谨按∶痞块，多在皮里膜外，并不系于肠胃间。而医者往往以峻剂下之，安能使此块入肠胃，从大便而出
哉？吾见病未必去而元气已耗，经年累月，遂至不治者多矣。历代医家皆曰在左为死血，在右为食积，在中为
痰饮。盖以左属肝，肝藏血，右属脾，脾化谷，而痰饮则结聚于中焦也。殊不知肝脾虽左右之分，而实无界限
之隔，非谓肝偏于左而无与右，脾偏右而无与于左。在左为死血，而在右独无死血乎？在中为痰饮，而左、右
独无痰饮乎？但在左、在右、在中，皆因虚之所在而入之耳，不可以死血、痰饮、食积分之也。或先有死血，
继以食积、痰饮；或先有食积，继以死血、痰饮，相裹而成者；或单是痰饮、单是食积、单是死血，久不愈，
遂为坚块。治之惟消坚破结为主，然当诊之以察其病。弦滑为痰，芤涩为血，沉实为食，三脉并见，则当兼治。
若夫女人积块，多是血结，治女病者，以调血为主。盖月事正临，适感寒气，寒客子门，血凝不行，日积月累
而成块，多在少腹间，发则上攻，痛楚万倍，面色不泽，是不在皮里膜外矣。小则下之，大则消之。至于食积，
乃是胃家所受，亦岂在皮里膜外耶？审其病，的是食积，或下、或消，随其所用而不
可泥也。又有停饮者，按之若有形，与积块相似，但不坚实耳。然求其因，悉是平日喜饮茶水，或恣食生冷所
至。脾家受寒，不能运化，又为火郁，化为清痰，停积日久，隐隐作痛。停于上焦，则吞酸饱闷；停于中焦，
则中脘膨胀；停于下焦，则少腹满急；停于两胁空隙处，则洒洒有声，时升时降。或涌之，或下之，随其所在
而施之可也。
仙传化痞丸
（一只，用白水煮烂，加酒半斤，阿魏五钱，再煮一滚，捞起，系肉炙干，骨头打碎，炒脆，捣为
末入） 五色糖阿魏（二两二钱，另烊入药） 水红花子（十两） 神曲（一两六钱） 白术 当归 陈皮
（各一两二钱） 急性子 芦荟（各七钱） 蓬术（六钱） 青皮（五钱） 甘草（四钱） 枳
壳雄黄（各五钱）
上为末，将 汁为丸，如梧子大，每服二钱五分。服药后，病在左睡朝左，病在右睡朝右。
薛氏阿魏膏
羌活 独活 赤芍 穿山甲 玄参 官桂 生地 两头尖 大黄 白芷 天麻（各五钱） 木鳖子（十
枚，去壳） 红花（四钱） 乱发（一团） 槐、柳、桃枝（各三钱）
上，用香油二斤四两，煎黑去渣，入发煎化，仍去渣，徐下黄丹十两，煎软硬得中，入芒硝、阿魏、苏合
香油、乳香、没药各五钱，麝香三钱调匀，即成膏矣。将帛绢摊贴患处，内服丸药。黄丹须用山东者效。
凡贴膏药，先用朴硝随患处铺半指浓，以纸覆上，用热熨斗熨良久，如硝耗，再加，熨之，二时许方贴膏药。
谨按：痞块，多位于皮肤与肌肉之间的膜外，并不附着于肠胃之间。然而医生们往往使用猛烈的泻药来攻下它，这怎么能使这些痞块进入肠胃，并从大便排出呢？我见到病情未必消除而元气已经耗损，经过长年累月，最终导致无法治愈的情况很多了。历代医家都说左侧为死血（瘀血），右侧为食积，中间为痰饮。这是因为左侧属肝，肝主藏血；右侧属脾，脾主运化水谷；而痰饮则结聚在中焦。殊不知肝和脾虽然分左右，但实际上并没有界限的阻隔，并不是说肝只偏在左边而与右边无关，脾只偏在右边而与左边无关。左侧有死血，难道右侧就没有死血吗？中间有痰饮，难道左侧和右侧就没有痰饮吗？只是在左、在右、在中，都是因为正气虚弱之处邪气才得以侵入罢了，不能简单地用死血、痰饮、食积来划分。或者先有死血，随后又有食积、痰饮；或者先有食积，随后又有死血、痰饮，相互裹结而成的；或者是单纯的痰饮、单纯的食积、单纯的死血，日久不愈，遂成为坚硬的痞块。治疗时以消坚破结为主，但应当通过诊脉来观察其病机。脉弦滑提示为痰，脉芤涩提示为血瘀，脉沉实提示为食积，如果三脉并见，则应当兼顾治疗。至于妇女的积块，多是血结所致，治疗女性疾病，应以调血为主。例如月经正来时，恰好感受寒气，寒邪客居于子宫，血液凝滞不行，日积月累而形成痞块，多在少腹部，发作时向上攻冲，疼痛剧烈百倍，面色无光泽，这种情况就不在皮里膜外了。小的痞块用泻法，大的痞块用消散法。至于食积，乃是胃所受纳的食物停滞，又怎会在皮里膜外呢？仔细审察病情，确是食积，或采用泻下法，或采用消散法，根据具体情况施用，不可拘泥。又有停饮者，按压时似乎有形，与积块相似，但不坚实罢了。然而探究其原因，都是平日喜欢喝茶水，或恣意食用生冷食物所致。脾胃受寒，不能运化，又被火郁所困，化为清稀之痰，停积日久，隐隐作痛。停在上焦，则吞酸饱闷；停在中焦，则中脘部膨胀；停在下焦，则少腹部满急；停在两胁空隙处，则身体洒洒有声，气机时升时降。或用涌吐法，或用泻下法，根据其所在部位施治即可。
仙传化痞丸
（一只，用白水煮烂，加酒半斤，阿魏五钱，再煮一滚，捞起，系肉炙干，骨头打碎，炒脆，捣为末入） 五色糖阿魏（二两二钱，另烊入药） 水红花子（十两） 神曲（一两六钱） 白术 当归 陈皮（各一两二钱） 急性子 芦荟（各七钱） 蓬术（六钱） 青皮（五钱） 甘草（四钱） 枳壳雄黄（各五钱）
上为末，将[肉汁]为丸，如梧子大，每服二钱五分。服药后，病在左睡朝左，病在右睡朝右。
薛氏阿魏膏
羌活 独活 赤芍 穿山甲 玄参 官桂 生地 两头尖 大黄 白芷 天麻（各五钱） 木鳖子（十枚，去壳） 红花（四钱） 乱发（一团） 槐、柳、桃枝（各三钱）
上，用香油二斤四两，煎黑去渣，入发煎化，仍去渣，徐下黄丹十两，煎软硬得中，入芒硝、阿魏、苏合香油、乳香、没药各五钱，麝香三钱调匀，即成膏矣。将帛绢摊贴患处，内服丸药。黄丹须用山东者效。凡贴膏药，先用朴硝随患处铺半指浓，以纸覆上，用热熨斗熨良久，如硝耗，再加，熨之，二时许方贴膏药。
According to careful analysis: Pi-blocks (masses in the epigastrium or hypochondrium) are mostly located outside the membranes between the skin and muscles, and are not attached to the intestines and stomach. However, physicians often use harsh purgatives to attack them. How can this cause such masses to enter the intestines and stomach and be expelled through the stool? I have seen many cases where the disease was not eliminated but the Yuan Qi (Original Qi) was already depleted, leading to incurable conditions after years of accumulation. Physicians of past dynasties all stated that masses on the left are due to Si Xue (Dead Blood/Stasis), those on the right are due to Shi Ji (Food Stagnation), and those in the middle are due to Tan Yin (Phlegm-Fluid). This is because the left belongs to the Liver, which stores blood; the right belongs to the Spleen, which transforms grains; and Phlegm-Fluid accumulates in the Middle Jiao (Middle Burner). Little do they know that although the Liver and Spleen are divided into left and right, there is actually no boundary separating them. It does not mean that the Liver is only on the left and has nothing to do with the right, nor that the Spleen is only on the right and has nothing to do with the left. If there is Dead Blood on the left, why would there be none on the right? If there is Phlegm-Fluid in the middle, why would there be none on the left and right? In fact, whether on the left, right, or in the middle, these masses arise because pathogens invade areas where Qi Deficiency exists. They cannot be simply categorized as Dead Blood, Phlegm-Fluid, or Food Stagnation. Sometimes, Dead Blood occurs first, followed by Food Stagnation and Phlegm-Fluid; or Food Stagnation occurs first, followed by Dead Blood and Phlegm-Fluid, wrapping around each other to form a mass; or it is merely Phlegm-Fluid, Food Stagnation, or Dead Blood alone, which persists for a long time without healing, eventually becoming a hard mass. Treatment should focus mainly on dissolving hardness and breaking up knots, but one must diagnose via pulse taking to observe the pathology. A Xuan Hua (Wiry and Slippery) pulse indicates Phlegm; a Kou Se (Hollow and Choppy) pulse indicates Blood stasis; a Chen Shi (Deep and Excess) pulse indicates Food stagnation. If all three pulses appear together, treatment should address all factors. As for women's abdominal masses, they are mostly caused by Blood Knotting. When treating female diseases, regulating Blood should be the primary approach. For example, if a woman contracts Cold Evil during her menstruation, the Cold lodges in the Zi Men (Cervix/Uterus), causing Blood to coagulate and fail to flow. Over days and months, a mass forms, mostly in the Shao Fu (Lower Abdomen). When it attacks upward, the pain is ten thousand times more severe, and the complexion lacks luster. Such cases are not located outside the membranes between skin and muscle. Small masses are treated with purgation, large masses with resolution. As for Food Stagnation, it results from food retained in the Wei (Stomach); how could it be located outside the membranes between skin and muscle? Carefully examine the condition; if it is indeed Food Stagnation, use either purgation or resolution according to the situation, without being dogmatic. There are also cases of Ting Yin (Retained Fluids), which feel shaped upon palpation, similar to masses, but are not firm. Investigating the cause, these are often due to a habit of drinking tea or consuming excessive cold and raw foods. The Pi (Spleen) suffers from Cold and fails to transform and transport, while being constrained by Fire Depression, transforming into clear Phlegm. After long retention, dull pain occurs. If retained in the Shang Jiao (Upper Burner), it causes acid regurgitation and fullness; if in the Zhong Jiao (Middle Burner), it causes distension in the Zhong Wan area; if in the Xia Jiao (Lower Burner), it causes fullness and urgency in the lower abdomen; if in the empty spaces of the two hypochondria, it produces rustling sounds and fluctuating Qi movement. One may use emesis or purgation depending on its location.
Xian Chuan Hua Pi Wan (Immortal Transmission Pill for Dissolving Masses)
(One [animal part], boiled until soft in white water, add half jin of Wine, five qian of Elaeocarpi Fructus (Awei), boil once again, remove, roast the meat until dry, crush the bones, stir-fry until crisp, and grind into powder to add) Wuse Tang Elaeocarpi Fructus (two liang two qian, melt separately and add to medicine) Polygoni Multiflori Caulis (Shuihong Huazi) (ten liang) Ziziphi Jujubae Fructus Fermentatum (Shenqu) (one liang six qian) Atractylodis Macrocephalae Rhizoma (Baizhu) Angelicae Sinensis Radix (Danggui) Citri Reticulatae Pericarpium (Chenpi) (each one liang two qian) Impatiens Balfourii Semen (Jixingzi) Aloe (Luhui) (each seven qian) Curcuma Longa Rhizoma (Pengzhu) Citri Aurantii Fructus Immaturus (Qingpi) (five qian) Glycyrrhizae Radix et Rhizoma (Gancao) (four qian) Aurantii Fructus Immaturus (Zhiqiao) Realgar (Xionghuang) (each five qian)
Grind all into powder, use [meat juice] to make pills the size of wu zi (Chinese apricot seeds). Take two qian five fen per dose. After taking the medicine, if the disease is on the left, sleep on the left side; if on the right, sleep on the right side.
Xue Shi Awei Gao (Dr. Xue's Elaeocarpi Fractus Plaster)
Notopterygii Rhizoma et Radix (Qianghuo) Angelicae Pubescentis Radix (Duhuo) Paeoniae Radix Rubra (Chishao) Manis Squama (Chuanshanjia) Scrophulariae Radix (Xuanshen) Cinnamomi Ramulus (Guangui) Rehmanniae Radix (Shengdi) Bupleuri Radix (Liangerjian - *Note: Likely refers to specific local herb or typo for Bupleurum/other, keeping literal*) Magnoliae Flos (Baizhi) Gastrodiae Rhizoma (Tianma) (each five qian) Momordicae Semen (Mubiezi) (ten pieces, remove shell) Carthami Flos (Honghua) (four qian) Capillus Humanus (Luancha) (one ball) Branches of Sophora, Willow, and Peach (Huai, Liu, Tao Zhi) (each three qian)
Take two jin four liang of Sesame Oil, fry until black, strain off dregs, add hair and fry until dissolved, strain off dregs again, slowly add ten liang of Minium (Huandan), fry until consistency is medium, add five qian each of Mirabilitum (Mangxiao), Elaeocarpi Fructus (Awei), Styrax Oil (Suhe Xiangyou), Boswelliae Resina (Ruxiang), and Commiphora Resina (Moyao), and three qian of Moschus (Shexiang), mix evenly, and the plaster is formed. Spread on silk cloth and apply to the affected area, while internally taking the pills. Huandan from Shandong is effective. Whenever applying plaster, first spread Puxiao (Mirabilitum) half a finger thick over the affected area, cover with paper, and iron with a hot ironing tool for a long time. If the salt diminishes, add more, continue ironing for about two hours before applying the plaster.