叙曰；消渴，无水也。《易义》曰∶火炎则水干。故消渴责之无水。然证有三焦之判，
病有虚实之分，常变不同，治疗亦异。方药十二考，示人以一得耳。
黄连末 栝蒌根末 人乳汁 藕汁 生 汁
古称三消，上消者，令人消渴，此方主之。
气厥论曰∶心移热于肺，传为膈消。夫心，火也；肺，金也。金得火而燥，故令膈消。
饮一溲二者死不治，得非以火来贼金之故乎！若时热者，主暑门人参白虎汤。
大黄（四钱） 芒硝（五钱） 甘草（二钱）
中消者，善食而溲，此方主之。
经曰∶瘅成为消中。瘅者，热也。消中者，善食而溲也。大黄苦寒，可以攻热。芒硝
咸寒，可以润燥，甘草甘平，可以调中。
大黄（一两五钱） 甘草（四两） 大豆（五升，先煮二三沸，去苦水再煮）
三物用井花水一桶煮熟，冷服无时。
此治中、上二焦消渴之方也。
大黄能去胃中实热，甘草能缓燥急之势，大豆能解诸家热毒，而必冷服者，寒因寒用也
熟地黄（八两） 山茱萸 山药（各四两） 白茯苓 牡丹皮 泽泻（各三两）
下消者，烦渴引饮，小便如膏，此方主之。
先有消渴善饮，而后小便如膏者，名曰下消。惧其燥热渐深，将无水矣！故用此方以救
肾水。熟地、山萸，质润味浓，为阴中之阴，故可以滋少阴之肾水。丹皮、泽泻，取其咸寒，
能
Preface: Xiao Ke (Wasting and Thirsting Syndrome) refers to the depletion of body fluids. The "Yi Yi" states: "When fire flares upward, water dries up." Therefore, in treating Xiao Ke, one must address the lack of fluids. However, there are distinctions among the Upper, Middle, and Lower Jiao (Triple Burner), and diseases can be classified as Excess or Deficiency patterns. Since routine and variable presentations differ, treatment methods also vary. These twelve formulas are examined here to demonstrate a single insight into therapy.
Coptidis Rhizoma Powder (Huanglian Mo), Trichosanthis Radix Powder (Gualou Gen Mo), Human Milk (Ren Ru Zhi), Lotus Root Juice (Ou Zhi), Fresh Ginger Juice (Sheng Jiang Zhi)
In ancient times, this was referred to as "Three Xiao" (Three Wasting Syndromes). The "Upper Xiao" manifests as extreme thirst; this formula is indicated for it.
The "Qi Jue Lun" states: "Heart heat transfers to the Lung, transforming into Ge Xiao (Diaphragm Wasting)." The Heart belongs to Fire; the Lung belongs to Metal. When Metal is scorched by Fire, it becomes dry, thus causing Ge Xiao. If a person drinks one cup of water but urinates two cups, it is considered a fatal condition difficult to cure; is this not due to Fire attacking and damaging Metal? If caused by summer-heat, refer to the Ginseng Baihu Tang (Ginseng White Tiger Decoction) in the Summer-Heat section.
Rhei Radix et Rhizoma (Dahuang, 4 qian), Mirabilite (Mangxiao, 5 qian), Glycyrrhizae Radix et Rhizoma (Gancao, 2 qian)
The "Middle Xiao" manifests as excessive hunger with frequent urination; this formula is indicated for it.
The Classics state: "Dan Re (Intense Heat) develops into Xiao Zhong (Middle Wasting)." "Dan" means heat. "Xiao Zhong" refers to excessive hunger and frequent urination. Dahuang is bitter and cold, capable of purging heat; Mangxiao is salty and cold, capable of moistening dryness; Gancao is sweet and neutral, capable of harmonizing the Middle Jiao.
Rhei Radix et Rhizoma (Dahuang, 1 liang 5 qian), Glycyrrhizae Radix et Rhizoma (Gancao, 4 liang), Sojae Semen Preparatum (Dadou, 5 sheng; boil first for two or three boils, discard the bitter water, then boil again)
Cook these three ingredients in one bucket of well water. Take cold at any time.
This is a formula for treating Upper and Middle Jiao Xiao Ke. Dahuang clears excess heat from the Stomach; Gancao alleviates the tendency toward dryness and urgency; Dadou resolves various types of heat toxicity. The reason for taking it cold is the application of "treating cold with cold" (Han Yin Han Yong - using cold natured herbs/methods for conditions that may present with false cold signs or to enhance cooling effects).
Rehmanniae Radix Praeparata (Shu Dihuang, 8 liang), Corni Fructus (Shanzhuyu), Dioscoreae Rhizoma (Shanyao, each 4 liang), Poria (Baifuling), Moutan Cortex (Mudanpi), Alismatis Rhizoma (Zexie, each 3 liang)
The "Lower Xiao" manifests as vexation, thirst with desire to drink, and urine resembling paste; this formula is indicated for it.
If one first has symptoms of Xiao Ke and excessive drinking, followed by urine resembling paste, it is named Lower Xiao. Fearing that the dryness-heat will deepen gradually until kidney fluids are exhausted, this formula is used to rescue Kidney Water. Shudi and Shanzhuyu have moist textures and rich flavors, belonging to Yin within Yin, thus they can nourish the Kidney Water of Shaoyin. Mudanpi and Zexie, utilizing their salty and cold properties, can...