【歌】消证良由燥热过，消中饮食善消磨。肾消溲浊腰肢瘦，消渴便多饮亦多。
【论】夫天一生水，肾实主之。膀胱为津液之腑，能宣行肾水，上润于肺，故肺为津液之脏。自上而下，
三焦脏腑，皆囿于天一真水之中，如水包天地也。经云∶水之本在肾，末在肺，然真水不竭，何渴之有？人惟
酒色是耽，嗜食辛辣浓味，或饵丹石药，于是火炎上熏，腑脏热炽，津液干枯而三消之病生焉。热气上腾，
心受之，故烦渴引饮，小便频数而多，曰消渴。热蓄于中，脾受之，伏阳蒸胃，消谷善饥，能食肌瘦，不甚渴，
便数，曰消中。热伏于下，肾受之，腿膝枯细，骨节酸疼，精竭髓枯，引水自救，饮而随溺，稠浊
如膏，曰肾消。善治者，补肾水真阴之虚，泻心火燔灼之势，除肠胃燥热之甚，济心中津液之衰，使道路散而
不结，津液生而不枯，气血利而不涩，则渴证自已矣。
消渴
消渴，热在上也，丹溪人乳膏、麦门冬饮子。
丹溪人乳膏
人乳（一大盏） 黄连（半两，为末） 天花粉（一两，为末） 藕汁（一大碗） 生地黄汁（一大碗）
以二汁为膏，入前三味，佐以姜汁些少，和蜜为膏，以白汤少许，徐送下。
麦门冬饮子
知母（一钱） 甘草（炙，一钱） 栝蒌仁（去油，一钱） 五味子（一钱） 人参（一钱） 葛根（一钱）
生地黄（一钱） 茯神（一钱） 麦门冬（一钱） 竹叶（十四片）
水二盏，煎服。
消中
消中，热在胃也，白虎汤、（方见中暑。）麦门冬饮。（方见前。）便结，调胃承气汤。（方见痢疾，
即大承气汤去枳实、浓朴，加炙甘草一钱。）
肾消
肾消，热在下也，大补阴丸。（方见火证。）肾虚，六味地黄丸。（方见劳瘵。）肾消小便白如膏，清
心莲子饮。大便秘结，大承气汤。（方见痢疾。）
清心莲子饮
黄 （一两） 石莲肉（一两） 白茯苓（一两） 人参（一两） 甘草（炙，五钱） 地骨皮（五
钱） 麦门冬（半两） 车前子（五钱） 黄芩（五钱）
每服五钱，水煎服。
【歌诀】消证（消渴类疾病）确实是由于燥热过盛所致，其中“消中”表现为饮食容易消化且食欲旺盛。“肾消”表现为小便浑浊、腰部和肢体消瘦；“消渴”表现为大便次数多、饮水也多。
【论述】天道中“一”生“水”，肾脏实际上主宰着水液代谢。膀胱是贮存和排泄津液的腑，能够宣通运行肾中的水气，向上滋润肺部，因此肺被称为津液之脏。从上至下，三焦及脏腑，都包含在先天真水之中，就像水包裹着天地一样。医经说：水的根本在肾，末梢在肺。然而，如果真水不枯竭，怎么会有口渴的症状呢？人们往往沉溺于酒色，嗜好食用辛辣浓厚的食物，或者服用丹石类药物，于是导致火气炎上熏蒸，脏腑热势炽盛，津液干枯，从而产生消渴病。热气向上腾涌，心脏受其影响，所以出现心烦口渴、大量饮水、小便频繁且量多的症状，称为“消渴”。热邪蓄积在中焦，脾脏受其影响，伏阳蒸腾胃部，导致食物被快速消化而容易饥饿，虽然能吃但身体消瘦，口渴感不明显，大便次数多，称为“消中”。热邪潜伏在下焦，肾脏受其影响，导致腿膝枯细、骨节酸痛，精气耗尽、骨髓干枯，只能引水来自救，喝水后随即排出，尿液稠浊如膏脂，称为“肾消”。善于治疗的人，应当补肾水中真阴的虚损，清泻心火燔灼的势头，清除肠胃中严重的燥热，救济心中津液的衰少，使经络道路通畅而不郁结，津液生成而不枯竭，气血流通而不涩滞，那么口渴的病证自然痊愈了。
丹溪人乳膏
配方：人乳（一大盏）、黄连（半两，研为粉末）、天花粉（一两，研为粉末）、藕汁（一大碗）、生地黄汁（一大碗）。
制法与用法：将两种汁液熬制成膏，加入前三味药粉，佐以少许姜汁，调和蜂蜜制成膏剂。服用时取少量白开水，慢慢送服。
麦门冬饮子
配方：知母（一钱）、甘草（炙，一钱）、栝蒌仁（去油，一钱）、五味子（一钱）、人参（一钱）、葛根（一钱）、生地黄（一钱）、茯神（一钱）、麦门冬（一钱）、竹叶（十四片）。
用法：用水二盏煎煮后服用。
消中
消中，是热邪在胃腑，可用白虎汤（方见中暑章节）、麦门冬饮（方见前文）治疗。若大便干结，用调胃承气汤（方见痢疾章节，即大承气汤去掉枳实、厚朴，加入炙甘草一钱）。
肾消
肾消，是热邪在下焦，可用大补阴丸（方见火证章节）治疗。若属肾虚，用六味地黄丸（方见劳瘵章节）。肾消患者小便白如膏脂，用清心莲子饮治疗。若大便秘结，用大承气汤（方见痢疾章节）。
清心莲子饮
配方：黄耆（一两）、石莲肉（一两）、白茯苓（一两）、人参（一两）、甘草（炙，五钱）、地骨皮（五钱）、麦门冬（半两）、车前子（五钱）、黄芩（五钱）。
用法：每次服用五钱，用水煎煮后服用。
[Verse] The syndrome of Xiao (Xiao syndrome, a group of diseases characterized by excessive thirst, frequent urination, and emaciation) is indeed caused by excessive dryness-heat. In "Xiao Zhong" (Middle Xiao), food is digested easily and appetite is strong. In "Shen Xiao" (Kidney Xiao), urine is turbid, and the waist and limbs are emaciated. In "Xiao Ke" (Upper/Middle/Lower Xiao or Diabetes Mellitus), there is frequent defecation and excessive drinking.
[Discussion] In the cosmic order, "One" generates "Water," and the Kidneys essentially govern water metabolism. The Bladder is the fu-organ of fluids; it can disseminate and circulate kidney-water, moistening the Lungs upward; thus, the Lungs are regarded as the zang-organ of fluids. From top to bottom, the Sanjiao (Triple Burner) and the zang-fu organs are all contained within the primordial true water, just as water envelops heaven and earth. The Classics state: "The root of water lies in the Kidneys, and its branches in the Lungs." However, if primordial water is not exhausted, how can thirst arise? People often indulge in alcohol and sexual activity, favor pungent and rich foods, or ingest cinnabar-and-stone elixirs. Consequently, fire flares up and scorches, causing intense heat in the zang-fu organs, drying up body fluids, and giving rise to Xiao disorders. When hot qi ascends, the Heart is affected, resulting in irritability, extreme thirst with copious drinking, and frequent, abundant urination; this is called "Xiao Ke." When heat accumulates in the Middle Jiao, the Spleen is affected; latent yang steams the Stomach, leading to rapid digestion and easy hunger, ability to eat but with emaciation, mild thirst, and frequent stools; this is called "Xiao Zhong." When heat lurks in the Lower Jiao, the Kidneys are affected, causing withered and thin legs and knees, soreness and pain in the bone joints, exhaustion of essence and depletion of marrow. The patient draws water to save themselves, but drinks and then immediately urinates; the urine is thick and turbid like paste; this is called "Shen Xiao." A skilled practitioner should tonify the deficiency of true yin in kidney-water, clear the blazing intensity of heart-fire, eliminate severe dryness-heat in the stomach and intestines, and replenish the decline of fluids in the heart. This ensures that pathways remain open and unobstructed, fluids are generated and not dried up, and qi and blood flow smoothly without stagnation, thereby resolving the thirst syndrome naturally.
Xiao Ke
Xiao Ke indicates heat in the Upper Jiao. Treat with Danxi Renru Gao (Danxi Human Milk Paste) or Maidong Yinzi (Ophiopogon Decoction).
Danxi Renru Gao
Ingredients: Human milk (one large cup), Huanglian (Coptidis Rhizoma, half liang, powdered), Tianhuafen (Trichosanthis Radix, one liang, powdered), Ou Zhi (Nelumbinis Nucis Stem Juice, one large bowl), Shengdihuang Zhi (Rehmanniae Radix Juice, one large bowl).
Preparation and Administration: Boil the two juices into a paste, add the three powdered ingredients, mix with a small amount of Jiang Zhi (Zingiberis Rhizoma Juice) and honey to form a paste. Take a small amount of warm boiled water and slowly swallow the paste.
Maidong Yinzi
Ingredients: Zhimu (Anemarrhenae Rhizoma, one qian), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, one qian), Gualouren (Trichosanthis Semen, oil removed, one qian), Wuweizi (Schisandrae Fructus, one qian), Renshen (Ginseng Radix, one qian), Gegen (Puerariae Lobatae Radix, one qian), Shengdihuang (Rehmanniae Radix, one qian), Fushen (Poria with Hostwood, one qian), Maidong (Ophiopogonis Radix, one qian), Zhuye (Bambusae Folium, fourteen leaves).
Administration: Decoct in two cups of water and take orally.
Xiao Zhong
Xiao Zhong indicates heat in the Stomach fu-organ. Treat with Baihu Tang (White Tiger Decoction) [see Heatstroke chapter] or Maidong Yin [see previous section]. If constipation occurs, use Tiaowei Chengqi Tang (Regulating the Intestines and Directing Downward Decoction) [see Dysentery chapter], which is Dachengqi Tang minus Zhishi (Aurantii Fructus Immaturus) and Houpo (Magnoliae Officinalis Cortex), plus one qian of roasted Gancao.
Shen Xiao
Shen Xiao indicates heat in the Lower Jiao. Treat with Dabu Yin Wan (Great Tonifying Yin Pill) [see Fire Syndrome chapter]. If due to Kidney deficiency, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) [see Consumption Disease chapter]. For Shen Xiao with urine white and pasty, use Qingxin Lianzi Yin (Clear the Heart and Lotus Seed Decoction). For severe constipation, use Dachengqi Tang [see Dysentery chapter].
Qingxin Lianzi Yin
Ingredients: Huangqi (Astragali Radix, one liang), Shilianrou (Nelumbinis Semen, one liang), Baifuling (Poria, one liang), Renshen (Ginseng Radix, one liang), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, five qian), Digupi (Lycii Cortex, five qian), Maidong (Ophiopogonis Radix, half liang), Cheqianzi (Plantaginis Semen, five qian), Huangqin (Scutellariae Radix, five qian).
Administration: Take five qian per dose, decoct in water, and take orally.