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[General Discussion] Distension (Zhang) and fullness (Man) are different. Distension refers to swelling between the skin, not within the Zang-Fu organs or intestines and stomach. Fullness refers to a sensation of being stuffed within the intestines and stomach, similar to feeling overly full after eating. Distension mostly belongs to deficiency syndromes, whereas fullness can be either excess or deficiency. Excess types belong to heat syndromes, caused by stagnation and obstruction of Middle Qi. If there is constipation, dark urine, dry mouth, and robust physical constitution, purgative methods are suitable. If it is a deficiency type, symptoms such as vomiting food or inability to swallow may occur, with clear and profuse urination and defecation; pressing the abdomen with fingers leaves an indentation, indicating deficiency. Alternatively, symptoms that ease in the morning and worsen in the evening, or worsen in the morning and ease in the evening, all belong to Qi deficiency, and warming and tonifying methods are suitable. For women, fullness and distension accompanied by blood stasis accumulation are common; treatment should focus on promoting blood circulation. Additionally, if men or women have pain in the limbs and joints accompanied by swelling, it belongs to Wind-Dampness. If the entire body and limbs are swollen, it is a Exterior syndrome. Cases where distension precedes swelling are treatable; however, cases where swelling precedes distension are difficult to treat. In men, swelling starting from the feet and moving upward, and in women, swelling starting from the face and head and moving downward, are considered favorable (Shun) and treatable; the reverse indicates unfavorable (Ni) prognosis and is difficult to treat. When the limbs are normal but only the abdomen is swollen, it is called Drum Distension (Gu Zhang). The treatment method requires distinguishing between Qi drum, Water drum, Dampness drum, and Food drum. Generally, Qi and Water causes are most common. Pressing the patient's abdomen with fingers: if an indentation remains, it is treatable. A strong pulse indicates easier treatment. If the pulse is fine/thin, the umbilicus is swollen and protruding, the scrotum has no seam, green veins are visible on the abdomen, or abdominal swelling persists after purging, these are incurable.

[Fullness and Distension] For Qi stagnation presenting as excess syndrome: Ji Nei Jin (Gallus gallus domesticus Burch. endostyleum, one piece roasted), Zhen Chen Xiang (Aquilaria sinensis wood), Sha Ren (Amomum villosum fruit) (each 3 qian), Chen Xiang Yuan (Citrus reticulata peel, pith removed, 5 qian). Grind into powder. Take 0.5 fen each time, washed down with Ginger Decoction. Tu Bie (Eupolyphaga sinensis, also known as Jie Gu Chong) roasted dry on a tile. Use 1-2 pieces each time, mixed with water made from grinding 1 qian of Chen Xiang, taken orally; this is very effective.

[Qi Deficiency with Middle Fullness] Whether due to post-illness weakness or excessive labor, leading to chest and abdominal stuffiness and fullness: Bu Zhong Yi Qi Tang (see Labor Damage section for formula). Take frequently to achieve efficacy.

[Qi Drum] Decoct water with aged barley awns and drink. The Qi will dissipate and distension will subside. (Subsequently take clearing and tonifying medicines to prevent recurrence.)

[All Types of Drum Distension] Take one male pig stomach, wash clean. Add 4 liang of garlic and boil lightly until soft. Remove the garlic and consume the stomach with the broth. Consume continuously for 5-7 times for complete recovery. Avoid certain foods.

[Water Drum] Use large carp with red tails. Boil lightly with 2 liang of garlic and eat. Cook thoroughly. Alternatively, take Chen Pi (Citrus reticulata peel), Mu Tong (Akebia quinata stem), Da Fu Pi (Areca catechu pericarp) (washed in salt water), Fu Ling (Poria cocos sclerotium) (each 1 qian), Che Qian Zi (Plantago asiatica seed), Yi Yi Ren (Coix lacryma-jobi var. ma-yuen seed) (each 3 qian), Yin Chen (Artemisia capillaris herb) (1.5 qian), Lang Bin (Areca catechu seed) (8 fen). Decoct in water and drink. Avoid table salt. After recovery, regulate the Spleen and Stomach to prevent relapse. Use Zhen Shui Yin Fen (Calomel, 2 qian), Ba Dou Rou (Croton tiglium seed flesh, ground and oil removed, 4 liang), Sheng Liu Huang (Sulfur, 1 qian). Grind into a cake and apply to the umbilicus. Yellow fluid will naturally drain out. (When applying, first place two layers of cotton on the umbilicus, then the medicine cake, and secure externally with cloth. Walk for 3-5 li; yellow fluid will drain naturally. After 3-5 applications, remove the cake and warm congee to tonify. Regulate the Spleen and Stomach for self-healing. For chronic patients, drain fluid every other day; one medicine cake can treat 20-30 people.) For Water Drum patients who eat salt too early and suffer relapse with no cure available: use large toads. Take the KT du (stomach/intestine content) from the abdomen, ensure no water is present, and chop finely.

[Abdominal Distension and Swelling of Limbs] Use half a jin of dried chicken feces. Soak in one dou of wine for seven days. Drink three cups daily. Or roast dry, grind into powder, and take 2 qian with wine for immediate effect. Roast chicken feces, grind, and pour boiling water over to extract juice. Mix with Mu Xiang (Saussurea lappa root, ground) and Bing Lang (Areca catechu seed, roasted and ground, each 1 qian). Immediate effect. (Note: According to Materia Medica, Ji Shi Bai (white part of chicken feces) is slightly cold and non-toxic. It treats mass formations and drum distension when other medicines fail; using it yields verification. Do not inform patients about using such formulas.) Lu Ci Niao (Phalacrocorax carbo) roasted dry, ground into powder, taken with rice drink; also effective.

[Women's Blood Drum] Ma Bian Cao (Verbena officinalis herb) and Liu Ji Nu (Vladimiria soulieana root) decocted strongly and taken.