五皮饮 此方出华元化《中藏经》,以皮治皮,不伤中气,所以为治肿通用之剂。
大腹皮(酒洗) 桑白皮(生,各三钱) 云苓皮(四钱) 陈皮(三钱) 生姜皮(一钱)
水三杯,煎八分,温服。上肿,宜发汗,加紫苏叶、荆芥各二钱,防风一钱,杏仁一钱
五分;下肿,宜利小便,加防己二钱,木通、赤小豆各一钱三分;喘而腹胀,加生莱菔子、
杏仁各二钱;小便不利者,为阳水,加赤小豆、防己、地肤子;小便自利者,为阴水,加白
术二钱,苍术、川椒各一钱五分;热,加海蛤三钱,知母一钱五分;寒,加附子、干姜各二
钱,肉桂一钱;呕逆,加半夏、生姜各二钱;腹痛,加白芍一钱,桂枝一钱,炙甘草一钱。
导水茯苓汤 治水肿,头面、手足、遍身肿如烂瓜之状,按而塌陷。胸腹喘满,不能转
侧安睡,饮食不下。小便秘涩,溺出如割,或如黑豆汁而绝少。服喘嗽气逆诸药不效者,用
此即渐利而愈。
泽泻 赤茯苓 麦门冬(去心) 白术(各二两) 桑白皮 紫苏 槟榔 木瓜(各一两) 大腹
皮陈皮 砂仁 木香(各七钱五分)
上 咀,每服一二两,水二杯,灯草三十根,煎八分,食远服。如病重者,可用药
二两,又加麦冬及灯草半两,以水一斗,于砂锅内熬至一大碗。再下小锅内,煎至一钟。五更空心服。
加减《金匮》肾气丸 治脾肾两虚,肿势渐大,喘促不眠等证。
熟地(四两) 云茯苓(三两) 肉桂 牛膝 丹皮 山药 泽泻 车前子 山茱萸(各二两) 附
子(五钱)
研末,炼蜜丸如桐子大。每服三钱,灯草汤送下,一日两服。以两为钱,水煎服,名加
减《金匮》肾气汤,但附子必倍用方效。加川椒目一钱五分,巴戟天二钱,治脚面肿。
五皮饮:此方出自华元化的《中藏经》,以植物之皮治疗人体肌肤之肿,不损伤中焦脾胃之气,因此被视为治疗水肿的通用方剂。
大腹皮(用酒清洗)三钱、桑白皮(生用,各三钱)、云苓皮四钱、陈皮三钱、生姜皮一钱。
用水三杯,煎煮至剩余八分,温服。若上半身肿胀,适宜发汗,加紫苏叶二钱、荆芥二钱、防风一钱、杏仁一钱五分;下半身肿胀,适宜利小便,加防己二钱、木通一钱三分、赤小豆一钱三分;气喘且腹部胀满,加生莱菔子二钱、杏仁二钱;小便不利者,属于阳水,加赤小豆、防己、地肤子;小便自利者,属于阴水,加白术二钱、苍术一钱五分、川椒一钱五分;有热象,加海蛤三钱、知母一钱五分;有寒象,加附子二钱、干姜二钱、肉桂一钱;呕吐逆气,加半夏二钱、生姜二钱;腹痛,加白芍一钱、桂枝一钱、炙甘草一钱。
导水茯苓汤:治疗水肿,头面、手足及全身肿胀如烂瓜状,按压后凹陷不起。伴有胸腹喘满,无法转身安睡,饮食难进。小便涩滞不通,排尿时疼痛如刀割,或尿色如黑豆汁且量极少。服用治疗喘咳气逆的各种药物无效者,使用此方即可逐渐利尿而痊愈。
泽泻二两、赤茯苓二两、麦门冬(去心)二两、白术二两、桑白皮一两、紫苏一两、槟榔一两、木瓜一两、大腹皮七钱五分、陈皮七钱五分、砂仁七钱五分、木香七钱五分。
将药材捣碎,每次服用一两至二两,用水两杯,灯草三十根,煎煮至剩余八分,饭后服用。如果病情严重,可用药二两,再加麦冬半两及灯草半两,用水十斗,在砂锅中熬至一大碗。再倒入小锅内,煎至一钟。五更天空腹服用。
加减《金匮》肾气丸:治疗脾肾两虚,肿胀程度逐渐加重,气喘急促不能入睡等症状。
熟地黄四两、云茯苓三两、肉桂二两、牛膝二两、丹皮二两、山药二两、泽泻二两、车前子二两、山茱萸二两、附子五钱。
研成细末,用炼蜜制成如梧桐子大小的丸药。每次服用三钱,用灯草汤送服,每日两次。若按“两”为“钱”的比例改为水煎服用,则称为加减《金匮》肾气汤,但必须加倍使用附子才能见效。加入川椒目一钱五分、巴戟天二钱,可治疗脚面肿胀。
Wu Pi Yin (Five Peel Decoction): This formula originates from Hua Yuanhua's *Zhong Zang Jing* (Classic of the Middle Viscera). It utilizes plant peels to treat swelling of the human skin and flesh without damaging the Qi of the middle Jiao (middle warmer, primarily referring to the Spleen and Stomach), thus making it a universal agent for treating edema.
Da Fu Pi (Areca Peel) (washed with wine) 3 qian, Sang Bai Pi (Morus Alba Root Bark) (raw, each 3 qian), Yun Ling Pi (Poria Cocos Peel) 4 qian, Chen Pi (Citrus Reticulata Peel) 3 qian, Sheng Jiang Pi (Zingiber Officinale Peel) 1 qian.
Add three cups of water, decoct until one-eighth remains, and take warm. For swelling in the upper body, sweating is indicated; add Zi Su Ye (Perilla Leaf) 2 qian, Jing Jie (Schizonepeta Spike) 2 qian, Fang Feng (Saposhnikovia Root) 1 qian, Xing Ren (Apricot Seed) 1.5 qian. For swelling in the lower body, promoting urination is indicated; add Fang Ji (Stephania Tetrandra Root) 2 qian, Mu Tong (Akebia Caulis) 1.3 qian, Chi Xiao Dou (Adzuki Bean) 1.3 qian. For wheezing accompanied by abdominal distension, add Sheng Lai Fu Zi (Radish Seed) 2 qian, Xing Ren (Apricot Seed) 2 qian. For those with difficult urination, this is classified as Yang Edema; add Chi Xiao Dou (Adzuki Bean), Fang Ji (Stephania Tetrandra Root), Di Fu Zi (Kochia Fruit). For those with spontaneous frequent urination, this is classified as Yin Edema; add Bai Zhu (Atractylodes Macrocephala Rhizome) 2 qian, Cang Zhu (Atractylodes Lancea Rhizome) 1.5 qian, Chuan Jiao (Sichuan Pepper) 1.5 qian. For heat signs, add Hai Ge (Clam Shell) 3 qian, Zhi Mu (Anemarrhena Rhizome) 1.5 qian. For cold signs, add Fu Zi (Aconite Lateral Root) 2 qian, Gan Jiang (Dried Ginger) 2 qian, Rou Gui (Cinnamon Bark) 1 qian. For vomiting and rebellious Qi, add Ban Xia (Pinellia Tuber) 2 qian, Sheng Jiang (Fresh Ginger) 2 qian. For abdominal pain, add Bai Shao (White Peony Root) 1 qian, Gui Zhi (Cinnamon Twig) 1 qian, Zhi Gan Cao (Honey-fried Licorice Root) 1 qian.
Dao Shui Fu Ling Tang (Water-Guiding Poria Decoction): Treats edema where the head, face, hands, feet, and entire body swell like rotting melons, leaving an indentation upon pressure. Accompanied by chest and abdominal wheezing and fullness, inability to turn over or sleep comfortably, and inability to eat or drink. Urine is scanty and difficult to pass, feeling as if cutting with a knife during urination, or urine is dark like black bean juice and extremely scarce. When various medicines for treating wheezing, coughing, and rebellious Qi are ineffective, using this formula will gradually promote diuresis and lead to recovery.
Ze Xie (Alisma Rhizome) 2 liang, Chi Fu Ling (Red Poria) 2 liang, Mai Men Dong (Ophiopogon Tuber) (core removed) 2 liang, Bai Zhu (Atractylodes Macrocephala Rhizome) 2 liang, Sang Bai Pi (Morus Alba Root Bark) 1 liang, Zi Su (Perilla Leaf/Stem) 1 liang, Bing Lang (Betel Nut) 1 liang, Mu Gua (Chaenomeles Fruit) 1 liang, Da Fu Pi (Areca Peel) 0.75 liang, Chen Pi (Citrus Reticulata Peel) 0.75 liang, Sha Ren (Amomum Fruit) 0.75 liang, Mu Xiang (Vladimiria Root) 0.75 liang.
Crush the herbs. Take 1-2 liang per dose, with two cups of water and thirty stalks of Deng Cao (Juncus Effusus Stem), decoct until one-eighth remains. Take after meals. If the disease is severe, use 2 liang of medicine, add half a liang of Mai Dong (Ophiopogon Tuber) and half a liang of Deng Cao (Juncus Effusus Stem). Use ten dou of water, simmer in a clay pot until one large bowl remains. Then transfer to a smaller pot and decoct until one bell (zhong) remains. Take on an empty stomach at Wu Geng (around 3-5 AM).
Jia Jian Jin Gui Shen Qi Wan (Modified Kidney Qi Pill from the Golden Cabinet): Treats deficiency of both Spleen and Kidney, with progressively increasing swelling, rapid breathing, and insomnia.
Shu Di Huang (Prepared Rehmannia Root) 4 liang, Yun Fu Ling (Poria Cocos) 3 liang, Rou Gui (Cinnamon Bark) 2 liang, Niu Xi (Achyranthes Root) 2 liang, Dan Pi (Moutan Cortex) 2 liang, Shan Yao (Dioscorea Rhizome) 2 liang, Ze Xie (Alisma Rhizome) 2 liang, Che Qian Zi (Plantago Seed) 2 liang, Shan Zhu Yu (Cornus Fruit) 2 liang, Fu Zi (Aconite Lateral Root) 5 qian.
Grind into powder, refine honey, and make pills the size of tung tree seeds. Take 3 qian per dose, delivered with Deng Cao Tang (Juncus Effusus Decoction), twice daily. If taken as a water decoction using the ratio where 1 liang equals 10 qian, it is called Jia Jian Jin Gui Shen Qi Tang (Modified Kidney Qi Decoction from the Golden Cabinet), but the dosage of Fu Zi (Aconite Lateral Root) must be doubled to be effective. Add Chuan Jiao Mu (Sichuan Pepper Seed) 1.5 qian, Ba Ji Tian (Morinda Officinalis Root) 2 qian to treat swelling of the instep.