升阳滋血汤 二月间，一小儿未满百日，病腹胀，不大便二日，便瘦弱，遍身黄色。
宜升阳气，滋血和血补血，利大便。
蝎稍（二分） 神曲（三分） 浓朴 当归（各一钱） 桃仁（十个） 升麻（三分）
上，作一服，水一盏，煎至半盏，去滓，食前服。
麻黄升麻汤 治小儿面色痿黄，腹胀食不下，正月、四月小儿服之，神效。
麻黄（二分） 桂枝 杏仁 吴茱萸 草豆蔻 浓朴 曲末 羌活 白茯苓 升麻根
苍术 泽泻 猪苓 陈皮 黄柏（各一分） 柴胡根 白术 青皮 黄连（各五分）
上 咀。作一服，水一大盏，煎七分，去滓，食前热服。
〔演山〕肿胀二证，此由虚中有积，久患失治，日渐传变，证候多喘，随轻重、
察盛衰、审表里以主治，先固其本，后正其标，斯无恙矣。〔钱〕肿病，肾热传于膀胱，热盛逆于脾胃，脾
虚而不能制肾水，反克脾土，脾随水行，脾主四肢，故流走而身面皆肿也。若加喘者重也，何以然？肾水胜而克
退脾土，反胜心火，心又胜肺，肺为心克，故喘。或问曰，心刑肺，肺本见虚，令何喘实？曰此有二，一者肺
大喘，此五脏逆。二者肾水气上行，傍侵于肺，故令大喘，此皆难治。
原肿病之由，标本之疾，肾主元气，天一之水生焉，肺主冲化，地四之金属焉，肾为本而肺为标，皆至阴以
积水，其为病也，肾者胃之关键，关键不利，枢机不转，水乃不行，渗于脉络皮肤而为浮肿，当推究内外所
因，而为施治。儿大者，凭脉以明虚实，古方有十种论证，短气不得卧，为心水。两胁紧痛，为肝水。大便鸭溏，
为肺水。四肢苦重，为脾水。腰痛足冷，为肾水。口苦咽干，为胆水。乍虚乍实，为大肠水。腹急肢瘦，为膀
胱水。小便闭涩，为胃水。小腹急满，为小肠水。然脉浮为风为虚，沉伏为水病，沉则脉络虚，伏则小便难，即
为正水，脾脉虚大，多作脾肿，因循不治，乃成水肿。盖脾属土，喜燥而恶湿，常感湿气，湿喜伤脾，血化
为水，土败不能制水，则停蓄不行，留滞皮肤，故作浮肿。初得病时，见眼胞早晨浮突，至午后稍消，以羌活
散（赤白痢）疏解，次醒脾散（慢惊）主之，及间投南星腹皮散。其脾冷困，则燥以草果、缩砂之类。然此
证，夏与秋冬治之颇易，惟春不然，盖四时之水，无如春水泛溢，兼肝木旺而脾土受克，不能受水，所以难疗，
进退不常，须徐徐调理取效。若脾热而困，又以热药燥之，虽火能生土，亦可胜水，奈何燥之太过，土不敌火，
则热愈甚而不食，发热烦渴，医者又进之以燥剂，由此而面目转浮，致脾败而手足背皆肿，盖手足背与脐凸，
即脾之外候。有未经发表，遽用下药以泻之，则一泻而肿消，乃曰得泻之力，殊不知脾愈泻而愈虚，不逾旬月，
其肿如初，此世人只知泻肿为最，而不求其十补勿一泻之论，法当随四时用药解表，通利小便，春以七宝散（伤
寒）加麻黄、桂枝、赤茯苓，水姜葱煎服。夏以五苓散（惊）加麻黄、车前子、薏苡仁。秋以清肺饮（嗽）加羌
活、细辛、商陆。冬以冲和饮（伤寒）白术、生川乌、赤小豆。以上三药，并用水姜葱煎，次投滋润救脾导水
汤剂渗泄之，乃为良法，更以香陆胃苓丸、赤苍饮顿服，自然获安。盖《内经》云∶开鬼门（发汗），洁净府（利
小便），平治权衡，以平为期，此之谓也。有国中便觉痰嗽气喘，小水不通，正属肺
肾所主，先服解表散（咳嗽），次以三白散为治，余证，轻者投商陆丸。故经曰∶其高者，因而越之即涌
吐之义也。下者，引而竭之即渗泄之义也。凡得此病，非一朝一夕之故，不可以孟浪之药，求其速效，以致虚脱，
如愈后再感外风，满面虚浮，用排风汤（惊痈鹤膝）和解，仍服前救脾汤剂，免致反复。饮食之忌，惟盐
酱齑 湿面，皆味咸能溢水者，并其他生冷毒物，亦宜戒之，重则半载，轻者三月，须脾胃平复，肿消气实，
然后于饮食中旋以烧盐少投，则其疾自不再作。故刘氏曰∶治肿非易，补养尤难。所忌者，切须详审。有经久
不消者，下浚川丸即效。
南星腹皮散 主肿疾欲愈未愈之间，脾胃虚慢，气促痰喘，腹胀胸满，饮减，精神困，小便不利，
面色痿黄。
南星（制，一两） 大腹皮（净洗，焙干） 生姜皮 陈皮（去白） 青皮（去白） 桑白皮（锉炒）
甘草 扁豆（炒，去壳。各半两）
上碎。每服二钱，水一盏，姜二片，煎七分，无时温服。
香陆胃苓丸 治肿疾日久不愈，此药大能实脾导水，多服取效。
丁香（去梗） 商陆 赤小豆 陈皮（去白） 甘草（炙。各二两） 苍术（米泔水、浸一宿，去粗皮、滤干、
锉片，炒微黄色） 泽泻（去粗皮。各二两半） 赤茯苓（去皮） 猪苓（去皮） 白术（各一两半）
肉桂（去粗皮，一两） 浓朴（去粗皮，用生姜汁炙令香熟，二两）
上，除丁香、肉桂不过火，余药锉焙，同二味为末，用面微炒，水浸透煮糊丸，绿豆大。每服三十丸至
五十丸或七十七丸，空心温汤下。儿小者，丸作粟谷大吞服之，粒数、引子，并如前法。
赤苍饮 主脾胃因虚受湿，面貌浮黄，或遍身作肿，饮食减少，气不升降，小便赤色，肚膨胀，咳
嗽有痰及肿，尝服神效。加草果仁炮过，水姜枣煎投。
赤茯苓（去皮） 苍术（去粗皮，米泔水浸一宿，滤干、锉片，炒微黄。各一两半） 枳壳（制，一两）
藿香（和根） 半夏（汤煮透，锉焙干） 净香附 紫苏（和梗） 浓朴（去粗皮，姜汁炙香熟） 陈
皮（去白。各七钱半） 甘草（炙，一两二钱）
上锉。每服二钱，水一盏，生姜二片，煎七分，无时温服。
三白散 解国中肿疾，四肢肤囊浮胀，大小便不利，皆因膀胱蕴热，风湿相乘。
白牵牛（半生半炒，杵碎） 桑白皮（锉、炒） 白术 木通（去皮节） 陈皮（去白） 甘草（各半两）
上碎。每服二钱，水一盏，煎七分，无时服。
商陆丸 治水肿小便不通，勿拘远近。
商陆（一两） 净黄连（半两）
上焙，为末，姜汁煮面糊丸，绿豆大。每服三十丸至五十丸，用温紫苏熟水空心下，或温葱汤。
浚川丸 治水肿及单腹满胀，气促食减，遍身面浮。
大戟 芫花（醋炒） 沉香 檀香 南木香 槟榔 蓬莪术 大腹皮（洗，焙干） 桑白皮（
锉炒。各半两） 黑白牵牛（晒研、取生末，一两） 巴豆（去壳膜心、存油，三十五粒）
上，除牵牛末、巴豆外，前丸味内有沉香、檀香、木香、槟榔不过火，余五味焙干，同沉香等为
末，就加牵牛末和匀，巴豆碎切，在乳钵内极细杵，入前药末同再杵匀，水煮面糊丸，麻仁大。每服十
七丸，浓煎葱汤候温，五更初空心下。
去水未尽，停一日，减用十三丸，次减作九丸，再减至七丸，汤使下法如前。证退即止，仍投南
星腹皮散。如单腹肿甚，能饮食气壮者，加甘遂末同丸取效。仍忌有甘草药饵，相反。
Shengyang Zixue Decoction (Ascending Yang and Nourishing Blood Decoction): In the second month, a child under one hundred days old suffered from abdominal distension, had not passed stool for two days, was emaciated, and had yellowish skin all over the body.
It is appropriate to ascend yang qi, nourish blood, harmonize blood, and tonify blood, while promoting bowel movement.
Scorpio Cauda (Quexie Shao, 蝎稍) - 2 fen; Shenqu (Medicated Leaven, 神曲) - 3 fen; Houpo (Magnolia Bark, 厚朴); Danggui (Angelicae Sinensis Radix, 当归) - each 1 qian; Taoren (Persic Semen, 桃仁) - 10 pieces; Shengma (Cimicifugae Rhizoma, 升麻) - 3 fen.
The above ingredients are combined as one dose. Boil with one cup of water until half a cup remains, strain, and take before meals.
Mahuang Shengma Tang (Ephedra and Cimicifuga Decoction): Treats children with sallow complexion, abdominal distension, and inability to eat. It is extremely effective when taken by children born in the first or fourth lunar months.
Mahuang (Ephedrae Herba, 麻黄) - 2 fen; Guizhi (Cinnamomi Ramulus, 桂枝); Xingren (Prunus Armeniaca Seed, 杏仁); Wuzhuyu (Evodiae Fructus, 吴茱萸); Caodoukou (Amomi Fructus Rotundus, 草豆蔻); Houpo (Magnolia Bark, 厚朴); Shenqu Mo (Powdered Medicated Leaven, 神曲末); Qianghuo (Notopterygii Rhizoma et Radix, 羌活); Baifuling (Poria, 白茯苓); Shengmageng (Cimicifugae Radix, 升麻根); Cangzhu (Atractylodis Rhizoma, 苍术); Zexie (Alismatis Rhizoma, 泽泻); Zhuling (Polyporus, 猪苓); Chenpi (Citri Reticulatae Pericarpium, 陈皮); Huangbai (Phellodendri Cortex, 黄柏) - each 1 fen; Chaihu Gen (Bupleuri Radix, 柴胡根); Baizhu (Atractylodis Macrocephalae Rhizoma, 白术); Qingpi (Citri Reticulatae Pericarpium Viride, 青皮); Huanglian (Coptidis Rhizoma, 黄连) - each 5 fen.
The above ingredients are chopped. Combine as one dose. Boil with one large cup of water until seven-tenths remain, strain, and take hot before meals.
[Yanshan] The syndromes of swelling and distension arise from deficiency complicated by accumulation. If neglected over a long period, the condition gradually progresses. Symptoms often include panting. Treatment should be determined by assessing severity, observing the excess or deficiency of pathogenic and healthy qi, and examining the exterior and interior levels. First, consolidate the root (deficiency), then correct the branch (accumulation/symptoms), and there will be no danger. [Qian Yi] Swelling disease involves kidney heat transmitting to the bladder. Excessive heat reverses into the spleen and stomach. Spleen deficiency fails to control kidney water, which instead counter-attacks spleen earth. The spleen follows the water qi; since the spleen governs the four limbs, the water flows around, causing swelling of the face and whole body. If panting is added, the condition is severe. Why? Because kidney water overcomes and retreats spleen earth, but overcomes heart fire instead. Heart then overcomes lung. Lung is overcome by heart, hence panting. One might ask: If heart penalizes lung, and lung is originally deficient, why is there excess panting? There are two reasons: First, massive lung panting indicates reversal of the five zang organs. Second, kidney water qi ascends and invades the lung laterally, causing massive panting. Both are difficult to treat.
Investigating the origin of swelling and the relationship between root and branch diseases: Kidney governs primordial qi and generates Tianyi Water. Lung governs chong transformation and generates Disi Metal. Kidney is the root, lung is the branch. Both are extreme yin and prone to accumulating water. Pathogenesis: Kidney is the key gate of the stomach. If the key gate is obstructed, the pivot does not turn, water cannot flow, and it seeps into meridians and skin causing edema. One must investigate internal and external causes to prescribe treatment. For older children, determine deficiency or excess via pulse diagnosis. Ancient formulas describe ten types of water disorders: Shortness of breath and inability to lie flat is Heart Water. Tight pain in both hypochondria is Liver Water. Duck-like loose stools is Lung Water. Heaviness in four limbs is Spleen Water. Lower back pain and cold feet is Kidney Water. Bitter taste and dry throat is Gallbladder Water. Alternating deficiency and excess is Large Intestine Water. Abdominal urgency and emaciated limbs is Bladder Water. Obstructed and difficult urination is Stomach Water. Urgency and fullness in lower abdomen is Small Intestine Water. However, floating pulse indicates wind or deficiency; deep and hidden pulse indicates water disease. Deep pulse means meridian deficiency; hidden pulse means difficult urination, known as Zhengshui (True Water). Spleen pulse deficiency and largeness often indicates Spleen Swelling. If neglected, it becomes Edema. Spleen belongs to Earth, likes dryness and dislikes dampness. It easily contracts dampness, which damages spleen. Blood transforms into water. When Earth fails, it cannot control water, leading to stagnation in skin and causing edema. At onset, eyelids swell in the morning and subside slightly in the afternoon. Use Qianghuo San (for red-white dysentery) to disperse, followed by Xingpi San (for slow convulsion). Intermittently administer Nanxing Fupi San. If spleen cold and fatigue occur, use drying agents like Caoguo (Tsaoko Fructus, 草果) and Suosha (Amomi Fructus, 缩砂). This syndrome is easy to treat in summer and autumn/winter, but difficult in spring. Spring water overflows, liver wood is strong and overcomes spleen earth, which cannot accept water, making it hard to heal. Progression is irregular; gradual regulation is needed. If spleen heat and fatigue occur, using hot drying drugs may generate earth and overcome water, but excessive drying makes earth unable to withstand fire, worsening heat, anorexia, fever, and thirst. Doctors further use drying agents, causing facial swelling, spleen failure, and swelling of dorsal hands and feet. Dorsal hands/feet and umbilical protrusion are external signs of spleen. If purgatives are used without prior diaphoresis, swelling subsides after one purge, falsely attributed to purgation. Actually, spleen becomes more deficient. Within ten days to a month, swelling returns. People only know purging reduces swelling, ignoring the principle of "ten tonifications, one purge." Treatment should follow seasonal patterns: release exterior, promote urination. Spring: Qibao San (for cold damage) plus Mahuang, Guizhi, Chifuling, decocted with water, ginger, scallion. Summer: Wuling San (for convulsion) plus Mahuang, Cheqianzi (Plantaginis Semen, 车前子), Yiyiren (Coicis Semen, 薏苡仁). Autumn: Qingfei Yin (for cough) plus Qianghuo, Xixin (Asari Radix et Rhizoma, 细辛), Shanglu (Phytolaccae Radix, 商陆). Winter: Chonghe Yin (for cold damage) plus Baizhu, Sheng Chuanwu (Aconiti Radix Carnea, 生川乌), Chixiaodou (Vigna Angularis Semen Rubrum, 赤小豆). These three formulas are decocted with water, ginger, scallion. Then administer Runji Paidu Tang (Moistening and Spleen-Saving Water-Guiding Decoction) for渗泄 (seeping and draining). This is a good method. Also take Xianglu Weiling Wan (Fragrant Phytolacca and Five-Ling Pill) and Chi Cang Yin (Red and Atractylodes Drink) in a single dose for natural peace. As stated in Neijing: Open the ghost door (diaphoresis), clean the net house (promote urination), balance and weigh, aiming for equilibrium. Some patients experience phlegm-cough and panting with urinary obstruction, governed by lung and kidney. First take Jiebiao San (for cough), then treat with Sanbai San. For other mild cases, use Shanglu Wan. Scripture says: High location, induce vomiting (surge); Low location, guide to exhaustion (seep and drain). This disease does not happen overnight. Do not use reckless drugs for quick results to avoid collapse. If relapse occurs with external wind and facial puffiness, use Paifeng Tang (for convulsion, carbuncle, crab-leg joint) to harmonize, and continue Jiupi Tang to prevent recurrence. Dietary taboos: Salt, soy sauce, pickles, wet noodles are salty and promote water retention. Avoid other raw, cold, toxic foods. Severe cases take half a year, mild cases three months. Only after spleen/stomach recover and swelling subsides with qi strengthening, slowly add roasted salt to diet to prevent recurrence. Liu said: Treating swelling is not easy; tonification is especially difficult. Taboos must be carefully considered. For chronic non-resolving cases, Xunchuan Wan is effective.
Nanxing Fupi San (Arisaema and Areca Peel Powder): Mainly treats swelling in the transition between healing and non-healing, spleen/stomach deficiency and slowness, shortness of breath with phlegm-panting, abdominal distension and chest fullness, reduced drinking, mental fatigue, difficult urination, and sallow complexion.
Zhi Nanxing (Prepared Arisaemae Rhizoma, 制南星) - 1 liang; Dafupi (Arecae Pericarpium, 大腹皮) - washed, dried; Shengjiangpi (Zingiberis Pericarpium, 生姜皮); Chenpi (Citri Reticulatae Pericarpium, 陈皮) - peeled; Qingpi (Citri Reticulatae Pericarpium Viride, 青皮) - peeled; Sangbaipi (Mori Cortex, 桑白皮) - chopped, fried; Gancao (Glycyrrhizae Radix et Rhizoma, 甘草); Bian Dou (Dolichoris Semen, 扁豆) - fried, shelled. Each 0.5 liang.
Chop finely. Take 2 qian per dose. Boil with one cup of water and two slices of ginger until seven-tenths remain. Take warm at any time.
Xianglu Weiling Wan (Fragrant Phytolacca and Five-Ling Pill): Treats chronic swelling that does not resolve. This pill strongly strengthens spleen and guides water. Frequent use yields results.
Dingxiang (Caryophylli Flos, 丁香) - stem removed; Shanglu (Phytolaccae Radix, 商陆); Chixiaodou (Vigna Angularis Semen Rubrum, 赤小豆); Chenpi (Citri Reticulatae Pericarpium, 陈皮) - peeled; Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) - honey-fried. Each 2 liang; Cangzhu (Atractylodis Rhizoma, 苍术) - soaked in rice wash overnight, peeled, dried, chopped, fried light yellow; Zexie (Alismatis Rhizoma, 泽泻) - peeled. Each 2.5 liang; Chifuling (Poria, 赤茯苓) - peeled; Zhuling (Polyporus, 猪苓) - peeled; Baizhu (Atractylodis Macrocephalae Rhizoma, 白术). Each 1.5 liang; Rougui (Cinnamomi Cortex, 肉桂) - peeled, 1 liang; Houpo (Magnolia Bark, 厚朴) - peeled, stir-fried with ginger juice until fragrant, 2 liang.
Except for Dingxiang and Rougui which should not be overheated, chop and fry remaining herbs. Mix with the two spices into powder. Stir-fry flour lightly, soak in water, boil into paste to make pills, size of mung beans. Take 30-50 or 77 pills on an empty stomach with warm water. For small children, make pills the size of millet grains. Dosage and guiding agents follow previous methods.
Chi Cang Yin (Red and Atractylodes Drink): Mainly treats spleen/stomach deficiency with dampness, puffy yellow face, generalized swelling, reduced appetite, qi ascent/descent dysfunction, dark urine, abdominal bloating, cough with phlegm and swelling. Previously found effective. Add fried Caoguo Ren (Tsaoko Fructus, 草果仁). Decoct with water, ginger, jujube.
Chifuling (Poria, 赤茯苓) - peeled; Cangzhu (Atractylodis Rhizoma, 苍术) - peeled, soaked in rice wash overnight, dried, chopped, fried light yellow. Each 1.5 liang; Zhike (Aurantii Fructus, 枳壳) - processed, 1 liang; Huoxiang (Agastaches Herba, 藿香) - with root; Banxia (Pinelliae Rhizoma, 半夏) - boiled through, chopped, dried; Jing Xiangfu (Cyperi Rhizoma, 净香附); Zisu (Perillae Folium, 紫苏) - with stem; Houpo (Magnolia Bark, 厚朴) - peeled, ginger juice fried; Chenpi (Citri Reticulatae Pericarpium, 陈皮) - peeled. Each 0.75 qian; Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) - honey-fried, 1.2 liang.
Chop. Take 2 qian per dose. Boil with one cup of water and two slices of ginger until seven-tenths remain. Take warm at any time.
Sanbai San (Three Whites Powder): Resolves internal swelling, puffy swollen limbs, difficult urination and defecation. Caused by bladder heat accumulation and wind-dampness invasion.
Bai Qianniu ( Pharbitidis Semen, 白牵牛) - half raw, half fried, pounded; Sangbaipi (Mori Cortex, 桑白皮) - chopped, fried; Baizhu (Atractylodis Macrocephalae Rhizoma, 白术); Mutong (Akebiae Caulis, 木通) - nodes removed; Chenpi (Citri Reticulatae Pericarpium, 陈皮) - peeled; Gancao (Glycyrrhizae Radix et Rhizoma, 甘草). Each 0.5 liang.
Chop finely. Take 2 qian per dose. Boil with one cup of water until seven-tenths remain. Take at any time.
Shanglu Wan (Phytolacca Pill): Treats edema with urinary obstruction, regardless of duration.
Shanglu (Phytolaccae Radix, 商陆) - 1 liang; Jing Huanglian (Coptidis Rhizoma, 净黄连) - 0.5 liang.
Fry, powder. Make pills with ginger juice and flour paste, size of mung beans. Take 30-50 pills on an empty stomach with warm Perilla water or warm scallion soup.
Xunchuan Wan (Deep River Pill): Treats edema and isolated abdominal distension, shortness of breath, reduced appetite, generalized facial/body swelling.
Daji (Euphorbiae Pekinensis Radix, 大戟); Yuanhua (Genkwa Flos, 芫花) - vinegar fried; Chenxiang (Aquilariae Lignum Resinatum, 沉香); Tanxiang (Santalum Album Lignum, 檀香); Nanmuxiang (Styrax Benzoin, 南木香); Binglang (Arecae Semen, 槟榔); Peng Ezhu (Curcumae Zedoariae Rhizoma, 蓬莪术); Dafupi (Arecae Pericarpium, 大腹皮) - washed, dried; Sangbaipi (Mori Cortex, 桑白皮) - chopped, fried. Each 0.5 liang; Heibai Qianniu (Pharbitidis Semen, 黑白牵牛) - sun-dried, ground, raw powder taken, 1 liang; Badou (Crotonis Fructus, 巴豆) - shell/membrane/core removed, oil retained, 35 kernels.
Except for Qianniu powder and Badou, the previous ingredients Chenxiang, Tanxiang, Muxiang, Binglang should not be overheated. Fry remaining five herbs dry. Mix with Chenxiang into powder. Add Qianniu powder and mix well. Chop Badou finely, pound in mortar until very fine. Add to previous powder and mix again. Make pills with water-boiled flour paste, size of hemp seeds. Take 17 pills on an empty stomach at dawn (fifth watch) with thick scallion soup cooled to warm.
If water removal is incomplete, stop for one day, reduce to 13 pills, then 9 pills, then 7 pills. Administration method remains the same. Stop when symptoms recede, then administer Nanxing Fupi San. If isolated abdominal swelling is severe, with good appetite and strong qi, add Gansui powder (Kansui Radix, 甘遂末) to the pill for effect. Still avoid Gancao (Licorice) preparations due to incompatibility.