颈脉动，喘疾咳曰水。（颈脉，谓结喉旁动脉，足阳明之人迎也，水气上逆，反侵阳明，则颈脉动；
水溢于肺，则喘急而疾咳。）目裹微肿，如卧蚕起之状曰水。（目裹者，目之下胞也，胃脉之所至，脾气
之所至。若见微肿如卧蚕起之状，是水气淫及脾胃也。水者阴也，目下亦阴也，腹者至阴之所居，故水在腹
中者必使目下肿也。）溺黄赤，安卧者黄胆。（疸，黄病也。身痛而色微黄，齿垢黄，爪甲上黄，黄胆也。
安卧，小便黄赤，脉小而寒者，不嗜食，谓之劳疸，以女劳得之也。）已食如饥者胃疸。（已食如饥者，是
胃热也。善消谷食，故曰“胃疸”，肺小而涩者。不嗜食，言中寒也。所以治疸者，当知阴阳之辨。）
面肿曰风。（风为阳邪，故面肿者曰“风”，阳受风气也。）足胫肿曰水。（水为阴邪，
故足胫肿者曰“水”，
阴受湿气也。）目黄者曰黄胆。（目者，宗脉之所聚也。诸经有热则上薰于目，故黄胆者其目必黄。）
消瘅脉实大，病久可治；脉悬小坚，病久不可治。（消瘅者，三消之总称，谓内热消中而肌肤消
瘦也，邪热在内，脉当实大者为顺，故病虽久犹可治；若脉悬小，则阳实阴虚，脉证之逆也，故不可治。五脏
皆柔弱者善病消瘅，又热则消肌肤，亦为消瘅也。）
热中、消中，不可服高粱、芳草、石药。石药发癫，芳草发狂。（多饮数溲，谓之热中。多食数溲，
谓之消中。多怒曰癫，多喜曰狂。）热中、消中者，皆富贵人也，禁高粱，是不合其心，禁
芳草、石药，不愈其病也，非也。（高粱，浓味也。芳草，辛香之品也。石药，锻炼金石之类也。三者皆能助
热，亦能销阴，凡病热者所当禁用。热中、消中者，即内热病也，惟富贵之人多有之。凡治消瘅肥贵人。
则高粱之疾也。盖富贵者以肥甘为事，肥者令人内热，甘者令人中满，气积成热；则转为消中、消渴之病，
故于高粱、芳草之类，皆不得不禁也。）芳草之气美，石药之气悍。二者，其气急疾坚劲，非缓心和
人，不可以服。（芳美者气热而散，悍急者性刚而烈也。）夫热气 悍，药气亦然，二者相遇，恐内伤脾。（
脾者，阴中之至阴也。阳胜则伤阴，故二热合气，必致伤脾。）脾者土也，而恶水，服此药者，至
甲乙日更论。（脾伤者畏木，故至甲乙日更论，盖谓其必甚也。消瘅、消中者，即后世所谓三消症也。凡
多饮而渴不止者为上消，消谷善饥者为中消；溲便频而膏浊不禁者为下消。如肺消、膈消、消渴，即上消也；
瘅成为消中，胃中热则消谷令人善饥，即中消也；肾脉，肝脉微小，皆为消瘅，肝肾在下，即下消也。然消
渴之病，本湿寒之阴气极衰，燥热之阳气太盛故也，治当补肾水阴寒之虚，泻心火阳热之实，除肠胃燥热之
甚，济身中津液之衰，使道路散而不结，津液生而不枯，气血和而不涩，则病自
已。若饮水多而小便多，名曰消渴；若饮食多不甚渴，小便数而消瘦者，名曰消中；若渴而饮水不绝，
腿消瘦而小便有脂液者，名曰肾消。一皆以燥热太甚，三焦肠胃之腠理脉络怫郁壅滞，虽多饮于中，终不能
浸润于外，营卫百骸，故渴不止而小便多出，或数溲也。盖五脏心为君火正化，肾为君火对化，三焦为相
火正化，胆为相火对化，得其平则烹炼饮食，糟粕去焉，不得其平则燔灼脏腑，津液竭焉，夫一身之心火，甚
于上为膈膜之消，甚于中为肠胃之消，甚于下为膏液之消，甚于外为肌肉之消。上甚不已，
则消及于肺；中甚不已，则消及于脾；下甚不已，则消及于肝肾；外甚不已，则消及于筋骨。四脏皆消尽，
则心始自焚而死矣。故有消瘅、消中、消渴、风消、膈消、肺消之说。消之症不同，归之火则一也，人身
之有肾，犹木之有根，故肾脏受病，必先形容憔悴，虽加以滋养，不能润泽，故患消渴者，皆是肾经为病，由
壮盛之时不自保养，快情恣欲，饮酒无度，食脯炙，饵丹石等药，遂使肾水枯竭，心火燔盛，三焦猛烈，五
藏渴燥，由是渴、利生焉，此又皆本于肾也。又二阳之病发心脾，其传为风消，以阳明为十二经之海，土衰
而木气乘之，故为肌肉风消也，心移寒于肺为肺消，饮一溲二，死不治。此言元阳之衰，而金寒水冷，则为
肺、肾之消也，五脏之脉微小者，皆为消瘅，此言寸口之弱见于外，以血气之衰而消于内也。又如岁水太过，
上临太阳，民病渴而妄冒；太阳司天，寒气下临，心火上从，民病嗌干善渴；太阳司天，寒淫所胜，民病嗌
干，渴而欲饮，是皆以阴抑阳，以水致火，必以温剂散去寒邪，其疾自愈，诸如此者，总皆消渴
之类也。夫消者，消耗之谓，阳胜固能消阴，阴胜独不能消阳乎？故凡于精神血气肌肉筋骨之消，无非消也，
又不得尽称为火矣。善学人当熟读而精思，因时制宜可也。）
有病口甘者，此五气之溢也，名曰“脾瘅”。（瘅，热病也。五气，五味之所化也，夫五味入口，藏
于胃，脾为之行其精气；津液在脾，故令人口甘也，（脾主为胃行其津液者也，）故五味入胃则
津液在脾，脾属土，其味甘，脾气通于口，故能令人口甘也。）此肥美之所发也，（肥甘太过，故发为病。）
此人必数食甘美而多肥也。肥者令人内热，甘者令人中满，故其气上溢，转为消渴。（肥者，
味浓助阳，故能生热，甘者，性缓不散，故能留中。热留不去，久必伤阴，其气上溢，故转变为消渴之病。）
治之以兰，除陈气也。（兰草性味甘寒，能利水道，辟不祥，除胸中痰癖，其气清香，能生津止渴，润肌肉，
故可除陈积蓄热之气。）有病口苦，名曰“胆瘅”，取阳陵泉。（阳陵泉，足少阳胆经穴。口苦者病在胆，故
名曰“胆瘅”。）夫肝者，中之将也，取决于胆，咽为之使。（谋虑在肝，无胆不断，故肝为中之将而取决于胆
也。又足少阳之脉上挟咽，足厥阴之脉循喉咙之后，上入颃颡，是肝胆之脉，皆会于咽，故咽为之使。）
此人者，数谋虑不决，故胆虚气上溢而口为之苦，治之以胆募、俞。（数谋虑不决，则肝胆俱劳，劳
则必虚，虚则气不固，故胆气上溢而口为之苦。胆募在肋，本经之日月也。胆俞在背，足太阳之穴也。
并前阳陵泉者，共六穴，皆可治之。）
Neck pulse pulsation accompanied by panting and rapid cough is termed Water Disease. (The neck pulse refers to the artery beside the laryngeal prominence, i.e., Renying [ST9] of Foot-Yangming Stomach Meridian; when Water Qi rebels upward and invades Yangming, the neck pulse pulsates; when Water overflows into the Lung, it causes panting and rapid cough.) Slight swelling of the lower eyelids, resembling a lying silkworm, is termed Water Disease. (The lower eyelid is the area below the eye, where the Stomach and Spleen meridians arrive. If slight swelling resembling a lying silkworm is seen, it indicates that Water pathogen has invaded the Spleen and Stomach. Water belongs to Yin, as does the area below the eyes; the abdomen is the residence of Supreme Yin, so when Water resides in the abdomen, it inevitably causes swelling below the eyes.) Yellowish-red urine with a desire to lie still indicates Jaundice Disease. (Dan refers to yellow disease. Body pain with slightly yellow complexion, yellow dental plaque, and yellow nails indicate Jaundice Disease. Lethargy, yellowish-red urine, small pulse, aversion to cold, and loss of appetite are called Lao Dan [Labor-induced Jaundice], caused by sexual exhaustion.) Feeling hungry shortly after eating is called Wei Dan [Stomach Jaundice]. (Feeling hungry shortly after eating indicates Heat in the Stomach. The Stomach easily digests food, hence it is called "Wei Dan". A small and choppy pulse with loss of appetite indicates Cold in the Middle Jiao. Therefore, treating Dan requires distinguishing between Yin and Yang.) Facial edema is termed Wind Disease. (Wind is a Yang pathogen; thus, facial edema is called "Wind" because Yang meridians are affected by Wind.) Edema of the feet and shins is termed Water Disease. (Water is a Yin pathogen; thus, edema of the feet and shins is called "Water" because Yin meridians are affected by Dampness.) Yellowing of the eyes is termed Jaundice Disease. (The eyes are the gathering point of numerous meridians. Heat in any meridian steams upward to the eyes, so patients with Jaundice Disease invariably have yellow eyes.)
In Xiao Dan [Wasting-Thirst Disease], if the pulse is full and large, even long-standing cases are treatable; if the pulse is suspended, small, and firm, long-standing cases are untreatable. (Xiao Dan is the general term for the Three Xiao diseases, referring to internal Heat causing middle-jiao consumption and emaciation. With Evil-Heat inside, a full and large pulse is favorable, so even long-standing cases are treatable; if the pulse is suspended and small, it indicates Excess Yang and Deficient Yin, a mismatch between pulse and symptoms, making it untreatable. Those with weak Zang organs are prone to Xiao Dan; additionally, Heat consuming flesh and skin is also termed Xiao Dan.)
Patients with Re Zhong [Middle Heat] and Xiao Zhong [Middle Consumption] should not consume rich foods, aromatic herbs, or mineral drugs. Mineral drugs may induce Dian [Mania/Epilepsy], and aromatic herbs may induce Kuang [Madness]. (Excessive drinking and frequent urination are called Re Zhong. Excessive eating and frequent urination are called Xiao Zhong. Excessive anger is Dian; excessive joy is Kuang.) Re Zhong and Xiao Zhong are common among wealthy individuals. Prohibiting rich foods goes against their desires; prohibiting aromatic and mineral drugs does not cure the disease, so this view is incorrect. (Gao Liang refers to strong-flavored foods. Fang Cao refers to pungent-aromatic substances. Shi Yao refers to refined mineral drugs. All three can assist Heat and consume Yin, and must be strictly avoided in Heat diseases. Re Zhong and Xiao Zhong are internal Heat diseases, prevalent among the wealthy. Treating Xiao Dan in obese, wealthy people addresses the damage caused by rich foods. Wealthy people rely on fatty and sweet foods; fat generates internal Heat, and sweetness causes Middle Jiao fullness; Qi accumulation transforms into Heat, leading to Xiao Zhong and Xiao Ke [Wasting-Thirst]. Thus, Gao Liang and Fang Cao must be prohibited.) Fang Cao has a pleasant aroma, while Shi Yao has a fierce nature. Their Qi is urgent and strong; only those with a calm mind can take them. (Pleasant aromas are hot and dispersing; fierce substances are rigid and violent.) Since both Pathogenic Heat and Drug Qi are fierce, their meeting may injure the Spleen internally. (The Spleen is the Supreme Yin within Yin. Excess Yang injures Yin; thus, combined Heat will inevitably injure the Spleen.) The Spleen belongs to Earth and dislikes Water/Dampness. Patients taking these drugs may see worsening on Jia-Yi days (Wood days), requiring re-evaluation. (When the Spleen is injured, it fears Wood control; thus, on Jia-Yi days, the condition may worsen, meaning it will definitely become severe. Xiao Dan and Xiao Zhong correspond to the later Three Xiao syndrome. Excessive thirst and unquenchable dryness are Upper Xiao; excessive hunger and digestion are Middle Xiao; frequent, turbid, lipid-rich urine is Lower Xiao. Fei Xiao, Ge Xiao, and Xiao Ke are Upper Xiao; Dan transforming into Xiao Zhong, with stomach heat causing hunger, is Middle Xiao; small/minor pulses in Kidney and Liver meridians indicate Xiao Dan, located inferiorly, representing Lower Xiao. However, Xiao Ke stems from extreme deficiency of Damp-Cold Yin Qi and excess of Dry-Heat Yang Qi. Treatment should tonify Kidney Water/Yin deficiency, drain Heart Fire/Yang excess, clear intestinal/stomach dry-heat, replenish body fluids, ensure smooth pathways without obstruction, generate fluids without depletion, and harmonize Qi/Blood without stagnation, leading to spontaneous recovery. Drinking much with frequent urination is Xiao Ke; eating much with mild thirst but frequent urination and emaciation is Xiao Zhong; intense thirst with continuous drinking, leg emaciation, and lipid in urine is Shen Xiao [Kidney Xiao]. All result from excessive Dry-Heat causing stagnation in San Jiao and intestinal collaterals; despite intake, fluids cannot moisten the exterior, causing persistent thirst and polyuria. Heart is Lord Fire's primary transformation; Kidney is Lord Fire's secondary transformation; San Jiao is Minister Fire's primary transformation; Gallbladder is Minister Fire's secondary transformation. Balance cooks food and eliminates waste; imbalance burns Zang organs and depletes fluids. Heart Fire manifesting severely above causes Ge Xiao; in the middle, Gastrointestinal Xiao; below, Gao Ye Xiao [Fluid/Lipid Xiao]; outside, Muscle Xiao. Unchecked upper consumption affects the Lung; unchecked middle affects the Spleen; unchecked lower affects Liver/Kidney; unchecked external affects sinews/bones. When four Zang are exhausted, the Heart burns itself, leading to death. Hence, terms like Xiao Dan, Xiao Zhong, Xiao Ke, Feng Xiao [Wind Consumption], Ge Xiao, and Fei Xiao exist. Though different, all return to Fire. The Kidney is like the root of a tree; Kidney disease first causes emaciation, which nourishment cannot reverse. Thus, Xiao Ke originates in the Kidney Meridian, due to lack of self-care during youth, unrestrained desires, excessive alcohol, dried meat/grilled food, and cinnabar/mineral drugs, leading to Kidney Water depletion, Heart Fire blazing, fierce San Jiao, and five Zang dryness, causing thirst and diuresis, rooted in the Kidney. Furthermore, illness in Er Yang [Yangming] originating in Heart/Spleen transmits to Feng Xiao; since Yangming is the Sea of Twelve Meridians, Earth deficiency allows Wood to invade, causing muscular wind-consumption. Heart transmitting Cold to Lung is Fei Xiao; drinking one part, urinating two parts, is fatal and untreatable. This describes Yuan Yang deficiency, Cold Metal/Water causing Lung/Kidney Xiao. Small/minor pulses in five Zang indicate Xiao Dan, showing exterior weakness due to interior Qi/Blood depletion. For example, excessive Water year affecting Taiyang causes thirst and confusion; Taiyang governing year with descending Cold and ascending Heart Fire causes dry throat and thirst; Taiyang governing year with excess Cold causes dry throat and thirst for water. These are Yin suppressing Yang, Water generating Fire, treated with warm agents to dispel Cold. Such cases belong to Xiao Ke. "Xiao" means consumption. While Yang excess consumes Yin, can Yin excess consume Yang? Thus, consumption of Spirit, Blood, Qi, flesh, and sinews is all "Xiao", but not all can be attributed solely to Fire. Scholars should study deeply and apply according to time and circumstances.)
A patient with a sweet taste in the mouth has an overflow of Five Qi, named Pi Dan [Spleen Dan]. (Dan is a Heat disease. Five Qi derives from Five Flavors. Flavors enter the mouth, store in the Stomach, and the Spleen distributes their Essence; Fluids remain in the Spleen, causing sweet taste. The Spleen distributes fluids for the Stomach; thus, flavors entering the Stomach leave fluids in the Spleen. Spleen belongs to Earth, its flavor is sweet, and Spleen Qi connects to the mouth, causing sweetness.) This arises from rich/fatty foods. (Excessive rich/sweet foods cause disease.) Such individuals likely consume many sweet and fatty foods. Fat generates internal Heat; sweetness causes Middle Jiao fullness; Qi overflows upward, transforming into Xiao Ke. (Fat is strong/flavorful, assisting Yang and generating Heat; sweetness is slow/non-dispersing, lingering in the Middle. Lingering Heat injures Yin over time; Qi overflows, transforming into Xiao Ke.) Treat with Lan Cao [Orchid Herb] to remove stale Heat. (Lan Cao is sweet/cold, promotes urination, wards off evil, clears phlegm-stasis in chest, has fresh aroma, generates fluids, stops thirst, moistens flesh, thus removing accumulated stale Heat.) A patient with bitter taste in the mouth is named Dan Dan [Gallbladder Dan]; treat by selecting Yanglingquan [GB34]. (Yanglingquan is a point on Foot-Shaoyang Gallbladder Meridian. Bitter taste indicates Gallbladder pathology, hence Dan Dan.) The Liver is the General within, decided by the Gallbladder; the throat is its envoy. (Planning lies in Liver, decision in Gallbladder; thus Liver is General depending on Gallbladder. Foot-Shaoyang meridian ascends flanking the throat; Foot-Jueyin meridian follows behind the throat to Yingxiang; Liver/Gallbladder meridians converge at the throat, making it the envoy.) Such individuals often deliberate without deciding, causing Gallbladder Deficiency and Qi rebellion, leading to bitter taste. Treat with Gallbladder Mu [Front-Mu] and Shu [Back-Shu] points. (Indecision exhausts Liver/Gallbladder; exhaustion leads to Deficiency; Deficiency fails to secure Qi; Gallbladder Qi rebels upward causing bitterness. Gallbladder Mu is Rib-side Riyue [GB24]; Gallbladder Shu is Back-point BL18; plus Yanglingquan [GB34], totaling six points, all treatable.)