(腹疳见疳积门。此症由脾胃虚气攻而作也)
消胀散(此方治儿胀之圣剂。累试辄效)
萝卜子 苏梗 干葛(各七分) 陈皮 白术 枳壳(麸炒) 甘草(各五分)
如气虚,加人参二、三分。
如气急,加苏子、葶苈子各五分,沉香三分。去白术(盖白术能闭气故也)。
如引饮,倍入干葛,加天麻粉七分。
如发热,加山栀子(炒)、黄连(酒炒)、前胡各五分。
如泄泻,加白芍药(酒炒)、砂仁(碎炒)各五分,木香三分。
如小便不通,加木通(去节,一钱)、滑石(五分)。
如饮食停滞,去白术加神曲、山楂肉(姜炒)各五分。
如恶寒手足冷,加官桂五分。
如腰上浮肿,加藿香五分。
如腰下浮肿,加牛膝五分、黄柏(炒,三分)。
如胁痛面黑(是气鼓),去白术加青皮五分。
如胁满,小腹胀痛,身上有血线(是血鼓),加当归、芍药(酒炒)各七分,牡丹皮、红花各三分,去白术。
如嗳气作酸,饱闷腹胀(是食鼓),加山楂肉(炒)、神曲(姜炒)、半夏(炒)各七分,去白术。
如饱腹胀满,有块如鼓(是痞鼓),加山楂肉(炒)、神曲、半夏(炮,姜炒)、当归尾、鳖甲、山枣仁、玄胡索
(醋炒)各七分,青皮三分,去白术。
如因胎肿,毒瓦斯入腹成胀,加连翘、牛蒡子、荆芥穗、茹片各七分。
如因疟母成胀,加柴胡、鳖甲、玄胡索(醋炒)各七分,槟榔、浓朴(姜炒)各三分。
如触湿成胀,加木通(去节,一钱),苍术(七分),泽泻(五分)。
如疳积成胀,加山楂肉(炒)、神曲(姜炒)各七分,黄连(姜炒)、青皮各五分。
如气郁成胀,加香附子(便炒)、浓朴(姜炒)各七分。
凡浮胀,总作虚治之,以参、术为君,陈皮、茯苓为臣,黄芩、麦门冬为使,少加浓朴、大腹皮,以消胀气。气
陷,加升麻、柴胡各三分,提之为妙,以治肿胀之大经大法也。
如虚胀,胡椒、全蝎各四十九个作末,糊丸粟米大,米饮下七、八丸,名榻气丸。
如头热腹胀而足冷者,脾风之候,补脾益真汤主之。
如形瘦腹饱,青络满腹者,脾疳也,肥儿丸主之。
(腹疳的症状在“疳积门”中已有记载。此症是由于脾胃虚弱,气机攻冲而引发的。)
萝卜子、苏梗、干葛(各七分),陈皮、白术、枳壳(用麦麸炒制)、甘草(各五分)。
如果气急,加入苏子、葶苈子各五分,沉香三分。去掉白术(因为白术能闭塞气机)。
如果泄泻,加入白芍药(酒炒制)、砂仁(捣碎后炒制)各五分,木香三分。
如果腰部以上浮肿,加入藿香五分。
如果胁部胀满,小腹胀痛,身上有血线(这是血鼓证),加入当归、芍药(酒炒制)各七分,牡丹皮、红花各三分,去掉白术。
如果嗳气带酸味,饱闷腹胀(这是食鼓证),加入山楂肉(炒制)、神曲(姜炒制)、半夏(炒制)各七分,去掉白术。
如果饱胀腹满,腹部有块状物如鼓(这是痞鼓证),加入山楂肉(炒制)、神曲、半夏(炮制,姜炒制)、当归尾、鳖甲、山枣仁、玄胡索(醋炒制)各七分,青皮三分,去掉白术。
如果是因胎肿,毒瓦斯进入腹部导致腹胀,加入连翘、牛蒡子、荆芥穗、茹片各七分。
如果是因疟母(疟疾形成的痞块)导致腹胀,加入柴胡、鳖甲、玄胡索(醋炒制)各七分,槟榔、浓朴(姜炒制)各三分。
如果是因触湿导致腹胀,加入木通(去节,一钱),苍术(七分),泽泻(五分)。
如果是因疳积导致腹胀,加入山楂肉(炒制)、神曲(姜炒制)各七分,黄连(姜炒制)、青皮各五分。
如果是因气郁导致腹胀,加入香附子(便炒制)、浓朴(姜炒制)各七分。
凡是浮胀,总按虚证治疗,以人参、白术为君药,陈皮、茯苓为臣药,黄芩、麦门冬为使药,少量加入浓朴、大腹皮,以消除胀气。如果气陷,加入升麻、柴胡各三分,提升气机为妙,这是治疗肿胀的大法。
(Abdominal Gan [Pediatric Malnutrition Syndrome] is described in the "Gan Accumulation Section." This syndrome arises from Spleen and Stomach deficiency, with Qi attacking and causing distension.)
Xiaozhang San (Dispel Distraction Powder) (This prescription is a sacred remedy for treating pediatric abdominal distension; it has proven effective in repeated trials.)
Radish Seed (Lai Fuzi), Perilla Stem (Sugeng), Kudzu Root (Gegen) (each 0.7 fen), Tangerine Peel (Chenpi), Atractylodes Macrocephala Rhizome (Baizhu), Bitter Orange (Zhiqiao) (stir-fried with bran), Licorice Root (Gancao) (each 0.5 fen).
If Qi deficiency is present, add Ginseng Root (Renshen) 2–3 fen.
If there is急促 breathing (Qi urgency), add Perilla Seed (Suzi) and Lepidium Seed (Tinglizi) each 0.5 fen, and Agarwood (Chenxiang) 0.3 fen. Remove Atractylodes Macrocephala Rhizome (Baizhu) (because Baizhu can obstruct Qi flow).
If there is excessive thirst and drinking, double the amount of Kudzu Root (Gegen) and add Gastrodia Tuber powder (Tianma Fen) 0.7 fen.
If fever is present, add Gardenia Fruit (Shanzhizi) (stir-fried), Coptis Rhizome (Huanglian) (wine-stir-fried), and Peucedanum Root (Qianhu) each 0.5 fen.
If diarrhea occurs, add White Peony Root (Baishaoyao) (wine-stir-fried) and Amomum Fruit (Sharen) (crushed and stir-fried) each 0.5 fen, and Aucklandia Root (Muxiang) 0.3 fen.
If urination is obstructed, add Akebia Caulis (Mutong) (nodes removed, 1 qian) and Talcum (Huashi) 0.5 fen.
If food stagnation is present, remove Atractylodes Macrocephala Rhizome (Baizhu) and add Medicated Leaven (Shenqu) and Hawthorn Flesh (Shanzha Rou) (ginger-stir-fried) each 0.5 fen.
If there is aversion to cold and cold hands and feet, add Cassia Bark (Guangui) 0.5 fen.
If edema is above the waist, add Agastache Herb (Huoxiang) 0.5 fen.
If edema is below the waist, add Achyranthes Root (Niuxi) 0.5 fen and Phellodendron Bark (Huangbai) (stir-fried, 0.3 fen).
If there is hypochondriac pain and dark complexion (indicating Qi Drum syndrome), remove Atractylodes Macrocephala Rhizome (Baizhu) and add Green Tangerine Peel (Qingpi) 0.5 fen.
If there is fullness in the hypochondrium, lower abdominal distension and pain, and blood lines on the body (indicating Blood Drum syndrome), add Angelica Sinensis Root (Danggui) and White Peony Root (Shaoyao) (wine-stir-fried) each 0.7 fen, Moutan Cortex (Mudanpi) and Safflower (Honghua) each 0.3 fen, and remove Atractylodes Macrocephala Rhizome (Baizhu).
If there is belching with sour taste, bloating and abdominal distension (indicating Food Drum syndrome), add Hawthorn Flesh (Shanzha Rou) (stir-fried), Medicated Leaven (Shenqu) (ginger-stir-fried), and Pinellia Tuber (Banxia) (stir-fried) each 0.7 fen, and remove Atractylodes Macrocephala Rhizome (Baizhu).
If there is bloating and abdominal fullness with mass-like hardness like a drum (indicating Pi Drum syndrome), add Hawthorn Flesh (Shanzha Rou) (stir-fried), Medicated Leaven (Shenqu), Pinellia Tuber (Banxia) (processed, ginger-stir-fried), Angelica Sinensis Root Tail (Danggui Wei), Softshell Turtle Shell (Biejia), Ziziphus Seed (Shanzao Ren), and Corydalis Rhizome (Yanhusuo) (vinegar-stir-fried) each 0.7 fen, Green Tangerine Peel (Qingpi) 0.3 fen, and remove Atractylodes Macrocephala Rhizome (Baizhu).
If distension results from fetal edema where toxic vapors enter the abdomen, add Forsythia Fruit (Lianqiao), Arctium Seed (Niubangzi), Schizonepeta Spike (Jingjiesui), and Ru Pian each 0.7 fen.
If distension results from malaria mass (Nuomu), add Bupleurum Root (Chaihu), Softshell Turtle Shell (Biejia), and Corydalis Rhizome (Yanhusuo) (vinegar-stir-fried) each 0.7 fen, Areca Seed (Binglang), and Magnolia Bark (Noupu) (ginger-stir-fried) each 0.3 fen.
If distension results from exposure to dampness, add Akebia Caulis (Mutong) (nodes removed, 1 qian), Atractylodes Rhizome (Cangzhu) 0.7 fen, and Alisma Rhizome (Zexie) 0.5 fen.
If distension results from Gan accumulation, add Hawthorn Flesh (Shanzha Rou) (stir-fried) and Medicated Leaven (Shenqu) (ginger-stir-fried) each 0.7 fen, Coptis Rhizome (Huanglian) (ginger-stir-fried), and Green Tangerine Peel (Qingpi) each 0.5 fen.
If distension results from Qi depression, add Cyperus Rhizome (Xiangfu Zi) (urine-stir-fried) and Magnolia Bark (Noupu) (ginger-stir-fried) each 0.7 fen.
For all floating distensions, treat generally as deficiency: use Ginseng Root (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) as Sovereign herbs, Tangerine Peel (Chenpi) and Poria (Fuling) as Minister herbs, Scutellaria Root (Huangqin) and Ophiopogon Tuber (Maimendong) as Envoy herbs, with small amounts of Magnolia Bark (Noupu) and Areca Peel (Dafupi) to dissipate Qi distension. If Qi sinks, add Cimicifuga Rhizome (Shengma) and Bupleurum Root (Chaihu) each 0.3 fen to lift it; this is the fundamental principle for treating swelling and distension.
For deficiency-type distension, grind Pepper (Hujiao) and Scorpion (Quanxie), 49 of each, into powder, make pills with paste the size of millet seeds, and take 7–8 pills with rice water; this is named Taqi Wan.
If there is heat in the head, abdominal distension, and cold feet, this is a sign of Spleen Wind; treat primarily with Bupi Yizhen Tang (Tonify Spleen and Benefit True Decoction).
If the body is emaciated but the abdomen is full, with green veins covering the abdomen, this is Spleen Gan; treat primarily with Fei'er Wan (Fatten Child Pill).