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9. Swelling predominantly in the upper body is often due to Wind, and sweating (Han) is appropriate; swelling predominantly in the lower body is often due to Dampness, and promoting urination (Li Shui) is appropriate. For sweating, Yuebi Jia Cangzhu Tang (Yuebi Decoction with Atractylodis Rhizoma) should be used; for promoting urination, external application methods such as Hupo Dan (Amber Pill) applied to the umbilicus can be utilized. To simultaneously disperse Wind externally and promote urination internally, Shuozao Yinzi (Shuozao Decoction) is indicated; if wheezing and inability to lie flat occur, Suzi Tingli Wan (Perilla Seed and Lepidium Seed Pill) should be used first. For Yang Edema belonging to Heat-Excess patterns, Da Sheng Xunchuan San (Great Sage River-Dredging Powder) is suitable for excessive Heat, and Zhouche Shenyou Wan (Boat and Divine Protection Pill) is suitable for excessive Dampness. For Yin Edema belonging to Cold-Deficiency patterns, Shipin Yin (Spleen-Strengthening Decoction) is suitable for Spleen Deficiency with poor appetite and loose stools, and Shenqi Wan (Kidney Qi Pill) is suitable for Kidney Deficiency with cold and hard calves and feet.

[Note] Swelling in the upper body is mostly caused by exogenous Wind pathogen, hence sweating is appropriate. Swelling in the lower body is mostly caused by endogenous Dampness pathogen, hence promoting urination is appropriate. To disperse Wind-Water externally, Yuebi Tang (Yuebi Decoction) added with Cangzhu (Atractylodis Rhizoma), i.e., Mahuang (Ephedrae Herba), Shigao (Gypsum Fibrosum), Gancao (Glycyrrhizae Radix et Rhizoma), and Cangzhu, is used. To promote urination of Water-Dampness internally, methods such as umbilical application are used. One method involves using Baidu (Crotonis Fructus) de-oiled, four qian; Yushuifen (Calomelas), two qian; and Liuhuang (Sulfur), one qian, ground evenly into a cake. First, place a piece of new cotton on the umbilicus, put the cake on it, and bind tightly with cloth. After a short while, foul water will naturally be discharged. After three to five discharges, remove the medicine and nourish the stomach with porridge. If the body becomes emaciated over time, apply once every other day; one cake can save three to five people. Another method uses fresh Chishanglu Gen (Phytolaccae Radix), pounded until soft, applied to the umbilicus and bound with cloth, allowing water to exit via urine. Another method uses four river snails, five cloves of garlic, and three qian of Cheqianzi Mo (Plantaginis Semen powder), ground into a cake, applied to the center of the umbilicus and bound with a handkerchief; urination will become smooth shortly thereafter, leading to recovery. Alternatively, Chenxiang Hupo Wan (Agarwood and Amber Pill) can be taken orally, which consists of Ku Tingli Zi (Lepidii Fructus), Zhen Yuliren (Pruni Semen), Fangji (Stephaniae Tetrandrae Radix), Chenxiang (Aquilariae Lignum Resinatum), Chenpi (Citri Reticulatae Pericarpium), Hupo (Electri Corium), Xingren (Armeniacae Semen Amarum), Suzi (Perillae Fructus), Chi Fuling (Poria cum Risus), Zexie (Alismatis Rhizoma), and Shexiang (Moschus). If the whole body is swollen, both external dispersion and internal promotion of urination are required, so Shuozao Yinzi (Shuozao Decoction) should be used to resolve both aspects. If Water pathogen surges upward causing severe wheezing and inability to lie flat, Suzi Tingli Wan (Perilla Seed and Lepidium Seed Pill) should be used to calm wheezing, consisting of these two herbs ground equally into powder and formed into pills with jujube flesh. For Yang Edema of Heat-Excess type, Da Sheng Xunchuan San (Great Sage River-Dredging Powder) is used for excessive Heat; Zhouche Shenyou Wan (Boat and Divine Protection Pill) is used for excessive Dampness. These two formulas are recorded in *Yizong Bidu* (Essentials of Medical Learning). For Yin Edema of Cold-Deficiency type, Shipin Yin (Spleen-Strengthening Decoction) is used for Spleen Deficiency with anorexia and soft stools; Shenqi Wan (Kidney Qi Pill) is used for Kidney Deficiency with cold and indurated lower limbs.

Shuozao Yinzi and Fuling Daoshui Tang

10. For the dual treatment of edema (dispersing externally and draining internally), Shuozao Yinzi (Shuozao Decoction) and Fuling Daoshui Tang (Poria Decoction from the *Taiping Huimin Heji Jufang*) are used. Shuozao Yinzi consists of Jiaomu (Semen Sesami Nigrum), Chixiaodou (Vigna Semen Rubrum), Binglang (Arecae Semen), Shanglu (Phytolaccae Radix), Mutong (Akebiae Caulis), Qianghuo (Notopterygii Rhizoma et Radix), Qinjiao (Gentianae Macrophyllae Radix), Dafupi (Bambusae Culm Cortex), Fulingpi (Poria Cum Cortice), and Zexie (Alismatis Rhizoma). Fuling Daoshui Tang consists of Zexie (Alismatis Rhizoma), Fuling (Poria), Sangpi (Mori Cortex), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Sharen (Amomi Fructus Rotundus), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Suye (Perillae Folium), Dafupi (Bambusae Culm Cortex), Maidong (Ophiopogonis Radix), and Binglang (Arecae Semen).

[Note] For edema treated with simultaneous external dispersion and internal drainage: for severe cases, Shuozao Yinzi (Shuozao Decoction) is used, comprising Jiaomu (Semen Sesami Nigrum), Chixiaodou (Vigna Semen Rubrum), Binglang (Arecae Semen), Shanglu (Phytolaccae Radix), Mutong (Akebiae Caulis), Qianghuo (Notopterygii Rhizoma et Radix), Qinjiao (Gentianae Macrophyllae Radix), Dafupi (Bambusae Culm Cortex), Fulingpi (Poria Cum Cortice), and Zexie (Alismatis Rhizoma). For milder cases requiring simultaneous external dispersion and internal drainage, Fuling Daoshui Tang (Poria Decoction) is used, comprising Zexie (Alismatis Rhizoma), Fuling (Poria), Sangpi (Mori Cortex), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Sharen (Amomi Fructus Rotundus), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Suye (Perillae Folium), Dafupi (Bambusae Culm Cortex), Maidong (Ophiopogonis Radix), and Binglang (Arecae Semen).