考 证
猪苓汤证曰∶渴欲饮水、小便不利。
猪苓散证曰∶思水者。
以上二方，猪苓诸药等分。
五苓散证曰∶小便不利、微热消渴。
以上一方，猪苓十八铢。
上历观此三方，猪苓所主治渴而小便不利也明矣。
品 考
猪苓 和、汉共有焉，汉产实者为良也。
主治血证也。
考 证
抵当汤证曰∶少腹硬满云云。又曰∶经水不利下。
抵当丸证曰∶少腹满，应小便不利。今反利者，为有血也。
以上二方，水蛭或三十个、或二十个。
上观此二方，则水蛭之所主治也明矣。为则按∶诊血证也，其法有三焉。一曰少腹硬满，
而小便利者，此为有血，而不利者，为无血也；二曰病患不腹满，而言腹满也；三曰病患喜
妄，屎虽硬，大便反易，其色必黑，此为有血也。仲景氏诊血证之法，不外于兹矣。
品 考
水蛭 苏恭曰∶有水蛭、草蛭。大者长尺许，并能咂牛马人血。今俗多取水中小者，用
之大效。
主治脐下动也。旁治烦惊失精。
考 证
桂枝去芍药加蜀漆龙骨牡蛎汤证曰∶惊狂、起卧不安。
以上一方，龙骨四两。
桂枝加龙骨牡蛎汤证曰∶失精、少腹弦急。
天雄散，证阙。（说在术部中）
蜀漆散，证不具也。（说在互考中）
以上三方，龙骨三两，或诸药等分。
柴胡加龙骨牡蛎汤证曰∶烦惊。
以上一方，龙骨一两。（说在外传中）
桂枝甘草龙骨牡蛎汤证曰∶烦躁。
以上一方，龙骨二两，而亦四两之例。
上历观此诸方，龙骨所治惊狂烦躁失精也。无容疑者，为则每值有其证者，辄用之而间
有无效者，于是乎中心疑之。居数岁，始得焉。其人脐下有动而惊狂、或失精、或烦躁者，
用龙骨剂，则是影响。其无脐下动者而用之，则未见其效。由是观之，龙骨之所主治者，脐
下之动也。而惊狂失精烦躁，其所旁治也。学人审诸。
互 考
蜀漆散条，所谓疟者，是寒热发作有时也；而其有脐下动者，此散所主治也；无脐下动
者，而用之，则未见其效。
辨 误
龙骨之说，或曰毙也，或曰石也，诸说终无有一定也。为则按∶譬如人物乎，父精母血，
相因为体，人人而所知也。虽然，果然之与，不孰究论之龙骨亦然。究论何益之有？至如
其效用，则此可论也可择也，不可不知也。
品 考
龙骨 以能化者为上品也。有半骨半石之状者，是未化也。取龙骨法，如取石膏法也。
打碎用之。
考证
猪苓汤的适应证表现为：口渴想喝水，但小便排出不畅。
猪苓散的适应证表现为：想要喝水。
以上两个方剂中，猪苓与其他药物的用量相等。
五苓散的适应证表现为：小便排出不畅，伴有轻微发热和极度口渴（消渴）。
在上述一个方剂中，猪苓的用量为十八铢。
综上所述，观察这三个方剂，可以明确猪苓主要治疗的是口渴且小便不利的症状。
品考
猪苓：中国和汉地（指中原地区）都有出产，其中汉地产的质地坚实者为上品。
主治血证（瘀血阻滞引起的病症）。
考证
抵当汤的适应证表现为：小腹部坚硬胀满等症。又说：月经排出不畅。
抵当丸的适应证表现为：小腹胀满，按理说应该小便不利。现在反而小便通利，这是因为有瘀血存在。
以上两个方剂中，水蛭的用量或是三十个，或是二十个。
综上所述，观察这两个方剂，可以明确水蛭的主要治疗作用。为此我按察认为：诊断血证的方法有三种。第一是小腹部坚硬胀满，而小便通利的，这是有瘀血；如果不通利的，则是无瘀血。第二是患者自己感觉不到腹部胀满，却诉说腹部胀满。第三是患者神志狂乱、胡言乱语，大便虽然干硬，但排便反而容易，颜色必定发黑，这是有瘀血的表现。张仲景诊断血证的方法，不外乎这三种了。
品考
水蛭：苏恭说：有水蛭和草蛭两种。大的长约一尺左右，都能吸食牛、马、人的血液。现在民间多取用水中的小型水蛭，使用效果显著。
考证
桂枝去芍药加蜀漆龙骨牡蛎汤的适应证表现为：惊悸发狂，坐卧不安。
以上一个方剂中，龙骨的用量为四两。
桂枝加龙骨牡蛎汤的适应证表现为：遗精，小腹部拘急紧绷。
天雄散，其适应证缺失。（详见白术部中）
蜀漆散，其适应证不完整。（详见互考部分）
以上三个方剂中，龙骨的用量为三两，或者是与诸药等量。
柴胡加龙骨牡蛎汤的适应证表现为：心烦惊恐。
以上一个方剂中，龙骨的用量为一两。（详见外传部分）
桂枝甘草龙骨牡蛎汤的适应证表现为：烦躁。
以上一个方剂中，龙骨的用量为二两，但也符合四两的惯例。
综上所述，观察这些方剂，龙骨所治疗的惊狂、烦躁、遗精等症状，是不容置疑的。但我每次遇到具备这些症状的患者时，使用龙骨制剂偶尔会有无效的情况，因此心中产生疑惑。过了几年，我才找到原因。那些脐下有悸动感并伴有惊狂、或遗精、或烦躁的患者，使用龙骨制剂，效果立竿见影。而那些没有脐下悸动感却使用龙骨制剂的，则未见疗效。由此看来，龙骨真正主治的是脐下的悸动感。而惊狂、遗精、烦躁则是其旁治的症状。学者们请仔细审察。
互考
蜀漆散条文中所说的疟疾，是指寒热发作有定时；而对于伴有脐下悸动的患者，此散剂是主要治疗对象；如果没有脐下悸动却使用它，则未见疗效。
辨误
关于龙骨的说法，有的说是动物骨骼，有的说是石头，各种说法最终都没有定论。我认为：这就好比人和物一样，父亲的精液和母亲的血液相互结合形成身体，这是人人都知道的道理。然而，对于龙骨究竟为何物，如果不深入探究讨论也是可以的。探究讨论有什么益处呢？至于它的药效，这是可以讨论和选择的，不可不知道。
品考
龙骨：以能自然风化分解的为上品。呈现出半骨半石状态的，是没有完全化开的。采集龙骨的方法，如同采集石膏的方法一样。使用时打碎。
Translation
Evidence Examination
The indication for Zhu Ling Tang (Polyporus Decoction) is: thirst with desire to drink water, and dysuria (difficult or painful urination).
The indication for Zhu Ling San (Polyporus Powder) is: craving water.
In the above two formulas, Zhu Ling (Polyporus) and other herbs are used in equal proportions.
The indication for Wu Ling San (Five-Ingredient Powder with Poria) is: dysuria, slight fever, and polydipsia (excessive thirst).
In the above single formula, Zhu Ling (Polyporus) is used in the amount of eighteen zhu.
Having observed these three formulas comprehensively, it is clear that Zhu Ling (Polyporus) primarily treats thirst accompanied by dysuria.
Product Examination
Zhu Ling (Polyporus): It is available in both Japan/China and Han regions (Central Plains); those produced in Han regions with solid texture are considered superior.
Primary Indication: Blood disorders (pathologies caused by blood stasis).
Evidence Examination
The indication for Di Dang Tang (Di Dang Decoction) includes: hardness and fullness in the lower abdomen, etc. It also states: irregular menstruation or obstruction of menstrual flow.
The indication for Di Dang Wan (Di Dang Pill) states: fullness in the lower abdomen, which should be accompanied by dysuria. However, if urination is normal, this indicates the presence of blood stasis.
In the above two formulas, Shui Zhi (Leech) is used in quantities of either thirty or twenty individuals.
Observing these two formulas, the primary therapeutic action of Shui Zhi (Leech) becomes clear. I have investigated and believe there are three methods for diagnosing blood stasis. First: hardness and fullness in the lower abdomen with normal urination indicate blood stasis; if urination is obstructed, it indicates no blood stasis. Second: the patient does not feel abdominal fullness but claims to have it. Third: the patient exhibits delirious speech, the stool is hard but easy to pass, and its color is necessarily black, indicating blood stasis. Zhang Zhongjing's methods for diagnosing blood stasis do not go beyond these three points.
Product Examination
Shui Zhi (Leech): Su Gong stated: There are aquatic leeches and grass leeches. The large ones are about one chi long and can suck the blood of cattle, horses, and humans. Currently, people mostly use small aquatic leeches, which yield significant effects.
Primary Indication: Palpitations below the umbilicus (subumbilical pulsation). Secondary indications: irritability, fright, and seminal emission.
Evidence Examination
The indication for Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Tang (Cinnamon Twig Decoction without Paeonia plus Rejin and Dragon Bone and Oyster Shell) is: palpitations, mania, restlessness, and inability to lie still.
In the above single formula, Longgu (Dragon Bone) is used in the amount of four liang.
The indication for Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell) is: seminal emission and tightness/hardness in the lower abdomen.
Tianxiong San (Aconite Root Powder), the indication is missing. (See the section on Baizhu).
Shuqi San (Rejin Powder), the indication is incomplete. (See the Mutual Examination section).
In the above three formulas, Longgu (Dragon Bone) is used in the amount of three liang, or in equal proportion with other herbs.
The indication for Chaihu Jia Longgu Muli Tang (Bupleurum Decoction plus Dragon Bone and Oyster Shell) is: irritability and fright.
In the above single formula, Longgu (Dragon Bone) is used in the amount of one liang. (See the External Transmission section).
The indication for Guizhi Gancao Longgu Muli Tang (Cinnamon Twig and Licorice Decoction plus Dragon Bone and Oyster Shell) is: irritability and restlessness.
In the above single formula, Longgu (Dragon Bone) is used in the amount of two liang, which also conforms to the pattern of four liang.
Observing all these formulas, the treatment of palpitations/manic behavior, irritability/restlessness, and seminal emission by Longgu (Dragon Bone) is undeniable. However, whenever I encountered patients with these symptoms, using Longgu preparations occasionally yielded no effect, causing doubt in my mind. After several years, I discovered the reason. For patients with subumbilical pulsation accompanied by palpitations/manic behavior, or seminal emission, or irritability, using Longgu formulations proved effective. For those without subumbilical pulsation who were treated with Longgu, no efficacy was seen. From this perspective, what Longgu (Dragon Bone) primarily treats is subumbilical pulsation. Palpitations/manic behavior, seminal emission, and irritability are secondary indications. Scholars should examine this carefully.
Mutual Examination
In the Shuqi San entry, the term "malaria" refers to alternating chills and fever occurring at regular intervals; for cases accompanied by subumbilical pulsation, this powder is the primary treatment; if used without subumbilical pulsation, no efficacy is seen.
Correction of Errors
Regarding Longgu (Dragon Bone), some say it is bone from dead animals, others say it is stone; various theories ultimately lack a definitive conclusion. I argue: just as human bodies are formed by the union of father's essence and mother's blood, known to everyone, so too is the nature of Longgu. However, whether or not we thoroughly investigate and discuss its origin, what benefit does it bring? As for its therapeutic efficacy, this can be discussed and selected, and must not be ignored.
Product Examination
Longgu (Dragon Bone): Those that can naturally decompose/fossilize are classified as top grade. Those showing a state of half-bone and half-stone have not fully transformed. The method of harvesting Longgu is similar to that of Shigao (Gypsum Fibrosum). It should be crushed before use.