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Abdominal distension caused by Spleen deficiency often results from prolonged illness, while that due to Stomach excess is mostly caused by food stagnation. Treatment should tonify deficiency, strengthen the Spleen, and regulate Qi; or purge food accumulation and promote digestion, thereby restoring tranquility.

[Note]
The disease of abdominal distension is primarily governed by the Spleen and Stomach meridians, manifesting as either deficiency or excess patterns, which must be carefully differentiated.
Deficiency patterns arise from internal injury to the Spleen due to prolonged illness;
Excess patterns arise from food stagnation in the Stomach. Deficiency requires tonification of the Spleen, while excess requires promotion of digestion. With appropriate regulation and treatment, the distension will gradually resolve.

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Chapter on Abdominal Distension

Prolonged illness leads to Spleen deficiency and loss of transportation and transformation functions, or sudden injury to Spleen Qi due to severe vomiting and diarrhea. Symptoms include abdominal distension after minimal food intake, mental fatigue, sallow complexion, and emaciation. The formula Si Jun Zi Tang (Four Gentlemen Decoction) modified with Xiang Fu and Hou Po is indicated.

[Note]
In children, prolonged illness causing Spleen deficiency, or sudden injury to Spleen Qi due to vomiting and diarrhea, results in abnormal transportation and transformation functions.
Consequently, food fails to digest, leading to abdominal fullness even with small amounts of food. Clinical manifestations include mental fatigue, sallow complexion, and emaciation, constituting a deficiency-type abdominal distension.
Xiang Po Si Jun Zi Tang (Atractylodes and Cyperus Four Gentlemen Decoction) is suitable for treatment.
(Xiang Po Si Jun Zi Tang)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, stir-fried with soil), Bai Fu Ling (Poria), Zhi Gan Cao (Prepared Licorice Root), Zhi Xiang Fu (Prepared Cyperi Rhizoma), Jiang Chao Hou Po (Magnolia Bark stir-fried with ginger juice). Decoct with fresh ginger water.
(Verse Formula)
Xiang Po Si Jun treats deficiency distension; Ginseng, Atractylodes, and Licorice combined with Poria; Add prepared Cyperi Rhizoma and Magnolia Bark; Decoct with ginger to calm distension.

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Chapter on Abdominal Distension

Overeating causes internal injury to the Stomach, leading to food stagnation and abdominal distension, accompanied by unsmooth bowel movements. If there is tidal fever, irritability, thirst, and robust physical constitution, Ping Wei San or Xiao Cheng Qi Tang may be applied flexibly.

[Note]
When children overeat, food stagnates in the Stomach,
resulting in abdominal distension, difficult defecation, tidal fever, irritability, thirst, and a robust physical constitution. This constitutes an excess-type abdominal distension.
For mild cases, Ping Wei San (Calm the Stomach Powder) is the primary formula; for severe cases, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is the primary formula.
(Jia Wei Ping Wei San - Modified Calm the Stomach Powder) Nan Cang Zhu (Atractylodis Rhizoma, stir-fried), Jiang Chao Hou Po (Magnolia Bark stir-fried with ginger juice), Zhi Da Fu Pi (Areca Peel processed), Sheng Gan Cao (Raw Licorice Root), Chen Pi (Citrus Reticulatae Pericarpium), Bei Lai Fu Zi (Raphani Semen roasted).
Shan Zha (Crataegi Fructus), Chao Mai Ya (Hordei Fructus Germinatus stir-fried), Chao Shen Qu (Medicated Leaven stir-fried). Decoct with fresh ginger water.
(Verse Formula)
Modified Ping Wei San treats excess distension; Atractylodes, Magnolia Bark, Areca Peel; Licorice, Citrus Reticulatae Pericarpium, Raphani Semen; Crataegi Fructus, Hordei Fructus Germinatus stir-fried with Medicated Leaven.
(Xiao Cheng Qi Tang) See entry under "Food Pain" for the formula.

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