（《金匮》。一名甘姜苓术汤）
治伤湿身重，腹痛腰冷，不渴，小便自利，饮食如故，病属下焦（肾主水，湿性下流，
必舍于其所合而归于坎势也。腰为肾之府，冷湿之邪着而不移，故腰冷、身痛，是着痹也。
此由身劳汗出，衣裹冷湿，久久得之）；《宣明》用治胞痹，膀胱热痛，涩于小便，上为清涕
（风寒湿邪客于胞中，气不能化，故水道不通；足太阳经上额络脑，太阳经气不得下行，上
入脑而流
干姜（炮） 茯苓（四两） 甘草（炙） 白术（炒，二两。）有寒者加附子。《经心录》
加肉
此足太阴、太阳药也。干姜辛热以燥湿，白术苦温以胜湿，茯苓甘淡以渗湿，甘草甘平
，和中而补土。此肾病而皆用脾药，益土正所以制水也（喻嘉言曰∶腰冷如坐水中，非肾之
精气冷也，故饮食如故，便利不渴，且与肠胃之腑无预，况肾脏乎。故但用甘温从阳，淡渗
行水之
（河间仿仲景十枣例制此汤，治一切水湿）
治水肿水胀，形气俱实（肿胀者，水道壅遏也，形气俱实，口渴面赤，气粗腹坚，大小
便秘也。阳水先肿上体肩背手膊，手三阳经；阴水先肿下体腰腹胫 ，足三阴经。肿属脾，
胀属肝，肿则阳气犹行；如单胀而不肿者，名蛊胀，为木横克土，难治。肿胀朝宽暮急，为
血虚，暮宽朝急，为气虚，朝暮俱急，为气血两虚。肿胀由心腹而散四肢者吉，由四肢而入
心腹者危。男自下而上，女自上而下者，皆难治。肿胀唇黑则伤肝，缺盆平则伤心，脐出则
伤脾，
黑牵牛（四两，炒） 大黄（二两，酒浸） 甘遂（面裹煨） 大戟（面裹煨） 芫花
（醋炒）
此足太阳药也。牵牛、大黄、大戟、芫花、甘遂皆行水之厉剂也
然肿属于脾，胀属于肝；水之不行，由于脾之不运；脾之不运，由于
防水而洋溢也。青皮、木香疏肝泄肺而健脾，与陈皮均为导气燥湿之
运则肿消也；轻粉无窍不入，能去积痰，故少加之；然非实证，不可
戟、青皮、陈皮、木香，加芒硝、郁李仁，名浚川散，姜汤下五分∶
（出自《金匮要略》。又名甘姜苓术汤）
治疗因感受湿邪导致身体沉重，腹部疼痛且腰部发冷，口不渴，小便通畅自如，饮食正常，病位属于下焦（肾主司水液代谢，湿性趋下，必定停留在与其相合的部位并归于坎卦之势。腰为肾之府邸，寒冷湿邪附着于此而不移动，所以出现腰部发冷、身体疼痛，这属于着痹证。这种情况多由身体劳累出汗后，衣物包裹着冷湿之气，日久逐渐形成）；《素问·宣明五气论》中用此方治疗胞痹，表现为膀胱热痛，小便涩滞不畅，上部流出清涕（风寒湿邪侵袭胞宫，气机不能化生，所以水道不通；足太阳膀胱经上行至额部联络脑部，太阳经气不能下行，反而上入脑络并流注于鼻窍）。
干姜（炮制） 茯苓（四两） 甘草（炙） 白术（炒，二两）。若有寒象者加附子。《经心录》中加入肉桂。
这是足太阴脾经和足太阳膀胱经的药物。干姜辛热以燥湿，白术苦温以胜湿，茯苓甘淡以渗湿，甘草甘平，调和脾胃并补益脾气。这是治疗肾病却使用健脾药的道理，培土正所以制水（喻嘉言说：腰部发冷如同坐在水中，并非肾的精气寒冷，所以饮食正常，大小便通畅且不口渴，况且与肠胃腑脏无关，更与肾脏无关。因此只使用甘温助阳、淡渗利水的药物）。
（刘河间模仿张仲景十枣汤的例法制作此汤，治疗一切水湿停聚之证）
治疗水肿、水胀，形体壮实且正气未虚（肿胀是由于水道壅塞遏阻所致，形气俱实表现为口渴、面红、气粗、腹部坚硬、大小便秘结。阳水先肿上半身肩背手臂，涉及手三阳经；阴水先肿下半身腰腹小腿，涉及足三阴经。肿属脾，胀属肝，肿则阳气尚能运行；如果单胀而不肿，名为蛊胀，为肝木横逆克制脾土，难以治疗。肿胀早晨宽舒傍晚紧急，为血虚；傍晚宽舒早晨紧急，为气虚；早晚都紧急，为气血两虚。肿胀从心腹向四肢消散者为吉兆，从四肢向内传入心腹者为危症。男性病势自下而上发展，女性病势自上而下发展，都难治。肿胀若唇色发黑则伤肝，锁骨上窝平坦则伤心，肚脐突出则伤脾）。
黑牵牛（四两，炒） 大黄（二两，酒浸） 甘遂（面粉包裹煨） 大戟（面粉包裹煨） 芫花（醋炒）
这是足太阳膀胱经的药物。牵牛子、大黄、大戟、芫花、甘遂都是行水利水的峻猛药剂。
然而肿属于脾，胀属于肝；水液不行，由于脾运化失职；脾运化失职，由于……防止水液泛滥。青皮、木香疏肝泄肺而健脾，与陈皮均为导气燥湿之药。脾运恢复则肿胀消退；轻粉无孔不入，能去除积痰，所以少量加入；然而若非实证，不可……大戟、青皮、陈皮、木香，加入芒硝、郁李仁，名为浚川散，用姜汤送服五分：
(From *Jin Gui Yao Lue*. Also known as Gan Jiang Ling Zhu Tang (Ginger, Poria, and Atractylodes Decoction).)
Treats body heaviness caused by injury from dampness, abdominal pain with coldness in the lower back, absence of thirst, free urination, and normal diet. The disease location is in the Lower Jiao (The Kidney governs water metabolism; Dampness has a downward nature and must settle in its corresponding area, returning to the Kan trigram's momentum. The waist is the mansion of the Kidney; Cold-Damp pathogenic factors adhere here and do not move, hence the coldness in the waist and body pain, which constitutes Zhe Bi (Fixed Bi Syndrome). This condition arises from sweating due to physical labor, followed by clothing enclosing cold dampness, accumulating over time); *Su Wen: Xuan Ming Wu Qi Lun* uses it to treat Bao Bi (Uterine/Bladder Bi), characterized by heat pain in the Bladder, difficult and scanty urination, and clear nasal discharge above (Wind-Cold-Damp pathogenic factors lodge in the Bao, Qi cannot transform, thus the water passages are blocked; the Foot-Taiyang Bladder Meridian ascends to the forehead and connects with the brain; when Taiyang meridian Qi fails to descend, it enters the brain and flows into the nasal cavity).
Dried Ginger (Pao processed) [Zingiberis Rhizoma Preparatum], Poria [Poria] (4 liang), Licorice Root (Zhi processed) [Glycyrrhizae Radix et Rhizoma Preparata], Atractylodes Macrocephala Rhizome (Chao fried, 2 liang). Addaconite Root (Prepared) [Aconiti Lateralis Radix Preparata] if there is cold. *Jing Xin Lu* adds Cinnamon Bark [Cinnamomi Cortex].
These are herbs for the Foot-Taiyin Spleen and Foot-Taiyang Bladder meridians. Dried Ginger is acrid and hot to dry dampness; Atractylodes Macrocephala Rhizome is bitter and warm to overcome dampness; Poria is sweet and bland to leach out dampness; Licorice Root is sweet and neutral, harmonizing the Middle Jiao and tonifying Earth. This treats Kidney disease using Spleen herbs; strengthening Earth is precisely how one controls Water (Yu Jiayan stated: Coldness in the waist feels like sitting in water, but it is not coldness of the Kidney's essence and Qi, hence diet is normal, urination and defecation are free without thirst, and it has nothing to do with the Fu organs of the intestines and stomach, let alone the Kidneys. Therefore, only sweet-warm Yang-assisting and bland-leaching water-moving herbs are used).
(Liu Hejian imitated Zhang Zhongjing's Shi Zao Tang example to create this decoction, treating all accumulations of water and dampness.)
Treats edema and water distension where both form (Xing) and Qi (Qi) are excess (Swelling is due to obstruction of water pathways; Excess Form and Qi present with thirst, red face, coarse breathing, hard abdomen, and constipation of both stool and urine. Yang Edema first swells the upper body—shoulders, back, arms—involving the Hand-Taiyang meridians; Yin Edema first swells the lower body—waist, abdomen, calves—involving the Foot-Taiyin meridians. Swelling belongs to the Spleen, Distension belongs to the Liver; in swelling, Yang Qi still circulates; if there is distension without swelling, it is named Gu Distension, caused by Wood overacting on Earth, which is difficult to treat. If swelling is loose in the morning and tight in the evening, it indicates Blood deficiency; if loose in the evening and tight in the morning, it indicates Qi deficiency; if tight at both times, it indicates dual Qi and Blood deficiency. If swelling disperses from the heart and abdomen to the limbs, it is auspicious; if it enters the heart and abdomen from the limbs, it is critical. In men, progression from below upward is difficult to treat; in women, progression from above downward is difficult to treat. Black lips indicate Liver injury; flat supraclavicular fossa indicates Heart injury; protruding umbilicus indicates Spleen injury).
Black Bean Vine Seed (Chao fried, 4 liang) [Pharbitidis Semen], Rhubarb (Jiu soaked, 2 liang) [Rhei Radix et Rhizoma], Kansui Root (wrapped in flour and baked) [Kansui Radix], Great Euphorbia Root (wrapped in flour and baked) [Euphorbiae Pekinensis Radix], Genkwa Flower (Chao fried with vinegar) [Genkwa Flos].
These are herbs for the Foot-Taiyang Bladder meridian. Phitilis Seed, Rhubarb, Great Euphorbia Root, Genkwa Flower, and Kansui Root are all harsh agents for moving water and draining fluid.
However, swelling belongs to the Spleen, distension belongs to the Liver; the failure of water movement is due to the Spleen's failure to transport; the Spleen's failure to transport is due to... preventing water overflow. Green Tangerine Peel [Citri Reticulatae Pericarpium] and Costus Root [Saussureae Radix] soothe the Liver, drain the Lung, and strengthen the Spleen; together with Chenpi [Citri Reticulatae Pericarpium], they are all Qi-directing and damp-drying agents. When the Spleen transports, swelling subsides; Calomel [Calomelas] penetrates every orifice and can remove accumulated phlegm, so it is added in small amounts; however, if it is not an Excess syndrome, one must not... Great Euphorbia Root, Green Tangerine Peel, Chenpi, Costus Root, add Mirabilite [Natrii Sulfas] and Apricot Kernel [Armeniacae Semen Amarum], named Jun Chuan San (Jun Chuan Powder), taken with Ginger Decoction, 5 fen: