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(The *Neijing* states: "If a patient is not aversion to cold but feels thirsty, this indicates the pathogen has transferred to the Yangming channel." It also says: "After taking Xiao Chai Hu Tang (Minor Bupleurum Decoction), if thirst occurs, it belongs to the Yangming pattern." Therefore, "thirst" is categorized under the Yangming chapter.)

Cheng Wuji stated: In Shanghan (Cold Damage), when the pathogen transmits inward, thirst occurs; when the pathogen remains in the exterior, thirst does not occur. Although the Three Yang channels may occasionally present with thirst, it is not as severe as in the Three Yin channels. Taiyin disease presents with abdominal fullness and dry throat; Shaoyin disease presents with dry mouth and tongue accompanied by thirst; Jueyin disease presents with Xiao Ke (wasting-thirst syndrome). Xiao Ke refers to drinking large amounts of water yet producing little urine, because heat consumes fluids. Generally, upon initial transmission, heat is mild, so thirst is mild; as transmission deepens, heat becomes severe, so thirst becomes severe. For patients with thirst, do not allow them to drink excessively. For mild thirst in the Three Yang channels, use Wuling San (Five-Ingredient Powder with Poria); for severe thirst, use Baihu Tang (White Tiger Decoction). For severe heat and thirst in the Three Yin channels, purgation should be employed. If a patient with mild thirst forces excessive water intake, it can lead to palpitations, chest and hypochondriac fullness, asthma and coughing, hiccups, dry retching, edema, diarrhea, and dysuria. All these conditions arise from such errors.

In Taiyang disease, after sweating therapy, profuse sweating leads to dryness in the stomach, irritability, insomnia, and desire for water. Give small amounts frequently until the Stomach Qi harmonizes and recovery ensues. If pulse is floating, urination is difficult, there is slight fever, and wasting-thirst, use Wuling San (Five-Ingredient Powder with Poria). (Zhang Yuansu argued: For irritability and thirst, Baihu Tang (White Tiger Decoction) is appropriate. Why use Wuling San (Five-Ingredient Powder with Poria) to promote fluid metabolism? The answer is: Baihu Tang (White Tiger Decoction) is used when the exterior syndrome has resolved and the pathogen has transmitted inward causing irritability and thirst. Here, the pulse is still floating, there is slight fever and thirst, indicating the exterior pathogen has not fully resolved. Thus, the acridity of Guizhi (Cinnamon Twig) harmonizes the muscle layer, while the sweet and bland nature of Baizhu (Atractylodis Rhizoma) and Fuling (Poria) moistens deficiency-dryness. Note: This explanation is not entirely clear. Taiyang corresponds to the Bladder organ; the Bladder is the reservoir of urine. Wuling San (Five-Ingredient Powder with Poria) promotes urination. The Bladder is the mansion of body fluids; thus, Li Dongyuan considered thirst a primary disease of the Bladder channel. Therefore, treating thirst requires clearing Bladder heat, which is achieved by promoting urination.) After sweating, if the pulse is floating and rapid with irritability and thirst, use Wuling San (Five-Ingredient Powder with Poria).

Originally due to erroneous purgation leading to epigastric fullness (Pi), if Pi persists despite Xixin Tang (Gastrodia and Pinellia Decoction variants), and the patient presents with thirst, dry mouth, irritability, and dysuria, use Wuling San (Five-Ingredient Powder with Poria). In Fengzhong (Wind Strike) with fever for six or seven days without resolution, accompanied by irritability, both exterior and interior signs, desire for water, and vomiting immediately after drinking (Shui Ni / Water Reversal), use Wuling San (Five-Ingredient Powder with Poria).

Wuling San (Five-Ingredient Powder with Poria) Formula: Zhu Ling (Polyporus), Zexie (Alisma), Fuling (Poria), Guizhi (Cinnamomi Ramulus), Baizhu (Atractylodis Rhizoma). Grind the five herbs into powder. Take one cunbi (measure) mixed with rice water, three times daily. Drink plenty of warm water afterwards to induce sweating for cure. ("Ling" implies command; it regulates fluids and subdues Kidney pathogens. Fuling is the chief herb, hence the name. As per the *Neijing*, bland flavors promote drainage (Yang). To drain internal fluid retention, sweet-bland herbs are essential. Fuling (sweet/neutral) is the Sovereign; Zhu Ling (sweet/neutral) is the Minister. Spleen dislikes dampness; fluid retention impairs Spleen function. Sweet-warm herbs assist the Spleen to overcome dampness; Baizhu (sweet/warm) is the Assistant. As per the *Neijing*, salty flavors promote drainage (Yin). To guide urination, salty herbs assist; Zexie (salty/cold) is the Envoy. Fluid stagnation dries Kidney Qi. The *Neijing* states the Kidney dislikes dryness and needs acrid flavors to moisten. Guizhi (acrid/hot) acts as the Envoy to disperse and moisten. Drinking warm water induces sweating, dispersing water qi via the exterior.)

After taking Guizhi Tang (Cinnamon Twig Decoction) and sweating profusely, if severe irritability and thirst persist with a flooding pulse, use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng).

Taiyang disease presenting with fever, thirst, and no aversion to cold is classified as Wenbing (Warm Disease).

Xiao Chai Hu Tang (Minor Bupleurum Decoction), Baihu Tang (White Tiger Decoction), Guizhi Tang (Cinnamon Twig Decoction), and Gui Zhi Jia Ren Shen Tang (Cinnamon Twig Decoction plus Ginseng, removing Cinnamon).

Shanghan with no significant fever, dry mouth/throat, irritability, and slight aversion to cold on the back, use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng).

In Shanghan, if the pulse is floating, there is fever and anhidrosis, and the exterior syndrome is unresolved, Baihu Tang (White Tiger Decoction) must not be given. If there is thirst and desire for water without exterior signs, use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). (Thirst and desire for water without exterior signs indicate the Taiyang syndrome has ceased and transferred to Yangming. The following clause shares this meaning: thirst arises from Taiyang transferring to Yangming.)

If Shanghan, after emesis or purgation, remains unresolved for seven to eight days, with heat accumulated internally, simultaneous exterior and interior heat, occasional aversion to wind, severe thirst, dry tongue, irritability, and desire to drink several liters of water, use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). (Wang Bing noted: Pure exterior syndromes have constant aversion to wind; here, heat exists in both interior and exterior, causing intermittent aversion to wind.)

Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng): Treats thirst with a flooding pulse and free urination.

Shigao (Gypsum), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Jingmi (Oryzae Fructus), Renshen (Panacis Ginseng). Cut the herbs. Boil one qian (approx. 30g) in water, take warm.

Xu Shumi stated: A patient initially vomited, then was erroneously purged by another physician. After seven to eight days, internal and external fever persisted. I diagnosed it as requiring Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). Someone asked: "Having vomited and been purged, the patient is doubly deficient; can Baihu Tang (White Tiger Decoction) be used?" I replied: "Zhongjing states that after emesis/purgation, if unresolved for seven to eight days with internal heat accumulation and simultaneous exterior/interior heat, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is indicated. Initial vomiting indicated heat in the Stomach; now the pulse is deficient and large. Three doses cured him." Zhongjing also stated: "In Shanghan, if pulse is floating, fever, anhidrosis, and exterior is unresolved, do not give Baihu Tang." And: "Floating-slippery pulse indicates exterior heat and interior cold; use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng)." Lin Yi corrected this, claiming Zhongjing confused interior/exterior. I disagree. Broadly, Baihu Tang clears thirst and fever in Shanghan. Whether described as simultaneous exterior/interior heat or exterior heat/interior cold, it is applicable. However, floating pulse with anhidrosis and unresolved exterior is strictly Mahuang Tang (Ephedra Decoction) or Gegen Tang (Kudzu Decoction); Baihu Tang is contraindicated. Lin Yi's criticism stems from lack of deeper thought.

Zhang Yuansu stated: Medication timing has risks of being too fast or slow. Rules prevent errors; formulas rescue where rules fail. The first clause above is Zhongjing's rule to prevent misuse; the second clause ("Shanghan after emesis/purgation...") provides the formula to treat. Baihu Tang (White Tiger Decoction) treats severe irritability and thirst. Ancient rules prevented its use before exterior resolution to avoid hastening treatment. However, if back aversion to cold or intermittent wind aversion coexist with severe thirst, only Baihu Tang (White Tiger Decoction) can suppress it. Waiting for complete exterior resolution risks delay. Where rules fail, formulas are needed. Abandoning formulas violates method. Both methods are indispensable.

Wu Kun stated: Some ask why Zhongjing forbids Baihu Tang (White Tiger Decoction) in unresolved exterior cases, yet prescribes it for intermittent wind aversion or back cold. Shi Gao (Gypsum) is acrid-cold, clearing Yangming channel heat. It is a divine drug for steaming fever, tidal fever, interior/exterior heat, dry tongue, and thirst. "Intermittent" means occasional; "back cold" is slight. For intense heat and dry thirst, Baihu Tang (White Tiger Decoction) is unquestionable. However, constant back cold without dry thirst is a strict contraindication. Also, Taiyang fever with thirst and anhidrosis is contraindicated. But post-sweating, if pulse is flooding and thirsty, it is allowed. For Yin Cold Damage with red face, irritability, fever, weak Stomach, loose stools, weak pulse, and minimal heat, Baihu Tang (White Tiger Decoction) is strictly forbidden; misuse brings immediate danger.

In Taiyang disease, after heavy sweating and purgation, if constipation persists for five to six days, with dry tongue, thirst, slight tidal fever at dusk, and hardness/fullness/pain from epigastrium to lower abdomen unyielding to touch, use Daxiexiong Tang (Major Expulsion of Chest Granules Decoction).

In Shanghan with fever, aversion to cold, severe thirst, abdominal fullness, spontaneous sweating, and free urination, the disease resolves. This is Liver attacking Lung, named Heng (Horizontal). Puncture Qimen (LR14).

In Yangming disease, profuse sweating and thirst contraindicate Zhuling Tang (Polyporus Decoction), as sweating causes Stomach dryness; further diuresis worsens deficiency. (Alternatives: Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng), Xiao Chai Hu Tang (Minor Bupleurum Decoction) removing Banxia (Pinelliae Rhizoma) adding Gualougen (Trichosanthis Radix), Zhuye (Phyllostachys Folium). Zhang Yuansu noted: Yangming sweating indicates unresolved disease and Stomach fluid dryness. Zhuling Tang (Polyporus Decoction) would cause double injury.) In Yangming disease, if pulse is floating-tight, throat dry, bitter taste, abdominal fullness, wheezing, fever, sweating, aversion to heat rather than cold, heaviness, and thirst with dry mouth/tongue, use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). If pulse is floating, fever, thirst, and dysuria, use Zhuling Tang (Polyporus Decoction).

In Shaoyang Shanghan/Wind Strike, with alternating chills and fever, hypochondriac fullness, silent anorexia, irritability, frequent retching, or thirst/cough, use Xiao Chai Hu Tang (Minor Bupleurum Decoction). If thirsty, remove Banxia (Pinelliae Rhizoma), add Renshen (Panacis Ginseng) and Gualougen (Trichosanthis Radix).

In Shanghan four to five days, with fever, aversion to wind, neck stiffness, hypochondriac fullness, warm hands/feet, and thirst, use Xiao Chai Hu Tang (Minor Bupleurum Decoction).

On day six or seven, with slow-floating-weak pulse, aversion to wind, warm hands/feet, if erroneously purged multiple times leading to inability to eat, hypochondriac fullness/pain, stiff neck/body, and dysuria, giving Chai Hu Tang (Bupleurum Decoction) will cause tenesmus. If originally thirsty and vomiting after drinking, Chai Hu Tang (Bupleurum Decoction) is contraindicated. (Some suggest Wuling San (Five-Ingredient Powder with Poria) plus Yinchenshao Tang (Artemisiae Scopariae Decoction).)

In Shaoyin disease, thirst with diarrhea belongs to Shaoyin. If accompanied by somnolence and white urine, use Sini Tang (Frigid Extremities Decoction). If accompanied by cough, retching, insomnia, and non-white urine, use Zhuling Tang (Polyporus Decoction). If accompanied by spontaneous diarrhea with pure green watery stool, use Dachengqi Tang (Major Order the Qi Decoction). If heat is present, use Baitouweng Tang (Pulsatillae Decoction) (see Diarrhea chapter).

In Jueyin disease, wasting-thirst, Qi rushing upward to the heart, heart pain, hunger without desire to eat, vomiting roundworms upon eating. If purged, diarrhea becomes uncontrollable. If desiring water, give small amounts frequently for cure. (Pathogen in Jueyin indicates deep heat. Transmission from Taiyang to Taiyin causes abdominal fullness/dry throat but not thirst. Transmission to Shaoyin causes dry mouth/tongue/thirst but not wasting-thirst. Only in Jueyin does severe heat consume fluids, causing wasting-thirst (drinking much, urinating little). Wood generates Fire; Liver Qi connects to Heart. Jueyin guest-heat rushes to Heart, causing heart pain. Day six/seven is Jueyin disease; transmission completes entering the Fu organs. Stomach deficiency with guest-heat causes hunger/anorexia. Roundworms move in empty stomach, emerge with food smell. This is heat in Jueyin channel. Purging damages Stomach Qi, allowing Jueyin Wood pathogen to attack, causing violent vomiting/diarrhea. Note: Cheng Wuji's view of exterior-Yang transmitting inward is incorrect. Wasting-thirst and heart pain are Jueyin characteristics.)

Case Examples:

Thirst with head sweating, dysuria, hypochondriac fullness, alternating chills/fever: Chaihu Guizhi Jiangxin Tang (Bupleurum, Cinnamon Twig, and Ginger Decoction). With jaundice: Yinchenshao Tang (Artemisiae Scopariae Decoction) (see Head Sweating chapter).

Unresolved exterior with fluid retention in Heart, dry retching, fever, cough, or thirst, diarrhea, dysphagia, dysuria, lower abdominal fullness, or asthma: Xiaolongtan Decoction (Minor Dragon Decoction). Alternatively, fluid retention with cough, slight asthma, fever, no thirst; post-medication thirst indicates cold resolving: Xiaolongtan Decoction (Remove Banxia (Pinelliae Rhizoma), add Gualougen (Trichosanthis Radix)).

Summer sweating, aversion to cold, fever, cold feet, thirst: Summerheat stroke. Use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) and Jiuhuanglian (Alcohol-processed Coptidis Rhizoma) (see Summerheat chapter; cold feet contraindicates exterior release).

Fever, aversion to cold, abdominal fullness, sweating, free urination, thirst: Liver attacking Spleen. Puncture Qimen (LR14) (see Abdominal Fullness chapter). Exterior resolved, no aversion to cold, thirst: Baihu Tang (White Tiger Decoction).

Thirst with hypochondriac fullness and alternating chills/fever, untreated: Xiao Chai Hu Tang (Minor Bupleurum Decoction) removing Banxia (Pinelliae Rhizoma) adding Renshen (Panacis Ginseng) and Gualougen (Trichosanthis Radix). Post-sweating/purgation: Chaihu Guizhi Jiangxin Tang (Bupleurum, Cinnamon Twig, and Ginger Decoction) (see Hypochondriac Pain chapter).

Thirst with epigastric hardness/pain, tidal fever, constipation: Jie Xiong (Chest Granules). Use Daxiexiong Tang (Major Expulsion of Chest Granules Decoction). If hard but painless: Pi (Fullness). Use Xixin Tang (Gastrodia and Pinellia Decoction variants). If unresolved with thirst and dysuria: Wuling San (Five-Ingredient Powder with Poria) (see Chest Granules/Pi chapters).

Yangming disease should be sweated; erroneously washed with cold water increases irritability, skin gooseflesh, desire for water but no thirst: Wenli San (Clam Shell Powder). If ineffective, Wuling Tang (Five-Ingredient Decoction) (see Chest Granules chapter).

Wenli San (Clam Shell Powder): Wenli (Clam Shell/Sea Clam Powder). Grind to powder, mix with boiling water, take one cunbi.

Thirst wanting water but unable to drink: Heat in Dantian, Cold in Chest (see Damp Bi chapter).

Wind Strike fever six/seven days, irritability, exterior/interior signs, thirst, vomiting after drinking: Shui Ni (Water Reversal). Use Wuling San (Five-Ingredient Powder with Poria).

Thirst wanting water: Post-Taiyang sweating (profuse sweating, irritability, insomnia) or Jueyin disease (Qi rushing, heart pain, vomiting worms): Give small amounts frequently for cure (see previous clauses and Qi Rushing chapter).

For seasonal epidemic diseases, days five/six with thirst wanting water: Do not give much. Internal heat is insufficient to metabolize water; excess water creates pathology. Days seven/eight with severe thirst: Give according to syndrome. Allow partial satisfaction, do not overfill. One dou gives five sheng. If abdominal fullness, dysuria, asthma, or hiccups occur after drinking, stop. Spontaneous profuse sweating indicates self-healing. (*Huoren* states: Only give water if severely thirsty; for mild thirst/dry throat, sip to moisten and harmonize Stomach.)

Ability to drink water indicates impending recovery. Forcing water for mild thirst causes disaster. (*Huoren* states: Forced water causing chest fullness/stress requires Wuling San (Five-Ingredient Powder with Poria) or Xiexiong Tang (Expel Granules Decoction).)

Diarrhea with weak/rapid pulse and thirst: Self-healing (see Diarrhea chapter).

Thirst with fever, floating-weak pulse (not string-tight): Sweating leads to cure (see Delirium chapter).

Lou Quanshan stated: *Huoren* warns: Taiyang anhidrosis with thirst contraindicates Baihu Tang (White Tiger Decoction); Yangming profuse sweating with thirst contraindicates Zhuling Tang (Polyporus Decoction). Is Taiyang thirst never treated with Baihu Tang (White Tiger Decoction)? Post-sweating, flooding pulse with thirst allows it. Is Yangming thirst never treated with Wuling San (Five-Ingredient Powder with Poria)? Yangming dysuria, less sweating, floating pulse with thirst allows it.

Zhao Sizhen stated: *Huoren* warns: Taiyang anhidrosis with thirst contraindicates Baihu Tang (White Tiger Decoction); Yangming profuse sweating with thirst contraindicates Wuling San (Five-Ingredient Powder with Poria). Examining Zhongjing: Two prohibitions exist. 1. "Shanghan floating pulse, fever, anhidrosis, thirst, no exterior signs: Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng); unresolved exterior: contraindicated." *Huoren* said "anhidrosis" instead of "unresolved exterior," which is an error. 2. "Yangming profuse sweating with thirst: contraindicate Zhuling Tang (Polyporus Decoction)." *Huoren* changed this to Wuling San (Five-Ingredient Powder with Poria). Zhuling Tang (Polyporus Decoction) drains; Wuling San (Five-Ingredient Powder with Poria) releases exterior and drains. Why change? Profuse sweating indicates Stomach dryness; Taiyang sweating is less severe, so Wuling San (Five-Ingredient Powder with Poria) harmonizes exterior and drains heat. Yangming sweating is severe, Stomach dry. Another clause: "Yangming fever, profuse sweating: urgent purgation." Same Yangming sweating, but one prohibits diuresis, the other prohibits delaying purgation. Thirst indicates pathogen in channel, not yet solidified in Stomach. No thirst indicates internal solidity and external heat, risking fluid exhaustion, hence urgent purgation. Regarding Zhuling Tang (Polyporus Decoction) vs. Wuling San (Five-Ingredient Powder with Poria): Taiyang floating pulse, dysuria, slight fever, wasting-thirst uses Wuling San (Five-Ingredient Powder with Poria). Yangming floating pulse, fever, thirst, dysuria uses Zhuling Tang (Polyporus Decoction). Similar symptoms, different formulas? Taiyang pathogen in exterior, post-sweating failure: Wuling San (Five-Ingredient Powder with Poria) harmonizes exterior/moves fluids. Yangming pathogen in interior, heat in Lower Jiao: Zhuling Tang (Polyporus Decoction) drains heat. Mastery of nuance reveals Zhongjing's brilliance.

Note on "Spontaneous Diarrhea with Thirst": Heat enters Zang, flows to Shaoyin. Kidney dislikes dryness, causing thirst. Formulas: Zhuling Tang (Polyporus Decoction), Baitouweng Tang (Pulsatillae Decoction). Later, regarding diarrhea, it attributes thirst to Kidney deficiency seeking water, using Baitong Tang (Aconite Decoction), Sini Tang (Frigid Extremities Decoction), Zhuling Tang (Polyporus Decoction). Contradiction: Thirst as Heat vs. Thirst as Deficiency. Mixing Ice and Charcoal causes confusion. Grouping them separately misleads later practitioners. Clarification: Shaoyin cough/diarrhea/vomit/thirst/irritability/insomnia + Jueyin diarrhea/desire for water = Transmitted Heat (deep-thready-rapid pulse). Use Huanglian (Coptidis Rhizoma)/Shihua (Gypsum) to clear/drain. Shaoyin spontaneous diarrhea/thirst/vomit/no appetite/somnolence = Direct Yin Pathogen (deep-micro pulse). Use Fuzi (Aconiti Lateralis Radix Preparata)/Ganjiang (Zingiberis Rhizoma) to warm. Why not combine? Clearing and warming depend on diagnosis.

Wu Kun stated: Classify thirst by Six Channels. Taiyang exterior heat: no thirst. Heat transmitting to Bladder base: irritability, floating-rapid pulse, dysuria. Use Wuling San (Five-Ingredient Powder with Poria); strictly contraindicate Baihu Tang (White Tiger Decoction).

Yangming long pulse, exterior heat, anhidrosis, thirst: Gegen Jieji Tang (Kudzu Muscle-Releasing Decoction) or Liutong Shengsan Decoction (Six-Unity Powder) with doubled Gegen (Kudzu Root) to sweat. Yangming heat transmitting to Stomach, aversion to heat, sweating, thirst, floating-hyper-rapid pulse: Renshen Baihu Tang (Ginseng White Tiger Decoction); Wuling San (Five-Ingredient Powder with Poria) contraindicated. Yangming base heat, steaming/tidal fever, dry tongue/thirst, constipation: Dachaihu Tang (Major Bupleurum Decoction) or Tiaowei Chengqi Tang (Regulate and Nourish the Qi Decoction) to purge. If not solid yet, use modified Xiao Chai Hu Tang (Minor Bupleurum Decoction).

Shaoyang string-rapid pulse, bitter taste, dry throat, fever, thirst: Xiao Chai Hu Tang (Minor Bupleurum Decoction) removing Banxia (Pinelliae Rhizoma) adding Gualougen (Trichosanthis Radix). See main clause.

Taiyin spontaneous diarrhea: no thirst. Shaoyin bitter taste, drinking, white urine: Cold below. Deep pulse: Fuzi Tang (Aconite Decoction). Body cold, cold extremities, slippery pulse, thirst: Heat inside. Renshen Baihu Tang (Ginseng White Tiger Decoction). Yin syndrome irritability/thirst, unable to drink, deep pulse, cold feet: Sini Tang (Frigid Extremities Decoction) served cold.

Desire for water in Shanghan/epidemics indicates recovery (water harmonizes Stomach, induces sweat). Without water, dryness prevents sweating, leading to death. Observe patient strength and heat severity. Give cautiously; better insufficient than excessive. Excess water causes retention harm. Use fresh well water. For severe heat/constipation, add Yuanmingfen (Mirabilite) 1-2 qian. For summerheat irritability/thirst, add Chen Sha Tianshui San (Cinnabar Sky-Water Powder). For deficiency irritability/anorexia, Dengxin Tang (Juncus Decoction) infused in water. For general thirst: weak tea, white plum soup, mung bean soup. Edibles: Perfume pear, lotus root, watermelon. Ice must be washed to remove salt.

Dai Yuanli stated: Ask about water preference (cold/hot, amount). Much/cold indicates Yang thirst. Investigate channel involvement. Taiyang dysuria/thirst: Wuling San (Five-Ingredient Powder with Poria). Yangming constipation/thirst: Seek in Yangming channel. If bowel movement restored but thirst persists: Baihu Tang (White Tiger Decoction). Shaoyang alternating chills/fever/thirst: Xiao Chai Hu Tang (Minor Bupleurum Decoction) removing Banxia (Pinelliae Rhizoma) adding Gualougen (Trichosanthis Radix). Yin syndromes may have spontaneous diarrhea/thirst. Ancient physicians often used cold agents for Yin-thirst as they involve Yang Qi (disease is Yang despite Yin channel). However, pure Yin syndrome with clear grains, no heat, reverse thirst: Yin below blocking Yang above, fluid loss from diarrhea causes dryness. Patient drinks little, prefers warmth. Do not use cold agents; use Lizhong Tang (Middle-Warming Decoction) or Sini Tang (Frigid Extremities Decoction) plus Renshen (Panacis Ginseng). Severe thirst: Lianli Tang (Coptis and Licorice Decoction). Yang syndromes rarely thirsty; Yin syndromes often thirsty. Yangming: mild thirst; Taiyin: severe thirst. Treatments: Harden Kidney Water (Huafen/Trichosanthis Radix) or Promote Urination (Fuling/Zhuling). Taiyin prioritizes urination; Yangming prohibits it; Shaoyang (half-exterior/half-interior) prohibits purgation. For persistent thirst, Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Huafen (Trichosanthis Radix) hardens Kidney Water, which moistens Large Intestine, softens stool, clears heat, resolves thirst. Taiyang/Bladder/Kidney channel: must promote urination to clear heat/thirst. Non-Taiyang irritability/thirst: Yin excess blocking Yang; do not moisten thirst, treat Yin.

Luo Tianyi stated: Shanghan with poor appetite and thirst: Harmonize Stomach herbs; avoid cooling agents. Cooling damages Stomach Qi, worsening anorexia. Baizhu (Atractylodis Rhizoma) and Fuling (Poria) are suitable.