EXPLANATIONS AND COMMENTARIES
I - Zhang Shi explains:
“Fu Zhang (anasarca) is caused by the presence of perverse cold at the external part of the body, while Gu Zhang (tympanism) is caused by perverse cold within the internal psrt of the body.
This is why:
_ first, disperse the Xuo Luo _ second, balance the Jingmai
_ and last, make the Xue Luo bleed to evacuate the viscous blood.” II - N.V.N.:
Blood stasis at the level of the Sun Luo (secondary vessels) are also studied in Chapter 39 of this classic (“Study on Stasis at the Level of the Blood Luo”) (2):
“In fullness, the Xue Luo are hard, red in color and arranged by length and width, at the top or at the bottom, without fixed localization; sometimes they are as fine as needles, sometimes they are as large as
chopsticks. It is necessary to disperse according to the rules and not make a mistake of “number” of the needling of the Luo.
To do the opposite is to provoke the above-noted signs.”
Blood stases at the level of the Jingluo (principal and secondary channels), in particular at the level of the Sun Luo (energetic capillaries), very common in clinic, are the precursor signs of numerous illnesses. Ma Shi emphasizes the method of dispersion of the Luo, according to the technique known as “in opposition”:
125.
“This paragraph explains the method of examination of blood stases at the level of the Jingluo (principal and secondary channels) whose ideal therapeutic technique is dispersion which consists of inclining the needle to perform movements called “in opposition”. This technique is in agreement with the “numbered” technique cited in the text. In contrast, the opposite technique can cause unfavorable signs like fainting, spurting out of the blood,
swelling...“.
• We present below a summary table of etiology, symptomatology and diagnosis of the 5 diseases (hydropsy, anasarca, tympanism, polyp and fibroma) cited in the text of this chapter.
Note, however, that in this Chapter 57 of the Lingshu, Huangdi also questioned Qi Bo about the formation of Shi Shui (hydronephrosis) (3). His reply is found in Chapter 7 of the Suwen (“Special Study on Yin and Yang”) and in Chapter 4 of the Lingshu (“Pathologic Forms of Attack of the Organs and Bowels by Perverse Energy”).
a - In Chapter 7 of the Suwen, we read:
“The concentration of perverse energy simultaneously in Yin and in Yang provokes Shi Shui (Stone-Water: hydronephrosis).”
“In relation to the human body, exterior is Yang, interior is Yin, stomach is Yang, kidneys are Yin. We read in the Neijing that the kidneys are the “doors” of the stomach because the stomach
2. Cf. Lingshu, Volume II, p. 257, N.V.N. Edition, English translation by ESG.
3. Literally, “Shi” = stone; “Shui” = water. It encompasses the group of diseases of renal origin such as: hydronephrosis, ascites, nephrolithiasis... .
communicates with the kidneys via the intermediary of the Lower Jiao (Xiajiao). The Lower Jiao leads the dietary liquid toward the intestines, then from the intestines toward the kidneys via its “internal duct” (internal trajectory). (Figure 1)
When the doors (kidneys) are “closed”, water accumulates within the peritoneal space located between the kidneys and stomach, hence ascites with hard belly; or else it accumulates within the kidneys, hence hydronephrosis.
These illnesses have the tendency to lean even more to the Yin side than to the Yang side; this is because they present more Yin signs than Yang signs.”
b - Chapter 4 of the Lingshu (4) also describes the pulse concerning Shi Shui:
“...The very changing (Da) pulse of the kidney is the signs of Yin Wei (sexual impotence).
Barely changing, it is the sign of Shi Shui (hydronephrosis). This disease starts at the sub-umbilical region and reaches the lower abdomen. When it ascends to the stomach, it is death”.
Here is the explanation of Zhang Shi:
“Yin Wei (sexual impotence) is an ailment characterized by a deadening of Yin, hence inability to have erection. As for Shi Shui (hydronephrosis), it is of “Kidney-Water” origin.
When is reaches the top, that is to say, the stomach, it constitutes what one calls “phenomenon of overflowing of Water (Kidney) with defeat of Earth (Spleen).”
Figure 1:
Energy of the Lower Jiao (Xiajiao) and the kidneys. Ma Shi adds:
“The changing (Da) pulse is a pathologic pulse of the heart.
If the pulse of the kidney is very changing, it is the sign revealing the excess of Fire and shortage of Water, responsible for Yin Wei (sexual impotence).
Barely changing, it is the sign of the presence of Shi Shui (hydronephrosis). Below, this affliction reaches the hypogastrium giving it a ptotic appearance, and above, it affects the epigastrium. This disease is fatal. Also Chapter 7 of the Suwen states: “Yin and Yang become concentrated because there is a plethora of Yin and
deficiency of Yang. This state is the origin of Shi Shui (hydronephrosis).”
Intra-uterine formation, influencing menstruation (absence of rules) _ progressive increase of fibromatous mass as in a pregnant woman Perverse “cold” energy
retained within the uterine neck:
_ obstruction of the uterus _ thick energy and blood unable to be evacuated. _ Extra-uterine formation without effect on menstruation (normal rules)
_ the size of an egg then develops as in a pregnant woman “Cold” perverse energy
retained within the abdominal cavity, at the exterior of the intestines: _ Energetic and blood stasis (thick energy and blood) _ Greyish yellow abdominal skin _ collateral circulation _ Swollen body as in anasarca
Acording to Zhang Shi: _ massive infiltration of “cold” perverse within the empty spaces of the organism (abdomen)
_ Presnce of pitting (The energy does not follow
the movements of the fingers)
_ generalized edema _ big abdomen _ thickened skin
_ absence of change of the color of the skin • to the touch: _ soft
_ buzzing sound
_ Fixation of perverse “cold” energy within the cutaneous spaces
_ Absence of pitting (Water follows the
movement of the fingers during pressure)
Starting phase: _ palpebral edema _ agitated carotid pulse _ cold at the inner thigh _ swollen legs and feet then abdomnal swelling According to Ma and Zhang: _ overflowing or water due to insufficiency of energy “cold” of Taiyang (Bl) “humidity” of Taiyin (Sp) Diagnosis Symptomatology Etiology Shi Jia