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It is stated that the disease of Xiao Ke (Wasting and Thirsting) is caused by pathogenic invasion of the San Jiao (Triple Burner). It is divided into Upper Xiao, Middle Xiao, and Kidney Xiao.

Upper Xiao involves pathology in the Upper Jiao, also known as Ge Xiao (Diaphragm Thirsting). Its symptoms include drinking large amounts of water while eating little, normal bowel movements, or clear and profuse urination. This indicates dryness-heat located in the Upper Jiao. The treatment should employ moistening methods to resolve dryness.

Middle Xiao involves the Stomach. Symptoms include thirst accompanied by polyphagia and yellow urine. The *Nei Jing* states: "Heat can digest grain," indicating heat in the Middle Jiao. According to medical principles, purgative methods should be used. The disease resolves when the patient loses their appetite.

Kidney Xiao involves pathology in the Lower Jiao. Initially presenting as Gao Lin (Gouty/Chyluria-like discharge), the urine resembles oil paste. As the condition progresses, the complexion becomes dark, the body emaciates, the ears become dry and shriveled, and the urine is turbid with lipid-like substances. The treatment method should focus on nourishing blood, regulating the separation of clear and turbid fluids, leading to spontaneous recovery. Medical theory states: "For upper dryness and thirst, use acrid-sweet herbs to moisten the Lungs." Therefore, Honey-fried Ginger Decoction can be used, prepared in a large vessel, taken in small sips frequently. Medical theory further states: "For diseases of the Heart and Lungs, do not hesitate to drink frequently in small amounts." The *Nei Jing* says: "Tonifying the upper and treating the upper requires gentle methods." It also says: "Acrid flavors moisten; opening the interstices allows fluid circulation, causing Lung Qi to descend." Thus, Qi descends, Fire subsides, dryness diminishes, and thirst ceases. Additionally, the *Nei Jing* states: "The binding of the Two Yangs leads to Xiao." Wang Bing's commentary notes: "The Two Yangs bind in the Stomach and Large Intestine, both being heat syndromes." Heat stored in the intestines and stomach causes rapid digestion of food and water. One may use acrid-sweet fire-descending agents: Coptis Rhizoma powder (1 jin), fresh juice of Rehmannia Root (1 jin), fresh juice of White Lotus Root (1 jin), and cow milk (1 jin). Boil these liquids into an ointment/paste, mix with Coptis powder to form pills the size of Sophora seeds. Take 30 pills each time, swallowed with warm water in small sips. Administer ten times daily; thirst stops immediately.

For treating Upper Jiao Ge Xiao with symptoms of anorexia and clear, profuse urination, Xiaochaihu Tang (Minor Bupleurum Decoction) is suitable. Alternatively, Baihu Tang (White Tiger Decoction) or Qian Shi's Digupi San (Anchors Bark Powder) modified with Paeoniae Radix Alba, Gypsum Fibrosum, Scutellariae Radix, and Platycodonis Radix may be used.

**Renshen Shigao Tang (Ginseng and Gypsum Decoction)**: Treats Ge Xiao, characterized by Upper Jiao vexation-thirst and anorexia.
Ingredients: Renshen (Ginseng Radix et Rhizoma, 0.5 liang), Shigao (Gypsum Fibrosum, 1.2 qian), Zhimu (Anemarrhenae Rhizoma, 7 qian), Gancao (Licorice Radix et Rhizoma, 4 qian).
Preparation: Grind into coarse powder. Take 5–7 qian per dose, decoct in water, and take warm after meals.

**Shunqi San (Regulating Qi Powder)**: Treats Xiao Zhong (Middle Xiao), characterized by gastric heat with preserved appetite and red-yellow urine. Mild purgation is the sign of efficacy; excessive purgation should be avoided. This medicine gradually promotes mild purgation until anorexia occurs, indicating cure.
Ingredients: Houpo (Magnoliae Officinalis Cortex, ginger-processed, 1 liang), Dahuang (Rhei Radix et Rhizoma, 4 liang), Zhishi (Aurantii Fructus Immaturus, stir-fried, 2 qian).
Preparation: [Grind/mix]. Take 5 qian per dose, decoct in water, and take well before meals.

**Huixiang San (Fennel Powder)**: Treats Kidney Xiao in the Lower Jiao. Initial symptom is urine resembling oil paste.
Ingredients: Huixiang (Foeniculi Fructus, stir-fried), Kelian (Meliae Cortex, stir-fried).
Preparation: Grind into fine powder. Mix with wine for 2 qian per dose, take before meals.

**Bawei Wan (Eight-Ingredient Pill)**: Modified usage for severe Kidney Xiao.
Increase the dosage of Dioscoreae Rhizoma (Shanyao) in the base formula. Adjust the dosages of Cinnamomi Ramulus (Guizhi) and Aconiti Lateralis Radix Praeparata (Fuzi) according to the four seasons. For example, if the original formula contains 1 liang of Guizhi and Fuzi, use 3 qian each in Spring, 1 qian in Summer, 5 qian in Autumn, and full 1 liang in Winter.

**Zhenzhu Fen Wan (Pearl Ash Powder Pill)**: Treats Bai Yin (white vaginal discharge/prostatic fluid emission), nocturnal emissions, spermatorrhea, and uncontrollable seminal leakage.
Ingredients: Huangbai (Phellodendri Cortex, 1 jin, fired on new tile until red-hot), Gao Fen (Concha Tridacnatis, 1 jin).
Preparation: Grind into fine powder, add water dropwise to form pills the size of Sophora seeds. Take 100 pills per dose, swallow with wine on an empty stomach. Medical theory states: "Excessive Yang attacking Yang causes seminal leakage." Huangbai descends Fire; Gao Fen is salty and tonifies Kidney Yin. This formula also treats conditions arising from endless thoughts and unfulfilled desires.

**Zhulong San (Bamboo Basket Powder)**: Treats Xiao Ke.
Ingredients: Wulingzhi (Trogopterori Faeces), Heidou (Sojae Semen Nigrum, skin and hilum removed).
Preparation: Equal parts ground into fine powder. Take 3 qian per dose, mixed with winter melon soup. If winter melon is unavailable, its vines and leaves may be used. Take twice daily. Mild thirst improves after 2–3 doses. Once thirst is controlled, hot-natured medicines must be stopped; only Bawei Wan should be used, with Fuzi removed and Wuweizi (Schisandrae Fructus) added.