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Edema with a洪大 (Hongda, surging and large) pulse is treatable; one with a微细 (Weixi, fine and thin) pulse is not. In edema accompanied by abdominal distension and obstruction, a浮大软 (Fudai ruan, floating, large, and soft) pulse indicates survival, while a沉细虚小 (Chenxi xuxiao, deep, fine, deficient, and small) pulse indicates death. In edema where the abdomen is enlarged like a drum, a实 (Shi, excess/full) pulse indicates survival, while a虚 (Xu, deficient/empty) pulse indicates death.

The *Yuan Bing Shi* states: Some say that edema arises from Spleen deficiency failing to control Kidney water, causing water qi to act recklessly. Since the Spleen governs the four limbs, the water qi wanders through the limbs, causing swelling of the entire body and face. This argument seems plausible but is actually incorrect. The treatment for edema and abdominal distension should prioritize bitter-pungent cold herbs to vigorously promote urination and defecation. The Classics state: "For fullness in the center, treat it internally." If this is so, how can it be attributed to Spleen Earth deficiency? This view directly contradicts the *Su Wen*. The Classics state: "All dampness, swelling, and fullness belong to Spleen Earth." It also states: "What Taiyin governs... swelling." Furthermore: "Excess dampness leads to loose stools; severely, it leads to water retention and edema." All these refer to an excess of dampness in Taiyin Spleen Earth. Additionally, the Classics state: "All abdominal distensions and enlargements belong to Heat." It also says: "All pain, itching, and sores belong to Fire." And: "Excess heat leads to swelling." These all refer to excess-heat of Heart Fire. How can one claim Spleen deficiency fails to control Kidney water? Therefore, various forms of edema are a combination of Damp-Heat. Just as in the sixth month, when Damp-Heat is excessive and all things flourish and swell, the phenomenon of edema is clearly visible. Thus, the ancients prescribed bitter-pungent cold herbs for treatment, assisting with pungent herbs to dissipate stagnation and bitter herbs to dry dampness, using cold properties to remove heat. As dampness is removed, stagnation dissipated, and heat recedes, Qi becomes harmonious. Those who absurdly claim Spleen deficiency fails to control Kidney water merely argue that frequent purgation leads to fluid accumulation. They fail to realize that the hot toxicity of Crotonis Fructus (Badou, 巴豆) depletes the Yin Qi of Kidney Water, causing Heart Fire and Spleen Earth to become excessive. Damp-Heat combats each other, leading to Qi stagnation and epigastric fullness, urinary difficulty, and edema. At this point, purgation is even more appropriate because bitter-pungent cold herbs can eliminate Damp-Heat and resolve Qi stagnation and epigastric fullness. Regarding the worldly transmission of using Calomel (Yinfen, 银粉) to cure edema, it is because it excels at opening Qi stagnation and epigastric fullness. However, one must never overuse it to cause harm. Moreover, Calomel can also damage the teeth; it is said that its toxic vapor affects the intestines and stomach, but the spirit, Qi, blood, and food essence can overcome its toxicity. Thus, the toxic vapor travels up along the meridians to the tender and thin parts of the gums, causing harm. The spaces between the upper and lower teeth are traversed by the Hand and Foot Yangming meridians. Whenever using this medicine, one must first secure and protect the Spleen and Stomach. Others say that Yin Edema involves whole-body swelling accompanied by aversion to cold; this is simply a Cold syndrome, not otherwise.

Danxi stated: "All Qi condensation and depression belong to the Lung; all dampness, swelling, and fullness belong to the Spleen; all abdominal distensions and enlargements belong to Heat." Dampness is the Qi of Earth, and Earth is the child of Fire. Therefore, Damp diseases often arise from Heat, and Heat Qi can also originate from Dampness; this is the child Qi influencing the mother Qi, a transformation of Dampness. For all swelling diseases, the primary treatment focuses on resolving the swelling, but methods vary according to accompanying pathogenic factors. Lu Dijing analyzed water distension, attributing it to the Kidney, Liver, and Stomach meridians, excluding the Spleen. He subsequently discussed the theory that Lung Metal abundance generates Water and Water fluids flow recklessly. Is this logical? When Spleen Earth is diseased, the Lung acts as its child. How can a strong child generate Water? If the water in swelling were truly generated by the clear Qi of Lung Metal, it would nourish Kidney Yin, execute descending functions, and serve as the source of bio-transformation. How could it cause swelling? Now, penetrating collaterals and flowing into valleys, it is turbid and putrid Qi obstructing Jin-Ye (Body Fluids). Over time, it pours into tunnels, and Blood transforms into Water. One might seek to use Spleen Earth to control it or guide Kidney Qi to promote diuresis. However, one fails to consider that when the Spleen is diseased, Liver Wood attacks it. The child Qi declines further; with Wood lacking fear, the Spleen cannot avoid disease. The treatment method should clear Heart Meridian Fire, tonify and nourish Spleen Earth, fully restoring its transportation and transformation duties. Lung Qi descends, the infiltration pathways open, and turbid Qi is cleared. The slightly clearer portion returns to become Qi, Blood, and Jin-Ye. The severely turbid portion manifests as sweat above and urine below, gradually dispersing. Lu did not clarify this but instead spoke of controlling and drying water, which is akin to Bai Gui treating neighboring countries as ditches.

Respectfully, Hejian's discussion on Water Qi emphasizes Spleen Earth and excessive Dampness as the pathology, referring to Excess syndromes. However, cases caused by Spleen deficiency receiving Dampness or self-generated excessive Damp-Heat resulting in Deficiency are far more common. Therefore, Danxi's arguments are included for readers to examine carefully. Nevertheless, the *Mai Jing* discusses excessive Heat causing Metal decline; Metal abandons Earth Mother and returns to Water. Water stores Fire Spirit; Earth loses its Child. Its Qi becomes weak, Water overflows, soaking like a pool, striking the skin, causing facial and ocular swelling, returning to the four limbs. Ignorant physicians see Water and blindly purge downward, causing empty Spleen and Stomach, allowing Water to reside there (see text). This is essentially the root disease of the Zang organs. Water is the origin of things; Earth is the mother of things. Yet if Origin and Mother fall ill, True Qi is endangered. Thus, blind purgation is forbidden. From this perspective, for Water Qi diseases not caused by Qi stagnation, diet, or Damp-Heat, blind purgation is strictly prohibited, lest it affect the True Zang organs. Therefore, Danxi's elucidation of Lung, Kidney, and Spleen meanings thoroughly embodies this principle.