论曰∶《内经》言∶水病下为 肿大腹。又曰∶上下溢于皮肤，故为 肿。其证腹大，
四肢小，阴下湿，手足逆冷，腰痛、上气、咳嗽、烦疼是也。盖三焦闭塞，水道不通，流溢
皮肤，营卫痞涩，内连腹膜，则至阴内动，胀急如鼓。得病之本，多因大病之后，或积虚劳
损，或新热食毕，入水自渍，及浴冷水，故令水气不散，理宜然也。
治大腹水肿，口苦干燥，此肠间有水。防己丸方。
防己 椒目 葶苈（炒令紫色） 大黄（锉，醋拌，炒干各一两）
上四味，捣罗为末，炼蜜为丸如小豆大。每服十丸，米饮下，日三服，稍稍增之。口中
有津，则止勿服。渴者，加芒硝半两。
治大腹水肿，气息不通，证候危笃者。牛黄丸方。
牛黄（研半两） 昆布（洗去咸，炙） 海藻（洗去咸，炙干各一两一分） 牵牛子（炒）
桂
（去粗皮各一两） 椒目 葶苈（炒令紫色各三分）
上七味，捣罗为末，炼蜜为丸如小豆大。每服十五丸，米饮下，日再服，稍加之，以小
便利为度。贞观十九年，汉阳王患水疾，医所不疗，服此药五六日瘥。
治水气大腹肿。麝香丸方。
麝香（一钱研） 甘遂（炒） 芫花（醋炒各半两） 人参（一两）
上四味，捣罗为末，炼蜜为丸如小豆大。每服二十丸，米饮下。
治大腹水肿。利小便。水银丸方。
水银（水煮一日一夜，研一两） 葶苈（炒令紫色） 椒目（各一升）
上三味，捣罗为末，炼蜜为丸如小豆大。每服十丸，米饮下，日再服。
治水气，腹大肿。甘草丸方。
甘草（炙，锉） 防己 葶苈（炒令紫色各一两）
上三味，捣罗为末，用酒熬为丸，如小豆大，每服二十丸至三十丸，米饮下。
治大腹水肿。利小便。苏合香丸方。
苏合香 水银（水煮一复时后入） 白蔹（为末各一两）
上三味，合研令匀，炼蜜为丸如小豆大。每服十丸，米饮下，日三。
治大腹水肿。利小便。葶苈散方。
葶苈（炒令紫色一两） 杏仁（二十枚汤浸去双仁、皮尖，麸炒）
上二味，捣令极烂，分为十服。每服用米饮调下，日二服。
治大腹水肿。利小便。蓖麻饮方。
蓖麻子（二十枚成熟者，去皮）
上一味，细研，以水半盏调匀，一服令尽，至日中当吐下水汁；若水不尽，三日后更服
三十枚；犹未尽者，更作。瘥后节饮及减食，食糜粥以养之。
治大腹水肿。利小便。葶苈酒方。
葶苈（一升）
上一味，用酒五升，浸三宿。每服半盏，日二服，小便利为度。
治久患大腹病，其状四肢细，腹大，有小劳苦则足胫肿满，食则气急，此病服下利药极
不瘥，宜用此酒，以散除风湿，利小水。丹参酒方。
丹参 鬼箭羽（各一两半） 秦艽（去苗土） 知母（冬月不用各一两） 猪苓（去黑
皮三
分） 白术（一两半） 海藻（洗去咸，炙三分） 赤茯苓（去黑皮一两） 桂（去粗皮） 独
活（去
芦头各三分）
上一十味，以酒九升，浸五日，急须者，置热灰上一日便可就。每服一盏，饮酒少者，
随意减之，日三服。
Commentary states: The *Neijing* (Inner Canon) mentions that water diseases manifest below as swelling of the lower legs and abdominal distension. It also states that when water overflows up and down into the skin, edema results. The symptoms include abdominal distension, smallness of the four limbs, dampness in the genital region, cold hands and feet, lumbar pain, upward rushing of qi, coughing, and painful irritability. This is due to the blockage of the Sanjiao (Triple Burner), leading to the obstruction of water passages; water flows and overflows into the skin, causing stagnation and涩滞 (stasis/stagnation) of Ying (Nutrient Qi) and Wei (Defensive Qi). Internally connecting to the peritoneum, it causes movement of Zhiyin (Supreme Yin), resulting in abdominal distension and urgency like a drum. The root cause of the disease often stems from after a major illness, or from chronic deficiency and consumptive damage, or from entering water for immersion immediately after eating hot food, or bathing in cold water, thereby preventing the dispersion of water qi, which is naturally the case.
To treat abdominal distension with edema accompanied by bitter taste and dry mouth, indicating water accumulation in the intestines, use Fangji Wan (Poria Pill).
Fangji (Stephaniae Tetrandrae Radix), Jiaomu (Semen Populi), Tingli (Semen Lepidii et Descurainiae, stir-fried until purple), Dahuang (Rhei Radix et Rhizoma, cut into pieces, mixed with vinegar, stir-fried until dry, each 1 liang).
The above four ingredients are crushed, sieved into powder, and made into pills the size of small beans using refined honey. Take ten pills per dose, washed down with rice drink, three times daily, gradually increasing the dosage. Stop taking the medicine when saliva appears in the mouth. If thirsty, add Mangxiao (Natrii Sulfas) half a liang.
To treat severe cases of abdominal distension with edema where breath is obstructed and the condition is critical, use Niuhuang Wan (Calculus Bovis Pill).
Niuhuang (Calculus Bovis, ground, half a liang), Kunbu (Laminariae Thallus, washed to remove saltiness, roasted), Haizao (Sargassii Thallus, washed to remove saltiness, roasted until dry, each 1 liang 1 fen), Qianniuzi (Semen Pharbitidis, stir-fried), Guizhi (Cinnamomi Ramulus, bark removed, each 1 liang), Jiaomu (Semen Populi), Tingli (Semen Lepidii et Descurainiae, stir-fried until purple, each 3 fen).
The above seven ingredients are crushed, sieved into powder, and made into pills the size of small beans using refined honey. Take fifteen pills per dose, washed down with rice drink, twice daily, gradually increasing the dosage until urination becomes unobstructed. In the 19th year of Zhenguan, the Prince of Hanyang suffered from water disease which physicians could not cure; after taking this medicine for five or six days, he recovered.
To treat water qi causing abdominal distension and swelling, use Shexiang Wan (Moschus Pill).
Shexiang (Moschus, one qian, ground), Gansui (Radix Kansui, stir-fried), Yuanhua (Genkwa Flos, vinegar-stir-fried, each half a liang), Renshen (Ginseng Radix, one liang).
The above four ingredients are crushed, sieved into powder, and made into pills the size of small beans using refined honey. Take twenty pills per dose, washed down with rice drink.
To treat abdominal distension with edema and promote diuresis, use Shuiyin Wan (Hydrargyrum Pill).
Shuiyin (Hydrargyrum, boiled in water for one day and night, ground, one liang), Tingli (Semen Lepidii et Descurainiae, stir-fried until purple), Jiaomu (Semen Populi, each one sheng).
The above three ingredients are crushed, sieved into powder, and made into pills the size of small beans using refined honey. Take ten pills per dose, washed down with rice drink, twice daily.
To treat water qi and abdominal distension, use Gancao Wan (Glycyrrhizae Radix Pill).
Gancao (Glycyrrhizae Radix et Rhizoma, roasted, cut), Fangji (Stephaniae Tetrandrae Radix), Tingli (Semen Lepidii et Descurainiae, stir-fried until purple, each one liang).
The above three ingredients are crushed, sieved into powder, and made into pills the size of small beans using wine decoction. Take twenty to thirty pills per dose, washed down with rice drink.
To treat abdominal distension with edema and promote diuresis, use Suhexiang Wan (Styrax Pill).
Suhexiang (Liquidambaris Resina), Shuiyin (Hydrargyrum, added after boiling in water for one shichen), Bailian (Bombycis Batryticatus, powdered, each one liang).
The above three ingredients are mixed and ground evenly, then made into pills the size of small beans using refined honey. Take ten pills per dose, washed down with rice drink, three times daily.
To treat abdominal distension with edema and promote diuresis, use Tingli San (Semen Lepidii et Descurainiae Powder).
Tingli (Semen Lepidii et Descurainiae, stir-fried until purple, one liang), Xingren (Armeniacae Semen, twenty seeds, soaked in hot water, remove double kernels and skin tips, bran-roasted).
The above two ingredients are pounded until extremely fine, divided into ten doses. Each dose is taken mixed with rice drink, twice daily.
To treat abdominal distension with edema and promote diuresis, use Bimayin (Ricini Oleum Drink).
Bimazi (Ricini Semen, twenty mature seeds, peel removed).
The above single ingredient is finely ground, mixed evenly with half a zhan of water, and taken all at once. By noon, water should be vomited out. If the water is not fully expelled, take thirty seeds again after three days. If still not cured, prepare and take more. After recovery, regulate drinking and reduce food intake, nourishing the body with congee.
To treat abdominal distension with edema and promote diuresis, use Tinglijiu (Semen Lepidii et Descurainiae Wine).
Tingli (Semen Lepidii et Descurainiae, one sheng).
The above single ingredient is soaked in five sheng of wine for three nights. Take half a zhan per dose, twice daily, until urination becomes unobstructed.
To treat long-standing abdominal disease characterized by small limbs, large abdomen, swelling of calves upon slight exertion, and shortness of breath after eating, which does not respond well to purgatives, use this wine to dispel wind-dampness and promote diuresis. Danshen Jiu (Salvia Miltiorrhiza Wine).
Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Guijianyu (Ramulus Eucommiae Ulmoidis cum Callo), Qinjiao (Gentianae Macrophyllae Radix, remove seedlings and soil), Zhimu (Anemarrhenae Rhizoma, not used in winter, each one liang), Zhuling (Polyporus, remove black skin, three fen), Baizhu (Atractylodis Macrocephalae Rhizoma, one liang and half), Haizao (Sargassii Thallus, washed to remove saltiness, roasted, three fen), Chifuling (Poria cum Ligno Rubrum, remove black skin, one liang), Guizhi (Cinnamomi Ramulus, bark removed), Duhuo (Angelicae Pubescentis Radix, remove rhizome head, each three fen).
The above ten ingredients are soaked in nine sheng of wine for five days. For urgent need, place in hot ashes for one day to complete preparation. Take one zhan per dose; those who drink less alcohol may reduce the amount as appropriate. Take three times daily.