(一名伤寒夹水)
【因】素有停饮。外感风寒。或先受风寒。后饮冷水。及恣饮冷茶冷酒。或贪食瓜果生冷。
【证】头痛身热。恶寒无汗。胸痞干呕。咳吐稀涎。甚则胸胁串痛。喘不得卧。舌苔白滑。甚或黑滑。或半
边夹一二条白色。或中间夹一段白色。
【脉】浮弦而缓。甚则迟弦。仲景所谓伤寒脉浮缓。身但重。无少阴证是也。
【治】先当辛温发散。轻则苏羌达表汤加半夏、茯苓。重则小青龙汤加减。如风寒外解。或变心下痞硬。引
胁下痛。干呕短气者。即当急下停饮。蠲饮万灵汤主之。若变腹痛自利。四肢重痛。咳而兼呕者。即当通阳利水。
真武汤加减为主。(本方重用茯苓八钱、去白芍、加干姜八分拌捣五味子五分、姜半夏四钱。)势轻者。但用
苓术二陈煎。温中利水可也。
【秀按】风寒邪从外入。裹其停饮。虽当以小青龙汤。散邪涤饮。然惟夹溢饮症。水流四肢。身体疼重。最
为的对。若夹支饮症。咳逆倚息。短气不得卧。形肿胸满。喉中如水鸡声者。则当用射干麻黄汤。(射干钱半、麻
黄八分、姜半夏二钱、款冬花、紫菀各三钱、五味子、细辛各三分、生姜两片、红枣两枚、去射干、紫菀、款冬、
姜枣、五味、加川朴一钱、石膏四钱、杏仁四钱、干姜一钱、淮小麦三钱、名浓朴麻黄汤、亦治咳而脉浮、喉中
水鸡声。)发表下气。润燥开痰。四法一方。以分解其外内夹发之证。始有效力。若支饮射肺则肺胀。咳而上气。
烦噪而喘。脉浮者。则当用小青龙加石膏汤。发表利水。豁痰清热。始效。至若蠲饮万灵汤。则合小半夏加茯苓、
甘遂半夏、十枣三汤为剂。无论心下支饮。膈间留饮。胃肠悬饮。为喘为满。为痛为胀。为巅眩心悸。为呕涎吐沫。
善用者投无不效。然皆治夹饮之属实也。惟苓术二陈及真武加减。一主外饮治脾。一主内饮治肾。则治夹饮之属
虚者也。夹饮症得此七方。则表里虚实。皆可从此类推矣。
【廉勘】饮入于胃。经火蒸变而稠浊者为痰。未经蒸变而清稀者为水。观此则痰从火化。水从寒凝。痰能作
热。水能作冷。此夹痰与夹水病源之异也。故其脉舌证治。亦因而各异。一辨其脉。脉必弦。或偏弦。或双弦。
或弦缓。或迟弦。或沉弦。或弦紧类数。二辨其舌。苔多白润。间有转黄转黑者。亦必仍有滑苔。或满舌黄
黑。每夹一二条白色。或舌苔边尖俱黄。中间辨一段白色。久则舌前半光滑而不生苔。后半白滑而浓。三辨其
证。胸脘虽满痛。按之则软。略加揉按。辘辘有声。甚则肠下抽痛。干呕短气。或腰重足肿。下利溺少。四辨
其治。风寒夹饮。固当以辛药散之。温药和之。即温热症见夹水。虽有表邪。不宜纯用辛凉发散。纯用则表不
能解。而转见沉困。有里症不可早用苦寒。早用则必转加昏愦。此水气郁遏热邪。阳气受困。宜于发表清里药
中。加辛淡利水利气之品。以祛水气。迨水气去。郁遏发。然后议攻议凉。则无不效者矣。总之夹饮病初起。
不外乎风寒外侵。肥甘内滞。气机因而不利。往往畏风畏寒。汗闭溲闭。咳逆倚息不得卧。甚则肤肿。水为阴
邪。故时而头目眩晕。是水邪怫郁。阳气不上升。非痰火湿热之谓也。总宜以宣气涤饮。振胃阳以逐寒水。宜
汗则汗。宜利则利。随证酌加他药。而不可遽补。虽在高年。亦必先通后补。即补亦惟参、术、姜、附是宜。
如仲景苓桂术甘汤及理中汤、真武汤辈。为水饮正治之方。纵使久咳肺虚。终是水寒在胃。故虽行补剂。但
当壮气以通阳。不可益阴而助病。若洋参、石斛之养胃。生熟二地之滋阴。麦冬、阿胶之保肺。兜铃、蛤壳之
清金。贝母、栝蒌辈之滑痰润燥。则皆宜于夹痰之火燥。适相反于夹饮之水寒。即有热饮。达表宜越脾加半夏
汤。逐里宜己椒苈黄丸及控涎丹。三方加减为宜。时医不读《伤寒》《金匮》不知饮证。放弃仲景良方。反有所谓阴虚
痰饮者。岂知痰饮为阴盛之病。乃以阴盛而误认阴虚。一味清滋。宜乎饮咳久病之数见不鲜也。
【荣斋按】本节证治,俞何两先生都根据吴坤安《伤寒指掌》而加以经验化裁,学说已达到“简而明”的
阶段。此证初起时,吴氏主张用桂枝、淡干姜、半夏、茯苓、杏仁、炙草,这方法是根据叶天士,有可靠的疗
效。另有一种“络中伏饮”,吴氏也有经验治法。“他说∶如胸胁刺痛,时吐酸水,脉沉弦而口不渴者,此伏饮在络
也;宜桂枝五苓加姜汁炒蒺藜、半夏、全福花主之。”《全国名医验案》卷二载袁桂生治季姓妇风寒夹痰饮一案,
证见∶咳喘,倚息不得卧,恶寒发热,头疼身痛,胸闷不舒,胸痛彻背。脉沉弦而滑,舌苔白腻。药用∶麻黄
四分、桂枝四分、淡干姜五分、北细辛四分、生白芍一钱半、五味子五分、甘草五分、栝蒌仁三钱(杵)、干
薤白三钱(白酒捣洗)、姜半夏三钱。服后得汗,而寒热喘息俱平,惟身痛咳嗽未已。易方以∶桂枝汤加干姜
五味子各五分、细辛三分;两剂后愈。廉臣先生对此案的评语说∶“小青龙汤为治风寒外搏、痰饮内动之主
方,临证善为加减,莫不随手而愈;况合栝蒌薤白辛滑涤痰,当然奏效更速。接方桂枝汤加味,陈修圆治身痛
咳嗽,凡夹痰饮者,辄用五味姜辛推为神应之妙法,故仲景《伤寒论》、《金匮要略》两书,不可不悉心
研究也。”我认为这个病例,是“夹饮伤寒”用小青龙汤的一个事实,所以把它转录过来。
(又名伤寒夹水)
【病因】患者素有痰饮停滞。外感风寒之邪。或是先感受风寒,后饮用冷水,以及恣意饮用冷茶、冷酒,或贪食瓜果生冷之物。
【证候】头痛,身体发热,恶寒,无汗,胸脘痞闷,干呕,咳嗽并吐出稀薄涎沫,甚至出现胸胁部窜痛,气喘不能平卧。舌苔白滑,甚则呈黑滑状,或半边夹杂一二条白色苔,或中间夹杂一段白色苔。
【脉象】脉浮弦而缓,甚则脉迟弦。这正是张仲景所说的“伤寒脉浮缓,身体沉重,且无少阴病证”的情况。
【治法】首先应当采用辛温发散之法。病情轻者,用苏羌达表汤加半夏、茯苓;病情重者,用小青龙汤加减治疗。如果风寒在表得以解除,但转变为心下痞硬,牵引胁下疼痛,伴有干呕、短气的症状,此时应立即急下以去除停饮,主方用蠲饮万灵汤。若转变为腹痛、自发性腹泻,四肢沉重疼痛,咳嗽兼有呕吐的症状,此时应当通阳利水,主方用真武汤加减。(本方重用茯苓八钱,去掉白芍,加入干姜八分拌捣五味子五分、姜半夏四钱。)病情较轻者,仅使用苓术二陈煎,以温中利水即可。
【秀按】风寒邪气从外部侵入,包裹住体内的停饮。虽然应当使用小青龙汤来散邪涤饮,但这仅适用于夹溢饮症,即水流注于四肢,身体疼痛沉重的情况,最为对症。如果是夹支饮症,表现为咳嗽气逆,倚靠呼吸,短气不能平卧,形体浮肿,胸满,喉中有如水鸡叫声的,则应当使用射干麻黄汤。(原方:射干一钱半、麻黄八分、姜半夏二钱、款冬花、紫菀各三钱、五味子、细辛各三分、生姜两片、红枣两枚。去射干、紫菀、款冬、姜枣、五味子,加川朴一钱、石膏四钱、杏仁四钱、干姜一钱、淮小麦三钱,名为浓朴麻黄汤,也治疗咳嗽且脉浮、喉中有水鸡声的情况。)此方集发表、下气、润燥、开痰四法于一方,以分解内外夹发的证候,始能见效。如果支饮射肺导致肺胀,咳嗽且上气,烦躁而喘,脉浮的,则应当使用小青龙加石膏汤,以发表利水,豁痰清热,才能见效。至于蠲饮万灵汤,则是合小半夏加茯苓汤、甘遂半夏汤、十枣汤三方为一剂。无论心下有支饮,膈间有留饮,胃肠有悬饮,表现为喘、满、痛、胀、巅顶眩晕心悸、呕吐涎沫等症,善于使用者投药无不有效。然而这些都是治疗夹饮属于实证的方法。只有苓术二陈汤及真武汤加减,一个主治外饮治脾,一个主治内饮治肾,则是治疗夹饮属于虚证的方法。夹饮症得到这七个方剂,那么表里虚实的情况都可以从此类推了。
【廉勘】水饮进入胃中,经过火气蒸变变得稠浊的称为痰,未经过蒸变保持清稀的称为水。由此可知,痰由火化,水由寒凝。痰能产生热,水能产生冷,这是夹痰与夹水病源的不同之处。因此,其脉象、舌象、证候和治法也因此各异。第一辨脉象,脉必现弦象,或偏弦,或双弦,或弦缓,或迟弦,或沉弦,或弦紧类似数脉。第二辨舌象,舌苔多白润,间或有转黄转黑的,但也必然仍有滑苔,或满舌黄黑,每夹杂一二条白色,或舌苔边尖俱黄,中间辨别出一段白色,久则舌前半光滑而不生苔,后半白滑而厚。第三辨证候,胸脘虽满痛,但按压时柔软,稍微揉按,辘辘有声,甚则肠部抽痛,干呕短气,或腰重足肿,下利尿少。第四辨治法,风寒夹饮,固然应当用辛药发散,温药调和。即使是温热症见到夹水,虽有表邪,也不宜纯用辛凉发散,纯用则表邪不能解,反而转为沉困。有里症不可早用苦寒,早用则必加重昏愦。这是因为水气郁遏热邪,阳气受困,应当在发表清里的药物中,加入辛淡利水利气的药物,以祛除水气。待水气去除,郁遏解开,然后讨论攻伐或清凉,则无不有效。总之,夹饮病初起,不外乎风寒外侵,肥甘内滞,气机因而不利,往往畏风畏寒,汗闭尿闭,咳逆倚息不能平卧,甚则皮肤浮肿。水为阴邪,所以时而头目眩晕,这是水邪怫郁,阳气不上升,并非痰火湿热所致。总宜宣气涤饮,振奋胃阳以驱逐寒水。宜汗则发汗,宜利则利尿,随证酌加其他药物,而不可急于进补。即使在高龄老人,也必须先通后补,即便进补也只适宜用人参、白术、干姜、附子。如张仲景的苓桂术甘汤及理中汤、真武汤之类,是治疗水饮的正治方剂。纵使久咳导致肺虚,终究是水寒在胃,所以即便使用补剂,也只应当壮气以通阳,不可益阴而助长病邪。如西洋参、石斛养胃,生熟地黄滋阴,麦冬、阿胶保肺,兜铃、蛤壳清金,贝母、瓜蒌辈滑痰润燥,这些都适宜于夹痰的火燥证,恰好与夹饮的水寒证相反。即使有热饮,在表宜用越婢加半夏汤,在里宜用己椒苈黄丸及控涎丹,三方加减为宜。当时的医生不读《伤寒论》《金匮要略》,不知道饮证的治法,放弃张仲景的良方,反而有所谓阴虚痰饮的说法,哪里知道痰饮是阴盛之病,却因阴盛而误认为阴虚,一味清滋,难怪饮咳久病屡见不鲜。
【荣斋按】本节证治,俞根初、何秀山两位先生都依据吴坤安《伤寒指掌》加以经验化裁,学说已达到“简而明”的阶段。此证初起时,吴氏主张用桂枝、淡干姜、半夏、茯苓、杏仁、炙甘草,这种方法是根据叶天士的经验,有可靠的疗效。另有一种“络中伏饮”,吴氏也有经验治法。他说:“如胸胁刺痛,时常吐酸水,脉沉弦而口不渴的,这是伏饮在络;宜用桂枝五苓汤加姜汁炒蒺藜、半夏、全福花主治。”《全国名医验案》卷二记载袁桂生治疗季姓妇人风寒夹痰饮一案,证见:咳喘,倚息不能平卧,恶寒发热,头疼身痛,胸闷不舒,胸痛彻背。脉沉弦而滑,舌苔白腻。药用:麻黄四分、桂枝四分、淡干姜五分、北细辛四分、生白芍一钱半、五味子五分、甘草五分、栝蒌仁三钱(杵)、干薤白三钱(白酒捣洗)、姜半夏三钱。服药后得汗,而寒热喘息俱平,惟身痛咳嗽未止。换方用:桂枝汤加干姜、五味子各五分、细辛三分;两剂后痊愈。廉臣先生对此案的评语说:“小青龙汤是治疗风寒外搏、痰饮内动的主方,临证善于加减,莫不随手而愈;何况合用栝蒌薤白辛滑涤痰,当然奏效更速。接方桂枝汤加味,陈修园治疗身痛咳嗽,凡夹痰饮者,辄用五味子、干姜、细辛推为神应之妙法,所以张仲景《伤寒论》、《金匮要略》两书,不可不悉心研究啊。”我认为这个病例,是“夹饮伤寒”使用小青龙汤的一个实例,所以把它转录过来。
(Also known as Taiyang Disease with Water Retention)
【Etiology】The patient has a pre-existing condition of fluid retention (Phlegm-Fluid). They contract Wind-Cold pathogens externally. Alternatively, they may first contract Wind-Cold and then drink cold water, or indulge in drinking cold tea and cold wine, or greedily consume raw fruits and vegetables.
【Symptoms】Headache, feverish sensation in the body, aversion to cold, absence of sweating, chest and epigastric stuffiness, dry retching, coughing up thin saliva, and in severe cases, wandering pain in the chest and hypochondrium, wheezing preventing lying flat. The tongue coating is white and slippery; in severe cases, it may be black and slippery, or have one or two white strips on half the tongue, or a white patch in the center.
【Pulse】Floating, wiry, and slow. In severe cases, it is deep-wiry or slow-wiry. This corresponds to what Zhang Zhongjing described as "Taiyang disease with a floating-slow pulse, heaviness of the body, and absence of Shaoyin symptoms."
【Treatment】Initially, acrid-warm dispersing methods should be employed. For mild cases, Suqiang Dabiao Decoction (Perilla and Notopterygium Exterior-Releasing Decoction) with Pinellia Rhizome (Banxia) and Poria (Fuling) is used. For severe cases, Xiao Qinglong Tang (Minor Blue Dragon Decoction) with modifications is used. If the exterior Wind-Cold is resolved but transforms into epigastric hardness and fullness, pain radiating to the hypochondrium, dry retching, and shortness of breath, immediate purgation to remove retained fluid is required, using Juan Yin Wan Ling Tang (Ten Thousand Miracle Fluid-Removing Decoction) as the main formula. If it transforms into abdominal pain, spontaneous diarrhea, heavy and painful limbs, cough accompanied by vomiting, Yang-transmitting and diuretic methods should be applied, with Zhen Wu Tang (True Warrior Decoction) modified as the main formula. (In this formula, Fuling is heavily dosed at 8 qian, Baishao is removed, Ganjiang is added at 8 fen mixed with Wuzi at 5 fen, and Jiang Banxia is added at 4 qian.) For milder conditions, simply using Lingzhu Erchen Decoction (Poria and Atractylodes Two-Ancients Decoction) to warm the middle and promote urination is sufficient.
【Commentary by Xiu】Wind-Cold pathogens enter from the exterior and envelop the existing fluid retention. Although Xiao Qinglong Tang (Minor Blue Dragon Decoction) should be used to disperse pathogens and eliminate fluids, this is specifically indicated for Jia Yi Yin Syndrome (Clasped Overflowing Fluid Syndrome), where water flows into the limbs causing body pain and heaviness, which is most accurate. If it involves Jia Zhi Yin Syndrome (Clasped Branching Fluid Syndrome), characterized by coughing, gasping while leaning forward, shortness of inability to lie flat, edema, chest fullness, and a sound in the throat like a waterfowl, then Shegan Mahuang Tang (Belamcanda and Ephedra Decoction) should be used. (Original prescription: Shegan 1.5 qian, Mahuang 8 fen, Jiang Banxia 2 qian, Kuandonghua and Ziwan each 3 qian, Wuzi and Xixin each 3 fen, Shengjiang 2 slices, Hongzao 2 pieces. Remove Shegan, Ziwan, Kuandonghua, Shengjiang, Hongzao, Wuzi; add Chuanpo 1 qian, Shigao 4 qian, Xingren 4 qian, Ganjiang 1 qian, Huaixiaomai 3 qian. Named Nongpu Mahuang Tang, also treats cough with floating pulse and waterfowl-like throat sounds.) This formula combines four methods: releasing the exterior, directing Qi downward, moistening dryness, and opening phlegm, to resolve the simultaneous exterior-interior manifestation, thereby achieving efficacy. If Zhi Yin attacks the Lung causing Lung Distension, with cough, upward rushing of Qi, irritability, wheezing, and a floating pulse, then Xiao Qinglong Tang plus Shigao (Minor Blue Dragon Decoction plus Gypsum) should be used to release the exterior, promote urination, resolve phlegm, and clear heat to be effective. As for Juan Yin Wan Ling Tang, it combines Xiaobanxia Jia Fuling Tang (Minor Pinellia with Poria Decoction), Gansui Banxia Tang (Kansui and Pinellia Decoction), and Shizao Tang (Ten Jujube Decoction) into one compound. Regardless of whether it is Zhi Yin in the epigastrium, Liu Yin between the diaphragm, or Xuan Yin in the stomach and intestines, manifesting as wheezing, fullness, pain, distension, dizziness, palpitations, or vomiting of saliva and foam, skilled practitioners find it invariably effective. However, these treat excess-type fluid retention. Only Lingzhu Erchen Tang and modified Zhen Wu Tang, one treating exterior fluid by regulating the Spleen and the other treating interior fluid by regulating the Kidney, address deficiency-type fluid retention. With these seven formulas for fluid-clasped diseases, patterns of exterior-interior and excess-deficiency can be extrapolated.
【Commentary by Lian】When fluid enters the Stomach, if it is steamed by Fire and becomes thick and turbid, it is called Tan (Phlegm); if it remains unsteamed and clear/thin, it is called Shui (Water). Thus, Tan transforms via Fire, while Shui coagulates via Cold. Tan generates Heat, while Shui generates Cold; this is the difference in etiology between Phlegm-clasped and Water-clasped diseases. Consequently, their pulse, tongue, symptoms, and treatments differ. First, distinguish the pulse: it must be Wiry, or biased-Wiry, double-Wiry, Wiry-Slow, Slow-Wiry, Deep-Wiry, or Wiry-Tight resembling Rapid. Second, distinguish the tongue: coating is mostly white and moist, occasionally turning yellow or black, but always remaining slippery, or fully yellow/black with interspersed white strips, or yellow edges/tips with a central white patch. Long-standing cases show a smooth anterior tongue without coating and a thick white-slippery posterior coating. Third, distinguish symptoms: although the chest and epigastrium are full and painful, they are soft upon pressure; slight rubbing produces gurgling sounds. Severe cases involve intestinal cramping pain, dry retching, shortness of breath, heavy waist, swollen feet, diarrhea, and scanty urination. Fourth, distinguish treatment: For Wind-Cold clasping fluid, acrid herbs should disperse, and warm herbs harmonize. Even if Warm-Heat disease presents with water retention, despite exterior pathogens, pure acrid-cool dispersants should not be used exclusively, as this fails to resolve the exterior and leads to sinking fatigue. Interior syndromes should not be treated early with bitter-cold herbs, as this worsens confusion. This is because Water Qi restrains Heat pathogens and confines Yang Qi; therefore, acrid-light diuretic and Qi-moving herbs should be added to exterior-releasing and interior-clearing prescriptions to dispel Water Qi. Once Water Qi is gone and restraint released, attack or cooling methods can be considered effectively. In summary, early fluid-clasped disease stems from external Wind-Cold invasion and internal stagnation of rich/greasy foods, leading to Qi mechanism obstruction, often presenting with fear of wind/cold, closed sweat/urine, coughing/gasping unable to lie flat, and even skin edema. Water is a Yin pathogen, causing occasional dizziness due to Water Qi depression blocking Yang ascent, distinct from Phlegm-Fire-Damp-Heat. Generally, promote Qi movement and eliminate fluid, invigorate Stomach Yang to drive out Cold Water. Induce sweat if appropriate, promote urination if appropriate, modify with other herbs as needed, but do not tonify hastily. Even in the elderly, unblocking must precede tonifying; if tonifying, only Renshen, Baizhu, Ganjiang, Fuzi are suitable. Formulas like Linggui Zhugan Tang, Lizhong Tang, and Zhen Wu Tang by Zhang Zhongjing are correct treatments for Water-Fluid. Even with chronic cough and Lung deficiency, the root is Cold Water in the Stomach; thus, tonics should strengthen Qi to unblock Yang, not nourish Yin which aids pathology. Herbs like Yangshen, Shihu for Stomach nourishment, Sheng/Di Huang for Yin nourishment, Maidong, Ejiao for Lung protection, Doulou, Geqiao for clearing Metal, Beimu, Gualou for sliding phlegm/moistening dryness, are suitable for Phlegm-Fire-Dryness, opposite to Water-Cold of Fluid-clasped disease. Even for Hot Fluid, exterior cases use Yebing Jia Banxia Tang, interior cases use Jingpi Li Huang Wan and Kongxian Dan, modified appropriately. Contemporary physicians who do not study Shanghan Lun and Jingui Yaolue fail to understand Fluid syndromes, abandoning Zhang Zhongjing's excellent formulas, instead proposing "Yin-Deficiency Phlegm-Fluid," mistakenly identifying Yin-Excess as Yin-Deficiency, and using purely moistening/clearing methods, explaining why chronic fluid-cough is common.
【Commentary by Rongzhai】The syndrome and treatment in this section, based on Wu Kun'an's Shanghan Zhizhang by Mr. Yu Genchu and Mr. He Xiushan, incorporate empirical modifications, reaching a stage of being "simple and clear." At onset, Wu advocated Guizhi, Dan Ganjiang, Banxia, Fuling, Xingren, Zhi Cao, a method derived from Ye Tianshi with reliable efficacy. Another type, "Latent Fluid in Collaterals," also has empirical treatments by Wu: "If there is stabbing pain in chest/hypochondrium, frequent sour regurgitation, deep-wiry pulse, and no thirst, this is Latent Fluid in Collaterals; use Guizhi Wuling Tang with Jiang Zhi Cili, Banxia, Quan Fuhua." Case 2 of Vol. 2 of Quanguo Mingyi An records Yuan Guisheng treating Mrs. Ji for Wind-Cold clasping Phlegm-Fluid: cough/wheezing, gasping unable to lie flat, aversion to cold/fever, headache/body ache, chest stuffiness, back-piercing chest pain. Pulse deep-wiry-slippery, coating white-greasy. Prescription: Mahuang 4 fen, Guizhi 4 fen, Dan Ganjiang 5 fen, Bei Xixin 4 fen, Sheng Baishao 1.5 qian, Wuzi 5 fen, Gancao 5 fen, Gualou Ren 3 qian (crushed), Gan Xiebai 3 qian (washed with rice wine), Jiang Banxia 3 qian. After taking, sweat occurred, cold/fever/wheezing subsided, but body ache/cough persisted. Changed formula: Guizhi Tang plus Ganjiang, Wuzi each 5 fen, Xixin 3 fen; cured after two doses. Mr. Lian commented: "Xiao Qinglong Tang is the main formula for Wind-Cold exterior constriction and internal Phlegm-Fluid movement; skillful modification yields instant cures; combined with Gualou Xiebai acrid-sliding phlegm-resolving action, efficacy is faster. The follow-up Guizhi Tang modification uses Chen Xiuyuan's divine method of Wuzi, Ganjiang, Xixin for body ache/cough with Phlegm-Fluid. Thus, Shanghan Lun and Jingui Yaolue must be studied diligently." I consider this case a factual application of Xiao Qinglong Tang for "Fluid-Clasped Taiyang Disease," so I transcribe it here.