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The *Yellow Emperor's Inner Canon* states: When turbid Qi remains in the upper part, distension occurs; when Taiyin (Taiyin Meridian) is affected, it manifests as鼓胀 (Gu Zhang, abdominal distension with fluid accumulation). This is abdominal distension. The *Chapter on Disease Capacities* states: Sudden distension belongs to Heat syndrome.

Distension and edema share a common origin: all are due to Spleen deficiency failing to transport and transform. When Qi enters the Zang organs, distension forms, characterized by an enlarged abdomen, emaciated body, and loss of appetite. A brilliant formula involves strengthening Earth (tonifying the Spleen) and dispersing accumulation (promoting diuresis and moving Qi), using Poria (Fuling), Atractylodes macrocephala (Baizhu), Tangerine Peel (Chenpi), and Aucklandia (Muxiang). Add Cyperus (Xiangfu), Magnolia Bark (Houpo), Amomum (Sharen), Mulberry Root Bark (Sangbaipi), Alisma (Zexie), and Areca Seed (Dafupi); grind Agarwood (Chenxiang) into juice and decoct with Ginger (Shengjiang) and water. If the abdomen is solid, painful, with red veins visible, this is Blood Gu (Blood Distension); try Angelica Sinensis (Danggui), White Peony Root (Baishao), Safflower (Honghua), and Moutan Cortex (Danpi). For Water Gu (Water Distension) with abdominal swelling and constipation, add Dafupi to Wuling San (Five-Ingredient Powder with Poria). For food-stagnation distension with coagulation in the large abdomen, use Betel Nut (Binglang), Morning Glory Seed (Qianniu), Radish Seed (Lanzisu), Burreed Tuber (Sanleng), and Turmeric Tuber (Ezhu). For Qi-excess distension accompanied by acid regurgitation, hypochondriac pain and distension, and dark complexion, use Fenxin Qi Yin (Decoction for Dividing Heart Qi), containing Notopterygium (Qianghuo), Cinnamon Twig (Guizhi), Poria (Fuling), Pinellia (Banxia), Thunberg Fritillary Vine (Tongcao), Green Tangerine Peel (Qingpi), Mulberry Root Bark (Sangbaipi), Areca Peel (Dafupi), Licorice (Gancao), Perilla Stem (Sugeng), and White Peony Root (Baishao). For Qi-deficiency distension triggered by overwork, accompanied by shortness of breath, loose stools, and decline of Yuan Qi (Original Qi), Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) must be used; treat according to specific patterns without hesitation. Earth Qi rises to become clouds, Heaven Qi descends to become rain; abnormal changes in the earth lead to Gu. Once the Yin of Spleen Earth is injured, the pivot of transportation also loses its foundation. Although the Stomach receives grain, it cannot transport and transform; Clear and Turbid mix chaotically, blocking the meridians. Stagnation generates Heat, which combines with Dampness, causing disease. This condition is suitable for tonification, not for purgation; drying Dampness and tonifying the Middle Jiao are the primary methods.

Chen Xiuyuan said: Qi sinking leads to dorsal foot edema; Qi stagnation leads to epigastric stuffiness.

He also said: Liver Wood overacting on Spleen Earth prevents the clear Yang from expanding, causing Turbid Qi to block and accumulate.

He further said: Deficiency-type swelling entering the abdomen from the feet should be treated by focusing on Shaoyin Kidney and Taiyin Spleen.

**Spleen Yang Deficiency Single Distension** (Suitable for strengthening Yang to move Dampness, warming and unblocking Spleen Yang):
Wuling San (see above), Purple Houpo (Magnolia Bark), Chenpi (Tangerine Peel), Papaya (Mugua), Ginseng (Renshen), Prepared Ginger (Paojiang), Dafupi (Areca Peel), Aconite (Fuzi), Roasted Caoguo (Black Cardamom), Cao Kou (Cardamom), Yizhi Ren (Alpinia Oxyphylla), Bibai (Long Pepper), Cang Zhu (Atractylodes lancea), Ganjiang (Dried Ginger), Chuan Guizhi (Cinnamon Twig), Chuanjiao (Sichuan Pepper).

**Kidney Qi**:
Jiajian Bawei Wan (Modified Eight-Ingredient Pill), *Jisheng Fang* Shenqi Wan (Kidney Qi Pill from *Essential Prescriptions for Life*).

**Nourishing Yangming**:
Dabanchang Tang (Major Half-Ginseng Decoction): Banxia (Pinellia), Renshen (Ginseng), Bai Mi (White Honey).

Chen Xiuyuan said: The Chong Mai (Penetrating Vessel) is subordinate to Yangming Stomach. If Stomach Yang is extremely damaged, lacking the true Qi to anchor the middle, the Chong Mai moves, causing all vessels to tremble, and Turbid Yin scatters; thus, lying down feels like standing unsteadily.

**Dispersing Jueyin**:
Xiaoyao San (Free and Easy Wanderer Powder): Danggui (Angelica Sinensis), Baishao (White Peony Root), Chaihu (Bupleurum), Fuling (Poria), Baizhu (Atractylodes Macrocephala), Shanzhi (Gardenia), Gancao (Licorice), Shengjiang (Fresh Ginger), Bohe (Mint), plus modified Danpi (Moutan Cortex).

He Shutian said: The Six Fu organs belong to Yang, and their benefit lies in unblocking. Unblocking Yang prevents Turbid Yin from gathering; merely tonifying may cause the Middle Jiao to become dull. Yu Jiayan stated that one can change the Stomach's state without being changed by it. Cold in the Zang organs causes fullness diseases; drying and warming the Yang of the Water organ (Kidney) is the method of "cultivating Fire to generate Earth." The essence of treating wheezing and distension is opening the "ghost door" (sweating pores) to induce sweat, and cleansing the "clean mansion" (bladder/kidneys) to promote urination, neither of which is other than disseminating and unblocking the exterior and interior.

The *Inner Canon* states: When pathology moves from above downward, treat the upper source. It also states: When pathology moves from above downward and worsens below, one must first treat the upper before treating the lower.

Ancient saying: Indulgence in rich foods leads to carbuncles and sores; excessive blandness fails to prevent distension.