脉∶胀满脉弦，脾制于肝；洪数热胀，迟弱阴寒；浮为虚胀，紧则中实；浮大者生，虚小危急。
夫胀者，由脾胃之气虚弱，不能运化精微而致水谷聚而不散，故成胀也。然饮食失节，不能调养则清气下降，
浊气填满胸腹，湿热相蒸，遂成胀满。经曰∶鼓胀是也。中空无物有似于鼓，小便短涩不利，其病胶固难以治疗
。用分消汤加减治之，健脾顺水宽中为主也。不可大用猛烈之药反伤脾胃，病再复来不可治也。若脐凸肉硬、肚
大青筋、足背手掌俱浮，男从脚下肿上，女从头上肿下，并皆不治。
腹胀者，肚腹胀起、中空似鼓是也。
分消汤 治中满成鼓胀，兼治脾虚发肿满饱闷。
苍术（米泔浸炒） 白术（去芦） 陈皮 浓朴（姜汁炒） 枳实（麸炒。各一钱） 砂仁（七分） 木香
（三分） 香附 猪苓 泽泻 大腹皮（各八分） 茯苓（一钱）
上锉一剂，生姜一片、灯草一团，水煎服。气急加沉香；
肿胀加萝卜子；胁痛面黑是气鼓，加青皮去白术；胁满小肠胀痛、身上有血丝缕是血鼓，加当归、芍药、红花、
牡丹皮，去白术、茯苓；嗳气作酸、饱闷腹胀是食鼓，加山楂、神曲、麦芽、萝卜子，去白术、茯苓；恶寒手足
厥冷、泻去清水是水鼓，加官桂；胸腹胀满有块如鼓者，是痞散成鼓，加山楂、神曲、半夏、青皮、归尾、玄胡、
鳖甲，去白术、茯苓、猪苓、泽泻。
腹胀脾胃气血俱虚者，宜半补而半消也。
行湿补气养血汤 治气血虚弱，单腹鼓胀浮肿。
人参 白术（去芦） 茯苓 当归 川芎 白芍（敛胀，各一钱） 苏梗 陈皮（泄满） 浓朴（姜炒）
大腹皮（敛气） 萝卜子（炒） 海金沙 木通（利水。各八分） 木香（运气） 甘草（生。各三分）
上锉一剂，生姜三片、枣一枚，水煎服。气虚倍人参、白术、茯苓；血虚倍当归、川芎、白芍；小便短少，
再加猪苓、泽泻、滑石；服后肿胀俱退，唯面足不消，此阳明经气虚，倍用白术、茯苓。
和荣顺气汤 治脾弱血虚，心腹胀闷、两足虚肿。
当归（酒洗，一钱） 川芎（六分） 白芍（酒浸） 白术（土炒。各一钱） 茯苓 乌药 苍术（米泔浸）
陈皮（去白） 枳实（炒） 神曲（炒） 香附（醋炒） 木瓜 牛膝（酒洗） 独活（酒洗） 泽泻 薏苡仁
（炒） 木通（各一钱） 甘草（三分）
上锉一剂，生姜煎服。
腹胀元气脾胃两虚者，宜补多而消少也。
调中健脾丸 治单腹胀及脾虚肿满、膈中闭塞及胃口作痛，并皆治之，神效。
黄 （蜜炒） 人参（去芦。各二两） 白术（六两，黄土拌炒） 茯苓（二两） 陈皮（二两，盐水炒）
苏子（二两半，微炒） 萝卜子（一两半，炒） 山楂肉（三
两，炒） 草豆蔻（二两半，酒拌炒） 泽泻（三两半） 薏苡仁（三两，炒） 沉香（六钱，另为末）
五加皮（三两，炒） 栝蒌（一两，用大栝蒌二个，钻一孔，每个入川椒三钱，多年粪 二钱敲米粒大，俱纳
入瓜内，外以绵纸糊完，再用纸筋、盐泥封固，炭火内 红为度，取出择去盐泥，其黑色一并入药。）
上锉为细末，煎荷叶、大腹皮汤，打黄米糊为丸，如梧桐子大。每服百丸，日进三次，白汤下。此药不伤
元气，大有补益，勿轻视之。
热胀腹有积聚者，宜分消也。
广术溃坚汤 治中满腹胀有积聚如石坚硬，令人坐卧不宁，二便涩滞，上气喘促，或通身虚肿。
浓朴（姜制） 黄连 黄芩 益智仁 草豆蔻 当归（各五分） 半夏（七分） 广术 升麻 红花
吴茱萸（各三分） 生甘草 柴胡 泽泻 神曲（炒） 青皮 陈皮（各三分） 口干加干葛（四分）
上锉一剂，生姜煎，食远服。忌酒醋湿面。
中满分消丸 治中满鼓胀、气胀、水胀、大热胀，不治寒胀。
人参 白术 姜黄 猪苓（去黑皮） 炙甘草（各一钱） 白芍 砂仁 干生姜（各二钱） 泽泻 陈皮
（各三钱） 知母（炒，四钱） 枳实（麸炒） 半夏（泡） 黄连（炒。各五钱） 黄芩（炒，一两二钱）
浓朴（姜炒，一两）
上为细末，水浸蒸饼为丸，如梧桐子大，每服百丸，熟白汤下，食远服。
寒胀不喜饮食，宜温散也。
香朴汤 治老人中寒下虚，心腹膨胀，不喜饮食，脉浮迟而弱，此名寒胀。
浓朴（姜炒，一两） 大附子（炮去皮脐，七钱半） 木香（三钱）
上锉一剂，姜七片、枣一枚，水煎服。
血气凝结积聚而成腹胀者，宜专攻也。
四炒枳壳丸 治气血凝滞，腹内鼓胀积聚，此药宽中快膈快气，消导饮食。
枳壳（四两，米泔浸，去瓤切片，分四处炒之∶）一分（苍术一两同煮干、炒黄色，去苍术），一分
（萝卜子一两水同煮干、炒黄色，去萝卜子），一分（小茴香一两水同煮干、炒黄色，去茴香），一分（干漆一
两水同煮干、炒黄色，去干漆）香附（二两）槟榔（一两）玄胡索（一两，微炒）三棱（二两，同莪术法制）莪
术（一两棱、莪二味用童便一钟浸一宿，次日用完巴豆仁去壳三十粒同水煮干，炒黄色，去豆不用。）
上为细末，用苍术、茴香、萝卜子、干漆煮汁，好醋一碗同面糊为丸，如梧桐子大。每服七十丸，清米汤下。
腹胀因于气者，宜顺气也。分心气饮（方见诸气）。根据本方，如水气浮肿因于气者加猪苓、泽泻、车前、
葶苈、木瓜、麦门冬。
金陵酒丸 治鼓肿。
真沉香（一两） 牙皂（一两） 广木香（二两半） 槟榔（一两）
上为末，用南京烧酒为丸。每服三钱，重者四钱，五更烧酒下。水肿，水自小便而出，气鼓放屁；水鼓
加苦亭苈五钱煎，酒送下再服。
金蟾散 治气鼓如神。
大虾膜一个，以砂仁推入其口内，使吞入腹，以满为度，用泥罐封固，炭火锻，令红透烟净取出，候冷去泥，
研末为一服，或酒、或陈皮汤送下。候撒屁多乃见其效。
宽中养胃汤 治胸膈胀满，饮食少用。
苍术（炒，四分） 香附（七分） 枳壳（麸炒，五分） 浓朴（姜炒，五分） 藿香（五分） 山楂（三分）
陈皮（一钱） 砂仁（三分，细） 神曲（炒，四分） 槟榔（三分） 麦芽（炒，四分） 青皮（去瓤，三分）
枳实（麸炒，四分） 半夏（五分） 茯苓（五分） 甘草（炙，三分）
上锉一剂，生姜三片、枣一枚，水煎，食远服。
春元李河山，患腹左一块，数年不愈。后食派饼过多，得腹胀满闷。余诊六脉洪数，气口紧盛。以藿香正
气散加山楂、神曲，二剂而愈。逾月又因饮食失节，腹胀如初，而仍以前正气散数剂弗效，又易行湿补气养血汤
二十余剂始安。余嘱曰∶病虽愈而体未撤消，务要谨守，勿犯禁戎。逾数月，过余曰∶凡有病，皆天与也，不在服
药，不在谨守，若当时颜子亚圣岂不能保养，何短命死矣。我今保养半年，未见何如，岂在保养服药者哉？予不能
对，渠遂放肆无忌。未经数旬，忽患痢赤白，里急后重，痛不可忍、昼夜无度。渠自制大黄一剂，数下勿效，复求
予诊。六脉洪数，先以调中理气汤二剂，又以补中益气汤加白芍、黄连微效。渠欲速效，遂易他医。其医不审病原，
数患内伤鼓胀之疾，辄用下药。不愈，又易一医，又下之。前后约三十余度，将元气愈惫而下脱，肛门痛如刀割，腹
胀如鼓。然医不知元气下陷，陷深则痛愈深，当大补元气、升提为主，非百剂不可。今以素损元气者，欲速效；岂可
得也。嗟夫！医者不补而反泻，病者不慎而欲速，安得不死也？信两误耳。
补遗方
化龙丹 治单腹胀。
用大鲤鱼一个、巴豆四十粒，将鱼FS 了，将鱼脊割开两刀，将巴豆下在两刀路合住，用纸包裹，慢火烧熟，
去豆食鱼，米汤下。
脉象：腹部胀满而脉象弦，是脾受肝制约所致；脉象洪数主热性胀满，脉象迟弱主阴寒性胀满；脉浮主虚性胀满，脉紧主中焦实证；脉象浮大者预后良好（生），脉象虚小者病情危急。
所谓胀病，是由于脾胃之气虚弱，不能运化水谷精微，导致水谷停滞积聚而不散，从而形成胀病。然而饮食不节制，不能调养身体，会导致清气下降，浊气充满胸腹，湿热相互蒸腾，于是形成胀满。医经说：这就是鼓胀。其特点是腹部中空无物，形状像鼓一样，小便短少涩滞不通利，这种病根深蒂固，难以治疗。使用分消汤加减来治疗，以健脾、利水、宽中为主要治法。不可大量使用猛烈药物，否则会反伤脾胃，导致疾病复发且无法治愈。如果脐部突出、肌肉坚硬、肚子大且青筋暴露、足背和手掌都浮肿，男性从脚部向上肿，女性从头部向下肿，这些都属于不治之症。
腹胀，是指肚腹膨胀隆起，内部中空像鼓一样。
分消汤：治疗因中焦痞满形成的鼓胀，兼治脾虚引起的浮肿、胀满、饱闷。
苍术（用米泔水浸泡后炒制） 白术（去芦头） 陈皮 浓朴（用姜汁炒制） 枳实（用麦麸炒制。各一钱） 砂仁（七分） 木香（三分） 香附 猪苓 泽泻 大腹皮（各八分） 茯苓（一钱）
以上药材锉成粗末，取一剂药量，加生姜一片、灯心草一团，用水煎服。若气急，加沉香；若肿胀严重，加萝卜子（莱菔子）；若胁痛、面色黑，属于气鼓，加青皮，去掉白术；若胁下胀满、小肠胀痛、身上有血丝缕，属于血鼓，加当归、芍药、红花、牡丹皮，去掉白术、茯苓；若嗳气泛酸、饱闷腹胀，属于食鼓，加山楂、神曲、麦芽、萝卜子，去掉白术、茯苓；若恶寒、手足厥冷、泻下清水，属于水鼓，加官桂（肉桂）；若胸腹胀满且有肿块如鼓状，属于痞散成鼓，加山楂、神曲、半夏、青皮、归尾、玄胡索、鳖甲，去掉白术、茯苓、猪苓、泽泻。
行湿补气养血汤：治疗气血虚弱导致的单腹鼓胀及全身浮肿。
人参 白术（去芦头） 茯苓 当归 川芎 白芍（收敛胀气，各一钱） 苏梗 陈皮（泄除胀满） 浓朴（姜炒） 大腹皮（收敛气机） 萝卜子（炒制） 海金沙 木通（利水。各八分） 木香（运行气机） 甘草（生用。各三分）
以上药材锉成粗末，取一剂药量，加生姜三片、大枣一枚，用水煎服。若气虚，加倍使用人参、白术、茯苓；若血虚，加倍使用当归、川芎、白芍；若小便短少，再加猪苓、泽泻、滑石；服药后肿胀消退，唯独面部和足部未消，这是阳明经气虚，应加倍使用白术、茯苓。
和荣顺气汤：治疗脾弱血虚导致的心腹胀闷、两足虚肿。
当归（酒洗，一钱） 川芎（六分） 白芍（酒浸） 白术（土炒。各一钱） 茯苓 乌药 苍术（米泔水浸） 陈皮（去白） 枳实（炒制） 神曲（炒制） 香附（醋炒） 木瓜 牛膝（酒洗） 独活（酒洗） 泽泻 薏苡仁（炒制） 木通（各一钱） 甘草（三分）
以上药材锉成粗末，取一剂药量，加生姜煎服。
调中健脾丸：治疗单腹胀及脾虚引起的肿满、膈中闭塞及胃口作痛，均有疗效，效果显著。
黄芪（蜜炒） 人参（去芦头。各二两） 白术（六两，黄土拌炒） 茯苓（二两） 陈皮（二两，盐水炒） 苏子（二两半，微炒） 萝卜子（一两半，炒制） 山楂肉（三两，炒制） 草豆蔻（二两半，酒拌炒） 泽泻（三两半） 薏苡仁（三两，炒制） 沉香（六钱，另研为末） 五加皮（三两，炒制） 栝蒌（一两，选用大栝蒌两个，钻一个孔，每个放入川椒三钱、多年陈粪二钱敲成米粒大小，全部纳入瓜内，外用绵纸糊完，再用纸筋、盐泥封固，在炭火中烧至红透为度，取出去除盐泥，其黑色部分一并入药。）
以上药材锉成细末，用荷叶、大腹皮煎汤，调和黄米糊制成丸药，如梧桐子大小。每次服用一百丸，每日三次，用白开水送服。此药不伤元气，大有补益，不要轻视它。
热胀伴有腹部积聚的，宜用分消法。
广术溃坚汤：治疗中焦痞满腹胀，内有积聚如石头般坚硬，令人坐卧不安，大小便涩滞，上气喘促，或全身虚肿。
浓朴（姜制） 黄连 黄芩 益智仁 草豆蔻 当归（各五分） 半夏（七分） 广术（莪术） 升麻 红花 吴茱萸（各三分） 生甘草 柴胡 泽泻 神曲（炒制） 青皮 陈皮（各三分） 口干者加干葛（四分）
以上药材锉成粗末，取一剂药量，加生姜煎服，饭后服用。忌食酒、醋、湿面。
中满分消丸：治疗中焦痞满鼓胀、气胀、水胀、大热胀，不治疗寒性胀满。
人参 白术 姜黄 猪苓（去黑皮） 炙甘草（各一钱） 白芍 砂仁 干生姜（各二钱） 泽泻 陈皮（各三钱） 知母（炒制，四钱） 枳实（麦麸炒） 半夏（泡制） 黄连（炒制。各五钱） 黄芩（炒制，一两二钱） 浓朴（姜炒制，一两）
以上药材研为细末，用水浸泡蒸饼制成丸药，如梧桐子大小，每次服用一百丸，用熟白开水送服，饭后服用。
香朴汤：治疗老人中寒下虚，心腹膨胀，不喜欢饮食，脉象浮迟而弱，这名叫寒胀。
浓朴（姜炒制，一两） 大附子（炮制去皮脐，七钱半） 木香（三钱）
以上药材锉成粗末，取一剂药量，加生姜七片、大枣一枚，用水煎服。
四炒枳壳丸：治疗气血凝滞，腹内鼓胀积聚，此药能宽中、快膈、顺气，消导饮食。
枳壳（四两，米泔水浸，去瓤切片，分为四处炒制∶）一份（与苍术一两同煮至干、炒至黄色，去掉苍术），一份（与萝卜子一两水同煮至干、炒至黄色，去掉萝卜子），一份（与小茴香一两水同煮至干、炒至黄色，去掉茴香），一份（与干漆一两水同煮至干、炒至黄色，去掉干漆） 香附（二两） 槟榔（一两） 玄胡索（一两，微炒） 三棱（二两，同莪术方法法制） 莪术（一两，三棱、莪术这两味药用童子尿一钟浸泡一夜，次日用完巴豆仁去壳三十粒同水煮干，炒至黄色，去掉豆子不用。）
以上药材研为细末，用苍术、茴香、萝卜子、干漆煮汁，加好醋一碗，同面糊制成丸药，如梧桐子大小。每次服用七十丸，用清米汤送服。
若腹胀由气滞引起，宜顺气。分心气饮（方剂见诸气章节）。根据本方，若水气浮肿由气引起，加猪苓、泽泻、车前子、葶苈子、木瓜、麦门冬。
金陵酒丸：治疗鼓肿。
真沉香（一两） 牙皂（一两） 广木香（二两半） 槟榔（一两）
以上药材研为末，用南京烧酒制成丸药。每次服用三钱，重症者四钱，五更天用烧酒送服。水肿，水从小便排出；气鼓放屁；水鼓加苦亭苈五钱煎汤，用酒送服再服。
金蟾散：治疗气鼓如神效。
取大虾蟆一个，将砂仁推入其口内，使其吞入腹中，以填满为度，用泥罐封固，在炭火中煅烧，令其红透无烟后取出，冷却后去泥，研末作为一服剂量，或用酒、或用陈皮汤送服。待病人放屁多时才能见到疗效。
宽中养胃汤：治疗胸膈胀满，饮食减少。
苍术（炒制，四分） 香附（七分） 枳壳（麦麸炒制，五分） 浓朴（姜炒制，五分） 藿香（五分） 山楂（三分） 陈皮（一钱） 砂仁（三分，细末） 神曲（炒制，四分） 槟榔（三分） 麦芽（炒制，四分） 青皮（去瓤，三分） 枳实（麦麸炒制，四分） 半夏（五分） 茯苓（五分） 甘草（炙制，三分）
以上药材锉成粗末，取一剂药量，加生姜三片、大枣一枚，用水煎服，饭后服用。
春元李河山，患左侧腹部有一肿块，数年不愈。后来吃派饼过多，导致腹胀满闷。我诊察其六脉洪数，气口脉紧盛。用藿香正气散加山楂、神曲，服用两剂后痊愈。过了一个月又因饮食不节制，腹胀如初，仍然用以前的正气散数剂无效，又改用行湿补气养血汤二十余剂才安定下来。我嘱咐他说：病虽然好了但体质尚未恢复，务必谨守医嘱，不要触犯禁忌。过了几个月，他经过我这里说：凡是生病，都是天命，不在于服药，也不在于谨守，如果当时的颜回、亚圣难道不能保养身体吗？为什么短命而死呢？我现在保养了半年，没看到什么效果，难道在于保养服药吗？我不能回答他，他便放肆无忌惮。没过几十天，突然患赤白痢疾，里急后重，疼痛难忍，昼夜无度。他自己配制大黄一剂，多次泻下无效，又来求我诊治。六脉洪数，先用调中理气汤两剂，又以补中益气汤加白芍、黄连，效果微弱。他想求速效，于是换其他医生。那医生不审察病因，他之前患有内伤鼓胀的疾病，医生辄用下药攻伐。病未愈，又换一医生，又用下药。前后约三十多次，导致元气更加疲惫而下脱，肛门痛如刀割，腹胀如鼓。然而医生不知道元气下陷，陷得越深则痛越深，应当以大补元气、升提为主，非百剂不可。现在以素来损伤元气的人，想求速效，怎么可能呢？唉！医生不补反泻，病人不慎且求速效，怎么能不死呢？确实是双方都误判了。
补遗方
化龙丹：治疗单腹胀。
用大鲤鱼一条、巴豆四十粒，将鱼剖开，将鱼脊背割开两刀，将巴豆放在两刀路合住，用纸包裹，慢火烧熟，去掉豆子吃鱼，用米汤送服。
Pulse: Abdominal distension with a wiry pulse indicates the Spleen is controlled by the Liver; a surging and rapid pulse indicates heat-type distension, while a slow and weak pulse indicates Yin-cold type distension; a floating pulse indicates deficiency-type distension, and a tight pulse indicates excess in the Middle Jiao; a floating and large pulse suggests a favorable prognosis (survival), whereas a deficient and small pulse indicates critical danger.
Distension arises from the deficiency of Qi in the Spleen and Stomach, which fails to transform and transport essential nutrients, causing food and water to accumulate without dispersing, thus forming distension. However, irregular diet and failure to nourish the body cause clear Qi to descend improperly, while turbid Qi fills the chest and abdomen. Damp-heat steams and boils together, resulting in distension. The Classics state: this is Drum Distension (Gu Zhang). Its characteristic is an empty abdomen resembling a drum, with short, scanty, and difficult urination. This disease is entrenched and difficult to treat. It should be treated with modified Fen Xiao Tang (Dividing and Eliminating Decoction), focusing on strengthening the Spleen, promoting diuresis, and relaxing the middle. One must not use strong or harsh medicines excessively, as this will damage the Spleen and Stomach, leading to recurrence that becomes incurable. If the umbilicus protrudes, muscles are hard, the abdomen is large with visible varicose veins, and edema affects both the dorsum of the feet and palms; if men swell upwards from the feet, and women downwards from the head, these are all untreatable conditions.
Abdominal distension refers to the swelling and bulging of the abdomen, which is hollow inside like a drum.
Fen Xiao Tang (Dividing and Eliminating Decoction): Treats drum distension caused by fullness in the Middle Jiao, and also treats edema, fullness, and stuffiness due to Spleen deficiency.
Cang Zhu (Atractylodis Rhizoma) (soaked in rice wash water and stir-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (remove rhizome base), Chen Pi (Citri Reticulatae Pericarpium), Hou Po (Magnoliae Officinalis Cortex) (stir-fried with ginger juice), Zhi Shi (Immature Bitter Orange Fruit) (stir-fried with bran. Each 1 qian), Sha Ren (Amomi Fructus Rotundus) (0.7 qian), Mu Xiang (Aucklandiae Radix) (0.3 qian), Xiang Fu (Cyperi Rhizoma), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Da Fu Pi (Arecae Pericarpium) (Each 0.8 qian), Fu Ling (Poria) (1 qian).
Grind the above into coarse powder. For one dose, add one slice of fresh ginger and a bunch of juncus effusus, decoct with water and take orally. Add Chen Xiang (Aquilariae Lignum Resinatum) for急促 breathing; add Luo Bo Zi (Raphani Semen) for severe swelling; for hypochondriac pain and dark complexion indicating Qi Distension, add Qing Pi (Citri Reticulatae Pericarpium Viride) and remove Bai Zhu; for hypochondriac fullness, lower abdominal distension and pain, and blood streaks on the body indicating Blood Distension, add Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix Alba), Hong Hua (Carthami Flos), Mu Dan Pi (Moutan Cortex), and remove Bai Zhu and Fu Ling; for belching with acid regurgitation, fullness and abdominal distension indicating Food Distension, add Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), Mai Ya (Hordei Fructus Germinatus), Luo Bo Zi (Raphani Semen), and remove Bai Zhu and Fu Ling; for aversion to cold, cold extremities, and diarrhea with clear watery stool indicating Water Distension, add Guan Gui (Cinnamomi Cortex); for chest and abdominal fullness with masses resembling a drum, indicating Pi San Cheng Gu (Dispersed Blockage becoming Drum Distension), add Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), Ban Xia (Pinelliae Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Gui Wei (Radix Angelicae Sinensis Cauda), Yuan Hu (Corydalis Rhizoma), Bie Jia (Testudinis Carapax et Plastrum), and remove Bai Zhu, Fu Ling, Zhu Ling, and Ze Xie.
If abdominal distension is due to combined deficiency of Qi and Blood in the Spleen and Stomach, it is appropriate to use half tonification and half elimination.
Xing Shi Bu Qi Yang Xue Tang (Moisture-Driving, Qi-Nourishing, and Blood-Supplementing Decoction): Treats single-abdomen drum distension and generalized edema due to Qi and Blood deficiency.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (remove rhizome base), Fu Ling (Poria), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba) (to restrain distension, each 1 qian), Su Geng (Perillae Caulis), Chen Pi (Citri Reticulatae Pericarpium) (to drain fullness), Hou Po (Magnoliae Officinalis Cortex) (stir-fried with ginger), Da Fu Pi (Arecae Pericarpium) (to restrain Qi), Luo Bo Zi (Raphani Semen) (stir-fried), Hai Jin Sha (Lygodii Spora), Mu Tong (Akebiae Caulis) (promote diuresis. Each 0.8 qian), Mu Xiang (Aucklandiae Radix) (to move Qi), Gan Cao (Glycyrrhizae Radix et Rhizoma) (raw. Each 0.3 qian).
Grind the above into coarse powder. For one dose, add three slices of fresh ginger and one jujube, decoct with water and take orally. Double the dosage of Ren Shen, Bai Zhu, and Fu Ling for Qi deficiency; double Dang Gui, Chuan Xiong, and Bai Shao for Blood deficiency; if urine is scanty, add Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), and Hua Shi (Talcum); after taking the medicine, if swelling subsides but the face and feet remain swollen, this indicates Qi deficiency in the Yangming Meridian; double the dosage of Bai Zhu and Fu Ling.
He Rong Shun Qi Tang (Harmonizing Nutrients and Smoothing Qi Decoction): Treats heart and abdominal stuffiness and virtual swelling of both legs due to Spleen weakness and Blood deficiency.
Dang Gui (Angelicae Sinensis Radix) (wine-washed, 1 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (6 fen), Bai Shao (Paeoniae Radix Alba) (wine-soaked), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (earth-stir-fried. Each 1 qian), Fu Ling (Poria), Wu Yao (Linderae Radix), Cang Zhu (Atractylodis Rhizoma) (soaked in rice wash water), Chen Pi (Citri Reticulatae Pericarpium) (remove white pith), Zhi Shi (Immature Bitter Orange Fruit) (stir-fried), Shen Qu (Massa Medicata Fermentata) (stir-fried), Xiang Fu (Cyperi Rhizoma) (vinegar-stir-fried), Mu Gua (Chaenomelis Fructus), Niu Xi (Achyranthis Bidentatae Radix) (wine-washed), Du Huo (Angelicae Pubescentis Radix) (wine-washed), Ze Xie (Alismatis Rhizoma), Yi Yi Ren (Coicis Semen) (stir-fried), Mu Tong (Akebiae Caulis) (Each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 fen).
Grind the above into coarse powder. For one dose, add fresh ginger and decoct with water.
If abdominal distension is due to deficiency of Primordial Qi and both Spleen and Stomach, it is appropriate to use more tonification and less elimination.
Tiao Zhong Jian Pi Wan (Regulating the Middle and Strengthening the Spleen Pill): Treats single abdominal distension, swelling and fullness due to Spleen deficiency, blockage in the diaphragm, and stomach ache, all of which respond well to this formula with miraculous effects.
Huang Qi (Astragali Membranacei Radix) (honey-stir-fried), Ren Shen (Ginseng Radix et Rhizoma) (remove rhizome base. Each 2 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (6 liang, stir-fried with yellow earth), Fu Ling (Poria) (2 liang), Chen Pi (Citri Reticulatae Pericarpium) (2 liang, salt-water stir-fried), Su Zi (Perillae Fructus) (2.5 liang, lightly stir-fried), Luo Bo Zi (Raphani Semen) (1.5 liang, stir-fried), Shan Zha Rou (Crataegi Fructus flesh) (3 liang, stir-fried), Cao Dou Kou (Alpiniae Katsumadai Semen) (2.5 liang, wine-mixed stir-fried), Ze Xie (Alismatis Rhizoma) (3.5 liang), Yi Yi Ren (Coicis Semen) (3 liang, stir-fried), Chen Xiang (Aquilariae Lignum Resinatum) (6 qian, ground separately into powder), Wu Jia Pi (Acanthopanacis Cortex) (3 liang, stir-fried), Gua Lou (Trichosanthis Fructus) (1 liang, use two large Trichosanthis Fructus, drill one hole in each, insert 3 qian of Chuan Jiao (Zanthoxyli Pericarpium) and 2 qian of aged feces crushed to rice-grain size into each melon, seal the outside with cotton paper, then seal firmly with mud mixed with salt and straw, roast over charcoal until red-hot, remove, scrape off the mud, and include the blackened part in the medicine.)
Grind the above into fine powder. Decoct He Ye (Nelumbinis Folium) and Da Fu Pi (Arecae Pericarpium) in water, mix with yellow millet paste to form pills the size of paulownia seeds. Take 100 pills per dose, three times daily, washed down with plain warm water. This medicine does not damage Primordial Qi and provides great tonification; do not underestimate it.
For heat distension accompanied by abdominal accumulations, the method of dividing and eliminating should be used.
Guang Zhu Kui Jian Tang (Curcuma Softening Hardness Decoction): Treats Middle Jiao fullness and abdominal distension with accumulations as hard as stones, causing restlessness in sitting and lying, obstructed urination and defecation, upper body panting, or generalized virtual edema.
Hou Po (Magnoliae Officinalis Cortex) (ginger-prepared), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Cao Dou Kou (Alpiniae Katsumadai Semen), Dang Gui (Angelicae Sinensis Radix) (Each 5 fen), Ban Xia (Pinelliae Rhizoma) (7 fen), Guang Zhu (Curcumae Longae Rhizoma), Sheng Ma (Bupleuri Radix), Hong Hua (Carthami Flos), Wu Zhu Yu (Evodiae Fructus) (Each 3 fen), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Chai Hu (Bupleuri Radix), Ze Xie (Alismatis Rhizoma), Shen Qu (Massa Medicata Fermentata) (stir-fried), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium) (Each 3 fen). Add Gan Ge (Puerariae Radix) (4 fen) if there is dry mouth.
Grind the above into coarse powder. For one dose, add fresh ginger, decoct, and take long after meals. Avoid alcohol, vinegar, and damp noodles.
Zhong Man Fen Xiao Wan (Middle Fullness Dividing and Eliminating Pill): Treats Middle Jiao fullness drum distension, Qi distension, Water distension, and severe heat distension; does not treat cold distension.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Jiang Huang (Curcumae Longae Rhizoma), Zhu Ling (Polyporus) (remove black skin), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (Each 1 qian), Bai Shao (Paeoniae Radix Alba), Sha Ren (Amomi Fructus Rotundus), Gan Sheng Jiang (Dried Fresh Ginger) (Each 2 qian), Ze Xie (Alismatis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium) (Each 3 qian), Zhi Mu (Anemarrhenae Rhizoma) (stir-fried, 4 qian), Zhi Shi (Immature Bitter Orange Fruit) (bran-stir-fried), Ban Xia (Pinelliae Rhizoma) (soaked), Huang Lian (Coptidis Rhizoma) (stir-fried. Each 5 qian), Huang Qin (Scutellariae Radix) (stir-fried, 1 liang 2 qian), Hou Po (Magnoliae Officinalis Cortex) (ginger-stir-fried, 1 liang).
Grind the above into fine powder. Soak steamed cake made from water in water, form pills the size of paulownia seeds. Take 100 pills per dose, washed down with cooked plain warm water, taken long after meals.
For cold distension where the patient dislikes food, the method of warming and dispersing should be used.
Xiang Po Tang (Costus and Magnolia Decoction): Treats elderly patients with Cold invasion and Lower Deficiency, causing heart and abdominal distension, dislike of food, and a floating, slow, and weak pulse. This is named Cold Distension.
Hou Po (Magnoliae Officinalis Cortex) (ginger-stir-fried, 1 liang), Da Fu Zi (Aconiti Lateralis Radix Praeparata) (processed, remove skin and navel, 7.5 qian), Mu Xiang (Aucklandiae Radix) (3 qian).
Grind the above into coarse powder. For one dose, add seven slices of fresh ginger and one jujube, decoct with water and take orally.
If abdominal distension is formed by coagulation and accumulation of Qi and Blood, the method of direct attack should be used exclusively.
Si Chao Zhi Qiao Wan (Four-Stir-Fried Aurantium Pill): Treats Qi and Blood stagnation, drum-like abdominal distension and accumulations. This medicine relaxes the middle, clears the diaphragm, smooths Qi, and aids digestion.
Zhi Qiao (Aurantii Fructus) (4 liang, soaked in rice wash water, remove pulp and slice, divide into four parts for stir-frying:): One part (boiled dry with 1 liang of Cang Zhu, stir-fried to yellow, remove Cang Zhu), One part (boiled dry with 1 liang of Luo Bo Zi, stir-fried to yellow, remove Luo Bo Zi), One part (boiled dry with 1 liang of Xiao Hui Xiang, stir-fried to yellow, remove Hui Xiang), One part (boiled dry with 1 liang of Gan Qi, stir-fried to yellow, remove Gan Qi), Xiang Fu (Cyperi Rhizoma) (2 liang), Bing Lang (Arecae Semen) (1 liang), Yuan Hu Suo (Corydalis Rhizoma) (1 liang, lightly stir-fried), San Leng (Sparganii Rhizoma) (2 liang, processed same as E Zhu), E Zhu (Curcumae Rhizoma) (1 liang, soak San Leng and E Zhu in one cup of child's urine overnight, next day boil dry with 30 peeled Ba Dou kernels, stir-fry to yellow, remove beans).
Grind the above into fine powder. Use the decoction of Cang Zhu, Hui Xiang, Luo Bo Zi, and Gan Qi, add one bowl of good vinegar, mix with flour paste to form pills the size of paulownia seeds. Take 70 pills per dose, washed down with clear rice soup.
If abdominal distension is caused by Qi, the method of smoothing Qi should be used. Fen Xin Qi Yin (Dividing Heart Qi Decoction) (formula see under Various Qi disorders). According to this formula, if water qi edema is caused by Qi, add Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Che Qian (Plantaginis Semen), Ting Li (Lepidii Semen), Mu Gua (Chaenomelis Fructus), Mai Men Dong (Ophiopogonis Radix).
Jin Ling Jiu Wan (Jinling Wine Pill): Treats drum swelling.
Zhen Chen Xiang (True Aquilariae Lignum Resinatum) (1 liang), Ya Zao (Gleditsiae Sinensis Spina) (1 liang), Guang Mu Xiang (Aucklandiae Radix) (2.5 liang), Bing Lang (Arecae Semen) (1 liang).
Grind the above into powder. Form pills using Nanjing distilled liquor. Take 3 qian per dose, 4 qian for severe cases, washed down with distilled liquor at the fifth watch (early morning). For edema, water exits via urination; for Qi distension, flatulence occurs; for Water distension, add Ku Ting Li (5 qian), decoct, and take with wine followed by another dose.
Jin Chan San (Golden Toad Powder): Treats Qi distension with divine efficacy.
Take one large toad membrane, push Sha Ren (Amomi Fructus Rotundus) into its mouth so it swallows it into its belly until full. Seal in a clay pot, roast over charcoal until red and smoke-free. Remove, cool, remove mud, grind into powder for one dose. Take with wine or Chen Pi (Citri Reticulatae Pericarpium) decoction. Efficacy is seen when the patient passes much gas.
Kuan Zhong Yang Wei Tang (Widen the Middle and Nourish the Stomach Decoction): Treats chest and diaphragm fullness and reduced appetite.
Cang Zhu (Atractylodis Rhizoma) (stir-fried, 4 fen), Xiang Fu (Cyperi Rhizoma) (7 fen), Zhi Qiao (Aurantii Fructus) (bran-stir-fried, 5 fen), Hou Po (Magnoliae Officinalis Cortex) (ginger-stir-fried, 5 fen), Huo Xiang (Agastaches Herba) (5 fen), Shan Zha (Crataegi Fructus) (3 fen), Chen Pi (Citri Reticulatae Pericarpium) (1 qian), Sha Ren (Amomi Fructus Rotundus) (3 fen, fine powder), Shen Qu (Massa Medicata Fermentata) (stir-fried, 4 fen), Bing Lang (Arecae Semen) (3 fen), Mai Ya (Hordei Fructus Germinatus) (stir-fried, 4 fen), Qing Pi (Citri Reticulatae Pericarpium Viride) (remove pulp, 3 fen), Zhi Shi (Immature Bitter Orange Fruit) (bran-stir-fried, 4 fen), Ban Xia (Pinelliae Rhizoma) (5 fen), Fu Ling (Poria) (5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (prepared, 3 fen).
Grind the above into coarse powder. For one dose, add three slices of fresh ginger and one jujube, decoct with water, and take long after meals.
Li Heshan, a scholar from Chunyuan, suffered from a lump on the left side of his abdomen for several years without cure. Later, after eating too many Pai Bing (pastries), he developed abdominal distension and stuffiness. I diagnosed his six pulses as surging and rapid, with the Qi Kou pulse being tight and vigorous. I prescribed Huo Xiang Zheng Qi San (Agastache Rectifying Qi Powder) plus Shan Zha (Crataegi Fructus) and Shen Qu (Massa Medicata Fermentata). He recovered after two doses. Over a month later, due to irregular diet, his abdominal distension returned as before. I again prescribed Zheng Qi San for several doses, but it was ineffective. I then changed to Xing Shi Bu Qi Yang Xue Tang (Moisture-Driving, Qi-Nourishing, and Blood-Supplementing Decoction) for over twenty doses before he stabilized. I advised him: Although the illness has healed, your constitution has not fully recovered. You must strictly observe precautions and avoid forbidden foods. Several months later, he passed by me and said: All illnesses are destined by Heaven. They depend neither on taking medicine nor on strict observation. Did Yan Hui and Meng Ke (the Sage) not know how to preserve their health? Why did they die young? I have preserved my health for half a year and see no difference. Is preservation and medicine really necessary? I could not answer him, and he became reckless and unbridled. Within a few weeks, he suddenly suffered from dysentery with red and white stools, tenesmus, unbearable pain day and night. He prepared a dose of Da Huang (Rhei Radix et Rhizoma) himself. Multiple purgations were ineffective. He sought my diagnosis again. His six pulses were surging and rapid. I first prescribed Tiao Zhong Li Qi Tang (Regulate the Middle and Smooth Qi Decoction) for two doses, then Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) plus Bai Shao (Paeoniae Radix Alba) and Huang Lian (Coptidis Rhizoma), with slight effect. Desiring quick results, he switched to another doctor. That doctor did not examine the root cause. Having previously suffered from internal injury drum distension, the doctor repeatedly used purgative drugs. When it didn't work, he switched to yet another doctor who also used purgatives. In total, about thirty times, his Primordial Qi became increasingly exhausted and sank downward. His anus felt like it was being cut by a knife, and his abdomen was distended like a drum. However, the doctors did not realize that the Primordial Qi had sunk; the deeper the sinking, the deeper the pain. The treatment should focus on greatly tonifying Primordial Qi and lifting it up, requiring no less than a hundred doses. Now, for someone whose Primordial Qi was already damaged, seeking quick results is impossible. Alas! The doctor tonified instead of purged, but here the doctor purged instead of tonifying; the patient was careless and desired quick results. How could he not die? It is indeed a double error.
Supplementary Prescriptions
Hua Long Dan (Dragon Transforming Pellet): Treats single abdominal distension.
Use one large carp and forty Ba Dou (Crotonis Semen). Gut the fish, make two cuts along the fish spine, place the Ba Dou between the cuts, wrap in paper, and slowly cook until done. Remove the beans and eat the fish, washed down with rice soup.