是证由膀胱蕴热，风湿相乘；或因湿热，水肿流注；或疝气攻作；或暴风客热，及小儿啼叫
，怒气结聚；或坐湿地冷石；或虫蚁吹毒所致。详其所因而施治之。
主方 白术 桑皮 木通 陈皮（各半两） 白丑（二两）共为末，每服二钱小儿止服五
分。空心姜汤调下。
治小儿啼叫成者∶桃仁（去皮尖） 官桂 黑丑（炒） 白蒺藜 牡丹皮 大黄（各三钱）
为末，蜜丸桐子大，每五十丸。青皮、木通、葱白、盐少许，煎汤下。
治小儿阴肿∶牡蛎（ ，研粉），津调服，次以粉擦之。
五苓散加丹皮、防风服。或桃仁研膏，津唾调敷。
又 蝉蜕五钱，煎水频洗，仍以五苓散加灯心煎服。
简便方 治外肾肿。
小茴香 穿山甲（炒） 木香（各等分）为末，每二钱酒下。
男、妇阴肿∶马鞭草捣烂绞汁涂。小儿用老杉木烧灰，入腻粉油调敷。
又 荆芥（一两） 朴硝（二两） 萝卜子（一两五钱）葱白同煎洗。
又 葱围蚯蚓粪，甘草煎汁调涂。或生薄荷汁敷亦可。
外肾肿∶大黄末，醋调涂，干再涂。或加牛粪烧灰等分。
《难经》曰∶积者，阴气也；聚者，阳气也。故阳浮而动，阴沉而伏。气之所积，名曰积。气
之所聚，名曰聚。故积者，五脏所生；聚者，六腑所成。积者，阴气也，其始发有常处，其痛不
离其部，上下有
所终始，左右有所穷处。聚者，阳气也，其始发无根本，上下无所留止，其痛无常处，谓之聚。
故以是别知积聚也。盖五积之名，肝之积名曰肥气，在左胁下，如覆杯。心之积名曰伏梁，在
心下，如臂。脾之积名曰痞气，在胃脘，如复盘。肺之积名曰息贲，在右胁下，大如杯。肾之积
名曰奔豚，在少腹上，若豚状。尤有 者，腹中坚硬，有形可征；瘕者，假物而结，推移可动；
者，气血凝聚肌肉之间；癖者，饮食凝滞，外无形迹及痞块。多证皆不外乎七情郁结，痰食气
血而成。凡积聚脉多沉伏或附骨， 瘕多弦。实强顺，微弱逆。治宜消积为标，次兼养正为本。
服药最忌浓味，发气之物
主方 陈皮 浓朴 枳实 青皮 香附 山楂（肉，各八分） 三棱（醋炒） 蓬术（醋
炒） 砂仁 槟榔（各六分） 木香（五分）上加生姜，水煎服。
痰积加半夏、贝母、海石、芒硝，去山楂；血积加桃仁、红花、官桂、当归尾；食积加神曲、
麦芽。痛加玄胡索、抚芎、五灵脂、草豆蔻，甚者加乳香、没药；痞加黄连（姜炒）；胀加萝卜
子；不消加黑丑、良姜；吐酸加红豆蔻。
上方五丸治五积，群书具载，根据法服亦多效。但五方中皆有巴豆霜，近世鲜用。今另考五方
于下，用者酌之。
伏梁丸 治心积。
茯苓（去皮） 浓朴（炒） 人参 枳壳（炒） 三棱（煨） 半夏（泡） 白术（各等分）
上为末，薄糊丸桐子大。每五十丸，食远，米汤送下。
痞气丸 治脾积。
大乌头（一两，炮去皮脐） 附子（同） 川椒（炒出汗） 干姜 桂心 赤石脂（火 ，醋淬
。各半两）
上为末，炼蜜丸桐子大，朱砂为衣，每服五丸，米汤下。
肥气丸 治肝积。
青皮 陈皮 三棱 蓬术（醋炒） 黄连 枳实 浓朴（各一两） 槟榔 萝卜子（炒）
穿山甲 肉桂 干姜（炮。各五钱）
上为末，入炒盐三钱，醋糊和丸桐子大，每五十丸，食远，米汤送下。
息贲丸 治肺积。
半夏（炮） 桂心 人参 吴茱萸（泡） 桑白皮（炙） 葶苈 甘草（各一钱半）
上水二盏，姜五片，枣一枚，煎至一盏服。作丸亦可。
奔豚丸 治肾积。
干葛 川芎 当归 桑白皮（炙） 黄芩 甘草（炙） 甘李根皮（焙，各一钱五分） 半
夏（泡，二钱）
加生姜三片，水煎，食远服，作丸亦可。
香棱丸 治五积六聚，二焦痞塞， 癖诸积。
三棱（四两，醋炒） 青皮 陈皮 蓬术（煨） 枳实 萝卜子 香附子 浓朴（各二两）
黄连 肉桂 神曲 麦芽 山楂肉 槟榔 益智（各一两） 干添（炒烟尽） 木香 砂仁 桃
仁（各五分）
上为末，醋糊丸桐子大，每服七十丸，空心姜汤下。
玄白丸 治五积六聚，胸膈胀满，痞闷吞酸，心疼腹痛，胁下刺痛。遇风寒、怒气、食生
冷、发气之物，劳碌忧愁则积。攻动大痛，得热熨暖气痛减者，宜服此。
黑丑 白丑 良姜（各四两） 砂仁 红豆蔻 陈皮 三棱 蓬术 干姜（各二两） 青皮
草豆蔻 肉桂 玄胡索 五灵脂（各一两）
上为末，用真阿魏五钱锉细，米醋浸研化，拌入末内，醋煮面糊丸桐子大。每服百丸，空心
姜汤下。
简便方 治诸积。瓦楞子火炼七次为末，酒调服。即蚶壳。
酒食积∶平胃散加丁香、神曲、麦芽、香附、砂仁，共研末，每二钱，姜汤下。
酒积酸呕∶神曲 麦芽（各一两） 黄连（五钱） 巴豆霜（一钱）同研为末，汤、丸每一
钱姜汤下。
鱼蟹积∶紫苏 陈皮 山楂 香附 煎服。
粉面积∶萝卜子炒研煎服。
癖 结及诸虫∶马齿苋和盐、醋煮一碗食，有虫尽出。
膜外 及气块∶玄胡索为末，猪胰一具切碎，炙熟拌食。
痰食积块∶风化锻石丸服（陈者尤妙）。
食脍成瘕∶马鞭草（捣汁），入姜汁服。
熨 法∶吴茱萸一斤擂碎，酒煮，干布包熨，冷再煮，炒至移动。
This syndrome arises from heat accumulation in the Bladder (Bladder Organ), with wind-dampness mutually attacking; or due to damp-heat, causing edema to flow and accumulate; or hernia attacks; or sudden wind-external heat, as well as infant crying and qi stagnation from anger; or sitting on wet, cold stones; or caused by insect/ant venom inhalation. Examine the etiology in detail and apply treatment accordingly.
Main Formula: Baizhu (Atractylodis Rhizoma), Sangbai Pi (Mori Cortex), Mutong (Akebiae Caulis), Chenpi (Citri Reticulatae Pericarpium) (each 1.5 liang), Bai Chou (Branched Morning Glory Seed) (2 liang). Grind into fine powder. Take 2 qian per dose; for infants, reduce to 0.5 qian. Mix with ginger decoction and take on an empty stomach.
For infant阴肿 (Yin Swelling): Taoren (Persicae Semen, peeled and core removed), Guanzi Gui (Cinnamomi Ramulus), Hei Chou (Black Morning Glory Seed, stir-fried), Bai Jili (Tribuli Fructus), Mudan Pi (Moutan Cortex), Dahuang (Rhei Radix et Rhizoma) (each 3 qian). Grind into powder, make honey pills the size of paulownia seeds. Take 50 pills per dose. Decoct Qingpi (Citri Reticulatae Pericarpium Viride), Mutong (Akebiae Caulis), Congbai (Allii Fistulosi Bulbus), and a little salt in water to administer.
For pediatric阴肿 (Yin Swelling): Musli (Ostreae Concha, calcined and ground to powder). Mix with saliva for oral administration, then apply powder topically.
Administer Wuling San (Five-Ingredient Powder with Poria) plus Mudan Pi (Moutan Cortex) and Fangfeng (Saposhnikoviae Radix). Alternatively, grind Taoren (Persicae Semen) into paste, mix with saliva, and apply topically.
Additionally, decoct Chan Tui (Cicadae Periostracum) 5 qian in water for frequent washing, while simultaneously administering Wuling San (Five-Ingredient Powder with Poria) with Dengxincao (Junci Medulla) decoction.
Simple Prescription: For external genital swelling.
Xiao Huixiang (Foeniculi Fructus), Chuanshanjia (Manis Squama, stir-fried), Muxiang (Aucklandiae Radix) (equal parts). Grind into powder, take 2 qian with wine.
Male/Female阴肿 (Yin Swelling): Mash Biancaomao (Verbenae Herba), squeeze juice, and apply topically. For infants, use ash from old fir wood mixed with Nifen (Calomel) and oil for topical application.
Additionally, decoct Jingjie (Schizonepetae Herba) 1 liang, Xiaokuniao (Natrii Sulfas), Luobozhi (Brassicae Semens) 1.5 liang, along with Congbai (Allii Fistulosi Bulbus) for washing.
Additionally, surround the area with earthworm feces, mix Gancao (Glycyrrhizae Radix et Rhizoma) decoction, and apply. Alternatively, apply fresh Bohe (Menthae Haplocalycis Herba) juice topically.
External Genital Swelling: Dahuang (Rhei Radix et Rhizoma) powder mixed with vinegar for topical application; reapply when dry. Alternatively, add equal parts of cow dung ash.
The Nan Jing (Classic of Difficult Issues) states: Ji (Accumulation) belongs to Yin Qi; Ju (Gathering) belongs to Yang Qi. Thus, Yang floats and moves, while Yin sinks and lies hidden. Where qi accumulates, it is called Ji (Accumulation). Where qi gathers, it is called Ju (Gathering). Therefore, Ji (Accumulation) originates from the Zang Organs; Ju (Gathering) is formed by the Fu Organs. Ji (Accumulation) involves Yin Qi; its onset has a fixed location, pain does not leave its region, and it has definite upper/lower and left/right boundaries. Ju (Gathering) involves Yang Qi; its onset has no root, no fixed upper/lower stopping point, and pain has no fixed location; this is called Ju (Gathering). Thus, one distinguishes between Accumulation and Gathering by these characteristics. The five types of Accumulation are named as follows: Liver Accumulation is called Feiqi (Fat Qi), located under the left hypochondrium, like an inverted cup; Heart Accumulation is called Fuliang (Hidden Beam), below the heart, like an arm; Spleen Accumulation is called Piqi (Stagnant Qi), in the epigastrium, like an overturned plate; Lung Accumulation is called Xiben (Breath Burden), under the right hypochondrium, large as a cup; Kidney Accumulation is called Bentun (Running Piglet), in the lower abdomen, resembling a running piglet. There are also Zheng (Masses), which are hard in the abdomen with tangible signs; Jia (False Masses), which form falsely and can be moved; Pi (Partial Stagnation), where qi and blood condense in the muscles; and Xi (Lateral Accumulation), where food stagnates without external visible masses. These syndromes generally stem from emotional stagnation, phlegm-food, and qi-blood condensation. Pulse in Accumulation/Gathering is often deep-hidden or adherent to bone; Zheng/Jia pulses are often wiry. Strong/solid pulse indicates favorable prognosis; weak pulse indicates unfavorable. Treatment should prioritize eliminating accumulation as the branch, while nourishing righteousness as the root. Medication strictly forbids rich flavors and qi-dispersing foods.
Main Formula: Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex), Zhishi (Aurantii Fructus Immaturus), Qingpi (Citri Reticulatae Pericarpium Viride), Xiangfu (Cyperi Rhizoma), Shanzha Rou (Crataegi Fructus Flesh) (each 0.8 fen), Sanleng (Sparganii Rhizoma, vinegar-fried), Pengzhu (Curcumae Rhizoma, vinegar-fried), Sharen (Amomi Fructus), Binglang (Arecae Semen) (each 0.6 fen), Muxiang (Aucklandiae Radix) (0.5 fen). Add fresh ginger, decoct in water, and take.
For Phlegm Accumulation: Add Banxia (Pinelliae Rhizoma), Beimu (Fritillariae Thunbergii Bulbus), Haishi (Pumex), Mangxiao (Natrii Sulfas); remove Shanzha. For Blood Accumulation: add Taoren (Persicae Semen), Honghua (Carthami Flos), Guanzi Gui (Cinnamomi Ramulus), Danggui Wei (Angelicae Sinensis Radix Cauda). For Food Accumulation: add Shenqu (Massae Fermentatae Medicamentosa), Maiya (Hordei Fructus Germinatus). For Pain: add Yanshusu (Corydalis Rhizoma), Fuxiong (Ligusticum Chuanxiong Rhizoma), Wulingzhi (Trogopteri Dung), Caodoukou (Alpiniae Katsumadai Semen); if severe, add Rushi (Boswelliae Resina), Moyao (Myrrhae Resina). For Stagnant Fullness: add Huanglian (Coptidis Rhizoma, ginger-fried). For Distension: add Luobozhi (Brassicae Semens). For Non-resolution: add Heichou (Black Morning Glory Seed), Liangjiang (Alpiniae Officinarum Rhizoma). For Sour Regurgitation: add Hongdoukou (Myristicae Arillus Ruber).
The above five pill formulas treat the Five Accumulations, recorded in various texts; following the method yields many effective results. However, all five contain Badoushuang (Crotonis Semen Pulvis), rarely used in recent times. Here are five alternative formulas for reference.
Fuliang Wan (Hidden Beam Pill): Treats Heart Accumulation.
Fuling (Poria), Houpo (Magnoliae Officinalis Cortex, stir-fried), Renshen (Ginseng Radix et Rhizoma), Zhike (Aurantii Fructus Immaturus, stir-fried), Sanleng (Sparganii Rhizoma, baked), Banxia (Pinelliae Rhizoma, soaked), Baizhu (Atractylodis Rhizoma) (equal parts). Grind into powder, make thin paste pills size of paulownia seeds. Take 50 pills after meals, with rice gruel.
Pi Qi Wan (Stagnant Qi Pill): Treats Spleen Accumulation.
Da Wutou (Aconiti Radix Preparata) (1 liang, processed, peel and umbilicus removed), Fuzi (Aconiti Lateralis Radix Preparata) (same amount), Chuanjiao (Zanthoxyli Pericarpium, stir-fried until sweat appears), Ganjiang (Zingiberis Rhizoma), Guixin (Cinnamomi Cortex), Chishizhi (Halloysit Rubrum, calcined, quenched in vinegar) (each 0.5 liang). Grind into powder, refine honey into pills size of paulownia seeds, coat with Cinnabar. Take 5 pills with rice gruel.
Fei Qi Wan (Fat Qi Pill): Treats Liver Accumulation.
Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Sanleng (Sparganii Rhizoma), Pengzhu (Curcumae Rhizoma, vinegar-fried), Huanglian (Coptidis Rhizoma), Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex) (each 1 liang), Binglang (Arecae Semen), Luobozhi (Brassicae Semens, stir-fried), Chuanshanjia (Manis Squama), Rougui (Cinnamomi Cortex), Ganjiang (Zingiberis Rhizoma, processed) (each 5 qian). Grind into powder, add 3 qian stir-fried salt, mix with vinegar paste into pills size of paulownia seeds. Take 50 pills after meals, with rice gruel.
Xi Ben Wan (Breath Burden Pill): Treats Lung Accumulation.
Banxia (Pinelliae Rhizoma, processed), Guixin (Cinnamomi Cortex), Renshen (Ginseng Radix et Rhizoma), Wuzhuyu (Evodiae Fructus, soaked), Sangbaipi (Mori Cortex, roasted), Tinglizi (Descurainiae Semen Lepidii et Descurainiae), Gancao (Glycyrrhizae Radix et Rhizoma, roasted) (each 1.5 qian). Decoct in 2 cups water with 5 slices ginger and 1 jujube until 1 cup remains. Pills are also acceptable.
Ben Tun Wan (Running Piglet Pill): Treats Kidney Accumulation.
Gange (Puerariae Lobatae Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Sangbaipi (Mori Cortex, roasted), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Ganligenpi (Pruni Spinossae Cortex, dried) (each 1.5 qian), Banxia (Pinelliae Rhizoma, soaked) (2 qian). Add 3 slices ginger, decoct in water, take after meals. Pills are also acceptable.
Xiang Leng Wan (Fragrant Prism Pill): Treats Five Accumulations and Six Gatherings, Upper/Lower Jiao stagnation, Pi/Xi accumulations.
Sanleng (Sparganii Rhizoma) (4 liang, vinegar-fried), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Pengzhu (Curcumae Rhizoma, baked), Zhishi (Aurantii Fructus Immaturus), Luobozhi (Brassicae Semens), Xiangfuzi (Cyperi Rhizoma), Houpo (Magnoliae Officinalis Cortex) (each 2 liang), Huanglian (Coptidis Rhizoma), Rougui (Cinnamomi Cortex), Shenqu (Massae Fermentatae Medicamentosa), Maiya (Hordei Fructus Germinatus), Shanzha Rou (Crataegi Fructus Flesh), Binglang (Arecae Semen), Yizhi (Alpiniae Oxyphyllae Fructus) (each 1 liang), Ganjian (Drynariae Rhizoma, stir-fried until smoke ceases), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Taoren (Persicae Semen) (each 5 fen). Grind into powder, mix with vinegar paste into pills size of paulownia seeds. Take 70 pills on empty stomach with ginger decoction.
Xuan Bai Wan (Black White Pill): Treats Five Accumulations and Six Gatherings, chest/diaphragm distension, stagnant fullness, sour regurgitation, heart/stomach pain, stabbing costal pain. Indicated when accumulation is triggered by wind-cold, anger, raw/cold food, qi-dispersing substances, fatigue, or worry, causing severe pain relieved by heat/warmth.
Heichou (Black Morning Glory Seed), Baichou (White Morning Glory Seed), Liangjiang (Alpiniae Officinarum Rhizoma) (each 4 liang), Sharen (Amomi Fructus), Hongdoukou (Myristicae Arillus Ruber), Chenpi (Citri Reticulatae Pericarpium), Sanleng (Sparganii Rhizoma), Pengzhu (Curcumae Rhizoma), Ganjiang (Zingiberis Rhizoma) (each 2 liang), Qingpi (Citri Reticulatae Pericarpium Viride), Caodoukou (Alpiniae Katsumadai Semen), Rougui (Cinnamomi Cortex), Yanshusu (Corydalis Rhizoma), Wulingzhi (Trogopteri Dung) (each 1 liang). Grind into powder. Take 5 qian real Asafoetida (Wei), mince finely, soak in rice vinegar, grind until dissolved, mix into powder. Cook with vinegar and wheat paste into pills size of paulownia seeds. Take 100 pills on empty stomach with ginger decoction.
Simple Prescription: Treats various accumulations. Walengzi (Arcae Testa) calcined seven times, ground to powder, taken with wine. This is clam shell.
Wine/Food Accumulation: Pingwei San (Peaceful Stomach Powder) plus Dingxiang (Caryophylli Flos), Shenqu (Massae Fermentatae Medicamentosa), Maiya (Hordei Fructus Germinatus), Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus). Grind together to powder, take 2 qian with ginger decoction.
Wine Accumulation with Sour Vomiting: Shenqu (Massae Fermentatae Medicamentosa), Maiya (Hordei Fructus Germinatus) (each 1 liang), Huanglian (Coptidis Rhizoma) (5 qian), Badoushuang (Crotonis Semen Pulvis) (1 qian). Grind together to powder. Take 1 qian with ginger decoction (decoction or pill form).
Fish/Crab Accumulation: Zisu (Perillae Folium), Chenpi (Citri Reticulatae Pericarpium), Shanzha (Crataegi Fructus), Xiangfu (Cyperi Rhizoma). Decoct and take.
Flour/Noodle Accumulation: Luobozhi (Brassicae Semens) stir-fried, ground, decocted, and taken.
Xi Stagnation and Parasites: Machixian (Portulacae Herba) boiled with salt and vinegar, drink one bowl; parasites will exit completely.
Membrane External Accumulation and Qi Mass: Yanshusu (Corydalis Rhizoma) powder, one pig pancreas chopped, cooked and eaten mixed with powder.
Phlegm-Food Accumulation Mass: Fenghua Duanshi (Calcined Alumen Pill) taken (aged is better).
Raw Meat Accumulation forming Jia: Biancaomao (Verbenae Herba) squeezed for juice, mixed with ginger juice and taken.
Warming Method (Ironing Therapy): Wuzhuyu (Evodiae Fructus) 1 jin pounded, boiled in wine, wrapped in dry cloth for ironing therapy. Re-boil when cool, stir-fry until movable.