Library

If one sleeps on cold and damp ground, it leads to pain in the lower back and hypochondrium, with an inability to turn the body.
Qianghuo (Notopterygii Rhizoma et Radix, 1.5 qian), Chaihu (Bupleuri Radix), Rougui (Cinnamomi Cortex), Cangzhu (Atractylodis Rhizoma), Dangguishao (Angelicae Sinensis Radix tip), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 1 qian), Duhuo (Angelicae Pubescentis Radix), Hongqu (Red Yeast Rice, stir-fried) (each 0.5 qian), Fangfeng (Saposhnikoviae Radix), Fangji (Stephaniae Tetrandrae Radix) (each 0.3 qian), Taoren (Persicae Semen, five seeds, peeled, remove tips, crushed). Decoct with water and wine, take hot after meals.

This is extremely effective for treating lower back pain in both men and women.
Yanhusuo (Corydalis Rhizoma), Danggui (Angelicae Sinensis Radix), Guixin (Cinnamomi Ramulus), Duzhong (Eucommiae Cortex) each in equal parts, grind into powder, take 3 qian with wine.

Treats unbearable severe lower back pain.
Chuanlianzi (Toosendan Fructus, use flesh, stir-fry with five shelled Badou (Crotonis Fructus) until red, then remove Badou), Huixiang (Foeniculi Fructus, salt-stir-fry, remove salt), Pogu zhi (Psoraleae Fructus, stir-fried) (each 1 liang). Grind into powder, take 1 qian per dose, mix with hot wine before meals.

Treats deficiency-cold of the Kidney channel, heavy and painful waist and legs; regular use strengthens sinews and tonifies deficiency.
Pogu zhi (Psoraleae Fructus, stir-fried, 4 liang), Duzhong (Eucommiae Cortex, 4 liang, stir-fried until fibers break), Shengjiang (Zingiberis Rhizoma Recens, 2.5 liang, stir-fried dry). Grind into powder, use thirty Hutaoren (Juglandis Semen), crush into paste, make pills with honey the size of paulownia seeds. Take 50 pills per dose, swallow with salted wine.

Treats Kidney deficiency with dampness invasion, heavy body, cold waist feeling like sitting in water, no thirst, free urination.
Ganjiang (Zingiberis Rhizoma, processed), Fuling (Poria) (each 4 liang), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 2 liang). Take 5 qian per dose, decoct with water, take on an empty stomach.

Treats injury from cold-dampness, heavy body as if in water, free urination, loose stools.
Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 1 liang), Fuling (Poria), Ganjiang (Zingiberis Rhizoma, processed) (each 1.5 liang), Juhong (Citri Reticulatae Pericarpium Rubrum) (0.35 liang), Dingxiang (Caryophylli Flos) (0.25 liang). Take 4 qian per dose, decoct with ginger and jujube water.

Meridian qi circulates continuously without stopping; if unobstructed, there is no pain, so what disease would there be? If cold pathogen lodges within the meridians, then meridian qi becomes stagnant and cannot flow; if it lodges outside the meridians, blood also coagulates and becomes discordant. Qi stagnation and blood coagulation cause sudden pain. When cold lodges outside the meridians, pain stops easily; when it lodges inside the meridians, pain does not stop. There are cases of heart and back pulling pain due to cold lodging in the Back-Shu meridians, which internally connect to the Heart, causing heart and back pulling pain. There are cases of hypochondrium and lower abdomen pulling pain due to cold lodging in the Jueyin meridians, causing blood stasis and tense meridians, resulting in pulling pain between hypochondrium, lower abdomen, and inner thigh. There are cases of pain with vomiting due to cold lodging in the Stomach and Intestines, causing Qi to fail to descend and instead rebel upwards; if cold remains, pain arises, and Yang rising causes vomiting. There are cases of abdominal pain with diarrhea due to cold lodging in the Small Intestine; since the Small Intestine is the palace of reception and transformation, cold pathogen prevents accumulation, so it transmits to the Large Intestine, causing painful diarrhea. There are cases of pain with constipation due to heat lingering in the Small Intestine, causing intestinal pain. Bi-heat and scorched thirst, where heat seeps fluids, cause pain and hard constipation. Pain accompanied by heat manifests as burning body, red face, irritability, and hot palms/soles. Pain accompanied by cold manifests as blue-white complexion, even cyanosis of lips, mouth, and nails, desire to press and warm the painful area, and clear saliva discharge. Furthermore, unresolved food retention with yellow face, abdominal distension, night fever/day coolness, and abdominal pain indicates wind-cold entering the Spleen, cold accumulation in Spleen and Stomach leading to fullness and pain persisting for years. The treatment principle is: warm for cold, clear for heat, purge for excess, regulate for deficiency. However, the *Neijing* discusses abdominal pain mostly citing cold pathogen, as cold obstructs Yang Qi most severely. Yet, six excesses and seven emotions damaging Ying and Wei cause diverse diseases, not just cold! Therefore, careful differentiation is essential for effective treatment. Differentiate cold and heat: (deep and slow pulse indicates cold, floating and rapid pulse indicates heat.) Differentiate deficiency and excess: (scattered, large, and forceless pulse indicates deficiency, wiry and forceful pulse indicates excess.) Differentiate phlegm-fluids: (slippery pulse indicates phlegm, deep and wiry pulse indicates fluid retention.) Differentiate masses and accumulations: (deep, wiry, and hidden pulse indicates accumulation, fluctuating or wiry pulse indicates gathering.) Differentiate worm pain: (pulse often deep-slippery or fluctuating in size.) Differentiate fixed blood (blood stasis): (deep, choppy, knotted, or hurried pulse.) Zhongwan pain belongs to Taiyin Spleen. Pain at the navel belongs to Shaoyin Kidney. Lower abdominal pain belongs to Jueyin Liver, Chong and Ren vessels, and Large/Small Intestines. Cold pain prefers hot hand pressure and hot food, presents with blue-white face, vomiting/diarrhea without thirst, and a deep, slow, continuous pulse without fluctuation; treat with warming herbs like Ginger, Cinnamon, and Aconite. Heat pain persists despite hot hand pressure, presents with surging-rapid pulse, intermittent pain, and vomiting. However, some find relief with heat because pungent-warm herbs open depression and smooth Qi flow temporarily, but Yin blood depletes daily while dry-fire flares, causing recurrence over years; this is accumulated heat. Mild cases use Gardenia, Coptis, White Peony, and Cyperus; severe cases use Tiaowei Chengqi Tang to purge. Note that heat pain may temporarily stop with cold pressure but worsen with moxibustion/warming. Deficiency pain stops with firm manual pressure; treat with Ginseng, Atractylodes, White Peony, and warming herbs. Excess pain is severe with distension, intolerable to touch, worsening with pressure; treat with resolving or purging methods based on symptoms. Upper abdominal pain often relates to food retention; treat by warming Spleen and moving Qi to digest; avoid cold herbs as food stagnates with cold and transforms with heat. If pain migrates downward and persists, consider purging. Initially, do not purge as undigested food remains in chest/diaphragm. Phlegm pain involves difficult urination, phlegm blocking Middle Jiao, Qi closing Lower Jiao, preventing upper-lower circulation; treat by guiding out phlegm and opening depression. Hidden fluid retention pain varies; treat according to constitution, referencing the Fluid Retention chapter. Worm pain features moving lumps, vomiting clear water, abdominal heat/thirst, white spots on face, vermilion lips, appetite after pain or craving specific foods, intermittent pain, fluctuating pulse, and changing complexion. Food retention and blood stasis pain have fixed locations; treat with Tao Ren Cheng Qi Tang. Summerheat-induced painful dysentery presents with deficient pulse; use Shiwei Xiangru Yin. Dampness-induced pain with loose stool and difficult urination presents with soggy pulse; use Weiqin Tang. Food retention pain involves urge to defecate with pain relief after bowel movement; treat with warming and resolving methods. For chronic cases, choose Yuxian Dan or Shenxiong Wan to purge. Qi stagnation pain features abdominal distension and deep pulse; use Muxiang Shunqi San to restore Yuan Yang circulation. Jiaochangsha (intestinal colic/spasm) is acute; first induce vomiting with salt water or bleed at Weizhong and ten fingers, then take Huoxiang Zhengqi San. Alcohol retention pain occurs after drinking; resolve accumulation to stop pain.
For initial pain with intact Yuan Qi, purging is necessary, applying "treat obstruction with unblocking" method. For weakness with chronic illness, use lifting and resolving methods.
Heart and abdominal pain requires warming and dispersing, as depression and Yin Qi stagnation cause disease. Although White Peony treats abdominal pain, it only treats blood-deficiency type; it is contraindicated for other types because most pains require pungent dispersal, whereas White Peony is sour and astringent. For those with weak constitution and dietary injury causing pain, tonify Spleen/Stomach while aiding digestion. For trauma-induced pain due to blood stasis, use Tao Ren Cheng Qi Tang plus Danggui, Sulum, and Honghua, decocted in water and wine. Abdominal pain in obese individuals indicates Qi deficiency with phlegm-dampness; use Ginseng, Cang/Bai Zhu, and Banxia. Phlegm itself does not cause pain; rather, Qi depression gathers phlegm, which blocks Qi flow, causing pain. Kidney Yang deficiency pain requires strong tonification. Generally, epigastric/lower abdominal pain indicates food retention/exterior pathogens; periumbilical pain indicates phlegm-fire/accumulated heat; suprapubic/lower abdominal pain indicates cold, blood stasis, or urinary difficulty. A maiden suffered recurrent abdominal pain, poor appetite, yellow face, and emaciation. Pediatric treatment used heat-clearing and food-resolving; gynecological treatment used menstruation-promoting and blood-moving methods; general physicians treated deficiency with tonification, all ineffective. Later, an expert noted: large pulse with rapid radial pulse alone, rough skin, and dull nails indicate intestinal abscess with pus formed and about to rupture. Immediately prescribe Luffa Root (1 liang), Honeysuckle Flower (3 qian), Licorice Joint (1 qian), Gleditsia Spine and Tangerine Peel (each 2 qian). After two doses, pus and blood discharged heavily. Then treat with Taiyi Paste and Ginseng, recovering in one month.