灵枢胀论云。帝问岐伯胀形何如。岐伯曰。夫心胀者。烦心短气。卧不安。肺胀者。虚满而喘咳。肝胀者。
胁下满而痛引少腹。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。
六腑胀。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。又水胀篇云。帝问岐伯水胀何如。答曰。水始起也。目窠上微肿。如新卧
起之状。其颈脉动。时咳。阴股间寒。足胫肿。腹乃大。其水已成矣。以手按其腹。随手而起。如裹水之状。
此其候也。帝曰。肤胀何如。岐伯曰。肤胀者。寒气客于皮肤之间。 然不坚。腹大身尽肿。皮浓。按其
腹而不起。腹色不变。此其候也。鼓胀何如。答曰。腹胀身皆大。大与肤胀等也。色苍黄。腹筋起。此其
候也。肠覃何如。答曰。寒气客于肠外。与卫气相搏。气不得营。因有所系。癖而内着。恶气乃起。 肉乃生。
其始生也。大如鸡卵。稍以益大。至其成。如怀子之状。久者离藏。按之则坚。推之则移。月事以时下。此其
候也。石瘕何如。答曰。石瘕生于胞中。寒气客于子门。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。帝曰。肤胀鼓胀可刺邪。曰。先泻其胀之血络。
后调其经。刺去其血络也。
经云。平治权衡。去宛陈 。开鬼门。洁净府。平治权衡者。察脉之浮沉也。去宛陈 者。疏涤肠胃也。
开鬼门洁净府者。发汗利小便也。又鼓胀之病。治以鸡屎醴。名医云。其肿有短气不得卧为心水。两胁痛为肝
水。大便鸭溏为肺水。四肢皆肿为脾
水。腰痛足冷为肾水。口苦咽干为胆水。乍虚乍实为大肠水。各随其经络。分其内外。审其脉证而别之。又有
风水皮水石水黄汗。归各脏以论之。风合归肝。皮合归肺。黄汗归脾。石合归肾。风水脉浮。必恶风。皮水脉
亦浮。按下没指。石水脉沉。腹满不喘。黄汗脉沉迟。发热而多涎。久而不愈。必致痈脓。水肿脉浮带数。即
是虚寒潜止其间。久必沉伏。沉伏则阳虚阴实。为水必矣。要知水脉必沉是也。论曰。脉出者死。与病不相应
也。诸唇黑则伤肝。缺盆盈平则伤心。脐出则伤脾。足平则伤肾。背平则伤肺。此五者必不可疗也。治法云。
腰以上宜发汗。腰以下利小便。钱氏论虚实腹胀。实则不因吐泻久病之后。亦不因下利。胀而喘急闷乱。更有
痰有热。及有宿食不化而胀者。宜服大黄丸白饼子紫霜丸下之。更详认大小便。如俱不通。先利小便。后利
大便。虚则久病吐泻后。其脉微细。肺主目胞腮虚肿。手足冷。当先服塌气丸。后服异功散。及和中丸益黄
散温其气。因于气肿者。橘皮煎丸。因于湿为肿。煎防己黄 汤。调五苓散。因于热为肿者。服八正散。
又一法。燥热于肺为肿者。乃绝水之源也。当清肺除燥。水自生矣。于豉栀汤中。加黄芩。如热在下焦。
阴消使气不得化者。当益阴。则阳气自化也。黄柏黄连是也。
五脉论五水灸法
青水灸肝井。赤水灸心荥。黄水灸脾俞。白水灸肺经。黑水灸肾合。
妇人蛊胀无脉。烧青丸。五皮散亦是。
论诸蛊胀者有二。肿若从胃。则旦食而不能夜食。旦则不胀。夜则胀是也。若水肿证。濡泄者是也。内经
曰。蛊胀之病。治以鸡屎醴。酒调服。水胀之病。当开鬼门。洁净府也。
白茯苓汤名变水
白茯苓 泽泻（各二两） 郁李仁（二钱）
上 咀。作一服。水一碗。煎至一半。常服无时。从少至多服。或煎得。澄入生姜自然汁在内和面。或作
粥饭。作常食。五七日后。觉胀下。再以白术散。
白术 泽泻（各半两）
上为细末。每服三钱。煎茯苓汤调下。或丸亦可。服三十丸。
末治之药。服黄 芍药建中之类。以调养之。平复后。忌房室猪鱼盐面等物。
治水气蛊胀。洁净府。楮实子丸。
楮实子（一斗水二斗熬成膏子） 白丁香（一两半） 茯苓（三两去皮）
上二味为细末。用楮实膏为丸。如桐子大。不计丸数。从少至多。服至小便清利。及腹胀减为度。后服中
治药末治药调养药。疏启其中。忌甘苦酸。补其下。五补七宣。
取穴法
治肿治其经。治金火也。井荥俞经。阴经金也。金水木火。阳经火也。
治肿木香散
木香 大戟 白牵牛（各等分）
上为细末。每用三钱。猪腰子一对。批开掺药在内。烧熟空心服之。如左则塌左。右则塌右。如水肿不能
全去。于腹上涂甘遂末。在绕脐满腹。少饮甘草水。其肿便去也。
治水肿
蝼蛄去头尾。与葡萄心同研。露七日。曝干为细末。淡酒调下。暑月湿用尤佳。
又方
枣一斗。锅内入水。上有四指。用大戟并根苗盖之遍。盆合
之。煮熟为度。去大戟不用。旋煮旋吃无时。尽枣决愈。神效。
The *Ling Shu: Zhang Lun* (Treatise on Distension) records: The Yellow Emperor asked Qibo about the morphological manifestations of distension diseases. Qibo replied: In cases of Heart Distension, symptoms include mental restlessness, shortness of breath, and restless sleep; in Lung Distension, there is a sensation of empty fullness in the chest accompanied by wheezing and coughing; in Liver Distension, there is fullness and pain under the hypochondrium radiating to the lower abdomen; in Spleen Distension, there is frequent hiccups, heaviness and irritability in the four limbs, a body so heavy that it cannot bear the weight of clothing, and restless sleep; in Kidney Distension, there is abdominal fullness radiating to the back with a sense of misery, and pain in the waist and thighs.
Regarding Six Fu-Organ Distensions: Stomach Distension presents as abdominal fullness, epigastric pain, sensitivity to burnt odors, difficulty eating, and difficult defecation; Large Intestine Distension presents as borborygmus and pain with a gurgling sound, and if exposed to cold again in winter, it leads to undigested diarrhea; Small Intestine Distension presents as lower abdominal fullness radiating to the waist with pain; Bladder Distension presents as lower abdominal fullness and urinary retention; Sanjiao (Triple Burner) Distension presents as Qi filling the skin, feeling light upon pressure but not firm; Gallbladder Distension presents as pain and fullness under the hypochondrium, bitter taste in the mouth, and frequent sighing.
Furthermore, the *Ling Shu: Shui Zhang Pian* (Treatise on Water Distension) records: The Yellow Emperor asked Qibo about the presentation of Water Distension. Qibo answered: At the onset of water disease, the area above the eyes swells slightly, resembling the appearance after just waking up; the neck vessels pulse; there is occasional coughing; coldness in the inner thighs; edema of the calves; and subsequently, abdominal enlargement, indicating that water disease has formed. Pressing the abdomen causes it to rise immediately upon release, resembling a bag filled with water; this is the sign of Water Distension.
The Yellow Emperor then asked: What is Cutaneous Distension? Qibo answered: Cutaneous Distension occurs when Cold Qi lodges between the skin and subcutaneous tissue. The abdomen is distended but not firm; the whole body is swollen; the skin is thickened; pressing the abdomen leaves an indentation that does not rebound; and the abdominal skin color remains unchanged. This is the sign of Cutaneous Distension.
The Yellow Emperor asked: What is Drum Distension? It was answered: The abdomen is distended and the whole body is enlarged to a degree similar to Cutaneous Distension, but the complexion is dark yellow, and the abdominal veins are prominent. This is the sign of Drum Distension.
The Yellow Emperor asked: What is Chang Qin (Intestinal Polyp/Tumor)? It was answered: Cold Qi lodges outside the intestines and contends with Wei Qi (Defensive Qi), preventing Qi from circulating properly. Due to attachment, masses form internally, evil Qi arises, and flesh growths (polyps/tumors) develop. Initially, they are the size of a chicken egg, gradually enlarging until they resemble pregnancy. If long-standing, the lesion is distant from the Zang organs; it is firm upon pressure but movable upon pushing. Menstruation still occurs on time. This is the sign of Chang Qin.
The Yellow Emperor asked: What is Shi Jia (Stone Fibroid)? It was answered: Shi Jia originates in the Bao Zhong (Uterus). Cold Qi lodges at the Zi Men (Cervical Os), causing closure and blocking Qi flow. Evil blood should be discharged but fails to do so, remaining and accumulating, growing daily larger, resembling pregnancy, yet menstruation does not occur on time. These conditions occur only in women and can be treated with guiding and purging methods.
The Yellow Emperor asked: Can Cutaneous Distension and Drum Distension be treated with acupuncture? It was answered: First, puncture the collateral vessels associated with the distension to bleed, then regulate the meridians, removing the blood stasis from the collaterals.
The classic states: "Balance and weigh, remove accumulation and stale matter, open the ghost gate, and cleanse the spirit mansion." "Balancing and weighing" refers to observing the floating or sinking of the pulse to assess the severity of the condition. "Removing accumulation and stale matter" refers to clearing and purging stagnation in the intestines and stomach. "Opening the ghost gate and cleansing the spirit mansion" refers to inducing sweating and promoting urination to eliminate dampness.
Additionally, for treating Drum Distension, Ji Shi Li (Chicken Dropping Wine) is used. Famous physicians note: If swelling is accompanied by shortness of breath and inability to lie flat, it is called Heart Water; pain in the two hypochondria is Liver Water; loose stools like duck feces is Lung Water; swelling of all four limbs is Spleen Water; lower back pain and cold feet is Kidney Water; bitter taste and dry throat is Gallbladder Water; alternating deficiency and excess is Large Intestine Water. One must distinguish them according to meridian distribution, internal/external locations, and pulse/syndrome differentiation. There are also Feng Shui (Wind Water), Pi Shui (Skin Water), Shi Shui (Stone Water), and Huang Han (Yellow Sweat), which are attributed to specific Zang organs: Wind combines with Liver, Skin pathology combines with Lung, Yellow Sweat belongs to Spleen, and Stone pathology combines with Kidney. Feng Shui presents with a floating pulse and aversion to wind; Pi Shui also has a floating pulse, and depression persists after pressing; Shi Shui has a deep pulse, abdominal fullness, but no wheezing; Huang Han has a deep-slow pulse, fever, and excessive saliva. If chronic, it inevitably leads to carbuncles and pus. Edema with a floating-rapid pulse indicates latent deficiency-cold; over time, the pulse becomes deep and hidden. A deep-hidden pulse indicates Yang deficiency and Yin excess, leading to water disease. It is essential to know that water disease pulses are invariably deep. The treatise states: A pulse that floats without root indicates death, as the pulse does not correspond to the disease. Black lips indicate Liver injury; a flat/collapsed Jian Ding (supraclavicular fossa) indicates Heart injury; an everted umbilicus indicates Spleen injury; flat foot dorsums indicate Kidney injury; a flat back indicates Lung injury. These five conditions are incurable.
Treatment principles state: Swelling above the waist should be treated with diaphoresis (sweating); swelling below the waist should be treated with diuresis. Qian Yi discussed deficiency and excess abdominal distension: Excess type is not caused by prolonged vomiting/diarrhea or chronic illness, nor by dysentery, but by abdominal distension, rapid breathing, chest tightness, and agitation, possibly with phlegm-heat or retained food. Suitable formulas include Da Huang Wan, Bai Bing Zi, or Zi Shuang Wan for purgation. One must carefully check bowel movements; if both urine and stool are blocked, promote urination first, then defecation. Deficiency type occurs after prolonged vomiting/diarrhea, with a faint and thin pulse, puffiness of eyelids and cheeks due to Lung Qi deficiency, and cold hands/feet. Treat first with Ta Qi Wan, followed by Yi Gong San, He Zhong Wan, and Yi Huang San to warm the Qi. For Qi-stagnation distension, use Ju Pi Jian Wan. For Dampness-induced swelling, decoct Fang Ji Huang Qi Tang and mix with Wu Ling San. For Heat-induced swelling, use Ba Zheng San.
Another method: Swelling due to Dryness-Heat in the Lung cuts off the water source; one must clear the Lung and remove dryness, allowing water to generate naturally. Add Huang Qin to Chi Zhi Tang. If heat is in the Lower Jiao, consuming Yin prevents Qi transformation; one must tonify Yin so Yang can transform naturally, using Huang Bo and Huang Lian.
Five Pulses and Five Waters Moxibustion Method: Qing Shui (Green Water) moxibustion at Liver Jing-Well; Chi Shui (Red Water) at Heart Ying-Spring; Huang Shui (Yellow Water) at Shu-Stream of Spleen; Bai Shui (White Water) at Lung Meridian; Hei Shui (Black Water) at Kidney He-Sea.
For women with Gu Distension and absent pulse, burn Qing Wan. Wu Pi San is also applicable.
Discussions on various Gu Distensions identify two types: If swelling originates from the Stomach, the patient can eat in the morning but not at night; no distension in the morning, distension at night—this is Gu Distension. If it is a Water Distension syndrome, it presents as soft diarrhea. The Inner Canon states: Gu Distension is treated with Ji Shi Li, taken with wine. Water Distension is treated by opening the ghost gate (diaphoresis) and cleansing the spirit mansion (diuresis).
[Formula] Bai Fu Ling Tang (Name changed to Bian Shui):
Ingredients: Bai Fu Ling (Poria), Ze Xie (Alisma Rhizome) (2 liang each), Yu Li Ren (Prunus Armeniaca Seed) (2 qian).
Preparation: Coarsely crush. Take as one dose. Decoct in 1 bowl of water until half remains. Take regularly at any time, starting with small amounts and increasing. Alternatively, clarify the decoction, add fresh Ginger Juice, mix with flour, or make into porridge/rice for regular meals. After 5-7 days, when distension moves downward, follow with Bai Zhu San.
Bai Zhu San Ingredients: Bai Zhu (Atractylodes Macrocephala Rhizome), Ze Xie (Alisma Rhizome) (0.5 liang each).
Usage: Grind to fine powder. Take 3 qian per dose, washed down with Fu Ling Tang. Can also be made into pills, 30 pills per dose.
Post-treatment care: Use formulas like Huang Qi Shao Yao Jian Zhong Tang for recovery. After recovery, abstain from sexual activity, pork, fish, salt, and wheat products.
To treat Water Qi and Gu Distension, cleanse the spirit mansion (diuresis), use Chu Shi Zi Wan.
Ingredients: Chu Shi Zi (Broussonetia Papyrifera Fruit) (boil 1 dou in 2 dou water to make paste), Bai Ding Xiang (Stolex Fermented Bean), Fu Ling (Poria) (3 liang, peeled).
Preparation: Grind ingredients to fine powder. Use Chu Shi Zi paste to form pills the size of tung seeds. Dosage varies, start low and increase until urine is clear and abundant, and abdominal distension subsides. Follow with mid-stage treatment, post-treatment powders, and conditioning. Unblock the middle jiao. Avoid sweet, bitter, and sour flavors. Tonify the lower jiao. Follow the principle of "five tonifications, seven dispersals."
Acupoint Selection Method:
Treating swelling involves treating the meridians, addressing Metal and Fire. Yin meridians belong to Metal, corresponding to Jing-Well, Ying-Spring, Shu-Stream, and Jing-River points. Yang meridians belong to Fire, corresponding to Metal, Water, Wood, and Fire meridians. (Note: The original text's theoretical mapping here is complex and archaic).
Mu Xiang San for Treating Swelling:
Ingredients: Mu Xiang (Aucklandiae Radix), Da Ji (Euphorbiae Pekinensis Radix), Bai Qian Niu (Pharbitidis Semen) (equal parts).
Usage: Grind to fine powder. Take 3 qian per dose. Take one pig kidney, slice open, insert medicine inside, roast thoroughly, and take on an empty stomach. If left side is swollen, focus on the left; if right, focus on right. If edema does not fully resolve, apply Gan Sui (Kansui Root) powder to the abdomen, covering the navel area, and drink a small amount of Gan Cao (Licorice Root) water; the swelling will subside.
Treating Edema:
Lou Gu (Mole Cricket), remove head and tail, grind together with Pu Tao Xin (Grape Heart), expose to dew for seven days, sun-dry, and grind to fine powder. Take with light wine. Especially effective in summer dampness.
Another Formula:
One dou of dates. Add water to the pot, level four fingers above the dates. Cover completely with Da Ji (root and shoots). Cover the pot with a basin and cook until done. Remove Da Ji. Eat the dates as they are cooked, at any time. Consuming all dates guarantees cure. Divine efficacy.