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Source: Shāng Hán Lùn 伤寒论

Ingredients:

• Fú líng (茯苓 Poria , poria) 9–15g
• Zhū líng (猪苓 Polyporus , polyporus) 9–12g
• Zé xiè (泽泻 Alismatis Rhizoma, alisma [tuber]) 9–15g
• Bái zhú (白朮 Atractylodis Macrocephalae Rhizoma, white atractylodes [root]) 9–12g
• Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig) 3–6g

Action: Frees yáng and promotes qì transformation; fortifies the spleen and disinhibits water.

Indication: (a) Cold damage greater yáng (tài yáng) bladder water amassment pattern with inhibited urination, headache, heat effusion, vexation and thirst with intake of fluid, immediate vomiting of ingested water, white tongue fur, and a floating pulse; (b) water-damp collecting internally with water swelling, diarrhea, and inhibited urination; (c) phlegm-rheum collecting internally with palpitation below the umbilicus, ejection of drool and froth, dizzy head, and in some cases shortness of breath and cough.

Category: Dampness-dispelling formulas / Water-disinhibiting dampness-percolating formulas

Method: Now usually prepared as a decoction.

Warnings: Contraindicated in inhibited urination after great sweating or diarrhea. Should not be taken for extended periods.

Rationale: Bái zhú fortifies the spleen and stomach and transport spleen liquid. Fú líng fortifies the spleen and percolates dampness; it separates and disinhibits water turbidity. Guì zhī warms the bladder and stimulates the transformative action of its qì, freeing the waterways. Zhū líng and Zé xiè disinhibit water and eliminate dampness, making water turbidity pass with the urine. Guì zhī combined with Bái zhú can warm and move spleen yáng, helping the spleen to spread its essence. Combined with Fú líng, it can warm and transform water-damp, helping it to descend.

Variations:

• Summerheat-damp diarrhea: Add Huò xiāng (藿香 Pogostemonis Herba, patchouli) and Pèi lán (佩兰 Eupatorii Herba, eupatorium).
• Damp-heat diarrhea: Omit Bái zhú (白朮 Atractylodis Macrocephalae Rhizoma, white atractylodes [root]) and Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig), and add Jīn yín huā (金银花 Lonicerae Flos, lonicera [flower]) and Yīn chén (茵陈 Artemisiae Scopariae Herba, virgate wormwood).
• Pronounced water swelling: Add Dà fù pí (大腹皮 Arecae Pericarpium, areca husk), Sāng bái pí (桑白皮 Mori Cortex, mulberry bark), and Chén pí (陈皮 Citri Reticulatae Pericarpium, tangerine peel).
• Diarrhea with abdominal distension due to qì stagnation: Add Hòu pò (厚朴 Magnoliae Officinalis Cortex, officinal magnolia bark) and Chén pí (陈皮 Citri Reticulatae Pericarpium, tangerine peel).
• Hydrocele (collection of fluid in the tunica vaginalis of the testicle): Add Xiǎo huí xiāng (小茴香 Foeniculi Fructus, fennel [fruit]) and Lì zhī hé (荔枝核 Litchi Semen, lychee pit).
• Auditory vertigo: Add Tíng lì zǐ (葶苈子 Lepidii/Descurainiae Semen, lepidium/descurainia) and Chán tuì (蝉蜕 Cicadae Periostracum, cicada molting).

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