典藏书目

Treats Kidney deficiency and Spleen weakness, presenting with heaviness in the lower back and edema of the feet, difficult urination, abdominal distension with panting, excessive phlegm, and progression to Drum disease (Gu Zheng, a type of abdominal distension characterized by fluid accumulation). The efficacy is miraculous.

Prepared Rehmanniae Radix (Shu Dihuang) 4 liang, Poria (Fuling) 3 liang, Moutan Cortex (Mudanpi) 1 liang, Alisma Rhizoma (Zexie) 1 liang, Dioscoreae Rhizoma (Shanyao) 1 liang, Plantaginis Semen (Cheqianzi) 1 liang, Corni Fructus (Shanzhuyu) 1 liang, Achyranthis Bidentatae Radix (Niuxi) 1 liang, Cinnamomi Ramulus (Rougui) 1 liang, Aconiti Lateralis Radix Praeparata (Fuzi) 5 qian. These ten ingredients are mixed with honey to form pills. Take 80 pills per dose, swallowed with rice water on an empty stomach.

[Collected Annotations] Li Zhongzi stated: The *Classic of Internal Medicine* (*Huangdi Neijing*) states: "All dampness-induced swelling and fullness belong to the Spleen." It also states: "The root lies in the Kidney, the branch lies in the Lung; all are accumulations of water." Furthermore, it says: "The Kidney governs water and serves as the gate of the Stomach. If the gate is not functioning properly, water accumulates and follows its kind." Although swelling diseases may arise from various meridians, they invariably involve the Lung and Kidney. This is because the Spleen governs transportation and transformation, the Lung governs Qi transformation, and the Kidney governs the five fluids. All fluids transformed by the five Qi belong to the Kidney; all Qi required for the movement of the five fluids belongs to the Lung; and the transmission and regulation between these two organs, thereby controlling Water generating Metal (Kidney generating Lung), belong to the Spleen. Thus, swelling diseases do not extend beyond these three organs. However, treatment methods must be distinguished according to interior/exterior, upper/lower, and deficiency/excess patterns. Exterior manifestations present as edema, corresponding to indications for Yebiao Decoction (Yuebi Tang) and Minor Blue Dragon Decoction (Xiao Qinglong Tang). Interior manifestations present as distension, corresponding to indications for Ten Jujube Pills (Shizao Wan) and Shenyao Pills. Upper jiao manifestations present as panting, corresponding to indications for Platycodon and Large Date Decoction (Tingli Dazao Tang) and Pachysandra, Lepidium Seed, Platycodon, and Rhubarb Pill (Fangji Jiumu Tingli Dahuang Wan). Lower jiao manifestations present as urinary retention, corresponding to indications for Agarwood and Amber Pills (Chenxiang Hupo Wan) and Scouring Decoction (Shuzao Yinzi). These are all methods for treating excess patterns. As for deficiency patterns, Spleen-Strengthening Drink (Shipin Yin) and this formula (Zisheng Shenqi Wan) are indicated. Zhang Jiabin stated: Prepared Rehmanniae Radix, Dioscoreae Rhizoma, and Moutan Cortex nourish the true Yin-water within the Yin. Corni Fructus, Cinnamomi Ramulus, and Aconiti Lateralis Radix Praeparata transform the true Qi within the Yin. Poria, Alisma Rhizoma, Plantaginis Semen, and Achyranthis Bidentatae Radix promote the flow of stagnation within the Yin. This enables Qi to transform within Jing (Essence), which is effectively treating the Lung; supplementing Fire to generate Earth, which is effectively treating the Spleen; strengthening water metabolism and unblocking orifices, which is effectively treating the Kidney. It tonifies without causing stagnation and drains without damaging healthy Qi. This is a formula for treating deficiency-type edema, unsurpassed by any other. However, one should expand upon this formula and modify it according to specific symptoms. If a patient suffers from water distension due to severe Spleen Qi deficiency following a major illness, taking this formula will cause no harm but will ultimately be ineffective. One must deliberate carefully: severe damage to Spleen Qi cannot be treated solely with Kidney-tonifying herbs. Use Lizhong Decoction (Lizhong Tang) 1 liang plus Poria 1 liang. If Mingmen Fire (Gate of Life) is deficient, add Aconiti Lateralis Radix Praeparata; if both legs are cold, add Cinnamomi Ramulus; if abdominal distension is severe, add Magnoliae Officinalis Cortex (Houpo). After three doses, swelling in the calves and shins will gradually subside; after more than ten doses, abdominal distension will recede. For patients past middle age suffering from Spleen-Kidney Yang deficiency and cold, this method should be applied universally. Generally, those with Qi deficiency should not undergo further Qi-moving therapies; those with Kidney deficiency should not specialize solely in diuresis. Warming and tonifying is the way to transform Qi. The subtlety of "treating obstruction with obstruction" (using tonification to treat blockage) depends entirely on the practitioner's skill. Ancient treatments for edema avoided tonics, instead using drugs to eliminate water. Mild cases used differentiation and diuresis; severe cases used purgation to drive out water. Formulas such as Five-Ingredient Powder with Poria (Wuling San), Five-Dampness Powder (Wulin San), Five-Rind Powder (Wupi San), and Water-Guiding Poria Decoction (Daoshui Fuling Tang) are all for promoting diuresis. Formulas such as Boat-Chariot Shenyao Pills, Xunchuan Powder, Yu Gong Powder, and Ten-Jujube Decoction (Shizao Tang) are all for driving out water. However, if it is confirmed that the pathogen is truly excess, these treatment methods should not be discarded.