（歌见长沙方歌括。） 治瘦人脐下有悸。吐涎沫而颠眩。此水也。此方主之。
猪苓 泽泻 白术 茯苓 桂枝。
喻嘉言云。水饮下郁于阴中。挟其阴邪。鼓动于脐则为悸。上入于胃则吐涎沫。及其郁
极乃发。直上头目。为颠为眩。五苓散利水以发汗。为分利表里阴阳之法。
男元犀按。脐下动气。去术加桂。仲师理中丸法也。兹何以脐下悸而用白术乎。不知吐
涎沫
白术
治心胸中有停痰宿水。自吐出水后。心胸间虚。气满不能食。消痰气。令能食
茯苓 人参 白术（各三两。） 枳实（二两。） 橘皮（二两半。） 生姜（四两。）
上六味。以水六升。煮取一升八合。分温三服。如人行八九里。通作一服进之。
歌曰 中虚不运聚成痰。枳二（两）参苓术各三。姜四橘皮二两半。补虚消满此中探。
男元犀按。人参乃水饮症之大忌。此方反用之。盖因自吐出水后虚气作满。脾弱不运而
设也
术
切
（见上。） 咳家其脉弦。为有水。此主之。 支饮家咳烦胸中痛者。不卒死。至一百
日
男蔚按。凡人将咳之顷。喉间似哽非哽。似痒非痒。若有若无者。皆饮气干之也。饮气
一干
十枣
百日
败名
喻云。咳嗽必因于痰饮。而五饮之中。独膈上支饮最为咳嗽根底。外邪入而合之固嗽。
即无
尤易
支饮
（相关歌诀见《长沙方歌括》。）本方主治形体消瘦者，脐下部位有跳动感，呕吐涎沫并伴有头晕目眩。这是水饮为患，本方为主治之方。
猪苓、泽泻、白术、茯苓、桂枝。
喻嘉言说：水饮郁结于阴分之中，挟带阴邪，鼓动于脐下则产生悸动感；向上侵入胃中则呕吐涎沫；等到郁结至极点而发作时，直冲头目，导致头晕和眩晕。五苓散通过利小便以发汗，是区分表里、调和阴阳的方法。
陈元犀按语：脐下有动气，应当去掉白术加上桂枝，这是张仲景理中丸的用法。这里为何在脐下悸动时使用白术呢？不知道呕吐涎沫……
治疗心胸中有停滞的痰饮宿水，自行吐出后，心胸间感到空虚，气满不能进食。此方能消除痰气，使患者能够进食。
茯苓、人参、白术（各三两）、枳实（二两）、橘皮（二两半）、生姜（四两）。
以上六味药，用水六升，煮取一升八合，分三次温服。如人行走八九里的时间，将药液合并为一次服用。
歌诀曰：中焦虚弱不运化聚而成痰，枳实二两、人参茯苓白术各三两，生姜四两、橘皮二两半，补虚消满的道理在此探寻。
陈元犀按语：人参是水饮病症的大忌，此方反而使用它。这是因为患者自行吐出痰水后，虚气导致胀满，因脾弱不运化而设立的。
（见上文。）咳嗽患者脉象弦，说明体内有水饮，本方主治。支饮患者咳嗽且心烦、胸中痛，如果没有突然死亡，病程可达一百日……
陈蔚按语：大凡人在将要咳嗽之际，喉间似哽非哽，似痒非痒，若有若无，这都是饮气干扰所致。饮气一旦干扰……
十枣汤……百日……败坏名声……
喻嘉言说：咳嗽必然由痰饮引起，而在五种饮证之中，唯独膈上的支饮最易成为咳嗽的根本原因。外邪入侵与之结合固然引起咳嗽，即使没有外邪……也更容易引发。
支饮
(See the song in *Changsha Fang Ge Kuo*.) This formula treats emaciated individuals who experience palpitations below the umbilicus, vomiting of saliva and froth, and dizziness or vertigo. This is caused by water retention; this formula is indicated.
Zhu Ling (Polyporus), Ze Xie (Alisma Rhizome), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Gui Zhi (Cinnamomi Ramulus).
Yu Jiayan stated: Water-fluids stagnate in the Yin aspect, carrying Yin pathogenic factors. When agitated at the umbilicus, it causes palpitations; when ascending into the Stomach, it causes vomiting of saliva and froth. When the stagnation reaches its extreme and erupts, it rises directly to the head and eyes, causing dizziness and vertigo. Wu Ling San (Five-Ingredient Powder with Poria) promotes urination to induce sweating, representing a method of separating the exterior and interior and harmonizing Yin and Yang.
Chen Yuanxi commented: For qi movement below the umbilicus, Bai Zhu should be removed and Gui Zhi added, following Zhang Zhongjing’s principle in Lizhong Wan. Why is Bai Zhu used here for palpitations below the umbilicus? One must not know that regarding vomiting of saliva and froth...
Treats retained phlegm and old fluids in the chest and heart region. After spontaneous vomiting of these fluids, the chest feels empty, accompanied by fullness of Qi and inability to eat. This formula eliminates phlegm and Qi, enabling the patient to eat.
Fu Ling (Poria), Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (each 3 liang), Zhi Shi (Immature Bitter Orange) (2 liang), Ju Pi (Citri Reticulatae Pericarpium) (2.5 liang), Sheng Jiang (Fresh Ginger Rhizome) (4 liang).
The above six ingredients are decocted in 6 sheng of water until 1.8 sheng remains. Divide into three warm doses. If the time taken for a person to walk eight or nine li passes, administer the entire amount as a single dose.
Song says: Middle Jiao deficiency fails to transport, leading to phlegm accumulation; Zhi Shi 2 liang, Ren Shen, Fu Ling, and Bai Zhu each 3 liang. Sheng Jiang 4 liang, Ju Pi 2.5 liang; exploring the principles of tonifying deficiency and eliminating fullness within.
Chen Yuanxi commented: Ren Shen is a major contraindication in water-fluid disorders, yet this formula uses it. This is because after spontaneous vomiting of fluids, deficient Qi causes fullness due to Spleen weakness and failure to transport.
(See above.) In patients with cough, a wiry pulse indicates the presence of water-fluids; this formula is indicated. In patients with Zhi Yin (Fluid Retention in the Diaphragm) who suffer from cough, irritability, and chest pain, if they do not die suddenly, the condition may persist for up to one hundred days...
Chen Wei commented: Generally, just before coughing occurs, the throat feels neither fully obstructed nor clear, neither fully itchy nor normal, existing between presence and absence. This is all due to fluid-Qi interfering. Once fluid-Qi interferes...
Shi Zao Tang (Ten-Date Decoction)... one hundred days... damaging reputation...
Yu Jiayan stated: Cough is inevitably caused by phlegm-fluids. Among the five types of fluid retention, only Zhi Yin (Fluid Retention in the Diaphragm) located above the diaphragm serves as the root foundation for cough. When external pathogens invade and combine with it, cough certainly results; even without external pathogens... it is more likely to occur.
Zhi Yin (Fluid Retention in the Diaphragm)