主利水也。故能治小便自利、不利、旁治身烦疼、痰饮、失精眩冒、下利、喜唾。
考 证
天雄散，证阙（说在互考中）
以上一方，术八两。
桂子附子去枝加术汤证曰∶小便自利。
麻黄加术汤证曰∶身烦疼。
越婢加术汤证曰∶一身面目黄肿、其脉沉、小便不利。
附子汤，证不具也。（说在互考中）
以上四方，术皆四两。
桂枝去桂加苓术汤证曰∶小便不利。
人参汤证曰∶喜唾。
桂枝人参汤证曰∶利下不止。
茯苓泽泻汤，证不具也。（说在《类聚方》）
茯苓饮证曰∶心胸中有停痰宿水、自吐出水。
以上五方，术皆三两。
甘草附子汤证曰∶小便不利。
真武汤证曰∶小便不利、四肢沉重疼痛、自下利。
苓姜术甘汤证曰∶小便自利。
苓桂术甘汤证曰∶小便自利。
苓桂术甘汤证曰∶心下有痰饮，又云头眩。
泽泻汤证曰∶其人苦冒眩。
枳术汤，证不具也，说在互考中。
茯苓戎盐汤证曰∶小便不利。
以上七方，术皆二两。
五苓散证曰∶小便不利。
以上一方，术十八铢，而三两之例。
上历观此诸方，无论小便之变。其他曰饮、曰痰、曰身烦疼、曰喜唾、曰冒眩、亦皆水
病也。凡小便不利而兼若证者，用术而小便通，则诸证乃治。由是观之，术之利水也明矣。
互 考
天雄散。《金匮要略》载在桂枝加龙骨牡蛎汤条后，而不载其证。而李时珍作《本草纲
目》曰∶此仲景治男子失精之方也。然则旧有此证，而今或脱也。男子失精、女子梦交，桂
枝龙骨牡蛎汤主之。下当云∶天雄散亦主之。以余观之，时珍之见，而岂以术、附为治失精
梦交乎？此则观于本草，可以知耳。夫失精梦交，水气之变也，故以术为主药也。
《金匮要略》白术附子汤，即《伤寒论中》桂枝附子去桂加术汤，而分量减其半也。盖
术别苍白，非古也。故今称方名，从《伤寒论》焉。《外台秘要》术附汤，亦同方。而分量
非古也，皆不可从焉！
附子汤证，不具也。此方之于真武汤，倍加术、附，以参代姜者也。而真武汤证，有小
便不
枳术汤、桂姜枣草黄辛附汤，二方《金匮要略》所载。同其因与证，而不可别焉；今审
其方剂，桂姜枣草黄辛附汤，其方合桂枝去芍药，及麻黄、附子、细辛也。而桂枝去芍药汤，
主
为则按∶所谓少阴病者，恶寒甚者也，故用附子。附子主恶寒也。依二汤之证推之，心下坚
大而恶寒，发热上逆者，桂姜枣草黄辛附汤主之。术主利水也，是以心下坚大而小便不利者
，枳术汤主之。夫秦张之治疾也，从其证而不取因矣。因者，想像也，以冥冥决事，秦张所
不取也，故其能治疾也。在方中其证矣，斯不知其方意，则未能中其证也。其知其方意，在
知药能也，能知药能，而后始可与言方已。
辨 误
《本事方》许叔微曰∶微患饮 三十年，后左下有声、胁痛、食减、嘈杂、饮酒半杯即
止，十数日必呕酸水数升，暑月止右边有汗，左边绝无。自揣必有 囊，如水之有科臼，不
盈科不行。但清者可行，而浊者停滞，无路以决之，故积至五六日必呕而去。脾土恶湿，而
水则流湿，莫若燥脾以去湿，崇土以填科臼，乃悉屏诸药，只以苍术麻油大枣丸，服三月而
疾除。自此常服，不呕不痛，胸膈宽利，饮啖如故。为则按∶仲景用术治水，而不云去湿补
脾也；许氏则以术为去湿补脾，而不云其治水。何其妄哉？许氏之病水变，故得术能治也。
人云许氏能治其湿痰，余戏之曰∶非许自能治其病，而术能治许病也。何则？许氏之所说，
以不可见为见，而以不可知为知也。空理惟依，古人则不然，有水声吐水，则为水治之。是
可知而知之，可见而见之实事。惟为此谓知见之道也，故有许氏之病者，用术、附以逐其水，
其效如神。呜呼！仲景之为方也，信而有征。由是观之，许之病已也，非许之功，而术之功
也。
品 考
术 宗 曰∶古方及《本经》，止单言术，而未别苍白也。陶隐居言有两种，而后人往
往贵白术而贱苍术也。为则曰∶华产两种，其利水也，苍胜于白，故余取苍术也。本邦所出，
其
主要功效是通利水湿。因此能治疗小便自利、小便不利，以及旁治身体烦痛、痰饮、遗精眩晕、腹泻、喜欢吐唾沫等症状。
考证：
天雄散，其适应证缺失（详见互考部分）。
以上一方，白术用量为八两。
桂枝附子去桂加白术汤的适应证记载为：小便自利。
麻黄加白术汤的适应证记载为：身体烦痛。
越婢加白术汤的适应证记载为：全身面目浮肿发黄，脉象沉，小便不利。
附子汤，其适应证不完整。（详见互考部分）
以上四方，白术用量均为四两。
桂枝去桂加茯苓白术汤的适应证记载为：小便不利。
人参汤的适应证记载为：喜欢吐唾沫。
桂枝人参汤的适应证记载为：腹泻不止。
茯苓泽泻汤，其适应证不完整。（详见《类聚方》）
茯苓饮的适应证记载为：心胸中有停积的痰饮宿水，自行呕吐出清水。
以上五方，白术用量均为三两。
甘草附子汤的适应证记载为：小便不利。
真武汤的适应证记载为：小便不利、四肢沉重疼痛、自发性腹泻。
苓姜术甘汤的适应证记载为：小便自利。
苓桂术甘汤的适应证记载为：小便自利。
苓桂术甘汤的适应证记载为：心下有痰饮，又说有头晕目眩。
泽泻汤的适应证记载为：患者苦于头昏目眩。
枳术汤，其适应证不完整，详见互考部分。
茯苓戎盐汤的适应证记载为：小便不利。
以上七方，白术用量均为二两。
五苓散的适应证记载为：小便不利。
以上一方，白术用量为十八铢，相当于三两的标准。
综上所述，纵观上述各方，无论小便情况如何变化，其他如“饮”、“痰”、“身体烦痛”、“喜欢吐唾沫”、“头昏目眩”等，也都属于水病范畴。凡是小便不利并兼有上述症状者，使用白术后小便通畅，则各种症状得以治愈。由此看来，白术的通利水湿功效是明确的。
互考：
天雄散。《金匮要略》记载在桂枝加龙骨牡蛎汤条文之后，但未记载其适应证。而李时珍在《本草纲目》中说：这是张仲景治疗男子遗精的方剂。那么，旧本中应有此适应证，而今可能脱漏了。男子遗精、女子梦交，由桂枝加龙骨牡蛎汤主治。下文应当接着说：天雄散也主治这些病症。依我看来，李时珍的观点，难道认为用白术、附子来治疗遗精和梦交吗？这通过观察本草书籍就可以知晓。所谓遗精梦交，是水气变化的表现，所以以白术为主药。
《金匮要略》中的白术附子汤，即《伤寒论》中的桂枝附子去桂加白术汤，只是分量减半罢了。大概是因为后来将白术分为苍、白两种，这不是古法。所以现在称方名，遵从《伤寒论》。《外台秘要》中的术附汤，也是同一个方子，但分量不符合古法，都不足取。
附子汤的适应证不完整。此方与真武汤相比，加倍使用了白术、附子，并用人参代替生姜。而真武汤的适应证中，有小便不...（原文此处中断，根据上下文推测应为小便不利或相关描述，但按规则不推测，故仅翻译可见部分）...
枳术汤、桂姜枣草黄辛附汤，这两方记载于《金匮要略》。病因与适应证相同，无法区分；现在仔细审查方剂组成，桂姜枣草黄辛附汤，该方结合了桂枝去芍药汤，以及麻黄、附子、细辛。而桂枝去芍药汤，主...（原文此处中断）...
为则按：所谓的少阴病，是指恶寒严重的病症，所以使用附子。附子的主要功效是治疗恶寒。依据这两方的适应证推断，心下痞硬胀大且伴有恶寒、发热上逆者，由桂姜枣草黄辛附汤主治。白术的主要功效是通利水湿，所以心下痞硬胀大且小便不利者，由枳术汤主治。秦代张仲景治疗疾病，是顺应症状而不拘泥于病因。病因是一种想象，凭模糊不清的情况决断事务，这是秦代张仲景所不取的，所以他能够治好疾病。在方剂中体现的是症状，如果不了解方剂的意图，就不能准确对应症状。要了解方剂的意图，在于了解药物的功效，只有了解了药物功效，然后才可以谈论方剂。
辨误：
《本事方》许叔微说：我患有痰饮病三十年，后来左下有声、胁痛、食欲减退、嘈杂感、饮酒半杯就停止，十几天必然呕吐几升酸水，夏季只有右边出汗，左边完全没有。我自己揣测体内必有类似盛水的容器，像水流注坑洼一样，不填满坑洼就不前行。但清者可以流动，而浊者停滞，没有道路排出，所以积聚到五六天必然呕吐出去。脾土厌恶湿气，而水会流向潮湿之处，不如燥脾以去除湿气，培补脾土以填平坑洼，于是停用所有药物，只用苍术、麻油、大枣制成的丸药，服用三个月而疾病痊愈。从此经常服用，不再呕吐疼痛，胸膈宽畅舒适，饮食如常。为则按：张仲景使用白术治疗水病，而没有说它能祛湿补脾；许氏则认为白术能祛湿补脾，而没有说它治疗水病。多么荒谬啊！许氏的病是由水变引起的，所以能用白术治愈。人们说许氏能治疗他的湿痰，我开玩笑说：不是许氏自己能治病，而是白术能治许氏的病。为什么呢？许氏所说的，是把不可见的当作可见的，把不可知的当作已知的。空谈理论只依靠这些，古人却不是这样，有水声、吐水，就认为是水病而治疗水。这是可知而知之、可见而见之的实际事情。只有这才是知见之道，所以对于患有许氏这种病的人，使用白术、附子来逐水，效果神奇。唉！张仲景制定方剂，确实有据可查。由此看来，许氏的病痊愈，不是许氏的功劳，而是白术的功劳。
品考：
术 宗曰：古方及《神农本草经》，只单言“术”，而未区分苍术和白术。陶隐居说有两种，而后人往往重视白术而轻视苍术。为则说：国产两种，其通利水湿的功效，苍术胜过白术，所以我选用苍术。本国出产的，其...（原文此处中断）
Its primary function is to promote diuresis and drain dampness. Therefore, it can treat spontaneous urination (polyuria), oliguria (difficulty in urination), and also treats body restlessness and pain, phlegm-fluid retention (Tan Yin), seminal emission with dizziness, diarrhea, and excessive salivation.
Textual Research:
Tianxiong San (Heavenly Male Dispersion), the indications are missing (see Mutual Examination).
In the above one formula, Baizhu (Atractylodis Rhizoma) dosage is eight liang.
The indication for Guizhi Fuzi Qu Gui Jia Zhu Tang (Cinnamon Twig and Aconite Decoction minus Cinnamon Twig plus Atractylodis Rhizoma) states: spontaneous urination.
The indication for Mahuang Jia Zhu Tang (Ephedra Decoction plus Atractylodis Rhizoma) states: body restlessness and pain.
The indication for Yebing Jia Zhu Tang (Yebing Decoction plus Atractylodis Rhizoma) states: edema and yellowish swelling of the whole body and face, deep pulse, and oliguria.
Fuzi Tang (Aconite Decoction), the indications are incomplete. (See Mutual Examination)
In the above four formulas, Baizhu (Atractylodis Rhizoma) dosage is four liang each.
The indication for Guizhi Qu Gui Jia Ling Zhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractylodis Rhizoma) states: oliguria.
The indication for Renshen Tang (Ginseng Decoction) states: excessive salivation.
The indication for Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) states: unceasing diarrhea.
Fuling Zexie Tang (Poria and Alisma Decoction), the indications are incomplete. (See "Leiju Fang")
The indication for Fuling Yin (Poria Drink) states: retained phlegm-fluid and old water in the chest and heart region, with spontaneous vomiting of clear water.
In the above five formulas, Baizhu (Atractylodis Rhizoma) dosage is three liang each.
The indication for Gancao Fuzi Tang (Licorice and Aconite Decoction) states: oliguria.
The indication for Zhenwu Tang (True Warrior Decoction) states: oliguria, heaviness and pain in the four limbs, and spontaneous diarrhea.
The indication for Ling Jiang Zhu Gan Tang (Poria, Ginger, Atractylodis Rhizoma, and Licorice Decoction) states: spontaneous urination.
The indication for Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodis Rhizoma, and Licorice Decoction) states: spontaneous urination.
The indication for Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodis Rhizoma, and Licorice Decoction) states: fluid-retention in the epigastrium, and also mentions dizziness.
The indication for Zexie Tang (Alisma Decoction) states: the patient suffers from severe dizziness and vertigo.
Zhizhu Tang (Immature Bitter Orange and Atractylodis Rhizoma Decoction), the indications are incomplete, see Mutual Examination.
The indication for Fuling Rongyan Tang (Poria and Salt Decoction) states: oliguria.
In the above seven formulas, Baizhu (Atractylodis Rhizoma) dosage is two liang each.
The indication for Wuling San (Five-Ingredient Powder with Poria) states: oliguria.
In the above one formula, Baizhu (Atractylodis Rhizoma) dosage is eighteen zhu, which corresponds to the standard of three liang.
From a comprehensive review of these formulas, regardless of variations in urination, other symptoms such as "fluid retention," "phlegm," "body restlessness and pain," "excessive salivation," and "dizziness/vertigo" all belong to water diseases. Whenever oliguria is accompanied by such symptoms, using Baizhu (Atractylodis Rhizoma) leads to patent urination, thereby curing the various symptoms. Thus, it is clear that Baizhu (Atractylodis Rhizoma) promotes diuresis.
Mutual Examination:
Tianxiong San (Heavenly Male Dispersion). It is recorded in *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) after the section on Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell), but its indications are not recorded. Li Shizhen in *Ben Cao Gang Mu* (Compendium of Materia Medica) states: This is a formula by Zhang Zhongjing for treating seminal emission in men. Then, there must have been such indications in the old texts, which may have been lost today. For seminal emission in men and dream intercourse in women, Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell) is the main treatment. The following text should say: Tianxiong San (Heavenly Male Dispersion) also treats these conditions. In my view, does Li Shizhen's opinion imply that Baizhu (Atractylodis Rhizoma) and Fuzi (Aconiti Lateralis Radix Preparata) are used to treat seminal emission and dream intercourse? This can be known by observing the materia medica. Seminal emission and dream intercourse are manifestations of water-energy disorders; therefore, Baizhu (Atractylodis Rhizoma) is used as the principal herb.
Baizhu Fuzi Tang (Atractylodis Rhizoma and Aconite Decoction) in *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) is the same as Guizhi Fuzi Qu Gui Jia Zhu Tang (Cinnamon Twig and Aconite Decoction minus Cinnamon Twig plus Atractylodis Rhizoma) in *Shang Han Lun* (Treatise on Cold Damage Disorders), with the dosage halved. This is likely because later periods distinguished between Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Rhizoma), which is not the ancient method. Therefore, when naming formulas now, we follow *Shang Han Lun* (Treatise on Cold Damage Disorders). Shu Fu Tang (Atractylodis Rhizoma and Aconite Decoction) in *Wai Tai Mi Yao* (Important Essential Prescriptions Worth a Thousand Pieces of Gold) is also the same formula, but the dosage does not conform to ancient standards and should not be followed!
The indications for Fuzi Tang (Aconite Decoction) are incomplete. Compared to Zhenwu Tang (True Warrior Decoction), this formula doubles the amount of Baizhu (Atractylodis Rhizoma) and Fuzi (Aconiti Lateralis Radix Preparata), and replaces Ginger with Ginseng. However, the indications for Zhenwu Tang (True Warrior Decoction) include oliguria... [Text cuts off here].
Zhizhu Tang (Immature Bitter Orange and Atractylodis Rhizoma Decoction) and Gui Jiang Zao Cao Huang Xin Fu Tang (Cinnamon Twig, Ginger, Jujube, Licorice, Rhubarb, Asarum, and Aconite Decoction) are both recorded in *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet). They share the same etiology and indications and cannot be distinguished; however, upon careful examination of the formula composition, Gui Jiang Zao Cao Huang Xin Fu Tang (Cinnamon Twig, Ginger, Jujube, Licorice, Rhubarb, Asarum, and Aconite Decoction) combines Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony) with Mahuang (Ephedrae Herba), Fuzi (Aconiti Lateralis Radix Preparata), and Xixin (Asari Radix et Rhizoma). And Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony)... [Text cuts off here].
Wei Ze notes: The so-called Shaoyin disease refers to severe aversion to cold, hence Fuzi (Aconiti Lateralis Radix Preparata) is used. Fuzi (Aconiti Lateralis Radix Preparata) primarily treats aversion to cold. Inferring from the indications of these two formulas, for cases of hardness and fullness in the epigastrium accompanied by aversion to cold and rebellious heat, Gui Jiang Zao Cao Huang Xin Fu Tang (Cinnamon Twig, Ginger, Jujube, Licorice, Rhubarb, Asarum, and Aconite Decoction) is indicated. Baizhu (Atractylodis Rhizoma) primarily promotes diuresis; therefore, for cases of hardness and fullness in the epigastrium accompanied by oliguria, Zhizhu Tang (Immature Bitter Orange and Atractylodis Rhizoma Decoction) is indicated. Zhang Zhongjing of Qin treated diseases by following the symptoms rather than focusing on the etiology. Etiology is an imagination; deciding matters based on obscure circumstances was not practiced by Zhang Zhongjing, which is why he could cure diseases. The symptoms are manifested in the formulas. If one does not understand the intent of the formula, one cannot accurately match the symptoms. To understand the intent of the formula, one must know the efficacy of the herbs. Only by knowing the efficacy of the herbs can one discuss formulas.
Correcting Errors:
Xu Shuwei in *Benshi Fang* (Formulas of Practical Value) said: I suffered from fluid retention for thirty years. Later, there was sound in the lower left side, hypochondriac pain, reduced appetite, and epigastric discomfort. After drinking half a cup of wine, I had to stop. Every ten or so days, I would vomit several sheng of sour water. In summer, sweat appeared only on the right side, with none on the left. I speculated that there must be a vessel in my body, like water filling depressions; water does not flow until the depression is filled. Clear fluids can flow, but turbid fluids stagnate without a way out, so after accumulating for five or six days, they must be vomited out. Spleen Earth dislikes dampness, and water flows towards damp places. It is better to dry the Spleen to remove dampness and fortify Earth to fill the depressions. Thus, I discarded all other medicines and only took pills made of Cangzhu (Atractylodis Rhizoma), sesame oil, and Jujube. After taking them for three months, the disease was cured. Since then, I have taken them regularly, with no vomiting or pain, the chest and diaphragm feel open and comfortable, and eating and drinking are normal. Wei Ze notes: Zhang Zhongjing used Baizhu (Atractylodis Rhizoma) to treat water diseases, without claiming it removes dampness and tonifies the Spleen; Xu claimed Baizhu (Atractylodis Rhizoma) removes dampness and tonifies the Spleen, without claiming it treats water diseases. How absurd! Xu's disease was caused by water transformation, so Baizhu (Atractylodis Rhizoma) could cure it. People say Xu could treat his damp-phlegm; I joke that it is not Xu who cures himself, but Baizhu (Atractylodis Rhizoma) that cures Xu. Why? What Xu describes is seeing the invisible as visible and knowing the unknowable as known. Empty theories rely on this, but ancients were different: if there is fluid sound and vomiting of water, it is treated as a water disease. These are actual matters that can be known through knowledge and seen through observation. This is the true way of knowing and seeing. Therefore, for those suffering from Xu's type of disease, using Baizhu (Atractylodis Rhizoma) and Fuzi (Aconiti Lateralis Radix Preparata) to expel water yields miraculous effects. Alas! Zhang Zhongjing's formulas are reliable and verifiable. From this, we see that Xu's recovery was not due to Xu's merit, but to the merit of Baizhu (Atractylodis Rhizoma).
Product Examination:
Zong says: Ancient formulas and *Shen Nong Ben Cao Jing* (Divine Farmer's Materia Medica) only mentioned "Zhu" (Atractylodis Rhizoma) singly, without distinguishing between Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Rhizoma). Tao Hongjing stated there are two types, and later generations often valued Baizhu (Atractylodis Rhizoma) over Cangzhu (Atractylodis Rhizoma). Wei Ze says: Both are produced domestically; regarding their ability to promote diuresis, Cangzhu (Atractylodis Rhizoma) is superior to Baizhu (Atractylodis Rhizoma), so I choose Cangzhu (Atractylodis Rhizoma). Those produced in our country... [Text cuts off here]