脉来大强者生。沉小者死。脉来附骨者积也。在寸口。积在胸中。在关上。积在脐旁。
在尺部。积在气冲。脉在左。积在左。脉在右。积在右。脉两出。积在
中央。脉来小沉而实者。脾胃中有积聚。不下食。食则吐。
积者。生于五脏之阴也。其发有根。其痛有常处。脉必结伏。聚者。成于六腑之阳也。
其发
无根。其痛无常处。脉必浮结。由阴阳不和。脏腑虚弱。四气七情失常。所以为积聚也。久
则为 瘕成块。不能移动者是 。或有或无。或上或下。或左或右者是瘕。气不能成块。块
乃有形之物。痰与食积死血。此理晓然。在中为痰饮。右为食积。左为死血。治
法。咸以软之。坚以削之。行气开痰为要。积块不可专用下药。徒损其气。病亦不去。当消
导。使之熔化其死血块。去须大补。痞块在皮里膜外。须用补药。宜六君子汤加香附、枳实
开之。
一论五积六聚。 瘕 癖。痰饮食积。死血成块者。
化坚汤
白术（去芦二钱） 白茯苓（去皮三钱） 当归（三钱） 川芎（一钱五分） 香附（炒二钱）
山楂
（二钱） 枳实（一钱） 陈皮（二钱） 半夏（姜炒二钱） 桃仁（去皮尖十粒） 红花（八分） 莪
术（一钱） 甘草（八分）
上锉一剂。生姜三片。水煎服。肉积。
加黄连六分。面积。加神曲二钱。左有块。倍川芎一钱。右有块。加青皮二钱。饱胀。加萝
卜子三钱。壮人。加三棱一钱。弱人。加人参二钱。
一论五积六聚。痰积血积。食积气积。一切积块。或中或左或右。或上或下。久不愈者
用之。
消积保中丸
陈皮（去白一两） 半夏（汤浸切片一两） 白茯苓（去皮二两） 白术（去芦炒二两） 香附
（醋
炒一两） 青皮（去肉四钱） 木香（三钱不见火） 槟榔（七钱） 莪术（醋炒八钱） 三棱（醋炒
八钱） 莱菔子（炒一两） 砂仁（炒四两） 神曲（炒一两） 麦芽（炒六钱） 白芥子（炒一两）
川芎（八钱） 黄连（姜炒一两） 桃仁（去皮尖一两） 栀子仁（姜汁炒一两） 红花（五钱）
当归（酒炒一两） 干漆（炒黄五钱） 真阿魏（醋浸五钱）
上为细末。姜汁酒打稀糊为丸。如梧桐子大。每服八十丸。食后白汤送下。体虚人。加
人参
一两。外宜化铁膏贴之。一论五积六聚。状如 瘕。随气上下。发作有时。心腹疼痛。上气
窒塞。小腹胀满。大小便不利。宜以
大七气汤
三棱（一钱） 莪术（一钱） 青皮（二钱） 陈皮（二钱） 桔梗（八分） 藿香（三钱） 益智
仁（一钱五分） 香附（二钱） 肉桂（八分） 甘草（八分）
上锉一剂。生姜三片。枣一枚。水煎。温服。渣再煎服。心脾痛。加乌药、枳壳。
一论心腹坚胀。胁下紧硬。胸中痞塞。喘满短气。 瘕积块。化痰饮。宽胸腹。顺气进
食。消胀软硬。用此
三棱煎丸
三棱（生细锉半斤捣为末以酒三升于砂锅内慢火熬成膏） 青皮（去穣二两） 萝卜子（炒
二两） 神曲（炒二两） 麦芽（炒三两） 干漆（炒令烟尽三两） 杏仁（汤泡去皮尖炒黄色三
两） 砂（用瓷盏细研入水调和坐于炭火上候水干取出为末）
上为细末。三棱膏为丸。如梧桐子大。每服十五丸。加至二十丸。食远。米饮送下。
一论男妇五积六聚。七 八瘕。破一切血。下一切气。宜
消 破积丸
三棱（煨） 干漆（炒去烟） 大黄（煨） 砂（入醋煎干） 巴豆（去油各一两）
上为末。醋糊为丸。如绿豆大。每服三丸至七丸。空心。米汤送下。量虚实加减服之。
不可过服。损人之真气。
一论 积。心腹内结一块如拳。渐上撞心。及腹胀痛。
保安丸
大黄（三两酒浸一宿蒸焙） 干姜（炮一两） 大附子（炮去皮脐用五钱） 鳖甲（醋煮一伏
时炙黄色一两五钱）
上为细末。
陈米醋一升。煮取四五合。和药为丸。
如梧子大。每服二十丸。五更。醋汤下。天明时。再服五丸。去积如鱼肠脓血烂泥而下
一论虚弱之人。腹内积聚癖块。胀满疼痛。面黄肌瘦。肚大青筋。不思饮食。此药消痰
利气。扶脾助胃。开胸快膈。消痞除胀。清热消食。久服积块渐消。大效。
加味保和丸
白术（去芦炒五两） 枳实（麸炒一两） 陈皮（去白三两） 半夏（泡姜炒二两） 白茯苓（
去皮
三两） 苍术（米泔浸炒一两） 川浓朴（姜炒二两） 香附（酒炒一两） 神曲（炒三两）
连翘
（二两） 黄连（酒炒一两） 黄芩（酒炒一两） 山楂肉（三两） 麦芽（炒一两） 萝卜子（
二两） 木香（五钱） 三棱（醋炒一两） 莪术（醋炒一两）
上为细末。姜汁糊为丸。如梧子大。每服五十丸。加至七八十丸。食后。白滚汤送下。
一论五积六聚。七 八瘕。或左或右。或上或下。或腹中有时攻作疼痛。诸医误治。以
攻击太过。以致面黄肌瘦。四肢困倦。不思饮食等症。宜以此方久服。则元气渐复。脾胃健
壮
盖养正积自除。譬如满坐皆君子。纵有一小人。自无容地而出。此洁古之言。岂欺我哉。
加减补中益气汤
黄 （蜜水炒一钱半） 人参（一钱） 白术（去芦炒一钱半） 白茯苓（去皮一钱） 陈皮（
七分）
柴胡（五分） 当归（酒炒一钱） 半夏（泡姜汁炒七分） 山楂肉（五分） 枳实（麸炒五
分） 浓朴（姜汁炒七分） 甘草（炙四分）
上锉一剂。生姜三片。枣一枚。水煎。温服。与前加味保和丸兼而服之。久则病根自拔
按上诸方。虚弱人患积块久不愈者。宜用
化铁膏
肥皂四两熬膏。生姜四两。葱半斤。蒜半斤。皮硝半斤化水。大黄末四两。入膏再熬。
贴块上。内服前方保中丸。
一治痞块。心下坚硬。状若覆杯者。服此一料即愈。
三棱（二两） 莪术（二两） 槟榔（二两） 草果（二两） 陈皮（二两） 枳壳（二两） 山
楂（二
两） 小茴（一两） 甘草（一两） 砂仁（五钱） 木香（五钱） 浮铁皮（五钱） 浓朴（姜炒
四两
）沉香（三钱） 枳实（一两） 神曲（酒炒二两） 麦芽（炒二两） 青皮（二两） 苍术（
米泔浸四两）
收贮。
一男子腹内有痞者。先以烫热好醋。将痞上洗净。量所患大小。用面圈圈定。用皮硝一
升。
放入面圈内铺定。用纸盖硝上。熨斗盛火。不住手熨。俟硝化尽。再用热醋洗去。用红绢摊
膏。贴于患处。用旧鞋底炙热。熨两三次。每七日一换贴药。重者不过三七。肿血化去。
一小儿幼女患痞者。酽醋熬硝洗之。用红绢摊膏贴患处。一人将小儿双手抱住肩上。却
用木鳖子捣烂。搽于双肾上。后用膏贴。炙鞋底熨之。觉腹内大热为度。
一戴雷门夫人。年近三旬。患腹左有一大块。坚硬如石。
有时作痛。肚腹膨闷。经水不调或前或后。或多或少。或闭而不通。白带频下。夜间发
热。脉急数。予以
千金化铁丸
当归（酒炒一两半） 白芍（酒炒一两半） 川芎（七钱） 怀生地（酒洗一两半） 白术（去
芦炒一两半） 白茯苓（去皮一两） 陈皮（去白一两）
青皮（七钱半） 半夏（姜汁炒一两） 枳实（麸炒七钱五分） 木香（炒七钱五分） 香附（
炒一
两） 槟榔（五钱） 萝卜子（炒五钱） 三棱（炒五钱） 红花（五钱） 干漆（炒令烟尽五
钱
）桃仁（去皮尖五钱） 莪术（醋炒一两五钱） 砂（为末瓷器内煨过五钱） 琥珀（五
钱）
上为细末。醋打面糊为丸。如梧桐子大。每服三钱。白汤送下。早晚各进一服。服尽药
其块潜消。经水即调。而后孕生一女也。
脉象来势盛大而有力的，预后良好；脉象沉细无力的，预后不良。脉象重按至骨才能触及的，是积证。如果脉象出现在寸口部位，说明积块在胸中；出现在关部，说明积块在肚脐旁边；出现在尺部，说明积块在气冲穴附近。脉象在左手显现，积块就在身体左侧；脉象在右手显现，积块就在身体右侧。脉象在左右两手都出现，积块就在身体中央。脉象细小、沉取且坚实的，说明脾胃中有积聚，导致不能进食，进食后就会呕吐。
积证，产生于五脏的阴分。其发作有固定的根基，疼痛有固定的位置，脉象必然呈现结伏（脉搏缓慢而有间歇）的状态。聚证，形成于六腑的阳分。其发作没有固定的根基，疼痛没有固定的位置，脉象必然呈现浮结（脉搏轻取即得且有间歇）的状态。这是由于阴阳失调，脏腑虚弱，加上四时气候异常和七情内伤失常，从而形成了积聚。时间久了，就会结成瘕块，不能移动的是“积”；有时存在有时不存在，或上或下，或左或右变动不居的是“瘕”。气本身不能结成块状，块状是有形的物体，是由痰饮、食积和死血形成的，这个道理是很清楚的。积块在身体中部多属痰饮，在右侧多属食积，在左侧多属死血。治疗方法，要用咸味药物来软化坚块，用攻削药物来消除积块，以行气化痰为主要原则。对于积块不可专门使用泻下药，那样只会徒然损伤正气，病也不会去除。应当采用消导的方法，使死血块逐渐熔化消散。去除积块之后，必须大补元气。痞块如果在皮里膜外，必须使用补益药物，适宜用六君子汤加入香附、枳实来开郁散结。
有一篇论述关于五积六聚、瘕癖、痰饮食积以及死血成块的情况。
化坚汤
白术（去芦头二钱） 白茯苓（去皮三钱） 当归（三钱） 川芎（一钱五分） 香附（炒制二钱）
山楂（二钱） 枳实（一钱） 陈皮（二钱） 半夏（姜汁炒二钱） 桃仁（去皮尖十粒） 红花（八分） 莪术（一钱） 甘草（八分）
以上药材锉碎为一剂，加生姜三片，水煎服。如果是肉积，加黄连六分；如果是面食积滞，加神曲二钱；左侧有积块，加倍川芎一钱；右侧有积块，加青皮二钱；如果饱胀，加萝卜子三钱；体质强壮的人，加三棱一钱；体质虚弱的人，加人参二钱。
有一篇论述关于五积六聚、痰积血积、食积气积以及一切积块，无论在中部、左侧、右侧，还是上部、下部，久治不愈者适用此方。
消积保中丸
陈皮（去白一两） 半夏（汤浸切片一两） 白茯苓（去皮二两） 白术（去芦炒二两） 香附（醋炒一两） 青皮（去瓤四钱） 木香（三钱，忌火） 槟榔（七钱） 莪术（醋炒八钱） 三棱（醋炒八钱） 莱菔子（炒一两） 砂仁（炒四两） 神曲（炒一两） 麦芽（炒六钱） 白芥子（炒一两） 川芎（八钱） 黄连（姜炒一两） 桃仁（去皮尖一两） 栀子仁（姜汁炒一两） 红花（五钱） 当归（酒炒一两） 干漆（炒黄五钱） 真阿魏（醋浸五钱）
以上药材研为细末，用姜汁和酒调稀糊制成丸药，如梧桐子大小。每次服用八十丸，饭后用白开水送服。体质虚弱的人，加人参一两。外用宜贴化铁膏。
有一篇论述关于五积六聚，症状类似瘕，随气机上下流动，发作有定时，心腹疼痛，气逆胸闷，小腹胀满，大小便不通利者，适宜用大七气汤。
大七气汤
三棱（一钱） 莪术（一钱） 青皮（二钱） 陈皮（二钱） 桔梗（八分） 藿香（三钱） 益智仁（一钱五分） 香附（二钱） 肉桂（八分） 甘草（八分）
以上药材锉碎为一剂，加生姜三片，大枣一枚，水煎，温服。药渣再煎一次服用。如果是心脾痛，加乌药、枳壳。
有一篇论述关于心腹坚硬胀满，胁下紧绷坚硬，胸中痞塞，喘促气短，瘕积成块，需要化痰饮、宽胸腹、顺气进食、消除软硬胀满者，用此方。
三棱煎丸
三棱（生品细锉半斤，捣为末，用酒三升在砂锅内慢火熬成膏） 青皮（去瓤二两） 萝卜子（炒二两） 神曲（炒二两） 麦芽（炒三两） 干漆（炒至烟尽三两） 杏仁（汤泡去皮尖炒黄色三两） 硼砂（用瓷盏细研，入水调和，置于炭火上候水干取出为末）
以上药材研为细末，用三棱膏作为粘合剂制成丸药，如梧桐子大小。每次服用十五丸，可加至二十丸，空腹时米汤送服。
有一篇论述关于男女五积六聚、七疝八瘕，旨在破血行气，适宜用消癥破积丸。
消癥破积丸
三棱（煨制） 干漆（炒去烟） 大黄（煨制） 硼砂（入醋煎干） 巴豆（去油，各一两）
以上药材研为末，用醋糊制成丸药，如绿豆大小。每次服用三丸至七丸，空腹时米汤送服。根据虚实情况加减剂量服用。不可过量服用，以免损伤人的真气。
有一篇论述关于积证，心腹内结成一团如拳头大小的块状物，逐渐向上顶撞心脏，以及腹胀痛者。
保安丸
大黄（三两，酒浸一夜，蒸焙） 干姜（炮制一两） 大附子（炮制，去皮脐，用五钱） 鳖甲（醋煮一个时辰，炙至黄色一两五钱）
以上药材研为细末。
用陈米醋一升，煮取四五合（约200-400毫升），与药粉混合制成丸药，如梧桐子大小。每次服用二十丸，五更天（凌晨3-5点），用醋汤送服。天明时，再服五丸。排出积块如同鱼肠、脓血、烂泥状。
有一篇论述关于虚弱之人，腹内有积聚癖块，胀满疼痛，面色萎黄，肌肉消瘦，肚子大且青筋暴露，不思饮食者。此药能消痰利气，扶脾助胃，开胸快膈，消痞除胀，清热消食，久服积块逐渐消退，效果显著。
加味保和丸
白术（去芦炒五两） 枳实（麸炒一两） 陈皮（去白三两） 半夏（泡姜炒二两） 白茯苓（去皮三两） 苍术（米泔水浸炒一两） 川厚朴（姜炒二两） 香附（酒炒一两） 神曲（炒三两） 连翘（二两） 黄连（酒炒一两） 黄芩（酒炒一两） 山楂肉（三两） 麦芽（炒一两） 萝卜子（二两） 木香（五钱） 三棱（醋炒一两） 莪术（醋炒一两）
以上药材研为细末，用姜汁糊制成丸药，如梧桐子大小。每次服用五十丸，可加至七八十丸，饭后用白开水送服。
有一篇论述关于五积六聚、七疝八瘕，或在左或在右，或在上或在下，或腹中有时攻作疼痛。因诸医误治，攻击太过，以致面色萎黄，肌肉消瘦，四肢困倦，不思饮食等症状。适宜以此方久服，则元气逐渐恢复，脾胃健壮。
正如“养正积自除”，好比满座都是君子，纵然有一个小人，自然没有容身之地而出走。这是洁古（张元素）的话，难道会欺骗我吗？
加减补中益气汤
黄芪（蜜水炒一钱半） 人参（一钱） 白术（去芦炒一钱半） 白茯苓（去皮一钱） 陈皮（七分）
柴胡（五分） 当归（酒炒一钱） 半夏（泡姜汁炒七分） 山楂肉（五分） 枳实（麸炒五分） 厚朴（姜汁炒七分） 甘草（炙四分）
以上药材锉碎为一剂，加生姜三片，大枣一枚，水煎，温服。与前方的加味保和丸配合服用。久服则病根拔除。
按照上述各方，虚弱之人患积块久治不愈者，适宜外用化铁膏。
化铁膏
肥皂四两熬膏，生姜四两，葱半斤，蒜半斤，皮硝半斤化水，大黄末四两，放入膏中再熬。贴于积块上。内服前方保中丸。
有一篇治疗痞块，心下坚硬，形状像倒扣的杯子者，服用一料即可痊愈。
三棱（二两） 莪术（二两） 槟榔（二两） 草果（二两） 陈皮（二两） 枳壳（二两） 山楂（二两） 小茴香（一两） 甘草（一两） 砂仁（五钱） 木香（五钱） 浮铁皮（五钱） 厚朴（姜炒四两） 沉香（三钱） 枳实（一两） 神曲（酒炒二两） 麦芽（炒二两） 青皮（二两） 苍术（米泔水浸四两）
收集储存备用。
有一名男子腹内有痞块。先用烫热的优质醋将痞块处洗净，根据患病大小，用面粉圈定范围。用皮硝一升，放入面圈内铺平。用纸盖住硝上，熨斗盛火，不停地熨烫。等到硝完全融化，再用热醋洗去。用红绢摊涂药膏，贴在患处。用旧鞋底烤热，熨烫两三次。每七日更换一次贴药。病情重的，不超过三七次，肿血化去。
一名小儿或幼女患痞块。用浓醋熬硝清洗患处，用红绢摊涂药膏贴在患处。一人将小儿双手抱住架在肩上，然后用木鳖子捣烂，搽在双肾上。之后用药膏贴敷，用炙热的鞋底熨烫。感觉到腹内大热为止。
有一位戴雷门夫人，年龄近三十岁，患腹部左侧有一大块，坚硬如石。
有时疼痛，肚腹膨闷，月经不调，或提前或推后，或量多或少，或闭经不通，白带频繁下行，夜间发热，脉象急数。我给予千金化铁丸。
千金化铁丸
当归（酒炒一两半） 白芍（酒炒一两半） 川芎（七钱） 怀生地（酒洗一两半） 白术（去芦炒一两半） 白茯苓（去皮一两） 陈皮（去白一两）
青皮（七钱半） 半夏（姜汁炒一两） 枳实（麸炒七钱五分） 木香（炒七钱五分） 香附（炒一两） 槟榔（五钱） 萝卜子（炒五钱） 三棱（炒五钱） 红花（五钱） 干漆（炒令烟尽五钱） 桃仁（去皮尖五钱） 莪术（醋炒一两五钱） 硼砂（为末瓷器内煨过五钱） 琥珀（五钱）
以上药材研为细末，用醋打面糊制成丸药，如梧桐子大小。每次服用三钱，白开水送服。早晚各进一服。服完药后，其块潜消，月经随即调畅，后来怀孕生下一女。
If the pulse comes large and strong, the prognosis is good; if the pulse is deep and small, the prognosis is fatal. A pulse that can only be felt by pressing to the bone indicates a Jī (Accumulation) syndrome. If the pulse appears at the Cun (Inch) position, the accumulation is in the chest; if it appears at the Guan (Bar) position, the accumulation is beside the navel; if it appears at the Chi (Cubit) position, the accumulation is near the Qichong (Chong Meridian Source) point. If the pulse manifests on the left hand, the accumulation is on the left side of the body; if it manifests on the right hand, the accumulation is on the right side. If the pulse appears on both hands, the accumulation is in the center of the body. A pulse that is small, deep, and firm indicates an accumulation in the Spleen and Stomach, leading to an inability to eat, and vomiting after eating.
Jī (Accumulation) arises from the Yin aspect of the Five Zang Organs. Its onset has a fixed root, its pain occurs in a constant location, and the pulse must be Jie Fu (Knotted and Hidden). Jù (Gathering) forms from the Yang aspect of the Six Fu Organs. Its onset has no fixed root, its pain occurs in varying locations, and the pulse must be Fu Jie (Floating and Knotted). This is due to disharmony between Yin and Yang, weakness of the Zang-Fu organs, and irregularities in the Four Qi (Seasonal influences) and Seven Emotions, thus forming accumulations and gatherings. Over time, masses form. Those that cannot move are called Jī (Accumulation); those that appear and disappear, or move up, down, left, or right, are called Jiá (Masses/Gas Gatherings). Qi itself cannot form a mass; a mass is a tangible object formed by Phlegm, Food Retention, and Dead Blood. This principle is clear. Accumulations in the center are mostly Phlegm-Fluids; on the right, mostly Food Retention; on the left, mostly Dead Blood. The treatment method involves using salty substances to soften hardness and reducing substances to削 (reduce/scrape) the mass, with moving Qi and resolving Phlegm as the key principles. One should not exclusively use purgative drugs for accumulations, as this merely damages Qi without removing the disease. Instead, one should employ digestion-promoting methods to melt the dead blood clots. After removing the accumulation, substantial tonification is required. For Pi (Stagnant Masses) located inside the skin but outside the membranes, tonifying medicines are necessary; Liu Junzi Tang (Six Gentlemen Decoction) added with Xiangfu (Cyperi Rhizoma) and Zhishi (Aurantii Fructus Immaturus) should be used to open stagnation.
One treatise discusses Wuji (Five Accumulations), Liuju (Six Gatherings), Jiapixi (Irregular Masses), Phlegm, Food Retention, and masses formed by Dead Blood.
Huajian Tang (Hardness-Resolving Decoction)
Baizhu (Atractylodis Macrocephalae Rhizoma, de-gorged, 2 qian) Baifuling (Poria, peeled, 3 qian) Danggui (Angelicae Sinensis Radix, 3 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma, 1.5 qian) Xiangfu (Cyperi Rhizoma, stir-fried, 2 qian) Shanzha (Crataegi Fructus, 2 qian) Zhishi (Aurantii Fructus Immaturus, 1 qian) Chenpi (Citri Reticulatae Pericarpium, 2 qian) Banxia (Pinelliae Tuber, ginger-fried, 2 qian) Taoren (Persicae Semen, peeled and tip removed, 10 grains) Honghua (Carthami Flos, 8 fen) Ezhu (Curcumae Longae Rhizoma, 1 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 8 fen)
The above ingredients are cut into pieces for one dose. Add three slices of fresh ginger, decoct in water, and take warm. For meat retention, add Huanglian (Coptidis Rhizoma, 6 fen); for grain retention, add Shenqu (Massae Fermentatae Medicinalis, 2 qian); for a mass on the left, double Chuanxiong by 1 qian; for a mass on the right, add Qingpi (Citri Reticulatae Pericarpium Viride, 2 qian); for fullness, add Luobozhi (Raphani Semen, 3 qian); for robust individuals, add Sanleng (Sparganii Rhizoma, 1 qian); for weak individuals, add Renshen (Ginseng Radix, 2 qian).
One treatise discusses Wuji (Five Accumulations), Liuju (Six Gatherings), Phlegm accumulation, Blood accumulation, Food accumulation, Qi accumulation, and all types of masses, whether in the center, left, right, upper, or lower parts, which have persisted for a long time. This formula is suitable.
Xiaoji Baozhong Wan (Accumulation-Resolving and Middle-Jiao-Nourishing Pill)
Chenpi (Citri Reticulatae Pericarpium, white pith removed, 1 liang) Banxia (Pinelliae Tuber, soaked in water and sliced, 1 liang) Baifuling (Poria, peeled, 2 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, de-gorged and stir-fried, 2 liang) Xiangfu (Cyperi Rhizoma, vinegar-fried, 1 liang) Qingpi (Citri Reticulatae Pericarpium Viride, albedo removed, 4 qian) Muxiang (Vladimiriae Radix, 3 qian, avoid fire) Binglang (Arecae Semen, 7 qian) Ezhu (Curcumae Longae Rhizoma, vinegar-fried, 8 qian) Sanleng (Sparganii Rhizoma, vinegar-fried, 8 qian) Laifuzi (Raphani Semen, stir-fried, 1 liang) Sharen (Amomi Fructus, stir-fried, 4 liang) Shenqu (Massae Fermentatae Medicinalis, stir-fried, 1 liang) Maiya (Hordei Fructus Germinatus, stir-fried, 6 qian) Baijiezi (Sinapis Semen, stir-fried, 1 liang) Chuanxiong (Ligustici Chuanxiong Rhizoma, 8 qian) Huanglian (Coptidis Rhizoma, ginger-fried, 1 liang) Taoren (Persicae Semen, peeled and tip removed, 1 liang) Zhizi Ren (Gardeniae Semen, ginger juice-fried, 1 liang) Honghua (Carthami Flos, 5 qian) Danggui (Angelicae Sinensis Radix, wine-fried, 1 liang) Ganqi (Dry Resin of Terminalia Chebula, stir-fried yellow, 5 qian) Zhenawei (Resina Asafetidae, vinegar-soaked, 5 qian)
The above ingredients are ground into fine powder. Use ginger juice and wine to make a thin paste for pills, sized like paulownia seeds. Take 80 pills per dose, washed down with plain boiled water after meals. For constitutionally weak persons, add Renshen (Ginseng Radix, 1 liang). Externally, apply Huatie Gao (Iron-Melting Plaster).
One treatise discusses Wuji (Five Accumulations), Liuju (Six Gatherings), resembling Jiá (Masses), moving up and down with Qi, occurring at specific times, with heart and abdominal pain, rebellious Qi causing chest tightness, lower abdominal fullness, and difficulty in urination and defecation. Daqi Qi Tang (Great Seven-Qi Decoction) is suitable.
Daqi Qi Tang (Great Seven-Qi Decoction)
Sanleng (Sparganii Rhizoma, 1 qian) Ezhu (Curcumae Longae Rhizoma, 1 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 2 qian) Chenpi (Citri Reticulatae Pericarpium, 2 qian) Jiegeng (Platycodonis Radix, 8 fen) Huoxiang (Agastaches Herba, 3 qian) Yizhiren (Alpiniae Oxyphyllae Fructus, 1.5 qian) Xiangfu (Cyperi Rhizoma, 2 qian) Rougui (Cinnamomi Cortex, 8 fen) Gancao (Glycyrrhizae Radix et Rhizoma, 8 fen)
The above ingredients are cut into pieces for one dose. Add three slices of fresh ginger and one jujube, decoct in water, and take warm. The dregs can be decocted again and taken. For heart-spleen pain, add Wuyao (Linderae Radix) and Zhike (Aurantii Fructus).
One treatise discusses hard and distended heart and abdomen, tight and hard hypochondrium, chest stuffiness, wheezing and shortness of breath, and Jiá masses. To resolve Phlegm-Fluids, widen the chest and abdomen, regulate Qi to promote eating, and relieve soft and hard distension, use this formula.
Sanleng Jian Wan (Sanleng Decoction Pill)
Sanleng (Sparganii Rhizoma, raw, finely cut, half jin, pounded into powder, slow-cooked with three sheng of wine in a clay pot until it becomes a paste) Qingpi (Citri Reticulatae Pericarpium Viride, albedo removed, 2 liang) Luobozhi (Raphani Semen, stir-fried, 2 liang) Shenqu (Massae Fermentatae Medicinalis, stir-fried, 2 liang) Maiya (Hordei Fructus Germinatus, stir-fried, 3 liang) Ganqi (Dry Resin of Terminalia Chebula, stir-fried until smoke ceases, 3 liang) Xingren (Armeniacae Semen Amarum, soaked in water, peeled and tip removed, stir-fried yellow, 3 liang) Pengsha (Borax, finely ground in a porcelain cup, mixed with water, placed on charcoal fire until dry, then powdered)
The above ingredients are ground into fine powder. Use the Sanleng paste to form pills, sized like paulownia seeds. Take 15 pills per dose, increasing to 20 pills, washed down with rice drink far from meals.
One treatise discusses Wuji (Five Accumulations), Liuju (Six Gatherings), Qishen Bajiá (Seven Strange-Eight Irregular Masses) in men and women, aiming to break Blood and descend Qi. Xiao Zheng Poji Wan (Accumulation-Breaking Pill) is suitable.
Xiao Zheng Poji Wan (Accumulation-Breaking Pill)
Sanleng (Sparganii Rhizoma, roasted) Ganqi (Dry Resin of Terminalia Chebula, stir-fried to remove smoke) Dahuang (Rhei Radix et Rhizoma, roasted) Pengsha (Borax, dried with vinegar) Badou (Crotonis Fructus, oil removed, each 1 liang)
The above ingredients are ground into powder. Use vinegar paste to form pills, sized like mung beans. Take 3 to 7 pills per dose, washed down with rice milk on an empty stomach. Adjust the dose according to deficiency or excess. Do not overdose, as it will damage the person's True Qi.
One treatise discusses Jī (Accumulation), where a mass like a fist forms inside the heart and abdomen, gradually pushing upwards towards the heart, accompanied by abdominal distension and pain.
Baoan Wan (Peace-Securing Pill)
Dahuang (Rhei Radix et Rhizoma, 3 liang, soaked in wine overnight, steamed and baked) Ganjiang (Zingiberis Rhizoma, processed, 1 liang) Dafuzi (Aconiti Lateralis Radix Praeparata, processed, peeled, and navel removed, 5 qian) Biejia (Testudinis Carapax et Plastrum, vinegar-boiled for one fushi, roasted yellow, 1.5 liang)
The above ingredients are ground into fine powder.
Take one sheng of aged rice vinegar, boil down to four or five he (approx. 200-400 ml), mix with the medicine to form pills, sized like paulownia seeds. Take 20 pills per dose at wugeng (early morning, 3-5 am), washed down with vinegar water. At dawn, take another 5 pills. The accumulated mass will be discharged like fish intestines, pus, blood, and rotten mud.
One treatise discusses weak individuals with internal accumulations, irregular masses, distension and pain, sallow complexion, emaciation, large abdomen with visible veins, and loss of appetite. This medicine resolves Phlegm, benefits Qi, supports the Spleen and assists the Stomach, opens the chest and diaphragm, removes stagnation and distension, clears heat, and digests food. Long-term use gradually reduces masses, showing great efficacy.
Jiawei Baohe Wan (Modified Harmony-Preserving Pill)
Baizhu (Atractylodis Macrocephalae Rhizoma, de-gorged and stir-fried, 5 liang) Zhishi (Aurantii Fructus Immaturus, bran-roasted, 1 liang) Chenpi (Citri Reticulatae Pericarpium, white pith removed, 3 liang) Banxia (Pinelliae Tuber, soaked and ginger-fried, 2 liang) Baifuling (Poria, peeled, 3 liang) Cangzhu (Atractylodis Rhizoma, soaked in rice wash water and stir-fried, 1 liang) Chuan Houpo (Magnoliae Officinalis Cortex, ginger-fried, 2 liang) Xiangfu (Cyperi Rhizoma, wine-fried, 1 liang) Shenqu (Massae Fermentatae Medicinalis, stir-fried, 3 liang) Lianqiao (Forsythiae Fructus, 2 liang) Huanglian (Coptidis Rhizoma, wine-fried, 1 liang) Huangqin (Scutellariae Radix, wine-fried, 1 liang) Shanzha Rou (Crataegi Fructus flesh, 3 liang) Maiya (Hordei Fructus Germinatus, stir-fried, 1 liang) Luobozhi (Raphani Semen, 2 liang) Muxiang (Vladimiriae Radix, 5 qian) Sanleng (Sparganii Rhizoma, vinegar-fried, 1 liang) Ezhu (Curcumae Longae Rhizoma, vinegar-fried, 1 liang)
The above ingredients are ground into fine powder. Use ginger juice paste to form pills, sized like paulownia seeds. Take 50 pills per dose, increasing to 70-80 pills, washed down with plain boiling water after meals.
One treatise discusses Wuji (Five Accumulations), Liuju (Six Gatherings), Qishen Bajiá (Seven Strange-Eight Irregular Masses), either on the left or right, upper or lower, or causing intermittent attacking pain in the abdomen. Due to misdiagnosis and excessive attack by other physicians, symptoms such as sallow complexion, emaciation, limb fatigue, and loss of appetite have arisen. It is suitable to take this formula for a long time so that Yuan Qi (Original Qi) gradually recovers and the Spleen and Stomach become strong.
As the saying goes, "Nourishing the Righteous causes the Pathogen to eliminate itself." It is like having a room full of gentlemen; even if there is one villain, he will naturally have no place to stay and will leave. These words belong to Jiegu (Zhang Yuansu); how could they deceive us?
Jiawei Buzhong Yiqi Tang (Modified Tonify the Middle and Augment the Qi Decoction)
Huangqi (Astragali Radix, honey-water stir-fried, 1.5 qian) Renshen (Ginseng Radix, 1 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, de-gorged and stir-fried, 1.5 qian) Baifuling (Poria, peeled, 1 qian) Chenpi (Citri Reticulatae Pericarpium, 7 fen)
Chaihu (Bupleuri Radix, 5 fen) Danggui (Angelicae Sinensis Radix, wine-fried, 1 qian) Banxia (Pinelliae Tuber, soaked and ginger juice-fried, 7 fen) Shanzha Rou (Crataegi Fructus flesh, 5 fen) Zhishi (Aurantii Fructus Immaturus, bran-roasted, 5 fen) Houpo (Magnoliae Officinalis Cortex, ginger juice-fried, 7 fen) Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted, 4 fen)
The above ingredients are cut into pieces for one dose. Add three slices of fresh ginger and one jujube, decoct in water, and take warm. Combine this with the previously mentioned Jiawei Baohe Wan. Long-term use will uproot the disease.
Regarding the above formulas, for weak individuals suffering from persistent accumulations, Huatie Gao (Iron-Melting Plaster) is suitable.
Huatie Gao (Iron-Melting Plaster)
Soap fruit (4 liang) boiled into paste. Fresh ginger (4 liang), Scallion (half jin), Garlic (half jin), Xiaokun (Mirabilite, half jin) dissolved in water. Rhubarb powder (4 liang) added to the paste and boiled again. Apply to the mass. Internally, take the aforementioned Baozhong Wan.
One case treats Pi (Stagnant Masses), hardness below the heart, resembling an inverted cup. Taking one dose leads to recovery.
Sanleng (Sparganii Rhizoma, 2 liang) Ezhu (Curcumae Longae Rhizoma, 2 liang) Binglang (Arecae Semen, 2 liang) Caoguo (Tsaoko Fructus, 2 liang) Chenpi (Citri Reticulatae Pericarpium, 2 liang) Zhike (Aurantii Fructus, 2 liang) Shanzha (Crataegi Fructus, 2 liang) Xiaohui (Foeniculi Fructus, 1 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang) Sharen (Amomi Fructus, 5 qian) Muxiang (Vladimiriae Radix, 5 qian) Futiepi (Float Iron Skin, 5 qian) Houpo (Magnoliae Officinalis Cortex, ginger-fried, 4 liang) Chenxiang (Aquilariae Lignum Resinatum, 3 qian) Zhishi (Aurantii Fructus Immaturus, 1 liang) Shenqu (Massae Fermentatae Medicinalis, wine-fried, 2 liang) Maiya (Hordei Fructus Germinatus, stir-fried, 2 liang) Qingpi (Citri Reticulatae Pericarpium Viride, 2 liang) Cangzhu (Atractylodis Rhizoma, soaked in rice wash water, 4 liang)
Store for use.
A male patient had a Pi (Stagnant Mass) in his abdomen. First, wash the area with hot good vinegar. According to the size of the lesion, draw a circle with flour paste. Place one sheng of Xiaokun (Mirabilite) inside the flour circle and level it. Cover the nitre with paper. Hold a hot ironing iron and continuously iron over the paper until the nitre melts completely. Then wash off with hot vinegar. Spread the plaster on red silk and apply to the affected area. Heat an old shoe sole and iron the area two or three times. Change the plaster every seven days. For severe cases, no more than twenty-one applications are needed; the swelling and blood will dissipate.
A child or young girl suffering from Pi (Stagnant Masses). Wash with thick vinegar and boiled nitre. Spread plaster on red silk and apply to the affected area. One person holds the child's hands on their shoulders. Then, pound Mu Bei Zi (Mucuna Semen) into a paste and apply it to both kidneys. Afterwards, apply the plaster and iron with a heated shoe sole. Continue until a great heat is felt in the abdomen.
Madam Dai Leimen, nearly thirty years old, suffered from a large mass on the left side of her abdomen, hard as stone.
Occasional pain, abdominal distension and fullness, irregular menstruation (early or late, heavy or light), amenorrhea, frequent leukorrhea, night fever, and rapid, urgent pulse. I prescribed Qianjin Huatie Wan (Thousand-Gold Iron-Melting Pill).
Qianjin Huatie Wan (Thousand-Gold Iron-Melting Pill)
Danggui (Angelicae Sinensis Radix, wine-fried, 1.5 liang) Baishao (Paeoniae Radix Alba, wine-fried, 1.5 liang) Chuanxiong (Ligustici Chuanxiong Rhizoma, 7 qian) Huaishengdi (Rehmanniae Radix Preparata, wine-washed, 1.5 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, de-gorged and stir-fried, 1.5 liang) Baifuling (Poria, peeled, 1 liang) Chenpi (Citri Reticulatae Pericarpium, white pith removed, 1 liang)
Qingpi (Citri Reticulatae Pericarpium Viride, 7.5 qian) Banxia (Pinelliae Tuber, ginger juice-fried, 1 liang) Zhishi (Aurantii Fructus Immaturus, bran-roasted, 7.5 qian) Muxiang (Vladimiriae Radix, stir-fried, 7.5 qian) Xiangfu (Cyperi Rhizoma, stir-fried, 1 liang) Binglang (Arecae Semen, 5 qian) Luobozhi (Raphani Semen, stir-fried, 5 qian) Sanleng (Sparganii Rhizoma, stir-fried, 5 qian) Honghua (Carthami Flos, 5 qian) Ganqi (Dry Resin of Terminalia Chebula, stir-fried until smoke ceases, 5 qian) Taoren (Persicae Semen, peeled and tip removed, 5 qian) Ezhu (Curcumae Longae Rhizoma, vinegar-fried, 1.5 liang) Pengsha (Borax, powdered and roasted in porcelain, 5 qian) Hupo (Succinum, 5 qian)
The above ingredients are ground into fine powder. Use vinegar and wheat starch paste to form pills, sized like paulownia seeds. Take 3 qian per dose, washed down with plain boiled water. Take once in the morning and once in the evening. After finishing the medicine, the mass will quietly dissolve, menstruation will regulate, and she subsequently conceived and gave birth to a daughter.