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Suppose a person with a thin physique experiences palpitations below the umbilicus, vomits saliva and froth, and suffers from vertigo affecting the vertex (top of the head). This is caused by fluid retention, and Wuling San (Five-Ingredient Powder with Poria) should be used as the primary treatment.

[Commentary]
The character "thin" (Shou) in "thin person" should likely be "sick" or "ill" (Bing); the character "dian" (Dian) in "dian xuan" should be "dian" (Dian), meaning the vertex or top of the head. With this correction, the textual meaning becomes coherent; this discrepancy is due to a transcription error.

[Annotation]
Palpitation (Ji) refers to the sensation of the heart beating vigorously. In the preceding clause, palpitations below the heart indicate that fluid retention has occurred in the epigastrium. In this clause, palpitations below the umbilicus indicate that fluid retention has occurred below the umbilicus. If there were a tendency for Ben Tun (a condition characterized by the sensation of Qi rushing upward from the lower abdomen to the chest and throat) to develop, it would be due to Yang deficiency, and Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) would be indicated. However, since there is vomiting of saliva and froth, indicating fluid rebellion against the Stomach, and vertigo of the vertex, indicating obstruction of Yang by fluid, this represents an excess of fluid. Therefore, Wuling San (Five-Ingredient Powder with Poria) is indicated.

Alisma Rhizoma (Zexie) 1 liang 1 fen, Polyporus (with skin removed) 3 fen, Poria (Fuling) 3 fen, Atractylodis Macrocephalae Rhizoma (Baizhu) 3 fen, Cinnamomi Ramulus (Guizhi, with skin removed) 2 fen.
Grind these five ingredients into powder. Take one fangcun bi (a square-inch measure) with warm rice water decoction, three times daily. Drink plenty of warm water after administration; recovery is indicated by sweating.

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In cases of shortness of breath accompanied by slight fluid retention, the fluid should be eliminated via urination. Lingui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) is the primary formula. Shenqi Wan (Kidney Qi Pill) may also be used.

[Annotation]
When fluid retention occurs in the epigastrium, severe cases result in palpitations, the treatment for which has already been explained. Mild cases manifest as shortness of breath, which has two treatment approaches: Shortness of breath due to Qi deficiency arises because there is insufficient Qi to sustain deep breathing. Shortness of breath due to slight fluid retention arises because retained fluid obstructs respiration. If shortness of breath occurs during exhalation, it indicates an obstruction of the Yang Qi of the Heart and Lungs; Lingui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) is used to unblock Yang Qi. Once Yang Qi is unblocked, the orifices of the Bladder become patent. If shortness of breath occurs during inhalation, it indicates an obstruction of the Yin Qi of the Liver and Kidneys; Shenqi Wan (Kidney Qi Pill) is used to unblock Yin Qi. Once Yin Qi is unblocked, the gates of urine excretion open. Thus, it is stated that Lingui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) is indicated, and Shenqi Wan (Kidney Qi Pill) is also indicated.

Poria (Fuling) 4 liang, Cinnamomi Ramulus (Guizhi) 3 liang, Atractylodis Macrocephalae Rhizoma (Baizhu) 3 liang, Glycyrrhizae Radix et Rhizoma (Gancao) 2 liang.
Take these four ingredients, add six sheng of water, and decoct to obtain three sheng of liquid. Divide into three warm doses. Urination will ensue upon efficacy.