（论三首 律三条 法一十四条）
喻昌曰∶痰饮为患，十人居其七八。《金匮》论之最详，分别而各立其名。后世以其名之多也，徒徇其末而忘其本。
曾不思圣人立法，皆从一源而出，无多歧也。盖胃为水谷之海，五脏六腑之大源。饮入于胃，游溢精气，上输于脾；脾
气散精，上归于肺，通调水道，下输膀胱；水精四布，五经并行，以为常人。《金匮》即从水精不四布，五经不并行之处，
以言其患。谓人身所贵者水也，天一生水，乃至充周流灌，无处不到。一有瘀蓄，即如江河回薄之处，秽 丛积，水道
日隘，横流旁溢，有所不免。必顺其性因其势而疏导之，由高山而平川，由平川而江海，庶得免乎泛滥。所以仲景分别
浅深，诲人因名以求其义焉。浅者在于躯壳之内，脏腑之外，其名有四∶曰痰饮、曰悬饮、曰溢饮、曰支饮。痰饮者，
水走肠间，沥沥有声。悬饮者，水流胁下，咳唾引痛。溢饮者，水流行于四肢，汗不出而身重。支饮者，咳逆倚息短气，
其形如肿。一由胃而下流于肠，一由胃而旁流于胁，一由胃而外出于四肢，一由胃而上入于胸膈，始先不觉，日积月累，
水之精华，转为混浊，于是遂成痰饮。必先团聚于呼吸大气难到之处，故由肠而胁，而四肢，至渐渍于胸膈，其势愈逆
矣。痰饮之患，未有不从胃起者矣。其深者，由胃上入阳分，渐及于心肺。由胃下入阴分，渐及于脾肝肾。故水在心，
心下坚筑短气，恶水不欲饮，缘水攻于外，火衰故水益坚。火郁于内，气收故筑动短气，火与水为仇，故恶而不饮也。
水在肺，吐涎沫，欲饮水，缘肺主气，行荣卫，布津液，水邪入之，则塞其气道，气凝则液聚，变成涎沫，失其清肃，
故引水自救也。水在脾，少气身重，缘脾恶湿，湿胜则气虚而身重也。水在肝，胁下支满，嚏而痛，缘肝与胆为表里，
经脉并行于胁，火气冲鼻则嚏，吊胁则痛也。水在肾，心下悸，缘肾水凌心，逼处不安，又非支饮邻国为壑之比矣。夫
五脏藏神之地也，积水泛为痰饮，包裹其外。诗有谓波撼岳阳城者，情景最肖，讵非人身之大患乎？然此特随其所在，
辨名定位，以祈治不乖方耳。究竟水所蓄聚之区，皆名留饮，留者留而不去也。留饮去而不尽者，皆名伏饮，伏者伏而
不出也。随其痰饮之或留或伏，而用法以治之，始为精义。昌试言之，由胃而上，胸膈心肺之分者，驱其所留之饮还胃，
下从肠出，或上从呕出，其出皆直截痛快，而不至于伏匿，人咸知之。若由胸膈而外出肌肤，其清者或从汗出，其浊
者无可出矣，必还返于胸膈。由胸膈还返于胃，乃可入肠而下出驱之，必有伏匿肌肤而不胜驱者。若由胸膈而深藏于背，
背为胸之府，更无出路，尤必还返胸膈，始得趋胃趋肠而顺下。岂但驱之不胜驱，且有挟背间之狂阳壮火，发为痈毒，
结如橘囊者。伏饮之艰于下出，易于酿祸，其谁能辨之，谁能出之耶？昌以静理而谭医施治，凿凿有据，谨因《金匮》
秘典，直授金针，令业医之子，已精而益求其精耳。
（论说三篇，律条三条，法则十四条）
喻昌说：痰饮为害，十个人中有七八个患病。《金匮要略》对此论述最为详尽，分别列举并各自确立名称。后世因为名称繁多，只是盲目追随末节而忘记了根本。
未曾思考圣人制定法则，都是从同一个源头而出，没有多条歧路。胃是受纳水谷的仓库，也是五脏六腑的大源泉。水饮进入胃中，游溢精气，向上输送到脾；脾气散布精微物质，向上归于肺，通调水道，向下输送到膀胱；水液精华四布全身，五条经脉并行运行，这是正常人的状态。《金匮要略》正是从水液精华不能四布、五经不能并行之处，来阐述其病患。认为人身所珍贵的是水，天一生水，以至于充盈周流灌溉，无处不到。一旦有瘀滞蓄积，就像江河回旋湍急之处，污秽丛生积聚，水道日益狭窄，横流旁溢，在所难免。必须顺应其本性，根据其势态进行疏导，使其由高山流向平川，由平川流向江海，这样才可以避免泛滥成灾。所以张仲景分别病位的浅深，教导人们通过名称来探求其义理。病位浅的在躯壳之内，脏腑之外，名称有四类：叫作痰饮、悬饮、溢饮、支饮。所谓痰饮，是水液走窜于肠间，沥沥有声。所谓悬饮，是水液流注于胁下，咳嗽吐唾时牵引疼痛。所谓溢饮，是水液流行于四肢，无汗且身体沉重。所谓支饮，是咳嗽气逆，倚靠呼吸，短气，身形浮肿。一种是由胃向下流入肠道，一种是由胃向旁流注胁下，一种是由胃向外出于四肢，一种是由胃向上进入胸膈。起初并不觉得异常，日积月累，水的精华转化为混浊，于是便形成痰饮。必定先团聚于呼吸之气难以到达的地方，所以由肠而胁，而四肢，逐渐浸渍于胸膈，其病势愈发逆乱。痰饮的病患，没有不从胃发起的。病位深的，由胃向上进入阳分，逐渐波及心肺；由胃向下进入阴分，逐渐波及脾肝肾。所以水邪在心，心下坚硬悸动，短气，厌恶水而不想喝水，这是因为水邪攻冲于外，心火衰弱所以水更加坚凝。火郁结于内，气机收敛所以悸动短气，火与水互为仇敌，所以厌恶水而不欲饮用。水邪在肺，吐出涎沫，想要喝水，这是因为肺主气，运行营卫，布散津液，水邪侵入其中，则堵塞气道，气机凝滞则津液聚结，变成涎沫，失去清肃功能，所以引水自救。水邪在脾，少气身重，这是因为脾恶湿，湿气胜则气虚而身体沉重。水邪在肝，胁下支撑胀满，打喷嚏时疼痛，这是因为肝与胆互为表里，经脉并行于胁部，火气冲鼻则打喷嚏，牵吊胁肋则疼痛。水邪在肾，心下悸动，这是因为肾水凌犯心脏，逼迫心神不安，这已经不是支饮那种邻国为壑（比喻祸患转移给他人或局部）的情况了。五脏是藏神的地方，积水泛溢为痰饮，包裹在五脏之外。诗经中说“波涛撼动岳阳城”，情景最相似，这难道不是人身的大患吗？然而这只是随着水邪所在部位，辨别名称确定位置，以祈求治疗不违背法度罢了。究竟水液蓄积聚集的区域，都叫作留饮，留是指停留不去。留饮去而不尽的，都叫作伏饮，伏是指潜伏不出。根据痰饮的或留或伏，采用相应的治法来治疗，这才是精微义理。我尝试论述一下，由胃向上，涉及胸膈心肺部位的，驱除其停留的水饮回归胃中，向下从肠道排出，或向上从呕吐排出，这种排出方式直截痛快，不至于潜伏隐匿，大家都知晓。如果由胸膈向外达肌肤，清稀的或许随汗排出，浑浊的就没有出路了，必须返回胸膈。由胸膈返回胃中，才能进入肠道向下排出进行驱除，必然有潜伏在肌肤而无法被驱除的。如果由胸膈深藏于背部，背为胸之府，更没有出路，尤其必须返回胸膈，才能趋向胃和肠而顺行向下。岂止是驱除不胜驱除，还有挟带背部间的狂阳壮火，发作成为痈毒，结块如橘囊一样。伏饮难以向下排出，容易酿成祸患，谁能辨别它，谁能排出它呢？我以静心思理来谈论医学施治，确凿有据，谨依据《金匮要略》这部秘典，直接传授关键诀窍，让从事医学的人，已经精通的基础上进一步追求精湛罢了。
(Three Treatises, Three Laws, Fourteen Methods)
Yu Chang stated: Phlegm-fluid retention (Tan Yin) causes harm in seven or eight out of ten people. The *Jingui Yaolue* discusses this most comprehensively, distinguishing them and establishing names for each. Later generations, due to the multitude of names, merely followed the superficial details while forgetting the root.
They failed to consider that the laws established by the Sages all emanate from a single source, without divergent paths. The Stomach is the sea of water and grain, the great source of the five zang and six fu organs. When fluids enter the Stomach, their essence and qi roam and overflow, moving upward to the Spleen; the Spleen's qi scatters the refined essence, sending it upward to return to the Lung, which regulates the water passages and transports them downward to the Bladder; the fluid essence distributes throughout the four directions, and the five meridians run in parallel, constituting the state of a normal person. The *Jingui Yaolue* elaborates on pathology precisely where the fluid essence fails to distribute and the five meridians fail to run in parallel. It posits that what is precious in the human body is water; "Heaven generates Water," which fills, circulates, and irrigates everywhere. Once there is stagnation and accumulation, it is like the turbulent areas of rivers and lakes where filth gathers, causing the water channels to narrow daily, leading inevitably to lateral overflow. One must follow its nature and utilize its momentum to guide and dredge it, allowing it to flow from high mountains to plains, and from plains to rivers and seas, thereby avoiding catastrophic flooding. Thus, Zhang Zhongjing distinguished the depth and shallowness of the disease, instructing people to seek its meaning through its names. Shallow cases lie within the body shell but outside the zang-fu organs, with four names: Tan Yin (Phlegm-Fluid), Xuan Yin (Hanging Fluid), Yi Yin (Overflowing Fluid), and Zhi Yin (Supporting Fluid). Tan Yin refers to water moving through the intestines, producing a gurgling sound. Xuan Yin refers to water flowing under the hypochondrium, causing pain upon coughing or spitting. Yi Yin refers to water circulating in the four limbs, accompanied by anhidrosis and heaviness of the body. Zhi Yin refers to coughing with air reversal, reliance on breathing, shortness of breath, and a swollen appearance. One type flows downward from the Stomach into the intestines; one flows laterally from the Stomach to the hypochondrium; one emerges outwardly from the Stomach to the four limbs; one enters upwardly from the Stomach into the chest and diaphragm. Initially unnoticed, day after day and month after month, the essence of water transforms into turbidity, thus forming Phlegm-Fluid. It must first gather in areas where respiratory qi cannot easily reach; therefore, from the intestines to the hypochondrium, to the limbs, gradually infiltrating the chest and diaphragm, the pathological momentum becomes increasingly rebellious. There is no case of Phlegm-Fluid that does not originate from the Stomach. Deep cases move upward from the Stomach into the Yang aspect, gradually affecting the Heart and Lungs; downward from the Stomach into the Yin aspect, gradually affecting the Spleen, Liver, and Kidneys. Therefore, when water is in the Heart, there is hardness and palpitations below the heart, shortness of breath, aversion to water, and lack of desire to drink. This is because water attacks externally, and since Heart Fire is deficient, water becomes more solid. Fire is depressed internally, causing qi to contract, leading to palpitations and shortness of breath; since Fire and Water are enemies, one avers water and does not drink. When water is in the Lung, there is expectoration of saliva and foam, and a desire to drink. This is because the Lung governs qi, circulates Ying and Wei, and distributes body fluids; when pathogenic water invades, it blocks the airway, causing qi stagnation and fluid aggregation, turning into saliva and foam, losing its clear and descending function, thus prompting the intake of water for self-rescue. When water is in the Spleen, there is shortness of qi and heaviness of the body. This is because the Spleen dislikes dampness; when dampness prevails, qi becomes deficient and the body feels heavy. When water is in the Liver, there is fullness and distension under the hypochondrium, and pain upon sneezing. This is because the Liver and Gallbladder are interior-exterior pairs, with meridians running parallel along the hypochondrium; fire qi rushing to the nose causes sneezing, and pulling on the hypochondrium causes pain. When water is in the Kidney, there are palpitations below the heart. This is because Kidney Water overcomes the Heart, forcing the Shen to be uneasy; this is not comparable to the situation of Zhi Yin where neighboring states act as ditches (metaphor for shifting disaster). The five zang organs are the residence of the Shen; accumulated water overflows into Phlegm-Fluid, wrapping around them externally. The *Shi Jing* (Classic of Poetry) says, "Waves shake Yueyang City," which best resembles the scenario; is this not a major affliction of the human body? However, this merely identifies names and locates positions according to where the water resides, hoping that treatment will not deviate from the correct methods. Ultimately, areas where water accumulates are all named Liú Yǐn (Retained Fluid), where "retained" means staying and not departing. Retained fluid that is not completely expelled is named Fú Yǐn (Hidden Fluid), where "hidden" means lurking and not emerging. Treating according to whether the Phlegm-Fluid is retained or hidden constitutes the profound essence. I attempt to explain: For cases originating from the Stomach and moving upward to the chest, diaphragm, Heart, and Lung regions, driving the retained fluid back to the Stomach allows it to exit downward via the intestines or upward via vomiting. These exits are direct and decisive, preventing latent hiding, and everyone knows this. If the fluid moves outward from the chest/diaphragm to the skin and muscles, the clear portion may exit via sweat, but the turbid portion has no exit and must return to the chest/diaphragm. Returning from the chest/diaphragm to the Stomach allows entry into the intestines for downward expulsion; however, some will remain latent in the skin/muscles and resist expulsion. If the fluid hides deeply in the back from the chest/diaphragm, and since the back is the mansion of the chest, there is even less outlet; it must especially return to the chest/diaphragm to trend toward the Stomach and intestines for smooth downward movement. Not only is it difficult to expel, but it may also carry the fierce yang and vigorous fire between the back, erupting as abscesses and toxins, knotting like orange sacs. The difficulty of Hidden Fluid in exiting downward and its tendency to breed disaster—who can distinguish it, who can expel it? I discuss medical treatment based on quiet reasoning, with solid evidence, strictly following the secret canon of the *Jingui Yaolue*, directly imparting the golden needle (key techniques), so that those practicing medicine may refine their expertise further after achieving proficiency.