苓令也。号令之令矣。通行津液。克伐肾邪。专为号令者。苓之功也。五苓之中。茯苓
为主。故曰五苓散。茯苓味甘平。猪苓味甘平。甘虽甘也。终归甘淡。内经曰。淡味渗
泄为阳。利大便曰攻下。利小便曰渗泄。水饮内蓄。须当渗泄之。必以甘淡为主。是
以茯苓为君。猪苓为臣。白术味甘温。脾恶湿。水饮内蓄。则脾气不治。益脾胜湿。必
以甘为助。故以白术为佐。泽泻味咸寒。内经曰。咸味下泄为阴。泄饮导溺。必以咸
为助。故以泽泻为使。桂味辛热。肾恶燥。水蓄不行。则肾气燥。内经曰。肾恶燥。急食
辛以润之。散湿润燥。故以桂枝为使。多饮暖水。令汗出愈者。以辛散水气外泄。是
以汗润而解也。
茯苓（君十八铢） 猪苓（臣十八铢去皮） 白术（佐十八铢） 泽泻（使一两六铢） 桂枝（使半两去皮）
上五味。捣为散。以白饮和服方寸七。日三服。多饮暖水。汗出愈。如法将息。
心肺在膈上为阳。肾肝在膈下为阴。此上下脏也。脾胃应土。处在中州。在五脏曰
孤脏。属三焦曰中焦。自三焦独治在中。一有不调。此丸专治。故名曰理中丸。人参
味甘温。内经曰。脾欲缓。急食甘以缓之。缓中益脾。必以甘为主。是以人参为君。白
术味甘温。内经曰。脾恶湿。甘胜湿。温中胜湿。必以甘为助。是以白术为臣。甘草味
甘平。内经曰。五味所入。甘先入脾。脾不足者。以甘补之。补中助脾。必先甘剂。是以
甘草为佐。干姜味辛热。喜温而恶寒者胃也。胃寒则中焦不治。内经曰。寒湿所胜。
平以辛热。散寒温胃。必先辛剂。是以干姜为使。脾胃居中。病则邪气上下左右无
所不至。故又有诸加减焉。若脐下筑者。肾气动也。去白术加桂。气壅而不泄。则筑
然动。白术味甘补气。去白术则气易散。桂辛热。肾气动者。欲作奔豚也。必服辛味
以散之。故加桂以散肾气。经曰。以辛入肾。能泄奔豚气故也。吐多者去白术。加生
姜。气上逆者则吐多。术甘而壅。非气逆者之所宜也。千金方曰。呕家多服生姜。此
是呕家圣药。生姜辛散。是于吐多者加之。下多者还用术。气泄而不收。则下多。术
甘壅补。使正气收而不泄也。或曰湿胜则濡泄。术专除湿。是于下多者加之。悸者
加茯苓。饮聚则悸。茯苓味甘。渗泄伏水。是所宜也。渴欲得水者加术。津液不足则
渴。术甘以补津液。腹中痛者加人参。虚则痛。本草曰。补可去弱。即人参羊肉之属
是也。寒多者加干姜。辛能散也。腹满者去白术。加附子。内经曰。甘者令人中满。术
甘壅补。于腹满者则去之。附子味辛热。寒气壅郁腹为之满。以热胜寒。以辛散满。
故加附子。内经曰。热者寒之。寒者热之。此之谓也。
人参（君） 白术（臣） 甘草（佐炙） 干姜（使各三两）
上四味。捣筛蜜丸。如鸡子黄许大。以沸汤数合。和一丸。 碎温服之。日三四。夜二服。
这是关于“苓”字的解释。所谓“苓”，取号令之意。它能通行津液，克制肾邪。专门起到号令作用的，就是茯苓的功效。在五苓散中，茯苓是主药，所以称为五苓散。茯苓味甘、性平；猪苓味甘、性平。虽然都言其甘，但最终归于甘淡之性。《内经》说：“淡味具有渗泄作用，属于阳。”利大便称为攻下，利小便称为渗泄。水饮内停蓄积，必须用渗泄的方法治疗，必须以甘淡的药物为主。因此，以茯苓为君药，猪苓为臣药。白术味甘、性温。脾脏厌恶湿气，水饮内停蓄积，则脾气不能正常运化。要补益脾气、胜湿燥，必须以甘味药物作为辅助。所以，以白术为佐药。泽泻味咸、性寒。《内经》说：“咸味具有下泄作用，属于阴。”泄除水饮、引导小便，必须以咸味药物作为辅助。所以，以泽泻为使药。桂枝味辛、性热。肾脏厌恶燥气，水饮蓄积不行，则肾气干燥。《内经》说：“肾脏厌恶燥气，应当急食辛味药物来滋润它。”发散水气、湿润燥气，所以以桂枝为使药。服用后多饮暖水，令身体出汗而痊愈的，是因为辛味能发散水气使其从体表泄出，从而汗出滋润而病解。
茯苓（君药，十八铢） 猪苓（臣药，十八铢，去皮） 白术（佐药，十八铢） 泽泻（使药，一两六铢） 桂枝（使药，半两，去皮）
以上五味药，捣碎制成散剂。用米汤调和，每次服用一方寸匕，每日三次。服药后多饮暖水，待身体出汗即可痊愈。按照上述方法调养护理。
心肺位于膈肌之上，属阳；肾肝位于膈肌之下，属阴。这是上下的脏腑。脾胃对应土行，处于中州之地。在五脏中称为孤脏，在三焦中属于中焦。既然三焦唯独治理在中部，一旦有不协调，此丸剂专门用于治疗，所以命名为理中丸。人参味甘、性温。《内经》说：“脾脏想要舒缓，应当急食甘味药物来缓和它。”缓和中焦、补益脾气，必须以甘味药物为主。因此，以人参为君药。白术味甘、性温。《内经》说：“脾脏厌恶湿气，甘味能胜湿。”温中焦、胜湿气，必须以甘味药物作为辅助。因此，以白术为臣药。甘草味甘、性平。《内经》说：“五味入五脏，甘味先入脾。”脾脏虚弱时，用甘味药物补益它。补益中焦、帮助脾气，必须先使用甘味药剂。因此，以甘草为佐药。干姜味辛、性热。胃喜温而恶寒。胃寒则中焦功能失调。《内经》说：“寒湿偏胜时，用辛热药物平抑它。”发散寒气、温暖胃腑，必须先使用辛味药剂。因此，以干姜为使药。脾胃位居中部，生病时邪气会上下左右无所不至，所以又有各种加减变化的方剂。如果感到脐下有跳动感的，是肾气动扰的表现。去掉白术，加入桂枝。气机壅滞而不能宣泄，就会出现筑筑跳动的感觉。白术味甘补气，去掉白术则气容易消散。桂枝味辛性热，肾气动扰者，欲发为奔豚病。必须服用辛味药物来消散它，所以加入桂枝以消散肾气。经书说：“辛味入肾，能泄奔豚之气。”呕吐较多者，去掉白术，加入生姜。气机上逆则呕吐较多。白术味甘且性质壅滞，不适合气机上逆的情况。《千金方》说：呕吐患者多服生姜，这是治疗呕吐的圣药。生姜味辛能发散，所以在呕吐较多者中加入。腹泻较多者，仍需用白术。气机泄脱而不能收敛，则导致腹泻过多。白术味甘且能壅补，使正气收敛而不外泄。有人说：湿气偏胜则导致濡泄，白术专门除湿，所以在腹泻较多者中加入。心悸者，加入茯苓。水饮聚结则导致心悸。茯苓味甘，能渗泄潜伏的水饮，这是适宜的。口渴想喝水者，加入白术。津液不足则口渴。白术味甘能补生津液。腹中疼痛者，加入人参。虚证则疼痛。《本草》说：“补法可以去除虚弱”，即如人参、羊肉之类的药物。寒气多者，加入干姜。辛味能发散寒气。腹部胀满者，去掉白术，加入附子。《内经》说：“甘味使人中焦胀满。”白术味甘且性质壅补，对于腹部胀满者则应去掉。附子味辛性热。寒气壅郁导致腹部胀满。用热性药胜寒邪，用辛味药散胀满，所以加入附子。《内经》说：“热证用寒药治疗，寒证用热药治疗。”说的就是这个道理。
人参（君药） 白术（臣药） 甘草（佐药，炙） 干姜（使药，各三两）
以上四味药，捣碎过筛，炼蜜为丸，大小如鸡蛋黄。用沸水少许，将一丸药溶化，温服。每日三四次，夜间两次。
This is an explanation of the character "Ling" (苓). The term "Ling" implies the meaning of command or order. It can circulate body fluids and subdue pathogenic factors in the Kidney. The function that specifically acts as a commander belongs to Poria (Fuling, 茯苓). In Wuling San (Five-Ingredient Powder with Poria), Poria is the principal herb, hence the name Wuling San. Poria has a sweet taste and neutral nature; Polyporus (Zhuling, 猪苓) also has a sweet taste and neutral nature. Although both are described as sweet, they ultimately return to a sweet and bland nature. The *Neijing* states: "Bland flavors have seeping and draining actions, which belong to Yang." Draining stool is called purgation, while draining urine is called seepage and drainage. When water and fluid accumulate internally, seepage and drainage methods must be employed, primarily using herbs with sweet and bland properties. Therefore, Poria is used as the Sovereign (Jun, 君) herb, and Polyporus as the Minister (Chen, 臣) herb. Atractylodes Macrocephala (Baizhu, 白术) has a sweet taste and warm nature. The Spleen dislikes dampness. When water and fluid accumulate internally, the Spleen Qi fails to govern properly. To benefit the Spleen and overcome dampness, sweet herbs must serve as assistance. Thus, Atractylodes Macrocephala is used as the Assistant (Zuo, 佐) herb. Alisma (Zexie, 泽泻) has a salty taste and cold nature. The *Neijing* states: "Salty flavors have downward-draining actions, which belong to Yin." To drain fluid and guide urination, salty herbs must serve as assistance. Thus, Alisma is used as the Envoy (Shi, 使) herb. Cinnamon Twig (Guizhi, 桂枝) has a pungent taste and hot nature. The Kidney dislikes dryness. When water accumulates and fails to move, the Kidney Qi becomes dry. The *Neijing* states: "The Kidney dislikes dryness; one should urgently consume pungent foods to moisten it." To disperse water qi and moisten dryness, Cinnamon Twig is used as an Envoy herb. Drinking plenty of warm water after administration causes sweating and recovery because the pungent flavor disperses water qi outwardly through the skin, leading to resolution via moistening sweat.
Poria (Sovereign, 18 zhu) Polyporus (Minister, 18 zhu, peeled) Atractylodes Macrocephala (Assistant, 18 zhu) Alisma (Envoy, 1 liang 6 zhu) Cinnamon Twig (Envoy, half liang, peeled)
Crush the above five ingredients into a powder. Mix with rice water and take one fangcun bi (a square-inch measure) per dose, three times daily. Drink plenty of warm water afterwards; recovery occurs when sweat appears. Follow these instructions for care.
The Heart and Lung are located above the diaphragm and belong to Yang; the Kidney and Liver are located below the diaphragm and belong to Yin. These are the upper and lower Zang organs. The Spleen and Stomach correspond to Earth and reside in the Central Region. Among the Five Zang organs, it is called the Solitary Organ; within the Triple Burner, it belongs to the Middle Jiao. Since the Triple Burner uniquely governs the middle, any dysfunction here is specifically treated by this pill, hence its name Lizhong Wan (Regulate the Middle Pill). Ginseng has a sweet taste and warm nature. The *Neijing* states: "The Spleen desires relaxation; urgently consume sweet foods to relax it." To relax the middle and benefit the Spleen, sweet herbs must be primary. Therefore, Ginseng is used as the Sovereign herb. Atractylodes Macrocephala has a sweet taste and warm nature. The *Neijing* states: "The Spleen dislikes dampness; sweet flavors overcome dampness." To warm the middle and overcome dampness, sweet herbs must serve as assistance. Therefore, Atractylodes Macrocephala is used as the Minister herb. Licorice Root (Gancao, 甘草) has a sweet taste and neutral nature. The *Neijing* states: "Of the five flavors, sweet enters the Splel first." When the Spleen is deficient, use sweet herbs to tonify it. To tonify the middle and assist the Spleen, sweet agents must be prioritized. Therefore, Licorice Root is used as the Assistant herb. Dried Ginger (Ganjiang, 干姜) has a pungent taste and hot nature. The Stomach prefers warmth and dislikes cold. If the Stomach is cold, the Middle Jiao fails to govern. The *Neijing* states: "When cold-damp prevails, pacify it with pungent-hot agents." To disperse cold and warm the Stomach, pungent agents must be prioritized. Therefore, Dried Ginger is used as the Envoy herb. The Spleen and Stomach occupy the center; when diseased, pathogenic factors can reach anywhere up, down, left, or right. Hence, there are various modifications. If there is a throbbing sensation below the umbilicus, it indicates Kidney Qi moving. Remove Atractylodes Macrocephala and add Cinnamon Twig. When Qi stagnates without draining, a throbbing sensation occurs. Atractylodes Macrocephala is sweet and tonifies Qi; removing it allows Qi to scatter easily. Cinnamon Twig is pungent and hot. For moving Kidney Qi, which threatens to become Ben Tun (Rushing Pig disease), pungent herbs must be consumed to disperse it. Thus, Cinnamon Twig is added to disperse Kidney Qi. The classics state: "Pungent flavors enter the Kidney and can drain Ben Tun Qi." If vomiting is frequent, remove Atractylodes Macrocephala and add Fresh Ginger. When Qi rebels upward, vomiting increases. Atractylodes Macrocephala is sweet and cloying/stagnant, unsuitable for rebellious Qi. The *Qianjin Fang* states: "Vomit-prone patients often take Fresh Ginger; this is the holy medicine for vomiting." Fresh Ginger is pungent and dispersing, so it is added for frequent vomiting. If diarrhea is frequent, continue using Atractylodes Macrocephala. When Qi leaks and cannot consolidate, frequent diarrhea results. Atractylodes Macrocephala is sweet and consolidating/tonifying, helping righteous Qi to consolidate and not leak. Some say: When dampness prevails, loose stools occur; Atractylodes Macrocephala specifically removes dampness, so it is added for frequent diarrhea. For palpitations, add Poria. When fluid accumulation gathers, palpitations occur. Poria is sweet and drains latent water, which is appropriate. For thirst desiring water, add Atractylodes Macrocephala. When body fluids are insufficient, thirst occurs. Atractylodes Macrocephala is sweet and generates fluids. For abdominal pain, add Ginseng. Deficiency causes pain. The *Bencao* states: "Tonification can remove weakness," referring to substances like Ginseng and mutton. For excessive cold, add Dried Ginger. Pungent flavors can disperse cold. For abdominal fullness, remove Atractylodes Macrocephala and add Aconite Root (Fuzi, 附子). The *Neijing* states: "Sweet flavors cause central fullness." Atractylodes Macrocephala is sweet and cloying/tonifying, so it is removed for abdominal fullness. Aconite Root is pungent and hot. Cold qi stagnation and depression cause abdominal fullness. Use hot herbs to overcome cold and pungent herbs to disperse fullness; thus, Aconite Root is added. The *Neijing* states: "Treat heat with cold, treat cold with heat." This refers to such cases.
Ginseng (Sovereign) Atractylodes Macrocephala (Minister) Licorice Root (Assistant, honey-fried) Dried Ginger (Envoy, each 3 liang)
Crush and sieve the above four ingredients. Form pills with refined honey, size of a chicken egg yolk. Dissolve one pill in a few ounces of boiling water. Take warm. Three to four times daily, two times at night.