肿有气肿、水肿、食积停痰之肿，又有阴阳肿各种不同。气肿，四君子合和中散；水肿
，胃苓汤；食积停痰肿，癞蛤蟆猪肚丸；阴阳肿，六味丸加牛膝、杜仲、破故、小茴，温而
利之。盖此证得之汗、吐、下后，或房劳太过，肾虚所致，故宜温肾而其肿自消也。
凡肿先从脚下起者，湿热在下也，宜先温补脾胃五、六帖，次以补中益气汤和之，后以
五苓散利之。先从身上肿者，湿热在上也，宜先利其湿热一、二帖，口渴加紫苏，次用温补
脾胃药。大抵脉浮而无力当汗，五积散；脉沉而无力当温，四君子、和中散。
猪肚丸
癞蛤蟆一只，用胡椒一钱，纳口内，猪肚一枚，包缝煮烂丸服。
五积散
白芷 桔梗 当归（各三钱） 陈皮（六钱） 川芎 甘草 茯苓 枳壳 半夏（各二钱）
麻黄（二钱） 肉桂 浓朴（各四钱，姜汁炒） 生姜（三片） 葱头（七枚）
脐凸肢浮，生之难，主三月而亡也。口青唇黑，死之易，主三日而亡也。此肿证之不治
验案
一人生疮，服败毒散数帖，又水蒸出汗，汗后浮肿，谓药不效。诊之六脉微紧数而无力
，乃中气虚也，两足流水，上气喘促，日夜不定。方用六君子加炮姜、吴茱萸，姜水煎。十
一人喘促、腹大、脚肿，六脉沉细。方用炮姜、肉桂、吴茱萸、甘草、五味子、白芍、半夏、枳壳愈。
一妇吐血发肿，腹大发热，不思饮食，似疟非疟，大便溏泄，诸药不效。此脾虚清阳下
陷，阳不发越也，脉浮大而缓。用四君子加羌活，三帖而愈。
一人六脉豁大，周身浮肿，上气喘促，呼不能吸。此肾虚水泛，气不归元也。八味汤加
人参、吴茱萸。十帖效，一月安，调理用肾气丸。
水肿分为气肿、水肿、因食积和痰饮停滞引起的水肿，以及阴阳两类不同性质的水肿。对于气肿，使用四君子汤合和中散；对于水肿，使用胃苓汤；对于因食积停痰导致的水肿，使用癞蛤蟆猪肚丸；对于阴阳虚损所致的水肿，使用六味地黄丸加牛膝、杜仲、补骨脂（破故纸）、小茴香，采用温补兼利水的方法治疗。这类病症多因发汗、催吐、泻下之后，或房事过度，导致肾虚而引起，因此适宜温补肾阳，肾气充足则水肿自然消退。
凡是水肿先从脚部开始的，说明湿热在下焦，宜先用温补脾胃的药物五到六帖，接着用补中益气汤调和，最后用五苓散利水消肿。凡是水肿先从身体上部开始的，说明湿热在上焦，宜先利湿清热一到两帖，若口渴可加紫苏，随后再用温补脾胃的药物。大抵而言，脉象浮而无力的应当用发汗法，选用五积散；脉象沉而无力的应当用温补法，选用四君子汤和中散。
猪肚丸方：癞蛤蟆一只，取胡椒一钱纳入其口中，用猪肚一枚包裹缝合，煮烂后制成丸剂服用。
五积散方：白芷、桔梗、当归（各三钱），陈皮（六钱），川芎、甘草、茯苓、枳壳、半夏（各二钱），麻黄（二钱），肉桂、浓朴（各四钱，用姜汁炒制），生姜（三片），葱头（七枚）。
脐部突出、四肢浮肿者，病情难治，预后不良，主三月内死亡。口唇发青、嘴唇发黑者，死亡较快，主三日内死亡。这是水肿病不治的验案。
一人患疮疡，服用败毒散数帖，又用水蒸气熏蒸出汗，汗后出现浮肿，认为药物无效。诊察发现六脉微紧、数且无力，这是中气虚弱所致，表现为两足流水，上气喘促，日夜不安。处方用六君子汤加炮姜、吴茱萸，姜水煎服。
另一人喘促、腹部胀大、脚部浮肿，六脉沉细。处方用炮姜、肉桂、吴茱萸、甘草、五味子、白芍、半夏、枳壳，服后痊愈。
一位妇女吐血并发肿，腹部胀大发热，不思饮食，症状似疟疾非疟疾，大便溏泄，各种药物均无效。此乃脾虚导致清阳之气下陷，阳气不能外达所致，脉象浮大而缓。使用四君子汤加羌活，三帖后痊愈。
一人六脉豁大，周身浮肿，上气喘促，呼气多吸气少。此为肾虚水液泛滥，气不归元所致。使用八味丸加人参、吴茱萸。十帖后见效，一月后安定，后续调理使用肾气丸。
Edema is categorized into Qi edema, Water edema, edema caused by food stagnation and phlegm retention, as well as various types of Yin and Yang edema. For Qi edema, Sijunzi Tang (Four Gentlemen Decoction) combined with Hezhong San (Harmonize the Middle Powder) is used; for Water edema, Weiling Tang (Stomach and Pingwei Decoction) is prescribed; for edema due to food stagnation and phlegm retention, Laihama Zhudu Wan (Toad Stomach Pills) is employed; for Yin-Yang deficiency edema, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) supplemented with Niuxi (Achyranthes Root), Duzhong (Eucommia Bark), Pogostemonis Herba (Pogostemon Patchouli Herb, referred to as Pogu in text), and Xiao Hui Xiang (Fennel Fruit) is used, applying warming and draining methods. Generally, this condition arises after sweating, vomiting, or purging therapies, or due to excessive sexual activity leading to Kidney deficiency; thus, warming the Kidney is appropriate, and the edema will subside naturally once Kidney Qi is restored.
When edema begins from the feet, it indicates Damp-Heat in the Lower Jiao. It is advisable to first use warming and tonifying formulas for the Spleen and Stomach for five to six doses, then harmonize with Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), and finally drain water using Wuling San (Five-Ingredient Powder with Poria). When edema begins from the upper body, it indicates Damp-Heat in the Upper Jiao. One should first clear Damp-Heat for one to two doses; if thirst is present, Zi Su (Perilla Leaf) can be added, followed by warming and tonifying herbs for the Spleen and Stomach. Broadly speaking, a floating but weak pulse indicates the need for diaphoresis (sweating method), treated with Wuji San (Five Accumulations Powder); a deep but weak pulse indicates the need for warming, treated with Sijunzi Tang (Four Gentlemen Decoction) and Hezhong San (Harmonize the Middle Powder).
Zhudu Wan Prescription: One Toad, place one qian of Hu Jiao (Black Pepper) inside its mouth, wrap it in one Pig Stomach, sew it shut, boil until soft, and form into pills for administration.
Wuji San Prescription: Bai Zhi (Angelicae Dahuricae Radix), Jie Geng (Platycodonis Radix), Dang Gui (Angelicae Sinensis Radix) (each 3 qian), Chen Pi (Citri Reticulatae Pericarpium) (6 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Fu Ling (Poria), Zhi Ke (Aurantii Fructus), Ban Xia (Pinelliae Rhizoma Praeparatum) (each 2 qian), Ma Huang (Ephedrae Herba) (2 qian), Rou Gui (Cinnamomi Cortex), Hou Po (Magnoliae Officinalis Cortex) (each 4 qian, stir-fried with Ginger Juice), Sheng Jiang (Zingiberis Rhizoma Recens) (3 slices), Cong Tou (Allii Cepae Bulbus) (7 pieces).
Umbilical protrusion with limb edema indicates a difficult-to-treat condition with poor prognosis, typically resulting in death within three months. Cyanosis of the mouth and black lips indicate rapid deterioration, typically resulting in death within three days. These are clinical cases of untreatable edema.
Case 1: A patient suffering from sores took several doses of Baidu San (Eliminate Toxicity Powder) and underwent steam sweating therapy. Post-sweating, edema appeared, and the patient claimed the medication was ineffective. Pulse diagnosis revealed all six pulses were slightly tight, rapid, and weak, indicating deficiency of Middle Qi. Symptoms included weeping fluid from both legs and shortness of breath with irregular breathing day and night. The prescription was Liujunzi Tang (Six Gentlemen Decoction) plus Pao Jiang (Prepared Ginger) and Wu Zhu Yu (Evodiae Fructus), decocted with Ginger Water.
Case 2: Another patient presented with shortness of breath, abdominal distension, and foot edema, with deep and fine pulses at all six positions. The prescription consisted of Pao Jiang (Prepared Ginger), Rou Gui (Cinnamon Twig), Wu Zhu Yu (Evodiae Fructus), Gan Cao (Licorice Root), Wu Wei Zi (Schisandrae Chinensis Fructus), Bai Shao (Paeoniae Radix Alba), Ban Xia (Pinelliae Rhizoma), and Zhi Ke (Bitter Orange Fruit), which led to recovery.
Case 3: A woman suffered from hematemesis accompanied by edema, abdominal distension, fever, anorexia, symptoms resembling malaria but not quite, and loose stools. Various medications had failed. This was diagnosed as Spleen deficiency causing sinking of Clear Yang and failure of Yang to ascend and diffuse. The pulse was large, floating, and slow. Si Jun Zi Tang (Four Gentlemen Decoction) plus Qiang Huo (Notopterygii Rhizoma et Radix) was used, resulting in recovery after three doses.
Case 4: A patient exhibited large and hollow pulses at all six positions, generalized edema, shortness of breath, and difficulty inhaling relative to exhalation. This was identified as Kidney deficiency leading to water flooding and Qi failing to return to its source. Bawei Wan (Eight-Ingredient Pill) plus Ren Shen (Ginseng Radix) and Wu Zhu Yu (Evodiae Fructus) was administered. Effectiveness was seen after ten doses, stability achieved after one month, and subsequent regulation was managed with Shenqi Wan (Kidney Qi Pill).