治腹中不和而痛(此阴阳气血不和,肝木乘脾之故也。腹痛有寒、有热、有虚、有实、
有食积、有湿痰、有死血、有虫。寒痛者,痛无增减,或兼吐利;热痛者,时痛时止,腹满
坚结;实痛者,痛甚胀满,手不可按;虚痛者,按之即止;食痛者,痛甚则利,利后痛减;
死血痛者,痛有常处;湿痰痛者,脉滑、痰气阻碍,不得升降;虫痛者,时作时止,面白唇
红。大抵胃脘下大腹痛者,多属食积外邪;绕脐痛者,属痰火积热;脐下小腹痛者,属寒,
或瘀血,或溺涩)。仲景用治误表发厥,脚挛吐逆,与干姜甘草汤以复其阳,厥愈足温者,
更作此汤以和其阴,其脚即伸(酸甘相合,用补阴血。王海藏曰∶稼穑作甘,甘者己也,曲
直作酸,酸者甲
白芍药 甘草(炙。各四两。)脉缓伤水,加桂枝、生姜;脉洪伤金,加黄芩、大枣;
脉
此足太阳、阳明药也。气血不和故腹痛,白芍酸收而苦泄,能行营气;炙草温散而甘缓
,能和逆气。又痛为木盛克土(诸痛皆属肝木),白芍能泻肝,甘草能缓肝和脾也(虞天民
曰∶白芍不惟治血虚,大能行气,腹痛者,营气不和,逆于肉里,得白芍行其营气,又以甘
草之甘缓和
本方去芍药,加干姜(一两,炮),名甘草干姜汤(仲景。别见寒门),《金匮》用此治
肺痿肺冷,吐涎沫,小便数(以此温之)。本方加附子,名芍药甘草附子汤(仲景。别见寒
门)。本方加黄芩,名黄芩芍药汤(《机要》)∶治热痢,腹痛后重,脓血稠粘,及鼻衄不止,
脉洪数(此即仲景之黄芩汤除大枣)。本方加白术,名白术芍药汤(《机要》)∶治脾湿水泻,
身重困弱(《保命集》曰∶泻痢不止,或暴下者,皆太阴受病,故不可离芍药;人不受湿则
不痢,故须白术;四时下痢,于白芍、白术内∶春加防风,夏加黄芩,秋加浓朴,冬加桂附。
更详外证治之,如身困倦加白术;自汗逆冷、气息微,加桂附以温之;如里急后重,脓血稠
粘,虽在盛冬,于温药内
Treats discomfort and pain in the abdomen (This is due to disharmony of Yin and Yang, Qi and Blood, where Liver Wood overacts on Spleen Earth. Abdominal pain can be categorized into Cold Pain, Heat Pain, Deficiency Pain, Excess Pain, Food Stagnation Pain, Damp-Phlegm Pain, Fixed Blood Pain, and Parasite Pain. In Cold Pain, the pain does not fluctuate in intensity, or is accompanied by vomiting and diarrhea; in Heat Pain, the pain comes and goes, with abdominal fullness and hardness; in Excess Pain, the pain is severe with distension, and cannot be touched by hand; in Deficiency Pain, pressing stops the pain; in Food Stagnation Pain, severe pain leads to diarrhea, and pain decreases after defecation; in Fixed Blood Pain, the pain is located in a fixed place; in Damp-Phlegm Pain, the pulse is slippery, phlegm-Qi obstructs, preventing ascending and descending movements; in Parasite Pain, it occurs intermittently, with pale complexion and red lips. Generally, pain below the epigastrium extending to the large abdomen mostly belongs to Food Stagnation or External Pathogens; pain around the umbilicus belongs to Phlegm-Fire and accumulated heat; pain in the lower abdomen below the umbilicus belongs to Cold, or Fixed Blood, or difficult urination). Zhang Zhongjing uses this formula to treat cold limbs (Jue) caused by mistaken sweating therapy, leg cramps, and vomiting/reversal of Qi. First, Ganjiang Gancao Tang (Dried Ginger and Licorice Decoction) is used to restore Yang Qi. When the cold limbs resolve and the feet become warm, this decoction is prepared again to harmonize Yin Qi, at which point the legs extend (Sour and Sweet flavors combined are used to tonify Yin and Blood. Wang Haicang said: "Jiaose produces Sweet, Sweet corresponds to Ji [Earth]; Quzhi produces Sour, Sour corresponds to Jia [Wood]").
Baishao Yao (White Peony Root), Gancao (Licorice Root, honey-fried). Each 4 liang. If the pulse is slow indicating Water injury, add Guizhi (Cinnamon Twig) and Shengjiang (Fresh Ginger); if the pulse is surging indicating Metal injury, add Huangqin (Scutellaria Root) and Dazao (Jujube Fruit).
These are herbs for the Foot-Taiyang and Foot-Yangming meridians. Because Qi and Blood are disharmonious, abdominal pain occurs. Baishao is sour and astringent, bitter and draining, capable of moving Ying-Qi; Honey-fried Gancao is warm and dispersing, sweet and relaxing, capable of harmonizing rebellious Qi. Furthermore, pain is caused by excessive Liver Wood suppressing Spleen Earth (all pains belong to Liver Wood); Baishao can drain the Liver, and Gancao can soothe the Liver and harmonize the Spleen (Yu Tianmin said: "Baishao not only treats Blood deficiency but greatly moves Qi. Abdominal pain is due to disharmony of Ying-Qi, rebelling within the muscle layers; obtaining Baishao to move its Ying-Qi, and using the sweet relaxation of Gancao...")
Removing Baishao from this formula and adding Ganjiang (Dried Ginger, 1 liang, processed), it is named Gancao Ganjiang Tang (Zhang Zhongjing. See also Cold Category). The *Jinkui Yaolue* uses this to treat Lung Wei (Flaccidity Syndrome) and Lung Cold, with symptoms of spitting saliva and foam, and frequent urination (using this to warm them). Adding Fuzi (Prepared Aconite Root) to this formula creates Shaoyao Gancao Fuzi Tang (Zhang Zhongjing. See also Cold Category). Adding Huangqin (Scutellaria Root) creates Huangqin Shaoyao Tang (*Lanshimibzang - Jiyao*): It treats Dysentery with Heat, abdominal pain with tenesmus, thick and sticky pus and blood, as well as persistent epistaxis, with a surging and rapid pulse (This is essentially Zhang Zhongjing's Huangqin Tang without Dazao). Adding Baizhu (Atractylodes Macrocephala Rhizome) creates Baizhu Shaoyao Tang (*Lanshimibzang - Jiyao*): It treats Spleen Dampness causing watery diarrhea, heavy body, and fatigue (*Weisheng Baojian* states: "Diarrhea and dysentery that do not stop, or sudden profuse discharge, all indicate disease of the Taiyin; thus, Shaoyao cannot be omitted; humans do not get dysentery without receiving Dampness, thus Baizhu is necessary; for dysentery in four seasons, within Baishao and Baizhu: add Fangfeng (Saposhnikovia Root) in Spring, Huangqin in Summer, Houpo (Magnolia Bark) in Autumn, Guizhi and Fuzi in Winter. Treat further according to external symptoms, such as adding Baizhu for bodily fatigue; spontaneous sweating, cold limbs, and faint breath, add Guizhi and Fuzi to warm; if there is tenesmus, thick and sticky pus and blood, even in deep winter, within warming medicines...")