腹胀有虚有实，皆由脾胃气攻所作也。实者闷乱喘满，可下之，紫霜丸、白饼子。其不喘者，虚也，不可下，若误
下，致脾虚气上附肺而行，肺与脾、子母皆虚，肺主目胞腮颊肿也，脾主四股，母气虚甚即黄也，治之用塌气丸渐消之，
未愈渐加丸数。然脾虚气不运动，故腹胀而不喘，可以散药治之，使上下分消，其气即愈也。又有疳气积胀，用褐丸子
治之。又有症癖痞胀，三棱丸主之。有实热胀满者，大承气汤主之，一法用五苓散吞紫霜丸，量虚实用丸数亦妙。热轻
者，大柴胡汤治之。
褐丸子 治小儿疳积肿胀。
萝卜子（一两、微炒） 陈皮 青皮 槟榔 五灵脂 莪术（煨） 赤茯苓（各半两） 木香（二钱半） 黑牵牛
（取净末、半生、半炒）
上为末，面糊丸如绿豆大，每服十五丸，苏叶泡汤送下。
紫霜丸 见第三问。
白饼子 见第十四问。
塌气丸 治小儿疳气腹胀喘急，并面目浮肿。
丁香（一钱） 胡椒（一钱） 萝卜子（炒） 白牵牛（生、各二钱）
上为末，面糊丸如小豆大，三岁三十丸，米汤下。
三棱丸 见第八十四问。
大承气汤 见第二十九问。
五苓散 见第五十二间。
大柴胡汤 见第二十九问。
下积丸 见第四十九问。
五珍丸 见第四十九问。
腹胀有虚证和实证两种，都是由脾胃之气运行失常所致。实证表现为胸闷烦乱、气喘胀满，可以用泻下法治疗，方剂选用紫霜丸或白饼子。如果不气喘的，属于虚证，不可用泻下法，如果误用泻下法，会导致脾气虚弱，气机上逆附着于肺而运行，肺与脾作为母子关系两脏皆虚，肺主司眼睑、腮部和脸颊的肿胀，脾主司四肢，母气（脾气）极度虚弱时面色就会发黄，治疗时使用塌气丸逐渐消除病邪，病情未愈则逐渐增加丸药的服用数量。然而因为脾气虚弱导致气机不运化，所以出现腹胀但不气喘，可以用散剂治疗，使气机上下分消，气机通畅后病症即可痊愈。又有疳积气滞导致的腹胀，使用褐丸子治疗。又有症癖痞块导致的腹胀，以三棱丸为主治方。有实热导致的胀满，以大承气汤为主治方，另一种方法是用五苓散吞服紫霜丸，根据虚实情况调整丸药数量也很巧妙。热象较轻的，用大柴胡汤治疗。
褐丸子：治疗小儿疳积引起的肿胀。
萝卜子（一两，微炒）、陈皮、青皮、槟榔、五灵脂、莪术（煨制）、赤茯苓（各半两）、木香（二钱半）、黑牵牛（取净末，一半生用，一半炒用）。
以上药物研为细末，用面糊制成如绿豆大小的丸药，每次服用十五丸，用苏叶泡的水送服。
塌气丸：治疗小儿疳气腹胀喘急，以及面目浮肿。
丁香（一钱）、胡椒（一钱）、萝卜子（炒制）、白牵牛（生用，各二钱）。
以上药物研为细末，用面糊制成如小豆大小的丸药，三岁儿童服用三十丸，用米汤送服。
三棱丸：见第八十四问。
大承气汤：见第二十九问。
五苓散：见第五十二问。
大柴胡汤：见第二十九问。
下积丸：见第四十九问。
五珍丸：见第四十九问。
Abdominal distension can be either deficiency or excess, both caused by the dysfunction of Spleen and Stomach Qi (Spleen and Stomach energy). Excess patterns present with chest oppression, restlessness, wheezing, and fullness; they can be treated with purgative methods, using Zishuang Wan (Purple Frost Pill) or Baibing Zi (White Cake Pill). If there is no wheezing, it is a deficiency pattern and should not be purged. If mistakenly purged, it leads to Spleen Qi deficiency, causing Qi to ascend and attach to the Lung, resulting in both the mother organ (Spleen) and child organ (Lung) being deficient. The Lung governs swelling of the eyelids, cheeks, and jaw; the Spleen governs the four limbs. When maternal Qi (Spleen Qi) is severely deficient, the complexion turns yellow. Treatment involves using Taqi Wan (Qi-Sinking Pill) to gradually resolve the condition; if not cured, gradually increase the number of pills. However, due to Spleen deficiency leading to stagnant Qi movement, abdominal distension occurs without wheezing. This can be treated with powder formulations to promote the dispersion of Qi upwards and downwards, resolving the Qi stagnation and curing the disease. For abdominal distension caused by malnutrition Qi stagnation (Gan Qi accumulation), He Wan Zi (Brown Pill) is used. For distension caused by mass formations and痞 (Pi syndrome), Sanleng Wan (Curcuma Pill) is the primary treatment. For distension caused by excess heat, Dachengqi Tang (Major Order the Qi Decoction) is used. Another method involves swallowing Zishuang Wan with Wuling San (Five-Ingredient Powder with Poria), adjusting the dosage based on deficiency and excess, which is also effective. For mild heat, Da Chaihu Tang (Major Bupleurum Decoction) is used.
He Wan Zi (Brown Pill): Treats pediatric abdominal swelling due to Gan accumulation (malnutrition).
Radish Seed (Luo Bo Zi, 1 liang, slightly stir-fried), Tangerine Peel (Chen Pi), Green Tangerine Peel (Qing Pi), Areca Nut (Bing Lang), Trogopterus Dung (Wu Ling Zhi), Curcuma Longa Rhizome (E Zhu, baked), Red Poria (Chi Fu Ling) (each half liang), Aucklandia Root (Mu Xiang, 2.5 qian), Black Morning Glory Seed (Hei Qian Niu, cleaned powder, half raw, half stir-fried).
Grind into powder, form pills with wheat paste size of mung beans. Take 15 pills per dose, washed down with Perilla Leaf infusion.
Zishuang Wan (Purple Frost Pill): See Question 3.
Baibing Zi (White Cake Pill): See Question 14.
Taqi Wan (Qi-Sinking Pill): Treats pediatric abdominal distension, wheezing, and urgency due to Gan Qi, along with facial and ocular edema.
Cardamom (Ding Xiang, 1 qian), Pepper (Hu Jiao, 1 qian), Radish Seed (Luo Bo Zi, stir-fried), White Morning Glory Seed (Bai Qian Niu, raw, each 2 qian).
Grind into powder, form pills with wheat paste size of adzuki beans. For three-year-olds, take 30 pills, washed down with rice soup.
Sanleng Wan (Curcuma Pill): See Question 84.
Dachengqi Tang (Major Order the Qi Decoction): See Question 29.
Wuling San (Five-Ingredient Powder with Poria): See Question 52.
Da Chaihu Tang (Major Bupleurum Decoction): See Question 29.
Xiaji Wan (Accumulation-Purging Pill): See Question 49.
Wuzhen Wan (Five-Treasure Pill): See Question 49.