肘后卒消渴小便多方。
多作竹沥。饮之恣口。数日瘥。忌面炙肉。（通按恣口者谓多饮竹沥非恣食也）
又方
酒煎黄柏汁。取性饮之。（通按性饮者若人性畏冷即少饮也）
又方
熬胡麻令变色。研淘取汁。饮半合。日可三四服。不过五升即瘥。
又疗日饮水一斛者方。
桑根白皮新掘入地三尺者佳。炙令黄黑色切。以水煮之。无多少。但令浓随意饮之。无
多少亦可。纳少粟米。勿与盐。（集验云宜热饮之）
又小便卒太数。复非淋。一日数十过。令人瘦方。
未中水猪脂如鸡子一枚炙。承取肥汁尽服之。不过三剂瘥。
又方
羊肺一具作羹。纳少肉和盐豉。如食法。任意进之。不过三具瘥。（千金同）
又方
豉一升。纳于盐中绵裹之。以白矾好者半斤。置绵上令蒸之三斗米许时。即下白矾。得
消入豉中。出曝干。捣末。服方寸匕。
又小便数。猪肚黄连丸方。
猪肚（一枚洗去脂膜） 黄连末（三斤） 纳猪肚中蒸之一石米熟。即出之。曝干。捣
丸如
梧子。服三十丸。日再服。渐渐加之。以瘥为度。忌猪肉。（出第二卷中）
论曰∶消渴者。原其发动。此则肾虚所致。每发即小便至甜。医者多不知其疾。所以古
方论亦阙而不言。今略陈其要。按洪范稼穑作甘。以物理推之。淋饧醋酒作脯法。须臾即皆
能甜也。足明人食之后。滋味皆甜。流在膀胱。若腰肾气盛。则上蒸精气。气则下入骨髓。
其次以为脂膏。其次为血肉也。其余别为小便。故小便色黄。血之余也。骚气者。五脏之气。
咸润者则下味也。腰肾既虚冷。则不能蒸于上。谷气则尽下为小便者也。故甘味不变。其色
清冷。则肌肤枯槁也。犹如乳母。谷气上泄。皆为乳汁。消渴疾者。下泄为小便。此皆精气
不实于内。则便羸瘦也。又肺为五脏之华盖。若下有暖气。蒸即肺润。若下冷极。即阳气不
能升。故肺干则热。故周易有否卦。干上坤下。阳阻阴而不降。阴无阳而不升。上下不交。
故成否也。譬如釜中有水。以火暖之。其釜若以板盖之。则暖气上腾。故板能润也。若无火
力。水气则不上。此板终不可得润也。火力者。则为腰肾强盛也。常须暖将息。其水气即为
食气。食气若得暖气。即润上而易消下。亦免干渴也。是故张仲景云∶宜服此八味肾气丸。
并不食冷物及饮冷水。今亦不复渴。比频得效。故录正方于后耳。凡此疾与香港脚。虽同为肾
虚所致。其香港脚始发于二三月。盛于五六月。衰于七八月。凡消渴始发于七八月。盛于十一
月十二月。衰于二月三月。其故何也。夫香港脚者。拥疾也。消渴者。宣疾也。春夏阳气上。
故拥疾发。即宣疾愈也。秋冬阳气下。故宣疾发。即拥疾愈也。审此二者。疾可理也。又宜
食者。每间五六日空腹一食饼。以精羊肉及黄雌鸡为 。此可温也。若取下气不食肉。菜食
者宜煮牛膝韭蔓荆。又宜食鸡子马肉。此物微拥。亦可疗宣疾也。拥之过度。便发香港脚。犹
如善为政者。宽以济猛。猛以济宽。随事制度。使宽猛得所。定之于心。口不能言也。又庸
医或令吃栝蒌粉。往往经服之都无一效。又每至椹熟之时。取烂美者水淘去浮者餐之。下候
心胸间气为度。此亦甚佳。生牛乳暖如人体。渴即细细呻之亦佳。张仲景云∶足太阳者。是
膀胱之经也。膀胱者。是肾之腑也。而小便数。此为气盛。气盛则消谷大便硬。衰则为消渴
也。男子消渴。饮一斗水。小便亦得一斗。宜八味肾气丸主之。
神方。消渴人宜常服之。
干地黄（八两） 薯蓣（四两） 茯苓（三两） 山茱萸（五两） 泽泻（四两） 牡
丹皮（三两） 附子（三两炮） 桂心（三两）
右药捣筛。蜜和丸如梧子大。酒下十丸。少少加。以知为度。忌猪肉冷水芜荑胡荽酢物
生葱（范汪短剧深师古今录验必效文仲方等并同）
先服八味肾气丸讫。后服此药压之方。
黄连（二十分） 苦参粉（十分） 干地黄（十分） 知母（七分） 牡蛎（八分） 麦
门冬（十
二分去心） 栝蒌（七分一方无余并同）
上七味捣筛。牛乳和为丸。如梧子大。并手作丸。曝干。油袋盛用。浆水或牛乳下。日
再服二十丸。一方服十五丸。患重者渴瘥后。更服一年以来。此病特慎獐鹿肉。须慎酒炙肉
咸物。吃索饼五日一顿。细切精羊肉勿着脂。饱食吃羊肉。须着桑根白皮食。一方云∶瘥后
须服此丸。一载以上。即永绝根源。此病特忌房室热面并干脯一切热肉粳米饭李子等。若觉
热渴。加至二十五丸亦得。定后还依前减。其方神效无比。余并准前方。忌猪肉芜荑。
Formulas from *Zhou Hou Bei Ji Fang* for treating sudden onset of Xiao Ke (Wasting and Thirsting Syndrome) with polyuria.
Prepare a large amount of Zhuli (Bamboo Juice, the juice obtained by heating bamboo), drink it freely, and recover in a few days. Avoid wheat products and roasted meat. (Tong's note: "Drinking freely" refers to drinking much Bamboo Juice, not indulging in food.)
Another formula
Decoct Huangbai (Phellodendri Cortex) in wine to extract the juice, and drink it while warm. (Tong's note: "Drink while warm" means if the patient naturally fears cold, drink a small amount.)
Another formula
Stir-fry Humazha (Sesamum indicum seeds) until the color changes, grind and wash to extract the juice. Drink half he (a traditional unit of volume). Take three to four times a day. The total amount should not exceed five sheng (a traditional unit of volume) for recovery.
Another formula for those who drink one hu (a large traditional unit of volume) of water daily.
Use newly dug Sanggen Baipi (Mori Cortex), preferably from three chi deep underground. Roast until yellow-black, then cut. Boil in water; the quantity of water is not fixed, just boil until concentrated and drink as desired. Adding a little Sumi (Setaria italica grain) is fine. Do not add salt. (*Ji Yan Fang* states it is suitable to drink hot.)
Another formula for sudden severe frequency of urination, not Lin syndrome (Dysuria), occurring dozens of times a day, causing emaciation.
Take Zhu Zhi (Porcine Fat) that has not touched water, size of a chicken egg. Roast it, collect the rendered fat, and consume it all. Recovery occurs within no more than three doses.
Another formula
Make soup with one Yang Fei (Ovis/Caprae Pulmo). Add a little meat, Yan Chi (Fermented Soybeans), and salt. Eat according to normal dietary methods, as much as desired. Recovery occurs within no more than three lungs. (*Qian Jin Fang* agrees.)
Another formula
Take Shi Er Dou Chi (Perillae Fructus Fermentatus) one sheng, wrap it in silk cloth, and place it in salt. Place Ban Xia Bai Fan (Alumen) half jin on top of the cloth. Steam for the time it takes to cook three dou of rice. Then remove the Alumen, allowing it to fully penetrate into the fermented soybeans. Remove, dry in the sun, grind into powder. Take one fang cun bi (a square-inch measure) per dose.
Another formula for polyuria: Zhu Du Huang Lian Wan (Pig Stomach with Coptis Pill).
One Zhu Du (Sus Scrofa Domesticus Stomach), washed clean to remove fat membrane. Three jin of Huanglian Mo (Coptidis Rhizoma Powder). Place the Coptis powder inside the pig stomach. Steam with one shi of rice until cooked. Remove, dry, grind, and make pills the size of Wuzi (Osleria Fruit seeds). Take thirty pills per dose, twice daily. Gradually increase the dosage until recovery. Avoid pork. (From Volume II)
Discussion:
Xiao Ke (Wasting and Thirsting Syndrome), investigating its origin, is caused by Shen Xu (Kidney Deficiency). Upon each attack, the urine tastes sweet. Physicians often do not understand this disease, so ancient texts omit it. Now I briefly state the essentials. According to *Hong Fan* ("Agriculture and Harvest yield sweetness"), deducing from physical principles, making syrup, vinegar, wine, or dried meat quickly becomes sweet. This proves that after human digestion, flavors are sweet, flowing into the Pang Guang (Urinary Bladder). If Yao Shen Qi (Qi of the Waist and Kidneys) is vigorous, it steams Jing Qi (Essence and Qi) upward. This Qi enters the Su Gou (Bone Marrow) downward, then forms Zhi Gao (Fat/Grease), then Xue Rou (Blood and Flesh). The remainder becomes Xiao Bian (Urine), hence urine is yellow, being the surplus of blood. Sao Qi (Pungent/Aromatic Qi) is the Qi of the Five Zang Organs; Xian Run (Salty/Moist) is the flavor below. Since Yao Shen is deficient and cold, it cannot steam upward, so Gu Qi (Grain Qi) goes entirely down to become urine. Thus, the sweet taste remains unchanged, the color is clear and cold, and the skin and muscles become withered. Like a nursing mother, Grain Qi flows up to become milk; in Xiao Ke, it flows down to become urine. This is because Jing Qi is not solidified internally, leading to emaciation. Furthermore, Fei (Lung) is the canopy of the Five Zang Organs. If there is warm Qi below steaming upward, the Lung is moistened. If the lower part is extremely cold, Yang Qi cannot ascend, causing Fei Dryness and Heat. Thus, in *I Ching*, there is the Pi Hexagram (Obstruction), Qian above, Kun below. Yang is blocked and cannot descend; Yin lacks Yang and cannot ascend. Upper and lower do not interact, resulting in obstruction. It is like having water in a pot and warming it with fire. If covered with a board, warm Qi rises, moistening the board. Without fire power, water vapor does not rise, and the board remains dry. Fire power refers to strong Yao Shen (Waist and Kidneys). One must maintain warmth and care. Water vapor is Food Qi. If Food Qi receives warm Qi, it moistens the upper part and facilitates digestion below, preventing dryness and thirst. Therefore, Zhang Zhongjing said: It is suitable to take Ba Wei Shen Qi Wan (Eight-Ingredient Replenishing the Kidney Qi Pill). Also, avoid cold foods and drinking cold water. Currently, there is no longer thirst. Having frequently achieved efficacy recently, I record the correct formulas below. This disease and Hong Jiao (Foot Qi/Jama), although both caused by Shen Xu (Kidney Deficiency), differ in timing. Hong Jiao begins in the second and third months, peaks in the fifth and sixth, and declines in the seventh and eighth. Xiao Ke begins in the seventh and eighth months, peaks in the eleventh and twelfth, and declines in the second and third. Why? Hong Jiao is a Yong Ji (Stagnant Disease); Xiao Ke is a Xuan Ji (Dispersing Disease). In spring and summer, Yang Qi ascends, so Stagnant Disease attacks, and Dispersing Disease heals. In autumn and winter, Yang Qi descends, so Dispersing Disease attacks, and Stagnant Disease heals. Understanding these two allows for regulation of the disease. Suitable foods: Every five or six days, eat a cake on an empty stomach, made with lean mutton and yellow hen. This can warm the body. If taking downward-moving Qi and avoiding meat, vegetable eaters should boil Niu Xi (Achyranthis Bidentatae Radix) and Jiu Man Jing. Also suitable are eggs and horse meat; these slightly stagnate but can treat Dispersing Disease. Excessive stagnation leads to Hong Jiao. It is like a good ruler balancing leniency and severity, adjusting measures according to circumstances, keeping balance in mind though words fail. Quack doctors may prescribe Gua Lou Fen (Trichosanthis Radix Powder), which often yields no effect. When mulberries ripen, select soft, good ones, wash away floating ones with water, and eat them, stopping when chest/heart Qi feels balanced. This is also very good. Warm raw cow's milk to body temperature and sip slowly when thirsty; this is also good. Zhang Zhongjing said: Zu Tai Yang Jing (Foot-Taiyang Meridian) is the meridian of Pang Guang (Urinary Bladder). Pang Guang is the Fu Organ of Shen (Kidney). Frequent urination indicates Qi Sheng (Excess Qi). Excess Qi causes Xiao Gu (Consuming Grain/Appetite) and hard stool; deficiency leads to Xiao Ke. For male Xiao Ke, drinking one dou of water results in excreting one dou of urine; Ba Wei Shen Qi Wan (Eight-Ingredient Replenishing the Kidney Qi Pill) is indicated.
Divine Formula, suitable for regular use by Xiao Ke patients.
Gan Di Huang (Rehmanniae Radix Preparata) eight liang, Shu Yu (Dioscoreae Rhizoma) four liang, Fu Ling (Poria) three liang, Shan Zhu Yu (Corni Fructus) five liang, Ze Xie (Alismatis Rhizoma) four liang, Mu Dan Pi (Moutan Cortex) three liang, Fu Zi (Aconiti Lateralis Radix Praeparata) three liang (prepared), Gui Xin (Cinnamomi Ramulus) three liang.
Crush and sieve the above herbs. Mix with honey to make pills the size of Osleria Fruit seeds. Take ten pills with wine, gradually increasing until effective. Avoid pork, cold water, Wu Yi (Houttuyniae Herba), Hu Sui (Coriandri Fructus), vinegar products, and raw scallions. (*Fan Wang Duan Ju*, *Shen Shi Fang*, *Gu Jin Lu Yan*, *Bi Xiao Fang*, *Wen Zhong Fang* etc. agree.)
After finishing Ba Wei Shen Qi Wan (Eight-Ingredient Replenishing the Kidney Qi Pill), take this suppressing formula.
Huang Lian (Coptidis Rhizoma) twenty fen, Ku Shen Fen (Sophorae Flavescentis Radix Powder) ten fen, Gan Di Huang (Rehmanniae Radix Preparata) ten fen, Zhi Mu (Anemarrhenae Rhizoma) seven fen, Mu Li (Ostreae Concha) eight fen, Mai Men Dong (Ophiopogonis Tuber) twelve fen (decored), Gua Lou (Trichosanthis Fructus) seven fen (one version has no others, all same).
Crush and sieve the seven ingredients. Mix with cow's milk to make pills the size of Osleria Fruit seeds, hand-rolled, dried, stored in oil bags. Take with Jiang Shui (Fermented Rice Liquid) or cow's milk, twice daily, twenty pills per dose. One version takes fifteen pills. For severe cases, continue taking for one year after thirst subsides. Specifically avoid deer/meat, alcohol-roasted meat, salty foods. Eat Suo Bing (Noodles) once every five days. Finely chop lean mutton without fat, eat until full, and must consume with Sang Gen Bai Pi (Mori Cortex). One version says: After recovery, take this pill for over a year to permanently eliminate the root cause. Specifically avoid sexual activity, hot noodles, dried meat jerky, all hot meats, Jing Mi Fan (Oryza Sativa Japonica Group Rice), plums, etc. If feeling hot/thirsty, increase to twenty-five pills; once stable, reduce as before. This formula is incredibly effective. Follow the previous precautions regarding avoiding pork and Wu Yi.