牡蛎（熬） 泽泻 栝蒌根 蜀漆（暖水洗去腥） 商陆根（熬） 海藻（洗去咸）
苦葶苈（熬）各等分
右七分，异捣下筛为散，更入臼中治之，白饮和服方寸匕，日三服，小便利，止后服
。
【方解】
水停于内，外泛作肿，腰以上者，当汗之，小青龙、越婢是也。腰以下者，当利小便
，此方是也。以牡蛎破水之坚，泽泻利水之蓄，海藻散水之泛，栝蒌根消水之肿，又
以蜀漆、苦葶苈、商陆根，辛苦有毒之品，直捣其巢，峻逐水气，使从大、小二便而
出。然此方施之于形气实者，其肿可随愈也，若病后土虚，不能制水，肾虚不能行水
，则又当别论，慎不可服也。
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大病差后，喜唾，久不了了，胸上有寒，当以丸药温之，宜理中丸。
【注】
大病差后，喜唾，久不了了者，胃中虚寒，不能运化津液，聚而成唾，故唾日久无已
时也，宜理中丸以温补其胃，自可已也。
【集注】
程知曰：病后阳气不足，胃中虚寒，不内津液，故喜唾不了了。前牡蛎泽泻用散者，
欲其恋肺而下水也；此理中用丸者，欲其温胃而收唾也。
喻昌曰：身中津液，因胃寒凝结而成浊唾，久而不清，其人必消瘦索泽，故不用汤药
荡涤，而用圆药缓图也。
张璐曰：伤寒差后体虚，每有遗热，故禁温补，即间有素禀虚寒者，祗宜理中圆调理
，未尝轻用桂、附也。
@@@
伤寒解后，虚羸少气，气逆欲吐，竹叶石膏汤主之。
【注】
伤寒解后虚羸，寒伤形也；少气，热伤气也；气逆欲吐，余邪挟饮犯胃也。故宜竹叶
石膏汤，益虚清热，以降逆气也。
【集注】
方有执曰：病后虚羸少气，脾胃未强，饮食难化，则痰饮易生，饮停气逆，故欲吐也
。
程知曰：伤寒解后，津液不足，则虚羸；余热不尽，则伤气，与竹叶石膏汤，以调胃
而去虚热。盖前条是治病后虚寒，此条是治病后虚热也。
牡蛎（煅制） 泽泻 栝蒌根 蜀漆（用温水洗涤以去除腥味） 商陆根（煅制） 海藻（洗涤以去除咸味）
苦葶苈（煅制） 各等分
以上七味药，分别捣碎并过筛制成散剂，再放入臼中进一步研磨均匀。用米汤调和，每次服用一方寸匕，每日三次。待小便通利后，停止后续服药。
【方解】
水饮停滞于体内，向外泛溢导致浮肿。若水肿在腰部以上，应当采用发汗法治疗，如小青龙汤、越婢汤即是此类。若水肿在腰部以下，应当采用利小便法治疗，此方（牡蛎泽泻散）即属此类。方中以牡蛎破除水饮之坚结，泽泻渗利水饮之蓄积，海藻消散水饮之泛溢，栝蒌根消除水饮之肿胀；又配合蜀漆、苦葶苈、商陆根这些辛苦有毒的药物，直捣病巢，峻猛驱逐水气，使水邪从大、小便排出。然而，此方仅适用于体质壮实之人，其肿可随之痊愈；若是大病之后脾气虚弱，不能制约水湿，或肾气虚弱，不能气化行水，则属于另一种情况，不可服用此方，务必谨慎。
@@@
大病初愈后，患者喜欢吐唾沫，长时间不能痊愈，这是因为胸中有寒邪，应当用丸药温补治疗，适宜使用理中丸。
【注】
大病初愈后，喜欢吐唾沫且久治不愈，是因为胃中虚寒，不能正常运化津液，津液凝聚而成唾沫，所以吐唾沫的症状日久不止。适宜使用理中丸来温补脾胃，症状自然可以痊愈。
【集注】
程知说：病后阳气不足，胃中虚寒，不能内守津液，所以喜欢吐唾沫且久不好。前条使用牡蛎泽泻散作散剂，是希望药物留恋于肺经从而下行排水；此处使用理中丸作丸剂，是希望温暖脾胃从而收敛唾沫。
喻昌说：体内的津液，因胃寒凝结而变成浑浊的唾沫，时间久了不能澄清，病人必定消瘦干枯，所以不用汤药荡涤，而用丸药缓慢图治。
张璐说：伤寒病愈后身体虚弱，常有余热残留，所以禁止温补；即使偶尔有素体虚寒的人，也只适宜用理中丸调理，未曾轻易使用桂枝、附子。
@@@
伤寒病解除后，身体虚弱消瘦，气息短少，气逆想呕吐，用竹叶石膏汤主治。
【注】
伤寒病解除后身体虚弱消瘦，是因为寒邪损伤了形体；气息短少，是因为热邪损伤了气机；气逆想呕吐，是因为残余邪气挟带痰饮侵犯胃腑。所以适宜使用竹叶石膏汤，益气养阴清热，以降逆止呕。
【集注】
方有执说：病后身体虚弱消瘦、气息短少，说明脾胃功能尚未恢复强健，饮食难以消化，则痰饮容易生成，饮邪停聚导致气逆，所以想呕吐。
程知说：伤寒病解除后，津液不足，所以身体虚弱消瘦；余热未尽，所以损伤气机。给予竹叶石膏汤，以调和胃气并清除虚热。前一条是治疗病后的虚寒证，这一条是治疗病后的虚热证。
Oyster Shell (Calcined) Alisma Rhizoma Trichosanthes Root Cladobotryum Mycelium (Washed with warm water to remove fishy odor) Phytolaccae Radix (Calcined) Sargassum Thallus (Washed to remove saltiness)
Perilla Seed (Calcined) Equal parts
The above seven herbs are individually crushed and sieved into a powder, then further ground in a mortar. Mix with rice water and administer one *cunbi* (a measure approx. 27g) per dose, three times daily. Discontinue use once urination becomes normal.
[Formula Analysis]
When fluid retention is internal and manifests externally as edema, if the swelling is above the waist, diaphoresis (sweating method) should be employed, such as Xiao Qing Long Tang (Minor Blue Dragon Decoction) or Yue Bi Tang (Crossing the House Decoction). If the swelling is below the waist, promoting urination should be employed; this formula (Mu Li Ze Xie San) belongs to this category. Oyster Shell breaks up the firmness of fluid retention; Alisma Rhizoma promotes the drainage of accumulated fluid; Sargassum Thallus dissipates overflowing fluid; Trichosanthes Root reduces fluid-induced swelling. Additionally, Cladobotryum Mycelium, Perilla Seed, and Phytolaccae Radix—herbs that are pungent, bitter, and toxic—are used to strike directly at the root of the disease, vigorously expelling fluid qi so that it exits through the large and small intestines. However, this formula is applicable only to patients with strong constitution and robust vital energy; their edema will resolve accordingly. If the condition arises after a major illness due to Spleen Qi deficiency failing to control water, or Kidney Qi deficiency failing to transform and move water, it constitutes a different pattern, and this formula must not be taken; caution is essential.
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After recovery from a major illness, the patient frequently spits saliva, which persists for a long time without resolution. This is due to Cold in the chest region. Treatment should involve pill medicine to warm the interior, specifically Li Zhong Wan (Regulate the Middle Pill).
[Annotation]
After recovery from a major illness, frequent spitting of saliva that persists indefinitely is caused by Deficiency-Cold in the Stomach, which fails to transport and transform body fluids. The fluids condense to form saliva, resulting in chronic salivation. Li Zhong Wan (Regulate the Middle Pill) should be used to warm and tonify the Stomach, leading to recovery.
[Collected Annotations]
Cheng Zhi stated: After illness, Yang Qi is insufficient, and there is Deficiency-Cold in the Stomach, preventing the retention of body fluids, hence the frequent spitting and lack of resolution. The previous section used Mu Li Ze Xie San (Oyster Shell and Alisma Powder) because its dispersing nature targets the Lung to drain water downward; here, Li Zhong Wan is used as a pill because its warming nature targets the Stomach to consolidate saliva.
Yu Chang stated: Body fluids, due to Stomach Cold congealing, become turbid saliva. If left unresolved for a long time, the patient will inevitably become emaciated and withered. Therefore, decoctions for drastic purging are not used; instead, pills are used for slow, gradual treatment.
Zhang Lu stated: After recovery from Shang Han (Cold Damage), the body is often deficient with residual heat remaining, thus warming and tonifying methods are contraindicated. Even in cases of inherent Deficiency-Cold, only Li Zhong Wan (Regulate the Middle Pill) is suitable for regulation; Gui Zhi Tang (Cinnamon Twig Decoction) and Fu Zi (Aconite Lateral Root) are rarely used lightly.
@@@
After the resolution of Shang Han (Cold Damage), the patient presents with emaciation, shortness of breath, and rebellious Qi causing nausea/vomiting. Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is the primary treatment.
[Annotation]
After the resolution of Shang Han (Cold Damage), emaciation indicates damage to the physical form by Cold; shortness of breath indicates damage to Qi by Heat; rebellious Qi and nausea indicate residual pathogenic factors carrying Fluid Retention invading the Stomach. Therefore, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is appropriate to tonify deficiency, clear heat, and descend rebellious Qi.
[Collected Annotations]
Fang Youzhi stated: After illness, emaciation and shortness of breath indicate that the Spleen and Stomach have not yet regained strength. Difficulty in digesting food leads to easy generation of Phlegm-Fluid. When Fluid Retention stagnates, it causes Qi rebellion, leading to nausea.
Cheng Zhi stated: After the resolution of Shang Han (Cold Damage), insufficiency of body fluids leads to emaciation; lingering residual heat damages Qi. Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is given to harmonize the Stomach and eliminate deficient heat. The previous clause treated post-illness Deficiency-Cold, while this clause treats post-illness Deficiency-Heat.