利水滲濕五苓散

文/卓鵬偉

“溪深古雪在，石斷寒泉流。”冬季氣溫較低，凜冽的寒氣很容易損傷腎中陽氣，影響腎陽的蒸騰氣化，使人體水液輸布代謝失常，患上水腫、瀉泄等病證。

''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

相傳古時候，有一位孝子名叫毛崇甫，他的母親葉夫人在六十多歲時得了一種怪病——心煩發熱、口渴，吐瀉交作、小便不利，持續半月不愈。毛崇甫非常憂慮，每天傍晚對著北極星跪拜，希望天神能保佑母親早日痊愈。其孝心感動天地，一天毛崇甫妹妹服侍在母親身旁，恍惚間聽見有人對她說，“為何不服用古方五苓散呢？”并送給她一副藥方。一會兒，妹妹從夢中醒來，趕緊對哥哥說起夢中之事，毛崇甫按方抓藥，果然藥到病除。

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.

據史料記載，五苓散早在漢代就已被用于治療瘧疾，后被醫圣張仲景收錄于《傷寒論》中，是千百年來利水滲濕的首選方劑。

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.

協調脾腎布津液Harmonizing the spleen and kidney to promote fluid circulation

五苓散方僅有五味藥：澤瀉用量最重，利小便、滲水濕，為君藥；豬苓、茯苓二者淡滲利濕，為臣藥；白術益氣健脾，桂枝通陽扶衛、解表散邪，共為佐藥。全方合用，利水滲濕、溫陽化氣，通過調整脾腎膀胱功能，使人體恢復正常的津液輸布與代謝。

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.

澤瀉

五苓散臨床應用非常廣泛，古代常用于治療霍亂、膀胱蓄水、痰飲病等，現代臨床應用范圍更是大大擴展，多用于治療急慢性腎炎、腎病綜合征、急性尿潴留、水腫及腔體（腦、胸腔、腹腔等）積液、急慢性胃腸炎、心力衰竭、肝膽疾病等，表現為水液代謝失常、水蓄體內的病癥。

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.

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

《素問?靈蘭秘典論》謂：“膀胱者，州都之官，津液藏焉，氣化則能出矣”，膀胱的氣化依賴陽氣的蒸騰，因此，治療膀胱氣化不利引起的水腫，關鍵就在于化氣利水。五苓散雖然配伍簡單，卻蘊含了培土制水的五行玄機。

"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.

從本方配伍看，茯苓、白術均入脾胃經，屬土，可益氣健脾利濕，治療脾氣不足、運化失健而引起的水濕內生；桂枝辛甘溫煦，可培脾土，有扶脾陽、逐寒邪之功，能助膀胱氣化；此外，五味藥物皆具甘味，甘味屬土，故均有補益脾胃、和中化氣之效。

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.

結語Conclusion

“水為至陰，其本在腎，其標在肺，其制在脾。”五苓散的標準密碼在于“利水滲濕”4個字，通過調節人體水液代謝，治療因水液停聚引起的諸多病癥。在臨床中，胃陰虧虛者也常出現口渴、小便不利等癥狀，但其病癥多因津液不足所致，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.