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"Xiao" (Consumption) refers to the state of being easily consumed. Pathogenic fire scorches internally, leading to the depletion of True Yin. The patient suffers from extreme thirst and hunger, while the body fails to nourish the muscles and skin. Food entering the stomach is digested and exhausted in a short time.

When this disease manifests primarily with polyphagia and easy hunger, it is called "Xiao Zhong" (Middle Consumption); when it manifests primarily with frequent urination, it is called "Xiao Shen" (Kidney Consumption). These are all Fire syndromes involving the Heart, Spleen, and Kidney meridians. However, the Heat in the Heart and Spleen meridians stems from Kidney deficiency. This is because the Kidney governs Water. If True Water is not depleted, it naturally suffices to nourish the Spleen and communicate upward to the Heart. How could dryness and consumption-thirst diseases arise? Only when Kidney Water becomes deficient can it fail to control other Fires. When Fire is vigorous and cannot be extinguished, it scorches the Zang-Fu organs. Fire becomes fiercer due to water depletion, and water becomes drier due to fierce fire. Yang excess and Yin deficiency constitute this syndrome, causing the affliction of the Three Xiao (Three Consumptions) to intensify. Is not the root cause inherent in the Kidney?

However, speaking separately, there appear to be independent pathologies. For instance: if the Heart meridian is deficient, pathogenic fire takes advantage to invade, and internal disturbance stirs up Heart Fire. Heart Fire and pathogenic fire rise simultaneously, unable to be restrained, steaming the Upper Jiao (Upper Burner), resulting in dry mouth and tongue, a sensation of burning in the throat. Although drinking much water, vexation and thirst do not cease, and urination is frequent and scanty. This is what is called "Xiao Ke" (Upper Consumption/Thirst).

If the Spleen meridian is deficient, pathogenic fire takes advantage to invade, and internal heat roasts the Spleen Earth. The Spleen is scorched by fire, and Stomach Fire arises accordingly. The official responsible for granaries (the Spleen/Stomach system) loses its function, and the central position (Middle Jiao) becomes empty. This causes the person to digest grain quickly and feel hungry easily, consuming food quantities much larger than usual, with muscles gradually thinning. Urine is turbid like rice washings. Although extremely vexed and thirsty, the amount of water drunk is not large. This is what is called "Xiao Zhong".

If the Kidney meridian is deficient, pathogenic fire takes advantage to invade. Normally, Water controls Fire, but now Fire overcomes Water. It is like a cup of water trying to extinguish the fire of a cartload of firewood; the Essence of Pre-Heaven True One will inevitably be scorched to exhaustion. Consequently, the marrow becomes withered, limbs and joints become thin, legs and knees ache, lips are dry and cracked as if burned, thirst prompts drinking, although intake is small, yet urination occurs frequently and involuntarily, unable to be retained. This is what is called "Xiao Shen".

Although the Three Jiao (Triple Burner) appears to suffer independently, the root always returns to the Kidney meridian. Once True Water is deficient, the other two illnesses follow. Physicians can seek the origin of the disease based on this. This disease is formed only by those who love alcohol, love sexual indulgence, enjoy eating roasted and fried foods, and love taking medicines containing Cinnabar (Zhusha) and mineral stones. Generally, loving alcohol allows Heat to accumulate easily; loving sexual indulgence makes Fire hard to control; enjoying roasted and fried foods depletes Body Fluids; loving Cinnabar and mineral stones causes dryness and acridity in the intestines and stomach, thereby initiating Fire syndromes. Those who can eat will surely develop carbuncles and sores; those who cannot eat will inevitably suffer from abdominal fullness and distension. Be cautious.