Abdominal mass is a condition characterized by the formation of lumps within the female pelvic reproductive system. Depending on the location of growth, it is referred to by different names. In ancient times, a mass growing in the uterus with appendages was called a "stony uterine mass," while a mass in the fallopian tubes was referred to as a "lower abdominal mass in woman (ovarian cyst)." The former commonly occurs in women over the age of 30, while the latter can occur at any age but is more prevalent among women aged 20 to 50.

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1. Blood Stasis︰The uterus with appendages gradually enlarges and hardens, usually without tenderness. Menstrual flow is heavy with blood clots, prolonged menstruation, or continuous dripping (if the mass grows outside the uterus with appendages, symptoms are often not obvious), and the cycle is irregular. Leucorrhea increases, sometimes appearing bloody or purulent with a foul odor. Patients have difficulty conceiving, and even if pregnancy occurs, late abortion is likely. The tongue texture is normal or dark red, and the pulse is wiry and thin. This condition is mostly caused by disharmony between the liver and spleen, imbalance of the Chong and Ren meridians, and the accumulation of qi and blood in the uterus with appendages or cervical orifice. Its clinical characteristics include: a hard, immobile mass, hypermenorrhea with blood clots, prolonged menstruation or continuous menstrual dripping, irregular cycles, increased leucorrhea, and a history of infertility or late abortion. If repeated heavy bleeding occurs during the course of the disease, symptoms of dual deficiency of qi and blood may appear. Treatment should focus on invigorating blood and resolving stasis, supplemented by regulating qi and softening hardness. The prescription Cinnamon Twig and Poria Pill can be used with Zedoary Rhizome, roasted pangolin scales, or wine-processed Rhubarb Rhizoma and ground beetle. Alternatively, the stony uterine mass decoction may be used. During menstruation with heavy bleeding, Danqi Decoction can be taken first. After bleeding stops and blood deficiency symptoms are corrected, blood-stasis-resolving and mass-dissipating formulas can be administered.
2. Damp Phlegm︰An abdominal mass often presents as a spherical, movable, and non-tender enlargement in one side of the lower abdomen. The size of the mass varies, with the largest occasionally reaching the size of a full-term pregnancy, while smaller ones may only be detected during a gynecological examination. Menstruation is mostly normal. Changes in pulse manifestation and tongue texture are not significant. The cause and symptoms of this condition differ from those of a blood stasis abdominal mass. The mass results from liver-spleen disharmony and qi depression in the Chong and Ren meridians, leading to the accumulation of phlegm-dampness in the uterine vessels. Initially, the mass may be as small as an egg and only detectable during a gynecological exam, but it gradually grows to resemble a pregnancy. The mass is soft to the touch and movable. Since it is located in the "uterine vessels" rather than within the uterus with appendages or the cervical orifice, menstruation remains unaffected. Treatment should focus on warming and resolving phlegm-dampness, using Cinnamon Twig and Poria Pill with Cowherb Seed and raw Coix Seed. Alternatively, the lower abdominal mass in woman (ovarian cyst) decoction may be used.

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1. Yizong Jinjian Gynecology Essentials-Syndromes of Abdominal Masses, Accumulations, Hernia, and Stubborn Disorders: "When treating various types of masses and accumulations, one should first assess the patient's physical constitution (whether strong or weak) and the urgency of the disease before proceeding with treatment. If the patient is deficient, with weakened qi and blood unable to withstand purgative therapies, even if the disease appears severe, the priority should be to support the vital energy before addressing the illness. If both the physical constitution and symptoms are robust, then attacking the disease should take precedence. The Classic states: 'For major accumulations and gatherings, reduce them by two-thirds and then stop, fearing excessive purgation may damage qi and blood.'"