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The onset of deficiency consumption (Xu Sun) arises from prolonged overwork, which damages Yang Qi, leading to fever and gradually progressing to cough. It may also result from wind-cold invasion that is left untreated or treated improperly. Alternatively, improper sweating or purging treatments for Cold Damage (Shang Han) can, over time, lead to alternating chills and fever. Hunger damaging the Spleen or overeating damaging the Stomach, coupled with inappropriate treatment, can also result in this condition. In all these cases, weak Yang Qi sinks inward and transforms into fire, causing fever. One must use Baoyuan Tang (Preserve the Origin Decoction) or Sijunzi Tang (Four Gentlemen Decoction) supplemented with Huangqi (Astragali Radix), along with Gegen (Puerariae Lobatae Radix) to release the muscle layer, and Zisu (Perillae Folium) to release the skin and hair pores. If the illness has not lasted long, taking fifteen or sixteen doses will naturally induce sweating. This is like the muggy heat in summer persisting for one to three days, followed by heavy rain that brings coolness; only when Yin and Yang harmonize does rain descend. Similarly, in autumn and winter, when Yang Qi descends into the earth, well water remains warm; whereas in spring and summer, as Yang Qi rises, the heaven and earth become mild and warm, allowing all things to grow and transform, while well water becomes bone-chillingly cold. Where would internal heat come from? For newly onset deficiency consumption within ten-plus days, provided no cooling/cold-natured herbs have been used, Huoyu Tang (Fire-Stagnation Decoction), Shengyang Sanhuo Tang (Raise Yang and Disperse Fire Decoction), and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) may be used. If the disease has persisted for a long time, Huoyu Tang should no longer be used. Instead, follow up with Baoyuan Tang and Sijunzi Tang; this constitutes the second stage of treatment. Since Yuan Qi (Primal Qi) is already deficient, one should only assist Yang Qi and avoid dispersing fire. Mistakenly using Danggui (Angelicae Sinensis Radix) and Dihuang (Rehmanniae Radix) to nourish blood, along with Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma)—which are bitter, cold, substantial, and heavy—will instead damage formless Yang Qi. The weaker the Yang Qi, the less it can ascend and sprout; if Yang Qi perishes, Yin Qi perishes with it. Death from deficiency consumption occurs due to this reason.

In deficiency consumption, if all six pulses are rapid (Shu), accompanied by hoarseness, mouth ulcers, and continuous day-and-night fever without respite, the Classic states: "Rapid pulse indicates Spleen Qi deficiency." This signifies a deficiency of True Yin, marking the third stage. At this point, previous prescriptions such as Baoyuan Tang and Sijunzi Tang will prove ineffective. One must use Sijunzi Tang supplemented with Huangqi (Astragali Radix), Shanyao (Dioscoreae Rhizoma), Lianrou (Nelumbinis Semen), Baishao (Paeoniae Radix Alba), Wuweizi (Schisandrae Chinensis Fructus), and Maidong (Ophiopogonis Radix). Decoct these, discard the first decoction, and consume only the second and third decoctions. This is a secret method for nourishing Spleen Yin. After taking this for more than ten days, as fever gradually subsides and mouth ulcers heal, switch to pill preparations, such as Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder). Discard the first decoction of this powder as well, dry it, grind it into fine powder, and use the charred crust from an old rice pot (Chenmiguo Jiao) mixed with water to form pills the size of mung beans. Take two qian daily, or one qian in the morning, washed down with boiling water. Boiling away the first decoction removes the drying properties, leaving a sweet and bland flavor. The bland flavor nourishes Stomach Qi, and the slight sweetness nourishes Spleen Yin. These are teachings passed down from master to disciple; do not neglect them lightly.