总括
小儿水肿，俱属水停于脾肺二经。如水停肺中则喘，水停脾中则胀，其间所肿部位，要分明也。若腰以上肿者，属
风，宜汗散之；腰以下肿者，属湿，利水之法最灵；有通身上下俱肿者，治宜利汗并施。肿而喘不得卧，则逐肺饮，肿
而胀满便闭，则宜攻脾。水肿从腹起至四肢者可治，从四肢起至腹者不可治。当再辨有阳水与阴水之分。阳水属实，法
宜攻泻，阴水属虚，法宜温补，临证之时，贵变通焉。
风水肿
凡肿在腰以上，如头面肩臂至腰肿者，病因外感风邪而起，急宜发汗，莫从容也。经云∶开鬼门之法，以越婢汤中
加苍术汗之。汗后全消，病即宁矣。
湿水肿
肿在腰脐之下两足者，病因脾经湿热而起，急宜利水可安然也。经云∶洁净府是也。先用外法，以药贴脐，如神之
妙，内服沉香琥珀丸。
风湿肿
通身头面手足皆肿者，得病之由，乃属外感风邪，内停湿饮，风湿相搏，水道不利，外攻肌表，因而作肿也。治法
用外散内利，则最相宜。重者用峻攻之，则用疏凿饮；轻者和解之剂，用茯苓导水汤医之。若水停上攻于肺，喘急不得
卧，用苏葶丸以定其喘，亦最相宜。水停中州，胀满喘急者，用舟车神 丸最攻之也。
阳水
阳水者，乃湿热内郁，水道阻塞，外攻肌表，以致外肿内胀，身热口渴，六脉沉数，小便赤涩，大便多难也。法当
泄水，如热盛心烦口渴者，用大圣 川散攻之；湿盛胀满者，用舟车神 丸攻之。
阴水
阴水者，乃脾肾虚弱，脾虚不能制水，肾虚不能生水，以致外泛作肿，内停作胀。若二便利，心不烦，身不热者，
须服实脾散、金匮肾气丸。若服温补药而无效验，则是虚中有实，欲投攻下，恐小儿难堪；若不攻之；则坐以待毙。虽
攻补兼施，或一补一攻，或三补一攻，或九补一攻，审其进退，俟有可攻之机，以意消息，始能逐邪而不伤正病可痊也，
必忌盐酱百日。
General Overview
Pediatric edema all belongs to water retention in the Spleen and Lung meridians. If water retains in the Lung, wheezing occurs; if water retains in the Spleen, distension occurs. The sites of swelling must be clearly distinguished. Swelling above the waist is attributed to Wind, and dispersing through sweating (sweating method) is appropriate; swelling below the waist is attributed to Dampness, and the method of promoting urination is most effective; for swelling throughout the entire body, treatment should combine sweating and promoting urination. If swelling is accompanied by wheezing and inability to lie flat, one should drive out fluid retention in the Lung; if swelling is accompanied by abdominal fullness and constipation, purging the Spleen is appropriate. Edema starting from the abdomen and spreading to the limbs is treatable, whereas edema starting from the limbs and spreading to the abdomen is untreatable. One must further distinguish between Yang Edema and Yin Edema. Yang Edema is excess syndrome, treated with purgation; Yin Edema is deficiency syndrome, treated with warming and tonification. In clinical practice, flexibility is crucial.
Wind-Induced Edema
Swelling located above the waist, such as on the head, face, shoulders, arms down to the waist, arises from external contraction of Wind pathogenic factors. Immediate sweating is required; do not delay. The classics state: Use the "opening the ghost gate" (sweating) method, adding Cang Zhu (Atractylodis Rhizoma) to Yuebi Tang (Yuebi Decoction) to induce sweating. After sweating, if the swelling completely subsides, the disease will resolve.
Damp-Induced Edema
Swelling located below the waist, navel, and in both feet arises from Damp-Heat in the Spleen meridian. Immediate promotion of urination leads to recovery. The classics state: This is the method of "cleansing the bladder" (promoting urination). First, use external therapy by applying medicine to the umbilicus, which is miraculous; internally administer Chenxiang Hupo Wan (Agarwood and Amber Pill).
Wind-Damp Edema
Swelling of the whole body, including head, face, hands, and feet, results from external contraction of Wind pathogenic factors and internal retention of Damp-fluid. Wind and Dampness contend with each other, causing dysfunction of the water passages, attacking the muscle surface externally, thereby causing swelling. The treatment method of dispersing externally and draining internally is most suitable. For severe cases, use strong purgation with Shuozao Yin (Shuozao Decoction); for mild cases, use a harmonizing formula, Fuling Dao Shui Tang (Poria Water-Guiding Decoction). If fluid retention attacks the Lung from above, causing urgent wheezing and inability to lie flat, Su Ting Wan (Perilla and Lepidum Pill) is most suitable to calm wheezing. If fluid retention stays in the Middle Jiao, causing fullness and urgent wheezing, Zhouche Shen Wan (Boat-Chariot Divine Pill) is best for purging.
Yang Edema
Yang Edema is caused by internal stagnation of Damp-Heat, blocking the water passages, attacking the muscle surface externally, resulting in external swelling and internal fullness, fever, thirst, deep and rapid pulse in all six positions, red and scanty urine, and difficult defecation. The treatment method should be to drain water. If heat is excessive with irritability and thirst, Dasheng Ze Chuan San (Great Sage Ze Chuan Powder) should be used for purging; if dampness is excessive with fullness, Zhouche Shen Wan (Boat-Chariot Divine Pill) should be used for purging.
Yin Edema
Yin Edema is caused by weakness of the Spleen and Kidney. Spleen deficiency fails to control water, and Kidney deficiency fails to transform water, leading to external flooding causing swelling and internal retention causing fullness. If bowel movements and urination are normal, without irritability or fever, Shipi San (Spleen-Solidifying Powder) and Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pill) should be taken. If warming and tonifying medicines are ineffective, it indicates a deficiency syndrome with concurrent excess. Wanting to administer purgatives may be intolerable for children; however, failing to purge leads to waiting for death. Although simultaneous tonification and purging can be employed—such as one part tonification to one part purging, three parts tonification to one part purging, or nine parts tonification to one part purging—one must assess the progression and regression, wait for the opportunity to purge, and adjust according to circumstances. Only then can pathogens be expelled without damaging healthy qi, and the disease can be cured. Salt and soy sauce must be avoided for one hundred days.