〔大〕夫妇人心腹胀满者，由脏腑久冷，气血虚损，而邪气客之，乘于心脾故也。足
太阴脾之经也，脾虚则胀。足少阴肾之经也，其脉起于小指之下斜趣足心，入跟中上股内
后廉，贯肾络膀胱，从肾上贯肝膈入肺中；其支者从肺出络于心脏。邪气客于三经，与正
气相搏，积聚在内，气并于脾，脾虚有胀，故令心腹烦满而胀也。诊其脉迟而滑者，胀满
也。
〔薛〕前证脾胃虚痞，用六君子汤。（杂病虚劳。）脾胃虚寒者，用人参理中汤。郁结气
滞者，用归脾汤。（杂病健忘。）肝侮脾土，用六君、柴芍。脾气壅滞，用平胃散。（杂病中食。）肺
气壅滞，用紫苏饮。宿食壅滞，用养胃汤。脾血虚痞，用四物汤加参、术。（上六证当互相参用，
仍与血风攻脾不食同用。）一妇人胸膈不利，饮食少思，腹胀吞酸，或用疏利之药，反致中
满不食。予以为脾土虚而肝木盛，用补中益气汤（杂病伤劳倦。）加砂仁、香附、煨姜，又以
六君子加芎、归、桔梗而愈。 吴江史玄年母久病之后，遇事拂意，忽胸腹胀满，面目
微肿，两腿重滞，气逆上升，言语喘促，服清气之剂不效。予曰∶此脾肺虚寒也。先用
六君子汤，一剂病势顿减，后用补中益气加茯苓、半夏、干姜，二剂形体顿安。后以七
情失调，夜间腹胀，乃用十全大补汤加木香治之而痊。
白术散 治妇人脾胃气虚，心腹胀满，不欲饮食，四肢无力。
白术 草果仁 诃子肉（各三分） 赤茯苓 槟榔 桂心（各半两） 陈皮 浓朴 人参（各
一两） 甘草（一分）
上为粗末，每服四钱，水一盅，姜三片，枣一枚，煎至七分，去滓食前热服。
槟榔散 治妇人脾胃虚冷，心腹胀满，不欲饮食。
槟榔 前胡 川芎 青皮（七钱半） 赤芍药 桂心 大黄 苦梗 木香 枳壳（各半两）
甘草（二钱半）
上 咀，每服四钱，姜三片，煎至七分，
去滓温服。
木香散 治证同前。
木香 桂心 白术 干姜（炮） 陈皮（去白） 草果仁 诃梨勒 人参（各一两） 神曲（炒黄，
七钱半） 甘草（炙，半两）
上为细末，每服一钱，茶清点，热服。
《补遗》治心腹胀满。予尝独用浓朴姜汁炒过，每服五钱，姜七片，水煎温服，不拘
时候，间服沉香降气汤得效。（见《资生经》。）
《局方》分心气饮亦妙。（方见杂病气。）三腕散亦妙。（方见两胁胀痛。）
[Da] When women experience fullness and distension in the heart and abdomen, it is caused by long-standing coldness of the Zang-Fu organs, deficiency and damage of Qi and Blood, allowing pathogenic factors to invade. These pathogens take advantage of the deficiency to affect the Heart and Spleen. The Foot-Taiyin Spleen Meridian belongs to the Spleen; when the Spleen is deficient, distension occurs. The Foot-Shaoyin Kidney Meridian belongs to the Kidney; its vessel originates below the little toe, slants towards the center of the foot, enters the heel, ascends along the inner posterior aspect of the thigh, penetrates the Kidney, and connects with the Bladder. From the Kidney, it ascends through the Liver and Diaphragm into the Lung; a branch emerges from the Lung, connects with the Heart. Pathogenic factors lodging in these three meridians contend with healthy Qi, accumulating internally. Qi converges on the Spleen; due to Spleen deficiency, distension arises, thus causing vexation, fullness, and distension in the chest and abdomen. If the pulse is diagnosed as slow (Chi) and slippery (Hua), it indicates distension and fullness.
[Xue] For the aforementioned symptoms attributed to Spleen-Stomach deficiency leading to Pi syndrome (痞证 - sensation of blockage without mass), use Liu Jun Zi Tang (Six Gentlemen Decoction). (From Miscellaneous Diseases: Deficiency and Exhaustion.) For those with Spleen-Stomach deficiency-cold, use Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction). For those with constrained Qi stagnation due to emotional depression, use Gui Pi Tang (Restore the Spleen Decoction). (From Miscellaneous Diseases: Forgetfulness.) For Liver overacting on Spleen Earth (Wood insulting Earth), use Liu Jun Zi Tang combined with Chai Hu (Bupleuri Radix) and Bai Shao (Paeoniae Radix Alba). For Spleen Qi congestion and stagnation, use Ping Wei San (Calm the Stomach Powder). (From Miscellaneous Diseases: Food Retention.) For Lung Qi congestion and stagnation, use Zi Su Yin (Perilla Leaf Decoction). For retained food stagnation, use Yang Wei Tang (Nourish the Stomach Decoction). For Spleen Blood deficiency leading to Pi syndrome, use Si Wu Tang (Four Substances Decoction) added with Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). (The above six syndromes should be referenced mutually for application, and can also be used concurrently with treatments for Blood-Wind attacking the Spleen causing anorexia.) A certain woman suffered from discomfort in the chest and diaphragm, poor appetite, abdominal distension, and acid regurgitation. After using purgative and draining medicines, she instead developed central fullness and inability to eat. I considered this to be Spleen Earth deficiency with exuberant Liver Wood. I used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) (From Miscellaneous Diseases: Injury from Fatigue) added with Sha Ren (Amomi Fructus), Xiang Fu (Cyperi Rhizoma), and Wei Jiang (Roasted Ginger). She was subsequently cured using Liu Jun Zi Tang added with Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Jie Geng (Platycodonis Radix). The mother of Shi Xuan from Wujiang, after a prolonged illness, encountered frustrating events and suddenly developed chest and abdominal distension, slight edema of the face and eyes, heavy and sluggish legs, rebellious Qi ascending, and rapid breathing with speech difficulty. Medicines that clear Heat were ineffective. I stated: This is Spleen-Lung deficiency-cold. Initially, I used Liu Jun Zi Tang; after one dose, the disease condition decreased sharply. Subsequently, I used Bu Zhong Yi Qi Tang added with Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma), and Gan Jiang (Zingiberis Rhizoma); after two doses, her physical form became stable. Later, due to dysregulation of the Seven Emotions, she experienced nighttime abdominal distension, so I treated her with Shi Quan Da Bu Tang (Comprehensive Great Tonic Decoction) added with Mu Xiang (Aucklandiae Radix), resulting in recovery.
Bai Zhu San (Atractylodis Macrocephalae Powder) treats women with Spleen-Stomach Qi deficiency, manifesting as heart and abdominal distension, lack of desire for food, and weakness in the four limbs.
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cao Guo Ren (Arecae Pericarpium), He Zi Rou (Terminalia Chebulae Fructus) (each 3 fen); Chi Fu Ling (Poria cum Rubrum), Bing Lang (Areca Seed), Gui Xin (Cinnamomi Ramulus) (each 0.5 liang); Chen Pi (Citri Reticulatae Pericarpium), Nong Po (Magnoliae Officinalis Cortex), Ren Shen (Ginseng Radix) (each 1 liang); Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 fen).
Grind into coarse powder. Each dose consists of 4 qian, boiled with 1 zhong of water, 3 slices of ginger, and 1 jujube. Decoct until 7/10 remains, strain, and take hot before meals.
Bing Lang San (Areca Seed Powder) treats women with Spleen-Stomach deficiency-cold, manifesting as heart and abdominal distension and lack of desire for food.
Bing Lang (Areca Seed), Qian Hu (Peucedani Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride) (7.5 qian); Chi Shao Yao (Paeoniae Radix Rubra), Gui Xin (Cinnamomi Ramulus), Da Huang (Rhei Radix et Rhizoma), Ku Jing (Platycodonis Radix), Mu Xiang (Aucklandiae Radix), Zhi Ke (Aurantii Fructus Immaturus) (each 0.5 liang); Gan Cao (Glycyrrhizae Radix et Rhizoma) (2.5 qian).
Cut into pieces. Each dose consists of 4 qian, boiled with 3 slices of ginger. Decoct until 7/10 remains, strain, and take warm.
Mu Xiang San (Aucklandiae Powder) treats the same syndromes as above.
Mu Xiang (Aucklandiae Radix), Gui Xin (Cinnamomi Ramulus), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Jiang (Zingiberis Rhizoma) (processed), Chen Pi (Citri Reticulatae Pericarpium) (without white pith), Cao Guo Ren (Arecae Pericarpium), He Li Le (Terminalia Chebulae Fructus), Ren Shen (Ginseng Radix) (each 1 liang); Shen Qu (Massa Medicata Fermentata) (stir-fried until yellow, 7.5 qian); Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted, 0.5 liang).
Grind into fine powder. Each dose consists of 1 qian, taken with tea infusion, hot.
"Supplement to Remedies" treats heart and abdominal distension. I once used Nong Po (Magnoliae Officinalis Cortex) stir-fried with ginger juice alone. Each dose was 5 qian, boiled with 7 slices of ginger in water, taken warm at any time. Intermittently taking Chen Xiang Jiang Qi Tang (Aquilariae Descending Qi Decoction) proved effective. (See "Zi Sheng Jing".)
Fen Xin Qi Yin (Dividing Heart Qi Decoction) from "Ju Fang" is also excellent. (Formula see Miscellaneous Diseases: Qi.) San Wan San (Three Wrists Powder) is also excellent. (Formula see Hypochondriac Distension and Pain.)