三消得之气之实。血之虚也。久久不治。气尽虚则无能为力矣。有一僧专用黄 饮加减。
其
论盖详之。益血为主。三消。小便去多上消消心。心火炎上。大渴而小便多。中消消脾。脾
气热燥。饮食倍常。皆消为小便。下消消肾。肾衰不能摄水。故小便虽多而渴。然小便既
多。津液必竭。久而未有不渴者。谓之全不渴。未有的论。诸消不宜用燥烈峻补之剂。惟当
滋养。除消脾外。心肾二消。宜用黄 饮。吞八味丸。或玄兔丹。或小菟丝子丸。又竹龙散
皆可。又用六神饮亦治肾消。惟脾消则加当归。去黄 。三消小便既多。大便必秘宜常服
四物汤。润其大肠。如加人参木瓜花粉在人。仍煮四皓粥食之。糯米泔。折二。亦可冷进。
三消久而小便不臭。反作甜气。在溺桶中滚涌。其病为重。更有浮在溺面如猪脂。溅在
桶边如 烛泪。此精不禁。真元竭矣。
上消中消。心脾既如此热。小便涩少而反无禁。盖燥热在上。虚冷在下。阴阳不交。所
以成消渴。
三消久之。精血既亏。或目无见。或手足偏废如风疾非风。然此证消肾得之为多。消心
之病
往往因欲饮食过多。及食啖辛热。饮引既多。小便亦多。当抑心火使之下降。自然不渴。
宜半夏泻心汤。去干姜。加栝蒌干葛如其数。吞猪肚丸。或酒连丸。仍佐独味黄连汤。多煎
候冷。遇渴恣饮。久而自愈。或自糯米煮稀粥。然同颖汤。梅花汤二药。于三消有渴者。皆
可用。若因用心过度。致心火炎上。渴而消者。宜黄 饮。加莲肉远志各半钱。吞玄兔丹。
仍以大麦煎汤。间下灵砂丹。
消脾。缘脾经燥热。食物易化。皆为小便。转食转饥。然脾消又自有三。曰消中。曰寒
中。曰热中。宜用莲茗饮加生地黄干葛各半钱。或乌金散。或止用莲茗饮。
若因色欲过度。水火不受。肾水下泄。心火自炎。以致渴浊。不宜备用凉心冷剂
宜坚肾水以济心火。当用黄 饮加苁蓉五味各半钱。吞八味丸及小菟丝子丸。玄兔丹。鹿
茸丸。加减安肾丸。皆可选用。或灵砂丹。消肾为病。比诸为重。古方谓之强中。又谓之内
消。多因恣意色欲。或饵金石。肾气既衰。石气独在精水无取养。故常发虚阳。不交精出。
小便无度。唇口干焦。黄 饮、吞玄兔丹。八味丸。鹿茸丸。加减肾气丸。小菟丝子丸。灵
砂丹皆可选用。或未效。黄 饮加苁蓉北五味山茱萸各四分。荠笼丸。苁蓉丸。
又有果木渴。因多食果子所致。宜麝香之药。
Sanxiao (Three Consumptions) arises from excess in the Qi aspect and deficiency in the Blood aspect. If left untreated for a long time, when Qi is completely depleted, the body loses its capacity to recover. A certain monk specialized in using Huangqi Yin (Astragalus Decoction) with modifications; his discussion on this matter was quite detailed. The treatment focuses primarily on nourishing the Blood.
Sanxiao is divided into Upper, Middle, and Lower Consumption. Upper Xiao involves the Heart: Heart Fire flares upward, causing excessive thirst and polyuria. Middle Xiao involves the Spleen: Spleen Qi is hot and dry, leading to doubled food intake, which is rapidly converted and excreted as urine. Lower Xiao involves the Kidney: Kidney decline fails to control water retention, resulting in polyuria accompanied by thirst. Since urine output is already high, Body Fluids must inevitably be exhausted; after a while, no one remains without thirst. Claims of "no thirst at all" lack theoretical basis. For all types of Xiao, harsh, drying, and strongly tonifying agents should not be used; only nourishing methods are appropriate. Except for Spleen Xiao, Heart and Kidney Xiao are suitable for Huangqi Yin (Astragalus Decoction), taken with Bawei Wan (Eight-Ingredient Pill), or Xuan Tu Dan (Mysterious Rabbit Pellet), or Xiaotusizi Wan (Small Dodder Seed Pill). Zhulong San (Bamboo Dragon Powder) is also applicable. Additionally, Liushen Yin (Six Deities Decoction) can treat Kidney Xiao. Only in Spleen Xiao should Danggui (Angelicae Sinensis Radix) be added, and Huangqi (Astragali Radix) removed. In Sanxiao, since urine output is high, stool tends to be constipated; thus, Siwu Tang (Four Substances Decoction) should be taken regularly to moisten the Large Intestine. If Renshen (Ginseng Radix), Mugua (Chaenomelis Fructus), and Huafen (Trichosanthis Radix) are added, one should still consume Sihao Zhou (Four Immortals Porridge). Nuomici (Rice Liquefaction Liquid), halved in dosage, may also be taken cold.
If Sanxiao persists for a long time, urine becomes odorless but emits a sweet smell, bubbling vigorously in the urinal; this indicates severe disease. Furthermore, if fat-like substances float on the urine surface, resembling lard, and splashes on the bucket sides look like candle wax tears, this signifies uncontrolled essence and depletion of True Yuan (Original Qi).
In Upper and Middle Xiao, given the intense heat in the Heart and Spleen, although urine flow is scanty and astringent, it is paradoxically incontinent. This occurs because dryness-heat resides above while deficiency-cold lies below, preventing the interaction of Yin and Yang, thereby forming Xiao Ke (Wasting-Thirst).
After Sanxiao has persisted for a long time, Essence and Blood are depleted. Some patients lose vision, while others suffer from hemiplegia resembling wind-stroke but not caused by external wind pathogens. However, this condition is most common in Kidney Xiao. Heart Xiao often results from excessive desires, overeating, and consuming spicy and heating foods. Excessive intake of fluids leads to polyuria. One should suppress Heart Fire to make it descend naturally, eliminating thirst. Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is suitable, removing Ganjiang (Zingiberis Rhizoma) and adding Gualou (Trichosanthis Fructus) and Gange (Puerariae Radix) in equal amounts, taken with Zhudu Wan (Pork Stomach Pill) or Jiulian Wan (Wine-Processed Coptis Pill). It should be assisted by a single-herb Huanglian Tang (Coptis Decoction), boiled sufficiently, cooled, and drunk freely when thirsty; self-healing will occur over time. Alternatively, one can cook thin porridge with glutinous rice. Tongying Tang and Meihua Tang are also applicable for thirst in Sanxiao. If excessive mental exertion causes Heart Fire to flare upward, leading to thirst and consumption, Huangqi Yin (Astragalus Decoction) should be used, adding Lianrou (Nelumbinis Semen) and Yuanzhi (Polygalae Radix), each half qian, taken with Xuantu Dan (Mysterious Rabbit Pellet). Meanwhile, Maimai decoction should be used to administer Lingsha Dan (Cinnabar Pellet) intermittently.
Spleen Xiao is due to dryness-heat in the Spleen Meridian, causing food to digest easily and transform into urine, leading to frequent hunger after eating. Spleen Xiao itself has three subtypes: Xiao Zhong, Han Zhong (Cold Middle), and Re Zhong (Heat Middle). Lianming Yin (Lotus Tea Drink) with Shengdihuang (Rehmanniae Radix) and Gange (Puerariae Radix), each half qian, is suitable, or Wujin San (Black Gold Powder), or simply Lianming Yin alone.
If caused by excessive sexual activity, failing to harmonize Water and Fire, with Kidney Water descending and Heart Fire flaring independently, resulting in thirst and turbid urine, cooling agents for the Heart should not be used. Instead, one should strengthen Kidney Water to assist Heart Fire. Huangqi Yin (Astragalus Decoction) with Congrong (Cynomorii Herba) and Wuweizi (Schisandrae Fructus), each half qian, is indicated, taken with Bawei Wan (Eight-Ingredient Pill), Xiaotusizi Wan (Small Dodder Seed Pill), Xuantu Dan (Mysterious Rabbit Pellet), Lurong Wan (Deer Antler Pill), or Jiajian Anshen Wan (Modified Kidney-Calming Pill), all of which are selectable options. Lingsha Dan (Cinnabar Pellet) is also an option.
Kidney Xiao is more severe than other types. Ancient texts call it Qiangzhong (Strong Middle) or Neixiao (Internal Consumption). It is often caused by indulgence in sex or ingestion of mineral drugs. Once Kidney Qi declines, the mineral energy remains dominant, but the Essence and Water lack nourishment, causing constant false Yang to flare, leading to spontaneous emission without intercourse, polyuria, dry and cracked lips and mouth. Huangqi Yin (Astragalus Decoction) with Xuantu Dan (Mysterious Rabbit Pellet), Bawei Wan (Eight-Ingredient Pill), Lurong Wan (Deer Antler Pill), Jiajian Shenqi Wan (Modified Kidney Qi Pill), Xiaotusizi Wan (Small Dodder Seed Pill), and Lingsha Dan (Cinnabar Pellet) are all selectable. If ineffective, Huangqi Yin (Astragalus Decoction) should be added with Congrong (Cynomorii Herba), Bei Wuweizi (Schisandrae Fructus), and Shanzhuyu (Corni Fructus), each four fen, along with Qilong Wan and Congrong Wan.
There is also Guomu Ke (Fruit Tree Thirst), caused by excessive consumption of fruits, which should be treated with musk-containing preparations.