治胃经聚水，乃通用之剂，华佗《中藏经》之方也。累用累验。
大腹皮（黑豆汁洗） 茯苓皮 陈皮 桑白皮（各一钱五分） 生姜皮（八分
水煎服。
仲景云∶腰以上肿，宜发汗，加紫苏、秦艽、荆芥、防风。腰以下肿，宜利小便，加赤
小豆、赤茯苓、泽泻、车前子、萆 、防己。若大便不通，宜下之，加大黄、葶苈。腹中胀
满，加卜子、浓朴、陈皮、麦芽、山楂。体虚者，加白术、人参、茯苓。审是阴水，加附
子、干姜、肉桂；审是阳水，加连翘、黄柏、黄芩。挟痰者，加半夏、生姜。既消之后，宜
用理中汤健脾实胃，或以金匮丸温暖命门，或以六味加牛膝、车前，滋肾水，清余热，庶
附子理中汤 （见中寒）
治肾经聚水，小便不利，腹胀肢肿，或痰喘气急，渐成水蛊，其效
如神。然肾经聚水，亦有阴阳之分，不可不辨也。经云∶阴无阳，无以生；阳无阴，无以化
经又云∶膀胱者，州都之官，津液藏焉，气化则能出矣。假如肾经阳虚，阴无以生，真火
不能制水者，宜用此丸。假如肾经阴虚，阳无以化，真阴不能化气者，宜用本方去附、桂主
之。东垣云∶土在雨中化为泥，阴水之象也。河间云∶夏热之甚，庶土蒸溽，阳水之象也。
知斯意者，可以治水矣。
大熟地（八两） 山药（四两） 山萸肉 丹皮 泽泻 车前子 牛膝（各二两） 茯苓（六两） 肉桂
（一两） 附子（一两，虚寒甚者倍之）
用五加皮八两，煮水一大碗，滤去渣，和药，加炼蜜为丸，如梧桐子大，每早开水下四钱。
前症若属阴虚，本方去桂附，盖文蛤、牡蛎各二两；湿热甚者，加黄柏五钱，不用五加
皮，以萆 八两熬汁代之。
论血分水分
妇人经水先断，后发肿者，名曰血分，通经丸主之。先发水肿，然后经断者，名曰水分
五加皮饮送下通经丸主之。
To treat water accumulation in the Stomach Meridian, this is a general-purpose formula from Hua Tuo's *Zhong Zang Jing* (Classic of Internal Organs). It has been used repeatedly with consistent efficacy.
Da Fu Pi (Arecae Pericarpium, washed with black soybean juice) Fu Ling Pi (Poria Cocos, bark) Chen Pi (Citri Reticulatae Pericarpium) Sang Bai Pi (Mori Cortex) [each 1.5 qian] Sheng Jiang Pi (Zingiberis Rhizoma Recens, skin) [0.8 qian]
Decoct in water and take orally.
Zhang Zhongjing stated: For edema above the waist, sweating is appropriate; add Zi Su Ye (Perillae Folium), Qin Jiao (Gentianae Macrophyllae Radix), Jing Jie (Schizonepetae Spica), Fang Feng (Saposhnikoviae Radix). For edema below the waist, promoting urination is appropriate; add Chi Xiao Dou (Adzuki Bean), Chi Fu Ling (Poria Cocos with red interior), Ze Xie (Alismatis Rhizoma), Che Qian Zi (Plantaginis Semen), Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Fang Ji (Stephaniae Tetrandrae Radix). If there is constipation, purgation is appropriate; add Da Huang (Rhei Radix et Rhizoma), Ting Li Zi (Lepidii Semen). For abdominal distension and fullness, add Bo Le Zi (Radish Seed), Hou Po (Magnoliae Officinalis Cortex), Chen Pi (Citri Reticulatae Pericarpium), Mai Ya (Hordei Fructus Germinatus), Shan Zha (Crataegi Fructus). For those with weak constitution, add Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma). If confirmed as Yin Water, add Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex); if confirmed as Yang Water, add Lian Qiao (Forsythiae Fructus), Huang Bo (Phellodendri Cortex), Huang Qin (Scutellariae Radix). For cases complicated by phlegm, add Ban Xia (Pinelliae Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens). After the edema subsides, it is appropriate to use Lizhong Tang (Regulate the Middle Decoction) to strengthen the Spleen and solidify the Stomach, or use Jin Kui Shen Qi Wan (Golden Cabinet Kidney Qi Pill) to warm the Ming Men (Gate of Vitality), or use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) plus Niu Xi (Achyranthis Bidentatae Radix) and Che Qian Zi (Plantaginis Semen) to nourish Kidney Water and clear residual heat, thus ensuring safety. Fu Zi Lizhong Tang (see Cold Damage section)
To treat water accumulation in the Kidney Meridian, characterized by difficult urination, abdominal distension, limb edema, or phlegm-wheezing and rapid breathing, gradually developing into Shui Gu (Water Distension/Gu Syndrome), the effect is miraculous. However, water accumulation in the Kidney Meridian also has Yin and Yang distinctions, which must not be ignored. The Classics state: Without Yang, Yin cannot generate; without Yin, Yang cannot transform. The Classics further state: The Bladder is the official of the capital, storing body fluids; only through Qi transformation can they be excreted. If Kidney Yang deficiency leads to an inability of Yin to generate, and True Fire fails to control Water, this pill is appropriate. If Kidney Yin deficiency leads to an inability of Yang to transform, and True Yin fails to generate Qi, this formula minus Fu Zi (Aconiti Lateralis Radix Praeparata) and Rou Gui (Cinnamomi Cortex) is primarily indicated. Li Dongyuan stated: Soil turning to mud in rain represents the image of Yin Water. Liu Hejian stated: Extreme summer heat causing soil to steam and humidify represents the image of Yang Water. Understanding this principle allows one to treat water diseases.
Da Shu Di Huang (Prepared Rehmanniae Radix, 8 liang) Shan Yao (Dioscoreae Rhizoma, 4 liang) Shan Yu Rou (Corni Fructus) Dan Pi (Moutan Cortex) Ze Xie (Alismatis Rhizoma) Che Qian Zi (Plantaginis Semen) Niu Xi (Achyranthis Bidentatae Radix) [each 2 liang] Fu Ling (Poria Cocos, 6 liang) Rou Gui (Cinnamomi Cortex, 1 liang) Fu Zi (Aconiti Lateralis Radix Praeparata, 1 liang; double for severe deficiency-cold)
Use Wu Jia Pi (Acanthopanacis Cortex, 8 liang), decoct in a large bowl of water, filter out the dregs, mix with the herbs, add refined honey to form pills, size of Sophora japonica seeds. Take 4 qian orally with warm water every morning.
If the aforementioned symptoms belong to Yin deficiency, remove Rou Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Praeparata) from this formula, and add Wen Ge (Clam Shell) and Mu Li (Ostreae Concha) each 2 liang. For severe damp-heat, add Huang Bo (Phellodendri Cortex) 5 qian, do not use Wu Jia Pi (Acanthopanacis Cortex); instead, replace it with a decoction of Bi Xie (Dioscoreae Hypoglaucae Rhizoma, 8 liang).
Discussion on Blood Component and Water Component
In women, if menstruation stops first and edema develops subsequently, it is named Blood Component (Xue Fen), treated mainly with Tong Jing Wan (Unblock Menses Pill). If edema develops first and menstruation stops subsequently, it is named Water Component (Shui Fen), treated mainly with Tong Jing Wan (Unblock Menses Pill) delivered via Wu Jia Pi Yin (Acanthopanax Decoction).