Treatise on the Three Forms of Wasting-Thirst

Treatise on the Three Types of Diabetes is a single-volume work by the Jin dynasty physician Liu Wansu (courtesy name Shouzhen, commonly known as Liu Hejian). As one of the earlier extant monographs devoted to consumptive thirst (diabetes), it runs to roughly seven thousand characters. The work was never issued as an independent edition in its own day and long circulated among Liu's literary remains; the Jin physician Zhang Congzheng included it in fascicle thirteen of his Confucians' Duties to Their Parents under the title Treatise on the Three Types of Diabetes by Master Liu Hejian. In 1884, the tenth year of the Guangxu reign of the Qing, Zhou Xuehai annotated a manuscript preserved by Liu's descendants and published it as a separate edition in the Zhou Medical Compendium, and thus the text finally became available as a standalone work.

Grounded in the theories of consumptive thirst found in the Inner Canon and informed by the discussions of earlier writers up to the Song as well as by Liu's own doctrine that the six climatic influences all transform into fire, the book sets out systematically the causes, pathogenesis, pattern differentiation, and treatment of the disease. Liu proposes that the core pathogenesis lies in dry heat stagnating in the triple burner, stomach, and intestines: when dry heat is excessive, the mysterious portals are blocked, and the movement of qi and fluids is disrupted, so that fluids dry up and unremitting thirst and drinking ensue. He distinguishes three types—upper diabetes associated with the lung, middle diabetes with the stomach, and lower diabetes with the kidney—and notes that prolonged illness may give rise to such complications as night blindness, internal eye disorders, deafness and blindness, sores and tinea, scabies and skin lesions, spontaneous sweating, and pulmonary atrophy with consumptive cough. For treatment he advocates replenishing the deficiency of yin and cold in the kidney water while draining the excess of yang heat in the heart fire, removing extreme dry heat from the stomach and intestines, and sustaining the body's depleted fluids, so that the pathways remain open and unobstructed, fluids are generated and do not run dry, and qi and blood flow freely without stagnation. The book appends formulas specific to consumptive thirst, including Divine White Powder, Pig Tripe Pill, Pueraria Pill, Lead Carbonate Powder, Three Yellows Pill, Ginseng and Atractylodes Powder, and Ginseng Powder, and closes with a colophon by the Old Recluse of Brocade Creek briefly recounting the work's transmission.