《灵枢·五变篇》帝曰∶人之善病消瘅者，何以候之？少俞曰∶五脏皆柔弱者，善病消瘅。帝曰∶何以
知五脏之柔弱也？少俞曰∶夫柔弱者，必有刚强，刚强多怒，柔者易伤也。此人薄皮肤，而目坚固以深者，长
冲直扬，其心刚。刚则多怒，怒则气上逆，胸中蓄积，气血逆留， 皮充肌，血脉不行，转而为热，热则消肌
肤，故为消瘅。此言其人刚暴，而肌肉弱者也。
消瘅者，渴饮多食，而肌肉消瘦也。由五脏柔弱，而其目坚固以深，其光长冲直扬者，心性刚暴多怒，则
心肝火炽而气逆，血脉因之不行，久郁而成邪热，以致此病。然此但言其人刚暴，而肌肉弱者也。或有饮食及
酒色所伤，而成消瘅者，亦皆邪热蕴蓄之所致也。
《素问·通评虚实论》帝曰∶消瘅虚实何如？岐伯曰∶脉实大，病久可治；脉悬小坚，病久不可治。
消瘅由邪热积蓄，病久脉实大，元气未败，可治；脉悬小者，小甚也，元气已败，又坚，则无和缓之象，
邪气痼结，故不
可治也。
凡治消瘅、仆击、偏枯、痿、厥、气满发逆，肥贵人则膏粱之疾也；隔塞闭绝，上下不通，则暴忧之病
也；暴厥而聋，偏应闭不通，内气暴薄也；不从内外中风之病，故瘦留着也； 跛，寒风湿之病也。
此言治病必当知其所因也。仆击者，忽然跌仆，或如被击而倒，以及消瘅、偏枯、痿、厥、气满发逆等病，
其富贵之人，则由膏粱浓味，情欲内伤所致也；若三焦之气隔塞闭绝，上下不通，则由暴忧郁结所致也；
以故暴厥而聋，偏应闭不通，而在一边者，因内气暴迫也；不从内外中风，而由本身之气为病，故消瘦而病气
留着也；其忽然跌仆、痿、厥等病，多生于膏粱肥贵之人，若此瘦而 跛者，内因暴忧气闭，外得寒风湿邪所
致之病也。
帝曰∶黄胆暴痛，癫疾厥狂，久逆之所生也，五脏不平，六腑闭塞之所生也；头痛耳鸣，九窍不利，肠胃
之所生也。
黄胆由湿热内闭，暴痛、癫疾由风痰内结，厥、狂由阴阳偏亢，皆因本身之气久逆之所生，多因五脏之气
偏胜不平，六腑闭塞不通，而成此病也。若头痛耳鸣，九窍不利，肠胃之传化失度，浊壅不行之所生，因清阳
不得流通之故，比上诸病为轻矣。
《灵枢·五变篇》黄帝问：人容易患消瘅病（以多饮、多食、消瘦为特征的疾病），如何从脉象或体征来预测呢？少俞回答说：五脏功能柔弱的人，容易患消瘅病。黄帝问：怎么知道五脏是柔弱的呢？少俞说：凡是体质柔弱的人，往往性格刚强；性格刚强且易怒的人，其柔弱的脏腑容易受到损伤。这类人皮肤较薄，但眼睛深邃且目光坚毅，眉毛长而直竖，内心刚强。内心刚强则容易发怒，发怒则导致气机上逆，气血在胸中蓄积停滞，皮肤和肌肉充血肿胀，血脉运行不畅，郁久转化为热邪，热邪消耗肌肤，因此形成消瘅病。这是在说明那些性格刚暴但肌肉虚弱的人。
所谓消瘅病，表现为口渴多饮、食欲亢进但肌肉消瘦。这是由于五脏柔弱，加上眼神深邃坚毅、目光长冲直竖，反映出心性刚暴易怒，导致心肝火旺、气机逆乱，血脉因此运行不畅，长期郁结而成邪热，从而引发此病。然而这仅指那些性格刚暴而肌肉虚弱的人。也有因饮食不节及酒色过度损伤，而患上消瘅病的，也都是由邪热蕴结蓄积所致。
《素问·通评虚实论》黄帝问：消瘅病的虚实证候是怎样的？岐伯回答说：脉象实大，病程较长但仍可治疗；脉象悬小且坚，病程较长则难以治疗。
消瘅病是由邪热积蓄引起的。若病程长久，脉象实大，说明元气尚未败坏，可以治疗；若脉象悬小，表示脉细甚微，说明元气已败，再加上脉坚，没有缓和之象，表明邪气痼结难解，所以不可治疗。
大凡治疗消瘅、仆击（突然昏倒）、偏枯（半身不遂）、痿证（肢体萎软无力）、厥证（四肢逆冷）、气满发逆（气逆喘满）等病，这些多是富贵之人食用膏粱厚味（油腻精细食物）所致的疾病；出现膈塞闭绝、上下不通的症状，则是由于突然遭受忧思郁结所致；突然发生厥证并伴有耳聋，身体一侧闭塞不通，是由于体内气机突然迫急所致；并非由外感风寒暑湿燥火或内伤七情中风引起的疾病，而是由于自身正气亏损、病邪留滞导致的消瘦；跛行，则是寒风湿邪侵袭所致。
这是在说明治病必须了解其病因。所谓仆击，是指突然跌倒，或者像被打击一样倒下，以及消瘅、偏枯、痿、厥、气满发逆等疾病，对于富贵之人而言，多由饮食肥甘厚味、情欲内伤所致；如果是三焦之气隔塞闭绝、上下不通，则是由突然的忧郁气结所致；因此突然发生厥证并耳聋，身体一侧闭塞不通，是因为体内气机突然迫急；并非由外感六淫或内伤七情中风引起，而是由自身气机失调致病，所以出现消瘦且病邪留滞的情况；那些突然跌倒、痿证、厥证等病，多发生于食用膏粱厚味的富贵之人，而那种瘦弱且跛行的人，则是由于内因突然忧怒气闭，外受寒风湿邪侵袭所致。
黄帝问：黄疸、突然剧痛、癫疾、厥狂，都是由气机长期逆乱所产生的；五脏功能不平，是由六腑闭塞不通所产生的；头痛、耳鸣，九窍不利，是由肠胃功能失调所产生的。
黄疸是由于湿热内闭所致，突然剧痛、癫疾是由于风痰内结所致，厥证、狂证是由于阴阳偏亢所致，这些都是因为自身气机长期逆乱而生，多因五脏之气偏胜而不平，六腑闭塞不通，从而形成这些疾病。至于头痛、耳鸣、九窍不利，则是由于肠胃传化功能失常，浊气壅滞不行，清阳之气不能流通所致，相比上述疾病，病情较轻。
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.