1．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，恶风；皮水其脉
亦浮，外证浮肿，按之没指，不恶风，其腹如鼓，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，身发热，胸满，四肢头面肿，久不愈，必致痈脓。
2．脉浮而洪，浮则为风，洪则为气。风气相搏，风强则为隐疹，身体为痒，痒为泄风，久为痂
癞；气强则为水，难以俯仰。风气相击，身体洪肿，汗出乃愈。恶风则虚，此为风水；不恶风者，小便通利，上
焦有寒，其口多涎，此为黄汗。
3．寸口脉沉滑者，中有水气，面目肿大有热，名曰风水。视人之目窠上微拥，如蚕新卧起状，其颈脉动，
时时咳，按其手足上，陷而不起者，风水。
4．太阳病脉浮而紧，法当骨节疼痛。反不疼，身体反重而酸，其人不渴，汗出即愈，此为风水。恶寒者，此
为极虚，发汗得之。
渴而不恶寒者，此为皮水。
身肿而冷，状如周痹，胸中窒不能食，反聚痛，暮躁不得眠，此为黄汗，痛在骨节。咳而喘，不渴者，此为
脾胀，其状如肿，发汗即愈。
然诸病此者，渴而下利，小便数者，皆不可
发汗。
5．里水者，一身面目黄肿，其脉沉，小便不利，故令病水。假如小便自利，此亡津液，故令渴也。越婢加
术汤主之。（方见中风。）
6．趺阳脉当伏，今反紧，本自有寒，疝、瘕腹中痛，医反下之，下之即胸满短气。
7．趺阳脉当伏，今反数，本自有热，消谷，小便数。今反不利，此欲作水。
8．寸口脉浮而迟，浮脉则热，迟脉则潜，热潜相搏，名曰沉。趺阳脉浮而数，浮脉即热，数脉即止，热止
相搏，名曰伏。沉伏相搏，名曰水。沉则络脉虚，伏则小便难，虚难相搏，水走皮肤，即为水矣。
9．寸口脉弦而紧，弦则卫气不行，即恶寒，水不沾流，走于肠间。
少阴脉紧而沉，紧则为痛，沉则为水，小便即难。
10．脉得诸沉，当责有水，身体肿重。水病脉出者，死。
11．夫水病患，目下有卧蚕，而目鲜泽，脉伏，其人消渴。病水腹大，小便不利，其脉沉绝者，有水，可下
之。
12．问曰∶病下利后渴饮水，小便不利，腹满阴肿者，何也？答曰∶此法当病水，若小便自利及汗出者，自
当愈。
13．心水者，其身重而少气不得卧，烦而躁，其人阴肿。
14．肝水者，其腹大，不能自转侧，胁下腹痛，时时津液微生，小便续通。
15．肺水者，其身肿，小便难，时时鸭溏。
16．脾水者，其腹大，四肢苦重，津液不生，但苦少气，小便难。
17．肾水者，其腹大，脐肿，腰痛，不得溺，阴下湿如牛鼻上汗，其足逆冷，面反瘦。
18．师曰∶诸有水者，腰以下肿，当利小便；腰以上肿，当发汗乃愈。
19．师曰∶寸口脉沉而迟，沉则为水，迟则为寒，寒水相搏，趺阳脉伏，水谷不化，脾气衰则 溏，胃气衰
则身肿。少阳脉卑，少阴脉细，男子则小便不利，妇人则经水不通，经为血，血不利则为水，名曰血分。
20．问曰∶病有血分、水分，何也？师曰∶经水前断，后病水，名曰血分，此病难治；先病水，后经水断，
名曰水分，此病易治。何以故？去水，其经自下。
21．问曰∶病者苦水，面目、身体、四肢皆肿，小便不利。脉之，不言水，反言胸中痛，气上冲咽，状如炙
肉，当微咳喘。审如师言，其脉何类？
师曰∶寸口脉沉而紧，沉为水，紧为寒，沉紧相
搏，结在关元。始时当微，年盛不觉。阳衰之后，荣卫相干，阳损阴盛，结寒微动，肾气上冲，喉咽塞噎，胁下
急痛。医以为流饮，而大下之。气击不去，其病不除。后重吐之，胃家虚烦，咽燥欲饮水，小便不利，水谷不化，
面目手足浮肿。又与葶苈丸下水，当时如小瘥，食饮过度，肿复如前，胸胁苦痛，象若奔豚，其水扬溢，则浮咳
喘逆。当先攻击卫气，令止，乃治咳，咳止，其喘自瘥。先治新病，病当在后。
22．风水脉浮，身重，汗出恶风者，防己黄 汤主之。腹痛加芍药。
防己黄 汤方（方见湿病中。）
23．风水恶风，一身悉肿，脉浮，不渴，续自汗出，无大热，越婢汤主之。
越婢汤方
麻黄（六两） 石膏（半斤） 生姜（三两） 甘草
（二两） 大枣（十五枚）
上五味，以水六升，先煮麻黄，去上沫，纳诸药，煮取三升，分温三服。恶风者，加附子一枚，炮。风水，
加术四两。（《古今录验》）
24．皮水为病，四肢肿，水气在皮肤中，四肢聂聂动者，防己茯苓汤主之。
防己茯苓汤方
防己（三两） 黄 （三两） 桂枝（三两） 茯苓（六两） 甘草（二两）
上五味，以水六升，煮取二升，分温三服。
25．里水，越婢加术汤主之，甘草麻黄汤亦主之。
越婢加术汤方 （见上。于内加白术四两。又见中风中。）
甘草麻黄汤方
甘草（二两） 麻黄（四两）
上二味，以水五升，先煮麻黄，去上沫，纳甘草，煮取三升，温服一升，重复汗出，不汗再服，慎风寒。
26．水之为病，其脉沉小，属少阴。浮者为风，
无水，虚胀者为气。水，发其汗即已。脉沉者，宜麻黄附子汤。浮者，宜杏子汤。
麻黄附子汤方
麻黄（三两） 甘草（二两） 附子（一枚，泡）
上三味，以水七升，先煮麻黄，去上沫，纳诸药，煮取二升半，温服八合，日三服。
杏子汤方 （未见。恐是麻黄杏仁甘草石膏汤。）
27．厥而皮水者，蒲灰散主之。（方见消渴中。）
28．问曰∶黄汗之为病，身体肿，发热，汗出而渴，状如风水，汗沾衣，色正黄如柏汁，脉自沉，何从得之？
师曰∶以汗出入水中浴，水从汗孔入得之，宜 芍桂酒汤主之。
黄 芍药桂枝苦酒汤方
黄 （五两） 芍药（三两） 桂枝（三两）
上三味，以苦酒一升，水七升，相和，煮取三升，温服一升。当心烦，服至六七日乃解。若心烦不止者，以
苦酒阻故也。（一方用美酒醯代苦酒。）
29．黄汗之病，两胫自冷；假令发热，此属历节。食已汗出，又身常暮卧盗汗出者，此劳气也。若汗出已，
反发热者，久久其身必甲错；发热不止者，必生恶疮。若身重，汗出已辄轻者，久久必身
， 即胸中痛，又从腰以上必汗出，下无汗，腰髋弛痛，如有物在皮中状，剧者不能食，身疼重，烦躁，小便
不利，此为黄汗，桂枝加黄 汤主之。
桂枝加黄 汤方
桂枝 芍药（各二两） 甘草（二两） 生姜（三两） 大枣（十二枚） 黄 （二两）
上六味，以水八升，煮取三升，温服一升，须臾，饮热稀粥一升余，以助药力，温复取微汗，若不汗更服。
30．师曰∶寸口脉迟而涩，迟则为寒，涩为血不足。趺阳脉微而迟，微则为气，迟则为寒。寒气不足，则手
足逆冷；手足逆冷，则荣卫不利；荣卫不利，则腹满肠鸣相逐。气转膀胱；荣卫俱劳。阳气不通即身冷，阴气不
通即骨疼；阳前通则恶寒，阴前通则痹不仁。阴阳相得，其气乃行，大气一转，其气乃散。实则失气，虚则遗溺，
名曰气分。
31．气分，心下坚，大如盘，边如旋杯，水饮所作，桂枝去芍加麻辛附子汤主之。
桂枝去芍药加麻黄细辛附子汤方
桂枝（三两） 生姜（三两） 甘草（二两） 大枣（十二枚） 麻黄 细辛（各二两） 附子（一枚，炮）
上七味，以水七升，煮麻黄，去上沫，纳诸药，煮取二升，分温三服。当汗出，如虫行皮中即愈。
32．心下坚，大如盘，边如旋盘，水饮所作，枳术汤主之。
枳术汤方
枳实（七枚） 白术（二两）
上二味，以水五升，煮取三升，分温三服。腹中软，即当散也。
附方
《外台》防己黄 汤 治风水，脉浮为在表，其人或头汗出，表无他病，病者但下重，从腰以上为和，
腰以下当肿及阴，难以屈伸。（方见风湿中。）
1. 老师说：水气病有风水、皮水、正水、石水、黄汗五种。风水病的脉象自然浮，外在症状是骨节疼痛，怕风；皮水病的脉象也浮，外在症状是全身浮肿，按压凹陷不起，不怕风，腹部像鼓一样胀满，口不渴，应当用发汗法治疗；正水病的脉象沉迟，外在症状是自觉气喘；石水病的脉象自然沉，外在症状是腹部胀满但不喘；黄汗病的脉象沉迟，身体发热，胸部胀满，四肢和头面浮肿，如果久治不愈，必然导致痈脓。
2. 脉象浮而洪大，浮脉主风邪，洪脉主气分热盛。风邪与气分热邪相互搏结，如果风邪偏盛，就会变成隐疹（荨麻疹），身体瘙痒，这种瘙痒称为泄风，日久会变成疥癞；如果气分热邪偏盛，就会变成水肿，难以俯仰。风邪与气邪相互搏击，身体出现严重浮肿，出汗后痊愈。如果怕风，说明正气虚弱，这是风水病；如果不怕风，小便通利，上焦有寒，口中多唾液，这是黄汗病。
3. 寸口脉象沉滑的，说明体内有水气，面目肿大且伴有热象，名叫风水。观察人的眼睑上方微微隆起，像蚕刚睡醒的样子，颈部动脉跳动，时常咳嗽，按压手足背部，凹陷不能立即弹起的，是风水病。
4. 太阳病脉象浮而紧，按常理应当骨节疼痛。反而不疼，身体反而沉重酸痛，病人不口渴，出汗后就痊愈了，这是风水病。如果怕冷，这是极度虚损，因误用发汗法所致。
口渴而不怕冷的，这是皮水病。
身体浮肿且发冷，症状像周痹（一种以关节疼痛为主的痹症），胸中窒塞不能进食，反而聚痛，傍晚烦躁不得睡眠，这是黄汗病，疼痛在骨节。咳嗽且气喘，不口渴的，这是脾胀，症状像浮肿，发汗即愈。
然而各种病如果有这种情况，口渴且腹泻，小便频数的，都不可发汗。
5. 里水病，一身面目黄肿，脉象沉，小便不利，所以导致水病。假如小便自利，这是津液亡失，所以导致口渴。用越婢加术汤主治。（方剂见中风篇。）
6. 趺阳脉本应伏匿，现在反而紧，本来就有寒邪，疝气、瘕积腹中痛，医生反而用攻下法，攻下后随即出现胸满短气。
7. 趺阳脉本应伏匿，现在反而数，本来就有热邪，消谷善饥，小便频数。现在反而不利，这是将要发生水病。
8. 寸口脉浮而迟，浮脉主热，迟脉主潜藏，热与潜相搏结，名叫沉。趺阳脉浮而数，浮脉主热，数脉主止息，热与止相搏结，名叫伏。沉与伏相搏结，名叫水病。沉则络脉空虚，伏则小便困难，虚与难相搏结，水气走窜皮肤，就形成水病了。
9. 寸口脉弦而紧，弦则卫气运行不畅，即怕冷，水液不循常道流注，走窜于肠间。
少阴脉紧而沉，紧则主痛，沉则主水，小便即困难。
10. 脉象见到各种沉脉，应当责求有水，身体肿胀沉重。水病脉象反常外浮无根的，死。
11. 凡是水病患者，眼下像卧蚕一样隆起，眼睛光泽鲜明，脉象伏匿，其人消渴。患水病腹部胀大，小便不利，脉象沉绝的，是有水，可以用攻下法。
12. 问：病人在腹泻后口渴想喝水，小便不利，腹部胀满，阴部浮肿，这是什么原因？答：这法当是水病，如果小便自利及出汗的，自然会痊愈。
13. 心水病，身体沉重且气短不能平卧，心烦且躁动，其人阴部浮肿。
14. 肝水病，腹部胀大，不能自行翻身侧卧，胁下腹痛，时常津液微生，小便断续通畅。
16. 脾水病，腹部胀大，四肢苦于沉重，津液不生，只苦于气短，小便困难。
17. 肾水病，腹部胀大，肚脐肿胀，腰痛，不能排尿，阴部潮湿像牛鼻上的汗水，两足逆冷，面部反而消瘦。
18. 老师说：凡是水气病，腰部以下浮肿，应当利小便；腰部以上浮肿，应当发汗才能痊愈。
19. 老师说：寸口脉沉而迟，沉则主水，迟则主寒，寒与水相搏结，趺阳脉伏匿，水谷不消化，脾气衰弱则便溏，胃气衰弱则身体浮肿。少阳脉低微，少阴脉细，男子则小便不利，妇人则月经不通，经血属于血，血行不利则化为水，名叫血分。
20. 问：病有血分、水分，是什么道理？老师说：月经先断绝，后生病水，名叫血分，此病难治；先生病水，后月经断绝，名叫水分，此病易治。为什么？因为去除了水邪，月经自然通下。
21. 问：病人苦于水病，面目、身体、四肢皆肿，小便不利。诊脉时，不说水病，反而说胸中痛，气上冲咽喉，感觉像炙烤的肉块堵着，应当轻微咳嗽气喘。确实像老师说的，其脉象是什么样？
老师说：寸口脉沉而紧，沉为水，紧为寒，沉紧相搏结，结在关元穴处。开始时症状轻微，年壮时不觉察。阳气衰退之后，营卫相互干扰，阳损阴盛，结寒微微触动，肾气上冲，喉咽堵塞噎塞，胁下急痛。医生以为是流饮（水饮流动之证），而用峻下法。气击不去，病根未除。后来再次用吐法，胃家虚烦，咽燥想喝水，小便不利，水谷不化，面目手足浮肿。又给予葶苈丸攻下水气，当时好像稍微好转，饮食过度，浮肿又恢复原状，胸胁苦痛，象若奔豚病，水气扬溢，则出现浮咳气喘逆乱。应当先攻击卫气，使其停止上冲，然后治疗咳嗽，咳嗽止住，气喘自然痊愈。先治新病，旧病当在后处理。
22. 风水病脉浮，身体沉重，出汗怕风的，用防己黄芪汤主治。腹痛加芍药。
防己黄芪汤方（方剂见湿病篇。）
23. 风水病怕风，全身悉肿，脉浮，不渴，持续自汗出，没有大热，用越婢汤主治。
越婢汤方
麻黄（六两） 石膏（半斤） 生姜（三两） 甘草（二两） 大枣（十五枚）
以上五味药，用水六升，先煮麻黄，去掉上面的沫，加入其他药物，煮取三升，分三次温服。怕风的，加附子一枚，炮制。风水病，加白术四两。（出自《古今录验》）
24. 皮水病，四肢浮肿，水气在皮肤中，四肢微微跳动的，用防己茯苓汤主治。
防己茯苓汤方
防己（三两） 黄芪（三两） 桂枝（三两） 茯苓（六两） 甘草（二两）
以上五味药，用水六升，煮取二升，分三次温服。
25. 里水病，用越婢加术汤主治，甘草麻黄汤也主治。
越婢加术汤方 （见上文。在内加白术四两。又见于中风篇中。）
甘草麻黄汤方
甘草（二两） 麻黄（四两）
以上两味药，用水五升，先煮麻黄，去掉上面的沫，加入甘草，煮取三升，温服一升，重复服用使出汗，不出汗再服，慎避风寒。
26. 水气病，脉象沉小，属少阴经。脉浮的属风邪，无水气，虚胀的是气病。水气病，发汗即已。脉沉的，宜用麻黄附子汤。脉浮的，宜用杏子汤。
麻黄附子汤方
麻黄（三两） 甘草（二两） 附子（一枚，炮制）
以上三味药，用水七升，先煮麻黄，去掉上面的沫，加入其他药物，煮取二升半，温服八合，每日三次。
杏子汤方 （未见。恐怕是麻黄杏仁甘草石膏汤。）
28. 问：黄汗病，身体肿，发热，出汗且口渴，症状像风水，汗沾衣服，颜色正黄如柏树汁，脉象自沉，是怎么得的？
老师说：因为出汗时进入水中洗澡，水从汗孔进入而得此病，宜用黄芪芍药桂枝苦酒汤主治。
黄芪芍药桂枝苦酒汤方
黄芪（五两） 芍药（三两） 桂枝（三两）
以上三味药，用苦酒一升，水七升，混合在一起，煮取三升，温服一升。服药后应当心烦，服至六七天乃解。如果心烦不止的，是因为苦酒阻滞的缘故。（一方用美酒醋代替苦酒。）
29. 黄汗病，两小腿自冷；假如发热，这属于历节病。饭后出汗，又身体常在傍晚睡觉时盗汗出的，这是劳气病。如果出汗后，反而发热的，久而久之身体必然甲错（皮肤干燥粗糙如鳞甲）；发热不止的，必然生恶疮。如果身体重，出汗后随即减轻的，久而久之必身体麻木不仁，即胸中痛，又从腰以上必出汗，腰以下无汗，腰髋弛痛，如有物在皮中状，严重的不能进食，身体疼重，烦躁，小便不利，这是黄汗病，用桂枝加黄芪汤主治。
桂枝加黄芪汤方
桂枝 芍药（各二两） 甘草（二两） 生姜（三两） 大枣（十二枚） 黄芪（二两）
以上六味药，用水八升，煮取三升，温服一升，片刻后，喝热稀粥一升多，以助药力，温覆取微汗，如果不出汗再服。
30. 老师说：寸口脉迟而涩，迟则为寒，涩为血不足。趺阳脉微而迟，微则为气虚，迟则为寒。寒气与血不足，则手足逆冷；手足逆冷，则营卫不利；营卫不利，则腹部胀满肠鸣相继作响。气转膀胱；营卫俱劳。阳气不通则身冷，阴气不通则骨痛；阳气前通则恶寒，阴气前通则麻痹不仁。阴阳相得，其气乃行，大气一转，其气乃散。实证则失气，虚证则遗尿，名叫气分。
31. 气分病，心下坚硬，大如盘，边缘如旋杯，由水饮所作，用桂枝去芍药加麻黄细辛附子汤主治。
桂枝去芍药加麻黄细辛附子汤方
桂枝（三两） 生姜（三两） 甘草（二两） 大枣（十二枚） 麻黄 细辛（各二两） 附子（一枚，炮制）
以上七味药，用水七升，煮麻黄，去掉上面的沫，加入其他药物，煮取二升，分三次温服。应当出汗，如虫行皮中即愈。
32. 心下坚硬，大如盘，边缘如旋盘，由水饮所作，用枳术汤主治。
枳术汤方
枳实（七枚） 白术（二两）
以上两味药，用水五升，煮取三升，分三次温服。腹中软，即当散也。
附方
《外台秘要》防己黄芪汤 治风水，脉浮为在表，其人或者头汗出，表无他病，病人但觉下半身沉重，从腰以上正常，腰以下当肿及阴部，难以屈伸。（方剂见风湿篇。）
1. The Master said: There are five types of water qi disorders: Fengshui (Wind Water), Pishui (Skin Water), Zhengshui (Standard Water), Shishui (Stone Water), and Huanghan (Yellow Sweat). In Fengshui, the pulse is naturally floating; the external symptoms include joint pain and aversion to wind. In Pishui, the pulse is also floating; the external symptoms include generalized edema that leaves an indentation upon pressure, no aversion to wind, abdominal distension like a drum, and no thirst; treatment should induce sweating. In Zhengshui, the pulse is deep and slow; the external symptom is spontaneous wheezing. In Shishui, the pulse is naturally deep; the external symptom is abdominal fullness without wheezing. In Huanghan, the pulse is deep and slow, with body fever, chest fullness, and swelling of the four limbs and head/face; if not cured for a long time, it will inevitably lead to carbuncles and pus.
2. A pulse that is floating and surging indicates that floating represents wind and surging represents Qi heat. When Wind and Qi pathogenic factors struggle against each other, if Wind is stronger, it becomes hidden rashes (urticaria) causing body itching; this itching is called Xiefeng (Leaking Wind), and if prolonged, it becomes scabies-like sores. If Qi is stronger, it becomes water retention, making it difficult to bend or stretch. When Wind and Qi strike each other, severe body swelling occurs, and sweating leads to recovery. Aversion to wind indicates deficiency, which is Fengshui; no aversion to wind, with free urination and cold in the Upper Jiao causing excessive saliva, is Huanghan.
3. A Cun Kou (radial artery at the wrist) pulse that is deep and slippery indicates internal water qi, with swollen face and eyes accompanied by heat, named Fengshui. Observing the upper eyelids slightly bulging, resembling the shape after a silkworm has just woken up, with pulsation in the neck vessels, frequent coughing, and pitting edema on the hands and feet that does not rebound immediately, confirms Fengshui.
4. In Taiyang disease, a floating and tight pulse typically causes joint pain. However, if there is no pain but rather heavy and sour body sensations, and the patient is not thirsty, sweating leads to recovery; this is Fengshui. Aversion to cold indicates extreme deficiency caused by improper sweating therapy. Thirst without aversion to cold indicates Pishui. Body swelling with coldness, resembling Zhoubi (a type of bi syndrome with joint pain), chest obstruction preventing eating, recurrent pain, evening restlessness, and insomnia indicate Huanghan with pain in the joints. Coughing and wheezing without thirst indicate Pi Zhang (Spleen Distension), presenting like swelling, cured by sweating. However, for any of these diseases, if there is thirst accompanied by diarrhea and frequent urination, sweating therapy is contraindicated.
5. Lishui (Internal Water) presents with yellowish swelling of the whole body and face, a deep pulse, and difficulty in urination, leading to water disease. If urination is normal, it indicates loss of body fluids, leading to thirst. Yuebi Jia Zhu Tang (Diaphoretic Decoction plus Atractylodes Macrocephala) is the primary formula. (Formula see Zhongfeng chapter.)
6. The Zu Yang (dorsalis pedis artery) pulse should be hidden; if it is instead tight, it indicates pre-existing cold, hernia, or abdominal masses causing pain. If the physician incorrectly uses purgatives, chest fullness and shortness of breath will follow.
7. The Zu Yang pulse should be hidden; if it is instead rapid, it indicates pre-existing heat, leading to excessive hunger and frequent urination. If urination becomes difficult instead, water disease is about to develop.
8. A Cun Kou pulse that is floating and slow: floating indicates heat, slow indicates潜藏 (submergence); the struggle between heat and submergence is named Chen (Deep). A Zu Yang pulse that is floating and rapid: floating indicates heat, rapid indicates cessation; the struggle between heat and cessation is named Fu (Hidden). The struggle between Deep and Hidden is named Water Disease. Deep implies empty collateral vessels; Hidden implies difficulty in urination. The struggle between emptiness and difficulty causes water to flow into the skin, forming edema.
9. A Cun Kou pulse that is wiry and tight: wiry implies blocked Wei Qi, leading to aversion to cold; water does not flow normally but moves into the intestines. A Shao Yin pulse that is tight and deep: tight indicates pain, deep indicates water, leading to difficulty in urination.
10. Any deep pulse suggests water presence and heavy body swelling. If the pulse in water disease floats abnormally without root, it is fatal.
11. Patients with water disease have卧蚕 (lying silkworms) under the eyes, bright eye luster, hidden pulse, and excessive thirst. For patients with abdominal distension due to water and difficulty in urination, if the pulse is extremely deep (Jue), water is present, and purgative therapy can be used.
12. Question: After diarrhea, the patient is thirsty and drinks water, with difficulty in urination, abdominal fullness, and genital swelling. What is this? Answer: This is likely water disease. If urination becomes free and sweating occurs, it will heal spontaneously.
13. Xin Shui (Heart Water): The body feels heavy with shortness of breath, inability to lie flat, irritability, agitation, and genital swelling.
14. Gan Shui (Liver Water): Abdominal distension, inability to turn over, pain under the ribs, occasional slight production of saliva, and intermittent urination.
15. Fei Shui (Lung Water): Body swelling, difficulty in urination, and frequent loose stools resembling duck feces.
16. Pi Shui (Spleen Water): Abdominal distension, heaviness in the four limbs, lack of saliva production, shortness of breath, and difficulty in urination.
17. Shen Shui (Kidney Water): Abdominal distension, umbilical swelling, lower back pain, inability to urinate, dampness in the genital area resembling sweat on a cow's nose, cold feet, and a thin face.
18. The Master said: For all water disorders, if swelling is below the waist, promote urination; if swelling is above the waist, induce sweating to cure.
19. The Master said: A Cun Kou pulse that is deep and slow: deep indicates water, slow indicates cold; the struggle between cold and water makes the Zu Yang pulse hidden, leading to indigestion. Spleen Qi deficiency causes loose stools; Stomach Qi deficiency causes body swelling. A low Shao Yang pulse and fine Shao Yin pulse indicate difficulty in urination for men and amenorrhea for women. Menstrual blood is blood; if blood circulation is impaired, it transforms into water, named Xuefen (Blood Division).
20. Question: What is the difference between Blood Division and Water Division? The Master said: If menstruation stops first and then water disease develops, it is Blood Division, which is difficult to treat. If water disease develops first and then menstruation stops, it is Water Division, which is easy to treat. Why? Because removing the water allows menstruation to resume naturally.
21. Question: A patient suffers from water disease with swelling of the face, body, and limbs, and difficulty in urination. Upon pulse diagnosis, the patient complains of chest pain, Qi rushing up to the throat feeling like a roasted meat block, and mild coughing/wheezing, denying water disease. What is the pulse like?
The Master said: A Cun Kou pulse that is deep and tight: deep indicates water, tight indicates cold; their struggle knots at the Guan Yuan point. Initially mild, unnoticed in youth. After Yang Qi declines, Ying and Wei interact; Yang damage leads to Yin excess, stirring the knotted cold. Kidney Qi rushes up, causing throat obstruction and hypochondriac pain. Physicians mistook it for flowing fluid and used strong purgatives. The Qi attack remained, and the disease persisted. Later, emetics were used, causing stomach deficiency, irritability, dry throat, thirst, difficulty in urination, indigestion, and swelling of the face, eyes, and extremities. Then Tingli Wan (Descurainia Seed Pill) was given to drain water. Symptoms improved temporarily, but overeating caused recurrence of swelling, chest/hypochondriac pain, and sensations resembling Ben Tun (Running Piglet). Overflowing water caused coughing and wheezing. One must first attack the Wei Qi to stop the upward rush, then treat coughing; once coughing stops, wheezing resolves. Treat new conditions first; old conditions follow.
22. For Fengshui with floating pulse, heavy body, sweating, and aversion to wind, Fangji Huangqi Tang (Stephania and Astragalus Decoction) is indicated. Add Shaoyao (Peony) if there is abdominal pain.
Fangji Huangqi Tang Formula (See Shi Bing chapter.)
23. For Fengshui with aversion to wind, generalized swelling, floating pulse, no thirst, continuous spontaneous sweating, and no high fever, Yuespi Tang (Diaphoretic Tiger Decoction) is indicated.
Yuespi Tang Formula
Mahuang (Ephedrae Herba, 6 liang) Shigao (Gypsum Fibrosum, 0.5 jin) Shengjiang (Zingiberis Rhizoma Recens, 3 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang) Dazao (Jujubae Fructus, 15 pieces)
Boil the five ingredients in 6 sheng of water. First boil Mahuang, remove foam, add other herbs, boil to obtain 3 sheng. Divide into three warm doses. For aversion to wind, add one Paofuzi (Aconiti Lateralis Radix Praeparata). For Fengshui, add 4 liang Baizhu (Atractylodis Macrocephalae Rhizoma). (From Gujin Lu Yan)
24. For Pishui with limb swelling, water qi in the skin, and trembling movements in the limbs, Fangji Fuling Tang (Stephania and Poria Decoction) is indicated.
Fangji Fuling Tang Formula
Fangji (Stephaniae Tetrandrae Radix, 3 liang) Huangqi (Astragali Radix, 3 liang) Guizhi (Cinnamomi Ramulus, 3 liang) Fuling (Poria, 6 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang)
Boil the five ingredients in 6 sheng of water to obtain 2 sheng. Divide into three warm doses.
25. For Lishui, Yuebi Jia Zhu Tang (Diaphoretic Decoction plus Atractylodes Macrocephala) is indicated; Gancao Mahuang Tang (Licorice and Ephedra Decoction) is also indicated.
Yuebi Jia Zhu Tang Formula (See above. Add 4 liang Baizhu. Also see Zhongfeng chapter.)
Gancao Mahuang Tang Formula
Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang) Mahuang (Ephedrae Herba, 4 liang)
Boil the two ingredients in 5 sheng of water. First boil Mahuang, remove foam, add Gancao, boil to obtain 3 sheng. Take 1 sheng warm. Repeat to induce sweating; if no sweat, take again. Avoid wind and cold.
26. Water disease with a deep and small pulse belongs to Shao Yin. Floating indicates Wind. Empty distension without water indicates Qi disorder. Water disease is cured by sweating. For deep pulses, Mahuang Fuzi Tang (Ephedra and Prepared Aconite Decoction) is suitable. For floating pulses, Xingzi Tang (Apricot Kernel Decoction) is suitable.
Mahuang Fuzi Tang Formula
Mahuang (Ephedrae Herba, 3 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang) Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, prepared)
Boil the three ingredients in 7 sheng of water. First boil Mahuang, remove foam, add other herbs, boil to obtain 2.5 sheng. Take 0.8 sheng warm, three times daily.
Xingzi Tang Formula (Not seen. Likely Mahuang Xingren Gancao Shigao Tang.)
27. For Jue (cold extremities) with Pishui, Puhui San (Thistle Ash Powder) is indicated. (Formula see Xiaoke chapter.)
28. Question: Huanghan disease presents with body swelling, fever, sweating, thirst, resembling Fengshui, with yellow sweat staining clothes like cypress juice and a deep pulse. How is it contracted?
The Master said: It is contracted when bathing in water while sweating, allowing water to enter through sweat pores. Huangqi Shaoyao Guizhi Kujiu Tang (Astragalus, Peony, Cinnamon Twig, and Vinegar Decoction) is indicated.
Huangqi Shaoyao Guizhi Kujiu Tang Formula
Huangqi (Astragali Radix, 5 liang) Shaoyao (Paeoniae Radix, 3 liang) Guizhi (Cinnamomi Ramulus, 3 liang)
Mix Kujiu (Vinegar, 1 sheng) and water (7 sheng), boil the three ingredients to obtain 3 sheng. Take 1 sheng warm. Heart irritation is expected; resolve after 6-7 days. If heart irritation persists, it is due to vinegar obstruction. (Alternative: use good wine vinegar instead of Kujiu.)
29. Huanghan disease presents with cold calves; if hot, it belongs to Ligong (Joint Bi). Sweating after meals and night sweats indicate Laoqi (Labor Qi). If fever persists after sweating, the body will become rough (Jiacuo) over time; persistent fever leads to malignant sores. If body heaviness lightens after sweating, numbness will develop over time, with chest pain, sweating above the waist but none below, soreness in the loins/hips, sensation of foreign body in skin, inability to eat in severe cases, body ache/heaviness, irritability, and difficulty in urination. This is Huanghan, treated with Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction plus Astragalus).
Guizhi Jia Huangqi Tang Formula
Guizhi (Cinnamomi Ramulus, 2 liang) Shaoyao (Paeoniae Radix, 2 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang) Shengjiang (Zingiberis Rhizoma Recens, 3 liang) Dazao (Jujubae Fructus, 12 pieces) Huangqi (Astragali Radix, 2 liang)
Boil the six ingredients in 8 sheng of water to obtain 3 sheng. Take 1 sheng warm. Drink hot millet gruel shortly after to assist medicinal power. Cover warmly to induce slight sweating. If no sweat, repeat dose.
30. The Master said: A Cun Kou pulse that is slow and choppy: slow indicates cold, choppy indicates blood deficiency. A Zu Yang pulse that is faint and slow: faint indicates Qi deficiency, slow indicates cold. Cold Qi and blood deficiency cause cold extremities. Cold extremities impair Ying and Wei circulation. Impaired Ying and Wei cause abdominal fullness and borborygmus. Qi moves to the Bladder; Ying and Wei are exhausted. Blocked Yang Qi causes body coldness; blocked Yin Qi causes bone pain. Early Yang passage causes aversion to cold; early Yin passage causes numbness. When Yin and Yang harmonize, Qi flows; when Great Qi rotates, stagnation disperses. Excess leads to flatus; deficiency leads to enuresis. This is named Qifen (Qi Division).
31. Qifen disease presents with hardness below the heart, large as a plate, edges like a rotating cup, caused by fluid retention. Guizhi Qu Shaoyao Jia Mahuang Xixin Fuzi Tang (Cinnamon Twig Decoction minus Peony plus Ephedra, Asarum, and Prepared Aconite) is indicated.
Guizhi Qu Shaoyao Jia Mahuang Xixin Fuzi Tang Formula
Guizhi (Cinnamomi Ramulus, 3 liang) Shengjiang (Zingiberis Rhizoma Recens, 3 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang) Dazao (Jujubae Fructus, 12 pieces) Mahuang (Ephedrae Herba, 2 liang) Xixin (Asari Radix et Rhizoma, 2 liang) Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, prepared)
Boil the seven ingredients in 7 sheng of water. First boil Mahuang, remove foam, add other herbs, boil to obtain 2 sheng. Divide into three warm doses. Recovery occurs with sweating, feeling like insects crawling under the skin.
32. Hardness below the heart, large as a plate, edges like a rotating dish, caused by fluid retention, is treated with Zhizhu Tang (Immature Bitter Orange and Atractylodes Decoction).
Zhizhu Tang Formula
Zhishi (Aurantii Fructus Immaturus, 7 pieces) Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang)
Boil the two ingredients in 5 sheng of water to obtain 3 sheng. Divide into three warm doses. Softening of the abdomen indicates resolution.
Attached Formula
Waitai Fangji Huangqi Tang (from Waitai Miyao): Treats Fengshui with floating pulse indicating exterior involvement. Patient may have head sweating, no other exterior symptoms, but feels heaviness from the waist down. Waist up is normal; waist down swells including genitals, with difficulty in flexion/extension. (Formula see Fengshi chapter.)