论七首 脉证五条 方九首（按此数目。并有讹。当考。）
师曰。病有风水。有皮水。（脉经。其腹如鼓下。注曰。如鼓。一作如故不满。痈脓。辑义误写作痈肿。诸本皆作
脓字。）
按风水。亦外证 肿。其不言者。盖系省文（医通。以为脱文。似非。）金鉴。以从上肿从下肿。辨风水皮水。恐
失拘执。（辑义。 。程读为跗。程。当作鉴。）又皮水。其腹如鼓云云。宜从巢源。及脉经注。改正为顺。正水。征以
水热穴论。水胀篇。则此证亦必腹满。今不言者。亦系省文。金鉴言胸满自喘者。非是。要之风水皮水。以表邪有无为
辨。正水石水。以喘不喘为别。其他证候。皆宜类推也。（医通引经。是大奇论。水热穴论。评热病论。阴阳别论。然
错综颠倒。颇加改易。学人宜考原文。）
又按内经之风水。为肾虚招风。以为水气。遂变正水者。仲景之风水。指邪水专郁于表者而言。其证稍异。又正水。
盖水肿之正证。水热穴论曰。故水病。下为 肿大腹。上为喘呼不得卧者。标本俱病。故肺为喘呼。肾为水肿。肺为逆
不得卧。分为相输俱受者。水气之所留也。水胀篇曰。水始起也。目窠上微肿。如新卧起之状。其颈脉动。时咳。阴股
间寒。足胫 。腹乃大。其水已成矣。以手按其腹。随手而起。如裹水之状。此其候也。俱是正水之谓耳。鸡峰普济方
曰。病肿者。皮肤紧急肿满。无文没指。若目下微肿。如卧蚕之状。及足胫皆肿。小便不利。其人喘急。脉沉大而疾。
此由脾肾虚弱。肾虚水不能蓄。水气扬溢。脾胃虚则不能制水。水气流散于经络。
经络水病。故能肿满。谓之正水。此说甚核。足以相征矣。至石水。则考之巢源。其水沉凝不行。亦不上泛。殆近
水鼓者也。鸡峰方。又以为腹胀如鼓。按之坚硬。腹中时痛。谓之石水。绕脐坚硬。腹不痛者。谓之鼓气。是以痛不痛
为别。恐非确论。又有治石水。用防己椒目葶苈大黄丸治验。文繁不录。宜阅。（巢源。又有毛水候。亦是皮水。又有
大腹水肿候。亦即正水。并宜相参。又三因。皮水。据巢源。处以五皮散。）
脉浮而洪。浮则为风。（相击。徐。沈。朱。作相系。非。恶风以下八字。圣济总录引。作恶风者为风水。）
按此条。风强气强二证。是客。风气相击证。是主。宜分别看。汗出乃愈。专属风水而言。不统前二证。赵氏曰。
风者。外感之风也。气者。营卫之气也。所谓气强者。卫因热则怫郁。停而不行。气水同类。气停则水生。所聚之液血。
皆化水也。程氏曰。气者。水气也。形盛于外。为气强。内经曰。津液充郭。其魄独居。即气强之意也。魏氏曰。气者
水气。即湿邪也。湿邪挟风邪。作热于表也。尤氏曰。风。天之气。气。人之气。是皆失其和者也。风气相搏。风强则
气从风。而侵淫肌体。故为瘾 。气强则风从气。而鼓涌水液。故为水。风气并强。两相搏击。而水液从之。则为风水。
汗之则风去而水行。故曰汗出乃愈。尤注与金鉴相发。最为稳贴。（身痒。多属表虚。特桂麻各半汤证。以不得小汗出
身痒。即是表郁。岂此条之类乎。）
平脉法曰。脉浮而大。浮为风虚。大为气强。风气相搏。必成隐疹。身体为痒。痒者名泄风。久久为痂癞。林亿等
注。眉少发稀。身有干疮。而腥臭也。
寸口脉沉滑者。中有水气。（拥上。诸本。有微字。辑义偶脱。）
按灵枢论疾诊尺篇。视人之目窠上。微痈如新卧起状。其颈脉动。时咳。按其手足上。 而不起者。风水肤胀也。
此本条所原。先兄曰。拥。臃同。肿起也。太阳病。脉浮而紧。
按身肿而冷。状如周痹。程氏属之黄汗。恐佳。痛在骨节。亦是黄汗。尤说为是。
趺阳脉当伏。今反紧。（寒字。句。疝瘕。宜接腹中痛读。）
趺阳脉当伏。今反数。
〔徐〕此二条。言水病患别有宿病。人各不同。当从趺阳脉。与其旧疾见证别之。〔尤〕趺阳虽系胃脉。而出于阴
部。故其脉当伏。今反紧者。以其腹中宿有寒疾故也。寒则宜温。而反下之。阳气重伤。即胸满短气。其反数者。以其
胃中有热故也。热则当消谷而小便数。今反不利。则水液日积。故欲作水。夫阴气伤者。水为热蓄而不行。阳气竭者。
水与寒积而不下。仲景并举二端。以见水病之原有如此也。
按诸家以趺阳脉伏为病脉。尤氏特以为平脉。而其注义亦畅。仍表出之。更推尤意。此欲作水一句。总括二条。亦
顶胸满气短来。或曰。此二条。前条是客。不过举其有寒者。以为照对。实无干水病。后条是主。示水之因热生者。此
说亦有理。姑附存之。
又按趺阳平脉。贵沉实不贵浮露。故尤氏以伏为平脉。辨脉法曰。趺阳脉迟而缓。胃气如经也。其意一也。但后条
有寒水相搏。趺阳脉伏语。义相矛盾。当考。又辨脉法曰。趺阳脉微而紧。紧则为寒。微则为虚。微紧相搏。则为短气。
夫水病患。目下有卧蚕。
按灵枢。无目下微肿如蚕之文。赵氏错引。盖目下如卧蚕者。色黄晶肿。如新卧起者。眼胞上庞然虚浮。其证
自异。方书中。或有曰有若卧蚕才起之状者。谬矣。
师曰。寸口脉沉而迟。
或曰。推他文例。趺阳脉伏一句。疑衍存考。
蒋示吉医宗说约曰。有血分症。妇人先经水断绝。而后四肢肿满。小便不通。此血瘀水道。以通经为主。宜小调经
散。
问曰。病者苦水。面目身体四肢皆肿。（脉之上。脉经。有师字。是。）
〔赵〕此水病。脉之不言水。反言胸中痛等病。当时记其说者以为异。非异也。是从色脉言耳。
按脉之不言水。反言胸中痛。二言字。沈氏属之病者。（本于徐氏。）赵氏则属之医师。殊觉妥协。盖此病者洪肿。
如以常情。则当言其所苦。与治之所急。皆在水。而师反举胸中痛等证以为言。故人疑而设问也。脉经作师脉之不言水。
语意最明。太阳上编。问曰证象阳旦条。及脉经中。并有同语例。宜相参。又关元。即泛称下焦之名。亦见厥阴篇。及
妇人杂病中。又医以为留饮。而大下之句。言医误认胁下急痛等证。以为悬饮支饮之属。错用十枣等汤。盖当时未至身
肿。而程氏谓见标证面目身体四肢皆肿云云。而大下之者。殆未为当。又胃家虚烦之烦。即太阳下编。吐之内烦之烦。
又按脉经。引四时经云。土亡其子。其气衰微。水为洋溢。浸渍为池。走击皮肤。面目浮肿。归于四肢。愚医见水。
直往下之。虚脾空胃。水遂居之。肺为喘浮。注云。肺得水而浮。故言喘浮。又巢源伤寒咳嗽候曰。水停心下。则肺为
之浮。肺主于咳。水气乘之。故咳嗽。又水肿候中曰。肺得水而浮。浮则上气而咳嗽也。盖得斯说。而浮咳之义始晰矣。
（何氏医碥曰。水气喘者。水气逆行。肺气得水而浮。观浴河者。水浸至胸则喘可见。）
风水。恶风一身悉肿。
按沈以为风多水少之证。恐拘。先兄曰。续。似续陆续之续。汗常出而不止。又前第四条曰。其人不渴。汗出即愈。
此为风水。存参。（评热病论。论风水。有口干苦渴证。）
越婢汤方
按药有性有用。方之既成。或取其性。或取其用。如此方。则石膏得麻黄之温发。但存逐水之用。相借以驱水气。
（石膏逐水。本草不言。然仲景用之驱饮者。不一而足。）加术汤。则麻石之功。与前方同。而术与麻黄相藉。走外之力
稍胜矣。（性用诸义。详开于拙着药治通义中。）
防己茯苓汤方
按此方系于发表利水相兼之剂。防己。黄 。俱逐外水。义具于湿病防己黄 汤下。须互参。
越婢加术汤方
按此方与次方。所主之证。盖在轻重剧易之别。不必拘有热无热矣。
甘草麻黄汤方
千金翼。麻黄汤。主风湿水疾。身体面目肿。不仁而重方。（即本方。）重覆。日移二丈汗出。不出更合服之。慎护
风寒。
皮水。用之良。
秘传经验方。走马通圣散。治诸风湿。及伤风伤寒头疼。并治疔疮一切肿毒。手足疼痛。风痹不仁。
即本方。炒微黄。碾为细末。每服三钱。用水钟半。锅内滚一大沸。凉温服。盖被暖不透风。汗出为度。仍要护慎
风触。遂无重复。
水之为病。其脉沉小。属少阴。
按少阴。即与伤寒少阴病同义。系于表虚寒之谓。其用麻黄附子甘草汤。取之温发。沈氏说虽巧。犹未免牵凑。
厥而皮水者。
医心方。张仲景方。青龙汤。治四肢疼痛。面目 肿方。
麻黄（半斤去节去末） 细辛（二两） 干姜（二两） 半夏（洗）
凡四物。切。以水八升。煮得二升。一服止。
又。又云。治脾胃水。面目手足 肿。胃管坚大满气。不能动摇。桑根白皮汤方。
桑根白皮切（二升） 桂（一尺） 生姜（三颗） 人参（一两）
凡四物。切。以水三斗。煮取桑根。竭得一斗。绞去滓。内桂。人参。生姜。黄饴十两。煮之竭得七升。服一升。
消息更服。（今案本草。桂一尺。重半两为正。○按右出其第十卷治通身水肿方中。未知果是本经之遗否。姑附于此。）
〔余述〕按本篇。首叙四证。而篇中特举风水皮水。不及正水石水。其论治法。有云可下之。有云当利小便。有云
当发汗。今考篇中。殊详于发表之方。而至攻下渗利之药。则缺而不出。岂皆是后人之所删难。抑仲景之
引而不发者乎。
黄汗之病。
先兄曰。此条。当为五节读。首二句。概称黄汗之证也。而下曰历节。曰劳气。曰生恶疮者。以其与黄汗相类。而
实不同。举以示之也。历节必兼寒邪。故周身发热。（尤氏所举第四条文。彼注属之皮水。与此 牾。然其属黄汗者。
为是。）
桂枝去芍药加麻黄细辛附子汤方（外台引深师。名附子汤。主证与本条同。甘草。炙。麻黄。去节。三两。细辛三
两。附子。冠大字。大枣。有擘字。煮麻黄下。有再沸二字。方后云。仲景伤寒论。名桂枝去芍药加麻黄细辛附子汤。
赵本。作桂姜草枣黄辛附子汤方。）
心下坚。大如盘。（本草。图经引。无边如旋盘四字。宋本外台饮癖门。引备急。亦作枳实术汤。）
按上条与此条。其病俱在内。与外体浮肿者不同。今编在本篇者。未详其解。疑是痰饮篇中所错也。巢源气分候曰。
夫气分者。由水饮搏于气。结聚所成。气之流行。常无壅滞。若有停积。水饮搏于气。则气分结而住。故云气分。医学
纲目曰。气分。谓气不通利而胀。血分。谓血不通利而胀。非胀病之外。又别有气分血分之病也。盖气血不通利。则水
亦不通利而尿少。尿少。则腹中水渐积而为胀。但气分。心下坚大。而病发于上。血分。血结胞门。
而病发于下。气分。先病水胀。后经断。血分。先经断。后病水胀也。（按楼氏此说。凑合水分为言。殊属刺缪。）
枳术汤方（外台两见。并作白术三两。本草引同。无白字。外台引备急。及本草。亦水五升。作水一斗。）
侣山堂类辨曰。金匮要略。用枳术汤。治水饮所作。心下坚。大如盘。盖胃为阳。脾为阴。阳常有余。而阴常不足。
胃强脾弱。则阳与阴绝矣。脾不为胃行其津液。则水饮作矣。故用术以补脾。用枳以抑胃。后人不知胃强脾弱用分理之
法。咸谓一补一消之方。再按局方之四物汤。二陈汤。四君子汤。易老之枳术丸。皆从金匮方套出。能明乎先圣立方大
义。后人之方不足法矣。（按胃强脾弱。补脾抑胃。并似迂曲。）
外台。文仲。徐王枳实散。宜春秋服。消肿利小便。兼补疗风虚冷胀不能食方。
枳实（半斤炙） 桂心（一斤） 茯苓 白术（各五两）为散。酒服方寸匕。日三服。加至二匕。千金月令。主结
气方。
白术 枳壳（炒） 上等分。捣筛。蜜丸如梧子大。空腹饮下二十五丸。
圣惠。治癖结不能饮食。心下虚满如水者。枳实散方。
于本方。加半夏。生姜。水煎。
又治膈气心胸间痛方。
于本方。加神麴。各一两。为散。不计时候。热酒调下一钱。
又治饮癖气分。心下坚硬如杯。水饮所作。桂心散方。
于本方。加桂心。细辛。附子。槟榔。姜。枣。用枳壳。水煎服。（按此严氏枳术汤祖方。）
又治饮癖。心下坚。大如杯。时复疼痛。宜服此方。
于本方。加桂心。生姜。
百一选方。治一切浮肿。水气亦可治。
于本方。如吴茱萸。茯苓。生姜。水煎。
奇效良方。加味枳术汤。治气为痰所隔。心下坚胀。名曰气分。
枳壳。白术。辣桂。紫苏。陈皮。槟榔。桔梗。五灵脂。木香。（各一分）半夏。茯苓。甘草。（各二分）每服二钱。
水二盏。生姜三片。
煎至一钟。去滓。食前温服。
Seven Treatises, Five Pulse and Symptom Sections, Nine Prescriptions (Note: These numbers are erroneous and should be verified.)
The Master said: "There are diseases of Wind-Edema (Fengshui) and Skin-Edema (Pishui)." (*Mai Jing* records that the abdomen is swollen like a drum. The commentary states: 'Like a drum,' alternatively read as 'like before, not full.' 'Carbuncle and pus' was erroneously written as 'carbuncle and swelling' in the *Jiyi*, while all other editions read 'pus'.)
Regarding Wind-Edema, there is also external edema; its omission here is likely due to ellipsis. (*YiTong* considers it a missing text, which seems incorrect. *Jinjian* distinguishes between Wind-Edema and Skin-Edema based on whether swelling starts from above or below, which may be too rigid. In *Jiyi*, Cheng reads 'Fu' as 'Shu'; Cheng should refer to Jin. Regarding Skin-Edema, the description of the abdomen being swollen like a drum should be corrected according to *Chao Yuan Fang* and the commentary in *Mai Jing* for consistency. For Zheng-Shui (True Water), referring to *Shui Re Xue Lun* and *Shui Zhang Pian*, this condition must also involve abdominal fullness; its omission here is also an ellipsis. *Jinjian*'s claim of chest fullness and spontaneous panting is incorrect. In summary, Wind-Edema and Skin-Edema are distinguished by the presence or absence of exterior pathogenic factors, while Zheng-Shui and Shi-Shui (Stone Water) are distinguished by the presence or absence of panting. Other symptoms should be inferred by analogy. (*YiTong* cites texts such as *Da Qi Lun*, *Shui Re Xue Lun*, *Ping Re Bing Lun*, and *Yin Yang Bie Lun*, but they are jumbled and altered; students should verify the original texts.)
Furthermore, the Wind-Edema in *Nei Jing* refers to wind attracting water qi due to Kidney deficiency, transforming into Zheng-Shui. Zhang Zhongjing's Wind-Edema refers specifically to pathogenic water stagnating in the exterior, with slightly different symptoms. Zheng-Shui is essentially the typical presentation of edema. *Shui Re Xue Lun* states: "Therefore, in water diseases, there is lower body swelling and abdominal distension, and upper body panting and inability to lie down; both root and branch are affected. Thus, the Lung manifests as panting, the Kidney as edema, and the Lung as rebellion preventing sleep. Divided into mutual transmission and joint reception, this is the retention of Water Qi." *Shui Zhang Pian* states: "When water disease begins, the eye sockets swell slightly, resembling the appearance after just waking up. The neck pulse beats, there is occasional coughing, coldness in the inner thighs, and swelling in the calves. Only then does the abdomen enlarge, indicating the water has formed. Pressing the abdomen with the hand causes it to rise immediately, resembling a bag of water. This is its sign." All these describe Zheng-Shui. *Jifeng Puji Fang* states: "Patients with edema have tight, swollen skin with no visible pores. If the eye sockets are slightly swollen like a sleeping silkworm, and the calves are swollen, with difficult urination, panting, and a deep, large, rapid pulse, this is due to Spleen and Kidney deficiency. Kidney deficiency fails to retain water, causing Water Qi to overflow. Spleen deficiency fails to control water, allowing water flow to scatter through the meridians. Meridian water disease causes swelling and fullness, called Zheng-Shui." This explanation is accurate and corroborative. As for Shi-Shui, consulting *Chao Yuan Fang*, the water is deep, stagnant, and does not rise, resembling Shu-Gu (Water Drum). *Jifeng Fang* further describes it as abdominal distension like a drum, hard upon pressure, with intermittent abdominal pain. Abdominal distension around the navel that is hard but painless is called Gu-Qi (Drum Qi). Distinguishing them by pain or lack thereof is likely inaccurate. There is a recorded successful treatment of Shi-Shui using Fangji Jiumu Tingli Dahuang Wan, but the text is too long to record; please consult it. (*Chao Yuan Fang* also lists Mao-Shui, which is Pishui, and Da-Fu Shui-Zhong, which is Zheng-Shui; both should be referenced. Additionally, *San Yin Fang* treats Pishui with Wupi San.)
A pulse that is floating and surging indicates floating represents wind. ('Xiang Ji', Xu, Shen, and Zhu read as 'Xiang Xi', which is incorrect. The eight characters 'aversion to wind...' in *Shengji Zonglu* read 'aversion to wind indicates Fengshui'.)
Note: In this section, the conditions of strong wind and strong qi are secondary (guest), while the condition of wind and qi clashing is primary (host); they should be viewed separately. Sweating leading to recovery applies specifically to Wind-Edema, not covering the previous two conditions. Zhao states: "Wind refers to externally contracted wind. Qi refers to Ying and Wei Qi. What is meant by strong qi is that Wei Qi becomes constrained due to heat, stagnating and failing to move. Qi and water are of the same category; when qi stagnates, water generates. The accumulated fluids and blood all transform into water." Cheng states: "Qi is Water Qi. Excessive form on the exterior is called strong qi. *Nei Jing* says: 'Fluids fill the Gu, leaving the Po alone,' which means strong qi." Wei states: "Qi is Water Qi, i.e., damp evil. Damp evil combined with wind evil creates heat at the exterior." You states: "Wind is the Qi of Heaven; Qi is the Qi of Man; both represent a loss of harmony. When wind and qi clash, if wind is strong, qi follows wind and invades the muscles/skin, causing urticaria. If qi is strong, wind follows qi and surges fluid, causing water accumulation. When both wind and qi are strong and clash, fluid follows, resulting in Wind-Edema. Sweating expels wind and moves water, hence 'sweating leads to recovery.'" You's commentary complements *Jinjian* and is most appropriate. (Body itching often belongs to exterior deficiency. Specifically, the Guizhi Mahuang Ge Ban Tang syndrome involves body itching due to failure to produce slight sweat, indicating exterior constraint. Could this section be similar?)
*Ping Mai Fa* states: "A pulse that is floating and large: floating indicates wind and deficiency; large indicates strong qi. When wind and qi clash, urticaria will certainly form. The body itches; itching is named Xie-Feng (Leaking Wind). Over time, it becomes scabs and leprosy." Lin Yi et al. comment: "Sparse eyebrows and hair, dry sores on the body with a foul odor."
If the Cunkou pulse is deep and slippery, there is water qi inside. ('Yong Shang', various editions have the character 'Wei', omitted accidentally in *Jiyi*.)
Note: *Ling Shu: Lun Ji Zhen Chi Pian* states: "Observe if the patient's eye sockets are slightly swollen like just waking up, the neck pulse beats, there is occasional coughing, and pressing the hands and feet leaves an indentation that does not rise immediately; this is Feng-Shui Fu-Zhang (Wind-Edema Skin-Bloating)." This is the origin of this section. My elder brother said: "'Yong' is the same as 'Yong', meaning swelling." Taiyang Disease, pulse floating and tight.
Note: Body swelling with coldness, resembling Zhou-Bi (Bi Syndrome affecting the whole body), Cheng attributes it to Huang-Han (Yellow Sweat), which seems appropriate. Pain in the bone joints is also Huang-Han; You's view is correct.
The Fuyang pulse should be hidden/deep, but now it is instead tight. (The sentence containing 'Han' [Cold] and 'Shan Xia' [Masses] should be read connected to 'Abdominal Pain'.)
The Fuyang pulse should be hidden/deep, but now it is instead rapid.
[Xu]: These two sections discuss that water disease patients have pre-existing conditions, varying by individual. One should distinguish them based on the Fuyang pulse and manifestations of old illnesses. [You]: Although Fuyang is the Stomach pulse, it emerges from the Yin portion, so its pulse should be hidden. Now it is tight because there is a chronic cold illness in the abdomen. Cold requires warming, but purgatives were used instead, severely injuring Yang Qi, leading to chest fullness and shortness of breath. Now it is rapid because there is heat in the Stomach. Heat should digest food and cause frequent urination, but now urination is difficult, causing daily accumulation of water, thus predisposing to water disease. When Yin Qi is injured, water is retained by heat and cannot move. When Yang Qi is exhausted, water and cold accumulate and cannot descend. Zhongjing presents both scenarios to show the origins of water disease.
Note: Most scholars consider a hidden Fuyang pulse as pathological, but You specifically considers it normal, and his interpretation is clear. It is presented here. Further inferring You's intent, the phrase 'predisposed to water disease' summarizes both sections and connects to 'chest fullness and shortness of breath'. Some say: In these two sections, the first is a guest condition, merely listing coldness for contrast, unrelated to water disease. The second is the host condition, showing water generated by heat. This reasoning is plausible and is tentatively preserved.
Also, a normal Fuyang pulse values depth and solidity over superficiality, so You considers 'hidden' as normal. *Bian Mai Fa* states: "Fuyang pulse slow and moderate indicates Stomach Qi is normal." The intent is the same. However, the latter section mentions 'cold-water clashing, Fuyang pulse hidden', which contradicts the meaning and should be verified. *Bian Mai Fa* also states: "Fuyang pulse fine and tight: tight indicates cold, fine indicates deficiency. Fine and tight clashing results in shortness of breath." In water disease patients, there is swelling under the eyes like a sleeping silkworm.
Note: *Ling Shu* lacks the text "swelling under the eyes like a silkworm"; Zhao cited it incorrectly. Generally, swelling under the eyes like a silkworm implies yellow, crystal-like swelling; swelling like just waking up implies puffy eyelids. The conditions differ. Some medical texts say "resembling the shape of a newly risen silkworm," which is erroneous.
The Master said: "The Cunkou pulse is deep and slow."
Someone said: By analogy with other texts, the phrase 'Fuyang pulse hidden' is suspected to be a superfluous insertion; keep for verification.
Jiang Shiji's *Yi Zong Shuo Yue* states: "There is a Blood-Segment syndrome where women first experience amenorrhea, followed by swelling of the four limbs and urinary obstruction. This is blood stasis blocking the water passages; treatment focuses on unblocking menstruation, using Xiao Tiao Jing San."
Question: "The patient suffers from water disease, with swelling of the face, eyes, body, and four limbs." (Above 'pulse', *Mai Jing* has the character 'Shi' [Master], which is correct.)
[Zhao]: This is a water disease. The pulse does not mention water but rather chest pain and other ailments. Those recording it at the time thought it strange, but it is not strange; it speaks from the perspective of color and pulse.
Note: The pulse not mentioning water but mentioning chest pain: Shen attributes the word 'yan' [say] to the patient (based on Xu). Zhao attributes it to the physician, which seems more appropriate. Given the patient's severe swelling, normally one would speak of their suffering and urgent treatment needs regarding water. However, the Master instead discusses chest pain, causing doubt and inquiry. *Mai Jing* reads "The Master's pulse does not mention water," which is clearest. *Taiyang Shang Bian* Question: Symptom resembles Yang Dan section, and *Mai Jing* have similar linguistic patterns; consult them. Guan Yuan generally refers to the Lower Jiao, also seen in Jueyin Pian and Women's Miscellaneous Diseases. It is stated that doctors mistook it for Li-Yin (Retained Fluids) and used harsh purgatives. This means doctors misdiagnosed hypochondriac urgency/pain as Xuan-Yin or Zhi-Yin, wrongly using Shi-Zao Tang etc. At that time, the patient had not yet developed full-body swelling, whereas Cheng claimed seeing marked symptoms of facial/body/limb swelling and then using harsh purgatives, which was likely inappropriate. Also, 'Fan' [vexation] in Wei-Jia Xu-Fan is the same as 'Fan' in Nei-Fan after vomiting in *Taiyang Xia Bian*.
Furthermore, *Mai Jing* cites *Si Shi Jing*: "Earth loses its son, its Qi declines and weakens. Water overflows, soaking like a pool, striking the skin, causing facial and eye swelling, returning to the four limbs. Ignorant doctors see water and directly use purgatives, emptying the Spleen and Stomach, allowing water to reside. The Lung becomes floating and panting." Commentary: "The Lung becomes floating due to water, hence panting." *Chao Yuan Shang Han Ke Sou Hou* states: "Water stops under the heart, causing the Lung to float. The Lung governs coughing; water qi attacks it, causing coughing." *Shui Zhong Hou* states: "The Lung becomes floating due to water; floating leads to upward Qi and coughing." With these explanations, the meaning of floating cough becomes clear. (He Shi's *Yi Quan* states: "In water-induced panting, water qi rebels, and Lung Qi floats due to water. Observing those bathing in rivers, when water reaches the chest, panting occurs.")
Wind-Edema: Aversion to wind, complete body swelling.
Note: Shen considers it a condition of much wind and little water, which seems rigid. My elder brother said: "'Xu' resembles 'Xu Xu' [successive/continuous]; sweat comes out constantly without stopping." Also, Section 4 previously stated: "If the patient is not thirsty, sweating leads to recovery; this is Wind-Edema." Keep for reference. (*Ping Re Bing Lun* discussing Wind-Edema includes symptoms of dry mouth, bitter taste, and thirst.)
Yuespi Tang Prescription
Note: Herbs have nature and function. Once a prescription is formed, one may take its nature or its function. In this prescription, Gypsum, aided by Ma Huang's warm dispersal, retains only the function of driving out water, borrowing each other to expel water qi. (Gypsum driving out water is not mentioned in Ben Cao, but Zhongjing used it frequently to expel fluid retention.) Jia Shu Tang has the same efficacy of Ma Huang and Gypsum as the previous formula, but Ba Zhu combined with Ma Huang enhances the outward-moving power slightly. (Details on nature and function are in my work *Yao Zhi Tong Yi*.)
Fangji Fuling Tang Prescription
Note: This prescription combines exterior-releasing and diuretic actions. Fangji and Huang Qi both drive out exterior water; the principle is detailed under the Shi Bing Fangji Huangqi Tang section; consult mutually.
Yuespi Jia Shu Tang Prescription
Note: The indications for this prescription and the next differ mainly in severity and complexity; one should not rigidly adhere to the presence or absence of heat.
Gancao Mahuang Tang Prescription
*Qianjin Yi*: Mahuang Tang treats Wind-Dampness and Water diseases, causing body and facial swelling, numbness, and heaviness. (This is the present formula.) Cover heavily; if sweat appears after moving two zhang during the day, do not administer again. Guard against wind and cold carefully.
Effective for Skin-Edema.
Secret Experience Formula: Zouma Tongsheng San treats various Wind-Dampness, Wind-Cold and Cold-Damage headaches, carbuncles, all swellings/toxins, limb pain, wind-bi numbness.
It is this formula. Stir-fry until slightly yellow, grind into fine powder. Take 3 qian per dose. Add half a bell of water, boil vigorously once in a pot. Drink when cool/warm. Cover with a blanket, keeping warm and wind-proof, until sweating occurs. Continue to guard against wind contact to prevent recurrence.
Water disease, with a deep and small pulse, belongs to Shaoyin.
Note: Shaoyin here has the same meaning as Shaoyin Disease in Shang Han, referring to exterior deficiency-cold. Using Mahuang Fuzi Gancao Tang takes advantage of warm dispersal. Shen's theory, though clever, is somewhat forced.
Jue Er Pi Shui Zhe (Extremities cold with Skin-Edema):
*Yi Xin Fang*: Zhang Zhongjing's prescription, Qinglong Tang, treats limb pain and facial/eye swelling.
Mahuang (8 liang, remove nodes and tips) Xixin (2 liang) Ganjiang (2 liang) Banxia (washed)
Four herbs, chopped. Boil in 8 sheng of water to obtain 2 sheng. Take one dose and stop.
Also, another statement: Treats Spleen-Stomach water, facial/limb swelling, epigastric hardness/fullness, immobility. Sanggenbaipi Tang Prescription.
Sanggenbaipi (chopped, 2 sheng) Gui (1 chi) Shengjiang (3 pieces) Renshen (1 liang)
Four herbs, chopped. Boil in 3 dou of water until Sanggen reduces to 1 dou. Strain and discard dregs. Add Gui, Renshen, Shengjiang, and Huangyi (10 liang). Boil until reduced to 7 sheng. Take 1 sheng, adjust and take more as needed. (Current Ben Cao notes: 1 chi of Gui weighing 0.5 liang is standard. ○ Note: This is extracted from Volume 10 treating generalized edema; unsure if it is a lost text of this classic. Tentatively attached here.)
[Additional Notes]: This chapter begins by describing four conditions but specifically highlights Fengshui and Pishui, omitting Zhengshui and Shishui. Its treatment methods mention purgation, promoting urination, and inducing sweating. Examining the chapter, it details exterior-releasing formulas extensively, but lacks purgative and diuretic drugs. Is this due to later deletions, or did Zhongjing intentionally leave them implicit?
Huanghan (Yellow Sweat) Disease:
My elder brother said: This section should be read in five parts. The first two sentences generally describe Huanghan symptoms. The subsequent mentions of Lijie, Laoqi, and malignant sores are because they are similar to Huanghan but actually different, listed to illustrate this. Lijie must combine with cold evil, hence whole-body fever. (You's citation of the fourth article, attributed to Pishui in that commentary, contradicts this; however, attributing it to Huanghan is correct.)
Guizhi Qu Shaoyao Jia Mahuang Xixin Fuzi Tang Prescription (Wai Tai cites Shen Shi, naming it Fuzi Tang, with main symptoms identical to this section. Gancao, roasted. Mahuang, de-node, 3 liang. Xixin 3 liang. Fuzi, emphasized with large character. Dazao, instruction to split. Boil Mahuang, add instructions for re-boiling. Post-prescription note: In Zhongjing's Shang Han Lun, it is named Guizhi Qu Shaoyao Jia Mahuang Xixin Fuzi Tang. Zhao edition names it Gui Jiang Cao Zao Huang Xin Fu Tang Fang.)
Xia Jian Jian, Da Ru Pan (Ben Cao, Tu Jing cite, without the four characters 'bian ru xuan pan'. Song edition Wai Tai Yin Pi Men cites Bei Ji, also as Zhishi Zhu Tang.)
Note: The diseases in the previous and current sections are internal, differing from external body swelling. Included in this chapter, the explanation is unclear; suspected to be misplaced from the Tan Yin (Phlegm-Fluids) chapter. Chao Yuan Qi Fen Hou states: "Qi Fen arises from water-fluids clashing with Qi, forming knots. Qi circulation is usually unobstructed; if stagnation occurs, water-fluids clash with Qi, causing Qi Fen to knot and stay, hence called Qi Fen." Yi Xue Gang Mu states: "Qi Fen refers to bloating due to obstructed Qi. Xue Fen refers to bloating due to obstructed Blood." It is not that outside of Zhabing (Bloating disease), there are separate Qi Fen and Xue Fen diseases. Essentially, if Qi and Blood are obstructed, water is also obstructed, leading to oliguria. Oliguria causes gradual water accumulation in the abdomen leading to bloating. However, Qi Fen presents with hardness/fullness under the heart, originating above; Xue Fen involves blood knotting in the Bao Men, originating below. Qi Fen: water bloating precedes amenorrhea. Xue Fen: amenorrhea precedes water bloating. (Note: Lou's theory combining this with Shui Fen is contradictory.)
Zhishi Zhu Tang Prescription (Appears twice in Wai Tai, both stating Ba Zhu 3 liang. Ben Cao citation agrees, without the character 'Bai'. Wai Tai cites Bei Ji and Ben Cao, using 5 sheng of water, making it 1 dou.)
Lv Shan Tang Lei Bian states: "Jin Gui Yao Lue uses Zhishi Zhu Tang to treat water-fluids causing hardness/fullness under the heart, large as a plate. Stomach is Yang, Spleen is Yin. Yang is often in excess, Yin is often deficient. Strong Stomach and weak Spleen lead to separation of Yang and Yin. Spleen fails to transport fluids for the Stomach, causing water-fluids to form. Thus, Zhu tonifies Spleen, Zhishi suppresses Stomach. Later generations, unaware of the method of separating Strong Stomach and Weak Spleen, universally regard it as a tonifying and reducing formula. Furthermore, Ju Fang's Si Wu Tang, Er Chen Tang, Si Jun Zi Tang, and Yi Lao's Zhishi Wan are all derived from Jin Gui prescriptions. Understanding the great principles of the Sages' prescription creation makes later formulas unworthy of imitation. (Note: Strong Stomach/Weak Spleen, tonifying Spleen/suppressing Stomach, seems circuitous.)"
Wai Tai, Wen Zhong, Xu Wang Zhishi San: Suitable for Spring/Autumn use, reduces swelling, promotes urination, supplements wind-deficiency/cold bloating/anorexia.
Zhishi (roasted, 8 liang) Guixin (1 jin) Fuling Ba Zhu (each 5 liang) Make powder. Take one cun bi with wine, three times daily, increase to two bi. Qianjin Yue Ling: Zhu Jie Qi Fang.
Ba Zhu Zhike (stir-fried) Equal parts, grind and sieve, honey pills like wu zi size. Take 25 pills on empty stomach with water.
Sheng Hui: Treats Pi Jie (masses) causing anorexia, emptiness/fullness under heart like water. Zhishi San Prescription.
Add Banxia, Shengjiang to this formula, decoct in water.
Another formula for Ge Qi/Chest-Heart pain.
Add Shen Qu (1 liang each) to this formula, make powder. Take 1 qian with hot wine at any time.
Another formula for Yin Pi Qi Fen, hardness under heart like a cup, caused by water-fluids. Guixin San Prescription.
Add Guixin, Xixin, Fuzi, Binglang, Jiang, Zao to this formula, use Zhike, decoct in water. (Note: This is the ancestral formula for Yan Shi's Zhishi Zhu Tang.)
Another formula for Yin Pi, hardness under heart like a cup, intermittent pain. Take this formula.
Add Guixin, Shengjiang to this formula.
Bai Yi Xuan Fang: Treats all types of edema, water qi can also be treated.
Add Wuzhuyu, Fuling, Shengjiang to this formula, decoct in water.
Qi Xiao Liang Fang: Modified Zhishi Zhu Tang. Treats Qi blocked by Phlegm, hardness/fullness under heart, named Qi Fen.
Zhike, Ba Zhu, La Gui, Zisu, Chenpi, Binglang, Jiegeng, Wulingzhi, Muxiang (each 1 fen). Banxia, Fuling, Gancao (each 2 fen). Take 2 qian per dose. Add 2 zhan of water, 3 slices of Shengjiang.
Decoct to one zhong, strain, take warm before meals.