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Abdominal pain may be caused by cold, accumulated heat, dead blood (blood stasis), food accumulation, and damp-phlegm. A wiry pulse indicates food accumulation; a slippery pulse indicates phlegm (or alternatively, a choppy pulse). Clear phlegm often causes abdominal pain; a standard formula involves grinding Taixiong (Ligusticum Chuanxiong Rhizoma), Cangzhu (Atractylodis Rhizoma), Xiangfu (Cyperus Rotundus Rhizome), and Baizhi (Angelicae Dahuricae Radix) into powder, mixing with ginger juice in decoction for oral administration. For abdominal pain due to qi stagnation, use qi-regulating herbs such as Muxiang (Aucklandiae Radix), Binglang (Arecae Semen), Xiangfu, and Zhike (Aurantii Fructus); for blood stasis, use blood-invigorating herbs such as Danggui (Angelicae Sinensis Radix), Chuanxiong, Taoren (Persicae Semen), and Honghua (Carthami Flos). In the early stage when primordial qi is not yet deficient, purgative methods must be employed; this is the principle of "treating obstruction with unblocking agents" (Tong Yin Tong Yong). However, if the disease has persisted for a long time, purgation becomes difficult. Those who are robust or in the acute phase should undergo purgation; those who are weak, debilitated, or suffering from chronic illness should undergo lifting and resolving methods. Borborygmus in the abdomen indicates fire disturbing water; Erchen Tang (Two-Cured Decoction) added with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Zhizi (Gardeniae Fructus) may be used. Alternatively, borborygmus may result from internal organ cold. Heart and abdominal pain generally require warming and dispersing methods because stagnation obstructs qi movement. Pain located uppermost is often due to food retention; warming and dispersing agents like Ganjiang (Zingiberis Rhizoma), fried Cangzhu, Chuanxiong, Baizhi, Xiangfu, and ginger juice are suitable. Harsh purgatives should not be used, as food congeals with cold and transforms with heat; combined with qi-moving herbs, recovery is assured. An elderly patient with abdominal pain who cannot tolerate purgation may be treated with Chuanxiong, Cangzhu, Xiangfu, Baizhi, Ganjiang, Fuling (Poria), and Huashi (Talcum).

Dai Yuanli stated: Cold pain presents as continuous dull pain without fluctuation; intermittent pain indicates heat; blood stasis pain is fixed in location and does not migrate; food accumulation pain is characterized by an urge to defecate with pain relief after bowel movement; damp-phlegm pain is invariably accompanied by dysuria.

For treating alcohol-induced abdominal pain, regulating qi is crucial.
Binglang, Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Xiangfu, Guangui (Cinnamomi Ramulus), Cangzhu, Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Fuling, Muxiang.
Grind these into powder, bind with dough made from Shenqu (Massa Medicata Fermentata), and form pills. Take 50 pills per dose with warm water.

[Appendix] Some ask: Can phlegm cause pain? The answer is: Phlegm accumulates due to qi stagnation; once accumulated, it obstructs pathways, preventing qi circulation, thus causing pain. In various abdominal pain syndromes, Renshen (Ginseng Radix), [missing character], and Baizhu (Atractylodis Macrocephalae Rhizoma) should not be used, as tonifying qi when it is stagnant exacerbates pain. Shaoyao (Paeoniae Radix Alba) treats only blood-deficiency abdominal pain and should not be used for other pain syndromes due to its sour astringent nature. Sudden severe pain below the umbilicus with black discoloration of the Renzhong area (philtrum) is often fatal.

Jiaochangsha (intestine-twisting colic) causing pain can be treated by inducing vomiting with Camphorwood (Camphorae Lignum) decoction, or alum-water decoction, or salt-water induced emesis; bleeding at Weizhong (BL40) is also indicated. Abdominal pain generally uses Shaoyao. If accompanied by aversion to cold, add Guizhi (Cinnamomi Ramulus); if accompanied by aversion to heat, add Huangbai (Phellodendri Cortex). For abdominal pain relieved by firm pressure, it is deficiency; use Renshen, Baizhu, Ganjiang, Rougui (Cinnamomi Cortex). For abdominal pain aggravated by pressure, it is excess; use Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas) for purgation. Abdominal pain in obese individuals indicates deficiency with damp-phlegm; use Renshen, Cangzhu, Baizhu, and Banxia (Pinelliae Rhizoma). If caused by cold invasion, use Ganjiang and Guizhi; if vomiting occurs, add Dingxiang (Caryophylli Flos). If caused by summerheat, use Yulong Wan (Jade Dragon Pill); if caused by dietary excess, use Muxiang Binglang Wan (Aucklandia and Areca Pill) for purgation. If caused by constitutional weakness and dietary excess, tonify spleen and stomach while promoting digestion using Renshen, Baizhu, Shanzha (Crataegi Fructus), Shenqu, Zhishi (Aurantii Fructus Immaturus), and Muxiang. If caused by trauma, it is blood stasis; use Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Decoction).

Supplementary Formulas:
Yulong Wan (Jade Dragon Pill), also known as Huanglong Wan (Yellow Dragon Pill), see Summerheat.
Muxiang Binglang Wan, see Dysentery.
Tao Ren Cheng Qi Tang, see Hematemesis.
Yangwei Tang (Stomach-Nourishing Decoction), see Malaria.
Lizhong Tang (Regulate the Middle Decoction), see Cold Damage.
Xiao Jianzhong Tang (Minor Construct the Middle Decoction)
Shaoyao (3 liang), Gancao (1 liang), Shengjiang (1.5 liang), Dazao (6 pieces), Guizhi (de-barked, 1.5 liang), Jiyi (half jin; omit Jiyi if mild diarrhea or vomiting exists).
Cut the herbs. For each dose, take 5 qian, add 1.5 cups of water, 3 slices of ginger, and 1 jujube. Decoct until 80% remains, strain, then add 2 spoons of maltose syrup, re-heat until dissolved, and take warm.

A sensation of tightness in the abdomen requires Cangzhu. If an obese person feels abdominal tightness, it is due to damp-phlegm flooding the organs, impairing ascending and descending functions. Use Cangzhu to dry dampness and Xiangfu to move qi. If a thin person feels abdominal tightness, it is due to heat steaming the organs; use Huanglian and Cangzhu.