经曰∶卫气者昼行于阳，夜行于阴。行于阳不得入于阴，阴虚故目不瞑。盖阳主动辟也，阴
主静 也。故行于阳则动而醒，行于阴则静而卧。阳光亢上，则气有余。又曰∶合夜至鸡鸣，天
之阴，阴中之阴也。气行于阳而阴不足，则阳愈狂而阴乃格。静反为动， 反为辟。神气散而不
守，故不得瞑也。然而又有思虑过极，心阳独亢者；有心气耗伤，血不育养者；有神明失养，真
阴不升者；有肺受火炎，膈上痰壅者。寸脉浮滑痰火，洪大阴虚阳盛，涩为血亏。治当养阴抑阳
，清痰降火，安神宁心。
主方 当归身 生地黄 黄连 橘红 半夏（制） 茯神 人参 麦门冬 酸枣仁 柏子仁
炙草（各一钱）
上加龙眼肉、竹茹、生姜、灯心，水煎成，调辰砂，临睡服。
朱砂安神丸 治心虚有热，夜卧不安，神气不宁。
黄连（二两） 甘草（炙，两半） 生地 当归身（各八钱） 朱砂（水飞，一两，一半为衣）
上为细末，入朱砂，蒸饼糊和丸粟米大，朱衣。每服一钱，临睡灯心汤下。
温胆汤 宁神豁痰（二陈汤加竹茹、枳实）。
竹叶石膏汤 伤寒
天王补心丸 虚损
经曰∶二阳结谓之消。又曰∶心移热于肺，传为膈消也。夫三消者，上焦受病，多饮而少食
，小便多利而不禁，甚至舌干白苔或裂，属肺，名消渴，亦名膈消。中焦受病，渴而多食，食已
即饥，属胃，名消中。下焦受病，小便淋浊如膏糊，甚至面色黧黑，形瘦耳焦，属肾，名肾消。
多因脾不输精于肺，肺乏生化之源。经曰∶多食肥，令人内热，恣食肥甘炙爆咸物，及醉饱入房，
斫丧伤肾。或大病阴虚，或过劳血耗，所因多种，燥热则一。宜清心绝欲，戒浓味，断思虑，静
养生阴。不则肾水不升，心火不降，复变痈毒、鼓胀等证者多矣。脉实疾可治，弦小难痊。洪数
阳盛，濡散血虚。宜养肺降火，生血滋阴，补益肾水。
主方 当归 生地（各三钱） 白芍药（二钱）
上消加人参、麦冬、五味、天粉水煎，入生藕、鲜地黄汁、人乳服。中消加石膏、知母、甘
草、滑石、寒水石。下消加黄柏、知母、熟地、五味之类。
加味白虎汤 治上焦消渴热甚。
石膏（三钱） 知母（钱半） 人参（一钱） 甘草（五分） 黄芩 杏仁 栀子（各一钱）
麦冬（二钱） 五味（十五粒，打）加粳米一撮，水煎服。
生津甘露饮 治消中，能食而瘦，口干自汗，大便结，小便数。
石膏（二钱） 黄柏 龙胆草 黄芩（各一钱） 黄 知母 生地（各八分） 葛根 栀
子当归 甘草（半炙） 天粉（各六分） 升麻（四分） 桃、杏仁（各十粒，去皮尖，研）
水煎，温服。
加味地黄丸 治肾消，小便淋浊等证（方见虚损）。
简便方 消渴。白芍药、甘草（等分），水煎服。或乌梅（一斤，打碎），水四腕，煎一
碗，入蜜（一斤）、砂仁（末，五钱），砂锅慢火熬膏。冷，入檀香末三钱，麝二分，汤服。
又 大豆（五升），大黄（两半）、甘草（四两，碎），水一桶，煮至豆熟，饮汁食豆。
又 缫丝汤，随意饮，大效。坛贮埋久愈佳。如无，丝棉煎汤亦可。
又 桑椹汁，牛乳 萝卜汁、栝蒌根汁、淘糯米泔水、黄连煎汁、蔗汁、梨汁、麻子煮汁、
陈粟米粥，随取饮。
又 栝蒌、葛根，捣焙研末。雄牛穿鼻横木烧灰，晚蚕沙末，随取服。
《黄帝内经》说：卫气白天运行于阳分，夜晚运行于阴分。如果卫气行于阳分而不能进入阴分，是因为阴气虚弱，所以眼睛无法闭合（失眠）。大概阳气主运动、主兴奋，阴气主静止、主抑制。因此，卫气行于阳分则人清醒活动，行于阴分则人安静入睡。如果阳气亢盛于上，则气有余而偏盛。又说：从黄昏到鸡鸣时分，是天的阴时，属于阴中之阴。如果气行于阳分而阴气不足，则阳气更加狂躁，阴气被格拒在外。本该静止的反而动，本该兴奋的反而抑制（此处原文“反为辟”疑为衍文或特定语境下的阴阳逆乱描述，意指阴阳失调）。神气散乱不能守舍，所以不能入睡。然而又有因为思虑过度，导致心阳单独亢盛的；有心气耗伤，血液不能滋养心神的情况；有神明失养，真阴不能上升的情况；有肺受火邪熏灼，膈上痰浊壅盛的情况。寸脉浮滑提示痰火，洪大提示阴虚阳盛，涩脉提示血亏。治疗应当滋养阴液以抑制阳气，清除痰浊、降泄火邪，安定神志、宁心安神。
主方：当归身、生地黄、黄连、橘红、半夏（制）、茯神、人参、麦门冬、酸枣仁、柏子仁、炙甘草（各一钱）。
上方加入龙眼肉、竹茹、生姜、灯心草，加水煎煮成汤，调入辰砂，临睡前服用。
朱砂安神丸：治疗心虚有热，夜间卧睡不安，神气不宁。
黄连（二两）、甘草（炙，一两半）、生地黄、当归身（各八钱）、朱砂（水飞法处理，一两，一半用于包衣）。
将上述药物研为细末，加入朱砂，用蒸饼糊作为粘合剂制成如粟米大小的丸剂，外用朱砂粉包衣。每次服用一钱，临睡前用灯心草汤送服。
《黄帝内经》说：“二阳结谓之消。”又说：“心移热于肺，传变为膈消。”所谓三消症，上焦受病，表现为多饮而少食，小便频多且不禁，甚至舌干白苔或出现裂纹，病位在肺，名为消渴，也名膈消。中焦受病，表现为口渴且多食，吃完不久即感饥饿，病位在胃，名为消中。下焦受病，表现为小便浑浊如膏糊状，甚至面色黧黑，形体消瘦，耳廓干枯，病位在肾，名为肾消。多因脾脏不能将精微物质输布给肺脏，导致肺脏缺乏生化之源。经书说：“多吃肥腻食物，使人内生湿热。”恣意食用肥甘厚味、烧烤咸物，以及醉酒后行房事，都会损伤肾脏。或者大病之后阴液亏损，或者过度劳累导致血液耗伤，致病原因虽多，但燥热这一病机是一致的。适宜清心绝欲，戒除浓味饮食，断绝思虑，静养以滋生阴液。如果不这样做，肾水不能上升，心火不能下降，就会反复变成痈毒、鼓胀等病症。脉象实而疾速的可治，弦小而弱的难愈。洪数脉提示阳盛，濡散脉提示血虚。适宜滋养肺阴、降泄火邪，生血滋阴，补益肾水。
主方：当归、生地黄（各三钱）、白芍药（二钱）。
上消加人参、麦冬、五味子、天花粉，水煎，加入鲜藕汁、鲜地黄汁、人乳服用。中消加石膏、知母、甘草、滑石、寒水石。下消加黄柏、知母、熟地黄、五味子之类。
加味白虎汤：治疗上焦消渴热势甚盛者。
石膏（三钱）、知母（一钱半）、人参（一钱）、甘草（五分）、黄芩、杏仁、栀子（各一钱）、麦冬（二钱）、五味子（十五粒，捣碎）。加入粳米一撮，水煎服。
生津甘露饮：治疗消中症，能食但身体消瘦，口干自汗，大便干结，小便频数。
石膏（二钱）、黄柏、龙胆草、黄芩（各一钱）、黄芪、知母、生地黄（各八分）、葛根、栀子、当归、甘草（半炙）、天花粉（各六分）、升麻（四分）、桃仁、杏仁（各十粒，去皮尖，研碎）。水煎，温服。
简便方：治疗消渴。白芍药、甘草（等分），水煎服。或者乌梅（一斤，捣碎），用水四碗，煎至一碗，加入蜂蜜（一斤）、砂仁末（五钱），在砂锅中用慢火熬成膏状。冷却后，加入檀香末三钱、麝香二分，用汤水送服。
又方：大豆（五升）、大黄（一两半）、甘草（四两，捣碎），用水一桶，煮至豆熟，饮用汤汁并吃豆子。
又方：缫丝汤，随意饮用，效果显著。装在坛子里埋藏越久越好。如果没有，用丝棉煎汤也可以。
The *Classic of Medicine* (Huangdi Neijing) states: The Wei Qi (Defensive Qi) circulates in the Yang aspects during the day and in the Yin aspects at night. If it circulates in the Yang but cannot enter the Yin, it is due to Yin deficiency, resulting in insomnia (inability to close the eyes). Generally, Yang governs movement and excitation, while Yin governs stillness and inhibition. Therefore, when circulating in the Yang, one is awake and active; when circulating in the Yin, one is calm and sleeps. If Yang energy is hyperactive and rises upward, there is an excess of Qi. It is also said: From dusk until the rooster crows, it is the Yin time of heaven, specifically Yin within Yin. If Qi circulates in the Yang while Yin is insufficient, Yang becomes increasingly erratic, and Yin is repelled. What should be still becomes active, and what should be excited becomes inhibited (indicating a reversal of normal Yin-Yang dynamics). The Shen (Spirit) scatters and fails to reside, thus preventing sleep. However, there are cases caused by excessive mental worry leading to isolated hyperactivity of Heart Yang; cases where Heart Qi is damaged and Blood fails to nourish the mind; cases where the Spirit lacks nourishment and True Yin fails to ascend; and cases where the Lung is scorched by Fire, causing Phlegm turbidity to obstruct the diaphragm. A floating and slippery pulse at the Cun position indicates Phlegm-Fire; a洪大 (Surging-Large) pulse indicates Yin deficiency with Yang hyperactivity; a 涩 (Choppy) pulse indicates Blood deficiency. Treatment should focus on nourishing Yin to suppress Yang, clearing Phlegm and descending Fire, calming the Spirit and soothing the Heart.
Main Formula: Danggui Shen (Radix Angelicae Sinensis Stem), Shengdihuang (Radix Rehmanniae Preparata), Huanglian (Rhizoma Coptidis), Juhong (Pericarpium Citri Reticulatae Rubrum), Banxia (Rhizoma Pinelliae Preparata), Fushen (Poria with Hostwood), Renshen (Radix Ginseng), Maimendong (Radix Ophiopogonis), Suanzaoren (Semen Ziziphi Spinosae), Baiziren (Semen Platycladi), Zhigancao (Radix Glycyrrhizae Preparata) (each 1 qian).
Add Longyanrou (Arillus Longan), Zhuru (Caulis Bambusae in Taeniam), Shengjiang (Rhizoma Zingiberis Recens), Dengxincao (Medulla Junci) to the above, decoct in water, adjust with Chensha (Cinnabar), and take before sleep.
Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill): Treats Heart deficiency with Heat, restlessness at night, and unsettled Spirit.
Huanglian (2 liang), Zhigancao (Roasted, 1.5 liang), Shengdihuang, Danggui Shen (each 8 qian), Zhusha (Water-triturated, 1 liang, half used for coating).
Grind the above into fine powder, mix with Zhusha, use steamed bread paste as a binder to form pills the size of millet seeds, coat with Zhusha powder. Take 1 qian per dose, washed down with Dengxincao (Juncus Marrow) decoction before sleep.
Wendan Tang (Warm the Gallbladder Decoction): Calms the Spirit and resolves Phlegm (composed of Erchen Tang plus Zhuru and Zhishi).
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction): Used for post-heatstroke or residual heat after Shanghan (Cold Damage).
Tianwang Buxin Wan (Emperor of Heaven's Tonic for the Heart Pill): Used for Xu Sun (Deficiency and Damage).
The *Classic of Medicine* states: "Binding of the Two Yangs is called Xiao (Consumption)." It also says: "Heart transfers Heat to the Lung, transmitting as Ge Xiao (Diaphragmatic Consumption)." Regarding the Three Xiao syndromes: When the Upper Jiao is affected, there is polydipsia with poor appetite, frequent and uncontrolled urination, and even dry tongue with white coating or cracks; this belongs to the Lung, named Xiao Ke (Wasting-Thirst), also called Ge Xiao. When the Middle Jiao is affected, there is thirst with polyphagia, hunger immediately after eating; this belongs to the Stomach, named Xiao Zhong. When the Lower Jiao is affected, urine is turbid like paste, complexion is dark, body is emaciated, and ears are dry; this belongs to the Kidney, named Shen Xiao. This is often due to the Spleen failing to transport essence to the Lung, leaving the Lung lacking its source of transformation and generation. The Classics say: "Excessive consumption of fatty foods causes internal Heat." Indulgence in rich, sweet, fried, and salty foods, as well as sexual activity after drunkenness or full meals, damages the Kidney. Alternatively, Yin fluid deficiency after severe illness, or Blood depletion from overwork; although causes vary, Dryness-Heat is the common pathogenesis. One should clear the Heart, abandon desires, avoid rich flavors, cease worrying, and rest to nourish Yin. Otherwise, Kidney Water will not ascend, Heart Fire will not descend, and complications such as carbuncles/toxins and Drum Distension (Ascites) will frequently occur. A solid and rapid pulse is treatable; a wiry and small pulse is difficult to cure. A Surging and Rapid pulse indicates Yang excess; a Soft and Scattered pulse indicates Blood deficiency. Treatment should nourish the Lung, descend Fire, generate Blood, nourish Yin, and tonify Kidney Water.
Main Formula: Danggui, Shengdihuang (each 3 qian), Baishaoyao (2 qian).
For Upper Xiao, add Renshen, Maidong, Wuweizi, Tianfengfen (Tianhuafen); decoct in water, add fresh lotus root juice, fresh Shengdihuang juice, and human milk. For Middle Xiao, add Shigao, Zhimu, Gancao, Huashi, Hanshui Shi. For Lower Xiao, add Huangbai, Zhimu, Shudihuang, Wuweizi, etc.
Jiawei Baihu Tang (Modified White Tiger Decoction): Treats Upper Jiao Xiao Ke with intense Heat.
Shigao (3 qian), Zhimu (1.5 qian), Renshen (1 qian), Gancao (0.5 qian), Huangqin, Xingren, Zhizi (each 1 qian), Maidong (2 qian), Wuweizi (15 grains, crushed). Add a pinch of Jingmi (Rice Grain), decoct in water, and take.
Shengjin Ganlu Yin (Saliva-Generating Sweet Dew Drink): Treats Xiao Zhong, characterized by ability to eat but weight loss, dry mouth, spontaneous sweating, constipation, and frequent urination.
Shigao (2 qian), Huangbai, Longdancao, Huangqin (each 1 qian), Huangqi, Zhimu, Shengdihuang (each 0.8 qian), Gegen, Zhizi, Danggui, Gancao (half roasted), Tianfengfen (each 0.6 qian), Shengma (0.4 qian), Taoren, Xingren (each 10 grains, peeled and pitted, crushed). Decoct in water, take warm.
Jiawei Dihuang Wan (Modified Rehmannia Pill): Treats Shen Xiao, turbid urine, etc. (See formula under "Xu Sun").
Simple Prescription: For Xiao Ke. Baishaoyao and Gancao (equal parts), decoct in water and take. Or Wumei (1 jin, crushed), boil in 4 bowls of water until reduced to 1 bowl, add Honey (1 jin) and Sharen powder (5 qian), simmer slowly in a clay pot to make a paste. After cooling, add Tanxiang powder (3 qian) and Shexiang (0.2 fen), take with water decoction.
Another prescription: Douda (Soybean, 5 sheng), Dahuang (1.5 liang), Gancao (4 liang, crushed), boil in 1 bucket of water until beans are cooked, drink the broth and eat the beans.
Another prescription: Sao Si Tang (Silkworm Reeling Soup), drink at will; highly effective. Stored in jars and buried for a long time is better. If unavailable, boiling silk cotton in water is also acceptable.
Another prescription: Sangshenzhi (Mulberry Berry Juice), Niu Ru (Cow's Milk), Luobo Zhi (Radish Juice), Gualou Gen Zhi (Trichosanthes Root Juice), Tao Nuomi Gan Shui (Starch Water from Washing Glutinous Rice), Huanglian Jian Zhi (Coptis Decoction), Zhe Zhi (Sugarcane Juice), Li Zhi (Pear Juice), Mazizi Zhu Zhi (Hemp Seed Decoction), Chen Sumi Zhou (Aged Millet Porridge). Choose any to drink as desired.
Another prescription: Gualou, Gegen, crush, roast, and grind into powder. Ash from the horizontal wooden bar used to pierce the nose of a male ox, and powder from late silkworm sand, take as desired.