腹中之气，不能从脐腹而行于胸膈，达于四肢，则为鼓胀肿痛之病。腹中之血不能从脐腹而内通
于胞中，外通于经络，则为血枯脓血之病。前节论腹中气血不和，则有腹中之病；后节论土气不和而
厥逆，经血不和而热甚，亦有腹中之病，故曰《腹中论》也。
黄帝问曰∶有病心腹满，旦食则不能暮食，此为何病？
心腹，心之下，腹之上也。满，胀满也。心腹胀满而不能食，外满内虚，此为何病？
岐伯对曰∶名为鼓胀。
外胀满而内不食，外劲内空，如按鼓革，故名为鼓胀。
帝曰∶治之奈何？
鼓胀之病，何以治之？
岐伯曰∶治之以鸡矢醴，一剂知，二剂已。
矢，屎通。鸡矢醴，以鸡屎和醴酒同服也。鸡属酉金，又主巽木，阳明燥金，济土之湿，东方
风木，伐土之顽；鸡无前阴，屎溺同窍。鼓胀则水气不行，治以鸡屎，使水湿从大便出也。醴者，熟
谷之液，见行皮毛，先充络脉，后谷而入，先谷而出，治之以醴，使足太阴脾土之气，合乎太阴肺主之
皮毛，从皮毛而行络脉，从络脉而通水道，使水湿从小便出也。一剂知，一剂则腹中和，二剂已，
二剂则腹膨潜消也。
帝曰∶其时有复发者，何也？
治以鸡屎醴，使水湿下行，则地土之气陷而不升，一周环转，土气虚而水复聚，故有复发之问。
岐伯曰∶此饮食不节，故时有病也，虽然其病且已时，故当病气聚于腹也。
此脾土气先虚，而饮食不节，故时有复发之病也。病虽复发，其腹满之病，且有已时，病已而土虚，
土虚而饮食不节，故当病气聚于腹而复发也。是知病已之后，饮食当慎择而有节也。
帝曰∶有病胸胁支满者，妨于食，病至则先闻腥臊臭，出清液，
先唾血，四肢清，目眩，时时前后血，病名为何，何以得之？
为，去声，下为何病之为俱同，承上文心腹满，不能暮食，而问有病胸胁支满，亦妨于食。胸者肺之
部，胁者肝之部，故病至则先闻肺臭之腥，肝臭之臊，肺病则出清液，肝病则先唾血，肺脉从
胸而行于手，肝脉从足而行于胁，肺肝皆病，故四肢清。肺主气，肝主血，气血皆虚，故目眩。肝主冲任之
血，不能热肉充肤，故时时前后血，病名为何？正其名也。何以得之？探其原也。
岐伯曰∶病名血枯，此得之年少时，有所大脱血，若醉入房中，气竭肝伤，故月事衰少不来也。
首少，去声。唾血便血，病名血枯，正其名也，此得之年少时有所大脱血，探其原也。男子脱血，若
醉入房中而阳气竭，气竭不能摄血矣。女子脱血，若肝伤，肝伤故月事衰少不来也，此气竭肝伤，
更为脱血之原也。
帝曰∶治之奈何？复以何术？
问治而求其术，欲多方以治也。
岐伯曰∶以四乌 骨一茹 ，二物并合之，丸以雀卵，大如小
豆，以五丸为后饭，欲以鲍鱼汁，利肠中，及伤肝也。
茹 ，旧本误 茹，今改。以，犹用也。乌 骨，乌贼鱼之骨也。鱼，水中生动之物， 鱼状若包
囊，腹中有墨，脊生一骨，轻脆空通，用四乌 骨，取水中生动之气，上通于肺而四布也。茹
名茜草，又名地血，色紫有汁，上通肝血，用一茹 ，取月事所生
之血，本于天一之癸水也。雀乃羽虫，主阳主气，入水为蛤，主阴主血。又卵白主气，卵黄主血，二物
并合，丸以雀卵，因气竭肝伤，补气补血也。小豆形园象土，五者土之数，气血由中土而化生，故
大如小豆，每用五丸也。后饭者，先药后饭，使药下行而以饭压之也。鲍鱼， 鱼也，味酸气臭，以鲍
鱼之汁，为饮送药，取其利肠中而下行，及伤肝而月事不来也。此论腹中血病，而明其治术也。
帝曰∶病有少腹盛，上下左右皆有根，此为何病？可治不？
不，作否。盛，犹满也。承上文心腹满，胸胁肢满，而问有少
腹盛满，致上下左右皆有根，此为何病？正其名也。可治否？求其治也。
岐伯曰∶病名曰伏梁。
如梁之横伏于下，故病名伏梁。
帝曰∶伏梁何因而得之？
何因得之，探其原也。
岐伯曰∶裹大脓血，居肠胃之外，不可治，治之每切按之，致死。
伏梁裹大脓血，而居空廓之间，肠胃之外，病形已成，故不可治，治之每急切而按摩之，必真气受伤，故致死。
帝曰∶何以然？
何以不可治，治之致死？
岐伯曰∶此下则因阴，必下脓血，上则迫胃脘，生膈侠胃脘内
痈，此久病也，难治。居齐上为逆，居齐下为从，勿动亟夺，论在刺法中。
齐，脐通，下同。因，犹根据也。动，犹用也。此肠胃之下，则根据于阴，每切按之而使下，必下脓血。每
切按之而使上，则迫近胃脘，当生膈侠胃脘之内痈。所谓不可治者，以此伏梁为久病而难治
也。伏梁者，如梁之横伏于下，故居脐上，为逆，若居脐下，为从，勿动亟夺，犹言勿用急切按摩以夺之，不
当亟夺而妄夺，必真气受伤而致死。论在本经《刺法》中，论其理也。
帝曰∶人有身体髀股 皆肿，环齐而痛，是为何病？
承上文心腹满，胸胁支满，少腹盛满，而问人有身体髀股 皆肿，环脐而痛，肿于外而痛于内，是为何病？
岐伯曰∶病名伏梁，此风根也，其气溢于大肠，而着于盲。盲之原，在齐下，故环齐而痛也，
不可动之；动之，为水溺涩之病。
溺，鸟去声。腹中之气，从脐腹而上行外达。今身体髀股 皆肿，真气不行于外关。环脐而痛，真
气不行于上关，为肿为痛，真气不行，病名伏梁，申明非裹大脓血之伏梁，此风动水涣，中土内
虚，因风而成，乃风根也。其风根之气，溢于大肠之外，而着于少腹之盲。《九针十二原》论云，盲之原出于
脖。是盲之原在脐下，故环脐而痛也。此病无形之气，亦不可妄攻以动之。若动之，则气
不化而水不行，当为水溺涩之病，此伏梁之在气分，不同于裹大脓血之伏梁也。
此一节，言腹中气血不和，而为腹中之病也。
帝曰∶夫子数言热中、消中，不可服高梁芳草石药，石药发癫，芳草发狂。夫热中、消中者，
皆富贵人也，今禁膏梁，是不合其心，禁芳草石药是病不愈，愿闻其说。
数，音朔。数，屡也。热中、消中，不可服膏梁芳草石药，石药发癫，芳草发狂，岐伯乃屡言之，帝
引以问，而言夫热中、消中者，精血内竭，火热消烁，皆富贵人之病也。富贵之人浓味自养。今禁膏梁，是
不合其心，富贵之人，土气壅滞，宜升散其上，镇重其下。今禁芳草石药，是病不愈，愿闻所以禁之之说。
岐伯曰∶夫芳草之气美，石药之气焊。二者，其气急疾坚劲，故非缓心和人，不可以服此二者。
芳草之气，香美而上散，石药之气 悍而下沉，是芳草之气急
疾，石药之气坚劲，故二者其气急疾坚劲，惟和缓之气可以化之，故非缓心和人，不可以服此二者。
帝曰∶不可以服此二者，何以然？
必欲详明不可服之义，故复问之。
岐伯曰∶夫热气 悍，药气亦然，二者相遇，恐内伤脾。脾者土也，而恶木，服此药者，
至甲乙日更论。
恶，去声。脾土之气，贵得其平。夫病热中、消中，乃热气 悍而然。今芳草石药，其气亦热而 悍，
以热气 悍之病，而遇热气 悍之药，二者相遇，亢害已极，恐内伤脾。盖脾者土也，而恶木
克，服此芳草石药之药者，恐有克贼之变，故至甲乙日更论，是脾土之气，贵乎和缓，芳草石药不宜服也。
帝曰∶善。有病膺肿颈痛，胸满腹胀，此为何痛？何以得之？
芳草石药恐内伤脾，不但热中消中不可服，脾土内虚亦不可服。帝故善之，复承身体髀股 皆肿，
环脐而痛之意，问有病膺肿颈痛，胸满腹胀者，此为何病？正其名也，何以得之？探其原也。
岐伯曰∶名厥逆。
膺肿颈痛，胸满腹胀，则表里阴阳之气不相顺接，故名厥逆。
帝曰∶治之奈何？
治厥逆奈何？
岐伯曰∶灸之则喑，石之则狂，须其气并乃可治之。
厥逆，则阴阳之气不相交并，若火灸以治之，则无声而喑，砭石
以治之，则烦热而狂，是厥逆之时，不可以治，须其气并，乃可治也。
帝曰∶何以然？
何以灸则喑，石则狂？
岐伯曰∶阳气重上，有余于上，灸之则阳气入阴，入则喑，石
之则阳气虚，虚则狂，须其气并而治之，可使全也。
要，平声。膺肿颈痛，胸满腹胀，是阳气重上，有余于上，而致厥逆也，其厥逆之时，取少腹之阴穴
灸之，则阳气不入于阴，入而不出则厥。厥逆之时，用砭石刺之，外泄其血，血不充肤，则阳气外虚，虚
则狂，故须其气并而治之，可使十全也。
帝曰∶善。何以知怀子之且生也？
申明灸则喑，石则狂，而言阳气重上，有余于上，则厥逆之原
亦明，帝故善之。复承胸满腹胀之意而问妇人怀子，亦胸满腹胀，何以主怀子之且生？知，犹主也。
岐伯曰∶身有病而无邪脉也。
妇人怀子，胸腹满胀，经脉循行，不失常度，是身有病而无邪脉，则主怀子之且生也。
帝曰∶病热而有所痛者，何也？
病热而有所痛，在妇人则不能怀子，故复问之。
岐伯曰∶病热者，阳脉也，以三阳之动也。
热为阳病，热则三阳经脉不和，故病热者，阳脉也，以三阳之动而不和也。
人迎一盛，少阳；二盛，太阳；三盛，阳明。
少阳、太阳、阳明，三阳也。人迎动脉，主三阳之六腑，故人迎一盛，热在少阳之胆与三焦。人迎
二盛，热在太阳之膀胱小肠。人迎三盛，热在阳明之胃与大肠。所谓病热者，阳脉也。以三阳之动，此之谓也。
入阴也。夫阳入于阴，故病在头与腹，乃腹胀而头痛也。
病热为阳病，热而有所痛者，阳病入阴也。夫阳入于阴，故当病在头与腹。申明在腹，乃为腹胀，在
头而头痛也。
帝曰∶善。
病热而痛，兼有腹中 胀之病，帝故善之。此一节，言土气不和而厥逆，经脉不和而热盛，亦为腹中之病也。
腹中的气，不能从脐腹部运行到胸膈，通达四肢，就会形成鼓胀、肿痛等疾病。腹中的血，不能从脐腹部向内通达胞宫，向外通达经络，就会形成血枯、脓血等疾病。前文论述了腹中气血不和，就会产生腹部的疾病；后文论述了土气不和导致厥逆，经血不和导致热盛，也都会产生腹部的疾病，所以这篇名为《腹中论》。
黄帝问道：有人患心腹胀满，早晨吃了饭晚上就不能再吃，这是什么病？
心腹，是指心之下、腹之上的部位。满，就是胀满。心腹胀满而不能进食，外表胀满而内部空虚，这是什么病？
外表胀满而内部不能进食，外实内空，像按压鼓皮一样，所以名叫鼓胀。
黄帝问：怎么治疗它呢？
对于鼓胀病，用什么方法治疗？
“矢”通“屎”。鸡矢醴，是用鸡屎和甜酒一起服用。鸡属酉金，又主巽木（风木），阳明燥金能济助脾土的湿气，东方风木能克制脾土的顽滞；鸡没有前阴，大小便同出一窍。鼓胀病是水气不行，用鸡屎治疗，是使水湿从大便排出。醴，是熟谷的液体，能行于皮毛，先充盈络脉，然后入胃，先入谷而后出谷，用醴来治疗，是使足太阴脾土之气，与主管皮毛的太阴肺相合，从皮毛进入络脉，从络脉通达水道，使水湿从小便排出。服一剂见效，是一剂后腹中调和；服两剂痊愈，是两剂后腹部膨隆逐渐消退。
黄帝问：为什么有时病情会复发呢？
用鸡屎醴治疗，使水湿下行，那么地土之气就会陷下而不能上升，经过一个周期的运转，土气虚弱而水湿再次聚集，所以有复发的疑问。
岐伯说：这是因为饮食不节制，所以时常发病。虽然病势暂时缓解，但病气仍聚积在腹部。
这是脾土之气先已虚弱，加上饮食不节制，所以时常有复发的疾病。病虽然暂时缓解，但腹满的症状也有停止的时候，病止之后土气依然虚弱，土虚加上饮食不节制，所以病气聚积在腹部而复发。由此可知，病愈之后，饮食应当谨慎选择且有节制。
黄帝问：有人患胸胁支撑胀满，妨碍进食，发病时先闻到腥臊臭味，流出清涕样液体，先唾血，四肢发冷，眼睛昏花，时常大小便出血，这叫什么病？是怎么得的？
“为”，读去声，下文“为何病”的“为”读音相同，承接上文的心腹满、不能暮食，而问是否有胸胁支撑胀满，也妨碍进食。胸是肺的部位，胁是肝的部位，所以发病时先闻到肺的臭气腥味，肝的臭气臊味；肺病则流出清液，肝病则先唾血；肺脉从胸走向手，肝脉从足走向胁，肺肝都生病，所以四肢发冷。肺主气，肝主血，气血都虚弱，所以眼睛昏花。肝主管冲任之血，不能温煦肌肉充实皮肤，所以时常大小便出血。这叫什么病？是正其名目。怎么得的？是探究其根源。
岐伯说：这病名叫血枯，这是由于年少时曾有大失血，或者醉酒后行房事，导致气竭肝伤，所以月经衰少或闭经不来。
“首少”，读去声。唾血便血，病名叫血枯，是正其名目；这是由于年少时曾有大失血，是探究其根源。男子大失血，或者醉酒后行房事导致阳气衰竭，气竭就不能摄血。女子大失血，如果肝受伤，肝伤所以月经衰少不来，这就是气竭肝伤，更是脱血的根源。
黄帝问：怎么治疗它？再用什么方法？
询问治疗方法并寻求技术，想要用多种方法来治疗。
岐伯说：用四份乌贼骨和一份茜草，两物混合，用雀卵做丸药，大小如小豆，每次五丸，饭后服用，用鲍鱼汁送服，以通利肠道，兼治肝脏损伤。
“茹”，旧本误作“茹”，今改正。“以”，即“用”。乌贼骨，是乌贼鱼的骨。鱼是水中活动的生物，乌贼状若包囊，腹中有墨，脊背生有一骨，轻脆中空通透，用四份乌贼骨，是取水中生动之气，上通于肺而布散全身。茜草名茹，又名地血，色紫有汁，上通肝血，用一份茜草，是取月经所生之血，本源于天一之癸水。雀是羽虫，主阳主气，入水变为蛤，主阴主血。又卵白主气，卵黄主血，两物合并，用雀卵做丸，是因为气竭肝伤，需要补气补血。小豆形状圆象土，五是土之数，气血由中土化生，所以药丸大小如小豆，每次用五丸。后饭，是先服药后进饭，使药力下行并用饭压住药力。鲍鱼，是鲑鱼之类，味酸气臭，用鲍鱼汁送服药物，是取其通利肠道而下行的作用，以及治疗肝脏损伤和月经不来的功效。这一段论述腹中的血病，并阐明其治疗方法。
黄帝问：有人患少腹坚硬胀满，上下左右都有根结，这是什么病？可以治疗吗？
“不”，作“否”解。“盛”，即“满”。承接上文的心腹满、胸胁肢满，而问是否有少腹盛满，导致上下左右都有根结，这是什么病？是正其名目。可治否？是求其治疗方法。
像房梁一样横伏在下部，所以病名叫伏梁。
什么原因引起的，是探究其根源。
岐伯说：包裹着大量的脓血，位于肠胃之外，不可治疗，如果治疗时每每切按它，会导致死亡。
伏梁包裹大量脓血，位于空廓之间，肠胃之外，病形已经形成，所以不可治疗，如果治疗时急切地按摩它，必然损伤真气，所以致死。
黄帝问：为什么这样？
为什么不可治疗，治疗会致死？
岐伯说：向下切按则会因阴分受损，必然下排脓血；向上切按则会压迫胃脘，产生膈膜夹持胃脘的内痈，这是久病，难治。位于脐上为逆证，位于脐下为顺证，不要动用它，切忌急夺，相关论述在《刺法》篇中。
“齐”通“脐”，下同。“因”，即“根据”。“动”，即“使用”。这位于肠胃之下，则依据于阴分，每每切按使其下行，必然下排脓血。每每切按使其上行，则压迫近胃脘，应当产生膈膜夹持胃脘的内痈。所谓不可治疗，是因为这伏梁是久病而难治。伏梁，像房梁一样横伏在下部，所以位于脐上，为逆证；若位于脐下，为顺证。勿动亟夺，意思是不要用急切按摩来攻夺，不应当急迫攻夺而妄加攻夺，必然损伤真气而致死。相关论述在本经《刺法》中，阐述其原理。
黄帝问：有人身体大腿和小腿都肿胀，环绕肚脐疼痛，这是什么病？
承接上文的心腹满、胸胁支满、少腹盛满，而问有人身体大腿和小腿都肿胀，环绕肚脐疼痛，外肿内痛，这是什么病？
岐伯说：这病名叫伏梁，这是风邪留下的病根，其气溢于大肠，而附着于盲原。盲原，在脐下，所以环绕肚脐疼痛，不可触动；触动它，会导致小便涩滞的疾病。
“溺”，读鸟去声。腹中的气，从脐腹部向上行并外达。现在身体大腿和小腿都肿胀，真气不能行于外关。环绕肚脐疼痛，真气不能行于上关，形成肿胀和疼痛，真气不行，病名叫伏梁，说明这不是包裹大量脓血的伏梁，而是风动水涣，中土内虚，因风而成，乃是风根。这风根之气，溢于大肠之外，而附着于少腹的盲原。《九针十二原》篇论述说，盲原出于脖胦。所以盲原在脐下，因此环绕肚脐疼痛。这病是无形的风气，也不可以妄加攻伐触动它。如果触动它，则气化不行而水液不通，应当出现小便涩滞的疾病，这是伏梁在气分，不同于包裹大量脓血的伏梁。
黄帝问：先生多次说热中、消中病患者，不可以服用膏粱厚味、芳草和石药，石药会引起癫狂，芳草会引起发狂。热中、消中病患者，都是富贵之人，现在禁止他们吃膏粱厚味，是不合乎他们的心意，禁止服用芳草石药，是病不会好，希望听听其中的道理。
“数”，音朔，意为屡次。热中、消中病患者，不可服用膏粱芳草石药，石药发癫，芳草发狂，岐伯屡次说过，黄帝引用此话来问，说那热中、消中病，精血内竭，火热消烁，都是富贵人的病。富贵之人以浓味自养。现在禁止膏粱厚味，是不合乎他们的心意；富贵之人，土气壅滞，宜升散其上，镇重其下。现在禁止芳草石药，是病不会好，希望听禁止这些药物的说法。
岐伯说：芳草的气味美，石药的气味悍烈。这两者，其气急疾坚劲，所以如果不是性情缓和的人，不可以服用这两类药物。
芳草的气，香美而上散；石药的气，悍烈而下沉。所以芳草的气急疾，石药的气坚劲，因此这两者的气急疾坚劲，只有和缓之气可以化解它们，所以如果不是性情缓和的人，不可以服用这两类药物。
黄帝问：不可以服用这两类药物，为什么这样？
一定要详细阐明不可服用的意义，所以再次询问。
岐伯说：热气悍烈，药气也是这样，两者相遇，恐怕内伤脾脏。脾属土，而恶木克，服用这类药的人，到了甲乙日（木旺之日）会有变化。
“恶”，读去声。脾土之气，贵在平和。那热中、消中病，是热气悍烈所致。现在芳草石药，其气也是热而悍烈，以热气悍烈的病，遇到热气悍烈的药，两者相遇，亢害已极，恐怕内伤脾脏。因为脾属土，而恶木克，服用这类芳草石药的人，恐怕有被克贼的变化，所以到了甲乙日（木旺之日）会有变化，这说明脾土之气贵在和缓，不宜服用芳草石药。
黄帝说：好。有人患胸部肿胀、颈部疼痛，胸满腹胀，这是什么病？怎么得的？
芳草石药恐怕内伤脾脏，不但热中消中病患者不可服用，脾土内虚者也不可服用。黄帝因此称赞，又承接身体大腿小腿肿胀、环绕肚脐疼痛的意思，问有人患胸部肿胀、颈部疼痛，胸满腹胀，这是什么病？是正其名目，怎么得的？是探究其根源。
胸部肿胀、颈部疼痛，胸满腹胀，则表里阴阳之气不相顺接，所以名叫厥逆。
黄帝问：怎么治疗它？
治疗厥逆用什么方法？
岐伯说：用火灸则会失音，用砭石则会发狂，必须等到阴阳之气相并合才可以治疗。
厥逆，则阴阳之气不相交并，如果用火灸治疗，则会无声而失音；用砭石治疗，则会烦热而发狂。所以在厥逆之时，不可以治疗，必须等到阴阳之气相并合，才可以治疗。
黄帝问：为什么这样？
为什么灸则失音，石则发狂？
岐伯说：阳气重积于上，有余于上部，灸之则阳气入阴，入阴则失音；用砭石则阳气虚，虚则发狂，必须等到阴阳之气相并合再治疗，可以使病痊愈。
“要”，读平声。胸部肿胀、颈部疼痛，胸满腹胀，是阳气重积于上，有余于上部，而导致厥逆。在厥逆之时，如果取少腹的阴穴灸之，则阳气不入于阴，入而不出则厥。厥逆之时，如果用砭石刺之，外泄其血，血不充肤，则阳气外虚，虚则发狂，所以必须等到阴阳之气相并合再治疗，可以使病十全痊愈。
黄帝说：好。怎么知道孕妇快要分娩了？
申明灸则失音、石则发狂，并说阳气重积于上，有余于上部，则厥逆的根源也明了，黄帝因此称赞。又承接胸满腹胀的意思而问妇人怀孕，也有胸满腹胀，怎么判断孕妇快要分娩？“知”，即“主”或“判断”。
岐伯说：身体有病象但没有邪脉。
妇人怀孕，胸腹满胀，经脉循行不失常度，是身体有病象但没有邪脉，则判断为孕妇快要分娩。
黄帝问：患热病而有疼痛的，是什么情况？
患热病而有疼痛，在妇人则不能怀孕，所以再次询问。
热是阳病，热则三阳经脉不和，所以患热病，是阳脉，因为三阳经脉躁动而不和。
人迎脉搏动比寸口大一倍，病在少阳；大两倍，病在太阳；大三倍，病在阳明。
少阳、太阳、阳明，是三阳。人迎动脉，主三阳六腑，所以人迎大一倍，热在少阳的胆与三焦；人迎大二倍，热在太阳的膀胱小肠；人迎大三倍，热在阳明的胃与大肠。所谓患热病，是阳脉，因为三阳经脉躁动，说的就是这个。
患热病是阳病，热而有疼痛，是阳病入阴。夫阳入于阴，所以应当病在头与腹。申明在腹，则是腹胀，在头则是头痛。
黄帝说：好。
The Qi in the abdomen, if unable to circulate from the umbilical and abdominal region to the chest and diaphragm, and reach the four limbs, will result in diseases such as drum distension (Gu Zhang) and swelling with pain. The Blood in the abdomen, if unable to internally connect to the uterus (Bao Zhong) and externally connect to the collaterals and vessels (Jing Luo), from the umbilical and abdominal region, will result in diseases such as blood depletion (Xue Ku) and pus-blood discharge. The preceding section discussed that disharmony of Qi and Blood in the abdomen leads to abdominal diseases; the following section discussed that disharmony of Earth Qi leading to Jue Ni (reversal of Qi flow), and disharmony of Jing Mai (meridian) Blood leading to severe heat, also result in abdominal diseases. Hence, this chapter is named "Treatise on the Abdomen" (Fu Zhong Lun).
Huang Di asked: There is a patient suffering from fullness and distension in the heart and abdomen, who can eat in the morning but cannot eat in the evening. What disease is this?
"Heart and abdomen" refers to the area below the heart and above the abdomen. "Fullness" means distension. Heart and abdominal distension with inability to eat, presenting external fullness and internal emptiness, what disease is this?
Qi Bo replied: It is named Drum Distension (Gu Zhang).
External distension with internal inability to eat, external firmness and internal hollowness, resembling pressing on a drum skin, hence it is named Drum Distension (Gu Zhang).
Huang Di asked: How should it be treated?
How should Drum Distension (Gu Zhang) be treated?
Qi Bo said: Treat it with Ji Shi Li (Chicken Excrement Sweet Wine Decoction). One dose brings improvement, two doses bring recovery.
"Shi" is synonymous with "shi" (excrement). Ji Shi Li (Chicken Excrement Sweet Wine Decoction) is taken by mixing chicken excrement with sweet wine. The chicken belongs to You Metal and governs Xun Wood (Wind Wood); Yangming Dry Metal assists the dampness of Spleen Earth, while East Wind Wood overcomes the stubbornness of Spleen Earth; chickens lack an anterior orifice, so urine and feces share the same opening. Drum Distension (Gu Zhang) involves stagnation of Water Qi; treating with chicken excrement causes Water-Dampness to exit via the large intestine. Li (Sweet Wine) is the liquid of cooked grains, which travels through the skin and hair, first filling the collaterals, then entering the stomach, first entering with grain and then exiting. Treating with Li (Sweet Wine) aligns the Qi of Foot-Taiyin Spleen Earth with the Lung Taiyin governing the skin and hair, allowing entry from the skin into the collaterals, and from the collaterals into the water passages, causing Water-Dampness to exit via urination. One dose brings improvement because the abdomen harmonizes after one dose; two doses bring recovery because the abdominal distension gradually subsides after two doses.
Huang Di asked: Why does the condition sometimes recur?
Treating with Ji Shi Li (Chicken Excrement Sweet Wine Decoction) causes Water-Dampness to descend, causing Earth Qi to sink and fail to ascend. After one cycle of circulation, Earth Qi becomes deficient and Water re-accumulates, hence the question of recurrence.
Qi Bo said: This is due to irregular diet, hence the occasional illness. Although the disease may temporarily subside, pathogenic Qi remains gathered in the abdomen.
This is because Spleen Earth Qi was initially deficient, compounded by irregular diet, leading to occasional recurrences. Even if the disease temporarily subsides, the abdominal fullness has its limits; after the disease stops, Earth Qi remains deficient. Deficient Earth Qi combined with irregular diet causes pathogenic Qi to gather in the abdomen and recur. Thus, it is known that after recovery, diet must be carefully selected and regulated.
Huang Di asked: There is a patient with support-like fullness in the chest and hypochondrium, interfering with eating. Upon onset, they first smell fishy and rank odors, clear fluid discharges, they expectorate blood first, their four limbs are cold, eyes are dizzy, and there is frequent bleeding from both anterior and posterior orifices. What is this disease called? How did it arise?
"Wei" (is/what) is pronounced with the departing tone; "wei" in "what disease" below follows the same pronunciation. Continuing from the previous discussion of heart-abdominal fullness and inability to eat at night, this asks about support-like fullness in the chest and hypochondrium, which also interferes with eating. The chest is the domain of the Lung, and the hypochondrium is the domain of the Liver. Hence, upon onset, they first smell the Lung's fishy odor and the Liver's rank odor; Lung disease causes clear fluid discharge, Liver disease causes initial expectoration of blood; the Lung meridian runs from the chest to the hand, the Liver meridian runs from the foot to the hypochondrium. With both Lung and Liver diseased, the four limbs become cold. The Lung governs Qi, the Liver governs Blood; since both Qi and Blood are deficient, the eyes become dizzy. The Liver governs the Chong and Ren vessels' blood; unable to warm muscles and fill the skin, there is frequent bleeding from both anterior and posterior orifices. What is this disease called? To name it correctly. How did it arise? To explore its origin.
Qi Bo said: This disease is named Blood Depletion (Xue Ku). It arises from significant blood loss in youth, or sexual intercourse while intoxicated, leading to exhaustion of Qi and injury to the Liver, thus causing menstrual scarcity or amenorrhea.
"Shou Shao" is pronounced with the departing tone. Expectorating blood and defecating blood, the disease is named Blood Depletion (Xue Ku), to name it correctly; arising from significant blood loss in youth, to explore its origin. In men, significant blood loss, or sexual intercourse while intoxicated leading to Yang Qi exhaustion, results in Qi exhaustion failing to control blood. In women, significant blood loss, if the Liver is injured, results in menstrual scarcity or amenorrhea due to Liver injury. This Qi exhaustion and Liver injury is the root cause of blood loss.
Huang Di asked: How should it be treated? What method should be used?
Asking for treatment and seeking methods, desiring multiple approaches to treat it.
Qi Bo said: Use four parts Oseos Sepiae (Cuttlefish Bone, Wuzhegu) and one part Radix Rubia Cordifoliae (Madder Root, Qiancao), combine them, form pills using Quail Eggs (Que Luan), size like small beans, take five pills after meals, and use Sauce Fish Juice (Bao Yu Zhi) to promote intestinal lubrication and heal Liver injury.
"Ru" was erroneously printed as "Ru" in old editions, now corrected. "Yi" means "use". Oseos Sepiae (Cuttlefish Bone, Wuzhegu) is the bone of the cuttlefish. Fish are living creatures in water; the cuttlefish resembles a pouch, contains ink in the abdomen, and has a light, brittle, hollow bone in the spine. Using four parts Oseos Sepiae (Cuttlefish Bone, Wuzhegu) takes the vital Qi of water, ascending to the Lung and distributing throughout. Qiancao (Madder Root, Radix Rubia Cordifoliae) is named Ru, also called Di Xue (Earth Blood), purple in color with juice, ascending to Liver Blood. Using one part Qiancao (Madder Root, Radix Rubia Cordifoliae) takes the blood generated by menstruation, originating from Tian Yi Gui Water. The quail is a feathered creature, governing Yang and Qi; entering water, it becomes a clam, governing Yin and Blood. Egg white governs Qi, egg yolk governs Blood. Combining these two, forming pills with Quail Eggs (Que Luan), addresses Qi exhaustion and Liver injury by tonifying Qi and Blood. Small beans are round, symbolizing Earth; five is the number of Earth. Qi and Blood are generated from Central Earth, hence the pill size is like small beans, five pills per dose. "After meals" means taking medicine before food, allowing the medicine to descend and using food to press it down. Bao Yu (Sauce Fish) is a type of fish, sour in taste and foul-smelling in odor. Using Sauce Fish Juice (Bao Yu Zhi) to deliver the medication leverages its ability to lubricate the intestines and descend, and to heal Liver injury and amenorrhea. This section discusses blood diseases in the abdomen and clarifies the treatment method.
Huang Di asked: There is a patient with hardness and fullness in the lower abdomen, with roots extending up, down, left, and right. What disease is this? Is it treatable?
"Bu" is read as "fou" (no). "Sheng" means "full". Continuing from the previous heart-abdominal fullness and chest-hypochondrial limb fullness, this asks about lower abdominal fullness causing roots extending up, down, left, and right. What disease is this? To name it correctly. Is it treatable? To seek treatment.
Qi Bo said: This disease is named Fu Liang (Hidden Beam).
Like a beam lying horizontally below, hence the disease name Fu Liang (Hidden Beam).
Huang Di asked: What causes Fu Liang (Hidden Beam)?
What causes it, to explore its origin.
Qi Bo said: It wraps large amounts of pus and blood, residing outside the intestines and stomach. It is untreatable; treating it often involves pressing and massaging, which leads to death.
Fu Liang (Hidden Beam) wraps large amounts of pus and blood, residing in the empty spaces outside the intestines and stomach. The pathological form is established, hence it is untreatable. If treated by urgent pressing and massaging, it inevitably injures True Qi, leading to death.
Huang Di asked: Why is this so?
Why is it untreatable, and why does treatment lead to death?
Qi Bo said: Pressing downward affects the Yin, inevitably causing pus and blood discharge downward. Pressing upward compresses the epigastrium, generating internal abscesses between the diaphragm and the epigastrium. This is a chronic disease, difficult to treat. Located above the umbilicus is adverse (Ni); located below the umbilicus is favorable (Cong). Do not manipulate it urgently or forcibly drain it. The discussion is in the "Acupuncture Methods" (Ci Fa) chapter.
"Qi" is synonymous with "Umbilicus", same below. "Yin" means "based on". "Dong" means "use/manipulate". Below the intestines and stomach, it is based on the Yin. Pressing and manipulating to force descent inevitably causes pus and blood discharge downward. Pressing and manipulating to force ascent compresses near the epigastrium, likely generating internal abscesses between the diaphragm and the epigastrium. The reason it is considered untreatable is that this Fu Liang (Hidden Beam) is a chronic, difficult-to-treat disease. Fu Liang (Hidden Beam) lies horizontally below like a beam; thus, located above the umbilicus is adverse, while located below the umbilicus is favorable. "Do not manipulate urgently or forcibly drain" means do not use urgent massage to forcibly drain. Do not urgently and recklessly drain, as this inevitably injures True Qi and leads to death. The principles are discussed in the "Acupuncture Methods" (Ci Fa) chapter of this classic.
Huang Di asked: There is a patient with swelling of the thighs and legs, and pain circling the umbilicus. What disease is this?
Continuing from the previous heart-abdominal fullness, chest-hypochondrial support-fullness, and lower abdominal fullness, this asks about swelling of the thighs and legs and pain circling the umbilicus. Swelling externally and pain internally, what disease is this?
Qi Bo said: This disease is named Fu Liang (Hidden Beam). This is the root of Wind. Its Qi overflows into the exterior of the Large Intestine and attaches to the Yuan (Origin) of the Mingmen (Blind Origin). The Yuan of the Mingmen is below the umbilicus, hence the pain circling the umbilicus. It must not be manipulated; manipulation leads to difficulty in urination.
"Niao" is pronounced with the departing tone. The Qi in the abdomen ascends from the umbilical-abdominal region and extends outward. Now, with swelling of the thighs and legs, True Qi fails to reach the outer gates. Pain circling the umbilicus indicates True Qi fails to reach the upper gate. Forming swelling and pain, True Qi fails to move, the disease is named Fu Liang (Hidden Beam). This clarifies that it is not the Fu Liang (Hidden Beam) wrapping pus and blood, but rather Wind moving and Water dispersing, with internal deficiency of Central Earth, caused by Wind, making it a Wind root. This Wind root Qi overflows outside the Large Intestine and attaches to the Mingmen (Blind Origin) of the lower abdomen. The "Twelve Original Acupoints of the Nine Needles" states that the Yuan of the Mingmen originates from the neck. Thus, the Yuan of the Mingmen is below the umbilicus, hence the pain circling the umbilicus. This disease involves formless Qi and should not be attacked recklessly. If manipulated, Qi transformation fails and Water movement stops, leading to difficulty in urination. This is Fu Liang (Hidden Beam) in the Qi level, distinct from the Fu Liang (Hidden Beam) wrapping pus and blood.
This section discusses how disharmony of Qi and Blood in the abdomen leads to abdominal diseases.
Huang Di asked: Master, you have often stated that patients with Re Zhong (Internal Heat) and Xiao Zhong (Consumption Heat) should not consume Gao Liang (rich/fatty foods), Fang Cao (fragrant herbs), or Shi Yao (mineral drugs). Mineral drugs induce Dian (epilepsy/madness), and fragrant herbs induce Kuang (mania). Patients with Re Zhong (Internal Heat) and Xiao Zhong (Consumption Heat) are all wealthy individuals. Prohibiting rich foods does not suit their desires; prohibiting fragrant herbs and mineral drugs means the disease will not cure. I wish to hear the reasoning behind this prohibition.
"Shuo" means frequent/repeated. Re Zhong (Internal Heat) and Xiao Zhong (Consumption Heat) patients should not consume Gao Liang (rich/fatty foods), Fang Cao (fragrant herbs), or Shi Yao (mineral drugs); mineral drugs induce Dian (epilepsy/madness), and fragrant herbs induce Kuang (mania). Qi Bo has stated this repeatedly. Huang Di cites this to ask, saying that Re Zhong (Internal Heat) and Xiao Zhong (Consumption Heat) involve internal depletion of essence and blood, with fire-heat consuming them, all being diseases of the wealthy. The wealthy nourish themselves with rich flavors. Prohibiting Gao Liang (rich/fatty foods) does not suit their hearts. For the wealthy, Earth Qi is stagnant; it is suitable to disperse upwards and sedate downwards. Prohibiting Fang Cao (fragrant herbs) and Shi Yao (mineral drugs) means the disease will not cure. I wish to hear the explanation for these prohibitions.
Qi Bo said: The Qi of Fang Cao (fragrant herbs) is beautiful/aromatic; the Qi of Shi Yao (mineral drugs) is harsh/pungent. Both have Qi that is rapid and firm/strong. Therefore, unless one has a gentle and harmonious disposition, one should not consume these two types.
The Qi of Fang Cao (fragrant herbs) is aromatic and disperses upward; the Qi of Shi Yao (mineral drugs) is harsh and sinks downward. Thus, the Qi of Fang Cao (fragrant herbs) is rapid, and the Qi of Shi Yao (mineral drugs) is firm/strong. Therefore, the Qi of both is rapid and firm/strong; only harmonious Qi can resolve them. Hence, unless one has a gentle and harmonious disposition, one should not consume these two types.
Huang Di asked: Why should one not consume these two types?
Desiring to clarify the meaning of why they should not be consumed, he asks again.
Qi Bo said: The pathogenic heat is harsh/pungent, and the medicinal Qi is likewise. When the two meet, there is fear of internal injury to the Spleen. The Spleen is Earth, and it dislikes Wood overcoming it. Those who take these medicines will face changes on Jia-Yi days (Wood days).
"E" is pronounced with the departing tone. Spleen Earth Qi values balance. Re Zhong (Internal Heat) and Xiao Zhong (Consumption Heat) are caused by harsh/pungent pathogenic heat. Now, Fang Cao (fragrant herbs) and Shi Yao (mineral drugs) also have hot and harsh/pungent Qi. Taking harsh/pungent pathogenic heat and meeting it with harsh/pungent medicinal Qi, when the two meet, the excess damage is extreme, fearing internal injury to the Spleen. Since the Spleen is Earth and dislikes Wood overcoming it, those taking Fang Cao (fragrant herbs) and Shi Yao (mineral drugs) may face overcoming/destruction changes. Hence, on Jia-Yi days (Wood days), changes will occur. This shows that Spleen Earth Qi values harmony and gentleness, and Fang Cao (fragrant herbs) and Shi Yao (mineral drugs) should not be taken.
Huang Di said: Good. There is a patient with swelling of the chest and neck, chest fullness, and abdominal distension. What disease is this? How did it arise?
Fearing that Fang Cao (fragrant herbs) and Shi Yao (mineral drugs) internally injure the Spleen, not only Re Zhong (Internal Heat) and Xiao Zhong (Consumption Heat) patients should avoid them, but those with internal Spleen Earth deficiency should also avoid them. Huang Di thus praises this, and continuing the theme of thigh/leg swelling and umbilical pain, asks about a patient with chest swelling, neck pain, chest fullness, and abdominal distension. What disease is this? To name it correctly. How did it arise? To explore its origin.
Qi Bo said: It is named Jue Ni (Reversal of Qi Flow).
Chest swelling, neck pain, chest fullness, and abdominal distension indicate that exterior-interior and Yin-Yang Qi do not connect smoothly, hence it is named Jue Ni (Reversal of Qi Flow).
Huang Di asked: How should it be treated?
How should Jue Ni (Reversal of Qi Flow) be treated?
Qi Bo said: Moxibustion will cause aphonia; stone therapy (bi-shi) will cause mania. One must wait until the Qi merges before treating.
In Jue Ni (Reversal of Qi Flow), Yin and Yang Qi do not intersect and merge. If treated with moxibustion, it causes aphonia without sound; if treated with bi-shi (stone therapy), it causes irritability and mania. Thus, during Jue Ni (Reversal of Qi Flow), treatment is contraindicated; one must wait until the Qi merges before treating.
Huang Di asked: Why is this so?
Why does moxibustion cause aphonia and stone therapy cause mania?
Qi Bo said: Yang Qi heavily accumulates upward, being excessive in the upper body. Moxibustion causes Yang Qi to enter Yin; entering Yin causes aphonia. Stone therapy depletes Yang Qi; depletion causes mania. Waiting until the Qi merges before treating can ensure complete recovery.
"Yao" is pronounced with the level tone. Chest swelling, neck pain, chest fullness, and abdominal distension indicate Yang Qi heavily accumulating upward, being excessive in the upper body, leading to Jue Ni (Reversal of Qi Flow). During Jue Ni (Reversal of Qi Flow), if one moxas Yin acupoints in the lower abdomen, Yang Qi does not enter Yin; if it enters and does not exit, it leads to Jue (reversal). During Jue Ni (Reversal of Qi Flow), if one uses bi-shi (stone therapy) to puncture, it leaks blood externally; if blood fails to fill the skin, Yang Qi becomes externally deficient; deficiency leads to mania. Thus, waiting until the Qi merges before treating can ensure complete recovery.
Huang Di said: Good. How can one know that a pregnant woman is about to give birth?
Clarifying that moxibustion causes aphonia and stone therapy causes mania, and stating that Yang Qi heavily accumulating upward, being excessive in the upper body, clarifies the origin of Jue Ni (Reversal of Qi Flow), Huang Di thus praises this. Continuing the theme of chest fullness and abdominal distension, he asks about pregnant women who also have chest fullness and abdominal distension; how to judge that a pregnant woman is about to give birth? "Zhi" means "judge" or "predict".
Qi Bo said: The body has symptoms, but the pulse is not aberrant.
In pregnancy, chest and abdominal fullness occur; the meridians circulate without deviating from normal patterns. Having bodily symptoms but no aberrant pulse predicts that a pregnant woman is about to give birth.
Huang Di asked: In cases of heat disease accompanied by pain, what is the situation?
Heat disease with pain, in women, prevents conception, hence the inquiry.
Qi Bo said: Heat disease manifests in Yang pulses, due to the activity of the Three Yang meridians.
Heat is a Yang disease; heat causes disharmony in the Three Yang meridians. Thus, heat disease manifests in Yang pulses, due to the activity and disharmony of the Three Yang meridians.
If the Renying pulse is one-fold stronger than the Cunkou pulse, the disease is in Shaoyang; two-fold stronger, in Taiyang; three-fold stronger, in Yangming.
Shaoyang, Taiyang, and Yangming are the Three Yang. The Renying pulse governs the Six Fu organs of the Three Yang. Thus, if the Renying pulse is one-fold stronger, heat is in Shaoyang Gallbladder and Sanjiao; if two-fold stronger, heat is in Taiyang Bladder and Small Intestine; if three-fold stronger, heat is in Yangming Stomach and Large Intestine. This is what is meant by heat disease manifesting in Yang pulses, due to the activity of the Three Yang.
Yang enters Yin. Since Yang enters Yin, the disease manifests in the head and abdomen, namely abdominal distension and headache.
Heat disease is a Yang disease; heat with pain indicates Yang disease entering Yin. Since Yang enters Yin, the disease should manifest in the head and abdomen. Clarifying that in the abdomen, it is abdominal distension, and in the head, it is headache.
Huang Di said: Good.
Heat disease with pain, accompanied by abdominal distension, Huang Di thus praises this. This section discusses how disharmony of Earth Qi leads to Jue Ni (Reversal of Qi Flow), and disharmony of meridians leads to excessive heat, which are also abdominal diseases.