Library

Danxi stated: The etiology of Shui Bing (Water Disease, i.e., edema) is not uniform. Jia Luoyang believed that if swelling disease is left untreated, it will inevitably become a stubborn and incurable ailment; even with the medical skills of Bian Que, it would be impossible to cure. Thus, we know that the danger and severity of edema are incomparable to other diseases.

The general principle for treating water disease is to tonify the Middle Jiao (Middle Burner/Spleen-Stomach), expel dampness, and promote urination. For cases accompanied by fever, where water qi resides in the exterior, sweating method should be used. For cases without fever, where water qi resides in the interior, treatment depends on location: for swelling below the waist, promoting urination is appropriate; for swelling above the waist, inducing sweating is appropriate. This is a key method of Zhang Zhongjing.

If there is generalized edema accompanied by irritability, thirst, dark and scanty urine, and constipation, this belongs to Yang Water (Yang-type Edema). One should first administer Wupi San (Five-Bark Powder), followed Simo Yin (Four-Mortar Drink). In severe cases, Shuzao Yin (Draining-Scouring Decoction) should be used. If there is generalized edema without irritability or thirst, with loose stools and scanty, non-acrid, non-red urine, this belongs to Yin Water (Yin-type Edema). It is suitable to treat with Shipi Yin (Spleen-Solidifying Drink) or Muxiang Liqi Yin (Aucklandia Qi-Regulating Drink).

For Yang Water accompanied by Yang syndromes, the pulse must be deep and rapid. For Yin Water accompanied by Yin syndromes, the pulse must be deep and slow. If Qi sinks, Erchen Tang (Two-Aged Decoction) with Qi-lifting herbs can be used to moisten the bowels and lengthen urination. If abdominal distension occurs, add Houpo (Magnolia Bark); if Qi movement is stagnant, add Muxiang (Aucklandia Root) and Mutong (Akebia Stem) to regulate. Additionally, if infants suddenly experience phlegm-cough and asthma, this pertains to the Spleen and Stomach. One should first release the exterior and scatter pathogens, then administer Shanglu Wan (Phytolacca Pill). As stated in the *Neijing* (Inner Canon): "Open the ghost gate (induce sweating), cleanse the clean mansion (promote urination)," which refers to this principle.

Edema that begins in the four limbs and subsequently involves the abdomen is considered incurable. Cases with loose stool incontinence, black lips, flat clavicular fossae, protruding umbilicus, flat dorsum pedis, hard flesh, flat palms, male edema rising from the feet upward, or female edema descending from the body downward are all considered incurable.

For infantile water qi edema with abdominal distension, moxa acupuncture at Fenshui (CV8) is indicated, three moxa cones per point. The location is one cun above the umbilicus.

Jiawei Wupi Yin (Modified Five-Bark Decoction): Treats infantile edema and fullness of the four limbs; applicable to both Yang and Yin Water.
Ingredients: Wujiapi (Acanthopanacis Cortex), Digupi (Lycii Cortex), Shengjiangpi (Zingiberis Rhizoma Recens Pericarpium), Dafupi (Arecae Pericarpium), Fulingpi (Poria Cocos Pericarpium) (each 1 qian, plus Jianghuang [Curcumae Radix] 1 qian and Mugua [Chaenomelis Fructus]).
Usage: Combine as one dose, decoct in water and take orally. Another prescription removes Wujiapi and uses Chenpi (Citri Reticulatae Pericarpium) and Sangbai pi (Mori Cortex).

Shuzao Yinzi (Draining-Scouring Decoction): Treats water qi causing generalized edema, panting and急促 breathing, irritability and thirst, difficulty in urination and defecation, when hot medicines are ineffective.
Ingredients: Zexie (Alismatis Rhizoma), Chixiaodou (Phaseoli Semen Rubrum, stir-fried), Shanglu (Phytolaccae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Dafupi (Arecae Pericarpium), Jiaomu (Zanthoxyli Semen), Mutong (Akebiae Caulis), Qinjiao (Gentianae Macrophyllae Radix), Binglang (Arecae Semen), Fulingpi (Poria Cocos Pericarpium) (equal parts).
Usage: Coarsely powder, decoct in water with five slices of fresh ginger.

Tingli San (Descurainiae Seed Powder): Treats infantile water qi edema and fullness.
Ingredients: Tian Tingli (Descurainiae Semen seu Lepidii Semen, stir-fried between papers), Hei Qianniu ( Pharbitidis Semen), Binglang (Arecae Semen), Dahuang (Rhei Radix et Rhizoma, baked) (equal parts).

Daju Pi Tang (Great Tangerine Peel Decoction): Treats internal attack of damp-heat causing abdominal distension and edema, difficulty in urination, and loose stools.
Ingredients: Chenpi (Citri Reticulatae Pericarpium, 1.5 liang), Muxiang (Aucklandiae Radix, 2.5 qian), Huashi (Talcum, 6 liang), Binglang (Arecae Semen, 2 qian), Fuling (Poria Cocos, 1 liang), Zhuling (Polyporus Umbellatus, half liang), Baizhu (Atractylodis Macrocephalae Rhizoma, half liang), Zexie (Alismatis Rhizoma, half liang), Rougui (Cinnamomi Cortex, half liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian).
Usage: Coarsely powder. Take 3 qian per dose, decoct in one cup of water.

Shizao Wan (Ten-Jujube Pills): Treats water qi causing edema of the four limbs, upper body panting and急促 breathing, and difficulty in urination and defecation.
Ingredients: Gansui (Kansui Radix), Daji (Euphorbiae Pekinensis Radix), Yuanhua (Genkwa Flos) (equal parts).
Usage: Grind into fine powder, bind with paste from boiled jujube meat to make pills the size of paulownia seeds. Take 30 pills early in the morning with hot water, until diarrhea occurs. Repeat the next morning. Do not use large doses for deficient patients.

Gancao Mahuang Tang (Licorice and Ephedra Decoction): Treats edema involving the entire area above the waist; induce sweating with this formula.
Ingredients: Gancao (Glycyrrhizae Radix et Rhizoma, half liang), Mahuang (Ephedrae Herba, 1 liang).
Usage: Coarsely powder, decoct in water as one dose.

Shipi San (Spleen-Solidifying Powder): Treats infantile Yin Water causing edema; use this to first solidify the Spleen Earth.
Ingredients: Houpo (Magnoliae Officinalis Cortex, ginger-processed), Baizhu (Atractylodis Macrocephalae Rhizoma), Mugua (Chaenomelis Fructus), Muxiang (Aucklandiae Radix), Ganjiang (Zingiberis Rhizoma, processed, each 1 liang), Caoguoren (Tsaoko Fructus Cardamomi), Dafuzi (Arecae Semen), Fuzi (Aconiti Lateralis Radix Praeparata), Fuling (Poria Cocos), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted, each half liang).
Usage: Coarsely powder. Take 3 qian per dose, decoct with fresh ginger and jujubes in water.

Xiaozhong Wan (Reducing-Edema Pills): Treats infantile edema, panting and fullness, and difficulty in urination.
Ingredients: Huashi (Talcum), Mutong (Akebiae Caulis), Baizhu (Atractylodis Macrocephalae Rhizoma), Hei Qianniu (Pharbitidis Semen, stir-fried), Tongtuomu (Pteridis Massae), Fuling (Poria Cocos), Fushen (Poria Cocos with Hostwood), Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 1 qian), Muxiang (Aucklandiae Radix), Qumai Sui (Dianthi Herba), Dingxiang (Caryophylli Flos) (each half liang).
Usage: Grind into fine powder, bind with wine paste to make pills the size of paulownia seeds. Take 20 pills per dose, washed down with Dengxincao (Junci Medulla) and Maidong (Ophiopogonis Radix) decoction.