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In the *Ling Shu: Wu Bian Pian* (Five Transformations Chapter of the Spirit Pivot), the Yellow Emperor asked, "How can one predict who is prone to Xiao Dan (Wasting and Thirsting disease characterized by polydipsia, polyphagia, and emaciation)?" Shao Yu replied, "Those with weak Zang organs are prone to Xiao Dan." The Yellow Emperor asked, "How do we know the Zang organs are weak?" Shao Yu said, "Weakness in constitution is often accompanied by a rigid and strong temperament; those who are rigid and prone to anger have Zang organs that are easily injured. Such individuals have thin skin but deep-set, firm eyes, long straight eyebrows, and a rigid heart. Rigidity leads to anger; anger causes Qi to rebel upward, leading to accumulation in the chest. Qi and Blood stagnate, causing the skin and muscles to become full and swollen, while the blood vessels fail to circulate properly. This stagnation transforms into Heat, which consumes the flesh and skin, thus resulting in Xiao Dan." This describes individuals who are aggressive in temperament but weak in muscle tissue.

Xiao Dan is characterized by excessive thirst, increased appetite, and emaciation. It arises from the weakness of the five Zang organs combined with deep-set, firm eyes and a gaze that shoots straight forward, reflecting a rigid and angry disposition. This leads to blazing Fire in the Heart and Liver, rebellious Qi, and stagnant blood circulation. Long-term stagnation generates pathogenic Heat, causing this disease. However, this only refers to those who are aggressive yet physically weak. There are also cases where Xiao Dan results from damage due to improper diet and excess alcohol or sexual indulgence, which are also caused by the accumulation of pathogenic Heat.

In the *Su Wen: Tong Ping Xu Shi Lun* (General Discussion on Deficiency and Excess in the Basic Questions), the Yellow Emperor asked, "What are the deficiency and excess patterns of Xiao Dan?" Qibo replied, "If the pulse is large and forceful, even after a long duration of illness, it is treatable; if the pulse is suspended, small, and hard, even after a short duration, it is untreatable."

Xiao Dan is caused by the accumulation of pathogenic Heat. If the illness has lasted long but the pulse remains large and forceful, it indicates that the Yuan Qi (Original Qi) has not yet failed, so it is treatable. If the pulse is suspended and small, it signifies extreme thinness, indicating that the Yuan Qi has already failed. If it is also hard, lacking any relaxed quality, it shows that pathogenic factors are firmly entrenched, making it untreatable.

Generally, treating diseases such as Xiao Dan, Pu Ji (sudden collapse/fainting), Pian Ku (hemiplegia), Wei Zheng (flaccidity syndrome), Jue Zheng (cold extremities/rebellious Qi), and Qi Man Fa Ni (distension with rebellious Qi) requires recognizing that these are often ailments of wealthy and noble individuals caused by consuming rich, greasy, and sweet foods (Gao Liang). Conditions involving obstruction and blockage, where upper and lower communications cease, are caused by sudden severe worry and depression. Sudden Jue with deafness, or unilateral blockage, is caused by a sudden surge of internal Qi. Diseases not caused by external wind-stroke or internal emotional injury, but resulting in chronic emaciation and lingering pathogens, stem from internal deficiency. Limping is caused by Cold, Dampness, and Wind pathogens.

This explains that treating disease requires understanding its etiology. Pu Ji refers to sudden falling or collapsing as if struck. For wealthy individuals, diseases like Xiao Dan, Pian Ku, Wei, Jue, and Qi Man Fa Ni are often caused by rich diets and internal injury from desires. Obstruction of the San Jiao (Triple Burner) Qi, leading to blockage between upper and lower parts, is caused by sudden depressive stagnation. Sudden Jue with deafness and unilateral blockage is due to a sudden rush of internal Qi. Illnesses not caused by external six climatic factors or internal seven emotions, but by dysfunction of one's own Qi, result in emaciation and lingering pathogens. Sudden collapse, flaccidity, and Jue often occur in those consuming rich foods, whereas limping in thin individuals is caused by internal sudden emotional Qi blockage combined with external invasion of Cold, Dampness, and Wind.

The Yellow Emperor asked, "Jaundice, sudden severe pain, Dian Ji (epilepsy/manic disorder), and Jue Kuang (Jue and mania) are generated by long-term rebellion of Qi; imbalance of the five Zang organs is generated by closure of the six Fu organs; headache, tinnitus, and dysfunction of the nine orifices are generated by disorders of the stomach and intestines."

Jaundice is caused by internal closure of Damp-Heat. Sudden severe pain and Dian Ji are caused by internal knotting of Wind-Phlegm. Jue and Kuang are caused by hyperactivity of Yin or Yang. All these arise from long-term rebellion of one's own Qi, often due to excessive dominance and imbalance of Zang Qi and closure of Fu organs. Headache, tinnitus, and dysfunction of the nine orifices are caused by loss of regulation in the transmission and transformation functions of the stomach and intestines, leading to turbid stagnation and failure of clear Yang to circulate. Compared to the aforementioned diseases, this condition is milder.