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[Classified as Lower Grade in the *Shennong Bencao Jing*]
【Names】 Gansui (from *Mingyi Bielu*), Lingsui (from *Wu Pu Bencao*), Chongze.
Li Shizhen states: The origins of these names are largely unknown.
【Collected Explanations and Verification】 *Mingyi Bielu* states: Gansui grows in the valleys of Zhongshan. The roots are harvested in February and dried in the shade.
Wu Pu states: Harvested in February and August.
Tao Hongjing states: Zhongshan is located in Dai Commandery. It originally originated from Mount Tai and the Jiangdong region. Recently, drugs from Jingkou are used, but they look quite different. Those with red skin are superior to those with white skin. White-skinned ones also exist in Duxia (Nanjing), called Caogansui (Herbal Gansui). Their medicinal properties are extremely poor; they are likely counterfeit.
Su Gong states: The sprouts of Gansui resemble *Phytolacca acinosa* (Zequi). Its root has red skin and white flesh. Those that form a beaded shape and are solid and heavy are of good quality. Caogansui is actually *Paris polyphylla* (Zaoxiu). Its therapeutic effects are completely different, and its sprouts differ as well. It is commonly known as Chongtai. The leaves resemble *Podophyllum emodi* (Guijiu) and *Ricinus communis* (Bima), and the root skin is white.
Meng Shen states: Those produced in Xijing (Chang'an) are the best. Those from Bianzhou, Cangzhou, and Wu regions are secondary. They resemble licorice root with peel.
Su Song states: It is now also produced in Shaanxi and Jiangdong. The sprouts resemble *Phytolacca acinosa*. The stem is short and contains juice. The root has red skin and white flesh, forming a beaded shape, about the size of a finger.
【Processing】 Lei Xiao states: After harvesting, remove the stems. Finely chop on a locust wood cutting board. Soak for three days in a mixture of raw Licorice Decoction (*Gancao Tang*) and natural juice of *Akebia quinata* (*Qili*). Stir until the water turns black like ink. Then filter out and wash six or seven hours with flowing water from the east.
Li Shizhen states: Nowadays, people often wrap it in flour and roast it before use to reduce its toxicity.
【Flavor and Properties】 Bitter, cold, toxic. *Mingyi Bielu* states: Sweet, greatly cold. Wu Pu states: Shennong and Tongjun considered it bitter and toxic; Qibo and Leigong considered it sweet and toxic.
Li Gao states: It belongs to pure Yang.
Xu Zhicai states: *Cucumis melo* var. *makuwa* fruit stalk (Gua Di) acts as an guiding herb. It is incompatible with *Polygala tenuifolia* (Yuanzhi) and counteracts *Glycyrrhiza uralensis* (Gancao).
【Indications】 Treats large abdominal hernia masses, abdominal fullness, edema of the face and eyes, retained fluid and undigested food, breaks up hard accumulations, and promotes urination and defecation (*Shennong Bencao Jing*).
Expels five types of water retention, dissipates retained heat in the bladder, treats palpable lumps under the skin, and reduces swelling caused by hot pathogens (*Mingyi Bielu*). Can drain twelve types of water diseases and eliminate phlegm-fluid (*Zhen Quan*). Drains damp-water from the Kidney meridian and collateral channels, treats podagra (Hongjiao), scrotal swelling and heaviness, phlegm-confusion epilepsy, and dysphagia with chest obstruction (*Li Shizhen*).
【Innovations and Elaborations】 Kou Zongshi states: This drug specifically moves water and acts by attacking and resolving.
Li Gao states: Bitter in flavor and cold in qi.
Bitterness drains downward, and cold overcomes heat. It reaches directly to where water qi condenses, making it a supreme drug for draining water. If water pathogen knots in the chest, only this drug can remove it. Therefore, Zhang Zhongjing uses it in Da Xianxiong Tang. However, it is toxic and should not be used lightly.
Li Shizhen states: The Kidney governs water. When condensed, it becomes phlegm-fluid; when overflowing, it causes swelling. Gansui can drain damp-water from the Kidney meridian and treat the root of phlegm. It must not be taken in excess; stop once the disease is cured. Zhang Zhongjing treated retained fluid below the heart by using Gansui together with Gancao, taking advantage of their opposing yet synergistic action. Liu Hejian in *Baoming Ji* stated: For edema patients whose symptoms do not fully resolve after medication, apply Gansui powder around the navel. Internally administer Gancao water, and the swelling will subside. Additionally, Wang Qiu's *Bai Yi Xuan Fang* states: For podagra attacking upwards forming nodules, and all kinds of swollen toxins, apply Gansui powder mixed with water to the swollen area, and immediately take concentrated Gancao decoction internally. The swelling will disperse. These two substances have contrary properties but respond so effectively. Han Yong from Qingliu suffered from foot disease and used this method. After one dose, the illness improved by seventy to eighty percent; after a second dose, he was cured.
【Attached Prescriptions】 Three old prescriptions, nineteen new prescriptions.
Edema with abdominal fullness: Gansui (stir-fried) 2.2 qian, Black Morning Glory Seed (*Hei Qianniu*) 1.5 liang, powdered. Decoct in water and sip frequently (*Puji Fang*).
Water qi outside the membranes: Gansui powder and barley flour, each half liang. Mix with water to make cakes, roast and eat to induce bowel movement (*Shengji Zonglu*).
Severe swelling of body and face: Gansui 2.5 qian, ground raw into powder. Take one pig kidney, cut into seven pieces, insert the powder inside, wrap in wet paper, roast until cooked, and eat. One dose per day. After four or five doses, one should feel abdominal rumbling and increased urination, which indicates efficacy (*Zhouhou Fang*).
Kidney water flowing downwards causing leg and knee spasms, and swelling/pain in limbs: Add 4 qian of *Aquilaria sinensis* (Muxiang) to the above prescription. Use 2 qian each time, roast until cooked, chew with warm wine. Passage of yellow water is the sign of efficacy (*Yuyao Yuanfang*).
Zhengshui (True Water) distension and urgency, severe difficulty in urination and defecation: Gansui 5 qian (half raw, half stir-fried), Ten pieces of *Carthamus tinctorius* stained seeds (Yanzhi Huaizi), ground evenly. Take 1 qian each time, mix with 4 liang of white flour, form into chess-piece sized balls, boil in water until floating, eat blandly. After urination and defecation resume, take Pingwei San with prepared Aconite (*Shu Fuzi*), 2 qian decocted and taken orally (*Puji Fang*).
Pediatric malnutrition edema: Bead-like Gansui (stir-fried) and Green Tangerine Peel (*Qing Jupi*) in equal parts. Powdered. For a three-year-old, take 1 qian, administered with malt soup. Stop when bowel movement occurs. Avoid sour and salty foods for three to five days. Named Shuibao San (*Zongwei Lun*).
Hydrops with wheezing and distension: Gansui and *Euphorbia pekinensis* (Daji), each 1 liang. Roast slowly on low fire and grind. Take one zi each time, with half a zhan of water, boil for three to five boils and drink. Do not exceed ten doses (*Shengji Lu*).
Edema with wheezing urgency, blockage of both urination and defecation: Shizao Wan: Equal parts of Gansui, Daji, and *Genkwa flos* (Yuanhua). Powdered, mixed with jujube pulp to make pills the size of wutong seeds. Take 40 pills early morning with hot water. Stop when yellow water is discharged via stool. Otherwise, take again at noon (*Sanyin Fang*).
Pregnancy edema and fullness, shortness of breath, lower abdominal fullness, difficulty in urination/defecation, unresponsive to Zhu Ling San: Use 2 liang of red-skinned Gansui from Mount Tai, sift, mix with white honey to make pills the size of wutong seeds. Take 50 pills each time. If mild diarrhea occurs, continue taking Zhu Ling San. If no effect, take again. Zhu Ling San is listed under Zhu Ling (*Duanju Fang*).
Retained fluid below the heart, hardness/fullness, hidden pulse, patient desires spontaneous diarrhea but feels relief: Gansui Banxia Tang: Use three large Gansui roots and twelve Banxia. Decoct in one sheng of water to half a sheng, strain. Add five Shaoyao and one section of Gancao. Decoct in two sheng of water to half a sheng, strain. Add half a sheng of honey, decoct together to eight he. Take in one dose to induce discharge (*Jingui Yufan* by Zhang Zhongjing).
Four Semen *Momordica cochinchinensis* (Mubiezi) kernels, powdered. One pig kidney, remove membrane, slice, sprinkle 4 qian of medicine inside, wrap in wet paper, roast until cooked. Eat on an empty stomach, swallow with rice drink. After ingestion, extend both legs. After bowel movement, eat white porridge for two to three days for best results (*Benshi Fang*).
Blockage of both urination and defecation: Gansui powder, mixed with raw flour paste, applied to the umbilicus and Dantian point. Moxibustion of three cones. Drink Gancao soup. Stop when patent. Alternatively, 1 liang of red-skinned Gansui from Mount Tai, mixed with refined honey, divided into four doses. Take one dose daily to induce discharge (*Shenghui Fang*).
Acute urinary retention (Zhuan Pao): Gansui powder 1 qian, taken with Zhu Ling Tang. Immediate relief (*Bifeng Zaxing Fang*).
Hernia with unilateral swelling: Gansui and *Foeniculum vulgare* (Huixiang) in equal parts. Powdered, taken with wine, 2 qian (*Rumen Shiqin*).
Women's blood knotting: Women with lower abdominal fullness like a pot, slight difficulty in urination but no thirst, indicating water and blood knotting in the Blood Chamber: Rhubarb (*Dahuang*) 2 liang, Gansui and *Colla Corii Asini* (Ejiao) each 1 liang. Decoct in 1.5 sheng of water to 0.5 sheng. Take in one dose. Blood clot should pass (*Zhang Zhongjing Formula*).
Diaphragmatic qi choking and dysphagia: Gansui (flour-roasted) 5 qian, Southern *Costus root* (Nanmuxiang) 1 qian. Powdered. Strong constitution takes 1 qian, weak takes 0.5 qian. Mixed with water and wine (*Guai Bing Qi Fang*).
Pi syndrome with fever and night sweats, chest and back pain: Gansui wrapped in flour, boiled in bean water for ten boils. Remove flour, stir-fry with fine bran until yellow, then powder. Adults take 3 qian, children 1 qian. Take with cold honey water before sleep. Avoid greasy meat and fish.
Xiaoke (Wasting-Thirst) with excessive drinking: Gansui (bran-stir-fried) half liang, Coptis (*Huanglian*) 1 liang. Powdered, made into pills the size of mung beans with steamed bread dough. Take two pills with mint tea. Avoid Gancao (*Yang Shi Jiacang Fang*).
Epilepsy and Heart Wind: Suixin Dan: Treats wind-phlegm confusing the heart, epilepsy, and women's heart wind/blood evil: Gansui 2 qian, powdered. Take three tubes of blood from a pig heart, mix with medicine, place back into the pig heart, tie securely, wrap in paper, roast until cooked. Grind into powder, add 1 qian of Cinnabar (*Chensha*) powder, divide into four pills. Take one pill each time, decoct the pig heart in water to swallow. Passage of foul matter in stool indicates efficacy; if not, take again (*Jisheng Fang*).
Ma Pi Feng disease: Pediatric wind-heat causing wheezing, restlessness, and discomfort, called Ma Pi Feng: Gansui (flour-boiled) 1.5 qian, Cinnabar (water-triturated) 2.5 qian, Calomel (*Qingfen*) one corner. Powdered. Take one zi each time, with a little grain water, drop a small point of oil, scoop medicine on top, let sink, remove water and administer. Named Wujia San (*Quanyou Xinjian*).
Numbness and pain: Wanling Gao: Gansui 2 liang, *Ricinus communis* kernel 4 liang, Camphor (*Zhangnao*) 1 liang. Pound into a cake and apply. Internally drink Gancao soup (*Zhai Xuan Fang*).
Sudden deafness and ear blockage: Half cun of Gansui, wrapped in silk, inserted into both ears. Chew a little Gancao in the mouth. The ears will naturally clear suddenly (*Yonglei Fang*).