又方 取古铁秤锤，或大斧头，或铁杵，以炭火烧令赤，投好酒三升中饮之。
疗妇人血瘕，攻刺腹胁时痛，导药方。
大黄 当归（各半两） 山茱萸 皂荚（去皮弦，各一两） 细辛 戎盐（各二钱半）
上捣以香脂丸如指大，每用一丸，绵裹纳阴中，正坐良久，瘕当下。养如乳妇法。
桃仁煎 （《本事》）治妇人血瘕、血积，经候不通。
桃仁 大黄（各一两） 虻虫（半两，炒黑） 川朴硝（另研）
上四味为末，以醇醋二升半，银石器中慢火煎取一升五合，下大黄、虻虫、桃仁等，
不住手搅，煎至可丸，下朴硝搅匀，出之，丸如梧桐子大。前一日不吃晚食，五更初，用
温酒吞下五丸，日午取下如赤豆汁，或如鸡肝、蛤蟆衣之状，未下再作，如鲜血来即止，
续以调补气血药补之。顷年在毗陵，有一贵宦妻患小便不通，脐腹胀不可忍，众医皆
作淋，治以八正散之类愈甚。予诊之曰∶此血瘕也，非瞑眩药不可去，用此药更初服，至
日午大痛不可忍，遂卧少顷，下血块如拳者数枚，小便如黑豆汁一二升，痛止得愈。
此药治病的切，然猛烈伤人，气虚血弱者不可轻用也。
三棱煎 （《选奇》）治妇人血瘕、血症、食积、痰滞。
三棱 莪术（各二两） 青橘皮（去白） 半夏 麦芽（炒，各一两）
上用好醋六升，煮干焙为末，醋糊丸如梧桐子大。每服三四十丸，淡醋汤下。痰积
多，姜汤下。
〔脂瘕〕者，妇人月水新来，若生未满三十日，以合阴阳，络脉分，胞门伤，子户失
禁，关节散，五脏六腑津液流行阴道， 动百脉，关枢四解，外不见其形，子精与血气
相遇，犯禁，子精化，不足成子，则生脂瘕之聚。令人支满里急，痹引少腹重，腰背如
刺状，四肢不举，饮食不甘，卧不安席，左右走腹中切痛，时瘥时甚，或时少气头眩，身
体解 ，苦寒恶风，膀胱胀，月水乍来乍去，不如常度，大小便血不止，如此者令人无子。
疗之当刺以长针，行以毒药，瘕当下，即愈。
疗脂瘕方（《圣惠》）
皂荚（七钱半，去皮子） 矾石（烧，二钱半） 五味子 蜀椒（去汗） 细辛 干姜（各半两）
上捣散，以香脂和如大豆，着男子阴头以合阴阳，不三行，其瘕即愈。
导散方（《圣惠》）
皂荚（炙，去皮子） 吴茱萸 当归（各一两） 蜀椒（去汗） 干姜 大黄 戎盐（各二两）
细辛（熬） 矾石（烧） 五味子（各二分）
上捣筛为散，以轻绢袋如指大长三寸，盛药令满，纳阴中，坐卧随意，勿行走，小便
时去之，别换新者。
〔狐瘕〕者，妇人月水当日数来，而反悲哀忧恐，若以远行逢暴风疾雨，雷电惊恐，衣
被沉湿，罢倦少气，心中恍惚未定，四肢懈惰，振寒，苦寤寐气绝，精神游亡，邪气入
于阴里不去，则生狐瘕之聚，食人子脏，令人月水闭不通，少腹瘀滞，胸胁腰背痛，阴
中肿，小便难，胞门子户不受男精，五脏气盛，令人嗜食，欲呕，喜唾，多所思，如
有身状，四肢不举，有此病者，终身无子。其瘕有手足成形者杀人，未成者可疗。以长针
急持刺之，行以毒药有法，瘕当下，即愈。
疗狐瘕方（《圣惠》）
上取新死鼠一枚，裹以新絮，涂以黄土，穿地坎足没鼠形，置其中，桑薪火灼其上，一
日一夜出之，研为末，纳桂心末二钱半，酒服二方寸匕，病当下。甚者不过再服，瘥。
〔蛇瘕〕者，妇人月水已下新止，适闭未复，胞门子户劳伤，阴阳未平，荣卫分行，若
其中风暴病羸劣，饮食未调，若起行当风，及度泥涂，因冲寒太早，若坐湿地，名阴阳乱，
腹中虚，若远行道路，饮污井之水，食不洁之食，吞蛇鼠之精，留络不去，因生蛇瘕之
聚。上食心肝，长大其形若漆，在脐上下，还 左右胁，不得吐气，两股胫间苦疼，少腹
多热，小便赤黄，膀胱引阴中挛急，腰目俱痛，难以动作，喜发寒热，月水或多或少，有
此病者，不复生子。其瘕手足成形者杀人，未成者可治。疗有法，行以毒药，瘕当下，即
愈。
疗蛇瘕方（《圣惠》）
大黄 黄芩 芒硝（各半两） 甘草（大如指一尺，炙） 乌贼鱼骨（二枚） 皂荚（六枚，去皮弦
子，酥炙）
上捣，以水六升，煮之三数沸，绞去滓，下硝，适寒温服之，十日一剂，空腹服之，瘕
即下。
〔鳖瘕〕者，妇人月水新至，其人剧作罢劳，汗出衣服润湿，不以时去之，若当风睡，
足践湿地，恍惚觉悟， 立未安，颜色未平，复见所好，心为之开，魂魄感动，五内脱消，
若入水浣洗沐浴，不以时出，而神不守，水精与邪气俱人，至三焦之中幕，玉门先闭，津
液妄行，留络不去、因生鳖瘕之聚。大如小 ，令人少腹内切痛，恶气左右走，上下腹
中苦痛，若存若亡，持之跃手，下引阴里，腰背亦痛，不可以息，月水不通，面目黄黑，脱
声少气，有此病者，令人绝子。其瘕有手足成形者杀人，未成者可治。疗有法度，以长
针按疗之，行以毒药，瘕当下，即愈。
疗鳖瘕方（《圣惠》）
大黄（一两半） 干姜 侧子（各半两） 附子 人参（各三钱七分半） 虫（一寸匕，熬） 桂心（一
两二钱半） 细辛 土 （各七钱半） 白术（一两）
上捣散，以酒服方寸匕，日三。
治鳖瘕及心腹宿 ，或卒得 。
上以白雄鸡矢无问多少，小便和之，于器中火上熬令燥，末服方寸匕，多服不限度，
以膏熬饭饲弥佳。
〔 痞〕
〔大〕妇人 痞，由饮食失节，脾胃亏损，邪正相搏，积于腹中，牢固不动，有可
征验，故名曰 ，气道壅塞，故名曰痞，得冷则发，冷入子脏则不孕，入胞络则月水不
通。
〔薛〕前证若脾胃虚弱，用六君子加芎、归。（方见杂病虚劳，）若肝脾虚弱，用补中益气
（杂病伤劳倦。）及归脾汤。（杂病健忘。）若肝火郁滞，佐以芦荟丸、（方见幼科疳门。）地黄丸。（即六味丸，
杂病虚劳。）外贴阿魏膏。（见前。）患者须慎七情六淫，饮食起居，治者不时审察病机而药之，
庶几有效。
穿山甲散 （《大全》）治妇人 痞及恶血，气攻心腹疼痛，面无颜色，四肢瘦弱。
穿山甲（灰炒燥） 鳖甲（醋灸） 赤芍药 大黄（炒） 干漆（炒令烟尽） 桂心（各一两）
川芎 芫花（醋炒） 当归（各半两） 麝香（二钱半，另研）
上为细末，入麝和匀，每服一钱，热酒调下，无时。
蓬莪术丸 （《大全》）治妇人 痞，腹胁妨痛，令人体瘦，不思饮食。
莪术（七钱半） 当归（焙） 桂心 赤芍药 槟榔 昆布 琥珀（研） 枳壳 木香（各半两）
桃仁 鳖甲 大黄（各一两）
上为末，烂蜜丸如梧子大，食前米饮下二十丸。
丁香丸 （《大全》）治妇人 痞，结块不散，心腹疼痛。
雄雀粪（炒黄） 鳖甲（各一两） 砂 当归（焙） 芫花（醋炒干，各半两） 巴豆（二分半，
去皮心油）
上为末，研令停，醋煮面糊丸如小豆大，当归酒下三丸。
桃仁散 （《普济》）治妇人 痞，心腹胀满，不能饮食，体瘦无力。
桃仁（一两，汤浸去皮尖双仁者，麸炒令微黄） 诃子皮 白术 赤芍药 当归（各七钱半）
京三棱（锉，微炒，一两） 鳖甲（醋炙，去裙烂，一两半） 陈皮（汤浸，去白焙，三两）
上为散，每服三钱，水一盏，入生姜一钱三分，煎至六分，去滓食前稍热服。
上方皆攻积之药，性多犷 ，用者慎之，如薛氏。
〔食 〕
妇人脏腑虚弱，月候来时食生冷之物，脾胃既虚，不能消化，与脏气相搏，结聚成块，
日渐生长，盘牢不移，故谓之食 也。
〔薛〕前证若形气虚弱，须先调补脾胃为主，而佐以消导。若形气充实，当先疏导
为主，而佐以补脾胃。若气壅血滞而不行者，宜用乌药散散而行之。（散用乌药、莪术、醋浸炒，
桂心、当归、桃仁、青皮、木香，各等分为末，每二钱热酒调下。）脾气虚而血不行者，宜用四君、
芎、归，补而行之。（方见杂病虚劳。）若脾气郁血不行者，宜用归脾汤（杂病健忘。）解而行之。若
肝脾血燥而不行者，宜用加味逍遥散（结核。）清而行之。大抵食积痞块之证为有形，盖邪气
胜则实，真气夺则虚，当养正辟邪而积自除矣。虽然，坚者削之，客者除之，胃气未虚，
或可少用，若病久虚弱者，不可轻试也。
砂丸 （《大全》）治妇人食 久不消，令人瘦弱食少。
砂 青礞石 穿山甲（炙） 三棱（炒） 干漆（炒令烟尽） 硫黄（各半两） 巴豆（三十枚，
去皮心炒，不去油）
上为末，用软饭丸如小豆大，每服五丸，生姜、橘皮汤下。
礞石丸 （《大全》）治妇人食 块久不消，攻刺心腹疼痛。
青礞石（末） 巴豆（去皮心油） 朱砂 粉霜（并研） 木香末（各二钱半） 砂（半两）
上研令停，以糯米软饭和丸如绿豆大，每
服二丸，空心温酒下，取下恶物为度。
上方犯 砂、巴豆，非胃气强壮而积气坚顽势不两立者，不可轻用也。
小三棱煎丸 治食 、酒癖、血瘕、气块，时发刺痛，全不思食，及一切积滞不消，
心腹坚胀，痰饮呕哕噫酸，胁肋刺痛，脾气横泄。
三棱 莪术（各四两） 芫花（一两）
上入瓷器中，用米醋五升，浸满封器口，以灰火煨令干，取出棱、术，将芫花以余醋
炒令微焦，同棱、术焙干为末，醋糊丸如绿豆大，每服十五丸，生姜汤下。妇人血分，男
子脾气横泄，肿满如水，桑白皮煎汤下。
〔血 〕
妇人寒温失节，脏腑气虚，风冷在内，饮食不消，与血气相结，渐生颗块，盘牢不移
动者是也。皆因血气劳伤，月水往来，经络痞塞，恶血不除，结聚所生，久而不瘥，则
心腹两胁苦痛，害于饮食，肌肤羸瘦。问∶ 一也，何以知是血 ？曰∶血之外证，瞀闷
烦躁，迷忘惊狂，痰呕汗多，骨热肢冷，其蓄在下焦者，必脐下结急，外热内痛，尺脉
洪而数也。桃仁、灵脂、生地黄、牛膝、大黄、甘草祛逐之。
〔薛〕前证多兼七情亏损，五脏气血乖违而致。盖气主嘘之，血主濡之，脾统血，肝
藏血，故郁结伤脾，恚怒伤肝者多患之，腹胁作痛，正属肝脾二经证也。洁古云∶养正
积自除。东垣云∶人以胃气为主，治法当主于固元气而佐以攻伐之剂，必需之岁月，若
期速效，投以峻剂，反致有误。
加减四物汤（方见杂病积聚。）当归丸 牡丹散（俱同上。）
大黄煎 （《圣惠》）治妇人血 血瘕，食积痰滞。
川大黄（七钱半，碎，微炒） 鳖甲（一两，醋炙黄，去裙 ） 牛膝（去芦，一两）
干漆（一两，炒烟尽）
上为末，用米醋一升，煎为膏，每服一钱，食前热酒调下。
〔腹中瘀血〕
妇人月经痞涩不通，或产后余秽未尽，因而乘风取凉，为风冷所乘，血得冷则成瘀血
也。血瘀在内，则时时体热面黄，瘀久不消，则为积聚 瘕矣。
〔薛〕前证若郁结伤脾，用加味归脾汤。（方见杂病健忘。）若恚怒伤肝，用加味逍遥散。（结
核。）若产后恶露，用失笑散。（方见心痛。）若肝脾亏损，用六君、柴胡，以补元气为主。（方见
虚劳。）胃气虚弱，用补中益气汤加茯苓、半夏为主。（方见杂病劳倦。）大凡腹中作痛畏手按者，
此内有瘀血，若形体如常，属病气元气俱实，用桃仁承气汤直下之。（方见伤寒蓄血。）若痛而
肢体倦怠，饮食少思，此脾胃受伤，属病气有余，元气不足，用当归散调和之。（方见杂病
溲血。）若痛而喜手按腹，形体倦怠，饮食少思，此形气病气俱不足，用六君、炮姜、芎、归
纯补之。若痛而大便不实，饮食难化，此脾肾虚寒，用六君、炮姜、肉果温补之。若痛
而作呕少食，此脾胃虚弱，用六君、炮姜、藿香。若痛而呕吐不食泄泻，用六君加姜、桂。
若兼手足逆冷自汗，更加附子。此证多有因攻伐而致者。
调荣汤 治瘀血不消，脐腹引腰背俱痛。
川芎 当归 芍药 地黄 生姜（各一两） 三棱 莪术 白芷 延胡索 蒲黄 香附子
泽兰叶 细辛 川白姜 浓朴（制） 半夏（制） 甘草（各七钱半，炙） 辣桂
桃仁（汤浸去皮，焙，各五钱）
上锉散，每服三钱，姜枣煎，食前服。
川当归散 理荣卫，消瘀血，出声音，治痰嗽。
川当归 牡丹皮 白芍药 子芩 木通 华阴细辛 麦门冬 甘草（各半两）
生地黄（一两）
上 咀，每服三钱，水一盏，姜三片，煎至七分，去滓温服。
大黄汤 治妇人血瘀不消，及扑损血瘀。
大黄（生用） 桃仁（汤浸去皮尖双仁，各一两）
桂（去粗皮） 郁李仁（去皮研，各半两） 生姜 地黄（各一两）
上粗捣节，每服三钱，水酒各半盏，同煎至七分，去滓温服。
琥珀散 治妇人经络痞塞，腹内瘀血，痛不可忍。
琥珀 乳香 没药
上三味，各研取细末五钱，每服二钱，水酒各半盏，煎至七分，入地黄自然汁二合，再
又一方：取古铁秤锤，或大斧头，或铁杵，用炭火烧至通红，投入三升好酒中，让患者饮用。
治疗妇人血瘕（腹内结块，固定不移，痛有定处），攻刺腹胁部时常感疼痛的导药方。
大黄、当归（各半两）、山茱萸、皂荚（去皮弦，各一两）、细辛、戎盐（各二钱半）。
以上药材捣碎，用香脂调和制成如手指大小的丸剂。每次使用一丸，用绵布包裹纳入阴道内，正坐良久，瘕块即可下行排出。护理方法如同产后妇女一样调养。
桃仁煎（出自《本事方》）：治疗妇人血瘕、血积（瘀血积聚），月经不通。
桃仁、大黄（各一两）、虻虫（半两，炒黑）、川朴硝（另研）。
以上四味药研为细末，用二升半纯醋，在银器或石器中以慢火煎取一升五合药液，加入大黄、虻虫、桃仁等药末，不停搅拌，煎至可制成丸剂的状态，再加入朴硝搅拌均匀，取出，制成如梧桐子大小的丸剂。服药前一天晚上不吃晚饭，五更初（凌晨3-5点），用温酒吞服五丸，中午时分排出如赤豆汁样的物质，或如鸡肝、蛤蟆衣状的瘀血块，若未排出则再次服用，若流出鲜血则停止服药，随后继续用调补气血的药物进行滋补。前几年在毗陵，有一位贵宦的妻子患小便不通，脐腹胀满难以忍受，众医生都当作淋证（以小便频数短涩、滴沥刺痛为主症）治疗，用八正散之类的药物后病情反而加重。我诊察后说：“这是血瘕病，不用猛烈引起眩晕反应的药物无法去除病邪。”于是让她在初更时服用此药，到中午时剧烈疼痛难忍，于是躺卧片刻，排出了数枚如拳头大的血块，小便排出如黑豆汁样的一二升，疼痛停止而痊愈。此药治病确切，但药性猛烈易伤人，气虚血弱者不可轻易使用。
三棱煎（出自《选奇方》）：治疗妇人血瘕、血症（血分病变）、食积、痰滞。
三棱、莪术（各二两）、青橘皮（去白）、半夏、麦芽（炒，各一两）。
以上用好醋六升，煮干后焙干研为细末，用醋糊制成如梧桐子大小的丸剂。每次服用三四十丸，用淡醋汤送下。若痰积多者，用姜汤送下。
【脂瘕】：妇人月经刚来，如果房事未满三十天，就进行阴阳交合，导致络脉分离，胞门受伤，子户失禁，关节松散，五脏六腑的津液流入阴道，扰动百脉，关枢解散，外表看不出异常，子精与血气相遇，触犯禁忌，子精化散，不足以成胎，从而生成脂瘕之聚。使人胸胁胀满里急，痹痛牵引少腹沉重，腰背如针刺状，四肢不能抬起，饮食无味，卧不安席，腹部左右走窜切痛，时好时坏，有时气短头晕，身体懈怠，苦于恶寒怕风，膀胱胀满，月经乍来乍去，不合常度，大小便出血不止，像这样的情况会导致不孕。
治疗应当用长针针刺，施用毒药，瘕块即可下行，随即痊愈。
治疗脂瘕方（出自《圣惠方》）：
皂荚（七钱半，去皮子）、矾石（烧，二钱半）、五味子、蜀椒（去汗）、细辛、干姜（各半两）。
以上捣碎成散剂，用香脂调和如大豆大小，置于男子阴头以行阴阳交合，不超过三次，其瘕即愈。
导散方（出自《圣惠方》）：
皂荚（炙，去皮子）、吴茱萸、当归（各一两）、蜀椒（去汗）、干姜、大黄、戎盐（各二两）、细辛（熬）、矾石（烧）、五味子（各二分）。
以上捣筛为散剂，用轻绢袋做成如手指粗细、长三寸，盛满药物，纳入阴道内，坐卧随意，不要行走，小便时取出，换新的继续使用。
【狐瘕】：妇人月经按日期应来，却反而悲哀忧恐，如同远行遭遇暴风疾雨、雷电惊恐，衣被沉湿，疲倦气少，心中恍惚不定，四肢懈怠懒惰，发冷颤抖，苦于醒睡间气息断绝，精神游荡亡失，邪气进入阴分不去，则生成狐瘕之聚，侵蚀子宫，使人月经闭止不通，少腹瘀滞，胸胁腰背痛，外阴肿胀，小便困难，胞门子户不接受男精，五脏气盛，使人嗜食，想呕吐，喜吐唾沫，思虑过多，如有身孕之状，四肢不能抬起，有此病者，终身无子。其瘕若有手足成形者会致死，未成形的可以治疗。用长针急速持针针刺，施用毒药有法度，瘕块即可下行，随即痊愈。
治疗狐瘕方（出自《圣惠方》）：
以上取一只新死的老鼠，用新棉絮包裹，涂上黄土，挖地坑深没鼠形，将鼠放入其中，用桑柴火灼烧其上，一日一夜后取出，研为细末，加入桂心末二钱半，用酒送服二方寸匕的病邪即可下行。严重者不过再服一次，病愈。
【蛇瘕】：妇人月经已下且刚停止，适逢闭合未复，胞门子户劳伤，阴阳未平，营卫分行，如果中途遭受风暴疾病，身体羸弱，饮食未调理，如果起身行走当风，以及经过泥涂，因冲寒太早，如果坐在湿地，名为阴阳紊乱，腹中虚寒，如果远行道路，饮污井之水，吃不洁的食物，吞食蛇鼠的精液，留滞在络脉不去，因而生成蛇瘕之聚。上蚀心肝，长大其形状如漆，在脐上下，还连左右胁，不得吐气，两股胫间苦痛，少腹多热，小便赤黄，膀胱牵引阴中挛急，腰目俱痛，难以动作，喜欢发寒热，月经或多或少，有此病者，不再能生子。其瘕若有手足成形者会致死，未成形的可以治疗。治疗有法度，施用毒药，瘕块即可下行，随即痊愈。
治疗蛇瘕方（出自《圣惠方》）：
大黄、黄芩、芒硝（各半两）、甘草（大如指一尺，炙）、乌贼鱼骨（二枚）、皂荚（六枚，去皮弦子，酥炙）。
以上捣碎，用水六升，煮三五个沸，绞去药渣，加入芒硝，待温度适宜时服用，十日一剂，空腹服用，瘕块即下。
【鳖瘕】：妇人月经刚到，其人剧烈劳作后休息，汗出衣服润湿，不及时更换，如果当风睡觉，脚踩湿地，恍惚觉醒，站立未安，面色未平，又见到所喜爱之物，心神开启，魂魄感动，五脏精气脱消，如果入水浣洗沐浴，不及时出来，而神不守舍，水精与邪气俱入，到达三焦之中幕，玉门先闭，津液妄行，留滞在络脉不去，因而生成鳖瘕之聚。大如小鳖，使人少腹内切痛，恶气左右走窜，上下腹中苦痛，似有似无，按压时跳跃应手，下引阴里，腰背也痛，不可以呼吸，月经不通，面目黄黑，失声气少，有此病者，令人绝育。其瘕若有手足成形者会致死，未成形的可以治疗。治疗有法度，用长针按压治疗，施用毒药，瘕块即可下行，随即痊愈。
治疗鳖瘕方（出自《圣惠方》）：
大黄（一两半）、干姜、侧子（各半两）、附子、人参（各三钱七分半）、䗪虫（一寸匕，熬）、桂心（一两二钱半）、细辛、土狗（各七钱半）、白术（一两）。
以上捣碎成散剂，用酒送服方寸匕，每日三次。
治疗鳖瘕及心腹宿积，或突然得积。
以上用白雄鸡屎不论多少，用小便调和，在器皿中火上熬令干燥，研为细末，每次服方寸匕，多服不限次数，如果用膏油熬饭喂食更好。
【癥痞】
【大论】妇人癥痞，由于饮食失节，脾胃亏损，邪正相搏，积于腹中，牢固不动，有可征验，故名曰癥，气道壅塞，故名曰痞，得冷则发作，冷入子脏则不孕，入胞络则月经不通。
【薛己】前证若脾胃虚弱，用六君子汤加川芎、当归。（方见杂病虚劳。）若肝脾虚弱，用补中益气汤（杂病伤劳倦。）及归脾汤。（杂病健忘。）若肝火郁滞，佐以芦荟丸、（方见幼科疳门。）地黄丸。（即六味丸，杂病虚劳。）外贴阿魏膏。（见前。）患者须慎七情六淫，饮食起居，治者不时审察病机而用药，庶几有效。
穿山甲散（出自《大全》）：治疗妇人癥痞及恶血，气攻心腹疼痛，面无颜色，四肢瘦弱。
穿山甲（灰炒燥）、鳖甲（醋灸）、赤芍药、大黄（炒）、干漆（炒令烟尽）、桂心（各一两）、川芎、芫花（醋炒）、当归（各半两）、麝香（二钱半，另研）。
以上为细末，入麝香和匀，每次服一钱，热酒调下，不拘时候。
蓬莪术丸（出自《大全》）：治疗妇人癥痞，腹胁妨痛，令人体瘦，不思饮食。
莪术（七钱半）、当归（焙）、桂心、赤芍药、槟榔、昆布、琥珀（研）、枳壳、木香（各半两）、桃仁、鳖甲、大黄（各一两）。
以上为末，烂蜜丸如梧子大，食前米饮下二十丸。
丁香丸（出自《大全》）：治疗妇人癥痞，结块不散，心腹疼痛。
雄雀粪（炒黄）、鳖甲（各一两）、砂仁、当归（焙）、芫花（醋炒干，各半两）、巴豆（二分半，去皮心油）。
以上为末，研令停匀，醋煮面糊丸如小豆大，当归酒下三丸。
桃仁散（出自《普济方》）：治疗妇人癥痞，心腹胀满，不能饮食，体瘦无力。
桃仁（一两，汤浸去皮尖双仁者，麸炒令微黄）、诃子皮、白术、赤芍药、当归（各七钱半）、京三棱（锉，微炒，一两）、鳖甲（醋炙，去裙烂，一两半）、陈皮（汤浸，去白焙，三两）。
以上为散剂，每次服三钱，水一盏，入生姜一钱三分，煎至六分，去滓食前稍热服。
上方皆攻积之药，性多犷烈，用者慎之，如薛氏所言。
【食积】
妇人脏腑虚弱，月候来时食生冷之物，脾胃既虚，不能消化，与脏气相搏，结聚成块，日渐生长，盘牢不移，故谓之食积也。
【薛己】前证若形气虚弱，须先调补脾胃为主，而佐以消导。若形气充实，当先疏导为主，而佐以补脾胃。若气壅血滞而不行者，宜用乌药散散而行之。（散用乌药、莪术、醋浸炒，桂心、当归、桃仁、青皮、木香，各等分为末，每二钱热酒调下。）脾气虚而血不行者，宜用四君、芎、归，补而行之。（方见杂病虚劳。）若脾气郁血不行者，宜用归脾汤（杂病健忘。）解而行之。若肝脾血燥而不行者，宜用加味逍遥散（结核。）清而行之。大抵食积痞块之证为有形，盖邪气胜则实，真气夺则虚，当养正辟邪而积自除矣。虽然，坚者削之，客者除之，胃气未虚，或可少用，若病久虚弱者，不可轻试也。
硇砂丸（出自《大全》）：治疗妇人食积久不消，令人瘦弱食少。
硇砂、青礞石、穿山甲（炙）、三棱（炒）、干漆（炒令烟尽）、硫黄（各半两）、巴豆（三十枚，去皮心炒，不去油）。
以上为末，用软饭丸如小豆大，每次服五丸，生姜、橘皮汤下。
礞石丸（出自《大全》）：治疗妇人食积块久不消，攻刺心腹疼痛。
青礞石（末）、巴豆（去皮心油）、朱砂、粉霜（并研）、木香末（各二钱半）、硇砂（半两）。
以上研令停匀，以糯米软饭和丸如绿豆大，每次服二丸，空心温酒下，取下恶物为度。
上方犯硇砂、巴豆，非胃气强壮而积气坚顽势不两立者，不可轻用也。
小三棱煎丸：治食积、酒癖、血瘕、气块，时发刺痛，全不思食，及一切积滞不消，心腹坚胀，痰饮呕哕噫酸，胁肋刺痛，脾气横泄。
三棱、莪术（各四两）、芫花（一两）。
以上入瓷器中，用米醋五升，浸满封器口，以灰火煨令干，取出棱、术，将芫花以余醋炒令微焦，同棱、术焙干为末，醋糊丸如绿豆大，每次服十五丸，生姜汤下。妇人血分，男子脾气横泄，肿满如水，桑白皮煎汤下。
【血积】
妇人寒温失节，脏腑气虚，风冷在内，饮食不消，与血气相结，渐生颗块，盘牢不移动者是也。皆因血气劳伤，月水往来，经络痞塞，恶血不除，结聚所生，久而不瘥，则心腹两胁苦痛，害于饮食，肌肤羸瘦。问：积一也，何以知是血积？曰：血之外证，瞀闷烦躁，迷忘惊狂，痰呕汗多，骨热肢冷，其蓄在下焦者，必脐下结急，外热内痛，尺脉洪而数也。桃仁、灵脂、生地黄、牛膝、大黄、甘草祛逐之。
【薛己】前证多兼七情亏损，五脏气血乖违而致。盖气主嘘之，血主濡之，脾统血，肝藏血，故郁结伤脾，恚怒伤肝者多患之，腹胁作痛，正属肝脾二经证也。洁古云：养正积自除。东垣云：人以胃气为主，治法当主于固元气而佐以攻伐之剂，必需之岁月，若期速效，投以峻剂，反致有误。
加减四物汤（方见杂病积聚。）当归丸 牡丹散（俱同上。）
大黄煎（出自《圣惠方》）：治疗妇人血积血瘕，食积痰滞。
川大黄（七钱半，碎，微炒）、鳖甲（一两，醋炙黄，去裙襕）、牛膝（去芦，一两）、干漆（一两，炒烟尽）。
以上为末，用米醋一升，煎为膏，每次服一钱，食前热酒调下。
【腹中瘀血】
妇人月经痞涩不通，或产后余秽未尽，因而乘风取凉，为风冷所乘，血得冷则成瘀血也。血瘀在内，则时时体热面黄，瘀久不消，则为积聚癥瘕矣。
【薛己】前证若郁结伤脾，用加味归脾汤。（方见杂病健忘。）若恚怒伤肝，用加味逍遥散。（结核。）若产后恶露，用失笑散。（方见心痛。）若肝脾亏损，用六君、柴胡，以补元气为主。（方见虚劳。）胃气虚弱，用补中益气汤加茯苓、半夏为主。（方见杂病劳倦。）大凡腹中作痛畏手按者，此内有瘀血，若形体如常，属病气元气俱实，用桃仁承气汤直下之。（方见伤寒蓄血。）若痛而肢体倦怠，饮食少思，此脾胃受伤，属病气有余，元气不足，用当归散调和之。（方见杂病溲血。）若痛而喜手按腹，形体倦怠，饮食少思，此形气病气俱不足，用六君、炮姜、芎、归纯补之。若痛而大便不实，饮食难化，此脾肾虚寒，用六君、炮姜、肉果温补之。若痛而作呕少食，此脾胃虚弱，用六君、炮姜、藿香。若痛而呕吐不食泄泻，用六君加姜、桂。若兼手足逆冷自汗，更加附子。此证多有因攻伐而致者。
调荣汤：治瘀血不消，脐腹引腰背俱痛。
川芎、当归、芍药、地黄、生姜（各一两）、三棱、莪术、白芷、延胡索、蒲黄、香附子、泽兰叶、细辛、川白姜、浓朴（制）、半夏（制）、甘草（各七钱半，炙）、辣桂、桃仁（汤浸去皮，焙，各五钱）。
以上锉散，每次服三钱，姜枣煎，食前服。
川当归散：理荣卫，消瘀血，出声音，治痰嗽。
川当归、牡丹皮、白芍药、子芩、木通、华阴细辛、麦门冬、甘草（各半两）、生地黄（一两）。
以上㕮咀，每次服三钱，水一盏，姜三片，煎至七分，去滓温服。
大黄汤：治妇人血瘀不消，及扑损血瘀。
大黄（生用）、桃仁（汤浸去皮尖双仁，各一两）、桂（去粗皮）、郁李仁（去皮研，各半两）、生姜、地黄（各一两）。
以上粗捣节，每次服三钱，水酒各半盏，同煎至七分，去滓温服。
琥珀散：治妇人经络痞塞，腹内瘀血，痛不可忍。
琥珀、乳香、没药。
以上三味，各研取细末五钱，每次服二钱，水酒各半盏，煎至七分，入地黄自然汁二合，再
Another prescription: Take an ancient iron steelyard weight, or a large axe head, or an iron pestle, heat it red-hot with charcoal fire, and throw it into three sheng (approx. 1.5 liters) of good wine for the patient to drink.
For treating blood jia (abdominal masses characterized by fixed location and pain) in women, with stabbing pain in the abdomen and flanks occurring intermittently, a guiding medicine prescription.
Da Huang (Rhei Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix) (each half liang); Shan Zhu Yu (Corni Fructus), Zao Jiao (Gleditsiae Fructus) (skin and strings removed, each one liang); Xi Xin (Asari Radix), Rong Yan (Natrii Sulfas) (each two qian and half).
The above herbs are crushed and mixed with aromatic balm to form pills the size of a finger. Use one pill each time, wrap it in cotton, and insert it into the vagina. Sit upright for a long time, and the mass will descend. Care for the patient as one would care for a postpartum woman.
Tao Ren Jian (Peach Kernel Decoction) (from *Ben Shi Fang*): Treats blood jia, blood accumulation (stasis), and amenorrhea in women.
Tao Ren (Persicae Semen), Da Huang (Rhei Radix et Rhizoma) (each one liang); Meng Chong (Blattariae Insectum) (half liang, stir-fried until black); Chuan Po Xiao (Natrii Sulfas) (separately ground).
The above four ingredients are powdered. Using two and a half sheng (approx. 1.25 liters) of pure vinegar, slowly simmer in a silver or earthenware vessel to reduce to one sheng and five he (approx. 0.75 liters). Add the powders of Da Huang, Meng Chong, and Tao Ren. Stir constantly until the mixture can be formed into pills. Add Po Xiao, mix evenly, remove from heat, and form pills the size of Sophora seeds. Do not eat dinner the day before. At dawn (Wu Geng, approx. 3-5 AM), swallow five pills with warm wine. By noon, discharge material resembling red bean juice, or clots resembling chicken liver or frog skin. If not discharged, administer again. If fresh blood flows, stop the medication. Subsequently, tonify qi and blood with appropriate medicines. In previous years in Piling, the wife of a noble official suffered from urinary retention and unbearable abdominal distension. Many physicians treated it as Lin syndrome (dysuria) using Ba Zheng San, which worsened her condition. I diagnosed it as blood jia, stating that only potent drugs causing severe dizziness could expel it. She took this medicine at the beginning of the first watch. By noon, she endured unbearable pain, lay down for a moment, and passed several blood clots the size of fists. Her urine flowed like black bean juice, about one to two sheng. The pain ceased, and she recovered. This medicine is effective but harsh and damaging; it should not be used lightly in patients with qi deficiency and blood weakness.
San Leng Jian (Curcuma Quinaria Decoction) (from *Xuan Qi Fang*): Treats blood jia, blood disorders, food stagnation, and phlegm obstruction in women.
San Leng (Bistortae Rhizoma), E Zhu (Curcumae Rhizoma) (each two liang); Qing Ju Pi (Citri Reticulatae Pericarpium) (white pith removed); Ban Xia (Pinelliae Tuber); Mai Ya (Hordei Fructus Germinatus) (stir-fried, each one liang).
Boil the above in six sheng (approx. 3 liters) of good vinegar until dry, then bake and powder. Form pills with vinegar paste the size of Sophora seeds. Take thirty to forty pills each time, washed down with light vinegar soup. For excessive phlegm accumulation, wash down with ginger soup.
[Li Jia]: When a woman's menstruation has just begun, if intercourse occurs within thirty days of its onset, the collaterals separate, the uterus door is injured, the child's chamber loses control, joints loosen, and the fluids of the five zang and six fu organs flow into the vagina. This disturbs the hundred vessels, causes the gate pivots to disperse, and although no external shape is visible, when seminal essence meets blood and qi, violating taboos, the seminal essence dissipates and fails to conceive, leading to the formation of Li Jia. Symptoms include fullness and tightness in the limbs and chest, bi-sensation pulling the lower abdomen with heaviness, stabbing pain in the lower back, inability to lift the limbs, lack of taste in food, restlessness in bed, wandering cutting pain in the abdomen, alternating remission and exacerbation, occasional shortness of breath and dizziness, body lethargy, aversion to cold and wind, bladder distension, irregular menstruation, continuous bleeding from the bowels and urine. Such conditions lead to infertility.
Treatment involves acupuncture with long needles and administration of toxic medicines to expel the mass, resulting in immediate recovery.
Prescription for Li Jia (from *Sheng Hui Fang*):
Zao Jiao (Gleditsiae Fructus) (seven qian and half, skin and seeds removed), Fan Shi (Alumen) (calcined, two qian and half), Wu Wei Zi (Schisandrae Fructus), Shu Jiao (Zanthoxyli Pericarpium) (sweat removed), Xi Xin (Asari Radix), Gan Jiang (Zingiberis Rhizoma) (each half liang).
Powder the above, mix with aromatic balm to form pills the size of soybeans. Apply to the male glans during intercourse. Within three times, the jia will heal.
Guiding Powder Prescription (from *Sheng Hui Fang*):
Zao Jiao (Gleditsiae Fructus) (roasted, skin and seeds removed), Wu Zhu Yu (Evodiae Fructus), Dang Gui (Angelicae Sinensis Radix) (each one liang), Shu Jiao (Zanthoxyli Pericarpium) (sweat removed), Gan Jiang (Zingiberis Rhizoma), Da Huang (Rhei Radix et Rhizoma), Rong Yan (Natrii Sulfas) (each two liang), Xi Xin (Asari Radix) (simmered), Fan Shi (Alumen) (calcined), Wu Wei Zi (Schisandrae Fructus) (each two fen).
Powder and sieve the above. Place in a small silk bag (finger-thick, three cun long), fill with medicine, and insert into the vagina. Sit or lie down as desired, do not walk. Remove during urination and replace with a new one.
[Hu Jia]: When a woman's menstruation is due but she experiences sorrow and fear, as if traveling far and encountering storms, rain, thunder, or lightning, with wet clothes and fatigue, shortness of breath, mental instability, limb lethargy, chills, difficulty breathing during sleep and wakefulness, wandering spirit, and pathogenic qi entering the yin interior without departing, Hu Jia forms. It consumes the uterus, causing amenorrhea, lower abdominal stasis, chest/flank/back pain, vulvar swelling, difficult urination, inability of the uterus to receive semen, excess qi in the five zang, increased appetite, nausea, excessive salivation, excessive thinking, pregnancy-like symptoms, limb immobility, and lifelong infertility. If the mass has formed hands and feet, it is fatal; if unformed, it is treatable. Treat with rapid acupuncture using long needles and specific toxic medicines to expel the mass for immediate recovery.
Prescription for Hu Jia (from *Sheng Hui Fang*):
Take one newly dead rat, wrap in new cotton, coat with yellow earth, dig a pit deep enough to submerge the rat, place it inside, and burn mulberry wood fire above it for one day and night. Remove, powder, add two qian and half of Gui Xin (Cinnamomi Ramulus Cortex powder), and take two fang cun bi with wine. The disease will descend. Severe cases may require one more dose for cure.
[She Jia]: After menstruation has stopped, if the closure is incomplete, the uterus is strained, yin and yang are unbalanced, and Ying and Wei circulate separately, exposure to wind-cold, poor diet, walking in wind, crossing mud, early exposure to cold, or sitting on damp ground causes yin-yang disorder and abdominal deficiency. Long travel, drinking dirty well water, eating unclean food, or swallowing snake/rat essence leads to stagnation in collaterals, forming She Jia. It attacks the heart and liver, grows like lacquer around the umbilicus and flanks, causes breathlessness, severe pain in thighs/calves, lower abdominal heat, dark yellow urine, bladder pulling the vulva into spasm, eye and back pain, difficulty moving, chills/fever, irregular menstruation, and infertility. If formed with hands/feet, it is fatal; if unformed, it is treatable. Treat with specific toxic medicines to expel the mass for immediate recovery.
Prescription for She Jia (from *Sheng Hui Fang*):
Da Huang (Rhei Radix et Rhizoma), Huang Qin (Scutellariae Radix), Mang Xiao (Natrii Sulfas) (each half liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (one chi long, roasted), Hai Piao Xiao (Sepiae Endoconcha) (two pieces), Zao Jiao (Gleditsiae Fructus) (six pieces, skin/strings removed, fried in butter).
Crush the above, boil in six sheng of water for three to five boils, strain, add Mang Xiao, and take when temperature is suitable. One dose per ten days, taken on an empty stomach. The mass will descend.
[Bie Jia]: When menstruation arrives, followed by strenuous labor and sweating, wet clothes not changed, sleeping in wind, stepping on damp ground, waking from trance, standing unsteadily, unstable complexion, seeing desirable objects, exciting the mind and soul, depleting internal organs, bathing in water without exiting promptly, losing spiritual guard, allowing water essence and pathogenic qi to enter the San Jiao, closing the Jade Gate, causing erratic fluid circulation and collateral stagnation, Bie Jia forms. Size of a small turtle, causing severe lower abdominal pain, wandering evil qi, fluctuating upper/lower abdominal pain, jumping upon pressure, pulling into the vulva, back pain, dyspnea, amenorrhea, yellow-black complexion, loss of voice, shortness of breath, and sterility. If formed with hands/feet, it is fatal; if unformed, it is treatable. Treat with long needle compression and toxic medicines to expel the mass for immediate recovery.
Prescription for Bie Jia (from *Sheng Hui Fang*):
Da Huang (Rhei Radix et Rhizoma) (one and a half liang), Gan Jiang (Zingiberis Rhizoma), Ce Zi (Aconiti Lateralis Radix Preparata) (each half liang), Fu Zi (Aconiti Radix Preparata), Ren Shen (Ginseng Radix) (each three qian seven fen half), Chan (Mantidis Oötheca) (one fang cun bi, roasted), Gui Xin (Cinnamomi Ramulus Cortex) (one liang two qian half), Xi Xin (Asari Radix), Tu Gong (Eupolyphaga Seu Steleochopus) (each seven qian half), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (one liang).
Powder the above, take one fang cun bi with wine, three times daily.
For Bie Jia and chronic abdominal accumulations or sudden accumulation:
Use white rooster manure in any amount, mix with urine, dry over fire in a vessel, powder, and take one fang cun bi. No limit on dosage. Feeding with oil-cooked rice is better.
[Zheng Pi]
[Great Treatise]: Women's Zheng Pi arises from irregular diet and spleen/stomach deficiency, where pathogenic and righteous qi clash, accumulating firmly in the abdomen. It is named Zheng due to tangible signs, and Pi due to qi blockage. Cold triggers it; cold entering the uterus causes infertility, while cold entering the uterine collaterals causes amenorrhea.
[Xue Ji]: For the above symptoms, if spleen/stomach is weak, use Liu Jun Zi Tang plus Chuan Xiong and Dang Gui. (See Misc Diseases, Deficiency Consumption.) If liver/spleen is weak, use Bu Zhong Yi Qi Tang (Misc Diseases, Fatigue from Overwork) and Gui Pi Tang. (Misc Diseases, Forgetfulness.) If liver fire stagnates, assist with Lu Hui Wan (Pediatrics, Malnutrition Gate) and Di Huang Wan (Six Ingredient Pill, Misc Diseases, Deficiency Consumption). Externally apply A Wei Gao. (See above.) Patients must guard against the Seven Emotions and Six Evils, diet, and lifestyle. Physicians must frequently examine the disease mechanism and medicate accordingly for effectiveness.
Chuan Shan Jia San (from *Da Quan*): Treats women's Zheng Pi and bad blood, qi attacking heart/abdomen causing pain, pale face, and emaciated limbs.
Chuan Shan Jia (Manis Squama) (ash-roasted dry), Bie Jia (Testudinis Carapax et Plastrum) (vinegar-roasted), Chi Shao Yao (Paeoniae Radix Rubra), Da Huang (Rhei Radix et Rhizoma) (roasted), Gan Qi (Dammaris Resina) (roasted until smoke ceases), Gui Xin (Cinnamomi Ramulus Cortex) (each one liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Yuan Hua (Genkwa Flos) (vinegar-roasted), Dang Gui (Angelicae Sinensis Radix) (each half liang), She Xiang (Moschus) (two qian and half, separately ground).
Powder finely, mix with She Xiang. Take one qian each time, mixed with hot wine, anytime.
Peng E Zhu Wan (from *Da Quan*): Treats women's Zheng Pi, flank pain, emaciation, and anorexia.
E Zhu (Curcumae Rhizoma) (seven qian and half), Dang Gui (Angelicae Sinensis Radix) (baked), Gui Xin (Cinnamomi Ramulus Cortex), Chi Shao Yao (Paeoniae Radix Rubra), Bing Lang (Arecae Semen), Kun Bu (Sargassum), Hu Po (Fossilia Succinum) (ground), Zhi Ke (Aurantii Fructus Immaturus), Mu Xiang (Aucklandiae Radix) (each half liang), Tao Ren (Persicae Semen), Bie Jia (Testudinis Carapax et Plastrum), Da Huang (Rhei Radix et Rhizoma) (each one liang).
Powder, mix with honey to form pills the size of Sophora seeds. Take twenty pills before meals with rice water.
Ding Xiang Wan (from *Da Quan*): Treats women's Zheng Pi, persistent masses, and abdominal pain.
Xiong Que Fen (Avian Excrement) (roasted yellow), Bie Jia (Testudinis Carapax et Plastrum) (each one liang), Sha Ren (Amomi Fructus), Dang Gui (Angelicae Sinensis Radix) (baked), Yuan Hua (Genkwa Flos) (vinegar-dried, each half liang), Ba Dou (Crotonis Fructus) (two fen and half, skin/core/oil removed).
Powder, grind evenly, make pills with vinegar-boiled wheat paste the size of mung beans. Take three pills with Dang Gui wine.
Tao Ren San (from *Pu Ji Fang*): Treats women's Zheng Pi, abdominal fullness, anorexia, emaciation, and weakness.
Tao Ren (Persicae Semen) (one liang, soaked in water, skin/spikes/double kernels removed, bran-roasted until slightly yellow), He Zi Pi (Terminaliae Chebulae Reticulatae Pericarpium), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chi Shao Yao (Paeoniae Radix Rubra), Dang Gui (Angelicae Sinensis Radix) (each seven qian and half), Jing San Leng (Polygonati Odorati Rhizoma) (cut, lightly roasted, one liang), Bie Jia (Testudinis Carapax et Plastrum) (vinegar-roasted, skirt removed, one and a half liang), Chen Pi (Citri Reticulatae Pericarpium) (soaked, white pith removed, baked, three liang).
Powder. Take three qian each time with one cup of water, add one qian and three fen of fresh ginger, decoct to six parts, strain, and take slightly warm before meals.
The above prescriptions are all aggressive accumulation-dispersing agents with harsh properties; use with caution, as noted by Dr. Xue.
[Food Accumulation]
Women with weak viscera who consume raw/cold foods during menstruation suffer from spleen/stomach deficiency and inability to digest. The food clashes with visceral qi, forming masses that grow daily and remain fixed, hence called Food Accumulation.
[Xue Ji]: For the above, if constitution/qi is weak, prioritize tonifying spleen/stomach with aiding digestion. If constitution/qi is robust, prioritize dredging with aiding spleen/stomach. If qi stagnation and blood stasis prevent flow, use Wu Yao San to disperse and move it. (Formula uses Wu Yao, E Zhu, vinegar-soaked/fried, Gui Xin, Dang Gui, Tao Ren, Qing Pi, Mu Xiang, equal parts powder, take two qian with hot wine.) If spleen qi deficiency prevents blood flow, use Si Jun Zi plus Chuan Xiong and Dang Gui to tonify and move. (See Misc Diseases, Deficiency Consumption.) If spleen qi depression prevents blood flow, use Gui Pi Tang (Misc Diseases, Forgetfulness) to resolve and move. If liver/spleen blood dryness prevents flow, use Jia Wei Xiao Yao San (Tubercles) to clear and move. Generally, food accumulation masses are tangible; excess pathogen means excess, depleted true qi means deficiency. Nourish righteousness, repel evil, and accumulation removes itself. Although "reduce hardness, eliminate intruders," if stomach qi is not weak, slight use is possible; if chronically weak, do not test lightly.
Nao Sha Wan (from *Da Quan*): Treats women's long-standing food accumulation, causing emaciation and poor appetite.
Nao Sha (Natrii Chloridum Impurum), Qing Meng Shi (Calamina), Chuan Shan Jia (Manis Squama) (roasted), San Leng (Polygonati Odorati Rhizoma) (roasted), Gan Qi (Dammaris Resina) (roasted until smoke ceases), Liu Huang (Sulfur) (each half liang), Ba Dou (Crotonis Fructus) (thirty pieces, skin/core removed, roasted, oil retained).
Powder, mix with soft rice to form pills the size of mung beans. Take five pills each time with ginger/orange peel soup.
Meng Shi Wan (from *Da Quan*): Treats women's long-standing food accumulation masses, stabbing abdominal pain.
Qing Meng Shi (Calamina) (powder), Ba Dou (Crotonis Fructus) (skin/core/oil removed), Zhu Sha (Cinnabar), Fen Shuang (Plumbum Subnitricum) (all ground), Mu Xiang (Aucklandiae Radix) powder (each two qian and half), Nao Sha (Natrii Chloridum Impurum) (half liang).
Grind evenly, mix with glutinous rice soft rice to form pills the size of mung beans. Take two pills each time on an empty stomach with warm wine. Stop when foul matter is discharged.
The above contain Nao Sha and Ba Dou; do not use lightly unless stomach qi is strong and accumulation is stubborn and life-threatening.
Xiao San Leng Jian Wan: Treats food accumulation, alcohol癖 (alcoholism-related masses), blood jia, qi masses, intermittent stabbing pain, total anorexia, all stagnant accumulations, hard abdominal distension, phlegm-fluid vomiting/hiccups/belching with sourness, flank stabbing pain, and spleen qi horizontal leakage.
San Leng (Polygonati Odorati Rhizoma), E Zhu (Curcumae Rhizoma) (each four liang), Yuan Hua (Genkwa Flos) (one liang).
Place in porcelain, cover with five sheng of rice vinegar, seal, and simmer in ash fire until dry. Remove San Leng and E Zhu. Stir-fry Yuan Hua in remaining vinegar until slightly scorched. Bake San Leng, E Zhu, and Yuan Hua together, powder, and form pills with vinegar paste the size of mung beans. Take fifteen pills each time with ginger soup. For women's blood division or men's spleen qi horizontal leakage with edema like water, take with Sang Bai Pi decoction.
[Blood Accumulation]
Women with irregular cold/heat, visceral qi deficiency, internal wind-cold, and undigested food experience blood/qi binding, gradually forming fixed masses. Caused by blood/qi strain, menstrual cycles, meridian blockage, unremoved bad blood, and clustering. Long-term untreated, it causes heart/abdomen/flank pain, dietary harm, and emaciation. Question: How to distinguish blood accumulation? Answer: External signs include dizziness, irritability, confusion, madness, phlegm/vomiting, excessive sweating, bone heat, cold limbs. If accumulated in lower jiao, there is umbilical urgency, external heat/internal pain, and surging-rapid chi pulse. Tao Ren, Ling Zhi, Sheng Di Huang, Niu Xi, Da Huang, Gan Cao expel it.
[Xue Ji]: These symptoms often involve emotional damage and five zang qi/blood disharmony. Qi moistens, blood nourishes. Spleen controls blood, Liver stores blood. Thus, depression damages spleen, anger damages liver, causing flank pain (liver/spleen meridians). Jie Gu said: Nourish righteousness, accumulation removes itself. Dong Yuan said: Stomach qi is primary; treatment should consolidate yuan qi with assisting attack agents, requiring time. Seeking quick results with harsh agents causes error.
Jia Jian Si Wu Tang (See Misc Diseases, Accumulation). Dang Gui Wan, Mu Dan San (Same as above).
Da Huang Jian (from *Sheng Hui Fang*): Treats women's blood accumulation/jia, food/phlegm stagnation.
Chuan Da Huang (Rhei Radix et Rhizoma) (seven qian and half, crushed, lightly roasted), Bie Jia (Testudinis Carapax et Plastrum) (one liang, vinegar-roasted yellow, skirt removed), Niu Xi (Achyranthis Bidentatae Radix) (stem removed, one liang), Gan Qi (Dammaris Resina) (one liang, roasted until smoke ceases).
Powder, decoct in one sheng of rice vinegar to paste. Take one qian each time before meals with hot wine.
[Abdominal Blood Stasis]
Women with obstructed menstruation or residual lochia postpartum, exposed to wind/cold for cooling, contract wind-cold. Blood becomes cold and forms stasis. Internal stasis causes periodic fever, yellow face. Long-term unresolved, it becomes accumulation/Zheng/Jia.
[Xue Ji]: For the above, if depression damages spleen, use Jia Wei Gui Pi Tang. (See Misc Diseases, Forgetfulness.) If anger damages liver, use Jia Wei Xiao Yao San. (Tubercles.) If postpartum lochia, use Shi Xiao San. (See Heart Pain.) If liver/spleen deficiency, use Liu Jun Zi + Chai Hu to tonify yuan qi. (See Deficiency Consumption.) If stomach qi weak, use Bu Zhong Yi Qi Tang + Fu Ling, Ban Xia. (See Misc Diseases, Fatigue.) Generally, abdominal pain fearing pressure indicates internal stasis. If physique normal, both pathogen and yuan qi are excess; use Tao Ren Cheng Qi Tang to purge directly. (See Shang Han, Blood Accumulation.) If pain with limb fatigue/poor appetite, spleen/stomach damaged, pathogen excess/yuan qi deficient; use Dang Gui San to harmonize. (See Misc Diseases, Hematuria.) If pain preferring pressure, fatigue/poor appetite, both physique/pathogen deficient; use Liu Jun Zi, Pao Jiang, Chuan Xiong, Dang Gui for pure tonification. If pain with loose stools/hard digestion, spleen/kidney cold; use Liu Jun Zi, Pao Jiang, Rou Guo for warming tonification. If pain with vomiting/poor intake, spleen/stomach weak; use Liu Jun Zi, Pao Jiang, Huo Xiang. If pain with vomiting/anorexia/diarrhea, use Liu Jun Zi + Ginger/Cinnamon. If accompanied by cold extremities/sweating, add Fu Zi. These cases often result from aggressive attack treatments.
Tiao Rong Tang: Treats unresolved blood stasis, umbilical/abdominal pain radiating to back.
Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix), Di Huang (Rehmanniae Radix), Sheng Jiang (Zingiberis Rhizoma Recens) (each one liang), San Leng (Polygonati Odorati Rhizoma), E Zhu (Curcumae Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Yan Hu Suo (Corydalis Rhizoma), Pu Huang (Typhae Pollen), Xiang Fu (Cyperi Rhizoma), Ze Lan Ye (Lycopersici Herba), Xi Xin (Asari Radix), Chuan Bai Jiang (Zingiberis Rhizoma), Hou Po (Magnoliae Officinalis Cortex) (processed), Ban Xia (Pinelliae Tuber) (processed), Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted, each seven qian and half), La Gui (Cinnamomi Ramulus), Tao Ren (Persicae Semen) (soaked, skin removed, baked, each five qian).
Cut into pieces. Take three qian each time with ginger/date decoction, before meals.
Chuan Dang Gui San: Regulates Ying/Wei, eliminates blood stasis, restores voice, treats phlegm cough.
Chuan Dang Gui (Angelicae Sinensis Radix), Mu Dan Pi (Moutan Cortex), Bai Shao Yao (Paeoniae Radix Alba), Zi Qin (Scutellariae Radix), Mu Tong (Akebiae Caulis), Hua Yin Xi Xin (Asari Radix), Mai Men Dong (Ophiopogonis Tuber), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each half liang), Sheng Di Huang (Rehmanniae Radix) (one liang).
Chop. Take three qian each time with one cup of water, three slices of ginger, decoct to seven parts, strain, and take warm.
Da Huang Tang: Treats women's unresolved blood stasis and traumatic blood stasis.
Da Huang (Rhei Radix et Rhizoma) (raw), Tao Ren (Persicae Semen) (soaked, skin/spikes removed, each one liang), Gui (Cinnamomi Ramulus) (bark removed), Yu Li Ren (Pruni Semen) (skin removed, ground, each half liang), Sheng Jiang (Zingiberis Rhizoma Recens), Di Huang (Rehmanniae Radix) (each one liang).
Coarsely chop. Take three qian each time with half cup water/half cup wine, decoct to seven parts, strain, and take warm.
Hu Po San: Treats women's meridian blockage, abdominal blood stasis, unbearable pain.
Hu Po (Fossilia Succinum), Ru Xiang (Olibanum), Mo Yao (Myrrha).
Each of the three ingredients, grind to fine powder (five qian each). Take two qian each time with half cup water/half cup wine, decoct to seven parts, add two he of natural juice from Sheng Di Huang, and