论曰凡积气在胃脘，复大如盘者，脾积也，痞结不通，故名痞气，此本肝病传脾。脾当
传肾，肾以冬适王而不受，邪气留于脾。故结为积，久不愈，令人四肢不收，发为黄胆。饮
食不为肌肤，所以然者，脾藏肌肉之气，能与胃行其津液，以荣养四肢，若为积气所留，不
能荣养，故有四肢不收，饮食不为肌肤之证。
治脾积痞气，胸胁胀满，气逆昏闷，四肢少力，乌头丸方
乌头（炮裂去皮脐） 半夏（汤洗去滑焙干各一两） 防风（去叉） 干姜（炮） 枳
实（去瓤麸炒） 皂荚
上七味，捣罗为末，生姜自然汁为丸，如小豆大，早晚用炒生姜汤，下七丸至十丸，不
可多服。
治脾积气，累有伤滞，食已腹痛，饮食不化，呕哕恶心，胸胁胀闷，大便秘利不定。
磨滞丸方
木香 青橘皮（汤浸去白焙） 桂（去粗皮各一两） 吴茱萸（汤洗焙干炒三两）
砂（醋熬成霜研
上六味，捣罗四味为末，与 砂巴豆霜同拌匀，醋煮面糊为丸，如绿豆大，每服三丸，
加至五丸，早晚食后临寝服，大便溏利时，减丸数服。
治脾积痞气，攻注腰背痛，豆蔻汤方
肉豆蔻（去壳） 赤茯苓（去黑皮） 高良姜 附子（炮裂去皮脐） 草豆蔻（去皮） 藿
香陈橘皮（汤
上一十味，锉如麻豆，每服二钱匕，水一盏半 入枣五枚劈，生姜一分切碎，煎至八分，
去滓热服。
治脾积冷气痞结，胸满痰逆，四肢怠堕，半夏汤方
半夏（陈者汤洗去滑焙干） 葶苈（纸上炒各一两） 麦门冬（去心焙干二两） 芦根
（锉碎三两）
上四味，粗捣筛，每服三钱匕，水一盏。入小麦净淘半合，生姜半枣大切，同煎至八分，
去滓空心日午夜卧各一，如病患瘦弱，即加桂心柏子仁各一两。
治脾积痞气，泄泻。日夜下痢白脓，矾石丸方
矾石（烧令汁枯） 诃黎勒（煨去核各二两） 黄连（去须三两） 木香（一两）
上四味，捣罗为末，水浸蒸饼滤如糊为丸，如梧桐子大，空心食前，陈米饮下三十丸，
以泄止为度。
治脾积痞气，微有滑泄，不思饮食，芜荑丸方
芜荑（四两） 陈橘皮（汤浸去白焙干四两为末米醋一升煎如糊） 附子（炮裂去皮脐
二两） 莎草
上六味，除橘皮外，捣罗为末，入橘皮煎，搜和，更入炼蜜为丸，如梧桐子大，空心日
午，陈米饮下三十丸。
治脾积痞气，大便不通，身重少力，肢节疼痛，牵牛子丸方
牵牛子（一两半微炒） 甘遂（半两微炒） 京三棱（炮锉） 陈橘皮（汤浸去白焙干）
诃黎勒（煨去皮
上六味，捣罗为末，生姜汁二两，蜜四两，同煎至四两，搜和前药末为丸。如梧桐子大，
临卧米饮下二十丸，如不转，加至三十丸。
治脾积痞气，烦渴口干，葛根丸方
葛根（锉） 附子（炮裂去皮脐） 薏苡（根锉） 芦根（锉各一分） 糯米（二合）
上五味，捣罗为末，入桃胶汤浸，煮为糊，和丸如小豆大，食后临卧灯心枇杷叶煎汤下
十丸至二十丸。
治脾积痞气，身黄口干，胸膈满闷，肌瘦减食，或时壮热，脾积丸方
陈仓米（一合醋浸淘过） 青橘皮（五十片醋浸软去白） 巴豆（五十枚去皮麻线系定
三味同炒干去巴豆不用入后药） 石三棱（一分） 鸡爪三棱（一分） 蓬莪术（三枚炮锉）
京三棱（一分炮锉） 槟
上八味，捣罗为末，取一半，面糊为丸，如绿豆大，一半作散，每服一钱匕，粥饮调下
三丸。
治脾积痞气，腹胁膨胀，心胸痛闷，不思饮食，平气丸方
槟榔（一枚锉） 乌梅（一两一半去核一半和核） 京三棱（炮半两） 青橘皮（去白
焙一两） 缩砂（去
上七味，将六味捣罗为末。入巴豆研匀，白面糊和丸，如绿豆大，每服三丸，温生姜汤
下，食后服
治脾积痞气 痰逆恶心，腹胁满闷，胸膈噎塞，不思饮食，金液丸方
京三棱（炮） 蓬莪术（炮） 白术 丁香皮（刮去粗皮） 牵牛子（麸炒） 青橘皮 陈
橘皮（并汤浸去白焙） 肉豆蔻（大者去壳） 槟榔（炮各一两） 干姜（炮） 丁香
砂（研各半两） 巴豆（半两和皮秤
上一十三味为末，搅拌匀，用头醋煮稠面糊和丸，如绿豆大，每服五丸，米饮下食后。
治脾积痞气，心腹胀满，呕逆噫酸，快气丸方
槟榔（三枚锉） 木香（一两） 肉豆蔻（去壳半两） 甘遂（半两麸炒黄） 大戟（一
分炮） 白牵牛（一两炒） 墨（烧赤醋淬一分） 沉香（半两） 陈橘皮（汤浸去白焙）
青
治痞气胁肋满闷，白术汤方
白术 柴胡（去苗） 生姜（去皮薄切焙干） 浓朴（去粗皮涂生姜汁炙香熟） 桂（去
粗皮各三两）
上七味，粗捣筛，每服三钱匕，水一盏，煎至七分，去滓温服，微利为度。
Commentary states: Whenever accumulated Qi resides in the epigastrium and swells to the size of a plate, it is called Pi Ji (Spleen Accumulation). Due to the obstruction and blockage causing a sensation of fullness and stuffiness, it is named Pi Qi (Stagnant Qi). This condition originally stems from Liver disease transmitting to the Spleen. The Spleen should transmit the pathogenic factor to the Kidney; however, since the Kidney is prosperous during winter, it does not accept the pathogen, causing the evil Qi to remain in the Spleen. Consequently, it condenses into an accumulation. If left untreated for a long time, it causes the limbs to become weak and unable to support the body, leading to Huang Dan (Jaundice). Food and drink fail to transform into muscle and flesh nutrition. The reason for this is that the Spleen stores the Qi of muscles and assists the Stomach in transporting fluids to nourish the four limbs. If obstructed by accumulated Qi, it cannot provide nourishment, thus resulting in symptoms of limb weakness and food failing to nourish the body.
Treatment for Pi Ji (Spleen Accumulation) with chest and hypochondriac distension, rebellious Qi causing dizziness and stuffiness, and limb weakness: Wutou Wan (Aconite Pill) Formula.
Wutou (Radix Aconiti Lateralis Preparata), cracked and split, skin and umbilicus removed, 1 liang; Banxia (Rhizoma Pinelliae Preparata), washed in water to remove slipperiness, dried by baking, 1 liang; Fangfeng (Radix Saposhnikoviae), forked parts removed; Ganjiang (Rhizoma Zingiberis Preparata), prepared; Zhishi (Fructus Aurantii Immaturus), pulp removed, stir-fried with bran; Zaojiao (Fructus Gleditsiae Sinensis).
The above seven ingredients are crushed, sieved into powder, and made into pills using fresh ginger juice, sized like small beans. Take 7 to 10 pills morning and evening with decoction of stir-fried ginger root. Do not overdose.
Treatment for Pi Ji (Spleen Accumulation) with frequent food stagnation, abdominal pain after eating, indigestion, vomiting, belching, nausea, chest and hypochondriac fullness, and irregular bowel movements (alternating constipation and diarrhea): Mozhi Wan (Grinding Stagnation Pill) Formula.
Muxiang (Radix Aucklandiae); Qingju pi (Pericarpium Citri Reticulatae Viride), soaked in water, white pith removed, baked; Gui (Cortex Cinnamomi), coarse bark removed, each 1 liang; Wuzhuyu (Fructus Evodiae Preparatus), washed in water, dried by baking and stir-fried, 3 liang; Sharen (Fructus Amomi Rotundus), boiled in vinegar until frost forms, ground; Badou (Semen Crotonis Tiglii), processed into paste.
The above six ingredients: Four are crushed and sieved into powder, then mixed evenly with Sharen frost and Badou paste. Made into pills using vinegar-boiled wheat starch paste, sized like mung beans. Take 3 pills per dose, increasing to 5 pills. Take morning and evening after meals and before sleep. Reduce dosage if loose stools occur.
Treatment for Pi Ji (Spleen Accumulation) with pain radiating to the lower back and waist: Doukou Tang (Cardamom Decoction) Formula.
Roudoukou (Semen Myristicae), shell removed; Chifuling (Poria cum Radix Pini Nigricans), black skin removed; Gaoliangjiang (Rhizoma Alpiniae Officinarum); Fuzi (Radix Aconiti Lateralis Preparata), cracked and split, skin and umbilicus removed; Caodoukou (Semen Cardamomi), skin removed; Huoxiang (Herba Agastaches); Chenju pi (Pericarpium Citri Reticulatae), soaked in water... [Text incomplete].
The above ten ingredients are cut into pieces the size of hemp seeds. Take 2 qian bi per dose, add 1.5 sheng of water, five split jujubes, and 1 fen of chopped fresh ginger. Decoct until 0.8 sheng remains, strain, and take hot.
Treatment for Pi Ji (Spleen Accumulation) caused by cold qi stagnation, chest fullness with rebellious phlegm, and limb heaviness/ptosis: Banxia Tang (Pinellia Decoction) Formula.
Banxia (Rhizoma Pinelliae Preparata), aged ones washed in water to remove slipperiness, dried by baking; Tingli (Semen Lepidii seu Descurainiae), stir-fried on paper, each 1 liang; Maimendong (Radix Ophiopogonis), heart removed, dried by baking, 2 liang; Lugeng (Rhizoma Phragmitis), cut into fragments, 3 liang.
The above four ingredients are coarsely crushed and sieved. Take 3 qian bi per dose, add 1 sheng of water. Add half he of clean wheat and half a jujube-sized piece of large-cut fresh ginger. Decoct together until 0.8 sheng remains, strain. Take once when empty-stomached, at noon, midnight, and before sleep. If the patient is emaciated and weak, add Guixin (Cortex Cinnamomi Ramulus) and Baiziren (Semen Platycladi) each 1 liang.
Treatment for Pi Ji (Spleen Accumulation) with diarrhea: Fanshi Wan (Alum Pill) Formula.
Fanshi (Alumen), roasted until liquid evaporates; Helile (Fructus Chebulae Preparata), roasted and pitted, each 2 liang; Huanglian (Rhizoma Coptidis), roots removed, 3 liang; Muxiang (Radix Aucklandiae), 1 liang.
The above four ingredients are crushed and sieved into powder. Soak steamed bread cake in water, filter to make a paste, and form pills sized like paulownia seeds. Take 30 pills before meals when empty-stomached, with aged rice wash. Stop when diarrhea ceases.
Treatment for Pi Ji (Spleen Accumulation) with slight slippery diarrhea and loss of appetite: Wuyi Wan (Melia Pill) Formula.
Wuyi (Fructus Meliae Toosendan), 4 liang; Chenju pi (Pericarpium Citri Reticulatae), soaked in water, white pith removed, dried, 4 liang, ground into powder, boiled with 1 sheng of rice vinegar into a paste; Fuzi (Radix Aconiti Lateralis Preparata), cracked and split, skin and umbilicus removed, 2 liang; Sucao (Radix Cyperi Rotundi).
The above six ingredients: All except Chenju pi are crushed and sieved into powder. Mix with the boiled Chenju pi paste, knead well, add refined honey, and form pills sized like paulownia seeds. Take 30 pills when empty-stomached and at noon, with aged rice wash.
Treatment for Pi Ji (Spleen Accumulation) with constipation, heavy body, limb weakness, and joint pain: Qianniuzi Wan (Pharbitis Seed Pill) Formula.
Qianniuzi (Semen Pharbitidis), 1.5 liang, lightly stir-fried; Gansui (Radix Euphorbiae Kansui), 0.5 liang, lightly stir-fried; Jingsanleng (Rhizoma Sparganii), prepared and cut; Chenju pi (Pericarpium Citri Reticulatae), soaked in water, white pith removed, dried; Helile (Fructus Chebulae)... [Text incomplete].
The above six ingredients are crushed and sieved into powder. Boil 2 liang of fresh ginger juice and 4 liang of honey until reduced to 4 liang. Mix with the powder to form pills sized like paulownia seeds. Take 20 pills before sleep with rice wash. If no bowel movement occurs, increase to 30 pills.
Treatment for Pi Ji (Spleen Accumulation) with irritability, thirst, and dry mouth: Gegen Wan (Kudzu Root Pill) Formula.
Gegen (Radix Puerariae Lobatae), cut; Fuzi (Radix Aconiti Lateralis Preparata), cracked and split, skin and umbilicus removed; Yiyi gen (Radix Coicis), cut; Lugeng (Rhizoma Phragmitis), cut, each 1 fen; Nuomi (Oryza Sativa Glutinosa), 2 he.
The above five ingredients are crushed and sieved into powder. Soak in Tao jiao (Persicae Gum) water, boil into a paste, and form pills sized like small beans. Take 10 to 20 pills after meals and before sleep with decoction of Dengxincao (Junci Medulla) and Pipaye (Folium Eriobotryae).
Treatment for Pi Ji (Spleen Accumulation) with yellow complexion, dry mouth, chest and diaphragm fullness, emaciation, loss of appetite, and occasional high fever: Pi Ji Wan (Spleen Accumulation Pill) Formula.
Chencang mi (Oryza Sativa stored for years), 1 he, soaked in vinegar and rinsed; Qingju pi (Pericarpium Citri Reticulatae Viride), 50 slices, soaked in vinegar until soft, white pith removed; Badou (Semen Crotonis Tiglii), 50 kernels, skin removed, tied with hemp thread... [Instruction: Stir-fry three items until dry, remove Badou, do not use, add to subsequent herbs]; Shisanleng (Rhizoma Sparganii), 1 fen; Jizhao sanleng (Rhizoma Sparganii), 1 fen; Peng'ezhu (Rhizoma Curcumae Longae), 3 pieces, prepared and cut; Jingsanleng (Rhizoma Sparganii), 1 fen, prepared and cut; Binglang (Areca Semen)... [Text incomplete].
The above eight ingredients are crushed and sieved into powder. Take half, mix with wheat starch paste to form pills sized like mung beans. The other half is kept as powder. Take 1 qian bi of powder or 3 pills with congee wash.
Treatment for Pi Ji (Spleen Accumulation) with abdominal and hypochondriac distension, chest and heart pain/stuffiness, and loss of appetite: Pingqi Wan (Calming Qi Pill) Formula.
Binglang (Areca Semen), 1 piece, cut; Wumei (Fructus Mume), 1.5 liang, half pitted, half with pit; Jingsanleng (Rhizoma Sparganii), prepared, 0.5 liang; Qingju pi (Pericarpium Citri Reticulatae Viride), white pith removed, baked, 1 liang; Suisha (Fructus Amomi Rotundus)... [Text incomplete].
The above seven ingredients: Six are crushed and sieved into powder. Mix evenly with Badou (Croton Seed). Form pills using white wheat starch paste, sized like mung beans. Take 3 pills with warm ginger decoction after meals.
Treatment for Pi Ji (Spleen Accumulation) with rebellious phlegm, nausea, abdominal and hypochondriac fullness, chest diaphragm obstruction, and loss of appetite: Jin Ye Wan (Golden Liquid Pill) Formula.
Jingsanleng (Rhizoma Sparganii), prepared; Peng'ezhu (Rhizoma Curcumae Longae), prepared; Baizhu (Rhizoma Atractylodis Macrocephalae); Dingxiang pi (Flos Caryophylli Cortex), coarse skin scraped off; Qianniuzi (Semen Pharbitidis), stir-fried with bran; Qingju pi (Pericarpium Citri Reticulatae Viride); Chenju pi (Pericarpium Citri Reticulatae), both soaked in water, white pith removed, baked; Roudoukou (Semen Myristicae), large ones pitted; Binglang (Areca Semen), prepared, each 1 liang; Ganjiang (Rhizoma Zingiberis Preparata), prepared; Dingxiang (Flos Caryophylli); Sharen (Fructus Amomi Rotundus), ground, each 0.5 liang; Badou (Semen Crotonis Tiglii), 0.5 liang, weighed with skin.
The above thirteen ingredients are made into powder, mixed evenly. Use first-grade vinegar to boil thick wheat starch paste to form pills sized like mung beans. Take 5 pills with rice wash after meals.
Treatment for Pi Ji (Spleen Accumulation) with heart and abdominal fullness, vomiting/rebellious Qi, and sour belching: Kuaiqi Wan (Promoting Qi Flow Pill) Formula.
Binglang (Areca Semen), 3 pieces, cut; Muxiang (Radix Aucklandiae), 1 liang; Roudoukou (Semen Myristicae), pitted, 0.5 liang; Gansui (Radix Euphorbiae Kansui), 0.5 liang, stir-fried with bran until yellow; Daji (Radix Euphorbiae Pekinensis), 1 fen, prepared; Bai Qianniuzi (Semen Pharbitidis Albae), 1 liang, stir-fried; Mo (Carbonized Ink), roasted red, quenched in vinegar, 1 fen; Chenxiang (Lignum Aquilariae Resinatum), 0.5 liang; Chenju pi (Pericarpium Citri Reticulatae), soaked in water, white pith removed, baked; Qing... [Text incomplete].
Treatment for Pi Qi (Stagnant Qi) with flank and rib fullness/stuffiness: Baizhu Tang (Atractylodes Macrocephala Decoction) Formula.
Baizhu (Rhizoma Atractylodis Macrocephalae); Chaihu (Radix Bupleuri), seedlings removed; Shengjiang (Rhizoma Zingiberis Recens), skin removed, thinly sliced, dried by baking; Houpo (Cortex Magnoliae Officinalis), coarse bark removed, brushed with ginger juice, roasted until fragrant and cooked; Guizhi (Ramulus Cinnamomi), coarse bark removed, each 3 liang.
The above seven ingredients are coarsely crushed and sieved. Take 3 qian bi per dose, add 1 sheng of water. Decoct until 0.7 sheng remains, strain, and take warm. Stop when mild laxation occurs.