半夏半升 生姜汁一升
右二味，以水三升，煮半夏取二升，内生姜汁，煮取一升半，小冷分四服，日三夜一
，呕止，停后服。
【集解】
李□曰：生姜、半夏，辛温之气，足以散水饮而舒阳气，然待小冷服者，死寒饮固结
于中，拒热药而不纳，反致呕逆。今热药冷饮下嗌之后，冷体既消，热性便发，情且
不违，而致大益，此「内经」之旨也。此方与前半夏干姜汤略同，但前温中气，故用
干姜，此散停饮，故用生姜；前因呕吐上逆，顿服之则药力猛峻，足以止逆降气，呕
吐立除；此心中无奈，寒饮内结，难以猝消，故分四服，使胸中邪气徐徐散也。
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吐后渴欲得水而贪饮者，文蛤汤主之。兼主微风，脉紧头痛。
【按】
「文蛤汤主之」五字，当在头痛之下，文义始属，是传写之□。兼主之「主」字，衍
文也。
【注】
吐后而渴，当稍稍与饮之，胃和吐自止也。若恣意贪饮，则新饮复停，而吐必不已也
，当从饮吐治之。若兼感微风，脉必紧，头必痛，主之文蛤汤者，是治渴兼治风水也
。故以越婢汤方中加文蛤。越婢散风水也，文蛤治渴不已也。
【集注】
程林曰：贪饮者，饮水必多，多则淫溢上焦，必是溢饮之患，故用此汤以散水饮，方
中皆辛甘发散之药，故亦主微风脉紧头痛。
半夏半升，生姜汁一升。
以上两味药，用水三升，先煮半夏，取药液二升，加入生姜汁，再煮至取药液一升半，待药液稍凉后，分四次服用，白天服三次，夜间服一次。呕吐停止后，停用后续药物。
【集解】
李□说：生姜和半夏具有辛温之气，足以驱散水饮并舒展阳气。然而之所以要求待药液稍凉后服用，是因为陈寒之饮坚固结聚于中焦，会抗拒热药而不接纳，反而导致呕吐逆乱。现在让热药在冷饮状态下咽下之后，冷体的性质既已消除，热的药性便随即发挥，病情不会违逆，从而获得大的疗效，这正是《内经》的宗旨。此方与前方的半夏干姜汤大致相同，但前方用于温中气，所以用干姜；此方用于驱散停积之水饮，所以用生姜；前方因呕吐上逆，一次性顿服则药力猛烈峻急，足以止逆降气，使呕吐立即消除；此方心中感觉无奈，寒饮内结，难以迅速消除，所以分四次服用，使胸中的邪气慢慢消散。
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呕吐后口渴想喝水且贪饮不止的，用文蛤汤主治。兼治微风侵袭，脉象紧，头痛。
【按】
“文蛤汤主之”这五个字，应当位于“头痛”之下，文义才通顺，这是传抄过程中的脱漏或错误。“兼主之”中的“主”字，是衍文（多余的字）。
【注】
呕吐后出现口渴，应当少量多次给予饮水，胃气调和呕吐自然停止。如果肆意贪饮，则新的水饮再次停聚，呕吐必定不能停止，应当从治疗水饮呕吐的角度入手。如果兼感微风，脉象必然紧，头部必然痛，使用文蛤汤主治，这是既治口渴又治风水病。因此以越婢汤方中加入文蛤。越婢散治疗风水病，文蛤治疗口渴不止。
【集注】
程林说：贪饮的人，喝水一定很多，多了就会泛滥溢于上焦，必然是溢饮的病患，所以用此汤来驱散水饮，方中都是辛甘发散的药物，所以也主治微风、脉紧、头痛。
Banxia (Pinelliae Rhizoma) half sheng, Shengjiang Zhi (Jingis Juice) one sheng.
The above two ingredients: use three sheng of water, decoct Banxia to obtain two sheng of liquid, add Shengjiang Zhi, and decoct again to obtain one and a half sheng. Take the mixture in four divided doses after it has cooled slightly; administer three times during the day and once at night. Discontinue subsequent doses if vomiting ceases.
[Collected Exegesis]
Li [Name Redacted] stated: The acrid-warm qi of Shengjiang (Zingiberis Rhizoma Recens) and Banxia is sufficient to dissipate fluid retention and unblock yang qi. However, the reason for administering the medicine when it is slightly cool is that old cold fluid retention is firmly knotted in the middle jiao, rejecting hot medicines and failing to accept them, which may instead induce vomiting and counterflow. When the hot medicine is swallowed while cold, the cold nature is eliminated first, and then the hot therapeutic effect takes place. This does not conflict with the patient's condition and brings great benefit, which is the principle of the *Neijing* (Classic of Internal Medicine). This formula is similar to the preceding Banxia Ganjiang Tang (Pinellia and Dried Ginger Decoction), but the former warms the middle qi, hence using Ganjiang (Zingiberis Rhizoma); this one disperses retained fluid, hence using Shengjiang. In the former case, due to vomiting and counterflow, a single large dose provides strong and rapid medicinal power to stop counterflow and descend qi, immediately eliminating vomiting. In this case, there is a sense of helplessness in the heart, with internal knotting of cold fluid that is difficult to eliminate suddenly; therefore, it is divided into four doses to slowly dissipate the pathogenic qi in the chest.
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For those who experience thirst and desire to drink water greedily after vomiting, Wenli Tang (Clam Shell Decoction) is the primary treatment. It also treats mild wind invasion, tight pulse, and headache.
[Annotation]
The five characters "Wenli Tang zhu zhi" (Wenli Tang is the primary treatment) should appear below "tou tong" (headache) for the text to make sense; this is an error in transcription. The character "zhu" (primary/treat) in "jian zhu zhi" (also primarily treats) is a superfluous character.
[Commentary]
After vomiting, if thirst occurs, water should be given in small amounts gradually; when the stomach qi harmonizes, vomiting will stop naturally. If one drinks excessively and greedily, new fluid retention will occur, and vomiting will certainly not cease; treatment should follow the principles for fluid retention and vomiting. If accompanied by mild wind invasion, the pulse will necessarily be tight, and the head will necessarily hurt. Using Wenli Tang as the primary treatment addresses both thirst and wind-water pathology. Therefore, Wenli (Venerable Clam Shell) is added to the Yuebi Tang (Yuebi Decoction). Yuebi San (Yuebi Powder) treats wind-water, and Wenli treats persistent thirst.
[Collected Notes]
Cheng Lin stated: Those who are greedy for drinking will consume large quantities of water. Excess water overflows into the upper jiao, resulting in the pathology of Yi Yin (Overflowing Fluid Retention). Therefore, this decoction is used to dissipate fluid retention. Since all ingredients in the formula are acrid-sweet and dispersing, it also treats mild wind, tight pulse, and headache.