利水渗湿五苓散

文/卓鹏伟

“溪深古雪在，石断寒泉流。”冬季气温较低，凛冽的寒气很容易损伤肾中阳气，影响肾阳的蒸腾气化，使人体水液输布代谢失常，患上水肿、泻泄等病证。

''The ravine streams are deep and is secluded with thousands of years of snow,the cliffs and rocks are broken,and cold springs flow from them.'' Winter temperatures are low and the biting cold is easy to damage the kidney-yang,affecting the its transpiration and gasification.As a result the body's water distribution and metabolism will be abnormal,then people will suffer from edema,diarrhea and other diseases.

孝感天地指迷津Filial piety touches the heavens to get the right therapy

相传古时候，有一位孝子名叫毛崇甫，他的母亲叶夫人在六十多岁时得了一种怪病——心烦发热、口渴，吐泻交作、小便不利，持续半月不愈。毛崇甫非常忧虑，每天傍晚对着北极星跪拜，希望天神能保佑母亲早日痊愈。其孝心感动天地，一天毛崇甫妹妹服侍在母亲身旁，恍惚间听见有人对她说，“为何不服用古方五苓散呢？”并送给她一副药方。一会儿，妹妹从梦中醒来，赶紧对哥哥说起梦中之事，毛崇甫按方抓药，果然药到病除。

In ancient times,there was a filial son named Mao Chongfu.His mother,Mrs.Ye,over 60 years old,suffered from a strange disease.There were symptoms such as,dysphoria,fever,thirst,vomiting and diarrhea,urination,which lasted for half a month.Mao Chongfu was very worried,kneeling to the North Star every night,hoping that the gods would bless his mother with an early recovery.His filial piety touched heavens.One day,when his younger sister was serving her mother,she heard someone talking to her in a trance "Why not try the ancient formula Wuling powder?" and then gave her the prescription.She woke up from the dream and told his brother about the dream.Mao Chongfu filled the medicine according to the prescription and it worked well immediately.

据史料记载，五苓散早在汉代就已被用于治疗疟疾，后被医圣张仲景收录于《伤寒论》中，是千百年来利水渗湿的首选方剂。

According to historical records,Wuling powder was used to treat malaria as early as the Han Dynasty,and was later included in the ''Treatiseon ExogenousFebrileDiseases'' by the medical sage Zhang Zhongjing,which has been the first choice of formula for diuresis and removing dampness for thousands of years.

协调脾肾布津液Harmonizing the spleen and kidney to promote fluid circulation

五苓散方仅有五味药：泽泻用量最重，利小便、渗水湿，为君药；猪苓、茯苓二者淡渗利湿，为臣药；白术益气健脾，桂枝通阳扶卫、解表散邪，共为佐药。全方合用，利水渗湿、温阳化气，通过调整脾肾膀胱功能，使人体恢复正常的津液输布与代谢。

Wuling powder consists of only five herbs.Alisma plantago-aquatica L.is of the heaviest dosage for diuresis and removing dampness,and is regarded as the monarch medicine.Polyporus and Poria are regarded as the minister medicines for promoting diuresis with tasteless flavor.Atractylodes macrocephala Koidz.enhancesqiand strengthens the spleen while Cinnamomi Ramulus activatesyangto relieve exterior syndrome and dispels pathogens,these two herbs are regarded as the assistant medicines.The combination of the whole formula has the effect of diuresis and removing dampness;activatingyangand transformingqi.By adjusting the functions of the spleen,kidney and bladder,normal transmission and metabolism of fluid will be recovered in the human body.

泽泻

五苓散临床应用非常广泛，古代常用于治疗霍乱、膀胱蓄水、痰饮病等，现代临床应用范围更是大大扩展，多用于治疗急慢性肾炎、肾病综合征、急性尿潴留、水肿及腔体（脑、胸腔、腹腔等）积液、急慢性胃肠炎、心力衰竭、肝胆疾病等，表现为水液代谢失常、水蓄体内的病症。

Wuling Powder has a wide range of clinical applications,commonly used in ancient times for the treatment of cholera,bladder water retention,phlegm-fluid retention,etc.The scope of modern clinical applications is greatly expanded,and is mostly used for the treatment of acute and chronic nephritis,nephrotic syndrome,acute urinary retention,edema and fluid accumulation in cavities (brain,thoracic,abdominal,etc.),acute and chronic gastroenteritis,heart failure,liver and gallbladder disease,etc.,which manifests itself as a malfunction in the metabolism of water and fluid,and a disease with water storage in the body.

培土制水化水湿Cultivate the earth to control the water to remove dampness

《素问・灵兰秘典论》谓：“膀胱者，州都之官，津液藏焉，气化则能出矣”，膀胱的气化依赖阳气的蒸腾，因此，治疗膀胱气化不利引起的水肿，关键就在于化气利水。五苓散虽然配伍简单，却蕴含了培土制水的五行玄机。

"ThesecretclassicsofLinglan" said: "the bladder,similar to the official of the state,is for fluid storage and there isqitransformation from the bladder".The bladder-qitransformation depends on the transpiration ofyang-qi,so the key therapy of edema caused by inhibitedqitransformation in the bladder is diuresis to promote transformation ofqi.Although Wuling powder is a simple formula,it contains the mystery of the five elements of cultivating the earth to control the water.

从本方配伍看，茯苓、白术均入脾胃经，属土，可益气健脾利湿，治疗脾气不足、运化失健而引起的水湿内生；桂枝辛甘温煦，可培脾土，有扶脾阳、逐寒邪之功，能助膀胱气化；此外，五味药物皆具甘味，甘味属土，故均有补益脾胃、和中化气之效。

From this formula,Poria and Atractylodes macrocephala Koidz,belonging to the earth,enter the spleen and stomach meridian to enhanceqi;nourish spleen and promote diuresis,which treats water dampness endogenesis caused by spleen qi insufficiency and dysfunction of spleen in transportation.Cinnamomi Ramulus tastes pungent,sweet and warm.It can cultivate the spleen-earth to support the spleen-yangand expel the cold pathogen.It also can help bladder-qitransformation.In addition,the five herbs are all with the taste of sweet and sweet taste belongs to the earth,so they all reach the effect of nourishing spleen and stomach and harmonizingqiin the body.

结语Conclusion

“水为至阴，其本在肾，其标在肺，其制在脾。”五苓散的标准密码在于“利水渗湿”4个字，通过调节人体水液代谢，治疗因水液停聚引起的诸多病症。在临床中，胃阴亏虚者也常出现口渴、小便不利等症状，但其病症多因津液不足所致，故不宜服用本方。

"Dampness belongs to utmostyin.Its root cause lies in the kidney while the symptoms manifest in the lung,and is restricted by the spleen." The standard code of WuLing powder lies in the words"Diuresis and Removing Dampness".Through regulating the metabolism of water in the human body,it can treat many diseases caused by the stagnation of water and fluid.In clinical practice,people with deficiency of stomach-yinoften have symptoms such as thirst and urination.However，their illnesses are mostly caused by insufficient fluid,so it is not advisable to take this formula.