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Any condition that damages the Yuan Qi (Original Qi) is fundamentally a deficiency syndrome. However, ancient texts classified Xu Sun (Deficiency and Wasting) and Lao Zhai (Consumptive Disease) into separate categories, indicating that although the diseases may appear different, they warrant distinct differentiation.

Deficiency syndromes can occur in the Yang aspect or the Yin aspect. When the pathology is still superficial, treatment may involve Yi Huo (Warming and Supplementing Fire/Yang) or Zi Yin (Nourishing Yin), with therapeutic strategies tailored to specific manifestations, each having its appropriate application. In contrast, Lao Zhai (Consumptive Disease) may present as Gu Zheng (Bone-steaming fever, a sensation of heat emanating from the bones due to Yin deficiency), dry cough, hemoptysis (coughing up blood), or expectoration of phlegm. In such cases, both Ying Wei (Nutritive and Defensive Qi) are exhausted, and emaciation worsens daily. The pathology is deep within the Yin-to-Yin aspect, and warm-tonifying methods are generally contraindicated. Thus, Xu (Deficiency) and Lao (Consumption) seem to have distinct differences. However, summarizing them, Lao Zhai (Consumptive Disease) is merely an extreme and severe stage of Yin deficiency! If medication for Yin deficiency is inappropriate—such as mistakenly using Xin Wen (Acrid-Warm herbs) or recklessly administering Xiao Fa (Draining and Reducing methods)—the condition will deteriorate daily until it becomes Lao Zhai (Consumptive Disease). Therefore, caution is essential.

Regardless of whether the injury involves Yin or Yang, prolonged deficiency and wasting can lead to disease transmission. Some claim that in men, disease transmits from the Kidney to the Heart, Lung, Liver, and Spleen, while in women, it transmits from the Heart to the Lung, Liver, Spleen, and Kidney; this theory is unreliable. The *Nan Jing* (Classic of Difficult Issues) states: Diseases caused by Sun Mai (Diminished Pulse) manifest as follows: First degree of damage affects the skin and hair, causing skin contraction and hair loss; second degree affects the blood vessels, leading to blood insufficiency unable to nourish the five zang and six fu organs; third degree affects the muscles, causing muscle emaciation where food intake fails to build flesh; fourth degree affects the sinews, causing flaccidity and inability to hold oneself upright; fifth degree affects the bones, causing bone atrophy and inability to rise from bed. The reverse progression characterizes the Zhi Mai (Excessive/Extreme Pulse) disease. Transmission from upper to lower levels, culminating in bone atrophy preventing one from rising from bed, indicates death. Transmission from lower to upper levels, culminating in skin contraction and hair loss, also indicates death. Observing these concepts of upper and lower damage reveals profound logic. Generally, conditions such as mental overwork, fatigue, and external pathogenic invasions injure Yang; injuries to Yang inevitably progress from top to bottom. Conditions such as sexual excess and overindulgence in food and alcohol injure Yin; injuries to Yin inevitably progress from bottom to top.

Progression from top to bottom first injures Qi. Thus, the first degree of damage in the Lung manifests as abnormalities in voice, respiration, skin, and interstices; the second degree in the Heart manifests as abnormalities in blood vessels and complexion; the third degree in the Stomach manifests as dietary irregularities; the fourth degree in the Liver manifests as hypochondriac pain; and the fifth degree in the Kidney manifests as bone atrophy and incontinence of urine and feces. This represents initial injury to Yang followed by involvement of Yin. When Yang exhausts at the lower level, isolated Yin cannot survive alone, rendering the condition untreatable. Progression from bottom to top first injures Essence. Thus, the first degree of damage in the Kidney manifests as the drying up of the source (essence); the second degree in the Liver manifests as restless blood and withered sinews; the third degree in the Spleen manifests as abundant phlegm and saliva; the fourth degree in the Heart manifests as loss of spirit and mind control; and the fifth degree in the Lung manifests as shortness of breath and wheezing. This represents initial injury to Yin followed by involvement of Yang. When Yin exhausts at the upper level, isolated Yang cannot survive alone, rendering the condition untreatable.

However, both types of damage regard the Spleen and Stomach as the critical juncture for life and death. Since the Spleen and Stomach belong to Earth, they are the root of all things. If the pathological transmission exceeds this point upward, it spreads to the Liver and Kidney, becoming untreatable. If it exceeds this point downward, it spreads to the Heart and Lung, also becoming untreatable. Therefore, it is said: Damage to the Heart and Lung leads to decline of Shen (Spirit); damage to the Liver and Kidney leads to deterioration of Xing (Form); damage to the Spleen and Stomach prevents food from transforming into Blood and Qi. By the time transmission has progressed deeply, hoping for recovery is already too late. The value of a wise person lies precisely in preventing problems before they arise (Fang Wei Du Jian).