（东垣）
治中满鼓胀，气胀，水胀，热胀（诸病有声，鼓之如鼓，为鼓胀。气不通利为气胀，血
不通利为血胀，但气分心下坚大而病发于上，血分血结胞门而病发于下；气血不通，则水亦
不通而
胀。《金匮》曰∶病有血分水分何也，
师曰
水
浓朴（炒，一两） 枳实（炒） 黄连（炒） 黄芩 半夏（姜制，五钱） 陈皮 知
母（炒，
草（炙） 猪苓（一钱。）蒸饼丸。焙热服（寒因热用。东垣立中满分消丸治热胀，分消汤
治寒胀，二者详而用之）。
此足太阴、阳明药也。浓朴、枳实行气而散满二药兼能破宿血，黄连、黄芩泻热而消痞
，姜
明独
则胀消也（按∶此方乃合六君、四苓、泻心、二陈、平胃而为一方者，但分两有多寡，则所
治有主客之异矣。朱丹溪曰∶脾具坤静之德，而有干健之运，故能使心肺之阳降，肝肾之阴
升，而成天地之泰，是为平人。今也七情内伤，六淫外感，饮食失节，房劳致虚，脾土之阴
受伤，转输之官失职，故阳升阴降，而成天地不交之否，清浊相混，隧道壅塞，郁而为热，
热留为湿，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；以
其胶固难治，又名曰蛊，若虫之侵蚀，而有蛊之义焉。宜补其脾，又须养肺金以制水，使脾
无贼邪之患；滋肾阴以制火，使肺得清化之令。却咸味、断妄想、无有不安。医者急于取效，
病者
（李东垣）
治疗中满鼓胀、气胀、水胀、热胀。（各种疾病发出声音，叩击腹部如敲鼓声，称为鼓胀。气机不通利称为气胀，血行不通利称为血胀；仅气分病变导致心下坚硬膨大且病发于上部，血分病变导致血结于胞门且病发于下部；气血不通，则水液也不通而致胀满。《金匮要略》说：什么是血分和水分呢？老师说……）
厚朴（炒，一两） 枳实（炒） 黄连（炒） 黄芩 半夏（姜制，五钱） 陈皮 知母（炒） 甘草（炙） 猪苓（一钱）。制成蒸饼丸。焙热后服用。（寒因热用。李东垣创立中满分消丸治疗热胀，分消汤治疗寒胀，二者详细辨别后使用。）
这是足太阴脾经、足阳明胃经的药物。厚朴、枳实行气并消除胀满，这两味药兼能破除陈旧之血；黄连、黄芩泻热并消除痞块，生姜……（原文此处有缺漏或断句不清，依文意推测为姜制半夏等配合清热化痰）。若……则胀满消除。（按语：此方乃是合并六君子汤、四苓散、泻心汤、二陈汤、平胃散为一方的制剂，只是剂量有多寡之分，因此主治有主证与兼证的差异。朱丹溪说：脾具有坤卦静止的德行，而具备乾卦刚健的运行功能，所以能使心肺的阳气下降，肝肾的阴气上升，从而形成天地交泰的局面，这就是健康的人。如今七情内伤，六淫外感，饮食不节制，房劳过度导致虚弱，脾土的阴气受伤，转输功能的官职失职，所以阳气上升阴气下降，形成天地不交的否塞状态，清浊之气相混，经络隧道壅塞郁滞而产生热邪，热邪停留化为湿邪，湿热相生，遂成胀满，医经所说的鼓胀就是这种病。因为它外表虽然坚满，中间空虚无物，形状像鼓；因为它胶固难治，又名为蛊，如同虫类侵蚀，含有蛊的含义。应当补益脾土，又须滋养肺金以制约水气，使脾脏没有贼邪的侵害；滋补肾阴以制约火邪，使肺脏得到清化肃降的命令。戒除咸味、断绝妄想，没有不安稳的道理。医生急于求效，病人……）
(Li Dongyuan)
Treats Zhongman (Middle Fullness) and Drum Distension, Qi Distension, Water Distension, and Heat Distension. (Various diseases manifest with sounds; striking the abdomen produces a drum-like sound, which is called Drum Distension. When Qi mechanism is not free-flowing, it is called Qi Distension; when Blood circulation is not free-flowing, it is called Blood Distension; if only the Qi aspect is affected causing hardness and distension below the heart with pathology originating in the upper jiao, while Blood aspect pathology involves blood stasis at the Bao Gate (uterus/pelvis) with pathology originating in the lower jiao; when both Qi and Blood are obstructed, then Water metabolism is also obstructed leading to distension. The *Jin Gui Yao Lue* states: What are Blood Distinction and Water Distinction? The Master said...)
Cortex Magnoliae Officinalis (Choupu, stir-fried, 1 liang), Fructus Aurantii Immaturus (Zhishi, stir-fried), Rhizoma Coptidis (Huanglian, stir-fried), Radix Scutellariae (Huangqin), Rhizoma Pinelliae Preparatum (Banxia, prepared with ginger juice, 5 qian), Pericarpium Citri Reticulatae (Chenpi), Rhizoma Anemarrhenae (Zhimu, stir-fried), Radix Glycyrrhizae Preparata (Gancao, honey-fried), Sclerotium Poriae Cocos (Zhuling, 1 qian). Form into pills using steamed wheat cake dough. Take warm after baking. (Use cold natured herbs for heat conditions [Han Yin Re Yong]. Li Dongyuan established Zhongman Fenxiao Wan to treat Heat Distension, and Fenxiao Tang to treat Cold Distension; distinguish between the two and use accordingly.)
This prescription acts on the Foot-Taiyin Spleen Meridian and Foot-Yangming Stomach Meridian. Cortex Magnoliae Officinalis (Choupu) and Fructus Aurantii Immaturus (Zhishi) promote Qi movement and dissipate fullness; these two herbs also possess the ability to break up old Blood stasis. Rhizoma Coptidis (Huanglian) and Radix Scutellariae (Huangqin) drain Heat and dissipate epigastric stuffiness... [Text fragment] ...then the distension will subside. (Note: This formula combines Liu Jun Zi Tang (Six Gentlemen Decoction), Si Ling San (Four Porias Powder), Xie Xin Tang (Drain the Epigastrium Decoction), Er Chen Tang (Two Aged Herbs Decoction), and Ping Wei San (Maintain the Stomach Powder) into one prescription. The differences lie in the dosages, determining whether the treatment targets the primary or secondary condition. Zhu Danxi said: The Spleen possesses the virtue of Kun (Earth/Stillness) but has the function of Qian (Heaven/Movement). Thus, it can cause the Yang of Heart and Lung to descend and the Yin of Liver and Kidney to ascend, achieving the state of Heaven and Earth interacting (Tai), which constitutes a healthy person. Currently, internal injury from Seven Emotions, external invasion by Six Excesses, irregular diet, and sexual exhaustion causing deficiency, all injure the Yin of Spleen Earth. The official responsible for transport and transformation loses its duty, causing Yang to rise and Yin to fall, resulting in the state of Pi (Stagnation/Non-interaction) where Heaven and Earth do not communicate. Clear and turbid Qi mix, meridians and collaterals become blocked and stagnant, generating Heat. Heat lingering transforms into Dampness. Dampness and Heat generate each other, eventually forming distension. The Classics call this Drum Distension. Because the exterior appears hard and full while the interior is empty, resembling a drum; and because it is stubborn and difficult to treat, it is also named Gu (Poisonous Worm), implying erosion like insects. One should tonify the Spleen, nourish Lung Metal to control Water, so the Spleen is free from thief pathogens; nourish Kidney Yin to control Fire, so the Lung receives the command of clear transformation. Abstain from salty flavors, cut off delusions, and there will be no unrest. Physicians eager for quick results, patients...)