孙思邈居太白山于推步医药无不善卢照邻有恶疾不可为而问曰高医愈疾奈何答曰天有四
时
五行寒暑迭居和为雨怒为风凝为霜雪张为虹 天常数也人之四肢五脏一觉一寐吐纳往来流为
荣
卫张为气色发为音声人常数也阳用其形阴用其精天人所同也失则蒸生热否生寒结为瘤赘陷为
痈疽奔则喘乏竭则焦槁发乎面动乎形天地亦然五纬缩赢孛彗飞流其危诊也寒暑不时其蒸否也
石立土 是其赘疣山崩土陷是其痈疽奔风豪雨其喘乏川渎竭涸其焦槁高医导以药石投以砭剂
圣人和以至德辅以人事故体有可已之疾天有可救之灾(唐书)
千金云消渴病所忌者三一饮酒二房室三咸食及面能忌此虽不服药亦自可消渴之人愈与未
愈常
须虑患大痈必于骨节间忽发痈疽而卒予亲见友人邵任道患渴数年果以痈疽而死唐祠部李郎中
论消渴者肾虚所致每发则小便甜医者多不知其疾故古今亦阙而不言洪范言稼穑作甘以物理推
之淋饧醋酒作脯法须臾即皆能甜也足明人食之后滋味皆甜流在膀胱若腰肾气盛是为真火上蒸
脾胃变化饮食分流水谷从二阴出精气入骨髓合荣卫行血脉荣养一身其次以为脂膏其次以为血
肉也其余则为小便故小便色黄血之余也HT 气者五脏之气咸润者则下味也腰肾既虚冷则不能蒸
于谷气则尽下为小便故味甘不变其色清冷则肌肤枯槁也由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
阳气不能升故肺干即渴易于否卦干上坤下阳无阴而不降阴无阳而不升上下不交故成否也譬如
釜中有水以火暖之其釜若以板覆则暖气上腾故板能润也若无火力水气则不能上此板则终不能
润也火力者则是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也故张仲景云宜
服肾气八味丸此病与香港脚虽同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月十二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也审此二者疾可理也犹如善为政者宽以济猛猛
以济宽随事制度尔仲景云足太阳者膀胱之经也膀胱者肾之府小便数此为气盛气盛则消谷大便
硬衰则为消渴也男子消渴饮一斗小便亦得一斗宜八味肾气丸(本事方)
孙思邈居住在太白山，在推算历法和医药方面没有不擅长的。卢照邻患有严重的疾病，无法治愈，便问道：“高明的医生如何治愈疾病？”孙思邈回答说：“天有四季、五行，寒暑交替，和谐时化为雨，暴怒时化为风，凝结时化为霜雪，张开时化为彩虹，这是天的常数。人的四肢、五脏，觉醒与睡眠，呼吸吐纳，流动化为营气与卫气，张开化为气色，发出化为声音，这是人的常数。阳作用于形体，阴作用于精髓，这是天与人共同的规律。如果失去平衡，就会蒸腾产生热，闭塞产生寒，结聚成为瘤赘，下陷成为痈疽；奔迫则气喘乏力，枯竭则身体焦枯。这些现象表现在面部，动于身形，天地也是如此：五星（金木水火土）缩小、变瘦、光芒杂乱、出现彗星、流星飞散，这是危险的征兆；寒暑失调，就是蒸热或闭塞；石头直立、土壤隆起，这是赘疣；山崩地陷，这是痈疽；狂风暴雨，这是气喘乏力；河流干涸，这是身体焦枯。高明的医生用药物引导，施用砭石治疗；圣人用最高的德行，辅以人事。所以身体有可以治愈的疾病，天有可以挽救的灾难。”（出自《唐书》）
《千金方》说：消渴病所忌讳的有三件事：一是饮酒，二是房事，三是吃咸食和面食。如果能忌掉这三样，即使不服药，消渴病也能自愈。但是，无论是已经痊愈还是未愈的人，都必须考虑到隐患：大痈疽必定发生在骨节之间，突然发作痈疽而死亡。我亲眼见到朋友邵任道患消渴症几年，最终因为痈疽而死。唐代祠部郎中李郎中论述消渴症，认为是肾虚所致，每次发病小便就甜。医生们大多不知道这个病，所以古今医籍中也缺漏而没有提及。《尚书·洪范》说“稼穑作甘”（庄稼成熟后味道甘甜），以此推究物理，淋饴糖、醋、酒制作肉脯，片刻间都能变甜。这足以证明人进食之后，滋味都是甜的，流注在膀胱。如果腰肾之气旺盛，这就是真火上蒸脾胃，变化饮食，分离水谷，从前后二阴排出，精气进入骨髓，配合营卫运行于血脉，荣养全身。其次化为脂膏，其次化为血肉。剩下的就成为小便，所以小便颜色黄，是血的剩余。气，是五脏之气，都滋润向下，味道也向下。腰肾既然虚冷，就不能蒸腾谷气，谷气完全下泄成为小便，所以味道甘甜且不变，颜色清冷，导致肌肤枯槁。就像乳母，谷气上泄都成为乳汁；消渴病患者，下泄成为小便，都是因为精气不能充实于内，所以小便频数、溺多。另外，肺是五脏的华盖（覆盖物），如果下面有暖气蒸腾，肺就滋润；如果下面极冷，阳气不能上升，所以肺干燥就口渴。这类似于《易经》中的否卦，乾上坤下，阳无阴就不下降，阴无阳就不上升，上下不交通，所以形成否塞之象。譬如锅中有水，用火温暖它，如果用板子盖住锅盖，暖气就上腾，所以板子能湿润；如果没有火力，水气就不能上达这块板子，板子终究不能湿润。火力，就是腰肾强盛。经常需要温补肾气，饮食得到火力的温煦就能润上而易消化，也能避免口干口渴。所以张仲景说适宜服用肾气八味丸。这个病与脚气病虽然同为肾虚所致，但脚气病开始发作于二三月，盛于五六月，衰于七八月。凡是消渴病，开始发作于七八月，盛于十一月十二月，衰于二三月。这是什么原因呢？脚气病是壅滞之疾，消渴病是宣通（耗散）之疾。春夏阳气上升，所以壅滞之疾发作，宣通之疾就痊愈；秋冬阳气下降，所以宣通之疾发作，壅滞之疾就痊愈。审察清楚这两点，疾病就可以治理了。这就像善于治国的人，用宽容来调剂严厉，用严厉来调剂宽容，根据事情制定制度罢了。张仲景说：足太阳经是膀胱的经脉，膀胱是肾的府库。小便频数，这是因为气盛。气盛则消化谷物快，大便硬；气衰则成为消渴病。男子患消渴病，喝一斗水，小便也排出一斗水，适宜服用八味肾气丸。（出自《本事方》）
Sun Simiao resided in Mount Taibai and was proficient in all aspects of calendrical calculation and medicine. Lu Zhaolin, suffering from a severe illness that could not be cured, asked him, "How do skilled physicians cure diseases?" Sun Simiao replied, "Heaven has four seasons and five phases (Wu Xing). Cold and heat alternate; when harmonious, they transform into rain; when violent, into wind; when condensed, into frost and snow; when expanded, into rainbows. These are the constant laws of Heaven. Human beings have four limbs and five zang organs, states of wakefulness and sleep, inhalation and exhalation; these flow to form Ying (Nutritive) Qi and Wei (Defensive) Qi, expand to manifest as complexion, and emit as voice. These are the constant laws of humanity. Yang acts upon the physical form, while Yin acts upon the essence. This is common to both Heaven and humanity. If balance is lost, steaming generates heat, and blockage generates cold; knotting forms tumors or swellings, sinking forms carbuncles and sores; rushing causes panting and fatigue, exhaustion leads to withering. These phenomena appear on the face and move in the body. Heaven and Earth are the same: the contraction or expansion of the five planets (Wu Wei), the appearance of comets or meteors indicate danger; irregular cold and heat indicate steaming or blockage; standing stones or rising soil indicate swellings; mountain collapses or earth subsidence indicate carbuncles and sores; fierce winds and heavy rains indicate panting and fatigue; dried-up rivers and streams indicate withering. Skilled physicians guide with medicinal herbs and apply bian stone therapy; sages employ supreme virtue and assist human affairs. Thus, the body has diseases that can be cured, and Heaven has disasters that can be saved." (From *Book of Tang*)
*Qianjin Fang* states: The three things to avoid for Xiao Ke (Wasting-Thirst disease) are: first, drinking alcohol; second, sexual activity; third, consuming salty foods and wheat products. If one can abstain from these three, even without taking medicine, the Xiao Ke condition will naturally resolve. However, whether the disease has healed or not, one must always consider the hidden danger: major carbuncles and sores inevitably occur between bone joints, leading to sudden onset and death. I personally witnessed my friend Shao Rendao suffer from Xiao Ke for several years and ultimately die from a carbuncle and sore. Li Langzhong, a Cibu official of the Tang Dynasty, discussed Xiao Ke as being caused by Kidney deficiency. Each time it flares up, the urine becomes sweet. Physicians mostly did not understand this disease, hence its absence in ancient and modern medical texts. The *Hong Fan* chapter of the *Book of Documents* states that "grains and beans taste sweet." Inferring from physical principles, malt syrup, vinegar, wine, and meat jerky all become sweet within moments. This clearly demonstrates that after humans eat, the flavors are sweet and flow into the Bladder. If the Qi of the Waist and Kidneys is vigorous, this is True Fire steaming upwards to the Spleen and Stomach, transforming food and drink, separating water and grain, which exit through the two lower orifices. The essence enters the marrow, combines with Ying and Wei to circulate in the blood vessels, nourishing the whole body. Next, it transforms into fat and paste, then into flesh and blood. The remainder becomes urine; therefore, urine is yellow, being the surplus of blood. Qi refers to the Qi of the five zang organs, all moistening downwards, and thus the flavor also goes downwards. Since the waist and kidneys are deficient and cold, they cannot steam the grain Qi, which fully descends as urine; thus, it tastes sweet and remains unchanged in color, appearing clear and cold, causing the skin and muscles to wither. It is like a nursing mother: grain Qi flows upward to become breast milk. Xiao Ke patients, however, have downward discharge as urine because the essence is not solidified internally, resulting in frequent urination and polyuria. Furthermore, the Lung is the canopy of the five zang organs. If there is warm Qi steaming from below, the Lung is moist; if it is extremely cold below, Yang Qi cannot ascend, causing the Lung to dry out and thirst to arise. This resembles the Pi hexagram in the *I Ching*: Qian (Heaven/Yang) above, Kun (Earth/Yin) below. Without Yin, Yang does not descend; without Yang, Yin does not ascend. When upper and lower do not interact, Pi (obstruction) forms. Imagine a pot with water heated by fire; if covered with a board, warm Qi rises, moistening the board. Without fire power, water vapor cannot reach the board, and it remains dry. This "fire power" represents the strength of the waist and kidneys. One must constantly warm and tonify Kidney Qi. With the warming power of digestion, food is moistened and easily digested, preventing dryness and thirst. Therefore, Zhang Zhongjing stated that it is appropriate to take Shen Qi Ba Wei Wan (Kidney Qi Eight-Ingredient Pill). Although this disease and Jiao Qi (Foot Weakness/Gout) are both caused by Kidney deficiency, Jiao Qi begins in the second and third months, peaks in the fifth and sixth, and declines in the seventh and eighth. Conversely, Xiao Ke begins in the seventh and eighth months, peaks in the eleventh and twelfth, and declines in the second and third. Why? Jiao Qi is an obstructive disease, while Xiao Ke is a dissipative disease. In spring and summer, Yang Qi ascends, so when the obstructive disease flares, the dissipative disease heals. In autumn and winter, Yang Qi descends, so when the dissipative disease flares, the obstructive disease heals. Understanding these two aspects allows for proper treatment. It is like a wise ruler who balances leniency with severity according to circumstances. Zhang Zhongjing said: The Foot-Taiyang channel belongs to the Bladder, which is the mansion of the Kidney. Frequent urination indicates excessive Qi. Excessive Qi consumes grain rapidly, leading to hard stool; deficiency leads to Xiao Ke. Men with Xiao Ke who drink one dou of water may pass one dou of urine; they should take Ba Wei Shen Qi Wan (Eight-Ingredient Kidney Qi Pill). (From *Benshi Fang*)