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Radix Angelicae Sinensis Caudex (Dangguiwei), Radix Paeoniae Rubra (Chishao), Radix Rehmanniae Preparata (Shengdihuang - *Note: Text says Sheng Dihuang, usually Raw Rehmannia*), Radix Chuanxiong (Chuanxiong), Radix Achyranthis Bidentatae (Niuxi), Resina Trogopterori (Wulingzhi) (each 1 liang), Flos Carthami Tinctorii (Honghua), Semen Persicae (Taoren) (each 5 qian), Rhizoma Cyperi Rotundi (Xiangfu) (2 liang), Subcorium Corvis Capitis et Cornu Cervi (Hupo) (7.5 qian). Use 2 liang of powder from the wood of Paolownia Tree (Sumu), decoct in wine, add brown sugar, and boil into pills the size of Torreya seeds. Take 3 qian per dose, with wine. For those with weak constitution, take with Lizhong Tang (Regulate the Middle Decoction); if there is blood-cold syndrome, add Cortex Cinnamomi (Rougui) 5 qian.

Someone asked: Medical texts distinguish between Drum Distension (Guzhang) and Gu Distension (Guzhang/Guzhang with insect/parasite implication). What is the difference? The answer is: Drum Distension refers to an abdomen that is hollow inside without solid matter, resembling a drum; Gu Distension refers to an abdomen that is solid inside with matter, which is either parasitic accumulation or blood stasis. For Drum Distension, which is hollow inside, using methods to fill/solidify causes it to resolve; this corresponds to the principle in the Classic of Internal Medicine known as "treating obstruction with obstructive methods" (Sai Yin Sai Yong). For Gu Distension, which is solid inside with matter, using methods to dissipate reduces it; this corresponds to the principle "those that are hard should be削 (scraped/reduced)" (Jian Zhe Xue Zhi). However, distension and fullness can be due to cold, heat, deficiency, or excess, and the depth of the lesion varies. Without careful differentiation, how can efficacy be achieved? If urine is dark red, stool is constipated, pulse is rapid and forceful, complexion is purple-black, respiration is coarse, thirst exists with desire for cold drinks, lips are cracked, tongue is dry, it mostly belongs to Heat Syndrome. If urine is clear, stool is loose, pulse is fine and weak, complexion is pale, breath is short, preference for hot drinks exists, tongue is moist, mouth feels normal, it mostly belongs to Cold Syndrome. Furthermore, if abdominal distension does not hurt upon pressure, or distension comes and goes, it is Deficiency; if pain increases upon pressure and distension does not decrease, it is Excess. In all cases of distension, if diet is normal, the disease is superficial; if appetite decreases, the disease is deep. Moreover, distension has specific locations. Even if the entire abdomen is distended, there must be a part where distension is most severe. Combined with the initial site of onset, one can determine which Zang-Fu organ is involved, and medication must primarily target that organ. Dongyuan's treatment of distension did not go beyond two formulas: Zhiji Zhu Wan (Atractylodes Magna and Immature Bitter Orange Pill) and Buzhong Yiqi Tang (Regulate the Middle and Boost Qi Decoction), modifying them according to circumstances, applying cold, heat, attack, or tonification based on symptoms. Therefore, I formulated Hezhong Wan (Harmonize the Middle Pill) to distribute widely, with many effective results. Those with means should prepare it to aid the poor. Additionally, for middle-fullness due to Qi deficiency, Baizhu Wan (Atractylodes Macrocephala Pill) should be used, assisted by Liujunzi Tang (Six Gentlemen Decoction). Since the interior is hollow without solid matter, Zhishi (Immature Bitter Orange) is not used, lest it damage the Qi.