经曰∶心之积,名曰伏梁。起脐上,大如臂,上至心下,久不愈。令人烦心。心为火脏
,心受邪,则火内郁而烦也。
温白丸 加石菖蒲、黄连、桃仁。
桃奴散 治伏梁气在心下,结聚不散。
桃奴(三两)
为末,空心温酒调下二钱。桃奴是桃实着树不落,正月中采者是也。
经曰∶脾之积,名曰痞气。在胃脘,复大如盘,久不愈,令人四肢不收,发黄胆,饮食
不为
肌肤。脾气行乎四肢,脾气既痞,四肢无以受气,故不收,不收犹不举也。脾色黄而合肉,
气痞不运,热郁于中,故黄色外见,而肌肤日削也。
温白丸 加吴茱萸、干姜。
经曰∶肺之积,名曰息贲。在右胁下,复大如杯,久不已,令人洒淅寒热,喘咳发肺壅
。肺
主气而合皮毛,肺郁成积,壅于内者不能卫于外,故洒淅寒热,痹于上者不复降于下,故喘
咳发肺壅。壅,痈也。
温白丸 加人参、紫菀。
经曰∶肾之积,名曰奔豚。发于少腹,上至心下,若豚状,或上或下,无时,久不已。
令人
喘逆,骨痿少气。肾为水脏而喜凌心,故上至心下,奔突如豚。肾居下焦,而善逆,故令人
喘逆。肾合骨而为气之根,故骨痿少气。
温白丸 加丁香、茯苓、远志。
气滞成积也。凡忧思郁怒,久不得解者,多成此疾。故王宇泰云∶治积之法,理气为先
,气
既升降,津液流畅,积聚何由而生。丹溪乃谓气无形,不能作聚成积,只一消痰破血为主,
误矣。天地间有形之物,每自无中生,何止积聚也。戴复庵只以一味大七气汤,治一切积聚
大七气汤
香附(一钱半) 青皮 陈皮 桔梗 官桂 藿香 益智 莪术 三棱(各一钱) 甘草(
为末,每服四五钱,姜三斤,枣一枚,水煎服。
肝积肥气,用前汤煎熟待冷,却以铁器烧通红,以药淋之,乘热服。肺积息贲,用前汤加桑
皮、半夏、杏仁各五分。心积伏梁,用前汤加石菖蒲、半夏各五分。脾积痞气,用前汤下
红丸子。肾积奔豚,用前方倍桂加茴香、炒楝
子肉各五分,此《济生方》也。《指迷》有半夏、无三棱。《统旨》有元胡索、姜黄、草蔻
The *Classic of Medicine* (Huangdi Neijing) states: The accumulation in the Heart is named Fuliang (Trunk-like Accumulation). It originates above the umbilicus, with a size resembling an arm, extending upward to below the heart region. If not cured for a long time, it causes mental restlessness. The Heart is the organ of Fire; when pathogenic factors invade the Heart, Fire becomes internally constrained, leading to vexation. Wenbai Wan (Warm White Pill) added with Shichangpu (Acori Tatarinowii Rhizoma), Huanglian (Coptidis Rhizoma), and Taoren (Persicae Semen) may be used.
Taonu San (Peach Twig Powder) treats Fuliang Qi accumulating in the epigastrium, knotting and failing to disperse.
Take Taonu (3 liang), grind into powder, and take 2 qian mixed with warm wine on an empty stomach. Taonu refers to peaches that remain attached to the tree without falling, harvested in the first lunar month.
The *Classic of Medicine* states: The accumulation in the Spleen is named Piqi (Stagnant Qi Accumulation). It is located in the epigastrium, large as a plate. If not cured for a long time, it causes weakness and inability to move the four limbs, jaundice, and failure of food intake to nourish the muscles and skin. Spleen Qi circulates through the four limbs; when Spleen Qi is stagnant, the limbs cannot receive Qi, hence they are weak and unable to lift ("unable to receive" implies inability to raise). The Spleen corresponds to the color yellow and governs the muscles. When Qi stagnates and fails to transport, heat constrains within the middle jiao, causing yellow discoloration to appear externally and muscles to waste away daily. Wenbai Wan (Warm White Pill) added with Wuzhuyu (Evodiae Fructus) and Ganjiang (Zingiberis Rhizoma) may be used.
The *Classic of Medicine* states: The accumulation in the Lung is named Xiben (Gasping Accumulation). It is located under the right hypochondrium, large as a cup. If not cured for a long time, it causes chills and fever, wheezing, coughing, and Lung obstruction. The Lung governs Qi and connects with the skin and hair. When Lung Qi stagnates and forms an accumulation, obstruction internally prevents protection externally, causing chills and fever; blockage superiorly prevents descent inferiorly, causing wheezing, coughing, and Lung obstruction. "Obstruction" here refers to abscess or swelling. Wenbai Wan (Warm White Pill) added with Renshen (Ginseng Radix et Rhizoma) and Ziwan (Asternatis Radix) may be used.
The *Classic of Medicine* states: The accumulation in the Kidney is named Bentun (Rushing Pig Accumulation). It arises in the lower abdomen, rushing upward to below the heart, resembling a pig running, moving up or down intermittently without fixed timing. If not cured for a long time, it causes wheezing and counterflow qi, bone萎 (bone atrophy/weakness), and shortness of breath. The Kidney is the organ of Water and tends to overwhelm the Heart, so Qi rushes to below the heart, surging like a pig. The Kidney resides in the Lower Jiao and is prone to rebellious Qi, causing wheezing and counterflow. The Kidney connects with bones and serves as the root of Qi, leading to bone weakness and shortness of breath. Wenbai Wan (Warm White Pill) added with Dingxiang (Caryophylli Flos), Fuling (Poria), and Yuanzhi (Polygalae Radix) may be used.
Qi stagnation leads to accumulation. Those who suffer from prolonged worry, overthinking, depression, and anger without relief often develop this disease. Therefore, Wang Yutai stated: The method for treating accumulations prioritizes regulating Qi. Once Qi ascends and descends properly, and body fluids flow smoothly, how can accumulations arise? Danxi argued that Qi is formless and cannot gather to form accumulations, advocating primarily for resolving phlegm and breaking blood stasis, which was erroneous. In the world, tangible things often emerge from the intangible; why should accumulations be an exception? Dai Fu'an used only Daqi Qi Tang (Great Seven-Qi Decoction) to treat all types of accumulations.
Daqi Qi Tang (Great Seven-Qi Decoction)
Xiangfu (Cyperi Rhizoma, 1.5 qian), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Jiegeng (Platycodonis Radix), Guangui (Cinnamomi Cortex), Huoxiang (Agastachis Herba), Yizhi (Alpiniae Oxyphyllae Fructus), Ezhu (Curcumae Rhizoma), Sanleng (Sparganii Rhizoma) (each 1 qian), Gancao (Liquorice Root and Rhizome, ground into powder). Take 4-5 qian per dose, decocted with 3 jin of fresh ginger and one date in water.
For Liver accumulation Feiqi (Fat Qi Accumulation), boil the aforementioned decoction, let it cool, then pour it onto a red-hot iron vessel and drink while hot. For Lung accumulation Xiben, add Sangbapi (Morus Albae Cortex), Banxia (Pinelliae Rhizoma), and Xingren (Armeniacae Semen Amarum), each 5 fen, to the aforementioned decoction. For Heart accumulation Fuliang, add Shichangpu (Acori Tatarinowii Rhizoma) and Banxia (Pinelliae Rhizoma), each 5 fen, to the aforementioned decoction. For Spleen accumulation Piqi, administer Hongwanzi (Red Pill) with the aforementioned decoction. For Kidney accumulation Bentun, double the amount of Rougui (Cinnamomi Cortex) in the aforementioned formula and add Huixiang (Foeniculi Fructus) and Chao Lianzirou (Fructus Meliae Toosendan, stir-fried), each 5 fen. This is from the *Jisheng Fang*. The *Zhimi Fang* includes Banxia but excludes Sanleng. The *Tongzhi Fang* includes Yuanhusuo (Corydalis Rhizoma), Jianghuang (Curcumae Longae Rhizoma), and Caokou (Amomi Fructus Rotundus).