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The syndrome of swelling and distension, as stated in the classics, occurs in all five zang organs and six fu organs. Further examination of the *Huangdi Neijing* (Yellow Emperor's Inner Canon) reveals: The *Suwen* chapter "Mai Yao Jing Wei Lun" (Essential Questions on Pulse Diagnosis) states: When the stomach pulse is excess and qi is surplus, distension occurs. The "Bing Xing Pian" (Chapter on Disease Manifestations) states: In stomach disease, there is abdominal swelling and pain in the epigastrium corresponding to the heart. The "Ben Shen Pian" (Chapter on Root Spirit) states: When spleen qi is excess, abdominal fullness occurs, and urination and defecation are obstructed. The "Yin Yang Ying Xiang Da Lun" (Great Treatise on Yin-Yang and Correspondences) states: If turbid qi remains in the upper jiao, distension arises. These are all cases of excess distension. The "Tai Yin Yang Ming Lun" (Treatise on Taiyin and Yangming) states: Irregularities in diet and lifestyle allow pathogens to enter the five zang organs, causing abdominal fullness and obstruction. The "Shi Chuan Pian" (Chapter on Master's Transmission) states: Deficiency in the collateral branches and minute vessels of the Foot-Taiyin Spleen Meridian leads to drum-like distension; these are all cases of deficiency distension. The "Jing Mai Pian" (Chapter on Meridians) states: Cold in the stomach causes fullness and distension. The "Yi Fa Fang Yi Lun" (Treatise on Different Methods and Regions) states: Cold in the internal organs generates fullness diseases. The "Feng Lun" (Treatise on Wind) states: Obstruction of qi flow leads to frequent distension; exposure to cold leads to frequent distension; these are all cold-induced distensions. The "Yin Yang Bie Lun" (Treatise on Differences between Yin and Yang) states: Disease involving Shaoyin and Yangming often presents with distension and chest fullness. The "Zhen Yao Jing Zhong Pian" (Chapter on Essential Points of Meridian Termination) states: When the Hand-Shaoyin Heart Meridian terminates, abdominal distension and closure occur; when the Foot-Taiyin Spleen Meridian terminates, abdominal distension and closure occur; this indicates distension due to injury of the Heart and Spleen. Furthermore, chapters such as "Liu Yuan Zheng Ji Da Lun" (Great Treatise on the Six Origins and Correct Statutes) and "Zhi Zhen Yao Da Lun" (Great Treatise on the Essentials of True Pathogens) state: Arrival of Taiyin dampness leads to edema of the dorsum of the foot; occurrences of earth stagnation, the initial qi phase of Taiyin, and Taiyin victory/reversal phases all result from dampness excess leading to swelling. Some say: Excessive water transport and cold excess lead to floating edema. Some say: Taiyin ruling heaven, with Sun (Taiyang) victory/reversal, results from cold excess leading to swelling. Some say: Shaoyin ruling heaven, with Shaoyin victory/reversal; Shaoyang ruling heaven, with Shaoyin victory/reversal, result from heat excess leading to swelling; these are all fire excess-induced swellings. Some say: Jueyin wind ruling heaven or earth, Jueyin reversal; or Yangming reversal, result from water evil insulting earth, or metal qi counter-attacking, leading to swelling. Thus, not only do the five zang and six fu organs cause swelling, but the Five Movements and Six Qi also each have factors causing swelling. However, the classics provide a general principle: "All dampness-induced swelling and fullness belong to the Spleen." It also states: "The root is in the Kidney, the branch is in the Lung; all are accumulations of water." It further states: "The Kidney is the gate of the Stomach; if the gate is not functional, water accumulates and follows its kind." Therefore, although various meridians may present with swelling, it invariably stems from the Spleen, Lung, and Kidney. The Spleen Earth governs transportation and transformation; the Lung Metal governs qi transformation; the Kidney Water governs the five fluids. All fluids produced by the movement of the five qi belong to the Kidney; all qi generated by the movement of the five fluids belongs to the Lung; the regulation of water generating metal through the transfer of these two organs belongs to the Spleen. Thus, swelling does not exceed these three organs. However, one must distinguish between yin/excess and yang/deficiency. 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; edema starting externally and affecting the interior 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 long breath indicate excess; haggard appearance and short breath indicate deficiency. All excess syndromes are caused by excess pathogenic factors of the Six Evils injuring the exterior, or diet and anger injuring the interior, leading to rebellious qi stagnation and blockage of the Sanjiao (Triple Burner). This affects the qi level, reaching everywhere, resulting in generalized edema without specific localization. Alternatively, qi excess in the middle leads to isolated abdominal distension and urgency. Since yang pathogens move rapidly, their onset is violent, often developing within days; this is common in young and strong individuals. Breaking the urgent qi and unblocking stagnation ensures recovery; this is the method for treating excess. If it is a deficiency syndrome, it is caused by accumulation of labor from seven emotions, excessive alcohol and sexual activity, injuring the Spleen and Kidney over time. The onset is gradual, often appearing after months, common in middle-aged people. The physical signs, symptoms, and pulse/qi will clearly show deficiency-cold characteristics, unlike the sudden onset of excess syndromes characterized by heat accumulation and rebellious liver qi. Thus, treating excess is relatively easy, while managing deficiency is difficult. Deficiency can be in the qi or in the water. Qi-level deficiency involves spleen qi deficiency and cold, unable to transform, described as "fullness of qi with emptiness in the center." Water-level deficiency involves spleen deficiency failing to control water, allowing cold water to insult spleen earth and flood as evil. Initially, it rises gradually from the yin levels; pressing the flesh leaves an indentation like mud, with distinct boundaries, known as "water bloating" or "water distension." Although water is controlled by the Spleen, it is ultimately governed by the Kidney. The Kidney is the water organ, from which primordial yang qi emerges. If kidney yang is deficient, the Fire of the Gate of Life declines, unable to control yin-cold or warm the spleen earth. Yin and yang lose their balance, transforming into evil. Qi is fire; essence is water. Qi and water are of the same category, differing only in transformation. Strong yang transforms essence into qi; weak yang fails to transform, turning essence into water, becoming evil. Fire excess and water deficiency lead to dryness; water excess and fire deficiency lead to dampness. If fire cannot transform, essence does not follow yang, and essence turns into water. Therefore, edema syndromes mostly belong to yang deficiency, hence "cold distension is common, heat distension is rare." Observing Zhu Danxi's treatment of swelling: He stated that mixing of clear and turbid, blockage of tunnels, and retention of heat generate dampness; heat and dampness generate swelling and fullness. Treatment should tonify the Liver, nourish Lung Metal to control Wood, protecting the Spleen from evil invasion, and nourish Kidney Water to control Fire, allowing the Lung to maintain clear transformation. Controlling fire protects metal, but does this not harm earth? This method is suitable for yang-excess and heat syndromes, but applying it to yang-deficiency and qi-weakness would aggravate yin evil and worsen the condition. Others, ignorant of excess and deficiency, rigidly adhere to purgation to stop distension. Though temporarily relieved, true qi declines further, and swelling recurs, leading to untreatable conditions, which is lamentable. I observe excess syndromes and directly clear Yangming, achieving quick results. For deficiency, I warm and tonify the Liver and Kidney for gradual recovery. In cases of mixed excess/deficiency or ambiguous yin/yang, I prefer first using tonification for deficiency to probe for excess. If symptoms worsen without medication, tonification is contraindicated, and the approach should be changed to avoid harm. Using excess-treatment methods on deficiency, especially after harsh purgation, injures true qi further, making even divine medicines ineffective. For mild deficiency/excess, use clearing/draining with mild purging, followed by mid-jiao tonification and regulation; this is the method for deficiency. For superficial excess with root deficiency, purging is ineffective and dangerous. Regarding disease names, there is a distinction between Drum Distension (Gu Zhang) and Gu Distension (Gu Zhang - homophone, different character). Drum Distension is hollow, with tight skin, mostly related to qi. Gu Distension has solid contents, with enlarged abdomen, related to parasites or blood stasis. In gynecology, there is a distinction between Qi Level and Blood Level. Qi Level: Firm and large chest/abdomen, disease starts above, edema precedes amenorrhea. Blood Level: Blood clots at the uterus gate, disease starts below, amenorrhea precedes edema. Regarding treatment methods, there is a distinction between regulating the Lung and regulating the Spleen. Wheezing preceding distension is treated in the Lung; distension preceding wheezing is treated in the Spleen. These are the general principles. Mastery and flexibility are required to avoid the harm of "treating deficiency as excess" or "treating excess as deficiency."