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The "Six Extremes" (Liu Ji) refer to six states of extreme deficiency: Extreme of Sinews, Extreme of Vessels, Extreme of Flesh, Extreme of Qi, Extreme of Bones, and Extreme of Essence. The Extreme of Sinews is primarily associated with the Liver Meridian; the Extreme of Vessels with the Heart; the Extreme of Flesh with the Spleen; the Extreme of Qi with the Lung; the Extreme of Bones with the Kidney; and the Extreme of Essence with the Zang-Fu organs.

The manifestations of the Extreme of Sinews include frequent muscle spasms (Zhuan Jin), pain and fatigue in all ten fingers and nails, and an inability to stand for long periods.

The manifestations of the Extreme of Vessels include mental confusion, propensity to forgetfulness, lack of luster in the complexion, and falling out of eyebrows and hair.

The manifestations of the Extreme of Flesh include loss of taste in food, inability to generate flesh, and dry, rough skin.

The manifestations of the Extreme of Qi include deficiency of Healthy Qi (Zheng Qi) and excess of Pathogenic Factors (Xie Qi); insufficient Qi leads to frequent panting and reluctance to speak.

The manifestations of the Extreme of Bones include soreness and emaciation of the lower back and spine, toothache, vexing heat and pain in the hands and feet, and aversion to movement.

The manifestations of the Extreme of Essence include emaciated muscles, shortness of breath, propensity to forgetfulness, and receding temples/hair.

These conditions are termed "Extremes" because the disease is more severe than ordinary "Fatigue" (Lao). Their treatment methods are the same as those for treating Fatigue.

The "Seven Injuries" (Qi Shang) include: First, great anger causes rebellious Qi to injure the Liver; second, sorrow and overthinking injure the Heart; third, excessive fullness from diet injures the Spleen; fourth, exposure to cold and drinking cold water injure the Lung; fifth, prolonged sitting on damp ground injures the Kidney; sixth, wind, rain, cold, and dampness injure the physical form; seventh, great anger and fear injure the Will (Zhi).

When the Liver is injured, there is a lack of Blood and dim vision; when the Heart is injured, there is distress from fright and forgetfulness; when the Spleen is injured, the face turns yellow and there is a tendency to sleep; when the Lung is injured, there is shortness of breath and cough; when the Kidney is injured, there is shortness of breath, lumbar pain, and cold extremities with coldness below; when the physical form is injured, the skin becomes dry and rough; when the Will is injured, there is mental vagueness and unhappiness. The treatment method is the same as that for the Five Fatigues and Six Extremes.

In men, a large pulse during normal health indicates Fatigue, and an extremely deficient pulse also indicates Fatigue. For men suffering from Fatigue, the pulse is floating and large, with vexing heat in the hands and feet; symptoms worsen in spring and summer and improve in autumn and winter. Internal cold leads to spontaneous emission of essence, soreness and emaciation of the waist, and difficulty walking. At the Cun Kou position, a floating and slow pulse indicates that floating signifies deficiency and slow signifies Fatigue; deficiency implies insufficiency of Defensive Qi (Wei Qi), while floating implies exhaustion of Nutritive Qi (Ying Qi). A straight pulse that is slow and obstructed indicates deficiency; a choppy pulse without Yang signs indicates scarcity of Kidney Qi; a choppy pulse at the Cun and Guan positions without Blood, accompanied by rebellious Qi and coldness, indicates severe deficiency; a floating, slightly moderate, and large pulse also indicates Fatigue. When a faint pulse and a soggy pulse interact, it constitutes the Five Fatigues; when faint and weak pulses interact, it constitutes deficiency damage, known as the Seven Injuries.

Individuals with Cold Fatigue have exhausted Qi and Blood, with both interior and exterior being deficient, Yin and Yang disharmonious, and Essence and Qi scattered, leading to internal generation of cold sensations. This arises from long-term deficiency of the Zang-Fu organs and accumulation of cold Qi, resulting in indigestion, accumulations in the heart and abdomen, pain in the umbilical and abdominal regions, sallow complexion, sores in the mouth and tongue, diarrhea and dysentery, weakness in the hands and feet, and soreness in bone joints. If untreated for a long time, it progresses to emaciation, hence called Cold Fatigue (quoted from *Jifeng Fang*).

"Lao" originally means labor or exertion. Guo Fengyuan stated that temporary fatigue in ordinary people is generally called Lao. However, modern people regard Lao as a malignant disease and abhor hearing about it; relatives and friends conceal it together. Seeing their symptoms, no one dares to call it Lao. They do not realize that Lao disease begins with failure to regulate and be cautious in physical activity, leading to continuous fatigue and injury, which gradually develops into a major illness. What is commonly referred to as Deficiency Fatigue (Xu Lao) refers to the Five Fatigues. The Six Extremes and Seven Injuries are categories within this. It is akin to Zhuangzi's saying: "If spirit is used too much, it will be exhausted; if Shen is labored too much, it will be damaged." The treatment method involves merely nourishing the Five Zang organs and benefiting Qi and Blood, making them strong, so that the disease naturally disappears. There is also Transmitted Corpse Fatigue (Chuan Shi Lao), which does not belong to this category. It is generally caused by Corpse Transmission (Shi Zhu) and the presence of pathogenic essence and ghostly Qi. The classics state: "When a person has three types of deficiency, encountering the decline of the year, the emptiness of the moon, and losing the harmony of the season, they may suddenly feel the Qi of life and death, or suddenly offend the essence of ghosts and spirits." Generally, this presents as alternating chills and fever, profuse sweating, lethargy, and silence, with unclear knowledge of specific discomfort but aversion everywhere. Over months and years, the patient gradually collapses. After death, it transmits to others; this is what is meant by Transmitted Corpse Fatigue. For this, one must use herbs capable of communicating with the divine and eliminating evil Qi. The classics say: "Herbs and plants fully acquire their nature; ghosts and spirits have nowhere to hide." Excavating rhino horn, driving away evil, refining cinnabar and stones, and attracting pure and harmonious Qi—these measures seem specifically designed for such diseases (ibid.).