从来肿病。遍身头面俱肿。尚易治。若只单单腹肿。则为难治。此其间有所以然之故。不可不辨也。盖
传世诸方。皆是悍毒攻劫之法。伤耗元气。亏损脾胃。可一不可再之药。纵取效于一时。倘至复肿。则更
无法可疗。此其一也。且遍身俱肿者。五脏六腑。各有见证。故泻肝泻肺泻膀胱泻大小肠之药。间有取效
之时。而单单腹肿。则中州之地。久窒其四运之轴。而清者不升。浊者不降。互相结聚。牢不可破。实因脾
气之衰微所致。而泻脾之药。尚敢漫用乎。此又其一也。且肿病之可泻者。但可施
之西北壮盛。及田野农夫之流。岂膏粱老少之所能受。设谓肿
病为大满大实。必从乎泻。则病后肿与产后肿。将亦泻之耶。此又其一也。且古方原载肿病五不治。唇黑伤
肝。缺盆平伤心。脐出伤脾。背平伤肺。足底平满伤肾。此五者不可治矣。是其立方
之意。皆非为不可治之证而设。后人不察。概从攻泻者何耶。惟理脾一法。虽五脏见不治之证。而能治者
尚多。此又其一也。张子和以汗吐下三法。劫除百病。后人有谓子和之书。非子和之
笔。乃麻征君文之者。诚为知言。如常仲明云。世人以补剂疗病。宜乎不效。此则过信刘张之学。而罔顾元气
之羸劣耳。所以凡用劫夺之药者。其始非不遽消。其后攻之不消矣。其后再攻之如铁石矣。不知者见之。方
谓何物邪气。若此之盛。自明者观之。不过为猛药所攻。即以此身之元气。转与此身为难者。实有
如驱良民为寇之比。所谓赤子盗兵。弄于潢池。 其然哉。明乎
此。则有培养一法。补益元气是也。则有招纳一法。升举阳气是也。则有解散一法。开鬼门洁净府是也。
三法虽不言泻。而泻在其中矣。无余蕴矣。
胡卣臣先生曰。胀满必从乎泻。然善言泻者。补之中无非泻也。观者须识此意。始得立言之旨。
自古以来，全身及头面浮肿的病证，尚属容易治疗。如果仅仅是腹部肿胀，则属于难治之症。这中间有它必然的道理，不可不加以辨析。
流传下来的各种方剂，大多采用猛烈有毒的攻伐劫夺之法，这会损伤耗竭元气，亏损脾胃，是只可偶尔使用、不可重复使用的药物。纵然能在一时取得疗效，倘若病情复发再次出现肿胀，那就更加无药可医了。这是第一个原因。
况且全身浮肿者，五脏六腑各有相应的见证表现，因此使用泻肝、泻肺、泻膀胱以及泻大小肠的药物，有时也能取得疗效。而如果是单纯的腹部肿胀，则是中焦（脾胃所在区域）长期阻塞了气机升降的枢纽，导致清气不能上升，浊气不能下降，相互结聚，牢固难以攻破。这实际上是由于脾气衰微所致，此时还敢随意滥用泻脾的药物吗？这是第二个原因。
况且对于可以施以泻法的肿病，仅适用于西北方体质壮盛之人，以及田野农夫这类人群，哪里是那些饮食精细、年老体弱或年幼娇贵之人所能承受的？如果说肿病属于大满大实的实证，必须从泻法治疗，那么病后浮肿和产后浮肿，难道也要用泻法吗？这是第三个原因。
况且古方原本记载了肿病的五种不治之症：嘴唇发黑说明伤及肝脏，锁骨上窝（缺盆）平坦说明伤及心脏，肚脐突出说明伤及脾脏，背部平坦说明伤及肺脏，足底平坦饱满说明伤及肾脏。这五种情况都属于不可治愈的范畴。古人制定这些方剂的用意，都不是为了针对不可治愈的证候而设的。后人不明此理，一概采用攻泻的方法，这是为什么呢？
只有调理脾脏这一种方法，即使五脏出现了看似不治的证候，但通过这种方法仍能治愈的情况还很多。这是第四个原因。
张子和主张运用汗、吐、下三法来劫除百病，后来有人指出张子和的著作并非张子和亲笔所写，而是麻征君文之所作，这确实是知情的言论。（注：此处原文引用争议，意指其法峻烈）。正如常仲明所说，世人认为用补剂治疗疾病理应无效，这是对刘完素、张子和学说的过度迷信，而忽视了元气虚弱的实际情况。所以，凡是使用劫夺攻伐药物的，起初并非不能迅速消退肿胀，但随后再攻伐就无法消退了，之后再攻伐就像面对铁石一样顽固了。不知情的人看到这种情况，才认为是有什么邪气如此强盛；但从明白医理的人看来，不过是因为猛药攻伐，使得自身的元气反过来与身体作对罢了，实在有如驱使良民成为盗贼一样的比喻。所谓“赤子盗兵，弄于潢池”，情况正是这样啊。
明白了这一点，就有培养正气这一种方法，即补益元气；就有招纳阳气这一种方法，即升举阳气；就有解散邪气这一种方法，即开鬼门（发汗）、洁净府（利小便）。这三种方法虽然口中不说“泻”字，但泻实的作用已包含在其中了，其中的奥妙已穷尽无余。
胡卣臣先生说：胀满之病必然要从泻法治，然而善于言说“泻”法的人，在补益之中无非就是泻法。读者必须领会这个意思，才能懂得立论的宗旨。
Since ancient times, edema affecting the whole body and head/face is relatively easy to treat. However, if only the abdomen is swollen, it becomes a difficult condition to treat. There are inherent reasons for this distinction that must not be overlooked.
The various prescriptions handed down through generations mostly employ harsh, toxic, and coercive methods of attack (Gongjie). These methods damage and deplete the Yuan Qi (Primary Vital Energy) and impair the Spleen and Stomach. They are medicines that should be used once but never again. Even if they achieve temporary efficacy, if the swelling recurs, there will be no further effective treatment available. This is the first reason.
Moreover, in cases of generalized edema, each of the Zang and Fu organs presents specific signs; therefore, herbs that drain the Liver, Lung, Bladder, Large Intestine, and Small Intestine can occasionally yield results. In contrast, isolated abdominal swelling indicates that the central pivot of transportation and transformation (Zhongzhou, referring to the Spleen/Stomach region) has been obstructed for a long time. Consequently, clear Yang fails to ascend, and turbid Yin fails to descend, leading to stubborn aggregation that is difficult to break apart. This is essentially caused by the decline of Spleen Qi. How dare one casually administer drugs that drain the Spleen? This is the second reason.
Furthermore, regarding edema that can be treated with draining methods, such approaches are only suitable for robust individuals from the Northwest or laborers in the fields. They are certainly not tolerated by those who consume rich foods, the elderly, the young, or the delicate. If one were to assert that edema represents a condition of great fullness and excess requiring draining, would post-illness edema and postpartum edema also be treated with draining methods? This is the third reason.
Additionally, ancient texts originally recorded five untreatable conditions for edema: black lips indicate injury to the Liver; a flat suprasternal notch (Quepen) indicates injury to the Heart; an everted umbilicus indicates injury to the Spleen; a flat back indicates injury to the Lung; and flat, full soles indicate injury to the Kidney. These five conditions are considered incurable. The intent behind formulating these prescriptions was not to address incurable syndromes. Why do later practitioners, failing to understand this, universally resort to attacking and draining methods?
Only the method of regulating the Spleen remains viable. Even when Zang and Fu organs present seemingly incurable signs, many cases can still be cured through this approach. This is the fourth reason.
Zhang Hezi advocated using the three methods of sweating, vomiting, and purging to eradicate myriad diseases. Later scholars have suggested that Zhang Hezi’s writings may not be his own work but rather authored by Master Ma Zhengjun. This is indeed an insightful observation. As Chang Zhongming stated, people believe that tonifying agents are ineffective for treating disease. This view stems from an excessive faith in the theories of Liu Wansu and Zhang Hezi, while ignoring the frailty of the Yuan Qi. Therefore, whenever coercive and draining drugs are used, although the swelling may subside rapidly at first, subsequent attacks fail to reduce it, and further attacks become as futile as striking iron or stone. Those who do not understand the pathology might attribute this persistence to the strength of pathogenic factors. However, from the perspective of those who comprehend medical principles, it is merely the result of harsh drugs attacking the body, causing the patient's own Yuan Qi to turn against them. It is akin to driving honest citizens to become bandits. As the saying goes, "Infants stealing weapons and playing in the moat," the situation is exactly like this.
Understanding this principle reveals three methods: the method of nurturing, which involves tonifying the Yuan Qi; the method of gathering, which involves raising the Yang Qi; and the method of dispersing, which involves opening the "ghost gates" (sweating pores) and cleansing the "clean mansion" (bladder/diuresis). Although these three methods do not explicitly mention "draining," the effect of draining is contained within them. Their essence is fully exhausted here.
Mr. Hu Youchen stated: "Abdominal distension must be treated with draining." However, those who truly understand "draining" know that within tonification lies the essence of draining. Readers must grasp this meaning to understand the author's intent.