（歌见长沙方歌括。） 治心下有痰饮。胸胁支满。目眩者。
茯苓 桂枝 白术 甘草
次孙男心兰禀按。心下者。脾之部位也。饮凌于脾。致脾弱不输。不能制水。则生痰矣。
故
其
动
。而水可从令而下耳。桂枝振心阳以退其群阴。如离照当空则阴霾全消。而天日复明也。白
术补中土以修其堤岸。使水无泛滥之虞。更以甘草助脾气转输以交上下。庶治节行。心阳振
。土气旺。转输速。而水有下行之势。无上凌之患矣。
（见妇人杂病。） 治短气有微饮。当从小便去之。苓桂术甘汤主之。此丸亦主之
次孙男心兰禀按。微者不显之谓也。饮水也。微饮者。犹阴霾四布细雨轻飞之状。阻于
胸中。蔽其往来之气。故曰短气有微饮者。谓微饮阻其气也。经云。呼出心与肺。吸入肝与
肾。若心肺之阳虚。则不能行水化气。用苓桂术甘汤振心阳崇土以防御之。使天日明而阴霾
散。则气化行矣。若肾虚而水泛。则吸引无权。当用肾气丸补肾行水。使肾气足。则能通腑
而化
治脉伏。其人欲自利。利反快。虽利。心下续坚满。此为留饮欲去故也。此汤
甘遂（大者三枚。） 半夏（十二枚。以水一升。煮取半升。去滓。） 芍药（五枚。） 甘
草
上四味。以水二升。煮取半升。去滓。以蜜半升和药汁。煎取八合。顿服之。
歌曰 满从利减续还来。（去者自去。续者自续。） 甘遂三枚芍五枚。十二枚夏指大草。
水
之势。故以甘遂、半夏因其势而导之。甘遂与甘草相反而同用之者。盖欲其一战而留饮尽去。
因相激而相成也
（歌诀见《长沙方歌括》。）治疗心下有痰饮。胸胁部支撑胀满。头晕目眩者。
茯苓 桂枝 白术 甘草
次孙陈心兰禀告按语：心下部位，是脾的管辖区域。水饮凌犯于脾，导致脾脏虚弱无法运化输布，不能制约水液，从而产生痰饮。
因此
利用药物的
作用，使水液顺从药令向下排泄。桂枝振奋心阳以驱散阴寒之邪，如同太阳当空照耀，阴霾全部消散，天空重新放晴。白
术补益中焦脾胃以修筑堤岸，防止水液泛滥成灾。再用甘草辅助脾气转输以沟通上下，使得治节功能运行正常，心阳振奋
，土气旺盛，转输迅速，而水液有向下流动的趋势，没有向上凌犯的隐患了。
（见《妇人杂病篇》。）治疗呼吸短促且有轻微水饮，应当通过小便排出。苓桂术甘汤主之。此丸（肾气丸）也主治此证。
次孙陈心兰禀告按语：微，指不明显。指水饮。微饮，就像阴霾四处弥漫、细雨轻飞的状态。阻滞在
胸中，遮蔽了气的往来通道，所以说“短气有微饮”，是指微饮阻碍了气机。经书说：呼气由心和肺主管，吸气由肝和
肾主管。如果心肺阳气虚，就不能行水化气，使用苓桂术甘汤振奋心阳、崇厚土气以防御它，使天日明朗而阴霾
散去，那么气化功能就能运行。如果肾虚而水液泛溢，则摄纳无权，应当使用肾气丸补肾行水，使肾气充足，则能通利腑
窍而化
治疗脉象潜伏。其人想要自下利，泻后反而感觉爽快，虽然腹泻，但心下继续坚硬胀满。这是留饮欲去的原因。此汤（甘遂半夏汤）
甘遂（大的三枚。） 半夏（十二枚。用水一升，煮取半升，去掉药渣。） 芍药（五枚。） 甘
草
以上四味药，用水二升，煮取半升，去掉药渣。用蜂蜜半升调和药汁，煎取八合，一次性服用。
歌诀曰：胀满随利减轻却复来。（离去者自然离去，续生者依然续生。） 甘遂三枚芍药五枚。十二枚半夏指大甘草。
水
液的势态，所以用甘遂、半夏顺应其势而引导它。甘遂与甘草相反却同时使用的缘故，大概是想让它们一战而让留饮尽去，
因为相互激荡而相互成就啊。
(See the song in *Changsha Fang Ge Kuo*.) Treats phlegm-fluid retention (Tan Yin) under the heart. Fullness and distension supporting the chest and hypochondrium. Vertigo.
Poria (Fuling), Cinnamon Twig (Guizhi), Atractylodes Macrocephala Rhizome (Baizhu), Licorice Root (Gancao).
Note by grandson Xinlan: The area "under the heart" is the domain of the Spleen. When fluid retention invades the Spleen, it causes Spleen weakness and failure to transport and transform, unable to control water, thus generating phlegm-fluid.
Therefore,
by utilizing the
action, the water follows the command of the medicine and flows downward. Cinnamon Twig (Guizhi) stirs up Heart Yang to retreat the group of Yin pathogens, just as when the sun shines brightly in the sky, all haze dissipates, and the sky becomes clear again. Atractylodes Macrocephala Rhizome (Baizhu) tonifies the Middle Earth to repair the dikes, preventing the danger of water overflowing. Furthermore, Licorice Root (Gancao) assists the Spleen Qi in transportation and transformation to connect the upper and lower, so that the regulatory functions proceed normally. With Heart Yang stirred up, Earth Qi prosperous, and rapid transportation, water has a tendency to flow downward, eliminating the hazard of upward invasion.
(See *Zabing Pian* on Miscellaneous Diseases of Women.) Treats shortness of breath with slight fluid retention; it should be expelled through urination. Ling Gui Zhu Gan Tang is the primary formula. This pill (Shen Qi Wan) also treats this condition.
Note by grandson Xinlan: "Slight" refers to what is not obvious. It refers to ingested water. Slight fluid retention is like haze spreading everywhere and light rain flying gently. It obstructs in the chest, blocking the free flow of Qi. Hence, "shortness of breath with slight fluid retention" means slight fluid retention obstructs Qi movement. The Classics state: Exhalation is governed by the Heart and Lung; inhalation is governed by the Liver and Kidney. If Heart and Lung Yang are deficient, they cannot move water and transform Qi. Use Ling Gui Zhu Gan Tang to stir Heart Yang and strengthen Earth to defend against it, making the sky bright and haze disperse, so that Qi transformation proceeds. If Kidney deficiency leads to water flooding, then the power of grasping Qi is lost; one should use Shen Qi Wan to tonify the Kidney and promote water metabolism. When Kidney Qi is sufficient, it can unblock the Fu organs and transform
Treats a submerged pulse. The person desires spontaneous diarrhea; after defecation, there is a feeling of relief. Although defecating, hardness and fullness persist under the heart. This is because retained fluid retention (Liu Yin) is attempting to exit. This decoction (Gan Suan Ban Xia Tang):
Kansui Root (Gansui) (three large pieces.), Pinellia Tuber (Banxia) (twelve pieces. Boil in one sheng of water until half a sheng remains, remove dregs.), Peony Root (Shaoyao) (five pieces.), Licorice Root (Gancao).
The above four ingredients: Boil in two sheng of water until half a sheng remains, remove dregs. Mix with half a sheng of honey and the medicinal juice, decoct until eight he remain, take in one dose.
Song says: Fullness decreases with diarrhea but returns continuously. (What leaves departs naturally; what continues to form persists.) Gansui three pieces, Shaoyao five pieces. Twelve pieces of Banxia refers to large Gancao.
The momentum of water, therefore, Kansui and Banxia are used to guide it according to its momentum. The reason Gansui and Gancao are used together despite being contrary lies in the desire for them to fight once and eliminate all retained fluid retention, achieving mutual success through mutual stimulation.