（附虫积）
〔总论〕 丹溪论积聚症瘕不一。积者停蓄之总名也。宜以在中在左在右分治。凡块乃
有形之物。气不能成形。痰与食积死血而已。在中为痰饮。在右为食积。在左为死血。大法
盐以软之。坚则削之。行气开痰为主。久痞及老年者。大约不宜妄动。虚损人亦不宜乱治。
而孕妇尤不宜治痞。恐伤其胎也。慎之慎之。有此症者。大宜戒气恼。及冷物发气等项。不
然。恐再发难治。（积聚之脉。实强可生。沉细难愈。）
〔治痞积方〕 不拘何膏药二张。以一张揭开。用白信五分。研细糁之。（小儿只用三
分。）再以一张粘贴。将背面贴患处。以布包好。数日痞化。治皮里膜外者效尤速。如贴膏
药后。腹中胀闷。乃痞积将散。须服枳壳。（八分）大腹皮。（盐水洗一钱）苏梗。（八分）
浓朴。（一钱二分）青皮。莪术。（各八分）山楂。（二钱）乌药。（六分）香附。（一钱五分）
缩砂。（五分）广木香。（三分）水二碗煎六分。空心服。三四剂愈。
〔痞块熨法〕 葱白同蜜二味捣烂。浓涂患处上。以布盖。用熨斗微火熨之。痞即消。
愈后宜服四物汤。（方见中风门以养气血。）
〔消痞膏〕 大黄。朴硝。（各一两）独部蒜。（七枚）同捣烂贴患处即消。 水红花。
（无
花。用子捣取汁。） 每汁一碗。水三碗。桑柴火熬成膏。量痞之大小。用纸摊贴以好为度。
仍将膏用酒调服。忌荤腥油腻。 独部蒜。穿山甲。真蕲艾等分。将穿山甲洗净。瓦上 过
成炭研细。又将艾拌匀。同蒜捣烂贴患处。（照痞大小药味量加。） 候线香一炷为度。
〔腹中痞积〕 观音柳。（即垂丝柳。）煎汤露一夜。五更空心饮数次。痞自消。 如已
成痞块。猪腰子两个切薄片。用木鳖子肉一两。与猪腰子相间缚定。外用湿纸包。火煨熟。
捣如泥。加黄连三钱。研末为丸。桐子大。初服二十丸。乌梅甘草汤下。第二服加五丸。渐
加至以痛为度。块从大便中出。神效。 凡服利药。或外治消痞之后。宜服人参。（一钱）
熟地。当归。（各二三钱）白术。（炒一钱半）炙甘草。（一钱）水煎。食远服。五七剂后不
再发。
〔诸物食积久不愈〕 海蜇。（一斤）水煮化。加白荠四十九个同煮收干。每早晚空心
吃五七枚。以好为度。 如食积作痛。白术。（炒焦）茯苓。制半夏。（各一两）萝卜子。（二
钱）
山楂肉。（一两五钱）陈皮。（五钱）炼蜜丸如弹子大。空心米汤下一丸即止。 如已成痞块
胀
痛。野芋头。（一名仙人掌。同野芋一种。但此种叶较小。略似慈菇。叶有尖。）磨烂和糯米
粉淡煮粥。每早食一茶钟。不用油盐。十服之后。其积自消。甚效无害。
〔食积成痞〕木贼草为末。每服三五分。白汤空心服即消。年远不过两服。
〔痰积成痞〕瓦棱子。（火 。醋淬三次研细。）醋糊为丸。桐子大。每服三四十丸。淡
醋汤下。
〔气滞似痞〕 胡桃肉每两加明矾末三钱。同捣为丸。桐子大。每服三五十丸。好酒下。
〔鱼 生 积〕 生鱼多食不化。即成瘕症。马鞭草捣汁饮之即消。 生姜汁点汤服。
或橄榄煎浓汁服皆效。
〔诸虫积〕 痛时口中清涎流出。汤饮不能进。用乌梅。花椒。生姜片煎汤服止痛。 于
月之初一至初五六虫头向上。用芦荟。（二钱）史君子肉。擂丸。（各四钱）苦楝根。（向东
不出土者佳。去皮及骨一两半。）白芜荑仁。（炒）鹤虱草。槟榔。（各五钱）俱研末。砂糖
为丸。
（附：虫积）
〔总论〕 朱丹溪论述积聚、症瘕等病证种类繁多。所谓“积”，是体内邪气停聚蓄结的总称。治疗时应根据病位在中焦、左侧或右侧分别施治。凡是形成的肿块，都是有形的病理产物；而单纯的“气”无法形成有形之物，只有痰饮、食积和瘀血才能形成肿块。位于中部的多为痰饮；位于右侧的多为食积；位于左侧的多为瘀血。基本治疗原则是：用咸味药物软化坚块，对坚硬者予以消削，以行气化痰为主要治法。对于病程长久或老年患者，大致不宜轻易妄动攻伐。身体虚弱亏损的人也不宜胡乱治疗，而孕妇尤其不宜治疗痞积，恐怕会损伤胎儿。务必谨慎再谨慎。患有此类病症的人，非常应当戒除恼怒情绪，以及生冷食物、易致气机逆乱的食物等，否则，恐怕病情复发后难以治愈。（积聚病的脉象，若实大有力则预后较好可生，若沉细无力则难愈。）
〔治疗痞积的方药〕 不拘泥于使用何种膏药两张，将其中一张揭开，取白信（砒霜制剂）五分，研成细末撒在膏药上。（小儿仅用三分。）再将另一张膏药粘贴覆盖在上面，将背面贴在患处，用布包裹固定。数日后痞积即可化解，治疗皮里膜外（皮下组织间隙）的病证效果尤其迅速。如果贴敷膏药后，腹中出现胀闷感，这是痞积即将消散的表现，此时需要服用枳壳（八分）、大腹皮（盐水洗一钱）、苏梗（八分）、厚朴（一钱二分）、青皮、莪术（各八分）、山楂（二钱）、乌药（六分）、香附（一钱五分）、缩砂仁（五分）、广木香（三分）。加水两碗煎至六分量的药液，空腹服用。三四剂后即可痊愈。
〔痞块熨烫疗法〕 将葱白与蜂蜜两味药材捣烂，浓稠地涂抹在患处上，盖上布，用熨斗微火熨烫。痞块随即消除。痊愈后宜服用四物汤（方见中风门，用以滋养气血）。
〔消痞膏〕 大黄、朴硝（各一两）、独头蒜（七枚），一同捣烂贴敷于患处，痞块即消。水红花（若无全草，可用种子捣取汁液），每取汁液一碗，加水三碗，用桑柴火熬制成膏。根据痞块的大小，用纸摊开贴敷，以痊愈为度。之后仍将此膏用药酒调匀内服。忌食荤腥油腻食物。另法：独头蒜、穿山甲、真蕲艾各等分，将穿山甲洗净，在瓦片上焙烧成炭后研细，又将艾叶拌匀，同蒜一起捣烂贴敷于患处。（根据痞块大小酌情增加药量。）候燃尽一炷线香的时间为度。
〔腹中痞积〕 观音柳（即垂丝柳），煎汤露置一夜，五更天时空腹饮用数次，痞积自然消除。如果已经形成痞块，取猪腰子两个切成薄片，用木鳖子肉一两，与猪腰子相间排列并用线缚定，外用湿纸包裹，用火煨熟，捣成泥状，加入黄连三钱，研末制成丸药，如梧桐子大。初次服用二十丸，用乌梅甘草汤送下；第二次服用加五丸，逐渐增加剂量，以疼痛缓解为度。痞块随大便排出，神效。凡服用通利药物，或经过外治法消除痞积之后，宜服用人参（一钱）、熟地黄、当归（各二三钱）、白术（炒一钱半）、炙甘草（一钱），水煎，饭后较远时服用。五到七剂后不再复发。
〔各种食物积滞日久不愈〕 海蜇（一斤），水煮化开，加入白荠菜四十九个同煮至收干水分。每早晚空腹吃五到七枚，以痊愈为度。如果因食积引起疼痛，用白术（炒焦）、茯苓、制半夏（各一两）、萝卜子（二钱）、山楂肉（一两五钱）、陈皮（五钱），炼蜜制成如弹子大的丸药，空腹时米汤送下一丸即可止痛。如果已经形成痞块且胀痛，取野芋头（一名仙人掌，与野芋同属一种，但这种叶子较小，略似慈菇，叶尖有刺），磨烂后和糯米粉淡煮粥，每天早晨吃一茶钟，不用油盐。十服之后，积滞自消，甚效且无害。
〔食积形成痞块〕 木贼草研为粉末，每次服用三五分，用白开水空腹送服即消。年代久远的积滞不过两服即可。
〔痰积形成痞块〕 瓦楞子（火烧红后醋淬三次，研细），用醋糊制成丸药，如梧桐子大。每次服用三四十丸，用淡醋汤送下。
〔气滞类似痞块〕 胡桃肉每两加入明矾末三钱，一同捣碎制成丸药，如梧桐子大。每次服用三五十丸，用好酒送下。
〔鱼生积〕 生鱼多食不消化，即形成瘕症。马鞭草捣汁饮用即消。生姜汁点入汤中服用，或者橄榄煎浓汁服用皆有效。
〔各种虫积〕 疼痛时口中流出清稀涎沫，汤水饮食不能进。用乌梅、花椒、生姜片煎汤服用以止痛。在农历初一至初五六期间，虫头向上，用芦荟（二钱）、使君子肉、雷丸（各四钱）、苦楝根（向东生长未出土者佳，去皮及骨一两半）、白芜荑仁（炒）、鹤虱草、槟榔（各五钱），全部研为粉末，用砂糖制成丸药。
(Attached: Worm Accumulation)
[General Discussion] Zhu Danxi discussed that diseases such as accumulation (Ji), mass (Zhi), and tumor (Jia) vary in type. "Accumulation" is the general term for the stagnation and storage of pathogenic factors within the body. Treatment should be differentiated based on whether the lesion is located in the center, left, or right. Any formed lump is a tangible pathological entity; Qi alone cannot form a tangible shape, only Phlegm-Fluids, Food Stagnation, and Dead Blood can form lumps. Located in the center, it is Phlegm-Fluids; located on the right, it is Food Stagnation; located on the left, it is Dead Blood (Blood Stasis). The general principle is to use salty substances to soften hardness, reduce firm masses, and prioritize moving Qi and resolving Phlegm. For long-standing cases or elderly patients, aggressive treatment should generally be avoided. Patients with deficiency and damage should not be treated recklessly, and pregnant women especially should not be treated for Pi accumulation, lest the fetus be harmed. Be extremely cautious. Those with these symptoms must avoid anger and irritability, as well as cold foods and other items that provoke Qi rebellion; otherwise, recurrence may be difficult to treat. (The pulse of accumulation: if solid and strong, survival is possible; if deep and fine, recovery is difficult.)
[Prescription for Treating Pi Accumulation] Use any two sheets of medicated plaster. Remove one sheet, take Bixin (Arsenic preparation) 5 fen, grind into fine powder, and sprinkle it on the plaster. (For children, use only 3 fen.) Paste the second sheet over it, place the adhesive side on the affected area, and wrap securely with cloth. After several days, the Pi will dissolve; this method is particularly effective for lesions in the subcutaneous tissue. If abdominal distension and fullness occur after applying the plaster, it indicates that the accumulation is about to disperse. At this point, administer Zhiqiao (Immature Bitter Orange) 8 fen, Dafupi (Areca Peel) 1 qian (washed with salt water), Sugen (Perilla Stem) 8 fen, Houpo (Magnolia Bark) 1 qian 2 fen, Qingpi (Aged Tangerine Peel), Ezhu (Curcuma Rhizome) (each 8 fen), Shanzha (Hawthorn Fruit) 2 qian, Wuyao (Lindera Root) 6 fen, Xiangfu (Cyperus Rhizome) 1 qian 5 fen, Suosha (Amomum Fruit) 5 fen, Guangmuxiang (Costus Root) 3 fen. Decoct in two bowls of water until six fen remains. Take on an empty stomach. Cure in three to four doses.
[Ironing Method for Pi Masses] Mash Scallion White and Honey together, apply thickly to the affected area, cover with cloth, and iron with a hot ironer using low heat. The Pi will immediately dissipate. After recovery, it is advisable to take Siwu Tang (Four Substances Decoction) (see Stroke Section for formula) to nourish Qi and Blood.
[Pi-Dissolving Plaster] Dahuang (Rhubarb Rhizome), Puxiao (Mirabilite) (each 1 liang), Dutou Suan (Single Clove Garlic) (7 cloves). Mash together and apply to the affected area; the Pi will disappear. Shuihonghua (Polygonum Ayapifolium Herb): if unavailable, use seeds and crush to extract juice. Take one bowl of juice, add three bowls of water, and simmer over mulberry wood fire until it forms a paste. Spread on paper according to the size of the Pi and apply externally until healed. Subsequently, mix the remaining paste with wine and ingest orally. Avoid greasy and pungent foods. Alternative method: Dutou Suan, Chuanshanjia (Pangolin Scale), Zhen Qiai (Mugwort Leaf) in equal proportions. Wash Chuanshanjia thoroughly, roast on a tile until charred, and grind into fine powder. Mix with Mugwort, then mash together with garlic and apply to the affected area (adjust dosage according to Pi size). Leave on for the duration of one incense stick.
[Abdominal Pi Accumulation] Guanyin Liu (Weeping Willow), decoct and leave exposed overnight. Drink several times on an empty stomach at dawn (Wu Geng); the Pi will naturally dissipate. If a Pi mass has already formed, take two pig kidneys, slice thinly. Take 1 liang of Mubiezi (Momordica Seed) flesh, layer it with the kidney slices, tie them together, wrap in wet paper, and bake in fire until cooked. Mash into a paste, add Huanglian (Coptis Rhizome) 3 qian, grind into powder, and make pills the size of wutong seeds. Initial dose: 20 pills, taken with Wu Mei Gancao Tang (Smoked Plum and Licorice Decoction). Second dose: increase by 5 pills. Gradually increase until pain subsides. The mass will pass out through the stool. This is miraculous. After taking purgatives or external treatments to resolve Pi, it is advisable to take Renshen (Ginseng Radix) 1 qian, Shudi (Prepared Rehmannia Root) and Danggui (Angelica Sinensis Root) (each 2-3 qian), Baizhu (Atractylodes Macrocephala Rhizome, stir-fried) 1 qian 5 fen, Zhigancao (Honey-fried Licorice Root) 1 qian. Decoct in water and take well after meals. After five to seven doses, it will not recur.
[Long-standing Food Stagnation from Various Foods] Hai Zhe (Sea Cucumber Jellyfish), boil until dissolved. Add 49 Baiqi (White Shepherd's Purse) and cook until dry. Eat 5-7 pieces on an empty stomach morning and evening, until cured. If food stagnation causes pain, use Baizhu (stir-fried until scorched), Fuling (Poria), Banxia (Pinellia Tuber, processed) (each 1 liang), Luobozi (Radish Seed) 2 qian, Shan Zha Rou (Hawthorn Flesh) 1 qian 5 fen, Chenpi (Tangerine Peel) 5 qian. Make pills with refined honey the size of a bullet. Take one pill on an empty stomach with rice gruel to stop pain immediately. If a Pi mass has formed causing distension and pain, take Ye Yutou (Wild Taro, also known as Xian Zhang Cao, similar to wild taro but with smaller leaves resembling arrowhead and pointed tips). Grind into a paste, mix with glutinous rice flour, and cook into a thin porridge without oil or salt. Eat one tea cup every morning. After ten doses, the accumulation will naturally dissipate. It is very effective and harmless.
[Food Stagnation Forming Pi] Mu Zei (Equisetum Hiemale) herb, grind into powder. Take 3-5 fen each time with plain water on an empty stomach; it will dissipate. For old cases, no more than two doses are needed.
[Phlegm Accumulation Forming Pi] Walengzi (Arca Shell), roast red, quench in vinegar three times, and grind finely. Make pills with vinegar paste the size of wutong seeds. Take 30-40 pills each time with light vinegar water.
[Qi Stagnation Mimicking Pi] Hutaoren (Walnut Kernel), add 3 qian of Mingfan (Alum) powder per liang. Mash together and make pills the size of wutong seeds. Take 30-50 pills each time with good wine.
[Fish Raw Accumulation] Excessive consumption of raw fish leads to indigestion and forms Jia syndrome. Mash Biancao (Verbena Officinalis Herb) and drink the juice; it will dissipate. Alternatively, add fresh ginger juice to soup or drink concentrated olive decoction; both are effective.
[Various Worm Accumulations] During pain, clear saliva flows from the mouth, and fluids cannot be ingested. Use Wumei (Smoked Plum), Huajiao (Sichuan Pepper), and Shengjiang (Fresh Ginger slices) to decoct and drink to relieve pain. On the first day of the lunar month up to the sixth, when worm heads face upward, use Lushen (Aloe) 2 qian, Shijunzi Rou (Buckeye Seed Flesh), Le Wan (Vernonia Fruit) (each 4 qian), Kuligen (Toona Root Bark, preferably east-facing and unrooted, peeled and de-boned) 1 lian 5 qian, Bai Wuyi Ren (Chenopodium Seed, stir-fried), Leshe Cao (Dysphania Herb), Binglang (Betel Nut) (each 5 qian). Grind all into powder and make pills with brown sugar.