1．问曰∶夫饮有四，何谓也？师曰∶有痰饮，有
悬饮，有溢饮，有支饮。
2．问曰∶四饮何以为异？师曰∶其人素盛今瘦，水走肠间，沥沥有声，谓之痰饮；饮后水流在胁下，咳吐
引痛，谓之悬饮；饮水流行，归于四肢，当汗出而不汗出，身体疼重，谓之溢饮；咳逆倚息，气短不得卧，其形
如肿，谓之支饮。
3．水在心，心下坚筑，短气，恶水不欲饮。
4．水在肺，吐涎沫，欲饮水。
5．水在脾，少气身重。
6．水在肝，胁下支满，嚏而痛。
7．水在肾，心下悸。
8．夫心下有留饮，其人背寒冷如掌大。
9．留饮者，胁下痛引缺盆，咳嗽则辄已（一作∶转甚。）
10．胸中有留饮，其人短气而渴。四肢历节病，脉沉者有留饮。
11．膈上病痰，满喘咳吐，发则寒热，背痛，腰疼，目泣自出，其人振振身 剧，必有伏饮。
12．夫病患饮水多，必暴喘满。凡食少饮多，水停心下，甚者则悸，微者短气。脉双弦者，寒也。皆大下后
里虚。脉偏弦者，饮也。
13．肺饮不弦，但苦喘短气。
14．支饮亦喘而不能卧，加短气，其脉平也。
15．病痰饮者，当以温药和之。
16．心下有痰饮，胸胁支满，目眩，苓桂术甘汤主之。
茯苓桂枝白术甘草汤方
茯苓（四两） 桂枝 白术（各三两） 甘草（二两）
上四味，以水六升，煮取三升，分温三服，小便则利。
17．夫短气有微饮，当从小便去之，苓桂术甘汤主之。（方见上）。肾气丸亦主之。（方见妇人杂病中。）
18．病者脉伏，其人欲自利，利反快，虽利，心下续坚满，此为留饮欲去故也，甘遂半夏汤主之。
甘遂半夏汤方
甘遂（大者，三枚） 半夏（十二枚 以水一升煮取半升，去滓） 芍药（五枚） 甘草（如指大一枚，炙
一本作无）
上四味，以水二升，煮取半升，去滓，以蜜半升，和药汁煎取八合，顿服之。
19．脉浮而细滑，伤饮。
20．脉弦数，有寒饮，冬夏难治。
21．脉沉而弦者，悬饮内痛。
22．病悬饮者，十枣汤主之。
十枣汤方
芫花熬 甘遂 大戟（各等分）
上三味，捣筛，以水一升五合，先煮肥大枣十枚，取八合，去滓，纳药末，强人服一钱匕，羸人服半钱，平
旦温服之，不下者，明日更加半钱，得快之后，糜粥自养。
23．病溢饮者，当发其汗，大青龙汤主之，小青龙汤亦主之。
大青龙汤方
麻黄（六两，去节） 桂枝（二两，去皮） 甘草（二两，炙） 杏仁（四十个，去皮尖） 生姜（三两）
大枣（十二枚） 石膏（如鸡子大，碎）
上七味，以水九升，先煮麻黄，减二升，去上沫，纳诸药，煮取三升，去滓，温服一升，取微似汗，汗多者
温粉粉之。
小青龙汤方
麻黄（三两，去节） 芍药（三两） 五味子（半升） 干姜（三两） 甘草（三两，炙） 细辛（三两）
桂枝（三两，去皮） 半夏（半升，汤洗）
上八味，以水一斗，先煮麻黄，减二升，去上沫，纳诸药，煮取三升，去滓，温服一升。
24．膈间支饮，其人喘满，心下痞坚，面色黧黑，其脉沉紧，得之数十日，医吐下之不愈，木防
己汤主之。虚者即愈，实者三日复发，复与不愈者，宜木防己汤去石膏加茯苓芒硝汤主之。
木防己汤方
木防己（三两） 石膏（十二枚，鸡子大） 桂枝（二两） 人参（四两）
上四味，以水六升，煮取二升，分温再服。
木防己加茯苓芒硝汤方
木防己 桂枝（各二两） 芒硝（三合） 人参 茯苓（各四两）
上五味，以水六升，煮取二升，去滓，纳芒硝，再微煎，分温再服，微利则愈。
25．心下有支饮，其人苦冒眩，泽泻汤主之。
泽泻汤方
泽泻（五两） 白术（二两）
上二味，以水二升，煮取一升，分温再服。
26．支饮胸满者，浓朴大黄汤主之。
浓朴大黄汤方
浓朴（一尺） 大黄（六两） 枳实（四枚）
上三味，以水五升，煮取二升，分温再服。
27．支饮不得息，葶苈大枣泻肺汤主之。（方见肺痈中。）
28．呕家本渴，渴者为欲解，今反不渴，心下有支饮故也，小半夏汤主之。（《千金》云∶小半夏加茯苓汤。）
小半夏汤方
半夏（一升） 生姜（半斤）
上二味，以水七升，煮取一升半，分温再服。
29．腹满，口舌干燥，此肠间有水气，己椒苈黄丸主之。
防己椒目葶苈大黄丸方
防己 椒目 葶苈（熬） 大黄（各一两）
上四味，末之，蜜丸如梧子大，先食饮服一丸，日三服。稍增，口中有津液。渴者加芒硝半两。
30．卒呕吐，心下痞，膈间有水，眩悸者，小半夏加茯苓汤主之。
小半夏加茯苓汤方
半夏（一升） 生姜（半斤） 茯苓（三两一法四两）
上三味，以水七升，煮取一升五合，分温再服。
31．假令瘦人，脐下有悸，吐涎沫而癫眩，此水也，五苓散主之。
五苓散方
泽泻（一两一分） 猪苓（三分，去皮） 茯苓（三分） 白术（三分） 桂（二分，去皮）
上五味，为末，白饮服方寸匕，日三服，多饮暖水，汗出愈。
附方
《外台》茯苓饮 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） 桔皮（二两半） 生姜（四两）
上六味，水六升，煮取一升八合，分温三服，如人行八九里进之。
32．咳家其脉弦，为有水，十枣汤主之。（方见上。）
33．夫有支饮家，咳烦，胸中痛者，不卒死，
至一百日或一岁，宜十枣汤。（方见上。）
34．久咳数岁，其脉弱者，可治；实大数者，死。其脉虚者，必苦冒，其人本有支饮在胸中故也。治属饮家。
35．咳逆倚息不得卧，小青龙汤主之。（方见上）。
36．青龙汤下已，多唾，口燥，寸脉沉，尺脉微，手足厥逆，气从小腹上冲胸咽，手足痹，其面翕热如醉状，
因复下流阴股，小便难，时复冒者，与茯苓桂枝五味甘草汤，治其气冲。
桂苓五味甘草汤方
茯苓（四两） 桂枝（去皮，四两） 甘草（炙，三两） 五味子（半升）
上四味，以水八升，煮取三升，去滓，分温三服。
37．冲气即低，而反更咳、胸满者，用桂苓五味甘草汤，去桂，加干姜、细辛，以治其咳满。
苓甘五味姜辛汤方
茯苓（四两） 甘草 干姜 细辛（各三两）
五味（半升）
上五味，以水八升，煮取三升，去滓，温服半升，日三。
38．咳满即止，而更复渴，冲气复发者，以细辛、干姜为热药也，服之当遂渴。而渴反止者，为支饮也。支
饮者，法当冒，冒者必呕，呕者复纳半夏以去其水。
桂苓五味甘草去桂加干姜细辛半夏汤方
茯苓（四两） 甘草 细辛 干姜（各二两） 五味子 半夏（各半升）
上六味，以水八升，煮取三升，去滓，温服半升，日三。
39．水去呕止，其人形肿者，加杏仁主之。其证应纳麻黄，以其人遂痹故不纳之。若逆而纳之者必厥，所以
然者，以其人血虚，麻黄发其阳故也。
苓甘五味加姜辛半夏杏仁汤方
茯苓（四两） 甘草（三两） 五味（半升） 干姜（三两） 细辛（三两） 半夏（半升） 杏仁（半升，
去皮尖）
上七味，以水一斗，煮取三升，去滓，温服半升，日三。
40．若面热如醉，此为胃热上冲熏其面，加大
黄以利之。
苓甘五味加姜辛半杏大黄汤方
茯苓（四两） 甘草（三两） 五味（半升） 干姜（三两） 细辛（三两） 半夏（半升） 杏仁（半升）
大黄（三两）
上八味，以水一斗，煮取三升，去滓，温服半升，日三。
41．先渴后呕，为水停心下，此属饮家，小半夏加茯苓汤主之。（方见上）。
1. 问：饮邪分为四种，具体是指什么？老师回答：有痰饮、悬饮、溢饮、支饮这四种。
2. 问：这四种饮邪的区别在哪里？老师回答：如果一个人平时身体壮实现在却消瘦，水液流动在肠间，发出沥沥的声音，这叫痰饮；饮水后水流停留在胁下，咳嗽吐唾沫时牵引作痛，这叫悬饮；饮水后水液流行，流注到四肢，本该出汗却不出汗，身体疼痛沉重，这叫溢饮；咳嗽气逆，需要倚靠物体呼吸，气短不能平卧，身形看起来像浮肿，这叫支饮。
3. 水饮停聚在心，心下部坚硬筑筑跳动，气短，厌恶水而不想喝水。
8. 心下有留饮（停留不去的水饮），病人的背部有一块手掌大小的地方感觉寒冷。
9. 留饮病，胁下疼痛牵引至缺盆穴，咳嗽时疼痛就会停止（另一版本说：咳嗽时疼痛反而加重）。
10. 胸中有留饮，病人气短且口渴。四肢关节疼痛，脉象沉的，是有留饮的表现。
11. 膈上有痰病，胸闷气喘咳嗽吐痰，发作时伴有寒热，背痛，腰痛，眼泪不由自主流出，病人身体震颤剧烈，这一定有伏饮（潜伏的水饮）。
12. 病人喝水多，一定会突然喘促胀满。凡是吃得少喝得多，水停在心下，严重的会出现心悸，轻微的会出现气短。脉象左右手都弦的，是寒证。这都是因为大病攻下之后导致里虚。脉象只有一侧弦的，是饮邪。
15. 患痰饮病的，应当用温性的药物来调和它。
16. 心下有痰饮，胸胁部支撑胀满，头晕目眩，用苓桂术甘汤主治。
苓桂术甘汤方
茯苓（四两） 桂枝 白术（各三两） 甘草（二两）
以上四味药，用水六升，煮取三升，分三次温服，小便通利则病愈。
17. 气短而有轻微饮邪的，应当从小便排出它，用苓桂术甘汤主治。（方剂见上文）。肾气丸也主治。（方剂见妇人杂病篇中）。
18. 病人脉象伏隐，他想自下利，泻后反而觉得爽快，虽然腹泻，心下部继续坚硬胀满，这是留饮欲去而未去的缘故，用甘遂半夏汤主治。
甘遂半夏汤方
甘遂（大的三枚） 半夏（十二枚，用水一升煮取半升，去渣） 芍药（五枚） 甘草（如手指大一枚，炙过，另一版本作无）
以上四味药，用水二升，煮取半升，去渣，加入蜂蜜半升，与药汁一起煎取八合，一次性服用。
19. 脉象浮而细滑，是伤于饮邪。
20. 脉象弦数，有寒饮，冬夏两季难治。
21. 脉象沉而弦的，是悬饮内痛。
22. 患悬饮病的，用十枣汤主治。
十枣汤方
芫花（熬制） 甘遂 大戟（各等分）
以上三味药，捣筛成散，用水一升五合，先煮肥大枣十枚，取八合，去渣，纳入药末，体质强壮的人服一钱匕，体质虚弱的人服半钱，清晨温服，若未排便，第二天增加半钱，得快利之后，用米粥调养自己。
23. 患溢饮病的，应当发汗，用大青龙汤主治，小青龙汤也主治。
大青龙汤方
麻黄（六两，去节） 桂枝（二两，去皮） 甘草（二两，炙） 杏仁（四十个，去皮尖） 生姜（三两） 大枣（十二枚） 石膏（如鸡蛋大，碎）
以上七味药，用水九升，先煮麻黄，减少二升，去掉上面的浮沫，加入其他药物，煮取三升，去渣，温服一升，取微似汗，如果汗出太多，用温粉扑身。
小青龙汤方
麻黄（三两，去节） 芍药（三两） 五味子（半升） 干姜（三两） 甘草（三两，炙） 细辛（三两） 桂枝（三两，去皮） 半夏（半升，汤洗）
以上八味药，用水一斗，先煮麻黄，减少二升，去掉上面的浮沫，加入其他药物，煮取三升，去渣，温服一升。
24. 膈间的支饮，病人喘满，心下部痞塞坚硬，面色黑褐，脉象沉紧，得病几十天，医生用吐法下法治疗没有痊愈，用木防己汤主治。虚证的即愈，实证三天后复发，再次给予木防己汤仍不愈的，适宜用木防己汤去石膏加茯苓芒硝汤主治。
木防己汤方
木防己（三两） 石膏（十二枚，鸡子大） 桂枝（二两） 人参（四两）
以上四味药，用水六升，煮取二升，分两次温服。
木防己加茯苓芒硝汤方
木防己 桂枝（各二两） 芒硝（三合） 人参 茯苓（各四两）
以上五味药，用水六升，煮取二升，去渣，纳入芒硝，再稍微煎煮，分两次温服，微微通利则病愈。
25. 心下有支饮，病人苦于头昏目眩，用泽泻汤主治。
泽泻汤方
泽泻（五两） 白术（二两）
以上两味药，用水二升，煮取一升，分两次温服。
26. 支饮胸满的，用浓朴大黄汤主治。
浓朴大黄汤方
浓朴（一尺） 大黄（六两） 枳实（四枚）
以上三味药，用水五升，煮取二升，分两次温服。
27. 支饮导致呼吸困难的，用葶苈大枣泻肺汤主治。（方剂见肺痈篇中）。
28. 呕吐的病人本来应该口渴，口渴的是病欲解，现在反而不渴，是因为心下有支饮的缘故，用小半夏汤主治。（《千金方》说：小半夏加茯苓汤）。
小半夏汤方
半夏（一升） 生姜（半斤）
以上两味药，用水七升，煮取一升半，分两次温服。
29. 腹部胀满，口舌干燥，这是肠间有水气，用己椒苈黄丸主治。
防己椒目葶苈大黄丸方
防己 椒目 葶苈（熬制） 大黄（各一两）
以上四味药，研为末，蜜丸如梧桐子大，饭前饮服一丸，每日三次。逐渐增加剂量，直到口中生津液。如果口渴，加芒硝半两。
30. 突然呕吐，心下部痞塞，膈间有水，头晕心悸的，用小半夏加茯苓汤主治。
小半夏加茯苓汤方
半夏（一升） 生姜（半斤） 茯苓（三两，另一法四两）
以上三味药，用水七升，煮取一升五合，分两次温服。
31. 假如瘦人，脐下有悸动感，吐涎沫并且发生癫眩，这是水饮，用五苓散主治。
五苓散方
泽泻（一两一分） 猪苓（三分，去皮） 茯苓（三分） 白术（三分） 桂（二分，去皮）
以上五味药，研为末，用米汤送服方寸匕，每日三次，多喝暖水，出汗则愈。
附方
《外台秘要》茯苓饮 治疗心胸中有停痰宿水，自行吐出后，心胸间空虚，气满不能进食，能消除痰气，使能进食。
茯苓 人参 白术（各三两） 枳实（二两） 桔皮（二两半） 生姜（四两）
以上六味药，水六升，煮取一升八合，分三次温服，大约在人行走八九里的时间内服完。
32. 咳嗽病人的脉象弦，说明有水饮，用十枣汤主治。（方剂见上文）。
33. 有支饮的病人，咳嗽心烦，胸痛，如果不猝死，经过一百天或一年，适宜用十枣汤。（方剂见上文）。
34. 久咳数年，脉象弱的，可治；脉象实大数的，死。脉象虚的，一定苦于头昏，这是因为人本有支饮在胸中的缘故。治疗属于治饮家之法。
35. 咳嗽气逆倚靠呼吸不能平卧，用小青龙汤主治。（方剂见上文）。
36. 服用青龙汤后，多唾，口燥，寸脉沉，尺脉微，手足厥冷，气从小腹上冲胸咽，手足麻木，面部发热像醉酒的样子，随后又向下流注到大腿内侧，小便困难，时常头晕的，给予茯苓桂枝五味甘草汤，治疗其气冲。
桂苓五味甘草汤方
茯苓（四两） 桂枝（去皮，四两） 甘草（炙，三两） 五味子（半升）
以上四味药，用水八升，煮取三升，去渣，分三次温服。
37. 冲气即降，反而更咳嗽、胸满的，用桂苓五味甘草汤，去掉桂枝，加干姜、细辛，以治疗其咳满。
苓甘五味姜辛汤方
茯苓（四两） 甘草 干姜 细辛（各三两）
五味子（半升）
以上五味药，用水八升，煮取三升，去渣，温服半升，每日三次。
38. 咳满即止，而又复渴，冲气复发的，是因为细辛、干姜是热药，服用后应当随即口渴。但如果口渴反而停止的，是因为有支饮。支饮病人，法当头昏，头昏的一定会呕吐，呕吐者再加半夏以去除水饮。
桂苓五味甘草去桂加干姜细辛半夏汤方
茯苓（四两） 甘草 细辛 干姜（各二两） 五味子 半夏（各半升）
以上六味药，用水八升，煮取三升，去渣，温服半升，每日三次。
39. 水去呕止，病人形体肿胀的，加杏仁主治。此证应当纳入麻黄，但因为病人已有麻木故不加。如果违背病情加入麻黄，必定会导致厥逆，之所以这样，是因为病人血虚，麻黄发散其阳气的原因。
苓甘五味加姜辛半夏杏仁汤方
茯苓（四两） 甘草（三两） 五味子（半升） 干姜（三两） 细辛（三两） 半夏（半升） 杏仁（半升，去皮尖）
以上七味药，用水一斗，煮取三升，去渣，温服半升，每日三次。
40. 如果面部发热像醉酒，这是胃热上冲熏蒸其面，加大黄以利之。
苓甘五味加姜辛半杏大黄汤方
茯苓（四两） 甘草（三两） 五味子（半升） 干姜（三两） 细辛（三两） 半夏（半升） 杏仁（半升） 大黄（三两）
以上八味药，用水一斗，煮取三升，去渣，温服半升，每日三次。
1. Q: The pathogenic factor of fluid retention (Yin) is divided into four types; what are they specifically? A: There are Phlegm-Fluid Retention (Tan Yin), Suspended Fluid Retention (Xuan Yin), Overflowing Fluid Retention (Yi Yin), and Branch Fluid Retention (Zhi Yin).
2. Q: What distinguishes these four types of fluid retention? A: If a person who was previously robust now appears emaciated, with water flowing in the intestines making a gurgling sound, this is called Phlegm-Fluid Retention (Tan Yin); if after drinking, water flows and stays under the hypochondrium, causing pain upon coughing or spitting, this is called Suspended Fluid Retention (Xuan Yin); if drinking water leads to fluid circulating and accumulating in the four limbs, where sweating should occur but does not, resulting in body ache and heaviness, this is called Overflowing Fluid Retention (Yi Yin); if there is coughing with air reflux, needing to lean on something to breathe, shortness of breath, inability to lie flat, and the appearance of edema, this is called Branch Fluid Retention (Zhi Yin).
3. When fluid retention is in the Heart, there is hardness and palpitations in the epigastrium, shortness of breath, aversion to water, and lack of desire to drink.
4. When fluid retention is in the Lung, there is expectoration of saliva and foam, and a desire to drink water.
5. When fluid retention is in the Spleen, there is deficiency of Qi and body heaviness.
6. When fluid retention is in the Liver, there is distension and fullness under the hypochondrium, and pain triggered by sneezing.
7. When fluid retention is in the Kidney, there are palpitations in the epigastrium.
8. When retained fluid (Liu Yin) is present below the Heart, the patient experiences coldness in a palm-sized area on the back.
9. In cases of retained fluid (Liu Yin), pain radiates from the hypochondrium to the Quepen acupoint (Dabao, GB21), and pain ceases (or worsens, depending on the version) upon coughing.
10. When retained fluid (Liu Yin) is in the chest, the patient suffers from shortness of breath and thirst. Joint pain throughout the four limbs and a deep pulse indicate the presence of retained fluid.
11. When phlegm disease affects the upper diaphragm, symptoms include fullness, wheezing, coughing, and expectoration. Upon onset, there may be alternating chills and fever, back pain, lower back pain, spontaneous tearing, and severe trembling of the body. This indicates the presence of latent fluid retention (Fu Yin).
12. If a patient drinks excessively, sudden wheezing and fullness will occur. Generally, when food intake is low but fluid intake is high, water stagnates below the Heart; severe cases manifest as palpitations, while mild cases manifest as shortness of breath. A string-like pulse in both hands indicates Cold; this often results from interior deficiency following aggressive purgation. A string-like pulse in only one hand indicates Fluid retention.
13. Fluid retention in the Lung does not present with a string-like pulse; the primary complaints are wheezing and shortness of breath.
14. Branch Fluid Retention (Zhi Yin) also causes wheezing and an inability to lie flat, accompanied by shortness of breath, though the pulse may appear normal.
15. For patients suffering from Phlegm-Fluid Retention (Tan Yin), warming herbs should be used to harmonize the condition.
16. When Phlegm-Fluid Retention (Tan Yin) is located below the Heart, causing distension and fullness in the chest and hypochondrium, and dizziness, Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction) is the primary formula.
Formula: Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction)
Poria (Si Liang), Cinnamon Twig, Atractylodes Macrocephala (each San Liang), Licorice (Er Liang).
Process the above four ingredients with six Sheng of water, decoct to obtain three Sheng, and divide into three warm doses. Urination will facilitate recovery.
17. For shortness of breath caused by slight fluid retention, the treatment should promote urination. Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction) is indicated. (See formula above). Shen Qi Wan (Kidney Qi Pill) is also indicated. (See formula in Women's Miscellaneous Diseases chapter).
18. If the patient's pulse is hidden (Fu), and they experience spontaneous diarrhea which brings relief, yet the epigastrium remains hard and full, this indicates that retained fluid (Liu Yin) is attempting to exit. Gan Sui Ban Xia Tang (Kansui and Pinellia Decoction) is indicated.
Formula: Gan Sui Ban Xia Tang (Kansui and Pinellia Decoction)
Kansui (three large pieces), Pinellia (twelve pieces, decocted in one Sheng of water to obtain half a Sheng, then filtered), Peony (five pieces), Licorice (one piece the size of a finger, roasted; some versions omit this).
Process the above four ingredients with two Sheng of water, decoct to obtain half a Sheng, filter, add half a Sheng of honey, and decoct together to obtain eight Ge. Take in one dose.
19. A floating, thin, and slippery pulse indicates injury by fluid retention.
20. A string-like and rapid pulse with cold fluid retention is difficult to treat in winter and summer.
21. A deep and string-like pulse indicates internal pain due to Suspended Fluid Retention (Xuan Yin).
22. For Suspended Fluid Retention (Xuan Yin), Shi Zao Tang (Ten Jujube Decoction) is indicated.
Formula: Shi Zao Tang (Ten Jujube Decoction)
Genkwa Flower (processed), Kansui, Oldenlandia (equal parts).
Grind the above three ingredients into powder. Boil ten large jujubes in one Sheng five He of water to obtain eight He, filter, and mix with the powder. Strong individuals take one Qian Bi; weak individuals take half a Qian Bi. Take warm on an empty stomach in the morning. If no bowel movement occurs, increase by half a Qian Bi the next day. After achieving a brisk purge, nourish with millet porridge.
23. For Overflowing Fluid Retention (Yi Yin), sweating should be induced. Da Qing Long Tang (Major Green Dragon Decoction) is indicated; Xiao Qing Long Tang (Minor Green Dragon Decoction) is also indicated.
Formula: Da Qing Long Tang (Major Green Dragon Decoction)
Ephedra (Liu Liang, nodes removed), Cinnamon Twig (Er Liang, bark removed), Licorice (Er Liang, roasted), Apricot Seed (Forty pieces, skin and tips removed), Fresh Ginger (San Liang), Jujube (Twelve pieces), Gypsum (Size of a chicken egg, crushed).
Process the above seven ingredients with nine Sheng of water. First boil Ephedra, reduce by two Sheng, remove the scum, add other ingredients, and decoct to obtain three Sheng. Filter and take one Sheng warm. Aim for slight sweating. If sweating is excessive, apply warm powder to the body.
Formula: Xiao Qing Long Tang (Minor Green Dragon Decoction)
Ephedra (San Liang, nodes removed), Peony (San Liang), Schisandra (Ban Sheng), Dried Ginger (San Liang), Licorice (San Liang, roasted), Asarum (San Liang), Cinnamon Twig (San Liang, bark removed), Pinellia (Ban Sheng, washed with hot water).
Process the above eight ingredients with one Dou of water. First boil Ephedra, reduce by two Sheng, remove the scum, add other ingredients, and decoct to obtain three Sheng. Filter and take one Sheng warm.
24. For Branch Fluid Retention (Zhi Yin) between the diaphragm, symptoms include wheezing and fullness, epigastric stiffness and hardness, dark complexion, and a deep, tight pulse. If the condition has persisted for dozens of days and failed to respond to emetic or purgative treatments, Mu Fang Ji Tang (Stephania Tetrandra Decoction) is indicated. If the pattern is deficient, recovery follows; if solid, it recurs in three days. If recurrence fails to respond to Mu Fang Ji Tang, Mu Fang Ji Tang minus Gypsum plus Poria and Mirabilite Decoction is indicated.
Formula: Mu Fang Ji Tang (Stephania Tetrandra Decoction)
Stephania Tetrandra (San Liang), Gypsum (Twelve pieces, size of a chicken egg), Cinnamon Twig (Er Liang), Ginseng (Si Liang).
Process the above four ingredients with six Sheng of water, decoct to obtain two Sheng, and divide into two warm doses.
Formula: Mu Fang Ji Tang minus Gypsum plus Poria and Mirabilite Decoction
Stephania Tetrandra, Cinnamon Twig (each Er Liang), Mirabilite (San He), Ginseng, Poria (each Si Liang).
Process the above five ingredients with six Sheng of water, decoct to obtain two Sheng, filter, add Mirabilite, and simmer slightly. Divide into two warm doses. Mild laxation indicates recovery.
25. When Branch Fluid Retention (Zhi Yin) is below the Heart, causing severe dizziness and vertigo, Ze Xie Tang (Alisma Decoction) is indicated.
Formula: Ze Xie Tang (Alisma Decoction)
Alisma (Wu Liang), Atractylodes Macrocephala (Er Liang).
Process the above two ingredients with two Sheng of water, decoct to obtain one Sheng, and divide into two warm doses.
26. For Branch Fluid Retention (Zhi Yin) with chest fullness, Hou Po Da Huang Tang (Magnolia Bark and Rhubarb Decoction) is indicated.
Formula: Hou Po Da Huang Tang (Magnolia Bark and Rhubarb Decoction)
Magnolia Bark (Chi length), Rhubarb (Liu Liang), Immature Bitter Orange (Four pieces).
Process the above three ingredients with five Sheng of water, decoct to obtain two Sheng, and divide into two warm doses.
27. For Branch Fluid Retention (Zhi Yin) causing difficulty breathing, Ting Li Da Zao Xie Fei Tang (Descurainia Seed and Jujube Lung-Purging Decoction) is indicated. (See formula in Lung Abscess chapter).
28. Patients who vomit should normally feel thirsty; thirst indicates resolution. If they do not feel thirsty, it is due to Branch Fluid Retention (Zhi Yin) below the Heart. Xiao Ban Xia Tang (Minor Pinellia Decoction) is indicated. (Qian Jin Fang states: Xiao Ban Xia Jia Fu Ling Tang).
Formula: Xiao Ban Xia Tang (Minor Pinellia Decoction)
Pinellia (One Sheng), Fresh Ginger (Half Jin).
Process the above two ingredients with seven Sheng of water, decoct to obtain one Sheng five He, and divide into two warm doses.
29. Abdominal fullness with dry mouth and tongue indicates water qi in the intestines. Yi Jiao Li Huang Wan (Stephania, Lepidium Seed, Descurainia Seed, and Rhubarb Pill) is indicated.
Formula: Fang Ji Jiao Mu Ting Li Da Huang Wan (Stephania, Lepidium Seed, Descurainia Seed, and Rhubarb Pill)
Stephania Tetrandra, Lepidium Seed, Descurainia Seed (processed), Rhubarb (each One Liang).
Grind the above four ingredients into powder, make pills the size of wutong seeds. Take one pill before meals with water, three times daily. Gradually increase the dose until saliva is produced. If thirsty, add half a Liang of Mirabilite.
30. Sudden vomiting, epigastric stuffiness, water between the diaphragm, dizziness, and palpitations are treated with Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Plus Poria Decoction).
Formula: Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Plus Poria Decoction)
Pinellia (One Sheng), Fresh Ginger (Half Jin), Poria (San Liang; another method uses Four Liang).
Process the above three ingredients with seven Sheng of water, decoct to obtain one Sheng five He, and divide into two warm doses.
31. If a thin person experiences palpitations below the umbilicus, expectoration of saliva and foam, and epilepsy-like vertigo, this is water retention. Wu Ling San (Five-Ingredient Powder with Poria) is indicated.
Formula: Wu Ling San (Five-Ingredient Powder with Poria)
Alisma (One Liang One Fen), Polyporus (Three Fen, skin removed), Poria (Three Fen), Atractylodes Macrocephala (Three Fen), Cinnamon (Two Fen, bark removed).
Grind the above five ingredients into powder. Take one Cun Bi with rice water, three times daily. Drink plenty of warm water; sweating indicates recovery.
Attached Formula:
Wai Tai Mi Yao Fu Ling Yin (Poria Infusion from External Cabinet) treats retained phlegm and old water in the heart and chest. After self-vomiting clears the fluid, the chest feels empty and full, preventing eating. This formula resolves phlegm and Qi, restoring appetite.
Poria, Ginseng, Atractylodes Macrocephala (each Three Liang), Immature Bitter Orange (Two Liang), Tangerine Peel (Two Liang Half), Fresh Ginger (Four Liang).
Process the above six ingredients with six Sheng of water, decoct to obtain one Sheng eight He, and divide into three warm doses. Administer over the time it takes to walk eight or nine li.
32. A coughing patient with a string-like pulse has water retention. Shi Zao Tang (Ten Jujube Decoction) is indicated. (See formula above).
33. For patients with Branch Fluid Retention (Zhi Yin) experiencing cough, irritability, and chest pain, if they do not die suddenly, after one hundred days or one year, Shi Zao Tang (Ten Jujube Decoction) is indicated. (See formula above).
34. Chronic cough lasting several years with a weak pulse is treatable; a strong, large, and rapid pulse indicates death. A deficient pulse implies severe dizziness, caused by pre-existing Branch Fluid Retention (Zhi Yin) in the chest. Treatment falls under the category of treating fluid retention disorders.
35. Coughing with air reflux and inability to lie flat is treated with Xiao Qing Long Tang (Minor Green Dragon Decoction). (See formula above).
36. After administering Qing Long Tang, if there is excessive salivation, dry mouth, deep pulse at the Cun position, faint pulse at the Chi position, cold extremities, Qi rushing from the lower abdomen to the chest and throat, numbness in extremities, facial flushing resembling drunkenness, downward flow of heat to the inner thighs, difficulty urinating, and intermittent dizziness, give Fu Ling Gui Zhi Wu Wei Gan Cao Tang (Poria, Cinnamon Twig, Schisandra, and Licorice Decoction) to treat the Qi rush.
Formula: Gui Ling Wu Wei Gan Cao Tang (Cinnamon Twig, Poria, Schisandra, and Licorice Decoction)
Poria (Si Liang), Cinnamon Twig (Si Liang, bark removed), Licorice (San Liang, roasted), Schisandra (Ban Sheng).
Process the above four ingredients with eight Sheng of water, decoct to obtain three Sheng, filter, and divide into three warm doses.
37. If the Qi rush subsides but cough and chest fullness worsen, use Gui Ling Wu Wei Gan Cao Tang (Cinnamon Twig, Poria, Schisandra, and Licorice Decoction), remove Cinnamon Twig, and add Dried Ginger and Asarum to treat the cough and fullness.
Formula: Ling Gan Wu Wei Jiang Xin Tang (Poria, Licorice, Schisandra, Dried Ginger, and Asarum Decoction)
Poria (Si Liang), Licorice, Dried Ginger, Asarum (each San Liang), Schisandra (Ban Sheng).
Process the above five ingredients with eight Sheng of water, decoct to obtain three Sheng, filter, and take half a Sheng warm, three times daily.
38. If cough and fullness cease but thirst returns and the Qi rush recurs, it is because Dried Ginger and Asarum are hot herbs, causing thirst. If thirst stops instead, it indicates Branch Fluid Retention (Zhi Yin). Patients with Branch Fluid Retention (Zhi Yin) typically experience dizziness; those who are dizzy often vomit. In such cases, add Pinellia to eliminate water.
Formula: Gui Ling Wu Wei Gan Cao Qu Gui Jia Jiang Xin Ban Xia Tang (Cinnamon Twig, Poria, Licorice, Schisandra, minus Cinnamon Twig, plus Dried Ginger, Asarum, and Pinellia Decoction)
Poria (Si Liang), Licorice, Asarum, Dried Ginger (each Er Liang), Schisandra, Pinellia (each Ban Sheng).
Process the above six ingredients with eight Sheng of water, decoct to obtain three Sheng, filter, and take half a Sheng warm, three times daily.
39. If water is eliminated and vomiting stops but the body becomes swollen, add Apricot Seed. Although Ma Huang (Ephedra) should theoretically be added, it is omitted because the patient already has numbness. Adding it against this indication would cause Jue (cold reversal) because the patient has Blood deficiency, and Ephedra disperses Yang Qi.
Formula: Ling Gan Wu Wei Jia Jiang Xin Ban Xia Xing Ren Tang (Poria, Licorice, Schisandra, plus Dried Ginger, Asarum, Pinellia, and Apricot Seed Decoction)
Poria (Si Liang), Licorice (San Liang), Schisandra (Ban Sheng), Dried Ginger (San Liang), Asarum (San Liang), Pinellia (Ban Sheng), Apricot Seed (Ban Sheng, skin and tips removed).
Process the above seven ingredients with one Dou of water, decoct to obtain three Sheng, filter, and take half a Sheng warm, three times daily.
40. If the face is flushed like drunkenness, this indicates Stomach Heat rushing upward to flush the face. Add Rhubarb to drain it.
Formula: Ling Gan Wu Wei Jia Jiang Xin Ban Xia Xing Ren Da Huang Tang (Poria, Licorice, Schisandra, plus Dried Ginger, Asarum, Pinellia, Apricot Seed, and Rhubarb Decoction)
Poria (Si Liang), Licorice (San Liang), Schisandra (Ban Sheng), Dried Ginger (San Liang), Asarum (San Liang), Pinellia (Ban Sheng), Apricot Seed (Ban Sheng), Rhubarb (San Liang).
Process the above eight ingredients with one Dou of water, decoct to obtain three Sheng, filter, and take half a Sheng warm, three times daily.
41. Thirst followed by vomiting indicates water stagnating below the Heart. This belongs to fluid retention disorders. Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Plus Poria Decoction) is indicated. (See formula above).