瘅成为中消。（全文见诊经云∶五脏皆柔弱而脆者为消瘅。王注云∶瘅为消热病也。）
已食而饥者胃疸。（平人气象论 一云∶注夏即瘅劳病也。）
谷入多而气少，得之有所脱血，湿居下也。（全文见诊生死。）
〔《灵》〕胃中热则消谷，令人心悬善饥， 以上皮热。（师傅篇 下同）胃中热，肠中寒，
则疾饥、小腹痛胀。中热则胃中消谷。（五癃津液篇）
〔《素》〕三阳结谓之消。（阴阳别论 王注云∶胃及大肠俱热结也，热则善消水谷。）
〔垣〕消渴中消，自古只治燥止渴，误矣。殊不知三阳结谓之消，三阳者，阳明也。手阳明
大肠主津液，所生病，热则目黄口干，是津液不足也。足阳明主血，所生病，热则消谷善饥，血
中伏火，是血不足也。结者，津液不足，结而不润，皆燥热为病也。此因数食甘美而多肥，
故其气上溢，转为消渴。治之以兰，除陈气也。不可服膏粱、芳草、石药，其气悍烈，能助热
燥也。越人云∶邪在六腑，则阳脉不和，阳脉不和，则气留之，气留之则阳脉盛矣，阳脉太盛
则阴气不得荣也，故肌肉皮肤消削是也。
〔《素》〕帝曰∶有病口甘者，病名为何？何以得之？岐伯曰∶此五气之溢也，名曰脾瘅。
夫五味入口，藏于胃，脾为之行其精气，津液在脾，故令人口甘也。此肥美之所发也，此人必
数食甘美而多肥也。肥者令人多热，甘者令人中满，故其气上溢，转为消渴。治之以兰，除陈
气也。（奇病论）
〔洁〕胃热则善消水谷，可饮甘辛降火之剂。用黄连末，生地、白藕各自然汁，牛乳各一升，
熬成膏。和黄连末一斤，丸如桐子大。每服三五十丸，少呷白汤下，日进十服。
〔河〕猪肚丸治消渴。
猪肚（一个） 黄连（一两） 栝蒌根（四两） 麦门冬（去心，四两） 知母（一两）
为细末，纳猪肚中，线缝，置甑中蒸极烂，乘热于石臼中杵，可丸为度。如硬，加少蜜为丸。
每服三十丸，渐加至四五十丸，渴则服之。（《三因方》多粱米、杜仲。本草云∶猪肚能补
中益气止渴。）
〔垣〕调胃承气汤 治消中 渴而饮食多。（方见伤寒，此初起时宜服之。） 三黄丸
（方见治发热条。）
〔洁〕顺利散治中热在胃而能食，小便赤黄微利。至不欲食为效，不可多利。
浓朴 枳实（各一两） 大黄（煨，四两）
每服五钱，水煎，食远服。
大肠移热于胃，善食而瘦，又谓之食 。（全文见诊病传变 食 者，谓食移易而过，
不生肌肤，亦易饥也。东垣云∶善食而瘦者，胃伏火邪于气分则能食，脾虚则肌肉削也。）胃移
热于胆，亦名食 。（同上）
〔河〕参蒲丸治食 。胃中结热，消谷善食，不生肌肉。
人参 赤茯苓 菖蒲 远志 地骨皮 牛膝（酒浸。各一两）
上为末，炼蜜丸。每服二十丸，米饮下。
运气消中皆属热。经云∶少阴之胜，心下热，善饥。又云∶少阳之胜，热客于胃，善饥，治以
寒剂是也。
针灸消中皆取于胃。经云∶邪在脾胃，阳气有余，阴气不足，则热中善饥，取三里灸之。又云∶
胃足阳明之脉，气盛则身以前皆热，于胃则消谷善饥。（热则清之，盛则泻之。）
〔《甲》〕阴气不足，热中，消谷善饥，腹热，身烦狂言，三里主之。腹中气胀引脊痛，饮食多
而身羸瘦，名曰食 。每作，先取脾俞，后取季胁。
瘅热发展为中消。（全文参见《诊经》说：五脏体质柔弱且脆性的，容易患消瘅病。王冰注解说：瘅是指产生热邪的消渴类疾病。）
吃完饭后不久就感到饥饿的，称为胃疸。（《平人气象论》中另一种说法认为：注夏即瘅劳病。）
摄入谷物多但气力不足，这是由于曾经失血，且湿气积聚在下部所致。（全文参见《诊生死》篇。）
〔《灵枢》〕胃中有热则消化食物快，使人心中空虚感并容易饥饿，这是皮肤发热的表现。（出自《师传》篇，下同）胃中有热，肠中有寒，则容易饥饿、小腹部疼痛胀满。体内有热则胃中消化食物过快。（出自《五癃津液篇》）
〔《素问》〕三阳经脉郁结称为消病。（《阴阳别论》王冰注解说：胃和大肠都热结，热盛则善于消耗水谷。）
〔李东垣〕治疗消渴中的中消证，自古以来只采用治燥止渴的方法，这是错误的。殊不知“三阳结谓之消”，所谓三阳，指的是阳明经。手阳明大肠主管津液，其病变表现为热盛则目黄口干，这是津液不足的表现。足阳明胃经主管血液，其病变表现为热盛则消谷善饥，血中伏藏火邪，这是血不足的表现。所谓“结”，是指津液不足，凝结而不滋润，都是燥热导致的疾病。这是因为长期食用甘甜美味且油腻的食物，导致气机上溢，转化为消渴。治疗应用兰草（如佩兰），以去除陈腐之气。不可服用膏粱厚味、芳草类药物及石药，因为这些药性悍烈，会助长热燥。越人（扁鹊）说：邪气在六腑，则阳脉不和，阳脉不和则气机留滞，气机留滞则阳脉盛大，阳脉太盛则阴气无法荣养，所以肌肉皮肤消瘦，就是这个道理。
〔《素问》〕黄帝问：有人口甜，这是什么病？怎么得的？岐伯回答说：这是五气上溢的表现，名叫脾瘅。五味入口后藏于胃，由脾来传输其精气，津液停留在脾，所以使人感觉口甜。这是肥美食物引发的疾病，这种人一定经常食用甘甜美味且油腻的食物。肥腻食物使人产生内热，甘甜食物使人中焦痞满，所以气机上溢，转化为消渴。治疗应用兰草，以去除陈腐之气。（出自《奇病论》）
〔张洁古〕胃热则善于消化水谷，可以使用甘辛降火的药剂。用黄连末，生地黄汁、白藕汁各一升，牛乳一升，熬制成膏。加入黄连末一斤，制成梧桐子大小的丸药。每次服用三五十丸，少量喝白开水送下，每天服用十次。
〔李东垣〕猪肚丸治疗消渴。
猪肚（一个） 黄连（一两） 栝蒌根（四两） 麦门冬（去心，四两） 知母（一两）
研为细末，纳入猪肚中，用线缝合，放在蒸笼中蒸至极烂，趁热在石臼中捣烂，能做成丸药的程度即可。如果太硬，加少许蜂蜜制成丸药。每次服用三十丸，逐渐增加到四五十丸，口渴时服用。（《三因方》中还有粱米、杜仲。《本草》说：猪肚能补中益气止渴。）
〔李东垣〕调胃承气汤，治疗消中证，口渴且饮食量大。（方剂见《伤寒论》，此病初起时适宜服用。）三黄丸（方剂见治疗发热条目）。
〔张洁古〕顺利散治疗胃中热盛而能进食，小便赤黄且轻微腹泻。以达到不想吃东西的效果为度，不可使腹泻过多。
浓朴 枳实（各一两） 大黄（煨制，四两）
每次服用五钱，水煎，饭前或饭后较长时间服用。
大肠的热邪移注于胃，容易进食但身体消瘦，又叫做食6（音同“肌”）。（全文参见《诊病传变》篇。食6的意思是：食物经过肠胃却不被吸收转化，不生肌肤，也表现为易饥。李东垣说：容易进食但身体消瘦，是因为胃中潜伏火邪于气分所以能食，脾虚则肌肉消瘦。）胃的热邪移注于胆，也称为食6。（同上）
〔李东垣〕参蒲丸治疗食6。症状为胃中结热，消化食物快且食欲旺盛，但不长肌肉。
人参 赤茯苓 菖蒲 远志 地骨皮 牛膝（酒浸，各一两）
以上药材研为细末，炼蜜为丸。每次服用二十丸，米汤送下。
运气学说中，消中证都属于热证。经文说：少阴司天胜气，心下热，容易饥饿。又说：少阳司天胜气，热邪客居于胃，容易饥饿，治疗使用寒凉药剂是正确的。
针灸治疗消中证都选取胃经穴位。经文说：邪气在脾胃，阳气有余，阴气不足，则出现热中、容易饥饿的症状，取足三里穴并施灸。又说：足阳明胃经，气盛则身体前部皆热，反映在胃则消谷善饥。（热则清之，盛则泻之。）
〔《甲乙经》〕阴气不足，热中，消谷善饥，腹部发热，身体烦躁狂言，由足三里主治。腹中气胀牵引脊背疼痛，饮食多但身体羸瘦，名叫食6。每次发作，先取脾俞穴，后取季胁穴。
Dian heat develops into Middle Xiao (Middle Jiao Diabetes). (The full text is found in *Zhen Jing* stating: When the five Zang organs are weak and brittle, one is prone to Xiao Dan [Diabetes with emaciation]. Wang Bing's commentary states: Dian refers to a heat-generating disease of the Xiao type.)
Feeling hungry shortly after eating is called Wei Dan (Stomach Jaundice). (Another version in *Ping Ren Qi Xiang Lun* states: Zhu Xia is equivalent to Dan Lao disease.)
Consuming large amounts of grain but having little Qi results from prior blood loss and dampness accumulating in the lower body. (The full text is found in *Zhen Sheng Si*.)
[From *Ling Shu*] Heat in the Stomach causes rapid digestion of food, leading to a sensation of emptiness in the heart and easy hunger; this corresponds to heat in the skin. (From *Shi Chuan* chapter, same below) If there is heat in the Stomach and cold in the Intestines, it leads to frequent hunger and pain/distension in the lower abdomen. Internal heat causes the Stomach to digest food rapidly. (From *Wu Long Jin Ye Pian*)
[From *Su Wen*] The binding of the Three Yang meridians is called Xiao (Wasting-Thirst). (Wang Bing’s commentary on *Yin Yang Bie Lun* states: Both the Stomach and Large Intestine have heat binding; heat promotes the consumption of water and grain.)
[Li Dongyuan] In treating Zhong Xiao (Middle Xiao) within Xiao Ke (Wasting-Thirst), ancient practitioners only treated dryness and stopped thirst, which was a mistake. One must not fail to realize that "the binding of the Three Yang is called Xiao." The Three Yang refers to the Yangming meridians. The Hand-Yangming Large Intestine governs body fluids; its pathology involves heat causing yellow eyes and dry mouth, indicating insufficient body fluids. The Foot-Yangming Stomach governs blood; its pathology involves heat causing rapid digestion and easy hunger, indicating hidden fire in the blood and insufficient blood. "Binding" means insufficient body fluids, condensation without lubrication, all caused by dryness-heat. This occurs because of frequent consumption of sweet, delicious, and fatty foods, causing Qi to overflow upward and transform into Xiao Ke. Treatment involves using Lan Cao (Plagiorhiza/Patchouli Herb) to remove stale Qi. One should not consume rich foods, aromatic herbs, or mineral drugs, as their fierce nature can assist heat and dryness. Yue Ren (Bian Que) stated: When pathogenic factors are in the Six Fu organs, the Yang pulses become discordant; discordance leads to Qi stagnation, which makes the Yang pulses vigorous. Excessive Yang pulse vigor prevents Yin Qi from nourishing, resulting in the wasting of muscles and skin.
[From *Su Wen*] The Yellow Emperor asked: There is a patient with a sweet taste in the mouth. What is this disease? How does it arise? Qibo answered: This is the overflow of the Five Qi, named Pi Dan (Spleen Dan). When the five flavors enter the mouth, they are stored in the Stomach, and the Spleen transports their essence. When fluids remain in the Spleen, it causes a sweet taste in the mouth. This arises from rich and fatty foods; such individuals must frequently eat sweet and fatty foods. Fatty foods cause internal heat, and sweet foods cause fullness in the center. Thus, Qi overflows upward, transforming into Xiao Ke. Treatment involves using Lan Cao to remove stale Qi. (From *Qi Bing Lun*)
[Zhang Jiegu] Heat in the Stomach leads to efficient digestion of water and grain; one may use sweet and acrid agents to descend fire. Use Coptis Rhizoma powder, fresh juice of Rehmanniae Radix and Nelumbinis Nucillus each one sheng, and cow's milk one sheng, boiled into an ointment. Mix with one jin of Coptis Rhizoma powder, form pills the size of paulownia seeds. Take 30–50 pills each time, swallowed with small sips of warm water, ten doses per day.
[Li Dongyuan] Zhu Du Wan treats Xiao Ke.
Pig Stomach (one) Coptidis Rhizoma (one liang) Trichosanthis Radix (four liang) Ophiopogonis Radix (decored, four liang) Anemarrhenae Rhizoma (one liang)
Grind into fine powder, place inside the pig stomach, sew with thread, steam in a steamer until extremely soft, pound while hot in a stone mortar until pillable consistency. If too hard, add a little honey to form pills. Take 30 pills each time, gradually increasing to 40–50 pills, take when thirsty. (*San Yin Fang* includes Sorghum Rice and Eucommiae Cortex. *Ben Cao* states: Pig Stomach tonifies the Center, benefits Qi, and stops thirst.)
[Li Dongyuan] Tiao Wei Cheng Qi Tang treats Xiao Zhong (Middle Wasting), characterized by thirst and excessive eating. (Formula seen in *Shang Han Lun*, suitable for early stage.) San Huang Wan (Formula seen under Fever treatment section).
[Zhang Jiegu] Shun Li San treats excess heat in the Stomach allowing for eating, with red-yellow urine and mild diarrhea. The goal is to reach a state of no desire to eat; do not cause excessive diarrhea.
Magnoliae Officinalis Cortex (one liang each) Immature Bitter Orange (one liang) Rheii Radix et Rhizoma (roasted, four liang)
Take five qian each time, decoct in water, take far from meals.
Heat transferring from the Large Intestine to the Stomach causes voracious eating yet emaciation, also known as Shi Ji (Eating without gaining flesh). (Full text in *Zhen Bing Chuan Bian*. Shi Ji means food passes through without nourishing muscles, accompanied by easy hunger. Dongyuan said: Voracious eating with emaciation occurs because latent fire pathogens in the Stomach allow for eating, while Spleen deficiency causes muscle wasting.) Heat transferring from the Stomach to the Gallbladder is also called Shi Ji. (Same source)
[Li Dongyuan] Shen Pu Wan treats Shi Ji. Symptoms include heat binding in the Stomach, rapid digestion, strong appetite, but failure to build muscle mass.
Ginseng Radix Red Poria Polyporus Acori Tatarinowii Rhizoma Polygalae Radix Cortex Lycii Radicis Achyranthis Bidentatae Radix (wine-soaked, one liang each)
Grind into powder, refine honey to make pills. Take 20 pills each time, swallow with rice drink.
In the theory of Six Qi transformations, Xiao Zhong belongs to heat. The Classics state: When Shaoyin prevails, there is heat in the epigastrium and easy hunger. It also states: When Shaoyang prevails, heat lodges in the Stomach causing easy hunger; treating with cold agents is correct.
Acupuncture and moxibustion for Xiao Zhong all select Stomach meridian points. The Classics state: When pathogens are in the Spleen and Stomach, with excess Yang and deficient Yin, one experiences Heat Zhong and easy hunger; select Zusanli and apply moxa. It also states: The Foot-Yangming Stomach Meridian, when Qi is excessive, causes heat in the anterior body; regarding the Stomach, this manifests as rapid digestion and easy hunger. (Heat requires clearing, excess requires draining.)
[From *Jia Yi Jing*] Deficiency of Yin Qi, Heat Zhong, rapid digestion with easy hunger, abdominal heat, restlessness, mania, and delirium are primarily treated by Zusanli. Abdominal distension radiating to the spine, excessive eating yet emaciation, is named Shi Ji. Upon onset, first select Shenshu, then select the costal margin.