倪氏论臌,有气、血、虫、水、单是也,论胀,有寒、热、虚、实、湿、食、瘀、积、肝、肾是也。方家必分五臌
若何?十胀若何?余谓∶臌胀在上,灸于上脘,在中;灸于中脘;在下,灸于下脘,或灸气海。至若胀及两胁者,灸于
期门。胀及背腰者,灸于胃俞。胀至两腿者,灸足三里。胀至两足者,灸行间可也。
上脘(见劳伤。)
中脘(见喘症。)
下脘(脐上二寸。)
气海(见劳伤。)
期门(见喘症。)
胃俞(十一节下,各开二寸。)
足三里(见痿症。)
行间(见尸厥。)
先圣曰∶诸湿肿满,皆属于脾。盖脾主水谷,虚而失运,水谷停留,故成肿满也。后贤分而为四∶一曰水肿,皮薄
色嫩,按之成凹也,一曰气肿,皮浓色苍,按之即起也;一曰风肿,走注肿疼,皮肤麻木也;一曰瘀肿,肿而红亮,有
血缕痕也。以上诸肿,宜灸内庭。如罔验者,行间、大敦皆可灸之。
内庭、行间、大敦(三穴皆见尸厥。)
症有七,蚊、蛇、鳖、虱、肉、米,发也。瘕有八,青、黄、燥、血、脂、狐、蛇、鳖也。其实症者,征也,有块
可征。瘕者,假也,假物成形。总之不外乎气血交滞。倘因气滞而成者,灸气海。因血凝而致者,灸天枢可耳。
气海、天枢(并见劳伤。)
Ni's discussion on鼓胀 (Gu Zhang, abdominal distension with fluid accumulation) states that Gu is categorized into five types: Qi, Blood, Parasite, Water, and Single; while Zhang (abdominal distension) includes Cold, Heat, Deficiency, Excess, Dampness, Food retention, Stasis, Accumulation, Liver, and Kidney. Physicians must distinguish what constitutes the Five Gues and the Ten Zhangs. I propose: for Gu/Zhang located in the upper jiao, moxa the Shangwan (CV13); in the middle jiao, moxa the Zhongwan (CV12); in the lower jiao, moxa the Xiawan (CV10) or Qihai (CV6). If distension extends to both hypochondria, moxa Qimen (LR14). If it extends to the back and waist, moxa Weishu (BL21). If it reaches both legs, moxa Zusanli (ST36). If it reaches both feet, moxing Xingjian (LR2) is appropriate.
Shangwan (see Lao Shang).
Zhongwan (see Chuan Zheng).
Xiawan (two cun above the umbilicus).
Qihai (see Lao Shang).
Qimen (see Chuan Zheng).
Weishu (below the 11th thoracic vertebra, two cun lateral).
Zusanli (see Wei Zheng).
Xingjian (see Shi Jue).
The Ancient Sage said: "All dampness-induced swelling and fullness belong to the Spleen." The Spleen governs the transformation and transportation of water and grain. When deficient and failing to transport, water and grain stagnate, thus forming swelling and fullness. Later sages divided this into four categories: First, Shui Zhong (Water Edema), where skin is thin and tender, leaving an indentation upon pressure; Second, Qi Zhong (Qi Edema), where skin is thick and pale, rebounding immediately after pressure; Third, Feng Zhong (Wind Edema), characterized by wandering swelling and pain with numbness of the skin; Fourth, Yu Zhong (Blood Stasis Edema), characterized by red and bright swelling with visible blood vessel traces. For all aforementioned swellings, moxa Neiting (ST44). If ineffective, Xingjian (LR2) and Dadun (LR1) may also be moxed.
Neiting, Xingjian, Dadun (all three points see Shi Jue).
Zheng (masses) have seven types: Mosquito, Snake, Turtle, Louse, Meat, Rice, and others manifesting as attacks. Jia (floating masses) have eight types: Green, Yellow, Dry, Blood, Fat, Fox, Snake, and Turtle. Essentially, Zheng refers to tangible signs, having palpable masses. Jia implies falsity, taking shape from external factors or pathological products. In summary, these do not exceed the obstruction of Qi and Blood interaction. If caused by Qi stagnation, moxa Qihai (CV6). If caused by Blood coagulation, moxa Tianshu (ST25) suffices.
Qihai, Tianshu (both see Lao Shang).