茯苓 猪苓（去皮） 白术（各十八铢） 泽泻（一两六铢半） 桂枝（半两去皮）
上五味。为末。以白饮和服方寸匕。多饮暖水。汗出愈。
此治太阳表病不解。邪陷入府。凡渴而小便不利者宜之。亦两解表里之法也。以其有表
证。
故用桂枝主表而化气。以其有里证。故用苓泽主里而利水水不下趋。势必上泛。故用白术奠安
太阴
。以土制水。此方不宜汤而宜散。以散能逗遛中焦。通调水道。更借多服暖水之力。使水精
四布。上输下注。热解津回。则小便利而渴自止矣。
按渴欲饮水。有类白虎加人参证。何以彼宜白虎。此宜五苓。盖白虎主治阳明经热。五
苓主清太阳府热。白虎证脉洪大。是表证已解。五苓证脉浮数。表证未解。以此为辨。
诸家皆以导湿滋干。释五苓之取义。但以桂枝之辛温。苓泽之渗泄。即白术亦主燥脾。
与生
津润燥之义。全不相涉。而渴证宜之何也。盖此证由经入府。水蓄于下。不能输津于上。故
治渴必先治水。且散服而多饮暖水。自有输精散布之功。
猪苓（去皮） 茯苓 泽泻 滑石（碎） 阿胶（各一两）
上五味。以水四升。先煮四味。取二升。去滓。纳阿胶烊消。温服十合。日三服。
同属渴欲饮水小便不利之证。太阳从寒水化气。故宜五苓散。主桂枝白术之甘温。以宣
阳而
输精。阳明从燥土化气。故宜猪苓汤主滑石阿胶之凉降。以育阴而利水。但利小便。还宜相
人之津液。若阳明汗出多而渴者。是津液已虚。便不宜重虚其津液也。
少阴病。下利六七日。咳而呕渴。心烦不得眠者。何以亦主猪苓汤。盖咳渴呕烦不得眠
。得
之下利之后。是阴津下迫。阳邪上逆。主猪苓汤育阴利水。正以少阴肾与太阳膀胱。一脏一
腑。相为表里。急引少阴之邪。从府而解。则下利得止。而热去津回矣。
茯苓、猪苓（去皮）、白术（各十八铢）、泽泻（一两六铢半）、桂枝（半两，去皮）。
以上五味药，研成细末。用米汤调和，每次服用一方寸匕的药粉。服药后多喝热水，待出汗后即可痊愈。
这是治疗太阳表证未解，邪气内陷膀胱腑的病证。凡是口渴且小便不利的患者适宜使用此方。这也是表里双解的方法之一。因为有表证，所以用桂枝来主治表证并化气行水；因为有里证，所以用茯苓、泽泻来主治里证并利水。如果水液不能向下排泄，势必会上泛，所以用白术来安固太阴脾土。以土来制约水湿。这个方剂不适合做成汤剂而适合做成散剂，因为散剂能在中焦停留较久，通调水道。再加上多服暖水的力量，使水精四布全身，上输下达，热解津回，那么小便通利，口渴自然停止。
按：口渴想喝水的症状，与白虎加人参汤证相似。为什么彼证宜用白虎汤，此证宜用五苓散呢？大概白虎汤主治阳明经的热证，五苓散主治太阳腑的热证。白虎汤证的脉象洪大，说明表证已解；五苓散的脉象浮数，说明表证未解。以此作为辨别依据。
各家都用水湿引导、滋润干燥来解释五苓散的取义，但仅凭桂枝的辛温，茯苓、泽泻的渗泄，以及白术的主燥脾，这与生津润燥的意义完全不相涉，那为什么口渴证适宜使用它呢？大概此证是由经络传入腑，水蓄积在下焦，不能将津液输送到上焦，所以治疗口渴必须先治疗水饮。而且服用散剂并多喝热水，自有输布精气的作用。
猪苓（去皮）、茯苓、泽泻、滑石（捣碎）、阿胶（各一两）。
以上五味药，用水四升，先煮前四味药，取二升药液，去渣，加入阿胶使其溶化。每次温服十合，每日三次。
同属于口渴想喝水且小便不利的病证。太阳经从寒水化气，所以适宜用五苓散，主要依靠桂枝、白术的甘温之性，来宣发阳气并输布精气。阳明经从燥土化气，所以适宜用猪苓汤，主要依靠滑石、阿胶的凉降之性，来滋养阴液并利水。但是，利小便容易耗伤人的津液。如果是阳明病汗出多而口渴的，说明津液已经虚损，就不宜再严重耗伤其津液了。
少阴病，下利六七天，咳嗽、呕吐、口渴、心烦、不得安眠的，为什么也主用猪苓汤？大概咳嗽、口渴、呕吐、心烦、不得安眠，是在下利之后出现的，这是阴津因下利而迫注于下，阳邪逆乱于上。主用猪苓汤滋养阴液并利水，正是利用少阴肾与太阳膀胱一脏一腑相为表里的关系，急引少阴之邪从膀胱腑而解，那么下利得以停止，热去津回。
Fuling (Poria), Zhuling (Polyporus, *Polyporus umbellatus*), Baizhu (Atractylodis Macrocephalae Rhizoma) [each 18 zhu], Zexie (Alismatis Rhizoma) [1 liang 6 zhu half], Guizhi (Cinnamomi Ramulus) [half liang, peeled].
The above five herbs are ground into powder. Mix with rice water and take one fangcunbi (a square-inch measure) of the powder per dose. Drink plenty of warm water after taking the medicine; recovery occurs when sweating ensues.
This formula treats Taiyang exterior syndrome that has not resolved, with pathogenic factors sinking into the Fu organ (Bladder). It is suitable for patients who present with thirst and difficulty in urination. It is also a method to resolve both exterior and interior simultaneously. Because there is an exterior syndrome, Guizhi is used to treat the exterior and transform Qi. Because there is an interior syndrome, Fuling and Zexie are used to treat the interior and promote diuresis. If water fails to flow downward, it will inevitably flood upward; therefore, Baizhu is used to stabilize the Taiyin Spleen. Earth controls Water. This formula is more suitable as a powder than as a decoction, because powders linger in the Middle Jiao, regulating water passages. Furthermore, by drinking plenty of warm water, the essence of water is distributed throughout the body, flowing up and down. As heat resolves and fluids return, urination becomes smooth and thirst ceases naturally.
Note: Thirst with desire to drink water resembles the Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) syndrome. Why is Baihu Tang indicated for the former and Wuling San (Five-Ingredient Powder with Poria) for the latter? Generally, Baihu Tang treats Heat in the Yangming Meridian, while Wuling San treats Heat in the Taiyang Fu organ. The pulse in Baihu Tang syndrome is洪大 (Hongda, large and surging), indicating that the exterior syndrome has resolved. The pulse in Wuling San syndrome is浮数 (Fushu, floating and rapid), indicating that the exterior syndrome has not yet resolved. This serves as the basis for differentiation.
Various commentators explain the rationale of Wuling San as guiding dampness and nourishing dryness. However, relying solely on the acrid-warm nature of Guizhi, the draining properties of Fuling and Zexie, and the spleen-drying action of Baizhu seems entirely unrelated to the principle of generating fluids and moistening dryness. So why is it suitable for thirst syndromes? In this syndrome, pathogens move from the meridian to the Fu organ, causing water accumulation in the Lower Jiao, which prevents the transport of fluids to the Upper Jiao. Therefore, treating thirst requires first treating water retention. Moreover, taking the powder and drinking warm water facilitates the distribution of essence and fluids.
Zhuling (Polyporus, *Polyporus umbellatus*, peeled), Fuling (Poria), Zexie (Alismatis Rhizoma), Huashi (Talcum, crushed), Ejiao (Colla Corii Asini) [each 1 liang].
The above five herbs are boiled in four sheng (liters) of water. First, boil the first four herbs until two sheng remain. Strain the decoction, then add Ejiao and melt it. Take ten he (units of volume) warm per dose, three times daily.
Both syndromes belong to thirst with desire to drink and difficulty in urination. The Taiyang channel transforms Qi from Cold-Water; thus, Wuling San is appropriate, utilizing the sweet-warm nature of Guizhi and Baizhu to disseminate Yang and distribute essence. The Yangming channel transforms Qi from Dry-Earth; thus, Zhuling Tang (Polyporus Decoction) is appropriate, utilizing the cooling-descending nature of Huashi and Ejiao to nourish Yin and promote diuresis. However, promoting diuresis tends to consume bodily fluids. In cases of Yangming syndrome with profuse sweating and thirst, fluids are already deficient, so one should not further severely deplete the fluids.
In Shaoyin disease, if diarrhea persists for six or seven days, accompanied by cough, vomiting, thirst, irritability, and inability to sleep, why is Zhuling Tang primarily indicated? The symptoms of cough, thirst, vomiting, irritability, and insomnia appearing after diarrhea indicate that Yin fluids are being forced downward while Yang pathogens rebel upward. Zhuling Tang is used to nourish Yin and promote diuresis. This precisely leverages the exterior-interior relationship between the Shaoyin Kidney and the Taiyang Bladder. By urgently drawing Shaoyin pathogens out through the Bladder Fu organ, diarrhea stops, heat dissipates, and fluids return.