其候浑身微热，不思饮食，昏昧神缓，抱着一似睡未觉，肚热足冷者。多因
吐泻大病及攻击之后而得此候，茅先生先用青金丸取积，后用匀气、醒脾散调理。
常服万灵丸、保童丸即愈。
〔王先生〕灵砂丹 下虚中积、脏腑虚滑泄泻，久经取转，里急后重，久积恶痢暴泻
久不止，神效。
通明 砂（一钱） 颗块辰砂（通明、有墙壁者，二钱半。各细研）
上二味，衮研极细，用黄蜡半两，先于盏内熔化，入去皮全巴豆三七粒煎，候
巴豆紫色为度，漉豆出，细研，入前二味再研匀，于黄蜡内三分取一，再熔成汁，
倾药入内，急搅令匀，刮入瓷合收之。每服，暴泻恶痢，旋绝三丸如绿豆大。浓
煎艾汤，先呷三五口，然后吞下。水泻，冷水吞下。如取积，每服三丸如梧桐子
大，浓煎甘草汤，放冷吞下，临卧服。其久积药随积下，其小可不动便安。
按∶既是虚，即不宜用峻剂取积，仍须用四君子、益黄散之类，相兼服之。
其候大便不通，风毒疮疖，喉闭 腮，咽中涎响。茅先生先用夺命散（急惊）吐下热
涎，后用匀气散、醒脾散调理。常服牛黄膏、天竺黄散（并实热）镇心丸即愈。
仲阳云∶积痛，口中气温，面色黄白，目无精光，或白睛多及多睡畏食，或
大便酸臭者，当磨积而痛自除，宜下积丸，甚者，白饼子下之，后和胃气，用
白术散（渴）、小沉香丸、感应丸治之。又有食积肚痛，有热者芍药甘草汤（腹痛）加干葛。
吐者加半夏、生姜，或加枳实亦效。
小沉香丸 和中顺气，进食消痰。
砂仁 蓬术（各四钱，煨） 香附子（去毛，炒，一两八钱） 舶上丁香皮（二两四钱） 沉香（六钱） 甘松
（去土，三两六钱） 益智仁（微炒，一两二钱） 甘草（炙，一两四钱）
上为细末，汤浸蒸饼丸，如桐子大。每服三十或四十丸，食后温姜汤下，或嚼破更妙。
其症状表现为全身轻微发热，不思饮食，神志昏沉迟钝，呈似睡非睡状态，腹部发热而足部发冷。这多因呕吐腹泻大病及攻伐治疗之后所致。茅先生先用青金丸（Qingjin Wan, Blue Gold Pill）祛除积滞，后用匀气散（Yunqi San, Qi-Regulating Powder）、醒脾散（Xingpi San, Spleen-Awakening Powder）调理。常服万灵丸（Wanling Wan, Ten Thousand Efficacy Pill）、保童丸（Bao Tong Wan, Child-Protecting Pill）即可痊愈。
〔王先生〕灵砂丹（Lingsha Dan, Cinnabar and Mercury Pill）可下除虚中积滞、脏腑虚寒滑泄之泻痢，经久攻下后出现的里急后重、长期积滞恶痢暴泻久不止者，用之神效。
通明砂（Tongming Sha, Transparent Cinnabar Ore）一钱，颗块辰砂（Tongming, having walls/solid structure, Erqianban Qian, Transparent Chunk Cinnabar）二钱半。（以上两味药分别细研）。将上述两味药共同研磨至极细，取黄蜡半两，先在盏内熔化，放入去皮的全巴豆三七粒煎煮，待巴豆变为紫色为度，滤出巴豆，细研，加入前两种药粉再研磨均匀，从黄蜡中取出三分之一，再次熔化成汁，将药液倒入其中，迅速搅拌令其均匀，刮入瓷盒中收藏。每次服用，若是暴泻恶痢，现制三丸如绿豆大。浓煎艾叶汤，先喝三五口，然后吞下药丸。若是水泻，用冷水送服。若是为了祛除积滞，每次服用三丸如梧桐子大，浓煎甘草汤，放冷后吞服，临睡前服用。其久积的药随积滞排出，若小便可不动则安。
按语：既然是虚证，就不宜使用峻猛药剂攻下积滞，仍须用四君子汤（Sijunzi Tang, Four Gentlemen Decoction）、益黄散（Yihuang San, Yellow-Benefiting Powder）之类，配合服用。
其症状表现为大便不通，风毒疮疖，喉闭腮肿，咽喉中有痰鸣声。茅先生先用夺命散（Duoming San, Life-Seizing Powder）（用于急惊风）吐下热涎，后用匀气散、醒脾散调理。常服牛黄膏（Niuhuang Gao, Calculus Bovis Ointment）、天竺黄散（Tianzhu Huang San, Bambusa Textilis Ointment Powder）（均属实热证）、镇心丸（Zhenxin Wan, Heart-Calming Pill）即可痊愈。
仲阳（Chunyu Yi, pseudonym of Qian Yi）说：积痛，口中气息温热，面色黄白，目无精光，或白睛多且多睡畏食，或大便酸臭者，应当磨积而痛自除，宜用下积丸（Xiaji Wan, Accumulation-Expelling Pill），严重者，用白饼子（Baibing Zi, White Cake Pill）下之，后调和胃气，用白术散（Baizhu San, Atractylodes Macrocephala Powder）（用于口渴）、小沉香丸（Xiao Chenxiang Wan, Minor Agarwood Pill）、感应丸（Ganying Wan, Resonance Pill）治疗。又有食积肚痛，有热者，用芍药甘草汤（Shaoyao Gancao Tang, Peony and Licorice Decoction）加干葛（Gegen, Puerariae Radix）。呕吐者加半夏（Banxia, Pinelliae Rhizoma）、生姜（Shengjiang, Zingiberis Rhizoma Recens），或加枳实（Zhishi, Aurantii Fructus Immaturus）亦有效。
小沉香丸 中和脾胃顺气，进食消痰。
砂仁（Sharen, Amomi Fructus）四钱，蓬术（Pengzhu, Curcumae Rhizoma）四钱（各煨制），香附子（Xiangfuzi, Cyperi Rhizoma）去毛炒制一两八钱，舶上丁香皮（Bo Shang Dingxiang Pi, Clove Peel）二两四钱，沉香（Chenxiang, Aquilariae Lignum Resinatum）六钱，甘松（Gansong, Nardostachyos Radix et Rhizoma）去土三两六钱，益智仁（Yizhiren, Alpiniae Oxyphyllae Fructus）微炒一两二钱，甘草（Gancao, Glycyrrhizae Radix et Rhizoma）炙制一两四钱。
以上药物研为细末，用汤浸蒸饼制作药丸，如梧桐子大。每次服用三十或四十丸，食后温姜汤送下，或嚼碎后服用更佳。
Its manifestations include slight fever throughout the body, loss of appetite, mental dullness and lethargy, a state of being half-asleep, heat in the abdomen with cold feet. This condition often arises after severe vomiting and diarrhea or following aggressive treatments. Master Mao first used Qingjin Wan (Blue Gold Pill) to expel accumulations, followed by Yunqi San (Qi-Regulating Powder) and Xingpi San (Spleen-Awakening Powder) for regulation. Regular intake of Wanling Wan (Ten Thousand Efficacy Pill) and Bao Tong Wan (Child-Protecting Pill) leads to recovery.
[Lord Wang] Lingsha Dan (Cinnabar and Mercury Pill) effectively treats internal accumulations due to deficiency, as well as chronic loose stools and diarrhea caused by visceral deficiency and slipping. It is highly effective for tenesmus, long-standing foul dysentery, and sudden severe diarrhea that persists despite prolonged purgation.
Tongming Sha (Transparent Cinnabar Ore), 1 qian; Kuaichen Sha (Chunk Cinnabar, transparent and solid), 2.5 qian. (Both are finely ground separately). The two ingredients are further ground together until extremely fine. Half liang of yellow wax is melted in a cup. Three to seven whole, peeled Baidu Dou (Semina Crotonis) are added and boiled until they turn purple. The beans are filtered out and finely ground, then mixed with the previously prepared powder. One-third of this mixture is added to the remaining melted yellow wax, stirred quickly until uniform, and stored in a porcelain container. For acute diarrhea and foul dysentery, administer three pills the size of mung beans immediately. First sip 3-5 mouthfuls of strong mugwort decoction, then swallow the pills. For watery diarrhea, swallow with cold water. To expel accumulations, administer three pills the size of sophora seeds, swallowed with cooled licorice decoction before bedtime. The medication will pass with the accumulation; if bowel movements remain normal, the patient is at ease.
Note: Since this is a deficiency pattern, harsh purgatives should not be used to expel accumulations. Instead, Sijunzi Tang (Four Gentlemen Decoction) and Yihuang San (Yellow-Benefiting Powder) should be used in combination.
Manifestations include constipation, wind-toxic sores and boils, throat closure with swollen cheeks, and phlegm rales in the throat. Master Mao first used Duoming San (Life-Seizing Powder) [for acute convulsions] to induce vomiting and purging of hot phlegm, followed by Yunqi San and Xingpi San for regulation. Regular intake of Niuhuang Gao (Calculus Bovis Ointment), Tianzhu Huang San (Bambusa Textilis Ointment Powder) [both for excess heat patterns], and Zhenxin Wan (Heart-Calming Pill) leads to recovery.
Zhongyang (pseudonym of Qian Yi) stated: In cases of accumulation pain, the breath from the mouth is warm, the complexion is yellowish-white, the eyes lack luster, there may be excessive whites in the eyes, hypersomnia, aversion to food, or sour-smelling stools. The pain should resolve once the accumulation is ground down and expelled. Xiaji Wan (Accumulation-Expelling Pill) is indicated. For severe cases, Baibing Zi (White Cake Pill) can be used to purge, followed by harmonizing stomach qi using Baizhu San (Atractylodes Macrocephala Powder) [for thirst], Xiao Chenxiang Wan (Minor Agarwood Pill), and Ganying Wan (Resonance Pill). Additionally, for abdominal pain due to food accumulation with heat, Shaoyao Gancao Tang (Peony and Licorice Decoction) is modified with Gegen (Puerariae Radix). If vomiting occurs, add Banxia (Pinelliae Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens); adding Zhishi (Aurantii Fructus Immaturus) is also effective.
Xiao Chenxiang Wan (Minor Agarwood Pill) harmonizes the middle jiao, regulates qi, promotes digestion, and resolves phlegm.
Sharen (Amomi Fructus), 4 qian; Pengzhu (Curcumae Rhizoma), 4 qian (both roasted); Xiangfuzi (Cyperi Rhizoma), de-haired and stir-fried, 1.8 liang; Bo Shang Dingxiang Pi (Clove Peel), 2.4 liang; Chenxiang (Aquilariae Lignum Resinatum), 6 qian; Gansong (Nardostachyos Radix et Rhizoma), cleaned of soil, 3.6 liang; Yizhiren (Alpiniae Oxyphyllae Fructus), lightly roasted, 1.2 liang; Gancao (Glycyrrhizae Radix et Rhizoma), honey-fried, 1.4 liang.
Grind all into a fine powder. Mix with steamed bread dough moistened with decoction to form pills the size of sophora seeds. Take 30-40 pills per dose, washed down with warm ginger tea after meals, or chewed thoroughly for better effect.