Jingui Yaolue · Essentials from the Golden Cabinet

10. Abdominal Fullness, Cold-Shan and Retained Food · Pulses, Signs and Treatment

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A faint, wiry fuyang pulse should mean abdominal fullness. Without fullness there must be difficult stool and pain in both flanks. Deficiency-cold rises from below; warming medicines should be given. Abdominal fullness without pain upon pressure is deficiency; pain means repletion and may be purged. With a yellow tongue not yet purged, purging makes the yellow leave of itself. Abdominal fullness that decreases at times then returns unchanged is cold; warming medicine should be given. A withered-yellow patient, agitated but not thirsty, with cold repletion in the chest and unceasing diarrhea, dies according to the text. A wiry cunkou pulse gives contracted pain beneath the ribs and shivering aversion to cold. A person struck by cold tends to yawn and has clear nasal discharge. With fever but harmonious color, sneezing is frequent. Diarrhea in cold strike comes from interior deficiency. Wanting to sneeze but unable means cold in the belly; a variant says pain. A thin person with pain around the navel must have wind-cold and grain qi not moving. Purging instead makes qi rush upward; if it does not rush, focal blockage appears below Heart. Abdominal fullness and fever for ten days, floating rapid pulse, food and drink unchanged, are governed by Houpo Qiwu Tang. Cold qi in the abdomen, thunderous rumbling and cutting pain, counterflow fullness of chest and flanks and vomiting are governed by Fuzi Jingmi Tang. Pain with closure is governed by Houpo Sanwu Tang. Fullness and pain below Heart upon pressure are repletion and should be purged. Da Chaihu Tang is suitable. Abdominal fullness not decreasing, or decreasing too little to mention, requires purging. Dachengqi Tang is suitable. Severe cold pain in Heart and chest, vomiting with inability to eat or drink, abdominal fullness with upward rushing that raises the skin into visible head-and-foot forms, pain above and below intolerant of touch or approach: Da Jianzhong Tang governs. One-sided pain below the ribs, fever and a tight, wiry pulse are cold. Purge with warming medicine; Dahuang Fuzi Tang is suitable. Cold qi with reversal counterflow is governed by Chi Wan. Abdominal pain and a wiry, tight pulse: wiry means defensive qi not moving and aversion to cold; tight no desire to eat. Pathogenic and upright qi contending make cold-shan. Cold-shan pain around the navel, attacks with white sweat, reversely cold hands and feet and a deep, tight pulse are governed by Da Wutou Jian. Cold-shan abdominal pain, also flank pain and internal urgency, are governed by Danggui Shengjiang Yangrou Tang. Cold-shan abdominal pain, reverse cold, numb hands and feet or bodily pain, unresponsive to moxa, needling and medicines, is governed by Wutou Guizhi Tang as the appropriate counteracting formula. A rapid, tight pulse is wiry, like a bowstring unmoved by pressure. Rapid and wiry means its cold should be purged. Tight, large and slow must mean hardness below Heart. Large and tight means yin within yang and may be purged. Supplement · Passage 21 Supplement. Question: How can retained food be distinguished? The Master replies: A floating, large cunkou pulse becomes rough under pressure; chi is also faint and rough. Thus retained food is known. Dachengqi Tang governs. Supplement · Passage 22 Supplement: A rapid, slippery pulse is repletion with retained food. Purging brings recovery; Dachengqi Tang is suitable. Supplement · Passage 23 Supplement: Diarrhea with no desire to eat means retained food. Purge it; Dachengqi Tang is suitable. Supplement · Passage 24 Supplement: Retained food in the upper stomach region should be expelled by vomiting. Guadi San is suitable. Supplement · Passage 25 Supplement: A tight pulse like an irregularly twisting rope means retained food. Supplement · Passage 26 Supplement: Tight pulse, headache and wind-cold mean undigested retained food in the abdomen. A variant specifies a tight cunkou pulse.

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