土，用白芍以土中泻木安脾。〕橘红 木香 沉香〔佐以调和中气。〕热加麦冬，〔散结热而下逆
气。〕渴者尤宜。或加黄连。〔清脾胃之积热，丸制最止邪热。〕有积加枳、曲、山楂、麦芽。〔助脾家之
健运。〕如肥人湿痰，加茅术、半夏。〔燥湿消痰，血家、渴家、汗家勿用。〕如脾虚水肿，加绿豆、
车前。如果虚而挟寒，方可加干姜。〔合理中汤方。〕寒甚则加附、桂。〔补命门之火，以生脾土，否则
不可浪用。〕
此方益气补脾为主，佐以调气之剂，备加减之法，以通其用。若系实症，即于前列诸方，对症取用。
其有不大实，亦不大虚者，本方去参，加减治之，后仍用参补之。按虞天民云∶虚胀必服人参，人参必
肺无热方可服，有热服之，肺火得参而愈甚。肺主出气，邪火挟气两出，脾胃受之，复助积热，则胀急益
加，筋青脐出，危笃立见。故虚胀而不能服参，不救之症也。
二病之脉，实大者可治，虚微者难治，水病脉出者死。〔谓沉按之则无，非浮脉主死也。〕
唇黑或肿，肝伤缺盆平，心伤；脐突，脾伤；足心平，肾伤；背平，肺伤，五伤者死。阴囊及茎肿
腐者死；泻后腹胀而有青筋者死∶大便滑泄，水肿不消者死。水肿先起于腹，后散于四肢者可治，先起于
四肢，后归于腹者死。男从上而下，女从下而上，皆难治，腹胀身热者死，腹胀寒热
如疟者死，腹胀便血，〔脾败不能统血也。〕脉大时绝者死，咳呕腹胀且飧泄，其脉绝者死。〔上为
咳呕，中则胀满，下为飧泄，三焦俱病，六脉已绝，安得不死。〕
(Bai Shao [Radix Paeoniae Alba]) is used to drain Wood within Earth, thereby calming the Spleen.〕Ju Hong (Exocarpium Citri Reticulatae), Mu Xiang (Radix Aucklandiae), Chen Xiang (Aquilaria Lignum) are added as assistants to harmonize and regulate the Middle Qi.〕If there is Heat, add Mai Dong (Radix Ophiopogonis),〔to dissipate knotted Heat and direct rebellious Qi downward.〕It is especially suitable for those with thirst. Alternatively, add Huang Lian (Coptidis Rhizoma).〔To clear accumulated Heat in the Stomach and Spleen; pill preparation is best to restrain pathogenic Heat.〕If there is food accumulation, add Zhi Shi (Fructus Aurantii Immaturus), Shen Qu (Massa Medicata Fermentata), Shan Zha (Fructus Crataegi), and Mai Ya (Fructus Hordei Germinatus).〔To assist the Spleen's healthy transportation and transformation.〕For obese individuals with Damp-Phlegm, add Cang Zhu (Rhizoma Atractylodis Lanceae) and Ban Xia (Rhizoma Pinelliae).〔To dry Dampness and resolve Phlegm; contraindicated for patients with Blood deficiency, thirst, or excessive sweating.〕For Edema due to Spleen deficiency, add Lu Dou (Semen Phaseoli Vulgaris) and Che Qian (Semen Plantaginis). If it is truly a deficiency pattern complicated by Cold, Gan Jiang (Rhizoma Zingiberis Preparatum) may be added.〔This aligns with the formula principles of Lizhong Tang (Regulate the Middle Decoction).〕If Cold is severe, add Fu Zi (Lateral Radix Aconiti Preparata) and Gui Zhi (Ramulus Cinnamomi).〔To tonify the Fire of the Gate of Vitality (Mingmen) to generate Spleen Earth; otherwise, they should not be used recklessly.〕
This formula primarily focuses on benefiting Qi and tonifying the Spleen, assisted by Qi-regulating agents, with various modification methods prepared to ensure flexible application. If it is an Excess syndrome, one should select from the previously listed formulas according to specific symptoms. For cases that are neither significantly Excess nor significantly Deficient, remove Ren Shen (Radix Ginseng) from this formula, treat with modifications, and subsequently use Ren Shen to tonify. According to Yu Tianmin: In cases of Deficiency-type distension, Ren Shen must be administered; however, Ren Shen can only be taken if there is no Heat in the Lung. If taken when Heat is present, Lung Fire will intensify due to Ren Shen. The Lung governs exhalation; when pathogenic Fire accompanies Qi, both exit together, affecting the Spleen and Stomach, which further aids accumulated Heat, causing distension and urgency to worsen. This leads to cyanotic veins and protruding umbilicus, with critical danger appearing immediately. Therefore, Deficiency-type distension where Ren Shen cannot be tolerated is an incurable condition.
Regarding the pulses for these two diseases (Edema and Distension), if Excess and large, it is treatable; if Deficient and minute, it is difficult to treat. In Water diseases, if the pulse "emerges" (floats without root upon deep pressure), death occurs.〔The term "pulse emerges" refers to the pulse disappearing upon deep palpation, not that a floating pulse indicates death.〕
Black or swollen lips indicate Liver injury; flatness of the Quepen (supraclavicular fossa) indicates Heart injury; protruding umbilicus indicates Spleen injury; flatness of the sole of the foot indicates Kidney injury; flatness of the back indicates Lung injury. Injury to all five Zang organs results in death. Swelling and putrefaction of the scrotum and penis result in death; abdominal distension with visible blue veins after diarrhea results in death; slippery diarrhea with unresolved edema results in death. Edema starting in the abdomen and spreading to the limbs is treatable; edema starting in the limbs and returning to the abdomen results in death. In men, progression from top to bottom is difficult to treat; in women, progression from bottom to top is difficult to treat. Abdominal distension with body heat results in death. Abdominal distension with alternating chills and fever resembling malaria results in death. Abdominal distension with bloody stools,〔due to Spleen failure unable to control blood〕results in death. Pulse that is large but intermittently absent results in death. Cough, vomiting, abdominal distension, and undigested stool diarrhea (Sun Xie) with absent pulses result in death.〔Upper Jiao presents with cough and vomiting, Middle Jiao with distension, Lower Jiao with Sun Xie; disease involves all three Jiaos, and the six pulses have ceased; how can death not occur?〕