省中周公者，山左人也，年逾四旬，因案牍积劳，致成羸疾。神困食减，时多恐惧，自
冬春达夏，通宵不寐者凡半年有余，而上焦无渴，不嗜汤水，或有少饮则沃而不行，然每夜
必去溺二三升，莫知其所从来，且半皆如膏浊液， 羸至极，自分必死。及予诊之，察其脉
犹带缓，肉亦未脱，知其胃气尚存，慰以无虑。乃用归脾汤去木香及大补元煎之属，一以养
阳，一以养阴，出入间用，至三百余剂，计人参二十斤，乃得全愈。此神消于上，精消于下
之证也，可见消有阴阳，不得尽言为火，姑纪此一按，以为治消治不寐者之鉴。
白虎汤（寒三） 玉女煎（新寒十二） 玉泉散（新寒十五） 四物汤（补八） 归脾汤（补三
二） 秘元煎（新固一） 固阴煎（新固二） 抽薪饮（新寒三） 补阴丸（寒百六十） 左归饮（新
补二） 右归饮（新补三） 右归丸（新补五） 六味丸（补百二十） 八味丸（补一二一） 三补
丸（寒一六二） 三黄丸（攻六八） 大补元煎（新补一） 大补阴丸（寒一五七） 人参白虎汤（
寒三） 加减一阴煎（新补九） 钱氏白术散（小七） 苓术菟丝丸（新固五） 调胃承气汤（攻三
）
玉泉丸（寒七五 热渴） 益元散（寒百十二） 龙脑鸡苏散（和三七二 虚火烦渴） 生脉
散（补五六） 火府丹（寒百二十 消渴） 麦门冬饮子（寒四八 膈消渴） 鹿茸丸（补一三三
肾虚消渴） 小建中汤（补二二 燥渴） 人参养营汤（补二一） 天花丸（和百四 消渴）
五味子汤（补五九 阴虚渴） 人参固本丸（补百六 阴虚渴） 天花散（寒七三） 地骨皮散（
寒七四 壮热渴） 天王补心丹（补百八 干渴） 醍醐膏（和三五三 消渴） 加减八味丸（补
一二二） 益阴肾气丸（补一二三 阴虚渴） 茯苓泽泻汤（热七四 反胃消渴）
There was an official named Zhou in the Ministry of Revenue, originally from Shandong. He was over forty years old. Due to long-term fatigue from handling official documents, he developed a debilitating illness. His spirit was exhausted, his appetite decreased, and he frequently experienced fear. From winter and spring through summer, he suffered from insomnia for more than half a year without sleeping all night. However, there was no thirst in the upper jiao (upper burner), and he had no desire for soups or liquids; even if he drank a little, he felt the fluid stagnating and failing to descend. Yet, every night he would urinate two to three sheng (approximately one liter), not knowing where it came from. Half of this urine resembled turbid fluid like grease. He became extremely emaciated and believed he would certainly die. When I examined him, I found his pulse still carried a moderate quality, and his flesh had not completely wasted away, indicating that his stomach qi remained intact. I comforted him, telling him not to worry. I then prescribed Guipi Tang (Restore the Spleen Decoction) with Xiangru (Aucklandiae Radix) removed, along with formulas such as Dabu Yuanjian (Great Tonification of the Origin Decoction). One formula nourished yang, while the other nourished yin. They were used alternately. After taking more than three hundred doses, accumulating twenty jin (approximately twelve kilograms) of Renshen (Ginseng Radix et Rhizoma), he made a full recovery. This is a syndrome of spirit dissipating in the upper part and essence consuming in the lower part. It can be seen that Xiao Ke (Wasting-Thirst) has yin and yang distinctions and cannot be entirely attributed to fire. I record this case here as a reference for treating Xiao Ke and Bu Mei (Insomnia).
Baihu Tang (Cold Three) Yinvu Jian (New Cold Twelve) Yuquan San (New Cold Fifteen) Siwu Tang (Tonify Eight) Guipi Tang (Tonify Thirty-Two) Miyuan Jian (New Secure One) Guyin Jian (New Secure Two) Chouxin Yin (New Cold Three) Buyin Wan (Cold Hundred Sixty) Zuogui Yin (New Tonify Two) Yougui Yin (New Tonify Three) Yougui Wan (New Tonify Five) Liuwei Wan (Tonify Hundred Twenty) Bawei Wan (Tonify One Twenty-One) Sanbu Wan (Cold One Hundred Sixty-Two) Sanhuang Wan (Attack Sixty-Eight) Dabu Yuanjian (New Tonify One) Dabu Yinwan (Cold One Hundred Fifty-Seven) Renshen Baihu Tang (Cold Three) Jiajian Yiyin Jian (New Tonify Nine) Qianshi Baizhu San (Small Seven) Lingzhu Tusian Wan (New Secure Five) Tiaowei Chengqi Tang (Attack Three)
Yuquan Wan (Cold Seventy-Five Heat Thirst) Yiyuan San (Cold Hundred Twelve) Longnao Jisu San (Harmonize Thirty-Seven-Two Deficient Fire Irritable Thirst) Shengmai San (Tonify Five-Six) Huofu Dan (Cold Hundred Twenty Wasting-Thirst) Maimendong Yinzi (Cold Forty-Eight Diaphragm Wasting-Thirst) Lurong Wan (Tonify One Hundred Thirty-Three Kidney Deficiency Wasting-Thirst) Xiaojianzhong Tang (Tonify Twenty-Two Dry Thirst) Renshen Yangying Tang (Tonify Twenty-One) Tianhua Wan (Harmonize Hundred Four Wasting-Thirst) Wuweizi Tang (Tonify Five-Nine Yin Deficiency Thirst) Renshen Guben Wan (Tonify Hundred Six Yin Deficiency Thirst) Tianhua San (Cold Seventy-Three) Digupi San (Cold Seventy-Four Intense Heat Thirst) Tianwang Buxin Dan (Tonify Hundred Eight Dry Thirst) Titigu (Harmonize Three Hundred Fifty-Three Wasting-Thirst) Jiajian Bawei Wan (Tonify One Hundred Twenty-Two) Yiyin Shenqi Wan (Tonify One Hundred Twenty-Three Yin Deficiency Thirst) Fuling Zexie Tang (Heat Seventy-Four Regurgitation Wasting-Thirst)