脉∶腹痛关脉紧小急速，或动而弦，甚则沉伏；弦实滑痰；尺紧脐腹、心腹痛；脉沉细是福；浮大弦长，
命不可复。
腹痛者，有寒、热、食、血、湿、痰、虫、虚、实九般也。
开郁导气汤 治一切腹痛之总司也。
苍术（米泔浸） 香附（童便浸） 川芎 白芷 茯苓（去皮） 滑石 栀子（炒黑） 神曲（炒，各一钱）
陈皮（五分） 干姜（炒黑，五分） 甘草（少许）
上锉一剂，水煎温服。
绵绵痛无增减，脉沉迟者，寒痛也。
姜桂汤 治寒腹痛。
干姜 肉桂 良姜（各七分） 枳壳（去穣，麸炒） 陈皮 砂仁 浓朴（姜汁炒） 吴茱萸（炒。各一钱）
香附（一钱半） 木香（五分，另研入服） 甘草（二分）
上锉一剂，姜一片，水煎服。痛不止加玄胡索、茴香、乳香；寒极手足冷加附子，去茱萸、良姜；泄泻去
枳壳。
乍痛乍止、脉数者，火痛也（即热痛。）
散火汤 治热痛。
黄连（炒） 芍药（炒） 栀子（炒） 枳壳（去穣） 陈皮 浓朴（去皮） 香附 抚芎（各一钱）
木香（另研） 砂仁 茴香（各五分） 甘草（三分）
上锉一剂，生姜一片，水煎服。痛甚不止加玄胡索、乳香。
腹痛而泻，泻后痛减者，食积也。
香砂平胃散 治食积痛。
香附（炒） 砂仁 浓朴（姜汁炒） 苍术（米泔浸） 陈皮 枳壳（去穣，面炒） 山楂（去子）
神曲（炒。各三钱） 木香（另研调入） 干姜 甘草（各三分）
上锉一剂，生姜三片，水煎服。
痛不移处者，是死血也。
活血汤 治死血痛，并治血结痛。
归尾 赤芍 桃仁（去皮） 官桂（五分） 玄胡索 乌药 香附 枳壳（去穣。各一钱） 红花（五分）
牡丹皮 川芎（七分） 木香（五分，另磨） 甘草（二分）
上锉一剂，姜一片，水煎服。
小便不利而痛者，是湿痰也。腹中引钓，胁下有声，是痰饮也。二陈汤加减。（方见痰饮。）
时痛时止，面白唇红者，是虫痛也。
椒梅汤 治虫痛。
乌梅 花椒 槟榔 枳实 木香（另研） 香附 砂仁 川楝子（去核） 肉桂 浓朴 干姜 甘草
（各等分）
上锉一剂，生姜一片，水煎服。
退虫丸 （方见诸虫积痛）
怒气伤肝，胁刺痛者，是刺风痛也。
木香顺气散 （方见诸气，治气痛。）
以手按之，腹软痛止者，虚痛也。
温中汤 治虚痛。
良姜 官桂 益智仁 砂仁 木香（另研） 香附 浓朴 陈皮 茴香 当归 玄胡索 甘草（各等分）
上锉一剂，生姜一片，水煎服。
腹满硬，手不敢按者，是实痛也。腹中积热，病久不止，大便实，脉数、烦渴者，枳实大黄汤下之，痛随
利减之法。
枳实大黄汤 治食积痛，并积热痛，大便不通者。
枳实 大黄 槟榔 浓朴（各二钱） 木香（五分，另研） 甘草（三分）
上锉一剂，水煎服。
秘方 治一切腹痛，不论虚实寒热皆效。用小麦秆烧灰，地上去火毒，将麻布包了，滚水淋汁，一服立止。
一肚腹作痛，或大便不通，按之痛甚，瘀血在内也。加味承气汤下之。既下而痛不止，按之仍痛，瘀血未
尽也。加味四物汤补而行之。（方见补益。）
加味承气汤 治瘀血内停，胸腹胀痛，或大便不通等症。
大黄 朴硝（各二钱） 枳实 浓朴 当归 红花（各一钱） 甘草（五分，病急者不用）
上锉一剂，酒、水各二钟，煎至一钟温服。仍量虚实加减。
Pulse: In cases of abdominal pain, the pulse at the Guan position is tight, small, and rapid, or moving and wiry; in severe cases, it may be deep and hidden. A wiry, full, and slippery pulse indicates phlegm. A tight pulse at the Chi position corresponds to pain in the umbilical and epigastric regions. A deep and fine pulse is auspicious; however, a floating, large, wiry, and long pulse indicates a poor prognosis with potential loss of life.
Abdominal pain is categorized into nine types: cold, heat, food stagnation, blood stasis, dampness, phlegm, parasites, deficiency, and excess.
Kaiyu Daoqi Decoction (Opening Stagnation and Directing Qi Decoction) is the general formula for treating all types of abdominal pain.
Cangzhu (Atractylodis Rhizoma, soaked in rice wash water), Xiangfu (Cyperi Rhizoma, soaked in urine of a young boy), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Fuling (Poria, peeled), Huashi (Talcum), Zhizi (Gardeniae Fructus, stir-fried until black), Shenqu (Massa Medicata Fermentata, stir-fried, each 1 qian),
Chenpi (Citri Reticulatae Pericarpium, 0.5 qian), Ganjiang (Zingiberis Rhizoma, stir-fried until black, 0.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, a small amount).
Crush these ingredients for one dose, decoct with water, and take warm.
Continuous pain without fluctuation, accompanied by a deep and slow pulse, indicates cold pain.
Jianggui Tang (Ginger and Cinnamon Decoction) treats cold abdominal pain.
Ganjiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), Liangjiang (Alpiniae Officinarum Rhizoma, each 0.7 fen), Zhiqiao (Aurantii Fructus, pith removed, stir-fried with bran), Chenpi (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus Rotundus, processed with ginger juice), Houpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Wuzhuyu (Evodiae Fructus, stir-fried, each 1 qian),
Xiangfu (Cyperi Rhizoma, 1.5 qian), Muxiang (Vladimiriae Radix, 0.5 fen, ground separately and taken with the decoction), Gancao (Glycyrrhizae Radix et Rhizoma, 0.2 fen).
Crush these ingredients for one dose, add one slice of fresh ginger, decoct with water, and take. If pain persists, add Yanshusuo (Corydalis Rhizoma), Huixiang (Foeniculi Fructus), and Ruxiang (Olibanum); if extreme cold causes cold hands and feet, add Fuzi (Aconiti Lateralis Radix Praeparata), and remove Wuzhuyu and Liangjiang; if diarrhea occurs, remove Zhiqiao.
Intermittent pain with a rapid pulse indicates fire pain (i.e., heat pain).
Sanhuo Tang (Dispersing Fire Decoction) treats heat pain.
Huanglian (Coptidis Rhizoma, stir-fried), Shaoyao (Paeoniae Radix Alba, stir-fried), Zhizi (Gardeniae Fructus, stir-fried), Zhiqiao (Aurantii Fructus, pith removed), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex, peeled), Xiangfu (Cyperi Rhizoma), Fuxiong (Ligustici Chuanxiong Rhizoma, each 1 qian),
Muxiang (Vladimiriae Radix, ground separately), Sharen (Amomi Fructus Rotundus), Huixiang (Foeniculi Fructus, each 0.5 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 fen).
Crush these ingredients for one dose, add one slice of fresh ginger, decoct with water, and take. If pain is severe and persistent, add Yanshusuo (Corydalis Rhizoma) and Ruxiang (Olibanum).
Abdominal pain accompanied by diarrhea, where pain decreases after defecation, indicates food stagnation.
Xiangsha Pingwei San (Cyperi and Amomi Powder to Calm the Stomach) treats pain due to food stagnation.
Xiangfu (Cyperi Rhizoma, stir-fried), Sharen (Amomi Fructus Rotundus), Houpo (Magnoliae Officinalis Cortex, processed with ginger juice), Cangzhu (Atractylodis Rhizoma, soaked in rice wash water), Chenpi (Citri Reticulatae Pericarpium), Zhiqiao (Aurantii Fructus, pith removed, stir-fried with flour), Shanzha (Crataegi Fructus, seeds removed),
Shenqu (Massa Medicata Fermentata, stir-fried, each 3 qian), Muxiang (Vladimiriae Radix, ground separately and mixed in), Ganjiang (Zingiberis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, each 0.3 fen).
Crush these ingredients for one dose, add three slices of fresh ginger, decoct with water, and take.
Fixed pain indicates death-blood (blood stasis).
Huoxue Tang (Invigorating Blood Decoction) treats pain due to blood stasis and also treats pain due to blood knotting.
Guiwei (Radix Angelicae Sinensis caudex), Chishao (Paeoniae Radix Rubra), Taoren (Persicae Semen, peeled), Guongui (Cinnamomi Ramulus, 0.5 fen), Yanshusuo (Corydalis Rhizoma), Wuyao (Tsaoko Fructus), Xiangfu (Cyperi Rhizoma), Zhiqiao (Aurantii Fructus, pith removed, each 1 qian), Honghua (Carthami Flos, 0.5 fen),
Mudanpi (Moutan Cortex), Chuanxiong (Ligustici Chuanxiong Rhizoma, 0.7 fen), Muxiang (Vladimiriae Radix, 0.5 fen, ground separately), Gancao (Glycyrrhizae Radix et Rhizoma, 0.2 fen).
Crush these ingredients for one dose, add one slice of fresh ginger, decoct with water, and take.
Pain accompanied by difficult urination indicates damp-phlegm. Pulling pain in the abdomen and sounds under the hypochondrium indicate phlegm-fluid retention. Use Erchen Tang (Two-Aged Decoction) with modifications. (Formula see Phlegm-Fluid Retention section.)
Intermittent pain with a pale face but red lips indicates parasite pain.
Jiaomei Tang (Pepper and Plum Decoction) treats parasite pain.
Wumei (Mume Fructus), Huajiao (Zanthoxyli Pericarpium), Binglang (Arecae Semen), Zhishi (Aurantii Fructus Immaturus), Muxiang (Vladimiriae Radix, ground separately), Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus Rotundus), Chuanlianzi (Toosendan Fructus, pith removed), Rougui (Cinnamomi Cortex), Houpo (Magnoliae Officinalis Cortex), Ganjiang (Zingiberis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, equal parts).
Crush these ingredients for one dose, add one slice of fresh ginger, decoct with water, and take.
Tuichong Wan (Parasite-Expelling Pill) (Formula see Pain Due to Various Parasite Accumulations section).
Anger injuring the Liver causing stabbing pain in the hypochondrium indicates "stabbing wind pain."
Muxiang Shunqi San (Vladimiriae and Aromatic Powder to Smooth Qi) (Formula see Various Qi Disorders, treats Qi pain.)
Soft abdomen where pain stops upon manual pressure indicates deficiency pain.
Wenzhong Tang (Warming the Middle Decoction) treats deficiency pain.
Liangjiang (Alpiniae Officinarum Rhizoma), Guongui (Cinnamomi Ramulus), Yizhiren (Alpiniae Oxyphyllae Fructus), Sharen (Amomi Fructus Rotundus), Muxiang (Vladimiriae Radix, ground separately), Xiangfu (Cyperi Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Huixiang (Foeniculi Fructus), Danggui (Angelicae Sinensis Radix), Yanshusuo (Corydalis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, equal parts).
Crush these ingredients for one dose, add one slice of fresh ginger, decoct with water, and take.
Abdominal fullness and hardness where manual pressure is intolerable indicates excess pain. If there is accumulated heat in the abdomen, prolonged illness, solid stool, rapid pulse, and irritability with thirst, use Zhishi Dahuang Tang (Immature Bitter Orange and Rhubarb Decoction) to purge, following the principle that "pain decreases with bowel movement."
Zhishi Dahuang Tang (Immature Bitter Orange and Rhubarb Decoction) treats pain due to food stagnation, accumulated heat pain, and constipation.
Zhishi (Aurantii Fructus Immaturus), Dahuang (Rhei Radix et Rhizoma), Binglang (Arecae Semen), Houpo (Magnoliae Officinalis Cortex, each 2 qian), Muxiang (Vladimiriae Radix, 0.5 fen, ground separately), Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 fen).
Crush these ingredients for one dose, decoct with water, and take.
Secret Formula: Effective for all abdominal pain regardless of deficiency, excess, cold, or heat. Burn wheat stalks to ash, remove fire toxicity on the ground, wrap in hemp cloth, pour boiling water over it to extract the juice, and take once for immediate relief.
1. Abdominal pain, or constipation with aggravated pain upon pressure, indicates internal blood stasis. Purge with Jiawei Chengqi Tang (Modified Chengqi Decoction). If pain persists after purging and pressure still elicits pain, it indicates incomplete removal of blood stasis. Tonify and move blood with Jiawei Siwu Tang (Modified Four Substances Decoction). (Formula see Tonification section.)
Jiawei Chengqi Tang (Modified Chengqi Decoction): Treats symptoms such as internal blood stasis, chest and abdominal distension and pain, or constipation.
Dahuang (Rhei Radix et Rhizoma), Poxiao (Natrii Sulfas, each 2 qian), Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), Danggui (Angelicae Sinensis Radix), Honghua (Carthami Flos, each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 fen, omit if condition is urgent).
Crush these ingredients for one dose, decoct with two units of wine and two units of water until reduced to one unit, and take warm. Dosage should still be adjusted according to deficiency and excess.