试观年老多夜尿，休信三消尽热干，饮多尿少浑赤热，饮少尿多清白寒。
【注】上消属肺，饮水多而小便如常；中
消属胃，饮水多而小便短赤；下消属肾，饮水多而小便混浊，三消皆燥热病也。然试观
年老好饮茶者，夜必多尿，则休信三消皆热，而亦有寒者矣。饮水多，小便少而浑赤者属
热，是火盛耗水而浑也。饮水少，小便多而清白者属寒，是火虚不能耗水也。
三消便硬若能食，脉大实强尚可医，不食舌白传肿泻，热多舌紫发痈疽。
【注】三消，饮水多不能食，若能食大便硬，脉大强实者，为胃实热，下之尚可医也。
若不能食，湿多舌白滑者，病久则传变水肿泄泻。热多舌紫干者，病久则发痈疽而死也。
竹叶黄 汤
便硬能食脉大强，调胃金花斟酌当，不食渴泻白术散，竹叶黄 不泻方，黄 黄芩
合四物，竹叶石膏减粳姜，气虚胃热参白虎，饮一溲二肾气汤。
【注】调胃，谓调胃承气汤。金花，谓栀子金花汤。方俱在伤寒门，酌其所当用可也。
不食而渴，已属胃虚，兼之泄泻，胃虚无热矣。故用七味白术散，方在虚损门。若不食
而渴，亦不泻者，是虽虚而犹有燥热也，宜用竹叶黄 汤，即黄 、黄芩、当归、川芎、
白芍、生地、竹叶，石膏、人参、炙草、麦冬、半夏也。若气虚胃热盛者，宜用人参白
虎汤。若下焦虚寒，饮一溲二者，宜用肾气汤。
试看老年人夜间小便频多，不要轻信“三消”病证全都是燥热津伤之象；若饮水多而小便量少、颜色浑浊赤红且伴有灼热感，属于热证；若饮水少而小便量多、颜色清白且伴有寒象，则属于寒证。
【注】上消病位在肺，表现为饮水多但小便正常；中消病位在胃，表现为饮水多但小便短少且色赤；下消病位在肾，表现为饮水多但小便混浊。这三种消渴病通常都被认为是燥热所致。然而，观察那些喜欢喝茶的老年人，夜间必然尿多，这说明不能坚信三消全是热证，也有属于寒证的。饮水多、小便少且浑浊赤红的，属于热证，这是火盛耗伤津液导致尿液浑浊；饮水少、小便多且清白的，属于寒证，这是命门火虚不能蒸化水液所致。
如果三消病患者大便干硬且能进食，脉象大而实强，尚可医治；如果不能进食、舌苔白腻并出现水肿泄泻，或者热邪偏盛、舌质紫暗并发痈疽，则预后不良。
【注】所谓三消，若是饮水多但不能进食，若能进食且大便干硬，脉象大且强实，这是胃家实热证，使用攻下法尚可医治。若不能进食，舌苔白滑表明湿邪偏盛，病程久了会传变为水肿和泄泻。若热邪偏盛，舌质紫干，病程久了会发为痈疽而死。
竹叶黄芪汤
针对大便干硬、能进食、脉象大且强实的证候，应斟酌使用调胃承气汤或栀子金花汤；对于不能进食且有口渴泄泻的，使用七味白术散；对于不能进食但不泄泻的，使用竹叶黄芪汤（由黄芪、黄芩、当归、川芎、白芍、生地、竹叶、石膏、人参、炙甘草、麦冬、半夏组成）；若属气虚兼胃热盛者，使用人参白虎汤；若属下焦虚寒、饮一溲二（喝多少尿多少）者，使用肾气汤。
【注】“调胃”指调胃承气汤。“金花”指栀子金花汤。这些方剂均记载在《伤寒论》相关章节中，可根据具体情况斟酌选用。不能进食且口渴，已属于胃气虚弱，若兼有泄泻，说明胃虚无热。因此使用七味白术散，该方记载在虚损门中。若不能进食且口渴，但不泄泻，说明虽然正气虚弱但仍有余热燥邪，适宜使用竹叶黄芪汤，即由黄芪、黄芩、当归、川芎、白芍、生地、竹叶、石膏、人参、炙甘草、麦冬、半夏组成。若气虚且胃热炽盛者，适宜使用人参白虎汤。若下焦虚寒，出现饮一溲二的症状，适宜使用肾气汤。
Observe that the elderly often have frequent nocturia; do not blindly believe that all "Sanxiao" (Three Burners/Three Thirsts) conditions are solely due to dryness-heat and fluid depletion. If there is excessive drinking but scanty, turbid, red, and hot urine, it indicates a heat pattern; if there is little drinking but copious, clear, and cold urine, it indicates a cold pattern.
[Note] Shangxiao (Upper Thirst) involves the Lung, characterized by excessive drinking with normal urination; Zhongxiao (Middle Thirst) involves the Stomach, characterized by excessive drinking with short, red urine; Xiaxiao (Lower Thirst) involves the Kidney, characterized by excessive drinking with turbid urine. All three types of Xiao (Wasting-Thirst) are generally considered diseases of dryness-heat. However, observing those elderly individuals who enjoy drinking tea, they inevitably have frequent nocturia. This shows that one should not firmly believe that Sanxiao are all heat patterns; there are also cold patterns. Excessive drinking with scanty, turbid, and red urine belongs to heat, which is caused by fire excess consuming fluids, leading to turbidity. Little drinking with copious, clear, and white urine belongs to cold, which is caused by deficient fire failing to transform fluids.
If patients with Sanxiao have hard stools and can eat, and their pulse is large, solid, and strong, the condition is still treatable. If they cannot eat, have a white tongue coating, and develop edema and diarrhea, or if heat is predominant with a purple tongue and development of carbuncles and sores, the prognosis is poor.
[Note] Regarding Sanxiao: if there is excessive drinking but inability to eat, yet if they can eat and have hard stools with a large, strong, and solid pulse, this is Stomach excess-heat; purgation may still be effective. If they cannot eat and have a slippery white tongue coating indicating dampness predominance, prolonged illness will lead to edema and diarrhea. If heat predominates with a dry purple tongue, prolonged illness will lead to carbuncles and sores and death.
Zhuye Huangqi Decoction (Bamboo Leaf and Astragalus Decoction)
For cases with hard stools, ability to eat, and a large, solid, strong pulse, consider using Tiaowei Chengqi Tang (Regulate the Stomach Purgative Decoction) or Zhizi Jinhua Tang (Gardenia Golden Flower Decoction). For those unable to eat with thirst and diarrhea, use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). For those unable to eat but without diarrhea, use Zhuye Huangqi Tang (Bamboo Leaf and Astragalus Decoction), composed of Huangqi (Astragali Radix), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Shengdi (Rehmanniae Radix), Zhuye (Phyllostachys Folium), Shigao (Gypsum Fibrosum), Renshen (Ginseng Radix), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Maidong (Ophiopogonis Radix), and Banxia (Pinelliae Rhizoma). For those with Qi deficiency and severe Stomach heat, use Renshen Baitu Tang (Ginseng and White Tiger Decoction). For lower jiao deficiency-cold with "drinking one and urinating two" (polyuria matching intake), use Shenqi Tang (Kidney Qi Decoction).
[Note] "Tiaowei" refers to Tiaowei Chengqi Tang. "Jinhua" refers to Zhizi Jinhua Tang. These formulas are recorded in the Treatise on Cold Damage section; select them according to appropriateness. Inability to eat with thirst already indicates Stomach deficiency; combined with diarrhea, it implies Stomach deficiency without heat. Therefore, Qiwei Baizhu San is used, recorded in the Deficiency and Injury section. If unable to eat with thirst but no diarrhea, although deficient, there remains dryness-heat; Zhuye Huangqi Tang is appropriate, consisting of Huangqi, Huangqin, Danggui, Chuanxiong, Baishao, Shengdi, Zhuye, Shigao, Renshen, Zhi Gancao, Maidong, and Banxia. For Qi deficiency with flourishing Stomach heat, Renshen Baitu Tang is appropriate. For lower jiao deficiency-cold presenting with "drinking one and urinating two," Shenqi Tang is appropriate.