（附 癖）
陈自明治昆陵一贵宦妻，患小便不通，脐腹胀痛不可忍。众医皆作淋治，如八正散之类，俱不得通。陈诊
之曰∶此血瘕也，非瞑眩药不可去。与桃仁煎，更初服，至日午，大痛不可忍，遂卧。少顷，下血块如拳者数
枚，小便如黑豆汁一二升，痛止得愈。此药治病的切，然猛烈大峻，气虚血弱者，宜斟酌之。桃仁、大黄、朴
硝各一两，虻虫半两炒黑，共为末，醋炼丸梧桐子大。五更初，温酒吞下五丸。（原注∶此方不可妄用。《良方》。）
杜壬治马氏妇，年三十二，腹中血块作疼，经五六年，形已骨立，众皆曰不可为，奈其未死何。家甚贫，
而大小悯之。一日召杜至，告杜曰∶但以济物为怀则可，业已请召明医，非所言也。遂以少物帛赠杜。杜不
受，曰∶但服某药必获安。无以是为疑，遂示方。用没药、牛膝、干漆、当归各半两， 砂、木香、水蛭炒、
红娘子炒、红花、丹皮、朱砂各一分，海马一个，斑蝥去翅足炒十四个，为末，酒醋各半升熬为膏。每日天明
用一皂子大，酒醋化下，一月病退，六十日渐安。（此药较桃仁汤更峻，宜斟酌用之。）
陈藏器曰∶昔有患 癖者，梦人教每日食大蒜三颗，初食遂致瞑眩吐逆，下部如火。后有人教取数瓣，合
皮截却两头吞之，名曰内炙，果获大效。（《本草纲目》∶张景岳治面停小肠右角，与此意同。）
张子和治汴梁曹大使女，年既笄，病血瘕数年。太医宜企贤以破血等药治之不愈。企贤曰∶除得陈州张戴
人方愈。一曰，戴人至汴京，曹乃邀问焉。戴人曰∶小肠移热于大肠为伏瘕，故结硬如块，面黄不食。乃用涌
泄之法，数年之疾，不再旬而愈。
柴屿青乾隆己未寓沈阳京兆署，兵房吏王某患症疾，教以蒸脐法治之，兼服加减五积散而愈。其妻母同患
是症，王即照方遗之，亦痊。
孙文垣治汪氏妇，经水久不止，内有紫黑色血块，胃胸腹皆痛，玉户且肿，手足皆冷，不知饥饿，腹下有
一块，坚如石，脉左数，右沉涩，此血瘕症也。用糖球子五钱，元胡索、五灵脂、香附、麦芽、青皮各一钱，水
煎服，痛减半，手足渐温。加当归、丹皮、蒲黄、益母、川芎，四帖痛止，玉户亦消。又四帖而经水调。（方甚平稳。）
张子和治一童子，入门状如鞠躬而行。张曰∶此 气也。令解衣揣之，二道如臂，其家求疗。先刺其左，
如刺重纸，剥然有声，而令按摩之，立软，其右亦然。观者嗟异，或问之。曰∶石关穴也。
永康应童婴腹疾，恒病 行，久不伸，松阳周汉卿解裳视之，气冲起腹间者二，其大如臂。汉卿刺其一，
魄然鸣，又刺其一，亦如之。稍按摩之，气血尽解，平趋无留行。（《续大粹》。）
武叔卿曰∶夫 癖 瘕，血气块硬，发歇刺痛，甚则欲死，究而言之，皆血之所为。
陈良甫常治一妇人，血气刺痛，极不可忍，甚而死一二日方省。医巫并治，数年不愈。仆以葱白散，乌鸡丸遂安。
陈良甫治一妇人，血气作楚，如一小盘样，走注刺痛，要一人扶定，方少止，亦用此一二药而愈。寻常小
小血气，用此二药，亦有奇效。（《济阴纲目》。）
陈良甫治妇人病，血气作楚，痛不可忍，服诸药无效。召诊之，曰∶关脉弱沉，而肝脉沉紧，此血气渐成
癖也。亦只以前二方治之而愈。又四明马朝奉后院，亦病此，用二方治之亦愈。（同上。）
宋孝武路太后病，众医不识，徐文伯诊之曰∶此石博小腹耳，乃为水济消石汤病即愈。（《南史》。）
董含外家腹内生一痞，始如弹丸，五六年后，大类鹅卵，中似有一窟，往来移动，或痛或止，百药罔效。久
之遍体发肿，内作水声，日夕呻吟，死而复苏者再，诸医束手无策，皆云∶此名水鼓，病已成，不可复痊矣。
章文学旭，字东生，名医也，善治奇疾。往邀之，曰∶此非水症，乃积聚所致，不半日可愈。但所用药猛烈，
转斗而下，驱水甚疾，试问疾人愿服与否？而病者曰∶我已垂殆，苟一钱可救，死无憾也。于是取红丸十粒，
如绿豆大，以槟榔、枳实等五六味煎汤下之。初觉喉中响声可畏，势将不支。顷之，胸膈间如刀刃乱刺，哀号
转掷，痛不可状。又顷之，下水斗许，头面肿退，不超时又下数升，腹背亦退。病患曰∶我今觉胸背顿宽，遂
熟睡片刻。时章君犹在坐也，曰∶此番不独水去，痞亦当渐散矣。进补剂二日，明后日可连服之，遂辞去。至
晚又下水四五升，手足肿全退，不三日病全愈。既而忽痞势摇动，下红黑痢三昼夜，痞亦不见。众医惊服，往
叩其故。章曰∶此名肠覃，在《内经》水胀论中，君辈自坐不读书耳。皆惭而退。按歧伯曰∶寒气客于肠外，
与胃气相搏，癖而内着， 肉乃生，始如鸡卵，至其成，若怀子之状，按之则坚，推之则移，月事以时下，肠
覃生于肠外故也。又有一种名石瘕，病状相同，月事不以时下，石瘕生于胞中故也。皆妇人之病，因有积聚，
可导而下，似水胀而非水胀也。（临症之工，大宜分别。）此疾若非章君，久作泉下之鬼矣。（今人能感激如
是者鲜矣。《三冈识略》。）
一男子肠鸣食少，脐下有块耕动，若得下气多乃已，已而复鸣，屡用疏气降火药，半年不愈。乃以理中汤
为君，佐芩、连、枳实，一服肠鸣止。又每服吞浓朴红豆蔻丸，其气耕亦平矣。
薛立斋治一妇人，经不调，两拗肿胀，小便涩滞，腹中一块作痛，或上攻胁腹，或下攻小腹，发热，晡热
恶寒，肌肤消瘦，饮食无味，殊类瘵症，久而不愈。此肝脾血气亏损，用八珍汤、逍遥散、归脾汤，随症互服而愈。
一妇人性多郁怒，勤于女工，小腹内结一块，或作痛，或痞闷，月经不调。恪服伐脾之剂，（今人受此
害者尤多。）内热寒热，胸膈不利，饮食不甘，形体日瘦，牙龈蚀烂。此脾土不能生肺金，肺金不能生肾水，
肾水不能生肝木，当滋化原，用补中益气、六味地黄，至仲春而愈。（必举仲春者，以肝木斯令时也。）
松江太守何恭人，性善怒，腹结一块，年余上 蚀透，血气虚极。时季冬，肝脉洪数，按之弦紧，余脉微
弱。或用伐肝木清胃火之药。薛曰∶真气虚而邪气实也，恐伐肝木，至春不发生耳。用八珍汤以生气血，用地
黄丸以滋肾水，肝脉顿退。因大怒耳内出血，肝脉仍大，烦热作渴，此无根之火也，仍以前药加肉桂，二剂脉
敛热退。复大怒，果卒于季冬辛巳日，乃以金克木故也。
一妇人耳下肿赤，寒热口苦，月经不调，小腹内一块，此肝火气滞而血凝也，用小柴胡加山栀、川芎、丹
皮治之，诸症悉退。
润州某公，补剂中多用败龟板，垂十年颇健，晚患蛊膈，乃谒白飞霞。飞霞诊视良久，曰∶此瘕也，公岂
饵龟板药耶？今满腹皆龟，吾药能逐之。其骨节腠理者，非吾药所能也。乃与赤丸如粒服之，下龟如菽大者升
余，得稍宽，不数月死。易箦时，验小遗，悉有细虫仿佛龟形。物得气而传如此，可不慎哉。（《周栎图书影》。）
黄山毕公，服腽肭脐，初颇有验，久之得沙淋疾，沙皆作犬形，头尾略具。（同上。）
陈自明治一妇人，腹内结块，久而不消，与神仙追毒丸一粒即痊。（方见蛊门。）
陈自明云∶予族子妇病，腹中大块如杯，每发则痛不可忍。时子妇已贵，京下善医者悉延医，莫能愈。予
应之曰∶此血瘕也。投黑神丸，尽三丸，块气尽消，终身不复作。（《良方》、《医说续编》。）
孙俟居比部病，腹中若有 瘕，不食不眠，烦懑身热。仲淳投以人参、白芍、茯苓、麦冬、木通、枣仁、
石斛。方甫具，史鹤亭太史至，见方中有大剂人参，骇曰∶向因投参至剧，此得无谬乎？仲淳曰∶病势先后不
同，当时邪未退，滞未消，故不宜。今病久，饱胀烦懑者，气不归元也；不食者，脾元虚也；不眠而烦者，内
热津液少也。今宜亟用此药矣，四剂而瘳。后复病，仲淳诊之曰∶此阴虚也，非前症矣。更以麦冬、白芍、枸
杞、五味、生地、车前，而热遂退。（《广笔记》。）
【附：癖】
陈自明治疗昆陵一位权贵宦官的妻子，患者小便不通，脐部及腹部胀满疼痛，难以忍受。众医生都将其当作淋证治疗，使用八正散之类的方剂，但小便始终无法排出。陈自明诊察后说：“这是血瘕病（瘀血结聚形成的肿块），非用引起剧烈反应的猛药不能去除。”于是给予桃仁煎剂，在初更时分服用，直到中午时，患者感到剧烈疼痛难忍，便躺下休息。过了一会儿，排出了几块拳头大小的血块，随后排出约一二升像黑豆汁一样的尿液，疼痛停止，疾病痊愈。此药治病确切，但药性猛烈峻急，对于气虚血弱的患者，应当斟酌使用。方药组成：桃仁、大黄、朴硝各一两，虻虫半两炒黑，共研为末，用醋炼制成梧桐子大小的丸剂。五更初，用温酒送服五丸。（原注：此方不可随意使用。出自《良方》。）
杜壬治疗马氏的妇人，三十二岁，腹中有血块作痛，病程长达五六年的，身体已经瘦得皮包骨头，众人都说无法医治，无奈她还没死。家境非常贫困，大家都怜悯她。有一天召请杜壬前去，对杜壬说：“只要您怀着济世救人的心意就可以了，既然已经邀请了名医，就不必多言了。”于是赠送少许丝织品给杜壬。杜壬不接受，说：“只要服用我的药必定能平安无事，不要对此怀疑。”于是出示处方。用药：没药、牛膝、干漆、当归各半两，砂仁、木香、水蛭炒制、红娘子炒制、红花、丹皮、朱砂各一分，海马一个，斑蝥去翅足炒制十四个，研为细末，用酒和醋各半升熬成膏状。每天天亮时用如皂角子大小的一块，用酒醋化开送服，一个月后病情减退，六十天后逐渐安康。（此药比桃仁汤更为峻烈，宜斟酌使用。）
陈藏器说：从前有患癖病的人，梦中有人教导他每天吃三颗大蒜，刚开始吃就导致出现瞑眩反应（服药后出现的剧烈不适反应），呕吐逆乱，下部感觉如火烧。后来有人教他取几瓣大蒜，连皮截去两头直接吞下，名叫“内炙”，果然获得很大疗效。（《本草纲目》记载：张景岳治疗面颊旁小肠经右角处的痞块，与此意相同。）
张子和治疗汴梁曹大使的女儿，年龄刚成年，患血瘕病已有数年。太医宜企贤用破血等药物治疗，未能治愈。宜企贤说：“只有陈州张戴人才能治好。”一天，戴人到汴京，曹家便邀请他问诊。戴人说：“小肠的热邪移传于大肠形成伏瘕，所以结硬如块，面色发黄，不思饮食。”于是采用涌泄法（催吐泻下之法），数年的疾病，不到十天便痊愈了。
柴屿青在乾隆己未年寓居沈阳京兆署时，兵房吏王某患症疾，教他用蒸脐法治之，兼服加减五积散而痊愈。他的岳母也患有同样的病症，王某即照方赠予她，也痊愈了。
孙文垣治疗汪氏的妇人，月经长久不止，经血中有紫黑色的血块，胃、胸、腹部都疼痛，外阴肿胀，手足发冷，不知饥饿，小腹下有一块坚硬的肿块，脉象左手数，右手沉涩，这是血瘕病。用糖球子五钱，元胡索、五灵脂、香附、麦芽、青皮各一钱，水煎服，疼痛减半，手足逐渐转温。加入当归、丹皮、蒲黄、益母草、川芎，服用四帖后疼痛停止，外阴肿胀也消退。再服用四帖后月经调和。（方药十分平稳。）
张子和治疗一个童子，进门时姿态如同鞠躬而行。张子和说：“这是疰气病。”让他解开衣服检查，发现两条筋脉如手臂般粗大，其家属求治。先针刺左侧，如同刺厚纸一样，发出剥然的声响，并令其按摩，立刻变软，右侧也是如此。旁观者惊叹奇异，有人问他原因。他说：“这是石关穴。”
永康应童婴患有腹疾，经常患病行走不便，长久不能伸直，松阳周汉卿解开衣服查看，发现气冲起于腹间两处，大小如手臂。周汉卿针刺其中一处，发出魄然鸣响，又针刺另一处，也是如此。稍加按摩，气血尽散，行走平直无滞留。（出自《续大粹》。）
武叔卿说：疰癖瘕，都是血气凝结成块坚硬，发作时刺痛，严重时欲死，究其根本而言，都是血分病变所致。
陈良甫常治疗一位妇人，血气刺痛，极度难以忍受，甚至昏死一二天才苏醒。医生和巫师共同治疗，数年不愈。我用葱白散、乌鸡丸使她安定下来。
陈良甫治疗一位妇人，血气作楚（痛苦），如一小盘样，游走刺痛，需要一人扶住固定，才能稍微缓解，也是用这两种药中的一种而痊愈。寻常轻微的血气病，用这两种药，也有奇效。（出自《济阴纲目》。）
陈良甫治疗一位妇人患病，血气作楚，疼痛难以忍受，服用各种药物无效。召来诊治，说：“关脉弱沉，肝脉沉紧，这是血气逐渐形成癖病。”也只以前述两种方剂治疗而痊愈。另外四明马朝奉的后院夫人，也患此病，用这两种方剂治疗也痊愈了。（同上。）
宋孝武路太后患病，众医生不认识，徐文伯诊察后说：“这是石博在小腹，”于是用水济消石汤治疗，病立即痊愈。（出自《南史》。）
董含的外家（外祖母家）腹内生一痞块，起初如弹丸大小，五六年后，大类鹅卵，中间似乎有一个窟窿，往来移动，有时痛有时止，百药无效。久而久之遍体发肿，内部有水声，日夜呻吟，死而复生两次，众医生束手无策，都说：“这叫水鼓，病已成，不可再治了。”
章文学旭，字东生，是名医，善于治疗奇疾。前往邀请他，他说：“这不是水症，乃是积聚所致，半天可以痊愈。只是所用药物猛烈，转斗而下，驱水很快，试问病人愿意服用吗？”病人说：“我已经濒临死亡，如果有一钱能救活，死也无憾了。”于是取红丸十粒，如绿豆大，用槟榔、枳实等五六味煎汤送下。起初觉得喉中响声可怕，势将不支。一会儿，胸膈间如刀刃乱刺，哀号翻滚，疼痛无法形容。又过一会儿，下水约一斗，头面浮肿消退，不超过一时辰又下数升，腹背也消退。病患说：“我现在觉得胸背顿时宽松，于是熟睡片刻。当时章君还在座，说：“这次不仅水去，痞块也应当逐渐消散了。”进补剂两天，明天后天可以继续服用，于是告辞离去。到了晚上又下水四五升，手足浮肿全退，不到三天病全愈。不久突然痞块摇动，下红黑痢疾三昼夜，痞块也不见了。众医生惊服，前往询问缘故。章医生说：“这叫肠覃，在《内经》水胀论中，各位自己坐着不读书罢了。”众人都惭愧退下。按岐伯说：“寒气客于肠外，与胃气相搏，癖而内着，肉乃生，开始如鸡蛋，到其成熟，像怀孕的样子，按之则坚，推之则移，月经按时来潮，肠覃生于肠外故也。又有一种名石瘕，病状相同，月经不按时来潮，石瘕生于胞中故也。都是妇人之病，因有积聚，可导而下，似水胀而非水胀也。（临症之工，大宜分别。）此疾若非章君，久作泉下之鬼矣。（今人能感激如是者鲜矣。《三冈识略》。）
一男子肠鸣食少，脐下有块耕动，若得下气多乃已，已而复鸣，屡用疏气降火药，半年不愈。乃以理中汤为君，佐芩、连、枳实，一服肠鸣止。又每服吞浓朴红豆蔻丸，其气耕亦平矣。
薛立斋治疗一位妇人，月经不调，两拗肿胀，小便涩滞，腹中一块作痛，或上攻胁腹，或下攻小腹，发热，晡热恶寒，肌肤消瘦，饮食无味，殊类瘵症，久而不愈。此肝脾血气亏损，用八珍汤、逍遥散、归脾汤，随症互服而愈。
一妇人性多郁怒，勤于女工，小腹内结一块，或作痛，或痞闷，月经不调。恪服伐脾之剂，（今人受此害者尤多。）内热寒热，胸膈不利，饮食不甘，形体日瘦，牙龈蚀烂。此脾土不能生肺金，肺金不能生肾水，肾水不能生肝木，当滋化原，用补中益气、六味地黄，至仲春而愈。（必举仲春者，以肝木斯令时也。）
松江太守何恭人，性善怒，腹结一块，年余上 蚀透，血气虚极。时季冬，肝脉洪数，按之弦紧，余脉微弱。或用伐肝木清胃火之药。薛曰：真气虚而邪气实也，恐伐肝木，至春不发生耳。用八珍汤以生气血，用地黄丸以滋肾水，肝脉顿退。因大怒耳内出血，肝脉仍大，烦热作渴，此无根之火也，仍以前药加肉桂，二剂脉敛热退。复大怒，果卒于季冬辛巳日，乃以金克木故也。
一妇人耳下肿赤，寒热口苦，月经不调，小腹内一块，此肝火气滞而血凝也，用小柴胡加山栀、川芎、丹皮治之，诸症悉退。
润州某公，补剂中多用败龟板，垂十年颇健，晚患蛊膈，乃谒白飞霞。飞霞诊视良久，曰：此瘕也，公岂饵龟板药耶？今满腹皆龟，吾药能逐之。其骨节腠理者，非吾药所能也。乃与赤丸如粒服之，下龟如菽大者升余，得稍宽，不数月死。易箦时，验小遗，悉有细虫仿佛龟形。物得气而传如此，可不慎哉。（《周栎图书影》。）
黄山毕公，服腽肭脐，初颇有验，久之得沙淋疾，沙皆作犬形，头尾略具。（同上。）
陈自明治一妇人，腹内结块，久而不消，与神仙追毒丸一粒即痊。（方见蛊门。）
陈自明云：予族子妇病，腹中大块如杯，每发则痛不可忍。时子妇已贵，京下善医者悉延医，莫能愈。予应之曰：此血瘕也。投黑神丸，尽三丸，块气尽消，终身不复作。（《良方》、《医说续编》。）
孙俟居比部病，腹中若有 瘕，不食不眠，烦懑身热。仲淳投以人参、白芍、茯苓、麦冬、木通、枣仁、石斛。方甫具，史鹤亭太史至，见方中有大剂人参，骇曰：向因投参至剧，此得无谬乎？仲淳曰：病势先后不同，当时邪未退，滞未消，故不宜。今病久，饱胀烦懑者，气不归元也；不食者，脾元虚也；不眠而烦者，内热津液少也。今宜亟用此药矣，四剂而瘳。后复病，仲淳诊之曰：此阴虚也，非前症矣。更以麦冬、白芍、枸杞、五味、生地、车前，而热遂退。（《广笔记》。）
[Appendix: Pi (Piecemeal Mass)]
Chen Ziming treated the wife of a high-ranking official in Kunling. The patient suffered from urinary retention, with unbearable distending pain in the umbilical and abdominal regions. All physicians treated it as Lin syndrome (dysuria), using formulas such as Bazheng San (Eight-Ingredient Powder for Rectifying Turbidity), but urination remained obstructed. Chen Ziming diagnosed, "This is Xue Jia (Blood Mass); only potent medicines inducing Mingxuan reactions (severe adverse reactions indicating effective treatment) can eliminate it." He prescribed Tao Ren Jian (Peach Kernel Decoction). Taken at the beginning of the first watch (approx. 7-9 PM), by noon the patient experienced severe pain and lay down. Shortly after, she passed several fist-sized blood clots, followed by one to two sheng (approx. 1-2 liters) of urine resembling black bean juice. The pain ceased, and she recovered. This medicine is effective but extremely potent; it should be used with caution in patients with Qi deficiency and Blood weakness. Formula: Tao Ren (Peach Seed, *Prunus persica* seed), Da Huang (Rhubarb Root, *Rhei Radix et Rhizoma*), and Po Xiao (Mirabilite, *Natrii Sulfas*) each 1 liang; Meng Chong (Dragonfly Larva, *Ephemeroptera larva*) half a liang, stir-fried until black. Grind into powder, refine with vinegar to make pills the size of paulownia seeds. At dawn on an empty stomach, swallow five pills with warm wine. (Original note: Do not use this formula casually. From *Liang Fang*.)
Du Ren treated a woman surnamed Ma, aged thirty-two, who had suffered from painful blood masses in the abdomen for five or six years. Her body was emaciated to the point of being skeletal. Everyone said it was incurable, yet she was not dead. Her family was very poor, and everyone pitied her. One day, he was summoned. He told Du Ren, "If you have compassion for saving lives, that is sufficient. Since a renowned physician has already been invited, no further words are needed." He offered some silk fabric to Du Ren. Du Ren refused, saying, "Just take my medicine, and you will surely be safe. Do not doubt this." He then presented the prescription. Ingredients: Mo Yao (Myrrh, *Commiphora myrrha*), Niu Xi (Achyranthes Root, *Achyranthis Bidentatae Radix*), Gan Qi (Dried Lacquer, *Rhus verniciflua resin*), and Dang Gui (Angelica Sinensis Root, *Angelicae Sinensis Radix*) each half a liang; Sha Ren (Amomum Fruit, *Amomi Fructus*), Mu Xiang (Vladimiria Root, *Vladimiriae Radix*), Shui Zhi (Leech, *Hirudo* species, stir-fried), Hong Niang Zi (Red Ladybug, *Mylabris phalerata*, stir-fried), Hong Hua (Safflower, *Carthami Flos*), Dan Pi (Moutan Bark, *Paeoniae Moutan Cortex*), and Zhu Sha (Cinnabar, *Cinnabaris) each one fen; one Hai Ma (Seahorse, *Hippocampus* species); fourteen Ban Mao (Mustard Beetle, *Meloides* species, wings and feet removed, stir-fried). Grind into powder, boil with half a sheng of wine and half a sheng of vinegar to form a paste. Each morning at dawn, take a piece the size of a soap pod, dissolve in wine and vinegar, and ingest. After one month, the disease receded; after sixty days, she gradually recovered. (This medicine is more potent than Tao Ren Tang; use with caution.)
Chen Cangqi stated: In the past, there was a patient with Pi disease who dreamed someone taught him to eat three cloves of garlic daily. Initially, eating them caused Mingxuan reactions, vomiting, and a burning sensation in the lower body. Later, someone taught him to take several cloves, keep the skin on, cut off both ends, and swallow them whole, called "Internal Roasting." It indeed yielded great efficacy. (*Ben Cao Gang Mu*: Zhang Jingyue's treatment of a mass at the right corner of the Small Intestine meridian on the face follows the same principle.)
Zi Hezi treated the daughter of Envoy Cao in Bianliang. She had just reached marriageable age and had suffered from Xue Jia (Blood Mass) for several years. Imperial Physician Yi Qixian treated her with blood-breaking medicines without success. Yi Qixian said, "Only Zhang Dairen from Chenzhou can cure her." One day, Dairen arrived in Bianjing, and the Cao family invited him for consultation. Dairen said, "Heat transferring from the Small Intestine to the Large Intestine forms Fu Jia (Hidden Mass), causing hard knots like lumps, yellow complexion, and loss of appetite." He employed Yong Xie Fa (Emetic and Purgative Method). The disease lasting several years was cured in less than ten days.
Chai Yuqing resided in the Shenyang Jingzhao Office during the Jiwei year of the Qianlong reign. Wang, a clerk in the Military Department, suffered from Zheng Ji (intermittent fever/mass disorder). Chai taught him the Umbilical Steaming method, combined with taking Modified Wuji San (Five Accumulations Powder), resulting in recovery. His mother-in-law suffered from the same condition; Wang gave her the same prescription, and she also recovered.
Sun Wen Yuan treated a woman surnamed Wang. Her menstruation had lasted for a long time without stopping, containing dark purple-black blood clots. Her stomach, chest, and abdomen all hurt. Her vulva was swollen, hands and feet were cold, she felt no hunger, and there was a rock-hard lump under her abdomen. Her pulse was rapid on the left and deep-choppy on the right. This was Xue Jia (Blood Mass). He used Tang Qiu Zi (Sugar Ball Pill) 5 qian, Yuan Hu Suo (Corydalis Rhizome, *Corydzidis Rhizoma*), Wu Ling Zhi (Trogopterus Dung, *Tragopodi Excrement*), Xiang Fu (Cyperus Rhizome, *Cyperi Rhizoma*), Mai Ya (Barley Sprout, *Hordei Fructus Germinatus*), and Qing Pi (Green Tangerina Peel, *Citri Reticulatae Pericarpium Viride*) each 1 qian. Decoct in water and take. Pain reduced by half, hands and feet gradually warmed. Added Dang Gui (Angelica Sinensis Root, *Angelicae Sinensis Radix*), Dan Pi (Moutan Bark, *Paeoniae Moutan Cortex*), Pu Huang (Typha Pollen, *Typhae Pollen*), Yi Mu Cao (Motherwort Herb, *Leonuri Herba*), and Chuan Xiong (Ligusticum Rhizome, *Ligustici Chuanxiong Rhizoma*). After four doses, pain stopped, and vulvar swelling subsided. After another four doses, menstruation regulated. (The formula is very mild.)
Zi Hezi treated a young boy who entered bowing while walking. Zi Hezi said, "This is Zhu Qi (Neurotic Gas)." He asked him to undress and palpated, finding two tendons as thick as arms. The family sought treatment. Zi Hezi first needled the left side; it felt like piercing heavy paper, making a peeling sound, and instructed massage, which immediately softened it. The right side was treated similarly. Observers marveled. When asked, he said, "These are Shiguan Acupoints."
Ying Tongying of Yongkang suffered from abdominal disease, often unable to walk straight for a long time. Zhou Hanqing of Songyang undressed him and observed two qi rushes rising in the abdomen, as thick as arms. Zhou Hanqing needled one, producing a resonant sound, then needled the other similarly. After slight massage, the qi and blood dispersed completely, and he walked normally without hesitation. (*Xu Da Cui*.)
Wu Shuqing said: Zhu, Pi, and Jia are hard masses formed by congealed Qi and Blood, causing intermittent stabbing pain, sometimes so severe as to cause near-death experiences. Ultimately, they are all disorders of the Blood.
Chen Liangfu frequently treated a woman with stabbing pain from Qi and Blood stagnation, unbearable, even fainting for one or two days before regaining consciousness. Doctors and shamans treated her for years without success. I used Cong Bai San (Scallion White Powder) and Wu Ji Wan (Black Chicken Pill) to stabilize her.
Chen Liangfu treated a woman whose Qi and Blood caused suffering, feeling like a small plate moving around with stabbing pain. She needed someone to hold her still to find slight relief. Using one of these two medicines cured her. For ordinary minor Qi and Blood disorders, these two medicines also yield miraculous effects. (*Ji Yin Gang Mu*.)
Chen Liangfu treated a woman with Qi and Blood suffering, unbearable pain, unresponsive to various medicines. Upon diagnosis, he noted the Guan pulse was weak and deep, and the Liver pulse was deep and tight, indicating Qi and Blood were gradually forming a Pi (mass). He treated her with the aforementioned two formulas, and she recovered. Similarly, the wife of Ma Chaofeng in Siming suffered from this and was also cured by these two formulas. (Ibid.)
Empress Dowager Lu of Emperor Xiaowu of Song fell ill. Physicians could not identify it. Xu Wenbo diagnosed, "This is Shi Bo (Stone Mass) in the lower abdomen," and prescribed Shui Ji Xiao Shi Tang (Water-Ji Magnesium Sulfate Decoction). The illness healed immediately. (*History of Southern Dynasties*.)
Dong Hany's maternal relative developed a Pi mass in the abdomen, initially the size of a bullet, growing to the size of a goose egg after five or six years. It seemed to have a cavity inside, moved back and forth, causing intermittent pain. Hundreds of medicines failed. Eventually, her whole body swelled, with fluid sounds internally. She groaned day and night, died and revived twice. Physicians were helpless, stating, "This is Shui Gu (Water Drum/Ascites). The disease is advanced and incurable."
Zhang Wenxue Xu, courtesy name Dongsheng, was a famous physician skilled in treating rare diseases. Invited, he said, "This is not Water Syndrome, but caused by Accumulation and Gathering. It can be cured in half a day. However, the medicine used is potent, driving water downward rapidly. Ask if the patient is willing to take it." The patient said, "I am on the verge of death. If a coin's worth of medicine can save me, I die without regret." Thus, ten Red Pills, sized like mung beans, were taken with a decoction of Bing Lang (Areca Nut, *Arecae Semen*), Zhi Shi (Immature Bitter Orange, *Aurantii Fructus Immaturus*), and five or six other herbs. Initially, terrifying noises were heard in the throat, and the patient felt unable to endure. Soon, stabbing pain like knife blades occurred in the chest and diaphragm, with wailing and rolling in agony. Then, about one dou (approx. 10 liters) of water was discharged. Head and facial swelling subsided. Within an hour, several more sheng were discharged, and abdominal/back swelling receded. The patient said, "I feel my chest and back are suddenly relaxed," and slept deeply. Mr. Zhang, still present, said, "Not only has the water gone, but the Pi mass should also gradually dissipate." Two days of tonic agents were prescribed for continued use, and he departed. That evening, four or five more sheng of water were discharged. Hand and foot swelling completely resolved. Within three days, the disease was fully cured. Suddenly, the Pi mass shifted, and red-black dysentery lasted for three days and nights, after which the Pi mass disappeared. Physicians were amazed and asked for the reason. Mr. Zhang said, "This is Chang Qin (Intestinal Polyp/Mass), described in the Water Swelling chapter of the *Nei Jing*. You simply sit here without reading books." They withdrew in shame. According to Qibo: "Cold pathogen lodges outside the intestines, combats with Stomach Qi, adheres internally, and flesh grows. Initially like a chicken egg, eventually like pregnancy. Hard to touch, movable when pushed. Menstruation occurs on time. Chang Qin arises outside the intestines." Another type is named Shi Jia (Stone Mass). Symptoms are identical, but menstruation is irregular. Shi Jia arises in the Uterus. Both are women's diseases caused by accumulation, treatable by guiding downward. It resembles Water Swelling but is not Water Swelling. (Clinicians must distinguish carefully.) If not for Mr. Zhang, this person would long have been a ghost beneath the springs. (Few people today are grateful like this. *San Gang Shi Lue*.)
A man suffered from borborygmus (intestinal rumbling) and poor appetite. A mass churned below the navel, resolving only after passing much gas, only to recur. Repeated use of Qi-dispersing and Fire-descending medicines for half a year failed. He used Lizhong Tang (Regulate the Middle Decoction) as the principal formula, assisted by Huang Qin (Scutellaria Root, *Scutellariae Radix*), Huang Lian (Coptis Rhizome, *Coptidis Rhizoma*), and Zhi Shi (Immature Bitter Orange, *Aurantii Fructus Immaturus*). After one dose, borborygmus stopped. Additionally, swallowing Nong Po Hong Dou Kou Wan (Thick Magnolia and Cardamom Pill) with each dose calmed the churning Qi.
Xue Lizhai treated a woman with irregular menstruation, swelling in both flanks, difficult urination, and a painful mass in the abdomen. Sometimes attacking the hypochondrium and abdomen upwards, sometimes the lower abdomen downwards. Fever, afternoon heat with aversion to cold, emaciation, loss of taste, resembling Phthisis (consumption), persisting for a long time. This was Liver and Spleen Qi and Blood deficiency. He used Bazhen Tang (Eight-Treasure Decoction), Xiaoyao San (Free and Easy Wanderer Powder), and Guipi Tang (Restore the Spleen Decoction), alternating according to symptoms, resulting in recovery.
A woman prone to depression and anger, diligent in needlework, developed a mass in the lower abdomen, causing pain or fullness, with irregular menstruation. She strictly took Spleen-attacking agents (many suffer this harm today). Internal heat, alternating chills and fever, chest/diaphragm discomfort, poor appetite, progressive emaciation, rotting gums. This was Spleen Earth failing to generate Lung Metal, Lung Metal failing to generate Kidney Water, Kidney Water failing to nourish Liver Wood. One must nourish the source of transformation. He used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). She recovered by mid-spring. (Mid-spring is mentioned because Liver Wood governs this season.)
He Gongren, Prefect of Songjiang, prone to anger, developed an abdominal mass. Over a year, it eroded through the upper body, leaving extreme Qi and Blood deficiency. In late winter, the Liver pulse was surging and rapid, wiry and tight upon pressure, while other pulses were faint. Some used Liver-attacking and Stomach-Fire-clearing medicines. Xue said, "True Qi is deficient, Evil Qi is excess. Attacking Liver Wood may prevent Spring generation." He used Bazhen Tang to generate Qi and Blood, and Dihuang Wan (Rehmannia Pill) to nourish Kidney Water. The Liver pulse instantly retreated. Due to great anger, bleeding occurred from the ear, and the Liver pulse remained large, with irritability, heat, and thirst. This was Rootless Fire. He added Rou Gui (Cinnamon Bark, *Cinnamomi Cortex*) to the previous medicine. After two doses, the pulse contained, and heat receded. Angering again, she indeed died on the Xin Si day of late winter, due to Metal overcoming Wood.
A woman had swelling and redness below the ear, alternating chills and fever, bitter taste, irregular menstruation, and a mass in the lower abdomen. This was Liver Fire with Qi stagnation and Blood coagulation. He treated with Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Shan Zhi (Gardenia Fruit, *Gardeniae Fructus*), Chuan Xiong (Ligusticum Rhizome, *Ligustici Chuanxiong Rhizoma*), and Dan Pi (Moutan Bark, *Paeoniae Moutan Cortex*). All symptoms receded.
A gentleman from Runzhou used Gui Ban (Tortoise Shell, *Testudinis Carapax et Plastrum)* extensively in tonics for nearly ten years, remaining quite healthy. In his later years, he suffered from Gu Ge (Gu Distension/Ascites). He visited Bai Feixia. Bai examined him for a long time and said, "This is a Jia (Mass). Did you take Tortoise Shell medicines? Now your abdomen is full of tortoises. My medicine can expel them. But those in bone joints and interstices are beyond my medicine's reach." He gave Chi Wan (Red Pills) the size of grains. More than a sheng of tortoise-shell-like particles were expelled. He felt slightly relieved but died within months. Upon changing clothes at death, examination of urine revealed tiny insects resembling tortoise shapes. Creatures transmitting via Qi in this manner—how careful one must be! (*Zhou Li Tu Shu Ying*.)
Mr. Bi of Huangshan took Asafoetida Umbilicus (Felimar Umbilicus, *Halichoeres margaritaceus umbilicus*). Initially effective, but after a long time, he developed Sha Lin (Sand Dysuria). The sand all resembled dog shapes, with heads and tails distinct. (Ibid.)
Chen Ziming treated a woman with an intra-abdominal mass that did not disappear for a long time. One pill of Shenxian Zhuidu Wan (Immortal Poison-Chasing Pill) cured her. (Formula seen in Gu section.)
Chen Ziming said: My clan's son's wife suffered from a large abdominal mass like a cup, with unbearable pain upon onset. By then, she was noble. Excellent physicians in the capital were invited, but none could cure her. I responded, "This is Xue Jia (Blood Mass)." I administered Hei Shen Wan (Black Divine Pill). After finishing three pills, the mass dissipated completely, never recurring in her lifetime. (*Liang Fang*, *Yi Shuo Xu Bian*.)
Sun Siju, a Ministry Official, suffered from a suspected Jia in the abdomen, unable to eat or sleep, with irritability and fever. Zhongchun prescribed Ren Shen (Ginseng Root, *Panacis Ginseng Radix*), Bai Shao (White Peony Root, *Paeoniae Radix Alba*), Fu Ling (Poria, *Poria*), Mai Dong (Ophiopogon Tuber, *Ophiopogonis Tuber*), Mu Tong (Akebia Stem, *Akebiae Caulis*), Suan Zao Ren (Ziziphus Seed, *Ziziphi Spinosae Semen*), and Shi Hu (Dendrobium Stem, *Dendrobii Caulis*). Just as the prescription was prepared, Shi Tingting, Grand Secretary, arrived. Seeing large-dose Ren Shen in the formula, he exclaimed, "Previously, administering Ren Shen worsened the condition severely. Could this be a mistake?" Zhongchun said, "The disease progression differs. Previously, Evil had not retreated, stagnation had not cleared, so it was unsuitable. Now, the disease is chronic. Fullness and irritability indicate Qi failing to return to its origin; inability to eat indicates Spleen Yuan deficiency; insomnia and irritability indicate internal heat and scanty fluids. Now, these medicines are urgently needed." After four doses, he improved. Later, he relapsed. Zhongchun diagnosed, "This is Yin Deficiency, not the previous condition." He prescribed Mai Dong (Ophiopogon Tuber, *Ophiopogonis Tuber*), Bai Shao (White Peony Root, *Paeoniae Radix Alba*), Gou Qi (Goji Berry, *Lycii Fructus*), Wu Wei Zi (Schisandra Fruit, *Schisandrae Chinensis Fructus*), Sheng Di (Rehmannia Root, *Rehmanniae Radix*), and Che Qian (Plantago Seed, *Plantaginis Semen*). The heat subsequently receded. (*Guang Biji*.)