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The *Ling Shu · Shui Zhang Pian* states: There are distinctions among five conditions: Shui Zhang (Water Swelling), Fu Zhang (Skin Swelling), Gu Zhang (Drum Distension), Chang Qin (Intestinal Polyp), and Shi Jia (Stone Fibroid). The *Jin Gui Yao Lue* and *Qian Jin Fang* discuss that there are ten types of water diseases with different names and varying etiologies. Generally, when water disease first arises, it invariably originates from the Heart and Kidney. The Heart and Kidney generate and nourish the Spleen and Lung; now, if Qi of the Heart and Kidney is deficient, they cannot nourish the Spleen and Lung, causing Earth (Spleen) to fail in controlling Water. Consequently, Water floods and acts recklessly, the San Jiao (Triple Burner) fails to excrete, Qi and vessels become blocked, the pivot mechanism is obstructed, leading to panting and urgency. Water Qi overflows, seeps into the collaterals, causing the skin to swell and fill up, with the eye sockets slightly swollen like a lying silkworm; this is its presentation. As for Fu Zhang and Gu Zhang, details regarding distension are discussed separately. Only Chang Qin and Shi Jia occur in women, originating from disorders of the Blood aspect, each having specific treatments, and thus difficult to conflate with Shui Zhang.

All edema diseases originate from the Zang-Fu organs. Books mention ten types of water: First is Qing Shui (Green Water), rooted in the Liver, starting with facial swelling and gradually spreading to the whole body; Second is Chi Shui (Red Water), rooted in the Heart, starting with chest swelling; Third is Huang Shui (Yellow Water), originating from the Spleen, starting with abdominal swelling; Fourth is Bai Shui (White Water), originating from the Lung, starting with foot swelling, accompanied by panting, coughing, and rebellious Qi; Fifth is Hei Shui (Black Water), originating from the Kidney, starting with limb swelling; Sixth is Xuan Shui (Dark Water), originating from the Gallbladder, starting from the head and face down to the shins; Seventh is Feng Shui (Wind Water), originating from the Stomach, starting from the limbs to the whole body, accompanied by abdominal distension; Eighth is Shi Shui (Stone Water), rooted in the Bladder, characterized by swelling starting below the umbilicus, with only the face and abdomen becoming large; Ninth is Li Shui (Interior Water), originating from the Small Intestine, starting from the lower abdomen and gradually swelling; Tenth is Qi Shui (Qi Water), originating from the Large Intestine, characterized by symptoms that come and go, wax and wane. This is its presentation; all result from obstruction above and below, failure of the gates and orifices, stagnation of Qi and Blood, and disharmony of Yin and Yang. The *Su Wen* states: Facial swelling is due to Wind, foot swelling is due to Water. However, one must distinguish between Yin Water and Yang Water and treat based on whether the patient is young and robust or old and weak. If edema is caused by Yin Water, the pulse is deep and hidden, the complexion is mostly blue-white, there is no irritability or thirst, urination is scanty but clear, and stool is loose; treatment should focus on strengthening the Spleen. If edema is caused by Yang Water, the pulse is deep and rapid, the complexion is mostly red-yellow, there may be irritability and thirst, urine is red and difficult to pass, and stool is often constipated; treatment should focus on regulating Qi and purging dampness. When diagnosing edema, one must first determine which part of the body is affected and seek the corresponding meridian to prescribe medication. If swelling is above the waist, treatment should induce sweating; if swelling is below the waist, diuresis should be employed. Generally, the treatment method strengthens the Spleen and Stomach Yuan Qi; when Earth is strong, it can transform and transport; when transformation and transportation function normally, Qi and Blood become abundant; when Qi and Blood are abundant, Yin and Yang harmonize; when harmonized, Water returns to its source.

If a young and robust person suffers from this, with a floating, large, and forceful pulse, one should guide out the pathogenic Water. If an elderly and weak person suffers from this, tonifying the Middle and resolving dampness should be prioritized; if there is sinking of Qi, it should be lifted. For the Spleen is the root of nourishing life, and the Kidney is the origin of generating Qi; their deficiency and excess must not be ignored. One must be cautious not to arbitrarily use drastic herbs such as Da Ji (Euphorbiae Pekinensis Radix), Yuan Hua (Genkwa Flos), Gan Sui (Kansui Radix), Ba Dou (Crotonis Fructus), and Qian Niu Zi (Pharbitidis Semen) to forcefully promote urination for temporary effect. Once Water is removed, the Spleen Earth becomes further damaged, leading to danger over time. If signs of Five Injuries appear, the condition is difficult to treat. Injury to the Liver manifests as black lips; injury to the Spleen manifests as protruding umbilicus; injury to the Lung manifests as a flat back; injury to the Heart manifests as a flat supraclavicular fossa; injury to the Kidney manifests as a flat sole. If this condition recurs once or twice, it is difficult to treat; students of medicine should take note.