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Historically, edema affecting the entire body and face is relatively easy to treat. However, if only the abdomen is swollen, it becomes difficult to treat. There are underlying reasons for this distinction that must be analyzed.

The various prescriptions handed down through generations mostly employ harsh, toxic, and rapid purgative methods. These deplete the True Yuan (True Original Qi) and damage the Spleen and Stomach. Such approaches can be used once but never repeated. Even if medication achieves temporary efficacy, if abdominal swelling recurs, there will be no further effective treatment available!

Furthermore, in cases of generalized edema, each of the Five Zang and Six Fu organs presents specific signs. Therefore, herbs that drain the Liver, Lung, Bladder, Large Intestine, or Small Intestine may occasionally yield results. In contrast, isolated abdominal distension indicates that the central region (Spleen and Stomach) has long obstructed the axis of movement for Qi transformation. As a result, Clear Qi fails to ascend, and Turbid Qi fails to descend; they accumulate and bind together, becoming firm and unbreakable. This is fundamentally caused by the decline and weakness of Spleen Qi. How dare one casually use herbs that drain the Spleen?

Moreover, edema suitable for purgation should only be applied to robust individuals from the Northwest or laborers in the fields. Could those who enjoy rich diets, particularly the elderly and children, withstand such treatments? If one claims that all edema can be treated with purgatives, then certainly cases of fullness and excess must be drained. But what about postpartum edema or edema following illness? Should these also be treated with purgation?

Ancient texts originally listed five untreatable conditions for edema: black lips indicate injury to the Liver; a flat suprasternal fossa (Quepen) indicates injury to the Heart; protruding umbilicus indicates injury to the Spleen; a flat back indicates injury to the Lung; and flat soles indicate injury to the Kidney. These five conditions are considered incurable. The intent behind formulating these rules was not merely to declare cases incurable, yet why do later generations, without careful examination, universally resort to purgative attacks?

Consequently, when using drugs that劫夺 (plunder/rob) Zheng Qi (Upright Qi), the swelling may initially subside rapidly. However, subsequent attempts at purgation fail to reduce the swelling, and further attacks render the condition as hard as iron or stone. Those ignorant of medicine might ask, "What pathogenic factor is so formidable?" But those with insight understand that this is merely the consequence of aggressive drug therapy. It feels as though the body's Yuan Qi is being turned against itself, creating difficulties. This is akin to driving common people into banditry, described metaphorically as "the son stealing soldiers' arms to rebel in the pond." Is this not the case?

Understanding this principle reveals three alternative methods: the method of nurturing, which involves tonifying and benefiting Yuan Qi; the method of gathering, which involves raising Yang Qi and lifting Qi; and the method of dispersing, which involves opening the "ghost gates" (inducing sweating) and cleansing the "clean mansion" (promoting urination). None of these three methods explicitly mention "purgation," yet the goal of resolving swelling is achieved within them, leaving no room for further improvement.