《脉经》曰“水肿之脉，浮大易愈，沉细难痊。”余谓医不细揣脉与症，斯已难矣。果脉清症确，浮大固
可十全，沉细未必难痊。余少时曾患水肿而回生者，欲知水肿幽明路，说法何妨我现身。人生饮入于胃，气化
之妙，全凭脾、肺、肾三经。脾专运用之职，肺擅通调之官，肾司熏蒸之用，而后云兴雨施，渗入膀胱。三经
失权，其气不化，蓄诸中州，横流四肢，泛溢皮肤，一身之中，无非水为之灌注矣。以其脉之沉细者言之，脉
而沉细，病愈深而侵入脏矣。即脉之沉细分症之阴阳，其为阴水肿也，形寒伤肺，湿寒侵脾，虚寒埋肾，大
便溏泻，小便清利，脉则沉细而迟，补土以温金，实脾汤（焦术、茯苓、炙草、浓朴、肉桂、草蔻、木瓜、木
香、附片、干姜、大枣引），实开斯世之福；壮水兼补火，肾气汤（熟地、茯苓、山药、丹皮、枣皮、淮膝、
车前子、附子、肉桂、泽泻），能挽造化之穷。其为阳水肿也，火盛克金，热郁侮土，燥过枯水，大便坚硬，
小便黄赤，脉则沉细而数，
石膏友麦冬（经验方∶石膏、麦冬、粳米、炙草、大枣、生姜），本草中足称治水之橇（《史记·夏纪》，禹
治水，泥行乘橇，山行乘 。橇，履器之有齿者，今之木屐仿之）；黄连伴黄柏（经验方∶黄连、苡米、黄柏
、车前、肉桂三分，知母、炙草），医方内大是分水之犀（《抱朴子》∶犀角一尺以上者，刻为鱼形，衔以入
水，水即分开）。余尝阅是症，阴阳俱厥，有令人不可测度。阳水之厥，更有十倍于阴水者。阴水误以阳治，
先或声哑而死；阳水误以阴治，定是吐血而亡。至于脉之浮大，邪犹在表，病之最浅者也。水蓄膀胱，五皮饮
（五加皮、地骨皮、茯苓皮、大腹皮、生姜皮），可洁清净之府；水行肌表，越婢汤（石膏八钱，麻黄六钱，
大枣一、二枚，炙草三钱，生姜三钱），足开鬼门之关。其朝宽暮急，暮宽朝急者，水随气之升降也，何必曰
阴虚阳亏；上气喘促，夜卧难安者，水淫肺之叶孔也，何必曰子胎母宫。曰风水，曰石水，曰皮水，多其水名；曰湿肿，
曰血肿，曰风肿，总
是水肿。揣摩脉症，辨别脏腑，沉细浮大，有何难易之分？酌理准情，无非从前所有之语；披肝沥胆，尽是劫
后余生之言。其于是症，煞吃苦辛矣。愁成白发三千丈，历尽洪涛十八滩。
人但知浮大为阳，沉细为阴，而不知沉细中有迟数，即有阴阳。治之之法，相去甚悬。世之患是症者，多
为药饵所误，惜不早得是而读之也。
《脉经》说：“水肿病的脉象，浮大者容易治愈，沉细者难以痊愈。”我认为医生如果不仔细揣测脉象与症状，这已经很难了。如果确实脉象清晰、症状确切，那么浮大的脉象固然可以十全十美，但沉细的脉象未必就难以痊愈。我年轻时曾患水肿病而得以康复，想要知晓水肿病深奥难明的道理，不妨让我现身说法。
人喝进去的水进入胃中，气化的奥妙，全凭脾、肺、肾三经的作用。脾专门负责运化转输的职责，肺擅长通调水道的职能，肾主管蒸腾气化的作用，然后才能像云兴雨施一样，使水液渗入膀胱。如果这三经失去职权，气化功能失常，水湿蓄积在中焦脾胃，横流于四肢，泛溢于皮肤，全身上下，无非都是水液的灌注。
从脉象沉细的角度来说，脉象沉细，说明病邪越深，已经侵入脏腑了。即使对于沉细的脉象，也要分辨阴阳：如果是阴水证，因形寒伤肺，湿寒侵脾，虚寒困肾，表现为大便溏泻，小便清长通畅，脉象沉细而迟。治疗应补益脾土以温养肺金，可用实开斯世之福方（由焦白术、茯苓、炙甘草、厚朴、肉桂、草豆蔻、木瓜、木香、附片、干姜、大枣组成），这是开启世间福祉的方法；或者壮肾水兼补命门火，可用肾气汤（由熟地黄、茯苓、山药、牡丹皮、山茱萸、怀牛膝、车前子、附子、肉桂、泽泻组成），能够挽回造化的穷困。
如果是阳水证，因火盛克金，热郁侮土，燥热过度耗伤肾水，表现为大便坚硬，小便黄赤，脉象沉细而数。治疗可用石膏配麦冬（经验方：石膏、麦冬、粳米、炙甘草、大枣、生姜），这在本草中足以称为治水的利器（《史记·夏纪》记载，禹治水时，泥行乘橇，山行乘檋。橇，是有齿的履器，现在的木屐仿照它制成）；或者黄连配黄柏（经验方：黄连、薏苡仁、黄柏、车前子、肉桂三分、知母、炙甘草），这在医方内大抵是分消水湿的犀角（《抱朴子》记载：一尺以上的犀角，刻成鱼形，衔着入水，水就会分开）。
我曾经诊察这类病症，发现阴阳之气皆有厥逆的情况，令人不可测度。阳水证的厥逆，程度更有十倍于阴水证的严重。阴水证误用阳水的治疗方法，起初可能声音嘶哑而死；阳水证误用阴水的治疗方法，必定导致吐血而亡。
至于脉象浮大，说明邪气仍在体表，是病情最浅显的阶段。水湿蓄积在膀胱，可用五皮饮（五加皮、地骨皮、茯苓皮、大腹皮、生姜皮），以洁净清净的膀胱府；水湿流行于肌表，可用越婢汤（石膏八钱，麻黄六钱，大枣一至二枚，炙甘草三钱，生姜三钱），足以打开鬼门（汗孔）的关隘。
如果早晨肿胀轻缓、傍晚急重，或傍晚轻缓、早晨急重，这是因为水湿随着气的升降运动而变化，何必说是阴虚阳亏？如果上气喘促，夜间躺卧不安，这是因为水湿淫溢侵犯肺叶的孔隙，何必说是子盗母气（肾水不足累及肺金）或胎宫病变。
所谓风水、石水、皮水，只是增加了水的名称；所谓湿肿、血肿、风肿，总归都是水肿。揣摩脉象与症状，辨别涉及的脏腑，无论是沉细还是浮大，有什么难易的区别呢？斟酌事理，符合常情，无非是前人已有的论述；披肝沥胆，尽是历经劫难后幸存者的肺腑之言。对于这种病症，真是煞费苦心啊。愁绪化作白发三千丈，历经洪涛十八滩的险阻。
世人只知道浮大为阳，沉细为阴，却不知道沉细脉中还有迟与数的区别，这就包含了阴阳的不同。治疗方法，相差甚远。世上患此病的人，大多被药物所误，可惜没有早点读到这篇文章。
The *Mai Jing* (Pulse Classic) states: "In edema, a floating and large pulse indicates ease of cure, while a deep and fine pulse indicates difficulty in recovery." I believe that if a physician fails to carefully examine the pulse and symptoms, it is already difficult. If the pulse is clear and the symptoms are accurate, a floating and large pulse may indeed lead to complete recovery, but a deep and fine pulse does not necessarily mean it is incurable. In my youth, I suffered from edema and was cured; to understand the profound mysteries of edema, I am willing to share my experience.
When humans ingest water, it enters the stomach. The miracle of qi transformation relies entirely on the Spleen, Lung, and Kidney meridians. The Spleen is responsible for transportation and transformation; the Lung excels in regulating water passages; and the Kidney governs steaming and vaporization. Only then can water descend like rain into the Bladder. If these three organs lose their authority, qi transformation fails, water accumulates in the central region (Middle Jiao), flows horizontally to the limbs, overflows onto the skin, and permeates the entire body.
Regarding the deep and fine pulse: a deep and fine pulse indicates that the disease has penetrated deeper and invaded the Zang organs. Even among deep and fine pulses, one must distinguish between Yin and Yang. If it is Yin Edema, caused by cold damaging the Lung, damp-cold invading the Spleen, or deficiency-cold burdening the Kidney, symptoms include loose stools and clear, profuse urination, with a deep, fine, and slow pulse. Treatment should tonify Earth to warm Metal (Spleen to Lung); one may use the *Shi Kai Si Shi Zhi Fu* Decoction (composed of Scorched Atractylodis Rhizoma, Poria, Prepared Licorice Root, Magnolia Bark, Cinnamon Twig, Cardamom Seed, Quince Fruit, Aucklandia Root, Prepared Aconite Root, Dried Ginger, and Jujube), which opens the blessings of this world. Alternatively, one may nourish Water and supplement Fire using the *Shen Qi Tang* (Kidney Qi Decoction, composed of Prepared Rehmannia Root, Poria, Chinese Yam, Moutan Cortex, Cornus Fruit, Achyranthes Bidentata Root, Plantago Seed, Aconite Root, Cinnamon Bark, and Alisma Rhizome), which can restore the limits of creation.
If it is Yang Edema, caused by excessive Fire overcoming Metal, Heat stagnation insulting Earth, or dryness excessively depleting Water, symptoms include hard stools and yellow-red urine, with a deep, fine, and rapid pulse. One may use Gypsum combined with Ophiopogon Root (Empirical Formula: Gypsum, Ophiopogon Root, Coix Seed, Prepared Licorice Root, Jujube, Fresh Ginger). In materia medica, this is sufficient to be called the "lever" for treating water (as recorded in *Records of the Grand Historian*, Yu used sleds for mud travel and wedges for mountain travel when controlling floods; the sled is a toothed footwear, imitated by modern wooden clogs). Alternatively, one may combine Coptis Rhizome with Phellodendron Bark (Empirical Formula: Coptis Rhizome, Coix Seed, Phellodendron Bark, Plantago Seed, a small amount of Cinnamon Twig, Anemarrhena Rhizome, and Prepared Licorice Root). In medical formulas, this is akin to the rhinoceros horn that parts the waters (as stated in *Baopuzi*: a rhino horn over one chi long, carved into a fish shape and held in the mouth, parts the water).
I have observed cases where both Yin and Yang Qi were reversed, which is unpredictable. The reversal in Yang Edema is ten times more severe than in Yin Edema. Treating Yin Edema with Yang methods may initially cause hoarseness leading to death; treating Yang Edema with Yin methods will certainly lead to hematemesis and death.
Regarding the floating and large pulse, the pathogen remains in the exterior, representing the shallowest stage of disease. If water accumulates in the Bladder, one may use the *Wu Pi Yin* (Five Peel Decoction, composed of Acanthopanacis Cortex, Lycii Cortex, Poria Peel, Areca Peel, and Ginger Peel) to cleanse the pure and empty organ. If water circulates in the muscle layer, one may use the *Yue Bi Tang* (Yue Bi Decoction, composed of Gypsum, Ephedra Herb, Jujube, Prepared Licorice Root, and Fresh Ginger) to open the gates of sweat (Guimen).
If swelling is mild in the morning and severe in the evening, or mild in the evening and severe in the morning, it is because water follows the ascending and descending of Qi; why attribute it to Yin deficiency and Yang insufficiency? If there is upper asthma and shortness of breath, making sleep difficult at night, it is because water invades the pores of the Lung lobes; why attribute it to the Child stealing from the Mother (Kidney-Lung relationship) or uterine issues?
Whether called Feng Shui (Wind Edema), Shi Shui (Stone Edema), or Pi Shui (Skin Edema), these are merely different names for water retention. Whether called Shi Zhong (Damp Swelling), Xue Zhong (Blood Swelling), or Feng Zhong (Wind Swelling), they all fall under the category of Edema. By analyzing pulse and symptoms and distinguishing the involved Zang-Fu organs, whether the pulse is deep/fine or floating/large, what is the difference in difficulty? Judging principles and circumstances, these are merely repetitions of previous teachings; speaking from the heart, these are words from someone who survived a disaster. Dealing with this condition requires great hardship. Worry turns hair white by three thousand zhang, enduring eighteen rapids of turbulent waves.
People generally know that floating and large pulses indicate Yang, and deep and fine pulses indicate Yin, but they do not realize that within deep and fine pulses, there are slow and rapid distinctions, which imply Yin and Yang differences. The treatment methods differ significantly. Many patients suffer due to medication errors, regretting not reading this text earlier.