治气郁成臌胀，兼治脾胃虚而且郁，饮食不能运化。
生鸡内金（四钱，去净瓦石糟粕捣碎） 于术（三钱） 生杭芍（四钱） 柴胡（二钱） 广陈皮（二钱） 生姜
（三钱）
《内经》谓∶“诸湿肿满，皆属于脾。”诚以脾也者，与胃相连以膜，能代胃行其津液。且地居中焦
（为中焦油膜所包），更能为四旁宣其气化。脾若失其所司，则津液气化凝滞，肿满即随之矣。是臌胀者，当
以理脾胃为主也。西人谓脾体中虚，内多回血管。若
其回血管之血，因脾病不能流通，瘀而成丝成块，原非草木之根 所能消化。鸡内金为鸡之脾胃，中有瓦石铜
铁皆能消化，其善化有形瘀积可知。故能直入脾中，以消回血管之瘀滞。而又以白术之健补脾胃者以驾驭之，
则消化之力愈大。柴胡，《神农本草经》谓“主肠胃中饮食积聚，能推陈致新”，其能佐鸡内金消瘀可知。且
与陈皮并用，一升一降，而气自流通也。用芍药者，因其病虽系气臌，亦必挟有水气，芍药善利小便，即善行
水，且与生姜同用，又能调和营卫，使周身之气化流通也。夫气臌本为难治之证，从拟此方之后，连治数证皆效。
治一叟年六旬，腹胀甚剧。治以此汤数剂，其效不速。用黑丑一钱炒研细，煎此汤送下，两剂大见功效。
又去黑丑，再服数剂全愈。若小便时觉热，且色黄赤者，宜酌加滑石数钱。
鸡内金虽饶有消化之力，而诸家本草，实有能缩小便之说，恐于证之挟有水气者不宜。方中用白芍以利
小便，所以济鸡内金之短也。
《内经》谓∶“按之 而不起者，风水也。”愚临证体验以来，知凡系水臌，按之皆不能即起。气臌则
按之举手即起。或疑若水积腹中，不行于四肢，如方书所谓单腹胀者，似难辨其为气为水。不知果为水证，重
按移时，举手则有微痕，而气证则无也。且气臌证，小便自若，水臌证，多小便不利，此又其明征也。
治疗因气机郁滞导致的鼓胀，同时兼治脾胃虚弱且伴有气郁、饮食无法运化的情况。
生鸡内金（四钱，去除干净的瓦石和糟粕后捣碎） 白术（三钱） 生杭芍（四钱） 柴胡（二钱） 广陈皮（二钱） 生姜（三钱）
《黄帝内经》说：“各种湿邪引起的肿胀和腹满，都归属于脾。”确实如此，脾与胃通过膜相连，能够代替胃输送津液。而且脾位于中焦（被中焦的油膜所包裹），更能为周围组织宣发气化功能。如果脾失去了其主管职能，那么津液和气化就会凝滞，肿胀和腹满也就随之产生了。因此，治疗鼓胀应当以调理脾胃为主。西医认为脾脏实体中间空虚，内部有很多回血管（静脉）。如果因为脾病导致回血管中的血液不能流通，瘀积而成丝状或块状，这原本不是草木药材所能消化的。鸡内金是鸡的脾胃，其中连瓦石铜铁都能消化，可知它善于化解有形的瘀积。所以它能直接进入脾中，以消除回血管中的瘀滞。再加上用白术来健补脾胃以驾驭药力，那么消化的力量就更大。柴胡，《神农本草经》记载“主治肠胃中的饮食积聚，能推陈出新”，可知它能辅助鸡内金消除瘀滞。并且与陈皮配合使用，一升一降，气机自然流通。使用芍药的原因，是因为此病虽然属于气臌，但也必然挟带水气，芍药善于通利小便，也就是善于行水；并且与生姜同用，又能调和营卫，使周身的气化流通。气臌本来是一种难治的病证，自从拟定这个方子之后，连续治疗几个病例都有效。
曾治疗一位六十多岁的老人，腹胀非常严重。用此方治疗几剂后，效果不明显。加入炒研细的黑丑一钱，煎煮此汤送服黑丑粉，服用两剂后大见功效。后来去掉黑丑，再服用几剂后完全痊愈。如果小便时感觉热，且颜色黄赤的，应当酌情加入滑石数钱。
鸡内金虽然富有消化的力量，但各家本草书中，实际上有它能缩小便的说法，恐怕对于挟带水气的病症不宜使用。方中使用白芍来通利小便，以此来弥补鸡内金的短处。
《黄帝内经》说：“按压腹部凹陷不起的，是风水病。”我临证体验以来，知道凡是水臌，按压都不能立即弹起。气臌则按压后举手即起。有人怀疑如果水积在腹中，不流注于四肢，像方书所说的单腹胀，似乎难以辨别是气还是水。不知道如果是水证，重按片刻后，举手会有轻微痕迹，而气证则没有。而且气臌证，小便正常；水臌证，多小便不利，这又是明显的证据。
To treat distension (鼓胀) caused by Qi stagnation, and simultaneously to treat deficiency with stagnation of the Spleen and Stomach, where food cannot be transformed and transported.
Raw Jineijin (Galli Gigerii Endothelium Corneum) (4 qian, cleaned of gravel and dregs, then crushed) Baizhu (Atractylodis Macrocephalae Rhizoma) (3 qian) Sheng Hangshao (Paeoniae Radix Alba) (4 qian) Chaihu (Bupleuri Radix) (2 qian) Guang Chenpi (Citri Reticulatae Pericarpium) (2 qian) Shengjiang (Zingiberis Rhizoma Recens) (3 qian)
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "All dampness-induced swelling and fullness belong to the Spleen." Indeed, the Spleen is connected to the Stomach via membranes and can assist the Stomach in distributing body fluids. Furthermore, residing in the Middle Jiao (enclosed by the oily membranes of the Middle Jiao), it can disseminate Qi transformation to the surrounding areas. If the Spleen loses its governing function, body fluids and Qi transformation will become stagnant, leading to swelling and fullness. Therefore, treating distension should primarily focus on regulating the Spleen and Stomach. Western medicine posits that the spleen has a hollow interior containing many veins. If blood in these veins fails to circulate due to spleen disease, becoming stagnant into threads or clumps, this is originally indigestible by herbal roots. Jineijin is the gizzard lining of the chicken; since it can digest gravel, copper, and iron, it is evident that it excels at resolving有形 (solid/physical) accumulations. Thus, it can directly enter the Spleen to eliminate venous stasis. Coupled with Baizhu to strengthen and tonify the Spleen and Stomach to control the action, the digestive power becomes even greater. Chaihu, as recorded in the *Shennong Bencao Jing* (Divine Farmer's Materia Medica), "mainly treats dietary accumulation in the intestines and stomach, promoting the elimination of the old and generation of the new," indicating its ability to assist Jineijin in resolving stasis. Moreover, used together with Chenpi, one ascending and one descending, allowing Qi to flow freely. Shaoyao (Paeoniae Radix) is used because although the condition is Qi distension, it must also involve water retention; Shaoyao effectively promotes urination, i.e., moves water. When used with Shengjiang, it also harmonizes Ying and Wei (Nutritive and Defensive Qi), ensuring the free flow of Qi transformation throughout the body. Qi distension is inherently difficult to treat. Since prescribing this formula, several cases have been treated successfully.
For example, an elderly man in his sixties suffered from severe abdominal distension. After administering this decoction for several doses, the effect was not rapid. One qian of Heiqiu (Semen Mezerei Preparatum), stir-fried and finely ground, was added and taken with the decoction. After two doses, significant improvement was observed. Heiqiu was then removed, and after several more doses, he was completely cured. If there is a sensation of heat during urination and the urine is yellow and red, Huashi (Talcum) should be酌情 (discretionarily) added in amounts of several qian.
Although Jinejin possesses strong digestive properties, various materia medica texts claim it can reduce urine volume, which may be unsuitable for conditions involving water retention. The use of Baishao (White Peony Root) in this formula to promote urination serves to compensate for the shortcomings of Jinejin.
The *Huangdi Neijing* states: "Pressing the abdomen leaving an indentation that does not immediately rise indicates Fengshui (Wind-Water edema)." From my clinical experience, I know that for all cases of Shui Gu (Water Distension), pressing leaves an indentation that does not immediately rebound. In contrast, for Qi Gu (Qi Distension), the indentation rebounds immediately upon lifting the hand. Some may doubt that if water accumulates in the abdomen without flowing to the limbs, resembling the "single abdominal distension" described in medical texts, it would be difficult to distinguish between Qi and Water. However, if it is indeed a Water condition, deep pressure followed by a pause will leave a slight indentation when the hand is lifted, whereas no such mark remains in Qi conditions. Furthermore, in Qi distension, urination is normal; in Water distension, urination is often obstructed. This is another clear sign.