典藏书目

Yu Chang said: Distension disease (Zhang Bing) and water disease (Shui Bing) are not two different diseases. When water qi accumulates and fails to circulate, it inevitably leads to extreme distension; distension disease is nothing but water enveloping, qi stagnation, and blood coagulation. If one applies only methods for treating water diseases, not one in a hundred will recover. This is due to the loss of lineage transmission, lack of guidance, and reckless treatment with inappropriate medications. Today, medical traditions have been severed for a long time, and medical studies have fallen into neglect. Even if one wishes to emulate Sima Qian (Sima Zichang), carrying books and traveling extensively through the Jianghuai, Wen, and Si regions, where can one find a true teacher? I have no place to stand in this world, yet I cannot remain indifferent to the suffering of humanity. Therefore, I propose an analogical approach for discussion with future students. Zhang Zhongjing stated that in water disease, there is a qi-level syndrome characterized by hardness and fullness below the heart as large as a plate, with edges like an inverted cup, caused by fluid retention. Then, does distension disease not also have a blood-level syndrome characterized by hardness and fullness in the abdomen as large as a plate? In cases of abundant blood and deficient qi, is there not hardness and fullness in the left hypochondrium as large as a plate? In cases of abundant qi and deficient blood, is there not hardness and fullness in the right hypochondrium as large as a plate? Thus, in individuals who appear healthy, any presence of masses or nodules constitutes the root of distension disease. Over time, the abdomen becomes distended like a winnowing basket or a jar, known as isolated abdominal distension (Dan Dan Zhang). This differs from water qi scattered across the skin, face, eyes, and limbs. The "Stone Water" (Shi Shui) mentioned by Zhang Zhongjing precisely refers to this condition. The chest remains hollow, allowing food and drink to pass by, while the small and large intestines and bladder in the abdomen are crowded and occupied by turbid stasis. Water cannot flow downward and instead overflows everywhere. The *Neijing* elucidates the principles of distension disease but provides no treatment methods. Zhang Zhongjing briefly indicated the beginning but did not establish specific laws; however, through analogy and deduction, the methods are actually quite detailed. For qi-level syndrome with hardness and fullness below the heart as large as a plate, Zhang Zhongjing presented two formulas: one treats Yin qi stagnation below the heart using Guizhi Qu Shaoyao Jia Mahuang Fuzi Xixin Tang (Cinnamon Twig Decoction Modified by Removing Peony and Adding Ephedra, Aconite Root, and Asarum); the other treats Yang qi stagnation below the heart using Zhizhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction). Since the chest is a Yang region and still distinguishes between Yin and Yang qi with different treatments, how much more so should the abdomen, a region of extreme Yin, be treated specifically from the perspective of Yin? Yin qi envelops Yin blood; if Yin qi does not dissipate, Yin blood cannot be exposed, and thus blood cannot be directly expelled. Besides using the potent Aconite Root (Fuzi), which penetrates deep like a single blade in nine armies, what other herb can dissipate Yin qi and break down hard accumulations? This logic extends to both hypochondriac regions, differing only in the severity of Qi and Blood Yin stagnation, while water pathogens follow their kind. Such methods represent the highest level of treatment, beyond the reach of average practitioners. I present them fully here to aid in extension and inspiration.

[Seven Laws]
1. Treating edema without distinguishing between Wind Water (Feng Shui), Skin Water (Pi Shui), Correct Water (Zheng Shui), Stone Water (Shi Shui), and Yellow Sweat (Huang Han), nor considering the governance of the Spleen, Lung, and Kidney organs, and recklessly using harsh diuretic drugs or fixed prescriptions such as Yugong San (Yugong Powder), Zhouche Wan (Boat Cart Pill), or Daoshui Wan (Water-Guiding Pill) is a murderous act.
2. Treating edema requiring sweating to disperse pathogens without simultaneously consolidating Wei Qi (Defensive Qi), leading to water escaping with sweat, infiltrating the skin and interstices, and failing to follow the normal water pathways downward, is the physician's fault.
3. Treating edema accompanied by thirst and diarrhea, and mistakenly using diuretics, causing exhaustion of body fluids and severe dysfunction of the Middle Jiao (Spleen and Stomach), potentially leading to intermittent pulse and shortness of breath approaching death, is the physician's fault.
4. Treating edema in patients with pre-existing masses or hernias in the lower abdomen, and mistakenly using exterior-releasing or interior-purging methods, causing turbid Qi to rush upward to the chest and stomach, resulting in severe vomiting, reversal, pain radiating to the genital tendons, and sudden untreatable death, is murder by the physician.
5. Treating edema with yellow sweat, which is formed by Stomach Heat brewing into Dan Water (Damp-Heat Water), and mistakenly using hot herbs, thereby increasing heat and causing carbuncles and pus, is the physician's fault.
6. Treating edema without examining the floating, sinking, slow, rapid, wiry, tight, fine, or choppy pulses at the Cun Kou (Radial artery) position, nor the floating, rapid, fine, slow, tight, or hidden pulses at the Zu Yang (Dorsalis pedis artery) position, makes differentiation and medication impossible, leading to disastrous outcomes; this is the physician's fault.
7. Treating distension disease with herbs that consume or scatter Qi, or drain the Lungs and Bladder, is a murderous act. Medicinal treatment must be appropriate. If pathology involves Qi stagnation that does not resolve, one must dissipate the stagnation; even after purging the lower jiao, if Qi stagnation persists, it is due to gradual accumulation. Current distension disease often involves Qi dispersion rather than convergence; further dispersing Qi would cause the abdomen to rupture. Convergence cannot be achieved instantly but requires gradual effort. Seeking immediate relief with folk remedies clearly leads to death. Those who do not repent and continue to sell such harmful practices possess hearts of darkness, destined for hell for countless kalpas.