论曰∶《内经》言,肺移寒于肾,为涌水。涌水者,按腹不坚,水气客于大肠,疾行则
鸣,濯濯如囊裹浆,水之病也。夫肾为肺之子而主水,大肠为肺之府而为传道之官,肺受寒
邪,宜传于肾。肾受寒邪,则其水闭郁而不流,水无所归,故客于大肠而不下。夫水性流下,
今乃客于大肠,不得宣通,而其证涌溢,如囊裹浆也。
治涌水,腹中动摇作水声,兼痰饮腹胁胀满。旋复花丸方。
旋复花 桂(去粗皮) 枳实(去瓤,麸炒) 人参(各一两一分) 干姜(炮) 芍
药白
术(各一两半) 赤茯苓(去黑皮) 野狼毒 乌头(炮裂,去皮脐) 石(各二两) 细
辛(去
苗叶) 大黄(锉,炒) 黄芩(去黑心) 葶苈(隔纸炒) 浓朴(去粗皮,姜汁炙) 吴
茱萸(汤
浸洗,炒) 芫花(醋浸半日,炒焦) 陈橘皮(汤浸去白,焙各一两) 甘遂(炒三分)
上二十味,捣罗为末,炼蜜丸如梧桐子大。每服五丸,酒下,日二,不知,稍加丸数,
以知为度。
治涌水腹满。大黄附子丸方。
大黄(锉,炒) 旋复花 附子(炮裂,去皮脐) 赤茯苓(去黑皮) 椒目 桂(去
粗皮)
芫花(醋浸,炒焦) 野狼毒 干姜(炮) 芍药 枳实(去瓤,麸炒) 细辛(去苗叶各二
两)
上一十二味,捣罗为末,炼蜜丸如梧桐子大。每服三丸,熟水下,渐增之,早晚食前、
临卧各一服。
治涌水腹满不坚,疾行则濯濯有声。葶苈丸方。
葶苈(隔纸炒) 泽泻(各一两) 猪苓(去黑皮) 椒目 桑根白皮 杏仁(去皮尖、
双
仁,麸炒) 牵牛子(炒各半两)
上七味,捣罗为末,炼蜜丸如梧桐子大。每服二十丸,葱白汤下,不知,加至三十丸。
治涌水腹满,肠间有水声。椒目丸方。
椒目 防己 大黄(锉,炒各一两) 葶苈(隔纸炒一两)
上四味,捣罗为末,炼蜜丸如梧桐子大。每服一丸至三丸,食前温水下,日三。渴者,
加芒硝半两。
治涌水。猪苓丸方。
猪苓(去黑皮三分) 牵牛子(炒一两) 葶苈(隔纸炒半两) 桑根白皮(锉各一两)
赤小
豆(炒半合) 郁李仁(汤浸去皮,炒) 防己(各一两) 大腹子(和皮锉三个) 生姜
(切,
焙一
上九味,捣罗为末,炼蜜为丸如小豆大。每服十五丸,米饮下,未效,加至二十丸,日
二。
治涌水及支满癖饮。干枣汤方。
大枣(去核十枚) 大戟(炒) 甘遂(炒) 大黄(锉,炒) 黄芩(去黑心各一两)
芫花(醋
浸,炒焦) 荛花(各半两)
上七味, 咀如麻豆。每服半钱匕,水一盏,煎至七分,早晚食前温服,以利为度。
治涌水。槟榔丸方。
槟榔(煨) 牵牛子(炒) 赤小豆(炒) 郁李仁(汤浸去皮,炒) 桑根白皮(锉)
肉豆蔻
(去壳) 杏仁(去皮尖、双仁,麸炒各一两)
上七味,捣罗为末,炼蜜丸如小豆大。每服十丸,以温水下,日再。
治涌水。海蛤汤方。
海蛤 紫菀(去苗土) 远志(去心各一两) 大戟 木香 防己(各半两)
上六味,粗捣筛。每服二钱匕,水一盏半,煎至八分,热服。若取下恶水,即以白粥补
之。禁盐一百二十日,兼不得服芫花甘遂药。
治涌水,诸般水肿。商陆丸方。
商陆(切,焙一斤) 陈橘皮(汤浸去白,焙二两) 木香(一两) 赤小豆面(四两)
上四味,捣罗为末,以新汲水和丸如绿豆大。每服二十丸,橘皮汤下。
治涌水,心下如有数升油囊,泶泶作声,日不欲食,但欲饮水,久病则成瘕。蓖麻单方
蓖麻子(去皮二十枚)
上一味熟研,以水解得三合。清旦顿服尽,日中当吐下青黄如葵汁。病不尽,即三日更
增十枚,服如上法,以病尽为度。五日内只吃白糜粥。
治涌水小便涩,卧即喘息。猪苓饮方。
猪苓(去黑皮) 桑根白皮(锉,炒) 防己 百合 郁李仁(研各一两半) 瞿麦(一
两) 木通(锉二两)
上七味,粗捣筛。每服三钱匕,水一盏半,煎至一盏,去滓,食前温服,如人行五里再
服。
治涌水肠鸣腹大,通草饮方。
木通(锉三两) 桑根白皮(锉,炒) 石苇(去毛) 赤茯苓(去黑皮) 防己 泽
泻(各一
两
上七味,粗捣筛。每服三钱匕,水一盏半,煎至一盏,去滓,食前温服,如人行五里再
服。
治涌水腹满,小便难。葶苈丸方。
葶苈子(炒一两半) 硝石(二两) 杏仁(汤去皮尖、双仁,炒,研二两半)
上三味,捣罗为细末,枣肉和丸如梧桐子大。食前木通汤下十丸,日二服。
论述说:《内经》中提到,肺将寒邪转移给肾,就会形成涌水病。所谓涌水,是指按压腹部并不坚硬,水气停留于大肠,快速行走时肠鸣辘辘,声音如同囊袋包裹着浆液,这是水气为患的疾病。肾是肺的子脏而主管水液代谢,大肠是肺的腑而为传导之官,肺受寒邪侵袭,寒邪适宜传变至肾。肾受到寒邪侵袭,则体内的水液闭郁而不流通,水液没有归处,所以客居于大肠而不能下行。水的本性是向下流动的,如今却客居于大肠,不能宣通,因此出现水液涌溢的症状,就像囊袋包裹着浆液一样。
治疗涌水症,表现为腹中动摇发出水声,兼有痰饮导致的腹胁胀满。使用旋复花丸方。
旋复花、桂枝(去除粗皮)、枳实(去除瓤,麸炒)、人参(各一两一分)、干姜(炮制)、芍药、白术(各一两半)、赤茯苓(去除黑皮)、野狼毒、乌头(炮裂,去皮和脐)、石韦(各二两)、细辛(去苗叶)、大黄(锉碎,炒制)、黄芩(去除黑心)、葶苈子(隔纸炒)、厚朴(去除粗皮,姜汁炙)、吴茱萸(汤浸洗,炒制)、芫花(醋浸半天,炒焦)、陈橘皮(汤浸去白,焙干)(各一两)、甘遂(炒三分)。
以上二十味药,捣碎过筛成粉末,用炼蜜制成梧桐子大小的丸剂。每次服用五丸,酒送服,每日两次,若无效,稍增加丸数,以见效为度。
治疗涌水引起的腹满。使用大黄附子丸方。
大黄(锉碎,炒制)、旋复花、附子(炮裂,去皮和脐)、赤茯苓(去除黑皮)、椒目、桂枝(去除粗皮)、芫花(醋浸,炒焦)、野狼毒、干姜(炮制)、芍药、枳实(去除瓤,麸炒)、细辛(去苗叶)(各二两)。
以上十二味药,捣碎过筛成粉末,用炼蜜制成梧桐子大小的丸剂。每次服用三丸,熟水送服,逐渐增加剂量,早晚饭前及临睡前各服一次。
治疗涌水引起的腹满但不坚硬,快速行走时肠鸣濯濯有声。使用葶苈丸方。
葶苈子(隔纸炒)、泽泻(各一两)、猪苓(去除黑皮)、椒目、桑根白皮、杏仁(去皮尖及双仁,麸炒)、牵牛子(炒制)(各半两)。
以上七味药,捣碎过筛成粉末,用炼蜜制成梧桐子大小的丸剂。每次服用二十丸,葱白汤送服,若无效,加至三十丸。
治疗涌水引起的腹满,肠间有水声。使用椒目丸方。
椒目、防己、大黄(锉碎,炒制)(各一两)、葶苈子(隔纸炒)(一两)。
以上四味药,捣碎过筛成粉末,用炼蜜制成梧桐子大小的丸剂。每次服用一至三丸,饭前温水送服,每日三次。若有口渴症状,加芒硝半两。
治疗涌水。使用猪苓丸方。
猪苓(去除黑皮)(三分)、牵牛子(炒制)(一两)、葶苈子(隔纸炒)(半两)、桑根白皮(锉碎)(各一两)、赤小豆(炒制)(半合)、郁李仁(汤浸去皮,炒制)、防己(各一两)、大腹子(带皮锉碎三个)、生姜(切片,焙干)(一枚)。
以上九味药,捣碎过筛成粉末,用炼蜜制成小豆大小的丸剂。每次服用十五丸,米饮送服,若未见效,加至二十丸,每日两次。
治疗涌水及支满癖饮。使用干枣汤方。
大枣(去核十枚)、大戟(炒制)、甘遂(炒制)、大黄(锉碎,炒制)、黄芩(去除黑心)(各一两)、芫花(醋浸,炒焦)、荛花(各半两)。
以上七味药,切碎如麻豆大小。每次服用半钱匕,用水一盏,煎至七分,早晚饭前温服,以利下为度。
治疗涌水。使用槟榔丸方。
槟榔(煨制)、牵牛子(炒制)、赤小豆(炒制)、郁李仁(汤浸去皮,炒制)、桑根白皮(锉碎)、肉豆蔻(去壳)、杏仁(去皮尖及双仁,麸炒)(各一两)。
以上七味药,捣碎过筛成粉末,用炼蜜制成小豆大小的丸剂。每次服用十丸,温水送服,每日两次。
治疗涌水。使用海蛤汤方。
海蛤、紫菀(去苗土)、远志(去心)(各一两)、大戟、木香、防己(各半两)。
以上六味药,粗捣过筛。每次服用二钱匕,用水一盏半,煎至八分,热服。若排出恶水,随即用白粥补养。禁盐一百二十天,同时不得服用芫花、甘遂类药物。
治疗涌水,各种水肿。使用商陆丸方。
商陆(切片,焙干)(一斤)、陈橘皮(汤浸去白,焙干)(二两)、木香(一两)、赤小豆面(四两)。
以上四味药,捣碎过筛成粉末,用新汲水和丸如绿豆大小。每次服用二十丸,橘皮汤送服。
治疗涌水,感觉心下有数个油囊,泶泶作响,白天不想进食,只想饮水,久病则形成瘕积。使用蓖麻单方。
蓖麻子(去皮二十枚)。
以上一味药,研烂,用水调和得到三合药液。清晨一次性服完,中午应当吐出或泻出青色黄色如葵菜汁样的物质。若病未尽除,三天后再增加十枚,按上述方法服用,以病愈为度。五日内只吃白糜粥。
治疗涌水引起的小便涩滞,躺卧即喘息。使用猪苓饮方。
猪苓(去除黑皮)、桑根白皮(锉碎,炒制)、防己、百合、郁李仁(研碎)(各一两半)、瞿麦(一两)、木通(锉碎)(二两)。
以上七味药,粗捣过筛。每次服用三钱匕,用水一盏半,煎至一盏,去渣,饭前温服,如人行走五里的时间再服第二次。
治疗涌水肠鸣腹大。使用通草饮方。
木通(锉碎三两)、桑根白皮(锉碎,炒制)、石苇(去毛)、赤茯苓(去除黑皮)、防己、泽泻(各一两)。
以上七味药,粗捣过筛。每次服用三钱匕,用水一盏半,煎至一盏,去渣,饭前温服,如人行走五里的时间再服第二次。
治疗涌水腹满,小便困难。使用葶苈丸方。
葶苈子(炒制)(一两半)、硝石(二两)、杏仁(汤浸去皮尖及双仁,炒制,研碎)(二两半)。
以上三味药,捣罗成细末,用枣肉和丸如梧桐子大小。饭前木通汤送服十丸,每日两次。
Discussion states: The *Neijing* (Inner Canon) mentions that when the Lung transfers cold pathogenic factors to the Kidney, it results in Yongshui (Surging Water). Yongshui is characterized by a abdomen that is not firm upon palpation; water qi lodges in the Large Intestine, producing gurgling sounds during rapid movement, resembling a bag containing liquid. This is a disease of water accumulation. The Kidney is the Zang organ corresponding to the Lung as its child and governs water metabolism. The Large Intestine is the Fu organ of the Lung and serves as the official of transmission and transformation. When the Lung is invaded by cold pathogenic factors, the pathogen tends to transmit to the Kidney. Once the Kidney is affected by cold, the body's water fluids become closed and stagnant, failing to circulate. With no proper destination for the water, it lodges in the Large Intestine and fails to descend. Since water naturally flows downward, lodging in the Large Intestine prevents its free diffusion, leading to surging overflow symptoms, akin to a bag filled with fluid.
For treating Yongshui, manifested by shaking water sounds in the abdomen accompanied by phlegm-fluid retention causing distension and fullness in the abdomen and hypochondrium, use Xuanfuhua Wan (Inula Flower Pill).
Xuanfuhua (Inulae Flos), Guizhi (Cinnamomi Ramulus, removed coarse bark), Zhishi (Aurantii Fructus Immaturus, removed pith, bran-fried), Renshen (Ginseng Radix et Rhizoma) (each 1 liang 1 fen), Ganjiang (Zingiberis Rhizoma, processed), Shaoyao (Paeoniae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 liang 5 qian), Chifuling (Polyporus, removed black skin), Yelangdu (Stellerae Radix), Wutou (Aconiti Radix, processed until cracked, removed skin and navel), Shiwei (Pyri Folium, each 2 liang), Xixin (Asari Radix et Rhizoma, removed seedlings and leaves), Dahuang (Rhei Radix et Rhizoma, crushed, fried), Huangqin (Scutellariae Radix, removed black heart), Tinglizi (Descurainiae Semen seu Lepidii Semen, fried between papers), Houpo (Magnoliae Officinalis Cortex, removed coarse bark, ginger-juice roasted), Wuzhuyu (Evodiae Fructus, soaked in water and washed, fried), Yuanhua (Genkwa Flos, soaked in vinegar for half a day, fried until scorched), Chenpi (Citri Reticulatae Pericarpium, soaked in water, white part removed, dried) (each 1 liang), Gansui (Kansui Radix, fried 3 fen).
The above twenty ingredients are pounded and sifted into powder, mixed with refined honey to form pills the size of paulownia seeds. Take five pills per dose, administered with wine, twice daily. If ineffective, slightly increase the number of pills until therapeutic effect is achieved.
For treating abdominal fullness caused by Yongshui, use Dahuang Fuzi Wan (Rhubarb and Aconite Pill).
Dahuang (Rhei Radix et Rhizoma, crushed, fried), Xuanfuhua (Inulae Flos), Fuzi (Aconiti Lateralis Radix Praeparata, processed until cracked, removed skin and navel), Chifuling (Polyporus, removed black skin), Jiaomu (Zanthoxyli Semen), Guizhi (Cinnamomi Ramulus, removed coarse bark), Yuanhua (Genkwa Flos, soaked in vinegar, fried until scorched), Yelangdu (Stellerae Radix), Ganjiang (Zingiberis Rhizoma, processed), Shaoyao (Paeoniae Radix), Zhishi (Aurantii Fructus Immaturus, removed pith, bran-fried), Xixin (Asari Radix et Rhizoma, removed seedlings and leaves) (each 2 liang).
The above twelve ingredients are pounded and sifted into powder, mixed with refined honey to form pills the size of paulownia seeds. Take three pills per dose, administered with warm boiled water, gradually increasing the dosage. Take one dose before morning and evening meals, and one dose before retiring.
For treating abdominal fullness due to Yongshui which is not firm, with gurgling sounds during rapid movement, use Tingli Wan (Descurainia Seed Pill).
Tinglizi (Descurainiae Semen seu Lepidii Semen, fried between papers), Zexie (Alismatis Rhizoma) (each 1 liang), Zhuling (Polyporus, removed black skin), Jiaomu (Zanthoxyli Semen), Sangbaipipi (Mori Cortex), Xingren (Pruni Semen, removed skin and tips, double-kernel removed, bran-fried), Qianniuzi (Pharbitidis Semen, fried) (each 0.5 liang).
The above seven ingredients are pounded and sifted into powder, mixed with refined honey to form pills the size of paulownia seeds. Take twenty pills per dose, administered with decoction of scallion whites. If ineffective, increase to thirty pills.
For treating abdominal fullness due to Yongshui with water sounds in the intestines, use Jiaomu Wan (Zanthoxylum Seed Pill).
Jiaomu (Zanthoxyli Semen), Fangji (Stephaniae Tetrandrae Radix), Dahuang (Rhei Radix et Rhizoma, crushed, fried) (each 1 liang), Tinglizi (Descurainiae Semen seu Lepidii Semen, fried between papers) (1 liang).
The above four ingredients are pounded and sifted into powder, mixed with refined honey to form pills the size of paulownia seeds. Take one to three pills per dose, administered with warm water before meals, three times daily. If thirst occurs, add Mangxiao (Natrii Sulfas) 0.5 liang.
For treating Yongshui, use Zhuling Wan (Polyporus Pill).
Zhuling (Polyporus, removed black skin) (3 fen), Qianniuzi (Pharbitidis Semen, fried) (1 liang), Tinglizi (Descurainiae Semen seu Lepidii Semen, fried between papers) (0.5 liang), Sangbaipipi (Mori Cortex, crushed) (each 1 liang), Chixiaodou (Phaseoli Semen Rubrum, fried) (0.5 he), Yuliren (Pruni Armeniacae Semen Amarum, soaked in water, skin removed, fried), Fangji (Stephaniae Tetrandrae Radix) (each 1 liang), Dafuzi (Arecae Pericarpium, cut with skin, crushed) (three pieces), Shengjiang (Zingiberis Rhizoma Recens, sliced, dried) (one piece).
The above nine ingredients are pounded and sifted into powder, mixed with refined honey to form pills the size of mung beans. Take fifteen pills per dose, administered with rice drink. If ineffective, increase to twenty pills, twice daily.
For treating Yongshui and Zhiman Pi Yin (fluid retention with distension and masses), use Ganzao Tang (Jujube Decoction).
Dazao (Zizyphi Fructus, pitted, ten pieces), Daji (Euphorbiae Pekinensis Radix, fried), Gansui (Kansui Radix, fried), Dahuang (Rhei Radix et Rhizoma, crushed, fried), Huangqin (Scutellariae Radix, removed black heart) (each 1 liang), Yuanhua (Genkwa Flos, soaked in vinegar, fried until scorched), Raohua (Adenophorae Radix) (each 0.5 liang).
The above seven ingredients are chopped like hemp or millet seeds. Take half a qianbi (measure) per dose, with one cup of water, decocted to 70% volume. Take warm before morning and evening meals, stopping when purgation occurs.
For treating Yongshui, use Binglang Wan (Areca Seed Pill).
Binglang (Arecae Semen, baked), Qianniuzi (Pharbitidis Semen, fried), Chixiaodou (Phaseoli Semen Rubrum, fried), Yuliren (Pruni Armeniacae Semen Amarum, soaked in water, skin removed, fried), Sangbaipipi (Mori Cortex, crushed), Roudoukou (Myristicae Semen, shell removed), Xingren (Pruni Semen Amarum, removed skin and tips, double-kernel removed, bran-fried) (each 1 liang).
The above seven ingredients are pounded and sifted into powder, mixed with refined honey to form pills the size of mung beans. Take ten pills per dose, administered with warm water, twice daily.
For treating Yongshui, use Hai Ge Tang (Clam Shell Decoction).
Haige (Concha Meretrix), Ziwan (Asteris Radix, removed seedlings and soil), Yuanzhi (Polygalae Radix, removed core) (each 1 liang), Daji (Euphorbiae Pekinensis Radix), Muxiang (Aucklandiae Radix), Fangji (Stephaniae Tetrandrae Radix) (each 0.5 liang).
The above six ingredients are coarsely crushed and sieved. Take two qianbi per dose, with one and a half cups of water, decocted to 80% volume. Take hot. If foul water is discharged, replenish with plain white porridge. Avoid salt for 120 days, and do not consume Yuanhua or Gansui medicines.
For treating Yongshui and various types of edema, use Shanglu Wan (Phytolaccae Radix Pill).
Shanglu (Phytolaccae Radix, sliced, dried) (1 jin), Chenpi (Citri Reticulatae Pericarpium, soaked in water, white part removed, dried) (2 liang), Muxiang (Aucklandiae Radix) (1 liang), Chixiaodou mian (Phaseoli Semen Rubrum flour) (4 liang).
The above four ingredients are pounded and sifted into powder, mixed with fresh well water to form pills the size of mung beans. Take twenty pills per dose, administered with tangerine peel decoction.
For treating Yongshui, where there is a sensation of several oil sacs under the heart making splashing sounds, loss of appetite during the day, desire only for drinking water, and long-term illness resulting in mass formation, use Bimadanfang (Castor Bean Single Herb Prescription).
Bimazi (Ricini Semen, shelled, twenty seeds).
The above single ingredient is thoroughly ground, mixed with water to obtain three he of liquid. Take all at once early in the morning. By noon, vomiting or purging of green-yellow fluid resembling amaranth juice should occur. If the disease persists, add ten seeds after three days and administer as before, continuing until the disease is completely resolved. For five days, consume only thin white porridge.
For treating Yongshui causing difficult urination and wheezing when lying down, use Zhuling Yin (Polyporus Drink).
Zhuling (Polyporus, removed black skin), Sangbaipipi (Mori Cortex, crushed, fried), Fangji (Stephaniae Tetrandrae Radix), Baihe (Lilii Bulbus), Yuliren (Pruni Armeniacae Semen Amarum, ground) (each 1.5 liang), Qumai (Dianthi Herba) (1 liang), Mutong (Akebiae Caulis, crushed) (2 liang).
The above seven ingredients are coarsely crushed and sieved. Take three qianbi per dose, with one and a half cups of water, decocted to one cup. Strain and take warm before meals. Administer again after walking the distance of five li.
For treating Yongshui with intestinal borborygmus and abdominal enlargement, use Tongcao Yin (Tetrapanacis Medulla Drink).
Mutong (Akebiae Caulis, crushed) (3 liang), Sangbaipipi (Mori Cortex, crushed, fried), Shiwei (Pyri Folium, removed hairs), Chifuling (Polyporus, removed black skin), Fangji (Stephaniae Tetrandrae Radix), Zexie (Alismatis Rhizoma) (each 1 liang).
The above seven ingredients are coarsely crushed and sieved. Take three qianbi per dose, with one and a half cups of water, decocted to one cup. Strain and take warm before meals. Administer again after walking the distance of five li.
For treating abdominal fullness due to Yongshui and difficult urination, use Tingli Wan (Descurainia Seed Pill).
Tinglizi (Descurainiae Semen seu Lepidii Semen, fried) (1.5 liang), Xiaoshi (Nitrumsulfatum) (2 liang), Xingren (Pruni Semen Amarum, soaked in water, skin and tips removed, double-kernel removed, fried, ground) (2.5 liang).
The above three ingredients are pounded into fine powder, mixed with jujube flesh to form pills the size of paulownia seeds. Take ten pills before meals, administered with Mutong decoction, twice daily.