仲景谓腰以上肿当发汗,腰以下肿当利小便,盖指湿家风水、皮水之肿而言。又谓无水虚肿,当
发其汗,盖指阳气闭结而阴不虚者言也。若温热大伤阴气之后,由阴精损及阳气,愈后阳气暴复,
阴尚亏歉之至,岂可发汗利小便哉!吴又可于气复条下,谓血乃气之根据归,气先血而生,无所根据归,
故暂浮肿,但静养节饮食自愈。余见世人每遇浮肿,便于淡渗利小便方法,岂不畏津液消亡而成三
消证,快利津液为肺痈肺痿证,与阴虚、咳嗽身热之劳损证哉!余治是证,悉用复脉汤,重加甘草,
只补其未足之阴,以配其已复之阳,而肿自消。千治千得,无少差谬,敢以告后之治温热气复者。暑温、湿温不在此例。
人之血,即天地之水也,在卦为坎(坎为血卦)治水者不求之水之所以治,而但曰治水,吾
未见其能治也。盖善治水者,不治水而治气。坎
之上下两阴爻,水也;坎之中阳,气也;其原分自干之中阳,干之上下两阳,臣与民也;干之中阳,在上
为君,在下为师;天下有君师各行其道于天下,而彝伦不叙者乎?天下有彝伦攸叙,而水不治
者乎?此《洪范》所以归本皇极,而与《禹贡》相为表里者也。故善治血者,不求之有形之血,而
求之无形之气。盖阳能统阴,阴不能统阳;气能生血,血不能生气。至于治之之法,上焦之血,责之
肺气,或心气;中焦之血,责之胃气,或脾气;下焦之血,责之肝气、肾气、八脉之气。治水与血之法,
间亦有用通者,开支河也;有用塞者,崇堤防也。然皆已病之后,不得不与治其末;而非未病之先,专治其本之道也。
Zhang Zhongjing stated that edema above the waist should be treated with sweating methods, and edema below the waist should be treated with diuretic methods. This likely refers to the edema caused by Wind-Water (Fengshui) or Skin-Water (Pishui) in patients with dampness constitutions. He further stated that empty edema without fluid retention should be treated with sweating methods, which likely refers to cases where Yang Qi is obstructed but Yin fluids are not deficient. However, after severe damage to Yin Qi by warm-heat pathogens, if Yin essence depletion affects Yang Qi, and after recovery, Yang Qi suddenly rebounds while Yin remains severely deficient, how can one possibly use sweating or diuretic methods? Wu Youke, under the section on Qi rebound, stated that blood is the foundation and destination of Qi; Qi generates before Blood. Without a foundation, temporary edema occurs, which heals itself through rest and dietary regulation. I observe that people often resort to bland and leaching diuretic methods whenever they encounter edema. Are they not afraid that this will consume body fluids and lead to Sanxiao (Three Wasting-Thirst) syndromes? Rapidly draining fluids may result in Lung Abscess (Feiyong) or Lung Flaccidity (Feiwei), as well as consumptive diseases characterized by Yin deficiency, cough, and fever! In my treatment of such conditions, I exclusively use Fumai Tang (Pulse-Recovering Decoction), significantly increasing the dosage of Gancao (Licorice Root). This solely supplements the insufficient Yin to harmonize with the recovered Yang, causing the edema to subside naturally. My treatments have been successful every time without error. I dare to share this with future practitioners treating Warm-Heat Qi Rebound. Shuwen (Summerheat-Warmth) and Shiwen (Damp-Warmth) do not fall under this category.
Human blood is equivalent to the water of Heaven and Earth, corresponding to the Kan hexagram (Kan represents the Blood trigram). Those skilled at managing water do not seek the root cause of why water floods, but merely speak of "managing water"; I have never seen them succeed. Generally, those skilled at managing water manage Qi rather than Water directly. In the Kan hexagram, the upper and lower Yin lines represent Water; the central Yang line represents Qi. The origin stems from the central Yang line of the Qian hexagram. The upper and lower Yang lines of Qian represent ministers and commoners; the central Yang line of Qian, when positioned above, represents the Ruler, and when positioned below, represents the Teacher. Is there any instance in the world where Rulers and Teachers each follow their respective paths, yet ethical order is chaotic? If ethical order is maintained, can water fail to be managed? This is why *Hongfan* (Great Plan) attributes its basis to Huangji (Supreme Ultimate), standing in mutual correspondence with *Yugong* (Tribute of Yu). Therefore, those skilled at treating blood do not seek tangible Blood, but intangible Qi. Yang can command Yin, but Yin cannot command Yang; Qi can generate Blood, but Blood cannot generate Qi. Regarding treatment methods: for Blood in the Upper Jiao, responsibility lies with Fei Qi (Lung Qi) or Xin Qi (Heart Qi); for Blood in the Middle Jiao, responsibility lies with Wei Qi (Stomach Qi) or Pi Qi (Spleen Qi); for Blood in the Lower Jiao, responsibility lies with Gan Qi (Liver Qi), Shen Qi (Kidney Qi), and the Qi of the Eight Extraordinary Vessels. Methods for managing water and blood occasionally include dredging (opening branch channels) or blocking (reinforcing dikes). However, these are measures taken after illness has occurred to address the symptoms (branch), rather than the method of specifically treating the root cause before illness occurs.