某 渴而溲赤，肺消之渐也。
煨石膏 元参 冬瓜子 空沙参 地骨皮 活水芦根
王（左） 消渴虽减于前，而肌肉仍然消瘦，舌干少津，溲多混浊。脉象沉细。水亏之极，损及命火，以致不
能蒸化清津上升。汤药气浮，难及病所，宜以丸药入下。
附桂八味丸（每服三钱淡盐汤送下上下午各一服）
杨（左） 膏淋之后，湿热未清，口渴溲浑酸浊，为肾消重症。
天花粉（二钱） 川萆 （二钱） 蛇床子（一钱五分） 川石斛（四钱） 秋石（三分） 天麦冬（各一钱
五分） 覆盆子（二钱） 海金砂（二钱） 炙内金（一钱五分入煎） 川连（二分）
再诊 小溲稍清，口渴略减。再清下焦湿热。
寒水石（三钱） 淡竹叶（一钱五分） 海金砂（一钱五分） 赤白苓（各二钱） 泽泻（二钱） 龟甲心（五
钱） 炒黄柏（二钱） 车前子（三钱） 滑石（三钱） 大淡菜（两只）
三诊 脉症俱见起色。效方出入，再望转机。
海金砂（三钱） 秋石（二分） 滑石块（三钱） 茯苓神（各二钱） 龟甲心（五钱） 福泽泻（一钱五分）
车前子（三钱） 炒牛膝（三钱） 川柏片（一钱） 大淡菜（二只） 鲜藕汁（一杯冲）
左 频渴引饮溲多。湿热内蕴，清津被耗，为膈消重症。
煨石膏（四钱） 甜桔梗（一钱） 杏仁泥（三钱） 黑大豆（四钱） 黑山栀（一钱） 栝蒌皮（三钱）
川贝母（四钱） 炒竹茹（一钱） 枇杷叶（二片）
左 频渴引饮，溲多混浊，目昏不寐。此肺胃湿热熏蒸，将成膈消重症。
煨石膏（四钱） 栝蒌皮（三钱） 磁石（三钱） 黑山栀（三钱） 川贝母（二钱） 酸枣仁（二钱川连
二分拌炒） 茯苓（三钱） 黑大豆（四钱） 夜交藤（四钱） 淡竹叶（一钱）
左 频渴溲多。膈消重症，不能许治。
天花粉（三钱） 煨石膏（六钱） 淡天冬（二钱） 大麦冬（二钱） 川萆 （二钱） 肥知母（二钱）
云茯苓（四钱） 淡黄芩（一钱五分） 甜桔梗（三钱） 枇杷叶（去毛四片）
又 渴饮稍退。的是气火劫烁津液。消渴重症，还难许治。
煨石膏 肥知母 大麦冬 覆盆子 枇杷叶 淡天冬 天花粉 川楝子 甜桔梗
唐（左） 消渴略定。的属中焦之气火过盛，荣液亦为煎灼。药既应手，效方续进。
天花粉（一钱五分） 鲜生地（六钱） 川雅连（三分） 黑大豆（四钱） 肥知母（一钱五分） 茯神（三
钱） 甜桔梗（二钱） 枇杷叶（去毛四片）
又 小溲略少，再踵前法。
鲜生地 甜桔梗 川雅连 黑大豆 肥知母 茯神 炒松麦冬 天花粉 枇杷叶（去毛）
Patient [Surname Omitted] experiences thirst with red urine, indicating the onset of Fei Xiao (Lung Diabetes/Upper Jiao Diabetes).
Calcined Gypsum (Wei Shigao) Scrophulariae Radix (Yuan Shen) Benincasae Fructus Seed (Donggua Zi) Adenophorae Radix (Kong Shashen) Cortex Lycii (Digupi) Fresh Reed Rhizome (Huoshui Lugen)
Patient Wang (Left pulse): Although the symptoms of Xiao Ke (Diabetes Mellitus) have decreased compared to before, the muscles remain emaciated, the tongue is dry with little fluid, and urination is frequent and turbid. The pulse is deep and fine. This indicates extreme deficiency of Yin water, damaging the Mingmen Fire (Gate of Life Fire), resulting in the inability to vaporize and ascend clear fluids. Decoctions have floating qi and are difficult to reach the disease site; therefore, pills should be used for treatment from the lower body.
Fuzi Guiji Wan (Eight-Ingredient Pill with Aconite and Cinnamon Twig) (Take 3 qian each time, taken down with light salt water, once in the morning and once in the afternoon)
Patient Yang (Left pulse): After Gao Lin (Chyluria/Paste-like Urine), damp-heat has not been cleared. Thirst and turbid, sour-smelling urine indicate a severe case of Shen Xiao (Kidney Diabetes/Lower Jiao Diabetes).
Trichosanthis Radix (Tianhuafen, 2 qian) Dioscoreae Hypoglaucae Rhizoma (Chuan Bi, 2 qian) Cnidii Fruit (Shechuangzi, 1.5 qian) Dendrobii Caulis (Chuan Shihu, 4 qian) Autumn Stone (Qiushi, 0.3 qian) Asparagi Radix (Tian Dong) and Ophiopogonis Radix (Mai Dong) (each 1.5 qian) Rubi Fructus (Fupenzi, 2 qian) Descurainiae Semen (Haijinsha, 2 qian) Roasted Gall Bladder Membrane (Zhi Neijin, 1.5 qian, added to decoction) Coptidis Rhizoma (Chuan Lian, 0.2 qian)
Second visit: Urine is slightly clearer, thirst is slightly reduced. Continue to clear damp-heat from the Lower Jiao.
Natron Crystal (Hanshuishi, 3 qian) Light Bamboo Leaf (Dan Zhuye, 1.5 qian) Descurainiae Semen (Haijinsha, 1.5 qian) Red Poria (Chi Ling) and White Poria (Bai Ling) (each 2 qian) Alismatis Rhizoma (Zexie, 2 qian) Carapax et Plastrum Testudinis Heart (Guijiaxin, 5 qian) Stir-fried Phellodendri Cortex (Chao Huangbai, 2 qian) Plantaginis Semen (Cheqianzi, 3 qian) Talcum (Huashi, 3 qian) Large Mussel (Da Dancai, 2 pieces)
Third visit: Both pulse and symptoms show improvement. Adjust the effective prescription, hoping for further turnaround.
Descurainiae Semen (Haijinsha, 3 qian) Autumn Stone (Qiushi, 0.2 qian) Talcum Block (Huashi Kuai, 3 qian) Poria (Fuling) and Poria with Hostwood (Fushen) (each 2 qian) Carapax et Plastrum Testudinis Heart (Guijiaxin, 5 qian) Fuzhou Alismatis Rhizoma (Fu Zexie, 1.5 qian) Plantaginis Semen (Cheqianzi, 3 qian) Stir-fried Achyranthis Bidentatae Radix (Chao Niuxi, 3 qian) Phellodendri Cortex Slice (Chuan Baipian, 1 qian) Large Mussel (Da Dancai, 2 pieces) Fresh Lotus Root Juice (Xian Ou Zhi, 1 cup, mixed in)
Patient Zuo experiences frequent thirst with excessive drinking and frequent urination. Internal accumulation of damp-heat consumes clear fluids, constituting a severe case of Ge Xiao (Middle Jiao Diabetes/Diaphragm Diabetes).
Calcined Gypsum (Wei Shigao, 4 qian) Sweet Platycodon Root (Tian Jiegeng, 1 qian) Apricot Kernel Paste (Xingren Ni, 3 qian) Black Soybean (Hei Dadou, 4 qian) Gardenia Fruit (Hei Shanzhi, 1 qian) Trichosanthis Peel (Gualou Pi, 3 qian) Fritillariae Cirrhosae Bulb (Chuan Beimu, 4 qian) Stir-fried Bamboo Shavings (Chao Zhuru, 1 qian) Loquat Leaf (Pipaye, 2 leaves)
Patient Zuo experiences frequent thirst with excessive drinking, frequent turbid urine, blurred vision, and insomnia. This is due to damp-heat steaming in the Lung and Stomach, likely to develop into a severe case of Ge Xiao.
Calcined Gypsum (Wei Shigao, 4 qian) Trichosanthis Peel (Gualou Pi, 3 qian) Magnetitum (Cishi, 3 qian) Gardenia Fruit (Hei Shanzhi, 3 qian) Fritillariae Cirrhosae Bulb (Chuan Beimu, 2 qian) Ziziphus Seed (Suanzaoren, 2 qian, stir-fried with 0.2 qian Chuan Lian) Poria (Fuling, 3 qian) Black Soybean (Hei Dadou, 4 qian) Polygoni Multiflori Caulis (Ye Jiaoteng, 4 qian) Light Bamboo Leaf (Dan Zhuye, 1 qian)
Patient Zuo experiences frequent thirst and frequent urination. Severe Ge Xiao; cure cannot be guaranteed.
Trichosanthis Radix (Tianhuafen, 3 qian) Calcined Gypsum (Wei Shigao, 6 qian) Light Asparagus Root (Dan Tiandong, 2 qian) Large Ophiopogon Root (Da Maidong, 2 qian) Dioscoreae Hypoglaucae Rhizoma (Chuan Bi, 2 qian) Fat Anemarrhenae Rhizome (Fei Zhimu, 2 qian) Yun Poria (Yun Fuling, 4 qian) Light Scutellaria Root (Dan Huangqin, 1.5 qian) Sweet Platycodon Root (Tian Jiegeng, 3 qian) Loquat Leaf (Pipaye, 4 leaves, hairs removed)
Subsequent visit: Thirst and drinking have slightly receded. Indeed, Qi fire is scorching and consuming body fluids. Severe Xiao Ke; still difficult to guarantee cure.
Calcined Gypsum Fat Anemarrhenae Rhizome Large Ophiopogon Root Rubi Fructus Loquat Leaf Light Asparagus Root Trichosanthis Radix Toosendan Fruit Sweet Platycodon Root
Patient Tang (Left pulse): Xiao Ke symptoms have slightly stabilized. It belongs to excessive Qi fire in the Middle Jiao, where Ying fluids are also being scorched. Since the medicine is effective, continue with the effective prescription.
Trichosanthis Radix (Tianhuafen, 1.5 qian) Fresh Rehmanniae Radix (Xian Shengdi, 6 qian) Sichuan Coptis Rhizome (Chuan Yalian, 0.3 qian) Black Soybean (Hei Dadou, 4 qian) Fat Anemarrhenae Rhizome (Fei Zhimu, 1.5 qian) Poria with Hostwood (Fushen, 3 qian) Sweet Platycodon Root (Tian Jiegeng, 2 qian) Loquat Leaf (Pipaye, 4 leaves, hairs removed)
Subsequent visit: Urine volume has slightly decreased. Continue following the previous method.
Fresh Rehmanniae Radix Sweet Platycodon Root Sichuan Coptis Rhizome Black Soybean Fat Anemarrhenae Rhizome Poria with Hostwood Stir-fried Songmai Dong Trichosanthis Radix Loquat Leaf (hairs removed)