Drum distension · gu zhang

At a glance

Pinyin

gǔ zhàng

Simplified

鼓胀

Literal

鼓 gǔ — a drum; 脹 zhàng — to swell, to be distended. Put together the word does not describe a symptom so much as hand the doctor an image: the belly is tight enough to sound. Chapter 40 is the first place in the Suwen where the illness is given this name, and it is introduced by a single clinical test that anyone can perform — 旦食則不能暮食, eat at dawn and you cannot eat at dusk. The belly that was empty enough for a morning meal is full enough by evening to refuse one. The treatment that follows is the earliest prescription in the book: chicken-draff wine, one dose and the patient knows it, two doses and it is finished. And the chapter then refuses to let the medicine stand alone: the illness returns in season because eating is not moderated, and the last word on it is a mechanism — 氣聚於腹, qi gathered in the abdomen. Later medicine writes the word 臌, with the flesh radical, to mark it as a disease of the body rather than a description of a sound; this base text writes 鼓, the drum itself.

Shuowen

《說文解字》：鼓，郭也——**春分之音，萬物郭皮甲而出**，**从壴从支，會擊鼓之意**；**「脹」《說文》無之，徐鉉新附：「脹，腹滿也」**。「鼓」讀 gǔ、「脹」讀 zhàng，**二字本篇各1見、3見**，**「鼓脹」1見**——**《素問》言脹之第一篇即在此**，**後世作「臌脹」，加肉旁以別之**，**底本作「鼓」，今照錄**。**「腹」（「腹」讀 fù）本篇5見**，**「滿」（「滿」讀 mǎn）3見**；**「旦」（「旦」讀 dàn）、「暮」（「暮」讀 mù）各一見**，**朝暮對舉，是本篇第一病之確據**。