疏凿饮 治水气通身浮肿。烦躁喘渴。小便不利。
泽泻 商陆 赤小豆 羌活 大腹皮(净) 椒目 木通
秦艽 茯苓 槟榔(各七分) 生姜(三片)
水煎。顿服。
禹功散 治阳水便秘脉实。初起元气未伤者。
黑牵牛(头末。四两) 茴香(炒) 木香(各一两)
为散。每服二钱。加生姜自然汁。调如稀饮服。
沉香琥珀丸 治血结小腹青紫筋绊。喘急胀痛。
琥珀(另研。) 杏仁(一作桃仁) 苏木 赤茯苓 泽泻(各五钱) 葶苈(隔纸焙
)郁李仁(去皮。各一两) 沉香(另研。) 陈皮 防己(酒洗。各五钱) 麝香(一钱)
蜜丸绿豆大。每服四五十丸。加至百丸。空心人参汤下。
三白散 治阳水囊肿。二便不通。
白牵牛(头末。二两) 桑白皮(姜汁炒) 白术(生用) 陈皮 木通(各一两)
为散。每服二钱。空心淡姜汤送下。未效。再服。
实脾散 治阴水发肿。宜此先实脾土。
白术(炒焦) 附子(炮) 干姜(炮) 茯苓 木香 木瓜 草果仁
浓朴(姜制) 大腹子(各一两) 甘草(炙。五钱)
为散。每服四钱。加生姜五片。枣一枚。水煎服。 治水以实脾为先务。不但阴水为然。方下
所云。治阴水发肿。宜此先实脾土。俨然阴水当温散。阳水当寒泻之旨横于胸中。夫阴水因肾中真阳
衰微。北方之水不能蛰藏。而泛溢无制。倘肾气不温。则真阳有灭顶之凶矣。实土堤水。宁不为第
二义乎。何方中不用肉桂辛温散结。反用木瓜、浓朴、大腹子耶。即有滞气当散。浓朴尚可暂投。
若大腹子之开泄大便。断乎不可妄用也。
复元丹 治脾肾俱虚。发为水肿。
附子(炮。二两。) 白术(炒焦。) 肉桂 吴茱萸(拣去闭口者。炒) 川椒(炒去
汗) 茴香
木香 浓朴(姜制。各一两) 泽泻(炒) 肉果(煨。各半两) 茯苓(一两五钱)
为末。陈米饮糊丸梧子大。每服五七十丸。紫苏汤或砂仁汤送下。
五皮散(局方) 治湿热积于脾经。面目四肢浮肿。
五加皮 地骨皮 大腹皮 茯苓皮 生姜皮(等分)
为散。每服五钱。水煎热服。 澹寮方。去骨皮、加皮。加桑皮、橘皮。治喘而腹满。
五子五皮汤
五皮散加紫苏子、莱菔子、香附子、车前子、葶苈子。 一方。无香附子。多大腹子。加生姜
煎服。
椒仁丸 治妇人先因经水断绝。后至四肢浮肿。小便不利。血化为水。名曰血分。
椒仁(炒) 甘遂 续随子(去皮。即千金子) 附子(炮) 郁李仁(去皮) 黑牵
牛(头末) 五灵脂(酒研。去砂土)
当归 吴茱萸(拣净。汤泡。炒) 延胡索(各五钱) 芫花(醋炒。二钱) 青(十枚。
去翅足。糯米炒) 胆矾
白砒(各一钱) 石膏(三钱)
为末。曲糊丸。豌豆大。每服一丸。空心橘皮汤下。
葶苈丸 治先因小便不利。后至四肢浮肿。名曰水分。
甜葶苈(隔纸焙) 续随子(去皮。各五钱) 干笋末(一两)
为末。煮红枣肉为丸。梧子大。每服七丸。煎 蓄汤送下。大便利者禁用。
人参丸 治月经不利。血化为水。四肢浮肿。亦曰血分。
人参 当归 大黄(酒蒸) 瞿麦穗 赤芍药 赤茯苓 肉桂(各二两)
苦葶苈(熬。一两)
为末。炼白蜜丸。梧子大。每服十五丸。空腹米饮下。
增损流气饮(痞满门) 葶苈木香散(五苓散下) 胃苓汤(平胃散下) 羌活胜湿汤(湿门
)归脾肠(保元汤下)
金液丹(方祖) 越婢加术汤(麻黄汤下) 芍桂酒汤(桂枝汤下) 桂枝加黄 汤(桂枝汤
下)
桂枝去芍药加麻黄附子细辛汤(桂枝汤下) 枳术汤(方祖) 浚川散(伊芳尹三黄汤下) 神 丸
(十枣汤下)
神芎丸(伊芳尹三黄汤下) 五苓散(方祖) 理苓汤(理中汤下) 六君子汤(四君子汤下)
济生肾气丸(崔氏八味丸下)
真武汤(术附汤下) 小青龙汤(桂枝汤下) 苏子降气汤(七气汤下) 除湿汤(平胃散下)
防己黄 汤(方祖)
越婢汤(麻黄汤下) 防己茯苓汤(防己黄 汤下) 蒲灰散(益气散下) 麻黄附子汤(麻黄
汤下) 杏子汤(麻黄汤下)
疏凿饮:治疗水气病导致全身浮肿。伴有烦躁、气喘、口渴、小便不通畅的症状。
药材组成:泽泻、商陆、赤小豆、羌活、大腹皮(洗净)、椒目、木通、秦艽、茯苓、槟榔(各七分),生姜(三片)。
煎服法:用水煎煮,一次性服用。
禹功散:治疗阳水证且便秘、脉象实有力者。适用于初起阶段元气尚未受损的患者。
药材组成:黑牵牛(取头末,四两)、茴香(炒制)、木香(各一两)。
制作与服用法:研为散剂。每次服用二钱,加入生姜自然汁,调成稀饮状服用。
沉香琥珀丸:治疗血结于小腹,可见青紫色筋脉缠绕,伴有气喘急促、腹部胀痛的症状。
药材组成:琥珀(单独研磨)、杏仁(一说用桃仁)、苏木、赤茯苓、泽泻(各五钱)、葶苈子(隔纸焙干)、郁李仁(去皮,各一两)、沉香(单独研磨)、陈皮、防己(酒洗,各五钱)、麝香(一钱)。
制作与服用法:炼蜜制成如绿豆大小的丸剂。每次服用四五十丸,可逐渐增加至一百丸。空腹时用人参汤送服。
三白散:治疗阳水引起的阴囊及腹部肿胀,大小便不通畅。
药材组成:白牵牛(取头末,二两)、桑白皮(姜汁炒制)、白术(生用)、陈皮、木通(各一两)。
制作与服用法:研为散剂。每次服用二钱,空腹时用淡姜汤送服。若无效,可再次服用。
实脾散:治疗阴水引起的浮肿,应当先用此方来充实脾土。
药材组成:白术(炒焦)、附子(炮制)、干姜(炮制)、茯苓、木香、木瓜、草果仁、浓朴(姜制)、大腹子(各一两)、甘草(炙,五钱)。
制作与服用法:研为散剂。每次服用四钱,加入生姜五片、大枣一枚,用水煎煮服用。
按语:治疗水肿以充实脾土为首要任务,这不仅仅是针对阴水而言。方名下方所说的“治疗阴水发肿,宜先实脾土”,使得人们心中横亘着阴水当用温散法、阳水当用寒泻法的观念。然而,阴水是因为肾中真阳衰微,北方之水不能蛰藏封固,从而泛溢失控。如果肾气不温,真阳就有灭顶之灾的危险。那么,通过实土来堤防水患,难道不是第二义吗?为何方中不用肉桂辛温以散结,反而使用木瓜、浓朴、大腹子呢?即使有滞气需要消散,浓朴尚可暂时投用,但像大腹子这样开泄大便的药物,断然不可妄用。
复元丹:治疗脾肾俱虚,引发水肿。
药材组成:附子(炮制,二两)、白术(炒焦)、肉桂、吴茱萸(拣去闭口者,炒制)、川椒(炒去汗液)、茴香、木香、浓朴(姜制,各一两)、泽泻(炒制)、肉果(煨制,各半两)、茯苓(一两五钱)。
制作与服用法:研为细末,用陈米饮糊制成如梧桐子大小的丸剂。每次服用五七十丸,用紫苏汤或砂仁汤送服。
五皮散(局方):治疗湿热积聚于脾经,导致面目及四肢浮肿。
药材组成:五加皮、地骨皮、大腹皮、茯苓皮、生姜皮(等分)。
制作与服用法:研为散剂。每次服用五钱,用水煎煮后热服。
澹寮方:去掉地骨皮和生姜皮,加上桑白皮和橘皮。用于治疗气喘且腹部胀满的症状。
五子五皮汤:在五皮散的基础上,加入紫苏子、莱菔子、香附子、车前子、葶苈子。
另一版本:不含香附子,多加大腹子,加生姜煎煮服用。
椒仁丸:治疗妇人先因月经断绝,随后出现四肢浮肿、小便不利,血液化为水湿,名为“血分”病。
药材组成:椒仁(炒制)、甘遂、续随子(去皮,即千金子)、附子(炮制)、郁李仁(去皮)、黑牵牛(取头末)、五灵脂(酒研,去除砂土)、当归、吴茱萸(拣净,汤泡,炒制)、延胡索(各五钱)、芫花(醋炒,二钱)、青黛(十枚,去翅足,糯米炒制)、胆矾、白砒(各一钱)、石膏(三钱)。
制作与服用法:研为细末,用曲糊制成如豌豆大小的丸剂。每次服用一丸,空腹时用橘皮汤送服。
葶苈丸:治疗先因小便不利,随后出现四肢浮肿,名为“水分”病。
药材组成:甜葶苈子(隔纸焙干)、续随子(去皮,各五钱)、干笋末(一两)。
制作与服用法:研为细末,煮红枣肉为丸,制成如梧桐子大小的丸剂。每次服用七丸,煎蓄汤送服。大便通畅者禁用。
人参丸:治疗月经不畅,血液化为水湿,四肢浮肿,也称为“血分”病。
药材组成:人参、当归、大黄(酒蒸)、瞿麦穗、赤芍药、赤茯苓、肉桂(各二两)、苦葶苈(熬制,一两)。
制作与服用法:研为细末,炼白蜜为丸,制成如梧桐子大小的丸剂。每次服用十五丸,空腹时以米饮送服。
增损流气饮(见痞满门)、葶苈木香散(见五苓散下)、胃苓汤(见平胃散下)、羌活胜湿汤(见湿门)、归脾肠(见保元汤下)、金液丹(见方祖)、越婢加术汤(见麻黄汤下)、芍桂酒汤(见桂枝汤下)、桂枝加黄芪汤(见桂枝汤下)、桂枝去芍药加麻黄附子细辛汤(见桂枝汤下)、枳术汤(见方祖)、浚川散(见伊芳尹三黄汤下)、神丸(见十枣汤下)、神芎丸(见伊芳尹三黄汤下)、五苓散(见方祖)、理苓汤(见理中汤下)、六君子汤(见四君子汤下)、济生肾气丸(见崔氏八味丸下)、真武汤(见术附汤下)、小青龙汤(见桂枝汤下)、苏子降气汤(见七气汤下)、除湿汤(见平胃散下)、防己黄芪汤(见方祖)、越婢汤(见麻黄汤下)、防己茯苓汤(见防己黄芪汤下)、蒲灰散(见益气散下)、麻黄附子汤(见麻黄汤下)、杏子汤(见麻黄汤下)。
Shuozao Yin (Drain and Scour Decoction): Treats edema caused by water qi, characterized by generalized swelling of the body. Accompanied by irritability, panting, thirst, and difficulty in urination.
Ingredients: Ze Xie (Alisma Rhizome), Shang Lu (Phytolaccae Radix), Chi Xiao Dou (Adzuki Bean), Qiang Huo (Notopterygii Rhizoma et Radix), Da Fu Pi (Arecae Pericarpium, cleaned), Jiao Mu (Zanthoxyli Semen), Mu Tong (Akebiae Caulis), Qin Jiao (Gentianae Macrophyllae Radix), Fu Ling (Poria), Bing Lang (Areca Seed) (each 0.23g), Sheng Jiang (Fresh Ginger, 3 slices).
Preparation and Administration: Decoct in water and take in one dose.
Yugong San (Efficacy Work Powder): Treats Yang Edema accompanied by constipation and a full pulse. Suitable for early stages where primordial Qi has not yet been damaged.
Ingredients: Hei Qian Niu (Pharbitidis Semen, head powder, 120g), Hui Xiang (Foeniculi Fructus, stir-fried), Mu Xiang (Aucklandiae Radix) (each 30g).
Preparation and Administration: Grind into powder. Take 6g per dose, mixed with fresh ginger juice to form a thin liquid for consumption.
Chenxiang Hupo Wan (Agarwood and Amber Pill): Treats blood stasis accumulating in the lower abdomen, presenting with cyanotic purple veins, urgent panting, and abdominal distension and pain.
Ingredients: Hu Po (Amber, separately ground), Xing Ren (Armeniacae Semen Amarum, alternatively Tao Ren), Su Mu (Sappan Lignum), Chi Fu Ling (Red Poria), Ze Xie (Alisma Rhizome) (each 15g), Ting Li Zi (Lepidii Semen, baked between paper), Yu Li Ren (Prunus Semen, peeled) (each 30g), Chen Xiang (Aquilariae Lignum Resinatum, separately ground), Chen Pi (Citri Reticulatae Pericarpium), Fang Ji (Stephaniae Tetrandrae Radix, wine-washed) (each 15g), She Xiang (Moschus, 3g).
Preparation and Administration: Honey-pelletized to the size of mung beans. Take 40-50 pills per dose, gradually increasing to 100 pills. Take on an empty stomach with Ginseng decoction.
San Bai San (Three Whites Powder): Treats Yang Edema causing scrotal and abdominal swelling, with obstruction of both urine and stool.
Ingredients: Bai Qian Niu (Pharbitidis Semen, head powder, 60g), Sang Bai Pi (Mori Cortex, stir-fried with ginger juice), Bai Zhu (Atractylodis Macrocephalae Rhizoma, raw), Chen Pi (Citri Reticulatae Pericarpium), Mu Tong (Akebiae Caulis) (each 30g).
Preparation and Administration: Grind into powder. Take 6g per dose on an empty stomach, delivered with light ginger soup. If ineffective, administer again.
Shipi San (Solidify Spleen Powder): Treats Yin Edema causing swelling; this formula should be used first to strengthen the Spleen Earth.
Ingredients: Bai Zhu (Atractylodis Macrocephalae Rhizoma, charred), Fu Zi (Aconiti Lateralis Radix Praeparata, processed), Gan Jiang (Zingiberis Rhizoma, processed), Fu Ling (Poria), Mu Xiang (Aucklandiae Radix), Mu Gua (Chaenomelis Fructus), Cao Guo Ren (Tsaoko Fructus), Hou Po (Magnoliae Officinalis Cortex, ginger-processed), Da Fu Zi (Arecae Semen, each 30g), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 15g).
Preparation and Administration: Grind into powder. Take 12g per dose, with 5 slices of fresh ginger and one jujube, decocted in water.
Commentary: In treating edema, strengthening the Spleen is the primary task, not only for Yin Edema. The note below the formula stating "for Yin Edema swelling, first solidify Spleen Earth" creates a preconceived notion that Yin Edema requires warming and dispersing, while Yang Edema requires cold purging. However, Yin Edema arises from the decline of True Yang in the Kidney, causing the Water of the North to fail in its storing function and overflow uncontrollably. If Kidney Qi is not warmed, there is a risk of extinguishing True Yang. Thus, using Earth to dam Water is arguably secondary. Why does this formula not use Rou Gui (Cinnamon Bark) for its acrid warmth to dissipate nodules, but instead uses Mu Gua (Chaenomelis Fructus), Hou Po (Magnoliae Officinalis Cortex), and Da Fu Zi (Arecae Semen)? Even if stagnation needs dispersing, Hou Po may be temporarily used, but Da Fu Zi, which opens and drains the bowels, must absolutely not be used recklessly.
Fuyuan Dan (Restoring Primordial Elixir): Treats edema caused by deficiency of both Spleen and Kidney.
Ingredients: Fu Zi (Aconiti Lateralis Radix Praeparata, processed, 60g), Bai Zhu (Atractylodis Macrocephalae Rhizoma, charred), Rou Gui (Cinnamomi Cortex), Wu Zhu Yu (Evodiae Fructus, select those without closed mouths, stir-fried), Chuan Jiao (Zanthoxyli Pericarpium, stir-fried until oil appears), Hui Xiang (Foeniculi Fructus), Mu Xiang (Aucklandiae Radix), Hou Po (Magnoliae Officinalis Cortex, ginger-processed) (each 30g), Ze Xie (Alisma Rhizome, stir-fried), Rou Dou Kou (Myristicae Semen, baked) (each 15g), Fu Ling (Poria, 45g).
Preparation and Administration: Grind into fine powder, mix with old rice water paste to make pills the size of wutong seeds. Take 50-70 pills per dose, delivered with Perilla decoction or Amomum decoction.
Wu Pi San (Five Barks Powder, Bureau Formula): Treats damp-heat accumulating in the Spleen meridian, causing swelling of the face, eyes, and limbs.
Ingredients: Wu Jia Pi (Acanthopanacis Cortex), Di Gu Pi (Lycii Cortex), Da Fu Pi (Arecae Pericarpium), Fu Ling Pi (Poria with Red Host), Sheng Jiang Pi (Zingiberis Rhizoma Recens Cortex) (equal parts).
Preparation and Administration: Grind into powder. Take 15g per dose, decocted in water and taken hot.
Danliao Fang: Removes Di Gu Pi and Sheng Jiang Pi, adds Sang Bai Pi (Mori Cortex) and Ju Pi (Citri Reticulatae Pericarpium). Treats panting with abdominal fullness.
Wu Zi Wu Pi Tang (Five Seeds and Five Barks Decoction): Wu Pi San plus Zi Su Zi (Perillae Fructus), Lai Fu Zi (Raphani Semen), Xiang Fu (Cyperi Rhizoma), Che Qian Zi (Plantaginis Semen), Ting Li Zi (Lepidii Semen).
Alternative version: Without Xiang Fu, adds more Da Fu Zi (Arecae Semen), decocted with fresh ginger.
Jiao Ren Wan (Pepper Kernel Pill): Treats women who first experience cessation of menstruation, followed by swelling of the four limbs and difficulty in urination. Blood transforms into water, named "Blood Partition" disease.
Ingredients: Jiao Ren (Zanthoxyli Semen, stir-fried), Gan Sui (Kansui Radix), Xu Sui Zi (Euphorbiae Lathyris Semen, peeled, i.e., Qian Jin Zi), Fu Zi (Aconiti Lateralis Radix Praeparata, processed), Yu Li Ren (Prunus Semen, peeled), Hei Qian Niu (Pharbitidis Semen, head powder), Wu Ling Zhi (Trogopterori Faeces, ground in wine, remove sand/soil), Dang Gui (Angelicae Sinensis Radix), Wu Zhu Yu (Evodiae Fructus, clean, soak in water, stir-fry), Yan Hu Suo (Corydalis Rhizoma) (each 15g), Yuan Hua (Genkwa Flos, vinegar-fried, 6g), Qing Dai (Indigo Naturalis, 10 pieces, remove wings/feet, stir-fry with glutinous rice), Dan Fan (Alumen), Bai Pi (Realgar, each 3g), Shi Gao (Gypsum Fibrosum, 9g).
Preparation and Administration: Grind into fine powder, use malt paste to make pills the size of pea seeds. Take one pill per dose on an empty stomach, delivered with Tangerine Peel decoction.
Ting Li Wan (Lepidium Pill): Treats patients who first have difficulty urinating, followed by swelling of the four limbs. Named "Water Partition" disease.
Ingredients: Tian Ting Li Zi (Lepidii Semen, baked between paper), Xu Sui Zi (Euphorbiae Lathyris Semen, peeled) (each 15g), Gan Sun Mo (Dried Bamboo Shoot Powder, 30g).
Preparation and Administration: Grind into fine powder, cook red dates flesh to make pills the size of wutong seeds. Take seven pills per dose, delivered with Plantago seed decoction. Contraindicated for those with loose stools.
Ren Shen Wan (Ginseng Pill): Treats irregular menstruation where blood transforms into water, causing swelling of the four limbs, also called "Blood Partition."
Ingredients: Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Da Huang (Rhei Radix et Rhizoma, steamed in wine), Qu Mai (Dianthi Herba), Chi Shao Yao (Paeoniae Radix Rubra), Chi Fu Ling (Red Poria), Rou Gui (Cinnamomi Cortex) (each 60g), Ku Ting Li Zi (Lepidii Semen, roasted, 30g).
Preparation and Administration: Grind into fine powder, refine white honey to make pills the size of wutong seeds. Take fifteen pills per dose on an empty stomach with rice drink.
Zengsun Liuqi Yin (Modified Flowing Qi Decoction) [See Pi Man Section], Tingli Muxiang San (Tingli and Aucklandia Powder) [See under Wuling San], Weiling Tang (Stomach and Five苓 Decoction) [See under Pingwei San], Qianghuo Shengshi Tang (Notopterygium Overcoming Dampness Decoction) [See under Shi Men], Guipi Chang [See under Baoyuan Tang], Jinye Dan (Golden Liquid Elixir) [See under Fangzu], Yebijia Zhush Tang (Yibo Plus Atractylodes Decoction) [See under Mahuang Tang], Shaoguijiu Tang (Peony and Cinnamon Wine Decoction) [See under Guizhi Tang], Guizhijia Huangqi Tang (Guizhi Plus Astragalus Decoction) [See under Guizhi Tang], Guizhi qu Shaoyao jia Mahuang Fuzi Xixin Tang (Guizhi Remove Peony Add Ephedra, Aconite, and Asarum Decoction) [See under Guizhi Tang], Zhizhu Tang (Immature Bitter Orange and Atractylodes Decoction) [See under Fangzu], Junchuan San (Deep River Powder) [See under Yi Fangyin Sanhuang Tang], Shen Wan (Divine Pill) [See under Shizao Tang], Shenxiong Wan (Divine Xiong Pill) [See under Yi Fangyin Sanhuang Tang], Wuling San (Five-Ling Powder) [See under Fangzu], Liling Tang (Li and Five-Ling Decoction) [See under Lizhong Tang], Liu Junzi Tang (Six Gentlemen Decoction) [See under Sijunzi Tang], Jisheng Shenqi Wan (Jisheng Kidney-Qi Pill) [See under Cuishi Bawei Wan], Zhenwu Tang (True Warrior Decoction) [See under Zhufu Tang], Xiao Qinglong Tang (Minor Blue Dragon Decoction) [See under Guizhi Tang], Suzi Jiangqi Tang (Perilla Descending Qi Decoction) [See under Qi Qi Tang], Chushi Tang (Remove Dampness Decoction) [See under Pingwei San], Fangji Huangqi Tang (Stephania and Astragalus Decoction) [See under Fangzu], YebiTang (Yibo Decoction) [See under Mahuang Tang], Fangji Fuling Tang (Stephania and Poria Decoction) [See under Fangji Huangqi Tang], Puhui San (Reed Catkin Powder) [See under Yiqi San], Mahuang Fuzi Tang (Ephedra and Aconite Decoction) [See under Mahuang Tang], Xingzi Tang (Apricot Seed Decoction) [See under Mahuang Tang].