仲景曰。发汗后。饮水多者。必喘。以水灌之。亦喘。常氏云。微
喘。宜麻黄杏子甘草石膏汤。雍曰。饮水多者。五苓散。
又曰。伤寒。大吐大下之。极虚。复极汗出者。其人外气怫郁。复
与之水。以发其汗。因得哕。所以然者。胃中寒冷故也。常氏曰。可小
温中汤、小半夏汤。雍曰。胃寒。理中汤。哕者。半夏汤、五苓散。
又曰。阳明病。潮热。大便微硬。可与承气汤。不坚。勿与之。若
不大便六七日。恐有燥屎。欲知之法。可与小承气汤。若腹中不转失
气者。此但初头硬。后必溏。不可攻之。攻之必胀满不能食。欲饮水
者。与水则哕。雍曰。可温中汤。哕者。小半夏汤。
又曰。下利。其脉浮大。此为虚。以强下之故也。设脉浮革。因尔
肠鸣。当温之。与水。哕。雍曰。宜温中汤。
又曰。病在阳。当以汗解。而反以冷水 之。若灌之。其热被却
不得去。弥更益烦。皮上粟起。意欲饮水。反不渴。宜文蛤散。若不
瘥。与五苓散。若寒实结胸。无热证者。与三物小陷胸汤。白散亦可
服。身热。皮粟不解。欲引衣自覆。若以水灌之洗之。益令热却不得
出。当汗而不汗。即烦。假令汗出已。腹中痛。与芍药三两。如上法。
又曰。寸口脉浮大。医反下之。此为大逆。浮则无血。大则为寒。
寒气相搏。则为肠鸣。医乃不知。而反饮冷水。令汗大出。水得寒气。
冷必相搏。其人则KT 。常氏云。宜草豆蔻散。
又曰。寸口脉濡而弱。濡则恶寒。弱则发热。濡弱相搏。脏气衰
微。胸中苦烦。此非结热。而反薄居水渍布。冷铫贴之。阳气遂微。诸
腑无所根据。阴脉凝聚。结在心下。而不肯移。胃中虚冷。水谷不化。小
便纵通。复不能多。微则可救。聚寒心下。当奈何也。
千金翼曰。太阳病。小便利者。为水多。心下悸。雍曰。宜小半夏
加茯苓汤。
仲景曰。凡得时气病。至五六日而渴欲饮水。饮不能多。不当与
也。何者。以腹中热尚少。不能消之。便更与人作病也。至七八日。大
渴欲饮水者。犹当根据证而与之。与之常令不足。勿极意也。言能饮一
斗。与五升。若饮而腹满。小便不利。若喘若哕。不可与之也。饮而忽
然大汗出。是为自愈也。
又曰。凡得病反能饮水者。此为欲愈之病。其不晓病者。但闻病
人饮水自愈。小渴者乃纵与之饮。因成其祸。不可复救也。庞氏曰。
凡病非大渴。不可与饮冷水。若小渴。口燥咽干。少少呷水滋润之。
若不与水。则干燥。无由作汗。烦喘而死者多巳。但勿令足意饮也。
若大汗将来。燥渴甚者。但足意饮之。勿疑。若小渴强饮者。致停饮。
心下满结。喘而死者多矣。其有热脉数。尚可作汗而解者。出于幸之
幸也。
Zhang Zhongjing said: After inducing sweating, if the patient drinks too much water, it will inevitably lead to panting (asthma). Washing the body with cold water will also cause panting. Chang Shi believed that for mild panting, Mahuang Xingzi Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) is suitable. Guo Yong stated that if it is caused by excessive drinking of water, Wuling San (Five-Ingredient Powder with Poria) should be used.
He further said: In cases of Shanghan (Cold Damage), after severe vomiting and purging, when the body is extremely deficient, and profuse sweating occurs, the patient exhibits exterior qi stagnation (Fu Yu). If water is then given to induce sweating, hiccups (Yue) may result. The reason for this is cold in the stomach. Chang Shi suggested Xiaowenzhong Tang (Minor Stomach-Warming Decoction) or Xiaobanxia Tang (Minor Pinellia Decoction). Guo Yong stated that for stomach cold, Lizhong Tang (Regulate the Middle Decoction) should be used. For hiccups, Banxia Tang (Pinellia Decoction) or Wuling San can be used.
He also said: In Yangming disease, with tidal fever and slightly hard stool, Chengqi Tang (Gut-Purging Decoction) may be administered; if the stool is not hard, do not administer it. If there has been no bowel movement for six or seven days, suspecting dry feces, one may administer Xiao Chengqi Tang (Minor Gut-Purging Decoction) as a test. If there is no passing of gas in the abdomen, it indicates only the beginning of the stool is hard, while the rest will be loose; attacking methods should not be used. Attacking will inevitably lead to abdominal fullness and inability to eat. If the patient desires water, giving it will cause hiccups. Guo Yong stated that Wenzhong Tang (Stomach-Warming Decoction) can be used. For hiccups, Xiao Banxia Tang (Minor Pinellia Decoction) is appropriate.
He further said: In diarrhea, if the pulse is floating and large, this indicates deficiency, caused by forced purging. If the pulse is floating and wiry (Ge), accompanied by borborygmus (intestinal rumbling), warming treatment is indicated. Giving water may cause hiccups. Guo Yong stated that Wenzhong Tang is suitable.
He also said: When the disease is in the Yang level, it should be resolved through sweating. However, if cold water is sprayed or poured on the patient, the heat is suppressed and cannot escape, leading to increased irritability and gooseflesh on the skin. The patient may feel thirsty but actually feels no thirst. Wen Ge San (Clam Shell Powder) is suitable. If the condition does not improve, Wuling San may be given. In cases of Cold-Excess Jie Xiong (Chest Binding) without heat signs, Sanwu Xiaoxianxiong Tang (Three-Ingredient Minor Chest-Penetrating Decoction) is indicated. Baisan (White Powder) may also be taken. If body heat and gooseflesh persist, and the patient desires to cover themselves with clothes, pouring cold water will further trap the heat. If sweating should occur but does not, irritability arises. If sweating has occurred but abdominal pain persists, give 3 liang of Shaoyao (Paeoniae Radix Alba) according to the aforementioned method.
He further said: If the Cun Kou (inch position) pulse is floating and large, and the physician incorrectly uses purging, this is a major contraindication. Floating indicates blood deficiency, and large indicates cold. When cold qi interacts, borborygmus occurs. Unaware of this, the physician gives cold water to induce profuse sweating. Water encountering cold qi leads to clashing, causing the patient to make specific sounds (KT, likely referring to hiccups or abdominal noises). Chang Shi suggested Caodoukou San (Cardamom Powder).
He also said: If the Cun Kou pulse is soft (Ru) and weak (Ruo), Ru indicates aversion to cold, and Ruo indicates fever. The interaction of Ru and Ruo indicates declining Zang Qi, causing distress in the chest. This is not constrained heat. However, applying cold wet cloths or cold iron vessels to the body causes Yang Qi to further decline. The Fu organs lose their foundation, Yin pulses condense, and stagnation forms below the heart, refusing to move. Stomach cold leads to indigestion of food and water. Urination may be free but scant. Mild cases can be saved. What should be done when cold accumulates below the heart?
Qianjin Yi Fang states: In Taiyang disease, if urination is frequent, it indicates excess water, leading to palpitations below the heart. Guo Yong stated that Xiaobanxia Jia Fuling Tang (Minor Pinellia Decoction with Added Poria) is suitable.
Zhang Zhongjing said: In seasonal febrile diseases, by the fifth or sixth day, if the patient is thirsty and wants to drink but cannot drink much, do not provide excessive water. This is because the internal heat is insufficient to transform the fluid, and providing more water may create new pathology. By the seventh or eighth day, if the patient is extremely thirsty, water may be given according to the syndrome. However, the amount should be kept insufficient, not allowing the patient to drink to satiety. For example, if they can drink one dou, give only five sheng. If abdominal fullness, dysuria, panting, or hiccups occur after drinking, do not give more water. If sudden profuse sweating occurs after drinking, it indicates spontaneous recovery.
He further said: Patients who are able to drink water during illness often indicate impending recovery. Those unfamiliar with medicine, hearing that drinking water aids recovery, may allow patients with slight thirst to drink freely, causing harm that cannot be remedied. Pang Shi stated: For any illness, unless there is extreme thirst, cold water should not be given. For slight thirst with dry mouth and throat, sip small amounts to moisten. Without water, dryness prevents sweating, leading to death from irritability and panting. Avoid over-drinking. If profuse sweating is imminent and thirst is severe, allow adequate drinking without hesitation. Forcing water intake during slight thirst causes fluid retention, subcardiac fullness, and death from panting. Cases where heat and rapid pulse allow resolution through sweating are rare blessings.