庞曰∶凡病非大渴,不可与冷水。若小渴口咽干,小小呷滋润之;若大渴烦躁甚,能饮一斗者
与五升,能饮一升者与半升,若乃不与,则干燥无由作汗,烦喘而死者多矣,但勿令足意饮也;若
大汗将来,躁渴甚者,但足意饮之勿疑。常人见因渴饮水而得汗,见小渴遂强与之致停饮,心下满
结喘而死者亦多矣。其有热脉数,尚可作汗而解者,出于天幸也。
五苓散 治病患水药入口则吐,或渴而呕者,或汗后脉尚浮而烦渴者,或下利渴而小便不利
者,或因渴停水心下,短息者,难治。呕而小便不利者,皆主之。
猪苓 白术 茯苓 桂枝 泽泻(各半两)
细末,白饮调下二钱,日三服,数饮暖水,汗出效。
阳明病,小便数者,大便即坚,不更衣十日无所苦。欲得水,但与之,当以法救;渴者,五苓
散主之。
霍乱,头痛发热,身体疼,热多欲饮水,五苓散主之。若得病无热,但狂言烦躁不安,精采不
与人相当,勿以火导之,但以猪苓散方寸匕服之。当逼饮新汲井水一升,即令指刺喉中吐去之,病
随手愈。若不能吐者,勿强与水,水停则结心下也,当以药吐之,不尔,更致危病。若当吐不吐时,
以猪苓散吐之,其死迨速矣,亦可针之尤佳。夫饮膈实难治,此皆三死一生也。太阳病,发汗后,
大汗出,胃中干,躁烦不得眠,其人欲饮水者,但与之,当稍稍饮之,令胃和则愈。
庞安石说:凡是疾病,如果不是极度口渴,就不可以给冷水。如果只是轻微口渴、口咽干燥,可以少量啜饮以滋润咽喉;如果是极度口渴且烦躁严重,想要喝一斗水的,只给五升;想要喝一升水的,只给半升。如果不给予饮水,身体就会因干燥而无法出汗,导致烦躁气喘而死亡的情况很多。但不要让患者喝得满足为止(即不要过量)。如果即将发生大汗出,且躁渴严重的,可以让患者随意饮用,不要犹豫。普通人看到因为口渴喝水后出了汗,就认为小渴时强行给水会导致水饮停滞,结果心下胀满结聚、气喘而死的也很多。那些脉象数而有热,本来还可以靠出汗来解除病邪的,纯属侥幸。
五苓散用于治疗患者服药入口即吐,或者口渴却呕吐,或者发汗后脉象仍然浮起且烦渴,或者腹泻后口渴且小便不利,或者因为口渴导致水饮停滞在心下引起呼吸短促的情况,这些都比较难治。对于呕吐且小便不利的情况,都用五苓散主治。
研成细末,用米汤调服二钱,每日三次服用,服药后多喝暖水,待汗出则见效。
阳明病中,小便频数的,大便就会干硬,即使十天不大便也没有痛苦。如果想喝水,就给他喝,应当依法救治;如果口渴,用五苓散主治。
霍乱病,出现头痛、发热、身体疼痛,热象多且想喝水的,用五苓散主治。如果患病没有发热,只是胡言乱语、烦躁不安,精神萎靡与常人不同,不要用火烤熨的方法治疗,只用猪苓散方寸匕的量服用。应当逼迫患者喝新打的井水一升,然后用手指刺激喉咙催吐排出,病随即痊愈。如果不能吐出,不要强行给水,水停滞就会结聚在心下,应当用药催吐,否则,会加重导致危重疾病。如果在应该催吐的时候不催吐,用猪苓散催吐,死亡的速度几乎很快了,也可以用针刺治疗,效果更佳。饮食停滞在膈部很难治疗,这些都是“三死一生”的情况。太阳病,发汗后,大汗出,导致胃中干燥,烦躁不得睡眠,这个人想喝水的,就给他喝,应当少量多次地喂,让胃气调和就好了。
Pang Anshi said: In all diseases, if there is no extreme thirst, cold water should not be administered. If there is slight thirst and dryness in the mouth and throat, small sips can be given to moisten; if there is extreme thirst with severe irritability, and the patient desires to drink one dou (a unit of volume), give five sheng (one fifth of a dou); if they desire one sheng, give half a sheng. If water is not provided, the body will become too dry to produce sweat, leading to many deaths from irritability and panting. However, do not allow the patient to drink until fully satisfied (i.e., avoid overconsumption). If profuse sweating is imminent accompanied by severe irritability and thirst, allow the patient to drink as much as they wish without hesitation. Laypeople often observe that drinking water due to thirst leads to sweating, and consequently, when patients have slight thirst, they force-feed them water, causing fluid retention. This results in many deaths from epigastric fullness, binding sensations, and panting. Those who have heat and rapid pulses, and whose conditions could still be resolved through sweating, survive only by sheer luck.
Wuling San (Five-Ingredient Powder with Poria) is used to treat patients who vomit immediately after taking medicine, or who are thirsty yet vomiting, or who remain floating in pulse and suffer from irritability and thirst after sweating, or who experience diarrhea followed by thirst and difficulty in urination, or who have fluid retention in the epigastrium due to thirst causing shortness of breath. These conditions are difficult to treat. For cases involving vomiting and difficulty in urination, Wuling San is the primary treatment.
Zhu Ling (Polyporus Umbellatus), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Guizhi (Cinnamomi Ramulus), Zexie (Alismatis Rhizoma) (each half liang).
Grind into fine powder, mix with rice water, and take two qian (approx. 6 grams) per dose, three times daily. Drink warm water afterwards; efficacy is achieved when sweat appears.
In Yangming disease, frequent urination leads to hard stools. Even if defecation does not occur for ten days, there is no discomfort. If the patient desires water, provide it, but rescue according to proper methods; if thirsty, Wuling San (Five-Ingredient Powder with Poria) is indicated.
In Huoluan (Cholera-like syndrome), presenting with headache, fever, and body pain, where heat predominates and there is a desire to drink water, Wuling San (Five-Ingredient Powder with Poria) is indicated. If the disease presents without fever, but with delirium, severe irritability, and spirit lacking vitality compared to normal, do not use fire therapy. Instead, administer one cun bi (approx. 3-5 grams) of Zhuling San (Polyporus Powder). Force the patient to drink one sheng (approx. 200 ml) of fresh well water, then stimulate the throat with fingers to induce vomiting. The illness will resolve promptly. If vomiting cannot be induced, do not force water intake, as fluid retention may bind in the epigastrium. Medication should be used to induce vomiting; otherwise, critical danger ensues. If vomiting is indicated but not performed, and Zhuling San is used to induce vomiting, death may occur rapidly. Acupuncture is also highly recommended. Fluid retention in the diaphragm region is extremely difficult to treat; these scenarios represent "three deaths for one life" prognosis. In Taiyang disease, after sweating, profuse sweating causes dryness in the stomach, irritability, and insomnia. If the patient desires water, provide it, but administer in small, gradual amounts until the stomach qi harmonizes and recovery occurs.