黄锦芳曰∶水肿之症，至为繁杂，有风有水，风湿、风痰、风热、风毒，与夫水湿、水气、湿热、食积，
诸虚夹杂等症，然总不越以水为害。大约阳脏多热，热则多实；阴脏多寒，寒则多虚。先滞于内而后及于外者
多实，先肿于表而后及于里者多虚。小便红赤，大便闭结者多实；小便清利，大便稀溏者多虚。脉滑而不远者
多实，脉浮而微细者多虚。形色红黄，声音如常者多实；形色憔悴，声音短促者多虚。少壮气道壅滞者多实，
中衰劳倦气怯者多虚。若但肿而不胀，则病在水，而气不坚。凡一切枳实、槟榔、枳壳、丁香、白蔻、故纸、
沉香，下气迅利之药，切勿轻投。犹之臌胀在气，则一切升提呆补之药，亦勿轻用也。余族一人病水肿，六脉
浮濡满指，而右寸尤甚。按其肿处浮而不起，知其水溢于肺，所服之药，皆破气破血之品，病安得愈？以连翘、
栀子、茯苓、泽泻、牛膝、滑石、葶苈、木通、防风、苍术，轻平之药投之，数服而愈。
叶天士治陈某肿胀，进神芎导水丸，二日所下，皆粘腻黄浊形色。前议腑气窒塞，水湿粘滞，浊攻犯肺为
痰嗽，水渍脉隧为浮肿。大凡经脉六腑之病，总以宣通为是。《内经》云∶六腑以通为补。今医不分脏腑经络，
必曰参、术是补，岂为明理？然肢节足跗之湿，出路无由，必针刺以决其流，内外冀可皆安。戊己丸三钱，用
二日后，再进前药一服。
徐灵胎曰∶句句名言，腹满等症，必须有出路，故人兼以针刺为治。但其道甚微，不知其理而蛮针之，
反有大害。又曰∶胀满之为病，即使正虚，终属邪实，故古人慎用补法。又胀必有湿，有湿则有热，《内
经》所以指为热症。若用温补之药，即兼通利之品，而臣不胜主，贻误必多。又曰∶胀满必有有形之物，
宜缓缓下之。
叶天士治朱某，初因面肿，邪干阳位，气壅不通，二便皆少。桂、附不应，即与导滞。滞属有质，湿热无
形，入肺为喘，乘脾为胀，六腑开合皆废，便不通爽，溺短混浊，时或点滴，舌绛口渴。腑病背胀，脏病腹满，
更兼倚倒，左右肿胀，随着处为甚，其湿热布散三焦，明眼难以决胜矣。经云∶从上之下者治其上。又云∶从
上之下而甚于下者，必先治其上，而后治其下。此症逆乱纷更，全无头绪，皆不辨有形无形之误，姑以清肃上
焦为先，飞滑石钱半，大杏仁去皮尖十粒，生薏仁三钱，白通草一钱，鲜枇杷叶去毛三钱，茯苓皮三钱，淡豆
豉钱半，黑山栀壳一钱，急火煎五分服。此手太阴肺经药也，肺气窒塞，当降不降，杏仁微苦则能降，滑石甘
凉渗湿解热，薏仁、通草淡而渗气分，枇杷叶辛凉能开肺气，茯苓用皮，谓诸皮皆凉，栀、豉宣其陈腐郁结。
凡此气味俱薄，为上焦药，仿齐之才轻可去实之义。
徐灵胎曰∶喘胀用此方甚合，足见心思灵巧，如此等治法真堪导入医案。
一宦者，年已近耄，因劳倦伤脾，脾虚病疟，疟愈而脾胃之虚日益，旋病肿，此时饮食尚进，起居亦不甚
衰，正宜补中益气汤，随症加减，以调脾胃元气。后用《金匮》肾气丸，补肾行水，使肿自消，始为至治。乃
日以泽泻、猪苓、柴胡、葛根、浓朴、陈皮等药，朝饵暮餐，咸不知返。两月后真气克削无余，肿胀弥剧，喘
息不得眠者六昼夜。更一医，犹以为肺病，而用苏子、芥子、二母、二冬之类，卒至汤饮俱废而死。王宇泰曰∶
手足浮肿，未必成水也。服耗气利水之药而不已，则水病成矣。赵养葵曰∶肾虚不能纳气归元而作喘，徒从事
于肺者，执流而忘源也。惜哉！
扁鹊玉壶丸，治命门火衰，阳气暴绝，寒水臌胀，殊有神功。凡硫黄八两，配真麻油八两，以硫打碎，入
冷油内，炖炉上，炭宜微勿烈，以桑条徐调。候硫溶尽，即倾入大水内，急搀去上面油水，其色如金。取缸底
净硫，见若干两仍配麻油若干两，照前溶倾，其色如绛。第五转，用肥皂四两，水中同煮六时。第六转，用牙
皂四两，水中同煮六时，投净制硫之油，搀去其水，其色如硫火之紫。第七转，用炉中炭灰淋碱水制六时。第
八转，用水豆腐制六时，拔净皂碱之性。第九转，用田字草，（出水荒稻田中，叶如田字，八月九月采。）捣汁
和水煮六时，临用研如飞面。凡净硫一两，配炒糯米粉二两，或水法或湿捣为丸。每服以三分为准，渐加至
一钱，开水送下。
窦材尝因路过衢州野店，见一妇人遍身浮肿，露地而坐。窦曰∶何不在门内坐？妇曰∶昨日蒙土地告我，
明日有扁鹊过此，可求治病，我故于此候之。窦曰∶汝若能听我，我当救汝。妇曰∶汝非医人，安能治病？窦
曰∶我虽非医，然得扁鹊真传，有奇方，故神预告汝。遂与保命延寿丹十粒服之，夜间小便约去二升，五更觉
饥。二次，又服十五粒，点左右命关穴，灸二百壮，大便下白脓五七块，半月全安。妇人曰∶真扁鹊再生也。
按∶材为绍兴间人，着有《扁鹊心书》，曾进呈，且有达天青词，谓其书得传，可以济人而非妄也。
此案在书中为首则，故表其为扁鹊之名如此。材曾为巡检官。
一人病四肢皆肿，气促，食则胀闷，止吃稀粥，令日服金液丹百粒，至四日觉大便滑，再二日乃令吃面食
亦不妨，盖治之早也。窦氏治疾，纯用大热之剂，肿胀之真阳衰绝者，用之能收捷效。若误用于湿热之症，亦
立致奇祸，用者审之。
一妇人病面脚皆肿，饮食减少。世医皆作血虚治之不效。窦曰∶非血病，乃脾胃虚也。令日服延寿丹十粒，
全真丹五十粒，至十日觉大便滑，病愈。
张子和治张小一，初病疥爬搔，变而成肿喘不能食。张断为风水，水得风而暴肿，故遍身皆肿。先令浴之，
乘腠理开豁，就燠室中，用酸苦之剂加全蝎一枚吐之，节次用药末至三钱许，出痰约数升，汗随涌出，肿去八
九分。隔一日临卧向一更来，又下神 丸七十余粒，三次咽之，至夜半动一行。又续下水煮桃仁丸六十丸，以
麝香汤下，又利三四行。后二三日，再以舟车丸、通经散及白术散，调之愈。
张子明之母极肥，偶得水肿，四肢不举。张令上涌汗而下泄之，去水三四斗。初下药时，以草储布囊，高
支两足而卧。其药之行，自腰以上，水觉下行，自足以上，水觉上行。水行之状，行如蛇走，坠如线牵，四肢
森然凉寒，会于脐下而出。不旬日间病大减，余邪未尽。张更欲用药，竟不能从其言。
张承应年几五十，腹如孕妇，面黄食减，欲作水气。或令服黄 建中汤及温补之剂，小溲涸闭。张曰∶建
中汤攻表之药也，古方用之攻里已误矣，今更以此取积，两重误也。先以涌剂吐之，置火于其旁大汗之，次与
猪肾散四钱，以舟车丸引之，下六缶。殊不困，续下两次，约三十余行，腹中软，健啖如昔。常仲明曰∶向闻
人言，泻五六缶，人岂能任？及问张承应，渠云诚然。乃知养生与攻 ，本自不同，今人以补剂疗病，宜乎不
效。（此与葛某之论同。常说丹溪大不然之，因谓子和书非手撰，乃出自麻知几等。）
元时名医宋会之治水蛊法，用老丝瓜一枚，去皮及子，剪碎，与巴豆二七粒同炒，视巴豆褐色为度，去巴
豆存丝瓜。又用黄米如丝瓜之数同炒，视米褐色，去丝瓜存米研末，清水和为丸，梧桐子大。每服百丸，白汤
下，蛊水尽从大便中出，而疾除矣。其言曰∶巴豆逐出水者也，而患其迅，藉丝瓜取其气，丝瓜有筋，象人身
脉络，得引巴豆之气，达诸脉络。而仍用米者，投其胃气也。仍去丝瓜者，畏其受巴豆之气太甚也。鲜于枢
为之记如此。
峨眉僧治一人肚腹四肢肿胀，用干鸡矢一升，炒黄，以酒醅三碗，煮一碗，滤汁饮之，名牵牛酒。少顷腹
中气大转动利下，即脚下皮皱消也。未尽，隔日再作，仍以田羸二枚，滚酒瀹食白粥，调理而愈。其人牵牛来
谢，故以名方。（《本草纲目》。）
魏秀才妻病腹大而鼓，四肢骨立不能贴席，惟衣被悬卧，谷食不下者数日矣。忽思鹑食，如法进之，遂晕
剧，少顷雨汗莫能言，但有更衣状，扶而圊，小便突出白液，凝如鹅脂。如此数次，下尽遂起，盖中焦湿热积
久所致也。（《董炳集验方》。）
张路玉治王庸若，水肿呕逆，溲便点滴不通。或用五苓、八正，不应，六脉沉细如丝。因与金液丹十五丸，
溺如泉涌，势顿平。后以济生肾气，培养而安。
李时珍治一人妻，自腰以下 肿，面目亦肿，喘急欲死，不能伏枕，大便溏滞，小便短少，服药罔效。其
脉沉而大，沉主水，大主虚，乃病后冒风所致，是名风水也。用《千金》神秘汤加麻黄，一服喘定十之五。再
以胃苓汤吞深师薷术丸，二日小便长，肿消十之七，调理数日全安。（《本草纲目》。）
俞东扶曰∶金液丹、神秘汤，人所罕用，而善用之，则各奏奇功。因思古方具在简册，特患寻不着对头
帽子耳。神秘汤乃生脉散合二陈汤去麦冬、茯苓，加紫苏、桑皮、桔梗、槟榔，生姜三片为引。施于此证
恰好，加麻黄更好。并非八寸三分通行之帽也。
邱汝诚友人朱升患酒积，举身黄肿，无能治者。邱视之，曰∶可救也。出囊中赤药七丸，以酒下之，须臾
下黄水满器，腹即消其半，下五丸遂愈。（《挥尘新谭》。）
陈三农治一人患腹胀满，服补中、六君，其胀减十之七八。误服行积丸，遂致食减胀甚，脉细数。以补中
汤加干姜、肉桂各五分，附子七分，吴茱萸一分姜水煎，饮愈。
一人腹胀时痛吐，小便利则大便不通，大便利则小便不通，用炒干姜三钱，升麻一钱五分，吴茱萸微炒五
分，煎服愈。（原注∶此寒邪痞塞于膀胱也。时吐者，寒迫火上也。）
一人患单腹胀将愈，因恼怒腹胀而痛，口干身热食减，膻中近右作痛，按之则止。用人参、干姜、炒半夏
各七分，白术、茯苓、苍术各二钱，陈皮、神曲各五分，甘草、肉桂各二分，吴茱萸七厘，服之愈。
一人头面四肢浮肿，带黄色，行动脚软。此脾胃虚弱，只宜健脾固中气为主。用人参、白术、茯苓、陈皮、
甘草，渐愈。
孙文垣治陈光禄松峦，常五更胸胁胀痛，遍治无效。诊之，右寸软弱，左平，两尺亦弱，曰∶肺肾二经之
不足也，补而敛之，可无恙矣。以补骨脂、萸肉、人参各三两，鹿角胶、鹿角霜各五两，杜仲、巴戟、白茯苓、
车前子各一两五钱，山药二两，鹿角胶酒化为丸，空心淡盐汤送下。又以御米谷去筋膜，蜜水炒三两，诃子面
煨去核一两，陈皮一两半，炼蜜为丸，五更枕上白汤送下一钱，服一月病愈。
溧水令吴涌澜夫人，每五更倒饱必泻一次，腹常作胀，间亦痛。脉之，两手寸关洪滑，两尺沉伏。曰∶此
肠胃中有食积痰饮也。乃与总管丸三钱，生姜汤送下，大便虽行，不甚快利。又以神授香连丸和之，外用滑石、
甘草、木香、枳壳、山楂、陈皮、白芍、酒连，调理而安。
熊成八官，江右南昌人，早起行路，忽见邪火两团，滚滚而来，大惊骇，次日腹中膨懑，渐成胀满，面白
皮薄，两手瘦削，两足皆有浮气，按之 然不起，（湿也。）行动气促，形神俱弱。医谓神弱气促，胸腹青筋缕
缕如贯索，小水清长，形症如此，脾虚所致。以参苓白术散投之，十日堵然如鼓，中有一块，累然突出，坚若铁石，
脐已平满，勺粒不入。医与决曰∶若疾法在不治，盍早归，毋作异乡鬼也。孙脉之，沉弦有力，曰∶非气虚中
满之候，前补大骤，适助长耳。顾今霉雨途遥，（湿热病值湿热时。）即归，未能时刻可到，且治非良手，则大
事去矣。予有一药，尚可冀生也，以琥珀调中丸，日二进之。一进甚甘，再进称快，十日腹渐宽，块渐熔，半月
尽消去，青筋俱敛。改以平胃散加萝卜子、姜黄、薏仁、木香，调养一月，饮食大加，两足之浮亦愈。（利水消积法。）
喻嘉言治刘泰来，年三十二岁，面白体丰，夏月用冷水灌汗，坐卧当风，新秋病疟。三五发后，用药截住，
遂觉胸腹胀满。不旬日外，腹大胸高，上气喘急，二便全无，食饮不入，能坐不能卧，能俯不能仰，势颇危急。
医以二便不通，下之不应，商用大黄二两，作一剂。喻骇曰∶此名何病，而敢放胆杀人耶？医曰∶伤寒肠结，
下而不通，惟有大下一法，何谓放胆？喻曰∶世有不发热之伤寒乎？伤寒因发热，故津液枯槁，肠胃燥结，可
用下药，以开其结，然有不转矢气者，不可攻之戒，正恐误治太阴经之腹胀也。此病因腹中之气散乱不收，故
水液随气横溢成胀，全是太阴脾气不能统摄所致。一散一结，相去天渊，再用大黄猛剂，若不胀死，定须腹破
矣。医唯唯辞去，病家仍欲服之，喻乃掷去其药，另与理中汤，畏不敢服，欲俟来日。喻曰∶腹中真气渐散，
今夜子丑二时，阴阳交剥之界，必大汗眩晕，难为力矣。不得已，令煎就以待，既而果发晕，即服下得睡片时，
次日略觉减可。遂以三剂作一服，加人参至三钱，服后又进一大剂，少加黄连，胀已大减。谓大便未通不敢进
黄锦芳说：水肿这一病症，非常繁杂，有风有水，包括风湿、风痰、风热、风毒，以及水湿、水气、湿热、食积，还有各种虚证夹杂等症，但总归都不超出以水为害的范围。大致来说，阳脏（体质偏阳者）多热，热则多实证；阴脏（体质偏阴者）多寒，寒则多虚证。先阻滞于体内而后波及体表的，多为实证；先浮肿于体表而后波及体内的，多为虚证。小便红赤，大便闭结的，多为实证；小便清长通利，大便稀溏的，多为虚证。脉象滑利而不远散的，多为实证；脉象浮而微细的，多为虚证。面色红黄，声音如常的，多为实证；面色憔悴，声音短促的，多为虚证。年少壮实、气道壅滞的，多为实证；中年衰退、劳倦气怯的，多为虚证。如果只肿而不胀，那么病在水，而气不坚实。凡是枳实、槟榔、枳壳、丁香、白豆蔻、补骨脂（故纸）、沉香等下气迅利的药物，千万不要轻易投用。这就好比鼓胀病在气分，那么一切升提呆补的药物，也不要轻易使用。我的同族一人患水肿，六脉浮濡满指，右寸脉尤其明显。按压其肿胀处，浮起后不能立即恢复，知道是水溢于肺，所服用的药物，都是破气破血的药，病怎么能痊愈呢？我用连翘、栀子、茯苓、泽泻、牛膝、滑石、葶苈子、木通、防风、苍术这些轻平的药物投治，服用几剂就好了。
叶天士治疗陈某的肿胀，给予神芎导水丸，两天内排出的，都是粘腻黄浊形色的粪便。之前的判断是腑气窒塞，水湿粘滞，浊邪攻犯肺部导致痰嗽，水液浸渍脉隧导致浮肿。大凡经脉和六腑的病，总以宣通为原则。《内经》说：六腑以通为补。现在的医生不分脏腑经络，一定说人参、白术就是补药，这难道算是明理吗？然而肢节足跗的湿气，出路无由，必须针刺来决其水流，内外希望都能安宁。戊己丸三钱，服用两天后，再进前药一服。
徐灵胎说：句句都是名言，腹满等症状，必须有出路，所以人兼用针刺作为治疗。但是道理很微妙，不知道原理而蛮横地针刺，反而有大害。又说：胀满这种病，即使正气虚弱，终究属于邪实，所以古人慎用补法。又说：胀必有湿，有湿则有热，《内经》因此将其指认为热症。如果用温补的药，即使兼用通利的药，但臣药不胜主药，贻误必定很多。又说：胀满必有有形之物，宜缓缓攻下。
叶天士治疗朱某，起初因为面肿，邪气侵犯阳位，气机壅塞不通，大小便都少。桂枝、附子无效，随即给予导滞药。滞属于有形之质，湿热属于无形之邪，进入肺部导致喘，侵犯脾部导致胀，六腑开合功能全部废弛，大便不通爽，尿短混浊，有时仅点滴而出，舌质绛红口渴。腑病背部胀，脏病腹部满，更兼身体倚倒，左右肿胀，随着部位加重，其湿热布散在三焦，明眼人难以迅速决胜。经文说：从上往下发展的病，治其上。又说：从上往下发展且在下部加重的，必须先治其上，而后治其下。此症逆乱纷更，全无头绪，都是不辨别有形无形的错误。姑且以清肃上焦为先，飞滑石半钱，大杏仁去皮尖十粒，生薏仁三钱，白通草一钱，鲜枇杷叶去毛三钱，茯苓皮三钱，淡豆豉半钱，黑山栀壳一钱，急火煎至五分服。这是手太阴肺经的药，肺气窒塞，当降不降，杏仁味微苦则能降，滑石味甘凉渗湿解热，薏仁、通草味淡而渗气分之湿，枇杷叶味辛凉能开肺气，茯苓用皮，说是诸皮皆凉，栀、豉宣散陈腐郁结。凡是气味都薄的，为上焦药，仿照齐之才“轻可去实”的意思。
徐灵胎说：喘胀用这个方子很合适，足见心思灵巧，像这样的治法真值得录入医案。
一位宦官，年纪接近八十，因为劳倦伤脾，脾虚患疟疾，疟疾好后脾胃的虚损日益严重，随即患病肿胀，此时饮食还能进食，起居也不甚衰弱，正适宜用补中益气汤，随症加减，来调理脾胃元气。后来用《金匮要略》的肾气丸，补肾行水，使肿胀自然消退，这才是最好的治疗。竟然每天服用泽泻、猪苓、柴胡、葛根、厚朴、陈皮等药，早晚服用，完全不知道回头。两个月后真气被削弱殆尽，肿胀更加剧烈，喘息不能睡觉达六昼夜。换了一个医生，还认为是肺病，而用苏子、芥子、知母、贝母、天冬、麦冬之类的药，最终导致汤饮都喝不下而死。王宇泰说：手足浮肿，未必就是水病。服用耗气利水的药不停止，那么水病就形成了。赵养葵说：肾虚不能纳气归元而作喘，只从事于治肺的，是执着于流而忘记源。可惜啊！
扁鹊玉壶丸，治疗命门火衰，阳气暴绝，寒水臌胀，非常有神效。凡是硫黄八两，配真麻油八两，将硫黄打碎，放入冷油内，放在炉上炖，炭火宜微勿烈，用桑条慢慢搅拌。等到硫黄溶尽，立即倒入大水内，急忙撇去上面的油水，颜色如金。取缸底干净的硫黄，看有多少两，仍配相应量的麻油，照前法溶解倾倒，颜色如绛。第五转，用肥皂四两，在水中同煮六小时。第六转，用牙皂四两，在水中同煮六小时，投入净制硫黄的油，撇去其中的水，颜色如硫磺燃烧后的紫色。第七转，用炉中炭灰淋碱水制作六小时。第八转，用水豆腐制作六小时，拔除净皂碱的性质。第九转，用田字草（出水荒稻田中，叶子像田字，八月九月采集），捣汁和水煮六小时，临用时研成飞面状。凡是净硫黄一两，配炒糯米粉二两，或用水法或湿捣成丸。每次服用以三分为准，逐渐加到一钱，开水送下。
窦材曾经路过衢州野店，看见一个妇人遍身浮肿，坐在露天地上。窦材说：为什么不在门内坐？妇人说：昨天蒙土地神告诉我，明天有扁鹊经过这里，可以求治病，所以我在这里等候他。窦材说：你如果能听我的话，我会救你。妇人说：你不是医生，怎么能治病？窦材说：我虽然不是医生，但得到扁鹊的真传，有奇方，所以土地神预告你。于是给她保命延寿丹十粒服用，夜间小便约排出二升，五更时觉得饿。第二次，又服用十五粒，点左右的命关穴，灸二百壮，大便排出白脓五七块，半个月完全康复。妇人说：真是扁鹊再生啊。
按语：窦材是绍兴年间的人，著有《扁鹊心书》，曾进呈朝廷，且有达天青词，说他的书得传，可以济人而不是妄言。此案在书中为首则，所以表彰其为扁鹊之名如此。窦材曾担任巡检官。
一人患四肢皆肿，气促，吃东西则胀闷，只吃稀粥，令其每天服用金液丹一百粒，到了第四天觉得大便滑利，再过两天才让他吃面食也无妨，这是因为治疗得早。窦氏治病，纯用大热的药剂，肿胀之真阳衰绝者，用之能收到捷效。如果误用于湿热之症，也会立刻招致奇祸，使用者务必审慎。
一妇人患面脚皆肿，饮食减少。世医都当作血虚治疗，无效。窦材说：不是血病，是脾胃虚。令其每天服用延寿丹十粒，全真丹五十粒，到了第十天觉得大便滑利，病愈。
张子和治疗张小一，起初患疥疮抓挠，变而成肿喘不能食。张断定为风水，水得风而暴肿，所以遍身皆肿。先令其洗澡，趁着腠理开豁，就在暖室中，用酸苦之剂加全蝎一枚催吐，分次用药末至三钱许，吐出痰约数升，汗随之涌出，肿去八九分。隔一天临睡前向一更时分，又下神祐丸七十余粒，三次咽下，到半夜动一行。又续下水煮桃仁丸六十丸，以麝香汤送下，又利三四行。后两三天，再用舟车丸、通经散及白术散，调治而愈。
张子明的母亲极肥，偶得水肿，四肢不能举动。张令上涌汗而下泄之，去水三四斗。初下药时，用草储布囊，高支两足而卧。其药之行，自腰以上，水觉下行，自足以上，水觉上行。水行之状，行如蛇走，坠如线牵，四肢森然凉寒，会于脐下而出。不到十天病大减，余邪未尽。张更想用药，竟不能听从他的话。
张承应年近五十，腹如孕妇，面黄食减，欲作水气。有人令其服黄芪建中汤及温补之剂，小溲涸闭。张说：建中汤是攻表之药，古方用它攻里已经错了，现在更以此取积，双重错误。先用涌剂吐之，置火于其旁大汗之，次与猪肾散四钱，以舟车丸引之，下六缶。并不困乏，续下两次，约三十余行，腹中软，健啖如昔。常仲明说：向来听人说，泻五六缶，人岂能忍受？及问张承应，他说确实如此。才知道养生与攻邪，本自不同，今人以补剂疗病，当然无效。（这与葛某的论述相同。常说丹溪对此大不以为然，因而谓张子和的书非手撰，乃出自麻知几等人。）
元代名医宋会之治水蛊法，用老丝瓜一枚，去皮及子，剪碎，与巴豆十四粒同炒，视巴豆褐色为度，去巴豆存丝瓜。又用黄米如丝瓜之数同炒，视米褐色，去丝瓜存米研末，清水和为丸，梧桐子大。每服百丸，白汤下，蛊水尽从大便中出，而疾除矣。其言曰：巴豆逐出水者也，而患其迅，藉丝瓜取其气，丝瓜有筋，象人身脉络，得引巴豆之气，达诸脉络。而仍用米者，投其胃气也。仍去丝瓜者，畏其受巴豆之气太甚也。鲜于枢为之记如此。
峨眉僧治疗一人肚腹四肢肿胀，用干鸡矢一升，炒黄，以酒醅三碗，煮一碗，滤汁饮之，名牵牛酒。少顷腹中气大转动利下，即脚下皮皱消也。未尽，隔日再作，仍以田螺二枚，滚酒瀹食白粥，调理而愈。其人牵牛来谢，故以名方。（《本草纲目》。）
魏秀才的妻子患腹大而鼓，四肢骨立不能贴席，惟衣被悬卧，谷食不下者数日矣。忽思鹑食，如法进之，遂晕剧，少顷雨汗莫能言，但有更衣状，扶而圊，小便突出白液，凝如鹅脂。如此数次，下尽遂起，盖中焦湿热积久所致也。（《董炳集验方》。）
张路玉治疗王庸若，水肿呕逆，溲便点滴不通。或用五苓散、八正散，不应，六脉沉细如丝。因与金液丹十五丸，溺如泉涌，势顿平。后以济生肾气丸，培养而安。
李时珍治疗一人妻，自腰以下肿，面目亦肿，喘急欲死，不能伏枕，大便溏滞，小便短少，服药罔效。其脉沉而大，沉主水，大主虚，乃病后冒风所致，是名风水也。用《千金》神秘汤加麻黄，一服喘定十之五。再以胃苓汤吞深师薷术丸，二日小便长，肿消十之七，调理数日全安。（《本草纲目》。）
俞东扶说：金液丹、神秘汤，人所罕用，而善用之，则各奏奇功。因思古方具在简册，特患寻不着对头帽子耳。神秘汤乃生脉散合二陈汤去麦冬、茯苓，加紫苏、桑皮、桔梗、槟榔，生姜三片为引。施于此证恰好，加麻黄更好。并非八寸三分通行之帽也。
邱汝诚友人朱升患酒积，举身黄肿，无能治者。邱视之，曰：可救也。出囊中赤药七丸，以酒下之，须臾下黄水满器，腹即消其半，下五丸遂愈。（《挥尘新谭》。）
陈三农治疗一人患腹胀满，服补中益气汤、六君子汤，其胀减十之七八。误服行积丸，遂致食减胀甚，脉细数。以补中益气汤加干姜、肉桂各五分，附子七分，吴茱萸一分姜水煎，饮愈。
一人腹胀时痛吐，小便利则大便不通，大便利则小便不通，用炒干姜三钱，升麻一钱五分，吴茱萸微炒五分，煎服愈。（原注：此寒邪痞塞于膀胱也。时吐者，寒迫火上也。）
一人患单腹胀将愈，因恼怒腹胀而痛，口干身热食减，膻中近右作痛，按之则止。用人参、干姜、炒半夏各七分，白术、茯苓、苍术各二钱，陈皮、神曲各五分，甘草、肉桂各二分，吴茱萸七厘，服之愈。
一人头面四肢浮肿，带黄色，行动脚软。此脾胃虚弱，只宜健脾固中气为主。用人参、白术、茯苓、陈皮、甘草，渐愈。
孙文垣治疗陈光禄松峦，常五更胸胁胀痛，遍治无效。诊之，右寸软弱，左平，两尺亦弱，曰：肺肾二经之不足也，补而敛之，可无恙矣。以补骨脂、萸肉、人参各三两，鹿角胶、鹿角霜各五两，杜仲、巴戟天、白茯苓、车前子各一两五钱，山药二两，鹿角胶酒化为丸，空心淡盐汤送下。又以御米壳去筋膜，蜜水炒三两，诃子面煨去核一两，陈皮一两半，炼蜜为丸，五更枕上白汤送下一钱，服一月病愈。
溧水县令吴涌澜夫人，每五更倒饱必泻一次，腹常作胀，间亦痛。脉之，两手寸关洪滑，两尺沉伏。曰：此肠胃中有食积痰饮也。乃与总管丸三钱，生姜汤送下，大便虽行，不甚快利。又以神授香连丸和之，外用滑石、甘草、木香、枳壳、山楂、陈皮、白芍、酒连，调理而安。
熊成八官，江右南昌人，早起行路，忽见邪火两团，滚滚而来，大惊骇，次日腹中膨懑，渐成胀满，面白皮薄，两手瘦削，两足皆有浮气，按之凹陷不起，（湿也。）行动气促，形神俱弱。医谓神弱气促，胸腹青筋缕缕如贯索，小水清长，形症如此，脾虚所致。以参苓白术散投之，十日堵然如鼓，中有一块，累然突出，坚若铁石，脐已平满，勺粒不入。医与决曰：若疾法在不治，盍早归，毋作异乡鬼也。孙脉之，沉弦有力，曰：非气虚中满之候，前补大骤，适助长耳。顾今霉雨途遥，（湿热病值湿热时。）即归，未能时刻可到，且治非良手，则大事去矣。予有一药，尚可冀生也，以琥珀调中丸，日二进之。一进甚甘，再进称快，十日腹渐宽，块渐熔，半月尽消去，青筋俱敛。改以平胃散加萝卜子、姜黄、薏仁、木香，调养一月，饮食大加，两足之浮亦愈。（利水消积法。）
喻嘉言治疗刘泰来，年三十二岁，面白体丰，夏月用冷水灌汗，坐卧当风，新秋病疟。三五发后，用药截住，遂觉胸腹胀满。不旬日外，腹大胸高，上气喘急，二便全无，食饮不入，能坐不能卧，能俯不能仰，势颇危急。医以二便不通，下之不应，商用大黄二两，作一剂。喻骇曰：此名何病，而敢放胆杀人耶？医曰：伤寒肠结，下而不通，惟有大下一法，何谓放胆？喻曰：世有不发热之伤寒乎？伤寒因发热，故津液枯槁，肠胃燥结，可用下药，以开其结，然有不转矢气者，不可攻之戒，正恐误治太阴经之腹胀也。此病因腹中之气散乱不收，故水液随气横溢成胀，全是太阴脾气不能统摄所致。一散一结，相去天渊，再用大黄猛剂，若不胀死，定须腹破矣。医唯唯辞去，病家仍欲服之，喻乃掷去其药，另与理中汤，畏不敢服，欲俟来日。喻曰：腹中真气渐散，今夜子丑二时，阴阳交剥之界，必大汗眩晕，难为力矣。不得已，令煎就以待，既而果发晕，即服下得睡片时，次日略觉减可。遂以三剂作一服，加人参至三钱，服后又进一大剂，少加黄连，胀已大减。谓大便未通不敢进
Huang Jinfang said: Edema (Edema) is a very complex disease, involving wind and water, including wind-dampness (Wind-Dampness), wind-phlegm (Wind-Phlegm), wind-heat (Wind-Heat), wind-toxin (Wind-Toxin), as well as water-dampness (Water-Dampness), water-qi (Water-Qi), damp-heat (Damp-Heat), food stagnation (Food Stagnation), and various deficiency syndromes with mixed patterns. However, it generally does not exceed the harm caused by water. Generally speaking, Yang constitutions (Yang Constitution) are prone to heat, and heat often indicates excess syndromes; Yin constitutions (Yin Constitution) are prone to cold, and cold often indicates deficiency syndromes. Conditions that first stagnate internally and then affect the exterior are mostly excess; conditions that first swell on the surface and then affect the interior are mostly deficiency. Red urine and constipation indicate excess; clear and profuse urination and loose stools indicate deficiency. A slippery pulse that is not distant indicates excess; a floating and fine pulse indicates deficiency. A ruddy and yellow complexion with normal voice indicates excess; a haggard complexion with short breath indicates deficiency. Youthful vigor with qi stagnation indicates excess; middle-aged decline with fatigue and qi deficiency indicates deficiency. If there is swelling without distension, the pathology lies in water, and qi is not firm. Drugs such as Zhi Shi (Immature Bitter Orange), Bing Lang (Areca Seed), Zhi Qiao (Aurantium Peel), Ding Xiang (Clove), Bai Kou (White Cardamom), Gu Zhi (Psoralea Fruit), and Chen Xiang (Agarwood), which rapidly move qi downward, should never be used lightly. Similarly, for鼓胀 (Tympanites) where the pathology lies in qi, all lifting and tonic drugs should also not be used lightly. A relative of mine suffered from edema. His six pulses were floating, soft, and full at the fingertips, with the right Cun position particularly prominent. Pressing the swollen area showed it floated up but did not rebound immediately, indicating water overflowing into the Lung. The medicines he had taken were all qi-breaking and blood-breaking agents; how could the disease heal? I treated him with light and mild herbs such as Lian Qiao (Forsythia Fruit), Zhi Zi (Gardenia Fruit), Fu Ling (Poria), Ze Xie (Alisma Rhizome), Niu Xi (Achyranthes Root), Hua Shi (Talcum), Ting Li Zi (Lepidium Seed), Mu Tong (Akebia Stem), Fang Feng (Saposhnikovia Root), and Cang Zhu (Atractylodes Rhizome). After a few doses, he recovered.
Ye Tianshi treated Chen Mou's swelling and distension with Shen Xiong Dao Shui Wan (Divine Celery Water-Guiding Pill). In two days, what was discharged were sticky, yellow, and turbid feces. The previous diagnosis was obstruction of fu-organ qi, sticky and stagnant water-dampness, with turbid pathogens attacking the Lung causing phlegm-cough, and water infiltrating the meridions causing edema. Generally, diseases of the meridians and fu-organs should always be treated with unblocking and promoting circulation. The *Neijing* states: "The fu-organs are tonified by unblocking." Modern physicians do not distinguish between zang-fu organs and meridians, insisting that Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Macrocephala Rhizome) are tonics. Is this truly understanding principles? However, for dampness in the limbs and feet, if there is no outlet, acupuncture must be used to drain the flow, hoping for relief both internally and externally. Wu Ji Wan (Wuji Pill) 3 qian was administered for two days, followed by one dose of the previous medicine.
Xu Lingtai said: Every sentence is a golden saying. For symptoms like abdominal fullness, there must be an outlet, so acupuncture is used concurrently. However, the principle is subtle; pricking blindly without understanding the rationale can cause great harm. He also said: Distension and fullness, even if accompanied by righteous qi deficiency, ultimately belong to pathogenic excess, which is why ancient masters were cautious about using tonic methods. Furthermore, distension always involves dampness; dampness generates heat, so the *Neijing* classifies it as a heat syndrome. If warm-tonic medicines are used, even with diuretics, the minister herbs cannot overcome the sovereign herbs, leading to many errors. He also said: Distension always involves tangible pathogens, so gentle purgation is appropriate.
Ye Tianshi treated Zhu Mou, who initially presented with facial swelling due to pathogens invading yang positions, causing qi stagnation and obstruction, resulting in scanty urination and defecation. Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root) were ineffective, so stagnation-resolving medicines were given. Stagnation refers to tangible substances, while damp-heat refers to intangible pathogens. When entering the Lung, it causes wheezing; when invading the Spleen, it causes distension. The opening and closing functions of the six fu-organs ceased, leading to unsatisfactory bowel movements and short, turbid urine, sometimes only dropping drops. The tongue was crimson with thirst. Fu-organ diseases manifest as back distension, while zang-organ diseases manifest as abdominal fullness. Additionally, the body leaned to one side, with swelling on left and right, worsening in specific areas. The damp-heat spread throughout the Sanjiao (Triple Burner), making it difficult for even skilled physicians to quickly resolve. The classics state: "For diseases descending from above, treat the upper part." And: "For diseases descending from above and worsening below, treat the upper part first, then the lower part." This case was chaotic and disordered, lacking clarity, due to failing to distinguish between tangible and intangible pathogens. Initially, focus was placed on clearing and purifying the Upper Jiao (Upper Burner): Fei Hua Shi (Precipitated Talcum) 0.5 qian, Da Xing Ren (Apricot Seed, peeled and tip removed) 10 grains, Sheng Yi Ren (Coix Seed) 3 qian, Bai Tong Cao (Stephania Stem) 1 qian, Xian Pi Pa Ye (Fresh Loquat Leaf, de-hairy) 3 qian, Fu Ling Pi (Poria Skin) 3 qian, Dan Dou Chi (Prepared Soybean) 0.5 qian, Hei Shan Zhi Ke (Gardenia Husk) 1 qian. Decocted rapidly with strong fire until reduced to 0.5 sheng and taken. These are medicines for the Hand-Taiyin Lung Meridian. When Lung qi is obstructed and fails to descend, the slightly bitter nature of Xing Ren enables descent; Hua Shi is sweet and cool, leaching out dampness and resolving heat; Yi Ren and Tong Cao are bland and leach qi-level dampness; Pi Pa Ye is acrid and cool, opening Lung qi; using Fu Ling skin is based on the idea that all skins are cool; Zhi and Dou Chi dissipate stale and stagnant accumulation. All these have thin flavors and act on the Upper Jiao, imitating Qi Zhicai's principle that "lightness can remove excess."
Xu Lingtai said: This prescription is very suitable for wheezing and distension, showing ingenious thinking. Such treatment methods are truly worthy of being recorded in medical cases.
A eunuch, nearing eighty years old, injured his Spleen through fatigue. Spleen deficiency led to Malaria (Malaria); after the malaria subsided, the Spleen-Stomach deficiency worsened, followed by swelling. At this time, diet and daily activities were still relatively normal, so Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should have been used with modifications to regulate Spleen-Stomach yuan qi. Instead, Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) was used to tonify the Kidney and promote water metabolism, expecting the swelling to subside naturally, which would have been the ideal treatment. Instead, he took Ze Xie (Alisma Rhizome), Zhu Ling (Polyporus), Chai Hu (Bupleurum Root), Ge Gen (Kudzu Root), Hou Po (Magnolia Bark), and Chen Pi (Citrus Peel) morning and night, refusing to change course. Two months later, his true qi was exhausted, swelling became severe, and he suffered from panting and insomnia for six days and nights. Another physician diagnosed it as a Lung disease and prescribed Su Zi (Perilla Seed), Jie Zi (Mustard Seed), Er Mu (Anemarrhena and Arisaema), and Er Dong (Asparagus and Ophiopogon roots). Ultimately, he died unable to take any food or drink. Wang Yutai said: Swelling of hands and feet does not necessarily mean water disease. Continuous use of qi-consuming and diuretic drugs leads to water disease. Zhao Yangkui said: Kidney deficiency failing to grasp qi and return it to its origin causes panting. Treating only the Lung is focusing on the branch and forgetting the root. What a pity!
Bianque Yu Hu Wan (Bianque Jade Pot Pill) treats Mingmen Fire Decline (Decline of Gate of Vitality Fire), sudden collapse of Yang qi, and cold-water tympanites, with miraculous effects. Eight liang of Liu Huang (Sulfur) is paired with eight liang of Zhen Ma You (True Sesame Oil). The sulfur is crushed and put into cold oil, stewed on a stove with mild charcoal fire, stirred slowly with mulberry branches. Once the sulfur dissolves, pour it into a large amount of water, quickly skim off the oil on the surface until the color is gold. Take the clean sulfur from the bottom of the vat, weigh it, and pair it with the corresponding amount of sesame oil, repeating the dissolution and pouring process until the color turns crimson. For the fifth cycle, add four liang of Soap Fruit (Fei Zao), boil in water for six hours. For the sixth cycle, add four liang of Toothed Soap Pod (Ya Zao), boil in water for six hours, then mix with the purified sulfur oil, removing the water until the color resembles the purple of burning sulfur. For the seventh cycle, use lye water from furnace ash to process for six hours. For the eighth cycle, use water tofu to process for six hours, removing the alkalinity of the soap. For the ninth cycle, use Tian Zi Cao (Field Character Herb - *Commelina communis*), found in abandoned rice fields, leaves shaped like characters, harvested in August and September. Crush and juice, boil with water for six hours. Grind into fine powder before use. One liang of purified sulfur is paired with two liang of fried glutinous rice flour, made into pills using water method or wet pounding. Each dose starts at 0.3 qian, gradually increasing to 1 qian, taken with boiled water.
Dou Cai once passed through a wild inn in Quzhou and saw a woman with whole-body edema sitting on the ground outdoors. Dou Cai asked, "Why not sit inside the door?" The woman replied, "Yesterday the Earth God told me that Bianque would pass by tomorrow, and I could seek treatment, so I waited here." Dou Cai said, "If you listen to me, I will save you." The woman said, "You are not a doctor, how can you cure illness?" Dou Cai said, "Although I am not a doctor, I have received the true transmission of Bianque and have a miraculous formula, which is why the Earth God warned you." He gave her ten pills of Bao Ming Yan Shou Dan (Life-Preserving Longevity Pill). That night, she urinated about two sheng, and felt hungry at dawn. She took fifteen more pills twice, moxa-ed the Ming Guan point on both sides for 200 moxibustion cones, and passed five or seven pieces of white pus in her stool. Half a month later, she was completely recovered. The woman said, "Truly Bianque reborn!"
Note: Dou Cai was a person from the Shaoxing era, author of *Bianque Xin Shu* (New Book of Bianque), which was presented to the court, along with a prayer to Heaven stating that his book was transmitted to save people and was not false. This case is the first in the book, hence its attribution to Bianque. Dou Cai served as a Patrol Officer.
A man suffered from swelling of all four limbs, shortness of breath, and abdominal distension after eating, consuming only thin porridge. He was instructed to take 100 pills of Jin Ye Dan (Golden Liquid Pill) daily. By the fourth day, his bowels moved smoothly. Two days later, he was allowed to eat wheat noodles without issue, because the treatment was early. Dou Cai’s treatments for diseases relied purely on strongly heating agents. For swelling caused by true Yang collapse, they achieve rapid results. If mistakenly used for damp-heat syndromes, they can cause disaster. Users must be cautious.
A woman suffered from swelling of the face and feet and reduced appetite. Contemporary physicians treated it as Blood Deficiency (Blood Deficiency) without effect. Dou Cai said, "It is not a blood disease, but Spleen-Stomach deficiency." He instructed her to take ten pills of Yan Shou Dan (Longevity Pill) and fifty pills of Quan Zhen Dan (Complete True Pill) daily. By the tenth day, her bowels moved smoothly, and she recovered.
Zhang Hezi treated Zhang Xiaoyi, who initially had scabies and scratching, which transformed into swelling, wheezing, and inability to eat. Zhang diagnosed it as Feng Shui (Wind-Water), where water swells violently upon contact with wind, causing whole-body swelling. First, he had him bathe. While the pores were open, in a warm room, he induced vomiting using a sour and bitter preparation with one Quan Xie (Scorpion). Gradually administering powder medicine up to 3 qian, several sheng of phlegm were vomited, sweat poured out, and 80-90% of the swelling subsided. One day later, just before midnight, he administered over 70 pills of Shen You Wan (Divine Protection Pill) three times. By midnight, the bowels moved once. Then, 60 pills of Shui Zhu Tao Ren Wan (Water-Boiled Peach Kernel Pill) were administered with Musket (She Xiang) soup, resulting in three or four bowel movements. Two or three days later, Zhou Che Wan (Boat Cart Pill), Tong Jing San (Meridian-Unblocking Powder), and Bai Zhu San (Atractylodes Powder) were used to regulate and cure the condition.
Zhang Ziming’s mother was very obese and accidentally developed edema, rendering her limbs immobile. Zhang induced sweating and purging, removing three or four dou of water. When the medicine was first administered, she lay with her legs elevated on grass-filled cloth bags. As the medicine worked, she felt water flowing down from above the waist and up from the feet. The movement of water resembled a snake slithering or a thread pulling, with limbs feeling cold. The water converged below the navel and exited. Within ten days, the illness greatly decreased, but residual pathogens remained. Zhang wanted to continue medication, but she refused to follow his advice.
Zhang Chengying, nearly fifty years old, had an abdomen like a pregnant woman, sallow complexion, and reduced appetite, suggesting water qi. Someone advised Huang Qi Jian Zhong Tang (Astragalus Center-Supplementing Decoction) and other warming tonics, leading to complete urinary retention. Zhang said, "Jian Zhong Tang is a surface-releasing medicine. Using it to attack the interior in ancient formulas was already a mistake; using it now to remove accumulation is a double error." First, he induced vomiting with a emetic agent and caused heavy sweating near a fire. Then, he gave Si Zhu San (Pig Kidney Powder) 4 qian, guided by Zhou Che Wan, resulting in the discharge of six fan of fluid. There was no exhaustion. After two more purgations, totaling over thirty movements, the abdomen softened, and appetite returned to normal. Chang Zhongming said, "I heard people say that discharging five or six fan of fluid is unbearable. When I asked Zhang Chengying, he confirmed it. Thus, nourishing health and attacking pathogens are fundamentally different. Today, people use tonics to treat diseases, so of course they are ineffective." (This aligns with the discussion on Ge Mou. Danyang strongly disagreed, claiming Zhang Hezi’s book was not handwritten but authored by Ma Zhiji et al.)
Song Huizhi, a famous physician of the Yuan Dynasty, treated water-gu (abdominal swelling due to parasites) using one old loofah fruit, peeled and seeded, chopped, and stir-fried with fourteen Ba Dou (Croton Seeds) until the croton seeds turned brown. Remove the croton seeds and keep the loofah. Stir-fry the same amount of yellow millet with the loofah until the millet turns brown. Remove the loofah and grind the millet into powder. Mix with clear water to make pills the size of sophora seeds. Take 100 pills with warm water. The gu water exits entirely through the bowels, curing the disease. He stated: "Ba Dou expels water, but we fear its speed. We borrow the qi of the loofah; its fibers resemble human meridians, guiding the qi of Ba Dou to reach all meridians. We use millet to support stomach qi. We remove the loofah because we fear it absorbs too much of Ba Dou's qi." Xianyu Shu recorded this.
An Emei monk treated a man with abdominal and limb swelling using one sheng of dried Ji Shi (Chicken Droppings), stir-fried until yellow, boiled in three bowls of wine lees until reduced to one bowl. Strain and drink. It is named Qian Niu Jiu (Morning Glory Wine). Soon, qi moved vigorously in the abdomen, leading to diarrhea, and the wrinkled skin on the feet resolved. If not fully cured, repeat the next day. Also consume two Tian Lei (Field Snails) boiled in hot wine with white porridge to regulate and cure. The patient brought Morning Glory seeds to thank him, hence the name of the formula. (*Bencao Gangmu*).
The wife of Scholar Wei suffered from a large, drum-like abdomen, with limbs so emaciated they could not touch the bed, forced to sleep suspended in clothes and blankets, unable to eat grain for several days. Suddenly craving quail, she ate it according to proper methods, then fainted severely, sweated profusely, could not speak, and felt the urge to defecate/urinate. Upon being helped to the toilet, white fluid resembling goose fat erupted from the urine. After several such episodes, she recovered. This was caused by long-standing damp-heat accumulation in the Middle Jiao. (*Dong Bing Ji Yan Fang*).
Zhang Luyu treated Wang Yongruo with edema, vomiting, and complete urinary and fecal retention. Wuling San (Five-Ling Powder) and Ba Zheng San (Eight-Righteous Powder) were ineffective. The six pulses were deep and fine as threads. He administered fifteen pills of Jin Ye Dan (Golden Liquid Pill). Urine flowed like a spring, and the condition stabilized. Later, Ji Sheng Shen Qi Wan (Jisheng Kidney Qi Pill) was used to nurture and recover.
Li Shizhen treated the wife of a man with swelling below the waist and on the face, severe wheezing threatening death, inability to lie flat, loose stools, and scanty urine. Medicines were ineffective. Her pulse was deep and large; deep indicates water, large indicates deficiency. This was caused by catching wind after illness, named Feng Shui (Wind-Water). Shen Mi Tang (Divine Mystery Decoction) from *Qianjin* with added Ma Huang (Ephedra) was given. After one dose, wheezing improved by half. Then, Wei Ling Tang (Stomach-Calm Decoction) was used to swallow Shen Shi Ru Zhu Wan (Shenshi Artemisia-Atractylodes Pill). In two days, urination increased, and swelling reduced by 70%. After a few days of regulation, she fully recovered. (*Bencao Gangmu*).
Yu Dongfu said: Jin Ye Dan and Shen Mi Tang are rarely used by people, but when used skillfully, each achieves miraculous results. Ancient formulas exist in books; the problem is finding the correct match. Shen Mi Tang is Sheng Mai San (Generate the Pulse Powder) combined with Er Chen Tang (Two-Chen Decoction), removing Mai Dong (Ophiopogon) and Fu Ling (Poria), adding Zi Su (Perilla Leaf), Sang Bai Pi (Mulberry Root Bark), Jie Geng (Platycodon Root), Bing Lang (Areca Seed), and three slices of Sheng Jiang (Fresh Ginger) as a guide. It fits this syndrome perfectly; adding Ma Huang is even better. It is not a standard "eight-inch-three" hat.
Zhu Sheng, friend of Qiu Rucheng, suffered from alcohol accumulation, presenting with whole-body yellow swelling. No one could cure him. Qiu examined him and said, "Curable." He took seven red pills from his pouch, swallowed them with wine. Soon, vessels filled with yellow water, and the abdomen reduced by half. After taking five more pills, he recovered. (*Hui Chen Xin Tan*).
Chen San Nong treated a man with abdominal distension and fullness. After taking Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Jun Zi Tang (Six-Gentlemen Decoction), the distension reduced by 70-80%. Mistakenly taking Xing Ji Wan (Move Accumulation Pill), he suffered reduced appetite and severe distension with a fine and rapid pulse. Bu Zhong Yi Qi Tang was modified with Gan Jiang (Dried Ginger) and Rou Gui (Cinnamon Bark) 0.5 fen each, Fu Zi (Aconite Root) 0.7 fen, and Wu Zhu Yu (Evodia Fruit) 0.1 fen, decocted in ginger water. He recovered after drinking it.
A man suffered from intermittent abdominal pain and vomiting. When urination was smooth, defecation was blocked; when defecation was smooth, urination was blocked. Chao Gan Jiang (Fried Dried Ginger) 3 qian, Sheng Ma (Cimicifuga Rhizome) 1.5 fen, and Wu Zhu Yu (Evodia Fruit) 0.5 fen (lightly fried) were decocted and taken. He recovered. (Original note: This is Cold Pathogen blocking the Bladder. Intermittent vomiting is due to cold forcing fire upward.)
A man suffering from isolated abdominal distension was nearly cured when anger caused abdominal pain, dry mouth, fever, reduced appetite, and pain near the right Shanzhong (Conception Vessel 17), relieved by pressure. Ren Shen (Ginseng Root), Gan Jiang (Dried Ginger), and Chao Ban Xia (Fried Pinellia) 0.7 fen each; Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria), and Cang Zhu (Atractylodes Rhizome) 2 qian each; Chen Pi (Citrus Peel) and Shen Qu (Medicated Leaven) 0.5 fen each; Gan Cao (Licorice Root) and Rou Gui (Cinnamon Bark) 0.2 fen each; Wu Zhu Yu (Evodia Fruit) 0.07 li. He recovered after taking it.
A man had swelling of the head, face, and limbs with a yellowish tint and weak legs when walking. This is Spleen-Stomach weakness; the main treatment should be strengthening the Spleen and consolidating Middle Qi. Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria), Chen Pi (Citrus Peel), and Gan Cao (Licorice Root) were used. He gradually recovered.
Sun Wen Yuan treated Chen Guanglu Songluan, who often experienced chest and hypochondriac pain and distension at dawn. Various treatments failed. Diagnosis: Right Cun was weak, Left was level, both Chi were weak. Sun said, "Deficiency of the Lung and Kidney meridians. Tonify and astringe, and you will be safe." Bu Gu Zhi (Psoralea Fruit), Yu Rou (Cornus Fruit), and Ren Shen (Ginseng Root) 3 liang each; Lu Jiao Jiao (Deer Antler Glue) and Lu Jiao Shuang (Deer Antler Frost) 5 liang each; Du Zhong (Eucommia Bark), Ba Ji Tian (Morinda Root), Bai Fu Ling (Poria), and Che Qian Zi (Plantago Seed) 1.5 liang each; Shan Yao (Dioscorea Rhizome) 2 liang. Lu Jiao Jiao was melted with wine to make pills, taken on an empty stomach with light salt water. Also, Yu Mi Gu (Poppy Shell) de-filmed, stir-fried with honey water 3 liang; He Zi (Chebula Fruit) baked in flour, pitted 1 liang; Chen Pi (Citrus Peel) 1.5 liang. Made into pills with refined honey. Take 1 qian with white water at dawn on the pillow. After one month, the illness healed.
Madam Wu Yonglan, magistrate of Lishui, always had one episode of diarrhea after overeating at dawn, with frequent abdominal distension and occasional pain. Pulses: Cun and Guan on both hands were surging and slippery; Chi on both hands were deep and hidden. Sun said, "There is food stagnation and phlegm-fluid in the intestines and stomach." Zong Guan Wan (Chief Commander Pill) 3 qian was given with ginger water. Bowels moved but not smoothly. Shen Shou Xiang Lian Wan (Divine Transmission Fragrant-Berberine Pill) was added. Externally, Hua Shi (Talcum), Gan Cao (Licorice Root), Mu Xiang (Aucklandia Root), Zhi Qiao (Aurantium Peel), Shan Zha (Hawthorn Fruit), Chen Pi (Citrus Peel), Bai Shao (White Peony Root), and Jiu Lian (Wine-processed Coptis) were used for regulation. She recovered.
Official Xiong Chengba, from Nanchang, Jiangxi, suddenly saw two balls of evil fire rolling towards him while walking early in the morning, causing great fright. The next day, his abdomen bloated and gradually became distended. Complexion was pale with thin skin, hands emaciated, feet had edema that did not rebound when pressed (dampness), shortness of breath when moving, and weak form and spirit. Physicians said that weak spirit and shortness of breath, with blue veins on chest and abdomen like ropes, clear and long urination, and these symptoms, indicated Spleen deficiency. Can Ling Bai Zhu San (Canling Atractylodes Powder) was administered. Ten days later, the abdomen was hard as a drum, with a lump protruding, hard as iron, navel flat and full, unable to ingest even a spoonful. The physician declared the disease incurable and advised him to return home soon to avoid dying as a foreign ghost. Sun palpated the pulse: deep, wiry, and forceful. He said, "This is not a sign of qi deficiency and middle-fullness. Previous aggressive tonification only aided the pathogen. Given the rainy season and long journey, returning home is impossible, and poor treatment would lead to death. I have a medicine that offers hope." Hu Po Tiao Zhong Wan (Amber Regulating-Middle Pill) was administered twice daily. The first dose felt pleasant, the second felt relieving. After ten days, the abdomen widened, the lump softened. Half a month later, it disappeared completely, and blue veins retracted. Modified to Ping Wei San (Peace the Stomach Powder) with Luo Bo Zi (Radish Seed), Jiang Huang (Turmeric), Yi Ren (Coix Seed), and Mu Xiang (Aucklandia Root) for one month of regulation. Appetite greatly increased, and foot edema resolved. (Method of draining water and eliminating accumulation.)
Yu Jiayan treated Liu Tailai, 32 years old, pale and plump. In summer, he used cold water to wash away sweat, sat and slept facing the wind, and contracted Malaria in early autumn. After three or five attacks, medication stopped the malaria, leading to chest and abdominal distension. Within ten days, abdomen enlarged, chest high, upper body wheezing and urgent, no urination or defecation, unable to eat or drink, able to sit but not lie down, able to bend forward but not backward, critical condition. Physicians, seeing no urination or defecation, attempted purgation without success. A merchant proposed two liang of Da Huang (Rhubarb) as one dose. Yu was horrified, asking, "What is this disease, and how dare you kill boldly?" The physician said, "Typhoid intestinal binding, purgation fails, only strong purgation works. How is this bold?" Yu said, "Is there typhoid without fever? Typhoid causes fever, drying fluids and causing dry intestinal binding, allowing purgatives to open blockage. However, the warning against attacking those who do not pass gas applies, fearing misdiagnosis of Taiyin abdominal distension. This disease is due to scattered and unrestrained qi in the abdomen, causing water to overflow horizontally and form distension, entirely due to Taiyin Spleen qi failing to control. Scattered vs. Bound, a world apart. Using strong Da Huang would cause death by bursting abdomen if not by distension." The physician agreed and left. The family still wanted to administer it. Yu threw away the medicine and prescribed Li Zhong Tang (Regulate the Middle Decoction). They feared taking it and wanted to wait until the next day. Yu said, "True qi in the abdomen is dispersing. Tonight, during the Zi and Chou hours (boundary of yin-yang exchange), there will be heavy sweating and dizziness, beyond help." Reluctantly, he ordered decoction to wait. Indeed, dizziness occurred. Taking it allowed brief sleep. Next day, slight improvement. Three doses were combined into one, with Ren Shen (Ginseng Root) increased to 3 qian. After taking another large dose with a little Huang Lian (Coptis Rhizome), distension greatly reduced. He stated that since bowels were not open, he dared not proceed...