Library

1. Wei Qi (defensive qi circulating outside the vessels) follows the meridians and circulates within the muscle spaces. Internal injury or external invasion of pathogens leads to the conflict between righteous Qi (healthy energy) and pathogenic factors. If external pathogens invade the vessels, Mai Zhang (vessel distension) occurs; if pathogens remain in the muscle spaces, Fu Zhang (skin distension) arises.
[Note] The Classic states: "Wei Qi exists in the body, usually accompanying the meridians and circulating within the muscle spaces, with Yin and Yang following each other; how could disease occur?" If a person suffers internal injury from the Seven Emotions (joy, anger, worry, thought, grief, fear, fright), external invasion by the Six Qi (wind, cold, summer-heat, dampness, dryness, fire), irregular diet, or excessive labor, then pathogens and righteous Qi conflict, causing Ying Qi (nutritive qi circulating inside the vessels) and Wei Qi to lose harmony. When Wei Qi and wind-cold pathogens reside in the vessels, it forms Mai Zhang. When Wei Qi and wind-cold pathogens remain in the muscle spaces, it forms Fu Zhang.

2. Symptoms of Mai Zhang include protruding abdominal veins and discoloration of collateral vessels. If prolonged and untreated, it develops into Dan Fu Zhang (abdominal distension with thin extremities), where the four limbs become emaciated and cold. Symptoms of Fu Zhang initially present as soft skin without hardness. If chronic and unhealed, it evolves into Qi Gu (distension due to qi stagnation), characterized by a distended, urgent, and hard abdomen.
[Note] In the syndrome of Mai Zhang, abdominal tendons protrude, and collateral colors change. If not cured over time, it becomes Dan Fu Zhang, with emaciated and cold extremities. In the syndrome of Fu Zhang, the flesh is initially soft and not hard. If chronic and unhealed, it becomes Qi Gu with fullness, presenting as a distended, urgent, and hard abdomen.

3. External pathogens interfere with Wei Qi and reside outside the intestines, causing Chang Tan (a mass growing outside the intestines), while menstruation continues regularly. External pathogens interfere with Ying Qi and reside inside the uterus, causing Shi Xia (a mass growing in the uterus), amenorrhea, and a body shape resembling pregnancy.
[Note] Wind-cold pathogens do not reside in the vessels or muscle spaces but interfere with Wei Qi, penetrating deeply to reside outside the intestines. They attach internally, increasing daily in size, resembling pregnancy, yet menstruation proceeds on schedule; this is named Chang Tan. Or, they interfere with Ying Qi, penetrating deeply to reside in the uterus. Evil blood remains stagnant, increasing daily in size, resembling pregnancy, yet menstruation is delayed; this is named Shi Xia. These conditions occur in women; in men, they are referred to as Shan Bing (hernia diseases).

4. Thick skin with a bluish-green complexion indicates Qi stagnation; thin skin with a lustrous complexion indicates Water-Dampness retention. Distension caused by Qi progresses rapidly; patients can lie comfortably, and swelling typically spreads from top to bottom. Distension caused by Water progresses slowly; patients suffer from insomnia, cough, and asthma. Shi Shui (stone water) presents with lower abdominal swelling but no asthma. Feng Shui (wind water) presents with simultaneous edema of the face and lower legs/feet. Shi Shui is a Yin pathogen formed by the congealing of cold water; Feng Shui is a Yang pathogen formed by the coagulation of heat and dampness.
[Note] In all swelling diseases, thick skin with a bluish-green color belongs to Qi disorders. Thin skin with a lustrous color belongs to Water disorders. Qi is Yang; its nature is rapid, so Qi distension develops quickly, often starting from the upper body and spreading downward, allowing the patient to lie down comfortably, as the pathogen is exterior. Water is Yin; its nature is slow, so Water distension develops gradually, often starting from the lower body and spreading upward, accompanied by signs such as cough, asthma, and inability to lie flat. The sign of Shi Shui is lower abdominal swelling and fullness; because the water is below, there is no asthma. Swelling above is called Wind; swelling below is called Water. Therefore, in Feng Shui, both the face and the shanks/feet swell simultaneously. However, Shi Shui belongs to Yin pathogens, hence described as Cold Congealment. Feng Shui belongs to Yang pathogens, hence described as Heat-Dampness Coagulation.