人有肠中自鸣，终日不已，嗳气吞酸，无有休歇，人以为脾气之虚也，谁知是肝气之旺
乎。夫肝木不郁，则脾气得舒，肠亦安然输挽，顺流而下，何至动不平之鸣耶。惟肝木克脾土，
则土气不能伸，而肠乃鸣矣。盖坤道主安宁者也，惟地中有风震动之，声出如霆如雷，非
明验乎。故治肠鸣之病，不必治肠，治脾土而已。亦不必专治脾土，治肝木而已。肝木之风静，
脾土之气自静也。方用安土汤∶
白芍（一两） 白术（一两） 柴胡（一钱） 茯苓（三钱） 甘草（一钱） 苍术（
二钱） 神曲（二钱） 炮姜（一钱）
水煎服。一剂少土，二剂全止，不必三剂。
此方脾肝同治之法。肝平而脾气得养矣，脾安而肠气得通矣。不必止鸣而鸣自止者，妙在
行肝气之郁居多，所以奏功特神耳。
此症用香栀平肝饮亦佳。
炒栀子（三钱） 茯苓 白芍 白术（各五钱） 陈皮 甘草（各一钱） 香附（
二钱）水煎服。
人有饥饿之后，腹中肠鸣，手按之鸣少止者，人以为大肠之虚也，谁知胃气之
虚乎。盖胃气者，阳气也。胃与大肠同合阳明之经，胃属足阳明，大肠属手阳明也。故阳明
胃燥，大肠亦燥，阳明胃虚，大肠亦虚。大肠之糟粕，必由胃而入，大肠气虚，必得胃气来
援。今胃气既虚，仅可自顾，安能分布于大肠，此大肠匮乏，所以呼号，求济于同经之胃而
频鸣也。治法必须助胃气之弱。方用实肠汤∶
黄 （一两） 茯苓（五钱） 山药（五钱） 白术（一两） 甘草（一钱） 神曲（
二钱） 五味子（一钱） 肉果（一枚）水煎服。一剂而肠鸣止，连服四剂不再发。
此方大补胃中之气，绝不去实大肠，治胃而肠鸣自止，故即谓之实肠汤。
此症用加味四君汤亦妙。
白术（三钱） 茯苓（二钱） 人参 谷芽（各一钱） 甘草 神曲（各五分） 砂
仁（一粒）水煎服。
人有肠中作水声者，如囊裹浆状，亦肠鸣之病也，谁知是水蓄于大肠乎。夫大肠之能
开能阖者，肾火操其权也，肾热而大肠亦热，肾寒而大肠亦寒。大肠寒而水乃注于中而不
化，故作水声也。虽然大肠能容糟粕，而不能容水，水入大肠，必随
糟粕而出，何以但作水声，不随糟粕而即出耶？盖大肠之下为直肠，直肠之下为魄门，乃肺
操其政，非肾操其政也。肺怜肾之弱，欲救之而无从，未常不恶邪水之入肠也。肺居上游，
不能禁邪水之不入于肠，实能断邪水之不出于肠。况大肠与肺为表里，肺气不下行，大肠之
气亦因之而不泄。魄门正肺之门也，肺门谨锁，大肠之水又何从而出乎？所以愈积于其中，
作裹浆之声也。治法补命门之火，兼利其水，则水从膀胱而化矣。方用五苓散治之。
白术（五钱） 茯苓（五钱） 猪苓 泽泻（各一钱） 肉桂（三钱）一剂而膀胱之
水若决江河而大出矣，二剂而腹中之水声顿息。
盖五苓散本是利水之圣药，我多加肉桂，则肾气温和，直走膀胱，水有出路，岂尚流入
大肠哉？故不必治大肠而自愈也。
此症用消浆饮亦效。
茯苓 山药（各一两） 芡实（五钱） 肉桂（一钱） 车前子（二钱）水煎服。
有人肠中自行鸣响，整天不停，伴有打嗝、吞酸，没有休息的时候。人们以为是脾气虚弱，哪里知道这是肝气旺盛呢。如果肝木不郁结，那么脾气就能舒展，肠道也能安然地传导，顺流而下，怎么会发出动荡不平的鸣响呢？只有当肝木克制脾土时，脾土之气不能伸展，肠道才会鸣响。因为坤道（脾土）主安宁，只有地中有风震动，声音才像雷霆一样发出，这不是明显的验证吗？所以治疗肠鸣的病，不必治肠，只要治脾土就可以了。也不必专门治脾土，只要治肝木就可以了。肝木的风静下来，脾土的气自然也就安静了。方子用安土汤：
白芍（一两） 白术（一两） 柴胡（一钱） 茯苓（三钱） 甘草（一钱） 苍术（二钱） 神曲（二钱） 炮姜（一钱）
用水煎服。吃一剂后症状减轻，两剂后完全停止，不需要第三剂。
这个方子是脾肝同治的方法。肝气平和而脾气得到滋养，脾土安定而肠气得以通畅。不必刻意止鸣而鸣声自止，妙处在于大多调理肝气的郁结，所以疗效特别神奇。
这种病症用香栀平肝饮也很好。
炒栀子（三钱） 茯苓 白芍 白术（各五钱） 陈皮 甘草（各一钱） 香附（二钱）水煎服。
有人在饥饿之后，腹中肠鸣，用手按压后鸣响稍微停止，人们以为是大肠虚弱，哪里知道是胃气虚弱呢。所谓胃气，就是阳气。胃与大肠共同归属于阳明经，胃属于足阳明经，大肠属于手阳明经。所以阳明胃燥，大肠也燥；阳明胃虚，大肠也虚。大肠中的糟粕，必须经由胃进入，大肠气虚，必须得到胃气的援助。现在胃气既然虚弱，只能顾全自己，怎么能分布到大肠去呢？这就是大肠匮乏，所以呼号，向同经的胃求援而频繁鸣响的原因。治疗方法必须帮助胃气的虚弱。方子用实肠汤：
黄芪（一两） 茯苓（五钱） 山药（五钱） 白术（一两） 甘草（一钱） 神曲（二钱） 五味子（一钱） 肉豆蔻（一枚）水煎服。一剂后肠鸣停止，连续服用四剂不再复发。
这个方子大补胃中之气，绝对不去充实大肠，通过治胃而使肠鸣自止，所以称之为实肠汤。
这种病症用加味四君汤也很巧妙。
白术（三钱） 茯苓（二钱） 人参 谷芽（各一钱） 甘草 神曲（各五分） 砂仁（一粒）水煎服。
有人肠中发出水声，像口袋包裹着浆液一样，这也是肠鸣的病，哪里知道是水蓄积在大肠呢？大肠之所以能开能阖，是由肾火掌控其权柄的，肾热则大肠也热，肾寒则大肠也寒。大肠寒冷而水注入其中不能化去，所以发出水声。虽然大肠能容纳糟粕，但不能容纳水，水进入大肠，必然随着糟粕排出，为什么只发出水声，不随着糟粕立即排出呢？因为大肠之下是直肠，直肠之下是魄门（肛门），这是由肺掌管政令，而不是由肾掌管政令。肺怜悯肾的虚弱，想要救助它却无从下手，未尝不厌恶邪水进入肠道。肺居上游，不能禁止邪水不进入肠道，实际上能切断邪水不从肠道排出。何况大肠与肺互为表里，肺气不下行，大肠之气也因此而不泄。魄门正是肺的门，肺门紧紧锁住，大肠的水又从哪里出去呢？所以水越积越多，发出包裹浆液的声音。治疗方法是补命门之火，兼利小便，那么水就会从膀胱气化排出。方子用五苓散治疗。
白术（五钱） 茯苓（五钱） 猪苓 泽泻（各一钱） 肉桂（三钱）一剂后膀胱之水像决堤江河一样大量排出，二剂后腹中的水声顿时平息。
因为五苓散本是利水的圣药，我多加肉桂，则肾气温和，直走膀胱，水有了出路，难道还会流入大肠吗？所以不必治大肠而自愈。
这种病症用消浆饮也有效。
茯苓 山药（各一两） 芡实（五钱） 肉桂（一钱） 车前子（二钱）水煎服。
There are cases where the intestines rumble spontaneously, continuously throughout the day, accompanied by belching and acid regurgitation without respite. People assume this is due to Spleen Qi deficiency (Spleen Qi Deficiency), but who would know that it is actually Liver Qi exuberance (Liver Qi Hyperactivity)? If Liver Wood does not stagnate, then Spleen Earth can relax, and the intestines will smoothly transport and transform, flowing downward in order. How could they produce unrestful rumbling? Only when Liver Wood overacts on Spleen Earth does Earth Qi fail to extend, causing the intestines to rumble. The Dao of Kun (Earth) governs tranquility; only when wind moves within the earth does sound emerge like thunder, which is a clear verification. Therefore, in treating intestinal rumbling, one need not treat the intestines directly, but rather treat Spleen Earth. Nor is it necessary to specifically treat Spleen Earth alone, but rather treat Liver Wood. When the wind of Liver Wood calms down, the Qi of Spleen Earth naturally becomes tranquil. Use An Tu Tang (Soil-Securing Decoction):
Bai Shao (Radix Paeoniae Alba, 1 liang) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang) Chai Hu (Radix Bupleuri, 1 qian) Fu Ling (Poria, 3 qian) Gan Cao (Radix Glycyrrhizae, 1 qian) Cang Zhu (Rhizoma Atractylodis, 2 qian) Shen Qu (Massa Medicata Fermentata, 2 qian) Pao Jiang (Rhizoma Zingiberis Preparatum, 1 qian)
Decoct in water and take orally. After one dose, symptoms lessen; after two doses, they cease completely; a third dose is unnecessary.
This formula employs the method of simultaneously treating the Spleen and Liver. When Liver Qi is pacified, Spleen Qi is nourished; when Spleen is secure, Intestinal Qi flows freely. The brilliance lies in resolving Liver Qi stagnation, allowing the rumbling to stop spontaneously without direct intervention, thus achieving remarkable efficacy.
For this condition, Xiang Zhi Ping Gan Yin (Fragrant Gardenia Liver-Pacifying Drink) is also excellent.
Chao Zhi Zi (Fructus Gardeniae Praeparatus, 3 qian) Fu Ling (Poria, 5 qian) Bai Shao (Radix Paeoniae Alba, 5 qian) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 5 qian) Chen Pi (Pericarpium Citri Reticulatae, 1 qian) Gan Cao (Radix Glycyrrhizae, 1 qian) Xiang Fu (Rhizoma Cyperi, 2 qian)
Decoct in water and take orally.
In cases where intestinal rumbling occurs after hunger, and pressing with the hand slightly alleviates the sound, people attribute it to Large Intestine deficiency. However, who would know it is Stomach Qi deficiency (Stomach Qi Deficiency)? Stomach Qi is Yang Qi. The Stomach and Large Intestine jointly belong to the Yangming Meridian; the Stomach belongs to the Foot-Yangming, and the Large Intestine to the Hand-Yangming. Thus, if Yangming Stomach is dry, the Large Intestine is also dry; if Yangming Stomach is deficient, the Large Intestine is also deficient. Feces in the Large Intestine must enter via the Stomach. If Large Intestine Qi is deficient, it must rely on assistance from Stomach Qi. Now, since Stomach Qi is deficient, it can only attend to itself and cannot distribute to the Large Intestine. This scarcity in the Large Intestine causes it to "call out," seeking aid from the same meridian's Stomach, resulting in frequent rumbling. The treatment method must assist the weakness of Stomach Qi. Use Shi Chang Tang (Intestine-Firming Decoction):
Huang Qi (Radix Astragali, 1 liang) Fu Ling (Poria, 5 qian) Shan Yao (Rhizoma Dioscoreae, 5 qian) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang) Gan Cao (Radix Glycyrrhizae, 1 qian) Shen Qu (Massa Medicata Fermentata, 2 qian) Wu Wei Zi (Fructus Schisandrae, 1 qian) Rou Dou Kou (Arillus Myristicae, 1 piece)
Decoct in water and take orally. One dose stops the rumbling; four consecutive doses prevent recurrence.
This formula greatly tonifies Qi in the Stomach, without directly firming the Large Intestine. By treating the Stomach, the intestinal rumbling ceases spontaneously, hence the name Shi Chang Tang.
For this condition, Jia Wei Si Jun Tang (Modified Four Gentlemen Decoction) is also effective.
Bai Zhu (Rhizoma Atractylodis Macrocephalae, 3 qian) Fu Ling (Poria, 2 qian) Ren Shen (Radix Ginseng, 1 qian) Gu Ya (Germinatio Hordei, 1 qian) Gan Cao (Radix Glycyrrhizae, 0.5 qian) Shen Qu (Massa Medicata Fermentata, 0.5 qian) Sha Ren (Fructus Amomi Rotundus, 1 grain)
Decoct in water and take orally.
There are cases where water-like sounds are heard in the intestines, resembling a bag containing liquid. This is also a form of intestinal rumbling, caused by water accumulation in the Large Intestine. The opening and closing of the Large Intestine are governed by Kidney Fire. If the Kidney is hot, the Large Intestine is hot; if the Kidney is cold, the Large Intestine is cold. Coldness in the Large Intestine prevents the transformation of injected water, producing water sounds. Although the Large Intestine can hold feces, it cannot hold water; water entering the Large Intestine should exit with feces. Why does it only make sound without exiting immediately? Below the Large Intestine is the rectum, and below that is the Po Men (anus), which is governed by the Lung, not the Kidney. The Lung pities the Kidney's weakness and wishes to help but finds no way, disliking the entry of pathogenic water into the intestine. Located upstream, the Lung cannot prevent pathogenic water from entering the intestine but can prevent it from exiting. Since the Large Intestine and Lung are interior-exterior pairs, if Lung Qi does not descend, Large Intestine Qi also fails to discharge. The Po Men is the gate of the Lung; if the Lung gate is tightly locked, how can water in the Large Intestine exit? Thus, water accumulates, producing the sound of liquid in a bag. The treatment method is to tonify the Fire of the Mingmen (Gate of Life) and promote diuresis, so that water transforms and exits via the Bladder. Use Wu Ling San (Five-Ingredient Powder with Poria) for treatment.
Bai Zhu (Rhizoma Atractylodis Macrocephalae, 5 qian) Fu Ling (Poria, 5 qian) Zhu Ling (Polyporus, 1 qian) Ze Xie (Rhizoma Alismatis, 1 qian) Rou Gui (Cortex Cinnamomi, 3 qian)
After one dose, water in the Bladder discharges abundantly like a broken river; after two doses, abdominal water sounds cease instantly.
Wu Ling San is originally a supreme herb for promoting urination. Adding Rou Ci warms the Kidney Qi, directing it straight to the Bladder, providing an outlet for water, preventing it from flowing into the Large Intestine. Thus, the Large Intestine heals itself without direct treatment.
For this condition, Xiao Jiang Yin (Slurry-Dispersing Drink) is also effective.
Fu Ling (Poria, 1 liang) Shan Yao (Rhizoma Dioscoreae, 1 liang) Qian Shi (Semini Nelumbinis, 5 qian) Rou Gui (Cortex Cinnamomi, 1 qian) Che Qian Zi (Semen Plantaginis, 2 qian)
Decoct in water and take orally.