厚朴一尺 大黄六两 枳实四枚
右三味，以水五升，煮取二升，分温再服。
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心下有痰饮，胸□支满，目眩，苓桂术甘汤主之。
【注】
此承上条详出其证，以明其治也。心下有痰饮，谓痰饮之水流在膈间，故胸□支满；
支满则阻碍阳气，不得上通于头目，故目眩也。主以苓桂术甘汤者，利水而通阳气也
。
【集注】
李□曰：胸□支满，痰饮停滞于中也；目眩，阻遏阳气不上升也。茯苓淡渗以利水饮
，桂枝宣导以行阳气，白术去湿健脾，甘草和中益气，同为补土制水之剂。
（见上）
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腹满，口舌干燥，此肠间有水气，已椒苈黄圆主之。
【注】
此又承上条互详其证，以别其治也。心下有痰饮，喉间有漉漉声，肠间有水气，肠中
有沥沥声者，用苓桂术甘汤，即温药和之之法也。若更腹满，则水结实矣，口舌干燥
，则水不化矣。故以防己、椒目、葶苈、大黄，前后分攻水结，水结开豁，则腹满可
除。水化津生，则口燥可滋。小服而频，示缓治之意。稍增者，稍稍增服之。口中有
津液渴者，乃饮渴也。加芒硝者，以峻药力耳！
【集注】
李□曰：腹满，水聚于胃也。肠间有水气，则湿渍中焦，津液不为灌溉，故口舌干燥
。前云水走肠间，沥沥有声为痰饮，此肠间有水气，即痰饮也。
厚朴一尺，大黄六两，枳实四枚。
以上三味药，用水五升，煎煮至二升，分两次温服。
心下有痰饮（水液代谢障碍形成的病理产物停滞于体内），胸胁支撑胀满，头晕目眩，用苓桂术甘汤主治。
【注】
这是承接上一条详细阐述其症状，以明确治疗方法。心下有痰饮，是指痰饮的水流停留在膈膜之间，所以胸胁支撑胀满；
胸胁支满阻碍了阳气的运行，不能向上通达头目，所以出现头晕目眩。主治用苓桂术甘汤，是为了利水并通调阳气。
【集注】
李□说：胸胁支满，是痰饮停滞在中焦；头晕目眩，是阳气被阻遏而不能上升。茯苓淡渗利湿以排除水饮，
桂枝宣导以运行阳气，白术祛湿健脾，甘草调和中焦益气，共同构成补益脾胃以制约水邪的方剂。
腹部胀满，口舌干燥，这是肠间有水气，用已椒苈黄丸主治。
【注】
这又是承接上一条互相详述症状，以区别治疗方法。心下有痰饮，喉间有漉漉的水声，肠间有水气，肠中有沥沥的水声，使用苓桂术甘汤，这就是“温药和之”的治疗方法。如果再加上腹部胀满，说明水邪已经结实；口舌干燥，说明水液不能化为津液。因此用防己、椒目、葶苈子、大黄，前后分消水结，水结散开，则腹部胀满可除。水液代谢正常，津液生成，则口燥可滋润。少量多次服用，表示缓治的意思。“稍增”，是稍微增加药量服用。口中若有津液且感到口渴，这是饮水后的口渴。加芒硝，是为了增强药力！
【集注】
李□说：腹部胀满，是水邪聚集在胃脘。肠间有水气，则湿气浸渍中焦，津液不能输布灌溉全身，所以口舌干燥。
前面说水走肠间，沥沥有声称为痰饮，这里说肠间有水气，也就是痰饮。
Houpo (Magnoliae Officinalis Cortex) one chi, Dahuang (Rhei Radix et Rhizoma) six liang, Zhishi (Aurantii Fructus Immaturus) four pieces.
The above three herbs, with five sheng of water, decocted to obtain two sheng, divided into two doses and taken warm.
When there is Phlegm-Fluid (Tan-Yin, pathological fluid retention due to impaired water metabolism) under the heart, with a sensation of fullness and distension supporting in the chest and hypochondrium, and vertigo, Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractodes, and Licorice Decoction) is the primary formula.
[Note]
This follows the previous clause to detail the symptoms, thereby clarifying the treatment. "Phlegm-Fluid under the heart" refers to the flow of Phlegm-Fluid stagnating between the diaphragm, hence the sensation of fullness and distension supporting in the chest and hypochondrium;
This support obstructs the Yang Qi, preventing it from ascending to the head and eyes, thus causing vertigo. The primary use of Ling Gui Zhu Gan Tang is to promote urination to remove fluids and unblock Yang Qi.
[Collected Notes]
Li [Qian] said: Fullness and distension supporting in the chest and hypochondrium indicate Phlegm-Fluid stagnation in the middle jiao; vertigo indicates that Yang Qi is blocked and cannot ascend. Poria (Fuling) is light and penetrating to promote urination and drain fluid; Cinnamon Twig (Guizhi) guides and directs to circulate Yang Qi; Atractodes (Baizhu) removes dampness and strengthens the Spleen; Licorice (Gancao) harmonizes the middle and benefits Qi. Together, they form a formula that tonifies Earth (Spleen/Stomach) to control Water.
Abdominal fullness and dryness of the mouth and tongue indicate that there is Water-Qi (abnormal accumulation of water) in the intestines; Yi Jiao Li Huang Wan (Evodia Seed, Lepidium Seed, Thladiantha Fruit, and Rhubarb Pill) is the primary formula.
[Note]
This again follows the previous clause to mutually detail the symptoms, distinguishing the treatments. When there is Phlegm-Fluid under the heart, with a gurgling sound in the throat, and Water-Qi in the intestines, with a sloshing sound in the bowels, Ling Gui Zhu Gan Tang is used; this is the method of "harmonizing with warm medicines." If abdominal fullness is added, it indicates that the Water has become solidified; dryness of the mouth and tongue indicates that the Water fails to transform into Jin-Ye (body fluids). Therefore, Fangji (Stephania Root), Jiaomu (Perilla Leaf/Seed - *Note: Context implies Perilla fruit/seed or similar diuretic, often interpreted as Jiaomu in this context*), Tingli (Thladianthae Fructus), and Dahuang are used to attack the Water-solidification from both front and back. Once the Water-solidification is resolved, abdominal fullness can be eliminated. As Water transforms and Jin-Ye generates, oral dryness can be moistened. Taking small doses frequently indicates a gentle treatment approach. "Slightly increasing" means slightly increasing the dosage. If there are saliva in the mouth but thirst persists, it is thirst caused by drinking. Adding Mangxiao (Natrii Sulfas) is to enhance the potency of the medicine!
[Collected Notes]
Li [Qian] said: Abdominal fullness indicates Water gathering in the Stomach. Water-Qi in the intestines causes dampness to soak the middle jiao, so Jin-Ye is not distributed for irrigation, resulting in dryness of the mouth and tongue.
Previously, it was stated that Water moving through the intestines with a sloshing sound is called Phlegm-Fluid; here, Water-Qi in the intestines is also Phlegm-Fluid.