上肿多风宜乎汗，下肿多湿利水泉，汗宜越婢加苍术，利用贴脐琥珀丹，外散内利
疏凿饮，喘不得卧苏葶先，阳水热浚湿神 ，阴水实脾肾气丸。
【注】从上肿者，多外感风邪，故宜乎汗。从下肿者，多内生湿邪，故宜乎利水。外散
风水，宜用越婢汤加苍术，即麻黄、石膏、甘草、苍术也。内利水湿，宜用贴脐等法。一
以巴豆去油四钱，水银粉二钱，硫黄一钱，研匀成饼。先用新绵一片布脐上，内饼，外用
帛缚，时许自然泻下恶水。待下三五次，去药以粥补往。日久形羸，隔一日取一次，一
饼可救三五人。一以鲜赤商陆根，杵烂贴脐上，以帛缚定，水自小便出。一以田螺四个，
大蒜五个，车前子末三钱，研成饼，贴脐中，以帕缚之，少时尿利即愈。或内服沉香琥珀
丸，即苦葶苈子、真郁李仁、防己、沉香、陈皮、琥珀、杏仁、苏子、赤茯苓、泽泻、麝
香也。若通身肿，则当外散内利，宜用疏凿饮子两解之。若水盛上攻，喘急不得卧，则
当先用苏子葶苈丸以定喘，即此二味，等分为末，枣肉丸。阳水属热实者，热盛宜用大
圣浚川散；湿盛宜用舟车神 丸以下之。二方在《医宗必读》。阴水属寒虚者，脾虚不食
便软，宜用实脾饮；肾虚胫足冷硬，宜用肾气丸。
疏凿饮子 茯苓导水汤
水肿两解疏凿饮，和剂茯苓导水汤，疏凿椒目赤小豆；槟榔商陆木通羌，秦艽大腹
苓皮泽，茯苓导水泽苓桑，木香木瓜砂陈术，苏叶大腹麦槟榔。
【注】水肿，外散内利两解，峻者疏凿饮，即椒目、赤小豆、槟榔、商陆、木通、羌活。
秦艽、大腹皮、茯苓皮、泽泻也。外散内利两解和者，茯苓导水汤，即泽泻、茯苓、桑
皮、木香、木瓜、砂仁、陈皮、白术、苏叶、大腹皮、麦冬、槟榔也。
实脾饮
里实自然寻浚 ，里虚实脾四君香，木瓜附子大腹子，浓朴草果炒干姜，投诸温补
俱无验，欲诸攻下又难当，须行九补一攻法，缓求淡食命多昌。
【注】里实二便涩者，宜用浚川散、神 丸。里虚二便通者，宜用实脾饮，即人参、白
术、茯苓、炙草、木香、木瓜、川附子、大腹子、浓朴、草果、炒干姜也。肿胀之病属
虚寒者，自宜投诸温补之药，而用之俱无效验者，虚中必有实邪也。欲投诸攻下之药，而
又难堪，然不攻之终无法也，须行九补一攻之法。是用补养之药九日，俟其有可攻之机，
而一日用泻下之药攻之。然攻药亦须初起少少与之，不胜病、渐加之，必审其药与元气
相当，逐邪而不伤正，始为法也。其后或补七日、攻一日，补五日、攻一日，补三日、攻
一日，缓缓求之，以愈为度。若能戒盐酱，淡食百日，多有生者。
上肢肿胀多因风邪所致，适宜采用发汗法治疗；下肢肿胀多因湿邪所致，适宜采用利水法治疗。发汗宜用越婢加苍术汤（即麻黄、石膏、甘草、苍术），利水可利用贴脐疗法如琥珀丹。若需外散风水、内利水湿，宜用疏凿饮子；若出现气喘不能平卧，宜先用苏子葶苈丸。阳水属热实证者，热盛宜用大圣浚川散，湿盛宜用舟车丸以攻下；阴水属寒虚证者，脾虚宜用实脾饮，肾虚宜用肾气丸。
【注】从上半身开始肿胀的，多由外感风邪引起，故适宜发汗。从下半身开始肿胀的，多由内生湿邪引起，故适宜利水。外散风水，宜用越婢汤加苍术，即麻黄、石膏、甘草、苍术。内利水湿，宜用贴脐等方法。一种方法是用巴豆去油四钱，水银粉二钱，硫黄一钱，研匀制成饼状。先用新棉一片敷在肚脐上，放上药饼，外用布带缚紧，约一时辰后自然泻出恶水。待泻下三至五次后，去掉药物，用粥食补养脾胃。若日久身体虚弱，可隔一日取一次，一个药饼可供三至五人使用。另一种方法是用鲜赤商陆根，捣烂贴于脐上，用布带缚紧，水液自然从小便排出。还有一种方法是用田螺四个，大蒜五个，车前子末三钱，研成饼状，贴于脐中，用帕子缚紧，片刻后小便通利即可痊愈。或者内服沉香琥珀丸，即苦葶苈子、真郁李仁、防己、沉香、陈皮、琥珀、杏仁、苏子、赤茯苓、泽泻、麝香。若全身肿胀，则应当外散内利，宜用疏凿饮子两解之。若水气上攻，喘急不能平卧，则应当先用苏子葶苈丸以定喘，即这两味药等分为末，枣肉为丸。阳水属热实证者，热盛宜用大圣浚川散；湿盛宜用舟车丸以下之。这两个方剂记载在《医宗必读》中。阴水属寒虚证者，脾虚不食、大便溏软，宜用实脾饮；肾虚、小腿足部冷硬，宜用肾气丸。
疏凿饮子与茯苓导水汤：
水肿两解用疏凿饮，和剂茯苓导水汤。疏凿饮含椒目、赤小豆、槟榔、商陆、木通、羌活、秦艽、大腹皮、茯苓皮、泽泻。茯苓导水汤含泽泻、茯苓、桑白皮、木香、木瓜、砂仁、陈皮、白术、苏叶、大腹皮、麦冬、槟榔。
【注】水肿，外散内利两解，峻猛者用疏凿饮，即椒目、赤小豆、槟榔、商陆、木通、羌活、秦艽、大腹皮、茯苓皮、泽泻。外散内利两解平和者用茯苓导水汤，即泽泻、茯苓、桑白皮、木香、木瓜、砂仁、陈皮、白术、苏叶、大腹皮、麦冬、槟榔。
实脾饮：
里实自然寻浚川，里虚实脾用四君香（木香）。木瓜、附子、大腹子，浓朴、草果、炒干姜。投诸温补俱无验，欲诸攻下又难当，须行九补一攻法，缓求淡食命多昌。
【注】里实且二便涩滞者，宜用浚川散、舟车丸。里虚且二便通畅者，宜用实脾饮，即人参、白术、茯苓、炙甘草、木香、木瓜、川附子、大腹子、浓朴、草果、炒干姜。肿胀之病属虚寒者，自宜投用温补之药，而用之均无效验者，说明虚中必有实邪。欲投用攻下之药，而又难以承受，然而不攻终究无法治愈，必须实行九补一攻之法。即用补养之药九日，等待其有可攻之机，然后一日用泻下之药攻之。然而攻下药也须初起时少量给予，不胜病者逐渐增加剂量，必须审慎使药力与元气相当，逐邪而不伤正气，这才是正确的方法。其后或补七日攻一日，补五日攻一日，补三日攻一日，缓缓求治，以痊愈为度。若能戒除盐酱，清淡饮食百日，多有存活者。
[Methods for Treating Edema]
Swelling in the upper body is mostly due to Wind pathogen and is suitable for diaphoresis (sweating method); swelling in the lower body is mostly due to Dampness pathogen and is suitable for promoting urination. For diaphoresis, Yuebi Jia Cangzhu Decoction (Yuebi Decoction plus Atractylodis Rhizoma) should be used; for promoting urination, Hupo Dan (Amber Pill) applied to the umbilicus can be utilized. If external dispersal of Wind-Dampness and internal draining of Water-Dampness are needed simultaneously, Shuozao Yinzi (Shuozao Decoction) may be chosen; if symptoms include asthma and inability to lie flat, Suzi Tingli Wan (Perilla Seed and Lepidium Seed Pill) should be used first. For Yang Edema belonging to Heat-Excess syndrome, if Heat is prevalent, Dasheng Xunchuan San (Dasheng Xunchuan Powder) should be used; if Dampness is prevalent, Zhouche Shenyou Wan (Zhouche Shenyou Pill) should be used to purge downward. For Yin Edema belonging to Cold-Deficiency syndrome, if Spleen Deficiency is present, Shipin Yin (Shipin Decoction) should be used; if Kidney Deficiency is present, Shenqi Wan (Kidney Qi Pill) should be used.
[Note] Swelling starting from the upper body is mostly caused by exogenous Wind pathogen, thus diaphoresis is suitable. Swelling starting from the lower body is mostly caused by endogenous Dampness pathogen, thus promoting urination is suitable. To externally disperse Wind-Water, Yuebi Tang (Cinnamon Twig Decoction) plus Cangzhu (Atractylodis Rhizoma) should be used, consisting of Mahuang (Ephedrae Herba), Shigao (Gypsum Fibrosum), Gancao (Glycyrrhizae Radix et Rhizoma), and Cangzhu (Atractylodis Rhizoma). To internally drain Water-Dampness, methods such as applying medicine to the umbilicus are suitable. One method uses Sidou (Cassiae Semen) de-oiled, four qian; Shuiyin Fen (Hydrargyrum), two qian; Liuhuang (Sulfur), one qian, ground evenly into a cake. First, place a piece of new cotton on the umbilicus, put the cake on it, and bind tightly with cloth. After a moment, foul water will naturally be purged. After three to five times of purging, remove the medicine and replenish with congee. If the body becomes emaciated after long use, take it once every other day; one cake can save three to five people. Another method uses fresh Chishanglu Gen (Phytolaccae Radix), pounded and applied to the umbilicus, bound with cloth, so that water exits naturally through urine. Another method uses four river snails, five cloves of garlic, and three qian of Cheqianzi Mo (Plantaginis Semen powder), ground into a cake, applied to the umbilicus, and bound with a handkerchief; urination will become smooth and recovery will occur shortly. Alternatively, Chenxiang Hupo Wan (Agarwood and Amber Pill) can be taken orally, consisting of Ku Tingli Zi (Lepidii Fructus), Zhen Yuliren (Prunus Armeniacae Semen Amarum), Fangji (Stephaniae Tetrandrae Radix), Chenxiang (Aquilariae Lignum Resinatum), Chenpi (Citri Reticulatae Pericarpium), Hupo (Electri Corium), Xingren (Armeniacae Semen Amarum), Suzi (Perillae Fructus), Chi Fuling (Poria cum Rosa), Zexie (Alismatis Rhizoma), and Shexiang (Moschus). If the whole body is swollen, external dispersal and internal draining should be combined, and Shuozao Yinzi (Shuozao Decoction) should be used for dual resolution. If Water Qi surges upward causing severe asthma and inability to lie flat, Suzi Tingli Wan (Perilla Seed and Lepidium Seed Pill) should be used first to calm asthma, consisting of these two ingredients ground equally into powder and formed into pills with jujube flesh. For Yang Edema belonging to Heat-Excess syndrome, if Heat is prevalent, Dasheng Xunchuan San (Dasheng Xunchuan Powder) should be used; if Dampness is prevalent, Zhouche Shenyou Wan (Zhouche Shenyou Pill) should be used to purge downward. These two formulas are recorded in *Yizong Bidu* (Essential Readings for Medical Practitioners). For Yin Edema belonging to Cold-Deficiency syndrome, if Spleen Deficiency causes poor appetite and loose stools, Shipin Yin (Shipin Decoction) should be used; if Kidney Deficiency causes cold and hard calves and feet, Shenqi Wan (Kidney Qi Pill) should be used.
[Shuozao Yinzi and Fuling Daoshui Tang]
For treating edema requiring dual resolution of external and internal factors, Shuozao Yinzi (Shuozao Decoction) and Heji Fuling Daoshui Tang (Fuling Daoshui Decoction from Standardized Formulas) can be used. Shuozao Yinzi contains Jiaomu (Phellodendri Cortex), Chixiaodou (Phaseoli Semen Rubrum), Binglang (Arecae Semen), Shanglu (Phytolaccae Radix), Mutong (Akebiae Caulis), Qianghuo (Notopterygii Rhizoma et Radix), Qinjiao (Gentianae Macrophyllae Radix), Dafupi (Tangerinae Fructus Pericarpium), Fulingpi (Poria Cum Cortice), and Zexie (Alismatis Rhizoma). Fuling Daoshui Tang contains Zexie (Alismatis Rhizoma), Fuling (Poria), Sangbai Pi (Mori Cortex), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Sharen (Amomi Fructus Rotundus), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Suye (Perillae Folium), Dafupi (Tangerinae Fructus Pericarpium), Maidong (Ophiopogonis Radix), and Binglang (Arecae Semen).
[Note] For edema requiring dual resolution of external dispersal and internal drainage, severe cases use Shuozao Yinzi (Shuozao Decoction), consisting of Jiaomu (Phellodendri Cortex), Chixiaodou (Phaseoli Semen Rubrum), Binglang (Arecae Semen), Shanglu (Phytolaccae Radix), Mutong (Akebiae Caulis), Qianghuo (Notopterygii Rhizoma et Radix), Qinjiao (Gentianae Macrophyllae Radix), Dafupi (Tangerinae Fructus Pericarpium), Fulingpi (Poria Cum Cortice), and Zexie (Alismatis Rhizoma). For milder cases requiring dual resolution, Fuling Daoshui Tang (Fuling Daoshui Decoction) is used, consisting of Zexie (Alismatis Rhizoma), Fuling (Poria), Sangbai Pi (Mori Cortex), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Sharen (Amomi Fructus Rotundus), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Suye (Perillae Folium), Dafupi (Tangerinae Fructus Pericarpium), Maidong (Ophiopogonis Radix), and Binglang (Arecae Semen).
[Shipin Yin]
Internal Excess naturally seeks Xunchuan San (Xunchuan Powder) for purging; Internal Deficiency with Cold requires Shipin Yin (Shipin Decoction), which includes Sijunzi Tang (Four Gentlemen Decoction) plus Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Fuzi (Aconiti Lateralis Radix Praeparata), Dafuzi (Arecae Semen), Houpo (Magnoliae Officinalis Cortex), Caoguo (Tsaoko Fructus), and Chao Ganjiang (Zingiberis Rhizoma Praeparatum). If various warming and tonifying methods fail, and purgative methods are too harsh to bear, the "nine parts tonification, one part purgation" method must be employed. Slow regulation and a bland diet will prolong life.
[Note] For Internal Excess presenting with obstructed urination and defecation, Xunchuan San (Xunchuan Powder) and Shenyou Wan (Shenyou Pill) should be used. For Internal Deficiency presenting with unobstructed urination and defecation, Shipin Yin (Shipin Decoction) should be used, consisting of Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Chuan Fuzi (Aconiti Lateralis Radix Praeparata), Dafuzi (Arecae Semen), Houpo (Magnoliae Officinalis Cortex), Caoguo (Tsaoko Fructus), and Chao Ganjiang (Zingiberis Rhizoma Praeparatum). For swelling diseases belonging to Deficiency-Cold, warming and tonifying medicines are naturally appropriate. However, if they prove ineffective, it indicates that there must be Excess pathogens within the Deficiency. While purgative medicines might be considered, they are often too harsh to bear. Yet, without purging, there is no cure. Therefore, the "nine parts tonification, one part purgation" method must be practiced: using tonifying medicines for nine days, waiting for an opportunity to purge, and then using purgative medicines for one day to attack the pathogen. However, purgative medicines must initially be given in small amounts; if the patient cannot tolerate them, the dose should be increased gradually. It is essential to ensure the medicine matches the patient's Yuan Qi (Original Qi), expelling pathogens without damaging the healthy Qi. This is the correct method. Subsequently, one might tonify for seven days and purge for one day, or tonify for five days and purge for one day, or tonify for three days and purge for one day, seeking recovery slowly until healed. If salt and sauces are abstained from and a bland diet is maintained for one hundred days, many patients will survive.