治伤寒表里未解。渴而小便不利。
白术(生) 茯苓 猪苓(各二钱) 泽泻(三钱) 桂(一钱)
上五味。为散。白饮和服方寸匕。日三服。或生料煎服。温覆取微似汗。按五苓散。本治太
阳经邪犯本。渴而小便不利。饮水即吐之水逆。故用二苓、泽、术。利水生津。又需桂以蒸动其津。
则渴者自不渴矣。后人不达此义。每用五苓治阴虚泉竭之证。重涸其水。发热发渴。势必转加。
岂方之咎欤。况有去桂而用四苓者。曷知此方全赖桂之辛温。则术不至壅满。用方者当须识此。无
愧圣贤一脉。
猪苓汤(玉函) 治渴欲饮水。小便不利。及少阴病下利。咳而呕渴。心烦不得眠。
五苓散去术、桂。加滑石、阿胶等分。水煎去滓温服。日三。按此太阳少阴药也。五苓散
用术以导水滋干。即兼桂之辛温以蒸动其津气。此用滑石之清热利水。即兼阿胶之甘润以保护
其血液。汗乃血之液。故汗出多而渴者禁用。
猪苓散(金匮) 治呕吐思水。
五苓散去泽泻、桂。为散。饮服方寸匕。日三服。
泽泻汤(金匮) 治支饮眩冒。
五苓散去猪苓、茯苓、桂。
茯苓泽泻汤(金匮) 治胃反吐而渴欲饮水。
五苓散去猪苓。加甘草、生姜。(家秘。加芦根。)
茯苓戎盐汤(金匮) 治胞中精枯。血滞小便不利。
五苓散去猪苓、泽泻、桂。加戎盐。(即青盐)
桂苓丸 治肾气上逆。水泛为痰。逆冲膈上。及冒暑烦渴。饮水过多。腹胀小便不利。
五苓散去猪苓、泽泻、白术。用桂一两。茯苓二两。蜜丸。沸汤下二钱。日三服(
作汤名桂苓饮。)
桂苓甘露饮 治温热病。小便不通。烦渴引饮。
五苓散加真寒水石、石膏、滑石。
四苓散 治小便赤涩胀痛。及温热时行烦渴。
五苓散去桂。
茵陈五苓散(金匮) 治黄瘅小便不利。
五苓散加茵陈蒿。
春泽汤 治气虚伤湿。小便不利。
五苓散加人参。
葶苈木香散 治阳水腹胀。大小便秘。
五苓散加葶苈、木香、木通、滑石、甘草。
治疗伤寒表证与里证均未解除。出现口渴且小便不利的症状。
白术(生用) 茯苓 猪苓(各二钱) 泽泻(三钱) 桂枝(一钱)
以上五味药,研成散剂。用米汤调和,每次服用一方寸匕的量。每日服用三次。或者用生药材煎服,服药后覆盖衣被以取得微微似有汗出的效果。按语:五苓散原本用于治疗太阳经受邪侵犯本经,导致口渴、小便不利,以及饮水后即呕吐的“水逆”证。因此使用猪苓、茯苓、泽泻、白术来利水生津,同时需要桂枝来蒸腾气化津液,那么口渴的症状自然就会消失。后世医家不理解这一含义,常常用五苓散治疗阴虚津液枯竭的病证,这会使津液更加枯竭,发热和口渴的症状势必加重。难道是方剂的过错吗?况且还有去掉桂枝而只用四味药组成“四苓散”的情况,哪里知道这个方剂完全依赖桂枝的辛温之性,才能使白术不至于造成气机壅滞胀满。使用此方的人应当认识这一点,才不愧对圣贤医学的一脉相承。
猪苓汤(出自《金匮玉函经》) 治疗想喝水但小便不利,以及少阴病下利,咳嗽兼呕吐、口渴、心烦不得安眠。
在五苓散的基础上去掉白术、桂枝,加入滑石、阿胶,剂量相等。用水煎煮,去渣后温服。每日三次。按语:这是治疗太阳病与少阴病的药物。五苓散使用白术来引导水湿并滋润干燥,同时借助桂枝的辛温之气来蒸腾气化津液;此方使用滑石的清热利水作用,同时借助阿胶的甘润之性来保护血液。汗是血的液体表现,所以出汗多而导致口渴的患者禁用此方。
猪苓散(出自《金匮要略》) 治疗呕吐后思虑喝水。
在五苓散的基础上去掉泽泻、桂枝,研成散剂。用饮服送服,每次一方寸匕,每日三次。
泽泻汤(出自《金匮要略》) 治疗支饮引起的眩晕昏冒。
在五苓散的基础上去掉猪苓、茯苓、桂枝。
茯苓泽泻汤(出自《金匮要略》) 治疗胃反呕吐且想喝水。
在五苓散的基础上去掉猪苓,加入甘草、生姜。(家传秘方中加芦根。)
茯苓戎盐汤(出自《金匮要略》) 治疗胞宫中精血枯涸,血行不畅导致的小便不利。
在五苓散的基础上去掉猪苓、泽泻、桂枝,加入戎盐。(即青盐)
桂苓丸 治疗肾气上逆,水湿泛滥化为痰饮,逆冲至膈膜之上,以及中暑烦渴、饮水过多导致的腹胀和小便不利。
在五苓散的基础上去掉猪苓、泽泻、白术,使用桂枝一两,茯苓二两,制成蜜丸。用沸水送服二钱,每日三次。(若改为汤剂则名为桂苓饮。)
桂苓甘露饮 治疗温热病,小便不通,烦渴引饮。
在五苓散的基础上加入真寒水石、石膏、滑石。
四苓散 治疗小便赤红涩痛胀痛,以及温热时行疾病引起的烦渴。
在五苓散的基础上去掉桂枝。
Treats Taiyang disease (disease of the Bladder and Small Intestine channels) where both exterior and interior syndromes are unresolved. Manifestations include thirst and difficulty in urination.
Bai Zhu (Atractylodis Rhizoma, raw), Fu Ling (Poria), Zhu Ling (Polyporus) (each 2 qian), Ze Xie (Alismae Rhizoma) (3 qian), Gui Zhi (Cinnamomi Ramulus) (1 qian).
The above five herbs are ground into a powder. Mix with rice water and administer one fang cun bi (a square-inch measure) per dose. Take three times daily. Alternatively, decoct the raw herbs. After taking the medicine, cover with blankets to induce a slight sweating effect. Commentary: Wu Ling San (Five-Ingredient Powder with Poria) is originally indicated for Taiyang channel pathogens invading the interior, causing thirst, difficulty in urination, and "water regurgitation" (shui ni) where drinking water immediately leads to vomiting. Therefore, Zhu Ling, Fu Ling, Ze Xie, and Bai Zhu are used to promote diuresis and generate fluids. Additionally, Gui Zhi is required to vaporize and move the fluids; thus, the thirst will naturally cease. Later practitioners failed to understand this principle and often used Wu Ling San to treat conditions of yin deficiency and fluid exhaustion, which would further deplete the fluids, inevitably exacerbating fever and thirst. Is this the fault of the formula? Moreover, there are cases where Gui Zhi is removed to form Si Ling San (Four-Ingredient Powder with Poria). How can they know that this formula relies entirely on the acrid-warm nature of Gui Zhi to prevent Bai Zhu from causing qi stagnation and fullness. Practitioners using this formula must recognize this point to remain worthy of the lineage of the sages.
Zhu Ling Tang (from *Jingui Yufan Jing*) Treats desire to drink water accompanied by difficulty in urination, as well as Shaoyin disease with diarrhea, cough, vomiting, thirst, irritability, and inability to sleep.
Remove Bai Zhu and Gui Zhi from Wu Ling San, add Hua Shi (Talcum) and E Jiao (Colla Corii Asini) in equal proportions. Decoct in water, strain, and take warm. Three times daily. Commentary: This is a formula for treating Taiyang and Shaoyin diseases. Wu Ling San uses Bai Zhu to guide water dampness and moisten dryness, assisted by the acrid-warm nature of Gui Zhi to vaporize and move qi and fluids. This formula uses Hua Shi to clear heat and promote diuresis, assisted by the sweet-moistening nature of E Jiao to protect blood. Since sweat is the fluid of blood, it is contraindicated for patients who are thirsty due to excessive sweating.
Zhu Ling San (from *Jingui Yaolue*) Treats vomiting followed by a desire to drink water.
Remove Ze Xie and Gui Zhi from Wu Ling San, grind into a powder. Administer with water, one fang cun bi per dose, three times daily.
Ze Xie Tang (from *Jingui Yaolue*) Treats vertigo and dizziness caused by Zhi Yin (fluid retention obstructing the chest/diaphragm).
Remove Zhu Ling, Fu Ling, and Gui Zhi from Wu Ling San.
Fu Ling Ze Xie Tang (from *Jingui Yaolue*) Treats stomach reversal (wei fan) with vomiting and desire to drink water.
Remove Zhu Ling from Wu Ling San, add Gan Cao (Glycyrrhizae Radix et Rhizoma) and Sheng Jiang (Zingiberis Rhizoma Recens). (Family secret recipe adds Lu Gen (Phragmitis Rhizoma)).
Fu Ling Rong Yan Tang (from *Jingui Yaolue*) Treats depletion of essence and blood in the bladder uterus, leading to blood stasis and difficulty in urination.
Remove Zhu Ling, Ze Xie, and Gui Zhi from Wu Ling San, add Rong Yan (Natrii Chlorum, i.e., Blue Salt).
Gui Ling Wan Treats rebellious Qi of the Kidney, where water dampness overflows and transforms into phlegm, rushing upward against the diaphragm. Also treats summerheat-induced irritability and thirst, abdominal distension, and difficulty in urination due to excessive water intake.
Remove Zhu Ling, Ze Xie, and Bai Zhu from Wu Ling San. Use Gui Zhi (1 liang) and Fu Ling (2 liang). Form into honey pills. Take 2 qian with boiling water, three times daily. (If prepared as a decoction, it is named Gui Ling Yin.)
Gui Ling Gan Lu Yin Treats warm-heat diseases with urinary obstruction, irritability, and intense thirst requiring drinking.
Add Zhen Han Shui Shi (Real Cold Water Stone), Shi Gao (Gypsum Fibrosum), and Hua Shi (Talcum) to Wu Ling San.
Si Ling San Treats dark, scanty, painful, and distending urination, as well as irritability and thirst during warm-heat epidemic diseases.
Remove Gui Zhi from Wu Ling San.
Yin Chen Wu Ling San (from *Jingui Yaolue*) Treats jaundice (huang dan) with difficulty in urination.
Add Yin Chen Hao (Artemisiae Scopariae Herba) to Wu Ling San.
Chun Ze Tang Treats Qi deficiency with injury from dampness, leading to difficulty in urination.
Add Ren Shen (Ginseng Radix) to Wu Ling San.
Ting Li Mu Xiang San Treats Yang Shui (edema characterized by acute onset and excess) causing abdominal distension, constipation of both large and small bowels.
Add Ting Li Zi (Lepidii Fructus), Mu Xiang (Aucklandiae Radix), Mu Tong (Akebiae Caulis), Hua Shi (Talcum), and Gan Cao (Glycyrrhizae Radix et Rhizoma) to Wu Ling San.