牵牛（四两，炒） 大黄（二两，酒浸） 甘遂（面裹煨） 大戟（面煨） 芫花（炒）
青皮（
炒） 陈皮（去白，各一两） 木香（五钱）
水肿证，病气、形气皆实者，此方主之。
通可以去塞，牵牛、大黄、甘遂、芫花、大戟，皆通剂之厉者也。辛可以行滞，陈皮、
青皮、木香，皆行滞之要药也。此方能下十二经之水，下咽之后，上下左右无所不至，故曰
舟车。
取苦瓠白穣实，捻如大豆，以面裹煮一沸，空腹吞七枚，至午当出水一升，如此三四日
，水自出不止，大瘦乃瘥。三年内慎口味。苦瓠须好，无厌翳细理者。不尔，有毒，不堪用。
大水，头面遍身肿胀者，此方主之。石水者，亦主之。
经曰∶苦能涌泄，故用之在上，则令人涌，用之在下，则令人泄。今以熟面裹之，空腹
而吞，盖用之于下也，宜乎水自泄矣。石水者，四肢皆瘦，惟有少腹坚硬如石，肿胀而便不
利也！
麦门冬（五十枚，去心，姜炒） 粮米（五十粒）
水出高源者，此方主之。
肺非无为也，主降下之令焉。凡人饮入于胃之时，脾气散精，上归于肺。肺热失其降下
之令，不能通调水道，下输膀胱，渍于高源，淫于皮肤，则作水肿。诸医罕明乎此，实土导
水，皆不能愈。故用麦门冬清肺，以开其降下之源。粮米益脾，而培乎金之母气。此治病必
求其本也。或问∶此证何以辨之？余曰∶肢体皆肿，少腹不急，初病便有喘满，此其候也。
Qian Niu Zi (Semen Koelreuteriae, four liang, stir-fried) Da Huang (Radix et Rhizoma Rhei, two liang, soaked in wine) Gan Sui (Radix Euphorbiae Kansui, wrapped in flour and baked) Da Ji (Radix Euphorbiae Lathyridis, baked in flour) Yuan Hua (Flos Genkwa, stir-fried)
Qing Pi (Pericarpium Citri Reticulatae Viride, stir-fried) Chen Pi (Pericarpium Citri Reticulatae, pith removed, one liang each) Mu Xiang (Radix Aucklandiae, five qian)
This formula is indicated for edema patterns where both the pathogenic qi and the constitutional qi are excess.
The "unblocking" method can remove obstructions; Qian Niu Zi, Da Huang, Gan Sui, Yuan Hua, and Da Ji are all potent agents of unblocking. The "acrid" flavor can circulate and disperse stagnation; Chen Pi, Qing Pi, and Mu Xiang are essential herbs for circulating qi and dispersing stagnation. This formula can purge water from the twelve meridians; after swallowing, its action reaches everywhere up, down, left, and right, hence the name "Zhou Che" (Boat and Chariot).
Take the white pith of Ku Hu (Fructus Lagenariae), shape it into pills the size of soybeans, wrap them in flour, boil once, and swallow seven pills on an empty stomach. By noon, one sheng (approx. 200ml) of fluid should be discharged. Repeating this for three to four days will cause continuous discharge of water until the body emaciates and the disease resolves. Dietary restrictions should be observed strictly for three years. The Ku Hu must be of good quality; avoid those with dark spots and fine textures. Otherwise, they may be toxic and unsuitable for use.
This formula is indicated for severe edema with swelling of the head, face, and entire body. It is also indicated for Shi Shui (Stone Water, a type of edema characterized by hardness of the lower abdomen).
The Classic states: "Bitter flavors induce vomiting and purging." When used superiorly, it induces vomiting; when used inferiorly, it induces purging. Now, wrapped in cooked flour and swallowed on an empty stomach, it is used inferiorly, so it is appropriate that water is purged from below. Shi Shui is characterized by emaciation of the four limbs, while only the lower abdomen is hard as stone, swollen, accompanied by difficult urination!
Mai Men Dong (Tuber Ophiopogonis, fifty pieces, heart removed, stir-fried with ginger juice) Liang Mi (Semen Oryzae Sativae Glutinosa, fifty grains)
This formula is indicated for edema originating from the high source (Lung).
The Lung is not inactive; it governs the descending directive. When fluids enter the Stomach, the Spleen scatters the essence and sends it upward to the Lung. If Lung heat causes the loss of its descending function, it cannot regulate the water passages and transport fluids downward to the Bladder. Instead, fluids stagnate at the high source, overflow into the skin, and result in edema. Few physicians understand this principle; methods that strengthen Earth to guide water often fail to cure. Therefore, Mai Men Dong is used to clear Lung heat and open the source of descent; Liang Mi benefits the Spleen to nourish the mother Qi of Metal (Lung). This embodies the principle of treating the root cause of disease. One might ask: How is this pattern differentiated? I say: Swelling of all limbs, non-tightness of the lower abdomen, and immediate onset of panting and chest fullness upon initial illness are its signs.