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Distension and fullness are primarily associated with the Lung. They can be categorized into deficiency distension, accumulation distension, heat distension, and cold distension.

Deficiency distension arises from vomiting or diarrhea, or from the mistaken administration of purgatives, resulting in distension and fullness. This condition is suitable for treatment by tonifying the Middle Jiao (the Spleen and Stomach), regulating Qi, and promoting urination. The prescription used is Sijunzi Tang (Four Gentlemen Decoction) with Licorice Root removed, supplemented with Magnolia Bark, Tangerine Peel, Atractylodes Rhizome, Aucklandia Root, and Akebia Stem. Licorice Root is removed because it is contraindicated in cases of fullness in the middle Jiao due to its sweet and cloying nature, whereas herbs like Magnolia Bark are essential for treating distension.

Accumulation distension is characterized by food stagnation and dry feces already present in the abdomen, accompanied by yellow urine, intermittent abdominal pain, slight wheezing, a solid pulse, frequent thirst, and an inability to eat. In such cases, purgation is indicated. Dingxiang Piji Wan (Clove Spleen Accumulation Pill) is used for purgation, followed by Jisheng Wan (Collective Sage Pill) for regulation.

If the patient has inherently weak Spleen and Stomach function, unable to digest and transport nutrients, leading to distension from food injury, the Spleen should first be tonified using Sijunzi Tang without Licorice Root, added with Magnolia Bark, Tangerine Peel, and Amomum Fruit. Subsequently, Piji Wan is used to purge the accumulation. After purgation, the Spleen is tonified again, primarily using Jisheng Wan. For mild cases, only Baohe Wan (Preserve Harmony Pill) is needed for regulation.

Heat distension presents with high fever throughout the body, red face, irritability, constipation, and hard stools. This is often caused by a robust constitutional foundation combined with the mistaken ingestion of drugs. It requires urgent purgation using Sanhuang Wan (Three Yellows Pill). If bowel movement remains obstructed, a gall-bladder suppository method (Dan Dao Fa) may be employed. After purgation, Weiling Wan (Stomach Cinnamon and Poria Pill) is used for regulation.

Cold distension results from the accumulation and constraint of cold pathogens, presenting with cold extremities, cyanotic complexion, and rapid breathing. Taki Wan (Collapse Qi Pill) should be administered first, followed by Weiling Wan for regulation.

For all cases of distension accompanied by wheezing and urgency, except for cold distension, Tingli Wan (Descurainia Seed Pill) is the appropriate treatment.

In some instances, widespread skin sores and scabies, after being washed or treated with topical applications, cause toxins to be forced inward, resulting in abdominal distension. Mild cases are treated with Baidu San (Defeat Toxin Powder); severe cases are purged with Jiedu Wan (Detoxify Toxin Pill). Recovery occurs when the sores erupt and the distension subsides. However, if the patient exhibits a cyanotic or black complexion,急促 upward rushing of Qi, cold hands and feet, fixed staring eyes, or closed eyes with vomiting of milk, these are signs of untreatable critical conditions.

Taki Wan Formula: Pepper (1 liang) and Scorpion Tail tip (de-toxified, 5 qian) are ground into powder, formed into pills with wheat paste, and taken with aged rice decoction. Another variation adds Radish Seeds, known as He Wan Zi (Brown Pill).