闻之背为阳。心肺主之。腹为阴。肾肝主之。人之初生。带系于脐。通命门。属两肾。为生
气之原。此钱氏有灸脐之法。而独享遐龄也。盖肾肝居至阴。喜温恶寒。独赖此真火藏于中。而
为生生不息之用。苟有以扑灭之。则有阴无阳。外无以御。内无以充。寒邪直犯。委顿呻吟。而
脐腹绞痛矣。即或禀赋浓者。真元未衰。过伤生冷。留滞于中。亦能为患。而绵绵痛无已时。缘
气因寒则凝。血因寒则结。痰食因寒则阻。故腹疼一症。大半从寒。而热者间出也。至外受炎暑。
内伤辛热。腹痛则有休止。脉必数或促。二便闭而烦躁欠宁。又彰彰已。然而大要尤在乎虚实。
虚者必寒。实者寒热兼之虚。者分水火。实者辨气血。食积其间。热因寒用。寒因热用。通因通
用。塞因塞用。本缓标急。标缓本急。又在临时变通之。如仲景用芍药、甘草。甲与己合。以调
腹痛。寒则加桂。热则加芩。立一标准。余可类推。后学所宜取法者。
一腹痛食积停滞。胀满不安。用浓朴、木香、青皮、枳壳、陈皮、山楂、甘草、砂仁、生姜。
一腹痛受寒。绞痛异常。或绵绵痛无增减。因肉桂、木香、芍药、甘草、当归、广皮、炮姜、茯苓。
一腹痛乍痛乍止。或受暑热。或嗜火酒。脉数或伏匿。投温药反剧者。用黄芩、山栀、芍药、
甘草、广皮、葛根、泽泻。
一腹痛触犯秽气。 痛不宁。作霍乱候。用探吐法。以霍乱治之。
一腹痛劳力所伤。喜手重按。困倦自汗。补中益气汤加木香、芍药。
一腹痛腰亦痛。色欲恐惧疾走所伤。六味汤加枣仁、杜仲、远志。少入柴胡以提之。若火衰畏寒。以八味汤投之。
治验
一男子过劳。患腹痛。医与破气药益甚。余按其脉。 细且弱。视其形气。倦怠异常。竟与补中益气汤而痊。
一男子患腹痛。五六日矣。延余侄视之。委顿殊甚。检前所服。惟枳、朴、木香辈。毫不减
可。乃连进八味汤而获愈。
It is heard that the back belongs to Yang, governed by the Heart and Lung. The abdomen belongs to Yin, governed by the Kidney and Liver. At the beginning of human life, the umbilical cord is tied to the navel, connecting to the Mingmen (Gate of Vitality), and belonging to the two Kidneys; this is the root of vital Qi. This is why Qian Yi (Qian Shi) had the method of moxibustion on the navel, thereby enjoying a long lifespan. Generally speaking, the Kidney and Liver reside in the position of extreme Yin, preferring warmth and disliking cold. They rely solely on this True Fire stored within to exert the function of continuous generation. If something extinguishes it, there will be Yin without Yang, unable to defend externally and unable to nourish internally. Cold pathogenic factors directly invade, causing prostration and groaning, leading to colicky pain in the navel and abdomen. Even if one has strong constitution and unexhausted True Yuan, excessive consumption of raw and cold foods can remain stagnant in the middle Jiao, causing harm, manifesting as lingering pain without end. This is because Qi becomes stagnant due to cold, Blood coagulates due to cold, and Phlegm and Food Stagnation are obstructed due to cold. Therefore, the majority of abdominal pain cases stem from Cold, while Heat patterns occur occasionally. As for external exposure to blazing heat and summer-heat, or internal injury from pungent and hot foods, abdominal pain may have intermittent episodes, with a rapid or hurried pulse, closed urination and defecation, and restlessness; this is also evident. However, the general principle lies particularly in distinguishing Deficiency and Excess. Deficiency inevitably involves Cold, while Excess involves both Cold and Heat. For Deficiency, distinguish between Fire decline and Water deficiency; for Excess, differentiate between Qi disorders and Blood disorders. When Food Stagnation is involved, employ contrary treatments such as "treating heat with cold," "treating cold with heat," "using unblocking methods for unblocking symptoms," and "using blocking methods for blocking symptoms." One must also adapt flexibly according to whether the root is slow and the branch urgent, or vice versa. For instance, Zhang Zhongjing used Shaoyao (Paeoniae Radix) and Gancao (Glycyrrhizae Radix), combining Wood (Jia) and Earth (Ji), to regulate abdominal pain. If Cold, add Guizhi (Cinnamon Twig); if Heat, add Huangqin (Scutellariae Radix). Establish a standard, and other cases can be inferred accordingly. This is what later students should emulate.
Case 1: Abdominal pain due to Food Stagnation and retention, with distension and discomfort. Prescription: Houpo (Magnoliae Officinalis Cortex), Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Zhike (Aurantii Fructus Immaturus), Chenpi (Citri Reticulatae Pericarpium), Shanzha (Crataegi Fructus), Gancao (Glycyrrhizae Radix), Sharen (Amomi Fructus), Shengjiang (Zingiberis Rhizoma Recens).
Case 2: Abdominal pain due to Cold invasion, with severe colicky pain, or lingering pain without increase or decrease. Prescription: Rougui (Cinnamomi Cortex), Muxiang (Aucklandiae Radix), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix), Danggui (Angelicae Sinensis Radix), Guangpi (Citri Reticulatae Pericarpium), Paojiang (Zingiberis Rhizoma Preparatum), Fuling (Poria).
Case 3: Abdominal pain that comes and goes, or caused by Summer-Heat, or indulgence in strong alcohol, with a rapid or hidden pulse, where taking warm medicines aggravates the condition. Prescription: Huangqin (Scutellariae Radix), Shanzhi (Gardeniae Fructus), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix), Guangpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix), Zexie (Alismatis Rhizoma).
Case 4: Abdominal pain triggered by foul odors, with restless pain, presenting as Huoluan (Cholera-like syndrome). Use the method of inducing vomiting, treating it as Huoluan.
Case 5: Abdominal pain due to labor injury, favoring heavy pressure, with fatigue and spontaneous sweating. Use Buzhong Yiqi Tang (Spleen-Raising Qi-Supplementing Decoction) plus Muxiang (Aucklandiae Radix) and Shaoyao (Paeoniae Radix).
Case 6: Abdominal pain accompanied by lower back pain, due to sexual excess, fear, or violent running. Use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) plus Zaoren (Ziziphi Spinosae Semen), Duzhong (Eucommiae Cortex), and Yuanzhi (Polygalae Radix). Add a small amount of Chaihu (Bupleuri Radix) to lift the Qi. If there is Fire decline and aversion to cold, use Bajia Tang (Eight-Ingredient Decoction, i.e., Jin Gui Shen Qi Wan).
Clinical Records:
One man suffered from abdominal pain after overwork. The physician administered Qi-breaking medicines, which worsened the condition. I palpated his pulse, finding it fine and weak. Observing his physique and Qi, he was extremely fatigued. I prescribed Buzhong Yiqi Tang (Spleen-Raising Qi-Supplementing Decoction), and he recovered.
Another man suffered from abdominal pain for five or six days. My nephew attended him, but the patient was extremely prostrate. Reviewing the previously taken medicines, they were only Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), and Muxiang (Aucklandiae Radix), with no reduction in symptoms. I then continuously administered Bajia Tang (Eight-Ingredient Decoction, i.e., Jin Gui Shen Qi Wan), resulting in recovery.