治里水脉沉，面目黄肿，小便不利。
甘草（二两炙） 麻黄（四两） 水五升，先煮麻黄，去上沫，纳甘草，煮取三升，温
服一升。
治里水脉沉小者，属少阴也。
麻黄（三两去节） 甘草（二两炙） 附子（一枚炮） 水七升，先煮麻黄一二沸，去
上沫，纳诸药，煮取三升，去滓，温服一升，日三服。
甘草麻黄（汤）治里水，水从汗解斯方美。（《金匮要略·水气病篇》云∶“水病发其汗
即已。”）脉沉小者属少阴，温固必须加附子。（名麻黄附子汤）麻得甘草缓中焦，汗不伤阴
厥有旨。（王晋三《古方选注》曰∶“甘草缓麻黄于中焦，取水谷之津为汗，则内不伤阴，
邪从表散。”深得厥旨。）水之为病殊多端，表里阴阳非一致。腰以上肿当发汗，腰以下肿
当分利。单单腹胀最难医，青筋突起无生理。（旭高按∶前一方用甘草，内助土气，后一方
用熟附，温固肾液，而外散水气，则皆君以麻黄。盖麻黄气味轻清，无微不入，故能透出肌
肤毛孔之外，又能深入积痰凝血之中，凡药力所不到之处，惟此能达之，故不特在表之风水
可用，而在里在肾之水，咸可用之也。《金匮要略·水气病篇》云∶“水病发其汗即已。”而
发汗之法，又各有浅深不同如此，可谓简而该矣。然又云∶“诸有水者，腰以下肿，当利小
便，腰以上肿，当发汗乃愈。”可见水病利小便一法，原不可缺，但以腰上半为阳，及一身
悉肿者为表，当发汗耳。若单腹胀青筋突起，为土败木贼之候，难治。）
治疗里水证，表现为脉象沉，面目浮肿发黄，小便不通畅。
甘草（二两，炙用） 麻黄（四两） 用水五升，先煮麻黄，去掉水面上的浮沫，加入甘草，再煮取三升药液，分次温服一升。
治疗里水证，脉象沉而细小的，属于少阴病。
麻黄（三两，去节） 甘草（二两，炙用） 附子（一枚，炮制） 用水七升，先煮麻黄一二沸，去掉水面上的浮沫，加入其余药物，煮取三升药液，滤去药渣，温服一升，每日服用三次。
甘草麻黄汤治疗里水，通过发汗使水邪从体表解除，此方效果极佳。（《金匮要略·水气病篇》记载：“水病通过发汗即可痊愈。”）脉象沉小属于少阴病，必须加入附子以温阳固本。（此方名为麻黄附子汤）。麻黄配合甘草可缓和其中焦作用，使得发汗而不损伤阴液，这其中有深意。（王晋三在《古方选注》中说：“甘草在中焦缓和麻黄的峻烈之性，利用水谷的精微津液化为汗，这样内部不损伤阴液，邪气从体表发散。”深刻领悟了其中的旨意。）水湿致病的情况多种多样，表里阴阳并非一致。腰部以上浮肿应当采用发汗法，腰部以下浮肿应当采用利尿法。单纯腹部胀大最难医治，若见青筋突起则无生机。（旭高按语：前一方使用甘草，内在辅助脾土之气；后一方使用熟附子，温固肾中精气，并外散水气，这两方都以麻黄为主药。因为麻黄气味轻清，无处不到，所以能透出肌肤毛孔之外，又能深入积痰凝血之中，凡是其他药力所不能到达的地方，只有它能到达，所以不仅表证的风水可用，而在里、在肾的水肿也都可用。《金匮要略·水气病篇》说：“水病通过发汗即可痊愈。”但发汗的方法，又有深浅不同如此，可谓简洁而完备。然而又说：“所有水肿患者，腰部以下浮肿，应当利小便；腰部以上浮肿，应当发汗才能痊愈。”可见治疗水病利小便这一方法，原本是不可缺少的，只是如果腰上半身为阳，以及全身都浮肿的属于表证，才应当发汗罢了。如果是单纯腹胀且青筋突起，这是脾土败坏、肝木乘克的征候，难以治疗。）
Treats *Li Shui* (Interior Water Retention) characterized by a deep pulse, yellowish edema of the face and eyes, and difficult urination.
Gancao (Licorice Root, two liang, honey-fried), Mahuang (Ephedrae Herba, four liang). Add five sheng of water. First boil Mahuang, remove the foam on the surface, then add Gancao. Boil until three sheng remain. Take one sheng warm.
Treats *Li Shui* with a deep and thin pulse, which belongs to *Shao Yin* (Lesser-Yin) syndrome.
Mahuang (Ephedrae Herba, three liang, nodes removed), Gancao (Licorice Root, two liang, honey-fried), Fuzi (Aconiti Lateralis Radix Praeparata, one piece, processed). Add seven sheng of water. First boil Mahuang for one or two boils, remove the foam on the surface, then add all other herbs. Boil until three sheng remain, strain, and take one sheng warm. Administer three times daily.
Gancao Mahuang Tang (Licorice and Ephedra Decoction) treats *Li Shui*; allowing water to resolve through sweating makes this formula excellent. (*Jingui Yaolue · Water Qi Disease Chapter* states: "Water disease is cured by inducing sweating.") A deep and thin pulse indicates *Shao Yin* syndrome; warming and consolidating requires the addition of Fuzi. (This formula is named Mahuang Fuzi Tang.) Mahuang combined with Gancao moderates the middle jiao, ensuring that sweating does not damage yin fluids, which holds profound significance. (Wang Jinsan in *Gu Fang Xuan Zhu* stated: "Gancao moderates Mahuang in the middle jiao, utilizing the essence and fluids from food and drink to transform into sweat, thereby internally protecting yin fluids while dispersing pathogenic factors from the exterior." This deeply grasps the underlying principle.) The manifestations of water diseases are numerous and varied; the interior and exterior, yin and yang are not uniform. Edema above the waist should be treated by inducing sweating; edema below the waist should be treated by promoting diuresis. Simple abdominal distension is the most difficult to treat; if green veins protrude, there is no hope for survival. (Xu Gao's note: The former formula uses Gancao to internally assist the qi of Earth (Spleen); the latter formula uses prepared Fuzi to warm and consolidate Kidney essence while externally dispersing water qi. Both formulas use Mahuang as the sovereign herb. Because Mahuang has a light and clear aroma and penetrates everywhere, it can emerge from the skin pores and also penetrate deeply into accumulated phlegm and coagulated blood. Wherever other medicinal powers cannot reach, only Mahuang can arrive. Therefore, it is not only applicable to wind-water at the exterior but also to water retention in the interior and the Kidneys. *Jingui Yaolue · Water Qi Disease Chapter* states: "Water disease is cured by inducing sweating." However, methods of inducing sweating vary in depth and superficiality, which can be described as concise and comprehensive. Yet it also states: "For all water patients, if edema is below the waist, promote urination; if edema is above the waist, induce sweating for recovery." This shows that the method of promoting urination for water disease is originally indispensable. It is only when the upper half of the body represents Yang, or when the whole body is swollen indicating an exterior pattern, that inducing sweating is appropriate. If there is simple abdominal distension with protruding green veins, this is a sign of failing Earth (Spleen) and attacking Wood (Liver), which is difficult to treat.)