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Xu Xueshi said: Generally, to treat accumulations (Ji), one may attack them with substances the patient dislikes, or lure them out with substances the patient likes, which makes them easier to cure. For example, Sha Ren (Amomi Fructus) and A Wei (Ferulae Resina) are used to treat meat accumulation; Shen Qu (Massa Medicata Fermentata) and Mai Ya (Hordei Fructus Germinatus) are used to treat alcohol accumulation; Shui Zhi (Hirudo) and Meng Chong (Ophiorrhizae Rhizoma) are used to treat blood accumulation; Mu Xiang (Aucklandiae Radix) and Bing Lang (Arecae Semen) are used to treat qi accumulation; Qian Niu Zi (Pharbitidis Semen) and Gan Sui (Kansui Radix) are used to treat water accumulation; Xiong Huang (Realgar) and Ni Fen (Calomelas) are used to treat phlegm-saliva accumulation; Meng Shi (Lepidocrocitum) and Ba Dou (Crotonis Fructus) are used to treat food accumulation. Each is treated according to its category. If a group of medicines is used to disperse the pathogenic factor's momentum, it will be difficult to achieve efficacy. One must clearly identify what kind of accumulation it is and what syndromes accompany it, then adjust and weigh the medications accordingly. Otherwise, harm may result. The key lies in flexible adaptation during clinical practice.

Wang Junyong from Zhengding, aged nineteen, suffered from an accumulation. There was a mass on the left side of the umbilicus extending to the hypochondrium, shaped like an inverted cup. His abdomen was distended like a drum, with many blue collateral vessels visible. He wheezed and could not lie flat. At that time, it was the rainy season with summer heat. Additionally, he had spontaneous diarrhea with undigested food, tidal fever in the late afternoon, and night sweats. He came seeking medical help in a critical condition. I examined him and found his pulse floating and rapid, but forceful upon deep pressure. I told the family: "Generally, treating accumulations requires toxic agents to attack them. However, given that the pulse is now weak [Note: Textual inconsistency noted], how dare I use standard methods?" Thus, I administered a formula for separating turbidity and benefiting the stomach (Fen Shen Yi Wei). After several doses, his urination and defecation naturally regulated. I then combined this with methods to ascend and descend yin and yang, promote appetite, and harmonize qi. His abdominal distension significantly decreased, and his stomach qi slightly stabilized. Intermittently using draining and reducing methods, he recovered well in less than a month. My former teacher once said: "The Elder Jieguo stated: 'Nourish the righteous qi, and the accumulation will remove itself.' This is like having a room full of gentlemen; even if there is one villain, he will have no place to stay and will leave on his own." Now, with righteous qi solidified and stomach qi strong, the accumulation naturally dissipates. Would Jieguo's words deceive us? The *Neijing* states: "For large accumulations, stop when more than half has been reduced." Even in cases of excess with accumulated qi, one should not overuse highly toxic drugs, let alone in cases where deficiency coexists with accumulation. This is also one aspect of treating accumulations. One must carefully examine the interplay of pathogenic factors, righteous qi, excess, and deficiency.

[Wumei Wan] Treats ascariasis caused by cold in the zang organs, where roundworms move restlessly, enter the epigastrium, causing irritability, vomiting, intermittent attacks, vomiting immediately after eating, and frequent expulsion of worms. When these symptoms occur, it is called "twirling jue" (Hui Jue). This medicine is indicated. It also treats chronic dysentery.
Wu Mei (300 fruits) Huang Bo (Zanthoxyli Cortex, processed with honey/fire) Xi Xin (Asari Radix et Rhizoma, removed roots) Rou Gui (Cinnamomi Cortex, removed rough bark)
Fu Zi (Aconiti Lateralis Radix Praeparata, processed, removed skin and navel) Ren Shen (Ginseng Radix, removed rhizome, each 6 liang) Gan Jiang (Zingiberis Rhizoma, processed, 10 liang) Dang Gui (Angelicae Sinensis Radix, removed rhizome, 4 liang)
Shu Jiao (Sichuan Pepper, removed eyes and closed ones, lightly fried until moisture evaporates, 4 liang) Huang Lian (Coptidis Rhizoma, removed roots, 16 liang)
Process each herb separately by pounding and sieving, then mix them together. Soak Wu Mei in wine overnight, remove pits, steam until cooked, mash with rice flour into a paste, and blend with the herbal powders. Place in a mortar, pound with refined honey two thousand times, and form pills the size of paulownia seeds. Take fifteen pills per dose, washed down with warm rice drink, before meals.

[Hua Chong Wan]
He Shi (Datiscae Caulis) Bing Lang (Arecae Semen) Ku Lian Gen (Meliae Cortex) Hu Fen (Cerussa, fried, each 1 liang)
Bai Fan (Alumen, calcined, 2 qian 5 fen)
Grind all ingredients into fine powder. Use water paste to form pills the size of sesame seeds. Children's illnesses often involve various parasites. These may arise due to weakness of the zang-fu organs or due to consumption of sweet and fatty foods. When the parasites move, abdominal pain occurs, and masses move up and down, with pain having intervals. They may attack the heart, causing crying without cessation, closing eyes, arching the back, flailing hands, mental confusion, vomiting saliva, or clear fluid. Limbs become emaciated and weak, complexion turns greenish-yellow. Although food intake continues, muscles do not grow. Symptoms may include alternating chills and fever, lethargy, and uncertainty about the disease location. If these parasites are not treated, they will reproduce endlessly. Those reaching one chi in length can harm the body. For a one-year-old child, administer five pills, mixed with warm grain water and one or two drops of raw oil, stirred evenly and given orally. Warm rice drink is also acceptable. Time of administration is unrestricted. Fine parasites will dissolve into water, while larger ones will be expelled naturally.

[Bu Jin San] Treats various types of parasites.
He Shi (Datiscae Caulis, raw) Lei Wan (Polyporus Umbellatus) Ding Fen (Cerussa) Xi Hui (Stannum Ash, equal parts)
Grind all ingredients into fine powder. Take three qian per dose, on an empty stomach before meals, mixed with a little oil. Alternatively, roast one liang of pork, sprinkle the medicine on top, and chew thoroughly. When taking the medicine, use a chicken feather to apply one qian of Gan Sui powder, and take it together with the main medicine. The parasites will be expelled.

[Lei Jin San] Treats various parasites.
Lei Wan (Polyporus Umbellatus, powdered, 8 fen) Yu Jin (Curcumae Longae Rhizoma, powdered, 7 fen) Hei Qian Niu (Pharbitidis Semen Nigrum, powdered, 1 qian 5 fen)
Mix the three powders evenly. Take three tablespoons mixed with raw oil, followed by a meal to suppress the drug's action.

[Hua Chong San] Expels Taenia saginata (Beef Tapeworm/Cun Bai Chong).
Huang Dan (Minii Oxidum Rubrum, half liang, fried) Xi Hui (Stannum Ash, one liang, sieved) Ding Fen (Cerussa, two liang)
Grind all ingredients together into an extremely fine powder. Take one qian per dose. First, roast five slices of pork, eat them, then take the medicine mixed with about one mouthful of raw oil. The worms will be expelled by evening. Pregnant women must not take this. Li Futong's daughter, Ju Hua, aged thirteen, expelled a handful of worms after a single dose and never suffered recurrence again.