Library

Treat Yangming disease presenting with a floating pulse, fever, and thirst for water; as well as Shaoyin disease involving diarrhea for six or seven days, accompanied by cough, vomiting, thirst, irritability, and inability to sleep.

Zhu Ling (Polyporus), Fu Ling (Poria), E Jiao (Donkey-hide Gelatin), Hua Shi (Talcum), Ze Xie (Alisma) each one liang. The above five herbs are decocted in four sheng of water. First, boil the first four herbs until two sheng remain, then strain. Add E Jiao and melt it. Take seven he of the warm decoction three times a day.

[Collected Notes] Zhao Yuhuang stated: Zhang Zhongjing formulated Zhu Ling Tang to regulate water-heat in the Yangming and Shaoyin meridians. However, its main purport lies in nourishing Yin, not merely in promoting diuresis. Generally, in Taiyang disease with exterior deficiency, the loss of Yang is most feared, whereas in interior heat conditions, the loss of Yin is a concern. Loss of Yin refers to the depletion of Kidney Yin and Stomach fluids. Therefore, in patients with Yin deficiency, not only should the bowels not be lightly purged, but also the urine should not be forced out through strong diuretics. For if Yin-deficient patients undergo excessive diuresis, their body fluids will instead be exhausted. In this formula, E Jiao has a gelatinous quality that nourishes Yin and moistens dryness; Hua Shi is slippery in nature, clearing heat and promoting urination; assisted by the draining actions of Fu Ling and Zhu Ling, it disperses turbid heat without retaining stagnation, and moistens true Yin without causing bitterness or dryness. Thus, it is an excellent remedy that promotes urination without damaging Yin. Hence, Wu Ling San is used for diuresis in Taiyang disease because Taiyang governs cold-water, so Gui Zhi (Cinnamon Twig) is added to warm it, thereby warming the Kidney to move water. In contrast, Zhu Ling Tang is used for Yangming and Shaoyin diseases because these two meridians are closely related to body fluids; specifically, E Jiao and Hua Shi are used to moisten them. This represents nourishing the formless (Yin) to move the formed (urine). Although both promote urination, their thermal natures are vastly different; only those with clear understanding can discern this.

Treat cases with a floating pulse, difficulty in urination, slight heat, and polydipsia. After sweating, if the pulse becomes floating and rapid with irritability and severe thirst. Or wind-stroke with fever persisting for six or seven days without resolution, accompanied by irritability, presenting both exterior and interior signs, thirst for water, and vomiting immediately after drinking.

Fu Ling (Poria) 18 zhu, Zhu Ling (Polyporus) 18 zhu, Bai Zhu (Atractylodes Macrocephala Rhizome) 18 zhu, Ze Xie (Alisma) one liang, Gui (Cinnamon Bark/Twig) half liang. The above five herbs are powdered. Mix with rice water and take one fang cun bi per dose, three times a day. Drink plenty of warm water after administration; recovery occurs when sweat appears.

[Note] This formula addresses Taiyang pathogenic heat entering the fu-organs, where water qi fails to transform. It treats disorders of the Bladder's exterior and interior. It treats Shui Ni (Water Reversal), where water is vomited upon ingestion; and it treats Xiao Ke (Wasting-Thirst), where water is consumed rapidly. The Bladder is the fu-organ of body fluids; it excretes urine only when Qi transformation functions normally. When pathogenic heat enters, if water accumulation predominates, water stagnates and fails to transform, accumulating above, while Bladder Qi transformation fails, leading to urinary retention or difficulty. If heat predominates, water is consumed by heat, depleting Bladder fluids, also leading to difficult urination. Vomiting after drinking indicates water excess over heat; consuming water quickly indicates heat excess over water. Both conditions feature difficult urination, hence this formula is indicated for both. However, it must not be used if urination is already normal, lest it severely damage body fluids. From this, we know that Wu Ling San is not exclusively for water-heat intermingling, but is the primary formula for water-heat causing difficult urination. Ze Xie (Alisma) is the Sovereign herb, salty and cold; saltiness directs action to the water fu-organs, and coldness overcomes pathogenic heat. Poria (Fu Ling) and Polyporus (Zhu Ling) act as Ministers, providing mild permeability to regulate water pathways and direct flow downward to the Bladder, draining water-heat together. Bai Zhu (Atractylodes Macrocephala Rhizome) dries dampness, strengthens the Spleen, and aids Earth element, acting as a dam to control water. Gui (Cinnamon) is acrid and warm, disseminating Yang Qi and steaming/transforming the Triple Burner to move water. With the descending assistance of Fu Ling and Zhu Ling, Ze Xie’s diuretic effect is doubled, allowing free urination and preventing water accumulation. With the ascending assistance of Gui, Bai Zhu’s efficacy in unblocking Yang is swift; as Qi rises and fluids transform, thirst ceases. If fever and exterior signs persist, use Gui Zhi (Cinnamon Twig); drink ample warm water afterward to induce sweating for cure. Thus, this formula not only treats interior water retention causing difficult urination but also resolves exterior heat caused by water retention. Adding Ren Shen (Ginseng) creates Chun Ze Tang, whose intent is specifically to assist Qi transformation to generate fluids. Adding Yin Chen (Artemisia Capillaris) creates Yin Chen Wu Ling San, which treats damp-heat jaundice with deficient exterior and interior and difficult urination, proving effective in all such cases.