治遍身水肿，喘呼口渴，大小便秘（上证为湿热甚而气尚实也，此为阳水。阳水见阳证，
脉必沉数；阴水见阴证，脉必沉迟）。
羌活 秦艽 槟榔 商陆 椒目 大腹皮 茯苓皮 木通 泽泻 赤小豆各等分。加姜
皮煎。
此足太阳、手足太阴药也。外而一身尽肿，内而口渴便秘，是上下表里俱病也。羌活、
秦艽
水于
之水，达于小肠；泽泻泻脾肾之水，通于膀胱（二物泻水，实泻火也）。上下内外分消其热，
亦犹神禹疏江凿河之意也（经曰∶肾何以主水，肾者、至阴也，至阴者，盛水也；肺者，太
阴也，少阴者，冬脉也，故其本在肾，其末在肺，皆积水也。肾何以聚水而生病，肾者，胃
之关也，关门不利，故水聚而从其类也。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。喻嘉言曰∶胃为水欲之海，五脏六腑之源。脾
不能散胃之水精于肺，而病于中；肺不能通胃之水道于膀胱，而病于上；肾不能司胃之关，
时其输泄，而病于下；以致积水浸淫，无所底止。王好古曰∶水者，脾肺肾三经所主，有五
脏、六腑、十二经之部，分上头面、中四肢、下腰脚，外皮肤、中肌肉、内筋骨，脉有尺寸
之殊，浮沉之别，不可轻泻药，当知病在何经何脏，方可用之。按∶水肿有痰阻、食积、血瘀
致清不升、浊不降而成者，有湿热相生、隧道阻塞而成者，有燥热冲激，秘结不通而成者，
证属有余；有服寒凉、伤饮食、中气虚衰而成者，有大病后正气衰惫而成者，有小便不利、
水液妄行、脾莫能制而成者，证属不足；宜分别治之。然其源多因中气不足而起。《医贯》
曰；治肿满先以脾土为主，宜补中益气汤、六君子汤，或疑水胀喘满，而纯补之剂不益胀满
乎，曰∶肺气既虚，不可复行其气；肾水既衰，不可复利其水；纯补之剂，初觉不快，过时
药力得行，渐有条理矣。昂按∶此即《内经》塞因塞用之义）。
治疗全身水肿，气喘呼叫，口渴，大小便不通（上述症状表明湿热严重且正气尚实，这属于阳水。阳水表现为阳证，脉象必然沉数；阴水表现为阴证，脉象必然沉迟）。
羌活、秦艽、槟榔、商陆、椒目、大腹皮、茯苓皮、木通、泽泻、赤小豆各等分。加入姜皮煎煮。
这是足太阳膀胱经、手太阴肺经和足太阴脾经的药物。外在表现为一身浮肿，内在表现为口渴和大便秘结，说明上下表里都患病了。羌活、秦艽疏通水道，使水液达于小肠；泽泻排泄脾肾的水湿，通达于膀胱（这两味药泻水，实际上是泻火）。上下内外分消热邪，也就像大禹疏导江河开凿河道的意思一样（《内经》说：肾脏为什么主管水？肾是至阴之脏，至阴意味着盛水；肺是太阴之脏，少阴是冬季的脉象，所以水的根本在肾，末梢在肺，都是积水所致。肾脏为什么聚集水而生病？肾是胃的关口，如果关门不利，水就聚积并随其同类而行。所以水病在下表现为腹部肿大，在上表现为气喘呼叫不能平卧。标本都病了，所以肺导致气喘呼叫，肾导致水肿，肺气上逆导致不能平卧。喻嘉言说：胃是水汇聚的海，是五脏六腑的源头。脾不能将胃中的水精散布到肺，从而在中焦生病；肺不能将胃中的水道通达于膀胱，从而在上焦生病；肾不能管理胃的关口，调节其输泄，从而在下焦生病；导致积水浸淫，没有止境。王好古说：水是由脾、肺、肾三经所主，涉及五脏、六腑、十二经的部位，分为头面、四肢、腰脚，外及皮肤、内及肌肉筋骨，脉象有寸尺的不同，浮沉的区别，不可轻易使用泻下药，应当知道病在何经何脏，才可以用药。按：水肿有因痰阻、食积、血瘀导致清气不升、浊气不降而形成的，有因湿热相生、经络阻塞而形成的，有因燥热冲激、秘结不通而形成的，这些证候属于有余；有因服用寒凉药物、损伤饮食、中气虚衰而形成的，有大病后正气衰弱疲惫而形成的，有小便不利、水液妄行、脾不能制约而形成的，这些证候属于不足；应当分别治疗。然而其根源多因中气不足而起。《医贯》说：治疗肿胀满闷先以健脾土为主，宜用补中益气汤、六君子汤，有人怀疑水胀喘满，纯用补剂不是会增加胀满吗？回答说：肺气既然虚弱，不能再强行行气；肾水既然衰败，不能再利水；纯补的药剂，起初觉得不快，过一段时间后药力发挥作用，逐渐有条理了。汪昂按：这就是《内经》“塞因塞用”的道理）。
Treats generalized edema of the whole body, panting and crying out, thirst, and constipation of both stool and urine (The above symptoms indicate severe damp-heat with sufficient healthy qi, which belongs to Yang Edema. Yang Edema presents with Yang syndromes, and the pulse must be deep and rapid; Yin Edema presents with Yin syndromes, and the pulse must be deep and slow).
Qianghuo (Notopterygii Rhizoma et Radix), Qinjiao (Gentianae Macrophyllae Radix), Binglang (Arecae Semen), Shanglu (Phytolaccae Radix), Jiaomu (Zanthoxyli Semen), Dafupi (Citri Grandis Pericarpium), Fulingpi (Poriae Cortex), Mutong (Akebiae Caulis), Zexie (Alismatis Rhizoma), Chixiaodou (Phaseoli Radiati Semen) in equal parts. Add Jiangpi (Zingiberis Recens Pericarpium) and decoct.
These are herbs for the Foot-Taiyang Bladder Channel, Hand-Taiyin Lung Channel, and Foot-Taiyin Spleen Channel. Externally, there is swelling all over the body; internally, there is thirst and constipation, indicating that the upper and lower, exterior and interior are all diseased. Qianghuo and Qinjiao unblock the water passages, directing water to the Small Intestine; Zexie drains water from the Spleen and Kidney, communicating with the Bladder (These two herbs drain water, which is essentially draining fire). They dissipate heat from the upper, lower, interior, and exterior, similar to the intent of Yu the Great dredging rivers and digging canals (The Classic says: Why does the Kidney govern water? The Kidney is the organ of Extreme Yin; Extreme Yin implies abundant water. The Lung is the organ of Taiyin; Shaoyin is the pulse of Winter. Thus, the root of water lies in the Kidney, and its branches in the Lung; both accumulate water. Why does the Kidney gather water and cause disease? The Kidney is the gate of the Stomach. If the gate is not functional, water gathers and follows its kind. Therefore, water disease manifests below as abdominal distension and swelling, and above as panting and inability to lie flat. Since both root and branch are diseased, the Lung causes panting, the Kidney causes edema, and rebellious Lung Qi causes inability to lie flat. Yu Jiayan said: The Stomach is the sea where water gathers and the source of the Five Zang and Six Fu organs. If the Spleen cannot scatter the water essence from the Stomach to the Lung, disease occurs in the Middle Jiao; if the Lung cannot communicate the water pathways from the Stomach to the Bladder, disease occurs in the Upper Jiao; if the Kidney cannot manage the gate of the Stomach and regulate its transport and excretion, disease occurs in the Lower Jiao; this leads to accumulating water overflowing without end. Wang Haogu said: Water is governed by the Spleen, Lung, and Kidney channels, involving the regions of the Five Zang, Six Fu, and Twelve Channels, divided into head and face, middle limbs, lower waist and feet, outer skin, inner muscles, and internal sinews and bones. Pulses differ in Cun and Chi positions and floating and sunken qualities. One should not lightly use purgative herbs; one must know which channel and Zang organ are affected before prescribing. Note: Edema can be caused by phlegm obstruction, food stagnation, or blood stasis leading to failure of clear Yang to ascend and turbid Yin to descend; it can be formed by mutually generating damp-heat and blocked meridians; it can be formed by dry-heat surging and blockage. These syndromes belong to Excess. It can be formed by taking cold-cooling herbs, damaging diet, or deficiency of Middle Qi; it can be formed after serious illness when healthy Qi is exhausted; it can be formed by ineffective urination, reckless flow of fluids, and Spleen's inability to control them. These syndromes belong to Deficiency. They should be treated separately. However, their source often arises from insufficiency of Middle Qi. *Yi Guan* states: To treat swelling and fullness, first focus on strengthening Spleen Earth, using Buzhong Yiqi Tang or Liujunzi Tang. Some doubt: "Water distension and panting/fullness—would pure tonifying agents not worsen the distension?" The answer is: If Lung Qi is already deficient, one cannot forcibly move Qi; if Kidney Water is already depleted, one cannot forcibly promote diuresis. Pure tonifying agents may initially feel uncomfortable, but after a while, when the medicinal power takes effect, things gradually become orderly. Ang notes: This is the meaning of 'treating obstruction with obstruction' (Sai Yin Sai Yong) from the *Inner Canon*).