of the center. Fine and faint — qi and blood both vacuous; small — qi and blood both scant. Large and scallion-stalk hollow — blood desertion, blood vacuity, the pulse large like a scallion tube. Sunken or slow — qi desertion. — A habitually stringlike, large pulse means taxation detriment with vacuity. Large without force — yang debilitation, easy to support; rapid without force — yin fire, hard to eliminate. A weak inch means damage above; floating and large means the interior is parched; inch and cubit both faint — a body in the five taxations. Blood depletion shows soggy on the left; qi is read by pushing on the right; when left and right are both faint and small, qi and blood have nothing left.
Clinical note The Hoechun couplet is the chapter's triage in pulse form: large-and-forceless (yang vacuity) is the easy case — supplement and it answers; rapid-and-forceless (yin-vacuity fire) is the hard one — the fire cannot be drained without deepening the vacuity that feeds it. This distinction organizes the entire treatment section that follows: 陽虛用藥 versus 陰虛用藥.

Maekgyeong 脉經 · Hoechun 回春

The five taxations 五勞證

五勞者, 心勞血損, 肝勞神損, 脾勞食損, 肺勞氣損, 腎勞精損也. 《金匱》

The five taxations: heart taxation damages the blood; liver taxation damages the spirit; spleen taxation damages the appetite; lung taxation damages the qi; kidney taxation damages the essence.

Geumgwe 金匱 — Jingui yaolüe

忽喜怒, 大便苦難, 口內生瘡, 此爲心勞. ○短氣面腫, 鼻不聞香, 咳嗽唾痰, 兩脇脹痛, 喘息不定, 此爲肺勞. ○面目乾黑, 精神不定, 不能獨臥, 目視不明, 頻頻下淚, 此爲肝勞. ○口苦舌强, 嘔逆醋心, 氣脹脣焦, 此爲脾勞. ○小便黃赤, 兼有餘瀝, 腰痛耳鳴, 夜間多夢, 此爲腎勞. 《千金》

Sudden shifts of joy and anger, difficult stool, and sores in the mouth — this is heart taxation. Shortness of breath and facial puffiness, a nose that cannot smell, cough with expectorated phlegm, distending pain in both rib-sides, and unsteady panting — lung taxation. A dry, darkened face, unsettled spirit, inability to lie alone, dim vision, and frequent tearing — liver taxation. Bitter mouth and stiff tongue, retching with sour upflow, qi distension and scorched lips — spleen taxation. Yellow-red urine with dribbling after voiding, lumbar pain, tinnitus, and many dreams at night — kidney taxation.

Cheongeum 千金 — Qianjin fang

心勞, 則口舌生瘡, 語澁肌瘦. ○肝勞, 則脇痛, 關格不通. ○脾勞, 則氣急, 肌痺, 多汗. ○肺勞, 則氣喘, 面腫, 口燥咽乾. ○腎勞, 則尿赤, 陰瘡, 耳鳴, 面黑. 《入門》

With heart taxation, sores of the mouth and tongue, halting speech, and thinning flesh. With liver taxation, rib-side pain and block-and-repulsion obstruction. With spleen taxation, hasty breathing, numbness of the flesh, and copious sweat. With lung taxation, panting, facial puffiness, and dry mouth and throat. With kidney taxation, red urine, genital sores, tinnitus, and a darkened face.

Immun 入門

曲運神機, 爲心之勞. 其證, 血少面無色, 驚悸, 盜汗, 夢遺, 極則心痛咽腫. ○盡力謀慮, 爲肝之勞. 其證, 筋骨拘攣, 極則頭目昏眩. ○意外過思, 爲脾之勞. 其證, 脹滿少食, 極則吐瀉肉削, 四肢倦怠. ○預事而憂, 爲肺之勞. 其證, 氣乏, 心腹冷痛, 極則毛焦津枯, 咳嗽鬨熱. ○矜持志節, 爲腎之勞. 其證, 腰脊痛, 遺精白濁, 極則面垢脊痛. 《入門》

Turning the spirit-mechanism through endless windings is the taxation of the heart: scant blood and a colorless face, fright palpitations, night sweats, dream emission — and at the extreme, heart pain and a swollen throat. Straining one's utmost in schemes and deliberations is the taxation of the liver: hypertonicity of sinew and bone — at the extreme, clouded head and dizzy vision. Excessive thought beyond one's station is the taxation of the spleen: distension, fullness, and little eating — at the extreme, vomiting, diarrhea, pared-away flesh, and weary limbs. Worrying over affairs before they arrive is the taxation of the lung: exhausted qi and cold pain of heart and abdomen — at the extreme, scorched hair, parched fluids, cough, and surging heat. Rigidly upholding one's principles and resolve is the taxation of the kidney: pain of the lumbus and spine, seminal loss and white turbidity — at the extreme, a grimy complexion and aching back.
Clinical note The chapter's psychological masterstroke: five styles of mental strain, each wearing down its own viscus — the over-deliberator's heart, the striver's liver, the ruminator's spleen, the pre-worrier's lung, and, most strikingly, the kidney worn down by rigid self-discipline itself. Read alongside modern burnout typologies, this passage needs almost no translation: it is an intake questionnaire for the exhausted high-functioner, four centuries early.

Immun 入門

The six extremes 六極證

數轉筋, 十指爪甲皆痛, 爲筋極. ○牙齒動, 手足痛, 不能久立, 爲骨極. ○面無血色, 頭髮墮落, 爲血極. ○身上往往如鼠走, 體上乾黑, 爲肉極. ○氣少無力, 身無膏澤, 翕翕羸瘦, 眼無精光, 立不能定, 身體苦痒, 搔之生瘡, 此爲精極. ○胸脇逆滿, 恒欲大怒, 氣少不能言, 此爲氣極. 《入門》

Frequent cramping of the sinews with pain in all ten fingers and nails — the extreme of the sinews. Loosening teeth, painful hands and feet, inability to stand long — the extreme of the bones. A face without color and falling hair — the extreme of the blood. Sensations over the body as of scurrying mice, with the skin dry and darkened — the extreme of the flesh. Scant qi and no strength, a body without sheen, wasting away breath by breath, eyes without luster, unable to stand steady, tormenting itch that breaks into sores when scratched — the extreme of the essence. Counterflow fullness of chest and rib-sides, a constant urge toward great anger, and qi too scant to speak — the extreme of the qi.
Clinical note Where the five taxations name the cause, the six extremes stage the destination — sinew, bone, blood, flesh, essence, qi, each depleted past its threshold. The formication of the flesh-extreme and the lusterless eyes of the essence-extreme remain vivid bedside signs of advanced cachexia.

Immun 入門

The seven damages 七傷證

虛損之疾, 生自五勞, 卽生六極, 復生七傷. 一曰, 陰寒. ○二曰, 陰痿. ○三曰, 裏急. ○四曰, 精漏. ○五曰, 精少. ○六曰, 精淸. ○七曰, 小便數. 又一曰, 陰汗. ○二曰, 精寒. ○三曰, 精淸. ○四曰, 精少. ○五曰, 囊下濕痒. ○六曰, 小便澁數. ○七曰, 夜夢陰人. 其病皆小便赤熱, 或如鍼刺. 《入門》

The illness of vacuity detriment arises from the five taxations, engenders the six extremes, and further engenders the seven damages. First, coldness of the genitals; second, impotence; third, tension in the abdomen; fourth, seminal leakage; fifth, scant semen; sixth, watery semen; seventh, frequent urination. In another reckoning: first, genital sweating; second, cold semen; third, watery semen; fourth, scant semen; fifth, damp itching beneath the scrotum; sixth, rough and frequent urination; seventh, dreaming of women at night. In all of these the urine is red and hot, sometimes stinging like a needle.
Clinical note The taxonomy narrows as the disease deepens: five causes, six tissue-endpoints, and finally seven damages — all of them genitourinary. The chapter's implicit claim is that reproductive function is depletion's most sensitive gauge, which is why the supplementation formulas that follow so consistently secure essence while they build qi and blood. In modern terms: a chronic-fatigue chapter that takes sexual-function decline seriously as an early marker.

Immun 入門

In the human body Yang is in surplus and Yin insufficient 人身陽有餘陰不足

天爲陽, 而運於地之外, 地爲陰, 而居乎中, 天之大氣擧之. 日, 實也, 屬陽, 而運於月之外, 月, 缺也, 屬陰, 稟日之光以爲明. 人受天地之氣以生, 天之陽氣爲氣, 地之陰氣爲血. 故陽常有餘, 而陰常不足, 氣常有餘, 而血常不足也. ○人之一身, 陽常有餘, 陰常不足, 氣常有餘, 血常不足. 故滋陰補血之藥, 自幼至老不可缺也. 《丹心》

Heaven is Yang and revolves outside the Earth; Earth is Yin and dwells at the center, held aloft by Heaven's great Qi. The sun is full — it belongs to Yang and revolves outside the moon; the moon is deficient — it belongs to Yin and borrows the sun's light for its brightness. The human being receives the Qi of Heaven and Earth to live: Heaven's Yang Qi becomes the Qi, Earth's Yin Qi becomes the Blood. Therefore Yang is constantly in surplus and Yin constantly insufficient; Qi is constantly in surplus and Blood constantly insufficient. — In the one body of a person, Yang is constantly in surplus and Yin constantly insufficient, Qi constantly in surplus and Blood constantly insufficient. Therefore the medicines that enrich Yin and supplement Blood may not be omitted from youth to old age.
Clinical note Danxi's cosmological signature — the doctrine that underwrites the entire Yin-vacuity wing of this chapter, argued from astronomy: a full sun, a borrowing moon, and a human body built to the same asymmetry. Its practical corollary is stated without hedging: Yin-enriching medicine is a lifelong companion, not a treatment.

Dansim 丹心

Distinguishing Qi, Blood, Yang, and Yin vacuity 辨氣虛血虛陽虛陰虛

虛脉多弦, 弦而濡大無力, 爲氣虛. ○脉沈微無力, 爲氣虛甚. ○脉弦而微, 爲血虛. ○脉澁而微, 爲血虛甚. ○形肥而面浮白者, 陽虛. ○形瘦而面蒼黑者, 陰虛. 《入門》

Vacuity pulses are often stringlike: stringlike yet soggy, large, and forceless — Qi vacuity. Sunken, faint, and forceless — severe Qi vacuity. Stringlike and faint — Blood vacuity. Rough and faint — severe Blood vacuity. A plump body with a puffy pale face — Yang vacuity. A thin body with a dark greenish face — Yin vacuity.

Immun 入門

房勞思慮傷心腎, 則陰血虛. ○飢飽勞役傷胃氣, 則陽氣虛. 此傷證之至要也. 《入門》

Bedroom taxation and brooding thought damage the Heart and Kidney — then the Yin Blood becomes vacuous. Irregular hunger and satiety with toilsome labor damage the Stomach Qi — then the Yang Qi becomes vacuous. This is the utmost essential of damage patterns.
Clinical note Two sentences that sort the entire etiology of the chapter — what you do with desire and worry drains the Yin column; what you do with meals and labor drains the Yang column. The pulse-and-physique table above tells you where the patient landed; this passage tells you how they got there.

Immun 入門

Methods of treatment 虛勞治法

損之證, 峻補者, 烏ㆍ附ㆍ天雄ㆍ薑ㆍ桂之屬, 潤補者, 鹿茸ㆍ當歸ㆍ蓯蓉之屬, 淸補者, 兩門冬ㆍ人參ㆍ地黃之屬也. 《得效》

For patterns of detriment there are three modes of supplementation: drastic supplementation — aconite main tuber, aconite accessory tuber, tianxiong aconite, ginger, and cinnamon and their kind; moist supplementation — deer antler, Korean angelica, and cistanche and their kind; and clear supplementation — the two winter-tubers, ginseng, and rehmannia and their kind.
Clinical note The chapter's entire pharmacy sorted into three temperatures of kindness: drastic (hot, for collapse), moist (warm and fleshly, for essence), clear (cool and juicy, for Yin-fluids). Every formula in the sections that follow can be placed on this dial — and much of the art of the chapter is choosing the gentlest setting that still works.

Deukhyo 得效

Medicinals for Yin vacuity 陰虛用藥

陰虛, 卽血虛也.

Yin vacuity is none other than Blood vacuity.

Donguibogam · Heoro

凡陰虛證, 每日午後惡寒發熱, 至晩亦得微寒而解. 脉必虛濡而數絶, 類瘧證. 但瘧脉弦, 而虛脉大弦爲辨耳. 若誤作瘧治, 多致不救. 《醫鑑》

In Yin-vacuity patterns, every day in the afternoon there is aversion to cold with heat effusion, which resolves toward evening with a slight chill. The pulse is invariably vacuous, soggy, rapid, and interrupted — resembling malaria. The distinction lies only in the pulse: the malarial pulse is stringlike, while the vacuity pulse is large and stringlike. If this is mistakenly treated as malaria, it often ends beyond saving.
Clinical note A differential that still earns its keep: cyclical afternoon fevers read as infection versus the tidal heat of depletion. The stakes written into the passage — treat the exhausted patient with malaria-attacking (draining) methods and you finish what the disease began.

Uigam 醫鑑

陰虛, 宜用四物湯 方見血門ㆍ加減四物湯ㆍ滋陰降火湯ㆍ淸离滋坎湯 二方幷見火門ㆍ補陰散ㆍ二宜丸ㆍ補陰丸ㆍ大補陰丸ㆍ加減補陰丸ㆍ加味補陰丸ㆍ虎潛丸ㆍ濟陰丸ㆍ補陰瀉火湯ㆍ瀉陽補陰湯ㆍ大造丸ㆍ補天大造丸ㆍ入門大造丸ㆍ補天丸ㆍ混元丹ㆍ太上混元丹ㆍ坎离旣濟丸 方見火門ㆍ滋陰降火丸.

For Yin vacuity, appropriate are Samul-tang 四物湯 — formula in the Blood chapter —, Gagamsamul-tang 加減四物湯, Jaeumganghwa-tang 滋陰降火湯, Cheongrijagam-tang 淸离滋坎湯 — both in the Fire chapter —, Boeum-san 補陰散, Iui-hwan 二宜丸, Boeum-hwan 補陰丸, Daeboeum-hwan 大補陰丸, Gagamboeum-hwan 加減補陰丸, Gamiboeum-hwan 加味補陰丸, Hojam-hwan 虎潛丸, Jeeum-hwan 濟陰丸, Boeumsahwa-tang 補陰瀉火湯, Sayangboeum-tang 瀉陽補陰湯, Daejo-hwan 大造丸, Bocheondaejo-hwan 補天大造丸, Immundaejo-hwan 入門大造丸, Bocheon-hwan 補天丸, Honwon-dan 混元丹, Taesanghonwon-dan 太上混元丹, Gamrigije-hwan 坎离旣濟丸 — formula in the Fire chapter —, and Jaeumganghwa-hwan 滋陰降火丸.
Clinical note The Yin-vacuity cabinet, twenty-two formulas deep — linked names open their pages here; Boeumsahwa-tang is the byname of Boeum-san and shares its page. The rest follow as their sections (Fire chapter, the great Daejo variants, the Hon-won elixirs) are translated.

Donguibogam · Heoro

Medicinals for Yang vacuity 陽虛用藥

陽虛, 卽氣虛也. ○脉微弱, 少氣力, 自汗不止者, 陽虛. 宜用四君子湯 方見氣門ㆍ益胃升陽湯 方見內傷ㆍ桂附湯ㆍ茸附湯ㆍ正氣補虛湯ㆍ增損樂令湯ㆍ參香散ㆍ三仙丹ㆍ四神丹ㆍ參芪健中湯ㆍ加減內固丸 方見前陰ㆍ鹿茸大補湯.

Yang vacuity is none other than Qi vacuity. — A faint, weak pulse, scant strength, and spontaneous sweating that will not stop: this is Yang vacuity. Appropriate are Sagunja-tang 四君子湯 — formula in the Qi chapter —, Igwiseungyang-tang 益胃升陽湯 — in the Internal Damage chapter —, Gyebu-tang 桂附湯, Yongbu-tang 茸附湯, Jeonggibobeo-tang 正氣補虛湯, Jeungsonyakryeong-tang 增損樂令湯, Samhyang-san 參香散, Samseon-dan 三仙丹, Sasin-dan 四神丹, Samgigeonjung-tang 參芪健中湯, Gagamnaego-hwan 加減內固丸 — in the Anterior Yin chapter —, and Nokyongdaebo-tang 鹿茸大補湯.
Clinical note The mirror sentence to the Yin section's opening — Yin is Blood, Yang is Qi — gives the chapter its two-column bookkeeping. The Yang cabinet runs hotter: cinnamon-aconite and antler-aconite pairs (Gyebu-tang, Yongbu-tang) at the drastic end of the Deukhyo's three-mode dial, with the gentler fortifiers already linked above.

Donguibogam · Heoro

Medicinals for dual Yin and Yang vacuity 陰陽俱虛用藥

陰陽俱虛, 謂氣血皆不足也. 宜用雙和湯ㆍ八物湯ㆍ十全大補湯ㆍ加味十全大補湯ㆍ黃芪十補湯ㆍ固眞飮子ㆍ人參養榮湯ㆍ補益養榮湯ㆍ凝神飮子 方見蟲門ㆍ二至丸ㆍ異類有情丸ㆍ是齋雙補丸ㆍ古庵心腎丸ㆍ究原心腎丸 二方見下ㆍ滋陰大補丸ㆍ加味虎潛丸ㆍ滋血百補丸ㆍ滋腎百補丸ㆍ沈香百補丸. 《諸方》

Dual Yin-Yang vacuity means Qi and Blood are both insufficient. Appropriate are Ssanghwa-tang 雙和湯, Palmul-tang 八物湯, Sipjeondaebo-tang 十全大補湯, Gamisipjeondaebo-tang 加味十全大補湯, Hwanggisipbo-tang 黃芪十補湯, Gojin-eumja 固眞飮子, Insamyangyeong-tang 人參養榮湯, Boikyangyeong-tang 補益養榮湯, Eungsineumja 凝神飮子 — formula in the Worms chapter —, Iji-hwan 二至丸, Iryuyujeong-hwan 異類有情丸, Sijaessangbo-hwan 是齋雙補丸, Goamsimsin-hwan 古庵心腎丸 and Guwonsimsin-hwan 究原心腎丸 — both below —, Jaeumdaebo-hwan 滋陰大補丸, Gamihojam-hwan 加味虎潛丸, Jahyeolbaekbo-hwan 滋血百補丸, Jasinbaekbo-hwan 滋腎百補丸, and Chimhyangbaekbo-hwan 沈香百補丸.
Clinical note The third and largest column of the chapter's bookkeeping — when neither treasure can carry the other, nineteen formulas answer, from the humble post-illness Ssanghwa-tang to the alternating two-pill regimens of Danxi. Eighteen of the nineteen now open to full pages here: the most completely linked cabinet on the site.

Various formularies 諸方

Medicinals for heart vacuity 心虛藥

心虛, 血氣不足, 以成虛勞, 宜用天王補心丹ㆍ加味寧神丸ㆍ加減鎭心丹ㆍ淸心補血湯 四方幷見神門ㆍ大五補丸ㆍ古庵心腎丸ㆍ究原心腎丸.

When the Heart is vacuous and Blood and Qi insufficient, forming vacuity taxation, appropriate are Cheonwangbosim-dan 天王補心丹, Gamiyeongsin-hwan 加味寧神丸, Gagamjinsim-dan 加減鎭心丹, Cheongsimbohyeol-tang 淸心補血湯 — these four in the Spirit chapter —, Daeobo-hwan 大五補丸, Goamsimsin-hwan 古庵心腎丸, and Guwonsimsin-hwan 究原心腎丸.
Clinical note The organ-by-organ tour of taxation begins with the heart — and both of its resident formulas here, the Five-Supplement and Guam's Heart-Kidney pill, treat it in tandem with the kidney. In this chapter the exhausted heart is never sick alone.

Donguibogam · Heoro

Medicinals for liver vacuity 肝虛藥

治虛勞肝損, 面無血色, 筋緩目暗, 宜用四物湯ㆍ雙和湯 方見上ㆍ補肝丸 方見五藏ㆍ黑元ㆍ歸茸元ㆍ拱辰丹ㆍ滋補養榮丸.

For vacuity taxation with the Liver damaged — a face without color of blood, slack sinews, and dim vision — appropriate are Samul-tang 四物湯, Ssanghwa-tang 雙和湯 — formula above —, Bogan-hwan 補肝丸 — in the Five Viscera chapter —, Heuk-won 黑元, Gwiyong-won 歸茸元, Gongjin-dan 拱辰丹, and Jaboyangyeong-hwan 滋補養榮丸.
Clinical note Liver taxation shows in the tissues the liver feeds — colorless face, slack sinew, dim eye — and its cabinet answers in blood: the Four Substances chassis, the angelica-antler pair in both its ratios, and the ambered luxury of Gongjin-dan. Five of the seven already open to full pages here.

Donguibogam · Heoro

Medicinals for spleen vacuity 脾虛藥

虛勞證, 肌肉消瘦, 飮食不進, 此是脾虛. 宜用天眞元ㆍ還元丹 二方見上ㆍ橘皮煎元ㆍ參苓白朮散 方見內傷ㆍ烏朮丸ㆍ潤腎丸ㆍ大山芋元ㆍ參朮調元膏ㆍ參苓白朮丸ㆍ九仙王道糕 三方見內傷.

In vacuity taxation, wasting of the flesh with food refused is Spleen vacuity. Appropriate are Cheonjin-won 天眞元 and Hwanwon-dan 還元丹 — both above —, Gyulpijeon-won 橘皮煎元, Samryeongbaekchul-san 參苓白朮散 — in the Internal Damage chapter —, Ochul-hwan 烏朮丸, Yunsin-hwan 潤腎丸, Daesanu-won 大山芋元, and Samchuljowon-go 參朮調元膏, Samryeongbaekchul-hwan 參苓白朮丸, and Guseonwangdo-go 九仙王道糕 — these three in the Internal Damage chapter —.
Clinical note The spleen's diagnostic is the bluntest of the five — flesh and appetite, the two things everyone can see across a dinner table. Its cabinet answers in kind: syrup-pills, seasonal pills, and cakes, tonics engineered to be swallowed by people who cannot eat.

Donguibogam · Heoro

Medicinals for lung vacuity 肺虛藥

虛勞證, 咳嗽痰盛, 氣急, 或唾血, 此爲肺虛. 宜用人參膏ㆍ獨參湯 二方見氣門ㆍ人參黃芪散ㆍ團參飮子 方見咳嗽ㆍ保和湯 方見下.

In vacuity taxation, cough with copious phlegm, hasty breathing, or spitting of blood is Lung vacuity. Appropriate are Insam-go 人參膏 and Doksam-tang 獨參湯 — both in the Qi chapter —, Insamhwanggi-san 人參黃芪散, Dansameumja 團參飮子 — in the Cough chapter —, and Bohwa-tang 保和湯 — formula below —.
Clinical note The shortest cabinet of the five, and the most ominous — its lone resident formula treats pus-blood and tidal fever, and its 'formula below' points into the consumption section. In this chapter a failing lung is where vacuity taxation and taxation consumption meet.

Donguibogam · Heoro

Medicinals for kidney vacuity 腎虛藥

腎藏有二, 左爲腎, 右爲命門. 腎屬水, 水不足, 則爲陰虛, 命門屬火, 火不足, 則爲陽虛.

The kidney viscus is twofold: the left is the Kidney, the right the Gate of Life. The Kidney belongs to Water — when Water is insufficient, Yin vacuity results; the Gate of Life belongs to Fire — when Fire is insufficient, Yang vacuity results.
Clinical note The theoretical keystone of the whole chapter, stated in one breath — the two-kidney doctrine maps the Yin-vacuity and Yang-vacuity columns of the preceding sections onto left and right at the wrist, and every formula list that follows is sorted by which side of this sentence the patient falls on.

Donguibogam · Heoro

腎虛, 宜用六味地黃元ㆍ太極丸ㆍ陰煉秋石丹ㆍ八味補腎丸ㆍ冷補丸ㆍ腎氣丸ㆍ三一腎氣丸ㆍ延年益壽不老丹 方見身形ㆍ無比山藥元ㆍ補腎養脾丸. ○命門火不足, 宜用陽煉秋石丹ㆍ秋石五精丸ㆍ增益歸茸元. ○腎與命門俱虛, 宜用玄菟固本丸ㆍ斑龍丹ㆍ陰陽煉秋石丹ㆍ茸珠丸.

For Kidney vacuity, appropriate are Yukmijihwang-won 六味地黃元, Taegeuk-hwan 太極丸, Eumryeonchuseok-dan 陰煉秋石丹, Palmibosin-hwan 八味補腎丸, Naengbo-hwan 冷補丸, Singi-hwan 腎氣丸, Samilsingi-hwan 三一腎氣丸, Yeonnyeoniksubulro-dan 延年益壽不老丹 — in the Body Form chapter —, Mubisanyak-won 無比山藥元, and Bosinyangbi-hwan 補腎養脾丸. — For insufficiency of the Gate of Life fire: Yangryeonchuseok-dan 陽煉秋石丹, Chuseokojeong-hwan 秋石五精丸, and Jeungikgwiyong-won 增益歸茸元. — When Kidney and Gate of Life are both vacuous: Hyeontogobon-hwan 玄菟固本丸, Banryong-dan 斑龍丹, Eumyangryeonchuseok-dan 陰陽煉秋石丹, and Yongju-hwan 茸珠丸.
Clinical note Three cabinets sorted by the two-kidney doctrine above — water-side, fire-side, and both. The chapter's largest formula territory, still mostly untranslated here; entries will link as their pages arrive, beginning with the five-phase Taegeuk-hwan.

Donguibogam · Heoro

六味地黃元, 治虛勞, 腎氣衰弱, 久新憔悴, 寢汗發熱, 五藏齊損, 瘦弱虛煩, 骨蒸痿弱, 脉沈而虛 方見五藏. ○此藥專補左尺腎水, 兼理脾胃, 少年水虧火旺, 陰虛之證, 最宜服之. ○凡人年幼被誘慾太早者, 根本受傷, 及禀賦薄者, 劚喪之過, 隱諱不敢實告, 以致元氣虛憊, 或遺精盜汗, 神疲力怯, 飮食不生肌肉, 面白, 五心發熱, 夏先惡熱, 冬先怕寒, 腰疼膝重, 頭暈目眩. 故曰, 水一虧則火必勝, 火動則肺金受剋而痰嗽作矣. 或勞汗當風, 面生粉刺, 則虛損成矣. 宜服此藥, 可保無虞. 《回春》

Yukmijihwang-won treats vacuity taxation with Kidney Qi debilitated — long haggard whether the illness is old or new, sleeping sweats and heat effusion, all five viscera damaged together, thin, weak, and vacuously vexed, with steaming bone and wilting weakness, the pulse sunken and vacuous — formula in the Five Viscera chapter —. — This medicine supplements above all the Kidney Water of the left cubit position, while also regulating the Spleen and Stomach; for the young whose Water is depleted and Fire effulgent — the Yin-vacuity pattern — it is the most suitable of all. — Whenever a person was drawn into desire too young, injuring the root, or was thinly endowed and squandered too much — and, concealing it, dares not tell the truth — the origin Qi becomes vacuous and exhausted: seminal loss and night sweats, weary spirit and timid strength, food that no longer builds flesh, a pale face, heat in the five hearts, dreading heat first in summer and cold first in winter, aching lumbus and heavy knees, dizzy head and swimming eyes. Hence it is said: once Water is depleted, Fire must prevail; when Fire stirs, Lung Metal suffers the restraint and phlegm cough arises. Or if, sweating from toil, one faces the wind, and the face breaks out in pimples — then vacuity detriment is formed. Taking this medicine, one may be kept free of harm.
Clinical note The Hoechun's case-portrait is the most clinically alive paragraph in the section — not just the symptom list of early depletion but the shame that hides it ('concealing it, dares not tell the truth'), a sentence every practitioner who has taken an adolescent's history will recognize. The pathomechanism is drawn in one line — Water fails, Fire prevails, Metal suffers — and Six Flavors is offered not as treatment but as insurance.

Hoechun 回春

Medicinals that treat vacuity taxation generally 虛勞通治藥

凡人四肢痿弱無力多困, 未知陰陽先損, 夏可用六味地黃元, 春秋宜腎氣丸, 冬宜八味丸 三方幷見上. 《保命》

When the limbs are wilting, weak, forceless, and much fatigued, and it is not yet known whether Yin or Yang was damaged first: in summer Yukmijihwang-won may be used; in spring and autumn Singi-hwan is appropriate; in winter, Palmi-hwan — all three above —.
Clinical note Diagnosis deferred to the calendar — when the chart cannot decide between Yin and Yang, the season casts the deciding vote. A triage rule of striking practicality: same patient, three prescriptions a year.

Bomyeong 保命

虛勞, 通用千金延壽丹ㆍ玄珠耘苗丹ㆍ神仙巨勝子元ㆍ神仙不老丸ㆍ膃肭補天丸 方見前陰ㆍ二神交濟丹ㆍ無比山藥元ㆍ神仙旣濟丹ㆍ五補元ㆍ補天大造丸 方見上ㆍ瓊玉膏 方見身形ㆍ小建中湯ㆍ大建中湯ㆍ十四味建中湯ㆍ黃芪益損湯ㆍ秦芃鱉甲散ㆍ沈香鱉甲散ㆍ黃芪鱉甲散ㆍ瑞蓮元ㆍ當歸膏ㆍ益壽固眞丹.

For vacuity taxation, generally used are Cheongeumyeonsu-dan 千金延壽丹, Hyeonjuunmyo-dan 玄珠耘苗丹, Sinseongeoseungja-won 神仙巨勝子元, Sinseonbulro-hwan 神仙不老丸, Olnulbocheon-hwan 膃肭補天丸 — formula in the Anterior Yin chapter —, Isingyoje-dan 二神交濟丹, Mubisanyak-won 無比山藥元, Sinseongije-dan 神仙旣濟丹, Obo-won 五補元, Bocheondaejo-hwan 補天大造丸 — formula above —, Gyeongok-go 瓊玉膏 — formula in the Body Form chapter —, Sogeonjung-tang 小建中湯, Daegeonjung-tang 大建中湯, Sipsamigeonjung-tang 十四味建中湯, Hwanggiikson-tang 黃芪益損湯, Jingyobyeolgap-san 秦芃鱉甲散, Chimhyangbyeolgap-san 沈香鱉甲散, Hwanggibyeolgap-san 黃芪鱉甲散, Seoryeon-hwan 瑞蓮元, Danggwi-go 當歸膏, and Iksugojin-dan 益壽固眞丹.
Clinical note The chapter's grand cabinet — twenty-one general-purpose answers, from two-herb decoctions to the thirty-four-ingredient securing elixir, and all but two now open to full pages here.

Donguibogam · Heoro

Medicinals for convalescent regulation 虛勞調理藥

宜用淸神甘露丸ㆍ天地煎ㆍ三才丸 方見血門ㆍ補精膏ㆍ補髓膏ㆍ陰陽煉秋石丹 方見上ㆍ固眞飮子 方見上ㆍ衛生湯ㆍ陰分生陽湯. 《諸方》

Appropriate are Cheongsingamro-hwan 淸神甘露丸, Cheonji-jeon 天地煎, Samjae-hwan 三才丸 — formula in the Blood chapter —, Bojeong-go 補精膏, Bosu-go 補髓膏, Eumyangryeonchuseok-dan 陰陽煉秋石丹 — above —, Gojin-eumja 固眞飮子 — above —, Wisaeng-tang 衛生湯, and Eumbunsaengyang-tang 陰分生陽湯.
Clinical note The convalescent shelf — pastes, marrow preserves, and four-herb daily decoctions: what the chapter offers once the crisis formulas have done their work and the task turns from rescue to tending.

Various formularies 諸方

Ge Kejiu's ten medicines for treating vacuity taxation 葛可久治虛勞十藥

保眞湯ㆍ保和湯ㆍ太平丸ㆍ消化丸ㆍ潤肺膏ㆍ白鳳膏ㆍ補髓丹ㆍ十灰散ㆍ花蘂石散ㆍ獨參湯. ○十灰散, 治虛勞, 心肺損, 大吐血, 及咯唾血不止 方見血門, 宜服此以止之. 若不效, 則用花蘂石散以消之. ○花蘂石散, 治虛勞吐血, 五內崩損, 涌出升斗者 方見血門, 宜服此. 使瘀血化爲黃水, 繼服獨參湯. 《新書》

Bojin-tang 保眞湯, Bohwa-tang 保和湯, Taepyeong-hwan 太平丸, Sohwa-hwan 消化丸, Yunpye-go 潤肺膏, Baekbong-go 白鳳膏, Bosu-dan 補髓丹, Siphoe-san 十灰散, Hwaryeseok-san 花蘂石散, and Doksam-tang 獨參湯. — Siphoe-san treats vacuity taxation with heart and lung damaged, great vomiting of blood, and coughing and spitting of blood that will not stop — formula in the Blood chapter —: take it to stanch. If ineffective, use Hwaryeseok-san to dissolve. — Hwaryeseok-san treats blood-vomiting in vacuity taxation with the five interiors collapsing and damaged, gushing out by the pint and peck — formula in the Blood chapter —: take it, let the static blood transform to yellow water, and follow with Doksam-tang.
Clinical note A complete fourteenth-century consumption service in one paragraph — daily base formula, lung lozenge and phlegm pill by night, food-form pastes, two hemorrhage protocols with an explicit escalation pathway, and a single-herb rescue to close. The Donguibogam preserves it as a unit because it works as a unit: the earliest intact treatment algorithm in the chapter.

Sinseo 新書 — Ge Kejiu's Shiyao Shenshu

Signs of life and death in vacuity taxation 虛勞生死證

難經曰, 七傳者死, 間藏者生, 何謂也. 然七傳者, 傳其所勝也. 間藏者, 傳其子也. 假令心病傳肺, 肺病傳肝, 肝病傳脾, 脾病傳腎, 腎病傳心, 一藏不再傷, 故言七傳者, 死也. 間藏者, 傳其所生也. 假令心傳脾, 脾傳肺, 肺傳腎, 腎傳肝, 肝傳心. 是子母相傳, 周而復始, 如環無端, 故言生也. ○盖虛勞之證, 必始於腎經, 五藏從相剋而逆傳, 已盡又復傳於腎與心, 則水絶滅而火太旺, 故死而不復再傳彼之三藏矣. 其有從相生而順傳者, 有生生不息之義, 故間藏者生也. 《正傳》

The Classic of Difficulties says: transmission through seven is death; transmission skipping a viscus is life. What does this mean? Transmission through seven passes to what one conquers: heart illness passes to the lung, lung to the liver, liver to the spleen, spleen to the kidney, kidney back to the heart — and since one viscus cannot bear a second wound, transmission through seven is death. Skipping transmission passes to one's child: heart to spleen, spleen to lung, lung to kidney, kidney to liver, liver to heart — mother and child passing one to the next, circling and beginning again like a ring without end; hence it is life. — Indeed the pattern of vacuity taxation must begin at the kidney channel, and the five viscera pass it along the conquest cycle in reverse; when the round is complete and it passes again to kidney and heart, Water is extinguished and Fire grows too effulgent — hence death, with no further passing to the remaining viscera. But when it passes along the engendering cycle in due order, there is the meaning of life engendering life without cease — hence skipping transmission is life.
Clinical note Prognosis as choreography — the same disease is fatal or survivable depending on which cycle it travels, conquest or engendering. The Jeongjeon's version quietly emends the received text of the Nanjing on philological grounds (a dropped clause, a miscopied number), a rare moment of textual criticism inside a medical chapter.

Jeongjeon 正傳

Intermittent pulse in vacuity taxation 虛勞脉代證

虛勞不足, 汗出而悶, 脉結代, 心動悸, 行動如常, 不出百日死, 急者, 十餘日死. 宜用灸甘草湯救之. 方見脉部 《仲景》

In the insufficiency of vacuity taxation — sweating with oppression, a bound and intermittent pulse, stirring palpitations of the heart, yet moving about as usual — death comes within a hundred days; in urgent cases, within ten-odd days. Roasted Licorice Decoction should be used for the rescue. — formula in the Pulse section —
Clinical note The chapter's starkest sentence: a patient who 'moves about as usual' carrying a hundred-day sentence in the wrist. The intermittent pulse outranks how the patient looks — an insight cardiology would eventually restate as arrhythmia preceding collapse.

Junggyeong 仲景 — Zhang Zhongjing

Simmering reversal 煎厥證

內經曰, 陽氣者, 煩勞則張, 精絶, 辟積於夏, 使人煎厥. 目盲不可以視, 耳閉不可以聽, 潰潰乎若壞都, 汨汨乎不可止. ○註曰, 以煎迫而氣逆, 因以煎厥爲名. 厥謂氣逆也. 夫目盲所視, 耳閉厥聽, 大矣哉, 房之爲患也. ○治法與陰虛火動同, 當用滋陰降火之藥. 《入門》

The Inner Classic says: the Yang Qi, when vexed and taxed, flares outward and the essence is cut off; accumulating through the summer, it makes a person simmer into reversal — eyes blind and unable to see, ears closed and unable to hear, crumbling like a city wall giving way, rushing like water that cannot be stopped. The commentary says: because the Qi counterflows under simmering pressure, it is named simmering reversal — reversal meaning Qi counterflow. Eyes gone blind, ears gone deaf: how great indeed is the havoc of the bedchamber! The method of treatment is the same as for Yin vacuity with stirring fire — Yin-enriching, fire-downbearing medicines are to be used.

Immun 入門

Loosened slackness 解㑊證

內經曰, 尺脉緩澁, 謂之解㑊. 釋曰, 尺爲陰部, 肝腎主之. 緩爲熱中, 澁爲無血. 故謂之解㑊. 解㑊者, 寒不寒, 熱不熱, 弱不弱, 壯不壯, 儜不可名, 謂之解㑊也. ○髓傷則消爍胻痠, 體解㑊然不去矣. 《靈樞》 ○解者, 肌肉解散, 㑊者, 筋不束骨. 其證似寒非寒, 似熱非熱, 四肢骨節解散怠惰, 煩疼, 飮食不美. 或因傷酒, 或中濕, 或感冒風寒, 或房事過多, 或婦人經事不調, 以此得病. 宜通其氣血, 疏其腠理, 以內傷兼外感藥調之. 《入門》

The Inner Classic says: a moderate and rough pulse at the cubit is called loosened slackness. The explanation: the cubit is the Yin station, governed by liver and kidney; moderate means heat in the center, rough means absence of blood — hence loosened slackness. In loosened slackness the patient is cold yet not cold, hot yet not hot, weak yet not weak, robust yet not robust — an ailing that cannot be named. — When the marrow is damaged there is melting wasting and aching shins, the body loosened and slack and unable to move on (Yeongchu 靈樞). — 'Loosened' means the flesh come apart; 'slack' means the sinews no longer binding the bones. The pattern seems cold but is not, seems hot but is not: limbs and joints loosened and indolent, vexatious aching, food without savor. It may arise from wine damage, from damp strike, from wind-cold contraction, from excess in the bedchamber, or from irregular menses. The Qi and Blood should be made to move and the interstices coursed, regulating with medicines for internal damage joined to external contraction.
Clinical note The chapter's entry for the illness without a name — 'cold yet not cold, hot yet not hot' remains one of the finest classical descriptions of the malaise modern clinics file under fatigue of unclear origin, and the passage's differential (alcohol, damp, infection, sex, menstrual irregularity) is a working intake list.

Yeongchu 靈樞 · Immun 入門

Summer-pouring illness 注夏病

平人脉大爲勞, 極虛亦爲勞. 夫勞之爲病, 其脉浮大, 手足煩熱, 陰寒, 精自出, 脚痠削不能行, 小腹虛滿, 春夏劇, 秋冬瘥, 俗謂之注夏病. 《仲景》 ○大者, 熱邪也. 極虛者, 氣損也. 春夏劇者, 時助邪也. 秋冬瘥者, 時勝邪也. 黃芪建中湯主之. 方見上 《東垣》 ○屬陰虛, 元氣不足, 補中益氣湯加減用之. 詳見暑門

In an ordinary person a large pulse means taxation; an extremely vacuous one is also taxation. As an illness, taxation shows a floating large pulse, vexing heat of hands and feet, cold genitals with essence escaping of itself, aching wasted legs that cannot walk, and vacuous fullness of the lower abdomen — severe in spring and summer, easing in autumn and winter: commonly called the summer-pouring illness (Junggyeong 仲景). — Large is the heat evil; extremely vacuous is the Qi detriment. Severe in spring and summer because the season aids the evil; easing in autumn and winter because the season prevails over it. Astragalus Jianzhong Decoction governs it — formula above — (Dongwon 東垣). — It belongs to Yin vacuity with origin Qi insufficient; Supplement the Center and Boost the Qi Decoction is used with modifications — details in the Summerheat chapter —.
Clinical note Seasonal fatigue given a mechanism three ways — Zhongjing names the syndrome, Dongwon explains its calendar (the season votes for one side of the vacuity-heat equation), and the chapter points to its two great center-fortifying answers. The patient who wilts every June is a classical entity.

Junggyeong 仲景 · Dongwon 東垣

Illness of the two Yang 二陽病

二陽之病, 發心脾, 有不得隱曲, 女子不月. 其傳爲風消, 其傳爲息賁者, 死不治. ○註曰, 二陽, 謂陽明, 大腸及胃之脉也. 隱曲, 謂隱蔽委曲之事也. 夫腸胃發病, 心脾受之. 心受之則血不流, 脾受之則味不化. 血不流故女子不月, 味不化故男子少精. 是以隱蔽委曲之事, 不能爲也. 由血虛精少, 證屬虛勞. 《綱目》

Illness of the two Yang arises in Heart and Spleen: the hidden and intimate matters cannot be performed, and in women the monthly courses cease. When it transmits, it becomes wind wasting; when it transmits further to rushing respiration, it is death, beyond treatment. — The commentary: the two Yang means the Yang Brightness — the vessels of large intestine and stomach. 'Hidden and intimate matters' means the concealed affairs of the private chamber. When intestine and stomach fall ill, Heart and Spleen receive it: the Heart receiving it, the Blood does not flow; the Spleen receiving it, the flavors do not transform. Blood not flowing, women lose their months; flavors not transforming, men grow scant of essence — and so the hidden and intimate matters cannot be done. Arising from Blood vacuity and scant essence, the pattern belongs to vacuity taxation.
Clinical note The Inner Classic's most delicate euphemism given a full mechanism — digestion fails, so blood and essence fail, so intimacy fails: sexual and reproductive decline traced to the gut, not the gonads. A chain of causation any modern clinic treating fatigue-related sexual dysfunction still walks.

Gangmok 綱目

Difficult and untreatable patterns 難治不治證

虛勞之疾, 不受補者, 難治. ○喉中生瘡, 聲啞者, 難治. ○久臥生胝瘡者, 難治. 《回春》 ○虛極之病, 火炎面紅, 發喘痰多, 身熱如火, 趺腫, 溏泄, 脉緊不食者, 死. 《入門》

In the illness of vacuity taxation, one who cannot receive supplementation is difficult to treat. Sores arising in the throat with a hoarse, mute voice — difficult to treat. Pressure sores from long lying — difficult to treat (Hoechun 回春). In the illness of utmost vacuity — fire flaming with a red face, panting with copious phlegm, body hot as fire, swollen insteps, sloppy diarrhea, a tight pulse, and no eating — death. (Immun 入門)
Clinical note The first criterion is the profoundest: a patient who can no longer absorb supplementation has lost the faculty every formula in this chapter depends on. The rest are its visible forms — the throat that cannot swallow, the skin that breaks from stillness, the fire that eats faster than food can arrive.

Hoechun 回春 · Immun 入門

五敗死證, 手足腫, 無交紋, 心敗. ○脣反黑無紋, 肺敗. ○面黑有瘡, 肝敗. ○陰腫囊縮, 腎敗. ○臍突腫滿, 脾敗. ○九死候者, 一手足靑. ○二手足久腫. ○三脉枯齒乾. ○四語聲散, 鼻虛張. ○五脣寒冷宣露. ○六脣腫齒焦. ○七手循衣縫. ○八汗出不流. ○九舌卷卵縮. ○十絶證者, 氣短, 目視亭亭無精光, 心絶. ○口鼻虛張, 氣復短, 肺絶. ○面靑, 眼視人不直, 數出淚, 肝絶. ○面黑, 眼睛黃, 素汁流, 腎絶. ○泄涎唾不覺, 時時忘語, 脾絶. ○爪甲靑, 惡罵不休, 膽絶. ○背脊痠疼, 腰重反覆難, 骨絶. ○面無精光, 頭髮自落, 血絶. ○舌卷縮如紅丹, 嚥唾不得, 足踝小腫, 肉絶. ○髮直如麻, 汗出不止, 腸絶也. 《千金方》

The five defeats, signs of death: hands and feet swollen with the crease-lines gone — the Heart defeated. Lips everted, black, without lines — the Lung defeated. Face black with sores — the Liver defeated. Genitals swollen, scrotum retracted — the Kidney defeated. Navel protruding with swelling fullness — the Spleen defeated. — The nine signs of death: first, hands and feet turned green-blue; second, hands and feet long swollen; third, vessels withered and teeth dry; fourth, the voice scattered and nostrils flaring empty; fifth, lips cold with teeth laid bare; sixth, lips swollen and teeth scorched; seventh, hands groping along the seams of the clothes; eighth, sweat beading but not flowing; ninth, tongue curled and testicles retracted. — The ten severances: breath short, the gaze fixed and lightless — the Heart severed. Mouth and nose gaping empty, the breath shorter still — the Lung severed. Face green-blue, the eyes unable to look at a person straight, tears falling often — the Liver severed. Face black, eyes yellow, spontaneous fluids flowing — the Kidney severed. Drooling unawares, speech forgotten moment to moment — the Spleen severed. Nails green-blue, cursing without cease — the Gallbladder severed. Spine aching, the lumbus too heavy to turn — the bones severed. A face without light, the hair falling of itself — the Blood severed. Tongue curled tight as red cinnabar, unable to swallow, ankles faintly swollen — the flesh severed. Hair standing straight as hemp, sweat pouring without stop — the intestines severed.
Clinical note The chapter's unflinching last taxonomy — a bedside semiotics of dying, sign by sign, organ by organ, from the hands that grope at seams to the sweat that beads and will not run. Kept here not as morbidity but as mercy: knowing the signs that no formula answers is what frees the physician to stop prescribing and start accompanying. On which threshold the theory of the chapter ends, and the simples and the moxa — the gentlest things it owns — take over.

Cheongeumbang 千金方

Simple medicinals 單方

凡三十六種. 有水芝丸. ○黃精. 治虛損, 五勞七傷, 安五藏. 根莖花實皆可服. 或採根蒸曝餌之, 或擣末淨水調服, 日三. 《本草》

Thirty-six kinds in all, including Suji-hwan (Water Iris Pill). — Solomon's seal (黃精): treats vacuity detriment, the five taxations and seven damages, and quiets the five viscera. Root, stalk, flower, and fruit may all be taken — steam and sun-dry the root and eat it, or pound to powder and take in clean water, three times daily.

Boncho 本草

兎絲子. 治虛勞, 補眞陽不足. 凡人氣血未定時, 失調護以致諸虛. 酒浸蒸九次擣爲末, 酒調二錢服, 日二. 《本草》

Cuscuta (兎絲子): treats vacuity taxation and supplements insufficiency of the true Yang — for all whose Qi and Blood, before they had settled, went unguarded and fell into the many vacuities. Wine-soak, steam nine times, pound to powder, and take 2 don in wine, twice daily.

Boncho 本草

天門冬. 補五勞七傷, 潤五藏. 冷而能補. 作末和酒服, 或蜜丸服, 或釀酒服幷佳. 《本草》

Asparagus root (天門冬): supplements the five taxations and seven damages and moistens the five viscera — cold, yet able to supplement. Powder and take in wine, take as honey pills, or brew into wine: all excellent.

Boncho 本草

麥門冬. 治五勞七傷, 安五藏. 服法與天門冬同. 《本草》

Ophiopogon (麥門冬): treats the five taxations and seven damages and quiets the five viscera. Taken the same ways as asparagus root.

Boncho 本草

朮. 主五勞七傷, 健脾胃, 能益壽. 作末和酒服, 或蜜丸服之, 或煎汁熬爲膏, 久服尤佳. 《本草》

Atractylodes (朮): governs the five taxations and seven damages, fortifies the Spleen and Stomach, and can lengthen the years. Powder and take in wine, take as honey pills, or simmer the decocted juice into a paste — taken long, finer still.

Boncho 本草

何首烏. 治虛勞, 五勞七傷, 能益血氣, 補陰壯陽. 取根擣末和酒服, 或作丸久服良. 《入門》

Fleeceflower root (何首烏): treats vacuity taxation and the five taxations and seven damages; able to boost Blood and Qi, supplement Yin, and invigorate Yang. Pound the root to powder and take in wine, or take long as pills — good.

Immun 入門

地黃. 主五勞七傷, 益氣力, 補虛損. 釀酒服之, 或作丸久服, 幷佳. 《本草》

Rehmannia (地黃): governs the five taxations and seven damages, boosts strength, and supplements vacuity detriment. Brew into wine, or take long as pills — both excellent.

Boncho 本草

山藥. 治虛勞羸瘦, 補五勞七傷. 採根蒸食之, 或作粥服皆佳. 《本草》

Dioscorea (山藥): treats the emaciation of vacuity taxation and supplements the five taxations and seven damages. Steam the root and eat it, or take as porridge — all excellent.

Boncho 本草

石斛. 補五藏虛勞羸瘦. 採取浸酒服之, 或煎服丸服幷佳. 《本草》

Dendrobium (石斛): supplements the five viscera in the emaciation of vacuity taxation. Steep in wine and take, or decoct, or take as pills — all excellent.

Boncho 本草

黃芪. 補虛勞羸瘦, 諸虛不足, 能瀉虛火. 剉蜜水炒煎服. 《東垣》

Astragalus (黃芪): supplements the emaciation of vacuity taxation and all vacuity insufficiency; able to drain vacuity fire. Cut, fry with honey water, decoct, and take.

Dongwon 東垣

五味子. 主虛勞羸瘦, 補不足, 令人悅澤, 去虛熱. 或作煎服, 或作丸服皆佳. 《本草》

Schisandra (五味子): governs the emaciation of vacuity taxation, supplements insufficiency, gives a person a pleased and lustrous look, and removes vacuity heat. Take as a decoction or as pills — all excellent.

Boncho 本草

當歸. 治虛勞, 寒熱, 補不足, 補血和血行血. 剉煎服, 或丸服, 散服皆良. 《本草》

Korean angelica (當歸): treats vacuity taxation with cold and heat, supplements insufficiency, and supplements, harmonizes, and moves the Blood. Cut and decoct, or take as pills or powder — all good.

Boncho 本草

知母. 治骨熱虛勞, 補陰氣. 剉五錢水煎服, 或作末丸服亦佳. 《本草》

Anemarrhena (知母): treats vacuity taxation with heat in the bones and supplements the Yin Qi. Cut 5 don, decoct in water and take, or powder and take as pills — also excellent.

Boncho 本草

仙靈脾. 一名淫羊藿. 治虛勞冷氣, 補腎益氣力. 酒漬服之甚良. 《本草》

Epimedium (仙靈脾) — also called 'licentious goat's herb' (淫羊藿): treats cold Qi in vacuity taxation, supplements the Kidney, and boosts strength. Steeped in wine and taken — exceedingly good.
Clinical note The byname carries the pharmacology: the herb named for what it did to the goats that grazed it, filed in this chapter under cold-type depletion rather than under aphrodisiacs — the Donguibogam treating restored vitality as the point and the legend as the footnote.

Boncho 本草

靑蒿. 治熱勞骨蒸. 多取童尿五升, 水三升, 煮取汁. 再熬成膏, 丸如梧子, 酒下三十丸. ○一法, 童尿浸曬, 丸服亦良. 《本草》

Sweet wormwood (靑蒿): treats heat taxation with steaming bone. Take a quantity with 5 doe of boys' urine and 3 doe of water, boil for the juice, then simmer again into a paste; roll into pills the size of parasol-tree seeds and take 30 with wine. — By another method, steep in boys' urine, sun-dry, and take as pills — also good.
Clinical note The same Artemisia annua whose extract now cures malaria, here already assigned to consumptive fevers — reduced to a paste, which modern chemistry would note preserves artemisinin poorly at heat, though the indication's instinct for this plant and fever remains striking.

Boncho 本草

枸杞. 主五勞七傷, 庶事衰弱. 皮葉及子同功, 皆主虛勞. ○子及皮, 可釀酒, 或作丸服. 葉作羹, 和五味常服. 《本草》

Lycium (枸杞): governs the five taxations and seven damages and debility in all one's affairs. Bark, leaf, and fruit share the same power — all govern vacuity taxation. Fruit and bark may be brewed into wine or taken as pills; the leaves, made into soup and seasoned with the five flavors, taken regularly.

Boncho 本草

五加皮. 補五勞七傷, 補虛損. 多取酒漬服, 或釀酒服, 又煎如茶常服皆佳. 《本草》

Acanthopanax bark (五加皮): supplements the five taxations and seven damages and vacuity detriment. Steep a quantity in wine and take, brew into wine, or decoct and drink regularly like tea — all excellent.

Boncho 本草

牡蠣. 主虛勞乏損, 能補養. 取其肉煮食之. 《本草》

Oyster (牡蠣): governs the exhaustion and detriment of vacuity taxation; able to supplement and nourish. Take the flesh, boil, and eat.

Boncho 本草

鱉甲. 主虛勞, 及熱勞骨蒸. 取甲灸爲末, 作丸服, 或水煮服之. ○肉作臛食之. 《本草》

Turtle shell (鱉甲): governs vacuity taxation, and heat taxation with steaming bone. Roast the shell, powder it, and take as pills, or boil in water and take. The flesh, made into a thick soup, may be eaten.

Boncho 本草

鰻鱺魚. 主熱勞, 補虛損. 肉作臛食之. 《本草》

Eel (鰻鱺魚): governs heat taxation and supplements vacuity detriment. The flesh is made into a thick soup and eaten.

Boncho 本草

金線蛙. 主熱勞骨蒸, 補虛損. 取肉作羹, 和五味, 常食最好. 《本草》

Gold-striped frog (金線蛙): governs heat taxation with steaming bone and supplements vacuity detriment. Take the flesh, make a soup seasoned with the five flavors, and eat regularly — best of all.
Clinical note The simples close their first file where the sogal chapter's did — at the kitchen: eel soup and frog broth for the consumptive, high-protein flesh foods prescribed for wasting bodies with an instinct any modern dietitian would co-sign.

Boncho 本草

蓮實. 補諸虛. 蓮肉 一斤, 入猪肚內蒸爛, 或水煮至爛, 擣丸梧子大. 酒下百丸. 名曰水芝丸. 《入門》

Lotus seed (蓮實): supplements all vacuities. Pack 1 geun of lotus seed into a pig's stomach and steam soft, or boil in water until soft; pound into pills the size of parasol-tree seeds and take 100 with wine. This is called Suji-hwan — the Water Iris Pill.
Clinical note The Suji-hwan promised in the section's opening line, revealed: lotus seed cooked inside the chapter's favorite vessel, the pig's stomach — the same delivery trick as the coptis pills, repurposed from clearing to supplementing.

Immun 入門

胡麻. 主虛損羸瘦, 補五藏. 蒸曬九次, 擣爲末, 酒飮任下三錢, 日三. 或作丸常服. 《本草》

Black sesame (胡麻): governs the emaciation of vacuity detriment and supplements the five viscera. Steam and sun-dry nine times, pound to powder, and take 3 don with wine or rice water as one pleases, three times daily; or take regularly as pills.

Boncho 本草

烏雄雞. 補虛勞羸瘦. 取一隻, 和五味, 煮極爛食之. 甚補益, 宜常食. 《本草》

Black rooster (烏雄雞): supplements the emaciation of vacuity taxation. Take one bird, season with the five flavors, boil until utterly soft, and eat. Greatly supplementing — suitable to eat regularly.

Boncho 本草

黃雌雞. 補勞劣, 益脾胃. 依上法煮食. 《本草》

Yellow hen (黃雌雞): supplements taxation debility and boosts the Spleen and Stomach. Boil and eat by the method above.

Boncho 本草

飴糖. 補虛乏, 健脾胃氣. 可常食之. 卽黑糖也. 《本草》

Malt syrup (飴糖): supplements vacuity exhaustion and fortifies Spleen-Stomach Qi. May be eaten regularly. This is the dark grain syrup.

Boncho 本草

鹿肉. 補虛損. 可煮爛, 和五味食之. ○茸主虛勞羸瘦, 洒洒如瘧, 酥灸作末, 和酒服. ○骨主虛勞, 切碎煮取汁, 釀酒飮. 《本草》

Venison (鹿肉): supplements vacuity detriment; boil soft, season with the five flavors, and eat. The antler governs the emaciation of vacuity taxation with malaria-like shivering — butter-roast, powder, and take in wine. The bone governs vacuity taxation — chop, boil for the liquor, brew into wine, and drink.

Boncho 本草

鹿角膠. 補虛勞, 益髓長肌, 令人肥健. 灸爲末, 酒服二三錢, 日二. 《本草》

Deer antler glue (鹿角膠): supplements vacuity taxation, boosts marrow, and grows flesh, making a person full and hardy. Roast, powder, and take 2–3 don in wine, twice daily.

Boncho 本草

牛髓. 主傷中, 絶脉, 筋拘急. 以酒和服良. ○大病後, 虛勞不足, 黃牛乳一升, 水四升, 煮取一升, 稍稍飮. 《本草》

Ox marrow (牛髓): governs damage to the center, severed vessels, and hypertonic sinews; taken mixed in wine — good. After a great illness, for the insufficiency of vacuity taxation: boil 1 doe of yellow-cow's milk with 4 doe of water down to 1 doe and sip little by little.

Boncho 本草

羊肉. 主五勞七傷, 補中續絶傷. 以酒和服之. ○羊腎, 補腎陽衰弱. 作羹, 和五味食. 《本草》

Mutton (羊肉): governs the five taxations and seven damages, supplements the center, and rejoins what is severed and damaged; taken with wine. Lamb kidney supplements debilitated Kidney Yang — make a soup, season with the five flavors, and eat.

Boncho 本草

黃狗肉. 補五勞七傷, 大能補益. 和五味, 煮極爛熟食之. ○戊戌酒, 極能補養. 方見雜方 《本草》

Yellow dog meat (黃狗肉): supplements the five taxations and seven damages — greatly supplementing and boosting. Season with the five flavors, boil until utterly soft and done, and eat. Musul wine is supremely nourishing — method in the Miscellaneous Methods chapter —.

Boncho 本草

猪肚. 補虛損. 取肚一箇洗淨, 將黃芪ㆍ地黃, 剉入肚內, 以竹簽簽定, 用醇醩包肚, 放罐內, 重湯煮爛熟取出. 常服健脾胃, 補虛弱. 《活心》 ○又法, 人參 五錢, 乾薑ㆍ胡椒 各二錢, 葱白 七莖, 糯米 三合, 爲末, 入猪肚內, 煮爛熟, 空心, 食以酒下. 《入門》

Pig's stomach (猪肚): supplements vacuity detriment. Take one stomach, wash clean, cut astragalus and rehmannia and pack them inside, pin it shut with bamboo skewers, wrap in rich wine lees, set in a jar, and cook soft in a double boiler; taken regularly it fortifies the Spleen and Stomach and supplements weakness (Hwalsim 活心). By another method: powder ginseng 5 don, dried ginger and black pepper 2 don each, 7 stalks of scallion white, and 3 hop of glutinous rice; pack into the stomach, boil until utterly soft, and eat on an empty stomach, sent down with wine.

Hwalsim 活心 · Immun 入門

膃肭臍. 主五勞七傷, 療虛勞羸瘦. 火灸爲末, 酒服二錢, 或作丸服亦佳. 《本草》

Fur-seal genitalia (膃肭臍): governs the five taxations and seven damages and heals the emaciation of vacuity taxation. Fire-roast, powder, and take 2 don in wine, or take as pills — also excellent.

Boncho 本草

人乳. 治諸虛百損, 五勞七傷. 取人乳二盞, 好淸酒半盞, 入銀石器內, 煮一沸, 頓服, 空心. 《種杏》

Human milk (人乳): treats all vacuities and the hundred detriments, the five taxations and seven damages. Take two cups of human milk with half a cup of good clear wine in a silver or stone vessel, bring once to the boil, and drink at a draught on an empty stomach.

Jonghaeng 種杏 — Zhongxing

婦人經血. 治勞瘦幾死者. 取室女無病者月經一盞, 二三次取之, 和童男三母乳半盞, 和之於淨室中. 服之後發熱作渴, 不可飮茶湯酒, 取人乳汁飮之. 經旬, 至一月後, 方可食烟火食. 忌用心. 《種杏》

Menstrual blood (婦人經血): treats those wasted by taxation to the point of death. Take one cup of the menses of a healthy unmarried woman, gathered over two or three cycles, and blend in a clean room with half a cup of milk from three mothers of boys. After taking it, heat and thirst will arise — drink no tea, broth, or wine, but only human milk. After ten days to a month one may again eat cooked food. Taxing the mind is forbidden.
Clinical note The section's most confronting entry, and its logic laid bare — for the patient at death's door, the pharmacy offers the two most literal forms of vital essence a body can donate. Shown as recorded, as textual history; the accompanying regimen (no stimulants, no mental strain, a month of liquid diet) reads like a hospice protocol wrapped around a symbolic medicine.

Jonghaeng 種杏 — Zhongxing

人胞衣. 治虛勞, 痰嗽, 羸悴, 潮熱盜汗. 紫河車一具, 長流水浸洗淨, 入砂鍋內, 重湯煮熟, 入鹽ㆍ椒末少許食之, 此補眞元氣也. 大有殊效. 《種杏》

Human placenta (人胞衣): treats vacuity taxation with phlegm cough, haggard emaciation, tidal heat, and night sweats. Take one placenta (紫河車), soak and wash clean in long-flowing water, cook thoroughly in an earthen pot over a double boiler, season with a little salt and ground pepper, and eat — this supplements the true origin Qi. Greatly and singularly effective.
Clinical note Note on modern practice: human placenta (紫河車) is not used in contemporary U.S. herbal practice; the entry is shown as recorded, for textual fidelity. With it the thirty-six simples complete their ascent — from Solomon's seal in the mountain soil to the blood-and-flesh medicines, ending at the tissue that once fed a life directly.

Jonghaeng 種杏 — Zhongxing

Acupuncture and moxibustion 鍼灸法

五勞羸瘦, 取足三里. ○體熱勞嗽, 瀉魄戶. ○虛勞骨蒸盜汗, 瀉陰郄. 《綱目》 ○眞氣不足, 灸氣海. 《資生》

For the emaciation of the five taxations, take ST-36 (Zusanli). For body heat with taxation cough, drain BL-42 (Pohu). For the steaming bone and night sweats of vacuity taxation, drain HT-6 (Yinxi) (Gangmok 綱目). For insufficiency of the true Qi, moxa CV-6 (Qihai) (Jasaeng 資生).

Gangmok 綱目 · Jasaeng 資生

虛勞百證, 宜灸膏肓腧穴ㆍ患門穴ㆍ崔氏四花穴 取法, 詳見鍼灸門, 無所不療. ○此等灸法, 皆陽虛所宜. 華佗云, 風虛冷熱, 惟有虛者, 不宜灸. 但方書云, 虛損勞瘵, 只宜早灸膏肓ㆍ四穴, 云乃虛損未成之際. 如瘦弱兼火, 雖灸, 亦只宜灸內關ㆍ三里, 以散其痰火. 早年欲作陰火, 不宜灸. 《入門》 ○大病虛脫, 本是陰虛, 用艾灸丹田者, 所以補陽, 陽生陰長, 故也. 《丹心》

For the hundred patterns of vacuity taxation, moxa at BL-43 (Gaohuang), the Hwanmun points, and Master Cui's Four Flowers points — location methods detailed in the Acupuncture chapter —: there is nothing they do not treat. — Such moxibustion methods all suit Yang vacuity. Hua Tuo said: among wind, vacuity, cold, and heat, only the vacuous are unsuited to moxa. Yet the formularies say vacuity detriment and taxation-consumption should be moxaed early at Gaohuang and the Four points — meaning while the detriment has not yet fully formed. If thin and weak with concurrent fire, even when moxa is used it should be only at PC-6 (Neiguan) and ST-36, to scatter the phlegm-fire. In the young, when Yin fire is about to arise, moxa is unsuitable (Immun 入門). — In the vacuity desertion of great illness, which is at root Yin vacuity, mugwort moxa at the Cinnabar Field is used to supplement the Yang — for when Yang is engendered, Yin grows. (Dansim 丹心)
Clinical note The chapter closes on its own central dialectic, now argued in fire — moxa builds Yang, so whom do you burn and whom do you spare? The resolution is timing (early, before detriment sets) and the final word is Danxi's, characteristically turning the tool around: even in Yin collapse, warm the Yang at the Cinnabar Field, for Yang engendered is Yin grown. On which note the vacuity-taxation chapter ends.

Immun 入門 · Dansim 丹心

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613), Japbyeongpyeon vol. 4, Heoro chapter, following the collated first-woodblock edition established by the Korea Institute of Oriental Medicine, Mediclassics database. Original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.