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In Taiyang syndrome (Taiyang channel disease) caused by Cold Damage, if polydipsia (excessive thirst) occurs accompanied by difficult urination, Wuling San (Five-Ingredient Poria Decoction) is indicated; in Jueyin syndrome (Jueyin channel disease), if polydipsia occurs, Da Chengqi Tang (Major Order the Qi Decoction) or similar formulas are indicated. This differs from polydipsia in miscellaneous diseases, sharing the same name but having different pathogenesis. They should be distinguished.

The *Classic of Difficult Issues* (*Jing*) states: "Heart transfers heat to the Lung, transmitting it to become Ge Xiao (Diabetes Mellitus of the Upper Jiao)." Ancient physicians called this Shang Xiao (Upper Diabetes), treating it with Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction). It also states: "Large Intestine transfers heat to the Stomach, resulting in excessive eating yet emaciation." Ancient physicians called this Zhong Xiao (Middle Diabetes), treating it with Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction) to purge downward. Xia Xiao (Lower Diabetes) is characterized by irritability and excessive drinking, dry and scorched earlobes, and urine resembling paste. Or, one may drink one sheng and urinate one sheng, or drink one dou and urinate one dou; Shengqi Wan (Kidney Qi Pill) is the primary treatment.

Zhao stated: In treating diabetes, regardless of whether it is Upper, Middle, or Lower, regulating the Kidney is the urgent priority. One should use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill), or Jiajian Bawei Wan (Modified Eight-Ingredient Rehmannia Pill), administered according to symptoms. By descending Heart Fire and nourishing Kidney Water, thirst will cease naturally. Baihu Tang and Chengqi Tang are not appropriate treatments. Someone asked: "Why does thirst persist in some patients after taking Dihuang Tang?" The answer was: "This is because the physician failed to adhere to established principles and altered the method arbitrarily. Generally, the Heart and Lung are located closely, so small doses are suitable; the Liver and Kidney are located distantly, so large doses are suitable. For Upper and Middle Diabetes, the aforementioned pills can be used for slow treatment; however, if Lower Diabetes is extreme, with severe thirst and dryness, one must use one jin of the ingredients for Jiajian Da Bawei Wan, adding one liang of Rougui (Cinnamon Twig), decocted in water into six or seven bowls, and allowed to drink it cold at will. After falling asleep, the thirst disappears as if lost. The formulation and dosage depend on the physician's flexibility."

Someone asked: "For Lower Diabetes involving a lack of fluids, using Liuwei Wan to nourish Shaoyin Kidney Water should suffice. Why add Fuzi (Prepared Aconite Root) and Rougui (Cinnamon Twig)?"

The reason is that the Fire of the Gate of Life (Mingmen) is deficient, unable to rot and cook food and water. The qi of food and water cannot steam upward to moisten the Lung. It is like a pot lid drying out because there is no firewood under the pot, leading to thirst. Furthermore, the Lung receives no nourishment and cannot distribute fluid essence throughout the body and the five meridians. The ingested water, without undergoing transformation by Kidney Fire, goes directly into the Bladder. This is what is meant by 'drinking one sheng and urinating one sheng.' Observing that the urine tastes sweet rather than salty confirms this. Therefore, the acrid and hot nature of Rougui and Fuzi is used to strengthen the Shaoyin Fire. It is like adding firewood to the stove base, creating steam in a dry steamer, and giving rain to withered seedlings to restore vitality. Only the wise understand this; the ignorant rarely fail to consider it pedantic.

Zhang Yinan (courtesy name Zhi Cong, a contemporary scholar, author of *Bencao Chongyuan* and *Lushan Tang Leibian*) stated: There are cases of diabetes where the Spleen fails to transport fluids for the Stomach, and the Lung fails to regulate water passages. People only know to treat diabetes with cooling medicines, unaware that the Spleen prefers dryness and the Lung dislikes cold. Indeed, those with diarrhea inevitably feel thirsty because fluid essence cannot ascend and instead drains downward. Thus, treating with herbs that dry dampness and strengthen the Spleen allows fluids to rise, and thirst ceases. Therefore, while everyone knows to treat thirst with cooling and moistening agents, few know to treat thirst with warming and drying agents.