论曰∶《内经》谓,肾者,胃之关也。关闭不利,故聚水而从其类,上下溢于皮肤而为
肿, 肿者,聚水而生病也。其状目窠上微肿,若新卧起然,颈脉微动,时作咳嗽,股冷
肤肿,口苦舌干,不得正偃,偃则咳清水;不得卧,卧则惊而咳,甚则小便黄涩,以手按肿
处,随手而起,如裹水之状是也。以脉别之,脉沉者水病也。洪大者可治,微细者难医。水
病有不可治者五,唇黑伤肝,一也;缺盆平伤心,二也;脐出伤脾,三也;足下平满伤肾,
四也;背平伤肺,五也。盖脾肾气虚,三焦闭塞,至阴之气内蓄巨阳之气,不得宣通,如是
则水道不利,饮湿攻脾,散于肌肉,而为水肿之病矣。
论曰∶水肿之病,以脾肾气虚,不能制水,水气妄行,溢于皮肤,其证股冷肤肿,时作
咳嗽,不得安卧,小便黄涩,以手按肿处,随手而起是也。
治水病不限年月深浅,洪肿大喘,几不能度日。防己饮方。
防己(一分) 大戟(炒) 木香 赤茯苓(去黑皮) 海蛤 犀角(镑) 胡黄连 白
术诃黎
陈橘皮(去白,
焙) 牵牛子 葶苈(隔纸炒) 郁李仁(各一两) 白槟榔(煨一两半) 大黄(锉,炒
二两)
上十九味,锉如麻豆大。每服二钱匕,水一盏半,煎至一盏,去滓,入麝香少许,再煎
一沸,平旦空心服。如人行五里再服,不可冷服。若久病肠胃虚弱,至第二服即微利;若肠
胃实者,约至数服,亦须转下恶浊黄水,或青黑恶物出三五升,此气化为之也。泻若不甚困
更服,如觉力乏,即以浆水粥止之。
治水气服前药瘥后。服此补气丸方。
防己 犀角(镑) 葶苈(隔纸炒) 牵牛子(半生半熟) 赤茯苓(去黑皮) 诃黎
勒(煨,
去核) 海蛤 芎 生干地黄(焙各一两) 大黄(二两半) 木通(锉) 桑根白皮(锉,
炒)
陈橘皮(去白,焙) 大戟(炒) 防风(去叉) 郁李仁(去皮尖,炒) 木香(各一两)
上一十七味,捣罗为末。炼蜜丸如梧桐子大。每服空心米饮下十丸。若觉气壅,加至十
五丸;如觉通,则减三丸至五丸;大小便不通,即服三十丸。此不独疗水气,但是气疾,皆
治之。
服前防己饮瘥,百日内更服五灵汤方。
葶苈(隔纸炒) 木通(锉) 赤茯苓(去黑皮) 防己 陈橘皮(去白,焙各一两)
上五味,粗捣筛。每服二钱匕,水一盏,煎三两沸,去滓饮之。觉热即勿服。
治水肿。牵牛汤方。
牵牛子 槟榔(煨,锉) 木香 赤茯苓(去黑皮) 陈橘皮(去白,焙各一两)
上五味,粗捣筛。每服二钱匕,水一盏,煎三两沸,去滓温服。此药不独疗水病,凡肺
气、香港脚、贲豚气,上筑心胸不可忍,皆治之。
治一切水气,四肢肿满。妙香汤方。
香子(炒) 乌药(生用) 高良姜(汤浸,焙干) 青橘皮(去白各一两)
上四味,同粗捣筛。每服二钱匕,酒半盏,煎数沸,去滓,稍热服。
治水气肿满。暖肾散方。
巴戟天(去心,麸炒黑) 甘遂(炒黄各一分) 槟榔(一枚生,一枚炮) 木香 苦
葶苈(
纸上炒各一分) 大麦 芫花(醋浸炒黄) 陈橘皮(去白,炒各半两) 腻粉(一钱) 沉
香(
上一十一味,捣罗为散。每服二钱匕,用猪腰子一只,以竹刀子割开,去筋膜,作三片,
掺药末在内,用湿纸裹,慢火煨令香熟,先煮葱白三茎,令熟细切,将葱与粟米同煮粥一碗,
先食粥一半,方食腰子,药后再食粥令尽,临卧服。如至五更,大便并小便下赤黄恶物,乃
验。
治水气肿满。夺命丸方。
大戟(麸炒) 甘遂(炒各一分) 苦葶苈(半两一半生,一半熟) 泽泻(一分半)
上四味,捣罗为末,煮枣肉和丸梧桐子大。若四肢肿者,名为顺水,温浆水下三丸,星
月上时服,至天晓利下恶物;若四肢瘦,腹肿者,名为逆水,煎苦葫芦子陈曲汤下三丸,小
便频快是效,三日后服补药矾石丸。
治水病补药矾石丸方。
白矾(半两) 雄黄(研) 丹砂(研各一分)
上三味,捣罗为末,粟米饭和丸绿豆大,丹砂为衣。每服五丸至七丸,食前生姜汤下,
日二。
治水气肿满。槟榔散方。
槟榔(二枚生) 郁李仁(去皮尖,炒) 芫花(炒) 甘遂(炒) 续随子 木通(锉
各二两)
海蛤(一钱) 陈橘皮(去白,焙) 商陆(各一分)
上九味,捣罗为散。每服一钱匕,温酒调下,临卧服。至五更取下恶物为验。
治水肿久不瘥。大戟丸方。
大戟(炒) 陈橘皮(去白,焙各一分) 巴豆(七粒去皮大麦内炒熟不用大麦)
上三味,捣罗为末,用大麦面糊丸如梧桐子大。每服三丸,生姜汤下,空心日晚服。
治水肿腹满。二气汤方。
牵牛子(半两生用) 甘遂(一钱微炒)
上二味,粗捣筛。分作二服,每服水一盏,煎至五分,放温细呷,不计时。
治水肿。大黄汤方。
大黄(锉碎醋炒二两) 桂(去粗皮) 甘草(炙,锉) 人参 细辛(去苗叶各一两)
桑
根白皮(炙黄色,锉二两)
上六味,粗捣筛。每服用水三盏,药五钱匕,入枣二枚劈破,同煎至九分,去滓入白
饧一匙头,更煎一沸,温服,日三。利小便三五升,即瘥。
治水肿及肢满 饮。芫花汤方。
芫花(炒黄色) 大黄(锉碎,醋炒) 甘遂(微炒) 甘草(炙,锉) 大戟(去皮,
微炒各
一两)
上五味,粗捣筛。每服三钱匕,水二盏,枣二枚劈破,同煎至九分,下芒硝半钱匕,
更煎一沸,去滓温服,以利为度。
治水气面目浮肿,因虚劳香港脚所致。鳖甲汤方。
鳖甲(去裙 ,醋炙焦二两) 人参 柴胡(去苗) 当归(切,焙) 枳壳(去瓤,
麸
炒各二两) 甘草(炙半两) 桃仁(七枚汤浸去皮尖) 白槟榔(煨二枚)
上八味,粗捣筛。先用小便二盏,浸药三钱匕,经半日,煎取七分,去滓温服,以瘥为
度。妇人病状同者,加牛膝半两。
治水肿。利小便。郁李仁丸方。
郁李仁(汤浸去皮尖,微炒三分) 海藻(洗去咸,炒) 桂(去粗皮各半两) 大黄
(锉碎,
醋炒) 葶苈(纸上炒令紫色各一两一分) 黄连(去须半两) 木通(锉) 石苇(去毛,
微炙
各一分) 松萝(三分)
上九味,捣罗为末,炼蜜丸梧桐子大。每服米饮下十五丸,日三,稍增,以知为度。
治水肿。麝香丸方。麝香(研半分) 芫花(炒黄三分) 甘遂(微炒,去皮半两)
上三味,捣罗为末,炼蜜丸梧桐子大。强壮人酒下一十五丸,老弱人十丸。
治水肿。利小便。商陆丸方。
商陆(微炙一两半) 芒硝(研一两) 甘遂(微炒) 大黄(锉碎,醋炒) 芫花(微
炒) 荛
花(微炒各三分) 麝香(研四钱) 猪苓(去黑皮一两)
上八味,捣罗为末,炼蜜丸梧桐子大。每服米饮下五丸,日三服,以微利为度。华佗方,
酒客虚热,当风饮冷,腹冷胀满,加麝香、猪苓各一两。
治水肿,眠卧不得。防己丸方。
防己 海蛤(研各一两) 葶苈(一升蒸熟) 杏仁(六十枚汤浸去皮尖,炒,别捣) 甘
遂(微炒一分)
上五味,先将葶苈、杏仁一处拌和,后以三味捣罗为末,再研匀,入枣肉和丸梧桐子大。
每服米饮下二十丸,渐加至二十五丸,以微利为度。其疾不过五六日即瘥。
治水肿久不瘥。 本丸方。
本(去苗土) 葶苈(炒紫色各一分) 大戟(微炒) 蜀椒(去目及闭口者,炒出
汗) 泽
漆(微炒) 巴豆(去皮、心,麸炒出油尽) 赤小豆(微炒) 泽泻(各半两) 甘遂(微
炒一
两) 牵牛子(炒熟一分) 连翘(微炒半两)
上一十一味,捣罗为末,炼蜜丸梧桐子大。每日空心温酒下一丸,加至二丸。服后小便
多白色即住。
治水肿。桑白皮丸方。
桑根白皮(取上有白椹者,北阴下根白皮,锉,炙黄二两) 郁李仁(汤去皮,炒) 商
陆
(微炙) 葶苈(纸上炒令紫色) 牵牛子(炒熟) 巴豆(清水煮一日,去皮、心、膜,
出油尽
各一两)
上六味,捣罗为末,炼蜜丸梧桐子大。每服茶汤下十五丸,利三五行见效,即止。
治水肿。槟榔丸方。
槟榔(微煨) 附子(炮裂,去皮脐) 吴茱萸(水浸,曝干,炒) 浓朴(去粗皮,
涂姜汁
炙) 干姜(炮) 防己 甘草(炙各一两) 葶苈(纸上炒紫色) 杏仁(浸去皮尖、双
仁,炒) 椒目(微炒) 赤茯苓(去黑皮) 黄 (锉,炒) 麻黄(去根节,炒) 桂
(去粗皮) 栝蒌(去
上一十七味,捣罗为末,炼蜜丸梧桐子大。每服米饮下十丸,日三,稍增至十五丸,未
知加至二十五丸,得大小便利为验。此方兼疗老小虚肿,大病后客肿作喘。
治水气肿满。服商陆豆方。
生商陆(切如麻豆) 赤小豆(与商陆等分) 鲫鱼三枚(去肠存鳞)
上三味,将二味实鱼腹中,以绵缚之,水三升,缓煮豆烂,去鱼,只取二味。空腹食之,
以鱼汁送下,甚者过二日再为之,不过三剂。
治水气。逐气散方。
白商陆(去粗皮,薄切,曝干)
上一味,捣罗为散。用黄颡鱼三枚,大蒜三瓣,绿豆一合,水一升,同煮以豆烂为度。
先食豆饮汁送下,又以汁调下药散二钱匕,水气内消。
论述说:《内经》提到,肾是胃的关口。如果这个关口开合不利,就会导致水液积聚并随其同类性质泛滥,上下溢出到皮肤而形成水肿,所谓“肿”,就是水液积聚而引发的疾病。其症状表现为眼睑上方微微肿胀,像刚睡醒的样子,颈部脉搏微动,时常咳嗽,大腿发冷且皮肤浮肿,口苦舌干,不能仰卧,一旦仰卧就会咳出清稀液体;不能平卧,一躺下就惊恐并咳嗽,严重时小便黄且排尿涩痛,用手按压肿胀处,手松开后凹陷立即恢复,就像包裹着水一样的状态。通过脉象来辨别,脉象沉的是水病。脉象洪大的是可治之症,脉象微细的是难治之症。水病有五种不可治愈的情况:嘴唇发黑损伤了肝,这是第一种;锁骨上窝(缺盆)平坦损伤了心,这是第二种;肚脐突出损伤了脾,这是第三种;足底平坦损伤了肾,这是第四种;背部平坦损伤了肺,这是第五种。大概是因为脾肾气虚,三焦闭塞,至阴之气在内蓄积,巨阳之气不得宣通,这样水道就不利,饮湿攻伐脾胃,散在于肌肉之间,从而形成水肿病。
论述说:水肿这种病,是因为脾肾气虚,不能制约水液,导致水气妄行,溢出到皮肤,其证候表现为大腿发冷、皮肤浮肿,时常咳嗽,不能安卧,小便黄且涩痛,用手按压肿胀处,手松开后凹陷立即恢复。
治疗水病不限发病时间的长短,若出现脉象洪大、喘促严重,几乎无法度日。防己饮方。
防己(一分) 大戟(炒) 木香 赤茯苓(去黑皮) 海蛤 犀角(镑片) 胡黄连 白术 诃黎勒 陈橘皮(去白,焙干) 牵牛子 葶苈(隔纸炒) 郁李仁(各一两) 白槟榔(煨一两半) 大黄(锉碎,炒二两)
以上十九味药,锉成如麻豆大小的颗粒。每次服用二钱匕,用水一盏半,煎煮至一盏,滤去药渣,加入少许麝香,再煮沸一次,清晨空腹服用。如果步行五里路后再服第二次,不可冷服。如果是久病导致肠胃虚弱,到第二次服药时就会轻微腹泻;如果是肠胃实证,大约经过几次服药,也会排出恶浊的黄水,或者青黑色的恶物三五升,这是气化作用的结果。如果腹泻不感到非常困倦,可以继续服用;如果觉得力气缺乏,就用浆水粥停止服药。
在水气病服用前药痊愈后,服用此补气丸方。
防己 犀角(镑片) 葶苈(隔纸炒) 牵牛子(半生半熟) 赤茯苓(去黑皮) 诃黎勒(煨,去核) 海蛤 川芎 生干地黄(焙干,各一两) 大黄(二两半) 木通(锉碎) 桑根白皮(锉碎,炒) 陈橘皮(去白,焙干) 大戟(炒) 防风(去叉) 郁李仁(去皮尖,炒) 木香(各一两)
以上十七味药,捣碎过筛成粉末。用炼蜜制成梧桐子大小的丸剂。每次空腹用米汤送服十丸。如果觉得气机壅滞,加至十五丸;如果觉得通畅,则减去三丸至五丸;如果大小便不通,就服用三十丸。此方不仅治疗水气,凡是气疾,都治疗。
服用前防己饮痊愈后,百日内再服用五灵汤方。
葶苈(隔纸炒) 木通(锉碎) 赤茯苓(去黑皮) 防己 陈橘皮(去白,焙干,各一两)
以上五味药,粗捣过筛。每次服用二钱匕,用水一盏,煎煮三沸,滤去药渣饮用。觉得热就不要服用。
治疗水肿。牵牛汤方。
牵牛子 槟榔(煨,锉碎) 木香 赤茯苓(去黑皮) 陈橘皮(去白,焙干,各一两)
以上五味药,粗捣过筛。每次服用二钱匕,用水一盏,煎煮三沸,滤去药渣温服。此药不仅治疗水病,凡是肺气、香港脚(脚气)、贲豚气,向上冲筑心胸难以忍受的,都治疗。
治疗一切水气,四肢肿满。妙香汤方。
香子(炒) 乌药(生用) 高良姜(汤浸,焙干) 青橘皮(去白,各一两)
以上四味药,一同粗捣过筛。每次服用二钱匕,用酒半盏,煎煮数沸,滤去药渣,稍热时服用。
治疗水气肿满。暖肾散方。
巴戟天(去心,麸炒黑) 甘遂(炒黄,各一分) 槟榔(一枚生,一枚炮制) 木香 苦葶苈(纸上炒,各一分) 大麦 芫花(醋浸炒黄) 陈橘皮(去白,炒,各半两) 腻粉(一钱) 沉香(上一十一味药,捣碎过筛成散剂。每次服用二钱匕,用猪腰子一只,用竹刀割开,去掉筋膜,切成三片,将药末掺在里面,用湿纸包裹,慢火煨烤至香熟,先煮葱白三茎,煮熟后切细,将葱与粟米同煮一碗粥,先吃一半粥,然后吃腰子,吃完药后再把剩下的粥吃完,临睡前服用。如果到五更时分,大便和小便排出赤黄色的恶物,就是见效。)
治疗水气肿满。夺命丸方。
大戟(麸炒) 甘遂(炒,各一分) 苦葶苈(半两,一半生,一半熟) 泽泻(一分半)
以上四味药,捣碎过筛成粉末,煮枣肉和匀制成梧桐子大小的丸剂。如果四肢肿胀,名为顺水,用温浆水送服三丸,在星月升起时服用,到天亮时排出恶物;如果四肢消瘦,腹部肿胀,名为逆水,用苦葫芦子和陈曲煎汤送服三丸,小便频快就是有效,三天后服用补药矾石丸。
治疗水病的补药矾石丸方。
白矾(半两) 雄黄(研细) 丹砂(研细,各一分)
以上三味药,捣碎过筛成粉末,用粟米饭和匀制成绿豆大小的丸剂,用丹砂为衣。每次服用五丸至七丸,饭前用生姜汤送服,每日两次。
治疗水气肿满。槟榔散方。
槟榔(二枚生) 郁李仁(去皮尖,炒) 芫花(炒) 甘遂(炒) 续随子 木通(锉碎,各二两) 海蛤(一钱) 陈橘皮(去白,焙干) 商陆(各一分)
以上九味药,捣碎过筛成散剂。每次服用一钱匕,用温酒调下,临睡前服用。到五更时分排出恶物即为见效。
治疗水肿久不愈。大戟丸方。
大戟(炒) 陈橘皮(去白,焙干,各一分) 巴豆(七粒,去皮在大麦内炒熟,不用大麦)
以上三味药,捣碎过筛成粉末,用大麦面糊制成梧桐子大小的丸剂。每次服用三丸,生姜汤送服,空腹早晚服用。
治疗水肿腹满。二气汤方。
牵牛子(半两生用) 甘遂(一钱微炒)
以上两味药,粗捣过筛。分作两次服用,每次用水一盏,煎煮至五分,放温后细细呷服,不拘时间。
治疗水肿。大黄汤方。
大黄(锉碎,醋炒二两) 桂(去粗皮) 甘草(炙,锉碎) 人参 细辛(去苗叶,各一两) 桑根白皮(炙黄色,锉碎二两)
以上六味药,粗捣过筛。每次用药五钱匕,用水三盏,放入劈破的二枚枣,同煎煮至九分,滤去药渣,加入一勺白饴糖,再煮沸一次,温服,每日三次。如果利尿三五升,病就好了。
治疗水肿及肢体胀满。芫花汤方。
芫花(炒黄色) 大黄(锉碎,醋炒) 甘遂(微炒) 甘草(炙,锉碎) 大戟(去皮,微炒,各一两)
以上五味药,粗捣过筛。每次服用三钱匕,用水二盏,放入劈破的二枚枣,同煎煮至九分,加入半钱匕芒硝,再煮沸一次,滤去药渣温服,以腹泻为限度。
治疗水气面目浮肿,因虚劳和香港脚所致。鳖甲汤方。
鳖甲(去裙襕,醋炙焦二两) 人参 柴胡(去苗) 当归(切,焙干) 枳壳(去瓤,麸炒,各二两) 甘草(炙半两) 桃仁(七枚,汤浸去皮尖) 白槟榔(煨二枚)
以上八味药,粗捣过筛。先用小便二盏,浸泡药三钱匕,经过半天,煎取七分,滤去药渣温服,以病愈为限度。妇女病情相同的,加牛膝半两。
治疗水肿。利小便。郁李仁丸方。
郁李仁(汤浸去皮尖,微炒三分) 海藻(洗去咸味,炒) 桂(去粗皮,各半两) 大黄(锉碎,醋炒) 葶苈(纸上炒令紫色,各一两一分) 黄连(去须半两) 木通(锉碎) 石苇(去毛,微炙,各一分) 松萝(三分)
以上九味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。每次用米汤送服十五丸,每日三次,逐渐增加,以见效为限度。
治疗水肿。麝香丸方。麝香(研细半分) 芫花(炒黄三分) 甘遂(微炒,去皮半两)
以上三味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。强壮的人用酒送服十五丸,年老体弱的人十丸。
治疗水肿。利小便。商陆丸方。
商陆(微炙一两半) 芒硝(研细一两) 甘遂(微炒) 大黄(锉碎,醋炒) 芫花(微炒) 荛花(微炒,各三分) 麝香(研细四钱) 猪苓(去黑皮一两)
以上八味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。每次用米汤送服五丸,每日三次,以轻微腹泻为限度。华佗方,酒客虚热,当风饮冷,腹冷胀满,加麝香、猪苓各一两。
治疗水肿,睡眠不得安宁。防己丸方。
防己 海蛤(研细,各一两) 葶苈(一升蒸熟) 杏仁(六十枚,汤浸去皮尖,炒,另捣) 甘遂(微炒一分)
以上五味药,先将葶苈、杏仁一处拌和,然后将另外三味药捣碎过筛成粉末,再研磨均匀,加入枣肉和匀制成梧桐子大小的丸剂。每次用米汤送服二十丸,逐渐加至二十五丸,以轻微腹泻为限度。此病不过五六天即可痊愈。
治疗水肿久不愈。本丸方。
本(去苗土) 葶苈(炒紫色,各一分) 大戟(微炒) 蜀椒(去目及闭口者,炒出汗) 泽漆(微炒) 巴豆(去皮、心,麸炒出油尽) 赤小豆(微炒) 泽泻(各半两) 甘遂(微炒一两) 牵牛子(炒熟一分) 连翘(微炒半两)
以上十一味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。每天空腹用温酒送服一丸,加至二丸。服药后如果小便多呈白色就停药。
治疗水肿。桑白皮丸方。
桑根白皮(取上有白椹者,北阴下根白皮,锉碎,炙黄二两) 郁李仁(汤去皮,炒) 商陆(微炙) 葶苈(纸上炒令紫色) 牵牛子(炒熟) 巴豆(清水煮一日,去皮、心、膜,出油尽,各一两)
以上六味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。每次用茶汤送服十五丸,腹泻三五行见效,就停止。
治疗水肿。槟榔丸方。
槟榔(微煨) 附子(炮裂,去皮脐) 吴茱萸(水浸,曝干,炒) 浓朴(去粗皮,涂姜汁炙) 干姜(炮) 防己 甘草(炙,各一两) 葶苈(纸上炒紫色) 杏仁(浸去皮尖、双仁,炒) 椒目(微炒) 赤茯苓(去黑皮) 黄芪(锉碎,炒) 麻黄(去根节,炒) 桂(去粗皮) 栝蒌(去上一十七味药,捣碎过筛成粉末,炼蜜制成梧桐子大小的丸剂。每次用米汤送服十丸,每日三次,逐渐增至十五丸,未见效加至二十五丸,得大小便利为验。此方兼疗老小虚肿,大病后客肿作喘。)
治水气肿满。服商陆豆方。
生商陆(切如麻豆) 赤小豆(与商陆等分) 鲫鱼三枚(去肠存鳞)
以上三味药,将二味药填入鱼腹中,用绵线缚紧,用水三升,慢煮至豆烂,去掉鱼,只取二味药。空腹食用,用鱼汁送下,严重的过两天再做一次,不超过三剂。
治水气。逐气散方。
白商陆(去粗皮,薄切,曝干)
以上一味药,捣碎过筛成散剂。用黄颡鱼三枚,大蒜三瓣,绿豆一合,水一升,同煮至豆烂为度。先吃豆,用汁送下药散二钱匕,水气内消。
Commentary states: The *Neijing* (Inner Canon) mentions that the Kidney is the gate of the Stomach. If the opening and closing of this gate are not smooth, water fluids will accumulate and spread according to their nature, overflowing upwards and downwards into the skin to form edema. "Swelling" refers to illness caused by the accumulation of water fluids. Its manifestations include slight swelling above the eye sockets, resembling the appearance after just waking up; slight pulsation in the neck vessels; occasional coughing; coldness in the thighs and swollen skin; bitter taste in the mouth and dry tongue; inability to lie flat on the back, as doing so induces coughing up of clear fluid; inability to sleep supine, as lying down causes palpitations and coughing; severe cases present with yellow, scanty, and painful urination. Pressing the swollen area results in immediate rebound, resembling a state of being wrapped in water. Differentiation by pulse indicates that a deep pulse signifies water disease. A surging and large pulse indicates a treatable condition, while a fine and weak pulse indicates a difficult-to-treat condition. There are five types of water disease that are incurable: black lips indicate injury to the Liver (first); flat clavicular fossae (quepen) indicate injury to the Heart (second); protruding umbilicus indicates injury to the Spleen (third); flat soles indicate injury to the Kidney (fourth); flat back indicates injury to the Lung (fifth). Generally, this is due to deficiency of Qi in the Spleen and Kidney, obstruction of the Sanjiao (Triple Burner), accumulation of Yin Qi internally, and failure of Yang Qi to circulate freely. Consequently, the water pathways become obstructed, dampness attacks the Spleen, disperses into the muscles, and results in edema.
Commentary states: Edema arises from deficiency of Qi in the Spleen and Kidney, leading to an inability to control water fluids. Water Qi acts recklessly, overflowing into the skin. Symptoms include coldness in the thighs, swollen skin, occasional coughing, inability to rest comfortably, yellow and painful urination, and immediate rebound upon pressing the swollen areas.
Treatment for water disease is not limited by the duration since onset. For conditions with surging/large pulses and severe asthma, where life seems barely sustainable, use Fangji Yin Decoction.
Fangji (1 fen), Daji (stir-fried), Muxiang, Chifuling (black skin removed), Hai Ge, Xijiao (sliced), Huhuanglian, Baizhu, Helile, Chenjupi (white part removed, baked), Qianniuzi, Tingli (stir-fried between paper), Yuliren (each 1 liang), Bai Binglang (roasted, 1.5 liang), Dahuang (chopped, stir-fried, 2 liang).
The above nineteen ingredients are chopped to the size of hemp seeds. Take 2 qianbi per dose, decoct in 1.5 sheng of water until reduced to 1 sheng, strain, add a small amount of Shexiang, boil once more, and take on an empty stomach in the morning. Administer a second dose after walking for five li; do not take cold. For chronic cases with weak intestines and stomach, mild purgation occurs after the second dose. For excess patterns in the intestines and stomach, after several doses, foul yellow water or dark green/black matter (3-5 sheng) will be discharged, resulting from Qi transformation. If diarrhea does not cause excessive fatigue, continue administration; if weakness is felt, stop with Jiangshui Zhou (fermented grain porridge).
After recovery from water Qi using the previous Fangji Yin, administer Buqi Wan (Tonify Qi Pill).
Fangji, Xijiao (sliced), Tingli (stir-fried between paper), Qianniuzi (half raw, half cooked), Chifuling (black skin removed), Helile (roasted, pitted), Hai Ge, Xiong, Sheng Gan Dihuang (baked, each 1 liang), Dahuang (2.5 liang), Mutong (chopped), Sanggenbaipi (chopped, stir-fried), Chenjupi (white part removed, baked), Daji (stir-fried), Fangfeng (forks removed), Yuliren (skin and tip removed, stir-fried), Muxiang (each 1 liang).
The above seventeen ingredients are crushed, sifted into powder, and mixed with refined honey to make pills the size of paulownia seeds. Take 10 pills on an empty stomach with rice drink. If Qi stagnation is felt, increase to 15 pills; if free flow is achieved, reduce by 3-5 pills. For urinary/fecal retention, take 30 pills. This formula treats not only water Qi but all Qi disorders.
After recovery from Fangji Yin, administer Wuling Tang within 100 days.
Tingli (stir-fried between paper), Mutong (chopped), Chifuling (black skin removed), Fangji, Chenjupi (white part removed, baked, each 1 liang).
The above five ingredients are coarsely crushed and sifted. Take 2 qianbi per dose, decoct in 1 sheng of water for three boils, strain, and drink. Do not take if heat sensation occurs.
For edema, use Qianniu Tang.
Qianniuzi, Binglang (roasted, chopped), Muxiang, Chifuling (black skin removed), Chenjupi (white part removed, baked, each 1 liang).
The above five ingredients are coarsely crushed and sifted. Take 2 qianbi per dose, decoct in 1 sheng of water for three boils, strain, and take warm. This treats not only water disease but also Fei Qi (Lung Qi), Hongjiaojiao (foot qi/gout), Ben Tun Qi (revolving Qi), which rushes upward to the chest and heart causing unbearable distress.
For all water Qi and fullness/swelling of the four limbs, use Miaoxiang Tang.
Xiangzi (stir-fried), Wuyao (raw), Gaoliangjiang (soaked in water, baked dry), Qingjupi (white part removed, each 1 liang).
The above four ingredients are coarsely crushed and sifted. Take 2 qianbi per dose, decoct in half a zhan of wine for several boils, strain, and take slightly warm.
For water Qi swelling and fullness, use Nuanshen San.
Bajitian (heart removed, bran-roasted black), Gansui (stir-fried yellow, each 1 fen), Binglang (one raw, one roasted), Muxiang, Ku Tingli (stir-fried on paper, each 1 fen), Damai, Yuanhua (vinegar-soaked, stir-fried yellow), Chenjupi (white part removed, stir-fried, each 0.5 liang), Nifen (1 qian), Chenxiang.
The above eleven ingredients are crushed and sifted into powder. Take 2 qianbi per dose. Use one pig kidney, cut open with a bamboo knife, remove fascia, slice into three pieces, stuff with powder, wrap in wet paper, and slow-roast until fragrant. Boil three stalks of scallion white until soft, chop finely, and cook congee with millet and scallions. Eat half the congee first, then the kidney, then finish the congee after taking the medicine, before bed. Efficacy is confirmed by discharge of red-yellow foul matter in stool and urine at wugeng (5-7 AM).
For water Qi swelling and fullness, use Duoming Wan.
Daji (bran-roasted), Gansui (stir-fried, each 1 fen), Ku Tingli (0.5 liang, half raw, half cooked), Zexie (1.5 fen).
The above four ingredients are crushed, sifted, and mixed with jujube paste to make pills the size of paulownia seeds. For limb swelling (Shun Shui/Water Following), take 3 pills with warm fermented grain water when stars/moon appear; efficacy is discharge of foul matter at dawn. For limb emaciation with abdominal swelling (Ni Shui/Water Opposing), take 3 pills with decoction of Ku Hulu Zi and aged Qu; efficacy is frequent and rapid urination. After three days, administer Bishi Wan (Tonifying Pill).
For water disease, use Tonifying Bishi Wan.
Baifan (0.5 liang), Xionghuang (ground), Dansha (ground, each 1 fen).
The above three ingredients are crushed, sifted, mixed with millet rice paste to make pills the size of mung beans, coated with Dansha. Take 5-7 pills before meals with ginger soup, twice daily.
For water Qi swelling and fullness, use Binglang San.
Binglang (two raw), Yuliren (skin and tip removed, stir-fried), Yuanhua (stir-fried), Gansui (stir-fried), Xusui Zi, Mutong (chopped, each 2 liang), Hai Ge (1 qian), Chenjupi (white part removed, baked), Shanglu (each 1 fen).
The above nine ingredients are crushed and sifted into powder. Take 1 qianbi per dose, mix with warm wine, take before bed. Efficacy is confirmed by discharge of foul matter at wugeng.
For chronic edema, use Daji Wan.
Daji (stir-fried), Chenjupi (white part removed, baked, each 1 fen), Badou (seven grains, skin removed, stir-fried in damai until cooked, discard mai).
The above three ingredients are crushed, sifted, and made into pills the size of paulownia seeds using damai flour paste. Take 3 pills with ginger soup on an empty stomach in the morning and evening.
For edema with abdominal fullness, use Erqi Tang.
Qianniuzi (0.5 liang, raw), Gansui (1 qian, lightly stir-fried).
The above two ingredients are coarsely crushed and sifted. Divide into two doses. Decoct each dose in 1 sheng of water until reduced to 0.5 sheng, cool to warm, and sip slowly. Time is not restricted.
For edema, use Dahuang Tang.
Dahuang (chopped, vinegar-stir-fried, 2 liang), Gui (bark removed), Gancao (roasted, chopped), Renshen, Xixin (tips and leaves removed, each 1 liang), Sanggenbaipi (roasted yellow, chopped, 2 liang).
The above six ingredients are coarsely crushed and sifted. Take 5 qianbi of herbs with 3 sheng of water and two cracked jujubes. Decoct until reduced to 0.9 sheng, strain, add one spoonful of Baixi (white maltose), boil once, and take warm. Three times daily. Efficacy is confirmed by urination of 3-5 sheng.
For edema and limb fullness, use Yuanhua Tang.
Yuanhua (stir-fried yellow), Dahuang (chopped, vinegar-stir-fried), Gansui (lightly stir-fried), Gancao (roasted, chopped), Daji (skin removed, lightly stir-fried, each 1 liang).
The above five ingredients are coarsely crushed and sifted. Take 3 qianbi per dose with 2 sheng of water and two cracked jujubes. Decoct until reduced to 0.9 sheng, add 0.5 qianbi of Mangxiao, boil once, strain, and take warm. Stop when purged.
For water Qi facial swelling due to Xu Lao (consumptive disease) and Hongjiaojiao, use Biejia Tang.
Biejia (apron removed, vinegar-roasted charred, 2 liang), Renshen, Chaihu (tips removed), Danggui (sliced, baked), Zhike (pith removed, bran-roasted, each 2 liang), Gancao (roasted, 0.5 liang), Taoren (seven grains, soaked in water, skin and tip removed), Bai Binglang (roasted, two grains).
The above eight ingredients are coarsely crushed and sifted. Soak 3 qianbi of herbs in two sheng of urine for half a day, decoct until reduced to 0.7 sheng, strain, and take warm. Efficacy is cure. For women with same symptoms, add Niuxi (0.5 liang).
For edema, promoting urination, use Yuliren Wan.
Yuliren (soaked in water, skin and tip removed, lightly stir-fried, 3 fen), Haizao (washed to remove saltiness, stir-fried), Gui (bark removed, each 0.5 liang), Dahuang (chopped, vinegar-stir-fried), Tingli (stir-fried on paper until purple, each 1 liang 1 fen), Huanglian (roots removed, 0.5 liang), Mutong (chopped), Shiwei (hairs removed, lightly roasted, each 1 fen), Songluo (3 fen).
The above nine ingredients are crushed, sifted, and mixed with refined honey to make pills the size of paulownia seeds. Take 15 pills with rice drink, three times daily. Increase gradually until effective.
For edema, use Shexiang Wan.
Shexiang (ground, 0.5 fen), Yuanhua (stir-fried yellow, 3 fen), Gansui (lightly stir-fried, skin removed, 0.5 liang).
The above three ingredients are crushed, sifted, and mixed with refined honey to make pills the size of paulownia seeds. Strong individuals take 15 pills with wine; elderly/weak take 10 pills.
For edema, promoting urination, use Shanglu Wan.
Shanglu (lightly roasted, 1.5 liang), Mangxiao (ground, 1 liang), Gansui (lightly stir-fried), Dahuang (chopped, vinegar-stir-fried), Yuanhua (lightly stir-fried), Raohua (lightly stir-fried, each 3 fen), Shexiang (ground, 4 qian), Zhuling (black skin removed, 1 liang).
The above eight ingredients are crushed, sifted, and mixed with refined honey to make pills the size of paulownia seeds. Take 5 pills with rice drink, three times daily. Stop when mild purgation occurs. Hua Tuo's prescription: for drinkers with deficiency-heat, drinking cold in wind, causing cold abdominal fullness, add Shexiang and Zhuling (each 1 liang).
For edema with insomnia, use Fangji Wan.
Fangji, Hai Ge (ground, each 1 liang), Tingli (1 sheng, steamed until cooked), Xingren (60 grains, soaked in water, skin and tip removed, stir-fried, separately pounded), Gansui (lightly stir-fried, 1 fen).
The above five ingredients: first mix Tingli and Xingren, then crush/sift the other three into powder, blend uniformly, mix with jujube paste to make pills the size of paulownia seeds. Take 20 pills with rice drink, gradually increase to 25 pills. Stop when mild purgation occurs. Cure within 5-6 days.
For chronic edema, use Ben Wan.
Ben (tips and soil removed), Tingli (stir-fried purple, each 1 fen), Daji (lightly stir-fried), Shujiao (eyes and closed ones removed, stir-fried until sweat appears), Zeqi (lightly stir-fried), Badou (skin and heart removed, bran-roasted until oil is gone), Chixiaodou (lightly stir-fried), Zexie (each 0.5 liang), Gansui (lightly stir-fried, 1 liang), Qianniuzi (cooked, 1 fen), Lianqiao (lightly stir-fried, 0.5 liang).
The above eleven ingredients are crushed, sifted, and mixed with refined honey to make pills the size of paulownia seeds. Take one pill on an empty stomach with warm wine daily, increasing to two. Stop when urine becomes abundant and white.
For edema, use Sangbaipi Wan.
Sanggenbaipi (from trees with white mulberries, northern shade roots, chopped, roasted yellow, 2 liang), Yuliren (skin removed by water, stir-fried), Shanglu (lightly roasted), Tingli (stir-fried on paper until purple), Qianniuzi (cooked), Badou (boiled in clear water for one day, skin/heart/membrane removed, oil gone, each 1 liang).
The above six ingredients are crushed, sifted, and mixed with refined honey to make pills the size of paulownia seeds. Take 15 pills with tea/water. Efficacy is 3-5 bowel movements; then stop.
For edema, use Binglang Wan.
Binglang (lightly roasted), Fuzi (roasted until cracked, skin and navel removed), Wuzhuyu (soaked in water, dried, stir-fried), Houpo (bark removed, brushed with ginger juice, roasted), Ganjiang (roasted), Fangji, Gancao (roasted, each 1 liang), Tingli (stir-fried on paper until purple), Xingren (soaked, skin/tip/double kernels removed, stir-fried), Jiaomu (lightly stir-fried), Chifuling (black skin removed), Huangqi (chopped, stir-fried), Mahuang (roots/joints removed, stir-fried), Gui (bark removed), Gualou (removed... [text cuts off]).
The above seventeen ingredients are crushed, sifted, and mixed with refined honey to make pills the size of paulownia seeds. Take 10 pills with rice drink, three times daily. Gradually increase to 15 pills; if no effect, increase to 25 pills. Efficacy is free passage of stool and urine. This formula also treats deficiency edema in old/young, and post-illness external edema with asthma.
For water Qi swelling and fullness, use Shanglu Dou Recipe.
Raw Shanglu (chopped like hemp seeds), Chixiaodou (equal parts to Shanglu), Three Crucian Carp (guts removed, scales kept).
The above three ingredients: stuff the two herbs into the fish bellies, tie with silk, simmer in 3 sheng of water until beans are soft. Remove fish, keep only the two ingredients. Eat on an empty stomach, washing down with fish broth. Severe cases repeat after two days. Do not exceed three courses.
For water Qi, use Zhuqi San.
White Shanglu (coarse bark removed, thinly sliced, sun-dried).
The above one ingredient is crushed and sifted into powder. Use three Yellow Catfish (Huangsang Yu), three cloves of garlic, one he of mung beans, and one sheng of water. Simmer together until beans are soft. Eat beans first, wash down with juice, then take 2 qianbi of powder mixed with juice. Water Qi dissipates internally.