病源夫消渴者。渴而不小便是也。由少服五石诸丸散积久经年。石势结于肾中。使人下
焦虚热。及至年衰血气减少。不能制于石。石势独盛。则肾为之燥。故引水而不小便也。其
病变者。多发痈疽。此坐热气留于经络。经络不利。血气壅涩。故成痈脓也。诊其脉数大者
生。细小浮者死。又沉小者生。实牢大者死。有病口甘者名为何。何以得之。此五气之溢也。
名曰脾瘅。夫五味入于口。藏于胃。脾为之行其精气。溢在于脾。令人口甘。此肥美之所发
也。此人必数食甘美而多肥。肥令人内热。甘者令人中满。故其气上溢为消渴也。厥阴之为
病消渴。气上冲。心中疼热。饥不欲食。甚者则欲吐下之不肯止。养生法云∶人睡卧勿张口。
久成消渴及失血也。赤松子云∶卧闭目不息十二通。治饮食不消。其汤熨针石。别有正方。
补养宣导。今附于后。法云∶解衣 卧。伸腰 少腹。五息止。引肾。去消渴。利阴阳。解
衣者使无挂碍。 卧者无外想。使气易行。伸腰者使肾无逼蹙。 者大努。使气满少腹者。
摄腹牵气。使五息即止之。引肾者引水来咽喉。润上部。去消渴枯槁病。利阴阳者。饶气力
也。（出第五卷通按后条古人喜石宜消渴今服石者少何有此症缘酒多令中 三焦热脏腑燥亦
致消渴不必皆由服石也。但治法颇同）千金论曰∶夫消渴者。凡积久饮酒。无有不成消渴病
者。然则大寒凝海而酒不冻。明其酒性酷热。物无以加。脯炙盐咸。此味酒客多嗜。不离其
口。三觞之后。制不由己。饮啖无度。咀嚼 酱。不择酸咸。积年长夜。酣典不懈。遂使三
焦猛热。五脏干燥。木石犹且焦枯。在人何能不渴。疗之愈否。属在病者。若能如方节慎。
旬月而瘳。不自爱惜。死不旋踵。方书医药。实多有效。其如不慎者何。其所慎者有三。一
饮酒。二房室。三咸食及面。能慎此者。虽不服药。而自可无他。不知此者。纵有金丹。亦
不
可救。深思慎之。深思慎之。凡消渴之人。愈与未愈。常须虑患大痈。何者。消渴之人。必
于大骨节间。忽发痈疽而卒。所以戒在大痈也。当预备痈药以防之。宜服麦门冬丸。除肠胃
热。实兼消渴方。
麦门冬（八分去心） 茯苓（八分坚白者） 黄连（八分） 石膏（八分碎） 葳蕤（八
分） 人
参（六分） 龙胆（六分） 黄芩（六分） 升麻（四分） 栝蒌（十分） 枳实（五分炙）
生姜屑
（十分） 地骨皮（六分） 茅根（切一升） 粟米（三合）
上十五味以水六升。煮茅根及粟米令烂。余十三味捣末。蜜和丸如梧子。以前茅根粟米
汁作饮。服十丸。日二。若渴则与此饮至足。大麻亦得。忌猪肉酢物。
又栝蒌汤方。
栝蒌（五两切） 麦门冬（汁三升） 生姜（五两切） 茅根（切三升） 芦根（切二
升）
上五味。以水一斗。煮取三升。分为三服。忌如药法。
又胃腑实热。引饮常渴。茯苓汤。泄热止渴方。
茯苓（五两一作茯神） 栝蒌（五两） 知母（四两） 小麦（二升） 麦门冬（五两
去心）
大枣（二十枚去核） 生地黄（六两） 葳蕤（四两） 淡竹叶（三升）
上九味切。以水三斗。先煮小麦竹叶。取九升。去滓。纳诸药。煮取四升。分四服。不
问早晚。随渴即进。非但正治胃渴。通治渴病。热即服之。忌芜荑酢物。
又猪肚丸。疗消渴方。
猪肚（一枚治如食法） 黄连（五两去毛） 栝蒌（四两） 麦门冬（四两去心） 知
母（四两）
茯
上七味捣为散。纳肚中。线缝。安置甑中蒸之极烂熟。接热及药。木臼中捣。可堪丸。
若硬加少蜜和丸如梧子。饮汁下三十丸。日再服。渐加至四五十丸。渴即服之。（翼同）
又栝蒌散方。
栝蒌（八分） 麦门冬（六分去心） 甘草（六分炙） 铅丹（八分）
上四味捣为散。以浆水服方寸匕。日三服。忌海藻菘菜。（一方有茯苓六分）
又黄 汤方。
黄 （三两） 茯神（三两） 栝蒌（三两） 甘草（三两炙） 麦门冬（三两去心） 干
地黄（
五两）
上六味切。以水八升。煮取二升半。分三服。忌芜荑酢物海藻菘菜。日进一剂。服十剂
讫。服丸药。后肾消门中宣补丸是。
又方
取七家井索近桶口结处烧作灰。
上一味。以井华水服之。不过三服。
又方
饮豉汁任性多少。瘥止。
又方
浓煮竹根汁饮之。取瘥止。（肘后同）
又方
煮青粱米汁饮之。瘥止。（肘后同）
又消渴阴脉绝。胃反吐食方。
茯苓（八两） 泽泻（四两） 白术（三两） 生姜（三两） 桂心（三两） 甘草（一
两炙）
上六味切。以水一斗煮小麦三升。取五升。去滓。纳茯苓等煮取二升半。一服八合。
日再。（翼同）
又方
取屋上瓦三十年者。破如雀头三大升。以东流水两石。煮取二斗。
干地黄（八两） 生姜（八两） 橘皮（三两） 甘草（三两炙） 人参（三两） 黄
（三两）
桂心（二两） 远志（三两去心） 当归（二两） 芍药（二两） 大枣（二十枚擘） 白
术（八两）
上十二味切。纳瓦汁中。煮取三升。分温四服。单瓦汁亦佳。（一方无甘草）
又疗热病后虚热渴。四肢烦疼方。
葛根（一斤） 人参（一两） 甘草（一两炙） 竹叶（一把）
上四味切。以水一斗五升。煮取五升。渴则饮一升。日三夜二。忌海藻菘菜。
又虚热渴无不效。填骨煎方。
茯苓（三两） 菟丝子（三两） 山茱萸（三两） 当归（三两） 大豆黄卷（一升） 石
苇（二
两去毛） 牛膝（三两） 巴戟天（三两） 麦门冬（三两去心） 天门冬（五两去心） 五
味子（三
两） 人参（二两） 远志（三两去心） 桂心（二两） 附子（二两炮） 石斛（三两）
上十六味先捣筛。别取生地黄十斤。生栝蒌十斤。舂绞取汁。于火上煎之减半。便作数
分纳药。并下白蜜二升。牛髓一升。微火煎之。令如糜。食如鸡子黄大。日三。亦可饮服之
佳。
忌酢物鲤鱼生葱猪肉冷水。（一方有肉苁蓉四两）
又方
桃胶如弹丸。含之咽津。甚佳。（本方疗渴小便利复非淋）
又方
蜡如鸡子大。酢一升煮两沸。适寒温。顿服之。（本方疗渴小便利复非淋通按小便利而
且长不比淋症之滴沥也故曰复非淋）
又方
水和栝蒌散服方寸匕。亦可蜜丸如梧子。服三十丸。
日再服。无所忌。（并出第二十一卷中）
[Background Information]
Book: Waitai Miyao (Essential Prescriptions Worth a Thousand Gold for Emergencies)
Author: Wang Tao
Dynasty: Tang Dynasty, Tianbao 11th Year
Chapter: Seventeen Formulas for Xiao Ke (Wasting-Thirst)
Category: Formulas
[Disease Etiology]
The source of the disease: Xiao Ke (Wasting-Thirst), characterized by excessive thirst and difficulty in urination, arises from the long-term consumption of "Five-Stone" pills and powders. Over years, the mineral nature of these stones accumulates in the Kidney, causing deficiency-heat in the Lower Jiao (Lower Burner). As one ages and Qi and Blood diminish, they can no longer control the mineral pathogenic factor. The mineral pathogen becomes dominant, drying out the Kidney. Consequently, the patient drinks water but cannot urinate properly. If the condition worsens, it often leads to carbuncles and sores. This is due to heat pathogens lingering in the meridians, obstructing their flow, causing stagnation and涩 (stasis) of Qi and Blood, resulting in pus formation. Prognosis based on pulse: A rapid and large pulse indicates survival; a fine, small, and floating pulse indicates death. A deep and small pulse indicates survival; a firm, hard, and large pulse indicates death.
A patient with a sweet taste in the mouth: What is this disease called? How does it occur? It is caused by the overflow of essence from the Five Zang organs, named Pi Dan (Spleen Heat/Delirium). When the five flavors enter the mouth, they are stored in the Stomach, and the Spleen transports their essence. If essence overflows into the Spleen, it causes a sweet taste. This disease originates from rich and fatty foods. Such individuals likely consume abundant sweet and fatty foods regularly. Fatty foods generate internal heat, while sweet foods cause fullness in the Middle Jiao. Thus, Qi overflows upward, developing into Xiao Ke.
Diseases of the Jueyin Meridian manifest as Xiao Ke, with symptoms including Qi rushing upward, pain and burning heat in the heart, hunger without desire to eat, and severe cases may involve vomiting. Purging methods will not stop diarrhea. Health preservation texts state: Do not sleep with your mouth open; doing so for a long time leads to Xiao Ke and blood loss. Chisongzi stated: Lying down with closed eyes and regulating breath twelve times treats indigestion. Methods such as hot compresses, acupuncture, and stone therapy have separate specific formulas. Nourishing and Daoyin (guiding and pulling) exercises are attached below. The method states: Undress and lie supine, extend the waist, and strain the lower abdomen for five breaths, then stop. This guides Kidney Qi, removes Xiao Ke, and benefits Yin and Yang. Undressing ensures no obstruction; lying supine eliminates external distractions, facilitating Qi movement; extending the waist prevents compression of the Kidney; straining the abdomen fills the lower abdomen with Qi; drawing Qi involves contracting the abdomen to guide Qi. Stop after five breaths. Guiding the Kidney brings fluids to the throat, moistening the upper body and removing dryness from Xiao Ke. Benefiting Yin and Yang increases physical strength. (From Volume 5, General Notes: Ancient people liked taking mineral stones, prone to Xiao Ke. Few take stones now, yet the disease persists because excessive alcohol causes heat in the Middle Jiao/San Jiao and dryness in Zang-Fu organs, leading to Xiao Ke, not just from stones. Treatment methods are similar.)
Qianjin Fang discusses: Long-term alcohol consumption invariably leads to Xiao Ke. Although seawater freezes in extreme cold, wine does not, proving wine's intense heat nature. Dried meats, roasted foods, and salty foods are favored by drinkers. After three cups, self-control is lost, leading to unregulated eating and drinking, chewing sauces, ignoring sour or salty preferences, year-round heavy drinking. This causes fierce heat in the San Jiao and dryness in the Five Zang. Even wood and stone would scorch; how much more so the human body? Recovery depends on the patient. If disciplined according to the formula, recovery occurs within weeks. Without self-care, death follows swiftly. Medical texts offer effective remedies, but what of the undisciplined? Three things must be avoided: alcohol, sexual activity, and salty/flour foods. Avoiding these ensures health even without medicine. Ignoring this renders even golden elixirs useless. Reflect deeply, be cautious!
Xiao Ke patients, whether recovering or not, must fear large carbuncles. Why? They often develop sudden carbuncles at major bone joints, leading to sudden death. Prevention is key. Prepare carbuncle medicines. Maimendong Wan is suitable to clear intestinal heat and treat Xiao Ke.
Maidong (Cistanche/Maidong - *Note: Text says Maidong*, Ophiopogonis Radix) (8 fen, remove heart) Fuling (Poria) (8 fen, firm and white) Huanglian (Coptidis Rhizoma) (8 fen) Shigao (Gypsum Fibrosum) (8 fen, crushed) Weirui (Polygonati Odorati Rhizoma) (8 fen) Renshen (Ginseng Radix et Rhizoma) (6 fen) Longdan (Gentianae Radix) (6 fen) Huangqin (Scutellariae Radix) (6 fen) Shengma (Cimicifugae Rhizoma) (4 fen) Gualou (Trichosanthis Fructus) (10 fen) Zhishi (Aurantii Fructus Immaturus) (5 fen, processed) Shengjiang (Zingiberis Rhizoma Recens) (10 fen, minced) Digupi (Lycii Cortex) (6 fen) Maogen (Imperatae Rhizoma) (cut, 1 sheng) Sumi (Setariae Italicae Semen) (3 he)
Boil Maogen and Sumi in 6 sheng of water until soft. Pound the remaining 13 herbs into powder. Mix with honey to make pills the size of wu zi (loquat seeds). Take 10 pills twice daily with the decoction of Maogen and Sumi. Drink more if thirsty. Hemp seeds may substitute. Avoid pork and vinegar.
Another Formula: Gualou Decoction
Gualou (5 liang, sliced) Maidong (Juice, 3 sheng) Shengjiang (5 liang, sliced) Maogen (cut, 3 sheng) Lugeng (Phragmitis Rhizoma) (cut, 2 sheng)
Boil 5 herbs in 1 dou of water to obtain 3 sheng. Divide into 3 doses. Avoidances same as above.
For Stomach Fu excess heat causing constant thirst, use Fuling Decoction to drain heat and relieve thirst.
Fuling (5 liang, or Fushen) Gualou (5 liang) Zhimu (Anemarrhenae Rhizoma) (4 liang) Xiaomai (Tritici Levis Fructus) (2 sheng) Maidong (5 liang, remove heart) Dazao (Jujubae Fructus) (20 pieces, pitted) Shengdihuang (Rehmanniae Radix) (6 liang) Weirui (4 liang) Danzhuye (Lophatheri Folium) (3 sheng)
Cut 9 herbs. Boil Xiaomai and Danzhuye in 3 dou of water to get 9 sheng. Strain, add other herbs, boil to 4 sheng. Divide into 4 doses. Take whenever thirsty. Treats stomach thirst and general thirst diseases with heat. Avoid Yuanqi and vinegar.
Another: Pig Stomach Pills for Xiao Ke.
Zhudu (Pig Stomach, 1 piece, cleaned) Huanglian (5 liang, remove hairs) Gualou (4 liang) Maidong (4 liang, remove heart) Zhimu (4 liang)
Pound 7 herbs into powder. Place inside pig stomach, sew shut, steam in a steamer until very soft. While hot, pound in a wooden mortar. If too hard, add honey to form pills. Take 30 pills with juice, twice daily. Gradually increase to 40-50 pills. Take when thirsty. (*Yi* version same).
Another: Gualou Powder
Gualou (8 fen) Maidong (6 fen, remove heart) Gancao (Licorice Root) (6 fen, processed) Qiandan (Mineral Lead) (8 fen)
Pound 4 herbs into powder. Take 1 cun bi with Jiangshui (fermented grain liquid) three times daily. Avoid Haizao and Songcai. (One version adds Fuling 6 fen).
Another: Huangqi Decoction
Huangqi (Astragali Radix) (3 liang) Fushen (Poria with Hostwood) (3 liang) Gualou (3 liang) Gancao (3 liang, processed) Maidong (3 liang, remove heart) Dihuang (Rehmanniae Radix Preparata) (5 liang)
Cut 6 herbs. Boil in 8 sheng water to get 2.5 sheng. Divide into 3 doses. Avoid Yuanqi, vinegar, Haizao, Songcai. One dose daily. After 10 doses, take pills (see Kidney Xiao section for Xuanbu Wan).
Another Formula:
Burn the knotted part near the bucket opening of well ropes from seven households to ash.
Take 1 ingredient with morning well water. Not exceeding 3 doses.
Another Formula:
Drink Douzhi (Fermented Soybean Juice) freely until cured.
Another Formula:
Drink thick Zhu Gen (Bamboo Root) juice until cured. (*Zhoubao* same).
Another Formula:
Drink Qingliangmi (Green Millet) juice until cured. (*Zhoubao* same).
Another for Xiao Ke with Yin pulse exhaustion and stomach reversal vomiting:
Fuling (8 liang) Zexie (Alismatis Rhizoma) (4 liang) Baizhu (Atractylodis Macrocephalae Rhizoma) (3 liang) Shengjiang (3 liang) Guixin (Cinnamomi Ramulus) (3 liang) Gancao (1 liang, processed)
Cut 6 herbs. Boil 3 sheng Xiaomai in 1 dou water to get 5 sheng. Strain, add Fuling etc., boil to 2.5 sheng. Take 8 ge per dose, twice daily. (*Yi* same).
Another Formula:
Use roof tiles aged 30 years, broken like sparrow heads, 3 da sheng. Boil in 2 shi of East-flowing water to get 2 dou.
Dihuang (8 liang) Shengjiang (8 liang) Ju pi (Citri Reticulatae Pericarpium) (3 liang) Gancao (3 liang, processed) Renshen (3 liang) Huangqi (3 liang) Guixin (2 liang) Yuanzhi (Polygalae Radix) (3 liang, remove heart) Danggui (Angelicae Sinensis Radix) (2 liang) Shaoyao (Paeoniae Radix Alba) (2 liang) Dazao (20 pieces, split) Baizhu (8 liang)
Cut 12 herbs. Add to tile water, boil to 3 sheng. Divide into 4 warm doses. Tile water alone is also good. (One version lacks Gancao).
Another for post-febrile deficiency heat thirst and limb pain:
Gegen (Puerariae Lobatae Radix) (1 jin) Renshen (1 liang) Gancao (1 liang, processed) Zhuye (Bambusae Folium) (1 bunch)
Cut 4 herbs. Boil in 1.5 dou water to get 5 sheng. Drink 1 sheng when thirsty, 3 times day, 2 times night. Avoid Haizao and Songcai.
Another for deficiency heat thirst, Tangu Jian (Bone-Filling Decoction):
Fuling (3 liang) Tusizi (Cuscutae Semen) (3 liang) Shanzhuyu (Corni Fructus) (3 liang) Danggui (3 liang) Dadou Huangjuan (Sojae Semen Praeparatum) (1 sheng) Shiwei (Pyri Folium) (2 liang, remove hairs) Niuxi (Achyranthis Bidentatae Radix) (3 liang) Bajitian (Morindae Officinalis Radix) (3 liang) Maidong (3 liang, remove heart) Tiandong (Asparagi Radix) (5 liang, remove heart) Wuweizi (Schisandrae Chinensis Fructus) (3 liang) Renshen (2 liang) Yuanzhi (3 liang, remove heart) Guixin (2 liang) Fuzi (Aconiti Lateralis Radix Preparata) (2 liang, processed) Shihu (Dendrobii Caulis) (3 liang)
Pound 16 herbs. Separate: Take 10 jin fresh Dihuang and 10 jin fresh Gualou, crush and extract juice. Boil juice on fire until halved. Add herb powders in portions, plus 2 sheng white honey and 1 sheng beef marrow. Simmer gently until porridge-like. Eat size of chicken egg yolk, 3 times daily. Can also dissolve and drink.
Avoid vinegar, carp, raw green onion, pork, cold water. (One version adds Roucongrong 4 liang).
Another Formula:
Tao jiao (Peach Gum) like a pellet, hold in mouth and swallow saliva. Very good. (Treats thirst with normal urination, not strangury).
Another Formula:
Beeswax size of an egg, boil with 1 sheng vinegar for two boils. Take when warm. (Treats thirst with normal urination, not strangury. Note: Urination is continuous, not dribbling like strangury).
Another Formula:
Take Gualou Powder with water, 1 cun bi. Or make honey pills, size of wu zi, take 30 pills, twice daily. No restrictions. (All from Volume 21).