千金论曰∶凡消渴病经百日以上者。不得灸刺。灸刺则于疮上漏脓水不歇。遂成痈疽。
羸瘦而死。亦忌有所误伤皮肉。若作针孔许大疮者。所饮之水。皆于疮中变成脓水而出。若
水出不止者必死。慎之慎之。初得消渴者。可依后方灸刺之为佳。孙氏云∶消渴病百日外既
不许针刺。所饮之水。皆化为脓水不止者皆死。特须慎之。又云∶仍不得误伤皮肉。若有小
疮。亦云致死。既今亦得消渴。且未免饮水。水入疮即损人。今初得日。岂得令其灸刺。致
此误伤之祸。辄将未顺其理。且取百日以上为能。未悟初灸之说。故不录灸刺。凡灸刺则外
脱其气。消渴皆是宣疾。灸刺特不相宜。唯香港脚宜即灸之。是以不取灸穴者耳。又有人患消
渴小便多而数。发在于春。经一夏专服栝蒌及豉汁。得其力。渴渐瘥。然小便犹数甚。昼夜
二十余行。常至三四升。极差不减二升也。转久便止。渐食肥腻。日就羸瘦。唇口干燥。吸
吸少气。不得多语。心烦热。两脚酸。食乃兼倍于常。而不为气力者。然此病皆由虚热所为
耳。疗法。栝蒌汁可长服以除热。牛乳杏酪善于补。此法最有益。（出第二十一卷中）
文仲疗消渴热中。加减六物丸方。
栝蒌根（八分） 麦门冬（六分去心） 知母（五分） 人参（四分） 苦参（四分） 土
瓜根（
四分）
右药捣筛。以牛胆和为丸。如小豆。服二十丸。日三服。麦粥汁下。未知。稍加至三十
丸。咽干者加麦门冬。舌干加知母。胁下满加人参。小便难加苦参。小便数加土瓜根。随患
加之一分。（肘后同）
又黄连丸。主消渴方。
黄连（一斤去毛） 生地黄（十斤）
上二味捣。绞地黄取汁渍黄连。出曝之燥。复纳之。令汁尽。干捣之下筛。蜜和丸如梧
子。服二十丸。日三服。亦可散。以酒服方寸匕。日三服。尽更令作。即瘥止。忌猪肉芜荑。
（
千金栝蒌粉散。疗消渴秘方。
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: For patients with Xiao Ke (Wasting and Thirsting Syndrome) whose condition has persisted for more than one hundred days, moxibustion and acupuncture are contraindicated. If moxibustion or acupuncture is performed, the resulting sores will leak pus and fluid incessantly, eventually developing into Yong Ju (carbuncles and malignant ulcers), leading to emaciation and death. One must also avoid accidental injury to the skin and flesh. If a wound the size of a needle puncture is created, all ingested water will transform into pus and drain from the wound. If this drainage does not cease, death is inevitable; therefore, extreme caution is required. For those who have just contracted Xiao Ke, it is advisable to follow the subsequent prescriptions for moxibustion and acupuncture. Sun Simiao stated: Acupuncture is prohibited for Xiao Ke after one hundred days; if the ingested water transforms into unceasing pus, death ensues. Special caution is necessary. He further stated that one must not accidentally injure the skin and flesh; even small sores can be fatal. Since I currently suffer from Xiao Ke and inevitably consume water, allowing water to enter a wound would harm the body. Given that the illness is in its early stages, how could one subject the patient to moxibustion or acupuncture, thereby inviting such mishap? This clearly contradicts medical principles. Moreover, the restriction on the hundred-day mark exists because the rationale for early-stage moxibustion had not yet been fully understood; thus, these methods were not recorded. Generally, moxibustion and acupuncture cause the exterior Qi to dissipate. Xiao Ke is characterized by dispersion and deficiency-heat, making moxibustion and acupuncture particularly unsuitable. Only Hong Jiao Jiao (Hongjiao disease, characterized by swelling and pain in the lower limbs) is suitable for immediate moxibustion; hence, acupoints for moxibustion are not selected for Xiao Ke.
Another case involves a patient with Xiao Ke presenting with polyuria and frequency, onset in spring. Throughout the summer, the patient exclusively consumed Gualou juice (Trichosanthes fruit juice) and Douchi juice (fermented soybean juice). With the efficacy of these remedies, thirst gradually subsided, yet urinary frequency remained severe, occurring more than twenty times day and night, with volumes reaching three to four sheng per occasion, and never less than two sheng even when symptoms were mild. Over time, the urinary symptoms ceased. The patient gradually resumed a diet rich in fatty and greasy foods, becoming increasingly emaciated, with dry lips and mouth, shortness of breath, inability to speak much, irritability, heat sensation, soreness in both legs, and food intake double the normal amount without corresponding increase in strength. This condition is attributed to deficiency-heat. The treatment method involves long-term consumption of Gualou juice to clear heat; milk and apricot cheese are beneficial for tonification. This method is highly effective. (Excerpted from Volume 21)
Wen Zhong’s prescription for treating Xiao Ke with Heat in the Middle Jiao, Modified Liu Wu Wan (Six-Ingredient Pill):
Gualou Gen (Trichosanthis Radix, 8 fen)
Maimendong (Ophiopogonis Radix, 6 fen, heart removed)
Zhimu (Anemarrhenae Rhizoma, 5 fen)
Renshen (Ginseng Radix, 4 fen)
Kushen (Sophorae Flavescentis Radix, 4 fen)
Tugua Gen (Cucumeris Radix, 4 fen)
Pulverize and sieve the above herbs. Mix with ox bile to form pills the size of small beans. Take 20 pills three times daily, administered with millet porridge liquid. If ineffective, slightly increase to 30 pills. Add Maimendong for dry throat, Zhi mu for dry tongue, Renshen for fullness under the hypochondrium, Kushen for difficult urination, and Tugua Gen for frequent urination. Increase each herb by 1 fen according to specific symptoms. (Identical to *Zhou Hou Bei Ji Fang*)
Another prescription is Huanglian Wan (Coptis Pill), indicated for Xiao Ke:
Huanglian (Coptidis Rhizoma, 1 jin, hairs removed)
Sheng Dihuang (Rehmanniae Radix Recens, 10 jin)
Pulverize the two ingredients. Squeeze juice from Sheng Dihuang to soak Huanglian. Remove and dry, then re-immerse until the juice is fully absorbed. Dry, pulverize, and sieve. Mix with honey to form pills the size of wutong seeds. Take 20 pills three times daily. Alternatively, prepare as powder; take 1 cun bi (approx. 5-10 grams) with wine, three times daily. Repeat preparation until cured, then discontinue. Avoid pork and Eruyi (Coriandrum sativum).
(The Gualou Fen San (Trichosanthes Powder) from *Qianjin Fang* is a secret prescription for treating Xiao Ke.)