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Chapter 40 of 78
黄帝内经·素问
Holistic Paraphrase
The Yellow Emperor asked: When someone suffers from a condition of abdominal distension and fullness, where they can eat in the morning but by evening can eat nothing more, what disease is this? Qi Bo replied: This disease is called Drum Distension (abdominal distension like a drum). The Yellow Emperor asked: How is it treated? Qi Bo said: Treat it with Chicken-Manure Wine (a medicinal wine fermented from chicken droppings). One dose will show effect, and after two doses the disease will be cured.
The Yellow Emperor asked: Sometimes this disease recurs—why is that?
Qi Bo said: This is because there is no restraint in diet, so the disease attacks from time to time. Although the disease is nearly cured, because eating and drinking are not moderated, pathogenic qi accumulates again in the abdomen, and so it recurs.
The Yellow Emperor asked: There is a disease in which the chest and rib-side feel distended and oppressed, hindering eating; when it attacks, one first smells a fishy and rank odor, clear fluids flow from the mouth, one first vomits blood, the four limbs are cold, the eyes are dizzy, and there is frequent bleeding from stool and urine. What disease is this? How is it contracted?
Qi Bo said: This disease is called Blood Exhaustion (depletion of blood). The cause of this disease is that in youth there was major blood loss; or, after drinking wine, indulging in sexual intercourse, leading to exhaustion of essence and injury to the liver—hence menstruation becomes scanty or stops altogether.
The Yellow Emperor asked: How is it treated? By what means can one recover?
Qi Bo said: Combine four parts of Cuttlefish Bone (ossis sepiae, i.e., cuttlebone) with one part of Lü茹 (madder root). Grind both into powder and mix with Sparrow Eggs to form pills the size of small beans. After each meal, take five pills, swallowed with Abalone Juice. This method can free the intestines and nourish the injured liver.
The Yellow Emperor asked: There is a disease in which the lower abdomen (the small abdominal region) is distended and hard, with root-like attachments above, below, left, and right. What disease is this? Can it be treated?
Qi Bo said: This disease is called Hidden Beam (a hard mass deep in the abdomen, lurking like a wooden beam). The Yellow Emperor asked: What causes Hidden Beam? Qi Bo said: It envelops a large amount of pus and blood, located outside the intestines and stomach. This disease must not be treated recklessly; reckless treatment or forceful pressure often leads to death.
The Yellow Emperor asked: Why is this so?
Qi Bo said: If the lesion moves downward, it approaches the private parts and will inevitably discharge pus and blood; if it moves upward, it presses upon the stomach cavity, generating obstruction near the diaphragm, and clinging to the inner stomach wall it forms an internal abscess. This is a disease of long accumulation that is difficult to treat. When the lesion is above the navel, the prognosis is contrary (unfavorable); when below the navel, it is favorable. It must not be lightly touched or excessively attacked. Relevant discussions are recorded in the chapter Cī Fǎ (Needling Methods).
The Yellow Emperor said: There are people whose body, thighs, and calves are all swollen, with pain circling the navel. What disease is this?
Qi Bo said: This is also Hidden Beam, but here it is rooted in Wind Pathogen. The pathogenic qi fills the large intestine and attaches to the Huáng (the interstices between the viscera within the abdominal cavity), and the source of Huáng is below the navel, hence the pain encircles the navel. This disease must not be recklessly agitated, for if touched it will become a disorder of fluid retention and difficult, dribbling urination.
The Yellow Emperor said: Sir, you have repeatedly spoken of Heat Center (internal heat consumption-thirst conditions) and Dispersion Center (excessive hunger with rapid digestion), stating that one must not take rich and generous foods (fatty, sweet, and cloying food), fragrant herbs (remedies with fragrant odors) and stone medicines (mineral remedies). Stone medicines cause mania, and fragrant herbs cause madness. Yet those who suffer from Heat Center and Dispersion Center are mostly wealthy people; now to forbid them rich foods goes against their desires, and to forbid fragrant herbs and stone medicines risks failure to cure the disease. I wish to hear the reasoning behind this.
Qi Bo said: The qi of fragrant herbs is fragrant, dispersing, and penetrating; the qi of stone medicines is fierce and strong. The natures of both kinds of medicines are hasty, hard, firm, and forceful. Therefore, only those who are calm by nature and composed at heart may take these two kinds of medicine.
The Yellow Emperor asked: What precisely is the reason these two kinds of medicine cannot be taken?
Qi Bo said: In patients with Heat Center and Dispersion Center, the heat qi in the body is itself swift, scorching, and powerful; and the qi of these two types of medicine is equally powerful. When the two meet, I fear there will be internal injury to the Spleen. The Spleen belongs to Earth among the Five Phases, and Earth fears the restraint of Wood. If one takes such medicine, then to Jiǎ-Yǐ days (days governed by Wood) the condition will worsen—at which point one must reconsider.
The Yellow Emperor said: Well spoken! There is a disease wherein the chest is swollen, the neck is painful, the chest feels full and stuffy, and the abdomen is distended. What disease is this, and how is it contracted?
Qi Bo said: The name of the disease is Counterflow Reversal (rebellion of qi, surging upward). The Yellow Emperor asked: How is it treated? Qi Bo said: If treated with moxibustion, it will cause loss of voice; if treated with stone needling, it will cause mad-speaking. One must wait until the qi of yin and yang merge and stabilize, and only then may it be treated.
The Yellow Emperor asked: Why does this occur?
Qi Bo said: In this condition, yang qi is hyperactive and surges upward—the upper body has excess yang. With moxibustion, the heat drives yang qi deeper into the yin aspect, and when yang sinks into yin, voice is lost; with stone needling, yang qi is drained and becomes deficient, and when yang qi is deficient, the spirit is not settled and madness results. One must wait until qi is harmonized and balanced before treating, so that recovery is possible.
The Yellow Emperor said: Well spoken! How does one know when a woman is in labor about to give birth? Qi Bo said: When the body shows signs of discomfort, but the pulse presents nothing pathological, this is the sign of pregnancy.
The Yellow Emperor asked: What do fever with body pain signify?
Qi Bo said: A disease manifesting with fever belongs to the category of yang pulse abnormalities, and results from the abnormal movement of the three yang meridians. When the Rén Yíng pulse (the artery beside the Adam's apple at the neck) beats at twice the size of the Cùn Kǒu pulse, it indicates disease in the Shào Yáng channel; at three times, disease in the Tài Yáng channel; at four times, disease in the Yáng Míng channel: With yang pathogen penetrating into the yin aspect, therefore, the disease manifests in both the head (headache) and the abdomen (abdominal distension). The Yellow Emperor said: Well spoken.
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This content is based on classical Chinese medicine texts and is provided solely for traditional culture study and research. It does not constitute any medical diagnosis, medication, or treatment advice; please consult a healthcare professional promptly if unwell.