论曰病消中者，不渴而多溲，一名内消。以邪热熏烁五脏。然后外及肌肉形体也。得之
年少饵石。房室太甚。真气耗惫。石气孤立。结于肾则实。肾实则消水浆。故不渴而小便利
多。不得润养五脏。使所食之物。皆消为小便。治宜滋肾水养津液。则瘥。
治初得消中。食已如饥。手足烦热。背膊疼闷。小便白浊。天门冬丸方
天门冬（去心焙二两半） 鸡内金（三具微炙） 桑螵蛸（十枚炙） 土瓜根（干者） 肉
苁
蓉（酒浸一宿切焙） 熟干地黄（焙） 栝蒌根 知母（焙） 泽泻（锉） 鹿茸（去皮毛
酒浸炙）
五味子 赤石脂（各一两半） 牡蛎（ 二两） 苦参（一两）
上一十四味。捣罗为末。炼蜜和丸。如梧桐子大。每服二十丸。煎粟米饮下。
治内消。所食物皆作小便。兼治强中。荠 汤方
荠 大豆 人参 白茯苓（去黑皮） 磁石（捣如米粒） 葛根（锉） 石膏（碎） 黄
芩（
去黑心） 栝蒌根 甘草（炙锉） 知母（焙各二两）
上一十一味。粗捣筛。每服五钱匕，水二盏。煎至一盏。去滓温服，日三夜一。
治消中。饮食无度，小便日夜频数，转加羸瘦。水银丸方
水银（一两） 银箔（二百片与水银共研） 铁粉（别研） 牡蛎（ 各三两） 栝蒌
根麦门
冬（去心焙） 黄芩（去黑心） 苦参 黄连（去须） 栀子仁（各二两）
上一十味。捣罗七味为末，与别研三味和匀。用枣肉研捣为丸，如梧桐子大。每服四十
丸。煎芦根汤下，日二夜一。
治消中脾胃热极，消谷引食。化为小便。黄芩汤方
黄芩（去黑心） 麦门冬（去心焙） 栝蒌根 栀子仁 石膏（碎） 淡竹叶（各一两）
上六味。粗捣筛。每服四钱匕，水一盏半。煎至八分，去滓温服。不拘时。
治消中。小便数。黄连丸方
黄连（去须五两） 栝蒌根 白龙骨碎 苦参 牡蛎粉 山茱萸 土瓜根（切） 葳蕤
（各
三两）
上八味，捣罗为末。炼蜜丸如梧桐子大，每服二十丸至三十丸。大麦饮下，日三夜一。
治消中、小便数。铅丹散方
铅丹（研） 胡粉（各半两） 栝蒌根 泽泻 石膏（碎） 赤石脂 白石脂 甘草（炙
锉
各二
上八味。捣研为散，每服二钱匕。米饮调下，日三夜一。
治内消。肌肤羸瘦，或转筋。小便利甚。栝蒌散方
栝蒌根 黄连（去须） 防己锉 铅丹研各一两半
上四味。捣罗三味为散，与铅丹和匀。每服二钱匕，用醋半合沸汤半盏调下。日二夜一
治消中。黄柏丸方
黄柏（去粗皮二两） 黄连（去须半斤）
上二味。捣罗为末。用酥拌和。捣三百杵。丸如梧桐子大。每服三十丸。温浆水下。
治消中。食已即饥。手足烦热。背膊疼闷。小便稠浊。牡蛎丸方
牡蛎（ 研） 赤石脂（研） 栝蒌根 肉苁蓉（酒浸一宿切焙各一两） 黄连（去须）
土瓜
根（锉） 黄芩（去黑心） 知母（焙） 泽泻 天门冬（去心焙） 鹿茸（去皮毛酒浸炙）
五味子
桑螵蛸（麸炒各三分） 熟干地黄（焙一两半）
上一十四味。捣罗十二味为末。与别研二味和匀。炼蜜丸如梧桐子大。每服三十丸。煎
陈粟米饮下。日三夜一。
治凡消渴变为消中者，饮食到胃。实时消化，小便多而色白。所食多而不觉饱者。猪肚
黄连丸方
猪肚（一枚洗去脂膜不切破） 黄连（去须捣罗为末五两）
上二味，以大麻子仁二合烂研。以水四升调，如杏酪汁。煮猪肚候烂。取出入黄连末在
内。密缝肚口，蒸令极烂。乘热细切。和黄连末，以木臼捣之。候可丸。即丸如梧桐子大。
曝干，每服三十丸。温水下，不拘时。
治消中虚极。小便无度。肉苁蓉丸方
肉苁蓉（酒浸一宿切焙二两） 泽泻 熟干地黄（焙） 五味子 巴戟天（去心） 地
骨皮
人参 栝蒌根 韭子（炒） 甘草（炙锉） 牡丹皮（各一两） 桑螵蛸（炙三十枚） 赤
石脂（研）
磁石（ 醋淬二七遍研龙骨） 禹余粮（ 醋淬二七遍研各一两半）
上一十六味，捣研为末。炼蜜和丸，如梧桐子大。每服三十丸，牛乳汁下。
治消渴消中久不瘥。知母丸方
知母（焙） 麦门冬（去心焙各一两） 犀角（镑） 铅霜 鸡 （炙） 土瓜根（各
半两）
白茯苓（去黑皮） 黄连（去须各三分） 金箔（二十片）
上九味。捣罗为末。炼蜜为丸。如梧桐子大。每服十丸。煎人参汤下。
Commentary states: Patients suffering from Xiao Zhong (Middle Jiao Diabetes, characterized by polyphagia and polyuria) do not feel thirsty but experience frequent urination; this condition is also known as Nei Xiao (Internal Consumption). It arises because pathogenic heat scorches the five Zang organs, subsequently affecting the muscles and body form. This disease often results from taking mineral drugs (Shi Yao, referring to mineral substances used in alchemy) in youth and excessive sexual activity, leading to depletion of True Qi (Zhen Qi, vital energy) and exhaustion. The qi of the minerals becomes isolated and dominant. When it accumulates in the Kidney, it causes Kidney Excess. When the Kidney is in a state of excess, it consumes fluids, resulting in a lack of thirst and frequent, clear urination. Consequently, fluids fail to moisten and nourish the five Zang organs, causing ingested food to be transformed entirely into urine. Treatment should focus on nourishing Kidney Water and preserving Body Fluids (Jin Ye), which will lead to recovery.
For early-stage Xiao Zhong, presenting with hunger immediately after eating, vexing heat in the hands and feet, pain and distension in the back and shoulders, and turbid white urine, use Tian Men Dong Wan (Asparagus Root Pill):
Tian Men Dong (Asparagi Radix, heart removed, roasted, 2 liang 5 qian) Ji Nei Jin (Galli Gigerii Endothelium Corneum, three pieces, lightly roasted) Sang Piao Xiao (Mantis Egg Case, ten pieces, roasted) Tu Gua Gen (Trichosanthes Thunbergiana Radix, dried) Rou Cong Rong (Cistanche Deserticola Stem, soaked in wine overnight, sliced, roasted) Shu Gan Di Huang (Prepared Rehmanniae Radix, roasted) Gua Lou Gen (Trichosanthis Radix) Zhi Mu (Anemarrhenae Rhizoma, roasted) Ze Xie (Alismatis Rhizoma, chopped) Lu Rong (Deer Antler without hair, soaked in wine, roasted)
Wu Wei Zi (Schisandrae Fructus) Chi Shi Zhi (Halloysit Rubrum, each 1 liang 5 qian) Mu Li (Ostrea Concha, 2 liang) Ku Shen (Sophorae Flavescentis Radix, 1 liang)
The above fourteen ingredients are crushed, sieved into fine powder, mixed with refined honey, and formed into pills the size of paulownia seeds. Take 20 pills per dose, washed down with decocted millet drink.
For Nei Xiao, where ingested food passes directly into urine, and for Qiang Zhong (Priapism), use Qi Tang (Shepherd's Purse Decoction):
Qi (Capsellae Fructus) Da Dou (Sojae Semen) Ren Shen (Ginseng Radix et Rhizoma) Bai Fu Ling (Poria, black skin removed) Ci Shi (Magnetitum, crushed to rice-grain size) Ge Gen (Puerariae Lobatae Radix, chopped) Shi Gao (Gypsum Fibrosum, crushed) Huang Qin (Scutellariae Radix, black heart removed) Gua Lou Gen (Trichosanthis Radix) Gan Cao (Licorice Radix et Rhizoma, roasted and chopped) Zhi Mu (Anemarrhenae Rhizoma, roasted, each 2 liang)
The above eleven ingredients are coarsely crushed and sieved. Take 5 qian bi per dose, add two zhan of water, decoct to one zhan, remove dregs, and take warm. Three times daily, once at night.
For Xiao Zhong, characterized by uncontrolled diet, frequent day and night urination, and progressive emaciation, use Shui Yin Wan (Mercury Pill):
Shui Yin (Hydrargyrum, 1 liang) Yin Bo (Lamina Aurii, 200 sheets, ground together with mercury) Tie Fen (Ferrum Pulveratum, separately ground) Mu Li (Ostrea Concha, each 3 liang) Gua Lou Gen (Trichosanthis Radix) Mai Men Dong (Ophiopogonis Radix, heart removed, roasted) Huang Qin (Scutellariae Radix, black heart removed) Ku Shen (Sophorae Flavescentis Radix) Huang Lian (Coptidis Rhizoma,须 removed) Zhi Zi Ren (Gardeniae Fructus, each 2 liang)
The above ten ingredients: crush and sieve seven ingredients into powder, mix evenly with the other three separately ground ingredients. Use date flesh to grind and form pills the size of paulownia seeds. Take 40 pills per dose, washed down with decocted reed root soup, twice daily, once at night.
For Xiao Zhong with extreme Heat in the Spleen and Stomach, rapid digestion of food, increased appetite, and food transforming into urine, use Huang Qin Tang (Scutellaria Decoction):
Huang Qin (Scutellariae Radix, black heart removed) Mai Men Dong (Ophiopogonis Radix, heart removed, roasted) Gua Lou Gen (Trichosanthis Radix) Zhi Zi Ren (Gardeniae Fructus) Shi Gao (Gypsum Fibrosum, crushed) Dan Zhu Ye (Lophatheri Herba, each 1 liang)
The above six ingredients are coarsely crushed and sieved. Take 4 qian bi per dose, add one and a half zhan of water, decoct to eight parts, remove dregs, and take warm. No specific time restriction.
For Xiao Zhong with frequent urination, use Huang Lian Wan (Coptis Pill):
Huang Lian (Coptidis Rhizoma, 5 liang,须 removed) Gua Lou Gen (Trichosanthis Radix) Bai Long Gu (Fossilia Ossis Mastodi, crushed) Ku Shen (Sophorae Flavescentis Radix) Mu Li Fen (Ostrea Concha Powder) Shan Zhu Yu (Corni Fructus) Tu Gua Gen (Trichosanthes Thunbergiana Radix, sliced) Wei Rui (Polygonati Odorati Rhizoma, each 3 liang)
The above eight ingredients are crushed, sieved into powder, mixed with refined honey, and formed into pills the size of paulownia seeds. Take 20 to 30 pills per dose, washed down with barley drink, three times daily, once at night.
For Xiao Zhong with frequent urination, use Qian Dan San (Lead Tetroxide Powder):
Qian Dan (Lithargyri Oxidum, ground) Hu Fen (Cerussa, each half liang) Gua Lou Gen (Trichosanthis Radix) Ze Xie (Alismatis Rhizoma) Shi Gao (Gypsum Fibrosum, crushed) Chi Shi Zhi (Halloysit Rubrum) Bai Shi Zhi (Halloysit Albus) Gan Cao (Licorice Radix et Rhizoma, roasted and chopped, each 2 liang)
The above eight ingredients are crushed and ground into powder. Take 2 qian bi per dose, mixed with rice drink, three times daily, once at night.
For Nei Xiao with emaciated skin or muscle cramps, and very frequent urination, use Gua Lou San (Trichosanthes Powder):
Gua Lou Gen (Trichosanthis Radix) Huang Lian (Coptidis Rhizoma, 须 removed) Fang Ji (Stephaniae Tetrandrae Radix, chopped) Qian Dan (Lithargyri Oxidum, ground, each 1 liang 5 qian)
The above four ingredients: crush and sieve three ingredients into powder, mix evenly with Qian Dan. Take 2 qian bi per dose, mixed with half he of vinegar and half zhan of boiling water, twice daily, once at night.
For Xiao Zhong, use Huang Bai Wan (Phellodendri Pill):
Huang Bai (Phellodendri Chinensis Cortex, coarse bark removed, 2 liang) Huang Lian (Coptidis Rhizoma, 5 jin, 须 removed)
The above two ingredients are crushed, sieved into powder, mixed with butter (Su), pounded 300 times, and formed into pills the size of paulownia seeds. Take 30 pills per dose, washed down with warm sour rice water.
For Xiao Zhong with hunger immediately after eating, vexing heat in hands and feet, pain and distension in back and shoulders, and thick turbid urine, use Mu Li Wan (Oyster Shell Pill):
Mu Li (Ostrea Concha, ground) Chi Shi Zhi (Halloysit Rubrum, ground) Gua Lou Gen (Trichosanthis Radix) Rou Cong Rong (Cistanche Deserticola Stem, soaked in wine overnight, sliced, roasted, each 1 liang) Huang Lian (Coptidis Rhizoma, 须 removed) Tu Gua Gen (Trichosanthes Thunbergiana Radix, chopped) Huang Qin (Scutellariae Radix, black heart removed) Zhi Mu (Anemarrhenae Rhizoma, roasted) Ze Xie (Alismatis Rhizoma) Tian Men Dong (Asparagi Radix, heart removed, roasted) Lu Rong (Deer Antler without hair, soaked in wine, roasted) Wu Wei Zi (Schisandrae Fructus) Sang Piao Xiao (Mantis Egg Case, bran-fried, each 3 fen) Shu Gan Di Huang (Prepared Rehmanniae Radix, roasted, 1 liang 5 qian)
The above fourteen ingredients: crush and sieve twelve ingredients into powder, mix evenly with the other two separately ground ingredients. Mix with refined honey and form pills the size of paulownia seeds. Take 30 pills per dose, washed down with decocted aged millet drink, three times daily, once at night.
For cases where Xiao Ke (Wasting-Thirst) transforms into Xiao Zhong, where food digests immediately upon reaching the stomach, urine is copious and white, and one eats much without feeling full, use Zhu Du Huang Lian Wan (Pig Stomach Coptis Pill):
Zhu Du (Sus Scrofa Domesticus Ventriculus, one piece, washed, fat membrane removed, not cut) Huang Lian (Coptidis Rhizoma, 5 liang, 须 removed, crushed, sieved into powder)
The above two ingredients: grind 2 he of hemp seeds thoroughly, mix with 4 sheng of water to resemble apricot kernel milk. Boil the pig stomach until tender. Remove, insert the Huang Lian powder inside, sew the opening tightly, and steam until extremely soft. While hot, slice finely, mix with Huang Lian powder, pound in a wooden mortar. When ready to form pills, make them the size of paulownia seeds. Dry in the sun. Take 30 pills per dose, washed down with warm water, no specific time restriction.
For severe deficiency in Xiao Zhong with uncontrolled urination, use Rou Cong Rong Wan (Cistanche Pill):
Rou Cong Rong (Cistanche Deserticola Stem, soaked in wine overnight, sliced, roasted, 2 liang) Ze Xie (Alismatis Rhizoma) Shu Gan Di Huang (Prepared Rehmanniae Radix, roasted) Wu Wei Zi (Schisandrae Fructus) Ba Ji Tian (Morinda Officinalis Radix, heart removed) Di Gu Pi (Lycii Cortex) Ren Shen (Ginseng Radix et Rhizoma) Gua Lou Gen (Trichosanthis Radix) Jiu Zi (Allii Tuberosi Semen, fried) Gan Cao (Licorice Radix et Rhizoma, roasted and chopped) Mu Dan Pi (Moutan Cortex, each 1 liang) Sang Piao Xiao (Mantis Egg Case, roasted, 30 pieces) Chi Shi Zhi (Halloysit Rubrum, ground) Ci Shi (Magnetitum, quenched in vinegar seven times, ground) Long Gu (Fossilia Ossis Mastodi) Yu Yu Liang (Haematitum, quenched in vinegar seven times, ground, each 1 liang 5 qian)
The above sixteen ingredients are crushed and ground into powder. Mix with refined honey and form pills the size of paulownia seeds. Take 30 pills per dose, washed down with cow's milk.
For chronic Xiao Ke and Xiao Zhong that does not heal, use Zhi Mu Wan (Anemarrhena Pill):
Zhi Mu (Anemarrhenae Rhizoma, roasted) Mai Men Dong (Ophiopogonis Radix, heart removed, roasted, each 1 liang) Xi Jiao (Rhino Ceratostigma, shaved) Qian Shuang (Plumbum Subacetatum) Ji Nei Jin (Galli Gigerii Endothelium Corneum, roasted) Tu Gua Gen (Trichosanthes Thunbergiana Radix, each half liang) Bai Fu Ling (Poria, black skin removed) Huang Lian (Coptidis Rhizoma, 须 removed, each 3 fen) Jin Bo (Lamina Aurii, 20 pieces)
The above nine ingredients are crushed, sieved into powder. Mix with refined honey and form pills the size of paulownia seeds. Take 10 pills per dose, washed down with Ginseng decoction.