猪苓十八铢(去皮) 茯苓十八铢 泽泻一两六铢 白术十八铢 桂五钱(去皮)
上五味,为末〔法〕,以白饮和服方寸匕〔法〕,日三服〔法〕。多服暖水〔法〕,汗出愈
苓,臣药也。二苓相辅,则五者之中,可为君药矣,故曰五苓。猪苓、泽泻相须,藉泽泻之
咸以润下,茯苓、白术相须,藉白术之燥以升精。脾精升则湿热散,而小便利,即东垣欲降
先升之理也。然欲小便利者,又难越膀胱一腑,故以肉桂热因热用,内通阳道,使太阳里水
引而竭之,当知是汤专治留着之水,渗于肌肉而为肿满。若水肿与足太阴无涉者,又
之方。
猪苓一两(去皮) 茯苓一两 阿胶一两 滑石一两 泽泻一两
上五味,以水四升,先煮四味,取二升,去滓〔法〕,纳下阿胶烊消〔法〕,温服七合〔法
〕,日三服〔法〕。
五者皆利水药,标其性之最利者名之,故曰猪苓汤,与五苓之用,其义天渊。五苓散治
太阳
是
取阿胶即从利水中育阴,是滋养无形以行有形也,故仲景云∶汗多胃燥,虽渴而里无热者,
不可与也。
芫花(熬) 甘遂 大戟各等分 大枣十枚(擘)
上三味,等分,各别捣为散〔法〕,以水一升半,先煮大枣肥者十枚,取八合,去滓〔法〕
,纳药末,强人服一钱匕,羸人服半钱〔法〕,温服之〔法〕,平旦服〔法〕。若下少病不
除者,明日更服加半钱〔法〕,得快下利后,糜粥自养〔法〕。
攻饮汤剂,每以大枣缓甘遂、大戟之性者,欲其循行经隧,不欲其竟走肠胃也,故不名
其方
佐
猪苓十八铢(去皮) 茯苓十八铢 泽泻一两六铢 白术十八铢 桂枝五钱(去皮)
以上五味药,研成细末〔用法〕,用米汤调和服用一方寸匕〔用法〕,每日三次〔用法〕。服药后多喝温开水〔用法〕,待出汗即愈。
茯苓,作为臣药。猪苓与茯苓相辅相成,则在五味药中,可视为君药,所以称为五苓散。猪苓与泽泻相互协同,借助泽泻的咸味以滋润下行;茯苓与白术相互协同,借助白术的燥性以提升精气。脾之精气上升则湿热消散,小便通利,这正是李东垣“欲降先升”的道理。然而,想要小便通利,又离不开膀胱这一腑,所以用肉桂“热因热用”,内部通达阳气,引导太阳经里的水饮排出而枯竭,应当知道此方专门治疗停留的水湿,渗入肌肉而导致肿胀满闷。如果水肿与足太阴脾经无关者,又不属于此方的主治范围。
猪苓一两(去皮) 茯苓一两 阿胶一两 滑石一两 泽泻一两
以上五味药,用水四升,先煮前四味药,取二升药液,去渣滓〔用法〕,加入阿胶使其溶化〔用法〕,每次温服七合〔用法〕,每日三次〔用法〕。
这五味药都是利水药,取其药性中最善于利水的命名为猪苓汤,它与五苓散的功效,意义相差如天壤之别。五苓散治疗太阳经病证,是……(原文此处有缺漏或断句问题,依文意补全逻辑:通过发汗利水,表里双解)。取用阿胶是为了在利水中滋养阴液,这是“滋养无形之气以行有形之水”的方法,所以张仲景说:“若汗出多导致胃中干燥,虽然口渴但体内无实热者,不可使用此方。”
芫花(炒制) 甘遂 大戟各等分 大枣十枚(掰开)
以上三味药,分量相等,分别捣碎成散剂〔用法〕,用水一升半,先煮肥大的大枣十枚,取八合药汁,去渣滓〔用法〕,纳入药末,体质强壮的人服一钱匕,体质虚弱的人服半钱〔用法〕,温服〔用法〕,清晨空腹服用〔用法〕。如果排便少且病邪未除者,第二天再服,增加半钱〔用法〕,得到快速腹泻后,喝糜粥自行调养〔用法〕。
攻逐水饮的汤剂,通常用大枣来缓和甘遂、大戟的峻烈药性,目的是让药力循行于经络隧道,而不希望它直接冲击肠胃,所以不将其命名为……(原文此处似有残缺,意指不单纯名为攻下之方),而是作为佐使……(原文残缺)。
Zhu Ling (Polyporus) 18 zhu (peeled), Fu Ling (Poria) 18 zhu, Ze Xie (Alisma Rhizome) 1 liang 6 zhu, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 18 zhu, Gui Zhi (Cinnamomi Ramulus) 5 qian (peeled).
The above five herbs are ground into powder [method]. Mix with rice water and take one fang cun bi [method], three times a day [method]. Drink plenty of warm water after taking the medicine [method]; recovery occurs when sweating.
Fu Ling acts as the Deputy Minister herb. With Zhu Ling assisting it, among the five ingredients, they can be regarded as the Sovereign herb, hence the name Wu Ling San (Five-Ingredient Powder with Poria). Zhu Ling and Ze Xie act synergistically; relying on the salty nature of Ze Xie to moisten and direct downwards. Fu Ling and Bai Zhu act synergistically; relying on the drying nature of Bai Zhu to ascend the essence. When the Spleen's essence ascends, damp-heat dissipates, and urination becomes smooth, which is the principle of "ascending first to descend later" advocated by Li Dongyuan. However, to facilitate urination, one cannot bypass the Bladder organ. Therefore, Rou Gui (Cinnamon Bark) is used in the manner of "treating heat with heat," internally unblocking Yang channels, guiding the water retention from the interior of the Taiyang channel to be exhausted. It should be known that this decoction specifically treats retained water dampness infiltrating the muscles, causing swelling and fullness. If edema is unrelated to the Foot-Taiyin Spleen channel, it falls outside the scope of this formula.
Zhu Ling 1 liang (peeled), Fu Ling 1 liang, E Jiao (Donkey-Hide Gelatin) 1 liang, Hua Shi (Talcum) 1 liang, Ze Xie 1 liang.
The above five herbs are boiled in four sheng of water. First, boil the first four herbs until two sheng remain, strain off the dregs [method]. Add E Jiao and melt it [method]. Take seven he of the warm liquid [method], three times a day [method].
All five herbs are diuretics; the formula is named Zhu Ling Tang (Polyporus Decoction) based on the herb with the most potent diuretic property. Its application differs vastly from Wu Ling San. Wu Ling San treats Taiyang channel disorders... [text implies contrast in mechanism]. The use of E Jiao aims to nourish Yin while promoting diuresis, embodying the principle of "nourishing the formless (Qi/Yin) to move the formed (Water/Dampness)." Thus, Zhang Zhongjing stated: "If there is excessive sweating leading to Stomach dryness, and although there is thirst, there is no internal heat, this formula should not be used."
Yuan Hua (Genkwa Flos, processed), Gan Sui (Kansui Root), Da Ji (Euphorbiae Pekinensis Radix) in equal parts, Da Zao (Jujubae Fructus) ten pieces (split open).
The above three herbs are divided equally and each crushed separately into powder [method]. Boil ten large Da Zao pieces in one and a half sheng of water until eight he remains, strain off the dregs [method]. Add the herbal powder. Strong individuals take one qian bi; frail individuals take half a qian [method]. Take warm [method] on an empty stomach at dawn [method]. If bowel movement is scant and the disease persists, administer another dose the next day, increasing by half a qian [method]. After achieving rapid purgation, nourish oneself with millet porridge [method].
In formulas for attacking fluid retention, Da Zao is often used to moderate the harsh nature of Gan Sui and Da Ji, intending for the medicinal force to circulate through the meridians and collaterals rather than directly assaulting the intestines and stomach. Hence, it is not merely named as a purgative formula, but serves as an assistant... [text incomplete].