The "Prescriptions of the Golden Chest" by Zhang Zhong Jing introduces the term "Exhaustion"
(xu lao) for the first time. It says in chapter 6: "When the pulse is big but empty in male patients,
it indicates extreme exhaustion from overexertion".2(330)
The "Discussion on Causes and Symptoms of Diseases" (AD 610) by Chao Yuan Fang elaborates
on the concept of Exhaustion by investigating its causes. Dr Chao considers Exhaustion to be
due to the "6 Extremes" and the "7 Injuries". The "6 Extremes" are due to overexertion of the
body leading to depletion of Qi, Blood, Tendons, Bones, Muscles and Essence. The "7 Injuries"
refer to the damage inflicted on internal organs by various excesses which injure their energy.
Thus:
- overeating injures the Spleen
- excessive and prolonged anger injures the Liver and makes Qi rise
- lifting excessive weights or sitting on damp ground injures the Kidneys
- exposure to cold and drinking cold liquids injure the Lungs
- excessive worrying and thinking injure the Heart
- wind, rain, cold and heat injure the body
- fear, anxiety and shock injure the Mind.3(331)
The "Simple Questions" in chapter 23 lists five causes of Exhaustion:
Excessive use of the eyes injures Blood [i.e. the Heart]; excessive lying down
injures Qi [i.e. the Lungs]; excessive sitting injures the muscles [i.e. the Spleen];
excessive standing injures the bones [i.e. the Kidneys]; excessive exercise injures
the tendons [i.e. the Liver].4(332)Over the centuries various doctors discussed the treatment of Exhaustion according to their
particular views and emphases. For example, Li Dong Yuan, author of the famous "Discussion
on Stomach and Spleen" (1249), considered Stomach and Spleen deficiency to be the main cause
of Exhaustion. Zhu Dan Xi, author of "Secrets of Dan Xi" (1347), placed the emphasis on
Kidney- and Liver-Yin deficiency as a cause of Exhaustion and advocated nourishing Yin and
clearing Heat. Zhang Jie Bin, author of the "Classic of Categories" (1624) and the "Complete
Book of Jing Yue" (1624), advocated tonifying the Kidneys for the treatment of Exhaustion. Zhu
Qi Shi (1463-1539) considered the Lungs, Spleen and Kidneys to be the three most important
organs to treat in Exhaustion. He said in his book "Discussion on Exhaustion":
To treat Exhaustion there are three roots: Lungs, Spleen and Kidneys. Lungs are
like the 'heaven' of the internal organs, the Spleen is like the 'mother' of the body
and the Kidneys are like the 'root' of life. Treat these three organs to treat