（添加痞块一条）
【歌】五积须知积有年，有形有质有根源。其如六聚无常处，聚散无时故易痊。假物而成名曰瘕，积 成
块不移迁。
【论】夫五积者，五脏之积也。肝曰肥气，在左胁下，如覆杯，有头足，如龟鳖状，久不愈，发咳逆呕，
其脉弦而细。心曰伏梁，起于脐，上至心，大如臂，久不已，病烦心，身体胫股皆肿，环脐而痛，其脉沉而芤。
脾曰痞气，在胃脘，覆大如盘，久不愈，病四肢不收，黄胆，饮食不为肌肤，心痛彻背，背痛彻心，其脉浮大
而长。肺曰息贲，在右胁下，
大如覆杯，久不愈，病洒洒寒热，呕逆咳喘，发肺痈，其脉浮而毛。肾曰奔豚，发于小腹，上至心，如豚奔走
之状，上下无时，久不愈，病喘逆骨痿少气，其脉沉而滑。六聚者，六腑之所成也，盖聚无常形，聚散不时，
非若积之有定处也。 者，征也，因物而成质，有块可征，不能移易也。瘕者，假也，假物而成形，推移能动
也。古方治积聚 瘕多用耗气峻削之剂，又佐以辛香热药，若轻浅者，因以消化，根深蒂固，日久气虚者，宁
不损正气者乎？正气既伤，其积转甚。故洁古有养正积自除之论，譬如满座皆君子，其中有小人，自不容而出，
斯言信矣。然当审其浅、深、轻、重之机，久、近、虚、实之势，可消、可补，必量其人之虚弱、强盛而施
之可也。
【脉】五积属阴，沉伏附骨，肝弦心芤，肾沉急滑，脾实且长，肺浮喘卒。六聚脉沉，痼则浮结。又有
瘕，其脉多弦，弦急瘕疾，弦细 坚。沉重中散，食成癖 。积聚 瘕，紧则痛缠。虚弱者死，实强可痊。
积聚
香积丸
治五积六聚气块。
三棱（醋炒，六两） 蓬术（炮，或醋炒） 青皮（炒） 陈皮（炒） 枳壳（炒） 枳实（炒） 萝
卜子（炒） 香附（醋炒，各二两） 黄连（姜炒） 神曲（炒） 麦 （炒） 鳖甲（醋炙） 干漆
（炒令烟尽） 桃仁（去皮、尖） 砂仁（炒） 砂 甘草（炙） 木香 归尾（各一两） 槟榔（六
两） 山楂（四两）
一方去枳实、陈皮、萝卜子，加益智、红花、柴胡、白术、茯苓。
上为末，醋糊丸，每服三，五十丸，空心陈米汤送下。
大阿魏丸
去诸积聚痰癖。
山楂 麦芽 神曲（炒） 南星 半夏 黄连（各两） 连翘 阿魏（醋浸，另研入药） 栝蒌仁 贝母
（各半两） 风化硝 石 萝卜子（蒸） 胡黄连（各一钱半）
上为末，姜汁浸，蒸饼为丸，空心白汤送下二钱。
大七气汤
散聚气。
青皮 陈皮 三棱（煨） 蓬术（煨，各一钱） 桔梗 甘草 藿香（各八分） 香附（一钱） 益智 官
桂（各六分）
瘕
保和丸
治食症。（方见伤食。）
阿魏丸
治肉症。
阿魏（一两） 山楂（一两） 黄芩（六钱） 连翘（五钱）
上为末，用阿魏醋煮作糊丸，如梧子大，每服二、三十丸，白汤下。
熨症法
用吴茱萸三斤，槌碎，以酒炒热，包于绢帛中，乘热熨患处，冷则易热者再熨，若症积移走，逐熨之，候
症消乃止。
见 丸
治妇人石瘕生于胞中，寒客子门，子门闭塞，气不宣行，恶血当泻不泻，日以留止，HT 以时下，状如怀子，
月事不以时下，以此丸导之。
附子（四钱，炮） 鬼箭羽 紫石英（各三钱） 泽泻（二钱） 血竭（二钱半） 肉桂 玄胡索 木香
（各二钱） 槟榔（二钱半） 桃仁（七钱，炒） 三棱（五钱） 水蛭（一钱，炒令烟尽） 大黄（二钱，
同三棱酒浸一夕，焙）
上为末，酒糊丸，如梧子大，每服三十丸，盐汤送下。
石 丸
治血瘕。血瘕者，血不流而寒薄，则血内凝而为瘕也，比之石瘕为轻，用以消之。
海粉 三棱 蓬术（醋炙） 五灵脂 红花 香附 石 瓦龙子（火淬）
上为末，醋糊丸，如梧子大，白术汤下。
（新增痞块一条）
【歌诀】五积需要知道积病已有多年，有形有质且有根源。至于六聚则没有固定位置，聚散无常所以容易痊愈。借外物而成形的称为瘕，积久形成块状且位置不移动。
【论述】所谓的五积，是指五脏的积病。肝的积叫肥气，位于左胁下，形状像倒扣的杯子，有头有足，像龟鳖的样子，久治不愈会引发咳嗽、气逆、呕吐，脉象弦而细。心的积叫伏梁，起于脐部，向上延伸至心窝，大小如手臂，久治不愈会导致心烦，身体小腿和大腿都肿胀，围绕肚脐疼痛，脉象沉而芤。脾的积叫痞气，位于胃脘部，覆盖面积大如盘子，久治不愈会导致四肢无力收持，黄疸，饮食不能转化为肌肉营养，心痛放射至背部，背痛放射至心脏，脉象浮大而长。肺的积叫息贲，位于右胁下，大小如倒扣的杯子，久治不愈会导致忽冷忽热，呕吐、气逆、咳嗽气喘，发作肺痈，脉象浮而毛（轻虚）。肾的积叫奔豚，发于小腹，向上至心窝，像小猪奔跑的样子，上下无定时，久治不愈会导致气喘逆乱、骨痿、少气，脉象沉而滑。六聚，是由六腑所形成的积聚，大概聚没有固定的形状，聚散没有定时，不像积那样有固定的位置。“征”是征兆的意思，因物而形成实质，有块状可以验证，不能移动改变。“瘕”是假的意思，借物而形成形态，推移可以变动。古方治疗积聚和瘕多用耗气峻猛的攻削药剂，又辅以辛香热药，如果是轻浅的病证，因此得以消散化解；但如果是根深蒂固、日久正气虚弱的人，难道不会损伤正气吗？正气既然受损，其积反而更严重。所以洁古老人有“养护正气，积自消除”的理论，譬如满座都是君子，其中混有小人，自然无法容留而排出，这话确实可信。然而应当审察病证的浅深、轻重之机，久近、虚实之势，可消可补，必须衡量病人的虚弱或强盛情况来施治才行。
【脉诊】五积属于阴证，脉象沉伏附骨，肝积脉弦，心积脉芤，肾积脉沉急滑，脾积脉实且长，肺积脉浮喘促突然。六聚脉象沉，病久则浮结。又有瘕病，其脉多弦，弦急则瘕病疾速，弦细则坚硬。脉沉重中散，食积成癖。积聚和瘕，脉紧则疼痛缠绕。脉虚弱者死，脉实强者可痊愈。
香积丸
治疗五积六聚气块。
三棱（醋炒，六两） 蓬术（炮制，或醋炒） 青皮（炒） 陈皮（炒） 枳壳（炒） 枳实（炒） 萝卜子（炒） 香附（醋炒，各二两） 黄连（姜炒） 神曲（炒） 麦芽（炒） 鳖甲（醋炙） 干漆（炒至烟尽） 桃仁（去皮、尖） 砂仁（炒） 砂仁 甘草（炙） 木香 当归尾（各一两） 槟榔（六两） 山楂（四两）
一方去掉枳实、陈皮、萝卜子，加益智仁、红花、柴胡、白术、茯苓。
以上研为末，用醋糊制成丸，每次服用三十至五十丸，空腹时用陈米汤送服。
大阿魏丸
去除各种积聚痰癖。
山楂 麦芽 神曲（炒） 南星 半夏 黄连（各一两） 连翘 阿魏（醋浸，另研入药） 瓜蒌仁 贝母（各半两） 风化硝 石决明 萝卜子（蒸） 胡黄连（各一钱半）
以上研为末，用姜汁浸泡，蒸饼为丸，空腹用白开水送服二钱。
大七气汤
疏散聚气。
青皮 陈皮 三棱（煨） 蓬术（煨，各一钱） 桔梗 甘草 藿香（各八分） 香附（一钱） 益智仁 官桂（各六分）
阿魏丸
治疗肉症。
阿魏（一两） 山楂（一两） 黄芩（六钱） 连翘（五钱）
以上研为末，用阿魏醋煮作糊丸，如梧桐子大，每次服用二三十丸，白开水送服。
熨症法
用吴茱萸三斤，捣碎，用酒炒热，包在绢帛中，趁热熨烫患处，冷了就用热的再熨，如果症积移动，就跟随熨烫，等到症积消退才停止。
见鬼丸（注：原文可能有误，通常指针对特定症状的丸剂，此处依原文翻译）
治疗妇人石瘕生于胞宫，寒邪客居子宫口，子宫口闭塞，气机不宣通运行，恶血应当泻出却未泻出，每天停留停止，月经有时按时而下，状如怀孕，月经不能按时而下，以此丸引导之。
附子（四钱，炮制） 鬼箭羽 紫石英（各三钱） 泽泻（二钱） 血竭（二钱半） 肉桂 玄胡索 木香（各二钱） 槟榔（二钱半） 桃仁（七钱，炒） 三棱（五钱） 水蛭（一钱，炒至烟尽） 大黄（二钱，同三棱酒浸一夜，焙干）
以上研为末，酒糊丸，如梧桐子大，每次服用三十丸，盐汤送服。
石瘕丸
治疗血瘕。血瘕，是因为血不流通而寒气薄迫，则血在内凝结而成瘕，比石瘕轻，用来消除它。
海粉 三棱 蓬术（醋炙） 五灵脂 红花 香附 石决明 瓦龙子（火淬）
以上研为末，醋糊丸，如梧桐子大，白术汤送服。
(Addition: One item on Pi Kuai [Bloating Mass])
[Verse]
One must know that Wu Ji (Five Accumulations) have existed for years, possessing form and substance with a root cause. In contrast, Liu Ju (Six Gatherings) have no fixed location; their gathering and dispersing are unpredictable, thus they are easy to cure. Jia (False/Assumed) refers to masses formed by borrowing external substances, while Ji (Accumulation) forms blocks that do not move.
[Dissertation]
The so-called "Wu Ji" (Five Accumulations) refer to the accumulations of the five Zang organs.
The Liver's accumulation is called Fei Qi (Fat Qi), located under the left hypochondrium, shaped like an inverted cup with heads and feet, resembling a turtle or tortoise. If untreated for a long time, it may induce cough, counterflow qi, and vomiting, with a pulse that is wiry and fine.
The Heart's accumulation is called Fu Liang (Hidden Beam), starting from the umbilicus and extending up to the heart, large as an arm. If not cured, it causes mental restlessness, swelling of the legs and thighs, and pain around the umbilicus, with a pulse that is deep and hollow (Kou).
The Spleen's accumulation is called Pi Qi (Pi Qi), located in the epigastrium, covering an area as large as a plate. If untreated for a long time, it leads to inability to control the four limbs, jaundice, failure of food to nourish muscles, heartache radiating to the back, and backache radiating to the heart, with a pulse that is floating, large, and long.
The Lung's accumulation is called Xi Ben (Breath Burden), located under the right hypochondrium, large as an inverted cup. If untreated for a long time, it causes chills and fever, vomiting, counterflow qi, cough, and asthma, potentially developing into Lung Abscess, with a pulse that is floating and hair-like (superficial and weak).
The Kidney's accumulation is called Ben Tun (Rushing Pig), originating in the lower abdomen and extending up to the heart, resembling a running piglet, moving up and down without fixed timing. If untreated for a long time, it causes panting, counterflow qi, bone萎 (weakness), and shortness of breath, with a pulse that is deep and slippery.
Liu Ju (Six Gatherings) are formed by the six Fu organs. Generally, Ju has no fixed shape, and its gathering/dispersing is untimely, unlike Ji which has a fixed location. "Zheng" means sign/evidence; due to material formation, there is a block that can be verified and cannot be moved. "Jia" means false/borrowed; it borrows form, and can be moved/displaced.
Ancient prescriptions for treating Ji, Ju, and Jia often used harsh agents that consume Qi and severely reduce pathogenic factors, supplemented by acrid-aromatic hot herbs. For mild cases, this may lead to resolution. However, for cases that are deeply rooted and where Qi deficiency has persisted for a long time, would this not damage the Healthy Qi? Once Healthy Qi is damaged, the accumulation worsens. Therefore, Jiegu Laoren proposed the theory of "Nourishing the Righteous, and the Accumulation will naturally eliminate." This is like having a room full of gentlemen; if a villain is among them, he will naturally be expelled. This statement is credible. However, one must examine the mechanisms of superficiality/deepness and lightness/heaviness, as well as the trends of duration (long/short) and deficiency/excess. Whether to reduce or tonify must be applied based on measuring the patient's weakness or strength.
[Pulse Diagnosis]
Wu Ji belong to Yin patterns; pulses are deep and hidden, adhering to the bone. Liver Ji pulse is wiry; Heart Ji pulse is hollow; Kidney Ji pulse is deep, urgent, and slippery; Spleen Ji pulse is excess and long; Lung Ji pulse is floating with sudden panting. Liu Ju pulses are deep; chronic cases show floating and knotted pulses. Jia pulses are mostly wiry; wiry and urgent indicates rapid Jia; wiry and fine indicates hardness. Heavy and scattered pulses indicate food-derived Pi (partial accumulation). Ji, Ju, and Jia with tight pulses indicate winding pain. Weak pulses indicate death; excess and strong pulses indicate recovery.
Xiang Ji Wan (Fragrant Accumulation Pill)
Treats Wu Ji, Liu Ju, and Qi masses.
San Leng (Rhizoma Sparganii, stir-fried with vinegar, 6 liang)
Peng Ze (Rhizoma Curcumae, processed or stir-fried with vinegar)
Qing Pi (Pericarpium Citri Reticulatae Viride, stir-fried)
Chen Pi (Pericarpium Citri Reticulatae, stir-fried)
Zhi Ke (Fructus Aurantii, stir-fried)
Zhi Shi (Fructus Aurantii Immaturus, stir-fried)
Luo Bo Zi (Semen Raphani, stir-fried)
Xiang Fu (Rhizoma Cyperi, stir-fried with vinegar, 2 liang each)
Huang Lian (Rhizoma Coptidis, stir-fried with ginger juice)
Shen Qu (Massa Medicata Fermentata, stir-fried)
Mai Ya (Fructus Hordei Germinatus, stir-fried)
Bie Jia (Carapax et Plastrum Testudinis, stir-fried with vinegar)
Gan Xi (Resina Xyli) (stir-fried until smoke ceases)
Tao Ren (Semen Persicae, peeled and remove tips)
Sha Ren (Fructus Amomi, stir-fried)
Sha Ren (duplicate in text, likely error, kept as is)
Gan Cao (Radix Glycyrrhizae, honey-fried)
Mu Xiang (Radix Aucklandiae)
Gui Wei (Caulis Rosae Rugosae) (1 liang each)
Bing Lang (Arecae Semen, 6 liang)
Shan Zha (Fructus Crataegi, 4 liang)
Alternative formula: Remove Zhi Shi, Chen Pi, Luo Bo Zi; add Yi Zhi Ren, Hong Hua, Chai Hu, Bai Zhu, Fu Ling.
Grind into powder, make pills with vinegar paste. Take 30-50 pills per dose, administered empty stomach with aged rice decoction.
Da A Wei Wan (Great Asafoetida Pill)
Eliminates various accumulations, phlegm, and partial accumulations.
Shan Zha (1 liang)
Mai Ya (1 liang)
Shen Qu (processed, 1 liang)
Nan Xing (Rhizoma Arisaematis Cum Bile)
Ban Xia (Rhizoma Pinelliae Preparatum)
Huang Lian (1 liang)
Lian Qiao (Fructus Forsythiae)
A Wei (Resina Asafoetidae, soaked in vinegar, ground separately and added to medicine)
Gua Lou Ren (Semen Benincasae)
Bei Mu (Bulbus Fritillariae Cirrhosae) (0.5 liang each)
Feng Hua Xiao (Natrii Sulfas Exsiccatus)
Shi Jue Ming (Concha Haliotidis)
Luo Bo Zi (steamed)
Hu Huang Lian (Radix Coptidis Chinensis var. Thibeticae) (1.5 qian each)
Grind into powder, soak in ginger juice, make pills with steamed bread dough. Take 2 qian per dose, administered empty stomach with plain warm water.
Da Qi Qi Tang (Great Seven-Qi Decoction)
Disperses gathered Qi.
Qing Pi (1 qian)
Chen Pi (1 qian)
San Leng (roasted, 1 qian)
Peng Ze (roasted, 1 qian)
Jie Geng (Radix Platycodi)
Gan Cao (Radix Glycyrrhizae)
Huo Xiang (Herba Agastaches) (0.8 qian each)
Xiang Fu (1 qian)
Yi Zhi Ren (Fructus Alpiniae Oxyphyllae)
Guan Gui (Cortex Cinnamomi) (0.6 qian each)
Bao He Wan (Preserve Harmony Pill)
Treats Food Syndrome. (Formula see Injury by Food section.)
A Wei Wan (Asafoetida Pill)
Treats Flesh Syndrome.
A Wei (1 liang)
Shan Zha (1 liang)
Huang Qin (Radix Scutellariae) (6 qian)
Lian Qiao (5 qian)
Grind into powder, use A Wei boiled in vinegar to make paste for pills, size of wu zi (wutong seeds). Take 20-30 pills per dose, with plain warm water.
Yi Zheng Fa (Ironing Method for Syndromes)
Use 3 jin of Wu Zhu Yu (Fructus Evodiae), crush it, stir-fry with wine until hot, wrap in silk fabric, and apply heat to the affected area while hot. When cold, replace with hot ones again. If the syndrome mass moves, follow and iron it. Stop when the syndrome dissipates.
Jian Gui Wan (See Ghost Pill - Note: Text likely contains typo or obscure name, translated literally)
Treats women's Shi Jia (Stone Jia) arising in the Bao Zhong (uterus). Cold pathogens invade the Zi Men (cervical os), causing closure, preventing Qi circulation. Evil blood should discharge but does not, accumulating daily. Menstruation may occur at times, resembling pregnancy, but menstruation is irregular. Use this pill to guide treatment.
Fu Zi (Radix Aconiti Lateralis Preparata, 4 qian, processed)
Gui Jian Yu (Ramulus Corni Swinhoei)
Zi Shi Ying (Fluorite, 3 qian each)
Ze Xie (Rhizoma Alismatis) (2 qian)
Xue Jie (Lignum Dracoanis Rubrum) (2.5 qian)
Rou Gui (Cortex Cinnamomi Cassiae)
Xuan Hu Suo (Rhizoma Corydalis Tenuifoliae)
Mu Xiang (1.5 qian each)
Bing Lang (2.5 qian)
Tao Ren (7 qian, stir-fried)
San Leng (5 qian)
Shui Zhi (Hirudo, 1 qian, stir-fried until smoke ceases)
Da Huang (Radix et Rhizoma Rhei, 2 qian, soaked in wine with San Leng overnight, dried)
Grind into powder, make pills with wine paste, size of wu zi. Take 30 pills per dose, with salt water.
Shi Jia Wan (Stone Jia Pill)
Treats Xue Jia (Blood Jia). Xue Jia occurs when blood flow is obstructed and cold constriction causes blood to coagulate internally forming Jia. It is milder than Shi Jia; used to eliminate it.
Hai Fen (Corallium Rubrum / Sea Powder)
San Leng
Peng Ze (stir-fried with vinegar)
Wu Ling Zhi (Faeces Troglodytis)
Hong Hua (Flos Carthami)
Xiang Fu
Shi Jue Ming (Concha Haliotidis)
Wa Long Zi (Os Draconis / Dragon Bone derivative, quenched in fire)
Grind into powder, make pills with vinegar paste, size of wu zi. Take with Bai Zhu decoction.