〔罗〕张安抚芸夫，年四十五岁，病消渴，舌上赤裂，饮水无度，小便数多，先师以此药治之，
良愈。消渴多传疮疡，为不救之疾，既效亦不成疮疡，享年七十五而终，名之曰生津甘露饮子。
治消渴上下齿麻，舌硬赤烂肿痛，食不下，腹时胀满疼痛，浑身色黄，目白睛黄。甚则四肢萎弱
无力，面尘脱色，胁下急痛，善嚏善怒健忘，臀肉腰背疼寒，两丸冷甚。一方石膏用一两二钱。
石膏（一钱二分） 人参 甘草（生） 山栀 白豆蔻 白芷 连翘 甘草（炙） 荜澄茄
黄连 姜黄 藿香（各一钱） 白葵
（五分） 麦门冬 杏仁（各一钱） 归身 兰香（各五分） 黄柏（酒炒，钱半） 升麻根（二钱）
木香（一钱） 桔梗（三分） 柴胡根（五分） 知母（酒，二钱） 全蝎（二个，去毒）
上为末，水浸，蒸饼和匀成剂，捏作饼子，晒干，杵碎如黄米大。每服二钱，挑于掌内，
以舌舐之，津液送下，或白汤食后服之，神效。凡消渴为病，燥热之气胜也。《内经》云∶
热淫所胜，佐以甘苦，以甘泻之。热则伤气，气伤则无润，折热补气，非甘寒之剂不能，故以
石膏之甘寒为君；启玄子曰∶滋水之源，以镇阳光，故以柏、连、栀子、知母之苦寒泻热补水为
臣；以当归、杏仁、麦门冬、全蝎、连翘、白葵、兰香、甘草甘寒和血润燥为佐；升麻、柴胡苦
平，行阳明、少阳二经，荜澄茄、白豆蔻、木香、藿香反佐以取之；又用桔梗为舟楫，使浮而不
下也。
〔垣〕和血养气汤治口渴舌干，小便数，舌上赤裂。此药生津除燥，生肌肉，一名地黄饮子。
黄连（酒，七分） 桃仁（六个） 生地（七分） 红花（少许） 黄柏（酒，一钱）
当归（酒，四分） 甘草（炙，三分） 升麻（一钱） 知母（酒，五分） 防己（酒，三分）
羌活（五分） 麻黄根（二分） 口干舌渴，加杏仁（六个）甘草（生，三分） 小便数，加石膏（六分）
上 咀，作一服，水煎去渣，稍热服。忌酒、面、房事。
清凉饮子治消中能食而瘦，口舌干，自汗，大便结，小便数。
羌活梢（一钱） 柴胡梢（一钱） 升麻梢（四分） 防风梢（五分） 当归（六分） 甘草梢（一钱）
石膏（一钱半） 知母（酒制，一钱） 红花（少许） 防己（五分） 龙胆草（一钱半） 黄柏（一钱半）
桃仁（五个） 杏仁（五个） 生地（酒，五分） 黄 根（一钱） 黄芩（酒，一钱） 甘草（炙，一钱）
上，水二盏，酒一小盏，煎服。
甘露膏治消渴，饮水极多，善食而瘦，自汗，大便结燥，小便频数。又名兰香饮子。
石膏（二钱） 知母（一钱半） 甘草（生一钱，炙五分） 人参（五分） 防风根（一钱） 半夏（制，五分）
兰香（五分） 白豆蔻 连翘 桔梗 升麻（各五分）
上为末，水浸蒸饼丸；或捏剂作薄饼子，晒干，碎如米大。每用淡姜汤下二钱。
〔丹〕徐兄，年四十岁。口干，小便数。春末得之，夏来求治。诊其两手，左涩，右略数而
不弦。重取似大而稍有力，左稍沉略弱而不弦，然涩却多于右，喜两尺皆不甚起。此由饮食味
浓生热，谓之痰热。禁其浓味，宜降火以清金，抑肝以补脾。用三消丸十粒；左金、阿魏丸各五
粒，以姜汤吞下，一日六次。又以四物汤加参、术、陈皮、生甘草、五味子、麦门冬煎服，一日
三次，与丸药间服。一二日自觉清快，小便减三之二，口亦不干。止渴未除，头晕眼花，久坐
则腰疼，遂以摩腰膏治腰疼；仍以四物汤用参、 ，减川芎，加牛膝、五味子、炒柏、麦门冬
煎饮，调六一散服。及觉便多，遂去六一散，仍服丸药而安。黄连末，治消渴要药，加天花粉末，
人乳、生地黄汁、生藕汁二物为膏，入山药末搜和，以姜汁和，炼蜜为膏，徐徐挑于舌上，以
白汤少许送下，亦得。能食，加软石膏。
治消渴，以天花粉为末，用人乳汁、生韭汁煎膏，丸如绿豆大。每服百丸，食后服。
〔《肘》〕治消渴小便多者，煮栝蒌根汁饮之良。
〔世〕 治消渴无方可治者，用天花粉、大乌头炒，等分为细末，蒸饼丸。每服百丸，黑豆汤下。
以上四方，栝蒌根为君。《本草》云∶栝蒌根，主消渴，止小便，通月水、乳汁。夫既能止
小便，又能通月水，知其流湿润燥，治消渴之要药也。
〔《本》〕千金地黄丸治肾渴。
黄连（四两，为末） 生地（半斤，研取汁，连渣拌黄连末，和匀，晒干用）
上再为细末，炼蜜为丸。食后，麦门冬汤下五六十丸。
〔罗〕黄连丸治消渴饮水无度，小便频数。
黄连（净，半斤，用无灰好酒浸一宿，重汤蒸一伏时，取出晒干用）
上为细末，滴水丸。白汤下五七十丸。
又方 治卒消渴，小便多。捣黄连细末，蜜丸。服三四十丸。
麦门冬汤治消渴，日夜饮水无度，饮下即溲。
麦门冬（去心） 黄连 冬瓜（各二两）
上为粗末。每服五钱，水煎八分，去渣温服。若冬瓜无干者，用新冬瓜肉三斤，去穣，分
作十二片，为十二服。每服用瓜一片，劈破水煎，日三服。
冬瓜饮子治消渴能食而饮水多，小便如脂麸片，日夜无度。
冬瓜（一枚） 黄连（十两，为细末）
上先以冬瓜破开去穣，掺黄连末在内，却用顶盖定，于热灰中煨熟去皮，切细，烂研绞汁。
每服一盏至二盏，日三、夜一服。
〔《本》〕三消丸用好黄连治净为细末，不拘多少；切冬瓜肉研取自然汁，和成饼，阴干，
再为细末。用汁浸和，加至七次，即用冬瓜末为丸。每服三四十丸，以冬瓜汁煎大麦仁汤送下。
寻常渴止一服效。
以上五方，黄连、冬瓜为君。丹溪云∶冬瓜性走而急，久病与阴虚者忌之，又有黄连
为佐，用者审之。
〔《食》〕治消渴饮水不止，小便数。用田螺五升，水一斗，浸一宿，渴即饮之，每日一度
易水换螺为妙。
又方 以水煮取汁饮之，螺亦任吃。
〔子和〕治饮水百杯，尚犹未足，小便如砂，或如杏色。服此方三五日，小便大出，毒注下，
十日除根。
此方子和自云∶此重剂，试有验。
水银（四钱） 锡（二钱，同水银炒成砂子） 牡蛎 密陀僧 知母 紫菀 苦参 贝母（各一两）
黄丹（半两） 栝蒌根（半斤）
上为细末。男子用不生儿猪肚，妇人用 猪肚一个，纳药于内，以麻线缝之，用新瓦二片，
绳系一二遭，别用米一升，栝蒌根末半升，于新水内煮熟。取出放冷，不用米及栝蒌，只研猪肚
并肚中药末，烂和为丸。如硬，加蜜。食前米汤下三四十丸。（《三因方》无贝母。）
〔河〕胡粉散治大渴百方不痊者，亦治肾消。
黄丹 胡粉（各半两） 栝蒌根（二两半） 甘草（一两） 泽泻 石膏 赤石脂 白石脂（各半两）
上 咀，水煎服，日二服。如腹痛减之，为丸服尤妙。每服十丸，多则腹痛。
葛根丸治消渴消肾，日饮硕水者。
葛根（三两） 栝蒌根（二两） 黄丹（二两） 附子（炮，去皮脐，一两）
上为末，炼蜜丸。每服十丸，日进三服。春夏去附子。
〔垣〕六味地黄丸 治肾消效。（方见治虚实法。）
〔《经》〕治消渴不止，下元虚者。用牛膝五两，细锉为末，生地黄汁五升，昼曝夜浸，以汁
尽为度，蜜丸。空心温酒下三十丸。久服壮筋骨，驻颜色，黑须发，生津液。
〔仲〕治男子消渴，小便反多。如饮水一斗，小便亦一斗，肾气丸主之。（方见治虚实法。）
〔子和〕治肾消。以肾气丸本方内加山药一味外，桂附从四时加减∶冬一两，春秋三钱，夏
一钱。又法，肾气丸去附子，加五味子一两半。
〔《本》〕唐祠部李郎中，治消渴者肾虚所致，每发则小便甜。医者多不知其故，亦缺而不言。
《洪范》曰∶稼穑作甘。以物理推之，淋 醋酒作脯法，须臾即甜，足明人之食后滋味皆甜，流在
膀胱。若腰肾气盛，则上蒸炎气，化成精气，下入骨髓，其次为脂膏，又其次为血肉，其余则为
小便。故小便色黄，血之余气也。五脏之气咸润者，则下味也。若腰肾既虚冷，则不能蒸化谷气，
尽下为小便，故味甘不变，其色清冷，则肌肤枯槁也。犹如乳母谷气上泄，皆为乳汁。消渴病者，
下泄为小便，皆精气不实于内，则小便数溲溺也。又肺为五脏华盖，若下有暖气蒸则肺润，若下冷
极，则阳不能升，故肺干而渴。《易》于否卦言之矣，干上坤下，阳无阴不降，阴无阳不升，上
下不交，故成否也。譬如釜中有水，以火暖之，又以板覆之，则暖气上腾，故板能润；若无火力，则
水气不能上升，此板终不得润。火力者，腰肾强盛也。常须暖补肾气，饮食得火力则润上而易消，
亦免干渴之患。故仲景云∶宜服肾气八味丸。此疾与香港脚虽同，皆为肾虚所致，其香港脚始发于二
三月，盛于五六月，衰于七八月；凡消渴始发于七八月，盛于十一二月，衰于二三月。其故何也？夫香港脚，壅
疾也；消渴，宣疾也。春夏阳气上，故壅疾发则宣疾愈。秋冬阳气下，故宣疾发则壅疾愈。
审此二者，疾可理也。犹如善为政者，宽以济猛，猛以济宽，随时变通耳。
〔和〕治诸虚不足，胸中烦悸，时常消渴，唇口干燥，或先渴而欲发疮，或病痈疽而后渴者，
宜用黄 汤多服之。（方见痈疽门。凡消渴而小便反多有脂者，皆肾气不管摄津液也，宜多服黄 ，
黄乃补气之要药。）
〔《保》〕行气丸治消渴。
五灵脂（《衍义》云∶五灵脂入肝最远，能行经血，不能生血） 乌头（去皮脐）
上等分为末。每服三钱，冬瓜汤下。无瓜时，苗叶亦可。日三服，渴止勿服。再服八味丸
去附子、加五味子。
〔《外》〕治消肾，小便数。鹿角一具炙焦，捣筛为末。酒服方寸匕，渐渐加之。
〔《保》〕茴香散治消病，下焦渴症，小便如膏。
茴香（炒） 苦楝（炒） 各等分，炒为末，食后酒调下一钱。
〔《食》〕治消渴，舌焦口干，小便数。野雉一只，以五味煮令极熟，去肉取汁，渴饮之，
肉亦可食。
肝瘅者，夜卧则惊，多饮，小便数。（全文见瘅。）
心移寒于肺消者，饮一溲二，不治。（全文见诊病传变 王注云∶肾脏消烁，气无所摄，
故饮一溲二也。）
〔仲〕寸口脉浮而迟，浮即为虚，迟即为劳。虚则卫气不足，劳则荣气竭。跗阳脉浮而数，
浮则为气，数则消谷而大坚。气盛则溲数，溲数则坚，坚数相搏，即为消渴。跗阳脉数，胃中
有热，即消谷引饮，大便必坚，小便即数。
【罗知悌】张安抚芸夫，四十五岁，患消渴病，舌面红赤裂纹，饮水无度，小便频数。先师用此药治疗他，痊愈良好。消渴病多会转化为疮疡，属于难治之疾，但他服药后既见效也未发生疮疡，享年七十五岁去世。此方名为生津甘露饮子。主治消渴症见上下齿麻木，舌体僵硬、红烂、肿痛，饮食难下，腹部时常胀满疼痛，全身肤色发黄，眼白睛黄。严重时四肢萎弱无力，面色如蒙尘且色泽脱失，胁肋下急痛，容易打喷嚏、易怒、健忘，臀部、肌肉、腰背疼痛发冷，两侧睾丸寒冷严重。另一版本中石膏用量为一两二钱。
药材：石膏（一钱二分）、人参、甘草（生用）、山栀、白豆蔻、白芷、连翘、甘草（炙用）、荜澄茄、黄连、姜黄、藿香（各一钱）、白葵（五分）、麦门冬、杏仁（各一钱）、当归身、兰香（各五分）、黄柏（酒炒，一钱半）、升麻根（二钱）、木香（一钱）、桔梗（三分）、柴胡根（五分）、知母（酒浸，二钱）、全蝎（二个，去毒）。
以上药物研为细末，用水浸泡，与蒸饼混合均匀制成剂型，捏成饼状，晒干后捣碎如黄米大小。每次服用二钱，置于掌心，用舌头舔舐，以津液送服，或在饭后用白开水送服，效果神奇。凡消渴病，皆因燥热之气偏胜所致。《内经》说：“热邪过盛，以甘苦味药物辅助，用甘味药泻热。”热邪会损伤正气，正气受损则失去滋润作用，要折损热邪并补益正气，非甘寒性质的药剂不能做到，所以以石膏的甘寒性质作为君药；启玄子说：“滋补水之源，以镇摄阳光（虚火），”所以以黄柏、黄连、栀子、知母的苦寒性质来泻热补水，作为臣药；以当归、杏仁、麦门冬、全蝎、连翘、白葵、兰香、甘草的甘寒性质来调和血液、润燥，作为佐药；升麻、柴胡苦平，通行阳明、少阳二经，荜澄茄、白豆蔻、木香、藿香作为反佐药以取效；又用桔梗作为舟楫之药，使药性上浮而不直下。
【李杲】和血养气汤治疗口渴舌干，小便频数，舌面红赤裂纹。此药能生津除燥，生肌长肉，又名地黄饮子。
药材：黄连（酒浸，七分）、桃仁（六个）、生地（七分）、红花（少许）、黄柏（酒浸，一钱）、当归（酒浸，四分）、甘草（炙用，三分）、升麻（一钱）、知母（酒浸，五分）、防己（酒浸，三分）、羌活（五分）、麻黄根（二分）。若口干舌渴，加杏仁（六个）、甘草（生用，三分）；若小便频数，加石膏（六分）。
以上药物切碎，作一剂，加水煎煮去渣，稍热时服用。忌食酒、面食及房事。
清凉饮子治疗消渴症中能进食但身体消瘦，口舌干燥，自汗，大便干结，小便频数。
药材：羌活梢（一钱）、柴胡梢（一钱）、升麻梢（四分）、防风梢（五分）、当归（六分）、甘草梢（一钱）、石膏（一钱半）、知母（酒制，一钱）、红花（少许）、防己（五分）、龙胆草（一钱半）、黄柏（一钱半）、桃仁（五个）、杏仁（五个）、生地（酒浸，五分）、黄芩根（一钱）、黄芩（酒浸，一钱）、甘草（炙用，一钱）。
以上药物，加水两盏，酒一小盏，煎服。
甘露膏治疗消渴，饮水极多，食欲旺盛但身体消瘦，自汗，大便干结，小便频数。又名兰香饮子。
药材：石膏（二钱）、知母（一钱半）、甘草（生用一钱，炙用五分）、人参（五分）、防风根（一钱）、半夏（制用，五分）、兰香（五分）、白豆蔻、连翘、桔梗、升麻（各五分）。
以上药物研为细末，用水浸泡蒸饼丸药；或捏成薄饼状，晒干后捣碎如米粒大小。每次用淡姜汤送服二钱。
【朱震亨】徐兄，四十岁。口干，小便频数。春末患病，夏季来求治。诊其两手脉象，左手涩，右手略数但不弦。重按似大且稍有力，左手稍沉略弱但不弦，然而涩脉多于右手，喜欢两尺脉都不甚起搏。这是由于饮食口味浓烈产生热邪，称为痰热。禁止食用浓味食物，宜降火以清肺金，抑肝以补脾土。使用三消丸十粒；左金丸、阿魏丸各五粒，用姜汤吞服，一日六次。又以四物汤加人参、白术、陈皮、生甘草、五味子、麦门冬煎服，一日三次，与丸药交替服用。一二日后自觉清爽舒适，小便减少三分之二，口也不干了。止渴症状未除，头晕眼花，久坐则腰痛，于是用摩腰膏治疗腰痛；仍以四物汤用人参、[缺字]，减去川芎，加牛膝、五味子、炒黄柏、麦门冬煎饮，调服六一散服用。等到觉得大便增多，便去掉六一散，继续服用丸药而安。黄连末是治疗消渴的要药，加入天花粉末，人乳、生地黄汁、生藕汁两种液体熬成膏，加入山药末搅拌混合，用姜汁调和，炼蜜为膏，慢慢挑于舌上，用少量白开水送下，也可以。若能进食，加软石膏。
治疗消渴，将天花粉研为末，用人乳汁、生韭菜汁煎膏，丸如绿豆大小。每次服用一百丸，饭后服用。
【世传方】治疗消渴无法可治者，用天花粉、大乌头炒制，等分为细末，蒸饼丸药。每次服用一百丸，黑豆汤送下。
以上四方，以栝蒌根为君药。《本草》说：“栝蒌根，主治消渴，止小便，通月水、乳汁。”既然能止小便，又能通月水，可知其具有流湿润燥的功效，是治疗消渴的要药。
药材：黄连（四两，研为末）、生地（半斤，研取汁，连同药渣拌入黄连末，混合均匀，晒干使用）。
以上再研为细末，炼蜜为丸。饭后，用麦门冬汤送服五六十丸。
药材：黄连（净选，半斤，用无灰好酒浸泡一夜，隔水蒸一个时辰，取出晒干使用）。
以上研为细末，滴水为丸。白开水送服五七十丸。
又一方 治疗突发消渴，小便多。捣黄连为细末，蜜丸。服用三四十丸。
以上研为粗末。每次服用五钱，加水煎至八分，去渣温服。若无干冬瓜，可用新冬瓜肉三斤，去瓤，分为十二片，作十二剂服用。每剂用瓜一片，劈破加水煎煮，每日三次服用。
以上先将冬瓜破开去瓤，掺入黄连末在内，再用顶盖盖好，在热灰中煨熟去皮，切细，烂研绞汁。每次服用一盏至二盏，日服三次，夜服一次。
【《证类本草》】三消丸用好黄连洗净研为细末，不拘多少；切冬瓜肉研取自然汁，和成饼，阴干，再研为细末。用汁浸泡调和，加至七次，即用冬瓜末为丸。每次服用三四十丸，用冬瓜汁煎大麦仁汤送下。寻常口渴服一剂即效。
以上五方，以黄连、冬瓜为君药。丹溪说：“冬瓜性走而急，久病与阴虚者忌用，又有黄连为佐，使用者需谨慎。”
【《食疗本草》】治疗消渴饮水不止，小便频数。用田螺五升，水一斗，浸泡一夜，口渴即饮之，每日一度换水换螺为妙。
又一方 用水煮取汁饮用，螺肉也可随意吃。
【张子和】治疗饮水百杯，尚犹未足，小便如砂，或如杏色。服用此方三五日，小便大量排出，毒素注下，十日除根。
此方张子和自称：“此为重剂，试之有效。”
药材：水银（四钱）、锡（二钱，同水银炒成砂子）、牡蛎、密陀僧、知母、紫菀、苦参、贝母（各一两）、黄丹（半两）、栝蒌根（半斤）。
以上研为细末。男子用不生仔猪肚一个，妇人用[缺字]猪肚一个，纳药于内，以麻线缝之，用新瓦二片，绳系一二遭，别用米一升，栝蒌根末半升，于新水内煮熟。取出放冷，不用米及栝蒌，只研猪肚并肚中药末，烂和为丸。如硬，加蜜。食前米汤送服三四十丸。（《三因方》无贝母。）
药材：黄丹、胡粉（各半两）、栝蒌根（二两半）、甘草（一两）、泽泻、石膏、赤石脂、白石脂（各半两）。
以上切碎，水煎服，日服两次。如腹痛减轻，改为丸药服用尤其好。每次服用十丸，多则腹痛。
药材：葛根（三两）、栝蒌根（二两）、黄丹（二两）、附子（炮制，去皮脐，一两）。
以上研为末，炼蜜为丸。每次服用十丸，日进三次。春夏季节去掉附子。
【《内经》】治疗消渴不止，下元虚者。用牛膝五两，细锉为末，生地黄汁五升，昼曝夜浸，以汁尽为度，蜜丸。空心温酒送服三十丸。久服壮筋骨，驻颜色，黑须发，生津液。
【张仲景】治疗男子消渴，小便反多。如饮水一斗，小便亦一斗，肾气丸主之。（方见治虚实法。）
【张子和】治疗肾消。以肾气丸本方内加山药一味外，桂附从四时加减∶冬一两，春秋三钱，夏一钱。又法，肾气丸去附子，加五味子一两半。
【《证类本草》】唐祠部李郎中，治疗消渴者肾虚所致，每发则小便甜。医者多不知其故，亦缺而不言。《洪范》曰：“稼穑作甘。”以物理推之，淋醋酒作脯法，须臾即甜，足明人之食后滋味皆甜，流在膀胱。若腰肾气盛，则上蒸炎气，化成精气，下入骨髓，其次为脂膏，又其次为血肉，其余则为小便。故小便色黄，血之余气也。五脏之气咸润者，则下味也。若腰肾既虚冷，则不能蒸化谷气，尽下为小便，故味甘不变，其色清冷，则肌肤枯槁也。犹如乳母谷气上泄，皆为乳汁。消渴病者，下泄为小便，皆精气不实于内，则小便数溲溺也。又肺为五脏华盖，若下有暖气蒸则肺润，若下冷极，则阳不能升，故肺干而渴。《易》于否卦言之矣，干上坤下，阳无阴不降，阴无阳不升，上下不交，故成否也。譬如釜中有水，以火暖之，又以板覆之，则暖气上腾，故板能润；若无火力，则水气不能上升，此板终不得润。火力者，腰肾强盛也。常须暖补肾气，饮食得火力则润上而易消，亦免干渴之患。故仲景云：“宜服肾气八味丸。”此疾与香港脚虽同，皆为肾虚所致，其香港脚始发于二三月，盛于五六月，衰于七八月；凡消渴始发于七八月，盛于十一二月，衰于二三月。其故何也？夫香港脚，壅疾也；消渴，宣疾也。春夏阳气上，故壅疾发则宣疾愈。秋冬阳气下，故宣疾发则壅疾愈。审此二者，疾可理也。犹如善为政者，宽以济猛，猛以济宽，随时变通耳。
【王履】治疗诸虚不足，胸中烦悸，时常消渴，唇口干燥，或先渴而欲发疮，或病痈疽而后渴者，宜用黄芪汤多服之。（方见痈疽门。凡消渴而小便反多有脂者，皆肾气不管摄津液也，宜多服黄芪，黄芪乃补气之要药。）
药材：五灵脂（《衍义》云：“五灵脂入肝最远，能行经血，不能生血”）、乌头（去皮脐）。
以上等分为末。每次服用三钱，冬瓜汤送下。无瓜时，苗叶亦可。日三服，渴止勿服。再服八味丸去附子、加五味子。
【《外台秘要》】治疗肾消，小便数。鹿角一具炙焦，捣筛为末。酒服方寸匕，渐渐加之。
【《保命集》】茴香散治疗消病，下焦渴症，小便如膏。
药材：茴香（炒）、苦楝（炒）。各等分，炒为末，食后酒调下一钱。
【《食疗本草》】治疗消渴，舌焦口干，小便数。野雉一只，以五味煮令极熟，去肉取汁，渴饮之，肉亦可食。
心移寒于肺消者，饮一溲二，不治。（全文见诊病传变 王注云：“肾脏消烁，气无所摄，故饮一溲二也。”）
【张仲景】寸口脉浮而迟，浮即为虚，迟即为劳。虚则卫气不足，劳则荣气竭。跗阳脉浮而数，浮则为气，数则消谷而大坚。气盛则溲数，溲数则坚，坚数相搏，即为消渴。跗阳脉数，胃中有热，即消谷引饮，大便必坚，小便即数。
[Luo Zhi Ti] Zhang Anfu Yunfu, aged forty-five, suffered from Xiao Ke (Wasting and Thirsting Syndrome). His tongue was red with cracks, he drank water without limit, and urinated frequently. The Master treated him with this prescription, resulting in a good recovery. Xiao Ke often progresses to sores and ulcers, a difficult-to-treat condition; however, after taking this medicine, he recovered without developing sores and lived to the age of seventy-five. This prescription is named Sheng Jin Gan Lu Yin Zi (Sweat-Generating Nectar Decoction). It treats Xiao Ke with numbness in the upper and lower teeth, stiffness, redness, ulceration, swelling, and pain of the tongue, difficulty eating, frequent abdominal distension and pain, yellowish complexion, and yellow sclera. In severe cases, there is flaccidity and weakness of the four limbs, a dusty and faded facial complexion, urgency and pain in the hypochondrium, frequent sneezing, irritability, and forgetfulness, cold pain in the buttocks, muscles, waist, and back, and extreme coldness in both testicles. In another version, the dosage of Shi Gao (Gypsum Fibrosum) is one liang two qian.
Herbs: Shi Gao (Gypsum Fibrosum) (1 qian 2 fen), Ren Shen (Codonopsis Radix or Panax Ginseng Radix), Gan Cao (Licorice Root, raw), Shan Zhi (Gardeniae Fructus), Bai Dou Kou (Amomi Fructus Rotundus), Bai Zhi (Angelicae Dahuricae Radix), Lian Qiao (Forsythiae Fructus), Gan Cao (Licorice Root, honey-fried), Bi Cheng Qie (Schizonepetae Fructus or Amomi Fructus), Huang Lian (Coptidis Rhizoma), Jiang Huang (Curcumae Longae Rhizoma), Huo Xiang (Pogostemonis Herba) (each 1 qian), Bai Kui (Alismatis Rhizoma or similar) (5 fen), Mai Men Dong (Ophiopogonis Tuber), Xing Ren (Armeniacae Semen Amarum) (each 1 qian), Dang Gui Shen (Angelicae Sinensis Radix body), Lan Xiang (Costi Herba) (each 5 fen), Huang Bo (Phellodendri Cortex, wine-fried) (1 qian 5 fen), Sheng Ma Gen (Bupleuri Radix or Cimicifugae Rhizoma root) (2 qian), Mu Xiang (Aucklandiae Radix) (1 qian), Jie Geng (Platycodonis Radix) (3 fen), Chai Hu Gen (Bupleuri Radix) (5 fen), Zhi Mu (Anemarrhenae Rhizoma, wine-soaked) (2 qian), Quan Xie (Scorpio, 2 pieces, detoxified).
Grind the above herbs into fine powder. Soak in water, mix evenly with steamed dough cakes, knead into cake shapes, dry in the sun, and crush into particles the size of millet seeds. Take 2 qian per dose, place on the palm, lick with the tongue, and swallow with saliva, or take with warm water after meals. The effect is miraculous. All cases of Xiao Ke are caused by excessive dryness-heat qi. The *Neijing* states: "When heat is excessive, assist with sweet and bitter flavors, use sweet flavor to drain heat." Heat damages Qi; when Qi is damaged, it loses its moistening function. To reduce heat and tonify Qi, only sweet-cold agents can achieve this. Therefore, Shi Gao (Gypsum Fibrosum), with its sweet-cold nature, serves as the Jun (Emperor) herb. Qixuanzi said: "Nourish the source of Water to suppress Yang fire." Thus, Huang Bo (Phellodendri Cortex), Huang Lian (Coptidis Rhizoma), Shan Zhi (Gardeniae Fructus), and Zhi Mu (Anemarrhenae Rhizoma), with their bitter-cold nature, drain heat and nourish Water, serving as the Chen (Minister) herbs. Dang Gui (Angelicae Sinensis Radix), Xing Ren (Armeniacae Semen Amarum), Mai Men Dong (Ophiopogonis Tuber), Quan Xie (Scorpio), Lian Qiao (Forsythiae Fructus), Bai Kui, Lan Xiang (Costi Herba), and Gan Cao (Licorice Root), with their sweet-cold nature, harmonize Blood and moisten dryness, serving as the Zuo (Assistant) herbs. Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) are bitter and neutral, circulating through the Yangming and Shaoyang meridians. Bi Cheng Qie, Bai Dou Kou, Mu Xiang, and Huo Xiang serve as Fan Zuo (Reverse Assistant) herbs to enhance efficacy. Jie Geng (Platycodonis Radix) acts as a boat and oar, keeping the medicinal action floating upward rather than sinking downward.
[Li Gao] He Xue Yang Qi Tang (Harmonizing Blood and Tonifying Qi Decoction) treats thirst, dry tongue, frequent urination, and red cracked tongue. This prescription generates fluids, removes dryness, and promotes tissue regeneration. It is also known as Di Huang Yin Zi (Rehmannia Decoction).
Herbs: Huang Lian (Coptidis Rhizoma, wine-soaked) (7 fen), Tao Ren (Persicae Semen) (6 pieces), Sheng Di (Rehmanniae Radix) (7 fen), Hong Hua (Carthami Flos) (a little), Huang Bo (Phellodendri Cortex, wine-soaked) (1 qian), Dang Gui (Angelicae Sinensis Radix, wine-soaked) (4 fen), Gan Cao (Licorice Root, honey-fried) (3 fen), Sheng Ma (Cimicifugae Rhizoma) (1 qian), Zhi Mu (Anemarrhenae Rhizoma, wine-soaked) (5 fen), Fang Ji (Stephaniae Tetrandrae Radix, wine-soaked) (3 fen), Qiang Huo (Notopterygii Rhizoma et Radix) (5 fen), Ma Huang Gen (Ephedrae Herba Radix) (2 fen). If mouth dryness and tongue thirst occur, add Xing Ren (Armeniacae Semen Amarum) (6 pieces) and Gan Cao (Licorice Root, raw) (3 fen). If urination is frequent, add Shi Gao (Gypsum Fibrosum) (6 fen).
Chop the above herbs, decoct one dose in water, strain, and drink while slightly warm. Avoid alcohol, wheat products, and sexual intercourse.
Qing Liang Yin Zi (Cooling and Clearing Decoction) treats Xiao Ke where the patient eats well but becomes thin, has dry mouth and tongue, spontaneous sweating, constipation, and frequent urination.
Herbs: Qiang Huo Shao (Notopterygii Rhizoma et Radix tip) (1 qian), Chai Hu Shao (Bupleuri Radix tip) (1 qian), Sheng Ma Shao (Cimicifugae Rhizoma tip) (4 fen), Fang Feng Shao (Saposhnikoviae Radix tip) (5 fen), Dang Gui (Angelicae Sinensis Radix) (6 fen), Gan Cao Shao (Licorice Root tip) (1 qian), Shi Gao (Gypsum Fibrosum) (1 qian 5 fen), Zhi Mu (Anemarrhenae Rhizoma, wine-processed) (1 qian), Hong Hua (Carthami Flos) (a little), Fang Ji (Stephaniae Tetrandrae Radix) (5 fen), Long Dan Cao (Gentianae Radix) (1 qian 5 fen), Huang Bo (Phellodendri Cortex) (1 qian 5 fen), Tao Ren (Persicae Semen) (5 pieces), Xing Ren (Armeniacae Semen Amarum) (5 pieces), Sheng Di (Rehmanniae Radix, wine-soaked) (5 fen), Huang Qin Gen (Scutellariae Radix root) (1 qian), Huang Qin (Scutellariae Radix, wine-soaked) (1 qian), Gan Cao (Licorice Root, honey-fried) (1 qian).
Add two cups of water and one small cup of wine, decoct, and take.
Gan Lu Gao (Nectar Ointment) treats Xiao Ke with excessive drinking, increased appetite but weight loss, spontaneous sweating, constipation, and frequent urination. It is also known as Lan Xiang Yin Zi (Costus Decoction).
Herbs: Shi Gao (Gypsum Fibrosum) (2 qian), Zhi Mu (Anemarrhenae Rhizoma) (1 qian 5 fen), Gan Cao (Licorice Root, raw 1 qian, honey-fried 5 fen), Ren Shen (Codonopsis Radix or Panax Ginseng Radix) (5 fen), Fang Feng Gen (Saposhnikoviae Radix root) (1 qian), Ban Xia (Pinelliae Rhizoma, processed) (5 fen), Lan Xiang (Costi Herba) (5 fen), Bai Dou Kou (Amomi Fructus Rotundus), Lian Qiao (Forsythiae Fructus), Jie Geng (Platycodonis Radix), Sheng Ma (Cimicifugae Rhizoma) (each 5 fen).
Grind into fine powder. Soak in water, mix with steamed dough to form pills; or knead into thin cakes, dry in the sun, and crush to rice-sized particles. Take 2 qian with light ginger soup.
[Zhu Zhenheng] Brother Xu, aged forty. Dry mouth, frequent urination. Contracted at the end of spring, sought treatment in summer. Pulse diagnosis: left hand choppy, right hand slightly rapid but not wiry. Heavy pressure feels large and slightly forceful; left side slightly deep, slightly weak, not wiry, yet choppy pulse is more prominent on the left. Both Chi (Kidney) pulses are not very distinct. This is due to rich dietary flavors generating heat, termed Phlegm-Heat. Advise avoiding rich flavors. Descend Fire to clear Lung Metal, subdue Liver to tonify Spleen Earth. Use San Xiao Wan (Three Xiao Pills) ten pills; Zuo Jin Wan (Left Metal Pill) and A Wei Wan (Asafoetida Pill) five pills each, swallowed with ginger soup, six times a day. Also decoct Si Wu Tang (Four Substances Decoction) with Ren Shen (Codonopsis Radix or Panax Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Sheng Gan Cao (Licorice Root, raw), Wu Wei Zi (Schisandrae Fructus), and Mai Men Dong (Ophiopogonis Tuber), taken three times a day, alternating with the pills. After one or two days, he felt refreshed, urination decreased by two-thirds, and mouth was no longer dry. Thirst relief was incomplete; dizziness, blurred vision, and lower back pain after prolonged sitting occurred. Used Mo Yao Gao (Waist-Massaging Ointment) for back pain. Continued Si Wu Tang with Ren Shen, [missing character], removed Chuan Xiong (Ligustici Chuanxiong Rhizoma), added Niu Xi (Achyranthis Bidentatae Radix), Wu Wei Zi (Schisandrae Fructus), Chao Huang Bo (Phellodendri Cortex, stir-fried), and Mai Men Dong (Ophiopogonis Tuber), taken with Liu Yi San (Six-to-One Powder). When bowel movements increased, stop Liu Yi San, continue pills for stability. Huang Lian (Coptidis Rhizoma) powder is a key drug for Xiao Ke. Add Tian Hua Fen (Trichosanthis Radix) powder, human milk, Sheng Di Huang juice, and Sheng Ou汁 (Lotus Root Juice) to make an ointment. Mix with Shan Yao (Dioscoreae Rhizoma) powder, blend with ginger juice, refine with honey into an ointment. Slowly pick onto the tongue and swallow with a little warm water. Effective. If appetite is good, add Ruan Shi Gao (Soft Gypsum).
For treating Xiao Ke, grind Tian Hua Fen (Trichosanthis Radix) into powder, decoct with human milk and fresh leek juice into an ointment, pill to the size of mung beans. Take 100 pills after meals.
*[Zhou Hou's Emergency Handbook]* For Xiao Ke with frequent urination, decoct Gua Lou Gen (Trichosanthis Radix) juice and drink. Effective.
[Popular Prescription] For untreatable Xiao Ke, use Tian Hua Fen (Trichosanthis Radix) and Da Wu Tou (Aconiti Radix Preparata), stir-fried, equal parts ground to fine powder, pill with steamed dough. Take 100 pills with black bean soup.
In the above four prescriptions, Gua Lou Gen (Trichosanthis Radix) is the Jun (Emperor) herb. *Bencao* states: "Gua Lou Gen treats Xiao Ke, stops urination, regulates menstruation and lactation." Since it can stop urination and regulate menstruation, it possesses the ability to moisten flow and dryness, making it a key drug for Xiao Ke.
*[Classification of Materia Medica]* Qian Jin Di Huang Wan (Thousand Gold Rehmannia Pill) treats Kidney Xiao (Kidney Wasting-Thirst).
Herbs: Huang Lian (Coptidis Rhizoma) (4 liang, ground to powder), Sheng Di (Rehmanniae Radix) (8 liang, crushed to extract juice, mixed with residue and Huang Lian powder, blended evenly, dried).
Grind again to fine powder, refine with honey to make pills. Take 50-60 pills after meals with Mai Men Dong Tang (Ophiopogon Decoction).
[Luo Zhi Ti] Huang Lian Wan (Coptis Pill) treats Xiao Ke with unlimited drinking and frequent urination.
Herbs: Huang Lian (Coptidis Rhizoma, cleaned) (8 liang, soaked overnight in good non-ashy wine, steamed over boiling water for one zhen period, taken out and dried).
Grind to fine powder, drop water to make pills. Take 50-70 pills with warm water.
Another Formula: Treats sudden Xiao Ke with frequent urination. Grind Huang Lian (Coptidis Rhizoma) to fine powder, honey-pill. Take 30-40 pills.
Mai Men Dong Tang (Ophiopogon Decoction) treats Xiao Ke with unlimited day and night drinking, urinating immediately after drinking.
Herbs: Mai Men Dong (Ophiopogonis Tuber, heart removed), Huang Lian (Coptidis Rhizoma), Dong Gua (Winter Melon) (each 2 liang).
Grind to coarse powder. Take 5 qian per dose, decoct in water to 80%, strain, and take warm. If no dried winter melon, use 3 jin of fresh winter melon flesh, remove pulp, divide into twelve slices for twelve doses. Each dose uses one slice, broken and decocted in water, taken three times daily.
Dong Gua Yin Zi (Winter Melon Decoction) treats Xiao Ke with good appetite but excessive drinking, urine resembling fat bran flakes, day and night without limit.
Herbs: Dong Gua (Winter Melon) (one piece), Huang Lian (Coptidis Rhizoma) (10 liang, ground to fine powder).
Break open the winter melon, remove pulp, sprinkle Huang Lian powder inside, replace top, bake in hot ashes until cooked, peel, cut finely, mash and squeeze juice. Take 1-2 cups, three times daily, once at night.
*[Classification of Materia Medica]* San Xiao Wan (Three Xiao Pills): Use high-quality Huang Lian (Coptidis Rhizoma), clean and grind to fine powder, quantity unspecified. Cut winter melon flesh, crush to extract natural juice, mix into cakes, dry in shade, grind to fine powder. Soak and mix with juice seven times, then use winter melon powder to make pills. Take 30-40 pills, send down with barley仁 (Barley Grain) soup decocted in winter melon juice. Ordinary thirst resolves with one dose.
In the above five prescriptions, Huang Lian (Coptidis Rhizoma) and Dong Gua (Winter Melon) are the Jun (Emperor) herbs. Danxi said: "Winter melon moves quickly and urgently; contraindicated in chronic illness and Yin deficiency. With Huang Lian as assistant, users must be cautious."
*[Food Therapy]* For Xiao Ke with incessant drinking and frequent urination, use 5 sheng of river snails, soak in 1 dou of water overnight. Drink when thirsty. Change water and snails daily for best results.
Another Method: Decoct in water, drink the juice, eat the snails freely.
[Zhang Zihe] Treats drinking hundreds of cups still feeling thirsty, urine like sand or apricot color. Take this formula for 3-5 days, urine will discharge heavily, toxins expelled downwards, cured in ten days.
Zhang Zihe claims: "This is a heavy dose, tested and effective."
Herbs: Shui Yin (Mercurius) (4 qian), Xi (Stannum) (2 qian, stir-fried with mercury into sand), Mu Li (Ostreae Concha), Mi Duo Seng (Lithargyri), Zhi Mu (Anemarrhenae Rhizoma), Zi Wan (Adenophorae Radix), Ku Shen (Sophorae Flavescentis Radix), Bei Mu (Fritillariae Cirrhosae Bulbus) (each 1 liang), Huang Dan (Minii Rubrum) (0.5 liang), Gua Lou Gen (Trichosanthis Radix) (8 liang).
Grind to fine powder. For men, use a pig stomach that has not produced offspring; for women, use a regular pig stomach. Place herbs inside, sew with hemp thread. Wrap in two new tiles, tie with rope. Cook separately with 1 sheng of rice and 0.5 sheng of Gua Lou Gen powder in fresh water until soft. Remove, cool. Discard rice and Gua Lou Gen. Only grind the pig stomach and the herbal powder inside, mix thoroughly into pills. If too hard, add honey. Take 30-40 pills before meals with rice soup. (*San Yin Fang* does not contain Bei Mu).
[Wang Haogu] Hu Fen San (Lead White Powder Powder) treats severe thirst unresponsive to other treatments, also treats Kidney Xiao.
Herbs: Huang Dan (Minii Rubrum), Hu Fen (Cerussita) (each 0.5 liang), Gua Lou Gen (Trichosanthis Radix) (2.5 liang), Gan Cao (Licorice Root) (1 liang), Ze Xie (Alismatis Rhizoma), Shi Gao (Gypsum Fibrosum), Chi Shi Zhi (Halloysit Rubrum), Bai Shi Zhi (Halloysit Alba) (each 0.5 liang).
Chop, decoct in water, take twice daily. If abdominal pain decreases, switch to pills for better effect. Take 10 pills per dose; too many causes abdominal pain.
Ge Gen Wan (Kudzu Pill) treats Xiao Ke and Kidney Xiao, for those drinking large amounts of water daily.
Herbs: Ge Gen (Puerariae Lobatae Radix) (3 liang), Gua Lou Gen (Trichosanthis Radix) (2 liang), Huang Dan (Minii Rubrum) (2 liang), Fu Zi (Aconiti Lateralis Radix Preparata, roasted, skin and navel removed) (1 liang).
Grind to powder, refine with honey to make pills. Take 10 pills, three times daily. Remove Fu Zi in spring and summer.
[Li Gao] Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) effectively treats Kidney Xiao. (Formula see Treatment of Deficiency and Excess).
*[Neijing]* For Xiao Ke unceasing, with lower Yuan deficiency. Use Niu Xi (Achyranthis Bidentatae Radix) 5 liang, finely chopped to powder. Mix with 5 sheng of Sheng Di Huang juice. Expose by day, soak by night, until juice is exhausted. Make honey pills. Take 30 pills on an empty stomach with warm wine. Long-term use strengthens sinews and bones, preserves complexion, darkens hair and beard, and generates fluids.
[Zhang Zhongjing] Treats male Xiao Ke with excessive urination. If drinking one dou results in urinating one dou, Shen Qi Wan (Kidney Qi Pill) is indicated. (Formula see Treatment of Deficiency and Excess).
[Zhang Zihe] Treats Kidney Xiao. Add Shan Yao (Dioscoreae Rhizoma) to the base Shen Qi Wan formula. Adjust Gui (Cinnamomi Cortex) and Fu (Aconiti Lateralis Radix Preparata) according to seasons: Winter 1 liang, Spring/Autumn 3 qian, Summer 1 qian. Another method: Remove Fu Zi from Shen Qi Wan, add Wu Wei Zi (Schisandrae Fructus) 1.5 liang.
*[Classification of Materia Medica]* Tang Cibu Li Langzhong stated that Xiao Ke is caused by Kidney deficiency, and urine is sweet upon onset. Most physicians do not know the cause and omit mentioning it. *Hongfan* says: "Sowing and reaping produce sweetness." Deduced from physical principles, the process of pickling vinegar/wine and making jerky turns sweet quickly, proving that food tastes sweet after digestion and flows to the Bladder. If Waist/Kidney Qi is strong, it steams upward, transforming into essence, entering marrow, then becoming fat, then blood and flesh, remaining as urine. Thus, urine is yellow, the residual Qi of Blood. The Qi of the Five Zang organs is salty and moist, which is the lower taste. If Waist/Kidney is deficient and cold, it cannot steam and transform Grain Qi, which all descends as urine. Thus, urine tastes sweet and remains unchanged, clear and cold, leading to withered skin and muscles. Like a nursing mother whose Grain Qi ascends as milk, Xiao Ke patients' essence leaks downward as urine. Because essence is not solid internally, urination is frequent. Furthermore, Lung is the canopy of the Five Zang organs. If there is warm Qi steaming from below, Lung is moist; if below is extremely cold, Yang cannot ascend, causing Lung dryness and thirst. The *I Ching* discusses this in the Pi Hexagram: Heaven above, Earth below. Yang without Yin does not descend; Yin without Yang does not ascend. Upper and Lower do not interact, forming Pi (Stagnation). Imagine a pot with water, warmed by fire, covered with a board. Warm air rises, moistening the board. Without fire, water vapor cannot rise, and the board remains dry. Fire represents strong Waist/Kidney. One must constantly warm and tonify Kidney Qi. Food, aided by fire power, moistens upwards and digests easily, avoiding dryness and thirst. Thus, Zhongjing said: "Suitable to take Shen Qi Ba Wei Wan (Kidney Qi Eight-Ingredient Pill)." This disease and Hong Jiao (Foot Paralysis/Gout) are both caused by Kidney deficiency. Hong Jiao starts in months 2-3, peaks in 5-6, declines in 7-8. Xiao Ke starts in months 7-8, peaks in 11-12, declines in 2-3. Why? Hong Jiao is a Stagnation disease; Xiao Ke is a Ventilation disease. In Spring/Summer, Yang Qi ascends, so Stagnation disease onset cures Ventilation disease. In Autumn/Winter, Yang Qi descends, so Ventilation disease onset cures Stagnation disease. Understanding these two allows management of the diseases. Like a good administrator who balances leniency with severity, adapting to circumstances.
[Wang Lv] Treats various deficiencies, chest irritability and palpitations, frequent Xiao Ke, dry lips and mouth, or thirst preceding sores, or thirst following carbuncles and ulcers. Should take Huang Qi Tang (Astragalus Decoction) in large quantities. (Formula see Carbuncle and Ulcer section. For Xiao Ke with fatty urine, Kidney Qi fails to control fluids; take Huang Qi, a key Qi-tonifying herb.)
*[Baoming Ji]* Xing Qi Wan (Moving Qi Pill) treats Xiao Ke.
Herbs: Wu Ling Zhi (Trogopterori Faeces) (*Yanyi* states: "Enters Liver furthest, moves channel blood, does not generate blood"), Wu Tou (Aconiti Radix, skin and navel removed).
Equal parts ground to powder. Take 3 qian with winter melon soup. If no melon, vines and leaves may be used. Three times daily, stop when thirst ceases. Follow with Ba Wei Wan (Eight-Ingredient Pill) removing Fu Zi, adding Wu Wei Zi.
*[Waitai Miyao]* Treats Kidney Xiao with frequent urination. Roast one deer horn until charred, grind to powder. Take with wine using a square-inch measure, gradually increasing dose.
*[Baoming Ji]* Hui Xiang San (Fennel Powder) treats Xiao disease, Lower Jiao thirst, urine like paste.
Herbs: Hui Xiang (Foeniculi Fructus, stir-fried), Ku Lian (Meliae Cortex, stir-fried). Equal parts, stir-fried and ground. Take 1 qian with wine after meals.
*[Food Therapy]* Treats Xiao Ke, scorched tongue, dry mouth, frequent urination. One wild pheasant, boiled thoroughly with five flavors. Remove meat, take juice, drink when thirsty. Meat may also be eaten.
Gan Dan (Liver Jaundice): Startles at night, drinks much, frequent urination. (Full text see Dan.)
Xin Yi Han Yu Fei Xiao (Heart Transferring Cold to Lung Wasting-Thirst): Drinks one, urinates two, untreatable. (Full text see Disease Transmission. Wang Note: "Kidney consumes, Qi has no control, thus drinks one, urinates two.")
[Zhang Zhongjing] Cun Kou pulse floating and slow. Floating indicates Deficiency; Slow indicates Labor. Deficiency means Wei Qi is insufficient; Labor means Ying Qi is exhausted. Fu Yang pulse floating and rapid. Floating indicates Qi; Rapid indicates consuming grain and firm stool. Excess Qi leads to frequent urination; frequent urination leads to firm stool. Firmness and frequency clashing result in Xiao Ke. Fu Yang pulse rapid indicates Heat in Stomach, consuming grain and inducing drinking, firm stool, and frequent urination.