论
《内经》曰∶诸湿肿满，皆属于脾。又曰，诸腹胀大，皆属于热。夫脾虚不能制水，水渍妄行，故通身面目手足皆
浮而肿，名曰水肿。或腹大如鼓，而面目四肢不肿者，名曰胀满，又名鼓胀。皆脾土湿热为病，肿轻而胀重也。丹溪曰∶
心肺阳也，居上；肾肝阴也，居下；脾居中，亦阴也，属土。经曰∶饮食入胃，游溢精气，上输于脾，脾气散精，上归
于肺，通调水道，下输膀胱，水精四布，五精并行。是脾具坤静之德，而有干健之运，故能使心肺之阳降，肾肝之阴升，
而成天地交之泰，是为平人。今也七情内伤，六淫外侵，饮食不节，房劳致虚，脾土之阴受伤，转输之官失职，胃虽受
谷，不能运化，故阳自升、阴自降，而成天地不交之否，清浊相混，隧道壅塞，湿郁为热，热又生湿，湿热相生，遂成
胀满，经曰鼓胀是也。以其外虽坚满，中空无物，有似于鼓，胶固难治。又曰蛊者，若虫侵蚀，有蛊之义。理宜补脾，
又须养肺以制木，使脾无贼邪之虑，滋肾以制火，使肺得清化之令，却盐味以防助邪，断妄想以保母气，远音乐，戒暴
怒，无有不安。医者不察，急于获效；病者苦于胀满，喜行利药，以求通快。殊不知宽得一日、二日，复胀愈甚，真气
已伤，去死不远矣。俗谓气无补法者，以其痞满壅塞，似难于补。不思正气虚而不能营运，邪滞着而不出，所以为病。
经曰∶壮者气行则愈，怯者着而成病。气虚不补，邪由何退，病何由安。且此病之起，固非一年，根深蒂固，欲取速效，
自取祸耳，知王道者，可与语此。其或受病之浅，脾胃尚壮，积滞不固者，惟可略与疏导，而不可峻与利药也。
愚按∶先生此论，详明殆尽，诚千古不易之定议也。及视东垣胀满论，又以脏寒生满病立说，引脉经胃中寒则胀满
之语以为之证。愚恐南北风土寒热不同，难以一途而论。虽然，愚尝以丹溪法活人多矣，是以东垣之论，不与吻合，故
不敢采取其言，以为后人之惑也。
脉法
《针经》曰∶其脉大坚以涩者，胀也。
《脉经》曰∶关上脉虚则内胀。迟而滑者胀。脉盛而紧者胀。虚而紧涩者胀。或弦而迟，或浮而数，皆胀也。
丹溪曰∶水肿脉多沉伏。病阳水兼阳证，脉必沉数。病阴水兼阴证，脉必沉迟。烦渴，小便赤涩，大便秘结，此为
阳水。不烦渴，大便溏，小便少而不赤涩，此为阴水。脉沉而滑，为风水。脉浮而迟，弦而紧，皆为肿也。
水病，腹大如鼓，脉实者生，虚者死，洪大者生，微细者死。腹胀便血，脉大时绝，剧；脉小疾者，死。中恶，腹
大四肢肿，脉大而缓者生，浮而紧者死。紧而荣卫俱绝，面浮肿者死。唇肿齿焦者死。卒唇肿、面苍黑者死。掌肿无纹
者死。脐肿凸出者死。缺盆平者死。阴囊茎俱肿者死。脉绝口张足肿者死。足趺肿、膝如斗者死。
方法
丹溪曰∶古方惟禹余粮丸，制肝补脾，殊为切当，然亦须随时随证加减。一友人得胀疾，自制此药服之。予曰∶温
热药多，且 炼之火尚存，宜自加减。彼不听，服之一月，口鼻出血，骨立而死。
朝宽暮急，血虚；暮宽朝急，气虚；朝暮急，气血俱虚。
治肿胀，大法宜补中行湿利小便，以人参、白术为君，苍术、陈皮、茯苓为臣，黄芩、麦门冬为使以制肝木，少加
浓朴以消腹胀，气不运加木香、木通，气下陷加升麻、柴胡提之，血虚加补血药，痰盛加利痰药，随证加减用之，无不
效者。
《卢氏医镜》以水肿隶于肾肝胃而不及脾，又肺金盛而生水，水溢妄行，岂理也哉。夫脾土受病，肺为之子，固不
能自盛而生水。然肺金气清而能生水，则滋长肾阴，奉行降令，为生化之源，何病肿之有。今为肿之水，乃腐浊之气，
渗透经络，流注溪谷，灌入隧道，血亦因之而化水。欲借脾土以制之，通肾气以利之，殊不知脾病则金气衰，木寡于畏
而来侮土，脾欲不病不可得矣。治法宜清心经之火，补养脾土，全运化之职，肺气下降，渗道开通，其精气之稍清者，
复回而为气为血为津液，其败浊之甚者，在上为汗，在下而为溺，以渐而分消矣。
腰以上肿者宜发汗，腰以下肿者宜利小便，此仲景之法。
东垣曰∶宜以辛散之，以苦泻之，以淡渗利之，使上下分消其湿，正所谓开鬼门、洁净府。开鬼门者，谓发汗也；
洁净府者，利小便也。
产后浮肿，必大补气血，少佐以苍术、茯苓，使水自降，大剂白术补脾。壅满者，用半夏、陈皮、香附监之。有热，
当清肺金，麦门冬、黄芩之属。
热水肿，用山栀子仁炒为末，米饮调下三、五钱。若胃脘热、病在上者，连壳用。
（以上丹溪方法凡八条）
禹余粮丸（局方） 治中满气胀喘满及水气胀。
蛇含石（三两， ） 针砂（五钱） 禹余粮（三两，同针砂炒）
以上三味为主，其次量人虚实，入下项药。
木香 牛膝 蓬莪术 白蒺藜 桂心 川芎 茴香 白豆蔻 三棱 羌活 茯苓 干姜 青皮 陈皮 附子（炮）
当归（各五钱）
上为末，汤浸蒸饼为丸，如梧桐子大，每服五十丸，空心温酒下。
矩三和汤（局方）
陈皮（去白） 紫苏 甘草（炙，各七分） 浓朴（姜制） 槟榔 白术（各一钱） 海金砂（四分） 木通（二
分）
上细切，作一服，加生姜三片，水煎服。
紫苏子汤（济生）
专治优虑过度，致伤脾肺，心腹胀满喘促。治肠鸣气走，漉漉有声，大小便不利，脉虚而紫涩。
紫苏子（一钱，研） 白术（二钱） 人参（一钱） 大腹皮（酒洗净） 草果仁 半夏 浓朴 木香 陈皮 枳
壳（麸炒黄色） 甘草（炙，各五分）
上细切，作一服，加生姜三片，大枣一枚，水煎温服。
木香顺气汤（东垣） 治浊气在上，则生 胀。
木香（三分） 浓朴（四分） 青皮 陈皮 益智 茯苓 泽泻 干生姜 半夏（各二分） 吴茱萸（汤泡二分） 川
归（五分） 升麻 柴胡（各一分） 草豆蔻（三分） 苍术（五分） 白术（一钱）
上细切，作一服，水二盏，煎至一盏，温服。
中满分消丸（东垣） 治中满，鼓胀气胀，水胀热胀。
黄芩（去朽，细切。酒拌炒二次，六钱） 黄连 枳实（麸炒黄色） 半夏（汤炮七次，去皮脐，各五钱） 姜黄 白
术人参（各二钱五分） 甘草（炙） 猪苓（去黑皮，各一钱） 干生姜 白茯苓 砂仁（各二钱） 浓朴（姜制，
五钱） 知母（去毛，酒炒） 泽泻 陈皮（去白，各三钱）
上为细末，蒸饼糊丸，如梧桐子大，每服百丸焙热，白汤或淡姜汤下。
广术溃坚汤（东垣） 治中满腹胀，内有积块坚硬如石，令人坐卧不宁，二便涩滞，上气喘促或通身虚肿。
浓朴（姜制） 黄芩 黄 连 益智 草豆蔻 当归（各五分） 半夏（七分） 广术 升麻 红花 吴茱萸（各
二
分） 生甘草 柴胡 泽泻 神曲（炒） 青皮 陈皮（各三分） 渴加干葛（四分）
上细切，作一服，加生姜三片，水二盏，煎七分，温服食远。忌酒、醋、湿面。二服之后，中满减半，止有积块未
消，再服后药。
半夏浓朴汤
红花 苏木（各半分） 木香 青皮（各二分） 吴茱萸 干生姜 黄连（各一分） 肉桂 苍术 白茯苓 泽泻 柴
胡陈皮 生黄芩 草豆蔻（面裹煨） 生甘草（各三分） 京三棱 当归梢 猪苓 升麻（各四分） 神曲（炒，六
分） 浓朴（姜制八分） 半夏（汤泡，三钱） 桃仁（七个，去皮尖，研如泥） 昆布（五分） 如渴加干葛（三分）
上细切，作一服，水三盏，煎至一盏，稍热服。服此药二帖之后，前证又减一半，却于前药中加减服之。
破滞气汤（一名木香化滞散。东垣） 破滞气，心腹满闷。
甘草（炙一分） 白檀香 藿香 陈皮 大腹子 白豆蔻 白茯苓 桔梗（各二分） 砂仁 人参 青皮 槟榔 木
香姜黄 白术（各四分）
上细切，作一服，水一盏半，煎至一盏，去渣温服，不拘时候。
草豆蔻汤（东垣） 治腹中虚胀。
泽泻（一分） 木香（三分） 神曲（四分） 半夏（泡） 枳实（麸炒） 草豆蔻 黄 （春夏不用） 益智 甘
草（各五分） 青皮 陈皮（各六分） 茯苓 当归（各七分）
上细切，作一服，加生姜三片，水二大盏，煎至一盏，温服。冬月加黄 五、七分，春夏止服正药，食远温服。
葶苈木香散（河间） 治湿热内外甚，水肿腹胀，小便赤涩，大便滑泄。此药，下水湿、消肿胀、止泻、利小
便
之圣药也。
葶苈子 茯苓（去皮） 猪苓（去白） 白术（各二钱五分） 木香（五分） 泽泻 木通 甘草（各五钱） 辣
桂（二钱五分） 白滑石（三两）
上为细末，每服三钱，白汤调下，食前服。
白术木香散（河间） 治喘嗽肿满，欲变成水病者，不能卧，不敢多食，小便闭而不通者。
白术 木猪苓（去皮） 甘草 泽泻 木通 赤茯苓（各五分） 木香 槟榔（各三分） 陈皮（去白，二钱） 官
桂（二分） 滑石（二钱）
上细切，作一服，加生姜三片，水一盏半，煎至一盏，温服。
二气散（河间） 治水气蛊胀满闷。
白丑 黑丑（各二钱）
上为细末，外用大麦面四两，同一处拌匀做烧饼，临卧用茶清一盏下，降气为验。
牵牛丸（河间） 治一切湿热肿满等证。
大黄 黑丑 椒目 黄芩 滑石（各等分）
上为细末，酒煮面糊为丸，如梧桐子大，每服五丸至七丸，生姜汤下，食后服，看虚实加减丸数。
三花神 丸（河间） 治中满腹胀，喘嗽淋 ，一切水湿肿满、湿热肠垢、陈积变生诸疾，久病不已，黄瘦困
倦，
气血壅滞，不得宣通，或风热燥郁，肢体麻痹，走注疼痛，风痰涎嗽，头目眩运，疟疾不已， 瘕积聚，坚满痞闷，酒
积食积，一切痰饮呕逆，及妇人经病不快，带下淋沥，无问赤白，并男妇伤寒湿热，腹满实痛，久新瘦弱，俗不能辨，
兼治新旧腰痛，并一切下痢，及小儿惊疳积热，乳癖腹满，并宜服之。
甘遂 大戟 芫花（醋拌湿炒，各五钱） 黑丑（二两，取头末一两净） 大黄（一两） 轻粉（一钱，另包不研）
上为细末，同轻粉拌匀，滴水为丸，如小豆大，初服五丸，每服加五丸，温水下，日三服，加至快利为度。利后却
又常服，病去乃止。设病愈后，惟老弱久病虚人勿服，平人常服保养，宜通气血，消进饮食。病痞闷极甚者，便多服则
顿攻不开，转加痛闷，宜初服二丸，每服加二丸，至快利为度，以意消息。小儿丸如麻子大，随强弱大小，增减丸数，
三、四岁者三、四丸，根据前法服。
宣明鸡屎醴饮（词出《素问》腹中论。河间） 治鼓胀，旦食则不能暮食，痞满壅塞难当。
大黄 桃仁（去皮） 干鸡屎
上各等分，为细末，每服二钱，水一盏，生姜三片，煎汤调下，食远临卧服。
（丹溪活套）云∶凡腹胀，须用姜制浓朴。肥人腹胀，必用利湿，苍术、茯苓、滑石、海金砂之类。色白人腹胀，
必是气虚，用人参、白术、白茯苓之类。瘦人腹胀是热，必用黄连、黄芩、栀子、浓朴之类。如因有故蓄血而腹胀者，
用桃仁、红花，甚者用抵当汤丸之类。如因食积而腹胀者，保和丸加木香、槟榔、阿魏之类。有热郁而胀者，木香槟榔
丸之类下之。有寒积郁结而胀者，局方丁香脾积丸、东垣三棱消积丸之类。如因外寒郁内热而腹胀者，用藿香、官桂、
升麻、干葛之类。如因多怒郁气而胀者，宜用苍术、抚芎、香附、青皮、芍药、柴胡，及龙荟丸之类。凡腹胀，初得是
气胀，宜行气疏导之剂，木香、槟榔、枳壳、青皮、陈皮、浓朴之类。久则成水胀，宜行湿利水之剂。
（祖传方）
鸡屎醴 治鼓胀、气胀、水胀等证。
羯鸡屎（一升）
上一味，研细炒焦色，地上出火毒，再研极细，百沸汤三升淋汁，每服一大盏，调木香、槟榔末各一钱，日三服，
空腹服，以平为期。
又方 治肿胀，或通身水肿，或腹大坚满。
三棱 莪术（各用醋炒） 陈皮（去白） 青皮 砂仁 羌活 防己 泽泻 连翘 槟榔（各三钱） 甘遂（二钱
五分） 椒目 木香 干漆（炒烟尽，各一钱） 白丑 黑丑（各二两，取头末九钱） 大黄（八钱） 双头连（三钱）
上研为细末，面糊为丸，如梧桐子大，每服三钱重，空心温酒送下，以利为度，病退即止药。忌甘草、菘菜、盐酱。
桃奴丸 治妇人或室女月经不通，渐成胀满，及男子坠马，跌扑损伤，以致瘀血停积，成血蛊病，皆能治之。
桃奴（桃树上干朽嫩桃也。十二月收用） 玄胡索 鼠粪（两头尖者是雄鼠粪也） 香附子 官桂 五灵脂 砂
仁桃仁（去皮尖，各等分）
上为末，每服三钱，温酒调下。
（医案）
予族八一兄，素能饮酒，年五十，得肿胀病，通身水肿，腹胀尤甚，小便涩而不利，大便滑泄，召予治。予曰∶若
论
《黄帝内经》说：各种湿邪导致的肿胀和腹满，都归属于脾。又说，各种腹部胀大，都归属于热。脾虚不能制约水液，水液浸渍妄行，所以全身、面目、手足都浮肿，名叫水肿。或者腹部像鼓一样大，而面目四肢不浮肿的，名叫胀满，又名叫鼓胀。这都是脾土湿热引起的疾病，肿较轻而胀较重。朱丹溪说：心和肺属阳，居于上部；肾和肝属阴，居于下部；脾居于中部，也属阴，五行属土。经书说：饮食进入胃中，游溢精气，向上输送到脾，脾气散布精微物质，向上归于肺，通调水道，向下输送到膀胱，水精四布，五脏之精并行。这说明脾具有坤卦静止的美德，同时具备乾卦健运的功能，所以能使心肺的阳气下降，肾肝的阴气上升，从而形成天地交泰的和谐状态，这就是健康的人。如今七情内伤，六淫外侵，饮食不节制，房劳导致虚弱，脾土的阴气受伤，负责转输的器官失职，胃虽然受纳谷物，但不能运化，所以阳气自升、阴气自降，形成天地不交的闭塞状态，清浊之气相混，经络隧道壅塞，湿气郁结化为热，热又生湿，湿热相生，于是形成胀满，这就是经书所说的鼓胀。因为它外表虽然坚硬胀满，内部中空无物，形状像鼓，胶固难治。又说“蛊”字，像虫子侵蚀，有蛊毒的含义。治疗应当补脾，还需要养肺以制约肝木，使脾没有贼邪的忧虑，滋肾以制约心火，使肺得到清化的命令，戒除盐味以防助长邪气，断绝妄想以保护母气（脾为肺之母），远离音乐，戒除暴怒，没有不安稳的道理。医生不考察病情，急于求效；病人苦于胀满，喜欢使用泻利药物，以求通畅爽快。却不知道宽舒了一两天，复发时胀满更严重，真气已经受伤，离死不远了。世俗认为气病没有补法，是因为痞满壅塞，似乎难以进补。却不思考正气虚弱而不能营运，邪气滞留而不能排出，所以才生病。经书说：身体强壮的人，气行则痊愈；身体虚弱的人，邪气留着而成病。气虚不补，邪气从何退去，病从何安宁？况且这个病的起因，本来就不是一年，根深蒂固，想要取得速效，是自取祸患罢了，懂得王道治疗的人，才可以与他谈论此道。如果受病较浅，脾胃尚且强壮，积滞不牢固的，只可以稍微给予疏导，而不可以猛烈使用泻利药物。
我按语：先生这篇论述，详尽明白，确实是千古不变的定论。等到看李东垣关于胀满的论述，又以脏寒产生胀病立说，引用《脉经》中“胃中寒则胀满”的话作为证明。我担心南北风土寒热不同，难以用一种途径来论述。虽然如此，我曾使用丹溪的方法治愈很多人，因此东垣的论述，不与我的经验吻合，所以不敢采纳他的言论，以免迷惑后人。
脉法
《针经》说：脉象大、坚而且涩的，是胀病。
《脉经》说：关部脉虚则内部胀满。脉迟而滑的是胀。脉盛而紧的是胀。脉虚而紧涩的是胀。或者弦而迟，或者浮而数，都是胀病。
朱丹溪说：水肿的脉多沉伏。病属阳水兼阳证，脉必沉数。病属阴水兼阴证，脉必沉迟。烦渴，小便赤涩，大便秘结，这是阳水。不烦渴，大便溏薄，小便少而不赤涩，这是阴水。脉沉而滑，是风水。脉浮而迟，弦而紧，都是肿病。
水病，腹部大如鼓，脉实的能生，脉虚的死；脉洪大的能生，脉微细的死。腹胀便血，脉大时而间歇的，病重；脉小疾快的，死。中恶，腹部大四肢肿，脉大而缓的能生，脉浮而紧的死。脉紧而营卫俱绝，面部浮肿的死。嘴唇肿牙齿焦黑的死。突然嘴唇肿、面色苍黑的死。手掌肿没有纹路的死。肚脐肿凸出的死。锁骨上窝平陷的死。阴囊阴茎都肿的死。脉绝口张足肿的死。足背肿、膝盖像斗一样的死。
方法
朱丹溪说：古方只有禹余粮丸，能制肝补脾，非常恰当，但也必须随时随证加减。一个朋友得了胀病，自制此药服用。我说：温热药多，而且炼制的火候尚存，应该自行加减。他不听，服用一个月后，口鼻出血，骨瘦如柴而死。
早晨宽舒傍晚紧急，是血虚；傍晚宽舒早晨紧急，是气虚；早晚都紧急，是气血俱虚。
治疗肿胀，大法宜补中行湿利小便，以人参、白术为君药，苍术、陈皮、茯苓为臣药，黄芩、麦门冬为使药以制约肝木，稍加浓朴以消除腹胀，气不运行加木香、木通，气下陷加升麻、柴胡提升它，血虚加补血药，痰多加利痰药，随证加减使用，没有不有效的。
《卢氏医镜》将水肿归入肾肝胃而没有提到脾，又说肺金盛而生水，水溢妄行，这合乎道理吗？脾土受病，肺是它的子脏，固然不能自己旺盛而生水。然而肺金气清而能生水，就能滋长肾阴，奉行降令，成为生化之源，哪里有肿病的呢？现在的肿之水，乃是腐浊之气，渗透经络，流注溪谷，灌入隧道，血液也因此化为水。想借脾土来制约它，通肾气来利导它，却不知道脾病则金气衰，木气因缺乏畏惧而来侮犯脾土，脾想不生病也不可能了。治疗方法宜清心经之火，补养脾土，完全发挥运化职能，肺气下降，渗道开通，那些稍微清亮的精气，重新回转为气、血、津液，那些败浊严重的，在上变为汗，在下变为尿，逐渐分消。
腰以上肿的宜发汗，腰以下肿的宜利小便，这是张仲景的方法。
李东垣说：宜用辛散之，用苦泻之，用淡渗利之，使上下分消其湿，正所谓开鬼门、洁净府。开鬼门，就是发汗；洁净府，就是利小便。
产后浮肿，必须大补气血，稍佐以苍术、茯苓，使水自然下降，大剂量白术补脾。壅满的，用半夏、陈皮、香附监制它。有热的，当清肺金，用麦门冬、黄芩之类。
热水肿，用山栀子仁炒为末，米饮调服三、五钱。如果是胃脘热、病在上部的，连壳使用。
（以上丹溪方法共八条）
禹余粮丸（局方） 治疗中满气胀喘满及水气胀。
蛇含石（三两，煅） 针砂（五钱） 禹余粮（三两，同针砂炒）
以上三味为主，其次根据人的虚实情况，加入下列药物。
木香 牛膝 蓬莪术 白蒺藜 桂心 川芎 茴香 白豆蔻 三棱 羌活 茯苓 干姜 青皮 陈皮 附子（炮） 当归（各五钱）
以上研为末，汤浸蒸饼为丸，如梧桐子大，每服五十丸，空心温酒送下。
矩三和汤（局方）
陈皮（去白） 紫苏 甘草（炙，各七分） 浓朴（姜制） 槟榔 白术（各一钱） 海金砂（四分） 木通（二分）
以上细切，作一服，加生姜三片，水煎服。
紫苏子汤（济生）
专门治疗忧虑过度，致伤脾肺，心腹胀满喘促。治疗肠鸣气走，漉漉有声，大小便不利，脉虚而涩。
紫苏子（一钱，研） 白术（二钱） 人参（一钱） 大腹皮（酒洗净） 草果仁 半夏 浓朴 木香 陈皮 枳壳（麸炒黄色） 甘草（炙，各五分）
以上细切，作一服，加生姜三片，大枣一枚，水煎温服。
木香顺气汤（东垣） 治疗浊气在上，则生胀。
木香（三分） 浓朴（四分） 青皮 陈皮 益智 茯苓 泽泻 干生姜 半夏（各二分） 吴茱萸（汤泡二分） 川归（五分） 升麻 柴胡（各一分） 草豆蔻（三分） 苍术（五分） 白术（一钱）
以上细切，作一服，水二盏，煎至一盏，温服。
中满分消丸（东垣） 治疗中满，鼓胀气胀，水胀热胀。
黄芩（去朽，细切。酒拌炒二次，六钱） 黄连 枳实（麸炒黄色） 半夏（汤炮七次，去皮脐，各五钱） 姜黄 白术 人参（各二钱五分） 甘草（炙） 猪苓（去黑皮，各一钱） 干生姜 白茯苓 砂仁（各二钱） 浓朴（姜制，五钱） 知母（去毛，酒炒） 泽泻 陈皮（去白，各三钱）
以上为细末，蒸饼糊丸，如梧桐子大，每服百丸焙热，白汤或淡姜汤送下。
广术溃坚汤（东垣） 治疗中满腹胀，内有积块坚硬如石，令人坐卧不宁，二便涩滞，上气喘促或通身虚肿。
浓朴（姜制） 黄芩 黄连 益智 草豆蔻 当归（各五分） 半夏（七分） 广术 升麻 红花 吴茱萸（各二分） 生甘草 柴胡 泽泻 神曲（炒） 青皮 陈皮（各三分） 渴加干葛（四分）
以上细切，作一服，加生姜三片，水二盏，煎七分，温服食远。忌酒、醋、湿面。二服之后，中满减半，止有积块未消，再服后药。
半夏浓朴汤
红花 苏木（各半分） 木香 青皮（各二分） 吴茱萸 干生姜 黄连（各一分） 肉桂 苍术 白茯苓 泽泻 柴胡 陈皮 生黄芩 草豆蔻（面裹煨） 生甘草（各三分） 京三棱 当归梢 猪苓 升麻（各四分） 神曲（炒，六分） 浓朴（姜制八分） 半夏（汤泡，三钱） 桃仁（七个，去皮尖，研如泥） 昆布（五分） 如渴加干葛（三分）
以上细切，作一服，水三盏，煎至一盏，稍热服。服此药二帖之后，前证又减一半，却于前药中加减服之。
破滞气汤（一名木香化滞散。东垣） 破滞气，治疗心腹满闷。
甘草（炙一分） 白檀香 藿香 陈皮 大腹子 白豆蔻 白茯苓 桔梗（各二分） 砂仁 人参 青皮 槟榔 木香 姜黄 白术（各四分）
以上细切，作一服，水一盏半，煎至一盏，去渣温服，不拘时候。
草豆蔻汤（东垣） 治疗腹中虚胀。
泽泻（一分） 木香（三分） 神曲（四分） 半夏（泡） 枳实（麸炒） 草豆蔻 黄芪（春夏不用） 益智 甘草（各五分） 青皮 陈皮（各六分） 茯苓 当归（各七分）
以上细切，作一服，加生姜三片，水两大盏，煎至一盏，温服。冬月加黄芪五、七分，春夏只服正药，食远温服。
葶苈木香散（河间） 治疗湿热内外甚，水肿腹胀，小便赤涩，大便滑泄。此药，是下水湿、消肿胀、止泻、利小便的圣药。
葶苈子 茯苓（去皮） 猪苓（去白） 白术（各二钱五分） 木香（五分） 泽泻 木通 甘草（各五钱） 辣桂（二钱五分） 白滑石（三两）
以上为细末，每服三钱，白汤调下，食前服。
白术木香散（河间） 治疗喘嗽肿满，欲变成水病者，不能卧，不敢多食，小便闭而不通者。
白术 木猪苓（去皮） 甘草 泽泻 木通 赤茯苓（各五分） 木香 槟榔（各三分） 陈皮（去白，二钱） 官桂（二分） 滑石（二钱）
以上细切，作一服，加生姜三片，水一盏半，煎至一盏，温服。
二气散（河间） 治疗水气蛊胀满闷。
白丑 黑丑（各二钱）
以上为细末，外用大麦面四两，同一处拌匀做烧饼，临卧用茶清一盏送下，以降气为验。
牵牛丸（河间） 治疗一切湿热肿满等证。
大黄 黑丑 椒目 黄芩 滑石（各等分）
以上为细末，酒煮面糊为丸，如梧桐子大，每服五丸至七丸，生姜汤送下，食后服，看虚实加减丸数。
三花神丸（河间） 治疗中满腹胀，喘嗽淋沥，一切水湿肿满、湿热肠垢、陈积变生诸疾，久病不已，黄瘦困倦，气血壅滞，不得宣通，或风热燥郁，肢体麻痹，走注疼痛，风痰涎嗽，头目眩晕，疟疾不已，瘕聚积聚，坚满痞闷，酒积食积，一切痰饮呕逆，及妇人经病不快，带下淋沥，无问赤白，并男妇伤寒湿热，腹满实痛，久新瘦弱，俗不能辨，兼治新旧腰痛，并一切下痢，及小儿惊疳积热，乳癖腹满，并宜服之。
甘遂 大戟 芫花（醋拌湿炒，各五钱） 黑丑（二两，取头末一两净） 大黄（一两） 轻粉（一钱，另包不研）
以上为细末，同轻粉拌匀，滴水为丸，如小豆大，初服五丸，每服加五丸，温水送下，日三服，加至快利为度。利后却又常服，病去乃止。设病愈后，惟老弱久病虚人勿服，平人常服保养，宜通气血，消进饮食。病痞闷极甚者，便多服则顿攻不开，转加痛闷，宜初服二丸，每服加二丸，至快利为度，以意消息。小儿丸如麻子大，随强弱大小，增减丸数，三、四岁者三、四丸，根据前法服。
宣明鸡屎醴饮（词出《素问》腹中论。河间） 治疗鼓胀，旦食则不能暮食，痞满壅塞难当。
大黄 桃仁（去皮） 干鸡屎
以上各等分，为细末，每服二钱，水一盏，生姜三片，煎汤调下，食远临卧服。
（丹溪活套）说：凡腹胀，须用姜制浓朴。肥人腹胀，必用利湿，苍术、茯苓、滑石、海金砂之类。色白人腹胀，必是气虚，用人参、白术、白茯苓之类。瘦人腹胀是热，必用黄连、黄芩、栀子、浓朴之类。如因有故蓄血而腹胀者，用桃仁、红花，甚者用抵当汤丸之类。如因食积而腹胀者，保和丸加木香、槟榔、阿魏之类。有热郁而胀者，木香槟榔丸之类下之。有寒积郁结而胀者，局方丁香脾积丸、东垣三棱消积丸之类。如因外寒郁内热而腹胀者，用藿香、官桂、升麻、干葛之类。如因多怒郁气而胀者，宜用苍术、抚芎、香附、青皮、芍药、柴胡，及龙荟丸之类。凡腹胀，初得是气胀，宜行气疏导之剂，木香、槟榔、枳壳、青皮、陈皮、浓朴之类。久则成水胀，宜行湿利水之剂。
（祖传方）
鸡屎醴 治疗鼓胀、气胀、水胀等证。
羯鸡屎（一升）
以上一味，研细炒焦色，地上出火毒，再研极细，百沸汤三升淋汁，每服一大盏，调木香、槟榔末各一钱，日三服，空腹服，以平为期。
又方 治疗肿胀，或通身水肿，或腹大坚满。
三棱 莪术（各用醋炒） 陈皮（去白） 青皮 砂仁 羌活 防己 泽泻 连翘 槟榔（各三钱） 甘遂（二钱五分） 椒目 木香 干漆（炒烟尽，各一钱） 白丑 黑丑（各二两，取头末九钱） 大黄（八钱） 双头连（三钱）
以上研为细末，面糊为丸，如梧桐子大，每服三钱重，空心温酒送下，以利为度，病退即止药。忌甘草、菘菜、盐酱。
桃奴丸 治疗妇人或室女月经不通，渐成胀满，及男子坠马，跌扑损伤，以致瘀血停积，成血蛊病，皆能治之。
桃奴（桃树上干朽嫩桃也。十二月收用） 玄胡索 鼠粪（两头尖者是雄鼠粪也） 香附子 官桂 五灵脂 砂仁 桃仁（去皮尖，各等分）
以上为末，每服三钱，温酒调下。
（医案）
我族中的八一兄，平时能饮酒，年五十岁，得肿胀病，通身水肿，腹胀尤其严重，小便涩而不利，大便滑泄，召我去治疗。我说：你……
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "All dampness-induced swelling and fullness belong to the Spleen." It also says, "All abdominal distension and enlargement belong to Heat." When Spleen deficiency fails to control water, water infiltrates and flows recklessly, causing the whole body, face, eyes, hands, and feet to swell. This is called Edema (Shuizhong). If the abdomen is large like a drum, but the face, eyes, and limbs do not swell, it is called Distension (Zhangman), also known as Drum Distension (Guzhang). These are diseases caused by Damp-Heat in the Spleen Earth; swelling is mild, while distension is severe. Zhu Danxi said: The Heart and Lung are Yang, residing above; the Kidney and Liver are Yin, residing below; the Spleen resides in the middle, also belongs to Yin, and corresponds to Earth. The classics state: "When food enters the Stomach, its essence floats and overflows, transmitting upwards to the Spleen. The Spleen scatters the essence, sending it upwards to the Lung. [The Lung] regulates the water passages, transmitting downwards to the Bladder. Water essence distributes in all directions, and the essence of the Five Zang organs proceeds together." This indicates that the Spleen possesses the virtue of stillness (Kun trigram) and the function of vigorous movement (Qian trigram). Thus, it can cause the Yang of the Heart and Lung to descend and the Yin of the Kidney and Liver to ascend, forming the harmonious state of Heaven and Earth interacting (Taiji), which constitutes a healthy person. Now, internal injury from the Seven Emotions, external invasion by the Six Evils, irregular diet, and sexual exhaustion leading to deficiency injure the Yin of the Spleen Earth. The official responsible for transportation and transformation loses his duty. Although the Stomach receives grain, it cannot transform and transport it. Consequently, Yang rises spontaneously and Yin descends spontaneously, forming the obstructed state of Heaven and Earth not interacting (Pipi). Clear and turbid Qi mix, meridians and collaterals become blocked. Dampness stagnates and transforms into Heat, and Heat generates Dampness. Damp-Heat generate each other, eventually forming distension. This is what the classics call Drum Distension. Because the exterior is hard and full, while the interior is hollow with nothing inside, resembling a drum, it is stubborn and difficult to treat. It is also said that "Gu" (poison/parasite) implies something like insects eroding, carrying the meaning of Gu poison. Treatment should tonify the Spleen, nourish the Lung to restrain Liver Wood, so the Spleen has no fear of hostile pathogens, nourish the Kidney to restrain Fire, so the Lung receives the command of clear transformation, avoid salty flavors to prevent aiding evil, cut off delusions to protect the Mother Qi (Lung is the Mother of Spleen in some contexts, or here referring to protecting the source), stay away from music, and abstain from violent anger. There will be no instability. Physicians who do not examine the condition and seek quick results; patients suffering from distension who prefer purgative drugs to seek relief, do not realize that after being relieved for one or two days, the distension returns more severely. The True Qi is already injured, and death is near. The common belief that there is no tonification method for Qi disorders arises because bloating and obstruction seem difficult to tonify. They fail to consider that when Righteous Qi is deficient and cannot circulate, and pathogenic stasis remains and cannot exit, disease occurs. The classics say: "Those who are strong recover when Qi moves; those who are weak develop disease when pathogens adhere." If Qi deficiency is not tonified, how will pathogens retreat? How will the disease be cured? Moreover, the onset of this disease is not recent; the roots are deep and solid. Seeking quick results is courting disaster. Only those who understand the "Kingly Way" of treatment can discuss this. If the disease is shallow, the Spleen and Stomach are still strong, and accumulation is not fixed, slight guidance and dredging may be used, but harsh purgatives must not be employed.
My commentary: Mr. Zhu's treatise is detailed and clear, truly an unchangeable judgment for millennia. Upon reading Li Dongyuan's treatise on distension, he established the theory that cold in the Zang organs causes distension, citing the *Mai Jing* (Pulse Classic): "Cold in the Stomach leads to abdominal distension." I worry that the climate differs between North and South, making it difficult to generalize. Nevertheless, I have cured many people using Danxi's methods. Therefore, Dongyuan's theories do not align with my experience, so I dare not adopt his words to avoid confusing future generations.
Pulse Diagnosis
The *Zhenjing* (Needle Classic) states: "A pulse that is large, firm, and choppy indicates distension."
The *Mai Jing* (Pulse Classic) states: "Deficiency at the Guan position indicates internal distension. A slow and slippery pulse indicates distension. A full and tight pulse indicates distension. A deficient and tight-choppy pulse indicates distension. Or a string-like and slow pulse, or floating and rapid, all indicate distension."
Zhu Danxi said: The pulse of edema is mostly deep and hidden. In cases of Yang-Water combined with Yang syndromes, the pulse must be deep and rapid. In cases of Yin-Water combined with Yin syndromes, the pulse must be deep and slow. Restlessness and thirst, red and scanty urine, and constipation indicate Yang-Water. No restlessness or thirst, loose stools, and little red/scanty urine indicate Yin-Water. A deep and slippery pulse indicates Wind-Water. A floating and slow pulse, or string-like and tight, both indicate swelling.
In water diseases, if the abdomen is large like a drum, a excess pulse indicates survival, while a deficient pulse indicates death. A surging and large pulse indicates survival, while a minute and fine pulse indicates death. Abdominal distension with bloody stool, a large pulse with intermittent stops indicates severe illness; a small and rapid pulse indicates death. In sudden poisoning (Zhong'e), with abdominal distension and limb swelling, a large and slow pulse indicates survival, while a floating and tight pulse indicates death. A tight pulse with exhaustion of Ying and Wei Qi, accompanied by facial edema, indicates death. Swollen lips and scorched teeth indicate death. Sudden lip swelling with pale-black complexion indicates death. Palm swelling without lines indicates death. Umbilical swelling protruding indicates death. Supraclavicular fossa flattening indicates death. Swelling of the scrotum and penis indicates death. Exhaustion of pulse with open mouth and foot swelling indicates death. Dorsal foot swelling and knees like a bucket indicate death.
Methods
Zhu Danxi said: Among ancient formulas, only the Yuyuliang Wan (Hematit Pill) effectively restrains the Liver and tonifies the Spleen. However, modifications must be made according to time and syndrome. A friend of mine suffered from distension and self-prepared this medicine. I said: "There are many warm-hot herbs, and the refining fire is still present; you should modify it yourself." He did not listen. After taking it for a month, he bled from the mouth and nose and died emaciated.
Morning relief and evening urgency indicate Blood deficiency; evening relief and morning urgency indicate Qi deficiency; urgency at both times indicates joint Qi and Blood deficiency.
The general principle for treating swelling is to tonify the center, resolve dampness, and promote urination. Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Rhizoma) serve as the Sovereign herbs; Cang Zhu (Atractylodis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), and Fu Ling (Poria) serve as the Minister herbs; Huang Qin (Scutellariae Radix) and Mai Men Dong (Ophiopogonis Tuber) serve as the Assistant herbs to restrain Liver Wood. Add a small amount of Hou Po (Magnoliae Officinalis Cortex) to reduce abdominal distension. If Qi does not move, add Mu Xiang (Aucklandiae Radix) and Mu Tong (Akebiae Caulis); if Qi sinks, add Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) to lift it. If Blood is deficient, add Blood-tonifying herbs; if Phlegm is abundant, add Phlegm-resolving herbs. Modify according to the syndrome, and efficacy is assured.
The *Lu Shi Yi Jing* (Mirror of Medicine by Master Lu) classifies edema under the Kidney, Liver, and Stomach, omitting the Spleen. It also states that excessive Lung Metal generates Water, causing water to overflow and flow recklessly. Is this logical? When Spleen Earth is diseased, the Lung, as its child organ, certainly cannot become excessive to generate water. However, if Lung Metal Qi is clear and can generate water, it nourishes Kidney Yin and executes descending commands, becoming the source of transformation and production. How could swelling occur? The current water causing swelling is actually turbid Qi, penetrating meridians, flowing into valleys, and entering tunnels. Blood also transforms into water. Attempting to use Spleen Earth to control it and Kidney Qi to drain it ignores the fact that Spleen disease leads to decline of Metal Qi. Wood, lacking restraint, comes to insult Earth. It becomes impossible for the Spleen not to be diseased. The treatment method should clear Fire in the Heart Meridian, tonify Spleen Earth, fully restore its transportation and transformation functions. When Lung Qi descends and seepage pathways open, the slightly clearer essence returns to become Qi, Blood, and Body Fluids. The severely turbid败败 materials become sweat above and urine below, gradually dissipating.
Swelling above the waist should be treated with sweating; swelling below the waist should be treated with promoting urination. This is Zhang Zhongjing's method.
Li Dongyuan said: Use acrid dispersants, bitter purgatives, and bland diuretics to distribute dampness above and below. This is precisely "Opening the Ghost Gate" (sweating) and "Cleaning the Residence" (promoting urination). Opening the Ghost Gate means sweating; cleaning the Residence means promoting urination.
Postpartum edema requires massive tonification of Qi and Blood, assisted slightly by Cang Zhu (Atractylodis Rhizoma) and Fu Ling (Poria) to allow water to descend naturally. Large doses of Bai Zhu (Atractylodis Rhizoma) tonify the Spleen. For obstruction and fullness, use Ban Xia (Pinelliae Tuber), Chen Pi (Citri Reticulatae Pericarpium), and Xiang Fu (Cyperi Rhizoma) to regulate. If heat is present, clear Lung Metal with Mai Men Dong (Ophiopogonis Tuber) and Huang Qin (Scutellariae Radix).
For hot-water edema, use fried Zhi Zi Ren (Gardeniae Semen) powdered, taken with rice water, 3-5 qian. If the heat is in the Epigastrium or the disease is located superiorly, use the fruit with the shell.
(Above are eight methods from Danxi.)
Yuyuliang Wan (Jufang) Treats central fullness, Qi distension, panting, and water-Qi distension.
She Han Shi (Snake-containing Stone, 3 liang, calcined), Zhen Sha (Needle Sand, 5 qian), Yu Yu Liang (Hematit, 3 liang, stir-fried with needle sand).
These three are the main ingredients. Secondly, based on the patient's deficiency or excess, add the following:
Mu Xiang (Aucklandiae Radix), Niu Xi (Achyranthis Bidentatae Radix), E Zhu (Curcumae Rhizoma), Bai Ji Li (Tribuli Fructus), Gui Xin (Cinnamomi Ramulus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Hui Xiang (Foeniculi Fructus), Bai Dou Kou (Amomi Fructus Rotundus), San Leng (Sparganii Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix), Fu Ling (Poria), Gan Jiang (Zingiberis Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium), Fu Zi (Aconiti Lateralis Radix Praeparata, processed), Dang Gui (Angelicae Sinensis Radix) (each 5 qian).
Grind into powder, soak in decoction, steam with leavened dough, make pills the size of Sophora seeds. Take 50 pills per dose, with warm wine on an empty stomach.
Ju San He Tang (Jufang)
Chen Pi (Citri Reticulatae Pericarpium, white removed), Zi Su (Perillae Folium), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 7 fen), Hou Po (Magnoliae Officinalis Cortex, ginger-processed), Bing Lang (Arecae Semen), Bai Zhu (Atractylodis Rhizoma, each 1 qian), Hai Jin Sha (Lygodii Spora, 4 fen), Mu Tong (Akebiae Caulis, 2 fen).
Cut finely, prepare as one dose. Add 3 slices of fresh ginger, decoct in water, and take orally.
Zi Su Zi Tang (Jisheng)
Specifically treats excessive worry injuring the Spleen and Lung, causing heart and abdominal fullness, distension, and panting. Treats intestinal rumbling, moving Qi, gurgling sounds, difficulty in urination and defecation, and a deficient, choppy pulse.
Zi Su Zi (Perillae Fructus, 1 qian, ground), Bai Zhu (Atractylodis Rhizoma, 2 qian), Ren Shen (Ginseng Radix, 1 qian), Da Fu Pi (Arecae Pericarpium, washed with wine), Cao Guo (Tsaoko Fructus), Ban Xia (Pinelliae Tuber), Hou Po (Magnoliae Officinalis Cortex), Mu Xiang (Aucklandiae Radix), Chen Pi (Citri Reticulatae Pericarpium), Zhi Ke (Aurantii Fructus, bran-fried yellow), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 5 fen).
Cut finely, prepare as one dose. Add 3 slices of fresh ginger and 1 jujube, decoct in water, and take warm.
Mu Xiang Shun Qi Tang (Dongyuan) Treats turbid Qi rising to the upper body, causing distension.
Mu Xiang (Aucklandiae Radix, 3 fen), Hou Po (Magnoliae Officinalis Cortex, 4 fen), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium), Yi Zhi (Alpiniae Oxyphyllae Fructus), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Gan Jiang (Zingiberis Rhizoma), Ban Xia (Pinelliae Tuber) (each 2 fen), Wu Zhu Yu (Evodiae Fructus, soaked in water, 2 fen), Chuan Gui (Angelicae Sinensis Radix, 5 fen), Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix) (each 1 fen), Cao Dou Kou (Cardamomi Fructus, 3 fen), Cang Zhu (Atractylodis Rhizoma, 5 fen), Bai Zhu (Atractylodis Rhizoma, 1 qian).
Cut finely, prepare as one dose. Decoct in 2 cups of water until 1 cup remains, and take warm.
Zhongman Fen Xiao Wan (Dongyuan) Treats central fullness, drum distension, Qi distension, water distension, and heat distension.
Huang Qin (Scutellariae Radix, remove rotten parts, cut finely, stir-fried twice with wine, 6 qian), Huang Lian (Coptidis Rhizoma), Zhi Shi (Aurantii Fructus, bran-fried yellow), Ban Xia (Pinelliae Tuber, boiled seven times, peel and navel removed, each 5 qian), Jiang Huang (Curcumae Longae Rhizoma), Bai Zhu (Atractylodis Rhizoma), Ren Shen (Ginseng Radix) (each 2.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Zhu Ling (Polyporus, remove black skin, each 1 qian), Gan Jiang (Zingiberis Rhizoma), Bai Fu Ling (Poria), Sha Ren (Amomi Fructus) (each 2 qian), Hou Po (Magnoliae Officinalis Cortex, ginger-processed, 5 qian), Zhi Mu (Anemarrhenae Rhizoma, remove hairs, stir-fried with wine), Ze Xie (Alismatis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium, white removed, each 3 qian).
Grind into fine powder, bind with leavened dough paste, make pills the size of Sophora seeds. Take 100 pills per dose, baked warm, with plain water or light ginger water.
Guang Zhu Kui Jian Tang (Dongyuan) Treats central fullness and abdominal distension, with hard accumulations inside like stones, causing restlessness in sitting and lying, difficulty in urination and defecation, upper body panting, or generalized flaccid swelling.
Hou Po (Magnoliae Officinalis Cortex, ginger-processed), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Yi Zhi (Alpiniae Oxyphyllae Fructus), Cao Dou Kou (Cardamomi Fructus), Dang Gui (Angelicae Sinensis Radix) (each 5 fen), Ban Xia (Pinelliae Tuber, 7 fen), Guang Zhu (Curcumae Rhizoma), Sheng Ma (Cimicifugae Rhizoma), Hong Hua (Carthami Flos), Wu Zhu Yu (Evodiae Fructus) (each 2 fen), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Chai Hu (Bupleuri Radix), Ze Xie (Alismatis Rhizoma), Shen Qu (Massae Fermentatae Medicinalis, fried), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium) (each 3 fen). Add Ge Gen (Puerariae Lobatae Radix, 4 fen) if thirsty.
Cut finely, prepare as one dose. Add 3 slices of fresh ginger, decoct in 2 cups of water until 0.7 cups remain, and take warm, well after meals. Avoid alcohol, vinegar, and wet noodles. After two doses, central fullness reduces by half, leaving only the accumulation. Then take the following prescription.
Hong Hua (Carthami Flos), Su Mu (Sappan Lignum) (each 0.5 fen), Mu Xiang (Aucklandiae Radix), Qing Pi (Citri Reticulatae Pericarpium Viride) (each 2 fen), Wu Zhu Yu (Evodiae Fructus), Gan Jiang (Zingiberis Rhizoma), Huang Lian (Coptidis Rhizoma) (each 1 fen), Rou Gui (Cinnamomi Cortex), Cang Zhu (Atractylodis Rhizoma), Bai Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Chai Hu (Bupleuri Radix), Chen Pi (Citri Reticulatae Pericarpium), Sheng Huang Qin (Scutellariae Radix), Cao Dou Kou (Cardamomi Fructus, wrapped in flour and baked), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 3 fen), Jing San Leng (Sparganii Rhizoma), Dang Gui Shao (Angelicae Sinensis Radix tip), Zhu Ling (Polyporus), Sheng Ma (Cimicifugae Rhizoma) (each 4 fen), Shen Qu (Massae Fermentatae Medicinalis, fried, 6 fen), Hou Po (Magnoliae Officinalis Cortex, ginger-processed, 8 fen), Ban Xia (Pinelliae Tuber, boiled, 3 qian), Tao Ren (Persicae Semen, 7 seeds, remove skin and tips, grind to paste), Kun Bu (Laminariae Thallus, 5 fen). Add Ge Gen (Puerariae Lobatae Radix, 3 fen) if thirsty.
Cut finely, prepare as one dose. Decoct in 3 cups of water until 1 cup remains, and take slightly warm. After two doses of this medicine, previous symptoms reduce by half again. Modify and take the previous prescription.
Po Zhi Qi Tang (Also named Mu Xiang Hua Zhi San. Dongyuan) Breaks stagnant Qi, treats heart and abdominal fullness and oppression.
Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 fen), Bai Tan Xiang (Santalum Album Lignum), Huo Xiang (Agastaches Herba), Chen Pi (Citri Reticulatae Pericarpium), Da Fu Zi (Arecae Semen), Bai Dou Kou (Amomi Fructus Rotundus), Bai Fu Ling (Poria), Jie Geng (Platycodonis Radix) (each 2 fen), Sha Ren (Amomi Fructus), Ren Shen (Ginseng Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Bing Lang (Arecae Semen), Mu Xiang (Aucklandiae Radix), Jiang Huang (Curcumae Longae Rhizoma), Bai Zhu (Atractylodis Rhizoma) (each 4 fen).
Cut finely, prepare as one dose. Decoct in 1.5 cups of water until 1 cup remains, strain, and take warm. Take at any time.
Cao Dou Kou Tang (Dongyuan) Treats empty distension in the abdomen.
Ze Xie (Alismatis Rhizoma, 1 fen), Mu Xiang (Aucklandiae Radix, 3 fen), Shen Qu (Massae Fermentatae Medicinalis, 4 fen), Ban Xia (Pinelliae Tuber, soaked), Zhi Shi (Aurantii Fructus, bran-fried), Cao Dou Kou (Cardamomi Fructus), Huang Qi (Astragali Radix, not used in spring/summer), Yi Zhi (Alpiniae Oxyphyllae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 5 fen), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium) (each 6 fen), Fu Ling (Poria), Dang Gui (Angelicae Sinensis Radix) (each 7 fen).
Cut finely, prepare as one dose. Add 3 slices of fresh ginger, decoct in 2 large cups of water until 1 cup remains, and take warm. In winter, add Huang Qi (Astragali Radix) 5-7 fen. In spring and summer, take only the main prescription, warm, well after meals.
Ting Li Mu Xiang San (Hejian) Treats severe internal and external Damp-Heat, edema, abdominal distension, red and scanty urine, and loose diarrhea. This medicine is a sacred remedy for draining damp-water, reducing swelling, stopping diarrhea, and promoting urination.
Ting Li Zi (Descurainiae Semen seu Lepidii Semen), Fu Ling (Poria, peel removed), Zhu Ling (Polyporus, white part removed), Bai Zhu (Atractylodis Rhizoma) (each 2.5 qian), Mu Xiang (Aucklandiae Radix, 5 fen), Ze Xie (Alismatis Rhizoma), Mu Tong (Akebiae Caulis), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 5 qian), La Gui (Cinnamomi Cortex, 2.5 qian), Bai Hua Shi (Kaolinite, 3 liang).
Grind into fine powder. Take 3 qian per dose, mixed with plain water, before meals.
Bai Zhu Mu Xiang San (Hejian) Treats panting, coughing, swelling, and fullness, where water disease is about to develop. Inability to lie down, fear of eating much, and closed, non-flowing urine.
Bai Zhu (Atractylodis Rhizoma), Mu Zhu Ling (Polyporus, peel removed), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ze Xie (Alismatis Rhizoma), Mu Tong (Akebiae Caulis), Chi Fu Ling (Poria, red, each 5 fen), Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen) (each 3 fen), Chen Pi (Citri Reticulatae Pericarpium, white removed, 2 qian), Guan Gui (Cinnamomi Cortex, 2 fen), Hua Shi (Kaolinite, 2 qian).
Cut finely, prepare as one dose. Add 3 slices of fresh ginger, decoct in 1.5 cups of water until 1 cup remains, and take warm.
Er Qi San (Hejian) Treats water-Qi, Gu distension, fullness, and oppression.
Bai Chou (Pharbitidis Semen, white), Hei Chou (Pharbitidis Semen, black) (each 2 qian).
Grind into fine powder. Mix with 4 liang of barley flour, form into roasted cakes. Take one cup of tea infusion before sleep. Verify by reduction of Qi.
Qian Niu Wan (Hejian) Treats all conditions of Damp-Heat swelling and fullness.
Da Huang (Rhei Radix et Rhizoma), Hei Chou (Pharbitidis Semen, black), Jiao Mu (Zanthoxyli Semen), Huang Qin (Scutellariae Radix), Hua Shi (Kaolinite) (equal parts).
Grind into fine powder. Boil flour paste with wine, make pills the size of Sophora seeds. Take 5-7 pills per dose, with ginger water, after meals. Adjust pill count based on deficiency or excess.
San Hua Shen Wan (Hejian) Treats central fullness and abdominal distension, panting, coughing, strangury, all water-dampness swelling and fullness, Damp-Heat intestinal filth, chronic accumulations generating various diseases, prolonged illness not resolving, sallow and thin fatigue, Qi and Blood stagnation unable to circulate, or wind-heat dryness depression, limb numbness, migrating pain, wind-phlegm saliva cough, dizziness of head and eyes, persistent malaria, masses and accumulations, hard fullness and oppression, wine and food accumulation, all phlegm-fluid retching and counterflow, women's menstrual irregularities, leukorrhea dripping, regardless of red or white, men and women's cold-heat damage and Damp-Heat, abdominal fullness and solid pain, long-term or new weakness, commonly indistinguishable, also treats old and new lower back pain, all dysentery, children's fright, malnutrition, accumulation heat, breast lumps and abdominal distension. All are suitable for taking this.
Gan Suan (Kanospores Radix), Da Ji (Euphorbiae Pekinensis Radix), Yuan Hua (Genkwa Flos, stir-fried moist with vinegar, each 5 qian), Hei Chou (Pharbitidis Semen, black, 2 liang, take first wash powder 1 liang purified), Da Huang (Rhei Radix et Rhizoma, 1 liang), Qing Fen (Calomelas, 1 qian, pack separately, do not grind).
Grind into fine powder, mix evenly with Calomelas. Add drops of water to make pills the size of adzuki beans. Initial dose 5 pills, increase by 5 pills per dose, take with warm water, three times a day. Increase until rapid purgation is achieved. After purgation, continue regular intake. Stop when disease is gone. If recovered, only frail, elderly, or chronically ill deficient persons should not take it. Healthy people can take it regularly for maintenance, to promote Qi and Blood circulation and improve appetite. For extremely severe oppression, too much at once will not break through and may increase pain and oppression. Initial dose 2 pills, increase by 2 pills per dose, until rapid purgation is achieved. Use discretion. For children, make pills the size of sesame seeds. Adjust pill count based on strength and size. For 3-4 year olds, 3-4 pills. Follow the previous method.
Xuan Ming Ji Si Li Yin (Source: *Suwen* Abdominal Discussion. Hejian) Treats drum distension, inability to eat in the evening after eating in the morning, severe oppression and blockage.
Da Huang (Rhei Radix et Rhizoma), Tao Ren (Persicae Semen, remove skin), Gan Ji Si (Dry Chicken Droppings) (equal parts).
Grind into fine powder. Take 2 qian per dose. Decoct 1 cup of water with 3 slices of fresh ginger. Mix powder with decoction. Take well after meals and before sleep.
(Danxi Flexible Sets) says: For all abdominal distension, ginger-processed Hou Po (Magnoliae Officinalis Cortex) must be used. For obese people with abdominal distension, dampness-resolving herbs like Cang Zhu (Atractylodis Rhizoma), Fu Ling (Poria), Hua Shi (Kaolinite), and Hai Jin Sha (Lygodii Spora) are necessary. For fair-skinned people with abdominal distension, it is definitely Qi deficiency; use Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), and Bai Fu Ling (Poria). For thin people with abdominal distension, it is Heat; use Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), and Hou Po (Magnoliae Officinalis Cortex). If abdominal distension is due to blood stasis, use Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos); for severe cases, use Didang Tang/Wan. If due to food accumulation, use Baohe Wan plus Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), and A Wei (Asini Corii Colla). If due to Heat stagnation, purge with Mu Xiang Bing Lang Wan. If due to Cold accumulation and stagnation, use Jufang Ding Xiang Pi Ji Wan or Dongyuan San Leng Xiao Ji Wan. If due to external Cold suppressing internal Heat, use Huo Xiang (Agastaches Herba), Guan Gui (Cinnamomi Cortex), Sheng Ma (Cimicifugae Rhizoma), and Ge Gen (Puerariae Lobatae Radix). If due to anger and Qi stagnation, use Cang Zhu (Atractylodis Rhizoma), Fu Xiong (Ligustici Chuanxiong Rhizoma), Xiang Fu (Cyperi Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Shao Yao (Paeoniae Radix Alba), Chai Hu (Bupleuri Radix), and Long Hui Wan. For initial abdominal distension (Qi distension), use Qi-moving and dredging agents like Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Zhi Ke (Aurantii Fructus), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium), and Hou Po (Magnoliae Officinalis Cortex). Over time, it becomes Water distension; use dampness-resolving and water-draining agents.
(Ancestral Formula)
Ji Si Li Treats drum distension, Qi distension, and water distension.
Jie Ji Si (Ram Droppings, 1 sheng).
Grind this single ingredient finely, stir-fry until dark brown, place on ground to remove fire toxicity, grind extremely fine. Pour 3 sheng of boiling water over it to extract juice. Take one large cup per dose, mixed with 1 qian each of Mu Xiang (Aucklandiae Radix) and Bing Lang (Arecae Semen) powder. Take three times a day, on an empty stomach. Continue until equilibrium is reached.
Another Prescription Treats swelling, either generalized edema or large, hard, and full abdomen.
San Leng (Sparganii Rhizoma), E Zhu (Curcumae Rhizoma) (each stir-fried with vinegar), Chen Pi (Citri Reticulatae Pericarpium, white removed), Qing Pi (Citri Reticulatae Pericarpium Viride), Sha Ren (Amomi Fructus), Qiang Huo (Notopterygii Rhizoma et Radix), Fang Ji (Stephaniae Tetrandrae Radix), Ze Xie (Alismatis Rhizoma), Lian Qiao (Forsythiae Fructus), Bing Lang (Arecae Semen) (each 3 qian), Gan Suan (Kanospores Radix, 2.5 qian), Jiao Mu (Zanthoxyli Semen), Mu Xiang (Aucklandiae Radix), Gan Qi (Stir-fried until smoke ceases, each 1 qian), Bai Chou (Pharbitidis Semen, white), Hei Chou (Pharbitidis Semen, black) (each 2 liang, take first wash powder 9 qian), Da Huang (Rhei Radix et Rhizoma, 8 qian), Shuang Tou Lian (Scrophulariae Radix, 3 qian).
Grind into fine powder, bind with flour paste, make pills the size of Sophora seeds. Take 3 qian per dose, with warm wine on an empty stomach. Stop when purgation is achieved and disease recedes. Avoid Gan Cao (Glycyrrhizae Radix et Rhizoma), Song Cai (Brassicae Pekinensis var. rapiferae Radix), salt, and soy sauce.
Tao Nu Wan Treats women or unmarried girls with amenorrhea gradually leading to distension, and men falling from horses or suffering trauma leading to blood stasis accumulation, forming Blood Gu disease. All can be treated.
Tao Nu (Dried tender peach on the tree. Harvest in December), Yan Hu Suo (Corydalis Rhizoma), Shu Fen (Mouse Droppings, pointed ends indicate male mouse droppings), Xiang Fu (Cyperi Rhizoma), Guan Gui (Cinnamomi Cortex), Wu Ling Zhi (Trogopterori Faeces), Sha Ren (Amomi Fructus), Tao Ren (Persicae Semen, remove skin and tips) (equal parts).
Grind into powder. Take 3 qian per dose, mixed with warm wine.
(Medical Case)
My clan brother Ba Yi, accustomed to drinking alcohol, aged fifty, suffered from swelling disease. Generalized edema, especially severe abdominal distension. Urine was astringent and difficult to pass, stools were loose and slippery. He summoned me for treatment. I said: You...