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For vertical measurements, use the midline of the Ren Mai (Conception Vessel); for horizontal measurements, use the distance between the nipples.

If there is abdominal distension without heat or pain, treatment should focus on the Foot-Yin meridians and the Back-Shu points of the Five Zang organs. If the pain is caused by cold qi stagnation and retention, acupuncture should be followed by Fu-Gang Moxibustion (moxibustion using a glass jar). For specific methods, refer to the end of the Abdomen and Hypochondrium section.

For epigastric pain: Select Ganshu (BL-18), Pishu (BL-20), Zusanli (ST-36), Ge Shu (BL-17), Taichong (LR-3), and Duyin (EX-SP-8). Apply moxibustion at each point one cun below the nipples, 20 moxa cones per site.

For difficulty in swallowing, borborygmus in the abdomen, uncontrolled defecation, and yellow-red urine: Needle Zhongwan (CV-12), and pair with Dachangshu (BL-25), Pangguangshu (BL-28), and Hunmen (BL-47) [located three and a half cun lateral to the lower border of the spinous process of the ninth thoracic vertebra]. Moxibustion may be applied, three cones.

For irregular cold and heat, with qi attacking around the umbilicus causing pain: Moxibustion on Qihai (CV-6), 37 cones; Tianshu (ST-25), 100 cones; Dachangshu (BL-25), three cones; Taixi (KI-3), three cones.

For abdominal distension and hardness, with hardness also extending to the umbilicus and lower abdomen: Moxibustion on Shuifen (CV-9) and Zhongji (CV-3), 100 cones each; Sanjiaoshu (BL-22) and Geshu (BL-17), three cones each; Shenshu (BL-23), number of cones determined by patient's age; needle Taixi (KI-3), Taichong (LR-3), Sanyinjiao (SP-6), Pishu (BL-20), and Zhongwan (CV-12).

For borborygmus and abdominal pain: Select Sanyinjiao (SP-6) and Gongsun (SP-4).

For stabbing pain from flowing and depositing qi in the abdomen, hypochondrium, and other areas, unbearable in intensity: Use a long glass jar whose mouth can accommodate three fingers of the hand, so that it can effectively absorb fluid. For each painful area, puncture four or five acupoints with a three-edged needle, insert the needles into the jar mouth, and apply Fu-Gang Moxibustion for seven cones. Puncture according to the pain location and apply Fu-Gang Moxibustion repeatedly; this yields miraculous effects.

For sudden generalized edema with severe facial swelling: Puncture the white flesh margin below the medial malleolus (near Zhaohai KI-6), three cones, immediate effect.

For edema and abdominal distension: Moxibustion on Shuifen (CV-9), Sanyinjiao (SP-6), and Yinjiao (CV-13), 100 cones each; treat the Back-Shu points of the Five Zang organs; needle Zhongwan (CV-12). After needling, press the needle hole to prevent fluid leakage; moxibustion on Yinqiao (EX-NC-6), seven cones.

For edema of the limbs and face: Needle Zhaohai (KI-6), Ruzhong (EX-UE-10), Hegu (LI-4), Zusanli (ST-36), Jiegu (GB-39), Quchi (LI-11), Zhongwan (CV-12), Wangu (SI-4), Pishu (BL-20), Weishu (BL-21), and Sanyinjiao (SP-6).

For bladder swelling and drum-like distension (Gu Zhang): Needle Pishu (BL-20), Weishu (BL-21), Dachangshu (BL-25), Pangguangshu (BL-28), Shuifen (CV-9), and Zhongwan (CV-12); needle Xialiao (BL-34? *Note: Text says Xiaochangshu BL-27*), Sanyinjiao (SP-6), and Zusanli (ST-36).

Edema and drum-like distension result from spleen and stomach disharmony, where water and grain fluids flow recklessly into the skin, leading to dysfunction of urination and defecation. Medical texts state that if water flows out completely after needling Shuifen (CV-9), death ensues. However, when water swelling is severe, patients cannot eat, the abdomen resembles a held drum, breath is faint, and the mind is confused and restless, leading to imminent death. At such times, if emergency rescue is not performed, death is inevitable. I speculate that rather than waiting for death, one should attempt emergency rescue. Needle Shuifen (CV-9) to allow two-thirds of the fluid to drain. When the swelling subsides to the level of the umbilicus but has not yet reached it, if fluid discharge is urgent, apply powder of Xuejie (Dragon's Blood) or Hanshuishi (Calcitum) to seal the needle site. Prepare emergency materials before needling. If Xuejie is unavailable, stir-fry Huaihua (Sophorae Flos) until yellow but not too dark, grind into powder, hold a full handful in hot hands, and apply firmly to the needle site. Do not move it by hand; wait until a scab forms to seal the fluid. Additionally, Baicaoshuang (Soot) powder can also stop fluid discharge. After three days of fluid drainage, observe if wind pathogens have subsided slightly, then treat the aforementioned acupoints for efficacy. Furthermore, in cases of edema, the external genitalia and scrotum may also swell. Puncturing the scrotal skin to release yellow fluid brings relief; however, if blood appears, it is an inauspicious sign. Generally, puncturing the external genitalia to release fluid corresponds to promoting diuresis, which is auspicious; puncturing the hands and feet to release fluid corresponds to pathological exudation through the skin, which is inauspicious. Whether a disease worsens or improves slightly depends on careful nursing and regulation. ○ Regarding pulse diagnosis: Quezhuo (Sparrow Pecking) pulse and Xiayou (Shrimp Swimming) pulse are both critical signs.