脉∶胀满脉弦，脾制于肝；洪数热胀，迟弱阴寒；浮为虚胀，紧则中实；浮大者生，虚小危急。
夫胀者，由脾胃之气虚弱，不能运化精微而致水谷聚而不散，故成胀也。然饮食失节，不能调养则清气下降，
浊气填满胸腹，湿热相蒸，遂成胀满。经曰∶鼓胀是也。中空无物有似于鼓，小便短涩不利，其病胶固难以治疗
。用分消汤加减治之，健脾顺水宽中为主也。不可大用猛烈之药反伤脾胃，病再复来不可治也。若脐凸肉硬、肚
大青筋、足背手掌俱浮，男从脚下肿上，女从头上肿下，并皆不治。
腹胀者，肚腹胀起、中空似鼓是也。
分消汤 治中满成鼓胀，兼治脾虚发肿满饱闷。
苍术（米泔浸炒） 白术（去芦） 陈皮 浓朴（姜汁炒） 枳实（麸炒。各一钱） 砂仁（七分） 木香
（三分） 香附 猪苓 泽泻 大腹皮（各八分） 茯苓（一钱）
上锉一剂，生姜一片、灯草一团，水煎服。气急加沉香；
肿胀加萝卜子；胁痛面黑是气鼓，加青皮去白术；胁满小肠胀痛、身上有血丝缕是血鼓，加当归、芍药、红花、
牡丹皮，去白术、茯苓；嗳气作酸、饱闷腹胀是食鼓，加山楂、神曲、麦芽、萝卜子，去白术、茯苓；恶寒手足
厥冷、泻去清水是水鼓，加官桂；胸腹胀满有块如鼓者，是痞散成鼓，加山楂、神曲、半夏、青皮、归尾、玄胡、
鳖甲，去白术、茯苓、猪苓、泽泻。
腹胀脾胃气血俱虚者，宜半补而半消也。
行湿补气养血汤 治气血虚弱，单腹鼓胀浮肿。
人参 白术（去芦） 茯苓 当归 川芎 白芍（敛胀，各一钱） 苏梗 陈皮（泄满） 浓朴（姜炒）
大腹皮（敛气） 萝卜子（炒） 海金沙 木通（利水。各八分） 木香（运气） 甘草（生。各三分）
上锉一剂，生姜三片、枣一枚，水煎服。气虚倍人参、白术、茯苓；血虚倍当归、川芎、白芍；小便短少，
再加猪苓、泽泻、滑石；服后肿胀俱退，唯面足不消，此阳明经气虚，倍用白术、茯苓。
和荣顺气汤 治脾弱血虚，心腹胀闷、两足虚肿。
当归（酒洗，一钱） 川芎（六分） 白芍（酒浸） 白术（土炒。各一钱） 茯苓 乌药 苍术（米泔浸）
陈皮（去白） 枳实（炒） 神曲（炒） 香附（醋炒） 木瓜 牛膝（酒洗） 独活（酒洗） 泽泻 薏苡仁
（炒） 木通（各一钱） 甘草（三分）
上锉一剂，生姜煎服。
腹胀元气脾胃两虚者，宜补多而消少也。
调中健脾丸 治单腹胀及脾虚肿满、膈中闭塞及胃口作痛，并皆治之，神效。
黄 （蜜炒） 人参（去芦。各二两） 白术（六两，黄土拌炒） 茯苓（二两） 陈皮（二两，盐水炒）
苏子（二两半，微炒） 萝卜子（一两半，炒） 山楂肉（三
两，炒） 草豆蔻（二两半，酒拌炒） 泽泻（三两半） 薏苡仁（三两，炒） 沉香（六钱，另为末）
五加皮（三两，炒） 栝蒌（一两，用大栝蒌二个，钻一孔，每个入川椒三钱，多年粪 二钱敲米粒大，俱纳
入瓜内，外以绵纸糊完，再用纸筋、盐泥封固，炭火内 红为度，取出择去盐泥，其黑色一并入药。）
上锉为细末，煎荷叶、大腹皮汤，打黄米糊为丸，如梧桐子大。每服百丸，日进三次，白汤下。此药不伤
元气，大有补益，勿轻视之。
热胀腹有积聚者，宜分消也。
广术溃坚汤 治中满腹胀有积聚如石坚硬，令人坐卧不宁，二便涩滞，上气喘促，或通身虚肿。
浓朴（姜制） 黄连 黄芩 益智仁 草豆蔻 当归（各五分） 半夏（七分） 广术 升麻 红花
吴茱萸（各三分） 生甘草 柴胡 泽泻 神曲（炒） 青皮 陈皮（各三分） 口干加干葛（四分）
上锉一剂，生姜煎，食远服。忌酒醋湿面。
中满分消丸 治中满鼓胀、气胀、水胀、大热胀，不治寒胀。
人参 白术 姜黄 猪苓（去黑皮） 炙甘草（各一钱） 白芍 砂仁 干生姜（各二钱） 泽泻 陈皮
（各三钱） 知母（炒，四钱） 枳实（麸炒） 半夏（泡） 黄连（炒。各五钱） 黄芩（炒，一两二钱）
浓朴（姜炒，一两）
上为细末，水浸蒸饼为丸，如梧桐子大，每服百丸，熟白汤下，食远服。
寒胀不喜饮食，宜温散也。
香朴汤 治老人中寒下虚，心腹膨胀，不喜饮食，脉浮迟而弱，此名寒胀。
浓朴（姜炒，一两） 大附子（炮去皮脐，七钱半） 木香（三钱）
上锉一剂，姜七片、枣一枚，水煎服。
血气凝结积聚而成腹胀者，宜专攻也。
四炒枳壳丸 治气血凝滞，腹内鼓胀积聚，此药宽中快膈快气，消导饮食。
枳壳（四两，米泔浸，去瓤切片，分四处炒之∶）一分（苍术一两同煮干、炒黄色，去苍术），一分
（萝卜子一两水同煮干、炒黄色，去萝卜子），一分（小茴香一两水同煮干、炒黄色，去茴香），一分（干漆一
两水同煮干、炒黄色，去干漆）香附（二两）槟榔（一两）玄胡索（一两，微炒）三棱（二两，同莪术法制）莪
术（一两棱、莪二味用童便一钟浸一宿，次日用完巴豆仁去壳三十粒同水煮干，炒黄色，去豆不用。）
上为细末，用苍术、茴香、萝卜子、干漆煮汁，好醋一碗同面糊为丸，如梧桐子大。每服七十丸，清米汤下。
腹胀因于气者，宜顺气也。分心气饮（方见诸气）。根据本方，如水气浮肿因于气者加猪苓、泽泻、车前、
葶苈、木瓜、麦门冬。
金陵酒丸 治鼓肿。
真沉香（一两） 牙皂（一两） 广木香（二两半） 槟榔（一两）
上为末，用南京烧酒为丸。每服三钱，重者四钱，五更烧酒下。水肿，水自小便而出，气鼓放屁；水鼓
加苦亭苈五钱煎，酒送下再服。
金蟾散 治气鼓如神。
大虾膜一个，以砂仁推入其口内，使吞入腹，以满为度，用泥罐封固，炭火锻，令红透烟净取出，候冷去泥，
研末为一服，或酒、或陈皮汤送下。候撒屁多乃见其效。
宽中养胃汤 治胸膈胀满，饮食少用。
苍术（炒，四分） 香附（七分） 枳壳（麸炒，五分） 浓朴（姜炒，五分） 藿香（五分） 山楂（三分）
陈皮（一钱） 砂仁（三分，细） 神曲（炒，四分） 槟榔（三分） 麦芽（炒，四分） 青皮（去瓤，三分）
枳实（麸炒，四分） 半夏（五分） 茯苓（五分） 甘草（炙，三分）
上锉一剂，生姜三片、枣一枚，水煎，食远服。
春元李河山，患腹左一块，数年不愈。后食派饼过多，得腹胀满闷。余诊六脉洪数，气口紧盛。以藿香正
气散加山楂、神曲，二剂而愈。逾月又因饮食失节，腹胀如初，而仍以前正气散数剂弗效，又易行湿补气养血汤
二十余剂始安。余嘱曰∶病虽愈而体未撤消，务要谨守，勿犯禁戎。逾数月，过余曰∶凡有病，皆天与也，不在服
药，不在谨守，若当时颜子亚圣岂不能保养，何短命死矣。我今保养半年，未见何如，岂在保养服药者哉？予不能
对，渠遂放肆无忌。未经数旬，忽患痢赤白，里急后重，痛不可忍、昼夜无度。渠自制大黄一剂，数下勿效，复求
予诊。六脉洪数，先以调中理气汤二剂，又以补中益气汤加白芍、黄连微效。渠欲速效，遂易他医。其医不审病原，
数患内伤鼓胀之疾，辄用下药。不愈，又易一医，又下之。前后约三十余度，将元气愈惫而下脱，肛门痛如刀割，腹
胀如鼓。然医不知元气下陷，陷深则痛愈深，当大补元气、升提为主，非百剂不可。今以素损元气者，欲速效；岂可
得也。嗟夫！医者不补而反泻，病者不慎而欲速，安得不死也？信两误耳。
补遗方
化龙丹 治单腹胀。
用大鲤鱼一个、巴豆四十粒，将鱼FS 了，将鱼脊割开两刀，将巴豆下在两刀路合住，用纸包裹，慢火烧熟，
去豆食鱼，米汤下。
Pulse: Abdominal distension with a wiry pulse indicates the Spleen is controlled by the Liver; a surging and rapid pulse indicates heat-type distension, while a slow and weak pulse indicates Yin-cold type distension; a floating pulse indicates deficiency-type distension, and a tight pulse indicates excess in the Middle Jiao; a floating and large pulse suggests a favorable prognosis (survival), whereas a deficient and small pulse indicates critical danger.
Distension arises from the deficiency of Qi in the Spleen and Stomach, which fails to transform and transport essential nutrients, causing food and water to accumulate without dispersing, thus forming distension. However, irregular diet and failure to nourish the body cause clear Qi to descend improperly, while turbid Qi fills the chest and abdomen. Damp-heat steams and boils together, resulting in distension. The Classics state: this is Drum Distension (Gu Zhang). Its characteristic is an empty abdomen resembling a drum, with short, scanty, and difficult urination. This disease is entrenched and difficult to treat. It should be treated with modified Fen Xiao Tang (Dividing and Eliminating Decoction), focusing on strengthening the Spleen, promoting diuresis, and relaxing the middle. One must not use strong or harsh medicines excessively, as this will damage the Spleen and Stomach, leading to recurrence that becomes incurable. If the umbilicus protrudes, muscles are hard, the abdomen is large with visible varicose veins, and edema affects both the dorsum of the feet and palms; if men swell upwards from the feet, and women downwards from the head, these are all untreatable conditions.
Abdominal distension refers to the swelling and bulging of the abdomen, which is hollow inside like a drum.
Fen Xiao Tang (Dividing and Eliminating Decoction): Treats drum distension caused by fullness in the Middle Jiao, and also treats edema, fullness, and stuffiness due to Spleen deficiency.
Cang Zhu (Atractylodis Rhizoma) (soaked in rice wash water and stir-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (remove rhizome base), Chen Pi (Citri Reticulatae Pericarpium), Hou Po (Magnoliae Officinalis Cortex) (stir-fried with ginger juice), Zhi Shi (Immature Bitter Orange Fruit) (stir-fried with bran. Each 1 qian), Sha Ren (Amomi Fructus Rotundus) (0.7 qian), Mu Xiang (Aucklandiae Radix) (0.3 qian), Xiang Fu (Cyperi Rhizoma), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Da Fu Pi (Arecae Pericarpium) (Each 0.8 qian), Fu Ling (Poria) (1 qian).
Grind the above into coarse powder. For one dose, add one slice of fresh ginger and a bunch of juncus effusus, decoct with water and take orally. Add Chen Xiang (Aquilariae Lignum Resinatum) for急促 breathing; add Luo Bo Zi (Raphani Semen) for severe swelling; for hypochondriac pain and dark complexion indicating Qi Distension, add Qing Pi (Citri Reticulatae Pericarpium Viride) and remove Bai Zhu; for hypochondriac fullness, lower abdominal distension and pain, and blood streaks on the body indicating Blood Distension, add Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix Alba), Hong Hua (Carthami Flos), Mu Dan Pi (Moutan Cortex), and remove Bai Zhu and Fu Ling; for belching with acid regurgitation, fullness and abdominal distension indicating Food Distension, add Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), Mai Ya (Hordei Fructus Germinatus), Luo Bo Zi (Raphani Semen), and remove Bai Zhu and Fu Ling; for aversion to cold, cold extremities, and diarrhea with clear watery stool indicating Water Distension, add Guan Gui (Cinnamomi Cortex); for chest and abdominal fullness with masses resembling a drum, indicating Pi San Cheng Gu (Dispersed Blockage becoming Drum Distension), add Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), Ban Xia (Pinelliae Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Gui Wei (Radix Angelicae Sinensis Cauda), Yuan Hu (Corydalis Rhizoma), Bie Jia (Testudinis Carapax et Plastrum), and remove Bai Zhu, Fu Ling, Zhu Ling, and Ze Xie.
If abdominal distension is due to combined deficiency of Qi and Blood in the Spleen and Stomach, it is appropriate to use half tonification and half elimination.
Xing Shi Bu Qi Yang Xue Tang (Moisture-Driving, Qi-Nourishing, and Blood-Supplementing Decoction): Treats single-abdomen drum distension and generalized edema due to Qi and Blood deficiency.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (remove rhizome base), Fu Ling (Poria), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba) (to restrain distension, each 1 qian), Su Geng (Perillae Caulis), Chen Pi (Citri Reticulatae Pericarpium) (to drain fullness), Hou Po (Magnoliae Officinalis Cortex) (stir-fried with ginger), Da Fu Pi (Arecae Pericarpium) (to restrain Qi), Luo Bo Zi (Raphani Semen) (stir-fried), Hai Jin Sha (Lygodii Spora), Mu Tong (Akebiae Caulis) (promote diuresis. Each 0.8 qian), Mu Xiang (Aucklandiae Radix) (to move Qi), Gan Cao (Glycyrrhizae Radix et Rhizoma) (raw. Each 0.3 qian).
Grind the above into coarse powder. For one dose, add three slices of fresh ginger and one jujube, decoct with water and take orally. Double the dosage of Ren Shen, Bai Zhu, and Fu Ling for Qi deficiency; double Dang Gui, Chuan Xiong, and Bai Shao for Blood deficiency; if urine is scanty, add Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), and Hua Shi (Talcum); after taking the medicine, if swelling subsides but the face and feet remain swollen, this indicates Qi deficiency in the Yangming Meridian; double the dosage of Bai Zhu and Fu Ling.
He Rong Shun Qi Tang (Harmonizing Nutrients and Smoothing Qi Decoction): Treats heart and abdominal stuffiness and virtual swelling of both legs due to Spleen weakness and Blood deficiency.
Dang Gui (Angelicae Sinensis Radix) (wine-washed, 1 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (6 fen), Bai Shao (Paeoniae Radix Alba) (wine-soaked), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (earth-stir-fried. Each 1 qian), Fu Ling (Poria), Wu Yao (Linderae Radix), Cang Zhu (Atractylodis Rhizoma) (soaked in rice wash water), Chen Pi (Citri Reticulatae Pericarpium) (remove white pith), Zhi Shi (Immature Bitter Orange Fruit) (stir-fried), Shen Qu (Massa Medicata Fermentata) (stir-fried), Xiang Fu (Cyperi Rhizoma) (vinegar-stir-fried), Mu Gua (Chaenomelis Fructus), Niu Xi (Achyranthis Bidentatae Radix) (wine-washed), Du Huo (Angelicae Pubescentis Radix) (wine-washed), Ze Xie (Alismatis Rhizoma), Yi Yi Ren (Coicis Semen) (stir-fried), Mu Tong (Akebiae Caulis) (Each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 fen).
Grind the above into coarse powder. For one dose, add fresh ginger and decoct with water.
If abdominal distension is due to deficiency of Primordial Qi and both Spleen and Stomach, it is appropriate to use more tonification and less elimination.
Tiao Zhong Jian Pi Wan (Regulating the Middle and Strengthening the Spleen Pill): Treats single abdominal distension, swelling and fullness due to Spleen deficiency, blockage in the diaphragm, and stomach ache, all of which respond well to this formula with miraculous effects.
Huang Qi (Astragali Membranacei Radix) (honey-stir-fried), Ren Shen (Ginseng Radix et Rhizoma) (remove rhizome base. Each 2 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (6 liang, stir-fried with yellow earth), Fu Ling (Poria) (2 liang), Chen Pi (Citri Reticulatae Pericarpium) (2 liang, salt-water stir-fried), Su Zi (Perillae Fructus) (2.5 liang, lightly stir-fried), Luo Bo Zi (Raphani Semen) (1.5 liang, stir-fried), Shan Zha Rou (Crataegi Fructus flesh) (3 liang, stir-fried), Cao Dou Kou (Alpiniae Katsumadai Semen) (2.5 liang, wine-mixed stir-fried), Ze Xie (Alismatis Rhizoma) (3.5 liang), Yi Yi Ren (Coicis Semen) (3 liang, stir-fried), Chen Xiang (Aquilariae Lignum Resinatum) (6 qian, ground separately into powder), Wu Jia Pi (Acanthopanacis Cortex) (3 liang, stir-fried), Gua Lou (Trichosanthis Fructus) (1 liang, use two large Trichosanthis Fructus, drill one hole in each, insert 3 qian of Chuan Jiao (Zanthoxyli Pericarpium) and 2 qian of aged feces crushed to rice-grain size into each melon, seal the outside with cotton paper, then seal firmly with mud mixed with salt and straw, roast over charcoal until red-hot, remove, scrape off the mud, and include the blackened part in the medicine.)
Grind the above into fine powder. Decoct He Ye (Nelumbinis Folium) and Da Fu Pi (Arecae Pericarpium) in water, mix with yellow millet paste to form pills the size of paulownia seeds. Take 100 pills per dose, three times daily, washed down with plain warm water. This medicine does not damage Primordial Qi and provides great tonification; do not underestimate it.
For heat distension accompanied by abdominal accumulations, the method of dividing and eliminating should be used.
Guang Zhu Kui Jian Tang (Curcuma Softening Hardness Decoction): Treats Middle Jiao fullness and abdominal distension with accumulations as hard as stones, causing restlessness in sitting and lying, obstructed urination and defecation, upper body panting, or generalized virtual edema.
Hou Po (Magnoliae Officinalis Cortex) (ginger-prepared), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Cao Dou Kou (Alpiniae Katsumadai Semen), Dang Gui (Angelicae Sinensis Radix) (Each 5 fen), Ban Xia (Pinelliae Rhizoma) (7 fen), Guang Zhu (Curcumae Longae Rhizoma), Sheng Ma (Bupleuri Radix), Hong Hua (Carthami Flos), Wu Zhu Yu (Evodiae Fructus) (Each 3 fen), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Chai Hu (Bupleuri Radix), Ze Xie (Alismatis Rhizoma), Shen Qu (Massa Medicata Fermentata) (stir-fried), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium) (Each 3 fen). Add Gan Ge (Puerariae Radix) (4 fen) if there is dry mouth.
Grind the above into coarse powder. For one dose, add fresh ginger, decoct, and take long after meals. Avoid alcohol, vinegar, and damp noodles.
Zhong Man Fen Xiao Wan (Middle Fullness Dividing and Eliminating Pill): Treats Middle Jiao fullness drum distension, Qi distension, Water distension, and severe heat distension; does not treat cold distension.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Jiang Huang (Curcumae Longae Rhizoma), Zhu Ling (Polyporus) (remove black skin), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (Each 1 qian), Bai Shao (Paeoniae Radix Alba), Sha Ren (Amomi Fructus Rotundus), Gan Sheng Jiang (Dried Fresh Ginger) (Each 2 qian), Ze Xie (Alismatis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium) (Each 3 qian), Zhi Mu (Anemarrhenae Rhizoma) (stir-fried, 4 qian), Zhi Shi (Immature Bitter Orange Fruit) (bran-stir-fried), Ban Xia (Pinelliae Rhizoma) (soaked), Huang Lian (Coptidis Rhizoma) (stir-fried. Each 5 qian), Huang Qin (Scutellariae Radix) (stir-fried, 1 liang 2 qian), Hou Po (Magnoliae Officinalis Cortex) (ginger-stir-fried, 1 liang).
Grind the above into fine powder. Soak steamed cake made from water in water, form pills the size of paulownia seeds. Take 100 pills per dose, washed down with cooked plain warm water, taken long after meals.
For cold distension where the patient dislikes food, the method of warming and dispersing should be used.
Xiang Po Tang (Costus and Magnolia Decoction): Treats elderly patients with Cold invasion and Lower Deficiency, causing heart and abdominal distension, dislike of food, and a floating, slow, and weak pulse. This is named Cold Distension.
Hou Po (Magnoliae Officinalis Cortex) (ginger-stir-fried, 1 liang), Da Fu Zi (Aconiti Lateralis Radix Praeparata) (processed, remove skin and navel, 7.5 qian), Mu Xiang (Aucklandiae Radix) (3 qian).
Grind the above into coarse powder. For one dose, add seven slices of fresh ginger and one jujube, decoct with water and take orally.
If abdominal distension is formed by coagulation and accumulation of Qi and Blood, the method of direct attack should be used exclusively.
Si Chao Zhi Qiao Wan (Four-Stir-Fried Aurantium Pill): Treats Qi and Blood stagnation, drum-like abdominal distension and accumulations. This medicine relaxes the middle, clears the diaphragm, smooths Qi, and aids digestion.
Zhi Qiao (Aurantii Fructus) (4 liang, soaked in rice wash water, remove pulp and slice, divide into four parts for stir-frying:): One part (boiled dry with 1 liang of Cang Zhu, stir-fried to yellow, remove Cang Zhu), One part (boiled dry with 1 liang of Luo Bo Zi, stir-fried to yellow, remove Luo Bo Zi), One part (boiled dry with 1 liang of Xiao Hui Xiang, stir-fried to yellow, remove Hui Xiang), One part (boiled dry with 1 liang of Gan Qi, stir-fried to yellow, remove Gan Qi), Xiang Fu (Cyperi Rhizoma) (2 liang), Bing Lang (Arecae Semen) (1 liang), Yuan Hu Suo (Corydalis Rhizoma) (1 liang, lightly stir-fried), San Leng (Sparganii Rhizoma) (2 liang, processed same as E Zhu), E Zhu (Curcumae Rhizoma) (1 liang, soak San Leng and E Zhu in one cup of child's urine overnight, next day boil dry with 30 peeled Ba Dou kernels, stir-fry to yellow, remove beans).
Grind the above into fine powder. Use the decoction of Cang Zhu, Hui Xiang, Luo Bo Zi, and Gan Qi, add one bowl of good vinegar, mix with flour paste to form pills the size of paulownia seeds. Take 70 pills per dose, washed down with clear rice soup.
If abdominal distension is caused by Qi, the method of smoothing Qi should be used. Fen Xin Qi Yin (Dividing Heart Qi Decoction) (formula see under Various Qi disorders). According to this formula, if water qi edema is caused by Qi, add Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Che Qian (Plantaginis Semen), Ting Li (Lepidii Semen), Mu Gua (Chaenomelis Fructus), Mai Men Dong (Ophiopogonis Radix).
Jin Ling Jiu Wan (Jinling Wine Pill): Treats drum swelling.
Zhen Chen Xiang (True Aquilariae Lignum Resinatum) (1 liang), Ya Zao (Gleditsiae Sinensis Spina) (1 liang), Guang Mu Xiang (Aucklandiae Radix) (2.5 liang), Bing Lang (Arecae Semen) (1 liang).
Grind the above into powder. Form pills using Nanjing distilled liquor. Take 3 qian per dose, 4 qian for severe cases, washed down with distilled liquor at the fifth watch (early morning). For edema, water exits via urination; for Qi distension, flatulence occurs; for Water distension, add Ku Ting Li (5 qian), decoct, and take with wine followed by another dose.
Jin Chan San (Golden Toad Powder): Treats Qi distension with divine efficacy.
Take one large toad membrane, push Sha Ren (Amomi Fructus Rotundus) into its mouth so it swallows it into its belly until full. Seal in a clay pot, roast over charcoal until red and smoke-free. Remove, cool, remove mud, grind into powder for one dose. Take with wine or Chen Pi (Citri Reticulatae Pericarpium) decoction. Efficacy is seen when the patient passes much gas.
Kuan Zhong Yang Wei Tang (Widen the Middle and Nourish the Stomach Decoction): Treats chest and diaphragm fullness and reduced appetite.
Cang Zhu (Atractylodis Rhizoma) (stir-fried, 4 fen), Xiang Fu (Cyperi Rhizoma) (7 fen), Zhi Qiao (Aurantii Fructus) (bran-stir-fried, 5 fen), Hou Po (Magnoliae Officinalis Cortex) (ginger-stir-fried, 5 fen), Huo Xiang (Agastaches Herba) (5 fen), Shan Zha (Crataegi Fructus) (3 fen), Chen Pi (Citri Reticulatae Pericarpium) (1 qian), Sha Ren (Amomi Fructus Rotundus) (3 fen, fine powder), Shen Qu (Massa Medicata Fermentata) (stir-fried, 4 fen), Bing Lang (Arecae Semen) (3 fen), Mai Ya (Hordei Fructus Germinatus) (stir-fried, 4 fen), Qing Pi (Citri Reticulatae Pericarpium Viride) (remove pulp, 3 fen), Zhi Shi (Immature Bitter Orange Fruit) (bran-stir-fried, 4 fen), Ban Xia (Pinelliae Rhizoma) (5 fen), Fu Ling (Poria) (5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (prepared, 3 fen).
Grind the above into coarse powder. For one dose, add three slices of fresh ginger and one jujube, decoct with water, and take long after meals.
Li Heshan, a scholar from Chunyuan, suffered from a lump on the left side of his abdomen for several years without cure. Later, after eating too many Pai Bing (pastries), he developed abdominal distension and stuffiness. I diagnosed his six pulses as surging and rapid, with the Qi Kou pulse being tight and vigorous. I prescribed Huo Xiang Zheng Qi San (Agastache Rectifying Qi Powder) plus Shan Zha (Crataegi Fructus) and Shen Qu (Massa Medicata Fermentata). He recovered after two doses. Over a month later, due to irregular diet, his abdominal distension returned as before. I again prescribed Zheng Qi San for several doses, but it was ineffective. I then changed to Xing Shi Bu Qi Yang Xue Tang (Moisture-Driving, Qi-Nourishing, and Blood-Supplementing Decoction) for over twenty doses before he stabilized. I advised him: Although the illness has healed, your constitution has not fully recovered. You must strictly observe precautions and avoid forbidden foods. Several months later, he passed by me and said: All illnesses are destined by Heaven. They depend neither on taking medicine nor on strict observation. Did Yan Hui and Meng Ke (the Sage) not know how to preserve their health? Why did they die young? I have preserved my health for half a year and see no difference. Is preservation and medicine really necessary? I could not answer him, and he became reckless and unbridled. Within a few weeks, he suddenly suffered from dysentery with red and white stools, tenesmus, unbearable pain day and night. He prepared a dose of Da Huang (Rhei Radix et Rhizoma) himself. Multiple purgations were ineffective. He sought my diagnosis again. His six pulses were surging and rapid. I first prescribed Tiao Zhong Li Qi Tang (Regulate the Middle and Smooth Qi Decoction) for two doses, then Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) plus Bai Shao (Paeoniae Radix Alba) and Huang Lian (Coptidis Rhizoma), with slight effect. Desiring quick results, he switched to another doctor. That doctor did not examine the root cause. Having previously suffered from internal injury drum distension, the doctor repeatedly used purgative drugs. When it didn't work, he switched to yet another doctor who also used purgatives. In total, about thirty times, his Primordial Qi became increasingly exhausted and sank downward. His anus felt like it was being cut by a knife, and his abdomen was distended like a drum. However, the doctors did not realize that the Primordial Qi had sunk; the deeper the sinking, the deeper the pain. The treatment should focus on greatly tonifying Primordial Qi and lifting it up, requiring no less than a hundred doses. Now, for someone whose Primordial Qi was already damaged, seeking quick results is impossible. Alas! The doctor tonified instead of purged, but here the doctor purged instead of tonifying; the patient was careless and desired quick results. How could he not die? It is indeed a double error.
Supplementary Prescriptions
Hua Long Dan (Dragon Transforming Pellet): Treats single abdominal distension.
Use one large carp and forty Ba Dou (Crotonis Semen). Gut the fish, make two cuts along the fish spine, place the Ba Dou between the cuts, wrap in paper, and slowly cook until done. Remove the beans and eat the fish, washed down with rice soup.