（附论）
结瘕者。积聚之类也。结伏积聚久不散。谓之结凝滞。腹内按抑有形。谓之结瘕。结
瘕
之证。形体瘦悴。食不知饥饱。遇阴寒冷湿之气。则发而腹胁块硬。隐隐然痛者是也。结瘕
之证
方
槟榔汤（出圣济总录）治结瘕。脉弦腹满。坐卧不安。食即欲吐而喘急。
槟榔（白者锉一两半） 赤茯苓（去黑皮） 芍药 陈橘皮（汤浸去白焙） 吴茱萸（陈
者淘
七遍炒） 郁李仁（汤退去皮别研如膏） 诃黎勒（煨去核各三分） 荆三棱（煨锉） 桑
根白皮
（焙锉各一两） 上粗捣筛。每服五钱匕。水一盏半。煎至八分。去滓温服。食前后各一服。
若服
紫葛丸（出圣济总录）治结瘕。腹胀。坚硬如石。肚上青筋浮起。
紫葛（一两） 芍药（赤者） 桔梗（炒） 紫菀（去苗土） 木香 诃黎勒皮（各三
分） 大黄
（锉熬一两半） 牵牛子（半两） 郁李仁（汤浸去皮研一两） 上为末。炼蜜为丸。如梧
桐子大。
每服十五丸。空腹煎木通及枣汤下。老幼量减丸数。
防己汤（出圣济总录）治结瘕气积。腹满如石。气急少卧。小便不利。
防己 百合（干者） 郁李仁（去皮各一两别研如膏） 木通（锉一两半） 吴茱萸（陈
者淘
七遍炒半两） 陈橘皮（汤浸去白焙） 当归（切焙） 赤茯苓（去黑皮各三分） 上捣筛
为散。
每服
羌活丸（出圣济总录）治结瘕气块。饮食不消。肺积气发。心胸痰逆。气喘
猝中风毒。香港脚
羌活（去芦头） 桂（去粗皮） 芎 木香 槟榔（锉各一两） 郁李仁（汤浸去皮
研如膏
五两） 大黄（锉炒二两） 上除郁李仁外。捣罗为末。与郁李仁研匀。炼蜜和丸。如梧桐
子
大。每
木通汤（出圣济总录）治结瘕。腹胀。坚硬不消。
木通（锉） 赤茯苓（去黑皮各一两） 赤芍药 吴茱萸（汤洗焙炒各三分） 槟榔
（一枚）
紫菀（去苗土） 郁李仁（去皮尖炒各半两） 上粗捣筛。每服三钱匕。水一盏半。煎取七
分。空腹服。日再。
防己散（出圣济总录）治结瘕癖实。腹满如鼓。食即欲吐。喘息急。其脉弦
而紧。
防己（煮） 诃黎勒（煨去核） 郁李仁（汤退皮研如膏） 白术 槟榔（锉各一两半）
吴茱
萸（陈者淘七遍炒三分） 上除郁李仁外。捣罗为散。入郁李仁同研令匀。每服三钱匕。水
一
盏
木香汤（出圣济总录）治远年虚实。积聚瘕块。
木香（一两） 海马子（一对雌雄者雌者黄色雄者青色） 大黄（锉炒） 青橘皮（汤
浸去皮焙） 白牵牛（炒各二两） 巴豆（四十九粒） 上以童子小便浸青橘皮软。裹巴豆
以绵系定。入小便内。再浸七日。取出麸炒黄。去巴豆。只用青橘皮。并余药。粗捣筛。每
服二钱匕。水一盏。煎至三五沸。去滓。临卧温服。
木香煎丸（一名木香 砂煎丸）治结瘕积聚。血结刺痛。\x
（附论）
结瘕，属于积聚类疾病。结伏的积聚物长久不散，称为结凝滞。腹部内按压时有形块感，称为结瘕。
结瘕的症状表现为：形体消瘦憔悴，饮食不知饥饱；遇到阴寒冷湿之气时，就会发作，导致腹胁部出现硬块，隐隐作痛。
治疗结瘕的方剂如下：
槟榔汤（出自《圣济总录》），用于治疗结瘕。症状见脉弦、腹部胀满、坐卧不安，进食后即想呕吐且呼吸急促。
药材及用量：槟榔（白色者，锉碎一两半）、赤茯苓（去掉黑色外皮）、芍药、陈橘皮（用热水浸泡后去掉白色内瓤并焙干）、吴茱萸（陈年的，淘洗七遍后炒制）、郁李仁（用热水退去外皮，单独研磨成膏状）、诃黎勒（煨制后去核，各三分）、荆三棱（煨制后锉碎）、桑根白皮（焙干后锉碎，各一两）。
制法与用法：将上述药物粗捣筛过。每次服用五钱匕，加水一盏半，煎煮至八分满，滤去药渣，温服。饭前饭后各服一次。
紫葛丸（出自《圣济总录》），用于治疗结瘕。症状见腹胀，坚硬如石头，肚子上青色筋脉浮起。
药材及用量：紫葛（一两）、芍药（红色的）、桔梗（炒制）、紫菀（去掉苗和泥土）、木香、诃黎勒皮（各三分）、大黄（锉碎并熬制一两半）、牵牛子（半两）、郁李仁（热水浸泡去皮研磨一两）。
制法与用法：将上述药物研为细末，用炼蜜制成梧桐子大小的丸剂。每次服用十五丸，空腹时用木通和枣汤送服。老人和儿童酌情减少丸数。
防己汤（出自《圣济总录》），用于治疗结瘕气积。症状见腹部胀满如石头，气急少卧，小便不利。
药材及用量：防己、百合（干燥者）、郁李仁（去皮，各一两，单独研磨成膏状）、木通（锉碎一两半）、吴茱萸（陈年的，淘洗七遍炒制半两）、陈橘皮（热水浸泡去白瓤焙干）、当归（切片焙干）、赤茯苓（去掉黑色外皮，各三分）。
制法与用法：将上述药物捣碎筛过制成散剂。
羌活丸（出自《圣济总录》），用于治疗结瘕气块。症状见饮食不消化，肺积气发作，心胸痰逆，气喘，突然中风毒，香港脚（痛风或下肢肿痛）。
药材及用量：羌活（去掉芦头）、桂（去掉粗皮）、芎（川芎）、木香、槟榔（锉碎，各一两）、郁李仁（热水浸泡去皮研磨成膏五两）、大黄（锉碎炒制二两）。
制法与用法：除郁李仁外，将其他药物捣罗成细末，与郁李仁研磨均匀，用炼蜜和丸，制成梧桐子大小的丸剂。每次服用...（原文此处缺失具体丸数和用法，仅保留现有文本）
木通汤（出自《圣济总录》），用于治疗结瘕。症状见腹胀，坚硬不消。
药材及用量：木通（锉碎）、赤茯苓（去掉黑色外皮，各一两）、赤芍药、吴茱萸（热水清洗焙炒，各三分）、槟榔（一枚）、紫菀（去掉苗土）、郁李仁（去皮尖炒制，各半两）。
制法与用法：将上述药物粗捣筛过。每次服用三钱匕，加水一盏半，煎取七分，空腹服用，每日两次。
防己散（出自《圣济总录》），用于治疗结瘕癖实。症状见腹部胀满如鼓，进食即欲吐，喘息急促，脉象弦而紧。
药材及用量：防己（煮制）、诃黎勒（煨制去核）、郁李仁（热水退皮研磨成膏）、白术、槟榔（锉碎，各一两半）、吴茱萸（陈年的，淘洗七遍炒制三分）。
制法与用法：除郁李仁外，将其他药物捣罗成散剂，加入郁李仁一同研磨均匀。每次服用三钱匕，加水一盏...（原文此处截断，仅保留现有文本）
木香汤（出自《圣济总录》），用于治疗多年的虚实夹杂证，积聚瘕块。
药材及用量：木香（一两）、海马子（一对，雌雄各一，雌性黄色，雄性青色）、大黄（锉碎炒制）、青橘皮（热水浸泡去皮焙干）、白牵牛（炒制，各二两）、巴豆（四十九粒）。
制法与用法：用童子小便浸泡青橘皮至软，包裹巴豆并用棉线系定，放入小便中再浸泡七日。取出后用麸皮炒至黄色，去掉巴豆，只用处理过的青橘皮，并与其他药物一起粗捣筛过。每次服用二钱匕，加水一盏，煎煮至三五沸，滤去药渣，临睡前温服。
(Attached Discussion)
Jiejia (Knot-like Masses) belongs to the category of Jiju (Accumulation and Gathering diseases). When accumulated masses remain stagnant and do not dissipate for a long time, it is called "Jie Ningzhi" (Stagnant Knots). When palpable lumps are felt upon pressing inside the abdomen, it is called "Jiejia".
The manifestations of Jiejia include: emaciation and physical decline; unawareness of hunger or satiety when eating; upon exposure to yin, cold, damp, or wet pathogenic factors, attacks occur characterized by hard lumps in the abdomen and hypochondrium with dull pain.
Formulas for treating Jiejia are as follows:
Binglang Tang (Pineapple Betel Nut Decoction) (from *Shengji Zonglu*), used to treat Jiejia. Symptoms include wiry pulse, abdominal fullness, restlessness in sitting or lying down, nausea/vomiting immediately after eating, and rapid breathing.
Ingredients: Binglang (Arecae Semen, white variety, crushed 1 liang 5 qian), Chifuling (Polyporus, black skin removed), Shaoyao (Paeoniae Radix), Chenjupi (Citri Reticulatae Pericarpium, soaked in hot water, white pith removed, dried), Wuzhuyu (Evodiae Fructus, aged, washed seven times, stir-fried), Yuliren (Prunus Armeniacae Semen, soaked in hot water, skin removed, ground into paste separately), Helile (Terminaliae Fructus, roasted, pit removed, each 3 fen), Jingsanleng (Sparganii Rhizoma, roasted, crushed), Sanggenbaipi (Mori Cortex, dried, crushed, each 1 liang).
Preparation and Administration: Coarsely grind and sieve the above ingredients. Take 5 qianbi per dose. Add 1.5 zhan of water, decoct until 0.8 zhan remains. Strain and take warm. Administer once before meals and once after meals.
Zige Wan (Cissampelos Pill) (from *Shengji Zonglu*), used to treat Jiejia. Symptoms include abdominal distension, hardness like stone, and protruding blue veins on the abdomen.
Ingredients: Zige (Cissampi Herba, 1 liang), Shaoyao (Paeoniae Radix, red variety), Jiegeng (Platycodonis Radix, stir-fried), Ziwan (Asteris Radix, seedlings and soil removed), Muxiang (Aucklandiae Radix), Helilepi (Pericarpium Terminaliae, each 3 fen), Dahuang (Rhei Radix et Rhizoma, crushed and processed, 1 liang 5 qian), Qianniuzi (Pharbitidis Semen, half liang), Yuliren (Prunus Armeniacae Semen, soaked in hot water, skin removed, ground, 1 liang).
Preparation and Administration: Grind the above ingredients into fine powder. Form pills using refined honey, sized like wutong seeds. Take 15 pills per dose. Take on an empty stomach with a decoction of Mutong and dates. Reduce dosage for elderly and children.
Fangji Tang (Stephaniae Tetrandrae Decoction) (from *Shengji Zonglu*), used to treat Jiejia qi accumulation. Symptoms include abdominal fullness hard as stone, shortness of breath with difficulty lying down, and difficult urination.
Ingredients: Fangji (Stephaniae Tetrandrae Radix), Baihe (Lilii Bulbus, dried), Yuliren (Prunus Armeniacae Semen, skin removed, each 1 liang, ground into paste separately), Mutong (Akebiae Caulis, crushed 1 liang 5 qian), Wuzhuyu (Evodiae Fructus, aged, washed seven times, stir-fried, half liang), Chenjupi (Citri Reticulatae Pericarpium, soaked in hot water, white pith removed, dried), Danggui (Angelicae Sinensis Radix, sliced and dried), Chifuling (Polyporus, black skin removed, each 3 fen).
Preparation and Administration: Crush and sieve the above ingredients to make a powder.
Qianghuo Wan (Notopterygii Rhizomatis Pilula) (from *Shengji Zonglu*), used to treat Jiejia qi lumps. Symptoms include indigestion, lung accumulation qi attack, phlegm counterflow in chest and heart, asthma, sudden wind-toxin stroke, and gout (Hongxiangjiao).
Ingredients: Qianghuo (Notopterygii Rhizoma, rhizome head removed), Gui (Cinnamomi Ramulus, coarse bark removed), Xiong (Chuanxiong Rhizoma), Muxiang (Aucklandiae Radix), Binglang (Arecae Semen, crushed, each 1 liang), Yuliren (Prunus Armeniacae Semen, soaked in hot water, skin removed, ground into paste, 5 liang), Dahuang (Rhei Radix et Rhizoma, crushed and stir-fried, 2 liang).
Preparation and Administration: Except for Yuliren, grind the other ingredients into fine powder. Mix evenly with the ground Yuliren. Form pills using refined honey, sized like wutong seeds. Each dose... [Text incomplete in source]
Mutong Tang (Akebiae Caulis Decoction) (from *Shengji Zonglu*), used to treat Jiejia. Symptoms include abdominal distension, hardness that does not resolve.
Ingredients: Mutong (Akebiae Caulis, crushed), Chifuling (Polyporus, black skin removed, each 1 liang), Chishaoyao (Red Paeoniae Radix), Wuzhuyu (Evodiae Fructus, washed in hot water, dried, stir-fried, each 3 fen), Binglang (Arecae Semen, one piece), Ziwan (Asteris Radix, seedlings and soil removed), Yuliren (Prunus Armeniacae Semen, skin and tip removed, stir-fried, each half liang).
Preparation and Administration: Coarsely grind and sieve the above ingredients. Take 3 qianbi per dose. Add 1.5 zhan of water, decoct until 0.7 zhan remains. Take on an empty stomach. Twice daily.
Fangji San (Stephaniae Tetrandrae Powder) (from *Shengji Zonglu*), used to treat Jiejia pi shi (stubborn solid masses). Symptoms include abdominal fullness like a drum, nausea/vomiting after eating, rapid panting, wiry and tight pulse.
Ingredients: Fangji (Stephaniae Tetrandrae Radix, boiled), Helile (Terminaliae Fructus, roasted, pit removed), Yuliren (Prunus Armeniacae Semen, skin removed, ground into paste), Baizhu (Atractylodis Macrocephalae Rhizoma), Binglang (Arecae Semen, crushed, each 1 liang 5 qian), Wuzhuyu (Evodiae Fructus, aged, washed seven times, stir-fried, 3 fen).
Preparation and Administration: Except for Yuliren, grind the other ingredients into powder. Add Yuliren and grind together until uniform. Take 3 qianbi per dose. Add 1 zhan of water... [Text truncated in source]
Muxiang Tang (Aucklandiae Radix Decoction) (from *Shengji Zonglu*), used to treat chronic deficiency-excess syndromes, accumulation and gathering masses.
Ingredients: Muxiang (Aucklandiae Radix, 1 liang), Haimaizi (Hippocampus Semen, one pair, female yellow, male green), Dahuang (Rhei Radix et Rhizoma, crushed and stir-fried), Qingjupi (Green Citri Reticulatae Pericarpium, soaked in hot water, skin removed, dried), Baiqianniu (White Pharbitidis Semen, stir-fried, each 2 liang), Badou (Crotonis Fructus, 49 grains).
Preparation and Administration: Soak Qingjupi in urine from a young boy until soft. Wrap Badou in the peel and tie securely with cotton thread. Place in the urine and soak for another seven days. Remove and stir-fry with bran until yellow. Remove Badou, use only the treated Qingjupi along with other herbs. Coarsely grind and sieve. Take 2 qianbi per dose. Add 1 zhan of water, boil three to five times. Strain and take warm before bedtime.
Muxiang Jian Wan (Aucklandiae Radix Decoction Pill) (also known as Muxiang Sha Jian Wan), used to treat Jiejia accumulation, blood stasis with stabbing pain.