黄帝问于岐伯曰∶水与肤胀、鼓胀、肠覃、石瘕、石水,何以别之?岐伯曰∶水之起也,
目窠上微肿,如新卧起之状,颈脉动,时咳,阴股间寒,足胫肿,腹乃大,其水已成也,以
手按其腹,随手而起,如裹水之状;肤胀者,寒气客于皮肤之间,彭彭然不坚,腹大,身尽
肿,皮浓,按其腹,腹陷而不起,腹色不变;鼓胀者,腹身皆肿大,大与肤胀拟也,其色苍
黄,腹脉起;肠覃者,寒气客于少腹,外与卫气相搏,气不得营,因有所系,瘦而内着,恶
气乃起,息肉乃生,始也大如鸡卵,稍以益大,至其成也,若怀子之状,久者离岁月,按之
则坚,推之则移,月事时下;石瘕者,生于胞中,寒气客于子门,子门闭塞,气不得通,
恶血当泻不泻,血不留止,日以益大,状如怀子,月事不以时下,皆生于女子,可导而下。
(《医心方》卷十)
治水肿方。
黄犍牛尿一饮三升,若不觉,更加服之,以得下为度,治老小者宁从少起,饮半,亦可
用后方。(《外台》卷二十)
又方
猪肾一枚,分为七脔,甘遂一分,末筛为散,以粉肾,微火炙令熟,食之,至三、四脔,
乃可止,当觉腹中鸣,转攻两胁下,小便利,去水即愈。若三、四脔不觉,可食七脔令尽。
(《外台》卷二十)
治大水肿,腹如鼓,坚如石方。
葶苈(一升,熬) 椒目(一升) 芒硝(六两) 水银(十二两)
上四味,以水煮练水银三日三夜,数益水,要当令黄白以合,捣药六万杵,自令相合如
梧子,先食服一丸,日三。日增一丸至十丸,不知,更从一丸始,病当从小便利,当饮好牛、
羊
二十)
周大候正大将军平公于礼患气兼水,身面肿,垂死,长寿公姚僧垣处二方,应手即瘥,
先服汤方。
桑根白皮(四两) 橘皮(二两) 海藻(三两,洗去咸) 茯苓 郁李仁(碎,各四
两) 赤小豆
上六味,切,以水八升,煮取二升半,分三服,甚效。《古今录验》治气水身肿胀满。
姚大夫治燕公雍州录事于志光送云∶从来知不能服汤,事较急,勿不努力服之。服此汤若微
觉为益,频服三、两剂,勿不服。此药甚易,必无逆忤,如不能服,可服后丸,丸迟不应急
耳。
又方
橘皮(五分) 郁李仁(十分) 茯苓(八分) 葶苈(六分,熬) 防己 桑根白皮
(各五分)
上八味,捣下筛,蜜和丸,取 白皮火炙焦黄煮饮,服十丸如梧子,日再服,若不得宣
通,稍稍加,常以宣为度。渴者饮此方。老蒋公处与张大夫家效。忌酢物。(《外台》卷二十)
治但两足肿者方。
锉葱叶煮令烂以渍之,日三、四度,良也。(《外台》卷二十)
治膀胱石水,四肢瘦,腹肿方。
大豆(五升) 防己(四两) 桑根白皮(切,三升) 白术(四两) 泽漆叶(切,
三升) 射干(
上七味,切,以水一斗半,煮取六升,去滓,内好酒三升,更煎取五升,分五服,日再
夜一。余煎明日服之。(《外台》卷二十)
治石水,痛引胁下胀,头眩痛,身尽热,灸法。
灸关元。(《外台》卷二十)
又灸石水法。
灸章门、然谷。(《外台》卷二十)
治暴患遍身肿满方。
大豆
上一味,捣筛为散,粥清服三方寸匕,日再,甚良验。(《外台》卷二十)
治身体暴肿如吹方。
巴豆(三十枚,合皮 咀)
上一味,以水五升,煮取三升,绵内汁中以拭肿上,随手减矣,日五、六拭,勿近目及
阴。(《外台》卷二十)
治男女心上胀满,胸背痛,食进少,面微似肿,小便如涩方。
杏仁(八分,熬) 橘皮(五分) 苏子(三合) 防己(五分) 葶苈(六分熬) 茯
苓(八分)
上六味,捣筛,蜜和为丸,如小豆,细切桑根白皮煮为饮,用服此丸,初服十丸,日
再,渐加至三十丸。(《外台》卷二十)
治水腹大脐平者法。
灸脐中,腹无文理者不可治。(《外台》卷二十)
治水腹胀皮肿法。
灸三里,风水灸解溪。(《外台》卷二十)
黄帝向岐伯问道:水肿、肤胀、鼓胀、肠覃、石瘕和石水,这几种病证如何区分?岐伯回答说:水肿的发生,眼睑下方微微肿胀,像刚睡醒的样子,颈部人迎脉搏动,时常咳嗽,大腿内侧发冷,小腿浮肿,腹部随之增大,这是水气已经形成的表现。用手按压腹部,随手抬起,就像包裹着水的状态;肤胀这种病,寒气停留在皮肤之间,腹部膨隆但不坚硬,腹部肿大,全身都肿,皮肤增厚,按压腹部时凹陷不起,腹部颜色没有变化;鼓胀这种病,腹部和身体都肿大,大小与肤胀相似,但肤色苍黄,腹部的脉络显露;肠覃这种病,寒气停留在小腹部,与卫气相互搏结,气机不能正常运行,因而有所羁绊,邪气附着在内,恶气由此产生,息肉于是生成,起初像鸡蛋那么大,逐渐增大,等到形成时,就像怀孕的样子,病程长的可达数年,按压它则坚硬,推动它则移动,月经仍然按时来潮;石瘕这种病,生长在子宫中,寒气停留在子门(子宫口),子门闭塞,气机不能通畅,恶血应当排出却排不出,血液滞留不去,每天逐渐增大,形状像怀孕,月经不能按时来潮,这些病都发生在女子身上,可以用导引通下的方法治疗。(出自《医心方》卷十)
治疗水肿的方剂。
用一头黄色公牛的尿液三升,如果喝了之后没有感觉,可以再服用,以能够排泄水湿为限度。治疗老人和小孩时,应从少量开始,喝半量也可以,或者使用后面的方剂。(出自《外台秘要》卷二十)
另一个方子
取猪肾一枚,切成七块,甘遂一分,研末过筛成散剂,用来涂抹在猪肾上,用微火烤熟后食用,吃到三到四块时就可以停止,此时应当感觉到腹中鸣响,气攻冲两胁下,小便通利,水湿去除即痊愈。如果吃了三到四块没有感觉,可以吃完七块。(出自《外台秘要》卷二十)
治疗严重水肿,腹部像鼓一样,坚硬如石的方剂。
葶苈子(一升,炒制)、椒目(一升)、芒硝(六两)、水银(十二两)。
以上四味药,用水煮炼水银三天三夜,多次加水,务必使水银呈现黄白色并与其他药物融合,将药捣碎六万次,使其自然结合成梧桐子大小的丸剂。饭前服用一丸,每日三次。每天增加一丸,直到十丸为止。如果无效,再从头从一丸开始服用。病情应当通过小便通利而好转,应饮用优质的牛、羊奶辅助。(注:原文此处有缺漏,根据语境补全逻辑,实际古籍中常配合乳饮或特定饮食,此处依原文断句处理)
周朝的大候正大将军平公于礼患有气滞兼水饮的病,身体面部浮肿,生命垂危。长寿公姚僧垣给了他两个方子,他立即见效,先服用了汤剂。
桑根白皮(四两)、橘皮(二两)、海藻(三两,洗去咸味)、茯苓、郁李仁(捣碎,各四两)、赤小豆。
以上六味药,切碎,用水八升,煮取二升半,分三次服用,效果很好。《古今录验》记载此方治疗气水导致的身面肿胀满闷。
姚大夫转述燕公雍州录事于志光的话说:“我一直知道不能服用汤药,但事情比较紧急,请务必努力服用。服用这个汤剂如果稍微觉得舒服有益,就频繁服用两三剂,不要不服用。这个药很容易接受,必定不会有不良反应。如果不能服用汤药,可以服用后面的丸药,只是丸药起效慢一些罢了。”
另一个方子
橘皮(五分)、郁李仁(十分)、茯苓(八分)、葶苈子(六分,炒制)、防己、桑根白皮(各五分)。
以上八味药,捣碎过筛,用蜂蜜调和做成丸剂。用桑根白皮火炙焦黄后煮水送服,每次服用十丸,如梧桐子大小,每日两次。如果感觉气机不通畅,逐渐增加剂量,始终以通畅为度。口渴的人可以饮用此方。老蒋公在张大夫家验证有效。忌食醋类食物。(出自《外台秘要》卷二十)
治疗仅双脚浮肿的方剂。
切碎的葱叶煮烂,用来浸泡双脚,每天三四次,效果良好。(出自《外台秘要》卷二十)
治疗膀胱石水,四肢消瘦,腹部浮肿的方剂。
大豆(五升)、防己(四两)、桑根白皮(切碎,三升)、白术(四两)、泽漆叶(切碎,三升)、射干。
以上七味药,切碎,用水一斗半,煮取六升,去掉药渣,加入好酒三升,再煎取五升,分五次服用,白天三次,晚上一次。剩下的药液第二天服用。(出自《外台秘要》卷二十)
治疗石水,疼痛牵引胁下胀满,头晕头痛,全身发热,采用灸法治疗。
灸关元穴。(出自《外台秘要》卷二十)
又一种治疗石水的方法。
灸章门穴、然谷穴。(出自《外台秘要》卷二十)
治疗突然患病全身肿胀满闷的方剂。
大豆。
以上一味药,捣碎过筛成散剂,用米汤送服三方寸匕,每日两次,效果非常好。(出自《外台秘要》卷二十)
治疗身体突然肿胀像被吹起来一样的方剂。
巴豆(三十枚,带皮切碎)。
以上一味药,用水五升,煮取三升,用棉布浸取汁液擦拭肿胀部位,肿胀随即消退,每天擦拭五六次,注意不要接近眼睛和阴部。(出自《外台秘要》卷二十)
治疗男女心中胀满,胸背痛,进食少,面部轻微似肿,小便涩滞的方剂。
杏仁(八分,炒制)、橘皮(五分)、苏子(三合)、防己(五分)、葶苈子(六分,炒制)、茯苓(八分)。
以上六味药,捣碎过筛,用蜂蜜调和做成丸剂,如小豆大小。细切桑根白皮煮水作为饮液,用来送服此丸,初次服用十丸,每日两次,逐渐增加到三十丸。(出自《外台秘要》卷二十)
Huangdi asked Qibo: How can one distinguish between edema (Shuizhong), skin distension (Fuzhang), drum distension (Guzhang), intestinal polyps (Changqin), stone fibroma (Shijia), and stone water (Shishui)? Qibo replied: The onset of edema is characterized by slight swelling under the eyes, resembling the appearance after just waking up. There is pulsation in the neck vessels, occasional coughing, coldness between the thighs, swelling of the calves, and subsequent abdominal enlargement, indicating that water retention has formed. Pressing the abdomen with the hand causes it to rise immediately, resembling a bag filled with water.
Skin distension (Fuzhang) occurs when cold qi lodges between the skin. The abdomen is bloated but not hard, the abdomen is large, the whole body is swollen, the skin is thickened, and pressing the abdomen leaves an indentation that does not rise immediately, with no change in abdominal color.
Drum distension (Guzhang) involves swelling of both the abdomen and the body, similar in size to skin distension, but the complexion is pale yellow, and the abdominal veins are prominent.
Intestinal polyps (Changqin) arise when cold qi lodges in the lower abdomen and contends with defensive qi (Weiqi). Qi fails to circulate properly, becoming bound and adhering internally. Evil qi arises, and polyps form. Initially, they are as large as a chicken egg, gradually increasing in size until they resemble pregnancy. Long-standing cases may last for years. They are firm to pressure but movable upon pushing, and menstruation continues regularly.
Stone fibroma (Shijia) originates in the uterus (Baogong). Cold qi lodges at the uterine gate (Zimen), causing closure. Qi cannot flow freely, and evil blood should be discharged but is retained, accumulating daily and enlarging the abdomen to resemble pregnancy. Menstruation becomes irregular. These conditions occur only in women and can be treated by guiding and purging downward. (From *Yixin Fang*, Vol. 10)
Formula for treating edema.
Take three sheng of urine from a young yellow ox. If there is no effect, administer more. The treatment is considered effective when water is discharged. For the elderly and children, start with a smaller dose, drinking half, or use the following formula. (From *Waitai Miyao*, Vol. 20)
Another formula.
Take one pig kidney, cut into seven pieces. Take one fen of Kansui Root (Gansui), grind into powder, and sift. Use this powder to coat the kidney pieces. Roast them over a mild fire until cooked, then eat them. Stop after consuming three to four pieces. One should feel rumbling in the abdomen, with qi attacking the hypochondrium, and urination becoming clear; the water will be expelled and the patient cured. If there is no effect after three or four pieces, consume all seven. (From *Waitai Miyao*, Vol. 20)
Formula for treating severe edema where the abdomen is drum-like and hard as stone.
Lepidium Seed (Tinglizi, 1 sheng, roasted), Zanthoxylum Seed (Jiaomu, 1 sheng), Mirabilite (Mangxiao, 6 liang), Mercury (Shuiyin, 12 liang).
Boil the mercury in water for three days and nights, adding water frequently, until it turns yellowish-white and combines with the other ingredients. Pound the mixture sixty thousand times until it forms pills the size of wutong seeds. Take one pill before meals, three times a day. Increase the dose by one pill daily up to ten pills. If ineffective, restart from one pill. The disease should improve through increased urination. Drink high-quality cow or sheep milk. (Note: Text fragmentary here)
Yu Li, General of the Great Houzheng during the Zhou Dynasty, suffered from qi stagnation combined with water retention, presenting with facial and bodily swelling, near death. Yao Sengyuan, Duke of Changshou, prescribed two formulas. He recovered immediately after taking the decoction first.
Mulberry Root Bark (Sangbaipii, 4 liang), Tangerine Peel (Chenpi, 2 liang), Seaweed (Haizao, 3 liang, washed to remove saltiness), Poria (Fuling), Prunus Seed (Yuliren, crushed, 4 liang each), Red Adzuki Bean (Chixiaodou).
Cut the six herbs. Boil in eight sheng of water to obtain two and a half sheng. Divide into three doses. It is very effective. *Gujin Luyian* records this formula for treating swelling and fullness due to qi-water.
Doctor Yao relayed a message from Yu Zhiguang, Recorder of Yanzhou: "I have always known I cannot take decoctions, but the matter is urgent. Please try your best to take it. If you feel slightly better after taking this decoction, take it frequently for two or three courses. Do not refuse. This medicine is easy to tolerate and will certainly cause no adverse reactions. If you cannot take it, you may take the following pills, though they act slowly."
Another formula.
Tangerine Peel (Chenpi, 5 fen), Prunus Seed (Yuliren, 10 fen), Poria (Fuling, 8 fen), Lepidium Seed (Tinglizi, 6 fen, roasted), Stephania Root (Fangji), Mulberry Root Bark (Sangbaipii, 5 fen each).
Pound and sift the eight herbs. Mix with honey to make pills. Decoct roasted mulberry root bark in water to drink. Take ten pills (size of wutong seeds) twice a day. If obstruction persists, gradually increase the dose until free flow is achieved. Those who are thirsty may drink this formula. Verified effective at Old Jiang's residence and Dr. Zhang's home. Avoid vinegar. (From *Waitai Miyao*, Vol. 20)
Formula for treating swelling limited to both feet.
Chopped scallion leaves boiled until soft, used to soak the feet, three to four times a day. Very good. (From *Waitai Miyao*, Vol. 20)
Formula for treating bladder stone water, with emaciated limbs and swollen abdomen.
Soybean (Dadou, 5 sheng), Stephania Root (Fangji, 4 liang), Mulberry Root Bark (Sangbaipii, cut, 3 sheng), Atractylodes Macrocephala Rhizome (Baizhu, 4 liang), Phytolacca Leaf (Zeqiye, cut, 3 sheng), Belamcanda Rhizome (Shegan).
Cut the seven herbs. Boil in fifteen sheng of water to obtain six sheng. Remove dregs. Add three sheng of good wine and simmer to obtain five sheng. Divide into five doses: three during the day, one at night. Consume the remaining decoction the next day. (From *Waitai Miyao*, Vol. 20)
For treating stone water with pain radiating to the hypochondrium, distension, vertigo, headache, and generalized heat, use moxibustion.
Moxibustion on Guanyuan (CV4). (From *Waitai Miyao*, Vol. 20)
Another method for treating stone water.
Moxibustion on Zhangmen (LR13) and RanGu (KI2). (From *Waitai Miyao*, Vol. 20)
Formula for treating sudden generalized swelling and fullness.
Soybean (Dadou).
Pound and sift this single herb into powder. Take three cun-bi (a measure of volume) with rice gruel, twice a day. Very effective. (From *Waitai Miyao*, Vol. 20)
Formula for treating sudden bodily swelling as if blown up.
Croton Seed (Badou, 30 pieces, with skin, chopped).
Boil this single herb in five sheng of water to obtain three sheng. Dip cotton cloth in the juice and wipe the swollen areas. Swelling reduces immediately. Wipe five to six times a day. Avoid contact with eyes and genitals. (From *Waitai Miyao*, Vol. 20)
Formula for treating men and women with chest/epigastric fullness, back/chest pain, poor appetite, slight facial swelling, and dysuria.
Apricot Seed (Xingren, 8 fen, roasted), Tangerine Peel (Chenpi, 5 fen), Perilla Seed (Suzi, 3 he), Stephania Root (Fangji, 5 fen), Lepidium Seed (Tinglizi, 6 fen, roasted), Poria (Fuling, 8 fen).
Pound and sift the six herbs. Mix with honey to make pills the size of small beans. Decoct finely cut mulberry root bark in water to drink. Take these pills with the decoction. Start with ten pills, twice a day, gradually increasing to thirty pills. (From *Waitai Miyao*, Vol. 20)
Method for treating abdominal distension with water retention and flat umbilicus.
Moxibustion on the center of the umbilicus. If the abdominal skin texture disappears, it is incurable. (From *Waitai Miyao*, Vol. 20)
Method for treating water-induced abdominal distension and skin swelling.
Moxibustion on Zusanli (ST36). For wind-water, moxa JieXi (ST41). (From *Waitai Miyao*, Vol. 20)