其一取肾、膀胱。经前篇云∶五十七穴者，是取其二经之穴也。又经云∶肾病者，腹大胫肿，取其经
少阴、太阳血者，是取其二经之血也。
其二取血络。经前云∶取皮肤之血者，尽取之是也。
其三取胃。经云∶胃足阳明之脉，所生病者，大腹水肿，视盛虚、热寒、陷下取之是也。
其四取委阳。经云∶三焦病者，不得小便，溢则水，取委阳是也。
其五筒针取水。先以铍针针之，已刺而筒之，引针而纳之，入而复之，以尽其 ，必坚来，
来缓则烦 ，来急则安静，间日一刺之， 尽乃止。（筒针，针中有空窍如筒，出水也。）
〔《撮》〕浮肿∶分水、中脘（各灸之。）内庭 行间 临泣（各泻，立安。）
〔东〕水气，皮痛不可近衣，小腹敦敦然，小便黄，身润∶章门 屋翳（灸。）阴交 章门（刺之。）
〔华〕外腰水肿，先从腰肿起∶肝募 水分
内中水肿，面痿黄∶胃脘 通谷 气海 水分
胞中水肿，根在心，水赤∶心俞 巨阙 气海
腹中水肿，从脾起，水黄∶脾俞 胃脘 水分
肺喘水肿，从胸起，水白∶肺俞 肝募
足心水肿，从足起∶白环俞 水分 中
四肢水肿，变身浮∶胆募
两胁水肿，四肢枯瘦，从胁肿起∶章门 期门
小肠水肿，从脐肿起∶气海。
〔《保》〕五脉论五水灸法∶
青水，灸肝井。（弦脉。）赤水，灸心荥。（洪脉。）黄水，灸脾俞。（缓脉。）白水，灸肺经。（涩脉。）
黑水，灸肾合。（沉脉。）
〔《甲》〕身肿，关门主之。水肿胀皮肿，三里主之。风水膝肿，巨虚上廉主之。风水，面 肿，颜黑，
解溪主之。风水，面 肿，冲阳主之。水中留饮，胸胁支满，刺陷谷出血，立已。面 肿，上星主之；先取噫嘻
，后取天牖、风池。水肿，人中尽满唇反者死，水沟主之。水肿大脐平，灸脐中，无理不治。
〔《素》〕目窠微肿如卧蚕之状，曰水。（平人气象论）足胫肿曰水。
〔仲〕病下利后，渴饮水，小便不利，腹满因肿者，何也？答曰∶此法当病水。若小便自利及汗出者，自
当愈。跗阳脉当伏，今反数，本自有热消谷，小便数，今反不利，此欲作水。寸口脉浮而迟，浮脉则热，迟脉
则潜，热潜相搏，名曰沉。跗阳脉浮而数，浮脉则热，数脉则止，热止相搏，名曰伏。沉伏相搏，名曰水。沉
则络脉虚，伏则小便难，虚难相搏，水走皮肤，则为水矣。
〔《素》〕颈脉动喘疾咳，曰水。（平人气象论）
〔仲〕风水，其脉自浮，外证骨节疼痛，恶风。（《针经·论疾诊尺篇》云∶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。又仲景云∶太阴脉浮而紧，法当骨节疼痛，反不疼，身体反
重而酸，其人不渴，汗出即愈，为风水。治法见前阳虚条。）
皮水，其脉亦浮，外证 肿，按之没指，不恶风，其腹如鼓，不渴，当发其汗。（又云∶渴而不恶寒者，此是
皮水。盖法当风水，恶寒不渴；皮水，不恶寒而渴。假令皮水不渴，亦当发汗也。治法见阳虚条。）正水，其脉沉
迟，外证自喘。
石水，其脉自沉，外证腹满不喘。（大奇论篇 肾肝并沉为石水，并浮为风水。）
黄汗，其脉沉迟，身发热，胸满，四肢、头面肿，久不愈，必致痈脓。（又云∶身肿而冷状如周痹，胸中窒
不能食，反聚痛，暮躁不得眠，此为黄汗。治法见黄胆条。）
〔仲〕心水者，其身重而少气，不得卧，烦而躁，其阴大肿。肝水者，其腹大，不能自转侧，胁下腹中痛，
时时津液微生，小便续通。肺水者，身肿，小便难，时时鸭溏。脾水者，其腹大，四肢苦重，津液不生，但苦
少气，小便难。肾水者，其腹大，脐肿腰痛，不得溺，阴下湿如牛鼻上汗，其足逆冷，面黄瘦。（一云∶大便反坚。）
〔无〕大抵浮肿带数，即是虚寒潜止于其间，久必沉伏，沉伏则阳虚阴实，为水必矣。面 然浮肿疼痛，
其色 黑，多汗恶风者，属肾风。（治见诸风注。）诸唇黑则伤肝，缺盆平则伤心，脐出则伤脾，足心平则伤肾，
背平则伤肺。凡此五伤，必不可治也。
〔仲〕脉得诸沉，当责有水，身体肿重。水病，脉出者死。（无择云∶大抵浮脉带数，即是虚寒潜止于其间，
久必沉伏，沉伏则阳虚阴实，为水必矣。）
〔《脉》〕水病，脉洪大者可治；微细者不可治。水病，腹大如鼓，脉实者生；虚者死。水病，夜半死。
（全文见诊生死。）
〔《仲》〕诸病水者，渴而下利，小便数者，皆不可发汗。
〔《素》〕帝曰∶有病肾风者，面 然壅，害于言，可刺否？岐伯曰∶虚不当刺，不当刺而刺，后五日
其气必至。帝曰∶其至何如？岐伯曰∶至必少气时热，时热从胸背上至头，汗出手热，口干苦渴，小便黄，目
下肿，腹中鸣，身重难以行，月事不下，烦而不能食，不能正偃，正偃则咳，病名曰风水，论在刺法中。帝曰∶
愿闻其说。岐伯曰∶邪之所凑，其气必虚。阴虚者，阳必凑之，故少气时热而汗出也。小便黄者，少腹中有
热也。不能正偃者，胃中不和也。正偃则咳甚，上迫肺也。诸有水气者，微肿先见于目下也。帝曰∶何以言之？
岐伯曰∶水者阴也；目者，亦阴也。腹者至阴之所居，故水在腹者，必使目下肿也。真气上逆，故口苦舌干，
卧不得正偃，正偃则咳出清水也。诸水病者，故不得卧，卧则惊，惊则咳甚也。腹中鸣者，病本于胃也。薄脾
则烦不能食，食不下者，胃脘隔也。身重难以行者，胃脉在足也。月事不来者，胞脉闭也，胞脉者属心而络于
胞中，今气上迫肺，心气不得下通，故月事不来也。（评热病论）
〔仲〕问曰∶病者苦水，面目、身体、四肢皆肿，小便不利，脉之不言水，反言胸中痛，气上冲咽，状如炙
肉，当微咳喘，审如师言，其脉何类？师曰∶寸口脉沉而紧，沉为水，紧为寒，沉紧相搏，结在关元，始时当
微，年盛不觉，阳衰之后，荣卫相干，阳损阴盛，结寒微动，紧气上冲，喉咽塞噎，胁下急痛。医以为留饮而
大下之，气击不去，其病不除。后重吐之，胃家虚烦，咽燥欲饮水，小便不利，水谷不化，面目手足浮肿。又
与葶苈丸下水，当时如小瘥，食饮过度，肿复如前，胸胁苦痛，象若奔豚，其水扬溢，则浮咳喘逆。当先攻击
冲气令止，乃治咳。咳止，其喘自瘥。先治新病，病当在后。
〔丹〕卢氏医镜水胀辨《内经》曰∶诸气 郁，皆属于肺。诸湿肿满，皆属于脾。诸腹胀大，皆属于热。
盖湿者，土之气，土者，火之子。故湿每生于热，热气亦能自湿者，子气感母，湿之变也。凡病肿，皆宜以治
湿为主。所挟不同，故治法亦异。《类例》治肿，以治水立说，而欲导肾以决去之，岂理也哉！脾土衰弱，
内因七情，外伤六气，失运化之职，清浊混淆，郁而为水。《类例》以为本末皆隶于肺、肾、胃三者而不及脾，
下文继以肺金盛而生水，水液妄行，气息闭，枢机壅而为肿。夫脾土受病，肺为之子，焉有自盛而生水者哉？
若谓肿之水果生于肺金之清气，则滋长肾阴，奉行降令，为化生之源，何病肿之有？今渗透经络，注流溪谷，
皆浊腐之气，窒碍津液，久久灌入隧道，血亦化水，而欲藉脾土以制之，导肾气以利之，不思脾病则肝木来侮，子
气亦衰，木寡于畏，脾欲不病，不可得矣。治法宜清心经之火，补养脾土，全运化之职，肺气下降，渗道开通，
使败浊之气其稍清者，复回而为气、为血、为津液；其甚者，在上为汗，在下为溺，以渐而分消矣。今不明言，
而曰制水、燥水，得非白圭以邻国为壑乎？经言肿病因津液充郭而致，不生于肺金之盛也明矣。又言气拒于内，
气耗于外，责其不能渗运败浊耳。又云∶开鬼门，洁净府。鬼门，肤腠也，属肺；净府，膀胱也，属肾之府。
未闻有导肾气之说。注衣冠文物言阴精耗损，肾气果可导乎？仲景谓治湿利小便，即经中洁净府之意。苟以清净为
肾而导之，果于经意有合乎？钱仲阳谓肾无泻法，其可轻易导之乎？或曰∶经言疏涤五脏，非导肾欤？予曰∶
此承上文五阳已布而言，若鬼门开矣，净府洁矣，五宫之阳气条布，彼败浊之气，自然疏导涤除，
于肾气何与焉。
其一，取用肾经和膀胱经的穴位。《内经》前篇说：“五十七个穴位，是取用这两条经脉的穴位。”又《内经》说：“肾病表现为腹部胀大、小腿浮肿，取用其经脉（少阴经、太阳经）的血络”，这是取用这两条经脉的血分。
其二，取用血络。《内经》前文说：“取用皮肤下的血络，全部刺破放血”，就是这个意思。
其三，取用胃经。《内经》说：“足阳明胃经所生的病证中，有大腹水肿，观察其脉气的盛衰、寒热以及下陷情况来选取穴位治疗”，就是这个意思。
其四，取用委阳穴。《内经》说：“三焦病的症状是小便不通，水液溢出导致水肿，取用委阳穴”，就是这个意思。
其五，使用筒针放水。先用铍针刺入，刺入后用筒针吸附，拔出针具并纳入筒针，进针再退针，以排尽积水，必须等到出水坚急有力；如果出水缓慢则患者会感到烦闷，如果出水急骤则患者感觉安静，每隔一天刺一次，直到积水排尽才停止。（筒针，是一种针身中间有空窍如竹筒状的针具，用于引出积水。）
〔《撮要方》〕浮肿：灸水分穴、中脘穴（各灸之）。泻内庭穴、行间穴、足临泣穴（各用泻法，立见安宁。）
〔朱丹溪〕水气病，皮肤疼痛不能靠近衣物，小腹胀满坚实，小便黄，身体湿润：灸章门穴、屋翳穴。刺阴交穴、章门穴。
〔华佗〕外腰水肿，先从腰部开始肿胀：灸肝募穴、水分穴。
内中水肿，面色萎黄：灸胃脘穴、通谷穴、气海穴、水分穴。
胞宫/下焦水肿，根源在心，尿色赤红：灸心俞穴、巨阙穴、气海穴。
腹中水肿，从脾脏引起，尿色黄：灸脾俞穴、胃脘穴、水分穴。
肺喘伴水肿，从胸部开始，尿色白：灸肺俞穴、肝募穴。
足心水肿，从脚部开始：灸白环俞穴、水分穴、中封穴。
四肢水肿，全身浮肿：灸胆募穴。
两胁水肿，四肢枯瘦，从胁肋开始肿胀：灸章门穴、期门穴。
小肠水肿，从脐部开始肿胀：灸气海穴。
〔《保命集》〕五脉论五水灸法：
青水，灸肝经井穴。（对应弦脉。）
赤水，灸心经荥穴。（对应洪脉。）
黄水，灸脾俞穴。（对应缓脉。）
白水，灸肺经。（对应涩脉。）
黑水，灸肾经合穴。（对应沉脉。）
〔《甲乙经》〕身体浮肿，关门穴主治。水肿腹胀皮肤肿，足三里穴主治。风水膝肿，上巨虚穴主治。风水，面部浮肿，面色暗黑，解溪穴主治。风水，面部浮肿，冲阳穴主治。水中留饮，胸胁支撑胀满，刺陷谷穴出血，立即痊愈。面部浮肿，上星穴主治；先取噫嘻穴，后取天牖穴、风池穴。水肿，若人中穴部位饱满隆起、嘴唇翻卷者死，水沟穴主治。水肿严重至肚脐平齐者，灸脐中穴，若无理可治则难愈。
〔《素问》〕眼窝轻微肿胀像卧蚕的样子，称为水病。（出自《平人气象论》）足胫部肿胀称为水病。
〔张仲景〕病人在腹泻后，口渴想喝水，小便不利，腹部胀满因而浮肿，这是什么病？回答说：这应当是水病。如果小便自利以及出汗的，自然会痊愈。跗阳脉应当伏匿不见，现在反而数，本来体内有热能消谷，小便频数，现在反而不利，这是将要发生水病。寸口脉浮而迟，浮脉主热，迟脉主潜藏，热与潜相搏结，名叫沉。跗阳脉浮而数，浮脉主热，数脉主止（或躁动），热与止相搏结，名叫伏。沉与伏相搏结，名叫水。沉则络脉空虚，伏则小便困难，虚与难相搏结，水气走窜皮肤，就形成水病了。
〔《素问》〕颈部动脉跳动，气喘且急促咳嗽，称为水病。（出自《平人气象论》）
〔张仲景〕风水病，其脉象自然浮，外在证候为骨节疼痛，恶风。（《针经·论疾诊尺篇》说：看人的眼窝上微肿像刚起床的样子，颈部脉搏跳动，时常咳嗽，按压手足背部凹陷不起的，是风水肤胀。另外仲景说：太阴脉浮而紧，按理应当骨节疼痛，反而不疼，身体反而沉重酸痛，病人不渴，出汗即愈，这是风水。治法见前文阳虚条。）
皮水，其脉象也浮，外在证候为全身浮肿，按之凹陷没指，不恶风，腹部像鼓一样胀，口不渴，应当发汗。（又说：口渴而不恶寒的，这是皮水。大概规律是：风水恶寒不渴；皮水不恶寒而渴。假如皮水不渴，也应当发汗。治法见阳虚条。）正水，其脉象沉迟，外在证候为自然气喘。
石水，其脉象自然沉，外在证候为腹部胀满但不气喘。（《大奇论篇》说：肾脉肝脉都沉是为石水，都浮是为风水。）
黄汗，其脉象沉迟，身体发热，胸满，四肢、头面肿胀，久不痊愈，必定导致痈脓。（又说：身体肿而冷，状如周痹，胸中窒塞不能进食，反而聚痛，傍晚烦躁不得眠，这是黄汗。治法见黄疸条。）
〔张仲景〕心水病，身体沉重而气短，不能平卧，心烦而躁动，生殖器肿大。肝水病，腹部胀大，不能自行翻身转侧，胁下及腹部疼痛，时时津液微生，小便断续通畅。肺水病，身体浮肿，小便困难，时时大便稀溏如鸭粪。脾水病，腹部胀大，四肢苦于沉重，津液不生，只苦于气短，小便困难。肾水病，腹部胀大，脐部肿胀腰痛，不能排尿，阴部潮湿像牛鼻上的汗，双脚逆冷，面色黄瘦。（另一种说法：大便反而干硬。）
〔王无择〕大抵浮肿兼见数脉，即是虚寒潜藏其中，时间久了必然沉伏，沉伏则阳气虚阴气实，必然形成水病。面部浮肿疼痛，其色暗黑，多汗恶风的，属于肾风。（治法见诸风注。）凡是嘴唇黑则伤肝，缺盆平则伤心，脐出则伤脾，足心平则伤肾，背部平则伤肺。凡此五种损伤，都是不可治愈的。
〔张仲景〕脉象见到各种沉脉，应当责求有水，身体肿重。水病，脉象浮大无根者死。（王无择说：大抵浮脉带数，即是虚寒潜藏其中，时间久了必然沉伏，沉伏则阳气虚阴气实，必然形成水病。）
〔《脉经》〕水病，脉象洪大的可治；脉象微细的不可治。水病，腹部胀大如鼓，脉象实的生；脉象虚的死。水病，夜半时死。（全文见诊生死篇。）
〔张仲景〕各种水病患者，口渴而下利，小便频数的，都不可发汗。
〔《素问》〕黄帝问：有患肾风的人，面部浮肿壅滞，言语不利，可以针刺吗？岐伯说：正气虚不当针刺，不当刺而刺，五天后邪气必至。黄帝问：邪气至会有什么表现？岐伯说：至后必然气短、时而发热，热感从胸背升至头部，手热，口干苦渴，小便黄，眼下肿，腹中鸣响，身体沉重难以行走，月经不来，心烦不能食，不能仰卧，仰卧则咳，病名叫做风水，论述在刺法中。黄帝说：愿闻其道理。岐伯说：邪气聚集的地方，正气必虚。阴虚者，阳邪必凑之，所以气短、时而发热而汗出。小便黄，是因为小腹部有热。不能仰卧，是因为胃中不和。仰卧则咳甚，是因为上迫肺脏。所有有水气的人，微肿先见于眼下。黄帝问：为什么这样说？岐伯说：水是阴邪；眼睛，也是阴位。腹部是至阴之所居，所以水在腹部，必然使眼下肿胀。真气上逆，所以口苦舌干，卧不得仰卧，仰卧则咳出清水。所有水病患者，所以不能卧，卧则惊，惊则咳甚。腹中鸣响，病本在于胃。邪气薄于脾则烦不能食，食不下，是因为胃脘阻隔。身体沉重难以行走，是因为胃脉在足。月经不来，是因为胞脉闭塞，胞脉属心而络于胞中，现在气上迫肺，心气不得下通，所以月经不来。（出自《评热病论》）
〔张仲景〕问：病人苦于水病，面目、身体、四肢皆肿，小便不利，切脉不说水病，反而说胸中痛，气上冲咽喉，感觉像有炙肉堵着，应当微咳喘，确实像老师说的，其脉象是什么样？老师说：寸口脉沉而紧，沉主水，紧主寒，沉紧相搏，结在关元穴处，开始时当轻微，年壮时不觉，阳气衰退之后，营卫相互干扰，阳损阴盛，结寒微动，紧气上冲，喉咽塞噎，胁下急痛。医生以为是留饮而用峻下法，气击不去，病不除。后来再次用吐法，胃家虚烦，咽燥欲饮水，小便不利，水谷不化，面目手足浮肿。又给予葶苈丸下水，当时好像稍好，饮食过度，肿复如前，胸胁苦痛，象若奔豚，水气扬溢，则浮咳喘逆。应当先攻击冲气令其停止，然后治咳。咳止，其喘自愈。先治新病，旧病当在后。
〔朱丹溪〕卢氏医镜水胀辨：《内经》说：诸气郁，皆属于肺。诸湿肿满，皆属于脾。诸腹胀大，皆属于热。盖湿是土之气，土是火之子。所以湿每生于热，热气也能由湿变来，是子气感母，湿的变化。凡是病肿，都宜以治湿为主。所挟不同，所以治法亦异。《类例》治肿，以治水立说，而想通过导引肾气来决去水邪，这合乎道理吗！脾土衰弱，内因七情，外伤六气，失运化之职，清浊混淆，郁而为水。《类例》认为本末都隶属于肺、肾、胃三者而不及脾，下文接着说肺金盛而生水，水液妄行，气息闭阻，枢机壅塞而为肿。夫脾土受病，肺为之子，哪有子盛而生水的道理呢？如果说肿的水果生于肺金的清气，那么滋长肾阴，奉行降令，作为化生之源，怎么会得肿病呢？如今水渗透经络，注流溪谷，都是浊腐之气，窒碍津液，久久灌入隧道，血也化为水，而想借脾土来制约它，导肾气来利它，不考虑脾病则肝木来侮，子气亦衰，木寡于畏，脾想要不病，是不可能的了。治法宜清心经之火，补养脾土，全运化之职，肺气下降，渗道开通，使败浊之气其稍清者，复回而为气、为血、为津液；其甚者，在上为汗，在下为溺，以渐而分消矣。现在不明言，而说制水、燥水，岂不是像白圭那样把邻国当作沟壑吗？经言肿病因津液充郭而致，不生于肺金之盛也明矣。又言气拒于内，气耗于外，责其不能渗运败浊耳。又云：开鬼门，洁净府。鬼门，肤腠也，属肺；净府，膀胱也，属肾之府。未闻有导肾气之说。注衣冠文物言阴精耗损，肾气果可导乎？仲景谓治湿利小便，即经中洁净府之意。苟以清净为肾而导之，果于经意有合乎？钱仲阳谓肾无泻法，其可轻易导之乎？或曰：经言疏涤五脏，非导肾欤？予曰：此承上文五阳已布而言，若鬼门开矣，净府洁矣，五宫之阳气条布，彼败浊之气，自然疏导涤除，于肾气何与焉。
First, select acupoints from the Kidney and Bladder meridians. The preceding chapter of the Classic states: "The fifty-seven acupoints are those selected from these two meridians." Furthermore, the Classic says: "In Kidney disease, characterized by abdominal distension and leg swelling, one should select the blood vessels of its meridians (Shaoyin and Taiyang)," which refers to selecting the blood aspect of these two meridians.
Second, select blood collaterals (Xueluo). The preceding text of the Classic states: "Select the blood in the skin collaterals and drain them all," which is the meaning here.
Third, select the Stomach meridian. The Classic states: "Among the diseases generated by the Foot-Yangming Stomach Meridian, there is large abdominal edema; one should observe the excess or deficiency, heat or cold, and sinking conditions to select points for treatment," which is the meaning here.
Fourth, select Weiyang (BL39). The Classic states: "In Sanjiao disease, characterized by inability to urinate and water overflowing causing edema, select Weiyang (BL39)," which is the meaning here.
Fifth, use tube needles (Tongzhen) to drain water. First, puncture with a Pi needle (Bizhen), then apply the tube needle after puncturing. Withdraw the needle and insert the tube, advancing and withdrawing repeatedly to exhaust the fluid accumulation. One must wait until the flow is firm and urgent; if the flow is slow, the patient will feel vexed; if the flow is rapid, the patient will feel calm. Puncture once every other day, stopping only when the fluid is exhausted. (Tube needles are needles with a hollow cavity like a cylinder, used to drain water.)
[From *Cuo Yao Fang*] For generalized edema: Moxibustion on Shuifen (CV9) and Zhongwan (CV12). Reducing method on Neiting (ST44), Xingjian (LR2), and Zulinqi (GB41); immediate relief follows.
[Zhu Danxi] For Water Qi disease, where the skin is painful and cannot tolerate clothing, the lower abdomen is full and firm, urine is yellow, and the body feels moist: Moxibustion on Zhangmen (LR13) and Wuyi (ST15). Needling Yinjiao (RN7) and Zhangmen (LR13).
[Hua Tuo] For external waist edema, starting with swelling in the waist: Moxibustion on Ganshu (Liver Mu point) and Shuifen (CV9).
For internal edema with sallow complexion: Moxibustion on Weiwuan (ST10), Tonggu (SP10), Qihai (CV6), and Shuifen (CV9).
For bladder/lower jiao edema, rooted in the Heart, with red urine: Moxibustion on Xinshu (BL15), Jueque (CV14), and Qihai (CV6).
For abdominal edema originating from the Spleen, with yellow urine: Moxibustion on Pishu (BL20), Weiwuan (ST10), and Shuifen (CV9).
For lung wheezing with edema, starting from the chest, with white urine: Moxibustion on Feishu (BL13) and Ganshu (Liver Mu point).
For edema starting from the soles of the feet: Moxibustion on Baihuanxu (BL30), Shuifen (CV9), and Zhongfeng (LR4).
For edema of the four limbs and generalized floating edema: Moxibustion on Danshu (Gallbladder Mu point).
For edema of the two hypochondria with emaciated limbs, starting from the ribs: Moxibustion on Zhangmen (LR13) and Qimen (LR14).
For Small Intestine edema, starting from the umbilicus: Moxibustion on Qihai (CV6).
[From *Bao Ming Ji*] Five Pulses discussing Five Waters moxibustion methods:
Green Water, moxa Liver Jing-Well point. (Corresponds to String-like pulse/Xian Mai.)
Red Water, moxa Heart Ying-Spring point. (Corresponds to Surging pulse/Hong Mai.)
Yellow Water, moxa Pishu (BL20). (Corresponds to Moderate pulse/Huan Mai.)
White Water, moxa Lung Meridian. (Corresponds to Choppy pulse/Sai Mai.)
Black Water, moxa He-Sea point of the Kidney Meridian. (Corresponds to Deep pulse/Chen Mai.)
[From *Jia Yi Jing*] Generalized body swelling: Guanmen (ST45) governs it. Edema with abdominal distension and skin swelling: Zusanli (ST36) governs it. Wind-water with knee swelling: Shangjuxu (ST37) governs it. Wind-water with facial swelling and dark complexion: Jiexi (ST41) governs it. Wind-water with facial swelling: Chongyang (ST42) governs it. Retained fluid in the water pathway with chest and hypochondriac fullness: Bleed Xiangu (ST43); immediate resolution. Facial swelling: Shangxing (GV23) governs it; first select Yixi (BL54), then Tianyou (TE16) and Fengchi (GB20). Edema: If the Renzhong area is full and lips are everted, death ensues; Shuigou (GV26) governs it. Severe edema with umbilicus level with the abdomen: Moxa the center of the umbilicus; without rational treatment, it is incurable.
[From *Su Wen*] Slight swelling of the eye sockets resembling a sleeping silkworm indicates Water disease. (From *Ping Ren Qi Xiang Lun*) Swelling of the calves and shins indicates Water disease.
[Zhang Zhongjing] After diarrhea, if the patient is thirsty and desires water, has difficulty urinating, and develops abdominal fullness and subsequent swelling, what is this? The answer is: This is Water disease. If urination becomes free and sweating occurs, it will heal spontaneously. The Fuyang pulse should be hidden/deep; if it is now rapid, indicating underlying heat that digests food and causes frequent urination, but now urination is difficult, this suggests impending Water disease. The Cun Kou pulse is floating and slow. Floating indicates Heat; Slow indicates Submergence. The interaction of Heat and Submergence is called Chen (Deep). The Fuyang pulse is floating and rapid. Floating indicates Heat; Rapid indicates Restlessness/Stagnation. The interaction of Heat and Restlessness is called Fu (Hidden). The interaction of Chen and Fu is called Water. Chen implies emptiness in the collateral vessels; Fu implies difficulty in urination. The interaction of Emptiness and Difficulty allows Water to move into the skin, forming Water disease.
[From *Su Wen*] Pulsation of the neck artery, wheezing, and rapid coughing indicate Water disease. (From *Ping Ren Qi Xiang Lun*)
[Zhang Zhongjing] In Feng Shui (Wind-Water) disease, the pulse is naturally floating, with external signs of joint pain and aversion to wind. (*Zhen Jing · Lun Ji Zhen Chi Pian* states: Observing slight swelling above the eye sockets as if just awakened, pulsation of the neck artery, occasional coughing, and pitting edema upon pressing the hands and feet indicates Feng Shui skin distension. Additionally, Zhang Zhongjing states: If the Taiyin pulse is floating and tight, joint pain is expected, but if there is no pain, instead feeling heavy and achy, without thirst, and healing with sweat, this is Feng Shui. Treatment is described in the Yang Deficiency section earlier.)
Pi Shui (Skin-Water) also presents with a floating pulse. External signs include generalized edema that pits upon pressure, aversion to wind is absent, the abdomen is drum-like, and there is no thirst. Sweating should be induced. (It is also stated: Thirst without aversion to cold indicates Pi Shui. Generally, Feng Shui involves aversion to cold and no thirst; Pi Shui involves no aversion to cold but thirst. Even if Pi Shui presents without thirst, sweating should still be induced. Treatment is described in the Yang Deficiency section.) Zheng Shui (True Water) presents with a deep and slow pulse, with external signs of spontaneous wheezing.
Shi Shui (Stone Water) presents with a naturally deep pulse, with external signs of abdominal fullness but no wheezing. (*Da Qi Lun Pian* states: When both Kidney and Liver pulses are deep, it is Shi Shui; when both are floating, it is Feng Shui.)
Huang Han (Yellow Sweat) presents with a deep and slow pulse, body fever, chest fullness, and swelling of the limbs, head, and face. If prolonged, it inevitably leads to abscesses and pus. (It is also stated: Body swelling with coldness, resembling Zhou Bi, chest oppression, inability to eat, intermittent pain, evening restlessness, and insomnia indicate Yellow Sweat. Treatment is described in the Jaundice section.)
[Zhang Zhongjing] Xin Shui (Heart Water): The body is heavy with shortness of breath, inability to lie flat, vexation and restlessness, and significant swelling of the genitals. Gan Shui (Liver Water): Abdominal distension, inability to turn over independently, pain in the hypochondrium and abdomen, occasional production of saliva, and intermittent urination. Fei Shui (Lung Water): Generalized swelling, difficulty urinating, and frequent loose stools resembling duck droppings. Pi Shui (Spleen Water): Abdominal distension, heaviness in the limbs, lack of saliva generation, shortness of breath, and difficulty urinating. Shen Shui (Kidney Water): Abdominal distension, umbilical swelling, lower back pain, inability to urinate, dampness in the genital area resembling sweat on an ox's nose, cold feet, and a sallow, emaciated face. (Another version states: Stools are conversely hard.)
[Wang Wuze] Generally, edema accompanied by a rapid pulse indicates latent deficiency-cold; over time, it becomes deep and hidden. Deep and hidden pulses indicate Yang deficiency and Yin excess, inevitably leading to Water disease. Facial edema with pain, dark color, excessive sweating, and aversion to wind belongs to Kidney Wind. (Treatment is in the Various Winds section.) Black lips indicate Liver injury; a flat clavicular fossa indicates Heart injury; protruding umbilicus indicates Spleen injury; flat soles indicate Kidney injury; a flat back indicates Lung injury. These five injuries are incurable.
[Zhang Zhongjing] When various deep pulses are found, one must suspect Water, presenting with body swelling and heaviness. In Water disease, a pulse that floats outwards (without root) indicates death. (Wang Wuze states: Generally, a floating pulse with rapidity indicates latent deficiency-cold; over time, it becomes deep and hidden. Deep and hidden pulses indicate Yang deficiency and Yin excess, inevitably leading to Water disease.)
[From *Mai Jing*] In Water disease, a洪大 (Surging-Large) pulse is treatable; a 微细 (Fine-Threadlike) pulse is untreatable. In Water disease, if the abdomen is distended like a drum, a solid pulse indicates survival; a deficient pulse indicates death. Water disease patients often die at midnight. (Full text see Diagnosis of Death and Life.)
[Zhang Zhongjing] In various Water diseases, if the patient is thirsty yet has diarrhea and frequent urination, sweating methods are contraindicated.
[From *Su Wen*] The Emperor asked: A patient with Kidney Wind has facial swelling and obstruction, impairing speech. Can they be needled? Qibo answered: Deficiency should not be needled. If needled inappropriately, the pathogenic factor will arrive in five days. The Emperor asked: What will happen upon arrival? Qibo answered: There will be shortness of breath and intermittent fever. The fever rises from the chest and back to the head, with hot hands, dry and bitter mouth, thirst, yellow urine, swelling under the eyes, borborygmus, heavy body making walking difficult, amenorrhea, vexation, inability to eat, inability to lie supine, and coughing when supine. This disease is named Feng Shui (Wind-Water), discussed in the Needling Methods. The Emperor asked: Explain the theory. Qibo answered: Where pathogens gather, Qi must be deficient. Yin deficiency attracts Yang pathogens, causing shortness of breath, intermittent fever, and sweating. Yellow urine indicates heat in the lower abdomen. Inability to lie supine is due to disharmony in the Stomach. Coughing when supine is due to upward pressure on the Lungs. In all cases of Water Qi, slight swelling appears first under the eyes. The Emperor asked: Why? Qibo answered: Water is Yin; Eyes are also Yin. The abdomen is the residence of Supreme Yin. Therefore, if water is in the abdomen, swelling under the eyes must occur. Rebellious True Qi causes bitter mouth and dry tongue. Inability to lie supine results in coughing up clear fluid. All Water disease patients cannot lie down; lying down causes fright, and fright worsens coughing. Borborygmus originates in the Stomach. Pathogens affecting the Spleen cause vexation and anorexia; inability to eat is due to Stomach obstruction. Heavy body and difficulty walking relate to the Stomach meridian in the foot. Amenorrhea is due to closure of the Bao Mai (Uterine Vessel), which connects to the Heart and links to the Bao Zhong. Now, Qi presses upward on the Lungs, preventing Heart Qi from descending, thus amenorrhea occurs. (From *Ping Re Bing Lun*)
[Zhang Zhongjing] Question: A patient suffers from Water disease, with swelling of the face, eyes, body, and limbs, and difficulty urinating. Pulse diagnosis does not mention Water, but rather chest pain, Qi rushing up the throat as if a piece of roasted meat is stuck, with mild coughing and wheezing. If this matches your description, what is the pulse like? Master said: The Cun Kou pulse is Deep and Tight. Deep indicates Water; Tight indicates Cold. Deep and Tight interact, knotting at the Guan Yuan point. Initially, it was subtle and unnoticed in youth. After Yang declines, Ying and Wei interfere. Yang damage leads to Yin excess. Knotting Cold moves subtly, Tight Qi rushes upward, causing throat obstruction and hypochondriac urgency/pain. Physicians mistook it for retained fluid and purged heavily. The Qi attack did not cease, and the disease remained. Later, vomiting was induced, causing Stomach deficiency, vexation, dry throat, desire for water, difficulty urinating, undigested food, and swelling of the face, eyes, hands, and feet. Then Ting Li Wan was given to drain water. It seemed slightly better initially, but overeating caused swelling to return, chest/hypochondriac pain, and sensations resembling Ben Tun (Running Piglet). Water overflowed, causing floating cough and wheezing. One must first attack the Rushing Qi to stop it, then treat the cough. Once cough stops, wheezing heals. Treat new disease first; old disease follows later.
[Zhu Danxi] Lu Shi Yi Jing Differentiation of Water Distension: The *Nei Jing* states: All Qi stagnation and depression belong to the Lungs. All Dampness, swelling, and fullness belong to the Spleen. All abdominal distension and enlargement belong to Heat. Dampness is the Qi of Earth; Earth is the child of Fire. Thus, Dampness often arises from Heat, and Heat can transform from Dampness (child influencing mother). For all swelling diseases, treating Dampness should be primary. Due to different accompanying factors, treatments vary. *Lei Li* discusses treating swelling by focusing on draining Water, suggesting guiding Kidney Qi to resolve it. Is this logical? Spleen Earth weakens, internally affected by Seven Emotions, externally by Six Qi, losing its transport and transformation function. Clear and turbid mix, stagnating into Water. *Lei Li* attributes the root and branch to Lung, Kidney, and Stomach, neglecting the Spleen. It subsequently states that excessive Lung Metal generates Water, water fluids act recklessly, Qi closes, pivot mechanisms block, causing swelling. If Spleen Earth is diseased, Lung is its child. How can the child become excessive and generate Water? If swelling water truly comes from Lung Qi, nourishing Kidney Yin and executing descending functions would create the source of transformation, preventing swelling. Now, water penetrates meridians and flows into valleys, being turbid and corrupt Qi, obstructing Jin Ye. Over time, it enters tunnels, blood transforms into water. To rely on Spleen Earth to control it and guide Kidney Qi to promote diuresis ignores that Spleen disease invites Liver Wood invasion. Child Qi also declines; Wood lacks fear, making Spleen disease inevitable. Treatment should clear Heart Fire, tonify Spleen Earth, restore transport functions, allow Lung Qi to descend, open seepage pathways, allowing clearer turbid Qi to revert to Qi, Blood, and Jin Ye; severe cases exit as sweat above and urine below, gradually dissipating. Now, failing to state this clearly, but speaking of controlling/drying Water, is this not like Bai Gui using neighboring states as ditches? The Classic states swelling is caused by Jin Ye filling the Guo (cavity/body), not by Lung Metal excess. It also states Qi rejects internally and耗 (consumes) externally, blaming the inability to seep and transport turbid Qi. It also says: Open Ghost Gates (sweat pores), Clean Pure Houses (bladder). Ghost Gates are skin/collaterals, belonging to Lung; Pure House is Bladder, belonging to Kidney. I have never heard of guiding Kidney Qi. Annotations on clothing/culture mention Yin Essence depletion; can Kidney Qi really be guided? Zhang Zhongjing said treating Dampness promotes urination, which is the meaning of cleaning the Pure House. If one considers Qing Jing (Pure/Clear) as Kidney and guides it, does it align with the Classic? Qian Zhongyang said Kidney has no draining method; how can it be lightly guided? Someone asks: The Classic says dredge and cleanse the Five Zang organs, is this not guiding Kidney? I say: This follows the previous statement that Five Yangs are already distributed. If Ghost Gates are open and Pure House is clean, Yang Qi of the Five Palaces distributes smoothly, and turbid Qi is naturally dredged and cleansed. What does this have to do with Kidney Qi?