茯苓系列

Chapter 11.  Fuling series

 Fuling is the fungus mass of Poria cocos (Schw.) Wolf. It works to deplete various Water disorders in the body: Phlegm, Swelling and Wetness. For this function, it helps the Spleen system in the body for digestion and for water metabolism.

(1). 茯苓饮

Fuling Yin

茯苓 人参 白朮（各三两） 枳实（二两） 橘皮（二两半） 生姜（四两）

Fuling 45 gram, Renshen 45 gram, Baizhu 45 gram, Zhishi 30 gram, Jupi 40 gram, fresh ginger 60 gram.

右六味，水六升，煮取一升八合。分温三服，如人行八九里进之。

Add the herbs and 1500 ml water into a herbal pot. Bring boil and keep in mild boiling until there is about 300 ml herbal tea left. Drink one third of the tea each time, three times a day.

《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。

In another book << Wai Tai >>, this formula is used for the treatment of Water-accumulation in the Chest. After vomit out of the water, the chest is empty with water but full of air that makes the person hard to eat. In this case, use this Fuling Yin.

(2). 茯苓杏仁甘草汤

Fuling Xinren Gancao Tang

茯苓三两，杏仁五十个，甘草一两

Fuling 45 gram, Xinren 50 badges, Gancao 15 gram,

右三味，以水一斗，煮取五升，温服一升，日三服，不差更服。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep to mild boiling until there is about 1250 ml left. Separate the herbal tea into five parts. Drink one part right away, then repeat three times later in the day. If the symptom is not improved, continue to drink.

胸痹，胸中气塞、短气，茯苓杏仁甘草汤主之，橘枳姜汤亦主之。

(3). 防己茯苓汤

Fangji Fuling Tang

防己  三两，茯苓  六两，黄耆  三两，桂枝  三两， 甘草  三两

Fangji 45 gram, Huangqi 45 gram, Guizhi 45 gram, Fuling 90 gram, Gancao 45 gram.

右五味，以水六升，煮取二升，分温三服。

Add the herbs and 1500 ml water into a herbal pot. Bring to boil until there is about 500 ml herbal tea left. Drink one third of the tea, three times a day.  

皮水为病，四肢肿，水气在皮肤中，四肢聂聂动者，防己茯苓汤主之。

With the Pishui condition, the person has swelling on the arms and legs, feet. The Water is in the skin, so the muscle has moving, tingling, or shaking feeling. In this case, use Fangji Fuling Tang.

(4). 茯苓泽泻汤

Fuling Zexie Tang

茯苓半斤，泽泻四两，甘草二两，桂枝二两，白术三两，生姜四两

Fuling 125 gram, Zexie 60 gram, Gancao 30 gram, Guizhi 30 gram, Baishu 45 gram, fresh ginger 60 gram.

右六味，以水一斗，煮取三升，内泽泻，再煮取二升半，温服八合，日三服。

Add the herbs (except Zexie) and 2500 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 750 ml herbal tea left. Add the Zexie in. Continue the boiling until there is 600 ml left. Drink one third of the herbal tea each time, three times a day.

胃反，吐而渴欲饮水者，茯苓泽泻汤主之。

With the Stomach-reverse condition, if the person feels thirsty after vomit, has strong willing to drink water, use Fuling Zexie Tang.[1]

(5).  苓桂五味甘草汤

Fuling Guizhi Wuwei Gancao Tang

茯苓　四两，桂枝　四两，甘草（炙）三两，五味子　半升

Fuling 60 gram, Guizhi 60 gram, Gancao (processed) 45 gram, Wuweizi 25 gram.

右四味，以水八升，煮取三升，去滓，分温三服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml herbal tea left. Drink one third of the tea each time, three times a day.

咳逆倚息不得卧，小青龙汤主之。青龙汤汗已[2]，多唾，口燥，寸脉沉，尺脉微，手足厥逆，气从少腹上冲胸咽，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。冲气即低，而反更咳，胸满者，用苓桂五味甘草汤去桂，加干姜、细辛，以治其咳满。

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；呕者复内半夏以去其水，茯苓桂枝五味甘草汤去甘草、桂枝，加细辛干姜半夏汤主之。

水去呕止，其人形肿者，加杏仁主之。其证应内麻黄，以其人遂痹故不内之，若逆而内之者必厥。所以然者，以其人血虚，麻黄发其阳故也。若面热如醉，此为胃热上冲熏其面，加大黄以利之。

If the person has frequent cough, asthma, so that he is hard to lie down for a sleep, use Xiao Qinglong Tang. Use Fuling Guizhi Wuwei Gancao Tang if , after drinking of the tea, the person starts to spit more saliva, feels dry in mouth, has deep pulse in the Chun position and mild in the Chin position, has reverse cold in the hands and feet, feels air pushing up from lower stomach to the throat, feels tight or pain in the hands and feet, has red face as drunk, feels kinds of liquid flowing feeling in the inguinal area, or in the inside of the thigh, has difficulty in urine, feels cloudy mind and dizzy from time to time. This herb formula works to reduce the up-pushing air feeling.

After drink of the tea, the up-pushing feeling is down, but the person feels more cough, and has fullness in the chest, remove Guizhi, but add Ganjiang and Xixin to the Fuling Guizhi Wuwei Gancao Tang.

If the cough and fullness stop, but the person feels more thirsty, has the up-pushing feeling again, it is due to the use of the Ganjiang and Xixin, which belongs to warm and should cause such thirsty. If the person has no thirsty however, it then indicates that the person has Branch-water accumulation.

With such Branch-water accumulation condition, the person should feel cloudy mind and dizziness and has nausea. If he indeed has such nausea, add Banxia to the herb formula to remove the Water.

After removal of the Water, and stop of the nausea, but the peron has swelling in the body, add Xinren to the formula. Theoretically Mahuang should be used. It is not used for the reason that he has the Bi syndrome in the hands and feet. Other wise the Mahuang may cause the Jue condition (cold hands and feet), because he has blood deficiency, the Mahuang will result in a depletion of Yangqi. If the person feels hot on the face as drunk, it is Stomach Hot pushes up to smoke the face, add Dahuang in the formula.   

(6). 苓甘五味姜辛汤

Fuling Gancao Wuweizi Ganjiang Xixin Tang

茯苓 四两，甘草，干姜，细辛各三两，五味子半升

Fuling 60 gram, Gancao 45 gram, Ganjinag 45 gram, Xixin 45 gram, Wuweizi 25 gram

右五味，以水八升，煮取三升，去滓，温服半升，日三服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml herbal tea left. Drink one third of the tea each time, three times a day.

冲气即低，而反更咳，胸满者，用苓桂五味甘草汤去桂，加干姜、细辛，以治其咳满。

After drink of the tea, the up-pushing feeling is down, but the person feels more cough, and has fullness in the chest, remove Guizhi, but add Ganjiang and Xixin to the Fuling Guizhi Wuwei Gancao Tang.

(7). 苓甘五味姜辛夏汤

Fuling Guizhi Wuweizi Gancao Tang, but remove Gancao and Guizhi, but add Ganjiang, Xixin, Banxia

茯苓 四两，细辛，干姜各二两，五味子，半夏各半升

Fuling 60 gram, Xixin 30 gram, Ganjiang 30 gram, Wuweizi 25 gram, Banxia 124 gram

右五味，以水八升，煮取三升，去滓，温服半升，日三服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml herbal tea left. Drink one third of the tea each time, three times a day.

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；

If the cough and fullness stop, but the person feels more thirsty, has the up-pushing feeling again, it is due to the use of the Ganjiang and Xixin, which belongs to warm and should cause such thirsty. If the person has no thirsty however, it then indicates that the person has Branch-water accumulation.

(8). 苓甘五味姜辛夏杏汤

Fuling Gancao Wuweizi jia Ganjiang, Xixin, Banxia, Xinren Tang

茯苓 四两，甘草 三两，五味子 半升，干姜 三两，细辛 三两，半夏 三两，杏仁（去皮、尖）半升。

Fuling 60 gram, Gancao 45 gram, Wuweizi 25 gram, Ganjiang 45 gram, Xixin 45 gram, Banxia 45 gram, Banxia 45 gram, Xinren 125 gram

右七味，以水一斗，煮取三升，去滓，温服半升，日三服。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml herbal tea left. Drink 125 ml first, then one third of the remaining tea each time, three times a day.

支饮者，法当冒，冒者必呕；呕者复内半夏以去其水，茯苓桂枝五味甘草汤去甘草、桂枝，加细辛干姜半夏汤主之。

With such Branch-water accumulation condition, the person should feel cloudy mind and dizziness and has nausea. If he indeed has such nausea, add Banxia to the herb formula to remove the Water.

(9). 苓甘五味姜辛夏杏汤

Fuling Gancao Wuweizi jia Gangjiang Xixin Banxia, Xinren, Dahuang Tang

茯苓四两，半夏半升，甘草三两，五味子半升，干姜三两，细辛三两，杏仁（去皮、尖）半升，大黄三两

Fuling 60 gram, Banxia 125 gram, Gancao 45 gram, Wuweizi 25 gram, Ganjiang 45 gram, Xixin 45 gram, Xinren 125 gram, Dahuang 45 gram

右八味，以水一斗，煮取三升，去滓，温服半升，日三服。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml herbal tea left. Drink 125 ml first, then one third of the remaining tea each time, three times a day.

水去呕止，其人形肿者，加杏仁主之。其证应内麻黄，以其人遂痹故不内之，若逆而内之者必厥。所以然者，以其人血虚，麻黄发其阳故也。若面热如醉，此为胃热上冲熏其面，加大黄以利之。

After removal of the Water, and stop of the nausea, but the peron has swelling in the body, add Xinren to the formula. Theoretically Mahuang should be used. It is not used for the reason that he has the Bi syndrome in the hands and feet. Other wise the Mahuang may cause the Jue condition (cold hands and feet), because he has blood deficiency, the Mahuang will result in a depletion of Yangqi. If the person feels hot on the face as drunk, it is Stomach Hot pushes up to smoke the face, add Dahuang in the formula.   

(10). 五苓散

Wuling San　

猪苓（去黑皮）十八铢， 茯苓十八铢， 泽泻一两六铢， 白术十八铢，桂枝半两

Zhuling 12 gram, Fuling 12 gram, Zexie 20 gram, Baishu 12 gram, Guizhi 8 gram.

右五味为散，更於臼中杵之，白饮和方寸匕服之，日三服，多饮暖水，汗出愈。

Grind all herbs into powder, drink 1 gram[3] each time, three times a day. Drink more warm water after the herb drinking. It will be cured after a sweat.

22  太阳病，发汗後，大汗出，胃中乾，烦躁不得眠，欲得饮水者，少少与饮之，令胃气和则愈。若脉浮，小便不利，微热，消渴者，五苓散主之。

When in Taiyang stage and after sweat therapy, if the person has hand heavy sweat which makes him dry in stomach, feels annoyed (irritable in emotion and in body), simply give him little water to drink to easy the stomach. If his pulse is floating, his urine is difficult, and if he feels slight hot and very thirsty, herb formula Wuling San[4] should be used mainly.[5]

53  病在阳，应以汗解之，反以冷水洗之，若灌之，其热被却不得去，弭更益烦，肉上粟起，意欲饮水，反不渴者，服文蛤散；若不差者，与五苓散。身热皮粟不解，欲引衣自覆者；若水以 之洗之，益令热被却不得出，当汗而不汗则烦。假令汗出已，腹中痛，与芍药三两如上法。

When a disease is in Taiyang stage, it should be resolved with a sweat therapy. If the person is given cold water to wash, to shower, to drink, his fever will remain and gain more annoyed emotionally. There will be lots of millet-like dotes on the skin (higher than the skin surface). The person has desire to drink water, but does not feel thirsty, herb Wenhe San should be used; if this herb does not work, try Wuling San. If the fever and skin dots remain, and he is eager to cover himself[6], but water wash is given, the cold water closes the skin to prevent evaporation of the fever, and causes annoyed feeling. If a correct sweat therapy has been used with sweat, but the person feels stomach pain, add herb Shaoyao (into the Guizhi Tang). 

14  发汗已，脉浮数, 小便不利[7]，烦渴者，五苓散主之。

After sweat therapy, the person has sweat, if he also feels thirsty, hard in urine, and his pulse is floating and fast, use herb Wuling San. [8]

46  本以下之，故心下痞，与泻心汤。痞不解，其人渴而口燥烦，小便不利者，五苓散主之。

The bowel-cleansing therapy may cause Fullness syndrome[9]. Various Xiexing Tang is needed. If none of them work, the person feels thirsty, dry in mouth, annoyed emotionally, hard in urine, herb Wuling San should be the main formula to try.[10]

44  太阳病，寸缓关浮尺弱，其人发热汗出，复恶寒不呕，但心下痞者，此以医下之也；如其不下者，病人不恶寒而渴者，此转属阳明也。小便数者，大便必硬，不更衣十日，无所苦也，渴欲饮水，少少与之，若小便不利[11]，渴者，宜五苓散。

In Taiyang stage, if the person’s pulse is slow in Chun position, floating in Guan position, and weak in Chi position, and if he feels hot and sweat, feels chilly again but no nausea, feels Fullness syndrome, it is all caused due to a wrong bowel-cleansing therapy. If the person has no bowel-cleansing therapy, has no chilly feeling but has thirsty, it has developed into Yangming stage. For such person, if he has frequent urine, will has hard stool. He may feel nothing painful even if he has no bowel movement for more than ten days. If he feels thirsty, give him water to drink by sip (no need to use herbs). If he has difficulty in urine and feels thirsty, use Wuling San. [12]

05  霍乱，头痛发热，身疼痛，热多欲饮水者，五苓散主之，寒多不用水者，理中丸主之。

In Huoluan disease, if the person has more fever and willing to drink more water, use Wuling San. If he has more cold and has no strong willing to drink, use Lizhong Tang. [13]

假令病人[14]脐下有悸，吐涎沫而癫眩，此水也，五苓散主之。

If a skinny person has palpitation feeling under the naval, spits saliva and feels dizzy, it is also a water-accumulation condition. Use Wuling San.[15]

脉浮，小便不利，微热消渴者，宜利小便，发汗，五苓散主之。

If the pulse is floating, the person feels hot (but no sweat), feels difficult in the urine, slight hot and heavy thirsty, the principle in the treatment is the urine therapy and sweat therapy. Use Wuling San.

渴欲饮水，水入则吐者，名曰水逆，五苓散主之。

If the person feels thirsty and wants to drink water, but has vomiting after drinking, the condition is called Reverse-water, use Wuling San.[16]

Fuling 90 gram, Guizhi 60 gram, Gancao (processed) 15 gram, Chinese date 78 gram.

右四味，以甘澜水一斗，先煮茯苓，减二升，内诸药，煮取三升，去滓，温服一升，日三服。作甘澜水法：取水二斗，置大盆内，以杓扬之，水上有珠子五六千颗相逐，取用之。

Add the Fuling and 2500 ml of Ganlan water in herbal pot. Bring to boil then keep to mild boiling until there is only 2000 ml left. Add the remaining herbs in and continue to cook until the liquid volume in the pot is about 750 ml. Collect the herbal tea. Drink one third of the tea each time, three times a day.

21 发汗後，其人脐下悸者，欲作奔豚，茯苓桂枝甘草大枣汤主之。

If after sweat, the person feels heart beat in the upper stomach area, feels to have a Bentun feeling[17],  though not really so yet, Fuling Guizhi Gancao Dazao Tang should be used mainly.[18]

(12). 猪苓汤

Zhuling Tang

猪苓（去皮）， 茯苓， 阿胶， 泽泻， 滑石（碎）各一两

Zhuling (remove skin) 15 gram, Fuling 15 gram, Ajiao 15 gram, Zexie 15 gram, Huashi (broken) 15 gram.

右五味，以水四升，先煮四味，取二升，去滓，内阿胶烊消，温服七合，日三服。

Add the herbs except Ajia and 1000 ml into a herb pot. Bring to boil and keep in mild boiling until there is about 500 ml liquid left. Remove the herb residue, add the Ajiao into the herb tea, bring to boiling with stirring until the Ajiao dissolved. Drink 175 ml. Repeat three times a day.

40　阳明病，脉浮而紧，咽燥口苦，腹满而喘，发热汗出，不恶寒反恶热，身重。若发汗则躁，心愦愦反? y。若加温 ，必怵惕烦躁不得眠。若下之，则胃中空虚，客气动膈，心中懊倄，舌上胎者，栀子豉汤主之。若渴欲饮水，口乾舌燥者，白虎加人参汤主之。若脉浮发热，渴欲饮水，小便不利者，猪苓汤主之。阳明病，汗出多而渴者，不可与猪苓汤，以汗多胃中燥，猪苓汤复利其小便故也。

In Yangming stage, if the person has floating and tight pulse, dry mouth and throat, fullness in Stomach and asthma, hot and sweat, no chilly but dislike hot, and heavy feeling in the body, sweat therapy will cause annoyed and irritable physically (due to depletion of Jingye); a warm therapy will cause annoyed emotionally and physically, and a phobia, scaring feeling; bowel-cleansing therapy will cause empty in the stomach, reverse pushing feeling to the diagram, annoyed in the upper stomach. For such complex condition, if the person has thick tongue covering, use Zhizi Zhi Tang; if he feel dry in mouth and want to drink water, use Baihu Tang jia Renshen Tang; if his pulse is floating and he feels hot, thirsty and want to drink, but has hard in urine, Zhuling Tang should be used. For Yangming stage, if person’s thirsty is due to big sweat, Zhuling Tang should not be given, because the sweat caused dryness in stomach, a depletion of Jingye in the body. The use of Zhuling Tang will further more deplete the Jingye to make the condition worse. 

29  少阴病，下利六、七日，咳而呕渴，心烦不得眠者，猪苓汤主之。

In Shaoyin stage and the person has had diarrhea for six to seven days, has cough, nausea and thirsty, annoyed/impatience that makes him hard to fall into sleep, use Zhuling Tang. [19]

03  太阳病中风，以火劫发汗，邪风被火热，血气流溢，失其常度，两阳相灼，其身发黄，阳盛则欲衄，阴虚则小便难，阴阳俱虚竭，身体则枯燥，但头汗出，剂颈而还，腹满微喘，口乾咽烂，或不大便，久则谵语，甚者至哕，手足躁扰，捻衣摸床，小便利者，其人可治。(此际，欲治风而火势沸腾，欲治火而风邪壅遏，何从治之？惟利小便一法。如猪苓汤类，可以导热滋乾，使小便得利，则太阳之邪亦从膀胱为去路，尚可治也。倘利之而不利，火无从出，危矣。)

In Wind-invasion Taiyang stage, the person was put in front of a fire to warm up the body with the aim to create sweat, the Xieqi (the Windxie) is disturbed by the fire, that makes the blood and Qi move without order, makes the body develops jaundice. If the person has overwhelming Yangqi, he may have bleeding in nose[20]; if he has Yin deficiency, he may have difficulty in urine. If both the Yin and Yang is weak and short, the body is dry[21] but there is sweat on the head (not down to neck), has fullness in abdomen, slight asthma, dry mouth and ulcer in throat[22], or stop the bowel movement, or has Chattering syndrome after a long time. The person even has Yu syndrome[23], irritable in the hands and feet (jumping and spasm), loss of mind to touch the bed or clothes[24]. If the person has easy urine, he still has chance to recover.[25]  

脉浮发热，渴欲饮水，小便不利者，猪苓汤主之。

If the pulse is floating, the person has fever (and sweat), feels thirsty and drink lot of water, has difficult in urine, use Zhuling Tang. [26]

哕而腹满，视其前 (小便)　 其后（大便），知何部不利，利之即愈。（前部不利猪苓汤，后部不利谓胃承气汤。）

If the person has burping and fullness in the abdomen, the treatment is variable depending on other symptoms, such as the bowel movement and urine conditions. To improve the bowel movement and the urine will solve the problem. [27]To improve the bowel movement, use Tiaowei Chengqi Tang; to improve the urine, use Zhuling Tang.

夫诸病在藏，欲攻之，当随其所得而攻之，如渴者，小便不利[28], 与猪苓汤，余皆仿此。

If a disease is in a fullness organ, and if the treatment principle is to deplete the Xieqi (rather than to nourish, or to supply it), deplete what it gets. For example for a person with thirst, he has willing to drink and has difficult in urine, use the Zhuling Tang to deplete the water, to solve the problem.

(13. 猪苓散方

Zhuling San

猪苓茯苓白术各等分

Zhuling, Fuling and Baishu, equal amount.

右三味，杵为散，饮服方寸匕，日三服。

Grind the herbs into powder. Drink 1 gram each time, three times a day.

呕吐而病在膈上，后思水者解，急与之，思水者，猪苓散主之。

If the person has nausea and the disease is above the diagram, he feels thirsty and wants to drink water, this suggests his condition is to solve. If he still has nausea, it suggests he still has Water-accumulation condition in the body. Use Zhuling San.[29]

(14). 葵子茯苓散方

Kuizi Fuling San

癸子  一升，茯苓  三两

Kuizi 130 gram, Fuling 45 gram.

右二味，杵为散，饮服方寸匕，日三服，小便利则愈。

Prepare the herbs into powder. Drink 1 gram each time, three times a day. The problem will be solved when she has easy urine.

妊娠，有水气，身重，小便不利，洒淅恶寒，起即头眩，葵子茯苓散主之。

IF the woman with pregnancy has Shuiqi in the body, feels heavy in the body, difficult in urine, mild chilly, dizzy when gets up, use Kuizi Fuling San.