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In addition to Pi Yin (Skin Decoction), add Jianghuang (Curcuma Longa Rhizome) and Mugua (Chaenomeles Fruit) each one qian. Alternatively, use Simo Yin (Four-Step Decoction). Or use Baizhu (Atractylodis Macrocephalae Rhizoma) three liang, cut into pieces, take half a liang per dose, add one and a half cups of water, three Jujubae Fructus (Chinese Date), crushed, decoct together until nine-tenths remain, remove the dregs, and take warm. Take three times a day without fixed time; this formula is named Dazao Tang (Jujube Decoction). If only the face is swollen, Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction) is suitable, especially for those with shortness of breath. After decocting and filtering the dregs, grind Chenxiang (Aquilaria Lignum) one xi and mix in. There is a condition where only the face and both feet are edematous throughout the body; in the morning the face swells more, and in the evening the feet swell more. The Classics state: "Facial swelling is due to Wind, foot swelling is due to Water." This is caused by Wind-Dampness. One must inquire about the patency or obstruction of urination and defecation to distinguish between Yin and Yang syndromes. For medication before and after, Chushi Tang (Dampness-Removing Decoction) added with Mugua (Chaenomeles Fruit), Fupi (Tangerine Peel), and Baizhi (Angelicae Dahuricae Radix) each half a qian can be used universally. Or decoct half a portion of Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction) and half a portion of Chushi Tang (Dampness-Removing Decoction) together. Luo Qianfu's Daozhi Tongjing Tang (Stagnation-Resolving and Meridian-Unblocking Decoction) treats edema of the face, eyes, hands, and feet. For those swollen due to contracting Dampness, although the whole body is swollen, the heaviness from the waist down to the feet is particularly severe, and leg distension is worse than elsewhere. Breath may be rapid or not, stool may be loose or normal, but it is best to promote diuresis. Swallow Mugua Wan (Chaenomeles Pill) with Wuling San (Five-Ingredient Powder with Poria). (Note: It contains Niuxi (Pipelinellae Rhizoma), so do not take lightly.) Intermittently take Chushi Tang (Dampness-Removing Decoction) added with Mugua (Chaenomeles Fruit) and Fupi (Tangerine Peel) each half a qian, and fried Laifuzi (Radish Seed) seven and a half fen. For swelling due to Qi stagnation, the pulse is deep and hidden, or there is abdominal distension or panting; Fenqi Xiangsu Yin (Qi-Separating Aromatic Perilla Drink) is suitable. For swelling due to dietary injury, or chest fullness or belching, Xiaodao Kuanzhong Tang (Digestion-Promoting and Middle-Widening Decoction) is suitable. For swelling due to incompatibility with local climate/water and soil, Weiling Tang (Gastrodia and Atractylodes Decoction) or Jiawei Wupi Tang (Modified Five-Peel Decoction) is used. For patients who developed sores and used drying topical medicines too early, causing generalized edema, Xiaofeng Baidu San (Wind-Expelling and Toxin-Resolving Powder) is suitable. If stool is obstructed, Shengma Heqi Yin (Cimicifuga Harmonizing Qi Drink) is used. If stool is normal or self-limiting diarrhea, guide the Qi out through urine using Wupi Yin (Five-Peel Drink) combined with Shengliao Wuling San (Unmodified Five-Ingredient Powder with Poria). If the abdomen is swollen, specifically in the lower abdomen, Chushi Tang (Dampness-Removing Decoction) combined with Shengliao Wuling San (Unmodified Five-Ingredient Powder with Poria) is suitable, adding Mugua (Chaenomeles Fruit) in the same quantity as Zexie (Alisma Rhizoma). The above items belong to Excess (Shi) syndromes. Edema after a major illness is due to Spleen Deficiency; Jiawei Liujunzi Tang (Modified Six-Gentlemen Decoction) is suitable. Baizhu (Atractylodis Macrocephalae Rhizoma) three qian, Renshen (Ginseng Radix), Huangqi (Astragali Radix) each one and a half qian, Baifuling (Poria with Hostwood) two qian, Chenpi (Tangerine Peel), Banxiaqu (Pinellia Fermented Paste), Shaoyao (Peony Root), Mugua (Chaenomeles Fruit) each one qian, Zhigancao (Honey-fried Licorice Root), Fupi (Tangerine Peel), Mugua (Chaenomeles Fruit) each five fen, decoct with Shengjiang (Fresh Ginger) and Dazao (Jujube). If urination is difficult, intermittently add Wuling San (Five-Ingredient Powder with Poria). For those with weak Spleen and Lung unable to regulate water passages, Buzhong Yiqi Tang (Middle-Warming and Qi-Supplementing Decoction) tonifies Spleen and Lung, and Liuwei Wan (Six-Ingredient Pill) tonifies Kidney. For Heart Fire suppressing Lung Metal, failing to generate Kidney Water, leading to difficult urination and Water Syndrome, Ren Shen Ping Fei San (Ginseng Calming Lung Powder) treats the Lung, and Ziyin Wan (Nourishing Yin Pill) moistens urination. For Kidney Yin deficiency with deficient fire scorching Lung Metal, resulting in no urine production, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) tonifies Kidney Water, and Buzhong Yiqi Tang (Middle-Warming and Qi-Supplementing Decoction) cultivates Spleen Earth. When Lung, Spleen, and Kidney Qi communicate, food and drink will naturally transform. If these two organs are already deficient, gradually forming Water Distension, and mistakenly using Qi-moving and diuretic drugs, leading to difficult urination, panting, and profuse phlegm, becoming Gu Distension, Jiajian Jingui Shenqi Wan (Modified Golden Cabinet Kidney Qi Pill) is the main treatment. The above items belong to Deficiency (Xu) syndromes. Deficiency refers to insufficient Righteous Qi. Excess refers to abundant Pathogenic Qi. Wherever Pathogenic Qi gathers, Righteous Qi must be deficient. Therefore, treating Excess with methods for Deficiency is acceptable, but treating Deficiency with methods for Excess is not. Jiegou's method: For edema due to Qi, add Chenpi (Tangerine Peel). For edema due to Dampness, decoct Fangji Huangqi Tang (Stephania and Astragalus Decoction) and mix with Wuling San (Five-Ingredient Powder with Poria). For edema due to Heat, Bazheng San (Eight-Righteous Powder) is used. If swelling is due to Heat-Dryness in the Lung, this cuts off the source of water. One should clear the Lung and remove dryness, and water will naturally generate. Add Huangqin (Scutellaria Root) to Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction). If Heat in the Lower Jiao consumes Yin, preventing Qi transformation, one should benefit Yin so that Yang transforms naturally, such as adding Huanglian (Coptis Rhizoma) to Huangbai (Phellodendron Bark). For Water Distension, one should open the Ghost Gates (induce sweating) and purify the Fu Organs (promote urination); Bai Fuling Tang (White Poria Decoction) is the main treatment. Bai Fuling Tang (White Poria Decoction) transforms water, composed of Bai Fuling (Poria), Zexie (Alisma Rhizoma) each two liang, Yuliren (Prunus Armeniaca Seed) five qian. Decoct one bowl of water until half remains, add fresh ginger juice, take regularly without fixed time, increasing dosage gradually. After five to seven days, if lower abdomen swells again, treat with Baizhu San (Atractylodes Powder): Baizhu (Atractylodis Macrocephalae Rhizoma), Zexie (Alisma Rhizoma) each half a liang, powdered, decoct and take three qian. Pills are also acceptable, take thirty pills with decocted Fuling Tang (Poria Decoction). Maintain health with Huangqi Shaoyao Jianzhong Tang (Astragalus and Peony Middle-Warming Decoction) and similar formulas. After recovery, avoid sexual intercourse, pork, fish, salt, and flour. Xiangru (Mosla Herb) boiled into paste, formed into pills the size of paulownia seeds, take five pills each time, three times daily, gradually increasing until urination is smooth. Winter melon, eat as much as desired. One carp weighing over one jin, boil thoroughly, take the broth, and make soup with winter melon and green onion white. Green-headed duck or white duck, prepare as food, chop finely, cook with rice and five flavors into porridge, take on an empty stomach. Scholar He Bozhai said: The mechanism of creation is merely Water and Fire; they should be balanced, not biased; united, not separated. Water manifests as Damp-Cold, Fire as Dry-Heat. Fire flares upward, Water moistens downward. Thus, Fire should be below, Water above, facilitating union. Union constitutes the Hexagram Ji Ji (After Completion); non-union constitutes Wei Ji (Before Completion). Extreme non-union leads to separation and death. Xiao Ke (Wasting-Thirst) syndrome is non-union with Fire prevailing; Shui Qi (Water Qi) syndrome is non-union with Water prevailing. Restraining bias to achieve union is the treatment method. Small Fire cannot transform large Water; thus, one must first drain Water, then tonify Fire. Opening Ghost Gates drains Water in the exterior and upper parts; Purifying Fu Organs drains Water in the interior and lower parts. Once Water volume decreases, use warm medicines to tonify Original Qi to unite Water and Fire; this is the sequence of medication. Furthermore: Lu attributed Edema to Liver, Kidney, and Stomach, omitting Spleen. Danxi criticized him, seemingly rightly, but actually both were wrong. Creation produces life through Heaven and Earth, Water and Fire. Heaven dominates, Earth completes. As stated, Qian knows the beginning, Kun forms the object. The function of Heaven and Earth union and change lies in Water and Fire Qi. Heaven circulates Water and Fire Qi within Earth, generating things. However, Water and Fire cannot prevail excessively. Too much drought prevents growth (Fire prevails); too much flood prevents growth (Water prevails). Balance of Water and Fire allows growth; this is natural law. In humans, Zang-Fu organs prioritize Spleen and Stomach. Food enters Stomach and is transported by Spleen, like Earth. Whether Spleen and Stomach can transform substances depends on Water and Fire Qi, not Spleen and Stomach alone. Fire excess makes Spleen-Stomach dry; Water excess makes Spleen-Stomach damp; neither can transform substances, leading to diseases. Edema is essentially Water excess with Fire inability to transform. Fire decline means inability to transform Water; thus, Water entering Spleen-Stomach seeps into blood vessels and flesh/bone, blood transforms to water, flesh swells—this is natural. Drain the Water to reduce Water Qi, then tonify Fire to balance the two Qi, and the disease resolves. Danxi claimed Spleen failure in transport was due to Liver Wood insulting Spleen, suggesting clearing Heart Fire so Lung Metal could control Liver Wood, allowing Spleen Earth to fully transport, making Water flow smoothly without swelling. His words were circuitous and imprecise, hence this refutation. Note: Although He Gong was not deeply proficient in medicine, his discussion on Water and Fire was unprecedented in medical texts and should be preserved; thus attached here.

[Diagnosis] Slight swelling of the eye sockets, resembling a sleeping silkworm, indicates Water Disease. Swelling of the shins and calves indicates Water Disease. Pulsation in the neck vessel, panting, and rapid cough indicate Water Disease. After diarrhea, thirst with desire to drink water, difficult urination, abdominal fullness followed by swelling, this method indicates impending Water Disease. If urination is free and sweating occurs, recovery is expected. The Duyang Pulse should be hidden; now it is rapid. Originally having internal Heat, consuming food quickly, frequent urination, now urination is difficult; this suggests impending Water Disease. Cun Kou Pulse floating and slow: Floating indicates Heat, Slow indicates submergence. Heat and Submergence interacting is called Chen (Deep). Duyang Pulse floating and rapid: Floating indicates Heat, Rapid indicates stopping. Heat and Stopping interacting is called Fu (Hidden). Chen and Fu interacting is called Water. Deep implies collateral emptiness; Hidden implies difficult urination. Emptiness and Difficulty interacting causes Water to move into skin, resulting in Water Disease. Any Deep pulse warrants suspicion of Water; body swelling and heaviness confirm it. In Water Disease, if the pulse emerges (floating and forceless at the root), death ensues. (San Yin Fang states: Generally, a Floating-Rapid pulse indicates latent Cold-Due-to-Deficiency within; prolonged, it becomes Deep-Hidden. Deep-Hidden implies Yang Deficiency and Yin Excess, inevitably leading to Water Disease.) Facial edema with pain, blackish color, excessive sweating, and aversion to wind belongs to Kidney Wind. Yang Water combined with Yang Syndromes has a Deep-Rapid pulse. Yin Water combined with Yin Syndromes has a Deep-Slow pulse. Deep and Slippery indicates Feng Shui (Wind Water). Floating and Slow, Wiry and Tight all indicate swelling. In Water Disease, a洪大 (Surging-Large) pulse is treatable; Micro-Fine is untreatable. (Also: Floating-Light indicates survival; Deep-Fine-Empty-Small indicates death. Also: Excess indicates survival; Deficiency indicates death.) Black lips indicate Liver injury. Flat clavicular fossa indicates Heart injury. Protruding umbilicus indicates Spleen injury. Flat soles indicate Kidney injury. Flat back indicates Lung injury. These five injuries are incurable.