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(See above.) First thirst followed by vomiting indicates water retention in the epigastrium (stomach area). This belongs to the category of fluid retention diseases. This decoction is indicated for this condition.

Xi Zaizhi, hearing instructions from his father Ting, said: This section seems unrelated to the preceding text, but one does not know that when Master treats cough, the focus is on the two characters "water and fluid" (Shui Yin). Therefore, regarding the completion of the chapter, Yin Xiao Qing has cold and transforms and guides, able to use Chu Di Huang Wan.

(See Women's Miscellaneous Diseases.) Treats male Xiao Ke (wasting-thirst syndrome) where urination is excessive; drinking one dou results in urinating one dou. This pill is indicated for this condition.

You Zaijing said: Water fluids belong to Yin and cannot reach without Qi. Although Qi belongs to Yang, it actually contains water within. Water and Qi are neither identical nor completely separate. Without Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root) in the formula, how can one rouse the declining Yang of the Kidney, allowing Jing Qi (Essence Qi) to overflow and be transported upward to the Spleen and Lung?

(See Phlegm-Fluids.) Treats patients with a floating pulse, difficulty in urination, slight fever, and wasting-thirst. One should promote diuresis and induce sweating. It also treats cases where there is an urge to drink water, but vomiting occurs immediately after swallowing, known as "Water Reversal" (Shui Ni).

You Zaijing said: When heat causes thirst and the desire to drink, water intake cannot extinguish the heat, nor can the heat dissolve the water. Water and heat bind together, with heat floating outside the water, thus causing urinary difficulty and preventing the elimination of heat.

(The rhyme is found in *Changsha Fang Ge Kuo*.) Treats cases of persistent thirst and inability to stop drinking. This powder is indicated for this condition.

Nan Yuanxi noted: This differs from the Wen Ge San (Clam Shell Powder) syndrome discussed in *Shang Han Lun*. *Shang Han Lun* states: If millet-grain-like bumps appear on the skin and there is no thirst, it is due to water-cold soaking the Lungs and surging outward. Ben stops Bian.

Treats difficulty in urination accompanied by water qi (fluid accumulation). If the patient presents with thirst, this formula is appropriate.

Dioscoreae Rhizoma (Shu Yu), Poria (Fu Ling) (each 3 liang), Puerariae Radix (Gua Lou Gen) (2 liang), Aconiti Lateralis Radix Praeparata (Fu Zi) (1 piece, prepared), Impatiens Herba (Qu Mai) (1 liang).

Grind the above five herbs into powder. Mix with refined honey to make pills the size of wu zi (cibotium seeds). Take 2 pills with water, three times a day. If ineffective, increase gradually to 7 or 8 pills. The treatment is considered effective when urination becomes smooth and the abdomen feels warm.

The rhyme states: Difficulty in urination leads to thirst; water qi stagnates in the middle, failing to generate fluids. (Lower Jiao fire declines, Middle Jiao earth weakens; water qi remains in the middle, obstructing the movement of upper and lower energies.)

Nan Yuanxi noted: *Nei Jing* states: The Bladder is the official of the capital, storing fluids; only through Qi transformation can they be excreted. Regarding the meaning of "Qi transformation enables excretion," I borrow the principle. Although coal needs to be added under the pot, cool water must frequently be replaced on top. Taking the energy of the cool water assists its clear and descending nature, ensuring a continuous supply. In the formula, Gua Lou Gen clears heat in the Upper Jiao, which illustrates this principle. As for the pathway of urine excretion, although it should be addressed last, one must remove accumulated impurities to ensure patency. Qu Mai in the formula specifically unblocks the water pathways, clearing the source and treating the branches simultaneously. The note "abdominal warmth" at the end of the formula carries profound significance.