（附虫积）
〔总论〕 丹溪论积聚症瘕不一。积者停蓄之总名也。宜以在中在左在右分治。凡块乃
有形之物。气不能成形。痰与食积死血而已。在中为痰饮。在右为食积。在左为死血。大法
盐以软之。坚则削之。行气开痰为主。久痞及老年者。大约不宜妄动。虚损人亦不宜乱治。
而孕妇尤不宜治痞。恐伤其胎也。慎之慎之。有此症者。大宜戒气恼。及冷物发气等项。不
然。恐再发难治。（积聚之脉。实强可生。沉细难愈。）
〔治痞积方〕 不拘何膏药二张。以一张揭开。用白信五分。研细糁之。（小儿只用三
分。）再以一张粘贴。将背面贴患处。以布包好。数日痞化。治皮里膜外者效尤速。如贴膏
药后。腹中胀闷。乃痞积将散。须服枳壳。（八分）大腹皮。（盐水洗一钱）苏梗。（八分）
浓朴。（一钱二分）青皮。莪术。（各八分）山楂。（二钱）乌药。（六分）香附。（一钱五分）
缩砂。（五分）广木香。（三分）水二碗煎六分。空心服。三四剂愈。
〔痞块熨法〕 葱白同蜜二味捣烂。浓涂患处上。以布盖。用熨斗微火熨之。痞即消。
愈后宜服四物汤。（方见中风门以养气血。）
〔消痞膏〕 大黄。朴硝。（各一两）独部蒜。（七枚）同捣烂贴患处即消。 水红花。
（无
花。用子捣取汁。） 每汁一碗。水三碗。桑柴火熬成膏。量痞之大小。用纸摊贴以好为度。
仍将膏用酒调服。忌荤腥油腻。 独部蒜。穿山甲。真蕲艾等分。将穿山甲洗净。瓦上 过
成炭研细。又将艾拌匀。同蒜捣烂贴患处。（照痞大小药味量加。） 候线香一炷为度。
〔腹中痞积〕 观音柳。（即垂丝柳。）煎汤露一夜。五更空心饮数次。痞自消。 如已
成痞块。猪腰子两个切薄片。用木鳖子肉一两。与猪腰子相间缚定。外用湿纸包。火煨熟。
捣如泥。加黄连三钱。研末为丸。桐子大。初服二十丸。乌梅甘草汤下。第二服加五丸。渐
加至以痛为度。块从大便中出。神效。 凡服利药。或外治消痞之后。宜服人参。（一钱）
熟地。当归。（各二三钱）白术。（炒一钱半）炙甘草。（一钱）水煎。食远服。五七剂后不
再发。
〔诸物食积久不愈〕 海蜇。（一斤）水煮化。加白荠四十九个同煮收干。每早晚空心
吃五七枚。以好为度。 如食积作痛。白术。（炒焦）茯苓。制半夏。（各一两）萝卜子。（二
钱）
山楂肉。（一两五钱）陈皮。（五钱）炼蜜丸如弹子大。空心米汤下一丸即止。 如已成痞块
胀
痛。野芋头。（一名仙人掌。同野芋一种。但此种叶较小。略似慈菇。叶有尖。）磨烂和糯米
粉淡煮粥。每早食一茶钟。不用油盐。十服之后。其积自消。甚效无害。
〔食积成痞〕木贼草为末。每服三五分。白汤空心服即消。年远不过两服。
〔痰积成痞〕瓦棱子。（火 。醋淬三次研细。）醋糊为丸。桐子大。每服三四十丸。淡
醋汤下。
〔气滞似痞〕 胡桃肉每两加明矾末三钱。同捣为丸。桐子大。每服三五十丸。好酒下。
〔鱼 生 积〕 生鱼多食不化。即成瘕症。马鞭草捣汁饮之即消。 生姜汁点汤服。
或橄榄煎浓汁服皆效。
〔诸虫积〕 痛时口中清涎流出。汤饮不能进。用乌梅。花椒。生姜片煎汤服止痛。 于
月之初一至初五六虫头向上。用芦荟。（二钱）史君子肉。擂丸。（各四钱）苦楝根。（向东
不出土者佳。去皮及骨一两半。）白芜荑仁。（炒）鹤虱草。槟榔。（各五钱）俱研末。砂糖
为丸。
(Attached: Worm Accumulation)
[General Discussion] Zhu Danxi discussed that diseases such as accumulation (Ji), mass (Zhi), and tumor (Jia) vary in type. "Accumulation" is the general term for the stagnation and storage of pathogenic factors within the body. Treatment should be differentiated based on whether the lesion is located in the center, left, or right. Any formed lump is a tangible pathological entity; Qi alone cannot form a tangible shape, only Phlegm-Fluids, Food Stagnation, and Dead Blood can form lumps. Located in the center, it is Phlegm-Fluids; located on the right, it is Food Stagnation; located on the left, it is Dead Blood (Blood Stasis). The general principle is to use salty substances to soften hardness, reduce firm masses, and prioritize moving Qi and resolving Phlegm. For long-standing cases or elderly patients, aggressive treatment should generally be avoided. Patients with deficiency and damage should not be treated recklessly, and pregnant women especially should not be treated for Pi accumulation, lest the fetus be harmed. Be extremely cautious. Those with these symptoms must avoid anger and irritability, as well as cold foods and other items that provoke Qi rebellion; otherwise, recurrence may be difficult to treat. (The pulse of accumulation: if solid and strong, survival is possible; if deep and fine, recovery is difficult.)
[Prescription for Treating Pi Accumulation] Use any two sheets of medicated plaster. Remove one sheet, take Bixin (Arsenic preparation) 5 fen, grind into fine powder, and sprinkle it on the plaster. (For children, use only 3 fen.) Paste the second sheet over it, place the adhesive side on the affected area, and wrap securely with cloth. After several days, the Pi will dissolve; this method is particularly effective for lesions in the subcutaneous tissue. If abdominal distension and fullness occur after applying the plaster, it indicates that the accumulation is about to disperse. At this point, administer Zhiqiao (Immature Bitter Orange) 8 fen, Dafupi (Areca Peel) 1 qian (washed with salt water), Sugen (Perilla Stem) 8 fen, Houpo (Magnolia Bark) 1 qian 2 fen, Qingpi (Aged Tangerine Peel), Ezhu (Curcuma Rhizome) (each 8 fen), Shanzha (Hawthorn Fruit) 2 qian, Wuyao (Lindera Root) 6 fen, Xiangfu (Cyperus Rhizome) 1 qian 5 fen, Suosha (Amomum Fruit) 5 fen, Guangmuxiang (Costus Root) 3 fen. Decoct in two bowls of water until six fen remains. Take on an empty stomach. Cure in three to four doses.
[Ironing Method for Pi Masses] Mash Scallion White and Honey together, apply thickly to the affected area, cover with cloth, and iron with a hot ironer using low heat. The Pi will immediately dissipate. After recovery, it is advisable to take Siwu Tang (Four Substances Decoction) (see Stroke Section for formula) to nourish Qi and Blood.
[Pi-Dissolving Plaster] Dahuang (Rhubarb Rhizome), Puxiao (Mirabilite) (each 1 liang), Dutou Suan (Single Clove Garlic) (7 cloves). Mash together and apply to the affected area; the Pi will disappear. Shuihonghua (Polygonum Ayapifolium Herb): if unavailable, use seeds and crush to extract juice. Take one bowl of juice, add three bowls of water, and simmer over mulberry wood fire until it forms a paste. Spread on paper according to the size of the Pi and apply externally until healed. Subsequently, mix the remaining paste with wine and ingest orally. Avoid greasy and pungent foods. Alternative method: Dutou Suan, Chuanshanjia (Pangolin Scale), Zhen Qiai (Mugwort Leaf) in equal proportions. Wash Chuanshanjia thoroughly, roast on a tile until charred, and grind into fine powder. Mix with Mugwort, then mash together with garlic and apply to the affected area (adjust dosage according to Pi size). Leave on for the duration of one incense stick.
[Abdominal Pi Accumulation] Guanyin Liu (Weeping Willow), decoct and leave exposed overnight. Drink several times on an empty stomach at dawn (Wu Geng); the Pi will naturally dissipate. If a Pi mass has already formed, take two pig kidneys, slice thinly. Take 1 liang of Mubiezi (Momordica Seed) flesh, layer it with the kidney slices, tie them together, wrap in wet paper, and bake in fire until cooked. Mash into a paste, add Huanglian (Coptis Rhizome) 3 qian, grind into powder, and make pills the size of wutong seeds. Initial dose: 20 pills, taken with Wu Mei Gancao Tang (Smoked Plum and Licorice Decoction). Second dose: increase by 5 pills. Gradually increase until pain subsides. The mass will pass out through the stool. This is miraculous. After taking purgatives or external treatments to resolve Pi, it is advisable to take Renshen (Ginseng Radix) 1 qian, Shudi (Prepared Rehmannia Root) and Danggui (Angelica Sinensis Root) (each 2-3 qian), Baizhu (Atractylodes Macrocephala Rhizome, stir-fried) 1 qian 5 fen, Zhigancao (Honey-fried Licorice Root) 1 qian. Decoct in water and take well after meals. After five to seven doses, it will not recur.
[Long-standing Food Stagnation from Various Foods] Hai Zhe (Sea Cucumber Jellyfish), boil until dissolved. Add 49 Baiqi (White Shepherd's Purse) and cook until dry. Eat 5-7 pieces on an empty stomach morning and evening, until cured. If food stagnation causes pain, use Baizhu (stir-fried until scorched), Fuling (Poria), Banxia (Pinellia Tuber, processed) (each 1 liang), Luobozi (Radish Seed) 2 qian, Shan Zha Rou (Hawthorn Flesh) 1 qian 5 fen, Chenpi (Tangerine Peel) 5 qian. Make pills with refined honey the size of a bullet. Take one pill on an empty stomach with rice gruel to stop pain immediately. If a Pi mass has formed causing distension and pain, take Ye Yutou (Wild Taro, also known as Xian Zhang Cao, similar to wild taro but with smaller leaves resembling arrowhead and pointed tips). Grind into a paste, mix with glutinous rice flour, and cook into a thin porridge without oil or salt. Eat one tea cup every morning. After ten doses, the accumulation will naturally dissipate. It is very effective and harmless.
[Food Stagnation Forming Pi] Mu Zei (Equisetum Hiemale) herb, grind into powder. Take 3-5 fen each time with plain water on an empty stomach; it will dissipate. For old cases, no more than two doses are needed.
[Phlegm Accumulation Forming Pi] Walengzi (Arca Shell), roast red, quench in vinegar three times, and grind finely. Make pills with vinegar paste the size of wutong seeds. Take 30-40 pills each time with light vinegar water.
[Qi Stagnation Mimicking Pi] Hutaoren (Walnut Kernel), add 3 qian of Mingfan (Alum) powder per liang. Mash together and make pills the size of wutong seeds. Take 30-50 pills each time with good wine.
[Fish Raw Accumulation] Excessive consumption of raw fish leads to indigestion and forms Jia syndrome. Mash Biancao (Verbena Officinalis Herb) and drink the juice; it will dissipate. Alternatively, add fresh ginger juice to soup or drink concentrated olive decoction; both are effective.
[Various Worm Accumulations] During pain, clear saliva flows from the mouth, and fluids cannot be ingested. Use Wumei (Smoked Plum), Huajiao (Sichuan Pepper), and Shengjiang (Fresh Ginger slices) to decoct and drink to relieve pain. On the first day of the lunar month up to the sixth, when worm heads face upward, use Lushen (Aloe) 2 qian, Shijunzi Rou (Buckeye Seed Flesh), Le Wan (Vernonia Fruit) (each 4 qian), Kuligen (Toona Root Bark, preferably east-facing and unrooted, peeled and de-boned) 1 lian 5 qian, Bai Wuyi Ren (Chenopodium Seed, stir-fried), Leshe Cao (Dysphania Herb), Binglang (Betel Nut) (each 5 qian). Grind all into powder and make pills with brown sugar.