论
《内经》曰∶寒气入经而稽迟，泣（与涩通）而不行，客于脉外则血少，客于脉中则气不通，故卒然而痛云云。按
《内经》举痛论言寒邪外客而为痛者，甚为详悉，但未能尽述，学人自宜检阅。外有因虚、因实、因伤寒、因痰火、因
食积、因死血者，种种不同，亦当表而出之，庶使学人易为参考焉。东垣曰∶腹中诸痛，皆由劳役过甚，饮食失节，中
气不足，寒邪乘虚而客入之，故卒然而作大痛，经云得炅则止。《此事难知》集论曰∶伤寒中脘痛，太阴也，理中汤、黄
建中汤之类。脐腹痛者，少阴也，四逆汤、真武汤、附子汤之类。小腹痛，厥阴也，重则正阳散、回阳丹，轻则当归
四逆汤之类。太阴连少阴痛甚者，当变为下利不止。若夫杂病腹痛，四物苦楝汤、酒煮当归丸之类。夏月腹痛，肌热恶
热，脉洪数，属手太阴、足阳明，黄芩芍药汤主之。秋月腹痛，肌寒恶寒，脉沉疾，属足太阴、足少阴，桂枝芍药汤主
之。四时腹痛，芍药甘草汤主之。原病式曰∶热郁于内，则腹满坚结而痛，不可例言为寒也。成无己曰∶阴寒为邪
者，则腹满而吐，食不下，自利益甚，腹 痛，太阴证也。发汗不解，医反下之，因而腹满时痛者，属太阳也，桂枝加
芍药汤主之。大实而痛者，桂枝加大黄汤主之。又曰∶邪气聚于下焦，则津液不得宣通，血气不得流行，或溺或血，流
滞于下，而生胀满硬痛也。若从心下至小腹皆硬满而痛者，是邪实也，须以大陷胸汤下之。若但小腹硬满而痛，小便利
者，则是蓄血之证；小便不利者，则为溺涩之证也。其有血虚瘦弱之人，津液枯涸，传送失常，郁火燥热煎成结粪，滞
于大小肠之间，阻气不运而作痛者，宜以枳实导滞丸、备急大黄丸之类，先通其滞、止其痛，然后用四物等生血润燥之
剂以治其本。外有卒然心腹大痛，欲吐不得吐，欲泻不得泻，唇青厥逆，死在须臾，此内因食积，外感寒邪，是名干霍
乱之候也，宜急以盐汤灌之，而以鹅翎探吐取涎而愈。若夫清痰留滞于胸腹之间，食积郁结于肠胃之内，皆能令人腹痛。
清痰作痛者，控涎丹、小胃丹之类。食积为患者，保和丸、枳术丸之类消之，枳实导滞丸、木香槟榔丸之类下之。浊气
在上者涌之，清气在下者提之，寒者温之，热者清之，虚者补之，实者泻之，结者散之，留者行之，此治法之大要也，
学人详之。
脉法
《脉经》曰∶脉细小紧急，病速进，在中，腹中刺病。阴弦，则腹痛。弦急，小腹痛。尺脉紧，脐下痛。尺脉伏，
小腹痛，症疝。尺脉实，小腹痛，当利之。心腹痛，不得息，脉细小迟者生，脉坚大疾者死。腹痛，脉反浮大而长者死。
方法
丹溪曰∶腹痛有寒，有积热，有食积，有痰，有死血。脉弦者多属食，宜温散之，盖食得寒则滞，得热则行，更宜
以行气或利药助之，无不愈者。
脉滑者是痰，痰因气滞而聚，阻碍道路，气不得宣通而痛，宜导痰解郁。
凡痛必用温散，以其郁结不行，阻气不运故也。
脐下忽大痛，人中黑色者，多死。
腹中水鸣，乃火击动其水也。
戴氏曰∶痛甚便欲大便，去后则痛减者，是食积也。绵绵痛而无增减者，是寒也。时痛时止者，是热也。其痛有常
处而不移动者，是死血也。痛而小便不利者，痰也。
治腹痛，用台芎、苍术、香附、白芷为末，姜汁入汤调服。
白芍药，止能治血虚腹痛，余俱不治。（以其酸寒收敛而别无温散之功者也。）
如饮食过伤而腹痛者，宜木香槟榔丸下之。
如气虚之人，伤饮食而腹痛，宜调补胃气并消导药，用人参、白术、山楂、神曲、枳实、麦芽、木香、砂仁之类。
如腹中常有热而痛，此为积热，宜调胃承气汤下之。
小腹实痛，用青皮以行其气。
小腹因寒而痛，宜肉桂、吴茱萸。
因寒气作痛者，宜小建中汤加干姜、官桂、台芎、苍术、白芷、香附。
因热而痛者，二陈汤加黄 、黄连、栀子，痛甚者加炒干姜从治之。
若腹痛不禁下者，宜川芎苍术汤以治之，川芎、苍术、香附、白芷、茯苓、滑石，加姜，水煎服。
（以上丹溪方法凡十五条）
高良姜汤（东垣） 治因寒心腹大痛。
高良姜（三钱） 浓朴（姜制） 官桂（各一钱）
上细切，作一服，水一盏半，煎至一盏，去渣稍热服。
草豆蔻汤（东垣） 治脐腹虚胀作痛。
泽泻（二钱） 木香（三分） 神曲（四分） 半夏 枳实（麸炒黄色） 草豆蔻（面裹煨） 黄 （春夏勿用） 益
智仁（去壳） 甘草（炙，各五分） 青皮 陈皮（各六分） 川归（七分） 茯苓（七分）
上细切，作一服，加生姜三片，水一盏半，煎至一盏，温服。
益胃散（东垣） 治因服寒药过多，致腹痛不止。
人参 浓朴（姜制） 甘草（炙） 白豆蔻（去壳） 姜黄 干姜（炮） 砂仁 泽泻（以上各三分） 益智仁（六
分） 陈皮（七分） 黄 （七分，蜜炙）
上细切，作一服，加姜，水煎服。
浓朴温中汤（东垣） 治胃虚寒，胀满疼痛。
浓朴 陈皮（各一钱） 茯苓 草豆蔻（面包煨） 甘草（炙） 木香（各五分） 干姜（三分半，炮）
上细切，加姜，水煎服。
六合散（又名密钥匙，河间） 治一切燥热郁结，汗后余热宣转不通，并治小肠气结，心腹满闷，胸中痞结，
走注疼痛。
大黄（一两，酒拌湿蒸） 白丑（炒） 黑丑（略炒） 甘遂（各五钱） 槟榔（三钱，生） 轻粉（一钱）
上为细末，每服一钱，蜜水调下，量虚实加减服。
没药散（河间） 治一切心腹疼痛不可忍者。
没药（另研） 乳香（另研，各三钱） 木鳖子（四钱，支壳） 穿山甲（五钱，糠灰火煨脆）
上为细末，每服五分或一钱，酒大半盏，煎三、五沸服。
木香槟榔丸（河间） 治食郁气滞作痛。
木香（三钱） 槟榔（三钱） 青皮（五钱，去白） 陈皮（五钱，去白） 麦 面（炒，七钱） 枳实（麸炒黄
色，六钱） 白术（五钱） 浓朴（姜制，四钱）
上为细末，汤浸蒸饼为丸，如梧桐子大，每服五十丸，温水下，食远。
枳实导滞丸（东垣） 治食伤湿热之物，不得施化，腹痛满闷不安，以利为度。（方见内伤门。）
瓜蒂散（活人） 治食伤太阴，填塞闷乱不快，甚则心胃大痛，兀兀欲吐者。（方见中风门。）
桂枝加芍药汤（活人） 治腹满时痛，脉弱。
桂枝 甘草（各二钱） 白芍药（四钱）
上作一服，姜三片，枣二枚，水煎服。
小建中汤（活人） 治伤寒，阳脉涩，阴脉弦，腹中急痛者。
桂枝 甘草（炙，各三分） 白芍药（六分） 阿胶（炒，一合）
上加姜二片，枣二枚，水煎服。
真武汤（活人）
治腹痛下痢，四肢沉重。（方见伤寒门。）
霹雳散（河间） 治腹痛脉微欲绝。
附子（一枚，泡，取出以糠灰焙之，去皮脐）
上以一味取五钱重，入真腊茶一钱，同研细为末，分作二服，每服用水一盏，煎七分，去渣，入蜜一匙，稍冷服。
酒煮当归丸（东垣） 治小腹寒痛，及妇人白带疝 大寒等证。
茴香（五钱） 黑附子（炮） 良姜（各七钱） 当归（一两）
上四味细切，以上好无灰酒一升半，煮至酒干尽，焙干入后药∶
炙甘草 苦楝（生用） 丁香（各五钱） 木香 升麻（各一钱） 柴胡（二钱） 炒黄盐 全蝎（各三钱） 玄
胡索（四钱）
上与前四味同研为细末，酒煮面糊为丸，如梧桐子大，每服五、七十丸，空心淡醋汤下。忌油腻、冷物及酒、湿面。
黄连汤（河间） 治胸中有热，胃中有邪气，腹内痛甚，时欲呕吐。此药升降阴阳。
黄连（酒炒） 甘草（炙） 干姜 桂枝（各五钱） 人参（二钱） 半夏（半合，泡七次，去皮脐）
上细切，入大枣二枚，量水煎服。
芍药甘草汤（河间） 治四时腹痛。
白芍药（酒炒） 甘草（炙）
上各等分，每服五钱，细切，入生姜三片，水一盏半，煎至一盏，温服。《医垒元戎》云∶腹痛脉弦伤气，用本药；
脉洪伤金，加黄芩；脉缓伤水，加桂枝；脉涩伤血，加当归；脉迟伤寒，加干姜。
加减小柴胡汤（河间） 治寒热脉弦腹痛
本方去黄芩，加白芍药。
四物苦楝汤（河间） 治脐下虚冷腹痛。
四物汤（六钱）加玄胡索、苦楝（各一钱五分）。
上细切，水二盏，煎至一盏，温服。
增损当归丸（河间） 治三阴受邪，心腹 痛。
四物汤（五钱） 防风 独活 全蝎（各五钱） 续断（原方无） 茴香（各一两） 苦楝（酒煮） 玄胡索（炒）
木香 丁香（各二钱）
上为细末，酒糊为丸，如梧桐子大，每服五十丸，白汤下。
苦楝丸（河间） 治奔豚小腹作痛。（方见疝气门。）
一捏金散（局方） 治脐腹大痛，及奔豚小肠气等证。
玄胡索 川楝子（酒煮） 全蝎（去毒，炒） 茴香
上各等分，为细末，每服二钱匕，热酒调下，神验。
（丹溪活套）云∶凡腹痛多是血脉凝涩不行，必用酒炒白芍药，恶寒而痛加桂，恶热而痛加黄柏。如腹痛欲以物拄
按者属虚，用人参、白术、干姜、官桂之类。如腹痛手不可按者属实，宜用建中汤加大黄，或调胃承气汤加桂枝类下之
而愈。如因饮食过伤而作痛者，必问因伤何物。如伤生冷硬物而作痛者，东垣木香见 丸、三棱消积丸之类。如伤热物
而作痛者，枳实导滞丸、三黄枳术丸之类。看强弱缓急，用而下之。如气虚之人，因饮食过伤而腹痛者，宜补泻兼施，
用二陈汤加川芎、白术、神曲、麦芽、人参、苍术之类，或送下前推积等丸子以下之。如腹中常觉有热而暴痛暴止者，
此为积热，宜调胃承气汤之类下之。如因跌扑损伤而作痛者，此瘀血证，宜桃仁承气汤，抵当汤之类，逐去其血即愈。
如因事损伤，或酒后涉水，血凝腹痛者，大承气汤加桂。
（医治）
一黄氏妇，年五十余，小腹有块作痛二月余。一医作死血治，与四物加桃仁等药，不效；又以五灵脂、玄胡索、乳
香、没药、三棱、莪术等作丸服，又不效。召予治，诊其六脉皆沉伏，两尺绝无。予曰∶乃结粪在下焦作痛耳，非死血
也。用金城稻 烧灰淋浓汁一盏服之，过一时许，与枳实导滞丸一百粒催之，下黑粪如梅核者一碗许，痛遂止。后与生
血润肠之药十数帖，调理平安。
一壮年男子，寒月入水网鱼，饥甚，遇凉粥食之，腹大痛，二昼夜不止。一医先与大黄丸，不通；又与大承气汤，
下粪水而痛愈甚。召予治，诊其六脉皆沉伏而实，面青黑色。予曰∶此大寒证，及下焦有燥屎作痛。先与丁附治中汤一
帖，又与灸气海穴二十一壮，痛减半。继以江子加陈皮、木香作丸，如绿豆大，生姜汁送下五粒，下五、七次，平安。
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When cold pathogenic qi enters the meridians, its movement becomes sluggish and stagnant. If it lodges outside the vessels, blood volume decreases; if it lodges inside the vessels, qi circulation is obstructed, thus causing sudden pain, and so on. Note: The *Jutong Lun* (Discourse on Pain) in the *Neijing* details the causes of pain due to external cold pathogenic factors quite thoroughly, though not exhaustively. Students should consult the original text. Additionally, abdominal pain may arise from deficiency, excess, cold damage (Shanghan), phlegm-fire, food stagnation, or fixed blood stasis (Si Xue). These various types should be listed for students' reference. Li Dongyuan stated: All kinds of abdominal pain are caused by excessive labor, irregular diet, insufficiency of Middle Qi, allowing cold pathogenic qi to invade when the body is deficient, resulting in sudden severe pain. The Classic says, "Pain ceases upon obtaining warmth." The *Cishi Nan Zhi* compilation states: Abdominal pain at the epigastrium in Cold Damage belongs to the Taiyin syndrome; treat with Lizhong Tang (Regulate the Middle Decoction) or Huangqi Jianzhong Tang (Astragalus Decoction to Construct the Middle). Pain at the umbilicus belongs to the Shaoyin syndrome; treat with Sini Tang (Frigid Extremities Decoction), Zhenwu Tang (True Warrior Decoction), or Fuzi Tang (Aconite Decoction). Pain in the lower abdomen belongs to the Jueyin syndrome; for severe cases, use Zhengyang San (Disperse Yang Powder) or Huiyang Dan (Return Yang Pill); for mild cases, use Danggui Sini Tang (Angelica Decoction to Warm the Extremities). If Taiyin pain extends to Shaoyin and is severe, it may transform into incessant diarrhea. For miscellaneous disease abdominal pain, use Siwu Kulian Tang (Four Substances and Melia Decoction) or Jiuzhu Danggui Wan (Wine-Boiled Angelica Pill). Summer abdominal pain with feverish skin and aversion to heat, with a surging and rapid pulse, belongs to the Hand-Taiyin Lung and Foot-Yangming Stomach channels; treat primarily with Huangqin Shaoyao Tang (Scutellaria and Peony Decoction). Autumn abdominal pain with cold skin and aversion to cold, with a deep and rapid pulse, belongs to the Foot-Taiyin Spleen and Foot-Shaoyin Kidney channels; treat primarily with Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction). Abdominal pain occurring in all seasons is treated primarily with Shaoyao Gancao Tang (Peony and Licorice Decoction). Liu Wansu's *Yuanbing Shi* states: Heat郁结 (depression/stagnation) internally causes abdominal fullness, hardness, and pain; one cannot generally attribute this to cold. Cheng Wuji stated: When Yin-cold acts as the pathogen, there is abdominal fullness and vomiting, inability to eat, worsening spontaneous diarrhea, and abdominal pain; this is a Taiyin syndrome. If sweating fails to resolve the condition, and the physician erroneously uses purgatives, leading to intermittent abdominal fullness and pain, it belongs to the Taiyang syndrome; treat with Guizhi Jiashaoyao Tang (Cinnamon Twig Decoction plus Peony). For severe excess pain, use Guizhi Jiadahuang Tang (Cinnamon Twig Decoction plus Rhubarb). He also stated: When pathogenic qi gathers in the Lower Jiao, body fluids fail to circulate freely, and qi-blood flow is obstructed. This may manifest as urinary abnormalities or bloody stools, stagnating below and causing distension, hardness, and pain. If hardness, fullness, and pain extend from the heart region down to the lower abdomen, it is an excess of pathogenic qi; it must be purged using Daxiexiong Tang (Major Trapping the Chest Decoction). If only the lower abdomen is hard, full, and painful, with free urination, it is a Blood Retention syndrome; if urination is difficult, it is a Urinary Obstruction syndrome. In individuals with blood deficiency and emaciation, where body fluids are depleted and transportation functions are abnormal,郁火燥热 (depressed fire and dry heat) may scorch feces into hard knots. These knots stagnate between the large and small intestines, obstructing qi movement and causing pain. One should first use Zhishi Daozhi Wan (Immature Bitter Orange Decoction to Guide Out Stagnation) or Beijiji Dahuang Wan (Emergency Preparedness Rhubarb Pill) to unblock stagnation and stop pain, then use Siwu Tang (Four Substances Decoction) and other blood-nourishing and moistening formulas to treat the root. Furthermore, sudden severe pain in the heart and abdomen, with an urge to vomit but unable to do so, and an urge to defecate but unable to do so, accompanied by cyanotic lips and cold extremities, potentially leading to death shortly, is known as Gan Huoluan (Dry Cholera) caused internally by food stagnation and externally by cold pathogenic qi. It should be urgently treated by administering salt water and inducing vomiting with a goose feather to expel phlegm-saliva. Clear phlegm stagnating in the chest and abdomen, or food stagnation郁结 (depressed/stagnated) in the stomach and intestines, can both cause abdominal pain. For pain caused by clear phlegm, use Kongyan Dan (Control Phlegm Pill) or Xiaowei Dan (Minor Stomach Pill). For harm caused by food stagnation, use Baohe Wan (Preserve Harmony Pill) or Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) to dissipate it, or Zhishi Daozhi Wan and Muxiang Binglang Wan (Areca Nut Pill) to purge it. Turbid qi above should be induced to vomit; clear qi below should be lifted. Cold should be warmed; heat should be cleared. Deficiency should be tonified; excess should be purged. Knots should be scattered; stagnation should be circulated. These are the general principles of treatment; students should study them carefully.
Pulse Diagnosis
The *Mai Jing* (Pulse Classic) states: A pulse that is fine, small, and urgent indicates rapid disease progression, located in the middle, with stabbing pain in the abdomen. A Yin-wiry pulse indicates abdominal pain. A wiry and urgent pulse indicates lower abdominal pain. A tight Chi pulse indicates pain below the umbilicus. A hidden Chi pulse indicates lower abdominal pain and hernia. A solid Chi pulse indicates lower abdominal pain, which should be relieved by promoting urination or bowel movements. Heart and abdominal pain with dyspnea: a fine, small, and slow pulse indicates survival; a firm, large, and rapid pulse indicates death. Abdominal pain with a floating, large, and long pulse indicates death.
Methods
Zhu Danxi stated: Abdominal pain includes cold, accumulated heat, food stagnation, phlegm, and fixed blood stasis (Si Xue). A wiry pulse mostly indicates food stagnation; warm dispersal is appropriate because food stagnates when cold and moves when hot. It is further advisable to assist with qi-moving or purgative herbs; recovery is assured.
A slippery pulse indicates phlegm. Phlegm accumulates due to qi stagnation, blocking pathways, preventing qi circulation, and causing pain. Promoting phlegm resolution and resolving depression is appropriate.
All pain requires warm dispersal because stagnation prevents qi movement.
Sudden severe pain below the umbilicus with black discoloration of the Renzhong area often leads to death.
Borborygmus in the abdomen is caused by fire agitating water.
Dai Shi stated: Severe pain with an urge to defecate, relieved after defecation, indicates food stagnation. Continuous dull pain without fluctuation indicates cold. Intermittent pain indicates heat. Pain fixed in one location without migration indicates fixed blood stasis (Si Xue). Pain with difficulty in urination indicates phlegm.
To treat abdominal pain, use Taixiong (Ligusticum chuanxiong), Cangzhu (Atractylodes lancea), Xiangfu (Cyperus rotundus), and Baizhi (Angelica dahurica) ground into powder, taken with ginger juice in decoction.
Baishao Yao (White Peony Root) only treats abdominal pain due to blood deficiency; it does not treat other types (because its sour and cold nature is astringent and lacks warming and dispersing properties).
If abdominal pain is caused by overeating, Muxiang Binglang Wan (Areca Nut Pill) should be used to purge.
If abdominal pain in a person with Qi deficiency is caused by dietary injury, tonify and regulate Stomach Qi while using digestive herbs such as Renshen (Ginseng), Baizhu (Atractylodes macrocephala), Shanzha (Hawthorn), Shenqu (Medicated Leaven), Zhishi (Immature Bitter Orange), Maiya (Barley Sprout), Muxiang (Vladimiria root), and Sharen (Amomum fruit).
If there is a constant sensation of heat in the abdomen with pain, indicating accumulated heat, Tiaowei Chengqi Tang (Regulate the Stomach and Descend Qi Decoction) should be used to purge.
Solid pain in the lower abdomen requires Qingpi (Green Tangerine Peel) to move Qi.
Cold-induced lower abdominal pain requires Rougui (Cinnamon Bark) and Wuzhuyu (Evodia Fruit).
Pain due to cold pathogenic qi requires Xiao Jianzhong Tang (Minor Construct the Middle Decoction) added with Ganjiang (Dried Ginger), Guigui (Official Cinnamon), Taixiong, Cangzhu, Baizhi, and Xiangfu.
Pain due to heat requires Erchen Tang (Two Aged Substances Decoction) added with Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Zhizi (Gardenia Fruit). For severe pain, add Chao Ganjiang (Stir-fried Dried Ginger) for counter-treatment.
If abdominal pain requires purgation, Chuanxiong Cangzhu Tang (Chuanxiong and Atractylodes Decoction) is appropriate: Chuanxiong, Cangzhu, Xiangfu, Baizhi, Fuling (Poria), Huashi (Talc), added with ginger, decocted in water.
(Above are fifteen methods from Danxi.)
Gaoliangjiang Tang (Li Dongyuan) Treats severe heart and abdominal pain due to cold.
Gaoliangjiang (Galangal Root) (3 qian) Nongpo (Magnolia Bark, processed with ginger) Guigui (Cinnamon Twig) (each 1 qian)
Finely chop, prepare as one dose. Add 1.5 cups of water, boil to 1 cup, remove dregs, and take slightly warm.
Caodoukou Tang (Li Dongyuan) Treats empty distension and pain at the umbilicus and abdomen.
Zexie (Alisma Rhizome) (2 qian) Muxiang (Vladimiria Root) (3 fen) Shenqu (Medicated Leaven) (4 fen) Banxia (Pinellia Tuber) Zhishi (Immature Bitter Orange, bran-fried yellow) Caodoukou (Cardamom Seed, wrapped in flour and baked) Huangqi (Astragalus Root - avoid in spring/summer) Yizhiren (Alpinia Oxyphylla Fruit, shelled) Gancao (Licorice Root, honey-fried) (each 5 fen) Qingpi (Green Tangerine Peel) Chenpi (Aged Tangerine Peel) (each 6 fen) Chuangui (Angelica Sinensis) (7 fen) Fuling (Poria) (7 fen)
Finely chop, prepare as one dose. Add 3 slices of fresh ginger and 1.5 cups of water, boil to 1 cup, and take warm.
Yiwei San (Li Dongyuan) Treats incessant abdominal pain caused by excessive intake of cold medicines.
Renshen (Ginseng) Nongpo (Magnolia Bark, ginger-processed) Gancao (Licorice Root, honey-fried) Baidoukou (White Cardamom, shelled) Jianghuang (Turmeric Rhizome) Ganjiang (Dried Ginger, roasted) Sharen (Amomum Fruit) Zexie (Alisma Rhizome) (each 3 fen) Yizhiren (Alpinia Oxyphylla Fruit) (6 fen) Chenpi (Aged Tangerine Peel) (7 fen) Huangqi (Astragalus Root, honey-fried) (7 fen)
Finely chop, prepare as one dose. Add ginger, decoct in water, and take.
Nongpo Wenzhong Tang (Li Dongyuan) Treats Stomach deficiency-cold, distension, fullness, and pain.
Nongpo (Magnolia Bark) Chenpi (Aged Tangerine Peel) (each 1 qian) Fuling (Poria) Caodoukou (Cardamom Seed, flour-wrapped and baked) Gancao (Licorice Root, honey-fried) Muxiang (Vladimiria Root) (each 5 fen) Ganjiang (Dried Ginger, roasted) (3.5 fen)
Finely chop, add ginger, decoct in water, and take.
Liuhe San (Also known as Mi Yaoshi, Liu Hejian) Treats all cases of dry-heat stagnation, residual heat after sweating failing to circulate, as well as Small Intestine Qi knot, heart and abdominal fullness, chest oppression, and migrating pain.
Dahuang (Rhubarb Root and Rhizome) (1 liang, mixed with wine, moistened, and steamed) Bai Chou (White Morning Glory Seed, fried) Hei Chou (Black Morning Glory Seed, lightly fried) Gansui (Euphorbia Lathyris Root) (each 5 qian) Binglang (Areca Nut) (3 qian, raw) Qingfen (Calomel) (1 qian)
Grind into fine powder. Take 1 qian per dose, mixed with honey water. Adjust dosage according to deficiency or excess.
Meyao San (Liu Hejian) Treats unbearable heart and abdominal pain.
Meyao (Myrrh) (separately ground) Ruxiang (Frankincense) (separately ground) (each 3 qian) Mugua Zi (Momordica Seed) (4 qian, shell removed) Chuanshanjia (Pangolin Scale) (5 qian, baked crisp in bran ash)
Grind into fine powder. Take 5 fen or 1 qian per dose, decocted in half a cup of wine for three to five boils, then take.
Muxiang Binglang Wan (Liu Hejian) Treats pain due to food depression and Qi stagnation.
Muxiang (Vladimiria Root) (3 qian) Binglang (Areca Nut) (3 qian) Qingpi (Green Tangerine Peel, white pith removed) (5 qian) Chenpi (Aged Tangerine Peel, white pith removed) (5 qian) Mai Mian (Wheat Flour, fried) (7 qian) Zhishi (Immature Bitter Orange, bran-fried yellow) (6 qian) Baizhu (Atractylodes Macrocephala Rhizome) (5 qian) Nongpo (Magnolia Bark, ginger-processed) (4 qian)
Grind into fine powder. Make pills with wheat flour dough soaked in soup, size of Sophora seeds. Take 50 pills per dose with warm water, far from meals.
Zhishi Daozhi Wan (Li Dongyuan) Treats abdominal pain, fullness, and restlessness caused by dietary injury with damp-heat substances that fail to transform. Use purgation as the goal. (Formula seen in Internal Injury section.)
Guiti San (Huoren) Treats Taiyin injury from food, causing blockage, oppression, discomfort, severe heart-stomach pain, and nausea. (Formula seen in Wind Stroke section.)
Guizhi Jiashaoyao Tang (Huoren) Treats abdominal fullness with intermittent pain and weak pulse.
Guizhi (Cinnamon Twig) Gancao (Licorice Root) (each 2 qian) Baishao Yao (White Peony Root) (4 qian)
Prepare as one dose. Add 3 slices of ginger and 2 jujubes, decoct in water, and take.
Xiao Jianzhong Tang (Huoren) Treats Cold Damage with a涩 (choppy) Yang pulse and 弦 (wiry) Yin pulse, with acute abdominal pain.
Guizhi (Cinnamon Twig) Gancao (Licorice Root, honey-fried) (each 3 fen) Baishao Yao (White Peony Root) (6 fen) Ejiao (Donkey-hide Gelatin, fried) (1 he)
Add 2 slices of ginger and 2 jujubes, decoct in water, and take.
Zhenwu Tang (Huoren)
Treats abdominal pain with diarrhea and heavy limbs. (Formula seen in Cold Damage section.)
Pili San (Liu Hejian) Treats abdominal pain with a faint pulse nearing extinction.
Fuzi (Prepared Aconite Child) (1 piece, soaked, removed, baked in bran ash, peel and navel removed)
Take 5 qian of this single herb, mix with 1 qian of Zhenla Tea, grind into fine powder, divide into two doses. For each dose, add 1 cup of water, boil to 0.7 cup, remove dregs, add one spoonful of honey, and take slightly cool.
Jiuzhu Danggui Wan (Li Dongyuan) Treats cold pain in the lower abdomen, and leukorrhea, hernia, and severe cold syndromes in women.
Huixiang (Fennel Fruit) (5 qian) Hei Fuzi (Prepared Black Aconite) Liangjiang (Galangal Root) (each 7 qian) Danggui (Angelica Sinensis) (1 liang)
Finely chop the four ingredients. Boil in 1.5 sheng of good non-intoxicating wine until dry. Bake dry, then add the following herbs:
Zhi Gancao (Honey-fried Licorice Root) Kulian (Melia Toosendan Fruit, raw) Dingxiang (Clove) (each 5 qian) Muxiang (Vladimiria Root) Shengma (Cimicifuga Rhizome) (each 1 qian) Chaihu (Bupleurum Root) (2 qian) Chao Huangyan (Stir-fried Yellow Salt) Quanxie (Scorpion) (each 3 qian) Yanhusuo (Corydalis Rhizome, stir-fried) (4 qian)
Grind together with the previous four ingredients into fine powder. Make pills with wine-boiled wheat paste, size of Sophora seeds. Take 50-70 pills per dose on an empty stomach with light vinegar water. Avoid greasy, cold foods, alcohol, and wet noodles.
Huanglian Tang (Liu Hejian) Treats heat in the chest, pathogenic qi in the Stomach, severe abdominal pain, and frequent vomiting. This formula regulates the ascending and descending of Yin and Yang.
Huanglian (Coptis Rhizome, wine-fried) Gancao (Licorice Root, honey-fried) Ganjiang (Dried Ginger) Guizhi (Cinnamon Twig) (each 5 qian) Renshen (Ginseng) (2 qian) Banxia (Pinellia Tuber, soaked seven times, peel and navel removed) (half he)
Finely chop, add 2 jujubes, decoct in appropriate amount of water, and take.
Shaoyao Gancao Tang (Liu Hejian) Treats abdominal pain in all seasons.
Baishao Yao (White Peony Root, wine-fried) Gancao (Licorice Root, honey-fried)
Equal parts. Take 5 qian per dose, finely chop, add 3 slices of ginger, 1.5 cups of water, boil to 1 cup, and take warm. *Yilei Yuanrong* states: For abdominal pain with wiry pulse injuring Qi, use this formula; for surging pulse injuring Metal, add Huangqin; for slow pulse injuring Water, add Guizhi; for choppy pulse injuring Blood, add Danggui; for delayed pulse injuring Cold, add Ganjiang.
Jiajian Xiao Chaihu Tang (Liu Hejian) Treats alternating chills and fever, wiry pulse, and abdominal pain.
Remove Huangqin from the base formula, add Baishao Yao.
Siwu Kulian Tang (Liu Hejian) Treats empty-cold pain below the umbilicus.
Siwu Tang (Four Substances Decoction) (6 qian) add Yanhusuo and Kulian (each 1.5 qian).
Finely chop, add 2 cups of water, boil to 1 cup, and take warm.
Zengsun Danggui Wan (Liu Hejian) Treats pain in the heart and abdomen due to pathogenic invasion of the Three Yin channels.
Siwu Tang (Five qian) Fangfeng (Saposhnikovia Root) Duhuo (Angelica Pubescens Root) Quanxie (Scorpion) (each 5 qian) Xuduan (Dipsacus Root - absent in original) Huixiang (Fennel Fruit) (each 1 liang) Kulian (Melia Toosendan Fruit, wine-boiled) Yanhusuo (Corydalis Rhizome, stir-fried) Muxiang (Vladimiria Root) Dingxiang (Clove) (each 2 qian)
Grind into fine powder. Make pills with wine paste, size of Sophora seeds. Take 50 pills per dose with plain boiled water.
Kulian Wan (Liu Hejian) Treats Ben Tun (rushing gas) causing lower abdominal pain. (Formula seen in Hernia section.)
Yinie Jin San (Ju Fang) Treats severe umbilical and abdominal pain, and Ben Tun or Small Intestine Qi syndromes.
Yanhusuo (Corydalis Rhizome) Chuanlianzi (Sichuan Chinaberry Fruit, wine-boiled) Quanxie (Scorpion, detoxified and fried) Huixiang (Fennel Fruit)
Equal parts. Grind into fine powder. Take 2 qian bi per dose with hot wine. Highly effective.
(Danxi Huotao) states: Most abdominal pain is due to coagulation and stagnation of blood vessels, requiring wine-fried Baishao Yao. Add Guizhi for pain with aversion to cold; add Huangbai (Phellodendron Bark) for pain with aversion to heat. If pressing on the abdomen relieves pain, it is deficiency; use Renshen, Baizhu, Ganjiang, Guigui. If touching the abdomen worsens pain, it is excess; use Jianzhong Tang plus Dahuang, or Tiaowei Chengqi Tang plus Guizhi to purge. If pain is due to dietary overindulgence, ask what was ingested. If injured by cold/raw/hard foods, use Li Dongyuan's Muxiang Jianqi Wan or Sanleng Xiaoji Wan. If injured by hot foods, use Zhishi Daozhi Wan or Sanhuang Zhizhu Wan. Assess strength and urgency, then purge. For Qi deficiency patients with dietary injury, combine tonification and purgation: use Erchen Tang plus Chuanxiong, Baizhu, Shenqu, Maiya, Renshen, Cangzhu, or send down previously mentioned purgative pills. If there is a constant sensation of heat with sudden onset and cessation of pain, it is accumulated heat; use Tiaowei Chengqi Tang to purge. If pain is due to trauma, it is blood stasis; use Tao Ren Chengqi Tang or Didang Tang to dispel blood. If pain is due to injury or wading in water after drinking, causing blood coagulation, use Dachengqi Tang plus Guizhi.
(Medical Cases)
A Mrs. Huang, over fifty years old, had a mass in the lower abdomen causing pain for over two months. A physician treated it as fixed blood stasis (Si Xue) with Siwu Tang plus Taoren, but it was ineffective. Then she took pills made of Wulingzhi (Trogopterus Dung), Yanhusuo, Ruxiang, Meyao, Sanleng, and Ezhu, but it was still ineffective. I was called to treat her. Her six pulses were deep and hidden, with no pulse felt at both Chi positions. I said: This is stool retention in the Lower Jiao causing pain, not fixed blood stasis. I used rice straw from Jincheng burned to ash, leached to make a strong decoction (one cup), administered orally. After about an hour, I gave 100 pills of Zhishi Daozhi Wan to induce evacuation. She passed about a bowl of black stools like plum pits, and the pain stopped. Later, she took ten-plus prescriptions of blood-nourishing and bowel-moistening herbs, and recovered peacefully.
A young man fished in winter, became very hungry, and ate cold congee. His abdomen suffered severe pain that lasted two days and nights without relief. A physician first gave Dahuang Wan, but there was no passage. Then he gave Dachengqi Tang, which expelled fecal water but worsened the pain. I was called to treat him. His six pulses were deep, hidden, and solid; his face was dark blue-black. I said: This is a severe cold syndrome with dry stool in the Lower Jiao causing pain. I first prescribed one dose of Dingfu Zhizhong Tang, and moxa-burned the Qihai acupoint 21 cones. The pain reduced by half. Then I prepared pills of Jiangzi (Croton Seed) added with Chenpi and Muxiang, size of mung beans. Five pills were taken with ginger juice. He had five to seven bowel movements and recovered.