论曰三焦有水气者。气滞不通,决渎之官内壅也。盖水聚于胃,气能传化。今气不升降,
水聚不行,则脾经受湿。故为腹满浮肿之证,治宜导气而行之,气通则水自决矣。
治三焦积气,渐成水病。腹胀四肢浮肿。宽胸膈,利小肠。槟榔汤方
槟榔(生锉) 大腹皮(锉) 白术 五味子(炒) 枳壳(去瓤麸炒) 黄 (锉) 防
己木
通(锉) 桑根白皮 陈橘皮(汤浸去白焙) 浓朴(去粗皮生姜汁炙) 桂(去粗皮各一
两) 木
上一十五味,粗捣筛,每服三钱匕,水一盏,生姜三片,枣二枚劈破,同煎至七分,去
滓温服。早晨临卧服。
治三焦不调。上乘于肺,时发喘咳,身体浮肿,坐卧不安。泽漆汤方
泽漆 防己 甜葶苈(纸上炒) 郁李仁(汤浸去皮炒各半两) 百合 陈橘皮(汤浸
去白
上九味,粗捣筛,每服三钱匕,水一盏,枣二枚劈破,同煎至七分,去滓温服,不拘时
治三焦有水气,满闷不能食,消痰气令能食。茯苓饮方
赤茯苓(去黑皮) 人参 白术 生姜(切各三两) 枳实(去瓤麸炒二两) 陈橘皮
(汤浸
上六味,锉如麻豆,每服五钱匕,水一盏半,煎至一盏。去滓温服,不拘时。
治三焦有水气,胸胁支满、目眩。茯苓汤方
赤茯苓(去黑皮四两) 桂(去粗皮) 白术 甘草(炙各三两)
上四味。粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓温服,不拘时。
治三焦不顺,心下痞满,膈间有水,目眩悸动。小半夏加茯苓汤方
半夏(汤洗去滑焙五两) 生姜(半斤) 赤茯苓(去黑皮三两)
上三味,锉如麻豆,每服五钱匕,水二盏,煎至一盏,去滓温服,不拘时。
治三焦气不通。心腹胀、喘促。大小便不利,甘遂散方
甘遂(生半两) 牵牛子(半生半炒) 续随子(去壳研) 大戟(各一两) 葶苈(纸
上炒一
分)
上五味。捣罗为散,每服半钱匕,空心浓煎灯心汤调下,利下水为效。未减更一服。
治三焦水气,甚者四肢虚肿。甘遂散方
甘遂(半两) 槟榔(生锉) 木香 牵牛子(半生半炒) 莱菔子(研各一两)
上五味,捣罗为散,每服半钱匕,煎紫苏木瓜汤调下,空心服,利下水为度,量人虚实
加减。
Discussion: When there is water qi in the Sanjiao (Triple Burner), it is due to the stagnation and obstruction of Qi, causing internal congestion in the Sanjiao, which serves as the official responsible for the drainage of water passages. Normally, water gathers in the Stomach, and Qi facilitates its transformation and distribution. However, when the ascending and descending movements of Qi are dysfunctional, water accumulates and fails to move, leading to dampness invading the Spleen Meridian. Consequently, symptoms such as abdominal fullness and edema appear. The treatment should focus on guiding and moving the Qi; once Qi flows freely, water will naturally drain.
For treating accumulated Qi in the Sanjiao that gradually evolves into a water disease, characterized by abdominal distension and edema of the four limbs, with the effect of widening the chest and diaphragm and promoting urination through the Small Intestine: Binglang Tang (Areca Nut Decoction).
Ingredients: Areca Seed (Binglang, raw and crushed), Betel Nut Peel (Dafupi, crushed), Atractylodes Macrocephala Rhizome (Baizhu), Schisandra Berry (Wuweizi, stir-fried), Bitter Orange (Zhiqiao, pith removed and stir-fried with bran), Astragalus Root (Huangqi, crushed), Stephania Tetrandra Root (Fangji), Akebia Stem (Mutong, crushed), Mulberry Root Bark (Sangbaipipi), Tangerine Peel (Chenjuapi, soaked in hot water, white pith removed, and dried), Magnolia Bark (Noupi, outer bark removed and stir-fried with ginger juice).
Preparation: The above fifteen ingredients are coarsely pounded and sieved. Each dose consists of 3 qianbi (approx. 9g), boiled with one sheng (approx. 200ml) of water, three slices of fresh Ginger (Shengjiang), and two Jujubes (Zao) split open. Simmer until reduced to 70%, strain, and take warm. Take in the morning and before bedtime.
For treating dysfunction of the Sanjiao, where pathogenic factors ascend to the Lung, causing intermittent wheezing and coughing, bodily edema, and restlessness in sitting or lying down: Zeqi Tang (Euphorbia Lathyris Decoction).
Ingredients: Euphorbia Lathyris Stem (Zeqi), Stephania Tetrandra Root (Fangji), Lepidium Seed (Tinglizi, stir-fried on paper), Apricot Kernel (Yuliren, soaked in hot water, skin removed, and stir-fried, each half liang), Lily Bulb (Baihe), Tangerine Peel (Chenjuapi, soaked in hot water, white pith removed).
Preparation: The above nine ingredients are coarsely pounded and sieved. Each dose consists of 3 qianbi, boiled with one sheng of water and two split Jujubes. Simmer until reduced to 70%, strain, and take warm. Take at any time.
For treating water qi in the Sanjiao, causing chest and epigastric fullness and anorexia, with the effect of resolving phlegm and restoring appetite: Fuling Yin (Poria Decoction).
Ingredients: Red Poria (Chifuling, black skin removed), Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Fresh Ginger (Shengjiang, sliced, each 3 liang), Immature Bitter Orange (Zhishi, pith removed and stir-fried with bran, 2 liang), Tangerine Peel (Chenjuapi, soaked in hot water...).
Preparation: The above six ingredients are cut like hemp seeds. Each dose consists of 5 qianbi, boiled with one and a half sheng of water until reduced to one sheng. Strain and take warm. Take at any time.
For treating water qi in the Sanjiao, causing distending fullness in the chest and hypochondrium, and dizziness: Fuling Tang (Poria Decoction).
Ingredients: Red Poria (Chifuling, black skin removed, 4 liang), Cinnamon Twig (Guizhi, outer bark removed), Atractylodes Macrocephala Rhizome (Baizhu), Licorice Root (Gancao, honey-stir-fried, each 3 liang).
Preparation: The above four ingredients are coarsely pounded and sieved. Each dose consists of 5 qianbi, boiled with one and a half sheng of water until reduced to one sheng. Strain and take warm. Take at any time.
For treating irregular flow of Qi in the Sanjiao, causing epigastric stuffiness and fullness, fluid retention between the diaphragm, dizziness, and palpitations: Xiao Banxia Jia Fuling Tang (Minor Pinellia Decoction plus Poria).
Ingredients: Pinellia Tuber (Banxia, washed in hot water to remove slipperiness and dried, 5 liang), Fresh Ginger (Shengjiang, half jin), Red Poria (Chifuling, black skin removed, 3 liang).
Preparation: The above three ingredients are cut like hemp seeds. Each dose consists of 5 qianbi, boiled with two sheng of water until reduced to one sheng. Strain and take warm. Take at any time.
For treating obstruction of Qi in the Sanjiao, characterized by epigastric and abdominal distension, panting, and difficulty in defecation and urination: Gansui San (Kansui Powder).
Ingredients: Kansui Root (Gansui, raw, half liang), Morning Glory Seed (Qianniuzi, half raw and half stir-fried), Spurge Seed (Xuisuizi, shell removed and ground), Great Euphorbia Root (Daji, each 1 liang), Lepidium Seed (Tinglizi, stir-fried on paper, 1 fen).
Preparation: The above five ingredients are pounded and sifted into a powder. Each dose consists of half a qianbi, taken on an empty stomach mixed with thickly decocted Juncus Decoction (Dengxin Tang). The goal is to promote the discharge of water. If symptoms do not subside, administer another dose.
For treating severe water qi in the Sanjiao, resulting in flaccid edema of the four limbs: Gansui San (Kansui Powder).
Ingredients: Kansui Root (Gansui, half liang), Areca Seed (Binglang, raw and crushed), Costus Root (Muxiang), Morning Glory Seed (Qianniuzi, half raw and half stir-fried), Radish Seed (Laifuzi, ground, each 1 liang).
Preparation: The above five ingredients are pounded and sifted into a powder. Each dose consists of half a qianbi, taken on an empty stomach mixed with Perilla and Papaya Decoction. The goal is to promote the discharge of water. Dosage should be adjusted according to the patient's deficiency or excess condition.