见阳明篇
发汗已，脉浮数，烦渴者，五苓散主之
【按】
脉浮数之下当有「小便不利」四字，若无此四字，则为阳明内热口燥之烦渴，白虎汤
证也。以其有小便不利烦渴，则为太阳水热瘀结之烦渴，五苓散证也。况无小便不利
证而用五苓散，则犯重竭津液之禁矣。太阳上篇，类此证者数条，唯一条水入即吐，
水不下行，故无小便不利之文，此条应有「小便不利」四字。
【注】
发汗已，为太阳病已发过汗也。脉浮数，知邪仍在表也。若小便利而烦渴者，是初入
阳明胃热，白虎汤证也。今小便不利而烦渴，是太阳府病，膀胱水畜，五苓证也。故
用五苓散，如法服之，外疏内利，表里均得解矣。
【集注】
方有执曰：已者言发汗毕，非谓表病罢也。烦渴者，膀胱水畜，不化津液，故用四苓
利之；浮数者，外表未除，故凭一桂以和之，所以谓五苓能两解表里也。
伤寒汗出而渴者，五苓散主之；不渴者，茯苓甘草汤主之。
【注】
此申上条或渴而不烦，或烦而不渴者，以别其治也。伤寒发汗后，脉浮数，汗出烦渴
，小便不利者，五苓散主之（今惟曰汗出者，省文也）。渴而不烦，是饮盛于热，故
亦以五苓散主之，利水以化津也。若不烦且不渴者，是里无热也。惟脉浮数汗出，小
便不利，是荣卫不和也，故主以茯苓甘草汤和表以利水也。
【集注】
郑重光曰：伤寒本无汗，汗因发而出也。上条烦而渴，此条但渴不烦，里证较轻，治
亦不殊；若更不渴，则内无燥，里病少而表证犹多也。故用桂枝汤之三，五苓散之一
，示三表一里之意，易名曰茯苓甘草汤者，乃桂枝五苓之变制也。
见阳明篇
发汗后，脉象浮数，出现心烦、口渴症状的，用五苓散主治。
【按语】
“脉浮数”之下应当有“小便不利”这四个字。如果没有这四个字，那就是阳明经内热导致的口燥烦渴，属于白虎汤证。因为伴有小便不利和烦渴，这就是太阳经水热互结导致的烦渴，属于五苓散证。况且如果没有小便不利的症状而使用五苓散，就犯了再次耗竭津液的禁忌了。在太阳病上篇中，类似这种证候的有好几条，只有一条是水入即吐、水液不下行，所以没有提到小便不利的文字，这一条应该有“小便不利”这四个字。
【注解】
“发汗已”，是指太阳病已经发过汗了。“脉浮数”，说明邪气仍在体表。如果小便利而心烦口渴，这是邪气初入阳明胃热，属于白虎汤证。现在小便不利而心烦口渴，这是太阳腑病，膀胱蓄水，属于五苓散证。所以使用五苓散，按照方法服用，外可疏解表邪，内可通利水道，表里都能得到解除。
【集注】
方有执说：“已”是说发汗完毕，并不是说表证已经痊愈。心烦口渴，是因为膀胱蓄水，不能化生津液，所以用四苓（猪苓、茯苓、泽泻、白术）来利水；脉浮数，说明表邪未除，所以凭借桂枝来调和营卫，所以说五苓散能同时解除表里之邪。
伤寒出汗且口渴的，用五苓散主治；不出汗或不渴的，用茯苓甘草汤主治。
【注解】
这是对上一条文的补充，区分或口渴而不心烦，或心烦而不口渴的情况，以区别治疗方法。伤寒发汗后，脉浮数，出汗、心烦口渴、小便不利的，用五苓散主治（现在只说“汗出”，是省略了其他症状的文字）。口渴而不心烦，是水饮盛于热邪，所以也用五苓散主治，通过利水来化生津液。如果不心烦也不口渴，说明体内没有热邪。只有脉浮数、出汗、小便不利，这是营卫不和，所以主治用茯苓甘草汤来调和表邪并利水。
【集注】
郑重光说：伤寒本来无汗，汗是因发汗药而出来的。上一条文是既心烦又口渴，这一条只是口渴而不心烦，里证较轻，治疗也没有太大不同；如果再既不渴也不烦，说明内部没有燥热，里病少而表证还多。所以用桂枝汤的三份，五苓散的一份，表示三分治表、一分治里的意思，改名为茯苓甘草汤，其实是桂枝汤合五苓散的变方。
See the Yangming Chapter.
After sweating therapy, if the pulse is floating and rapid, accompanied by vexation and thirst, Wuling San (Five-Ling Powder) should be administered.
[Commentary]
Under "pulse floating and rapid," the four characters "difficulty in urination" (xiaobian buli) should be present. Without these four characters, it would be the vexation and thirst due to internal heat and dryness of the mouth in Yangming syndrome, which is a Baizhu Tang (White Tiger Decoction) pattern. Because there is difficulty in urination along with vexation and thirst, it is the vexation and thirst due to water-heat binding in the Taiyang syndrome, which is a Wuling San pattern. Moreover, using Wuling San without the symptom of difficulty in urination violates the prohibition against further depleting body fluids. In the first part of the Taiyang chapter, there are several similar patterns; only one case involves vomiting immediately after drinking water with failure of fluid descent, hence no mention of difficulty in urination. This case should include the four characters "difficulty in urination."
[Annotation]
"After sweating therapy" refers to the fact that sweating therapy has already been performed for Taiyang syndrome. A floating and rapid pulse indicates that the pathogenic factor remains in the exterior. If urination is free but vexation and thirst occur, this indicates the initial entry into Yangming stomach heat, which is a Baizhu Tang pattern. Now, with difficulty in urination and vexation/thirst, this is a Taiyang fu-organ disease, specifically bladder water accumulation, which is a Wuling San pattern. Therefore, Wuling San is used; when taken according to the method, it disperses externally and promotes urination internally, resolving both the exterior and interior.
[Collected Annotations]
Fang Youzhi stated: "Already" means the completion of sweating therapy, not that the exterior disease has ceased. Vexation and thirst result from bladder water accumulation failing to transform into body fluids; thus, Si Ling (Four-Ling) ingredients are used to promote urination. A floating and rapid pulse indicates the exterior has not yet been cleared; therefore, Guizhi (Cinnamon Twig) is relied upon to harmonize the exterior. Hence, it is said that Wuling San can resolve both exterior and interior simultaneously.
In cold damage, if sweating occurs with thirst, Wuling San is indicated; if there is no thirst, Fuling Gancao Tang (Poria and Licorice Decoction) is indicated.
[Annotation]
This supplements the previous clause, distinguishing between cases of thirst without vexation or vexation without thirst, to differentiate treatments. After cold damage sweating therapy, if the pulse is floating and rapid, with sweating, vexation, thirst, and difficulty in urination, Wuling San is indicated (the current text only mentions "sweating" as an abbreviation). Thirst without vexation indicates water retention exceeds heat; thus, Wuling San is also indicated to promote urination and transform fluids. If there is neither vexation nor thirst, it indicates no heat in the interior. Only with a floating and rapid pulse, sweating, and difficulty in urination does it indicate disharmony of Ying and Wei nutrients; thus, Fuling Gancao Tang is indicated to harmonize the exterior and promote urination.
[Collected Annotations]
Zheng Zhongguang stated: Cold damage originally presents without sweating; sweating arises due to diaphoretic treatment. The previous clause involved both vexation and thirst; this clause involves only thirst without vexation, indicating a milder interior condition, so the treatment is not significantly different. If there is additionally no thirst, it indicates no dryness in the interior, with fewer interior diseases and more exterior symptoms. Therefore, three parts of Guizhi Tang (Cinnamon Twig Decoction) and one part of Wuling San are used, demonstrating the principle of treating three parts exterior and one part interior. Renamed as Fuling Gancao Tang, it is actually a modified formulation combining Guizhi Tang and Wuling San.