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[Symptoms of Retained Fluid] The *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) states: When fluid is retained under the heart, the patient experiences coldness on the back, covering an area the size of a palm. It further states: Regarding retained fluid (Liu Yin), there is pain in the hypochondrium radiating to the Quepen point (LI 18), which intensifies upon coughing. Additionally, when retained fluid exists in the chest, the patient suffers from shortness of breath and thirst, wandering pain in the four limbs and joints, and a deep pulse; this indicates the presence of retained fluid.

[Etiology of Retained Fluid] Initially, water-fluid stagnates and condenses into phlegm-fluid. After a long time without resolving, it is termed retained fluid. "Retained" implies accumulation without dispersion. When fluid remains in the back, it obstructs the ascending Yang of the Du Mai (Governing Vessel), causing back coldness. The Shaoyang Gallbladder and Liver meridians pass from Quepen (LI 18) through the lateral costal region; fluid retention in the hypochondrium obstructs the rising Qi of the Liver and Gallbladder, resulting in hypochondriac pain radiating to Quepen. Retained fluid in the chest causes shortness of breath, thirst, and pain in the limbs and joints.

[Pulse of Retained Fluid] The pulse is mostly deep, indicating retained fluid in the chest. A bilateral wiry pulse indicates Cold; a unilateral wiry pulse indicates Fluid.

[Treatment of Retained Fluid] If the patient's pulse is hidden (Fu) and they desire spontaneous diarrhea, feeling relief after defecation, yet the epigastrium remains hard and full despite the diarrhea, this signifies that the retained fluid is attempting to exit but has not fully resolved.
Gansui Banxia Tang (Kansui and Pinellia Decoction)
Gansui (Kansui Radix), Banxia (Pinelliae Rhizoma), Shaoyao (Paeoniae Radix), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma).

[Symptoms of Hidden Fluid] Phlegm-fullness, wheezing, and coughing. Upon attack, symptoms include aversion to cold with fever, backache, and lumbago, spontaneous tearing, and severe tremors of the body. This is named Hidden Fluid (Fu Yin).

[Etiology of Hidden Fluid] Water-fluid does not disperse but hides in the chest, obstructing Lung Qi, leading to phlegm-fullness, wheezing, and coughing. Obstruction of Middle Jiao Qi leads to vomiting. If Taiyang exterior pathogens bind externally, aversion to cold with fever and back pain occur. If fluid hides in the Upper Jiao, obstructing the ascending clear Qi, tears flow spontaneously. If fluid hides in the Stomach, Stomach Yang becomes congealed and blocked, unable to circulate, causing severe tremors. The term "attack" (Fa) implies that symptoms like aversion to cold, fever, and back pain appear only when vomiting occurs; if there is no vomiting, there is no attack. Because fluid is hidden internally, external pathogens trigger the onset.

[Pulse of Hidden Fluid] The left pulse is floating and tight, indicating Cold pathogens binding the fluid. The Cun (inch) position is deep and wiry, indicating obstruction in the Upper Jiao. The Guan (middle) position is deep and wiry, indicating congestion in the Zhongwan area. A deep pulse indicates hidden pathogens; a wiry pulse indicates fluid. A deep-wiry pulse is the diagnostic sign for Hidden Fluid.

[Treatment of Hidden Fluid] If there are aversion to cold and fever, the pathogen is in the Exterior. If there is lumbago and back pain, the pathogen is in the Taiyang channel. Here, there is hidden fluid internally and exterior pathogens externally; thus, both Interior and Exterior should be treated simultaneously.
For exterior symptoms such as vomiting, treatment focuses on dispersing from the Exterior.
Xiao Qinglong Tang (Minor Blue Dragon Decoction) (See previous section on Overflowing Fluid).
Mufangji Tang (Stephania Tetrandra Decoction) (See previous section on Pivotal Fluid).

Note by Zhen: The above paragraphs discuss phlegm-fluid according to the *Jin Gui*. This text attributes phlegm-fluid formation to Spleen dampness, distinguishing it from other phlegm syndromes, hence naming it specifically as "Phlegm-Fluid." "Fluid" refers to accumulated water-fluid. Generally, Phlegm is formed due to Fire agitation, while Fluid is caused by Water-Cold.