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The *Mai Jing* (Pulse Classic) states: In edema diseases, if the pulse is *hongda* (surging and large), it is treatable; if the pulse is *weixi* (faint and fine), it is untreatable. In edema with abdominal distension and obstruction, if the pulse is *fuda ruan* (floating, large, and soft), life can be preserved; if the pulse is *chenxi xuxiao* (deep, fine, deficient, and small), death ensues. In edema where the abdomen is distended like a drum, if solid upon palpation, life can be preserved; if deficient/soft, death ensues.

Qian Yi (Qianshi) stated: Kidney heat transmits to the Bladder. When heat becomes excessive, it rebels against the Spleen and Stomach. Due to Spleen deficiency, it cannot control Kidney water, which instead counter-attacks Earth (Water overacting on Earth in the Five Phases). The Spleen Qi follows the downward movement of Water. Since the Spleen governs the four limbs, water-dampness flows through, causing swelling throughout the body and face. If severe panting occurs, the condition is critical. Why is this so? Because excessive Kidney Water overacts on Spleen Earth, causing Spleen Earth to decline; at this time, Heart Fire also becomes excessive, and Lung Metal is controlled by Heart Fire, resulting in panting. One may ask: Heart Fire punishing Lung Metal usually indicates Lung deficiency; why does it now manifest as excess panting? The answer is that there are two scenarios. First, extreme upward rebellion of Lung Qi, which indicates reversal of the five Zang organs' Qi mechanisms. Second, Kidney Water Qi moves upward and invades the Lungs from the side, causing severe panting. All these conditions are difficult to treat.

Zhu Danxi stated: It is only when Kidney deficiency fails to transport water, and Spleen deficiency fails to control water, that issues arise. The Stomach and Spleen are exterior-interior related, and the Stomach is the Sea of Grain and Water. Due to deficiency, it fails to transmit and transform. Consequently, Kidney Water floods and inundates Spleen Earth, causing stagnation in the Sanjiao (Triple Burner) and obstruction in the collaterals. Water seeps into the skin and pours into the muscles, causing edema. The presentation includes slight swelling above and below the eye sockets, heaviness of the limbs, possibly accompanied by panting, coughing, palpitations (*zhengchong*), coldness in the groin area, scanty yellow urine, thin and shiny skin, pitting edema that remains after pressure is released, and immediate rebound upon lifting the hand. Ancient formulas describe ten types of edema: Shortness of breath and inability to lie flat is Heart Edema; tight pain in both hypochondriac regions is Liver Edema; stool resembling duck feces is Lung Edema; suffering from heaviness in the four limbs is Spleen Edema; lower back pain and cold feet is Kidney Edema; bitter taste in the mouth and dry throat is Gallbladder Edema; deficiency below and excess above is Large Intestine Edema; abdominal urgency with emaciated limbs is Bladder Edema; urinary retention or incontinence is Stomach Edema; urgency and fullness in the lower abdomen is Small Intestine Edema.

Various schools only know the method of treating dampness by promoting urination. Clinging to this single path and using various diuretic drugs often leads to death. They do not realize that when the Spleen is extremely deficient, although the immediate symptoms may be suppressed, the water qi will return, leaving the physician helpless and awaiting death.

According to the *Neijing* (Inner Canon): The Kidney is the organ of Supreme Yin. Supreme Yin refers to Kidney Water. The Lung is the organ of Grand Yin. Shaoyin corresponds to the winter pulse. Therefore, the root of edema lies in the Kidney, and its branch lies in the Lung; both involve water accumulation. The Yellow Emperor asked: How can water accumulate to cause disease? Qibo answered: The Kidney is the gate of the Stomach. If the gate is not functional, water accumulates and follows its kind, overflowing up and down onto the skin, causing abdominal distension and swelling. If it further affects the upper jiao causing rapid breathing, panting, and inability to lie flat, it indicates that both the root (Kidney) and the branch (Lung) are diseased. Thus, Lung disease manifests as panting and difficulty exhaling, Kidney disease manifests as edema, and Lung Qi rebellion causes inability to lie flat. Overflow of water from the Lower Jiao forms edema; when Lung transfers cold to the Kidney, it is called "Yong Shui" (Surging Water). Therefore, in all cases of water disease, slight swelling first appears under the eyes.