尝观铜人内景诸图。脐在腹中。胃居脐上。肠居脐下。其中行直行者。任脉也。次于任脉者。足少阴。次于少
阴者。足阳明。阳明之旁。足厥阴也。厥阴之旁。足太阴也。若少阳则行于侧。太阳则行于背矣。然其分属脏
腑者。又与脉行异。如胸膈之上。心肺之部也。胁肋之间。肝胆之部也。脐上属胃。脐下属肠。大腹属太阴。脐
腹属少阴。少腹属厥阴。冲任在于中央。肾部主乎季胁。以及左胁属肝。右 属脾。皆诊家所宜究心者。由
是而观。则上下左右不同。前后中外亦异。按其经络。分其部位。而病症之殊。治疗之辨。亦有确可凭者。如
腹大支满。或上肢两胁者。属胃。胁下胀痛。善太息。口苦者。属胆。腹气满。少腹尤坚者。属三焦。少腹偏肿而
痛者。属膀胱。少腹 胀。引腰而痛者。属小肠。肠鸣而痛。飧泄不化者。属大肠。 胀经溲不利者。为脾。喘而
两满者。为肺。腹满引腰背者。为肾。胁下满而痛。引小腹者。为肝。小腹满大。上走胃至心者。足厥阴。腹满
大便不利。上走胸嗌者。足少阴。厥而腹满。响响然者。足太阴。是皆部位上下之分。脏腑经络之辨也。析而
言之。脏病为积。腑病为聚。积终不移。聚则转移。居脐上为逆。居脐下为从。皮浓色苍者。皆属气。皮薄色泽
者。皆属水。肿起者。为实。陷下者。为虚。腹肿胀者。病气有余。腹消减者。形气不足。腹满按之痛者。为实。按之
不痛者。为虚。腹满时减。复如故者。为寒。腹满不减。且燥实者。为热。新积痛可移者。易已。积不痛不可移者。
难已。腹胀心窝未满者。可治。心窝已满者。不可治。缺盆未平者。可治。缺盆已平者。不可治。筋未青。涨高起
者。可治。筋已青。涨高起者。不可治。从上肿下者。属气。其邪在外。从下肿上者。属水。其邪在内。男从身上肿
下。女从身下肿上者。易治。男从身下肿上。女从身上肿下者。难治。先起于腹。而后散于四肢者。可治。先起
于四肢。而后归于腹者。难治。旋消旋减者。正胜邪。为可治。旋消旋起者。正不胜邪。为不可治。石水起脐以
下至小腹。 然。上至胃脘者。死不治。久病腹皮甲错。着于背而成深凹者。肠胃干瘪。亦死不治。是皆诊
腹之要也。至若按其腹。 而不起。腹色不变。为肤胀。随手而起。如囊裹水之状。为水胀。肿聚往来上下。为
蛔胀。弹之而声空者。是气。弹之而声实者。是水。妇人腹皮宽大者。子多。紧急者。子少。妊娠腹形如箕者。是
男。腹形如釜者。是女。男胎腹硬。女胎腹软。如覆杯者则男。如肘头参差起者。则女。冷者为死。温者为生。若
是双躯。令人摸之。冷在何面。则知死在何处。凡诸诊候。能参合而行之。皆确有可凭者焉。
我曾经观察过《铜人内景图》等解剖图示。肚脐位于腹部中央。胃位于肚脐上方。肠位于肚脐下方。其中沿身体正中线直行的经脉，是任脉。紧挨着任脉的是足少阴肾经。紧挨着足少阴肾经的是足阳明胃经。在足阳明胃经的旁边，是足厥阴肝经。在足厥阴肝经的旁边，是足太阴脾经。至于足少阳胆经则行于身体侧面，足太阳膀胱经则行于背部。
然而，这些经络所属的脏腑部位，又与经络循行的路线有所不同。例如胸膈以上，是心和肺的部位。胁肋之间，是肝和胆的部位。肚脐以上属于胃。肚脐以下属于肠。大腹（下腹部）属于太阴（脾）。脐腹（脐周）属于少阴（肾）。小腹（下腹两侧）属于厥阴（肝）。冲脉和任脉位于中央。肾的部位主要对应季胁（侧胸部肋骨末端）。以及左侧胁部属于肝，右侧胁部属于脾。这些都是诊察医生应当深入研究的要点。
由此看来，上下左右各不相同，前后内外也有差异。通过按摸经络、区分部位，病症的差异和治疗的区别，就有确实可以依据的标准了。例如：腹部胀大且支撑满闷，或者上肢及两胁不适的，属于胃病。胁下胀痛，喜欢叹气，口苦的，属于胆病。腹部气机壅满，小腹部尤其坚硬的，属于三焦病变。小腹部偏侧肿胀而疼痛的，属于膀胱病变。小腹胀满，牵引腰部疼痛的，属于小肠病变。肠鸣且疼痛，完谷不化（腹泻中有未消化食物）的，属于大肠病变。腹部胀满且小便不利的，属于脾病。气喘且两胁胀满的，属于肺病。腹部胀满牵引腰背疼痛的，属于肾病。胁下胀满且疼痛，牵引小腹的，属于肝病。小腹部胀大，向上延伸至胃部和心窝的，属于足厥阴肝经病变。腹部胀满且大便不通利，向上延伸至胸部和咽喉的，属于足少阴肾经病变。四肢厥冷且腹部胀满，发出响响声音的，属于足太阴脾经病变。这些都是根据部位上下、脏腑经络进行的辨析。
进一步分析而言，脏病表现为“积”，腑病表现为“聚”。“积”始终不移位，“聚”则会转移位置。病位在脐上为逆证，病位在脐下为顺证。皮肤厚颜色青暗的，多属于气滞；皮肤薄颜色润泽的，多属于水湿。肿起高突的，属于实证；凹陷下去的，属于虚证。腹部肿胀的，是病气有余；腹部消瘦减小的，是形气不足。腹部胀满且按压疼痛的，属于实证；按压不疼痛的，属于虚证。腹部胀满时而减轻，过后又像原来一样的，属于寒证；腹部胀满不减轻，且干燥坚实的，属于热证。新形成的积块，疼痛可移动的，容易治愈；积块不痛且不可移动的，难以治愈。腹部胀满但心窝部未满的，可治；心窝部已满的，不可治。缺盆（锁骨上窝）未平陷的，可治；缺盆已平陷的，不可治。筋脉未显露青色，虽然胀高起的，可治；筋脉已显露青色，且胀高起的，不可治。从上往下肿的，属于气邪，其邪气在外；从下往上肿的，属于水邪，其邪气在内。男性从身上肿向下的，女性从身下肿向上的，容易治疗；男性从身下肿向上的，女性从身上肿向下的，难治。先起于腹部，而后散在于四肢的，可治；先起于四肢，而后归于腹部的，难治。肿胀消退的同时病情减轻的，是正气战胜邪气，为可治；肿胀刚消退又重新起来的，是正气不胜邪气，为不可治。石水病起于脐下直至小腹，坚硬如石，向上延伸至胃脘部的，死症，无法治疗。久病导致腹部皮肤像铠甲一样粗糙开裂，紧贴背部形成深凹的，说明肠胃干瘪，也是死症，无法治疗。这些都是诊察腹部的关键要点。
至于按摸腹部，如果凹陷不起，腹部颜色不变，这是肤胀；随手按之即起，像囊袋包裹水的样子，这是水胀。肿胀聚散往来上下移动，是蛔虫胀。弹击腹部声音空响的，是气胀；弹击腹部声音实浊的，是水胀。妇人腹部皮肤宽大的，胎儿多；腹部皮肤紧急的，胎儿少。妊娠时腹部形状像簸箕（尖底）的，是男胎；腹部形状像锅（圆底）的，是女胎。男胎腹部硬，女胎腹部软。腹部形状像倒扣的杯子（圆润饱满）的是男胎；腹部形状像手肘头参差不齐突起的是女胎。触之发冷的为死胎，温热的为生胎。如果是双胎，让人触摸，看哪一面冷，就知道哪个胎儿死亡。凡是各种诊候，能够综合参合而行，都有确实可以依据的地方。
I have observed anatomical diagrams such as the *Tongren Neijing Tu* (Bronze Man Internal Landscape Diagram). The umbilicus is located in the center of the abdomen. The Stomach resides above the umbilicus. The Intestines reside below the umbilicus. Among these, the meridian running straight along the midline is the Ren Mai (Conception Vessel). Adjacent to the Ren Mai is the Foot-Shaoyin Kidney Meridian. Adjacent to the Shaoyin is the Foot-Yangming Stomach Meridian. Beside the Yangming is the Foot-Jueyin Liver Meridian. Beside the Jueyin is the Foot-Taiyin Spleen Meridian. As for the Foot-Shaoyang Gallbladder Meridian, it runs on the lateral side; and the Foot-Taiyang Bladder Meridian runs on the back.
However, the zang-fu organs associated with these meridians differ from the meridian pathways. For instance, the area above the chest and diaphragm belongs to the Heart and Lungs. The hypochondriac region belongs to the Liver and Gallbladder. The area above the umbilicus belongs to the Stomach. The area below the umbilicus belongs to the Intestines. The lower abdomen (Da Fu) belongs to Taiyin (Spleen). The periumbilical area belongs to Shaoyin (Kidney). The lower lateral abdomen (Shao Fu) belongs to Jueyin (Liver). The Chong Mai (Penetrating Vessel) and Ren Mai are located centrally. The Kidney region corresponds mainly to the costal margin (Ji Xie). Furthermore, the left hypochondrium belongs to the Liver, and the right hypochondrium belongs to the Spleen. These are all points that practitioners should study carefully.
From this perspective, the upper and lower, left and right are distinct, and the anterior and posterior, interior and exterior also differ. By palpating the meridians and distinguishing the regions, the differences in symptoms and the distinctions in treatment can be reliably determined. For example: Abdominal distension with a feeling of fullness and support, or discomfort extending to the upper limbs and hypochondrium, belongs to the Stomach. Distending pain in the hypochondrium, frequent sighing, and bitter taste belong to the Gallbladder. Abdominal Qi stagnation with fullness, especially hardness in the lower abdomen, belongs to the Sanjiao (Triple Burner). Unilateral swelling and pain in the lower abdomen belongs to the Bladder. Lower abdominal distension radiating to the lower back belongs to the Small Intestine. Borborygmus with pain and undigested food in stool (Sun Xie) belongs to the Large Intestine. Abdominal distension with difficult urination belongs to the Spleen. Panting with bilateral hypochondriac fullness belongs to the Lung. Abdominal fullness radiating to the lower back belongs to the Kidney. Fullness and pain in the hypochondrium radiating to the lower abdomen belongs to the Liver. Lower abdominal fullness and enlargement, extending upward to the stomach and heart region, belongs to the Foot-Jueyin Liver Meridian. Abdominal fullness with difficulty in defecation, extending upward to the chest and throat, belongs to the Foot-Shaoyin Kidney Meridian. Cold extremities with abdominal fullness and resonant sounds belong to the Foot-Taiyin Spleen Meridian. These are all distinctions based on upper/lower locations and zang-fu/meridian differentiation.
Analyzing further: Zang diseases manifest as "Ji" (accumulations), while Fu diseases manifest as "Ju" (gatherings). "Ji" remains fixed in place, whereas "Ju" moves. A condition located above the umbilicus is considered "Ni" (adverse/rebellious), while one below the umbilicus is "Cong" (favorable/compliant). Thick skin with dark color indicates Qi stagnation; thin skin with lustrous color indicates Water-Dampness. Swelling that protrudes indicates Excess; sinking/caving in indicates Deficiency. Abdominal swelling indicates excess pathogenic Qi; abdominal emaciation indicates deficiency of Form and Qi. Abdominal fullness with tenderness upon pressure indicates Excess; lack of tenderness indicates Deficiency. Abdominal fullness that decreases intermittently but returns to normal indicates Cold; abdominal fullness that does not decrease and is dry/hard indicates Heat. New accumulations that are painful and movable are easy to cure; accumulations that are painless and immovable are difficult to cure. Abdominal distension without fullness in the epigastrium is treatable; fullness in the epigastrium is untreatable. Supraclavicular fossae (Que Pen) that are not flattened are treatable; those that are flattened are untreatable. Veins that are not cyanotic, even if swollen and raised, are treatable; veins that are cyanotic and swollen/raised are untreatable. Swelling descending from top to bottom indicates Qi pathogen, external in nature; swelling ascending from bottom to top indicates Water pathogen, internal in nature. In men, swelling descending from the upper body is easy to treat; in women, swelling ascending from the lower body is easy to treat. In men, swelling ascending from the lower body is difficult to treat; in women, swelling descending from the upper body is difficult to treat. Edema starting in the abdomen and spreading to the limbs is treatable; edema starting in the limbs and returning to the abdomen is difficult to treat. Rapid reduction of swelling accompanied by symptom relief indicates Righteous Qi overcoming Pathogenic Qi, which is treatable. Rapid disappearance followed by recurrence indicates Righteous Qi failing to overcome Pathogenic Qi, which is untreatable. Shi Shui (Stone Water) starting below the umbilicus to the lower abdomen, hard as stone, extending upward to the epigastrium, is a fatal condition, untreatable. Chronic disease causing abdominal skin to become rough like armor (Jia Cuo), adhering to the back forming deep depressions, indicates atrophy of the intestines and stomach, also a fatal condition, untreatable. These are the essentials of abdominal diagnosis.
Regarding palpation: If depression persists after pressing and abdominal color does not change, it is Fu Zhang (Skin Distension); if it rises immediately upon release, resembling a water-filled bag, it is Shui Zhang (Water Distension). Swelling that gathers and disperses, moving up and down, is Hui Zhang (Roundworm Distension). An empty sound upon tapping indicates Qi; a solid/dull sound indicates Water. In pregnant women, loose abdominal skin indicates many fetuses; tight abdominal skin indicates few fetuses. A uterus shaped like a winnowing basket (pointed bottom) indicates a male fetus; a uterus shaped like a pot (round bottom) indicates a female fetus. Male fetuses result in a hard abdomen; female fetuses result in a soft abdomen. A shape like an inverted cup indicates a male; a shape with irregular protrusions like elbows indicates a female. Cold to touch indicates death; warm indicates life. If twins are present, touching reveals which side is cold, indicating where death has occurred. All such diagnostic signs, when combined and applied together, provide reliable basis for judgment.