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Edema arises from various causes. Generalized edema, edema of the four limbs, facial edema, and pedal edema are collectively referred to as Water Qi (Water Pathogen) disease. However, edema is categorized into Yang Edema and Yin Edema. In both cases, it is appropriate to initially administer Wupi Yin (Five-Bark Decoction), Shengjiang Tang (Ascending-Descending Decoction), or Chushi Tang (Dampness-Expelling Decoction), adding Semen Momordicae (Mugua, 木瓜) and Pericarpium Citri Reticulatae Viride (Fupi, 大腹皮) each at half a qian. If there is no effect, proceed with Simo Yin (Four-Gargle Decoction) and concurrently swallow Guihuang Wan (Cinnamon-Yellow Pill). The term "edema" is generally called "Zhong," referring to the accumulation of Cold and Heat Qi. Whether it is Yin Edema, Yang Edema, or Gu Zhang (Gu Distension), while taking medicine, it is advisable to assist with Adzuki Bean Porridge externally/dietarily.

Generalized edema accompanied by irritability and thirst, dark and scanty urine, and frequent constipation belongs to Yang Edema. For mild cases, Simo Yin is appropriate, with raw Zhiqiao (Fructus Aurantii Immaturus) added for grinding, along with Radish Drink. For severe cases, Shuozao Yinzi (Scouring Decoction) or Wanling Yin (Ten-Thousand-Spirit Decoction) should be used to promote diuresis, aiming for patency.

In cases where there is irritability and thirst but the stool is already loose, further purgation is contraindicated. It is appropriate to use Wuling San (Five-Ingredient Powder with Poria), adding Tongcao (Akebia Stem) and Fupi each at half a qian to promote urination; alternatively, Fenxin Qi Yin (Heart-Qi Separating Decoction) may be used.

Generalized edema without irritability or thirst, with normal or loose stools, and although urine volume is low, it is not painful or red, belongs to Yin Edema. Shipi Yin (Spleen-Strengthening Decoction) is appropriate. If the urine volume is normal, sometimes red and sometimes not, becoming slightly red in the evening but without dysuria, this also belongs to Yin Edema. Hasty tonification is contraindicated here. Muxiang Liqi Yin (Costus Flowing-Qi Decoction) is appropriate, followed by Fuyuan Dan (Restoring Primordial Pill). If the stool is not loose but there is abdominal distension and fullness, Simo Yin is appropriate, administered with Heixi Dan (Black Tin Pill).

Edema caused by dampness invasion presents with generalized swelling, but heaviness from the waist down to the feet, with leg distension being more severe than elsewhere. Qi flow may be rapid or normal, and stool may be loose or normal. Only promoting diuresis is indicated. Frequent use of Wuling San and swallowing Mugua Wan (Momordica Pill) is advised, occasionally using Chushi Tang with added Mugua and Fupi each at half a qian, and fried Raphani Semen (Luobozi, 萝卜子) ground to 7.5 fen.

Patients who develop sores and use drying topical medicines too early may result in generalized edema. Other remedies should not be applied arbitrarily. If stool is obstructed, Shengma Heqi Yin (Immature Bitter Orange and Cimicifuga Harmonizing-Qi Decoction) is used. If stool is normal or spontaneously loose, Qi should be guided out through urination. Wupi Yin combined with Shengliao Wuling San (Raw-Material Five-Ingredient Powder with Poria) is appropriate. If abdominal swelling is localized only below, Chushi Tang combined with Shengliao Wuling San, adding Mugua and herbs like Ze Xie (Alisma Rhizome), is suitable.

Edema of the feet resulting from Kidney Qi sinking to the lower part should be treated at its root (the Kidneys). Do not arbitrarily apply medicines for Hongjiaojiao (Hongjiao, often referring to gout or varicose veins). When Qi enters the Kidney, foot swelling appears first, followed by Kidney pain; when Kidney Qi stagnates, Kidney pain appears first, followed by foot swelling. If the five centers (palms, soles, and chest) are sunken and flat, lips are swollen, and the umbilicus protrudes, the condition is incurable.

Post-illness edema is due to Spleen Deficiency. Use two parts Pingwei San (Peaceful Stomach Powder) and one part Wuling San, mixed evenly, taken with decoction water, or decocted as raw materials. Alternatively, use Shengliao Pingwei San with added Mugua, Fupi, and Renshen (Ginseng Root) each at half a qian, and Fu Ling (Poria) at one qian; or use Liujunzi Tang (Six-Gentleman Decoction) with added Muxiang (Costus Root) at half a qian. For severe generalized edema, Muxiang Liqi Yin can be used. For whole-body edema, eating one or two frogs after removing skin and roasting them over fire can reduce swelling. There are cases of isolated abdominal distension where these methods are ineffective.

To treat Yang Edema, burn lotus leaves until carbonized but retaining their nature, grind into powder, and take with rice water. Lotus leaf ash can make a person thin. Some people today feign illness to appear slender, consuming only lotus leaf ash, which thus reduces swelling.

If the edematous area is hot, red, swollen, and hard, the patient may experience chills and high fever, carbuncles, or generalized sores with swelling. Refer to the "Sores and Toxins Section."

Edema of the four limbs is called Zhi Zhong (Limb Edema). Wupi Yin with added Jianghuang (Curcuma Longa Rhizome) and Mugua each at one qian is appropriate, or Simo Yin.

Pedal edema refers to the Hongjiao syndrome described in this section.

Isolated facial edema is treated with Suzi Jiangqi Tang (Perilla Fruit Descending-Qi Decoction), especially if accompanied by shortness of breath. After decocting and straining, add Chenxiang (Aquilaria Wood) ground to a sip.

In cases where only the face and both feet are edematous, with facial swelling worse in the morning and pedal swelling worse in the evening: The Classics state, "Facial swelling is Wind, Pedal swelling is Water." This is caused by Wind-Dampness. One must inquire about the patency of bowel and bladder movements to distinguish between Yin and Yang syndromes. The primary prescription throughout is Chushi Tang with added Muxiang, Fupi, and Baizhi (Angelica Dahurica Root) each at half a qian, which can be used universally. Alternatively, half doses of Suzi Jiangqi Tang and Chushi Tang can be decocted together.