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Shenfu Decoction: Treats deficiency of True Yang (Zhen Yang, the foundational Yang energy), manifesting as wheezing and急促 breathing (Shangchuan), spontaneous sweating (Zihan), night sweating (Daohan), shortness of breath (Qiduan), and dizziness. Ren Shen (Ginseng Radix et Rhizoma, half liang), Fu Zi (Prepared Aconiti Lateralis Radix, peeled and de-navelled after processing, one liang). Cut into pieces, divide into three doses, add fresh ginger (Sheng Jiang) and decoct.

(Three discourses combined; discussion of six prescriptions from *Jin Gui Yao Lue* [Essential Prescriptions of the Golden Cabinet], seven laws, plus an appendix on one method from Hai Zang.)

Yu Chang said: The pathogenic mechanisms most pertinent to the human body are Water and Fire. Water flows towards dampness; Fire moves towards dryness. Water is soft and weak; Fire is fierce and violent. If water overflows in the exterior and interior, and Fire wanders through the San Jiao (Triple Burner), is it not necessary to have methods to rescue from drowning and save from burning? The *Classic* (*Huang Di Nei Jing*) states: "Binding of the Two Yangs leads to Xiao [Wasting-Thirst]; binding of the Three Yin leads to Shui [Edema]." Heat binding in the Hand-Foot Yangming meridians causes Wasting-Thirst disease; the harm of Fire has already been discussed. As for the "Three Yin," these refer to the Hand-Foot Taiyin Spleen and Lung organs. The Stomach is the Sea of Water and Grain; all Water diseases fundamentally originate from the Stomach. Why does the *Classic* attribute this to the Spleen and Lung? It is because the Foot-Taiyin Spleen has the capacity to transport fluid essences upward. The Hand-Taiyin Lung has the capacity to regulate water passages downward, so that the Sea does not raise waves. Only when the Qi of the Spleen and Lung becomes bound and fails to circulate does the water in the Stomach accumulate day by day, flooding the exterior and interior, reaching everywhere. Thus, how can the authority of the Spleen and Lung fail to be extended? However, its authority is particularly heavy in the Kidney. The Kidney is the gatekeeper of the Stomach. The Kidney governs opening and closing. When Kidney Qi follows Yang, it opens; if Yang is too excessive, the gate opens wide, water flows straight down, resulting in Wasting-Thirst. When Kidney Qi follows Yin, it closes; if Yin is too excessive, the gate remains closed constantly, water cannot pass, resulting in Edema. The *Classic* also states that the Kidney is the root and the Lung is the branch, transmitting together and both receiving the disease. Therefore, regarding Water diseases, the Spleen, Lung, and Kidney form the three main principles. The details within these are especially difficult to distinguish clearly. *Jin Gui Yao Lue* distinguishes the names of the Five Waters and discusses the diseases governed by the interior-exterior relationships of the Five Zang organs thoroughly. Later generations, carelessly failing to examine this, often resort to coercive methods in treating Water diseases, unable to handle matters with ease. Can this be called wisdom? The Five Waters are: Feng Shui (Wind Edema), Pi Shui (Skin Edema), Zheng Shui (Regular Edema), Shi Shui (Stone Edema), and Huang Han (Yellow Sweat).

Feng Shui has a floating pulse. Its external symptoms include joint pain and aversion to wind. It is entirely consistent with the primary syndrome of Wind-Cold/Wind-Strike injury, so treating from the Exterior is appropriate. Pi Shui also has a floating pulse. Its external symptoms include edema of the dorsum of the foot that leaves an indentation upon pressure, no aversion to wind, abdomen like a drum, no thirst. One should induce sweating. Although the syndromes differ, the treatment is the same. What is the rationale? Because the skin and hair are the exterior correspondence of the Lung. The Lung circulates Ying (Nutritive) and Wei (Defensive) Qi. When water stagnates between the skin layers, Ying and Wei Qi become depressed and fail to circulate, causing the abdomen to resemble a drum. Inducing sweat disperses pathogens in the skin and hair; once exterior Qi flows freely, internal depression resolves naturally.

Zheng Shui has a deep and slow pulse. Its external symptom is spontaneous wheezing. This is a self-disease of the Northern Ren-Gui (Water) organ. Yang fails to ascend, the gate closes, and water accumulates daily. Overflowing up and down onto the skin, it causes edema of the dorsum of the foot and abdominal distension. Upward, it manifests as wheezing and inability to lie flat. This is the case where the Kidney is the root and the Lung is the branch, with both mother and child organs diseased.

Shi Shui has a deep pulse. Its external symptom is abdominal fullness without wheezing. The governing organ is the Kidney, which connects to the Liver rather than the Lung. The Classic states that simultaneous deep pulses of the Liver and Kidney indicate Shi Shui. This is because water accumulates in the Bao (Uterus/Lower Abdomen), becoming hard and full like stone, not extending upward to the large abdomen. It lies precisely in the region governed by the Jueyin Liver meridian, belonging to the category of Shaofu hernia masses. Those who do not understand often, while treating other diseases, inadvertently disturb their Qi, leading upward to vomiting and retching, which usually indicates death. *Chao Shi Bing Yuan* [Source Book of Diseases] states that Shi Shui draws pain and distension in the lower flanks, or if it extends upward to the epigastrium, it results in death. Although this is less severe than mis-treatment, it is generally a syndrome of excess Liver and deficient Kidney.

Huang Han (Yellow Sweat) presents with sweat resembling arbor juice (dark yellow/brown), a deep and slow pulse, fever in the body, chest fullness, and edema of the limbs, head, and face. If prolonged and unresolved, it inevitably leads to carbuncles and pus. This is a Yin pulse with Yang syndrome, where the Kidney is the root and the Stomach is the branch. The disease occurs along the pathways of the Stomach meridians; later generations call this Dan Shui [Hot Water]. When water-drink enters the Stomach but fails to move, it depresses and transforms into Heat. Heat causes Ying and Wei Qi to become hot. Wherever Heat passes, the terminal disasters are countless, all stemming from the endless infiltration of Dan Shui.

However, when water resides in the Heart's domain, it depresses the bright transformation of Heart Fire. When water resides in the Liver's domain, it depresses the generating transformation of Liver Wood. When water resides in the Lung's domain, solitary Yang exhausts itself externally, leaving only the Po (Corporeal Soul) alone. When water resides in the Spleen's domain, Yin exhausts itself internally, and grain essence fails to distribute. When water resides in the Kidney's domain, not only do all Yang energies retreat and hide, but even the Yin that follows Yang retreats and hides. Solitary Yin dwells alone below, causing isolation.

Therefore, regarding water in the Stomach, one fears Fire; if Fire exists, it still belongs to Wasting-Thirst, which transmits to Zhong Man [Fullness in the Middle] and becomes incurable. Regarding water in the Kidney, one fears the absence of Fire; without Fire, True Yang extinguishes, and vital Qi is cut off internally. Regarding water in the Heart, it suppresses Jun Fire [Monarch Fire]. If the Earth of the Spleen is strong and transporting, the Child will rescue the Mother. Even for water in the Liver, Lung, or Kidney, once the Spleen Earth prospers, water is controlled and dares not rampage. Only during times of overwhelming floods ("mountains embracing rivers") is it sufficient to seek Earth that does not collapse. To make Earth suitable for sowing and reaping, is it not difficult? For the harmony of Water and Earth, one takes Yu the Great as the model. In the medical door, to harmonize Water and Earth, who else but Zhang Zhongjing should one follow?