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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 40 · Illness within the Abdomen
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “What illness causes fullness in the Heart region and abdomen, so that eating in the morning prevents eating in the evening?”
Qi Bo replied: “It is called drum distention.”
The Emperor asked: “How is it treated?”
Qi Bo said: “Treat with chicken-dropping fermented liquor, ji shi li. One preparation brings a perceptible response; two end the illness.”
The Emperor asked: “Why does it sometimes recur?”
Qi Bo said: “Food and drink are unregulated, so illness sometimes returns. Although the illness is about to end, at certain times it must still recur: qi gathers in the abdomen.”
The Emperor asked: “What illness causes spreading fullness in chest and flanks that interferes with eating? At its onset, fishy and rank smells are first perceived, clear fluid emerges, blood is first spat out, the four limbs are cold, vision reels, and blood periodically leaves through the front and rear passages. What is its name, and how is it acquired?”
Qi Bo said: “The illness is called blood withering. It is acquired through a great loss of blood when young, or entering the bedchamber while drunk. Qi is exhausted and Liver injured, so menstruation diminishes and fails to come.”
The Emperor asked: “How is it treated, and by what method restored?”
Qi Bo said: “Combine four parts cuttlefish bone with one part lu ru. Form the two ingredients into pills with sparrow eggs, each the size of a small bean. Use five pills before the following meal, drinking them with a decoction of salted fish. This benefits the intestinal interior and the injured Liver.
Reading note: Lu ru retains the supplied 藘茹 ingredient name. The four-to-one ratio, five pills and bean size are preserved without invented weight units. 鮑魚 is read in its older salted-fish sense, rather than automatically as modern abalone.”
The Emperor asked: “What illness causes fullness in the lower abdomen with roots above, below, left and right? Can it be treated?”
Qi Bo said: “The illness is called hidden beam, fu liang.”
The Emperor asked: “What gives rise to hidden beam?”
Qi Bo said: “It encloses a great quantity of pus and blood outside intestines and Stomach. It cannot be treated. Repeated cutting pressure in treatment causes death.”
The Emperor asked: “Why is this so?”
Qi Bo said: “If it moves downward, it follows the lower passage and must discharge pus and blood. Above, it presses on the Stomach cavity, producing obstruction and an internal abscess beside it. This is longstanding illness and difficult to treat. Above the navel is contrary; below the navel follows the proper course. Do not disturb it or rapidly strip it away. Its discussion is in the Needling Methods.”
The Emperor asked: “What illness causes swelling throughout the body, hips, thighs and shins, with pain around the navel?”
Qi Bo said: “It is called hidden beam: the root of Wind. Its qi overflows into Large Intestine and lodges in the huang membranes. Their source is below the navel, so pain encircles it. It must not be disturbed. Disturbing it produces Water illness and rough, difficult urination.
Reading note: The supplied 鴬 in the preceding swelling list follows the earlier shin reading; huang retains the historical 肓 membrane region.”
The Emperor asked: “You repeatedly say that internal heat and internal wasting should not be treated with rich grains, aromatic herbs or mineral medicinals: mineral medicinals set off dian illness and aromatic herbs frenzy. Yet those with internal heat and wasting are wealthy people of rank. Forbidding rich food goes against their wishes; forbidding aromatic herbs and minerals seems to leave illness uncured. I wish to hear the explanation.”
Qi Bo said: “Aromatic herbs have pleasing qi; mineral medicinals fierce qi. Both act urgently, swiftly, firmly and forcefully. Unless a person’s Heart is relaxed and disposition harmonious, these two should not be taken.”
The Emperor asked: “Why should they not be taken?”
Qi Bo said: “Heat qi is swift and fierce; medicinal qi is likewise. When they meet, injury to Spleen within is feared. Spleen is Earth and dislikes Wood. For those who take such medicinals, reassess when jia and yi days arrive.”
The Emperor said: “Good. What illness brings swelling of the breast, neck pain, chest fullness and abdominal distention? How is it acquired?”
Qi Bo said: “It is called counterflow reversal.”
The Emperor asked: “How is it treated?”
Qi Bo said: “Moxa causes loss of voice; stone lancets cause frenzy. Wait until its qi gathers before treating.”
The Emperor asked: “Why is this so?”
Qi Bo said: “Yang qi has doubled upward, leaving excess above. Moxa drives yang into yin, causing loss of voice. Stone lancets make yang qi deficient, causing frenzy. Wait until its qi gathers and then treat: the person can be preserved whole.”
The Emperor said: “Good. How does one know a pregnancy is about to produce a child?”
Qi Bo said: “The body has signs of illness, but there is no harmful pulse.”
The Emperor asked: “Why does heat illness sometimes have pain?”
Qi Bo said: “Heat illness involves the yang vessels, through movement of the three yang. At the Renying pulse, one degree of abundance is Shaoyang; two Taiyang; three Yangming. This enters yin. Yang entering yin causes illness in head and abdomen, with flooding distention and headache.”
The Emperor said: “Good.”
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