鼓胀又名单鼓，宜大补中气行湿，此乃脾虚之甚，必须远音乐，断浓味，大剂人
参、白术，佐以陈皮、茯苓、苍术之类。有血虚者，用四物汤行血药。有脉实坚人壮盛
者，或可攻之，便可收拾，用参、术为主。凡补气，必带浓朴宽满，浓朴治腹胀，因味辛
以气聚于下焦故也，须用姜汁制之。如肥胖之人腹胀者，宜平胃、五苓共服之；如白人腹
者，是气虚，宜参、术、浓朴、陈皮；如瘦人腹胀者，是热，宜黄连、浓朴、香附、白芍
如因有故蓄血而腹胀者，宜抵当丸下死血；如因有食积而腹胀者，有热，用木香槟榔丸，有
寒，用木香、浓朴、丁香，砂仁、神曲、香附；如因外寒郁内热而腹胀者，用藿香、麻黄
麻、干葛、桂枝；因大怒而腹胀者，宜青皮、陈皮、香附、木香、栀子仁、芦荟。实者，按之
不坚不痛。治须实者下之、消之，次补之；虚者温之、升之，补为要。朝宽暮急，血虚；暮
宽朝急，气虚；终日急，气血皆虚。腹胀不觉满者，食肉多，以黄连一两，阿魏半两，醋浸
蒸饼为丸，同温中丸、白术汤下。食肉多腹胀，三补丸料内加香附、半夏曲，蒸饼丸服。
〔附录〕心肺阳也居上，肾肝阴也居下，脾居中，亦阴也，属土。经曰∶“饮食入胃，游
溢精
之德，而有干健之运，故能使心肺之阳降，肾肝之阴升，而成天地交之泰，是为无病。今
七情内伤，六淫外侵，饮食不节，房劳致虚，脾土之阴受伤，转运之官失职，胃虽受谷，不
运化，故阳自升，阴自降，而成天地不交之痞，清浊相混，隧道壅塞，郁而为热，热留为湿
，湿热相生，遂成胀满。经曰∶“鼓胀”是也。以其外虽坚满，中空无物，有似于鼓，其
，难以治疗，又名曰蛊，若虫侵蚀之义。理宜补脾，又须养脾金以制木，使脾无贼邪之患；滋
肾水以制火，使肺得清化。却浓味，断妄想，远音乐，无有不安。医又不察虚实，急于作
，病者苦于胀急，喜行利药，以求通快，不知觉得一日半日，其肿愈甚，病邪甚矣，真气伤
矣。古方惟禹余粮丸，又名紫金丸，制肝补脾，殊为切当。
附方
中满分消丸 治中满鼓胀，水气胀大热胀，并皆治之。
黄芩 枳实（炒） 半夏 黄连（炒，各五钱） 姜黄 白术 人参 甘草 猪苓（各一钱） 浓
朴（制，一两） 茯苓 砂仁（各二钱） 泽泻 陈皮（各三钱） 知母（四钱） 干生姜（二钱）
上为末，水浸蒸饼，丸如梧子大。每服百丸，焙热，白汤下，食后。寒因热用，故焙服
广术溃坚汤 中满腹胀，内有积块，坚硬如石，令人坐卧不安，大小便涩滞，上气喘促
浓朴 黄芩 益智 草豆蔻 当归（各五钱） 黄连（六钱） 半夏（七钱） 广术 升麻 红花（
炒） 吴茱萸（各二钱） 甘草（生） 柴胡 泽泻 神曲（炒） 青皮 陈皮（各三钱）
渴者，加葛根四钱。上每服七钱，生姜三片，煎服。
紫苏子汤 治忧思过度，致伤脾胃，心腹胀满，喘促烦闷，肠鸣气走，漉漉有声，大小
便不利，脉虚紧而涩。
苏子（一两） 大腹皮 草果 半夏 浓朴 木香 陈皮 木通 白术 枳实 人参 甘草
上水煎，生姜三片，枣一枚。
人参芎归汤 治血胀，烦躁，水不咽，迷忘，小便多，大便异，或虚厥逆。妇人多有此
当归 半夏（七钱半）川芎（一两） 蓬术 木香 砂仁 白芍 甘草（炙，各半两） 人参 桂
心五灵脂（炒，各二钱半）
上水煎，生姜三片，枣一个，紫苏四叶。
禹余粮丸 治中满，气胀，喘满，及水气胀。
蛇含石（大者三两，以铁铫盛入炭火中 ，药与铫子一样通红，用钳出铫子，以药淬醋中
，候冷，研极细）
真针砂（五两，先以水淘净，控干，更以铁铫子炒干，入禹余粮。一处用米醋二升就铫内煮
令醋干为度，却就用铫子同二药入一秤炭火中 令通赤，钳出铫子，倾药于
净砖地上，候冷研极细） 禹余粮（三两，同入针砂内制）
以上三物为主，其次量人虚实，入下项药∶
木香 牛膝（酒浸） 莪术（炮） 白蒺藜 桂心 川芎 白豆蔻 土茴香（炒） 三棱（炮）
羌活 茯苓 干姜（炮） 青皮（去白） 附子（炮） 陈皮 当归（酒浸一夕）
上各半两，虚人老人，全用半两。实壮之人，随意减之。
上为末，拌匀，以汤浸蒸饼，滤去水，和药再捣极匀，丸如梧桐子大。每服五十丸，空
心温酒下。最忌食盐，否则发疾愈甚。
平胃散 见脾胃。
五苓散 见中暑。
抵当丸
水蛭（七个） 虻虫（八个） 桃仁（七个） 大黄（一两）
上为末，分作四丸。水一盏，煎一丸，取七分，温服，当下血，未下再服。
《绀珠》木香槟榔丸
木香 槟榔 当归 黄连 枳壳 青皮 黄柏（各一两） 黄芩 陈皮 三棱 香附 牛末
（各二两） 莪术 大黄（各四两）
上为末，面糊丸梧子大。每服五七十丸，临卧姜汤下。寻常消导开胃，只服三四十丸。
温中丸 见积类。
三补丸 见补损。
Distension and fullness of the abdomen, also known as "Single Drum" (Dan Gu), should be treated by greatly tonifying Middle Qi (Zhong Qi) and moving dampness. This condition stems from severe Spleen deficiency (Pi Xu). One must avoid excessive entertainment to nourish the spirit, cut off rich and greasy foods, and use large doses of Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), assisted by Chen Pi (Tangerine Peel), Fu Ling (Poria), Cang Zhu (Atractylodes Lancea Rhizome), etc. If there is Blood deficiency (Xue Xu), Si Wu Tang (Four Substances Decoction) combined with blood-moving herbs should be used. If the pulse is solid and firm, and the patient's constitution is robust, purgative methods may perhaps be applied, but this must be followed by recovery using Ren Shen and Bai Zhu. Whenever tonifying Qi, Hou Po (Magnolia Bark) must be included to relieve distension; Hou Po treats abdominal distension because its pungent flavor causes Qi to gather in the Lower Jiao (Lower Burner), so it must be processed with Ginger Juice (Jiang Zhi). For obese individuals with abdominal distension, Ping Wei San (Peaceful Stomach Powder) and Wu Ling San (Five-Ingredient Powder with Poria) should be taken together; for pale individuals with abdominal distension, this indicates Qi deficiency, and Ren Shen, Bai Zhu, Hou Po, and Chen Pi are suitable; for thin individuals with abdominal distension, this indicates Heat (Re), and Huang Lian (Coptis Rhizome), Hou Po, Xiang Fu (Cyperus Rhizome), and Bai Shao (White Peony Root) are suitable. If abdominal distension is caused by accumulated Blood stasis (Yu Xue), Di Dang Wan (Di Dang Pill) should be used to purge dead blood; if caused by Food stagnation (Shi Ji) with Heat, Mu Xiang Bing Lang Wan (Costus and Areca Nut Pill) is used; if with Cold, Mu Xiang (Costus Root), Hou Po, Ding Xiang (Clove), Sha Ren (Amomum Fruit), Shen Qu (Medicated Leaven), and Xiang Fu are used; if caused by external Cold constraint leading to internal Heat, Huo Xiang (Patchouli Herb), Ma Huang (Ephedra Stem), Gan Ge (Kudzu Root), and Gui Zhi (Cinnamon Twig) are used; if caused by great anger, Qing Pi (Green Tangerine Peel), Chen Pi, Xiang Fu, Mu Xiang, Zhi Zi Ren (Gardenia Seed), and Lu Hui (Aloe) are suitable. For Excess (Shi) type distension, palpation reveals hardness or pain is absent. Treatment requires purging and resolving excess first, then tonifying; for Deficiency (Xu) types, warming and ascending are needed, with tonification being essential. Symptoms easing in the morning and worsening in the evening indicate Blood deficiency; symptoms easing in the evening and worsening in the morning indicate Qi deficiency; constant urgency throughout the day indicates both Qi and Blood deficiency. Abdominal distension without a feeling of fullness is due to excessive meat consumption; treat with one liang of Huang Lian and half a liang of A Wei (Asparagopsis/Colloquium), soaked in vinegar, steamed, formed into pills with steamed wheat cake, and taken with Wen Zhong Wan (Warm the Center Pill) and Bai Zhu Tang (Atractylodes Decoction). For abdominal distension due to excessive meat consumption, add Xiang Fu and Ban Xia Qu (Pinellia Medicated Leaven) to the ingredients of San Bu Wan (Three Tonics Pill), form into steamed wheat cake pills, and take.
[Appendix] Heart and Lung belong to Yang and reside in the Upper Jiao (Upper Burner); Kidney and Liver belong to Yin and reside in the Lower Jiao; Spleen resides in the Middle, also belongs to Yin, and corresponds to Earth. The Classics state: "When food enters the stomach, essence and qi float and overflow." This is the virtue of the Spleen bearing all things and having vigorous transportive functions, enabling Heart and Lung Yang to descend and Kidney and Liver Yin to ascend, thereby achieving the harmony of Heaven and Earth (Tai), which constitutes health. Currently, emotional injuries (Seven Emotions), external invasions (Six Evils), irregular diet, and sexual exhaustion causing deficiency, damage the Yin of Spleen Earth. The official of transport fails in his duty; although the Stomach receives grain, it cannot transform and transport. Thus, Yang rises spontaneously, Yin descends spontaneously, forming a blockage where Heaven and Earth do not interact. Clear and turbid Qi mix, meridians and collaterals become obstructed, stagnation generates Heat, and lingering Heat transforms into Dampness. Dampness and Heat generate each other, resulting in distension and fullness. The Classics call this "Gu Zhang" (Drum Distension). Although the exterior is hard and full, the interior is empty, resembling a drum; it is difficult to treat and is also called "Gu" (Poison/Gu Worm), implying erosion like insects. The principle should be to tonify the Spleen, and further nourish Spleen Metal to control Liver Wood, preventing the Spleen from suffering from hostile pathogens; nourish Kidney Water to control Fire, allowing the Lung to receive clear transformation. One must abandon rich foods, cut off delusions, and stay away from music, ensuring no discomfort. Physicians who fail to examine Excess and Deficiency, acting hastily, find patients suffering from distension and urgency, preferring laxatives to seek relief. They do not realize that after a day or half-day of comfort, swelling becomes worse, pathogenic factors intensify, and True Qi is damaged. Among ancient formulas, only Yu Yu Liang Wan (Halloysitum Pill), also known as Zi Jin Wan (Purple Gold Pill), which controls Liver and tonifies Spleen, is highly appropriate.
Attached Formulas:
Zhong Man Fen Xiao Wan (Middle Fullness Dissolving and Descending Pill): Treats middle fullness, drum distension, water distension, and heat distension.
Ingredients: Huang Qin (Scutellaria Root), Zhi Shi (Immature Bitter Orange, stir-fried), Ban Xia (Pinellia Tuber), Huang Lian (Coptis Rhizome, stir-fried, 5 qian each), Jiang Huang (Turmeric Rhizome), Bai Zhu, Ren Shen, Gan Cao (Licorice Root), Zhu Ling (Poria, 1 qian each), Hou Po (processed, 1 liang), Fu Ling, Sha Ren (2 qian each), Ze Xie (Alisma Rhizome), Chen Pi (3 qian each), Zhi Mu (Anemarrhena Rhizome, 4 qian), Gan Sheng Jiang (Dried Fresh Ginger, 2 qian).
Grind into powder, soak steamed wheat cake in water, form pills the size of mustard seeds. Take 100 pills per dose, baked warm, taken with plain hot water after meals. Because cold is treated with heat method, bake before taking.
Guang Zhu Kui Jian Tang (Curcuma Softening Hardness Decoction): Treats middle fullness and abdominal distension, intra-abdominal masses hard as stone, causing restlessness in sitting and lying, sluggish urination and defecation, upper body asthma and shortness of breath.
Ingredients: Hou Po, Huang Qin, Yi Zhi (Alpinia Oxyphylla Fruit), Cao Dou Kou (Black Cardamom), Dang Gui (Angelica Sinensis Root, 5 qian each), Huang Lian (6 qian), Ban Xia (7 qian), E Zhu (Curcuma Zedoaria Rhizome), Sheng Ma (Cimicifuga Rhizome), Hong Hua (Safflower, stir-fried), Wu Zhu Yu (Evodia Fruit, 2 qian each), Sheng Gan Cao (Raw Licorice Root), Chai Hu (Bupleurum Root), Ze Xie, Shen Qu (stir-fried), Qing Pi, Chen Pi (3 qian each).
If thirsty, add Ge Gen (Pueraria Lobata Root, 4 qian). Take 7 qian per dose, decoct with 3 slices of fresh ginger.
Zi Su Zi Tang (Perilla Seed Decoction): Treats excessive worry and thought damaging Spleen and Stomach, heart and abdominal distension and fullness, asthma and shortness of breath, irritability and oppression, borborygmus and gas movement, loud intestinal sounds, difficulty in urination and defecation, pulse deficient, tight, and choppy.
Ingredients: Zi Su Zi (Perilla Seed, 1 liang), Da Fu Pi (Areca Peel), Cao Guo (Black Cardamom), Ban Xia, Hou Po, Mu Xiang, Chen Pi, Mu Tong (Akebia Stem), Bai Zhu, Zhi Shi, Ren Shen, Gan Cao.
Decoct in water with 3 slices of fresh ginger and 1 jujube.
Ren Shen Xiong Gui Tang (Ginseng, Ligusticum, and Angelica Decoction): Treats blood distension, irritability, inability to swallow water, confusion and forgetfulness, frequent urination, abnormal defecation, or deficiency syncope and cold limbs. Common in women.
Ingredients: Dang Gui, Ban Xia (7 qian 5 fen), Chuan Xiong (Ligusticum Chuanxiong Rhizome, 1 liang), Peng Zhu (Curcuma Phaeocaulis Rhizome), Mu Xiang, Sha Ren, Bai Shao, Zhi Gan Cao (Honey-fried Licorice Root, 0.5 liang each), Ren Shen, Gui Xin (Cinnamon Heart), Wu Ling Zhi (Trogopterus Dung, stir-fried, 2 qian 5 fen each).
Decoct in water with 3 slices of fresh ginger, 1 jujube, and 4 leaves of Zi Su (Perilla Leaf).
Yu Yu Liang Wan (Halloysitum Pill): Treats middle fullness, Qi distension, asthma and fullness, and water distension.
Main Ingredients: She Han Shi (Snake-containing Stone, large pieces 3 liang, placed in an iron pot in charcoal fire until red-hot, removed with tongs, quenched in vinegar, cooled, ground extremely fine); Zhen Zhen Sha (Real Needle Sand, 5 liang, washed clean with water, drained, stir-fried dry in iron pot, added with Yu Yu Liang. Boil together with 2 sheng of rice vinegar in the pot until vinegar is dry, then place pot with two medicines in 1 jin of charcoal fire until red-hot, remove pot, pour medicine onto clean brick ground, cool, grind extremely fine); Yu Yu Liang (Halloysitum, 3 liang, prepared with needle sand).
These three are the main ingredients. Secondly, according to the patient's Excess or Deficiency, add the following:
Mu Xiang, Niu Xi (Achyranthes Root, wine-soaked), E Zhu, Bai Ji Li (Tribulus Fruit), Gui Xin, Chuan Xiong, Bai Dou Kou (White Cardamom), Tu Hui Xiang (Fennel, stir-fried), San Leng (Knotweed Rhizome, stir-fried), Qiang Huo (Notopterygium Rhizome), Fu Ling, Gan Jiang (Dried Ginger, stir-fried), Qing Pi (peeled), Fu Zi (Prepared Aconite Root, stir-fried), Chen Pi, Dang Gui (wine-soaked overnight).
Each ingredient 0.5 liang. For deficient elderly people, use the full 0.5 liang. For robust persons, reduce amount as needed.
Grind into powder, mix well, soak steamed wheat cake in water, filter out water, mix with medicine, pound extremely uniform, form pills the size of paulownia seeds. Take 50 pills per dose, empty stomach with warm wine. Most strictly avoid salt, otherwise the disease will flare up severely.
Ping Wei San: See Spleen and Stomach section.
Wu Ling San: See Summerheat section.
Di Dang Wan (Di Dang Pill):
Shui Zhi (Leech, 7), Meng Chong (Dragonfly Larva, 8), Tao Ren (Peach Seed, 7), Da Huang (Rhubarb Root, 1 liang).
Grind into powder, divide into four pills. Decoct one pill in one cup of water, reduce to 0.7 cup, take warm. Should pass blood; if not, take again.
"Cian Zhu" Mu Xiang Bing Lang Wan (Costus and Areca Nut Pill):
Mu Xiang, Bing Lang (Areca Nut), Dang Gui, Huang Lian, Zhi Ke (Bitter Orange, 1 liang each), Huang Qin, Chen Pi, San Leng, Xiang Fu, Niu Xi (Butternut/Knee root? Note: Text says Niu Mo/Ban Xia? Correction: Text says "Niu Mo", likely typo for Niu Xi or similar, but standard formula uses Niu Xi or similar. Based on text "Niu Mo", assuming Niu Xi or similar herb, but sticking to text entities: Niu Mo [likely Niu Xi]), Huang Bai (Phellodendron Bark, 2 liang each), E Zhu, Da Huang (4 liang each).
Grind into powder, paste with flour dough, form pills the size of paulownia seeds. Take 50-70 pills per dose, with ginger water before bed. For ordinary digestion and appetite stimulation, take only 30-40 pills.
Wen Zhong Wan: See Accumulation section.
San Bu Wan: See Tonification and Damage section.