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Abdominal edema accompanied by asthma and abdominal distension, with constipation of both stool and urine, is treated with Tingli Muxiang San (Lepidium and Costus Powder). Edema caused by inability to adapt to local climate and water is treated with Weiling Tang (Atractylodes Macrocephala and Poria Decoction). Post-illness edema in the lower back and feet indicates the presence of pathogenic water qi; it is treated with Weiling Tang (Atractylodes Macrocephala and Poria Decoction) added with Huanglian (Coptis Rhizome). Edema resulting from using drying agents for sores too early: if the upper body is more severely affected, treat with Qianghuo Shengshi Tang (Notopterygium and Dryopteris Decoction) added with Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Suye (Perillae Folium); if the lower body is more severely affected, use Wuling San (Poria Pill) replacing Cangzhu (Atractylodis Rhizoma) with Maozhu (a variety of Atractylodes), and add Mugua (Chaenomelis Fructus) and Dafupi (Arecae Pericarpium).

In women, if menstruation stops first followed by edema of the four limbs, urinary obstruction, and generalized swelling, this is blood transforming into water, termed "Blood Partition" (Xuefen). This condition arises from emotional disharmony and spleen-stomach deficiency failing to control blood, making it extremely difficult to treat. Daily administration of Guipi Tang (Restore the Spleen Decoction) with one pill of Jiaoren Wan (Pepper Seed Pill) is indicated. Although the medication is potent, improvement should occur within a few days. Fearful refusal to use these drugs risks harming the body while attempting to nurture health. If urinary difficulty precedes facial and bodily edema, with amenorrhea, it is water destroying blood, termed "Water Partition" (Shuifen), treated with Guipi Tang (Restore the Spleen Decoction) delivering seven Tingli Wan (Lepidium Pills). When meridians are blocked and transform into water flowing to the limbs causing full swelling, it is also called "Blood Partition." The symptoms resemble edema but are not truly water retention. Treat with Guipi Tang (Restore the Spleen Decoction) delivering fifteen Renshen Wan (Ginseng Pills). These patients suffer from insufficiency of form and qi, with pathogens invading the collaterals; such medications are necessary to vent and guide out the pathogens, assisted by tonifying primordial qi. Thus, the medicinal force has support to act, pathogens cannot remain, and true qi is not damaged.

Critical signs of fatal edema include any one of the following: Liver injury manifests as black lips and swelling; Heart injury as flat clavicular fossae (Quepen) and palm lines disappearing; Spleen injury as protruding umbilicus; Kidney injury as flat soles; Lung injury as flat back and shrugging shoulders, testicles retracting upward, seamless scrotum, or swollen and putrid penis—all indicate death. Profuse loose stools with persistent edema indicate death. Asthma and chest fullness, even in acute onset, are untreatable. Abdominal distension with visible blue veins after diarrhea indicates death. Nasal flaring, cyanotic eye orbits, scorched ears, black face, and muscle wasting indicate imminent death. Edema starting in the abdomen and spreading to limbs is treatable; starting in limbs and returning to the abdomen is fatal. If lung qi fails to descend, leading to ulcerated edema of both legs and complete anuria, with indescribable abdominal pain where pressing the left side causes pain on the right and vice versa, and pressing the navel causes whole-abdomen pain with incessant crying, diuretics and umbilical applications fail; this is incurable.

Diaphoretic agents (Kai Guimen) include Mahuang (Ephedrae Herba), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Congbai (Allii Fistulosi Bulbus), and willow branch washes. Diuretic agents (Jing Jingfu) include Zexie (Alismatis Rhizoma), Mutong (Akebiae Caulis), Tongcao (Tetrapanacis Medulla), Fangji (Stephaniae Tetrandrae Radix), Tingli (Lepidii Semen), Fuling (Poria), and Zhuling (Polyporus). Shi Yanshi (Mineral Salt) can replace table salt. Agents to remove accumulated stagnation (Qu Yuan Chen) include Shanglu (Phytolaccae Radix), Daji (Euphorbiae Pekinensis Radix), Gansui (Kansui Radix), Yuanhua (Genkwa Flos), and Qianniu (Pharbitidis Semen). Agents to disseminate Yang qi include Fuzi (Aconiti Lateralis Radix Praeparata), Rougui (Cinnamomi Cortex), Ganjiang (Zingiberis Rhizoma), and Wuzhuyu (Evodiae Fructus). Agents for blood edema include Hupo (Fossilia Os Sacrum), Yujin (Curcumae Longae Radix), Liujinu (Artemisiae Anomalous Herb), and Sumu (Sappan Lignum).

Prescriptions: For edema, roast about one sheng of Zaixin Tudi (Caosinis Cauda/Fire-warmed Soil) until red, pour aged three-white wine or strong liquor over it while hot, clarify, and drink on an empty stomach. For blood edema, use red wine. For deficient persons, decoct Caosinis Cauda, clarify, and cook porridge daily. For blood edema with excess pulse/symptoms and constipation, crush fresh Radish (Laifu) to extract half a cup of juice, mix with honey, warm in a double boiler, and consume. Fresh Achyranthes Bidentata Juice (Niuxi) also promotes urination but is contraindicated in those with seminal emission.

Another prescription: Boil seven frogs (removed skin/feet, washed in white wine) with 40-50 cloves of garlic inside a pig's stomach in white wine until soft. Eat the stomach; urination increases, and edema subsides. Another method: Boil one live snakehead fish (with gutted viscera stuffed with garlic) in white wine and eat. Urination and flatus resume simultaneously, and edema resolves. For deficient persons, take ash powder three times with sugar; edema subsides. If bloating recurs after resolution, repeat every 3-4 days for three courses, then regulate with spleen-tonifying, qi-regulating, and kidney-warming herbs.

For edema with anuria unresponsive to other drugs: Crush fresh Plantago leaf (Cheqian Cao), extract one cup of juice, mix with half cup of distilled liquor, warm, and drink on an empty stomach; effect within seven days. For chronic, extremely deficient patients intolerant to draining methods: Soak Coix Seed (Yiyiren) in water, boil briefly, drink frequently while hot; do not overcook. Red bean tea is beneficial. Roast a ~1 jin carp, decoct with winter melon and green onion whites, and consume. Crucian carp is also good. Snakehead fish soup with vinegar, no salt. *Qianjin Fang* advises avoiding garlic and vinegar for edema due to their turbid nature, especially for blood edema. Duck (green-headed or white) cooked with red beans, eaten on an empty stomach without salt/soy sauce. Salt exacerbates kidney water pathology; beans/wheat generate damp-heat. If salt cannot be avoided, use roasted red bean and barley flour clarified with Caosinis Cauda water, taken with Qingyan (Green Salt/Sand Earth Salt), which clears heart/kidney without aiding water. Avoid pork, mutton, poultry, seafood, bran, raw/cold, and fried foods. Strictly avoid sexual activity, worry, fatigue, and excessive eating/drinking.

[Pulse Diagnosis] Deep pulses indicate water disease. Deep-slippery, floating-slow, string-tight pulses all indicate edema. In abdominal edema, solid-large pulses indicate survival; floating-empty pulses indicate death. In abdominal closure, deep-solid-stringy pulses indicate survival; deep-fine-empty-small pulses indicate death. In generalized edema with diarrhea and cold extremities, deep-solid pulses require urgent warming; large-empty pulses indicate certain death. Asthma with this indicates terminal failure.

Li Shicai treated Qian Shangzhi with generalized tense edema, protruding umbilicus, and flat back—prognosis hopeless. Family insisted on treatment. Prescribed large dose of Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pill) combined with Lizhong Tang (Regulate the Middle Decoction). No effect after five days. Then administered Ren Shen (Ginseng Root) 1 liang, Sheng Fuzi (Prepared Aconite Root) 3 qian, Niuxi (Achyranthes Root) and Fuling (Poria) 5 qian each. Urination suddenly resumed, appetite returned. Total consumption: 4 jin Ginseng, >1 jin each of Fuzi, Ginger, and Cinnamon. Patient recovered.

Liu Mosheng treated Wang Quchen with spleen-deficient water counterflow injuring lungs, causing asthma, cough, anorexia, and anuria. Pulse was weak, intolerant to tonification or purgation. Prescribed Fuling 5 qian, Zexie and Ju Hong (Citri Reticulatae Pericarpium) 1.5 qian each, Fangfeng and Rougui (Cinnamon Bark) 0.5 qian each, Shu Fuzi (Prepared Aconite) 0.5 qian. After two doses, water receded. Later supplemented with Ren Shen for recovery.

Shi Wan treated Wang Yongruo with vomiting, edema, and complete anuria. Wuling San and Bazheng San failed. Six pulses were deep-fine like threads. Administered Jin Ye Dan (Golden Liquid Pill) 15 pills. Urine flowed like a spring, condition stabilized. Later cultivated with Jisheng Shen Qi Wan (Jisheng Kidney Qi Pill) for recovery.