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Lu's variant formula, Yinggan Wan (Response Pill), differs significantly from the formula in *Taiping Huimin Heji Jufang* (Formulas of the Bureau of People's Welfare and Relief). Provided that the processing methods are standard and the proportions of ingredients are most carefully balanced, its action is merely to warm and transform stagnation, avoiding excessive bias or intensity. This medicine eliminates accumulation without damaging the Zang-Fu organs; its subtlety lies in the large quantity of Beeswax used, which must not be reduced. Regular consumption strengthens the Spleen and promotes appetite, preventing diseases such as alternating chills and fever, diarrhea, and dysentery, because it gradually dissipates stagnation, naturally resulting in health. It is especially advisable to take more when overindulging in alcohol or food; its miraculous effects cannot be fully described.

Myristicae Semen (Nutmeg) (roasted wrapped in flour) Aquilariae Lignum Resinatum (Agarwood) (roasted wrapped in wet paper) Zingiberis Rhizoma Preparatum (Prepared Ginger) Curcumae Longae Rhizoma (Slice Turmeric) Carbonis Trichomanatis (Barn Soot) (sifted fine) Caryophylli Flos (Clove) Arecae Semen (Betel Nut) Citri Reticulatae Pericarpium Viride (Green Tangerine Peel) (soaked in water, white pith removed, stir-fried) Fructus Schisandrae Chinensis (Schisandra) (each 1 liang) Frankincense (Ru Xiang) (3 qian, crushed and ground fine) Armeniacae Semen Amarum (Apricot Kernel) (70 seeds, skin and tip removed, ground fine, oil removed according to the method for Crotonis Semen) Mel (Beeswax) (10 liang) Crotonis Semen (Croton Seed) (100 seeds, skin removed, ground into powder, wrapped in multiple layers of paper and pounded until oil penetrates, change paper repeatedly until all oil is gone and it becomes a white frost.)

Except for the Croton powder, Barn soot, Apricot kernels, and Frankincense, grind the rest into fine powder, then mix evenly with the previous four ingredients. First, melt the 10 liang of Beeswax in a silver or stone vessel into liquid, filter through thick cotton cloth to remove dregs. Boil the wax in 1 sheng of good unadulterated wine in a silver/stone vessel, boil several times, then remove. Upon cooling, the wax will float on the wine; discard the wine. For spring and summer preparation, use 1 liang of clear sesame oil; for autumn and winter, use 1.5 liang of oil. Heat the oil in a large silver vessel until fragrant, then add the wine-boiled wax, melting them together into liquid. While hot, mix thoroughly with the medicinal powder. Allow to cool slightly, divide into doses, store in jars, and may be taken after half a month. If made fresh, form pills the size of radish seeds and take as desired, increasing from 20-30 pills to 50 pills is safe. Due to the high wax content, these pills are hard to form, but the finer the pill, the broader the efficacy. They should be taken regularly before sleep. To treat disease, timing is flexible. (From *Heji Jufang*)

Awei Wan (Asafoetida Pill), treats weak Spleen and Stomach, where meat, noodles, or raw fruits cause stagnation in the Middle Jiao, leading to indigestion, distension, abdominal pain, nausea, vomiting, anorexia, diarrhea, or constipation.

Asafetida (dissolved in wine) Cinnamomi Ramulus (Cinnamon Twig) (not exposed to fire directly) Curcumaee Rhizoma (Curcuma) (processed) Malt (stir-fried) Massae Fermentatae Medicinalis (Medicated Leaven) (stir-fried) Citri Reticulatae Pericarpium Viride (Green Tangerine Peel) (white pith removed) Raphani Fructus (Radish Seed) (stir-fried) Atractylodis Rhizoma (Atractylodes) (each 0.5 liang) Carbonis Trichomanatis (Barn Soot) (3 qian) Crotonis Semen (Croton Seed) (3 seeds, husked and de-oiled) Zingiberis Rhizoma Preparatum (Prepared Ginger) (0.5 liang, processed)

Grind all into powder and mix evenly. Form pills the size of mung beans using thin paste. Take 20 pills each time, at any time, with Ginger Decoction. For noodle injury, use noodle water. For raw fruit injury, use Moschus (Musk) decoction. (From *Defang*)

Xinzhi Yinyang Gongji Wan (Newly Formulated Yin-Yang Attack Accumulation Pill), treats Five Accumulations and Six Gatherings, Seven Zha and Eight Jia masses, as well as Pi masses, worm infestations, blood stasis, phlegm, and food stagnation. Effective regardless of Yin or Yang patterns.

Evodiae Fructus (Evodia) (soaked) Zingiberis Rhizoma Preparatum (Prepared Ginger) (stir-fried) Cinnamomi Ramulus (Cinnamon Twig) (skin removed) Aconiti Radix Preparata (Prepared Aconite Root) (each 1 liang, processed) Coptidis Rhizoma (Coptis) (stir-fried) Pinelliae Rhizoma Preparatum (Prepared Pinellia) (washed) Citri Reticulatae Pericarpium (Tangerine Peel) Poria (Poria Cocos) Arecae Semen (Betel Nut) Magnoliae Officinalis Cortex (Magnolia Bark) (stir-fried) Aurantii Fructus Immaturus (Immature Bitter Orange) (stir-fried) Acori Tatarinowii Rhizoma (Sweet Flag) (avoid iron) Corydalis Rhizoma (Corydalis) (stir-fried) Ginseng Radix et Rhizoma (Ginseng) (rhizome removed) Agarwood (Agarwood) Succinum (Amber) (separately ground) Platycodonis Radix (Balloon Flower Root) (each 8 qian) Crotonis Semen Frost (Croton Frost) (separately ground 5 qian)

Grind all into fine powder. Use 6 liang of Gleditsiae Sinensis Fructus (Chinese Honeylocust Pod) decoction to form pills the size of mung beans. Start with 8 fen per dose, gradually increase to 1.5 qian, taken with Ginger Decoction. Yu Jianru, Prefect of Xiangyang, suffered post-alcohol abdominal pain that hardened and worsened with eating. Pulse was floating, large, and long, indicating large accumulation in the Spleen. However, the Chi pulse was soft upon pressure, so harsh purgation was contraindicated. Prescribed Sijunzi Tang (Four Gentlemen Decoction) for seven days, followed by 3 qian of self-made Gongji Wan. Mild purgation occurred. Increased to 4 qian, resulting in >10 evacuations of black, tough material. Observing no fatigue, administered another 4 qian, causing severe abdominal pain and massive evacuation. After 10 days of Sijunzi Tang, another 4 qian of pills were given, removing accumulation three times. Another 2 qian led to evacuations totaling 6-7 bowls. Pulse became large and empty, hollow at the Guan position. Then used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for regulation and tonification. Fully recovered in one month. (From *Bidu*) *Yitong* notes this formula lacks Arecae Semen, Citri Reticulatae Pericarpium, Magnoliae Officinalis Cortex, Aurantii Fructus Immaturus, Acori Tatarinowii Rhizoma, and Platycodonis Radix, stating it comes from Mr. Shicai's *Bidu*. The formula uses yeast paste for pills, which is milder than honeylocust pod juice. Its妙用 (subtle application) lies in alternating with Spleen/Stomach tonics. I have used this: often modifying Liujunzi Tang (Six Gentlemen Decoction) by removing Atractylodes, doubling Poria, adding Cinnamomi Ramulus and Angelicae Sinensis Radix, forming pills with rice drink. Or taking Zengsun Liujun in the morning and Yinyang Gongji in the evening. Or taking Gongji Wan one day, Liujun two-three days, depending on strength. Initial doses are effective; stop when accumulation declines ("stop when half is gone"), focusing solely on Spleen tonification.

Awei Xiaopi San (Asafoetida Eliminating Mass Powder), Pi and Pi masses arise from excessive internal injury, with Qi and Blood rebelling and knotting. Initially, small lumps are felt in the abdomen, painful upon movement. Over time, they grow larger and take shape. In severe cases, internal throbbing occurs, accompanied by Qi/Blood deficiency and reduced appetite. Internally take Awei Xiaopi San; externally apply Qiankun Yiqi Gao (Universe One Qi Plaster). Expel evil, nourish righteous Qi, balancing attack and tonification.

Chuanxiong Rhizome (Chuanxiong) Angelicae Sinensis Radix (Dong Qu) Atractylodis Rhizoma (Atractylodes) Polyporus (Polyporus) Carthami Flos (Safflower) Asafetida Trionycis Carapax et Plastrum (Softshell Turtle Shell) tip (fried in butter, ground, each 1 qian) Rheis Radix et Rhizoma (Rhubarb) (wine-fried 8 qian) Fagopyri Dibotryosis Semen (Buckwheat Flour) (1 liang, lightly fried)

Grind all into powder. Take 3 qian each time on an empty stomach, mixed with a cup of good wine. After three days, pus and blood in stool indicate efficacy. Avoid cold, raw, greasy, and pungent foods. (From *Waike Zhengzong*) *Qiankun Yiqi Gao* is not recorded here. *Yitong* states it treats malaria-related Pi masses and chills/fever, but is contraindicated for deficient persons.

Hua Pi Dan (Mass Dissolving Pill), a specialized agent for attacking accumulation masses.

Rhei Radix et Rhizoma (Rhubarb) (4 liang, soaked in rice vinegar for 7 days, sun-dried by day and dew-exposed by night for 7 days.) Euphorbiae Lathyridis Semen (Euphorbia Seed) (de-oiled 1 liang) Manis Squama (Pangolin Scale) (de-scaled, fried 2 liang) Cyperi Rhizoma (Cyperus) (steeped in child's urine, fried 1 liang) Persicae Semen (Peach Kernel) (skin removed, ground 1 liang) Carthami Flos (Safflower) (3 qian, raw) Indigo Naturalis (Indigo) (5 fen)

Grind into powder. Boil Rhubarb in vinegar to make a paste, form pills the size of beans. Take 50 pills each time, with Mugwort Root and Kudzu Root decoction. Avoid Sichuan pepper, black pepper, fried/grilled foods, and glutinous rice. (From *Huichun*)

Alcohol Accumulation Treatment Formula (Note: Food and Blood accumulation formulas are categorized separately, but Alcohol accumulation is distinct from Tea accumulation, hence listed separately as a variation.) Jiuxing Wan (Alcohol Pattern Pill), treats alcohol addiction, salivation, headache, back fatigue, red frequent urination.

Poria (Poria Cocos) Polyporus (Polyporus) (each 0.5 liang) Massae Fermentatae Medicinalis (Medicated Leaven) Bai Dingxiang (White Star Anise? Note: Likely refers to a specific herb, possibly related to bird droppings or similar traditional item, literal translation kept) Hordeum Vulgare (Barley) Puerariae Radix (Kudzu Root) Puerariae Flos (Kudzu Flower) (each 1 liang, raw)

Eight ingredients. Mix 2.5 liang of Medicated Leaven powder with water to form paste, blend with other powders. Form pills the size of paulownia seeds. Leave overnight. Stir-fry with aged millet until holes appear and aroma is released. Take 50 pills, anytime. (From *Jifeng*)

Jiuji Wan (Alcohol Accumulation Pill), treats persistent alcohol pattern, chest/abdominal fullness, belching with sour taste, hiccups, anorexia, stabbing flank pain.

Massae Fermentatae Medicinalis (Medicated Leaven) (stir-fried) Hordeum Vulgare (Barley) (each 1 qian, stir-fried) Amomi Fructus Rotundus (Cardamom) (1 zi, separately ground) Triticum aestivum (Wheat Flour) (4 liang) Crotonis Semen Frost (Croton Frost) [from 60 liang] Coptidis Rhizoma (Coptis) (1 zi)

Grind into fine powder. Mix with boiling water to form pills the size of paulownia seeds. Take 3 pills each time, chewing roasted ginger, with warm wine, after meals. (From *Yangshi*) *Jisheng Xufang* Qu Wan (same indication): Remove Cardamom and Wheat Flour from base formula. Use 0.5 liang Coptis and 3 Croton seeds (husked, stir-fried together until color changes, remove Croton). Remaining herbs 1 liang each. Take 50 pills. (From *Jisheng Xufang*)

Tea Accumulation Treatment Formula (Refer to *Roundworm* section). Moji Wan (Accumulation Grinding Pill), treats tea accumulation, reduced appetite, yellow complexion, abdominal pain.

Chencangmi (Stored Rice) (0.5 jin, stir-fry with 7 husked Croton seeds until red, remove Croton.) Citri Reticulatae Pericarpium Viride (Green Tangerine Peel) Chenjuhong (Aged Tangerine Peel) (each 2 liang)

Grind into powder. Mix with good vinegar to form pills the size of pea seeds. Take 20 pills after meals, with light Ginger Decoction. (From *Defang*)

Treating Tea Pi Pattern.

Gypsum Fibrosum (Gypsum) Scutellariae Radix (Scutellaria) Cimicifugae Rhizoma (Black Cohosh)

Grind into powder. Take with sugar water. (From *Danxi*)

For those addicted to tea, with yellow complexion and weakness: 2 liang Sichuan pepper red, 1 liang tea leaves, ground. Mix with refined wheat flour fried until fragrant, paste to form pills. Take 30 pills with tea infusion. Another formula: 2 liang bitter grass, 1 liang tea leaves. If addicted to grains, soil, charcoal, paper, etc., add the specific substance and cook in its decoction to take. (From *Yitong*) (*Shengjin Fang* treats raw tea addiction with unspecified amount of pepper powder, formed into pills with paste, take 10 with tea. See *Bencao*).

External Treatment: Zhouhou Ironing Formula.

Zaozhong Huangtu (Yellow Earth from Hearth) (1 sheng) Sheng Cong (Raw Green Onion) (1 sheng)

Crush green onion until cooked, mix with earth, crush again. Moisten with good vinegar. Apply to cloth, place on affected area, reapply cloth, replace when dry, until resolved. (From *Waitai*) *Qianjin* adds Cinnamon. (Note: Current *Zhouhou* matches *Qianjin*).

Treatment for Knotting Disease (original mentions melon disease, omitted), Pepper Ironing Formula.

Take a new 1-sheng basin, drill 120 holes in bottom. Place 3 he of pepper on holes, cover with paper, add 1 sheng cold ash, then 0.5 sheng hot ash, then 1 jin hot charcoal fire. After one meal time, basin bottom is hot. Place on disease site. Initially place one layer of felt, then hot basin. Increase layers if too hot. Rest if unbearable. Drink cold beverage. Reapply. Stop after reducing 20%. Do not apply for 3 days. By day 7, sudden recovery expected. Then eat nutritious food to recover. (From *Qianjin*)

Ironing Qi Method.

Ai Ye (Mugwort Leaf) (beaten ripe, fried in stone pot, add vinegar for fragrance, fry very hot.)

Place in 2-3 silk bags, alternate applying hot to abdomen. Alternative: Fry coarse salt until very hot, press onto painful area. Also effective. (From *Danliao*)

Umbilical Paste, treats deficiency with accumulation, abdominal distension/pain, bowel/bladder obstruction.

Manis Squama (Pangolin Scale) (processed/dried) Trogopteri Dung (Flying Squirrel Droppings) Crotonis Semen (Croton Seed) (husked) Allium Sativum (Garlic) (peeled, each 3 qian)

Grind into fine powder, mix into mud. Form cakes the size of a copper coin (approx 3 qian). Wrap in cotton, place in umbilicus, secure. When heat spreads, remove for effect. (From *Shiwanduan Xiao Fang*)

Moxibustion Method: Hard accumulations lie outside intestines/stomach, in Mu Yuan (semi-interior/exterior space), inaccessible to drugs alone. Use external plasters like Awei Gao, Hupo Gao, Shuihonghua Gao, Sansheng Gao to attack externally, then Zhang Sangjun needle method internally. Hard accumulations require fire therapy to dissipate; moxibustion is best. In Yanjing, I cured several left hypochondriac masses via moxibustion. Zhang Sangjun Needle/Mass Method: Needle the mass first. Severe cases: needle head and tail. Then moxa immediately for cure. (Also cited in *Gangmu*, mentions Zusanli). Another method: To moxa Pi masses, moxa "Pi Gen" (Root of Pi). Location: Below 13th thoracic vertebra, midline. Mark with ink. Not a standard acupoint. Measure 3.5 cun lateral to mark. Palpate for slight arterial pulsation. Mark and moxa. Level with umbilicus. Usually moxa left side, or both. This is Pi Gen. Left lesion moxa right, right lesion moxa left, also effective. Acupoints: Zhongwan, Qimen, Zhangmen, Pishu, Sanjiaoshu, Tonggu. These are suitable for Pi masses. Upper accumulations: Shangwan, Zhongwan, Qimen, Zhangmen. Lower accumulations: Tianshu, Zhangmen, Shenshu, Qihai, Guanyuan, Zhongji, Shuidao. Moxa order: Top to bottom. Abdominal moxa requires stronger fire, start with 7 or 14 moxa cones, increase gradually. More is better. Select points as needed. For non-standard points, locate hardest part, head/tail, protruding/moving areas, follow meridians, and moxa thoroughly. Fire disperses accumulation qi magically. Moxa for Pi is not immediate; repeat multiple times, selecting key points, continuous sessions ensure cure. (From *Jingyue*)

Case: Chang'an tavern worker, 17 years old, had Pi mass 4-5 cun diameter, abdominal distension. I moxa Pishu, Ganshu, Zhangmen, Zhongwan, Zusanli. Mass disappeared completely in half a month. (From *Cheng Xinghai Medical Case*)

Regulation/Dietary Advice: Physicians find Yin Deficiency hard to tonify and long-standing accumulation hard to remove. Like a mountain collapsing from within (Yin Def), or raising a tiger leaving future trouble (Accumulation). Those suffering both must restrain desires to nourish nature, practice introspection to nourish spirit, remain calm and detached, then entrust to medicine. Otherwise, even Liu, Zhang, Li reincarnated cannot save you. (From *Xinfa Fuyu*)

Beyond mild tonification, cut rich flavors, restrain sexual desire, avoid rage, regulate thoughts, for complete safety. (From *Rumen*)

If source is not cleared, flow cannot be pure; if fuel not added, soup cannot boil; if rich flavors not cut, accumulation cannot dissolve. This is impossible. (From *Yijin Yifa*)

Medication strictly forbids rich, Qi-dispersing foods. (From *Jianming Yigou*)