丹溪云水之为病不一贾洛阳以病肿不治必为痼疾虽有扁鹊亦莫能为则知肿之危恶非他病比也
治水大法宜补中行湿利小便凡有热者水气在表可汗身无热者水气在里宜上腰以下肿宜利小便
腰以上肿宜发汗此仲景之要法也若遍身肿烦渴小便赤涩大便闭结此属阳水先五皮散次四磨饮
加生枳壳重则疏凿饮若遍身肿不烦渴大便溏小便少不涩赤此属阴水宜实脾饮或木香流气饮主
之阳水病兼阳证者脉必沉数阴水病兼阴证者脉必沉迟气若陷下用二陈加升提之药能使大便润
而
小便长如腹胀少加浓朴佐之气不运加木香木通以调之又有小儿国中便觉痰嗽喘急正属脾胃所
主宜先解表散次投商陆丸内经曰开鬼门洁净府正此谓也
凡水肿先起于四肢而后归于腹者不治大便滑泄与夫唇黑缺盆平脐突足平背平或肉硬或手
掌平或男从脚下肿而上女从身上肿而下并皆不治
加味五皮饮 治小儿四肢肿满阳水阴水皆可服之
五加皮 地骨皮 生姜皮 大腹皮 茯苓皮（各一钱内加姜黄一钱木瓜）
上作一服水煎服一方去五加皮用陈皮桑皮
疏凿饮子 治水气通身浮肿喘呼气急烦渴大小便不利服热药不得者
泽泻 赤小豆（炒） 商陆 羌活 大腹皮 椒目 木通 秦艽 槟榔 茯苓皮（各等分）
上 咀水煎姜五片
葶苈散 治小儿水气肿满
甜葶苈（隔纸炒） 黑牵牛 槟榔 大黄（各等分煨）
大橘皮汤 治湿热内攻腹胀水肿小便不利大便滑泄
陈皮（一两半） 木香（二钱半） 滑石（六两） 槟榔（二钱） 茯苓（一两） 猪苓 白术
泽泻 肉桂（各半两） 甘草（一钱）
上锉散每服三钱水一盏煎服
十枣丸 治水气四肢浮肿上气喘急大小便不利
甘遂 大戟 芫花（各等分）
上为末煮枣肉为丸桐子大清晨热汤下三十丸以利为度次早再服虚人不可多服
甘草麻黄汤 治水肿从腰以上俱肿宜此汗之
甘草（半两） 麻黄（一两）
上 咀水煎作一服
实脾散 治小儿阴水发肿用此先实脾土
浓朴（姜制） 白术 木瓜 木香 干姜（炮各一两） 草果仁 大腹子 附子 白茯苓
甘草（炙各半两）
上 咀每服三钱入姜枣水煎服
消肿丸 治小儿水肿喘满小便不利
滑石 木通 白术 黑牵牛（炒） 通脱木 茯苓 茯神 半夏 陈皮（各一钱） 木香
瞿麦穗 丁香（各半两）
上为末酒糊丸梧桐子大每二十丸灯心麦门冬汤下
丹溪说：水病（水肿）的病因并不单一。贾洛阳认为，如果患有肿胀病却得不到治疗，必然会成为顽固难愈的疾病，即使有扁鹊那样的神医也无可奈何。由此可知，水肿的危险和凶险程度，不同于其他疾病。
治疗水病的总原则是：宜补益中气、祛除湿邪、通利小便。凡是伴有发热症状的，说明水气停留在体表，可以采用发汗法；身体没有发热的，说明水气在体内。腰部以下出现浮肿的，宜采用通利小便的方法；腰部以上出现浮肿的，宜采用发汗的方法。这是张仲景的重要治法。
如果全身浮肿，伴有烦躁口渴、小便短赤涩痛、大便闭结不通，这属于阳水证。应先服用五皮散，再服用四磨饮。病情严重的，服用疏凿饮。如果全身浮肿，但不烦躁口渴，大便溏薄，小便量少且不涩不红，这属于阴水证。适宜服用实脾饮或木香流气饮来主治。
阳水病兼见阳证者，脉象必定沉数；阴水病兼见阴证者，脉象必定沉迟。若气机下陷，可用二陈汤加入升提的药物，能使大便滋润而小便通畅。如果腹部胀满，可稍加浓朴辅助；若气机运行不畅，可加木香、木通以调理。又有小儿突然感到痰嗽、气喘急促，这正属于脾胃所主的问题，宜先解表散邪，然后投予商陆丸。《内经》说：“开鬼门（发汗），洁净府（利小便）”，正是这个意思。
凡水肿先从四肢开始，随后波及腹部的，属于不治之症。大便滑泄不禁，以及嘴唇发黑、缺盆穴处平满无凹陷、肚脐突出、足背平满无凹陷、肌肉坚硬、手掌平满无凹陷，或者男子从脚部向上肿，女子从身体向下肿，这些情况都属于不治之症。
小儿水气肿且腹部胀大，可灸分水穴一穴，每穴三壮。取穴方法是在脐上一寸处。
加味五皮饮：治疗小儿四肢肿满，阳水和阴水皆可服用。
药材：五加皮、地骨皮、生姜皮、大腹皮、茯苓皮（各一钱，内加姜黄一钱、木瓜）。
用法：以上作一服，用水煎服。另一方去掉五加皮，改用陈皮、桑白皮。
疏凿饮子：治疗水气导致全身浮肿，喘促气急，烦躁口渴，大小便不利，服用热药无效者。
药材：泽泻、赤小豆（炒）、商陆、羌活、大腹皮、椒目、木通、秦艽、槟榔、茯苓皮（各等分）。
用法：以上切碎，用水煎煮，加生姜五片。
葶苈散：治疗小儿水气肿满。
药材：甜葶苈（隔纸炒）、黑牵牛、槟榔、大黄（各等分，煨制）。
大橘皮汤：治疗湿热内攻导致的腹胀水肿，小便不利，大便滑泄。
药材：陈皮（一两半）、木香（二钱半）、滑石（六两）、槟榔（二钱）、茯苓（一两）、猪苓、白术、泽泻、肉桂（各半两）、甘草（一钱）。
用法：以上锉碎成散剂，每次服用三钱，用水一盏煎服。
十枣丸：治疗水气导致四肢浮肿，上气喘急，大小便不利。
药材：甘遂、大戟、芫花（各等分）。
用法：以上研为细末，用煮枣肉制成梧桐子大小的丸剂。清晨用热汤送下三十丸，以腹泻为度。次日早晨再服。体虚之人不可多服。
甘草麻黄汤：治疗水肿从腰部以上全部浮肿，宜用此方发汗。
药材：甘草（半两）、麻黄（一两）。
用法：以上切碎，用水煎煮，作一服服用。
实脾散：治疗小儿阴水发作导致浮肿，用此方先实脾土。
药材：浓朴（姜制）、白术、木瓜、木香、干姜（炮制，各一两）、草果仁、大腹子、附子、白茯苓、甘草（炙制，各半两）。
用法：以上切碎，每次服用三钱，加入生姜、大枣，用水煎服。
消肿丸：治疗小儿水肿，喘满，小便不利。
药材：滑石、木通、白术、黑牵牛（炒）、通脱木、茯苓、茯神、半夏、陈皮（各一钱）、木香、瞿麦穗、丁香（各半两）。
用法：以上研为细末，用酒糊制成梧桐子大小的丸剂。每次二十丸，用灯心草、麦门冬汤送下。
Danxi stated: The etiology of Shui Bing (Water Disease, i.e., edema) is not uniform. Jia Luoyang believed that if swelling disease is left untreated, it will inevitably become a stubborn and incurable ailment; even with the medical skills of Bian Que, it would be impossible to cure. Thus, we know that the danger and severity of edema are incomparable to other diseases.
The general principle for treating water disease is to tonify the Middle Jiao (Middle Burner/Spleen-Stomach), expel dampness, and promote urination. For cases accompanied by fever, where water qi resides in the exterior, sweating method should be used. For cases without fever, where water qi resides in the interior, treatment depends on location: for swelling below the waist, promoting urination is appropriate; for swelling above the waist, inducing sweating is appropriate. This is a key method of Zhang Zhongjing.
If there is generalized edema accompanied by irritability, thirst, dark and scanty urine, and constipation, this belongs to Yang Water (Yang-type Edema). One should first administer Wupi San (Five-Bark Powder), followed Simo Yin (Four-Mortar Drink). In severe cases, Shuzao Yin (Draining-Scouring Decoction) should be used. If there is generalized edema without irritability or thirst, with loose stools and scanty, non-acrid, non-red urine, this belongs to Yin Water (Yin-type Edema). It is suitable to treat with Shipi Yin (Spleen-Solidifying Drink) or Muxiang Liqi Yin (Aucklandia Qi-Regulating Drink).
For Yang Water accompanied by Yang syndromes, the pulse must be deep and rapid. For Yin Water accompanied by Yin syndromes, the pulse must be deep and slow. If Qi sinks, Erchen Tang (Two-Aged Decoction) with Qi-lifting herbs can be used to moisten the bowels and lengthen urination. If abdominal distension occurs, add Houpo (Magnolia Bark); if Qi movement is stagnant, add Muxiang (Aucklandia Root) and Mutong (Akebia Stem) to regulate. Additionally, if infants suddenly experience phlegm-cough and asthma, this pertains to the Spleen and Stomach. One should first release the exterior and scatter pathogens, then administer Shanglu Wan (Phytolacca Pill). As stated in the *Neijing* (Inner Canon): "Open the ghost gate (induce sweating), cleanse the clean mansion (promote urination)," which refers to this principle.
Edema that begins in the four limbs and subsequently involves the abdomen is considered incurable. Cases with loose stool incontinence, black lips, flat clavicular fossae, protruding umbilicus, flat dorsum pedis, hard flesh, flat palms, male edema rising from the feet upward, or female edema descending from the body downward are all considered incurable.
For infantile water qi edema with abdominal distension, moxa acupuncture at Fenshui (CV8) is indicated, three moxa cones per point. The location is one cun above the umbilicus.
Jiawei Wupi Yin (Modified Five-Bark Decoction): Treats infantile edema and fullness of the four limbs; applicable to both Yang and Yin Water.
Ingredients: Wujiapi (Acanthopanacis Cortex), Digupi (Lycii Cortex), Shengjiangpi (Zingiberis Rhizoma Recens Pericarpium), Dafupi (Arecae Pericarpium), Fulingpi (Poria Cocos Pericarpium) (each 1 qian, plus Jianghuang [Curcumae Radix] 1 qian and Mugua [Chaenomelis Fructus]).
Usage: Combine as one dose, decoct in water and take orally. Another prescription removes Wujiapi and uses Chenpi (Citri Reticulatae Pericarpium) and Sangbai pi (Mori Cortex).
Shuzao Yinzi (Draining-Scouring Decoction): Treats water qi causing generalized edema, panting and急促 breathing, irritability and thirst, difficulty in urination and defecation, when hot medicines are ineffective.
Ingredients: Zexie (Alismatis Rhizoma), Chixiaodou (Phaseoli Semen Rubrum, stir-fried), Shanglu (Phytolaccae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Dafupi (Arecae Pericarpium), Jiaomu (Zanthoxyli Semen), Mutong (Akebiae Caulis), Qinjiao (Gentianae Macrophyllae Radix), Binglang (Arecae Semen), Fulingpi (Poria Cocos Pericarpium) (equal parts).
Usage: Coarsely powder, decoct in water with five slices of fresh ginger.
Tingli San (Descurainiae Seed Powder): Treats infantile water qi edema and fullness.
Ingredients: Tian Tingli (Descurainiae Semen seu Lepidii Semen, stir-fried between papers), Hei Qianniu ( Pharbitidis Semen), Binglang (Arecae Semen), Dahuang (Rhei Radix et Rhizoma, baked) (equal parts).
Daju Pi Tang (Great Tangerine Peel Decoction): Treats internal attack of damp-heat causing abdominal distension and edema, difficulty in urination, and loose stools.
Ingredients: Chenpi (Citri Reticulatae Pericarpium, 1.5 liang), Muxiang (Aucklandiae Radix, 2.5 qian), Huashi (Talcum, 6 liang), Binglang (Arecae Semen, 2 qian), Fuling (Poria Cocos, 1 liang), Zhuling (Polyporus Umbellatus, half liang), Baizhu (Atractylodis Macrocephalae Rhizoma, half liang), Zexie (Alismatis Rhizoma, half liang), Rougui (Cinnamomi Cortex, half liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian).
Usage: Coarsely powder. Take 3 qian per dose, decoct in one cup of water.
Shizao Wan (Ten-Jujube Pills): Treats water qi causing edema of the four limbs, upper body panting and急促 breathing, and difficulty in urination and defecation.
Ingredients: Gansui (Kansui Radix), Daji (Euphorbiae Pekinensis Radix), Yuanhua (Genkwa Flos) (equal parts).
Usage: Grind into fine powder, bind with paste from boiled jujube meat to make pills the size of paulownia seeds. Take 30 pills early in the morning with hot water, until diarrhea occurs. Repeat the next morning. Do not use large doses for deficient patients.
Gancao Mahuang Tang (Licorice and Ephedra Decoction): Treats edema involving the entire area above the waist; induce sweating with this formula.
Ingredients: Gancao (Glycyrrhizae Radix et Rhizoma, half liang), Mahuang (Ephedrae Herba, 1 liang).
Usage: Coarsely powder, decoct in water as one dose.
Shipi San (Spleen-Solidifying Powder): Treats infantile Yin Water causing edema; use this to first solidify the Spleen Earth.
Ingredients: Houpo (Magnoliae Officinalis Cortex, ginger-processed), Baizhu (Atractylodis Macrocephalae Rhizoma), Mugua (Chaenomelis Fructus), Muxiang (Aucklandiae Radix), Ganjiang (Zingiberis Rhizoma, processed, each 1 liang), Caoguoren (Tsaoko Fructus Cardamomi), Dafuzi (Arecae Semen), Fuzi (Aconiti Lateralis Radix Praeparata), Fuling (Poria Cocos), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted, each half liang).
Usage: Coarsely powder. Take 3 qian per dose, decoct with fresh ginger and jujubes in water.
Xiaozhong Wan (Reducing-Edema Pills): Treats infantile edema, panting and fullness, and difficulty in urination.
Ingredients: Huashi (Talcum), Mutong (Akebiae Caulis), Baizhu (Atractylodis Macrocephalae Rhizoma), Hei Qianniu (Pharbitidis Semen, stir-fried), Tongtuomu (Pteridis Massae), Fuling (Poria Cocos), Fushen (Poria Cocos with Hostwood), Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 1 qian), Muxiang (Aucklandiae Radix), Qumai Sui (Dianthi Herba), Dingxiang (Caryophylli Flos) (each half liang).
Usage: Grind into fine powder, bind with wine paste to make pills the size of paulownia seeds. Take 20 pills per dose, washed down with Dengxincao (Junci Medulla) and Maidong (Ophiopogonis Radix) decoction.