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In the Eight Trigrams, Li (Fire) represents fire. In the Five Elements, fire can burn objects. In the Six Qi, fire can consume objects. Therefore, the function of fire is to burn wood until it is consumed and turns into charcoal, to burn earth until it is consumed and turns into bricks, to smelt metal until it is consumed and becomes like sweat (metaphor for molten state), to calcine stone until it is consumed and turns into ash, to boil water until it is consumed and becomes soup, to boil seawater until it is consumed and becomes salt, to refine mercury until it is consumed and becomes powder, to distill tin until it is consumed and becomes cinnabar. Thus, the water in marshes dries up under the scorching sun; the water in cauldrons dries up under fierce fire.

Among the Five Zang organs, the Heart belongs to the orthodox transformation of Sovereign Fire (Jun Huo), the Kidney belongs to the counter-transformation of Sovereign Fire, the Sanjiao (Triple Burner) belongs to the orthodox transformation of Ministerial Fire (Xiang Huo), and the Gallbladder belongs to the counter-transformation of Ministerial Fire. If balance is maintained, food and drink are cooked and digested, and waste products are expelled. If balance is not maintained, organs and tissues are scorched, and body fluids (Jin Ye) are exhausted. Therefore, objects entering water grow without exception; objects entering fire are consumed without exception. If Heart Fire in the body is excessive, it manifests as Xiao Ke (Wasting-Thirst) in the diaphragm region above, in the stomach and intestines in the middle, in the essence and fluids below, and causes muscle wasting on the exterior. If the upper symptoms are severe and uncontrolled, the wasting affects the Lungs; if the middle symptoms are severe and uncontrolled, the wasting affects the Spleen; if the lower symptoms are severe and uncontrolled, the wasting affects the Liver and Kidneys; if the exterior symptoms are severe and uncontrolled, the wasting affects the sinews and bones. When the other four Zang organs are completely consumed, the Heart itself burns out and death ensues. Therefore, the *Su Wen* (Basic Questions) mentions Xiao Dan (Wasting-Fever), Xiao Zhong (Middle Wasting), Xiao Ke (Wasting-Thirst), Feng Xiao (Wind Wasting), Ge Xiao (Diaphragm Wasting), and Fei Xiao (Lung Wasting). Although the manifestations of Xiao differ, they all归结 to Fire pathogen.

Xiao Dan is the general term for all types of wasting syndromes; Xiao Zhong is the common term for excessive hunger; Xiao Ke is the common term for excessive thirst. Only Feng Xiao, Ge Xiao, and Fei Xiao must be distinguished. Feng Xiao is a disease of the Two Yang meridians (Stomach and Large Intestine), often driven by Wind pathogen. The pathogen obstructs the贲门 (cardia), consumes the stomach and intestines, making it impossible to swallow water, causing dry mouth and excessive thirst. The classic states: "When the Two Yang are knotted, wasting occurs." Eating well but becoming thin is called Shi Yi (Food Wasting). Ge Xiao occurs when Metal (Lung) is invaded by Fire pathogen, leading to excessive drinking and frequent urination, which may transform into edema. The classic states: "Heart transfers heat to the Lung, resulting in Ge Xiao." Fei Xiao occurs when the exterior of the Lung is constrained by Cold pathogen, preventing Yang Qi from distributing, while internally it is dried by Fire, causing extreme depletion of Yuan Qi and exhaustion of fluids. Consequently, the skin becomes dry and shrinks against the bones, and urine accumulates dampness and is passed frequently; half a sheng of liquid drunk results in ten he of liquid excreted. The classic states: "Heart transfers cold to the Lung, resulting in Fei Xiao. Drinking one part and urinating two parts indicates a fatal, incurable condition." Ge Xiao is not constrained by Cold, allowing Yang Qi to dissipate outwardly, making it treatable. Fei Xiao is constrained by Cold, causing Yang Qi to collapse centrally, making it incurable.

All wasting syndromes involve thirst, but there are distinctions. Those who eat rich foods often have thirst due to sweet and fatty foods or medicinal side effects; those who eat coarse foods have thirst only due to dryness-heat. Fire in the upper jiao causes excessive thirst; Fire in the middle jiao causes excessive hunger; Fire in the lower jiao causes excessive thirst. Excessive drinking with frequent urination indicates Fire in the middle and lower jiao, where there is no thirst but white fluid in urine; Fire pervading the upper, middle, and lower jiao causes excessive drinking and frequent urination. These are the differentiating factors. Later physicians diagnosed wasting syndromes as Kidney deficiency failing to control Fire, yet their medication was incorrect. Why? Using Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) to treat wasting fails to generate Water and instead aids Fire. Only Liu Hejian's theories and prescriptions align well with the principles of the *Nei Jing*, though this is unknown to the secular world. Therefore, for Xiao Ke, if one only regulates without purging, Kidney Water will be insufficient to moisten and cannot suppress the flaming-up tendency; if one only purges without regulating, drinking and wasting occur simultaneously, unable to moisten the dry diaphragm. If one purges and regulates but does not abstain from desires, control emotions, or reduce rich foods, the disease will recur after remission. Understanding these principles makes Xiao Ke a matter of little concern.