论曰结瘕者、积聚之类也，结伏聚积，久不散，谓之结，浮流腹内，按抑有形，谓之瘕，
结之证，形体瘦瘁，食不作肌肤，遇阴寒冷湿之气则发，而胁块硬。隐隐然痛者是也。瘕之
证，腹中气痛，动转横连胁下，有如癖气，遇脾胃有冷，阳气不足而发动者是也。
治结癖瘕实，腹满如鼓。食即欲吐，喘息急，其脉弦而紧，防己散方
防己（煮） 诃黎勒（煨去核） 郁李仁（汤退皮研如膏） 白术 槟榔（锉各一两半）
吴茱萸（陈者淘
上六味，除郁李仁外，捣罗为散，入郁李仁同研令匀。每服三钱匕，水一盏。煎至六分，
和滓空心温服。
治结瘕脉弦，腹满坐卧不安，食即欲吐，喘息急，槟榔汤方
槟榔（白者锉一两半） 赤茯苓（去黑皮） 芍药 陈橘皮（汤浸去白焙） 吴茱萸（陈
者淘七遍炒） 郁李仁（汤退去皮别研如膏） 诃黎勒（煨去核各三分） 京三棱（煨锉） 桑
根白皮（焙锉各一两）
上九味，粗捣筛，每服五线匕，水一盏半，煎至八分，去滓温服，食前后各一服。若服
后频利，即减槟榔郁李仁。
治结瘕气积，腹满如石，气急少卧，小便不利，防己汤方
防己 百合（干者） 郁李仁（去皮别研如膏各一两） 木通（锉一两半） 吴茱萸（陈
者淘七遍炒半
上八味，捣罗为散，每服三钱匕，水一盏，生姜半分，煎至六分去滓，空心温服。
治结瘕喘嗽，腹中 痛，饮食减少。四肢乏力，防葵丸方
防葵（三分） 桂心（半两） 木香（半两） 吴茱萸（半两汤浸七遍焙干微炒） 鳖
甲（一两半涂醋炙令黄去裙 ） 桔梗（三分去芦头） 川大黄（一两锉碎微炒） 当归（半
两锉微炒） 京三棱（三分微煨锉） 赤芍药（三分） 五味子（半两） 槟榔（一两半） 郁
李仁（一两汤浸去皮微炒）
上一十三味，捣罗为细末。炼蜜和捣三二百杵。丸如梧桐子大，每服二十丸，温酒下。
治结瘕久不瘥，令人不思饮食，羸瘦少力，芎 散方
芎 （一两） 桂心（一两） 川大黄（二两锉碎微炒） 鳖甲（二两涂醋炙令黄去裙
） 京三棱（一两微
上六味，捣筛为散，每服三钱匕，水一盏。生姜半枣大拍破、同煎至七分，去滓温服。
空心日午夜卧各一服。
治结癖气块，饮食不消，肺积气发、心胸痰逆气喘，卒中风毒。香港脚大肠秘涩。奔豚气
痛，羌活丸方
羌活（去芦头） 桂（去粗皮） 芎 木香 槟榔（锉各一两） 郁李仁（汤浸去皮
研如膏五两） 大
上七味。除郁李仁外，捣罗为末，与郁李仁研匀，炼蜜和丸。如梧桐子大，每服二十丸。
空腹煎生姜汤，或姜枣汤下，气痛温酒下。
治结瘕腹胀，坚硬如石，肚上青筋浮起，紫葛丸方
紫葛（一两） 芍药（赤者） 桔梗（炒） 紫菀（去苗土） 木香 诃黎勒皮（各三
分） 大黄（锉熬一两半
上九味，捣研为末，炼蜜和丸，梧桐子大，每服十五丸，空腹煎木通及枣汤下，老幼量
减丸数。
治结瘕腹胀坚硬不消，木通汤方
木通（锉） 赤茯苓（去黑皮各一两） 赤芍药 吴茱萸（汤洗焙炒各三分） 槟榔（白
者煨一枚锉） 紫菀
上七味，粗捣筛，每服三钱匕，水一盏半，煎取七分，空腹服日再。
治积聚气块癖瘕。干柿丸方
砂（研） 砒霜 粉霜 干漆（烧烟出） 鳖甲（去裙 醋炙） 黄连（去须各一分）
旋复花（炒） 京三棱（炮各半两） 杏仁（去皮尖双仁麸炒） 干姜（炮各一两） 皂荚
（四挺不 者去皮酥炙） 巴豆（四十
上一十二味，各捣研为细末，先将干漆鳖甲京三棱三味末。用粟米半盏、不淘洗。以酽
醋五升，同熬成粥，入众药拌和丸。如豌豆大。每服三丸。烂嚼干柿裹药，临卧温水下。
治远年虚实积聚瘕块。木香汤方
木香（一两） 海马子（一对雌雄者雌者黄色雄者青色） 大黄（锉炒） 青橘皮（汤
浸去白焙） 白牵
上六味，以童子小便，浸青橘皮软。裹巴豆，以线系定，入小便内，再浸七日，取出麸
炒黄，去巴豆，只使青橘皮，并余药粗捣筛，每服二钱匕，水一盏，煎三五沸。去滓临卧温
服。
治结瘕积聚，血结刺痛，木香煎丸方
木香 巴豆（去皮心膜不出油细研） 大黄（锉炒） 京三棱（生锉） 筒子干漆（碎
炒烟出） 青橘皮（汤浸去白焙） 蓬莪术（炮锉） 附子（炮裂去皮脐） 桂（去粗皮） 干
姜（炮裂各一分） 墨（一指大研） 砂（半两好醋一盏化一宿去砂石）
上一十二味，各捣研为细末，先将大黄京三棱巴豆等三味，同于银石器内，用醋一升，
煎一二沸，次入 砂，同熬成膏，次入诸药末和匀，再入臼杵千下，丸如绿豆大，每服五丸
，伤冷食冷酒冷水不消，结聚成气块痛者，干姜汤或橘皮汤下，冷面粘食不消者，煮面汤下
，牛羊鳖肉等不消，各以本肉煎淡汁下，宿酒不消，温酒下，妇人诸血气。当归酒下，妊娠
不可服。欲宣转者，茶下七丸，小儿三丸。
Discussion states: Jie Jia (Knot-like Masses) belongs to the category of Ji Ju (Accumulations and Gatherings). When pathogenic factors adhere and accumulate, remaining unresolved for a long time, it is called "Jie" (Knot); when they float within the abdomen and present a palpable form upon pressure, it is called "Jia" (Mass).
The syndrome of Jie manifests as emaciation and physical decline, where food fails to nourish the muscles and flesh. It exacerbates upon exposure to cold, damp, and yin pathogens, presenting with hard masses in the hypochondrium and dull pain.
The syndrome of Jia manifests as qi pain in the abdomen, radiating laterally to the hypochondrium, resembling Pi Qi (a type of accumulation disorder). It is triggered by spleen-stomach coldness and insufficiency of yang qi.
To treat excess syndromes of Jie Pi Jia, characterized by abdominal distension like a drum, postprandial vomiting, rapid breathing, and a wiry and tight pulse, use Fang Ji San Formula:
Fangji (Root of Stephania Tetrandra, boiled) Heheli (Fructus Chebulae, roasted, pitted) Yuliren (Semen Pruni Persicae, skin removed by hot water, ground into paste) Baizhu (Rhizoma Atractylodis Macrocephalae) Binglang (Fructus Arecae, sliced, each 1.5 liang) Wuzhuyu (Fructus Evodiae, aged ones washed)
The above six herbs, except Yuliren, are crushed, sieved into powder, and mixed thoroughly with Yuliren paste. Each dose consists of three qianbi (approx. 9 grams), decocted in one sheng (approx. 200 ml) of water until reduced to 6 fen (approx. 120 ml). Take warm, including the dregs, on an empty stomach.
To treat Jie Jia with a wiry pulse, abdominal distension causing restlessness in sitting or lying, postprandial vomiting, and rapid breathing, use Binglang Tang Formula:
Binglang (Fructus Arecae, white variety, sliced 1.5 liang) Chifuling (Poria Cocos with black skin removed) Shaoyao (Radix Paeoniae Rubra or Alba) Chenjupi (Pericarpium Citri Reticulatae, soaked in hot water, white pith removed, dried) Wuzhuyu (Fructus Evodiae, aged ones washed seven times and stir-fried) Yuliren (Semen Pruni Persicae, skin removed by hot water, separately ground into paste) Heheli (Fructus Chebulae, roasted, pitted, each 3 fen) Jingsanleng (Rhizoma Sparganii, roasted and sliced) Sangbaipipi (Cortex Morus Radicis, dried and sliced, each 1 liang)
The above nine herbs are coarsely crushed and sieved. Each dose consists of five xianbi (approx. 1.5 grams), decocted in 1.5 sheng of water until reduced to 8 fen. Strain and take warm, once before meals and once after meals. If frequent diarrhea occurs after administration, reduce the dosage of Binglang and Yuliren.
To treat Jie Jia qi accumulation, characterized by abdominal distension hard as stone, shortness of breath, difficulty sleeping, and dysuria, use Fangji Tang Formula:
Fangji (Root of Stephania Tetrandra) Baihe (Bulbus Lilii, dried) Yuliren (Semen Pruni Persicae, skin removed, separately ground into paste, each 1 liang) Mutong (Caulis Akebiae Trifoliatae or Caulis Tetrapanacis Agycocardi, sliced 1.5 liang) Wuzhuyu (Fructus Evodiae, aged ones washed seven times and stir-fried, 0.5 liang)
The above eight herbs are crushed, sieved into powder. Each dose consists of three qianbi, decocted in one sheng of water with 0.5 fen of fresh ginger until reduced to 6 fen. Strain and take warm on an empty stomach.
To treat Jie Jia with wheezing and cough, abdominal pain, decreased appetite, and limb weakness, use Fangkui Wan Formula:
Fangkui (Radix Glehniae, 3 fen) Guixin (Cortex Cinnamomi, 0.5 liang) Muxiang (Radix Aucklandiae, 0.5 liang) Wuzhuyu (Fructus Evodiae, 0.5 liang, soaked in hot water seven times, dried and lightly stir-fried) Biejia (Carapax et Plastrum Testudinis, 1.5 liang, coated with vinegar, roasted until yellow, skirt removed) Jiegeng (Radix Platycodonis, 3 fen, radix end removed) Chuandahuang (Radix et Rhizoma Rhei, 1 liang, sliced and lightly stir-fried) Danggui (Radix Angelicae Sinensis, 0.5 liang, sliced and lightly stir-fried) Jingsanleng (Rhizoma Sparganii, 3 fen, lightly roasted and sliced) Chishaoyao (Radix Paeoniae Rubra, 3 fen) Wuweizi (Fructus Schisandrae, 0.5 liang) Binglang (Fructus Arecae, 1.5 liang) Yuliren (Semen Pruni Persicae, 1 liang, soaked in hot water, skin removed, lightly stir-fried)
The above thirteen herbs are crushed, sieved into fine powder. Mix with refined honey and pound 300-400 times. Form pills the size of paulownia seeds. Take 20 pills per dose with warm wine.
To treat chronic Jie Jia not healing, leading to loss of appetite, emaciation, and weakness, use Xiong Qiong San Formula:
Xiongyao (Radix Ligustici Chuanxiong, 1 liang) Guixin (Cortex Cinnamomi, 1 liang) Chuandahuang (Radix et Rhizoma Rhei, 2 liang, sliced and lightly stir-fried) Biejia (Carapax et Plastrum Testudinis, 2 liang, coated with vinegar, roasted until yellow, skirt removed) Jingsanleng (Rhizoma Sparganii, 1 liang, lightly roasted and sliced)
The above six herbs are crushed and sieved into powder. Each dose consists of three qianbi, decocted in one sheng of water with half a jujube-sized piece of fresh ginger (crushed). Decoct until reduced to 7 fen. Strain and take warm. Take once on an empty stomach, once at midnight, and once before noon sleep.
To treat Jie Pi qi masses, indigestion, lung qi accumulation causing chest phlegm reversal and asthma, sudden wind-toxicity, Hong Kong foot (podagra/gout), large intestine constipation, and Ben Tun (rushing gas) pain, use Qiang Huo Wan Formula:
Qianghuo (Rhizoma et Radix Notopterygii, radix end removed) Gui (Cortex Cinnamomi, outer bark removed) Xiongyao (Radix Ligustici Chuanxiong) Muxiang (Radix Aucklandiae) Binglang (Fructus Arecae, sliced, each 1 liang) Yuliren (Semen Pruni Persicae, soaked in hot water, skin removed, ground into paste, 5 liang) Daji (Radix Euphorbiae Lathyridis, heart and membrane removed, stir-fried until smoke appears, 1 liang)
The above seven herbs, except Yuliren, are crushed, sieved into powder, and mixed uniformly with Yuliren paste. Mix with refined honey and form pills the size of paulownia seeds. Take 20 pills per dose. Decoct fresh ginger soup or ginger-jujube soup on an empty stomach for administration; for qi pain, take with warm wine.
To treat Jie Jia abdominal distension, hard as stone, with prominent blue veins on the abdomen, use Zige Wan Formula:
Zige (Herba Siegesbeckiae, 1 liang) Shaoyao (Radix Paeoniae, red variety) Jiegeng (Radix Platycodonis, stir-fried) Ziwan (Herba Asteris Tatarici, stems and soil removed) Muxiang (Radix Aucklandiae) Helilepi (Pericarpium Chebulae, each 3 fen) Dahuang (Radix et Rhizoma Rhei, sliced and stewed, 1.5 liang)
The above nine herbs are crushed, ground into powder, mixed with refined honey, and formed into pills the size of paulownia seeds. Take 15 pills per dose on an empty stomach, administered with decoction of Mutong and jujube soup. Reduce the number of pills for the elderly and children.
To treat Jie Jia abdominal distension and hardness that does not resolve, use Mutong Tang Formula:
Mutong (Caulis Akebiae Trifoliatae or Caulis Tetrapanacis Agycocardi, sliced) Chifuling (Poria Cocos with black skin removed, each 1 liang) Chishaoyao (Radix Paeoniae Rubra) Wuzhuyu (Fructus Evodiae, washed with hot water, dried, stir-fried, each 3 fen) Binglang (Fructus Arecae, white variety, roasted, one piece sliced) Ziwan (Herba Asteris Tatarici, stems and soil removed, 3 liang)
The above seven herbs are coarsely crushed and sieved. Each dose consists of three qianbi, decocted in 1.5 sheng of water until 7 fen remains. Take on an empty stomach, twice daily.
To treat Ji Ju qi masses and Pi Jia, use Ganshi Wan Formula:
Naosha (Natrii Nitras, ground) Pishuang (Arsenici Trioxidum) Fenshuang (Calomelas) Ganqi (Resina Taxilli, burned until smoke appears) Biejia (Carapax et Plastrum Testudinis, skirt removed, vinegar-roasted) Huanglian (Rhizoma Coptidis, roots removed, each 1 fen) Xuanjinflores (Flos Inulae, stir-fried) Jingsanleng (Rhizoma Sparganii, processed, each 0.5 liang) Xingren (Semen Armeniacae Amarum, skin and tip removed, double-kernel, bran-roasted) Ganjiang (Rhizoma Zingiberis Recens, processed, each 1 liang) Zhaojiao (Fructus Gleditsiae Sinensis, four sturdy pods without wormholes, skin removed, roasted with lard) Badou (Semen Crotonis Tiglii, forty kernels, skin and membrane removed, ground without releasing oil)
The above twelve herbs are each crushed and ground into fine powder. First, take the powders of Ganqi, Biejia, and Jingsanleng. Add half a sheng of millet (unwashed) and five sheng of strong vinegar, boil together into a porridge. Mix in all herb powders and form pills the size of mung beans. Take three pills per dose. Chew a dried persimmon thoroughly, wrap the pill inside, and take with warm water before bed.
To treat long-standing deficiency-excess Ji Ju and Jia masses, use Muxiang Tang Formula:
Muxiang (Radix Aucklandiae, 1 liang) Haimaqi (Ovum Hippocampi, one pair, female is yellow, male is green) Dahuang (Radix et Rhizoma Rhei, sliced and stir-fried) Qingjupi (Pericarpium Citri Reticulatae Viride, soaked in hot water, white pith removed, dried) Baiqianniu (Semen Phytolaccae Acinospermae, stir-fried, each 1 liang) Badou (Semen Crotonis Tiglii, ten kernels, skin and membrane removed, ground without releasing oil)
The above six herbs: Soak Qingjupi in urine of a young boy until soft. Wrap Badou in the peel, tie securely with thread, and immerse in the urine for seven more days. Remove, stir-fry with bran until yellow, discard the Badou, and use only the Qingjupi. Coarsely crush and sieve this along with the other herbs. Each dose consists of two qianbi, decocted in one sheng of water for three to five boils. Strain and take warm before bed.
To treat Jie Jia Ji Ju with blood stasis causing stabbing pain, use Muxiang Jian Wan Formula:
Muxiang (Radix Aucklandiae) Badou (Semen Crotonis Tiglii, skin, heart, and membrane removed, finely ground without releasing oil) Dahuang (Radix et Rhizoma Rhei, sliced and stir-fried) Jingsanleng (Rhizoma Sparganii, raw and sliced) Tongziganqi (Resina Taxilli, crushed and stir-fried until smoke appears) Qingjupi (Pericarpium Citri Reticulatae Viride, soaked in hot water, white pith removed, dried) Peng'ezhu (Rhizoma Curcumae Longae, processed and sliced) Fuzi (Radix Aconiti Lateralis Preparata, cracked, skin and navel removed) Gui (Cortex Cinnamomi, outer bark removed) Ganjiang (Rhizoma Zingiberis Recens, processed, each 1 fen) Mo (Lacca, finger-sized, ground) Naosha (Natrii Nitras, 0.5 liang, dissolved in one sheng of good vinegar overnight, sand and gravel removed)
The above twelve herbs are each crushed and ground into fine powder. First, place Dahuang, Jingsanleng, and Badou together in a silver or earthenware vessel. Add one sheng of vinegar, boil for one or two boils. Then add Naosha, simmer until it becomes a paste. Add all herb powders, mix evenly, and pound in a mortar 1,000 times. Form pills the size of mung beans. Take five pills per dose. For indigestion caused by cold food, cold wine, or cold water resulting in qi mass pain, administer with Ganjiang Tang or Jupi Tang. For indigestion of cold noodles or sticky foods, administer with noodle cooking water. For indigestion of beef, mutton, turtle meat, etc., administer with light broth made from the respective meat. For residual alcohol intoxication, administer with warm wine. For women's blood and qi disorders, administer with Danggui wine. Contraindicated during pregnancy. To promote bowel movement, administer seven pills with tea. For children, administer three pills.