【伤寒腹胀之症】恶寒发热，自汗口渴，小便不利，小腹胀满，此热结膀胱腹胀之症。
若里热不恶寒，自汗不大便，烦满燥实，此阳明胃实腹胀之症。若腹胀硬痛，小便自利，大便或黑
，此蓄血腹胀之症也。
【伤寒腹胀之因】表邪不解，内传太阳之本，则热结膀胱，小便不利而腹胀。若表已解
，肠胃有实热，大便闭结，则腹亦胀。若血蓄下焦，结硬小腹，则腹亦胀。凡此皆伤寒门腹胀也。
【伤寒腹胀之脉】左尺沉数，膀胱结热。右脉沉实，肠胃实热。两尺沉牢，乃是蓄血。
【伤寒腹胀之治】热邪入里，腹胀满，脉沉数，大便结，承气汤选用，腹胀宜下。若寒热者，
大柴胡汤。若热结膀胱，腹胀，小便不利者，仲景用五苓散，家秘用羌活木通汤，调六一散
。若腹胀小便利，大便黑，桃仁承气汤。
承气汤
大柴胡汤 上二方，见伤寒。
羌活木通汤 见后不得卧。
五苓散
白术 茯苓 猪苓 泽泻 肉桂
桃仁承气汤 见后血鼓胀。
【风湿腹胀之症】发热身重，不能转侧，一身尽痛，心腹胀满，外连头面，此风湿腹胀
之症也。
【风湿腹胀之因】或居处卑湿，或冒湿冲风，脾胃受伤，中州痞塞，而腹胀之症作矣。
【风湿腹胀之脉】脉多浮濡，或见浮缓，或见弦长，或见浮涩。
【风湿腹胀之治】胸前饱闷，防风平胃散。身热恶风，羌独败毒散、荆芥汤。下体重滞
，五苓散。内外皆热，用防风木通汤，此上下分消法也。
防风平胃散
苍术 浓朴 广皮 甘草
加防风。下部胀加防己。
羌活败毒散 见后湿痿。
荆芥汤 见后湿热腹胀。
五苓散 即四苓散加桂。身发热，加防风。
防风木通汤 治风湿神效。
防风 木通
【伤寒腹胀的症状】恶寒发热，自汗出且口渴，小便不通畅，小腹部胀满，这是热邪结聚于膀胱所致腹胀的症状。
如果体内有热而不恶寒，自汗出且大便不通，心烦、腹满、燥结、实痛，这是阳明胃腑实证所致腹胀的症状。如果腹部胀满且坚硬疼痛，小便通畅，大便是黑色的，这是瘀血蓄积所致腹胀的症状。
【伤寒腹胀的病因】表邪未解，内传至太阳经的本脏（膀胱），则热邪结聚于膀胱，导致小便不利而腹胀。如果表证已解，肠胃中有实热，大便闭结，那么腹部也会胀满。如果血液蓄积在下焦，凝结硬结于小腹，那么腹部也会胀满。以上这些都属于伤寒门中的腹胀病证。
【伤寒腹胀的脉象】左尺脉沉数，提示膀胱结热。右脉沉实，提示肠胃实热。两尺脉沉牢，则是瘀血的征象。
【伤寒腹胀的治疗】热邪入里，腹胀满，脉沉数，大便结滞，选用承气汤（Chengqi Tang, 调胃承气汤/大承气汤类方剂）进行攻下治疗，腹胀适宜用下法。如果有寒热往来症状，使用大柴胡汤（Dachaihu Tang, Great Bupleurum Decoction）。如果热邪结聚于膀胱，出现腹胀、小便不利，张仲景（Zhang Zhongjing, a famous physician of the Eastern Han Dynasty）使用五苓散（Wuling San, Five-Ingredient Powder with Poria），家传秘方使用羌活木通汤（Qianghuo Mutong Tang, Notopterygium and Akebia Decoction），并配合调服六一散（Liuyi San, Six-to-One Powder）。如果腹胀且小便通畅，大便黑色，使用桃仁承气汤（Taoren Chengqi Tang, Peach Kernel Decoction to Order the Qi）。
承气汤
大柴胡汤 上述两个方剂，见《伤寒论》相关章节。
羌活木通汤 见后文“不得卧”章节。
五苓散
白术（Atractylodis Rhizoma, Baizhu） 茯苓（Poria, Fuling） 猪苓（Polyporus, Zhuling） 泽泻（Alismatis Rhizoma, Zexie） 肉桂（Cinnamomi Cortex, Rougui）
桃仁承气汤 见后文“血鼓胀”章节。
【风湿腹胀的症状】发热，身体沉重，不能翻身转侧，全身疼痛，心腹部胀满，甚至外连头面部，这是风湿所致腹胀的症状。
【风湿腹胀的病因】或者居住在地势低洼潮湿之处，或者冒犯湿气兼受风邪，导致脾胃受伤，中焦气机痞塞，从而引发腹胀症状。
【风湿腹胀的脉象】脉象多呈浮濡，或见浮缓，或见弦长，或见浮涩。
【风湿腹胀的治疗】胸前饱闷，使用防风平胃散（Fangfeng Pingwei San, Saposhnikovia Powder to Regulate the Stomach）。身热恶风，使用羌活败毒散（Qianghuo Baidu San, Notopterygium Powder to Overcome Toxins）、荆芥汤（Jingjie Tang, Schizonepeta Decoction）。下肢沉重滞重，使用五苓散。内外皆热，使用防风木通汤，这是上下分消的治疗方法。
防风平胃散
苍术（Atractylodis Rhizoma, Cangzhu） 浓朴（Magnoliae Officinalis Cortex, Houpo） 广皮（Citri Reticulatae Pericarpium, Chenpi） 甘草（Glycyrrhizae Radix et Rhizoma, Gancao）
加防风（Saposhnikoviae Radix, Fangfeng）。下部胀加防己（Stephaniae Tetrandrae Radix, Fangji）。
羌活败毒散 见后文“湿痿”章节。
荆芥汤 见后文“湿热腹胀”章节。
五苓散 即四苓散加肉桂。身发热，加防风。
防风木通汤 治疗风湿神效。
防风（Saposhnikoviae Radix, Fangfeng） 木通（Akebiae Caulis, Mutong）
[Symptoms of Abdominal Distension in Cold Damage]
Chills and fever, spontaneous sweating with thirst, difficult urination, and distension in the lower abdomen are symptoms of abdominal distension caused by heat binding in the Bladder (Bladder). If there is internal heat without chills, spontaneous sweating, constipation, restlessness, fullness, dryness, and excess, these are symptoms of abdominal distension caused by Yangming Stomach excess syndrome. If the abdomen is distended, hard, and painful, with free urination and black stools, this is abdominal distension caused by blood stasis accumulation.
[Etiology of Abdominal Distension in Cold Damage]
When exterior pathogens remain unresolved and transmit internally to the root organ of the Taiyang (Sun) channel, heat binds in the Bladder, causing difficult urination and abdominal distension. If the exterior condition has resolved but there is excess heat in the intestines and stomach with closed bowels, the abdomen will also become distended. If blood accumulates in the Lower Jiao (Lower Burner), condensing and hardening in the lower abdomen, the abdomen will also become distended. All of these belong to abdominal distension within the category of Cold Damage.
[Pulse Signs of Abdominal Distension in Cold Damage]
The left Chi (Cun-Kou position at the wrist) pulse is deep and rapid, indicating heat binding in the Bladder. The right pulse is deep and excess, indicating excess heat in the intestines and stomach. Both Chi pulses are deep and firm, indicating blood stasis.
[Treatment of Abdominal Distension in Cold Damage]
When heat pathogens enter the interior, causing abdominal distension, a deep and rapid pulse, and constipation, select Chengqi Tang (Chengqi Tang, Purging Decoctions) for purgative treatment; abdominal distension is suitable for downward draining methods. If there are alternating chills and fever, use Dachaihu Tang (Dachaihu Tang, Great Bupleurum Decoction). If heat binds in the Bladder, causing abdominal distension and difficult urination, Zhang Zhongjing uses Wuling San (Wuling San, Five-Ingredient Powder with Poria); the family secret formula uses Qianghuo Mutong Tang (Qianghuo Mutong Tang, Notopterygium and Akebia Decoction), taken with Liuyi San (Liuyi San, Six-to-One Powder). If there is abdominal distension with free urination and black stools, use Taoren Chengqi Tang (Taoren Chengqi Tang, Peach Kernel Decoction to Order the Qi).
Chengqi Tang
Dachaihu Tang: The above two formulas are seen in the Cold Damage texts.
Qianghuo Mutong Tang: See the section on "Inability to Sleep" later.
Wuling San
Baizhu (Atractylodis Rhizoma), Fuling (Poria), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Rougui (Cinnamomi Cortex)
Taoren Chengqi Tang: See the section on "Blood Drum Distension" later.
[Symptoms of Abdominal Distension due to Wind-Dampness]
Fever, heavy body, inability to turn or shift position, pain throughout the body, and distension in the heart and abdomen extending outward to the head and face are symptoms of abdominal distension caused by Wind-Dampness.
[Etiology of Abdominal Distension due to Wind-Dampness]
Living in low-lying damp places, or being exposed to dampness and wind, injures the Spleen and Stomach, causing obstruction in the Middle Jiao (Middle Burner), thereby triggering abdominal distension.
[Pulse Signs of Abdominal Distension due to Wind-Dampness]
The pulse is mostly floating and soggy, or may appear floating and slow, string-taut and long, or floating and choppy.
[Treatment of Abdominal Distension due to Wind-Dampness]
For fullness and oppression in the chest, use Fangfeng Pingwei San (Fangfeng Pingwei San, Saposhnikovia Powder to Regulate the Stomach). For fever and aversion to wind, use Qianghuo Baidu San (Qianghuo Baidu San, Notopterygium Powder to Overcome Toxins) and Jingjie Tang (Jingjie Tang, Schizonepeta Decoction). For heaviness and stagnation in the lower body, use Wuling San. For heat inside and outside, use Fangfeng Mutong Tang (Fangfeng Mutong Tang, Saposhnikovia and Akebia Decoction); this is a method of dispersing from top and bottom.
Fangfeng Pingwei San
Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma)
Add Fangfeng (Saposhnikoviae Radix). Add Fangji (Stephaniae Tetrandrae Radix) if there is distension in the lower part.
Qianghuo Baidu San: See the section on "Damp Paralysis" later.
Jingjie Tang: See the section on "Damp-Heat Abdominal Distension" later.
Wuling San: This is Si Ling San (Four-Ingredient Powder with Poria) plus Rougui (Cinnamomi Cortex). If there is fever, add Fangfeng (Saposhnikoviae Radix).
Fangfeng Mutong Tang: Highly effective for treating Wind-Dampness.
Fangfeng (Saposhnikoviae Radix), Mutong (Akebiae Caulis)