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The Heart governs blood and houses the Shen (Spirit); the Kidney governs Zhi (Will) and stores Jing (Essence). From the perspective of the congenitally formed constitution, Jing generates Qi, and Qi generates Shen; from the perspective of acquired nourishment, for various diseases of Jing such as spermatorrhea and nocturnal emission, treatment must be based on calming the Shen; for various diseases of Shen such as palpitations and fright, treatment must be based on tonifying Qi. For calming the Shen requires benefiting Qi, and benefiting Qi requires tonifying Jing.

In the initial stage of Xu Lao (Deficiency Consumption), it is mostly due to the failure of communication between the Heart and Kidney, or due to a momentary vexation causing Fire to surge upward suddenly, shaking Tian Jing (Kidney Essence), causing Jing to depart from its profound depth. In mild cases, it manifests as nocturnal emission leading to a Yang Deficiency pattern, rather than a Yin Deficiency syndrome. If one presents solely with Heart-Kidney non-communication, accompanied by symptoms such as slippery spermatorrhea, nocturnal emission, night fever, and internal heat, this is the cause of Lao Sou (Consumption Cough), but has not yet developed into the syndrome itself. If Heart-Kidney non-communication occurs, with Heart Fire flaring up to overact upon Metal (Lung), causing urgency and itching at the Tiantu acupoint, with phlegm that cannot be expectorated nor swallowed, and a sensation in the throat like broken cotton wadding sticking and blocking, this is the syndrome of established Lao Sou.

At the initial stage of Heart-Kidney non-communication, there may be nocturnal emission and slippery spermatorrhea, body fatigue, bone萎 (withering/weakness), forgetfulness, and palpitations; or insufficient Blood in the Heart and Spleen, with Liver and Gallbladder Fire flaming wildly, rising to invade the head and descending to cause Jue (cold extremities). Guizhi Tang (Cinnamon Twig Decoction) can communicate the Heart and Kidney in an instant; within Guipi Wan (Restore the Spleen Pill), ingredients like Longyan Rou (Longan Fruit) and Muxiang (Aucklandia Root), which are sweet, warm, pungent, and hot, reach the Heart and Spleen directly, primarily tonifying the Middle Jiao to generate Blood. Quoting the scriptural meaning "When the Monarch is clear, the subordinates are peaceful," treatment uses tonifying Fire. Therefore, whenever Fire has not yet reached the point of overacting upon Metal, tonifying Fire is also a subtle application of generating Earth (Spleen), so why worry about the inadmissibility of warm-hot treatments? However, if Yin is severely deficient and Yang is hyperactive, Wood and Fire act according to their season, Heart Fire肆意ly issues commands to flare upward, Ministerial Fire raises flames like a prairie fire, the Lung loses its authority to descend and purify, and the Kidney lacks its function of continuous flow. This results in latent rebellious Fire in the Lung, and stubborn phlegm in the Diaphragm. Both fear non-seasonal external pathogens, and the chest is full of obstructive evils. Breath is high and wheezing, coughing is frequent, Tiantu burns like fire, the throat itches, expectoration and swallowing are impossible, prolonged coughing leads to loss of Qi, Qi fails to grasp into the Dantian, True Water fails to control Fire. Thus, dampness carries heat causing phlegm stagnation in the Middle Jiao, Fire carries Blood causing Jue Ni (rebellious counterflow) and coldness. Latent Fire shoots into the Lung system, enabling sitting but preventing lying down; Diaphragmatic phlegm stagnates in the Stomach collaterals, enabling turning left but preventing turning right. At this time, it is urgent to Clear Metal and Protect the Lung to promote the command of purity and descent; calm the Liver and缓 (slow/soothe) Fire to stabilize the positions of the Sovereign and Ministerial Fires; cultivate Earth and regulate the Middle to establish the mother source of generating Metal; nourish Yin and tonify the Kidney to suppress the flame of Solar Yang. All should be treated with Zhong He (Harmonizing Balance), tonifying deficiency, carrying sinking Qi, anchoring floating Yang, stabilizing chaos, resolving contention, restraining excess, moistening dryness, unblocking stagnation, and gathering dissipation, so that there may be benefit. If one clings to the theory of tonifying Fire, using pungent-hot substances, treating it similarly to conditions where cold-cool substances injure the Middle, although different diseases share the same treatment, is this not dangerous!