Library

Sanxiao (Three Consumptions) refers to what is mentioned in the *Neijing* (*Classic of Internal Medicine*) as Xiaodan (Consumption and Diabetes) and Xiaozhong (Middle Consumption). Excessive drinking with unquenchable thirst is called Shangxiao (Upper Consumption), as stated in the *Qijue Lun* (*Treatise on Qi Reversal*): Feixiao (Lung Consumption) and Gexiao (Diaphragm Consumption); and in the *Qibing Lun* (*Treatise on Strange Diseases*): Xiaoke (Wasting-Thirst Syndrome). Rapid digestion of food with easy hunger is called Zhongxiao (Middle Consumption), as stated in the *Maiyao Jingwei Lun* (*Essential Essentials of Pulse Diagnosis*): Danre developing into Xiaozhong; and in the *Shichuan Pian* (*Chapter on Transmission from Master*): Heat in the Stomach leads to consumption of food. Frequent urination with turbid, paste-like urine that cannot be controlled is called Xiaxiao (Lower Consumption), as stated in the *Bingxing Pian* (*Chapter on Disease Manifestations*): Micro-pulse of Liver and Kidney indicates Xiaodan, because Liver and Kidney are located inferiorly. He Baiqizhai said: The mechanism of creation lies only in Water and Fire; they should be balanced rather than biased, and connected rather than separated. Water represents Cold-Dampness, while Fire represents Dry-Heat. The nature of Fire is to flare upwards, and the nature of Water is to moisten downwards. Only when Fire is below and Water is above does the state of "Ji Ji" (Perfect Balance/Completion of Kan and Li) occur, representing the intersection of Kan and Li. If Water is excessive and fails to connect, it results in swelling; if Fire is excessive and fails to connect, it results in Xiaoke. Only by restraining the excess and facilitating their connection can one be considered a skilled healer. The *Xiu Zhen Fang* states: The human body's Kidneys are like the source of water. Therefore, when the Kidney Meridian is diseased, emaciation appears first; even with increased nourishment, luster cannot be restored. All cases of this syndrome originate from disease in the Kidney Meridian, caused by failing to preserve vitality during youth, indulging in sexual desires, excessive alcohol consumption, overeating roasted or fried foods, or long-term use of cinnabar and stone medicines. This leads to exhaustion of Kidney Water, blazing Heart Fire, fierce heat in the Sanjiao (Triple Burner), and the simmering of the Five Zang Organs, giving rise to Xiaoke. Treatment should tonify Kidney Water, drain Heart Fire, eliminate excessive dry-heat in the Stomach and Intestines, and replenish the decline of body fluids. This ensures that pathways remain open and not obstructed, fluids are generated and not dried up, and Blood and Qi are harmonious, leading to spontaneous recovery. This is the method for treating Xiaoke: observe deficiency or excess, clear fire and strengthen water, or employ yin-nourishing or draining methods according to suitability. However, the *Yinyang Bie Lun* (*Treatise on Differentiation of Yin and Yang*) in the *Neijing* states: Diseases of Er Yang (Yangming/Stomach and Large Intestine) originating from Heart and Spleen transmit as Fengxiao (Wind Consumption). This is because Yangming is the Sea of the Twelve Meridians; when Earth Qi declines, Wood Qi overacts upon it, causing muscle wasting. The *Qijue Lun* states: When Heart transmits Cold to Lung, it is called Feixiao; drinking one part results in urinating two parts, which is incurable and fatal. This describes the decline of Primordial Yang, where Metal becomes cold and Water becomes icy, resulting in Lung-Kidney consumption. The *Bingxing Pian* states: Micro-pulses of the Five Zang Organs all indicate Feidan (Lung Fever). This means weak pulses at the Cun Kou (Radial Artery) manifest externally due to internal depletion of Qi and Blood. Furthermore, the *Jiaoliu Bian Da Lun* (*Great Treatise on Changes in Qi Interaction*) states: When the annual Water Qi is excessive and influences Taiyang, people suffer from thirst and delirium. The *Wuchang Zheng Da Lun* (*Great Treatise on Normal Conditions of the Five Constants*) states: When Taiyang governs the year and Cold pathogen prevails, people suffer from dry throat and thirst craving drink. These are all cases where Yin suppresses Yang and Water controls Fire; treatment must use warm agents to dispel Cold pathogens for spontaneous recovery. Thus, how can one generally treat this as Heat? I once treated a scholar-official over forty years old who, due to mental labor from official documents, suffered from mental fatigue, reduced appetite, and frequent fear. He had no thirst in the Upper Jiao, disliked hot drinks, and any small amount of fluid intake stagnated without moving. Every night he urinated more than thirty units, half of which were clear fluids. Finally, he consulted me and confessed: Since falling ill, he had slept through the night for over half a year; occasionally dozing off, he always dreamed of deceased persons, funerals, and felt close to ghosts/spirits. I told him: This is accumulation of worry and labor damaging Heart and Kidney. Since Yuan Qi (Primal Qi) is deficient, Yin Evil prevails. Hence, many Yin dreams. Yang decline leads to Qi deficiency; Yang fails to command Yin, so Water fails to transform into Qi. Thus, although fluid intake is small, the output of Yin turbidity is large. This is exactly the disease described in the *Suwen* as "drinking one part, urinating two." Fortunately, the pulse still shows a Huan (Moderate) quality, muscles have not wasted away, and Stomach Qi remains functional, so there is no need to worry. Once Yang Qi gradually returns, Yin Evil will naturally recede. I prescribed Guipi Tang (Restore the Spleen Decoction) removing Xiangru (Aucklandiae Radix), and Bawei Wan (Eight-Ingredient Pill) removing Mudanpi (Moutan Cortex) and Zexie (Alisma Rhizome). One formula was used to nourish Yang, the other to nourish Yin. After taking over three hundred doses and consuming more than twenty jin (approx. 12 kg) of Renshen (Ginseng Radix et Rhizoma), he recovered. This was precisely a case of Feixiao in the Upper Jiao and Jingxiao (Essence Consumption) in the Lower Jiao. It is evident that Xiao also has Yin and Yang aspects; physicians must not be rigid but must adapt. May those who understand me forgive me, and those who blame me take my words as a warning.