答曰。积聚者。繇阴阳不和。腑脏虚弱。受其风邪。搏于腑脏之气所为也。积者。五脏所生
。聚者。六腑所生。然阳化气。气属于六腑。阴成形。形主于五脏。阳则动而不息。故聚者
。始
发无根本。上下无所留止。其痛无常处。故谓之聚也。阴则定而守住。故积者。始发有常处
。其痛不离其部。上下有所终始。左右有所穷处。乃谓之积也。积脉阴沉而伏。象阴体之沉
静。聚脉阳浮而动。法阳性之浮高。然积病有五。随其五脏相传而生焉。经云。在肝则曰肥
气。在心则曰伏梁。在脾则曰痞气。在肺则曰息贲。在肾则曰奔豚。故曰积聚之病。此可别
也。
鳖甲丸。治小腹中积聚。大如七八寸盘面。上下周旋。痛不可忍。
鳖甲 官桂(各一两半) 蜂房(半两) 川椒 细辛 人参 苦参 丹参 沙参 吴茱萸(各
十八铢) 虫 干姜 牡丹皮 附子 水蛭 皂角(一本牛白角腮) 当归 赤芍 甘草
防葵(各一两) 蛴螬(二十枚) 大黄 虻虫 玄参(十八铢)
上为细末。蜜丸桐子大。每服七丸。温酒下。日三服。加之。以效为度。
没药散。治妇人一
切血气脐腹撮痛。
血竭(别研) 肉桂 当归 蒲黄 红花 木香 没药 玄胡索 干漆(炒令烟出尽) 赤芍(
各等分)
上为细末。每服二钱。热酒调下。食前。
紫金散。治妇人血气不和。血块疼痛。常服暖子宫。通经络。
橘红 枳壳 肉桂 玄胡索 甘草(炙各一两) 紫金牛(五两一本紫金皮) 当归(酒浸一宿
焙干锉) 香附(炒去毛各三两) 南木香(半两生)
上为末。妇人室女月水不调。久闭羸瘦。苏木煎汤调下。白鸡冠花末煎酒调下亦得。每服一
匙。常服安胎养气。临产横逆。葱白煎酒下。血气胀满。催生下死胎。煎枳壳酒下。地榆末
煎酒下亦得。产后血运。头旋中风口噤。恶证发动。虚肿。豆淋酒下。产后恶血不止。血海
衰败。赤白带下。胞漏。棕榈灰酒下。绵灰亦得。胎气绞刺。肋胁腹肚疼痛。炒姜酒下。心
气不足。陈皮汤下。产后败血停积。攻刺腰痛。无灰酒下。日午临睡三服。忌生冷淹藏毒鱼
。
回答说：积聚病，是由于阴阳失调，脏腑虚弱，感受风邪，邪气与脏腑之气相搏结而形成的。积证，由五脏产生；聚证，由六腑产生。然而，阳主化气，气归属于六腑；阴主成形，形质主宰于五脏。阳气主动且运行不息，所以聚证发作时没有固定的根基，病位上下游走无定处，疼痛部位不固定，因此称为“聚”。阴气主静且固守不移，所以积证发作时有固定的部位，疼痛不离其所在区域，上下有起止范围，左右有穷尽之处，这才称为“积”。
诊察方面，积证的脉象沉伏而阴沉，符合阴体沉静的特性；聚证的脉象浮而动，符合阳性浮高的特性。然而积病分为五种，随着五脏的传变而生发。医经记载：在肝的叫肥气，在心的叫伏梁，在脾的叫痞气，在肺的叫息贲，在肾的叫奔豚。所以说，积聚这类疾病，是可以这样加以区分的。
鳖甲丸，治疗小腹部中的积聚肿块，大小如七八寸的盘子，上下旋转移动，疼痛难以忍受。
药材包括：鳖甲、官桂（各一两半）、蜂房（半两）、川椒、细辛、人参、苦参、丹参、沙参、吴茱萸（各十八铢）、䗪虫、干姜、牡丹皮、附子、水蛭、皂角（另一版本用牛白角腮）、当归、赤芍、甘草、防葵（各一两）、蛴螬（二十枚）、大黄、虻虫、玄参（十八铢）。
以上药物研成细末，用蜂蜜制成梧桐子大小的丸剂。每次服用七丸，温酒送服，每日三次。若效果不明显，可增加剂量，以见效为度。
没药散，治疗妇人各种血气引起的脐腹部拘急疼痛。
药材包括：血竭（单独研磨）、肉桂、当归、蒲黄、红花、木香、没药、玄胡索、干漆（炒至烟尽）、赤芍（各等分）。
以上药物研成细末。每次服用二钱，热酒调服，饭前服用。
紫金散，治疗妇人血气不和、血块疼痛。常服可温暖子宫，疏通经络。
药材包括：橘红、枳壳、肉桂、玄胡索、炙甘草（各一两）、紫金牛（五两，另一版本为紫金皮）、当归（酒浸一夜后焙干锉碎）、炒去毛的香附（各三两）、生南木香（半两）。
以上药物研成粉末。若妇女月经不调、久闭导致身体消瘦，可用苏木煎汤调服；或用白鸡冠花末加酒调服也可。每次服用一匙。常服可安胎养气。临产时胎位横逆不正，用葱白煎酒送服。若因血气胀满需催产下死胎，用枳壳酒送服；用地榆末煎酒送服也可。产后血晕、头晕、中风口噤、恶证发作、虚肿，用豆淋酒送服。产后恶露不止、血海衰败、赤白带下、胞漏，用棕榈灰酒送服；用绵灰也可。胎气绞刺痛及肋胁腹肚疼痛，用炒姜酒送服。心气不足，用陈皮汤送服。产后败血停积，攻刺腰痛，用无灰酒送服。每日午时和临睡前各服三次。忌食生冷、腌制食品及有毒鱼类。
Answer: Accumulation (Ji) and Gathering (Ju) disorders arise from disharmony of Yin and Yang, weakness of the Zang and Fu organs, invasion by Wind pathogenic factors, and the struggle between these pathogens and the Qi of the Zang and Fu organs. Accumulations (Ji) originate from the Five Zang organs, while Gatherings (Ju) originate from the Six Fu organs. However, Yang transforms into Qi, which belongs to the Six Fu organs; Yin forms structure, which is governed by the Five Zang organs. Yang is dynamic and unceasing in its movement; therefore, a Gathering (Ju) has no fixed root upon onset, moves up and down without staying in one place, and the pain occurs in varying locations, hence it is called "Ju". Yin is static and steadfast; therefore, an Accumulation (Ji) has a fixed location upon onset, the pain remains within its specific area, and there are definite boundaries above and below and limits on the left and right, thus it is called "Ji".
Regarding pulse diagnosis, the pulse for an Accumulation (Ji) is deep, hidden, and yin-like, reflecting the stillness of the Yin body; the pulse for a Gathering (Ju) is floating and moving, reflecting the high-floating nature of Yang. There are five types of Accumulation diseases, generated according to the transmission among the Five Zang organs. The Classics state: in the Liver, it is called Feiqi (Fatty Qi); in the Heart, Fuliang (Hidden Beam); in the Spleen, Piqi (Stagnant Qi); in the Lung, Xiben (Breathful Burden); in the Kidney, Bentun (Running Piglet). Thus, Accumulation and Gathering disorders can be distinguished in this manner.
Biejia Wan (Turtle Shell Pill) treats accumulations in the lower abdomen, large as a plate of seven or eight cun, rotating up and down, with unbearable pain.
Ingredients: Bie Jia (Testudinis Carapax et Plastrum), Guan Gui (Cinnamomi Ramulus), Feng Fang (Veliapis), Chuan Jiao (Zanthoxyli Pericarpium), Xi Xin (Asari Radix), Ren Shen (Ginseng Radix), Ku Shen (Sophorae Flavescentis Radix), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Sha Shen (Glehniae Radix), Wu Zhu Yu (Evodiae Fructus) (each 1 liang 5 qian); Feng Fang (Veliapis - *Note: listed again in source context or distinct part*), E Chong (Eupolyphaga), Gan Jiang (Zingiberis Rhizoma), Mu Dan Pi (Moutan Cortex), Fu Zi (Aconiti Lateralis Radix Praeparata), Shui Zhi (Hirudo), Zao Jiao (Gleditsiae Spina), Dang Gui (Angelicae Sinensis Radix), Chi Shao (Paeoniae Radix Rubra), Gan Cao (Glycyrrhizae Radix et Rhizoma), Fang Kui (Peucedani Radix) (each 1 liang); Shi Cao (Oryctolagi Larva) (20 pieces); Da Huang (Rhei Radix et Rhizoma), Meng Chong (Glossoscolex), Xuan Shen (Scrophulariae Radix) (each 18 zhu).
Grind all ingredients into fine powder. Mix with honey to form pills the size of tung tree seeds. Take 7 pills per dose, administered with warm wine, three times daily. If necessary, increase the dosage until therapeutic effect is achieved.
Moyao San (Myrrh Powder) treats various blood and Qi disorders in women causing cramping pain in the umbilical and abdominal regions.
Ingredients: Xue Jie (Dragon's Blood), Rou Gui (Cinnamomi Cortex), Dang Gui (Angelicae Sinensis Radix), Pu Huang (Typhae Pollen), Hong Hua (Carthami Flos), Mu Xiang (Aucklandiae Radix), Mo Yao (Myrrha), Yan Hu Suo (Corydalis Rhizoma), Gan Qi (Drynariae Rhizoma - *Note: Source says Gan Qi but description implies Drynaria or similar processed herb, usually Gan Qi refers to Drynaria in some contexts or could be typo for another herb, keeping literal translation based on text 'Gan Qi' often mapped to Drynariae Rhizoma or similar in ancient texts, but strictly 'Gan Qi' is not standard modern name, assuming Drynariae Rhizoma or similar resinous substance if context implies, however standard WHO term for 'Gan Qi' is not direct, likely referring to a specific processed herb. Given 'Chao ling yan chu jin' (stir-fried until smoke disappears), it is likely a resin or hard substance. In Song dynasty texts, Gan Qi might refer to Drynariae Rhizoma or similar. Let's use standard term if possible, otherwise transliterate. Actually, 'Gan Qi' in this context often refers to Drynariae Rhizoma or sometimes a typo for 'Gan Cao'. But given 'chao', it's likely a solid. Let's assume Drynariae Rhizoma or keep as Gan Qi if uncertain. However, looking at common formulas, it might be 'Gan Jiang' or similar. Wait, 'Gan Qi' (干漆) is Drynaria? No, 'Gan Qi' (干漆) is Toxicodendri Resina Purificata (Lacca Preparata). Yes, Gan Qi is Lacca.*). Chi Shao (Paeoniae Radix Rubra) (equal parts).
Grind all ingredients into fine powder. Take 2 qian per dose, mixed with hot wine, taken before meals.
Zijin San (Purple Gold Powder) treats disharmony of blood and Qi in women, blood masses, and pain. Regular use warms the uterus and unblocks the meridians.
Ingredients: Ju Hong (Citri Reticulatae Pericarpium), Zhi Ke (Aurantii Fructus Immaturus), Rou Gui (Cinnamomi Cortex), Yan Hu Suo (Corydalis Rhizoma), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (each 1 liang); Zi Jin Niu (Ardisiae Japonicae Radix) (5 liang, alternative version uses Zi Jin Pi); Dang Gui (Angelicae Sinensis Radix) (soaked in wine overnight, dried, and sliced); Chao Qu Mao Xiang Fu (Processed Cyperi Rhizoma with hairs removed) (each 3 liang); Sheng Nan Mu Xiang (Fresh Aucklandiae Radix) (0.5 liang).
Grind all ingredients into powder. For menstrual irregularities or amenorrhea leading to emaciation in women, take with decoction of Su Mu (Sappan Lignum). Alternatively, mix with powder of Bai Ji Guan Hua (Celosiae Cristatae Flos) and wine. Take one spoon per dose. Regular use calms the fetus and nourishes Qi. For malpresentation during labor, take with scallion white decoction in wine. For distension due to blood and Qi stagnation requiring induction of labor for a dead fetus, take with Zhi Ke decoction in wine; Di Yu decoction in wine is also effective. For postpartum blood syncope, dizziness, stroke with locked jaw, onset of evil symptoms, and edema, take with Dou Lin Jiu (bean-leavened wine). For postpartum lochia rubra persisting, decline of the Sea of Blood, leukorrhea (red and white), uterine bleeding, take with Zong Lu Hui (Palmae Folium Cinis) in wine; Mian Hui (cotton ash) is also acceptable. For fetal colic and stabbing pain in the hypochondrium and abdomen, take with stir-fried ginger wine. For deficiency of Heart Qi, take with Chen Pi decoction. For postpartum retained blood accumulation attacking the lower back causing stabbing pain, take with Wu Hui Jiu (wine without alum). Take three doses daily at noon and before sleep. Avoid raw, cold, preserved foods, and toxic fish.