（严氏）
治肢体浮肿，色悴声短，口中不渴，二便通利（脾胃虚寒，土不能制水，故水妄行而浮
肿
白术（土炒） 茯苓 甘草（炙） 浓朴（姜炒） 大腹皮 草豆蔻 木香 木瓜 附
子黑
此足太阴药也。脾虚故以白术、苓、草补之；脾寒故以姜、附、草蔻温之；脾湿故以大
腹、
然土
使木不克土而肝和，则土能制水而脾实矣。经曰∶湿胜则地泥，泻水正所以实土也（朱丹溪
曰∶治水肿宜清心火、补脾土，火退则肺气下降而水道通，脾旺则运化行而清浊分，其清者
复回为气为血为津为液，浊者为汗为溺而分消矣。又曰∶水病当以健脾为主，使脾实而气运，
则水自行，宜参苓为君，视所挟证加减。苟徒用利水药，多致不救。喻嘉言曰∶治水以实脾
为先，不但阴水为然。然阴水者，少阴肾中之真阳衰微，不能封闭而泛滥无制耳，方中不用
桂而用浓朴、木香，尚有可议耳。按∶治水有三法；实土者，守也；泄水者，攻也；兼之发
汗，
（《澹寮》）
治水病肿满，上气喘急，或腰以下肿（脾虚不能制水，故传化失常，肾水泛滥，反渍脾
土
五加皮 地骨皮 茯苓皮 大腹皮 生姜皮。一方五加易陈皮。罗氏∶五加易桑白皮，
治病后脾肺气虚而致肿满。
此足太阳、太阴药也。五加祛风胜湿，地骨退热补虚，生姜辛散助阳水为阴邪，大腹下
气行水，茯苓渗湿健脾。于散泻之中，犹寓调补之意。皆用皮者，水溢皮肤，以皮行皮也。
麦门冬汤
治水溢高原，肢体皆肿（经曰∶三焦者，决渎之官，水道出焉。上焦不治，水溢高原；
中焦不治，水停中脘；下焦不治，水蓄膀胱。经曰∶三焦病者，腹气满，小腹尤坚，不得小
便，窘急，溢则水留则为胀。下焦少阳经气，当相火之化，相火有其经无其脏腑，游行于五
者之间，故曰少阳为游部，其经脉上布膻中、络心包，下出委阳、络膀胱，岂非上佐天施，
下佐地生，与手厥阴相表里，以行诸经者乎。故肾经受邪，则下焦之火气郁矣，郁则水精不
得四布，而水聚矣，火郁之久必发，则与冲脉之属火者同逆而上。冲为十二经脉之海，其上
者出颃颡，渗诸阳，灌诸精；其下者并少阳，下足，渗三阴，灌诸络；由是水从火溢，上积
于肺而为喘呼不得卧，散于阴络而为 肿，随五脏之虚者，入而聚之，为五脏之胀，皆相火
泛滥其水而生病者也。非相火则水不溢而止，为积水。昂按∶经曰∶诸腹胀大，皆属于热。
诸病
（严氏）
治疗肢体浮肿，面色憔悴，声音短促，口中不渴，大小便通畅。这是脾胃虚寒，土不能制约水，导致水气妄行而引发浮肿。
白术（土炒） 茯苓 甘草（炙） 厚朴（姜炒） 大腹皮 草豆蔻 木香 木瓜 附子
这是足太阴脾经的药物。因为脾虚，所以用白术、茯苓、甘草来补益；因为脾寒，所以用生姜、附子、草豆蔻来温煦；因为脾湿，所以用大腹皮等药来利水渗湿。从而使肝木不克制脾土而肝脏调和，那么脾土就能制约水气而使脾气充实。《内经》说：湿气胜则大地泥泞，泻去水气正是为了充实脾土。（朱丹溪说：治疗水肿适宜清心火、补脾土，火退则肺气下降而水道通调，脾旺则运化功能行使而清浊分离，其中清的部分重新化为气、血、津、液，浊的部分化为汗和尿而分消排出。又说：水病应当以健脾为主，使脾实而气机运转，那么水气自然运行，适宜用人参、茯苓为君药，根据兼夹证候加减。如果只用利水药，多导致无法救治。喻嘉言说：治疗水气以充实脾土为先，不仅仅是阴水如此。然而阴水，是少阴肾中的真阳衰微，不能封闭固摄而泛滥无制罢了，方中不用桂枝而用厚朴、木香，尚且有可讨论之处。按：治疗水气有三种方法；充实脾土，是守正；泄去水气，是攻邪；兼用发汗，
（《澹寮方》）
治疗水病肿胀满闷，上气喘急，或者腰部以下浮肿（脾虚不能制约水气，导致传化失常，肾水泛滥，反过来浸渍脾土）。
五加皮 地骨皮 茯苓皮 大腹皮 生姜皮。一方将五加皮换成陈皮。罗氏：将五加皮换成桑白皮，治疗病后脾肺气虚而导致肿胀满闷。
这是足太阳膀胱经、足太阴脾经的药物。五加皮祛风胜湿，地骨皮退热补虚，生姜辛散助阳。水为阴邪，大腹皮下气行水，茯苓渗湿健脾。在发散泻利之中，还寓含调补之意。都用皮的原因，是水溢于皮肤，以皮行皮也。
麦门冬汤
治疗水气溢出高原，肢体全部浮肿（《内经》说：三焦，是决渎之官，水道由此而出。上焦不治，水气溢出高原；中焦不治，水停在中脘；下焦不治，水蓄积在膀胱。《内经》说：三焦病的症状，腹部胀满，小腹尤其坚硬，小便不通，窘迫急迫，溢出则水留滞成为胀病。下焦少阳经气，当相火的化生，相火有其经脉而无其脏腑，游行于五脏之间，所以说少阳为游部，其经脉上行布散膻中，联络心包，下行出委阳，联络膀胱，这难道不是上佐天施，下佐地生，与手厥阴心包经相表里，以运行诸经吗？所以肾经受邪，则下焦的火气郁结，郁结则水精不得四布，而水聚积，火郁之久必发作，则与冲脉中属火的部分一同逆而上行。冲脉是十二经脉之海，其上行的部分出于颃颡，渗灌诸阳经，灌注诸精；其下行的部分并合少阳，下行至足，渗灌三阴经，灌注诸络脉；因此水从火溢，上积于肺而成为喘息呼叫不能卧，散于阴络而成为浮肿，随着五脏的虚弱处，进入而聚积，成为五脏的胀病，都是相火泛滥其水而生病的。如果不是相火，则水不溢出而停止，成为积水。汪昂按：《内经》说：各种腹胀大，都归属于热。各种病……
(Yan Shi)
Treats limb edema (swelling), sallow complexion, shortness of voice, absence of thirst in the mouth, and free passage of urine and stool. This is due to Spleen-Stomach deficiency-cold, where Earth fails to control Water, causing Water to act recklessly and resulting in edema.
Bai Zhu (Stir-fried with soil) Fu Ling Gan Cao (Honey-fried) Hou Po (Ginger-fried) Da Fu Pi Cao Dou Kou Mu Xiang Mu Gua Fu Zi
This acts on the Foot-Taiyin Splein Meridian. Because of Spleen deficiency, Bai Zhu, Fu Ling, and Gan Cao are used to tonify; because of Spleen cold, Sheng Jiang, Fu Zi, and Cao Dou Kou are used to warm; because of Spleen dampness, Da Fu Pi etc. are used to promote urination and leach out dampness. Thus, Liver Wood does not overact on Spleen Earth, allowing the Liver to harmonize, so that Spleen Earth can control Water and the Spleen Qi becomes solid. The Classic says: When dampness prevails, the earth becomes muddy; draining water is precisely the method to solidify Earth. (Zhu Danxi said: To treat edema, it is appropriate to clear Heart Fire and tonify Spleen Earth. When Fire retreats, Lung Qi descends and the water passages become unobstructed; when Spleen is robust, transformation and transportation function properly, separating clear from turbid. The clear part returns to become Qi, Blood, Jin Ye (Body Fluids); the turbid part becomes sweat and urine, being dispersed and eliminated. He also said: For water diseases, one should primarily tonify the Spleen. If the Spleen is solid and Qi moves, Water will flow naturally. It is suitable to use Ren Shen and Fu Ling as the sovereign herbs, modifying according to accompanying syndromes. If only diuretic herbs are used, it often leads to untreatable conditions. Yu Jiayan said: Treating water qi prioritizes solidifying the Spleen, not only for Yin Water. However, Yin Water refers to the decline of True Yang in the Shaoyin Kidney, which cannot seal and contain, leading to unrestrained flooding. In this formula, Gui Zhi is not used but Hou Po and Mu Xiang are, which is still open to discussion. Note: There are three methods for treating water qi; solidifying Earth is maintaining stability; draining water is attacking pathogenic factors; combining with sweating...)
(Dan Liao Fang)
Treats water disease with swelling and fullness, upper body asthma and rapid breathing, or swelling below the waist (Spleen deficiency fails to control Water, leading to abnormal transmission and transformation, Kidney Water floods, and conversely soaks Spleen Earth).
Wu Jia Pi Di Gu Pi Fu Ling Pi Da Fu Pi Sheng Jiang Pi. One prescription replaces Wu Jia Pi with Chen Pi. Luo Shi: Replaces Wu Jia Pi with Sang Bai Pi, treating post-illness Spleen-Lung Qi deficiency leading to swelling and fullness.
This acts on the Foot-Taiyang Bladder Meridian and Foot-Taiyin Splein Meridian. Wu Jia Pi dispels wind and overcomes dampness; Di Gu Pi clears heat and tonifies deficiency; Sheng Jiang is pungent and dispersing, assisting Yang. Water is a Yin pathogen; Da Fu Pi directs Qi downward and moves Water; Fu Ling leaches out dampness and strengthens the Spleen. Within the dispersing and draining actions, there is still an intention of regulation and tonification. All parts used are peels because Water overflows into the skin, so peel treats peel.
Mai Men Dong Tang
Treats water overflowing from the high source, with whole-body edema. The Classic says: The San Jiao (Triple Burner) is the official of irrigation, through which water passages emerge. If the Upper Jiao is not regulated, water overflows from the high source; if the Middle Jiao is not regulated, water stagnates in the Zhong Wan region; if the Lower Jiao is not regulated, water accumulates in the Bladder. The Classic says: Symptoms of San Jiao disease include abdominal fullness, especially hardness in the lower abdomen, inability to urinate, distress and urgency; overflow causes water retention leading to distension. The Lower Jiao Shaoyang meridian Qi corresponds to the transformation of Ministerial Fire. Ministerial Fire has its meridian but no zang-fu organ, roaming among the five zang organs, hence Shaoyang is called the wandering department. Its meridian ascends to distribute at Dan Zhong, connects with the Pericardium, descends to exit at Wei Yang, and connects with the Bladder. Is this not assisting Heaven above and Earth below, exterior-interior related to the Hand-Jueyin Pericardium, to conduct Qi through all meridians? Therefore, when the Kidney meridian is affected by pathogens, the Fire Qi in the Lower Jiao becomes stagnant. Stagnation prevents Jing (Essence/Water) from distributing to four directions, leading to water accumulation. Long-standing Fire stagnation must erupt, rising counterflow together with the Fire-associated branches of the Chong Mai (Penetrating Vessel). The Chong Mai is the Sea of the Twelve Meridians; its ascending branch emerges at Hang Sang, seeps into all Yang meridians, and irrigates essences; its descending branch merges with Shaoyang, goes down to the feet, seeps into all Yin meridians, and irrigates collaterals. Thus, water overflows from fire, accumulating upward in the Lung causing panting, coughing, and inability to lie flat; scattering into Yin collaterals causing edema; entering and gathering wherever the Five Zang are deficient, becoming distension of the Five Zang. All are diseases caused by Ministerial Fire flooding Water. Without Ministerial Fire, Water would not overflow and stop, becoming accumulated water. Ang notes: The Classic says: All abdominal distensions and enlargements belong to Heat. Various diseases...