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1. Observe that elderly people often suffer from nocturia; do not blindly believe that all cases of San Xiao (Three Burners Diabetes) are caused by dryness-heat consuming fluids. If there is excessive drinking but scanty urine that is turbid, red, and hot, this indicates a Heat syndrome; if there is little drinking but copious urine that is clear, white, and cold, this indicates a Cold syndrome.
[Note] Shang Xiao (Upper Xiao) involves the Lung, characterized by excessive drinking with normal urinary volume; Zhong Xiao (Middle Xiao) involves the Stomach, characterized by excessive drinking with scanty, red urine; Xia Xiao (Lower Xiao) involves the Kidney, characterized by excessive drinking with turbid urine. All three Xiao conditions are essentially diseases of dryness-heat. However, observing elderly individuals who prefer tea and inevitably have frequent urination at night shows that one should not firmly believe all San Xiao cases are heat syndromes; some are indeed cold syndromes. Excessive drinking with scanty, turbid, and red urine belongs to Heat, where vigorous Fire consumes Yin fluids causing turbidity. Little drinking with copious, clear, and white urine belongs to Cold, where deficient Fire fails to vaporize and consume water.

2. In San Xiao patients, if stool is hard but appetite is preserved, and the pulse is large, full, and strong, the condition is treatable; if appetite is lost, accompanied by white tongue coating progressing to edema and diarrhea, or if Heat is excessive with a purple, dry tongue leading to carbuncles and sores, the prognosis is poor.
[Note] The typical manifestation of San Xiao is excessive drinking but inability to eat. If the patient can eat, has hard stool, and presents with a large, full, and strong pulse, it indicates excess Heat in the Stomach, which can be treated with purgative methods. If the patient cannot eat and the tongue coating is white and slippery, indicating dampness predominance, prolonged illness will transform into edema and diarrhea. If Heat predominates and the tongue is purple and dry, prolonged illness will result in carbuncles and sores, leading to death.

Zhu Ye Huang Qi Tang (Bamboo Leaf and Astragalus Decoction)
3. For cases with hard stool, preserved appetite, and a large, full, and strong pulse,酌情 use Tiao Wei Cheng Qi Tang (Regulate the Stomach Order the Qi Decoction) or Jin Hua Tang (Golden Flower Decoction); for those unable to eat with thirst and diarrhea, use Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder); for those unable to eat without diarrhea, use Zhu Ye Huang Qi Tang (Bamboo Leaf and Astragalus Decoction). This formula consists of Huang Qi (Astragali Radix), Huang Qin (Scutellariae Radix), Si Wu Tang (Four Substances Decoction) components including Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Sheng Di Huang (Rehmanniae Radix), Zhu Ye (Phyllostachidis Folium), Shi Gao (Gypsum Fibrosum), Ren Shen (Ginseng Radix), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata), Mai Dong (Ophiopogonis Tuber), and Ban Xia (Pinelliae Tuber). For Qi deficiency with blazing Stomach Heat, Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) is appropriate. For lower jiao deficiency-cold, characterized by drinking one part and urinating two parts, Shen Qi Tang (Kidney Qi Decoction) is appropriate.
[Note] "Wei Wei" refers to Tiao Wei Cheng Qi Tang. "Jin Hua" refers to Zhi Zi Jin Hua Tang (Gardenia Golden Flower Decoction). These formulas are recorded in the Treatise on Cold Damage sections; select them according to clinical indication. Inability to eat with thirst indicates Stomach Qi deficiency; combined with diarrhea, it signifies Stomach emptiness without Heat. Therefore, Qi Wei Bai Zhu San is used, recorded in the Deficiency and Injury section. If unable to eat and thirsty but without diarrhea, although deficient, there remains dryness-heat; thus, Zhu Ye Huang Qi Tang is suitable, composed of Huang Qi, Huang Qin, Dang Gui, Chuan Xiong, Bai Shao, Sheng Di Huang, Zhu Ye, Shi Gao, Ren Shen, Zhi Gan Cao, Mai Dong, and Ban Xia. For Qi deficiency with severe Stomach Heat, Ren Shen Bai Hu Tang is indicated. For lower jiao deficiency-cold with polydipsia and polyuria, Shen Qi Tang is indicated.