试观年老多夜尿，休信三消尽热干，饮多尿少浑赤热，饮少尿多清白寒。
【注】上消属肺，饮水多而小便如常；中
消属胃，饮水多而小便短赤；下消属肾，饮水多而小便混浊，三消皆燥热病也。然试观
年老好饮茶者，夜必多尿，则休信三消皆热，而亦有寒者矣。饮水多，小便少而浑赤者属
热，是火盛耗水而浑也。饮水少，小便多而清白者属寒，是火虚不能耗水也。
三消便硬若能食，脉大实强尚可医，不食舌白传肿泻，热多舌紫发痈疽。
【注】三消，饮水多不能食，若能食大便硬，脉大强实者，为胃实热，下之尚可医也。
若不能食，湿多舌白滑者，病久则传变水肿泄泻。热多舌紫干者，病久则发痈疽而死也。
竹叶黄 汤
便硬能食脉大强，调胃金花斟酌当，不食渴泻白术散，竹叶黄 不泻方，黄 黄芩
合四物，竹叶石膏减粳姜，气虚胃热参白虎，饮一溲二肾气汤。
【注】调胃，谓调胃承气汤。金花，谓栀子金花汤。方俱在伤寒门，酌其所当用可也。
不食而渴，已属胃虚，兼之泄泻，胃虚无热矣。故用七味白术散，方在虚损门。若不食
而渴，亦不泻者，是虽虚而犹有燥热也，宜用竹叶黄 汤，即黄 、黄芩、当归、川芎、
白芍、生地、竹叶，石膏、人参、炙草、麦冬、半夏也。若气虚胃热盛者，宜用人参白
虎汤。若下焦虚寒，饮一溲二者，宜用肾气汤。
Observe that the elderly often have frequent nocturia; do not blindly believe that all "Sanxiao" (Three Burners/Three Thirsts) conditions are solely due to dryness-heat and fluid depletion. If there is excessive drinking but scanty, turbid, red, and hot urine, it indicates a heat pattern; if there is little drinking but copious, clear, and cold urine, it indicates a cold pattern.
[Note] Shangxiao (Upper Thirst) involves the Lung, characterized by excessive drinking with normal urination; Zhongxiao (Middle Thirst) involves the Stomach, characterized by excessive drinking with short, red urine; Xiaxiao (Lower Thirst) involves the Kidney, characterized by excessive drinking with turbid urine. All three types of Xiao (Wasting-Thirst) are generally considered diseases of dryness-heat. However, observing those elderly individuals who enjoy drinking tea, they inevitably have frequent nocturia. This shows that one should not firmly believe that Sanxiao are all heat patterns; there are also cold patterns. Excessive drinking with scanty, turbid, and red urine belongs to heat, which is caused by fire excess consuming fluids, leading to turbidity. Little drinking with copious, clear, and white urine belongs to cold, which is caused by deficient fire failing to transform fluids.
If patients with Sanxiao have hard stools and can eat, and their pulse is large, solid, and strong, the condition is still treatable. If they cannot eat, have a white tongue coating, and develop edema and diarrhea, or if heat is predominant with a purple tongue and development of carbuncles and sores, the prognosis is poor.
[Note] Regarding Sanxiao: if there is excessive drinking but inability to eat, yet if they can eat and have hard stools with a large, strong, and solid pulse, this is Stomach excess-heat; purgation may still be effective. If they cannot eat and have a slippery white tongue coating indicating dampness predominance, prolonged illness will lead to edema and diarrhea. If heat predominates with a dry purple tongue, prolonged illness will lead to carbuncles and sores and death.
Zhuye Huangqi Decoction (Bamboo Leaf and Astragalus Decoction)
For cases with hard stools, ability to eat, and a large, solid, strong pulse, consider using Tiaowei Chengqi Tang (Regulate the Stomach Purgative Decoction) or Zhizi Jinhua Tang (Gardenia Golden Flower Decoction). For those unable to eat with thirst and diarrhea, use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). For those unable to eat but without diarrhea, use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction), composed of Huangqi (Astragali Radix), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Shengdi (Rehmanniae Radix), Zhuye (Phyllostachys Folium), Shigao (Gypsum Fibrosum), Renshen (Ginseng Radix), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Maidong (Ophiopogonis Radix), and Banxia (Pinelliae Rhizoma). For those with Qi deficiency and severe Stomach heat, use Renshen Baitu Tang (Ginseng and White Tiger Decoction). For lower jiao deficiency-cold with "drinking one and urinating two" (polyuria matching intake), use Shenqi Tang (Kidney Qi Decoction).
[Note] "Tiaowei" refers to Tiaowei Chengqi Tang. "Jinhua" refers to Zhizi Jinhua Tang. These formulas are recorded in the Treatise on Cold Damage section; select them according to appropriateness. Inability to eat with thirst already indicates Stomach deficiency; combined with diarrhea, it implies Stomach deficiency without heat. Therefore, Qiwei Baizhu San is used, recorded in the Deficiency and Injury section. If unable to eat with thirst but no diarrhea, although deficient, there remains dryness-heat; Zhuye Huangqi Tang is appropriate, consisting of Huangqi, Huangqin, Danggui, Chuanxiong, Baishao, Shengdi, Zhuye, Shigao, Renshen, Zhi Gancao, Maidong, and Banxia. For Qi deficiency with flourishing Stomach heat, Renshen Baitu Tang is appropriate. For lower jiao deficiency-cold presenting with "drinking one and urinating two," Shenqi Tang is appropriate.