Library

Tympanites presents with ten types of symptoms: Qi Tympanites (distension due to Qi stagnation), Food Stagnation Tympanites, Heat Tympanites, Wind Tympanites, Exhaustion Tympanites, Dampness Tympanites, Parasite Tympanites, Blood Stasis Tympanites, Gan Accumulation Tympanites, and cases where the chest and abdomen are swollen accompanied by swelling of the four limbs. When examining a patient, if pressing the abdomen leaves an indentation that recovers (reversible depression), it is treatable; if the pulse is strong, it is easy to treat; if the pulse is fine/thin, and the umbilicus protrudes and swells, it is difficult to treat.

Take one piece of Chicken Gizzard Lining (Jineijin), Zhen Chenxiang (Agarwood) and Sha Ren (Amomum Fruit) each at 3 qian, and Chen Xiangyuan (Aged Tangerine Peel) at 5 qian.
Grind them all into fine powder. Take 0.5 qian per dose, washed down with Ginger Decoction.

Another method: Take one stomach of a male black pig, insert 4 liang of garlic, boil until soft, and consume both meat and broth together for five to seven doses. Avoid salt, vinegar, and soy sauce for one hundred days. (Empirical Single Formula)

The Yellow Emperor asked: "How can we distinguish between Water Disease, Skin Distension (Fuzhang), Tympanites (Guzhang), Intestinal Polyps (Changqin), Stone Mass (Shijia), and Stone Water?" Qibo replied: "When Water Disease begins, there is slight swelling above the eye sockets, resembling the appearance after just waking up. The neck vessels pulse, there is occasional coughing, coldness in the inner thighs, swelling of the calves, and subsequently the abdomen enlarges, indicating that water has formed. Pressing the abdomen causes it to rise immediately upon release, resembling a bag filled with water; this is its sign. In Skin Distension, cold pathogen lodges between the skin layers. Percussion sounds hollow but is not firm. The abdomen is large, the whole body is swollen, the skin is thickened. Pressing the abdomen leaves an indentation that does not rise, and the abdominal color remains unchanged; this is its sign. In Tympanites, the abdomen is distended and the body is enlarged, comparable in size to Skin Distension. The complexion is dark yellow, and abdominal collateral veins are prominent; this is its sign. In Intestinal Polyps, cold pathogen lodges outside the intestines, struggling with Defensive Qi. Qi fails to nourish, leading to binding and internal fixation. Evil Qi arises, and polyps form. Initially, they are as large as a chicken egg, gradually increasing until resembling pregnancy. After more than a year, pressing makes them hard, pushing moves them, and menstruation still occurs on time; this is its sign. Stone Mass originates in the uterus. Cold pathogen lodges at the cervical os, causing closure. Qi cannot flow freely. Evil blood should be discharged but is retained, accumulating daily, enlarging until resembling pregnancy. Menstruation does not occur on time. These conditions occur only in women and can be treated by guiding and purging."

Tympanites refers to isolated abdominal distension. Initially limited to the abdomen, this is abdominal distension. If untreated for a long time, it leads to edema of the four limbs. Its pathology involves two patterns: one caused by Damp-Heat, and one caused by Deficiency-Cold. For Deficiency-Cold, no prescription is superior to Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet). For Damp-Heat, use roasted Chicken Droppings White mixed with one sheng of sifted Agarwood powder. Place in a ceramic jar, soak in two jin of good wine, seal with dough, and boil for the duration of three incense sticks. Clarify and take warm as desired. Alternatively, use one jin of real yellow beef boiled in river water until soft, add one liang of Mirabilite (Piao Xiao), and eat as desired. Swelling subsides in two to three days; severe cases may require repeated doses until full recovery. Within one hundred days, strictly avoid sour, salty, raw/cold foods, wheat products, meat/fish, greasy foods, and hard items.

Ten Types of Water Diseases (including origin, symptoms, and methods):
1. Clear Water: Swelling starts from the left and right ribs, rooted in the Liver. Herb: Dayflower Root (Daji).
2. Red Water: Starts from the root of the tongue, rooted in the Heart. Herb: Lepidium Seed (Tinglizi).
3. Yellow Water: Starts from the waist and abdomen, rooted in the Spleen. Herb: Kansui Root (Gansui, stir-fried).
4. White Water: Starts from the feet, rooted in the Lung. Herb: Mulberry Root Bark (Sangbaipi).
5. Black Water: Starts from the external kidneys (testicles), rooted in the Kidney. Herb: Forsythia Fruit (Lianqiao).
6. Dark Water: Starts from the face, rooted in the external kidneys. Herb: Genkwa Flower (Yuanhua, vinegar-fried).
7. Wind Water: Starts from the four limbs, rooted in the bones. Herb: Alisma Rhizome (Zexie).
8. Stone Water: Starts from the kidneys, rooted in the Bladder. Herb: Ligusticum Rhizome (Gaoben).
9. High Water: Starts from the lower abdomen, rooted in the Small Intestine. Herb: Croton Seed (Badou, peeled and oil-extracted).
10. Qi Water: Fluctuates in severity, rooted in the abdomen. Herb: Adzuki Bean (Chixiaodou).

For the above ten types of swelling diseases, each has a different origin. Identify the root cause herb for each disease, double its dosage, and mix equally with the other nine herbs, which are then dried and powdered. Honey-pelletized to the size of a wu zi pill. Take three pills swallowed with Red Poria Decoction (Chifuling Tang), anytime, three times daily. After cure, take tonic medicines. The formula consists of:
Cinnamon Twig (Rougui, bark removed), Dried Ginger (Ganjiang), Nutmeg (Roudoukou), Red Poria (Chifuling), Curcuma Zedoaria (Ezhu, vinegar-boiled), Szechwan Lovage Root (Chuanxiong), and Platycodon Root (Jiegeng) in equal proportions.
Powdered. Take 3 qian per dose, washed down with plain hot water. On an empty stomach before meals, once at noon and once at night. These two formulas treat edema with 100% efficacy, saving countless people. (From *Chishui Xuanzhu*)

Yu Yuliang Wan (Wang Yuxue and Zhu Danxi praised this formula as a divine medicine for water distension)
Ophicalcite (Shehanshi, large pieces 3 liang, heated red in an iron pot, quenched in vinegar until cool, taken out and ground extremely fine), Yu Yuliang Stone 3 liang, Real Needle Sand (Zhensha) 5 liang (washed clean, dried, boiled with two zhong of vinegar and Yu Yuliang stone until dry, then heated red in the pot again, poured onto a clean brick, cooled, and ground fine), Qianghuo, Costus Root (Muxiang), Poria (Fuling), Szechwan Lovage Root (Chuanxiong), Achyranthes Root (Niuxi, wine-soaked), Cinnamon Heart (Guixin), White Cardamom (Baidoukou), Star Anise (Da Hui, stir-fried), Curcuma Zedoaria (Pengzhu, soaked), Aconite Root (Fuzi, soaked), Dried Ginger (Ganjiang, soaked), Green Tangerine Peel (Qingpi), Bupleurum Root (Jingsanleng, processed), Tribulus Fruit (Bajili), and Angelica Sinensis (Danggui, wine-soaked) each at 5 qian.
Powdered. Mix with three decocted ingredients, pelletize to the size of a wu zi pill. Take 30-50 pills on an empty stomach with plain hot water, three times daily. Follow with warming and tonifying medicines for miraculous effects. (From *Yizong Bidu*)

Spleen Disease causing Yellow Edema
Alum (Qingfan, calcined to red beads), Angelica Sinensis (Danggui, wine-soaked for seven days) each at 4 liang, soot from burning grass (Baicaoshuang) 3 liang.
Powdered. Use the wine used to soak the Danggui to make pellets the size of a wu zi pill. Take 5-7 pills per dose, washed down with wine. Effective within one month. (Ancestral Seven-Generation Formula)

Tympanites and Edema
One dried loofah, peeled and crushed, stir-fried with fourteen Croton seeds (Badou) until the seeds turn yellow. Remove the seeds, keep the loofah. Stir-fry aged rice until yellow (rice and Badou must be equal parts initially). Remove the loofah, keep the rice. Grind finely, make pills with clear water. Take 100 pills per dose, washed down with boiling water.
Method to remove water without oral medication for swelling: 2 qian of Calomel (Shuiyinfen), 4 liang of oil-extracted Croton seed (Badou), and 1 qian of native sulfur (Sheng Liuhuang). Grind into a cake and apply to the umbilicus. Yellow fluid will naturally drain. Before application, place one jin of cotton over the umbilicus, then the medicine cake. Bind externally with cloth. Walk for the distance of three to five li; yellow fluid will drain naturally. Remove the cake after three to five applications, replenish with warm congee. For chronic patients, drain water every other day. (From *Mifang Jiyuan*)

Edema with Abdominal Distension (or generalized edema)
Use one dou of dates. Place in a pot, cover with water, cover with roots and shoots of Dayflower (Daji), seal with a tile lid, cook until soft. Eat the dates frequently. Cure is certain when the dates are finished. (From *Bencao*)

Another method: One jin of Verbena Officinalis (Mabiancao), one jin of Sage (Shuweicao). Boil in one shi of water to obtain five dou. Strain, re-decoct until thick. Mix with flour to make pills the size of soybeans. Take 2-3 pills, increase to 4-5 pills. Miraculous effect. (From *Zhouhou Fang*)

Edema
Roast and powder the Mole Cricket (Tugou/Loulvfu). The upper half eliminates upper body edema; the lower half eliminates lower body edema. Left side treats left, right side treats right. Alchemists consider this formula magical. (From *Yizong Bidu*)

Abdominal Distension with Yellow Edema
Charred Lotus Seeds from a Gourd (Yayao Hulu Lianzi). Take one per dose, wash down with warm wine before meals. Non-drinkers use plain water. Effective in ten-plus days. (From *Jianbian Fang*)

External Application (for abdominal hardness like stone or scrotal swelling; first chew Licorice root, then apply this)
Dayflower Root (Daji), Genkwa Flower (Yuanhua), Kansui Root (Gansui), and Sargassum (Haizao) in equal proportions.
Powdered. Mix with strong vinegar and flour, spread on cotton paper, apply to the swollen area, and wrap with soft cotton. (From *Yizong Bidu*)

White Migratory Wind Swelling
Snail meat with a little salt, pounded into paste and applied. Miraculous effect. (From *Zhexuan Fang*)

Blue Abdominal Skin (Death ensues quickly if not treated urgently)
Lead White (Hufen, specifically Tin Powder, not Lead Powder). Fry with salt until color changes. Rub onto the abdomen. (From *Zimu Milu*)

Phlegm Tympanites
One old gourd, remove the top. Loosen the seeds inside with a chopstick. Pour in wine. Seal with the top. Boil in water for several boils. Remove seeds and drink the wine. Cure after one vomit. Suitable only for those with robust Yuan Qi. (From *Danfang Quanji*)