经曰∶二阳结，谓之消。周梦觉曰∶同一消也，而气分血分判焉。气分结者，病发于阳。血分结者，病发于
阴。二症相反，如同冰炭。其发于阳也，阳明被火煎熬，时引冷水自救，脉浮洪而数。其发于阴也，阳明无水涵
濡，时引热水自救，脉沉弱而迟。发于阳者，石膏黄连，可以折狂妄之火，人所共知。发于阴者，其理最为微妙，
非三折其肱，殊难领会。人之灌溉一身，全赖两肾中之水火，犹之甑乘于釜。釜中水足，而甑自水气交流；倘水
涸火熄，而甑反干枯缝裂。血分之渴，作如是观。当此舌黑肠枯之时，非重用熟地不足以滋其水；非重用桂附，
不足以益其火。火炽水胜，而渴自止。余尝治是症，发于阳者十居二三，发于阴者十居七八，用桂附多至数斤而
愈。彼本草所注，无非治气分之品，而治血分之药性，不注于本草。方实治始于仲
景，至喻嘉言而昌明其说。上消如是，中下消可类推矣。昔汉武帝患是症，仲景进桂附八味汤服之而愈，因赐相
如，服之无效。或曰相如之渴，发于气分；或曰相如为房劳所伤，非草木之精华所能疗。武帝不赐方而赐以金
茎露一杯，庶几愈焉，未可知也。
梦觉甘石汤 治气分有热消渴。
石膏（二钱） 知母（一钱） 炙草（一钱） 黄连（一钱） 粳米（一钱）
桂附地黄汤 （即肾气丸，见前肿满方内）
涂蔚生曰∶梦觉所论之气分消渴，亦即水虚消渴。如火过盛，而水之化气过少，不能上输肺部，水津四布者，
亦须加入人参，使气滋火降、津升渴止。若其所谓发于阴者，用桂附地黄汤，则必须肾中水火俱亏，兼有下消
症者方可用。否则水亏火旺，滋阴降火，尚恐不济，何可以热济热，速其危殆者哉。故知柏地黄汤，实为治消渴
症之要药。因此症较他症为多也。如其阴亏已极，则补有形之阴，必须有形之质，而龟胶尤可加入。至于瘀血消
渴，则为血阻气升，清其瘀，而渴血自止。杂病消渴则为水停不化，化其水，理其脾，益其火，而渴亦自止。此皆
非消之正症者也，亦不可不知。
知柏地黄汤（见前咳嗽方内）
《黄帝内经》说：“二阳（指阳明胃与大肠）气机郁结，称为消渴。”周梦觉说：“同样是消渴病，但气分病变和血分病变截然不同。气分郁结的，病发于阳；血分郁结的，病发于阴。这两种证候相反，就像冰和炭一样对立。那种发于阳的，是阳明经被火热煎熬，患者时常想喝冷水来自救，脉象浮大而数。那种发于阴的，是阳明经缺乏阴液滋润，患者时常想喝热水来自救，脉象沉弱而迟。对于发于阳的，用石膏、黄连可以遏制狂妄的火邪，这是大家都知道的。对于发于阴的，其道理最为微妙，如果不是医术精湛的人，很难领会。人体灌溉全身，全赖两肾中的水火平衡，就像蒸笼放在锅上一样。如果锅中水充足，蒸笼自然会被水蒸气充满；倘若水干火灭，蒸笼反而干枯裂缝。血分导致的口渴，应当这样理解。当出现舌苔黑、肠道干枯的时候，不重用熟地黄不足以滋养其阴水；不重用肉桂、附子不足以温益其阳气。只有火旺而水足，口渴自然停止。我曾经治疗这种病症，发于阳的占二三成，发于阴的占七八成，使用肉桂、附子多至几斤才痊愈。那些本草书记载的，无非是治疗气分病的药物，而对于治疗血分病的药性，本草书中并没有记载。方剂治疗始于张仲景，到了喻嘉言才昌明这一学说。上消是这样，中消和下消可以类推。从前汉武帝患这种病，张仲景进献桂附八味汤服用后痊愈，于是赐给司马相如，但他服用无效。有人说司马相如的渴是发于气分；也有人说司马相如是因房劳过度受伤，不是草木精华所能治愈的。汉武帝没有赐给他药方，而是赐给他一杯金茎露，或许能治好，也未可知。
梦觉甘石汤：治疗气分有热的消渴病。
石膏（二钱） 知母（一钱） 炙甘草（一钱） 黄连（一钱） 粳米（一钱）
涂蔚生说：周梦觉所论述的气分消渴，也就是水虚消渴。如果火过盛，而水化为气太少，不能上输到肺部，导致水津不能四布，也必须加入人参，使气滋火降、津升渴止。至于他所说的发于阴的，使用桂附地黄汤，则必须是肾中水火俱亏，兼有下消症状者方可使用。否则如果是水亏火旺，滋阴降火尚且恐怕不够，怎么能用热药来济热，从而加速危殆呢？所以知柏地黄汤，实际上是治疗消渴病的重要药物。因为这个病症比其他病症多见。如果阴虚已经极度严重，那么补有形之阴，必须有形之质地，龟胶尤其可以加入。至于瘀血导致的消渴，则是由于血阻气升，清除瘀血，而渴血自止。杂病导致的消渴则是由于水停不化，化解水饮，调理脾胃，补益阳气，而口渴也会自然停止。这些都不是消渴的正症，也是不可不知道的。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When the Two Yangs (referring to the Yangming Stomach and Large Intestine channels) are constrained, it is called Xiao Ke (Wasting-Thirst)." Zhou Mengjue said: "Although it is all Xiao Ke, there is a clear distinction between Qi-level pathology and Blood-level pathology. When constraint occurs at the Qi level, the disease originates from Yang; when constraint occurs at the Blood level, the disease originates from Yin. These two syndromes are opposite, like ice and charcoal. In cases originating from Yang, the Yangming channel is scorched by fire, and patients frequently crave cold water for self-rescue, presenting with a floating, large, and rapid pulse. In cases originating from Yin, the Yangming channel lacks yin fluid nourishment, and patients frequently crave hot water for self-rescue, presenting with a deep, weak, and slow pulse. For those originating from Yang, using Shigao (Gypsum Fibrosum) and Huanglian (Coptidis Rhizoma) can subdue reckless fire, which is common knowledge. For those originating from Yin, the principle is most subtle; unless one has profound medical expertise, it is difficult to comprehend. The body's irrigation relies entirely on the balance of water and fire in the two Kidneys, similar to a steamer placed on a pot. If the water in the pot is sufficient, the steamer naturally fills with steam; if the water dries up and the fire extinguishes, the steamer becomes dry and cracked. One should view thirst caused by Blood-level pathology in this manner. When the tongue coating is black and the intestines are dry, heavy doses of Shudi (Rehmanniae Radix Preparata) are insufficient to nourish the yin water; heavy doses of Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Preparata) are insufficient to tonify the fire. Only when fire is vigorous and water is abundant will the thirst cease. I have treated this condition before; cases originating from Yang accounted for two or three out of ten, while those originating from Yin accounted for seven or eight out of ten. I used Guizhi and Fuzi in amounts reaching several jin (approx. 500g each) to achieve recovery. Materia Medica texts mainly record herbs for treating Qi-level conditions, but do not annotate the properties of herbs for treating Blood-level conditions. Formula treatment began with Zhang Zhongjing, and the theory was clarified and promoted by Yu Jiayan. Shang Xiao (Upper Wasting-Thirst) is like this; Zhong Xiao (Middle Wasting-Thirst) and Xia Xiao (Lower Wasting-Thirst) can be inferred analogously. In ancient times, Emperor Wu of Han suffered from this condition. Zhang Zhongjing prescribed Guifu Bawei Tang (Cinnamon Twig and Aconite Eight-Ingredient Decoction), which cured him, so he bestowed it upon Sima Xiangru, who took it without effect. Some say Sima Xiangru's thirst originated from the Qi level; others say Sima Xiangru was injured by sexual exhaustion, and the essence of herbs could not cure him. Emperor Wu did not bestow a prescription but gave him a cup of Dew from the Golden Pillar, perhaps this might have cured him, though it is uncertain.
Mengjue Ganshi Tang: Treats Xiao Ke with heat in the Qi level.
Shigao (Gypsum Fibrosum) (2 qian) Zhimu (Anemarrhenae Rhizoma) (1 qian) Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (1 qian) Huanglian (Coptidis Rhizoma) (1 qian) Jingmi (Oryzae Semen) (1 qian)
Guifu Dihuang Tang (Same as Shenqi Wan, see formula for swelling/fullness above).
Tu Weisheng said: The Qi-level Xiao Ke discussed by Zhou Mengjue is also Water-deficiency Xiao Ke. If fire is excessive and water transforms into Qi too little, failing to transport upwards to the Lung, causing body fluids not to distribute widely, Renshen (Ginseng Radix et Rhizoma) must also be added to moisten Qi, descend fire, raise fluids, and stop thirst. Regarding his statement that for those originating from Yin, Guifu Dihuang Tang is used, this applies only when both water and fire in the Kidney are deficient, accompanied by symptoms of Xia Xiao. Otherwise, if it is water deficiency with fire hyperactivity, even nourishing yin and descending fire may be insufficient; how can one use hot herbs to assist heat, thereby accelerating danger? Therefore, Zhibai Dihuang Tang (Anemarrhenae, Phellodendri and Rehmanniae Pill) is actually an essential medicine for treating Xiao Ke, as this syndrome is more common than others. If yin deficiency is extremely severe, then to tonify substantial yin, one must use substantial substances, and Guijiao (Testudinis Carapax et Plastrum Gelatinum) is particularly suitable for addition. As for Xiao Ke caused by blood stasis, it is due to blood obstruction causing qi to rise; clearing the stasis will cause the thirst and blood issues to cease spontaneously. Xiao Ke caused by miscellaneous diseases is due to retained water failing to transform; resolving the water, regulating the Spleen, and benefiting the fire will cause the thirst to cease spontaneously. These are not the typical syndromes of Xiao Ke, but one must know them.
Zhibai Dihuang Tang (See formula for cough above).