气生于肺，而根于肾，肾阳不升则气不化水，而抑郁于下，是为气鼓。气鼓者，脐以下肿是也
。盖肾不升，由于土湿，土湿则木郁，木失发达之性，是以凝滞，而生胀满。木失疏泄之
权，是以淋涩，而小便不利。且土湿脾必陷，脾陷则肝木沉郁，而生下热。土湿胃必逆，胃逆则胆火
浮升，而生上热。病本则属湿寒，病标则属湿热，法宜泄湿行郁，补脾精而达木气，清利膀胱之郁热也
。以桂枝姜砂汤主之。胃苓汤亦主之。如脾虚不运，而作鼓胀者，以六君子汤主之。如脾肺湿旺，
化生郁浊，腐败胶粘，不得下行，宜用瓜蒂散去其郁陈，然后调之。如病重人虚，不可服此，以葶苈散主之。
桂枝姜砂汤
茯苓（三钱） 泽泻（三钱） 桂枝（三钱） 芍药（三钱） 甘草（二钱炙） 砂仁（一钱炒
研） 生姜（三钱） 杏仁（三钱） 水煎大半杯，入砂仁略煎，去渣，入西瓜浆一汤匙，温服。如膀
胱湿热，小便红涩者，加栀子清之。
胃苓汤
浓朴（二钱） 陈皮（三钱） 白术（二钱） 茯苓（三钱） 猪苓（三钱） 泽泻（三钱）
桂枝（三钱） 甘草（二钱） 加生姜（三片），水煎服。如上热加黄芩，下寒加干姜。
六君子汤
（方见疟疾）
瓜蒂汤
（方见痰饮）
葶苈散
（方见中风）
Qi is generated by the Lung, but its root lies in the Kidney. If Kidney Yang fails to ascend, Qi cannot transform water, leading to stagnation and depression of Qi and water in the lower Jiao (Lower Burner); this condition is termed Qi Drum (Qi Gu). Qi Drum refers to swelling below the umbilicus.
This occurs because the failure of Kidney Qi to ascend is often due to dampness in the Spleen Earth. When Spleen Earth is damp, Liver Wood becomes depressed. Deprived of its natural tendency to flourish and spread, Liver Wood causes stagnation and distension. Furthermore, when Liver Wood loses its authority to disperse and drain, it results in dribbling dysuria and difficult urination.
Moreover, dampness in Spleen Earth inevitably causes Spleen Qi to sink; when Spleen Qi sinks, Liver Wood becomes deeply depressed, generating heat in the lower part. Simultaneously, dampness in Spleen Earth inevitably causes Stomach Qi to rebel upward; when Stomach Qi rebels, Gallbladder Fire floats and ascends, generating heat in the upper part. The root of the disease belongs to Cold-Dampness, while the branch manifests as Damp-Heat. The therapeutic method should involve draining dampness, moving Qi to resolve depression, tonifying Spleen Essence to facilitate the flow of Wood Qi, and clearing and draining the stagnant heat in the Bladder.
The primary formula is Guizhi Jiangsha Tang (Cinnamon Twig, Ginger, and Amomum Decoction). Weiling Tang (Atractylodes Macrocephala and Poria Decoction) may also be used. If drum distension arises from Spleen deficiency with failed transportation, Liujunzi Tang (Six Gentlemen Decoction) is the primary formula. If excessive dampness in the Spleen and Lungs transforms into turbid, stagnant, putrid, and sticky pathogens that cannot descend, Gouti San (Melon Seed Powder) should be used first to remove the old stagnant pathogens, followed by regulation. If the disease is severe and the patient is deficient, these formulas are contraindicated; instead, Tingli San (Descurainia Seed Powder) is the primary formula.
[Guizhi Jiangsha Tang]
Fuling (Poria, 3 qian), Zexie (Alisma Rhizome, 3 qian), Guizhi (Cinnamomi Ramulus, 3 qian), Shaoyao (Paeoniae Radix Alba, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian, honey-fried), Sharen (Amomi Fructus Rotundus, 1 qian, stir-fried and crushed), Shengjiang (Zingiberis Rhizoma Recens, 3 qian), Xingren (Armeniacae Semen Amarum, 3 qian). Decoct in water until half a cup remains, add Sharen and simmer briefly, strain, add one tablespoon of Watermelon Juice, and take warm. If there is Damp-Heat in the Bladder with red and painful/difficult urination, add Zhizi (Gardeniae Fructus) to clear heat.
[Weiling Tang]
Houpo (Magnoliae Officinalis Cortex, 2 qian), Chenpi (Citri Reticulatae Pericarpium, 3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, 2 qian), Fuling (Poria, 3 qian), Zhuling (Polyporus, 3 qian), Zexie (Alisma Rhizome, 3 qian), Guizhi (Cinnamomi Ramulus, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian). Add Shengjiang (Zingiberis Rhizoma Recens, 3 slices), decoct in water, and take. If there is heat above, add Huangqin (Scutellariae Radix); if there is cold below, add Ganjiang (Zingiberis Rhizoma).
[Liujunzi Tang]
(See formula under "Malaria")
[Gouti Tang]
(See formula under "Phlegm-Fluids Retention")
[Tingli San]
(See formula under "Wind-Stroke")