寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Wasting Thirst

Sogal

한글 소갈  ·  Pinyin Xiao Ke

Three wastings by burner — and a disease read from thirst, hunger and what the urine looks like

消渴

A short chapter with an unusually clear structure. Two yang bound is called wasting, says the Neijing at the opening, and the commentary names them: stomach and large intestine both bound with heat. From that the chapter builds a scheme of three. Upper wasting is the lung — much drinking, little eating, urine clear and free. Middle wasting is the stomach — eating well and still growing thin, with bound stool and frequent urine. Lower wasting is the kidney — thighs and knees wasted, urine turbid like grease, the face darkening. Danxi adds that all three usually come of blood vacuity failing to make fluids, and gives Samul-tang as the base with additions by burner. What makes the chapter worth reading closely is how much it noticed. It records that the urine is sweet and reasons about why; it warns that the strong-centre pattern is fatal; it traces the late course to abscess, dropsy and blindness; and it puts a term on the prognosis when the urine passed exceeds the water drunk. The last sections are prohibitions, thirty-nine simples and the acupuncture method.

4.1 The Source of Wasting Thirst 消渴之源

4.1.1
Source원문

內經曰, 二陽結謂之消. 註曰, 二陽結, 謂胃及大腸俱熱結也. 腸胃藏熱, 則喜消水穀.

Translation영역
The Neijing says: two yang bound is called wasting. The commentary says: two yang bound means the stomach and the large intestine both bound with heat. The intestines and stomach storing heat, they readily consume water and grain.
Clinical note임상 주석
The chapter opens by naming its organs: stomach and large intestine, the two yang bright bowels. 喜消水穀 — readily consuming water and grain — is the mechanism in three graphs, and it accounts for both the hunger and the wasting that give the disease its name.

Naegyeong 內經

4.1.2
Source원문

手陽明大腸, 主津液. 所生病, 熱則目黃口乾, 是津液不足也. 足陽明胃, 主血. 所生病, 熱則消穀善飢, 血中伏火, 是血不足也. 結者, 津液不足, 結而不潤, 皆燥熱爲病也. 《東垣》

Translation영역
The hand yang brightness large intestine governs the fluids; in the diseases it engenders, heat brings yellow eyes and a dry mouth — this is insufficiency of fluids. The foot yang brightness stomach governs the blood; in the diseases it engenders, heat brings the consuming of grain with ready hunger and hidden fire within the blood — this is insufficiency of blood. Bound means the fluids are insufficient, bound and not moistening; in all cases dryness and heat make the disease.

Dongwon 東垣

4.1.3
Source원문

消者, 燒也. 如火烹燒物理者也. 《入門》

Translation영역
Wasting means burning — as fire boils and burns a thing away.

Immun 入門

4.1.4
Source원문

心移寒於肺爲肺消, 肺消者, 飮一溲二, 死不治. 註曰, 金受火邪, 肺藏消爍, 氣無所持, 故飮一而溲二也. 《內經》

Translation영역
The heart transferring cold to the lung makes lung wasting; in lung wasting one drinks one measure and passes two, and it is death and cannot be treated. The commentary says: the metal receiving the fire evil, the lung organ is consumed and melted away and the qi has nothing to hold it — hence one drinks one and passes two.
Clinical note임상 주석
飮一溲二 — drinking one measure and passing two — is the chapter's single prognostic figure and it recurs at 4.15. What it describes is fluid leaving faster than it is taken in, which in uncontrolled diabetes is exactly what happens. The chapter treats it as the line past which the disease cannot be reversed, and 4.15 qualifies it: where the urine has not yet exceeded the drink, the case is still shallow.

Naegyeong 內經

4.1.5
Source원문

心移熱於肺, 傳爲膈消. 註曰, 心肺兩間中, 有斜膈膜, 膈膜下際, 內連於橫膈膜. 故心熱入肺, 久久傳化, 內爲膈熱, 消渴而多飮也. 《內經》

Translation영역
The heart transferring heat to the lung is transmitted as diaphragm wasting. The commentary says: between the heart and lung there is a slanting diaphragmatic membrane, and its lower edge joins within to the transverse diaphragm. Therefore heart heat entering the lung is transmitted and transformed over a long while and becomes heat at the diaphragm within, with wasting thirst and much drinking.

Naegyeong 內經

4.1.6
Source원문

癉成爲消中. 註曰, 癉謂消熱病也. 多飮數溲, 謂之熱中, 多食數溲, 謂之消中. 《內經》

Translation영역
Dan becoming wasting in the centre. The commentary says: dan means a disease of wasting heat. Much drinking with frequent urination is called heat in the centre; much eating with frequent urination is called wasting in the centre.
Clinical note임상 주석
Two conditions separated by one question: is it the drinking or the eating that is excessive? Both pass urine frequently, and the chapter distinguishes them by which end of the appetite has gone.

Naegyeong 內經

4.1.7
Source원문

凡消癉, 肥貴人, 則膏粱之疾也. 此人因數食甘美而多肥, 故其氣上溢, 轉爲消渴. 註曰, 食肥則腠理密, 而陽氣不得外泄, 故肥令人內熱. 甘者, 性氣和緩而發散逆, 故甘令人中滿. 然內熱則陽氣炎上, 炎上則欲飮而嗌乾. 中滿則陽氣有餘, 有餘則脾氣上溢, 故轉爲消渴. 《內經》

Translation영역
In wasting dan generally, among the stout and the noble it is a disease of fat meat and fine grain. Such people, from frequently eating what is sweet and fine, grow stout; therefore their qi overflows upward and turns into wasting thirst. The commentary says: eating fat closes the interstices so that the yang qi cannot discharge outward, and hence fat makes a person hot within. The sweet is mild and slow in nature and goes against effusing and scattering, and hence the sweet makes a person full in the centre. Now heat within makes the yang qi flame upward, and flaming upward there is a wish to drink with a dry throat. Fullness in the centre makes the yang qi in surplus, and in surplus the spleen qi overflows upward — hence it turns into wasting thirst.
Clinical note임상 주석
肥貴人, 膏粱之疾 — a disease of the stout and the well-off, of fat meat and fine grain. The Neijing names obesity and a rich diet as the cause and states the social distribution, which is as near as the tradition comes to an epidemiology. The reasoning that follows is mechanical rather than moral: fat closes the pores so heat cannot escape, and sweet slows the qi so it gathers in the centre. Both then push upward as thirst.

Naegyeong 內經

4.1.8
Source원문

喜渴者, 由心熱也. 心主便汗, 便汗出多則腎中虛燥, 故令渴. 凡夏月渴而汗出多, 則小便少, 冬月不汗, 故小便多, 皆平人之常也. 《聖惠》

Translation영역
One readily thirsty has heat in the heart. The heart governs the discharge of sweat, and where much sweat is discharged the kidney is vacuous and dry within, and hence thirst. In summer, being thirsty and sweating much, the urine is scant; in winter there is no sweat and so the urine is copious — in both, this is the constancy of a normal person.
Clinical note임상 주석
The last sentence is a piece of physiology stated so as to set a baseline: seasonal variation in urine volume is normal and is not wasting thirst. What makes the disease is copious urine out of season and against the drinking.

Seonghye 聖惠

4.2 The Forms and Patterns of Wasting Thirst 消渴形證

4.2.1
Source원문

渴病有三, 曰消渴, 曰消中, 曰消腎.

Translation영역
Thirst disease is of three kinds: wasting thirst, wasting in the centre, and wasting of the kidney.

Jikji 直指

4.2.2
Source원문

熱氣上騰, 心虛受之, 心火散漫, 不能收斂, 胸中煩燥, 舌赤脣紅. 此渴, 引飮常多, 小便數而少, 病屬上焦, 謂之消渴.

Translation영역
Hot qi rises and the heart, being vacuous, receives it; the heart fire scatters and spreads and cannot be gathered in; within the chest there is vexation and agitation, the tongue red and the lips scarlet. In this thirst the drinking drawn in is always much, the urine frequent but scant. The disease belongs to the upper burner, and it is called wasting thirst.

Jikji 直指

4.2.3
Source원문

熱蓄於中, 脾虛受之, 伏陽蒸胃, 消穀善飢, 飮食倍常, 不生肌肉. 此渴, 亦不甚煩, 但小便數而甛. 病屬中焦, 謂之消中.

Translation영역
Heat is stored in the centre and the spleen, being vacuous, receives it; hidden yang steams the stomach, grain is consumed with ready hunger, food and drink are double the usual and yet no flesh is engendered. In this thirst the vexation is not severe, only the urine is frequent and sweet. The disease belongs to the middle burner, and it is called wasting in the centre.
Clinical note임상 주석
小便數而甛 — urine frequent and sweet — stated plainly and without emphasis, as one sign among several. The chapter devotes a whole section to it at 4.6 and reasons about why it should be so. 飮食倍常, 不生肌肉 — eating twice the usual and engendering no flesh — is the other half, and the two together are a description of diabetes that needs no translation.

Jikji 直指

4.2.4
Source원문

熱伏於下, 腎虛受之, 腿膝枯細, 骨節痠疼, 精走髓虛, 引水自救, 飮水不多, 隨卽尿下, 小便多而濁. 病屬下焦, 謂之消腎.

Translation영역
Heat lies hidden below and the kidney, being vacuous, receives it; the thighs and knees are withered and thin, the bones and joints ache, the essence runs off and the marrow is empty. Water is drawn in to rescue oneself, but the water drunk is not much and passes out as urine at once; the urine is copious and turbid. The disease belongs to the lower burner, and it is called wasting of the kidney.
Clinical note임상 주석
腿膝枯細 with 骨節痠疼 — thighs and knees wasted, joints aching — is the muscle loss of long-standing diabetes, and the chapter places it in the lower burner because the legs waste and the urine is heaviest. 隨卽尿下, passing as urine at once, is the detail that distinguishes this from the upper form: here the drink is not much but goes straight through.

Jikji 直指

4.2.5
Source원문

自消腎而析之, 又有五石過度之人, 眞氣旣盡石勢獨留, 陽道興强, 不交精泄, 謂之强中. 消渴輕也, 消中甚焉, 消腎又甚焉. 若强中則其斃, 可立待也. 《直指》

Translation영역
Dividing further from wasting of the kidney, there are also those who have taken the five minerals to excess; the true qi being exhausted, the force of the minerals alone remains, the yang way is roused and strong, and the essence is discharged without intercourse. This is called the strong centre. Wasting thirst is the light case, wasting in the centre is severe, wasting of the kidney is more severe still; and as for the strong centre, its death may be awaited standing.
Clinical note임상 주석
A prognosis in four grades, and the last is absolute: 其斃, 可立待 — death may be awaited standing. 五石 are the mineral elixirs of the alchemical tradition, and 强中 is the presentation that follows their use: priapism with involuntary emission on a wasted body. The chapter gives it its own section at 4.12 and treats it as beyond recovery.

Jikji 直指

4.2.6
Source원문

上消者, 肺也. 又謂之膈消, 多飮水而少食, 大便如常, 小便淸利.

Translation영역
Upper wasting is the lung, also called diaphragm wasting: much water drunk and little eaten, the stool as usual, the urine clear and free.

Yeokro 易老

4.2.7
Source원문

中消者, 胃也. 渴而飮食多, 小便赤黃.

Translation영역
Middle wasting is the stomach: thirst with much food and drink, the urine red-yellow.

Yeokro 易老

4.2.8
Source원문

下消者, 腎也. 小便濁淋, 如膏油之狀, 面黑耳焦而形瘦. 《易老》

Translation영역
Lower wasting is the kidney: the urine turbid and dribbling, like grease and oil in appearance, the face black and the ears parched and the form thin.
Clinical note임상 주석
如膏油之狀 — like grease and oil — describes urine that is cloudy and leaves a film, and it is the chapter's standing image for lower wasting. 面黑耳焦, a darkened face and parched ears, belongs with it. Taken together the three passages give a usable triage: ask what is excessive, then look at the urine.

Yeokro 易老

4.2.9
Source원문

渴而多飮爲上消, 消穀善飢爲中消, 渴而尿數有膏油爲下消. 《綱目》

Translation영역
Thirst with much drinking is upper wasting; the consuming of grain with ready hunger is middle wasting; thirst with frequent urine carrying grease and oil is lower wasting.

Gangmok 綱目

4.2.10
Source원문

飮水而安睡者, 實熱也. 飮水少傾卽吐者, 火邪假渴耳. 《入門》

Translation영역
One who drinks water and then sleeps at ease has repletion heat. One who drinks water and vomits it up a moment later has a fire evil counterfeiting thirst.
Clinical note임상 주석
假渴, counterfeit thirst, and the test is what happens after drinking. Water that settles and is followed by sleep means real heat; water brought straight back up means the thirst was not a want of fluid at all. It is a simple bedside test and it separates true polydipsia from the dry mouth of other causes.

Immun 入門

4.3 Pulse Method 脉法

4.3.1
Source원문

消渴, 脉實大, 病久可治, 脉懸小堅, 病久不可治. 《內經》

Translation영역
In wasting thirst, where the pulse is replete and large, though the disease be long-standing it can be treated; where the pulse is suspended, small and firm, a long-standing disease cannot be treated.

Naegyeong 內經

4.3.2
Source원문

消渴, 脉當得緊實而數, 反得沈濇而微者死. 《難經》

Translation영역
In wasting thirst the pulse should be tight, replete and rapid; where on the contrary it is sunken, rough and faint, the patient dies.

Nangyeong 難經

4.3.3
Source원문

消渴脉數大者活, 細小浮短者死. 《脉訣》

Translation영역
In wasting thirst a rapid large pulse means life; fine, small, floating and short means death.

Maekgyeol 脉訣

4.3.4
Source원문

心脉滑爲渴, 滑者, 陽氣勝也.

Translation영역
A slippery heart pulse means thirst; slippery means the yang qi prevails.

Maekgyeong 脉經

4.3.5
Source원문

心脉微小爲消癉.

Translation영역
A faint small heart pulse means wasting dan.

Maekgyeong 脉經

4.3.6
Source원문

脉數大者生, 沈小者死. 《脉經》

Translation영역
A rapid large pulse means life; a sunken small one means death.

Maekgyeong 脉經

4.3.7
Source원문

心脉滑甚爲喜渴. 《聖惠》

Translation영역
A heart pulse very slippery means one is readily thirsty.

Seonghye 聖惠

4.3.8
Source원문

趺陽脉數, 胃中有熱. 卽消穀引飮, 大便必堅, 小便卽數. 《仲景》

Translation영역
Where the instep yang pulse is rapid there is heat in the stomach: grain is consumed and drink drawn in, the stool must be hard and the urine frequent.

Junggyeong 仲景

4.3.9
Source원문

消渴, 脉宜數大, 忌虛小. 《醫鑑》

Translation영역
In wasting thirst a rapid large pulse is favourable; vacuous and small is to be avoided.
Clinical note임상 주석
Eight of these nine say the same thing: large and rapid is treatable, small and sunken is not. In a disease of heat consuming the fluids, a forceful pulse means there is still substance to work with. That is the reverse of the Uterus chapter's rule at 13.4, where a large pulse in a bleeding woman means death. The two chapters are reading different situations — heat against volume loss — and the contradiction is only apparent.

Uigam 醫鑑

4.4 Wasting Thirst Is of Three Kinds 消渴有三

4.4.1
Source원문

上消者, 舌上赤裂, 大渴引飮, 膈消是也. 白虎加人參湯卽人參白虎湯也. 方見寒門主之, 治能食而渴. 若不能食而渴, 宜加味錢氏白朮散. 又麥門冬飮子ㆍ降心湯ㆍ人參石膏湯ㆍ淸心蓮子飮ㆍ和血益氣湯ㆍ生津養血湯ㆍ黃芩湯, 皆治上消.

Translation영역
In upper wasting the tongue is red and cracked, there is great thirst with drink drawn in — this is diaphragm wasting. White Tiger with Ginseng Decoction that is, Ginseng White Tiger Decoction; formula in the Cold Damage chapter governs it, treating one who can eat and is thirsty. Where the patient cannot eat and is thirsty, Augmented Qian's White Atractylodes Powder is appropriate. Ophiopogon Drink, Downbear the Heart Decoction, Ginseng and Gypsum Decoction, Clear the Heart Lotus Seed Drink, Harmonize the Blood and Boost the Qi Decoction, Engender Fluids and Nourish the Blood Decoction and Scutellaria Decoction all treat upper wasting.
Clinical note임상 주석
能食而渴 against 不能食而渴 — thirsty and able to eat, or thirsty and unable — is the branch point, and it decides between a cold clearing formula and a warm supplementing one. 舌上赤裂, a red cracked tongue, is the confirmatory sign, and it is what a severely dehydrated tongue looks like.

Immun 入門

4.4.2
Source원문

中消者, 善食而瘦, 自汗, 大便硬, 小便數. 所謂癉成爲消中者, 是也. 調胃承氣湯方見寒門ㆍ加減三黃丸方見火門, 主之. 又蘭香飮子ㆍ生津甘露湯ㆍ順氣散ㆍ人參散ㆍ黃連猪肚丸ㆍ藕汁膏, 皆可用.

Translation영역
In middle wasting the patient eats well and is thin, with spontaneous sweating, hard stool and frequent urine. This is what is called dan becoming wasting in the centre. Regulate the Stomach and Order the Qi Decoction formula in the Cold Damage chapter and Modified Three Yellows Pill formula in the Fire chapter govern it. Orchid Fragrance Drink, Engender Fluids and Sweet Dew Decoction, Normalize the Qi Powder, Ginseng Powder, Coptis and Pig Stomach Pill and Lotus Root Juice Paste may all be used.
Clinical note임상 주석
善食而瘦 — eating well and thin — is the one sign that most reliably points to diabetes in this chapter, and it recurs at 4.5 under another name. **Weight loss despite a good appetite requires medical investigation.**

Immun 入門

4.4.3
Source원문

下消者, 煩燥引飮, 耳輪焦乾, 小便如膏, 腿膝枯細, 所謂焦煩水易虧者, 是也. 六味元方見虛勞ㆍ鹿茸丸. 《諸方》

Translation영역
In lower wasting there is vexation and agitation with drink drawn in, the rims of the ears parched and dry, the urine like grease, the thighs and knees withered and thin — this is what is called parched and vexed, the water readily depleted. Six Flavours Pill formula in the Vacuity Taxation chapter and Deer Antler Velvet Pill.

Jebang 諸方

4.4.4
Source원문

養肺降火生血爲主, 分上中下治之. 《丹心》

Translation영역
Nourishing the lung, downbearing fire and engendering blood are the mainstay, and treatment divides by upper, middle and lower.

Dansim 丹心

4.4.5
Source원문

三消多屬血虛不生津液. 宜以四物湯方見血門爲主治. 上消, 加人參ㆍ五味子ㆍ麥門冬ㆍ天花粉煎, 入牛乳汁ㆍ生地黃汁ㆍ生藕汁. 酒客, 生葛根汁調服.

Translation영역
The three wastings mostly belong to blood vacuity not engendering fluids. Four Substances Decoction formula in the Blood chapter should be the governing treatment. For upper wasting add ginseng, schisandra, ophiopogon and trichosanthes root, decoct, and put in cow's milk, fresh rehmannia juice and fresh lotus root juice. For a drinker, stir in fresh pueraria juice and give.
Clinical note임상 주석
Danxi's reframing of the whole chapter: not three diseases of three burners but one disease of blood vacuity, treated from a single base with additions by location. The juices added at the end — milk, rehmannia, lotus root — are the same ones that make up Ujeup-go at 4.4.14, and they are chosen for substance rather than for action.

Dansim 丹心

4.4.6
Source원문

中消, 加知母ㆍ石膏ㆍ寒水石ㆍ滑石.

Translation영역
For middle wasting add anemarrhena, gypsum, glauberite and talc.

Dansim 丹心

4.4.7
Source원문

下消, 加黃柏ㆍ知母ㆍ熟地黃ㆍ五味子. 《丹心》

Translation영역
For lower wasting add phellodendron, anemarrhena, cooked rehmannia and schisandra.

Dansim 丹心

4.4.8
Source원문

消渴病, 小便反多, 如飮水一斗, 小便亦一斗, 腎氣丸方見虛勞主之. 《仲景》

Translation영역
In wasting thirst disease where the urine is on the contrary copious — as when a mal of water is drunk and a mal of urine likewise passed — Kidney Qi Pill formula in the Vacuity Taxation chapter governs it.
Clinical note임상 주석
Zhongjing's formula for the case where intake and output match exactly, and 4.15 explains the reasoning: while the urine has not yet exceeded the drink the disease is still shallow and can be treated. Once it exceeds, it cannot. That a warming kidney formula is given for a disease of heat is the chapter's one reversal, and 4.7 argues the case for it.

Junggyeong 仲景

4.5 The Food-Passing Pattern 食㑊證

4.5.1
Source원문

內經曰, 大腸移熱於胃, 善食而瘦, 又謂之食㑊.

Translation영역
The Neijing says: the large intestine transferring heat to the stomach, the patient eats well and is thin — and this is also called food passing through.

Naegyeong 內經

4.5.2
Source원문

胃移熱於膽, 亦曰食㑊. 註曰, 㑊, 易也. 飮食移易而過, 不生肌膚也. 治法與消中同. 《綱目》

Translation영역
The stomach transferring heat to the gallbladder is likewise called food passing through. The commentary says: 㑊 means passing over. Food and drink shift and pass through without engendering flesh and skin. The treatment method is the same as for wasting in the centre.
Clinical note임상 주석
㑊 is glossed as 易, to shift or pass over, and the image is exact: food goes through without being taken up. 治法與消中同 — treated the same as middle wasting — settles what the section is for, which is to give a name to a presentation that would otherwise be missed. Eating well and losing weight with no other complaint is the whole of it, and it is still the presentation that most often brings undiagnosed diabetes to a clinic.

Gangmok 綱目

4.6 In Wasting Thirst the Urine Is Sweet 消渴小便甛

4.6.1
Source원문

消渴者, 腎虛所致, 每發則小便必甛. 以物理推之, 淋餳醋酒作脯法, 須臾卽甛, 足明人之食後, 滋味皆甛, 流在膀胱. 若腰腎氣盛, 則上蒸炎氣, 化成精氣, 下入骨髓, 其次爲脂膏, 又其次爲血肉, 其餘則爲小便. 故小便色黃, 血之餘也. 五藏之氣醎潤者, 則下味也. 若腰腎旣虛冷, 則不能蒸化穀氣, 盡下爲小便. 故味甘, 不變其色, 淸冷則肌膚枯槁也. 《本事》

Translation영역
Wasting thirst is brought about by kidney vacuity, and whenever it breaks out the urine must be sweet. Reasoning from the nature of things: in the methods of making malt syrup, vinegar, wine and dried meat, in a short while the thing turns sweet — which sufficiently shows that after a person eats, the savours are all sweet and flow into the bladder. If the qi of the lumbus and kidney is exuberant, it steams the blazing qi upward and transforms it into essential qi, which descends into the bones and marrow; the next portion becomes fat and grease, the next after that becomes blood and flesh, and what remains becomes urine. Hence the urine is yellow in colour, being the remainder of the blood. Where the qi of the five viscera is salty and moistening, it is the lower savour. But if the lumbus and kidney are already vacuous and cold, they cannot steam and transform the grain qi, and it all descends as urine. Hence the flavour is sweet and the colour unchanged; being clear and cold, the flesh and skin wither.
Clinical note임상 주석
The most remarkable passage in the chapter. Xu Shuwei starts from an observed fact — the urine is sweet — and reasons out why, using fermentation as his evidence: syrup, vinegar, wine and cured meat all turn sweet given time, so what is eaten must carry sweetness into the bladder. His conclusion is that the kidney has failed to process the grain qi, so the sweetness passes through unaltered rather than being built into marrow, fat and flesh. That is glycosuria described accurately, with an explanation drawn from the only chemistry available. 味甘, 不變其色 — sweet in flavour and unchanged in colour — is the clinical observation: glycosuria without the darkening that concentration would produce. And 肌膚枯槁, the flesh withering, follows because the substance that should have become tissue is going out in the urine. This was written around 1132. Sweet urine was not described in Europe until Thomas Willis in 1674.

Bonsa 本事

4.7 Wasting Thirst Comes of the Kan Fire Declining 消渴由坎火衰少

4.7.1
Source원문

肺爲五藏華盖, 若下有煖氣蒸則肺潤, 若下冷極則陽不能升, 故肺乾而渴. 易乾上坤下, 其卦爲否, 陽無陰不降, 陰無陽不升, 故成否也. 譬如釜中有水, 以火煖之, 又以板覆, 則煖氣上騰, 故板能潤. 若無火力, 則水氣不能上升, 此板終不得潤. 火力者, 腰腎强盛, 常須煖補腎氣. 飮食得火力則潤上而易消, 亦免乾渴之患. 宜服八味腎氣丸卽八味元, 加五味子也. 《本事》

Translation영역
The lung is the flowery canopy of the five viscera. If there is warm qi steaming below, the lung is moistened; if below is extremely cold, the yang cannot rise and so the lung is dry and there is thirst. In the Yi, qian above and kun below make the hexagram of stagnation: yang without yin does not descend, yin without yang does not rise, and so stagnation is formed. Compare it to water in a cauldron: warm it with fire and cover it with a board, and the warm qi rises, so the board can be moistened. Without the force of fire the water qi cannot rise, and that board will never be moistened. The force of fire is the lumbus and kidney strong and exuberant, and it must always be warmed and supplemented. When food and drink obtain the force of fire, they moisten above and are readily digested, and the trouble of dry thirst is avoided. Eight Flavours Kidney Qi Pill that is, the Eight Flavours Pill with schisandra added should be taken.
Clinical note임상 주석
The argument for warming a disease of heat, and the cauldron image carries it: a board over a pot stays dry unless there is fire underneath. The lung is the board, the kidney fire is the flame, and thirst above comes of cold below. The Internal Damage chapter uses the identical image at 1.21.1 for anorexia — grain in a pot with no fire under it — and the two sections argue the same case for different organs. The chapter records this beside the cold and bitter formularies of 4.4 without reconciling them, which is its usual practice where authorities differ on mechanism.

Bonsa 本事

4.8 Wasting Thirst and Leg Qi Are Opposites 消渴與脚氣相反

4.8.1
Source원문

消渴與脚氣, 雖皆爲腎虛所致, 其爲病則相反. 脚氣始發於二三月, 盛於五六月, 衰於七八月. 消渴始發於七八月, 盛於十一十二月, 衰於二三月, 其故何也. 盖脚氣, 壅疾也. 消渴, 宣疾也. 春夏陽氣上, 故壅疾發則宣疾愈, 秋冬陽氣下, 故宣疾發則壅疾愈. 審此二者, 疾可理也. 《本事》

Translation영역
Wasting thirst and leg qi, though both brought about by kidney vacuity, are opposite as diseases. Leg qi first breaks out in the second and third months, is at its height in the fifth and sixth, and declines in the seventh and eighth. Wasting thirst first breaks out in the seventh and eighth months, is at its height in the eleventh and twelfth, and declines in the second and third. Why is this so? Leg qi is a disease of blockage; wasting thirst is a disease of diffusion. In spring and summer the yang qi is above, and so when the blocking disease breaks out the diffusing disease is cured; in autumn and winter the yang qi is below, and so when the diffusing disease breaks out the blocking disease is cured. Examining these two, the disease may be put in order.
Clinical note임상 주석
Two diseases with the same root and opposite seasons, and the observation is specific enough to be checked: leg qi peaks in summer, wasting thirst in winter. 壅 against 宣 — blockage against diffusion — is the axis. A disease that holds things in and a disease that lets them out cannot both worsen at once, which is the argument.

Bonsa 本事

4.9 Medicines for Wasting Thirst in General Use 消渴通治藥

4.9.1
Source원문

宜滋陰養榮湯ㆍ活血潤燥生津飮ㆍ桑白皮湯ㆍ梅花湯ㆍ大黃甘草飮子ㆍ淸神補氣湯ㆍ黃芪湯ㆍ天花散ㆍ黃連地黃湯ㆍ生地黃飮子ㆍ門冬飮子ㆍ玉泉散ㆍ玄菟丹ㆍ三消丸ㆍ玉泉丸ㆍ五汁玉泉丸ㆍ生地黃膏ㆍ荔枝膏ㆍ衛生天花元. 《諸方》

Translation영역
Enrich the Yin and Nourish the Construction Decoction, Quicken the Blood, Moisten Dryness and Engender Fluids Drink, Mulberry Root Bark Decoction, Plum Blossom Decoction, Rhubarb and Licorice Drink, Clear the Spirit and Supplement the Qi Decoction, Astragalus Decoction, Trichosanthes Powder, Coptis and Rehmannia Decoction, Fresh Rehmannia Drink, Ophiopogon Drink, Jade Spring Powder, Mysterious Cuscuta Elixir, Three Wastings Pill, Jade Spring Pill, Five Juices Jade Spring Pill, Fresh Rehmannia Paste, Lychee Paste and Protect Life Trichosanthes Pill are appropriate.
Clinical note임상 주석
Nineteen formulas, and the names run to springs and juices — Jade Spring appears three times, Five Juices once, and four of the nineteen are pastes or syrups. That concentration reflects what the chapter is treating. Where the complaint is that the fluids are consumed, the answer is something thick and moistening that can be held in the mouth, and the section's formulary is built accordingly.

Jebang 諸方

4.10 Alcohol Thirst 酒渴

4.10.1
Source원문

治嗜酒積熱, 津液枯燥, 煩渴引飮, 專嗜冷物. 宜龍鳳元ㆍ烏梅木瓜湯ㆍ五豆湯ㆍ酒蒸黃連丸方見暑門ㆍ朱砂黃連元. 《得效》

Translation영역
Treats one given to drink with accumulated heat, the fluids withered and dry, vexing thirst with drink drawn in, and an exclusive craving for cold things. Dragon and Phoenix Pill, Mume and Chaenomeles Decoction, Five Beans Decoction, Wine-Steamed Coptis Pill formula in the Summerheat chapter and Cinnabar and Coptis Pill are appropriate.
Clinical note임상 주석
專嗜冷物 — an exclusive craving for cold things — is the sign that marks this from ordinary wasting thirst. The Internal Damage chapter treats the same patient from the other side at 1.12, where drink's late consequences include wasting thirst by name.

Deukhyo 得效

4.11 Worm Thirst 蟲渴

4.11.1
Source원문

蟲在藏府, 耗其津液而成消渴, 宜苦練湯. 《得效》

Translation영역
Where worms lie in the viscera and bowels and consume the fluids so that wasting thirst is formed, Chinaberry Root Decoction is appropriate.
Clinical note임상 주석
A whole category built backwards from a treatment result. The formula's own entry records the reasoning: worms came down, the thirst stopped, and by that it was known that some wasting thirst is worms consuming the fluids. Heavy intestinal parasitosis does cause thirst and wasting, so the category answered something real even if the inference ran the wrong way.

Deukhyo 得效

4.12 The Strong Centre Pattern 强中證

4.12.1
Source원문

多因耽嗜色慾, 或服丹石. 眞氣旣脫, 熱邪獨盛, 飮食如湯消雪, 肌膚日削, 小便如膏油, 陽强興盛, 不交精泄. 三消之中, 最爲難治. 姑錄一二方, 聊爲備用, 宜石子薺苨湯ㆍ黃連猪肚丸. 《得效》

Translation영역
It comes mostly of indulgence in sexual desire, or of taking mineral elixirs. The true qi having deserted, the heat evil alone is exuberant; food and drink vanish as hot water melts snow, the flesh is pared away by the day, the urine is like grease and oil, the yang is roused and strong, and the essence is discharged without intercourse. Among the three wastings it is the hardest of all to treat. A formula or two are set down here merely to have something in reserve: Mineral Seed and Adenophora Decoction and Coptis and Pig Stomach Pill are appropriate.
Clinical note임상 주석
姑錄一二方, 聊爲備用 — a formula or two set down merely to have something in reserve. The source is saying plainly that it does not expect them to work, and 4.2.5 has already put the prognosis at death awaited standing. 飮食如湯消雪, food vanishing as hot water melts snow, is the same image the Accumulations chapter uses for a mass that dissolves, turned here to describe a body consuming itself. **This describes advanced uncontrolled diabetes with severe catabolism. It requires urgent medical management.**

Deukhyo 得效

4.13 The Transmuted Patterns of Wasting Thirst 消渴傳變證

4.13.1
Source원문

消渴之疾末傳, 能食者, 必發腦疽背瘡, 不能食者, 必傳中滿鼓脹, 皆爲不治之證. 張潔古老人分而治之, 能食而渴者, 白虎加人參湯方見寒門主之, 或加減白虎湯, 不飮食而渴者, 錢氏白朮散方見小兒, 倍加葛根與之, 或加減白朮散. 上中旣平, 不復傳下消矣. 《東垣》

Translation영역
In the late transmission of wasting thirst disease, one who can eat must break out in abscess of the head and sores of the back; one who cannot eat must be transmitted to central fullness and drum distension — and both are patterns that cannot be treated. Old Zhang Jiegu divided them in treatment: for one who can eat and is thirsty, White Tiger with Ginseng Decoction formula in the Cold Damage chapter governs it, or Modified White Tiger Decoction; for one who does not eat and is thirsty, Qian's White Atractylodes Powder formula in the Children's chapter with the pueraria doubled, or Modified White Atractylodes Powder. The upper and middle being settled, it is not transmitted further to lower wasting.
Clinical note임상 주석
The chapter's account of how wasting thirst ends, and it forks on the same question as 4.4: can the patient still eat? One road leads to abscess, the other to ascites, and both are called untreatable. What Zhang Yuansu adds is that the fork can be prevented — settle the upper and middle and it does not descend. That is the argument for treating early rather than the late stage.

Dongwon 東垣

4.13.2
Source원문

或曰, 末傳癰疽者何也. 此火邪勝也. 其瘡痛甚而不潰, 或赤水者, 是也. 末傳中滿者何也. 如上消中消制之太急, 寒藥傷胃, 久而成中滿之疾, 所謂上熱未除, 中寒復生也. 《東垣》

Translation영역
It may be asked: why is the late transmission an abscess? It is that the fire evil prevails, and such sores are severely painful and do not burst, or run a red water. Why is the late transmission central fullness? Where upper and middle wasting have been checked too urgently and cold medicines have damaged the stomach, in time the disease of central fullness is formed — what is called the upper heat not yet removed and cold in the centre newly engendered.
Clinical note임상 주석
上熱未除, 中寒復生 — the upper heat not yet removed and cold in the centre newly engendered. The second outcome is attributed to the treatment: cold medicines pressed too hard damage the stomach and produce a disease the patient did not have. The chapter names physician error as a cause here as the Internal Damage chapter does at 1.22.3 and the Jaundice chapter at 5.7.

Dongwon 東垣

4.13.3
Source원문

消渴久病, 變成發癰疽, 或成水病, 或雙目失明. 《類聚》

Translation영역
Where wasting thirst has long been a disease, it changes into abscess breaking out, or becomes a water disease, or both eyes lose their sight.
Clinical note임상 주석
Three late complications in one line — infection, fluid retention and blindness — and all three are recognized complications of long-standing diabetes. 雙目失明, both eyes losing sight, is diabetic retinopathy, and that the tradition recorded it as a late consequence of this particular disease is a real observation.

Yuchwi 類聚

4.13.4
Source원문

甚而水氣浸漬, 溢於肌膚則脹, 爲腫滿. 猛火自炎, 留於分肉, 則發爲癰疽. 此又病之深而證之變者也. 《直指》

Translation영역
In severe cases water qi soaks and spills over into the flesh and skin and there is swelling, becoming distension and fullness. A fierce fire burning of itself and lodging in the partings of the flesh breaks out as abscess. These again are the disease gone deep and the pattern changed.

Jikji 直指

4.13.5
Source원문

渴利者, 謂隨飮卽小便也. 由腎氣虛不能制水液, 故隨飮卽小便也. 以其內熱, 故小便利, 小便利則津液竭, 津液竭則經絡澁, 經絡澁則榮衛不行, 榮衛不行則熱氣留滯, 故成癰疽也. 《聖惠》

Translation영역
Thirst disinhibition means passing urine as soon as one drinks. It comes of the kidney qi being vacuous and unable to control the water humour, and so urine is passed as soon as one drinks. Because there is heat within, the urine is disinhibited; the urine disinhibited, the fluids are exhausted; the fluids exhausted, the channels and network vessels are rough; the channels rough, the construction and defence do not move; the construction and defence not moving, the hot qi lodges and stagnates — and hence abscess is formed.
Clinical note임상 주석
A chain in five steps from polyuria to abscess, each following from the last. Whatever is made of the intermediate terms, the endpoints are right: uncontrolled diabetes with polyuria does predispose to skin and soft-tissue infection, and poor circulation is part of why.

Seonghye 聖惠

4.14 In Wasting Thirst, Abscess Must Be Guarded Against 消渴須預防癰疽

4.14.1
Source원문

消渴之人, 常須慮患大癰. 必於骨節間, 忽發癰疽而卒, 須預防之. 宜加減八味元ㆍ黃芪六一湯方見癰疽ㆍ忍冬元, 長服爲妙. 又益元散方見暑門, 井水調服. 《入門》

Translation영역
One with wasting thirst must constantly be anxious about a great abscess. It will surely break out suddenly between the bones and joints and the patient dies, and it must be guarded against beforehand. Modified Eight Flavours Pill, Astragalus Six to One Decoction formula in the Abscess chapter and Honeysuckle Pill are best taken over a long period. Also Boost the Origin Powder formula in the Summerheat chapter, stirred into well water and taken.
Clinical note임상 주석
A whole section given to prophylaxis, which is unusual in these chapters. 忽發癰疽而卒 — breaking out suddenly and the patient dies — is why: the abscess is not a complication to be treated when it comes but a cause of death to be prevented. 長服爲妙, best taken over a long period, sets the frame. These are maintenance medicines for a patient who is not acutely ill. **Diabetic foot and soft-tissue infection remains a leading cause of amputation and death. The chapter's instinct — prevent rather than wait — is sound.**

Immun 入門

4.15 Patterns That Cannot Be Treated 不治證

4.15.1
Source원문

內經曰, 肺消者, 飮一溲二, 死不治. 盖肺藏氣, 肺無病則氣能管攝津液, 而津液之精微者, 收養筋骨血脉, 餘者爲溲. 肺病則津液無氣管攝, 而精微者, 亦隨溲下. 故飮一溲二, 而如膏油也. 津液下脫, 未能榮養, 故漸形瘦焦乾也. 或問經云, 飮一溲二, 死不治, 仲景復用八味丸治之何也. 曰, 飮一未至溲二者, 病尙淺猶可治. 故仲景腎氣丸, 治飮水一斗, 小便亦一斗之證. 若小便過於所飮則無及矣. 《綱目》

Translation영역
The Neijing says: in lung wasting one drinks one measure and passes two, and it is death and cannot be treated. The lung stores qi; where the lung is without disease the qi can manage and hold the fluids, and the essential and subtle part of the fluids gathers and nourishes the sinews, bones, blood and vessels, while the remainder becomes urine. Where the lung is diseased the fluids have no qi to manage them, and the essential and subtle part descends with the urine too. Hence one drinks one and passes two, and it is like grease and oil. The fluids deserting downward cannot nourish, and so the form gradually grows thin and parched. It may be asked: the classic says that drinking one and passing two is death and cannot be treated, yet Zhongjing again uses the Eight Flavours Pill to treat it — why? The answer: where one drinks one and it has not yet come to passing two, the disease is still shallow and can be treated. Therefore Zhongjing's Kidney Qi Pill treats the pattern of drinking a mal of water and passing a mal of urine. But if the urine exceeds what is drunk, there is no help for it.
Clinical note임상 주석
The chapter's clearest piece of reasoning, and it resolves an apparent contradiction between two authorities by finding the line between them: at one-to-one the disease is treatable, past one-to-two it is not. What the passage describes is the essential substance going out in the urine instead of building tissue — 精微者, 亦隨溲下 — which is what happens in uncontrolled diabetes, and explains why the patient wastes while eating and drinking. 如膏油, like grease and oil, recurs from 4.2.8, and 形瘦焦乾 completes the picture.

Gangmok 綱目

4.15.2
Source원문

消渴之餘, 傳爲脹滿, 發爲癰疽, 及强中證, 皆不治. 《綱目》

Translation영역
What follows from wasting thirst — transmitted as distension and fullness, breaking out as abscess, and the strong centre pattern — none of these can be treated.

Gangmok 綱目

4.16 Prohibitions 禁忌法

4.16.1
Source원문

內經曰, 熱中消中, 不可服膏梁, 芳草ㆍ石藥.

Translation영역
The Neijing says: in heat in the centre and wasting in the centre, fat meat and fine grain, fragrant herbs and mineral medicines must not be taken.

Naegyeong 內經

4.16.2
Source원문

消渴病, 宜愼者有三, 一飮酒, 二房勞, 三醎食及麪. 能愼此三者, 雖不服藥, 亦可自愈. 《千金》

Translation영역
In wasting thirst disease there are three things to be careful of: first drink, second sexual taxation, third salty food and wheat. One who can be careful of these three, though they take no medicine, may yet recover of themselves.
Clinical note임상 주석
雖不服藥, 亦可自愈 — though they take no medicine, they may yet recover of themselves. Sun Simiao puts regimen above prescription for this disease, and names three things only. Drink and salt still matter. The middle item reflects the tradition's reading of kidney depletion rather than anything a modern clinician would say, but the shape of the advice — that behaviour governs the course more than medicine does — has not dated at all.

Cheongeum 千金

4.16.3
Source원문

凡消渴, 大忌飮酒房事, 及食炙煿, 辛熱, 醎藏之物.

Translation영역
In wasting thirst generally, drink and sexual matters are greatly to be avoided, and so are roasted and scorched foods, the acrid and hot, and salted preserves.

Deukhyo 得效

4.16.4
Source원문

百日以上, 不可鍼灸. 鍼灸則瘡中出膿水, 不止而死. 《得效》

Translation영역
Where it has lasted more than a hundred days, needling and moxa must not be used. Needled or moxaed, pus and water issue from the wound, do not stop, and the patient dies.
Clinical note임상 주석
The most important warning in the chapter and the one that has been vindicated. A puncture in a long-standing diabetic does not close, and the wound suppurates. That the tradition set a threshold — a hundred days — and made the prohibition absolute after it shows this was learned from cases rather than deduced. **This is correct. Diabetic patients have impaired wound healing and are prone to infection; needling carries real risk, particularly in the lower limb.**

Deukhyo 得效

4.16.5
Source원문

渴疾, 大忌半夏ㆍ南星燥劑. 《東垣》

Translation영역
In thirst disease, pinellia and arisaema and other drying medicines are greatly to be avoided.
Clinical note임상 주석
A pharmacological prohibition to close the section: the drying medicinals that would be reached for in any phlegm pattern are forbidden here, because the fault is already a want of fluid.

Dongwon 東垣

4.17 Simple Medicinals 單方

4.17.1
Source원문

石膏 主消渴. 搗末取五錢, 和粳米煮取汁飮. 《本草》

Translation영역
Gypsum (石膏): Governs wasting thirst. Pound to a powder, take 5 don, boil with non-glutinous rice and drink the liquor.

Boncho 本草

4.17.2
Source원문

竹葉 止消渴. 取靑葉煮汁飮. 《本草》

Translation영역
Bamboo leaf (竹葉): Stops wasting thirst. Take the green leaves, boil and drink the liquor.

Boncho 本草

4.17.3
Source원문

滑石 治消渴. 爲末, 取三錢, 井水, 或蜜水調下, 卽益元散也. 一名神白散. 《醫鑑》

Translation영역
Talc (滑石): Treats wasting thirst. Powder it and take 3 don stirred into well water or honey water — this is Boost the Origin Powder. It is also called Spirit White Powder.

Uigam 醫鑑

4.17.4
Source원문

地漿 治熱渴心悶. 取一盞, 飮之妙. 《本草》

Translation영역
Earth water (地漿): Treats heat thirst with oppression of the heart. Take one jan and drink; it is marvellous.

Boncho 本草

4.17.5
Source원문

竹瀝 治消渴. 不拘時恣飮之妙. 雷公云, 久渴心煩, 宜投竹瀝. 《本草》

Translation영역
Bamboo sap (竹瀝): Treats wasting thirst. Drink freely at any time; it is marvellous. Leigong said that for long thirst with vexation of the heart, bamboo sap should be given.

Boncho 本草

4.17.6
Source원문

麥門冬 治消渴, 及口乾燥渴. 去心煮湯飮之. 《本草》

Translation영역
Ophiopogon (麥門冬): Treats wasting thirst and dryness of the mouth with thirst. Remove the hearts, decoct and drink.

Boncho 本草

4.17.7
Source원문

黃柏 主消渴. 水煎服, 又作末水丸服之. 《本草》

Translation영역
Phellodendron (黃柏): Governs wasting thirst. Decoct in water and take, or powder it and make water pills and take.

Boncho 本草

4.17.8
Source원문

黃連 治消渴要藥. 酒浸蒸曬乾爲末, 蜜丸, 白湯下五七十丸. 《綱目》

Translation영역
Coptis (黃連): The essential medicine for treating wasting thirst. Steep in wine, steam and sun-dry, powder, make honey pills, and take fifty to seventy down with plain hot water.
Clinical note임상 주석
治消渴要藥 — the essential medicine — and coptis appears in more of this chapter's formulas than anything else. The chapter's reading is that the disease is heat consuming fluids, and coptis is its coldest bitter.

Gangmok 綱目

4.17.9
Source원문

黃芪 治消渴. 凡消渴而欲發瘡, 或病癰疽而後渴, 宜多取黃芪煮湯服之妙. 《綱目》

Translation영역
Astragalus (黃芪): Treats wasting thirst. Wherever wasting thirst is about to break out in sores, or thirst follows an abscess, much astragalus should be boiled into a decoction and taken; it is marvellous.
Clinical note임상 주석
The one simple here chosen for the complication rather than the disease. Astragalus is the tradition's medicinal for a sore that will not close, and the chapter has already named abscess as what kills these patients at 4.14.

Gangmok 綱目

4.17.10
Source원문

葛根 主消渴. 取五錢水煎飮之. 又取生者, 搗汁飮亦好. 《本草》

Translation영역
Pueraria (葛根): Governs wasting thirst. Take 5 don, decoct in water and drink. Taking the fresh root, pounding out the juice and drinking it is also good.

Boncho 本草

4.17.11
Source원문

瓜蔞根 卽天花粉也. 治消渴之聖藥也. 水煮取汁, 隨意飮之甚佳. 《本草》

Translation영역
Trichosanthes root (瓜蔞根): That is, trichosanthes powder. It is the sagely medicine for treating wasting thirst. Boil in water, take the liquor and drink at will; it is excellent.
Clinical note임상 주석
治消渴之聖藥 — the sagely medicine — is the strongest claim in the section, and trichosanthes root is the one simple that appears under two names in the chapter's own formulary, as 瓜蔞根 and as 天花粉.

Boncho 本草

4.17.12
Source원문

漬苧汁 主消渴. 取生苧, 水漬取汁飮之. 《本草》

Translation영역
Steeped ramie juice (漬苧汁): Governs wasting thirst. Take fresh ramie, steep it in water, take the liquor and drink.

Boncho 本草

4.17.13
Source원문

地骨皮 治消渴. 水煎服之. 又取葉作飮, 啜之. 《本草》

Translation영역
Lycium root bark (地骨皮): Treats wasting thirst. Decoct in water and take. The leaves may also be made into a drink and sipped.

Boncho 本草

4.17.14
Source원문

蚊蛤 卽五倍子也. 最能回津止渴. 爲末, 沸湯調下二錢, 最妙. 《入門》

Translation영역
Chinese gall (蚊蛤): That is, the gallnut. It is best of all at restoring the fluids and stopping thirst. Powder it and take 2 don stirred into boiling water; most marvellous.
Clinical note임상 주석
回津, restoring the fluids, rather than engendering them — the gallnut is astringent and holds what is there instead of adding. That distinction runs through the section: some simples moisten, others bind.

Immun 入門

4.17.15
Source원문

忍冬草 治消渴. 水煮取汁, 四時長服. 《丹心》

Translation영역
Honeysuckle (忍冬草): Treats wasting thirst. Boil in water, take the liquor and drink through all four seasons.

Dansim 丹心

4.17.16
Source원문

桑枝茶 療口乾. 如茶常服爲佳. 《本草》

Translation영역
Mulberry twig tea (桑枝茶): Cures dryness of the mouth. Taken regularly like tea it is good.

Boncho 本草

4.17.17
Source원문

桑根白皮 主熱渴. 水煎飮之. 黑椹, 搗濾去滓, 入石器中, 入蜜熬膏. 每取二三匙, 沸湯點服, 止渴生精神. 《本草》

Translation영역
Mulberry root bark (桑根白皮): Governs heat thirst. Decoct in water and drink. Black mulberries, pounded and strained of their dregs, put in a stone vessel with honey and reduced to a paste; take two or three spoonfuls at a time sprinkled into boiling water — it stops thirst and engenders the spirit.

Boncho 本草

4.17.18
Source원문

牡蠣肉 治酒渴. 和薑ㆍ醋, 生食之. 俗名石花. 《本草》

Translation영역
Oyster flesh (牡蠣肉): Treats alcohol thirst. Eat it raw with ginger and vinegar. It is commonly called stone flower.

Boncho 本草

4.17.19
Source원문

蚌蛤 止消渴. 煮食, 或和薑ㆍ醋, 生食幷佳. 《本草》

Translation영역
Freshwater mussel (蚌蛤): Stops wasting thirst. Boiled and eaten, or eaten raw with ginger and vinegar — both are good.

Boncho 本草

4.17.20
Source원문

鮎魚涎 主三消. 取涎, 搜黃連末作丸, 烏梅湯下五十丸, 渴頓減. 《本草》

Translation영역
Catfish slime (鮎魚涎): Governs the three wastings. Take the slime, work it with powdered coptis into pills, and take fifty down with mume decoction; the thirst abates at once.

Boncho 本草

4.17.21
Source원문

田螺 治消渴, 小便數. 取螺五升, 水一斗, 浸經宿, 取水飮之, 每日易水. 又取螺, 煮汁飮, 食肉良. 《本草》

Translation영역
River snail (田螺): Treats wasting thirst with frequent urine. Take 5 seung of snails in 1 mal of water, steep overnight, and drink the water, changing it daily. Also take the snails, boil and drink the liquor, and the flesh eaten is good.
Clinical note임상 주석
每日易水 — changing the water daily — is the working detail. Snails steeped overnight give a cool mucilaginous water, and the instruction to renew it suggests the preparation was actually kept up over days rather than made once.

Boncho 本草

4.17.22
Source원문

生藕 取汁一盞, 入蜜一合, 分三服. 止渴最好. 《綱目》

Translation영역
Fresh lotus root (生藕): Take one jan of the juice, add 1 hop of honey, and divide into three doses. Best of all for stopping thirst.

Gangmok 綱目

4.17.23
Source원문

紅柿 止渴, 取啖之. 《本草》

Translation영역
Ripe persimmon (紅柿): Stops thirst; take and eat it.

Boncho 本草

4.17.24
Source원문

烏梅 療口乾, 止消渴. 作湯和少蜜, 常啜. 《本草》

Translation영역
Mume (烏梅): Cures dryness of the mouth and stops wasting thirst. Make a decoction, mix in a little honey, and sip regularly.

Boncho 本草

4.17.25
Source원문

梨 止消渴. 取消梨, 常常啖之, 最治心熱渴. 《本草》

Translation영역
Pear (梨): Stops wasting thirst. Take a juicy pear and eat it often; it is best for treating heart heat thirst.

Boncho 本草

4.17.26
Source원문

獼猴桃 止消渴. 取霜後熟者, 常啖之. 又和蜜作正果, 尤佳. 《俗方》

Translation영역
Hardy kiwi (獼猴桃): Stops wasting thirst. Take those ripened after the frost and eat them often. Made into a confection with honey it is better still.

Sokbang 俗方

4.17.27
Source원문

五味子 止消渴最良. 作飮常啜之. 又作丸久服, 生津止渴. 《本草》

Translation영역
Schisandra (五味子): Best of all for stopping wasting thirst. Make it into a drink and sip regularly. Made into pills and taken long, it engenders fluids and stops thirst.

Boncho 本草

4.17.28
Source원문

麻仁 止消渴. 麻仁一升, 擣碎之, 水三升煮取汁, 溫凉任服. 《本草》

Translation영역
Hemp seed (麻仁): Stops wasting thirst. Hemp seed 1 seung, pounded and crushed, boiled in 3 seung of water; take the liquor warm or cool as preferred.

Boncho 本草

4.17.29
Source원문

粟米泔 酸者, 止消渴甚良. 常取飮之. 泔久留則酸. 《本草》

Translation영역
Millet washing water (粟米泔): The sour kind stops wasting thirst very well. Take and drink it regularly. Washing water left long turns sour.

Boncho 本草

4.17.30
Source원문

菉豆 治消渴. 煮汁飮之, 或硏取汁服幷佳. 《本草》

Translation영역
Mung bean (菉豆): Treats wasting thirst. Boil and drink the liquor, or grind and take the juice — both are good.

Boncho 本草

4.17.31
Source원문

靑粱米 主熱中, 消渴. 煮取汁飮之, 或煮粥, 或作飯, 常食佳. 《本草》

Translation영역
Green millet (靑粱米): Governs heat in the centre and wasting thirst. Boil and drink the liquor, or make congee, or cook it as rice and eat regularly.

Boncho 本草

4.17.32
Source원문

糯米 主消渴. 淘取泔飮之. 又水硏取白汁, 恣飮之, 以差爲度.

Translation영역
Glutinous rice (糯米): Governs wasting thirst. Rinse it and drink the washing water. Also grind it in water, take the white liquor and drink freely, taking recovery as the measure.

Boncho 本草

4.17.33
Source원문

糯米 糯稻稈灰, 淋汁飮之, 甚妙. 一人病渴殆死, 有人敎以糯稻稈斬去穗及根, 取中心, 淨器中燒作灰. 每取一合, 湯水一椀, 沃浸良久, 澄去滓, 取淸頓飮之. 卽取效如神. 《澹寮》

Translation영역
Glutinous rice (糯米), second method: Ash of glutinous rice straw, leached and the liquor drunk, is most marvellous. A person was ill with thirst and near death; someone taught him to take glutinous rice straw, cut away the ears and the roots, take the middle part and burn it to ash in a clean vessel. Take 1 hop at a time in a bowl of hot water, let it steep a good while, let it settle and pour off the dregs, and drink the clear liquor at a draught. The effect follows at once as though by spirit.
Clinical note임상 주석
The one case history in the section, and the preparation is described precisely enough to repeat: the ears and roots cut away, only the middle of the straw burnt, the ash steeped and the clear liquor poured off. Straw ash leached in water gives a strongly alkaline potassium solution, the same lye the Oedema and Distension chapters use for their bean congees. Whether it helped the thirst is another matter, but the person who taught it had a method rather than a notion.

Damryo 澹寮

4.17.34
Source원문

冬瓜 主三消渴. 擣絞取汁飮之. 又作羹作虀, 常食佳. 《本草》

Translation영역
Wax gourd (冬瓜): Governs the three wasting thirsts. Pound and press out the juice and drink it. Made into broth or pickle and eaten regularly, it is good.

Boncho 本草

4.17.35
Source원문

蓴 主消渴. 作羹作虀, 常食佳. 《本草》

Translation영역
Water shield (蓴): Governs wasting thirst. Made into broth or pickle and eaten regularly, it is good.

Boncho 本草

4.17.36
Source원문

菘菜 治消渴. 常食最佳. 或取汁飮亦可. 《本草》

Translation영역
Chinese cabbage (菘菜): Treats wasting thirst. Eaten regularly it is best of all; the juice may also be taken and drunk.

Boncho 本草

4.17.37
Source원문

雄雞湯 治三消渴疾. 退雄雞湯, 澄淸飮之神效. 白雄雞尤佳. 《醫鑑》

Translation영역
Cock broth (雄雞湯): Treats the three wasting thirst diseases. The broth of a plucked cock, let to settle clear and drunk, has spirit-like effect. A white cock is better still.

Uigam 醫鑑

4.17.38
Source원문

白鵝 主消渴. 煮取汁飮之. 《本草》

Translation영역
White goose (白鵝): Governs wasting thirst. Boil and drink the liquor.

Boncho 本草

4.17.39
Source원문

黃雌雞 主消渴. 煮熟取汁飮之, 肉亦可食. 《本草》

Translation영역
Yellow hen (黃雌雞): Governs wasting thirst. Boil it through, take the liquor and drink; the flesh may also be eaten.

Boncho 本草

4.17.40
Source원문

牛乳 主消渴. 取生乳, 渴則飮之. 又作酪粥, 常食亦佳. 《本草》

Translation영역
Cow's milk (牛乳): Governs wasting thirst. Take fresh milk and drink it when thirsty. Made into a curd congee and eaten regularly it is also good.

Boncho 本草

4.17.41
Source원문

猪肚 止渴利. 爛蒸, 和薑ㆍ醋食之. 《本草》

Translation영역
Pig stomach (猪肚): Stops thirst disinhibition. Steam it soft and eat it with ginger and vinegar.
Clinical note임상 주석
The section closes with the organ that gives its name to Hwangryeonjeodu-hwan, the formula the chapter reaches for twice — at 4.4.2 for middle wasting and at 4.12 for the strong centre. Stomach treats stomach, on the organ-for-organ reasoning that runs through the Bogam. Of the thirty-nine simples here, more than half are ordinary foods — pear, persimmon, kiwi, mung bean, millet, cabbage, wax gourd, milk, chicken. For a disease the chapter says may resolve on regimen alone at 4.16.2, that is consistent.

Boncho 本草

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 6, Wasting Thirst chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.