先腹大，后四肢肿，为胀。或独腹大，四肢不肿者，治法同。
〔无〕附子绿豆汤 治寒客皮肤，壳壳然而坚，腹大身肿，按之陷而不起，色不变，病名肤胀。一剂
未知，再作。
大附子（一个，重七钱者，生，去皮脐，半破） 绿豆（二两）
上以生姜二两切，水二碗煎至一碗，去渣，分三服，空腹温服。次日，将前附子破作四片，再用绿豆
二两，姜一两，如前煎服。停三日，复将附子作八片，如前煎服。
（治鼓胀法，并见后行湿寒热气血诸条，皆其法也。）
〔仲〕胀满，按之不痛为虚，痛者为实，可下之。腹胀时减，复如故，此为寒，当与温药。腹满不减，减
不足言，须当下之，宜大承气汤。
〔海〕脾虚满者，黄 汤。（芍药停湿。）脾实满不运，平胃散。（苍术泄湿。）
东垣云∶腹胀满，气不转者，加浓朴以破滞气。腹中夯闷，此非腹胀满，乃散而不收，可加芍药收之。是
知气结而胀，宜浓朴散之；散而胀，宜芍药收之。
〔丹〕鼓胀，大补中气行湿。此乃脾虚之甚，必须远音乐，断浓味。朝宽暮急，血虚；暮宽朝急，气虚；
终日急，气血皆虚。用大剂人参、白术，佐以陈皮、苍术、茯苓之类。有血虚者，四物行血，随证加减。凡补
气，必带浓朴宽满。腹胀必少佐浓朴者，盖浓朴味辛，以气聚于上焦故也。气不运，加木香。气若陷下，用升
麻、柴胡以提其气。水肿当补脾为主，白术、茯苓、陈皮佐之。
鼓胀论 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，游溢精气，上输干
脾。脾气散精，上归于肺。通调水道，下输膀胱。水精四布，五经并行。是脾具坤静之德，而有干健之运，故
能致心肺之阳，降肾肝之阴，升而成天地交之泰，是为无病之人。今也七情内伤，六淫外侵，饮食失节，房劳
致虚，脾土之阴受伤，转输之官失职。胃虽受谷，不能运化，故阳自升，阴自降，而成天地不交之否。于斯时
也，清浊相混，隧道壅塞，气化浊血瘀郁而为热；热留而久，气化成湿；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，其病胶固，难以治疗，故又名曰蛊。若虫侵蚀，有蛊之义。验之治法，
理宜补脾。又须养肺金以制木，使脾无贼邪之虑。滋肾水以制火，使肺得清化之令。却盐味以防助邪；断妄想，
远音乐，以保母气，无有不安。医者不察，病起于虚，急于取效， 能希赏。病者苦于胀急，喜行利药，以求
一时之快。不知宽得一日半日，其肿愈甚，病邪甚矣，真气伤矣，去死不远。古方惟禹余粮丸，又名石中黄丸，
又名紫金丸，制肝补脾，殊为切当。亦须随证，又须顺时加减用之为妙。
予友俞仁叔，儒而医，连得家难，年近五十得此疾，自制禹余粮丸服之。予诊其脉，弦涩而数，曰∶此丸
新制， 炼之火邪尚存，温热之药太多，宜自加减，不可执方。俞笑曰∶今人不及古人，此方不可加减。服之
一月，口鼻出血，色黑骨立而死。
杨兄年五十，性嗜酒，病疟半年，患胀病，自察必死来求治。诊其脉弦而涩，重则大。疟未愈，手足瘦而
腹状如蜘蛛。遂教以参、术为君，当归、川芎、芍药为臣，陈皮、黄连、浓朴、茯苓为佐，生甘草些少，作浓
汤饮之，一日定三帖。彼亦严守戒忌。一月后疟得汗而愈。又半月，小便长而胀愈。中间虽少有加减，大意只
是利气行湿。
又，陈氏年四十余，性嗜酒，大便时见血，于春间患胀，色黑而腹大，其形如鬼。诊其脉数而涩，重似弱。
予以四物加黄连、黄芩、木通、白术、陈皮、浓朴、生甘草作汤与之，近一年而安。一补气，一补血，余药大
率相出入，皆获安以保天寿。或曰∶气无补法，子何补气而获安？果有说以通之乎？予曰∶气无补法，乃世俗
之言也，盖气之为病，痞闷壅塞，似难于补，恐增病势。不思正气虚者，不能营运，邪滞所着而不去，所以为
病。《经》曰∶壮者气行则愈，怯者着而成病。苟或气怯不用补法，气何由行？或曰∶子之药审则审矣，何效
之迟也。病者久在床枕，将必厌子之迂而求速效者矣。予曰∶此病之起，或三五年，或十余年，根深势笃，欲
求速效，自求祸耳。知王道者，能治此病也。或曰∶胀病将终，不可与利药乎？予曰∶灼知其不因于虚，受病
亦浅，脾胃尚壮，积滞不固，而又有可下之证，亦宜略与疏导。若援张子和浚川散、禹功丸为例，行迅攻之策，
实所不敢。
潘可达女，年十九岁，禀受颇浓，患胸腹胀满，自用下药，利十数行，时胀无增减来求治。诊其脉皆大，
略按即散而无力，全无数意。予曰∶此有表证，反攻里，当死。赖禀受好，时又在室，尚可挽回，寿损矣。急
与四物汤加人参、白术、带白陈皮、炙甘草煎服。至半月后，病不退，又自用萝卜根种煎汤，澡浴两度，时肿
稍增。予曰∶表病攻里，已自难救，今又虚其表，事急矣。于前药去地黄、芍药，加黄 ，倍白术，大剂浓煎
汤饮；又吞人参白术丸。十日后，如初病时。又因吃难化物自利，以参、术为君，少加陈皮为佐，又与肉豆蔻、
诃子为君，山楂子为使，粥和作丸吞之，至四五十帖而安。
一男子年四十余，患疟久而腹胀，脉不数而微弦，重取则来不滑利，轻重又皆无力。遂与索氏三和汤三倍
加白术，入姜汁服之。数服而疟愈，小便利二三行，胀稍减。遂又小便短少，予作气血两虚，于前药内入人参、
牛膝、当归身尾作大剂料，百服而愈。
索氏三和汤三倍加白术方
白术 浓朴 陈皮（各三两） 木通（一两） 槟榔 紫苏（各二两） 甘草 海金沙 大腹皮 白茯苓
枳壳（各一两） 水煎服。
〔海〕调胃白术泽泻散 治痰病化为水气传变，水谷不能食。
白术（半斤） 泽泻 芍药 陈皮 茯苓 生姜 木香 槟榔（各一两）
上为末，治腹肿如神。若心下痞，加枳实。若心下盛，加牵牛。
〔仲〕心下坚大如盘，边如旋杯，水饮所作，枳术汤主之。
枳实（七个） 白术（二两）
上二味，以水五升，煮取三升，分温三服。腹中软，即当散也。
〔罗〕真定王君用，年一十九岁，病积，脐左连胁如覆杯，腹胀如鼓，多青络脉，喘不得卧。时值暑雨，
加之自利完谷，日晡潮热，夜有盗汗，求予往治之。脉得浮数，按之有力。谓病家曰∶凡治积，非有毒之剂攻
之则不可。今脉虚弱如此，岂敢以常法治之。遂投分渗益胃之剂，数服而便清自调；杂以升降阴阳、进食和气
而腹大减。胃气稍平，间以消积之剂，不月余，良愈。先师尝曰∶洁古老人有云∶养正积自除。譬如满座君子，
纵有一小人，自无容地。今令真气实，胃气强，积自消矣。
〔丹〕一妇人，年三十六岁，家贫多劳，性偏急。自七月断经后，八月小腹下有一块，偏左如拳，有时块
起即痛作，伏则势减。至半月后，腹渐肿胀，食减平时三分之二，无力，遇夜发热．天明即稍退，其脉得虚微
短弱涩，左尤甚。初与白术一斤，带白陈皮一斤，作二十帖服。以三圣膏贴块上，经宿则块软，再宿则块小。
旬日后食稍进，热减半，脉稍有力。又与白术一斤，带白陈皮半斤，酒当归身半斤，木通三两，每帖研桃仁九
粒。尽此剂，病悉除。
一妇人，年五十余岁，素好怒，因食烧猪肉，次早面胀，绝不思食，倦怠，六脉沉涩，独左豁大。余作体
虚有痰，气为痰所隔不得降，当以补虚利痰为主。每早以二陈汤加参、术大剂与一帖，服后探令吐出药。辰巳
时，复与索氏三和汤一倍加白术二帖。至睡后，以神佑七丸以挠其痰，去牵牛。如此服至一月而安矣。
金寿一安人，年七十一岁，好湿面，得带下病，亦恶寒淋沥。医与荷花须、柴胡等药，发热，所下愈多。医
与缩砂、豆蔻药，以其食少也；腹满胀，气喘，又与葶苈散，不应。又与禹余粮丸，病愈甚。医又与崇土散，亦不应。
予脉之，两手洪涩，轻则弦长而滑实，至是喘甚不得卧。此不是湿而酿成湿，在足太阴、阳明二经。水谷之气
为湿所抑，不得上升，遂成带下。理用升举之剂，以补气、和血吹之。而医反与涩燥，宜其展转身病。遂与人参
生肺之阴以拒火毒；白术以补胃气除湿热、行水道；桃仁去污生新；郁李仁行积水，以通草佐之；犀角屑解食
毒、消肿闷；槟榔治最高之气。作浓汤吞下保和丸药。又疑素浓养，有肉积，加阿魏小丸同咽之。四五日后，
积气渐消，肿渐下。又加补肾丸以生肾水之真阴。又两三日后，渐安而得睡，食有味矣。又两日后，加与点丸
以驱逐肺家之积热而愈。
一丈夫，脾有热，肾有虚，胃有积，得肿疾或进或退，口干或气喘。医连月，不退。脉软而细，以其形肥，
不以为忌。用∶
白术（四钱） 芍药 地黄（三钱） 连翘 当归（二钱） 青皮（二钱半） 人参 木通 羌活 黄芩（各一钱
半） 甘草 红花（些）
上分五帖，煎下保和丸。
杨生，年三十，因疟初安，淡食豆腐斋饭成胀，在膈上，小便赤少，不思食，口渴，脉弦而涩，此胃中有
瘀血。用∶
苏梗（三分） 木通（半钱） 白术（一钱半） 川芎 枳实 白芍（各五分） 甘草（二分，炙） 陈皮（五分）
浓朴（三分）
上研，益元散下保和丸五十粒。
一丈夫气上，肚或膨胀，此下虚所致。
陈皮（五钱） 人参 归须 白术 连翘（各三钱） 地黄 芍药（各二钱） 木通（一钱半） 甘草（五分）
上分五帖，煎下保和丸。
木香化滞汤
白豆蔻（仁） 陈皮 大腹子 白茯苓 砂仁 人参（各一钱） 青皮 槟榔 木香 姜黄（各二钱） 白术（一
钱） 甘草（炙，四分） 白檀（二分） 藿香叶（二分） 桔梗（五分）
上为细末，水一大盏二分，煎至一盏，稍热服；食前沸汤点服亦得。
上方，治因积滞成胀，皆以参、术、朴、通等煎汤，补虚行湿；下神佑、阿魏等丸消积，所谓攻补兼施
者也。
小温中丸 治胀。是脾虚不能运化，不可下之。
陈皮 半夏（汤泡，去皮脐） 神曲（炒） 茯苓（各一两） 白术（二两） 香附子（不要烘晒） 针砂（各
一两半，醋炒红） 苦参（炒） 黄连（炒。各半两） 甘草（三钱）
上为末。醋水各一盏，打糊为丸，如桐子大。每服七八十丸。白术六钱，陈皮一钱，生姜一片，煎汤吞下。
虚甚，加人参一钱。各用本方去黄连，加浓朴半两。忌口。病轻者，服此丸六七两，小便长；病甚者服一斤，
小便始长。
〔无〕禹余粮丸 治十种水气，脚膝肿，上气喘满，小便不利。但是水气，悉皆主之。（许学士及丹溪皆云∶
此方治膨胀之要药。）
蛇含石（大者三两以新铁铫盛，入炭火中烧，蛇黄与铫子一般红，用钳取蛇黄，倾入醋中，候冷取出，研极
细） 禹余粮（三两） 真针砂（五两，先以水淘净，炒干，入禹余粮一处，用米醋二升就铫内煮，醋干为度。
后用铫，并药入炭中烧红，钳出倾药净砖地上，候冷研细）
以三物为主，其次量人虚实入下项∶（治水多是取转。惟此方三物既非大戟、甘遂、芫花之比，又有下项药
扶持，故虚人老人亦可服）
羌活 木香 茯苓 川芎 牛膝（酒浸） 桂心 白豆蔻（炮） 大茴香（炒） 蓬术（炮） 附子（炮）
干姜（炮） 青皮 京三棱（炮） 白蒺藜 当归（酒浸一宿。各半两）
上为末，拌匀，以汤浸蒸饼捩去水，和药再捣极匀，丸如桐子大。食前，温酒、白汤送下三十丸至五十丸。
最忌盐，一毫不可入口，否则发疾愈甚。但试服药，即于小便内旋去，不动脏腑。病去，日三服。兼以温和
调补气血药助之，真神方也。
〔丹〕脉坚实，人壮盛者，或可用攻药，便收拾白术为主。
〔垣〕中满治法，开鬼门、洁净府。开鬼门者，发汗也；洁净府，利小便也。又中满者泻之于内，谓脾胃
有病，当令上下分消其气。下焦如渎，气血自然分化，不待泄滓秽，如或大实大满，大小便不利，从权以寒热
药下之。或伤酒、湿面，及味浓之物，膏粱之人，又或食已便卧，使湿热之气不得施化，致令腹胀满，此亦是
热胀也。治热胀、分消丸主之。
〔仲〕气分，心下坚，大如盘，边如旋杯，水饮所作，桂枝去芍加麻辛附子汤主之。
桂枝 生姜（三两） 甘草（一两） 大枣（十二个） 麻黄 细辛（各二两） 附子（一个，炮）
上七味，以水七升，煮麻黄去上沫，内诸药，煮取二升，分温三服。当汗出，如虫行皮中，即愈。
〔《圣》〕牛黄琥珀丸 治水肿腹大，气息不通危急者，神效。
牛黄 琥珀 椒目（沉水者） 葶苈（炒紫色。各三分） 昆布（洗，炙） 海藻（洗，炙。各一两一钱）
牵牛（炒） 桂（各一两）
上七味为末，另研葶苈如泥，一处拌匀，炼蜜丸如桐子大。每服十五丸，米饮下，以小便利为度，日再服。
The abdomen swells first, followed by edema of the four limbs; this is termed "Zhang" (Distension). If only the abdomen swells without edema in the four limbs, the treatment method is the same.
[Danxi] Fuzi Lutou Tang (Aconite and Mung Bean Decoction): Treats cold pathogen lodging in the skin, where the skin is hard like a shell, the abdomen is swollen and the body is edematous, pressing leaves an indentation that does not rise immediately, with unchanged skin color; the disease name is "Fuzhang" (Skin Distension). Take one dose; if unknown effect, prepare again.
Da Fuzi (One piece, weighing seven qian, raw, peeled of skin and umbilicus, half-broken) Lutou (Two liang)
Take Shengjiang (Fresh Ginger, two liang) sliced, add two bowls of water, decoct to one bowl, remove dregs, divide into three doses, take warm on an empty stomach. The next day, break the previous Fuzi into four pieces, use Lutou (Mung Bean, two liang), Jiang (Ginger, one liang), decoct and take as before. Stop for three days, then break the Fuzi into eight pieces, decoct and take as before.
(The methods for treating Guzhang [Drum Distension] are also seen in the following sections on moving dampness, cold, heat, qi, and blood; all are these methods.)
[Zhongjing] Abdominal fullness and distension: pressing without pain indicates deficiency; pain indicates excess, which can be treated with purgatives. Abdominal distension that reduces at times and returns to normal is Cold; give warming medicines. Abdominal fullness that does not reduce, or reduction is negligible, must be purged; Da Chengqi Tang (Major Order the Qi Decoction) is suitable.
[Hailan] Fullness due to Spleen deficiency: Huangqi Jianzhong Tang (Honeyed Cinnamon Twig Decoction modified with Astragalus) [Note: Text says "Huang ... Tang", likely referring to a formula containing Huangqi/Astragalus given context of Spleen deficiency, but strictly translating text "Huang ... Tang"]. (Shaoyao [Paeoniae Radix Alba] stops dampness.) Fullness due to Spleen excess with poor transport: Pingwei San (Calm the Stomach Powder). (Cangzhu [Atractylodis Rhizoma] drains dampness.)
Dongyuan said: For abdominal distension where qi does not move, add Houpo (Magnoliae Officinalis Cortex) to break stagnant qi. A feeling of heaviness and oppression in the abdomen is not simple distension, but qi scattering without gathering; add Shaoyao (Paeoniae Radix Alba) to gather it. Thus, distension due to qi knotting should be scattered with Houpo; distension due to qi scattering should be gathered with Shaoyao.
[Danchi] For Guzhang (Drum Distension), greatly tonify Middle Qi and move dampness. This is extreme Spleen deficiency; one must stay away from music/entertainment and cut off rich flavors. Morning relief and evening urgency indicate Blood deficiency; evening relief and morning urgency indicate Qi deficiency; constant urgency indicates both Qi and Blood deficiency. Use large doses of Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), assisted by Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma), Fuling (Poria), etc. For Blood deficiency, use Siwu Tang (Four Substances Decoction) to move blood, modify according to syndrome. Whenever tonifying Qi, always include Houpo (Magnoliae Officinalis Cortex) to widen the chest and relieve fullness. Treating abdominal distension requires a small amount of Houpo because Houpo is pungent and addresses qi gathering in the Upper Jiao. If qi does not move, add Muxiang (Aucklandiae Radix). If qi sinks, use Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) to lift it. For edema, focus on tonifying the Spleen, assisted by Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), and Chenpi (Citri Reticulatae Pericarpium).
"Treatise on Drum Distension": Heart and Lung are Yang, residing above; Kidney and Liver are Yin, residing below; Spleen resides in the middle and is also Yin, belonging to Earth. The Classics say: Food enters the Stomach, its essence floats and overflows, transporting upwards to the Spleen. The Spleen scatters essence, sending it upwards to the Lung. It regulates water passages, transporting downwards to the Bladder. Water essence distributes throughout the four directions, and the five meridians proceed together. Thus, the Spleen possesses the stillness of Kun (Earth) and the movement of Qian (Heaven), enabling it to descend Heart/Lung Yang and ascend Kidney/Liver Yin, creating the harmony of Heaven and Earth interaction, which is the state of health. Now, internal injury from Seven Emotions, external invasion of Six Evils, irregular diet, or sexual exhaustion causing deficiency injures Spleen Yin. The official of transformation and transportation fails. Although the Stomach receives grain, it cannot transform and transport. Thus, Yang rises spontaneously, Yin descends spontaneously, creating the obstruction of non-interaction between Heaven and Earth. At this time, clear and turbid mix, tunnels become blocked, qi transformation fails, turbid blood stasis郁 (depresses) generating Heat; long-standing Heat transforms qi into Dampness; Dampness and Heat generate each other, resulting in distension, known as Guzhang. Although the exterior is hard and full, the interior is hollow, resembling a drum; the disease is stubborn and difficult to treat, hence also called "Gu" (Poison/Gu). Like insects eroding, it has the meaning of Gu. Verifying treatment methods, it is appropriate to tonify the Spleen. One must also nourish Lung Metal to control Liver Wood, so the Spleen has no fear of thief pathogens. Nourish Kidney Water to control Fire, so the Lung receives the command of clear transformation. Reject salt flavor to prevent aiding evil; cut off delusions, stay away from music, to preserve Mother Qi (Spleen is Mother of Lung), and there will be no instability. Physicians who do not observe that the disease arises from deficiency, yet seek quick effects hoping for reward... Patients suffering from distension and urgency prefer purgatives to seek temporary relief. They do not know that although relieved for a day or half-day, the swelling becomes worse, the pathogen is stronger, true Qi is injured, and death is near. Ancient formulas only have Yuyuliang Wan (Yiyu Liang Pill), also known as Shizhonghuang Wan or Zijin Wan, which controls Liver and tonifies Spleen, very appropriate. But one must modify according to syndrome and follow seasons for best results.
My friend Yu Renshu, a scholar and physician, suffered family tragedies, nearly fifty when he got this disease. He made Yuyuliang Wan himself and took it. I palpated his pulse: Wiry, Choppy, and Rapid. I said: "This pill is newly made, fire evil remains from calcination, too many warming/hot medicines; you should modify it yourself, do not stick to the formula." Yu smiled and said: "Modern people are inferior to ancients; this formula cannot be modified." After taking it for one month, bleeding from mouth and nose occurred, complexion turned black, emaciated, and he died.
Brother Yang, fifty years old, loved alcohol, had malaria for half a year, developed distension disease, came seeking treatment believing he would die. Pulse was Wiry and Choppy, heavy pressure made it Large. Malaria not cured, limbs thin, abdomen swollen like a spider. Taught him to use Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) as Sovereign, Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix Alba) as Ministers, Chenpi (Citri Reticulatae Pericarpium), Huanglian (Coptidis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling (Poria) as Assistants, small amount of Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), decoct strong tea, drink, three doses per day. He strictly observed taboos. After one month, malaria cured via sweating. Half a month later, urination increased and distension cured. Minor modifications in between, main idea was promoting Qi and moving dampness.
Also, Mr. Chen, over forty, loved alcohol, stool sometimes had blood, developed distension in spring, dark complexion, abdomen large like a ghost. Pulse Rapid and Choppy, heavy pressure seemed Weak. I gave Siwu Tang (Four Substances Decoction) plus Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Mutong (Akebiae Caulis), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) decocted. Stable for nearly a year. One tonified Qi, one nourished Blood, other herbs largely similar, all achieved peace and preserved natural lifespan. Someone asked: "Qi has no tonification method, why did your tonification bring peace? Is there a theory?" I said: "Qi has no tonification method is secular talk. Qi pathology involves stagnation and blockage, seemingly hard to tonify, fearing it increases disease. But consider: if Righteous Qi is deficient, it cannot circulate, pathogenic stagnation adheres and does not leave, thus causing disease. The Classic says: 'The robust recover as Qi moves; the timid develop disease as Qi sticks.' If Qi is timid and not tonified, how can Qi move?" Someone asked: "Your medicine is prudent, why slow effect? Patient bedridden, will tire of your slowness and seek speed." I said: "This disease starts, maybe 3-5 years, or 10+ years, deep root and strong momentum, seeking quick effect is seeking disaster. Those who understand the King's Way can cure this." Someone asked: "At end of distension disease, can we give purgatives?" I said: "If clearly not due to deficiency, shallow disease, Spleen/Stomach still strong, accumulation not fixed, and purgative indications exist, slight guidance is suitable. But citing Zhang Hezi's Xunchuan San or Yugong Wan for rapid attack, I dare not."
Pan Keda's daughter, 19, constitution rich, chest/abdominal fullness, self-administered purgatives, diarrhea 10+ times, distension unchanged, sought treatment. Pulse Large, disperses on light pressure, weak, no Rapid quality. I said: "Exterior syndrome present, attacking Interior, should die. Fortunately constitution good, unmarried, can recover, but lifespan reduced." Urgently gave Siwu Tang (Four Substances Decoction) plus Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi with white pith (Citri Reticulatae Pericarpium), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) decocted. After half month, disease not receding, self-used radish seed decoction for bath twice, swelling slightly increased. I said: "Exterior disease attacked Interior, already hard to save, now weakened Exterior, urgent." Removed Dihuang (Rehmanniae Radix) and Shaoyao (Paeoniae Radix Alba) from previous prescription, added Huangqi (Astragali Radix), doubled Baizhu (Atractylodis Macrocephalae Rhizoma), large dose strong decoction; swallowed Renshen Baizhu Wan (Ginseng and Atractylodes Pill). Ten days later, back to initial state. Then ate indigestible food causing self-diarrhea, used Renshen/Baizhu as Sovereign, small Chenpi as Assistant, Rou Doukou (Myristicae Semen) and Hezi (Terminalia Chebulae Fructus) as Sovereign, Shanzhazhi (Crataegi Fructus) as Envoy, mixed with congee into pills, swallowed. After 40-50 doses, stable.
Man, 40+, malaria prolonged, abdominal distension, pulse not Rapid but slightly Wiry, heavy pressure not slippery, light/heavy both weak. Gave Suoshi Sanhe Tang (Mr. Su's Three-Harmony Decoction) tripled with Baizhu (Atractylodis Macrocephalae Rhizoma), added Jiangzhi (Ginger Juice). Several doses, malaria cured, urination 2-3 times daily, distension slightly reduced. Then urine short, considered Qi and Blood dual deficiency, added Renshen (Ginseng Radix et Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Danggui Shenwei (Angelicae Sinensis Radix tip and tail) to previous prescription, large dose, 100 doses, cured.
Suoshi Sanhe Tang Tripled with Baizhu Formula:
Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium) (each 3 liang); Mutong (Akebiae Caulis) (1 liang); Binglang (Arecae Semen), Zisu (Perillae Folium) (each 2 liang); Gancao (Glycyrrhizae Radix et Rhizoma), Haijinsha (Lygodii Spora), Dafupi (Trogopterori Fructus), Baifuling (Poria cum Ligno Quercus), Zhike (Aurantii Fructus Immaturus) (each 1 liang). Decoct in water and take.
[Hailan] Tiaowei Baizhu Zexie San (Regulate Stomach Atractylodes and Alisma Powder): Treats Phlegm transforming into Water Qi transmission, unable to eat water/grain.
Baizhu (Atractylodis Macrocephalae Rhizoma) (8 liang); Zexie (Alismatis Rhizoma), Shaoyao (Paeoniae Radix Alba), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Shengjiang (Zingiberis Rhizoma Recens), Muxiang (Aucklandiae Radix), Binglang (Arecae Semen) (each 1 liang).
Powder above. Divine for abdominal swelling. If epigastric stuffiness, add Zhishi (Aurantii Fructus Immaturus). If epigastric fullness, add Qianniu (Pharbitidis Semen).
[Zhongjing] Epigastric hardness large as a plate, edge like a rotating cup, caused by Water Drink; Zhizhu Tang (Immature Bitter Orange and Atractylodes Decoction) governs.
Zhishi (Aurantii Fructus Immaturus) (7 pieces); Baizhu (Atractylodis Macrocephalae Rhizoma) (2 liang).
Two ingredients, water 5 sheng, boil to 3 sheng, divide warm, 3 doses. Abdomen soft, then dispersed.
[Luo] Wang Junyong of Zhending, 19 years old, Ji (Accumulation) disease, left of navel connecting to hypochondrium like inverted cup, abdomen distended like drum, many blue collaterals, panting unable to lie flat. Season hot rain, plus spontaneous diarrhea undigested food, afternoon tidal fever, night sweats, sought treatment. Pulse Floating and Rapid, forceful on pressure. Said to family: "Treating Ji requires toxic agents to attack. Now pulse so weak, dare not use ordinary method." Gave Fen Shen Yiwei (Separate Drainage Benefit Stomach) agent, several doses, stool clear and regulated; mixed with Sheng Jiang Yin Yang (Ascend Descend Yin Yang), Jing Shi He Qi (Nourish Food Harmonize Qi) agents, abdomen greatly reduced. Stomach Qi calmed, occasionally used Xiao Ji (Reduce Accumulation) agents, less than a month, well recovered. Master said: Jiegu Old Man said: "Nourish Righteousness, Accumulation removes itself." Like a room full of gentlemen, even one villain has no place. Now make True Qi solid, Stomach Qi strong, Accumulation disappears naturally.
[Danchi] Woman, 36, poor laborious, impatient nature. After menstruation stopped in July, August lump appeared lower abdomen, left like fist, painful when lump rises, relieved when lying down. Half month later, abdomen gradually swollen, appetite 2/3 normal, weak, night fever, morning subsides, pulse Deficient, Micro, Short, Weak, Choppy, Left worse. Initially gave Baizhu (Atractylodis Macrocephalae Rhizoma) 1 jin, Chenpi with white pith (Citri Reticulatae Pericarpium) 1 jin, 20 doses. Applied Sansheng Gao (Three Holy Ointment) to lump. Overnight lump soft, second night lump smaller. 10 days later, appetite improved, fever halved, pulse slightly forceful. Again gave Baizhu (Atractylodis Macrocephalae Rhizoma) 1 jin, Chenpi with white pith (Citri Reticulatae Pericarpium) 0.5 jin, Jiudanggui Shen (Wine-processed Angelicae Sinensis Radix Root Body) 0.5 jin, Mutong (Akebiae Caulis) 3 liang, per dose grind 9 Tao Ren (Persicae Semen). Finished this course, disease removed.
Woman, 50+, prone to anger, ate roasted pork, next morning facial swelling, no appetite, fatigue, six pulses Deep and Choppy, Left only Hollow and Large. Considered Body Deficiency with Phlegm, Qi blocked by Phlegm unable to descend, treat tonifying deficiency and draining phlegm primarily. Every morning Erchen Tang (Two-Cured Decoction) plus Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) large dose one packet, induce vomiting after taking. Chen/Si hours, Suoshi Sanhe Tang (Mr. Su's Three-Harmony Decoction) double dose plus Baizhu (Atractylodis Macrocephalae Rhizoma) two packets. After sleep, Shenyou Qi Wan (Divine Protection Seven Pills) to disturb phlegm, remove Qianniu (Pharbitidis Semen). Took for one month, stable.
Jin Shouyi Anren, 71, liked wet noodles, got Dai Xia (Leukorrhea) disease, also aversion to cold dripping. Doctor gave Heluaxu (Nelumbinis Plumula) Chaihu (Bupleuri Radix) etc., fever, discharge increased. Doctor gave Suosha (Amomi Fructus Rotundus) Doukou (Cardamomi Fructus) because low appetite; abdominal fullness, panting, gave Tingli San (Descurainiae Semen Lepidii Semis Decoction), ineffective. Gave Yuyuliang Wan (Yiyu Liang Pill), disease worsened. Doctor gave Chongtu San (Fortify Earth Powder), ineffective. My pulse: Both hands Hong and Choppy, light Wiry Long Slippery Solid, now panting severely unable to lie flat. Not damp酿成 (brewing) damp, in Foot Taiyin/Yangming meridians. Water/grain Qi suppressed by damp, unable to ascend, thus Dai Xia. Should use Sheng Ju (Ascending Lift) agents, tonify Qi, harmonize Blood. Doctor used astringent/dry agents, causing wandering disease. Gave Renshen (Ginseng Radix et Rhizoma) to generate Lung Yin to reject Fire Toxicity; Baizhu (Atractylodis Macrocephalae Rhizoma) to tonify Stomach Qi, drain Damp-Heat, move water passages; Tao Ren (Persicae Semen) to remove filth generate new; Yuliren (Prunus japonica Seed) to move accumulated water, assisted by Tongcao (Tetrapanacis Medulla); Xijiaoxie (Rhinocerotis Cornu) to resolve food toxicity, reduce swelling/oppression; Binglang (Arecae Semen) to treat highest Qi. Strong decoction swallow Baohe Wan (Harmonize the Stomach Pill). Suspected rich nourishment, meat accumulation, added Aw ei (Ferulae Resina) small pills to swallow. 4-5 days later, accumulated gas gradually reduced, swelling went down. Added Bushen Wan (Tonify Kidney Pill) to generate Kidney Water True Yin. 2-3 days later, gradually stable, slept, food tasted good. 2 days later, Dian Wan (Dot Pill) to drive out Lung accumulated heat, cured.
Man, Spleen Heat, Kidney Deficiency, Stomach Accumulation, swelling disease advancing/retreating, dry mouth or panting. Doctor months, not receding. Pulse Soft and Fine, fat body, not contraindicated. Used:
Baizhu (Atractylodis Macrocephalae Rhizoma) (4 qian); Shaoyao (Paeoniae Radix Alba), Dihuang (Rehmanniae Radix) (3 qian); Lianqiao (Forsythiae Fructus), Danggui (Angelicae Sinensis Radix) (2 qian); Qingpi (Citri Reticulatae Pericarpium Viride) (2.5 qian); Renshen (Ginseng Radix et Rhizoma), Mutong (Akebiae Caulis), Qianghuo (Notopterygii Rhizoma et Radix), Huangqin (Scutellariae Radix) (each 1.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma), Honghua (Carthami Flos) (some).
Divide 5 doses, decoct, swallow Baohe Wan (Harmonize the Stomach Pill).
Yang Sheng, 30, malaria just calm, bland tofu vegetarian meal caused distension, above diaphragm, urine red/scant, no appetite, thirst, pulse Wiry and Choppy, Stomach has Blood Stasis. Used:
Sugeng (Perillae Caulis) (3 fen); Mutong (Akebiae Caulis) (0.5 qian); Baizhu (Atractylodis Macrocephalae Rhizoma) (1.5 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhishi (Aurantii Fructus Immaturus), Baishao (Paeoniae Radix Alba) (each 5 fen); Gancao (Glycyrrhizae Radix et Rhizoma) (2 fen, prepared); Chenpi (Citri Reticulatae Pericarpium) (5 fen); Houpo (Magnoliae Officinalis Cortex) (3 fen).
Grind, Yi Yuan San (Benefit Origin Powder) swallow Baohe Wan (Harmonize the Stomach Pill) 50 pills.
Man, Qi ascends, belly distends, Lower Deficiency cause.
Chenpi (Citri Reticulatae Pericarpium) (5 qian); Renshen (Ginseng Radix et Rhizoma), Guixu (Angelicae Sinensis Radix Tip), Baizhu (Atractylodis Macrocephalae Rhizoma), Lianqiao (Forsythiae Fructus) (each 3 qian); Dihuang (Rehmanniae Radix), Shaoyao (Paeoniae Radix Alba) (each 2 qian); Mutong (Akebiae Caulis) (1.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (5 fen).
Divide 5 doses, decoct, swallow Baohe Wan (Harmonize the Stomach Pill).
Muxiang Huazhi Tang (Aucklandia Transform Stagnation Decoction):
Baidoukou Ren (Cardamomi Fructus Kernel), Chenpi (Citri Reticulatae Pericarpium), Dafuzi (Arecae Semen), Baifuling (Poria cum Ligno Quercus), Sharen (Amomi Fructus), Renshen (Ginseng Radix et Rhizoma) (each 1 qian); Qingpi (Citri Reticulatae Pericarpium Viride), Binglang (Arecae Semen), Muxiang (Aucklandiae Radix), Jianghuang (Curcumae Longae Rhizoma) (each 2 qian); Baizhu (Atractylodis Macrocephalae Rhizoma) (1 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (4 fen, prepared); Baitan (Santalum Album); Huoxiangye (Agastaches Folium) (each 2 fen); Jiegeng (Platycodonis Radix) (5 fen).
Fine powder, water 1 da zhang 2 fen, decoct to 1 da zhang, take slightly warm; before meals boil water point take also ok.
Above formulas, treat distension due to stagnation, all use Renshen/Baizhu/Houpo/Mutong decoction, tonify deficiency move dampness; swallow Shenyou/Awei pills to reduce accumulation, so-called Attack and Tonify combined.
Xiao Wen Zhong Wan (Minor Warm Middle Pill): Treats distension. Spleen deficiency cannot transport, do not purge.
Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma - boiled peel umbilicus), Shenqu (Massa Medicata Fermentata - fried), Fuling (Poria) (each 1 liang); Baizhu (Atractylodis Macrocephalae Rhizoma) (2 liang); Xiangfuzi (Cyperi Rhizoma - do not bake/dry); Zhensha (Magnetitum) (each 1.5 liang, vinegar fried red); Kushen (Sophorae Flavescentis Radix - fried); Huanglian (Coptidis Rhizoma - fried) (each 0.5 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (3 qian).
Powder. Vinegar/Water each 1 da zhang, paste into pills, size tung zi. Each take 70-80 pills. Baizhu (Atractylodis Macrocephalae Rhizoma) 6 qian, Chenpi (Citri Reticulatae Pericarpium) 1 qian, Shengjiang (Zingiberis Rhizoma Recens) 1 slice, decoct swallow. Very deficient, add Renshen (Ginseng Radix et Rhizoma) 1 qian. Each formula remove Huanglian (Coptidis Rhizoma), add Houpo (Magnoliae Officinalis Cortex) 0.5 liang. Taboo diet. Light disease, take 6-7 liang, urine long; severe disease take 1 jin, urine begins long.
[Zhenheng] Yuyuliang Wan (Yiyu Liang Pill): Treats ten types of Water Qi, foot/knee swelling, upper body panting/fullness, urination difficulty. Any Water Qi, all govern. (Xu Xueshi and Danxi say: This formula is key drug for distension.)
Shehanshi (Depressorum Herba - large 3 liang, new iron pot, charcoal fire burn until yellow same red as pot, clamp take yellow, pour into vinegar, cool take, grind fine); Yuyuliang (Haematitum) (3 liang); Zhen Zhensha (Magnetitum) (5 liang, water wash clean, fry dry, put with Yuyuliang, rice vinegar 2 sheng pot boil until vinegar dry. Then pot and medicine charcoal fire red, clamp pour medicine clean brick ground, cool grind fine).
These three main, next measure person deficiency/excess add below: (Water treatment mostly takes rotation. Only this formula three items not comparable to Daji/Gansui/Yuanhua, plus below items support, so deficient/elderly can take)
Qianghuo (Notopterygii Rhizoma et Radix), Muxiang (Aucklandiae Radix), Fuling (Poria), Chuanxiong (Ligustici Chuanxiong Rhizoma), Niuxi (Achyranthis Bidentatae Radix - wine soak), Guixin (Cinnamomi Ramulus), Baidoukou (Cardamomi Fructus - processed), Dahuixiang (Foeniculi Fructus - fried), Pengzhu (Curcumae Rhizoma - processed), Fuzi (Aconiti Lateralis Radix Praeparata - processed), Ganjiang (Zingiberis Rhizoma - processed), Qingpi (Citri Reticulatae Pericarpium Viride), Jingsanleng (Sparganii Rhizoma - processed), Baijili (Tribuli Fructus), Danggui (Angelicae Sinensis Radix - wine soak overnight) (each 0.5 liang).
Powder, mix well, soup soaked steamed cake wring water, mix medicine pound uniform, pills tung zi size. Before meal, warm wine/white water send down 30-50 pills.
Most taboo salt, not a hair enter mouth, otherwise disease worse. Try medicine, immediately in urine go out, not move organs/zang-fu. Disease gone, 3 doses/day. Plus mild harmonize tonify Qi/Blood agents assist, truly divine formula.
[Danchi] Pulse firm/solid, person robust/sturdy, or can use attack drugs, then gather Baizhu (Atractylodis Macrocephalae Rhizoma) as main.
[Yuan] Zhongman (Middle Fullness) treatment: Kai Guimen (Open Ghost Gate), Jing Jingfu (Clean Pure Mansion). Kai Guimen is Fa Han (Induce Sweating); Jing Jingfu is Li Xiao Bian (Promote Urination). Also Zhongman Xie Yu Nei (Drain Middle from Inside), means Spleen/Stomach sick, let upper/lower separate dissipate its Qi. Lower Jiao like ditch, Qi/Blood naturally differentiate, no need to drain dregs, if Great Excess Great Fullness, urination/defecation not smooth, temporarily use Cold/Hot drugs to purge. Or damage wine/wet noodles, strong flavor things, Gao Liang (Rich/Fatty) people, or eat then lie down, make Damp-Heat Qi not transform, causing abdominal distension, this is also Re Zhang (Heat Distension). Treat Heat Distension, Fenxiao Wan (Separate Dissipate Pill) governs.
[Zhongjing] Qi Fen (Qi Division), Epigastric hardness, large as plate, edge like rotating cup, Water Drink caused, Guizhi Qu Shao Jia Mahan Fuzi Tang (Cinnamon Twig Decoction Remove Paeonia Add Ephedra, Asarum, Aconite Decoction) governs.
Guizhi (Cinnamomi Ramulus), Shengjiang (Zingiberis Rhizoma Recens) (3 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang), Dazao (Ziziphi Jujubae Fructus) (12 pieces), Mahuang (Ephedrae Herba), Xixin (Asari Radix et Rhizoma) (each 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, processed).
Seven ingredients, water 7 sheng, boil Mahuang remove foam, add others, boil to 2 sheng, divide warm, 3 doses. Should sweat, like insect walking in skin, then cured.
[Sheng] Niuhang Hupo Wan (Ox Gallstone Amber Pill): Treats edema abdominal large, breath not passing critical, divine effect.
Niuhuang (Bovis Calculus), Hupo (Electrum), Jiaomu (Zanthoxyli Semen - sinking), Tingli (Descurainiae Semen Lepidii Semis - fried purple) (each 3 fen); Kunbu (Laminariae Thallus - wash roast), Haizao (Sargassii Thallus - wash roast) (each 1 liang 1 qian); Qianniu (Pharbitidis Semen - fried), Gui (Cinnamomi Ramulus) (each 1 liang).
Seven ingredients powder, separately grind Tingli like mud, mix together, refine honey pills tung zi size. Each take 15 pills, rice drink down, limit by urination smooth, 2 doses/day.