1.卫气并脉循分肉, 内伤外感正邪攻, 外邪客脉为脉胀, 邪留分肉
肤胀生.
【注】经曰: 卫气之在身也, 常然并脉循分肉行, 阴阳相随, 何病之
有?若其人内伤七情, 外感六气, 饮食失节, 劳役过度, 则邪正相攻
,荣卫失和. 卫气与风寒之邪客于脉中, 则为脉胀. 卫气与风寒之邪
留于分肉, 则为肤胀也.
2.脉胀筋起络色变, 久成单腹末脱清, 肤胀???? 初不硬, 缠绵气鼓
胀膨膨.
【注】脉胀之证, 腹筋起, 络色变, 久而不巳, 则成单腹胀, 四末脱
瘦清冷也. 肤胀之证???? 然初不坚硬, 缠绵不愈, 则成气鼓胀满,
膨膨急硬也.
3.外邪干卫客肠外, 肠覃月事以时行, 外邪干营客胞内, 石瘕经闭
状妊盈.
【注】风寒之邪, 不客于脉中分肉, 而干卫气, 深入客于肠外, 僻而
内着, 日以益大, 状如怀子, 月事仍以时行, 名曰肠覃. 或干营气,
深入客于胞中, 恶血留止, 日以益大, 状如怀子, 月事不以时下, 名
曰石瘕, 此皆生于女子, 在男子则为疝病也.
4.皮厚色苍多是气, 皮薄色泽水湿成, 气速安卧从上下, 水渐难眠
咳喘征, 石水少腹肿不喘, 风水面肿胫足同, 石水阴邪寒水结, 风水
阳邪热湿凝.
【注】凡肿胀之病, 皮厚色苍者, 皆属气也. 皮薄色泽者, 皆属水也
.气, 阳也, 阳性急, 故为胀速, 每从上肿而渐下, 得以安卧, 邪在
外也. 水, 阴也, 阴性迟, 故为胀渐, 每从下肿而渐上, 更有咳喘不
能卧之征也. 石水之征, 少腹肿满, 水在下, 故不喘也. 上肿曰风,
下肿曰水. 故风水之证, 面与胫足同肿也. 然石水属阴邪, 故曰寒结
也.风水属阳邪, 故曰热湿凝也.
1. 卫气（运行于脉外、具有防御功能的气）沿着经脉在肌肉间隙中运行，体内受伤或外部感受邪气时，正气与邪气相互攻伐。如果外邪侵入经脉，就会形成脉胀；如果邪气停留在肌肉间隙，就会形成肤胀。
【注】《内经》说：卫气存在于身体中，通常伴随着经脉在肌肉间隙中运行，阴阳相互跟随，怎么会生病呢？如果一个人内伤于七情（喜、怒、忧、思、悲、恐、惊），外感于六气（风、寒、暑、湿、燥、火），饮食失去节制，劳役过度，那么邪气与正气相互攻伐，营气（行于脉中、具有营养作用的气）和卫气失去和谐。卫气与风寒之邪客居于脉中，就形成脉胀。卫气与风寒之邪留滞于肌肉间隙，就形成肤胀。
2. 脉胀的症状是腹部筋脉凸起，络脉颜色改变，日久不愈，最终形成单腹胀（腹部一侧或整体肿胀而四肢消瘦），四肢末端脱瘦且清冷。肤胀的症状起初皮肉柔软不坚硬，病情缠绵难愈，最终形成气鼓（以气滞为主的腹胀），腹部膨隆急硬。
【注】脉胀这一病症，表现为腹壁筋脉凸起，络脉颜色改变，时间久了不痊愈，就会变成单腹胀，四肢末端消瘦清冷。肤胀这一病症，起初皮肉柔软不坚硬，病情缠绵不愈，就会变成气鼓胀满，腹部膨隆急硬。
3. 外邪侵犯卫气，客居在肠管之外，导致肠覃（一种生于肠外的肿块），月经仍然按时来潮。外邪侵犯营气，客居在子宫之内，导致石瘕（一种生于胞宫的肿块），闭经，身体状态像怀孕一样充盈。
【注】风寒之邪，不客居于脉中和肌肉间隙，而是侵犯卫气，深入客居于肠管之外，偏侧附着在内，每天逐渐增大，形状像怀着孩子，月经仍然按时来潮，名叫肠覃。或者侵犯营气，深入客居于胞宫之中，恶血停留停止，每天逐渐增大，形状像怀着孩子，月经不按时来潮，名叫石瘕，这些病都发生在女子身上，在男子身上则称为疝病。
4. 皮肤厚、颜色青苍的多属于气滞，皮肤薄、色泽润泽的多属于水湿停聚。气滞引起的肿胀发展迅速，患者能安卧，肿胀多从上往下蔓延；水湿引起的肿胀发展缓慢，患者难以安卧，伴有咳嗽气喘的症状。石水的特征是少腹肿胀但不气喘，风水的特征是面部和胫足同时浮肿。石水是阴邪，由寒水凝结而成；风水是阳邪，由热湿凝滞而成。
【注】凡是肿胀的病证，皮肤厚、颜色青苍的，都属于气病。皮肤薄、色泽润泽的，都属于水病。气，属阳，阳性急躁，所以气胀发展迅速，往往从上部开始肿胀逐渐向下蔓延，患者能够安卧，因为邪气在外表。水，属阴，阴性迟缓，所以水胀发展缓慢，往往从下部开始肿胀逐渐向上蔓延，更有咳嗽气喘不能平卧的症状。石水的征象是少腹肿胀满闷，因为水在下部，所以不气喘。上部肿胀叫风，下部肿胀叫水。所以风水的证候，面部和小腿足部同时浮肿。然而石水属于阴邪，所以说它是寒结。风水属于阳邪，所以说它是热湿凝滞。
1. Wei Qi (defensive qi circulating outside the vessels) follows the meridians and circulates within the muscle spaces. Internal injury or external invasion of pathogens leads to the conflict between righteous Qi (healthy energy) and pathogenic factors. If external pathogens invade the vessels, Mai Zhang (vessel distension) occurs; if pathogens remain in the muscle spaces, Fu Zhang (skin distension) arises.
[Note] The Classic states: "Wei Qi exists in the body, usually accompanying the meridians and circulating within the muscle spaces, with Yin and Yang following each other; how could disease occur?" If a person suffers internal injury from the Seven Emotions (joy, anger, worry, thought, grief, fear, fright), external invasion by the Six Qi (wind, cold, summer-heat, dampness, dryness, fire), irregular diet, or excessive labor, then pathogens and righteous Qi conflict, causing Ying Qi (nutritive qi circulating inside the vessels) and Wei Qi to lose harmony. When Wei Qi and wind-cold pathogens reside in the vessels, it forms Mai Zhang. When Wei Qi and wind-cold pathogens remain in the muscle spaces, it forms Fu Zhang.
2. Symptoms of Mai Zhang include protruding abdominal veins and discoloration of collateral vessels. If prolonged and untreated, it develops into Dan Fu Zhang (abdominal distension with thin extremities), where the four limbs become emaciated and cold. Symptoms of Fu Zhang initially present as soft skin without hardness. If chronic and unhealed, it evolves into Qi Gu (distension due to qi stagnation), characterized by a distended, urgent, and hard abdomen.
[Note] In the syndrome of Mai Zhang, abdominal tendons protrude, and collateral colors change. If not cured over time, it becomes Dan Fu Zhang, with emaciated and cold extremities. In the syndrome of Fu Zhang, the flesh is initially soft and not hard. If chronic and unhealed, it becomes Qi Gu with fullness, presenting as a distended, urgent, and hard abdomen.
3. External pathogens interfere with Wei Qi and reside outside the intestines, causing Chang Tan (a mass growing outside the intestines), while menstruation continues regularly. External pathogens interfere with Ying Qi and reside inside the uterus, causing Shi Xia (a mass growing in the uterus), amenorrhea, and a body shape resembling pregnancy.
[Note] Wind-cold pathogens do not reside in the vessels or muscle spaces but interfere with Wei Qi, penetrating deeply to reside outside the intestines. They attach internally, increasing daily in size, resembling pregnancy, yet menstruation proceeds on schedule; this is named Chang Tan. Or, they interfere with Ying Qi, penetrating deeply to reside in the uterus. Evil blood remains stagnant, increasing daily in size, resembling pregnancy, yet menstruation is delayed; this is named Shi Xia. These conditions occur in women; in men, they are referred to as Shan Bing (hernia diseases).
4. Thick skin with a bluish-green complexion indicates Qi stagnation; thin skin with a lustrous complexion indicates Water-Dampness retention. Distension caused by Qi progresses rapidly; patients can lie comfortably, and swelling typically spreads from top to bottom. Distension caused by Water progresses slowly; patients suffer from insomnia, cough, and asthma. Shi Shui (stone water) presents with lower abdominal swelling but no asthma. Feng Shui (wind water) presents with simultaneous edema of the face and lower legs/feet. Shi Shui is a Yin pathogen formed by the congealing of cold water; Feng Shui is a Yang pathogen formed by the coagulation of heat and dampness.
[Note] In all swelling diseases, thick skin with a bluish-green color belongs to Qi disorders. Thin skin with a lustrous color belongs to Water disorders. Qi is Yang; its nature is rapid, so Qi distension develops quickly, often starting from the upper body and spreading downward, allowing the patient to lie down comfortably, as the pathogen is exterior. Water is Yin; its nature is slow, so Water distension develops gradually, often starting from the lower body and spreading upward, accompanied by signs such as cough, asthma, and inability to lie flat. The sign of Shi Shui is lower abdominal swelling and fullness; because the water is below, there is no asthma. Swelling above is called Wind; swelling below is called Water. Therefore, in Feng Shui, both the face and the shanks/feet swell simultaneously. However, Shi Shui belongs to Yin pathogens, hence described as Cold Congealment. Feng Shui belongs to Yang pathogens, hence described as Heat-Dampness Coagulation.