又方 取古铁秤锤，或大斧头，或铁杵，以炭火烧令赤，投好酒三升中饮之。
疗妇人血瘕，攻刺腹胁时痛，导药方。
大黄 当归（各半两） 山茱萸 皂荚（去皮弦，各一两） 细辛 戎盐（各二钱半）
上捣以香脂丸如指大，每用一丸，绵裹纳阴中，正坐良久，瘕当下。养如乳妇法。
桃仁煎 （《本事》）治妇人血瘕、血积，经候不通。
桃仁 大黄（各一两） 虻虫（半两，炒黑） 川朴硝（另研）
上四味为末，以醇醋二升半，银石器中慢火煎取一升五合，下大黄、虻虫、桃仁等，
不住手搅，煎至可丸，下朴硝搅匀，出之，丸如梧桐子大。前一日不吃晚食，五更初，用
温酒吞下五丸，日午取下如赤豆汁，或如鸡肝、蛤蟆衣之状，未下再作，如鲜血来即止，
续以调补气血药补之。顷年在毗陵，有一贵宦妻患小便不通，脐腹胀不可忍，众医皆
作淋，治以八正散之类愈甚。予诊之曰∶此血瘕也，非瞑眩药不可去，用此药更初服，至
日午大痛不可忍，遂卧少顷，下血块如拳者数枚，小便如黑豆汁一二升，痛止得愈。
此药治病的切，然猛烈伤人，气虚血弱者不可轻用也。
三棱煎 （《选奇》）治妇人血瘕、血症、食积、痰滞。
三棱 莪术（各二两） 青橘皮（去白） 半夏 麦芽（炒，各一两）
上用好醋六升，煮干焙为末，醋糊丸如梧桐子大。每服三四十丸，淡醋汤下。痰积
多，姜汤下。
〔脂瘕〕者，妇人月水新来，若生未满三十日，以合阴阳，络脉分，胞门伤，子户失
禁，关节散，五脏六腑津液流行阴道， 动百脉，关枢四解，外不见其形，子精与血气
相遇，犯禁，子精化，不足成子，则生脂瘕之聚。令人支满里急，痹引少腹重，腰背如
刺状，四肢不举，饮食不甘，卧不安席，左右走腹中切痛，时瘥时甚，或时少气头眩，身
体解 ，苦寒恶风，膀胱胀，月水乍来乍去，不如常度，大小便血不止，如此者令人无子。
疗之当刺以长针，行以毒药，瘕当下，即愈。
疗脂瘕方（《圣惠》）
皂荚（七钱半，去皮子） 矾石（烧，二钱半） 五味子 蜀椒（去汗） 细辛 干姜（各半两）
上捣散，以香脂和如大豆，着男子阴头以合阴阳，不三行，其瘕即愈。
导散方（《圣惠》）
皂荚（炙，去皮子） 吴茱萸 当归（各一两） 蜀椒（去汗） 干姜 大黄 戎盐（各二两）
细辛（熬） 矾石（烧） 五味子（各二分）
上捣筛为散，以轻绢袋如指大长三寸，盛药令满，纳阴中，坐卧随意，勿行走，小便
时去之，别换新者。
〔狐瘕〕者，妇人月水当日数来，而反悲哀忧恐，若以远行逢暴风疾雨，雷电惊恐，衣
被沉湿，罢倦少气，心中恍惚未定，四肢懈惰，振寒，苦寤寐气绝，精神游亡，邪气入
于阴里不去，则生狐瘕之聚，食人子脏，令人月水闭不通，少腹瘀滞，胸胁腰背痛，阴
中肿，小便难，胞门子户不受男精，五脏气盛，令人嗜食，欲呕，喜唾，多所思，如
有身状，四肢不举，有此病者，终身无子。其瘕有手足成形者杀人，未成者可疗。以长针
急持刺之，行以毒药有法，瘕当下，即愈。
疗狐瘕方（《圣惠》）
上取新死鼠一枚，裹以新絮，涂以黄土，穿地坎足没鼠形，置其中，桑薪火灼其上，一
日一夜出之，研为末，纳桂心末二钱半，酒服二方寸匕，病当下。甚者不过再服，瘥。
〔蛇瘕〕者，妇人月水已下新止，适闭未复，胞门子户劳伤，阴阳未平，荣卫分行，若
其中风暴病羸劣，饮食未调，若起行当风，及度泥涂，因冲寒太早，若坐湿地，名阴阳乱，
腹中虚，若远行道路，饮污井之水，食不洁之食，吞蛇鼠之精，留络不去，因生蛇瘕之
聚。上食心肝，长大其形若漆，在脐上下，还 左右胁，不得吐气，两股胫间苦疼，少腹
多热，小便赤黄，膀胱引阴中挛急，腰目俱痛，难以动作，喜发寒热，月水或多或少，有
此病者，不复生子。其瘕手足成形者杀人，未成者可治。疗有法，行以毒药，瘕当下，即
愈。
疗蛇瘕方（《圣惠》）
大黄 黄芩 芒硝（各半两） 甘草（大如指一尺，炙） 乌贼鱼骨（二枚） 皂荚（六枚，去皮弦
子，酥炙）
上捣，以水六升，煮之三数沸，绞去滓，下硝，适寒温服之，十日一剂，空腹服之，瘕
即下。
〔鳖瘕〕者，妇人月水新至，其人剧作罢劳，汗出衣服润湿，不以时去之，若当风睡，
足践湿地，恍惚觉悟， 立未安，颜色未平，复见所好，心为之开，魂魄感动，五内脱消，
若入水浣洗沐浴，不以时出，而神不守，水精与邪气俱人，至三焦之中幕，玉门先闭，津
液妄行，留络不去、因生鳖瘕之聚。大如小 ，令人少腹内切痛，恶气左右走，上下腹
中苦痛，若存若亡，持之跃手，下引阴里，腰背亦痛，不可以息，月水不通，面目黄黑，脱
声少气，有此病者，令人绝子。其瘕有手足成形者杀人，未成者可治。疗有法度，以长
针按疗之，行以毒药，瘕当下，即愈。
疗鳖瘕方（《圣惠》）
大黄（一两半） 干姜 侧子（各半两） 附子 人参（各三钱七分半） 虫（一寸匕，熬） 桂心（一
两二钱半） 细辛 土 （各七钱半） 白术（一两）
上捣散，以酒服方寸匕，日三。
治鳖瘕及心腹宿 ，或卒得 。
上以白雄鸡矢无问多少，小便和之，于器中火上熬令燥，末服方寸匕，多服不限度，
以膏熬饭饲弥佳。
〔 痞〕
〔大〕妇人 痞，由饮食失节，脾胃亏损，邪正相搏，积于腹中，牢固不动，有可
征验，故名曰 ，气道壅塞，故名曰痞，得冷则发，冷入子脏则不孕，入胞络则月水不
通。
〔薛〕前证若脾胃虚弱，用六君子加芎、归。（方见杂病虚劳，）若肝脾虚弱，用补中益气
（杂病伤劳倦。）及归脾汤。（杂病健忘。）若肝火郁滞，佐以芦荟丸、（方见幼科疳门。）地黄丸。（即六味丸，
杂病虚劳。）外贴阿魏膏。（见前。）患者须慎七情六淫，饮食起居，治者不时审察病机而药之，
庶几有效。
穿山甲散 （《大全》）治妇人 痞及恶血，气攻心腹疼痛，面无颜色，四肢瘦弱。
穿山甲（灰炒燥） 鳖甲（醋灸） 赤芍药 大黄（炒） 干漆（炒令烟尽） 桂心（各一两）
川芎 芫花（醋炒） 当归（各半两） 麝香（二钱半，另研）
上为细末，入麝和匀，每服一钱，热酒调下，无时。
蓬莪术丸 （《大全》）治妇人 痞，腹胁妨痛，令人体瘦，不思饮食。
莪术（七钱半） 当归（焙） 桂心 赤芍药 槟榔 昆布 琥珀（研） 枳壳 木香（各半两）
桃仁 鳖甲 大黄（各一两）
上为末，烂蜜丸如梧子大，食前米饮下二十丸。
丁香丸 （《大全》）治妇人 痞，结块不散，心腹疼痛。
雄雀粪（炒黄） 鳖甲（各一两） 砂 当归（焙） 芫花（醋炒干，各半两） 巴豆（二分半，
去皮心油）
上为末，研令停，醋煮面糊丸如小豆大，当归酒下三丸。
桃仁散 （《普济》）治妇人 痞，心腹胀满，不能饮食，体瘦无力。
桃仁（一两，汤浸去皮尖双仁者，麸炒令微黄） 诃子皮 白术 赤芍药 当归（各七钱半）
京三棱（锉，微炒，一两） 鳖甲（醋炙，去裙烂，一两半） 陈皮（汤浸，去白焙，三两）
上为散，每服三钱，水一盏，入生姜一钱三分，煎至六分，去滓食前稍热服。
上方皆攻积之药，性多犷 ，用者慎之，如薛氏。
〔食 〕
妇人脏腑虚弱，月候来时食生冷之物，脾胃既虚，不能消化，与脏气相搏，结聚成块，
日渐生长，盘牢不移，故谓之食 也。
〔薛〕前证若形气虚弱，须先调补脾胃为主，而佐以消导。若形气充实，当先疏导
为主，而佐以补脾胃。若气壅血滞而不行者，宜用乌药散散而行之。（散用乌药、莪术、醋浸炒，
桂心、当归、桃仁、青皮、木香，各等分为末，每二钱热酒调下。）脾气虚而血不行者，宜用四君、
芎、归，补而行之。（方见杂病虚劳。）若脾气郁血不行者，宜用归脾汤（杂病健忘。）解而行之。若
肝脾血燥而不行者，宜用加味逍遥散（结核。）清而行之。大抵食积痞块之证为有形，盖邪气
胜则实，真气夺则虚，当养正辟邪而积自除矣。虽然，坚者削之，客者除之，胃气未虚，
或可少用，若病久虚弱者，不可轻试也。
砂丸 （《大全》）治妇人食 久不消，令人瘦弱食少。
砂 青礞石 穿山甲（炙） 三棱（炒） 干漆（炒令烟尽） 硫黄（各半两） 巴豆（三十枚，
去皮心炒，不去油）
上为末，用软饭丸如小豆大，每服五丸，生姜、橘皮汤下。
礞石丸 （《大全》）治妇人食 块久不消，攻刺心腹疼痛。
青礞石（末） 巴豆（去皮心油） 朱砂 粉霜（并研） 木香末（各二钱半） 砂（半两）
上研令停，以糯米软饭和丸如绿豆大，每
服二丸，空心温酒下，取下恶物为度。
上方犯 砂、巴豆，非胃气强壮而积气坚顽势不两立者，不可轻用也。
小三棱煎丸 治食 、酒癖、血瘕、气块，时发刺痛，全不思食，及一切积滞不消，
心腹坚胀，痰饮呕哕噫酸，胁肋刺痛，脾气横泄。
三棱 莪术（各四两） 芫花（一两）
上入瓷器中，用米醋五升，浸满封器口，以灰火煨令干，取出棱、术，将芫花以余醋
炒令微焦，同棱、术焙干为末，醋糊丸如绿豆大，每服十五丸，生姜汤下。妇人血分，男
子脾气横泄，肿满如水，桑白皮煎汤下。
〔血 〕
妇人寒温失节，脏腑气虚，风冷在内，饮食不消，与血气相结，渐生颗块，盘牢不移
动者是也。皆因血气劳伤，月水往来，经络痞塞，恶血不除，结聚所生，久而不瘥，则
心腹两胁苦痛，害于饮食，肌肤羸瘦。问∶ 一也，何以知是血 ？曰∶血之外证，瞀闷
烦躁，迷忘惊狂，痰呕汗多，骨热肢冷，其蓄在下焦者，必脐下结急，外热内痛，尺脉
洪而数也。桃仁、灵脂、生地黄、牛膝、大黄、甘草祛逐之。
〔薛〕前证多兼七情亏损，五脏气血乖违而致。盖气主嘘之，血主濡之，脾统血，肝
藏血，故郁结伤脾，恚怒伤肝者多患之，腹胁作痛，正属肝脾二经证也。洁古云∶养正
积自除。东垣云∶人以胃气为主，治法当主于固元气而佐以攻伐之剂，必需之岁月，若
期速效，投以峻剂，反致有误。
加减四物汤（方见杂病积聚。）当归丸 牡丹散（俱同上。）
大黄煎 （《圣惠》）治妇人血 血瘕，食积痰滞。
川大黄（七钱半，碎，微炒） 鳖甲（一两，醋炙黄，去裙 ） 牛膝（去芦，一两）
干漆（一两，炒烟尽）
上为末，用米醋一升，煎为膏，每服一钱，食前热酒调下。
〔腹中瘀血〕
妇人月经痞涩不通，或产后余秽未尽，因而乘风取凉，为风冷所乘，血得冷则成瘀血
也。血瘀在内，则时时体热面黄，瘀久不消，则为积聚 瘕矣。
〔薛〕前证若郁结伤脾，用加味归脾汤。（方见杂病健忘。）若恚怒伤肝，用加味逍遥散。（结
核。）若产后恶露，用失笑散。（方见心痛。）若肝脾亏损，用六君、柴胡，以补元气为主。（方见
虚劳。）胃气虚弱，用补中益气汤加茯苓、半夏为主。（方见杂病劳倦。）大凡腹中作痛畏手按者，
此内有瘀血，若形体如常，属病气元气俱实，用桃仁承气汤直下之。（方见伤寒蓄血。）若痛而
肢体倦怠，饮食少思，此脾胃受伤，属病气有余，元气不足，用当归散调和之。（方见杂病
溲血。）若痛而喜手按腹，形体倦怠，饮食少思，此形气病气俱不足，用六君、炮姜、芎、归
纯补之。若痛而大便不实，饮食难化，此脾肾虚寒，用六君、炮姜、肉果温补之。若痛
而作呕少食，此脾胃虚弱，用六君、炮姜、藿香。若痛而呕吐不食泄泻，用六君加姜、桂。
若兼手足逆冷自汗，更加附子。此证多有因攻伐而致者。
调荣汤 治瘀血不消，脐腹引腰背俱痛。
川芎 当归 芍药 地黄 生姜（各一两） 三棱 莪术 白芷 延胡索 蒲黄 香附子
泽兰叶 细辛 川白姜 浓朴（制） 半夏（制） 甘草（各七钱半，炙） 辣桂
桃仁（汤浸去皮，焙，各五钱）
上锉散，每服三钱，姜枣煎，食前服。
川当归散 理荣卫，消瘀血，出声音，治痰嗽。
川当归 牡丹皮 白芍药 子芩 木通 华阴细辛 麦门冬 甘草（各半两）
生地黄（一两）
上 咀，每服三钱，水一盏，姜三片，煎至七分，去滓温服。
大黄汤 治妇人血瘀不消，及扑损血瘀。
大黄（生用） 桃仁（汤浸去皮尖双仁，各一两）
桂（去粗皮） 郁李仁（去皮研，各半两） 生姜 地黄（各一两）
上粗捣节，每服三钱，水酒各半盏，同煎至七分，去滓温服。
琥珀散 治妇人经络痞塞，腹内瘀血，痛不可忍。
琥珀 乳香 没药
上三味，各研取细末五钱，每服二钱，水酒各半盏，煎至七分，入地黄自然汁二合，再
又一方：取古旧的铁秤砣，或者大斧头，或者铁杵，用炭火烧得通红，投入三升好酒中，让患者饮用。
治疗妇人血瘕（瘀血结块），攻刺腹胁部时常有疼痛，导药方。
大黄、当归（各半两）、山茱萸、皂荚（去皮弦，各一两）、细辛、戎盐（各二钱半）。
将上述药物捣碎，用香脂调和成如手指大小的丸剂。每次使用一丸，用绵布包裹后纳入阴道内，正坐良久，瘕块应当排出。调养方法如同产后妇女一样。
桃仁煎（出自《本事方》）：治疗妇人血瘕、血积，月经不通。
桃仁、大黄（各一两）、虻虫（半两，炒黑）、川朴硝（单独研细）。
将以上四味药研为粉末，用二升半醇醋，在银器或石器中以慢火煎取一升五合药液，加入大黄、虻虫、桃仁等药，不停手搅拌，煎至可以制成丸剂时，加入朴硝搅匀，取出，制成如梧桐子大小的丸剂。前一天晚上不吃晚饭，五更初（凌晨3-5点），用温酒吞服五丸，中午时分排出如赤豆汁样的东西，或者像鸡肝、蛤蟆衣形状的物质，若未排出可再服用，若出现鲜血流出即停止服药，随后继续用调理补益气血的药物进行滋补。前几年在毗陵，有一位贵宦的妻子患小便不通，脐腹胀痛难以忍受，众医生都当作淋证治疗，用八正散之类的药物治疗后病情反而加重。我诊断说：这是血瘕，不用猛烈引起眩晕反应的药物不能去除病邪，于是用此药在初更（晚上7-9点）服用，到中午时剧烈疼痛难以忍受，于是躺卧片刻，排出数枚如拳头大小的血块，小便排出如黑豆汁一二升，疼痛停止而痊愈。此药治病确切，但药性猛烈伤人，气虚血弱的人不可轻易使用。
三棱煎（出自《选奇方》）：治疗妇人血瘕、血症、食积、痰滞。
三棱、莪术（各二两）、青橘皮（去白）、半夏、麦芽（炒，各一两）。
用好醋六升，煮干后焙干研为粉末，用醋糊制成如梧桐子大小的丸剂。每次服用三四十丸，淡醋汤送下。若是痰积多者，用姜汤送下。
【脂瘕】：妇人月经刚来，如果房事未满三十天，就进行阴阳交合，导致络脉分离，胞门受伤，子户失禁，关节松弛，五脏六腑的津液流入阴道，扰动百脉，关枢解散，外表看不出异常，子精与血气相遇，触犯禁忌，子精化散，不足以形成胎儿，从而产生脂瘕的积聚。使人支节胀满、里急，痹症牵引少腹沉重，腰背如针刺状，四肢不能抬起，饮食无味，睡眠不安，腹部左右走窜切痛，时好时坏，有时气短头晕，身体懈怠，苦于恶寒怕风，膀胱胀，月经忽来忽去，不合常规，大小便出血不止，像这样的情况会导致不孕。
治疗应当用长针针刺，施用毒药，瘕块应当排出，即可痊愈。
治疗脂瘕方（出自《圣惠方》）：
皂荚（七钱半，去皮子）、矾石（烧，二钱半）、五味子、蜀椒（去汗）、细辛、干姜（各半两）。
将上述药物捣碎成散剂，用香脂调和如大豆大小，置于男子阴头以进行阴阳交合，不超过三次，其瘕即可痊愈。
导散方（出自《圣惠方》）：
皂荚（炙，去皮子）、吴茱萸、当归（各一两）、蜀椒（去汗）、干姜、大黄、戎盐（各二两）、细辛（熬）、矾石（烧）、五味子（各二分）。
将上述药物捣碎筛为散剂，用轻绢袋做成如手指粗细、长三寸的大小，装满药物，纳入阴道内，坐卧随意，不要行走，小便时取出，更换新的。
【狐瘕】：妇人月经按日期该来时，反而悲哀忧恐，就像远行遇到暴风疾雨，雷电惊恐，衣被潮湿，疲倦气少，心中恍惚不定，四肢懈怠，发冷颤抖，苦于醒睡间气息断绝，精神游荡亡失，邪气进入阴分不去，则产生狐瘕的积聚，侵蚀子宫，使人月经闭止不通，少腹瘀滞，胸胁腰背痛，阴中肿胀，小便困难，胞门子户不接受男精，五脏气盛，使人嗜食，想呕吐，喜吐唾沫，思虑过多，好像怀孕的样子，四肢不能抬起，有此病的人，终身无子。其瘕若有手足成形者会致死，未成形的可以治疗。用长针急速持针刺之，施用有方法的毒药，瘕块应当排出，即可痊愈。
治疗狐瘕方（出自《圣惠方》）：
取一只新死的老鼠，用新棉絮包裹，涂上黄土，在地上挖坑刚好没过老鼠形状，将老鼠放入其中，用桑柴火在上面灼烧，一天一夜后取出，研为粉末，加入桂心末二钱半，用酒送服二方寸匕，病邪应当排出。严重的不过再服用一次，即可痊愈。
【蛇瘕】：妇人月经刚下且新近停止，适逢闭合未复，胞门子户劳伤，阴阳未平，营卫分行，如果其中遭遇风暴病邪，身体羸弱，饮食未调，如果起身行走当风，以及经过泥泞涂地，因冲寒太早，如果坐在湿地，名为阴阳紊乱，腹中虚寒，如果远行道路，饮用污井之水，吃不洁的食物，吞食蛇鼠的精液，留滞在络脉不去，因而产生蛇瘕的积聚。上蚀心肝，长大其形如漆，在脐上下，还及左右胁，不得吐气，两股胫间苦痛，少腹多热，小便赤黄，膀胱牵引阴中挛急，腰目俱痛，难以动作，喜欢发寒热，月经或多或少，有此病的人，不再能生子。其瘕若有手足成形者会致死，未成形的可以治疗。治疗有方法，施用毒药，瘕块应当排出，即可痊愈。
治疗蛇瘕方（出自《圣惠方》）：
大黄、黄芩、芒硝（各半两）、甘草（大如指一尺，炙）、乌贼鱼骨（二枚）、皂荚（六枚，去皮弦子，酥炙）。
将上述药物捣碎，用水六升，煮开三五个滚，绞去药渣，加入芒硝，调节至适宜温度服用，十日一剂，空腹服用，瘕块即下。
【鳖瘕】：妇人月经刚到，其人剧烈劳作后休息，汗出衣服润湿，不及时去掉，如果当风睡觉，足踩湿地，恍惚觉悟，站立未安，脸色未平，又见到所喜欢的东西，心为之开，魂魄感动，五脏内消，如果入水浣洗沐浴，不及时出来，而神不守舍，水精与邪气俱入，到达三焦之中幕，玉门先闭，津液妄行，留滞在络脉不去，因而产生鳖瘕的积聚。大如小鳖，使人少腹内切痛，恶气左右走窜，上下腹中苦痛，若存若亡，按压时跃动应手，下引阴里，腰背亦痛，不可以呼吸，月经不通，面目黄黑，失声少气，有此病的人，令人绝育。其瘕若有手足成形者会致死，未成形的可以治疗。治疗有法度，用长针按疗之，施用毒药，瘕块应当排出，即可痊愈。
治疗鳖瘕方（出自《圣惠方》）：
大黄（一两半）、干姜、侧子（各半两）、附子、人参（各三钱七分半）、䗪虫（一寸匕，熬）、桂心（一两二钱半）、细辛、土狗（各七钱半）、白术（一两）。
将上述药物捣碎成散剂，用酒送服方寸匕，每日三次。
治疗鳖瘕及心腹宿积，或突然得到积块。
以上用白雄鸡屎无论多少，用小便调和，在器皿中火上熬令干燥，研为粉末，每次服方寸匕，多服没有限度，如果用膏煎饭喂食更好。
【气痞】
【大论】妇人气痞，由饮食失节，脾胃亏损，邪正相搏，积于腹中，牢固不动，有可征验，故名曰积，气道壅塞，故名曰痞，得冷则发作，冷入子脏则不孕，入胞络则月经不通。
【薛己】前证若脾胃虚弱，用六君子汤加川芎、当归。（方见杂病虚劳。）若肝脾虚弱，用补中益气汤（杂病伤劳倦。）及归脾汤。（杂病健忘。）若肝火郁滞，佐以芦荟丸、（方见幼科疳门。）地黄丸。（即六味丸，杂病虚劳。）外贴阿魏膏。（见前。）患者须慎七情六淫，饮食起居，治者不时审察病机而药之，庶几有效。
穿山甲散（出自《大全》）：治疗妇人气痞及恶血，气攻心腹疼痛，面无颜色，四肢瘦弱。
穿山甲（灰炒燥）、鳖甲（醋灸）、赤芍药、大黄（炒）、干漆（炒令烟尽）、桂心（各一两）、川芎、芫花（醋炒）、当归（各半两）、麝香（二钱半，另研）。
将上述药物研为细末，加入麝香和匀，每次服一钱，热酒调下，不拘时候。
蓬莪术丸（出自《大全》）：治疗妇人气痞，腹胁妨痛，令人体瘦，不思饮食。
莪术（七钱半）、当归（焙）、桂心、赤芍药、槟榔、昆布、琥珀（研）、枳壳、木香（各半两）、桃仁、鳖甲、大黄（各一两）。
将上述药物研为粉末，烂蜜制成如梧子大小的丸剂，食前米饮送下二十丸。
丁香丸（出自《大全》）：治疗妇人气痞，结块不散，心腹疼痛。
雄雀粪（炒黄）、鳖甲（各一两）、砂仁、当归（焙）、芫花（醋炒干，各半两）、巴豆（二分半，去皮心油）。
将上述药物研为粉末，研令均匀，醋煮面糊制成如小豆大小的丸剂，当归酒送下三丸。
桃仁散（出自《普济方》）：治疗妇人气痞，心腹胀满，不能饮食，体瘦无力。
桃仁（一两，汤浸去皮尖双仁者，麸炒令微黄）、诃子皮、白术、赤芍药、当归（各七钱半）、京三棱（锉，微炒，一两）、鳖甲（醋炙，去裙烂，一两半）、陈皮（汤浸，去白焙，三两）。
将上述药物研为散剂，每次服三钱，水一盏，入生姜一钱三分，煎至六分，去滓食前稍热服。
上方皆攻积之药，性多犷烈，使用者慎之，如薛氏所言。
【食积】
妇人脏腑虚弱，月候来时食生冷之物，脾胃既虚，不能消化，与脏气相搏，结聚成块，日渐生长，盘牢不移，故谓之食积也。
【薛己】前证若形气虚弱，须先调补脾胃为主，而佐以消导。若形气充实，当先疏导为主，而佐以补脾胃。若气壅血滞而不行者，宜用乌药散散而行之。（散用乌药、莪术、醋浸炒，桂心、当归、桃仁、青皮、木香，各等分为末，每二钱热酒调下。）脾气虚而血不行者，宜用四君、芎、归，补而行之。（方见杂病虚劳。）若脾气郁血不行者，宜用归脾汤（杂病健忘。）解而行之。若肝脾血燥而不行者，宜用加味逍遥散（结核。）清而行之。大抵食积痞块之证为有形，盖邪气胜则实，真气夺则虚，当养正辟邪而积自除矣。虽然，坚者削之，客者除之，胃气未虚，或可少用，若病久虚弱者，不可轻试也。
硇砂丸（出自《大全》）：治疗妇人食积久不消，令人瘦弱食少。
硇砂、青礞石、穿山甲（炙）、三棱（炒）、干漆（炒令烟尽）、硫黄（各半两）、巴豆（三十枚，去皮心炒，不去油）。
将上述药物研为粉末，用软饭制成如小豆大小的丸剂，每次服五丸，生姜、橘皮汤送下。
礞石丸（出自《大全》）：治疗妇人食积块久不消，攻刺心腹疼痛。
青礞石（末）、巴豆（去皮心油）、朱砂、粉霜（并研）、木香末（各二钱半）、硇砂（半两）。
将上述药物研令均匀，以糯米软饭和丸如绿豆大，每次服二丸，空心温酒送下，取下恶物为度。
上方犯硇砂、巴豆，非胃气强壮而积气坚顽势不两立者，不可轻用也。
小三棱煎丸：治食积、酒癖、血瘕、气块，时发刺痛，全不思食，及一切积滞不消，心腹坚胀，痰饮呕哕噫酸，胁肋刺痛，脾气横泄。
三棱、莪术（各四两）、芫花（一两）。
将上述药物放入瓷器中，用米醋五升，浸满封器口，以灰火煨令干，取出棱、术，将芫花以余醋炒令微焦，同棱、术焙干为末，醋糊制成如绿豆大的丸剂，每次服十五丸，生姜汤送下。妇人血分病，男子脾气横泄，肿满如水，桑白皮煎汤送下。
【血积】
妇人寒温失节，脏腑气虚，风冷在内，饮食不消，与血气相结，渐生颗块，盘牢不移动者是也。皆因血气劳伤，月水往来，经络痞塞，恶血不除，结聚所生，久而不瘥，则心腹两胁苦痛，害于饮食，肌肤羸瘦。问：积一也，何以知是血积？曰：血之外证，瞀闷烦躁，迷忘惊狂，痰呕汗多，骨热肢冷，其蓄在下焦者，必脐下结急，外热内痛，尺脉洪而数也。桃仁、灵脂、生地黄、牛膝、大黄、甘草祛逐之。
【薛己】前证多兼七情亏损，五脏气血乖违而致。盖气主嘘之，血主濡之，脾统血，肝藏血，故郁结伤脾，恚怒伤肝者多患之，腹胁作痛，正属肝脾二经证也。洁古云：养正积自除。东垣云：人以胃气为主，治法当主于固元气而佐以攻伐之剂，必需之岁月，若期速效，投以峻剂，反致有误。
加减四物汤（方见杂病积聚。）当归丸 牡丹散（俱同上。）
大黄煎（出自《圣惠方》）：治疗妇人血积血瘕，食积痰滞。
川大黄（七钱半，碎，微炒）、鳖甲（一两，醋炙黄，去裙）、牛膝（去芦，一两）、干漆（一两，炒烟尽）。
将上述药物研为粉末，用米醋一升，煎为膏，每次服一钱，食前热酒调下。
【腹中瘀血】
妇人月经痞涩不通，或产后余秽未尽，因而乘风取凉，为风冷所乘，血得冷则成瘀血也。血瘀在内，则时时体热面黄，瘀久不消，则为积聚瘕矣。
【薛己】前证若郁结伤脾，用加味归脾汤。（方见杂病健忘。）若恚怒伤肝，用加味逍遥散。（结核。）若产后恶露，用失笑散。（方见心痛。）若肝脾亏损，用六君、柴胡，以补元气为主。（方见虚劳。）胃气虚弱，用补中益气汤加茯苓、半夏为主。（方见杂病劳倦。）大凡腹中作痛畏手按者，此内有瘀血，若形体如常，属病气元气俱实，用桃仁承气汤直下之。（方见伤寒蓄血。）若痛而肢体倦怠，饮食少思，此脾胃受伤，属病气有余，元气不足，用当归散调和之。（方见杂病溲血。）若痛而喜手按腹，形体倦怠，饮食少思，此形气病气俱不足，用六君、炮姜、芎、归纯补之。若痛而大便不实，饮食难化，此脾肾虚寒，用六君、炮姜、肉果温补之。若痛而作呕少食，此脾胃虚弱，用六君、炮姜、藿香。若痛而呕吐不食泄泻，用六君加姜、桂。若兼手足逆冷自汗，更加附子。此证多有因攻伐而致者。
调荣汤：治瘀血不消，脐腹引腰背俱痛。
川芎、当归、芍药、地黄、生姜（各一两）、三棱、莪术、白芷、延胡索、蒲黄、香附子、泽兰叶、细辛、川白姜、浓朴（制）、半夏（制）、甘草（各七钱半，炙）、辣桂、桃仁（汤浸去皮，焙，各五钱）。
将上述药物锉散，每次服三钱，姜枣煎，食前服。
川当归散：理荣卫，消瘀血，出声音，治痰嗽。
川当归、牡丹皮、白芍药、子芩、木通、华阴细辛、麦门冬、甘草（各半两）、生地黄（一两）。
将上述药物㕮咀，每次服三钱，水一盏，姜三片，煎至七分，去滓温服。
大黄汤：治妇人血瘀不消，及扑损血瘀。
大黄（生用）、桃仁（汤浸去皮尖双仁，各一两）、桂（去粗皮）、郁李仁（去皮研，各半两）、生姜、地黄（各一两）。
将上述药物粗捣节，每次服三钱，水酒各半盏，同煎至七分，去滓温服。
琥珀散：治妇人经络痞塞，腹内瘀血，痛不可忍。
琥珀、乳香、没药。
将上述三味药，各研取细末五钱，每次服二钱，水酒各半盏，煎至七分，入地黄自然汁二合，再
Another prescription: Take an old iron steelyard weight, or a large axe head, or an iron pestle, heat it red-hot with charcoal, and throw it into three sheng of good wine for the patient to drink.
For treating blood jia (blood stasis mass) in women, characterized by stabbing pain in the abdomen and hypochondrium occurring intermittently, a guiding drug prescription.
Da Huang (Rhei Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix) (each half liang), Shan Zhu Yu (Corni Fructus), Zao Jiao (Gleditsiae Fructus) (skin and strings removed, each one liang), Xi Xin (Asari Radix et Rhizoma), Rong Yan (Natrii Sulfas) (each two qian and half).
Pound the above ingredients, mix with fragrant fat to form pills the size of a finger. Use one pill each time, wrap in cotton, insert into the vagina, sit upright for a long time, and the jia should be discharged. Care as for a postpartum woman.
Tao Ren Jian (Peach Kernel Decoction) (from *Ben Shi Fang*): Treats blood jia, blood accumulation, and amenorrhea in women.
Tao Ren (Persicae Semen), Da Huang (Rhei Radix et Rhizoma) (each one liang), Meng Chong (Blatta Orientalis) (half liang, stir-fried until black), Chuan Po Xiao (Natrii Sulfas Exsiccatus) (separately ground).
Pound the above four ingredients into powder. Add two sheng and half of strong vinegar, slowly simmer in a silver or earthenware vessel until reduced to one sheng and five he. Add Da Huang, Meng Chong, Tao Ren, etc., stir continuously, simmer until it can be formed into pills. Add Po Xiao, stir evenly, remove from heat, and form pills the size of sophora seeds. Do not eat dinner the day before. At wu geng (early morning, 3-5 AM), swallow five pills with warm wine. By noon, discharge material resembling red bean juice, or resembling chicken liver or frog skin. If not discharged, take again. If fresh blood flows, stop immediately, and subsequently supplement with herbs that regulate and tonify qi and blood. In previous years in Piling, the wife of a noble official suffered from urinary retention, unbearable abdominal distension and pain. All physicians treated it as lin syndrome (strangury), using prescriptions like Ba Zheng San, which worsened the condition. I diagnosed it as blood jia, stating that only a potent medicine causing severe reaction could remove it. Using this medicine at chu geng (early evening, 7-9 PM), by noon she suffered unbearable severe pain, lay down for a moment, and discharged several blood clumps the size of fists, followed by one or two sheng of urine resembling black bean juice. The pain ceased and she recovered. This medicine is effective but harsh and damaging; it should not be used lightly by those with qi deficiency and blood weakness.
San Leng Jian (Curcuma Longa Decoction) (from *Xuan Qi Fang*): Treats blood jia, blood disorders, food stagnation, and phlegm obstruction in women.
San Leng (Bistortae Rhizoma), E Zhu (Curcumae Rhizoma) (each two liang), Qing Ju Pi (Citri Reticulatae Pericarpium Viride) (white pith removed), Ban Xia (Pinelliae Tuber), Mai Ya (Hordei Fructus Germinatus) (stir-fried, each one liang).
Boil six sheng of good vinegar until dry, bake, and grind into powder. Form pills with vinegar paste the size of sophora seeds. Take thirty to forty pills each time, washed down with light vinegar soup. For excessive phlegm accumulation, wash down with ginger soup.
[Zhi Jia]: When a woman's menstruation has just begun, if intercourse occurs within thirty days of its onset, the collaterals separate, the uterus gate is injured, the child chamber loses control, joints relax, fluids of the five zang and six fu organs flow into the vagina, disturbing the hundred vessels, the pivot mechanisms disperse. Externally no shape is visible. The essence of conception meets with blood and qi, violating taboos, the essence dissipates, insufficient to form a fetus, thus generating the accumulation of Zhi Jia (fat jia). It causes fullness in the limbs and urgency inside, bi-syndrome pulling the lower abdomen heavy, waist and back feeling like stabbing, inability to raise limbs, lack of taste in food, restless sleep, cutting pain moving left and right in the abdomen, fluctuating severity, sometimes shortness of breath and dizziness, body lethargy, aversion to cold and wind, bladder distension, menstruation coming and going irregularly, continuous bleeding from bowels and bladder. Such conditions lead to infertility.
Treatment requires acupuncture with long needles and administration of toxic drugs; the jia should be discharged, leading to recovery.
Prescription for Zhi Jia (from *Sheng Hui Fang*):
Zao Jiao (Gleditsiae Fructus) (seven qian and half, skin and seeds removed), Fan Shi (Alumen) (calcined, two qian and half), Wu Wei Zi (Schisandrae Fructus), Shu Jiao (Zanthoxyli Pericarpium) (sweat removed), Xi Xin (Asari Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma) (each half liang).
Pound into powder, mix with fragrant fat to the size of soybeans. Apply to the male glans for intercourse. Within three times, the jia will heal.
Guiding Powder Prescription (from *Sheng Hui Fang*):
Zao Jiao (Gleditsiae Fructus) (roasted, skin and seeds removed), Wu Zhu Yu (Evodiae Fructus), Dang Gui (Angelicae Sinensis Radix) (each one liang), Shu Jiao (Zanthoxyli Pericarpium) (sweat removed), Gan Jiang (Zingiberis Rhizoma), Da Huang (Rhei Radix et Rhizoma), Rong Yan (Natrii Sulfas) (each two liang), Xi Xin (Asari Radix et Rhizoma) (roasted), Fan Shi (Alumen) (calcined), Wu Wei Zi (Schisandrae Fructus) (each two fen).
Pound and sieve into powder. Place in a light silk bag, size of a finger, three cun long, fill with medicine, insert into the vagina. Sit or lie as desired, do not walk. Remove when urinating, replace with a new one.
[Hu Jia]: When a woman's menstruation should arrive on schedule, but instead she feels sorrowful, fearful, as if traveling far encountering violent storms, rain, thunder, lightning, fear, wet clothes and bedding, fatigue, shortness of breath, mental confusion and instability, limb lethargy, chills, suffering from interrupted sleep and breathing, spirit wandering, pathogenic qi enters the yin interior and does not leave, thus generating Hu Jia (fox jia) accumulation, eating the uterine organ, causing amenorrhea, lower abdominal stasis, chest, hypochondrium, waist, and back pain, vulvar swelling, difficult urination, the uterus gate rejecting male essence, excess qi in the five zang, craving food, desire to vomit, frequent spitting, excessive thinking, appearing pregnant, inability to raise limbs. Those with this disease will be sterile forever. If the jia has formed hands and feet, it kills; if unformed, it can be treated. Prick urgently with a long needle, administer toxic drugs according to method, the jia should be discharged, leading to recovery.
Prescription for Hu Jia (from *Sheng Hui Fang*):
Take one newly dead rat, wrap in new cotton, coat with yellow earth, dig a pit just covering the rat's shape, place it inside, burn mulberry fire above it for one day and night, then remove, grind into powder. Add Gui Xin (Cinnamomi Ramulus) powder two qian and half, take with wine two fang cun bi. The disease should discharge. Severe cases may require no more than two doses to recover.
[She Jia]: When a woman's menstruation has just stopped after flowing, the closure is not yet restored, the uterus gate is strained, yin and yang are not balanced, ying and wei circulate separately. If struck by wind-cold while weak, diet unregulated, walking in wind, crossing mud, catching cold too early, sitting on damp ground, named yin-yang disorder, empty abdomen. If traveling far, drinking dirty well water, eating unclean food, swallowing snake or rat essence, remaining in collaterals without leaving, thus generating She Jia (snake jia) accumulation. It eats the heart and liver, grows large like lacquer, located above and below the umbilicus, extending to left and right hypochondrium, inability to exhale, severe pain between thighs and calves, heat in lower abdomen, red-yellow urine, bladder pulling vulva into spasms, waist and eyes both painful, difficulty moving, prone to chills and fever, menstruation varying in amount. Those with this disease will never bear children. If the jia has formed hands and feet, it kills; if unformed, it can be treated. Treatment has methods, administer toxic drugs, the jia should be discharged, leading to recovery.
Prescription for She Jia (from *Sheng Hui Fang*):
Da Huang (Rhei Radix et Rhizoma), Huang Qin (Scutellariae Radix), Mang Xiao (Natrii Sulfas Exsiccatus) (each half liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (large as a finger, one chi long, roasted), Ou Zei Gu (Sepiae Endoconcha) (two pieces), Zao Jiao (Gleditsiae Fructus) (six pieces, skin, strings, and seeds removed, fried in butter).
Pound, boil in six sheng of water for three to five boils, strain off dregs, add Xiao, take at appropriate temperature. One dose every ten days, taken on an empty stomach, the jia will discharge.
[Bie Jia]: When a woman's menstruation has just arrived, she works strenuously then rests, sweats wetting clothes, does not change them in time, sleeps facing wind, steps on wet ground, wakes from trance, stands unsteady, complexion not settled, sees what she likes, heart opens, soul moves, internal organs consume. If entering water to wash or bathe, not exiting in time, spirit not guarding, water essence and pathogenic qi enter together, reaching the middle curtain of San Jiao (Triple Energizer), Yu Men (vulva) closes first, fluids run wild, remain in collaterals without leaving, thus generating Bie Jia (turtle jia) accumulation. Large as a small turtle, causing severe pain inside lower abdomen, evil qi moving left and right, severe pain in upper and lower abdomen, seeming present then absent, jumping upon pressure, pulling down to yin interior, waist and back also painful, difficult breathing, amenorrhea, yellow-black face, loss of voice, shortness of breath. Those with this disease become sterile. If the jia has formed hands and feet, it kills; if unformed, it can be treated. Treatment has rules, press and treat with long needles, administer toxic drugs, the jia should be discharged, leading to recovery.
Prescription for Bie Jia (from *Sheng Hui Fang*):
Da Huang (Rhei Radix et Rhizoma) (one liang and half), Gan Jiang (Zingiberis Rhizoma), Ce Zi (Aconiti Lateralis Radix Praeparata) (each half liang), Fu Zi (Aconiti Radix Praeparata), Ren Shen (Ginseng Radix) (each three qian and seven fen and half), Chan (Mantis Ootheca) (one fang cun bi, roasted), Gui Xin (Cinnamomi Ramulus) (one liang and two qian and half), Xi Xin (Asari Radix et Rhizoma), Tu Gou (Myobatrachus gularis) (each seven qian and half), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (one liang).
Pound into powder, take one fang cun bi with wine, three times daily.
Treating Bie Jia and chronic accumulations in heart and abdomen, or sudden accumulation.
Use white rooster manure, any amount, mix with urine, dry over fire in a vessel, grind into powder. Take one fang cun bi, no limit on dosage. Feeding with rice cooked in ointment is better.
[Qi Pi]
[Great Theory]: Women's Qi Pi (qi palpable mass) arises from irregular diet, spleen and stomach damage, struggle between pathogenic and righteous qi, accumulating in the abdomen, firm and immobile, with observable signs, hence named Ji (accumulation); qi pathway blocked, hence named Pi (stuffiness). Triggered by cold, if cold enters Zi Zang (uterus), infertility results; if it enters Bao Luo (uterine collaterals), amenorrhea results.
[Xue Ji]: For the aforementioned symptoms, if spleen and stomach are weak, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Xiong (Chuanxiong Rhizoma) and Gui (Dang Gui). (Formula seen in Miscellaneous Diseases - Deficiency Labor.) If liver and spleen are weak, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) (Miscellaneous Diseases - Injury from Labor and Fatigue) and Gui Pi Tang (Restore the Spleen Decoction). (Miscellaneous Diseases - Forgetfulness.) If liver fire is stagnant, assist with Lu Hui Wan (Aloe Pill) (Juvenile Diseases - Malnutrition Gate) and Di Huang Wan (Rehmannia Pill) (i.e., Liu Wei Di Huang Wan, Miscellaneous Diseases - Deficiency Labor). Apply Ai Wei Gao (Artemisia Argyi Plaster) externally. (Seen previously.) Patients must guard against the Seven Emotions and Six Evils, diet, and daily routine. Physicians must constantly examine the disease mechanism and medicate accordingly, hoping for effectiveness.
Chuan Shan Jia San (Pangolin Scale Powder) (from *Da Quan*): Treats women's Qi Pi and evil blood, qi attacking heart and abdomen causing pain, pale complexion, thin and weak limbs.
Chuan Shan Jia (Pangolini Squama) (ash-roasted dry), Bie Jia (Testudinis Carapax et Plastrum) (vinegar-roasted), Chi Shao Yao (Paeoniae Radix Rubra), Da Huang (Rhei Radix et Rhizoma) (stir-fried), Gan Qi (Dammar Resina) (stir-fried until smoke ceases), Gui Xin (Cinnamomi Ramulus) (each one liang), Chuan Xiong (Chuanxiong Rhizoma), Yuan Hua (Genkwa Flos) (vinegar-stir-fried), Dang Gui (Angelicae Sinensis Radix) (each half liang), She Xiang (Moschus) (two qian and half, separately ground).
Grind into fine powder, mix with She Xiang evenly. Take one qian each time, mixed with hot wine, at any time.
Peng E Zhu Wan (Curcuma Pill) (from *Da Quan*): Treats women's Qi Pi, obstructive pain in abdomen and hypochondrium, causing emaciation, loss of appetite.
E Zhu (Curcumae Rhizoma) (seven qian and half), Dang Gui (Angelicae Sinensis Radix) (baked), Gui Xin (Cinnamomi Ramulus), Chi Shao Yao (Paeoniae Radix Rubra), Bing Lang (Arecae Semen), Kun Bu (Laminariae Thallus), Hu Po (Electrum) (ground), Zhi Ke (Aurantii Fructus Immaturus), Mu Xiang (Aucklandiae Radix) (each half liang), Tao Ren (Persicae Semen), Bie Jia (Testudinis Carapax et Plastrum), Da Huang (Rhei Radix et Rhizoma) (each one liang).
Grind into powder, mix with rotten honey to form pills the size of sophora seeds. Take twenty pills before meals with rice drink.
Ding Xiang Wan (Clove Pill) (from *Da Quan*): Treats women's Qi Pi, lump formation not dispersing, heart and abdominal pain.
Xiong Que Fen (Excrement of Male Sparrow) (stir-fried yellow), Bie Jia (Testudinis Carapax et Plastrum) (each one liang), Sha Ren (Amomi Fructus), Dang Gui (Angelicae Sinensis Radix) (baked), Yuan Hua (Genkwa Flos) (vinegar-dried, each half liang), Ba Dou (Crotonis Fructus) (two fen and half, skin and heart oil removed).
Grind into powder, ensure uniformity. Boil with vinegar and wheat starch paste to form pills the size of small beans. Take three pills washed down with Dang Gui wine.
Tao Ren San (Peach Kernel Powder) (from *Pu Ji*): Treats women's Qi Pi, heart and abdominal distension and fullness, inability to eat, emaciation and weakness.
Tao Ren (Persicae Semen) (one liang, soaked in water, skin and tip removed, double-kernel ones avoided, bran-roasted until slightly yellow), He Zi Pi (Terminalia Chebulae Pericarpium), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chi Shao Yao (Paeoniae Radix Rubra), Dang Gui (Angelicae Sinensis Radix) (each seven qian and half), Jing San Leng (Bistortae Rhizoma) (cut, slightly roasted, one liang), Bie Jia (Testudinis Carapax et Plastrum) (vinegar-roasted, skirt removed, one liang and half), Chen Pi (Citri Reticulatae Pericarpium) (soaked in water, white pith removed, baked, three liang).
Grind into powder. Take three qian each time, one sheng of water, add one qian and three fen of ginger, decoct to six fen, strain, take slightly warm before meals.
The above formulas are all accumulation-dispelling medicines, mostly harsh in nature; users must be cautious, as stated by Dr. Xue.
[Food Accumulation]
Women with weak zang-fu organs, eating raw and cold foods during menstruation, spleen and stomach already weak, unable to digest, struggling with organ qi, knotting into lumps, growing day by day, firmly fixed and immobile, hence called Food Accumulation.
[Xue Ji]: For the aforementioned symptoms, if constitution and qi are weak, first tonify and strengthen spleen and stomach as main treatment, assisting with digestion-promoting herbs. If constitution and qi are solid, first guide and dredge as main treatment, assisting with spleen and stomach tonification. If qi is congested and blood is stagnant and not flowing, use Wu Yao San (Maytenus Powder) to scatter and promote flow. (Powder uses Wu Yao (Maytenus Root Bark), E Zhu (Curcuma Rhizoma) soaked in vinegar and stir-fried, Gui Xin (Cinnamon Twig), Dang Gui (Angelica Root), Tao Ren (Peach Kernel), Qing Pi (Green Tangerina Peel), Mu Xiang (Aucklandia Root), equal parts ground into powder, take two qian each time mixed with hot wine.) If spleen qi is deficient and blood does not flow, use Si Jun Zi Tang (Four Gentlemen Decoction), Xiong (Chuanxiong), Gui (Dang Gui) to tonify and promote flow. (Formula seen in Miscellaneous Diseases - Deficiency Labor.) If spleen qi is depressed and blood does not flow, use Gui Pi Tang (Restore the Spleen Decoction) (Miscellaneous Diseases - Forgetfulness) to resolve and promote flow. If liver and spleen blood is dry and does not flow, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) (Tubercles) to clear and promote flow. Generally, food accumulation and palpable masses are tangible; excess pathogenic qi leads to excess, depletion of true qi leads to deficiency. One should nourish righteousness and repel evil, and the accumulation will naturally remove itself. Although, hard things should be削 (scraped/reduced), guests should be removed. If stomach qi is not yet weak, slight use might be possible; if the disease is prolonged and the patient is weak, do not try lightly.
Nao Sha Wan (Sal Ammoniac Pill) (from *Da Quan*): Treats women's food accumulation not resolving for a long time, causing emaciation and poor appetite.
Nao Sha (Sal Ammoniac), Qing Meng Shi (Fluorite) (blue), Chuan Shan Jia (Pangolin Scale) (roasted), San Leng (Bistort Rhizome) (stir-fried), Gan Qi (Dammar Resin) (stir-fried until smoke ceases), Liu Huang (Sulfur) (each half liang), Ba Dou (Croton Seed) (thirty seeds, skin and heart removed, stir-fried, oil not removed).
Grind into powder, use soft rice to form pills the size of small beans. Take five pills each time, washed down with ginger and tangerina peel tea.
Meng Shi Wan (Fluorite Pill) (from *Da Quan*): Treats women's food accumulation lumps not resolving for a long time, stabbing pain in heart and abdomen.
Qing Meng Shi (Fluorite) (powder), Ba Dou (Croton Seed) (skin and heart removed, oil removed), Zhu Sha (Cinnabar), Fen Shuang (Calomelas) (both ground), Mu Xiang (Aucklandia Root) (powder) (each two qian and half), Nao Sha (Sal Ammoniac) (half liang).
Grind uniformly, mix with glutinous rice soft rice to form pills the size of mung beans. Take two pills each time on an empty stomach with warm wine, until foul matter is discharged.
The above formulas contain Nao Sha and Ba Dou; unless stomach qi is strong and accumulation qi is stubborn and mutually exclusive, they should not be used lightly.
Xiao San Leng Jian Wan: Treats food accumulation, alcohol癖 (habit/palpable mass), blood jia, qi blocks, intermittent stabbing pain, complete loss of appetite, and all kinds of stagnation not resolving, hard and distended heart and abdomen, phlegm-fluid vomiting, belching acid, stabbing pain in hypochondrium, spleen qi horizontal leakage.
San Leng (Bistort Rhizome), E Zhu (Curcuma Rhizome) (each four liang), Yuan Hua (Genkwa Flower) (one liang).
Put into porcelain vessel, soak with five sheng of rice vinegar, seal mouth, simmer with ash fire until dry. Remove San Leng and E Zhu. Stir-fry Yuan Hua with remaining vinegar until slightly scorched. Bake San Leng and E Zhu until dry, grind into powder. Form pills with vinegar paste the size of mung beans. Take fifteen pills each time, washed down with ginger soup. For women's blood division disease, men's spleen qi horizontal leakage, edema full like water, wash down with Sang Bai Pi (Mulberry Root Bark) decoction.
[Blood Accumulation]
Women with irregular cold and heat, weak zang-fu qi, wind-cold inside, undigested food, knotting with blood and qi, gradually forming lumps, firmly fixed and immobile. All due to blood and qi labor injury, menstruation coming and going, meridian blockage, evil blood not removed, knotting and gathering generated. Long-term unresolved leads to severe pain in heart, abdomen, and hypochondrium, harming diet, emaciated skin and muscles. Question: Accumulation is one thing, how to know it is Blood Accumulation? Answer: External signs of blood [accumulation], dizziness and irritability, confusion and forgetfulness,惊狂 (fright and madness), phlegm vomiting, profuse sweating, bone heat and cold limbs. If accumulated in lower jiao, there must be knotting and urgency below umbilicus, external heat and internal pain, chi pulse surging and rapid. Tao Ren (Peach Kernel), Ling Zhi (Lignosus Resina), Sheng Di Huang (Rehmannia Root), Niu Xi (Achyranthes Root), Da Huang (Rhubarb Root), Gan Cao (Licorice Root) to驱逐 (expel and purge).
[Xue Ji]: The aforementioned symptoms often involve damage from the Seven Emotions, causing discordance of qi and blood in the five zang. Qi mainly moistens, blood mainly nourishes. Spleen governs blood, Liver stores blood. Thus, depression injuring spleen, anger injuring liver often suffer from this. Abdominal and hypochondrial pain belongs precisely to liver and spleen meridians. Jie Gu said: Nourish righteousness, accumulation removes itself. Dong Yuan said: People rely on stomach qi as main. Treatment should focus on consolidating original qi and assisting with attacking agents. Time is necessary. If seeking quick effect, administering harsh agents causes errors.
Jia Jian Si Wu Tang (Modified Four Substances Decoction) (Formula seen in Miscellaneous Diseases - Accumulation). Dang Gui Wan (Angelica Pill). Mu Dan San (Moutan Powder) (Both same as above).
Da Huang Jian (Rhubarb Decoction) (from *Sheng Hui Fang*): Treats women's blood accumulation, blood jia, food accumulation, phlegm stagnation.
Chuan Da Huang (Rhubarb Root) (seven qian and half, crushed, slightly roasted), Bie Jia (Turtle Shell) (one liang, vinegar-roasted yellow, skirt removed), Niu Xi (Achyranthes Root) (remove radicle, one liang), Gan Qi (Dammar Resin) (one liang, stir-fried until smoke ceases).
Grind into powder. Use one sheng of rice vinegar, decoct into paste. Take one qian each time before meals, mixed with hot wine.
[Abdominal Stasis Blood]
Women with menstrual blockage and non-flow, or residual filth after childbirth not fully cleared, thereby catching wind and cooling, attacked by wind-cold, blood becomes stasis blood upon getting cold. Stasis blood inside causes frequent body heat and yellow face. If stasis persists and does not resolve, it becomes accumulation and jia.
[Xue Ji]: For the aforementioned symptoms, if depression injures spleen, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). (Formula seen in Miscellaneous Diseases - Forgetfulness.) If anger injures liver, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). (Tubercles.) If postpartum lochia, use Shi Xiao San (Instant Gratification Powder). (Formula seen in Heart Pain.) If liver and spleen deficiency, use Liu Jun Zi Tang (Six Gentlemen Decoction) and Chai Hu (Bupleuri Root), focusing on tonifying original qi. (Formula seen in Deficiency Labor.) If stomach qi is weak, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fu Ling (Poria) and Ban Xia (Pinellia Tuber) as main. (Formula seen in Miscellaneous Diseases - Labor Fatigue.) Generally, abdominal pain fearing hand pressure indicates internal stasis blood. If body shape is normal, belonging to both disease qi and original qi being excess, use Tao Ren Cheng Qi Tang (Peach Kernel Major Order the Qi Decoction) to directly purge. (Formula seen in Shang Han - Blood Accumulation.) If pain with limb fatigue and little desire for food, this is spleen and stomach injury, belonging to excess disease qi and deficient original qi, use Dang Gui San (Angelica Powder) to harmonize. (Formula seen in Miscellaneous Diseases - Hematuria.) If pain preferring hand pressure on abdomen, body fatigue, little desire for food, this is both form/qi and disease qi deficient, use Liu Jun Zi Tang (Six Gentlemen Decoction), Pao Jiang (Roasted Ginger), Xiong (Chuanxiong), Gui (Dang Gui) for pure tonification. If pain with loose stools and difficult digestion, this is spleen and kidney deficiency-cold, use Liu Jun Zi Tang (Six Gentlemen Decoction), Pao Jiang (Roasted Ginger), Rou Guo (Nutmeg) for warming tonification. If pain with vomiting and little food, this is spleen and stomach weakness, use Liu Jun Zi Tang (Six Gentlemen Decoction), Pao Jiang (Roasted Ginger), Huo Xiang (Pogostemon). If pain with vomiting, no food, and diarrhea, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Jiang (Ginger) and Gui (Cinnamon). If accompanied by cold extremities and spontaneous sweating, add Fu Zi (Prepared Aconite). This condition often results from attacking treatments.
Tiao Rong Tang (Regulate Nutrient Decoction): Treats stasis blood not resolving, navel and abdomen pulling waist and back all painful.
Chuan Xiong (Chuanxiong Rhizome), Dang Gui (Angelica Root), Shao Yao (Peony Root), Di Huang (Rehmannia Root), Sheng Jiang (Fresh Ginger) (each one liang), San Leng (Bistort Rhizome), E Zhu (Curcuma Rhizome), Bai Zhi (Angelica Dahurica Root), Yan Hu Suo (Corydalis Rhizome), Pu Huang (Typha Pollen), Xiang Fu (Cyperus Rhizome), Ze Lan Ye (Lycopus Herb), Xi Xin (Asarum Root), Chuan Bai Jiang (Zingiber Root), Hou Po (Magnolia Bark) (prepared), Ban Xia (Pinellia Tuber) (prepared), Gan Cao (Licorice Root) (each seven qian and half, roasted), La Gui (Cinnamon Twig), Tao Ren (Peach Kernel) (soaked in water, skin removed, baked, each five qian).
Cut into pieces. Take three qian each time, decoct with ginger and jujube, take before meals.
Chuan Dang Gui San (Chuan Angelica Powder): Regulates Ying and Wei, eliminates stasis blood, restores voice, treats phlegm cough.
Chuan Dang Gui (Angelica Root), Mu Dan Pi (Moutan Cortex), Bai Shao Yao (White Peony Root), Zi Qin (Scutellaria Root), Mu Tong (Akebia Stem), Hua Yin Xi Xin (Asarum Root), Mai Men Dong (Ophiopogon Tuber), Gan Cao (Licorice Root) (each half liang), Sheng Di Huang (Rehmannia Root) (one liang).
Cut into pieces. Take three qian each time, one sheng of water, three slices of ginger, decoct to seven fen, strain, take warm.
Da Huang Tang (Rhubarb Decoction): Treats women's blood stasis not resolving, and traumatic blood stasis.
Da Huang (Rhubarb Root) (raw use), Tao Ren (Peach Kernel) (soaked in water, skin and tip removed, double-kernel ones, each one liang), Gui (Cinnamon Bark) (remove rough bark), Yu Li Ren (Prunus Seed) (skin removed, ground, each half liang), Sheng Jiang (Fresh Ginger), Di Huang (Rehmannia Root) (each one liang).
Coarsely chop. Take three qian each time, half sheng water and half sheng wine, decoct together to seven fen, strain, take warm.
Hu Po San (Amber Powder): Treats women's meridian blockage, abdominal stasis blood, unbearable pain.
Hu Po (Amber), Ru Xiang (Frankincense), Mo Yao (Myrrh).
The above three ingredients, each grind to fine powder, five qian. Take two qian each time, half sheng water and half sheng wine, decoct to seven fen, add Er He of natural juice from Sheng Di Huang (Rehmannia Root), then