《孫真人備急千金要方》Vol. 64

Urinary retention (linbi) is often caused by pathogenic heat congealing inside the body. When heat congeals in the middle burner, substances in the body may harden and form lumps. When it congeals in the lower burner—the lower abdomen, bladder, kidneys, and related areas—it may cause blood in the urine and make urination difficult or even impossible. Most people with this condition are already physically weak; in some, it develops after taking powerful, warming medicines, which cause heat to accumulate in the lower burner. In others, heat arises naturally in the lower burner. The condition should be examined carefully and treated early.

The signs of Qi strangury are hesitant, difficult urination with a small amount of urine continuing to dribble afterward. Stone strangury, a condition resembling urinary stones, causes pain in the urethra and prevents urine from flowing out all at once. Oily strangury produces urine that is cloudy and viscous, like grease, and flows out involuntarily. Taxation strangury occurs after exertion and fatigue, with pain drawing into the lower abdomen, Qi surging downward, and a sensation of heat. Heat strangury is brought on by heat; in severe cases, there may be blood in the urine. These conditions may all be treated by referring to the method for Qi strangury.

When examining the patient, a yellow tip of the nose is, according to experience, a sign from which one may infer difficulty urinating.

The Di Fu Zi Decoction treats reddish-yellow urine, impaired flow, frequent urges to urinate with only a small amount passed each time, pain in the urethra, and sometimes blood in the urine, all caused by pathogenic heat congealing in the lower burner. Residual heat after warm disease or cholera, heat contracted after exposure to wind, excessive drinking, sexual activity and fatigue, overheating while walking, or heat stirred up by taking mineral powders may all cause heat to congeal in the lower burner. This can lead to blockage of both urination and defecation, as well as hardness and distension in the lower abdomen. This formula may be used for any such strangury, and the text says it takes effect quickly.

Take three liang each of Di Fu Zi, Zhi Mu, Huang Qin, Zhu Ling, Qu Mai, Zhi Shi (also given as “Song Shi”), Sheng Ma, Tong Cao, Kui Zi, and Hai Zao. Cut the ten ingredients into pieces, decoct them in one dou of water, and reduce the liquid to three sheng. Divide it into three doses.

If both urination and defecation are blocked, add three liang of Da Huang. If, after sexual activity and fatigue, a woman develops heat in the kidneys, difficulty urinating, distending pain in the lower abdomen, and a deep, fine pulse, add one pig kidney. Cui’s text says that when adding a pig kidney, first boil it in one and a half dou of water and reduce the liquid to one dou, then add the other ingredients and decoct them. The Xiao Pin Fang says that Zhi Shi is omitted from this formula.

A formula for treating various kinds of strangury, including cold, heat, and taxation strangury, as well as hesitant urination, bladder distension, and cramping abdominal pain, lists the following ingredients: Tong Cao, Shi Wei, and Gan Cao.

Wangbuliuxing, winter-hollyhock seeds, and talc, two liang each; common melicgrass, white atractylodes, and peony, three liang each.

Coarsely chop the six ingredients. Boil them in one dou of water until three sheng of liquid remain, then divide into three doses.

The formula recorded in Records of Verified Prescriptions from Ancient and Modern Times also adds two liang of Chinese angelica. Grind the ingredients into a fine powder and take it with the clear liquid skimmed from wheat porridge. Take one square-inch spoonful each time—the ancient measure for powdered medicine—and take it three times a day.

Another formula: talc, pyrrosia leaf, and trichosanthes root, two liang each.

Grind the three ingredients into a fine powder and take it with barley decoction, one square-inch spoonful each time, three times a day.

Formulas for treating various types of painful urinary disorder

Mallow root, eight liang; cogongrass root and the stone from a yellow croaker’s head, three liang each; licorice, one liang; rice-paper plant pith, two liang; shell powder, five ge; and gastrodia root, five liang.

Coarsely chop the seven ingredients. Boil them in one dou and two sheng of water until five sheng of liquid remain, then divide into five doses. Take three doses during the day and two at night. This formula is also used to treat stone painful urinary disorder, in which sand or stones pass in the urine.

Another formula: elm bark, one jin; plantain seeds and winter melon seeds, one sheng each; carp teeth, peach gum, rice-paper plant pith, and di mai, two liang each; common melicgrass, four liang.

Coarsely chop the eight ingredients. Boil them in one dou of water until three sheng of liquid remain, then divide into three doses and take three times a day.

Another formula: Take three sheng of fine white sand and heat it until very hot. Pour three sheng of wine over it, then strain off the liquid. Take one he each time.

Formulas for painful urinary disorder with pain

Talc, four liang; seven shell pieces, burned and pounded; poria, white atractylodes, rice-paper plant pith, and peony, two liang each.

Grind the six ingredients into a fine powder and take it with wine, one square-inch spoonful each time, twice a day. Taking it for ten days should bring a cure.

Another formula: mallow seeds, five he; poria, white atractylodes, and Chinese angelica, two liang each.

Coarsely chop the four ingredients. Boil them in seven sheng of water until two sheng of liquid remain, then divide into three doses and take three times a day.

Another formula: Take three he of lard with wine, three times a day; children should take one he. Use lard rendered in the twelfth lunar month.

Formulas for difficulty urinating, pain in the urethra, and cramping pain in the lower abdomen

Rice-paper plant pith and poria, three liang each; field pennycress seeds, two liang.

Grind the three ingredients into a fine powder. Take one square-inch spoonful with water, three times a day.

Another prescription: Take equal amounts of Puhuang (cattail pollen) and Huashi (talc), and grind them into a fine powder. Take one square-inch spoonful each time, washed down with wine, three times a day.

Prescription for difficulty urinating, a distended bladder, and edema from water retention

Dry duckweed from the surface of the water and grind it into a fine powder. Take one square-inch spoonful each time, three times a day.

Prescription for complete urinary obstruction

Take three liang of Huashi (talc), one liang each of Kuizi (winter-melon seeds) and elm bark. Grind the three ingredients into a fine powder, then simmer it in one and a half sheng of hemp-seed juice until one sheng remains. Take two square-inch spoonfuls of the powder, divided into three doses, to restore the flow of urine.

Another prescription: Take four sheng of water and use it to wash the steaming-basket strap. Use the wash water to cook Kuizi until two and a half sheng remain, then divide it into three doses.

Another prescription: Take one he each of wild-swallow droppings and fermented black beans. Mix and pound them together, then form pills the size of wutong seeds. Take three pills each time, three times a day.

Another prescription: Clean the grime from hair, burn it to ash, and take one sheng of the ash together with one sheng of Kuizi. Take one square-inch spoonful each time, washed down with a drink, three times a day.

Another prescription: Grind the head bones of Shishou fish (yellow croaker) into a fine powder. Take one square-inch spoonful with water, three times a day.

Another prescription: Take the ash and earth from a stone trough’s plug, and swallow it with well water drawn at dawn, three times a day.

Another prescription: Burn carp teeth to ash and grind them into a fine powder. Take one square-inch spoonful with wine, three times a day.

Another prescription: Grind Cheqianzi (plantain seeds) into a fine powder. Take one square-inch spoonful each time, three times a day, and stop after one hundred days.

Prescription for sudden inability to urinate

Swallow egg white until the condition is cured. (Ge Hong’s account says to swallow the yolk.)

Another prescription: Take a handful of Cheqiancao (plantain herb) and half a liang of mulberry root bark. Chop the ingredients, simmer them in three sheng of water until one sheng remains, and drink it all at once.

Prescription for sudden inability to urinate in women

Take twenty-seven almonds, roast them, grind them into a fine powder, and swallow it; urination should soon follow.

Another prescription: Grind Ziwan into a fine powder and take a three-finger pinch with well water drawn at dawn; urination should soon resume. If there is blood in the urine, take it four or five times.

Prescription for dribbling urination after jaundice

Take one pig kidney, sliced; one jin of Fuling; six liang of Qumai; two dou of chopped Cheqian root; three liang of Huangqin; and three he of Jiaomu, wrapped in cotton cloth. Also take four liang each of Zexie and Difuzi. Chop all eight ingredients. First simmer the Cheqian root in two dou of water until one dou and six sheng remain, then strain out the herbs. Add the pig kidney and simmer until one dou and three sheng remain; remove the kidney. Add the remaining herbs and simmer until three sheng remain. Divide into three doses.

Prescription for Qi Lin (urinary dribbling associated with Qi stagnation)

Take three sheng of water and boil a piece of ship’s-bottom moss about the size of a duck egg until two sheng remain. Drink it all at once.

Another formula: Take three sheng of water and boil one sheng of fermented soybeans. After it comes to a boil once, strain out the solids and add one he of salt. Drink it all at once. You may also boil the fermented soybeans and drink only the broth.

Another formula: Take one dou of water and boil a piece of birun about the size of three hundred cash coins until three sheng remain. Drink it warm.

Another formula: Grind sunflower seeds into powder and swallow one square-inch spoonful with hot water.

Another formula: On an empty stomach, eat one full mouthful of hollyhock.

Another formula: Heat salt in a pan and apply it to the lower abdomen as a hot compress. Replace it with fresh hot salt when it cools. This method also treats blood in the urine. (See Zhouhou fang; it is indicated for difficulty urinating.)

Moxibustion

Place salt in the navel and apply three moxa cones (each cone is one application of moxibustion). (Ge says this method treats difficulty urinating.)

Apply fifty moxa cones at Guanyuan, then thirty at the points beside Yuquan. The two points are one and a half cun apart.

Formula for treating stone strangury

Take two sheng of plantain seeds, put them in a silk bag, and boil them in nine sheng of water until three sheng remain. The patient must stop eating the night before and drink the decoction all at once on an empty stomach at dawn. The stones should then pass. (Beiji fang says this formula treats heat strangury.)

Another formula: Take a full handful of pumice, grind it to a fine powder, and sift it. Boil it with three sheng of water and one sheng of vinegar until two sheng remain. Let it settle, then drink one sheng. Take no more than three doses; the stones should then pass. This formula also treats cough. For cough, boil it in plain wine and drink it.

Another formula: Take one piece of peach gum about the size of a jujube. In summer, dissolve it in three he of cold water; in winter, use three he of hot water. Take it three times a day. Stones ranging in size from a bean to a chicken egg should pass. Stop taking it once all the stones have passed. This formula also treats blood in the urine.

Moxibustion

For stone strangury, the thirty-six disorders below the navel, and difficulty urinating, apply thirty moxa cones at Guanyuan, thirty at Qimen, and thirty at Shuiquan. Shuiquan is the same point as Taidun on the foot.

Formula for treating milky strangury

Pound Japanese hop until you have two sheng of juice, add two he of vinegar, and drink it all at once on an empty stomach. The urine should then resemble the juice of small red beans. You may also boil the Japanese hop down to a thick decoction and drink it; this also treats dribbling urination. (Su Cheng once used this formula to treat blood in the urine.)

Formula for treating the five taxations and seven injuries, the eight winds and twelve impediments, blood strangury caused by damage and stagnation, flesh strangury caused by heat and stagnation, difficulty urinating, and unbearable pain in the urethra and lower abdomen

Talc, cassia bark, and winter-melon seeds.

(The original text lists only the ingredients; the subsequent dosages and method of administration are not preserved.)

Grind two fen each of Wangbuliuxing, Tongcao, and Cheqianzi, one fen of Gansui, and four fen of Shiwei into a fine powder. Mix with five he of hemp-seed drink and take one fangcunbi per dose (an ancient measure for powdered medicine). After taking it for seven days, it is said, sand and stones will be expelled. Another prescription adds three fen of elm bark.

Moxibustion

For fatigue-related strangury, apply one hundred moxa cones to a point on the Spleen channel of Foot Taiyin. The point is three cun above the inner ankle. Divide the treatment into three sessions.

Prescriptions for treating heat strangury

Take fourteen jujubes and one sheng of chopped winter-mallow root (use winter-mallow seeds in winter and its shoots in summer). Add three sheng of water and boil down to one sheng and two he. Divide into two doses.

If the heat signs are pronounced, add one liang of Huangqin. If urination is difficult, add two liang of Huashi, ground into powder. If there is blood, add three liang of Qian Gen. If there is pain, add two liang of Shaoyao. For each added ingredient, increase the amount of water used for decoction accordingly.

Another prescription: Chop four jin of cogongrass root, add one dou and five sheng of water, and boil down to five sheng. Take one sheng per dose, three times during the day and twice more at night.

Another prescription: Regularly boil winter-mallow root and drink it.

Prescriptions for treating bloody strangury and painful, difficult urination

Take two liang of Jisu; five liang each of Tongcao and Huashi; a handful of bamboo leaves; half a jin of raw Rehmannia root; and one liang of Xiaojijin root. Chop all six ingredients, add nine sheng of water, and boil down to three sheng. Strain out the herbs and take warm in three doses.

Shiwei Powder: a prescription for bloody strangury

Take equal parts of Shiwei, Danggui, Puhuang, and Shaoyao. Grind into a fine powder and swallow with wine, one fangcunbi per dose, three times a day for seven days.

Another prescription: Boil ten fresh hemp roots in five sheng of water until reduced to two sheng, then drink in one dose. This also treats blood in the urine.

Another prescription: Boil a handful of soybean leaves in four sheng of water until reduced to two sheng, then drink in one dose.

Another prescription: Boil one sheng of sunflower seeds in three sheng of water. Divide the liquid into three doses to take over the day. This also treats blood in the urine due to deficiency and exhaustion.

Moxibustion

For bloody strangury, apply moxibustion to the Dantian, with the number of cones determined by the patient’s age; then apply fifty cones to the Fuliu point. Another account says the number of cones at Fuliu should also be determined by age.

When the Five Stranguries prevent urination, apply fourteen cones to the Xuánquán point. It lies on a slanting small vessel one cun in front of the inner ankle and is another name for the Zhongfeng point.

For the Five Stranguries, apply thirty cones to Dadun.

For a sudden onset of strangury, apply seven cones to the tip of the outer ankle.

Gonorrhea is divided into nine types. For treatment, moxibustion may be applied to the Foot Taiyang (Bladder) channel, using fifty cones.

When gonorrhea causes difficulty urinating and pain in the genital area, apply fifty cones of moxibustion at Taichong on the Foot channel.

For abdominal distension and frequent urination, apply moxibustion one inch below Yuquan. This point is called “Urinary Bladder” and is also known as “End of the Curved Bone.” Apply fourteen cones. For children, reduce the number of cones as appropriate.

Prescription for treating enuresis and difficult urination

Oyster shell and deer antler, four liang each; mulberry ear (the source text gives a damaged dosage, recorded as “three lu,” so the exact amount is unclear); donkey-hide gelatin, two liang.

Coarsely chop the four ingredients, add seven sheng of water, and boil down to two sheng. Divide into two doses and take twice daily.

Another prescription: fangji, hollyhock seeds, and fangfeng, two liang each.

Coarsely chop the three ingredients, add five sheng of water, and boil down to two and a half sheng. Divide into three doses. They may also be prepared as a powder and taken.

Prescription for treating urinary incontinence

Boil chicken intestines in three sheng of water until reduced to one sheng. Divide into three doses.

Prescription for treating incontinence when urine flows without the person noticing

Mix bean paste liquid with soot scraped from a chimney, take an amount the size of a bean, and place it at the opening of the urethra. Fan Wang says this prescription also treats bladder displacement and may be used for children.

Prescriptions for treating bedwetting

Fill a sheep’s stomach with water and tie both ends with string. Boil it until cooked, then open it and drink all the liquid inside at one time. It is said to bring a quick recovery.

Another prescription: take one chicken gizzard, burn it together with the intestines, grind to a powder, and swallow with wine. Use a hen for a man and a rooster for a woman.

Another prescription: fill a sheep’s bladder with water and roast it over charcoal until the flesh has burned away and only the empty casing remains. Eat it on an empty stomach. It is said that no more than four or five doses are needed for recovery.

Another prescription: take a bowl of freshly steamed, hot rice and mix it with the place where the patient wet the bed, then have the patient eat it without their knowledge. It is said to work well.

Moxibustion methods

For enuresis or incontinence when urine flows without the person noticing, apply moxibustion at Yinlingquan, using a number of cones equal to the person’s age.

For enuresis, apply moxibustion at Yidao, five inches beside Yuquan. Moxibustion may also be applied at Yanglingquan and at points on the Foot Yangming channel; in each case, use a number of cones equal to the person’s age.

For urinary incontinence, apply seven cones at each of Dadun and Xingjian.

For bedwetting, apply seven cones to the hollow indicated by the tip of the middle finger when the arm hangs down close to the thigh. Moxibustion may also be applied at the transverse crease below the navel, using seven cones.

Third: Blood in the Urine (Thirteen Prescriptions)

Prescription for blood in the urine caused by excessive sexual activity that injures the internal organs:

Oyster shell, cassia bark, scutellaria, and plantain seeds, in equal amounts.

Grind the four ingredients above into a coarse powder and take it with a drink. The dose is one square-inch spoonful (the capacity of a small ancient medicine spoon), gradually increasing to two spoonfuls. Take it three times a day.

Formula for Bloody Urine

Eight liang of fresh rehmannia root, one handful of arborvitae leaves, two liang of scutellaria root, and two liang of donkey-hide gelatin.

Chop the four ingredients. Boil them in eight sheng of water until three sheng of liquid remain, then strain out the dregs and add the donkey-hide gelatin. Take in three doses. Another version adds two liang of licorice root.

Another formula: dodder seed, cattail pollen, angelica dahurica root, Vitex fruit, dried rehmannia root, sour jujube (the Xiaopin Fang gives “Patrinia”), cnidium rhizome, sunflower seed, Chinese angelica root, and poria, in equal amounts.

Grind the ten ingredients into a fine powder and use honey to make pills the size of firmiana seeds. Take five pills with a drink three times a day, gradually increasing to ten pills.

Another formula: six fen of Rong salt, two liang of licorice root, two liang each of cattail pollen, deer-horn glue, and peony root, three liang of alum, and ten jujubes.

Chop the seven ingredients. Boil them in nine sheng of water until two sheng of liquid remain, then take in three doses.

Another formula: Pound three sheng of sesame seeds into a fine powder and soak them overnight in two sheng of flowing water from the east. At dawn, strain out the dregs, bring the liquid to a boil twice, and drink it all at once.

Another formula: Grind dragon bone into a fine powder and take it with warm water, one square-inch spoonful at a time, five or six times a day. The Zhang Wenzhong Formula says to take it with wine.

Another formula: Boil four liang of Sichuan angelica root in three sheng of wine until one sheng remains, then drink it all at once.

Another formula: Pound Vitex leaves and extract the juice; take two he of it with wine.

Another formula: Boil the roots, leaves, and seeds of plantain and drink as much of the liquid as possible.

Another formula: Take the ash of burnt, disordered hair with wine. The Su Cheng Formula says to take it with water.

Another formula: Take the ash of burnt sunflower stalks with wine, one square-inch spoonful at a time, three times a day.

Another formula: Scrape off talc powder, mix it with water, and apply it around the lower abdomen and the area around the genitals. This is quite effective. The Ge Formula says this method also treats difficulty urinating.

Another formula: Boil two sheng of fermented soybeans in four sheng of wine until one sheng of liquid remains, then drink it all at once.

Fourth: Edema

(This section contains one discussion, eight disease signs, forty-nine formulas, and one moxibustion method.)

The discussion says: In general, edema is difficult to treat. After recovery, particular care must be taken with diet. People with edema often fail to moderate their eating, so the illness is difficult to cure. Since ancient times, some physicians have catered to popular expectations and focused their thoughts on money, rather than putting their patients’ lives first…

Some people advise those suffering from abdominal distension and edema to eat meat such as sheep’s head and trotters, claiming that it will cure them. Yet I have never seen anyone recover this way. In these illnesses, Water Qi is congested throughout the network of the body’s channels. Treatment usually needs to make the body excrete and ease the congestion. Sheep’s head and trotters are highly nourishing—how could they help a patient recover?

For this reason, medicines for Water illness often include tinglizi and similar substances. The herbal compendia say that taking tinglizi for a long time makes a person extremely weak. This shows that Water illness requires a period of time in which the body becomes weakened before its root can be completely removed.

There is also an illness called “Gu distension,” in which the abdomen is full and distended but the body does not swell all over. “Water distension,” by contrast, causes the abdomen to enlarge while the limbs and face also swell. Some physicians do not know how to examine patients: they mistake Gu distension for edema and use medicines for Water illness, or mistake edema for Gu distension and use medicines for Gu distension. Some even prescribe medicines for Water illness whenever they see abdominal distension. As Zhongjing said, such inept physicians can kill their patients. The things to avoid and abstain from are listed below. (Prescriptions for treating Gu distension are found in “Miscellaneous Prescriptions,” fascicle seventy-four.)

Mourning observances, childbirth and nursing, music, sexual intercourse, noisy play, all kinds of fish, all kinds of meat, raw and cold foods, sour and slippery foods, garlic, sticky foods, rice, beans, and greasy foods must all be avoided, and one must also avoid troubling oneself over these matters. Other things that need not be avoided are listed beneath the relevant prescriptions. Caution regarding sexual intercourse and related matters should continue for three years. According to this book, if this can be done, the illness will not recur. Otherwise, even if the patient recovers for a time, the illness will return; once it does, it can no longer be treated.

Among the ancient prescriptions is the “Ten Waters Pill.” Repeated experience has shown that it often causes bowel movements but does not promote urination, so it is not included here.

The Yellow Emperor asked Qibo, “How can Water illness, skin distension, drum distension, intestinal conglomeration, and stone conglomeration be distinguished?” Qibo replied:

At the beginning of Water illness, the eyelids become slightly swollen, making the person look as though they have just woken up. The pulse in the neck beats noticeably, and there may sometimes be coughing. The inner thighs feel cold, the feet and lower legs swell, and the abdomen gradually enlarges. Once Water illness has taken shape, pressing the abdomen with the hand leaves it bulging as soon as the hand is lifted, as if it contained water. This is a sign of Water illness.

How, then, is skin distension recognized? Cold Qi lodges between the skin and the flesh. The surface of the skin looks swollen and feels hard to the touch. The abdomen enlarges, the whole body swells, and the skin thickens. Pressing the abdomen leaves a hollow that does not rise when the hand is removed, while the color of the abdomen remains unchanged. These are signs of skin distension.

How, then, is drum distension recognized? (The original text does not continue its explanation here.)

Abdominal distension is marked by an enlarged abdomen and swelling of the body. The degree of swelling is similar to that of “skin distension.” The skin takes on a bluish-yellow hue, and visible veins appear across the abdomen. These are its symptoms.

What is intestinal conglomeration, a disorder involving an accumulation inside the abdomen? Cold Qi lodges outside the intestines and binds with Stomach Qi, preventing the body’s vital energy from circulating normally. A mass then forms and attaches within the body. As pathogenic Qi gathers, polyps begin to grow. At first they are the size of an egg, then gradually enlarge. Once fully developed, the mass resembles a pregnancy and may persist for years. It feels hard when pressed but can be moved, and menstruation continues to arrive on time. These are its symptoms.

What is stone conglomeration, an abdominal mass formed when cold pathogenic influence obstructs the body? It develops in the womb and its associated structures. Cold Qi lodges at the uterine opening, blocking the womb and obstructing the flow of Qi. Blood that should have been discharged is retained and congeals, then gradually grows into a mass resembling a pregnancy. Menstruation no longer arrives on time. These disorders all occur in women; the masses can be expelled by inducing discharge.

Someone asked, “Can skin distension and drum distension be treated with acupuncture?” The reply was, “First drain the stagnant blood in the abdominal vessels, then regulate the channels. Use acupuncture to expel the stagnant blood from the vessels.”

The Master said: Edema has five types: wind-water, skin-water, normal-water, stone-water, and yellow sweat.

Wind-water: The pulse is floating. External symptoms include pain in the bones and joints and aversion to wind.

Skin-water: The pulse is also floating. External symptoms include swelling that leaves a pronounced indentation when pressed, but no aversion to wind. The abdomen is distended like a drum, yet there is no abdominal fullness or thirst. It should be treated by inducing sweating.

Normal-water: The pulse is deep and slow, and the external symptom is shortness of breath.

Stone-water: The pulse is deep, and the external symptom is abdominal fullness and distension.

Yellow sweat: The pulse is deep and slow. The body is hot, the chest is distended and full, and the limbs, head, and face are all swollen. If the condition does not resolve after prolonged treatment, abscesses and suppuration will inevitably develop.

Heart-water: The body feels heavy (some versions read “swollen”), breathing is short, and the person cannot lie flat. There is restlessness, and the genital area is enlarged.

Liver-water: The abdomen is distended, and the person cannot turn over unaided. There is pain below the ribs and in the abdomen. At times, a small amount of fluid seeps out, while urination remains possible but intermittent.

Spleen-water: The abdomen is distended, and the limbs feel heavy and uncomfortable. No fluids are produced; the person feels only shortness of breath and has difficulty urinating.

Lung-water: The body is swollen, and urination is difficult. At times, the stool is loose and watery, like duck droppings.

Kidney-water: The abdomen is distended, the navel bulges, and there is lower back pain. The person cannot urinate; the genital area is damp, with sweat like that on a cow’s nose. The feet are cold, while the face is unusually thin. The Master…

Water diseases should be treated according to where the swelling occurs. If the swelling is below the waist, one should try to promote urination. If it is above the waist, one should try to induce sweating; the condition will then improve.

Someone asked: “After an illness with diarrhea, a person becomes thirsty and drinks water, but urinates poorly. The abdomen becomes distended and full, and then swelling appears. Why?” The teacher replied: “This should be treated as a water disease. If urination resumes on its own, or if the person sweats, the condition will improve by itself.”

At the onset of a water disease, swelling usually first appears above the eyes, with a color like that of an old silkworm. The pulse at the side of the neck beats visibly, the inner thighs feel cold, and the lower legs become swollen and full. Pressing the swelling leaves an indentation. There may also be a sound, as if something is moving in the abdomen. These are all early signs. Without timely treatment, swelling soon spreads gradually over the whole body, and the abdomen becomes completely distended. When pressed, the swollen area rises again as soon as the hand is lifted. At this point, edema has formed, but it can still be treated. Such illnesses are mostly caused by physical weakness or injury.

After a serious illness, an episode of diarrhea, or childbirth, water that is drunk may not be promptly transformed and discharged. The Triple Burner (the channels through which fluids move, according to Chinese medicine) fails to regulate fluid passage, and urination is impaired. Fluids then gradually accumulate and spread through the channels and collaterals.

There are ten kinds of water disease, five of which are considered incurable. First, blackened lips indicate injury to the liver. Second, flattening of the supraclavicular hollow indicates injury to the heart. Third, a protruding navel indicates injury to the spleen. Fourth, a flattened back indicates injury to the lungs. Fifth, swelling that fills and flattens the soles of the feet indicates injury to the kidneys. According to this account, all five conditions are difficult to cure.

People with water disease must avoid discharging fluid through the abdomen. If fluid comes out through the abdomen, the ancient texts say the person will die within a month, so this must be especially avoided.

Zhongjun Houhei Pills are used to treat Gallbladder Dark Water. In Gallbladder Dark Water, swelling begins at the head and face and gradually spreads over the whole body down to the feet. It is accompanied by dizziness, headache, and a mild feverish sensation in the body. This illness is called “Dark Water” and involves swelling throughout the body, along with difficulty urinating and defecating. The formula appears in Volume Fifty-Eight.

A formula for treating Small Intestine Water, with fullness and distension in the lower abdomen, sudden swelling, and a bitter taste in the mouth and dry throat:

Thirty ba dou seeds, crushed with their shells. Add five sheng of water and boil until three sheng remain. Soak cotton in the liquid and wipe the swollen areas; the swelling will subside after wiping. Do this five or six times a day. Do not wipe near the eyes or the genitals. Another medical text records that this formula is used to treat sudden swelling of the body, as though it had been inflated.

A formula for treating Large Intestine Water, with the abdomen alternately hollow and full, and distension that shifts up and down:

Five sheng of red adzuki beans, three sheng of chopped mulberry root bark, a carp weighing four jin, and eight liang of white atractylodes. Chop the four ingredients, add three dou of water, and boil the fish until its flesh is tender. Do not add salt. When it is cooked, remove the fish and eat all the flesh. Take about four sheng of the medicinal liquid and drink it slowly.

Another prescription: one jin of lamb and one sheng of danglu (that is, shanglu, or pokeweed root). Chop the danglu finely and first boil it in two dou of water until soft. Strain out the herbs, then add the lamb, scallions, fermented beans, and vinegar, and prepare it as you would a meat soup. According to the Zhouhou Fang, this prescription is used for sudden swelling of the whole body or face.

A prescription for bladder edema, wasting of the limbs, and abdominal swelling:

Three sheng each of mulberry root bark, cereal root bark, and leaves of zeqi; five sheng of soybeans; and four liang each of fangji, shegan, and atractylodes rhizome.

Chop the seven ingredients and boil them in one dou and five sheng of water until six sheng of liquid remain. Strain out the herbs, add three sheng of good wine, and continue boiling until five sheng remain. Take it twice during the day and once at night, then take the remaining liquid the next day. The prescription recorded in the Jiyan Fang omits zeqi, fangji, and shegan, and contains only four ingredients.

Another prescription:

Six liang of mulberry root bark; four liang each of shegan, scutellaria root, poria, and atractylodes rhizome; three liang of alisma rhizome; two liang of fangji; three sheng of soybeans; and one sheng of zeqi.

Chop the nine ingredients. First boil the soybeans in five dou of water until three dou of liquid remain. Strain out the beans and let the liquid settle. Then take one dou of the liquid and boil the remaining herbs in it until three sheng remain. Take on an empty stomach, divided into three doses.

A prescription for gastric water (edema of the stomach), swelling of the limbs, and abdominal fullness:

One pig kidney; two liang each of poria, fangji, dried tangerine peel, scrophularia root, scutellaria root, apricot kernels, alisma rhizome (another version reads “zeqi”), and mulberry root bark; three liang each of polyporus and atractylodes rhizome; and three sheng of soybeans.

Chop the twelve ingredients. Boil the pig kidney, soybeans, alisma rhizome, and mulberry root bark in one dou and eight sheng of water until one dou remains. Let it settle and strain out the herbs, then add the remaining ingredients and continue boiling until three sheng remain. Divide into three doses. If there is coughing, add three liang of schisandra berries. After taking three doses, wait five days before taking another. The text says this regimen is generally effective.

Many people suffer from long-lasting asthma that never resolves and later develops into edema. When fluid accumulates beneath the skin and the swelling spreads to the face, eyes, and whole body, especially above the waist, the following decoction is said to cure it by inducing sweating. The ingredients listed are four liang of ephedra and two liang of licorice root.

Coarsely chop the two ingredients above. Boil the Ephedra in five sheng of water. After the water has boiled twice, skim off the foam, add the Licorice, and continue boiling until three sheng remain. Divide into three doses and take until sweating occurs and the illness is cured. While taking the medicine, be careful to avoid exposure to cold wind.

A prescription for facial swelling, difficulty urinating, and fullness and distension in the chest and abdomen

Poria and Apricot Kernel, eight fen each; Tangerine Peel, Stephania Root, and Garden Cress Seed, five fen each; Perilla Seed, three he.

Grind the six ingredients above into a fine powder and mix with honey to make pills the size of small beans. Take ten pills at a time with a decoction of mulberry root bark, twice daily. Gradually increase the dose to thirty pills at a time.

A prescription for mild, persistent swelling of the face, eyes, hands, and feet

Chop the leaves of the paper mulberry tree (Broussonetia papyrifera). Take two sheng of leaves and boil them in four sheng of water until three sheng of liquid remain. Strain out the leaves, then add rice and cook it into porridge. Eat as usual without interruption. In winter, the leaves may be gathered ahead of time and dried in the sun; cook the porridge in the same way. Continue for a year, and the condition will be cured. Be careful to avoid raw and cold foods and anything else unsuitable.

A prescription for severe abdominal edema, difficulty breathing, and a critical condition

Bovine Bezoar, two fen; Sichuan Pepper Seed, three fen; Kelp and Sargassum, ten fen each; Black-Banded Kudzuvine Seed and Cinnamon Bark, eight fen each; Garden Cress Seed, six fen.

Grind the seven ingredients above into a fine powder. Separately pound the Garden Cress Seed into a paste, then mix it with the powder and form pills the size of Chinese parasol tree seeds. Take ten pills at a time, twice daily, gradually increasing the dose until urination flows freely. The original text says this prescription is highly effective.

In the ninth year of the Zhenguan era, the Prince of Hanyang suffered from edema, and the physicians could not cure him. I gave him this prescription. Day and night, he passed one or two dou of urine, and he recovered within five or six days. After recovering, he died because of another offense. This shows that the prescription is truly miraculous. Cui says that the medicine may also be mixed with honey to make pills, then taken with honey water.

Some people suffer from edema in which the abdomen is large and hard as stone, while the limbs are thin and small. After exertion, the feet and lower legs swell; even a little food or drink leaves them short of breath. The illness persists for a long time, and purgative medicines have no effect. The following prescription is suitable: it gently dispels wind-dampness, promotes urination, and reduces swelling. It may take years of use to work, and it may also be continued after recovery.

Winged Euonymus, Salvia, Atractylodes, and Angelica Pubescens, five liang each; Japanese Gentian and Polyporus, three liang each; Anemarrhena, Sargassum, Poria, and Cinnamon Bark, two liang each.

Coarsely chop the ten ingredients above and soak them in three dou of wine for five days. Take five he at a time, daily…

Take in three “portions,” meaning in separate doses, increasing the amount gradually according to one’s strength and tolerance.

A prescription to treat edema and promote urination, for cases in which a person who drinks alcohol has deficiency heat and, after exposure to wind and drinking cold water, develops abdominal swelling and distension in the genital area:

Danglu (four liang), Gansui (one liang), Mangxiao, Yuanhua, and Wuzhuyu (two liang each).

Grind these five ingredients into a fine powder and use honey to make pills the size of wutong seeds. Take three pills per dose, three times daily. Another version uses Dahuang and Raohua, two liang each; omits Wuzhuyu; and adds Shexiang and Zhuling, one liang each.

Powder of Soybeans: A prescription for chronic edema with the abdomen swollen like a drum.

Take one dou of black beans and dry-fry them until fragrant, but do not cook them too thoroughly. Remove the skins, grind the beans into a fine powder, and sift it. The powder may be mixed with sweet rice porridge for taking. Take one he to begin with, then gradually increase the amount. If too much is taken at first, the medicine may later seem unpleasant in taste. After finishing the powder, prepare another batch according to the prescription and continue until the illness is cured.

While taking the medicine, do not eat rich, fatty foods. When thirsty, drink broth or soup. Avoid alcohol, meat, pork, chicken, fish, raw or cold foods, vinegar, and greasy or slippery foods; sexual activity should also be avoided. Rice gruel and porridge may be eaten. Beef, mutton, rabbit, and venison, it is said, should be eaten only when hunger becomes unbearable; if one can endure the hunger, one should avoid them as well. This illness is difficult to treat. Even when various powerful medicines, pills, powders, decoctions, or pastes are used, they often bring only temporary relief, after which the illness returns. This powder alone is said to prevent recurrence after recovery. In daily life, too, one should eat little of the prohibited foods and avoid eating salty foods or assorted dishes indiscriminately.

Another prescription: Powdered Tinglizi and ash made by burning Cang’erzi, twenty-seven portions of each. Mix with water and take twice daily.

Another prescription: Take pepper seeds that have settled to the bottom of water, dry-fry them, and pound them into a paste. Take one square-inch spoonful (about a small teaspoon) with wine.

Another prescription: Boil the roots of Malin in water and drink the decoction.

A prescription to treat water swelling, abdominal distension, and inability to urinate:

One sheng of Langdangzi and the lungs of one male goat (blue goat lungs may also be used).

First wash the goat lungs, briefly scald them in hot water, slice them thinly, dry them in the sun, and grind them into powder. Soak the Langdangzi in vinegar aged for three years for one day and one night, then remove it and dry-fry it until its color changes. Pound it thoroughly into a paste. Mix it with the lung powder and honey, and pound the mixture three thousand times. Form pills the size of wutong seeds. Some time after a meal, take four pills with a decoction of Maidong, three times daily. Watch for a dry throat, a sticky feeling in the mouth, and delirious speech. If urination increases markedly after several days, this indicates improvement. Shānlián once used this prescription to cure Assistant Director Wei. Assistant Director Wei’s nephew…

The medicinal formulas sent from the clouds are said to have been used many times, with reliable results.

Ophiopogon Drink Formula

Twenty-five pieces of Ophiopogon root and twenty-five grains of rice.

Boil these two ingredients together in one sheng of water until the rice is cooked, then strain out the dregs. When taking the pills mentioned earlier, swallow them with this medicinal liquid.

Prince Xu’s Boiled Powder: A Formula for Treating Edema and Promoting Urination

Ox horn, sinomenium root, Notopterygium root, ginseng, red sage root, Achyranthes root, cimicifuga root, Saposhnikovia root, gentian root, powdered fresh ginger, grain husks, aster root, apricot kernels, aconite, and Dendrobium, three liang each; mulberry root bark, six liang; tangerine peel, two liang; Atractylodes rhizome, Alisma rhizome, Poria, Chinese dwarf cherry seed, Polyporus, and Coptis, one liang each.

Process these twenty-three ingredients and sift them into a coarse powder. Add three square-inch spoonfuls of the powder to one sheng and five he of water. Boil until one sheng remains, then drink. Take twice a day. If the body cannot tolerate that amount, take it only once. This formula is said to work very well for people whose illness has lasted no more than two or three months, who pass a relatively large volume of urine but have difficulty urinating.

Chu Cheng’s Stephania Powder: A Formula for Treating Edema and Upward Surging of Breath

Han fangji, Euphorbia herb leaves, Pyrrosia leaf, and Alisma rhizome, five liang each; mulberry root bark, Atractylodes rhizome, red sage root, red Poria, tangerine peel, and Tetrapanax pith, three liang each; fresh ginger, ten liang; Chinese dwarf cherry seed, five he.

Process these twelve ingredients and sift them into a coarse powder. Add three square-inch spoonfuls of the powder to one sheng and five he of water. Boil until eight he remain, then strain out the dregs and drink in one dose. Take three times a day, stopping when urination becomes free.

Poria Pills: A Formula for Treating Edema, Prescribed by Zhen Quan for the Duke of Ankang

Poria, Atractylodes rhizome, and prickly ash seed, four fen each; woody fangji, large-seed cress seed, and Alisma rhizome, five fen each; kansui, twelve fen; red adzuki beans, Chinese thorowax root, Genkwa flowers, and cinnamon bark, two fen each; mirabilite, seven fen, ground separately.

Grind the twelve ingredients into a fine powder and mix with honey to form pills the size of parasol-tree seeds. Take five pills with honey water once a day, then gradually increase the dose according to the body’s response.

A Formula for Treating Edema and Promoting Urination

Take equal parts of rhubarb, white atractylodes (another version reads “tinglizi”), and root of Chinese aristolochia. Grind them into a fine powder and make pills with honey, each the size of a parasol tree seed. Swallow ten pills with water, taking enough to make urination free-flowing. If they have no effect, increase the dose.

Another formula: Grind pharbitis seeds into powder and swallow one square-inch spoonful with water once a day, taking enough to make urination free-flowing.

Another formula: Grind four liang of raw tinglizi and one liang of cassia bark into a fine powder. Make pills with honey, each the size of a parasol tree seed. Swallow seven pills with water twice a day, continuing until they take effect.

Another formula: Grind Chinese dwarf cherry kernels and take one sheng of the powder with one sheng of flour. Mix them and shape into seven cakes, then bake them. Eat four while hot on an empty stomach. If they have no effect, eat one more, up to a maximum of seven.

Another formula: Three liang of mercury (boiled for three days and three nights), one sheng each of tinglizi and prickly ash seeds, twenty-six silverfish, two liang each of duckweed, melon stems, and talc, and five liang of mirabilite.

Pound the tinglizi finely, add the mercury, and continue pounding until it can no longer be seen. Separately, pound the prickly ash seeds finely; crush and sift the melon stems and duckweed. Mix these ingredients with the remaining medicines, blend with honey, and pound thirty thousand times to make pills.

At first, take one pill the size of a parasol tree seed. Then take two, three, and so on, increasing up to seven pills. After taking the medicine for seven days, start again with one pill and increase in order up to six. Whenever the dose reaches six pills, start again from one.

At the beginning of treatment, lumps may appear high in the throat, the cheeks may become swollen and full, and the gums may swell. The saliva may contain small clots of blood; there is no need for alarm. These signs usually subside within three to five days, and the illness will also be cured. If the medicine causes excessive diarrhea, stop taking it and use an antidiarrheal remedy; stop after five bouts of diarrhea. If the illness has not yet cleared, the medicine may be taken again; stop once it is cured.

This formula treats a condition in which the flesh throughout the body is swollen and does not leave an indentation when pressed. In severe cases, the arms become so thick that they cannot fit into sleeves. It may also be used for the ten kinds of “great water” (severe edema) that physicians consider difficult to treat. It is said to be highly effective. The formulas recorded by Shen Shi, in the Collected Effective Prescriptions, and by Tao in the Collected Records of Ancient and Modern Prescriptions do not include silverfish, duckweed, melon stems, or talc.

Zeqi Decoction: Used to treat generalized swelling caused by water qi, weakness in the limbs, or symptoms that begin with wasting…

If the patient is thirsty, the cause may be jaundice or fluid retention in the chest and flanks (zhi yin), or it may be internal deficiency and weakness, with impaired circulation of the nutritive and defensive Qi. In that case, fluids cannot be distributed normally and collect beneath the skin. The patient may breathe uneasily, have rumbling and distension in the abdomen, and blurred vision.

Formula:

Ten liang of zeqi root, five jin of carp, eight liang of fresh ginger, two sheng of red beans, three liang of poria, and two liang each of ginseng, licorice, and dwarf lilyturf root.

Cut the eight ingredients into pieces. Add one dou and seven sheng of water, and first boil the carp and red beans. When the liquid has reduced to seven sheng, strain out the solids. Add the remaining ingredients and simmer until four and a half sheng remain. Take three he of the decoction each time, three times a day. For a weak patient, begin with three he per dose. If the Qi descends and the labored breathing stops after taking it, the dose may be increased to four he. Increased urination, reduced swelling, or slightly loose stools after taking the formula are all described as possible responses to the medicine. If urination becomes excessive, restart with one he per dose. If urine output remains excessive, stop taking the formula. If carp is unavailable, mullet may be used instead.

If the edema is severe enough to prevent the patient from resting comfortably or turning over after lying down, add one jin of zeqi. For thirst, add two liang of trichosanthes root. For cough, add two liang of aster root, one liang of asarum, one he of coltsfoot flower, and three liang of cassia bark, and increase the fish broth by two sheng. The Hu Qia version omits red beans and dwarf lilyturf root. The Gu jin lu yan version omits red beans and adds five liang of alisma and one liang of apricot kernels.

This formula is used for disorders caused by pathogenic water lodged in the Five Viscera. Symptoms may include coughing, Qi surging upward, labored breathing, abdominal distension and rumbling, swelling in both legs, puffiness beneath the eyes resembling silkworms, slight thirst, and inability to sleep comfortably. The patient may also become short of breath, then feel slightly better after a while, and have difficulty urinating, with a small volume of urine passed frequently. When the Lungs are affected, the chest may feel distended and ache dully. The original text states that the water should be expelled by promoting urination. When water Qi presses on the Lungs, mild chills and fever may also occur.

Zhu Ling San (Polyporus Powder): A formula for deficiency-type distension and generalized edema, intended to promote the flow of the Triple Burner and clear the waterways.

Two liang each of polyporus, kansui, ginseng, scrophularia, schisandra, saposhnikovia, alisma, cassia bark, langdu, zanthoxylum seed, atractylodes, dried ginger, euphorbia, and licorice; two and a half liang of cistanche; three he of wheat leaven; and two he of red beans.

Grind the seventeen ingredients into a fine powder. Take with wine, one square-inch spoonful at a time, three times a day. For older adults and children, take one coin-sized spoonful per dose. Use the ease of urination as the measure of the medicine’s effect.

Formula for severe generalized edema when all medicines have failed and the condition is critical: The original text gives only the formula’s name here; it does not provide the ingredients or preparation instructions.

Hemp seeds—that is, the seeds of the hemp plant, preferably fresh and plump—and red adzuki beans, which should be pure and free of other beans. A note in parentheses in the original also gives “one shi of each.”

Choose fresh, clean ingredients of both kinds. Sort them carefully, wash them in water, and dry them in the sun. Steam the hemp seeds, then dry them in the sun and store them in a clean container.

When ready to take the preparation, use five sheng of hemp seeds. Dry-fry them over low heat until they turn yellow and become fragrant, taking care not to burn them. Grind them into a very fine powder, add five sheng of water, and knead to extract the liquid. Press out as much as possible, then pour it into a clean, sealed container.

If you plan to take it the next morning, soak one sheng of red adzuki beans the night before after washing them clean. The next day, drain them and boil them in fresh water. Remove them before they are fully cooked, drain them, and add them to the hemp-seed liquid. Boil until the beans are very soft. Eat as desired on an empty stomach, three times a day. Pay close attention after taking it: if you experience a spell of discomfort in the chest or abdomen, stop taking it for the time being. After five days, you may urinate frequently, have reddish urine, or experience thick saliva or a dry mouth; the text says there is no need to be alarmed by these effects. During the course of treatment, free urination is considered desirable.

Another formula: Boil human urine down to a thick consistency and make it into pills the size of small beans. Take three times a day.

Another formula: Take the flesh of seven jujubes and a piece of the membrane of a bitter gourd, about the size of a date pit. Crush them and form pills. Take three pills, then take another three after roughly the time it takes to walk fifteen li. If urination begins, take one more pill and stop.

Another formula: Crush raw tinglizi seeds and take them mixed with vinegar, continuing until urination becomes frequent.

Another formula: Heat ginger stone until red-hot, then place it in black ox urine to warm the urine. Take one sheng once a day.

Another formula: Take ox urine by itself; the text says it works very well. It claims that all cases of water illness will be cured by taking it. Begin with a small amount and take enough to produce the discharge of fluid.

Another formula: Apply moxibustion one cun above the second toe of each foot, using a number of moxa cones determined by the person’s age. Then apply seven cones at the top of the web between the thumbs of both hands. A “cone” is a unit of moxibustion, referring to one burning moxa cone.

Ma Huang Decoction: A formula for wind-water—edema caused by wind evil and dampness—that makes the whole body swell as if it were about to burst. It is also used to promote urination.

Ma Huang, Fu Ling, and Ze Xie, four liang each; Fang Feng, Ze Qi, and Bai Zhu, five liang each; Xing Ren, Da Ji, and clear rice wine, one sheng each; Huang Qi and Zhu Ling, three liang each; Du Huo, eight liang; and two sheng of soybeans. Add seven sheng of water and boil down to one sheng.

Cut up the thirteen ingredients. Combine the soybean liquid, wine, and one dou of water, then boil down to six sheng. Divide into six or seven doses and take them all within a day and a night, continuing until urination is free.

Soybean Decoction is used to treat wind-water disease. It can cause severe swelling throughout the body, with the eyes so swollen they cannot be opened, and shortness of breath that may become life-threatening.

One sheng each of soybeans, apricot kernels, and clear wine; four liang each of ephedra, Chinese aristolochia root, saposhnikovia root, and polyporus; three liang each of alisma, astragalus root, and aconite; seven liang of fresh ginger; six liang of pinellia; five liang each of poria and atractylodes; two liang each of kansui and licorice.

Cut the sixteen ingredients into pieces. First boil the soybeans in one dou and four sheng of water until one dou remains, then strain out the beans. Add the other herbs and the clear wine, and boil everything together until seven sheng remain. Divide into seven doses: take four during the day and three at night. Continue until urination becomes free. Stop once the swelling has subsided; there is no need to finish the medicine. If urination remains difficult, add one sheng of fresh kansui root and two liang of lepidium seed. According to the original text, this should restore free urination. The formula in the Shenshi version does not include polyporus, alisma, aconite, pinellia, or kansui.

Formula for Treating Wind-Water Swelling

Three sheng of soybeans; five liang each of poria, atractylodes, saposhnikovia root, tangerine peel, pinellia, and fresh ginger; three liang each of softshell turtle shell, angelica, fangji, ephedra, and polyporus; one liang of kansui root; one sheng of hollyhock seeds. First boil five sheng of mulberry root bark in two dou of water until one dou remains, then strain out the herbs.

Cut the fifteen ingredients into pieces, add them to the mulberry root bark decoction, and boil until five sheng remain. Take eight ge per dose, three times a day, leaving between doses roughly the time it takes to walk ten li.

Hempseed Decoction

Used to treat swelling throughout the body. Five sheng of hempseeds, three sheng of red adzuki beans, one jin of phyllanthus root, three liang of saposhnikovia root, and one liang of aconite.

Cut the five ingredients into pieces. First pound the hempseeds until finely crushed, then boil them in three dou of water until one dou and three sheng remain. Strain out the herbs, add the remaining ingredients and the red adzuki beans, and boil until four sheng remain. Strain out the herbs; eat the beans and drink the decoction.

Soybean Decoction Paste

Used to treat new or long-standing swelling in men and women. It is also used when, after childbirth, a woman is exposed to wind while using the toilet, and wind enters the abdomen, causing hard, whip-like bands to form inside it, accompanied by abnormal breathing and other symptoms. The remainder of the original text is missing.

A Prescription for Treating Shortness of Breath and Cough

Take one dou of carefully sorted and washed soybeans. Boil them in five dou of water until only one dou and five sheng remain. Strain the bean liquid until clear and pour it into a pot. Add one and a half dou of good wine, then continue boiling until nine sheng remain. Do not eat the night before. At dawn the next day, drink three sheng while warm, then cover yourself with a quilt and sweat. After about the time it takes to eat two meals, the so-called “wind Qi” in the body should be expelled, and the swelling should subside. Avoid wind and cold, and take care of yourself for ten days.

If the condition is urgent and you cannot wait ten days, prepare and take the prescription as soon as possible. If the swelling has not completely subsided, take another dose. Once it has subsided, take another three sheng; if you have fully recovered, stop taking it. During the illness, you may also drink according to your needs, allowing the wine’s effects to continue working. The Zhouhou Fang says that thirst may follow as the swelling subsides; be cautious and do not drink much water.

Another Prescription

Take a large bundle of paper mulberry bark and branches with leaves. Chop them and boil to extract the juice, then brew wine using an amount of juice appropriate to the quantity. Drink until drunk. The swelling usually lessens somewhat within three or four days. You may continue taking it regularly after recovery. Another version uses the bark and branches with leaves of prickly ash.

Another Prescription

Take a carp one chi and five cun long and soak it in urine overnight. At dawn the next day, pass a wooden skewer through its mouth to its tail and roast it over low heat until partly cooked. Remove the skin. Do not eat the night before; take the fish on an empty stomach in one sitting. If you cannot finish it at once, divide it into two portions. Do not add salt.

A Topical Ointment for Swelling

Swelling should be treated according to the circumstances, using different approaches such as internal medicine or topical application. The same prescription should not be used indiscriminately in every case.

Take one jin of fresh shanglu root, a medicinal plant, and one jin of lard. Combine and fry them until the mixture turns yellow, then strain out the herbs. Massage the swollen areas with the medicinal oil. You may also take a small amount internally while applying it to the affected area, then cover the area with paper. Reapply when it dries. The original text says it can be cured within three days.

Musk Powder

This prescription is used for the relatively uncommon condition in women marked by shortness of breath, bodily weakness and emaciation, generalized swelling, and tight skin.

Take three zhu of musk, six zhu of realgar, and two fen each of genkwa and kansui. Grind the four ingredients into a fine powder and take five to seven qian with wine. Adjust the dose as appropriate for older people and children. The powder may also be made into pills the size of adzuki beans; people of robust constitution should take seven pills.

The Xiaopin Fang omits realgar. The Shenshi Fang says to make the powder into pills the size of soybeans with honey, and to take two pills three times daily. It uses them to treat “water illness,” in which the Triple Burner is congested and fluid accumulates along the outer sides of the chest. When fluid accumulates in the abdomen, the condition is called “abdominal turbidity, greatly accumulated in the abdomen.” The Huatuo Fang records the use of large musk pills; the Zhouhou Fang adds two fen of ginseng and makes them into pills for use.

Method for treating debility and edema:

Apply one hundred moxa cones to Taichong (an acupuncture point on the top of the foot), then apply moxibustion to Shenshu (an acupuncture point on the back corresponding to the kidneys).