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(One Treatise, Forty-One Prescriptions, One Moxibustion Method)

The treatise states: There are four types of Yin (fluid retention), what are they? The Master said: There is Tan Yin (Phlegm-Fluid), Xuan Yin (Hanging Fluid), Yi Yin (Overflowing Fluid), and Zhi Yin (Branch Fluid). It was asked: How do the manifestations of these four types of Yin differ? The Master said: When a person who was formerly plump becomes emaciated, and water flows between the intestines making a gurgling sound, it is called Tan Yin. When fluid remains in the hypochondrium after drinking, causing pain upon coughing and spitting, it is called Xuan Yin. When excessive water intake causes fluid to distribute to the four limbs, sweating should occur but does not, resulting in body ache and heaviness, it is called Yi Yin. When a person suffers from coughing and wheezing, relying on objects to breathe, shortness of breath preventing lying flat, and appearing swollen, it is called Zhi Yin.

Wherever there is water below the heart, there is palpitation (Zhu Zhu Ji), shortness of breath, and fear; the person may experience dizziness or fainting. If cold precedes, it indicates deficiency; if heat precedes, it indicates excess. Therefore, when water is in the Heart, the person feels hardness below the heart, palpitation, shortness of breath, aversion to water, and lack of desire to drink. When water is in the Lung, the person expectorates saliva and foam and desires to drink. When water is in the Spleen... [text missing].

If a patient suddenly drinks a large amount of water, sudden asthma and chest fullness will definitely occur. Generally, eating little and drinking much causes water to stagnate below the heart; severely, this leads to palpitations; mildly, it leads to shortness of breath. A double-strand pulse (Shuang Xian) indicates cold, usually occurring after severe purgation leading to deficiency. A single-strand pulse (Pian Xian) indicates fluid retention. Pulmonary fluid retention may not present with a strand pulse, but rather a preference for asthma and shortness of breath. Zhi Yin also involves asthma preventing sleep, plus shortness of breath, while the pulse may be normal. Retained fluid (Liu Yin) does not manifest violently, has no fever, presents with a subtle pulse, vexation, fullness, inability to eat, and a deep-slippery pulse characterizes Liu Yin disease. Patients with Liu Yin suffer from hypochondriac pain radiating to the Clavicular Fossa (Que Pen), worsening with coughing. The patient coughs unable to lie down, with pain radiating to the neck, and the cough resembles the jerking motion of a child. When retained fluid is in the Chest, the patient experiences shortness of breath and thirst, and pain in the four limbs at all joints. A deep pulse indicates the presence of retained fluid. When retained fluid is below the Heart, the back feels cold over an area the size of a hand, and the patient breathes with raised shoulders. These conditions involve Overflowing Fluid in the Chest. In chronic cases, there is fullness in the Clavicular Fossa, and occasional severe swelling known as "Ma Dao" (a type of scrofula), caused by Qi and Fluid accumulation. Diseases above the Diaphragm involve fullness, asthma, coughing, and expectoration; upon onset, there are alternating chills and fever, back pain, aversion to cold, spontaneous tearing, and violent trembling of the body, indicating Hidden Fluid (Fu Yin). If one arm is paralyzed, shifting occasionally to the other arm, with a deep-thin pulse, this is not Wind pathogen, but likely Fluid in the Upper Jiao. A deficient pulse indicates minor labor exhaustion due to uneven circulation of Ying (Nutritive) and Wei (Defensive) Qi, which heals naturally in winter (another version says heals naturally after a long time). For treating Tan Yin diseases, one should use warm herbs to harmonize the condition.