（寓木）导心痰湿
茯神（专入心）。功与茯苓无异。但神抱心以生。苓则不从心抱。故苓则能入脾与肾。
而神则
多入心耳。书曰服此开心益智。安魂（肝藏魂。）定魄。（肺藏魄。）无非入心导其痰湿。故
能
使心与肾交通之谓耳。（的解）心木书名黄松节。味苦性温。能治诸筋挛缩。偏风 斜。心
掣
健忘。（汪昂曰。方用心木一两。乳香一钱。石器炒研。名松节散。每服二钱。木瓜汤下。
治一切筋挛疼痛。乳香能伸筋。木瓜能舒筋也。）亦是入血渗湿之意。取苓有心者是。（汪昂
曰。以其抱心。故能治心也。）去皮及中木用。
（鱼）利水消肿
鲤鱼（专入脾）。气味甘平。每于急流之水跳跃而下。是鲤已有治水之功。且甘能入脾。
故书
载能下气利水。凡因水气内停。而见咳气上逆。黄胆水肿香港脚等症。服此则能以消。河间云
。鲤之治水。因其气以相感。（犹 之治水。）是以外台秘要用赤小豆一升。水二升。煮作三
升余。摅去渣。顿尽服利。利尽即愈。又治孕妇水肿亦效。然性禀六阴阳气初生。（故为阴
中之阳。）故多食则能动风发热也。鲤鳞烧灰存性。可治产后血滞。鲤骨烧灰。可疗鱼骨鲠
。
泻湿与渗湿不同。渗湿者。受湿无多。止用甘平轻淡。使水缓渗。如水入土。逐步渗泄。
渐
渍不骤。泻湿者。受湿既多。其药既须甘淡以利。又须咸寒以泻。则湿始从热解。故曰泻湿
。然泻亦须分其脏腑。如湿在肺不泄。宜用薏苡仁黑牵牛车前子黄芩白薇之类。但薏苡仁则
治水肿湿痹。疝气热淋。黑牵牛则治香港脚肿满。大小便秘。黄芩则治癃闭肠 。寒热往来。
车前子则治肝肺湿热以导膀胱水邪。白薇则治淋痹酸痛。身热肢满之为异耳！如湿在于脾胃
不泻。宜用木瓜白藓皮蚯蚓白矾寒水石之类。但木瓜则治霍乱泄泻转筋。湿热不调。白藓皮
则治关窍闭塞。溺闭阴肿。蚯蚓则治伏热鬼疰。备极热毒。白矾则能酸收涌吐。逐热去沫。
寒水石则能解热利水之有别耳。如湿在于脾胃不清。宜用扁蓄茵陈苦参刺 皮之类。
但扁蓄苦参则除湿热杀虫。茵陈则除湿热在胃发黄。
刺 皮则治噎膈反胃之不同耳。如湿在心不化。宜用灯草木通黄连连翘珍珠苦楝子之类。
但
灯草则治五淋伏热。黄连则治实热湿蒸。木通则治心热水闭。连翘则治痈毒淋结。珍珠则治
神气浮游。水胀不消。苦楝子则治热郁狂燥。疝瘕蛊毒之有分耳。若在小肠湿闭而见淋闭茎
痛。则有海金沙以除之。溺闭腹肿。则有赤小豆以利之。娠妊水肿。则有赤茯苓以导之。膀
胱湿闭而见水肿风肿。则有防己以泄之。暑湿内闭。则有猪苓以宣之。小便频数。则有地肤
子以开之。水蓄烦渴。则有泽泻以治之。实热炽甚。则有黄柏以泻之。暑热湿利。则有滑石
以分之。他如肾有邪湿症见血瘀溺闭。则有宜于琥珀海石矣。症见水气浮肿。则有宜于海蛤
矣。症见痔漏淋渴。则有宜于文蛤矣！而寒水石苦参之能入肾除湿。又自可见。肝有邪湿。
症见惊痫疫疟。则有宜于龙胆矣！症见风湿内乘。小便痛闭。则有宜于萆 矣！而连翘珍珠
琥珀之能入肝除湿。又自可推。凡此皆属泻湿之剂也。至于水势澎湃。盈科溢川。则又另有
法在。似不必于此琐赘云。
茯神（专门入心经）。其功效与茯苓没有不同。但茯神是抱着心而生长的，而茯苓则不是从心中抱生出来的。所以茯苓能够进入脾和肾，而茯神则主要进入心经。医书说服用茯神可以开窍益智、安魂（肝藏魂）、定魄（肺藏魄），这无非是因为它能进入心经并引导其中的痰湿。因此，它能使心与肾相互交通。（详解）心木在书名中称为黄松节，味苦性温。能够治疗各种筋脉挛缩、偏风斜视、心脏掣痛及健忘等症状。（汪昂说：方剂用心木一两，乳香一钱，用石器炒后研碎，名为松节散。每次服用二钱，用木瓜汤送下。治疗一切筋挛疼痛。因为乳香能舒展筋脉，木瓜能舒缓筋络。）这也是入血分渗除湿邪的意思。选取那些中心有木心的茯苓即可。（汪昂说：因为它抱着心，所以能治疗心病。）使用时需去皮及中间的木心。
鲤鱼（专门入脾经）。气味甘平。鲤鱼经常在急流的水中跳跃而下，这说明鲤鱼本身已有治理水患的功效。而且甘味能入脾，所以医书记载它能下气利水。凡是因水气内停，而出现咳嗽气逆、黄疸、水肿、脚气等病症，服用鲤鱼就能消除这些症状。河间（刘完素）说：鲤鱼治水，是因为其气机能够相互感应。（就像用禹王治水的方法一样。）因此《外台秘要》中使用赤小豆一升，加水二升，煮至剩余三升多，滤去药渣，一次性服完以通利小便，小便通利后病即痊愈。又用于治疗孕妇水肿也有效。然而鲤鱼禀受的是六阴之气初生的状态（所以属于阴中之阳）。因此多吃会动风发热。将鲤鱼鳞烧成灰保留药性，可治疗产后血滞；将鲤鱼骨烧成灰，可治疗鱼骨卡喉。
泻湿与渗湿是不同的。渗湿法，适用于受湿不多的情况，只用甘平轻淡的药物，使水分缓慢渗透，就像水渗入泥土一样，逐步渗泄，逐渐浸渍而不猛烈。泻湿法，适用于受湿很多的情况，药物既需要用甘淡以利水，又需要用咸寒以泻下，这样湿气才能随热邪解除，所以称为泻湿。然而泻法也必须区分脏腑。例如湿气在肺且不能排出时，宜用薏苡仁、黑牵牛、车前子、黄芩、白薇之类的药物。但薏苡仁主要用于治疗水肿、湿痹、疝气、热淋；黑牵牛主要用于治疗脚气肿满、大小便秘；黄芩主要用于治疗癃闭、肠痈、寒热往来；车前子主要用于治疗肝肺湿热以引导膀胱水邪；白薇主要用于治疗淋证、痹证酸痛、身体发热、四肢胀满，这是它们的不同之处！如果湿气在脾胃而不能泻除，宜用木瓜、白鲜皮、蚯蚓、白矾、寒水石之类的药物。但木瓜主要用于治疗霍乱泄泻转筋、湿热不调；白鲜皮主要用于治疗关窍闭塞、尿闭、阴部肿胀；蚯蚓主要用于治疗伏热、鬼疰（一种传染病或怪病），极度的热毒；白矾具有酸收和涌吐的作用，能逐热去沫；寒水石能解热利水，这是它们的区别所在。如果湿气在脾胃但没有被清除干净，宜用扁蓄、茵陈、苦参、刺蓼皮之类的药物。但扁蓄和苦参主要用于除湿热、杀虫；茵陈主要用于清除胃中的湿热导致的发黄；刺蓼皮主要用于治疗噎膈、反胃，这是它们的不同之处。如果湿气在心而不能化解，宜用灯草、木通、黄连、连翘、珍珠、苦楝子之类的药物。但灯草主要用于治疗五淋伏热；黄连主要用于治疗实热湿蒸；木通主要用于治疗心热、尿闭；连翘主要用于治疗痈毒、淋结；珍珠主要用于治疗神气浮游、水胀不消；苦楝子主要用于治疗热郁狂躁、疝瘕、蛊毒，这是它们各自的分野。如果在小肠出现湿闭导致淋证、尿闭、茎部疼痛，则有海金沙来清除它；尿闭腹部肿胀，则有赤小豆来利水；妊娠水肿，则有赤茯苓来引导水邪；膀胱湿闭导致水肿、风肿，则有防己来泄水；暑湿内闭，则有猪苓来宣通；小便频数，则有地肤子来开通；水蓄积导致烦渴，则有泽泻来治疗；实热炽盛，则有黄柏来泻火；暑热湿利，则有滑石来分利。其他如肾有邪湿，症状见血瘀尿闭，适宜用琥珀、海浮石；症状见水气浮肿，适宜用海蛤；症状见痔漏、淋证、口渴，适宜用文蛤！而寒水石、苦参能入肾除湿，这一点自然可见。肝有邪湿，症状见惊痫、疫疟，适宜用龙胆；症状见风湿内侵、小便痛闭，适宜用萆薢！而连翘、珍珠、琥珀能入肝除湿，这一点也可以推知。以上都属于泻湿的方剂。至于水势澎湃，盈科溢川（比喻水势浩大，像孟子所说的那样填满坑洼再流向河流），那又有另外的治疗方法，这里就不必琐碎赘述了。
[Wood from Heart] Guiding Phlegm-Dampness in the Heart
Fushen (Poria with Hostwood) (specifically enters the Heart meridian). Its efficacy is no different from Fuling (Poria). However, Fushen grows embracing the heartwood, whereas Fuling does not grow from an embrace of the heart. Therefore, Fuling can enter the Spleen and Kidney, while Fushen primarily enters the Heart meridian. Medical texts state that taking this herb opens the orifices, enhances intelligence, calms the Hun (Soul, stored in the Liver), and stabilizes the Po (Corporeal Soul, stored in the Lungs). This is none other than its ability to enter the Heart and guide out phlegm-dampness. Thus, it facilitates the communication between the Heart and the Kidney. (Detailed Explanation) Xinmu (Heartwood) is known in books as Huangsongjie (Yellow Pine Joint). It is bitter in taste and warm in nature. It can treat various tendon spasms, hemiplegia with deviation, cardiac pulling pain, and forgetfulness. (Wang Ang stated: In the formula, use one liang of Xinmu and one qian of Xurong (Olibanum), stir-fry in a stone mortar, and grind into powder, named Songjie San. Take two qian each time, washed down with Mugua (Chaenomeles) decoction. It treats all kinds of tendon spasms and pain. Because Xurong can extend tendons, and Mugua can soothe tendons.) This also embodies the intention of entering the Blood level to渗湿 (leach out dampness). Select those Fuling that have a central wood core. (Wang Ang stated: Because it embraces the heart, it can treat Heart diseases.) Use after removing the skin and the central wood core.
[Fish] Promoting Urination and Reducing Edema
Liyu (Common Carp) (specifically enters the Spleen meridian). Its flavor is sweet and neutral. Common carp often leaps down from rapid currents, indicating that the carp itself possesses the merit of governing water. Moreover, the sweet flavor enters the Spleen. Therefore, medical texts record that it can direct Qi downward and promote urination. For any condition caused by internal retention of Water-Qi, manifesting as cough with rebellious Qi, jaundice, edema, or Hongjiao (Gouty Arthritis/Foot Rot), taking this fish can eliminate these symptoms. Hejian (Liu Wansu) said: The carp's ability to govern water is due to the mutual resonance of its Qi. (Similar to Yu the Great's method of controlling floods.) Therefore, *Waitai Miyao* uses one sheng of Chixiaodou (Adzuki Bean), adds two sheng of water, boils until slightly more than three sheng remains, filters out the dregs, and takes it all at once to induce diuresis. Once urination is promoted, the illness is cured. It is also effective for treating edema in pregnant women. However, the carp inherits the initial generation of Yin-Yang Qi within the Six Yin categories (thus belonging to Yang within Yin). Therefore, excessive consumption can stir Wind and generate Heat. Burning carp scales to ash while retaining their properties can treat postpartum blood stasis. Burning carp bones to ash can treat fishbone impaction in the throat.
Xieshi (Draining Dampness) differs from Shenshi (Leaching Dampness). Shenshi is used when dampness accumulation is slight; only sweet, neutral, light, and bland herbs are used to allow water to seep slowly, like water infiltrating soil, gradually excreting without being abrupt. Xieshi is used when dampness accumulation is heavy; herbs must be sweet and bland to promote urination, and salty and cold to purge, so that dampness resolves along with Heat. Hence it is called Xieshi. However, draining methods must distinguish the Zang-Fu organs. If dampness is in the Lung and not excreted, herbs such as Yiyiren (Coix Seed), Heiqianniu (Black Morning Glory Seed), Cheqianzi (Plantago Seed), Huangqin (Scutellaria Root), and Baiwei (Cichorii Radix) should be used. But Yiyiren treats edema, damp-bi, hernia, and hot strangury; Heiqianniu treats Hongjiao swelling and fullness, constipation of both bowels and bladder; Huangqin treats strangury, intestinal abscess, and alternating chills and fever; Cheqianzi treats Liver-Lung damp-heat to guide Bladder water pathogenic factors; Baiwei treats strangury, bi-syndrome soreness and pain, body heat, and limb fullness. These are their differences! If dampness is in the Spleen-Stomach and not drained, herbs such as Mugua (Chaenomeles), Baixianpi (Dictamni Cortex), Diqianchong (Earthworm), Baifan (Alumen), and Hanshuishi (Calcitum) should be used. But Mugua treats Huoluan diarrhea with tendon cramping and damp-heat imbalance; Baixianpi treats closure of orifices, urinary retention, and genital swelling; Diqianchong treats latent heat and Gui Zhu (ghostly infections), extreme heat toxins; Baifan has sour-astringent and emetic properties, driving out heat and foam; Hanshuishi clears heat and promotes urination. These are their distinctions. If dampness in the Spleen-Stomach is not cleared, herbs such as Bianxu (Polygonum Aviculare Herb), Yichen (Artemisiae Capillaris Herba), Kushen (Sophorae Flavescentis Radix), and Cilaopi (likely referring to a bark, possibly *Prunus* or similar, contextually treated here) should be used. But Bianxu and Kushen remove damp-heat and kill parasites; Yichen removes damp-heat in the Stomach causing jaundice; Cilaopi treats dysphagia and regurgitation. These are their differences. If dampness in the Heart is not transformed, herbs such as Dengcao (Junci Medulla), Mutong (Akebia Caulis), Huanglian (Coptidis Rhizoma), Lianqiao (Forsythiae Fructus), Zhenzhu (Margarita), and Kulianzi (Meliae Semen) should be used. But Dengcao treats five types of strangury with latent heat; Huanglian treats excess heat with damp steaming; Mutong treats Heart heat and urinary retention; Lianqiao treats carbuncles and toxic heat with strangury; Zhenzhu treats floating Shen (Spirit) and unresolving water distension; Kulianzi treats heat depression with mania, hernia masses, and gu poison. These are their respective domains. If damp-closure in the Small Intestine presents with strangury, urinary retention, and penile pain, Haijinsha (Lygodii Spora) is used to clear it. If urinary retention and abdominal swelling occur, Chixiaodou (Adzuki Bean) is used to promote urination. For pregnancy edema, Chifuling (Red Poria) is used to guide water. If Bladder damp-closure presents with edema and wind-swelling, Fangji (Stephaniae Tetrandrae Radix) is used to drain water. If summer-heat dampness is internally closed, Zhuling (Polyporus) is used to ventilate. If frequent urination occurs, Difuzi (Kochiae Fructus) is used to open. If water accumulation causes irritability and thirst, Zexie (Alismatis Rhizoma) is used to treat it. If excess heat is blazing, Huangbai (Phellodendri Cortex) is used to purge. If summer-heat dampness leads to profuse urination, Huashi (Talcum) is used to separate. Others: If the Kidney has pathogenic dampness manifesting as blood stasis and urinary retention, Hupo (Amber) and Haishi (Floating Quartz) are suitable. If symptoms show water-Qi edema, Haige (Concha Meretricis) is suitable. If symptoms show hemorrhoids, fistulas, strangury, and thirst, Wen Ge (Concha Cycladis) is suitable! That Hanshuishi and Kushen can enter the Kidney to remove dampness is evident. If the Liver has pathogenic dampness manifesting as fright epilepsy and epidemic malaria, Longdan (Gentianae Radix) is suitable. If symptoms show internal invasion of wind-dampness and painful urinary retention, Bibi (Dioscoreae Hypoglaucae Rhizoma) is suitable! That Lianqiao, Zhenzhu, and Hupo can enter the Liver to remove dampness can be inferred. All these belong to Xieshi (draining dampness) agents. As for water surging like waves, filling ditches and overflowing rivers, there are other methods applicable, which need not be detailed here.