木香 沉香 巴豆肉（各一两） 青皮（二两，不去皮） 铜青（半两，研） 砂（一钱，研）
上以上二香、青皮三味，细研同巴豆慢火炒令紫色为度，去巴豆为细末，入 砂二味，同研匀，蒸饼和丸，
如梧桐子大，每服七丸至十丸，盐汤吞下，日二三服，空心食前服。
〔子和〕律科王敏之，病寒疝，脐下结聚如黄瓜，每发绕脐急痛不能忍。戴师先以舟车丸及猪肾散下四五
行，觉药绕病三五次而下，其泻皆水也。猪肾甘遂皆苦寒，经言以寒治寒，万举万全。但下后忌饮冷水及寒物，
宜食干物，以寒疝本是水故也。即日病减八分，食进一倍。又数日，以舟车丸百余粒，通经散四五钱，服之利
下。候三四日，又服舟车丸七八十粒，猪肾散三钱，乃健步如常矣。
近颖尾一夫，病卒疝赤肿，大痛数日不止。余以导水丸一百五十丸，令三次咽之，次以通经散三钱，空腹
淡酒调下，五更下二三十行，肿痛皆去。不三日，平复如故。
上治实疝，利大便，形气实，脉有力者宜之。
〔杜〕三十七太尉，忽患小肠气痛，医官及京城医家，用药皆不效。每一发几死，上召杜至，进药数服不验。
太尉曰∶我命不久，致良医不能治。上召杜问所以。杜对∶臣用古方书，皆不获愈，今日撰一方，容进上。杜
曰∶撰方已成，未敢进，先合药以进。太尉一服，十愈八九，再服全愈。然后进方，名曰救命通心散。
川乌头一两，用青盐一钱，酒一盏，浸一宿，去皮尖，焙干。川楝子一两，用巴豆二十一粒，同炒候黑色，
去巴豆。茴香半两，石燕一对，土狗五枚，芥子一钱六分，为末。每服三钱，入羊石子，内湿纸煨香熟，夜
半时，用好酒半升，入盐细嚼石子，以酒咽下，不得作声，小便大利，其病遂去。（曹五家今秘此方。）
〔《本》〕顷在岳城日，歙尉宋荀甫，膀胱气作疼不可忍。医者以刚剂与之，痛愈甚，小便不通三日
矣，脐下虚胀，心闷。予因候之，见其面赤黑，脉洪大。予曰∶投热药太过，阴阳痞塞，气不得通，为之奈何？
宋尚手持四神丹数粒，云∶医谓不止，更服此。予曰∶若服此，定毙，后无悔。渠求治，予适有五苓散一两许，
令三服。用连须葱一茎，茴香一撮，盐一钱，水一盏半，煎至七分，令接续三服。中夜下小便如墨汁者一二升，
脐下宽，得睡。翌日诊之，脉已平安矣。续用 砂丸与之，数日瘥。
上利小便治疝。常治谢人妻小腹疼痛，小便不通，先艾灸三阴交，以茴香、丁香、青皮、槟榔、桂、茱
萸、玄胡索、山楂、枳实，又倍用黄柏，煎服之愈。
〔丹〕赤岸朱同道，年四十岁，八月望雨后得凉，半夜后腹痛甚，汗如雨，两脚踏破壁，痛在小腹，手不
可近，六脉弦而细实，重取如循刀刃责责然。问之云∶六月大热时，于深潭浴水，病或起于此。与大承气汤，
大便微利，痛遂顿止。至次日酉时，其痛复作，痛在小腹，坚硬手不可近，又与大承气加桂两服，研桃仁同煎，
大便下紫黑血升余，而痛顿止。至次日酉时，痛复作如初，脉虽稍减，而责责然犹在，与大承气汤加附子两帖，
研桃仁同煎，下大便五行，得黑紫血如破絮者二升许，痛遂顿止。一夜得睡，次日酉时，痛复如初，询知小腹
和软，痛在脐腹间下，脉亦和，似若无病，但呻吟如旧，询知乃食萝卜菜苗羹两顿，与小建中汤一帖而愈。
〔世〕一妇人少腹痛，百药不效，一医用杉木节童便煎服，下血而愈。
〔丹〕治膀胱气急，用芜荑和食盐等分，绵裹如枣大，纳下部，或下水恶汁，并下气佳。
〔《斗》〕治小肠气。用血师一两，米醋一升，以火烧血师通赤，淬入醋中，以淬竭为度，捣罗如面，用
汤调下一大盏即瘥，如神。血师，代赭石也。
〔《圣》〕治寒疝，小腹及阴中相引而痛，自汗出欲死。丹参一两，杵为散，每服热酒调下二钱匕。
〔丹〕治诸疝发时，用海石、香附二味为末，生姜汁汤调。亦能治心疼。
〔《衍》〕木贼细锉微炒，捣为末，沸汤点二钱服，食前，治小肠膀胱气，缓缓必效。
〔《本》〕治疝气。
青矾（一两） 白矾（一两。各为粗末）
上用小瓦罐子一只，入二药在内，用麻皮缚紧，捣盐泥封固，以炭五斤， 令通红，尽炭为度，取出埋地
穴中，伏一宿，出火毒，醋糊为丸，如绿豆大。每服十丸，空心盐汤送下，或白汤亦可。
运气 小腹痛有三∶
一曰肝病，小腹引胁痛是也。经云∶厥阴之复，少腹坚满，里急暴痛，是风气助肝盛而然，治法当泻肝也。
又云∶岁金太过，民病两胁下痛，小腹痛。又云∶岁木不及，燥乃大行，民病中清， 胁痛，少腹痛。又云∶
岁土不及，风乃大行，民病腹痛，复则胸胁暴痛，下引小腹者，是燥邪攻肝虚而然，治法当补肝泻金也。又寒
气客于厥阴之脉，则血泣脉急，故胁肋与小腹相引痛者，治法亦同也。（全文见诸痛门。）
二曰小肠，其病小腹引睾丸腰脊痛是也。经云∶少阴之脉，心下热，善饥，脐下痛。又云∶少阴之复，燠
热内作，小腹绞痛者，是热助小肠盛而然，治法当泻小肠也。又太阳在泉，寒淫所胜，与太阳之复，皆病小腹，
控睾引腰脊，上冲心痛。及太阴司天，大寒且至，病小腹痛者，是寒邪攻小肠虚而然，治法当补小肠，泻寒邪也。
三曰膀胱，其病小腹痛肿，不得小便是也。经云∶太阴在泉，病小腹痛肿，不得小便者，是湿邪攻膀胱虚
而然，治法当补膀胱，泻湿土邪也。（以上经文见运气类注。）
内经刺灸小腹痛共四法∶
一曰肝。经曰∶肝病者，两胁下痛引小腹，取其经，厥阴小肠。（全文见灸刺门五脏条。）又曰∶邪客厥阴之络，
令人卒疝暴痛，刺足大指爪甲上与肉交者各一 ，男子立已，女子有顷已，左取右，右取左者是也。（全文见灸
刺门六腑条。爪甲上，大敦穴也。）
二曰小肠。经云∶小肠病者小腹痛，腰脊控睾而痛，时窘之后，取巨虚下廉。又云∶小肠控睾引腰脊，上
冲心，邪在小肠，取之肓原以散之，刺太阴以予之，取厥阴以下之，巨虚下廉以去之，按其所过之经以调之是
也。（全文并见针灸门六腑条。肓原，气海穴也。）又云∶疝暴痛，取足太阴、厥阴，尽刺去其血络。（《灵枢》
热病为心风疝，而小肠病。经云∶心为牡脏，小肠为之使，故小腹当有形也。）
三曰膀胱。经云∶膀胱病者，小腹偏肿而痛，以手按之，即欲小便而不得，取委中央。又云∶小腹痛肿，
不得小便，邪在三焦，约取之足太阳大络者是也。（全文见针灸门六腑条。太阳大络，委阳穴也。）
四曰督任冲脉。经文见如下。
〔《素》〕病在少腹，腹痛不得大小便，病名曰疝得之寒，刺少腹两股间，刺腰髁骨间，刺而多之，尽炅
病已。（长刺节篇 小腹两股间者，气冲穴也，冲脉起于气冲故也。腰髁间者，王注谓腰尻挟脊平立陷
者中，按之有骨处是也。疝为寒生，故多刺之，少腹尽热乃止针。）
〔《灵》〕肾脉生病，从少腹上冲心而痛，不得前后，为冲疝。任脉为病，男子内结七疝，女子带下瘕聚。
（俱见骨空论）
〔《摘》〕元藏发动，脐下痛不可忍∶气海 三阴交（立愈。左取右，右取左，下同。）
〔《玉》〕疝气少腹偏痛∶大敦（二分，沿皮向后三分，泻之；灸，左取右，右取左，下同。）三阴交（一
寸，泻十吸。）
〔《撮》〕又法∶大敦 水道 小海
〔桑〕又法∶中极 印肾
〔《摘》〕卒疝少腹痛不可忍∶大敦（三分，陷六呼，灸七壮。）阴市（三分，灸五壮。）照海（三分，灸
七壮。以上皆左取右，右取左。）
癖，小肠膀胱，肾余疝气∶气海 五枢（各用燔针刺入五分，灸百壮。）三里 三阴交（刺之。）
〔桑〕疝∶三阴交 三里 足三间
〔《摘》〕疝∶行间 三里
〔《集》〕大法∶关门 关元 水道 三阴交 不已，再取下穴∶海底 归来
〔《摘》〕少腹痛∶关元 三里
〔《甲》〕阴跳遗溺，小便难痛，阴上下入腹中，寒疝阴挺出，偏大肿，腹脐痛，腹中悒悒不乐，大敦主之。
腹痛上抢心，心下满，癃，茎中痛，怒 不欲视，泣出，长太息，行间主之。环脐痛，阴骞两丸缩，腹坚痛
不得卧，太冲主之。疝癃，脐、少腹引痛，腰中痛，中封主之。阴跳腰腹痛，实则挺长，寒热，挛，阴暴痛，
遗溺便，大虚则暴痒气逆，肿睾卒疝，小便不利如癃状，数噫，恐悸，气不足，腹中悒悒，少腹痛，嗌中有热，
有肉状，如着欲出，背挛不可俯仰，蠡沟主之。
上取藏经厥阴。
男子阴疝，两丸上下少腹痛，五枢主之。大疝腹坚， 墟主之。
上取腑经少阳。
少腹痛，飧泄出糜，次指热，若脉陷，寒热身痛，唇干不渴，汗出，毛发焦，脱肉少气，内有热，不欲动
摇，泄脓血，腰引少腹痛，暴惊，狂言非常，巨虚下廉主之。少腹痛，控睾引腰脊，疝痛，上冲心，腰脊强，
溺黄赤，口干，小肠 主之。疝瘕髀中急痛，循胁上下抢心，腹痛积聚，府舍主之。腹痛，疝积聚，上冲心，
云门主之。
上巨虚下廉、小肠 者，取本腑也。府舍、云门者，刺太阴以予之也。
四肢淫泺，身闷癃疝，至阴主之。脐疝绕脐痛，冲胸，不得息，灸脐中。阴疝引睾，阴交主之。少腹
疝，卧善惊，气海主之，脐疝绕脐痛，石门主之。暴疝痛，少腹大热，关元主之。少腹痛，溺难，阴下纵，横骨主
之。男子阴端寒，上冲心中 ，会阴主之。癃疝，然谷主之。卒疝，少腹痛，照海主之，病在左取右，右取
左，立已。阴暴起疝瘕，胞中有血，四满主之。脐疝绕脐痛，时上冲心，天枢主之。气疝，哕呕面肿，奔豚，
天枢主之。阴疝气疝，天枢主之。阴疝痿，茎中痛，两丸骞，卧不可仰卧。刺气冲。阴疝，冲门主之。（一作衡门）
寒疝，下至腹腠膝腰痛，如清水，大腹诸疝，按之至膝上，伏兔主之。寒疝痛，腹胀满，痿厥少气，阴谷主之。
〔《素》〕厥阴脉滑则病狐疝风。少阴滑则病肺风疝，太阴脉滑则病脾风疝，阳明脉滑则病心风疝，太阳
脉滑则病肾风疝，少阳脉滑则病肝风疝。（四时刺逆从论）
〔《诊》〕肝脉滑甚为 疝。心脉微滑为心疝，引脐下小腹鸣。肾肝滑甚为癃 。（全文见治法。）
〔东〕夫滑脉，关以上见者为大热，盖阳与阳并也，故大热。滑脉，尺部见为大寒，生 疝。滑脉者，命
门包络之名也，为丙。丙丁热火并于下，盖丙丁不胜壬癸，从寒水之化也，故生 疝。
〔《素》〕帝曰∶诊得心脉而急，此为何病？岐伯曰∶病名心疝，少腹当有形也。帝曰∶何以言之？岐
伯曰∶心为牡脏，小肠为之使，故曰少腹当有形也。（脉要精微论）心脉搏滑急，为心疝。肺脉沉搏，为肺疝。
肾脉肝脉大急沉，皆为疝。（俱大奇论。）
〔《脉》〕脉来中央坚实，径至关者，冲脉也。动苦少腹痛，上抢心，有瘕疝。绝孕遗矢溺，胁支满烦也。
〔丹〕脐下忽大痛，人中如墨色者，多死。
〔子和〕七疝图 寒疝，其状囊冷，结硬如石，阴茎不举，或控睾丸而痛。得于坐卧湿地，或寒月涉水，
或冒雨雪，或坐卧砖石，或风冷处使内过劳。宜以温剂下之。久而无子。
水疝，其状肾囊肿痛，阴汗时出，或囊肿而状如水晶，或囊痒而搔出黄水，或少腹中按之作水声。得于饮
水醉酒，使内过劳，汗出而遇风寒湿之气，聚于囊中，故水多，今人为卒疝。宜以逐水之剂下之。有漏针去水
者，人多不得其法。
筋疝，其状阴茎肿胀，或溃或痛而里急筋缩，或茎中痛，痛极则痒，或挺纵不收，或白物如精，随溲而下，
久而得于房室劳伤，及邪术所使。宜以降心火之剂下之。
血疝，其状如黄瓜，在小腹两旁，横骨两端约中，俗云便痈。得于重感春夏大燠，劳于使内，气血流溢，
渗入脬囊，留而不去，结成痈肿，脓少血多。宜以和血之剂下之。（和血四物汤、调胃承气汤各半服之是也。）
气疝，其状上连肾区，下及阴囊，或因号哭忿怒，则气郁之而胀，罢则气散者是也。有一治法，以针出气
而愈者。然针有得失，宜以散气之药下之。或小儿亦有此疾，俗云偏气，得于父已年老，或年少多病，阴痿精
怯，强力入房，因而有子，胎中病也。此疝不治，惟筑宾一穴主之。
狐疝，其状如瓦，卧则入小腹，行立则出小腹入囊中，狐则昼出穴而溺，夜则入穴而不溺。此疝出入上下
往来，正与狐相类也。亦与气疝大同小异，令人带钩钳是也。宜以逐气流经之药下之。
疝，其状阴囊肿缒，如升如斗，不痒不痛者是也。得之地气卑湿所生，故江淮之间，湫溏之处，多有此
疾。宜以去湿之药下之。女子阴户突出，虽亦此类，乃热则不禁固也，不可便谓虚寒，而涩之燥之补之。本名
曰瘕。宜以苦下之，以苦坚之。（王注云∶阳气下坠，阴气上争，则寒多，下坠则筋缓，故睾垂纵缓因作 疝也。）
以上七疝，下去其病之后，可调则调，可补则补，各量病势，勿拘俗法。经所谓阴盛则腹胀不通者，癃
Mu Xiang (Costus Root), Chen Xiang (Aquilaria Wood), Ba Dou Rou (Croton Seed Flesh) (each 1 liang), Qing Pi (Green Tangerine Peel) (2 liang, without removing the peel), Tong Qing (Malachite Green) (0.5 liang, ground), Sha (Realgar) (1 qian, ground).
Take the above two aromatic herbs and Qing Pi, grind them finely together with Ba Dou Dou, stir-fry slowly over low heat until purple, remove the Ba Dou, make into a fine powder, add the Sha, mix evenly, knead with steamed dough pills,
size like wu tong zi (fruit of Firmiana simplex), take 7 to 10 pills each time, swallow with salt water, 2-3 times a day, taken on an empty stomach or before meals.
[Liu Wansu] Wang Minzhi, a medical official, suffered from Han Shan (Cold Hernia), with a lump under the umbilicus like a cucumber, and severe pain around the umbilicus upon each attack that was unbearable. Dai Shixian first used Zhou Che Wan (Boat Pill) and Zhu Shen San (Pig Kidney Powder) to induce diarrhea four or five times. He felt the medicine circulate around the disease three or five times before moving down, and all the stool was watery. Zhu Shen San contains Gan Sui (Kansui Root), which is bitter and cold. The classics state "treat cold with cold," which is foolproof. However, after purging, one must avoid cold water and cold foods,
and should eat dry foods, because Cold Hernia is originally caused by water-dampness. On that day, the illness decreased by eight parts, and appetite doubled. A few days later, he took over a hundred pills of Zhou Che Wan and 4-5 qian of Tong Jing San (Meridian-Penetrating Powder), which induced diarrhea. After waiting three or four days, he took another 70-80 pills of Zhou Che Wan and 3 qian of Zhu Shen San, and then could walk briskly as usual.
Near Yingwei, a man suffered from Zu Shan (Sudden Hernia) with redness and swelling, and severe pain lasting several days. I used Dao Shui Wan (Water-Guiding Pill) 150 pills, swallowed in three doses, followed by Tong Jing San 3 qian, mixed with light wine and taken on an empty stomach. At dawn, he had 20-30 bowel movements, and the swelling and pain disappeared. Within three days, he recovered completely.
The above treats Shi Shan (Excess Hernia), promoting bowel movements, suitable for patients with robust constitution and strong pulse.
[Du] The Grand Commandant of the Thirty-Seventh Rank suddenly suffered from Xiao Chang Qi (Small Intestine Qi) pain. Medical officials and famous doctors in the capital were ineffective. Each attack nearly killed him. The Emperor summoned Du. After a few doses of medicine, there was no improvement.
The Grand Commandant said: "My life is short, and even good doctors cannot cure me." The Emperor summoned Du to ask why. Du replied: "I consulted ancient prescriptions, but none cured him. Today I have drafted a prescription, please allow me to present it." Du
said: "The prescription is ready, but I dare not present it directly; let me prepare the medicine first for trial." One dose cured 80-90% of the symptoms, and a second dose resulted in complete recovery. Then he presented the prescription, named Jiu Ming Tong Xin San (Life-Saving Heart-Unblocking Powder).
Chuan Wu Tou (Aconitum Carmichaelii Radix Preparata) 1 liang, soaked overnight in 1 qian of Qing Yan (Green Salt) and 1 zhan of wine, remove skin and tips, bake dry. Chuan Liu Zi (Toosendan Fruit) 1 liang, stir-fry together with 21 grains of Ba Dou (Croton Seed) until black,
remove Ba Dou. Hui Xiang (Fennel Fruit) 0.5 liang, Shi Yan (Swallow Stone) 1 pair, Tu Gou (Ground Dog/Meerkat) 5 pieces, Jie Zi (Mustard Seed) 1.6 qian, grind into powder. Take 3 qian each time, place inside a sheep stone, wrap in wet paper and roast until fragrant. At midnight, use half a sheng of good wine, chew the stone finely in the mouth, and swallow with wine, without making any sound. With profuse urination, the disease will disappear. (The Cao family keeps this prescription secret to this day.)
[Zhang Yuansu] When I was in Yuecheng, Song Xunfu, the county magistrate of She, suffered from unbearable bladder Qi pain. Doctors used harsh hot medicines, worsening the pain. He had not urinated for three days, had a distended lower abdomen, and chest oppression. Upon examination, his face was dark red, and the pulse was large and forceful. I said: "Too much hot medicine has been administered, causing blockage of Yin and Yang, preventing Qi circulation. What shall we do?"
Song held several pills of Si Shen Dan (Four Spirit Pill), saying: "The doctor said if the pain doesn't stop, take this." I said: "If you take this, you will certainly die, with no regret afterwards." He begged for treatment. I happened to have about 1 liang of Wu Ling San (Five-Ling Powder),
ordered him to take it in three doses. Use 1 stalk of scallion with roots, a handful of fennel, 1 qian of salt, 1.5 zhan of water, decoct to 0.7 zhan, and drink continuously in three doses. At midnight, he passed 1-2 sheng of urine as dark as ink, the lower abdomen relaxed, and he slept. The next day, the pulse was peaceful. Subsequently, he took Sha Wan (Realgar Pill), and recovered in a few days.
The above uses diuresis to treat hernia. I once treated the wife of Mr. Xie for lower abdominal pain and urinary retention. First, moxa was applied to Sanyinjiao (SP6). Then, a decoction of Hui Xiang (Fennel Fruit), Ding Xiang (Clove), Qing Pi (Green Tangerine Peel), Bing Lang (Areca Seed), Gui Zhi (Cinnamon Twig), Zhu Yu (Evodia Fruit), Yuan Hu Suo (Corydalis Rhizome), Shan Zha (Hawthorn Fruit), Zhi Shi (Immature Bitter Orange), and double the amount of Huang Bo (Phellodendron Bark) was administered, resulting in recovery.
[Zhu Danxi] Zhu Tongdao from Chi'an, aged forty, caught a chill after rain on the Mid-Autumn Festival. After midnight, severe abdominal pain broke out, sweating profusely, kicking through walls. The pain was in the lower abdomen, intolerable to touch. The six pulses were wiry, thin, and solid; deep pressure felt like touching a blade. He said he bathed in a deep pool during the intense heat of June, and the illness likely started there. Da Cheng Qi Tang (Major Order the Qi Decoction) was given. Bowels moved slightly, and pain stopped instantly. At You hour the next day, pain returned, hard and tender in the lower abdomen. Another two doses of Da Cheng Qi Tang plus Gui Zhi (Cinnamon Twig), with crushed Tao Ren (Peach Kernel) decocted together, resulted in passing over a jin of dark purple blood, and pain stopped instantly. At You hour the following day, pain returned as before. Pulses were slightly weaker but still sharp. Two doses of Da Cheng Qi Tang plus Fu Zi (Prepared Aconite Root), with crushed Tao Ren (Peach Kernel) decocted together, resulted in five bowel movements and passing about two sheng of dark purple blood like broken cotton, and pain stopped instantly. He slept through the night. At You hour the next day, pain returned as before. Inquiry revealed the lower abdomen was soft, pain was below the umbilicus, pulses were harmonious, seemingly healthy, yet he groaned as usual. Inquiry revealed he had eaten two bowls of radish seedling soup. One dose of Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) cured him.
[Popular] A woman suffered from lower abdominal pain, unresponsive to hundreds of medicines. A doctor decocted Shan Mu Jie (Cedar Knots) with Tong Bian (Boy's Urine) and administered it. Passage of blood cured her.
[Zhu Danxi] To treat urgent Bladder Qi, mix Wu Yi (Quinine Tree Bark) and edible salt in equal parts, wrap in silk like a date, insert into the vagina. It may discharge foul fluid and promotes Qi movement.
[Dou Men Fang] Treat Xiao Chang Qi (Small Intestine Qi). Use Xue Shi (Hematite) 1 liang, rice vinegar 1 sheng. Heat Xue Shi until red-hot, quench in vinegar repeatedly until exhausted. Grind into flour-like powder. Mix with water and drink one large cup for immediate cure, miraculous. Xue Shi is Dai Zhe Shi (Hematite).
[Sheng Ji Zong Lu] Treat Han Shan (Cold Hernia), with pain radiating from lower abdomen to genitals, sweating profusely, feeling like death. Dan Shen (Salvia Miltiorrhiza) 1 liang, crush into powder. Take 2 qian each time, mixed with hot wine.
[Zhu Danxi] For various hernias at onset, use Hai Shi (Floating Limestone) and Xiang Fu (Cyperus Rhizome), grind into powder, mix with ginger juice and warm water. Also treats heart pain.
[Yan Yi] Mu Zei (Equisetum Hiemale) finely chopped and lightly stir-fried, ground into powder. Take 2 qian with boiling water before meals. Treats Small Intestine and Bladder Qi, slow but effective.
[Zhang Yuansu] Treat Hernia Qi.
Qing Fan (Green Alum) (1 liang) Bai Fan (White Alum) (1 liang. Both coarsely ground).
Place the two drugs in a small clay pot, tie tightly with hemp rope, seal with mud made from pounded salt. Fire with 5 jin of charcoal until red-hot, burn all charcoal. Remove and bury in a hole in the ground overnight to eliminate fire toxicity. Make pills with vinegar paste, size of mung beans. Take 10 pills each time on an empty stomach with salt water, or plain water is also acceptable.
According to Yun Qi (Six Qi) theory, there are three types of lower abdominal pain:
First is Liver disease, where lower abdomen pain radiates to hypochondrium. Classics say: "When Jue Yin rebounds, Shaofu becomes firm and full, internal urgency and sudden pain." This is wind Qi assisting Liver excess. Treatment method: Drain the Liver.
Also says: "When Metal Qi is excessive, people suffer pain in both hypochondria and lower abdomen." Also says: "When Wood Qi is insufficient, Dryness prevails, people suffer cold abdomen, hypochondriac pain, and lower abdominal pain." Also says:
"When Earth Qi is insufficient, Wind prevails, people suffer abdominal pain. Rebound causes sudden chest/hypochondriac pain radiating to lower abdomen." This is Dryness attacking Liver deficiency. Treatment method: Tonify Liver, Drain Metal. Also, when Cold Qi invades Jue Yin meridians, blood stasis and meridian tension occur, causing radiating pain between hypochondrium and lower abdomen. Treatment method is the same. (Full text in Chapter on Various Pains.)
Second is Small Intestine, where disease presents as lower abdominal pain radiating to testicles, waist, and spine. Classics say: "Shaoyin meridian, heat below heart, frequent hunger, pain below umbilicus." Also says: "When Shaoyin rebounds, internal warmth arises, sudden lower abdominal colic." This is Heat assisting Small Intestine excess. Treatment method: Drain Small Intestine. Also, when Taiyang is in泉 (Earthly Branch position), Cold prevails, and Taiyang rebound, both cause lower abdominal pain,
radiating to testicles, waist, spine, and upward to heart pain. Also, when Taiyin governs Heaven, Great Cold arrives, causing lower abdominal pain. This is Cold attacking Small Intestine deficiency. Treatment method: Tonify Small Intestine, Drain Cold.
Third is Bladder, where disease presents as lower abdominal swelling and inability to urinate. Classics say: "When Taiyin is in泉, disease involves lower abdominal swelling and inability to urinate." This is Dampness attacking Bladder deficiency. Treatment method: Tonify Bladder, Drain Damp-Earth. (Above classics cited in Yun Qi Annotations.)
Neijing acupuncture methods for lower abdominal pain include four approaches:
First is Liver. Classics say: "Liver disease, pain in hypochondria radiating to lower abdomen, select Jueyin and Shaoyang meridians." (Full text in Acupuncture/Moxibustion Chapter, Five Zang section.) Also says: "Pathogen invading Jueyin collateral, causes sudden hernia and violent pain. Needle one point at the junction of nail and flesh on big toe. Men recover immediately, women shortly. Left side needle right, right side needle left." This is. (Full text in Acupuncture/Moxibustion Chapter, Six Fu section. Junction of nail and flesh is Dadun (LR1) acupoint.)
Second is Small Intestine. Classics say: "Small Intestine disease, lower abdominal pain, waist/spine/testicle radiation, tenesmus. Select Xiajuxu (ST39)." Also says: "Small Intestine radiating to testicles/waist/spine, upward to heart. Pathogen in Small Intestine, select Hunyuan to disperse it, needle Taiyin to support it, select Jueyin to descend it, select Xiajuxu to remove it, press along meridians to regulate it." This is. (Full text in Acupuncture Chapter, Six Fu section. Hunyuan is Qihai (CV6) acupoint.) Also says: "Sudden hernia pain, select Taiyin and Jueyin, exhaust blood collaterals." (Ling Shu
Heat disease is Heart Wind Hernia, involving Small Intestine. Classics say: "Heart is Yang organ, Small Intestine is its envoy, thus lower abdomen should have palpable mass.")
Third is Bladder. Classics say: "Bladder disease, unilateral lower abdominal swelling and pain, pressing induces urge to urinate but cannot. Select Weizhong (BL40)." Also says: "Lower abdominal swelling/pain, inability to urinate, pathogen in Sanjiao, select Taiyang major collateral." This is. (Full text in Acupuncture Chapter, Six Fu section. Taiyang major collateral is Weiyang (BL39) acupoint.)
Fourth is Du, Ren, and Chong meridians. Text follows.
[Su Wen] Disease in Shaofu, abdominal pain, inability to pass stool/urine, named Shan, caused by Cold. Needle between lower abdomen and thighs, needle between waist and hip bones. Multiple needles until heat penetrates, disease resolves. (Chang Ci Jie Pian Between lower abdomen and thighs is Qichong (ST30) acupoint, origin of Chong Mai. Waist/hip area refers to depression beside spine at level of sacrum, bony prominence. Hernia caused by Cold, so multiple needles are used, stop when lower abdomen feels hot.)
[Ling Shu] Kidney meridian disease, rising from Shaofu to heart with pain, inability to pass stool/urine, called Chong Shan. Ren Mai disease, men develop seven types of hernia internally, women develop leukorrhea and masses.
(Both in Gu Kong Lun)
[Zi Sheng Jing] Yuan Zang activation, unbearable pain below umbilicus: Qihai (CV6), Sanyinjiao (SP6) (Immediate cure. Left needle right, right needle left, same below.)
[Yu Long Ge] Hernia Qi, unilateral lower abdominal pain: Dadun (LR1) (Needle 2 cun, subcutaneously backwards 3 cun, draining method; Moxa, left needle right, right needle left, same below.) Sanyinjiao (SP6) (Needle 1 cun, drain 10 breaths.)
[Zhen Jiu Ju Ying] Another method: Dadun (LR1), Shuidao (ST28), Xiaohai (SI8)
[Sang] Another method: Zhongji (CV3), Yinshen (Note: Likely typo in original, possibly referring to a specific point or technique not standard, kept as is)
[Zi Sheng Jing] Sudden Hernia, unbearable lower abdominal pain: Dadun (LR1) (Needle 3 cun, sink 6呼, moxa 7 cones.) Yinshi (ST33) (Needle 3 cun, moxa 5 cones.) Zhaohai (KI6) (Needle 3 cun, moxa 7 cones. All left needle right, right needle left.)
Pi (Masses), Small Intestine/Bladder, residual Kidney Hernia Qi: Qihai (CV6), Wushu (GB25) (Each use burning needle insertion 5 fen, moxa 100 cones.) Zusanli (ST36), Sanyinjiao (SP6) (Needle.)
[Sang] Hernia: Sanyinjiao (SP6), Zusanli (ST36), Zusanjian (ST41)
[Zi Sheng Jing] Hernia: Xingjian (LR2), Zusanli (ST36)
[Zhen Jiu Ji Cheng] General Method: Guanmen (ST21), Guanyuan (CV4), Shuidao (ST28), Sanyinjiao (SP6). If ineffective, select lower points: Haidi (Extra), Guilai (ST29)
[Zi Sheng Jing] Lower Abdominal Pain: Guanyuan (CV4), Zusanli (ST36)
[Jia Yi Jing) Yin jumping, enuresis, difficult/painful urination, Yin ascending/descending into abdomen, Cold Hernia, Yin prolapse, unilateral swelling, abdominal/umbilical pain, gloomy mood, Dadun (LR1) governs.
Abdominal pain rushing to heart, epigastric fullness, strangury, glans pain, anger, unwillingness to look, weeping, long sighs, Xingjian (LR2) governs. Periumbilical pain, Yin retraction/testicular shrinkage, rigid abdominal pain, insomnia, Taichong (LR3) governs. Hernia/Strangury, umbilical/lower abdominal radiating pain, lumbar pain, Zhongfeng (LR4) governs. Yin jumping/lumbar/abdominal pain, excess leads to erection, chills/fever, spasms, sudden Yin pain, enuresis/incontinence, severe deficiency leads to sudden itching/Qi rebellion, swollen testes/sudden hernia, difficult urination like strangury, frequent belching, fear/palpitations, Qi insufficiency, gloomy abdomen, lower abdominal pain, heat in throat, fleshy sensation, back spasm limiting bending/extending, Ligou (LR5) governs.
Above selects Zang meridians, Jueyin.
Men's Yin Hernia, testicular movement/lower abdominal pain, Wushu (GB25) governs. Large Hernia, rigid abdomen, Xiangu (GB29) governs.
Above selects Fu meridians, Shaoyang.
Lower abdominal pain, incomplete digestion diarrhea, heat in second toe, sunken pulse, chills/fever/body pain, dry lips/no thirst, sweating, scorched hair, emaciation/Qi deficiency, internal heat, reluctance to move, pus/blood diarrhea, lumbar radiating lower abdominal pain, sudden fright, delirium, Xiayu (ST32) governs. Lower abdominal pain, testicular/waist/spine radiation, hernia pain, upward to heart, stiff waist/spine, yellow/red urine, dry mouth, Xiaochangshu (BL27) governs. Hernia/mass thigh acute pain, hypochondriac radiation to heart, abdominal pain/masses, Fushé (ST25) governs. Abdominal pain, hernia/masses, upward to heart, Yunmen (LU2) governs.
Shangjuxu/Xiajuxu, Xiaochangshu: Select the respective Fu organ. Fushé/Yunmen: Needle Taiyin to support.
Limbs heaviness, body oppression/strangury/hernia, Zhiyin (BL67) governs. Umbilical Hernia, periumbilical pain, rushing to chest, dyspnea, moxa umbilicus. Yin Hernia radiating to testicles, Yinjiao (CV7) governs. Lower abdominal hernia, waking easily frightened, Qihai (CV6) governs. Umbilical Hernia periumbilical pain, Shimén (CV5) governs. Sudden Hernia pain, lower abdominal heat, Guanyuan (CV4) governs. Lower abdominal pain, difficult urination, Yin flaccidity, Hénggǔ (BL28) governs. Men's Yin end cold, rushing to heart, Huìyīn (CV1) governs. Strangury/Hernia, Rángǔ (KI2) governs. Sudden Hernia, lower abdominal pain, Zhaohai (KI6) governs. Left disease needle right, right disease needle left, immediate cure. Sudden Yin Hernia/Mass, blood in uterus, Simǎn (KI14) governs. Umbilical Hernia periumbilical pain, sometimes rushing to heart, Tiānshū (ST25) governs. Qi Hernia, hiccups/vomiting/facial swelling, Running Piglet, Tiānshū (ST25) governs. Yin Hernia/Qi Hernia, Tiānshū (ST25) governs. Yin Hernia/Atrophy, glans pain, testicular retraction, unable to lie supine. Needle Qìchōng (ST30). Yin Hernia, Chōngmén (ST29) governs. (Also Héngmén)
Cold Hernia, descending to abdominal muscles/knee/lumbar pain, clear fluid, major abdominal hernias, pressing up to knees, Fútù (ST32) governs. Cold Hernia pain, abdominal distension, atrophy/cold/Qi deficiency, Yīngǔ (KI10) governs.
[Su Wen] Jueyin pulse slippery indicates Fox Hernia Wind. Shaoyin slippery indicates Lung Wind Hernia. Taiyin slippery indicates Spleen Wind Hernia. Yangming slippery indicates Heart Wind Hernia. Taiyang slippery indicates Kidney Wind Hernia. Shaoyang slippery indicates Liver Wind Hernia. (Si Shi Ci Ni Cong Lun)
[Zhen Jiu Da Cheng] Liver pulse very slippery indicates Hernia. Heart pulse slightly slippery indicates Heart Hernia, radiating to umbilicus/lower abdomen with rumbling. Kidney/Liver very slippery indicates Strangury. (Full text in Treatment Methods.)
[Li Dongyuan] Slippery pulse appearing above Guan indicates Great Heat, as Yang combines with Yang. Slippery pulse appearing at Chi indicates Great Cold, generating Hernia. Slippery pulse is the name of Mingmen/Baoluo, associated with Bing. Bing/Ding Fire/Heat combining below, Bing/Ding cannot overcome Ren/Gui, transforming into Cold Water, thus generating Hernia.
[Su Wen] Emperor asked: Diagnosing Heart pulse rapid/tight, what disease? Qibo answered: Disease named Heart Hernia, lower abdomen should have a mass. Emperor asked: Why? Qibo answered: Heart is Yang organ, Small Intestine is its envoy, thus lower abdomen should have a mass. (Mai Yao Jing Wei Lun) Heart pulse slippery/rapid/tight indicates Heart Hernia. Lung pulse sinking/tight indicates Lung Hernia. Kidney/Liver pulse large/rapid/tight/sinking all indicate Hernia. (Da Qi Lun)
[Mai Xue] Pulse coming from center, solid, reaching Guan, is Chong Mai. Movement causes lower abdominal pain, rushing to heart, masses/hernia. Infertility, incontinence, hypochondriac fullness/annoyance.
[Zhu Danxi] Sudden severe pain below umbilicus, line on face turning black, usually fatal.
[Liu Wansu] Seven Hernias Diagram. Cold Hernia: Scrotum cold, hard as stone, impotence, or radiating testicular pain. Caused by sitting/sleeping on damp ground, wading in cold months, exposure to snow/rain, sitting on bricks/stones, or intercourse in cold windy places with overexertion. Should use warming purgatives. Long-term infertility results.
Water Hernia: Scrotal swelling/pain, intermittent sweating, or cyst like crystal, or itchy with yellow discharge, or water sound on pressing lower abdomen. Caused by drinking alcohol/water, intercourse overexertion, sweating then encountering wind/cold/damp, accumulating in scrotum, hence excess water. Now called Sudden Hernia. Should use water-draining purgatives. Some use needle drainage, but most lack proper method.
Sinew Hernia: Penile swelling, ulceration/pain with internal tension/sinus contraction, or glans pain, extreme pain causes itching, or persistent erection, or white fluid like semen discharging with urine. Caused long-term by sexual exhaustion and evil arts. Should use Heart-Fire-draining purgatives.
Blood Hernia: Like cucumber, on both sides of lower abdomen, midway between transverse bone ends, popularly called "Bian Yong" (Gonococcal Abscess). Caused by heavy exposure to summer heat, sexual overexertion, Qi/Blood overflow infiltrating bladder/scrotum, stagnating and forming abscess, less pus more blood. Should use Blood-nourishing purgatives. (Mix Si Wu Tang and Tiao Wei Cheng Qi Tang equally.)
Qi Hernia: Radiates up to kidney region, down to scrotum.或因号哭忿怒 (due to crying/anger), Qi stagnates causing distension, dissipates when resting. One treatment is needle release of Qi. Needling has pros/cons, better to use Qi-dispersing purgatives. Children also get this, popularly called "Pian Qi" (Unilateral Hernia). Caused by father being old or sickly, impotent/weak essence, forcing intercourse to conceive, fetal disease. This hernia is untreatable except by Zhubin (KI9) acupoint.
Fox Hernia: Like tile, enters lower abdomen when lying, exits to scrotum when standing/walking. Fox leaves den to urinate by day, enters den without urinating by night. This hernia moves up/down, similar to fox. Similar to Qi Hernia but distinct, causing hook/clamp sensation. Should use Qi-moving meridian-penetrating purgatives.
Jue Hernia: Scrotal swelling like bucket, non-itchy/non-painful. Caused by low-lying damp earth. Common in Jianghuai marshes. Should use Dampness-draining purgatives. Women's vaginal prolapse is similar but due to Heat failing to secure, not deficiency-cold, so do not astringe/dry/tonify. Originally named Jia Mass. Should use bitter purgatives, bitter to consolidate. (Wang Bing note: Yang Qi sinks, Yin Qi competes upwards, Cold increases. Sinking relaxes sinews, testicles hang/flaccid, causing Hernia.)
After treating the above seven hernias and eliminating the pathogen, tonify or regulate according to condition, do not stick to folk methods. Classics say: "Yin excess causes abdominal distension/blockage, strangury..."