Suwen · On the Center of the Abdomen

The text

The Yellow Emperor asked: There is fullness of the heart and belly; eating at dawn, one cannot eat at dusk. What illness is this? Qi Bo answered: It is named drum distention. The Emperor said: How does one treat it? Qi Bo said: Treat it with chicken-droppings sweet wine. One dose, and you know it; two doses, and it ends. The Emperor said: Why does it at times come back? Qi Bo said: This is drink and food without measure; therefore at times there is illness. Although the illness is about to end, at times it must therefore be ill: qi gathers in the belly. The Emperor said: There are those with propped fullness in the chest and flanks, hindering food. When the illness arrives, one first smells rank and foul odors; clear fluid goes out; first one spits blood; the four limbs are clear-cold; the eyes whirl; at times there is blood before and behind. What is the name of the illness? How is it obtained? Qi Bo said: The illness is named blood withering. It is obtained in the years of youth, from a great loss of blood, or from entering the inner chamber while drunk. Qi is exhausted, the liver is harmed; therefore the monthly affair declines, is little, and does not come. The Emperor said: How does one treat it? By what art does one restore it? Qi Bo said: Take four of cuttlebone and one of madder; join the two things; make pills with sparrow eggs, as large as a small bean. Take five pills and let the meal come after; drink them with abalone broth. This frees the intestines and the injured liver. The Emperor said: There is an illness with the lesser abdomen abundant, with roots above and below, left and right. What illness is this? Can it be treated or not? Qi Bo said: The illness is named hidden beam. The Emperor said: From what is hidden beam obtained? Qi Bo said: It wraps great pus and blood, dwelling outside the intestines and stomach. It cannot be treated. If you treat it, each time you press it hard, it brings death. The Emperor said: Why is this so? Qi Bo said: Below, because of yin, it must send down pus and blood; above, it presses the stomach duct and gives birth to an inner abscess of the diaphragm, flanking the stomach duct. This is a long illness; it is hard to treat. Dwelling above the navel is against; dwelling below the navel is following. Do not move it or seize it urgently. The discourse is in the Needling Methods. The Emperor said: A person has swelling of the body, the thighs, the upper legs, and the shins, and pain ringing the navel. What illness is this? Qi Bo said: The illness is named hidden beam. This has a root in wind. Its qi overflows in the large intestine and lodges in the gao. The origin of the gao is below the navel; therefore there is pain ringing the navel. It cannot be moved. Move it, and it becomes an illness of water, urine rough. The Emperor said: You have often said that heat in the center and wasting in the center must not take rich and greasy fare, fragrant herbs, or stone medicines. Stone medicines bring on withdrawal; fragrant herbs bring on mania. Those with heat in the center and wasting in the center are all of the wealthy and noble. Now to forbid rich fare does not suit their hearts; to forbid fragrant herbs and stone medicines means the illness will not recover. I wish to hear the account. Qi Bo said: The qi of fragrant herbs is beautiful; the qi of stone medicines is fierce. Both have qi that is urgent, swift, hard, and strong. Therefore those whose hearts are not slow and who are not people of accord cannot take these two. The Emperor said: They cannot take these two — why is this so? Qi Bo said: Heat qi is fierce and swift; the qi of the medicines is also so. When the two meet, I fear they will harm the spleen within. The spleen is earth and dislikes wood. Those who take this medicine — when jia and yi days come, discuss it further. The Emperor said: Good. There is swelling of the breast, pain in the neck, fullness in the chest, and distention of the belly. What illness is this? How is it obtained? Qi Bo said: It is named reversal against. The Emperor said: How does one treat it? Qi Bo said: Moxa it, and there is loss of voice; stone it, and there is mania. Wait until the qi has joined; then it can be treated. The Emperor said: Why is this so? Qi Bo said: Yang qi is heavy above, with surplus above. Moxa it, and yang qi enters yin; entering, there is loss of voice. Stone it, and yang qi is vacant; vacant, there is mania. Wait until the qi has joined, then treat it; it can be made whole. The Emperor said: Good. How does one know that one who is carrying a child is about to give birth? Qi Bo said: The body has an illness, yet there is no pathogenic pulse. The Emperor said: When there is a heat illness and also pain somewhere — why? Qi Bo said: A heat illness is a yang vessel. It is by the movement of the three yang. Renying one degree full is Shaoyang; two degrees full, Taiyang; three degrees full, Yangming — then it enters yin. Yang entering yin: therefore the illness is in the head and the belly, and there is flooding distention and headache. The Emperor said: Good.

The line

Although the illness is about to end, at times it must therefore be ill: qi gathers in the belly.

The note

Distention, blood, and worms in the abdomen all first have a “why in the center.” Drum distention is only the shape. The root is still qi that has stayed.