经曰∶厥气在下，营卫留止，寒气逆上，真邪相攻，两气相搏，乃合为胀。一则曰厥气，再则
曰寒气，可知各种胀症，皆由浊阴上乾清道所致。卫气遇寒则滞，营血遇寒则凝，营卫不调，不能
捍卫，阴邪乃得乘虚而入，何脏虚即入何脏，何腑虚即入何腑，真气与邪气相搏，而五脏六腑遂各
有胀病矣。兹将见症及治法，详列于后。
经曰∶心胀者，烦心短气，卧不安。心本纯阳，寒邪来犯，阴阳相战，故烦满短气而卧不安也。治
之之法，但须发其神明，摧荡邪气，使浮云不能蔽日，自然离照当空，太阳之火不烦补助也。离照
汤主之。
离照汤（自制）
琥珀（一钱） 丹参（三钱） 朱砂（五分） 茯神（三钱） 柏子仁（二
钱） 沉香（五分） 广皮（一钱） 青皮（一钱） 郁金（二钱） 灯芯（三
尺） 姜皮（五分）
本方仍用心痹通阳抑阴煎之辰砂、琥珀、茯神、丹参、沉香，而去当归、白术、远志、益智、
故纸、红枣，加柏子仁、灯芯、郁金、青陈皮，姜亦用皮。以痹偏于血，而胀偏于气，故减去归、
术等六味，而加郁金、青陈皮等助沉香以行气也。祖怡注。
肺胀者，虚满而喘咳。肺为主气之脏，居于至高，寒气逆上，肺气壅塞，清肃之令不能下行，
故虚满而喘咳。当温肺降气，以解寒邪，温肺桂枝汤主之。
温肺桂枝汤（自制）
桂枝（五分） 当归（二钱） 茯苓（二钱） 沉香（五分） 苏子（一钱五分）
橘红（一钱） 半夏（一钱二分） 栝蒌实（四钱） 桑皮（二钱） 姜汁（二小匙冲服）
本方以姜汁、桂枝为主药，所以用当归、茯苓者，助姜、桂也。消胀仍以沉香为大将，橘、
半、栝蒌、苏子、桑皮，皆肺胃气分药，所以助沉香也。祖怡注。
肝胀者，胁下满而痛引小腹。肝为将军之官，气血皆盛。但木喜条达，寒气上逆，则两气相积，
而肝木怒张。
胁下乃肝之本位，痛引小腹，则壅极而决矣。当疏肝化浊；青阳汤主之。
青阳汤（自制）
青皮（一钱五分醋炒） 柴胡（一钱醋炒） 蒺藜（四钱） 乌药（一钱） 炮姜（五分）
广皮（一钱） 延胡（一钱酒炒） 木香（五分） 郁金（二钱） 花椒子（二十四粒打碎）
本方所用青皮、柴胡、蒺藜、乌药、延胡、郁金、广皮、木香，无非疏肝解郁、利气活血之品
，俱是肝家不祧要药。然而重点则在独取乌梅安胃丸之椒、姜，盖温通之性强，而前八味皆大得其
力矣。祖怡注。
脾胀者，善哕，四肢烦 ，体重不能胜衣，卧不安。脾为湿土而主四肢，寒气乘之，则土德衰
而真阳不运，故善哕而肢体疲重，夜卧不安也。当扶土渗湿，兼解寒邪，姜术二仁汤主之。
姜术二仁汤（自制）
炮姜（五分） 白术（二钱） 茯苓（三钱） 半夏（一钱） 当归（二钱）
苡仁（八钱炒） 砂仁（一钱） 浓朴（一钱） 木香（五分） 广皮（一钱） 生熟谷芽
（各四钱煎汤代水）
本方以姜术二仁命名，扶中阳即所以去伏寒。半夏、茯苓、浓朴、广皮、砂仁、木香、生熟谷
芽，所以健脾胃而助消化者至矣。一派纯阳药中，加一味当归补血活血，不完全放弃血分，是制方
之正法。本方与脾痹方姜、术、苓、归、夏、朴、砂七味相同，而不用桑皮、苏子、杏仁。祖怡注
。
肾胀者，腹满引背，央央然腰髀痛。肾本属水，寒气乘之，水寒则成冰，气益坚凝，坎中之真
阳不能外达，故腹满引背，时形困苦。腰髀痛则下元虚寒，营血不能流灌也。当温肾祛寒，温泉汤
主之。
温泉汤（自制）
当归（二钱） 附子（八分） 小茴香（一钱） 破故纸（一钱五分核桃肉拌炒） 乌药（一钱）
杜仲（三钱） 牛膝（二钱） 木香（五分） 广皮（一钱） 青皮（一钱） 姜（三片）
本方与肾痹用附、归、茴、故、木香、牛膝、姜七味相同，而去茸、脊、菟、智、独活、枣，
加杜仲、核桃、乌药、青陈皮，因彼系虚多，此则寒重。两方皆温通温补，而用药不同，大有分寸
，其为重视肾阳，尤觉显而易见，以丹田元阳，乃人类生命之本也。祖怡注。
胃胀者，腹满，胃脘痛，鼻闻焦臭，妨于食，大便难。胃为水谷之腑，职司出纳。阴寒之气上
逆，水谷不能营运，故腹满而胃痛。水谷之气腐于胃中，故鼻闻焦臭，而妨食便难也。当平胃祛寒
温中平胃散主之。
温中平胃散（自制）
炮姜（五分） 砂仁（一钱） 木香（五钱） 谷芽（三钱炒） 神曲（三钱炒）
广皮（一钱） 茅术（一钱） 浓朴（一钱） 枳壳（一钱） 青皮（一钱） 陈香橼
皮（八分）
本方以平胃散去甘草加炮姜、香、砂，而以神曲、枳壳、谷芽助消化，青皮、香橼和肝胃。平
胃散所以燥脾湿，此方所以温胃寒，胃寒乃胃病中最习见之一种。祖怡注。
大肠胀者，肠鸣而痛濯濯，冬日重感于寒，则飧泄不化。大肠为传道之官，居小肠之下，司变
化而出糟粕。
寒气上逆，变化失度，故肠鸣腹痛而有水声。重感于寒，故完谷不化也。当温通肠胃，上下兼
顾，未可徒治
大肠也。顾母理脏汤主之。
顾母理脏汤（自制）
枳壳（一钱五分麸炒） 青皮（一钱五分） 浓朴（一钱） 干姜（五分） 谷芽（二钱
炒） 当归（二钱） 茯苓（二钱） 白术（一钱） 木香（五分） 白蔻（六分）
橘饼（三钱切片）
本方乃上条温中平胃散加减，以干姜易炮姜，以白术易茅术，加当归、茯苓等，所以顾母也。
枳、朴、蔻、香辈，所以温通肠胃也。谷芽、橘饼皆扶胃药，所以佐姜、术、归、苓也。理脏必须
顾母者，胃是来源，大肠乃出路也。祖怡注。
小肠胀者，小腹 胀，引腰而痛。小肠为受盛之官，居胃之下，受盛水谷而厘清浊，水液渗于
前，糟粕归于后。寒气上逆，则化物不出，故小腹 胀、引腰而痛也。当分理水谷，俾二便通行，
则胀满自解。通幽化浊汤主之。
通幽化浊汤（自制）
枳壳（一钱五分） 青皮（一钱五分） 木通（一钱五分酒炒） 车前（二钱） 赤苓（
二钱） 蒌仁（三钱） 浓朴（一钱） 木香（五分） 乌药（一钱） 谷芽（三钱炒）
姜（三大片）
本方与脾痹加味木通汤相同者，仅有木通（减其量而加酒炒）、赤苓车前三味，而另用枳、朴
、青皮、乌药、蒌仁、木香，以通幽门；重用生姜，佐以谷芽，以顾脾胃。因小肠上承胃而下走膀
胱、大肠，所以分水谷而行糟粕。其本身薄而且细，曲折最多，上不如胃之浓，下不如大肠之宽，
是消化系之关隘，其为病比胃、大肠为独多，故以通二便为急务也。祖怡注。
膀胱胀者，少腹满而气癃。膀胱主藏津液，气化则出。盖水气循下焦而渗入膀胱，津液之藏，
皆由气化渗入，然后能出。寒气上逆，则水气窒塞不通，故少腹满而小便癃也。当理气行水，俾寒
水得真阳而通利，既济汤主之。
既济汤（自制）
当归（二钱） 肉桂（五分） 沉香（五分） 广皮（一钱） 泽泻（一钱五分）
牛膝（二钱） 瞿麦（二钱） 车前（二钱） 苡仁（四钱） 葵花子（四钱炒研同煎）
本方用当归、牛膝、沉香、广皮、泽泻、车前，与胞痹利济汤同，而其着重则在肉桂之活血，
同沉香之通气，二味大力之药合作。因为胀重于痹，膀胱最易蓄血，而小便不通，有发生水道闭塞
之危险。本方与其说是重在利水，不如说其重在通阳之更为正确也。祖怡注。
三焦胀者，气满于皮肤中，轻轻然而不坚。上焦如雾，中焦如沤，下焦如渎，此状其气与水之
流行，而究无实在形质。受寒气逆，故气满于皮肤之中。因无形质，故虽胀而轻轻然不坚也。当调
和气血，疏导行水。通皮饮主之。
通皮饮（自制）
广皮（一钱） 青皮（一钱） 冬瓜皮（二钱） 茯苓皮（四钱） 当归（二
钱） 浓朴（一钱） 枳壳（一钱） 砂仁（一钱） 泽泻（一钱五分） 车前子（二钱
）鲜姜皮（一钱）
本方以五皮饮为主，所谓以皮行皮，轻可去实也。再以枳、朴消痞满，以泽泻、车前利水道，
最后以当归、砂仁调和肝胃之气血，可谓轻松流利，举重若轻，于气满皮肤中，轻轻然不坚，针锋
相对矣。祖怡注。
胆胀者，胁下痛胀，口中苦，善太息。胆为中正之官，决断出焉。肝虽强，非胆不能断。但胆
气血皆少，为清静之腑，寒气干之，故胁痛口苦；气郁不舒，故善太息也。当轻扬和解，后辛汤主
之。
后辛汤（自制）
柴胡（一钱） 郁金（二钱） 广皮（一钱） 当归（二钱） 茯苓（二钱）
栀子皮（一钱姜汁炒） 蒺藜（四钱） 枳壳（一钱） 合欢花（二钱） 佛手（五分）
本方柴胡为少阳正药，郁金为治郁良剂，当归、茯苓肝脾兼顾，栀子佐柴胡而清少阳，合欢佐
郁金而通心气，枳壳、蒺藜、广皮、佛手皆肝家气分药，肝胆相为表里，深得手挥目送之妙。祖怡
注。
The classics state: "Jue Qi (rebellious Qi) remains below, Ying and Wei Qi stagnate and stop, Cold Qi rebels upward, True Qi and Evil Qi attack each other, the two forces contend, thus forming distension." The text first mentions "Jue Qi," then again mentions "Cold Qi," indicating that various types of distension syndromes are all caused by turbid Yin rebelling against the clear pathways. Wei Qi becomes stagnant when encountering Cold, and Ying Blood coagulates when encountering Cold. When Ying and Wei are disharmonious and fail to defend the body, Yin Evil takes advantage of the deficiency to enter. Wherever an organ is deficient, the Evil enters that organ; wherever a fu-organ is deficient, the Evil enters that fu-organ. True Qi contends with Evil Qi, leading to distension diseases in each of the five zang-organs and six fu-organs. The manifestations and treatment methods are detailed below.
The classics state: "Heart Distension manifests as vexation, shortness of breath, and restless sleep." The Heart belongs to pure Yang. When Cold Evil attacks, Yin and Yang battle, resulting in vexation, fullness, shortness of breath, and restless sleep. The treatment method requires only to stimulate the Shen Ming (Spirit/Mind), destroy and sweep away the Evil Qi, so that floating clouds cannot obscure the sun. Naturally, the light of Li (the Sun/Fire) will shine from above, and the Fire of Taiyang (Heart Fire) will not need auxiliary support. The main formula is Lizhao Tang.
Lizhao Tang (Self-made Formula)
Hupo (Succinite, 1 qian) Danshen (Salviae Miltiorrhizae Radix et Rhizoma, 3 qian) Zhusha (Cinnabaris, 0.5 qian) Fushen (Poria Cum Radix Pini, 3 qian) Baiziren (Biota Seed, 2 qian) Chenxiang (Aquilaria Lignum, 0.5 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1 qian) Yujin (Curcumae Longae Radix, 2 qian) Dengxin (Sparganii Stamen, 3 chi) Jiangpi (Zingiberis Pericarpium, 0.5 qian)
This formula retains Chen Sha (Cinnabar), Hupo (Succinite), Fushen (Poria with Pine Root), Danshen (Salvia), and Chenxiang (Aquilaria) from Xinbi Tongyang Yiyin Decoction for treating Heart Bi, but removes Danggui (Angelica Sinensis), Baizhu (Atractylodes Macrocephala), Yuanzhi (Polygalae Radix), Yizhi (Alpiniae Oxyphyllae Fructus), Guzhi (Bursae Semen), and Hongzao (Jujubae Fructus). It adds Baiziren (Biota Seed), Dengxin (Sparganii Stamen), Yujin (Curcuma Longa), Qingpi (Green Tangerine Peel), and Guangpi (Tangerine Peel), and uses only Jiangpi (Ginger Peel). Since Xinbi (Heart Bi) tends toward blood pathology, while Distension tends toward Qi pathology, the six herbs including Danggui and Baizhu are reduced, and Yujin, Qingpi, and Guangpi are added to assist Chenxiang in moving Qi. Note by Zuyi.
Lung Distension manifests as empty fullness accompanied by wheezing and coughing. The Lung is the organ governing Qi, residing at the highest position. When Cold Qi rebels upward, Lung Qi becomes congested, and its descending and purifying function cannot go downward, resulting in empty fullness and wheezing/coughing. One should warm the Lung and descend Qi to resolve the Cold Evil. The main formula is Wenfei Guizhi Tang.
Wenfei Guizhi Tang (Self-made Formula)
Guizhi (Cinnamomi Ramulus, 0.5 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Fuling (Poria, 2 qian) Chenxiang (Aquilaria Lignum, 0.5 qian) Suzi (Perillae Fructus, 1.5 qian) Juhong (Citri Reticulatae Pericarpium Rubrum, 1 qian) Banxia (Pinelliae Tuber, 1.2 qian) Gualou Shi (Trichosanthis Fructus, 4 qian) Sangbai Pi (Mori Cortex, 2 qian) Jiangzhi (Zingiberis Juice, 2 small spoons taken with decoction)
In this formula, Jiangzhi (Ginger Juice) and Guizhi (Cinnamon Twig) are the principal drugs. Danggui (Angelica) and Fuling (Poria) are used to assist Jiang and Guizhi. To eliminate distension, Chenxiang (Aquilaria) serves as the general commander. Juhong (Red Tangerine Peel), Banxia (Pinellia), Gualou (Trichosanthes), Suzi (Perilla), and Sangbaipi (Mulberry Bark) are all Qi-regulating herbs for the Lung and Stomach, assisting Chenxiang. Note by Zuyi.
Liver Distension manifests as fullness and pain under the hypochondrium radiating to the lower abdomen. The Liver is called the "General Officer," and both Qi and Blood are abundant. However, Wood (Liver) prefers free flow and expansion. When Cold Qi rebels upward, the two forces accumulate, causing Liver Wood to become angry and distended. The hypochondrium is the native location of the Liver. Pain radiating to the lower abdomen indicates extreme congestion about to rupture. One should soothe the Liver and transform turbidity. The main formula is Qingyang Tang.
Qingyang Tang (Self-made Formula)
Qingpi (Citri Reticulatae Pericarpium Viride, 1.5 qian stir-fried with vinegar) Chaihu (Bupleuri Radix, 1 qian stir-fried with vinegar) Jili (Tribuli Fructus, 4 qian) Wuyao (Linderae Radix, 1 qian) Paojiang (Zingiberis Rhizoma Preparatum, 0.5 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Yanhu (Corydalis Rhizoma, 1 qian stir-fried with wine) Muxiang (Aucklandiae Radix, 0.5 qian) Yujin (Curcumae Longae Radix, 2 qian) Huajiaozi (Zanthoxyli Pericarpium, 24 grains crushed)
The Qingpi, Chaihu, Jili, Wuyao, Yanhu, Yujin, Guangpi, and Muxiang used in this formula are all herbs for soothing the Liver, resolving depression, promoting Qi circulation, and invigorating Blood. They are essential medicines for Liver disorders. However, the focus lies in separately selecting the Pepper and Ginger from Anwei Wan (Stomach-Calming Pill), as their warming and unblocking properties are strong, greatly enhancing the efficacy of the preceding eight herbs. Note by Zuyi.
Spleen Distension manifests as frequent hiccups, heavy and uncomfortable limbs, body weight making one feel unable to bear clothing, and restless sleep. The Spleen belongs to Wet Earth and governs the four limbs. When Cold Qi attacks it, the virtue of Earth declines, and True Yang fails to circulate, resulting in frequent hiccups, limb fatigue/heaviness, and restless night sleep. One should support Earth, leach out dampness, and simultaneously resolve Cold Evil. The main formula is Jiangshu Erren Tang.
Jiangshu Erren Tang (Self-made Formula)
Paojiang (Prepared Ginger, 0.5 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 2 qian) Fuling (Poria, 3 qian) Banxia (Pinelliae Tuber, 1 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Yiren (Coicis Semen, 8 qian stir-fried) Sharen (Amomi Fructus, 1 qian) Nongpo (Magnoliae Officinalis Cortex, 1 qian) Muxiang (Aucklandiae Radix, 0.5 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Shengshu Guya (Hordei Fructus Germinatus, raw and cooked, 4 qian each, decocted as water substitute)
Named after Jiang (Ginger), Shu (Atractylodes), and Er Ren (Two Kernels), this formula supports Middle Jiao Yang to remove latent Cold. Banxia, Fuling, Nongpo, Guangpi, Sharen, Muxiang, and Shengshu Guya strongly strengthen the Spleen and Stomach and aid digestion. Among these purely Yang herbs, adding one dose of Danggui to nourish and invigorate Blood ensures that the Blood aspect is not entirely abandoned, which is the correct method of formula construction. This formula shares seven herbs (Ginger, Atractylodes, Poria, Angelica, Pinellia, Magnolia, Amomum) with the Pi Bi (Spleen Bi) formula but excludes Sangbaipi, Suzi, and Xingren. Note by Zuyi.
Kidney Distension manifests as abdominal fullness radiating to the back, with aching pain in the waist and thighs. The Kidney belongs to Water. When Cold Qi attacks, Water becomes cold like ice, and Qi becomes firm and coagulated. The True Yang within Kan (Kidney) cannot reach the exterior, resulting in abdominal fullness radiating to the back and constant distress. Pain in the waist and thighs indicates deficiency-cold in the Lower Origin, where Ying Blood cannot flow and irrigate. One should warm the Kidney and dispel Cold. The main formula is Wenquan Tang.
Wenquan Tang (Self-made Formula)
Danggui (Angelicae Sinensis Radix, 2 qian) Fuzi (Aconiti Lateralis Radix Praeparata, 0.8 qian) Xiaohuixiang (Foeniculi Fructus, 1 qian) Guzhi (Psoraleae Fructus, 1.5 qian stir-fried with Walnut Meat) Wuyao (Linderae Radix, 1 qian) Duzhong (Eucommiae Cortex, 3 qian) Niuxi (Achyranthis Bidentatae Radix, 2 qian) Muxiang (Aucklandiae Radix, 0.5 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1 qian) Jiang (Zingiberis Rhizoma, 3 slices)
This formula shares seven herbs (Aconite, Angelica, Fennel, Psoralea, Aucklandia, Achyranthes, Ginger) with the Shen Bi (Kidney Bi) formula but removes Lurong (Deer Antler), Luji (Deer Spine), Tusizi (Cuscutae Semen), Yizhi (Alpinia), Duhuo (Angelicae Pubescentis Radix), and Zao (Jujube). It adds Duzhong (Eucommia), Walnut, Wuyao (Lindera), Qingpi, and Guangpi, because the former case was primarily deficiency, whereas this case involves severe Cold. Both formulas use warming, unblocking, and tonifying methods, but the herb selection differs significantly, demonstrating precise dosage control. This clearly shows the emphasis on Kidney Yang, as the Yuan Yang of the Dantian is the root of human life. Note by Zuyi.
Stomach Distension manifests as abdominal fullness, epigastric pain, smelling burnt odors from the nose, difficulty eating, and difficult defecation. The Stomach is the Fu-organ of water and grain, responsible for receiving and discharging. When Yin-Cold Qi rebels upward, water and grain cannot be transported and transformed, resulting in abdominal fullness and stomach pain. The qi of water and grain rots in the Stomach, causing the nose to smell burnt odors, hindering food intake and bowel movements. One should calm the Stomach, dispel Cold, and warm the Middle. The main formula is Wenzhong Pingwei San.
Wenzhong Pingwei San (Self-made Formula)
Paojiang (Prepared Ginger, 0.5 qian) Sharen (Amomi Fructus, 1 qian) Muxiang (Aucklandiae Radix, 5 qian) Guya (Hordei Fructus Germinatus, 3 qian stir-fried) Shenqu (Massae Fermentatae Medicinalis, 3 qian stir-fried) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Maozhu (Atractylodis Rhizoma, 1 qian) Nongpo (Magnoliae Officinalis Cortex, 1 qian) Zhiqiao (Aurantii Fructus, 1 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1 qian) Chenxiangyuanpi (Erythraeae Exocarpium, 0.8 qian)
This formula is based on Pingwei San, removing Gancao (Licorice) and adding Paojiang (Prepared Ginger), Muxiang (Aucklandia), and Sharen (Amomum). Shenqu, Zhiqiao, and Guya aid digestion, while Qingpi and Xiangyuan harmonize the Liver and Stomach. Pingwei San dries Spleen dampness; this formula warms Stomach Cold. Stomach Cold is the most common type of Stomach disease. Note by Zuyi.
Large Intestine Distension manifests as borborygmus and gurgling pain. If exposed to Cold again in winter, it leads to undigested stool diarrhea. The Large Intestine is the official of transmission, located below the Small Intestine, responsible for transformation and excretion of waste. When Cold Qi rebels upward, transformation loses its measure, causing borborygmus, abdominal pain, and water sounds. Re-exposure to Cold causes undigested food to pass through. One should warm and unblock the intestines and stomach, attending to both upper and lower aspects, rather than treating only the Large Intestine. The main formula is Gumu Lizang Tang.
Gumu Lizang Tang (Self-made Formula)
Zhiqiao (Aurantii Fructus, 1.5 qian stir-fried with bran) Qingpi (Citri Reticulatae Pericarpium Viride, 1.5 qian) Nongpo (Magnoliae Officinalis Cortex, 1 qian) Ganjiang (Zingiberis Rhizoma, 0.5 qian) Guya (Hordei Fructus Germinatus, 2 qian stir-fried) Danggui (Angelicae Sinensis Radix, 2 qian) Fuling (Poria, 2 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Muxiang (Aucklandiae Radix, 0.5 qian) Baiko (Amomi Fructus Rotundus, 0.6 qian) Jubing (Citri Reticulatae Fructus Conservatus, 3 qian sliced)
This formula is a modification of the previous Wenzhong Pingwei San, using Ganjiang (Dried Ginger) instead of Paojiang, and Baizhu (White Atractylodes) instead of Maozhu (Raw Atractylodes), adding Danggui and Fuling to "protect the mother" (Stomach). Zhiqiao, Nongpo, Baiko, and Muxiang warm and unblock the intestines and stomach. Guya and Jubing support Stomach Qi, assisting Ginger, Atractylodes, Angelica, and Poria. Treating Zang organs must protect the Mother (Stomach) because the Stomach is the source, and the Large Intestine is the outlet. Note by Zuyi.
Small Intestine Distension manifests as lower abdominal distension radiating to the back with pain. The Small Intestine is the official of reception and transformation, located below the Stomach, receiving water and grain and separating the clear from the turbid. Fluids seep forward (to Bladder), and waste goes backward (to Large Intestine). When Cold Qi rebels upward, transformation fails to discharge, causing lower abdominal distension and back pain. One should separate and manage water and grain, allowing both urination and defecation to proceed freely, thereby resolving distension. The main formula is Tongyou Huazhuo Tang.
Tongyou Huazhuo Tang (Self-made Formula)
Zhiqiao (Aurantii Fructus, 1.5 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1.5 qian) Mutong (Akebiae Caulis, 1.5 qian stir-fried with wine) Cheqian (Plantaginis Semen, 2 qian) Chiling (Poria Coccinea, 2 qian) Louren (Trichosanthis Semen, 3 qian) Nongpo (Magnoliae Officinalis Cortex, 1 qian) Muxiang (Aucklandiae Radix, 0.5 qian) Wuyao (Linderae Radix, 1 qian) Guya (Hordei Fructus Germinatus, 3 qian stir-fried) Jiang (Zingiberis Rhizoma, 3 large slices)
This formula shares only three herbs with the modified Mutong Tang for Pi Bi: Mutong (reduced dose and wine-fried), Chiling (Red Poria), and Cheqian (Plantago). It additionally uses Zhiqiao, Nongpo, Qingpi, Wuyao, Louren, and Muxiang to open the幽门 (pylorus); heavily uses Shengjiang (Fresh Ginger) assisted by Guya to protect the Spleen and Stomach. Since the Small Intestine receives from the Stomach above and drains to the Bladder and Large Intestine below, it separates water and grain to move waste. Its wall is thin and narrow, with many twists and turns; it is narrower than the Stomach above and wider than the Large Intestine below, serving as a bottleneck in the digestive system. Thus, it suffers more diseases than the Stomach or Large Intestine, making the urgent task to promote both urination and defecation. Note by Zuyi.
Bladder Distension manifests as lower abdominal fullness and urinary retention (Long). The Bladder stores Jin Ye (fluids), which are discharged through Qi transformation. Water Qi follows the Lower Jiao to seep into the Bladder; the storage of fluids depends on Qi transformation to seep in before they can be discharged. When Cold Qi rebels upward, Water Qi becomes obstructed and blocked, causing lower abdominal fullness and urinary retention. One should regulate Qi and move water, allowing the Cold Water to be promoted by True Yang for free flow. The main formula is Jiji Tang.
Jiji Tang (Self-made Formula)
Danggui (Angelicae Sinensis Radix, 2 qian) Rougui (Cinnamomi Cortex, 0.5 qian) Chenxiang (Aquilaria Lignum, 0.5 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Zexie (Alismatis Rhizoma, 1.5 qian) Niuxi (Achyranthis Bidentatae Radix, 2 qian) Qumai (Dianthi Herba, 2 qian) Cheqian (Plantaginis Semen, 2 qian) Yiren (Coicis Semen, 4 qian) Kuihuazi (Helianthi Annuus Semen, 4 qian stir-fried and ground, decocted together)
This formula uses Danggui, Niuxi, Chenxiang, Guangpi, Zexie, and Cheqian, same as Bao Bi Liji Tang, but emphasizes Rougui (Cinnamon Bark) for invigorating Blood and Chenxiang (Aquilaria) for moving Qi. These two powerful herbs work together. Because Distension is more severe than Bi, the Bladder easily accumulates Blood stasis, and urinary retention poses a risk of water pathway obstruction. Therefore, it is more accurate to say this formula focuses on promoting Yang rather than merely draining water. Note by Zuyi.
Sanjiao (Triple Energizer) Distension manifests as Qi filling the skin, feeling light and not firm. "Upper Jiao is like mist, Middle Jiao is like foam, Lower Jiao is like a ditch" describes the flow of Qi and Water, which ultimately lack substantial form. Affected by rebellious Cold Qi, Qi fills the skin. Because it lacks form, although distended, it feels light and not firm. One should harmonize Qi and Blood, and guide/drain water. The main formula is Tongpi Yin.
Tongpi Yin (Self-made Formula)
Guangpi (Citri Reticulatae Pericarpium, 1 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1 qian) Dongguapi (Benincasae Exocarpium, 2 qian) Fulingpi (Poria Peridium, 4 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Nongpo (Magnoliae Officinalis Cortex, 1 qian) Zhiqiao (Aurantii Fructus, 1 qian) Sharen (Amomi Fructus, 1 qian) Zexie (Alismatis Rhizoma, 1.5 qian) Cheqianzi (Plantaginis Semen, 2 qian) Xianjiangpi (Fresh Zingiberis Pericarpium, 1 qian)
This formula is based on Wupi Yin (Five Peel Decoction), employing the principle of "using peel to treat peel," where light herbs can dispel excess. Zhiqiao and Nongpo eliminate痞满 (fullness/stagnation); Zexie and Cheqian promote urination. Finally, Danggui and Sharen harmonize Liver and Stomach Qi and Blood. This approach is light and fluid, handling heavy burdens with ease, precisely targeting the symptom of Qi filling the skin, feeling light and not firm. Note by Zuyi.
Gallbladder Distension manifests as pain and distension under the hypochondrium, bitter taste in the mouth, and frequent sighing. The Gallbladder is the "Official of Justice," from which decision-making arises. Although the Liver is strong, it cannot make decisions without the Gallbladder. The Gallbladder has little Qi and Blood and is a "Clear and Quiet" Fu-organ. When Cold Evil interferes, it causes hypochondriac pain and bitter taste; Qi stagnation and discomfort cause frequent sighing. One should use light, ascending, and harmonizing methods. The main formula is Houxin Tang.
Houxin Tang (Self-made Formula)
Chaihu (Bupleuri Radix, 1 qian) Yujin (Curcumae Longae Radix, 2 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Fuling (Poria, 2 qian) Zhizipi (Gardeniae Pericarpium, 1 qian stir-fried with Ginger Juice) Jili (Tribuli Fructus, 4 qian) Zhiqiao (Aurantii Fructus, 1 qian) Hehuanhua (Albiziae Flos, 2 qian) Foshou (Citri Sarcodactylis Fructus, 0.5 qian)
In this formula, Chaihu is the primary herb for the Shaoyang channel; Yujin is an excellent remedy for depression; Danggui and Fuling address both Liver and Spleen; Zhizi assists Chaihu to clear Shaoyang heat; Hehuan assists Yujin to connect Heart Qi; Zhiqiao, Jili, Guangpi, and Foshou are all Qi-regulating herbs for the Liver. Since Liver and Gallbladder are interior-exterior partners, this formula captures the subtlety of skillful execution. Note by Zuyi.