喻昌曰∶诸病辨脉，以浮沉迟数四脉为纲，而水病之精微要渺，莫不从此四字参出。其及于弦紧微涩伏潜之脉者，
愈推愈广之节目耳。风水脉浮，此定法也。然有太阳脉浮之风水，有肝肾并沉之风水，有勇而劳汗之风水，有面 庞郁
壅害于言之风水，治法同一开鬼门，而标中之本，则微有分矣。抑且当汗之证，渴而下利，小便数，皆不可发汗，可不
辨而犯其戒乎？脉沉曰水，此定法也。而肝肾并沉为石水，沉伏相搏名曰水，少阴脉紧而沉，紧则为痛，沉则为
水，脉得诸沉，当责有水，身体肿重，水病脉出者死。沉为水，紧为寒，沉紧相搏，结在关元。沉为里水，水之为病，
其脉沉小，属少阴，《内经》明有洁净府之法，《金匮》治诸沉脉俱不及之。另曰∶腰以下肿者，宜利小便。又曰∶小便
自利者愈。正恐沉微沉迟，肾气衰少，误用其法耳。以上所论浮沉诸脉，皆显明而可解者也。至论迟数之脉，谓寸口脉
浮而迟，浮脉则热，迟脉则潜，热潜相搏，名曰沉。趺阳脉浮而数，浮脉即热，数脉即止，数止相搏，名曰伏。沉伏相
搏，名曰水。沉则络脉虚，伏则小便难，虚难相搏，水走皮肤，即为水矣。如是言脉，截断众流，令聪明知见，全不得
入，岂非最上一乘乎？寸口者，肺脉所过。趺阳者，胃脉所过。二脉合证者，表章《内经》三阴结谓之水，当以寸口趺
阳定其证也。寸口脉浮而迟，浮为卫为阳，迟为荣为阴，卫不与荣和，其阳独居脉外则为热。荣不从卫，匿于脉中则为
潜。荣卫之间，热潜之邪，相搏而至，则肺气不能布化，故自结而沉也。脾与胃以膜相连而为表里，趺阳脉浮而数，
胃阳不与脾阴相合，浮而独居于表则为热。脾阴不得胃阳以和，反为阳气所促而变量，数则阴血愈虚而止矣。数止相搏，
名曰伏者，趺阳之脉本不伏，以热止之故而脉伏也。寸口之沉，趺阳之伏，相搏于中则为水，岂非三阴结一定之证乎？
然肺合皮毛者也，皮肤者络脉之所过，肺沉而气不为充，荣潜而血不为养，则络脉虚。脾为胃行津液者也，脾伏则津液
不入膀胱，故小便难，络虚便难，水之积者，乘虚而走皮间为肿矣。《金匮》之书，观之不解，正精微所在，未可释手也。
寸口脉迟而涩，解见二卷水寒中，然以寸口定肺之证矣。而肺者，外合皮毛，内合大肠者也。外合皮毛，既推皮虚，所
过络脉之虚，水入为肿矣。而内合大肠，岂无脉法以推之耶？《金匮》又曰寸口脉弦而紧，弦则卫气不行，紧即恶寒，
水不活流，走于肠间，以浮迟弦紧为肺脉主水，表里之分也。弦为水，紧为寒，水寒在肺，则荣卫不温分肉而恶寒，肺
之治节不行，不能通调水道，故水不活流，而但走大肠之合也。即肺水者，其身肿，小便难，时时鸭溏之互辞也，以趺
阳定胃之诊矣。而胃之或寒或热，亦即于脉之或紧或数而辨之。故曰趺阳脉当伏，今反紧，本自有寒疝瘕，腹中痛，医
反下之，下之即胸满短气。又曰趺阳脉当伏，今反数，本自有热，消谷，小便数，反今不利，此欲作水，一寒一热，两
出趺阳所主脉证。寒疝瘕即石水之类，腹中痛，宜温不宜下，下之而伤其胸中之阳，则浊阴上攻，胸满短气也。《内经》
肿满环脐痛，名风根不可动，动之为水溺涩之病。风根为阳，动之则乘阴，疝瘕为阴，动之则乘阳，皆精义也。热能消
谷，小便数，本是瘅成消中之病，今反小便不利，此欲作水，亦可见其水必乘热势浸淫，无所不至，与黄汗证大同小异
耳。《金匮》水病脉法之要，全在求责有无盛虚。有者求之，无者求之，凡属本证兼证，胸中了然，无所疑惑矣。盛者责
之，为风，为热，为肿，为痛，为气强，为发热躁烦，莫不有脉可据矣。虚者责之，为正虚，卫虚，荣虚，经虚，络虚，
水谷气虚，少阳卑少阴细之虚，亦莫不有脉可据矣。究竟脉者精微之学也，昌欲传其精微，而精微出于平淡，愈推愈广，
愈求愈获。如水病脉出者死，徒读其文，宁不误人自误乎？风水黄汗等证，脉之浮大且洪者，岂亦主死乎？惟少阴肾水，
其脉本沉者，忽焉沉之乌有，而反外出则主死耳。又如荣卫之虚，其辨不一，有荣卫随风火热上行，而不环周于身者；
有荣卫因汗出多，而不固于腠理者；有荣卫因谷气少，并虚其宗气，胸中作痛者；有荣卫不和于脉之内外者；有荣卫阻
绝于脉之上下者；有荣卫所主，上中下三焦俱病，四属断绝者；有荣卫热 肌肤疡溃者，一一致详，始得其精，学脉者
自为深造可矣。
论《金匮》防己黄 汤方 本文云∶风水脉浮，身重汗出恶风者，防己黄 汤主之。腹痛加芍药。
脉浮，表也。汗出恶风，表之虚也。身重，水客分肉也。防己疗风肿水肿，通腠理。黄 温分肉，补卫虚，白术治
皮风止汗。甘草和药益土。生姜、大枣辛甘发散，腹痛并阴阳气塞，不得升降，再加芍药收阴。
论《金匮》越婢汤方 本文云∶风水，恶风，一身悉肿，脉浮，不渴，续自出汗，无大热，越婢汤主之。里水
者，一身面目黄肿，其脉沉，小便不利，故令病水。假如小便自利，此亡津液，故令渴也，越婢加术汤主之。
前条风水续自汗出，无大热，故用之。设不汗出且大热，表法当不主此也。后条里水，假如小便自利，亡津而渴故
用之。不尔，里法当不主此也。曰无大热，则有热可知；曰里水，乃躯壳之里，非脏腑之里可知，故俱得用越婢汤也。
越婢汤者，示微发表于不发之方也，《尚论》伤寒太阳第三篇，已详之矣。大率取其通调荣卫，和缓之性，较女婢尤过
之，
而命其名也。盖麻黄、石膏二物，一甘热，一甘寒，合而用之，脾偏于阴，则和以甘热。胃偏于阳，则和以甘
寒。乃至风热之阳，水寒之阴，凡不和于中土者，悉得用之，何者中土不和，则水谷不化其精悍之气以实荣卫，荣卫虚，
则或寒或热之气，皆得壅塞其隧道，而不通于表里，所以在表之风水用之；而在里之水兼渴而小便自利者，咸必用之，
无非欲其不害中土耳。不害中土，自足消患于方萌，抑何待水土平成乎？
论《金匮》防己茯苓汤方 本文云∶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。
风水脉浮，用防己黄 汤矣，而皮水即仿佛而用之。前脉论中，谓同一开鬼门，而标中之本，则微有分，此方是也。
风水下郁其土气，则用白术崇土，姜枣和中。皮水内合于肺，金郁泄之，水渍于皮，以淡渗之，故以茯苓易白术，加桂
枝解肌，以散水于外，不用姜枣和之于中也。况四肢聂聂，风在荣卫，触动经络，桂枝尤不可少耶。
论《金匮》麻黄附子汤杏子汤二方 本文云∶水之为病，其脉沉小，属少阴。浮者为风，无水虚胀者为气。水，
发其汗即已。脉沉者宜麻黄附子汤，浮者宜杏子汤。
此论少阴正水之病，其脉自见沉小，殊无外出之意。若脉见浮者，风发于外也。无水虚胀者，手太阴气郁不行也。
风气之病，发其汗则自已耳。即脉沉无他证者，当仿伤寒少阴例，用麻黄附子甘草汤，荡动其水以救肾。若脉浮者其外
证必自喘，当仿伤寒太阳例，用麻黄杏子甘草石膏汤，发散其邪以救肺，此治金水二藏之大法也。
论黄 芍药桂枝苦酒汤桂枝加黄 二方 本文云∶黄汗之为病，身体肿，发热汗出而渴，状如风水，汗沾衣，
色正黄如柏汁，脉自沉，何从得之？师曰∶以汗出入水中浴，水从汗孔入得之，宜 芍桂酒汤主之。黄汗之病，两足自
冷，假令发热，此属历节；食已汗出，又身常暮盗汗者，此劳气也；若汗出已，反发热者，久久其身必甲错；发热不止
者，必生恶疮；若身重汗出已辄轻者，久久必身 ， 即胞中痛，又从腰以上必汗出，下无汗，腰髋弛痛，如有物在皮
肤中状，剧者不能食，身疼重，烦躁，小便不利，此为黄汗，桂枝加黄 汤主之。
两证大同小异，前一证以汗出而卫气不固，外水入搏于荣，郁而为热。热盛则肿而发黄，热盛则耗其津液而作渴，
故以黄 固护其卫，以桂枝本方加苦酒，引入荣分，散其水寒之邪。但卫虚多汗，不在发表，故不用姜枣辅助胃气，所
恃者黄 实卫之大力耳。后一方用桂枝全方，啜热稀粥助其得汗，加黄 固卫，以其发热，且兼自汗盗汗，发热故用桂
枝，多汗故加黄 也。其发汗已仍发热，邪去不尽，势必从表解之，汗出辄轻，身不重也，久久身 胸中痛，又以过汗
而伤其卫外之阳，并胸中之阳也。腰以上有汗，腰以下无汗，阳通而阴不通，上下痞隔，更宜黄 固阳，桂枝通阴矣。
黄汗与历节有分，阳火独壅于上为黄汗；阴水独积于下为两胫冷；阳火盛及肌肉则发热；阴水寒及筋骨则历节痛，源同
而流不同也。食已汗出者，食入于所长之阳，与劳气相搏散出为汗，乃至气门不闭，津液常泄，暮为盗汗也。甲错者，
皮间枯涩，如鳞甲错出也。发热不已，热入肉腠，必生恶疮，留结痈脓也。腰髋弛痛，如有物在皮中状，即《内经》痛
痹，逢寒则虫之类也。小便不利，津液从汗越也。不能食，脾胃气虚不能化谷也。身体重，卫气不充分肉也。烦躁，胃
热上熏心肺也。治黄汗之法，尽发于此矣。
论《金匮》桂枝去芍药加麻黄附子细辛汤枳术汤 本文云∶气分，心下坚，大如盘，边如旋杯，水饮所作，桂
枝去芍药加麻黄附子汤主之。又云∶心下坚，大如盘，边如旋杯，水饮所作，枳术汤主之。
心下，胃之上也。胃中阳气不布，心下乃为水饮之阴占据，坚大如盘，阻其上下出入之坦道，只从边旁辗转，虽总
一阳气之权不伸所致。然有阴阳二候，阳气虚而阴气乘之，结于心下，必用桂枝汤去芍药之走阴，而加麻黄、附子、细
辛，其散胸中之水寒。以少阴主内，水寒上入，即从少阴温经散寒之法而施治也。所以方下云∶当汗出如虫行皮中即愈。
可见胃中之阳不布，即胸中之阳亦虚，胸中阳虚，并卫外之阳亦不固，故其汗出时，如虫行皮中，尚显阳气滞涩之象，
设非桂、麻、细辛，协附子之大力，心下水寒，能散走皮中乎？水寒散，斯重云见 ，而心下之坚大者，豁热空矣，此
神治也。其有阳邪自结于阳位，阴寒未得上入者，但用枳术二味，开其痰结，健其脾胃，而阳分之阳邪，解之自易易耳。
论海藏集仲景水气例 海藏于治水肿一门，务为致详。设为水气问难，求责脉之有力无力，藏沉府浮，用药大
凡，意在发明《内经》仲景，其实浑是后人窠臼，中无实得也。其云∶高低、内外、轻重、表里，随经补泻，要当详察
肺胃肾三经，病即瘥也，此一语最为扼要，然终未到家。《内经》明谓三阴结谓之水，三阴者，太阴也。足太阴脾，手
太
阴肺，气结不行，即成水病，而水之源出自肾，故少阴肾亦司之。但当言肺脾肾，不当言肺胃肾也，何也？胃不必言也，
胃本水谷之海，五脏六腑之大源，脾不能散胃之水精于肺，而病于中。肺不能通胃之水道于膀胱，而病于上。肾不能司
胃之关门，时其输泄而病于下。所以胃中积水浸淫，无所底止耳。海藏举肺胃肾而遗脾，于至理不过一间未达，原不必
议，其治例仍以肺沉大肠浮，心沉小肠浮为言，此则相沿之陋也。讵知脏腑各分浮沉，而大小二肠，不当从上焦分证耶。
至于所集仲景水气例，则未窥宫墙富美，反多门外邪僻矣！夫仲景论杂证，于水气一门，极其精详，惟恐足太阴脾之健
运失职，手太阴肺之治节不行，足少阴肾之关门不开，并其府膀胱之气化不行，所用方药，皆不蹈重虚之戒，立于无过
之地。海藏集仲景治肺痈葶苈大枣泻肺汤为例，是欲以泻肺之法，为泻水之法矣。集仲景治伤寒痞连两胁，杂证支饮在
胁之十枣汤为例，是欲以泻胸胁及膀胱，为泻水之法矣。何其敢于操刃，而借口仲景耶？不但此也，抑且假托后人治水
之峻药，本之仲景，谓三化神 丸即十枣汤加牵牛、大黄、轻粉；除湿丹即神 丸加乳香、没药；元青丹又即神 丸加
黄连、黄柏、青黛，集仲景之方，以傅会后人，罪不容诛矣。后来依样葫芦，更改一味二味，即成一方，不伤脾即泻肺，
不泻肺即泻膀胱，乃致积水滔天，载胥及溺，绝无一人追悔从前用药之咎，正以繇来者非一日耳。水病门中，成方百道，
求一救肺气之 郁，而伸其治节之方，无有也。求一救膀胱阻绝，而伸其气化之方，无有也。节取数方，发明备用，临
病自出生心化裁，是所望矣。
喻昌说：辨别各种疾病的脉象，以浮、沉、迟、数这四种脉象为纲领，而水病（水肿）的精微奥妙之处，无不从这四个字中推演出来。那些涉及弦、紧、微、涩、伏、潜等脉象的，不过是进一步推演后更细致的分类罢了。风水病脉象浮，这是确定的法则。然而，有太阳经脉浮的风水，有肝肾脉并见沉象的风水，有因勇力过度导致劳汗出的风水，有面部肿胀壅塞影响言语的风水，治疗方法虽然都是采用“开鬼门”（发汗法），但标与本的区别，则略有不同。况且，应当用发汗法的证候中，如果有口渴且下利、小便频数的情况，都不可发汗，难道可以不加以辨别就违反这些禁忌吗？
脉象沉主水病，这是确定的法则。肝肾脉并见沉象称为石水，沉脉与伏脉相搏结称为水病，少阴脉紧而沉，紧主痛，沉主水，脉象出现各种沉象，应当责求体内有水，身体浮肿沉重，水病脉象突然浮大外出的预后不良（死证）。沉主水，紧主寒，沉紧相搏结，病位在关元穴处。沉主里水，水病的脉象沉小，属于少阴经，《内经》明确提出了“洁净府”（利小便）的方法，《金匮要略》治疗各种沉脉却未提及此法。又说：腰以下肿者，宜用利小便的方法。又说：小便自利者自愈。这正是担心脉象沉微或沉迟，肾气衰少，误用了利小便的方法罢了。以上所论述的浮、沉诸脉，都是显明易懂的。至于论述迟、数之脉，说寸口脉浮而迟，浮脉主热，迟脉主潜藏，热与潜相搏结，称为沉。趺阳脉浮而数，浮脉即热，数脉主止（阻滞），数与止相搏结，称为伏。沉与伏相搏结，称为水。沉则络脉虚，伏则小便难，虚与难相搏结，水湿走窜皮肤，就成为水病了。像这样论述脉象，截断众流，使聪明人的知见完全无法介入，这岂不是最高深的学问吗？
寸口脉，是肺脉经过的地方。趺阳脉，是胃脉经过的地方。这两处脉合参来辨证，是为了彰显《内经》中“三阴结谓之水”的理论，应当通过寸口和趺阳脉来确定证候。寸口脉浮而迟，浮为卫气属阳，迟为荣气属阴，卫气不与荣气调和，阳气独居脉外则为热。荣气不从卫气，隐匿于脉中则为潜。在荣卫之间，热与潜的邪气相搏而至，肺气不能布散化生，所以自身结聚而现沉脉。脾与胃以膜相连，互为表里。趺阳脉浮而数，胃阳不与脾阴相合，浮而独居于表则为热。脾阴得不到胃阳的调和，反而被阳气催促而改变常态，数脉则阴血愈虚而阻滞。数与止相搏结，称为伏的，是因为趺阳脉本不伏，因为热与滞的缘故导致脉伏。寸口脉沉，趺阳脉伏，二者相搏于中焦则生水，这难道不是三阴结这一确定证候吗？
然而，肺合皮毛，皮肤是络脉经过的地方，肺脉沉而气不充盛，荣气潜藏而血不滋养，则络脉空虚。脾为胃运行津液的，脾脉伏则津液不能进入膀胱，所以小便困难，络脉虚且小便难，积聚的水湿乘虚走窜皮间成为浮肿。《金匮要略》这本书，如果不深入理解就无法明白，这正是其精微所在，不可轻易放下。寸口脉迟而涩，解释见于第二卷水寒中篇，这里是用寸口脉来判定肺的证候。而肺，外合皮毛，内合大肠。外合皮毛，既然推导了皮虚，所经过的络脉也虚，水入则为肿。内合大肠，难道没有脉法可以推断吗？《金匮要略》又说寸口脉弦而紧，弦则卫气不行，紧即恶寒，水不流动，走于肠间，以浮、迟、弦、紧作为肺脉主水的依据，这是表里的分别。弦主水，紧主寒，水寒在肺，则荣卫不能温煦分肉而恶寒，肺的治节功能不行，不能通调水道，所以水不流动，只走大肠的合穴。所谓肺水，就是身体肿、小便难、时时鸭溏（大便稀薄如鸭粪）的互文说法。
用趺阳脉来定胃的诊察。而胃的或寒或热，也从脉象的或紧或数来辨别。所以说趺阳脉应当伏，现在反而紧，原本自有寒疝瘕（腹中寒气凝结成块），腹中痛，医生反而用攻下法，攻下后即胸满短气。又说趺阳脉应当伏，现在反而数，原本自有热，消谷善饥，小便数，现在反而小便不利，这是将要发生水病。一寒一热，两种情况出自趺阳脉所主的脉证。寒疝瘕即石水之类，腹中痛，宜温不宜下，攻下损伤胸中之阳，则浊阴上攻，导致胸满短气。《内经》说肿满环脐痛，名为风根，不可动，动了就会变成水溺涩的病。风根属阳，动之则乘阴；疝瘕属阴，动之则乘阳，这都是精妙的义理。热能消谷，小便数，本是瘅成消中的病，现在反而小便不利，这也可见水必乘热势浸淫，无所不至，与黄汗证大同小异罢了。《金匮要略》水病脉法的要点，全在于求责有无盛虚。有的求其因，无的求其果，凡是属于本证兼证，心中了然，无所疑惑。盛者责之，为风、为热、为肿、为痛、为气强、为发热躁烦，莫不有脉可据。虚者责之，为正虚、卫虚、荣虚、经虚、络虚、水谷气虚、少阳卑少阴细之虚，也莫不有脉可据。
究竟脉学是精微的学问，我想传授其精微之处，而精微出于平淡，越推演越广博，越寻求越有所收获。如水病脉出者死，如果只读其文字，岂不误人又误己呢？风水、黄汗等证，脉象浮大且洪的，难道也主死吗？只有少阴肾水，其脉本沉的，忽然沉而无迹，反而外出则主死。又如荣卫之虚，辨别不一，有荣卫随风火热上行，而不环绕周身者；有荣卫因出汗多，而不固密于腠理者；有荣卫因谷气少，并虚其宗气，胸中作痛者；有荣卫不和于脉之内外者；有荣卫阻绝于脉之上下者；有荣卫所主的上中下三焦俱病，四属断绝者；有荣卫热毒致肌肤疡溃者，一一详细辨析，才能得其精微，学习脉学的人自然能深造了。
论《金匮要略》防己黄芪汤方：本文说：风水脉浮，身重汗出恶风者，防己黄芪汤主之。腹痛加芍药。脉浮，表示表证。汗出恶风，表示表虚。身重，是水湿客留于分肉之间。防己治疗风肿水肿，通达腠理。黄芪温养分肉，补卫气之虚，白术治疗皮风止汗。甘草调和药性益脾胃。生姜、大枣辛甘发散，腹痛并阴阳气塞，不得升降，再加芍药收敛阴气。
论《金匮要略》越婢汤方：本文说：风水，恶风，一身悉肿，脉浮，不渴，续自出汗，无大热，越婢汤主之。里水者，一身面目黄肿，其脉沉，小便不利，故令病水。假如小便自利，此亡津液，故令渴也，越婢加术汤主之。前条风水续自汗出，无大热，所以用此方。假设不汗出且大热，解表法就不以此为主了。后条里水，假如小便自利，亡津而渴所以用此方。否则，治里法就不以此为主了。说“无大热”，则有热可知；说“里水”，乃躯壳之里，非脏腑之里可知，所以都得用越婢汤。越婢汤，是示微发表于不发之方的意思，《尚论篇》伤寒太阳第三篇，已经详细论述过了。大率取其通调荣卫，和缓之性，较女婢（指柔弱女子）尤过之，而命其名也。盖麻黄、石膏二物，一甘热，一甘寒，合而用之，脾偏于阴，则和以甘热。胃偏于阳，则和以甘寒。乃至风热之阳，水寒之阴，凡不和于中土者，悉得用之，何者中土不和，则水谷不化其精悍之气以实荣卫，荣卫虚，则或寒或热之气，皆得壅塞其隧道，而不通于表里，所以在表之风水用之；而在里之水兼渴而小便自利者，咸必用之，无非欲其不害中土耳。不害中土，自足消患于方萌，抑何待水土平成乎？
论《金匮要略》防己茯苓汤方：本文说：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。风水脉浮，用防己黄芪汤矣，而皮水即仿佛而用之。前脉论中，谓同一开鬼门，而标中之本，则微有分，此方是也。风水下郁其土气，则用白术崇土，姜枣和中。皮水内合于肺，金郁泄之，水渍于皮，以淡渗之，故以茯苓易白术，加桂枝解肌，以散水于外，不用姜枣和之于中也。况四肢聂聂，风在荣卫，触动经络，桂枝尤不可少耶。
论《金匮要略》麻黄附子汤杏子汤二方：本文说：水之为病，其脉沉小，属少阴。浮者为风，无水虚胀者为气。水，发其汗即已。脉沉者宜麻黄附子汤，浮者宜杏子汤。此论少阴正水之病，其脉自见沉小，殊无外出之意。若脉见浮者，风发于外也。无水虚胀者，手太阴气郁不行也。风气之病，发其汗则自已耳。即脉沉无他证者，当仿伤寒少阴例，用麻黄附子甘草汤，荡动其水以救肾。若脉浮者其外证必自喘，当仿伤寒太阳例，用麻黄杏子甘草石膏汤，发散其邪以救肺，此治金水二藏之大法也。
论黄芪芍药桂枝苦酒汤桂枝加黄芪汤二方：本文说：黄汗之为病，身体肿，发热汗出而渴，状如风水，汗沾衣，色正黄如柏汁，脉自沉，何从得之？师曰：以汗出入水中浴，水从汗孔入得之，宜黄芪芍药桂枝苦酒汤主之。黄汗之病，两足自冷，假令发热，此属历节；食已汗出，又身常暮盗汗者，此劳气也；若汗出已，反发热者，久久其身必甲错；发热不止者，必生恶疮；若身重汗出已辄轻者，久久必身 ， 即胞中痛，又从腰以上必汗出，下无汗，腰髋弛痛，如有物在皮肤中状，剧者不能食，身疼重，烦躁，小便不利，此为黄汗，桂枝加黄芪汤主之。两证大同小异，前一证以汗出而卫气不固，外水入搏于荣，郁而为热。热盛则肿而发黄，热盛则耗其津液而作渴，故以黄芪固护其卫，以桂枝本方加苦酒，引入荣分，散其水寒之邪。但卫虚多汗，不在发表，故不用姜枣辅助胃气，所恃者黄芪实卫之大力耳。后一方用桂枝全方，啜热稀粥助其得汗，加黄芪固卫，以其发热，且兼自汗盗汗，发热故用桂枝，多汗故加黄芪也。其发汗已仍发热，邪去不尽，势必从表解之，汗出辄轻，身不重也，久久身 胸中痛，又以过汗而伤其卫外之阳，并胸中之阳也。腰以上有汗，腰以下无汗，阳通而阴不通，上下痞隔，更宜黄芪固阳，桂枝通阴矣。黄汗与历节有分，阳火独壅于上为黄汗；阴水独积于下为两胫冷；阳火盛及肌肉则发热；阴水寒及筋骨则历节痛，源同而流不同也。食已汗出者，食入于所长之阳，与劳气相搏散出为汗，乃至气门不闭，津液常泄，暮为盗汗也。甲错者，皮间枯涩，如鳞甲错出也。发热不已，热入肉腠，必生恶疮，留结痈脓也。腰髋弛痛，如有物在皮中状，即《内经》痛痹，逢寒则虫之类也。小便不利，津液从汗越也。不能食，脾胃气虚不能化谷也。身体重，卫气不充分肉也。烦躁，胃热上熏心肺也。治黄汗之法，尽发于此矣。
论《金匮要略》桂枝去芍药加麻黄附子细辛汤枳术汤：本文说：气分，心下坚，大如盘，边如旋杯，水饮所作，桂枝去芍药加麻黄附子汤主之。又云：心下坚，大如盘，边如旋杯，水饮所作，枳术汤主之。心下，胃之上也。胃中阳气不布，心下乃为水饮之阴占据，坚大如盘，阻其上下出入之坦道，只从边旁辗转，虽总一阳气之权不伸所致。然有阴阳二候，阳气虚而阴气乘之，结于心下，必用桂枝汤去芍药之走阴，而加麻黄、附子、细辛，其散胸中之水寒。以少阴主内，水寒上入，即从少阴温经散寒之法而施治也。所以方下云：当汗出如虫行皮中即愈。可见胃中之阳不布，即胸中之阳亦虚，胸中阳虚，并卫外之阳亦不固，故其汗出时，如虫行皮中，尚显阳气滞涩之象，设非桂、麻、细辛，协附子之大力，心下水寒，能散走皮中乎？水寒散，斯重云见 ，而心下之坚大者，豁热空矣，此神治也。其有阳邪自结于阳位，阴寒未得上入者，但用枳术二味，开其痰结，健其脾胃，而阳分之阳邪，解之自易易耳。
论海藏集仲景水气例：海藏（张元素）于治水肿一门，务为致详。设为水气问难，求责脉之有力无力，藏沉府浮，用药大凡，意在发明《内经》仲景，其实浑是后人窠臼，中无实得也。其云：高低、内外、轻重、表里，随经补泻，要当详察肺胃肾三经，病即瘥也，此一语最为扼要，然终未到家。《内经》明谓三阴结谓之水，三阴者，太阴也。足太阴脾，手太阴肺，气结不行，即成水病，而水之源出自肾，故少阴肾亦司之。但当言肺脾肾，不当言肺胃肾也，何也？胃不必言也，胃本水谷之海，五脏六腑之大源，脾不能散胃之水精于肺，而病于中。肺不能通胃之水道于膀胱，而病于上。肾不能司胃之关门，时其输泄而病于下。所以胃中积水浸淫，无所底止耳。海藏举肺胃肾而遗脾，于至理不过一间未达，原不必议，其治例仍以肺沉大肠浮，心沉小肠浮为言，此则相沿之陋也。讵知脏腑各分浮沉，而大小二肠，不当从上焦分证耶。至于所集仲景水气例，则未窥宫墙富美，反多门外邪僻矣！夫仲景论杂证，于水气一门，极其精详，惟恐足太阴脾之健运失职，手太阴肺之治节不行，足少阴肾之关门不开，并其府膀胱之气化不行，所用方药，皆不蹈重虚之戒，立于无过之地。海藏集仲景治肺痈葶苈大枣泻肺汤为例，是欲以泻肺之法，为泻水之法矣。集仲景治伤寒痞连两胁，杂证支饮在胁之十枣汤为例，是欲以泻胸胁及膀胱，为泻水之法矣。何其敢于操刃，而借口仲景耶？不但此也，抑且假托后人治水之峻药，本之仲景，谓三化神丸即十枣汤加牵牛、大黄、轻粉；除湿丹即神丸加乳香、没药；元青丹又即神丸加黄连、黄柏、青黛，集仲景之方，以傅会后人，罪不容诛矣。后来依样葫芦，更改一味二味，即成一方，不伤脾即泻肺，不泻肺即泻膀胱，乃致积水滔天，载胥及溺，绝无一人追悔从前用药之咎，正以繇来者非一日耳。水病门中，成方百道，求一救肺气之郁，而伸其治节之方，无有也。求一救膀胱阻绝，而伸其气化之方，无有也。节取数方，发明备用，临病自出生心化裁，是所望矣。
Yu Chang stated: In differentiating the pulse of various diseases, the four pulses of Floating (Fu), Deep (Chen), Slow (Chi), and Rapid (Shu) serve as the general principles. The subtleties and profundities of water diseases (Edema) are all derived from these four characters. Those involving the Wiry (Xian), Tight (Jin), Fine (Wei), Choppy (Se), Hidden (Fu), and Concealed (Qian) pulses are merely further subdivisions resulting from deeper deduction. Wind-water (Feng Shui) presents with a Floating pulse; this is a fixed rule. However, there is wind-water associated with a Floating pulse of the Taiyang channel, wind-water with simultaneous Deep pulses of the Liver and Kidney, wind-water caused by excessive exertion and sweating, and wind-water characterized by facial swelling and congestion affecting speech. Although the treatment method for all is "opening the ghost gate" (Diaphoresis/Sweating), the distinction between the branch (Biao) and the root (Ben) varies slightly. Furthermore, in conditions where diaphoresis is indicated, if there is thirst accompanied by diarrhea, or frequent urination, sweating must not be induced. How can one violate these prohibitions without careful differentiation?
A Deep pulse indicates water; this is a fixed rule. Simultaneous Deep pulses of the Liver and Kidney are termed Stone Water (Shi Shui). When Deep and Hidden pulses interact, it is called Water Disease. A Tight and Deep pulse at the Shaoyin position indicates pain for Tightness and water for Deepness. Whenever Deep pulses are found, one should investigate the presence of water; the patient will present with bodily swelling and heaviness. If the pulse of a water disease suddenly becomes superficial and large, it is a sign of death. Deep indicates water, Tight indicates cold; when Deep and Tight interact, the pathology is located at the Guanyuan acupoint. Deep indicates interior water; water diseases with a Small Deep pulse belong to the Shaoyin channel. The *Neijing* explicitly prescribes the method of "cleansing the bladder" (Promoting Urination), yet the *Jingui Yaolue* does not mention this for treating various Deep pulses. It also states: For edema below the waist, promote urination. It also states: Spontaneous urination indicates recovery. This caution arises from the fear that if the pulse is Fine-Deep or Slow-Deep, indicating deficient Kidney Qi, the method of promoting urination might be misapplied. The aforementioned discussions on Floating and Deep pulses are clear and understandable.
Regarding the discussion on Slow and Rapid pulses: If the Cun Kou (Radial artery at wrist) pulse is Floating and Slow, Floating indicates Heat, and Slow indicates concealment. The interaction of Heat and concealment is termed Chen (Sinking/Depressed). If the Fu Yang (Radial artery at foot) pulse is Floating and Rapid, Floating indicates Heat, and Rapid indicates stagnation/stopping. The interaction of Rapid and Stagnation is termed Fu (Hidden). The interaction of Chen and Fu constitutes Water Disease. Chen implies deficiency of the collaterals, while Fu implies difficulty in urination. The interaction of deficiency and difficulty causes water to flow into the skin, resulting in edema. Such discourse on pulses cuts off superficial understanding, preventing even the wise from easily grasping it; is this not the highest level of learning?
Cun Kou is where the Lung pulse passes. Fu Yang is where the Stomach pulse passes. Combining these two pulses for diagnosis elucidates the *Neijing* principle that "binding of the three Yin channels leads to water," determining the syndrome via Cun Kou and Fu Yang. At Cun Kou, a Floating and Slow pulse: Floating represents Wei (Defensive) Qi and Yang; Slow represents Ying (Nutritive) Qi and Yin. If Wei does not harmonize with Ying, Yang resides alone outside the vessels, causing Heat. If Ying does not follow Wei and hides within the vessels, it becomes concealed. When Heat and concealed pathogens interact between Ying and Wei, the Lung Qi cannot distribute and transform, leading to self-binding and a Sinking pulse. The Spleen and Stomach are connected by membranes and form an exterior-interior relationship. At Fu Yang, a Floating and Rapid pulse: Stomach Yang does not combine with Spleen Yin. Floating and residing alone at the exterior causes Heat. Spleen Yin, unable to harmonize with Stomach Yang, is urged by Yang Qi and changes state; Rapidness indicates Yin blood becoming increasingly deficient and stagnant. The term "Fu" (Hidden) for the interaction of Rapid and Stagnation means that although the Fu Yang pulse is naturally not Hidden, it becomes Hidden due to Heat and stagnation. The Sinking at Cun Kou and Hidden at Fu Yang interacting in the middle generates water; is this not the definitive manifestation of the binding of the three Yin channels?
The Lung governs the skin and hair; the skin is where the collaterals pass. If the Lung pulse is Sinking and Qi is not充盈 (full), and Ying is concealed and Blood does not nourish, the collaterals become deficient. The Spleen transports fluids for the Stomach; if the Spleen pulse is Hidden, fluids do not enter the Bladder, causing difficult urination. Deficient collaterals and difficult urination allow accumulated water to move into the interstitial spaces of the skin, causing swelling. The *Jingui Yaolue* is profound and difficult to understand; this is precisely where its subtlety lies, and one should not let go of it easily.
A Slow and Choppy pulse at Cun Kou is explained in Volume 2 under Cold-Dampness; here, Cun Kou determines the Lung syndrome. The Lung externally connects with the skin and hair and internally with the Large Intestine. Externally connecting with skin and hair, having deduced skin deficiency and collateral deficiency, water entering causes swelling. Internally connecting with the Large Intestine, is there no pulse method to deduce it? The *Jingui Yaolue* also states: A Wiry and Tight pulse at Cun Kou. Wiry indicates Wei Qi obstruction; Tight indicates aversion to cold. Water fails to circulate freely and moves into the intestines. Using Floating, Slow, Wiry, and Tight as the main pulses for Lung-related water distinguishes the exterior and interior. Wiry indicates water, Tight indicates cold. With water-cold in the Lung, Ying and Wei fail to warm the muscle intervals, causing aversion to cold. The Lung's regulatory function fails, and it cannot regulate water passages, so water does not circulate freely but flows into the Large Intestine. "Lung water" refers interchangeably to bodily swelling, difficult urination, and frequent loose stools resembling duck droppings.
Using Fu Yang to diagnose the Stomach: Whether the Stomach is Cold or Hot is distinguished by the pulse being Tight or Rapid. Thus, it is said that the Fu Yang pulse should be Hidden; if it is now Tight, the patient originally had Cold Hernia (Han Shan) or Masses (Jia), with abdominal pain. If the physician incorrectly uses purgatives, chest fullness and shortness of breath result. It also says: The Fu Yang pulse should be Hidden; if it is now Rapid, the patient originally had Heat, consuming food quickly, and frequent urination. Now, if urination becomes difficult, water disease is about to develop. These two cases, one Cold and one Hot, arise from the pulses and syndromes governed by Fu Yang. Cold Hernia is similar to Stone Water; abdominal pain requires warming, not purging. Purging damages the Yang Qi of the chest, allowing turbid Yin to attack upward, causing chest fullness and shortness of breath. The *Neijing* states that swelling and fullness with pain around the navel is named "Wind Root" and should not be disturbed; disturbing it leads to water retention and difficult urination. Wind Root is Yang; disturbing it attacks Yin. Hernia/Masses are Yin; disturbing them attacks Yang. These are profound insights. Heat consumes food, and frequent urination characterizes Dian Cheng Xiao Zhong (Heat-induced Thirst and Wasting); now, with difficult urination, it is evident that water will invade according to the heat trend, spreading everywhere, similar to but slightly different from Yellow Sweat (Huang Han). The key to the pulse methods for water disease in the *Jingui Yaolue* lies in investigating excess and deficiency. Investigate what exists and what does not exist; clarify all primary and secondary syndromes without doubt. For excess, investigate Wind, Heat, Swelling, Pain, Strong Qi, Fever, and Restlessness, all supported by pulse evidence. For deficiency, investigate Deficiency of Righteous Qi, Wei, Ying, Channels, Collaterals, Grain and Water Qi, and the deficiency of Shaoyang and Lesser Yin, all supported by pulse evidence.
Ultimately, pulse study is a subtle science. I wish to transmit its subtlety, which emerges from simplicity; the more it is deduced, the broader it becomes, and the more it is sought, the more it is obtained. For example, "pulse emerging in water disease indicates death"; reading only the text without understanding would surely mislead others and oneself. For Wind-water and Yellow Sweat, if the pulse is Floating, Large, and Surging, does it also indicate death? Only in Shaoyin Kidney Water, where the pulse is naturally Deep, if it suddenly disappears and emerges outward, does it indicate death. Regarding deficiency of Ying and Wei, differentiation is complex: there is Ying and Wei moving upward with Wind, Fire, and Heat without circulating the body; Ying and Wei failing to secure the cou li due to excessive sweating; Ying and Wei deficiency due to insufficient grain Qi, depleting Zong Qi and causing chest pain; Ying and Wei disharmony inside and outside the vessels; Ying and Wei blockage above and below the vessels; Ying and Wei pathology affecting the Upper, Middle, and Lower Jiao with severance of the four limbs; and Ying and Wei heat toxins causing skin ulcers. Detailed analysis of each allows one to grasp the essence; those studying pulses will naturally achieve deep proficiency.
Discussion on the Fangji Huangqi Tang Formula from *Jingui Yaolue*: The text states: For Wind-water with a Floating pulse, heaviness, sweating, and aversion to wind, Fangji Huangqi Tang is the primary formula. Add Shaoyao if there is abdominal pain. A Floating pulse indicates an exterior syndrome. Sweating and aversion to wind indicate exterior deficiency. Heaviness indicates water dampness lodging in the muscle intervals. Fangji treats wind-edema and water-swelling, unblocking the cou li. Huangqi warms the muscle intervals and tonifies Wei deficiency. Baizhu treats wind in the skin and stops sweating. Gancao harmonizes the herbs and benefits the Earth (Spleen/Stomach). Shengjiang and Dazao have pungent-sweet properties to disperse. Abdominal pain involves blockage of Yin and Yang Qi, preventing ascending and descending; adding Shaoyao collects Yin.
Discussion on the Yeshibi Tang Formula from *Jingui Yaolue*: The text states: For Wind-water with aversion to wind, generalized swelling, a Floating pulse, no thirst, continuous spontaneous sweating, and no significant fever, Yeshibi Tang is the primary formula. For Interior Water, presenting with generalized yellowish swelling of the face and body, a Deep pulse, and difficult urination, thus causing water disease. If urination is spontaneous, this indicates loss of body fluids, hence thirst; Yeshibi Jia Zhuyu Tang is the primary formula. The previous case of Wind-water with continuous sweating and no significant fever justifies its use. If there were no sweating and significant fever, the exterior-releasing method would not prioritize this. The latter case of Interior Water, if urination is spontaneous, indicates fluid loss and thirst, justifying its use. Otherwise, the interior method would not prioritize this. Saying "no significant fever" implies heat is present; saying "Interior Water" refers to the interior of the body shell, not the interior of the Zang-Fu organs, hence Yeshibi Tang is applicable in both. Yeshibi Tang demonstrates mild release without aggressive sweating. As detailed in the *Shanglun* commentary on the Taiyang chapter of Shanghan Lun, it generally utilizes the property of regulating Ying and Wei gently. Its name derives from this gentle nature compared to a weak woman. Mahuang (Ephedrae Herba) is Pungent-Warm, and Shigao (Gypsum Fibrosum) is Sweet-Cold. Used together, if the Spleen leans toward Yin, it is harmonized with Pungent-Warm; if the Stomach leans toward Yang, it is harmonized with Sweet-Cold. Thus, for Yang pathogenic factors like Wind-Heat or Yin pathogenic factors like Water-Cold that disrupt the Middle Jiao, this formula is suitable. If the Middle Jiao is disharmonious, Grain and Water cannot transform their refined essence to nourish Ying and Wei. With deficient Ying and Wei, Cold or Heat pathogens obstruct the pathways, preventing communication between interior and exterior. Hence, it is used for Exterior Wind-water and for Interior Water with thirst and spontaneous urination, aiming primarily not to harm the Middle Jiao. By protecting the Middle Jiao, disasters are prevented at their inception, without waiting for the harmony of Earth and Water.
Discussion on the Fangji Fuling Tang Formula from *Jingui Yaolue*: The text states: For Pi Shui (Skin Water) disease, with swelling of the four limbs and water qi in the skin, causing slight tremors in the limbs, Fangji Fuling Tang is the primary formula. Wind-water with a Floating pulse uses Fangji Huangqi Tang, and Skin Water is treated similarly. As discussed in the pulse section, although both use "opening the ghost gate," the distinction between branch and root differs; this formula exemplifies that. Wind-water depresses the Earth Qi, so Baizhu is used to fortify Earth, and Jiang-Zao to harmonize the center. Skin Water internally connects with the Lung; Metal depression is relieved, and water soaking the skin is drained with bland leaching agents. Therefore, Fuling replaces Baizhu, and Guizhi is added to release the muscle layer and scatter water externally, avoiding Jiang-Zao to harmonize the center. Moreover, with limb tremors, wind affects Ying and Wei and disturbs the collaterals, making Guizhi indispensable.
Discussion on the Mahuang Fuzi Tang and Xingzi Tang formulas from *Jingui Yaolue*: The text states: For water disease, if the pulse is Small and Deep, it belongs to Shaoyin. If Floating, it is Wind. If bloated without water, it is Qi. For water, inducing sweat resolves it. For a Deep pulse, Mahuang Fuzi Tang is appropriate; for a Floating pulse, Xingzi Tang is appropriate. This discusses Zheng Shui (True Water) of Shaoyin, where the pulse is naturally Small and Deep, showing no tendency to emerge. If the pulse is Floating, Wind is manifesting externally. Bloated without water indicates stagnation of Hand-Taiyin (Lung) Qi. Wind diseases resolve with diaphoresis. Even if the pulse is Deep without other symptoms, following the Shaoyin pattern of Shanghan, Mahuang Fuzi Gancao Tang should be used to agitate the water and rescue the Kidney. If the pulse is Floating, external symptoms likely include wheezing; following the Taiyang pattern of Shanghan, Mahuang Xingzi Gancao Shigao Tang should be used to disperse pathogens and rescue the Lung. This is the major method for treating the Metal (Lung) and Water (Kidney) organs.
Discussion on the Huangqi Shaoyao Guizhi Kujiu Tang and Guizhi Jia Huangqi Tang formulas: The text states: Huang Han (Yellow Sweat) presents with bodily swelling, fever, sweating, and thirst, resembling Wind-water. Sweat stains clothes yellow like cypress juice, and the pulse is naturally Deep. How is it acquired? The Master said: Bathing in water while sweating allows water to enter through the pores. Huangqi Shaoyao Guizhi Kujiu Tang is the primary formula. Huang Han disease presents with cold feet; if fever occurs, it belongs to Li Jie (Joint Bi). Sweating after eating and night sweats indicate Lao Qi (Consumption Qi). If fever persists after sweating, the body will eventually become rough like fish scales. Persistent fever leads to malignant sores. If heaviness lightens after sweating, prolonged cases may develop abdominal pain. Sweating above the waist but not below, with flaccid pain in the lower back and hips, feeling like something is in the skin, severe cases involve inability to eat, body ache and heaviness, irritability, and difficult urination. This is Huang Han, treated with Guizhi Jia Huangqi Tang.
The two syndromes are largely similar. The first syndrome involves sweating due to insecure Wei Qi, allowing external water to interact with Ying, generating Heat. Severe Heat causes swelling and yellowing; it consumes fluids, causing thirst. Thus, Huangqi secures Wei, and Guizhi Tang plus Kujiu (Vinegar) guides the action into Ying to scatter Water-Cold. Since Wei deficiency causes sweating, it is not an exterior-releasing condition, so Jiang-Zao are omitted to avoid assisting Stomach Qi; reliance is placed solely on Huangqi's power to solidify Wei. The second formula uses the complete Guizhi Tang, drinking hot millet porridge to assist sweating, adding Huangqi to secure Wei. Due to fever and spontaneous/night sweats, Guizhi is used for fever, and Huangqi for excessive sweating. If fever persists after sweating, pathogens remain and must resolve from the exterior; sweating brings relief, and heaviness decreases. Prolonged abdominal/chest pain results from excessive sweating damaging exterior and chest Yang. Sweating above the waist but not below indicates Yang circulation but Yin blockage, causing upper-lower obstruction. Huangqi secures Yang, and Guizhi unblocks Yin. Huang Han and Li Jie are distinct: Yang Fire stagnating upward causes Huang Han; Yin Water accumulating downward causes cold calves. Yang Fire flourishing in muscles causes fever; Yin Cold penetrating bones and joints causes Li Jie pain. They share the same source but different manifestations. Sweating after eating occurs because food enters the growing Yang and interacts with Consumption Qi, dispersing as sweat; since the Qi Gates are not closed, fluids leak constantly, causing night sweats. "Jia Cuo" (rough skin) indicates dry, scaly skin. Persistent fever allows Heat to enter flesh and collaterals, forming abscesses. Flaccid hip pain feeling like an object in the skin corresponds to the *Neijing*'s description of Painful Bi aggravated by cold. Difficult urination results from fluids escaping through sweat. Inability to eat indicates Spleen-Stomach Qi deficiency failing to transform grain. Body heaviness indicates Wei Qi failing to warm the muscles. Irritability indicates Stomach Heat steaming upward to Heart and Lung. The methods for treating Huang Han are fully expounded here.
Discussion on the Guizhi Qu Shaoyao Jia Mahuang Fuzi Xixin Tang and Zhizhu Tang formulas: The text states: For Qi Fen (Qi Division) disease, hardness below the heart, large as a plate, with edges like a turned cup, caused by water-fluid retention, Guizhi Qu Shaoyao Jia Mahuang Fuzi Tang is the primary formula. It also states: Hardness below the heart, large as a plate, with edges like a turned cup, caused by water-fluid retention, Zhizhu Tang is the primary formula. "Below the heart" refers to above the Stomach. If Stomach Yang Qi does not distribute, Yin of water-fluid occupies the area below the heart, becoming hard and large as a plate, blocking the smooth passage up and down, forcing circulation to the sides. This is caused by the failure of Yang Qi authority to extend. There are two Yin-Yang presentations. If Yang Qi is deficient and Yin Qi takes advantage, binding occurs below the heart. One must use Guizhi Tang removing Shaoyao (which moves inward/Yin) and add Mahuang, Fuzi, and Xixin to scatter Water-Cold in the chest. Since Shaoyin governs the interior, and Water-Cold enters from above, treatment follows the Shaoyin method of warming meridians and scattering cold. The formula notes: Recovery occurs when sweating feels like insects crawling under the skin. This shows that if Stomach Yang does not distribute, Chest Yang is also deficient. Chest Yang deficiency implies insecurity of exterior Wei Yang. Thus, during sweating, the sensation of insects crawling indicates stagnant Yang Qi. Without the powerful combination of Guizhi, Mahuang, Xixin, and Fuzi, could Water-Cold below the heart be scattered to the skin? Once Water-Cold is scattered, the heavy clouds clear, and the hardness below the heart vanishes; this is divine treatment. If Yang pathogens bind themselves in Yang positions without Yin-Cold invading above, using only Zhizhu (Zhishi and Baizhu) opens phlegm binding and strengthens Spleen-Stomach, making it easy to resolve Yang-pathogens in the Yang division.
Discussion on Haizang's Collection of Zhang Zhongjing's Water-Qi Examples: Haizang (Zhang Yuansu) was meticulous in treating edema. He posed questions on water-qis, investigating whether pulses were forceful or feeble, and distinguishing Zang (Deep) and Fu (Floating) pulses, summarizing medication principles. His intent was to elucidate the *Neijing* and Zhang Zhongjing, but his work essentially follows later conventions without substantial insight. He stated: "Height, depth, severity, exterior-interior; tonify and drain according to the meridian; carefully examine the Lung, Stomach, and Kidney meridians, and the disease will heal." This statement is concise but ultimately misses the mark. The *Neijing* clearly states that binding of the Three Yin leads to water. The Three Yin refers to Taiyin. Foot-Taiyin Spleen and Hand-Taiyin Lung, if Qi binds and fails to circulate, lead to water disease. Since the source of water comes from the Kidney, Foot-Shaoyin Kidney also governs it. Therefore, one should speak of Lung, Spleen, and Kidney, not Lung, Stomach, and Kidney. Why? The Stomach need not be singled out; it is the Sea of Grain and Water and the great source of the five Zang and six Fu organs. If the Spleen cannot scatter the water essence of the Stomach to the Lung, disease occurs in the middle. If the Lung cannot communicate the water pathways of the Stomach to the Bladder, disease occurs in the upper. If the Kidney cannot manage the Stomach's closing gate and regulate its discharge, disease occurs in the lower. Thus, water accumulates in the Stomach and spreads endlessly. Haizang mentioned Lung, Stomach, and Kidney, omitting the Spleen; he missed a crucial point in the profound principle, which need not be debated. His treatment examples still relied on Lung Deep/Large Intestine Floating and Heart Deep/Small Intestine Floating, which is a long-standing error. Did he not know that Zang and Fu organs each have their own Floating and Deep characteristics, and that the Large and Small Intestines should not be differentiated solely from the Upper Jiao? As for his collection of Zhang Zhongjing's water-q examples, he failed to penetrate the inner sanctum and instead included many heterodox views from outside. Zhang Zhongjing's discussion of miscellaneous diseases regarding water-q is extremely precise and detailed, fearing the failure of Foot-Taiyin Spleen transportation, Hand-Taiyin Lung regulation, Foot-Shaoyin Kidney gate opening, and Bladder Qi transformation. His prescribed formulas avoided the taboo of double deficiency, standing in a faultless position. Haizang took Zhang Zhongjing's Tingli Dazao Xiefei Tang for Lung Abscess as an example, intending to use lung-draining methods for draining water. He took Zhang Zhongjing's Shizao Tang for Cold Damage palpitations extending to both hypochondria and miscellaneous disease fluid retention in the hypochondria, intending to use thoracic-hypochondriac and bladder-draining methods for draining water. How dare he wield the knife under the pretext of Zhang Zhongjing? Moreover, he falsely attributed harsh post-Zhang water-draining drugs to Zhang Zhongjing, claiming Sanhua Shen Wan is Shizao Tang plus Qian Niu, Da Huang, and Qing Fen; Chushi Dan is Shen Wan plus Ruxiang and Moyao; Yuanqing Dan is Shen Wan plus Huanglian, Huangbai, and Qingdai. He collected Zhang Zhongjing's formulas to accommodate later ones, a crime unforgivable. Later practitioners imitated this, changing one or two ingredients to create new formulas, either injuring the Spleen, draining the Lung, or draining the Bladder, leading to catastrophic water accumulation and drowning, with no one regretting past medication errors, simply because this practice has existed for a long time. Among the hundreds of established formulas for water disease, none save Lung Qi depression and restore its regulation. None rescue Bladder obstruction and restore Qi transformation. Selecting a few formulas to explain for future reference, and improvising based on clinical judgment, is what is hoped for.