肿病不一。遍身肿。四肢肿。面肿。脚肿。方谓之水气。然
有阳水。有阴水。并宜先用五皮饮。升降汤。或除湿汤。加木瓜腹皮各半钱。如未效。继以
四磨饮。兼吞桂黄丸。肿者。总名曰钟也。寒热气所钟聚也。应阴水阳水。及蛊胀。服药。
外并宜赤小豆粥佐之。
遍身肿。烦渴。小便赤涩。大便多闭。此属阳水。轻宜四磨饮。添磨生枳壳。兼进莱菔
饮。重则疏凿饮子。万灵饮利之。以通为度。
亦有虽烦渴。而大便已利者。此不可更利。宜用五苓散。加木通大腹皮半钱。以通小便
或分心气饮。
遍身肿。不烦渴。大便自调。或溏泄。小便虽少。而不涩赤。此属阴水。宜实脾饮。小
便多少
如常。有赤时。有不赤时。至晚则微赤。却无涩滞者。亦属阴也。不可遽补。木香流气饮。
继进复元丹。若大便不溏。气息胀满。宜四磨饮。下黑锡丹。
感湿而肿者。其身虽肿。而自腰下至脚重。腿胀满、尤甚于身。气或急。或不急。大便
或溏
或不溏。但宜通利小便。多服五苓散。吞木瓜丸。间进除湿汤。加木瓜腹皮各半钱。炒萝
卜子七分半碾碎之。
有患生疮。用干疮药太早。致遍身肿。不可妄施他剂。若大便不通。升麻和气饮。若大
便如
常。或以自利。当导其气。自小便导之。宜五皮饮。和生料五苓散。腹若肿。只在下。宜
除湿汤。和生料五苓散。加木瓜如泽泻之类。
有元肾气根下注。而成脚肿。此当就元头上治。不可妄以香港脚药施之。盖气入肾。则先
脚肿。而后肾疼肾气注。
则先肾疼。而后脚肿。五心缺而平。唇肿脐突者。不可治。
病后浮肿。此系脾虚。用二分平胃散。一分五苓散。和匀。汤调。或生料煎服。或用生
料平
胃散。加木瓜腹皮人参各半钱。茯苓一钱。或六君子汤。加木香半钱。肿甚者。木香流气饮
有浑身水肿。以青蛙一二个。去皮火炙食之。肿退。亦有单独腹胀。用亦不效者。
治阳水浮肿。败荷叶烧存性。碾末。米饮调下。荷叶灰服之令人瘦劣。今假病。欲容体
瘦以示人者。一味服荷叶灰。故可以退肿。
浮肿之处。若 热。赤肿而坚。其人或增寒壮热。或为痈疽。或遍身生疮而肿。并见疮
毒门。
四肢肿谓之肢肿。宜五皮饮。加姜黄木瓜各一钱。或四磨饮。
脚肿见本门香港脚证。
面独肿。苏子降气汤。兼气急者尤宜。或煎熟去滓后。更磨沉香一呷。
有一身之间。唯面与双脚浮肿。早起则面甚。晚则脚甚。经云。面肿为风。脚肿为水。
乃风
湿所致。须问其大小腑门通闭。别其阴阳二证。前后用药惟除湿汤。加木香腹皮白芷各半钱
可通用。或以苏子降气汤。除湿汤。各半帖煎之。
水肿的病因并不单一。全身浮肿、四肢浮肿、面部浮肿、足部浮肿，这些情况才称为水气病。然而，水肿分为阳水和阴水两类，治疗时都适宜先使用五皮饮、升降汤或除湿汤，并加入木瓜和大腹皮各半钱。如果效果不明显，接着使用四磨饮，同时吞服桂黄丸。所谓“肿”，总称为“钟”，是指寒热之气聚集所致。无论是阴水、阳水，还是蛊胀，服药期间，外部饮食都适宜用赤小豆粥辅助。
全身浮肿，伴有烦躁口渴，小便短赤涩痛，大便多闭塞不通，这属于阳水。病情轻者适宜用四磨饮，添加生枳壳一起研磨，并配合服用莱菔饮；病情重者则用疏凿饮子，或用万灵饮来利水，以通利为度。
也有虽然烦躁口渴，但大便已经通畅的情况，此时不可再使用泻下法，适宜用五苓散，加入木通和大腹皮半钱，以通利小便；或者使用分心气饮。
全身浮肿，没有烦躁口渴，大便正常或溏泄，小便虽然量少，但不涩痛且颜色不红，这属于阴水。适宜用实脾饮。如果小便量多少如常，有时发红，有时不发红，到了晚上微微发红，但没有涩滞感，这也属于阴水。此时不可急于进补，适宜用木香流气饮，接着服用复元丹。如果大便不溏，气息胀满，适宜用四磨饮，送服黑锡丹。
因感受湿邪而致水肿的，身体虽然浮肿，但从腰部以下至脚沉重，腿部胀满，比身体其他部位更严重。气机或有急促，或不急促，大便或溏或不溏。只宜通利小便，多服用五苓散，吞服木瓜丸，间或服用除湿汤，加入木瓜和大腹皮各半钱，以及炒萝卜子七分半碾碎服用。
有患者患疮疡，过早使用干燥收敛的疮药，导致全身浮肿，此时不可随意使用其他药物。如果大便不通，用升麻和气饮；如果大便正常，或者自行通畅，应当疏导其气，从小便引导排出，适宜用五皮饮，合用生料五苓散。如果腹部肿胀，仅在下部，适宜用除湿汤，合用生料五苓散，加入木瓜及泽泻之类的药物。
有因肾气根源下行注于下部，而形成脚肿的，这应当在源头（肾脏）上治疗，不可随意使用治疗香港脚（痛风/下肢静脉曲张等）的药物。因为气入肾，则先出现脚肿，随后肾疼；若是肾气注滞，则先出现肾疼，随后脚肿。如果出现五心（两手心、两足心及心口）凹陷且平齐，嘴唇肿胀，肚脐突出，则不可治愈。
病后出现浮肿，这是由于脾虚引起的，用二分平胃散和一分五苓散，混合均匀，用汤剂调服，或者用生料煎服。或者使用生料平胃散，加入木瓜、大腹皮、人参各半钱，茯苓一钱；或者使用六君子汤，加入木香半钱。浮肿严重的，可用木香流气饮。对于浑身水肿，可以用青蛙一二只，去皮后火烤食用，浮肿即可消退。也有单独腹胀，使用上述方法无效的。
治疗阳水浮肿，可将败荷叶烧存性，碾成粉末，用米汤调服。荷叶灰服用后可使人消瘦。现在有些人假借疾病，想通过身体消瘦来展示给他人看，所以单味服用荷叶灰，因此它可以退肿。
浮肿之处，如果发热，红肿坚硬，其人可能增加恶寒壮热，或者形成痈疽，或者全身生疮而肿，这些情况请参见“疮毒门”。
四肢浮肿称为肢肿，适宜用五皮饮，加入姜黄、木瓜各一钱；或者用四磨饮。
只有面部浮肿，适宜用苏子降气汤，兼有气急者尤其适宜。或者煎煮去渣后，再研磨沉香一呷（少量）。
有一身之中，唯独面部和双脚浮肿，早起时面部浮肿明显，晚上时脚部浮肿明显。经云：“面肿为风，脚肿为水。”这是由风湿所致。必须询问其大小便的通闭情况，辨别阴阳二证。前后的用药惟独除湿汤，加入木香、大腹皮、白芷各半钱，可以通用。或者将苏子降气汤和除湿汤各半帖煎服。
Edema arises from various causes. Generalized edema, edema of the four limbs, facial edema, and pedal edema are collectively referred to as Water Qi (Water Pathogen) disease. However, edema is categorized into Yang Edema and Yin Edema. In both cases, it is appropriate to initially administer Wupi Yin (Five-Bark Decoction), Shengjiang Tang (Ascending-Descending Decoction), or Chushi Tang (Dampness-Expelling Decoction), adding Semen Momordicae (Mugua, 木瓜) and Pericarpium Citri Reticulatae Viride (Fupi, 大腹皮) each at half a qian. If there is no effect, proceed with Simo Yin (Four-Gargle Decoction) and concurrently swallow Guihuang Wan (Cinnamon-Yellow Pill). The term "edema" is generally called "Zhong," referring to the accumulation of Cold and Heat Qi. Whether it is Yin Edema, Yang Edema, or Gu Zhang (Gu Distension), while taking medicine, it is advisable to assist with Adzuki Bean Porridge externally/dietarily.
Generalized edema accompanied by irritability and thirst, dark and scanty urine, and frequent constipation belongs to Yang Edema. For mild cases, Simo Yin is appropriate, with raw Zhiqiao (Fructus Aurantii Immaturus) added for grinding, along with Radish Drink. For severe cases, Shuozao Yinzi (Scouring Decoction) or Wanling Yin (Ten-Thousand-Spirit Decoction) should be used to promote diuresis, aiming for patency.
In cases where there is irritability and thirst but the stool is already loose, further purgation is contraindicated. It is appropriate to use Wuling San (Five-Ingredient Powder with Poria), adding Tongcao (Akebia Stem) and Fupi each at half a qian to promote urination; alternatively, Fenxin Qi Yin (Heart-Qi Separating Decoction) may be used.
Generalized edema without irritability or thirst, with normal or loose stools, and although urine volume is low, it is not painful or red, belongs to Yin Edema. Shipi Yin (Spleen-Strengthening Decoction) is appropriate. If the urine volume is normal, sometimes red and sometimes not, becoming slightly red in the evening but without dysuria, this also belongs to Yin Edema. Hasty tonification is contraindicated here. Muxiang Liqi Yin (Costus Flowing-Qi Decoction) is appropriate, followed by Fuyuan Dan (Restoring Primordial Pill). If the stool is not loose but there is abdominal distension and fullness, Simo Yin is appropriate, administered with Heixi Dan (Black Tin Pill).
Edema caused by dampness invasion presents with generalized swelling, but heaviness from the waist down to the feet, with leg distension being more severe than elsewhere. Qi flow may be rapid or normal, and stool may be loose or normal. Only promoting diuresis is indicated. Frequent use of Wuling San and swallowing Mugua Wan (Momordica Pill) is advised, occasionally using Chushi Tang with added Mugua and Fupi each at half a qian, and fried Raphani Semen (Luobozi, 萝卜子) ground to 7.5 fen.
Patients who develop sores and use drying topical medicines too early may result in generalized edema. Other remedies should not be applied arbitrarily. If stool is obstructed, Shengma Heqi Yin (Immature Bitter Orange and Cimicifuga Harmonizing-Qi Decoction) is used. If stool is normal or spontaneously loose, Qi should be guided out through urination. Wupi Yin combined with Shengliao Wuling San (Raw-Material Five-Ingredient Powder with Poria) is appropriate. If abdominal swelling is localized only below, Chushi Tang combined with Shengliao Wuling San, adding Mugua and herbs like Ze Xie (Alisma Rhizome), is suitable.
Edema of the feet resulting from Kidney Qi sinking to the lower part should be treated at its root (the Kidneys). Do not arbitrarily apply medicines for Hongjiaojiao (Hongjiao, often referring to gout or varicose veins). When Qi enters the Kidney, foot swelling appears first, followed by Kidney pain; when Kidney Qi stagnates, Kidney pain appears first, followed by foot swelling. If the five centers (palms, soles, and chest) are sunken and flat, lips are swollen, and the umbilicus protrudes, the condition is incurable.
Post-illness edema is due to Spleen Deficiency. Use two parts Pingwei San (Peaceful Stomach Powder) and one part Wuling San, mixed evenly, taken with decoction water, or decocted as raw materials. Alternatively, use Shengliao Pingwei San with added Mugua, Fupi, and Renshen (Ginseng Root) each at half a qian, and Fu Ling (Poria) at one qian; or use Liujunzi Tang (Six-Gentleman Decoction) with added Muxiang (Costus Root) at half a qian. For severe generalized edema, Muxiang Liqi Yin can be used. For whole-body edema, eating one or two frogs after removing skin and roasting them over fire can reduce swelling. There are cases of isolated abdominal distension where these methods are ineffective.
To treat Yang Edema, burn lotus leaves until carbonized but retaining their nature, grind into powder, and take with rice water. Lotus leaf ash can make a person thin. Some people today feign illness to appear slender, consuming only lotus leaf ash, which thus reduces swelling.
If the edematous area is hot, red, swollen, and hard, the patient may experience chills and high fever, carbuncles, or generalized sores with swelling. Refer to the "Sores and Toxins Section."
Edema of the four limbs is called Zhi Zhong (Limb Edema). Wupi Yin with added Jianghuang (Curcuma Longa Rhizome) and Mugua each at one qian is appropriate, or Simo Yin.
Pedal edema refers to the Hongjiao syndrome described in this section.
Isolated facial edema is treated with Suzi Jiangqi Tang (Perilla Fruit Descending-Qi Decoction), especially if accompanied by shortness of breath. After decocting and straining, add Chenxiang (Aquilaria Wood) ground to a sip.
In cases where only the face and both feet are edematous, with facial swelling worse in the morning and pedal swelling worse in the evening: The Classics state, "Facial swelling is Wind, Pedal swelling is Water." This is caused by Wind-Dampness. One must inquire about the patency of bowel and bladder movements to distinguish between Yin and Yang syndromes. The primary prescription throughout is Chushi Tang with added Muxiang, Fupi, and Baizhi (Angelica Dahurica Root) each at half a qian, which can be used universally. Alternatively, half doses of Suzi Jiangqi Tang and Chushi Tang can be decocted together.