上一十二味，捣罗为末，炼密和丸。如梧桐子大，每服空心温酒下三十丸，至四十丸，
通利则减丸数。
治症癖积聚。牛膝丸方
牛膝（酒浸切焙） 芍药 桔梗（炒） 浓朴（去粗皮涂生姜汁炙香熟） 赤茯苓（去
黑皮） 大黄（锉炒） 柴胡（去苗） 诃黎勒皮（各三两） 枳壳*去瓤麸炒一两一分） 陈
橘皮（去白焙） 槟榔（锉各一两）
上一十一味，捣罗为末。炼蜜和丸，如梧桐子大，每服二十丸，空心枣汤下，加至三十
丸，通利为度。
治一切积聚，心腹疼痛，年月深久者，皆治，老少并可服，百当膏方
丹砂（研） 腻粉（研各半两） 水银 铅各（一分二味结成沙子） 牛黄 龙脑（研）
铅霜（研各二钱） 粉霜（研） 阳起石（研各一分） 黄蜡（半两） 巴豆（肥者一百二
十粒去皮心膜研出油取霜用） 蝎梢
上一十三味，合研极匀，熔蜡并熟蜜少许，同和成膏，旋丸如梧桐子大，每服三丸至五
丸。量大小虚实加减服，吐逆藿香汤下，取热积生姜蜜水下，取冷积乳香汤下，风涎薄荷汤
下，便痢米饮下。
论曰凡积气在左胁下，如复杯有头足，名曰肥气，肝之积也，肝藏血，故阴多而阳少，
病为气积，此由肺病传肝，肝传脾，脾以季夏适王而不受，邪气留于肝，故结为积。久不愈，
令人发咳逆 疟，连岁不已，此阴盛阳虚故也。
治久积结癖气不散，左胁下如复杯，咽酸吐水，面目萎黄，此名肥气，并女子血瘕。
根汤方
蓬 根（锉二两） 牡丹皮（锉） 赤芍药（各一两） 桂（去粗皮） 枳壳（去瓤麸
炒各三分） 槟榔（锉）
上九味。粗捣筛，每服三钱匕，水一盏，煎至七分，去滓温服，空心日晚各一服。
治久积肥气，寒热 疟，青蒿汤方
青蒿（自然汁一合） 生姜（自然汁半合） 童子（小便半合） 常山（锉三分） 鳖
甲（去裙 醋炙黄）
上八味，除汁外，粗捣筛，每服五钱匕，水一盏半，煎至八分，入前三味汁各少许。同
煎至一大盏，去滓食后临卧温服。
治肝积肥气，久不已变疟，令人热多寒少，小便赤涩，酸枣仁丸方
酸枣仁（生用） 薏苡仁 紫苏子炒（研） 木通（锉） 黄 （锉） 枳壳（去瓤麸
炒） 升麻 大黄（锉炒）
上一十二味，捣罗为末，炼蜜和丸，如梧桐子大，每服二十丸，渐加至三十丸，煎麦门
冬汤下。
治肝积气，石苇丸方
石苇（拭去毛焙） 京三棱（煨锉） 附子（炮裂去皮脐） 吴茱萸（水洗七遍焙干炒）
陈橘皮（汤浸去
上六味，捣罗为末，炼蜜为丸。如梧桐子大，空腹煎荆芥汤下二十丸。
治肝积肥气，结硬不散，木香丸方
木香 大黄（锉各一两） 鳖甲（去裙 锉二两米醋三升与大黄同煎醋尽为度焙干）
上三味，捣罗为末，酒煮面糊为丸，如梧桐子大，每服二十丸，空心食前生姜汤下。
取上述十二味药，捣碎并过筛成细末，用炼制的蜂蜜调和制成丸剂。大小如梧桐子，每次空腹时温酒送服三十至四十丸，若大便通畅则减少丸数。
治疗症癖积聚的牛膝丸方：
牛膝（酒浸后切片焙干）三两，芍药三两，桔梗（炒制）三两，浓朴（刮去粗皮，涂生姜汁炙至香熟）三两，赤茯苓（去掉黑皮）三两，大黄（锉碎炒制）三两，柴胡（去苗）三两，诃黎勒皮三两，枳壳（去瓤，麸炒）一两一分，陈橘皮（去白瓤焙干）一两，槟榔（锉碎）一两。
以上十一味药，捣碎过筛成细末，用炼蜜调和制成丸剂，大小如梧桐子。每次服用二十丸，空腹时用枣汤送服，可加至三十丸，以大便通畅为度。
治疗各种积聚，心腹疼痛，病程长久者，皆有效，老少均可服用，名为百当膏方：
丹砂（研细）半两，腻粉（研细）半两，水银一分，铅一分（这两味结成沙子状），牛黄二钱，龙脑（研细）二钱，铅霜（研细）二钱，粉霜一分，阳起石（研细）一分，黄蜡半两，巴豆（肥大的一百二十粒，去皮、心、膜，研出油取霜用），蝎梢。
以上十三味药，混合研至极均匀，熔化黄蜡并加入少许熟蜜，一同和匀制成膏状，随即搓成如梧桐子大小的丸剂。每次服用三至五丸，根据患者体型大小及虚实情况加减剂量。呕吐逆气者用藿香汤送服，热积者用生姜蜜水送服，冷积者用乳香汤送服，风涎者用薄荷汤送服，便痢者用米饮送服。
论述说：凡是积气在左胁下，形状像倒扣的杯子，有头有足，名叫“肥气”，这是肝的积病。肝藏血，所以阴多阳少，发病为气积。这是由于肺病传变给肝，肝再传变给脾，脾在季夏时节正当旺相而不受邪，邪气留滞在肝，所以结聚成为积块。久治不愈，使人发生咳嗽气逆、疟疾，连年不断，这是因为阴盛阳虚的缘故。
治疗久积结癖之气不散，左胁下如倒扣之杯，咽中泛酸、吐清水，面目萎黄，这名叫肥气，同时也治疗女子的血瘕。根汤方：
蓬莪术根（锉碎）二两，牡丹皮（锉碎）一两，赤芍药一两，桂枝（刮去粗皮）三分，枳壳（去瓤，麸炒）三分，槟榔（锉碎）。
以上九味药，粗捣筛过，每次服用三钱匕，用水一盏，煎至七分，去渣温服，空腹及晚间各服一次。
治疗久积肥气，寒热交替的疟疾，青蒿汤方：
青蒿（自然汁一合），生姜（自然汁半合），童子小便（半合），常山（锉碎）三分，鳖甲（去裙边，醋炙至黄色）。
以上八味药，除汁液外，其余粗捣筛过，每次服用五钱匕，用水一盏半，煎至八分，加入前三味汁液各少许。同煎至一大盏，去渣，饭后及临睡前温服。
治疗肝积肥气，久治不愈变为疟疾，使人热多寒少，小便赤涩，酸枣仁丸方：
酸枣仁（生用），薏苡仁，紫苏子（炒后研碎），木通（锉碎），黄芪（锉碎），枳壳（去瓤，麸炒），升麻，大黄（锉碎炒制）。
以上十二味药，捣碎过筛成细末，用炼蜜调和制成丸剂，大小如梧桐子。每次服用二十丸，逐渐增加至三十丸，用麦门冬汤煎送。
治疗肝积气，石苇丸方：
石苇（拭去毛后焙干），京三棱（煨后锉碎），附子（炮裂，去皮脐），吴茱萸（水洗七遍，焙干炒制），陈橘皮（汤浸，去白瓤）。
以上六味药，捣碎过筛成细末，用炼蜜制成丸剂。大小如梧桐子，空腹时煎荆芥汤送服二十丸。
治疗肝积肥气，结硬不散，木香丸方：
木香一两，大黄（锉碎）一两，鳖甲（去裙边，锉碎，用二两米醋三升与大黄同煎，待醋尽后焙干）。
以上三味药，捣碎过筛成细末，用酒煮面糊制成丸剂，大小如梧桐子。每次服用二十丸，空腹食前用生姜汤送服。
Take the aforementioned twelve medicinal materials, crush and sieve them into fine powder, mix with refined honey to form pills. Size similar to *Coculus trilobus* seeds (Wutongzi). Take 30–40 pills each time on an empty stomach with warm wine. Reduce the number of pills if bowel movements become unobstructed.
**Niuxi Wan Formula for Treating Zhengxi Accumulation**
* *Achyranthis Bidentatae Radix* (Niuxi) [soaked in wine, sliced, and dried] – 3 liang
* *Paeoniae Radix* (Shaoyao) – 3 liang
* *Platycodonis Radix* (Jiegeng) [stir-fried] – 3 liang
* *Magnoliae Officinalis Cortex* (Noupu) [scraped of rough bark, brushed with fresh ginger juice, stir-fried until fragrant and cooked] – 3 liang
* *Poria Cocos with Red Bark* (Chifuling) [remove black skin] – 3 liang
* *Rhei Radix et Rhizoma* (Dahuang) [cut into pieces and stir-fried] – 3 liang
* *Bupleuri Radix* (Chaihu) [remove seedlings] – 3 liang
* *Terminalia Chebulae Pericarpium* (Helilepi) – 3 liang
* *Aurantii Fructus Immaturus* (Zhike) [remove pith, stir-fried with bran] – 1 liang 1 fen
* *Citri Reticulatae Pericarpium* (Chenjiupi) [remove white pith and dried] – 1 liang
* *Arecae Semen* (Binglang) [cut into pieces] – 1 liang
Process the above eleven medicinal materials: crush and sieve into fine powder. Mix with refined honey to form pills, size similar to *Coculus trilobus* seeds. Take 20 pills each time on an empty stomach with jujube decoction; may increase to 30 pills. Stop or adjust when bowel movements are unobstructed.
**Baidang Gao Formula for Treating All Types of Accumulation, Abdominal Pain, Long-standing Cases**
Suitable for all ages.
* *Cinnabaris* (Dansha) [pulverized] – 0.5 liang
* *Calomelas* (Nifen) [pulverized] – 0.5 liang
* *Hydrargyrum* (Shuiyin) – 1 fen
* *Plumbum* (Qian) – 1 fen (These two react to form sand-like particles)
* *Bovis Calculus* (Niuhuang) – 2 qian
* *Borneolum Syntheticum* (Longnao) [pulverized] – 2 qian
* *Plumbum Subacetatum* (Qianshuang) [pulverized] – 2 qian
* *Calomelas* (Fenshuang) – 1 fen
* *Yangqishi* [pulverized] – 1 fen
* *Cera Flava* (Huangla) – 0.5 liang
* *Crotonis Fructus* (Badou) [Select plump ones, 120 grains; remove shell, core, and membrane; grind to extract oil, use the residue as paste/rub]
* *Scorpio* (Xieshao)
Process the above thirteen medicinal materials: mix and grind extremely uniformly. Melt yellow beeswax and add a small amount of cooked honey, mix thoroughly to form a paste. Shape into pills size similar to *Coculus trilobus* seeds. Take 3–5 pills each time. Adjust dosage based on patient's size and deficiency/excess condition.
* For vomiting/reversal qi: take with *Agastache* decoction.
* For heat accumulation: take with fresh ginger and honey water.
* For cold accumulation: take with *Boswellia* decoction.
* For wind-phlegm: take with mint decoction.
* For dysentery: take with rice drink.
**Discussion:**
When accumulated qi is located under the left hypochondrium, resembling an inverted cup with head and feet, it is named "Feiqi" (Fat Qi), which is an accumulation of the Liver. The Liver stores blood, thus Yin is abundant and Yang is scarce. Pathogenesis involves Qi accumulation. This arises from Lung disease transmitting to the Liver, then to the Spleen. In late summer, the Spleen is in its prosperous phase and does not accept pathogenic factors; thus, pathogenic qi remains in the Liver, knotting to form an accumulation. If prolonged without cure, it causes coughing, counterflow qi, and malaria, persisting year after year. This is due to excess Yin and deficiency of Yang.
**Gen Tang Formula for Treating Long-standing Accumulation, Knotting of Pathogenic Qi, Left Hypochondriac Mass Resembling Inverted Cup, Sour Regurgitation, Vomiting Water, Withered Yellow Complexion (Feiqi), and Female Blood Mass (Xuejia)**
* *Curcumae Radix* (Penggen) [cut into pieces] – 2 liang
* *Moutan Cortex* (Mudanpi) [cut into pieces] – 1 liang
* *Paeoniae Radix Rubra* (Chishaoyao) – 1 liang
* *Cinnamomi Ramulus* (Gui) [scraped of rough bark] – 3 fen
* *Aurantii Fructus Immaturus* (Zhike) [remove pith, stir-fried with bran] – 3 fen
* *Arecae Semen* (Binglang) [cut into pieces]
Process the above nine medicinal materials: coarsely crush and sieve. Take 3 qianbi (approx. 3-4 grams) each time. Add one sheng (approx. 200ml) of water, decoct until 7/10 remains. Strain and take warm. One dose on an empty stomach and one dose in the evening.
**Qinghao Tang Formula for Treating Long-standing Accumulation Feiqi, Alternating Chills and Fever Malaria**
* *Artemisiae Annuae Herba* (Qinghao) [fresh juice, 1 he]
* *Zingiberis Rhizoma Recens* (Shengjiang) [fresh juice, 0.5 he]
* *Pueri Urina* (Tongzi Xiaobian) [half-he]
* *Dichroae Radix* (Changshan) [cut into pieces] – 3 fen
* *Testudinis Carapax et Plastrum* (Biejia) [remove skirt-edge, vinegar-fried until yellow]
Process the above eight medicinal materials: except for the juices, coarsely crush and sieve the solids. Take 5 qianbi each time. Add 1.5 sheng of water, decoct until 8/10 remains. Add small amounts of the three juices mentioned above. Decoct together until one large sheng remains. Strain and take warm after meals and before bedtime.
**Suanzaoren Wan Formula for Treating Liver Accumulation Feiqi, Prolonged Cases Transforming into Malaria, Excessive Heat with Mild Chills, Red and Scanty Urine**
* *Ziziphi Spinosae Semen* (Suanzaoren) [used raw]
* *Coicis Semen* (Yiyiren)
* *Perillae Fructus* (Zisuzi) [stir-fried and ground]
* *Akebiae Caulis* (Mutong) [cut into pieces]
* *Astragali Radix* (Huangqi) [cut into pieces]
* *Aurantii Fructus Immaturus* (Zhike) [remove pith, stir-fried with bran]
* *Cimicifugae Rhizoma* (Shengma)
* *Rhei Radix et Rhizoma* (Dahuang) [cut into pieces and stir-fried]
Process the above twelve medicinal materials: crush and sieve into fine powder. Mix with refined honey to form pills, size similar to *Coculus trilobus* seeds. Take 20 pills each time, gradually increasing to 30 pills. Take with decoction of *Ophiopogonis Radix* (Mendongtang).
**Shiwei Wan Formula for Treating Liver Accumulation Qi**
* *Periplocae Caulis* (Shiwei) [wipe off hairs and dry]
* *Sparganii Rhizoma* (Jingsanleng) [warm-roasted and cut into pieces]
* *Aconiti Lateralis Radix Praeparata* (Fuzi) [pounded/cracked, peel removed, umbilicus removed]
* *Evodiae Fructus* (Wuzhuyu) [wash seven times, dry, stir-fry]
* *Citri Reticulatae Pericarpium* (Chenjiupi) [soak in hot water, remove white pith]
Process the above six medicinal materials: crush and sieve into fine powder. Mix with refined honey to form pills. Size similar to *Coculus trilobus* seeds. Take 20 pills on an empty stomach with decoction of *Schizonepetae Spica* (Jingjie).
**Muxiang Wan Formula for Treating Liver Accumulation Feiqi, Hard Knotting Not Dispersing**
* *Aucklandiae Radix* (Muxiang) – 1 liang
* *Rhei Radix et Rhizoma* (Dahuang) [cut into pieces] – 1 liang
* *Testudinis Carapax et Plastrum* (Biejia) [remove skirt-edge, cut into pieces, decoct with 3 sheng of rice vinegar and Dahuang until vinegar is exhausted, then dry]
Process the above three medicinal materials: crush and sieve into fine powder. Use wine-boiled wheat flour paste to form pills, size similar to *Coculus trilobus* seeds. Take 20 pills each time on an empty stomach before meals with fresh ginger decoction.