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Abdominal borborygmus accompanied by pain may also be caused by fire pathogen or qi stagnation. Zhu Danxi stated: Abdominal borborygmus is the result of fire agitating the water within the body.
Generally, this occurs because water qi desires to descend while fire qi desires to ascend, and their collision produces the sound. For such cases, Erchen Tang (Two Aged Decoction) can be used with added Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Zhizi (Gardeniae Fructus). There are also cases where visceral cold causes a gurgling water sound; these should be treated according to the divisions of the Three Yin meridians. The Zhongwan point belongs to the Taiyin meridian, the area around the umbilicus belongs to the Shaoyin meridian, and the lower abdomen belongs to the Jueyin meridian; each should be warmed according to its specific indication. Additionally, there is water qi retained under the hypochondrium; due to upper jiao deficiency failing to control the water, borborygmus resembling thunder and diarrhea occur, which is termed "Xiere Li" (Diarrhea accompanying heat). There are also cases of borborygmus due to emptiness of the stomach and intestines, which should be treated with tonics such as Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma). The *Classic* states: Spleen and stomach deficiency leads to intestinal borborygmus and abdominal fullness. It also states: Deficiency of middle qi causes painful intestinal borborygmus.

A sensation of cold in the abdomen is not only due to severe deficiency of middle qi and yang qi, but also due to significant depletion of the true fire of the Mingmen gate.
For a sensation of tightness or narrowness in the abdomen, Cangzhu (Atractylodis Rhizoma) must be used. If obese individuals feel a sensation of narrowness in the abdomen, it is due to damp-phlegm flowing into the zang-fu organs, causing obstruction of qi ascent and descent; for drying dampness and resolving phlegm, Cangzhu is used, and for moving qi, Xiangfu (Cyperi Rhizoma) is used. If thin individuals feel a sensation of narrowness in the abdomen, it is due to heat steaming the zang-fu organs, and Huanglian (Coptidis Rhizoma) and Cangzhu (Atractylodis Rhizoma) should be used.

There are two types of lower abdominal pain. Whenever the chi pulse is surging and large, it indicates yin insufficiency, and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is appropriate. Whenever the chi pulse is deep and faint, it indicates yang insufficiency, and Bawei Wan (Eight-Ingredient Pill) is appropriate. In women, this often belongs to jia masses (abdominal masses), and warming and tonifying the liver and kidneys is suitable. In patients with Shanghan (Cold Damage), if blood stasis is stored in the lower jiao, Didang Tang (Rescue the Extremities Decoction) or Taoren Chengqi Tang (Peach Kernel and Rhubarb Decoction) are appropriate. If the pain is due to qi stagnation, Qingpi (Citri Reticulatae Pericarpium Viride) is the primary herb. If it is due to cold, Guizhi (Cinnamomi Ramulus) and Wuzhuyu (Evodiae Fructus) are used to warm and disperse. If it is due to hernia, Bentun (Rushing Pig Qi), or jia masses, treatment should follow the protocols in the respective sections. Whenever there is pain below the navel accompanied by blackening of the Renzhong area (philtrum), death is likely.

This formula treats five types of Yeguan (dysphagia/obstruction of food passage) disorders. The pills treat heart pain, pi masses (lumps), qi masses, stabbing pain from cold qi attacking, male hernia, and female blood qi pain.
Ingredients: Huixiang (Foeniculi Fructus, stir-fried), Qingpi (Pericarpium Citri Reticulatae Viride, white pith removed), Gancao (Glycyrrhizae Radix et Rhizoma, stir-fried), Chenpi (Pericarpium Citri Reticulatae, white pith removed), Peng'ezhu (Curcumae Longae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 1 liang); Shengjiang (Zingiberis Rhizoma Recens, 4 liang, sliced, pickled overnight with half a liang of salt); Hujiao (Piperis Nigris Fructus), Baizhi (Angelicae Dahuricae Radix), Rougui (Cinnamomi Cortex, bark removed), Suosha (Amomi Fructus Rotundus), Xiaohuixiang (Foeniculi Fructus, stir-fried) (each 5 qian); Awèi (Asafoetidae Resina, soaked in wine overnight, made into paste with flour, each 1.5 qian). Grind all ingredients into powder. Use the Awèi-flour paste to form pills the size of Euryale Seed (Qianshi). For every 1 jin of medicine, coat with 7 qian of Zhusha (Cinnabar). Take 3–5 pills per dose. For male qi pain, swallow with stir-fried ginger and salt water. For female blood qi pain, swallow with vinegar water.