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The *Ben Shi Fang* records: Li Sicbu of the Tang Dynasty treated Xiao Ke (Wasting and Thirsting Syndrome), attributing it to Kidney Deficiency. Upon each onset, the urine was sweet, yet physicians largely did not understand the cause, and medical texts lacked this explanation.

The *Hong Fan* states: "Grains and harvest correspond to Earth, whose flavor is Sweet." By applying physical principles, in the method of making preserved foods from syrup, vinegar, and wine, sweetness appears quickly. This sufficiently proves that after human consumption, the essence of flavors is Sweet. These substances flow into the Bladder. If the Qi of the Waist and Kidneys is vigorous, it steams upward; through Qi transformation, it becomes Essence. The Qi descends into the Marrow, then transforms into Lipids and Fats, subsequently into Flesh and Blood, and the remainder becomes Urine. Therefore, urine is yellow, being the residual Qi of Blood. When the Qi of the Five Zang Organs is moistening, the downward transmission is Sweet. If the Waist and Kidneys are deficient and cold, they cannot steam and transform Grain Qi, causing all Grain Qi to descend as Urine. Thus, the urine tastes Sweet, remains clear and cold, and leads withered skin and muscles. This is like a nursing mother: Grain Qi ascends and leaks out, becoming breast milk, which is therefore Sweet. In patients with Xiao Ke (Wasting and Thirsting Syndrome), the descending output becomes Urine. Since Essence and Qi are not solidified internally, frequent urination occurs.

Furthermore, the Lung is the Canopy of the Five Zang Organs. If there is warm Qi steaming from below, the Qi becomes moist; if the lower part is extremely cold, Yang Qi cannot ascend, leading to a dry Lung and thirst. For example, if there is water in a pot and fire warms it, while a board covers it, warm Qi rises, making the board moist. Without fire, water vapor cannot rise, and the board remains dry. The "Fire Power" refers to the strength of the Waist and Kidneys. One must constantly warm and tonify Kidney Qi. With the aid of Fire Power, food and drink are moistened in the upper body and easily digested, avoiding the affliction of dryness and thirst. Therefore, Zhang Zhongjing stated: It is appropriate to take Ba Wei Shen Qi Wan (Eight-Ingredient Pill for the Kidney Qi).

My clan brother, Sun Shuangbai, suffered from this illness after age fifty. Contemporary physicians prescribed agents for Nourishing Yin and Descending Fire, resulting in increased urine volume, clear and long urine, sweeter taste, and exacerbated thirst. Physicians changed repeatedly, all diagnosing Heat, and using Bitter-Cold herbs. Mild agents included Tian Hua Fen (Trichosanthes Root), Huang Lian (Coptis Rhizome), Mai Dong (Ophiopogon Tuber), Shi Gao (Gypsum Fibrosum), and Zhi Mu (Anemarrhenae Rhizoma); heavy agents included Mercury Pills. Not only were they ineffective, but the patient developed widespread eczema-like rashes, emaciation, and a fine-rapid pulse. I later examined him and said: This is the terminal transmission of Xiao Ke (Wasting and Thirsting Syndrome) as described by Li Dongyuan. Those who can eat will likely develop Brain Carbuncles or Back Sores; those who cannot eat will develop abdominal fullness and distension. Currently, the pulse is fine and rapid, and the skin has hidden rashes. How can one avoid carbuncles and sores? Medication must be urgently changed; do not use Cold-Cooling herbs to damage the Stomach. I prescribed Shen Qi Wan (Kidney Qi Pill) augmented with Gui Xin (Cinnamon Twig Heart), Wu Wei Zi (Schisandra Fruit), Lu Jiao Jiao (Deer Antler Glue), and Yi Zhi Ren (Alpinia Oxyphylla Fruit). After half a month of administration, spirit and vitality recovered, Xiao Ke (Wasting and Thirsting Syndrome) was cured, urine lost its sweetness, and skin rashes resolved. He remained healthy for ten years. Later, triggered by dissatisfaction, the thirst disease recurred. Other physicians again administered Nourishing Yin agents, leading to generalized edema and death. Alas, how painful! Had he adhered to the Augmented Shen Qi Wan (Kidney Qi Pill), such edema and death might have been avoided. Zhang Zhongjing and Li Dongyuan are truly the grandmasters; a millennium later, their teachings inspire even greater reverence. I record this here to inform my colleagues.