升阳滋血汤 二月间，一小儿未满百日，病腹胀，不大便二日，便瘦弱，遍身黄色。
宜升阳气，滋血和血补血，利大便。
蝎稍（二分） 神曲（三分） 浓朴 当归（各一钱） 桃仁（十个） 升麻（三分）
上，作一服，水一盏，煎至半盏，去滓，食前服。
麻黄升麻汤 治小儿面色痿黄，腹胀食不下，正月、四月小儿服之，神效。
麻黄（二分） 桂枝 杏仁 吴茱萸 草豆蔻 浓朴 曲末 羌活 白茯苓 升麻根
苍术 泽泻 猪苓 陈皮 黄柏（各一分） 柴胡根 白术 青皮 黄连（各五分）
上 咀。作一服，水一大盏，煎七分，去滓，食前热服。
〔演山〕肿胀二证，此由虚中有积，久患失治，日渐传变，证候多喘，随轻重、
察盛衰、审表里以主治，先固其本，后正其标，斯无恙矣。〔钱〕肿病，肾热传于膀胱，热盛逆于脾胃，脾
虚而不能制肾水，反克脾土，脾随水行，脾主四肢，故流走而身面皆肿也。若加喘者重也，何以然？肾水胜而克
退脾土，反胜心火，心又胜肺，肺为心克，故喘。或问曰，心刑肺，肺本见虚，令何喘实？曰此有二，一者肺
大喘，此五脏逆。二者肾水气上行，傍侵于肺，故令大喘，此皆难治。
曾氏治法∶
原肿病之由，标本之疾，肾主元气，天一之水生焉，肺主冲化，地四之金属焉，肾为本而肺为标，皆至阴以
积水，其为病也，肾者胃之关键，关键不利，枢机不转，水乃不行，渗于脉络皮肤而为浮肿，当推究内外所
因，而为施治。儿大者，凭脉以明虚实，古方有十种论证，短气不得卧，为心水。两胁紧痛，为肝水。大便鸭溏，
为肺水。四肢苦重，为脾水。腰痛足冷，为肾水。口苦咽干，为胆水。乍虚乍实，为大肠水。腹急肢瘦，为膀
胱水。小便闭涩，为胃水。小腹急满，为小肠水。然脉浮为风为虚，沉伏为水病，沉则脉络虚，伏则小便难，即
为正水，脾脉虚大，多作脾肿，因循不治，乃成水肿。盖脾属土，喜燥而恶湿，常感湿气，湿喜伤脾，血化
为水，土败不能制水，则停蓄不行，留滞皮肤，故作浮肿。初得病时，见眼胞早晨浮突，至午后稍消，以羌活
散（赤白痢）疏解，次醒脾散（慢惊）主之，及间投南星腹皮散。其脾冷困，则燥以草果、缩砂之类。然此
证，夏与秋冬治之颇易，惟春不然，盖四时之水，无如春水泛溢，兼肝木旺而脾土受克，不能受水，所以难疗，
进退不常，须徐徐调理取效。若脾热而困，又以热药燥之，虽火能生土，亦可胜水，奈何燥之太过，土不敌火，
则热愈甚而不食，发热烦渴，医者又进之以燥剂，由此而面目转浮，致脾败而手足背皆肿，盖手足背与脐凸，
即脾之外候。有未经发表，遽用下药以泻之，则一泻而肿消，乃曰得泻之力，殊不知脾愈泻而愈虚，不逾旬月，
其肿如初，此世人只知泻肿为最，而不求其十补勿一泻之论，法当随四时用药解表，通利小便，春以七宝散（伤
寒）加麻黄、桂枝、赤茯苓，水姜葱煎服。夏以五苓散（惊）加麻黄、车前子、薏苡仁。秋以清肺饮（嗽）加羌
活、细辛、商陆。冬以冲和饮（伤寒）白术、生川乌、赤小豆。以上三药，并用水姜葱煎，次投滋润救脾导水
汤剂渗泄之，乃为良法，更以香陆胃苓丸、赤苍饮顿服，自然获安。盖《内经》云∶开鬼门（发汗），洁净府（利
小便），平治权衡，以平为期，此之谓也。有国中便觉痰嗽气喘，小水不通，正属肺
肾所主，先服解表散（咳嗽），次以三白散为治，余证，轻者投商陆丸。故经曰∶其高者，因而越之即涌
吐之义也。下者，引而竭之即渗泄之义也。凡得此病，非一朝一夕之故，不可以孟浪之药，求其速效，以致虚脱，
如愈后再感外风，满面虚浮，用排风汤（惊痈鹤膝）和解，仍服前救脾汤剂，免致反复。饮食之忌，惟盐
酱齑 湿面，皆味咸能溢水者，并其他生冷毒物，亦宜戒之，重则半载，轻者三月，须脾胃平复，肿消气实，
然后于饮食中旋以烧盐少投，则其疾自不再作。故刘氏曰∶治肿非易，补养尤难。所忌者，切须详审。有经久
不消者，下浚川丸即效。
南星腹皮散 主肿疾欲愈未愈之间，脾胃虚慢，气促痰喘，腹胀胸满，饮减，精神困，小便不利，
面色痿黄。
南星（制，一两） 大腹皮（净洗，焙干） 生姜皮 陈皮（去白） 青皮（去白） 桑白皮（锉炒）
甘草 扁豆（炒，去壳。各半两）
上碎。每服二钱，水一盏，姜二片，煎七分，无时温服。
香陆胃苓丸 治肿疾日久不愈，此药大能实脾导水，多服取效。
丁香（去梗） 商陆 赤小豆 陈皮（去白） 甘草（炙。各二两） 苍术（米泔水、浸一宿，去粗皮、滤干、
锉片，炒微黄色） 泽泻（去粗皮。各二两半） 赤茯苓（去皮） 猪苓（去皮） 白术（各一两半）
肉桂（去粗皮，一两） 浓朴（去粗皮，用生姜汁炙令香熟，二两）
上，除丁香、肉桂不过火，余药锉焙，同二味为末，用面微炒，水浸透煮糊丸，绿豆大。每服三十丸至
五十丸或七十七丸，空心温汤下。儿小者，丸作粟谷大吞服之，粒数、引子，并如前法。
赤苍饮 主脾胃因虚受湿，面貌浮黄，或遍身作肿，饮食减少，气不升降，小便赤色，肚膨胀，咳
嗽有痰及肿，尝服神效。加草果仁炮过，水姜枣煎投。
赤茯苓（去皮） 苍术（去粗皮，米泔水浸一宿，滤干、锉片，炒微黄。各一两半） 枳壳（制，一两）
藿香（和根） 半夏（汤煮透，锉焙干） 净香附 紫苏（和梗） 浓朴（去粗皮，姜汁炙香熟） 陈
皮（去白。各七钱半） 甘草（炙，一两二钱）
上锉。每服二钱，水一盏，生姜二片，煎七分，无时温服。
三白散 解国中肿疾，四肢肤囊浮胀，大小便不利，皆因膀胱蕴热，风湿相乘。
白牵牛（半生半炒，杵碎） 桑白皮（锉、炒） 白术 木通（去皮节） 陈皮（去白） 甘草（各半两）
上碎。每服二钱，水一盏，煎七分，无时服。
商陆丸 治水肿小便不通，勿拘远近。
商陆（一两） 净黄连（半两）
上焙，为末，姜汁煮面糊丸，绿豆大。每服三十丸至五十丸，用温紫苏熟水空心下，或温葱汤。
浚川丸 治水肿及单腹满胀，气促食减，遍身面浮。
大戟 芫花（醋炒） 沉香 檀香 南木香 槟榔 蓬莪术 大腹皮（洗，焙干） 桑白皮（
锉炒。各半两） 黑白牵牛（晒研、取生末，一两） 巴豆（去壳膜心、存油，三十五粒）
上，除牵牛末、巴豆外，前丸味内有沉香、檀香、木香、槟榔不过火，余五味焙干，同沉香等为
末，就加牵牛末和匀，巴豆碎切，在乳钵内极细杵，入前药末同再杵匀，水煮面糊丸，麻仁大。每服十
七丸，浓煎葱汤候温，五更初空心下。
去水未尽，停一日，减用十三丸，次减作九丸，再减至七丸，汤使下法如前。证退即止，仍投南
星腹皮散。如单腹肿甚，能饮食气壮者，加甘遂末同丸取效。仍忌有甘草药饵，相反。
演山翁治法∶
受湿肿（脚手面目虚浮） 食毒瓦斯肿（腹肚肾蛊胀急） 伤寒虚气入腹肿 泻痢虚气入腹肿 此
四种所患病不相同，皆由虚得之。受湿，谓脾胃受湿冷，久不克化，气浮，四肢头面皆肿。食毒瓦斯，由脾
胃伤之冷积，毒瓦斯停留胃脘，致虚入腹作肿。伤寒由下之太早，乘虚入腹作肿。泻痢之久，脾气亦虚，是以
致肿。以上宜平调胃气，补脏充实，方可去肿，先服四味理中，无减半干姜，加白术、桑白皮同煎。伤
寒虚肿，加枳实。作喘，加淡豆豉。泻痢虚肿，服正气调胃。胃气既壮，以救生丹利之，其肿即退。再调补
脏腑，用观音散，即平复矣。
气虚肿（亦名气蛊）、血虚肿（亦名血蛊）、荣卫俱虚肿（亦名气血蛊），小儿所患，肿胀一门最为
要急，前人少有究竟，然肿胀之作，皆由荣卫不顺，脏腑怯弱，壅滞三焦，流注百脉，表里俱虚，邪正相乱，
所以致受。四大浮盛，腹肚膨满，多由食毒得之，饮食得之，症伤得之，饥饱得之，积久不化，故成斯病。
病由虚得，或则妄乱通下，因虚致虚，根不得去，疾加已盛，是谓坏证危候，智者怯而为辞，庸者暴以攻击，
二医不同，诚属难治。智者商之，良者审之，疑者塌之（疑其病盛不可利只与塌其气），明者调之
（正荣卫也），先调荣卫之顺，次服分气饮子以散其滞，斯病去矣。
荣卫饮子 调补婴孩气血俱虚，荣卫不顺，四肢、头面、手足俱浮肿以至喘急者，并宜服之。
川当归 熟干地黄（净洗） 人参 白茯苓 川芎 白术 甘草（炙） 白芍药 枳壳（炒、
别制） 黄 （蜜炙） 陈皮
上件等分， 咀。每服二钱匕，水一小盏，煎至半盏，去滓通口，不拘时候。
议曰∶荣者，血温流行于脉，卫者，气顺调和于络，是故荣行脉中，卫行脉外，阴阳相安，循环无止，
自幼至长，不离呼吸，无少滞碍，其脉方调，其气乃顺。呼吸之间，脉不应息，气有违滞，流注经络，
隐伏脏腑，百病皆由兹始，此方最良，虽儿幼小，并可与服，以壮其根，使血荣气卫，顺且和矣，
腑寒脏虚，温且壮矣，
盈亏自然而平，怯弱自然而正，阴阳调均，气脉充实，何病之有。
分气饮子 调理小儿肿胀作喘，气短促急，坐卧不任，四体浮肿，饮食呕逆，神困喜睡。
五味子 桔梗 白茯苓 甘草（炙） 陈橘皮 桑白皮 草果（去壳） 大腹皮 白术
枳壳（去穣、切，炒） 川当归 紫苏 苏子 半夏曲
上，等分， 咀。每服二大钱匕，水一小盏，生姜二小片，枣子半个，煎至半盏，去滓通口，不拘时候。
兼八味理中丸煎服。以上，宜用救生丹通利。
议曰∶清浊无混，邪正不干，上焦得之清凉，下部受之温暖，气滞则少升降，血虚则多流注，虽是乳子，
呼吸一息，其脉之至，徐徐应指，不违其数者，亦同大人流行，但随小大受之短浅而已，若也留滞，其
脉迟数，即太过不及而病生焉。善疗治者，郁则分之，逆则顺之，停则利之，滞则降之，调理之法，先宜顺气，
大抵婴孩气顺即易治，此方分气，与分水谷之分者不同，明者察之。
大效神功救生丹 治小儿气虚喘息，四肢浮肿，肚腹胀急，冲满胁肋，乍热乍寒，或泻或秘，皆由久
停虚积，荣卫不顺，宜用推去其恶毒之气。
雄黄（另研） 朱砂（各一分） 巴豆（二十一粒，去壳） 干姜（二钱）
上件，用米醋一盏，以巴、姜就煮令干，去姜不用，将巴出油，和雄、朱研匀，雪糕搜丸，如麻子大。
每一岁三丸，并用酒浸赤芍药，以少许送下。
薛氏治法∶
经曰∶至阴者，肾水也，少阴者，冬脉也，其本在肾，其末在肺，皆积水也。又曰∶肾者，胃之关
也。关门不利，故聚水而从其类也，上下溢于皮肤，故 肿腹大，上为喘呼不得卧者，标本俱病也。丹
溪云∶惟肾虚不能行水，脾虚不能制水，胃与脾合，又胃为水谷之海，因虚而不能传化，肾水泛滥，反得
以浸渍脾土，于是三焦停滞，经络壅塞，水渗于皮肤，注于肌肉而发肿也。其状，目胞上下微起，肢
体重着，喘咳怔忡，股间清冷，小便涩黄，皮薄而光，手按成窟，举手即满是也。古方有十种论证，又有
湿气、毒瓦斯、伤寒后、泻痢后、气血虚者之五种，及疳气、症积、锁肚、胸膈作膨、蛔、气虚、冷积者
之七胀，亦当详之。其受湿气者，由脾胃之气敦阜，四肢头面皆肿也。食毒者，脾伤积毒，停留于胃也。
伤寒下早者，邪气乘虚而入也。泻痢后者，脾气虚也。皆宜先调胃气，吹可治肿。其患七胀，皆
由血气不足，脏腑怯弱，表里俱虚，邪正相乱，以致四肢浮肿，腹肚膨满，亦当先调荣卫，分别阴阳，治
法宜补中、行湿、利小便。凡有热者，水气在表也，可汗之。身无热者，水气在里也，宜下之。腰以上肿，
宜利小便，腰以下肿，宜发汗，此仲景之法也。若遍身肿，烦渴，小便赤涩，大便秘结，此属阳水；遍身
肿，不渴，大
便溏泄，小便清利，此属阴水；阳水兼阳证者，脉必浮数，阴水兼阴证者，脉必沉迟，气若陷下，宜用二
陈加升提之药，如腹胀，少加木香调之。若朝宽暮急属阴虚，朝用四物汤加参术，夕用加减肾气丸。朝急
暮宽属阳虚，朝用六君子汤，夕用加减肾气丸。朝暮皆急阴阳俱虚也，用八珍汤主之。真阳虚者朝用八味地
黄丸，夕用补中益气汤。若肚腹痞满，肢体肿胀，手足并冷，饮食难化，或大便泄泻，呼吸气冷者，
此真阳衰败，脾肺肾虚寒不能司摄，而水泛行也，急用加减肾气丸，否则不治，惟调补脾土，多有生者。
《金匮》加减肾气丸
熟地黄（八两） 干山药 山茱萸（各四两） 泽泻 白茯苓 牡丹皮（各三两） 肉桂 附子（炮
）车前子（炒） 牛膝（酒微炒。各一两）
上，各另为末，米糊丸，小豆大。每服三四十丸，空心食前，白汤下。
附杂方
〔丹〕白文举儿五岁，身面皆肿，尿多。
升阳滋血汤：二月间，有一个未满百日的小儿，患腹胀病，两天没有大便，身体瘦弱，全身皮肤发黄。
应当提升阳气，滋养血液、调和血液并补血，通利大便。
全蝎梢（二分） 神曲（三分） 厚朴 当归（各一钱） 桃仁（十个） 升麻（三分）
以上药物，作为一剂服用，用水一盏，煎煮至半盏，滤去药渣，饭前服用。
麻黄升麻汤：治疗小儿面色萎黄，腹胀且饮食不下，正月和四月出生的小儿服用此方，效果神奇。
麻黄（二分） 桂枝 杏仁 吴茱萸 草豆蔻 厚朴 神曲末 羌活 白茯苓 升麻根
苍术 泽泻 猪苓 陈皮 黄柏（各一分） 柴胡根 白术 青皮 黄连（各五分）
以上药物切碎。作为一剂服用，用水一大盏，煎煮至七分，滤去药渣，饭前热服。
〔演山〕肿胀这两种证候，这是由于虚证中夹杂积滞，长期患病且失治，病情日渐传变，症状多见气喘，应根据病情的轻重，观察正气盛衰，审察表里关系来制定主治方案，先固护根本，后纠正标症，这样就不会有危险了。〔钱乙〕肿病，是肾热传于膀胱，热势亢盛逆犯脾胃，脾虚而不能制约肾水，反而被肾水反克脾土，脾随水气运行，脾主四肢，所以水气流走导致身面和全身皆肿。如果加上气喘，说明病情严重，为什么这样说呢？因为肾水胜而克制退却脾土，反而胜过心火，心又胜过肺，肺被心克制，所以气喘。有人问：心刑克肺，肺本已见虚弱，为何出现实性气喘？回答说：这有两种情况，一是肺大喘，这是五脏之气逆乱；二是肾水气上行，旁侵于肺，所以导致大喘，这些都属于难治之症。
曾氏的治疗方法：
探究肿病的起因，分辨标本疾病，肾主元气，是天一所生的水；肺主冲和变化，是地四所生的金。肾为本而肺为标，二者皆属至阴，从而积聚水液。其发病机理在于，肾是胃的关键，关键不利，枢机不转，水液便不能正常运行，渗入脉络皮肤而形成浮肿，应当推究内外病因，从而施以治疗。患儿较大的，凭脉象来明确虚实。古方中有十种论证：短气不得卧，称为心水。两胁紧痛，称为肝水。大便像鸭粪一样稀溏，称为肺水。四肢苦重，称为脾水。腰痛足冷，称为肾水。口苦咽干，称为胆水。时而虚弱时而实证，称为大肠水。腹部急迫肢体消瘦，称为膀胱水。小便闭塞涩滞，称为胃水。小腹急满，称为小肠水。然而脉浮主风或主虚，沉伏主水病，脉沉则脉络虚，脉伏则小便难，这就是正水。脾脉虚大，多表现为脾肿，若拖延不治，便成为水肿。盖因脾属土，喜燥而恶湿，常感受湿气，湿邪易伤脾，血化为水，土败不能制水，则水液停蓄不行，留滞皮肤，所以发生浮肿。初得病时，可见眼睑早晨浮肿突起，到午后稍消，用羌活散（用于赤白痢疾）疏解，接着用醒脾散（用于慢惊风）主治，以及间歇投用南星腹皮散。若脾冷困倦，则用草果、缩砂等燥湿药。然而此证，夏季与秋冬治疗颇容易，唯独春季不然，因为四季之水，没有比春水泛溢更厉害的，加之肝木旺盛而克制脾土，脾不能受纳水气，所以难以治疗，病情进退无常，必须慢慢调理才能见效。若脾热而困倦，又用热药燥之，虽然火能生土，也可胜水，奈何燥之太过，土不敌火，则热更甚而不思饮食，发热烦渴，医生又进用燥剂，由此导致面目更加浮肿，致使脾败而手足背皆肿，盖手足背与脐凸出，即是脾的外在征候。有未经发表解表，就急于用下药泻下，则一泻而肿消，人们便说是泻下的功劳，殊不知脾越泻越虚，不超过旬月，其肿如初，这是世人只知道泻肿最好，而不探求“十补勿一泻”的理论，治疗方法应当随四季用药解表，通利小便，春季用七宝散（用于伤寒）加麻黄、桂枝、赤茯苓，用水、姜、葱煎服。夏季用五苓散（用于惊风）加麻黄、车前子、薏苡仁。秋季用清肺饮（用于咳嗽）加羌活、细辛、商陆。冬季用冲和饮（用于伤寒）加白术、生川乌、赤小豆。以上三种药物，均用水、姜、葱煎煮，随后投用滋润救脾导水汤剂渗泄，这才是良法，再配合香陆胃苓丸、赤苍饮顿服，自然能获得安宁。盖《内经》说：开鬼门（发汗），洁净府（利小便），平治权衡，以平衡为准则，说的就是这个道理。有的国家（此处指地域或泛指人群）便觉痰嗽气喘，小便不通，这正是肺肾所主，先服解表散（用于咳嗽），次以三白散治疗，其余证候，轻者投用商陆丸。所以经书说：病位高的，因而越之，即涌吐的意思；病位低的，引而竭之，即渗泄的意思。凡是得此病，不是一朝一夕的原因，不能用孟浪（轻率猛烈）的药物求速效，以致造成虚脱，如痊愈后再感外风，满面虚浮，用排风汤（用于惊痈鹤膝风）和解，仍服前救脾汤剂，避免反复。饮食禁忌，只有盐酱齑（咸菜）、湿面，都是味咸能溢水的食物，以及其他生冷毒物，也宜戒除，重的半年，轻的三月，须脾胃平复，肿消气实，然后在饮食中逐渐少量投入烧盐，则疾病自然不再发作。所以刘氏说：治肿不容易，补养尤其困难。所忌之物，切须详细审查。有经久不消的，下浚川丸即有效。
南星腹皮散：主治肿疾欲愈未愈之间，脾胃虚慢，气促痰喘，腹胀胸满，饮水减少，精神困倦，小便不利，面色萎黄。
天南星（制，一两） 大腹皮（净洗，焙干） 生姜皮 陈皮（去白） 青皮（去白） 桑白皮（锉炒）
甘草 扁豆（炒，去壳。各半两）
以上切碎。每服二钱，用水一盏，生姜二片，煎至七分，不拘时候温服。
香陆胃苓丸：治疗肿疾日久不愈，此药大能实脾导水，多服可取效。
丁香（去梗） 商陆 赤小豆 陈皮（去白） 甘草（炙。各二两） 苍术（米泔水浸一宿，去粗皮、滤干、锉片，炒微黄色） 泽泻（去粗皮。各二两半） 赤茯苓（去皮） 猪苓（去皮） 白术（各一两半）
肉桂（去粗皮，一两） 厚朴（去粗皮，用生姜汁炙令香熟，二两）
以上，除丁香、肉桂不过火外，其余药物锉碎焙干，同这两味研为末，用面微炒，水浸透煮糊丸，绿豆大小。每服三十丸至五十丸或七十七丸，空心温汤送下。幼儿小的，丸做成粟谷大小吞服，粒数、引药，都按前述方法。
赤苍饮：主治脾胃因虚受湿，面貌浮黄，或遍身作肿，饮食减少，气不升降，小便赤色，肚膨胀，咳嗽有痰及肿，曾经服用神效。加炮过的草果仁，用水、姜、枣煎服。
赤茯苓（去皮） 苍术（去粗皮，米泔水浸一宿，滤干、锉片，炒微黄。各一两半） 枳壳（制，一两）
藿香（带根） 半夏（汤煮透，锉焙干） 净香附 紫苏（带梗） 厚朴（去粗皮，姜汁炙香熟） 陈
皮（去白。各七钱半） 甘草（炙，一两二钱）
以上锉碎。每服二钱，用水一盏，生姜二片，煎至七分，不拘时候温服。
三白散：解除体内肿疾，四肢肤囊浮胀，大小便不利，皆因膀胱蕴热，风湿相乘。
白牵牛（半生半炒，杵碎） 桑白皮（锉、炒） 白术 木通（去皮节） 陈皮（去白） 甘草（各半两）
以上切碎。每服二钱，用水一盏，煎至七分，不拘时候服。
商陆丸：治疗水肿小便不通，不拘病程远近。
商陆（一两） 净黄连（半两）
以上焙干，研为末，姜汁煮面糊丸，绿豆大小。每服三十丸至五十丸，用温紫苏熟水空心送下，或用温葱汤。
浚川丸：治疗水肿及单腹满胀，气促食减，遍身面浮。
大戟 芫花（醋炒） 沉香 檀香 南木香 槟榔 蓬莪术 大腹皮（洗，焙干） 桑白皮（
锉炒。各半两） 黑白牵牛（晒研、取生末，一两） 巴豆（去壳膜心、存油，三十五粒）
以上，除牵牛末、巴豆外，前丸味内有沉香、檀香、木香、槟榔不过火，其余五味焙干，同沉香等为
末，加入牵牛末和匀，巴豆碎切，在乳钵内极细杵，加入前药末同再杵匀，水煮面糊丸，麻仁大小。每服十
七丸，浓煎葱汤候温，五更初空心服。
去水未尽，停一日，减用十三丸，再次减作九丸，再减至七丸，汤使下法如前。证退即止，仍投南
星腹皮散。如单腹肿甚，能饮食气壮者，加甘遂末同丸取效。仍忌有甘草药饵，相反。
演山翁的治疗方法：
受湿肿（手脚面目虚浮） 食毒瓦斯肿（腹肚肾蛊胀急） 伤寒虚气入腹肿 泻痢虚气入腹肿 这四
种所患疾病不相同，皆由虚证引起。受湿，谓脾胃受湿冷，久不消化，气浮，四肢头面皆肿。食毒瓦斯，由脾
胃伤于冷积，毒瓦斯停留胃脘，致虚入腹作肿。伤寒由攻下太早，乘虚入腹作肿。泻痢日久，脾气亦虚，是以
致肿。以上宜平调胃气，补脏充实，方可去肿，先服四味理中汤，若无减半干姜，加白术、桑白皮同煎。伤
寒虚肿，加枳实。作喘，加淡豆豉。泻痢虚肿，服正气调胃汤。胃气既壮，以救生丹利之，其肿即退。再调补
脏腑，用观音散，即平复矣。
气虚肿（亦名气蛊）、血虚肿（亦名血蛊）、荣卫俱虚肿（亦名气血蛊），小儿所患，肿胀一门最为
要急，前人少有究竟，然肿胀之作，皆由荣卫不顺，脏腑怯弱，壅滞三焦，流注百脉，表里俱虚，邪正相乱，
所以致受。四大浮盛，腹肚膨满，多由食毒得之，饮食得之，症伤得之，饥饱得之，积久不化，故成斯病。
病由虚得，或则妄乱通下，因虚致虚，根不得去，疾加已盛，是谓坏证危候，智者怯而为辞，庸者暴以攻击，
二医不同，诚属难治。智者商之，良者审之，疑者塌之（疑其病盛不可利只与塌其气），明者调之
（正荣卫也），先调荣卫之顺，次服分气饮子以散其滞，斯病去矣。
荣卫饮子：调补婴孩气血俱虚，荣卫不顺，四肢、头面、手足俱浮肿以至喘急者，并宜服之。
川当归 熟干地黄（净洗） 人参 白茯苓 川芎 白术 甘草（炙） 白芍药 枳壳（炒、
别制） 黄芪（蜜炙） 陈皮
以上件等分，切碎。每服二钱匕，用水一小盏，煎至半盏，滤去药渣通口，不拘时候。
议曰：荣者，血温流行于脉，卫者，气顺调和于络，是故荣行脉中，卫行脉外，阴阳相安，循环无止，
自幼至长，不离呼吸，无少滞碍，其脉方调，其气乃顺。呼吸之间，脉不应息，气有违滞，流注经络，
隐伏脏腑，百病皆由兹始，此方最良，虽儿幼小，并可与服，以壮其根，使血荣气卫，顺且和矣，
腑寒脏虚，温且壮矣，
盈亏自然而平，怯弱自然而正，阴阳调均，气脉充实，何病之有。
分气饮子：调理小儿肿胀作喘，气短促急，坐卧不任，四体浮肿，饮食呕逆，神困喜睡。
五味子 桔梗 白茯苓 甘草（炙） 陈橘皮 桑白皮 草果（去壳） 大腹皮 白术
枳壳（去穣、切，炒） 川当归 紫苏 苏子 半夏曲
以上，等分，切碎。每服二大钱匕，用水一小盏，生姜二小片，枣子半个，煎至半盏，滤去药渣通口，不拘时候。
兼八味理中丸煎服。以上，宜用救生丹通利。
议曰：清浊无混，邪正不干，上焦得之清凉，下部受之温暖，气滞则少升降，血虚则多流注，虽是乳子，
呼吸一息，其脉之至，徐徐应指，不违其数者，亦同大人流行，但随小大受之短浅而已，若也留滞，其
脉迟数，即太过不及而病生焉。善疗治者，郁则分之，逆则顺之，停则利之，滞则降之，调理之法，先宜顺气，
大抵婴孩气顺即易治，此方分气，与分水谷之分者不同，明者察之。
大效神功救生丹：治疗小儿气虚喘息，四肢浮肿，肚腹胀急，冲满胁肋，乍热乍寒，或泻或秘，皆由久
停虚积，荣卫不顺，宜用推去其恶毒之气。
雄黄（另研） 朱砂（各一分） 巴豆（二十一粒，去壳） 干姜（二钱）
以上件，用米醋一盏，以巴、姜就煮令干，去姜不用，将巴出油，和雄、朱研匀，雪糕搜丸，如麻子大。
每一岁三丸，并用酒浸赤芍药，以少许送下。
薛氏的治疗方法：
经书说：至阴者，肾水也，少阴者，冬脉也，其本在肾，其末在肺，皆积水也。又说：肾者，胃之关
也。关门不利，故聚水而从其类也，上下溢于皮肤，故胕肿腹大，上为喘呼不得卧者，标本俱病也。丹
溪云：惟肾虚不能行水，脾虚不能制水，胃与脾合，又胃为水谷之海，因虚而不能传化，肾水泛滥，反得
以浸渍脾土，于是三焦停滞，经络壅塞，水渗于皮肤，注于肌肉而发肿也。其状，目胞上下微起，肢
体重着，喘咳怔忡，股间清冷，小便涩黄，皮薄而光，手按成窟，举手即满是也。古方有十种论证，又有湿气、毒瓦斯、伤寒后、泻痢后、气血虚者之五种，及疳气、症积、锁肚、胸膈作膨、蛔、气虚、冷积者
之七胀，亦当详之。其受湿气者，由脾胃之气敦阜，四肢头面皆肿也。食毒者，脾伤积毒，停留于胃也。
伤寒下早者，邪气乘虚而入也。泻痢后者，脾气虚也。皆宜先调胃气，吹可治肿。其患七胀，皆
由血气不足，脏腑怯弱，表里俱虚，邪正相乱，以致四肢浮肿，腹肚膨满，亦当先调荣卫，分别阴阳，治
法宜补中、行湿、利小便。凡有热者，水气在表也，可汗之。身无热者，水气在里也，宜下之。腰以上肿，
宜利小便，腰以下肿，宜发汗，此仲景之法也。若遍身肿，烦渴，小便赤涩，大便秘结，此属阳水；遍身
肿，不渴，大
便溏泄，小便清利，此属阴水；阳水兼阳证者，脉必浮数，阴水兼阴证者，脉必沉迟，气若陷下，宜用二
陈加升提之药，如腹胀，少加木香调之。若朝宽暮急属阴虚，朝用四物汤加参术，夕用加减肾气丸。朝急
暮宽属阳虚，朝用六君子汤，夕用加减肾气丸。朝暮皆急阴阳俱虚也，用八珍汤主之。真阳虚者朝用八味地
黄丸，夕用补中益气汤。若肚腹痞满，肢体肿胀，手足并冷，饮食难化，或大便泄泻，呼吸气冷者，
此真阳衰败，脾肺肾虚寒不能司摄，而水泛行也，急用加减肾气丸，否则不治，惟调补脾土，多有生者。
《金匮》加减肾气丸
熟地黄（八两） 干山药 山茱萸（各四两） 泽泻 白茯苓 牡丹皮（各三两） 肉桂 附子（炮
）车前子（炒） 牛膝（酒微炒。各一两）
以上，各另为末，米糊丸，小豆大小。每服三四十丸，空心食前，白汤下。
Shengyang Zixue Decoction (Ascending Yang and Nourishing Blood Decoction): In the second lunar month, a child under one hundred days old suffered from abdominal distension, had not passed stool for two days, was emaciated, and had yellowish discoloration of the entire body.
The treatment should be to ascend Yang Qi, nourish, harmonize, and tonify blood, and promote bowel movement.
Scorpio Cauda (Quexie, Scorpion Tail) (2 fen) Shenqu (Fermented Wheat Mass) (3 fen) Houpo (Magnolia Bark) Danggui (Angelica Sinensis Root) (1 qian each) Taoren (Peach Seed) (10 pieces) Shengma (Cimicifugae Rhizoma) (3 fen)
Grind the above into powder. Prepare as one dose, add one cup of water, decoct until half a cup remains, strain, and take before meals.
Mahuang Shengma Decoction (Ephedra and Cimicifuga Decoction): Treats children with sallow complexion, abdominal distension, and inability to eat. It is effective when taken by children born in the first and fourth lunar months.
Mahuang (Ephedrae Herba) (2 fen) Guizhi (Cinnamomi Ramulus) Xingren (Armeniacae Semen) Wuzhuyu (Evodiae Fructus) Caodoukou (Cardamomi Fructus Rotundus) Houpo (Magnolia Bark) Qumo (Shenqu Powder) Qianghuo (Notopterygii Rhizoma et Radix) Baifuling (Poria) Shengmagen (Cimicifugae Radix)
Cangzhu (Atractylodis Rhizoma) Zexie (Alismatis Rhizoma) Zhuling (Polyporus) Chenpi (Citri Reticulatae Pericarpium) Huangbai (Phellodendri Cortex) (1 fen each) Chaihu (Bupleuri Radix) Baizhu (Atractylodis Macrocephalae Rhizoma) Qingpi (Citri Reticulatae Pericarpium Viride) Huanglian (Coptidis Rhizoma) (5 fen each)
Coarsely crush the above. Prepare as one dose, add one large cup of water, decoct until seven-tenths remain, strain, and take hot before meals.
[Yanshan]: The syndromes of swelling and distension arise from deficiency complicated by accumulation. If neglected over a long period, the condition gradually progresses. Symptoms often include asthma (wheezing/shortness of breath). Treatment should be based on the severity, observing the excess or deficiency of pathogenic factors and healthy Qi, and examining the exterior and interior. First, secure the root (deficiency), then correct the branch (accumulation/swelling), and there will be no danger. [Qian Yi]: Swelling disease involves Kidney Heat transmitting to the Bladder. Excessive heat rebels against the Spleen and Stomach. Spleen deficiency fails to control Kidney Water, which counter-attacks Spleen Earth. The Spleen follows the Water; since the Spleen governs the four limbs, the water flows around, causing swelling of the face and body. If accompanied by asthma, the condition is severe. Why? Because Kidney Water overcomes and retreats Spleen Earth, but overcomes Heart Fire instead. Heart then overcomes Lung Metal. Since the Lung is overcome by Heart, asthma occurs. One may ask: If Heart penalizes Lung, and Lung is already deficient, why does it present with excess-type asthma? There are two reasons: First, severe Lung asthma indicates rebellion of the Five Zang organs. Second, Kidney Water Qi ascends and invades the Lung, causing severe asthma. Both are difficult to treat.
Zeng's Treatment Method:
Investigating the cause of swelling and distinguishing root and branch diseases: The Kidney governs Yuan Qi (Original Qi) and generates Tianyi Water (Kidney Water). The Lung governs Chong transformation and corresponds to Disi Metal (Lung Metal). The Kidney is the root, and the Lung is the branch; both are extreme Yin and accumulate water. Pathologically, the Kidney is the key gate of the Stomach. If the gate is obstructed, the pivot mechanism does not turn, water cannot flow normally, infiltrates the collaterals and skin, and causes edema. One must investigate internal and external causes to apply treatment. For older children, determine deficiency or excess via pulse diagnosis. Ancient formulas describe ten types of water disorders: Shortness of breath and inability to lie flat is Heart Water. Tight pain in the hypochondrium is Liver Water. Duck-dung-like loose stools is Lung Water. Heavy limbs is Spleen Water. Lower back pain and cold feet is Kidney Water. Bitter taste and dry throat is Gallbladder Water. Alternating deficiency and excess is Large Intestine Water. Abdominal urgency and emaciated limbs is Bladder Water. Obstructed and difficult urination is Stomach Water. Lower abdominal fullness is Small Intestine Water. However, a floating pulse indicates Wind or Deficiency; a deep and hidden pulse indicates Water Disease. Deep pulse implies collateral deficiency; hidden pulse implies difficulty in urination, constituting Zhengshui (True Water). A deficient and large Spleen pulse often indicates Spleen swelling. If neglected, it becomes Edema. The Spleen belongs to Earth, prefers dryness, and dislikes dampness. It is often affected by dampness, which injures the Spleen. Blood transforms into water; when Earth fails, it cannot control water, leading to stagnation in the skin and causing edema. Initially, eyelids swell in the morning and subside slightly by afternoon. Use Huojie San (Expel Wind Powder - used for dysentery) to resolve the exterior, followed by Xingpi San (Awaken Spleen Powder - used for slow convulsion), and intermittently administer Nanxing Fupi San (Arisaema and Areca Peel Powder). If the Spleen is cold and sluggish, use drying herbs like Caoguo (Tsaoko Cardamom Fruit) and Suosha (Amomi Fructus Rotundus). This syndrome is easier to treat in summer and autumn, but difficult in spring because Spring Water overflows, and flourishing Liver Wood overcomes Spleen Earth, making it hard to accept water. The condition fluctuates, requiring gradual regulation. If the Spleen is hot and sluggish, using hot drying herbs might seem logical (Fire generates Earth and controls Water), but excessive drying damages Earth, leading to more heat, anorexia, fever, irritability, and thirst. Further use of drying agents causes facial swelling and failure of the Spleen, resulting in swelling of the dorsum of hands and feet, which are external signs of the Spleen. If purgatives are used without prior exterior resolution, swelling may temporarily disappear due to diarrhea, but this falsely attributes success to purgation. In reality, purgation further weakens the Spleen. Within a month, swelling returns. People only know that purging reduces swelling but ignore the principle of "tonify ten times rather than purge once." Treatment should follow seasonal regulations to resolve the exterior and promote diuresis. In Spring, use Qibao San (Seven Treasures Powder - used for Cold Damage) added with Mahuang, Guizhi, and Chifuling, decocted with water, ginger, and scallion. In Summer, use Wu Ling San (Five Ingredient Powder with Poria) added with Mahuang, Cheqianzi, and Yiyiren. In Autumn, use Qingfei Yin (Lung-Clearing Decoction - used for cough) added with Qianghuo, Xixin, and Shanglu. In Winter, use Chonghe Yin (Harmonizing Decoction - used for Cold Damage) added with Baizhu, Sheng Chuanwu, and Chi Xiaodou. These three prescriptions are decocted with water, ginger, and scallion, followed by Runze Jiupi Daoshui Tang (Moisturizing Spleen-Saving and Water-Guiding Decoction) for seepage and excretion. Then administer Xianglu Weiling Wan (Fragrant and Phytolacca Weiling Pill) and Chican Yin (Red and Atractylodes Drink) as a single dose for natural relief. As stated in the *Neijing*: Open the ghost door (perspire), clean the pure mansion (diurese), balance the weights and measures, aiming for equilibrium. Some regions experience phlegm-cough and asthma with urinary obstruction, governed by Lung and Kidney. First take Jiebiao San (Exterior-Resolving Powder - used for cough), then treat with Sanbai San (Three Whites Powder). For other mild cases, use Shanglu Wan (Phytolacca Pill). Thus, the classics state: "For high positions, induce vomiting"; "For low positions, drain thoroughly." This disease does not occur overnight. Do not use reckless drugs for quick results to avoid collapse. If relapse occurs with wind invasion causing facial puffiness, use Paifeng Tang (Wind-Expelling Decoction - used for convulsions, carbuncles, crab-knee) to harmonize, and continue Jiupi Tang (Spleen-Saving Decoction) to prevent recurrence. Dietary taboos include salt, soy sauce, pickles, and wet noodles, all salty and promoting water overflow, as well as other raw, cold, and toxic foods. Severe cases take half a year, mild cases three months. Only after Spleen and Stomach recover and swelling subsides with strong Qi should roasted salt be gradually added to diet to prevent recurrence. Liu said: Treating swelling is not easy; nourishment is even harder. Taboos must be carefully observed. For chronic non-resolving cases, Xunchuan Wan (Xunchuan Pill) is effective.
Nanxing Fupi San (Arisaema and Areca Peel Powder): Mainly treats swelling in the transition between healing and non-healing, with Spleen-Stomach deficiency and slowness, shortness of breath with phlegm-wheezing, abdominal distension and chest fullness, reduced drinking, mental fatigue, difficult urination, and sallow complexion.
Zhizhi Nanxing (Prepared Arisaematis Rhizoma) (1 liang) Jingxi Dafupi (Cleaned and dried Arecae Pericarpium) Shengjiangpi (Zingiberis Pericarpium) Chenpi (Citri Reticulatae Pericarpium, white removed) Qingpi (Citri Reticulatae Pericarpium Viride, white removed) Sangbaipi (Mori Cortex, crushed and stir-fried)
Gancao (Licorice Root) Bian Dou (Vigna Angularis Seed, stir-fried, husked. 0.5 liang each)
Crush the above. Take 2 qian per dose, add one cup of water and two slices of ginger, decoct to seven-tenths, and take warm at any time.
Xianglu Weiling Wan (Fragrant and Phytolacca Weiling Pill): Treats chronic swelling that does not heal. This medicine strongly solidifies the Spleen and guides out water. Frequent administration yields results.
Dingxiang (Caryophylli Flos, stem removed) Shanglu (Phytolaccae Radix) Chi Xiaodou (Phaseoli Semen Rubrum) Chenpi (Citri Reticulatae Pericarpium, white removed) Zhi Gancao (Honey-fried Licorice Root. 2 liang each) Cangzhu (Soaked in rice wash water overnight, coarse skin removed, filtered, sliced, stir-fried to light yellow) Zexie (Alismatis Rhizoma, coarse skin removed. 2.5 liang each) Chifuling (Poria, skin removed) Zhuling (Polyporus, skin removed) Baizhu (Atractylodis Macrocephalae Rhizoma. 1.5 liang each)
Rougui (Cinnamomi Cortex, bark removed, 1 liang) Houpo (Magnolia Bark, coarse skin removed, stir-baked with ginger juice until fragrant, 2 liang)
Except for Dingxiang and Rougui which should not be overheated, crush and bake the remaining herbs, mix with the two powders, lightly stir-fry flour, soak in water, boil into paste, and make pills the size of mung beans. Take 30-50 or 77 pills on an empty stomach with warm water. For small infants, make pills the size of millet grains. Dosage and guiding substances follow the previous method.
Chican Yin (Red and Atractylodes Drink): Mainly treats Spleen-Stomach deficiency with dampness, puffy yellow face, or generalized swelling, reduced appetite, impaired Qi ascent and descent, red urine, abdominal bloating, cough with phlegm and swelling. Previously found very effective. Add roasted Caoguo Ren (Tsaoko Cardamom Seed), decoct with water, ginger, and jujube.
Chifuling (Poria, skin removed) Cangzhu (Atractylodis Rhizoma, coarse skin removed, soaked in rice wash water overnight, filtered, sliced, stir-fried to light yellow. 1.5 liang each) Zhike (Aurantii Fructus, processed, 1 liang)
Huoxiang (Agastaches Herba, with root) Banxia (Pinelliae Rhizoma, boiled through, crushed, baked, dried) Jing Xiangfu (Cyperi Rhizoma) Zisu (Perillae Folium, with stem) Houpo (Magnolia Bark, coarse skin removed, stir-baked with ginger juice until fragrant) Chenpi (Citri Reticulatae Pericarpium, white removed. 0.75 qian each) Zhi Gancao (Honey-fried Licorice Root, 1.2 qian)
Crush the above. Take 2 qian per dose, add one cup of water and two slices of ginger, decoct to seven-tenths, and take warm at any time.
Sanbai San (Three Whites Powder): Resolves internal swelling, puffy distension of limbs and skin, and difficulty in urination and defecation. All caused by Bladder heat accumulation and wind-dampness attack.
Bai Qianniu (Ipomoeae Semen, half raw half fried, pounded) Sangbaipi (Mori Cortex, crushed and stir-fried) Baizhu (Atractylodis Macrocephalae Rhizoma) Mutong (Akebiae Caulis, nodes removed) Chenpi (Citri Reticulatae Pericarpium, white removed) Gancao (Licorice Root. 0.5 liang each)
Crush the above. Take 2 qian per dose, add one cup of water, decoct to seven-tenths, and take at any time.
Shanglu Wan (Phytolacca Pill): Treats edema with urinary obstruction, regardless of duration.
Shanglu (Phytolaccae Radix) (1 liang) Jing Huanglian (Coptidis Rhizoma, cleaned) (0.5 liang)
Bake and grind into powder. Make pills with ginger juice and wheat paste, size of mung beans. Take 30-50 pills on an empty stomach with warm Perilla water or warm scallion soup.
Xunchuan Wan (Xunchuan Pill): Treats edema and isolated abdominal fullness, shortness of breath, reduced appetite, and generalized facial/body puffiness.
Daji (Euphorbiae Pekinensis Radix) Yuanhua (Genkwa Flos, vinegar-fried) Chenxiang (Aquilariae Lignum Resinatum) Tanxiang (Santal Albi Lignum) Nanmuxiang (Styraxis Platanifoliae Gum Resina) Binglang (Arecae Semen) Peng'e Zhu (Curcumae Longae Rhizoma) Dafupi (Arecae Pericarpium, washed and dried) Sangbaipi (Mori Cortex, crushed and stir-fried. 0.5 liang each) Heibai Qianniu (Morning Glory Seeds, sun-dried, ground, raw powder taken, 1 liang) Badou (Crotonis Fructus, shell and membrane removed, oil retained, 35 seeds)
Except for Qianniu powder and Badou, the ingredients containing Chenxiang, Tanxiang, Nanmuxiang, and Binglang should not be overheated. Bake the remaining five herbs dry, grind into powder with Chenxiang, mix with Qianniu powder, finely pound Badou in a mortar, mix with the powder, boil water with wheat paste to make pills the size of hemp seeds. Take 17 pills on an empty stomach at dawn with thick scallion soup.
If water is not fully expelled, pause for one day, reduce to 13 pills, then 9 pills, then 7 pills. Administration method remains the same. Stop when symptoms recede, and resume Nanxing Fupi San. If isolated abdominal swelling is severe but appetite and Qi are strong, add Gansui powder to the pill for effect. Avoid Gancao (Licorice Root) as they are incompatible.
Yanshan Weng's Treatment Method:
Shoushi Zhong (Swelling from Dampness: puffy extremities and face) Shidu Was Zhong (Swelling from Food Toxicity/Gas: urgent abdominal and kidney distension) Shanghan Xuqi Ru Fu Zhong (Swelling from Deficient Qi entering abdomen after Cold Damage) Xielie Xuqi Ru Fu Zhong (Swelling from Deficient Qi entering abdomen after Dysentery).
These four diseases differ but all arise from deficiency. Shoushi refers to Spleen-Stomach receiving cold-dampness, failing to digest over time, causing Qi float and swelling of limbs and face. Shidu refers to cold accumulation injuring Spleen-Stomach, toxicity staying in the stomach, causing deficiency and abdominal swelling. Shanghan refers to premature purging allowing pathogenic Qi to enter the abdomen due to deficiency. Xielie refers to prolonged dysentery weakening Spleen Qi, causing swelling. Above cases require balancing Stomach Qi, tonifying Zang organs to fill them, then removing swelling. First take Siwei Lizhong (Four-Ingredient Regulating Middle Decoction); if Jianban Ganjiang (Half-dried Ginger) is unavailable, add Baizhu and Sangbaipi. For Shanghan deficiency swelling, add Zhishi. For asthma, add Danshichao (Fermented Soybean). For dysentery deficiency swelling, take Zhengqi Tiaowei (Righteous Qi Regulating Stomach Decoction). Once Stomach Qi is strong, use Jiusheng Dan (Life-Saving Pill) to promote drainage, and swelling recedes. Then regulate and tonify Zang organs with Guanyin San (Guanyin Powder), and recovery is achieved.
Qixu Zhong (Qi Deficiency Swelling, also named Qi Gu), Xuexu Zhong (Blood Deficiency Swelling, also named Blood Gu), Rongwei Ju Xu Zhong (Rong-Wei Joint Deficiency Swelling, also named Qi-Blood Gu). Among pediatric diseases, swelling and distension are most critical. Predecessors rarely explored this thoroughly. However, swelling arises from disordered Rong and Wei, weak Zang-Fu, stagnation in the Triple Burner, flowing into hundred vessels, exterior-interior deficiency, and chaotic pathogenic vs. healthy Qi. Massive floating pulses and abdominal distension are mostly caused by food toxicity, dietary issues, injury from symptoms, hunger/fullness extremes, and long-term indigestion. The disease stems from deficiency. Reckless purging leads to further deficiency, roots remain, disease worsens, constituting a critical bad syndrome. Wise doctors hesitate, mediocre doctors attack violently. Both approaches are difficult. Wise ones consult, good ones examine, doubtful ones collapse (collapse Qi if disease is too severe to drain), clear ones regulate (correct Rong-Wei). First regulate Rong-Wei order, then take Fenqi Yinzi (Qi-Dividing Drink) to dissipate stagnation, and the disease goes.
Rongwei Yinzi (Rong-Wei Drink): Tonifies infant Qi and Blood deficiency, regulates disordered Rong-Wei, treating generalized swelling of limbs, head, face, and hands/feet up to asthma. Suitable for all such cases.
Chuan Danggui (Angelicae Sinensis Radix) Shu Gan Dihuang (Rehmanniae Radix Praeparata, cleaned) Renshen (Ginseng Radix) Baifuling (Poria) Chuanxiong (Ligustici Chuanxiong Rhizoma) Baizhu (Atractylodis Macrocephalae Rhizoma) Zhi Gancao (Honey-fried Licorice Root) Baishaoyao (Paeoniae Radix Alba) Zhike (Aurantii Fructus, stir-fried, separately processed) Huangqi (Astragali Radix, honey-fried) Chenpi (Citri Reticulatae Pericarpium)
Equal parts. Coarsely crush. Take 2 qian bi per dose, add one small cup of water, decoct to half a cup, strain, and drink at any time.
Discussion: Rong (Nutrient) is warm blood circulating in vessels; Wei (Defensive) is smooth Qi harmonizing in collaterals. Thus, Rong moves inside vessels, Wei outside. Yin and Yang are peaceful, cycling endlessly. From childhood to adulthood, linked to breathing, without obstruction, pulses are regulated, Qi is smooth. Between breaths, if pulses do not match breaths, Qi has stagnation, flowing into collaterals, hiding in Zang-Fu, starting hundred diseases. This formula is best. Even for young infants, it can be taken to strengthen roots, making blood nourished and Qi defensive, smooth and harmonious. Organ cold and Zang deficiency become warm and strong. Fullness and emptiness naturally balance, weakness naturally rectifies, Yin-Yang equalizes, Qi and pulses fill. What disease would exist?
Fenqi Yinzi (Qi-Dividing Drink): Regulates pediatric swelling with asthma, shortness of breath, inability to sit/lie comfortably, generalized swelling, vomiting/reversal of food, mental fatigue, and sleepiness.
Wuweizi (Schisandrae Fructus) Jiegeng (Platycodonis Radix) Baifuling (Poria) Zhi Gancao (Honey-fried Licorice Root) Chenjupi (Chenpi) Sangbaipi (Mori Cortex) Caoguo (Tsaoko Cardamom Fruit, husked) Dafupi (Arecae Pericarpium) Baizhu (Atractylodis Macrocephalae Rhizoma)
Zhike (Aurantii Fructus, pulp removed, sliced, stir-fried) Chuan Danggui (Angelicae Sinensis Radix) Zisu (Perillae Folium) Suzi (Perillae Fructus) Banxiaqu (Pinelliae Fermentatum)
Equal parts. Coarsely crush. Take 2 large qian bi per dose, add one small cup of water, two small slices of ginger, half a jujube, decoct to half a cup, strain, and drink at any time.
Also decoct and take with Bawei Lizhong Wan (Eight-Ingredient Regulating Middle Pill). Above cases should use Jiusheng Dan for drainage.
Discussion: Clear and turbid do not mix, pathogenic and healthy do not interfere. Upper Jiao receives coolness, lower part receives warmth. Qi stagnation reduces ascent/descent; Blood deficiency increases flow/stagnation. Even for nursing infants, during one breath, pulses arrive slowly and regularly, similar to adults, just shallower due to smaller size. If stagnation occurs, pulses become slow or rapid, indicating excess or deficiency, and disease arises. Good practitioners divide stagnation, smooth rebellion, drain retention, descend blockage. Regulation method first favors smoothing Qi. Generally, infant Qi smoothing makes treatment easy. This Fenqi formula differs from those dividing grain/water. Wise observers note this.
Da Xiao Shen Gong Jiusheng Dan (Great Efficacy Divine Power Life-Saving Pill): Treats infant Qi deficiency asthma, limb swelling, abdominal urgency, distension filling hypochondrium, alternating hot/cold, diarrhea or constipation. All due to long-standing deficiency accumulation and disordered Rong-Wei. Should use this to push away toxic Qi.
Xionghuang (Realgar, separately ground) Zhusha (Cinnabar, 1 fen each) Badou (Crotonis Fructus, 21 seeds, shelled) Ganjiang (Zingiberis Rhizoma, 2 qian)
Add one cup of rice vinegar to the above. Boil Badou and Ganjiang in vinegar until dry. Remove ginger, do not use. Extract oil from Badou. Mix with Xionghuang and Zhusha, grind evenly. Form pills with snow sugar paste, size of hemp seeds. Three pills per year of age. Send down with a little wine-soaked Chishaoyao (Paeoniae Radix Rubra).
Xue's Treatment Method:
Classics say: Extreme Yin is Kidney Water; Shaoyin is Winter Pulse. Its root is in Kidney, its tip in Lung; both accumulate water. Also: Kidney is the gate of Stomach. If the gate is obstructed, water gathers and follows its kind, overflowing skin above and below, causing edema and abdominal distension. Upward, it causes wheezing and inability to lie flat; both root and branch are diseased. Danxi said: Only Kidney deficiency fails to move water; Spleen deficiency fails to control water. Stomach combines with Spleen; Stomach is the sea of grain and water. Due to deficiency, transmission and transformation fail. Kidney Water floods, soaking Spleen Earth. Thus, Triple Burner stagnates, collaterals block, water seeps into skin, pours into muscles, causing swelling. Signs: slight swelling of eyelids, heavy limbs, asthma/cough/palpitations, cold thighs, scanty yellow urine, thin shiny skin, pitting edema that refills immediately upon lifting hand. Ancient formulas have ten water types, plus five from dampness, toxicity, post-Cold Damage, post-dysentery, and Qi-Blood deficiency. Also seven distensions from malnutrition, masses, locked belly, chest fullness, roundworms, Qi deficiency, and cold accumulation. These should be detailed. Dampness affects Spleen-Stomach Qi, causing limb/face swelling. Food toxicity injures Spleen, accumulating toxin in Stomach. Premature purging in Cold Damage allows pathogenic Qi to enter. Post-dysentery involves Spleen Qi deficiency. All should first regulate Stomach Qi; only then can swelling be treated. Seven distensions result from insufficient Qi-Blood, weak Zang-Fu, exterior-interior deficiency, and chaotic pathogenic/healthy Qi, causing limb swelling and abdominal distension. Also first regulate Rong-Wei, distinguish Yin-Yang. Treatment should tonify middle, move dampness, promote diuresis. With heat, water is in exterior, can sweat. Without heat, water is in interior, should purge. Swelling above waist: promote diuresis. Below waist: induce sweating. This is Zhongjing's method. Generalized swelling, thirst, red/scanty urine, constipation: Yang Water. Generalized swelling, no thirst, loose stool, clear urine: Yin Water. Yang Water with Yang signs: floating-rapid pulse. Yin Water with Yin signs: deep-slow pulse. If Qi sinks, use Erchen Tang plus lifting herbs. If abdominal distension, add small amount of Muxiang. Morning wide/evening urgent: Yin deficiency. Morning: Siwu Tang plus Renshen/Baizhu. Evening: Jiajian Shenqi Wan. Morning urgent/evening wide: Yang deficiency. Morning: Liujunzi Tang. Evening: Jiajian Shenqi Wan. Both urgent: Yin-Yang dual deficiency. Use Bazhen Tang. True Yang deficiency: Morning: Bawei Dihuang Wan. Evening: Buzhong Yiqi Tang. Abdominal fullness, limb swelling, cold hands/feet, indigestion, diarrhea, cold breath: True Yang decline, Spleen-Lung-Kidney deficiency failing to control, water flooding. Urgently use Jiajian Shenqi Wan, otherwise untreatable. Only regulating/tonifying Spleen Earth often saves lives.
*Jingui* Jiajian Shenqi Wan (Modified Kidney Qi Pill)
Shu Dihuang (Rehmanniae Radix Praeparata) (8 liang) Shanyao (Dioscoreae Rhizoma) Shanzhuyu (Corni Fructus) (4 liang each) Zexie (Alismatis Rhizoma) Baifuling (Poria) Mudanpi (Moutan Cortex) (3 liang each) Rougui (Cinnamomi Cortex) Fuzi (Aconiti Lateralis Radix Praeparata, prepared) Cheqianzi (Plantaginis Semen, stir-fried) Niuxi (Achyranthis Bidentatae Radix, wine-lightly fried. 1 liang each)
Grind each into powder separately. Make pills with rice paste, size of adzuki beans. Take 30-40 pills on an empty stomach before meals with plain water.
Attached Miscellaneous Prescriptions
[Danxi]: Bai Wenju's son, five years old, swollen face and body, frequent urination.