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Huangdi asked: Why are some people prone to Xiao Dan (Wasting-Thirst and Carbuncle disease), and how can it be predicted through diagnosis? Qibo replied: Those with weak Zang organs are prone to Xiao Dan. Weakness in constitution often correlates with a rigid and strong temperament; those with such temperaments are prone to anger, which makes the body susceptible to injury. These individuals have thin skin, deep-set eyes with firm gazes, long and straight eyebrows, and a rigid heart. Rigidity leads to anger; anger causes Qi to rebel upward, leading to accumulation in the chest, stagnation of Blood and Qi, abdominal distension, and obstruction of blood vessels. This stagnation transforms into Heat, which consumes fluids causing thirst, thus forming Xiao Dan. This describes those who are aggressive in temperament but weak in muscles. If the complexion is slightly yellow, teeth are coated with yellow deposit, and nails are yellow, this indicates Huang Dan (Jaundice). Lethargy, dark yellow urine, a small and choppy pulse, and lack of appetite are also symptoms.

Someone asked: Some people have a sweet taste in their mouth. What is this disease called, and how does it arise? It was answered: This is caused by the overflow of the Five Qi, named Pi Dan (Spleen Heat). When flavors enter the mouth, they are stored in the Stomach, and the Spleen distributes their essence. Fluids remain in the Spleen, causing sweetness in the mouth. This arises from rich and fatty foods. Such people must frequently eat delicious, sweet, and fatty foods. Fatty foods cause internal Heat, and sweet foods cause fullness in the Middle Jiao. Thus, Qi overflows upward and transforms into Xiao Dan. Treatment involves using Lantcao (Peilan, *Plagiorhechae Herba*) to eliminate stale turbid Qi.

Generally, treating Xiao Dan, Pian Ku (Hemiplegia), and Ju Qi Ni Man (Rebellious Qi with Fullness) addresses diseases of the wealthy, resulting from rich and refined diets. Obstruction at the diaphragm, with upper and lower Qi not communicating, is a disease caused by sudden severe worry or anger. In Xiao Dan, if the pulse is excess and large, even with long duration, it is treatable; if the pulse is suspended, extremely small, and hard, it is untreatable after a long duration.

Someone asked: Patients with Re Zhong (Internal Heat) and Xiao Zhong (Wasting Thirst) should not consume rich foods, fragrant herbs (*Fang Cao*), or mineral drugs (*Shi Yao*). Mineral drugs induce carbuncles, and fragrant herbs induce madness. Re Zhong and Xiao Zhong are diseases of the wealthy. Prohibiting rich foods goes against their desires; prohibiting fragrant herbs and mineral drugs fails to cure the illness. I wish to hear the explanation. The answer was: Fragrant herbs have beautiful aromas, and mineral drugs have fierce and potent energies. Both have rapid and forceful properties. Therefore, unless one has a calm and gentle mind, these two types of medicine should not be taken. Internal Heat is fierce, and drug energy is likewise fierce. When they meet, there is fear of internal damage to the Spleen. The Spleen belongs to Earth and fears Wood. Taking these medicines, on Jia-Yi days (Wood days), the condition will likely worsen. Dan may transform into Xiao Zhong.

For Huang Dan, (Qianjin Fang notes: abdominal fullness and loss of appetite), puncture Jizhong. For Huang Dan with frequent yawning and hypochondriac fullness with desire to vomit (Qianjin Fang notes: heavy body unable to move), Spleen Shu (BL20) governs. For Xiao Ke with body heat and red-yellow complexion (Qianjin Fang notes: yellow eyes), Yishe (BL17) governs. For Xiao Ke with excessive thirst, Chengjiang (CV24) governs. Wanggu (SI4) governs. For Huang Dan with Re Zhong and excessive thirst, Taichong (LR3) governs. For yellowing of the body with slight fever, loss of appetite, pain anterior to the medial malleolus of the knee, shortness of breath, and heavy body, Zhongfeng (LR6) governs. For Xiao Dan with frequent asthma, Qi blocking the throat preventing speech, cold hands and feet, yellow urine, difficult defecation, sore and swollen throat, hemoptysis, hot mouth, and sticky saliva, Taixi (KI3) governs. For Xiao Ke and Huang Dan with one cold and one hot foot, tongue relaxation with irritability and fullness, Rangu (KI2) governs. For insufficient Yin Qi, Re Zhong with rapid digestion and hunger, warm abdomen, restlessness, and delirious speech, Zusanli (ST36) governs.