（附∶肿胀概论）
朱女 痧子后，因谷食不谨，积滞生湿，湿郁化热，
阻于募原，太阴失健运之常，阳明乏通降之职，遂致脘腹膨胀，小溲不利，咳嗽气喘，面目虚浮，身热肢肿，苔
干腻而黄，脉弦滑，右甚于左，肿胀之势渐着。急拟疏上焦之气机，通中宫之湿滞，去其有形，则无形之热自
易解散。
淡豆豉（三钱） 黑山栀（一钱五分） 枳实炭（一钱五分） 光杏仁（三钱） 川贝母（三钱） 桑白皮（二钱）
陈广皮（一钱） 大腹皮（二钱） 莱菔子（炒、研，二钱） 福泽泻（一钱五分） 鸡金炭（二钱） 茯苓皮
（三钱） 冬瓜子皮（各三钱）
程女 肺有伏风，痰气壅塞，脾有湿热，不能健运，以致咳嗽气逆，面浮四肢肿，食入腹胀有形，小溲不利，
苔薄腻，脉浮滑，势成肿胀。急拟疏风宣肺，运脾逐湿，庶免加剧耳。
紫苏叶（一钱） 青防风（一钱） 光杏仁（三钱） 象贝母（三钱） 连皮苓（四钱） 陈广皮（一钱）
桑白皮（二钱） 大腹皮（二钱） 莱菔子（炒研，三钱） 枳实炭（一钱） 汉防己（三钱） 冬瓜子皮（各三钱）
徐右 产后两月余，遍体浮肿，颈脉动时咳，难于平卧，口干欲饮，大腹胀满，小溲短赤，舌光红无苔，
脉虚弦而数。良由营阴大亏，肝失涵养，木克中土，脾不健运，阳水湿热，日积月聚，上射于肺，肺不能通调水
道，下输膀胱，水湿无路可出，泛滥横溢，无所不到也。脉症参合，刚剂尤忌，急拟养肺阴以柔肝木，运中土而
利水湿，冀望应手，庶免凶危。
南北沙参（各三钱） 连皮苓（四钱） 生白术（二钱） 清炙草（五分） 淮山药（三钱） 川石斛（三钱）
陈广皮（一钱） 桑白皮（二钱） 川贝母（三钱） 甜光杏（三钱） 大腹皮（二钱） 汉防己（三钱） 冬
瓜子皮（各三钱） 生苡仁（五钱） 另用冬瓜汁温饮代茶。
二诊 服药三剂，小溲渐多，水湿有下行之势，遍体浮肿，稍见轻减。而咳嗽气逆，不能平卧，内热
口干，食入之后，脘腹饱胀益甚。舌光红，脉虚弦带数。皆由血虚阴亏，木火上升，水气随之逆肺，肺失
肃降之令，中土受木所侮，脾失健运之常也。仍宜养金制木，崇土利水，使肺金有治节之权，脾土得砥柱
之力，自能通调水道，下输膀胱，而水气不致上逆矣。
南北沙参（各三钱） 连皮苓（四钱） 生白术（二钱） 清炙草（五钱） 川石斛（三钱） 肥知母（一钱五分）
川贝母（二钱） 桑白皮（二钱） 大腹皮（二钱） 汉防己（二钱） 炙白苏子（一钱五分） 甜光杏（三钱）
冬瓜子皮（各三钱） 鸡金炭（二钱）
卫左 曝于烈日，暑气内逼，居处潮湿，湿郁滞阻，三焦决渎无权，遂致脘腹胀满，泛泛呕恶，面浮
肢肿，里热口干，二便不通，皮色晦黄，苔灰腻，脉弦滑而数，此属热胀。先拟苦辛通降，泄上中之痞满。
川雅连（五分） 仙半夏（二钱） 淡黄芩（一钱） 枳实炭（一钱五分） 制小朴（一钱） 大腹皮（二钱）
连皮苓（四钱） 福泽泻（一钱五分） 莱菔子（炒研，三钱） 鲜霍香（一钱五分） 西茵陈（一钱五分）
六神曲（三钱）
金童 初病春温寒热，经治已愈，继因停滞，引动积湿，湿郁化水，复招外风，风激水而横溢泛滥，
以致遍体浮肿，两目合缝，气逆不能平卧，大腹胀满，囊肿如升，腿肿如斗，小溲涩少，脉象浮紧，苔
白腻，此为风水重症。急拟开鬼门，洁净府。
紫苏叶（一钱） 青防风（一钱） 川桂枝（五分） 连皮苓（四钱） 福泽泻（一钱五分） 陈广皮（一钱）
大腹皮（二钱） 水炙桑叶（二钱） 淡姜皮（五分） 鸡金炭（一钱五分） 莱菔子（炒研，二钱）
二诊 遍体浮肿，咳嗽气急，难于平卧，大腹胀满，小溲不利，囊肿腿肿如故，苔白腻，脉浮紧而
弦。良由脾阳不运，积滞内阻，水湿泛滥横溢，灌浸
表里，无所不到也。恙势尚在重途，还虑易进难退。再拟汗解散风，化气利水，俾气化能及州都，则水湿
斯有出路。
净麻黄（四分） 川桂枝（六分） 连皮苓（四钱） 生白术（一钱五分） 猪苓（二钱） 泽泻（一钱五分）
陈皮（一钱） 大腹皮（二钱） 水炙桑叶（二钱） 汉防己（二钱） 莱菔子（炒研，三钱） 淡姜皮（五分）
三诊 连投开鬼门，洁净府之剂，虽有汗不多，小溲渐利，遍体浮肿不减，咳嗽气逆如故，大腹胀
满，苔白腻，脉浮紧。良由中阳受伤，脾胃困顿。阳气所不到之处，即水湿灌浸之所，大有水浪滔天之
势，尚在重险一途。今拟麻黄附子甘草汤合真武、五苓、五皮，复方图治，大病如大敌，兵家之总攻击
也。然乎否乎？质之高明。
净麻黄（四分） 熟附块（一钱） 生甘草（五分） 猪云苓（各三钱） 川椒目（二十粒） 川桂枝（六分）
生白术（一钱五分） 福泽泻（一钱五分） 陈广皮（一钱） 大腹皮（二钱） 水炙桑皮（二钱） 淡姜皮
（五分） 汉防己（二钱）
外以热水袋熨体，助阳气以蒸汗，使水气从外内分消也。
四诊 服复方后，汗多小溲亦畅，遍体浮肿渐
退，气逆咳嗽渐平，大有转机之兆。自觉腹内热气蒸蒸，稍有口干，是阳气内返，水湿下趋之佳象，不可
因其口干，遽谓寒已化热，而改弦易辙，致半途尽废前功也。仍守原法，毋庸更章。
原方加生熟苡仁（各三钱）。
五诊 遍体浮肿，十去五六，气逆亦平，脉紧转和，水湿已得分消。惟脾不健运，食入难化，易于便
溏，口干欲饮，脾不能为胃行其津液，输润于上，不得据为热象也。今制小其剂，温肾助阳，运脾利水，
去疾务尽之意。
熟附块（一钱） 生白术（二钱） 生甘草（五分） 茯猪苓（各三钱） 炒补骨脂（一钱五分）
川桂枝（五分） 福泽泻（一钱五分） 陈广皮（一钱） 大腹皮（二钱） 水炙桑皮（二钱） 淡姜皮（五分）
生熟苡仁（各三钱） 冬瓜子皮（各三钱）
六诊 遍体浮肿，已退八九，气逆咳嗽亦平，饮食亦觉渐香。诸病已去，正气暗伤，脾土未健，神疲
肢倦，自汗蒸蒸，有似虚寒之象。今拟扶其正气，调其脾胃，佐化余湿，以善其后。
炒潞党参（二钱） 熟附片（八分） 生白术（二钱） 云茯苓（三钱） 清炙草（五分） 陈广皮（一钱）
大砂仁（研，八分） 炒补骨脂（一钱五分） 炒谷麦芽（各三钱） 生熟苡仁（各三
钱） 冬瓜子皮（各三钱） 福泽泻（一钱五分） 生姜（二片） 红枣（四枚）
关左 暴肿气急，小溲短赤，口渴欲饮，脉浮滑而数。此外邪壅肺，气道不通，风水为患。风为阳邪，
水为阳水，风能消谷，故胃纳不减也。拟越婢汤加味。
净麻黄（四分） 熟石膏（三钱） 生白术（一钱五分） 光杏仁（三钱） 肥知母（一钱五分）
茯苓皮（三钱） 大腹皮（二钱） 桑白皮（二钱） 冬瓜子皮（各三钱） 淡姜皮（五分）
林左 年近花甲，思虑伤脾，脾阳不运，湿浊凝聚，以致大腹胀满，鼓之如鼓，小溲清白，脉象沉
细。脾为太阴，湿为阴邪。当以温运分消。
熟附子块（一钱） 淡干姜（八分） 生白术（三钱） 广陈皮（一钱） 制川朴（一钱） 大腹皮（二钱）
鸡金炭（一钱五分） 炒谷芽（四钱） 陈胡芦瓢（四钱） 清炙草（五分）
二诊 前进温运分消之剂，脐腹胀满略松，纳谷减少，形瘦神疲，小溲清长，腑行不实，脉沉细。良
由火衰不能生土，中阳不运，浊阴凝聚，鼓之如鼓，中空无物，即无形之虚气散逆，而为满为胀也。仍拟
益火消阴，补虚运脾，亦经旨塞因塞用之意。
炒潞党参（三钱） 熟附子（一钱五分） 淡干姜（八分） 清炙
草（五分） 陈广皮（一钱） 大砂仁（研，八分） 陈胡芦瓢（四钱） 胡芦巴（一钱五分） 炒补骨脂（一钱
五分） 煨益智（一钱五分）
三诊 脐腹胀满较前大减，小溲微黄，自觉腹内热气烘蒸，阳气内返之佳象。脉沉未起，形肉削瘦。
仍拟益火之源，以消阴翳，俾得离照当空，则浊阴自散。
炒潞党参（三钱） 熟附子（一钱五分） 淡干姜（八分） 清炙草（八分） 陈广皮（一钱） 大砂仁
（研，八分） 炒淮药（三钱） 炒补骨脂（一钱五分） 胡芦巴（一钱五分） 煨益智（一钱五分） 小茴香
（八分） 焦谷芽（四钱） 陈胡芦瓢（四钱）
陈左 大腹膨胀，鼓之如鼓，脐突青筋显露，形瘦色萎，脉沉细，舌无苔。良由脾肾之阳大伤，虚气
散逆，阳气不到之处，即浊阴凝聚之所。阅前方均用理气消胀之剂，胀势有增无减，病延一载，虚胀无
疑。姑仿经旨塞因塞用之法，冀望应手为幸。
炒潞党参（三钱） 熟附块（一钱） 淡干姜（六分） 清炙草（六分） 连皮苓（四钱） 陈广皮（一钱）
炒补骨脂（一钱五分） 胡芦巴（一钱五分） 陈胡芦瓢（三钱） 金液丹（一钱，每早空心吞服）
傅左 宦途失意，忧思伤脾，营运无权，肝木来
侮，浊气在上，则生 胀，大腹胀满，自秋至冬，日益加剧，动则气逆，小溲涓滴难通，青筋显露，足肿
不能步履，口燥欲饮，舌红绛，脉细数。叠进六君，五皮，肾气等剂，病势不减，已入危笃一途！勉拟养
金制木，运脾化气，亦不过尽心力而已。
南北沙参（各三钱） 连皮苓（四钱） 生白术（三钱） 淮山药（三钱） 左牡蛎（四钱） 花龙骨（三钱）
川贝母（三钱） 甜光杏（三钱） 汉防己（二钱） 鲜冬瓜汁（冲服，二两） 滋肾通关丸（包煎，一钱五分）
另单方∶每日虾士蟆（二钱），泛水如银耳状，煮服。
连蟆肉食之，如法食两天后，即小溲畅行，且时时频转矢气，肿胀渐消。按虾士蟆为益肾利水之品，故能
应效，洵治虚胀之妙品也。
文右 旧有脘痛，继则腹满作胀，食入难化，面黄溺少。此肝气怫郁，木乘土位，湿热浊气，凝聚于
募原之间，三焦气机流行窒塞，书所谓浊气在上，则生 胀是也。两关脉弦，寸部郁涩，急拟疏肝解郁，
运脾逐湿。
银州柴胡（一钱） 生白术（二钱） 枳实炭（一钱） 连皮苓（四钱） 陈广皮（一钱） 大腹皮（二钱）
黑山栀（一钱五分） 带壳砂仁（八分） 冬瓜皮（三钱） 鸡金炭（一钱五分） 炒谷
麦芽（各三钱） 小温中丸（每早吞服，三钱）
杨左 形瘦色苍，木火体质，抑郁不遂，气阻血痹，与湿热凝聚募原，始则里热口干，继而大腹胀
硬，自夏至秋，日益胀大，今已脐突，红筋显露，纳谷衰少，大便色黑，小溲短赤，舌灰黄，脉弦数，此
血臌之重症也。气为血之先导，血为气之根据附，气滞则血凝，气通则血行。先拟行气去瘀，清热化湿，然
恙根已深，非旦夕所能图功者也。
银州柴胡（一钱） 生香附（二钱） 连皮苓（四钱） 紫丹参（二钱） 粉丹皮（一钱五分） 赤芍（二钱）
藏红花（八分） 当归尾（三钱） 绛通草（八分） 黑山栀（一钱五分） 泽兰叶（一钱五分） 青宁丸（包，三钱）
[Appendix: General Discussion on Swelling]
**Case of Ms. Zhu:** After suffering from smallpox/rubella (Shazi), due to careless diet, food stagnation generated dampness. The dampness became depressed and transformed into heat, obstructing the Mu Yuan (Membrane Source, a location between the exterior and interior). The Taiyin Spleen lost its normal function of healthy transportation, and the Yangming Stomach lacked its function of descending and unblocking. Consequently, epigastric and abdominal distension occurred, urination was difficult, cough and asthma appeared, the face and eyes were puffy, the body had fever and limb edema. The tongue coating was dry, greasy, and yellow; the pulse was wiry and slippery, more pronounced on the right than the left. The trend of swelling was gradually intensifying. Urgently prescribed to regulate the Qi mechanism of the Upper Jiao, unblock the dampness stagnation in the Middle Jiao. Once the tangible pathogens are removed, the intangible heat will easily dissipate.
Fermented Soybean (Douchi) (3 qian), Black Gardenia Fruit (Zhizi) (1.5 qian), Charred Immature Bitter Orange (Zhishi Tan) (1.5 qian), Apricot Seed (Xingren) (3 qian), Fritillaria Bulb (Beimu) (3 qian), Mulberry Root Bark (Sangbaipi) (2 qian), Aged Tangerine Peel (Chenpi) (1 qian), Areca Peel (Fupi) (2 qian), Radish Seed (Laifuzi) (stir-fried, ground, 2 qian), Alisma Rhizome (Zexie) (1.5 qian), Chicken Gizzard Lining (Jijin) charred (2 qian), Poria Cocos with Skin (Fuling Pi) (3 qian), Winter Melon Seed and Peel (Dongguazi Pi) (each 3 qian).
**Case of Ms. Cheng:** There is latent wind in the Lung, with phlegm and Qi obstructing. The Spleen has damp-heat and cannot transport effectively, leading to cough, rebellious Qi, facial edema, limb swelling, palpable abdominal distension after eating, and difficult urination. The tongue coating is thin and greasy; the pulse is floating and slippery. The condition is developing into swelling. Urgently prescribed to dispel wind and ventilate the Lung, strengthen the Spleen and drain dampness, to prevent aggravation.
Perilla Leaf (Zisuye), Blue Windproof Rhizome (Fangfeng) (each 1 qian), Apricot Seed (Xingren) (3 qian), Fritillaria Bulb (Beimu) (3 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Aged Tangerine Peel (Chenpi) (1 qian), Mulberry Root Bark (Sangbaipi) (2 qian), Areca Peel (Fupi) (2 qian), Radish Seed (Laifuzi) (stir-fried, ground, 3 qian), Charred Immature Bitter Orange (Zhishi Tan) (1 qian), Stephania Root (Hanfangji) (3 qian), Winter Melon Seed and Peel (Dongguazi Pi) (each 3 qian).
**Case of Mr. Xu:** More than two months postpartum, generalized edema occurs. When the neck vessels pulsate, coughing ensues; lying flat is difficult. There is dry mouth with desire to drink, severe abdominal distension, and short, red urine. The tongue surface is bare and red without coating; the pulse is deficient, wiry, and rapid. This is largely due to a major deficiency of Ying (Nutritive) Yin and Blood. The Liver loses nourishment, Wood overacts on Earth (Liver attacks Spleen), and the Spleen fails to transport. Yang water and damp-heat accumulate day by day, affecting the Lung upwards. The Lung cannot regulate the water passages and transmit water downwards to the Bladder. With no outlet for water-dampness, it floods and overflows everywhere. Combining pulse and symptoms, harsh/dry agents are contraindicated. Urgently prescribed to nourish Lung Yin to soften Liver Wood, and strengthen Middle Earth to promote water metabolism, hoping for immediate effect to avoid critical danger.
Northern and Southern Glehnia Root (Shashen) (each 3 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (2 qian), Prepared Licorice Root (Gancao) (0.5 qian), Chinese Yam (Shanyao) (3 qian), Dendrobium Stem (Shihu) (3 qian), Aged Tangerine Peel (Chenpi) (1 qian), Mulberry Root Bark (Sangbaipi) (2 qian), Fritillaria Bulb (Beimu) (3 qian), Sweet Apricot Seed (Guangxing) (3 qian), Areca Peel (Fupi) (2 qian), Stephania Root (Hanfangji) (3 qian), Winter Melon Seed and Peel (Dongguazi Pi) (each 3 qian), Coix Seed (Yiren) (5 qian). Additionally, use fresh winter melon juice, warmed, as tea substitute.
**Second Visit:** After three doses, urination gradually increased, indicating water-dampness moving downward. Generalized edema slightly reduced. However, cough, rebellious Qi, inability to lie flat, internal heat, dry mouth, and worsening abdominal fullness after eating persist. Tongue is bare and red; pulse is deficient, wiry, and rapid. This is due to blood deficiency and Yin depletion, causing Liver Fire to rise. Water Qi follows and rebels against the Lung; the Lung loses its descending function. The Middle Earth (Spleen) is insulted by Liver Wood, losing its transport function. Continue to nourish Metal (Lung) to control Wood (Liver), fortify Earth (Spleen) to promote diuresis. Let Lung Metal have regulatory authority, and Spleen Earth act as a pillar, so water passages can be regulated and water transmitted to the Bladder, preventing water rebellion upward.
Northern and Southern Glehnia Root (Shashen) (each 3 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (2 qian), Prepared Licorice Root (Gancao) (5 qian), Dendrobium Stem (Shihu) (3 qian), Anemarrhena Rhizome (Zhimu) (1.5 qian), Fritillaria Bulb (Beimu) (2 qian), Mulberry Root Bark (Sangbaipi) (2 qian), Areca Peel (Fupi) (2 qian), Stephania Root (Hanfangji) (2 qian), Prepared Perilla Seed (Zisuzi) (1.5 qian), Sweet Apricot Seed (Guangxing) (3 qian), Winter Melon Seed and Peel (Dongguazi Pi) (each 3 qian), Chicken Gizzard Lining (Jijin) charred (2 qian).
**Case of Wei Zuo:** Exposed to scorching sun, summer-heat forced inward. Dwelling in dampness caused dampness to depress and obstruct. The Sanjiao (Triple Burner) lost its function of draining water. Epigastric and abdominal distension, nausea, facial and limb edema, internal heat with dry mouth, and obstruction of both stool and urine occurred. Skin color is dull yellow; tongue coating is gray and greasy; pulse is wiry, slippery, and rapid. This belongs to Heat Distension. First prescribed bitter and acrid agents to unblock and descend, clearing stagnation in the Upper and Middle Jiao.
Coptis Rhizome (Huanglian) (0.5 qian), Pinellia Tuber (Banxia) (2 qian), Scutellaria Root (Huangqin) (1 qian), Charred Immature Bitter Orange (Zhishi Tan) (1.5 qian), Processed Magnolia Bark (Houpo) (1 qian), Areca Peel (Fupi) (2 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Alisma Rhizome (Zexie) (1.5 qian), Radish Seed (Laifuzi) (stir-fried, ground, 3 qian), Fresh Patchouli Leaf (Huoxiang) (1.5 qian), Artemisia Capillaris Herb (Yinchen) (1.5 qian), Medicated Leaven (Shenqu) (3 qian).
**Case of Jin Tong:** Initially suffered from Spring-Warmth with chills and fever, which resolved after treatment. Subsequently, due to food stagnation, accumulated dampness was triggered. Dampness depressed and transformed into water, attracting external wind. Wind agitated water, causing it to flood and overflow. Generalized edema resulted, eyes tightly shut, rebellious Qi preventing lying flat, abdominal distension, scrotal swelling like a measuring cup, leg swelling like a bucket, scanty and painful urination. Pulse is floating and tight; tongue coating is white and greasy. This is a severe case of Wind-Water Edema. Urgently prescribed to open the skin pores (sweating) and purify the bladder (diuresis).
Perilla Leaf (Zisuye), Blue Windproof Rhizome (Fangfeng) (each 1 qian), Cinnamon Twig (Guizhi) (0.5 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Alisma Rhizome (Zexie) (1.5 qian), Aged Tangerine Peel (Chenpi) (1 qian), Areca Peel (Fupi) (2 qian), Water-processed Mulberry Leaf (Sangye) (2 qian), Light Ginger Peel (Jiangpi) (0.5 qian), Chicken Gizzard Lining (Jijin) charred (1.5 qian), Radish Seed (Laifuzi) (stir-fried, ground, 2 qian).
**Second Visit:** Generalized edema, cough,急促 breathing, inability to lie flat, abdominal distension, difficult urination, scrotal and leg swelling remain unchanged. Tongue coating is white and greasy; pulse is floating, tight, and wiry. This is mainly due to Spleen Yang failing to transport, internal stagnation blocking, and water-dampness flooding and overflowing, infiltrating both interior and exterior. The condition remains severe, feared to be easy to progress but hard to retreat. Again prescribed to disperse wind via sweating and transform Qi to promote diuresis, so that Qi transformation reaches the Zhou Du (Bladder), providing an exit for water-dampness.
Ephedra Herb (Mahuang) (0.4 qian), Cinnamon Twig (Guizhi) (0.6 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (1.5 qian), Polyporus (Zhuling) (2 qian), Alisma Rhizome (Zexie) (1.5 qian), Tangerine Peel (Chenpi) (1 qian), Areca Peel (Fupi) (2 qian), Water-processed Mulberry Leaf (Sangye) (2 qian), Stephania Root (Hanfangji) (2 qian), Radish Seed (Laifuzi) (stir-fried, ground, 3 qian), Light Ginger Peel (Jiangpi) (0.5 qian).
**Third Visit:** Continuous administration of sweating and diuretic formulas resulted in little sweat, though urination gradually improved. Generalized edema persists, cough and rebellious Qi remain, abdominal distension continues. Tongue coating is white and greasy; pulse is floating and tight. This is due to injury of Middle Yang and exhaustion of Spleen and Stomach. Where Yang Qi does not reach, there is water-dampness infiltration, resembling a raging flood. Still in a critical state. Now prescribed Mahuang Fuzi Gancao Tang combined with Zhenwu Tang, Wuling San, and Wupi Tang as a compound formula for comprehensive treatment. Treating a major illness is like a major enemy; this is the general's total attack. Is this correct? Seeking advice from experts.
Ephedra Herb (Mahuang) (0.4 qian), Prepared Aconite Root (Fuzi) (1 qian), Raw Licorice Root (Gancao) (0.5 qian), Polyporus and Poria Cocos (Zhuling/Fuling) (each 3 qian), Sichuan Pepper Seed (Huajiaomu) (20 grains), Cinnamon Twig (Guizhi) (0.6 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (1.5 qian), Alisma Rhizome (Zexie) (1.5 qian), Aged Tangerine Peel (Chenpi) (1 qian), Areca Peel (Fupi) (2 qian), Water-processed Mulberry Root Bark (Sangpi) (2 qian), Light Ginger Peel (Jiangpi) (0.5 qian), Stephania Root (Hanfangji) (2 qian).
Externally, apply hot water bags to warm the body, assisting Yang Qi to vaporize sweat, allowing water Qi to dissipate from both inside and outside.
**Fourth Visit:** After taking the compound formula, profuse sweating and smooth urination occurred. Generalized edema gradually receded, rebellious Qi and cough subsided, showing signs of significant improvement. Self-reported feeling of steaming heat in the abdomen and slight dry mouth indicate returning Yang Qi and downward movement of water-dampness—a good sign. Do not mistake dry mouth for cold transforming into heat and change the treatment strategy, ruining previous efforts. Stick to the original method.
Original formula plus Raw and Prepared Coix Seed (Yiren) (each 3 qian).
**Fifth Visit:** Generalized edema reduced by 50-60%, rebellious Qi subsided, pulse tightness softened, water-dampness partially resolved. However, Spleen fails to transport, food is hard to digest, prone to loose stools. Dry mouth with desire to drink is due to Spleen failing to distribute fluids upward from the Stomach, not a heat pattern. Reduce dosage slightly. Warm Kidney and assist Yang, strengthen Spleen and promote diuresis, aiming to eradicate the disease completely.
Prepared Aconite Root (Fuzi) (1 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (2 qian), Raw Licorice Root (Gancao) (0.5 qian), Poria Cocos and Polyporus (Fuling/Zhuling) (each 3 qian), Stir-fried Psoralea Fruit (Buguzhi) (1.5 qian), Cinnamon Twig (Guizhi) (0.5 qian), Alisma Rhizome (Zexie) (1.5 qian), Aged Tangerine Peel (Chenpi) (1 qian), Areca Peel (Fupi) (2 qian), Water-processed Mulberry Root Bark (Sangpi) (2 qian), Light Ginger Peel (Jiangpi) (0.5 qian), Raw and Prepared Coix Seed (Yiren) (each 3 qian), Winter Melon Seed and Peel (Dongguazi Pi) (each 3 qian).
**Sixth Visit:** Generalized edema reduced by 80-90%, rebellious Qi and cough subsided, appetite improving. Pathogens are gone, but Zheng Qi (Upright Qi) is secretly damaged. Spleen Earth is not yet robust; spirit is fatigued, limbs are weak, spontaneous sweating resembles deficiency-cold. Now prescribed to support Zheng Qi, regulate Spleen and Stomach, assist in resolving residual dampness to conclude treatment.
Stir-fried Codonopsis Root (Dangshen) (2 qian), Prepared Aconite Slice (Fupian) (0.8 fen), Raw Atractylodes Macrocephala Rhizome (Baizhu) (2 qian), Cloud Poria (Fuling) (3 qian), Prepared Licorice Root (Gancao) (0.5 qian), Aged Tangerine Peel (Chenpi) (1 qian), Large Amomum Fruit (Sharen) (ground, 0.8 fen), Stir-fried Psoralea Fruit (Buguzhi) (1.5 qian), Stir-fried Rice Sprout and Malt (Guya/Maiya) (each 3 qian), Raw and Prepared Coix Seed (Yiren) (each 3 qian), Winter Melon Seed and Peel (Dongguazi Pi) (each 3 qian), Alisma Rhizome (Zexie) (1.5 qian), Fresh Ginger (2 slices), Red Date (4 pieces).
**Case of Guan Zuo:** Sudden swelling,急促 breathing, short red urine, thirst with desire to drink. Pulse is floating, slippery, and rapid. This is external pathogen congesting the Lung, airway blocked, Wind-Water pathology. Wind is a Yang pathogen, water is Yang water. Wind aids digestion, hence appetite remains normal. Prescribed Yebip Decoction with modifications.
Ephedra Herb (Mahuang) (0.4 qian), Prepared Gypsum (Shigao) (3 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (1.5 qian), Apricot Seed (Xingren) (3 qian), Anemarrhena Rhizome (Zhimu) (1.5 qian), Poria Cocos with Skin (Fuling Pi) (3 qian), Areca Peel (Fupi) (2 qian), Mulberry Root Bark (Sangbaipi) (2 qian), Winter Melon Seed and Peel (Dongguazi Pi) (each 3 qian), Light Ginger Peel (Jiangpi) (0.5 qian).
**Case of Lin Zuo:** Near sixty years old. Overthinking injured the Spleen. Spleen Yang failed to transport, turbid dampness condensed. Abdominal distension, drum-like upon percussion, clear urine. Pulse is deep and fine. Spleen is Taiyin; dampness is a Yin pathogen. Should use warming and transporting methods to separate and eliminate.
Prepared Aconite Block (Fuzi) (1 qian), Light Dried Ginger (Ganjiang) (0.8 fen), Raw Atractylodes Macrocephala Rhizome (Baizhu) (3 qian), Broad-leaved Citrus Peel (Chenpi) (1 qian), Processed Magnolia Bark (Houpo) (1 qian), Areca Peel (Fupi) (2 qian), Chicken Gizzard Lining (Jijin) charred (1.5 qian), Stir-fried Rice Sprout (Guyaf) (4 qian), Dried Bottle Gourd Rind (Hulupiao) (4 qian), Prepared Licorice Root (Gancao) (0.5 qian).
**Second Visit:** Previous warming and transporting agents slightly relieved umbilical and abdominal distension. Appetite decreased, emaciation and fatigue noted, clear long urine, loose stools. Pulse is deep and fine. This is due to Fire deficiency failing to generate Earth, Middle Yang failing to transport, turbid Yin condensing. Drum-like percussion, hollow inside, indicates intangible deficient Qi scattering and rebelling, causing fullness and distension. Continue to benefit Fire to eliminate Yin, tonify deficiency and strengthen Spleen transport, following the classic principle of "treating obstruction with obstruction" (Se Yin Se Yong).
Stir-fried Codonopsis Root (Dangshen) (3 qian), Prepared Aconite (Fuzi) (1.5 qian), Light Dried Ginger (Ganjiang) (0.8 fen), Prepared Licorice Root (Gancao) (0.5 qian), Aged Tangerine Peel (Chenpi) (1 qian), Large Amomum Fruit (Sharen) (ground, 0.8 fen), Dried Bottle Gourd Rind (Hulupiao) (4 qian), Hook-shaped Barnacle Shell (Huluba) (1.5 qian), Stir-fried Psoralea Fruit (Buguzhi) (1.5 qian), Roasted Smartweed Seed (Yizhi) (1.5 qian).
**Third Visit:** Umbilical and abdominal distension significantly reduced compared to before. Urine slightly yellow. Self-reported steaming heat in abdomen indicates returning Yang Qi—a good sign. Pulse remains deep, flesh is emaciated. Continue to benefit the source of Fire to eliminate Yin shadows. Let the sun shine brightly, then turbid Yin will naturally dissipate.
Stir-fried Codonopsis Root (Dangshen) (3 qian), Prepared Aconite (Fuzi) (1.5 qian), Light Dried Ginger (Ganjiang) (0.8 fen), Prepared Licorice Root (Gancao) (0.8 fen), Aged Tangerine Peel (Chenpi) (1 qian), Large Amomum Fruit (Sharen) (ground, 0.8 fen), Stir-fried Chinese Yam (Shanyao) (3 qian), Stir-fried Psoralea Fruit (Buguzhi) (1.5 qian), Hook-shaped Barnacle Shell (Huluba) (1.5 qian), Roasted Smartweed Seed (Yizhi) (1.5 qian), Small Fennel Fruit (Xiaohuixiang) (0.8 fen), Scorched Rice Sprout (Guyaf) (4 qian), Dried Bottle Gourd Rind (Hulupiao) (4 qian).
**Case of Chen Zuo:** Abdominal distension, drum-like upon percussion, protruding umbilicus with visible blue veins. Emaciated, sallow complexion. Pulse is deep and fine, tongue lacks coating. This is due to major injury of Spleen and Kidney Yang. Deficient Qi scatters; where Yang Qi does not reach, turbid Yin condenses. Previous prescriptions used Qi-regulating and distension-reducing agents, but distension increased rather than decreased. Disease persisted for a year; deficiency distension is certain. Tentatively follow the classic principle of "treating obstruction with obstruction." Hope for effectiveness.
Stir-fried Codonopsis Root (Dangshen) (3 qian), Prepared Aconite Block (Fuzi) (1 qian), Light Dried Ginger (Ganjiang) (0.6 fen), Prepared Licorice Root (Gancao) (0.6 fen), Poria Cocos with Skin (Lianpi Ling) (4 qian), Aged Tangerine Peel (Chenpi) (1 qian), Stir-fried Psoralea Fruit (Buguzhi) (1.5 qian), Hook-shaped Barnacle Shell (Huluba) (1.5 qian), Dried Bottle Gourd Rind (Hulupiao) (3 qian), Jin Ye Dan (Golden Liquid Pill) (1 qian, taken empty stomach every morning).
**Case of Fu Zuo:** Disappointment in official career. Worry and overthinking injured the Spleen. Transport and transformation lost power. Liver Wood insults Spleen. Turbid Qi rises, causing distension. Abdominal distension worsened from autumn to winter. Movement triggers rebellious Qi. Urine is scanty and difficult to pass. Blue veins visible. Feet swollen, unable to walk. Dry mouth with desire to drink. Tongue is red and crimson; pulse is fine and rapid. Repeated administration of Liu Jun Zi Tang, Wu Pi Yin, and Shen Qi Wan failed to reduce the condition; it entered a critical stage. Tentatively prescribe nourishing Metal to control Wood, strengthening Spleen and transforming Qi. Doing one's utmost.
Northern and Southern Glehnia Root (Shashen) (each 3 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (3 qian), Chinese Yam (Shanyao) (3 qian), Left Oyster Shell (Muli) (4 qian), Flower Dragon Bone (Longgu) (3 qian), Fritillaria Bulb (Beimu) (3 qian), Sweet Apricot Seed (Guangxing) (3 qian), Stephania Root (Hanfangji) (2 qian), Fresh Winter Melon Juice (2 liang, mixed in), Zishen Tongguan Wan (wrapped and decocted, 1.5 qian).
Alternative prescription: Daily use of Bullfrog (Xia Shima) (2 qian), soaked until it expands like silver ear fungus, boiled and consumed.
After consuming the bullfrog meat according to the method for two days, urination became smooth, frequent passage of flatus occurred, and swelling gradually subsided. Bullfrog is a herb that benefits the Kidney and promotes diuresis, hence its efficacy. It is indeed a wonderful product for treating deficiency distension.
**Case of Wen You:** History of epigastric pain, followed by abdominal fullness and distension. Food is hard to digest. Sallow complexion, scanty urine. This is Liver Qi depression, Wood attacking Earth. Damp-heat and turbid Qi condense in the Mu Yuan. Sanjiao Qi mechanism flow is obstructed. As the book says, "Turbid Qi in the upper causes distension." Both Guan pulses are wiry; Cun pulse is depressed and choppy. Urgently prescribed to soothe Liver and resolve depression, strengthen Spleen and drain dampness.
Chaihu from Yinzhou (Chaihu) (1 qian), Raw Atractylodes Macrocephala Rhizome (Baizhu) (2 qian), Charred Immature Bitter Orange (Zhishi Tan) (1 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Aged Tangerine Peel (Chenpi) (1 qian), Areca Peel (Fupi) (2 qian), Black Gardenia Fruit (Zhizi) (1.5 qian), Shell-on Amomum Fruit (Sharen) (0.8 fen), Winter Melon Peel (Dongguapi) (3 qian), Chicken Gizzard Lining (Jijin) charred (1.5 qian), Stir-fried Rice Sprout and Malt (Guya/Maiya) (each 3 qian), Xiao Wen Zhong Wan (Little Warm Middle Pill, taken every morning, 3 qian).
**Case of Yang Zuo:** Emaciated, dark complexion. Wood-Fire constitution. Depression and frustration lead to Qi stagnation and Blood bi. Combined with damp-heat condensing in Mu Yuan. Initially internal heat and dry mouth, then abdominal hardness and distension. From summer to autumn, distension worsened. Now umbilicus protrudes, red veins visible. Poor appetite, black stool, short red urine. Tongue is gray-yellow; pulse is wiry and rapid. This is a severe case of Blood Drum (Blood Distension). Qi is the pioneer of Blood; Blood is the foundation of Qi. Qi stagnation leads to Blood coagulation; Qi movement allows Blood flow. First prescribed to move Qi and remove stasis, clear heat and resolve dampness. However, the root of the disease is deep; success cannot be achieved overnight.
Chaihu from Yinzhou (Chaihu) (1 qian), Raw Cyperus Rhizome (Xiangfu) (2 qian), Poria Cocos with Skin (Lianpi Ling) (4 qian), Salvia Miltiorrhiza Root (Danshen) (2 qian), Moutan Cortex (Danpi) (1.5 qian), Red Peony Root (Chishao) (2 qian), Safflower (Honghua) (0.8 fen), Angelica Sinensis Tail (Dangguiwei) (3 qian), Red Reed Knotgrass (Tongcao) (0.8 fen), Black Gardenia Fruit (Zhizi) (1.5 qian), Leaves of Lyonia Ovalifolia (Zelan) (1.5 qian), Qing Ning Wan (wrapped, 3 qian).