于越婢汤中加术四两
甘草二两 麻黄四两
右二味，以水五升，先煮麻黄，去上沫，内甘草，煮取三升，温服一升，重覆汗出，
不汗再服，慎风寒。
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厥而皮水者，蒲灰散主之。
【按】
「厥而」二字，当是衍文。
【注】
水在皮肤，浸淫日久，必然腐溃而出水也，当以蒲灰散敷之，以燥水也。
（见消渴中）
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水之为病，其脉沉小，属少阴。浮者为风，无水虚胀者为气水，发其汗即已。脉沉者
，宜麻黄附子汤，浮者，宜杏子汤。
【按】
为气水之「气」字，当是「风」字，若是「气」字，则无发汗之理，且通篇并无气水
之病。
【注】
水之为病，其脉沉小，属少阴水也，今脉不沉小而浮，浮者为风，非少阴水也。若无
水虚胀者，为风水也，风水发其汗即已。风水脉沉者，宜麻黄附子汤汗之，脉浮者，
宜杏子汤汗之。
麻黄三两 甘草二两 附子（炮）一枚
右三味，以水七升，先煮麻黄，去上沫，内诸药，煮取二升半，温服八合，日三服。
【集解】
沈明宗曰：麻黄附子汤，今人置之不讲，余特举而明之。麻黄、附子通阳开窍，治水
妙剂，今人惟用肾气汤、丸壅补其内，致阳气不宣，转补转壅，邪无出路，水肿日增
，欬血而死者，不知凡几矣。
Add four liang of Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) to the Yuebi Decoction.
Two liang of Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), four liang of Ephedrae Herba (Mahuang, 麻黄).
These two ingredients are decocted in five sheng of water. First, boil Mahuang, remove the foam on the surface, then add Gancao, and decoct until three sheng remain. Take one sheng warm. Cover with blankets to induce sweating. If sweat does not occur, administer again. Avoid wind and cold.
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For patients presenting with cold extremities (Jue, 厥) and Pi Shui (Pi Water, skin edema), Puhui San (Puhui Powder) is the primary treatment.
[Commentary]
The characters "Jue er" (cold extremities and) are likely interpolations (erroneous additions).
[Annotation]
When water-dampness remains in the skin for a long time, it inevitably causes rotting, ulceration, and oozing fluid. It should be treated by applying Puhui San externally to dry the dampness.
(See in the chapter on Xiao Ke / Wasting and Thirst)
@@@
In diseases of water-dampness, if the pulse is deep and small, it belongs to Shaoyin (Lesser Yin). If the pulse is floating, it is due to Wind. If there is no water but false distension occurs, it is Qi Water; inducing sweating will cure it. For those with a deep pulse, Mahuang Fuzi Tang (Ephedra and Prepared Aconite Decoction) is appropriate; for those with a floating pulse, Xingzi Tang (Apricot Seed Decoction) is appropriate.
[Commentary]
The character "Qi" (Air/Energy) in "Qi Water" should be "Feng" (Wind). If it were "Qi," there would be no rationale for inducing sweating, and furthermore, the entire text contains no mention of a disease called "Qi Water."
[Annotation]
In water-dampness diseases, a deep and small pulse indicates Shaoyin Water-Dampness. However, if the pulse is not deep and small but floating, the floating pulse indicates Wind, not Shaoyin Water-Dampness. If there is no water but false distension occurs, it is Feng Shui (Wind Water); inducing sweating will cure it. For Feng Shui with a deep pulse, Mahuang Fuzi Tang should be used to induce sweating; for a floating pulse, Xingzi Tang should be used to induce sweating.
Three liang of Ephedrae Herba (Mahuang, 麻黄), two liang of Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), one prepared root of Aconiti Lateralis Radix (Fuzi, 附子).
These three ingredients are decocted in seven sheng of water. First, boil Mahuang, remove the foam on the surface, then add the other herbs, and decoct until two and a half sheng remain. Take eight ge warm, three times a day.
[Collected Explanations]
Shen Mingzong said: Mahuang Fuzi Tang is currently neglected and not discussed by practitioners. I specifically bring it up to clarify its use. Mahuang and Fuzi unblock Yang and open orifices; they are excellent remedies for treating water-dampness. Currently, people only use Shenqi Tang (Kidney Qi Decoction) and pills to tonify internally, causing Yang Qi to become stagnant. The more they tonify, the more stagnation occurs, leaving the pathogenic factors without an exit. Edema increases daily, leading to death from coughing blood, a number too great to count.