有病心腹痛，旦食则不能暮食，名为“鼓胀”。（内伤脾肾，留滞于中，则心腹胀满不能再食，其胀
如鼓，故名“鼓胀”。）治之以鸡矢醴，一剂知，二剂已。（鸡矢之性，能消积下气，通利大、小二便，盖
攻伐实邪之剂也。一剂可知其效，二剂可已其病。凡鼓胀由于停积，及湿热有余者，皆宜用之。若肾脾虚寒发
胀，及气虚中满等症，最所忌也，误服则死。鸡矢醴法∶用羯鸡矢一升，研细炒焦色，地上出火毒，以百沸汤
淋汁；每服一大盏，调木香、槟榔末各一钱，日三服，空腹服，以平为度。
又有用干羯鸡矢八合，炒微焦，入无灰好酒三碗共煎，干至一半许，用布滤汁，五更热饮，则腹鸣，辰、巳时
行二三次，皆黑水也。次日觉足面渐有皱纹，又饮一次，则渐皱至膝上而病愈矣。此二法似用后者为便。）其时
有复发者，饮食不节故也。（鼓胀之病本因留滞，故不可复纵饮食也。）虽然，其病且已时，故当病气聚于腹
也。（病虽将愈而复伤其脾，所以气复聚也。）
应于寸口，其脉大坚以涩者，胀也。（脉大者，邪之盛也；脉坚者，邪之实也；涩因气血之虚而不能流
利也。大都洪大之脉，阴气必衰，坚强之脉，胃气必损，故大坚以涩，则病当为胀。）何以知脏腑？阴为
脏，阳为腑也。（涩而坚者为阴，其胀在脏，大而坚者为阳，其胀在腑。一曰∶脉病在阴，则胀在脏；脉病在
阳，则胀在腑。）夫气之令人胀也，血脉之中，脏腑之内，三者皆存焉，然非胀之舍也。（舍，言留
止之处也。）胀之舍在于脏腑之外，排脏腑而郭胸胁，胀皮肤，故命曰“胀”。（排挤于脏腑之外，以胸胁
为郭而居于皮肤之中，是即胀之所舍。）脏腑之在胸胁腹里之内也，若匣匮之脏禁器也，各有次
舍，异名而同处一域之中，其气各异，盖胸腹，脏腑之郭也。（胸腹者，所以保障五内，故为脏腑之郭。）
膻中者，心主之宫城也。（膻中者，胸中也，肺覆于上，膈膜障于下，为清虚周密之宫，心主之所居
也，故曰“宫城”。）胃者，太仓也。（胃为水谷之海，故曰“太仓”。）咽喉、
小肠者，传达也；（咽喉传送者，谷气自上而入；小肠传送者，清浊自下而出。）胃之五窍者，闾里门户也；
（闾，巷门也。里，邻里也。五家为比，五比为闾，盖二十五家为闾也。五家为轨，十轨为里，盖五十家
为里也。胃之五窍为闾里门户者，非言胃有五窍，正以上自胃脘，下至小肠、大肠，皆属于胃，故曰“闾里门
户”，如咽门、贲门、幽门、阑门、魄门，皆胃气之所行也，故总属胃，谓之“五窍”。）廉泉、玉英者，津
液之道也。（二穴俱属任脉，玉英即玉堂。）故五脏六腑者，各有畔界，
其病各有形状。（畔界各有所属，故病之形见可按也。下文所以辨之。）营气循脉，胃气逆为脉胀。（清者为
营，营在脉中，其气精专，未即致胀。浊者为卫，卫行脉外，其气 疾滑利，而行于分肉之间，故必由卫
气之逆，而后病及于营，则为脉胀，是以凡病胀者，皆发于卫气也。）卫气并脉循分为肤胀。（卫气逆而并
于脉，复循分肉之间，故为肤胀。）三里而泻，近者一下，远者三下，无问虚实，工在疾泻。（三里，足
阳明经穴。阳明为五脏六腑之海而主肌肉，故胀在肌肤者，当以针泻之。一下、三下，谓一次、再次、三次
也。盖邪有远近，故泻有难易耳。）心胀者，烦心短气，卧不安；肺胀者，虚满而喘咳；肝胀者，胁
下满而痛引小腹，脾胀者，善哕，四肢烦 ，体重不能胜衣，卧不安；肾胀者，腹满引背，央央然腰髀痛；
（此五脏之胀也。 ，闷乱也。央央然，困苦貌。）胃胀者，腹满，胃脘痛，鼻闻焦臭，妨于食，大便难；
大肠胀者，肠鸣而痛濯濯，冬日重感于寒，则飧泄不化；小肠胀者，少腹 胀，引腰而痛；膀胱
胀者，少腹满而气癃；三焦胀者，气满于皮肤中，轻轻然而不坚；胆胀者，胁下痛胀，口中苦，善太息。（
此六腑之胀也。濯濯，肠鸣水声也。飧泄不化，完谷而泄也，气癃，膀胱气闭，小水不通也。）
凡此诸胀者，其道在一。明知逆顺，针数不失，泻虚补实，神去其室，致邪失正，真不可定，粗之所败，
谓之天命，补虚泻实，神归其室，久塞其空，谓之良工。（此下言治胀之得失也。胀有虚实，而当补当泻，
其道唯一，能察者谓之良工，粗者误用。则伤人矣。）卫气之在身也，常然并脉循分肉，行有逆顺，阴阳
相随，乃得天和，五脏更始，四时循序，五谷乃化。（此卫气之常度也。）然后厥气在下，营卫留止，寒
气逆上，真邪相攻，两气相搏，乃合为胀也。（上节言卫气之顺，此节明卫气之逆也。厥逆之
气，自下而上，营卫失常，故真邪相攻而合为胀也。）合之于真，三合而得。（胀虽由于卫气，然有合于血
脉之中者，在经络也；有合于脏者，在阴分也；有合于腑者，在阳分也。三合既明，得其真矣。）无问虚实，
工在疾泻，近者一下，远者三下，其有三而不下者焉。下者，陷于肉肓而中气穴者也。（一下，三下者，言
针当必陷于肉盲，亦必中于气穴，然后可以取效也。）不中气穴，则气内闭，针不陷肓，则气不行，上越
中肉，则卫气相乱，阴阳相逐。（不中穴，不陷肓，则妄中于分肉间矣，故卫气相乱而阴阳之邪反相逐
以乘之也。）其于胀也，当泻不泻，气故不下。（不得其气穴肉肓也。）三而不下，必更其
道，气下乃止，不下复始，针药不二，必审其脉，当泻当补，如鼓应桴，恶有不下者乎！（三而不下，必未
得其所也，故当更穴再刺之，针与药，其法一也。肿胀一症，五脏六腑无不有之。如“胃脉实，
气有余则胀”，“胃病者腹 胀”，“胃脘当心而痛，脾气实则腹胀泾溲不利”，“浊气在上，则生 胀“，
此皆实胀也；“饮食起居失节，入五脏则 满闭塞“，“足太阴之别公孙，虚则鼓胀”，此皆虚胀也∶“胃
中寒则胀满”，“脏寒生满病”，“胃风膈塞不通，腹善胀”；“失衣则 胀”，此皆寒胀也；
“二阴一阳发病，善胀心满”，“手少阴终者，腹胀闭”，“足太阴终者，腹胀闭”，此心脾受伤之胀也；
又如“太阴所至为重跗肿”，及土郁之发，太阴之初气，太阴之胜复，皆湿胜之肿胀也；又曰水运之太过，
寒胜则浮；太阳之司天，太阳之胜复，皆寒胜之肿胀也。有曰少阴之司天，少阴之胜复，少阳之司天，少阳之
胜复，又曰“热甚则肿”，皆火胜之肿胀也；若厥阴之司天、在泉，厥阴之复及阳明之复，是皆木邪侮土
及金气反胜之肿胀也，观此则不惟五脏六腑，即五运六气，亦无不皆有是病。然曰“诸湿肿满，皆属于脾”，
又曰“其本在肾，其末在肺，皆聚水也”，又曰“肾者，胃之关也。关门不利，故聚水而从其类也”，由
此言之，则诸经虽皆有胀，无不干于脾、肺、肾三脏。盖脾属土，其主运化；肺属金，其主气；肾属
水，其主五液。凡五气所化之液，悉属于肾；五液所行之气，悉属于肺；转输于二脏之中，以制水生金者，悉
属于脾。所以肿胀之生，无不由此三者，但症有阴阳、虚实、寒热、新久之别，不可不察焉。）
水与肤胀、鼓胀、肠覃、石瘕、石水，有以别之。（此六症者，病异而形相似，故宜有以别之。覃，
音潭。）水始起也，目窠上微肿，如新卧起之状，（目之下为目窠，微肿如新卧起之状者，形如卧蚕也。）
其颈脉动，时咳，（颈脉，足阳明人迎也。阳明之脉，自人迎下循腹里。由水邪乘之，故为颈脉动，水之标在
肺，故为时咳。）阴股间寒，足胫 ，腹乃大，其水已成矣。（阴邪始于阴分也。）以手按其腹，随
手而起，如裹水之状，此其候也。（凡按水囊者，必随手而起，故病水者亦若是。以上皆水肿之候。）肤胀
者，寒气客于皮肤之间， 然不坚，腹大，身尽肿，皮浓，（ ，鼓声也，寒气客于皮肤之间
者，阳气不行，病在气分，故有声若鼓。气本无形，故不坚。气无所不至，故腹大，身尽肿。若因于水，则有
水处肿，无水处不肿，此为可辨，然有水则皮泽而薄，无水则皮浓。）按其腹， 而不起，腹色不变，此
其候也。（寒气在肤腠之间，按散之则不能猝聚，故 然不起。腹色不变，即皮浓故也，以手按其腹，随
手而起者属水， 而不起者属气，此固然也，然按气囊者亦随手而起，又水在肌肉之中，按而散之，猝不
能聚，如按糟囊者亦 而不起，故未可以起与不起为水气之的辨，但当察其皮浓色苍，或一身尽肿，或自上
而下者多属气，若皮薄色泽，或肿有分界，或自下而上者多属水也。 ，音夭，深也。）鼓胀者，腹胀，身
皆大，大与肤胀等也；色苍黄，腹筋起也。（腹胀，身皆大，与上文肤胀者证同。色苍黄者，亦皮浓腹色不
变之义，但腹有筋起，为稍异耳，盖此亦病在气分，故名鼓胀也。）肠覃者，寒气客于肠外，与卫气相搏，气不
得荣，因有所系，癖而内着，恶气乃起， 肉乃生。（覃，延布而深也，寒气与卫气相搏，则蓄积不行，留
于肠外，有所系着，故癖
积起， 肉生，病日以成矣。 肉，恶肉也。）其始生也，大如鸡卵，稍以盆大，至其成，如怀子之状，久
者离岁，按之则坚，推之则移，月事以时下也。（离岁，越岁也。寒邪客于肠外，不在胞中，
故无妨于月事，其非血病可知。盖由汁沫所聚而生，此肠覃之候也。）石瘕生于胞中，寒气客于子门，（胞，
即子宫也，男女皆有之∶在男谓之精室，在女谓之血海，子门，即子宫之门也。）子门闭塞，气不得通，
恶血当泻不泻， 以留止，日以益大，状如怀子，月事不以时下。皆生于女子，可导而下。（ ，凝败之血
也，子门闭塞，则 血留止，其坚如石，故曰“石瘕”。月事不以时下，惟女子有之也，故可以
导血之剂下之。 ，铺杯切。）肤胀、鼓胀亦可刺，先泻其胀之血络，后调其经，刺去其血络也。（先泻其
胀之血络，谓无论虚实，凡有血络之外见者，必先泻之，而后因虚实以调其经也。刺去其血络，即重
明先泻之义，所言者凡六证，而独云肤胀、鼓胀者，盖兼五证而统言之，辞虽简而意则在也。）
There is a disease characterized by pain in the heart and abdomen, where one cannot eat dinner if they have eaten breakfast. This is named "Drum Distension" (Gu Zhang). (This is due to internal injury of the Spleen and Kidney, with pathogenic factors stagnating in the middle jiao, causing distension and fullness in the heart and abdomen, inability to eat, and abdominal distension resembling a drum, hence the name "Drum Distension".) It is treated with Ji Shi Li (Chicken Dropping Wine), showing improvement after one dose and cure after two doses. (The nature of chicken droppings can eliminate accumulation, direct qi downward, and promote urination and defecation; it is an agent that attacks excess pathogens. Improvement can be seen after one dose, and the disease can be cured after two doses. Drum Distension caused by food stagnation or damp-heat excess should all use this. However, for distension caused by Spleen-Kidney deficiency-cold, or middle-fullness due to qi deficiency, it is strictly contraindicated; mistaken administration leads to death. Method for Ji Shi Li: Take one sheng of dried male chicken droppings, grind finely, stir-fry until scorched, place on the ground to remove fire toxicity, pour boiling water over it to extract the juice; take one large cup per dose, mixed with one qian each of powdered Muxiang (Aucklandiae Radix) and Binglang (Arecae Semen), taken three times daily on an empty stomach, stopping when symptoms resolve.) Another method uses eight he of dried male chicken droppings, stir-fried until slightly scorched, boiled together with three bowls of good unadulterated wine until reduced by half, filtered through cloth, and drunk hot at wu geng (early morning); this causes abdominal borborygmus, and during Chen and Si hours (7-11 AM), two or three bowel movements occur, discharging black fluid. The next day, wrinkles gradually appear on the dorsum of the feet; drinking once more causes wrinkles to extend up to the knees, curing the disease. (Of these two methods, the latter seems more convenient.) Recurrences at that time are due to irregular diet. (Since Drum Distension originates from stagnation, one must not indulge in dietary excess.) Although so, when the disease is about to heal, recurrence occurs because pathological qi re-aggregates in the abdomen. (Although the disease is nearly cured, damaging the Spleen again causes qi to re-aggregate.)
At the Cun Kou pulse position, if the pulse is large, firm, and choppy, it indicates distension. (A large pulse indicates abundant pathogens; a firm pulse indicates solid pathogens; choppy indicates deficiency of qi and blood preventing smooth flow. Generally, a surging-large pulse implies declining yin; a firm-strong pulse implies damaged Stomach qi. Thus, large, firm, and choppy pulses indicate the development of distension.) How to distinguish Zang and Fu? Yin meridians correspond to Zang organs, Yang meridians to Fu organs. (Choppy and firm pulses belong to Yin, indicating distension in Zang organs; large and firm pulses belong to Yang, indicating distension in Fu organs. Alternatively: If the pulse pathology is in Yin, distension is in Zang; if in Yang, distension is in Fu.) Qi causing distension exists in blood vessels, inside Zang-Fu organs, and in the three areas mentioned, but these are not the residence of distension. ("Residence" refers to the place where qi stays.) The residence of distension lies outside the Zang-Fu organs, pushing against them outward to the chest and hypochondrium, and filling the skin, hence named "Distension". (Pushing outwards from the Zang-Fu, residing within the skin with the chest-hypochondrium as its outer boundary, this is the residence of distension.) The Zang-Fu organs reside within the chest, hypochondrium, and abdomen, like forbidden artifacts in boxes and cabinets, each having its specific location, different names but sharing the same region, with distinct qi. Essentially, the chest and abdomen serve as the outer wall for the Zang-Fu organs. (The chest and abdomen protect the five viscera, thus serving as the outer wall of the Zang-Fu.) Dan Zhong (Chest Center) is the palace city of the Heart Master. (Dan Zhong refers to the chest center, covered by the Lungs above and diaphragm below, a clear, void, and complete palace where the Heart Master resides, hence called "Palace City".) The Stomach is the Grand Granary. (The Stomach is the sea of water and grain, hence "Grand Granary".) The pharynx and Small Intestine are responsible for transmission. (The pharynx transmits food, allowing grain qi to enter from above; the Small Intestine transmits waste, allowing clear and turbid substances to exit from below.) The five orifices of the Stomach are the gates and doors of the neighborhood. (Lü refers to alley gates; Li refers to neighborhoods. Five families form Bi, five Bis form Lü, roughly twenty-five families make a Lü. Five families form Gui, ten Guis form Li, roughly fifty families make a Li. The five orifices of the Stomach are called neighborhood gates/doors not because the Stomach has five physical holes, but because from the upper Stomach body down to the Small and Large Intestines, all belong to the Stomach. Thus, gates like the Pharyngeal gate, Cardia, Pylorus, Ileocecal valve, and Anus are all pathways for Stomach qi, collectively belonging to the Stomach, termed "Five Orifices".) Lian Quan and Yu Ying are the channels for body fluids. (Both points belong to the Ren Mai; Yu Ying is equivalent to Yu Tang point.) Therefore, the Five Zang and Six Fu organs each have boundaries, and their diseases present with distinct shapes. (Boundaries have specific associations, so disease manifestations can be palpated and identified. The following text elaborates on this.) Ying Qi circulates within the vessels; rebellious Stomach qi causes vessel distension. (Clear essence becomes Ying, circulating within vessels, possessing refined qi that does not immediately cause distension. Turbid essence becomes Wei Qi, circulating outside vessels, possessing swift and slippery qi moving between muscle intervals. Thus, only when Wei Qi rebels does the pathology affect Ying, resulting in vessel distension. Hence, all distension diseases originate from Wei Qi.) When Wei Qi merges with vessels and circulates along muscle intervals, it causes cutaneous distension. (Rebellious Wei Qi merges into vessels and circulates along muscle intervals, causing cutaneous distension.) Needle San Li (Zusanli, ST36) with reducing method: for nearby pathology, needle once; for distant pathology, needle three times. Regardless of deficiency or excess, the key is rapid reduction. (San Li is an acupoint of the Foot-Yangming Meridian. Yangming is the sea of the Five Zang and Six Fu organs and governs muscles; thus, distension in skin and muscles should be treated with needle reduction. "Once" and "three times" refer to single or repeated needling. Pathogens vary in distance, so reduction difficulty varies.) Heart distension presents with vexation, shortness of breath, and restless sleep; Lung distension presents with empty fullness, wheezing, and coughing; Liver distension presents with fullness and pain under the hypochondrium radiating to the lower abdomen; Spleen distension presents with frequent hiccups, limb restlessness, heavy body unable to bear clothes, and restless sleep; Kidney distension presents with abdominal fullness radiating to the back, and severe lumbar and thigh pain. (These are distensions of the Five Zang organs. , denotes mental distress. Yang yang ran describes a state of hardship.) Stomach distension presents with abdominal fullness, epigastric pain, smelling burnt odors, difficulty eating, and constipation; Large Intestine distension presents with borborygmus and gurgling pain, and if exposed to cold in winter, results in undigested diarrhea; Small Intestine distension presents with lower abdominal fullness radiating to the lower back; Bladder distension presents with lower abdominal fullness and urinary retention; San Jiao distension presents with qi filling the skin, feeling light but not hard; Gallbladder distension presents with hypochondriac pain and fullness, bitter taste, and frequent sighing. (These are distensions of the Six Fu organs. Zhuo zhuo describes intestinal gurgling. Sun xie refers to undigested stool in diarrhea. Qi long refers to bladder qi obstruction and urinary retention.)
All these distensions share one underlying principle. Understanding reversal and normalcy, maintaining correct needle frequency, reducing deficiency and tonifying excess—if Shen (Spirit) leaves its chamber, inviting pathogens and losing righteousness, true qi becomes unstable. This failure attributed to "heaven's will" is actually the result of incompetent practitioners. Conversely, tonifying deficiency, reducing excess, returning Shen to its chamber, and filling emptiness defines a skilled practitioner. (This section discusses the gains and losses in treating distension. Distension has deficiency and excess types, requiring appropriate tonification or reduction. Those who discern this are skilled; incompetence harms patients.) Wei Qi normally circulates with vessels along muscle intervals, with reversible and forward flows, yin and yang following each other, achieving heavenly harmony, allowing Zang organs to renew functions, seasons to follow order, and grains to digest. (This is the normal state of Wei Qi.) Then, jue qi (rebellious qi) arises below, Ying and Wei stagnate, cold qi rebels upward, true qi and pathogens attack each other, two qi clash, and combine to form distension. (The previous section described normal Wei Qi flow; this section explains rebellious Wei Qi. Rebellious qi rises from below, disrupting Ying and Wei, causing true qi and pathogens to clash and form distension.) Combining with true qi, there are three combinations to confirm diagnosis. (Although distension stems from Wei Qi, it may combine with blood vessels in meridians; combine with Zang in yin divisions; combine with Fu in yang divisions. Clarifying these three combinations yields true diagnosis.) Regardless of deficiency or excess, the key is rapid reduction: needle once for nearby, three times for distant. If three needles fail, change the approach. "Reducing" means the needle must penetrate into the muscle fat (huang) and hit the qi acupoint. (Needling once or three times implies the needle must reach the huang and acupoint to be effective.) If not hitting the acupoint, qi closes internally; if not penetrating the huang, qi does not move; if rising into muscle flesh, Wei Qi becomes chaotic, and yin-yang chase each other. (Missing the acupoint and huang means striking randomly between muscle layers, causing Wei Qi chaos and allowing yin-yang pathogens to invade.) For distension, failing to reduce when necessary prevents qi descent. (Failing to locate the correct acupoint and huang.) If three needles fail, change the method; stop only when qi descends. If it doesn't descend, restart. Acupuncture and herbal medicine follow the same principle: carefully examine the pulse, reduce when needed, tonify when needed. Like a drum responding to a beat, how could it fail to descend? (Three failures mean incorrect positioning; change points and needle again. Acupuncture and herbs share the same logic. Swelling affects all Zang-Fu. Examples of excess distension include "Stomach meridian excess causes distension," "Stomach disease causes abdominal distension," "Spleen excess causes abdominal distension and urinary/fecal dysfunction," "Turbid qi above causes distension." Examples of deficiency distension include "Irregular diet entering Zang causes blockage," "Deficiency in Foot-Taiyin collateral Gongsun causes Drum Distension." Examples of cold distension include "Cold in Stomach causes fullness," "Visceral cold causes fullness," "Stomach wind causes obstruction and distension," "Exposure to cold causes distension." Examples of Heart-Spleen injury distension include "Two Yin-One Yang disease causes distension and chest fullness," "End stage of Hand-Shaoyin causes abdominal closure," "End stage of Foot-Taiyin causes abdominal closure." Examples of dampness-induced swelling include "Taiyin arrival causes severe edema," "Earth depression onset," "Taiyin initial qi," "Taiyin victory/reversal." Examples of cold-induced swelling include "Water transport excess," "Cold victory causes floating," "Sun-Taiyang ruling heaven," "Sun-Taiyang victory/reversal." Examples of fire-induced swelling include "Shao-Yin ruling heaven," "Shao-Yin/Shao-Yang victory/reversal," "Extreme heat causes swelling." Examples of wood invading earth or metal counter-attacking include "Jue-Yin ruling heaven/in泉," "Jue-Yin/Metal recovery." Observing these, not only Zang-Fu but also Five Movements and Six Qi involve this disease. However, "All dampness swelling/fullness belongs to Spleen," "Root in Kidney, branch in Lung, all gather water," "Kidney is the gate of Stomach; if gate fails, water gathers." Thus, although all meridians can have distension, none do not affect Spleen, Lung, and Kidney. Spleen (Earth) governs transformation; Lung (Metal) governs qi; Kidney (Water) governs five fluids. Fluids transformed by five qi belong to Kidney; qi moving five fluids belongs to Lung; transmission between these two to control water generating metal belongs to Spleen. Therefore, swelling originates from these three, differing only in yin-yang, deficiency-excess, cold-heat, and chronicity. Careful observation is essential.)
How to differentiate Edema, Cutaneous Distension, Drum Distension, Intestinal Polyps (Chang Qin), Stone Mass (Shi Xia), and Stone Water? (These six conditions differ in pathology but resemble each other morphologically, requiring differentiation. Qin sounds like tan.) Edema begins with slight swelling of the eye sockets, resembling the appearance after waking up. (The area below the eye is the eye socket; slight swelling resembles a sleeping silkworm.) Neck pulse throbs, occasional coughing. (Neck pulse refers to Renying, ST9 of Foot-Yangming. Yangming channel descends from Renying along the abdomen. Water pathogen invasion causes neck pulse throbbing; water's manifestation relates to Lungs, causing cough.) Coldness in the inner thighs, swelling of calves, then abdominal enlargement indicates established water disease. (Yin pathogen starts in yin divisions.) Pressing the abdomen causes immediate rebound, like pressing a water bag; this is the sign. (Pressing a water bag causes rebound; similarly, edema patients show this. Above are signs of edema.) Cutaneous Distension occurs when cold qi lodges between skin layers, sounding hollow like a drum but not hard, with abdominal enlargement, whole-body swelling, and thick skin. (Describes drum-like sound; cold qi blocks yang qi, affecting qi level, hence drum sound. Qi is formless, hence not hard. Qi pervades everywhere, hence general swelling. Unlike water which swells only where present, this is distinguishable. Water makes skin shiny/thin; lack of water makes skin thick.) Pressing the abdomen remains hollow without rebound, abdominal color unchanged; this is the sign. (Cold qi in skin/collaterals scatters upon pressure, not aggregating quickly, hence no rebound. Unchanged color due to thick skin. Rebound indicates water; no rebound indicates qi. However, pressing air sacs also rebounds; water in muscles scatters without quick aggregation like pressing dregs, also no rebound. Thus, rebound alone isn't definitive. Observe thick/pale skin, general swelling, or top-down progression suggests qi; thin/shiny skin, defined borders, or bottom-up progression suggests water. Yao means deep.) Drum Distension features abdominal distension, whole-body enlargement equal to Cutaneous Distension; pale-yellow complexion, and visible abdominal veins. (Abdominal and whole-body enlargement matches Cutaneous Distension. Pale-yellow implies thick skin/unabdominal color, but visible veins distinguish it. Also qi-level pathology, hence "Drum Distension".) Intestinal Polyps (Chang Qin) occur when cold qi lodges outside intestines, clashing with Wei Qi, preventing nourishment, attaching firmly, forming masses, generating evil qi, and producing polyps. (Qin means spreading deep. Cold-Wei Qi clash accumulates outside intestines, attaching firmly, forming masses/polyps, progressing slowly. Polyps refer to malignant growths.) Initially small as a chicken egg, growing to basin size, eventually resembling pregnancy. Long-standing cases exceed a year. Firm upon pressure, movable upon pushing, menstruation continues regularly. (Exceeding a year. Cold qi outside uterus, not affecting menses, proving non-blood origin. Caused by fluid accumulation. Signs of Chang Qin.) Stone Mass (Shi Xia) forms in the uterus. Cold qi lodges at Zi Men (uterine mouth). (Uterus exists in both sexes: Jing Shi in males, Blood Sea in females. Zi Men is uterine opening.) Zi Men closes, qi blocked, bad blood should discharge but doesn't, stagnant blood accumulates, enlarging daily, resembling pregnancy, menstruation delayed. Occurs only in women, treatable with blood-moving purgatives. (Stagnant blood hardens like stone, hence "Stone Mass". Menstrual delay unique to women, hence blood-moving treatment. Pu bei qie is pronunciation guide.) Cutaneous and Drum Distension can also be needled. First reduce blood collaterals involved in distension, then regulate meridians, removing blood collaterals. (Reduce externalized blood collaterals regardless of deficiency/excess, then regulate based on pattern. Removing collaterals reiterates reduction. Mentioning only Cutaneous and Drum Distension covers all six conditions concisely.)