茯苓（二两味甘平） 桂枝（二两去皮味辛热） 生姜（三两切味辛温） 甘草（一
两味甘平）
上四味。以水四升。煮取二升。去滓。分温三服。
茯苓甘草之甘。益津液而和卫。桂枝生姜之辛。助阳气而解表。
中风发热。六七日不解而烦。有表里证。渴欲饮水。水入则吐者。名曰水逆。五苓
散主之。
中风发热。至六七日则当解。若不解。烦者。邪在表也。渴欲饮水。邪传里也。里
热甚。则能消水。水入则不吐。里热少。则不能消水。停积不散。饮而吐水也。以其因
水而吐。故名水逆。与五苓散。和表里。散停饮。
娄氏云。既曰里热少。不能消水。与五苓。则前治烦躁消渴。益爽然矣。
未持脉时。病患叉手自冒心。师因教试令咳。而不咳者。此必两耳聋。无闻也。所以
然者。以重发汗虚故如此。
发汗多。亡阳。胸中阳气不足者。病患手叉自冒心。师见外证。知阳气不足也。又
试令咳而不即咳者。耳聋也。知阳气虚明矣。耳聋者阳气虚。精气不得上通于耳故也。
王三阳云。看此病。当常思少阳柴胡证。但强弱自不同耳。
发汗后。饮水多。必喘。以水灌之。亦喘。
喘、肺疾。饮水多。喘者。饮冷伤肺也。以冷水灌洗而喘者。形寒伤肺也。
发汗后。水药不得入口。为逆。若更发汗。必吐下不止。
发汗后。水药不得入口。为之吐逆。发汗亡阳。胃中虚冷也。若更发汗。则愈损阳
气。胃气大虚。故吐下不止。
发汗吐下后。虚烦不得眠。若剧者。必反复颠倒。心中懊 。栀子豉汤主之。
发汗吐下后。邪热乘虚。客于胸中。谓之虚烦者。热也。胸中烦热郁闷而不得发散
者。是也。热气伏于里者则喜睡。今热气浮于上。烦扰阳气。故不得眠。心恶热。热甚
则必神昏。是以剧者。反复颠倒而不安。心中懊 而愤闷。懊 者。俗谓鹘突是也。内
经曰。其高者。因而越之。与栀子豉汤。以吐胸中之邪。
Fuling (Poria, two liang, sweet flavor, neutral nature) Guizhi (Cinnamon Twig, two liang, peeled, pungent flavor, hot nature) Shengjiang (Fresh Ginger, three liang, sliced, pungent flavor, warm nature) Gancao (Licorice Root, one liang, sweet flavor, neutral nature)
The above four herbs. Decoct with four sheng of water, reduce to two sheng. Remove the dregs. Divide into three doses and take warm.
The sweetness of Fuling (Poria) and Gancao (Licorice Root) benefits the body fluids and harmonizes the Wei Qi (Defensive Qi). The pungency of Guizhi (Cinnamon Twig) and Shengjiang (Fresh Ginger) assists Yang Qi and releases the exterior.
In Wind-Strike (Zhong Feng) with fever, if unresolved after six or seven days accompanied by vexation, presenting both exterior and interior signs, thirst with desire to drink water but vomiting immediately upon ingestion, this is named Water Reversal (Shui Ni). It is primarily treated with Wuling San (Five-Ingredient Powder with Poria).
Wind-Strike with fever should resolve by the sixth or seventh day. If it does not resolve and vexation occurs, the pathogen remains at the exterior. Thirst with desire to drink indicates the pathogen has transmitted to the interior. If interior heat is severe, it can consume water, so drinking will not cause vomiting. If interior heat is mild, it cannot consume water, leading to stagnation and accumulation; thus, drinking causes vomiting of clear fluid. Because the vomiting is caused by water retention, it is named Water Reversal. Administer Wuling San (Five-Ingredient Powder with Poria) to harmonize the exterior and interior and dissipate retained fluid.
Lou stated: Since it is said that interior heat is mild and cannot consume water, using Wuling San clarifies the efficacy of previous treatments for vexation and excessive thirst.
Before taking the pulse, the patient crosses their hands over the heart. The physician instructs them to try coughing, but they do not cough. This indicates bilateral deafness and inability to hear. This occurs because excessive sweating has depleted the healthy Qi.
Excessive sweating leads to loss of Yang. Patients with insufficient Yang Qi in the chest cross their hands over the heart. Observing these external signs, the physician knows Yang Qi is insufficient. By testing for cough and noting the absence thereof, deafness is confirmed. Thus, Yang deficiency is clearly established. Deafness results from deficient Yang Qi, preventing Essence and Qi from ascending to the ears.
Wang Sanyang stated: When treating this condition, one should constantly consider the Shaoyang syndrome (Lesser Yang Syndrome) Chai Hu Tang (Bupleurum Decoction) pattern, though the severity differs.
After sweating, if water intake is excessive, wheezing (Chuan) will inevitably occur. Washing the body with cold water also causes wheezing.
Wheezing is a lung disease. Wheezing due to excessive water intake is caused by cold drinks injuring the Lung. Wheezing due to washing with cold water is caused by external cold injuring the Lung.
After sweating, if water and medicine cannot be taken orally, this is a counterflow (Ni) syndrome. If sweating is induced again, it will inevitably lead to continuous vomiting and diarrhea.
After sweating, if water and medicine cannot be taken orally, it is called vomiting and counterflow. This is due to sweating causing loss of Yang and cold deficiency in the Stomach. If sweating is induced again, it further damages Yang Qi, causing extreme deficiency of Stomach Qi, hence continuous vomiting and diarrhea.
After sweating, vomiting, or purging, deficiency vexation occurs with insomnia. If severe, the patient tosses and turns restlessly, feeling deeply troubled and stifled in the chest. Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is primarily indicated.
After sweating, vomiting, or purging, pathogenic heat enters the chest due to deficiency, termed "deficiency vexation," which is a heat syndrome. Vexation, heat, depression, and stifling in the chest without dispersion constitute this condition. Heat lurking internally favors sleep; now heat floats upward, disturbing Yang Qi, causing insomnia. The Heart dislikes heat; severe heat leads to mental confusion. Therefore, in severe cases, the patient tosses and turns restlessly, feeling deeply troubled and stifled. "Ao Nao" (deeply troubled) is colloquially known as "Hu Tu" (muddled/confused). The *Nei Jing* states: Where the pathology is high, use emesis to expel the pathogen. Administer Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) to emetic the pathogen from the chest.