消渴之脉。数大者活。虚小病深厄难脱。
夫消渴者。由壮盛之时。不自保养。任情纵欲。饮酒无度。喜食脍炙。或服丹
石。遂使肾水枯竭。心火大燔炽。三焦猛烈。五脏干燥。由是渴利生焉。心烦口渴。燥
强中。二症皆消渴也。多渴而利。燥渴者。由热中所作。但饮食皆作小便。自利而渴。令人
虚极短气。强中者。阳具不交。而精液自出。凡消渴之人。常防患痈疽。所怕者。一饮酒。
二房劳。咸食及面。俱宜忌之。大抵脉大者。易治。细小者。难医也。
一论消渴。引饮无度。脉实是也。
黄连 麦冬 牛乳 生地黄汁 生藕汁（各等分）
上二味熬汁去渣。入和牛乳二汁。佐姜和蜜为膏。徐徐于舌上。以白汤些少送下。或将
前二味药和汁为丸。如梧桐子大。每服五十丸。白汤送下。一日进十次。
一论治三消总治之方。服之立愈。
人参 白术（去芦） 白茯苓（去皮） 当归（酒洗） 生地黄（各一钱） 黄柏（酒炒） 知
母黄连 麦门冬（去心） 天花粉 黄芩（各八分） 桔梗（五分） 甘草（二分）
上锉一剂。水煎服。
天池膏 治三消如神。
天花粉 黄连（各半斤） 人参 知母（去壳） 白术（炒去芦各四两） 五味子（三两）
麦门
冬（六两去心） 藕汁（二碗） 怀生地黄汁（二碗） 人乳 牛乳（各一碗） 生姜汁（二酒
杯）
上先将天花粉七味切片。用米泔水十六碗。入砂锅内浸半日。用桑柴火慢熬。至五六碗
滤清。又将渣捣烂。以水五碗煎至二碗。同前汁又煎二三碗。入生地等汁。慢熬如饧。加白
蜜一斤。煎去沫。又熬如膏。乃收入瓷罐内。用水浸三日。去火毒。每用二三匙。安舌咽之
或用白汤送下。
一论消渴。口干心烦。用天花粉长流水煎。当茶服之。立效。
一论治三消渴神效。用缫丝汤。如无缫丝汤。却以原蚕茧壳丝绵煎汤。皆可代之。不时
饮之。极效。盖此物属火。有阴之用。大能泻膀胱中伏火。引阴水上潮于口而不渴也。
一论阴虚火盛。烦渴。引饮无度。
养血清火汤
当归（一钱） 川芎（八分） 白芍（酒炒一钱） 生地黄（酒炒一钱） 麦冬（一钱） 石莲
肉（五
分） 天花粉（七分） 知母（一钱） 黄连（八分） 薄荷（五分） 乌梅肉（五分） 黄柏（
蜜水炒五分） 甘草（五分）
上锉。水煎。温服。
一治消渴病通用。
生地黄膏
生地黄束如碗大一把。洗切研细。以新水一碗调开。用冬蜜一碗。煎至半。取出。入人
参五钱。白茯苓去皮一两。为末。拌和。瓷器密收。以匙挑服。夏月可加五味子、麦门冬。
一治消渴。
玉泉丸
人参 黄 （半生半蜜炙） 白茯苓 干姜 麦冬 乌梅肉 甘草（各一两） 天花粉（
一两五钱）
上为细末。炼蜜为丸。如弹子大。每服一丸。温汤嚼下。
一人消渴。引饮无度。或令食韭苗。或炒或作羹。无入盐。日二三次。其渴遂止。
一人消中。日夜尿七八升者。鹿角烧令焦为末。以酒调服五分。日三次。渐加至方寸匕
一治消渴。
天花散
天花粉（一两） 生地黄（一两） 麦门冬（五钱） 五味子（三钱） 葛粉（五分） 甘草（五
钱）
上锉。糯米一撮。水煎服。
一论肾水枯竭。不能运上。作消渴。恐生痈疽。
参 救元汤
黄 （蜜炒） 人参 粉草（炙） 麦门冬（去心） 五味子
上锉。水煎。入朱砂少许。不拘时服。
一论一常人平日口干作渴。因饮酒食炙爆。补剂房劳。凡若此类过多。致令肾水枯竭。
不能
上制心火。故有此症。后必有疽发也。宜先服此。以绝其源。及痈疽发后服此。尤有益也。
八味丸
怀生地黄（酒浸瓦焙干二两） 山药（一两） 牡丹皮（八钱） 泽泻（酒浸焙干八钱） 山茱
萸（去核焙一两） 肉桂（五钱） 白茯苓（去皮八钱） 五味（微焙一两五钱）
上为细末。炼蜜为丸。如梧子大。每服五六十丸。五更时。淡盐汤送下。温酒亦可。
一论心肾不交。消渴引饮。有人病渴用渴药。累年不愈。用加减八味丸而愈。其疾本以
肾水枯竭。不能制火。心火上炎。是以生渴。此药降心火。生肾水。
一人不时发热。日饮冷水数碗。寒药二剂。热渴益甚。形体日瘦。尺脉洪大而数。时或
无力
王太仆曰。热之不热。责其无火。寒之不寒。责其无水。又云。倏热往来。是无火也。时
作时止。是无水也。法当补肾。用加减八味丸。不月而愈。
一治肾水不足。虚火上炎。发热作渴。口舌生疮。或牙龈溃蚀。咽喉作痛。或形体憔悴
寝汗发热。五脏齐损。以六味丸加肉桂一两。五味子四两。
一人形体魁伟。冬日饮水。自喜壮实。余曰。此阴虚也。不信。一日。口舌生疮。或用
寒凉之剂。肢体倦怠。发热恶寒。以六味丸、补中益气汤而愈。
一晡热内热。不时而热。作渴痰唾。小便频数。而口舌生疮者。此下焦阴火也。以六味
丸效。
The pulse of Xiao Ke (Wasting and Thirsting Syndrome) that is rapid and large indicates a favorable prognosis; one that is deficient and small indicates deep-seated disease, which is difficult to cure.
Xiao Ke arises from failing to maintain health during youth and vigor, indulging in desires, drinking excessively, preferring rich and greasy foods, or taking cinnabar and stone minerals. This leads to the depletion of Kidney Water, blazing of Heart Fire, intense heat in the San Jiao (Triple Burner), and dryness of the Five Zang Organs, thereby generating Xiao Ke. Symptoms include mental restlessness, thirst, and Qiang Zhong (priapism with spontaneous seminal emission). Both excessive thirst with polyuria and internal dryness with Qiang Zhong fall under the category of Xiao Ke. Excessive thirst and polyuria result from heat in the Middle Jiao, where ingested food and drink are quickly converted into urine, causing extreme deficiency and shortness of breath. Qiang Zhong refers to erections without sexual intercourse accompanied by spontaneous seminal emission. Patients with Xiao Ke must constantly guard against carbuncles and sores. They should avoid two things: alcohol and sexual exhaustion. Salty foods and wheat products should also be avoided. Generally, a large pulse is easier to treat, while a fine and small pulse is difficult to manage.
One discussion addresses Xiao Ke characterized by uncontrolled drinking and a solid pulse, indicating excess syndrome.
Formula: Huanglian (Coptidis Rhizoma), Maidong (Ophiopogonis Radix), Niu Nai (Cow's Milk), Sheng Dihuang Zhi (Fresh Rehmanniae Radix Juice), Sheng Ou Zhi (Fresh Lotus Rhizome Juice) in equal parts.
Boil these ingredients to extract the juice, remove the dregs, add the Cow's Milk and the two juices, mix with Ginger Juice and Honey, and boil into a paste. Slowly hold it on the tongue and swallow with a little warm water. Alternatively, mix the first two herbs (Huanglian, Maidong) with their juices to form pills the size of Sophora seeds. Take 50 pills each time with warm water, ten times a day.
One discussion presents a general formula for treating the Three Xiao (Upper, Middle, and Lower Wasting-Thirst), which brings immediate relief upon ingestion.
Formula: Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizomatized), Baifuling (Poria, peeled), Danggui (Angelicae Sinensis Radix, wine-washed), Sheng Dihuang (Rehmanniae Radix, each 1 qian); Huangbai (Phellodendri Cortex, wine-fried), Zhimu (Anemarrhenae Rhizoma), Huanglian (Coptidis Rhizoma), Maimendong (Ophiopogonis Radix, heart removed), Tianhuafen (Trichosanthis Radix), Huangqin (Scutellariae Radix, each 8 fen); Jiegeng (Platycodonis Radix, 5 fen); Gancao (Licorice Radix et Rhizoma, 2 fen).
Crush these ingredients into one dose, decoct in water, and take orally.
Tian Chi Gao (Heavenly Pool Paste) treats the Three Xiao with miraculous efficacy.
Formula: Tianhuafen (Trichosanthis Radix), Huanglian (Coptidis Rhizoma) (each half jin); Renshen (Ginseng Radix et Rhizoma), Zhimu (Anemarrhenae Rhizoma, shell removed), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried and de-rhizomatized, each 4 liang); Wuweizi (Schisandrae Fructus, 3 liang); Maimendong (Ophiopogonis Radix, 6 liang, heart removed); Ou Zhi (Lotus Rhizome Juice, 2 bowls); Huai Sheng Dihuang Zhi (Fresh Rehmanniae Radix Juice from Huai region, 2 bowls); Ren Nai (Human Milk), Niu Nai (Cow's Milk) (each 1 bowl); Shengjiang Zhi (Ginger Juice, 2 wine cups).
First, slice the seven ingredients including Tianhuafen. Soak them in 16 bowls of rice washing water in a clay pot for half a day. Simmer slowly over mulberry wood fire until reduced to 5-6 bowls, then filter to clear the liquid. Pound the dregs thoroughly, add 5 bowls of water, boil down to 2 bowls, and combine with the previous liquid to boil again until reduced to 2-3 bowls. Add the juices of Sheng Dihuang etc., simmer slowly until thick like maltose syrup. Add 1 jin of white honey, skim off foam, and boil into a paste. Store in a porcelain jar, soak in water for three days to remove "fire toxicity." Take 2-3 spoons at a time, place on the tongue to swallow, or take with warm water.
One discussion states that for Xiao Ke with dry mouth and mental restlessness, decoct Tianhuafen (Trichosanthis Radix) with running water and drink it as tea for immediate effect.
One discussion claims that Silk Reeling Soup (Sao Si Tang) is highly effective for treating the Three Xiao. If unavailable, decoct raw silkworm cocoons or silk wadding as a substitute. Drink frequently for excellent results. This substance possesses fire nature but yin function, effectively draining latent fire in the Bladder and guiding Yin fluids upward to moisten the mouth, relieving thirst.
One discussion addresses Yin deficiency with flourishing Fire, causing irritability, thirst, and uncontrolled drinking.
Formula: Yang Xue Qing Huo Tang (Nourish Blood and Clear Fire Decoction)
Danggui (Angelicae Sinensis Radix, 1 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 8 fen), Baishao (Paeoniae Radix Alba, wine-fried, 1 qian), Sheng Dihuang (Rehmanniae Radix, wine-fried, 1 qian), Maidong (Ophiopogonis Radix, 1 qian), Shilianrou (Nelumbinis Plumula, 5 fen), Tianhuafen (Trichosanthis Radix, 7 fen), Zhimu (Anemarrhenae Rhizoma, 1 qian), Huanglian (Coptidis Rhizoma, 8 fen), Bohe (Menthae Haplocalycis Herba, 5 fen), Wumei Rou (Mume Fructus pulp, 5 fen), Huangbai (Phellodendri Cortex, honey-water fried, 5 fen), Gancao (Licorice Radix et Rhizoma, 5 fen).
Crush the ingredients, decoct in water, and take warm.
A general treatment for Xiao Ke:
Formula: Sheng Dihuang Gao (Fresh Rehmannia Paste)
Take a handful of fresh Sheng Dihuang (Rehmanniae Radix) bundled like a bowl, wash, cut, and grind finely. Mix with one bowl of fresh water. Add one bowl of winter honey, boil until reduced by half, then remove from heat. Add 5 qian of Renshen (Ginseng Radix et Rhizoma) and 1 liang of Baifuling (Poria, peeled), grind into powder, mix well, and store in a sealed porcelain container. Take with a spoon. In summer, add Wuweizi (Schisandrae Fructus) and Maimendong (Ophiopogonis Radix).
Another treatment for Xiao Ke:
Formula: Yu Quan Wan (Jade Spring Pill)
Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix, half raw half honey-fried), Baifuling (Poria, peeled), Ganjiang (Zingiberis Rhizoma), Maidong (Ophiopogonis Radix), Wumei Rou (Mume Fructus pulp), Gancao (Licorice Radix et Rhizoma) (each 1 liang); Tianhuafen (Trichosanthis Radix, 1.5 liang).
Grind into fine powder, bind with refined honey into pills the size of quail eggs. Take one pill at a time, chew with warm water.
Case: A patient with Xiao Ke drank excessively. Advised to eat leek shoots, either stir-fried or made into soup without salt, two to three times daily, which stopped the thirst.
Case: A patient with Xiao Zhong (Middle Wasting-Thirst) urinated 7-8 sheng per day. Calcined deer horn to ash, powdered it, and took 5 fen mixed with wine, three times daily, gradually increasing to the volume of a square inch scoop.
Another treatment for Xiao Ke:
Formula: Tian Hua San (Trichosanthes Powder)
Tianhuafen (Trichosanthis Radix, 1 liang), Sheng Dihuang (Rehmanniae Radix, 1 liang), Maimendong (Ophiopogonis Radix, 5 qian), Wuweizi (Schisandrae Fructus, 3 qian), Ge Fen (Puerariae Radix starch, 5 fen), Gancao (Licorice Radix et Rhizoma, 5 qian).
Crush the ingredients, add a pinch of glutinous rice, decoct in water, and take orally.
One discussion addresses Xiao Ke caused by Kidney Water depletion failing to ascend, fearing the development of carbuncles.
Formula: Shen Jiu Yuan Tang (Ginseng Restoring Origin Decoction)
Huangqi (Astragali Radix, honey-fried), Renshen (Ginseng Radix et Rhizoma), Fen Cao (Licorice Radix et Rhizoma, roasted), Maimendong (Ophiopogonis Radix, heart removed), Wuweizi (Schisandrae Fructus).
Crush the ingredients, decoct in water, add a small amount of Cinnabar (Zhusha), and take at any time.
One discussion notes that ordinary people often suffer from dry mouth and thirst due to alcohol consumption, roasted/fried foods, tonics, and sexual excess. This depletes Kidney Water, failing to control Heart Fire, leading to this syndrome and subsequent carbuncles. Taking this formula beforehand prevents the source; taking it after carbuncles appear is even more beneficial.
Formula: Ba Wei Wan (Eight-Ingredient Pill)
Huai Sheng Dihuang (Rehmanniae Radix, wine-soaked and baked on tile, 2 liang), Shanyao (Dioscoreae Rhizoma, 1 liang), Mudanpi (Moutan Cortex, 8 qian), Zexie (Alisma Rhizoma, wine-soaked and baked, 8 qian), Shanzhuyu (Corni Fructus, pitted and baked, 1 liang), Rougui (Cinnamomi Cortex, 5 qian), Baifuling (Poria, peeled, 8 qian), Wuweizi (Schisandrae Fructus, lightly baked, 1.5 liang).
Grind into fine powder, bind with refined honey into pills the size of Sophora seeds. Take 50-60 pills at dawn with light salt water, or warm wine.
One discussion addresses Heart-Kidney non-interaction causing Xiao Ke with excessive drinking. A patient treated with standard thirst remedies for years failed to recover but was cured using Modified Ba Wei Wan. The root cause was Kidney Water depletion failing to control Fire, causing Heart Fire to flare upward. This formula lowers Heart Fire and generates Kidney Water.
Case: A patient experienced intermittent fever, drinking several bowls of cold water daily. After taking two doses of cold-natured medicines, the fever and thirst worsened, and the body emaciated. The Chi (Cun-Guan-Chi) pulse was surging, large, and rapid, sometimes weak.
Wang Tai Pu stated: "If heating does not produce warmth, blame the lack of Fire (Kidney Yang); if cooling does not stop cold, blame the lack of Water (Kidney Yin)." He further said: "Sudden alternating hot and cold indicates lack of Fire; intermittent symptoms indicate lack of Water." The method is to tonify the Kidney using Modified Ba Wei Wan, resulting in recovery within a month.
Treatment for insufficient Kidney Water with defluxion of Deficiency Fire, causing fever, thirst, mouth/tongue ulcers, gum erosion, sore throat, emaciation, night sweats, and damage to all Five Zang Organs: Use Liu Wei Wan (Six-Ingredient Pill) plus 1 liang of Rougui (Cinnamomi Cortex) and 4 liang of Wuweizi (Schisandrae Fructus).
Case: A robust man drank water in winter, believing himself strong. I diagnosed him with Yin deficiency. He disagreed. Later, he developed mouth ulcers, used cold-natured drugs, became lethargic, and suffered fever and aversion to cold. He recovered using Liu Wei Wan (Six-Ingredient Pill) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
Afternoon fever, internal heat, intermittent fever, thirst with phlegm saliva, frequent urination, and mouth/tongue ulcers indicate Lower Jiao Deficient Fire. Liu Wei Wan (Six-Ingredient Pill) is effective.