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There is damp-type Huoluan (acute vomiting and diarrhea), characterized by abdominal pain accompanied by upper vomiting and lower diarrhea. Huoxiang San (Patchouli Powder) is the primary prescription for this condition. There is also dry-type Huoluan, commonly known as Bansha (Spotted Sha), alternatively called Jiaochangsha (Intestine-Twisting Sha). Its symptoms include absence of vomiting and diarrhea, bluish-cold complexion, and severe cramping abdominal pain. This results from the disorder of Yin and Yang, representing a most ominous prognosis, yet it is also the easiest to treat. One should urgently prick the Weizhong area to induce bleeding, drink a mixture of alum powder with water to induce vomiting via probing, or use Yinyang salt soup, or vegetable oil to induce vomiting. Simultaneously, scrape the back using a bowl, dipping roots of Boehmeria nivea (Ramie root) in clear vegetable oil, scraping acupoints such as Duoming, Houding of the Governor Vessel, and Tianting. Afterwards, take a few mouthfuls of fine Sandaren powder (Amomum fruit powder); after belching dozens of times, recovery occurs. If spots appear all over the body, roast them with an oil-paper torch until they pop; or simply drink buckwheat soup for recovery. However, the key lies in urgently pricking Weizhong to bleed, ensuring survival. (Even bleeding from the ten fingertips is a good method. Note: Weizhong [BL40] is located at the midpoint of the transverse crease of the popliteal fossa, directly opposite the knee, taken with the leg extended.)

Huoxiang San
Patchouli Rhizome (Huoxiang) Atractylodes Rhizome (Cangzhu) Magnolia Bark (Nongpu) Tangerine Peel (Chenpi) Pinellia Tuber (Banxia) Poria Sclerotium (Fuling)

What is the clinical presentation of Stomach-epigastric Pain? It is said that Stomach-epigastric pain is what is colloquially referred to as Heart pain. The Heart itself cannot feel pain; if it does, death is immediate. Because the Heart lies anterior to the stomach epigastrium, gastric pain is mistakenly identified as heart pain. Gastric pain is differentiated into types caused by food retention, phlegm-dampness, static blood, Qi stagnation, cold pathogen, fire-heat, and deficiency of Middle Qi. Medical texts describe these clearly without profound subtleties. Uniquely, there is a type where Fire from the Liver and Gallbladder transfers into the Stomach causing heat. Since the Liver stores Blood, Blood deficiency causes the Liver lobes to become hard and fail to descend properly, pressing against the Stomach. When the Stomach receives this pressure, eating fills it, exacerbating the compression by the Liver, resulting in dull pain. Over time, this transforms into a Dryness syndrome, leading to Ge Syndrome (dysphagia/choking sensation). (This type should be viewed together with Ge Syndrome). Another type involves sourness in the Stomach, which the patient does not consciously recognize as sour. They dare not eat much; excessive intake causes whole-day oppression, relieving only slightly after digestion. This pain is due to a specific Sour-Heat in the Stomach. Belching brings slight relief, but belching is rare. Forceful belching indicates Qi rising from below, often carrying food gas, water, or foreign matter causing acidity. Lower expulsion of Qi is difficult, accompanied by hard stools. These are caused by the Qi of the Shaoyang and Jueyin organs. Over time, one must guard against transformation into Pi (obstruction), Ge (choking), or Zhongman (abdominal fullness) syndromes. (This type can be included under Sour Regurgitation). Another type of Stomach-epigastric pain indicates the impending formation of Yin Deficiency syndrome, requiring careful identification. "Diseases of the Two Yangs originate in the Heart and Spleen"; this category can be generalized. Food-retention pain presents with severe tenderness upon palpation of the chest and diaphragm, inability to swallow even a spoonful of water, constipation, and nausea upon smelling grain odors. (The following symptom verification is excellent). Use Erchen Tang (Two-Cured Decoction) or Pingwei San (Stomach-Pacifying Powder) with Jiegeng (Platycodon Root) and Zhishi (Immature Bitter Orange). (This corresponds to the Changzhou school's concept of food stagnation treated by promoting digestion). Phlegm-pain presents with loss of appetite, desire to eat but inability to do so, normal bowel movements. Use Erchen Tang with Zhike (Aurantium Fruit), Huangqin (Scutellaria Root), and Haishi (Floating Limestone). (Food pain stops when food is resolved; phlegm pain stabilizes when phlegm is treated. Although this is the standard method, if previous methods fail, observe the Spleen and Stomach status and refer to the diagnostic principles for Phlegm and Food). Blood-stasis pain presents with stabbing pain in the chest and diaphragm (pulse must be soggy and choppy), ability to eat. Use Siwu Tang (Four Substances Decoction) with Dahuang (Rhubarb Root), Taoren (Peach Kernel), and Honghua (Safflower). (Some cases may suit Lizhong Tang with Rougui (Cinnamon Bark), Taoren, and Honghua, depending on symptoms). Worm-pain presents with anorexia, intermittent pain, radiation to arms or shoulders like piercing pain, red lips, and white spots on the face. No appetite during pain, but appetite returns immediately after pain ceases. Excess patterns are treated with Huachong Wan (Worm-Expelling Pill); deficiency patterns with Liuwei Wan (Six-Ingredient Pill) plus Huhuanglian (Phellodendron Bark), Chuanlianzi (Sichuan Chinaberry Seed), Qingdai (Indigo Naturalis), and Lvhui (Aloe). (All worms transform from Wind-Wood; draining Jueyin removes worms; Liuwei Dihuang Wan is excellent. Huhuanglian, Lvhui, Qingdai are unsuitable for deficiency; use cautiously. Qian notes: Deficient worm-pain arises from Earth failure allowing Wood to overcome. Liuwei Tang treats Spleen-Stomach Yin deficiency well, but is unsuitable for Spleen-Stomach Yang deficiency. Since worms transform from Wind-Wood, objects must rot before worms arise; focus on generating Qi. Use Lizhong Tang minus Gancao, add少量 Chuanjiao, delivered with Wumei Anwei Wan, often achieving miraculous effects). Stomach-deficiency pain stops upon eating (relieved by pressure), recurs with overeating or post-prandially. Treat with Lizhong Tang. (This is Middle Qi deficiency pain). Liver-deficiency dryness-pain presents with anorexia, worsening during Yin hours, cool exterior touch despite patient's subjective fever and thirst (dry stool). Use Xiaoyao San with Shengdi (Rehmannia Root), Danpi (Moutan Bark), and Shanzhi (Gardenia Fruit). Severe cases use Shugan Yishen Tang with Danggui. (Qi-cold and Fire syndromes were not listed by Siming physicians, but Zhunsheng's symptom differentiation is detailed, while Xue Ji's treatment principles are sound; consult both).

Erchen Tang
Tangerine Peel (Chenpi) Pinellia Tuber (Banxia) Poria Sclerotium (Fuling) Licorice Root (Gancao)

Pingwei San
Magnolia Bark (Nongpu) Atractylodes Rhizome (Cangzhu) Tangerine Peel (Chenpi) Licorice Root (Gancao)

Huachong Wan
Toosendan Fruit (Wuyi) Polyporus (Leiwu) Phellodendron Bark (Hulian) Aloe (Luhui) Quinine Tree Seed (Shijunzi) Burreed Tuber (Sanleng) Curcuma Rhizome (Ezhu)