猪苓（十八铢去皮） 泽泻（一两六铢半） 茯苓（十八铢） 桂（半两去皮） 白术（十八铢）
上五味。为末。以白饮和服方寸匕日三服。多饮暖水。汗出愈。
成氏明理论云。苓。令也。号令之令。通行津液。克伐肾邪。专为号令者。苓之功也。五苓之中。茯苓为主。故曰
五苓散。茯苓猪苓。味俱甘平。甘虽甘也。终归于淡。甘归于淡。如人多食甘。则口反淡。是也。内经曰。淡味渗泄为
阳。利大便曰攻下。利小便曰渗泄。水饮内蓄。须当渗泄之必以甘淡为主。是以茯苓为君。猪苓为臣。白术味甘温。脾
恶湿。水饮内蓄。则脾气不治。益脾胜湿。必以甘为助。故以白术为佐。泽泻味咸寒。内经曰咸味下泄为阴。泄阴导溺。
必以咸为助。故以泽泻为使。桂枝味辛热。肾恶燥。水蓄不行。则肾气燥。内经曰。肾恶燥。急食辛以润之。散湿润燥。
故以桂枝为使。多饮暖水。令汗出愈者。以辛散水气外泄。是以汗润而解也。
琥按原方中。止用桂。而成注又云。桂枝。且云。其味辛能散湿润燥。作两可之论。其义何居。内台方议云。桂与
桂枝。可以两用。若兼表邪者。用桂枝。若专利水饮者。却用桂也。若然。则上方中当用桂枝无疑。
琥又按方后云。多服暖水。令汗出愈。此即桂枝汤方下。 热稀粥一升余。以助药力之义。建安许氏云。五苓散。
乃汗后一解表药。于此可见。
发汗已。脉浮数。烦渴者。五苓散主之。（发汗已者。谓太阳病。已发过汗也。脉浮数者。成注云。表邪未尽。不因
汗而解也。烦渴者。此系膀胱热结。小便不利。热气不得下泄。因反上逆。熏于胸膈。肺胃受伤而作烦渴也。脉浮数为
太阳经病。烦渴乃太阳府病。故亦宜五苓散。以解表邪。泄里热。或问五苓散。治膀胱热结之药。何以反用肉桂。余曰
不然。膀胱热结。诚当去桂。但此条病用桂。乃是桂枝。为脉浮数而设。非肉桂也。若其人饮水多。小便不利。无表证
者。方中竟可用肉桂也。或又问五苓散中用术。昔贤如朱奉议。孙真人许学士等。皆用白术近医方中行。喻嘉言改作苍
术。何也。余答云改用苍术。虽未合义。然使其人里实热结。小便不利。虽用苍术。不为害也。若其人发汗过多。亡津
液。胃虚燥渴。欲饮水而小便不利者。则苍术过于燥烈。断不可用。不若白术之甘平滋腻。能补津液而润燥。为可用也。
方喻二氏所可怪者。凡仲景用术之方。皆云。此是苍术。倘后学起而宗之。不论其人虚实燥湿之证。凡方中类用苍术。
不其大害者邪。纵使仲景时无白术。于今业已有之。在医人亦可权宜取用。如死执古方以疗今病。断断不可行也。）
（附例）中风发热。六七日不解。而烦有表里证。渴欲饮水。水入则吐者。名曰水逆。五苓散主之。（成注云。中风
发热至六七日则当解。若不解而烦者。邪在表也。渴欲饮水者。邪传里也。太阳之里为膀胱府。府病。则里热气结。而
小便不利。内不得出。外亦不得入。所以饮水。反上行而作吐也。若此者。名曰水逆。用五苓散者。以表能散邪。里能
消水也。或问上证。既烦且渴。何以不用白虎。余答云。白虎汤治烦渴。乃上焦肺胃热也。其人必小便利今者小便不利。
知其热在下焦。乃膀胱府病也。经云。膀胱者。州都之官。津液藏焉。气化则能出矣。上病用五苓散者。以利小便。使
气化得输。则津液流通。烦与渴不治而自愈矣。）
本以下之。故心下痞。与泻心汤。痞不解。其人渴而口燥烦。小便不利者。五苓散主之。（本以太阳病发汗后不解。
因复下之。故心下成痞。痞者。不通泰也。仲景法。当与泻心汤除之。若服之痞不解。其人渴而口中燥烦。小便不利者。
此为水饮内蓄膀胱。热结津液不行。故口燥烦渴。气不输化。因反上逆。故心下痞。要其病。实非在心下也。与五苓散
以分消表里之水邪。不治痞而痞自愈矣。）
太阳病寸缓。关浮尺弱。其人发热汗出复恶寒。不呕。但心下痞者。此以医下之也。如其不下者。病患不恶寒而渴
者。此转属阳明也。小便数者大便必硬。不更衣十日无所苦也。渴欲饮水。少少与之。但以法救之渴者宜五苓散。（渴欲
饮水至救之十三字当在小便数者之前。不恶寒而渴者者字可删。太阳病其脉寸缓关浮尺弱。其证发热汗出。复恶寒。此
系风邪正盛于表也。不呕者。里气和也。里气既和。缘何而至心下痞。其痞者。此以医下之早。邪气乘虚而入。留于心
下。故致痞也。如其不因误下者。则阳邪必渐传经。在病患已无恶寒等证。邪热传里。必变而作渴。此太阳病转属阳明
也。阳明者。胃也。胃中热渴。无有不欲饮水。第饮水时。当少少与之。不可不与。亦不可多与。但以法救其渴可耳。
如饮水之后。而小便数者。大便必硬。此因津液偏渗于膀胱。小水既多。则胃中邪热。亦随溺而泄出。虽不更衣十日。
胃中无满实之苦也。更衣者。古人于大便时。必更衣而后入厕。故相传以大便为更衣也。若饮水之后。渴终不解者。其
人饮水必不合法而多。故云。宜五苓散。以导其停水也。尚论篇于此条证。注五苓散云。能消热而回津。夫津液偏渗于
小便者。用五苓散以利之。小水利。则邪热消。而津回渴止。大便得润而自行。正内经通因通用之法也。愚以上论殊为
穿凿。病如小便数而少者。法宜用五苓散以利之。此为通因通用之法。今者小便数而至大便硬。则此小便不可为不多矣。
小便既多。则津液必耗。复用五苓散以利之。是愈燥其津液也。喻氏反以回津作解。大谬之极。或问小便数。大便硬仲
景论中。何以无治法。余答云。此是仲景不须用药处。俟其阴阳自和。则小便渐少。大便必自出也。如欲用药。少与麻
仁丸以润其大便。庶几犹可。）
伤寒汗出而渴者。五苓散主之。不渴者。茯苓甘草汤主之。（伤寒汗出者。服发汗药。而太阳经之邪未尽。故汗出也。
渴者。太阳之邪传里。膀胱府病。水气上逆而作渴也。故宜五苓散。以表里兼主之。若汗出不渴者。此为邪气传里未甚。
水气不至上逆。故不作渴也。所以五苓散中。止用茯苓以主里。而泄水气。更留桂枝。加生姜甘草。以解表而固卫虚。
更其名为茯苓甘草汤方也。）
猪苓（十八铢，去皮） 泽泻（一两六铢半） 茯苓（十八铢） 桂（半两，去皮） 白术（十八铢）
以上五味药。研成细末。用米汤调和，每次服用一方寸匕，每日三次。服药后多喝温开水，使身体出汗即可痊愈。
成无己在《明理论》中说：苓，意为号令。如同发布号令一样，通行津液，克制肾邪。专门发挥号令作用的，就是苓的功效。在五苓散中，茯苓是主药，所以叫五苓散。茯苓和猪苓，味道都是甘平的。甘味虽然甘，但最终归于淡味。甘归于淡，就像人多吃甜食，嘴里反而觉得淡一样。《内经》说：淡味具有渗泄作用，属于阳。通利大便叫做攻下，通利小便叫做渗泄。水饮内停蓄积，必须用渗泄的方法治疗，且必须以甘淡味的药物为主。因此用茯苓作为君药。猪苓作为臣药。白术味道甘温。脾脏厌恶湿气。水饮内停蓄积，会导致脾气不能正常运化。要补益脾气、胜湿，必须以甘味药物为辅助。所以用白术作为佐药。泽泻味道咸寒。《内经》说：咸味具有下泄作用，属于阴。泄阴导溺，必须以咸味药物为辅助。所以用泽泻作为使药。桂枝味道辛热。肾脏厌恶燥气。水液蓄积不运行，会导致肾气燥。《内经》说：肾脏厌恶燥气，应当紧急食用辛味药物来滋润它。散发湿气、润泽燥气，所以用桂枝作为使药。多饮温水，让身体出汗而痊愈，是因为辛味能发散水气向外排泄，所以通过汗出而病解。
琥按原方中，只用桂，而成无己的注释又说桂枝，并且说它的味道辛能散发湿气、润泽燥气，做出两种可能的解释，这是什么意思？《内台方议》说：桂和桂枝可以两用。如果兼有表邪，就用桂枝；如果专门治疗水饮，却用桂。如果是这样，那么上面的方子中应当用桂枝无疑。
琥又按方剂后面的说明说：多服温水，让身体出汗而痊愈。这也就是桂枝汤方剂后面所说的“喝热稀粥一升多，以助药力”的意思。建安许氏说：五苓散，是发汗后解除表邪的药物，从这里可以看出。
发汗之后，脉象浮数，心烦口渴的，用五苓散主治。（发汗之后，是指太阳病已经发过汗了。脉象浮数，成无己注释说：表邪没有完全解除，并没有因为发汗而解。心烦口渴，这是膀胱热结，小便不利，热气不能向下排泄，反而向上逆行，熏蒸胸膈，肺胃受伤而产生烦渴。脉浮数是太阳经病，烦渴是太阳腑病，所以也适宜用五苓散，以解除表邪，泄去里热。有人问五苓散是治疗膀胱热结的药，为什么反而用肉桂？我回答说：不对。膀胱热结，确实应当去掉桂。但这一条病症用桂，乃是桂枝，是为了脉浮数而设的，不是肉桂。如果这个人饮水多，小便不利，没有表证的，方子中竟然可以用肉桂。又有人问五苓散中用术，以前的贤人如朱奉议、孙真人、许学士等，都用白术。近代的医家方中行、喻嘉言改作苍术，为什么呢？我回答说：改用苍术，虽然不符合本义，但如果这个人里有实热结聚，小便不利，即使使用苍术，也不会造成危害。如果这个人发汗过多，亡失津液，胃虚燥渴，想要喝水而小便不利的，那么苍术过于燥烈，绝对不可使用。不如白术的甘平滋腻，能够补益津液而润燥，才可以使用。方中行和喻嘉言两位先生所奇怪的是，凡是张仲景用术的方子，都说这是苍术。如果后学者起来效法他们，不论病人的虚实燥湿证候，凡是方子中类似的地方都用苍术，这不是大害吗？纵使张仲景时代没有白术，到现在已经有了。医生也可以权宜选用。如果死守古方来治疗现在的病，绝对不可行。）
（附例）中风发热，六七天不缓解，而且有烦扰，既有表证又有里证，想喝水，水喝进去就吐出来，名叫水逆。用五苓散主治。（成无己注释说：中风发热到六七天就应该解除了。如果不解除而且烦扰，说明邪气在表。想喝水，说明邪气传入里。太阳的里是膀胱腑。腑病，则里热气结，而小便不利。内部不得排出，外部也不能进入。所以喝水，反而上行而呕吐。像这种情况，名叫水逆。使用五苓散的原因，是因为它能从表散邪，从里消水。有人问上述症状，既烦且渴，为什么不用白虎汤？我回答说：白虎汤治疗烦渴，是上焦肺胃的热证。这个人一定小便通畅。现在小便不利，知道热在下焦，是膀胱腑病。经文说：膀胱是州都之官，津液藏在那里，气化才能排出。使用五苓散在上部治疗，是通过利小便，使气化得以输布，那么津液流通，烦和渴不治而自愈了。）
本来因为误用下法，所以心下痞满。给予泻心汤，痞满不解除。这个人渴而口干燥烦，小便不利的，用五苓散主治。（本来是太阳病发汗后不缓解，于是又用下法，所以心下形成痞满。痞，就是不通畅。张仲景的法度，应当用泻心汤来消除它。如果服用后痞满不解除，这个人渴而口中干燥烦，小便不利的，这是水饮内停蓄积在膀胱，热结津液不行，所以口燥烦渴，气机不能输布转化，反而向上逆行，所以心下痞。追究其病因，其实病不在心下。给予五苓散以分消表里的水邪，不治痞满而痞满自然痊愈了。）
太阳病，寸脉缓，关脉浮，尺脉弱。这个人发热汗出又恶寒，不呕，只是心下痞满。这是因为医生误用下法。如果没有误用下法，病人不恶寒而渴的，这是转属阳明病。小便频数的，大便一定硬，十天不大便也没有痛苦。想喝水，少量给他喝，只按照法度救治他。对于渴者，适宜用五苓散。（“渴欲饮水至救之”十三字应当在“小便数者”之前，“不恶寒而渴者”中的“者”字可删。太阳病，其脉象寸缓关浮尺弱，其症状发热汗出，又恶寒，这是风邪正盛于表。不呕，说明里气和平。里气既然和平，为什么会到心下痞满？这个痞满，是因为医生过早使用下法，邪气乘虚而入，留滞于心下，所以导致痞满。如果不是因为误用下法，那么阳邪必定逐渐传经。在病人身上已经没有恶寒等症状。邪热传入里，必定变而为渴。这是太阳病转属阳明病。阳明，就是胃。胃中热渴，没有不想喝水的。只是在喝水时，应当少量给予，不可以不给，也不可以多给。只按照法度救治他的渴症即可。如果在喝水之后，而小便频数的，大便一定硬。这是因为津液偏渗于膀胱，小便多了，那么胃中的邪热，也随着尿液而泄出。虽然十天不大便，胃中没有胀满实苦的痛苦。更衣，是古人上大便时，一定要换衣服然后进厕所，所以相传把大便称为更衣。如果在喝水之后，渴始终不解除，这个人喝水必定不合法度而过多，所以说：适宜用五苓散，来引导其中的停水。《尚论篇》在这条证候的注释中说五苓散：能消热而回津。津液偏渗于小便的，用五苓散来利它。小便利，那么邪热消，而津液回，渴止，大便得润而自行，正是《内经》通因通用的方法。我认为以上的论述非常穿凿附会。病如小便数而量少，法度适宜用五苓散来利它，这才是通因通用的方法。现在小便数而至大便硬，那么这个小便不可谓不多。小便既多，那么津液必耗，再用五苓散来利它，是更加燥竭津液。喻氏反而以回津做解释，大错特错。有人问小便数，大便硬，张仲景的论述中，为什么没有治法？我回答说：这是张仲景认为不需要用药的情况。等待其阴阳自和，那么小便渐渐减少，大便必然自行排出。如果想要用药，少量给予麻仁丸来润其大便，或许还可以。）
伤寒，汗出而渴的，用五苓散主治。不渴的，用茯苓甘草汤主治。（伤寒汗出，是服用发汗药后，太阳经的邪气没有完全解除，所以汗出。渴，是太阳的邪气传入里，膀胱腑病，水气上逆而作渴。所以适宜用五苓散，以表里兼治。如果汗出不渴，这是邪气传入里还不严重，水气不至上逆，所以不作渴。所以在五苓散中，只用茯苓来主里，而泄水气，更保留桂枝，加生姜甘草，以解表而固卫气虚。更改名称为茯苓甘草汤方。）
Zhu Ling (Polypori Sclerotium, 18 zhu, peeled) Ze Xie (Alismatis Rhizoma, 1 liang 6 zhu half) Fu Ling (Poria, 18 zhu) Gui (Cinnamomi Ramulus or Cortex, half liang, peeled) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 18 zhu)
The above five herbs. Grind into powder. Mix with rice water and take one fang cun bi each time, three times a day. Drink plenty of warm water after taking the medicine; recovery occurs when sweat appears.
Cheng Wuji stated in his "Ming Li Lun" (Theory of Clarification): "Ling" means command or order. Just like issuing orders, it unblocks and circulates body fluids and subdues pathogenic factors affecting the Kidney. The function that specifically acts as an order is the merit of Ling. Among the Five Ling Powder, Poria is the chief herb, hence the name Five Ling Powder. Both Poria and Polyporus have sweet and neutral flavors. Although sweet, they ultimately return to blandness. Sweet returning to bland is like how eating too much sweet food makes the mouth taste bland. The "Nei Jing" (Inner Canon) states: Bland flavor has seeping and draining properties and belongs to Yang. Purging stool is called attacking and descending; promoting urination is called seeping and draining. When water retention accumulates internally, it must be treated by seeping and draining, primarily using sweet and bland herbs. Therefore, Poria is used as the Sovereign (Jun) herb. Polyporus is used as the Minister (Chen) herb. Atractylodis Macrocephalae Rhizoma has a sweet and warm flavor. The Spleen dislikes dampness. When water retention accumulates internally, the Spleen Qi fails to govern properly. To tonify the Spleen and overcome dampness, sweet herbs are necessary as assistance. Thus, Atractylodis Macrocephalae Rhizoma is used as the Assistant (Zuo) herb. Alismatis Rhizoma has a salty and cold flavor. The "Nei Jing" states: Salty flavor has downward draining properties and belongs to Yin. Draining Yin and guiding urine requires salty herbs as assistance. Thus, Alismatis Rhizoma is used as the Envoy (Shi) herb. Cinnamon Twig has a pungent and hot flavor. The Kidney dislikes dryness. When water accumulates and does not circulate, Kidney Qi becomes dry. The "Nei Jing" states: The Kidney dislikes dryness; urgently eat pungent substances to moisten it. Dispersing dampness and moistening dryness, therefore Cinnamon Twig is used as an Envoy (Shi) herb. Drinking plenty of warm water to induce sweating for recovery works because pungent substances disperse water qi outwardly, leading to resolution through sweat.
Hu notes that the original formula uses only Gui (Cinnamon Bark), while Cheng's commentary mentions Gui Zhi (Cinnamon Twig) and says its pungent flavor can disperse dampness and moisten dryness, presenting an ambiguous argument. What is the rationale? The "Nei Tai Fang Yi" discusses that both Cinnamon Bark and Cinnamon Twig can be used interchangeably. If there are exterior pathogens, use Cinnamon Twig; if treating water retention exclusively, use Cinnamon Bark. If so, the aforementioned formula should undoubtedly use Cinnamon Twig.
Hu further notes that the post-formula instructions say: "Drink plenty of warm water to induce sweating for recovery." This corresponds to the instruction in the Gui Zhi Tang (Cinnamon Twig Decoction) formula section: "Drink more than one sheng of hot thin porridge to assist the medicinal power." Xu from Jian'an stated that Wu Ling San (Five Ling Powder) is a formula to release the exterior after sweating, which can be seen here.
After sweating, if the pulse is floating and rapid, accompanied by vexation and thirst, Wu Ling San (Five Ling Powder) is indicated. ("After sweating" refers to the Taiyang disease having already undergone sweating treatment. Floating and rapid pulse, Cheng's commentary states: Exterior pathogens remain unresolved and did not resolve due to sweating. Vexation and thirst indicate Bladder heat accumulation with difficulty in urination. Heat qi cannot drain downward but reverses upward, steaming the chest and diaphragm, injuring Lung and Stomach, causing vexation and thirst. Floating and rapid pulse indicates Taiyang Meridian disease; vexation and thirst indicate Taiyang Fu organ disease. Hence, Wu Ling San (Five Ling Powder) is also suitable to release exterior pathogens and drain interior heat. Someone asks: Wu Ling San (Five Ling Powder) treats Bladder heat accumulation, why use Rou Gui (Cinnamon Bark)? I reply: Incorrect. For Bladder heat accumulation, Gui should indeed be removed. But in this condition, the Gui used is Gui Zhi (Cinnamon Twig), prescribed for the floating and rapid pulse, not Rou Gui (Cinnamon Bark). If a person drinks much water, has difficulty urinating, and no exterior syndrome, Rou Gui (Cinnamon Bark) could be used in the formula. Another question: Regarding the use of Shu (Atractylodes) in Wu Ling San (Five Ling Powder), past sages such as Zhu Fengyi, Sun Taoren, and Xu Xueshi all used Bai Zhu (White Atractylodes Rhizoma). Recent physicians Fang Zhongxing and Yu Jiayan changed it to Cang Zhu (Coarse-leaf Atractylodes Rhizoma). Why? I answer: Changing to Cang Zhu (Coarse-leaf Atractylodes Rhizoma) may not align with the original intent, but if the patient has interior excess heat accumulation and difficulty urinating, using Cang Zhu (Coarse-leaf Atractylodes Rhizoma) causes no harm. However, if the patient sweated excessively, lost body fluids, has deficient Stomach with dry thirst, desires water but has difficulty urinating, then Cang Zhu (Coarse-leaf Atractylodes Rhizoma) is too drying and absolutely contraindicated. Bai Zhu (White Atractylodes Rhizoma) is sweet, neutral, moistening, able to tonify body fluids and moisten dryness, making it usable. What is strange about Fang and Yu is that whenever Zhang Zhongjing used Shu in formulas, he specified it was Cang Zhu (Coarse-leaf Atractylodes Rhizoma). If later generations follow them, using Cang Zhu (Coarse-leaf Atractylodes Rhizoma) indiscriminately regardless of patient deficiency/excess or dryness/dampness, would this not cause great harm? Even if Bai Zhu (White Atractylodes Rhizoma) did not exist in Zhang Zhongjing's time, it exists now. Physicians can make flexible choices. Insisting on using ancient formulas to treat modern diseases is strictly inadvisable.)
(Attached Example) Wind-stroke with fever, unresolved after six or seven days, accompanied by vexation, presenting both exterior and interior syndromes, desire to drink water, but vomiting immediately after drinking, named Water Reversal (Shui Ni). Wu Ling San (Five Ling Powder) is indicated. (Cheng's commentary: Wind-stroke fever should resolve by day six or seven. If unresolved and vexed, pathogens are in the exterior. Desire to drink indicates pathogens transmitted to the interior. The interior of Taiyang is the Bladder Fu organ. Fu organ disease leads to interior heat qi accumulation and difficulty urinating. Internal blockage prevents exit, external blockage prevents entry. Thus, drinking water causes it to reverse upward and vomit. This condition is named Water Reversal (Shui Ni). Wu Ling San (Five Ling Powder) is used because it disperses pathogens from the exterior and eliminates water from the interior. Someone asks: Given the vexation and thirst, why not use Bai Hu Tang (White Tiger Decoction)? I reply: Bai Hu Tang (White Tiger Decoction) treats vexation and thirst caused by Upper Jiao Lung and Stomach heat. The patient must have normal urination. Now, urination is difficult, indicating heat is in the Lower Jiao, a Bladder Fu organ disease. The Classic states: The Bladder is the official of the capital, storing body fluids; transformation allows excretion. Using Wu Ling San (Five Ling Powder) treats the upper symptoms by promoting urination, allowing Qi transformation to distribute, thus circulating body fluids. Vexation and thirst heal spontaneously without direct treatment.)
Originally due to incorrect purgative treatment, epigastric fullness/stuffiness (Pi) occurred. Given Xie Xin Tang (Drain the Epigastrium Decoction), but fullness/stuffiness did not resolve. If the patient is thirsty, has dry mouth and vexation, and difficulty urinating, Wu Ling San (Five Ling Powder) is indicated. (Originally, Taiyang disease remained unresolved after sweating, followed by incorrect purgative treatment, causing epigastric fullness/stuffiness (Pi). Pi means lack of smooth flow. According to Zhang Zhongjing's method, Xie Xin Tang (Drain the Epigastrium Decoction) should be used to eliminate it. If fullness/stuffiness persists after administration, and the patient is thirsty, has dry mouth/vexation, and difficulty urinating, this is water retention accumulating in the Bladder, with heat binding and fluid metabolism blocked, causing dry mouth/vexation/thirst. Qi fails to transform and distribute, reversing upward, causing epigastric fullness/stuffiness (Pi). Tracing the pathology, the disease is actually not in the epigastrium. Wu Ling San (Five Ling Powder) is given to differentiate and eliminate exterior-interior water pathogens. Treating the fullness/stuffiness directly is unnecessary; it resolves naturally.)
Taiyang disease with Cun (inch) position pulse slow/harmonious, Guan (bar) position pulse floating, Chi (cubit) position pulse weak. The patient has fever, sweating, and aversion to cold, does not vomit, but has epigastric fullness/stuffiness (Pi). This is due to the physician incorrectly using purgatives. If purgatives were not used, and the patient has no aversion to cold but has thirst, this has transferred to Yangming disease. Frequent urination leads to hard stools; even without defecation for ten days, there is no discomfort. Desire to drink water, give small amounts, rescue according to principles. For thirst, Wu Ling San (Five Ling Powder) is appropriate. (The phrase "desire to drink water... rescue" should precede "frequent urination". The character "zhe" in "no aversion to cold and thirst" can be deleted. Taiyang disease with Cun slow, Guan floating, Chi weak pulses, symptoms of fever, sweating, aversion to cold, indicate wind pathogens strong at the exterior. No vomiting indicates harmonious interior Qi. Since interior Qi is harmonious, why is there epigastric fullness/stuffiness (Pi)? This Pi results from premature purgative use, allowing pathogens to enter via deficiency and lodge in the epigastrium, causing Pi. If not due to erroneous purgatives, Yang pathogens gradually transmit meridians. The patient loses aversion to cold etc., heat transmits interior, transforming into thirst. This is Taiyang transferring to Yangming. Yangming is the Stomach. Stomach heat/thirst inevitably desires water. However, water should be given in small amounts, neither withheld nor excessive. Rescue thirst according to principles. After drinking, if urination is frequent, stools become hard. This is because body fluids leak into the Bladder. With abundant urine, Stomach heat drains with urine. Even without defecation for ten days, there is no epigastric fullness/obstruction discomfort. "Geng yi" (changing clothes) refers to defecation, as ancients changed clothes before entering the toilet. If thirst persists after drinking, the patient drank excessively improperly. Hence, "appropriate to use Wu Ling San (Five Ling Powder)" to guide stagnant water. "Shang Lun Pian" comments on this syndrome: Wu Ling San (Five Ling Powder) clears heat and returns fluids. For body fluids leaking into urine, use Wu Ling San (Five Ling Powder) to promote urination. Once urination is promoted, heat clears, fluids return, thirst stops, stools moisten and pass naturally. This is the Nei Jing method of "treating obstruction with unblocking methods" (Tong Yin Yong Tong). I find the above discussion forced. If urination is frequent but scant, Wu Ling San (Five Ling Powder) to promote urination fits the "treat obstruction with unblocking" method. Now, frequent urination leads to hard stools, meaning urination is not scant. Abundant urination consumes fluids; using Wu Ling San (Five Ling Powder) again dries fluids further. Yu's explanation of "returning fluids" is extremely wrong. Someone asks: Why no treatment method for frequent urination and hard stools in Zhang Zhongjing's text? I reply: This is a case where Zhang Zhongjing deemed medication unnecessary. Wait for Yin-Yang self-harmony; urination will decrease, stools will pass naturally. If medication is desired, administer Ma Ren Wan (Hemp Seed Pill) in small amounts to moisten stools.)
Sha Han (Cold Damage) with sweating and thirst is treated with Wu Ling San (Five Ling Powder). Without thirst, Fu Ling Gan Cao Tang (Poria and Licorice Decoction) is treated. (Sweating in Sha Han indicates exterior pathogens in Taiyang meridian remain unresolved after sweating medication, hence sweating. Thirst indicates Taiyang pathogens transmitted interior, Bladder Fu organ disease, water qi reversing upward causing thirst. Hence, Wu Ling San (Five Ling Powder) is suitable to treat both exterior and interior. If sweating without thirst, pathogens transmitting interior are mild, water qi does not reverse upward, hence no thirst. Therefore, in Wu Ling San (Five Ling Powder), only Poria is used to manage interior and drain water qi, retaining Gui Zhi (Cinnamon Twig), adding Sheng Jiang (Fresh Ginger) and Gan Cao (Licorice Root) to release exterior and secure deficient Wei Qi. The name is changed to Fu Ling Gan Cao Tang (Poria and Licorice Decoction).)