（论一首 方四十九首 证三首 灸法二首）
论曰∶大凡水病难治，瘥后特须慎于口味，病水人多嗜食，所以此病难愈也。代有医者
，随逐时情，意在财物，不本性命。病患欲食，劝令食羊头蹄肉，如此未有一愈者。又此病
百脉之中，气水俱实，治者皆欲令泻之。羊头蹄极补，哪得瘳愈？所以治水药，多用葶苈等
诸药。《本草》云∶葶苈久服令人大虚，故水病非久虚，不得绝其根本。又有蛊胀，但腹满
不肿，水胀四肢面目俱肿，医者不善诊候，治蛊以水药，治水以蛊药，或但胀满，皆以水药
。仲景所云∶愚医杀之。今录忌如下∶丧孝、产乳、音乐、房室、喧戏、一切鱼，一切肉、
一切生冷、醋滑 蒜、粘食、米豆、油腻。其治蛊方具在杂方篇，见第二十四卷蛊毒篇中。
上前所禁不得食，不得用心。其不禁者，并具本方之下，其房室等禁，须三年慎之，永不复
发。不尔者虽瘥，复发不可更治也。古方有十水丸历验，多利大便而不利小便，所以不录。
黄帝问岐伯曰∶水与肤胀、鼓胀、肠覃、石瘕，何以别之？岐伯曰∶水之始起也，目窠
上微肿（《灵枢》、《太素》作微壅），如新卧起之状。其颈脉动，时咳，阴股间寒，足胫肿
腹乃大，其水已成也。以手按其腹，随手而起，如裹水之状，此其候也。肤胀者，寒气客于
皮肤之间，壳壳然而坚（《太素》、《外台》作不坚），腹大身尽肿皮浓，按其腹陷（《太素
作）而不起，腹色不变，此其候也。鼓胀者，腹胀身肿大，大与肤胀等，色苍黄，腹筋起，
此其候也。肠覃者，寒气客于肠外与胃（《太素》作卫）气相搏，正气不得营，因有所系瘕
而
内注，恶气乃起，息肉乃生。其始生也。大如鸡卵，稍以益大，至其成也。如怀子之状。久
者
子门闭塞，气不得通，恶血当泻不泻， 以留止，日以益大，状如怀子，月事不以时下，皆
生于女子，可导而下之。曰∶肤胀、鼓胀可刺乎？曰∶先泻其腹之血络，后调其经，刺去其
血脉。师曰∶病有风水、有皮水、有正水、有石水、有黄汗。风水，其脉自浮，外证骨节疼
痛，恶风。皮水，其脉亦浮，外证浮肿，按之没指，不恶风，其腹如鼓，不渴，当发其汗。
正水，其脉沉迟，外证自喘。石水，其脉自沉，外证腹满（《脉经》作痛），不喘。黄汗，其
脉沉迟，身体发热，胸满，四肢头面肿，久不愈必致痈脓。心水者，身重（一作肿）而少气，
不得卧，烦而躁，其人阴肿。肝水者，腹大不能自转侧，胁下腹中痛，时时津液微生，小便
续通。脾水者，腹亦大，四肢苦重，津液不生，但苦少气，小便难。肺水者，其身肿，小便
难，时时鸭溏。肾水者，其人腹大，脐肿腰痛，不得溺，阴下湿如牛鼻上汗，其足逆冷，其
面反瘦。师曰∶诸有水者，腰以下肿，当利小便，腰以上肿，当发汗乃愈。问曰∶病下利后，
渴饮水，小便不利，腹满因肿者何也？师曰∶此法当病水，若小便自利及汗出者，自当愈（一
作盈月当愈。）凡水病之初，先两目上肿起如老蚕色，挟颈脉动，股里冷，胫中满，按之没
指，
已成，犹可治也。此病皆从虚损所致。
大病或下利后，妇人产后，饮水不消，三焦决漏，小便不利，仍相结渐渐生聚，遂流诸
经故也。
水有十种，不可治者有五。第一唇黑伤肝。第二缺盆平伤心。第三脐出伤脾。第四背平
伤肺。第五足下平满伤肾。此五伤必不可治。
凡水病忌腹上出水，出水者，一月死，大忌之。
（一篇论述，四十九首方剂，三首证候描述，两首灸法）
论述说：大凡水气病难以治愈，病愈之后特别需要在饮食口味上谨慎。患水气病的人往往嗜好进食，所以这种病很难痊愈。历代有些医生，迎合世俗风气，意在谋取财物，不重视病人的性命。病人想吃东西时，他们劝病人吃羊头和羊蹄肉，像这样没有一个人能痊愈的。另外，这种病在百脉之中，气和水都处于实证状态，治疗者都想通过泻下法来治疗。羊头和羊蹄极其滋补，怎么能痊愈呢？所以治疗水气的药物，多使用葶苈等诸药。《本草》说：葶苈长期服用会使人极度虚弱，因此水气病患者如果不是长期虚弱，就不能切断其根本。又有蛊胀病，只是腹部胀满而不浮肿；水胀病则是四肢和面目都浮肿。医生如果不善于诊断，治疗蛊胀用水气药，治疗水胀用蛊毒药，或者只是单纯的胀满，也都用水气药治疗。张仲景所说的：愚笨的医生害死了病人。现在记录禁忌如下：丧事孝期、产后、音乐娱乐、房事、喧闹嬉戏、一切鱼类、一切肉类、一切生冷食物、醋和滑腻食物、蒜、粘性食物、米豆、油腻食物。治疗蛊胀的方剂详细记载在杂方篇中，见第二十四卷蛊毒篇里。上述所禁止的食物不能吃，也不能用心思虑。不在禁止范围内的，都在本方下面注明。关于房事等禁忌，必须谨慎三年，永不复发。不然的话，即使痊愈了，复发后也无法再治疗。古方中有十水丸，经过多次验证，大多通利大便而不利小便，所以不收录。
黄帝问岐伯说：水气病与肤胀、鼓胀、肠覃、石瘕，如何区别？岐伯说：水气病刚开始发生时，眼睑上方微微肿胀（《灵枢》、《太素》作微壅），像刚睡醒的样子。颈部脉搏跳动，时常咳嗽，大腿内侧发冷，小腿肿胀，腹部才变大，这说明水气已经形成。用手按压腹部，手离开后腹部立即弹起，像包裹着水的样子，这是它的征候。肤胀病，是寒气停留在皮肤之间，空空然而坚硬（《太素》、《外台》作不坚硬），腹部大全身都肿，皮肤厚，按压腹部凹陷（《太素》作）且不起，腹部颜色不变，这是它的征候。鼓胀病，腹部胀大身体也肿大，大小与肤胀相等，面色苍黄，腹部青筋暴露，这是它的征候。肠覃病，寒气停留在肠外，与卫气（《太素》作胃气）相搏结，正气不能运行，因而有所系结的癥块向内注注，恶气于是产生，息肉于是生成。它刚开始发生时，大如鸡蛋，逐渐增大，等到形成时，像怀孕的样子。时间久的，子门闭塞，气不得通畅，恶血应当排出而不能排出，留止在那里，一天天增大，形状像怀孕，月经不能按时来潮，这些都发生在女子身上，可以用导引法使其排出。黄帝问：肤胀、鼓胀可以针刺吗？岐伯说：先泻除腹部的血络，然后调理经脉，刺去血脉中的瘀血。老师说：疾病有风水、皮水、正水、石水、黄汗。风水，脉象自然浮，外证骨节疼痛，怕风。皮水，脉象也浮，外证浮肿，按压凹陷没入指头，不怕风，腹部像鼓一样，口不渴，应当发汗。正水，脉象沉迟，外证自喘。石水，脉象自然沉，外证腹部胀满（《脉经》作痛），不喘。黄汗，脉象沉迟，身体发热，胸满，四肢头面肿，久不愈必然导致痈脓。心水病，身体沉重（一作肿）而且气短，不能躺卧，心烦而躁动，病人的阴部肿胀。肝水病，腹部大不能自行翻身，胁下和腹中痛，时时津液微生，小便断续通畅。脾水病，腹部也大，四肢苦于沉重，津液不生，只苦于气少，小便困难。肺水病，身体浮肿，小便困难，时时大便稀溏如鸭粪。肾水病，病人腹部大，肚脐肿胀腰痛，不能排尿，阴部潮湿像牛鼻上的汗，双脚逆冷，面部反而消瘦。老师说：凡是患有水气病的，腰部以下浮肿，应当利小便；腰部以上浮肿，应当发汗才能痊愈。问：病人大便泄泻后，口渴想喝水，小便不利，腹部胀满进而浮肿，这是什么原因？老师说：这种方法应当是患水气病，如果小便自利以及出汗的，自然会痊愈（一作满月当愈）。凡是水气病初起，先两眼上方肿起像老蚕的颜色，挟带颈部脉搏跳动，大腿里面冷，小腿中胀满，按压凹陷没入指头，水气已成，还可以治疗。这种病都是从虚损导致的。
大病或者泄泻后，妇人产后，饮水不能消化，三焦决漏，小便不利，仍然相互结聚渐渐生聚，于是流注到各条经脉的缘故。
水气病有十种，不可治疗的有五种。第一嘴唇黑伤肝。第二缺盆穴平陷伤心。第三肚脐突出伤脾。第四背部平塌伤肺。第五足底平满伤肾。这五种损伤必不可治。
凡是水气病忌讳腹部出水，腹部出水的，一个月死，非常忌讳。
(One treatise, forty-nine prescriptions, three syndrome descriptions, two moxibustion methods)
The treatise states: Generally speaking, edema (water disease) is difficult to cure. After recovery, one must be particularly cautious about diet. Patients with edema often have cravings for food, which makes this disease hard to heal. Some physicians in past dynasties, following worldly trends and seeking profit, disregarded the patients' lives. When a patient desired food, they advised eating sheep heads and hooves; under such circumstances, not a single patient recovered. Furthermore, in this disease, both Qi and water are in a state of excess within the hundred vessels. Physicians all wish to treat it by purging. However, sheep heads and hooves are extremely tonifying; how can recovery be achieved? Therefore, herbs used to treat edema mostly include Lepidium Seed (Tingli, 葶苈) and others. The *Materia Medica* states: Long-term use of Lepidium Seed causes severe deficiency. Thus, unless an edema patient has been chronically deficient, one must not sever their root foundation. There is also Gu distension (Gu Zhang), where only the abdomen is distended without swelling; whereas in water distension, the limbs, face, and eyes are all swollen. If physicians are not skilled in diagnosis, they may treat Gu distension with water-draining medicines, or treat water distension with Gu-toxin medicines. Or, if there is merely distension, they still use water-draining medicines. As Zhang Zhongjing said: "Foolish physicians kill them." The following taboos are recorded: mourning periods, postpartum state, music and entertainment, sexual intercourse, noisy play, all fish, all meats, all raw and cold foods, vinegar and slippery foods, garlic, sticky foods, rice and beans, and greasy foods. The prescriptions for treating Gu distension are detailed in the Miscellaneous Prescriptions chapter, found in Volume 24, Gu Toxin chapter. The aforementioned prohibited foods should not be eaten, nor should one exert mental effort. Items not prohibited are listed below each prescription. Regarding taboos on sexual intercourse, etc., one must be cautious for three years to prevent recurrence. Otherwise, even if cured, recurrence will make further treatment impossible. Ancient formulas include Shishui Wan (Ten Waters Pill), which has been verified many times; it mostly promotes bowel movements rather than urination, so it is not recorded here.
The Yellow Emperor asked Qibo: How can one distinguish between Edema (Shui), Skin Distension (Fuzhang), Drum Distension (Guzhang), Intestinal Polyps (Changqin), and Ovarian Tumors (Shijia)? Qibo replied: At the onset of Edema, there is slight swelling above the eye sockets (recorded as "slight obstruction" in *Ling Shu* and *Tai Su*), resembling the appearance after just waking up. The neck vessels pulse, there is occasional coughing, coldness in the inner thighs, and swelling of the calves. Only then does the abdomen enlarge, indicating that water has formed. Pressing the abdomen with the hand causes it to rise immediately upon release, resembling a bag wrapped around water; this is its sign. In Skin Distension, cold qi lodges between the skin and flesh. The abdomen is hollow yet firm (recorded as "not firm" in *Tai Su* and *Wai Tai Mi Yao*), the abdomen is large, the whole body is swollen, the skin is thick, pressing the abdomen leaves an indentation that does not rebound (recorded as such in *Tai Su*), and the abdominal color remains unchanged; this is its sign. In Drum Distension, the abdomen is distended and the body is swollen, similar in size to Skin Distension, the complexion is dark yellow, and the abdominal veins are prominent; this is its sign. In Intestinal Polyps, cold qi lodges outside the intestines and clashes with Wei Qi (recorded as Stomach Qi in *Tai Su*). Zheng Qi cannot circulate, leading to binding masses that inject inward, causing evil qi to arise and polyps to form. Initially, they are as large as a chicken egg, gradually increasing in size until they resemble pregnancy. In long-standing cases, the cervical os becomes blocked, Qi cannot flow freely, and evil blood should be discharged but remains stagnant, enlarging daily, resembling pregnancy. Menstruation does not occur on time. These conditions occur only in women and can be treated by guiding and draining them. The Yellow Emperor asked: Can Skin Distension and Drum Distension be treated with acupuncture? Qibo replied: First, drain the blood collaterals in the abdomen, then regulate the meridians, and puncture to remove blood stasis. The Master said: Diseases include Wind-Edema, Skin-Edema, Correct-Edema, Stone-Edema, and Yellow Sweat. In Wind-Edema, the pulse is naturally floating, external signs include bone and joint pain, and aversion to wind. In Skin-Edema, the pulse is also floating, external signs include edema that indents deeply upon pressure, no aversion to wind, abdomen like a drum, no thirst, and treatment should induce sweating. In Correct-Edema, the pulse is deep and slow, external signs include spontaneous wheezing. In Stone-Edema, the pulse is naturally deep, external signs include abdominal fullness (recorded as pain in *Mai Jing*), without wheezing. In Yellow Sweat, the pulse is deep and slow, the body feels feverish, there is chest fullness, swelling of the limbs, head, and face; if untreated for a long time, it will inevitably lead to abscesses and pus. In Heart-Edema, the body is heavy (or swollen) and short of breath, unable to lie down, irritable and restless, with swelling of the genitalia. In Liver-Edema, the abdomen is large and the patient cannot turn over independently, with pain in the hypochondrium and abdomen, occasional production of saliva, and intermittent urination. In Spleen-Edema, the abdomen is also large, the limbs suffer from heaviness, saliva is not produced, there is only shortness of breath, and difficulty urinating. In Lung-Edema, the body is swollen, urination is difficult, and stools are loose like duck droppings. In Kidney-Edema, the abdomen is large, the umbilicus is swollen with lower back pain, inability to urinate, dampness in the genitalia resembling sweat on a cow's nose, cold feet, and a thin face. The Master said: For all edema cases, if swelling is below the waist, promote urination; if swelling is above the waist, induce sweating for recovery. A question was raised: After diarrhea, if the patient is thirsty and drinks water, has difficulty urinating, and develops abdominal fullness followed by swelling, what is the cause? The Master said: This condition should be considered Water Disease. If urination becomes free and sweating occurs, it will heal spontaneously (or heal within a month). At the beginning of any edema, swelling appears first above the eyes, resembling the color of an old silkworm, accompanied by pulsation of the neck vessels, coldness in the thighs, fullness in the calves, and deep indentation upon pressure. If water has already formed, it is still treatable. This disease arises from deficiency and damage.
After a major illness or diarrhea, or in postpartum women, if ingested water fails to transform, and the Triple Burner leaks, causing difficulty in urination, the fluids bind and accumulate, eventually flowing into the various meridians.
There are ten types of edema, five of which are incurable. The first is black lips, injuring the Liver. The second is a flat Supraclavicular Fossa (Quepen), injuring the Heart. The third is protruding umbilicus, injuring the Spleen. The fourth is a flat back, injuring the Lungs. The fifth is flat and full soles, injuring the Kidneys. These five injuries are definitely incurable.
In all edema cases, one must taboo fluid leaking from the abdomen. If fluid leaks from the abdomen, death occurs within one month; this is strictly forbidden.