论曰∶诸家方书论水病甚详，未尝有言膜外气者。唐天宝间有徒都子者，始着膜外气方
书，本末完具，自成一家，今并编之。然究其义，本于肺受寒邪，传之于肾，肾气虚弱，脾
土又衰，不能制水，使水湿散溢于肌肤之间，气攻于腹膜之外，故谓之膜外气。其病令人虚
胀，四肢肿满，按之没指是也。
徒都子论病本
膜外气者，或谓之水病起于他疾，不可常定。或因患疟，或因积劳，或因肾脏中风，或
因肺腑伤冷，或因膈上气，或因冲热远行，或因酒肉中所得，始于肺，终于肾，或因咳嗽，
或多涕唾，或因蓄聚，冷气壅塞不散，遂使肺脏热气攻心，五脏冷气下化为水，流入膀胱，
在大肠膜外，所以切脉不能知，针灸不能及。盖人肾为命本，不可虚也。本固即叶茂，本虚
即易枯。况四时衰旺，皆乘肾脏之气，肾损即五脏皆衰，是致胃闭而脾不磨，气结而小便涩。
轻重之候，在大小便耳。若小便不通则气壅，攻击腹内，冲出膜外，化而为水，使人手足头
面浮肿。若大小便微涩则微肿；极涩则极肿；大小便俱不通，三日即遍身洪肿；至重则阴亦
肿。夫阴肿有二，有肿而小便自出者，有肿而小便出涩者，又有茎头连少腹脐皆肿者，此并
为死候，宜速治之。若患此疾，肿亦不常定，或先手足面目浮肿，或先腰肋微肿，或先手足
小肿。其候或消或甚，三五日稍愈，或三五日再发，亦以小便通涩为候，积渐变成洪肿。妇
人得之，与此略同。凡患此疾，令人腹胀烦闷，胸间气急，此由肺胀甚即喘如牛吼，坐卧行
立不得，或中夜后气攻胸心，重者一年二年方死，有一月两月死者。若将息失度，误食毒物，
十日五日即甚也。愚医多以针灸出水为功，又以鲤鱼赤小豆为药，又令病患饮黄牛尿、服商
陆根，反有所损，少有瘥者。大抵此病尤忌针灸，华佗云，患水病未遇良医，第一不得针灸，
言气在膜外，已化为水，水出即引出腹中气，水尽则死。扁鹊云，水病在膜外，常针不可及，
常药不可疗，憔神针良药可也。有此疾者，宜向阳行坐，遇阴雨则愈觉壅滞，房中常须存火，
服药后夜卧觉胸间热甚，宜含红雪与好茶之类，慎勿饮酒及冷茶冷水。若渴，宜吃五灵汤方，
录在卷后。尤忌盐、生冷醋滑。
治膜外气水病，不限年月深浅，洪肿大喘，须臾不可过，朝服暮瘥。防己汤方。
防己 大戟 木香 赤茯苓（去黑皮） 海蛤 犀角（屑） 胡椒 白术 葶苈 防风
（去
叉） 木通 桑根白皮 紫苏 陈橘皮（炙） 牵牛子 诃黎勒（去核） 郁李仁 白槟榔
（各
一
上二十味等分，唯大黄一味倍用，并须新药，锉了秤为二剂，以水三升宿浸，明日五更，
用铛文火煎，减去一升，绞取饮可三盏。平旦空腹，且服一盏，如人行五里更服一盏，又如
人行五里更服一盏，至第二第三服。如药冷，用重汤暖之，不可冷服。若久病腹中虚，服至
第三盏，即微利三两行。若腹中实者，至日午即转泻，宜用盆盛验之，必有恶浊黄水，或青
里恶物出三五升，并气化为之。泻若不甚困，慎勿止之，必自住。若觉力乏，即服浆水粥补
之。后隔三五日，更服一剂，还根据此法服之。按徒都先生云，服第一剂则病减半，至第二剂
则去根本，前后历试。绝重者，朝服一剂，而暮已瘥。根本深者，服药当日肿消能起。但觉
小腹内有块结，则须后剂去之。其药滓慎勿抛弃，布囊盛，悬于风中。他日或觉微有发动，
则更煎药滓，可更治两人。徒都先生云，人家有此药滓，悬于户上，一家终不患疫气。此饮
不独治水气，凡是气病，皆治之。若患肺气，不限年月深浅，于此药二十味中，减去大黄及
诃黎勒，加贝母、人参，以童子小便煎，每日空心服之，当去病根。有患肺气困重者，因逢
患水气人服此药，偶得一盏服之，盒饭永瘥。有人一生患香港脚，时时冲心，服此饮亦除根本。
以此推之，但是气皆治，不独治水气而已。产妇有娠人服之亦无妨，小儿及老人随意如减，
瘥后宜服顺气丸。
治水气。顺气丸方。
防己（一两半） 大黄（二两半） 犀角（炙，镑） 诃黎勒皮 牵牛子 赤茯苓（去
黑
皮） 葶苈（炒） 海蛤 芎 干地黄（焙） 木通（锉） 大戟 桑根白皮（锉） 陈
橘皮（去白） 防风（
上一十七味，捣罗为末，炼蜜丸梧桐子大。每服十丸，空腹米饮下。觉壅不快，则加至
十五丸；觉通，则减至三五丸；大小便不通，即加至三十丸。此药不独治水气，其功与前饮
相类。若患水气人，服前饮后肿既消，便服此顺气丸，气顺血滑，体气轻健即止。患香港脚人，
常合此药备急。服前饮瘥，百日内即宜服五灵汤。
治水气。五灵汤方
诃黎勒皮 木通（锉） 赤茯苓（去黑皮） 防己（锉） 陈橘皮（汤浸去白，焙各一
两）
上五味，粗捣筛。每服五钱匕，水一盏半，煎至一盏。去滓，渴即饮之。觉热，即吃好
茶。
治水气。牵牛五灵煮散方。
牵牛子（炒） 槟榔（锉） 木香 赤茯苓（去黑皮） 陈橘皮（汤浸去白，焙各一两）
上五味，捣罗为散，如茶法煎三两沸，渴即饮之。此药兼治一切肺气香港脚。每觉心胸烦
闷时，服一盏即愈；奔豚气上筑心胸不可忍者，并三两盏立效。
治水气。紫苏煮散方。
紫苏叶 防风（去叉） 桑根白皮（切） 白术（锉碎等分）
上四味，捣罗为散，如茶法煎三两沸。觉热，即去白术，加甘草。功效如前方所说。又
有蛇蛊，状与水病相似，四肢如故，小便不甚涩，但腹急肿而蛊胀不下食，凡医多误作水气
治之，宜仔细详审，当服太上五蛊丸。
治百病及诸色蛊，常合随身备急。五蛊丸方。
雄黄（研） 椒目（炒） 巴豆（出油尽） 莽草 真珠末（研） 芫花（醋浸，炒焦）
鬼臼
矾石（烧令汁枯） 藜芦（去芦头） 獭肝（各一分） 蜈蚣（一寸） 附子（炮裂，去皮
脐半
两） 斑蝥（去翅、足，炒十枚）
上一十三味，捣研为末，炼蜜丸如小豆大，瓷合密收。每食后服一丸，如未效，日增一
丸，以利为度。当有虫出，形状不可具载。虫下后七日内，切宜将摄。凡服此药一剂，蛊不
能侵，百病尽除。勿食五辛。又蛇毒甚者，合五蛊丸未及，且以大豆渍酒，绞汁服半升即瘥。
又酒服桔梗、犀角末方寸匕，日三服。中毒甚不能自服，干口开与之。药下心头当烦闷，须
臾即稣。如此服七日后，宜食猪脾脏补养。今所录蛇蛊方，在卷末者，缘蛇蛊状似水病，恐
人不辨，误作水病治之，且谓水药不验。杨馨所传地仙徒都先生神方一十五首，皆治恶病。
而膜外水气，方具于首，蛇蛊次之，余方世人无有传者。杨馨云，曾有亲识患水病，洪肿满
在床，顷刻必死。旦服此药，至暮获安。不忍弃其滓，常以绢囊盛之。凡煎防己汤，须用旧
铛于火中烧令通赤，揩磨取净，免有油腻。又于药名二十味中，各取一字，合成四句之歌，
庶使年久不忘。胡牵犀苈海，汉茯戟通桑，青黄诃麝橘，白郁紫防榔。
治膜外水气，神效。牛李子丸方。
牛李子（微炒） 牵牛子（微炒） 吴茱萸（水浸一宿，炒干） 青橘皮（去白，焙各
半两）
杏仁（汤浸去皮尖、双仁，生用十五枚） 葶苈（纸上炒少许）
上六味，捣罗为末，用水浸蒸饼丸如小豆大。每服三十丸，夜后煎橘皮汤下，以转下气
为度。
治膜外水肿。泽漆丸方。
泽漆（微炒一两） 水银（炼） 葶苈（纸上炒） 大戟（微煨） 郁李仁（汤浸去皮，
炒） 枳
壳（去瓤，麸炒各一两半） 甘遂 椒目（微炒各一两）
上八味，捣罗为末，炼蜜丸如小豆大。每服十丸，空腹米饮下。未利，加至十五丸。
治膜外水气身肿。十水丸方。
本（去苗土） 泽漆（微炒） 大戟（微煨） 连翘 葶苈（纸上炒） 甘遂（微炒）
芫花（
醋浸，炒焦） 桑根白皮（炙，锉） 赤小豆（微炒各三分） 巴豆（去皮、心、膜，麸炒，
出油
尽一两）
上一十味，捣罗为末，炼蜜丸如小豆大。每服五丸，空心米饮下，不利加至十丸。
治膜外气。白牵牛散方。
白牵牛子（炒） 青橘皮（去白，焙，炒） 木通（锉各一两）
上三味，捣罗为散。每服一钱匕，煎商陆汤调下，大便下黄水为度。忌盐一百日。
治膜外水气。甘遂饼方。
甘遂 大麦面（各半两）
上二味，捣罗为末，以水和作饼子，烧熟，热服之。如不利，以熟饮投之；如利，以冷
水洗手面即止。
【论述】
各家医书对水病的论述非常详尽，却从未提及“膜外气”这一病症。唐代天宝年间，有一位名叫徒都子的人，开始撰写关于膜外气的方书，内容完整详备，自成一家体系，现在将其一并编入本书。然而探究其病机，本源于肺脏受寒邪侵袭，病邪传至肾脏，导致肾气虚弱，脾土功能衰退，无法制约水湿，致使水湿散漫溢出于肌肤之间，气流攻冲于腹膜之外，因此称为膜外气。这种病症使人出现虚性腹胀，四肢肿胀饱满，按压后凹陷不起。
【徒都子论病之本源】
膜外气，有时被称为因其他疾病引起的水病，病情变化无常。有的因为患疟疾，有的因为过度劳累，有的因为肾脏感受风邪，有的因为肺腑受寒，有的因为膈上气滞，有的因为受热后远行，有的因为饮食酒肉不当而得病。此病始于肺，终于肾，或者表现为咳嗽、多涕唾，或者因为寒气积聚，冷气壅塞不散，进而使肺脏热气攻心，五脏的冷气下化为水，流入膀胱，停留在大肠膜外。因此切脉难以察觉，针灸也难以触及。大概因为肾为生命之根本，不可虚弱。根本稳固则枝叶茂盛，根本虚弱则容易枯萎。况且四季的盛衰，都依赖于肾脏之气，肾受损则五脏皆衰，从而导致胃气闭塞而脾不运化，气机郁结而小便涩滞。轻重的征候，取决于大小便的情况。如果小便不通，则气机壅滞，攻冲腹内，冲出膜外，化为水液，使人手足头面浮肿。如果大小便轻微涩滞，则身体轻微肿胀；极度涩滞则极度肿胀；大小便完全不通，三天后全身严重肿胀；病情极重时阴部也会肿胀。阴部肿胀有两种情况：一种是肿胀但小便自出，另一种是肿胀且小便排出涩滞，还有阴茎头部连同少腹、肚脐全部肿胀的，这些都属于死证，应当迅速治疗。如果患此病，肿胀也不固定，有时先从头面手足浮肿，有时先从腰肋轻微肿胀，有时先从手足轻微肿胀。症状或减轻或加重，三五天稍愈，或三五天复发，也以小便通利与否为征候，逐渐演变成严重肿胀。妇女患此病，与此大致相同。凡是患此病，使人腹胀烦闷，胸中气急，这是因为肺胀严重时喘息如牛吼声，坐卧行走站立都不安适，或者半夜后气攻胸心，重的患者一年或两年后死亡，也有一个月或两个月死亡的。如果调养失当，误食毒物，五到十天就会加重。庸医多以针灸出水为功效，又用鲤鱼、赤小豆作为药物，又让病人饮黄牛尿、服商陆根，反而造成损害，很少有好转的。大体上此病尤其忌讳针灸。华佗说，患水病未遇到良医，第一不要针灸，因为气在膜外，已经化为水，水流出就会引出腹中的气，水尽则人死。扁鹊说，水病在膜外，常针不能及，常药不能疗，只有焦神针和良药才能治愈。有此病的人，适宜向阳行走坐卧，遇到阴雨天气则更加觉得壅滞，房中常须保持温暖，服药后夜间睡觉觉得胸间很热，适宜含服红雪和好茶之类，千万不要饮酒以及冷茶冷水。如果口渴，适宜服用五灵汤方，记录在卷后。尤其忌讳盐、生冷、醋和滑腻食物。
【治疗膜外气水病】
无论患病时间长短，只要出现严重肿胀和大喘，片刻也不能拖延，早晨服用晚上即可痊愈。防己汤方。
防己、大戟、木香、赤茯苓（去黑皮）、海蛤、犀角（锉屑）、胡椒、白术、葶苈、防风（去叉）、木通、桑根白皮、紫苏、陈橘皮（炙）、牵牛子、诃黎勒（去核）、郁李仁、白槟榔（各一两）。
以上二十味药等分，唯独大黄一味加倍使用，都必须用新药材，切碎后称重分为两剂，用水三升浸泡过夜，第二天五更天，用锅以文火煎煮，减去一升水，过滤取汁约三盏。清晨空腹，先服一盏，如人行走五里路后再服一盏，再如人行走五里路后再服一盏，直到第二、第三服。如果药凉，隔水加热，不可冷服。如果久病腹中虚，服到第三盏，就会轻微腹泻两三行。如果腹中实者，到中午就会转泻，应用盆承接检验，必定有恶浊黄水，或青色恶物排出三到五升，这都是气化作用的结果。如果腹泻不是很困倦，千万不要止泻，它自然会停止。如果觉得乏力，就服浆水粥来补益。之后隔三到五天，再服一剂，仍按此法服用。据徒都先生所说，服第一剂则病减半，服第二剂则去除病根，前后多次试验验证。病情极重的，早晨服一剂，晚上就已痊愈。病根深者，服药当天肿消能起。只觉小腹内有块结，则需用后剂消除它。药渣千万不要抛弃，用布袋装好，悬挂在风中。日后如果觉得微微发作，则再煎药渣，可以治疗两个人。徒都先生说，人家如果有这个药渣，悬挂在门上，全家终身不会患疫气。这种饮剂不仅治水气，凡是气病，都能治疗。如果患肺气病，不限时间长短，在此药二十味中，减去大黄及诃黎勒，加贝母、人参，用童子小便煎煮，每天空腹服用，应当去除病根。有患肺气病困重的人，因为遇到患水气的人服用此药，偶然得到一盏服用，盒饭（此处疑为文本讹误，意指必然）永远痊愈。有人一生患香港脚（足踝肿痛），时时冲心，服用此饮也去除了病根。以此类推，只要是气病都能治，不只是治水气而已。产妇和孕妇服用也无妨，小儿及老人酌情减量，痊愈后宜服用顺气丸。
【治疗水气。顺气丸方】
防己（一两半）、大黄（二两半）、犀角（炙，镑）、诃黎勒皮、牵牛子、赤茯苓（去黑皮）、葶苈（炒）、海蛤、芎藭、干地黄（焙）、木通（锉）、大戟、桑根白皮（锉）、陈橘皮（去白）、防风（一两半）。
以上十七味药，捣碎过筛为末，炼蜜制成梧桐子大小的丸药。每次服十丸，空腹米饮送下。觉得壅滞不快，则加至十五丸；觉得通畅，则减至三到五丸；大小便不通，即加至三十丸。此药不仅治水气，功效与前方的饮剂相似。如果患水气的人，服前方饮剂后肿胀既消，便服此顺气丸，气顺血滑，身体轻健即停服。患香港脚的人，常备此药以备急用。服前方饮剂痊愈后，百日内宜服用五灵汤。
【治疗水气。五灵汤方】
诃黎勒皮、木通（锉）、赤茯苓（去黑皮）、防己（锉）、陈橘皮（汤浸去白，焙，各一两）。
以上五味药，粗捣筛过。每次服五钱匕，水一盏半，煎至一盏。去渣，渴即饮用。觉得热，即吃好茶。
【治疗水气。牵牛五灵煮散方】
牵牛子（炒）、槟榔（锉）、木香、赤茯苓（去黑皮）、陈橘皮（汤浸去白，焙，各一两）。
以上五味药，捣罗为散，像煎茶一样煎煮三沸，渴即饮用。此药兼治一切肺气病和香港脚。每觉得心胸烦闷时，服一盏即愈；奔豚气上冲心胸不可忍受的，并服三盏立效。
【治疗水气。紫苏煮散方】
紫苏叶、防风（去叉）、桑根白皮（切）、白术（锉碎，等分）。
以上四味药，捣罗为散，像煎茶一样煎煮三沸。觉得热，就去掉白术，加甘草。功效如前方所述。又有蛇蛊，症状与水病相似，四肢正常，小便不甚涩滞，只是腹部紧急肿胀且蛊胀不能进食，凡医多误作水气治疗，应仔细详审，应当服用太上五蛊丸。
【治疗百病及各类蛊毒，常备随身急救。五蛊丸方】
雄黄（研）、椒目（炒）、巴豆（去油尽）、莽草、真珠末（研）、芫花（醋浸，炒焦）、鬼臼、矾石（烧令汁枯）、藜芦（去芦头）、獭肝（各一分）、蜈蚣（一寸）、附子（炮裂，去皮脐，半两）、斑蝥（去翅、足，炒，十枚）。
以上十三味药，捣研为末，炼蜜制成小豆大小的丸药，瓷盒密封保存。每次饭后服一丸，如果无效，每日增加一丸，以腹泻为度。应当有虫排出，形状无法详细记载。虫排出后七日内，务必注意调养。凡是服此药一剂，蛊毒不能侵害，百病尽除。不要吃五辛。另外蛇毒严重的，配制五蛊丸来不及，先用大豆浸泡酒，绞汁服半升即愈。另外用酒送服桔梗、犀角末一方寸匕，每天三次。中毒严重不能自服的，撬开嘴灌入。药下心头应当烦闷，一会儿就苏醒。如此服用七日后，宜吃猪脾脏补养。现在所录的蛇蛊方，在卷末，因为蛇蛊状似水病，恐怕人不辨别，误作水病治疗，且认为水药无效。杨馨所传的地仙徒都先生神方共十五首，都是治疗恶病的。而膜外水气，方剂列在首位，蛇蛊次之，其余方世人没有流传的。杨馨说，曾有亲友患水病，严重肿胀满床，顷刻必死。早晨服此药，到晚上获得安宁。不忍丢弃药渣，常用绢袋装好。凡是煎防己汤，必须用旧锅在火中烧得通红，揩磨取净，避免有油腻。又在药名二十味中，各取一字，合成四句歌诀，以便年久不忘：“胡牵犀苈海，汉茯戟通桑，青黄诃麝橘，白郁紫防榔。”
【治疗膜外水气，神效。牛李子丸方】
牛李子（微炒）、牵牛子（微炒）、吴茱萸（水浸一夜，炒干）、青橘皮（去白，焙，各半两）、杏仁（汤浸去皮尖、双仁，生用十五枚）、葶苈（纸上炒少许）。
以上六味药，捣罗为末，用水浸蒸饼制成小豆大小的丸药。每次服三十丸，夜间煎橘皮汤送下，以转下气为度。
【治疗膜外水肿。泽漆丸方】
泽漆（微炒一两）、水银（炼制）、葶苈（纸上炒）、大戟（微煨）、郁李仁（汤浸去皮，炒）、枳壳（去瓤，麸炒，各一两半）、甘遂、椒目（微炒，各一两）。
以上八味药，捣罗为末，炼蜜制成小豆大小的丸药。每次服十丸，空腹米饮送下。未腹泻，加至十五丸。
【治疗膜外气身肿。十水丸方】
本（去苗土）、泽漆（微炒）、大戟（微煨）、连翘、葶苈（纸上炒）、甘遂（微炒）、芫花（醋浸，炒焦）、桑根白皮（炙，锉）、赤小豆（微炒，各三分）、巴豆（去皮、心、膜，麸炒，出油尽，一两）。
以上十味药，捣罗为末，炼蜜制成小豆大小的丸药。每次服五丸，空心米饮送下，不腹泻加至十丸。
【治疗膜外气。白牵牛散方】
白牵牛子（炒）、青橘皮（去白，焙，炒）、木通（锉，各一两）。
以上三味药，捣罗为散。每次服一钱匕，煎商陆汤调下，大便下黄水为度。忌盐一百日。
【治疗膜外水气。甘遂饼方】
甘遂、大麦面（各半两）。
以上二味药，捣罗为末，用水和成饼子，烧熟，热服。如果不腹泻，用熟饮投服；如果腹泻，用冷水洗手面即止。
[Discussion]
Various medical texts discuss water diseases (Shuibing, Water Retention Disorders) in great detail, yet none mention "Qi outside the Membrane" (Mowaiqi). During the Tianbao era of the Tang Dynasty, a man named Tu Du Zi began writing treatises on Mowaiqi formulas. His works were complete and comprehensive, forming a unique school of thought, which is now compiled into this book. However, upon investigating its pathology, it originates from the Lung receiving cold pathogenic factors (Hanxie), transmitting to the Kidney. The Kidney Qi becomes weak, and Spleen Earth declines, failing to control water. This causes water-dampness to scatter and overflow between the skin and muscles, while Qi attacks outside the abdominal membrane, hence the name Mowaiqi. This disease causes false distension, swelling and fullness of the four limbs, where pressing leaves an indentation that does not immediately rise.
[Tu Du Zi on the Root of the Disease]
Mowaiqi is sometimes referred to as water disease arising from other illnesses, with unpredictable progression. It may result from malaria, chronic fatigue, Wind striking the Kidney, Cold injuring the Lung and Intestines, Qi stagnation above the diaphragm, traveling far after exposure to heat, or improper consumption of alcohol and meat. The disease begins in the Lung and ends in the Kidney. Symptoms may include coughing, excessive phlegm and saliva, or accumulation of Cold Qi obstructing circulation without dispersing. This eventually causes Heat Qi in the Lung to attack the Heart, transforming Cold Qi of the Five Zang Organs into water, flowing into the Bladder, and settling outside the membrane of the Large Intestine. Therefore, pulse diagnosis cannot detect it, and acupuncture cannot reach it. The Kidney is the root of life and must not be deficient. If the root is solid, the branches flourish; if deficient, it easily withers. Moreover, the prosperity and decline of the four seasons all depend on Kidney Qi. Damage to the Kidney leads to the decline of all Five Zang Organs, resulting in Stomach closure and Spleen failure to grind/digest, Qi knotting, and astringent urination. The severity depends on bowel and bladder movements. If urination is blocked, Qi stagnates, attacks the abdomen, breaks out through the membrane, transforms into water, causing edema of the hands, feet, head, and face. If bowel and bladder movements are slightly astringent, there is slight swelling; extremely astringent means extreme swelling; if both are completely blocked, general severe edema occurs within three days; in severe cases, the genitals also swell. There are two types of genital edema: one where urine flows freely despite swelling, and another where urination is difficult. Also, swelling of the glans penis extending to the lower abdomen and umbilicus indicates a fatal prognosis requiring urgent treatment. In this disease, edema is variable: it may start with facial and limb swelling, or mild waist/rib swelling, or slight hand/foot swelling. Symptoms fluctuate, improving slightly every three to five days or recurring, depending on urinary patency, gradually progressing to massive edema. Women suffer similarly. Generally, this disease causes abdominal distension, irritability, chest tightness, and shortness of breath. Severe Lung distension causes wheezing like a bull's bellow, making sitting, lying, walking, or standing impossible. Qi may attack the chest and heart at midnight. Severe cases may die within one to two years, or even one to two months. Improper care or ingestion of toxic substances can worsen the condition within five to ten days. Quack doctors often claim success by draining fluid via acupuncture, using Carp and Adzuki Beans as medicine, or prescribing Bull urine and Phytolaccae Radix (Shanglu), which often causes harm rather than cure. This disease strictly contraindicates acupuncture. Hua Tuo stated that for water disease, before meeting a good physician, one must absolutely avoid acupuncture because Qi outside the membrane has already transformed into water; draining water draws out abdominal Qi, leading to death when water is exhausted. Bian Que said water disease outside the membrane is beyond the reach of common needles and medicines, requiring special techniques and potent herbs. Patients should sit or walk facing the sun; rainy weather exacerbates stagnation. Keep the room warm. After taking medicine, if chest heat is felt at night, hold Red Snow (Hongxue, a cooling preparation) or good tea in the mouth. Avoid alcohol, cold tea, and cold water. For thirst, take Wuling Tang (recorded later). Strictly avoid salt, raw/cold foods, vinegar, and slippery/greasy foods.
[Treatment for Mowaiqi Water Disease]
Regardless of duration, for massive edema and sudden dyspnea, immediate treatment is required; morning administration brings evening recovery. Fangji Tang Formula.
Fangji (Stephaniae Tetrandrae Radix), Daji (Euphorbiae Pekinensis Radix), Muxiang (Aucklandiae Radix), Chifuling (Poria Cocos with Black Skin Removed), Hai Ge (Concha Meretricis et Cyclinae), Xijiao (Rhinocerotis Cornu - *Note: Use substitutes in modern practice*), Hujiao (Piperis Longi Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Tingli (Descurainiae Semen seu Lepidii Semen), Fangfeng (Saposhnikoviae Radix), Mutong (Akebiae Caulis), Sangbaipipi (Mori Cortex), Zisu (Perillae Folium), Chenjupi (Citri Reticulatae Pericarpium), Qianniuzi (Pharbitidis Semen), Helile (Terminalia Chebulae Fructus), Yuliren (Pruni Semen), Baibinglang (Arecae Semen) [Each 1 qian].
The above twenty ingredients are equal parts, except Dahuang (Rhei Radix et Rhizoma) which is doubled. Use fresh herbs, chop, weigh, and divide into two doses. Soak in 3 sheng of water overnight. At dawn (5-7 AM), simmer gently in a pot until reduced by 1 sheng. Strain to obtain approximately 3 cups. Take 1 cup on an empty stomach in the morning. After walking about 5 li (2.5 km), take another cup. After another 5 li, take a third cup. If the medicine is cold, warm it in a double boiler; do not take cold. For chronic cases with abdominal deficiency, mild diarrhea (2-3 stools) may occur after the third cup. For excess patterns, diarrhea may occur by noon; collect stool to verify foul yellow water or green/black matter (3-5 sheng), indicating Qi transformation. Do not stop mild diarrhea; it will resolve spontaneously. If weakness ensues, replenish with Jiangshui Zhou (Fermented Rice Porridge). Repeat the dose every 3-5 days following the same method. Mr. Tu Du Zi claimed the first dose halves the disease, the second removes the root. For critical cases, one dose in the morning cures by evening. For deep-rooted cases, swelling subsides and mobility returns on the day of administration. If abdominal masses remain, subsequent doses remove them. Do not discard dregs; store in cloth bags and hang in the wind. Re-boiling dregs can treat others. Hanging these dregs at the door protects the household from epidemic Qi. This drink treats all Qi disorders, not just water. For Lung Qi disease, omit Dahuang and Helile, add Beimu (Fritillariae Bulbus) and Renshen (Ginseng Radix et Rhizoma), decoct in Urine of a Boy (Tongzi Xiaon), take on empty stomach daily to remove the root. A case of severe Lung Qi distress cured by accidental intake of this formula for water disease confirms its efficacy. Even chronic Hongjiaojiao (Hong Kong Foot/Gouty Arthritis) attacking the heart was cured. Thus, it treats all Qi disorders. Safe for pregnant/nursing women; adjust dosage for children/elderly. Post-recovery, take Shunqi Wan.
[For Water Qi. Shunqi Wan Formula]
Fangji (1.5 liang), Dahuang (2.5 liang), Xijiao (Roasted, shaved), Helile Pi (Chebulae Exocarpium), Qianniuzi, Chifuling, Tingli (Stir-fried), Hai Ge, Xiong (Ligustici Chuanxiong Rhizoma), Dihuang (Rehmanniae Radix Praeparata, baked), Mutong (Chopped), Daji, Sangbaipipi (Chopped), Chenjupi (White part removed), Fangfeng (1.5 liang).
Grind seventeen ingredients into powder, mix with refined honey to make pills the size of paulownia seeds. Take 10 pills with rice water on an empty stomach. Increase to 15 if feeling stagnant; decrease to 3-5 if unobstructed; increase to 30 if constipation/urinary retention persists. Similar efficacy to the previous drink. After edema subsides with the drink, switch to Shunqi Wan to smooth Qi and blood. Keep for emergency use in Hongjiaojiao. After recovery with the drink, take Wuling Tang within 100 days.
[For Water Qi. Wuling Tang Formula]
Helile Pi, Mutong (Chopped), Chifuling, Fangji (Chopped), Chenjupi (Soaked in soup, white part removed, baked, each 1 liang).
Coarsely crush five ingredients. Take 5 qian bi (spoonfuls), decoct in 1.5 sheng water to 1 sheng. Strain. Drink when thirsty. If feeling hot, consume good tea.
[For Water Qi. Qianni Wuling Zhusan Formula]
Qianniuzi (Stir-fried), Binglang (Betel Nut, chopped), Muxiang, Chifuling, Chenjupi (each 1 liang).
Grind into powder. Decoct like tea for 3 boils. Drink when thirsty. Treats all Lung Qi disorders and Hongjiaojiao. Relieves chest oppression instantly. For Ben Tun Qi (Running Piglet Qi) attacking the chest, 3 cups provide immediate relief.
[For Water Qi. Zisu Zhusan Formula]
Zisu Ye (Perillae Leaf), Fangfeng, Sangbaipipi, Baizhu (equal parts).
Grind into powder. Decoct like tea for 3 boils. If feeling hot, remove Baizhu and add Gancao (Licorice). Efficacy as described above. Note: Snake Gu (Poison) resembles water disease but limbs are normal, urination is not very astringent, only abdomen is tense/swollen with inability to eat. Physicians often misdiagnose as water disease. Carefully differentiate and use Taishang Wugu Wan.
[For Hundred Diseases and Various Gu Poisons. Emergency Kit. Wugu Wan Formula]
Xionghuang (Realgar), Jiaomu (Semen Piperis Longi), Badou (Crotonis Fructus, oil removed), Mangcao (Illicii Anisi Stellati Herba), Zhenzhu Mo (Margarita Pulvis), Yuanhua (Genkwa Flos, vinegar-soaked, charred), Guiji (Podophylli Peltati Rhizoma et Radix), Fanshi (Alumen, burnt dry), Lilu (Veratri Rhizoma), Talei (Leporis Hepatis), Wugong (Centipedae Corpus), Fuzi (Aconiti Lateralis Radix Praeparata, half liang), Banmao (Mylabris, wings/legs removed, fried, 10 units).
Grind thirteen ingredients into powder, mix with honey to make bean-sized pills. Store in porcelain. Take 1 pill after meals. Increase by 1 pill daily until purgation occurs. Parasites/worms will exit (shape indescribable). Care for 7 days post-purgation. One dose prevents Gu invasion and cures hundred diseases. Avoid Five Pungent Spices. For severe snake venom, if Wugu Wan is unavailable, soak Soybeans in wine, squeeze juice, take 0.5 sheng. Alternatively, take Jiegeng (Platycodonis Radix) and Xijiao powder with wine, 3 times daily. If unable to swallow, pry mouth open. Chest oppression followed by rapid recovery is expected. After 7 days, nourish with Pig Spleen. The Snake Gu formula is at the end of the volume because it mimics water disease, leading to misdiagnosis and ineffective water treatments. Yang Xin transmitted 15 divine formulas from Tu Du Zi for malignant diseases. Mowaiqi is first, Snake Gu second; others are lost. Yang Xin recounted a relative with massive edema dying instantly; morning dose brought evening peace. Dregs were saved in silk bags. When decocting Fangji Tang, use an old pot heated red-hot and cleaned to avoid grease residue. Mnemonic song for the 20 ingredients: "Hu Qian Xi Li Hai, Han Fu Ji Tong Sang, Qing Huang Ke She Ju, Bai Yu Zi Fang Lang."
[For Mowaiqi Water Qi. Niuzi Zi Wan Formula]
Niuzi Zi (Slightly fried), Qianniuzi (Slightly fried), Wuzhuyu (Soaked overnight, fried dry), Qingjupi (White part removed, baked, each 0.5 liang), Xingren (Skin/kernel removed, 15 raw kernels), Tingli (Fried on paper, small amount).
Grind six ingredients. Make pills with steamed dough soaked in water, bean-sized. Take 30 pills at night with Tangerine Peel Soup, aiming to move Qi downward.
[For Mowaiqi Edema. Zeqi Wan Formula]
Zeqi (Slightly fried, 1 liang), Shuiyin (Refined Mercury), Tingli, Daji (Slightly roasted), Yuliren, Zhike (Pulp removed, bran-fried, each 1.5 liang), Gansui, Jiaomu (Slightly fried, each 1 liang).
Grind eight ingredients. Honey pills, bean-sized. Take 10 pills with rice water on empty stomach. Increase to 15 if no purgation.
[For Mowaiqi Generalized Edema. Shishui Wan Formula]
Ben (Cnidii Rhizoma, roots/soil removed), Zeqi, Daji, Lianqiao, Tingli, Gansui, Yuanhua, Sangbaipipi, Chixiaodou (Adzuki Bean, each 3 fen), Badou (Kernel/membrane removed, bran-fried, oil removed, 1 liang).
Grind ten ingredients. Honey pills, bean-sized. Take 5 pills on empty stomach with rice water. Increase to 10 if no purgation.
[For Mowaiqi. Bai Qianniu San Formula]
Bai Qianniuzi (Fried), Qingjupi (White part removed, baked/fried), Mutong (Chopped, each 1 liang).
Grind three ingredients. Take 1 qian bi with Shanglu Tang (Phytolaccae Radix decoction). Stop when yellow water passes in stool. Avoid salt for 100 days.
[For Mowaiqi Water Qi. Gansui Bing Formula]
Gansui, Damaimian (Barley Flour, each 0.5 liang).
Grind two ingredients. Mix with water to form cakes. Bake thoroughly. Eat hot. If no purgation, take cooked beverage. If purgation occurs, wash face/hands with cold water to stop.