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In cases of Shanghan (Cold Damage) where the patient desires to drink water, it is because the internal fluids are exhausted, and they seek external water for self-rescue. If the patient is extremely thirsty and wishes to drink one sheng (a unit of volume), only provide one bowl; always keep them slightly unsatisfied, do not allow excessive intake. If drinking is indulged in excessively, causing water retention under the heart, it results in Water Jie Xiong (Water Binding Chest); if retained in the stomach, it leads to dysphagia (Yi) or hiccups (Yue); if overflowing into the skin, it causes edema; if accumulating in the Lower Jiao (Lower Burner), it causes urinary difficulty (Long); if seeping into the intestines, it causes dysentery. All these are faults caused by excessive water intake.

However, water cannot be withheld entirely, nor can it be forced upon the patient. Thus it is said: "If proper treatment (regarding water intake) is not applied, forcing water consumption will inevitably generate other diseases."

In Yangming disease, where there is dryness in the mouth, a desire to drink water but no desire to swallow, it is because the heat is in the meridians, while there is no heat in the interior. This condition will likely result in epistaxis (nosebleed), and cooling medicines should not be administered.

Commentary: The issue of water intake is originally most suitable for those with extreme internal heat and severe Yang toxicity. It appears that this applies only to excess pathogens and not deficiency pathogens; however, deficiency patterns vary. For instance, in cases of Yang deficiency without fire, avoiding water is obvious. But in cases of Yin deficiency with flourishing fire, where Yuan Qi (Original Qi) is weak and essence and blood are depleted, symptoms such as cracked tongue, scorched lips, extreme thirst preferring cold drinks, burning sensation in the Three Jiao (Triple Burner), and constipation of both urine and feces are common. If one does not rely on Tian Yi Zhi Jing (Essence of Heaven One, referring to water/kidney essence) to relieve the urgent situation, what else can be done? Therefore, initially use ice water to resolve the superficial symptoms, followed by sweet-warm herbs to cultivate the root. Administering both water and medicine simultaneously is acceptable.

In cases presenting with true cold inside and false heat outside, or Yin exuberance repelling Yang, observing the Yuan Qi indicates that only sweet-warm tonic agents can restore vitality; observing the throat and tongue shows that even slight pungent-warm substances cannot be tolerated. In such cases, use only sweet-warm grand tonifying formulas, or simply decoct Ren Shen (Ginseng Radix) alone into a liquid, soak it in water until extremely cold, and then drink it. This uses the taste of false cold to resolve the false heat of the Upper Jiao, while the true warm nature restores the true Yang of the Lower Jiao. Although this is not using water as a direct cure, it essentially utilizes the principle of water. I have saved many lives using this method; it is truly ingenious.

However, in cases of false heat, although the symptoms appear hot, the pulse is faint, and although the mouth is dry/thirsty, urination and defecation are not obstructed. In such instances, if the patient desires water, it must absolutely not be given. If this contraindication is mistakenly violated, it will damage and drain the Yuan Yang (Original Yang), causing significant harm. Caution is essential.