治消渴证每用凉药，然观孙文垣治消渴，小便色清而长，其味甘，脉细数，以肾气丸加桂心、
五味子、鹿角胶、益智仁，服之而愈。陆养愚治消渴，喜饮热而恶凉，大便秘，小便极多，
夜尤甚，脉浮按数大而虚，沉按更无力，以八味丸加益智仁煎人参胶糊丸，服之而愈。其法
本于《金匮》，由火虚不能化水，故饮一斗小便亦一斗，凡见渴而水不消，小便多者，即当
合参脉证，以此法治之。
中食之证，往往状似中风，非详问病因，必难奏效。《明医杂着》有案可法，录之。一壮年
人忽得暴疾如中风，口不能言，目不识人，四肢不举，急投苏合香丸不效，余偶过闻之，因
询其由，曰∶适方陪客，饮食后忽得此症。遂教以煎生姜淡盐汤，多饮探吐之，吐出饮食数
碗，后服白术陈皮半夏麦芽汤而愈。
湖州某绅，老而矍铄，食量兼人，暑月有馈盛馔者，快意加餐，次日蒸豚味变，不忍舍
复饱啖焉，遂得河鱼疾以卒。观此知高年胃强不足持，且以见圣人肉败不食，诚养生之道也
少壮时饭后作书，未尝有滞食之病，中岁以来，遂膺斯患。丁巳年假得秘书数种，克期
约还
食，服保和丸及米灰等不效，投陆氏润字丸，（大黄一两酒浸晒干蒸半熟，制半夏、前胡、
山楂肉、天花粉、陈皮、白术、枳实、槟榔各钱二分五厘，每药须略炒或晒干为末，姜汁打
神曲糊为丸梧子大。）始愈。自是饭后不敢作书。（余服润字丸时，适陈载庵来，告以所患，
问宜何药，载庵曰∶《三世医验》中润字丸最稳最灵。余曰∶鄙意正同，已服二钱许矣。载
庵曰∶不妨再服一次，如其言大便遂通。）伤食者，往往发热口渴，有似外感，辨之之法，
以皮硝二钱，用纸（纸须浓）坚包固，缚置胃脘，静卧数刻，启纸视之，皮硝若湿，便是伤食
，伤之轻者，此亦可以消化，伤之重者，其湿必更甚，乃服消食药可也。
治疗消渴证通常使用寒凉药物，然而观察孙文垣治疗消渴的案例：患者小便颜色清长，味道甘甜，脉象细数，孙文垣使用肾气丸（温补肾阳的方剂）加入桂心、五味子、鹿角胶、益智仁，服用后痊愈。陆养愚治疗消渴：患者喜欢喝热水而厌恶凉水，大便秘结，小便极多，夜间尤其严重，脉象浮取时数大而虚，沉取时更加无力，陆养愚使用八味丸（即金匮肾气丸）加入益智仁煎煮，用人参胶制成糊状丸药，服用后痊愈。这些治疗方法本源于《金匮要略》，其原理是火（肾阳）虚弱不能气化水液，所以喝一斗水，小便也排出一斗。凡是见到口渴且饮水不消解、小便多的情况，就应当结合脉象和症状，用这种方法治疗。
中食（饮食停滞导致的病症）的症状，往往看起来像中风，如果不详细询问病因，很难取得疗效。《明医杂着》中有值得效法的案例，记录如下：一个壮年人突然患上类似中风的急症，口不能言，眼睛看不清人，四肢无法抬起，紧急投用苏合香丸无效。我偶然路过听到此事，便询问病因，回答说：刚才陪客人饮酒吃饭后突然得了这个病。于是教他用生姜淡盐汤煎服，大量饮用并催吐，吐出几碗食物后，再服用白术陈皮半夏麦芽汤而痊愈。
湖州某位绅士，年老但精神矍铄，食量超过常人。暑天有人赠送丰盛酒席，他尽情加餐，第二天猪肉变质，他不忍丢弃又饱食一顿，于是得了因食用腐败食物引起的腹泻疾病而死亡。看这件事就知道老年人虽然胃气强盛也不足以支撑过度饮食，这也印证了圣人所说的“肉败不食”，这确实是养生的道理。年轻时饭后写字，从未有过食积停滞的毛病，中年以来，就患上了这种病。丁巳年假期得到几种秘书籍，约定日期归还，期间进食，服用保和丸及米灰等药无效，投用陆氏润字丸（大黄一两用酒浸泡晒干蒸至半熟，制半夏、前胡、山楂肉、天花粉、陈皮、白术、枳实、槟榔各钱二分五厘，每种药需略微炒或晒干研末，用姜汁打神曲糊做成梧桐子大小的丸药），才痊愈。从此以后饭后不敢写字。（我服用润字丸时，正好陈载庵来访，告知我的病情，问他该用什么药，载庵说：《三世医验》中的润字丸最稳妥最灵验。我说：我的想法也正相同，已经服用了二钱左右。载庵说：不妨再服一次，照他的话做，大便随即通畅。）伤食的人，往往发热口渴，有点像外感病，辨别的方法是：用皮硝二钱，用厚纸紧紧包裹牢固，绑在胃脘部，静卧片刻，打开纸查看，如果皮硝变湿了，就是伤食；伤食轻的，这样也可以帮助消化；伤食重的，湿气必然更重，然后才可以服用消食药。
In the treatment of Xiao Ke (Wasting and Thirsting Syndrome), cooling herbs are often used. However, observing Sun Wenyuan's treatment of Xiao Ke: the patient had clear, long-lasting urine with a sweet taste, and a fine and rapid pulse. Sun Wenyuan prescribed Shengqi Wan (Kidney Qi Pill) added with Guixin (Cinnamon Heart), Wuweizi (Schisandra Fruit), Lujiaojiao (Deer Antler Glue), and Yizhiren (Bitter Apricot Seed), after which the patient recovered. Lu Yangyu treated another case of Xiao Ke where the patient preferred hot drinks and disliked cold ones, suffered from constipation, had excessive urination especially at night, and presented with a floating pulse that was rapid, large, and deficient upon light pressure, becoming even more powerless upon deep pressure. Lu Yangyu prescribed Bawei Wan (Eight-Ingredient Pill with Rehmannia Root) added with Yizhiren, decocted and formed into pills using Ren Shen Jiao (Ginseng Glue) as a binder, after which the patient recovered. These methods originate from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet). The principle is that Fire (Kidney Yang) deficiency fails to transform water; thus, for every dou of water drunk, a dou of urine is excreted. Whenever thirst is present with undigested water intake and polyuria, one should combine pulse diagnosis and symptoms to apply this method of treatment.
Zhong Shi (Food Stagnation) often presents with symptoms resembling Zhong Feng (Wind Stroke). Without a detailed inquiry into the cause, efficacy is difficult to achieve. A case in *Ming Yi Za Zhuo* (Miscellaneous Notes on Medicine by Famous Physicians) is worthy of emulation and is recorded below: A young man suddenly fell ill with an acute condition resembling wind stroke: he could not speak, could not recognize people, and his four limbs were immobile. Emergency administration of Suhexiang Wan (Styrax Pill) was ineffective. I happened to pass by and heard of this, so I inquired about the cause. He replied that he had just accompanied guests and consumed food and drink before suddenly falling ill. I then instructed him to decoct ginger and light salt water, drink it in large quantities to induce vomiting. After vomiting several bowls of food, he took Baizhu Chenpi Banxia Maiya Tang (Atractylodes Macrocephala, Tangerine Peel, Pinellia, and Malt Decoction) and recovered.
A gentry member in Huzhou was old but vigorous, with an appetite exceeding normal levels. During summer, someone gifted him a lavish meal, which he enjoyed heartily. The next day, the pork had spoiled; unwilling to discard it, he ate his fill, resulting in diarrhea caused by eating rotten food, leading to his death. This observation reveals that even strong stomach qi in the elderly cannot withstand overeating, confirming the sage's teaching: "Do not eat meat that has spoiled." This is indeed a way of preserving health. In my youth, writing after meals never caused food stagnation, but since middle age, I have suffered from this ailment. During the holiday of the Ding Si year, I obtained several secret manuscripts and agreed on a date to return them. Upon eating during this period, Baohewan (Harmonizing Preservation Pill) and rice ash proved ineffective. I administered Lu Shi Runzi Wan (Lu's Moistening Pill) [Dahuang (Rhubarb Rhizome) 1 liang soaked in wine, dried, steamed until half-cooked; Zhi Banxia (Prepared Pinellia Tuber), Qianhu (Peucedani Radix), Shan Zha Rou (Hawthorn Flesh), Tian Hua Fen (Trichosanthes Root), Chenpi (Tangerine Peel), Baizhu (Atractylodes Macrocephala Rhizome), Zhishi (Immature Bitter Orange), Binglang (Areca Seed) each 2 qian 5 li; each herb slightly fried or dried and powdered; mixed with Jiangzhi (Ginger Juice) and Shenqu Paste to form pills the size of a loquat seed], after which I recovered. From then on, I dared not write after meals. (When I was taking Runzi Wan, Chen Zai'an visited. I told him of my illness and asked what medicine was suitable. Zai'an said: "Runzi Wan in *Sanshi Yiyan* (Three Generations of Medical Verification) is the most stable and effective." I said: "My opinion is exactly the same; I have already taken about 2 qian." Zai'an said: "It is safe to take another dose." Following his advice, my bowels moved freely.) Patients with Shang Shi (Food Injury) often experience fever and thirst, resembling external contraction. The method to distinguish it is as follows: Take 2 qian of Pinxiao (Mirabilite), wrap it securely in thick paper, bind it to the epigastrium, and lie quietly for a while. Open the paper to check; if the Mirabilite has become damp, it indicates Food Injury. For mild cases, this may aid digestion; for severe cases, the dampness will be more pronounced, and only then should digestive-resolving medicines be administered.