心下满而不痛，谓之痞。食积兼湿，心下痞，须用枳实、黄连。痞挟痰成窠囊，用桃仁、红花、香附、大黄之
类。食已心下痞，橘皮枳术丸。治痞满方∶黄芩（酒浸一两） 黄柏（酒浸一两） 滑石（五钱） 甘草（二钱） 上
末之，水丸，午后至夜，不食不睡。治痞枳术丸∶白术（二两） 枳实（一两） 半夏（一两） 神曲（一两） 麦
芽（一两） 山楂（一两） 姜黄（五钱） 陈皮（五钱） 木香（二钱半） 上末之，荷叶饭丸。又枳术丸助胃消
食，宽中去痞满∶白术（四两） 枳实（二两） 末之，荷叶烧饭为丸。大消痞丸∶黄连（炒六钱） 黄芩（六钱）
姜黄（一两） 白术（一两） 人参 陈皮（各二钱） 泽泻（二钱） 甘草（炙） 砂仁（各一钱） 干生姜（一钱）
神曲（炒一钱） 枳实（炒一钱） 半夏（四钱） 浓朴（三钱） 猪苓（一钱半） 上末之，蒸饼为丸。
饮食多伤，为久满不食，用宽中进食丸；心下痞，用消痞丸；食已不饿，皆属于寒，此戊土已衰，不能腐熟水谷所
致，用丁香烂饭丸；夏郁伤脾，不思饮食，炒黄连、酒芍药、生莎末、青六末，用姜汁饼丸；湿痰气滞，不喜谷，三
补丸加苍术倍香附。回令丸，泻肝火行湿为热，甚之反佐开痞结，治肝邪补脾∶黄连（六两） 吴茱萸（一两） 上末
之粥丸。一人内多食积，心腹常膨胀∶南星（姜制一两） 半夏（栝蒌制一两半） 其法，以栝蒌仁研和润之，香附（便
浸一两） 青礞石（硝 一两） 萝卜子（蒸五钱） 橘红（五钱） 麝香（少许） 上末之，曲糊丸。一饮
酒人，胃大满，发热，夜谵语，类伤寒，右脉不如左大，补中益气汤去 、柴胡、升麻，加半夏。以 补乘作满，柴
胡、升麻又升，故去之。服后病愈，因食凉物心痛，于前药加草豆蔻数粒。一妇人痞结，膨胀不通，坐卧不安，用麦
芽末酒调服，良久自通。
The sensation of fullness in the epigastrium (lower chest/upper abdomen) without pain is termed Pi syndrome (Pih, obstruction/fullness). If Pi syndrome is caused by food stagnation combined with dampness, Zhi Shi (Immature Bitter Orange) and Huang Lian (Coptis Rhizome) must be used. If Pi syndrome involves phlegm forming "cocoons" (accumulations of phlegm-fluid), drugs such as Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), Xiang Fu (Cyperi Rhizoma), and Da Huang (Rhei Radix et Rhizoma) should be employed. For postprandial epigastric fullness, Ju Pi Zhi Zhu Wan (Tangerine Peel and Immature Bitter Orange Pill) is indicated.
Formula for treating Pi and fullness: Huang Qin (Scutellariae Radix) soaked in wine (1 liang), Huang Bo (Phellodendri Cortex) soaked in wine (1 liang), Hua Shi (Talcum) (5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (2 qian). Grind these into fine powder and form pills using water. Administer from afternoon to night; during this period, the patient should abstain from food and remain awake without sleeping.
Zhi Zhu Wan for treating Pi: Bai Zhu (Atractylodis Macrocephalae Rhizoma) (2 liang), Zhi Shi (Aurantii Fructus Immaturus) (1 liang), Ban Xia (Pinelliae Rhizoma) (1 liang), Shen Qu (Massa Medicata Fermentata) (1 liang), Mai Ya (Hordei Fructus Germinatus) (1 liang), Shan Zha (Crataegi Fructus) (1 liang), Jiang Huang (Curcumae Longae Rhizoma) (5 qian), Chen Pi (Citri Reticulatae Pericarpium) (5 qian), Mu Xiang (Aucklandiae Radix) (2.5 qian). Grind into fine powder and form pills wrapped in lotus leaves with rice.
Another Zhi Zhu Wan assists the stomach, promotes digestion, and relieves central fullness and Pi: Bai Zhu (4 liang), Zhi Shi (2 liang). Grind into fine powder and form pills wrapped in lotus leaves with steamed rice.
Da Xiao Pi Wan (Great Pill for Eliminating Obstruction): Huang Lian (6 qian, stir-fried), Huang Qin (6 qian), Jiang Huang (1 liang), Bai Zhu (1 liang), Ren Shen (Panacis Ginseng Radix), Chen Pi (each 2 qian), Ze Xie (Alismatis Rhizoma) (2 qian), Gan Cao (2 qian, honey-fried), Sha Ren (Amomi Fructus) (each 1 qian), Gan Sheng Jiang (Dried Ginger) (1 qian), Shen Qu (1 qian, stir-fried), Zhi Shi (1 qian, stir-fried), Ban Xia (4 qian), Hou Po (Magnoliae Officinalis Cortex) (3 qian), Zhu Ling (Polyporus) (1.5 qian). Grind into fine powder and form pills using steamed wheat cake.
Excessive dietary intake causing damage leads to chronic fullness and anorexia; Kuan Zhong Jin Shi Wan (Pill for Widening the Middle and Promoting Appetite) is used. For epigastric Pi, Xiao Pi Wan (Pill for Eliminating Obstruction) is used. Feeling no hunger after eating indicates a Cold pattern, resulting from the decline of Wu Earth (Spleen/Stomach) which fails to rot and ripen food and drink; Ding Xiang Lan Fan Wan (Clove and Rice Pill) is indicated. Summer heat depression injuring the Spleen, leading to loss of appetite, is treated with stir-fried Huang Lian, wine-processed Shao Yao (Paeoniae Radix Alba), fresh Chai Hu root powder (assuming 'Shamo' refers to a specific herb or typo for Chaihu/Shama, but strictly translating 'Shamo' as given contextually often implies a local herb, here interpreted as a specific ingredient mentioned, likely distinct from standard names, kept as transliteration or specific term if known, otherwise generic 'Chai Hu' is not applicable here as it says 'Shamo'. Note: 'Shamo' might be a typo for 'Chai Hu' or a specific local herb. Given strict translation, I will use 'Shamo' or interpret based on common pairings. However, 'Shamo' is not a standard WHO term. Looking at context 'Qing Liu', likely 'Qing Dai'. Let's assume 'Shamo' is a specific herb name provided. Actually, 'Shamo' might refer to 'Sha Shen' or similar, but without certainty, I will translate literally or use Pinyin if unknown. Re-evaluating: 'Shamo' might be 'She Chuang Zi'? No. It is likely a specific local herb. I will use 'Shamo Herb'. Wait, 'Qing Liu' is likely 'Qing Dai' (Indigo Naturalis). 'Shamo' might be 'Shi Gao'? Unlikely. Let's stick to the text: 'Shamo' -> 'Shamo'. 'Qing Liu' -> 'Qing Liu' (Likely Qing Dai). *Correction*: In many editions, this is 'Shi Chang Pu' or similar? No. Let's look at 'San Bu Wan'. 'Shamo' is rare. I will use 'Shamo' as a proper noun for the herb.)... *Self-Correction*: The text says "Sheng Sha Mo". This is likely a typo for "Sheng Ma" or a specific herb. However, to be safe and accurate to the source text provided: "Sheng Sha Mo" (Raw Shamo). "Qing Liu" is likely "Qing Dai". I will translate them as named.
Treatment: Stir-fried Huang Lian, wine-processed Shao Yao, raw Shamo powder, Qing Liu powder (likely Qing Dai), formed into pills with ginger juice. For damp-phlegm and Qi stagnation with aversion to grains, San Bu Wan (Three Supplement Pills) added with Cang Zhu (Atractylodis Rhizoma) and doubled Xiang Fu is used.
Hui Ling Wan (Revival Pill) clears Liver Fire and moves Dampness transforming into Heat; in severe cases, it uses reverse supplementation to open Pi knots, treating Liver pathogen invasion by tonifying the Spleen: Huang Lian (6 liang), Wu Zhu Yu (Evodiae Fructus) (1 liang). Grind into fine powder and form pills using congee.
Case 1: A person with significant internal food stagnation experiences constant abdominal distension: Nan Xing (Arisaematis Rhizoma processed with ginger) (1 liang), Ban Xia (1.5 liang, processed with Gua Lou). The preparation method involves grinding Gua Lou Ren (Trichosanthis Semen) and mixing it to moisten the powder, then adding Xiang Fu (soaked in urine) (1 liang), Qing Meng Shi (Calamina processed with saltpeter) (1 liang), Luo Bo Zi (Brassicae Semens) (steamed, 5 qian), Ju Hong (Citri Reticulatae Pericarpium Rubrum) (5 qian), She Xiang (Moschus) (a small amount). Grind into fine powder and form pills using grain paste.
Case 2: A wine drinker presents with extreme gastric fullness, fever, and nocturnal delirium, resembling Taiyang disease (Cold Damage); however, the Right pulse is not larger than the Left pulse. Use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), removing Huang Qi (Astragali Radix), Chai Hu (Bupleuri Radix), and Sheng Ma (Cimicifugae Rhizoma), and add Ban Xia. Huang Qi tonifies and may exacerbate fullness; Chai Hu and Sheng Ma are ascending, hence they are removed. After taking the medicine, the illness resolves, but heart pain occurs due to consuming cold food; add several grains of Dou Kou (Amomi Fructus Rotundus) to the previous prescription.
Case 3: A woman with Pi knotting, abdominal distension and obstruction, unable to sit or lie comfortably, is treated with Mai Ya powder mixed with wine. After some time, patency is naturally restored.