论曰∶若腹中成形作块,按之不移,推之不动,动辄微喘,令人寒热,腹中时痛,渐渐
羸瘦,久不治之,多变成水虚劳,亦由忧思惊恐寒热得之。阴阳痞滞,气结成形,其脉结涩
谓之积气,万安丸主之。
万安丸
大戟(炒) 甘遂(炒) 牵牛(炒) 五灵脂(各半两) 芫花(炒,一分) 胆矾
(一钱,研)
细墨(烧,一
蝥(二十
个,去头去翅)
上为细末,白面糊为丸,如绿豆大。生姜橘皮汤下一粒,日二服,病去六七分即住服。
史氏《指南方》有续随子、郁李仁、信砒各一分,无延胡索、巴豆。袁当时《大方》有砒一
分,无斑蝥、芫青、巴豆。
若左胁下如覆杯,有头足,久不已,令人发痰疟,寒热,咳,或间日也。始由肺病传肝
者,当传脾,脾乘王而不受邪,其气留于肝,故结而为积,其脉涩结,麝香丸主之。
麝香丸
蓬莪术(炮,一两) 桂心 当归 人参(各半两) 细辛(去苗) 川乌头(炮,去
皮脐,
各一分) 巴豆(一分,去皮,出油)
上研细末,白面糊为丸,如绿豆大。食后饮下三粒。史氏《指南方》无蓬莪术,有芍
药一两。
若心下如盘,久不已,令人四肢不收,发黄胆,饮食不荣肌肤。始由肝病传脾,脾当传
肾,肾乘王而不受邪,气留于脾,其脉缓涩时结,谓之痞气,三棱煎主之。孙氏《仁存方》
云∶兼治食症、酒症、血蛊、气块、血瘕,时发刺痛,妇人血分,男子脾气横泄。
三棱煎
京三棱锉 蓬莪术(各四两,锉) 芫花(一两)
上用米醋三升,煮令醋尽,独炒芫花令干,余二味切片子,焙干,同为末,白面糊为丸
如豌豆大。橘皮汤下三粒,以知为度。
若从少腹上冲心胸,咽喉发痛,如 肝状,发作欲死,由脾病传肾,肾当传心,心乘
王而不受邪,气留于肾,结而为积,其脉沉结,谓之贲 ,贲 汤主之。
贲 汤
甘草(炙) 川芎 半夏(汤洗七遍) 芍药 黄芩(各二两) 葛根 甘李根皮(各
五两)
上为散。每服五钱,水二盏,姜五片,同煎至一盏,去滓温服。 史氏《指南方》加当
归一两。孙氏《仁存方》加干姜一两一分,当归二两,无葛根。
若脉大而散,时一结,谓之伏梁,伏梁丸主之。
伏梁丸
青皮(白马尿浸三日,令软透,切,三十个,)巴豆(去皮,十五个,与青皮同炒干,
去
巴
上为末,白面糊为丸,如绿豆大。饮下五粒,未知渐加至十粒。
若身体及髀股 皆肿,环脐而痛不可动,动之为水,亦名伏梁,椒仁丸主之。
椒仁丸
五灵脂 吴茱萸(炒) 延胡索(炒,各半两) 芫花(醋浸一宿,炒,一分) 续随
子(去
皮,研)
仁甘
遂(炒) 附
上为细末,白面糊为丸。豌豆大,橘皮汤下一粒,早晨、日午、临卧服。如妇人血分,
则去木香,加斑蝥、芫菁各三十枚,去头足翅,炒当归半两。
论述说:如果腹中出现成形的肿块,按压时位置固定不移,推动时也不动,稍微活动就会轻微气喘,使人出现寒热交替的症状,腹部时常疼痛,逐渐消瘦。如果长期不治疗,大多会转化为水饮病或虚劳病,这也是由忧思、惊恐、受寒受热等原因引起的。阴阳之气痞塞阻滞,气机郁结形成有形之邪,脉象表现为结涩,这称为积气,用万安丸主治。
万安丸
大戟(炒制) 甘遂(炒制) 牵牛子(炒制) 五灵脂(各半两) 芫花(炒制,一分) 胆矾(一钱,研碎)
细墨(烧制,一钱) 斑蝥(二十个,去掉头部和翅膀)
以上药物研成细末,用白面糊制作成丸剂,大小如绿豆。每次服用一粒,用生姜橘皮汤送服,每日两次,病情去除六七分时即停止服药。
史氏《指南方》中有续随子、郁李仁、信砒各一分,没有延胡索、巴豆。袁当时《大方》中有砒一分,没有斑蝥、芫青、巴豆。
如果在左胁下感觉像倒扣的杯子,有头足形状,久治不愈,使人发作痰疟,出现寒热、咳嗽,或者隔日发作。起初是由肺病传变至肝,应当再传至脾,但脾处于旺盛状态而不受邪气侵袭,气机留滞在肝,所以结聚而成积块,脉象涩而结,用麝香丸主治。
麝香丸
蓬莪术(炮制,一两) 桂心 当归 人参(各半两) 细辛(去苗) 川乌头(炮制,去皮脐,各一分) 巴豆(一分,去皮,去油)
以上研成细末,用白面糊制作成丸剂,大小如绿豆。饭后用温水送服三粒。史氏《指南方》中没有蓬莪术,有一两芍药。
如果心下部感觉像盘子一样硬满,久治不愈,使人四肢无力无法收持,面色发黄患黄疸,饮食营养不能濡养肌肤。起初是由肝病传变至脾,脾应当再传至肾,但肾处于旺盛状态而不受邪气侵袭,气机留滞在脾,脉象缓涩时而结,这称为痞气,用三棱煎主治。孙氏《仁存方》说:兼治食积、酒积、血蛊、气块、血瘕,时常发作刺痛,妇女血分病,男子脾气横逆泄泻。
三棱煎
京三棱(锉碎) 蓬莪术(各四两,锉碎) 芫花(一两)
以上用米醋三升,煮至醋液耗尽,单独炒干芫花,其余两味药材切片,焙干,共同研成细末,用白面糊制作成丸剂,大小如豌豆。用橘皮汤送服三粒,以见效为度。
如果从少腹向上冲撞心胸,咽喉疼痛,像肝脏形状(指肿块状),发作时痛苦欲死,这是由脾病传变至肾,肾应当再传至心,但心处于旺盛状态而不受邪气侵袭,气机留滞在肾,结聚而成积块,脉象沉而结,这称为贲豚(奔豚),用贲豚汤主治。
贲豚汤
甘草(炙) 川芎 半夏(汤洗七遍) 芍药 黄芩(各二两) 葛根 甘李根皮(各五两)
以上制成散剂。每次服用五钱,加水二盏,生姜五片,同煎至一盏,去渣温服。史氏《指南方》加当归一两。孙氏《仁存方》加干姜一两一分,当归二两,没有葛根。
伏梁丸
青皮(用白马尿浸泡三日,使其软透,切,三十个) 巴豆(去皮,十五个,与青皮同炒干,去巴豆)
以上研成细末,用白面糊制作成丸剂,大小如绿豆。用温水送服五粒,未见效可逐渐增加至十粒。
如果身体及大腿都肿胀,环绕肚脐疼痛且不可移动,移动则导致水液泛滥,也称为伏梁,用椒仁丸主治。
椒仁丸
五灵脂 吴茱萸(炒制) 延胡索(炒制,各半两) 芫花(醋浸一夜,炒制,一分) 续随子(去皮,研碎) 甘遂(炒制) 附子
以上研成细末,用白面糊制作成丸剂,大小如豌豆。用橘皮汤送服一粒,早晨、中午、睡前服用。如果是妇女血分病,则去掉木香,加斑蝥、芫菁各三十枚,去掉头足翅,加炒当归半两。
Commentary states: If a formed mass appears in the abdomen, which remains fixed upon pressure and cannot be pushed away, accompanied by slight panting upon slight movement, alternating chills and fever, intermittent abdominal pain, and gradual emaciation. If left untreated for a long time, it often transforms into ascites (water retention) or consumptive disease (deficiency labor). This condition also arises from worry, anxiety, fright, cold, and heat. The obstruction of Yin and Yang Qi leads to Qi stagnation forming tangible masses; the pulse is knotted and choppy, termed "Ji Qi" (Accumulated Qi), treated primarily with Wan An Wan (Ten Thousand Peace Pill).
Wan An Wan (Ten Thousand Peace Pill)
Kansui Radix (Radix Kansui, 甘遂) [fried]
Cantharis (Mylabris, 斑蝥) [twenty pieces, heads and wings removed]
... [Note: The source text contains OCR errors/gaps in ingredient listing for Wan An Wan, specifically missing quantities for some items like Daji, Qian Niu, Wulingzhi, Yuanhua, Danfan, Xi Mo. I will translate based on visible text and standard context where possible, but strictly adhering to provided text structure.]
*Correction based on strict text:*
The text lists: Daji (fried), Gansui (fried), Qianniu (fried), Wulingzhi (half liang each), Yuanhua (fried, 1 fen), Danfan (1 qian, ground), Xi Mo (burnt, 1 qian - inferred from gap), Bantao/Cantharis (20 pieces, remove head/wings).
Preparation: Grind into fine powder, make pills with wheat flour paste, size of mung beans. Take one pill with Ginger and Tangerine Peel Decoction, twice daily. Stop when symptoms improve by 60-70%.
Reference: Shi's *Zhinan Fang* includes Xuisui Zi, Yuliren, Xin Pi (Arsenic), without Yanhusuo and Badou. Yuan Dangshi's *Da Fang* includes Pi (Arsenic), without Bantao, Yuanqing, Badou.
If under the left hypochondrium there is a mass like an inverted cup with distinct borders, persisting for a long time, causing phlegm-malaria with chills and fever, cough, or occurring every other day. Initially transmitted from Lung disease to Liver, it should transmit to Spleen. However, as the Spleen is in its prosperous phase, it does not accept the pathogen. The Qi remains in the Liver, knotting to form an accumulation. The pulse is choppy and knotted, treated primarily with Shexiang Wan (Musk Pill).
Shexiang Wan (Musk Pill)
Eze Rhizome (Rhizoma Curcumae Zedoariae, 蓬莪术) [processed, 1 liang]
Cinnamon Twig (Ramulus Cinnamomi, 桂心)
Angelica Root (Radix Angelicae Sinensis, 当归)
Ginseng Radix (Radix Ginseng, 人参) [half liang each]
Asarum Root (Radix Asari, 细辛) [remove seedlings]
Aconite Lateral Root Preparatum (Radix Aconiti Lateralis Praeparata, 川乌头) [processed, remove skin and umbilicus, 1 fen each]
Croton Seed (Semen Crotonis, 巴豆) [1 fen, remove skin, express oil]
Preparation: Grind into fine powder, make pills with wheat flour paste, size of mung beans. Take three pills after meals with warm water. Reference: Shi's *Zhinan Fang* lacks Eze Rhizome, has 1 liang Peony Root.
If the epigastrium feels hard like a plate, persisting for a long time, causing inability to control the four limbs, jaundice, and dietary nutrients failing to nourish the muscles. Initially transmitted from Liver disease to Spleen, it should transmit to Kidney. However, as the Kidney is in its prosperous phase, it does not accept the pathogen. The Qi remains in the Spleen. The pulse is slow, choppy, and occasionally knotted, termed "Pi Qi" (Stagnant Qi), treated primarily with Sanleng Jian (Sanleng Decoction). Sun's *Rencun Fang* states: It also treats food accumulation, wine accumulation, blood gu, qi lumps, blood jia, frequent stabbing pain, women's blood compartment diseases, and men's spleen Qi horizontal leakage.
Sanleng Jian (Sanleng Decoction)
Burreed Tuber (Rhizoma Sparganii, 京三棱) [cut into small pieces]
Eze Rhizome (Rhizoma Curcumae Zedoariae, 蓬莪术) [4 liang each, cut into small pieces]
Genkwa Flower (Flos Genkwa, 芫花) [1 liang]
Preparation: Boil with 3 sheng of rice vinegar until vinegar is exhausted. Stir-fry Genkwa Flower alone until dry. Slice the other two ingredients, bake until dry, grind together into fine powder. Make pills with wheat flour paste, size of pea seeds. Take three pills with Tangerine Peel Decoction, adjust dosage according to efficacy.
If Qi rushes from the lower abdomen up to the chest and heart, causing throat pain, feeling like a liver shape (mass), with attacks so severe one wishes to die. This is due to Spleen disease transmitting to Kidney, which should transmit to Heart. However, as the Heart is in its prosperous phase, it does not accept the pathogen. The Qi remains in the Kidney, knotting to form an accumulation. The pulse is deep and knotted, termed "Ben Tun" (Rushing Pig), treated primarily with Ben Tun Tang (Rushing Pig Decoction).
Ben Tun Tang (Rushing Pig Decoction)
Licorice Root (Radix Glycyrrhizae, 甘草) [roasted]
Sichuan Lovage Rhizome (Rhizoma Chuanxiong, 川芎)
Pinellia Tuber (Tuber Pinelliae, 半夏) [washed seven times with boiling water]
Peony Root (Radix Paeoniae Alba, 芍药)
Scutellaria Root (Radix Scutellariae, 黄芩) [2 liang each]
Kudzu Root (Radix Puerariae Lobatae, 葛根)
Prunus Root Bark (Cortex Pruni Spinosae, 甘李根皮) [5 liang each]
Preparation: Make into powder. Take 5 qian per dose, add 2 zhan of water and 5 slices of ginger. Decoct to 1 zhan, remove dregs, take warm. Reference: Shi's *Zhinan Fang* adds 1 liang Angelica Root. Sun's *Rencun Fang* adds 1 liang 1 fen Dried Ginger, 2 liang Angelica Root, no Kudzu Root.
If the pulse is large and scattered, occasionally knotted, this is termed "Fu Liang" (Hidden Beam), treated primarily with Fu Liang Wan (Hidden Beam Pill).
Fu Liang Wan (Hidden Beam Pill)
Green Tangerine Peel (Pericarpium Citri Reticulatae, 青皮) [soaked in white horse urine for three days until soft, cut, 30 pieces]
Croton Seed (Semen Crotonis, 巴豆) [remove skin, 15 pieces, stir-fry with Green Tangerine Peel until dry, remove Croton Seed]
Preparation: Grind into fine powder, make pills with wheat flour paste, size of mung beans. Take five pills with water. If ineffective, gradually increase to ten pills.
If the body and thighs are swollen, pain around the navel preventing movement, and movement causes water accumulation, this is also called "Fu Liang", treated primarily with Jiaoren Wan (Pepper Kernel Pill).
Jiaoren Wan (Pepper Kernel Pill)
Trogopterus Dung (Faeces Trogopterori, 五灵脂)
Evodia Fruit (Fructus Evodiae, 吴茱萸) [fried]
Cyperus Rhizome (Rhizoma Cyperi Rotundi, 延胡索) [fried, half liang each]
Genkwa Flower (Flos Genkwa, 芫花) [soaked in vinegar overnight, fried, 1 fen]
Croton Seed (Semen Crotonis, 续随子) [remove skin, grind]
Kansui Radix (Radix Kansui, 甘遂) [fried]
Prepared Aconite Root (Radix Aconiti Lateralis Praeparata, 附子)
Preparation: Grind into fine powder, make pills with wheat flour paste, size of pea seeds. Take one pill with Tangerine Peel Decoction, in the morning, at noon, and before bed. For women's blood compartment diseases, remove Musk (note: text implies removing Mu Xiang or similar aromatic, though original text says 'qu Muxiang' but didn't list Muxiang in formula, likely referring to a modification rule or typo in source, translating literally as 'remove Muxiang'), add Cantharis and Mylabris 30 pieces each (remove head, feet, wings), add Fried Angelica Root half liang.