当归尾 赤芍药 生地黄 川芎 牛膝 五灵脂（各一两） 红花 桃红（各五钱） 香附（二两
琥珀（七钱五分）
苏木屑二两，煎酒，和砂糖，熬化为丸，如桐子大。每服三钱，酒下。体虚者，用理中
汤送下；若血寒，加肉桂五钱。
或问∶方书有鼓胀、蛊胀之别，何也？答曰∶鼓者，中空无物，有似于鼓；蛊者，中实
有物，非虫即血也。中空无物，填实则消，经所谓塞因塞用是已。中实有物，消之则平，经
所谓坚者削之是已。然胀满有寒、热、虚、实，浅深部位之不同，若不细辨，何由取效。假
如溺赤，便闭，脉数有力，色紫黑，气粗厉，口渴饮冷，唇焦，舌燥，多属于热。假如溺清
便溏，脉细无力，色 白，气短促，喜饮热汤，舌润，口和，多属于寒。又如腹胀，
按之不痛，或时胀时减者，为虚；按之愈痛，腹胀不减者，为实。凡胀满，饮食如常者，其
病浅；饮食减少者，其病深。且胀有部分，纵是通腹胀满，亦必有胀甚之部，与病先起处，
即可知属何脏腑，而用药必以之为主。东坦治胀满，不外枳术、补中二方，出入加减，寒
热攻补，随症施治。予因制和中丸普送，效者甚多，有力者，当修合以济贫乏。又气虚中满
宜用白术丸，而以六君子汤佐之，中空无物，不用枳实，恐伤气也。
当归尾、赤芍药、生地黄、川芎、牛膝、五灵脂（各一两），红花、桃仁（各五钱），香附（二两），琥珀（七钱五分）。用苏木屑二两，煎煮酒液，加入砂糖，熬制成丸剂，大小如梧桐子。每次服用三钱，用酒送服。身体虚弱者，用理中汤送服；若是血寒证，加肉桂五钱。
有人问：医书中鼓胀与蛊胀有区别，为什么呢？回答说：鼓胀，腹部中空无物，形状像鼓；蛊胀，腹部充实有物，不是虫积就是瘀血。对于中空无物的鼓胀，采用填实的方法使其消退，这就是《内经》所说的“塞因塞用”（以补开塞）的道理。对于中实有物的蛊胀，采用消导的方法使其平复，这就是《内经》所说的“坚者削之”（坚硬者用攻削法）的道理。然而，胀满病有寒、热、虚、实的不同，病变部位的深浅也有差异，如果不仔细辨别，怎么能取得疗效呢？假如小便颜色红赤，大便闭结，脉搏快而有力，面色紫黑，呼吸粗重，口渴想喝冷水，嘴唇焦裂，舌面干燥，多属于热证。假如小便清长，大便稀溏，脉搏细弱无力，面色㿠白，气短急促，喜欢喝热汤，舌面湿润，口中平和，多属于寒证。又如腹部胀满，按压时不疼痛，或者有时胀满有时减轻的，属于虚证；按压时疼痛加剧，腹部胀满不减的，属于实证。凡是胀满病，饮食正常的，病情较浅；饮食减少的，病情较深。而且胀满有特定的部位，即使是全腹胀满，也一定有胀满严重的部位，结合发病最初的地方，就可以知道属于哪个脏腑，用药必然以该脏腑为主。东垣治疗胀满，不外乎枳术丸和补中益气汤两个方剂，根据情况加减变化，寒热攻补，随症状施治。我因此制作了和中丸普遍赠送，见效的人很多，有能力的人，应当配制来救济贫困之人。另外，气虚导致的中满应当使用白术丸，并用六君子汤辅助，因为腹部中空无物，不用枳实，恐怕会损伤正气。
Radix Angelicae Sinensis Caudex (Dangguiwei), Radix Paeoniae Rubra (Chishao), Radix Rehmanniae Preparata (Shengdihuang - *Note: Text says Sheng Dihuang, usually Raw Rehmannia*), Radix Chuanxiong (Chuanxiong), Radix Achyranthis Bidentatae (Niuxi), Resina Trogopterori (Wulingzhi) (each 1 liang), Flos Carthami Tinctorii (Honghua), Semen Persicae (Taoren) (each 5 qian), Rhizoma Cyperi Rotundi (Xiangfu) (2 liang), Subcorium Corvis Capitis et Cornu Cervi (Hupo) (7.5 qian). Use 2 liang of powder from the wood of Paolownia Tree (Sumu), decoct in wine, add brown sugar, and boil into pills the size of Torreya seeds. Take 3 qian per dose, with wine. For those with weak constitution, take with Lizhong Tang (Regulate the Middle Decoction); if there is blood-cold syndrome, add Cortex Cinnamomi (Rougui) 5 qian.
Someone asked: Medical texts distinguish between Drum Distension (Guzhang) and Gu Distension (Guzhang/Guzhang with insect/parasite implication). What is the difference? The answer is: Drum Distension refers to an abdomen that is hollow inside without solid matter, resembling a drum; Gu Distension refers to an abdomen that is solid inside with matter, which is either parasitic accumulation or blood stasis. For Drum Distension, which is hollow inside, using methods to fill/solidify causes it to resolve; this corresponds to the principle in the Classic of Internal Medicine known as "treating obstruction with obstructive methods" (Sai Yin Sai Yong). For Gu Distension, which is solid inside with matter, using methods to dissipate reduces it; this corresponds to the principle "those that are hard should be削 (scraped/reduced)" (Jian Zhe Xue Zhi). However, distension and fullness can be due to cold, heat, deficiency, or excess, and the depth of the lesion varies. Without careful differentiation, how can efficacy be achieved? If urine is dark red, stool is constipated, pulse is rapid and forceful, complexion is purple-black, respiration is coarse, thirst exists with desire for cold drinks, lips are cracked, tongue is dry, it mostly belongs to Heat Syndrome. If urine is clear, stool is loose, pulse is fine and weak, complexion is pale, breath is short, preference for hot drinks exists, tongue is moist, mouth feels normal, it mostly belongs to Cold Syndrome. Furthermore, if abdominal distension does not hurt upon pressure, or distension comes and goes, it is Deficiency; if pain increases upon pressure and distension does not decrease, it is Excess. In all cases of distension, if diet is normal, the disease is superficial; if appetite decreases, the disease is deep. Moreover, distension has specific locations. Even if the entire abdomen is distended, there must be a part where distension is most severe. Combined with the initial site of onset, one can determine which Zang-Fu organ is involved, and medication must primarily target that organ. Dongyuan's treatment of distension did not go beyond two formulas: Zhiji Zhu Wan (Atractylodes Magna and Immature Bitter Orange Pill) and Buzhong Yiqi Tang (Regulate the Middle and Boost Qi Decoction), modifying them according to circumstances, applying cold, heat, attack, or tonification based on symptoms. Therefore, I formulated Hezhong Wan (Harmonize the Middle Pill) to distribute widely, with many effective results. Those with means should prepare it to aid the poor. Additionally, for middle-fullness due to Qi deficiency, Baizhu Wan (Atractylodes Macrocephala Pill) should be used, assisted by Liujunzi Tang (Six Gentlemen Decoction). Since the interior is hollow without solid matter, Zhishi (Immature Bitter Orange) is not used, lest it damage the Qi.