【支饮之症】咳逆倚息，气短不得卧，其形如肿，即《金匮》支饮症也。
【支饮之因】饮邪偏注，停留曲折之间，盖肺与大肠之脉，下膈络肠，今饮积于中，
外不得达
，喘促而不得卧矣。形如肿者，水饮之外现也。
【支饮之脉】脉多沉紧，脉弦为水，脉弱可治，数实者死。其脉虚者，必苦眩晕。
【支饮之治】《金匮》曰∶膈间支饮，其人必喘，心下痞坚，面色黎黑，其脉沉紧，
得之十数日，医吐下之不愈，木防己汤；虚者即愈，实者三日复发，复与，不愈者，以前方去石
膏，加茯苓、芒硝主之。以胃有痰饮之积热，石膏止清无形气分之热，不能去有形痰饮之
实热，故易芒硝。又云∶心下有支饮，其人苦冒眩，泽泻汤主之。又云∶支饮胸满者，浓朴
大黄汤主之。支饮不得息，葶苈大枣汤主之。呕家本渴，今反不渴，心下有支饮故也，小半
夏汤。又云∶卒呕吐，心下痞，膈间有水，眩悸者，小半夏加茯苓。咳家，其脉弦，为有水
，十枣汤主之。夫有支饮家，咳烦，胸中痛，不卒死，至一百日，或一岁，十枣汤主之。咳
逆倚息不得卧，小青龙汤主之。外另有腹满口舌干燥，此肠间有水气，己椒苈黄丸主之。假
令瘦人脐下有悸，吐涎沫而颠眩，此水也，五苓散主之。
按此二条，非指定支饮而立说，大约统言水饮家之条目。
木防己汤
木防己 石膏 桂枝 人参
上四味，煮取一升，温服，愈后复发，去石膏，加芒硝。
泽泻汤 治心下有支饮，其人苦冒眩。
泽泻 白术
上二味，水二升，煮取一升，温服。
浓朴大黄汤 治支饮胸满者。
浓朴 大黄 枳实
上三味，以水五升，煮取二升温服。
葶苈大枣汤
葶苈子 大枣肉
先以水三升，煮枣取二升，去枣，纳葶苈子。
半夏汤
半夏 生姜
上二味，以水七升，煮一升服。
小半夏加茯苓汤
半夏 生姜 白茯苓
上三味，煮一升服。
十枣汤 见前悬饮门。
小青龙汤 见前溢饮门。
己椒苈黄丸
防己 椒目 葶苈 大黄
蜜丸如梧子大，日三服。
五苓散
泽泻 猪苓 白茯苓 白术 肉桂
上五味为末，暖水调服。
[Symptoms of Zhi Yin (Branching Fluid Retention)] Cough with qi reversal, leaning on objects to breathe, shortness of breath unable to lie flat, and the body appearing swollen. This is the symptom of Zhi Yin as described in *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet).
[Etiology of Zhi Yin] The pathogenic factor of fluid retention deviates and stagnates in the tortuous areas of the meridians. Since the meridians of the Lung and Large Intestine pass downward through the diaphragm and connect with the intestines, when fluid accumulation occurs internally, it cannot reach the exterior, leading to panting, urgency in breathing, and inability to lie flat. The appearance of swelling is the manifestation of water-fluid retention presenting externally.
[Pulse Diagnosis of Zhi Yin] The pulse is mostly Chen Jin (Deep and Tight). A Xian (Wiry) pulse indicates water; a Ruo (Weak) pulse indicates the condition is treatable; a Shu Shi (Rapid and Excess) pulse indicates a fatal prognosis. If the pulse is Xu (Deficient), the patient must suffer from dizziness and vertigo.
[Treatment of Zhi Yin] *Jin Gui Yao Lue* states: When there is Zhi Yin between the diaphragm, the patient will inevitably pant, have epigastric fullness and hardness, a dark complexion, and a Chen Jin pulse. After ten or more days, if the condition has not been cured by physicians using emesis or purgation, Mu Fang Ji Tang (Stephania Decoction) should be used. If the patient is Deficient, they will recover; if Excess, it will relapse after three days. Upon recurrence, if the same prescription fails to cure, remove Shi Gao (Gypsum) from the previous formula and add Fu Ling (Poria) and Mang Xiao (Mirabilite) as the main treatment. This is because there is accumulated heat from phlegm-fluid in the stomach; Shi Gao only clears the heat of formless Qi-level, but cannot eliminate the excess heat of formless phlegm-fluid, hence Mang Xiao is substituted. It also states: When there is Zhi Yin in the heart region (epigastrium), the patient suffers from severe dizziness and vertigo; Ze Xie Tang (Alisma Decoction) should be used. Furthermore: For Zhi Yin causing chest fullness, Nong Po Da Huang Tang (Magnolia Bark and Rhubarb Decoction) should be used. For Zhi Yin causing difficulty in breathing, Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction) should be used. Patients who vomit are usually thirsty; if they are not thirsty now, it is due to Zhi Yin in the heart region; Xiao Ban Xia Tang (Minor Pinellia Decoction) should be used. Additionally: Sudden vomiting, epigastric fullness, water between the diaphragm, dizziness, and palpitations are treated with Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia and Poria Decoction). For chronic coughers with a Xian pulse indicating water, Shi Zao Tang (Ten Date Decoction) should be used. For those with Zhi Yin who experience cough, irritability, and chest pain, if they do not die suddenly but survive for one hundred days or a year, Shi Zao Tang should still be used. For cough with qi reversal, leaning to breathe, and inability to lie flat, Xiao Qing Long Tang (Minor Green Dragon Decoction) should be used. Additionally, abdominal fullness with dry mouth and tongue indicates water gas in the intestines, treated with Ji Ding Li Huang Wan (Stephania, Zanthoxylum, Descurainia, and Rhubarb Pill). If a thin person experiences palpitations below the umbilicus, spitting out saliva and foam, and dizziness, this is water pathology, treated with Wu Ling San (Five-Ingredient Powder with Poria).
Note: These two passages are not specifically established for Zhi Yin alone, but generally summarize entries for all patients with fluid retention diseases.
Mu Fang Ji Tang (Stephania Decoction)
Ingredients: Mu Fang Ji (Stephaniae Tetrandrae Radix), Shi Gao (Gypsum Fibrosum), Gui Zhi (Cinnamomi Ramulus), Ren Shen (Ginseng Radix et Rhizoma).
Preparation: Boil the above four ingredients to obtain one sheng of liquid. Take warm. If it recurs after recovery, remove Shi Gao and add Mang Xiao.
Ze Xie Tang (Alisma Decoction)
Indication: Zhi Yin in the heart region, causing severe dizziness and vertigo.
Ingredients: Ze Xie (Alismatis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma).
Preparation: Boil the above two ingredients in two sheng of water to obtain one sheng. Take warm.
Nong Po Da Huang Tang (Magnolia Bark and Rhubarb Decoction)
Indication: Zhi Yin causing chest fullness.
Ingredients: Nong Po (Magnoliae Officinalis Cortex), Da Huang (Rhei Radix et Rhizoma), Zhi Shi (Aurantii Fructus Immaturus).
Preparation: Boil the above three ingredients in five sheng of water to obtain two sheng. Take warm.
Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction)
Ingredients: Ting Li Zi (Descurainiae Semen), Da Zao Rou (Sarcocarpus Jujubae).
Preparation: First boil jujubes in three sheng of water to obtain two sheng, remove the jujubes, and add Ting Li Zi.
Ban Xia Tang (Pinellia Decoction)
Ingredients: Ban Xia (Pinelliae Tuber), Sheng Jiang (Zingiberis Recens Rhizoma).
Preparation: Boil the above two ingredients in seven sheng of water to obtain one sheng. Take orally.
Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia and Poria Decoction)
Ingredients: Ban Xia (Pinelliae Tuber), Sheng Jiang (Zingiberis Recens Rhizoma), Bai Fu Ling (Poria).
Preparation: Boil the above three ingredients to obtain one sheng. Take orally.
Shi Zao Tang (Ten Date Decoction)
Reference: See the section on Xuan Yin (Hanging Fluid) previously.
Xiao Qing Long Tang (Minor Green Dragon Decoction)
Reference: See the section on Yi Yin (Overflowing Fluid) previously.
Ji Ding Li Huang Wan (Stephania, Zanthoxylum, Descurainia, and Rhubarb Pill)
Ingredients: Fang Ji (Stephaniae Tetrandrae Radix), Jiao Mu (Zanthoxyli Fructus), Ting Li (Descurainiae Semen), Da Huang (Rhei Radix et Rhizoma).
Preparation: Honey-pill size of wu zi (wutzu seeds). Take three times daily.
Wu Ling San (Five-Ingredient Powder with Poria)
Ingredients: Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Bai Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Rou Gui (Cinnamomi Cortex).
Preparation: Grind the above five ingredients into powder. Mix with warm water and take.