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Sometimes, due to excessive labor or strenuous activity, the Yin fire within the kidneys boils. During periods of leisure, if one removes clothing in a cool place, or after a fresh bath, sits or lies in a shaded area, the Yin fire descends and returns to the kidneys. At this time, the skin and interstices (Couli) are extremely deficient, lacking Yang Qi. When wind blows, the cold and chill obstruct the exterior. Because the exterior is deficient and cannot withstand Wind-Cold, patients often mistakenly believe they have contracted an external Wind-Cold invasion and seek physicians for diaphoretic treatment (sweating therapy). This severely depletes Yuan Qi (Original Qi), bringing disaster as easily as turning one's hand. If one luckily survives, it leads to Xu Lao (Deficiency Consumption), where both Qi and Blood become weak and unable to fully recover.

Furthermore, when individuals with a deficient exterior are obstructed by Wind-Cold, it is also considered Deficient Evil invading the exterior. In the first one or two days of illness, the presentation closely resembles that of Excess patterns caused by External Thieves' Evil (pathogenic factors), leading to confusion. Physicians should distinguish based on whether Qi is deficient or abundant. If injured by external Thieves' Evil, the voice will be light at first and heavy later, high-pitched and forceful. However, if injured by labor combined with irregular diet, resulting in a deficient exterior pattern, there will be shortness of breath, rapid breathing, upward rushing of Qi with high panting, reluctance to speak, and a voice that is weary, weak, and powerless; this is easy to identify. A minute error can lead to a massive mistake. Regarding these differentiations, detailed discussions on treatment methods and medication follow separately.

There is another scenario: contracting illness from labor during extreme heat, either while traveling or working in fields; or for those with weak constitutions who eat little but overwork; or for practitioners of asceticism and vegetarianism whose Stomach Qi has been long deficient, leading to illness from labor. These conditions resemble the Baihu Tang (White Tiger Decoction) syndrome of Yangming Zhong Re (Heat Stroke/Excessive Heat in Yangming). They necessarily present with burning heat upon touching the body, restlessness, stifling sensation, severe aversion to heat, thirst, and desire to drink water, due to excessive labor. There may also be body pain. Initially, the presentation closely resembles external Excess Heat patterns. Misusing Baihu Tang will result in death within ten days. This condition involves severe deficiency of the Spleen and Stomach and insufficiency of Yuan Qi, manifesting as shortness of breath from the mouth and nose with upward panting. After noon, when the Yangming channel is at its peak, the illness will slightly subside. In contrast, true external Heat Stroke will, by late afternoon (Ri Bu), cause delirious shouting, increased fever, extreme thirst, and unceasing restlessness. Patients with labor-induced deficiency do not exhibit these symptoms, making them easy to differentiate. For ambiguous cases that are difficult to decide, one must wait one or two days before seeking medical treatment to avoid errors.