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Shengfu suffered from monobdominal distension (single abdominal swelling). The abdomen was large as a winnowing basket, tight and hard as stone. Acidic fluid frequently generated in the stomach; both swallowing and vomiting yielded acidic taste. Treatment over many years proved ineffective. This was likely due to physicians employing rash, established methods without investigating the origin of the disease or the principles of its transformation after formation, thereby exacerbating the condition. Yesterday, I saw a prescription by an elderly physician from Yunjian. It was complex and chaotic, lacking any logical basis. Only the Shenqi Wan (Kidney Qi Pill) remained, a method already tested by predecessors. However, using this for such a disease is like intending to go north to Yan but pointing south. Shenqi Wan is considered a divine medicine for swelling because it can gather Kidney Qi, preventing water from overflowing. Now, with urination occurring six or seven times a day, the channels are smooth, and there is no danger of water overflow. Furthermore, the principle is "benefiting the source of fire to eliminate yin shadows." Currently, the acidic taste is transformed from fire. How can one further benefit the fire? Others identify abdominal distension as food stagnation and use harsh purgatives from the *Ju Fang* (Formulary of the Bureau of Medical Practitioners), which is even more shocking. I must clarify the rationale. Shengfu's illness originated from the failure of Spleen Qi to circulate freely, leading to depression and transformation into fire. If the method of "releasing fire when depressed" had been used at that time—raising Yang and dispersing fire—the illness would have resolved instantly. Instead, due to increasing depression and blockage, it gradually progressed to distension. The Qi in the body became like Heaven and Earth failing to interact, resulting in obstruction. The disease formed and transformed. Although the symptoms seemed devoid of fire, fire was entirely the root. Not investigating the root but treating only the distension with herbs like Areca Seed (Binglang), Magnolia Bark (Houpo), and Radish Seed (Laifuzi) consumes Qi and aids fire. Thus, the pathogen entered the Stomach, worsening day by day, boiling down Body Fluids to become acidic juice. The Stomach opening resembled a vinegar jar, and the heat within was like yeast fermentation. Once grain or drink entered, it instantly brewed into an acidic taste. Sometimes, newly swallowed grain was immediately ejected along with old grain, as if exchanged. This occurred because new grain, still aromatic and sweet, was favored and accepted by the Stomach, while the acidic residue could not remain. The innate Qi of the human body resides entirely in the Stomach opening. Now, it secretly transforms via fire, with fluids rising and scattering, which is no minor issue. Moreover, Earth governs sowing and reaping, producing sweetness; Wood governs bending and straightening, producing acidity. Sweetness transforming into acidity indicates Wood insulting Earth (Liver Wood overacting on Spleen Earth). In spring, when Wood is prosperous, it will be difficult to treat. While it is still treatable, treating only distension and not acidity ignores that acidic fluid entering the abdomen will increase distension. Without blocking the source and stopping the flow, will the momentum ever cease? Let me outline the general approach. Treating fire involves only two methods: tonification for deficiency and purgation for excess. Although internal depression should ideally be treated with tonification, the method of using sweet-warm herbs to remove heat and purge fire, when applied during periods of acidity production, increases acidity and proves useless. Therefore, to drive out acidity and restore sweetness, one must use "rigid medicines." Rigid medicines are those with potent flavors and aromas that can alter the Stomach's state without being altered by it. Balancing them through comprehensive coordination allows for the use of "rigidity within softness," but not "softness within rigidity." For example, Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Cinnamon Twig (Guizhi) and Aconite Root (Fuzi) represents softness within rigidity. Adding two anti-acidity herbs to Liuwei Wan, which produces acidity, is inappropriate. Lianli Tang (Coptis and Poria Decoction) represents rigidity within softness. The rigidity is not excessive, aided by soft herbs to achieve the effect of removing acidity. After acidity is removed, treating distension becomes easy, like splitting bamboo. Stubborn diseases vanish instantly, Spleen function recovers, Taihe (Great Harmony) is preserved, and natural destiny is maintained. Can practitioners not be prudent regarding the sequence and dosage of medications?

Years later, it was heard that using Phellodendron Bark (Huangbai) and Anemarrhena Rhizome (Zhimu) finally achieved complete efficacy. More remarkably, taking rigid and soft herbs as pills made the chest feel like Heaven and Earth interacting to form the hexagram Tai (Peace), indescribably refreshing. The distension healed effortlessly.

Appendix: Discussion on Post-Recovery Methods. A disciple asked, "Master, you often discuss before prescribing, yet the results are immediate and accurate. Now that acidity has ceased and distension subsided, with the umbilicus retracting and abdomen shrinking, achieving full recovery, what other hidden dangers might arise? Please explain the post-recovery methods thoroughly." I replied, "Your question is detailed. Liu Hejian elaborated extensively on the pathogenesis in the *Neijing*, but subtle points cannot be fully conveyed verbally. I will expand upon it for you. Diseases transmit in various ways, forward or backward. This is the mechanism of disease formation. However, the mechanism of disease removal has never been discussed. Previously, Shengfu's disease transmitted from Spleen to Stomach. Now, with acidity gone and distension reduced, it returns from Stomach to Spleen. Therefore, post-recovery treatment prioritizes regulating the Spleen, with the Stomach secondary. The mechanism can be explained. If Stomach Qi is not harmonious, pathogens cannot be expelled. Only when Stomach Qi harmonizes does acidity decrease and appetite increase, gradually restoring normal capacity. However, while the Stomach likes containment, the Spleen dislikes vigorous transportation. Fatigue, excessive sleep, and preference for massage occur. Eating one bowl makes the body feel heavy; eating three bowls feels like adding immense weight. Walking normally, climbing heights reveals lightness below and heaviness above, weak legs, heavy limbs, dizziness, and shortness of breath. Weak Spleen Yang leads to preferring boiling water after meals to borrow thermal energy. Residual pathogens may cause damp-heat in summer, malaria in autumn, dryness constraining the Spleen, or dampness causing Spleen diarrhea. Regulating the Spleen prevents myriad diseases; neglecting it causes successive illnesses, eventually affecting the Stomach. Improper care, diet, or sexual fatigue first affects the Spleen, which is understandable. But anger stirring fire carries Wood pathogen directly invading Stomach Earth, causing sudden relapse, which is dangerous. As the saying goes, 'A momentary anger can cost life and harm kin,' a deep warning. Regarding initial acidity and distension, a membrane likely formed in the Stomach, sac-like and protruding, caused by Liver Fire penetrating the Stomach membrane. Accumulated water transformed into acidity via Wood. Over time, it filled, the sac enlarged, becoming the root of abdominal distension. New grain entering causes acidic expulsion, while sweet grain remains. Eating malt sugar triggers acid eruption like a suction tube. These prove the existence of a separate locus. If not, vomiting would expel both new and old content, like in diaphragm qi disorders, but they are distinct. Visiting Yufeng, locals asked me to instruct other doctors on care and the concept of the separate membrane. The doctor laughed, saying, 'If so, Master truly sees through walls.' Alas, inferior scholars hear the Dao thus. The prescribed formula was Liujunzi Tang (Six Gentlemen Decoction) decocted with Red Halloysite Powder (Chishizhi). The doctor did not understand my intent to fill the empty sac to prevent future issues. I once treated a blood gu case in Guangling. After 100 days of medication, the abdomen flattened, revealing a pillow-shaped mass in the left hypochondrium. Stimulating it caused vomiting of black sludge and evacuation via stool, resolving the condition. Gu distension, whether blood, Qi, water, or phlegm, always creates a locus, like bandits occupying fortified positions. The *Neijing* states five-zang accumulations have fixed locations. Why assume six-fu aggregations like drum distension lack roots? This supplements the *Neijing*'s pathogenesis theory.

Appendix: Evidence of Locuses. Xu Shumi in *Ben Shi Fang* stated: "I suffered from drinking disease for 30 years. Initially, writing late at night leaning left caused food to settle on the left. Drinking wine at night lying left went unnoticed in youth. Years later, wine sounds came from the lower left, with hypochondriac pain, reduced appetite, and irritability. Half a cup of wine stopped intake. Every ten days, liters of acidic fluid were vomited. In summer, sweat appeared only on the right, none on the left. Seeking famous doctors and sea prescriptions provided temporary relief, lasting only a month. Tonics like Aconite Root (Fuzi) and Alum, and purgatives like Morning Glory Seed (Qianniu), Great Euphorbia (Daji), and Kansui (Gansui) were tried. I deduced a sac existed, like water needing a basin to flow. Clear fluid flowed, turbid stagnated, with no outlet. Every 5-7 days, vomiting expelled it. Spleen Earth dislikes dampness, water flows to damp places. Drying the Spleen removes dampness; reinforcing Earth fills the basin. I made Cangzhu Wan (Atractylodes Pill), taken for three months, curing the disease. Thus, even minor phlegm-fluid retention has a locus; how could major distension lack one? Xu's acidic fluid was vomited completely, not seeping into the abdomen. Shengfu accumulated for years, holding several dou in the abdomen, with only mouthfuls erupting. Had I not treated gastric acidity first, accumulation would have lasted another year. Discussing intra-abdominal matters seems absurd, so credit is rightly withheld. Ancient sages realized truths after 30 years of illness. How few modern doctors view patients as themselves? Those changing doctors without planning for recovery simply haven't penetrated this barrier. Mr. Hu Youchen said: Understanding pathogenesis, tracing sources to the origin, is boundless like the Milky Way, yet solidly grounded, not speculative. Ten years of study and three broken bones (experience) may not yield such insight."