叙曰∶鼓胀是虚中之实，宜分气、血、虫、食而治之，以朝宽暮急，能食不能食而辨之
。实者可攻，虚者渐磨可也。例之相道焉，国内空虚，则宜惠养元气，恶能黩武？今考名方
七首，示大法耳。或较形气、病气而攻补兼施，此在人之妙用，初不必泥也。
山楂肉（二两，炒） 白术（炒） 神曲（炒） 半夏（制） 茯苓（各一两） 陈皮
（去白） 连
翘萝卜子（生用各五钱）
饮食伤脾，成鼓胀者，此方主之。
鼓胀者，腹皮虚大，鼓之坚急而有声也。经曰∶阴之五宫，伤在五味。故饮食过其分量
，则伤脾，脾伤则不能运化，积其谷气，虚大而鼓胀矣。然五味之变，酸性甘，腐胜焦，苦
胜热，香胜腐，燥胜湿，淡胜饮，利胜滞，气胜味。故用山楂之酸以消肥甘，用神曲之腐以
化焦炙，用连翘之苦以磨积热，用陈皮之香以开腐秽，用半夏之燥以胜土湿，用茯苓之淡以
利水饮，用萝卜子之利以行食滞，用白术之气以胜五味。五味能胜，则脾不伤，脾不伤，则
中气营运而无鼓胀矣。此大安之旨也！
青皮（水蛭炒） 莪术（虻虫炒） 三棱（干漆炒） 槟榔（斑蝥炒） 吴茱萸（牵牛
炒） 干姜
（砂炒） 胡椒（茴香炒） 附子（盐炒） 赤芍药（川椒炒） 石菖蒲（桃仁炒）
上件同炒药熟，去水蛭等不用，研末，酒糊为丸，如梧桐子大。每服五丸至七丸，空心
紫苏汤下。
诸腹胀大，痞塞不通，大便虚秘，此方主之。
青皮、莪术、三棱、菖蒲，气积药也，炒以水蛭、虻虫、干漆、桃仁，则逐败血矣！干
姜、附子、胡椒、茱萸，温中药也，炒以 砂、食盐、茴香、牵牛，则软坚而疏利矣。槟榔
炒以斑蝥，下气者得破气者而益悍。赤芍药炒以川椒，泻肝者得疏肝者而益利。制度之工如
此，以之而治气实有余之证，斯其选矣。
[Preface] Distension and swelling (Gu Zhang) is a condition of deficiency in the root but excess in the branch. It should be treated by distinguishing between Qi, Blood, Parasites, and Food stagnation, differentiating based on whether symptoms are milder in the morning and worse in the evening, and whether the patient can or cannot eat. For excess patterns, purgative methods may be used; for deficiency patterns, gradual resolution is appropriate. This is analogous to governing a state: if the interior is empty, one should bestow grace to nourish Yuan Qi (Primal Energy); how could one resort to military force? Herein, seven famous prescriptions are examined to demonstrate the general principles. Alternatively, depending on the balance between physical constitution and pathogenic factors, simultaneous tonification and purgation may be employed. This relies on the subtle application of the physician and need not be rigidly adhered to initially.
Shanzha Rou (Hawthorn Fruit Flesh, 2 liang, stir-fried) Baizhu (Atractylodis Rhizoma, stir-fried) Shenqu (Medicated Leaven, stir-fried) Banxia (Pinelliae Rhizoma, processed) Fuling (Poria, each 1 liang) Chenpi (Citri Reticulatae Pericarpium, white pith removed) Lianqiao Luobozi (Folium Coptidis et Semen Raphi, raw, each 5 qian)
This prescription is indicated for distension and swelling caused by dietary injury to the Spleen and Stomach.
Distension and swelling refers to the condition where the abdominal skin is flaccidly enlarged, feeling hard and tense upon percussion with an audible sound. The Classics state: "The five Yin palaces are injured by the Five Flavors." Therefore, consuming food beyond proper limits injures the Spleen; when the Spleen is injured, it fails to transport and transform, leading to the accumulation of Grain Qi, resulting in a flaccid yet distended abdomen. However, the transformations of the five flavors follow specific rules: Sour overcomes Sweet, Putrid overcomes Scorched, Bitter overcomes Heat, Fragrant overcomes Putrid, Dryness overcomes Dampness, Blandness overcomes Fluid retention, Acuity overcomes Stagnation, and Qi movement overcomes Flavor. Thus, the sourness of Shanzha is used to digest rich and sweet foods; the putridity of Shenqu is used to resolve scorched/fried foods; the bitterness of Lianqiao is used to grind down accumulated heat; the fragrance of Chenpi is used to open up putrid turbidity; the dryness of Banxia is used to overcome Spleen Earth dampness; the blandness of Fuling is used to promote urination to remove fluid retention; the acuity of Luobozi is used to move food stagnation; and the Qi-moving property of Baizhu is used to harmonize the five flavors. If the five flavors can mutually overcome and balance each other, the Spleen will not be injured; if the Spleen is not injured, Middle Qi will circulate and operate normally, preventing distension and swelling. This is the essence of Da'an Wan!
Qingpi (Citri Reticulatae Pericarpium Viride, stir-fried with Shuizhi/Leeches) Ezhu (Curcumae Rhizoma, stir-fried with Mengchong/Ground Beetles) Sanleng (Sparganii Rhizoma, stir-fried with Ganxi/Dry Lacquer) Binglang (Arecae Semen, stir-fried with Banmao/Mustard Blister Beetles) Wuzhuyu (Evodiae Fructus, stir-fried with Qianniu/Pharbitidis Semen) Ganjiang (Zingiberis Rhizoma, stir-fried with Sha/Sand) Hujiao (Piperis Longi Fructus, stir-fried with Huixiang/Foeniculi Fructus) Fuzi (Aconiti Lateralis Radix Praeparata, stir-fried with Yan/Salt) Chishaoyao (Paeoniae Radix Rubra, stir-fried with Chuanjiao/Zanthoxyli Pericarpium) Shichangpu (Acori Tatarinowii Rhizoma, stir-fried with Taoren/Persicae Semen)
All the above ingredients are stir-fried together until cooked, then the leeches, ground beetles, etc., are removed. The remaining material is ground into powder, mixed with wine paste to form pills the size of paulownia seeds. Take 5 to 7 pills per dose, administered on an empty stomach with Zisu Tang (Perilla Decoction).
This prescription is indicated for various types of abdominal distension and enlargement, stuffiness and obstruction, and false constipation.
Qingpi, Ezhu, Sanleng, and Shichangpu are Qi-accumulating herbs; when stir-fried with Shuizhi, Mengchong, Ganxi, and Taoren, they drive out stale blood! Ganjiang, Fuzi, Hujiao, and Wuzhuyu are Middle-Warming herbs; when stir-fried with Sha, Salt, Huixiang, and Qianniu, they soften hardness and promote unblocking and draining. Binglang, when stir-fried with Banmao, enhances the aggressive nature of Qi-descending herbs by combining them with Qi-breaking herbs. Chishaoyao, when stir-fried with Chuanjiao, enhances the benefit of Liver-draining herbs by combining them with Liver-soothing herbs. Such craftsmanship in processing demonstrates their efficacy; using them to treat conditions of Qi excess and surplus is indeed an excellent choice.