〔大〕夫妇人心腹胀满者，由脏腑久冷，气血虚损，而邪气客之，乘于心脾故也。足
太阴脾之经也，脾虚则胀。足少阴肾之经也，其脉起于小指之下斜趣足心，入跟中上股内
后廉，贯肾络膀胱，从肾上贯肝膈入肺中；其支者从肺出络于心脏。邪气客于三经，与正
气相搏，积聚在内，气并于脾，脾虚有胀，故令心腹烦满而胀也。诊其脉迟而滑者，胀满
也。
〔薛〕前证脾胃虚痞，用六君子汤。（杂病虚劳。）脾胃虚寒者，用人参理中汤。郁结气
滞者，用归脾汤。（杂病健忘。）肝侮脾土，用六君、柴芍。脾气壅滞，用平胃散。（杂病中食。）肺
气壅滞，用紫苏饮。宿食壅滞，用养胃汤。脾血虚痞，用四物汤加参、术。（上六证当互相参用，
仍与血风攻脾不食同用。）一妇人胸膈不利，饮食少思，腹胀吞酸，或用疏利之药，反致中
满不食。予以为脾土虚而肝木盛，用补中益气汤（杂病伤劳倦。）加砂仁、香附、煨姜，又以
六君子加芎、归、桔梗而愈。 吴江史玄年母久病之后，遇事拂意，忽胸腹胀满，面目
微肿，两腿重滞，气逆上升，言语喘促，服清气之剂不效。予曰∶此脾肺虚寒也。先用
六君子汤，一剂病势顿减，后用补中益气加茯苓、半夏、干姜，二剂形体顿安。后以七
情失调，夜间腹胀，乃用十全大补汤加木香治之而痊。
白术散 治妇人脾胃气虚，心腹胀满，不欲饮食，四肢无力。
白术 草果仁 诃子肉（各三分） 赤茯苓 槟榔 桂心（各半两） 陈皮 浓朴 人参（各
一两） 甘草（一分）
上为粗末，每服四钱，水一盅，姜三片，枣一枚，煎至七分，去滓食前热服。
槟榔散 治妇人脾胃虚冷，心腹胀满，不欲饮食。
槟榔 前胡 川芎 青皮（七钱半） 赤芍药 桂心 大黄 苦梗 木香 枳壳（各半两）
甘草（二钱半）
上 咀，每服四钱，姜三片，煎至七分，
去滓温服。
木香散 治证同前。
木香 桂心 白术 干姜（炮） 陈皮（去白） 草果仁 诃梨勒 人参（各一两） 神曲（炒黄，
七钱半） 甘草（炙，半两）
上为细末，每服一钱，茶清点，热服。
《补遗》治心腹胀满。予尝独用浓朴姜汁炒过，每服五钱，姜七片，水煎温服，不拘
时候，间服沉香降气汤得效。（见《资生经》。）
《局方》分心气饮亦妙。（方见杂病气。）三腕散亦妙。（方见两胁胀痛。）
【大论】妇女出现心腹胀满的症状，是由于脏腑长期受寒，气血虚弱受损，导致邪气侵入，乘袭心脾所致。足太阴脾经属于脾脏，脾气虚弱则会导致胀满。足少阴肾经属于肾脏，其经脉起于小趾之下，斜向足心，进入脚跟中，沿大腿内侧后缘上行，贯穿肾脏并联络膀胱，从肾脏向上贯穿肝脏、横膈，进入肺中；其分支从肺出来联络心脏。邪气客居在这三条经脉中，与正气相互搏击，积聚在体内，气机偏并于脾，因脾虚而产生胀满，所以导致心胸腹部烦闷胀满。诊察其脉象迟而滑的，是胀满病。
【薛己按语】上述证候若属脾胃虚弱导致的痞满，使用六君子汤。（出自杂病虚劳篇。）若属脾胃虚寒者，使用人参理中汤。若属郁结气滞者，使用归脾汤。（出自杂病健忘篇。）若属肝木克制脾土者，使用六君子汤加柴胡、白芍。若属脾气壅滞者，使用平胃散。（出自杂病中食篇。）若属肺气壅滞者，使用紫苏饮。若属宿食停滞者，使用养胃汤。若属脾血虚导致的痞满，使用四物汤加入人参、白术。（以上六种证候应当互相参考使用，同时配合治疗血风攻脾不食的方药一起使用。）有一位妇人胸膈不畅，饮食减少，腹胀吞酸，有人使用疏利药物，反而导致中焦胀满不能进食。我认为这是脾土虚弱而肝木亢盛，使用补中益气汤（出自杂病伤劳倦篇）加入砂仁、香附、煨姜，又用六君子汤加入川芎、当归、桔梗而痊愈。吴江史玄年的母亲久病之后，遇到事情不如意，忽然出现胸腹胀满，面目轻微浮肿，双腿沉重滞涩，气逆上升，言语喘促，服用清气的药剂无效。我说：这是脾肺虚寒。先用六君子汤，一剂后病势立刻减轻，后用补中益气汤加入茯苓、半夏、干姜，两剂后身体顿时安适。后来因为七情失调，夜间腹胀，于是使用十全大补汤加入木香治疗而痊愈。
白术散 治疗妇人脾胃气虚，心腹胀满，不想饮食，四肢无力。
白术、草果仁、诃子肉（各三分）、赤茯苓、槟榔、桂心（各半两）、陈皮、浓朴、人参（各一两）、甘草（一分）。
以上药材捣成粗末，每次服用四钱，用水一盅，生姜三片，大枣一枚，煎煮至七分，去渣滓，饭前热服。
槟榔散 治疗妇人脾胃虚冷，心腹胀满，不想饮食。
槟榔、前胡、川芎、青皮（七钱半）、赤芍药、桂心、大黄、苦梗、木香、枳壳（各半两）、甘草（二钱半）。
以上药材切碎，每次服用四钱，生姜三片，煎煮至七分，去渣滓温服。
木香散 治疗的证候同前。
木香、桂心、白术、干姜（炮制）、陈皮（去白）、草果仁、诃梨勒、人参（各一两）、神曲（炒黄，七钱半）、甘草（炙，半两）。
以上药材研为细末，每次服用一钱，用茶清点服，热服。
《补遗》治疗心腹胀满。我曾单独使用浓朴用姜汁炒过，每次服用五钱，生姜七片，水煎温服，不限时候，间或服用沉香降气汤也有效。（见《资生经》。）
《局方》中的分心气饮也很好。（方剂见杂病气篇。）三腕散也很好。（方剂见两胁胀痛篇。）
[Da Lun] When women experience fullness and distension in the heart and abdomen, it is caused by long-standing coldness of the Zang-Fu organs, deficiency and damage of Qi and Blood, allowing pathogenic factors to invade and attack the Heart and Spleen. The Foot-Taiyin Spleen Meridian belongs to the Spleen; when Spleen Qi is deficient, distension occurs. The Foot-Shaoyin Kidney Meridian belongs to the Kidney; its vessel originates below the little toe, slants toward the center of the foot, enters the heel, ascends along the posterior medial aspect of the thigh, penetrates the Kidney, and connects with the Bladder; from the Kidney, it ascends through the Liver and diaphragm into the Lung; its branch emerges from the Lung and connects with the Heart. Pathogenic factors lodging in these three meridians contend with Healthy Qi, accumulating internally. Qi merges with the Spleen; due to Spleen deficiency, distension arises, thus causing vexation, fullness, and distension in the chest, heart, and abdomen. Palpating a pulse that is slow (Chi) and slippery (Hua) indicates distension and fullness.
[Xue Ji's Commentary] For the aforementioned syndrome of Spleen-Stomach deficiency leading to stuffiness, use Liu Jun Zi Tang (Six Gentlemen Decoction). (From Miscellaneous Diseases: Deficiency Labor.) For Spleen-Stomach deficiency-cold, use Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction). For constraint and Qi stagnation, use Gui Pi Tang (Restore the Spleen Decoction). (From Miscellaneous Diseases: Forgetfulness.) For Liver overacting on Spleen Earth, use Liu Jun Zi Tang plus Chai Hu (Bupleuri Radix) and Bai Shao (Paeoniae Radix Alba). For Spleen Qi congestion and stagnation, use Ping Wei San (Calm the Stomach Powder). (From Miscellaneous Diseases: Food Retention.) For Lung Qi congestion and stagnation, use Zi Su Yin (Perilla Infusion). For retained food stagnation, use Yang Wei Tang (Nourish the Stomach Decoction). For Spleen Blood deficiency leading to stuffiness, use Si Wu Tang (Four Substances Decoction) added with Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). (The above six syndromes should be used in conjunction with reference to one another, and still employed together with treatments for Blood Wind attacking the Spleen causing anorexia.) A woman suffered from chest and diaphragm discomfort, poor appetite, abdominal distension, and acid regurgitation. After using draining and regulating herbs, she instead developed middle-jiao fullness and inability to eat. I considered this to be Spleen Earth deficiency with Liver Wood excess. I used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Sha Ren (Amomi Fructus), Xiang Fu (Cyperi Rhizoma), and Wei Jiang (Roasted Ginger), followed by Liu Jun Zi Tang added with Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Jie Geng (Platycodonis Radix), resulting in recovery. The mother of Shi Xuan from Wujiang, after a prolonged illness, encountered frustrating events and suddenly developed chest and abdominal distension, slight facial edema, heavy and sluggish legs, ascending rebellious Qi, and panting speech. Administration of clearing-heat agents was ineffective. I stated: This is Spleen-Lung deficiency-cold. First, administer Liu Jun Zi Tang; after one dose, the disease severity decreased abruptly. Then, use Bu Zhong Yi Qi Tang added with Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma Preparatum), and Gan Jiang (Zingiberis Rhizoma), resulting in physical restoration after two doses. Later, due to emotional imbalance, she experienced nighttime abdominal distension; thus, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) added with Mu Xiang (Aucklandiae Radix) was used to cure her.
Bai Zhu San (Atractylodis Macrocephalae Powder) treats women with Spleen-Stomach Qi deficiency, heart and abdominal distension, lack of desire for food, and weakness in the four limbs.
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cao Guo Ren (Tsaoko Cardamomi Fructus), He Zi Rou (Terminalia Chebulae Fructus Flesh) (each 3 fen), Chi Fu Ling (Poria cum Ligno Rubrum), Bing Lang (Arecae Semen), Gui Xin (Cinnamomi Ramulus Cortex) (each 0.5 liang), Chen Pi (Citri Reticulatae Pericarpium), Nong Po (Magnoliae Officinalis Cortex), Ren Shen (Ginseng Radix et Rhizoma) (each 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 fen).
Grind into coarse powder. Each dose consists of 4 qian, boiled with 1 zhong of water, 3 slices of ginger, and 1 jujube, until reduced to 7/10. Strain and take warm before meals.
Bing Lang San (Arecae Semen Powder) treats women with Spleen-Stomach deficiency-cold, heart and abdominal distension, and lack of desire for food.
Bing Lang (Arecae Semen), Qian Hu (Peucedani Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride) (7.5 qian), Chi Shao Yao (Paeoniae Radix Rubra), Gui Xin (Cinnamomi Ramulus Cortex), Da Huang (Rhei Radix et Rhizoma), Ku Jing (Platycodonis Radix), Mu Xiang (Aucklandiae Radix), Zhi Ke (Aurantii Fructus Immaturus) (each 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (2.5 qian).
Chop ingredients. Each dose consists of 4 qian, boiled with 3 slices of ginger, until reduced to 7/10. Strain and take warm.
Mu Xiang San (Aucklandiae Radix Powder) treats the same syndromes as above.
Mu Xiang (Aucklandiae Radix), Gui Xin (Cinnamomi Ramulus Cortex), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Jiang (Zingiberis Rhizoma Preparatum) (processed), Chen Pi (Citri Reticulatae Pericarpium) (peeled), Cao Guo Ren (Tsaoko Cardamomi Fructus), He Li Le (Terminalia Chebulae Fructus), Ren Shen (Ginseng Radix et Rhizoma) (each 1 liang), Shen Qu (Massa Medicata Fermentata) (stir-fried yellow, 7.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted, 0.5 liang).
Grind into fine powder. Each dose consists of 1 qian, taken with tea infusion, hot.
[Bu Yi] Treats heart and abdominal distension. I once used alone Nong Po (Magnoliae Officinalis Cortex) stir-fried with ginger juice, each dose 5 qian, with 7 slices of ginger, boiled in water and taken warm, at any time. Intermittently taking Chen Xiang Jiang Qi Tang (Aquilariae Descending Qi Decoction) proved effective. (See Zi Sheng Jing.)
Fen Xin Qi Yin (Dividing Heart Qi Infusion) from Ju Fang is also excellent. (Formula seen in Miscellaneous Diseases: Qi.) San Wan San (Three Wrists Powder) is also excellent. (Formula seen in Hypochondriac Distension and Pain.)