消渴之证，乃三焦受病也，东垣有法，分上、中、下治。上消者，肺也，多饮水而少食，大小便如常，或云小便
清利，其燥在上焦也，治宜流湿润燥；中消者，胃也，渴多饮水，而小便赤黄，宜下至不饮而愈；下消者，肾也，小便
浊淋如膏之状，宜养血而整肃，分其清浊而自愈。大法养肺
降火生血为主。消渴泄泻，先用白术、白芍药炒为末，调服后，隙服白莲藕汁膏。内伤病，退后燥渴不解，此有余
热在肺家，以人参、黄芩、甘草少许同煎，加姜汁冷服。或以茶匙挑药，渐渐服之。虚者，亦可服独参汤。消渴而小
便频数，宜生津甘露饮，琼玉膏亦妙。口干舌干，小便赤数，舌上赤裂，地黄饮子。一孕妇当盛夏渴思水，与四物
汤加黄芩、陈皮、生甘草、木通数帖愈。白藕汁膏∶黄连末 生地汁 牛乳汁 白莲藕汁（各一斤） 上将诸汁，慢
火熬膏，入连末和丸，每服二三十丸，温水下，日服数次。缫丝汤∶天花粉、芦根汁、淡竹茹、麦门冬、知母、牛
乳，皆消渴之要药也。
因脾虚不能行浊气，气聚则为水，水溃妄行，当以参、术补脾，使脾气得实，则自能健运，自然升降运动其枢机，
而水自行，非五苓神 之行水也。大抵宜补中行湿，利小便，切不可妄下，以二陈汤加人参、苍术、白术为主，佐以
黄芩、麦冬、栀子制肝木，土气得平，以制其水。若腹胀少佐浓朴，气不运加木香、木通，气陷下加柴、升，随证加减
可也。经曰∶诸气 郁皆属于肺；诸湿肿满皆属于脾；诸腹胀大皆属于热。盖湿者土之气，土者火之子也，故湿病每
生于热，热气亦不能自湿者，子气感母，湿之变也。凡治肿病，皆宜以治湿为主，所挟不同，治法亦异。或以治肿，以
治水立说，而欲导肾，以决去之，岂理也哉。盖脾土衰弱，内因七情，外伤六气，失运化之职，清浊混淆，郁而为水，
渗透经络，流注溪谷，浊腐之气，窒碍津液，久久灌入隧道，血亦化水，欲藉脾上以制之，殊不知，土病则金气衰，木
寡于畏而来侮土，脾欲不病不可得矣。治法，宜清心经之火，补养脾土，全运化之职，肺气下降，渗道开通。浊败之气，
其稍清者，复回而为气、为血、为津液；其败浊之甚者，在上为汗，在下为溺，以渐而分消矣。又曰∶开鬼门，洁净府。
鬼门，肤腠也，属肺；净府，膀胱也，属肾，未闻有导肾之说。仲景云∶治湿利小便，即经洁净府之意；钱仲阳云∶肾
无泻法，请以此视之肾其可易导之乎？水肿本自中宫，诸家只知治湿利小便之说，而类用去水之药，此速死之兆也。
盖脾极虚而败，愈下愈虚，虽或劫效目前，而阴损正气，然病亦有不旋踵而至者。治宜大补中宫为主，看所挟加减，不
尔则死。脉来沉迟，色多青白，不烦不渴，小便涩少而清，大便多泄，此阴水也，治宜温暖之剂；脉来沉数，色多
黄赤，或烦或渴，小便涩少而赤，大腑多闭，此阳水也，治宜清平之剂。有久病气虚而浮，手足皆肿，是虚气妄行
也。产后与经事过多而病肿，血虚也。腰以上肿宜汗，腰以下肿宜利小便，此仲景法。防己治腰以下湿热肿，如
内伤胃弱者，不可用。孕妇水肿，名曰子肿。水肿，痢后浮者，内服益肾散，外用甘草汤淋洗。产后水肿，必用大
补气血为主。水肿五不治者，五脏齐损故也。出血水者不治。虚弱人浮肿，大便泄泻，用四君子汤加陈皮、甘草、
白芍药、升麻、炒曲、泽泻、木通、砂仁、姜煎服之。妇人因月经不行，遍身水肿，恶心，恶血凝滞，腹痛，用当
归、赤芍、青皮、木通、牡丹皮、玄胡索、滑石、没药、血竭。面浮，因元气衰少，力弱脾虚所致，用当归、白术、
木通、苍术、甘葛各一钱，参、 、白芍各五分，柴胡四分。湿胜作肿或自利少食，胃苓汤加木通、麦门冬。面
目或遍身虚浮，用五皮散加紫苏、麻黄、桔梗。治湿肿，
用苍术、浓朴、陈皮、莱菔子、猪苓、泽泻、车前、滑石、茯苓、枳壳、木通、大腹皮、槟榔，上煎服。喘急加苦葶
苈，小便不利加牵牛，又重者加浚川散，其湿毒自消。疟疾后发浮肿，四苓散加青皮、木通、腹皮、木香、槟榔。
脚面浮肿，咳嗽红痰，二陈加木通、泽泻、芩、术、桑皮、贝母、麦冬、五味、苏子。一方治水肿，山栀仁炒为末，
米饮下一手勺许。一云∶胃脘热病在上者，带皮用之。又方∶山栀（五钱） 木香（一钱） 白术（二钱半） 以急流
水煎服。水肿劫药，以大戟为末，枣肉丸，服十一丸，可劫气实者，虚者不可用。
消渴这一病证，是三焦受到邪气侵袭所致。李东垣有治疗方法，分为上、中、下三焦来治疗。上消，病变在肺，表现为饮水多而进食少，大小便正常，或者说小便清长通畅，这是燥热在上焦，治疗应当用滋润的方法以润燥；中消，病变在胃，口渴且大量饮水，小便颜色深黄，治疗宜通利大便直至不再感到口渴而痊愈；下消，病变在肾，小便浑浊如膏脂状，治疗宜养血并调理气机，分清泌浊即可自愈。总的治疗大法以养肺、降火、生血为主。
若消渴兼见泄泻，先用炒过的白术、白芍药研成粉末，调服之后，间歇服用白莲藕汁膏。内伤杂病，腹泻后燥渴不解，这是因为有余热在肺，用人参、黄芩、甘草少许同煎，加入姜汁冷服。或者用茶匙挑着药物，慢慢服用。体质虚弱者，也可以服用独参汤。消渴且小便频数，宜用生津甘露饮，琼玉膏效果也很好。口干舌干，小便赤红频数，舌上有红色裂纹，用地黄饮子。一位孕妇在盛夏时节口渴想喝水，给予四物汤加黄芩、陈皮、生甘草、木通，服用几帖后痊愈。
白藕汁膏：黄连末、生地汁、牛乳汁、白莲藕汁（各一斤）。先将上述几种汁液，用慢火熬制成膏，加入黄连末调和做成丸药，每次服用二三十丸，温水送下，每日服用数次。
缫丝汤：天花粉、芦根汁、淡竹茹、麦门冬、知母、牛乳，这些都是治疗消渴的重要药物。
因为脾虚不能运化浊气，气聚积则化为水，水液泛滥妄行，应当用人参、白术补益脾气，使脾气充实，则自然能健运，升降运动的枢机得以运转，水液自然通行，这并不是五苓散那样的行水方法。大抵适宜补中健脾、祛湿，通利小便，切不可妄用攻下法。以二陈汤加人参、苍术、白术为主方，佐以黄芩、麦冬、栀子来制约肝木，使土气平和，从而制约水邪。如果腹胀，稍加浓朴；气机不运转，加木香、木通；气陷下坠，加柴胡、升麻，随证加减即可。
《内经》说：各种气机郁滞都归属于肺；各种湿邪肿胀满闷都归属于脾；各种腹部胀大都归属于热。大概湿是土的气化表现，土是火的子脏，所以湿病多生于热，热气也不能独自导致湿，这是子气感应母气，是湿的变化。凡是治疗水肿病，都应当以治湿为主，所夹杂的病邪不同，治疗方法也各异。有人主张治肿就是治水，想要通过引导肾脏来决去水邪，这符合医理吗？大概脾土衰弱，内因七情刺激，外受六淫侵袭，失去运化职能，清浊混淆，郁结而化为水，渗透经络，流注溪谷，浊腐之气阻碍津液运行，久而久之灌入隧道，血液也化为水，想要依靠脾土来制约它，却不知道，土病则金气衰败，木气缺乏制约而来乘侮脾土，脾想要不生病是不可能的了。治疗方法，宜清心经之火，补养脾土，恢复其运化职能，肺气下降，渗道开通。浊败之气，其中较清的，重新回转为气、为血、为津液；其中败浊严重的，在上部化为汗，在下部化为尿，逐渐分消排出。又说：开鬼门（发汗），洁净府（利小便）。鬼门，指皮肤腠理，属于肺；净府，指膀胱，属于肾，没听说过有导引肾脏的说法。张仲景说：治湿利小便，这就是《内经》“洁净府”的意思；钱乙说：肾无泻法，请以此来看待，肾脏岂可轻易被导利呢？水肿本源于中焦脾胃，各家只知道治湿利小便的说法，而类似地使用去水之药，这是速死之兆。大概脾极度虚弱而败坏，越攻下越虚，虽然或许能暂时见效，但会损伤阴气和正气，然而病情也有立刻恶化的。治疗宜以大补中焦脾胃为主，根据所夹杂的病邪加减，否则就会死亡。脉象沉迟，面色多青白，不烦躁不口渴，小便涩少而清，大便多泄泻，这是阴水，治疗宜用温阳暖剂；脉象沉数，面色多黄赤，或烦躁或口渴，小便涩少而赤，大便秘结，这是阳水，治疗宜用清热平剂。有久病气虚而浮肿，手足皆肿，这是虚气妄行。产后和月经过多导致的水肿，是血虚所致。腰以上肿宜发汗，腰以下肿宜利小便，这是张仲景的方法。防己治疗腰以下湿热肿，但如果内伤导致胃弱者，不可使用。孕妇水肿，名叫子肿。水肿，痢疾后浮肿的，内服益肾散，外用甘草汤淋洗。产后水肿，必须以大补气血为主。水肿五种不治的情况，是因为五脏都受损的缘故。出血水的，不治。虚弱人浮肿，大便泄泻，用四君子汤加陈皮、甘草、白芍药、升麻、炒曲、泽泻、木通、砂仁、生姜煎服。妇人因月经不行，遍身水肿，恶心，恶血凝滞，腹痛，用当归、赤芍、青皮、木通、牡丹皮、玄胡索、滑石、没药、血竭。面部浮肿，因元气衰少，力弱脾虚所致，用当归、白术、木通、苍术、甘葛各一钱，人参、[缺字]、白芍各五分，柴胡四分。湿气胜致肿或自利少食，用胃苓汤加木通、麦门冬。面目或遍身虚浮，用五皮散加紫苏、麻黄、桔梗。治疗湿肿，用苍术、浓朴、陈皮、莱菔子、猪苓、泽泻、车前、滑石、茯苓、枳壳、木通、大腹皮、槟榔，以上药物煎服。喘急加苦葶苈，小便不利加牵牛子，更重的加浚川散，其湿毒自然消除。疟疾后发生浮肿，用四苓散加青皮、木通、腹皮、木香、槟榔。脚面浮肿，咳嗽红痰，用二陈汤加木通、泽泻、黄芩、白术、桑白皮、贝母、麦冬、五味子、苏子。一方治疗水肿，山栀仁炒为末，米汤送服一手勺许。一说：胃脘热病在上部的，带皮使用山栀。又一方：山栀（五钱）、木香（一钱）、白术（二钱半），以急流水煎服。水肿劫药，以大戟为末，枣肉做丸，服用十一丸，可以劫夺气实者的水邪，虚者不可用。
The syndrome of Xiao Ke (Wasting and Thirsting) is a disease affecting the San Jiao (Triple Burner). Li Dongyuan had methods for treatment, dividing it into Upper, Middle, and Lower Jiao treatments. Upper Xiao Ke involves the Lung; patients drink much water but eat little, with normal bowel movements or clear and profuse urination. This indicates dryness-heat in the Upper Jiao; treatment should employ moistening methods to resolve dryness. Middle Xiao Ke involves the Stomach; patients are thirsty and drink copiously, with dark yellow urine. Treatment should involve purging until thirst ceases and health returns. Lower Xiao Ke involves the Kidney; urine is turbid and resembles paste. Treatment should nourish blood and regulate Qi, separating the clear from the turbid, leading to self-healing. The general principle of treatment focuses on nourishing the Lung, descending Fire, and generating Blood.
If Xiao Ke is accompanied by diarrhea, first use stir-fried Baizhu (Atractylodis Rhizoma) and Shaoyao (Paeoniae Radix Alba) ground into powder, taken mixed with water, followed by intermittent administration of Bai Ou Lian Zhi Gao (White Lotus Root Juice Paste). For internal injury diseases, if dryness and thirst persist after diarrhea, this indicates residual heat in the Lung. Decoct Ren Shen (Ginseng Radix et Rhizoma), Huang Qin (Scutellariae Radix), and Gan Cao (Licorice Radix et Rhizoma) in small amounts, add Ginger Juice, and take cold. Alternatively, pick up the medicine with a tea spoon and take it slowly. Those with deficiency can also consume Du Shen Tang (Single Ginseng Decoction). For Xiao Ke with frequent urination, Sheng Jin Gan Lu Yin (Sweat Dew Drink that Generates Fluids) is suitable; Qiong Yu Gao (Jade Jade Paste) is also excellent. For dry mouth and tongue, red scanty urine, and red cracks on the tongue, use Di Huang Yin Zi (Rehmannia Decoction). A pregnant woman who craved water during midsummer was cured after taking several doses of Si Wu Tang (Four Substances Decoction) added with Huang Qin (Scutellariae Radix), Chen Pi (Citri Reticulatae Pericarpium), Sheng Gan Cao (Raw Licorice Radix et Rhizoma), and Mu Tong (Akebiae Caulis).
Recipe for Bai Ou Zhi Gao: Huang Lian Mo (Coptidis Rhizoma Powder), Sheng Di Zhi (Rehmanniae Radix Juice), Niu Nai Zhi (Cow's Milk Juice), and Bai Ou Lian Zhi (White Lotus Root Juice), each one jin. Slowly boil these juices into a paste, mix in the Huang Lian powder, and form pills. Take 20-30 pills each time with warm water, several times a day.
Sao Si Tang (Silkworm Reeling Soup): Hua Fen (Trichosanthis Radix), Lu Gen Zhi (Phragmitis Rhizome Juice), Dan Zhu Ru (Bambusae Caulis in Taenia), Mai Men Dong (Ophiopogonis Radix), Zhi Mu (Anemarrhenae Rhizoma), and Niu Nai (Cow's Milk) are all essential herbs for treating Xiao Ke.
Because Spleen deficiency fails to transport turbid Qi, Qi accumulation transforms into Water, which floods and moves recklessly. One should use Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Rhizoma) to tonify the Spleen. When Spleen Qi becomes solid, it naturally functions vigorously, regulating the pivot of ascending and descending, allowing Water to move freely. This is not like the water-draining method of Wu Ling San (Five-Ingredient Poria Pill). Generally, one should tonify the Middle, dry Dampness, and promote urination. One must absolutely avoid reckless purgation. The main formula is Er Chen Tang (Two-Cured Decoction) added with Ren Shen (Ginseng Radix et Rhizoma), Cang Zhu (Atractylodis Rhizoma), and Bai Zhu (Atractylodis Rhizoma), assisted by Huang Qin (Scutellariae Radix), Mai Men Dong (Ophiopogonis Radix), and Zhi Zi (Gardeniae Fructus) to control Liver Wood. When Earth Qi is balanced, it controls Water. If abdominal distension occurs, add Hou Po (Magnoliae Officinalis Cortex); if Qi stagnates, add Mu Xiang (Aucklandiae Radix) and Mu Tong (Akebiae Caulis); if Qi sinks, add Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma), adjusting according to symptoms.
The Classics state: All Qi stagnations belong to the Lung; all Dampness swelling and fullness belong to the Spleen; all abdominal distensions belong to Heat. Dampness is the Qi of Earth, and Earth is the child of Fire; thus, Damp diseases often arise from Heat. Heat cannot become Damp alone; it is the child Qi sensing the mother Qi, a transformation of Dampness. In treating all edema diseases, one should primarily treat Dampness. Depending on accompanying pathogens, methods vary. Some argue that treating edema is treating Water, suggesting guiding the Kidney to drain it. Is this logical? When Spleen Earth is weak, due to internal Seven Emotions and external Six Evils, losing its transport function, Clear and Turbid mix, stagnate, and transform into Water. It penetrates collaterals, flows into valleys, and turbid corrupt Qi obstructs Jin Ye (Body Fluids). Over time, it pours into tunnels, and Blood transforms into Water. Trying to rely on Spleen Earth to control it, one ignores that when Earth is diseased, Metal Qi declines, and Wood Qi, lacking restraint, attacks Earth. Thus, the Spleen inevitably suffers. Treatment should clear Heart Fire, tonify Spleen Earth, restore its transport function, descend Lung Qi, and open the渗道 (seeping passages). The clearer part of turbid waste Qi reverts to Qi, Blood, and Jin Ye; the more turbid part exits as sweat above and urine below, gradually dissipating. It is said: "Open the Ghost Gates (sweat pores), cleanse the Pure Mansion (bladder)." Ghost Gates refer to skin and interstices, belonging to the Lung; Pure Mansion refers to the Bladder, belonging to the Kidney. There is no hearing of "guiding the Kidney." Zhang Zhongjing said: "Treat Dampness by promoting urination," which aligns with "cleansing the Pure Mansion." Qian Zhongyang said: "The Kidney has no draining method." Consider this; how can the Kidney be easily guided/drained? Edema originates from the Central Palace (Spleen/Stomach). Practitioners only know treating Dampness and promoting urination, using water-draining drugs indiscriminately. This is a sign of rapid death. When Spleen is extremely deficient and failing, purging makes it more deficient. Although immediate effect may occur, Yin and Zheng Qi are damaged, and the disease may worsen instantly. Treatment should primarily greatly tonify the Central Palace, adjusting for accompanying factors; otherwise, death ensues.
If the pulse is deep and slow, complexion is mostly green-white, without irritability or thirst, urine is scanty, turbid, and clear, and stool is often loose, this is Yin Edema; treat with warming agents. If the pulse is deep and rapid, complexion is mostly yellow-red, with irritability or thirst, urine is scanty, turbid, and red, and bowels are often constipated, this is Yang Edema; treat with clearing and neutral agents. Chronic illness with Qi deficiency causing floating edema, swelling of hands and feet, is caused by erratic movement of deficient Qi. Postpartum edema and edema from excessive menstruation are due to Blood deficiency. Swelling above the waist should be treated with sweating; swelling below the waist with promoting urination. This is Zhang Zhongjing's method. Fang Ji (Stephaniae Tetrandrae Radix) treats damp-heat swelling below the waist, but should not be used if internal injury causes stomach weakness. Edema in pregnancy is called Zi Zhong (Fetal Edema). Edema following dysentery with floating signs: internally use Yi Shen San (Kidney-Nourishing Powder); externally wash with Gan Cao Tang (Licorice Decoction). Postpartum edema must be primarily treated with greatly tonifying Qi and Blood. Five untreatable cases of edema exist because all five Zang organs are damaged. Edema with bleeding fluid is untreatable. For weak persons with edema and diarrhea, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Licorice Radix et Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Sheng Ma (Cimicifugae Rhizoma), Chao Qu (Stir-fried Leaven), Ze Xie (Alismatis Rhizoma), Mu Tong (Akebiae Caulis), Sha Ren (Amomi Fructus), and Jiang (Zingiberis Rhizoma Freshum) decocted and taken. For women with amenorrhea, generalized edema, nausea, stagnant evil blood, and abdominal pain, use Dang Gui (Angelicae Sinensis Radix), Chi Shao (Paeoniae Radix Rubra), Qing Pi (Citri Reticulatae Pericarpium Viride), Mu Tong (Akebiae Caulis), Mu Dan Pi (Moutan Cortex), Yan Hu Suo (Corydalis Rhizoma), Hua Shi (Talcum), Mo Yao (Myrrha), and Xue Jie (Santalum Rubrum). Facial swelling due to depleted Yuan Qi, weakness, and Spleen deficiency: use Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Rhizoma), Mu Tong (Akebiae Caulis), Cang Zhu (Atractylodis Rhizoma), Gan Ge (Puerariae Lobatae Radix) each 1 qian; Ren Shen (Ginseng Radix et Rhizoma), [missing character], Bai Shao (Paeoniae Radix Alba) each 5 fen; Chai Hu (Bupleuri Radix) 4 fen. For swelling or spontaneous diarrhea with poor appetite due to excess Dampness, use Wei Ling Tang (Stomach-Pacifying Decoction) added with Mu Tong (Akebiae Caulis) and Mai Men Dong (Ophiopogonis Radix). For facial or generalized puffiness, use Wu Pi San (Five-Bark Powder) added with Zi Su (Perillae Folium), Ma Huang (Ephedrae Herba), and Jie Geng (Platycodonis Radix). To treat Dampness edema, use Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Chen Pi (Citri Reticulatae Pericarpium), Lai Fu Zi (Raphani Semen), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Che Qian (Plantaginis Semen), Hua Shi (Talcum), Fu Ling (Poria), Zhi Ke (Aurantii Fructus Immaturus), Mu Tong (Akebiae Caulis), Da Fu Pi (Arecae Pericarpium), and Bing Lang (Arecae Semen) decocted and taken. Add Ku Ting Li (Semen Lepidii seu Descurainiae) for panting; add Qian Niu (Semen Pharbitidis) for difficult urination; for severe cases, add Jun Chuan San (Jun Chuan Powder), and the Damp-Toxin will naturally dissipate. Edema after malaria: use Si Ling San (Four-Poria Powder) added with Qing Pi (Citri Reticulatae Pericarpium Viride), Mu Tong (Akebiae Caulis), Fu Pi (Arecae Pericarpium), Mu Xiang (Aucklandiae Radix), and Bing Lang (Arecae Semen). Swelling of the instep with cough and red sputum: use Er Chen Tang (Two-Cured Decoction) added with Mu Tong (Akebiae Caulis), Ze Xie (Alismatis Rhizoma), Qin (Scutellariae Radix), Zhu (Atractylodis Rhizoma), Sang Pi (Mori Cortex), Bei Mu (Fritillariae Bulbus), Mai Men Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus), and Su Zi (Perillae Fructus). Another prescription for edema: Shan Zhi Ren (Gardeniae Semen) stir-fried and powdered, taken with rice water, about one hand-spoonful. Another says: For upper gastric heat disease, use Gardenia with peel. Yet another: Shan Zhi (Gardeniae Fructus) 5 qian, Mu Xiang (Aucklandiae Radix) 1 qian, Bai Zhu (Atractylodis Rhizoma) 2.5 qian, decocted in fast-flowing water. Edema coercive drug: Da Ji (Euphorbiae Pekinensis Radix) powdered, made into pills with date flesh, take 11 pills. This can coerce Qi-excess edema, but is contraindicated in deficiency.