一方∶治蛊胀身干黑瘦，多渴烦闷，用马鞭草细锉晒干，勿见火，以酒或水同煮，味出去
渣，温服无时，六月中旬雷鸣时采有效。
又方∶治水蛊，不问年月，深者用大戟、当归、陈皮各一两，细锉，水二升煮七分顿
服，利二三斗物怪，至重不通，再服。
（附 瘕 癖）
《素问》《针经》云∶积者，厥气生足 ，足 生胫寒，胫寒则血脉凝涩，凝涩则寒气上
入于肠胃，则腹胀，腹胀则肠外之汁沫迫聚不得散，日以成积。卒然多饮食，则肠满。起居
不节，用力过度，则络脉伤。阳络伤则血外溢，血外溢则衄血；阴络伤则血内溢，血内溢则
后血。肠胃之络伤，则血溢于肠外，有寒汁沫与血相抟，则并合凝聚不得散而成积矣。或外
伤于寒，内伤于忧怒，则气上逆，气上逆则六输不通，温气不行矣。凝血蕴里不散，津液涩渗，
着而不去，而皆成积矣。又曰∶思则气结，久成积也。
奇病篇帝曰∶病胁下满气逆，二三岁不已，是为何病？岐伯曰∶病名曰息积。此不
妨于食，不可灸刺，积为导引服药，药不能独治也。
运气积块皆属湿土。经曰∶土太过，曰敦阜之纪，其动濡积并搐是也。
五脏生成篇曰∶赤脉之至也喘而坚，诊曰有积气在中，时害于食，名曰心痹，得之外疾，
思虑而心虚，故邪从之。白脉之至也喘而浮，上虚下实，惊，有积气在胸中，喘而虚，名曰肺
痹，寒热，得之醉而使内也。青脉之至也长而左右弹，有积气在心下支 ，名曰肝痹，得
之寒湿，与疝同法，腰痛足清头脉紧。黄脉之至也大而虚，有积气在腹中，有厥气，名曰厥
疝，女子同法，得之疾使四肢，汗出当风。黑脉之至也上坚而大，有积气在小腹与阴，名曰肾
痹，得之沐浴清而卧。
《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，六腑所成也。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。
又曰∶五脏之积，各有名乎？肝之积，名曰肥气，在左胁下，如覆杯，有头足。久不愈，
令人发咳逆喑疟，连岁不已，以季夏戊己日得之。何以言之？肺病传肝，肝当传脾。脾季夏适王，
王者不受邪。肝复欲还肺，肺不肯受，故留结为积，故知肥气以季夏戊己日得之。（甫按∶
积病传其所胜，王气不受，固理也。肝积传自肺金，得于季夏，亦理也。肝欲还肺，肺不肯
受，定于戊己日干，似为太凿。或木气自病，而非由于胜之所传，则亦有也，奚必拘于是？）
心之积名曰伏梁，起脐上，大如臂，上至心下。久不愈，令人烦心。脾之积名曰痞气，在胃脘，
大如复盘。久不愈，令人四肢不收，发黄胆，饮食不为肌肤。肺之积名曰息贲，在右胁下，
覆大如杯。久不已，令人洒淅寒热，喘咳发肺痈。肾之积名曰奔豚，发于少腹，上至心下，
若豚状，上下无时。久不已，令人喘逆骨痿少气。
《原病式》曰∶积聚者，由阴阳不知，脏腑虚弱，或受于风邪，搏于脏腑之气所为也。
《巢氏病源》曰∶积聚痼结者，是五脏六腑之气已积聚于内，重因饮食不节，寒温不调，
邪气重沓，牢痼坚结者也。若久即成 。
《玉机微义》曰∶积聚因饮食及七情而成者多。滑氏谓越人之意，盖以五行之道推其理势之所
有者，演而成文。初不必论其情感，亦不必论其还不还，与其必然否也。读者但以所胜传不
胜，及王者不受邪遂留结为积，治之可矣。
一方：治疗蛊胀（腹部胀大如鼓，伴有虫积或水湿内停）导致身体干枯、面色黑瘦、口渴烦躁闷乱的症状。使用马鞭草细切后晒干，注意不要见火，用酒或水共同煎煮，待味道变淡后去掉药渣，随时温服。此药在六月中旬雷鸣时采集效果更佳。
又一方：治疗水蛊（以腹水为主要特征的积聚病），不论发病时间长短，病情深重的使用大戟、当归、陈皮各一两，细切后，用水二升煎煮至七分，一次性服用。若排出二三斗的异常物质（如瘀血、积水等），对于病情极重且大便不通者，可再次服用。
（附 瘕 癖）
《素问》和《针经》说：积证（腹内结块，固定不移，痛有定处），是由于厥气（逆乱之气）产生于足部，足部受邪进而导致小腿寒冷，小腿寒冷则血脉凝滞涩缓，血脉凝滞则寒气向上进入肠胃，导致腹胀，腹胀则肠外的津液泡沫被迫聚集而不能消散，日久形成积块。突然暴饮暴食，会导致肠道充满。起居没有节制，用力过度，会导致络脉损伤。阳络受损则血液外溢，血液外溢则出现鼻衄（鼻出血）；阴络受损则血液内溢，血液内溢则出现便血。肠胃的络脉受损，则血液溢出到肠外，若有寒邪和津液泡沫与血液相互搏结，则混合凝聚不能消散而成为积块。或者外伤于寒邪，内伤于忧怒情绪，导致气机上逆，气机上逆则六输（六腑之腧穴或经络气血输注之处）不通畅，温煦之气不能运行。凝血蕴积在体内不散，津液渗泄涩滞，附着不去，最终都形成积块。又说：思虑过度会导致气机郁结，日久形成积证。
《奇病篇》中黄帝问：胁下满闷，气机上逆，两三年不愈，这是什么病？岐伯回答：病名叫做息积。这种病不影响进食，不能用灸法和针刺治疗，积证需要通过导引（古代健身疗法）配合服药，单靠药物不能单独治愈。
运气学说认为积块多属于湿土范畴。经典记载：土气太过，称为敦阜之年，其病变表现为濡湿、积块并伴有抽搐，就是这种情况。
《五脏生成篇》说：赤色脉象来势急促而坚实，诊断为中有积气，时常妨碍饮食，病名叫做心痹，得自外感疾病，因思虑过度导致心气虚弱，所以邪气得以侵入。白色脉象来势急促而浮浅，上部虚下部实，易惊，胸中有积气，气喘而虚，病名叫做肺痹，寒热往来，得自醉酒行房事。青色脉象来势长且左右弹指，心下有积气支撑，病名叫做肝痹，得自寒湿，治疗方法同疝病，症状包括腰痛、脚冷、头部脉紧。黄色脉象来势大而虚，腹中有积气，有厥气，病名叫做厥疝，女子治法相同，得自四肢剧烈活动，汗出当风。黑色脉象来势上部坚实而大，小腹与阴部有积气，病名叫做肾痹，得自沐浴后受凉躺卧。
《难经》说：积证，是阴气所致；聚证，是阳气所致。所以阳气浮而动，阴气沉而伏。气所积聚的地方，叫做积；气所聚集的地方，叫做聚。所以积证，由五脏产生；聚证，由六腑形成。积证，是阴气，开始发病时有固定部位，疼痛不离其部位，上下有始有终，左右有穷尽之处。聚证，是阳气，开始发病没有根本，上下没有停留止息之处，疼痛无常处，这叫做聚。因此通过这种方式来辨别积聚。
又说：五脏的积，各有名称吗？肝的积，名叫肥气，位于左胁下，像倒扣的杯子，有头有足。久治不愈，使人发生咳嗽、气逆、声音嘶哑、疟疾，连年不愈，这是在季夏戊己日得的。为什么这样说？肺病传变给肝，肝应当传变给脾。脾在季夏正值旺盛，旺盛之气不受邪气侵犯。肝想再传回给肺，肺不肯接受，所以留结成为积，因此知道肥气是在季夏戊己日得的。（徐春甫按：积病传其所胜（我克者），王气（当令之气）不受邪，固然是常理。肝积传自肺金，得于季夏，也是常理。肝想传回给肺，肺不肯接受，定于戊己日干，似乎过于穿凿。或者是木气自身生病，而非由于相胜关系传变而来，那么也有这种情况，何必拘泥于此呢？）
心的积名叫伏梁，起于脐上，大如手臂，上至心下。久治不愈，使人烦闷忧心。脾的积名叫痞气，在胃脘部，大如盘。久治不愈，使人四肢无力不收，发黄疸，饮食不能化为肌肉。肺的积名叫息贲，在右胁下，覆盖大如杯。久治不愈，使人洒淅恶寒发热，气喘咳嗽，引发肺痈。肾的积名叫奔豚，发于少腹，上至心下，像小猪奔跑状，上下无定时。久治不愈，使人喘逆、骨痿、少气。
《原病式》说：积聚病，是由于阴阳失调，脏腑虚弱，或者受风邪侵袭，搏结于脏腑之气所形成的。
《巢氏病源》说：积聚痼结，是五脏六腑之气已在体内积聚，再加上饮食不节，寒温不调，邪气重叠，牢固坚硬地结聚在一起。如果时间久了就会变成癥瘕。
《玉机微义》说：积聚多因饮食及七情（喜、怒、忧、思、悲、恐、惊）而成。滑寿先生认为，这是根据越人（扁鹊）的意思，大概是以五行之道推演其道理趋势所必然有的情况，演绎成文。起初不必讨论情感因素，也不必讨论是否传还，以及是否必然如此。读者只需以“所胜传不胜”（克我者传给我）及“王者不受邪”（当令之气不受邪）遂留结为积的观点，进行治疗即可。
One prescription: For treating Gu Zhang (abdominal distension resembling a drum, accompanied by parasitic accumulation or internal retention of water and dampness) resulting in a dry body, dark and emaciated complexion, excessive thirst, irritability, and oppression. Use Ma Bian Cao (Patrinia Herba), finely chopped and sun-dried, avoiding fire. Decoct with wine or water. Remove the dregs when the flavor is gone, and take warm at any time. It is effective if harvested during thunderstorms in mid-June.
Another prescription: For treating Shui Gu (accumulation disease characterized primarily by ascites), regardless of the duration of onset. For deep-seated cases, use Da Ji (Kansui Radix), Dang Gui (Angelicae Sinensis Radix), and Chen Pi (Citri Reticulatae Pericarpium), each one liang. Finely chop, add two sheng of water, decoct to seven-tenths, and take in one dose. If two or three dou of abnormal matter (such as blood stasis or fluid) is discharged, for severe cases with obstruction, administer again.
(Attached: Jia and Pi)
Su Wen (Basic Questions) and Zhen Jing (Needle Classic) state: Ji (accumulation; fixed abdominal masses with definite location and pain) arises from Jue Qi (rebellious qi) originating in the feet, leading to cold in the lower legs. Cold in the lower legs causes blood vessels to become stagnant and sluggish. Stagnation allows cold qi to ascend into the stomach and intestines, causing abdominal distension. Distension forces the fluids and foam outside the intestines to gather and not disperse, gradually forming an accumulation. Sudden overeating leads to intestinal fullness. Irregular lifestyle and excessive exertion damage the collaterals. Damage to Yang collaterals causes external bleeding, manifesting as epistaxis; damage to Yin collaterals causes internal bleeding, manifesting as hematochezia. Damage to the collaterals of the stomach and intestines causes blood to overflow outside the intestines. If cold and fluid foam contend with blood, they mix and coagulate without dispersing, forming an accumulation. Alternatively, external injury to cold and internal injury to sorrow and anger cause qi to rebel upward. Upward rebellion obstructs the Six Shu points (acupoints where qi and blood transport), preventing the movement of warming qi. Coagulated blood remains inside without dispersing, and fluid secretion becomes sluggish. Adhesion and non-dispersion ultimately result in accumulation. It is also stated that excessive thinking causes qi to knot, which over time forms accumulation.
In the Chapter on Rare Diseases, the Yellow Emperor asked: The hypochondrium is full, qi rebels upward, and this persists for two or three years. What disease is this? Qibo replied: The disease is named Xi Ji (breathing accumulation). This condition does not interfere with eating. Moxibustion and acupuncture are contraindicated. Accumulation requires Dao Yin (ancient therapeutic exercises) combined with herbal medicine; herbs alone cannot cure it independently.
According to the theory of Five Movements and Six Qi, accumulations generally belong to Damp Earth. The classics state: When Earth qi is excessive, it is called the Era of Dun Fu (solid mounds). Its manifestations include dampness, accumulation, and convulsions.
The Chapter on Generation of the Five Viscera states: When the red pulse arrives rapid and firm, the diagnosis indicates accumulated qi in the center, occasionally hindering food intake. This is named Xin Bi (heart bi-syndrome), acquired from external diseases. Due to excessive thinking, heart qi becomes deficient, allowing pathogenic factors to enter. When the white pulse arrives rapid and floating, indicating deficiency above and excess below, with fright, there is accumulated qi in the chest. It presents with asthma and deficiency, named Fei Bi (lung bi-syndrome), with chills and fever, caused by sexual intercourse after drunkenness. When the green pulse arrives long and pulses left and right, there is accumulated qi supporting beneath the heart, named Gan Bi (liver bi-syndrome), caused by cold-dampness, treated similarly to Shan syndrome (hernia), with symptoms of lumbar pain, cold feet, and tight head pulses. When the yellow pulse arrives large and deficient, there is accumulated qi in the abdomen and Jue Qi (rebellious qi), named Jue Shan (rebellious hernia), with the same treatment for women, caused by strenuous limb activity and exposure to wind while sweating. When the black pulse arrives firm and large above, there is accumulated qi in the lower abdomen and yin organs, named Shen Bi (kidney bi-syndrome), caused by bathing while cold and lying down.
Nan Jing (Classic of Difficult Issues) states: Ji (accumulation) is Yin qi; Ju (gathering) is Yang qi. Therefore, Yang floats and moves, while Yin sinks and hides. Where qi accumulates, it is called Ji; where qi gathers, it is called Ju. Thus, Ji arises from the Five Zang organs; Ju is formed by the Six Fu organs. Ji is Yin qi; its onset has a constant location, pain does not leave its area, and it has specific upper/lower and left/right boundaries. Ju is Yang qi; its onset has no root, no fixed upper/lower stopping point, and pain occurs in variable locations. This is how Ji and Ju are distinguished.
It further asks: Do the accumulations of the five viscera have specific names? The accumulation of the liver is named Fei Qi (fat qi), located under the left hypochondrium, like an inverted cup, with a head and feet. If not cured for a long time, it causes cough, rebellious qi, aphonia, and malaria, persisting for years. It is acquired on Wu-Ji days in late summer. Why? Lung disease transmits to the Liver, and the Liver should transmit to the Spleen. In late summer, the Spleen is prosperous and does not accept pathogens. The Liver attempts to return the pathogen to the Lung, but the Lung refuses to accept it, so it stays and knots to form accumulation. Hence, Fei Qi is acquired on Wu-Ji days in late summer. (Xu Chunfu notes: It is logical that accumulation transmits to what it overcomes, and the prosperous qi does not accept pathogens. It is also logical that liver accumulation originates from lung metal and is acquired in late summer. However, stating that the liver tries to return to the lung and the lung refuses, specifically on Wu-Ji days, seems overly rigid. If the wood qi is diseased itself, rather than transmitted via overcoming relationships, such cases also exist. Why be constrained by this?)
The accumulation of the heart is named Fu Liang (hidden beam), starting above the umbilicus, as thick as an arm, extending up to below the heart. If not cured for a long time, it causes vexation and anxiety. The accumulation of the spleen is named Pi Qi (stagnant qi), in the epigastrium, as large as a plate. If not cured for a long time, it causes inability to move the four limbs, jaundice, and failure of diet to nourish muscles. The accumulation of the lung is named Xi Ben (gasping accumulation), under the right hypochondrium, covering an area as large as a cup. If not cured for a long time, it causes aversion to cold and fever, asthma, cough, and may lead to Lung Abscess. The accumulation of the kidney is named Ben Tun (flying pig), originating in the lower abdomen, extending up to below the heart, resembling a pig running, moving up and down without fixed times. If not cured for a long time, it causes wheezing, bone萎 (weakness), and shortness of breath.
Yuan Bing Shi states: Accumulation and gathering arise from the lack of harmony between Yin and Yang, weakness of the zang-fu organs, or invasion by wind pathogens contending with the qi of the zang-fu organs.
Chao Shi Bing Yuan states: Persistent accumulation and knotting occur when the qi of the five zang and six fu organs has already accumulated internally, compounded by irregular diet, improper adjustment to cold and heat, and overlapping pathogenic factors, resulting in firm and hard knotting. If prolonged, it becomes Zheng Jia (fixed masses).
Yu Ji Wei Yi states: Accumulation and gathering are mostly caused by diet and the Seven Emotions (joy, anger, worry, thought, grief, fear, fright). Mr. Hua (Hua Shou) believed this follows the intent of Yue Ren (Bian Que), deducing the inevitable trends based on the principles of the Five Elements and elaborating them into text. Initially, one need not discuss emotional factors, nor whether transmission returns, or whether it is inevitable. Readers should simply treat based on the principle that "what is overcome transmits to the overcomer" and "the prosperous qi does not accept pathogens, thus leaving knots to form accumulation."