肘后卒消渴小便多方。
多作竹沥。饮之恣口。数日瘥。忌面炙肉。（通按恣口者谓多饮竹沥非恣食也）
又方
酒煎黄柏汁。取性饮之。（通按性饮者若人性畏冷即少饮也）
又方
熬胡麻令变色。研淘取汁。饮半合。日可三四服。不过五升即瘥。
又疗日饮水一斛者方。
桑根白皮新掘入地三尺者佳。炙令黄黑色切。以水煮之。无多少。但令浓随意饮之。无
多少亦可。纳少粟米。勿与盐。（集验云宜热饮之）
又小便卒太数。复非淋。一日数十过。令人瘦方。
未中水猪脂如鸡子一枚炙。承取肥汁尽服之。不过三剂瘥。
又方
羊肺一具作羹。纳少肉和盐豉。如食法。任意进之。不过三具瘥。（千金同）
又方
豉一升。纳于盐中绵裹之。以白矾好者半斤。置绵上令蒸之三斗米许时。即下白矾。得
消入豉中。出曝干。捣末。服方寸匕。
又小便数。猪肚黄连丸方。
猪肚（一枚洗去脂膜） 黄连末（三斤） 纳猪肚中蒸之一石米熟。即出之。曝干。捣
丸如
梧子。服三十丸。日再服。渐渐加之。以瘥为度。忌猪肉。（出第二卷中）
论曰∶消渴者。原其发动。此则肾虚所致。每发即小便至甜。医者多不知其疾。所以古
方论亦阙而不言。今略陈其要。按洪范稼穑作甘。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。则上蒸精气。气则下入骨髓。
其次以为脂膏。其次为血肉也。其余别为小便。故小便色黄。血之余也。骚气者。五脏之气。
咸润者则下味也。腰肾既虚冷。则不能蒸于上。谷气则尽下为小便者也。故甘味不变。其色
清冷。则肌肤枯槁也。犹如乳母。谷气上泄。皆为乳汁。消渴疾者。下泄为小便。此皆精气
不实于内。则便羸瘦也。又肺为五脏之华盖。若下有暖气。蒸即肺润。若下冷极。即阳气不
能升。故肺干则热。故周易有否卦。干上坤下。阳阻阴而不降。阴无阳而不升。上下不交。
故成否也。譬如釜中有水。以火暖之。其釜若以板盖之。则暖气上腾。故板能润也。若无火
力。水气则不上。此板终不可得润也。火力者。则为腰肾强盛也。常须暖将息。其水气即为
食气。食气若得暖气。即润上而易消下。亦免干渴也。是故张仲景云∶宜服此八味肾气丸。
并不食冷物及饮冷水。今亦不复渴。比频得效。故录正方于后耳。凡此疾与香港脚。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。衰于二月三月。其故何也。夫香港脚者。拥疾也。消渴者。宣疾也。春夏阳气上。
故拥疾发。即宣疾愈也。秋冬阳气下。故宣疾发。即拥疾愈也。审此二者。疾可理也。又宜
食者。每间五六日空腹一食饼。以精羊肉及黄雌鸡为 。此可温也。若取下气不食肉。菜食
者宜煮牛膝韭蔓荆。又宜食鸡子马肉。此物微拥。亦可疗宣疾也。拥之过度。便发香港脚。犹
如善为政者。宽以济猛。猛以济宽。随事制度。使宽猛得所。定之于心。口不能言也。又庸
医或令吃栝蒌粉。往往经服之都无一效。又每至椹熟之时。取烂美者水淘去浮者餐之。下候
心胸间气为度。此亦甚佳。生牛乳暖如人体。渴即细细呻之亦佳。张仲景云∶足太阳者。是
膀胱之经也。膀胱者。是肾之腑也。而小便数。此为气盛。气盛则消谷大便硬。衰则为消渴
也。男子消渴。饮一斗水。小便亦得一斗。宜八味肾气丸主之。
神方。消渴人宜常服之。
干地黄（八两） 薯蓣（四两） 茯苓（三两） 山茱萸（五两） 泽泻（四两） 牡
丹皮（三两） 附子（三两炮） 桂心（三两）
右药捣筛。蜜和丸如梧子大。酒下十丸。少少加。以知为度。忌猪肉冷水芜荑胡荽酢物
生葱（范汪短剧深师古今录验必效文仲方等并同）
先服八味肾气丸讫。后服此药压之方。
黄连（二十分） 苦参粉（十分） 干地黄（十分） 知母（七分） 牡蛎（八分） 麦
门冬（十
二分去心） 栝蒌（七分一方无余并同）
上七味捣筛。牛乳和为丸。如梧子大。并手作丸。曝干。油袋盛用。浆水或牛乳下。日
再服二十丸。一方服十五丸。患重者渴瘥后。更服一年以来。此病特慎獐鹿肉。须慎酒炙肉
咸物。吃索饼五日一顿。细切精羊肉勿着脂。饱食吃羊肉。须着桑根白皮食。一方云∶瘥后
须服此丸。一载以上。即永绝根源。此病特忌房室热面并干脯一切热肉粳米饭李子等。若觉
热渴。加至二十五丸亦得。定后还依前减。其方神效无比。余并准前方。忌猪肉芜荑。
《肘后备急方》中治疗突发消渴、小便频多的方剂。
大量制作竹沥（竹子加热后流出的汁液），随意饮用，数日即可痊愈。忌食面食、烤肉。（通按：所谓“恣口”是指多饮竹沥，并非指放纵饮食。）
又一方
用酒煎煮黄柏取汁，趁热服用。（通按：所谓“性饮”是指如果患者本性畏冷，就少量饮用。）
又一方
炒胡麻至颜色改变，研磨淘洗取汁，服用半合。每天可服三四次，总量不超过五升即可痊愈。
又一方治疗每日饮水一斛的患者。
选用新挖掘的桑根白皮，深入地下三尺处的为佳，炙烤至黄黑色后切碎。用水煮，水量不限，只要煮得浓稠，随意饮用即可，水量多少也可以。加入少许粟米，不要放盐。（《集验方》说适宜热饮。）
又一方治疗突然小便极频，但不是淋证，一天几十次的，使人消瘦的方子。
未接触水的猪脂，如鸡蛋大小一枚，炙烤，承接收集其融化的油脂，全部服下。不超过三剂即可痊愈。
又一方
羊肺一副做成羹汤，加入少许肉和盐豉，按照食用方法，任意进食。不超过三副即可痊愈。（《千金方》相同）
又一方
豆豉一升，放入盐中用绵布包裹。用好白矾半斤，放在绵布上，蒸约三斗米煮熟的时间，然后取出白矾，使其完全渗入豆豉中，取出晒干，捣成粉末。每次服用方寸匕大小的量。
又一方治疗小便频数的猪肚黄连丸方。
猪肚一个，洗净去掉脂膜；黄连末三斤。将黄连末纳入猪肚中，用一石米蒸煮至熟，取出，晒干，捣碎制成梧桐子大小的药丸。每次服用三十丸，每天两次，逐渐增加剂量，以痊愈为限度。忌食猪肉。（出自第二卷）
论述说：消渴病，推究其发病原因，这是由于肾虚所致。每次发作时，小便味道甘甜。医生们大多不了解这种病，所以古方的论述中也缺失而未提及。现在简要陈述其要点。根据《尚书·洪范》中“稼穑作甘”的说法，从物理道理推断，熬糖、酿醋、酿酒制作肉脯的方法，很快都能变甜。这足以证明人进食之后，滋味都是甜的，流经膀胱。如果腰肾之气旺盛，就能向上蒸腾精气，气则向下进入骨髓，其次形成脂膏，其次形成血肉。其余部分成为小便，所以小便色黄，是血的余绪。骚气，是五脏之气；咸润，则是下面的味道。腰肾既虚冷，就不能向上蒸腾，谷气就全部向下变成小便。所以甜味不变，颜色清冷，肌肤就会枯槁。就像乳母，谷气向上宣泄，都变成了乳汁；消渴病患者，向下宣泄变成小便。这都是因为精气不能在体内充实，所以身体羸弱消瘦。另外，肺是五脏的华盖，如果下部有暖气，蒸腾上来肺就滋润；如果下部极冷，阳气就不能上升，所以肺干则热。因此《周易》中有否卦，乾上坤下，阳被阻而不能降，阴无阳而不能升，上下不交，所以形成否塞之象。譬如锅中有水，用火温暖它，如果用板盖住锅，那么暖气上升，所以板能湿润。如果没有火力，水气就不能上升，这块板终究无法湿润。火力，就是指腰肾强盛。必须经常注意保暖调养，水气就是食气。食气如果得到暖气，就能滋润上部而易于消化下部，也能避免干渴。所以张仲景说：适宜服用八味肾气丸。并且不吃冷物及喝冷水，现在也不再口渴，近来频繁获得疗效，所以记录正方的在后面。凡是此病与香港脚（脚气病），虽然同为肾虚所致，但香港脚病始于二三月，盛于五六月，衰于七八月。凡消渴病始于七八月，盛于十一月十二月，衰于二月三月。这是什么缘故呢？香港脚是壅滞之疾，消渴是宣散之疾。春夏阳气上升，所以壅滞之疾发作，宣散之疾就痊愈了。秋冬阳气下降，所以宣散之疾发作，壅滞之疾就痊愈了。审察这两者，疾病就可以调理了。又适宜吃的食物：每隔五六天空腹吃一次饼，用精羊肉和黄雌鸡做馅。这可以温补。如果取下焦气机不畅而不吃肉，吃蔬菜的人适宜煮牛膝、韭蔓荆。又适宜吃鸡蛋、马肉，这些食物轻微壅滞，也可以治疗宣散之疾。壅滞过度，就会引发香港脚。就像善于治理国家的人，宽厚来调剂严厉，严厉来调剂宽厚，根据事情制定制度，使宽严得当，在心里确定，口中不能说出来。又有庸医让人吃栝蒌粉，往往经过服用都没有任何效果。又到桑葚成熟的时候，选取腐烂美味的用水淘去浮起的食用，以下候心胸间气感为度，这也很好。生牛乳加热至人体温度，口渴时细细啜饮也很好。张仲景说：足太阳经，是膀胱的经脉。膀胱，是肾的腑。而小便频数，这是气盛的表现。气盛则消谷善饥、大便硬，衰退则为消渴病。男子消渴，喝一杯水，小便也排出一杯，适宜用八味肾气丸主治。
神方，消渴病人适宜常服。
干地黄（八两） 薯蓣（四两） 茯苓（三两） 山茱萸（五两） 泽泻（四两） 牡丹皮（三两） 附子（三两，炮制） 桂心（三两）
以上药物捣碎过筛，蜂蜜调和制成梧桐子大小的药丸。酒送服十丸，逐渐增加，以见效为限度。忌食猪肉、冷水、芜荑、胡荽、醋类食物、生葱。（范汪《短剧》、《深师方》、《古今录验》、《必效方》、《文仲方》等与此相同）
先服用八味肾气丸完毕，后服用此药压制的方子。
黄连（二十分） 苦参粉（十分） 干地黄（十分） 知母（七分） 牡蛎（八分） 麦门冬（十二分，去心） 栝蒌（七分，一方无其他，均相同）
以上七味药捣碎过筛，用牛乳和匀制成梧桐子大小的药丸，并用手搓丸，晒干，用油袋盛装使用。浆水或牛乳送服，每天两次，每次二十丸。一方服用十五丸。病情重者，口渴症状缓解后，继续服用一年。此病特别要慎食獐鹿肉，必须慎食酒烤肉、咸物，五天吃一次索饼，细切精羊肉不要带脂肪，吃饱羊肉，必须搭配桑根白皮一起吃。一方说：痊愈后必须服用此丸，一年以上，就能永远断绝病根。此病特别禁忌房事、热面以及干肉脯一切热性肉类、粳米饭、李子等。如果觉得热渴，加量至二十五丸也可以，定下来后还依照前面减少剂量。此方神效无比，其余都遵照前方。忌食猪肉、芜荑。
Formulas from *Zhou Hou Bei Ji Fang* for treating sudden onset of Xiao Ke (Wasting and Thirsting Syndrome) with polyuria.
Prepare a large amount of Zhuli (Bamboo Juice, the juice obtained by heating bamboo), drink it freely, and recover in a few days. Avoid wheat products and roasted meat. (Tong's note: "Drinking freely" refers to drinking much Bamboo Juice, not indulging in food.)
Another formula
Decoct Huangbai (Phellodendri Cortex) in wine to extract the juice, and drink it while warm. (Tong's note: "Drink while warm" means if the patient naturally fears cold, drink a small amount.)
Another formula
Stir-fry Humazha (Sesamum indicum seeds) until the color changes, grind and wash to extract the juice. Drink half he (a traditional unit of volume). Take three to four times a day. The total amount should not exceed five sheng (a traditional unit of volume) for recovery.
Another formula for those who drink one hu (a large traditional unit of volume) of water daily.
Use newly dug Sanggen Baipi (Mori Cortex), preferably from three chi deep underground. Roast until yellow-black, then cut. Boil in water; the quantity of water is not fixed, just boil until concentrated and drink as desired. Adding a little Sumi (Setaria italica grain) is fine. Do not add salt. (*Ji Yan Fang* states it is suitable to drink hot.)
Another formula for sudden severe frequency of urination, not Lin syndrome (Dysuria), occurring dozens of times a day, causing emaciation.
Take Zhu Zhi (Porcine Fat) that has not touched water, size of a chicken egg. Roast it, collect the rendered fat, and consume it all. Recovery occurs within no more than three doses.
Another formula
Make soup with one Yang Fei (Ovis/Caprae Pulmo). Add a little meat, Yan Chi (Fermented Soybeans), and salt. Eat according to normal dietary methods, as much as desired. Recovery occurs within no more than three lungs. (*Qian Jin Fang* agrees.)
Another formula
Take Shi Er Dou Chi (Perillae Fructus Fermentatus) one sheng, wrap it in silk cloth, and place it in salt. Place Ban Xia Bai Fan (Alumen) half jin on top of the cloth. Steam for the time it takes to cook three dou of rice. Then remove the Alumen, allowing it to fully penetrate into the fermented soybeans. Remove, dry in the sun, grind into powder. Take one fang cun bi (a square-inch measure) per dose.
Another formula for polyuria: Zhu Du Huang Lian Wan (Pig Stomach with Coptis Pill).
One Zhu Du (Sus Scrofa Domesticus Stomach), washed clean to remove fat membrane. Three jin of Huanglian Mo (Coptidis Rhizoma Powder). Place the Coptis powder inside the pig stomach. Steam with one shi of rice until cooked. Remove, dry, grind, and make pills the size of Wuzi (Osleria Fruit seeds). Take thirty pills per dose, twice daily. Gradually increase the dosage until recovery. Avoid pork. (From Volume II)
Discussion:
Xiao Ke (Wasting and Thirsting Syndrome), investigating its origin, is caused by Shen Xu (Kidney Deficiency). Upon each attack, the urine tastes sweet. Physicians often do not understand this disease, so ancient texts omit it. Now I briefly state the essentials. According to *Hong Fan* ("Agriculture and Harvest yield sweetness"), deducing from physical principles, making syrup, vinegar, wine, or dried meat quickly becomes sweet. This proves that after human digestion, flavors are sweet, flowing into the Pang Guang (Urinary Bladder). If Yao Shen Qi (Qi of the Waist and Kidneys) is vigorous, it steams Jing Qi (Essence and Qi) upward. This Qi enters the Su Gou (Bone Marrow) downward, then forms Zhi Gao (Fat/Grease), then Xue Rou (Blood and Flesh). The remainder becomes Xiao Bian (Urine), hence urine is yellow, being the surplus of blood. Sao Qi (Pungent/Aromatic Qi) is the Qi of the Five Zang Organs; Xian Run (Salty/Moist) is the flavor below. Since Yao Shen is deficient and cold, it cannot steam upward, so Gu Qi (Grain Qi) goes entirely down to become urine. Thus, the sweet taste remains unchanged, the color is clear and cold, and the skin and muscles become withered. Like a nursing mother, Grain Qi flows up to become milk; in Xiao Ke, it flows down to become urine. This is because Jing Qi is not solidified internally, leading to emaciation. Furthermore, Fei (Lung) is the canopy of the Five Zang Organs. If there is warm Qi below steaming upward, the Lung is moistened. If the lower part is extremely cold, Yang Qi cannot ascend, causing Fei Dryness and Heat. Thus, in *I Ching*, there is the Pi Hexagram (Obstruction), Qian above, Kun below. Yang is blocked and cannot descend; Yin lacks Yang and cannot ascend. Upper and lower do not interact, resulting in obstruction. It is like having water in a pot and warming it with fire. If covered with a board, warm Qi rises, moistening the board. Without fire power, water vapor does not rise, and the board remains dry. Fire power refers to strong Yao Shen (Waist and Kidneys). One must maintain warmth and care. Water vapor is Food Qi. If Food Qi receives warm Qi, it moistens the upper part and facilitates digestion below, preventing dryness and thirst. Therefore, Zhang Zhongjing said: It is suitable to take Ba Wei Shen Qi Wan (Eight-Ingredient Replenishing the Kidney Qi Pill). Also, avoid cold foods and drinking cold water. Currently, there is no longer thirst. Having frequently achieved efficacy recently, I record the correct formulas below. This disease and Hong Jiao (Foot Qi/Jama), although both caused by Shen Xu (Kidney Deficiency), differ in timing. Hong Jiao begins in the second and third months, peaks in the fifth and sixth, and declines in the seventh and eighth. Xiao Ke begins in the seventh and eighth months, peaks in the eleventh and twelfth, and declines in the second and third. Why? Hong Jiao is a Yong Ji (Stagnant Disease); Xiao Ke is a Xuan Ji (Dispersing Disease). In spring and summer, Yang Qi ascends, so Stagnant Disease attacks, and Dispersing Disease heals. In autumn and winter, Yang Qi descends, so Dispersing Disease attacks, and Stagnant Disease heals. Understanding these two allows for regulation of the disease. Suitable foods: Every five or six days, eat a cake on an empty stomach, made with lean mutton and yellow hen. This can warm the body. If taking downward-moving Qi and avoiding meat, vegetable eaters should boil Niu Xi (Achyranthis Bidentatae Radix) and Jiu Man Jing. Also suitable are eggs and horse meat; these slightly stagnate but can treat Dispersing Disease. Excessive stagnation leads to Hong Jiao. It is like a good ruler balancing leniency and severity, adjusting measures according to circumstances, keeping balance in mind though words fail. Quack doctors may prescribe Gua Lou Fen (Trichosanthis Radix Powder), which often yields no effect. When mulberries ripen, select soft, good ones, wash away floating ones with water, and eat them, stopping when chest/heart Qi feels balanced. This is also very good. Warm raw cow's milk to body temperature and sip slowly when thirsty; this is also good. Zhang Zhongjing said: Zu Tai Yang Jing (Foot-Taiyang Meridian) is the meridian of Pang Guang (Urinary Bladder). Pang Guang is the Fu Organ of Shen (Kidney). Frequent urination indicates Qi Sheng (Excess Qi). Excess Qi causes Xiao Gu (Consuming Grain/Appetite) and hard stool; deficiency leads to Xiao Ke. For male Xiao Ke, drinking one dou of water results in excreting one dou of urine; Ba Wei Shen Qi Wan (Eight-Ingredient Replenishing the Kidney Qi Pill) is indicated.
Divine Formula, suitable for regular use by Xiao Ke patients.
Gan Di Huang (Rehmanniae Radix Preparata) eight liang, Shu Yu (Dioscoreae Rhizoma) four liang, Fu Ling (Poria) three liang, Shan Zhu Yu (Corni Fructus) five liang, Ze Xie (Alismatis Rhizoma) four liang, Mu Dan Pi (Moutan Cortex) three liang, Fu Zi (Aconiti Lateralis Radix Praeparata) three liang (prepared), Gui Xin (Cinnamomi Ramulus) three liang.
Crush and sieve the above herbs. Mix with honey to make pills the size of Osleria Fruit seeds. Take ten pills with wine, gradually increasing until effective. Avoid pork, cold water, Wu Yi (Houttuyniae Herba), Hu Sui (Coriandri Fructus), vinegar products, and raw scallions. (*Fan Wang Duan Ju*, *Shen Shi Fang*, *Gu Jin Lu Yan*, *Bi Xiao Fang*, *Wen Zhong Fang* etc. agree.)
After finishing Ba Wei Shen Qi Wan (Eight-Ingredient Replenishing the Kidney Qi Pill), take this suppressing formula.
Huang Lian (Coptidis Rhizoma) twenty fen, Ku Shen Fen (Sophorae Flavescentis Radix Powder) ten fen, Gan Di Huang (Rehmanniae Radix Preparata) ten fen, Zhi Mu (Anemarrhenae Rhizoma) seven fen, Mu Li (Ostreae Concha) eight fen, Mai Men Dong (Ophiopogonis Tuber) twelve fen (decored), Gua Lou (Trichosanthis Fructus) seven fen (one version has no others, all same).
Crush and sieve the seven ingredients. Mix with cow's milk to make pills the size of Osleria Fruit seeds, hand-rolled, dried, stored in oil bags. Take with Jiang Shui (Fermented Rice Liquid) or cow's milk, twice daily, twenty pills per dose. One version takes fifteen pills. For severe cases, continue taking for one year after thirst subsides. Specifically avoid deer/meat, alcohol-roasted meat, salty foods. Eat Suo Bing (Noodles) once every five days. Finely chop lean mutton without fat, eat until full, and must consume with Sang Gen Bai Pi (Mori Cortex). One version says: After recovery, take this pill for over a year to permanently eliminate the root cause. Specifically avoid sexual activity, hot noodles, dried meat jerky, all hot meats, Jing Mi Fan (Oryza Sativa Japonica Group Rice), plums, etc. If feeling hot/thirsty, increase to twenty-five pills; once stable, reduce as before. This formula is incredibly effective. Follow the previous precautions regarding avoiding pork and Wu Yi.