心气虚怯之人，怔忡或烦乱，或健忘，或失心后，神痴
不清，辰砂安神丸。心风气热痰盛者，滚痰丸。心病，郁金、猪牙皂角、白矾、蜈蚣。人壮气实，火盛癫狂者，
可用正治，或朴硝冰水饮之。虚火盛狂者，以姜汤与之，若投冰水，立死。火急甚者，生甘草缓之能泻火，参术亦
可。凡气有余，是火；不足，是气虚。一人年壮肥实，心风痴，吐后与此∶贝母 栝蒌 南星 黄连（各一两）
郁金 天麻 青子 生甘草 枳实 连翘 苦参（各半两） 白矾 皂角（各二钱） 上作丸，服后用蜈蚣黄、赤
各一条（香油炙黄） 芎 防南星 白附 白矾 牙皂（各一两） 郁金（半两） 上丸，朱砂为
衣。癫狂病，癫属阴，多喜狂；属阳，多怒。脉实，死；虚者，可治，大概多因痰结心胸间，治当镇心神，开痰
结。亦有中邪而为此疾者，则以治邪法治之。然《原病式》所论尤精，盖世以重阴为癫，重阳为狂，误也，大概
皆是热耳。
块，在中为痰饮；在右为食积；在左为死血。气不能作块，成聚块乃有形之物。痰与食积、死血，用药醋煮海
石、醋煮三棱、醋煮蓬术、桃仁、红花、五灵脂、香附，石碱为丸，白术汤下。一本有针沙。瓦龙子能消血块、亦有
痰。凡治块，降火消食积，积即痰也。行死血块去，必用大补。咸治痰积，有块用之，洗涤垢腻。一方治一切
积聚 瘕，用蜀葵根煎汤去粗，再煎人参、白术、陈皮、青皮、甘草梢、牛膝成汤，入细研桃仁少许及玄明粉，热饮
之，二服可见积块下。病重者，补接之后，加减再行法。大法，咸以软之，削以消之，行气开痰为要。一方贴积聚
块，大黄二两，一本一两，朴硝一两各为末，用大蒜捣和成膏，贴之，后干用醋调，再贴。块在皮里膜外，须补气药兼
香附开之，兼二陈。妇人死血、食积、痰饮成块，或在两胁，动作腹鸣、嘈杂、眩晕、身热，时发时止∶黄连（一
两，半两用吴茱萸同炒，半两用益智炒，去二药只用连） 山栀（半两炒） 台芎（半两炒） 香附（一两或作
半两，童便浸） 萝卜子（一两半炒） 山楂肉（一两） 三棱（五钱） 蓬术（半两醋煮） 桃仁（半两，留尖去
皮） 青皮（半两，或作麦皮曲半两） 上为末，蒸饼丸。一方有神曲五钱，白芥子一两半，
瓦龙子一两醋 。凡积病下亦不退，当用消积药融化，开则消。治胁痛有块∶龙荟丸（二钱半） 片姜黄（半两）
桃仁（半两） 上末之，蜜丸。又方，龙荟丸和白鸽粪，能大消食积。或入保和丸治块，看在何部分。诸块虚中，
块攻胀，无可奈何，不可用攻战之药，四君子汤加半夏、陈皮，作大剂服之，候元气平复，却用攻药。治痞块，木鳖，
一云壳二十一个，用 猪腰子批开煨熟，捣烂，入黄连末三钱，为丸，如绿豆大，每服三十丸。腹中脐下气作
痛∶木香 槟榔 三棱 莪术 青皮（各半两） 木通（半两） 黄连（炒半两） 陈皮（半两）
缩砂 红豆（各三钱） 香附（一两）。血分肝经块痛，末子药服亦好，丸子尤好∶当归（半两） 红花（炒一钱）
桃仁（二十个去皮尖） 玄胡索（擂半两） 赤芍药（半两） 没药（三钱） 干漆（半两炒烟尽） 或大便
燥，加熟大黄。凡人上、中、下有块，是痰，问其平日好食何物，以相制之药消之，吐后用药。一人心胸痰满如一
块，攻塞不开∶白术（一两） 南星 贝母 神曲 山楂 姜黄 陈皮 茯苓（以上各五钱） 山栀（半两） 香
附（一两） 萝卜子 皂角刺（以上各三钱） 上末之，姜饼丸。一人小腹块∶栝蒌 贝母 黄芩 南星 白术（各一
两，以上一作各半两） 香附（醋煮一两） 熟地黄 当归 玄胡索 桃仁（以上各五钱） 三棱 蓬术（以上醋煮
各五钱） 上末之，曲丸。千金硝石丸磨块，三圣膏贴块（俱效）。尝记先生治一妇人小腹中块，其脉涩，服攻
药后脉见大，以四
物汤倍白术、陈皮、甘草为佐使，脉充实，间与硝石丸，两月块消尽。一人年六十，素好酒，因行暑中得疾，冷膝
上，上脘有块，如掌牵引，胁痛不得眠，饮食减，不渴，已自服生料五积散三帖，六脉俱沉涩而小，按之不为弱，皆
数，右甚，大便如常，小便赤，遂用大承气汤减大黄之半而熟炒，加黄连、芍药、川芎、干葛、甘草作汤，栝蒌仁、半
夏、黄连、贝母为丸，至十二帖，足冷退，块减半，遂止药，至半月病悉除。积聚当分阴阳，积者，其发有根，其
痛有常处，脉结伏；聚者，其发无根，其痛无常处，脉浮结，由阴阳不和，脏腑虚弱，四气、七情失常所致也。
心气虚弱胆怯的人，出现怔忡（心跳不安）或心烦意乱，或者健忘，或者神志丧失后神情痴呆不清，用辰砂安神丸。心经风气热盛且痰多的人，用滚痰丸。治疗心病，可用郁金、猪牙皂角、白矾、蜈蚣。身体强壮、正气充足、火盛导致癫狂的人，可以采用正治法，或者用朴硝冰水饮用。如果是虚火旺盛导致的狂躁，用姜汤送服，如果误投冰水，会立即死亡。火势急迫严重的，生甘草能缓和火势并泻火，人参、白术也可以使用。凡是气有余就是火；气不足就是气虚。有一个年轻人身体壮实肥胖，患有心风痴症，吐痰后给予以下方剂：贝母、栝蒌、南星、黄连（各一两），郁金、天麻、青子、生甘草、枳实、连翘、苦参（各半两），白矾、皂角（各二钱）。以上药物制成丸药，服用后，再用蜈蚣黄、赤色各一条（用香油炸至黄色）、川芎、防风、南星、白附子、白矾、牙皂（各一两），郁金（半两），制成丸药，以朱砂为衣。
癫狂病中，癫属阴，多表现为喜笑不休；狂属阳，多表现为愤怒。脉象实的，预后不良甚至死亡；脉象虚的，可以治疗。大概多因痰结聚在心胸之间，治疗应当镇安心神，开通痰结。也有因中邪而患此病的，则用治邪的方法治疗。然而《原病式》中的论述尤为精辟，世人认为重阴为癫，重阳为狂，这是错误的，大概都是热证罢了。
肿块，在中间部位多为痰饮；在右侧多为食积；在左侧多为死血（瘀血）。气不能形成肿块，形成的块都是有形之物。对于痰、食积、死血，用药醋煮海浮石、醋煮三棱、醋煮蓬术、桃仁、红花、五灵脂、香附，石碱为丸，用白术汤送下。有的版本中有针砂。瓦龙子能消除血块，也有化痰作用。凡是治疗肿块，需降火、消食积，积即是痰。行散死血块去除后，必须用大补之法。咸味药能治痰积，有块时用之，可洗涤垢腻。一方治疗一切积聚瘕，用蜀葵根煎汤去渣，再煎入人参、白术、陈皮、青皮、甘草梢、牛膝成汤，加入细研的桃仁少许及玄明粉，热饮，服两次可见积块下行。病情重的，在补益之后，根据情况加减再行攻法。大法则是：咸味以软化之，削削以消除之，行气开痰是关键。一方贴敷积聚块，大黄二两（有的版本是一两），朴硝一两，各研为末，用大蒜捣烂和成膏，贴敷患处，干了后用醋调匀再贴。肿块在皮里膜外，须用补气药兼香附开通，兼用二陈汤。妇人因死血、食积、痰饮成块，或在两胁，动作时腹鸣、嘈杂、眩晕、身热，时发时止：黄连（一两，一半用吴茱萸同炒，一半用益智仁炒，去掉两种辅料只用黄连），山栀（半两炒），台芎（半两炒），香附（一两或作半两，童便浸），萝卜子（一两半炒），山楂肉（一两），三棱（五钱），蓬术（半两醋煮），桃仁（半两，留尖去皮），青皮（半两，或用麦皮曲半两）。以上研为末，蒸饼为丸。一方有神曲五钱，白芥子一两半，瓦龙子一两醋制。凡是积病用下法也不退的，当用消积药融化，开通则能消除。治疗胁痛有块：龙荟丸（二钱半），片姜黄（半两），桃仁（半两）。以上研末，蜜丸。又一方，龙荟丸加白鸽粪，能大消食积。或者加入保和丸治疗块，看在哪个部分。诸种肿块若属虚中夹实，块攻胀满，无可奈何，不可用攻伐之药，用四君子汤加半夏、陈皮，做大剂量服用，等元气平复后，再用攻药。治疗痞块，木鳖子（一说壳）二十一个，用猪腰子剖开煨熟，捣烂，入黄连末三钱，为丸，如绿豆大，每服三十丸。腹中脐下气作痛：木香、槟榔、三棱、莪术、青皮（各半两），木通（半两），黄连（炒半两），陈皮（半两），缩砂、红豆（各三钱），香附（一两）。血分肝经块痛，末子药服用也好，丸子更好：当归（半两），红花（炒一钱），桃仁（二十个去皮尖），玄胡索（擂碎半两），赤芍药（半两），没药（三钱），干漆（半两炒烟尽）。如果大便干燥，加熟大黄。凡人身上下有块，是痰，询问其平日喜好吃什么食物，用相制的药消除它，吐后用药。有一人心胸痰满如一块，攻塞不开：白术（一两），南星、贝母、神曲、山楂、姜黄、陈皮、茯苓（以上各五钱），山栀（半两），香附（一两），萝卜子、皂角刺（以上各三钱）。以上研末，姜饼为丸。有一人小腹有块：栝蒌、贝母、黄芩、南星、白术（各一两，以上一作各半两），香附（醋煮一两），熟地黄、当归、玄胡索、桃仁（以上各五钱），三棱、蓬术（以上醋煮各五钱）。以上研末，曲丸。千金硝石丸磨块，三圣膏贴块（都有效）。曾记得先生治疗一位妇人小腹中块，其脉涩，服用攻药后脉见大，用四物汤倍加白术、陈皮、甘草为佐使，脉充实，间或给予硝石丸，两个月块消尽。有一人六十岁，素来好酒，因在暑天行走得病，冷膝上，上脘有块，如手掌牵引，胁痛不得眠，饮食减少，不渴，已经自服生料五积散三帖，六脉俱沉涩而小，按之不弱，皆数，右甚，大便如常，小便赤，遂用大承气汤减去一半大黄并熟炒，加黄连、芍药、川芎、干葛、甘草作汤，栝蒌仁、半夏、黄连、贝母为丸，服到十二帖，足冷退，块减半，于是停药，到半月病悉除。积聚应当分阴阳，积者，其发作有根，其痛有固定处，脉结伏；聚者，其发作无根，其痛无固定处，脉浮结，由阴阳不和，脏腑虚弱，四气、七情失常所致也。
For individuals with deficient and timid Heart Qi, presenting with palpitations (Zhenchong), restlessness, forgetfulness, or mental confusion following loss of spirit, use Chensha Anshen Wan. For those with Wind-Heat and excessive Phlegm in the Heart, use Guntan Wan. For Heart diseases, use Yujin, Ya Zao Jiao, Bai Fan, and Wugong. For robust individuals with excess Zheng Qi and Fire causing mania, direct treatment may be used, such as drinking Puxiao (Mirabilite) with ice water. If it is mania caused by deficient Fire, administer Ginger Decoction; if Ice Water is mistakenly given, death will ensue immediately. For severe and urgent Fire, Sheng Gancao can moderate and drain Fire; Renshen and Baizhu are also applicable. Generally, excess Qi constitutes Fire; deficiency of Qi constitutes Qi Deficiency. A young, robust, and obese individual suffering from Heart Wind and dementia was treated after emesis with the following formula: Beimu, Gualou, Nanting, Huanglian (each 1 liang); Yujin, Tianma, Qingzi, Sheng Gancao, Zhishi, Lianqiao, Kushen (each 0.5 liang); Bai Fan, Zaojiao (each 2 qian). These were made into pills. After taking the pills, one yellow Wugong and one red Wugong (fried in sesame oil until yellow), Xiong, Fangfeng, Nanting, Baifu, Bai Fan, Ya Zao (each 1 liang), and Yujin (0.5 liang) were processed into pills, coated with Zhusha.
In manic-depressive disorders, Dian (depression) belongs to Yin and often manifests as excessive laughter; Kuang (mania) belongs to Yang and often manifests as anger. A solid pulse indicates a poor prognosis or death; a deficient pulse indicates treatability. Generally, this is due to Phlegm knotting in the chest and heart region; treatment should calm the Spirit and resolve Phlegm knots. Some cases result from pathogenic invasion, which should be treated accordingly. However, the discussion in *Yuan Bing Shi* is particularly refined; the common belief that heavy Yin causes Dian and heavy Yang causes Kuang is erroneous; generally, these are Heat syndromes.
Masses located in the center are usually Phlegm-Fluids; on the right, Food Retention; on the left, Dead Blood (Blood Stasis). Qi alone cannot form masses; formed masses are tangible entities. For Phlegm, Food Retention, and Dead Blood, use Hai Shi boiled in vinegar, Sanleng boiled in vinegar, Ezhu boiled in vinegar, Taoren, Honghua, Wulingzhi, Xiangfu, and Shijian, made into pills, taken with Baizhu Decoction. Some versions include Zhen Sha. Walongzi can dissolve blood masses and also resolves Phlegm. In treating masses, one must descend Fire and resolve Food Retention, as retention is essentially Phlegm. After moving and eliminating Dead Blood, strong tonification is necessary. Salty flavors treat Phlegm accumulation; when masses are present, they cleanse turbidity. One formula for all accumulations and masses uses Shuhui Gen decocted, strained, then re-decocted with Renshen, Baizhu, Chenpi, Qingpi, Gancao Shao, and Niuxi. Add finely ground Taoren and Xuanningfen, drink hot. After two doses, the mass may descend. For severe cases, after tonification, adjust and proceed with attacking methods according to condition. The general principle is: salty to soften, reducing to eliminate, and moving Qi and opening Phlegm are key. Another formula for external application on accumulations uses Dahuang (2 liang, or 1 liang in some texts) and Puxiao (1 liang), powdered, mixed with mashed garlic into a paste, applied to the site. When dry, mix with vinegar and reapply. For masses in the subcutaneous tissue, combine Qi-tonifying herbs with Xiangfu to open blockages, combined with Erchen Tang. For women with masses due to Dead Blood, Food Retention, or Phlegm-Fluids, located in the hypochondrium, accompanied by abdominal borborygmus, epigastric discomfort, dizziness, fever, intermittent onset: Huanglian (1 liang, half stir-fried with Wuzhuyu, half with Yizhi, discard auxiliaries, keep Huanglian), Zhizi (0.5 liang, stir-fried), Taixiong (0.5 liang, stir-fried), Xiangfu (1 liang or 0.5 liang, soaked in child's urine), Luobozi (1.5 liang, stir-fried), Shanzha Rou (1 liang), Sanleng (5 qian), Ezhu (0.5 liang, boiled in vinegar), Taoren (0.5 liang, leave tips, remove skin), Qingpi (0.5 liang, or use Maidaiqu 0.5 liang). Powder these, make pills with steamed dough. Another formula includes Shenqu (5 qian), Baijiezi (1.5 liang), Walongzi (1 liang, vinegar-treated). If downward purging fails for accumulation, use resolving herbs to melt it; once opened, it dissipates. For hypochondriac pain with masses: Longhui Wan (2.5 qian), Pian Jianghuang (0.5 liang), Taoren (0.5 liang). Powder these, make honey pills. Another method combines Longhui Wan with White Pigeon Droppings to greatly reduce Food Retention. Or add Baohe Wan depending on the location. For deficient masses causing distension, avoid attacking drugs; use Sizjunzi Tang with Banxia and Chenpi in large doses. Wait for Yuan Qi to recover before using attacking drugs. For痞块 (痞块), use Mugua (or its shell) 21 pieces, split pig kidneys, bake until cooked, mash, add Huanglian powder (3 qian), make pills size of mung beans, take 30 pills per dose. For Qi pain below the umbilicus: Muxiang, Binglang, Sanleng, Ezhu, Qingpi (each 0.5 liang), Mutong (0.5 liang), Huanglian (stir-fried 0.5 liang), Chenpi (0.5 liang), Suosha, Hongdou (each 3 qian), Xiangfu (1 liang). For Liver Meridian Blood-Stasis pain, powders are good, but pills are better: Danggui (0.5 liang), Honghua (stir-fried 1 qian), Taoren (20, peeled and pitted), Yanhusuo (crushed 0.5 liang), Chi Shaoyao (0.5 liang), Moyao (3 qian), Ganqi (0.5 liang, stir-fried until smoke ceases). If stool is dry, add Shu Dahuang. For masses anywhere in the body, consider Phlegm; ask about dietary preferences and use counteracting herbs to resolve, administered after emesis. For a case of chest fullness like a mass blocking flow: Baizhu (1 liang), Nanting, Beimu, Shenqu, Shanzha, Jianghuang, Chenpi, Fuling (each 5 qian), Zhizi (0.5 liang), Xiangfu (1 liang), Luobozi, Zaocici (each 3 qian). Powder these, make pills with ginger cake. For a lower abdominal mass: Gualou, Beimu, Huangqin, Nanting, Baizhu (each 1 liang, or 0.5 liang in some texts), Xiangfu (vinegar-boiled 1 liang), Shu Dihuang, Danggui, Yanhusuo, Taoren (each 5 qian), Sanleng, Ezhu (vinegar-boiled each 5 qian). Powder these, make pills with yeast. Qianjin Xiaoshi Wan grinds masses; Sansheng Gao applies externally (both effective). I recall Master treating a woman with a lower abdominal mass; her pulse was choppy. After attacking drugs, the pulse became large. He used Siwu Tang doubled with Baizhu, Chenpi, and Gancao as assistants. When the pulse became full, he intermittently gave Xiaoshi Wan. After two months, the mass disappeared completely. A sixty-year-old man, accustomed to alcohol, contracted illness while walking in summer heat. Cold knees, a mass in the upper epigastrium pulling like a palm, hypochondriac pain preventing sleep, reduced appetite, no thirst. He had self-administered Shengliao Wuji San for three doses. All six pulses were deep, choppy, small, not weak upon pressure, rapid, especially on the right. Bowel movements were normal, urine red. He prescribed Dachengqi Tang with half the Dahuang removed and stir-fried, plus Huanglian, Shaoyao, Chuanxiong, Ge Gen, and Gancao as decoction, and Gualou Ren, Banxia, Huanglian, Beimu as pills. After twelve doses, cold feet receded, mass halved. Medication stopped. By half a month, the disease resolved. Accumulations and aggregations should be distinguished by Yin and Yang. Ji (accumulation) has a root, fixed pain, and knotted/depressed pulse. Ju (aggregation) has no root, wandering pain, and floating/knotted pulse. These result from Yin-Yang disharmony, Zang-Fu weakness, and dysfunction of Four Qi and Seven Emotions.