黄帝问曰∶水与肤胀、鼓胀、肠覃、石瘕，何以别之？岐伯对曰∶水之始起也，目窠上
微肿，如新卧起之状，颈脉动，时咳，阴股间寒，足胫肿，腹乃大。其水已成也，以手按
其腹，随手而起，如裹水之状，此其候也。肤胀者，寒气客于皮肤之间，壳壳然不坚，腹大
，身尽肿，皮肤浓，按其腹，腹陷而不起，腹色不变，此其候也。鼓胀者，腹身皆肿大
如肤胀等，其色苍黄，腹筋（一本作脉）起，此其候也。肠覃者，寒气客于肠外，与卫气相搏
，正气不得营，因有所系，瘕而内着，恶气乃起，息肉乃生。其始生也，大如鸡卵，稍以益
大。至其成也，如杯子状，久者离岁月，按之则坚，推之则移，月事时下，此其候也。石瘕
者，生于胞中，寒气客于子门，子门闭塞，气不通，恶血当泻不泻，血 乃留止，日以
益大，状如杯子，月事不以时下，皆生于女子，可导而下之。曰∶肤胀鼓胀可刺耶？曰∶先
刺其腹之血络，后调其经，亦刺去其血脉。曰∶有病心腹满，旦食则不能暮食，此为何病？
曰∶此名为鼓胀，治之以鸡矢醴，一剂知，二剂已。曰∶其时有复发者何也？曰∶此食饮不
节。故时有病也。虽然其病且已，因当风气聚于腹也。
风水肤胀为五十九刺（《灵枢》作五十七刺），取皮肤之血者，尽取之。徒水，先取环谷
下三寸，以 针刺之而藏之，引而内之，入而复出，以尽其水，必坚束之，束缓则烦闷，束
急则安静。间日一刺之，水尽乃止。饮则闭药，方刺之时徒饮之，方饮无食，方食无饮，无
食他食，百三十五日。
水肿，人中尽满，唇反者死，水沟主之。水肿大脐平，灸脐中，无理
不治。水肿，水气行皮中，阴交主之。水肿腹大，水胀，水气行皮中，石门主之。石水痛
引胁下胀，头眩痛，身尽热，关元主之。振寒大腹石水，四满主之。石水，刺气冲，石水，
章门及然谷主之。石水，天泉主之。腹中气盛，腹胀逆（《千金》作水胀逆），不得卧，阴陵
泉主之。水中留饮，胸胁支满，刺陷谷，出血，立已。水肿胀皮肿，三里主之。胞中有大
疝瘕积聚，与阴相引而痛，苦涌泄上下出，补尺泽、太溪，手阳明寸口皆补之。
黄帝问道：水气病、肤胀、鼓胀、肠覃、石瘕，这几种病症如何鉴别？岐伯回答说：水气病刚开始发生时，眼睑下方微微肿胀，像刚睡醒时的样子，颈部人迎脉搏动，时常咳嗽，大腿内侧感觉寒冷，小腿浮肿，随后腹部才变大。当水气病已经形成时，用手按压腹部，手松开后腹部立即弹起，像包裹着水的状态，这就是它的征候。
肤胀，是寒气停留在皮肤之间，腹部膨隆但按之不坚实，全身都浮肿，皮肤增厚，用手按压腹部，凹陷不能立刻恢复，腹部颜色没有变化，这就是它的征候。
鼓胀，腹部和身体都像肤胀一样肿大，肤色苍黄，腹部的青筋（脉络）显露，这就是它的征候。
肠覃，是寒气停留在肠道外面，与卫气相互搏结，正气不能正常营运，因而有所依附，形成积块并附着在内，恶气于是产生，息肉随之生成。它刚开始发生时，大小如鸡蛋，逐渐慢慢增大。等到长成时，形状像杯子，病程长的可达数年，用手按压则坚硬，推动它可以移动，月经仍能按时来潮，这就是它的征候。
石瘕，生于子宫之中，寒气停留在子门（子宫口），子门闭塞，气机不通，应当排出的恶血无法排出，血液便滞留停止，一天天逐渐增大，形状像杯子，月经不能按时来潮，这些病症都发生在女子身上，可以用导引通下的方法治疗。
（有人）问：肤胀和鼓胀可以针刺吗？（岐伯）说：先针刺腹部的血络，然后调理经脉，也要刺去瘀阻的血脉。（有人）问：有心腹胀满的病，早上吃了饭晚上就不能再吃，这是什么病？（岐伯）说：这名叫鼓胀，用鸡矢醴治疗，服一剂见效，服两剂痊愈。（有人）问：为什么有时病情会复发呢？（岐伯）说：这是因为饮食不节制，所以时有发病。虽然病势暂时平息，但风气仍聚积在腹部。
风水和肤胀采用五十九刺法（《灵枢》中作五十七刺），取皮肤中的血络，全部刺之。对于只肿水而不伴其他症状的“徒水”，先取环谷穴下三寸处，用针针刺并留针，引导经气内入，进针后出针，以排尽积水，必须坚固地束扎患处，束扎松了就会烦闷，束扎紧了就会安静。每隔一天针刺一次，直到积水排尽为止。服药期间要闭药（指禁食特定食物或药物），针刺的时候只喝水，喝水的时候不吃东西，吃东西的时候不喝水，不吃其他食物，持续一百三十五天。
水肿患者，如果人中部位完全饱满，嘴唇外翻，这是死证，由水沟穴主治。水肿严重导致肚脐变平，灸脐中穴，若无理乱治则无法治愈。水肿，水气运行于皮肉之间，由阴交穴主治。水肿腹部肿大，水胀，水气运行于皮肉之间，由石门穴主治。石水疼痛牵引胁下且胀满，头晕头痛，全身发热，由关元穴主治。寒战、大腹石水，由四满穴主治。石水，针刺气冲穴；石水，由章门穴和然谷穴主治。石水，由天泉穴主治。腹中气盛，腹胀气逆（《千金方》作水胀逆），不能卧倒，由阴陵泉穴主治。水中留饮，胸胁支撑胀满，针刺陷谷穴并出血，症状立即停止。水肿胀满皮肤浮肿，由足三里穴主治。胞宫中有大疝瘕积聚，牵引阴部疼痛，痛苦表现为上下涌泄，补尺泽穴、太溪穴，手阳明大肠经的寸口脉也进行补法。
Huangdi asked: How can one differentiate between edema (Shui), distension of the skin (Fuzhang), drum-like distension (Guzhang), intestinal polyps (Changqin), and stone masses in the uterus (Shijia)? Qibo replied: When edema first begins, there is slight swelling above the eye sockets, resembling the appearance after just waking up; the pulse at the neck moves; there is occasional coughing; a sensation of coldness between the inner thighs; swelling of the calves; and subsequently, the abdomen becomes enlarged. Once the edema has fully formed, pressing the abdomen with the hand causes it to rise immediately upon release, resembling a state where water is wrapped inside; this is its clinical manifestation.
Distension of the skin (Fuzhang) occurs when cold qi lodges between the skin and flesh. The abdomen is distended but not firm to the touch; the entire body is swollen; the skin is thickened; pressing the abdomen leaves an indentation that does not rebound quickly; and the abdominal color remains unchanged; this is its clinical manifestation.
Drum-like distension (Guzhang) presents with abdominal and bodily swelling similar to Fuzhang, but the complexion is pale yellow, and the abdominal collateral vessels are prominent; this is its clinical manifestation.
Intestinal polyps (Changqin) occur when cold qi lodges outside the intestines and contends with Wei Qi (Defensive Qi). Zheng Qi (Upright Qi) fails to circulate properly, leading to attachment and formation of a mass within. Evil qi arises, and polyps grow. Initially, the mass is the size of a chicken egg and gradually enlarges. Upon full development, it resembles a cup. After many years, it feels hard to pressure but movable upon pushing; menstruation still occurs on time; this is its clinical manifestation.
Stone masses in the uterus (Shijia) originate in the Bao Zhong (uterus). Cold qi lodges at the Zi Men (cervical os), causing closure and obstruction of Qi flow. Evil blood that should be discharged is retained and stagnates, enlarging daily until it resembles a cup. Menstruation does not occur on time. These conditions occur only in women and can be treated by guiding and purging downward methods.
A question was posed: Can Fuzhang and Guzhang be treated with acupuncture? The answer was: First, puncture the blood collaterals in the abdomen, then regulate the meridians, and also puncture to remove stagnant blood. Another question arose: What disease is characterized by fullness in the heart and abdomen, where one cannot eat dinner if they ate breakfast? The answer was: This is called Guzhang. It is treated with Jishi Li (Chicken Excrement Fermented Liquid); improvement is seen after one dose, and recovery after two doses. Why does it sometimes recur? Because of irregular diet and drinking habits. Thus, the disease appears intermittently. Although the acute phase may subside, wind qi tends to accumulate in the abdomen.
For Feng Shui (Wind Edema) and Fuzhang, the "Fifty-Nine Acupoints" needling method (recorded as Fifty-Seven in *Ling Shu*) is used, targeting all visible blood collaterals in the skin. For pure water retention (Tu Shui) without other symptoms, first needle three cun below Huan Gu, retain the needle, guide the Qi inward, withdraw, and repeat to drain the water completely. The area must be tightly bound; loose binding causes irritability, while tight binding brings calmness. Needle every other day until the water is exhausted. During medication, observe dietary restrictions: during needling, drink only water; during drinking, do not eat; during eating, do not drink; avoid all other foods for 135 days.
If edema patients have complete fullness in the Ren Zhong (philtrum) and everted lips, it indicates a fatal prognosis; Shuigou (GV26) governs this condition. If edema is severe enough to flatten the umbilicus, moxibustion on Shenque (CV8) is indicated; improper treatment leads to incurability. For edema with water qi moving within the skin, Yinjiao (CV7) governs this. For edema with abdominal distension and water qi moving within the skin, Shimen (CV5) governs this. For Shi Shui (Stone Water) with pain radiating to the hypochondrium and distension, dizziness, headache, and generalized heat, Guanyuan (CV4) governs this. For chills and large abdominal Shi Shui, Siman (KI14) governs this. For Shi Shui, needle Qichong (ST30); Shi Shui is also governed by Zhangmen (LR13) and Ranggu (KI2); Shi Shui is also governed by Tianquan (HT2). For excessive Qi in the abdomen, abdominal distension with counterflow Qi (or water distension counterflow), and inability to lie down, Yinlingquan (SP9) governs this. For retained fluid in the water mechanism with chest and hypochondriac fullness and distension, needle Xangu (ST41) and bleed to achieve immediate relief. For edema with skin swelling, Zusanli (ST36) governs this. For large hernias, masses, and accumulations in the Bao Zhong (uterus) causing pain radiating to the Yin region, with distressing upward and downward discharge, tonize Chize (LU5) and Taixi (KI3); also apply tonification to the Cun Kou pulse of the Hand-Yangming Large Intestine Meridian.