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The pathology of Xu Lao (Deficiency Consumption) arises from only three causes: injury due to sexual excess, injury due to excessive thinking and depression, and injury due to improper medical treatment. The presenting symptoms include bone-steaming fever, coughing, hemoptysis, diarrhea, seminal emission in men, and amenorrhea in women; these five are common manifestations of the primary disease. Injury due to sexual excess results from excessive indulgence, damaging Jing and Qi. The pathology ascends from below, affecting the Kidney and Liver before involving the Spleen; it may initially present with blood loss or seminal emission, followed by symptoms such as coughing and bone-steaming fever. In cases of True Yang deficiency, there is a lack of energy and appetite, eventually leading to diarrhea and critical illness. In cases of True Yin deficiency, vigorous fire leads to blood stasis, inevitably resulting in carbuncles and death. Injury due to excessive thinking and depression stems from unfulfilled emotions, damaging Shen and Qi. This disease originates in the Kidney, involves the Heart and compresses the Lung, damages the Liver and Spleen, and further complicates with Water and Fire interactions, known as "Seven Transmissions." Initially, it presents with bone-steaming and dry coughing; subsequently, it leads to blood loss, seminal emission, and amenorrhea in women. Until death, the complexion does not appear wan because Yin fire steams fluids upward; thus, the limbs waste away daily while the spirit appears increasingly vibrant. This is the most difficult to treat. Injury due to improper medical treatment occurs when exterior pathogens remain unresolved and lodge in the Lung collaterals; misusing cold and cooling descending herbs causes pathogens to sink from the skin and hair into the interior. Alternatively, cold herbs damage the Stomach, transmitting cold qi to the Lung, both causing persistent coughing. If wind-heat is mistakenly treated with acrid-dispersing herbs, the Shaoyin meridian is damaged, first presenting with purulent bloody vomiting followed by diarrhea. Or, if sweating and purging methods are misused without proper aftercare, Ying and Wei are damaged, first presenting with slight chills and frequent fevers, followed by coughing. If accompanied by eye diseases in cases of sexual excess, treatment focuses on Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and Ba Wei Di Huang Wan (Eight-Ingredient Pill with Rehmannia). For injuries due to thinking and depression, treatment focuses on Xiao Yao San (Free and Easy Wanderer Powder) and Gui Pi Tang (Restore the Spleen Decoction). For injuries due to medical mishandling, treatment focuses on regulating and tonifying Yuan Qi. However, at the initial stage, rescue is possible; if delayed until terminal transmission, efficacy is ultimately hard to achieve. Exercise extreme caution.

For Gu Zhang (Drum Distension), one must clearly differentiate between deficiency/excess and cold/heat before administering treatment to avoid errors. For instance, if urine is dark red, stool is constipated, pulse is rapid and forceful, complexion is purple and dull, breath is coarse, thirst drives one to drink cold water, lips are cracked, and tongue is dry, this corresponds to the principle that "all abdominal swellings belong to Heat." Conversely, if urine is clear, stool is loose, pulse is slow and weak, complexion is white, breath is short and hurried, one prefers hot drinks, tongue is moist, and mouth feels harmonious, this corresponds to the principle that "all fluid pathologies that are clear and cold belong to Cold." Abdominal distension that is painless upon pressure and fluctuates in severity indicates Deficiency. Distension that worsens with pain upon pressure and does not subside indicates Excess. Li Dongyuan's therapeutic approach involves modifying the two formulas Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) according to specific symptoms. This condition typically involves pre-existing phlegm-dampness and prior injury to Middle Qi, potentially manifesting as Blood Gu (Blood Parasite/Distension) or Edema, with varied presentations. Treatments may include Kai Gui Men (opening the ghost gate/sweating), Jing Jian Fu (cleansing the clean mansion/diuresis), or Chu Chen Cuo (removing old accumulation/purgation), as detailed by predecessors, representing the method of dispersing pathogenic momentum from above and below. If accompanied by eye diseases, swelling of both eyelids, excessive discharge, tearing, redness, and astringency are invariably present. One must investigate the root cause of the primary disease and prioritize protecting the Spleen and Stomach. Since Earth (Spleen) failure allows Wood (Liver) to attack, and Wood generates Fire, which in turn generates Wind, unpredictable changes may occur around the eyebrows and lashes. If it is a new contraction of seasonal pathogens causing Tian Xing Chi Re (Epidemic Red Eye Heat), standard treatment suffices, and no excessive worry is needed.