海藏水气问难
经云∶诸水身半以下肿者，当利小便，身半以上，当发汗。经云∶身半以上，天气主
之，身半以下，地气主之。天气主之者，其在皮也，其在皮者，故汗而发之。
问曰∶肌肉之外，皮肤之里，首至足一身皆肿者，当作何治？答曰∶亦宜汗之也，与
身半以上同法。身半以上汗之者，尺寸之天地也，故汗之。肌肉之外，皮肤之里，一身
尽肿者，从天而汗之，此表里之浮沉，凡治之法，当如是也。肺心肝肾中州以上俱宜汗，
中州已下皆宜下，如小便利而渴，不宜汗，不宜下，以其重亡津液故也。
问曰∶仲景云∶少阴脉紧而沉，紧则为
痛，沉则为水，小便则难。脉得诸沉，当附骨，身体肿重，水病脉出者死。王叔和云∶水
气浮大即延生。二者不同，何也？答曰∶少阴证当沉，故脉出者死也。此水附骨，以当
沉而下出，则当微出本部，即是得生也。此个出字，出本部之外，故死也。经云∶阴阳
俱虚，脉出者死，与此同意。水气浮大即延生者，总而言之也。五脏六腑，上下表里，及
诸部分，俱在其中矣。此阴盛而阳虚也，故暴出者死。何以然？少阴沉，知周身无阳也。
水病滞塞不通，脉暴出，阳何以周流于一身，养育一体，故死也。腹上肿者属厥阴，腰肿者属肾。
水气求责法
有沉而有力，有沉而无力。有浮而有力，有浮而无力。中得之，亦有有力无力。
水气脉并药
肺沉大肠浮
大腹皮 茯苓 甘遂 大戟 芫花 旋复花 紫菀 陈皮 桑皮 杏仁 木香 葶
苈麻黄 栀子 芍药 白术 生姜皮
心沉小肠浮
桂 枳实 牵牛 芍药 木通
脾沉胃浮
白术 芍药 生姜 赤小豆 枣 槟榔 黄 甘草 石膏
肝沉胆浮
川芎 芍药 细辛
肾沉膀胱浮
泽泻 茯苓 猪苓 白术 木通 灯草 通草 牡蛎 滑石 泽兰 附子 葶苈 瞿麦 车前子 防己
海藏集仲景水气例（水气源流，并出《素问·水热穴论》。）
高低内外，轻重表里，随经补泻，要当谨察肺、胃、肾三经，病即瘥也。
仲景葶苈大枣泻肺汤治 喘嗽痰涎，面目浮肿。
甜葶苈 苦葶苈（等分） 大枣
仲景枳术汤治心下水结如盘。
仲景牡蛎泽泻散治腰以下有水气。
仲景生姜泻心汤 治两胁水气，腹中雷鸣。
仲景甘草附子白术桂枝汤 治阴证自汗，身微肿，风湿相搏，小便不利。
仲景真武汤 治少阴三二日不已，至四五日，腹痛，小便不利，四肢沉重疼痛，自
下利，此为水气。其人或咳，或小便利，或不利而呕者。
仲景十枣汤 大戟 芫花 甘遂（各等分）
三花神佑丸 十枣汤加牵牛 大黄 轻粉（水丸。）
除湿丹 神佑丸加乳香 没药 玄青丹
神佑丸加黄连 黄柏 青黛
上以上四方，药极有毒，不可轻也。
防己黄 汤（仲景，下同）
防己（一两） 黄 （一两二钱半） 白术（七钱半） 甘草（炙，半两）
上锉，每服五钱匕，生姜四片，枣一枚，水一盏半，煎取八分，去滓温服，良久再服。
腹痛，加芍药。一法，洁古用此汤调五苓散，治因湿为肿者。（又云∶防己黄 汤，治风水脉浮为
在表，其人或头汗出，表无他证，病者但下重，从腰以上为和，腰以下常肿，及身重难以屈伸。）
越婢汤 加术四两，即越婢加术汤。（又见痿厥。）
麻黄（六两） 石膏（半斤） 生姜（三两） 大枣（十五枚） 甘草（二两）
以水六升，先煮麻黄，去上沫，纳诸药，煮取三升，分温三服。
大腹皮散
大腹皮 桑白皮 川芎（各二两） 汉防己 羌活 青皮（去白） 大黄（炒） 槟榔 桂心（各
一两） 甘草（炙，半两）
上 咀，每服五钱，水一大盏，煎五分，
去滓，不拘时温服。
楮白皮散
楮白皮 猪苓（去皮） 木通（各二两） 紫苏 茎叶 桑白皮（各三两） 陈皮（去白，一两）
上 咀，每服五钱，水一大盏，生姜三片，煎至六分，去滓，不拘时温服。
防己茯苓汤
防己 黄 桂枝（各三两） 茯苓（六两） 甘草（二两）
水六升，煮取二升，分温三服。
蒲灰散（见淋。）
木香丸
木香 苦葫芦子（炒） 乳香（各二钱五分） 槟榔（二枚，一生一炮） 甘遂（炒令黄） 朱砂
（细研。各半钱）
为细末，以烂饭和，分作四十九丸，面裹。于铫纳水煮熟，令患人和汁吞之，以尽
为度。清晨服药，至午时其水便下，不计行数，水尽自止。
海蛤丸
海蛤（研） 防己（各七钱五分） 陈皮（炒，去白） 郁李仁（去皮，炒。各半两） 赤茯苓（去皮） 桑白
皮葶苈（隔纸炒。各一两。）
上为细末，炼蜜和丸，如桐子大。每服二十丸，加至三十丸，米饮送下，早晚各一服。
槟榔散
槟榔（半两。另研末） 商陆 生姜（各一两） 桑白皮（一两半） 甘草（炙，二钱半）
上除槟榔外，用水二大盏，煎至一大盏，去滓，五更初分作二服，每服调槟榔末二钱
半服，至平明当利，如未利再服。
甘草麻黄汤
甘草（二两） 麻黄（四两）
水五升，先煮麻黄，去上沫，纳甘草，煮取三升，温服一升，重覆汗出，不汗再服。慎风寒。
麻黄附子汤
麻黄（三两） 甘草（二两） 附子（一枚，炮）
水七升，先煮麻黄，去上沫，纳二味，煮取二升半，温服八合，日三服。
杏子汤（未见，恐是麻黄杏仁甘草石膏汤。）
五皮散（《和剂》） 治风湿客于脾经，气血凝滞，以致面目虚浮，四肢肿满，心腹膨胀，
上气促急。兼治皮水，妊娠胎水。
五加皮 地骨皮 生姜皮 大腹皮 茯苓皮（各等分 一方，加白术，磨沉香、木香入。）
上 咀，每服三钱，水一盏，煎七分，热服无时。
五皮散（《澹寮》） 治他病愈后，或疟痢后，身体目四肢浮肿，小便不利，脉虚而大。此
由脾肺虚弱，不能营运诸气，诸气不理，散漫于皮肤肌腠之间，故令肿满也，此药最宜。
大腹皮 赤茯苓皮 生姜皮 陈皮 桑白皮（炒。各等分）
上为粗末，每服五钱，水一大盏，同煎八分，去滓温服，不拘时，日三服。并忌生
冷油腻坚硬之物。
香苏散（《宝鉴》） 治水气虚肿，小便赤涩。
陈皮（去白，一两） 防己 木通 紫苏叶（各半两）
上为末，每服二钱，水二盏，生姜三片，煎至一盏，去滓，食前温服。
除湿汤（见中湿。） 四磨汤（见气。） 桂黄丸（缺。） 保和丸（见伤食。）
疏凿饮子（《济生》） 治水气通身浮肿，喘呼气急，烦躁多渴，大小便不利，服热药不得者。
泽泻 商陆 赤小豆（炒） 羌活（去芦） 大腹皮 椒目 木通 秦艽（去芦） 茯苓皮 槟榔（各等分）
上 咀，每服四钱，水一盏，姜五片，煎七分，不拘时温服。
实脾饮（《济生》） 治阴水发肿，用此先实脾土。
浓朴（去皮，姜制） 白术 木瓜（去穣） 大腹子 附子（炮） 木香（不见火） 草果仁 白茯苓
（去皮） 干姜（炮。各一两） 甘草（炙，半两）
上 咀，每服四钱，水一盏，姜五片，枣一枚，煎七分，不拘时温服。
五苓散（见消瘅。） 木香流气饮（见气。）
复元丹（《三因》） 治脾肾俱虚，发为水肿，四肢虚浮，心腹坚胀，小便不通，两目下肿。
附子（炮，二两） 南木香（煨） 茴香（炒） 川椒（炒，出汗） 浓朴（去粗皮，姜制） 独活 白术（炒）
陈皮（去白） 吴茱萸（炒） 桂心（各一两） 泽泻（一两半） 肉豆蔻（煨） 槟榔（各半两）
上为细末，糊丸如梧桐子大。每服五十丸，不拘时，紫苏汤送下。
黑锡丹（见诸逆冲上。） 苏子降气汤（见气。）
导滞通经汤（《宝鉴》） 治脾湿有余，及气不宣通，面目手足浮肿。
木香 白术 桑白皮 陈皮（各五钱） 茯苓（去皮，一两）
上 咀，每服五钱，水二盏，煎至一盏，去渣温服，空心食前。
《内经》曰∶湿淫所胜，平以苦热，以苦燥之，以淡泄之。陈皮苦温，理肺气，去气
滞，故以为主。桑白皮甘寒，去肺中水气，水肿肤胀，利水道，故以为佐。木香苦辛温，除
肺中滞气；白术苦甘温，能除湿和中，以苦燥之；白茯苓甘平，能止渴除湿，利小便，以
淡渗之，故以为使也。
至元戊寅五月间，霖淫积雨不止，鲁齐许平仲先生，时年五十有八，面目肢体浮肿，
大便溏多，腹胀肠鸣时痛，饮食减少。命予治之，脉得弦细而缓。先生曰∶年壮时多曾
服牵牛、大黄药，面目四肢，时有浮肿，今因阴雨，故大发。予曰∶营运之气，出自中
焦，中焦者胃也，胃气弱，不能布散水谷之气，荣养脏腑经络皮毛，气行而涩为浮肿，大
便溏多而腹肿肠鸣，皆湿气胜也。四时五脏皆以胃气为本，五脏有胃气，则和平而身安。
若胃气虚弱，不能运动，滋养五脏，则五脏脉不和平。本脏之气盛者，其脉独见，轻则
病甚，过则必死。故经曰∶真脏之脉弦，无胃气则死。先生之疾，幸而未至于甚，尚可
调补。人知服牵牛、大黄为一时之快，不知其为终身之害也。遂用平胃散加白术、茯苓、
草豆蔻仁，数服而腹胀溏泻肠鸣时痛皆愈，饮食进，止有肢体浮肿，以导滞通经汤主之，良愈。
木瓜丸（见中风。）
分气香苏饮
桑白皮（炒） 陈皮 茯苓 大腹皮 香附（炒。各一钱） 紫苏（一钱半） 桔梗 枳壳（各八分）
草果仁（七分） 五味子（十五粒）
水二盅，姜三片，煎八分，入盐少许，食前服。
消导宽中汤
白术（一钱五分） 枳实（麸炒） 浓朴（姜制） 陈皮 半夏 茯苓 山楂肉 神曲（炒） 麦芽（炒）
萝卜子（炒，各一钱）
水二盅，姜三片，煎八分服。（小便不利，加泽泻、猪苓。）
胃苓汤
苍术 浓朴（姜汁炒） 陈皮 白术 茯苓（各一钱半） 泽泻 猪苓（各一钱） 甘草（六分） 官
桂（五分）
上水加生姜煎服。
加味五皮汤 即五皮散内，脚肿加五加皮、木瓜、防己。不服水土，入胃苓汤。
消风败毒散
人参 独活 柴胡 桔梗 枳壳（麸炒） 羌活 茯苓 川芎 前胡 甘草 荆芥防风（各一钱）
水二盅，姜三片，煎八分，食远服。
升麻和气散（《和剂》）
干姜（半钱） 干葛（一两） 大黄（蒸，半两） 熟枳壳（半钱） 桔梗 熟苍术 升麻（各一两） 芍
药（七钱半） 陈皮 甘草（各一两半） 当归 熟半夏 白芷 茯苓（各二钱）
每服四钱，水一盏，姜三片，灯芯十茎，煎七分，食前温服。
补中益气汤（见劳倦。） 六味丸（见虚劳。） 人参平肺散（见喘。） 滋阴丸（即益阴肾气丸，见目。）
加减《金匮》肾气丸 治肺肾虚，腰重脚肿，小便不利；或肚腹肿胀，四肢浮肿；或
喘急痰盛，已成蛊证，其效如神。此证多因脾胃虚弱，治失其宜，元气复伤而变证者，非
此药不能救。
白茯苓（三两） 附子（五钱） 川牛膝 官桂 泽泻 车前子 山茱萸 山药 牡丹皮（各
一两） 熟地黄（四两，捣碎，酒拌杵膏）
上为末，和地黄，炼蜜丸如桐子大。每服七八十丸，空心白汤下。（《济生》以附子为君，
此薛新甫重定者。）
调胃白术泽泻散（《元戎》） 治痰病化为水气，传为水鼓，不能食。
白术 泽泻 芍药 陈皮 茯苓 生姜 木香 槟榔（各等分）
上为末。
一法，加白术，本药各半，治脐腹上肿如神。心下痞者加枳实，下盛者加牵牛。
八正散（见淋。） 栀子豉汤（见虚烦。）
附方
汉防己煮散 主水肿上气方。（褚澄秘之。）
汉防己 泽漆叶 石韦（去毛） 桑白皮 泽泻 丹参 茯苓 橘皮 白术（各三两） 生
姜（切 十两） 郁李仁（五合） 通草（一两）
上十二味，捣筛为散，以水一升七合，内四方寸匕，煮取八合，顿服，日二。小便利为度。
葶苈丸 治肺气咳嗽，面目浮肿，喘促不安，小便赤色。
甜葶苈（隔纸炒） 贝母（煨黄色） 木通（各一两） 杏仁（去皮尖双仁，炒） 防己（各二两）
上为细末，用枣肉和丸，如梧桐子大。每服五十丸，桑白皮煎汤，食前送下。
白术木香散 治喘嗽肿满，变成水病者，不能食，不能卧，小便秘者宜服。
白术 猪苓（去皮） 槟榔 赤茯苓 泽泻（各一钱半） 木香 甘草（各一钱） 官桂（七分） 滑
石（三钱） 陈皮（二钱）
上作一服，水二盅，生姜三片，煎一盅，食前服。
分气补心汤 治心气郁结，发为四肢浮肿，上气喘急。
木通 川芎 前胡（去苗） 大腹皮（泡） 青皮 白术 枳壳（麸炒） 甘草（各一钱，炙） 香附
（去毛，炒） 白茯苓 桔梗（各一钱半） 细辛 木香（各五分）
上作一服，水二盅，姜三片，红枣二枚，煎至一盅，食前服。
调荣饮 治瘀血留滞，血化为水，四肢浮肿，皮肉赤纹，名血分。
Questions and Answers on Water-Qi Disease by Hai Zang
The Classic states: For cases where swelling is below the middle of the body, one should promote urination; for swelling above the middle of the body, one should induce sweating. The Classic also states: The upper half of the body is governed by Heaven Qi, and the lower half by Earth Qi. That which is governed by Heaven Qi lies in the skin. Since the pathology is in the skin, it should be treated by inducing sweating.
Question: If swelling occurs from head to foot, both outside the muscles and inside the skin, how should it be treated? Answer: Sweating should also be employed, using the same method as for swelling above the middle of the body. Sweating for the upper half is applicable because that region corresponds to the "Cun and Chi" (pulse positions representing heaven and earth), thus allowing for sweating. For generalised swelling outside the muscles and inside the skin, treatment is also derived from the exterior through sweating. This addresses the floating and sinking of pathogenic factors in the exterior and interior. Generally, treatment should follow this principle. Pathologies involving the Lung, Heart, Liver, Kidney, and areas above the Middle Jiao are suitable for sweating, while those below the Middle Jiao are suitable for purgation. However, if urination is free and thirst is present, neither sweating nor purgation should be used, as this would severely deplete Body Fluids.
Question: Zhang Zhongjing stated: In Shaoyin disease, the pulse is tight and deep; tightness indicates pain, and depth indicates water retention, with difficulty in urination. When various deep pulses are found, it indicates the disease is attached to the bone, accompanied by bodily swelling and heaviness; this is the pulse of water disease. If a water disease patient's pulse suddenly emerges (floating and large without root), it is a death sign. Wang Shuhe stated: A floating and large pulse in water-qì disease prolongs life. These two statements differ; why? Answer: In Shaoyin syndrome, the pulse should naturally be deep. Therefore, if the pulse suddenly emerges, it indicates the collapse of Yang Qi, leading to death. This water pathogen is deeply attached to the bone; the pulse should be deep and directed downward. If it slightly reveals the original pulse quality, survival is possible. The term "emerge" here refers to the pulse exceeding the normal range of its own channel, hence indicating death. The Classic states: When Yin and Yang are both deficient, a sudden emergence of the pulse indicates death, which aligns with the above view. Wang Shuhe’s statement that "a floating and large pulse in water-qì prolongs life" is a generalisation. It encompasses the five Zang and six Fu organs, upper and lower aspects, exterior and interior, and all divisions. This condition represents excess Yin and deficiency of Yang; thus, a sudden emergence of the pulse leads to death. Why? A deep Shaoyin pulse indicates the absence of Yang throughout the body. In water disease, Qi mechanism is stagnant and blocked. If the pulse suddenly emerges, how can Yang Qi circulate throughout the body to nourish it? Hence, death ensues. Swelling in the upper abdomen belongs to the Jueyin channel, and swelling in the waist belongs to the Kidney.
Methods for Investigating Water-Qi Disease
Pulses may be deep and forceful, or deep and non-forceful. They may be floating and forceful, or floating and non-forceful. At the middle pressure level, they may also be forceful or non-forceful.
Water-Qi Disease: Corresponding Pulses and Medicinals for Each Organ
Lung (Deep Pulse), Large Intestine (Floating Pulse)
Dadu Pi (Magnolia Bark), Poria (Fu Ling), Kansui Radix (Gansui), Genkwa Flos (Yanhua), Inula Flower (Xuanfu Hua), Aster Tataricus Radix (Ziwan), Tangerine Peel (Chenpi), Mulberry Root Bark (Sangbaipi), Apricot Seed (Xingren), Costus Root (Muxiang), Lepidium Seed (Tingli), Ephedra Herb (Mahuang), Gardenia Fruit (Zhizi), Peony Root (Shaoyao), Atractylodes Rhizome (Baizhu), Ginger Peel (Shengjiangpi).
Heart (Deep Pulse), Small Intestine (Floating Pulse)
Cinnamon Twig (Gui), Immature Bitter Orange (Zhishi), Morning Glory Seed (Qianniu), Peony Root (Shaoyao), Akebia Stem (Mutong).
Spleen (Deep Pulse), Stomach (Floating Pulse)
Atractylodes Rhizome (Baizhu), Peony Root (Shaoyao), Fresh Ginger (Shengjiang), Red Bean (Chixiaodou), Jujube (Zao), Areca Seed (Binglang), Astragalus Root (Huangqi), Licorice Root (Gancao), Gypsum (Shigao).
Liver (Deep Pulse), Gallbladder (Floating Pulse)
Sichuan Lovage Rhizome (Chuanxiong), Peony Root (Shaoyao), Asarum Root (Xixin).
Kidney (Deep Pulse), Bladder (Floating Pulse)
Alisma Rhizome (Zexie), Poria (Fuling), Polyporus (Zhuling), Atractylodes Rhizome (Baizhu), Akebia Stem (Mutong), Juncus Effusus (Dengcao), Tetrapanax Pith (Tongcao), Oyster Shell (Muli), Talcum (Huashi), Lyonia Berry (Zelan), Prepared Aconite Root (Fuzi), Lepidium Seed (Tingli), Knotweed Herb (Qumai), Plantago Seed (Cheqianzi), Stephania Root (Fangji).
Hai Zang’s Collection of Zhang Zhongjing’s Examples for Water-Qi Disease (The origin and flow of water-qì are derived from *Suwen: Shuire Xuelun*.)
According to the height, interior/exterior, severity, and superficiality/deepness of the condition, apply tonification and draining along the meridians. Carefully examine the Lung, Stomach, and Kidney channels; the disease will then resolve.
Zhang Zhongjing’s Tingli Dazao Xiefei Tang treats wheezing, coughing, excessive phlegm-saliva, and facial/ocular edema.
Sweet Tingli (Lepidium Seed, Tingli), Bitter Tingli (equal parts), Jujube (Dazao).
Zhang Zhongjing’s Zhizhu Tang treats water accumulation in the epigastrium resembling a plate.
Zhang Zhongjing’s Muli Zexie San treats water-qì below the waist.
Zhang Zhongjing’s Shengjiang Xiexin Tang treats water-qì in the hypochondrium and borborygmus in the abdomen.
Zhang Zhongjing’s Gancao Fuzi Baizhu Guizhi Tang treats spontaneous sweating in Yin syndromes, slight bodily swelling, wind-dampness binding, and difficult urination.
Zhang Zhongjing’s Zhenwu Tang treats Shaoyin disease persisting for two to three days, progressing to four or five days with abdominal pain, difficult urination, heavy and painful limbs, and spontaneous diarrhea; this is water-qì disease. The patient may also have cough, free urination, or difficult urination with vomiting.
Zhang Zhongjing’s Shizao Tang
Kansui Radix (Gansui), Genkwa Flos (Yanhua), Mustard Seed (Dazao - *Note: Text lists 'San Hua' ingredients but title says Shizao Tang, standard Shizao Tang uses Da Zao. Text lists Gansui, Yanhua, Gansui again? No, text says "Da Ji, Yan Hua, Gan Sui". Standard is Da Ji, Yan Hua, Gan Sui. Wait, text says "Da Ji, Yan Hua, Gan Sui (each equal part)").*
Correction based on text: Kansui Radix (Gansui), Genkwa Flos (Yanhua), Kansui Radix (Gansui - *Text likely implies Da Ji/Euphorbia, let's stick to text list*: Da Ji, Yan Hua, Gan Sui).
Sanhua Shenyao Wan: Shizao Tang plus Morning Glory Seed (Qianniu), Rhubarb (Dahuang), Calomelas (Qingfen), made into water pills.
Chushi Dan: Shenyao Wan plus Frankincense (Ruxiang), Myrrh (Moyao), Xuanqing Dan.
Shenyao Wan plus Coptis Rhizome (Huanglian), Phellodendron Bark (Huangbai), Indigo Naturalis (Qingdai).
The above four formulas contain highly toxic medicines and must not be taken lightly.
Fangji Huangqi Tang (Zhang Zhongjing, same below)
Stephania Root (Fangji, 1 liang), Astragalus Root (Huangqi, 1 liang 2 qian 5 fen), Atractylodes Rhizome (Baizhu, 7 qian 5 fen), Licorice Root (Gancao, roasted, 0.5 liang).
Cut the herbs. For each dose of 5 qian bi, add 4 slices of fresh ginger and 1 jujube. Add 1.5 sheng of water, decoct to obtain 0.8 sheng, remove dregs, and take warm. Repeat after some time. If abdominal pain occurs, add Peony Root (Shaoyao). Another method: Jiegu used this formula combined with Wuling San to treat edema caused by dampness. (Also stated: Fangji Huangqi Tang treats Fengshui with a floating pulse, indicating the pathogen is in the exterior. The patient may have sweating only on the head, with no other exterior symptoms. The patient feels heaviness in the lower body; the area above the waist is normal, while the area below the waist is constantly swollen, and the body is heavy and difficult to flex or extend.)
Yebibo Tang plus 4 liang of Atractylodes Rhizome (Baizhu) becomes Yebibo Jia Baizhu Tang. (Also seen in Wei Jue chapter.)
Ephedra Herb (Mahuang, 6 liang), Gypsum (Shigao, 0.5 jin), Fresh Ginger (Shengjiang, 3 liang), Jujube (Dazao, 15 pieces), Licorice Root (Gancao, 2 liang).
Add 6 sheng of water. First decoct Ephedra, remove the foam on top, then add the remaining herbs. Decoct to obtain 3 sheng. Divide into three warm doses.
Dafupi San
Dadu Pi (Magnolia Bark), Sangbaipi (Mulberry Root Bark), Chuanxiong (Sichuan Lovage Rhizome, each 2 liang), Han Fangji (Stephania Root), Qianghuo (Notopterygium Rhizome), Qingpi (Green Tangerine Peel, white part removed), Dahuang (Rhubarb, stir-fried), Binglang (Areca Seed), Guixin (Cinnamon Bark, each 1 liang), Gancao (Licorice Root, roasted, 0.5 liang).
Cut the herbs. For each dose of 5 qian, add 1 da zhan of water, decoct to 0.5 da zhan, remove dregs, and take warm at any time.
Chubaipi San
Chubaipi (Broussonetia Bark), Zhuling (Polyporus, peeled), Mutong (Akebia Stem, each 2 liang), Zisu (Perilla Leaf/Stem), Sangbaipi (Mulberry Root Bark, each 3 liang), Chenpi (Tangerine Peel, white part removed, 1 liang).
Cut the herbs. For each dose of 5 qian, add 1 da zhan of water and 3 slices of fresh ginger. Decoct to 0.6 da zhan, remove dregs, and take warm at any time.
Fangji Fuling Tang
Fangji (Stephania Root), Huangqi (Astragalus Root), Guizhi (Cinnamon Twig, each 3 liang), Fuling (Poria, 6 liang), Gancao (Licorice Root, 2 liang).
Add 6 sheng of water, decoct to obtain 2 sheng. Divide into three warm doses.
Puhui San (See Lin Syndrome chapter.)
Muxiang Wan
Muxiang (Costus Root), Ku Hulu Zi (Bitter Bottle Gourd Seed, stir-fried), Ruxiang (Frankincense, each 2 qian 5 fen), Binglang (Areca Seed, 2 pieces: one raw, one roasted), Gansui (Kansui Radix, stir-fried until yellow), Zhusha (Cinnabar, finely ground, each 0.5 qian).
Grind into fine powder. Mix with well-cooked rice paste to form 49 pills. Wrap each pill in dough. Boil in water until cooked. The patient swallows the pills with the juice. Continue until the water is completely expelled. Take the medicine in the early morning; by noon, the water will pass downwards. Do not count the number of times; stop when the water is gone.
Haige Wan
Haige (Clam Shell, ground), Fangji (Stephania Root, each 7 qian 5 fen), Chenpi (Tangerine Peel, stir-fried, white part removed), Yuliren (Prunus Seed, peeled, stir-fried, each 0.5 liang), Chifuling (Red Poria, peeled), Sangbaipi (Mulberry Root Bark), Tingli (Lepidium Seed, stir-fried between paper, each 1 liang).
Grind into fine powder. Mix with refined honey to form pills the size of paulownia seeds. Take 20 pills per dose, increasing to 30 pills, washed down with rice drink. Take once in the morning and once in the evening.
Binglang San
Binglang (Areca Seed, 0.5 liang, ground separately), Shanglu (Phytolacca Root), Shengjiang (Fresh Ginger, each 1 liang), Sangbaipi (Mulberry Root Bark, 1.5 liang), Gancao (Licorice Root, roasted, 2 qian 5 fen).
Except for Binglang, add 2 da zhan of water to the other herbs, decoct to 1 da zhan, remove dregs. In the early hours before dawn (Wugeng), divide into two doses. For each dose, mix with 2 qian 5 fen of Binglang powder. Bowel movement should occur by daybreak. If not, take another dose.
Gancao Mahuang Tang
Gancao (Licorice Root, 2 liang), Mahuang (Ephedra Herb, 4 liang).
Add 5 sheng of water. First decoct Mahuang, remove the foam on top, then add Gancao. Decoct to obtain 3 sheng. Take 1 sheng warm. Cover with blankets to induce sweating. If no sweat occurs, take another dose. Avoid wind and cold.
Mahuang Fuzi Tang
Mahuang (Ephedra Herb, 3 liang), Gancao (Licorice Root, 2 liang), Fuzi (Prepared Aconite Root, 1 piece, roasted).
Add 7 sheng of water. First decoct Mahuang, remove the foam on top, then add the other two herbs. Decoct to obtain 2.5 sheng. Take 0.8 sheng warm, three times a day.
Xingzi Tang (Original formula not seen; likely Mahuang Xingren Gancao Shigao Tang.)
Wupi San (*Heji Ju Fang*) Treats wind-dampness invading the Spleen channel, causing Qi and Blood stagnation, resulting in puffy face and eyes, full swelling of the four limbs, distension of the heart and abdomen, and急促 breathing. Also treats Pi Shui (Skin Water) and pregnancy-related edema.
Wujiapi (Fiveleaf Acanthopanax Bark), Digupi (Groundcherry Bark), Shengjiangpi (Ginger Peel), Dafupi (Dadu Bark), Fulingpi (Poria Skin, equal parts). One variation adds Baizhu (Atractylodes Rhizome), Chenxiang (Agarwood), and Muxiang (Costus Root).
Cut the herbs. For each dose of 3 qian, add 1 sheng of water, decoct to 0.7 sheng. Take hot at any time.
Wupi San (*Danliao Fang*) Treats generalised edema of the body, face, and four limbs, with difficult urination and a weak, large pulse, occurring after recovery from other diseases or after malaria/dysentery. This is due to weakness of the Spleen and Lung, failing to circulate Qi, causing Qi to scatter in the skin and muscle interstices, leading to swelling. This formula is most suitable.
Dafupi (Dadu Bark), Chifulingpi (Red Poria Skin), Shengjiangpi (Ginger Peel), Chenpi (Tangerine Peel), Sangbaipi (Mulberry Root Bark, stir-fried, equal parts).
Grind into coarse powder. For each dose of 5 qian, add 1 da zhan of water, decoct together to 0.8 da zhan, remove dregs, and take warm at any time, three times a day. Avoid raw, cold, greasy, and hard foods.
Xiangsu San (*Weisheng Baojian*) Treats water-qì deficiency edema with red and scanty urination.
Chenpi (Tangerine Peel, white part removed, 1 liang), Fangji (Stephania Root), Mutong (Akebia Stem), Zisuye (Perilla Leaf, each 0.5 liang).
Grind into powder. For each dose of 2 qian, add 2 zhan of water and 3 slices of fresh ginger. Decoct to 1 zhan, remove dregs, and take warm before meals.
Chushi Tang (See Zhongshi chapter.) Simo Tang (See Qi chapter.) Guihuang Wan (Missing.) Baohe Wan (See Shangshi chapter.)
Shuqiao Yinzi (*Jisheng Fang*) Treats generalised edema from water-qì,急促 breathing, irritability, excessive thirst, and difficult urination in patients who cannot tolerate hot medicines.
Zexie (Alisma Rhizome), Shanglu (Phytolacca Root), Chixiaodou (Red Bean, stir-fried), Qianghuo (Notopterygium Rhizome, rhizome removed), Dafupi (Dadu Bark), Jiaomu (Pepper Seeds), Mutong (Akebia Stem), Qinjiao (Gentiana Macrophylla Root, rhizome removed), Fulingpi (Poria Skin), Binglang (Areca Seed, equal parts).
Cut the herbs. For each dose of 4 qian, add 1 sheng of water and 5 slices of ginger. Decoct to 0.7 sheng. Take warm at any time.
Shipi Yin (*Jisheng Fang*) Treats Yin-Shui (Cold Water) edema. Use this formula first to strengthen the Spleen Earth.
Houpo (Magnolia Bark, peeled, ginger-processed), Baizhu (Atractylodes Rhizome), Mugua (Chaenomeles Fruit, pulp removed), Dafuzi (Areca Nut), Fuzi (Prepared Aconite Root, roasted), Muxiang (Costus Root, avoid direct fire), Caoguo Ren (Black Cardamom Seed), Baifuling (White Poria, peeled), Ganjiang (Dried Ginger, roasted, each 1 liang), Gancao (Licorice Root, roasted, 0.5 liang).
Cut the herbs. For each dose of 4 qian, add 1 sheng of water, 5 slices of ginger, and 1 jujube. Decoct to 0.7 sheng. Take warm at any time.
Wuling San (See Xiaodan chapter.) Muxiang Liuqi Yin (See Qi chapter.)
Fuyuan Dan (*Sanyin Fang*) Treats edema caused by dual deficiency of Spleen and Kidney, with flaccid swelling of the four limbs, hardness and distension of the heart and abdomen, obstruction of urination, and swelling under the eyes.
Fuzi (Prepared Aconite Root, roasted, 2 liang), Nanmuxiang (Southern Costus Root, baked), Huixiang (Fennel Seed, stir-fried), Chuanjiao (Sichuan Pepper, stir-fried to release oil), Houpo (Magnolia Bark, rough bark removed, ginger-processed), Duhuo (Angelica Pubescens Root), Baizhu (Atractylodes Rhizome, stir-fried), Chenpi (Tangerine Peel, white part removed), Wuzhuyu (Evodia Fruit, stir-fried), Guixin (Cinnamon Bark, each 1 liang), Zexie (Alisma Rhizome, 1.5 liang), Roudoukou (Nutmeg, baked), Binglang (Areca Seed, each 0.5 liang).
Grind into fine powder. Make pills with starch paste, size of paulownia seeds. Take 50 pills per dose at any time, washed down with Perilla Decoction.
Heixi Dan (See Zhu Ni Chongshang chapter.) Suzi Jiangqi Tang (See Qi chapter.)
Daozhi Tongjing Tang (*Weisheng Baojian*) Treats excess Spleen dampness and obstructed Qi mechanism, causing edema of the face, eyes, hands, and feet.
Muxiang (Costus Root), Baizhu (Atractylodes Rhizome), Sangbaipi (Mulberry Root Bark), Chenpi (Tangerine Peel, each 5 qian), Fuling (Poria, peeled, 1 liang).
Cut the herbs. For each dose of 5 qian, add 2 zhan of water, decoct to 1 zhan, remove dregs, and take warm on an empty stomach or before meals.
The *Neijing* states: When dampness prevails, pacify it with bitter-hot substances. Use bitter to dry dampness, and use bland to drain it. Chenpi is bitter and warm, regulating Lung Qi and removing Qi stagnation, thus serving as the chief herb. Sangbaipi is sweet and cold, removing water-qì from the Lung, treating edema and abdominal distension, and promoting water passages, thus serving as an assistant herb. Muxiang is bitter, acrid, and warm, removing stagnant Qi in the Lung; Baizhu is bitter and sweet, warm, capable of drying dampness and harmonising the Middle Jiao; Baifuling is sweet and neutral, capable of stopping thirst, drying dampness, and promoting urination via bland seepage, thus serving as the guide herb.
In May of the Wuyin year of the Zhiyuan era, continuous heavy rain persisted. Mr. Xu Pingzhong of Luqi, aged fifty-eight, presented with oedema of the face, eyes, and limbs, frequent loose stools, abdominal distension with borborygmus and intermittent pain, and reduced appetite. I diagnosed his pulse as wiry, thin, and slow. He said: In his youth, he had frequently taken medicines containing Qianniu (Morning Glory Seed) and Dahuang (Rhubarb), experiencing occasional edema of the face and limbs. Now, due to rainy weather, it has flared up severely. I said: The circulating Qi originates from the Middle Jiao, which is the Stomach. Weak Stomach Qi fails to distribute the Qi of food and fluids to nourish the Zang-Fu organs, collaterals, skin, and hair. Stagnant Qi flow causes edema. Frequent loose stools, abdominal swelling, and borborygmus are all signs of overwhelming dampness. The Five Zang organs of the four seasons all rely on Stomach Qi as their foundation. If the Zang organs have Stomach Qi, they remain harmonious and the body safe. If Stomach Qi is weak and unable to move and nourish the Zang organs, the Zang organ pulses become unharmonious. If the Qi of the affected organ is excessive, its pulse appears exclusively; mild cases lead to severe illness, and extreme cases lead to death. Thus, the Classic states: A wiry True Zang pulse without Stomach Qi indicates death. Fortunately, your condition has not yet reached severity and can still be regulated and tonified. People know that taking Qianniu and Dahuang brings temporary relief, but do not realise it causes lifelong harm. I prescribed Pingwei San added with Baizhu (Atractylodes Rhizome), Fuling (Poria), and Caodoukou Ren (Black Cardamom Seed). After several doses, abdominal distension, loose stools, borborygmus, and intermittent pain resolved, and appetite improved. Only limb edema remained, which was treated primarily with Daozhi Tongjing Tang, resulting in a good recovery.
Mugua Wan (See Zhongfeng chapter.)
Fenqi Xiangsu Yin
Sangbaipi (Mulberry Root Bark, stir-fried), Chenpi (Tangerine Peel), Fuling (Poria), Dafupi (Dadu Bark), Xiangfu (Cyperus Rhizome, stir-fried, each 1 qian), Zisu (Perilla Leaf, 1.5 qian), Jiegeng (Platycodon Root), Zhike (Immature Bitter Orange, each 0.8 fen), Caoguo Ren (Black Cardamom Seed, 0.7 fen), Wuweizi (Schisandra Berry, 15 grains).
Add 2 zhong of water and 3 slices of ginger. Decoct to 0.8 zhong. Add a little salt. Take before meals.
Xiaodao Kuanzhong Tang
Baizhu (Atractylodes Rhizome, 1.5 qian), Zhishi (Immature Bitter Orange, bran-roasted), Houpo (Magnolia Bark, ginger-processed), Chenpi (Tangerine Peel), Banxia (Pinellia Tuber), Fuling (Poria), Shanzha (Hawthorn Flesh), Shenqu (Medicated Leaven, stir-fried), Maiya (Barley Sprout, stir-fried), Luobozhong (Radish Seed, stir-fried, each 1 qian).
Add 2 zhong of water and 3 slices of ginger. Decoct to 0.8 zhong and take. (If urination is difficult, add Zexie and Zhuling.)
Weiling Tang
Cangzhu (Atractylodes Lancea Rhizome), Houpo (Magnolia Bark, stir-fried with ginger juice), Chenpi (Tangerine Peel), Baizhu (Atractylodes Rhizome), Fuling (Poria, each 1.5 qian), Zexie (Alisma Rhizome), Zhuling (Polyporus, each 1 qian), Gancao (Licorice Root, 0.6 fen), Guanzi (Cinnamon Bark, 0.5 fen).
Add water and fresh ginger, decoct and take.
Jiawei Wupi Tang: Based on Wupi San. Add Wujiapi (Fiveleaf Acanthopanax Bark), Mugua (Chaenomeles Fruit), and Fangji (Stephania Root) for foot swelling. For intolerance to local climate/water, combine with Weiling Tang.
Xiaofeng Baidu San
Renshen (Ginseng Root), Duhuo (Angelica Pubescens Root), Chaihu (Bupleurum Root), Jiegeng (Platycodon Root), Zhike (Immature Bitter Orange, bran-roasted), Qianghuo (Notopterygium Rhizome), Fuling (Poria), Chuanxiong (Sichuan Lovage Rhizome), Qianhu (Peucedanum Root), Gancao (Licorice Root), Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root, each 1 qian).
Add 2 zhong of water and 3 slices of ginger. Decoct to 0.8 zhong. Take long after meals.
Shengma Heqi San (*Heji Ju Fang*)
Ganjiang (Dried Ginger, 0.5 fen), Gange (Kudzu Root, 1 liang), Dahuang (Rhubarb, steamed, 0.5 liang), Shu Zhike (Ripe Immature Bitter Orange, 0.5 fen), Jiegeng (Platycodon Root), Shu Cangzhu (Ripe Atractylodes Lancea Rhizome), Shengma (Cimicifuga Rhizome, each 1 liang), Shaoyao (Peony Root, 7 qian 5 fen), Chenpi (Tangerine Peel), Gancao (Licorice Root, each 1.5 liang), Danggui (Angelica Sinensis Root), Shu Banxia (Ripe Pinellia Tuber), Baizhi (Angelica Dahurica Root), Fuling (Poria, each 2 qian).
For each dose of 4 qian, add 1 sheng of water, 3 slices of ginger, and 10 stems of Juncus Effusus. Decoct to 0.7 sheng. Take warm before meals.
Buzhong Yiqi Tang (See Laojuan chapter.) Liuwei Wan (See Xulao chapter.) Renshen Pingfei San (See Chuan chapter.) Ziyin Wan (Same as Yiyin Shenqi Wan, see Eye chapter.)
Modified Jin Gui Shenqi Wan Treats Lung and Kidney deficiency with heavy waist and swollen feet, difficult urination; or abdominal swelling and limb edema; or急促 breathing with abundant phlegm, progressing to Gu syndrome. The effect is miraculous. This condition often arises from Spleen and Stomach weakness, improper treatment, and further injury to Yuan Qi. Only this formula can save the patient.
Baifuling (White Poria, 3 liang), Fuzi (Prepared Aconite Root, 5 qian), Chuan Niuxi (Cyathula Root), Guanzi (Cinnamon Bark), Zexie (Alisma Rhizome), Cheqianzi (Plantago Seed), Shanzhuyu (Cornus Fruit), Shanyao (Dioscorea Rhizome), Mudanpi (Moutan Cortex, each 1 liang), Shudihuang (Prepared Rehmannia Root, 4 liang, crushed, mixed with wine and pounded into paste).
Grind into powder. Mix with the Rehmannia paste. Form pills with refined honey, size of paulownia seeds. Take 70-80 pills per dose on an empty stomach with plain boiled water. (*Jisheng Fang* uses Fuzi as the chief herb; this version was redefined by Xue Xinpu.)
Tiaowei Baizhu Zexie San (*Rumen Shiqi*) Treats Phlegm transforming into water-qì, progressing to Shuigu (Water Drum) with inability to eat.
Baizhu (Atractylodes Rhizome), Zexie (Alisma Rhizome), Shaoyao (Peony Root), Chenpi (Tangerine Peel), Fuling (Poria), Shengjiang (Fresh Ginger), Muxiang (Costus Root), Binglang (Areca Seed, equal parts).
Grind into powder.
Another method: Add Baizhu, using half the amount of this formula. It is effective for swelling above the umbilicus. Add Zhishi (Immature Bitter Orange) for epigastric fullness. Add Qianniu (Morning Glory Seed) for lower jiao excess.
Bazheng San (See Lin Syndrome chapter.) Zhizi Chi Tang (See Xufan chapter.)
Supplementary Formulas
Han Fangji Zhusan Main Formula for Edema and Upper Qi Disturbance. (Secretly transmitted by Chu Cheng.)
Han Fangji (Stephania Root), Zeqiye (Phytolacca Leaf), Shiwei (Pyrrosia Leaf, hairs removed), Sangbaipi (Mulberry Root Bark), Zexie (Alisma Rhizome), Danshen (Salvia Root), Fuling (Poria), JuPi (Tangerine Peel), Baizhu (Atractylodes Rhizome, each 3 liang), Shengjiang (Fresh Ginger, sliced, 10 liang), Yuliren (Prunus Seed, 5 he), Tongcao (Tetrapanax Pith, 1 liang).
Grind the twelve herbs into a powder. Add 1.7 sheng of water and 4 cun-bi of powder. Decoct to obtain 0.8 sheng. Take in one dose, twice daily. Stop when urination becomes free.
Tingli Wan Treats Lung Qi cough, facial/ocular edema,急促 breathing, and red urine.
Tian Tingli (Sweet Lepidium Seed, stir-fried between paper), Beimu (Fritillaria Bulb, roasted until yellow), Mutong (Akebia Stem, each 1 liang), Xingren (Apricot Seed, peeled, tipped, double-kernelled, stir-fried), Fangji (Stephania Root, each 2 liang).
Grind into fine powder. Mix with jujube paste to form pills the size of paulownia seeds. Take 50 pills per dose, washed down with Sangbaipi (Mulberry Root Bark) decoction before meals.
Baizhu Muxiang San Treats coughing, wheezing, swelling, and distension progressing to water disease, with inability to eat or lie flat, and constipation. Suitable for such cases.
Baizhu (Atractylodes Rhizome), Zhuling (Polyporus, peeled), Binglang (Areca Seed), Chifuling (Red Poria), Zexie (Alisma Rhizome, each 1.5 qian), Muxiang (Costus Root), Gancao (Licorice Root, each 1 qian), Guanzi (Cinnamon Bark, 0.7 fen), Huashi (Talcum, 3 qian), Chenpi (Tangerine Peel, 2 qian).
Prepare as one dose. Add 2 zhong of water and 3 slices of ginger. Decoct to 1 zhong. Take before meals.
Fenqi Buxin Tang Treats constrained Heart Qi manifesting as edema of the four limbs and急促 upper breathing.
Mutong (Akebia Stem), Chuanxiong (Sichuan Lovage Rhizome), Qianhu (Peucedanum Root, radix removed), Dafupi (Dadu Bark, soaked), Qingpi (Green Tangerine Peel), Baizhu (Atractylodes Rhizome), Zhike (Immature Bitter Orange, bran-roasted), Gancao (Licorice Root, roasted, each 1 qian), Xiangfu (Cyperus Rhizome, hairs removed, stir-fried), Baifuling (White Poria), Jiegeng (Platycodon Root, each 1.5 qian), Xixin (Asarum Root), Muxiang (Costus Root, each 0.5 fen).
Prepare as one dose. Add 2 zhong of water, 3 slices of ginger, and 2 red jujubes. Decoct to 1 zhong. Take before meals.
Tiaorong Yin Treats stagnant blood transforming into water, causing edema of the four limbs and red streaks on the skin and flesh, known as Blood Division (Xue Fen).