（附肿胀）
鼓症者，其大腹逢逢如鼓之谓也。有气有血，有水有食积，有痞有虫，各有寒热虚实之
分，
肿胀之别。其因气者，其人善怒，肝旺脾衰，致肺气不宣。流为是症者，必兼咳嗽。治宜先
用轻剂，如桑皮、杏仁、通草之类，即徐之才《十剂》中所谓轻可去实也。继用泄木化气之
品，如桑叶、黑栀、夏枯草、广皮、砂仁壳、大苏梗之类。其因气虚腹满者，当补中益气，
加五皮化气之品。其因血者，必血已离经，瘀滞脏腑，以成是症，或血痢涩早，邪不得泄，
亦成此患。治宜逐瘀，如桃仁、归尾、红花、楂肉、枳实、鸡内金、大黄，再加气药。其因
水者，一因土虚不能制水，一因肾脏虚寒，不能化气，致水泛滥者，治当补土温肾，加利水
化气之药。有实水肿，腿踝按之则陷如泥，目下浮起如新卧起状，兼头面浮肿者，先开鬼门
，用风药散之；继用五皮饮，加苡仁、砂壳、泽泻、车前之类利之，谓之洁净府，此症最为
易治。其气血水三症之中，如带食积，各宜加消积之品；其痞而胀者，当用消痞丸，随其因
而加减之；其虫积为鼓，当用槟榔、雷丸、芜荑、使君子，或加大黄、枳实等药治之。凡肿
易治，胀难治，肿因有邪，胀从脏腑而发。若
凡上下不肿，惟大腹青筋累累，脐突单腹胀，尤为难治。
凡疟疾愈后，切忌骤补，往往为患不测。盖邪半入于里，初愈者邪未尽泄，十有四五。
善调
者素食淡荤，待其胃气撤消，正强而留邪自去。常见一人，疟愈后服人参汤，竟成痿症；一
人疟后食煨扁豆，即成鼓胀，皆致不起，可不慎哉！
（附注：肿胀）
鼓胀病，是指腹部膨大如鼓的症状。其病因有气滞、血瘀、水停、食积、痞块和虫积之分，各自又有寒热虚实的不同，以及肿胀性质的区别。
因气滞引起的，患者容易发怒，导致肝气旺盛而脾气虚弱，致使肺气不能宣发。出现这种病症的，必定兼有咳嗽症状。治疗应当先用轻扬之剂，如桑白皮、杏仁、通草之类，这就是徐之才《十剂》中所说的“轻可去实”（轻清之品可以去除实证）。随后使用疏泄肝木、化除气滞的药物，如桑叶、黑栀子、夏枯草、广陈皮、砂仁壳、紫苏梗之类。如果是因气虚导致的腹部胀满，应当补中益气，并加入五皮饮以化气行水。
因血瘀引起的，必然是血液已经离开经脉，瘀滞于脏腑之中而形成此症；或者是患有血痢且排便涩滞不畅，邪气无法排出，也会造成这种病患。治疗应当逐瘀，如用桃仁、当归尾、红花、山楂肉、枳实、鸡内金、大黄，再配合行气药物。
因水湿引起的，一是因为脾土虚弱不能制约水湿，二是因为肾脏虚寒，不能气化水分，导致水湿泛滥。治疗应当健脾补土、温补肾阳，并加入利水化气的药物。如果有实性水肿，腿部脚踝按压后凹陷如泥，眼下浮肿像刚睡醒的样子，兼有头面部浮肿的，先采用“开鬼门”（发汗）的方法，用风药发散；随后使用五皮饮，加薏苡仁、砂仁壳、泽泻、车前子之类以利小便，这叫做“洁净府”（清理膀胱），这种病症最容易治疗。
在上述气、血、水三种病症中，如果夹杂食积，各宜加入消食导滞的药物；如果是痞块导致的胀满，应当使用消痞丸，根据具体病因进行加减；如果是虫积导致的鼓胀，应当使用槟榔、雷丸、芜荑、使君子，或者加大黄、枳实等药物治疗。
凡是水肿容易治疗，胀满难治，因为水肿多由外邪引起，而胀满是从脏腑内部产生的。如果上下身体都不肿，只有大腹部的青筋暴露凸起，肚脐突出且单腹胀大，尤其难以治疗。
凡是疟疾痊愈后，切忌急于进补，往往会造成不可预测的祸患。因为邪气一半进入体内，初愈时邪气尚未完全清除，这种情况占十分之四五。善于调养的人应食用素食和清淡荤食，等待胃气恢复，正气强盛后，留存的邪气自然离去。常见有人，疟疾痊愈后服用人参汤，最终竟变成痿证；还有人疟疾后吃煨熟的扁豆，立即形成鼓胀，都导致死亡，能不谨慎吗！
(Note: Swelling)
Guzhang (Drum Distension) refers to the condition where the abdomen is distended and large like a drum. The etiologies include Qi stagnation, Blood stasis, Water retention, Food accumulation, Pi masses (obstructive masses), and Parasite accumulation. Each has its own differentiation of Cold/Heat and Deficiency/Excess, as well as distinctions in swelling characteristics.
For cases caused by Qi stagnation, the patient is prone to anger, leading to Hyperactive Liver Qi and Spleen Qi Deficiency, resulting in the failure of Lung Qi to disperse. Patients presenting this syndrome will invariably have accompanying coughing. Treatment should initially employ light agents, such as Sangbai Pi (Morus Albae Cortex), Xingren (Armeniacae Semen Amarum), and Tongcao (Tetrapanacis Medulla). This corresponds to what Xu Zhicai described in his "Ten Categories of Formulas" (Shi Ji) as "Lightness can dispel Excess." Subsequently, herbs that drain the Liver and transform Qi should be used, such as Sang Ye (Mori Folium), Hei Zhi Zi (Gardeniae Fructus Preparatus), Xiakucao (Prunellae Spica), Guangpi (Citri Reticulatae Pericarpium), Sharen Qiao (Amomi Fructus Pericarpium), and Dasu Geng (Perillae Caulis). For abdominal fullness caused by Qi Deficiency, one should tonify the Middle and augment Qi, adding ingredients from Wupi Yin (Five-Peel Decoction) to transform Qi and promote diuresis.
For cases caused by Blood stasis, it implies that blood has left the vessels, causing stasis within the Zang-Fu organs. Alternatively, it may result from bloody dysentery with difficult defecation, preventing the expulsion of pathogens. Treatment should focus on expelling stasis using Tao Ren (Persicae Semen), Guiwei (Angelicae Sinensis Radix Caudex), Honghua (Carthami Flos), Zharu (Crataegi Fructus), Zhishi (Aurantii Fructus Immaturus), Jineijin (Galli Gigerii Endothelium Corneum), and Dahuang (Rhei Radix et Rhizoma), combined with Qi-moving herbs.
For cases caused by Water retention, the causes are either Spleen Earth Deficiency failing to control Water, or Kidney Yang Deficiency and Cold failing to transform Qi, leading to water flooding. Treatment requires tonifying Earth and warming the Kidney, along with herbs that promote urination and transform Qi. In cases of Excess-type edema, where pressing the ankles leaves an indentation like mud, the infraorbital area is puffy as if just awakened, accompanied by facial edema, one should first apply "Kai Guimen" (Opening the Ghost Gate, i.e., inducing sweating) using Wind-dispelling herbs. Subsequently, use Wupi Yin (Five-Peel Decoction) supplemented with Yiren (Coicis Semen), Sharen Qiao (Amomi Fructus Pericarpium), Zexie (Alismatis Rhizoma), and Cheqianzi (Plantaginis Semen) to promote urination, known as "Jing Jingfu" (Cleaning the Fu Organs). This type of case is the easiest to treat.
Among these Qi, Blood, and Water syndromes, if complicated by food accumulation, digestive-resolving herbs should be added. If distension is due to Pi masses, Xiaopi Wan (Mass-Resolving Pill) should be used, modified according to the specific cause. If Guzhang is caused by parasite accumulation, Binlang (Arecae Semen), Leiwuan (Oryzodendronis Rhizoma), Wuyi (Meliosmae Fructus), and Shijunzi (Quisqualis Fructus) should be used, possibly augmented with Dahuang (Rhei Radix et Rhizoma) and Zhishi (Aurantii Fructus Immaturus).
Generally, edema is easy to treat, while distension is difficult. Edema often stems from external pathogens, whereas distension originates from internal Zang-Fu dysfunction. If there is no swelling in the upper or lower body, but only prominent varicose veins on the abdomen, protruding umbilicus, and isolated abdominal distension, it is particularly difficult to treat.
After malaria resolves, one must strictly avoid sudden tonification, which often leads to unpredictable complications. Since the pathogen is half-inside, upon initial recovery, the pathogen is not yet fully expelled in 40-50% of cases. Those skilled in regulation should consume vegetarian and bland meat diets, waiting for the Stomach Qi to recover; once Zheng Qi (Upright Qi) is strong, the lingering pathogen will naturally depart. It is common to see individuals who, after recovering from malaria, take Ginseng Decoction and ultimately develop Wei Syndrome (Flaccidity Syndrome); others who eat baked Lablab Beans immediately after malaria develop Guzhang, both leading to death. How prudent one must be!