东垣，百世之师也。其制肥气丸以治肝积，制息贲丸以治肺积，制伏梁丸以治心积，制
痞气丸以治脾积，制奔豚丸以治肾积，率以攻下温热之品类聚为丸，夫五脏积气，辟在肠胃
之外，而用巴霜、浓朴辈峻剂以攻肠胃之内，非其治也。人皆曰东垣方，余直以为非东垣之
剂也。借曰东垣为之，则无《脾胃论》矣。明者辨之。
半夏 槟榔 川归（各四分） 大黄（酒浸） 陈皮 杏仁 桂心 茯苓（各一钱） 甘
草
附子 川芎（各五分） 枳壳 浓朴 吴茱萸（各一钱五分）
聚气在六腑，随其上下，发作有时，令人心腹 痛，攻刺腰胁，少腹 胀，大小便不利
者，此方主之。
上件皆六腑之病也。气之所积名曰积，气之所聚名曰聚。积者五脏之邪，聚者六腑之病
也。是方名曰散聚者，所以散六腑之聚气耳。盖中气之道，热则施张，施张弗聚也。寒则收
引，收引则气斯聚矣。故桂心、附子、吴朱萸辛热之品也，半夏、陈皮辛温之品也，川芎、
当归、杏仁辛润之品也。辛则能散聚，热则能壮气，温者能和中，润者能泽六腑。乃茯苓、
甘草之甘平，可以使之益胃。而槟榔、枳壳、浓朴、大黄，则皆推陈之品也。
此即天鼠之粪也，又名夜明沙。古人治血积，每用水蛭、虻虫辈，以其善吮血耳！然其
性毒，人多患之。而伏翼屎者，食蚊而化之者也，蚊之吮血，不减蛭、虻，故亦可以攻血积。
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李东垣是百代师表。他配制肥气丸来治疗肝积，配制息贲丸来治疗肺积，配制伏梁丸来治疗心积，配制痞气丸来治疗脾积，配制奔豚丸来治疗肾积，这些方剂都是将攻下、温热的药物类别聚集制成丸药。五脏的积气，病位位于肠胃之外，却使用巴豆霜、厚朴等峻烈药物来攻伐肠胃之内，这不符合治疗原则。人们都说这是李东垣的方子，我直接认为这不是李东垣的药剂。假如说是李东垣制作的，那就不存在《脾胃论》了。明眼人应当辨别清楚。
半夏、槟榔、川当归（各四分），大黄（酒浸），陈皮、杏仁、桂心、茯苓（各一钱），甘草，附子、川芎（各五分），枳壳、厚朴、吴茱萸（各一钱五分）。
聚气在六腑，随着气的上下运行，发作有定时，导致心腹疼痛，痛感如针刺并放射至腰胁，少腹胀满，大小便不通利的，此方主治。
上述情况都属于六腑的疾病。气所积聚称为“积”，气所汇聚称为“聚”。积是五脏的邪气，聚是六腑的疾病。这个方子名叫散聚汤，是用来疏散六腑中汇聚之气的。大概中焦之气之道，受热则舒展张开，舒展张开就不会凝聚；受寒则收缩牵引，收缩牵引则气就会凝聚。所以桂心、附子、吴茱萸是辛热性质的药物，半夏、陈皮是辛温性质的药物，川芎、当归、杏仁是辛润性质的药物。辛味能够消散凝聚，热性能够壮旺正气，温性能够调和中和，润性能够滋润六腑。至于茯苓、甘草的甘平性质，可以借此益胃。而槟榔、枳壳、厚朴、大黄，则是推陈出新的药物。
这就是天鼠的粪便，又名夜明沙。古人治疗血积，常用水蛭、虻虫之类，因为它们善于吮吸血分！然而它们的性质有毒，人容易因此患病。而伏翼屎（蝙蝠粪），是吃了蚊子转化而成的，蚊子吮吸血液，其能力不亚于水蛭、虻虫，所以也可以用来攻逐血积。
Li Dongyuan is the teacher of a hundred generations. He formulated Feiqi Wan (Liver Accumulation Pill) to treat Liver Accumulation, Xiben Wan (Lung Accumulation Pill) to treat Lung Accumulation, Fuliang Wan (Heart Accumulation Pill) to treat Heart Accumulation, Piqi Wan (Spleen Accumulation Pill) to treat Spleen Accumulation, and Bentun Wan (Kidney Accumulation Pill) to treat Kidney Accumulation. These formulas generally gather purgative and warming herbs into pills. The accumulated Qi of the five Zang organs resides outside the intestines and stomach; yet using harsh medicines such as Crotonis Fructus Preparatus (Bashuang, 巴豆霜) and Magnoliae Officinalis Cortex (Houpo, 厚朴) to attack the interior of the intestines and stomach is not the correct treatment. People all say these are Li Dongyuan's formulas, but I directly consider them not to be his prescriptions. If it were indeed created by Li Dongyuan, then *Pi Wei Lun* (Treatise on the Spleen and Stomach) would not exist. Those with clarity should distinguish this.
Pinelliae Rhizoma (Banxia), Arecae Semen (Binglang), Angelicae Sinensis Radix (Chuan Gui) (each 4 fen); Rheum Palmatum Radix et Rhizoma (Dahuang) (soaked in wine); Citri Reticulatae Pericarpium (Chenpi), Armeniacae Semen Amarum (Xingren), Cinnamomi Ramulus (Guixin), Poria (Fuling) (each 1 qian); Glycyrrhizae Radix et Rhizoma (Gancao); Aconiti Lateralis Radix Praeparata (Fuzi), Ligusticum Chuanxiong Rhizoma (Chuanxiong) (each 5 fen); Aurantii Fructus Immaturus (Zhike), Magnoliae Officinalis Cortex (Houpo), Evodiae Fructus (Wuzhuyu) (each 1.5 qian).
When Qi gathers in the Six Fu organs, moving up and down, it attacks at specific times, causing pain in the heart and abdomen, stabbing pain radiating to the waist and hypochondrium, distension in the lower abdomen, and difficulty in urination and defecation. This formula is indicated for such conditions.
The above conditions all belong to diseases of the Six Fu organs. When Qi accumulates, it is called "Accumulation" (Ji); when Qi gathers, it is called "Mass" (Ju). Accumulations are pathogenic factors of the Five Zang organs, while Masses are diseases of the Six Fu organs. This formula is named Sanju Tang (Dispersing Mass Decoction) because it disperses the gathered Qi of the Six Fu organs. Generally, the pathway of Middle Jiao Qi expands when hot, and expansion prevents gathering; it contracts when cold, and contraction leads to Qi gathering. Therefore, Cinnamomi Ramulus (Guixin), Aconiti Lateralis Radix Praeparata (Fuzi), and Evodiae Fructus (Wuzhuyu) are acrid and hot substances; Pinelliae Rhizoma (Banxia) and Citri Reticulatae Pericarpium (Chenpi) are acrid and warm substances; Ligusticum Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), and Armeniacae Semen Amarum (Xingren) are acrid and moistening substances. Acridness can disperse gathering, heat can strengthen Qi, warmth can harmonize and neutralize, and moisture can nourish the Six Fu organs. Meanwhile, the sweet and neutral properties of Poria (Fuling) and Glycyrrhizae Radix et Rhizoma (Gancao) can benefit the Stomach. Arecae Semen (Binglang), Aurantii Fructus Immaturus (Zhike), Magnoliae Officinalis Cortex (Houpo), and Rheum Palmatum Radix et Rhizoma (Dahuang) are substances that push out the old and bring forth the new.
This refers to the feces of the flying squirrel, also known as Ye Mingsha (Night-bright Sand). In ancient times, to treat Blood Accumulation, people often used Leeches (Shuizhi) and Horseflies (Menggong) because they are good at sucking blood. However, their nature is toxic, and many people suffer adverse effects from them. Ye Mingsha, however, is formed from eating mosquitoes. Mosquitoes suck blood just as effectively as leeches and horseflies, so Ye Mingsha can also be used to attack Blood Accumulation.