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For individuals with deficient and timid Heart Qi, presenting with palpitations (Zhenchong), restlessness, forgetfulness, or mental confusion following loss of spirit, use Chensha Anshen Wan. For those with Wind-Heat and excessive Phlegm in the Heart, use Guntan Wan. For Heart diseases, use Yujin, Ya Zao Jiao, Bai Fan, and Wugong. For robust individuals with excess Zheng Qi and Fire causing mania, direct treatment may be used, such as drinking Puxiao (Mirabilite) with ice water. If it is mania caused by deficient Fire, administer Ginger Decoction; if Ice Water is mistakenly given, death will ensue immediately. For severe and urgent Fire, Sheng Gancao can moderate and drain Fire; Renshen and Baizhu are also applicable. Generally, excess Qi constitutes Fire; deficiency of Qi constitutes Qi Deficiency. A young, robust, and obese individual suffering from Heart Wind and dementia was treated after emesis with the following formula: Beimu, Gualou, Nanting, Huanglian (each 1 liang); Yujin, Tianma, Qingzi, Sheng Gancao, Zhishi, Lianqiao, Kushen (each 0.5 liang); Bai Fan, Zaojiao (each 2 qian). These were made into pills. After taking the pills, one yellow Wugong and one red Wugong (fried in sesame oil until yellow), Xiong, Fangfeng, Nanting, Baifu, Bai Fan, Ya Zao (each 1 liang), and Yujin (0.5 liang) were processed into pills, coated with Zhusha.

In manic-depressive disorders, Dian (depression) belongs to Yin and often manifests as excessive laughter; Kuang (mania) belongs to Yang and often manifests as anger. A solid pulse indicates a poor prognosis or death; a deficient pulse indicates treatability. Generally, this is due to Phlegm knotting in the chest and heart region; treatment should calm the Spirit and resolve Phlegm knots. Some cases result from pathogenic invasion, which should be treated accordingly. However, the discussion in *Yuan Bing Shi* is particularly refined; the common belief that heavy Yin causes Dian and heavy Yang causes Kuang is erroneous; generally, these are Heat syndromes.

Masses located in the center are usually Phlegm-Fluids; on the right, Food Retention; on the left, Dead Blood (Blood Stasis). Qi alone cannot form masses; formed masses are tangible entities. For Phlegm, Food Retention, and Dead Blood, use Hai Shi boiled in vinegar, Sanleng boiled in vinegar, Ezhu boiled in vinegar, Taoren, Honghua, Wulingzhi, Xiangfu, and Shijian, made into pills, taken with Baizhu Decoction. Some versions include Zhen Sha. Walongzi can dissolve blood masses and also resolves Phlegm. In treating masses, one must descend Fire and resolve Food Retention, as retention is essentially Phlegm. After moving and eliminating Dead Blood, strong tonification is necessary. Salty flavors treat Phlegm accumulation; when masses are present, they cleanse turbidity. One formula for all accumulations and masses uses Shuhui Gen decocted, strained, then re-decocted with Renshen, Baizhu, Chenpi, Qingpi, Gancao Shao, and Niuxi. Add finely ground Taoren and Xuanningfen, drink hot. After two doses, the mass may descend. For severe cases, after tonification, adjust and proceed with attacking methods according to condition. The general principle is: salty to soften, reducing to eliminate, and moving Qi and opening Phlegm are key. Another formula for external application on accumulations uses Dahuang (2 liang, or 1 liang in some texts) and Puxiao (1 liang), powdered, mixed with mashed garlic into a paste, applied to the site. When dry, mix with vinegar and reapply. For masses in the subcutaneous tissue, combine Qi-tonifying herbs with Xiangfu to open blockages, combined with Erchen Tang. For women with masses due to Dead Blood, Food Retention, or Phlegm-Fluids, located in the hypochondrium, accompanied by abdominal borborygmus, epigastric discomfort, dizziness, fever, intermittent onset: Huanglian (1 liang, half stir-fried with Wuzhuyu, half with Yizhi, discard auxiliaries, keep Huanglian), Zhizi (0.5 liang, stir-fried), Taixiong (0.5 liang, stir-fried), Xiangfu (1 liang or 0.5 liang, soaked in child's urine), Luobozi (1.5 liang, stir-fried), Shanzha Rou (1 liang), Sanleng (5 qian), Ezhu (0.5 liang, boiled in vinegar), Taoren (0.5 liang, leave tips, remove skin), Qingpi (0.5 liang, or use Maidaiqu 0.5 liang). Powder these, make pills with steamed dough. Another formula includes Shenqu (5 qian), Baijiezi (1.5 liang), Walongzi (1 liang, vinegar-treated). If downward purging fails for accumulation, use resolving herbs to melt it; once opened, it dissipates. For hypochondriac pain with masses: Longhui Wan (2.5 qian), Pian Jianghuang (0.5 liang), Taoren (0.5 liang). Powder these, make honey pills. Another method combines Longhui Wan with White Pigeon Droppings to greatly reduce Food Retention. Or add Baohe Wan depending on the location. For deficient masses causing distension, avoid attacking drugs; use Sizjunzi Tang with Banxia and Chenpi in large doses. Wait for Yuan Qi to recover before using attacking drugs. For痞块 (痞块), use Mugua (or its shell) 21 pieces, split pig kidneys, bake until cooked, mash, add Huanglian powder (3 qian), make pills size of mung beans, take 30 pills per dose. For Qi pain below the umbilicus: Muxiang, Binglang, Sanleng, Ezhu, Qingpi (each 0.5 liang), Mutong (0.5 liang), Huanglian (stir-fried 0.5 liang), Chenpi (0.5 liang), Suosha, Hongdou (each 3 qian), Xiangfu (1 liang). For Liver Meridian Blood-Stasis pain, powders are good, but pills are better: Danggui (0.5 liang), Honghua (stir-fried 1 qian), Taoren (20, peeled and pitted), Yanhusuo (crushed 0.5 liang), Chi Shaoyao (0.5 liang), Moyao (3 qian), Ganqi (0.5 liang, stir-fried until smoke ceases). If stool is dry, add Shu Dahuang. For masses anywhere in the body, consider Phlegm; ask about dietary preferences and use counteracting herbs to resolve, administered after emesis. For a case of chest fullness like a mass blocking flow: Baizhu (1 liang), Nanting, Beimu, Shenqu, Shanzha, Jianghuang, Chenpi, Fuling (each 5 qian), Zhizi (0.5 liang), Xiangfu (1 liang), Luobozi, Zaocici (each 3 qian). Powder these, make pills with ginger cake. For a lower abdominal mass: Gualou, Beimu, Huangqin, Nanting, Baizhu (each 1 liang, or 0.5 liang in some texts), Xiangfu (vinegar-boiled 1 liang), Shu Dihuang, Danggui, Yanhusuo, Taoren (each 5 qian), Sanleng, Ezhu (vinegar-boiled each 5 qian). Powder these, make pills with yeast. Qianjin Xiaoshi Wan grinds masses; Sansheng Gao applies externally (both effective). I recall Master treating a woman with a lower abdominal mass; her pulse was choppy. After attacking drugs, the pulse became large. He used Siwu Tang doubled with Baizhu, Chenpi, and Gancao as assistants. When the pulse became full, he intermittently gave Xiaoshi Wan. After two months, the mass disappeared completely. A sixty-year-old man, accustomed to alcohol, contracted illness while walking in summer heat. Cold knees, a mass in the upper epigastrium pulling like a palm, hypochondriac pain preventing sleep, reduced appetite, no thirst. He had self-administered Shengliao Wuji San for three doses. All six pulses were deep, choppy, small, not weak upon pressure, rapid, especially on the right. Bowel movements were normal, urine red. He prescribed Dachengqi Tang with half the Dahuang removed and stir-fried, plus Huanglian, Shaoyao, Chuanxiong, Ge Gen, and Gancao as decoction, and Gualou Ren, Banxia, Huanglian, Beimu as pills. After twelve doses, cold feet receded, mass halved. Medication stopped. By half a month, the disease resolved. Accumulations and aggregations should be distinguished by Yin and Yang. Ji (accumulation) has a root, fixed pain, and knotted/depressed pulse. Ju (aggregation) has no root, wandering pain, and floating/knotted pulse. These result from Yin-Yang disharmony, Zang-Fu weakness, and dysfunction of Four Qi and Seven Emotions.