《大全良方》分 癖、 瘕、八瘕、 痞、食 、血 、血瘀凡七门，多妇科下部症。而名目纷沓，症状相
近，反遗肠覃、石瘕，今统叙而条分之，以类相从，不淆亦不眩矣。 者近脐左右，各有一条筋起急痛，因
气而成，如弦状，名曰 。癖者僻在两肋间，有时而痛，名曰癖。疝瘕者，小腹气聚成块，或上逆，或下坠也。
八瘕者黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、龟瘕，皆胎产经行，气血不调之所生也。 者积坚不可
推移、痞者气壅不得宣畅。既有食 、血 ，不应复出 条，宜改痰痞为优。伤食成积，坚而难移，名食 。
瘀血成块，坚而难移，名血 。若腹中血瘀，则留滞不行，未至成块者也。别有石瘕生胞中，肠覃生肠外，
详载《内经》，亦 癖之类，并为条列症治于后。
〔 癖〕二症皆阴阳不和，冷气搏结经络，血气作楚， 近脐左右，两条筋起急痛，大如臂，小如指，
癖隐两肋，冷则痛发，宜葱白散，再服乌鸡丸。若胁腹胀痛，肝脾失和，木香顺气散去
苍术，加郁金、延胡。
〔疝瘕〕小腹有块，或时动移，因损伤胞门，宜八珍汤，加疏气药。血虚受寒，宜宽胀汤加归、芍。
气虚下坠，补中益气汤。血瘀气逆，当归散。
〔石瘕〕生胞中，由寒客子门，子门闭塞，恶血当泻不泻， 以留止，日益大，状如孕，坚如石，
月事不下。见 丸加减，或以坐导药下之。
〔八瘕〕皆生于左胞宫，右子户，多由经行交合，小腹满急，经血瘀阻，因成瘕聚。如怀孕，甚则溺涩，
痛苦如淋，今人无子。一、黄瘕。经行不利，左胁气结，阴中刺痛，淋露黄汁。用坐导皂荚散。二、青瘕。新
产浴早风袭，瘕聚左右胁，崩中不禁，下青汁。用坐导戎盐散。三、燥瘕。经行胃热，心烦汗多，大便艰涩，
瘕聚如杯。加味四物汤。四、血瘕。经行劳动感寒，留络不去，腰腹急痛。宣血瘕方，或调经散。五、脂瘕。
新产交合早胞伤，子户失禁，精血杂下如膏。宜坐导脂瘕方。六、狐瘕。经行受惊，心志恍惚，邪入于阴，
月闭溺难。宜狐瘕方。七、蛇瘕。经后阴未复，食饮误中虺毒，成形长而 痛。宜蛇瘕方。八、龟瘕。经行浴
水，水精与邪气袭入子户，形如小拌，少腹切痛。宜龟瘕方此照《巢氏病源》，删节爽净，简要有体。
〔痰痞〕涎沫凝结为痰，气道壅滞为痞。中脘痰气不利，砂枳二陈汤。痰结胸满，顺气导痰汤。心下痞，
发热而呕，半夏泻心汤。心下积冷如覆杯，按之有水声，热手熨之如冰，脉沉迟，三圣散吐之，次服白术调中
汤。
〔食 〕脾胃先弱，饮食失调，生冷不化，日渐成块，治先主疏导，而佐以和中。大和中饮，或消食丸。
若气壅血滞形寒者，乌药散。脾气虚，血不行者，芎归四君子汤。脾气郁，血不行者，归脾汤。肝脾血燥不
行者，加味逍遥散。
〔血 〕经水不调，结而成块，脐下冷痛，五物煎。情志郁损，气血乖违，加味归脾汤。恚怒伤肝，
加味逍遥散。产后恶露，失笑散。血积胀满，当归活血汤。肝脾虚损，芎归六君子汤。凡
块有形，皆正虚邪实，宜扶正除邪，毋轻议攻伐也。薛云∶此症多因七情亏损五脏，如脾统血，肝藏血，故郁
伤脾，怒伤肝者，多患胁腹作痛，正肝脾经症也，宜养正则积自除。
〔血瘀〕经水不行，或产后恶露未净，得寒则涩为瘀，久而不消则为 。腹痛畏手按者，内有血瘀。通瘀
煎加桃仁、延胡、牛膝。怒伤肝者，胁腹胀痛，化肝煎。郁伤脾者，食减刺痛，归脾汤。
〔肠覃〕寒气客肠外，与卫气搏，癖而内着， 肉乃生。大如鸡卵，渐如怀子，按之则坚，推之则移，
月事以时下，是气病血未病也。二陈汤加香附。若坚久作痛，宜 露丸。
统按前症，宜辨新久，有形无形，或痛不痛，动不动，在气在血，在胸胁，在少腹，在冲任，在肠外，
在胞宫。新者易治，久者难治。痛犹通连气血，不痛则另结窠囊。瘕者假也，无形而聚亦能散。 者征也，成
形而坚不可移。成形者，或由食积为食 ，由血结为血 。无形者，但在气分，气滞则聚而见形，气行则散
而无迹。 癖与痛俱现，不痛则隐，痰气居多。疝瘕气结，石瘕血结，八瘕阻于胞宫，肠覃生于肠外，月事
不异。又气血痰沫所成，痰痞各分寒热，且痰有物而痞无形。其狐瘕、蛇瘕、鳖瘕，异气所感，或饮食误中，
留聚脏腹，假血而成。与宿血之自内而凝为 为瘀者不同。古法败梳治虱瘕，铜屑治龙瘕，曲柏治米瘕，锻石
治酒瘕，理可类推矣。血瘕、血 、血瘀、血同而新久分。且血必随气，气行则血行，故治血先理气。又必
察其正气衰旺，若正气已虚，必先补正，乃可除邪，或兼外治法助之。阿魏膏、琥珀膏、三圣膏。古方治死血
食积痰饮，成块在胁，用化积丸。治气血郁结，食积胀痛，用开郁正元散。气血兼治，寒热互施，治血积月
水不调，用当归丸。血瘀痛不可忍，用琥珀散。余如血竭散、牡丹散。俱主热，桃仁煎、三棱煎并主攻。乃
寒则温之，结则散之，坚则削之也。其峻厉猛剂，如硝石丸、 砂丸、巴豆丸、干漆散。或不得已用之，
恐伤元气，后成不救，宜仿立斋、景岳治法为稳。
《准绳》以 瘕并属血病。《纲目》谓∶ 瘕积聚，并起于气，以瘕属血病者，气聚而后血凝也。
立斋治一妇，内热作渴，腹瘕如鸡卵，渐大四寸许，经水三月一至。凡瘕聚 块，在子宫则不孕，在冲任
则不月。肢体消瘦，脉洪而虚，左关尤甚，此肝脾郁结症也。外贴阿魏膏，午前用补中益气汤，午后用加味归
脾汤。肝火稍退，脾土稍健，用六味丸、归脾丸间服。又日用芦荟丸二服，空心以逍遥散下。日晡以归脾
汤下。调理年余而愈。又治一妇，腹块上攻作痛，吞酸痞闷，面色青黄，此肝脾气滞症也、六君子汤加芎、
归、柴、连、木香、吴萸各少许，二服。又以归脾汤，送下芦荟丸。三月余，肝脾和，诸症退。以调中益气
汤加茯苓、牡丹皮而经调。
景岳论瘀血成形，初成形则根盘未固。痛在脐腹者，五物煎、决津煎。如病气形气俱实，腹胀痛甚者，通
瘀煎、元胡当归散。稍久而坚者消磨之，三棱煎、万病丸。形气强壮，瘀滞不行，腹胀痛甚者，下之，桃仁承
气汤，或穿山甲散。然须详慎，其气壅瘕聚，为胀为痛者，排气饮、木香顺气散。如血中之气滞，为瘀为痛者，
通瘀煎、调经饮。疝瘕气聚者，荔香散。肝气逆而为聚者，解肝煎。三焦壅滞，气道不利，中满肿胀者，廓清
饮。
李氏曰∶治 瘕者，调其气，破其血，消其食，豁其痰，衰其大半而止，不可峻攻，以伤元气，且扶脾胃，
待其自化。愈后，用大小乌鸡丸、八珍汤、交加散、交加地黄丸调之。若用攻击，胃气先伤，或待块消尽，而
后补养，迟不及矣。
《大全良方》将癖、瘕、八瘕、痞、食积、血积、血瘀分为七个门类，多涉及妇科下部的症状。然而这些名目繁杂，症状相似，反而遗漏了肠覃和石瘕。现在统一叙述并分条解析，按类别归拢，既不混淆也不令人眩惑。
“”（此处原文缺字，根据上下文推测为“奔豚”或类似气病，但依原文保留空缺或指代不明之症）靠近肚脐左右，各有一条筋突起，紧急疼痛，因气而成，形状如弦，名为“”。癖位于两肋之间，有时疼痛，名为癖。疝瘕是小腹气聚成块，有时上逆，有时下坠。
八瘕包括黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、龟瘕，都是由胎产、月经期间气血不调所生成的。“”是指积聚坚硬不可移动；“痞”是指气机壅塞不得宣畅。既然已有食积、血积，不应再重复列出“”条，宜改为以痰痞为优。伤食形成积块，坚硬难移，名为食积。瘀血形成块状，坚硬难移，名为血积。若腹中血瘀，则留滞不行，尚未形成块状。另有石瘕生于胞宫之中，肠覃生于肠外，详细记载于《内经》，也属于癖类，一并分条列出症治如下。
〔癖〕这两种病症都是阴阳不和，冷气搏结经络，血气作痛。“”靠近肚脐左右，两条筋突起，紧急疼痛，大如手臂，小如手指；“癖”隐伏在两肋，遇冷则痛发，宜用葱白散，再服用乌鸡丸。若胁腹胀痛，肝脾失和，用木香顺气散去苍术，加郁金、延胡索。
〔疝瘕〕小腹有块，有时动移，因损伤胞门所致，宜用八珍汤，加疏气药。血虚受寒，宜用宽胀汤加当归、芍药。气虚下坠，用补中益气汤。血瘀气逆，用当归散。
〔石瘕〕生于胞宫之中，由寒气客居子门，子门闭塞，恶血应当排出却排不出，因而留止，日益增大，状如怀孕，坚硬如石，月经不下。见丸剂加减，或用坐导药使其排出。
〔八瘕〕都生于左边的胞宫或右边的子户，多由经期交合，小腹满急，经血瘀阻，因而成为瘕聚。如果怀孕，甚至小便涩痛，痛苦如淋证，导致今人无子。一、黄瘕。经期不利，左胁气结，阴中刺痛，淋露黄汁。用坐导皂荚散。二、青瘕。新产后过早洗浴受风袭击，瘕聚在左右胁，崩中不禁，下青汁。用坐导戎盐散。三、燥瘕。经期胃热，心烦汗多，大便艰涩，瘕聚如杯。用加味四物汤。四、血瘕。经期劳动感寒，留络不去，腰腹急痛。用宣血瘕方，或调经散。五、脂瘕。新产后过早交合损伤胞宫，子户失禁，精血杂下如膏。宜用坐导脂瘕方。六、狐瘕。经期受惊，心志恍惚，邪入于阴，月经闭止，小便困难。宜用狐瘕方。七、蛇瘕。经期后阴部未恢复，饮食误中虺毒，成形长而疼痛。宜用蛇瘕方。八、龟瘕。经期洗浴冷水，水精与邪气袭入子户，形如小拌斗，少腹切痛。宜用龟瘕方。此照《巢氏病源》，删节清爽干净，简要有体例。
〔痰痞〕涎沫凝结为痰，气道壅滞为痞。中脘痰气不利，用砂仁、枳实二陈汤。痰结胸满，用顺气导痰汤。心下痞，发热而呕，用半夏泻心汤。心下积冷如覆杯，按之有水声，热手熨之如冰，脉沉迟，用三圣散吐之，次服白术调中汤。
〔食积〕脾胃先弱，饮食失调，生冷不化，日渐成块，治疗先主疏导，而佐以和中。用大和中饮，或消食丸。若气壅血滞形寒者，用乌药散。脾气虚，血不行者，用芎归四君子汤。脾气郁，血不行者，用归脾汤。肝脾血燥不行者，用加味逍遥散。
〔血积〕经水不调，结而成块，脐下冷痛，用五物煎。情志郁损，气血乖违，用加味归脾汤。恚怒伤肝，用加味逍遥散。产后恶露不尽，用失笑散。血积胀满，用当归活血汤。肝脾虚损，用芎归六君子汤。凡块有形，皆正虚邪实，宜扶正除邪，不要轻议攻伐。薛己说：此症多因七情亏损五脏，如脾统血，肝藏血，故郁伤脾，怒伤肝者，多患胁腹作痛，正是肝脾经症，宜养正则积自除。
〔血瘀〕经水不行，或产后恶露未净，得寒则涩为瘀，久而不消则为积。腹痛畏手按者，内有血瘀。用通瘀煎加桃仁、延胡索、牛膝。怒伤肝者，胁腹胀痛，用化肝煎。郁伤脾者，食减刺痛，用归脾汤。
〔肠覃〕寒气客居肠外，与卫气搏结，癖而内着，肌肉乃生。大如鸡卵，渐如怀子，按之则坚，推之则移，月事以时下，是气病血未病也。用二陈汤加香附。若坚久作痛，宜用露丸。
统观前述病症，宜辨新久，有形无形，或痛不痛，动不动，在气在血，在胸胁，在少腹，在冲任，在肠外，在胞宫。新者易治，久者难治。痛犹通连气血，不痛则另结窠囊。瘕者假也，无形而聚亦能散。积者征也，成形而坚不可移。成形者，或由食积为食积，由血结为血积。无形者，但在气分，气滞则聚而见形，气行则散而无迹。癖与痛俱现，不痛则隐，痰气居多。疝瘕气结，石瘕血结，八瘕阻于胞宫，肠覃生于肠外，月事不异。又气血痰沫所成，痰痞各分寒热，且痰有物而痞无形。其狐瘕、蛇瘕、鳖瘕，异气所感，或饮食误中，留聚脏腹，假血而成。与宿血之自内而凝为积为瘀者不同。古法败梳治虱瘕，铜屑治龙瘕，曲柏治米瘕，锻石治酒瘕，理可类推矣。血瘕、血积、血瘀、血同而新久分。且血必随气，气行则血行，故治血先理气。又必察其正气衰旺，若正气已虚，必先补正，乃可除邪，或兼外治法助之。阿魏膏、琥珀膏、三圣膏。古方治死血食积痰饮，成块在胁，用化积丸。治气血郁结，食积胀痛，用开郁正元散。气血兼治，寒热互施，治血积月水不调，用当归丸。血瘀痛不可忍，用琥珀散。余如血竭散、牡丹散。俱主热，桃仁煎、三棱煎并主攻。乃寒则温之，结则散之，坚则削之也。其峻厉猛剂，如硝石丸、硇砂丸、巴豆丸、干漆散。或不得已用之，恐伤元气，后成不救，宜仿立斋、景岳治法为稳。
《准绳》以积瘕并属血病。《纲目》谓：积瘕积聚，并起于气，以瘕属血病者，气聚而后血凝也。
薛己治一妇，内热作渴，腹瘕如鸡卵，渐大四寸许，经水三月一至。凡瘕聚块，在子宫则不孕，在冲任则不月。肢体消瘦，脉洪而虚，左关尤甚，此肝脾郁结症也。外贴阿魏膏，午前用补中益气汤，午后用加味归脾汤。肝火稍退，脾土稍健，用六味丸、归脾丸间服。又日用芦荟丸二服，空心以逍遥散下。日晡以归脾汤下。调理年余而愈。又治一妇，腹块上攻作痛，吞酸痞闷，面色青黄，此肝脾气滞症也。六君子汤加川芎、当归、柴胡、黄连、木香、吴茱萸各少许，二服。又以归脾汤，送下芦荟丸。三月余，肝脾和，诸症退。以调中益气汤加茯苓、牡丹皮而经调。
张景岳论瘀血成形，初成形则根盘未固。痛在脐腹者，用五物煎、决津煎。如病气形气俱实，腹胀痛甚者，用通瘀煎、元胡当归散。稍久而坚者消磨之，用三棱煎、万病丸。形气强壮，瘀滞不行，腹胀痛甚者，下之，用桃仁承气汤，或穿山甲散。然须详慎，其气壅瘕聚，为胀为痛者，用排气饮、木香顺气散。如血中之气滞，为瘀为痛者，用通瘀煎、调经饮。疝瘕气聚者，用荔香散。肝气逆而为聚者，用解肝煎。三焦壅滞，气道不利，中满肿胀者，用廓清饮。
李氏曰：治积瘕者，调其气，破其血，消其食，豁其痰，衰其大半而止，不可峻攻，以伤元气，且扶脾胃，待其自化。愈后，用大小乌鸡丸、八珍汤、交加散、交加地黄丸调之。若用攻击，胃气先伤，或待块消尽，而后补养，迟不及矣。
The *Daquan Liangfang* (Great Collection of Excellent Prescriptions) divides Pi (abdominal masses), Jia (intermittent abdominal masses), Eight Jias, Pi (stagnation), Shi Ji (food accumulation), Xue Ji (blood accumulation), and Xue Yu (blood stasis) into seven categories, mostly involving symptoms in the lower jiao of gynecology. However, these names are numerous and confusing, with similar symptoms, and they omit Chang Qin (intestinal polyps/tumors) and Shi Jia (stone jia). Now, I will systematically narrate and analyze them item by item, grouping them by category, so as not to cause confusion or dizziness.
" [Missing Character] is located near the left and right sides of the navel, with a tendon rising on each side causing urgent pain. It forms due to Qi, resembling a string, and is named " [Missing Character]. Pi (Pian Yi) is hidden between the two hypochondria, causing pain at times, and is named Pi. Shan Jia (Hernia Jia) refers to Qi gathering into a mass in the lower abdomen, sometimes moving upward or downward.
The Eight Jias include Huang Jia (Yellow Jia), Qing Jia (Green Jia), Zao Jia (Dry Jia), Xue Jia (Blood Jia), Zhi Jia (Fat Jia), Hu Jia (Fox Jia), She Jia (Snake Jia), and Gui Jia (Turtle Jia). All are generated from irregular Qi and Blood during pregnancy, childbirth, or menstruation. "Ji" (Accumulation) refers to a hard mass that cannot be moved; "Pi" (Stagnation) refers to Qi obstruction without free flow. Since there are already Shi Ji (Food Accumulation) and Xue Ji (Blood Accumulation), it is inappropriate to repeat the "[Missing Character]" category; it is better to prioritize Tan Pi (Phlegm Stagnation). Food injury leading to accumulation, which is hard and difficult to move, is named Shi Ji. Blood stasis forming a mass, which is hard and difficult to move, is named Xue Ji. If there is blood stasis in the abdomen, it stagnates and does not move, but has not yet formed a mass. Additionally, Shi Jia (Stone Jia) arises in the Bao Gong (uterus), and Chang Qin (Intestinal Polyp/Tumor) arises outside the intestines. These are detailed in the *Nei Jing* (Inner Canon) and also belong to the category of Pi/Jia. Their symptoms and treatments are listed below.
[Pi] Both conditions result from disharmony of Yin and Yang, with cold Qi binding the meridians, causing pain in Qi and Blood. "[Missing Character]" appears near the navel on both sides, with two tendons rising and causing urgent pain, large as an arm or small as a finger. "Pi" hides in the hypochondria, and pain occurs when exposed to cold. Use Cong Bai San (Scallion White Powder), followed by Wu Ji Wan (Black Chicken Pill). If there is hypochondriac and abdominal distension and pain due to Liver-Spleen disharmony, use Mu Xiang Shun Qi San (Aucklandia Regulating Qi Powder) removing Cang Zhu (Atractylodes Rhizome), adding Yu Jin (Curcuma Tuber) and Yan Hu Suo (Corydalis Rhizome).
[Shan Jia] There is a mass in the lower abdomen that moves at times, caused by damage to the Bao Men (uterine gate). Use Ba Zhen Tang (Eight Treasure Decoction) with Qi-regulating herbs. For Blood deficiency with cold invasion, use Kuan Zhang Tang (Relaxing Distension Decoction) adding Dang Gui (Angelica Sinensis) and Shao Yao (Peony Root). For Qi deficiency with sinking, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For Blood stasis with rebellious Qi, use Dang Gui San (Angelica Powder).
[Shi Jia] Arises in the Bao Gong (uterus). Cold pathogens invade the Zi Men (uterine opening), causing closure. Evil blood should be discharged but is retained, accumulating day by day, becoming larger, resembling pregnancy, hard as stone, with no menstruation. See Wan (Pill) for modifications, or use suppositories to discharge it.
[Eight Jias] All arise in the Bao Gong (uterus) on the left or Zi Hu (uterine door) on the right. They are mostly caused by intercourse during menstruation, leading to fullness and urgency in the lower abdomen, blood stasis obstructing menses, thus forming Jia masses. If pregnant, it may even cause difficult urination, pain like strangury, leading to infertility. 1. Huang Jia (Yellow Jia): Irregular menstruation, Qi knot in the left hypochondrium, stabbing pain in the vagina, dripping yellow fluid. Use Suppository Gleditsia Sinensis Powder. 2. Qing Jia (Green Jia): Early bathing after childbirth exposes one to wind, causing Jia masses in the hypochondria, uncontrollable metrorrhagia, discharging green fluid. Use Suppository Rock Salt Powder. 3. Zao Jia (Dry Jia): Stomach heat during menstruation, irritability, excessive sweating, difficult defecation, Jia mass like a cup. Use Modified Si Wu Tang (Four Substance Decoction). 4. Xue Jia (Blood Jia): Labor and cold invasion during menstruation, lingering in collaterals, urgent pain in waist and abdomen. Use Xuan Xue Jia Fang (Prescription for Dispersing Blood Jia) or Diao Jing San (Regulate Menses Powder). 5. Zhi Jia (Fat Jia): Early intercourse after childbirth damages the uterus, loss of control of Zi Hu, essence and blood mixed and discharged like paste. Use Suppository Fat Jia Prescription. 6. Hu Jia (Fox Jia): Shock during menstruation, mental agitation, pathogen entering Yin, amenorrhea and difficult urination. Use Hu Jia Prescription. 7. She Jia (Snake Jia): Vagina not recovered after menstruation, accidental ingestion of venomous snake poison during eating/drinking, forming a long shape with pain. Use She Jia Prescription. 8. Gui Jia (Turtle Jia): Bathing in cold water during menstruation, water essence and pathogenic qi invade Zi Hu, shape like a small ladle, severe lower abdominal pain. Use Gui Jia Prescription. This follows the *Chao Shi Bing Yuan* (Source of Diseases of the Chao Family), deleted cleanly, concise and structured.
[Tan Pi] Saliva and foam condense into Phlegm; airway obstruction constitutes Pi. Phlegm-Qi dysfunction in Zhong Wan (CV12), use Sha Zhi Er Chen Tang (Sand and Immature Orange Er Chen Decoction). Phlegm knot with chest fullness, use Shun Qi Dao Tan Tang (Regulate Qi Guide Phlegm Decoction). Pi under the heart, fever and vomiting, use Ban Xia Xie Xin Tang (Pinellia Drain the Epigastrium Decoction). Cold accumulation under the heart like an inverted cup, water sound upon pressing, feels like ice when warmed by hand, deep and slow pulse, use San Sheng San (Three Saints Powder) to induce vomiting, then take Bai Zhu Tiao Zhong Tang (Atractylodes Regulate Middle Decoction).
[Shi Ji] Spleen and Stomach are initially weak, diet is irregular, raw and cold foods are not transformed, gradually forming masses. Treatment first focuses on guiding out, assisted by harmonizing the middle. Use Da He Zhong Yin (Great Harmonize Middle Drink) or Xiao Shi Wan (Digest Food Pill). If Qi stagnation, Blood stasis, and cold form, use Wu Yao San (Lindera Powder). If Spleen Qi deficiency with non-moving Blood, use Xiong Gui Si Jun Zi Tang (Ligusticum and Angelica Four Gentlemen Decoction). If Spleen Qi depression with non-moving Blood, use Gui Pi Tang (Restore the Spleen Decoction). If Liver-Spleen Blood dryness with non-moving Blood, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder).
[Xue Ji] Irregular menstruation, knotting into masses, cold pain below the umbilicus, use Wu Wu Jian (Five Material Decoction). Emotional depression damaging Qi and Blood disharmony, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). Anger injuring the Liver, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). Postpartum lochia retention, use Shi Xiao San (Instant Gratification Powder). Blood accumulation with distension, use Dang Gui Huo Xue Tang (Angelica Invigorating Blood Decoction). Liver-Spleen deficiency, use Xiong Gui Liu Jun Zi Tang (Ligusticum and Angelica Six Gentlemen Decoction). Any mass with form indicates Righteous Qi deficiency and Pathogenic Excess. One should support the Righteous and eliminate the Pathogen, avoiding light attacks. Xue Ji said: This condition often results from Seven Emotions damaging the Five Zang. The Spleen governs Blood, the Liver stores Blood. Thus, depression damages the Spleen, anger damages the Liver, often causing hypochondriac and abdominal pain, which is a Liver-Spleen meridian symptom. Supporting the Righteous will naturally remove the accumulation.
[Xue Yu] Menstruation does not occur, or postpartum lochia is not cleared. Cold causes涩 (astringency/stasis) becoming Yu (stasis); if prolonged without resolution, it becomes Ji (accumulation). Abdominal pain fearing pressure indicates internal Blood stasis. Use Tong Yu Jian (Unblock Stasis Decoction) adding Tao Ren (Peach Kernel), Yan Hu Suo (Corydalis Rhizome), and Niu Xi (Achyranthes Root). Anger injuring the Liver, causing hypochondriac and abdominal distension/pain, use Hua Gan Jian (Transform Liver Decoction). Depression damaging the Spleen, causing reduced appetite and stabbing pain, use Gui Pi Tang (Restore the Spleen Decoction).
[Chang Qin] Cold pathogens lodge outside the intestines, battling with Wei Qi (Defensive Qi), attaching internally, causing muscle growth. Large as a chicken egg, gradually like pregnancy, hard upon pressing, movable upon pushing, menstruation occurs on time. This is a Qi disease where Blood is not yet affected. Use Er Chen Tang (Two Aged Ingredients Decoction) adding Xiang Fu (Cyperus Rhizome). If hard and painful for a long time, use Lu Wan (Dew Pill).
Summarizing the above conditions, one must distinguish new vs. old, formed vs. unformed, painful vs. painless, mobile vs. immobile, in Qi vs. in Blood, in chest/hypochondrium, in lower abdomen, in Chong and Ren meridians, outside intestines, or in Bao Gong. New cases are easy to treat; old cases are difficult. Pain still connects Qi and Blood; painlessness implies a separate nest formation. Jia means false; unformed, gathering can also scatter. Ji means sign/manifestation; formed, hard and immovable. Formed cases arise from food accumulation as Shi Ji, or blood knotting as Xue Ji. Unformed cases exist only in the Qi level; Qi stagnation gathers and shows form, Qi movement scatters leaving no trace. Pi and Jian present with pain; if painless, they hide, mostly due to Phlegm-Qi. Shan Jia is Qi knotting, Shi Jia is Blood knotting, Eight Jias obstruct the Bao Gong, Chang Qin arises outside intestines, menstruation remains unchanged. Also, those formed by Qi, Blood, Phlegm, and Foam: Tan Pi distinguishes Cold and Heat; Phlegm has substance while Pi is formless. Hu Jia, She Jia, Bie Jia are affected by different Qi, or mistaken ingestion, staying in viscera, relying on Blood to form. This differs from old Blood coagulating internally into Ji and Yu. Ancient methods used Bai Shu (decayed comb) for Shi Jia, Tong Xie (copper filings) for Long Jia, Qu Bai (fermented wheat) for Mi Jia, Duan Shi (calcined iron ore) for Jiu Jia; logic can be extended. Xue Jia, Xue Ji, Xue Yu, and Xue are the same but distinguished by new vs. old. Blood follows Qi; when Qi moves, Blood moves. Thus, treating Blood requires regulating Qi first. One must also observe the strength of Righteous Qi. If Righteous Qi is deficient, one must first tonify it before eliminating Pathogens, or combine with external treatments. A Wei Gao (Asafoetida Plaster), Hu Po Gao (Amber Plaster), San Sheng Gao (Three Saints Plaster). Ancient formulas for dead Blood, food accumulation, and Phlegm-Fluid forming masses in hypochondria use Hua Ji Wan (Resolve Accumulation Pill). For Qi-Blood depression and food accumulation distension/pain, use Kai Yu Zheng Yuan San (Open Depression Correct Origin Powder). Treating Qi and Blood together, alternating Cold and Heat, for Blood accumulation and menstrual irregularity, use Dang Gui Wan (Angelica Pill). For unbearable pain from Blood stasis, use Hu Po San (Amber Powder). Others include Xue Jie San (Dragon's Blood Powder), Mu Dan San (Moutan Powder). All primarily address Heat; Tao Ren Jian (Peach Kernel Decoction) and San Leng Jian (Burreed Decoction) focus on attacking. Warm what is Cold, scatter what is knotted, reduce what is hard. Harsh agents like Xiao Shi Wan (Niter Pill), Niao Sha Wan (Realgar/Nitrum Pill), Ba Dou Wan (Croton Seed Pill), Gan Qi San (Dried Lacquer Powder) should be used only when necessary, fearing damage to Yuan Qi (Original Qi), leading to incurable conditions later. It is safer to follow the treatment methods of Li Zhi Tai (Li Zhongzi) and Zhang Jing Yue.
*Zhun Sheng* classifies Ji and Jia as Blood diseases. *Gang Mu* states: Ji, Jia, and Ju all originate from Qi. Those considering Jia as a Blood disease argue that Qi gathers first, then Blood coagulates.
Li Zhi Tai treated a woman with internal heat and thirst, an abdominal Jia like a chicken egg, gradually growing to four cun, menstruation once every three months. Generally, Jia masses in the Zi Gong (uterus) cause infertility; in Chong and Ren meridians, they cause amenorrhea. Emaciated limbs, surging and empty pulse, especially strong at Left Guan (Liver position). This is a Liver-Spleen depression knotting syndrome. External application of A Wei Gao (Asafoetida Plaster). Morning: Bu Zhong Yi Qi Tang (Tonify Middle and Augment Qi Decoction). Afternoon: Jia Wei Gui Pi Tang (Modified Restore Spleen Decoction). As Liver Fire subsides and Spleen Earth strengthens, alternate Liu Wei Wan (Six Ingredient Pill) and Gui Pi Wan (Restore Spleen Pill). Daily: two doses of Lu Hui Wan (Aloe Pill), taken on an empty stomach with Xiao Yao San (Free and Easy Wanderer Powder). Evening: taken with Gui Pi Tang (Restore Spleen Decoction). Regulated for over a year until cured. He also treated a woman with abdominal mass attacking upwards causing pain, acid regurgitation, chest stuffiness, blue-yellow complexion. This is Liver-Spleen Qi stagnation. Liu Jun Zi Tang (Six Gentlemen Decoction) added with Xiong (Ligusticum), Gui (Angelica), Chai (Bupleurum), Lian (Coptis), Mu Xiang (Aucklandia), and Wu Yu (Evodia) in small amounts, two doses. Then, Gui Pi Tang (Restore Spleen Decoction) administered with Lu Hui Wan (Aloe Pill). After three months, Liver and Spleen harmonized, symptoms receded. Menstruation regulated with Tiao Zhong Yi Qi Tang (Regulate Middle and Augment Qi Decoction) added with Fu Ling (Poria) and Mu Dan Pi (Moutan Bark).
Zhang Jing Yue discussed Blood stasis forming masses. Initially formed, the root is not solid. Pain in umbilicus/abdomen: Wu Wu Jian (Five Material Decoction), Jue Jin Jian (Decide Flow Decoction). If disease Qi and Body Qi are both excess, severe abdominal distension/pain: Tong Yu Jian (Unblock Stasis Decoction), Yuan Hu Dang Gui San (Corydalis and Angelica Powder). Hardened after some time, grind it down: San Leng Jian (Burreed Decoction), Wan Bing Wan (Ten Thousand Disease Pill). Strong constitution, stagnant Blood, severe abdominal distension/pain, purge it: Tao Ren Cheng Qi Tang (Peach Kernel Order Qi Decoction) or Chuan Shan Jia San (Pangolin Scale Powder). However, caution is required. For Qi obstruction and Jia gathering causing distension/pain: Pai Qi Yin (Expel Qi Drink), Mu Xiang Shun Qi San (Aucklandia Regulating Qi Powder). For Qi stagnation within Blood causing stasis/pain: Tong Yu Jian (Unblock Stasis Decoction), Diao Jing Yin (Regulate Menses Drink). For Shan Jia Qi gathering: Li Xiang San (Litsea and Aucklandia Powder). For Liver Qi rebellion causing gathering: Jie Gan Jian (Resolve Liver Decoction). For San Jiao obstruction, airway dysfunction, middle fullness/swelling: Kuo Qing Yin (Clear Out Drink).
Mr. Li said: To treat Ji and Jia, regulate its Qi, break its Blood, digest its Food, resolve its Phlegm. Stop when it has diminished by more than half. Do not attack harshly to damage Yuan Qi. Support Spleen and Stomach, waiting for self-transformation. After cure, regulate with Da/Xiao Wu Ji Wan (Large/Small Black Chicken Pills), Ba Zhen Tang (Eight Treasure Decoction), Jiao Jia San (Interlaced Additions Powder), Jiao Jia Di Huang Wan (Interlaced Added Rehmannia Pill). If using attacking methods, Stomach Qi is damaged first. Or waiting until the mass is completely dissolved before tonifying is too late.