〔总论〕 胀与满不同。胀者胀于皮肤之间。非脏腑肠胃之内。满者满在肠胃之内。如
饱满一般。胀多属虚。而满有虚实之别。实者属热。中气郁滞不行也。若大便结。小便赤。
口干。体壮者宜下。如虚则吐食。或食不下。大小便清利。以指按之陷者为虚。或朝宽而暮
急。或朝急而晚宽。皆属气虚。宜温补。 妇女满胀兼积血者多。治宜行血。又若男妇四肢
节痛而兼肿。则属风湿。又有周身四肢皆肿。乃表病也。有先胀满而后肿者可治。若先肿而
后胀满者难治。男从脚下肿而上。女从头面肿而下。为顺可治。反此则难治也。 四肢安而
腹独胀者为鼓胀。其治之法。须审其气鼓、水鼓、湿鼓、食鼓之不同。大抵气与水者居多。
将手指按病患腹上。有窝者可治。脉壮者易治。若脉细脐肿突出者。阴囊无缝者。肚上青筋
见。泻后腹肿者。皆不治。
〔满胀〕 气滞属实者。鸡内金。（一个焙）真沉香。砂仁。（各三钱）陈香圆。（去核
五
钱）共为末。每服五分。姜汤下。 土鳖。（即接骨虫）瓦上焙燥。每用一二个。以沉香一
钱
磨水调服甚效。
〔气虚中满〕 或因病后。或劳役过度。胸腹痞满者。宜补中益气汤。（方见劳损门。）
多服取效。
〔气鼓〕 陈年大麦须水煎汤服。泄气即消。（再以清补药服之不再发。）
〔一切鼓胀〕 雄猪肚一具洗净。入大蒜四两淡煮烂。去蒜连汁食之。连吃五七次全愈。
忌
〔水鼓〕 赤尾大鲤鱼。用大蒜二两淡煮食。以好为度。 或服陈皮。木通。大腹皮。
（盐水洗）茯苓。（各一钱）车前子。米仁。（各三钱）茵陈。（一钱半）榔槟。（八分）水煎
服。忌
食盐。好后。调养脾胃。方无后患。真水银粉。（二钱）巴豆肉。（研去油四两）生硫黄。（一
钱）研成饼贴脐上。黄水自下。（贴时。先以绵二片铺脐上。次贴药饼。外用帛缚之。如人
行
三五里。黄水自下。待三五度后。去饼温粥补之。调理脾胃自愈。久患者隔日取水。一药饼
可治二三十人。）凡水鼓食盐太早。复发无药可治者。用大虾蟆。（取腹中KT 肚。不见水
切碎）
〔腹胀及四肢发肿〕 干鸡屎半斤。酒一斗浸七日。日饮三杯。或炒燥为末。酒下二钱
即效。 鸡屎炒研。沸汤淋汁。调木香。（研）槟榔。（炒研各一钱）即效。（按本草鸡屎白。
微寒无毒。治瘕症鼓胀。诸药不效者。用之即验。用此等方勿与病患知之） 鸬 鸟焙干为
末。米饮调下亦效。
〔妇人血鼓〕 马鞭草。刘寄奴煎浓服。
【总论】胀与满是不同的。胀是指腹部在皮肤之间肿胀，并不在脏腑和肠胃内部。满是指腹部在肠胃内部感到饱胀，就像吃饱了一样。胀多属于虚证，而满则有实证和虚证的区别。实证属于热证，是中气郁滞不通所致。如果大便干结、小便色赤、口干、身体壮实的人，适宜使用攻下法。如果是虚证，则会出现呕吐食物或饮食难以下咽的情况，大小便清长通畅，用手指按压腹部出现凹陷的为虚证。或者早晨症状缓解而傍晚加重，或者早晨加重而傍晚缓解，都属于气虚，适宜温补。妇女的满胀兼有瘀血积滞的情况较多，治疗适宜活血化瘀。另外，男女四肢关节疼痛并伴有肿胀的，属于风湿病。又有全身四肢都肿胀的，这是表证。有先出现胀满而后出现肿胀的可以治疗，如果先出现肿胀而后出现胀满的则难以治疗。男性从脚部开始肿胀向上蔓延，女性从头面部开始肿胀向下蔓延，这是顺证，可以治疗；反之则是逆证，难以治疗。四肢正常而唯独腹部肿胀的称为鼓胀。其治疗方法，必须辨别是气鼓、水鼓、湿鼓、食鼓的不同。大抵上气和水引起的居多。将手指按在患者腹部，按压后留有凹陷的可以治疗。脉象有力的容易治疗。如果脉象细弱、脐部肿胀突出、阴囊没有缝隙、肚子上青筋暴露、泻下后腹部依然肿胀的，都是不治之症。
【满胀】气滞属实证的，用鸡内金（一个焙干）、真沉香、砂仁（各三钱）、陈香圆（去核五钱），共研为末。每次服用五分，姜汤送服。土鳖（即接骨虫）在瓦上焙干，每次用一到两个，用一钱沉香磨成的水调服，效果很好。
【气虚中满】或者因病后体虚，或者劳役过度，导致胸腹痞闷胀满的，适宜服用补中益气汤（方剂见劳损门）。多服用以取得疗效。
【气鼓】用陈年大麦须煎汤服用，泄气后胀满即可消除。（再用清补药服用，不再复发。）
【一切鼓胀】取雄猪肚一个洗净，放入四两大蒜淡煮至烂熟，去掉大蒜，连汁一起食用。连续吃五到七次即可痊愈。忌口。
【水鼓】选用赤尾大鲤鱼，用二两大蒜淡煮食用，以煮熟为佳。或者服用陈皮、木通、大腹皮（盐水洗）、茯苓（各一钱）、车前子、薏苡仁（各三钱）、茵陈（一钱半）、槟榔（八分），水煎服用。忌食盐。病好后，调养脾胃，才不会有后患。用真水银粉（二钱）、巴豆肉（研去油四两）、生硫黄（一钱），研成饼状贴在脐上，黄色水液自然流出。（贴的时候，先在脐上铺两片绵，再贴药饼，外面用布帛捆扎固定。如人行走三五里路，黄水自然流出。等流三四次后，去掉药饼，喝温粥补益。调理脾胃自愈。久病患者隔日取水一次，一个药饼可治二三十人。）凡是水鼓患者过早吃盐，复发无药可治的，用大虾蟆（取其腹中的KT肚，不见水切碎）。
【腹胀及四肢发肿】用干鸡屎半斤，酒一斗浸泡七天，每天饮三杯。或者炒干研为末，酒送服二钱，即刻见效。鸡屎炒后研碎，用沸水淋取汁液，调入木香（研）、槟榔（炒研各一钱），即刻见效。（按《本草》记载，鸡屎白，微寒无毒，治疗瘕聚鼓胀，其他药物无效的，用它即验。使用此类方剂不要告诉病患。）鸬鹚鸟焙干研为末，米饮调服也有效。
[General Discussion] Distension (Zhang) and fullness (Man) are different. Distension refers to swelling between the skin, not within the Zang-Fu organs or intestines and stomach. Fullness refers to a sensation of being stuffed within the intestines and stomach, similar to feeling overly full after eating. Distension mostly belongs to deficiency syndromes, whereas fullness can be either excess or deficiency. Excess types belong to heat syndromes, caused by stagnation and obstruction of Middle Qi. If there is constipation, dark urine, dry mouth, and robust physical constitution, purgative methods are suitable. If it is a deficiency type, symptoms such as vomiting food or inability to swallow may occur, with clear and profuse urination and defecation; pressing the abdomen with fingers leaves an indentation, indicating deficiency. Alternatively, symptoms that ease in the morning and worsen in the evening, or worsen in the morning and ease in the evening, all belong to Qi deficiency, and warming and tonifying methods are suitable. For women, fullness and distension accompanied by blood stasis accumulation are common; treatment should focus on promoting blood circulation. Additionally, if men or women have pain in the limbs and joints accompanied by swelling, it belongs to Wind-Dampness. If the entire body and limbs are swollen, it is a Exterior syndrome. Cases where distension precedes swelling are treatable; however, cases where swelling precedes distension are difficult to treat. In men, swelling starting from the feet and moving upward, and in women, swelling starting from the face and head and moving downward, are considered favorable (Shun) and treatable; the reverse indicates unfavorable (Ni) prognosis and is difficult to treat. When the limbs are normal but only the abdomen is swollen, it is called Drum Distension (Gu Zhang). The treatment method requires distinguishing between Qi drum, Water drum, Dampness drum, and Food drum. Generally, Qi and Water causes are most common. Pressing the patient's abdomen with fingers: if an indentation remains, it is treatable. A strong pulse indicates easier treatment. If the pulse is fine/thin, the umbilicus is swollen and protruding, the scrotum has no seam, green veins are visible on the abdomen, or abdominal swelling persists after purging, these are incurable.
[Fullness and Distension] For Qi stagnation presenting as excess syndrome: Ji Nei Jin (Gallus gallus domesticus Burch. endostyleum, one piece roasted), Zhen Chen Xiang (Aquilaria sinensis wood), Sha Ren (Amomum villosum fruit) (each 3 qian), Chen Xiang Yuan (Citrus reticulata peel, pith removed, 5 qian). Grind into powder. Take 0.5 fen each time, washed down with Ginger Decoction. Tu Bie (Eupolyphaga sinensis, also known as Jie Gu Chong) roasted dry on a tile. Use 1-2 pieces each time, mixed with water made from grinding 1 qian of Chen Xiang, taken orally; this is very effective.
[Qi Deficiency with Middle Fullness] Whether due to post-illness weakness or excessive labor, leading to chest and abdominal stuffiness and fullness: Bu Zhong Yi Qi Tang (see Labor Damage section for formula). Take frequently to achieve efficacy.
[Qi Drum] Decoct water with aged barley awns and drink. The Qi will dissipate and distension will subside. (Subsequently take clearing and tonifying medicines to prevent recurrence.)
[All Types of Drum Distension] Take one male pig stomach, wash clean. Add 4 liang of garlic and boil lightly until soft. Remove the garlic and consume the stomach with the broth. Consume continuously for 5-7 times for complete recovery. Avoid certain foods.
[Water Drum] Use large carp with red tails. Boil lightly with 2 liang of garlic and eat. Cook thoroughly. Alternatively, take Chen Pi (Citrus reticulata peel), Mu Tong (Akebia quinata stem), Da Fu Pi (Areca catechu pericarp) (washed in salt water), Fu Ling (Poria cocos sclerotium) (each 1 qian), Che Qian Zi (Plantago asiatica seed), Yi Yi Ren (Coix lacryma-jobi var. ma-yuen seed) (each 3 qian), Yin Chen (Artemisia capillaris herb) (1.5 qian), Lang Bin (Areca catechu seed) (8 fen). Decoct in water and drink. Avoid table salt. After recovery, regulate the Spleen and Stomach to prevent relapse. Use Zhen Shui Yin Fen (Calomel, 2 qian), Ba Dou Rou (Croton tiglium seed flesh, ground and oil removed, 4 liang), Sheng Liu Huang (Sulfur, 1 qian). Grind into a cake and apply to the umbilicus. Yellow fluid will naturally drain out. (When applying, first place two layers of cotton on the umbilicus, then the medicine cake, and secure externally with cloth. Walk for 3-5 li; yellow fluid will drain naturally. After 3-5 applications, remove the cake and warm congee to tonify. Regulate the Spleen and Stomach for self-healing. For chronic patients, drain fluid every other day; one medicine cake can treat 20-30 people.) For Water Drum patients who eat salt too early and suffer relapse with no cure available: use large toads. Take the KT du (stomach/intestine content) from the abdomen, ensure no water is present, and chop finely.
[Abdominal Distension and Swelling of Limbs] Use half a jin of dried chicken feces. Soak in one dou of wine for seven days. Drink three cups daily. Or roast dry, grind into powder, and take 2 qian with wine for immediate effect. Roast chicken feces, grind, and pour boiling water over to extract juice. Mix with Mu Xiang (Saussurea lappa root, ground) and Bing Lang (Areca catechu seed, roasted and ground, each 1 qian). Immediate effect. (Note: According to Materia Medica, Ji Shi Bai (white part of chicken feces) is slightly cold and non-toxic. It treats mass formations and drum distension when other medicines fail; using it yields verification. Do not inform patients about using such formulas.) Lu Ci Niao (Phalacrocorax carbo) roasted dry, ground into powder, taken with rice drink; also effective.
[Women's Blood Drum] Ma Bian Cao (Verbena officinalis herb) and Liu Ji Nu (Vladimiria soulieana root) decocted strongly and taken.