饮食入胃脾不逆，湿热相蒸为酸病。吐出酸水名吐酸，吐不退场门吞酸认。此而不药渐恶
心，反胃噎膈日渐进。吐因津液气随升，郁积已久湿热甚。乃从火化（木火也）遂作酸，病属
于热分明应。吞应积热在内藏，酸水酿成寒束定。外寒束之难外行，心胃之间作酸甚。二陈
（汤）越鞠（丸）主治之，寒用吴萸热连进。再戒忿怒以平肝，滋味薄时胃清净。
肿本乎水，胀由乎气。水分阴阳，外来者为有余，即为阳水，其或固大病后脾肺虚弱，
不能通调水道。或因心火克金，肺不能生肾水，致小便不利。或因肾经阴亏，虚火烁肺金
而溺少，误用行气分利之剂，致喘急痰盛，小水短少，酿成肿症。此内发者为不足，即为阴水。
人之生兮资水谷，脾主谷兮肾水属。水旺土虚不胜水，水气泛溢浮肿肉。实脾饮于阴水
宜（便利不渴而肿胀者为阴水也），阳水舟车丸可录（舟车丸宜慎用）。口渴面赤气阻便（秘
而肿胀者为阳水也），上为风肿麻防要。下属湿肿苡防（己）足。又有虚症气血分，四物汤兮
合四君。朝宽暮急血虚病，暮宽朝急气虚成。先胀后喘用二术（苍白术），先喘后胀加麦
（冬）苓。水胀总由湿热积，渗道少通遂闭塞。邪水随气注络中，甚至唇肿脐突出（唇肿脐突
者死症）。虽云湿胜实脾虚，大法补中最有益。
舟车丸 甘遂 大戟 大黄 黑丑 芫花 轻粉 橘皮 青皮 木香 实脾饮见前
脾胃阳虚（腑阳不行）
人参 茯苓 益智 白芍 白术 归身 广皮 附子 砂仁 槟榔 炮姜 草果 肉果 川朴
肾胃阳虚
肾气丸 五苓散 人参 干姜 茯苓 附子 菟丝 葫芦巴 刚人参 干姜 制半夏 枳实
木火犯胃
川朴 山栀 楂肉 川楝子 白芍 川椒 枳实 铁锈水 逍遥散去白术合左金丸。
湿壅三焦，肺气不降（宜清肃上焦治之）
蜜炙麻黄 杏仁 紫菀 苡仁 茯芩皮 枇杷叶 石膏 前胡 姜皮 川通草
木郁气滞，血滞，便涩，通幽法
川楝 橘核 桂枝 香附 桃仁 当归 小荷柔叶 楂肉 钩藤 延胡 神曲 丹皮 禹余粮丸
湿滞凝滞（小溲不行，当开太阳）
川朴 川椒 干姜 牡蛎 汉防己 橘核 桂木 五味 通草 海金砂 寒水石 五苓散
湿郁兼热（苦辛通肾）
半夏泻心汤见前。
下焦寒热流经（辛香通经府之郁）
生于术 北细辛 川独活 炮川乌 汉防己 白茯苓
气血郁积，兼挟湿热
清理相火，健运中州，小温中丸。
湿热寒水之气交横，气喘溺少
崇土制水，暖下泄浊，禹余粮丸。
肝脾不和，兼挟暑邪
半夏 广藿 川朴 甘草 茯苓 山楂 郁金
脾胃不和清阳痹结（以滑润治之）
栝蒌 川楝 桂木 生姜 桃仁 薤白 延胡 归须 半夏 茯苓
饮食进入胃中，脾胃运化正常则不反逆；若湿热相互熏蒸，则形成酸证。吐出酸水称为吐酸，若呕吐不止、肛门坠胀感明显，则认定为吞酸。此病若不治疗，会逐渐发展为恶心，进而演变为反胃和噎膈，病情日益加重。吐酸是因为津液随气机上逆，郁结积滞日久，导致湿热严重，从而从火化（木火相生）而变成酸味，这属于热证的范畴，应当明确辨别。吞酸则是由于积热蕴藏于内脏，酸水酿成后又被外寒束缚所致。外寒束表，使邪气难以向外发散，在心胃之间产生严重的酸楚感。二陈汤和越鞠丸是主治方剂，若属寒证用吴茱萸，属热证连进黄连。此外，还要戒除愤怒以平抑肝气，饮食清淡时胃气自然清净。
水肿的根本在于水，胀满的根源在于气。水分为阴水和阳水两类，由外感邪气引起且表现为有余之证的是阳水；若是大病之后脾肺虚弱，不能通调水道，或因心火克制肺金，导致肺不能生肾水，致使小便不利；或因肾经阴亏，虚火灼伤肺金而尿少，误用行气分利的药物，导致喘急痰多、小便短少，酿成水肿，这类内发者为不足之证，即为阴水。人的生存依赖水谷精微，脾主运化水谷，肾主水液。若水旺土虚，脾不胜水，水气泛溢肌肤则出现浮肿。实脾饮适用于阴水（表现为二便通利但不口渴且肿胀者），舟车丸可用于阳水（但需慎用）。若见口渴、面赤、气阻、便秘且肿胀者，为阳水，上部风肿可用麻黄、防风等药；下部湿肿可用薏苡仁、防己等药。又有虚证涉及气血分辨：四物汤合四君子汤使用。若早晨宽舒傍晚紧急，属血虚病；傍晚宽舒早晨紧急，属气虚病。先胀后喘的用苍术、白术；先喘后胀的加麦冬、茯苓。水胀总因湿热积滞，渗道不通遂致闭塞。邪水随气注入络脉，甚至出现唇肿脐突（这是死症）。虽然说是湿胜导致脾虚，但大法中以补中益气最为有益。
舟车丸组成：甘遂、大戟、大黄、黑丑、芫花、轻粉、橘皮、青皮、木香。
实脾饮见前文。
脾胃阳虚（腑阳不行）：人参、茯苓、益智仁、白芍、白术、当归身、广陈皮、附子、砂仁、槟榔、炮姜、草果、肉豆蔻、厚朴。
肾胃阳虚：肾气丸、五苓散、人参、干姜、茯苓、附子、菟丝子、葫芦巴。另有人参、干姜、制半夏、枳实。
木火犯胃：厚朴、山栀、山楂肉、川楝子、白芍、川椒、枳实、铁锈水。逍遥散去白术合左金丸。
湿壅三焦，肺气不降（宜清肃上焦治之）：蜜炙麻黄、杏仁、紫菀、薏苡仁、茯苓皮、枇杷叶、石膏、前胡、生姜皮、川通草。
木郁气滞，血滞，便涩，通幽法：川楝子、橘核、桂枝、香附、桃仁、当归、小荷柔叶、山楂肉、钩藤、延胡索、神曲、丹皮、禹余粮丸。
湿滞凝滞（小便不行，当开太阳）：厚朴、川椒、干姜、牡蛎、汉防己、橘核、桂木、五味子、通草、海金砂、寒水石、五苓散。
湿郁兼热（苦辛通肾）：半夏泻心汤见前文。
下焦寒热流经（辛香通经府之郁）：生于术、北细辛、川独活、炮川乌、汉防己、白茯苓。
气血郁积，兼挟湿热：清理相火，健运中州，用小温中丸。
湿热寒水之气交横，气喘溺少：崇土制水，暖下泄浊，用禹余粮丸。
肝脾不和，兼挟暑邪：半夏、广藿香、厚朴、甘草、茯苓、山楂、郁金。
脾胃不和清阳痹结（以滑润治之）：栝蒌、川楝子、桂木、生姜、桃仁、薤白、延胡索、归须、半夏、茯苓。
Diet enters the stomach; if the Spleen and Stomach function normally, there is no regurgitation. If Damp-Heat steams and fumes mutually, it forms an Acid Syndrome. Vomiting acidic water is called "Vomiting Acid" (Tu Suan); if vomiting persists with a sensation of rectal prolapse/heaviness, it is recognized as "Swallowing Acid" (Tun Suan). If this condition is not treated, it will gradually worsen into nausea, progressing day by day to Fan Wei (Regurgitation) and Ye Ge (Dysphagia). Vomiting acid occurs because body fluids rise with Qi; after long-term stagnation and accumulation, Damp-Heat becomes severe. It then transforms via Fire (Wood generating Fire), thus becoming sour. This disease belongs clearly to Heat patterns. Swallowing acid results from accumulated heat stored in the internal organs; acidic water is formed and fixed by external Cold binding. External Cold constrains the exterior, making it difficult for pathogens to diffuse outward, causing severe acidity between the Heart and Stomach. Er Chen Tang (Two-Aged Decoction) and Yue Ju Wan (Pill Relieving Depression) are the primary treatments: use Wu Zhu Yu (Evodia Fruit) for Cold patterns, and Lian Lian (Coptis Rhizome, implying Huang Lian) continuously for Heat patterns. Furthermore, avoid anger to calm the Liver; when flavors are light, the Stomach remains pure and clear.
Edema originates from Water, while Distension arises from Qi. Water is divided into Yin and Yang types. Exogenous causes resulting in excess conditions are Yang Edema (Yang Shui). Alternatively, after a major illness, weakness of the Spleen and Lung fails to regulate the Water passages. Or, Heart Fire overacts on Metal (Lung), preventing the Lung from generating Kidney Water, leading to difficult urination. Or, Yin deficiency of the Kidney channel allows Deficient Fire to scorch Lung Metal, reducing urine output. Misuse of Qi-moving and diuretic agents leads to panting, profuse phlegm, and scanty urine, brewing into Edema. These internally originated cases represent deficiency and are Yin Edema (Yin Shui). Human life relies on Water and Grain; the Spleen governs Grain, and the Kidney governs Water. When Water is excessive and Earth (Spleen) is weak, failing to control Water, Water Qi overflows, causing edematous flesh. Shi Pi Yin (Realize the Spleen Decoction) is suitable for Yin Edema (characterized by free bowel movements, no thirst, and swelling); Zhou Che Wan (Boat and Cart Pill) can be recorded for Yang Edema (use with caution). Thirst, red face, Qi obstruction, constipation, and swelling indicate Yang Edema. For upper Wind Edema, Ma Huang (Ephedrae Herba) and Fang Feng (Saposhnikoviae Radix) are essential. For lower Damp Edema, Yi Yi Ren (Coicis Semen) and Fang Ji (Stephaniae Tetrandrae Radix) are sufficient. There are also deficiency patterns distinguishing Qi and Blood: Si Wu Tang (Four Substances Decoction) combined with Si Jun Zi Tang (Four Gentlemen Decoction). Morning ease and evening urgency indicate Blood Deficiency; evening ease and morning urgency indicate Qi Deficiency. Distension preceding panting uses Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma); panting preceding distension adds Mai Dong (Ophiopogonis Radix) and Fu Ling (Poria). Water swelling generally stems from Damp-Heat accumulation; blockage of the seepage pathways leads to occlusion. Pathogenic Water follows Qi into the collaterals, even reaching lip swelling and umbilical protrusion (lip swelling and umbilical protrusion are death signs). Although it is said that Dampness excess implies Spleen deficiency, the general principle holds that tonifying the Middle Jiao is most beneficial.
Zhou Che Wan: Gan Sui (Kansui Radix), Da Ji (Euphorbiae Pekinensis Radix), Da Huang (Rhei Radix et Rhizoma), Hei Chou (Pharbitidis Semen), Yuan Hua (Genkwa Flos), Qing Fen (Calomel), Ju Pi (Citri Reticulatae Pericarpium), Qing Pi (Citri Reticulatae Pericarpium Viride), Mu Xiang (Aucklandiae Radix). See Shi Pi Yin previously.
Spleen-Stomach Yang Deficiency (Fu Yang does not circulate): Ren Shen (Ginseng Radix), Fu Ling (Poria), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Bai Shao (Paeoniae Radix Alba), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui Shen (Angelicae Sinensis Radix), Guang Pi (Citri Reticulatae Pericarpium), Fu Zi (Aconiti Lateralis Radix Praeparata), Sha Ren (Amomi Fructus), Bing Lang (Arecae Semen), Pao Jiang (Zingiberis Rhizoma Praeparatum), Cao Guo (Tsaoko Fructus), Rou Guo (Myristicae Semen), Chuan Po (Magnoliae Officinalis Cortex).
Kidney-Stomach Yang Deficiency: Shen Qi Wan (Kidney Qi Pill), Wu Ling San (Five-Ingredient Powder with Poria), Ren Shen (Ginseng Radix), Gan Jiang (Zingiberis Rhizoma), Fu Ling (Poria), Fu Zi (Aconiti Lateralis Radix Praeparata), Tu Si Zi (Cuscutae Semen), Hu Lu Ba (Trigonellae Semen). Additionally: Ren Shen (Ginseng Radix), Gan Jiang (Zingiberis Rhizoma), Zhi Ban Xia (Pinelliae Rhizoma Preparatum), Zhi Shi (Aurantii Fructus Immaturus).
Wood-Fire Invading Stomach: Chuan Po (Magnoliae Officinalis Cortex), Shan Zhi (Gardeniae Fructus), Zha Rou (Crataegi Fructus), Chuan Li Zi (Toosendan Fructus), Bai Shao (Paeoniae Radix Alba), Chuan Jiao (Zanthoxyli Pericarpium), Zhi Shi (Aurantii Fructus Immaturus), Tie Xiu Shui (Iron Rust Water). Xiao Yao San (Rambling Powder) minus Bai Zhu combined with Zuo Jin Wan (Left Metal Pill).
Dampness Obstructing Triple Burner, Lung Qi Not Descending (Clear and purify Upper Jiao): Mi Zhi Ma Huang (Honey-fried Ephedrae Herba), Xing Ren (Armeniacae Semen Amarum), Zi Wan (Asteris Radix), Yi Yi Ren (Coicis Semen), Fu Ling Pi (Poria Cum Cortice), Pi Pa Ye (Loquat Leaf), Shi Gao (Gypsum Fibrosum), Qian Hu (Peucedani Radix), Jiang Pi (Zingiberis Pericarpium), Chuan Tong Cao (Tetrapanacis Medulla).
Wood Stagnation, Qi Stagnation, Blood Stasis, Difficult Urination, Tong You Method: Chuan Li Zi (Toosendan Fructus), Ju He (Fortunelle Seed), Gui Zhi (Cinnamomi Ramulus), Xiang Fu (Cyperi Rhizoma), Tao Ren (Persicae Semen), Dang Gui (Angelicae Sinensis Radix), Xiao He Rou Ye (Small Lotus Soft Leaf), Zha Rou (Crataegi Fructus), Gou Teng (Uncariae Ramulus cum Uncis), Yan Hu (Corydalis Rhizoma), Shen Qu (Massa Medicata Fermentata), Dan Pi (Moutan Cortex), Yu Yu Liang Wan (Yu Yuliang Pill).
Dampness Stagnation and Coagulation (No urination, open Taiyang): Chuan Po (Magnoliae Officinalis Cortex), Chuan Jiao (Zanthoxyli Pericarpium), Gan Jiang (Zingiberis Rhizoma), Mu Li (Ostrea Concha), Han Fang Ji (Stephaniae Tetrandrae Radix), Ju He (Fortunelle Seed), Gui Mu (Cinnamomi Ramulus), Wu Wei (Schisandrae Fructus), Tong Cao (Tetrapanacis Medulla), Hai Jin Sha (Lygodii Spora), Han Shui Shi (Calcitum), Wu Ling San (Five-Ingredient Powder with Poria).
Dampness Stagnation with Heat (Bitter-Pungent unblocking Kidney): Ban Xia Xie Xin Tang (Banxia Xiexin Decoction) see previous.
Lower Jiao Cold-Heat Flowing Through (Pungent-Aromatic unblocking Collateral and Fu organ stagnation): Sheng Bai Zhu (Raw Atractylodis Macrocephalae Rhizoma), Bei Xi Xin (Asari Radix et Rhizoma), Chuan Du Huo (Angelicae Pubescentis Radix), Pao Chuan WU (Prepared Aconiti Radix), Han Fang Ji (Stephaniae Tetrandrae Radix), Bai Fu Ling (White Poria).
Qi and Blood Stagnation, complicated with Damp-Heat: Clear Ministerial Fire, strengthen and transport the Middle Jiao, use Xiao Wen Zhong Wan (Minor Warm Middle Pill).
Damp-Heat and Cold-Water Qi Interlacing, Panting and Scanty Urine: Revere Earth to Control Water, warm Lower Jiao to drain turbidity, use Yu Yu Liang Wan (Yu Yuliang Pill).
Liver-Spleen Disharmony, complicated with Summer-Heat: Ban Xia (Pinelliae Rhizoma), Guang Huo (Pogostemonis Herba), Chuan Po (Magnoliae Officinalis Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Fu Ling (Poria), Shan Zha (Crataegi Fructus), Yu Jin (Curcumae Radix).
Spleen-Stomach Disharmony, Clear Yang Bi-Occlusion (Treat with slippery and moistening methods): Gua Lou (Trichosanthis Fructus), Chuan Li Zi (Toosendan Fructus), Gui Mu (Cinnamomi Ramulus), Sheng Jiang (Zingiberis Rhizoma Recens), Tao Ren (Persicae Semen), Xie Bai (Allii Macrostemonis Bulbus), Yan Hu (Corydalis Rhizoma), Gui Xu (Angelicae Sinensis Radix Caulis), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria).