水统于肾，而根于肺，肺阴不降，则水不化气，而泛滥于上，是为水胀。水胀者，脐以上肿是
也。盖肺不降，由于胃逆，胃逆由于土湿，土湿乃由水寒，水寒而肾失封蛰之性，则相火不得秘藏，
土湿乃令木郁，木郁而肝失疏泄之权，则水道不能清利，是以膀胱癃闭，水不归壑而逆行于胸腹，浸淫
于经络，则肿胀之病作矣。其本之在脏者，宜泄之于膀胱。其标之在经者，宜泄之于汗孔。汗溺之行
，总以燥土疏木为主。盖水病虽在肺肾，而土湿木郁乃其根本也。如初起宜发汗者，以苓桂麻
黄汤主之。宜利水者，以苓桂阿胶汤主之。如水在太阳之经，宜发汗以驱水者，以小青龙汤主之。如水在
少阴之经，宜化气以导水者，以真武汤主之，如风水脉浮、身重汗出恶风者，以防己黄 汤主之。如皮水
四肢肿，水在皮中，聂聂动者，以防己茯苓汤主之。如治正水者。以桂枝去芍药加麻黄细辛附子汤主之。
如治石水者，以麻黄附子汤主之。
苓桂麻黄汤
茯苓（三钱） 泽泻（三钱） 半夏（三钱） 杏仁（三钱） 甘草（二钱） 麻黄（二钱）
桂枝（三钱） 水煎大半杯，热服，覆衣取汗。中气虚加人参，寒加干姜，肺热加麦冬、贝母。用五
苓散加茵陈亦妙。
苓桂阿胶汤
茯苓（三钱） 泽泻（三钱） 甘草（二钱） 桂枝（三钱） 阿胶（三钱） 猪苓（三钱）
水煎大半杯，热服。小便不清加西瓜浆，热加栀子，中虚加人参，寒加干姜。乙木遏陷，疏泄不行，阳
败土湿，不能制伏水邪，故病肿胀。泄湿燥土，疏木行水，是定法也。后世八味加减之方，地黄助脾之湿
，附子益肝之热，肝脾未至极败，服之可效，肝脾病深，则不效，而反益其害，最误人也。
小青龙汤
（方见咳嗽）
桂枝去芍药加麻黄细辛附子汤 麻黄附子汤（二方，均见金匮。）
真武汤
（方见痰饮）
防己黄 汤
防己（三钱） 甘草（一钱半炙） 白术（二钱） 黄 （二钱） 生姜（一钱）
大枣（一枚） 水煎大半杯，温服。服后如虫行皮中，从腰下如冰，后坐被上，又以一被绕腰下，温令微
汗瘥。喘者加麻黄。胃中不和者，加芍药。气上冲者，加桂枝。
防己茯苓汤
防己（三钱） 桂枝（三钱） 黄 （三钱） 茯苓（六钱） 甘草（一钱炙） 水煎大半
杯，温服，日夜作三服。
桂枝苓泽汤
此方统治鼓胀 桂枝（三钱） 茯苓（六钱） 泽泻（三钱） 杏仁（三钱） 半夏（三钱）
甘草（二钱） 防己（三钱） 桑叶（三钱） 生姜（三钱） 水煎大半杯，温服。
水液代谢统属于肾，其根源在于肺。若肺阴不能正常肃降，则水液无法转化为气，从而泛滥于上部，这就形成了水胀病。所谓水胀，是指肚脐以上的部位出现肿胀。
这是因为肺气不降，是由于胃气上逆所致；胃气上逆，是因为脾土湿气过重；脾土湿气重，又源于肾水寒冷。当肾水寒冷时，肾脏失去了封藏的本性，导致相火（寄居于命门之火）不能秘藏。脾土湿盛进而导致肝木郁结，肝木郁结使得肝脏失去疏泄的功能，导致水道不能清利通畅。因此，膀胱排尿困难，水液不能归入下焦壅塞之处，反而逆行于胸腹，浸淫于经络，于是肿胀的病证就产生了。
对于病本在脏腑的，应当通过膀胱排泄水湿；对于病标在经络的，应当通过汗孔发散水湿。发汗和利尿的关键，总以燥湿健脾、疏畅肝木为主。虽然水病的表现虽然在肺和肾，但脾土湿盛和肝木郁结才是其根本原因。
如果初起阶段适合发汗的，用苓桂麻黄汤主治。适合利水的，用苓桂阿胶汤主治。如果水邪停留在太阳经，适合发汗以驱除水邪的，用小青龙汤主治。如果水邪停留在少阴经，适合化气以引导水行的，用真武汤主治。如果是风水证，表现为脉浮、身体沉重、出汗且怕风的，以防己黄芪汤主治。如果是皮水证，表现为四肢肿胀，水在皮肤之中，肌肤微微跳动的，以防己茯苓汤主治。如果是治疗正水证的，用桂枝去芍药加麻黄细辛附子汤主治。如果是治疗石水证的，用麻黄附子汤主治。
苓桂麻黄汤：茯苓三钱，泽泻三钱，半夏三钱，杏仁三钱，甘草二钱，麻黄二钱，桂枝三钱。用水煎至大半杯，热服，服药后覆盖衣物取汗。若中气虚弱加人参，寒象明显加干姜，肺热加麦冬、贝母。使用五苓散加茵陈也效果很好。
苓桂阿胶汤：茯苓三钱，泽泻三钱，甘草二钱，桂枝三钱，阿胶三钱，猪苓三钱。用水煎至大半杯，热服。小便不清加西瓜浆，有热象加栀子，中气虚弱加人参，寒象加干姜。乙木（肝）遏陷，疏泄功能不行，阳气败坏脾土湿盛，不能制伏水邪，所以发生肿胀。泄除湿邪、燥湿健脾、疏畅肝木、行水利尿，这是确定的治法。后世八味丸加减的方剂，地黄助长脾湿，附子增加肝热，如果肝脾尚未极度衰败，服用可能有效；但如果肝脾病情深重，则无效，反而增加危害，最误导人。
桂枝去芍药加麻黄细辛附子汤、麻黄附子汤：（这两个方剂均见《金匮要略》）
防己黄芪汤：防己三钱，甘草一钱半（炙），白术二钱，黄芪二钱，生姜一钱，大枣一枚。用水煎至大半杯，温服。服药后感觉像虫子在皮肤中爬行，腰部以下如冰般寒冷，随后坐在被子上，再用一条被子环绕腰部以下，保暖令其微微出汗即可痊愈。气喘者加麻黄。胃中不和者加芍药。气上冲者加桂枝。
防己茯苓汤：防己三钱，桂枝三钱，黄芪三钱，茯苓六钱，甘草一钱（炙）。用水煎至大半杯，温服，白天黑夜分三次服用。
桂枝苓泽汤：此方统治鼓胀病。桂枝三钱，茯苓六钱，泽泻三钱，杏仁三钱，半夏三钱，甘草二钱，防己三钱，桑叶三钱，生姜三钱。用水煎至大半杯，温服。
Water metabolism is governed by the Kidney (Shen) and rooted in the Lung (Fei). If Lung Yin fails to descend, water cannot transform into Qi, leading to flooding in the upper jiao, which constitutes Water Distension (Shui Zhang). Water Distension refers to swelling above the umbilicus.
The failure of Lung Qi to descend is due to Stomach Qi rebelling upward; Stomach Qi rebellion is caused by Dampness in the Spleen Earth; Spleen Earth dampness stems from Cold in the Kidney Water. When Kidney Water is cold, the Kidney loses its sealing and storing nature, causing Ministerial Fire (Xiang Huo) to fail in being securely stored. Excessive Spleen Earth dampness leads to Liver Wood stagnation; Liver Wood stagnation causes the Liver to lose its power of free flow and drainage, resulting in the inability of the water passages to clear and benefit. Consequently, the Bladder suffers from strangury (long bi), water fails to return to its proper reservoir, and reverses to flow into the chest and abdomen, infiltrating the meridians and collaterals, thus giving rise to swelling diseases.
For the root located in the Zang-Fu organs, it is appropriate to drain via the Bladder. For the branch located in the meridians, it is appropriate to drain via the sweat pores. The execution of sweating and urination primarily relies on drying dampness and soothing Liver Wood. Although water disease manifests in the Lung and Kidney, Spleen Earth dampness and Liver Wood stagnation are the fundamental causes.
If at the initial stage sweating is indicated, Ling Gui Ma Huang Tang (Poria, Cinnamon Twig, and Ephedra Decoction) should be used. If diuresis is indicated, Ling Gui E Jiao Tang (Poria, Cinnamon Twig, and Donkey-Hide Gelatin Decoction) should be used. If water resides in the Taiyang Meridian and sweating is indicated to drive out water, Xiao Qing Long Tang (Minor Green Dragon Decoction) should be used. If water resides in the Shaoyin Meridian and transforming Qi to guide water is indicated, Zhen Wu Tang (True Warrior Decoction) should be used. If it is Feng Shui (Wind Water) presenting with floating pulse, heavy body, sweating, and aversion to wind, Fang Ji Huang Qi Tang (Stephania and Astragalus Decoction) should be used. If it is Pi Shui (Skin Water) presenting with edema of the four limbs and water in the skin with slight tremors, Fang Ji Fu Ling Tang (Stephania and Poria Decoction) should be used. To treat Zheng Shui (Correct Water), Gui Zhi Qu Shao Yao Jia Ma Huang Xi Xin Fu Zi Tang (Cinnamon Twig Decoction without Peony plus Ephedra, Asarum, and Aconite) should be used. To treat Shi Shui (Stone Water), Ma Huang Fu Zi Tang (Ephedra and Aconite Decoction) should be used.
Ling Gui Ma Huang Tang: Fu Ling (Poria cocos, 3 qian), Ze Xie (Alisma rhizome, 3 qian), Ban Xia (Pinellia tuber, 3 qian), Xing Ren (Apricot seed, 3 qian), Gan Cao (Licorice root, 2 qian), Ma Huang (Ephedrae Herba, 2 qian), Gui Zhi (Cinnamomi Ramulus, 3 qian). Decoct in water to obtain half a cup, take hot, cover with clothing to induce sweating. Add Ren Shen (Ginseng radix) if Middle Qi is deficient; add Gan Jiang (Zingiberis Rhizoma) if there is cold; add Mai Dong (Ophiopogonis Radix) and Bei Mu (Fritillariae Bulbus) if there is Lung heat. Using Wu Ling San (Five-Ingredient Powder with Poria) plus Yin Chen (Artemisiae Scopariae Herba) is also excellent.
Ling Gui E Jiao Tang: Fu Ling (Poria cocos, 3 qian), Ze Xie (Alisma rhizome, 3 qian), Gan Cao (Licorice root, 2 qian), Gui Zhi (Cinnamomi Ramulus, 3 qian), E Jiao (Donkey-hide gelatin, 3 qian), Zhu Ling (Polyporus, 3 qian). Decoct in water to obtain half a cup, take hot. Add Xi Gua Jiang (Watermelon juice) if urine is unclear; add Zhi Zi (Gardeniae Fructus) if there is heat; add Ren Shen (Ginseng radix) if Middle Qi is deficient; add Gan Jiang (Zingiberis Rhizoma) if there is cold. Yi Mu (Liver Wood) is suppressed and sunken, free flow and drainage do not function, Yang is damaged, Spleen Earth dampness is excessive, failing to control Water Evil, thus swelling occurs. Draining dampness, drying Spleen Earth, soothing Liver Wood, and promoting water movement are the established methods. Later generations' modified formulas based on Ba Wei Wan (Eight-Ingredient Pill) use Di Huang (Rehmanniae Radix) which aids Spleen dampness, and Fu Zi (Aconiti Lateralis Radix Preparata) which increases Liver heat. If Liver and Spleen are not extremely depleted, taking these may be effective; but if Liver and Spleen disease is deep, they will be ineffective and instead increase harm, most misleading people.
Xiao Qing Long Tang: (Formula see Cough section)
Gui Zhi Qu Shao Yao Jia Ma Huang Xi Xin Fu Zi Tang, Ma Huang Fu Zi Tang: (Both formulas see Jingui Yaolue)
Zhen Wu Tang: (Formula see Phlegm-Fluids section)
Fang Ji Huang Qi Tang: Fang Ji (Stephaniae Tetrandrae Radix, 3 qian), Gan Cao (Licorice root, 1.5 qian, honey-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 2 qian), Huang Qi (Astragali Radix, 2 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 1 qian), Da Zao (Jujubae Fructus, 1 piece). Decoct in water to obtain half a cup, take warm. After taking, if one feels like insects crawling in the skin, and the lower waist feels like ice, sit on the quilt, then wrap another quilt around the lower waist, keep warm until slight sweating occurs for recovery. Add Ma Huang (Ephedrae Herba) if panting. Add Shao Yao (Paeoniae Radix Alba) if Stomach is disharmonious. Add Gui Zhi (Cinnamomi Ramulus) if Qi rushes upward.
Fang Ji Fu Ling Tang: Fang Ji (Stephaniae Tetrandrae Radix, 3 qian), Gui Zhi (Cinnamomi Ramulus, 3 qian), Huang Qi (Astragali Radix, 3 qian), Fu Ling (Poria cocos, 6 qian), Gan Cao (Licorice root, 1 qian, honey-fried). Decoct in water to obtain half a cup, take warm, divide into three doses throughout day and night.
Gui Zhi Ling Ze Tang: This formula generally treats Gu Zhang (Drum Distension). Gui Zhi (Cinnamomi Ramulus, 3 qian), Fu Ling (Poria cocos, 6 qian), Ze Xie (Alisma rhizome, 3 qian), Xing Ren (Apricot seed, 3 qian), Ban Xia (Pinellia tuber, 3 qian), Gan Cao (Licorice root, 2 qian), Fang Ji (Stephaniae Tetrandrae Radix, 3 qian), Sang Ye (Mori Folium, 3 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian). Decoct in water to obtain half a cup, take warm.