四证丹溪主二陈（汤），寒温虚实审其因，若由虚呃人参附，蛔证黄（连）梅椒伯遵。
吞酸病多属于肝，宜以左金丸，连理汤加陈半为主方，小柴胡汤，平胃散佐之。
（经义）《至真要大论》曰∶“诸呕吐酸，暴注下追？皆属于热。”又曰∶“少阳之胜，呕
吞酸连理（汤）左金丸，平胃（散小）柴胡（汤）亦可安，寒热补消灵变用，病机指示属于肝。
三消证∶上消者口渴不止也，治以人参白虎汤；中消者，食入即饥也，治以调胃承气汤
；下消者，饮一溲二也，治以肾气丸。赵养葵云∶无分上、中、下，先以治肾为急。以六味
丸料一斤、入肉桂、五味子各一两，水煎六、七碗恣意冷冻饮料，熟睡而病如失。此以其温药引
其真水，以滋上、中、下之燥也，此为火病，故列于热证。
上消（人参）白虎（汤）中（消调胃）承气（汤），下消肾气丸可贵，赵氏治肾统三消，地黄丸料（一斤加
桂（心）五味子（各一两，水煎冷服。
病阳明之燥热而消渴者，白虎汤主之，此外因之渴也。胃气弱而津液不生者，人参汤主
之，此内因之渴也。有脾不能为胃行其津液，肺不能通调水道，而但消渴者，人但知以凉润
之药治渴，不知脾喜燥而肺恶寒。试观泄泻者必渴，此因水津不能上输，而惟下泄故尔。以
燥脾之药治之，水液上升即不渴矣。故以凉润治渴，人皆知之，以燥热治渴，人所不知也。
人参汤方解（按∶理中丸原方参、术、姜、草各三两，人参汤甘草则用四两，以此分别。
程郊倩云∶参、术、炙草，所以固中州，干姜守中，必假之焰釜薪而腾阳气。是以谷
入于阴，长气于阳，上输华盖，下摄州都，五脏六腑，皆以受气矣，此理中之旨也。
The fourth syndrome is primarily treated by Zhu Danxi with Erchen Tang (Two-Chen Decoction), but the etiology must be carefully examined for cold, heat, deficiency, and excess. If the hiccups are due to deficiency-cold, Ren Shen (Ginseng Radix) and Fu Zi (Aconiti Lateralis Radix Praeparata) should be used; if it is a case of roundworms, follow the usage of Huang Lian (Coptidis Rhizoma), Wu Mei (Mume Fructus), Hua Jiao (Zanthoxyli Pericarpium), and Chuan Bei Mu (Fritillariae Cirrhosae Bulbus).
Acid regurgitation often belongs to the Liver. Zuojin Wan (Left Metal Pill) is suitable, with Lianli Tang (Coptis and Poria Decoction) plus Chen Pi (Citri Reticulatae Pericarpium) and Ban Xia (Pinelliae Tuber) as the main formula, while Xiao Chaihu Tang (Minor Bupleurum Decoction) and Pingwei San (Level the Stomach Powder) serve as adjuvants.
As stated in the *Suwen: Zhi Zhen Yao Da Lun* (Treatise on the Most Essential and Important Principles): "All vomiting and acid regurgitation, sudden diarrhea with urgent downward flow, belong to Heat." It also states: "When Shaoyang (Lesser Yang) fire prevails, vomiting occurs..."
For acid regurgitation, Lianli Tang and Zuojin Wan are effective; Pingwei San and Xiao Chaihu Tang can also bring relief. Apply flexible variations based on cold, heat, deficiency, and excess; the pathogenesis indicates the involvement of the Liver.
Regarding the Three Xiao (Wasting-Thirst) syndromes: Shang Xiao (Upper Wasting-Thirst) is characterized by incessant thirst, treated with Renshen Baihu Tang (Ginseng and White Tiger Decoction); Zhong Xiao (Middle Wasting-Thirst) is characterized by hunger immediately after eating, treated with Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction); Xia Xiao (Lower Wasting-Thirst) is characterized by drinking one part and urinating two parts, treated with Shenqi Wan (Kidney Qi Pill). Zhao Yangkui stated: Regardless of whether it is Upper, Middle, or Lower, treating the Kidney is the priority. Use one jin (approx. 500g) of Liuwei Dihuang Wan ingredients, add Rou Gui (Cinnamomi Cortex) and Wu Wei Zi (Schisandrae Fructus), each one liang (approx. 30g), decoct in water to yield six or seven bowls. Drink freely while cold; after falling into a deep sleep, the illness disappears as if lost. This uses warm medicines to guide the True Water (Kidney Yin) to nourish the dryness of the Upper, Middle, and Lower Jiao. Since this is a Fire disease, it is classified under Heat syndromes.
Shang Xiao is treated with Renshen Baihu Tang; Zhong Xiao with Tiaowei Chengqi Tang; Xia Xiao with Shenqi Wan is highly valued. Mr. Zhao advocates treating the Kidney to govern all three Xiao types, using one jin of Dihuang Wan ingredients, adding Guixin (Cinnamomi Cortex) and Wuweizi (Schisandrae Fructus), each one liang, decocted in water and taken cold.
Xiao-thirst caused by燥热 (Dryness-Heat) in the Yangming channel is primarily treated with Baihu Tang (White Tiger Decoction); this is thirst due to external factors. Thirst caused by weak Stomach Qi failing to generate fluids is primarily treated with Renshen Tang (Ginseng Decoction); this is thirst due to internal factors. In cases where the Spleen cannot transport fluids for the Stomach, and the Lung cannot regulate water passages, resulting solely in wasting-thirst, people only know to treat thirst with cooling and moistening herbs, unaware that the Spleen prefers dryness and the Lung dislikes cold. Observe that patients with diarrhea are invariably thirsty; this is because fluid essences cannot ascend upward but instead leak downward. Treating with herbs that dry the Spleen allows fluids to ascend, and the thirst ceases. Thus, while everyone knows to treat thirst with cooling-moistening methods, few know to treat thirst with warming-drying methods.
Explanation of Renshen Tang Formula (Note: The original Lizhong Wan formula contains Ren Shen, Bai Zhu, Gan Jiang, and Zhi Gan Cao, each at three liang. In Renshen Tang, Zhi Gan Cao is increased to four liang to distinguish them. Cheng Jiaoqian said: Ren Shen, Bai Zhu, and Zhi Gan Cao consolidate the Central Jiao (Spleen and Stomach). Gan Jiang remains in the center; its flame-like heat is necessary to stoke the cauldron and raise Yang Qi. Thus, grain enters the Yin, generates Qi in the Yang, ascends to the Huagai (Lung), and descends to control the Zhou Du (Bladder/Kidney system). The Five Zang and Six Fu organs all receive Qi. This is the essence of Lizhong Tang.)