瘕冷热都是瘀，或因食积或郁怒；
者，坚而不移；瘕者，坚而能移。七 八瘕，经亦不详。虽有蛇、蚊、鳖、肉、发、虱、米等名，偶因食
物相感，假血而成形耳，瘕比 稍轻。其为病所以异于男子者，皆曰产后及经水行时，或饮食生冷，以致脾虚
与脏气相结；或七情气郁生痰，皆必挟瘀血而后成形。要知 瘕、 癖、石瘕、肠覃、食 、血 、食 、血
瘕，种种不一，尽皆痞块之异名耳。经云∶大肠移热于小肠，小肠移热于大肠，两热相搏，则血溢而为伏瘕，
月事不利。以此推之， 瘕皆有热者，盖瘀血亦有热燥逼成，况阳气怒火蕴聚，饮食湿热拂郁结成，未可专以寒
冷论也。大概虚冷者，内炙散、琥珀丸、温白丸；热者，消块丸、连萝丸，外贴三圣膏，神效阿魏散。久不愈
者，猪肝丸、辰砂一粒丹、神圣代针散。瘀血，四物汤加桃仁、韭汁。甚者加蜀葵根，入玄明粉下之；或桂枝桃
仁汤，外以韭菜捣饼熨痛处；或万痛丸、桃奴散。食积，三棱煎、保和丸、红丸子；虚者，白术膏、补中益气
汤；热者，大承气汤加黄连、芍药、川芎、干姜、甘草，或单黄连丸，小调中汤加贝母，姜汁糊丸服。郁气，
白葱散、蟠葱散、七制香附丸、当归龙荟丸。痰饮，润下丸，或二陈汤加香附、枳壳、桔梗；痰瘀食积者，白
芥丸，海石丸。
腹痛经闭如怀胎，面黄寒热梦无数。
瘕得冷则发，腹痛支满，胸胁腰背相引，四肢疼痛，月事不调，如怀胎之状。邪气甚盛，令人恍惚，夜
多异梦，寒热往来，四肢不举，阴中生疮，甚者小便淋沥，或兼带下，小腹重痛，面色黄黑，入于子脏则绝产，
入于胞络则经闭，宜人参荆芥散、小温经汤、逍遥散、通经丸、古斑玄丸选用。血与气并，心腹痛连腰胁背膂，
甚则搐搦，经候不调，谓之血气，玄胡索散、手拈散、失笑散、单干漆丸。数证因痰瘀气积者，与上诸方通用。
癖病治颇相同，
者，在腹内近脐，左右各有一条筋脉急痛，如臂、如指、如弦之状，名曰 ；癖者，偏僻在两肋之间，
有时而痛，名曰癖。皆阴阳不和，饮食停滞，冷气相搏而成，亦得冷则发。
腹胀不食亦可惧；
红丸子、猪肝丸、小乌鸡丸、葱白散。
肠覃可按血自通，
肠覃，乃寒气客于大肠，与胃相搏。大肠为肺传送，肺主气，气得热则行，得冷则凝，凝则清气散，而
浊气结而为瘕。覃延日久不已， 肉乃生，始如鸡卵，久如怀胎，按之坚，推之移，月事时下，或多或少，气
病而血未病也，宜二陈汤加香附以开之，或香粉丸。
石疝塞胞经无路。
女子 瘕疝气，发则腹痛逆气上冲，乃胞中伤损，瘀血结成。久则坚硬如石，塞于子门，大如怀胎，月事
不下，乃先感寒气，而后血壅不流所致。血瘕，石 丸；气血瘕，散聚汤；疝瘕，麝香丹、古硝黄膏；石瘕，
见丹主之，或通经丸，加红花尤妙。
血蛊气蛊坚如石，水蛊肿满俱难治；
蛊者，三虫聚而食血之象，即 瘕之甚者。肚腹急硬如石，肿满如水，乃瘀结胞门，或产后为水与血搏，
通用四香散、千金桃仁煎、内消散、蛤蟆煮肚法、抱瓮丸、黄米丸。单腹蛊胀者，大腹皮饮救之。详男科肿胀
类。
调气破血渐消除，虚者还宜补脾胃。
善治 瘕者，调其气而破其血，消其食而豁其痰，衰其大半而止，不可猛攻峻施，以伤元气。宁扶脾正气，
待其自化，此开郁正元散之由名也。愈后宜大小乌鸡丸、八珍汤、交加
散、交加地黄丸调之。凡攻击之药，病重病受，病轻胃气受之而伤矣。或云待块消尽而后补养，则胃气之存也几希。
**Jia (Masses) and Pin (Lumps)**
Whether cold or heat, *jia* (masses) are fundamentally caused by blood stasis. Etiology may involve food retention or emotional depression/anger.
"Qin" (寝) is characterized by hardness and immobility; "Jia" (瘕) is relatively hard but movable. The specific categories of "Seven Jias and Eight Masses" are not detailed in classical texts. Although names such as Snake Jia, Mosquito Jia, Turtle Jia, Flesh Jia, Hair Jia, Louse Jia, and Rice Jia exist, these merely represent forms created by blood accumulation triggered by the ingestion of specific foods. Among them, *jia* is slightly less severe than *qin*.
The pathology of these conditions differs from abdominal masses in men primarily because they often occur postpartum or during menstruation, or result from consuming raw/cold foods leading to Spleen deficiency and Qi binding with Zang-Fu organs. Alternatively, emotional stagnation generates Phlegm. In all cases, Blood Stasis must be involved for a tangible mass to form. It should be understood that Qin, Pin, Shi Jia (Stone Jia), Chang Qun (Intestinal Growth), Shi Qin (Food Qin), Xue Qin (Blood Qin), Shi Jia (Food Jia), and Xue Jia (Blood Jia), though varied in name, are all alternative terms for Pi Ku (痞块 - subcutaneous lumps/masses).
As stated in the *Huangdi Neijing* (Yellow Emperor's Inner Canon): "Heat transferring from the Large Intestine to the Small Intestine, and from the Small Intestine to the Large Intestine, causes two heats to clash, leading to blood extravasation and forming Fu Jia (Hidden Jia), resulting in irregular menstruation." From this, it can be inferred that Qin and Jia often involve Heat. This is because Blood Stasis can also be formed by dryness and heat forcing blood, and furthermore, Yang Qi hyperactivity, anger accumulation, and damp-heat from diet can bind together. Thus, one cannot exclusively attribute these conditions to Cold.
Generally:
For Deficiency-Cold patterns, use **Neizhi San** (Internal Moxibustion Powder), **Hupo Wan** (Amber Pill), or **Wenbai Wan** (Warm White Pill).
For Heat patterns, use **Xiao Kuai Wan** (Mass Dissolving Pill), **Lianluo Wan** (Lotus Root Pill), apply **Sansheng Gao** (Three Saints Plaster) externally, or take **Shenxiao Awie San** (Miraculous Asafoetida Powder).
For chronic cases unresponsive to treatment, use **Zhugan Wan** (Pig Liver Pill), **Chensha Yili Dan** (Cinnabar One-Pill Elixir), or **Shensheng Daizhen San** (Divine Needle Replacement Powder).
For Blood Stasis, use **Siwu Tang** (Four Substances Decoction) plus **Taoren** (Peach Kernel) and **Jiu Zhi** (Leek Juice). For severe cases, add **Shuhui Gen** (Malva Root) and **Xuanming Fen** (Nitrified Saltpeter) to purge downward; or use **Guizhi Taoren Tang** (Cinnamon Twig and Peach Kernel Decoction), with external application of mashed leek cakes on painful areas; or use **Wantong Wan** (Ten Thousand Pain Pill) or **Taonü San** (Peach Bud Powder).
For Food Retention, use **Sanleng Jian** (Burreed Decoction), **Baohe Wan** (Preserve Harmony Pill), or **Hongwanzi** (Red Pill). For deficiency, use **Baizhu Gao** (Atractylodes Paste) or **Buzhong Yiqi Tang** (Tonify the Middle and Augment the Qi Decoction). For heat patterns, use **Dachengqi Tang** (Major Order the Qi Decoction) plus **Huanglian** (Coptis Rhizome), **Shaoyao** (Peony Root), **Chuanxiong** (Sichuan Lovage Rhizome), **Ganjiang** (Dried Ginger), and **Gancao** (Licorice Root); or simply **Huanglian Wan** (Coptis Pill), or **Xiaozhongtang** (Minor Harmonizing Decoction) plus **Beimu** (Fritillaria Bulb), made into pills with ginger juice.
For Qi Stagnation, use **Baicong San** (White Scallion Powder), **Pancong San** (Coiled Scallion Powder), **Qizhi Xiangfu Wan** (Seven-Processed Cyperus Pill), or **Danggui Longhui Wan** (Angelica and Gardenia Pill).
For Phlegm-Fluids, use **Runxia Wan** (Moistening Purge Pill), or **Erchen Tang** (Two Aged Ingredients Decoction) plus **Xiangfu** (Cyperus Rhizome), **Zhiqiao** (Aurantium Fruit), and **Jiegeng** (Platycodon Root). For combined Phlegm, Stasis, and Food Retention, use **Baijie Wan** (White Mustard Seed Pill) or **Haishi Wan** (Calcium Carbonate Pill).
**Symptoms:** Abdominal pain, amenorrhea resembling pregnancy, yellowish complexion, alternating chills and fever, and numerous vivid dreams.
When Qin/Jia is triggered by cold, it presents with abdominal pain, distension and fullness, pain radiating to the chest, hypochondrium, lower back, and limbs, irregular menstruation, and a sensation akin to pregnancy. If pathogenic factors are excessive, it causes mental confusion, strange dreams at night, alternating chills and fever, inability to move the limbs, sores in the vagina, severe cases presenting with dysuria or leukorrhea, heavy pain in the lower abdomen, and a sallow-black complexion. If the pathogen enters the Zi Zang (uterus), it leads to sterility; if it enters the Bao Luo (uterine collaterals), it causes amenorrhea. Treatment should select from **Renshen Jingjie San** (Ginseng and Schizonepeta Powder), **Xiao Wenjing Tang** (Minor Warming the Menses Decoction), **Xiaoyao San** (Free and Easy Wanderer Powder), **Tongjing Wan** (Unblocking Menses Pill), or **Gu Banxuan Wan**.
When Blood and Qi combine causing heart and abdominal pain radiating to the waist, hypochondrium, and back, potentially with spasms and irregular menstruation, this is called "Xue Qi" (Blood-Qi disorder). Use **Xuansu San** (Corydalis Powder), **Shounian San** (Hand-Grasping Powder), **Shixiao San** (Instant Relief Powder), or **Dan Ganqi Wan** (Single Dry Lacquer Pill). For the above conditions caused by Phlegm, Stasis, and Qi accumulation, the aforementioned formulas can be used generally.
**Pin Disease** treatment is similar.
"Pin" (寢) refers to tendons near the umbilicus on either side that become tight and painful, feeling like an arm, finger, or string. "Pi" (癖) refers to pain occurring intermittently in the lateral recesses between the ribs. Both result from Yin-Yang disharmony, food stagnation, and Cold Qi clashing, and are triggered by cold.
**Abdominal distension and anorexia** are also alarming. Treat with **Hongwanzi**, **Zhugan Wan**, **Xiao Wuji Wan**, or **Congbai San**.
**Chang Qun (Intestinal Growth)** can be palpated, and menstruation usually remains regular.
Chang Qun arises when Cold Qi lodges in the Large Intestine and clashes with the Stomach. The Large Intestine transmits Lung Qi; Lung governs Qi. When Qi encounters heat, it moves; when it encounters cold, it coagulates. Coagulation disperses clear Qi and allows turbid Qi to knot into a mass. Over time, fleshy growths develop, starting the size of a chicken egg and growing to resemble pregnancy. They are hard to the touch but movable. Menstruation occurs regularly, though volume may vary. This indicates a Qi disorder without Blood involvement. Use **Erchen Tang** plus **Xiangfu** to open stagnation, or **Xiangfen Wan**.
**Shi Han (Stone Hernia)** blocks the uterus, leaving no path for menstruation.
In women, Jia-Hernia Qi attacks cause abdominal pain and rebellious Qi rushing upward due to uterine injury and blood stasis formation. Over time, it becomes hard as stone, blocking the Zi Men (cervical opening), appearing large as pregnancy, with absent menstruation. This results from initial Cold invasion followed by blood congestion and stagnation. For Blood Jia, use **Shi [Missing Character] Wan**; for Qi-Blood Jia, use **Sanju Tang**; for Hernia-Jia, use **Shexiang Dan** or **Gu Xiaohuang Gao**; for Shi Jia, refer to previous prescriptions or use **Tongjing Wan** with added **Honghua** (Safflower) for better effect.
**Xue Gu (Blood Gu), Qi Gu** are hard as stone; **Shui Gu (Water Gu)** involves swelling and fullness and is difficult to treat.
"Gu" represents three parasites gathering and consuming blood, representing the most severe form of Jia/Qin. The abdomen becomes urgent, hard as stone, and swollen with water-like fluid. This is due to blood stasis knotting at the Baomen (uterine gate) or postpartum water-blood conflict. General treatments include **Sixiang San**, **Qianjin Taoren Jian**, **Neixiaosan**, **Hamazhu Du Method** (Toad-boiled Stomach method), **Baoweng Wan**, or **Huangmi Wan**. For isolated abdominal distension (Danfu Guzhang), use **Dafupi Yin**. See Male Disorders section on Swelling for details.
**Regulate Qi and Break Blood** to gradually eliminate the disease; for deficiency, **Tonify Spleen and Stomach**.
Skilled practitioners treating Qin/Jia regulate Qi, break Blood, resolve Food, and expel Phlegm. Treatment should cease when the pathogen is reduced by more than half; do not use fierce attacks that damage Yuan Qi (Primal Qi). It is better to support Spleen Zheng Qi (Upright Qi) and wait for self-resolution, which is the rationale behind the name "Kaiyu Zhengyuan San" (Open Depression and Restore Primal Source Powder). Post-recovery, regulate with **Da/Xiao Wuji Wan** (Large/Small Black Chicken Pills), **Bazhen Tang** (Eight Treasures Decoction), **Jiajiao San**, or **Jiajiao Dihuang Wan**. Attack-type drugs burden the body in severe disease and damage Stomach Qi even in mild disease. Some suggest waiting until the mass disappears before tonifying, but this leaves very little Stomach Qi remaining.