肿有二。经云。面肿曰风。足肿曰水。凡肿自上起者。皆因于风。治在肺。宜发散
之。所谓开鬼门者是也。鬼门。汗孔也。参苏饮合五皮汤主之。
肿自下起者。因于肾虚。宜渗利之。所谓洁净府。是利其小便也。故仲景云。治湿不利
小便。非其治也。宜五苓散加防己槟榔主之。
有一身尽肿者。宜胃苓五皮汤主之。经郁则折之。谓上下分消。以去其湿。发汗利小便
。此方是小儿者。胃苓丸煎五皮汤送下。
胃苓丸 此家传十三方也。
苍术（泔浸） 浓朴 陈皮 猪苓 泽泻 白术 茯苓（各一两） 甘草 官桂 草果仁（
各三钱） 上为末。水面丸麻子大。米饮下。此小儿常用之药。随病换引。
先翁治小儿肿。只用胃苓丸正方。顺收长流水。入灯心煎汤送下。每日午时。用五加皮
煎汤
未有不效者。
五皮汤
桑白皮 陈皮 生姜皮 茯苓皮 大腹皮 水煎。
经纪万邦瑞女。二十七岁。病肿甚异。寅后午前。上半身肿。午后丑前。下半身肿。上
下尽消
。
湿之法。唯半夜阴户肿。不得小便。此又当从肝经求之。盖厥阴肝经之脉。丑时起于足上。
环阴器。又肝病者。则大小便难。用胃苓五皮汤。发汗利小便也。内有茯苓。所以伐肾肝之
邪。木得桂而枯。又以辛散其肝经之水。以温肾之真寒湿也。连服十一剂。而肿尽消去矣。
予奉先翁之教。凡肿微者。只用胃苓丸本方治之。如面肿甚者。胃苓丸本方内。加紫苏
钱。苦葶苈一钱隔纸炒。以去肺经之风。足肿甚者。本方内加汉防己二钱。牵牛炒取头末一
钱。共为丸。灯心煎汤下。吾有一二门人。不守先训。专用葶苈牵牛为治肿之药。随消随
肿。杀儿甚多。累吾之德。虽禁之不能阻也。
湖广右布政使孙。隆庆丁卯。入场监试。为书经礼记总裁。有小姐病。留全司中调理。
误食菱角伤脾。面肿而喘。夫人忧之。命余进药。余立一方。用钱氏异功散。加藿香叶以去
脾经之湿。紫苏叶以去肺经之风。一剂而安。场罢后公出。见其方。谓全曰。此方甚好。取
笔札令舍人孙环书记之。
小儿病嗽病疟病疮后肿者。皆虚肿也。
如受风雨水湿之气而肿者。实肿也。通用胃苓丸主之。此家传之法也。
小儿诸肿。不问虚实。并用胃苓丸五皮汤主之。此家传也。
如因喘嗽面目浮肿者。宜消肿。葶苈丸主之。
如疟后遍身浮肿者。此因疟发之后。外中风邪。内伤冷水得之。宜胃苓丸。用长流水顺
取。入灯心煎汤送下。更于日午浴之。法如前。
如无他病浮肿者。视其肿起之处治之。如自面起。上半身先肿者。此风肿也。宜五皮汤
加紫苏叶防风主之。如从足起。下半身先肿者。此湿肿也。宜五苓散加防己木通主之。
如肿久不消。气实能食者。宜利其水。商陆胃苓丸主之。肾者水之根。湿则伤肾。小儿
久坐湿地者多此疾。
如气弱食少者。只以补脾为主。脾属土。土能胜水。脾强则水去。而肿消矣。宜参苓平
胃散。加藿香叶紫苏叶木香砂仁为丸服之。
有肾虚者。安肾丸服之。
有面目俱黄。遍身俱黄且肿者。此黄肿也。宜胃苓丸加茵陈服之。
如黄而不肿者。此疸证也。观其色之明黯。如黄而色鲜明。小便色黄且涩者。此热也。
宜三黄金花丸主之。如黄色昏黯。小便不利者。此湿也。宜茵陈五苓散主之。
安肾丸 大肿不消。肾虚不纳也。
川乌（炮去皮尖） 桂心（各一两） 白茯苓 白术 石斛（酒炒） 白蒺藜（炒去刺） 巴戟
天苁蓉（酒洗焙） 故纸（炒） 桃仁（微炒去皮尖） 萆 （各三两） 上为末。炼蜜为丸芡实大。
每一丸盐汤下。
胃苓五皮汤 治肿要药。平胃 五苓（方见前） 上锉。取长流水。灯心煎服。
商陆胃苓丸 病肿气壮能食者。宜此治之。谓去菀陈 洁净府也。上共为末。水煮面丸
。麻子大。每服三十丸。至五十丸止。大便后快。又服。衰其半而止。
一儿疟后肿。用胃苓丸。长流水煎灯心汤下。又用浴法。调理二十日而安。
一儿病肿。有庸医假专门之名。不守家传之法。尝称得异人之术。用牵牛葶苈为治肿方
药。作散服之。元气下陷。肚大坐不得卧。阴囊肿大。茎长而卷。予见之叹曰。脾土已败。
肝木独旺。乃贼邪也。不可治矣。果死。
一儿病肿。腹大。彼有庸医妄谈。五日消一分。乃取绳子围其腹量之。投以牵牛葶苈服
利下数行。肿减十分之三。父母甚喜。约至五日再消三分。未三日又大肿。较大于前。庸医
闻之走去。病势益甚而死。
一义子十五岁病疸。面目俱黄。予问之。对曰。伤食起。腹中大热又痛。乃立一方。用
黄柏栀
积。茵陈蒿倍用以去其黄。共为细末。酒糊丸。车前子煎汤下。三日后吐去黄水一碗许。胃
中不热。又二日泄三行。腹中不痛。十日以后。小便渐清。黄亦减矣。（此一段在疸门）
肿胀分为两种。《黄帝内经》说：面部浮肿称为“风”，足部浮肿称为“水”。凡是浮肿从上部开始的，都是由于风邪引起，治疗应在肺经，适宜用发散的方法。这就是所说的“开鬼门”。“鬼门”指的是汗孔。主方使用参苏饮合五皮汤。
浮肿从下部开始的，是由于肾虚引起，适宜用渗湿利水的方法。这就是所说的“洁净府”，即通过利小便来排除水湿。所以张仲景说：治疗湿病如果不通利小便，就不是正确的治法。主方使用五苓散加防己、槟榔。
如果全身都浮肿的，主方使用胃苓五皮汤。对于郁结的湿邪应当折损其势，意思是上下分消，以去除体内的湿邪，通过发汗和利小便的方法。如果是小儿患者，可以用胃苓丸煎汤，送服五皮汤。
胃苓丸：这是我家传的十三首方剂之一。
药材包括：苍术（用米泔水浸泡）、厚朴、陈皮、猪苓、泽泻、白术、茯苓（以上各一两）、甘草、官桂、草果仁（以上各三钱）。将上述药物研成细末，用水泛丸，大小如麻子。用米饮送服。这是小儿常用的药物，可根据病情更换引药。
先父治疗小儿浮肿，只用胃苓丸的原方，取顺长的流水，加入灯心草煎汤送服。每天午时，再用五加皮煎汤服用，没有不有效的。
五皮汤
药材包括：桑白皮、陈皮、生姜皮、茯苓皮、大腹皮。用水煎服。
我经纪万邦瑞的女儿，二十七岁，患了一种非常奇特的浮肿病。寅时后到午前，上半身浮肿；午后到丑时前，下半身浮肿；到了半夜，上下全部消退。
治疗湿邪的方法中，唯独半夜阴户肿胀，且无法小便，这又应当从肝经寻求病因。因为厥阴肝经的经脉，在丑时开始起于足上，环绕阴器。另外，肝病的人，往往大小便困难。使用胃苓五皮汤，通过发汗和利小便来治疗。方中含有茯苓，所以能伐除肾肝之邪。木得桂而枯，利用桂枝的辛散作用疏散肝经的水湿，以温补肾中的真寒湿。连续服用十一剂，浮肿完全消退。
我秉承先父的教诲，凡是轻微浮肿，只用胃苓丸原方治疗。如果面部浮肿严重的，在胃苓丸原方内，加紫苏一钱，苦葶苈一钱隔纸炒，以去除肺经的风邪。如果足部浮肿严重的，在原方内加汉防己二钱，牵牛子炒取头末一钱，共同制成丸药，用灯心草煎汤送服。我有一个一二个门人，不遵守先人的训诫，专门用葶苈子和牵牛子作为治疗浮肿的药物，导致浮肿随消随长，害死了许多孩子，损害了我的德行，虽然禁止他们，也不能阻止。
湖广右布政使孙某，隆庆丁卯年，进入考场监考，担任《书经》和《礼记》的总裁官。他有一位小姐生病，留在我处调理。误食菱角损伤了脾气，导致面部浮肿且气喘。夫人很担忧，命令我进药。我立即开一方，使用钱氏异功散，加藿香叶以去除脾经的湿邪，加紫苏叶以去除肺经的风邪。服用一剂后病情安定。考试结束后，孙公外出，看到我的方子，对我说：“这个方子很好。”取笔札让舍人孙环抄写记录。
如果是受风雨水湿之气侵袭而导致的浮肿，属于实肿。通用胃苓丸主治。这是我家的传承之法。
小儿的各种浮肿，不论虚实，都用胃苓丸合五皮汤主治。这也是我家的传承。
如果是疟疾之后遍身浮肿的，这是因为疟疾发作后，外中风邪，内伤冷水所致。适宜用胃苓丸，用长流水顺取，加入灯心草煎汤送服。更要在日午时分洗浴，方法如前所述。
如果没有其他疾病而浮肿的，要观察浮肿起始的部位进行治疗。如从面部开始，上半身先肿的，这是风肿，适宜用五皮汤加紫苏叶、防风主治。如从足部开始，下半身先肿的，这是湿肿，适宜用五苓散加防己、木通主治。
如果浮肿日久不消，气实且能进食的，适宜利水，主方使用商陆胃苓丸。肾是水液的根源，湿邪会伤害肾脏，小儿久坐湿地者多患此病。
如果气弱且食少的，只以补脾为主。脾属土，土能胜水，脾强则水去，而浮肿消除。适宜用参苓平胃散，加藿香叶、紫苏叶、木香、砂仁制成丸药服用。
有面目俱黄，遍身俱黄且浮肿的，这是黄肿，适宜用胃苓丸加茵陈服用。
如果发黄但不浮肿的，这是疸证。观察其颜色的明暗，如果黄色鲜明，小便色黄且涩滞的，这是热证，适宜用三黄金花丸主治。如果黄色昏黯，小便不利的，这是湿证，适宜用茵陈五苓散主治。
安肾丸：治疗大肿不消，肾虚不能纳气。
药材包括：川乌（炮制去皮尖）、桂心（以上各一两）、白茯苓、白术、石斛（酒炒）、白蒺藜（炒去刺）、巴戟天、肉苁蓉（酒洗焙干）、故纸（炒）、桃仁（微炒去皮尖）、萆薢（以上各三两）。将上述药物研成细末，炼蜜为丸，大小如芡实。每服一丸，用盐汤送下。
胃苓五皮汤：治疗浮肿的要药。由平胃散和五苓散（方见前文）组成。将药物切碎，取长流水，加入灯心草煎服。
商陆胃苓丸：治疗浮肿气壮且能进食的患者，适宜用此方治疗。意思是去除郁积的陈腐之物，洁净膀胱府。将上述药物共为细末，水煮面糊为丸，大小如麻子。每次服用三十至五十丸。大便通畅后快意，再服用。症状减半即可停止。
一个患儿在疟疾后浮肿，用胃苓丸，长流水煎灯心草汤送服。又用洗浴法，调理二十天后痊愈。
一个患儿患浮肿，有个庸医假借专门之名，不遵守家传之法，曾声称得到异人之术，用牵牛子和葶苈子作为治疗浮肿的方药，做成散剂服用。导致元气下陷，肚子大得坐着不能卧倒，阴囊肿大，阴茎伸长卷曲。我见到后叹息道：“脾土已败，肝木独旺，这是贼邪，不可治愈了。”果然死亡。
一个患儿患浮肿，腹部大。那个庸医妄谈，说五天能消一分，于是拿绳子围住他的腹部测量，投喂牵牛子和葶苈子，服药后腹泻数次，浮肿减少了十分之三。父母非常高兴，约定五天后再消三分。不到三天，又大肿起来，比之前更大。庸医听说后逃走，病势更加严重而死。
一个义子十五岁时患黄疸，面目俱黄。我询问他，回答说：因伤食而起，腹中大热又痛。于是我立一方，用黄柏、栀子、枳实，茵陈蒿加倍用以去除黄疸，共为细末，酒糊为丸，车前子煎汤送服。三日后吐出一碗左右的黄水，胃中不再发热。又过了两天，腹泻三次，腹中不再疼痛。十天以后，小便逐渐变清，黄色也减轻了。（这一段在疸证门类中）
The *Classic of Acupuncture* (Huangdi Neijing) states: "All dampness-induced swelling and fullness belong to the Spleen Earth."
Swelling is divided into two types. The *Classic* states: "Facial swelling is called 'Wind,' while foot swelling is called 'Water.'" Swelling that originates from the upper body is caused by Wind pathogenic factors; treatment should target the Lung Meridian, employing dispersing methods. This is referred to as "opening the Ghost Gate" (Kai Gui Men). The "Ghost Gate" refers to sweat pores. The primary formula is Shen Su Yin combined with Wu Pi Tang.
Swelling that originates from the lower body is caused by Kidney Deficiency; treatment should employ draining and diuretic methods. This is referred to as "cleansing the Clean House" (Jie Jing Fu), which means promoting urination to eliminate dampness. Thus, Zhang Zhongjing stated: "Treating dampness without promoting urination is not the correct method." The primary formula is Wu Ling San added with Fang Ji and Bing Lang.
For generalized whole-body swelling, the primary formula is Wei Ling Wu Pi Tang. For stagnant dampness, its momentum should be broken, meaning to drain it from both above and below to remove dampness through sweating and diuresis. For pediatric patients, Wei Ling Wan can be decocted to send down Wu Pi Tang.
Wei Ling Wan: This is one of the thirteen formulas in our family's transmission.
Herbs include: Cang Zhu (immersed in rice water), Hou Po, Chen Pi, Zhu Ling, Ze Xie, Bai Zhu, Fu Ling (each 1 liang), Gan Cao, Guan Gui, Cao Guo Ren (each 3 qian). Grind these herbs into powder, form pills using water, sized like hemp seeds. Take with rice drink. This is a commonly used medicine for children, with the guiding substance changed according to the disease.
My late father treated pediatric edema using only the original formula of Wei Ling Wan, taken with smooth-flowing long water decocted with Deng Xin Cao (Juncus effusus). Administered at noon daily, followed by Wu Jia Pi decoction, there were no ineffective cases.
Wu Pi Tang
Herbs include: Sang Bai Pi, Chen Pi, Sheng Jiang Pi, Fu Ling Pi, Da Fu Pi. Decoct in water.
The daughter of my broker, Wan Bangrui, aged twenty-seven, suffered from a highly unusual edema. From Yin hour to Wu hour, the upper half of her body swelled; from Wei hour to Chou hour, the lower half swelled; by midnight, the swelling subsided completely from top to bottom.
Among methods for treating dampness, only when the vulva swells at midnight accompanied by dysuria should one seek the etiology in the Liver Meridian. The Jueyin Liver Meridian begins at the foot during Chou hour and circles the genitalia. Furthermore, Liver diseases often cause difficulty in urination and defecation. Use Wei Ling Wu Pi Tang to treat via sweating and diuresis. The presence of Fu Ling in the formula allows for subduing pathogens in the Kidney and Liver. Wood withers when aided by Cinnamon; thus, the acrid-dispersing nature of Cinnamon dissipates water-dampness in the Liver Meridian and warms the true cold-dampness in the Kidney. After eleven doses, the swelling completely disappeared.
I follow my late father's teachings: for mild edema, use only the original Wei Ling Wan. For severe facial swelling, add Zi Su (Perilla Leaf) 1 qian and Ku Ting Li (Semen Lepidii/Descurainiae, stir-fried through paper) 1 qian to the original Wei Ling Wan to dispel Wind from the Lung Meridian. For severe foot swelling, add Han Fang Ji (Stephania Tetrandra) 2 qian and Qian Niu Zi (Semen Pharbitidis, head powder from stir-frying) 1 qian to the original formula, form into pills, and take with Deng Xin Cao decoction. I have a few disciples who do not adhere to ancestral instructions, specifically using Ting Li and Qian Niu for treating edema. This results in recurring swelling after temporary reduction, causing many deaths and damaging my reputation. Despite my prohibitions, they cannot be stopped.
Sun, the Right Vice Commissioner of Huguang, served as an examiner and chief editor for the *Book of Documents* and *Book of Rites* during the Dingmao year of Longqing. His young lady fell ill and was kept under my care for recovery. She injured her Spleen Qi by mistakenly eating water caltrops, resulting in facial swelling and asthma. Her wife was worried and ordered me to prescribe medicine. I immediately prescribed Qian Shi Yi Gong San, adding Huo Xiang Ye to remove dampness from the Spleen Meridian and Zi Su Ye to remove Wind from the Lung Meridian. One dose brought relief. After the examination session ended, Lord Sun saw my prescription and said, "This is an excellent formula." He took a brush and paper, ordering his scribe Sun Huan to record it.
Edema occurring in children after coughing, malaria, or sores belongs to Deficiency Edema.
Edema caused by exposure to wind, rain, water, and dampness belongs to Excess Edema. The general treatment is Wei Ling Wan. This is our family's transmitted method.
For all types of pediatric edema, regardless of deficiency or excess, use Wei Ling Wan combined with Wu Pi Tang. This is also our family's transmission.
If edema of the face and eyes is caused by asthma and coughing, suitable for reducing swelling, use Ting Li Wan.
If generalized edema occurs after malaria, it is due to external Wind pathogen invasion and internal injury from cold water following a malaria attack. Use Wei Ling Wan, taken with smooth-flowing long water decocted with Deng Xin Cao. Additionally, bathing should be performed at noon, following the previous method.
For edema without other diseases, treat based on the site of onset. If starting from the face with upper body swelling first, this is Wind Edema; use Wu Pi Tang added with Zi Su Ye and Fang Feng. If starting from the feet with lower body swelling first, this is Damp Edema; use Wu Ling San added with Fang Ji and Mu Tong.
If edema persists for a long time, with strong Qi and good appetite, promote water drainage using Shang Lu Wei Ling Wan. The Kidney is the root of water; dampness injures the Kidney. Children who sit on wet ground for long periods often suffer from this condition.
If Qi is weak and appetite is poor, focus primarily on tonifying the Spleen. The Spleen belongs to Earth, and Earth controls Water. When the Spleen is strong, water recedes, and edema subsides. Use Shen Ling Ping Wei San, added with Huo Xiang Ye, Zi Su Ye, Mu Xiang, and Sha Ren, formed into pills.
For those with Kidney Deficiency, take An Shen Wan.
For yellowing of the face and eyes, generalized yellowing with swelling, this is Yellow Edema; use Wei Ling Wan added with Yin Chen.
If yellowing occurs without swelling, this is Jaundice. Observe the color's brightness. If the yellow is bright and urine is yellow and涩 (astringent/hesitant), this is Heat; use San Huang Jin Hua Wan. If the yellow is dull and urine is difficult, this is Dampness; use Yin Chen Wu Ling San.
An Shen Wan: Treats persistent severe edema due to Kidney Deficiency failing to grasp Qi.
Herbs include: Chuan Wu (processed, skin and tip removed), Gui Xin (each 1 liang), Bai Fu Ling, Bai Zhu, Shi Hu (stir-fried with wine), Bai Ji Li (stir-fried, thorns removed), Ba Ji Tian, Rou Cong Rong (washed with wine and baked), Gu Zhi (stir-fried), Tao Ren (lightly stir-fried, skin and tip removed), Bi Xie (each 3 liang). Grind into powder, form pills with refined honey, sized like Euryale Seed. Take one pill with salt water.
Wei Ling Wu Pi Tang: A key drug for treating edema. Composed of Ping Wei San and Wu Ling San (formula seen previously). Chop herbs, take long flowing water, decoct with Deng Xin Cao, and take.
Shang Lu Wei Ling Wan: For edema with robust Qi and good appetite. It eliminates accumulated stagnation and cleanses the Bladder. Grind all ingredients into powder, make pills with boiled flour paste, sized like hemp seeds. Take 30-50 pills per dose. Resume taking after comfortable bowel movement. Stop when symptoms reduce by half.
A child developed edema after malaria. Treated with Wei Ling Wan, taken with Deng Xin Cao decocted in long flowing water. Bathing therapy was also used. Recovered after twenty days of regulation.
A child suffered from edema. A quack doctor, falsely claiming specialized expertise and ignoring family transmissions, claimed to possess unique skills. He used Qian Niu and Ting Li as edema treatments in powder form. This caused sinking of Yuan Qi, massive abdominal distension preventing sitting or lying, scrotal swelling, and elongated, curled penis. I sighed upon seeing him: "Spleen Earth has failed, Liver Wood dominates alone; this is a thief pathogen, incurable." He indeed died.
Another child had edema with abdominal distension. The quack doctor boasted he could reduce it by one fen every five days. He measured the abdomen with a rope, administered Qian Niu and Ting Li, causing several diarrheal episodes. Swelling reduced by three-tenths. The parents were delighted, expecting another three-tenths reduction in five days. Within three days, swelling returned worse than before. The quack fled upon hearing this. The condition worsened, leading to death.
An adopted son, aged fifteen, suffered from jaundice with yellow face and eyes. I asked him, and he replied it started from food stagnation, with intense heat and pain in the abdomen. I prescribed Huang Bo, Zhi Zi, Zhi Shi, with double the amount of Yin Chen Hao to clear the yellow. Ground into fine powder, made into pills with wine paste, taken with Che Qian Zi decoction. After three days, he vomited about one bowl of yellow fluid, and stomach heat subsided. Two days later, three bowel movements occurred, and abdominal pain ceased. After ten days, urine gradually cleared, and yellowing diminished. (This section belongs to the Jaundice category.)