病源积者。阴气五脏所生。其痛不离其部。故上下有所穷已。聚者。阳气六腑所成。故
无根本。上下无所留止。其痛无有常处。此皆由寒气搏于脏腑。与阴阳气相击下上。故心腹
痛也。诊其寸口之脉。沉而横。胁下有积。腹中有横积聚痛。又寸口脉细沉滑者。有积聚在
胁下。左右皆满。与背相引痛。又云∶寸口脉紧而牢者。胁下腹中有横积结。痛而泄痢。脉
微细者生。浮者死。（出第十九卷中）
范汪通命丸。疗心腹积聚。寒中 痛。又心胸满。胁下急绕脐痛方。
大黄（四分） 远志（四分去心） 黄 （四分） 麻黄（四分去节） 甘遂（四分） 鹿
茸（四
分炙） 杏仁（六十枚） 豉（一合） 巴豆（五十枚） 芒硝（三分）
上十味捣合下筛。和以蜜。丸如小豆。先食服三丸。日再。忌芦笋野猪肉。（一方无鹿
茸黄 用黄芩出第十四卷中）
又疗心腹积聚。食苦不消。胸胁满除。去五脏邪气。四物丸方。
大戟（五分 咀熬令色变） 芫花（四分熬） 杏仁（一分） 巴豆（一百枚去皮心熬）
右药捣合下细筛。以鸡子中黄亦可。以蜜和丸如小豆。日三。日增一丸。觉勿复益。欲
下顿服七丸。下如清漆陈宿水。妇人乳有余疾。留饮者下水之后。养之勿饮冷水。长壮者服
五丸。先食。忌野猪肉芦笋。（出第十三卷中）
古今录验匈奴露宿丸。疗心腹积聚。膈上下有宿食留饮神方。（出僧深）
甘草（三分炙） 大黄（二分） 甘遂（二分） 芫花（二分熬） 大戟（二分炙） 葶
苈子（二
分熬） 苦参（一分） 硝石（一分） 巴豆（半分去心皮熬）
上九味细捣。合蜜和丸如小豆。服三丸当吐下。不吐下。稍益至五六丸。以知为度。先
少起。忌海藻芦笋菘菜野猪肉。（范汪同出第十卷中）
病因方面，积证是由阴气在五脏产生。其疼痛位置固定，不离所属部位，所以上下有一定的界限。聚证是由阳气在六腑形成。所以没有固定的根基，上下游走没有停留之处。其疼痛没有固定的位置。这些情况都是由于寒气搏结于脏腑，与阴阳之气相互冲击、上下往来，从而导致心腹疼痛。诊察寸口脉，如果脉象沉而横，说明胁下有积块；腹中有横向的积聚疼痛。如果寸口脉细、沉、滑，说明胁下有积聚，左右两侧都感到胀满，并牵引背部疼痛。又说：寸口脉紧而牢，说明胁下腹中有横向的积结，伴有疼痛和泄痢。脉象微细的预后良好（生），脉象浮大的预后不良（死）。（出自第十九卷中）
范汪通命丸。治疗心腹积聚。寒邪入中引起的疼痛。以及心胸痞满，胁下拘急，环绕脐部疼痛的方剂。
大黄（四分） 远志（四分，去心） 黄芩（四分） 麻黄（四分，去节） 甘遂（四分） 鹿茸（四分，炙） 杏仁（六十枚） 豆豉（一合） 巴豆（五十枚） 芒硝（三分）
以上十味药捣碎混合后过筛。用蜂蜜调和，制成如小豆大小的丸药。饭前服用三丸，每日两次。忌食芦笋、野猪肉。（另一版本无鹿茸、黄芩，改用黄芩，出自第十四卷中）
又一方，治疗心腹积聚，饮食停滞难以消化，胸胁胀满消除，去除五脏邪气的四物丸方。
大戟（五分，切碎熬至颜色改变） 芫花（四分，熬） 杏仁（一分） 巴豆（一百枚，去皮心，熬）
以上药物捣碎混合后过细筛。也可以用鸡蛋黄作为粘合剂。用蜂蜜调和，制成如小豆大小的丸药。每日三次，每天增加一丸，感觉有效后不再增加。想要通过泻下排毒，可一次性服用七丸。排出物像清漆或陈旧的宿水一样。妇女产后余疾，体内有留饮者，在泻下之后，需调养，不要喝冷水。身体强壮的人服用五丸，饭前服用。忌食野猪肉、芦笋。（出自第十三卷中）
古今录验匈奴露宿丸。治疗心腹积聚，膈肌上下有宿食和留饮的神效方。（出自僧深）
甘草（三分，炙） 大黄（二分） 甘遂（二分） 芫花（二分，熬） 大戟（二分，炙） 葶苈子（二分，熬） 苦参（一分） 硝石（一分） 巴豆（半分，去心皮，熬）
以上九味药细细捣碎。用蜂蜜调和，制成如小豆大小的丸药。服用三丸，应当引起呕吐或腹泻。如果不吐不泻，逐渐增加到五六丸。以见效为度。服药后稍作活动。忌食海藻、芦笋、白菜、野猪肉。（范汪方相同，出自第十卷中）
Regarding the etiology, *Ji* (accumulation) arises from Yin Qi within the Zang organs. Its pain remains fixed in its location and does not depart from its area; thus, it has definite upper and lower boundaries. *Ju* (mass) is formed by Yang Qi within the Fu organs. Therefore, it lacks a fixed root, moving up and down without staying in one place. Its pain occurs in no constant location. All these conditions result from Cold Qi clashing with the Zang and Fu organs, striking against the Yin and Yang Qi as they move up and down, thereby causing heart and abdominal pain. Upon palpating the Cun Kou pulse, if it is deep and transverse, there is an accumulation under the hypochondrium; there is horizontal accumulation pain in the abdomen. If the Cun Kou pulse is fine, deep, and slippery, there is accumulation under the hypochondrium, with fullness on both left and right sides, radiating pain to the back. It is also said: if the Cun Kou pulse is tight and firm, there is horizontal accumulation and knotting under the hypochondrium and in the abdomen, accompanied by pain, diarrhea, and dysentery. A fine and minute pulse indicates survival (favorable prognosis), while a floating pulse indicates death (unfavorable prognosis). (From Volume 19)
Fan Wang Tongming Wan. Treats heart and abdominal accumulations. Pain caused by Cold invading the interior. Also treats chest and heart fullness, hypochondriac tension, and pain encircling the umbilicus.
Da Huang (Rhei Radix et Rhizoma) (4 fen) Yuan Zhi (Polygalae Radix) (4 fen, remove heart) Huang Qin (Scutellariae Radix) (4 fen) Ma Huang (Ephedrae Herba) (4 fen, remove joints) Gan Sui (Kansui Radix) (4 fen) Lu Rong (Cervi Cornu Pantotrichum) (4 fen, roasted) Xing Ren (Armeniacae Semen Amarum) (60 seeds) Chi Dou (Glycines Sojae Semen Praeparatum) (1 he) Ba Dou (Crotonis Fructus) (50 seeds) Mang Xiao (Natrii Sulfas) (3 fen)
The above ten ingredients are crushed, mixed, and sifted. Combined with honey, form pills the size of small beans. Take three pills before meals, twice daily. Avoid eating reeds (Lu Sun) and wild boar meat. (Another version excludes Lu Rong and Huang Qin, using Huang Qin instead; From Volume 14)
Another formula, Si Wu Wan. Treats heart and abdominal accumulations, indigestion of bitter or difficult foods, relieves chest and hypochondriac fullness, and eliminates pathogenic factors from the five Zang organs.
Da Ji (Euphorbiae Pekinensis Radix) (5 fen, cut into pieces and roasted until color changes) Yuan Hua (Genkwa Flos) (4 fen, roasted) Xing Ren (Armeniacae Semen Amarum) (1 fen) Ba Dou (Crotonis Fructus) (100 seeds, remove skin and heart, roasted)
The above medicines are crushed, mixed, and sifted finely. Egg yolk may be used as a binder. Combine with honey to form pills the size of small beans. Take three times daily, increasing by one pill each day until efficacy is felt, then stop increasing. To induce purgation, take seven pills at once. The discharge will resemble clear lacquer or old stagnant water. For women with residual postpartum diseases and retained fluid, after purgation, nourish the body and avoid drinking cold water. Robust individuals take five pills before meals. Avoid wild boar meat and reeds. (From Volume 13)
Gujin Luyan Xiongnu Luxiu Wan. Treats heart and abdominal accumulations, and lingering food retention and fluid retention above and below the diaphragm. A divine prescription. (From Monk Shen)
Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 fen, roasted) Da Huang (Rhei Radix et Rhizoma) (2 fen) Gan Sui (Kansui Radix) (2 fen) Yuan Hua (Genkwa Flos) (2 fen, roasted) Da Ji (Euphorbiae Pekinensis Radix) (2 fen, roasted) Ting Li Zi (Lepidii Semen) (2 fen, roasted) Ku Shen (Sophorae Flavescentis Radix) (1 fen) Xiao Shi (Natrii Nitras) (1 fen) Ba Dou (Crotonis Fructus) (0.5 fen, remove heart and skin, roasted)
The above nine ingredients are finely crushed. Combine with honey to form pills the size of small beans. Take three pills; vomiting or purgation should occur. If neither occurs, gradually increase to five or six pills. Use the appearance of effect as the limit. Rise slightly after taking the medicine. Avoid consuming Hai Zao (Sargassum), Lu Sun (reeds), Song Cai (Chinese cabbage), and wild boar meat. (Same as Fan Wang's formula; From Volume 10)