医学中，刘、李、朱、张而下，瓣香敬祝者，汪子 庵，独于气鼓症，列之湿门中，殊不谓然，究其源，
方书俱然，不自 庵始。余考其症，是气也，当列于气门。气以类而方明；病虽难而易治。夫气之功用，全赖
脾土为之转运（气分气与 ，土分有无形。脾属土，有形者也，有形之土运气。脾藏意，意亦属土，无形者也。
无形之土运 。有形之土，以药补之；无形之土，以心养之。二者得兼，而土斯健矣）。土旺而气乃周流四
体，土衰而气遂停滞中州，贯注躯壳，充盈腠理，郁而为热，气鼓成焉。经曰∶“诸胀腹大，皆属于热”是也。
其为症也，四肢日见瘦羸，肚腹日见胀满，任人揉按，痛痒不关。稍进 粮，饱闷难受。脾愈虚，肝益肆其
侮；气愈积，热益张其威。脉之弦且数，其所由来者，有明征矣。治是症者，当青筋未大见，脐心未大突，缺
盆未大满之时，重用黄连，以解其热。清金以制肝盛，培土不受肝邪（经验方∶人参、黄连、焦术、麦冬、青
皮、肉桂、炙草）。药固有维持之力，尤宜却咸味，断妄想，存神静虑，以养无形之土，不治气而气自宣通，
多有得安者。其名不一，曰单胀，以其独胀于腹也；曰鼓胀，以其中空无物也；曰蛊胀，若虫食物而中空也；
曰热胀，由热而胀也；曰气胀，由气而胀也。统名之曰气鼓也。彼水胀、
寒胀，列于湿门，宜也，原与此症毫不相涉。东垣一代伟人，中满分消丸（浓朴一两，枳实、黄连、黄芩、法
夏五钱，陈皮、知母、泽泻三钱，茯苓、砂仁、干姜二钱，人参、白术、甘草、猪苓一钱，蒸饼为丸），亦尚
未晰分也。
In the field of medicine, among those physicians revered and devoutly worshipped as masters since Liu Wansu, Li Dongyuan, Zhu Danxi, and Zhang Congzheng, Wang Zi'an (Wang Ang) alone classified Qi-distension syndrome into the "Dampness Category," a view I cannot accept. Tracing its origin, this is not unique to Wang Zi'an; it is a common practice in classical formularies and did not start with him.
Upon investigating this syndrome, I consider it belongs to the category of "Qi" and should be classified under the "Qi Gate." When diseases are categorized by their nature (Qi), the formulas become clear; although the disease may appear difficult to diagnose, it is relatively easy to treat. The function of Qi relies entirely on the transportation and transformation provided by Spleen Earth. (Distinction between Qi and Form: Earth is divided into tangible and intangible aspects. The Spleen belongs to Earth and is a tangible organ responsible for transporting Qi. The Spleen houses Yi [Intellect/Thought], which also belongs to Earth and is an intangible spiritual activity responsible for transforming Shen [Spirit]. Tangible Earth is supplemented by herbs; intangible Earth is nourished by mental cultivation. When both are combined, Earth becomes strong.) When Spleen Earth is prosperous, Qi circulates freely throughout the four limbs; when Spleen Earth declines, Qi stagnates in the Central Region (Middle Jiao), filling the body shell and interstices (Couli), where it condenses into Heat, resulting in Qi-distension. As stated in the Classics: "All cases of abdominal distension and enlargement belong to Heat."
The symptoms manifest as: the limbs becoming increasingly emaciated day by day, while the abdomen becomes increasingly distended day by day; regardless of external massage or pressure, the patient feels no pain or itching. Even slight intake of food causes severe fullness and discomfort. As Spleen Qi becomes more deficient, Liver Wood acts more tyrannically to overact upon it (Overacting); as Qi accumulates more, Heat exerts its dominance more fiercely. The pulse being both Wiry (Xian) and Rapid (Shu) has clear etiological origins.
To treat this syndrome, one must act before the superficial veins (Green Veins) become prominent, before the umbilicus protrudes significantly, and before the supraclavicular fossa (Quepen) becomes full. Use a heavy dose of Huanglian (Coptidis Rhizoma) to resolve the Heat. Clear Lung Metal to restrain excessive Liver Wood, and tonify Spleen Earth so it does not suffer from Liver pathogenic factors. (Empirical Formula: Renshen [Ginseng Radix], Huanglian [Coptidis Rhizoma], Jiaozhuzhu [Atractylodis Macrocephalae Rhizoma, Charred], Maidong [Ophiopogonis Radix], Qingpi [Citri Reticulatae Pericarpium Viride], Rougui [Cinnamomi Cortex], Zhigancao [Glycyrrhizae Radix et Rhizoma, Prepared]). While herbs certainly have the power to sustain health, it is especially important to avoid salty flavors, eliminate delusional thoughts, and maintain mental tranquility to nourish the intangible Earth. In this way, even without directly treating Qi, Qi will naturally flow smoothly, and many patients will recover.
This condition has various names: called "Dan Zhang" (Single Distension) because only the abdomen distends; called "Gu Zhang" (Drum Distension) because the interior is hollow; called "Gu Zhang" (Poison/Bug Distension) because it resembles hollowing out by insects; called "Re Zhang" (Heat Distension) because it arises from Heat; and called "Qi Zhang" (Qi Distension) because it arises from Qi. Collectively, they are named "Qi Gu" (Qi Drum). Water distension and Cold distension, classified under the Dampness category, are appropriate, as they have nothing to do with this specific syndrome. Li Dongyuan, a great master of his generation, also failed to clearly distinguish this in his formula Zhongman Fenxiao Wan (Houpo [Magnoliae Officinalis Cortex] 1 liang, Zhishi [Aurantii Fructus Immaturus], Huanglian [Coptidis Rhizoma], Huangqin [Scutellariae Radix], Banxia [Pinelliae Rhizoma] 5 qian, Chenpi [Citri Reticulatae Pericarpium], Zhimu [Anemarrhenae Rhizoma], Zexie [Alismatis Rhizoma] 3 qian, Fuling [Poria], Sharen [Amomi Fructus], Ganjiang [Zingiberis Rhizoma] 2 qian, Renshen [Ginseng Radix], Baizhu [Atractylodis Macrocephalae Rhizoma], Gancao [Glycyrrhizae Radix et Rhizoma], Zhuling [Polyporus] 1 qian, formed into pills with steamed dough).