黄帝问曰∶脉之应于寸口，如何而胀？岐伯对曰∶其至大坚直以涩者，胀也。曰∶何以
知其脏腑之胀也？曰∶阴为脏而阳为腑也。曰∶夫气之令人胀也，在于血脉之中耶，抑脏腑
之内乎？曰∶二者皆在焉，然非胀之舍也。曰∶愿闻胀舍？曰∶夫胀者，皆在于腑脏之外，
排脏腑而廓胸胁，胀皮肤，故命曰胀。曰∶脏腑之在内也，若匣匮之藏禁器也，各有次舍
，异名而同处一域之中，其气各异，愿闻其故？曰∶夫胸腹者，脏腑之城郭。膻中者，心
主之中宫也。胃者，太仓也。咽喉少腹者，传道也。胃之五窍者，闾里之门户也。廉泉玉英
者，津液之道路也。故五脏六腑，各有畔界，其病各有形状。营气循脉，卫气逆为脉胀，卫
气并血脉循分肉为肤胀（《灵枢》作营气循脉为脉胀，卫气并脉循分肉为肤胀）。取三里泻之
，近者一下（一本作分，下同），远者三下，无问虚实，工在疾泻也。曰∶愿闻胀形？曰∶心
胀者，烦心短气，卧不得安。肺胀者，虚满而喘咳。肝胀者，胁下满而痛引少腹。脾胀者，
苦哕，四肢闷，体重不能衣。肾胀者，腹满引背怏怏然，腰髀痛。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，冬日重感于寒则泄飧不化。小肠胀
者，小腹 胀，引腰而痛。膀胱胀者，小腹满而气癃。三焦胀者，气满于皮肤中，壳壳
然而不坚。胆胀者，胁下痛胀，口苦，好太息。凡此诸胀，其道在一，明知逆顺，针数不
失。泻虚补实，神去其室，致邪失正，真不可定，粗工所败，谓之夭命。补虚泻实，神归其
室，久塞其空，谓之良工。曰∶胀者焉生，何因而有名？曰∶卫气之在身也，常并脉循分肉
，行有逆顺，阴阳相随，乃得天和，五脏皆治，四时皆叙，五谷乃化。然而厥气在下，营卫
留止，寒气逆上，真邪相攻，两气相搏，乃舍为胀。曰何以解惑？曰∶合之于真，三合而
得。曰∶无问虚实，工在疾泻，近者一下，远者三下，今有三而不下，其过焉在？曰∶此言
陷于肉肓而中气穴者也。不中气穴而气内闭藏，不陷肓则气不行，上越中肉则卫气相乱，
阴阳相逆。其于胀也，当泻而不泻，故气不下。必更其道，气下乃止，不下复起，可以万
全，恶有殆者乎。其于胀也，必审其诊，当泻则泻，当补则补，如鼓之应桴，恶有不下者乎
。
心胀者，心俞主之，亦取列缺。肺胀者，肺俞主之，亦取太渊。肝胀者，肝俞主之，亦
取太冲。脾胀者，脾俞主之，亦取太白。肾胀者，肾俞主之，亦取太溪。胃胀者，中脘主之
，亦取章门。大肠胀者，天枢主之。小肠胀者，中 主之。膀胱胀者，曲骨主之。三焦
胀者，石门主之。胆胀者，阳陵泉主之。五脏六腑之胀，皆取三里。三里者，胀之要穴也。
黄帝问道：脉象在寸口部的表现，如何判断是否发生胀病？岐伯回答说：脉象盛大、坚实、挺直且涩滞的，是胀病。黄帝问：怎样知道是哪个脏腑发生了胀病呢？岐伯说：阴经主脏，阳经主腑。黄帝问：导致人发生胀病的气，是在血脉之中，还是在脏腑之内呢？岐伯说：两者都涉及，但这并不是胀病的居所（根本所在）。黄帝说：我想听听胀病的居所在哪里？岐伯说：胀病，都在脏腑之外，排挤脏腑，扩张胸胁，使皮肤胀起，所以命名为胀。黄帝问：脏腑位于体内，就像匣子和柜子里收藏着珍贵的器物一样，各有固定的位置，名称不同但处于同一区域中，它们的气各不相同，我想听听其中的缘故？岐伯说：胸腹，是脏腑的外郭城墙。膻中，是心主的内宫。胃，是太仓（储存粮食的地方）。咽喉和少腹，是传导通道。胃的五窍，是里巷的门户。廉泉和玉英，是津液运行的道路。因此五脏六腑，各有边界，它们的病变也各有不同的形态。营气循行于脉中，卫气逆乱则导致脉胀；卫气与血脉并行，循行于分肉之间，则导致肤胀（《灵枢》记载为：营气循行于脉中导致脉胀，卫气与脉并行循行于分肉之间导致肤胀）。治疗时取足三里穴进行泻法，病程短的一针见效，病程长的三针见效，不论虚实，关键在于迅速泻邪。黄帝问：我想听听各种胀病的症状表现？岐伯说：心胀，表现为心烦、气短、睡眠不安。肺胀，表现为胸部虚满、气喘咳嗽。肝胀，表现为胁下胀满疼痛，并牵引至小腹。脾胀，表现为呃逆、四肢沉重困倦、身体沉重不能穿衣物。肾胀，表现为腹部胀满牵引背部不适、腰部和大腿疼痛。胃胀，表现为腹部胀满、胃脘疼痛、鼻闻焦臭味、饮食受阻、大便困难。大肠胀，表现为肠鸣且痛声濯濯，冬天再次受寒则泄泻完谷不化。小肠胀，表现为小腹胀满，牵引腰部疼痛。膀胱胀，表现为小腹胀满、小便不通畅。三焦胀，表现为气充满于皮肤之中，膨隆如鼓壳但不坚硬。胆胀，表现为胁下疼痛胀满、口苦、喜欢长叹气。凡是这些胀病，其治疗原则是一致的，只要明辨气的逆顺，针刺的次数就不会失误。对于虚证用补法，实证用泻法，如果操作不当导致神气离去，就会招致邪气、丧失正气，真气无法安定，这是粗劣医生造成的败坏，称之为夭折命运。如果是补虚泻实，神气回归本位，长久地充实空虚之处，这就称为良医。黄帝问：胀病是怎么产生的，因何而得名？岐伯说：卫气在人身中，常伴随血脉循行于分肉之间，运行有逆有顺，阴阳相随，才能顺应自然和谐，五脏功能正常，四时秩序井然，五谷得以消化。然而如果厥气在下，营卫之气停留停止，寒气逆上，真气与邪气相互攻伐，两气相搏结，于是形成胀病。黄帝问：怎样才能解除疑惑？岐伯说：结合真气的运行规律，综合三个方面就能明白。黄帝问：前面说“不论虚实，关键在于迅速泻邪，近者一针，远者三针”，现在用了三针却无效，过错在哪里？岐伯说：这是因为针刺陷于肌肉间的脂膜而未能准确刺中气穴。如果没有刺中气穴，气就会在内闭藏；如果没有陷入肓膜，气就不能运行；如果气向上溢出或停留在肌肉中，就会导致卫气紊乱，阴阳逆乱。对于胀病，应当泻而不泻，所以气不能下行。必须改变方法，气下行后才停止，如果气不下行就反复尝试，可以达到万全，哪里有危险的呢？对于胀病，必须仔细诊察，应当泻的就泻，应当补的就补，就像鼓槌敲击鼓面立刻响应一样，哪有气不下行的呢？
心胀，以心俞穴为主治穴位，也可取列缺穴。肺胀，以肺俞穴为主治穴位，也可取太渊穴。肝胀，以肝俞穴为主治穴位，也可取太冲穴。脾胀，以脾俞穴为主治穴位，也可取太白穴。肾胀，以肾俞穴为主治穴位，也可取太溪穴。胃胀，以中脘穴为主治穴位，也可取章门穴。大肠胀，以天枢穴为主治穴位。小肠胀，以中髎穴为主治穴位。膀胱胀，以曲骨穴为主治穴位。三焦胀，以石门穴为主治穴位。胆胀，以阳陵泉穴为主治穴位。五脏六腑的胀病，都可取足三里穴。足三里，是治疗胀病的关键穴位。
Huangdi asked: How do the pulses at the Cun Kou (Inch Port) position indicate distension? Qibo replied: When the pulse is large, firm, straight, and choppy, it indicates distension. Huangdi asked: How can one know which Zang or Fu organ is affected by distension? Qibo said: The Yin meridians correspond to the Zang organs, and the Yang meridians correspond to the Fu organs. Huangdi asked: Does the Qi that causes distension reside within the blood vessels, or inside the Zang and Fu organs? Qibo said: It involves both, but this is not the abode of distension. Huangdi said: I wish to hear about the abode of distension. Qibo said: Distension occurs outside the Zang and Fu organs, pushing against them, expanding the chest and hypochondrium, and causing the skin to swell; hence it is named "distension." Huangdi asked: The Zang and Fu organs are located internally, like precious vessels stored in boxes and cabinets, each having its specific place, different names but residing in the same region, with distinct Qi. I wish to understand the reason behind this. Qibo said: The chest and abdomen are the city walls for the Zang and Fu organs. Danzhong (Conception Vessel 17) is the inner palace of the Heart Master. The Stomach is the Great Granary. The pharynx and lower abdomen are the passages for transmission. The five orifices of the Stomach are the gates of the neighborhoods. Lianquan (Conception Vessel 23) and Yuying are the pathways for body fluids. Therefore, the Five Zang and Six Fu organs have their boundaries, and their diseases present with distinct shapes. Ying Qi (Nutritive Qi) circulates within the vessels; when Wei Qi (Defensive Qi) rebels, it causes Mai Zhang (Vessel Distension). When Wei Qi moves along with the blood vessels through the muscle intervals, it causes Fu Zhang (Skin Distension). Treatment involves reducing the Zusanli (Stomach 36) point. For recent onset, one application suffices; for long-standing cases, three applications suffice. Regardless of deficiency or excess, the skill lies in rapid reduction. Huangdi asked: I wish to hear the manifestations of various distensions. Qibo said: Heart distension presents with vexation, shortness of breath, and restless sleep. Lung distension presents with empty fullness, wheezing, and coughing. Liver distension presents with fullness and pain under the hypochondrium radiating to the lower abdomen. Spleen distension presents with hiccups, heaviness and stuffiness in the four limbs, and a heavy body making it difficult to wear clothes. Kidney distension presents with abdominal fullness radiating to the back with a sense of discomfort, and pain in the waist and thighs. Stomach distension presents with abdominal fullness, epigastric pain, smelling burnt odors from the nose, difficulty eating, and constipation. Large Intestine distension presents with borborygmus and gurgling pain; if exposed to cold in winter, it leads to diarrhea with undigested food. Small Intestine distension presents with lower abdominal fullness radiating to the waist with pain. Bladder distension presents with lower abdominal fullness and urinary retention. Sanjiao (Triple Burner) distension presents with Qi filling the skin, bulging like a drumshell but not hard. Gallbladder distension presents with pain and fullness under the hypochondrium, bitter taste in the mouth, and frequent sighing. For all these types of distension, the principle is one: knowing the reversal and smooth flow ensures the number of needle insertions is accurate. Reducing deficiency and tonifying excess incorrectly causes Shen (Spirit) to leave its chamber, inviting pathogenic factors and losing righteousness, destabilizing the True Qi; this failure by crude practitioners is called premature death. Tonifying deficiency and reducing excess allows Shen to return to its chamber and fills the emptiness for a long time; this is called a skilled practitioner. Huangdi asked: How does distension arise, and why is it named so? Qibo said: Wei Qi on the body usually follows the vessels and circulates through the muscle intervals. Its movement has reversal and smoothness, with Yin and Yang following each other, achieving harmony with Heaven, regulating the Five Zang organs, ordering the Four Seasons, and digesting the Five Grains. However, if Jue Qi (Rebellious Qi) arises below, Ying and Wei Qi stagnate, Cold Qi rebels upward, True Qi and Pathogenic Qi attack each other, and the two Qi clash, forming distension. Huangdi asked: How can confusion be resolved? Qibo said: By aligning with True Qi and integrating three aspects, one can understand. Huangdi asked: You said "regardless of deficiency or excess, the skill lies in rapid reduction, one for recent, three for distant." Now, if three applications fail to work, where is the error? Qibo said: This refers to needling sinking into the muscular adipose tissue without hitting the Qi acupoint. If the Qi acupoint is not hit, Qi becomes internally blocked; if it does not sink into the Huang (membranous) layer, Qi cannot move; if Qi floats upward or stays in the flesh, Wei Qi becomes chaotic, and Yin and Yang reverse. In cases of distension, if reduction should be performed but is not, Qi will not descend. One must change the approach; stop when Qi descends. If Qi does not descend, repeat until it does, ensuring safety and avoiding danger. In treating distension, one must carefully diagnose: reduce when appropriate, tonify when appropriate, just as a drum responds instantly to the beat. How could Qi fail to descend?
For Heart distension, Xinshu (Bladder 15) is the primary point, also taking Lieque (Lung 7). For Lung distension, Feishu (Bladder 13) is the primary point, also taking Taiyuan (Lung 9). For Liver distension, Ganshu (Bladder 18) is the primary point, also taking Taichong (Liver 3). For Spleen distension, Pishu (Bladder 20) is the primary point, also taking Taibai (Spleen 3). For Kidney distension, Shenshu (Bladder 23) is the primary point, also taking Taixi (Kidney 3). For Stomach distension, Zhongwan (Conception Vessel 12) is the primary point, also taking Zhangmen (Liver 13). For Large Intestine distension, Tianshu (Stomach 25) is the primary point. For Small Intestine distension, Zhongliao (Bladder 32) is the primary point. For Bladder distension, Qugu (Conception Vessel 2) is the primary point. For Sanjiao distension, Shimen (Conception Vessel 6) is the primary point. For Gallbladder distension, Yanglingquan (Gallbladder 34) is the primary point. For distension of the Five Zang and Six Fu organs, Zusanli (Stomach 36) is taken. Zusanli is the key acupoint for treating distension.