诸经论消渴脉证所因
内经阴阳别论曰二阳结谓之消脉要精微论曰瘅成为消中
按东垣曰二阳者阳明也手阳明大肠主津病消则目黄口干是津不足也足阳明胃主血热则消
谷善
饥血中伏火乃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剽悍能助燥热也
调逆论曰心移热于肺传为膈消也 凡治消瘅仆系偏枯痿厥气满发逆肥贵人则膏粱之疾也
岐伯曰脉实病久可治脉弦小病久不可治后分为三消高消者舌上赤裂大渴引饮
脉经云紧数相搏则为消渴 脉软散者当病消渴
论消渴为三焦受病
病机云消渴之疾三焦受病也上消者肺也多饮水而少食大便如常小便清利知其燥在上焦也治宜
流湿以润其燥消中者胃也渴而饮食多小便赤黄热能消谷知其热在中焦也宜下之
消肾者初发而为膏淋谓淋下如膏油之状至病成面
色黧黑形瘦而耳焦小便浊而有脂液治法宜养血以整肃分其清浊而自愈也
陈无择云消渴属心故烦心致心火散浸渴而引饮诸脉软散皆气实血虚也消中属脾瘅热减则
为消
中消中复有三有因寒中阴胜阳郁久必为热中经云脉洪大阴不足阳有余则为热中多食数溺为消
中阴狂兴盛不交精泄则为强中至病强中不亦危矣消肾属肾盛壮之时不谨而纵欲房劳年长肾衰
多服金石真气既丧口干精溢自泄不饮而利经云肾实则消不渴而小便自利名曰肾消亦曰内消
《内经·阴阳别论》说：“二阳（阳明经）气机郁结，称为消渴。”《脉要精微论》说：“瘅热（高热）发展为消中（多食易饥）。
按李东垣所说：二阳指的是阳明经。手阳明大肠经主管津液，患消渴病时出现目黄、口干，这是津液不足的表现；足阳明胃经主管血液，血中有伏火则能消化食物且容易饥饿，这是血分不足的表现。所谓“结”，是指津液不足，凝结而不能滋润，这都是燥热导致的疾病。这是因为长期食用甘甜美味且肥腻的食物，导致热气上溢，从而转变为消渴。治疗应当用兰草（佩兰）来清除陈腐之气。不可以服用膏粱厚味、芳草类或石类药物，因为这些药性剽悍猛烈，会助长燥热。
《素问·调经论》说：“心将热邪移于肺，传变为膈消（膈间燥热，口渴多饮）。”凡是治疗消渴、瘅热、仆击、偏枯、痿厥、气满发逆等病症，多见于富贵之人，这是由膏粱厚味引起的疾病。
岐伯说：“脉象实大，病程虽久仍可治愈；脉象弦小，病程久则难以治愈。”后来将消渴分为三消：上消（高消），表现为舌面红赤裂纹，极度口渴想喝水。
《脉经》说：“紧脉与数脉相搏结，则为消渴。”脉象软散者，应当患有消渴病。
《病机》论述消渴为三焦受病：消渴之疾，是三焦受到病邪侵袭。上消属于肺，症状是多饮水而少进食，大便正常，小便清利，可知燥热在上焦。治疗宜用淡渗利湿之法以润其燥。中消属于胃，症状是口渴且饮食量大，小便颜色赤黄，热能消化食物，可知热在中焦。治疗宜用攻下法。下消（消肾），初发时表现为膏淋，即小便排出如膏油状；等到病情形成，面色黧黑，形体消瘦，耳朵干枯焦黑，小便浑浊且有脂液。治疗方法宜养血以分清浊，使清浊分离，病即可自愈。
陈无择说：消渴归属于心，所以心烦导致心火散布浸淫，口渴想喝水，各种脉象软散，都是气实血虚的表现。消中归属于脾，瘅热减退后转为消中。消中又分为三种：有因寒中（寒邪直中脾胃）、阴盛阳郁，日久必化为热中。经文说：“脉象洪大，阴不足而阳有余，即为热中。”多食、多尿为消中。若阴气狂盛，精气不交而外泄，则成为强中（阳强不倒）。到了强中的地步，不也很危险吗？消肾归属于肾。在身体壮盛之时，如果不谨慎节制，纵欲房劳，年老后肾衰，又多服金石类药物，导致真气丧失，出现口干、精液自溢外泄，不喝水却小便频利的情况。经文说：“肾实则消，不渴而小便自利，名为肾消，也称为内消。”
The *Neijing* (Inner Canon), in the chapter "Yin Yang Bie Lun" (Differentiation of Yin and Yang), states: "When the Two Yang (Yangming meridians) are knotted, it is called Xiao (Wasting-Thirst)." In the chapter "Mai Yao Jing Wei Lun" (Essentials of Pulse Diagnosis), it states: "Dan-heat (febrile heat) develops into Xiao Zhong (Middle Wasting-Thirst characterized by polyphagia)."
According to Li Dongyuan: The "Two Yang" refers to the Yangming meridians. The Hand-Yangming Large Intestine meridian governs body fluids; when afflicted with Xiao, symptoms such as yellow eyes and dry mouth appear, indicating a deficiency of fluids. The Foot-Yangming Stomach meridian governs blood; latent fire within the blood leads to efficient digestion and easy hunger, indicating a deficiency of blood. The term "knot" (Jie) refers to insufficient fluids that fail to moisten due to stagnation; this is a disease caused by dryness and heat. This arises from long-term consumption of sweet, delicious, and fatty foods, causing Qi to overflow upward and transform into Xiao Ke (Wasting-Thirst). Treatment should employ Lancao (Pei Lan, *Herba Agrimoniae* or *Eupatorii Herba*) to eliminate stale Qi. One must not consume Gao Liang (rich food) or Fang Cao (aromatic herbs) and Shi Yao (mineral drugs), as their pungent and fierce nature will assist dryness and heat.
The *Suwen*, in the chapter "Tiao Jing Lun" (Regulating the Meridians), states: "If Heart heat transfers to the Lung, it transmits as Ge Xiao (Upper Wasting-Thirst/Intersticial Thirst)." Generally, treating Xiao, Dan, Pu Ji (collapse/stroke), Pian Ku (hemiplegia), Wei Jue (flaccidity/cold limbs), and Qi Man Fa Ni (distension and rebellious Qi) often involves wealthy individuals; these are diseases resulting from rich diets.
Qibo states: "If the pulse is substantial, even after a long duration, the disease is treatable; if the pulse is wiry and small, after a long duration, it is untreatable." Later, Xiao was divided into Three Xiaos: Shang Xiao (Upper Xiao) presents with red cracks on the tongue and extreme thirst with desire to drink.
The *Mai Jing* (Pulse Classic) states: "When Jin (tight) and Shu (rapid) pulses contend, it becomes Xiao Ke." A soft and scattered pulse indicates one should suffer from Xiao Ke.
The *Bing Ji* (Pathogenesis) discusses Xiao Ke as a disease of the San Jiao (Triple Burner): The ailment of Xiao Ke affects the San Jiao. Shang Xiao belongs to the Lung; symptoms include drinking much water but eating little, normal stools, and clear urine, indicating dryness in the Upper Jiao. Treatment should utilize damp-draining methods to moisten dryness. Zhong Xiao belongs to the Stomach; symptoms include thirst, large food intake, and dark yellow urine, with heat capable of digesting food, indicating heat in the Middle Jiao. Treatment should employ purgative methods. Xia Xiao (Xiao Shen/Lower Xiao) initially manifests as Gao Lin (Chyluria/Greasy Strangury), where urine resembles oil paste. When the disease matures, the complexion becomes dark, the body emaciates, ears become dry and black, and urine is turbid with lipid fluid. The treatment method should nourish Blood to separate the clear from the turbid, allowing self-healing.
Chen Wuyue states: Xiao Ke belongs to the Heart; thus, vexation causes Heart Fire to scatter and immerse, leading to thirst and desire to drink. All pulses being soft and scattered indicate Excess of Qi and Deficiency of Blood. Zhong Xiao belongs to the Spleen; after Dan-heat subsides, it becomes Zhong Xiao. Zhong Xiao has three subtypes: one due to Han Zhong (Cold striking the middle), where Yin excess and Yang depression eventually generate Re Zhong (Heat in the middle). The classic states: "A Hong Da (surging-large) pulse, with Yin deficiency and Yang excess, is Re Zhong." Polyphagia and frequent urination constitute Zhong Xiao. If Yin pathogen is rampant and essence leaks without interaction, it becomes Qiang Zhong (Priapism/Excessive Sexual Potency). Reaching Qiang Zhong is indeed perilous. Xiao Shen belongs to the Kidney. During times of robust health, if one is not cautious and indulges in sexual activity, leading to Kidney decline in old age, and additionally consumes mineral drugs, losing true Qi, symptoms include dry mouth, spontaneous seminal emission, and frequent urination without thirst. The classic states: "When the Kidney is Excess, there is Xiao; without thirst but with spontaneous urination, it is named Xiao Shen, also called Nei Xiao (Internal Wasting-Thirst)."