帝曰∶愿闻胀形。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
小腹；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。
此分五脏之形证也。阳经内通于腑，阴经内通于脏，其由经脉之胀，甚则内遏脏气，故有各脏之病形。
或先由脏病而致外胀者，则必先现脏证也。下节六腑之胀亦然。若肤胀，仅在卫分，不涉于经，必无脏腑现证
也。
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。
此分六腑，证状各有不同。或由各经气逆侵内者，或因内伤食积所致者。其脏胀，或由脾虚、肝郁、肺逆
使然，或腑不通畅，遏其脏气者，皆当详审其因而治之。三焦胀与肤胀相类，以其同属于气也。
帝曰∶胀者焉生？何因而有？岐伯曰∶卫气之在身也，常然并脉循分肉，行有逆顺，阴阳相随，乃得天
和，五脏更始，四时有序，五谷乃化。然后厥气在下，营卫留止，寒气逆上，真邪相攻，两气相搏，乃合为胀
也。
营卫外护，脏腑内居，经络气血，通贯流行，其起止皆有次序，阴阳相随，如环无端，合乎五行四时之气
化，义详营卫经络门中。卫气之行，并脉循分肉，虽行脉外，而必随顺经脉流行之序。若其逆而失度，升降不
调，然后厥逆之气在下，于是营卫气血留止不行，内寒之气上逆，真气与邪互相攻击，阴阳两气不得通和，而
搏结壅塞，乃合为胀病也。
《素问·大奇论》曰∶肝满、肾满、肺满皆实，即为肿。
气盛于阳为肿，盛于阴为满。此言内满实而肿于外，其病自内而之外者，当先治其内也。
肺之雍，喘而两 满∶肝雍，两 满，卧则惊，不得小便；肾雍，脚下至少腹满，胫有大小，髀 大，跛，
易偏枯。
此申明上条之现证以辨之也，雍同壅，言邪气壅而致满也。肺肝之壅，皆两 满，而肺则有喘，肝则有惊
而不得小便之异也；肾壅则少腹至脚下气血瘀闭，故胫有大小，髀 大，跛不能行，或左或右，相易不定而偏
枯也。其壅者，或因内伤，或受外感，皆不可定。此明脏病而不及心脾者，心藏神明，为一身之主宰，若其气
壅，则必昏愦多狂；脾司转运，若其气壅，则一身内外皆不通和，不止如三脏之现证者。即参上文五脏之胀，
其义理可知矣。
黄帝说：我想听听胀病的形态表现。岐伯说：心胀的表现是心烦、气短，睡眠不安；肺胀的表现是胸部虚满且伴有气喘咳嗽；肝胀的表现是胁下胀满并疼痛牵引至小腹；脾胀的表现是容易呃逆，四肢烦闷沉重，身体沉重到连衣服都承受不起，睡眠不安；肾胀的表现是腹部胀满并牵连背部感到不适，腰部和髋部疼痛。这是分别论述五脏的胀病证候。阳经内通于六腑，阴经内通于五脏，如果是经脉本身的胀病，严重时就会向内遏制脏气，因此会出现各脏的病形。也有先由脏病导致外部出现胀满的情况，那么必定先出现脏病的证候。下面一节关于六腑的胀病也是同样的道理。如果是肤胀，病位仅在卫分，不涉及经脉，就一定不会出现脏腑的现证。
六腑胀的表现：胃胀表现为腹部胀满，胃脘疼痛，鼻子闻到焦臭味，妨碍进食，大便困难；大肠胀表现为肠鸣音重且腹痛如水流声，如果在冬天再次感受寒邪，就会导致完谷不化的泄泻；小肠胀表现为小腹胀满，疼痛牵引腰部；膀胱胀表现为小腹胀满且小便不通畅；三焦胀表现为气充满于皮肤之中，按之轻轻然但不坚硬；胆胀表现为胁下疼痛胀满，口苦，喜欢叹气。这是分别论述六腑，其症状各有不同。有的由各经气机逆乱侵犯内部引起，有的因内伤饮食积滞所致。至于脏胀，有的由脾虚、肝郁、肺气上逆造成，有的是因为腑气不通畅，遏制了脏气，这些都应当详细审察病因进行治疗。三焦胀与肤胀相似，因为它们都属于气分的病变。
黄帝说：胀病是怎么产生的？是什么原因导致的？岐伯说：卫气在人体中，通常沿着血脉循行于分肉之间，运行有逆有顺，阴阳相互跟随，这样才能获得天地的和谐，五脏功能更替有序，四季运行规律，五谷才能消化。如果厥逆之气在下，营卫之气停留停止，寒气逆而上行，真气与邪气相互攻击，两股气机相互搏结，就形成了胀病。营卫护卫于外，脏腑居于内，经络气血贯通流行，其起止都有次序，阴阳相随，如环无端，符合五行四时的气化规律，详细义理参见营卫经络门。卫气的运行，伴随血脉循行于分肉，虽然行于脉外，但必须顺应经脉流行的次序。如果卫气逆乱失去常度，升降不调，于是厥逆之气在下，导致营卫气血停留不行，内寒之气上逆，真气与邪气互相攻击，阴阳两气不能通和，搏结壅塞，从而形成胀病。
《素问·大奇论》说：肝满、肾满、肺满都是实证，就会表现为浮肿。气盛于阳分称为肿，盛于阴分称为满。这里说的是内部满实而外部浮肿，病自内向外发展的，应当先治疗内部。
肺雍（壅滞），气喘且两侧胁肋胀满；肝雍，两侧胁肋胀满，睡觉时易惊，小便不通；肾雍，从脚底到小腹胀满，小腿粗细不一，大腿肿胀，行走跛行，容易发生偏枯。这是进一步阐明上述条文中出现的证候以便进行辨别。雍同壅，指邪气壅滞导致胀满。肺和肝的壅滞，都会出现两侧胁肋胀满，但肺会有气喘，肝则有易惊和小便不通的不同；肾壅则导致少腹到脚底的气血瘀闭，所以小腿粗细不一，大腿肿胀，行走跛行，或左或右，交替不定而发生偏枯。这种壅滞的原因，有的因内伤，有的受外感，都不能确定。这里只说明了脏病而未涉及心和脾，是因为心藏神，是一身的主宰，如果心气壅滞，一定会出现昏愦多狂的症状；脾主转运，如果脾气壅滞，会导致一身内外都不通和，不仅仅像上述三脏那样出现特定的证候。结合上文五脏胀的内容，其中的义理就可以明白了。
Huangdi said: I wish to hear about the manifestations of distension. Qibo said: In cases of Heart Distension, there is mental restlessness, shortness of breath, and restless sleep; in cases of Lung Distension, there is a sensation of empty fullness accompanied by wheezing and coughing; in cases of Liver Distension, there is fullness and pain under the hypochondrium radiating to the lower abdomen; in cases of Spleen Distension, there is frequent hiccups, heaviness and discomfort in the four limbs, a sense of bodily weight such that one cannot bear the weight of clothes, and restless sleep; in cases of Kidney Distension, there is abdominal fullness radiating to the back with a feeling of discomfort, and pain in the waist and hips. This distinguishes the clinical manifestations of distension in the Five Zang Organs. The Yang Channels connect internally with the Six Fu Organs, and the Yin Channels connect internally with the Zang Organs. If the distension originates from the channels, when severe, it can internally obstruct the Qi of the Zang Organs, thus producing the specific pathological forms of each Zang Organ. Alternatively, if external distension arises from an internal Zang disease, the Zang symptoms will necessarily appear first. The same principle applies to the distension of the Six Fu Organs described below. However, in cases of Skin Distension (Fu Zhang), the pathology is confined to the Wei (Defensive) level and does not involve the channels; therefore, no Zang or Fu clinical manifestations will be present.
Distension of the Six Fu Organs: Stomach Distension presents with abdominal fullness, epigastric pain, olfactory hallucinations of a burnt odor, difficulty eating, and constipation; Large Intestine Distension presents with borborygmus and gurgling pain; if exposed to cold again in winter, it leads to undigested diarrhea (Sun Xie); Small Intestine Distension presents with lower abdominal distension and pain radiating to the lower back; Bladder Distension presents with lower abdominal fullness and difficulty urinating (Qi Long); San Jiao Distension presents with Qi filling the skin, feeling soft upon pressure but not hard; Gallbladder Distension presents with pain and distension under the hypochondrium, bitter taste in the mouth, and frequent sighing. This distinguishes the Six Fu Organs, noting that their symptoms vary. These may result from Qi rebellion in the respective channels invading internally, or from internal injury due to food stagnation. As for Zang Distension, it may be caused by Spleen deficiency, Liver Qi stagnation, or Lung Qi rebellion, or by the obstruction of Zang Qi due to the malfunction of the Fu Organs. All these must be carefully examined for etiology and treated accordingly. San Jiao Distension is similar to Skin Distension because both belong to disorders of Qi.
Huangdi said: How does distension arise? What are its causes? Qibo said: When Wei Qi (Defensive Qi) is in the body, it normally runs alongside the vessels through the intermuscular spaces. Its movement has a direction of reverse and smooth flow, with Yin and Yang following each other, thereby achieving harmony with Heaven. The Five Zang Organs function in rotation, the four seasons follow their order, and grains are digested properly. However, if Jue Qi (Rebellious Qi) accumulates below, Ying Qi (Nutritive Qi) and Wei Qi remain stagnant, Cold Qi rebels upward, and True Qi attacks Evil Qi, the two forces collide and combine to form distension. Ying and Wei protect the exterior, while Zang and Fu reside within. The meridians and Qi-Blood circulate continuously with a definite sequence, Yin and Yang following each other in an endless cycle, conforming to the Qi transformation of the Five Elements and four seasons. Detailed principles are found in the section on Ying-Wei and Meridians. The movement of Wei Qi runs alongside the vessels through the intermuscular spaces; although it travels outside the vessels, it must follow the sequential flow of the meridians. If it rebels and loses its measure, with dysregulation of ascending and descending, then Jue Qi accumulates below. Consequently, Ying-Qi, Wei-Qi, and Blood become stagnant and cease to flow. Internal Cold Qi rebels upward, True Qi and Evil Qi attack each other, and Yin and Yang Qi fail to communicate harmoniously. They collide, knot, and obstruct, thereby forming distension disease.
The *Su Wen · Da Qi Lun* states: "Liver Fullness, Kidney Fullness, and Lung Fullness are all Excess patterns, manifesting as swelling." Qi flourishing in the Yang aspect is called swelling; flourishing in the Yin aspect is called fullness. This refers to internal fullness and excess manifesting externally as swelling. For diseases originating internally and extending outward, treatment should first address the interior.
Lung Yong (Obstruction) presents with wheezing and bilateral hypochondriac fullness; Liver Yong presents with bilateral hypochondriac fullness, fright during sleep, and inability to urinate; Kidney Yong presents with fullness from the soles of the feet to the lower abdomen, asymmetry of the calves (one large, one small), swelling of the thighs, limping, and susceptibility to hemiplegia (Pian Gu). This clarifies the clinical manifestations mentioned above for differentiation. Yong is synonymous with Yong (Obstruction), referring to fullness caused by the obstruction of pathogenic factors. Both Lung and Liver Obstruction present with bilateral hypochondriac fullness, but Lung Obstruction involves wheezing, whereas Liver Obstruction involves fright and urinary retention. Kidney Obstruction leads to Qi and Blood stasis from the lower abdomen to the soles, resulting in asymmetric calves, swollen thighs, limping, and alternating left or right hemiplegia. The cause of such obstruction may be internal injury or external contraction, which cannot be definitively determined. This passage explains Zang diseases but omits the Heart and Spleen. The Heart houses the Shen (Spirit) and is the master of the body; if Heart Qi is obstructed, it必然 leads to confusion and mania. The Spleen governs transportation and transformation; if Spleen Qi is obstructed, it causes blockage throughout the entire body, internal and external, presenting differently than the specific symptoms of the three aforementioned Zang organs. By combining this with the preceding text on the distension of the Five Zang Organs, the underlying principles can be understood.