麻黄六两 石膏半筋 生姜三两 甘草二两 大枣十五枚
右五味，以水六升，先煮麻黄，上去沫，内诸药，煮取三升，分温三服。恶风者，加
附子一枚，炮。风水，加术四两。
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皮水为病，四肢肿，水气在皮肤中，四肢聂聂动者，防己茯苓汤主之。
【注】
此承皮水互详其证，以明其治也。皮水之病，是水气相搏，在皮肤之中，故四肢聂聂
□动也，以防己茯苓汤补卫通荣，祛散皮水也。
【集注】
沈明宗曰：此邪在皮肤而肿也。风入于卫，阳气虚滞，则四肢肿，经谓结阳者肿四肢
，即皮水也。皮毛受风气虚而肿，所谓水气在皮肤中，邪正相搏，风虚内豉，故四肢
聂聂而动，是因表虚也。盖三焦之气，同入膀胱，而行决渎，今水不行，则当使小便
利而病得除。故防己、茯苓除湿而利水，以黄耆补卫而实表，表实则邪不能容，甘草
安土而制水邪，桂枝以和荣卫，又行阳化气而实四末，俾风从外出，水从内泄矣。
防己三两 黄耆三两 桂枝三两 茯苓六两 甘草三两
右五味，以水六升，煮取二升，分温三服。
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里水，越婢加术汤主之，甘草麻黄汤亦主之。
【按】
里水之「里」字，当是「皮」字，岂有里水而用麻黄之理？阅者自知，是传写之□。
【注】
皮水表虚有汗者，防己茯苓汤固所宜也。若表实无汗有热者，则当用越婢加术汤。无
热者，则当用甘草麻黄汤发其汗，使水外从皮去也。
麻黄六两，石膏半升，生姜三两，甘草二两，大枣十五枚。
以上五味药，用水六升，先煮麻黄，去掉浮沫，再加入其他药物，煎煮取药液三升，分三次温服。如果有恶风症状的，加炮附子一枚。如果是风水证，加白术四两。
@@@
皮水病表现为四肢浮肿，水气停留在皮肤之中，四肢微微颤动的，用防己茯苓汤主治。
【注】
这里承接上文详细阐述皮水的证候，以明确其治疗方法。皮水病，是水气相互搏结，停留在皮肤之中，所以四肢会微微颤动，使用防己茯苓汤来补益卫气、疏通营血，祛除皮水。
【集注】
沈明宗说：这是邪气在皮肤导致的肿胀。风邪侵入卫分，阳气虚弱阻滞，就会导致四肢肿胀，经书所说“结阳者肿四肢”，就是皮水。皮毛因受风气侵袭且正气虚而肿胀，所谓水气在皮肤中，邪气与正气相搏结，风邪内扰，所以四肢微微颤动，这是因为表虚的缘故。大概三焦之气，同入膀胱，运行水道，现在水液不行，就应当使小便通利而疾病得以消除。所以防己、茯苓除湿利水，黄芪补益卫气而固表，表实则邪气不能容留，甘草安土以制约水邪，桂枝调和营卫，又通行阳气化生元气而充实四肢末端，使得风邪从外排出，水湿从内泄出。
防己三两，黄芪三两，桂枝三两，茯苓六两，甘草三两。
以上五味药，用水六升，煎煮取药液二升，分三次温服。
@@@
里水，用越婢加术汤主治，甘草麻黄汤也主治。
【按】
里水中的“里”字，应该是“皮”字，哪有里水却用麻黄的道理？读者自然明白，这是传抄过程中的讹误。
【注】
皮水表虚有汗的，防己茯苓汤固然适宜。如果表实无汗且有热的，则应当用越婢加术汤。没有热的，则应当用甘草麻黄汤发汗，使水湿从皮肤排出。
Ephedrae Herba (Mahuang, 麻黄) six liang, Gypsum Fibrosum (Shigao, 石膏) half sheng, Zingiberis Rhizoma Recens (Shengjiang, 生姜) three liang, Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) two liang, Jujubae Fructus (Dazao, 大枣) fifteen pieces.
The above five herbs are boiled in six sheng of water. First, boil Ephedrae Herba (Mahuang, 麻黄), remove the foam, then add the remaining herbs, and decoct to obtain three sheng of liquid. Divide into three doses and take warm. If there is aversion to wind, add one prepared Aconiti Lateralis Radix (Fuzi, 附子). For Fengshui (Wind-water edema), add four liang of Atractylodis Macrocephalae Rhizoma (Baizhu, 白术).
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Pi Shui (Skin Water Edema) presents with swelling of the four limbs, where water qi stagnates within the skin, causing slight tremors in the limbs. Fangji Fuling Tang (Stephania and Poria Decoction) is the primary treatment.
[Annotation]
This follows up on the detailed discussion of Pi Shui (Skin Water Edema) symptoms to clarify its treatment. Pi Shui (Skin Water Edema) involves the struggle between water qi and pathogenic factors within the skin, hence the slight tremors in the four limbs. Fangji Fuling Tang (Stephania and Poria Decoction) is used to tonify Wei Qi (Defensive Qi), unblock Ying Qi (Nutritive Qi), and dispel Pi Shui (Skin Water Edema).
[Collected Annotations]
Shen Mingzong stated: This is swelling caused by pathogenic factors in the skin. When Wind enters the Wei Qi (Defensive Qi) level and Yang Qi is deficient and stagnant, it leads to swelling of the four limbs. The Classics state that "Yang binding results in swelling of the four limbs," which refers to Pi Shui (Skin Water Edema). The skin and hair follicles become swollen due to Wind invasion and deficiency; this is what is meant by "water qi in the skin." The struggle between pathogenic factors and righteous Qi, with Wind disturbing internally, causes slight tremors in the four limbs, which is due to exterior deficiency. Generally, the Qi of the Sanjiao (Triple Burner) enters the Bladder together and regulates water passages. Now that water flow is obstructed, promoting urination will eliminate the disease. Therefore, Fangji (Stephaniae Tetrandrae Radix) and Fuling (Poria) drain dampness and promote diuresis; Huangqi (Astragali Radix) tonifies Wei Qi (Defensive Qi) and consolidates the exterior; Gancao (Glycyrrhizae Radix et Rhizoma) stabilizes the Earth to control water pathogens; Guizhi (Cinnamomi Ramulus) harmonizes Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi), promotes Yang Qi transformation, and strengthens the extremities, allowing Wind to exit from the exterior and Water to drain from the interior.
Stephaniae Tetrandrae Radix (Fangji, 防己) three liang, Astragali Radix (Huangqi, 黄芪) three liang, Cinnamomi Ramulus (Guizhi, 桂枝) three liang, Poria (Fuling, 茯苓) six liang, Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) three liang.
The above five herbs are boiled in six sheng of water, decocted to obtain two sheng of liquid, divided into three doses, and taken warm.
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Li Shui (Interior Water) is primarily treated with Yuabi Jia Zhu Tang (Ma Huang and Gypsum Decoction plus Atractylodes); Gancao Mahuang Tang (Licorice and Ephedra Decoction) is also indicated.
[Commentary]
The character "Li" (Interior) in Li Shui (Interior Water) should be "Pi" (Skin). How could Interior Water be treated with Ephedra? Readers will understand naturally; this is a transcription error.
[Annotation]
For Pi Shui (Skin Water Edema) with exterior deficiency and sweating, Fangji Fuling Tang (Stephania and Poria Decoction) is indeed appropriate. If there is exterior excess, no sweating, and heat, Yuabi Jia Zhu Tang (Ma Huang and Gypsum Decoction plus Atractylodes) should be used. If there is no heat, Gancao Mahuang Tang (Licorice and Ephedra Decoction) should be used to induce sweating, allowing water to exit through the skin.