〔丹〕气不能作块成聚，块乃有形之物，痰与食积死血成聚，宜醋煮海石、醋三棱、莪术、桃仁、红花、
五灵脂、香附之类，石碱白术汤下之。瓦龙子能消血块，又能消痰。治块当降火消食积。（食积即痰也。）
行死血，血块去后，须大补之。
石碱，痰积有块可用，洗涤垢腻，又能消食积。块在皮里膜外，须用补气香药开之，兼二陈汤加补气药，
先须断浓味。凡积病不可用下药，徒损真气，病亦不退，当用消积药，融化开则自消。
〔垣〕治积要法 许学士云∶大抵治积，或以所恶者攻之，所喜者诱之，则易愈。如 砂、水银治肉积，
神曲、麦 治酒积，水蛭、虻虫治血积，木香、槟榔治气积，牵牛、甘遂治水积，雄黄、腻粉治痰积，礞石、巴
豆治食积，各从其类也。若用群队之药分其势，则难取效。须要认得分明是何积聚，兼见何证，然后增加佐使
之药。不尔，反有所损，要在临时通变也。治积当察其所痛，以知其病有余不足，可补可泻，无逆天时，详脏
腑之高下。如寒者热之，结者散之，客者除之，留者行之，坚者削之，强者夺之，咸以 之，苦以泻之，全真
气药补之，随其所积而行之，节饮食，慎起居，和其中外，可使必已。不然，遽以大毒之剂攻之，积不能除，
反伤正气，终难复也，医者可不慎欤！
诸积皆本于喜怒伤脏而阴虚，阴既虚矣，则风雨袭阴之虚，病起于上而生积，清湿袭阴之虚，病起于下而
成积。（详见针灸条。）
〔洁〕壮人无积，虚人则有之。皆由脾胃怯弱，气血两衰，四时有感，皆能成积。若遽以磨坚破结之药治
之，疾似去而人已衰矣。干漆、 砂、三棱、牵牛、大黄之类，得药则暂快，药过则依然，气愈消，疾愈大，
竟何益哉！故善治者，当先补虚，使血气壮，积自消，如满座皆君子，则小人自无容地也。不问何脏，先调其
中，使能饮食，是其本也。
〔丹〕有妇人三十岁，因哭子，至半年后，胸痞有块如杯，饮食大减，面淡黄惨黑，若不胜衣，六脉弦细
虚涩，至日晡后则发寒热。予察其事势已急，补泻兼用，以补中益气汤随天气寒暄加减法，与东垣痞气丸相间
服，方见五积门，食前用汤，食后用丸，常令汤多于丸些少。如此近一月，寒热皆退，食亦稍进，又以丸用汤
相等服之，至第二月以后，忽一夜大发寒热，至天明热退，胸中之块如失，至晚手足下半节皆肿，遂停药。三
五日后，忽一夜手足之肿如失，至天明胸中之块复有，比如前觉小一晕。遂以二陈汤加桔梗、白术、枳实，调
理半月而安。次年复生一男。一妇人四十余，面白形瘦性急，因大不如意，三月后乳房下贴肋骨作一块，渐渐
长大，掩心微痛膈闷，饮食减四之三，每早觉口苦，两手脉微而短涩。予知其月经不来矣，为之甚惧，辞勿与
治。思至夜半，其妇尚能出外见医，梳妆言语如旧，料其尚有胃气，遂以参、术、归、芎，佐以气药作大服，
一昼夜与四次，外以大琥珀膏贴块上，防其长。经一月余，服补药百余帖，食及平时之半。仍用前药，又过一月，
脉气渐充。又与前药吞润下丸百余帖，月经不及两月而至，涩脉减五分之四。时天气热，意其经行时，必带紫
色，仍与前补药加醋炒三棱，吞润下丸，以抑青丸十五粒佐之。又经一月，忽报块已消及大半，月经及期尚欠
平时半日，饮食甘美如常，但食肉则觉不快。予令止药，且待来春木旺时又与区处。至次年六月，忽报一夜块
大，比旧反加大半指，脉略弦，左略怯于右，至数日平和，自言食饱后则块微闷，食行却自平。予意有动心事激
之，问之果然。仍与前补药加黄芩、炒黄连，以少木通、生姜佐之，去三棱煎汤吞润下丸，外以琥珀膏贴之半
月，值经行而块散。此是肺金为内火所烁，木邪胜士，土不能运，清浊相干，旧块轮廓尚在者，因气血之未尽
复也。浊气稍留，旧块复起，补其血气，使肺不受邪，木气平而土气正，浊气行而块散矣。
方提领年五十六，丁丑年冬，因饮酒后受怒气，于左胁下与脐平作痛。自此以后，渐渐成小块，或起或不起，
起则痛，痛止则伏，面黄口干，无力食少，吃此物便嗳此味，转恶风寒。脉之左大于右，弦涩而长，大率左
甚，重取则全弦。此得热散太多，以致胃气大伤，阴血下衰。且与和胃汤以补胃气，滋养阴血，并下保和丸
助其化粕，伺胃实阴血稍充，却用消块和胃汤方。
人参（三钱） 白术（一钱半） 陈皮（一钱） 芍药 归身（各五分） 干葛（三分） 红花（豆大） 甘草（二
钱，炙）
作一帖，下保和丸二十五、龙荟丸十五。
上三法，补气血药为主，磨积出入佐之，皆补多于磨，乃气血虚甚而有积块之法也。
敢村妇人腹下有块。白术汤下保和丸三十五粒。
王郎心痛膈有块，与
白术（二钱） 青皮（一钱） 芍药 木通 川芎 苍术（各一钱） 甘草（五分）
作一帖，煎下保和丸三十粒。
冯氏女年三十岁，形瘦色嫩，滋味素浓，幼年曾踏雪，尝以火烘鞋履，以致湿热上袭。至二十五岁时，口尝
吐清水吞酸。医用丁香等热药，时止时作，作时仍服前药，至当年心痛胸痞有块，吃饭即吐些，常出三之一，
遂与佐金丸二十四粒，以姜汤下之。与三十余次，全不进食。予曰∶结已开矣。且令止药。或口干思饮，止与半
盏熟水，间以青六丸与之。虽困卧着床，尤以绝药为善。如此近四十日，诊其脉前后些微弦，重取似涩，轻取
稍和，至此弦脉渐添。遂令与人参酒芍药汤，引金泻木，渐渐思食，而苦于大便秘。病家必欲行大黄，予止之。
遂以生芍药、陈皮、桃仁、人参为丸与之，用蜜煎导，大便行而食进，调理半月而安。
参萸丸 即佐金丸加人参一钱是也。
庐子裕左胁下因疟后食肉与酒而成块。
白术（一钱） 柴胡（醋炒，一钱） 茯苓（二钱） 枳壳（炒，五分） 人参（五分）
作汤下阿魏五、保和二十、抑青十、与点十、攻块五。
长垣朱郎因酒多年湿病，胁上有块，腹滑泄，小便黄。
滑石（一两） 白术 三棱（各六钱） 陈皮（五钱） 黄连 猪苓（各三钱） 黄芩 木通（各二钱）
防风（一钱半） 干姜（一钱） 甘草（五分，炙）
分七帖，煎下保和丸二十。
一丈夫肚左边带胁上有块，先吃匾食牛乳者成气痛，又因酒肉块大如桃，食减三分之一。
滑石（半两） 白术（四钱） 陈皮 三棱（各三钱） 萝卜子 连翘 黄连（各一钱） 干葛（二钱半）
桃仁（二十个） 黄芩（一钱） 甘草（钱半，炙）
上分四帖，水煎服。
妇人胁下有块，大如掌，脉涩，时有热，此虚中有气积，先与补虚，次与磨积药。
白芍 归须（四钱） 陈皮 白术（三钱） 青皮 川芎 木通（各一钱） 甘草（半钱）
白水煎，热服。
磨积药∶
三棱（醋煮，一钱） 枳实 青皮 桃仁（各五钱） 大黄（五钱） 桂枝（钱半） 海藻（醋煮，三钱）
细末，神曲糊丸，如桐子大，每服四十丸。
〔世〕一孺人左胁下旧有块，渐长大，脉弦而大稍数，询之近亦发热，食亦减，倦怠，先与补之，次攻此
块。
陈皮（五钱） 白术（两半） 柴胡 归头 青皮（各五钱） 甘草（一块） 木通（三钱半）
上作八帖服。
次与攻块∶
青皮（醋，一两半） 桃仁（五钱） 三棱（醋，一两半） 桂枝（三钱半） 海藻（醋洗，三钱）
锉末，神曲糊为丸。
一丈夫胁下有积块，内有痰热，汗不得泄，两脉大而散软，此体有虚。
三棱（五钱） 白术 黄连（各三钱） 人参（二钱半） 甘草（五分） 连翘 木通（各三钱） 川芎 桂（一
钱）
水煎，下保和丸。
富小娘疟后左胁下块，小便少。
浓朴 柴胡（各二钱） 三棱（一钱半） 甘草（半钱） 木通（五钱） 白术（六钱半） 青皮（五钱） 生姜
（一片）
上食前热服。
下邳钱郎正月发沙，因此脐边有块二枚，发起则痛，伏则不痛，有时又隐痛。自灸脐中，脉甚弦，右手伏，
重取则略数。此蕴热因春欲汗解，而气弱不能自发为汗，复郁，又因食不节，邪挟宿食，所以成块。宜以保和
二十、温中二十、抑青十，用白术、木通、三棱汤下。
上十一法，皆补药与磨积相半兼服之。前七法治饮食酒肉成积，后三法治体虚有热成积也。
〔丹〕陈里长男二十七岁，旧因饱食牛肉豆腐，患呕吐，又不节饮食，右胁下生一块渐长，今大如掌，痛发
则见，痛止则伏，其脉弦而数。知此人必性急，块上不可按，按则愈痛，痛则必吐黄酸苦水。询之果然。或作
肾气治。予曰∶非也，此足太阴有食积与湿痰。
荔枝核（烧，二个） 山栀（炒，五个，去壳） 枳实（炒，十五个） 山楂（九个） 茱萸（炒，九枚）
一方有人参。
上细研，急流水一盏，荡起煎沸，入生姜汁令辣，食前热服，与六帖，吐二帖，服四帖，与此药且止其痛，
却与消块药∶
半夏末（六钱，皂角六个，水煮取汁，拌半夏末，晒干。） 黄连（炒，五钱） 石碱（二钱，另研）
以上三件，同为细末，以糖球膏为丸，如胡椒大。
〔丹〕一婢色紫稍肥，性沉多忧，年近四十，经不行三月矣。小腹中有一气块，初起如栗，渐如炊饼。予
脉之，两手皆涩，重取却稍和。试令按块痛甚，扪之高寸半，遂与《千金》消石丸，至四五次后，忽自言乳头
黑且有汁，恐是孕。予曰∶韭也，涩脉无孕之理。又与三五帖，脉之稍觉虚豁。予悟曰∶经阻久矣，令止前药，
与四物汤倍白术，佐以陈皮、炙甘草至三十帖，候服完，再与消石丸数次。忽自言块消一晕，便令莫服。又半
月，经行痛甚，下黑血半升，内有如椒核者数十粒，而块消一半。又来索药，以消余块。予晓之曰∶勿性急，
似开矣，不可又攻。若次月经行，当消尽矣。次月经行，下少黑血块，又消一晕。又来问药，予曰∶且守禁忌，
至次月又消尽，已而果然。大凡攻击之药，有病则病受之，病邪轻而药力重，则胃气受伤。夫胃气者，清纯冲
和之气也，惟与谷肉菜果相宜。盖药石皆偏胜之气，虽参、 辈，为性亦偏，况攻击之药乎。此妇胃气弱，血
亦少，若待块尽而去药，胃气之存者几希矣。
一妇人年五十五岁，形气俱实，富而神劳，味浓性急，常经水过多。医每用涩药止。后病气痛，胸腹共有
积块大小十三枚，遇夜痛甚，着床累月，饮食虽减，应接家事如故，其脉两手皆涩而弱。此因屡用涩药，致败
血积聚不行故尔。时三月间用蜀葵根煎汤，再煎人参、白术、陈皮、青皮、甘草梢、牛膝成汤，入玄明粉少许，
研桃仁调热饮之，服至二帖，腹痛下块一枚，再并渣煎服，又下一枚，时以病久血耗，不敢再取块，告技穷而
归。后想此症患病虽重，其形质尚可受药，但当去葵根、玄明粉，其后块渐消而病安。
一女子年二十一岁，累因食伤，胃脘有块，随气上塞咽中。问之，又因食煨盐配粥。与∶
白术（一钱半） 陈皮 半夏（各一钱） 桔梗 青皮 木通（各五钱） 甘草（炙些） 生姜（二片）
煎服一二次，病遂平复，再与前药。半月后加桔梗煎一服，令其吐，吐出痰积，遂愈。
〔子和〕息城司侯闻父死于贼，乃大悲。哭罢，便觉心痛，日增不已，月余成块，状若覆杯，大痛不堪，
药皆无功，议用燔针炷艾，病患恶之，乃求治于戴人。戴人至，适巫者在其傍，乃学巫者杂以狂言，以谑病者，
至是大笑不忍，回面向壁一二日，心中结硬皆散。戴人曰∶《内经》言忧则气结，喜则百脉舒和。又云∶喜胜
悲，《内经》自有此法。
〔丹〕吕宗信年六十，素好酒，八月间因暑热中得疾，两足冷过膝，上脘有块如掌，牵引胁痛，不可眠卧，
饮食减半，却不渴。已自服生料五积散三帖。予脉之，六脉俱沉涩而小，按之不为弱，皆数，而右为甚。大便
如常，小便赤色。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，下栝蒌仁、半夏、
黄连、贝母丸。至十二帖，足冷退至胫，块减半，遂止药。至半月，饮食复旧，诸症悉除。
〔唐〕柳宗元纂救死方 元和十二年二月，得香港脚，夜半痞绝，胁有块大如石，且死。因大寒不知人三日，
家人号哭，荥阳郑询美传杉木汤，服半食顷，大下三次，气通块散。其方用杉木节一大升，橘叶一大升，无叶
以皮代之，大腹槟榔七个，合捣碎之，童便三大升，共煮取一升半，分二服，若一服得快利，停后服。
〔《肘》〕治卒暴症，腹中有如石刺痛。牛膝一大把并叶，酒煮饮之。
〔《外》〕治卒暴症，腹中有物，坚如石，痛欲死。取蒴 根一小束洗，沥去水，细擘，以酒二升，渍三
宿，暖温服五合至一升，日三。若欲速得服，于热灰中温令药味出服之，此方无毒，神效。
上暴积急去条四方，如块除后，必用补剂，以救其受攻之伤也。
【朱丹溪】气不能形成有形的积块，积块是有形之物，是由痰、食积和死血凝聚而成。适宜用醋煮的海浮石、醋制的三棱、莪术、桃仁、红花、五灵脂、香附等药，用石碱白术汤送服。瓦楞子能消除血块，又能化痰。治疗积块应当降火、消食积。（食积即是痰。）行散死血，在血块去除后，必须大补气血。
石碱，对于痰积形成的块状物可用，它能洗涤污垢油腻，又能消食积。如果块在皮里膜外，必须用补气且芳香开窍的药来开通，兼用二陈汤加入补气药，首先必须断绝浓味饮食。凡是积病不可用泻下药，徒然损伤真气，病也不会退去，应当用消积药，使积块融化消散则自然消失。
【李东垣】治疗积块的要法。许学士说：大概治疗积块，或用其所厌恶的药物攻伐它，或用其所喜欢的药物引诱它，就容易痊愈。如硇砂、水银治肉积，神曲、麦芽治酒积，水蛭、虻虫治血积，木香、槟榔治气积，牵牛子、甘遂治水积，雄黄、腻粉治痰积，礞石、巴豆治食积，各从其类而治。如果用大队药物分散其势，就难以取效。必须要认清楚是何种积聚，兼见什么证候，然后增加佐使之药。不这样做，反而会有损害，关键在于临时变通。治疗积块应当观察疼痛之处，以知道病有余还是不足，可补可泻，不要违背天时，详细辨别脏腑的高下位置。如寒者用热药治之，结者用散法治之，客邪用除法治之，留滞者用行法治之，坚硬者用削法治之，强盛者用夺法治之，咸味药软坚，苦味药泻下，用保全真气的药补益，随着所积之物而行气，节制饮食，谨慎起居，调和内外，可以使病必愈。不然，突然用大毒的药物攻伐，积块不能除去，反而损伤正气，最终难以恢复，医者能不慎重吗！
各种积块都本于喜怒伤脏导致阴虚，阴既已虚，则风雨侵袭阴之虚处，病起于上而生积；清湿侵袭阴之虚处，病起于下而成积。（详见针灸条。）
【张洁古】壮年人没有积块，体虚的人则有。这都是因为脾胃怯弱，气血两衰，四时感受外邪，都能形成积块。如果突然用磨坚破结的药物治它，病似乎去了但人已衰弱了。干漆、硇砂、三棱、牵牛子、大黄之类，得药则暂时痛快，药过后依然如故，气更消损，病更大，究竟有什么益处呢！所以善于治疗的人，应当先补虚，使血气强壮，积块自然消退，就像满座都是君子，小人自然没有容身之地。不问哪一脏，先调和中焦，使能进食，这是根本。
【朱丹溪】有一个三十岁的妇人，因哭丧儿子，半年后，胸中痞闷有块如杯，饮食大减，面色淡黄惨黑，瘦弱得好像连衣服都穿不住，六脉弦细虚涩，到了傍晚时分则发寒热。我考察病情形势已急，补泻兼用，用补中益气汤随天气寒暄加减，与东垣的痞气丸交替服用（方见五积门），饭前喝汤剂，饭后服丸药，常令汤剂比丸药稍多些。如此近一个月，寒热皆退，饮食也稍进，又让丸药与汤剂用量相等服用，到第二个月以后，忽然一夜大发寒热，到天明热退，胸中的块状物像消失了一样，到了晚上手足下半节都肿了，于是停药。三五日后，忽然一夜手足的肿胀像消失了一样，到天明胸中的块状物又出现了，比如之前觉得小了一圈。于是用二陈汤加桔梗、白术、枳实，调理半月而安。次年又生一男婴。另一个四十多岁的妇人，面白形瘦性急，因非常不如意，三个月后乳房下贴肋骨处作一块，渐渐长大，掩心微痛膈闷，饮食减少四分之三，每天早晨觉得口苦，两手脉微而短涩。我知道她月经不来很久了，为她感到十分恐惧，推辞不给她治。想到半夜，那妇人还能出门见医生，梳妆言语如旧，料想她还有胃气，于是用人参、白术、当归、川芎，佐以理气药做成大剂量，一昼夜服用四次，外面用大琥珀膏贴在块上，防止其生长。经过一个多月，服用补药百余帖，饮食恢复到平时的一半。仍用前药，又过一月，脉气逐渐充盈。又与前药吞服润下丸百余帖，月经不到两个月就到了，涩脉减少了五分之四。当时天气热，料想她行经时，必带紫色，仍给前补药加醋炒三棱，吞服润下丸，以抑青丸十五粒佐之。又经过一月，忽然报信说块已消及大半，月经按期而至，只是比平时晚半天，饮食甘美如常，但吃肉则觉得不快。我让她停药，暂且等到来年春天木旺时再作打算。到次年六月，忽然报信说一夜之间块变大，比以前反而加大半指，脉略弦，左脉略怯于右脉，过了几天平和，自己说吃饱后则块微闷，活动后却自平。我意思想是动心事激怒了她，问之果然。仍给前补药加黄芩、炒黄连，以少量木通、生姜佐之，去掉三棱煎汤吞服润下丸，外用琥珀膏贴半个月，正值行经而块散。这是肺金为内火所灼，木邪胜土，土不能运化，清浊相干，旧块轮廓尚在的，是因为气血未尽复。浊气稍留，旧块复起，补其血气，使肺不受邪，木气平而土气正，浊气行而块散矣。
方提领五十六岁，丁丑年冬天，因饮酒后受怒气，于左胁下与脐平处作痛。自此以后，渐渐成小块，或起或不起，起则痛，痛止则伏，面黄口干，无力食少，吃此物便嗳此味，转恶风寒。诊脉左大于右，弦涩而长，大率左甚，重取则全弦。这是得热散太多，以致胃气大伤，阴血下衰。且与和胃汤以补胃气，滋养阴血，并下保和丸助其消化，等待胃实阴血稍充，却用消块和胃汤方。
人参（三钱） 白术（一钱半） 陈皮（一钱） 芍药 归身（各五分） 干葛（三分） 红花（豆大） 甘草（二钱，炙）
以上三种方法，以补气血药为主，磨积药出入佐之，都是补多于磨，是气血虚甚而有积块的治疗方法。
王郎心痛膈有块，给予：
白术（二钱） 青皮（一钱） 芍药 木通 川芎 苍术（各一钱） 甘草（五分）
作一帖，煎下保和丸三十粒。
冯氏女三十岁，形瘦色嫩，口味素来浓厚，幼年曾踏雪，曾用火烘鞋履，以致湿热上袭。到二十五岁时，口中常吐清水吞酸。医生用丁香等热药，时止时作，发作时仍服前药，到当年心痛胸痞有块，吃饭即吐一些，常吐出三分之一，于是给予佐金丸二十四粒，以姜汤送下。给予三十余次，完全不能进食。我说：结已开了。且令停药。或者口干思饮，只给半盏熟水，间或用青六丸与之。虽然困卧着床，尤其以绝药为好。如此近四十日，诊其脉前后有些微弦，重取似涩，轻取稍和，至此弦脉渐添。于是让人参酒芍药汤，引金泻木，渐渐思食，而苦于大便秘。病家必欲行大黄，我制止了。于是以生芍药、陈皮、桃仁、人参为丸与之，用蜜煎导，大便行而食进，调理半月而安。
庐子裕左胁下因疟疾后食肉与酒而成块。
白术（一钱） 柴胡（醋炒，一钱） 茯苓（二钱） 枳壳（炒，五分） 人参（五分）
长垣朱郎因多年饮酒湿病，胁上有块，腹滑泄，小便黄。
滑石（一两） 白术 三棱（各六钱） 陈皮（五钱） 黄连 猪苓（各三钱） 黄芩 木通（各二钱）
防风（一钱半） 干姜（一钱） 甘草（五分，炙）
分七帖，煎下保和丸二十。
一个丈夫肚左边带胁上有块，先吃匾食牛乳者成气痛，又因酒肉块大如桃，食减三分之一。
滑石（半两） 白术（四钱） 陈皮 三棱（各三钱） 萝卜子 连翘 黄连（各一钱） 干葛（二钱半）
桃仁（二十个） 黄芩（一钱） 甘草（钱半，炙）
上分四帖，水煎服。
妇人胁下有块，大如掌，脉涩，时有热，此虚中有气积，先与补虚，次与磨积药。
白芍 归须（四钱） 陈皮 白术（三钱） 青皮 川芎 木通（各一钱） 甘草（半钱）
白水煎，热服。
磨积药：
三棱（醋煮，一钱） 枳实 青皮 桃仁（各五钱） 大黄（五钱） 桂枝（钱半） 海藻（醋煮，三钱）
细末，神曲糊丸，如桐子大，每服四十丸。
【世医】一位孺人左胁下旧有块，渐长大，脉弦而大稍数，询问之近亦发热，食亦减，倦怠，先与补之，次攻此块。
陈皮（五钱） 白术（两半） 柴胡 归头 青皮（各五钱） 甘草（一块） 木通（三钱半）
上作八帖服。
次与攻块：
青皮（醋，一两半） 桃仁（五钱） 三棱（醋，一两半） 桂枝（三钱半） 海藻（醋洗，三钱）
锉末，神曲糊为丸。
一个丈夫胁下有积块，内有痰热，汗不得泄，两脉大而散软，此体有虚。
三棱（五钱） 白术 黄连（各三钱） 人参（二钱半） 甘草（五分） 连翘 木通（各三钱） 川芎 桂（一钱）
水煎，下保和丸。
富小娘疟后左胁下块，小便少。
浓朴 柴胡（各二钱） 三棱（一钱半） 甘草（半钱） 木通（五钱） 白术（六钱半） 青皮（五钱） 生姜（一片）
上食前热服。
下邳钱郎正月发沙疹，因此脐边有块二枚，发起则痛，伏则不痛，有时又隐痛。自灸脐中，脉甚弦，右手伏，重取则略数。这是蕴热因春欲汗解，而气弱不能自发为汗，复郁，又因食不节，邪挟宿食，所以成块。宜以保和二十、温中二十、抑青十，用白术、木通、三棱汤下。
以上十一法，都是补药与磨积相半兼服之。前七法治饮食酒肉成积，后三法治体虚有热成积也。
【朱丹溪】陈里长男二十七岁，旧因饱食牛肉豆腐，患呕吐，又不节饮食，右胁下生一块渐长，今大如掌，痛发则见，痛止则伏，其脉弦而数。知此人必性急，块上不可按，按则愈痛，痛则必吐黄酸苦水。询问之果然。有人作肾气治。我说：不是，这是足太阴有食积与湿痰。
荔枝核（烧，二个） 山栀（炒，五个，去壳） 枳实（炒，十五个） 山楂（九个） 茱萸（炒，九枚）
一方有人参。
上细研，急流水一盏，荡起煎沸，入生姜汁令辣，食前热服，与六帖，吐二帖，服四帖，与此药且止其痛，却与消块药：
半夏末（六钱，皂角六个，水煮取汁，拌半夏末，晒干。） 黄连（炒，五钱） 石碱（二钱，另研）
以上三件，同为细末，以糖球膏为丸，如胡椒大。
【朱丹溪】一个婢女色紫稍肥，性沉多忧，年近四十，经不行三月矣。小腹中有一气块，初起如栗，渐如炊饼。我诊其脉，两手皆涩，重取却稍和。试令按块痛甚，扪之高寸半，遂与《千金》消石丸，至四五次后，忽自言乳头黑且有汁，恐是孕。我说：韭也（意指不可能），涩脉无孕之理。又与三五帖，诊其脉稍觉虚豁。我悟曰：经阻久矣，令止前药，与四物汤倍白术，佐以陈皮、炙甘草至三十帖，候服完，再与消石丸数次。忽自言块消一晕，便令莫服。又半月，经行痛甚，下黑血半升，内有如椒核者数十粒，而块消一半。又来索药，以消余块。我晓谕她说：勿性急，似开矣，不可又攻。若次月经行，当消尽矣。次月经行，下少黑血块，又消一晕。又来问药，我说：且守禁忌，至次月又消尽，已而果然。大凡攻击之药，有病则病受之，病邪轻而药力重，则胃气受伤。夫胃气者，清纯冲和之气也，惟与谷肉菜果相宜。盖药石皆偏胜之气，虽参、芪辈，为性亦偏，况攻击之药乎。此妇胃气弱，血亦少，若待块尽而去药，胃气之存者几希矣。
一个妇人年五十五岁，形气俱实，富而神劳，味浓性急，常经水过多。医生每用涩药止。后病气痛，胸腹共有积块大小十三枚，遇夜痛甚，着床累月，饮食虽减，应接家事如故，其脉两手皆涩而弱。这是因为屡用涩药，致败血积聚不行故尔。当时三月间用蜀葵根煎汤，再煎人参、白术、陈皮、青皮、甘草梢、牛膝成汤，入玄明粉少许，研桃仁调热饮之，服至二帖，腹痛下块一枚，再并渣煎服，又下一枚，当时因为病久血耗，不敢再取块，告技穷而归。后来想此症患病虽重，其形质尚可受药，但当去葵根、玄明粉，其后块渐消而病安。
一个女子年二十一岁，累因食伤，胃脘有块，随气上塞咽中。问之，又因食煨盐配粥。给予：
白术（一钱半） 陈皮 半夏（各一钱） 桔梗 青皮 木通（各五钱） 甘草（炙些） 生姜（二片）
煎服一二次，病遂平复，再与前药。半月后加桔梗煎一服，令其吐，吐出痰积，遂愈。
【张子和】息城司侯听说父亲死于贼手，乃大悲。哭罢，便觉心痛，日增不已，月余成块，状若覆杯，大痛不堪，药皆无功，议用燔针炷艾，病患恶之，乃求治于戴人。戴人到，适巫者在其傍，乃学巫者杂以狂言，以谑病者，至是大笑不忍，回面向壁一二日，心中结硬皆散。戴人说：《内经》言忧则气结，喜则百脉舒和。又说：喜胜悲，《内经》自有此法。
【朱丹溪】吕宗信年六十，素好酒，八月间因暑热中得疾，两足冷过膝，上脘有块如掌，牵引胁痛，不可眠卧，饮食减半，却不渴。已自服生料五积散三帖。我诊其脉，六脉俱沉涩而小，按之不为弱，皆数，而右为甚。大便如常，小便赤色。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，下栝蒌仁、半夏、黄连、贝母丸。至十二帖，足冷退至胫，块减半，遂止药。至半月，饮食复旧，诸症悉除。
【唐】柳宗元纂救死方 元和十二年二月，得香港脚，夜半痞绝，胁有块大如石，且死。因大寒不知人三日，家人号哭，荥阳郑询美传杉木汤，服半食顷，大下三次，气通块散。其方用杉木节一大升，橘叶一大升，无叶以皮代之，大腹槟榔七个，合捣碎之，童便三大升，共煮取一升半，分二服，若一服得快利，停后服。
【《肘后备急方》】治卒暴症，腹中有如石刺痛。牛膝一大把并叶，酒煮饮之。
【《外台秘要》】治卒暴症，腹中有物，坚如石，痛欲死。取蒴藋根一小束洗，沥去水，细擘，以酒二升，渍三宿，暖温服五合至一升，日三。若欲速得服，于热灰中温令药味出服之，此方无毒，神效。
以上暴积急去条四方，如块除后，必用补剂，以救其受攻之伤也。
[Zhu Danxi] Qi cannot form tangible accumulations; accumulations are tangible entities formed by the aggregation of phlegm, food retention, and dead blood. It is appropriate to use sea coral (Hai Shi) boiled in vinegar, San Leng and E Zhu processed with vinegar, Tao Ren, Hong Hua, Wu Ling Zhi, Xiang Fu, and similar herbs, administered with Shi Jian Bai Zhu Tang. Va Le Zi (Argopecten irradians shell) can eliminate blood masses and also resolve phlegm. When treating accumulations, one should clear fire and resolve food retention. (Food retention is essentially phlegm.) To move dead blood, after the blood mass is removed, a substantial tonification is required.
Shi Jian (Stone Alkali) can be used for phlegm accumulations forming masses; it cleanses greasy filth and resolves food retention. If the mass is located between the skin and fascia, qi-tonifying and aromatic opening herbs must be used, combined with Er Chen Tang plus qi-tonifying herbs. First, rich and heavy flavors must be avoided. In cases of accumulation diseases, purgatives should not be used, as they merely damage true qi without resolving the disease. Instead, herbs that dissolve accumulations should be used to melt and disperse them until they vanish naturally.
[Li Dongyuan] The essential method for treating accumulations: Xu Xueshi stated that generally, accumulations are treated by attacking what the pathogen dislikes or enticing it with what it likes, making recovery easier. For example, Nao Sha (Sal Ammoniac) and Shui Yin (Mercury) treat flesh accumulations; Shen Qu (Medicated Leaven) and Mai Ya (Malt) treat wine accumulations; Shui Zhi (Leech) and Meng Chong (Blue Bottle Fly larva) treat blood accumulations; Mu Xiang (Aucklandia Root) and Bing Lang (Areca Seed) treat qi accumulations; Qian Niu Zi (Pharbitis Seed) and Gan Suan (Kansui Root) treat water accumulations; Xiong Huang (Realgar) and Ni Fen (Calomel) treat phlegm accumulations; Meng Shi (Quercus Galla) and Ba Dou (Croton Seed) treat food accumulations, each treating according to its category. Using large groups of medicines to scatter their momentum makes efficacy difficult to achieve. One must clearly identify the type of accumulation and accompanying syndromes before adding assistant and guiding herbs. Otherwise, harm may result; flexibility is key. When treating accumulations, observe the site of pain to determine excess or deficiency, knowing when to tonify or drain, without violating seasonal timing, and carefully distinguishing the location of zang-fu organs. Cold is treated with heat; stagnation is dispersed; external pathogens are eliminated; retained substances are moved; hardness is reduced; excess is depleted; salty substances soften hardness; bitter substances purge. Herbs that preserve true qi are used for tonification, moving according to the accumulated substance. Regulate diet, be cautious with daily activities, and harmonize interior and exterior to ensure cure. Otherwise, suddenly using highly toxic drugs to attack will fail to remove the accumulation and instead damage righteous qi, making recovery difficult. Can physicians not be cautious?
All accumulations originate from emotional injuries (anger and joy) damaging the zang organs leading to yin deficiency. Once yin is deficient, wind and rain invade this deficiency; pathology arising from above leads to accumulation; clear dampness invading yin deficiency leads to accumulation below. (See detailed acupuncture sections.)
[Zhang Jiegu] Robust individuals do not have accumulations; only deficient individuals do. This is due to weak spleen and stomach, dual deficiency of qi and blood, and seasonal pathogenic influences, all capable of forming accumulations. If one suddenly uses hard-resolving and knot-breaking drugs, the disease may seem to recede while the person becomes weakened. Drugs like Gan Xi (Dried Lacquer), Nao Sha, San Leng, Qian Niu Zi, and Da Huang provide temporary relief but leave the condition unchanged afterward, further depleting qi and enlarging the disease, yielding no benefit. Therefore, skilled practitioners first tonify deficiency to strengthen qi and blood, allowing the accumulation to dissipate naturally, just as if the room were full of gentlemen, there would be no place for villains. Regardless of the affected organ, first regulate the middle jiao to restore appetite, which is the root.
[Zhu Danxi] A thirty-year-old woman, after weeping for her deceased son, developed chest oppression and a mass the size of a cup half a year later. Her appetite decreased significantly, her complexion was pale yellow and dark, she was emaciated, and her six pulses were wiry, thin, deficient, and choppy. She experienced chills and fever after dusk. Observing the urgency, I used both tonification and draining methods. I prescribed Bu Zhong Yi Qi Tang adjusted for weather changes, alternating with Dong Yuan's Pi Qi Wan (see Five Accumulations section). She took the decoction before meals and the pill after meals, ensuring slightly more decoction than pills. After nearly a month, chills and fever subsided, and appetite improved. Then, equal amounts of decoction and pills were taken. In the second month, she suddenly had severe chills and fever overnight, which resolved by dawn, and the chest mass seemed to disappear. However, by evening, her lower limbs swelled, so I stopped the medication. Three to five days later, the swelling vanished overnight, but by dawn, the chest mass reappeared, slightly smaller than before. I then used Er Chen Tang with Jie Geng, Bai Zhu, and Zhi Shi, regulating for half a month until she recovered. She gave birth to a son the following year.
Another woman, over forty, pale and thin with an irritable temperament, developed a mass under her breast adhering to the ribs three months after severe frustration. The mass grew gradually, causing mild pain under the heart and diaphragmatic oppression, reducing her appetite by three-quarters. She felt bitter taste in her mouth every morning, and her pulses were faint, short, and choppy. Knowing her menstruation had ceased for some time, I feared for her prognosis and initially declined treatment. However, realizing she still had stomach qi (evidenced by her ability to dress and speak normally), I prescribed Ren Shen, Bai Zhu, Dang Gui, and Chuan Xiong with qi-regulating herbs in large doses, four times a day, applying Da Hu Po Gao externally to prevent growth. After over a month and more than a hundred doses of tonics, her appetite reached half of normal. Continuing the same prescription for another month, her pulse became fuller. She then took Run Xia Wan with the tonic for over a hundred doses, and menstruation returned within two months, with the choppy pulse reducing by four-fifths. Due to hot weather, anticipating purple menstrual blood, I added Cu Zhi San Leng (Vinegar-processed San Leng) to the tonic and supplemented with Yi Qing Wan (15 pills). After another month, the mass reduced by more than half, menstruation arrived on schedule (half a day late), and appetite was normal, though meat caused discomfort. I advised stopping medication until spring when wood qi is prosperous. In June of the next year, the mass suddenly enlarged by half a finger width, with a slightly wiry pulse, weaker on the left. She reported slight fullness after eating, resolving with movement. I suspected emotional agitation, which was confirmed. I prescribed the previous tonic with Huang Qin and Chao Huang Lian, assisted by small amounts of Mu Tong and Sheng Jiang, removing San Leng, decocting to swallow Run Xia Wan, and applying Hu Po Gao externally for half a month. Menstruation occurred, and the mass dissipated. This was lung metal scorched by internal fire, wood overcoming earth, earth failing to transport, causing turbid and clear qi to mix. The residual mass remained because qi and blood had not fully recovered. Retained turbid qi caused the mass to recur. Tonifying qi and blood protected the lungs from pathogens, balanced wood, rectified earth, moved turbid qi, and dispersed the mass.
Fang Tiling, aged fifty-six, suffered left hypochondriac pain level with the umbilicus in winter of the Ding Chou year after drinking and anger. Gradually, a small mass formed, appearing with pain and disappearing when pain ceased. He had a sallow face, dry mouth, weakness, poor appetite, belching the smell of consumed food, and aversion to wind and cold. His left pulse was larger than the right, wiry, choppy, and long, predominantly on the left, becoming entirely wiry upon heavy pressure. This resulted from excessive sweating damaging stomach qi and lowering yin blood. I prescribed He Wei Tang to tonify stomach qi and nourish yin blood, along with Bao He Wan to aid digestion. Once stomach qi and yin blood were sufficient, I switched to Xiao Kuai He Wei Tang.
Ren Shen (3 qian), Bai Zhu (1.5 qian), Chen Pi (1 qian), Shao Yao, Dang Gui Shen (0.5 qian each), Ge Gen (0.3 qian), Hong Hua (bean-sized), Zhi Gan Cao (2 qian).
One dose, taken with 25 Bao He Wan and 15 Long Hui Wan.
The above three methods prioritize qi and blood tonification, using accumulation-resolving herbs as assistants, with tonification exceeding resolution. This is the method for accumulations due to severe qi and blood deficiency.
For the woman from Gan Cun with an abdominal mass: Administer 35 Bao He Wan with Bai Zhu Tang.
For Wang Lang with heart pain and diaphragmatic mass:
Bai Zhu (2 qian), Qing Pi (1 qian), Shao Yao, Mu Tong, Chuan Xiong, Cang Zhu (1 qian each), Zhi Gan Cao (0.5 qian).
One dose, taken with 30 Bao He Wan.
Feng Shi Nu, aged thirty, thin with delicate skin, accustomed to rich flavors, once walked in snow and dried shoes with fire, leading to damp-heat ascending. At twenty-five, she frequently vomited clear fluid and acid regurgitation. Doctors used warm herbs like Ding Xiang, providing intermittent relief. By that year, she developed heart pain, chest oppression, and a mass, vomiting one-third of her food. I prescribed 24 Zuo Jin Wan with ginger juice. After more than thirty doses, she could eat nothing. I said, "The knot has opened." Advise stopping medication. If thirsty, give half a cup of boiled water, occasionally giving Qing Liu Wan. Although bedridden, abstaining from medicine is best. After nearly forty days, her pulse was slightly wiry, choppy on heavy pressure, and harmonious on light pressure, with the wiry quality increasing. I prescribed Ren Shen Jiu Shao Yao Tang to guide metal to drain wood. Appetite gradually returned, but constipation persisted. The family insisted on Da Huang, but I refused. I made pills with Sheng Shao Yao, Chen Pi, Tao Ren, and Ren Shen, using honey suppositories. Bowels moved, appetite increased, and she recovered after half a month of regulation.
Can Yu Wan is Zuo Jin Wan plus 1 qian Ren Shen.
Lu Zi Yu developed a mass in the left hypochondrium after malaria, consuming meat and alcohol.
Bai Zhu (1 qian), Cu Zhi Chai Hu (1 qian), Fu Ling (2 qian), Chao Zhi Ke (0.5 qian), Ren Shen (0.5 qian).
Decocted, taken with 5 Ai Wei, 20 Bao He, 10 Yi Qing, 10 Yu Dian, and 5 Gong Kuai.
Zhu Lang from Chang Yuan suffered from dampness due to years of drinking, with a mass on the hypochondrium, loose stools, and yellow urine.
Hua Shi (1 liang), Bai Zhu, San Leng (6 qian each), Chen Pi (5 qian), Huang Lian, Zhu Ling (3 qian each), Huang Qin, Mu Tong (2 qian each), Fang Feng (1.5 qian), Gan Jiang (1 qian), Zhi Gan Cao (0.5 qian).
Divided into seven doses, taken with 20 Bao He Wan.
A husband had a mass on the left abdomen extending to the hypochondrium, initially caused by gas pain from eating noodles and milk, then enlarged by meat and alcohol to the size of a peach, reducing appetite by one-third.
Hua Shi (0.5 liang), Bai Zhu (4 qian), Chen Pi, San Leng (3 qian each), Luo Bo Zi, Lian Qiao, Huang Lian (1 qian each), Ge Gen (2.5 qian), Tao Ren (20 pieces), Huang Qin (1 qian), Zhi Gan Cao (1.5 qian).
Divided into four doses, decocted in water.
A woman had a palm-sized mass in the hypochondrium, choppy pulse, and occasional fever. This is qi accumulation amidst deficiency. First tonify deficiency, then use accumulation-resolving drugs.
Bai Shao, Gui Xu (4 qian each), Chen Pi, Bai Zhu (3 qian), Qing Pi, Chuan Xiong, Mu Tong (1 qian each), Zhi Gan Cao (0.5 qian).
Decoct in plain water, take hot.
Accumulation-resolving drugs:
Cu Zhi San Leng (1 qian), Zhi Shi, Qing Pi, Tao Ren (5 qian each), Da Huang (5 qian), Gui Zhi (1.5 qian), Cu Zhi Hai Zao (3 qian).
Grind to fine powder, make pills with Shen Qu paste, size of sesame seeds. Take 40 pills per dose.
[World Physicians] A lady had an old mass in the left hypochondrium growing larger, with a wiry, large, slightly rapid pulse. She recently had fever, reduced appetite, and fatigue. First tonify, then attack the mass.
Chen Pi (5 qian), Bai Zhu (1.5 liang), Chai Hu, Dang Gui Tou, Qing Pi (5 qian each), Gan Cao (one piece), Mu Tong (3.5 qian).
Eight doses.
Next, attack the mass:
Cu Qing Pi (1.5 liang), Tao Ren (5 qian), Cu San Leng (1.5 liang), Gui Zhi (3.5 qian), Cu Xi Hai Zao (3 qian).
Grind, make pills with Shen Qu paste.
A husband had an accumulation in the hypochondrium with internal phlegm-heat, inability to sweat, and large, scattered, soft pulses, indicating body deficiency.
San Leng (5 qian), Bai Zhu, Huang Lian (3 qian each), Ren Shen (2.5 qian), Zhi Gan Cao (0.5 qian), Lian Qiao, Mu Tong (3 qian each), Chuan Xiong, Gui (1 qian).
Decoct, take with Bao He Wan.
Fu Xiao Niang had a left hypochondriac mass after malaria with scanty urination.
Hou Po, Chai Hu (2 qian each), San Leng (1.5 qian), Zhi Gan Cao (0.5 qian), Mu Tong (5 qian), Bai Zhu (6.5 qian), Qing Pi (5 qian), Sheng Jiang (one slice).
Take hot before meals.
Qian Lang from Xiapi developed sand-rash in January, resulting in two masses near the umbilicus, painful when raised, painless when flat, sometimes dull pain. He moxibusted the umbilicus. Pulse was very wiry, hidden on the right, slightly rapid on heavy pressure. This was latent heat wanting to resolve via sweat in spring, but weak qi prevented spontaneous sweating, leading to stagnation. Combined with irregular diet, pathogens clung to retained food, forming masses. Use 20 Bao He, 20 Wen Zhong, 10 Yi Qing, taken with Bai Zhu, Mu Tong, San Leng decoction.
The above eleven methods combine tonics and accumulation-resolving drugs equally. The first seven treat accumulations from diet, wine, and meat; the last three treat accumulations from body deficiency and heat.
[Zhu Danxi] Chen Lizhang's son, aged twenty-seven, previously vomited after overeating beef and tofu, continued irregular diet, and developed a mass in the right hypochondrium growing to palm size. Painful when active, painless when resting, pulse wiry and rapid. He is likely impatient; pressing the mass increases pain, leading to vomiting of yellow, sour, bitter fluid. Confirmed. Some treated it as Kidney Qi disorder. I said: No, this is food retention and damp-phlegm in the Foot Taiyin.
Shao Li Zhi He (roasted, 2), Chao Shan Zhi (shelled, 5), Chao Zhi Shi (15), Shan Zha (9), Chao Zhu Yu (9).
Some formulas include Ren Shen.
Grind finely, boil in fast-flowing water, add ginger juice until spicy, take hot before meals. Six doses. Vomiting occurred after two doses. Continue for four doses to stop pain, then switch to mass-dissolving drugs:
Ban Xia Mo (6 qian, mixed with juice from 6 Ze Xie boiled in water, dried), Chao Huang Lian (5 qian), Shi Jian (2 qian, ground separately).
Mix into fine powder, make pills with sugar paste, size of peppercorns.
[Zhu Danxi] A maid, slightly fat with purple complexion, melancholic, nearly forty, had amenorrhea for three months. A qi mass in the lower abdomen started like a chestnut and grew like a steamed bun. Pulses were choppy on both hands, slightly harmonious on heavy pressure. Pressing the mass caused severe pain; it was palpable 1.5 cun high. I prescribed Qian Jin Xiao Shi Wan. After four or five doses, she claimed her nipples were black and secreted fluid, fearing pregnancy. I said: Impossible; choppy pulses do not indicate pregnancy. After three or five more doses, pulses felt slightly hollow. I realized menstruation had been blocked for a long time. Stop previous drugs, prescribe Si Wu Tang with doubled Bai Zhu, assisted by Chen Pi and Zhi Gan Cao for thirty doses. After finishing, resume Xiao Shi Wan several times. She reported the mass shrank slightly, so I stopped medication. Half a month later, menstruation occurred with severe pain, passing half a sheng of black blood containing dozens of pepper-seed-like clots, and the mass reduced by half. She sought medicine to remove the rest. I advised: Do not be impatient; it seems to be opening, do not attack again. Next month's menstruation should clear it. Next month, she passed less black blood clots, and the mass shrank slightly more. She asked for medicine again. I said: Observe taboos, next month it will clear. It did. Generally, attacking drugs affect the disease; if pathogenic evil is light but drug force is heavy, stomach qi is injured. Stomach qi is pure, neutral, and harmonious, suitable for grains, meats, vegetables, and fruits. Medicines possess biased properties; even Ren Shen and Huang Qi are biased, let alone attacking drugs. This woman had weak stomach qi and little blood. If waiting for the mass to completely disappear before stopping drugs, her remaining stomach qi would be scarce.
A fifty-five-year-old woman, robust in form and qi, wealthy but mentally taxed, accustomed to rich flavors and irritable, often had menorrhagia. Doctors used astringents to stop it. Later, she developed qi pain with thirteen masses of varying sizes in the chest and abdomen, severe night pain, bedridden for months, reduced appetite but managing household affairs. Pulses were choppy and weak on both hands. This was due to repeated use of astringents causing stagnant blood accumulation. In March, I used Shu Kui Gen decoction, then added Ren Shen, Bai Zhu, Chen Pi, Qing Pi, Gan Cao Shao, and Niu Xi. Added a little Xuan Ming Fen and ground Tao Ren, taken hot. After two doses, abdominal pain passed one mass. Decocting dregs again passed another mass. Due to prolonged illness and blood loss, I dared not extract more masses and withdrew. Later, I realized although the disease was severe, her constitution could tolerate drugs, provided Shu Kui Gen and Xuan Ming Fen were removed. Subsequently, the mass gradually dissolved, and she recovered.
A twenty-one-year-old woman, repeatedly injured by food, had a mass in the epigastrium rising to block the throat due to qi. She also ate salt-roasted porridge. Prescribed:
Bai Zhu (1.5 qian), Chen Pi, Ban Xia (1 qian each), Jie Geng, Qing Pi, Mu Tong (5 qian each), Zhi Gan Cao (some), Sheng Jiang (2 slices).
Decoct and take one or two times; condition stabilized. Repeat prescription. Add Jie Geng after half a month, induce vomiting to expel phlegm-food retention, cured.
[Zhang Zihe] The Magistrate of Xicheng heard his father died by bandits, grieved deeply. After crying, he felt heart pain increasing daily, forming a mass like an inverted cup after a month, unbearable pain, ineffective drugs. Discussed burning needles and moxa, but the patient disliked them, seeking Dai Ren. Dai Ren found a shaman nearby, imitated the shaman mixing madness with words to tease the patient, causing uncontrollable laughter. Turning away for one or two days, the internal hardness dispersed. Dai Ren said: *Nei Jing* states sorrow knots qi, joy relaxes meridians. Joy overcomes sorrow; *Nei Jing* has this method.
[Zhu Danxi] Lv Zongxin, aged sixty, loved wine, fell ill in August due to summer heat. Feet cold past knees, palm-sized mass in upper epigastrium pulling to hypochondrium, unable to sleep, halved appetite, no thirst. Self-administered Sheng Liao Wu Ji San for three doses. Pulses were deep, choppy, small, not weak on pressure, rapid, especially on the right. Bowels normal, urine red. Used Da Cheng Qi Tang with half Da Huang roasted, plus Huang Lian, Shao Yao, Chuan Xiong, Ge Gen, Gan Cao as decoction, taken with Gua Lou Ren, Ban Xia, Huang Lian, Bei Mu pills. After twelve doses, foot cold retreated to calves, mass halved, stopped medication. Half a month later, appetite restored, symptoms cleared.
[Tang] Liu Zongyuan compiled Rescue Dead Form. In February of the 12th year of Yuanhe, he suffered from gout, sudden obstruction at midnight, stone-hard mass in hypochondrium, near death. Unconscious for three days due to severe cold, family wailed. Zheng Xunmei of Xingyang transmitted Shan Mu Tang. After half a meal time, profuse diarrhea three times, qi flowed, mass dispersed. Formula: Shan Mu Jie (1 sheng), Ju Ye (1 sheng, substitute bark if no leaves), Da Fu Bing Lang (7), crushed together, Tong Bian (3 sheng), boil to 1.5 sheng, divide into two doses. If one dose causes rapid relief, stop the second.
*[Zhou Hou]* Treats sudden acute masses, stone-like stabbing pain in abdomen. Niu Xi (large bunch) with leaves, decoct in wine and drink.
*[Wai Tai]* Treats sudden acute masses, hard as stone in abdomen, painful to death. Take a small bundle of Shuo Bi Gen, wash, drain water, tear finely, soak in 2 sheng wine for three nights. Warm and take 5 ge to 1 sheng, three times daily. For faster effect, warm in hot ashes until aroma emerges, then drink. This formula is non-toxic and miraculous.
The above four formulas for urgent removal of sudden accumulations. After masses are removed, tonics must be used to rescue injury from attack.