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The *Yellow Emperor's Inner Canon* states: "Zhiyin" refers to Kidney Water; Shaoyin is the pulse of winter. Its root lies in the Kidney, its branch in the Lung, and both involve fluid accumulation. It also states: The Kidney is the gate of the Stomach. If this gate functions improperly, water accumulates and follows the principle of like attracting like, overflowing upward and downward into the skin, resulting in edema and abdominal distension. If it reverses upward causing panting, calling out, and inability to lie flat, this indicates disease in both the root (Ben) and the branch (Biao).

Zhu Danxi said: Only when Kidney deficiency fails to transform water, and Spleen deficiency fails to control water, does pathology arise. The Stomach combines with the Spleen, and the Stomach is the sea of water and grain. Due to deficiency, it fails to transport and transform, causing Kidney water to flood and soak the Spleen Earth. Consequently, the Sanjiao (Triple Burner) stagnates, meridians become blocked, water seeps into the skin, pours into muscles, and causes edema. The manifestations include slight swelling above and below the eyelids, heaviness of the limbs, panting, cough, palpitations, coldness in the groin area, scanty yellow urine, thin and shiny skin, pitting upon pressure that rebounds immediately upon lifting the hand.

Ancient formularies discuss ten types of edema, as well as five conditions caused by dampness, toxic vapors, post-typhoid fever, post-dysentery, and Qi-Blood deficiency. Additionally, seven types of distension—such as those due to malnutrition (Gan Qi), mass accumulation (Zheng Ji), locked abdomen (Suo Du), chest/diaphragm bloating, roundworms, Qi deficiency, and cold accumulation—should also be carefully differentiated. Those affected by dampness suffer from excessive accumulation of Spleen-Stomach Qi, leading to edema in the four limbs and head/face. Those suffering from food toxicity have a damaged Spleen accumulating toxins retained in the Stomach. In typhoid cases treated too early with purgatives, pathogenic factors enter due to deficiency. Post-dysentery cases involve Spleen Qi deficiency. All these should first regulate Stomach Qi before treating edema.

Those suffering from the seven types of distension are caused by insufficiency of Qi and Blood, weakness of Zang-Fu organs, deficiency in both interior and exterior, and chaos between pathogenic and healthy factors, resulting in edema of the four limbs and abdominal distension. Treatment should first regulate Ying (Nutritive) and Wei (Defensive) Qi, differentiate Yin and Yang, and employ methods such as tonifying the Middle, moving dampness, and promoting urination. Where heat signs exist, water qi is in the exterior, and sweating may be induced. Where no heat exists, water qi is in the interior, and purgation is appropriate. Edema above the waist should be treated by promoting urination; edema below the waist should be treated by inducing sweating. This is the method of Zhang Zhongjing.

If the whole body is swollen, accompanied by irritability, thirst, dark/scanty urine, and constipation, this belongs to Yang Water. If the whole body is swollen, without thirst, with loose stools and clear/profuse urine, this belongs to Yin Water. Yang Water combined with Yang syndromes presents with floating and rapid pulses; Yin Water combined with Yin syndromes presents with deep and slow pulses. If Qi sinks, use Erchen Tang (Two-Cured Decoction) with ascending herbs; if abdominal distension occurs, add small amounts of Muxiang (Aucklandiae Radix) to regulate Qi. If symptoms ease in the morning and worsen at night, it indicates Yin deficiency; take Siwu Tang (Four Substance Decoction) with Renshen (Ginseng) and Baizhu (Atractylodis Macrocephalae Rhizoma) in the morning, and Jiajian Shenqi Wan (Modified Kidney Qi Pill) in the evening. If symptoms worsen in the morning and ease at night, it indicates Yang deficiency; take Liujunzi Tang (Six-Gentleman Decoction) in the morning, and Jiajian Shenqi Wan in the evening. If symptoms worsen both morning and night, it indicates dual deficiency of Yin and Yang; treat primarily with Bazhen Tang (Eight-Treasure Decoction). For true Yang deficiency, take Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) in the morning and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) in the evening.

If there is epigastric fullness, limb swelling, cold hands and feet, difficulty digesting food, diarrhea, or cold breath, this indicates collapse of true Yang, with Cold-Deficiency in the Spleen, Lungs, and Kidneys failing to secure and control, leading to flooding of water. Urgently administer Jiajian Shenqi Wan, otherwise it is untreatable. Only by regulating and tonifying Spleen Earth is survival likely.

*Jinkui Yaolue* Modified Kidney Qi Pill Formula: Shudihuang (Prepared Rehmanniae Radix, 8 liang), Ganshanyao (Dioscoreae Rhizoma, 4 liang), Shanzhuyu (Corni Fructus, 4 liang), Zexie (Alismatis Rhizoma, 3 liang), BaiFuling (Poria, 3 liang), Mudanpi (Moutan Cortex, 3 liang), Rougui (Cinnamomi Cortex, 1 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 1 liang), Cheqianzi (Plantaginis Semen, 1 liang), Niuxi (Achyranthis Bidentatae Radix, 1 liang).

Process each herb separately into fine powder. Form pills using rice paste, sized like adzuki beans. Take 30–40 pills per dose, on an empty stomach before meals, washed down with warm water.