古方有五积、六聚、七 、八瘕之名。五脏之气积，名曰积，故积有五。六腑之气聚，
名曰聚，故聚有六。《杂病准绳》言之详矣。若夫七 八瘕，则妇人居多，七者火数属心，
盖血生于心。八者木数属肝，盖血归于肝。虽曰强分，理似不混。夫 者坚也，坚则难破。
瘕者假也，假物成形。古人将妇人病为痼疾，以蛟龙等为生瘕，然亦不必如此执泥。妇人
瘕，并属血病，龙、蛇、鱼、鳖、肉、发、虱瘕等事，皆出偶然。但饮食间误中之，留
聚腹脏，假血而成，自有活性，亦犹永徽中僧病噎者，腹中有一物，其状如鱼，即生瘕
也。与夫宿血停凝，结为痞块，虽内外所感之不同，治法当以类相从，所为医者意也。如
以败梳治虱瘕，铜屑治龙瘕，曲 治米瘕，锻石治酒瘕，如此等类，学人可以理解也。《大
全良方》分 癖诸气、疝瘕、八瘕、腹中瘀血、 痞、食 、血 凡七门。 者在腹内
近脐左右各有一条筋脉急痛，大者如臂，次者如指，因气而成，如弦之状，故名曰 。癖
者僻在两肋之间，有时而痛，故名曰癖。疝者痛也，瘕者假也，其结聚浮假而痛，推移
乃动也。八瘕者，黄瘕、青瘕、燥瘕、血瘕、脂瘕，狐瘕、蛇瘕、鳖瘕。积在腹内，或肠
胃之间，与脏气结搏坚牢，虽推之不移，名曰 ，言其病形可征验也。气壅塞为痞，言
其气痞塞不宣畅也。伤食成块，坚而不移，名曰食 。瘀血成块，坚而不移，名曰血 。若
夫腹中瘀血，则积而未坚，未至于成块者也。大抵以推之不动为 ，推之动为瘕也。至夫
疝与 癖，则与痛俱，痛即现，不痛即隐。在脐左上为 ，在两肋之间为癖，在小腹而牵
引腰胁为疝。恐学人一时难了，未免淆滥，故总叙叙而条析之。
张戴人过谯，遇一卒，说出妻事。戴人问其故，答曰∶吾妇为室女时，心下有冷积
如覆杯，按之如水声，以热手熨之如冰，娶来已十五年矣，恐断我嗣，是故弃之。戴人
曰∶公勿黜也，如用吾药，病可除，孕可得。卒从之。戴人诊其脉，沉而迟，尺脉洪大而
有力，非无子之候也，可不逾年而孕。其良人笑曰∶试之。先以三圣散吐涎一斗，心下
平软，次服白术调中汤、五苓散，后以四物汤和之，不再月气血合度，数月而娠二子。戴
人尝曰∶用吾此法，无不子之妇。此言不诬。（三圣散用防风、瓜蒂各三两，藜芦一两，
为粗末，以齑汁煎服。制煎法，详见《儒门事亲》。白术调中汤用白术、茯苓、泽泻、橘
红各半两，甘草一两、干姜、官桂、砂仁、藿香各二钱半，为末，白汤化蜜调服二钱，无
时。五苓散见伤寒渴门。）阳夏张主簿之妻，病肥气，初如酒杯大，发寒热十五
余年，后因性急悲感，病益甚，惟心下三指许无病，满腹如石片，不能坐卧，针灸匝矣，
徒劳人耳。乃邀戴人诊之曰∶此肥气也。得之季夏戊巳日，在左胁下如覆杯，久不愈，令
人发 疟。以瓜蒂散吐之鱼腥黄涎约一二击，
至夜继用舟车丸、通经散投之，五更黄涎脓水相半五六行，凡有积处皆觉痛，后用白术
散、当归散和血流经之药，如斯涌泄凡三四次方愈。（瓜蒂散、舟车丸，方见杂病伤食、痰饮二
门。通经散用橘红、当归、甘遂，以面包不令透水，煮百余沸，用冷水浸过，去面晒干，三味各等分为细
未，每服三钱，临卧温淡酒调下。白术散，白术、黄芩、当归各等分为末，每服二三钱，水煎，食前服。
当归散，当归、杜蒺藜等分为末，米饮调服，食前。此吐下兼施，且甘遂等逐水太峻，用者审之。）
薛新甫云∶妇人 癖 瘕，大抵因饮食起居七情失宜，亏损脏腑，气血乖违，阴络
受伤，循行失度所致，罗谦甫云∶养正积自除，必先调养，使荣卫充实，若不消散，方
可议下。但除之不以渐，则必有颠覆之害，若不守禁忌，纵情嗜欲，其有不丧身者鲜矣。
一妇人内热作渴，饮食少思，腹内初如鸡卵，渐大四寸许，经水三月一至，肢体消瘦，齿
颊似疮，脉洪数而虚，左关尤甚。此肝脾郁结之证，外贴阿魏膏，午前用补中益气汤，（杂
病伤劳倦。）午后用加味归脾汤，（即归脾加山栀、丹皮。）两月许，肝火稍退，脾土少健，午前补中
益气下六味丸，（杂病虚劳。）午后逍遥散（调经。）下归脾丸，又月余，日用芦荟丸（本门之末。）二服，
空心以逍遥散下，日晡以归脾汤下。喜其谨疾，调理年余而愈。一妇人腹内一块，不
时上攻，或作痛有声，或吞酸痞闷，月经不调，小便不利，二年余矣，面色青黄。余以
为肝脾气滞，以六君加芎、归、柴胡、炒连、木香、吴茱各少许，二剂，却与归脾汤送下
芦荟丸。三月余，肝脾和而诸证退，又与调中益气汤加茯苓、牡丹皮，中气健而经自调。
一妇人性多郁善怒，勤于女工，小腹内结一块，或作痛，或痞闷，月经不调，恪服伐
肝之剂，内热寒热，胸膈不利，饮食不甘，形体日瘦，牙龈蚀烂。此脾土不能生肺金，肺
金不能生肾水，肾水不能生肝木，当滋化源。用补中益气汤、六味丸，至仲春而愈。一
妇人经候过期，发热倦怠，或用四物、黄连之类，反两月一度，且少而成块；又用峻药
通之，两目如帛所蔽。余曰∶脾为诸阴之首，目为血脉之宗，此脾伤五脏皆为失所，不能
归于目也。遂用补中益气、《济生》归脾二汤，专主脾胃，年余而愈。松江太守何恭人，性
善怒，腹结一块，年余上 蚀透，血气虚极，时季冬肝脉洪数，按之弦紧。或用伐肝木、清
胃火之药。余曰∶真气虚而邪气实也，恐伐肝木至春不能发生耳。用八珍汤以生气血，用
地黄丸以滋肾水，肝脉顿退。因大怒耳内出血，肝脉仍大，烦热作渴，此无根之火也。仍
以前药加肉桂二剂，脉敛热退。复因大怒，果卒于季冬辛巳日，乃金克木故也。
〔通治诸积〕
顺气丸 （《简易》）治三十六种风，七十二般气，去上热下冷，腰脚疼痛，四肢困倦，减
食羸瘦，颜色赤黄，恶疮下疰，口苦无味，憎寒毛耸， 癖气块，男子世事断绝，女子久
无子息，久患疟痢，发成劳疾，百节酸疼。自婴孩至百岁老人皆可服，疏风顺气，补精驻
颜。
锦纹大黄（五两，一半生用，一半湿纸里煨） 车前子（二两半） 白槟榔（二两）
火麻子仁（微炒赤，退壳，取二两净，另研入） 川牛膝（酒浸三夕） 郁李仁（泡去皮，另研）
山药 菟丝子（酒蒸研焙，各二两） 山茱萸肉 防风 枳壳（麸炒） 独活（各一两）
上为细末，炼蜜丸如梧子大，茶清粥饮下二十丸，百无所忌，空心临卧服，一月消
食，二月去肠内宿滞，三月无倦少睡，四月精神强盛，五月耳目聪明，六月腰脚轻健，一
年消百病。如服药脏腑微动，以羊肚肺羹补之。
胜红丸 （《简易》）治脾积气滞，胸膈满闷，气促不安，呕吐清水，丈夫酒积，女人脾血
积气，小儿食积。
陈皮 青皮 京三菱 莪术（二味同醋煮） 干姜（炮） 良姜（炒，各一两）
香附子（净炒，各二两） 一方加神曲、麦芽。
上为末醋糊丸如梧子大，每服三十丸，姜
汤下。虚者宜以补药下之。
香棱丸 （《济生》）治一切积聚。破痰癖，消 块。
木香 丁香（各半两） 三棱（酒浸一夕） 枳壳（麸炒） 莪术（细锉，每一两，用巴豆三十粒
去壳同炒，待巴豆黄色，去巴豆不用） 青皮（制） 川楝子肉（炒） 香（炒，各等分）
上末之，醋煮面糊，丸如梧桐子大，朱砂为衣，每三十丸，姜盐汤或温酒下，无时。
大消石丸 治七 八瘕，聚结杯块，及妇人带下绝产，腹中有 瘕者，当先下此药，
但去 瘕，令人不困。
消石（三两） 大黄（四两） 人参 甘草（各一两）
上为末，以三年苦酒三升，置铜石器中，先纳大黄微火熬微沸，常搅不息，至七分，纳
余药，复熬成膏，至可丸即丸如梧桐子大，每服三十丸，米饮下，三日服。妇人服之，或
下如鸡肝，或如米泔、赤黑等物二三升，后忌风冷。
阿魏膏 治一切痞块。
羌活 独活 玄参 官桂 赤芍药 穿山甲 生地黄 两头尖 大黄 白芷 天麻
（各五钱） 槐、柳、桃枝（各三钱） 红花（四钱） 木鳖子（十枚，去壳） 乱发（一团，如鸡子大）
上用香油二斤四两，煎黑去渣，入发煎，发化，仍去渣，徐下黄丹，煎软硬得中，入
芒硝、阿魏、苏合油、乳香、没药各五钱，麝香三钱，调匀即成膏矣。摊贴患处。黄丹须
用真正者方效。凡贴膏药，先用朴硝随患处铺平半指浓，以纸盖，用热熨斗熨良久，如
硝耗再加，熨之二时许，方贴膏药。
〔八瘕〕
《病源》曰∶八瘕者，皆胞胎生产、月水往来、血脉精气不调之所生也。肾为阴主开
闭，左为胞门，上为子户，主定月水，生子之道，胞门子户，主子精神气所出入，合于
中黄门、玉门四边，主持关元，禁闭子精。脐下三寸，名曰关元，主藏魂魄，妇人之胞，三
焦之府，常所从止。然妇人经脉俞络合调，则月水以时来至，故能生子而无病。妇人荣卫
经络断绝不通，邪气便得往来，入合于脏，若经血未尽，而合阴阳，即令妇人血脉挛急，
小腹重急支满，胸胁腰背相引，四肢酸痛，饮食不调，结牢恶血不除，月水不时，或月前
月后，因生积聚，如怀胎状。邪气甚盛者，令人恍惚多梦，寒热，四肢不欲动，阴中生气，
肿内生风，甚者小便不利，苦痛如淋状，面目黄黑，岁月久即不复生子也。
薛氏曰∶经云∶气主嘘之，血主濡之。若血不流则凝而为瘕也。瘕者中虽硬而忽聚忽
散，多因六淫七情，饮食起居，动伤脏腑而成，当与 癖诸证治同，慎勿复伤元气。
〔黄瘕〕者，妇人月水始下，若新伤堕血气未止，卧寝未定，五脏六腑虚羸，精神不
足，因向大风便利，阴阳开阖，关节四远中于风湿，气从下上，入于阴中，稽留不去，名
为阴虚，则生黄瘕。黄瘕之聚，令人苦四肢寒热，身重淋露，卧不欲食，左胁下有气结
牢，不可得抑，若腰背相引痛，月水不利，令人不产，小腹急，下引阴中如刺，不得小便，
或时寒热，下赤黄汁，令人无子。当刺开元、气冲，行以毒药，瘕下即愈。
皂荚散 （《圣惠》）疗黄瘕导方。
皂荚（一两，炙，去皮子） 蜀椒（一两，去汗） 细辛（一两半）
上捣散，以三角囊大如指，长二寸，贮之，纳阴中，欲便，闷则出之，已则复纳之。
恶血华出，乃洗以温汤，三日勿近男子，忌生菜等。
〔青瘕〕者，妇人新产，未满十日起行，以浣洗太早，阴阳虚，玉门四边皆解散，子
户未安，骨肉皆痛，手臂不举，饮食未复，五内吸吸，又当风卧不自隐蔽，若居湿席，令
人苦寒洒洒入腹，烦闷沉淖，恶血不除，结热不得散，则生青瘕。瘕聚在左右胁下，藏
于背膂，上与肩胛，腰下挛急，腹下有气起，
喜唾，不可多食，四肢不欲动摇，手足肿，面目黄，大小便难，其后月水为之不通利，或
不复禁，状如崩中，此自过所致，令人少子。疗之当刺胃管，行以毒药有法，瘕当下即愈。
疗青瘕导药方
戎盐（一升） 皂荚（半两，去皮子，炙） 细辛（一两）
上捣散，以三角囊大如指，长三寸，贮之，纳阴中，但卧，瘕当下，青如葵汁。养
之如产法。
〔燥瘕〕者，妇人月水下恶血未尽，其人虚惫，而以夏月热行疾步，若举重移轻，汗
出交流，气血未平，而卒以恚怒，致腹中猥咽不泄，经脉挛急，内结不舒，烦懑少力，气
上达胸膈背膂，少腹壅急，月水与气俱不通利，而反以饮清水快心，月水横流，溢入
他脏不去，有热则生燥瘕之聚，大如半杯，上下腹中苦痛，还两胁下，上引心而烦，害饮
食欲呕吐，胸及腹中不得太息，腰背重，喜卧盗汗，足酸削久立而痛，小便失时，忽然
自出，若失精，月水闭塞，大便涩难，病如此者，其人少子。疗之以长针，按而刺之法
度，行以毒药，瘕当下即愈。
疗燥瘕方（《圣惠》）
大黄（如鸡子许） 干姜（各二两） 黄连（三两） 鸡 中黄膜（一枚，炙） 桂心（一尺）
虫（三枚，熬） 浓朴（十颗，炙） 郁李仁（一两，去皮尖，熬）
上捣散，早朝空腹，以温酒一盏，和三钱顿服，瘕当下，毕，养之如产妇法，三月
勿合阴阳，无子者当有。
〔血瘕〕者，妇人月水新下，未满日数而中止，因饮食过度，五谷气盛，溢入他脏，若
大饥寒吸吸不足，呼吸未调，而自劳动，血下未定，左右走肠胃之间，留络不去，内有
寒热，与月水合会，为血瘕之聚，令人腰痛不可以俯仰，横骨下有积气，牢如石，少腹
里急苦痛，背膂疼深达腰腹，下挛阴里，若生风冷，子门僻，月水不时，乍来乍不来，此
病令人无子。疗之瘕当下，即愈。
疗妇人血瘕痛方（《圣惠》）
干姜 乌贼鱼骨（各一两，炙） 桃仁（一两，去皮尖）
上捣散，酒服二方寸匕，日二。一方无桃仁。
古代医方中有五积、六聚、七 、八瘕的名称。五脏之气积聚，称为“积”，所以积有五种。六腑之气聚结，称为“聚”，所以聚有六种。《杂病准绳》中对此论述得非常详细。至于七 和八瘕，则多见于妇女。七为数之属火，对应心脏，因为血液由心所生。八为数之属木，对应肝脏，因为血液归于肝。虽然说是强行区分，但道理似乎并不混杂。“ ”是指坚硬，坚硬则难以攻破。“瘕”是指假象，借助外物形成形状。古人将妇女的疾病视为顽固疾病，认为蛟龙等生物形成了“瘕”，但这也不必如此拘泥固执。妇女的瘕证，都属于血分病变，龙、蛇、鱼、鳖、肉、头发、虱子形成的瘕等情况，都是偶然发生的。只是在饮食间误食了这些东西，停留在腹脏之中，借由血液而成形，自有活性，也就像永徽年间有个僧人患噎膈病，腹中有一个物体，形状像鱼，这就是生瘕。这与宿血停滞凝结，结成痞块，虽然内外感受的原因不同，但治疗方法应当归类进行，这就是所谓医者的心意（灵活变通）。比如用败梳治疗虱瘕，用铜屑治疗龙瘕，用曲 （发酵物）治疗米瘕，用锻石（烧红的铁淬水后的氧化物）治疗酒瘕，这类方法，学习的人可以由此理解。《大全良方》将 癖诸气、疝瘕、八瘕、腹中瘀血、 痞、食 、血 分为七个门类。“ ”是指在腹内靠近肚脐左右各有一条筋脉紧急疼痛，大的像手臂，小的像手指，因气而成，像琴弦一样，所以叫作“ ”。“癖”是指偏居在两肋之间，有时疼痛，所以叫作“癖”。“疝”是疼痛的意思，“瘕”是假的意思，其结聚浮泛虚假且疼痛，推动它才会移动。“八瘕”包括：黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、鳖瘕。“积”在腹内，或在肠胃之间，与脏气结搏坚牢，虽然推动它也不移动，名叫“ ”，是说它的病形可以征验证实。气壅塞不通叫做“痞”，是说气机痞塞不宣畅。伤食成块，坚硬而不移动，名叫“食 ”。瘀血成块，坚硬而不移动，名叫“血 ”。至于腹中瘀血，则是积聚但未坚硬，尚未到结成块状的程度。大抵以推动不动为“ ”，推动能动为“瘕”。至于疝与 癖，则伴随疼痛出现，痛时就显现，不痛就隐没。在脐左上方的为“ ”，在两肋之间的为“癖”，在小腹部并牵引腰胁的为“疝”。恐怕学习者一时难以明了，难免混淆滥竽充数，所以总括叙述并条分缕析地解释。
张戴人经过谯地，遇到一个士兵，说出休妻的事。戴人问其原因，士兵回答说：“我妻子还是处女时，心下有一冷积，像倒扣的杯子，按压时有水声，用热手熨烫感觉像冰一样，娶来已经十五年了，担心断绝我的后代，所以抛弃了她。”戴人说：“您不要休弃她，如果用我的药，病可以除去，孩子也可以得到。”士兵听从了他。戴人诊察她的脉象，沉而迟，尺脉洪大而有力，不是不能生育的征候，可以不出一年就怀孕。她的丈夫笑着说：“试试看。”先用三圣散催吐涎液一斗，心下变得平软，接着服用白术调中汤、五苓散，后来用四物汤调和气血，不到一个月气血调和适度，几个月后怀了双生子。戴人曾经说：“用我这个方法，没有不能生育的妇女。”这话是不虚假的。（三圣散使用防风、瓜蒂各三两，藜芦一两，研成粗末，用腌菜汁煎服。制作煎法，详见《儒门事亲》。白术调中汤使用白术、茯苓、泽泻、橘红各半两，甘草一两、干姜、官桂、砂仁、藿香各二钱半，研成末，用开水化开蜂蜜调服二钱，不限时间。五苓散见伤寒渴门。）阳夏县张主簿的妻子，患肥气病，起初像酒杯大小，发作寒热十五六年，后来因为性情急躁悲伤感慨，病情更加严重，只有心下三指宽的地方没有病，满腹像石板片一样，不能坐卧，针灸遍了，只是让人徒劳罢了。于是邀请戴人诊治说：“这是肥气病。”得病于季夏戊己日，在左胁下像倒扣的杯子，久治不愈，使人发疟疾。用瓜蒂散催吐鱼腥黄涎约一二升，到了晚上继用舟车丸、通经散投服，五更时分黄涎脓水相半五六次，凡是积聚的地方都感到疼痛，后来用白术散、当归散调和血流经络的药物，像这样涌吐泄下共三四次才痊愈。（瓜蒂散、舟车丸，方剂见杂病伤食、痰饮二门。通经散使用橘红、当归、甘遂，用面包裹不让透水，煮一百多沸，用冷水浸过，去掉面晒干，三味各等分为细末，每服三钱，临睡前温淡酒调下。白术散，白术、黄芩、当归各等分为末，每服二三钱，水煎，饭前服。当归散，当归、杜蒺藜等分为末，米饮调服，饭前。这是吐下兼施的方法，而且甘遂等逐水药太峻猛，使用者要审慎。）薛新甫说：妇女 癖 瘕，大抵因为饮食起居、七情失宜，亏损脏腑，气血乖违，阴络受伤，循行失度所致。罗谦甫说：保养正气积自除，必须先调养，使营卫充实，如果不消散，才可以讨论攻下。但如果去除它不循序渐进，则必然有颠覆的危害，如果不遵守禁忌，放纵情欲，能不丧身的很少了。
一个妇人内热口渴，饮食少思，腹内起初像鸡蛋，逐渐大四寸左右，月经三个月来一次，肢体消瘦，齿颊像疮疡，脉洪数而虚，左关尤其明显。这是肝脾郁结的证候，外贴阿魏膏，午前用补中益气汤，午后用加味归脾汤，两个月左右，肝火稍退，脾土稍微强健，午前补中益气汤送服六味丸，午后逍遥散送服归脾丸，又过了一个多月，每天用芦荟丸二服，空心时用逍遥散送服，傍晚时用归脾汤送服。庆幸她谨慎治病，调理了一年多才痊愈。一个妇人腹内有一块，不时向上攻冲，有时疼痛有声，有时吞酸痞闷，月经不调，小便不利，两年多了，面色青黄。我认为这是肝脾气滞，用六君子汤加川芎、当归、柴胡、炒黄连、木香、吴茱萸各少许，两剂后，却用归脾汤送服芦荟丸。三个多月后，肝脾调和而诸证消退，又给予调中益气汤加茯苓、牡丹皮，中气健旺而月经自然调顺。
一个妇人性情多郁易怒，勤于女工，小腹内结成一塊，有时疼痛，有时痞闷，月经不调，严格服用伐肝的药物，导致内热寒热，胸膈不利，饮食不甘，形体日渐消瘦，牙龈蚀烂。这是脾土不能生肺金，肺金不能生肾水，肾水不能生肝木，应当滋生化源。用补中益气汤、六味丸，到仲春时节痊愈。一个妇人月经过期，发热倦怠，有人用四物汤、黄连之类，反而两个月来一次，而且量少而成块；又用峻猛药物通利，导致两眼像被布遮住一样模糊。我说：“脾为诸阴之首，目为血脉之宗，这是脾伤五脏都失去所养，不能上注于目。”于是用补中益气汤、《济生》归脾汤二方，专主脾胃，一年多才痊愈。松江太守何恭人，性情易怒，腹结一块，一年多后向上侵蚀穿透，血气虚极，当时是季冬肝脉洪数，按之弦紧。有人用伐肝木、清胃火的药。我说：“真气虚而邪气实，恐怕伐肝木到春天不能发生生机。”用八珍汤以生气血，用地黄丸以滋肾水，肝脉顿时减退。因为大怒耳内出血，肝脉仍然大，烦热口渴，这是无根之火。仍用前面的药加肉桂两剂，脉收敛热退。又因为大怒，果然在季冬辛巳日去世，这是金克木的缘故。
〔通治诸积〕
顺气丸（出自《简易》）治疗三十六种风，七十二般气，去除上热下冷，腰脚疼痛，四肢困倦，食欲减退身体瘦弱，颜色赤黄，恶疮下疰，口苦无味，憎寒毛耸， 癖气块，男子世事断绝，女子久无子息，久患疟痢，发成劳疾，百节酸疼。从婴孩到百岁老人都可服用，疏风顺气，补精驻颜。
锦纹大黄（五两，一半生用，一半湿纸里煨） 车前子（二两半） 白槟榔（二两） 火麻子仁（微炒赤，退壳，取二两净，另研入） 川牛膝（酒浸三夕） 郁李仁（泡去皮，另研） 山药 菟丝子（酒蒸研焙，各二两） 山茱萸肉 防风 枳壳（麸炒） 独活（各一两）
以上研为细末，炼蜜丸如梧桐子大，茶清或粥饮送下二十丸，百无所忌，空心及临卧时服用，一个月消除食积，两个月去除肠内宿滞，三个月没有疲倦少睡，四个月精神强盛，五个月耳目聪明，六个月腰脚轻健，一年消除百病。如果服药后脏腑微动，用羊肚肺羹补益。
胜红丸（出自《简易》）治疗脾积气滞，胸膈满闷，气促不安，呕吐清水，丈夫酒积，女人脾血积气，小儿食积。
陈皮 青皮 京三菱 莪术（二味同醋煮） 干姜（炮） 良姜（炒，各一两） 香附子（净炒，各二两） 一方加神曲、麦芽。
以上研为末，醋糊丸如梧桐子大，每服三十丸，姜汤送下。虚者宜用补药送下。
香棱丸（出自《济生》）治疗一切积聚。破痰癖，消 块。
木香 丁香（各半两） 三棱（酒浸一夕） 枳壳（麸炒） 莪术（细锉，每一两，用巴豆三十粒去壳同炒，待巴豆黄色，去巴豆不用） 青皮（制） 川楝子肉（炒） 木香（炒，各等分）
以上研末，醋煮面糊，丸如梧桐子大，朱砂为衣，每三十丸，姜盐汤或温酒送下，不限时间。
大消石丸 治疗七 八瘕，聚结杯块，及妇人带下绝产，腹中有 瘕者，应当先下此药，但去 瘕，使人不困顿。
消石（三两） 大黄（四两） 人参 甘草（各一两）
以上研为末，用三年陈醋三升，放在铜石器中，先放入大黄微火熬至微沸，常搅不停，至剩七分，放入其余药物，再熬成膏，至可丸即丸如梧桐子大，每服三十丸，米饮送下，三日服一次。妇人服用，或排出像鸡肝，或像米泔水、赤黑等物二三升，之后忌风冷。
阿魏膏 治疗一切痞块。
羌活 独活 玄参 官桂 赤芍药 穿山甲 生地黄 两头尖 大黄 白芷 天麻（各五钱） 槐、柳、桃枝（各三钱） 红花（四钱） 木鳖子（十枚，去壳） 乱发（一团，如鸡子大）
以上用香油二斤四两，煎至黑色去渣，放入头发煎，头发化掉，再去渣，慢慢加入黄丹，煎至软硬适中，加入芒硝、阿魏、苏合油、乳香、没药各五钱，麝香三钱，调匀即成膏。摊贴患处。黄丹必须用真正的才有效。凡贴膏药，先用朴硝随患处铺平半指厚，用纸盖住，用热熨斗熨很久，如果硝消耗再加，熨两个多小时，才贴膏药。
〔八瘕〕
《病源》说：八瘕，都是胞胎生产、月水往来、血脉精气不调所生成的。肾为阴主开闭，左为胞门，上为子户，主管定月水，生子之道，胞门子户，主管子精神气所出入，合于中黄门、玉门四边，主持关元，禁闭子精。脐下三寸，名叫关元，主管藏魂魄，妇人之胞，是三焦之府，常所从止。然而妇人经脉俞络合调，则月水按时来至，所以能生子而无病。妇人荣卫经络断绝不通，邪气便得往来，入合于脏，如果经血未尽，而行阴阳之事，即使妇人血脉挛急，小腹重急支满，胸胁腰背相引，四肢酸痛，饮食不调，结牢恶血不除，月水不时，或月前月后，因而生成积聚，像怀胎状。邪气很盛的，令人恍惚多梦，寒热，四肢不想动，阴中生风气，肿内生风，严重的甚至小便不利，痛苦像淋证状，面目黄黑，岁月久了就不再能生子了。
薛氏说：经云：气主嘘之，血主濡之。如果血不流则凝而为瘕。瘕是中虽硬而忽聚忽散，多因六淫七情，饮食起居，动伤脏腑而成，应当与 癖诸证治疗相同，千万不要再损伤元气。
〔黄瘕〕：妇人月水刚下，如果新伤堕血气未止，卧寝未定，五脏六腑虚羸，精神不足，因而向大风便利，阴阳开阖，关节四远中于风湿，气从下上，入于阴中，稽留不去，名叫阴虚，则生黄瘕。黄瘕之聚，令人苦四肢寒热，身重淋露，卧不欲食，左胁下有气结牢，不可得抑，如果腰背相引痛，月水不利，令人不产，小腹急，下引阴中如刺，不得小便，或时寒热，下赤黄汁，令人无子。应当刺开元、气冲穴，行以毒药，瘕下即愈。
皂荚散（出自《圣惠》）治疗黄瘕导方。
皂荚（一两，炙，去皮子） 蜀椒（一两，去汗） 细辛（一两半）
以上捣散，用三角囊大如指，长二寸，贮之，纳入阴中，想解大小便时，闷则取出，好了再纳入。恶血华出，然后用温水清洗，三天不要接近男子，忌生菜等。
〔青瘕〕：妇人新产，未满十天起身行走，浣洗太早，阴阳虚，玉门四边皆解散，子户未安，骨肉皆痛，手臂不举，饮食未复，五内吸吸，又当风卧不自隐蔽，如果居湿席，令人苦寒洒洒入腹，烦闷沉淖，恶血不除，结热不得散，则生青瘕。瘕聚在左右胁下，藏于背膂，上与肩胛，腰下挛急，腹下有气起，喜唾，不可多食，四肢不欲动摇，手足肿，面目黄，大小便难，其后月水为之不通利，或不再禁固，状如崩中，这是自己过错所致，令人少子。治疗应当刺胃管穴，行以毒药有法，瘕当下即愈。
疗青瘕导药方
戎盐（一升） 皂荚（半两，去皮子，炙） 细辛（一两）
以上捣散，用三角囊大如指，长三寸，贮之，纳入阴中，只要躺着，瘕当下，青色像葵汁。养护像产后法。
〔燥瘕〕：妇人月水下恶血未尽，其人虚惫，而以夏月热行疾步，如果举重移轻，汗出交流，气血未平，而突然恚怒，致腹中猥咽不泄，经脉挛急，内结不舒，烦懑少力，气上达胸膈背膂，少腹壅急，月水与气俱不通利，反而饮清水快心，月水横流，溢入他脏不去，有热则生燥瘕之聚，大如半杯，上下腹中苦痛，还两胁下，上引心而烦，害饮食欲呕吐，胸及腹中不得太息，腰背重，喜卧盗汗，足酸削久立而痛，小便失时，忽然自出，像失精，月水闭塞，大便涩难，病像这样的，其人少子。治疗用长针，按而刺的法度，行以毒药，瘕当下即愈。
疗燥瘕方（出自《圣惠》）
大黄（如鸡子许） 干姜（各二两） 黄连（三两） 鸡 中黄膜（一枚，炙） 桂心（一尺） 虫（三枚，熬） 浓朴（十颗，炙） 郁李仁（一两，去皮尖，熬）
以上捣散，早朝空腹，用温酒一盏，和三钱顿服，瘕当下，毕，养护像产妇法，三个月不要合阴阳，无子的应当会有。
〔血瘕〕：妇人月水新下，未满日数而中止，因饮食过度，五谷气盛，溢入他脏，如果大饥寒吸吸不足，呼吸未调，而自己劳动，血下未定，左右走肠胃之间，留络不去，内有寒热，与月水合会，为血瘕之聚，令人腰痛不可以俯仰，横骨下有积气，牢如石，少腹里急苦痛，背膂疼深达腰腹，下挛阴里，如果生风冷，子门僻，月水不时，乍来乍不来，这病令人无子。治疗瘕当下，即愈。
疗妇人血瘕痛方（出自《圣惠》）
干姜 乌贼鱼骨（各一两，炙） 桃仁（一两，去皮尖）
以上捣散，酒服二方寸匕，日二。一方无桃仁。
Ancient prescriptions include the names of Five Accumulations (Wu Ji), Six Gatherings (Liu Ju), Seven [Pi], and Eight Lei. The accumulation of Qi in the five Zang organs is called "Ji" (Accumulation), hence there are five types of Ji. The gathering of Qi in the six Fu organs is called "Ju" (Gathering), hence there are six types of Ju. This has been discussed in detail in *Za Bing Zhun Sheng*. As for the seven [Pi] and eight Lei, they occur mostly in women. The number seven belongs to Fire and corresponds to the Heart, because Blood is generated by the Heart. The number eight belongs to Wood and corresponds to the Liver, because Blood returns to the Liver. Although this is a forced distinction, the principles seem not to be mixed up. "[Pi]" refers to hardness; hard things are difficult to break. "Lei" refers to something false or temporary; it takes shape by borrowing external matter. The ancients regarded women's diseases as stubborn illnesses, believing that dragons and other creatures formed Lei, but one need not be so rigid in interpretation. Women's Lei syndromes all belong to Blood pathologies. Cases of Lei formed by dragons, snakes, fish, turtles, meat, hair, or lice are accidental occurrences. They are merely ingested by mistake during eating, remain stagnant in the abdominal viscera, take form through Blood, and possess their own vitality. This is similar to a monk in the Yonghui era who suffered from dysphagia; there was an object in his abdomen shaped like a fish, which constituted a Lei. Although the causes of internal and external contraction differ from stagnant blood coagulating into masses, the treatment methods should follow similar principles. This is what is meant by "the physician's intent." For example, using a worn comb to treat Lice Lei, copper filings to treat Dragon Lei, fermented grain starter to treat Rice Lei, and calcined iron oxide (Duan Shi) to treat Wine Lei. Such categories can be understood by students. *Da Quan Liang Fang* categorizes Pi Qi syndromes, Shan Lei, Eight Lei, intra-abdominal Stasis Blood, Pi Obstruction, Food Stagnation, and Blood Stagnation into seven sections. "[Pi]" refers to a tendon-like vessel on either side of the navel that becomes tense and painful; the larger ones are arm-thick, the smaller finger-thick. Formed by Qi, resembling a string, it is named "[Pi]." "Pian" (Partiality) refers to pain located between the two hypochondria, occurring intermittently, hence named "Pian." "Shan" means pain; "Lei" means false. Its aggregation is floating and false with pain, moving only when pushed. The "Eight Lei" include: Yellow Lei, Green Lei, Dry Lei, Blood Lei, Fat Lei, Fox Lei, Snake Lei, and Turtle Lei. "Ji" is within the abdomen, either between the intestines and stomach, knotting firmly with Zang Qi. Even if pushed, it does not move, hence named "[Pi]," indicating its pathological form can be verified. Qi stagnation and obstruction is called "Pi," meaning Qi is blocked and not flowing smoothly. Food injury forming a mass, hard and immovable, is named "Food [Pi]." Stasis blood forming a mass, hard and immovable, is named "Blood [Pi]." Intra-abdominal stasis blood, however, is accumulated but not yet hard, not yet formed into a distinct mass. Generally, immovable upon pushing is "[Pi]," movable upon pushing is "Lei." As for Shan and Pian, they appear with pain; present when painful, hidden when painless. Located above the left of the navel is "[Pi]," between the hypochondria is "Pian," in the lower abdomen radiating to the waist and flanks is "Shan." To prevent students from being confused due to difficulty in understanding at once, I summarize and analyze them item by item.
When Zhang Dairen passed Qiao, he met a soldier who spoke of divorcing his wife. Dairen asked the reason. The soldier replied, "When my wife was a maiden, she had a cold accumulation under the heart like an inverted cup. Pressing it produced a sound like water; warming it with hot hands felt like ice. We have been married for fifteen years. I fear it will cut off my lineage, so I divorced her." Dairen said, "Do not dismiss her. If you use my medicine, the disease can be cured, and pregnancy obtained." The soldier agreed. Dairen palpated her pulse: deep and slow, but the Chi position was surging, large, and forceful, which is not a sign of infertility. She could conceive within a year. Her husband laughed and said, "Let us try." First, San Sheng San (Three Holy Powders) was used to induce vomiting of one dou of saliva/phlegm, making the area under the heart flat and soft. Then, Bai Zhu Tiao Zhong Tang (Atractylodes Macrocephala Decoction for Regulating the Middle) and Wu Ling San (Five-Ingredient Powder with Poria) were administered. Later, Si Wu Tang (Four Substance Decoction) was used to harmonize Qi and Blood. Within a month, Qi and Blood were balanced. Within several months, she conceived twins. Dairen once said, "Using this method, there are no women who cannot bear children." This statement is not false. (San Sheng San uses Fang Feng, Gua Di each 3 liang, and Li Lu 1 liang, ground into coarse powder, decocted in brine juice. Preparation details are in *Ru Men Shi Qin*. Bai Zhu Tiao Zhong Tang uses Bai Zhu, Fu Ling, Ze Xie, Ju Hong each 0.5 liang, Gan Cao 1 liang, Gan Jiang, Guan Gui, Sha Ren, Huo Xiang each 2.5 qian, ground into powder, taken with warm honey-water, 2 qian per dose, anytime. Wu Ling San is seen in the Cold Damage Thirst section.) The wife of Magistrate Zhang of Yangxia suffered from Fei Qi (Fat Qi). Initially the size of a wine cup, she experienced chills and fever for over fifteen years. Later, due to irritability and grief, the condition worsened. Only an area three fingers wide under the heart was free of disease; the rest of the abdomen was hard as a stone slab, preventing sitting or lying down. Acupuncture and moxibustion had been tried everywhere, to no avail. Dairen was invited to diagnose and said, "This is Fei Qi." It originated on a Wuyi day in late summer, located under the left hypochondrium like an inverted cup. Long-standing and untreated, it causes malaria. He used Gua Di San (Melon Seed Powder) to vomit out about one or two sheng of fishy yellow phlegm. That night, Zhou Che Wan (Boat and Cart Pill) and Tong Jing San (Unblocking Collaterals Powder) were administered. At dawn, five to six stools of half-yellow-phlegm and half-pus occurred. All areas of accumulation felt painful. Subsequently, Bai Zhu San and Dang Gui San were used to harmonize blood flow and collaterals. After three or four such emetic and purgative treatments, she recovered. (Gua Di San and Zhou Che Wan formulas are in the Food Injury and Phlegm-Fluid sections. Tong Jing San uses Ju Hong, Dang Gui, and Gan Sui wrapped in dough to prevent water penetration, boiled for over a hundred boils, soaked in cold water, dried, removed from dough, ground equally fine. Take 3 qian before bed with warm light wine. Bai Zhu San uses equal parts Bai Zhu, Huang Qin, Dang Gui, ground. Take 2-3 qian decocted in water before meals. Dang Gui San uses equal parts Dang Gui and Ji Li, taken with rice drink before meals. This combines emesis and purgation. Gan Sui is too harsh for water-draining; users must be cautious.) Xue Xinpu stated: Women's Pian and Lei syndromes are generally caused by improper diet, lifestyle, and emotional disturbances, damaging the Zang-Fu organs, causing Qi and Blood disharmony, injuring Yin collaterals, and disrupting circulation. Luo Qianfu stated: Nourish the righteous Qi, and the accumulation will remove itself. One must first nourish and regulate, ensuring Ying and Wei are sufficient. Only if it does not dissipate should one consider purgation. However, removing it without gradual steps will surely cause collapse. If taboos are not observed and desires indulged, few will avoid death.
One woman suffered from internal heat and thirst, poor appetite. Initially, an egg-sized mass appeared in the abdomen, gradually growing to four cun. Menstruation occurred every three months. Limbs wasted, teeth and cheeks resembled ulcers. Pulse was surging, rapid, and deficient, especially at the Left Guan position. This was a Liver-Spleen Qi stagnation syndrome. External application of A Wei Gao (Asafoetida Plaster) was used. In the morning, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was given. In the afternoon, Jia Wei Gui Pi Tang (Augmented Return the Spleen Decoction with Gardenia and Moutan) was given. After about two months, Liver fire subsided slightly, and Spleen earth strengthened. Morning: Bu Zhong Yi Qi Tang with Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia). Afternoon: Xiao Yao San (Free and Easy Wanderer Powder) with Gui Pi Wan. Another month later, daily: Lu Hui Wan (Aloe Pill), 2 doses. Empty stomach: Xiao Yao San. Evening: Gui Pi Tang. Fortunately, she was diligent in health care. After more than a year of regulation, she recovered.
Another woman had a mass in the abdomen that occasionally attacked upwards, sometimes producing pain with sounds, acid regurgitation, and fullness. Menstruation was irregular, urination difficult. This lasted over two years. Complexion was greenish-yellow. I diagnosed Liver-Spleen Qi stagnation. Liu Jun Zi Tang (Six-Gentlemen Decoction) plus Chuan Xiong, Dang Gui, Chai Hu, fried Lian Su, Mu Xiang, and Wu Zhu Yu was given for two doses. Then, Gui Pi Tang was used to deliver Lu Hui Wan. After three months, Liver and Spleen harmonized, symptoms receded. Then, Tiao Zhong Yi Qi Tang plus Fu Ling and Mu Dan Pi was given. Middle Qi strengthened, menstruation regulated naturally.
A woman prone to depression and anger, diligent in needlework, had a mass in the lower abdomen, causing pain or fullness, irregular menstruation. She strictly took Liver-suppressing drugs, leading to internal heat, alternating chills and fever, chest oppression, poor taste in food, and wasting. Gums eroded. This indicated Spleen Earth failing to generate Lung Metal, Lung Metal failing to generate Kidney Water, and Kidney Water failing to generate Liver Wood. The source of transformation should be nourished. Bu Zhong Yi Qi Tang and Liu Wei Di Huang Wan were used. She recovered by mid-spring.
A woman had delayed menstruation, fever, and fatigue. Someone used Si Wu Tang and Huang Lian, resulting in menstruation occurring only once every two months, scanty and clotted. Strong purgatives were then used to unblock, causing vision obscured as if by cloth. I said, "The Spleen is the head of all Yin; the eyes are the congregation of Blood vessels. This indicates Spleen damage, causing all five Zang organs to lose their support, unable to nourish the eyes." Bu Zhong Yi Qi Tang and *Ji Sheng* Gui Pi Tang were used, focusing solely on the Spleen and Stomach. She recovered after more than a year.
He Gongren, Prefect of Songjiang, was prone to anger, had an abdominal mass. Over a year, it eroded upwards and penetrated. Qi and Blood were extremely deficient. In late winter, the Liver pulse was surging and rapid, wiry and tight upon pressure. Someone used Liver-suppressing and Stomach-fire-clearing herbs. I said, "True Qi is deficient, evil Qi is excess. Suppressing Liver Wood may prevent spring generation." Ba Zhen Tang (Eight-Treasure Decoction) was used to generate Qi and Blood; Di Huang Wan (Rehmannia Pill) to nourish Kidney Water. The Liver pulse immediately subsided. Due to great anger, ear bleeding occurred; the Liver pulse remained large, with vexation, heat, and thirst—this was rootless fire. The previous formula plus Rou Gui (Cinnamon Bark) for two doses constricted the pulse and reduced heat. Again due to anger, she died on a Xin Si day in late winter. This was Metal overcoming Wood.
[General Treatment for Various Accumulations]
Shun Qi Wan (Smooth Qi Pill) (*Jian Yi*) treats thirty-six types of Wind and seventy-two types of Qi. Removes upper heat and lower cold, waist and leg pain, limb fatigue, reduced appetite and emaciation, red-yellow complexion, malignant sores and dripping sores, bitter taste and loss of taste, aversion to cold with piloerection, Pian masses, men's sexual impotence, women's long-term infertility, chronic malaria and dysentery, labor disease, joint soreness. Suitable from infants to centenarians. Smooths wind and Qi, tonifies essence, preserves youth.
Jin Wen Da Huang (Brocade-pattern Rhubarb) (5 liang, half raw, half baked in wet paper) Che Qian Zi (Plantago Seeds) (2.5 liang) Bai Bin Lang (Areca Seed) (2 liang) Huo Ma Zi Ren (Hemp Seed) (2 liang net, lightly fried, husked, ground separately) Chuan Niu Xi (Cyathula Root) (soaked in wine for three nights) Yu Li Ren (Bush Cherry Seed) (soaked, skin removed, ground separately) Shan Yao (Dioscorea Rhizome) Tu Si Zi (Dodder Seed) (steamed in wine, ground, roasted, 2 liang each) Shan Zhu Yu (Cornus Fruit) Fang Feng (Saposhnikovia Root) Zhi Ke (Bitter Orange) (bran-fried) Du Huo (Angelica Pubescens) (1 liang each)
Grind into fine powder. Honey pills the size of mulberry seeds. Take 20 pills with tea clear or gruel. No restrictions. Take on empty stomach and before bed. One month eliminates food stagnation; two months removes intestinal old retention; three months reduces fatigue and insomnia; four months strengthens spirit; five months clarifies ears and eyes; six months lightens waist and legs; one year cures hundred diseases. If organs move slightly after medication, supplement with lamb lung soup.
Sheng Hong Wan (Victorious Red Pill) (*Jian Yi*) treats Spleen accumulation with Qi stagnation, chest fullness, shortness of breath, vomiting clear fluid, men's alcohol accumulation, women's Spleen-Blood accumulation, children's food stagnation.
Chen Pi (Tangerine Peel) Qing Pi (Green Tangerine Peel) Jing San Leng (Kadsura Rhizome) E Zhu (Curcuma Rhizome) (boiled together in vinegar) Gan Jiang (Dried Ginger) (parched) Liang Jiang (Alpinia Officinarum Rhizome) (fried, 1 liang each) Xiang Fu (Cyperus Rhizome) (cleaned, fried, 2 liang) Alternative adds Shen Qu (Medicated Leaven) and Mai Ya (Malt).
Grind into powder. Vinegar paste pills the size of mulberry seeds. Take 30 pills with ginger decoction. Deficient patients should take with tonic medicine.
Xiang Leng Wan (Fragrant Triangle Pill) (*Ji Sheng*) treats all accumulations and masses. Breaks Phlegm-Pian, eliminates [Pi] masses.
Mu Xiang (Costus Root) Ding Xiang (Clove) (0.5 liang each) San Leng (Kadsura Rhizome) (soaked in wine overnight) Zhi Ke (Bitter Orange) (bran-fried) E Zhu (Curcuma Rhizome) (finely chopped, for every 1 liang, stir-fry with 30 shell-less Ba Dou beans until beans turn yellow, discard beans) Qing Pi (Prepared Green Tangerine Peel) Chuan Lian Zi Rou (Toosendan Fruit Flesh) (fried) Mu Xiang (Fragrant Wood) (fried, equal parts)
Grind into powder. Vinegar-boiled wheat paste pills the size of mulberry seeds. Coated with Cinnabar. Take 30 pills with ginger-salt decoction or warm wine, anytime.
Da Xiao Shi Wan (Great Calcite Pill) Treats seven [Pi] and eight Lei, cup-shaped aggregations, women's leukorrhea and sterility, and intra-abdominal [Pi]-Lei. This medicine should be taken first to purge the [Pi]-Lei without exhausting the patient.
Xiao Shi (Calcite) (3 liang) Da Huang (Rhubarb) (4 liang) Ren Shen (Ginseng) Gan Cao (Licorice Root) (1 liang each)
Grind into powder. Use three sheng of three-year-old vinegar in a copper or ceramic vessel. Add Da Huang first, simmer gently until bubbling, stirring constantly until reduced to 7/10. Add remaining medicines, simmer into a paste. When pillable, form mulberry-seed-sized pills. Take 30 pills with rice drink, once every three days. Women taking it may pass chicken-liver-like substances, rice-water-like fluids, or dark red/black materials, 2-3 sheng. Avoid wind and cold afterwards.
A Wei Gao (Asafoetida Plaster) Treats all Pi masses.
Qiang Huo (Notopterygium Rhizome) Du Huo (Angelica Pubescens) Xuan Shen (Scrophularia Root) Guan Gui (Cassia Bark) Chi Shao Yao (Red Peony Root) Chuan Shan Jia (Pangolin Scale) Sheng Di Huang (Rehmannia Root) Liang Tou Jian (Lonicera Bractea) Da Huang (Rhubarb) Bai Zhi (Angelica Dahurica) Tian Ma (Gastrodia Rhizome) (5 qian each) Huai, Liu, Tao branches (3 qian each) Hong Hua (Safflower) (4 qian) Mu Bie Zi (Momordica Seed) (10 pieces, husked) Luan Fa (Human Hair) (one ball, egg-sized)
Fry in 2 jin 4 liang of sesame oil until black, strain. Add hair, fry until dissolved, strain again. Slowly add Huang Dan (Lead Monoxide), fry to medium consistency. Add Mang Xiao (Mirabilite), A Wei (Asafoetida), Su He You (Styrax Oil), Ru Xiang (Frankincense), Mo Yao (Myrrh) each 5 qian, She Xiang (Musk) 3 qian. Mix well to form plaster. Apply to affected area. Real Huang Dan is required for efficacy. Before applying plaster, spread Pu Xiao (Mirabilite) evenly over the area half-finger thick, cover with paper, apply hot iron for a long time. Replenish Pu Xiao as consumed. Iron for two hours before applying plaster.
[Eight Lei]
*Bing Yuan* states: Eight Lei are generated by issues in conception, childbirth, menstrual flow, and disharmony of blood vessels and essence. The Kidney governs Yin and opening/closing. The left is Bao Men (Womb Gate), the upper is Zi Hu (Child Chamber), governing menstrual timing and childbearing. Bao Men and Zi Hu manage the entry and exit of essence and spirit, connecting to Zhong Huang Men and Yu Men. They control Guan Yuan, sealing reproductive essence. Three cun below the navel is Guan Yuan, governing the storage of Hun and Po. The female womb is the mansion of the San Jiao (Triple Burner). When meridians and collaterals are harmonious, menstruation arrives on time, enabling childbearing without disease. If Ying and Wei meridians are blocked, evil Qi wanders in, combining with Zang organs. If intercourse occurs before menstrual blood is cleared, it causes blood vessel spasms, heavy and urgent lower abdomen, distension, radiating pain to chest, flanks, waist, back, and limbs, dietary irregularity, retained evil blood, irregular menstruation (early or late), leading to accumulations resembling pregnancy. Severe evil Qi causes hallucinations, dreams, chills and fever, limb inactivity, genital wind sensation, swelling, internal wind, severe urinary difficulty, pain like strangury, yellow-black complexion, and eventual sterility.
Xue stated: Classics say: Qi moistens, Blood nourishes. If Blood does not flow, it coagulates into Lei. Lei is hard inside but gathers and scatters intermittently. Mostly caused by Six Evils, Seven Emotions, diet, and lifestyle damaging Zang-Fu. Treatment should be same as Pian syndromes. Do not damage Righteous Qi.
[Yellow Lei]: When menstruation begins, if fresh trauma causes bleeding not to stop, and rest is insufficient, with Zang-Fu deficiency and lack of spirit, exposure to strong wind during bowel movements, opening and closing of Yin-Yang, joints distant from wind-damp invasion, Qi rises from below into the Yin, lingering there, named Yin Deficiency, generating Yellow Lei. Yellow Lei aggregation causes bitter cold and heat in limbs, heaviness, sweating, desire to lie down but no appetite, firm Qi knot under left hypochondrium, unrestrainable, radiating back pain, difficult menstruation, sterility, lower abdominal urgency, piercing pain in genitals, inability to urinate, intermittent chills, red-yellow discharge, sterility. Moxibustion/Acupuncture at Kai Yuan and Qi Chong points, administer toxic drugs. Lei passes, cure follows.
Zao Jiao San (Soap Pod Powder) (*Sheng Hui*) Guide formula for Yellow Lei.
Zao Jiao (Soap Pod) (1 liang, roasted, skin and seeds removed) Shu Jiao (Sichuan Pepper) (1 liang, sweat removed) Xi Xin (Asarum) (1.5 liang)
Grind into powder. Place in triangular bag, finger-sized, 2 cun long. Insert into vagina. Remove if stifling during urination/defecation, reinsert when done. Expel bad blood. Wash with warm water. Avoid men for three days. Avoid raw vegetables.
[Green Lei]: After childbirth, if walking starts before ten days, washing too early, Yin-Yang deficiency, Yu Men sides loosen, Zi Hu unstable, bones and flesh painful, arms unable to lift, diet not restored, internal consumption, sleeping exposed to wind or damp mats, cold enters abdomen, vexation, heaviness, bad blood not expelled, heat trapped, generating Green Lei. Lei aggregates in left/right hypochondria, stored in back, reaching shoulder blades, lower back spasms, Qi rising in lower abdomen, excessive salivation, inability to eat much, limbs unwilling to move, hand-foot swelling, yellow face, difficult urination/defecation, subsequent menstrual blockage or uncontrollable flooding like Beng Zhong. Caused by self-neglect, leading to few children. Treat by puncturing Wei Guan point, administering toxic drugs properly. Lei passes, cure follows.
Guide Formula for Green Lei
Rong Yan (Rock Salt) (1 sheng) Zao Jiao (Soap Pod) (0.5 liang, skin/seeds removed, roasted) Xi Xin (Asarum) (1 liang)
Grind into powder. Place in triangular bag, finger-sized, 3 cun long. Insert into vagina. Lie down. Lei passes, green like spinach juice. Nurture as postpartum method.
[Dry Lei]: When menstruation flows with incomplete expulsion of bad blood, person is weak, but walks fast in summer heat, lifts heavy objects, sweats profusely, Qi and Blood unsettled, sudden anger causes abdominal constriction without release, meridian spasms, internal knotting, vexation, weakness, Qi rising to chest/back, lower abdominal urgency, menstrual and Qi blockage, drinking cold water to soothe heart causes menstrual blood to flow sideways into other organs, heat generates Dry Lei aggregation, half-cup size, painful abdomen radiating to flanks, heart vexation, loss of appetite/vomiting, inability to sigh deeply, heavy back, night sweats, leg soreness/pain standing long, urinary incontinence, sudden leakage like seminal emission, menstrual closure, difficult defecation. Such persons have few children. Treat with long needles, pressing and puncturing method, administer toxic drugs. Lei passes, cure follows.
Formula for Dry Lei (*Sheng Hui*)
Da Huang (Rhubarb) (egg-sized) Gan Jiang (Dried Ginger) (2 liang each) Huang Lian (Coptis) (3 liang) Ji Nei Jin (Chicken Gizzard Lining) (1 piece, roasted) Gui Xin (Cinnamon Heart) (1 chi) Tu Chong (Earthworm) (3 pieces, roasted) Hou Po (Magnolia Bark) (10 pods, roasted) Yu Li Ren (Bush Cherry Seed) (1 liang, skin/kernel removed, roasted)
Grind into powder. Early morning empty stomach, take 3 qian with one cup warm wine in one dose. Lei passes. Nurture as postpartum. No intercourse for three months. Infertile women may conceive.
[Blood Lei]: When menstruation newly stops before normal duration ends, due to overeating, Grain Qi excess overflowing to other organs, combined with hunger/cold insufficiency, irregular breathing, and physical labor while blood is settling, blood moves left/right between intestines/stomach, staying in collaterals, internal cold/heat combining with menstruation, forming Blood Lei. Causes lower back pain unable to bend/straighten, Qi accumulation under Heng Gu (Pubic Bone), hard as stone, lower abdominal urgency/pain, deep back/waist/abdomen pain, genital spasms, wind-cold in Zi Men, irregular menstruation. Sterility results. Treat by passing Lei, cure follows.
Formula for Women's Blood Lei Pain (*Sheng Hui*)
Gan Jiang (Dried Ginger) Hai Piao Xiao (Cuttlefish Bone) (1 liang each, roasted) Tao Ren (Peach Kernel) (1 liang, skin/kernel removed)
Grind into powder. Take two fang cun bi with wine, twice daily. Alternative omits Tao Ren.