病源肾主水,肺主气,肾虚不能制水,故水妄行,浸溢皮肤,而身体肿满,流散不已,
上乘于肺,肺得水而浮,浮则上气咳嗽也。(出第二十一卷中)
深师疗水咳逆上气,通身洪肿,短气胀满,昼夜倚壁不得卧,喉中水鸡鸣,大小便不通
,不下食而不甚渴,白前汤方。
白前(三两) 紫菀(四两) 半夏(一升洗) 生泽漆根(一汁切)
凡四味,水一斗七升,煮取一斗汁,又纳后药。
桂心(三两) 人参(六分) 大枣(二十枚擘) 白术(五两) 生姜(八两一方干
者二两)
茯苓(四两) 吴茱萸(五两) 杏仁(三两去两仁皮尖碎) 葶苈(二两) 栝蒌(五合
一方十合
上十味纳前汁中,煮取三升,分四服,当得微下,利小便,气即下肿减,深云,增损用
之若神。忌羊肉饧生葱桃李雀肉酢物。(出第十九卷中)
古今录验夫水在五脏,令人咳逆喘上气,腹大向向,两脚肿,目下有卧蚕,微渴,不得
安卧
热,
生鲤鱼(一头重五斤粗锉) 麦门冬(二两去心) 甘草(二两炙) 人参(二两) 茯
苓(二
两) 泽漆根(八两生者)
上六味切,以水一斗七升煮鱼,取一斗,去鱼以煮药,取四升,分服,日三,小便利为
度,不利,增服之,大便如利,而小便未利者,增至四合,服一日,气即下得安卧,有寒可
纳生
又防己煮散,疗水肿上气方。(出许谏议)
汉防己(三两) 泽漆叶(三两) 石苇(三两去毛) 泽泻(三两) 郁李仁(五两)
白术(
三两) 丹参(三两) 赤茯苓(三两) 桑白皮(三两) 橘皮(二两) 生姜(十两) 通
草(二两
)
上十二味,粗筛为散,以水一斗七合,纳四方寸匕散,煮取八合,去滓,一服令尽,日
三,大便利者一服,取小便利为度,许澄秘方。忌同前。(千金同出第十一卷中)
病因源于肾主水液代谢,肺主气机运行。若肾气虚弱无法制约水液,导致水湿妄行,浸淫溢出于皮肤,致使身体肿胀满闷,水流散漫不止;进而水气上乘于肺,肺脏受水邪影响而功能浮越,气机上逆引发咳嗽。(出自第二十一卷)
《深师方》治疗因水饮引起的咳逆上气,全身严重浮肿,呼吸短促且腹部胀满,昼夜只能倚靠墙壁无法平卧,喉间有如水鸡鸣叫的声音,大小便不通畅,无法进食但口渴不明显,使用白前汤方。
白前三两,紫菀四两,半夏一升(洗净),生泽漆根一汁(切碎)。
以上四味药,用水一斗七升,煎煮至取汁一斗,然后加入后续药物。
桂心三两,人参六分,大枣二十枚(掰开),白术五两,生姜八两(另一版本用干姜二两),茯苓四两,吴茱萸五两,杏仁三两(去皮尖及双仁,捣碎),葶苈子二两,栝蒌五合(另一版本用十合)。
以上十味药加入前面的药汁中,煎煮至取汁三升,分四次服用。服药后应当出现轻微腹泻,通利小便,气机下降则肿胀消退。《深师方》记载称增减使用此方效果如神。忌食羊肉、饴糖、生葱、李子、桃子、雀肉及醋制食物。(出自第十九卷)
《古今录验》认为水邪停留于五脏,令人咳逆喘促上气,腹部胀大,双脚浮肿,眼下如卧蚕状,轻微口渴,不能安稳卧床休息。
使用生鲤鱼一头(重五斤,粗切),麦门冬二两(去心),甘草二两(炙),人参二两,茯苓二两,泽漆根八两(鲜品)。
以上六味药切碎,用水一斗七升先煮鲤鱼,取汁一斗,捞出鲤鱼后用鱼汁煮药,取汁四升,分次服用,每日三次,以小便通利为度。若未通利,增加剂量服用。若大便像腹泻一样,但小便仍未通利,增至每次四合,服用一天后,气机下降即可安卧。若有寒象可加入生姜。(许谏议秘方)
另外有防己煮散,治疗水肿伴上气的方剂。(出自许谏议)
汉防己三两,泽漆叶三两,石苇三两(去毛),泽泻三两,郁李仁五两,白术三两,丹参三两,赤茯苓三两,桑白皮三两,橘皮二两,生姜十两,通草二两。
以上十二味药,粗筛成散剂。用水一斗七合,加入四方寸匕的散剂,煎煮至取汁八合,滤去药渣,一次服完,每日三次。若大便通畅则停服,以小便通利为度。此为许澄秘方。禁忌同前。(与《千金方》一同出自第十一卷)
The etiology stems from the Kidney governing water metabolism and the Lung governing Qi dynamics. If Kidney Qi is deficient and unable to control water, pathological water fluids will flow recklessly, infiltrating and overflowing into the skin, causing bodily swelling and fullness, with fluid dispersing endlessly; subsequently, water Qi ascends to overwhelm the Lung. The Lung, affected by water pathogens, becomes hyperactive (floating), leading to upward reversal of Qi and coughing. (From Volume 21)
*Shen Shi Fang* treats water-induced coughing, retching, and upward rushing of Qi, characterized by severe generalized edema, shortness of breath, abdominal distension, inability to lie flat day or night (only able to lean against a wall), a sound in the throat resembling a water frog croaking, obstruction of both urination and defecation, inability to eat but without significant thirst. Use Baiqian Tang Decoction.
Baiqian (Radix Cynanchi Stauntonii) 3 liang, Ziwan (Herba Asteris Tatarici) 4 liang, Banxia (Rhizoma Pinelliae Preparatum) 1 sheng (washed), Sheng Zeqigen (Radix Euphorbiae Lathyridis, fresh) sufficient for one juice portion (cut).
These four ingredients are decocted in 1 dou 7 sheng of water until 1 dou of liquid remains. Then add the subsequent herbs.
Guixin (Cortex Cinnamomi) 3 liang, Renshen (Radix Ginseng) 6 fen, Dazao (Fructus Jujubae) 20 pieces (split), Baizhu (Rhizoma Atractylodis Macrocephalae) 5 liang, Shengjiang (Rhizoma Zingiberis Recens) 8 liang (another version uses Ganjiang/Dried Ginger 2 liang), Fuling (Sclerotium Poriae) 4 liang, Wuzhuyu (Fructus Evodiae) 5 liang, Xingren (Semen Armeniacae Amarum) 3 liang (skin, tips, and twin kernels removed, crushed), Tingli (Semen Lepidii seu Descurainiae) 2 liang, Gualou (Fructus Trichosanthis) 5 he (another version uses 10 he).
Add these ten ingredients to the previously obtained liquid, decoct until 3 sheng of liquid remains. Divide into four doses. Upon administration, mild diarrhea should occur, promoting diuresis. As Qi descends, the swelling will subside. *Shen Shi Fang* states that adjusting this formula yields miraculous results. Avoid mutton, maltose, raw green onions, plums, peaches, sparrow meat, and vinegar-preserved foods. (From Volume 19)
*Gujin Luyan* posits that water retention in the five Zang organs causes coughing, retching, wheezing, and upward rushing of Qi, abdominal distension, bilateral lower limb edema, "lying silkworm" appearance under the eyes, slight thirst, and inability to rest comfortably in bed.
Use Sheng Liyu (Fresh Carp) 1 head (approx. 5 jin, coarsely chopped), Maimendong (Radix Ophiopogonis) 2 liang (heart removed), Gancao (Radix Glycyrrhizae Preparata) 2 liang (honey-fried), Renshen (Radix Ginseng) 2 liang, Fuling (Sclerotium Poriae) 2 liang, Zeqigen (Radix Euphorbiae Lathyridis, fresh) 8 liang.
Cut these six ingredients. Decoct the carp in 1 dou 7 sheng of water to obtain 1 dou of liquid. Remove the carp and use the fish broth to decoct the herbs, obtaining 4 sheng of liquid. Divide into three daily doses. The treatment is considered effective when urination becomes free. If not, increase the dose. If stool resembles diarrhea but urination remains obstructed, increase each dose to 4 he. After one day of administration, Qi will descend, allowing for restful sleep. If cold signs are present, add Shengjiang (Rhizoma Zingiberis Recens). (Secret Formula of Xu Jianyi)
Additionally, there is Fangji Zhusan (Prepared Powder of Stephania Tetrandra), a formula for treating edema accompanied by upward rushing of Qi. (From Xu Jianyi)
Han Fangji (Radix Stephaniae Tetrandrae) 3 liang, Zeqieye (Folium Euphorbiae Lathyridis) 3 liang, Shiwei (Folium Pyrrosiae) 3 liang (remove hairs), Zexie (Rhizoma Alismatis) 3 liang, Yuliren (Semen Pruni) 5 liang, Baizhu (Rhizoma Atractylodis Macrocephalae) 3 liang, Danshen (Radix Salviae Miltiorrhizae) 3 liang, Chi Fuling (Sclerotium Poriae Rubrum) 3 liang, Sangbaipi (Cortex Mori Radicis) 3 liang, Juapi (Pericarpium Citri Reticulatae) 2 liang, Shengjiang (Rhizoma Zingiberis Recens) 10 liang, Tongcao (Medulla Tetrapanacis) 2 liang.
Sieve these twelve ingredients coarsely to make a powder. Add 4 square-cun-bi (a traditional measure for powder) of the powder to 1 dou 7 he of water. Decoct until 8 he of liquid remains. Strain the dregs. Take the entire amount at once, three times daily. If bowel movements are unobstructed, stop taking it. The goal is free urination. This is the secret formula of Xu Cheng. Dietary restrictions are the same as above. (Also found in Volume 11 of *Qianjin Fang*)