温中二十。抑青十。以白术、木通、三棱汤下。此等方法。皆补药与磨积相半。而必兼清肝
之药。大抵因怒成块者居多也。又如陈里长男。饱食牛肉豆腐。成块在右胁。脉弦而数。即
明告以此人必性急。块上不可按。按则愈痛。痛则必吐酸黄苦水。而用荔核、山楂、枳实、
山栀、茱萸、人参、姜汁以止痛。继用皂角煎汁制半夏。合黄连、石碱。用糖球膏为丸以消
块。此仍是治肝为主。磨积为助。学人能逐案细绎之。自有悟处。
王海藏载万病紫菀丸云。李灵患肥气。日服五丸。经一年。泻出肉鳖二枚愈。李知府妻
梅氏。带下血崩七年。骨痿着床。日服五丸至十丸。取下肉块如鸡子状愈。以及赵侍郎泻出
青蛇七条。王氏泻出癞虫如马尾者二升。今览其方。巴霜、川乌甚少。余如人参、黄连、皂
荚、川椒等。皆平庸药。不若耆婆万病丸之芫花、甘遂、蜈蚣、芫青、石蜥蜴等之有毒也。
何以能着奇功。惜未试之。
又按阿魏丸方甚多。如医林阿魏十四味。内有石碱、风化硝。小阿魏丸七味。乃棱、蓬
胡椒、青皮、木麝二香。心统消积阿魏丸共八味。内有三棱、莪术、牵牛、穿山甲。丹溪
阿魏丸治肉积者只四味。又医林小阿魏丸。即丹溪治陈里长男之三味。却无阿魏。犹之琥珀
膏。只大黄、朴硝各一两为末。以大蒜捣膏贴之。并无琥珀也。总须对证择用之。
温中二十丸，抑青十丸。用白术、木通、三棱煎汤送服。这类方法，都是补益药与消积药各占一半，并且必须兼用清肝的药物。大抵因愤怒而结成块状的病证居多。
又比如陈里长的儿子，饱食牛肉和豆腐后，右胁下形成块状物，脉象弦而数。我明确告知此人必定性格急躁，块状物部位不可按压，一按就会更加疼痛；疼痛则必然呕吐酸黄苦水。于是使用荔枝核、山楂、枳实、山栀、吴茱萸、人参、姜汁来止痛。随后用皂角煎汁炮制半夏，配合黄连、石碱，用糖球膏制成丸剂以消除块状物。这仍然是以治肝为主，磨积为辅助。学习的人如果能逐案仔细推究，自然会有领悟之处。
王海藏记载万病紫菀丸说：李灵患有肥气（左胁下有痞块），每天服用五丸，经过一年，泻出两块肉鳖而痊愈。李知府的妻子梅氏，带下及血崩七年，骨痿困卧于床，每天服用五丸至十丸，排出如鸡蛋大小的肉块而痊愈。以及赵侍郎泻出七条青蛇，王氏泻出如马尾状的癞虫二升。如今查看该方，巴豆霜、川乌用量很少，其余如人参、黄连、皂荚、川椒等，都是平庸的药物，不如耆婆万病丸中的芫花、甘遂、蜈蚣、芫青、石蜥蜴等具有毒性。为什么能取得奇效？可惜未曾尝试过。
另外，阿魏丸的方子很多。如《医林》中的阿魏十四味，内含石碱、风化硝。小阿魏丸七味，乃是三棱、蓬术、胡椒、青皮、木香、麝香、沉香。心统消积阿魏丸共八味，内有三棱、莪术、牵牛子、穿山甲。丹溪阿魏丸治疗肉积的只有四味。还有《医林》中的小阿魏丸，就是丹溪治疗陈里长儿子的三味药，却没有阿魏。这就好比琥珀膏，只用大黄、朴硝各一两研末，用大蒜捣成膏贴敷，其中并没有琥珀。总之，必须根据证候选择使用。
Wenzhong Wan (Warm the Middle Decoction Pill), twenty pills; Yiqing Wan (Suppress Green Decoction Pill), ten pills. Administered with a decoction of Baizhu (Atractylodis Rhizoma), Mutong (Akebiae Caulis) and Sanleng (Sparganii Rhizoma). Such methods involve half tonifying herbs and half stasis-resolving herbs, and must simultaneously include herbs that clear Liver heat. Generally, masses formed due to anger are predominant.
For instance, the son of Chen Lichang developed a mass in his right hypochondrium after overeating beef and tofu. His pulse was wiry and rapid. I explicitly informed him that he must have an impatient temperament, and the mass area should not be pressed; pressing would exacerbate pain, which would inevitably lead to vomiting of sour, yellow, bitter fluid. Therefore, Lizhihe (Litchi Seed), Shanzha (Crataegi Fructus), Zhishi (Aurantii Fructus), Shanzhi (Gardeniae Fructus), Zhuyu (Corni Fructus), Renshen (Ginseng Radix et Rhizoma), and Jiangzhi (Zingiberis Rhizoma Recens Juice) were used to relieve pain. Subsequently, Banxia (Pinelliae Rhizoma) was processed using Gaojiao decoction, combined with Huanglian (Coptidis Rhizoma) and Shijian (Alkali), and formed into pills using Tangqiu Gao (Sugar Ball Paste) to dissipate the mass. This approach still prioritizes treating the Liver, with resolving accumulation as an auxiliary measure. Practitioners who carefully analyze each case will naturally gain insights.
Wang Haicang recorded the Wanbing Ziwan Wan (Myriads-of-Diseases Asther Decoction Pill): Li Ling suffered from Feiqi (a mass in the left hypochondrium). He took five pills daily for one year, passing two pieces of fleshy fluke in stool, and was cured. Mei Shi, wife of Prefect Li, suffered from leukorrhea and metrorrhagia for seven years, becoming emaciated and bedridden. She took five to ten pills daily, passed egg-sized fleshy masses, and was cured. Additionally, Vice Minister Zhao passed seven green snakes, and Ms. Wang passed two sheng (approx. 1 liter) of leech-like parasites resembling horse tails. Upon examining this prescription, Bashuang (Crotonis Semen Preparatum) and Chuanwu (Aconiti Radix) are present in very small amounts. The rest, such as Renshen (Ginseng Radix et Rhizoma), Huanglian (Coptidis Rhizoma), Gaojiao (Gleditsiae Sinensis Fructus Spina), and Chuanjiao (Zanthoxyli Pericarpium), are common herbs. They are inferior to Qiepo Wanbing Wan (Jivaka's Myriads-of-Diseases Pill), which contains toxic herbs like Yuanhua (Genkwa Flos), Gansui (Euphorbiae Kansui Radix), Wugong (Scolopendra), Yuanqing (Mylabris), and Shixiyi (Takydromi Lacerta). How can it achieve miraculous results? It is a pity that I have not tested it myself.
Furthermore, there are many prescriptions forawei Wan (Asafoetida Pill). For example, the Si-shi-wei Awei Wan (Fourteen-Ingredient Asafoetida Pill) in *Yilin* contains Shijian (Alkali) and Fenghuaxiao (Natrii Sulfas Exsiccatus). The Xiao Awei Wan (Small Asafoetida Pill) consists of seven ingredients: Sanleng (Sparganii Rhizoma), Pengling (Curcumae Rhizoma), Hujiao (Piperis Longi Fructus), Qingpi (Citri Reticulatae Pericarpium Viride), Muxiang (Aucklandiae Radix), Shexiang (Moschus), and Chenxiang (Aquilariae Lignum Resinatum). Xin Tong Xiaoji Awei Wan (Heart-Regulating Accumulation-Resolving Asafoetida Pill) has eight ingredients, including Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Qianniu (Pharbitidis Semen), and Chuanshanjia (Manis Squama). Danxi's Awei Wan for treating meat accumulation contains only four ingredients. Also, the Xiao Awei Wan in *Yilin* corresponds to the three ingredients Danxi used for Chen Lichang's son, but lacks Awei (Asafoetida). Similarly, Hu Po Gao (Amber Plaster) uses only Dahuang (Rhei Radix et Rhizoma) and Puxiao (Natrii Sulfatis Crystallis), each one liang (approx. 37 grams), ground into powder and applied as a paste made from crushed garlic; it contains no Hu Po (Fossilia Succinum Griseum). Ultimately, one must select the appropriate formula based on the syndrome.