古方有五积、六聚、七 、八瘕之名。五脏之气积，名曰积，故积有五。六腑之气聚，
名曰聚，故聚有六。《杂病准绳》言之详矣。若夫七 八瘕，则妇人居多，七者火数属心，
盖血生于心。八者木数属肝，盖血归于肝。虽曰强分，理似不混。夫 者坚也，坚则难破。
瘕者假也，假物成形。古人将妇人病为痼疾，以蛟龙等为生瘕，然亦不必如此执泥。妇人
瘕，并属血病，龙、蛇、鱼、鳖、肉、发、虱瘕等事，皆出偶然。但饮食间误中之，留
聚腹脏，假血而成，自有活性，亦犹永徽中僧病噎者，腹中有一物，其状如鱼，即生瘕
也。与夫宿血停凝，结为痞块，虽内外所感之不同，治法当以类相从，所为医者意也。如
以败梳治虱瘕，铜屑治龙瘕，曲 治米瘕，锻石治酒瘕，如此等类，学人可以理解也。《大
全良方》分 癖诸气、疝瘕、八瘕、腹中瘀血、 痞、食 、血 凡七门。 者在腹内
近脐左右各有一条筋脉急痛，大者如臂，次者如指，因气而成，如弦之状，故名曰 。癖
者僻在两肋之间，有时而痛，故名曰癖。疝者痛也，瘕者假也，其结聚浮假而痛，推移
乃动也。八瘕者，黄瘕、青瘕、燥瘕、血瘕、脂瘕，狐瘕、蛇瘕、鳖瘕。积在腹内，或肠
胃之间，与脏气结搏坚牢，虽推之不移，名曰 ，言其病形可征验也。气壅塞为痞，言
其气痞塞不宣畅也。伤食成块，坚而不移，名曰食 。瘀血成块，坚而不移，名曰血 。若
夫腹中瘀血，则积而未坚，未至于成块者也。大抵以推之不动为 ，推之动为瘕也。至夫
疝与 癖，则与痛俱，痛即现，不痛即隐。在脐左上为 ，在两肋之间为癖，在小腹而牵
引腰胁为疝。恐学人一时难了，未免淆滥，故总叙叙而条析之。
张戴人过谯，遇一卒，说出妻事。戴人问其故，答曰∶吾妇为室女时，心下有冷积
如覆杯，按之如水声，以热手熨之如冰，娶来已十五年矣，恐断我嗣，是故弃之。戴人
曰∶公勿黜也，如用吾药，病可除，孕可得。卒从之。戴人诊其脉，沉而迟，尺脉洪大而
有力，非无子之候也，可不逾年而孕。其良人笑曰∶试之。先以三圣散吐涎一斗，心下
平软，次服白术调中汤、五苓散，后以四物汤和之，不再月气血合度，数月而娠二子。戴
人尝曰∶用吾此法，无不子之妇。此言不诬。（三圣散用防风、瓜蒂各三两，藜芦一两，
为粗末，以齑汁煎服。制煎法，详见《儒门事亲》。白术调中汤用白术、茯苓、泽泻、橘
红各半两，甘草一两、干姜、官桂、砂仁、藿香各二钱半，为末，白汤化蜜调服二钱，无
时。五苓散见伤寒渴门。）阳夏张主簿之妻，病肥气，初如酒杯大，发寒热十五
余年，后因性急悲感，病益甚，惟心下三指许无病，满腹如石片，不能坐卧，针灸匝矣，
徒劳人耳。乃邀戴人诊之曰∶此肥气也。得之季夏戊巳日，在左胁下如覆杯，久不愈，令
人发 疟。以瓜蒂散吐之鱼腥黄涎约一二击，
至夜继用舟车丸、通经散投之，五更黄涎脓水相半五六行，凡有积处皆觉痛，后用白术
散、当归散和血流经之药，如斯涌泄凡三四次方愈。（瓜蒂散、舟车丸，方见杂病伤食、痰饮二
门。通经散用橘红、当归、甘遂，以面包不令透水，煮百余沸，用冷水浸过，去面晒干，三味各等分为细
未，每服三钱，临卧温淡酒调下。白术散，白术、黄芩、当归各等分为末，每服二三钱，水煎，食前服。
当归散，当归、杜蒺藜等分为末，米饮调服，食前。此吐下兼施，且甘遂等逐水太峻，用者审之。）
薛新甫云∶妇人 癖 瘕，大抵因饮食起居七情失宜，亏损脏腑，气血乖违，阴络
受伤，循行失度所致，罗谦甫云∶养正积自除，必先调养，使荣卫充实，若不消散，方
可议下。但除之不以渐，则必有颠覆之害，若不守禁忌，纵情嗜欲，其有不丧身者鲜矣。
一妇人内热作渴，饮食少思，腹内初如鸡卵，渐大四寸许，经水三月一至，肢体消瘦，齿
颊似疮，脉洪数而虚，左关尤甚。此肝脾郁结之证，外贴阿魏膏，午前用补中益气汤，（杂
病伤劳倦。）午后用加味归脾汤，（即归脾加山栀、丹皮。）两月许，肝火稍退，脾土少健，午前补中
益气下六味丸，（杂病虚劳。）午后逍遥散（调经。）下归脾丸，又月余，日用芦荟丸（本门之末。）二服，
空心以逍遥散下，日晡以归脾汤下。喜其谨疾，调理年余而愈。一妇人腹内一块，不
时上攻，或作痛有声，或吞酸痞闷，月经不调，小便不利，二年余矣，面色青黄。余以
为肝脾气滞，以六君加芎、归、柴胡、炒连、木香、吴茱各少许，二剂，却与归脾汤送下
芦荟丸。三月余，肝脾和而诸证退，又与调中益气汤加茯苓、牡丹皮，中气健而经自调。
一妇人性多郁善怒，勤于女工，小腹内结一块，或作痛，或痞闷，月经不调，恪服伐
肝之剂，内热寒热，胸膈不利，饮食不甘，形体日瘦，牙龈蚀烂。此脾土不能生肺金，肺
金不能生肾水，肾水不能生肝木，当滋化源。用补中益气汤、六味丸，至仲春而愈。一
妇人经候过期，发热倦怠，或用四物、黄连之类，反两月一度，且少而成块；又用峻药
通之，两目如帛所蔽。余曰∶脾为诸阴之首，目为血脉之宗，此脾伤五脏皆为失所，不能
归于目也。遂用补中益气、《济生》归脾二汤，专主脾胃，年余而愈。松江太守何恭人，性
善怒，腹结一块，年余上 蚀透，血气虚极，时季冬肝脉洪数，按之弦紧。或用伐肝木、清
胃火之药。余曰∶真气虚而邪气实也，恐伐肝木至春不能发生耳。用八珍汤以生气血，用
地黄丸以滋肾水，肝脉顿退。因大怒耳内出血，肝脉仍大，烦热作渴，此无根之火也。仍
以前药加肉桂二剂，脉敛热退。复因大怒，果卒于季冬辛巳日，乃金克木故也。
〔通治诸积〕
顺气丸 （《简易》）治三十六种风，七十二般气，去上热下冷，腰脚疼痛，四肢困倦，减
食羸瘦，颜色赤黄，恶疮下疰，口苦无味，憎寒毛耸， 癖气块，男子世事断绝，女子久
无子息，久患疟痢，发成劳疾，百节酸疼。自婴孩至百岁老人皆可服，疏风顺气，补精驻
颜。
锦纹大黄（五两，一半生用，一半湿纸里煨） 车前子（二两半） 白槟榔（二两）
火麻子仁（微炒赤，退壳，取二两净，另研入） 川牛膝（酒浸三夕） 郁李仁（泡去皮，另研）
山药 菟丝子（酒蒸研焙，各二两） 山茱萸肉 防风 枳壳（麸炒） 独活（各一两）
上为细末，炼蜜丸如梧子大，茶清粥饮下二十丸，百无所忌，空心临卧服，一月消
食，二月去肠内宿滞，三月无倦少睡，四月精神强盛，五月耳目聪明，六月腰脚轻健，一
年消百病。如服药脏腑微动，以羊肚肺羹补之。
胜红丸 （《简易》）治脾积气滞，胸膈满闷，气促不安，呕吐清水，丈夫酒积，女人脾血
积气，小儿食积。
陈皮 青皮 京三菱 莪术（二味同醋煮） 干姜（炮） 良姜（炒，各一两）
香附子（净炒，各二两） 一方加神曲、麦芽。
上为末醋糊丸如梧子大，每服三十丸，姜
汤下。虚者宜以补药下之。
香棱丸 （《济生》）治一切积聚。破痰癖，消 块。
木香 丁香（各半两） 三棱（酒浸一夕） 枳壳（麸炒） 莪术（细锉，每一两，用巴豆三十粒
去壳同炒，待巴豆黄色，去巴豆不用） 青皮（制） 川楝子肉（炒） 香（炒，各等分）
上末之，醋煮面糊，丸如梧桐子大，朱砂为衣，每三十丸，姜盐汤或温酒下，无时。
大消石丸 治七 八瘕，聚结杯块，及妇人带下绝产，腹中有 瘕者，当先下此药，
但去 瘕，令人不困。
消石（三两） 大黄（四两） 人参 甘草（各一两）
上为末，以三年苦酒三升，置铜石器中，先纳大黄微火熬微沸，常搅不息，至七分，纳
余药，复熬成膏，至可丸即丸如梧桐子大，每服三十丸，米饮下，三日服。妇人服之，或
下如鸡肝，或如米泔、赤黑等物二三升，后忌风冷。
阿魏膏 治一切痞块。
羌活 独活 玄参 官桂 赤芍药 穿山甲 生地黄 两头尖 大黄 白芷 天麻
（各五钱） 槐、柳、桃枝（各三钱） 红花（四钱） 木鳖子（十枚，去壳） 乱发（一团，如鸡子大）
上用香油二斤四两，煎黑去渣，入发煎，发化，仍去渣，徐下黄丹，煎软硬得中，入
芒硝、阿魏、苏合油、乳香、没药各五钱，麝香三钱，调匀即成膏矣。摊贴患处。黄丹须
用真正者方效。凡贴膏药，先用朴硝随患处铺平半指浓，以纸盖，用热熨斗熨良久，如
硝耗再加，熨之二时许，方贴膏药。
〔八瘕〕
《病源》曰∶八瘕者，皆胞胎生产、月水往来、血脉精气不调之所生也。肾为阴主开
闭，左为胞门，上为子户，主定月水，生子之道，胞门子户，主子精神气所出入，合于
中黄门、玉门四边，主持关元，禁闭子精。脐下三寸，名曰关元，主藏魂魄，妇人之胞，三
焦之府，常所从止。然妇人经脉俞络合调，则月水以时来至，故能生子而无病。妇人荣卫
经络断绝不通，邪气便得往来，入合于脏，若经血未尽，而合阴阳，即令妇人血脉挛急，
小腹重急支满，胸胁腰背相引，四肢酸痛，饮食不调，结牢恶血不除，月水不时，或月前
月后，因生积聚，如怀胎状。邪气甚盛者，令人恍惚多梦，寒热，四肢不欲动，阴中生气，
肿内生风，甚者小便不利，苦痛如淋状，面目黄黑，岁月久即不复生子也。
薛氏曰∶经云∶气主嘘之，血主濡之。若血不流则凝而为瘕也。瘕者中虽硬而忽聚忽
散，多因六淫七情，饮食起居，动伤脏腑而成，当与 癖诸证治同，慎勿复伤元气。
〔黄瘕〕者，妇人月水始下，若新伤堕血气未止，卧寝未定，五脏六腑虚羸，精神不
足，因向大风便利，阴阳开阖，关节四远中于风湿，气从下上，入于阴中，稽留不去，名
为阴虚，则生黄瘕。黄瘕之聚，令人苦四肢寒热，身重淋露，卧不欲食，左胁下有气结
牢，不可得抑，若腰背相引痛，月水不利，令人不产，小腹急，下引阴中如刺，不得小便，
或时寒热，下赤黄汁，令人无子。当刺开元、气冲，行以毒药，瘕下即愈。
皂荚散 （《圣惠》）疗黄瘕导方。
皂荚（一两，炙，去皮子） 蜀椒（一两，去汗） 细辛（一两半）
上捣散，以三角囊大如指，长二寸，贮之，纳阴中，欲便，闷则出之，已则复纳之。
恶血华出，乃洗以温汤，三日勿近男子，忌生菜等。
〔青瘕〕者，妇人新产，未满十日起行，以浣洗太早，阴阳虚，玉门四边皆解散，子
户未安，骨肉皆痛，手臂不举，饮食未复，五内吸吸，又当风卧不自隐蔽，若居湿席，令
人苦寒洒洒入腹，烦闷沉淖，恶血不除，结热不得散，则生青瘕。瘕聚在左右胁下，藏
于背膂，上与肩胛，腰下挛急，腹下有气起，
喜唾，不可多食，四肢不欲动摇，手足肿，面目黄，大小便难，其后月水为之不通利，或
不复禁，状如崩中，此自过所致，令人少子。疗之当刺胃管，行以毒药有法，瘕当下即愈。
疗青瘕导药方
戎盐（一升） 皂荚（半两，去皮子，炙） 细辛（一两）
上捣散，以三角囊大如指，长三寸，贮之，纳阴中，但卧，瘕当下，青如葵汁。养
之如产法。
〔燥瘕〕者，妇人月水下恶血未尽，其人虚惫，而以夏月热行疾步，若举重移轻，汗
出交流，气血未平，而卒以恚怒，致腹中猥咽不泄，经脉挛急，内结不舒，烦懑少力，气
上达胸膈背膂，少腹壅急，月水与气俱不通利，而反以饮清水快心，月水横流，溢入
他脏不去，有热则生燥瘕之聚，大如半杯，上下腹中苦痛，还两胁下，上引心而烦，害饮
食欲呕吐，胸及腹中不得太息，腰背重，喜卧盗汗，足酸削久立而痛，小便失时，忽然
自出，若失精，月水闭塞，大便涩难，病如此者，其人少子。疗之以长针，按而刺之法
度，行以毒药，瘕当下即愈。
疗燥瘕方（《圣惠》）
大黄（如鸡子许） 干姜（各二两） 黄连（三两） 鸡 中黄膜（一枚，炙） 桂心（一尺）
虫（三枚，熬） 浓朴（十颗，炙） 郁李仁（一两，去皮尖，熬）
上捣散，早朝空腹，以温酒一盏，和三钱顿服，瘕当下，毕，养之如产妇法，三月
勿合阴阳，无子者当有。
〔血瘕〕者，妇人月水新下，未满日数而中止，因饮食过度，五谷气盛，溢入他脏，若
大饥寒吸吸不足，呼吸未调，而自劳动，血下未定，左右走肠胃之间，留络不去，内有
寒热，与月水合会，为血瘕之聚，令人腰痛不可以俯仰，横骨下有积气，牢如石，少腹
里急苦痛，背膂疼深达腰腹，下挛阴里，若生风冷，子门僻，月水不时，乍来乍不来，此
病令人无子。疗之瘕当下，即愈。
疗妇人血瘕痛方（《圣惠》）
干姜 乌贼鱼骨（各一两，炙） 桃仁（一两，去皮尖）
上捣散，酒服二方寸匕，日二。一方无桃仁。
In ancient prescriptions, there are names for Five Accumulations (Wu Ji), Six Gatherings (Liu Ju), Seven Hernias (Qi Shan), and Eight Masses (Ba Xia). The accumulation of Qi in the five Zang organs is called "Ji" (Accumulation), hence there are five types. The gathering of Qi in the six Fu organs is called "Ju" (Gathering), hence there are six types. This has been discussed in detail in *Za Bing Zhun Sheng*. As for the seven hernias and eight masses, they occur mostly in women. The number seven belongs to Fire and corresponds to the Heart, because blood is generated by the Heart. The number eight belongs to Wood and corresponds to the Liver, because blood returns to the Liver. Although this is a forced distinction, the principles seem not to be mixed. "Shan" means hard; if it is hard, it is difficult to break. "Xia" means false or temporary; it takes form by borrowing external matter. The ancients regarded women's diseases as stubborn illnesses, believing that dragons and other creatures were the cause of forming masses, but one need not be so rigid in this view. Women's Xia masses all belong to blood disorders. Matters such as Dragon Xia, Snake Xia, Fish Xia, Turtle Xia, Meat Xia, Hair Xia, and Louse Xia are all accidental occurrences. They arise merely from accidentally swallowing foreign objects during eating, which remain in the abdominal viscera, borrow blood to take shape, and possess their own vitality. This is similar to a monk in the Yonghui era who suffered from dysphagia and had an object in his abdomen shaped like a fish; this was a case of a living mass. Although the internal and external causes differ from cases where old blood stagnates and coagulates into lumps, the treatment methods should follow similar principles. This is what is meant by "the physician's intent." For example, using a broken comb to treat Louse Xia, copper filings to treat Dragon Xia, yeast to treat Rice Xia, and calcined stone to treat Wine Xia—such methods can be understood by students of medicine. *Da Quan Liang Fang* categorizes Zhu Pi various Qi, Shan Xia, Eight Masses, intra-abdominal blood stasis, Pi (stagnation), Shi (food) accumulation, and Xue (blood) accumulation into seven categories. "Zhu" refers to a painful, tense meridian near the umbilicus on either side, large as an arm or small as a finger, formed by Qi obstruction, resembling a string, hence named "Zhu." "Pi" refers to something located between the two hypochondria, causing intermittent pain, hence named "Pi." "Shan" means pain; "Xia" means false. Its aggregation is floating and false yet painful, and moves when pushed. The "Eight Masses" include: Huang Xia (Yellow Mass), Qing Xia (Green Mass), Zao Xia (Dry Mass), Xue Xia (Blood Mass), Zhi Xia (Fat Mass), Hu Xia (Fox Mass), She Xia (Snake Mass), and Bie Xia (Turtle Mass). "Ji" (Accumulation) is within the abdomen, or between the intestines and stomach, knotting firmly with the organ Qi. It does not move even when pushed, and is called "Ji," indicating its pathological form can be verified. Qi obstruction and blockage is called "Pi," meaning Qi stagnation without smooth flow. Food injury forming a lump, hard and immobile, is called "Shi Ji" (Food Accumulation). Blood stasis forming a lump, hard and immobile, is called "Xue Ji" (Blood Accumulation). Intra-abdominal blood stasis, however, is accumulated but not yet hard, and has not reached the stage of forming a distinct lump. Generally speaking, what cannot be moved by pushing is "Ji," while what moves when pushed is "Xia." As for Shan and Zhu-Pi, they appear with pain; they manifest when painful and hide when painless. Located above and to the left of the umbilicus is Zhu; between the hypochondria is Pi; in the lower abdomen drawing to the waist and flanks is Shan. To prevent students from being confused due to difficulty in understanding at once, I summarize and analyze them item by item.
When Zhang Dairen passed through Qiao, he met a soldier who spoke of divorcing his wife. Dairen asked the reason. The soldier replied, "When my wife was a maiden, she had a cold accumulation under the heart like an inverted cup. Pressing it produced a sound like water, and warming it with hot hands felt like ice. We have been married for fifteen years. I fear it will cut off my lineage, so I abandoned her." Dairen said, "Do not divorce her. If you use my medicine, the disease can be cured, and pregnancy obtained." The soldier agreed. Dairen palpated her pulse: deep and slow, but the Chi position was full, large, and forceful. This is not a sign of infertility; she could conceive within a year. Her husband laughed and said, "Let us try." First, San Sheng San (Three Holy Powders) was used to induce vomiting of one dou of saliva. The area under the heart became flat and soft. Then, Bai Zhu Tiao Zhong Tang (Atractylodes Macrocephala Decoction for Regulating the Middle) and Wu Ling San (Five-Ingredient Powder with Poria) were administered. Finally, Si Wu Tang (Four Substances Decoction) was used to harmonize the Qi and blood. Within less than a month, Qi and blood were balanced. Several months later, she conceived twins. Dairen once said, "Using this method of mine, there are no women who cannot bear children." This statement is not false. (San Sheng San uses Fang Feng, Gua Di each 3 liang, and Li Lu 1 liang, ground into coarse powder, decocted in vinegar juice. See *Ru Men Shi Qin* for preparation details. Bai Zhu Tiao Zhong Tang uses Bai Zhu, Fu Ling, Ze Xie, Ju Hong each 0.5 liang, Gan Cao 1 liang, Gan Jiang, Guan Gui, Sha Ren, Huo Xiang each 2.5 qian, ground into powder, taken with warm honey-water, 2 qian per dose, anytime. Wu Ling San is found in the Shang Han thirst section.) The wife of Magistrate Zhang of Yangxia suffered from Fei Qi (Fat Qi). Initially, it was the size of a wine cup, accompanied by alternating chills and fever for over fifteen years. Later, due to irritability and grief, the condition worsened. Only an area three fingers wide under the heart was free of disease; the rest of the abdomen was hard as a stone slab, making sitting and lying impossible. Acupuncture and moxibustion had been tried extensively to no avail. He invited Dairen to diagnose, saying, "This is Fei Qi. It originated on a Wu-Ji day in late summer, located under the left hypochondrium like an inverted cup. Untreated for long, it causes malaria." He vomited about one or two sheng of yellow, fishy phlegm using Gua Di San. That night, Zhou Che Wan and Tong Jing San were administered. At dawn, five or six stools of yellow phlegm and pus were passed. All areas of accumulation felt painful. Afterwards, Bai Zhu San and Dang Gui San were used to harmonize the blood and meridians. After three or four rounds of emesis and purgation, the disease was cured. (Gua Di San and Zhou Che Wan are found in the food injury and phlegm-fluid sections. Tong Jing San uses Ju Hong, Dang Gui, Gan Sui wrapped in dough, boiled for over a hundred boils, cooled in cold water, dried, and ground equally. Take 3 qian before bed with warm light wine. Bai Zhu San uses Bai Zhu, Huang Qin, Dang Gui equally ground. Take 2-3 qian decocted in water before meals. Dang Gui San uses Dang Gui, Tu Ji Li equally ground. Take with rice drink before meals. This combines emesis and purgation; Gan Sui is too harsh, so use with caution.) Xue Xinpu stated: "Women's Zhu-Pi-Xia conditions generally result from improper diet, lifestyle, and emotional disturbances, damaging the Zang-Fu organs, causing Qi and blood disharmony, injuring the Yin collaterals, and disrupting normal circulation. Luo Qianfu said: 'Nourish the righteous Qi, and the accumulation will naturally disappear. One must first nourish and regulate until Ying and Wei are sufficient. Only then can purgation be considered.' However, if removal is not gradual, disaster may ensue. If taboos are not observed and desires indulged, few will survive without losing their lives.
One woman suffered from internal heat and thirst, poor appetite, and an abdominal mass initially the size of a chicken egg, gradually growing to four cun. Her menstruation occurred only once every three months. She wasted away, her teeth and cheeks resembled ulcers, and her pulse was rapid, large, and deficient, especially at the Left Guan position. This was a syndrome of Liver-Spleen Qi stagnation. External application of A Wei Gao (Asafoetida Plaster) was used. In the morning, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was given; in the afternoon, Jia Wei Gui Pi Tang (Modified Return the Spleen Decoction) was administered. After about two months, Liver fire subsided slightly, and Spleen Earth strengthened. In the morning, Liu Wei Wan (Six-Ingredient Pill with Rehmannia) was added to Bu Zhong Yi Qi Tang; in the afternoon, Xiao Yao San (Free and Easy Wanderer Powder) was used to regulate menstruation, followed by Gui Pi Wan. Over another month, Lu Hui Wan (Aloe Pill) was taken twice daily, with Xiao Yao San on an empty stomach in the morning and Gui Pi Tang in the evening. Fortunately, she was diligent in self-care. After more than a year of regulation, she recovered.
Another woman had an abdominal mass that occasionally attacked upwards, sometimes causing painful sounds, acid regurgitation, and stifling sensation. Her menstruation was irregular, urination was difficult, and this persisted for over two years. Her complexion was greenish-yellow. I diagnosed it as Liver-Spleen Qi stagnation. Liu Jun Zi Tang (Six Gentlemen Decoction) was modified with Xiong, Dang Gui, Chai Hu, Chao Lian, Mu Xiang, and Wu Zhu Yu. After two doses, Gui Pi Tang was used to deliver Lu Hui Wan. After three months, Liver and Spleen harmonized, and symptoms receded. Tiao Zhong Yi Qi Tang (Regulate the Middle and Augment the Qi Decoction) with Fu Ling and Mu Dan Pi was then prescribed. With strong Middle Qi, menstruation regulated itself.
Another woman was prone to depression and anger, worked diligently at needlework, and had a lump in the lower abdomen causing pain and stifling sensation, with irregular menstruation. She strictly took herbs to suppress the Liver, leading to internal heat, alternating chills and fever, chest oppression, poor taste in mouth, and emaciation. Her gums eroded. This indicated Spleen Earth failing to generate Lung Metal, Lung Metal failing to generate Kidney Water, and Kidney Water failing to nourish Liver Wood. The source of transformation needed nourishing. Bu Zhong Yi Qi Tang and Liu Wei Wan were used, and she recovered by mid-spring.
Another woman had delayed menstruation, fever, and fatigue. Others used Si Wu Tang and Huang Lian, resulting in menstruation occurring only once every two months, scanty and clotted. Harsh purgatives were used to unblock it, causing vision obscured as if by cloth. I said, "The Spleen is the head of all Yin organs; the eyes are the congregation of blood vessels. This indicates Spleen damage affecting all five Zang organs, unable to nourish the eyes." Bu Zhong Yi Qi Tang and *Ji Sheng* Gui Pi Tang were used to focus on the Spleen and Stomach. She recovered after more than a year.
He Gongren, wife of the Prefect of Songjiang, was prone to anger, had an abdominal mass, and after a year, it ulcerated and leaked. Her Qi and blood were extremely deficient. In late winter, her Liver pulse was rapid, large, and wiry-tight. Others used herbs to suppress Liver Wood and clear Stomach fire. I said, "This is deficiency of True Qi and excess of pathogenic Qi. Suppressing Liver Wood may prevent the generation of Yang in spring." Ba Zhen Tang was used to generate Qi and blood; Di Huang Wan was used to nourish Kidney Water. The Liver pulse immediately subsided. Due to great anger, bleeding occurred from the ear, and the Liver pulse remained large, with irritability, heat, and thirst. This was rootless fire. The previous prescription plus Rou Gui for two doses caused the pulse to converge and heat to retreat. Again due to great anger, she died on a Xin-Si day in late winter, due to Metal overcoming Wood.
[General Treatment for Various Accumulations]
Shun Qi Wan (*Jian Yi*) treats thirty-six types of Wind and seventy-two types of Qi, removing upper heat and lower cold, waist and leg pain, limb fatigue, reduced appetite and emaciation, red-yellow complexion, malignant sores, bitter taste, aversion to cold with piloerection, Zhu-Pi masses, male impotence, female infertility, chronic malaria-dysentery, labor disease, and joint soreness. Suitable from infants to centenarians, it disperses wind, regulates Qi, tonifies essence, and preserves youth.
Jin Wen Da Huang (5 liang, half raw, half baked in wet paper) Che Qian Zi (2.5 liang) Bai Bin Lang (2 liang) Huo Ma Zi Ren (2 liang, lightly fried, husked, ground separately) Chuan Niu Xi (soaked in wine for 3 days) Yu Li Ren (soaked, peeled, ground separately) Shan Yao Tu Si Zi (steamed in wine, ground, roasted, 2 liang each) Shan Zhu Yu Rou Fang Feng Zhi Ke (bran-fried) Du Huo (1 liang each)
Grind into fine powder, make pills with refined honey the size of mulberry seeds. Take 20 pills with tea or gruel. No dietary restrictions. Take on an empty stomach and before bed. One month eliminates food accumulation; two months removes intestinal stagnation; three months reduces fatigue and sleepiness; four months strengthens spirit; five months improves hearing and vision; six months lightens waist and legs; one year cures hundred diseases. If organs feel slightly disturbed after medication, supplement with lamb lung soup.
Sheng Hong Wan (*Jian Yi*) treats Spleen accumulation with Qi stagnation, chest oppression, shortness of breath, vomiting clear fluid, male alcohol accumulation, female Spleen-blood Qi accumulation, and pediatric food accumulation.
Chen Pi Qing Pi Jing San Leng E Zhu (boiled in vinegar) Gan Jiang (roasted) Liang Jiang (fried, 1 liang each) Xiang Fu Zi (clean fried, 2 liang) Alternative formula adds Shen Qu and Mai Ya.
Grind into powder, make pills with vinegar paste the size of mulberry seeds. Take 30 pills with ginger soup. Deficient patients should take with tonic medicine.
Xiang Leng Wan (*Ji Sheng*) treats all accumulations. Breaks phlegm-pi, eliminates pi-lumps.
Mu Xiang Ding Xiang (0.5 liang each) San Leng (soaked in wine for one night) Zhi Ke (bran-fried) E Zhu (finely chopped, 1 liang stir-fried with 30 deshelled Ba Dou until Ba Dou turns yellow, then remove Ba Dou) Qing Pi (processed) Chuan Lian Zi Rou (fried) Xiang (fried, equal parts)
Grind into powder, make pills with vinegar-boiled flour paste the size of mulberry seeds, coated with Cinnabar. Take 30 pills with ginger-salt water or warm wine, anytime.
Da Xiao Shi Wan Treats seven hernias and eight masses, cup-shaped aggregations, female leukorrhea and infertility, and intra-abdominal Zhu-Xia. Administer this first to remove Zhu-Xia without exhausting the patient.
Xiao Shi (3 liang) Da Huang (4 liang) Ren Shen Gan Cao (1 liang each)
Grind into powder. Place three sheng of three-year-old vinegar in a copper or ceramic vessel. Add Da Huang first, simmer gently until slightly boiling, stirring constantly. When reduced to 7/10, add remaining medicines. Simmer into a paste. Make into mulberry-sized pills. Take 30 pills with rice drink, for three days. Women may pass chicken-liver-like material, rice water, or dark red/black substances (2-3 sheng). Avoid wind and cold afterwards.
A Wei Gao (Asafoetida Plaster) Treats all pi-masses.
Qiang Huo Du Huo Xuan Shen Guan Gui Chi Shao Yao Chuan Shan Jia Sheng Di Huang Liang Tou Jian Da Huang Bai Zhi Tian Ma (5 qian each) Huai, Liu, Tao branches (3 qian each) Hong Hua (4 qian) Mu Bie Zi (10 pieces, deshelled) Luan Fa (one ball, egg-sized)
Fry in 2 jin 4 liang of sesame oil until black, strain. Add hair, fry until dissolved, strain. Slowly add Huang Dan (lead tetroxide), fry until consistency is moderate. Add Mang Xiao, A Wei, Su He You, Ru Xiang, Mo Yao (5 qian each), She Xiang (3 qian). Mix well to form plaster. Apply to affected area. Real Huang Dan is required for efficacy. Before applying plaster, spread Pu Xiao evenly over the area half a finger thick, cover with paper, and iron with a hot ironer for a long time. Replenish Pu Xiao as consumed. Iron for about two hours before applying the plaster.
[Eight Masses]
*Bing Yuan* states: The Eight Masses arise from conception, childbirth, menstrual cycles, and disharmony of blood vessels and essence. The Kidney governs opening and closing as Yin. The left is the Bao Men (Womb Gate), the upper is the Zi Hu (Child Chamber), governing menstruation and childbearing. The Bao Men and Zi Hu control the entry and exit of spirit and Qi, connecting to the Zhong Huang Men and Yu Men boundaries, managing Guan Yuan, and sealing reproductive essence. Three cun below the umbilicus is Guan Yuan, storing魂魄 (Hun and Po). The female womb is the residence of the San Jiao. When meridians and collaterals are harmonious, menstruation arrives on time, enabling childbearing without disease. If Ying and Wei meridians are blocked, pathogens wander and enter the Zang organs. If intercourse occurs before menstruation ends, blood vessels contract, causing heaviness and urgency in the lower abdomen, distension,牵引 (drawing pain) in chest/flanks/waist/back, limb soreness, digestive disturbance, retention of evil blood, irregular menstruation (early or late), leading to accumulations resembling pregnancy. Severe pathogens cause hallucinations, dreams, chills/fever, limb immobility, genital gas, swelling, wind generation, severe urinary difficulty, pain like strangury, yellow-black complexion, and eventual infertility.
Xue stated: Classics say: Qi moistens, Blood nourishes. If blood does not flow, it coagulates into Xia. Xia is hard in the center but gathers and scatters intermittently. It is mostly caused by six excesses and seven emotions, improper diet/lifestyle, damaging Zang-Fu. Treatment should be same as Zhu-Pi syndromes. Do not damage Righteous Qi.
[Huang Xia (Yellow Mass)]: When menstruation begins, if injured or aborted with blood not stopped, resting not settled, Zang-Fu weak, spirit insufficient, exposed to strong wind/dampness via joints, Qi rises from below into Yin, lingering as Yin deficiency, generating Huang Xia. Huang Xia causes limb chills/fever, heaviness, sweating, anorexia, firm knot under left hypochondrium, back-waist pain, difficult menstruation, infertility, lower abdominal urgency, stabbing pain in genitals, urinary difficulty, chills/fever, red-yellow discharge, infertility. Moxibustion/acupuncture at Kai Yuan, Qi Chong points, combined with toxic drugs, cures upon expulsion.
Zao Jia San (*Sheng Hui*) for Huang Xia.
Zao Jia (1 liang, roasted, peeled/seeded) Shu Jiao (1 liang, sweat removed) Xi Xin (1.5 liang)
Grind. Place in triangular bag (finger-sized, 2 cun long). Insert into vagina. Remove if uncomfortable during defecation, reinsert when done. Wash with warm water after evil blood flows. Avoid men for three days. Raw vegetables forbidden.
[Qing Xia (Green Mass)]: Postpartum, walking before ten days, washing too early, Yin-Yang deficiency, Yu Men loose, Zi Hu unstable, bone/muscle pain, arm immobility, poor appetite, internal whining, exposure to wind/wet bedding. Cold enters abdomen, causing oppression, retained evil blood, heat accumulation, generating Qing Xia. Mass in hypochondria, back, shoulder blades, lower back spasm, abdominal Qi rise, salivation, anorexia, limb immobility, edema, yellow face, difficult urination/stool, subsequent menstrual obstruction or flooding, causing infertility. Self-inflicted. Treat by puncturing Wei Guan point, using specific toxic drugs.
Treatment for Qing Xia:
Rong Yan (1 sheng) Zao Jia (0.5 liang, roasted, peeled) Xi Xin (1 liang)
Grind. Place in triangular bag (finger-sized, 3 cun long). Insert into vagina. Lie down. Mass expels, green like mallow juice. Care as postpartum.
[Zao Xia (Dry Mass)]: Menstrual blood not fully expelled, body weak, walking fast in summer heat, lifting heavy, sweating profusely, Qi/blood unsettled, sudden anger causing abdominal blockage, meridian contraction, internal distress, Qi rising to chest/back, lower abdominal urgency, menstrual/Qi obstruction. Drinking cold water causes menstrual reflux into other organs. Heat generates Zao Xia, size of half cup, painful abdomen/flanks, heart vexation, nausea, inability to sigh, heavy back, night sweats, leg soreness, urinary incontinence, constipation, amenorrhea. Causes infertility. Treat with long needles and toxic drugs.
Treatment for Zao Xia (*Sheng Hui*):
Da Huang (egg-sized) Gan Jiang (2 liang) Huang Lian (3 liang) Ji Zao Huang Mo (1 piece, roasted) Gui Xin (1 chi) Meng Chong (3 pieces, roasted) Hou Po (10 pods, roasted) Yu Li Ren (1 liang, peeled/seeded, roasted)
Grind. Take 3 qian with warm wine on empty stomach in morning. Mass expels. Care as postpartum. Abstain from sex for three months. Infertile may conceive.
[Xue Xia (Blood Mass)]: Menstruation stops early due to overeating, Grain Qi overflowing to other organs. Hunger/cold, irregular breathing, physical labor while blood settling. Blood wanders intestines/stomach, stays in collaterals, internal chills/fever mixing with menstruation. Forms Xue Xia. Lower back pain, immobility, Qi accumulation under Heng Gu hard as stone, lower abdominal urgency/pain, deep back/waist pain, genital contraction, wind-cold, Zi Men deviation, irregular menstruation. Causes infertility. Expel mass to cure.
Treatment for Female Xue Xia Pain (*Sheng Hui*):
Gan Jiang Ou Mei Yu Gu (Cuttlefish Bone) (1 liang each, roasted) Tao Ren (1 liang, peeled/seeded)
Grind. Take 2 fang cun bi with wine, twice daily. Alternative formula omits Tao Ren.