墀儿年逾弱冠，向无疾病，夏间偶患腹胀，以为湿滞，无关紧要，虽服药饵，然饮食起
居，
失于谨慎。纠缠两月，腹形渐大，肌瘦食减，时作呕吐，自疗不愈。就同道曹肖岩余朗亭二
公延医，药如和渗温清消补，遍尝无验。其时尚能勉力出户，犹不介意。予思既诸药无功，
谚云∶不药得中医。遂令停药。迨至冬初，因事触怒，病益增剧，食入旋呕，卧即气冲，二
便欠利。予忆经云∶肝主怒，怒则气上，得无肝气横逆，阻胃之降。是以为呕为胀，与自拟
越鞠逍遥，及安胃制肝方法，亦不应。渐至腹大如鼓，坚硬如石，筋绽脐突，骨立形羸，行
步气促。予技已穷，复邀同道诸公视之，皆称证成中满，消补两难，有进专治鼓胀丸药者，
言其音如响，一下其腹即消。予料彼药乃巴黄霸劫之品，今恙久胃虚，如何能受。即古治单
胀，有用鸡矢醴一方，顾斯畏食呕吐，气味亦不相投，昼夕踌躇，无策可画。俄延至腊，忽
睹梅梢蕊放，见景生情，旋摘数十枝，令以汤泡代茶，日啜数次。机关勘破，触类旁通，家
有藏酿，用木瓜橘饼各三钱，另以村醪煎熟，与藏酿对冲，晚饮两杯。以前腹胀否塞，绝不
响动。如此啜饮三日，腹中微鸣，不时天气，坚硬稍软，迨至旬余，胀势减半，二便觉爽，
食入不呕，夜能安卧，匝月后腹胀全消。当时胀甚腹如抱瓮，疑谓何物邪气?若此之盛，及
其胀消，大便并无秽恶遗出，可知即此身之元气，与此身为难首耳。儿病愈后，咸以为奇。
友人问予所用梅花治胀，出于何书。予曰∶运用之妙，存乎一心，此予之会心偶中，无古可
师。大概梅占先春，花发最早，其气芳香，故能舒肝醒脾。橘皮调和诸气。肝以敛为泻，木
瓜酸柔，能于土中泻木，更藉酒力，是以得效。友人喟然曰∶子良工也。公郎之疾，固虽有
术起之于后，尚且无法疗之于前。此医之难也。然使此证患于不明医理之家，当其迫切之际
，未有不随下药而毙者。此又医之不可不知也。予聆斯语，不觉悚然。
安波按∶膨证一候，世乏良方。细绎此子得愈之由，缘年正方刚，血气甚盛，虽病久
形衰
，而根蒂尚固。更兼年轻无知，郁怒未深，并非冤沉海底，大怒不解，日就忧抑者同日而语
。不然腊残春回，木升当阳，其病日增之不暇，岂藉梅花微末之材，可能却病乎?余见是证
，不治者甚众，其年均在四五六左右，三十以外，尚未之闻也。余生也晚，不然责之杏翁，
以为然乎否乎。
程杏轩的次子光墀，年龄刚过二十岁，向来没有疾病。夏天时偶然患上腹胀，（我）认为是湿气停滞，觉得无关紧要，虽然服用了药物，但在饮食起居方面缺乏谨慎。病情纠缠了两个月，腹部逐渐变大，肌肉消瘦，食欲减退，时常呕吐，自行治疗未能痊愈。于是请同道的曹肖岩、余朗亭两位先生延请医生诊治，用药包括调和、渗利、温补、清热、消导、补益等法，遍尝无效。当时他尚能勉强出门活动，仍不以为意。我想既然各种药物都无效果，俗话说：“不吃药反而能得到中等水平的治疗效果。”于是令其停药。等到初冬时节，因事情触怒，病情更加严重，吃下去的食物随即呕吐，躺下就感觉气逆上冲，大小便不畅。我回忆《内经》所说：“肝主怒，怒则气上”，莫非是肝气横逆，阻碍了胃气的下降？因此出现呕吐和腹胀的症状，使用我自拟的越鞠逍遥汤，以及安胃制肝的方法，也没有见效。逐渐发展到腹部大如鼓，坚硬如石，青筋暴露，肚脐突出，骨骼显露，形体羸弱，行走时气喘急促。我的医术已穷尽，再次邀请同道各位先生诊视，大家都称此证已成“中满”（指脘腹胀满严重的病证），消法和补法都难以施用。有人推荐专门治疗鼓胀的丸药，说服药后腹中声音如响，一下药腹部就会消退。我推测那些药物是巴豆、大黄等峻猛攻伐之品，如今病久胃气虚弱，怎能承受得住？即使是古代治疗单腹胀，有用鸡矢醴这一方剂，但患者畏惧进食且呕吐，气味也不相投合。昼夜犹豫，无计可施。拖延到腊月，忽然看到梅花枝头绽放，见景生情，随即摘下几十枝，让人用热水冲泡代茶饮用，每天喝几次。思路豁然开朗，触类旁通，家中还有自酿的酒，于是用木瓜、橘饼各三钱，另外用村酿白酒煎熟，与自酿酒对冲，晚上喝两杯。此前腹胀痞塞，完全没有排气反应。这样连续饮用三天，腹中微微鸣响，不时有气体排出，腹部坚硬程度稍变柔软。等到十几天后，腹胀症状减轻一半，大小便感觉通畅，进食不再呕吐，夜晚能够安卧。一个月后，腹胀完全消除。当时腹胀严重时腹部像抱着瓮一样大，怀疑是什么邪气如此旺盛？等到胀消之后，大便并没有秽恶之物排出，可知这不过是自身的元气，与身体为难罢了。儿子病愈后，大家都觉得很神奇。朋友问我所用梅花治疗腹胀，出自哪本书？我说：“运用的妙处，存乎一心”，这是我心领神会的偶然中效，没有古人可以师法。大概梅花在春天之前开放，花开最早，其气味芳香，所以能疏肝醒脾。橘皮能调和诸气。肝以收敛为泻（此处意指通过酸收之法来制约肝木之横逆），木瓜味酸性柔，能在土中泻木（即健脾抑肝），更借助酒力，因此得以奏效。朋友感叹道：“您是良医啊。您公子的病，固然虽然有办法在后起死回生，但之前却无方法治疗。这就是行医的难点所在。然而如果这个病症发生在不懂医理的人家里，在病情紧迫之际，没有不因为乱下药而死亡的。这又是行医者不可不知道的道理。”我听了这番话，不觉感到敬畏。
安波按语：膨证这一候病，世间缺乏良方。仔细推究这个孩子痊愈的原因，是因为他年轻正气刚强，血气很盛，虽然病久形体衰败，但根基尚且稳固。再加上年轻无知，郁怒未深，并不是那种冤屈沉底、大怒不解、日渐忧郁压抑的情况，不能同日而语。否则，腊尽春回，木气升发当阳之时，他的病情只会日益加重都来不及，哪里依靠梅花微末的材料，就能驱除疾病呢？我见到这类病症，不治而亡者很多，他们的年龄都在四五十岁左右，三十岁以上，我还没听说过。我出生得晚，不然要责怪杏翁，不知是否同意我的看法。
Cheng Xuanxuan's second son, Guangchi, was just past the age of twenty (ruo guan, 弱冠) and had never been ill before. In summer, he accidentally developed abdominal distension. It was thought to be due to dampness stagnation (Shi Zhi, 湿滞), considered insignificant. Although he took medicine, he was not careful in his diet and daily life. The condition dragged on for two months, with the abdomen gradually enlarging, muscles wasting, appetite decreasing, and frequent vomiting. Self-treatment failed. He then invited doctors through his colleagues, Mr. Cao Xiaoyan and Mr. Yu Langting. Medications used included methods for harmonizing (He, 和), draining (Shen, 渗), warming (Wen, 温), clearing heat (Qing, 清), reducing accumulation (Xiao, 消), and tonifying (Bu, 补), but none were effective. At that time, he could still勉强 go out, paying little attention to it. I thought, since all medicines were ineffective, as the proverb says: "Not taking medicine can sometimes yield a moderate effect" (Bu Yao De Zhong Yi, 不药得中医). Thus, I ordered him to stop medication. By early winter, provoked by an incident, the illness worsened significantly. Food eaten was immediately vomited; lying down caused Qi rushing upward; urination and defecation were difficult. I recalled the Classic stating: "The Liver governs anger; anger causes Qi to ascend." Could it be that Liver Qi (Gan Qi, 肝气) was rebellious and obstructing the descent of Stomach Qi? Hence the vomiting and distension. My self-formulated Yueju Xiaoyao Tang (Yueju Xiaoyao Decoction) and methods for calming the Stomach and restraining the Liver were also ineffective. Gradually, the abdomen became large as a drum, hard as stone, with distended veins and protruding umbilicus, emaciated bones, shortness of breath upon walking. My skills were exhausted. I invited other colleagues to consult again. All stated this had become "Zhong Man" (Middle Fullness/Abdominal Distension, 中满), where both reducing and tonifying methods were difficult to apply. Some recommended special pills for Drum Distension (Gu Zhang, 鼓胀), claiming that after administration, sounds like resonance would occur, and the abdomen would shrink immediately. I suspected those drugs contained drastic purgatives like Ba Dou (Croton Seed) and Da Huang (Rhubarb Root and Rhizome). With long-standing illness and deficient Stomach Qi, how could he tolerate them? Even though ancient texts mention Ji Shi Li (Chicken Dropping Fermented Liquid) for single abdominal distension, the patient feared food and vomited, so the taste did not agree. Day and night I pondered, having no strategy. Delaying until December (La month), suddenly seeing plum blossoms on branches, inspired by the scene, I picked dozens of branches, instructed to brew them in water as tea, drinking several times a day. The key was unlocked, drawing analogies. There was aged wine stored at home. I used Mu Gua (Chaenomeles Fruit) and Ju Bing (Tangerine Peel Candy) each 3 qian, separately boiled with village wine, mixed with the aged wine, drinking two cups at night. Previously, the abdominal distension was blocked with no bowel sounds or gas. After drinking thus for three days, slight rumbling occurred in the abdomen, gas was expelled occasionally, the hard abdomen softened slightly. After more than ten days, the distension reduced by half, urination and defecation felt smooth, eating no longer caused vomiting, and peaceful sleep was possible at night. After one month, the abdominal distension completely disappeared. At that time, the abdomen was swollen like holding a urn, leading one to suspect what pathogenic factor (Xie Qi, 邪气) was so vigorous? When the distension subsided, no foul matter was excreted in stool. It is known that this was merely the body's own Yuan Qi (Original Qi, 元气) causing trouble for itself. After the son recovered, everyone considered it miraculous. A friend asked which book my use of plum blossoms for treating distension came from. I said: "The subtlety of application lies in the mind." This was my intuitive insight, without precedent in ancient texts to follow. Generally, plum blossoms appear early in spring, blooming first; their aroma allows them to soothe the Liver and awaken the Spleen. Tangerine peel harmonizes various Qi. For the Liver, astringency acts as purging; Mu Gua is sour and soft, able to drain Wood within Earth (restraining Liver overacting on Spleen), aided by the power of wine, hence the efficacy. The friend sighed, saying: "You are a skilled physician. Your son's disease, although successfully treated later, had no method to treat it earlier. This is the difficulty of medicine. However, if this syndrome occurred in a family ignorant of medical principles, during the urgent phase, they would surely have died following inappropriate prescriptions. This is another thing physicians must know." Hearing these words, I felt startled and reverent.
An Bo's Note: The syndrome of abdominal swelling (Peng Zheng, 膨证) lacks good prescriptions in the world. Carefully analyzing the reason for this child's recovery, it is because he was young with strong upright Qi, abundant blood and Qi. Although the long illness caused physical decline, the root was still solid. Furthermore, being young and ignorant, the depression and anger were not deep, unlike cases of deep-seated grievance, unrelenting rage, and daily melancholy. Otherwise, when late winter ends and spring returns, Wood Qi ascends under Yang energy, his condition would only worsen rapidly. How could the trivial material of plum blossoms possibly dispel disease? I have seen many such cases untreated, where patients were around forty to fifty years old. I have rarely heard of cases over thirty. I was born late; otherwise, I might blame Old Man Xing, wondering if he would agree.