证治总例 腹胀心膨者，若因伤寒，或寒热瘴疟，或泻痢大病之后，只是吃食后，便腹胀心膨，不美饮
食，噫醋吞酸，纵食些少，亦觉膨胀者，切不可用消食克化之药。若用药动下，转加困重，去生便远也。但可与
正气散、嘉禾散、参苓白术散、四君子汤，但得气壮，自能饮食加倍，膨胀自愈。（《和剂指南》）
设冬感寒，胸中痞满，脉来沉细，为寒胀，治宜温解寒邪。夏月伤热，胸腹坚满，脉来虚弱，为暑胀，治宜
清热除湿。若饥饱伤脾，脾气若虚，迟于克化，少有停滞，即为胀满，脉浮滑者，为膨满也，宜以消导所滞，
其病自愈。若其不升降，痞结胸中，三焦相混，大小便不通，卒然胀满，脉来沉伏，为三焦胀也。又有虚实之分，
虚者皮肤壳壳然而坚，不痛而气满，治以升降气道，温补脾元，即复矣；实者内挟宿食，邪实于内，按之坚痛，
当以疏气涤实可也。至以久病而胀，脾土已败，最为危证，治难取效。诸胀当推其原
【证治总例】腹部胀大、心窝部膨隆的症状，如果是由于伤寒病，或者寒热往来的瘴疟病，或者是严重的腹泻痢疾大病之后，仅仅是在进食后出现腹部胀大、心窝部膨隆，食欲不佳，嗳气带有酸腐味或吞酸，即使只吃很少的食物，也感觉腹胀膨胀的，千万不可使用消食导滞、攻伐消化的药物。如果使用这类药导致腹泻，病情反而会加重困重，离康复就越来越远了。只能给予正气散、嘉禾散、参苓白术散、四君子汤等方剂治疗，只要脾胃之气强壮起来，自然能够加倍饮食，腹胀膨胀的症状也会自行痊愈。（出自《和剂指南》）
如果在冬季感受寒邪，胸中痞塞满闷，脉象沉细，这是寒胀，治疗应当温散寒邪。夏季感受热邪，胸腹部坚硬胀满，脉象虚弱，这是暑胀，治疗应当清热除湿。如果因饥饱不节损伤了脾胃，脾气虚弱，消化功能迟缓，稍有停滞，就会形成胀满，脉象浮滑的，属于膨满，适宜用消导积滞的方法治疗，疾病自然会痊愈。如果气机不升降，痞结在胸中，三焦（上焦、中焦、下焦的功能系统）混乱，大小便不通，突然发生胀满，脉象沉伏，这是三焦胀。又有虚实之分，虚证表现为皮肤松弛而按之坚硬，不疼痛但气机壅满，治疗以调理气机升降、温补脾阳元气为主，即可恢复；实证表现为体内夹杂宿食，邪气实于内，按压时坚硬且疼痛，应当用疏理气机、涤荡实邪的方法治疗。至于久病导致的腹胀，脾土之气已经败坏，是最为危重的证候，治疗难以见效。各种胀满病症都应当推究其根本原因。
[General Principles of Syndrome Differentiation and Treatment] Abdominal distension and epigastric fullness (swelling of the heart region), if caused by Shanghan (Cold Damage disease), or chills and fever malarial fevers, or after a severe illness such as dysentery or diarrhea, occurring merely after eating with abdominal distension and epigastric swelling, poor appetite, belching with acid regurgitation, and feeling bloated even after consuming small amounts of food, must absolutely not be treated with digestive-promoting or purgative medications. If such medicines are used to induce defecation, the condition will worsen with increased heaviness and fatigue, moving further away from recovery. Instead, one may administer Zhengqi San (Regular Qi Powder), Jiahe San (Harvesting Grain Powder), Shenling Baizhu San (Ginseng, Atractylodes Macrocephala, and Poria Powder), or Sijunzi Tang (Four Gentlemen Decoction). Once the healthy Qi is strengthened, appetite will naturally double, and the distension will heal itself. (From *Heji Zhinan*)
If cold pathogen is contracted in winter, resulting in chest stuffiness and fullness with a deep and fine pulse, this is Cold Distension; treatment should focus on warming and resolving the cold pathogen. If heat pathogen is injured in summer, causing hardness and fullness of the chest and abdomen with a weak pulse, this is Summerheat Distension; treatment should focus on clearing heat and removing dampness. If the spleen is damaged by irregular eating habits, leading to Spleen Qi deficiency and sluggish digestion, any slight stagnation can result in distension. With a floating and slippery pulse, it is classified as Puffiness Distension; treatment should employ methods to resolve and guide out the stagnation, and the disease will heal spontaneously. If the ascending and descending mechanisms fail, causing obstruction and knotting in the chest, mixing of the Sanjiao (Triple Burner), and blockage of urination and defecation, sudden distension occurs with a deep and hidden pulse; this is Sanjiao Distension. There are also distinctions between deficiency and excess patterns. In deficiency patterns, the skin appears loose yet feels firm upon palpation, without pain but with Qi fullness; treatment involves regulating the ascending and descending of Qi and warming and tonifying the Spleen's primal Qi, leading to recovery. In excess patterns, there is internal retention of undigested food, with pathogenic excess inside, presenting as hardness and pain upon pressure; treatment should involve dispersing Qi and cleansing out the excess. As for distension resulting from chronic illness, where the Earth element of the Spleen has failed, it is a critical condition difficult to treat effectively. For all types of distension, one must investigate the root cause.