水之正伏也。其脉迟者，水属阴也。外证自喘者，阴甚于下，不复与胸中之阳气相调，
水气格阳而喘也。其目窠如蚕，两胫肿大诸证，《金匮》未言，无不俱见。
愚按∶正水《金匮》未出方。然提纲云∶脉沉迟外证自喘，则真武汤、小青龙汤皆正治
之的方，越婢加附子汤、麻黄附子汤亦变证之备方，桂甘麻辛附子汤加生桑皮五钱、黑豆一
两，为穷极之巧方，此正水之拟治法也。
谓下焦水坚如石也。其脉自沉，外证少腹满，不喘。
麻黄附子汤
麻黄（三钱） 炙草（二钱） 附子（一钱）
水二杯，先煮麻黄至一杯半，去沫，入诸药煎七分温服，日作三服。此即麻黄附子甘草
汤，分两略异。即以温经散寒之法，变为温经利水之妙。
汗出沾衣而色黄也。汗出入水，水邪伤心；或汗出当风所致。汗与水皆属水气，因其入
而内结，则郁热而黄，其脉沉而迟。外证身发热，四肢头面肿，久不愈必致痈脓。
黄 桂枝芍药苦酒汤(《金匮》) 治身体肿，发热汗出而渴，状如风水。汗出沾衣色正
黄如柏汁，脉自沉(风水脉浮，黄汗脉沉)。以汗出入水中浴，水从毛孔入得之。(水气从
毛孔入而伤其心，故水火相侵而色黄，水气搏结，而脉沉也。凡看书宜活看，此证亦有从酒
后汗出当风所致者，虽无外水，而所出之汗，因风内返亦是水。凡脾胃受湿，湿久生热，湿
热交蒸而成黄色，皆可以汗出。入水之意，悟之！)
黄 （五钱） 芍药 桂枝（各三钱）
苦酒一杯半，水一杯，煎八分，温服。当心烦，至六七日乃解。(汗出于心，苦酒止之
太急，故心烦。至六七日，正复而邪自退也。)
桂枝加黄 汤(《金匮》) 黄汗之病，两胫自冷，盗汗出。汗已反发热，久久身必甲错
，发热不止者，必生恶疮。若身重汗出已辄轻者，久久必身 ， 即胸中痛。又从腰以上汗
出，下无汗，腰 弛痛，如有物在皮中状。剧者不能食，身疼重，烦躁小便不利(以上
皆黄汗之变证、师备拟之，以立治法。兹因集隘，不能全录，只辑其要)。此为黄汗。(言变
证虽多，而其源总由水气伤心所致。结此一句，见治法不离其宗。)
桂枝 芍药 生姜（各三钱） 甘草(炙) 黄 （各二钱） 大枣（四枚）
水三杯，煮八分，温服。须臾啜热粥一杯余，以助药力。温覆取微汗，若不汗，更服。
前方止汗，是治黄汗之正病法。此方令微汗，是治黄汗之变症法。
水气潜伏于体内。脉象迟的，是因为水属阴邪。外部症状表现为自发性气喘的，是由于阴寒之邪盛于下部，不能与胸中的阳气相互调和，水气阻隔阳气导致气喘。其眼睑如蚕卧状浮肿、双小腿肿大等诸种证候，《金匮要略》中未详细列举，但临床上这些症状往往全部出现。
我按语：正水在《金匮要略》中未列出具体方剂。然而提纲指出：“脉沉迟，外证自喘”，那么真武汤（温阳利水方）、小青龙汤（解表散寒、温肺化饮方）都是治疗正水的对症良方；越婢加附子汤（发汗清热、温阳利水方）、麻黄附子汤（助阳解表方）也是应对变证的完备方剂；桂枝甘草麻黄细辛附子汤加入生桑白皮五钱、黑豆一两，是极为巧妙的穷极之法，这是针对正水的拟制治法。
所谓石水，是指下焦的水邪坚硬如石头。其脉象自然沉伏，外部症状为少腹部胀满，但不气喘。
麻黄附子汤
麻黄（三钱） 炙甘草（二钱） 附子（一钱）
用水两杯，先煮麻黄至一杯半，去掉浮沫，加入其他药物煎至七分，温服，每日分三次服用。这就是麻黄附子甘草汤，只是分量略有不同。将温经散寒的方法，转变为温经利水的妙法。
所谓黄汗，是指汗水沾湿衣物且颜色发黄。因出汗时入水，水邪伤害心脏；或因出汗时受风所致。汗与水都属于水气，因为水邪进入体内凝结，导致郁热而发黄，其脉象沉而迟。外部症状为身体发热，四肢、头部和面部浮肿，久治不愈必然导致痈脓。
黄汗用桂枝芍药苦酒汤（出自《金匮要略》）。治疗身体浮肿，发热出汗且口渴，症状类似风水病。汗水沾湿衣物，颜色纯正像柏树汁一样黄，脉象自沉（风水病脉浮，黄汗病脉沉）。这是因为出汗时在水中沐浴，水从毛孔进入所致。（水气从毛孔进入伤害心脏，所以水火相侵而色黄，水气搏结，所以脉沉。凡是读书应当灵活看待，此证也有因酒后出汗受风所致的，虽然没有外水进入，但排出的汗因风邪内返也属于水。凡是脾胃受湿气困扰，湿气久了产生热邪，湿热交蒸形成黄色，都可以导致出汗。由此领悟“入水”的含义！）
黄芪（五钱） 芍药 桂枝（各三钱）
苦酒（醋）一杯半，水一杯，煎至八分，温服。服药后应当感到心烦，到六七天才会解除。（汗出于心，苦酒收敛止汗太急，所以心烦。到六七天，正气恢复邪气自然退去。）
桂枝加黄芪汤（出自《金匮要略》）。患黄汗病的人，两小腿自然发冷，睡中出汗（盗汗）。出汗后反而发热，时间久了身体必定皮肤粗糙如鳞甲交错，发热不止的人，必然生恶疮。如果身体沉重，出汗后随即感觉轻快，时间久了必然身体麻木不仁，甚至胸中疼痛。又如有腰部以上出汗，腰部以下无汗，腰部弛缓疼痛，好像有东西在皮肤中的感觉。病情严重的不能进食，身体疼痛沉重，烦躁，小便不利（以上都是黄汗的变证，老师预先拟定了治法以确立治疗原则。此处因篇幅限制，不能全录，只摘录其要点）。这属于黄汗。（说明变证虽然多，但其根源总由水气伤害心脏所致。总结这一句，表明治法不离其宗）。
桂枝 芍药 生姜（各三钱） 炙甘草 黄芪（各二钱） 大枣（四枚）
用水三杯，煎至八分，温服。片刻后喝热粥一杯多，以助药力。覆盖衣被取微汗，如果不发汗，再服用。前方止汗，是治疗黄汗正病的常规方法。此方令微汗，是治疗黄汗变症的方法。
The latent nature of water qi. When the pulse is slow, it is because water belongs to Yin. The external manifestation of spontaneous panting occurs when Yin cold is excessive in the lower part and fails to harmonize with the Yang Qi in the chest; water qi obstructs Yang, leading to panting. Regarding symptoms such as eyelids swollen like a silkworm lying down and swelling of both calves, although not explicitly detailed in *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), these signs are invariably present together.
My commentary: Although *Jin Gui Yao Lue* does not provide a specific formula for Zheng Shui (True Water Edema), the outline states: "Pulse is deep and slow, external symptom is spontaneous panting." Therefore, Zhen Wu Tang (True Warrior Decoction) and Xiao Qing Long Tang (Minor Blue Dragon Decoction) are direct and appropriate formulas for treatment. Yue Bi Jia Fu Zi Tang (Yue Bi Decoction plus Aconite) and Ma Huang Fu Zi Tang (Ephedra and Aconite Decoction) are comprehensive formulas for managing variant conditions. Gui Zhi Gan Cao Ma Huang Xi Xin Fu Zi Tang (Cinnamon Twig, Licorice, Ephedra, Asarum, and Aconite Decoction) added with five qian of Sheng Sang Bai Pi (Bark of Mulberry Root) and one liang of Hei Dou (Black Soybean) constitutes an ingenious prescription for extreme cases. This represents the proposed treatment method for Zheng Shui.
Shi Shui (Stone Water) refers to water accumulation in the lower jiao that is hard as stone. The pulse is naturally deep. External symptoms include fullness in the lower abdomen but no panting.
Ma Huang Fu Zi Tang (Ephedra and Aconite Decoction)
Ma Huang (Herba Ephedrae) (3 qian)
Zhi Gan Cao (Radix Glycyrrhizae Preparata) (2 qian)
Fu Zi (Radix Aconiti Lateralis Preparata) (1 qian)
Use two cups of water. First, boil Ma Huang until reduced to one and a half cups, skim off the foam, then add the other herbs and decoct until seven parts remain. Take warm. Divide into three doses per day. This is essentially the same as Ma Huang Fu Zi Gan Cao Tang (Ephedra, Aconite, and Licorice Decoction), with slight variations in dosage. It transforms the method of warming meridians and dispersing cold into the subtle art of warming meridians and promoting diuresis.
Huang Han (Yellow Sweat) refers to sweat that stains clothes yellow. It is caused by entering water while sweating, allowing water pathogenic factors to damage the Heart; or by exposure to wind while sweating. Both sweat and water belong to water qi. Because water enters and binds internally, it generates stagnant heat, resulting in yellow coloration. The pulse is deep and slow. External symptoms include feverish sensation of the body, swelling of the limbs, head, and face. If prolonged without cure, it will inevitably lead to carbuncles and pus.
For Huang Han, use Gui Zhi Shao Yao Ku Jiu Tang (Cinnamon Twig, Peony, and Vinegar Decoction) from *Jin Gui Yao Lue*. It treats body swelling, fever, sweating, and thirst, resembling Feng Shui (Wind Water Edema). The sweat stains clothes yellow like cypress juice, and the pulse is deep (whereas the pulse for Feng Shui is floating). This condition arises from bathing in water while sweating, allowing water to enter through the pores. (Water qi enters through the pores and damages the Heart, causing water and fire to invade each other, resulting in yellow color; water qi knots together, causing a deep pulse. One should read texts flexibly; this condition can also result from sweating after drinking alcohol and being exposed to wind. Even without external water, the sweat expelled may return inward due to wind, effectively becoming water. Furthermore, when the Spleen and Stomach are affected by dampness, long-standing dampness generates heat; the steaming interaction of damp-heat produces yellow color and sweating. From this, one can comprehend the meaning of "entering water"!)
Huang Qi (Radix Astragali) (5 qian)
Shao Yao (Radix Paeoniae Alba)
Gui Zhi (Ramulus Cinnamomi) (each 3 qian)
Ku Jiu (Vinegar) one and a half cups, water one cup. Decoct until eight parts remain. Take warm. The patient will likely experience mental restlessness (xin fan); resolution occurs after six to seven days. (Sweat originates from the Heart; Ku Jiu stops it too abruptly, causing mental restlessness. After six to seven days, righteous Qi recovers, and pathogens retreat spontaneously.)
Gui Zhi Jia Huang Qi Tang (Cinnamon Twig Decoction plus Astragalus) from *Jin Gui Yao Lue*. Patients with Huang Han disease have naturally cold lower legs and night sweats. After sweating, fever may persist; if prolonged, the skin becomes rough and scaly (jia cuo). Persistent fever leads to malignant sores. If the body feels heavy but lightens after sweating, prolonged illness may cause body numbness (rou bi) and even chest pain. Another presentation includes sweating above the waist but none below, with flaccid pain in the lower back and a sensation of something trapped in the skin. Severe cases involve inability to eat, body ache and heaviness, irritability, and difficult urination (above are all variant syndromes of Huang Han; the Master provided treatments to establish principles. Due to space constraints, only key points are recorded here). This defines Huang Han. (This statement indicates that although variants are numerous, their source always stems from water qi damaging the Heart. This summary shows that treatment methods adhere to the fundamental principle.)
Gui Zhi (Ramulus Cinnamomi)
Shao Yao (Radix Paeoniae Alba)
Sheng Jiang (Rhizoma Zingiberis Recens) (each 3 qian)
Zhi Gan Cao (Radix Glycyrrhizae Preparata)
Huang Qi (Radix Astragali) (each 2 qian)
Da Zao (Fructus Jujubae) (4 pieces)
Use three cups of water. Decoct until eight parts remain. Take warm. Shortly after, drink more than one cup of hot congee to assist the medicinal power. Cover with blankets to induce mild sweating. If sweating does not occur, administer again. The previous formula stops sweating, which is the standard treatment for typical Huang Han. This formula induces mild sweating, which is the treatment method for variant syndromes of Huang Han.