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Xiao Ke (Wasting-Thirst Syndrome), characterized by the depletion of Jin Ye (Body Fluids). Unceasing thirst is classified as Upper Xiao Ke, treated with Renshen Baihu Tang (Ginseng White Tiger Decoction). Hunger shortly after eating is classified as Middle Xiao Ke, treated with Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Yang Decoction). Drinking a small amount yet urinating frequently, with urine resembling paste, is classified as Lower Xiao Ke, treated with Shenqi Wan (Kidney Qi Pill). Fundamentally, all these are diseases caused by the dryness and depletion of Jin Ye. Zhao Yangkui altered this therapeutic approach.

Qiwei Yin (Seven-Ingredient Decoction) brings relief with a single dose. Zhao Yangkui stated: When treating Xiao Ke, one should not distinguish between Upper, Middle, or Lower types; if extreme thirst and dryness are observed, one must use one jin (approx. 500g) of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) ingredients, one liang (approx. 30g) of Rougui (Cortex Cinnamomi), and one liang of Wuweizi (Fructus Schisandrae). Boil these in water to yield six or seven bowls, and drink them freely while cold. After falling into a deep sleep, the thirst will vanish as if it never existed. Neither Baizhu Tang nor Chengqi Tang is suitable for this condition.

The method from *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) distinguishes three categories. Those who can eat but feel thirsty focus on the treatment of the Yangming Meridians. This is because the Hand-Taiyang Small Intestine Meridian governs Jin Ye, while the Foot-Taiyang Bladder Meridian governs Blood. Those who drink a little and urinate a little focus on the treatment of the Shaoyin Meridians. This is because Kidney Qi deficiency fails to secure and retain fluids, causing water to flow directly downward; furthermore, Kidney Qi deficiency fails to vaporize and ascend fluids, preventing water from nourishing the upper body. Those who cannot eat and experience rebellious Qi rushing upward focus on the treatment of the Jueyin Meridians. Among all meridians, Liver Fire is the most rampant, burning scorchingly without restraint, consuming Jin Ye and resulting in Xiao Ke. The discussion on Xiao Ke in *Jingui Yaolue* reveals this principle right at the beginning, supplementing what was omitted in *Huangdi Neijing* (The Yellow Emperor's Classic of Internal Medicine); there is no need to suspect textual corruption.

Yangming Disease has diverse treatments. For cases where labor and damage to Ying and Wei (Nutritive and Defensive Qi) lead to gradual stagnation and heat generation, Zhigancao Tang (Licorice Decoction) can be used. Yu Jiayan’s Qingzao Jiufei Tang (Clear Dryness and Rescue the Lung Decoction) is a variation that changes this formula from sweet-warm to sweet-cool. For heat steaming in the chest, Renshen Baihu Tang can be used; Maidong Tang (Ophiopogon Decoction) in *Jingui Yaolue* is a variation that changes this formula from sweet-cool to sweet-neutral. For rapid digestion accompanied by hard, dry stools, Maren Wan (Hemp Seed Pill) added with Gancao (Radix Glycyrrhizae), Renshen (Radix Ginseng), and Danggui (Radix Angelicae Sinensis) can be used. Its brilliance lies in attacking hardness while nourishing fluids. Hardness prevents the digestion of water, just as pouring water on stone results in the water flowing away while the stone remains unchanged. Xiao Ke belongs to Fire syndrome; internal stagnant fire is sufficient to consume water, and the ingested water is sufficient to quench thirst. However, due to dryness and hardness in the Stomach, the body completely fails to absorb the moistening effect of water. Instead, following the trend of fire, the water rushes rapidly to the Bladder. Thus, frequent urination leads to greater hardness, and greater hardness leads to further consumption. This argument originates from Yu Jiayan and is extremely precise.

Shaoyin Disease involves Cold Kidney Qi. Drinking much but urinating little is named Upper Xiao Ke; eating much but having hard stools is named Food Xiao Ke, also known as Middle Xiao Ke. Both Upper and Middle Xiao Ke belong to Heat syndromes. Only Lower Xiao Ke, characterized by drinking a little and urinating a little, lacks the transformation of Fire, indicating Cold Kidney Qi; therefore, Shenqi Wan is used.

Jueyin Syndrome is treated with Wumei Wan (Mume Pill). The formula combines Sweet, Pungent, Bitter, and Sour flavors. Sweetness soothes and relaxes, thereby accommodating the nature of the Liver. Pungency disperses, thereby pleasing the spirit of the Liver. Bitterness descends, allowing rebellious fire to flow smoothly downward. Sourness astringes, restoring the Liver’s original nature of bending and straightening becoming sour, allowing it to function according to its nature without obstruction. Therefore, this pill is the general formula for Jueyin Syndrome. In treating this syndrome, aside from this pill, bitter herbs are generally avoided to prevent bitterness from transforming into Fire.

Flexible application addresses dryness and heat from diet. In cases where the Spleen fails to transport Jin Ye for the Stomach, and the Lung fails to regulate water passages, resulting in Xiao Ke, people only know to treat it with clearing and moistening methods, unaware that the Spleen prefers dryness and the Lung dislikes cold. Observe that patients with diarrhea must feel thirsty; this is because fluid essence cannot ascend and instead drains downward. Treating this with herbs that dry dampness and strengthen the Spleen causes fluid essence to ascend, and the thirst disappears. I often use Lizhong Wan (Regulate the Middle Pill) or Lizhong Tang (Regulate the Middle Decoction) with doubled Baizhu (Rhizoma Atractylodis Macrocephalae) plus Gualougen (Radix Trichosanthis), yielding miraculous effects.