议曰∶肿、胀二症，此由虚中有积，久患失治，日渐传变，症候多端。随轻重，察盛衰，审表里以主治，先固其本，
后正其标，斯无恙矣。有湿肿，有毒瓦斯肿，伤寒虚肿，泻痢虚肿，气血虚肿；有疳胀气胀，症积胀，锁肚胀，脘膈胀，
食膨胀，蛔气胀，虚冷积胀。以上肿胀虚积，并当下之，各有其法。其受湿于脾胃，久不克化，气浮四肢，头面皆肿。
食毒瓦斯，由脾胃伤之，冷积毒瓦斯，停留于脘膈，致虚入腹作肿。伤寒下之太蚤，乘虚入腹作肿。泻痢之人，脾气亦虚，
是以致肿。以上宜平调胃气，补脏充实，方可去肿。其气血虚肿。皆由荣卫不顺，脏腑怯弱，壅滞三焦，流注百脉，表
里俱虚，邪正相乱，以致四肢浮肿，腹肚膨满；以上先调荣卫之顺，次服分气以散之。其疳气积胀，宜先与保童，当兼
塌气以去之。其痞癖气胀症积胀，宜三棱以消痞。其锁肚胀，宜与珍珠天麻丸以通之。其上膈中脘，食伤膨胀，宜三棱、
塌气、大茱连丸以消磨之。其蛔胀，宜下虫丸以化之。其虚冷积胀，宜沉香煎以温之。以上诸症，宜调和胃气，消磨通
利，肿胀必然平复矣，如有热者，必以葶苈、牵牛等辈以治之，推气丸剂亦可服。
分气饮 治小儿肿胀作喘气短而急。
桔梗 赤茯苓 陈皮 桑白皮（锉） 大腹皮 枳壳（炒） 半夏曲 真苏子（微炒） 紫苏 甘草（炙、各二钱）
草果仁（一钱）
上锉散，每服一钱半，姜枣煎服。
五疳保童丸 治五种疳疾。
五倍子（生） 青黛 夜明砂（布裹洗） 苦楝根皮 芦荟 熊胆（研入） 黄连（去毛） 龙胆草（生用） 干
蟾（酥炙、去骨皮） 麝香（研） 芜荑（取仁） 蝉蜕（去土、各等分）
上为末，粟米糊丸麻子大，一岁儿二十丸，米饮下二、三服。
汤氏塌气散 治小儿腹胀气喘，体肿面浮。
陈皮（一合、炒） 青皮（去瓤、巴豆二十一粒、炒黄色、去巴豆用） 甘草（炙、各半两） 黑牵牛（二钱半、
半生半炒） 肉豆蔻（二个、煨香）
上末半钱，米饮调下，加槟榔一个。
塌气丸 治小儿疳气，腹胀喘急，并面浮肿。
丁香 胡椒（炒、各五钱） 莱菔子（炒） 白牵牛（各七钱半）
上为末，面糊丸小豆大，三岁三十丸，米汤下。
塌气散 治小儿腹胀气粗，并疳疾相攻，面目浮肿。
木香（一钱） 青皮（五钱） 巴豆（三十粒、同炒、豆黄色、去巴豆用）
上为末，三岁半钱，米汤下，食前连进即效。
三棱煎丸 治婴孩食伤生冷、甜腻、毒热、等物，脾胃积滞，久不克化，令儿壮热脚冷，痞癖寒热。及疗 瘕。
中脘不和，膨胀上膈，气壅心腹，不得通宣，所以作疾。此药温良，但是诸积滞食不化，并宜与服。
京三棱（成块煮、半两） 莪术（并炮、、各半两） 芫花（二钱半、醋浸、炒） 鳖甲（去裙、米醋炙焦、半两）
淡豆豉（一钱） 巴豆（二十一粒、去壳） 川当归（半两） 杏仁（去皮尖、二钱半、炒令赤）
上前四味一处，以米醋一碗，煮令干，仍用炒起，更细锉焙为末，次入当归末，杏仁、巴豆、淡豉、和匀水煮，面
糊丸麻子大，每服二十丸，姜汤下，大小加减服之。
三棱丸 治小儿停积，腹胁胀满，干哕恶心，全不入食。
三棱（煨） 木香 神曲（炒） 陈皮（去白） 半夏（姜制、各一两） 丁香桂（各五钱）
上为末，曲和丸如黄米大，每二十丸，乳食后，温生姜汤下。
珍珠天麻丸 治急惊风，请量用之，以通为度。此方仍治吊肠、锁肚、撮口、至妙。丸如麻子大，初生患者；
三日三丸，五日五丸，七日七丸。加青黛、名青黛丸。
天南星（炮） 天麻 白附子（炮、各二钱半） 腻粉（半钱） 巴霜（一字） 芜荑（炒） 全蝎 滑石（各二
钱半）
上为末，煮细面糊丸如麻子大，一岁每服五丸，二岁十丸，大小加减，薄荷汤点茶清送下。
大茱连丸 治小儿饮食过度，胸膈膨胀，上下气不宣通，郁滞迷闷，情思少乐，大则作喘，饮食不化，作渴烦
躁，坐卧不任，肢体倦怠，腹胁疼痛。
莪术 京三棱（各二钱半、醋煮） 干姜（炮） 陈皮（去白） 木香 丁香（各三钱） 巴豆（二十一粒、去膜
心、去油用） 绿细小茱萸（二钱）
上为末，醋和为丸麻子大，每服七丸至十丸，大者加服，生姜枣子汤下。
下虫丸 见第七十九问。
沉香煎 治脾气冷积。
乳香 沉香 丁香 杏仁（炒） 百草霜 木香（各一钱） 肉豆蔻（一个、煨） 巴豆（十四粒、出油如霜）
上为末，酒煮蜡和，丸绿豆大，每服三、五丸，淡生姜汤下，应患肚痛不止者、服之效。常服以通为度。
推气丸 见第四十九问。
遇仙丹 治诸虫，取诸积。
牵牛（三斤） 大腹子（二斤） 锡灰（二两、炙干为末） 大黄（四两） 雷丸（四两） 青木香 鹤虱（各二
两）干漆（二两） 皂角（四条）
上后四味煎水，用粟米煮粥，初用牵牛末，次用大腹末，三用锡灰，四用大黄，五用雷丸，六用青木香，和剂丸如
梧桐子大，每服五、七丸，用姜汤熟水送下。
此药专治男子妇人、积虫气块，五劳七伤，赤白痢疾，便血注下，皮黄水肿，十般气，十一般恶虫，又进饮食，除
病悦颜色，不与他药相反，四季可服，细末三四钱，量大小加减，服时不吃晚饭，三更用清茶下，次早桶子内虫积、及
粒米尽，方可洗面，温粥补之。伤寒孕妇不可服。
Discussion: The syndromes of swelling (Zhong) and distension (Zhang) arise from deficiency with accumulation within. If left untreated for a long time, the condition gradually progresses, presenting diverse symptoms. One must assess severity, observe the strength or weakness of healthy Qi, examine the interior and exterior to determine treatment principles: first secure the root (Ben), then correct the branch (Biao), thus ensuring safety. There are edema caused by dampness, edema caused by toxic vapors, deficiency edema due to Cold Damage (Shanghan), deficiency edema due to diarrhea and dysentery, and deficiency edema due to Qi and Blood; there is distension due to malnutrition (Gan) Qi, Qi distension, mass distension (Zhengji), locked belly distension, epigastric/distal chest distension, food distension, roundworm Qi distension, and cold-deficiency accumulation distension. All the above swellings and deficiency accumulations should be treated with purgation methods, each having its specific approach. When the Spleen and Stomach are affected by dampness and fail to transform it over time, Qi floats to the four limbs, causing swelling in the head and face. Food poisoning or inhalation of toxic vapors damages the Spleen and Stomach; cold accumulation and toxic vapors remain in the epigastrium and diaphragm, leading to deficiency allowing pathogens to enter the abdomen and cause swelling. In Cold Damage, if purgatives are used too early, pathogens enter the abdomen through deficiency causing swelling. Patients with diarrhea and dysentery have weak Spleen Qi, leading to swelling. For these cases, it is appropriate to harmonize Stomach Qi, tonify the Zang organs to fill them, thereby eliminating swelling. Deficiency edema due to Qi and Blood results from unsmooth Ying and Wei circulation, weak Zang organs, stagnation in the Triple Burner (San Jiao), pathogenic flow into the hundred vessels, deficiency in both interior and exterior, and chaos between pathogenic factors and healthy Qi, resulting in edema of the four limbs and abdominal distension. For these, first regulate Ying and Wei to ensure smooth circulation, then administer Fenqi Yin to dissipate the swelling. For distension due to Gan Qi and accumulation, Baotong Wan should be given first, combined with Taqi San to remove it. For masses and Qi distension due to Zhengji, Sanleng Jian Wan should be used to eliminate masses. For locked belly distension, Zhenzhu Tianma Wan should be used to promote unblocking. For distension in the upper chest and epigastrium due to food injury, Sanleng Jian Wan, Taqi San, and Dajulian Wan should be used to digest accumulation. For roundworm distension, Xiachong Wan should be used to resolve it. For cold-deficiency accumulation distension, Chenxiang Jian should be used to warm. For all the above syndromes, harmonizing Stomach Qi, digesting accumulation, and promoting unblocking will inevitably resolve the swelling. If heat signs are present, Tinglizi (Seed of Lepidium) and Qianniu (Seed of Morning Glory) should be used; Tuiqi Wan may also be taken.
Fenqi Yin treats pediatric swelling accompanied by wheezing, shortness of breath, and urgency.
Jiegeng (Platycodon Root), Chifuling (Red Poria), Chenpi (Aged Tangerine Peel), Sangbaipi (Mulberry Root Bark [processed]), Dafupi (Areca Stem), Zhike (Bitter Orange Fruit [stir-fried]), Banxiaqu (Pinellia Fermented Paste), Zhen Suzi (Perilla Seed [lightly stir-fried]), Zisu (Perilla Leaf), Gancao (Licorice Root [roasted], 2 qian each), Caoguoren (Tsaoko Cardamom Kernel, 1 qian).
Grind into powder. Take 1.5 qian per dose, decoct with Ginger and Jujube.
Wugan Baotong Wan treats five types of Gan disorders.
Wubeizi (Chinese Gallnut [raw]), Qingdai (Indigo Naturalis), Yemingsha (Night-bright Sand), Kulgenpi (Root Bark of Melia Toosendan), Lvhui (Aloe), Xiondan (Bear Bile [ground]), Huanglian (Coptis Rhizome [deprived of hairs]), Longdancao (Gentiana Root [raw]), Ganchan (Dried Toad [fried with rice wine, bones and skin removed), Shexiang (Musk), Wuyi (Chaulmoogra Seed Kernel), Chantui (Cicada Slough [cleaned], equal parts).
Grind into powder, mix with millet paste to form pills the size of hemp seeds. For one-year-olds, take 20 pills, washed down with rice drink, two to three times daily.
Tangshi Taqi San treats pediatric abdominal distension with wheezing, body edema, and facial puffiness.
Chenpi (Aged Tangerine Peel, 1 he, stir-fried), Qingpi (Green Tangerine Peel [pith removed, fried with 21 Bitter Apricot Kernels until yellow, discard kernels]), Gancao (Licorice Root [roasted], 0.5 liang each), Heiqianniu (Black Morning Glory Seed, 2.5 qian, half raw half stir-fried), Roudoukou (Nutmeg [two, baked until fragrant]).
Grind into powder. Take 0.5 qian, mixed with rice drink. Can add one Betel Nut.
Taqi Wan treats pediatric Gan Qi, abdominal distension with rapid breathing, and facial edema.
Dingxiang (Clove), Hujiao (Black Pepper [stir-fried], 5 qian each), Laifuzi (Radish Seed [stir-fried]), Baiqianniu (White Morning Glory Seed, 7.5 qian each).
Grind into powder, mix with flour paste to form pills the size of mung beans. For three-year-olds, take 30 pills, washed down with rice soup.
Taqi San treats pediatric abdominal distension with coarse breathing, mutual attack of Gan disorders, and facial edema.
Muxiang (Costus Root, 1 qian), Qingpi (Green Tangerine Peel, 5 qian), Badou (Croton Seed [thirty grains, fried together until bean-yellow, discard seeds]), equal parts Qingpi.
Grind into powder. For three-year-olds, take 0.5 qian, washed down with rice soup. Take before meals continuously for effect.
Sanleng Jian Wan treats infants injured by eating raw, cold, sweet, greasy, toxic, or hot foods, causing Spleen-Stomach accumulation that fails to transform over time, leading to high fever with cold feet, masses with alternating cold and heat. It also treats Jia masses. Disharmony in Zhongwan leads to distension affecting the upper chest, Qi stagnation in heart and abdomen, inability to circulate freely, thus causing disease. This medicine is warm and mild; suitable for any accumulation of undigested food.
Jingsanleng (Curcuma Zedoaria Rhizome [boiled in chunks], 0.5 liang), Ezhu (Curcuma Phaeocaulis Rhizome [processed], 0.5 liang each), Yuanhua (Genkwa Flower, 2.5 qian, soaked in vinegar, stir-fried), Biejia (Turtle Shell [remove skirt, roast scorched with rice vinegar], 0.5 liang), Dandouchi (Fermented Soybean, 1 qian), Badou (Croton Seed [twenty-one grains, shelled], Danggui (Angelica Sinensis Root, 0.5 liang), Xingren (Apricot Seed [skin and tip removed, 2.5 qian, stir-fried until red]).
Place the first four ingredients together, boil in one bowl of rice vinegar until dry, then stir-fry, grind finely, and bake into powder. Add Danggui powder, Xingren, Badou, Dandouchi, mix evenly, boil with water, and form pills with flour paste the size of hemp seeds. Take 20 pills per dose, washed down with Ginger Soup. Adjust dosage according to age.
Sanleng Wan treats pediatric food retention, abdominal and hypochondriac fullness, dry retching, nausea, and complete anorexia.
Sanleng (Curcuma Zedoaria Rhizome [baked]), Muxiang (Costus Root), Shenqu (Medicated Leaven [stir-fried]), Chenpi (Aged Tangerine Peel [remove white pith]), Banxia (Pinellia Tuber [prepared with ginger], 1 liang each), Dingxiang (Clove), Guixin (Laurel Branch [likely typo for Gui Xin or similar, assuming standard herb context, but text says Dingxiang Gui], 5 qian each).
Grind into powder, mix with Shenqu powder to form pills the size of broomcorn millet. Take 20 pills after milk/food, washed down with warm Ginger Soup.
Zhenzhu Tianma Wan treats acute convulsive disorder (Ji Jing Feng). Use discretion, aiming for unblocking. This formula is also excellent for Diaochang (intussusception-like), Suodu (locked belly), and Cuokou (lockjaw). Form pills the size of hemp seeds. For newborns: 3 pills on day 3, 5 pills on day 5, 7 pills on day 7. Add Qingdai to name Qingdai Wan.
Tiannanxing (Arisaema Rhizome [processed]), Tianma (Gastrodia Rhizome), Baifuzi (Typhonium Rhizome [processed], 2.5 qian each), Nifen (Calomel, 0.5 qian), Bashuang (Croton Resin, 1 zi), Wuyi (Chaulmoogra Seed Kernel [stir-fried]), Quanxie (Scorpion), Huashi (Talcum Powder, 2.5 qian each).
Grind into powder, mix with fine flour paste to form pills the size of hemp seeds. For one-year-olds, take 5 pills; for two-year-olds, 10 pills. Adjust according to age. Wash down with Mint Soup and tea liquor.
Dajulian Wan treats pediatric overeating, chest and diaphragm distension, obstruction of Qi movement above and below, stagnation causing dizziness and depression, lack of joy, severe wheezing, indigestion, thirst, irritability, restlessness, fatigue, and abdominal/hypochondriac pain.
Ezhu (Curcuma Phaeocaulis Rhizome), Jingsanleng (Curcuma Zedoaria Rhizome, 2.5 qian each, boiled in vinegar), Jiangjiang (Dried Ginger [processed]), Chenpi (Aged Tangerine Peel [remove white pith]), Muxiang (Costus Root), Dingxiang (Clove, 3 qian each), Badou (Croton Seed [twenty-one grains, remove membrane and heart, remove oil]), Lvxi Xiao Zhuyu (Small Green Cornelian Cherry Fruit, 2 qian).
Grind into powder, mix with vinegar to form pills the size of hemp seeds. Take 7 to 10 pills per dose, increase for older children, washed down with Ginger and Jujube Soup.
Xiachong Wan See Question 79.
Chenxiang Jian treats cold accumulation due to Spleen Qi deficiency.
Ruxiang (Frankincense), Chenxiang (Agarwood), Dingxiang (Clove), Xingren (Apricot Seed [stir-fried]), Baicaoshuang (Burnt Hair Ash), Muxiang (Costus Root, 1 qian each), Roudoukou (Nutmeg [one, baked]), Badou (Croton Seed [fourteen grains, expressed oil like frost]).
Grind into powder, mix with wax boiled in wine to form pills the size of mung beans. Take 3 to 5 pills, washed down with light Ginger Soup. Effective for persistent abdominal pain. Regular use aims for unblocking.
Tuiqi Wan See Question 49.
Yuxian Dan treats various parasites and removes various accumulations.
Qianniu (Morning Glory Seed, 3 jin), Dafuzi (Areca Nut, 2 jin), Xihui (Tin Ash [dry-roasted to powder], 2 liang), Dahuang (Rhubarb Root, 4 liang), Leiwan (Hairy Ball Fern Spore, 4 liang), Qingmuxiang (Costus Root), Lesi (Chrysanthemum Seed), Ganqi (Dried Lacquer, 2 liang each), Zaojiao (Gleditsia Sinensis Fruit [four strips]).
Decoct the last four ingredients in water, cook millet porridge. First add Qianniu powder, second Dafu powder, third Tin Ash, fourth Dahuang powder, fifth Leiwan powder, sixth Qingmuxiang powder. Mix to form pills the size of Chinese honeylocust seeds. Take 5 to 7 pills, washed down with Ginger Soup and cooked water.
This medicine specifically treats adults' parasite masses, Five Exhaustions and Seven Injuries, bloody and non-bloody dysentery, hematochezia, yellow skin edema, ten types of Qi disorders, ten types of evil parasites. It promotes appetite, cures disease, improves complexion, does not conflict with other medicines, can be taken in all seasons. Take 3 to 4 qian of fine powder, adjust according to size. Do not eat dinner when taking this medicine. At midnight (third watch), wash down with clear tea. The next morning, check the chamber pot for accumulated parasites and undigested rice grains; only then wash face. Supplement with warm porridge. Contraindicated in Cold Damage and pregnancy.