Library

The *Shengji Zonglu* states: Various medical texts discuss water diseases (Edema) in great detail, yet none have ever mentioned "Qi outside the Membrane" (Membrane-bound Qi disorder). During the Tianbao era of the Tang Dynasty, a monk named Yu Zi began to write about kidney-related pathologies. This disease causes bodily weakness and distension, with fullness and swelling of the four limbs that leave an indentation when pressed. In his discussion on the origin of this disease, Yu Zi stated that "Qi outside the Membrane," also referred to as "Water Qi," originates from other ailments and its presentation is unpredictable. It may arise from malaria, wind-stroke affecting the Kidney organ, cold injury to the Lung or Intestines, Qi stagnation above the diaphragm, strenuous travel in extreme heat, or improper consumption of alcohol and meat. The pathology begins in the Lung and concludes in the Kidney; it may also result from coughing, excessive phlegm and saliva, or the accumulation and obstruction of cold Qi, causing Lung Heat to attack the Heart, or Kidney Cold failing to transform fluids, allowing them to flow into the Bladder. The lesion lies outside the membrane of the Large Intestine, making it difficult to detect via pulse diagnosis and inaccessible to acupuncture. Generally, the Kidney is the root of life and must not be deficient. If the root is solid, the branches flourish; if deficient, they wither easily. Moreover, the waxing and waning of the four seasons all depend on the Qi of the Kidney. Damage to the Kidney leads to the decline of the Five Zang organs, resulting in weak Stomach function and Spleen failure to transport, Qi knotting, and dysuria. The severity of the condition is reflected in urination and defecation. If urination is obstructed, Qi becomes stagnant, attacks the abdomen, breaks through the membrane, transforms into fluid, and causes edema of the hands, feet, head, and face. Mild obstruction of urination and defecation causes mild swelling; severe obstruction causes severe swelling; complete obstruction leads to generalized massive edema within three days. In critical cases, the external genitalia also swell. There are two types of genital edema: one where urine flows spontaneously despite swelling, and another where urination is severely obstructed. Swelling extending from the glans penis to the lower abdomen and umbilicus indicates a fatal prognosis. The swelling in this disease is variable: it may start in the face, hands, or feet; or begin with slight swelling in the waist and ribs; or manifest initially in the extremities. Symptoms may subside or worsen, improving slightly after three to five days, or recurring after a similar period, depending on the patency of urination. Gradually, it develops into massive edema. Women suffering from this disease present similarly. Patients experience abdominal distension, irritability, chest tightness, and shortness of breath due to Lung distension. In severe cases, wheezing resembles a bull's bellowing, preventing sitting, lying down, walking, or standing. If Qi attacks the chest at midnight, causing Heart swelling, death may occur within one to two years, or even one to two months. Improper care or ingestion of toxic substances can exacerbate the condition within five to ten days. Quack doctors often claim success by draining fluid via acupuncture, using Carp and Adzuki Beans as medicine, or instructing patients to drink cattle urine and consume Phytolacca radix (Shanglu), which often causes harm rather than cure. Recovery is rare. This disease particularly contraindicates acupuncture. Hua Tuo stated: For water diseases, do not use acupuncture unless treated by a qualified physician. Since the Qi is outside the membrane and has transformed into water, draining the water draws out the abdominal Qi; once the Qi is exhausted, death ensues. Bian Que stated: Water disease located outside the membrane cannot be treated with ordinary medicines; only divine acupuncture and potent herbs are effective. Patients should sit or walk facing the sun; cloudy or rainy weather exacerbates stagnation. Keep fire sources available for warmth. After taking medication, if one feels intense heat in the chest during sleep, holding Red Snow (a traditional cooling preparation) or good tea may help. Avoid alcohol and cold tea. If thirsty, drink Wulingzhi Decoction (formula recorded at the end of the volume). Strictly avoid salt, raw/cold foods, vinegar, and slippery/greasy foods.

**Fangji Tang** (from *Shengji Zonglu*) treats Membrane-bound Qi disorder and water disease, regardless of duration. Indications include massive edema and panting.
Ingredients: Fangji (*Stephaniae Tetrandrae Radix*), Daji (*Euphorbiae Pekinensis Radix*), Muxiang (*Aucklandiae Radix*), Chifuling (*Poria Cocos cum Ligno*, black skin removed), Haizao (*Sargassum*), Xijiao (*Rhinocerotis Cornu*, shaved), Hujiao (*Piperis Longi Fructus*), Baizhu (*Atractylodis Macrocephalae Rhizoma*), Tinglizi (*Lepidii Semen seu Descurainiae Semen*), Fangfeng (*Saposhnikoviae Radix*, awn removed), Binglang (*Arecae Semen*). Each ingredient weighs 1 liang.
Preparation: Use freshly harvested herbs. Coarsely crush and weigh.
Administration: Decoct with 2 sheng of water until 1 sheng remains. Strain and take warm.
If the abdomen is full, diarrhea will occur around noon. Observe the excrement in a basin; foul yellow water or dark green-black matter will be discharged. This is the result of Qi transformation leading to purgation. If the patient is not excessively weakened, do not stop the diarrhea; it will cease spontaneously. If fatigue occurs, replenish with normal gruel.
After one dose, continue according to this method. According to Mr. Yu Zi, the first dose reduces symptoms by half. Repeated trials show that for extremely severe cases, morning administration leads to recovery by evening. For deep-rooted cases, swelling subsides and the patient can rise on the day of administration, though minor abdominal discomfort may persist, requiring subsequent doses to clear residual pathogens. Do not discard the dregs; store them in a cloth bag and hang in a ventilated area. If slight recurrence occurs later, reuse them. Yu Zi claimed that hanging these dregs at the household entrance prevents epidemic Qi within the family. This decoction treats various Qi disorders. For Lung Qi disorders, modify the twenty ingredients by removing Dahuang (*Rhei Radix et Rhizoma*) and Helile (*Terminalia Chebulae Fructus*). Decoct with urine from an uncircumcised boy. Take on an empty stomach daily to eradicate the root cause. For severe Lung Qi distress caused by exposure to water-disease patients, permanent cure is possible. For lifelong Hong Kong Foot (podagra/chronic lower limb edema) with upward rushing sensation to the heart, this decoction removes the root. By analogy, it treats all Qi disorders. It is safe for postpartum women and pregnant women. Dosage for children and the elderly should be adjusted. After recovery, take Shunqi Wan (Regulate Qi Pill).

**Shunqi Wan** (from *Shengji Zonglu*) treats Water Qi.
Ingredients: Fangji (1.5 liang), Dahuang (2.5 liang), Xijiao (shaved), Helilepi (skin of *Terminalia chebula*), Qianniu (Morning Glory Seed), Chifuling (black skin removed), Tinglizi (stir-fried), Chenpi (orange peel, white pith removed), Fangfeng.
Preparation: Powder, mix with honey, form pills the size of tung tree seeds.
Administration: Take 10 pills with rice water on an empty stomach. Stop when body feels light and vigorous. Patients with Hong Kong Foot should keep this remedy handy for emergencies. After recovering from the previous decoction, take Wuling Tang within 100 days.

**Wuling Tang** (from *Shengji Zonglu*) treats Water Qi.
Ingredients: Helilepi, Mutong (*Akebiae Caulis*), Chifuling (black skin removed), Fangji (coarsely crushed), Chenju pi (orange peel, soaked in water, white pith removed, dried, each 1 liang).
Preparation: Coarsely grind and sieve.
(Administration details appear missing in the source text, typically implying decoction and oral intake.)

**Shishui Wan** (from *Shengji Zonglu*) treats Membrane-bound Water Qi with generalized edema.
Ingredients: Zeqi (*Phytolaccae Radix*, roots and soil removed), Daji (lightly stir-fried), Lianqiao (*Forsythiae Fructus*), Tinglizi (stir-fried on paper), Gansui (*Kansui Radix*, lightly stir-fried), Yuanhua (*Genkwa Flos*, vinegar-soaked... amount specified as 1 liang processed).
Preparation: Powder, mix with honey, form pills the size of tung tree seeds.

**Zeqi Wan** (from *Shengji Zonglu*) treats Membrane-bound Edema.
Ingredients: Zeqi (lightly stir-fried, 1 liang), Shuiyin (Refined Mercury), Tinglizi (stir-fried on paper), Daji (lightly stir-fried and crushed), Yuliren (*Pruni Semen*, soaked in water, skin and twin kernels removed, stir-fried), Zhike (*Aurantii Fructus Percarpium*, bran-fried, core removed).
Preparation: Powder, mix with honey, form pills the size of tung tree seeds.
Administration: Take 10 pills with rice water on an empty stomach. Increase to 15 pills if no bowel movement occurs.

**Niuzi Wan** (from *Shengji Zonglu*) treats Membrane-bound Water Qi.
Ingredients: Niuzi (stir-fried), Wuzhuyu (*Evodiae Fructus*, soaked in water overnight, stir-fried dry), Qingju pi (green orange peel, white pith removed, stir-fried, each 0.5 liang), Xingren (*Armeniacae Semen Amarum*, soaked in water, skin and twin kernels removed, stir-fried, 0.5 liang).
Preparation: Powder, mix with honey, form pills the size of tung tree seeds.
Administration: Take 3 pills with rice water.

**Baiqianniu San** (from *Shengji Zonglu*) treats Membrane-bound Qi.
Ingredients: Baiqianniu (stir-fried), Qingju pi (white pith removed, baked and stir-fried), Mutong (coarsely crushed, each 1 liang).
Preparation: Powder.
Administration: Take 1 qianbi (approx. 3-5 grams) per dose, washed down with decoction of fresh Phytolacca root (*Shanglu*).

**Gansui Bing** (from *Shengji Zonglu*) treats Membrane-bound Water Qi.
Ingredients: Gansui, Damaimian (Barley flour, each 0.5 liang).
Preparation: Powder, mix with water to form cakes, bake until cooked. Eat hot. If no laxative effect, take with warm cooked liquid. If laxative effect occurs... (text incomplete).

**Formula for Membrane-bound Qi and Qi Masses.**
Ingredients: Yanhusuo (*Corydalis Rhizoma*), quantity unspecified, ground to powder. One pig pancreas, cut into pieces, roasted/grilled. Dip the meat into the powder and eat.