Wu Ling San and Fu Ling Gan Cao Tang July 5, 1977

Wu Ling San and Fu Ling Gan Cao Tang July 5, 1977

In “Shang Han Lun,” Article 71 states: “If a patient with Tai Yang illness sweats profusely, the stomach becomes dry, they feel restless and cannot sleep, and they want to drink water, give them small sips to calm the stomach qi and they will recover. If the pulse is floating, urination is difficult, and there is slight fever and thirst, use Wu Ling San.” Article 74 says: “If a patient with wind-cold fever does not improve after six or seven days and feels restless, with both exterior and interior symptoms, and wants to drink water but vomits when drinking, this is called water reversal, and Wu Ling San is the remedy.” Article 72 states: “If a patient has already sweated and the pulse is floating and rapid, and they feel thirsty, use Wu Ling San.” Article 73 says: “If a patient with cold damage sweats and feels thirsty, use Wu Ling San; if they do not feel thirsty, use Fu Ling Gan Cao Tang.” Based on these four passages, the main indication for Wu Ling San is post-fever conditions, with symptoms of profuse sweating, intense thirst, severe restlessness, and significant swelling. These “four major symptoms” are similar to the “four major symptoms” of Bai Hu Tang in two ways and different in two ways: the similarities are thirst and sweating, while the differences are restlessness and swelling. The “four major symptoms” of the former are real fire, while those of the latter are虚热; the former affects the Yang Ming meridian, while the latter affects the Tai Yang meridian; the former is internal heat, suitable for clearing and purging, while the latter is external heat, suitable for dispersing and releasing. In terms of organs, the former affects the stomach, while the latter affects the bladder. The bladder is “the official of the state, where the waterways flow out.” The primary task of clearing the bladder’s虚火 is to warm, unblock, and dilute, and Wu Ling San is an excellent remedy for this. From a Western medical perspective, Bai Hu Tang treats heat by inducing high fever, while Wu Ling San treats heat by addressing autonomic nervous system dysfunction. The former deals with heat during the illness, while the latter deals with heat after the illness—this is the subtlety of Wu Ling San. In addition, Wu Ling San also has diuretic, anti-edema, and anti-reversal effects, which should not be overlooked. The main indication for Fu Ling Gan Cao Tang is “patients with cold damage who sweat but do not feel thirsty.” This is essentially the same as the indication for Gui Zhi Tang, but unlike Gui Zhi Tang, Fu Ling Gan Cao Tang can also treat difficulty in urination, whereas Gui Zhi Tang does not have this diuretic effect. The two differ in their approach—one acts from above, the other from below—and both can eliminate excess water. Gui Zhi Tang eliminates water from the top down, while Fu Ling Gan Cao Tang eliminates water from the bottom up. For those with superficial deficiency but no edema, use Gui Zhi Tang; for those with superficial deficiency and edema, use Fu Ling Gan Cao Tang.