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Dou Hanqing stated: When sores and ulcers cause thirst, if accompanied by pain and fever, with normal bowel movements and urination, it indicates heat in the Upper Jiao (Upper Burner), treated with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). If there is swelling, pain, and fever, with constipation, it indicates heat within the five Zang organs, treated with Sishun Qingliang Yin (Four-Obedience Cooling Beverage). If the swelling and pain are severe, it indicates accumulation and knotting of heat-toxin, treated with Xianfang Huoming Yin (Immortal Life-Activating Beverage). If there is diffuse swelling with slight pain, it indicates qi and blood deficiency leading to stagnation, treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If caused by stomach fire consuming fluids, resulting in shortness of body fluids, treat with Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction). If caused by deficiency of stomach qi failing to generate fluids, treat with Buzhong Yiqi Tang. If caused by injury to stomach qi leading to internal loss of fluids, treat with Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). If caused by depletion of kidney water leading to thirst, or dry mouth and tongue, treat with Jiaban Bawei Wan (Modified Eight-Ingredient Pill) for best results. Alternatively, if one first experiences dry mouth and thirst, frequent urination, followed by carbuncles, or after carbuncles heal, experiences thirst and drinking, or yellow dry hard tongue coating with frequent urination preceding carbuncles, this is particularly ominous. If the cause can be anticipated, pre-administering Jiaban Bawei Wan and Buzhong Yiqi Tang to nourish the source of transformation can prevent this affliction. Administering this pill during active carbuncles stops thirst; administering it when stable and without thirst prevents future thirst; administering it before carbuncles appear not only stops thirst but also prevents carbuncles.

Zhu Danxi stated: Regarding thirst caused by sores and ulcers, if one does not rule out internal fire from improper diet, liver fire from anger, or ministerial fire from sexual exhaustion, I fear the thirst will not be easily stopped.

The *Jingyao* states: Thirst (Kou Ke) differs from dry mouth (Kou Gan); one should not recklessly use mineral pills for sedation, as disaster can occur instantly. It is best to decoct mulberry twig with Schisandra chinensis (Wuweizi) and drink the soup to rescue yin fluids, which is excellent.

Feng Luzhan stated: After the healing of abscesses and carbuncles, sudden onset of thirst without treatment leads to death in eight or nine out of ten cases. Those who experience thirst prior to developing carbuncles are particularly difficult to treat. Therefore, one should frequently administer Bawei Wan (Eight-Ingredient Pill), which not only prevents thirst but also greatly tonifies qi and blood and promotes muscle growth.

Shen Douyuan stated: Thirst involves the consumption of fluids, arising from extreme heat causing thirst due to the scorching of heart fire. If thirst occurs before a sore ulcerates, it indicates rampant toxin; the pulse at the heart and lung positions will likely be surging, rapid, full, and large. One should descend fire and clear metal using agents like Qinlian Neishu (Scutellaria and Coptis Internal Purging Agent). If the chi position pulse is surging but forceless, one should nourish yin and descend fire using agents that greatly tonify qi and blood, or Dushen Tang (Single Ginseng Decoction). If thirst arises after ulceration due to severe qi and blood deficiency (eight or nine out of ten cases), use Huangqi Liuyi Tang (Astragalus Six-One Decoction) and Jiaban Bawei Wan. However, for developed abscesses and carbuncles, whether ulcerated or not, Jiaban Bawei Wan is highly effective. If there is no abscess or carbuncle, but the lung pulse is extremely surging and rapid with thirst, an abscess or carbuncle will certainly develop; this is the sign.

Wu Shi stated: For severe thirst caused by sores, urgently administer Shenxian Zhuidu Wan (Immortal Poison-Chasing Pill) to purge evil matter. If thirst persists after purgation, switch to fluid-generating medicines. Once fluids are generated and qi and blood are abundant, thirst ceases naturally. (*Jingyao* records using tender mulberry twig, finely cut one sheng, stir-fried, decocted in water, taken five to seven doses daily to stop severe thirst; more administration is even better. For treating depleted kidney water with dry mouth and tongue, use Wuweizi Tang (Schisandra Decoction), which combines Licorice Six-One Decoction and Shengmai Tang (Generate Pulse Decoction), yielding miraculous effects.)

Zhang Jingyue stated: When internal heat is severe, there is great thirst preferring cold drinks, continuous intake of ice water, hard abdomen, and constipation, with a full pulse and strong qi; this is a yang syndrome.

He further stated: If one has thirst but prefers hot drinks over cold, this is not a fire syndrome; rather, it indicates middle jiao cold. Since it is not a fire syndrome, why does thirst occur? It is due to the deficiency of yin water.

He also stated: When asking patients if they are thirsty, they may say "thirsty." But when asked if they desire soup or water, they may say "no desire." This is because there is no pathogenic fire internally, hence no desire for liquids. True yin is deficient internally, resulting in lack of saliva in the mouth. This is dry mouth, not thirst. One must not treat dry mouth as thirst.

He further stated: When pathogenic yang is excessive yet true yin is also deficient, one cannot label it as excess heat simply because the patient desires cold drinks due to fire. The internal yin water is insufficient, seeking external water to compensate. With dried-up water and depleted essence, true yin is withered. One must carefully examine the pulse and symptoms together. A slight error here determines life or death immediately. I have treated critical cases of severe typhoid fever with such presentations, often using potent tonics cooled in water, or alternating ice water, Ginseng, and Prepared Aconite, saving many lives. Laypeople find this strange, not realizing it follows principle. However, this approach of combining Ginseng, Aconite, and cool water is only suitable for severe dry thirst and dryness-constipation. Without actual excrement retention, water should not be given alone. Similarly, for abscesses and carbuncles, cool water should not be combined with Ginseng and Aconite.

He finally stated: Internal heat steaming and burning the zang-fu organs必然 causes thirst and constipation, or diarrhea with intestinal mucus, and scanty dark urine.