五苓散

• Function: Disinhibits water and percolates dampness; warms yang to transform qi.
• Core pathomechanism: Water-damp accumulating internally, with impaired qi transformation of the bladder. External pathogens entering the interior affect the bladder's qi-transforming function, leading to disordered water metabolism; fluids fail to ascend, and water-damp collects in the lower burner.

1. When it is used

This formula is a classic prescription for water-retention patterns arising from impaired qi transformation of the bladder. Its combination of yang-freeing and water-disinhibiting actions is intended to restore the normal distribution and excretion of body fluids.

2. Pattern and presentation

Main symptoms:

• Inhibited urination, with headache and slight fever.
• Vexing thirst with desire to drink, vomiting immediately after drinking water ("water reflux pattern").

Generalized and accompanying symptoms:

• Edema, diarrhea, white tongue coating.

3. Tongue and pulse

• Tongue: pale tongue body with white, slippery coating.
• Pulse: floating or moderate (slow) pulse.

4. Granule conversion and dose

Calculation of the total raw herb weight in the original formula:

Fu Ling (poria) 9 g + Zhu Ling (polyporus) 9 g + Ze Xie (alismatis rhizome) 15 g + Bai Zhu (white atractylodes rhizome) 9 g + Gui Zhi (cinnamon twig) 6 g = 48 g.