问曰。中焦为病侯何谓也。答曰。乳食饥饱失度。遂致腹内万变病。假令如疳癖谷瘕。若肿满胀单。即是也。儿嗔
声缓急。啼号无泪。而脉弦急。此为腹痛也。腹痛在脐上硬满者。必食饪也在脐下石硬者。后必致淋也。腹痛。食饪所
致者。平胃散主之。
平胃散方
浓朴（三两四钱） 陈皮（四两） 苍术（一两） 甘草（五钱） 生姜（五钱）
上五味。 咀。焙捣为末。每服一钱。以盐汤。搅调服。伤寒。发汗后。腹胀满者。宜浓朴生姜甘草半夏人参汤主
之。
浓朴生姜甘草半夏人参汤方
浓朴（一钱） 生姜（三分） 半夏（五分） 人参（二分） 甘草（三分）
上五味。以水一升。煮取七合。去滓。分温服。儿肠脆窄。过餐生冷。腹郁满而微痛此为食郁。莪术丸主之。
莪术丸方
莪术 三棱 陈皮 青皮 缩砂（各五钱） 干姜 胡椒（各二钱）
上七味。捣筛。以醋糊为丸。每服二三分。胁腹。挛拘而痛者。与建中汤。若膨满而痛者不当。与也。体肤 白。
四肢乏力。腔内时痛。雷鸣而溏。宜浓朴枳实汤。
浓朴枳实汤方
浓朴（五分） 枳实（三分） 陈皮（五分） 茯苓（五分） 香附子（五分） 槟榔（五分） 黄连（三分）
上七味。以水二升。煮取一升。去滓。分温服。腹硬脉弦。痛而闭者。浓朴三物汤主之。
浓朴三物汤方
浓朴（一钱） 枳实（五分） 大黄（五分） 甘草（三分）
上四味。以水一升。煮取七合。去滓。分温服。腹内绞痛。四肢厥冷。脉沉伏而阴缩者。猪胆酒主之。
猪胆酒方
野猪胆（二个）
上一味。以烧酒一升。煮减二三分。分温。频频服。胸腹雷鸣急痛。脉沉弦。腰脚如冰冷者。宜熏脐法。熏脐法。
碗表凿二三孔。仍以熟艾指大。倒着其里面。点火以覆其脐。烟当从孔出。熏竭再三根据前法。以腹温为度。盘肠痛。属
寒疝。但不直视者是也。乌头桂枝汤主之。
乌头桂枝汤方
乌头（一枚熬）
上一味。以蜜三升。煎减一升。去滓。以桂枝汤一升解之。分温少少服。不知者。稍加服。知者如醉状。得吐者为
中病。盘肠痛。冷气郁结而不解者。当归四逆加吴茱萸汤主之。
当归四逆加吴茱萸汤方
当归（一钱） 芍药（一钱） 桂枝（三分） 细辛（三分） 吴茱萸（二分） 生姜（三分） 通草（一钱） 甘
草（二分） 大枣（二枚）
上九味。以水一升。清酒一升。煮和。取一升。去滓。分温三服。儿腹肚绞痛。有螈 者内钓也。无螈 此为盘肠。
宜当归附子汤。
当归附子汤方
当归 牛膝 芍药（各二钱） 桂枝 附子 甘草（各五分）
上六味。以水二升。煮取一升。去滓。分温服。妇女腰腹绞痛。面红者。此为血气所致也。宜桃核承气汤。桂枝茯
苓丸亦主之。
桂枝茯苓丸方
桂枝 茯苓 牡丹（去心） 桃仁（去皮尖熬） 芍药（各等分）
上五味。末之。炼蜜和丸。如弹丸大。每日食前服一丸。不知加至三丸。腹内血气 痛者。蟹爪枳实汤主之。
蟹爪枳实汤方
蟹爪（浸醋灸一钱） 枳实（一钱） 芒硝（三分） 芍药（一钱） 桃仁（五分） 甘草（三分）
上六味。以水二升。煮取一升。去滓。分温服。胁下偏痛。发热脉紧弦。此寒也。以温药下之。大黄附子汤主之。
大黄附子汤方
大黄（五分） 附子（三分） 细辛（三分）
上三味。以水二升。煮取一升。去滓。分温三服。腹中寒气。雷鸣切痛。胸胁逆满呕吐。附子粳米汤主之。
附子粳米汤方
附子（三分炮） 半夏（五分） 甘草（三分） 大枣（三枚） 粳米（五分）
上五味。以水一升。煮米熟。汤成去滓。分温服。论曰。腹满按之硬。而落落者。为癖块也。濡而漉漉者。为湿肿
也。儿脾弱。食谷不化。遂致食瘕。宜溃坚汤主之。腹内食谷不消。郁塞而硬满。逐致虫块。宜鹧鸪菜汤。癖块属脾弱。
其治无泻法。宜磨谷化块方。 结。积聚虚冷。若中 霍乱。宜木天蓼汤主之。
木天蓼汤方
木天蓼（五分） 枳实（三分） 茯苓（五分） 桂枝（三分） 生姜（三分）
上五味。以水一升。煮取七合。去滓。分温服。 块鼓满。按之不移。四肢细削者。溃坚酒服之。
溃坚酒方
野狼毒（一两） 三棱（五钱） 莪术（五钱） 枳实（四钱） 槟榔（四钱） 缩砂（三钱） 青皮（三钱） 干
姜（三钱） 白糖（半斤）
上九味捣筛。以烧酒一斗。搅调蜜封。四五日分服。日二三次。病者腹满。时减。复如故。此为脾虚鼓满之渐也。
宜罗勒汤主之。
罗勒汤方
罗勒（一钱） 人参（三分） 枳实（三分） 青皮（三分） 茯苓（五分） 白术（三分） 浓朴（三分） 生
姜（三分） 大枣（三枚）
上九味。以水二升。煮取一升。去滓。分温服。消食破满气。槟榔丸主之。
槟榔丸方
槟榔（三钱） 木香 人参（各二钱） 枳实（四钱） 胡椒（一钱） 甘草（二钱）
上六味。酒糊丸。病患鼓满渐胀。饮食反如故。此为肠表 肉。名曰胀单。废人也。胸腹大满。奔豚悸动。短息而
额汗出者。不可治。块瘕渐大。四肢肿满。从脐水沥流者。为难治。肿从四肢。向腹者。尚可治也。从腹向四肢者。不
可治也。
Question: What are the manifestations of diseases in the Middle Jiao? Answer: These arise from irregular feeding and eating habits, leading to various pathological changes within the abdomen. For instance, conditions such as Ganic accumulation (pediatric malnutrition syndrome), Piku masses (abdominal lumps due to food stagnation), Gujia (masses formed by undigested food), and Dan Zhang (monolithic abdominal distension with thin limbs) fall into this category. If a child cries with varying intensity, wails without tears, and presents with a wiry and rapid pulse, this indicates abdominal pain. If the painful area is above the umbilicus and feels hard and full upon palpation, it is certainly caused by food retention; if it feels stone-hard below the umbilicus, it will likely lead to Lin syndrome (dysuria) later. For abdominal pain caused by food retention, Pingwei San (Stomach-Pacifying Powder) is indicated.
Pingwei San Formula
Cortex Magnoliae Officinalis (3 liang 4 qian)
Pericarpium Citri Reticulatae (4 liang)
Rhizoma Atractylodis Macrocephalae (1 liang)
Radix Glycyrrhizae (5 qian)
Rhizoma Zingiberis Recens (5 qian)
The above five herbs are chopped, dried, and ground into powder. Take 1 qian per dose, mixed and taken with salt water. In cases of Cold Damage (Shanghan), if abdominal distension occurs after sweating, Houpo Shengjiang Banxia Gancao Renshen Tang (Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction) is indicated.
Houpo Shengjiang Banxia Gancao Renshen Tang Formula
Cortex Magnoliae Officinalis (1 qian)
Rhizoma Zingiberis Recens (3 fen)
Rhizoma Pinelliae Preparatum (5 fen)
Radix Ginseng (2 fen)
Radix Glycyrrhizae (3 fen)
The above five herbs are boiled in 1 sheng of water until reduced to 7 ge. Strain and take warm in divided doses. Children have fragile and narrow intestines; overconsumption of cold and raw foods leads to abdominal stagnation, distension, and mild pain, known as Food Stagnation Syndrome. Ezhu Wan (Curcuma Pill) is indicated.
Ezhu Wan Formula
Rhizoma Curcumae (5 qian)
Rhizoma Sparganii (5 qian)
Pericarpium Citri Reticulatae (5 qian)
Pericarpium Citri Reticulatae Viride (5 qian)
Fructus Amomi Rotundus (5 qian)
Rhizoma Zingiberis Secatum (2 qian)
Fructus Piperis Longi (2 qian)
The above seven herbs are crushed, sifted, and made into pills using vinegar paste. Take 2-3 fen per dose. For cramping pain in the hypochondrium and abdomen, Jianzhong Tang (Middle-Jiao-Supplementing Decoction) is given. However, for distension and fullness with pain, Jianzhong Tang is not suitable. For pale skin, weak limbs, occasional abdominal pain, loud borborygmus, and loose stools, Houpo Zhishi Tang (Magnolia Bark and Immature Bitter Orange Decoction) is indicated.
Houpo Zhishi Tang Formula
Cortex Magnoliae Officinalis (5 fen)
Fructus Aurantii Immaturus (3 fen)
Pericarpium Citri Reticulatae (5 fen)
Poria (5 fen)
Rhizoma Cyperi Rotundi (5 fen)
Semen Arecae (5 fen)
Rhizoma Coptidis (3 fen)
The above seven herbs are boiled in 2 sheng of water until reduced to 1 sheng. Strain and take warm in divided doses. For a hard abdomen, wiry pulse, pain, and constipation, Houpo Sangu Tang (Magnolia Bark and Three Ingredients Decoction) is indicated.
Houpo Sangu Tang Formula
Cortex Magnoliae Officinalis (1 qian)
Fructus Aurantii Immaturus (5 fen)
Radix et Rhizoma Rhei (5 fen)
Radix Glycyrrhizae (3 fen)
The above four herbs are boiled in 1 sheng of water until reduced to 7 ge. Strain and take warm in divided doses. For severe colicky abdominal pain, cold extremities, deep and hidden pulse, and retraction of the genitals, Zhudanjie (Pig Gallbladder Wine) is indicated.
Zhudanjie Formula
Gallbladder of Wild Boar (2 units)
Boil the above single ingredient in 1 sheng of distilled spirits until reduced by 2-3 fen. Take warm frequently. For urgent thunder-like pain in the chest and abdomen, deep wiry pulse, and icy cold sensation in the waist and legs, the Umbilical Moxibustion Method is indicated. The method involves drilling two or three holes in a bowl, placing a thumb-sized piece of prepared mugwort inside, lighting it, and covering the umbilicus so that smoke exits through the holes. Repeat this process several times until the abdomen feels warm. Pan Chang Tong (Intestinal Coiling Pain) belongs to Cold Hernia, characterized by the absence of upward gaze. Wutou Guizhi Tang (Aconite and Cinnamon Twig Decoction) is indicated.
Wutou Guizhi Tang Formula
Radix Aconiti Lateralis Preparata (1 piece, processed)
Boil the above single ingredient in 3 sheng of honey until reduced to 1 sheng. Strain and mix with 1 sheng of Guizhi Tang (Cinnamon Twig Decoction). Take small amounts warm. If there is no effect, slightly increase the dose. A feeling similar to drunkenness or vomiting indicates the medicine has taken effect. For Pan Chang Tong caused by unresolved cold qi stagnation, Danggui Sini Jia Wuzhuyu Tang (Angelica Sinensis, Cold-Unblocking Decoction plus Evodia) is indicated.
Danggui Sini Jia Wuzhuyu Tang Formula
Radix Angelicae Sinensis (1 qian)
Radix Paeoniae Alba (1 qian)
Ramulus Cinnamomi (3 fen)
Radix Asari (3 fen)
Fructus Evodiae (2 fen)
Rhizoma Zingiberis Recens (3 fen)
Herba Tectariae Communes (1 qian)
Radix Glycyrrhizae (2 fen)
Fructus Jujubae (2 pieces)
The above nine herbs are boiled together in 1 sheng of water and 1 sheng of clear wine until reduced to 1 sheng. Strain and take warm in three divided doses. Severe colicky abdominal pain in children with convulsions indicates Neidiao (Internal Hooking); without convulsions, it is Pan Chang (Coiled Intestine) pain. Danggui Fuzi Tang (Angelica and Aconite Decoction) is indicated.
Danggui Fuzi Tang Formula
Radix Angelicae Sinensis
Radix Achyranthis Bidentatae
Radix Paeoniae Alba (each 2 qian)
Ramulus Cinnamomi
Radix Aconiti Lateralis Preparata
Radix Glycyrrhizae (each 5 fen)
The above six herbs are boiled in 2 sheng of water until reduced to 1 sheng. Strain and take warm in divided doses. Abdominal and lumbar colicky pain with facial redness in women is caused by blood and qi disorders. Taohe Chengqi Tang (Peach Kernel and Salty Decoction) is indicated. Guizhi Fuling Wan (Cinnamon Twig and Poria Pill) is also applicable.
Guizhi Fuling Wan Formula
Ramulus Cinnamomi
Poria
Cortex Moutan (core removed)
Semen Persicae (skin and tip removed, roasted)
Radix Paeoniae Alba (equal parts)
The above five herbs are powdered, mixed with refined honey, and made into pills the size of a bullet. Take one pill before meals daily; increase to three pills if ineffective. For abdominal pain due to blood and qi stagnation, Xiezha Zhishi Tang (Crab Claw and Immature Bitter Orange Decoction) is indicated.
Xiezha Zhishi Tang Formula
Claws of Crab (soaked in vinegar and roasted, 1 qian)
Fructus Aurantii Immaturus (1 qian)
Natrii Sulfas (3 fen)
Radix Paeoniae Alba (1 qian)
Semen Persicae (5 fen)
Radix Glycyrrhizae (3 fen)
The above six herbs are boiled in 2 sheng of water until reduced to 1 sheng. Strain and take warm in divided doses. Unilateral hypochondriac pain with fever and a tight, wiry pulse indicates Cold. Warm purgatives should be used. Dahuang Fuzi Tang (Rhubarb and Aconite Decoction) is indicated.
Dahuang Fuzi Tang Formula
Radix et Rhizoma Rhei (5 fen)
Radix Aconiti Lateralis Preparata (3 fen)
Radix Asari (3 fen)
The above three herbs are boiled in 2 sheng of water until reduced to 1 sheng. Strain and take warm in three divided doses. For cold qi in the abdomen causing loud borborygmus, cutting pain, rebellious fullness in the chest and hypochondrium, and vomiting, Fuzi Jingmi Tang (Aconite and Rice Decoction) is indicated.
Fuzi Jingmi Tang Formula
Radix Aconiti Lateralis Preparata (3 fen, processed)
Rhizoma Pinelliae Preparatum (5 fen)
Radix Glycyrrhizae (3 fen)
Fructus Jujubae (3 pieces)
Semen Oryzae Glutinosa (5 fen)
The above five herbs are boiled in 1 sheng of water until the rice is cooked. Strain and take warm in divided doses. It is stated: Abdominal fullness that is hard upon palpation with distinct masses indicates Pi Ku (accumulated masses); soft and gurgling upon palpation indicates Shi Zhong (dampness-induced edema). Due to weak spleen function and inability to digest food, children may develop Shi Xia (food mass). Kuijian Tang (Hardness-Dissolving Decoction) is indicated. If food remains undigested in the abdomen, causing stagnation, hardness, and eventually worm masses, Zhegu Cai Tang (Pheasant Fern Decoction) is indicated. Pi Ku belongs to spleen deficiency; treatment should not involve purging. Mogu Huakuai Fang (Grain-Grinding Mass-Dissolving Formula) is indicated. For accumulation and excess-cold, or sudden violent vomiting and diarrhea (Huoluan), Mutianliao Tang (Kadsura and Vine Decoction) is indicated.
Mutianliao Tang Formula
Fructus Kadsurae Longipedunculatae (5 fen)
Fructus Aurantii Immaturus (3 fen)
Poria (5 fen)
Ramulus Cinnamomi (3 fen)
Rhizoma Zingiberis Recens (3 fen)
The above five herbs are boiled in 1 sheng of water until reduced to 7 ge. Strain and take warm in divided doses. For fixed masses and drum-like abdominal distension that does not move upon pressure, with emaciated limbs, Kuijian Jiu (Hardness-Dissolving Wine) is taken.
Kuijian Jiu Formula
Radix Stellerae Chamaejasme (1 liang)
Rhizoma Sparganii (5 qian)
Rhizoma Curcumae (5 qian)
Fructus Aurantii Immaturus (4 qian)
Semen Arecae (4 qian)
Fructus Amomi Rotundus (3 qian)
Pericarpium Citri Reticulatae Viride (3 qian)
Rhizoma Zingiberis Secatum (3 qian)
Saccharum (half jin)
The above nine herbs are crushed and sifted, mixed with 1 dou of distilled spirits, sealed with honey, and left for 4-5 days. Take in divided doses, 2-3 times daily. If the patient's abdomen is full but occasionally reduces, only to return to normal, this is the onset of Pi Xu Drum Distension (Spleen Deficiency Abdominal Distension). Luole Tang (Basil Decoction) is indicated.
Luole Tang Formula
Herba Ocimi Basilici (1 qian)
Radix Ginseng (3 fen)
Fructus Aurantii Immaturus (3 fen)
Pericarpium Citri Reticulatae Viride (3 fen)
Poria (5 fen)
Rhizoma Atractylodis Macrocephalae (3 fen)
Cortex Magnoliae Officinalis (3 fen)
Rhizoma Zingiberis Recens (3 fen)
Fructus Jujubae (3 pieces)
The above nine herbs are boiled in 2 sheng of water until reduced to 1 sheng. Strain and take warm in divided doses. To digest food and break up Qi stagnation and fullness, Binglang Wan (Areca Nut Pill) is indicated.
Binglang Wan Formula
Semen Arecae (3 qian)
Lignum Aucklandiae (2 qian)
Radix Ginseng (2 qian)
Fructus Aurantii Immaturus (4 qian)
Fructus Piperis Longi (1 qian)
Radix Glycyrrhizae (2 qian)
The above six herbs are made into pills using a rice wine paste. If abdominal distension gradually worsens while appetite remains normal, this is "Chang Biao Rou" (intestinal outer flesh), named Zhang Dan. This condition renders the person disabled. If the chest and abdomen are largely full, with sensations of running piglet (Ben Tun) palpitations, shortness of breath, and sweating on the forehead, it is incurable. If masses gradually enlarge, limbs become swollen and full, and fluid leaks from the umbilicus, it is difficult to treat. Edema starting from the limbs and moving toward the abdomen is still treatable; edema starting from the abdomen and moving toward the limbs is incurable.