从来肿病，遍身头面俱肿，尚易治。若只单单腹肿，则为难治。此其间有所以然之故，
不可
不辨也。盖传世诸方，皆是悍毒急攻之法，耗损真元，亏伤脾胃，可一而不可再。用药纵取
效于一时，倘再腹肿，则更无法可用矣！且遍身俱肿者，五脏六腑各有现证，故泻肝泻肺泻
膀胱大小肠之药，间有取效之时。而单单腹胀，则中州之地久窒其四运之轴，而清者不升，
浊者不降，互相聚结，牢不可破，实因脾气衰微所致。而泻脾之药，尚敢漫用乎？且肿病之
可泻者，但可施之西北盛壮之人，及田野农夫之流，岂膏粱老少之所能受？设谓肿病概可用
之，大满大实，必从乎泻，而病后肿与产后肿，亦将泻之耶？且古方原载肿病五不治∶唇
黑伤肝，缺盆平伤心，脐突伤脾，背平伤肺，足底平伤肾，此五者不可治矣。是其立方之意
，非皆为不可治之证而设，后人不察，概从攻泻者何耶？所以凡用劫夺之药者，其始非不遽
消，其后攻之不消矣，其后再攻之如铁石矣。不知者观之，方谓何物邪气？若此之盛，自明
者观之，不过为猛药所攻而致。觉此身之元气，转于此身为难者，直有驱良民为寇之弊，所
谓亦子盗兵，弄于潢池 其然乎？明乎此，则有培养一法，补益元气是也；则有招纳一法，
升阳举气是也，则有解散一法，开鬼门洁净府是也。三法俱不言泻，而泻在其中矣，无余蕴
矣。
历来水肿病，若全身及头面都肿胀，尚属容易治疗。如果仅仅腹部肿胀，则属于难治之症。这其中自有其道理，不可不加以辨析。
流传下来的诸多方剂，大多采用猛烈有毒、急于攻下的治法，这会耗损人体的真元，损伤脾胃之气，这种办法只能使用一次，绝不可重复使用。用药即使能在一时取得疗效，倘若日后再次出现腹部肿胀，那就更加无药可施了！
况且全身肿胀者，五脏六腑各有相应的证候表现，因此使用泻肝、泻肺、泻膀胱以及大小肠的药物，偶尔也能取得疗效。而单纯的腹部胀满，则是由于中焦（脾胃）之地长久阻滞了气机升降的枢纽，导致清阳之气不能上升，浊阴之气不能下降，二者互相聚结，牢固难以攻破，这实际上是因为脾气衰微所致。对于这种情况，还敢随意使用泻脾的药物吗？
此外，适用于泻法的水肿病，仅可施用于西北地区的体格健壮之人，以及田野农夫这类人群，难道是那些生活优渥的老人和小孩所能承受的？如果说水肿病一概可以使用泻法，那么遇到大满大实的证候，必然要从泻法治之；但是产后水肿或病后水肿，难道也要用泻法吗？
况且古方原本记载水肿病有五种不治之症：嘴唇发黑说明伤及肝脏，锁骨上窝（缺盆）平坦说明伤及心脏，肚脐突出说明伤及脾脏，背部平坦说明伤及肺脏，足底平坦说明伤及肾脏，这五种情况都属于不可治愈的范畴。古人设立这些方剂的用意，并非都是针对不可治之证而设，为何后世人不加考察，一概采用攻泻之法呢？
所以，凡是使用劫夺正气药物的患者，起初并非不能迅速消退肿胀，但随后再攻下时，肿胀已无法消除；到了第三次再攻下时，病情便如铁石般坚硬难解了。不了解医理的人看到这种情况，会认为是何种邪气如此强盛？但从明眼人看来，这不过是因猛药攻伐所导致的后果。感觉身体的元气，反而因为治疗而在体内造成困难，这简直有驱使良民沦为盗贼的弊端，也就是所谓的“亦子盗兵，弄于潢池”（比喻百姓被迫反抗），情况确实如此吗？
明白了这个道理，就有培养正气这一方法，即补益元气；就有招纳正气这一方法，即升举阳气；就有解散水湿这一方法，即开鬼门（发汗）、洁净府（利小便）。这三种方法都不直接言说“泻”，但消胀的目的已在其中了，其中的奥妙已无遗漏。
Historically, edema affecting the entire body and face is relatively easy to treat. However, if only the abdomen is swollen, it becomes difficult to treat. There are underlying reasons for this distinction that must be analyzed.
The various prescriptions handed down through generations mostly employ harsh, toxic, and rapid purgative methods. These deplete the True Yuan (True Original Qi) and damage the Spleen and Stomach. Such approaches can be used once but never repeated. Even if medication achieves temporary efficacy, if abdominal swelling recurs, there will be no further effective treatment available!
Furthermore, in cases of generalized edema, each of the Five Zang and Six Fu organs presents specific signs. Therefore, herbs that drain the Liver, Lung, Bladder, Large Intestine, or Small Intestine may occasionally yield results. In contrast, isolated abdominal distension indicates that the central region (Spleen and Stomach) has long obstructed the axis of movement for Qi transformation. As a result, Clear Qi fails to ascend, and Turbid Qi fails to descend; they accumulate and bind together, becoming firm and unbreakable. This is fundamentally caused by the decline and weakness of Spleen Qi. How dare one casually use herbs that drain the Spleen?
Moreover, edema suitable for purgation should only be applied to robust individuals from the Northwest or laborers in the fields. Could those who enjoy rich diets, particularly the elderly and children, withstand such treatments? If one claims that all edema can be treated with purgatives, then certainly cases of fullness and excess must be drained. But what about postpartum edema or edema following illness? Should these also be treated with purgation?
Ancient texts originally listed five untreatable conditions for edema: black lips indicate injury to the Liver; a flat suprasternal fossa (Quepen) indicates injury to the Heart; protruding umbilicus indicates injury to the Spleen; a flat back indicates injury to the Lung; and flat soles indicate injury to the Kidney. These five conditions are considered incurable. The intent behind formulating these rules was not merely to declare cases incurable, yet why do later generations, without careful examination, universally resort to purgative attacks?
Consequently, when using drugs that劫夺 (plunder/rob) Zheng Qi (Upright Qi), the swelling may initially subside rapidly. However, subsequent attempts at purgation fail to reduce the swelling, and further attacks render the condition as hard as iron or stone. Those ignorant of medicine might ask, "What pathogenic factor is so formidable?" But those with insight understand that this is merely the consequence of aggressive drug therapy. It feels as though the body's Yuan Qi is being turned against itself, creating difficulties. This is akin to driving common people into banditry, described metaphorically as "the son stealing soldiers' arms to rebel in the pond." Is this not the case?
Understanding this principle reveals three alternative methods: the method of nurturing, which involves tonifying and benefiting Yuan Qi; the method of gathering, which involves raising Yang Qi and lifting Qi; and the method of dispersing, which involves opening the "ghost gates" (inducing sweating) and cleansing the "clean mansion" (promoting urination). None of these three methods explicitly mention "purgation," yet the goal of resolving swelling is achieved within them, leaving no room for further improvement.