水肿方一十三首
病源肾者主水，脾胃俱主土，土性克水，脾与胃合，相为表里，胃为水谷之海。今胃虚
不能传化水气，使水气渗溢经络，浸渍腑脏，脾得水湿之气加之则病，脾病则不能制水。故
水气
之状
偃则
第二
脉沉者水也，脉洪大者可疗，微细者不疗也。养生方云∶十一月勿食经夏自死肉脯，内动于
肾，喜成水病，其汤熨针石，别有正方，补养宣导，今附于后，养生方导引法云∶虾蟆行气
，正坐动摇两臂，不息十二通，以治五劳水肿之病也。又云∶人卧勿以脚悬蹋高处，不久必
成肾水。（出第二十一卷中）
黄帝问曰∶水与肤胀鼓胀肠单石瘕，何以别之。岐伯对曰∶水始起也。目里上微肿。如
新卧起之状，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，
按
此其候也，肠覃者，寒气客于肠外，与卫气相薄，正气不得营，因有所系，癖而内着，恶气
乃起，息肉乃生，其始生也，大如鸡卵，稍以益大，至其成也。若怀子之状，久者离岁月，
按之则坚，推之则移。月事不以时下。此其候也，石瘕者，生于胞中，寒气客于子门，子门
闭塞，气不得通，恶血当写不写， 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。曰∶肤胀鼓胀可刺耶。对曰∶先写其腹之血络，后调其经，亦刺去其血
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，
其人恶风，皮水其脉亦浮，外证 肿，按之没指，不恶风，其腹如鼓，不满不渴，当发其汗
，正水其脉沉迟，外证自喘，石水其脉自沉，外证腹满不喘，黄汗其脉沉迟，身体发热，胸
满四肢头面肿，久未愈必致痫脓。（千金范汪同并出甲乙经第八辛卷）
范汪疗水肿方。
葶苈子（一两熬黑） 甘遂（一两熬） 吴茱萸（四两）
上三味，别捣异下筛，和以蜜丸如梧子，服可至五丸，经心录云，服三丸，日三服，余
同。
又葶苈丸，疗水肿方。
葶苈（一升熬） 吴茱萸（一升）
上二味各别捣筛合，以蜜和，更捣二万杵，药成，饮服二丸如梧实，不知增之，当以小
便利及下为候。若下者，但可清旦一服；若不下，但小便利者，日可再三服，常将服肿消耳，
一
又利小便，消水肿，郁李核丸方。
郁李核仁（三分） 松萝（三分） 海藻（二分） 桂心 大黄（五分） 葶苈（五分
熬） 黄连
（二分） 通草（一分） 石苇（一分去毛）
上九味，捣合下筛，和以蜜，九如梧子，先食饮服七丸，日二，稍增以知为度。（并出
第二十八卷中）
又疗水肿，大槟榔丸方。
槟榔（三两） 桂心（三两） 附子（二两炮） 栝蒌（三两） 杏仁（三两熬一方无）
干姜（
二两） 甘草（二两炙） 麻黄（三两去节） 黄 （三两） 茯苓（三两）
浓朴（二两炙） 葶苈（三两熬） 椒目（三两） 吴茱萸（王合） 白术（三两） 防
已（二两）
上十六味下筛，蜜和服如梧子大二丸，日三，不知，稍增至四丸，不知，又加二丸，不
下，还
猪肉冷
短剧疗水肿方。
大豆（三升）
上一味。以水六升，煮令熟，出豆澄汁，更纳美酒五升，微火煎如饧，服一升，渐增之
，令小下。
又桃皮酒，疗水肿方。
桃皮（三斤削去黑取黄皮） 女曲（一升） 秫米（一升）
上三味。以水三斗，煮桃皮令得一斗，以五升汁渍女曲，五升汁 饭，酿如酒法，熟漉
去滓，可服一合，日三，耐酒者增之，以体中有热为候，小便多者即是，病去便愈。忌生冷
酒面一切毒物。
又麝香散，疗水肿方。（千金云治妇人短气虚羸遍身浮肿皮虚急）
麝香（三铢） 芫花（三分熬） 甘遂（三分）
上三味合下筛，酒服钱半边匕，老小钱边三分匕，亦可丸服之，强人如小豆十丸，老人
五丸。（千金有雄黄一味并麝香各用六铢肘后又有人参二分）
又疗水肿，商陆膏方。
商陆根（一斤生者） 猪膏（一斤先煎可有二升）
上二味合煎令黄，去滓，以摩肿，亦可服少许。忌大肉，经心录同。（千金云涂以纸覆
之燥即涂不过三日愈并出第一卷中）
集验疗水肿方。
黄犍牛尿一饮三升，若不觉更加服之，以得下为度。疗老小者宁从少起，饮半，亦可用
后方。
又疗水肿方。
猪肾一枚，分为七脔，甘遂一分末筛为散，以粉肾，微火炙令熟，食之至三四脔，乃可
止，
经心
千金翼疗水肿方。
葶苈子（六两生用） 桂心（二两）
上二味捣蜜和丸，饮服十丸如梧子，日二。慎蒜面猪鸡油腻。（出第二十卷中）
必效疗水肿方。
皂荚（一挺去皮子炙） 乌饧（五两）
一味。以酒二升煮取六沸，绞去滓，顿服之，须臾即小便一三升，肿消。忌一切肉及面
生冷咸酢食一周年。
又方
取苦瓠（一枚）
上一味。以水一石煮一炊久，去滓煎汁令堪丸。如胡豆，一服二丸，当小便下，后作小
豆羹饭。慎勿饮水效。（并出第二卷中）
水肿方剂共十三首
病因方面，肾主水液代谢，脾和胃都主管土性。土的属性克制水，脾与胃互为表里，胃是水谷汇聚的海。现在如果胃气虚弱，不能正常传输和转化水气，导致水气渗漏溢出经络，浸渍脏腑，脾受到水湿之气的影响就会生病，脾病后就不能制约水液。所以水气泛滥的症状是：身体浮肿，平卧时加重。
脉象方面，脉沉的属于水病；脉洪大的可以治疗；脉微细的难以治疗。养生方说：十一月不要吃经过夏天而自然死亡的肉干，这会内动于肾，容易形成水病。其治疗方法如汤熨、针刺、砭石等，另有专门的方剂。补养和宣导的方法，现在附在后面。养生方的导引法说：模仿虾蟆行气，端正坐姿，摇动双臂，憋气十二次，用来治疗五劳水肿的病。又说：人睡觉时不要把脚悬空踩在高处，时间久了必然形成肾水病。（出自第二十一卷）
黄帝问道：水病、肤胀、鼓胀、肠覃、石瘕，如何区别？岐伯回答说：水病刚开始发作时，眼睑内侧微微肿胀，像刚睡醒的样子，颈部动脉跳动，时常咳嗽，大腿内侧感觉寒冷，小腿浮肿，腹部变大，这时水病已经形成。用手按压腹部，手离开后凹陷随即弹起，这是它的征候。肠覃，是寒气客居在肠外，与卫气相搏，正气不能正常运行，因此有所羁绊，癖积在内附着，恶气于是产生，息肉于是生成。它刚开始生长时，大小像鸡蛋，逐渐增大，等到成熟时，像怀孕的样子，病程长的可达数年，按压它则坚硬，推动它则移动，月经不能按时来潮。这是它的征候。石瘕，生于胞宫之中，寒气客居在子门，子门闭塞，气机不得通畅，恶血应当排出却未排出，因而留滞停止，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，可以用导引等方法使其下行排出。黄帝问：肤胀和鼓胀可以针刺吗？岐伯回答：先刺破腹部的血络放血，然后调理经脉，也要刺去血脉中的瘀血。
老师（指《甲乙经》作者或相关医家）说：疾病有风水、皮水、正水、石水、黄汗。风水的脉象自浮，外证骨节疼痛，病人怕风；皮水的脉象也浮，外证全身浮肿，按压凹陷不起，不怕风，腹部像鼓一样胀满，但不胀闷不口渴，应当发汗治疗；正水的脉象沉迟，外证自喘；石水的脉象自沉，外证腹部胀满但不喘；黄汗的脉象沉迟，身体发热，胸满，四肢头面肿，久治不愈必然导致痈脓。（千金方、范汪方相同，均出自《甲乙经》第八卷）
范汪治疗水肿方：
葶苈子（一两，炒黑）、甘遂（一两，炒）、吴茱萸（四两）。
以上三味药，分别捣碎过筛，混合后用蜂蜜制成梧桐子大小的丸药，每次服用五丸左右。《经心录》说，服用三丸，每天三次，其余方法相同。
又葶苈丸，治疗水肿方：
葶苈（一升，炒）、吴茱萸（一升）。
以上两味药，分别捣碎过筛混合，用蜂蜜调和，再捣两万杵。药成后，用温水送服二丸，大小如梧实。如果无效则增加剂量，以小便通利及大便排泄为见效标志。如果已见排泄效果，只需清晨服用一次；如果未见排泄，仅小便通利，每天可服用三次，常服直至消肿为止。
又利小便，消水肿，郁李核丸方：
郁李核仁（三分）、松萝（三分）、海藻（二分）、桂心、大黄（五分）、葶苈（五分，炒）、黄连（二分）、通草（一分）、石苇（一分，去毛）。
以上九味药，捣碎混合过筛，用蜂蜜调和，制成梧桐子大小的丸药。饭前用温水送服七丸，每天两次，逐渐增加剂量，以见效为度。（均出自第二十八卷）
又治疗水肿，大槟榔丸方：
槟榔（三两）、桂心（三两）、附子（二两，炮制）、栝蒌（三两）、杏仁（三两，炒，一方无此味）、干姜（二两）、甘草（二两，炙）、麻黄（三两，去节）、黄芪（三两）、茯苓（三两）、浓朴（二两，炙）、葶苈（三两，炒）、椒目（三两）、吴茱萸（王合，疑为“五合”或特定量）、白术（三两）、防己（二两）。
以上十六味药，过筛，用蜂蜜调和，制成梧桐子大小的丸药，每次服用二丸，每天三次。如果无效，逐渐增加到四丸；如果再无效，再加二丸。如果不排便，还...（原文此处似有缺漏或错简，接下文“猪肉冷”可能为禁忌或另一段开头，但根据上下文逻辑，此处应为服药反应描述，暂按原文结构处理，注：原文“不下，还 猪肉冷”语意不通，推测为排版错误，此处仅翻译可见部分）。
短剧治疗水肿方：
大豆（三升）。
以上一味药，用水六升，煮至熟透，取出豆子澄清汁液，再加入美酒五升，用微火煎至如饴糖状，服用一升，逐渐增加剂量，令轻微腹泻。
又桃皮酒，治疗水肿方：
桃皮（三斤，削去黑皮取黄皮）、女曲（一升）、秫米（一升）。
以上三味药，用水三斗，煮桃皮至剩下一斗汁，用五升汁浸泡女曲，用五升汁拌饭，按照酿酒方法发酵。熟后过滤去渣，可服用一合，每天三次，能喝酒者可增加剂量，以体内有热感为见效标志，小便多者即是有效，病愈即停。忌食生冷、酒、面及一切毒物。
又麝香散，治疗水肿方。（千金方云治疗妇人短气虚羸遍身浮肿皮虚急）
麝香（三铢）、芫花（三分，炒）、甘遂（三分）。
以上三味药混合过筛，用酒送服半边钱匕大小的药粉，老人小孩用钱边三分大小的药粉，也可以制成丸药服用，强壮的人如小豆大小十丸，老人五丸。（千金方中有雄黄一味，并麝香各用六铢，肘后方后又有人参二分）。
又治疗水肿，商陆膏方：
商陆根（一斤，鲜品）、猪膏（一斤，先煎至约二升）。
以上两味药合煎至黄色，去渣，涂抹于肿胀处，也可少量服用。忌食大肉（狗肉或牛肉等发物），《经心录》相同。（千金方云涂后用纸覆盖，干了就再涂，不超过三天痊愈，均出自第一卷）。
集验治疗水肿方：
黄犍牛尿一饮三升，如果觉得不够再服用，以下泄为度。治疗老人小孩应从少量开始，喝半升，也可以用后方。
又治疗水肿方：
猪肾一枚，切成七块，甘遂一分末过筛成散，撒在肾上，用微火烤熟，吃下去直到三四块，就可以停止。
千金翼治疗水肿方：
葶苈子（六两，生用）、桂心（二两）。
以上两味药捣碎，用蜂蜜调和成丸，温水送服十丸，大小如梧桐子，每天两次。慎食蒜、面、猪鸡油腻食物。（出自第二十卷）。
必效治疗水肿方：
皂荚（一挺，去皮子，炙）、乌饧（五两）。
一味药，用酒二升煮至沸腾六次，绞去渣，一次性服用，片刻之后小便一至三升，肿胀消退。忌食一切肉类及面食、生冷、咸酸食物一年。
又方：
取苦瓠（一枚）。
以上一味药，用水一石煮一顿饭的时间，去渣，煎汁至可制成丸药的程度。做成胡豆大小的丸药，每次服用二丸，应当小便通利，之后吃小豆羹饭。千万不要喝水效仿。（均出自第二卷）。
Thirteen Formulas for Edema
Regarding the etiology, the Kidney governs water metabolism, while the Spleen and Stomach both govern the Earth element. The nature of Earth controls Water. The Spleen and Stomach are exterior-interiorly related; the Stomach is the sea of food and fluids. If the Stomach Qi is deficient and unable to transport and transform fluid-Qi normally, fluid-Qi will seep and overflow through the collaterals, infiltrating the Zang-Fu organs. When the Spleen is affected by dampness-water Qi, it becomes diseased, and once the Spleen is diseased, it loses its ability to control water. Therefore, the manifestation of overflowing fluid-Qi is: body edema that worsens when lying flat.
Regarding pulse diagnosis, a sunken pulse indicates water disease; a surging and large pulse indicates a treatable condition; a fine and minute pulse indicates a difficult-to-treat condition. The Health Preservation Formula states: In the eleventh lunar month, do not consume dried meat that died naturally during the summer, as this moves internally into the Kidney and predisposes one to water disease. Treatments such as hot compresses (Tangwen), acupuncture, and stone therapy have separate specific formulas. Methods of nourishment and guidance (Daoyin) are attached below. The Health Preservation Daoyin method states: Mimic the movement of a frog to circulate Qi; sit upright and shake both arms, holding the breath twelve times, to treat edema caused by five types of exhaustion. It also states: Do not sleep with feet suspended high above the head; doing so for a long time will inevitably lead to Kidney water disease. (From Volume 21)
The Yellow Emperor asked: How can one distinguish between Water Disease, Skin Distension, Drum Distension, Intestinal Polypus (Changtan), and Stone Mass (Shijia)? Qibo replied: At the onset of Water Disease, there is slight swelling in the inner canthus of the eyes, resembling the appearance after just waking up. There is pulsation in the neck vessels, frequent coughing, coldness in the inner thighs, swelling of the calves, and abdominal enlargement, indicating that water has formed. Pressing the abdomen with the hand results in immediate rebound after the hand is removed; this is its sign. Changtan (Intestinal Polypus) occurs when cold pathogen lodges outside the intestines, conflicting with Defensive Qi (Wei Qi). Healthy Qi fails to circulate properly, becoming bound and adhering internally. Evil Qi arises, and polyps form. Initially, they are the size of a chicken egg, gradually enlarging until maturity, resembling pregnancy. Long-standing cases may last years; pressing them feels hard, but pushing them moves them. Menstruation does not occur on time. This is its sign. Shijia (Stone Mass) originates in the Uterus (Bao Zhong). Cold pathogen lodges in the Gate of the Substrate (Zi Men), causing closure. Qi cannot flow freely, and evil blood should be discharged but remains stagnant, enlarging daily. It resembles pregnancy, and menstruation is delayed. These conditions occur only in women and can be treated by guiding and purging downward. The Yellow Emperor asked: Can Skin Distension and Drum Distension be treated with acupuncture? Qibo answered: First, puncture the blood collaterals in the abdomen to release blood, then regulate the meridians, and also puncture to remove blood stasis from the vessels.
The Master states: Diseases include Wind Water, Skin Water, Correct Water, Stone Water, and Yellow Sweat. Wind Water presents with a floating pulse, external signs of joint pain, and aversion to wind. Skin Water also presents with a floating pulse, external signs of generalized edema where indentation persists upon pressure, no aversion to wind, abdominal distension like a drum without fullness or thirst; treatment requires inducing sweating. Correct Water presents with a deep and slow pulse and spontaneous panting. Stone Water presents with a deep pulse and abdominal fullness without panting. Yellow Sweat presents with a deep and slow pulse, fever, chest fullness, and swelling of the limbs, head, and face; if prolonged, it inevitably leads to abscess formation. (Formulas from Qianjin Fang and Fan Wang are identical and originate from Volume 8 of Jia Yi Jing).
Fan Wang’s Formula for Edema:
Semen Lepidii (Tinglizi, 1 liang, roasted black), Kansui Radix (Gansui, 1 liang, roasted), Evodiae Fructus (Wuzhuyu, 4 liang).
Grind the three herbs separately and sieve them. Mix with honey to make pills the size of wu zi (Cibotium seeds). Take approximately 5 pills per dose. Jingxin Lu states to take 3 pills, three times daily; other instructions remain the same.
Another Tinglizi Pill for Edema:
Semen Lepidii (Tinglizi, 1 sheng, roasted), Evodiae Fructus (Wuzhuyu, 1 sheng).
Grind each herb separately, sieve, and mix. Combine with honey and pound for twenty thousand strokes. Take 2 pills the size of wu shi (walnut kernels) with warm water. If ineffective, increase the dose. The goal is patent urination and bowel movements. If discharge occurs, take only once in the morning. If no discharge but urination is patent, take up to three times daily. Continue until edema subsides.
Another Formula for Promoting Urination and Reducing Edema: Yulihe Pill:
Semen Pruni (Yuliren, 3 fen), Ramuli Claviceps (Songluo, 3 fen), Thallus Laminariae (Haizao, 2 fen), Cinnamomi Cortex (Guixin), Rhei Radix et Rhizoma (Dahuang, 5 fen), Semen Lepidii (Tinglizi, 5 fen, roasted), Coptidis Rhizoma (Huanglian, 2 fen), Tetsii Herba (Tongcao, 1 fen), Folium Pyri (Shiwei, 1 fen, hairs removed).
Pound the nine herbs together and sieve. Mix with honey to make pills the size of wu zi. Take 7 pills before meals with water, twice daily. Gradually increase the dose until therapeutic effect is achieved. (All from Volume 28).
Another Formula for Edema: Dabinglang Pill:
Arecae Semen (Binglang, 3 liang), Cinnamomi Cortex (Guixin, 3 liang), Aconiti Lateralis Radix Praeparata (Fuzi, 2 liang, processed), Trichosanthis Fructus (Gualou, 3 liang), Armeniacae Semen Amarum (Xingren, 3 liang, roasted; absent in one version), Zingiberis Rhizoma (Ganjiang, 2 liang), Glycyrrhizae Radix et Rhizoma (Gancao, 2 liang, honey-fried), Ephedrae Herba (Mahuang, 3 liang, nodes removed), Astragali Radix (Huangqi, 3 liang), Poria (Fuling, 3 liang), Magnoliae Officinalis Cortex (Houpo, 2 liang, honey-fried), Semen Lepidii (Tinglizi, 3 liang, roasted), Zanthoxyli Pericarpium (Jiaomu, 3 liang), Evodiae Fructus (Wuzhuyu, Wang he [likely a textual error]), Atractylodis Macrocephalae Rhizoma (Baizhu, 3 liang), Stephaniae Tetrandrae Radix (Fangji, 2 liang).
Sieve the sixteen herbs. Mix with honey to make pills the size of wu zi. Take 2 pills three times daily. If ineffective, increase to 4 pills. If still ineffective, add 2 more pills. If constipation persists... (Text appears corrupted here, followed by "pork cold").
Duanju’s Formula for Edema:
Sojae Semen Preparatum (Dadou, 3 sheng).
Boil the single herb in six sheng of water until cooked. Remove the beans and clarify the juice. Add five sheng of fine wine. Simmer over low heat until syrupy. Take one sheng, increasing gradually to induce mild purgation.
Another Peach Bark Wine for Edema:
Persicae Cortex (Taopi, 3 jin, scrape off black skin to use yellow bark), Nvqu (1 sheng), Sorghum (Shumi, 1 sheng).
Boil the peach bark in three dou of water until one dou of liquid remains. Use five sheng of this liquid to soak Nvqu and five sheng to moisten the sorghum. Ferment according to wine-making methods. Strain and filter. Take one ge, three times daily. Those tolerant to alcohol may increase the dose. Therapeutic effect is indicated by internal heat sensation and increased urination. Discontinue when cured. Avoid raw/cold foods, alcohol, wheat products, and all toxic substances.
Another Musk Powder for Edema: (Qianjin Fang states it treats women with shortness of breath, emaciation, generalized edema, and tight skin.)
Moschus (Shexiang, 3 zhu), Genkwa Flos (Yuanhua, 3 fen, roasted), Kansui Radix (Gansui, 3 fen).
Mix and sieve. Take half a coin-sized scoop with wine for adults, or one-third for children/elderly. Can also be made into pills: ten small-bean-sized pills for strong individuals, five for the elderly. (Qianjin Fang includes Realgar, 6 zhu each with Musk; Zhouhou Fang adds Codonopsis Radix, 2 fen).
Another Shanglu Paste for Edema:
Phytolaccae Radix (Shanglu, 1 jin, fresh), Porcine Fat (Zhugao, 1 jin, pre-boiled to yield approx. 2 sheng).
Simmer together until yellow. Strain. Apply topically to swollen areas; can also be taken in small amounts. Avoid beef/pork (fatty meats). Jingxin Lu agrees. (Qianjin Fang states cover with paper after application; reapply when dry; cures within three days. From Volume 1).
Jiyan’s Formula for Edema:
One drink of urine from a yellow castrated bull (San sheng). If insufficient, take more. Stop when purged. For elderly and children, start with half a sheng. Alternatively, use the following formula.
Another Formula for Edema:
One pig kidney, cut into seven pieces. One fen of Gansui powder, sifted. Dust the kidney pieces with the powder. Roast over low heat until cooked. Eat up to three or four pieces, then stop.
Qianjin Yi’s Formula for Edema:
Semen Lepidii (Tinglizi, 6 liang, raw), Cinnamomi Cortex (Guixin, 2 liang).
Pound and mix with honey to make pills. Take 10 pills the size of wu zi with water, twice daily. Avoid garlic, wheat products, pork, chicken, and greasy foods. (From Volume 20).
Bixiao’s Formula for Edema:
Gleditsiae Sinensis Fructus (Zaojiao, one pod, remove skin and seeds, roast), Wuxing (Dark maltose, 5 liang).
Boil the single ingredient in two sheng of wine until it boils six times. Strain. Take in one dose. Within moments, urinate one to three sheng, and edema subsides. Avoid all meats, wheat products, raw/cold foods, salty, and sour foods for one year.
Another Formula:
Take one bitter gourd (Kuhu).
Boil in one shi of water for the duration of one meal. Strain and reduce the liquid to form pills the size of vetch beans. Take two pills per dose. Expect patent urination. Follow with a mung bean soup meal. Do not drink water. (From Volume 2).