（叶应昌《袖中金》） 治噤口下痢，纯血秽腐，身热脉大，大孔如竹筒，诸般恶证，
并可主之。但恐服之已迟，毒邪攻坏脏腑，则难救耳。
黄连（酒炒六分） 赤芍药（酒炒一钱） 木香（煨三分） 青皮（醋炒） 枳壳（麸
炒） 槟榔（各
花（酒洗三分） 桃仁（去
草（炙五分） 水煎服。
如痢初
四分，诸药
白术（土炒）
治痢奇方出叶氏，东风散里加红花，桃仁黄连地榆炭，（此方即东风散加味）青出于蓝
尤足夸
方中
攻邪
痢身
治痢，
云∶此
邪气
亦
治太阳病发汗后，汗出恶寒，脉浮，小便不利，微热消渴，及中风发热，六七日不
烦，有表里证，渴欲饮水，水入即吐，名曰水逆，宜此主之。通治水肿，霍乱身疼，胸
脐下悸，吐涎，头眩等证。此利水之祖方也。
猪苓 茯苓 白术（各十八铢） 泽泻（一两六铢） 桂（五钱） 为末，以白饮和服
方寸匕，日
（汪 庵《医方集解》） 治无病而渴，与病瘥后渴者。
五苓散加人参。（再加甘草，亦名春泽汤。）
五苓散治太阳腑，（王好古《此事难知》曰∶“五苓散为下药，乃太阳里之下药也。太阳
高
小便不利，五苓散主之；小便利者，不宜用。”）桂术泽泻猪茯苓，多饮暖水取微汗，双解表
解也。服后多饮暖水，取其气散营卫，令得似汗而表里双解矣。）小便不利而渴饮，饮蓄胸
中水气停。（胃中干燥而渴饮，此无水也，与水则愈，宜白虎汤。小便不利而渴饮，此蓄水
也，利水则愈，宜五苓散。）水入即吐名水逆，（胸中有水，则不能容水，故水入则吐。水入
合看益分明。（按∶五苓证，一则曰“伤寒脉浮，小便不利，微热消渴”，一则曰“中风发热
而烦，渴欲饮水，水入即吐”，二条合看，益知五苓为利水而设，非治烦渴也。）故用五苓（散）
通水道，不然烦渴岂堪烹。（水气蒸腾，为烦，为渴，与五苓以利水，水去则烦渴
治病必求其本也。若烦渴非因水气者，岂五苓所可治哉！）身疼霍乱分寒热，表里阴
行。（霍乱身疼，须分寒、热二证∶若热多欲饮水者，宜五苓散和太阳之表里；若寒
水者，宜理中丸理中脏之阴阳。）若以桂枝更肉桂，（此本一方二法。治伤寒用桂枝，
用肉桂，乃有表无表之分。）吐涎眩悸水邪听。（脐下悸，吐涎沫，水气自下而上逆头
精气不布于上也。惟利其水，则眩悸吐涎悉愈。）水邪内着诚能却，外溢肌肤肿亦灵
治内着之水，诚为合度，即里水外渗于肌肉而为肿满者，亦灵。）除桂名为四苓散，
渴服之宁。（周扬俊曰∶“但小便不利而渴，只用四苓足矣。”盖外无恶寒发热身痛之
则不必用桂枝；内无眩悸吐涎之里证，则不必用肉桂。）辰砂清热苍除湿，黄胆茵陈
（五苓散加辰砂清热，名辰砂五苓散，加苍术胜湿，名苍术五苓散，加茵陈治疸，
苓散，皆仍五苓之名。）春泽（汤）加参名便易，病前病后渴能平。（五苓散加人参，
汤，取古诗“春水满泗泽”意，明言此汤治胸中有蓄水之渴也。一因无病而津气先虚
病后而津气未复，故加参以生津益气。）五苓（散）利水之专剂，作散方能布水精。（五
利水之专剂，作散服者，取其停留胸中，缓循经络，以输脾归肺，下达膀胱，水精四布
经并行，则水得尽去，而津液不伤，此仲景之微意也。）宁静水邪从下竭，（小青龙治动
逆之水，故汗而散之；五苓散治静而不行之水，故引而竭之。）变汤鲜效古来评。（徐灵
台轨范》曰∶“此乃散方，近人用以作汤，往往鲜效。”终当从古法为是，用者审之
（叶应昌《袖中金》）治疗噤口下痢，大便纯为血及秽浊腐败之物，身体发热，脉象洪大，肛门松弛如竹筒般无法收缩，以及各种严重的恶候，都可以用此方主治。但担心服用时已经太晚，毒邪已经攻伐损伤脏腑，那就难以救治了。
黄连（酒炒六分） 赤芍药（酒炒一钱） 木香（煨三分） 青皮（醋炒） 枳壳（麸炒） 槟榔（各四分） 红花（酒洗三分） 桃仁（去皮尖，研碎） 甘草（炙五分） 白术（土炒） 水煎服。
如果痢疾初起，上述药物用量各四分。
治痢奇方出自叶氏，是在东风散基础上加入红花、桃仁、黄连和地榆炭而成。（这个方子就是东风散的加味方），青出于蓝而胜于蓝，尤其值得称赞。
方中主要作用是攻逐邪气。治疗痢疾导致身体……（原文此处有缺漏或排版错误，结合上下文推测意为：治疗痢疾身痛等证）。云：此……邪气……亦……
（汪昂《医方集解》）治疗没有患病却口渴，以及病愈后仍然口渴的情况。
五苓散中加入人参。（如果再加入甘草，也叫做春泽汤。）
五苓散治疗太阳腑证。（王好古在《此事难知》中说：“五苓散属于下药，是治疗太阳里证的下药。太阳病出现小便不利，由五苓散主治；小便利的，不宜使用。”）桂枝、白术、泽泻、猪苓、茯苓，服药后多饮暖水以取微汗，表里双解。服药后多饮暖水，取其发散营卫之气，使身体微微出汗，从而达到表里双解的效果。（小便不利且口渴想喝水，是因为水气停蓄在胸中。如果是胃中干燥而口渴想喝水，这是无水之渴，给水就能好，适宜用白虎汤。小便不利且口渴想喝水，这是蓄水之渴，利水就能好，适宜用五苓散。）喝水后立即呕吐，叫做水逆。（胸中有水，所以不能容纳新入之水，因此水入即吐。综合来看更加明白清楚。（按语：五苓散证，一条说“伤寒脉浮，小便不利，微热消渴”，另一条说“中风发热而不烦，渴欲饮水，水入即吐”，将这两条合看，更知道五苓散是为利水而设，并非治疗烦渴。）所以用五苓散通调水道，否则烦渴怎么能够缓解呢。（水气蒸腾，导致烦闷和口渴，用五苓散利水，水去则烦渴自除。治病必须探求根本。如果烦渴不是由水气引起的，难道五苓散能治吗！）身体疼痛、霍乱要区分寒热，表里阴阳运行。（霍乱身体疼痛，必须区分寒、热两种证候：如果热多想喝水的，适宜用五苓散调和太阳的表里；如果寒多不想喝水的，适宜用理中丸调理中焦脏腑的阴阳。）如果用桂枝换成肉桂，（这原本是一方两法。治疗伤寒用桂枝，治疗其他情况用肉桂，是有表证和无表证的区别。）呕吐涎沫、眩晕、悸动，听凭水邪作祟。（脐下悸动，呕吐涎沫，是水气自下而上逆冲头部，精气不能布达于上。只有利其水，那么眩晕、悸动、呕吐涎沫都会痊愈。）水邪内着确实能去除，外溢肌肤的水肿也有效。（治疗内着的水邪，确实合乎法度，即使是里水外渗于肌肉而导致肿胀满闷的，也灵验。）去掉桂枝名称改为四苓散，口渴者服用安宁。（周扬俊说：“只是小便不利而口渴，只用四苓就够了。”因为外无恶寒发热身体疼痛的症状，则不必用桂枝；内无眩晕悸动呕吐涎沫的里证，则不必用肉桂。）辰砂清热，苍术除湿，黄疸用茵陈。（五苓散加辰砂清热，名叫辰砂五苓散；加苍术胜湿，名叫苍术五苓散；加茵陈治疗黄疸，名叫茵陈五苓散，都仍保留五苓散之名。）春泽汤加入人参名字便容易理解，病前病后的口渴都能平息。（五苓散加入人参，取自古诗“春水满泗泽”之意，明确说明此汤治疗胸中有蓄水导致的口渴。一是因为没生病时津气先虚，二是因为病后津气未恢复，所以加入人参以生津益气。）五苓散是利水的专剂，做成散剂才能布散水精。（五苓散是利水的专剂，做成散剂服用，是取其停留于胸中，缓慢循行经络，以输注脾肺，下达膀胱，使水精四布，经脉并行，这样水得以尽去，而津液不受伤，这是张仲景的深意。）宁静水邪从下竭尽，（小青龙汤治疗动逆之水，所以发汗以消散它；五苓散治疗静止而不流动的水，所以引导它从下排出。）变成汤剂鲜少有效，古来已有评价。（徐灵胎在《伤寒论类方·轨范》中说：“这是一个散方，近人用来煮成汤剂，往往很少见效。”终究应当遵循古法，使用者请审慎考虑。）
(Ye Yingchang's *Xiu Jin Zhong*) Treats dysentery with inability to eat (Jinkou Xili), where stool consists purely of blood and foul, putrid matter; accompanied by fever, a large pulse, anus flaccid like a bamboo tube, and various severe adverse symptoms. This formula can be the primary treatment for all such conditions. However, it is feared that if administered too late, the toxic pathogenic factors will have already damaged the Zang-Fu organs, making rescue difficult.
Coptidis Rhizoma (Huanglian) (stir-fried with wine, 2g)
Red Peony Root (Chishao Yao) (stir-fried with wine, 3g)
Aucklandiae Radix (Muxiang) (roasted, 1g)
Citri Reticulatae Pericarpium (Qingpi) (stir-fried with vinegar)
Magnoliae Officinalis Fructus (Zhi Qiao) (stir-fried with bran)
Arecae Semen (Binglang) (each 1.5g)
Carthami Flos (Honghua) (washed with wine, 1g)
Persicae Semen (Taoren) (dehulled and plumule removed)
Glycyrrhizae Radix et Rhizoma (Gancao) (roasted, 1.5g)
Atractylodis Macrocephalae Rhizoma (Baizhu) (soil-stir-fried)
Decoct in water and take orally.
If dysentery has just begun, use 1.5g for each of the above herbs.
The "Miraculous Formula for Treating Dysentery" originates from Master Ye. It adds Carthami Flos (Honghua), Persicae Semen (Taoren), Coptidis Rhizoma (Huanglian), and prepared Rheum Palmatum Rhizome Charcoal (Diyutan) to Dongfeng San. This formula is an augmented version of Dongfeng San, surpassing its predecessor, which is truly praiseworthy.
The main action of the formula is to attack and eliminate pathogenic factors. In treating dysentery... [Text fragment] ...pathogenic factors... also...
(Wang Ang's *Yi Fang Ji Jie*) Treats disorders caused by summer-heat and dampness.
Wuling San (Five-Ingredient Powder with Poria) added with Cinnabar (Zhusha).
Treats disorders caused by cold-dampness.
Wuling San (Five-Ingredient Powder with Poria) added with Atractylodis Rhizoma (Cangzhu).
Treats jaundice.
Wuling San (Five-Ingredient Powder with Poria) added with Artemisiae Scopariae Herba (Yinchen Hao).
(Wang Ang's *Yi Fang Ji Jie*) Treats thirst occurring without illness, or thirst persisting after recovery from illness.
Wuling San (Five-Ingredient Powder with Poria) added with Ginseng Radix et Rhizoma (Renshen). (If Licorice Root (Gancao) is also added, it is also called Chunze Tang.)
Wuling San (Five-Ingredient Powder with Poria) treats Taiyang Fu syndrome. (Wang Haogu in *Ci Shi Nan Zhi* stated: "Wuling San belongs to purgative formulas; it is a purgative for Taiyang interior syndromes. If Taiyang disease presents with difficulty in urination, Wuling San is indicated; if urination is free, it should not be used.") Cinnamon Twig (Guizhi), Atractylodis Macrocephalae Rhizoma (Baizhu), Alisma Rhizoma (Zexie), Polyporus (Zuling), and Poria (Fuling). After taking the powder, drink plenty of warm water to induce slight sweating, thereby resolving both exterior and interior simultaneously. Drinking warm water after administration helps disperse Qi in Ying and Wei, allowing slight sweating to achieve dual resolution of exterior and interior. (Difficulty in urination accompanied by thirst indicates water qi stagnating in the chest. If dryness in the Stomach causes thirst, this is a deficiency of fluids; providing water cures it, indicating Baihu Tang. Difficulty in urination with thirst indicates water retention; promoting diuresis cures it, indicating Wuling San.) Vomiting immediately after drinking water is named Shui Ni (Water Reversal). (Water in the chest cannot accommodate new intake, hence vomiting upon ingestion. Considering these together clarifies matters. Note: The Wuling San pattern includes one description stating "Taiyang disease with floating pulse, difficulty in urination, slight fever, and thirst," and another stating "Wind-stroke with fever, no irritability, desire to drink water, and vomiting immediately after drinking." Comparing these two confirms that Wuling San is designed for diuresis, not for treating irritability and thirst.) Therefore, Wuling San (San) is used to unblock the water passages; otherwise, how could irritability and thirst be alleviated? (Vaporization of water qi causes irritability and thirst. Using Wuling San to promote diuresis removes the water, thus resolving irritability and thirst. Treating disease requires addressing the root cause. If irritability and thirst are not due to water qi, can Wuling San treat them?) Body pain and Huoluan (acute gastrointestinal disorder) must distinguish between cold and heat, and the movement of exterior-interior Yin-Yang. (For Huoluan with body pain, distinguish cold and heat syndromes: If heat predominates and there is desire to drink water, Wuling San is suitable to harmonize the Taiyang exterior and interior; if cold predominates and there is no desire to drink water, Lizhong Wan is suitable to regulate the Yin-Yang of the Middle Jiao organs.) If Cinnamon Twig (Guizhi) is replaced by Cinnamon Bark (Rougui)... (This originally represents one formula with two methods. For treating Cold Damage, Guizhi is used; for other cases, Rougui is used, distinguishing the presence or absence of an exterior syndrome.) Vomiting saliva/phlegm, vertigo, and palpitations allow the water pathogen to act unchecked. (Palpitations below the umbilicus, vomiting of saliva/phlegm, indicate water qi counterflowing upward to the head, preventing Jing-Qi from distributing upwards. Only by promoting diuresis will vertigo, palpitations, and vomiting of saliva cease.) Effectively eliminating internally adhering water pathogens, and even edema overflowing into the skin muscles is effective. (Treating internally adhering water pathogens is indeed appropriate; even edema resulting from interior water seeping into muscles is effectively treated.) Removing Cinnamon changes the name to Siling San (Four-Ingredient Powder); taking it for thirst brings peace. (Zhou Yangjun said: "If there is only difficulty in urination and thirst, using Siling San alone is sufficient." Because there are no exterior symptoms like aversion to cold, fever, or body pain, Guizhi is unnecessary; because there are no interior symptoms like vertigo, palpitations, or vomiting of saliva, Rougui is unnecessary.) Cinnabar clears heat, Atractylodis Rhizoma (Cangzhu) dries dampness, and Yinchen Hao treats jaundice. (Wuling San added with Cinnabar to clear heat is named Chensha Wuling San; added with Cangzhu to overcome dampness, named Cangzhu Wuling San; added with Yinchen Hao to treat jaundice, named Yichen Wuling San; all retain the name Wuling San.) Chunze Tang added with Ginseng makes the name easy to understand; it can calm thirst before and after illness. (Wuling San added with Ginseng takes the meaning from the ancient poem "Spring water fills the ponds and marshes," explicitly stating that this decoction treats thirst caused by water retention in the chest. One reason is pre-existing deficiency of Jin-Qi before illness; the other is incomplete recovery of Jin-Qi after illness. Thus, Ginseng is added to generate Jin and tonify Qi.) Wuling San is a specialized agent for promoting diuresis; only as a powder can it distribute water essence. (Wuling San is a specialized diuretic. Taking it as a powder allows it to remain in the chest, slowly circulate through the meridians, transport to the Spleen and Lung, and descend to the Bladder, distributing water essence throughout. As meridians function together, water is completely eliminated without injuring Jin-Ye. This is Zhang Zhongjing's subtle intent.) Calming the water pathogen exhausts it from below. (Xiao Qinglong Tang treats turbulent, counterflowing water, so it uses sweating to dissipate it; Wuling San treats static, non-flowing water, so it guides it out from below.) Transforming into decoction rarely yields efficacy, as evaluated since ancient times. (Xu Lingtai in *Gui Fan* stated: "This is a powder formula. When modern practitioners use it as a decoction, it often lacks efficacy." One should ultimately follow the ancient method; users please exercise caution.)