其候浑身微热，不思饮食，昏昧神缓，抱着一似睡未觉，肚热足冷者。多因
吐泻大病及攻击之后而得此候，茅先生先用青金丸取积，后用匀气、醒脾散调理。
常服万灵丸、保童丸即愈。
〔王先生〕灵砂丹 下虚中积、脏腑虚滑泄泻，久经取转，里急后重，久积恶痢暴泻
久不止，神效。
通明 砂（一钱） 颗块辰砂（通明、有墙壁者，二钱半。各细研）
上二味，衮研极细，用黄蜡半两，先于盏内熔化，入去皮全巴豆三七粒煎，候
巴豆紫色为度，漉豆出，细研，入前二味再研匀，于黄蜡内三分取一，再熔成汁，
倾药入内，急搅令匀，刮入瓷合收之。每服，暴泻恶痢，旋绝三丸如绿豆大。浓
煎艾汤，先呷三五口，然后吞下。水泻，冷水吞下。如取积，每服三丸如梧桐子
大，浓煎甘草汤，放冷吞下，临卧服。其久积药随积下，其小可不动便安。
按∶既是虚，即不宜用峻剂取积，仍须用四君子、益黄散之类，相兼服之。
其候大便不通，风毒疮疖，喉闭 腮，咽中涎响。茅先生先用夺命散（急惊）吐下热
涎，后用匀气散、醒脾散调理。常服牛黄膏、天竺黄散（并实热）镇心丸即愈。
仲阳云∶积痛，口中气温，面色黄白，目无精光，或白睛多及多睡畏食，或
大便酸臭者，当磨积而痛自除，宜下积丸，甚者，白饼子下之，后和胃气，用
白术散（渴）、小沉香丸、感应丸治之。又有食积肚痛，有热者芍药甘草汤（腹痛）加干葛。
吐者加半夏、生姜，或加枳实亦效。
小沉香丸 和中顺气，进食消痰。
砂仁 蓬术（各四钱，煨） 香附子（去毛，炒，一两八钱） 舶上丁香皮（二两四钱） 沉香（六钱） 甘松
（去土，三两六钱） 益智仁（微炒，一两二钱） 甘草（炙，一两四钱）
上为细末，汤浸蒸饼丸，如桐子大。每服三十或四十丸，食后温姜汤下，或嚼破更妙。
其症状表现为全身轻微发热，不思饮食，精神昏沉迟钝，抱着人像是睡而未醒的样子，腹部发热而脚部发冷。这多是因为吐泻大病以及经过攻伐治疗之后而得到这种证候。茅先生先用青金丸（Qingjin Wan, Blue Gold Pill）来攻下积滞，后用匀气散（Yunqi San, Qi-Regulating Powder）、醒脾散（Xingpi San, Spleen-Awakening Powder）进行调理。常服万灵丸（Wanling Wan, Ten Thousand Efficacy Pill）、保童丸（Bao Tong Wan, Child-Preserving Pill）即可痊愈。
〔王先生〕灵砂丹（Lingsha Dan, Cinnabar and Mercury Pill）能攻下虚中积滞、脏腑虚弱导致的滑泄腹泻，久经攻下后出现的里急后重（Tenesmus），长期积滞引起的恶痢暴泻久久不止，效果神效。
通明砂（Tongming Sha, Clear Crystal Cinnabar）一钱，颗块辰砂（Kekuai Chensha, Chunky Cinnabar，要求透明且有完整晶壁的，二钱半。各需细细研磨）。以上两味药，共同研磨至极细，用黄蜡半两，先在盏内熔化，放入去皮的全巴豆三七粒煎煮，等到巴豆变成紫色为度，捞出巴豆，将其细细研磨，加入前两味药再次研磨均匀，从黄蜡中取出三分之一，再次熔化成汁，将药倒入其中，迅速搅拌使其均匀，刮入瓷盒中收藏。每次服用，若是暴泻恶痢，现做三丸如绿豆大。浓煎艾叶汤，先喝三五口，然后吞下药丸。若是水泻，用冷水送服。如果是为了攻下积滞，每次服用三丸如梧桐子大，浓煎甘草汤，放冷后吞服，临睡前服用。那些长期的积滞药物会随着积滞排出，小的积滞则不会移动，身体便安适了。
按语：既然是虚证，就不宜使用峻猛的药物攻下积滞，仍须用四君子汤（Sijunzi Tang, Four Gentlemen Decoction）、益黄散（Yihuang San, Yellow-Enhancing Powder）之类的方剂，配合服用。
其症状表现为大便不通，风毒疮疖，喉闭（Throat obstruction/swelling），腮部肿胀，咽喉中有痰鸣声。茅先生先用夺命散（Duoming San, Life-Seizing Powder，用于急惊风）通过催吐和泻下来清除热涎，后用匀气散、醒脾散进行调理。常服牛黄膏（Niuhuang Gao, Calculus Bovis Ointment）、天竺黄散（Tianzhu Huang San, Bambusa Textilis Ointment Powder，均用于实热证）、镇心丸（Zhenxin Wan, Heart-Calming Pill）即可痊愈。
钱乙（仲阳）说：积痛（Colic due to accumulation），口中气息温热，面色黄白，眼睛缺乏神采，或者白眼球部分较多且嗜睡畏食，或者大便酸臭的，应当磨消积滞而疼痛自然消除，适宜用下积丸（Xiaji Wan, Accumulation-Expelling Pill），严重的，用白饼子（Baibing Zi, White Cake Pills）攻下，之后调和胃气，用白术散（Baizhu San, Atractylodes Macrocephala Powder，用于口渴）、小沉香丸（Xiao Chenxiang Wan, Minor Aquilaria Pill）、感应丸（Ganying Wan, Responsive Pill）来治疗。又有食积肚痛，有热象的，用芍药甘草汤（Shaoyao Gancao Tang, Peony and Licorice Decoction，用于腹痛）加干葛（Gegen, Kudzu Root）。呕吐的加半夏（Banxia, Pinellia Rhizome）、生姜（Shengjiang, Fresh Ginger），或者加枳实（Zhishi, Aurantium Fructus Immaturus）也有效。
小沉香丸 能和中顺气，进食消痰。
砂仁（Sharen, Amomum Fruit）四钱，蓬术（Pngzhu, Curcuma Zedoaria Rhizome，煨制）四钱，香附子（Xiangfuzi, Cyperus Rhizome，去毛，炒制）一两八钱，舶上丁香皮（Bo Shang Dingxiang Pi, Clove Bark from Ships）二两四钱，沉香（Chenxiang, Aquilaria Lignum）六钱，甘松（Gansong, Nardostachys Radix，去土）三两六钱，益智仁（Yizhiren, Alpinia Oxyphylla Fruit，微炒）一两二钱，甘草（Gancao, Glycyrrhiza Radix et Rhizoma，炙制）一两四钱。
以上研为细末，用米汤浸湿蒸饼制成丸剂，如梧桐子大。每次服用三十或四十丸，饭后用温姜汤送服，或者嚼碎服用更好。
Its symptoms present as slight fever over the whole body, loss of appetite, mental dullness and lethargy, holding onto someone as if half-asleep, with a hot abdomen and cold feet. This condition often arises after severe vomiting and diarrhea or following aggressive treatments. Master Mao first used Qingjin Wan (Blue Gold Pill) to purge accumulations, then regulated with Yunqi San (Qi-Regulating Powder) and Xingpi San (Spleen-Awakening Powder). Regular intake of Wanling Wan (Ten Thousand Efficacy Pill) and Bao Tong Wan (Child-Preserving Pill) leads to recovery.
[Master Wang] Lingsha Dan (Cinnabar and Mercury Pill) effectively purges middle-jiao deficiency-type accumulations, deficiency-induced slippery diarrhea of the zang-fu organs, tenesmus after prolonged purging, and persistent violent diarrhea from long-standing malignant dysentery.
Tongming Sha (Clear Crystal Cinnabar) 1 qian, Kekuai Chensha (Chunky Cinnabar, transparent with intact crystal walls) 2.5 qian. Both are finely ground separately. These two ingredients are further ground together until extremely fine. Half liang of yellow wax is melted in a cup; 7–30 peeled whole Baidu Dou (Ephedrae Herba? No, *Note: Ba Dou is Crotonis Fructus* -> Crotonis Fructus) seeds are added and boiled until the seeds turn purple. The seeds are removed and finely ground, then mixed with the previous two powders. One-third of this mixture is added to the remaining melted yellow wax, stirred rapidly until uniform, scraped into a porcelain container for storage. For acute violent diarrhea or malignant dysentery, prepare three pills the size of mung beans. Drink 3–5 mouthfuls of strong mugwort decoction first, then swallow the pills. For watery diarrhea, swallow with cold water. To purge accumulations, take three pills the size of sophora seeds, swallowed in cooled strong licorice decoction before bed. Long-standing accumulations will be expelled by the medicine; minor ones remain undisturbed, bringing comfort.
Commentary: Since it is a deficiency pattern, harsh purgatives should not be used to expel accumulations. Instead, formulas such as Sijunzi Tang (Four Gentlemen Decoction) and Yihuang San (Yellow-Enhancing Powder) should be used in combination.
Symptoms include constipation, wind-toxic sores and boils, throat obstruction (swelling), swollen cheeks, and phlegm-rattling sounds in the throat. Master Mao first used Duoming San (Life-Seizing Powder, for acute convulsive disorders) to expel hot phlegm via emesis and purgation, followed by regulation with Yunqi San and Xingpi San. Regular use of Niuhuang Gao (Calculus Bovis Ointment), Tianzhu Huang San (Bambusa Textilis Ointment Powder, both for excess-heat patterns), and Zhenxin Wan (Heart-Calming Pill) leads to recovery.
Qian Yi (Zongyang) stated: In colic due to accumulation, the breath is warm, the complexion is yellowish-white, the eyes lack luster, there may be excessive whites in the sclera, somnolence, and aversion to food, or sour-smelling stools. The accumulation should be ground down, and the pain will resolve spontaneously. Xiaji Wan (Accumulation-Expelling Pill) is appropriate; for severe cases, Baibing Zi (White Cake Pills) can be used to purge, followed by harmonizing stomach qi using Baizhu San (Atractylodes Macrocephala Powder, for thirst), Xiao Chenxiang Wan (Minor Aquilaria Pill), and Ganying Wan (Responsive Pill). Additionally, for abdominal pain due to food accumulation with heat signs, Shaoyao Gancao Tang (Peony and Licorice Decoction, for abdominal pain) is used with added Gegen (Kudzu Root). For vomiting, add Banxia (Pinellia Rhizome) and Shengjiang (Fresh Ginger); adding Zhishi (Aurantium Fructus Immaturus) is also effective.
Xiao Chenxiang Wan harmonizes the middle, regulates qi, promotes digestion, and resolves phlegm.
Sharen (Amomum Fruit) 4 qian, Pengzhu (Curcuma Zedoaria Rhizome, roasted) 4 qian, Xiangfuzi (Cyperus Rhizome, de-husked, stir-fried) 1.8 liang, Bo Shang Dingxiang Pi (Clove Bark imported by ship) 2.4 liang, Chenxiang (Aquilaria Lignum) 6 qian, Gansong (Nardostachys Radix, cleaned) 3.6 liang, Yizhiren (Alpinia Oxyphylla Fruit, lightly roasted) 1.2 liang, Gancao (Glycyrrhiza Radix et Rhizoma, honey-fried) 1.4 liang.
Grind all into a fine powder. Mix with rice paste steamed buns to form pills the size of sophora seeds. Take 30–40 pills per dose after meals, washed down with warm ginger tea, or chewed for better effect.