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Zhang Jingyue said: I have examined the syndrome of distension and edema (swelling). Referring to the meaning of *Ling Shu: Zhang Lun* (Treatise on Distension), it can be seen that no organ of the five zang or six fu is exempt from this condition. Further examination of other chapters reveals: *Mai Yao Jing Wei Lun* (Essential Essentials of Pulse Diagnosis) states: "When the stomach pulse is excess and qi is in surplus, distension occurs." *Xie Qi Zang Fu Bing Xing Pian* (Chapter on Pathogenic Factors and Disease Manifestations of Organs and Fu) states: "In diseases of the stomach, there is abdominal distension and pain in the epigastrium corresponding to the heart." *Ben Shen Pian* (Chapter on the Root of Spirit) states: "When spleen qi is excess, there is abdominal distension and difficulty in urination and defecation." *Yin Yang Ying Xiang Da Lun* (Great Treatise on Yin and Yang Correspondences) states: "When turbid qi remains above, distension arises." These all belong to excess distension. *Tai Yin Yang Ming Lun* (Treatise on Tai Yin and Yang Ming) states: "Irregularities in diet and lifestyle allow pathogens to enter the five zang, leading to fullness and obstruction." *Jing Bie Pian* (Chapter on Extraordinary Meridians) states: "The collateral point of Foot Taiyin, Gongsun (SP4), when deficient, results in drum-like distension." These belong to deficiency distension. *Jing Mai Pian* (Chapter on Meridians) states: "Cold in the stomach leads to distension and fullness." *Yi Fa Fang Yi Lun* (Treatise on Different Methods and Appropriate Areas) states: "Internal cold generates fullness disorders." *Feng Lun* (Treatise on Wind) states: "Wind affecting the stomach causes blockage at the diaphragm, easy abdominal distension, which worsens upon exposure to cold." These all belong to cold distension. *Yin Yang Bie Lun* (Treatise on Differences between Yin and Yang) states: "Disease arising from two yin and one yang often presents with distension and chest fullness." *Zhen Yao Jing Zhong Lun* (Treatise on Essential Acupoints and Meridian Termination) states: "When Hand Shaoyin terminates, there is abdominal distension and closure; when Foot Taiyin terminates, there is also abdominal distension and closure." This is distension due to injury of the heart and spleen. Furthermore, chapters such as *Liu Yuan Zheng Ji Da Lun* and *Zhi Yao Yao Da Lun* state that when Taiyin prevails, it causes heavy body and swelling. Also, during the onset of Earth depression, the initial qi of Taiyin, and the victory and reversal of Taiyin, are all swellings caused by excessive dampness. It is stated that excessive water transport, excessive cold causing floating/swelling, the governing heaven of Taiyang, and the victory and reversal of Taiyang are all swellings caused by excessive cold. The governing heaven of Shaoyin, its victory and reversal, the governing heaven of Shaoyang, and its victory and reversal, along with excessive heat causing swelling, are all swellings caused by excessive fire. The governing heaven and earth of Jueyin, Jueyin reversal, and Yangming reversal are all swellings caused by water evil insulting Earth and Metal qi counter-attacking. Observing these, not only do the five zang and six fu suffer from this disease, but the Five Movements and Six Qi also invariably produce it. However, *Zhi Yao Yao Da Lun* states: "All dampness, swelling, and fullness belong to the Spleen." *Shui Re Xue Lun* (Treatise on Water and Heat Acupoints) states: "Its root is in the Kidney, its branch is in the Lung; both accumulate water." It further states: "The Kidney is the gate of the Stomach. If the gate is not functional, water accumulates and follows its kind." From this perspective, although all meridians may have distension, none are unrelated to the Spleen, Lung, and Kidney. The Spleen belongs to Earth and governs transportation and transformation. The Lung belongs to Metal and governs Qi. The Kidney belongs to Water and governs the five fluids. All fluids transformed by the five qi belong to the Kidney. All qi transported by the five fluids belongs to the Lung. The transmission between these two organs, which controls Water to generate Metal, belongs to the Spleen. Therefore, the generation of distension and edema stems inevitably from these three organs. However, syndromes differ in Yin/Yang and Excess/Deficiency, as described in various treatises, and must be distinguished. Generally, Yang syndromes involve heat, and heat implies excess. Yin syndromes involve cold, and cold implies deficiency. Distension starting internally and spreading externally usually indicates excess; swelling starting superficially and worsening internally usually indicates deficiency. Yellow-red urine and constipation indicate excess; clear-white urine and loose stools indicate deficiency. Slippery, rapid, and forceful pulses indicate excess; wiry, floating, faint, and fine pulses indicate deficiency. Red-yellow complexion and coarse breathing indicate excess; haggard appearance and short voice indicate deficiency. All excess syndromes result from the excess of the Six Evils injuring the exterior, or diet and anger injuring the interior, causing Qi mechanism failure and Sanjiao obstruction. This affects the Qi level, reaching everywhere, resulting in generalized edema regardless of location. Or, if Qi is excess in the middle, it leads to isolated abdominal distension and urgency. However, Yang pathogens are rapid and violent, appearing within days or weeks, common in young and strong individuals. Breaking stagnant Qi and draining obstruction cures these. This is the method for treating excess. Deficiency syndromes, however, result from accumulation of labor from the Five Emotions, or excess wine and sex, injuring Spleen and Kidney over time. These conditions often manifest after middle age. Their signs, symptoms, and pulses show obvious deficiency-cold patterns, unlike the sudden onset of excess with heat stagnation or fierce Liver Qi rebellion. Treating excess is straightforward; treating deficiency is difficult. Deficiency can be in Qi or in Water. Deficiency in Qi involves Spleen Qi deficiency and cold, failing to transform, known as Qi-deficiency central fullness. Deficiency in Water involves Spleen deficiency failing to control Water, allowing Cold Water to insult Spleen Earth and flood as pathogen. Initially, it rises gradually from the Yin aspect, leaving pitting edema with defined boundaries, known as Drum Distension or Water Distension. Although Water is controlled by the Spleen, it is governed by the Kidney. The Kidney is a Water organ, the source of Primordial Yang and vital Qi. If Kidney Yang is deficient, the Fire of the Gate of Life declines. It cannot control internal cold nor warm Spleen Earth. Yin and Yang lose their balance, transforming into pathogen. Qi is Fire; Essence is Water. Qi and Water are of the same category, differing only in transformation. When Yang is prosperous, Essence transforms into Qi; when Yang declines, lack of transformation turns Water into pathogen. Fire excess and Water deficiency cause dryness; Water excess and Fire deficiency cause dampness. Thus, if Fire fails to transform, Yin does not follow Yang, and Essence/Qi become Water. Therefore, edema mostly belongs to Yang deficiency, hence cold distension is common, heat distension rare. Danyu treated swelling by clearing heat, stating that mixing of clear/turbid and blocked tunnels cause heat. Heat retention creates dampness, generating distension. Treatment should tonify Spleen, nourish Lung Metal to control Wood, protect Spleen from hostile influence, and nourish Kidney Water to control Fire, allowing Lung clear transformation. His theory emphasizes damp-heat and controlling Fire. While controlling Fire protects Metal, does it not fail to generate Earth? This method suits Yang-excess heat cases but harms Yang-deficiency non-transforming cases by aiding Yin pathogen. My treatment requires distinguishing true excess: directly clearing Yangming is easy. For deficiency consumption, warming and tonifying Spleen/Kidney restores health. If diagnosis is unclear between excess/deficiency, it is safer to first treat deficiency (tonify) to probe for excess. If symptoms worsen without medication, tonification is inappropriate; change strategy safely. If disease worsens naturally despite medicine, carefully assess severity and truthfulness. Mistakenly using excess-treatment on deficiency, especially after harsh purging, damages True Qi beyond cure even with divine medicine. Temporary relief from clearing/draining without substantial Spleen/Kidney tonification leads to eventual collapse. This is the method for treating deficiency. Swelling diseases often present with apparent excess and root deficiency, a critical prognosis. Misdiagnosis causes severe harm.