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[Ping An]: This chapter appears in *Suwen* (Plain Questions), Volume 13, Chapter 47 "Treatise on Strange Diseases", and also in *Jiayi Jing* (The Systematic Classic of Acupuncture and Moxibustion), Volume 8, Chapter 2.

Yellow Emperor asked Qibo: A patient presents with fullness under the hypochondrium, rebellious Qi moving upward, persisting for two or three years without resolution. What is this disease? Qibo replied: It is named Xi Ji (Respiration Accumulation, a chronic condition characterized by respiratory abnormalities and hypochondriac masses). This condition does not affect eating, but moxibustion is contraindicated. Acupuncture should be combined with Daoyin (guiding and pulling exercises) and herbal medicine; medication alone cannot cure it. Yellow Emperor said: Good. [Annotation: Fullness under the hypochondrium is due to the gathering of Liver Qi. Due to panting, Qi moves rebelliously, causing Qi accumulation. After two or three years, it is named Xi Ji. Although it does not hinder eating, moxibustion is forbidden. One can use acupuncture to guide Jing (Essence) and take medicine; after the medicine acts, no further need for acupuncture exists. [Ping An]: In *Suwen*, there is no character "Xing" (move) after "Ni" (rebellious). "Jing Wei Yin" (Essence as guidance) in *Suwen* and *Jiayi Jing* is written as "Ji Wei Daoyin" (Accumulation as guidance), while Yuan's edition writes "Jing Wei Daoyin". In the annotation "Ke Yi Ci" (Can puncture), Yuan's edition places "Ci" above "Ke Yi", with "Daoyin" below "Ke Yi" and no "Jing". The original manuscript writes "Ke Yi Ci", missing one character after "Ci", followed by "Yin Jing" (Guide Essence). I strictly follow the original manuscript.]

[Ping An]: This chapter appears in *Suwen*, Volume 11, Chapter 40 "Treatise on Abdominal Center", also in *Suwen*, Volume 13, Chapter 47 "Treatise on Strange Diseases", and again in *Jiayi Jing*, Volume 8, Chapter 2.

Yellow Emperor asked: There is a person whose body is swollen, with both thighs and calves swollen, and pain surrounding the navel. What is this disease? Qibo replied: The disease is named Fu Liang (Hidden Beam, an abdominal mass disease). This is a root caused by Wind pathogen. It must not be disturbed; if disturbed, it will transform into water retention, leading to abnormal urination (clear or scanty). [Annotation: The head and trunk are called Shen (body), and the four limbs are called Ti (body/extremities). Here, the character implies rotting/swelling. The outer part of the thigh is Gu (thigh), and the long bone below the knee is Jing (shin). Swelling and rotting occur in these four areas, along with pain around the navel, named Fu Liang. This Fu Liang disease has Wind as its root. "Dong" means transformation/manifestation. If it transforms, it may become a water disease. "Niao" refers to the organ of cold and clear fluids. [Ping An]: In *Suwen*, the character is written as "Bi" (thigh). Above "Bu Ke Dong" (Cannot disturb), there are twenty-two characters: "Qi overflows into the Large Intestine and attaches to Huang (Diaphragmatic Origin); the origin of Huang is below the navel, hence pain surrounds the navel." These are placed later in this book. In *Jiayi Jing* and *Suwen*, "Qing" is written as "Se" (astringent/scanty), and "Fu" is written as "Bing" (disease).]

Yellow Emperor asked: There is a person with fullness and hardness in the lower abdomen, with roots extending up, down, left, and right. What is this disease? Can it be treated? Qibo replied: The disease is named Fu Liang. What causes Fu Liang? ([Ping An]: *Suwen* reads: "Emperor said: How is Fu Liang acquired?") Answer: It wraps pus and blood, residing outside the stomach and intestines. It is incurable; treating it by pressing hard will cause death. [Annotation: Because there is a membrane wrapping pus and blood outside the stomach and intestines, with roots in the lower abdomen, it must not be pressed. Pressing causes pain and leads to death, named Fu Liang. [Ping An]: In *Suwen* and *Jiayi Jing*, there is a large character "Da" after "Guo" (wrap).] Asked: Why is this so? Answer: Because it connects to the Yin below, and presses against the Stomach Guan (cardia/pylorus) above, piercing through the Diaphragm, causing an internal abscess in the Stomach Guan. [Annotation: Why does pressing cause death? Because Fu Liang connects to Yin below, pus and blood inevitably press upward on the Stomach Guan, emerging above the Diaphragm, causing an abscess in the Stomach Guan. Thus, pressing downward pulls on Yin, and upward connects to the heart and abdomen, leading to death. Guan□□□ [Ping An]: In *Suwen* and *Jiayi Jing*, "Bi Nong Xue" (must pus blood) is written as "Bi Xia Nong Xue" (must downward pus blood), "Chu Ge" (exit diaphragm) as "Sheng Ge" (generate diaphragm), and "Shi Wei" (make stomach) as "Xie Wei" (clasp stomach). *Suwen* Xin Zheng Xiao says: *Taisu* writes "Xie Wei" as "Shi Wei".] This person's disease is difficult to treat. Located above the navel is a counter-flow (adverse) pattern; located below the navel is a smooth (favorable) pattern. Do not disturb frequently or drain aggressively. The discussion is in *Cifa* (Needling Methods). This is a root caused by Wind; its Qi overflows into the Large Intestine and attaches to the Huang (diaphragmatic area). The source of Huang is below the navel, hence pain surrounds the navel. [Annotation: Such a disease, once contracted, lasts a long time. "Ji" (pronounced qi-li fan) means frequent/repeated. This disease has Wind as its root; its Qi overflows within the Large Intestine and attaches to the Huang Yuan (origin of the diaphragm) below the navel, hence pain surrounds the navel. Do not lightly disturb or drain repeatedly; draining leads to death. Because it resides in the Huang Yuan, being above the navel is adverse. [Ping An]: "Ci Ren Zhi Bing Nan Zhi Ye" (This person's disease is difficult to treat) in *Suwen* and *Jiayi Jing* is written as "Ci Jiu Bing Nan Zhi" (This long-standing disease is difficult to treat). Yuan's edition writes "Ren" as "Ji Ren" (two characters). "Qi" (nape/center) in *Suwen* and *Jiayi Jing* is written as "Qi" (navel). "Yuan" (source) in *Suwen* and *Jiayi Jing* is written as "Yuan" (original/source).]