(仲景)治阳明病,脉浮发热,渴欲饮水,小便不通。(成氏曰∶脉浮发热,热在表
也
脉
汤
少
沉
利不渴者,里寒也。渴者,阳邪入里。心烦不眠,知挟热也。咳而渴呕,有停饮也。渴而下
利,知小便必不利,是热邪已入膀胱也。宜利小便,则热降而便实。)通治湿热黄胆,口渴
溺赤。(五苓泻湿胜,故用桂术。猪苓泻热胜,故用滑石。)
猪苓 茯苓 泽泻 滑石 阿胶(一两)
热上壅,则下不通。下不通,热益上壅。又湿郁为热,热蒸更为湿。故心烦而呕渴,便
秘而
膀胱
水道
津液
以行
(仲景) 治伤寒水气乘心,厥而心下悸者,先治其水,隙治其厥,不尔,水渍入
必作利也。(太阳证饮水过多,水停心下,必悸。火畏水,故心惕惕然动不自安也。)亦
寒汗出不渴者。(经曰∶伤寒汗出而渴者,五苓散主之。不渴者,茯苓甘草汤主之。汗
渴,为邪未入里,故但解表利水,而兼和中。)亦治膀胱腑咳,咳而遗溺。
茯苓 桂枝(二两) 甘草(一两) 生姜(三两)
淡能渗水,甘能宁心助阳,故用茯苓。辛能散饮,温能发汗解肌,故用姜桂。益土可以
制水
去生姜,加白术,名茯苓桂枝白术甘草汤(仲景)。 治伤寒吐下后,心下逆满,气上
冲胸,
故令
饮和中,益阳固卫。)金匮用治心下有痰饮,胸胁支满目眩。
(张仲景)治疗阳明病,脉象浮、发热,口渴想喝水,小便不通畅。(成无己说:脉浮发热,说明热邪在表;脉沉不渴,是里有寒邪。口渴,是阳热之邪入里。心烦失眠,知道体内挟有热邪。咳嗽且口渴呕吐,是有停饮。口渴且下利,可知小便必然不利,这是热邪已传入膀胱。适宜通利小便,则热势下降而大便成形。)通用治疗湿热黄疸,口渴,尿色红赤。(五苓散用于湿邪偏胜,所以用桂枝和白术。猪苓汤用于热邪偏胜,所以用滑石。)
热邪上壅,则下部水道不通。下部不通,热邪更加上壅。另外湿气郁结化为热,热气蒸腾又加重湿气。所以出现心烦、呕吐、口渴,便秘以及……(此处原文残缺,推测为小便不利等症)。
(张仲景)治疗伤寒水气凌心,四肢厥冷且心下悸动的,先治疗水饮,再治疗厥逆,否则,水湿浸渍入肠,必定导致下利。(太阳证饮水过多,水停在心下,必然心悸。火畏水,所以心中惕惕然跳动不安。)也治疗……(此处原文残缺,结合后文应为汗出、不渴等症状)。经书说:伤寒汗出且口渴的,用五苓散主治。不口渴的,用茯苓甘草汤主治。汗出而不渴,是因为邪气未入里,所以只解表利水,兼以和中。也治疗膀胱腑咳,咳嗽且遗尿。
淡味能渗泄水湿,甘味能宁心安神助阳,所以用茯苓。辛味能发散水饮,温性能发汗解肌,所以用姜和桂。补益脾土可以制约水湿。去掉生姜,加入白术,名为茯苓桂枝白术甘草汤(张仲景)。治疗伤寒吐下之后,心下逆满,气上冲胸……(此处原文残缺),故令……(此处原文残缺),饮和中,益阳固卫。《金匮要略》用它治疗心下有痰饮,胸胁支撑胀满,目眩。
(Zhang Zhongjing) treats Yangming disease (Yangming disease), characterized by a floating pulse (floating pulse), fever, thirst with desire to drink water, and dysuria (difficulty in urination). (Cheng Wuji states: A floating pulse with fever indicates heat at the exterior; a deep pulse without thirst indicates cold at the interior. Thirst indicates yang pathogenic factors entering the interior. Restlessness and insomnia indicate the presence of internal heat. Cough with thirst and vomiting indicates retained fluid. Thirst with diarrhea indicates that urination must be difficult, signifying that heat pathogens have entered the Bladder. It is appropriate to promote diuresis, which will lower the heat and firm the stool.) It is generally used to treat damp-heat jaundice, thirst, and red urine. (Wuling San [Five-Ingredient Powder with Poria] is used when dampness prevails, hence it employs Guizhi [Cinnamon Twig] and Baizhu [Atractylodes Macrocephala Rhizome]. Zhuling Tang [Polyporus Decoction] is used when heat prevails, hence it employs Huashi [Talcum].)
Zhuling [Polyporus], Fuling [Poria], Zexie [Alisma Rhizome], Huashi [Talcum], Ejiao [Donkey-Hide Glue] (1 liang).
When heat obstructs upward, the lower pathways are blocked. When the lower pathways are blocked, heat further obstructs upward. Furthermore, dampness stagnates and transforms into heat, while heat steaming exacerbates dampness. Thus, one experiences restlessness, vomiting, thirst, constipation, and... [text missing, likely referring to urinary difficulty].
(Zhang Zhongjing) treats Taiyang disease (Taiyang disease) where water qi invades the Heart, causing cold extremities (cold limbs) and palpitations under the heart. One should first treat the water retention, then treat the cold extremities; otherwise, water soaking into the intestines will inevitably cause diarrhea. (In Taiyang syndrome, excessive drinking leads to water retention under the heart, causing palpitations. Fire fears water, so the heart feels restless and uneasy.) It also treats... [text missing, likely sweating without thirst]. The Classics state: In Taiyang disease, if there is sweating and thirst, Wuling San [Five-Ingredient Powder with Poria] is the primary formula. If there is no thirst, Fuling Gancao Tang [Poria and Licorice Decoction] is the primary formula. Sweating without thirst indicates that the pathogen has not entered the interior; therefore, one only releases the exterior and promotes diuresis, while simultaneously harmonizing the Middle Jiao. It also treats Bladder Fu-cough, characterized by coughing with involuntary urination.
Fuling [Poria], Guizhi [Cinnamon Twig] (2 liang), Gancao [Licorice Root] (1 liang), Shengjiang [Fresh Ginger] (3 liang).
The bland flavor can渗泄 (percolate and drain) water; the sweet flavor can calm the Heart and assist Yang, hence Fuling [Poria] is used. The pungent flavor can disperse retained fluids; the warm nature can induce sweating and release the muscle layer, hence Ginger and Cinnamon are used. Strengthening Earth (Spleen/Stomach) can control Water. Removing Shengjiang [Fresh Ginger] and adding Baizhu [Atractylodes Macrocephala Rhizome] creates the name Linggui Zhugan Tang [Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction] (Zhang Zhongjing). It treats conditions after vomiting or purgation in Taiyang disease, featuring fullness and rebellious Qi rising from the epigastrium, with Qi rushing up to the chest... [text missing], thus causing... [text missing], harmonizing fluids, benefiting Yang, and securing the Wei (Defensive) Qi. The *Jin Gui Yao Lue* [Essential Prescriptions from the Golden Cabinet] uses it to treat phlegm-fluid retention in the epigastrium, distending fullness in the hypochondrium, and vertigo.