（附丁奚）
〔洁〕腹胀虚实 凡久病吐泻之后，虚则其脉微细。肺主目胞及腮，脾主四肢。若色淡黄，目胞腮虚肿，
手足冷，先服塌气丸，后服异功散、和中丸、四君子汤、益黄散之类，用诸温药养真气。（异功散、和中
丸方见吐泻，四君子汤方见治虚实法。）
塌气丸
胡椒（一两） 蝎尾（半两）
上为末，糊丸如粟米大。每服五七丸至一二十丸，陈米饮下，无时。（一方有木香一钱。）
〔《本》〕调中丸 治小儿久伤脾胃，腹胀。
干姜 橘红 白术 茯苓 木香 砂仁 官桂 良姜（各等分）
上细末，糊丸如麻子大。每服二三十丸，食后熟水下。
〔洁〕实则脉洪实，不因吐泻久病后，亦不因痢下，腹胀而喘急闷乱，更有痰有热，及有宿食不化
而腹胀者，宜服白饼子、大黄丸、解毒丸下之。兼须详认大小便，如都不通，先利小便，后利大便。（白饼子
方见癖。解毒丸方见喉痹。大黄丸方见伤寒。）
〔云〕小儿热结于内，腹胀壮热，大便赤黄，躁闷烦乱者，宜泻青丸。
〔钱〕腹胀由脾胃虚气攻作也，实者闷乱喘满可下之，用紫霜丸、白饼子。（此言未下而喘者为实，故可
下，若误下而喘者为虚气附肺，不可下也。紫霜丸、白饼子方见癖。）不喘者虚也，不可下，若误下之，
则脾虚气上附肺而行。肺与脾子母皆虚，肺主目胞腮之类，脾主四肢，母气虚甚，即目胞腮肿，四肢黄色，
治之用塌气丸渐消之，未愈，渐加丸数，不可以丁香、木香、橘皮、豆蔻大温散药治之。何以然？脾虚气
未出，故虽腹胀而不喘，可以温散药治之，使上下分消其气则愈矣。若气虚已出，附肺而行，即脾胃内弱，
每生虚气，入于四肢面目矣。小儿易为虚实，脾虚则不受寒温，服寒则生冷，服温则生热，当识此，勿误也。
胃久虚热多生疸病，或引饮不止。脾虚不能胜肾，随肺气上行于四肢，而目肿若水状。肾气漫浮于肺，
即大喘也。此当用塌气丸，病愈后面未红者，虚衰未复故也。（此下后喘，故宜塌气丸。若未下而喘，宜下
之。）治腹胀者，譬如行兵，战寇于林，寇未出林，以兵攻之，必可获；寇若出林，不可急攻，攻则必有失，
当以意渐收之，即顺也。（寇未出林谓虚气未出而不喘，不目胞腮肿，故可用丁香、木香大温散药上下分
消其气而愈也。寇已出林，谓虚气已出为喘，为目腮肿，须用塌气丸渐消之。）
治小儿虚腹胀，先服塌气丸。不愈，腹中有食积结粪，小便黄，时微喘，脉伏而实，时饮水能食者，可下之。
盖脾初虚而后有积，所治宜先补脾，然后下之，后又补脾，即愈也。不可补肺，恐生虚喘。
〔丹〕阿魏丸 治小儿食积，腹如蜘蛛状，肚痛，小便白浊。
阿魏（醋浸一宿，研如泥，半两） 黄连（炒，半两） 花碱（研如粉，三钱） 山楂肉（一两）
连翘（一两半） 半夏（皂角水浸一宿，一两）
上为末，炒神曲糊丸如卜子大。每服二十丸，空心米饮下。吃果子多者加胡黄连，米食多者加神
曲、山楂，肉食多者加阿魏。
又阿魏丸
阿魏（一两） 黄连（酒煮，六两）
上为末，醋浸阿魏一宿，研如泥，汤浸，蒸饼丸。如元气不足，加人参。
小阿魏丸
山楂肉（三两） 石碱（三钱） 半夏（一两）
上为末，阿魏半两，醋浸糊丸，白汤下。
小儿疳病，或腹大。
胡黄连（二钱，去果积） 阿魏（一两半，去肉积） 神曲（二两，去食积） 黄连（二钱，去热积）
麝香（四粒，通窍）
上为末，每服十二粒，白术汤下。
〔无〕肥儿丸 治小儿病多因缺乳吃食太早所致，或因久患脏腑胃虚虫动，日渐羸瘦，腹大不能行，
发竖，发热，无精神。
黄连 神曲（各一两） 麦芽（炒，半两） 木香（二钱） 槟榔（三个，不见火） 使君子 肉豆蔻（面裹
煨。各半两）
上为末，糊为丸如桐子大。每服三二十丸，量儿加减，熟水吞下。
六神丸 治如前证。
丁香 木香 肉豆蔻（用面裹煨。各五钱） 诃子（煨，去核，半两） 使君子 芦荟（研。各一两）
上为末，以枣肉和丸，如麻子大。每服五丸至七丸，温米饮下，食前。
丁奚者，腹大、颈小、黄瘦是也。无辜、哺露三候，大体相似，轻重立名，宜服十全丹。
十全丹 治丁奚、哺露神效方。
槟榔 枳壳（麸炒） 青皮 陈皮 三棱（炒） 蓬术（炒） 砂仁（各半两） 丁香 木香（各一分）
香附（一两）
上为末，神曲糊丸如黍米大。空心食前，米饮下百丸。一方，去香附、砂仁、丁香、三棱、枳壳，
加五灵脂、白蔻、使君子、芦荟、虾蟆、川芎。
〔世〕治小儿腹如蜘蛛，四肢瘦者。用黑骨鸡子破顶，入蜘蛛一枚于内，以湿纸糊窍，用文武火煨
熟，去蜘蛛，食其鸡子，累效。必数枚方愈。
〔垣〕中满分消丸
黄连 枳实 浓朴（各五钱） 干姜 姜黄 猪苓 砂仁 泽泻 茯苓（各三分） 陈皮 白术（各一分）
半夏（四分） 黄芩（一两二钱） 甘草（一分）
上为细末，蒸饼为丸如黍米大，每服三十丸，温酒送下。
消痞丸 快利之剂。
黄连（半两） 枳实 黄芩 甘草 人参（各三钱） 浓朴（七分） 干姜（四分） 橘皮（一钱）
姜黄（五分）
上为细末，蒸饼为丸如黍米大。每服三十丸，随乳下。
〔丹〕腹胀。
萝卜子 苏梗 干葛 陈皮（各等分） 甘草（减半）
如食减，加白术煎服。
〔垣〕升阳滋血汤 二月间，一小儿未满百日，病腹胀，不大便，二日便瘦弱，遍身黄色，宜升阳气，
滋血和血补血，利大便。
蝎梢（二分） 神曲（三分） 浓朴 当归（各一钱） 桃仁（十个） 升麻（三分）
上作一服，水一盏，煎至半盏，去渣，食前服。
麻黄升麻汤 治小儿面色痿黄，腹胀食不下。正月四月，小儿服之神效。
麻黄（二分） 桂枝（一分） 杏仁 吴茱萸 草豆蔻 浓朴 曲末 羌活（各一分） 柴胡根（五分）
白茯苓（一分） 白术 青皮（各五分） 升麻根 苍术 泽泻 猪苓 陈皮（各一分） 黄连（五分）
黄柏（一分）
上 咀，作一服，水一大盏，煎七分，去渣，食前热服。
〔丹〕寄子年五岁，痘后肚急。
白术（一钱） 陈皮 木通（各五分） 犀角屑 川芎 白芷 苏梗 甘草（炙。各三分）
上 咀，水煎服。
〔田〕治腹胀引背，食饮多，渐渐羸瘦黄。可灸脾 二穴七壮，在十一椎下两旁相去各一寸五分，黄胆
灸三壮。
〔《甲》〕小儿腹满，不能食饮，悬钟主之。
丁奚即胀，治见胀门丹溪条。
(Attached: Ding Xi Syndrome)
[Li Dongyuan] Differentiation of Deficiency and Excess in Abdominal Distension: In cases following prolonged vomiting and diarrhea, the pulse of deficiency syndrome is fine and faint. The Lung governs the eyelids and cheeks, while the Spleen governs the four limbs. If the complexion is pale yellow, with puffy swelling of the eyelids and cheeks, and cold hands and feet, one should first administer Taqi Wan (Collapse Qi Pill), followed by Yigong San (Extraordinary Efficacy Powder), Hezhong Wan (Harmonize the Middle Pill), Sijunzi Tang (Four Gentlemen Decoction), Yihuang San (Benefit Yellow Powder) and similar formulas, using various warm-natured drugs to nourish the True Qi. (The formulas for Yigong San and Hezhong Wan are found in the "Vomiting and Diarrhea" section; the formula for Sijunzi Tang is found in the "Treating Deficiency and Excess Methods" section.)
Taqi Wan (Collapse Qi Pill)
Hu Jiao (Pepper, 1 liang) Xie Wei (Scorpion Tail, 0.5 liang)
Grind the above into fine powder, make pills with paste the size of millet seeds. Take 5-7 pills per dose, up to 10-20 pills, swallow with old rice decoction, at any time. (Another prescription adds Mu Xiang, 1 qian.)
[Ben Cao Note] Tiaozhong Wan (Regulate the Middle Pill): Treats abdominal distension caused by long-term damage to the Spleen and Stomach in children.
Gan Jiang (Dried Ginger) Ju Hong (Aged Tangerine Peel) Bai Zhu (Atractylodes Macrocephala Rhizome) Fu Ling (Poria) Mu Xiang (Costus Root) Sha Ren (Amomum Fruit) Guan Gui (Cinnamon Twig) Liang Jiang (Galangal Rhizome) (Equal parts)
Grind the above into fine powder, make pills the size of hemp seeds. Take 20-30 pills per dose, swallow with cooked water after meals.
[Li Dongyuan] In excess syndromes, the pulse is surging and solid. This is not due to prolonged vomiting/diarrhea or dysentery, but rather abdominal distension accompanied by panting, chest tightness, and restlessness, with phlegm-heat inside, or undigested food retention causing distension. It is appropriate to use purgatives such as Baibing Zi (White Cake Pill), Dahuang Wan (Rhubarb Pill), and Jiedu Wan (Detoxification Pill). One must also carefully distinguish urination and defecation status; if both are blocked, first promote urination, then promote defecation. (The formula for Baibing Zi is found in the "Pi Accumulation" section; the formula for Jiedu Wan is found in the "Sore Throat" section; the formula for Dahuang Wan is found in the "Cold Damage" section.)
[Yun Qizi] For children with internal heat accumulation, presenting with abdominal distension, high fever, reddish-yellow stool, and irritability/restlessness, Xieqing Wan (Drain Green Pill) is appropriate.
[Qian Yi] Abdominal distension is caused by Spleen-Stomach deficiency and rebellious Qi attacking upwards. Excess syndromes manifest as chest tightness, restlessness, panting, and fullness, which can be treated with purgatives using Zishuang Wan (Purple Frost Pill) or Baibing Zi. (This refers to panting present before purgation, indicating an excess syndrome suitable for purgation; if panting occurs after mistaken purgation, it indicates deficient Qi attaching to the Lung, and purgation is contraindicated. Formulas for Zishuang Wan and Baibing Zi are found in the "Pi Accumulation" section.) Non-panting cases indicate deficiency and should not be purged. Mistaken purgation leads to Spleen Qi deficiency with Qi rebelling upwards to attach to the Lung. Since Lung and Spleen have a mother-child relationship, severe deficiency of the Mother Qi (Lung) results in swollen eyelids/cheeks and yellow limbs. Treatment uses Taqi Wan to gradually dissipate the condition. If not cured, gradually increase the dosage. Do not use strongly warming and dispersing drugs like Ding Xiang (Clove), Mu Xiang, Ju Pi (Tangerine Peel), or Dou Kou (Cardamom). Why? Because Spleen Qi is deficient and has not yet escaped outward; thus, although there is distension, there is no panting. At this stage, warming and dispersing drugs can be used to distribute and eliminate Qi from above and below, leading to recovery. If Qi deficiency has already escaped and attached to the Lung, meaning internal Spleen-Stomach weakness generates frequent deficient Qi invading the limbs and face, treatment differs. Children easily oscillate between deficiency and excess; Spleen deficiency cannot tolerate either cold or warmth—cold drugs generate cold-damp, warm drugs generate heat. One must recognize this to avoid error. Long-term Stomach deficiency generating heat often causes Jaundice or excessive thirst. Spleen deficiency failing to control Kidney Qi allows it to ascend with Lung Qi to the limbs, causing watery eye swelling. Kidney Qi floating diffusely into the Lung causes severe panting. This situation requires Taqi Wan. If the face remains pale after cure, it indicates incomplete recovery from deficiency. (This refers to panting after purgation, hence Taqi Wan is suitable. If panting exists before purgation, purgation is indicated.) Treating abdominal distension is like military strategy: fighting bandits in the forest. If bandits have not left the forest, attacking them ensures victory; if they have left, hasty attack leads to loss. One should gradually surround and suppress them according to circumstances. ("Bandits not leaving the forest" means deficient Qi has not escaped, no panting, no facial swelling, so strongly warming/dispersing drugs can distribute Qi. "Bandits having left the forest" means deficient Qi has escaped, manifesting as panting and facial swelling, requiring Taqi Wan to gradually dissipate.)
To treat pediatric deficiency-type abdominal distension, first administer Taqi Wan. If ineffective, and there is food stagnation/fecal impaction in the abdomen, yellow urine, occasional mild panting, deep and solid pulse, frequent thirst but ability to eat, purgation may be used. This is because initial Spleen deficiency led to accumulation; treatment should first tonify the Spleen, then purge, then tonify the Spleen again for recovery. Do not tonify the Lung, lest it induce deficient panting.
[Zhu Danxi] Awei Wan (Asafoetida Pill): Treats pediatric food stagnation, abdomen shaped like a spider, abdominal pain, cloudy white urine.
A Wei (Asafoetida, soaked in vinegar overnight, ground to paste, 0.5 liang) Huang Lian (Coptis Rhizome, stir-fried, 0.5 liang) Hua Jian (Flower Alkali, ground to powder, 3 qian) Shan Zha Rou (Hawthorn Flesh, 1 liang)
Lian Qiao (Forsythia Fruit, 1.5 liang) Ban Xia (Pinellia Tuber, soaked in soapberry water overnight, 1 liang)
Grind the above into fine powder, make pills with fried Shen Qu paste the size of radish seeds. Take 20 pills per dose, swallow with rice decoction on an empty stomach. Increase Hu Huang Lian (Picrorhiza Rhizome) if fruit intake is high; increase Shen Qu (Medicated Leaven) and Shan Zha if rice intake is high; increase A Wei if meat intake is high.
Another Awei Wan Formula
A Wei (Asafoetida, 1 liang) Huang Lian (Coptis Rhizome, boiled in wine, 6 liang)
Grind the above into fine powder. Soak A Wei in vinegar overnight, grind to paste, mix with soup-soaked steamed cake dough to make pills. Add Ren Shen (Ginseng Root) if Yuan Qi (Primal Qi) is insufficient.
Small Awei Wan
Shan Zha Rou (Hawthorn Flesh, 3 liang) Shi Jian (Stone Alkali, 3 qian) Ban Xia (Pinellia Tuber, 1 liang)
Grind the above into fine powder, add 0.5 liang A Wei, soak in vinegar, make pills with paste, swallow with plain hot water.
Pediatric Gan Disease (Malnutrition), sometimes with abdominal enlargement.
Hu Huang Lian (Picrorhiza Rhizome, 2 qian, removes fruit stagnation) A Wei (Asafoetida, 1.5 liang, removes meat stagnation) Shen Qu (Medicated Leaven, 2 liang, removes food stagnation) Huang Lian (Coptis Rhizome, 2 qian, removes heat stagnation)
She Xiang (Musk, 4 grains, opens orifices)
Grind the above into fine powder. Take 12 grains per dose, swallow with Bai Zhu Tang (Atractylodes Macrocephala Decoction).
[Wang Yinjun] Fei'er Wan (Child-Nourishing Pill): Treats pediatric diseases often caused by lack of breast milk or introducing solids too early, or due to long-term visceral/Stomach deficiency with worm activity, leading to gradual emaciation, abdominal enlargement preventing walking, erect hair, fever, and lethargy.
Huang Lian (Coptis Rhizome) Shen Qu (Medicated Leaven) (Each 1 liang) Mai Ya (Barley Sprout, stir-fried, 0.5 liang) Mu Xiang (Costus Root, 2 qian) Bing Lang (Areca Seed, 3 pieces, avoid fire frying) Shi Jun Zi (Quisqualis Fruit) Rou Dou Kou (Nutmeg, baked in flour paste. Each 0.5 liang)
Grind the above into fine powder, make pills the size of paulownia seeds. Take 20-30 pills per dose, adjust according to age, swallow with cooked water.
Liushen Wan (Six Gods Pill): Treats the aforementioned conditions.
Ding Xiang (Clove) Mu Xiang (Costus Root) Rou Dou Kou (Nutmeg, baked in flour paste. Each 5 qian) He Zi (Chebula Fruit, baked, pitted, 0.5 liang) Shi Jun Zi (Quisqualis Fruit) Lu Hui (Aloe, ground. Each 1 liang)
Grind the above into fine powder, mix with jujube flesh to make pills the size of hemp seeds. Take 5-7 pills per dose, before meals, swallow with warm rice decoction.
Ding Xi Syndrome is characterized by abdominal enlargement, thin neck, and sallow emaciation. Wugu Gan (Innocent Malnutrition) and Bulu Gan (Breastfeeding Malnutrition) are similar in nature but differ in severity. Shiquan Dan (Ten Perfections Pill) is appropriate.
Shiquan Dan (Ten Perfections Pill): A miraculous formula for treating Ding Xi and Bulu Gan.
Bing Lang (Areca Seed) Zhi Ke (Bitter Orange Peel, bran-fried) Qing Pi (Green Tangerine Peel) Chen Pi (Aged Tangerine Peel) San Leng (Burreed Rhizome, stir-fried) Peng Ze (Curcuma Rhizome, stir-fried) Sha Ren (Amomum Fruit) (Each 0.5 liang) Ding Xiang (Clove) Mu Xiang (Costus Root) (Each 1 fen)
Xiang Fu (Cyperus Rhizome, 1 liang)
Grind the above into fine powder, make pills with Shen Qu paste the size of millet seeds. Before meals on an empty stomach, swallow 100 pills with rice decoction. Another prescription removes Xiang Fu, Sha Ren, Ding Xiang, San Leng, Zhi Ke, and adds Wu Ling Zhi (Trogopterus Dung), Bai Kou (White Cardamom), Shi Jun Zi, Lu Hui, Xia Pa (Toad), Chuan Xiong (Ligusticum Rhizome).
[Worldly Prescription] To treat children with spider-shaped abdomen and emaciated limbs. Break the top of a black-bone chicken egg, insert one spider inside, seal the hole with wet paper, and bake over gentle fire until cooked. Remove the spider and eat the egg. Repeatedly effective. Several eggs may be needed for cure.
[Zhang Yuansu] Zhongman Fenxiao Wan (Middle Fullness Dissipating Pill)
Huang Lian (Coptis Rhizome) Zhi Shi (Immature Bitter Orange, 5 qian each) Hou Po (Magnolia Bark) Gan Jiang (Dried Ginger) Jiang Huang (Turmeric Rhizome) Zhu Ling (Polyporus) Sha Ren (Amomum Fruit) Ze Xie (Alisma Rhizome) Fu Ling (Poria) (Each 3 fen) Chen Pi (Aged Tangerine Peel) Bai Zhu (Atractylodes Macrocephala Rhizome) (Each 1 fen)
Ban Xia (Pinellia Tuber, 4 fen) Huang Qin (Scutellaria Root, 1 liang 2 qian) Gan Cao (Licorice Root, 1 fen)
Grind the above into fine powder, make pills with steamed cake dough the size of millet seeds. Take 30 pills per dose, swallow with warm wine.
Xiaopi Wan (Eliminate Epigastric Mass Pill): A brisk and draining agent.
Huang Lian (Coptis Rhizome, 0.5 liang) Zhi Shi (Immature Bitter Orange) Huang Qin (Scutellaria Root) Gan Cao (Licorice Root) Ren Shen (Ginseng Root) (Each 3 qian) Hou Po (Magnolia Bark, 7 fen) Gan Jiang (Dried Ginger, 4 fen) Ju Pi (Tangerine Peel, 1 qian)
Jiang Huang (Turmeric Rhizome, 5 fen)
Grind the above into fine powder, make pills with steamed cake dough the size of millet seeds. Take 30 pills per dose, swallow with breast milk.
[Zhu Danxi] Abdominal Distension.
Luo Bo Zi (Radish Seed) Su Geng (Perilla Stem) Gan Ge (Kudzu Root) Chen Pi (Aged Tangerine Peel) (Equal parts) Gan Cao (Licorice Root, halved)
If appetite decreases, add Bai Zhu and decoct.
[Zhang Yuansu] Shengyang Zixue Tang (Raise Yang and Nourish Blood Decoction): In February, a child under 100 days old suffered abdominal distension and constipation. After two days, became emaciated and sallow. Should raise Yang Qi, nourish, harmonize, and tonify blood, and promote defecation.
Xie Shao (Scorpion Tail Tip, 2 fen) Shen Qu (Medicated Leaven, 3 fen) Hou Po (Magnolia Bark) Dang Gui (Angelica Sinensis Root) (Each 1 qian) Tao Ren (Peach Kernel, 10 pieces) Sheng Ma (Cimicifuga Rhizome, 3 fen)
Prepare as one dose, decoct 1 cup of water to half a cup, strain, take before meals.
Mahuang Shengma Tang (Ephedra and Cimicifuga Decoction): Treats children with sallow complexion, abdominal distension, and inability to eat. Highly effective for children in January and April.
Mahuang (Ephedra Herb, 2 fen) Guizhi (Cinnamon Twig, 1 fen) Xing Ren (Apricot Seed) Wu Zhu Yu (Evodia Fruit) Cao Dou Kou (Grass Cardamom) Hou Po (Magnolia Bark) Qu Mo (Medicated Leaven Powder) Qiang Huo (Notopterygium Rhizome) (Each 1 fen) Chai Hu Gen (Bupleurum Root, 5 fen)
Bai Fu Ling (Poria, 1 fen) Bai Zhu (Atractylodes Macrocephala Rhizome) Qing Pi (Green Tangerine Peel) (Each 5 fen) Sheng Ma Gen (Cimicifuga Root) Cang Zhu (Atractylodes Lancea Rhizome) Ze Xie (Alisma Rhizome) Zhu Ling (Polyporus) Chen Pi (Aged Tangerine Peel) (Each 1 fen) Huang Lian (Coptis Rhizome, 5 fen)
Huang Bo (Phellodendron Bark, 1 fen)
Cut into pieces, prepare as one dose, decoct 1 large cup of water to 0.7 cups, strain, take hot before meals.
[Zhu Danxi] Ji Zi, aged five, suffered urgent abdominal distension after smallpox.
Bai Zhu (Atractylodes Macrocephala Rhizome, 1 qian) Chen Pi (Aged Tangerine Peel) Mu Tong (Akebia Stem, Each 5 fen) Xi Jiao Xie (Rhinoceros Horn Shavings - *Note: Substitute with Water Buffalo Horn in modern practice*) Chuan Xiong (Ligusticum Rhizome) Bai Zhi (Angelica Dahurica Root) Su Geng (Perilla Stem) Gan Cao (Licorice Root, honey-fried. Each 3 fen)
Cut into pieces, decoct in water and take.
[Tian's Method] To treat abdominal distension radiating to the back, increased food intake, gradual emaciation and yellowness. Moxibustion can be applied to Pishu (BL20) acupoint, 7 moxa cones. Location: Below the 11th thoracic vertebra, lateral to the midline, 1.5 cun apart. For Jaundice, apply 3 moxa cones.
[Neijing Jingjiu Yiyi Shuyi / Jia Yi Jing] For pediatric abdominal fullness and inability to eat/drink, Xuanzhong (GB39) is indicated.
Ding Xi is synonymous with distension. Treatment is detailed in the "Distension Section" under Danxi's entries.