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General Overview: Disharmony of the Spleen Meridian and deficiency of the Stomach lead to contention between pathogenic factors and healthy Qi, resulting in stagnant Qi flow. Heat-type abdominal pain presents with a red face and dark urine; cold-type abdominal pain presents with a cyan-white complexion and black lips.

Pulse Diagnosis: A Yin-chord (Xian) pulse indicates abdominal pain; a tense-urgent (Xian-Ji) pulse indicates lower abdominal pain; a tight pulse at the Chi position indicates periumbilical and lower abdominal pain; a deep-hidden (Fu) pulse at the Chi position indicates lower abdominal pain.

Abdominal masses and hernia pains (Jia-Shan Tong), heart and abdominal pain that do not cease: if the pulse is fine, small, and slow, survival is likely; if the pulse is tight, solid, and large, death is likely; if abdominal pain presents with a pulse that is unexpectedly large and long, death is likely; severe pain below the umbilicus accompanied by blackening of the Renzhong area indicates death.

The Huangdi Neijing states: When cold pathogen enters the meridians, its movement becomes sluggish and obstructed. If it lodges outside the vessels, blood volume decreases; if it lodges inside the vessels, Qi stagnates. Thus, sudden pain occurs.

According to the Huangdi Neijing, the discussion on pain caused by external invasion of cold pathogen is very detailed and cannot be fully recounted here; later students should consult the original text themselves.

The Yuanbing Shi states: Heat stagnating internally causes abdominal fullness, hardness, and pain; this cannot be indiscriminately diagnosed as a cold syndrome.

Zhu Danxi stated: Abdominal pain relieved by pressure belongs to deficiency-cold; abdominal pain intolerable to touch belongs to excess-heat. The various types of pain are listed in detail below:

There is a condition called Suochang Tong (Locking Intestine Pain). About a month after birth, an infant suddenly fails to swallow milk, the abdomen becomes hard as stone, the face is red like cinnabar, the mouth puckers while crying, the complexion turns cyan, lips turn black, and the hands, feet, and breath become cold. This initially occurs because the umbilical cord was not tied tightly during severance, allowing wind-cold to invade. The symptoms are critical. Treat with Baishaoyao Tang (White Peony Decoction) or Wumei San (Mume Powder). If left untreated for a long time, it becomes difficult to cure. Refer also to the discussion on Umbilical Wind Syndrome. Jia Tong (Mass Pain) results from long-standing accumulation and can develop into Gan Syndrome (Infantile Malnutrition). These conditions arise from dual deficiency of Ying (Nutritive) and Wei (Defensive) Qi, external contraction of wind-cold, and internal overconsumption of milk and food leading to stagnation and inability to digest. Pathogenic factors merging into Yin result in "Yi" (fixed mass), which is quiet, coagulated, and immobile; pathogenic factors merging into Yang result in "Jia" (mobile mass), which takes shape from objects and moves incessantly. If these two conditions are not treated for a long time, they may become Pi Gan Ji (Spleen Malnutrition Accumulation), or lumps like stones may appear between the hypochondrium, painful upon pressure but light when untouched, or the face may be yellow, muscles emaciated, abdomen hard and distended, with visible blue veins, coolness by day and heat by night, intermittent steaming fever, reduced milk intake, craving for dirt/clay, or sour diarrhea. During pain, the body feels cold as ice. The treatment method should regulate the Spleen and nourish the Stomach using Xingpi San (Awaken Spleen Powder); grind accumulations and treat Gan using Huapi Wan (Eliminate Mass Pill); treat Yi diarrhea using Moshizi Wan (Myrobalan Pill). However, such accumulation diseases cannot be cured in seven doses; sequential regulation is required, and recovery will occur naturally over time.

"Yi" pain begins with a small, elongated, hard lump inside the abdomen, hard as an arm, winding around from the waist, either left or right. After a while, pain intensifies and becomes visible subcutaneously, accompanied by loss of appetite. This condition initially arises from phlegm, where the exterior syndrome is not fully resolved, followed by excessive purgation, leading to Qi deficiency, cold condensation, and stagnation. The treatment method should tonify Qi. For Spleen deficiency, use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) or Chenxiang Binglang Wan (Aquilaria and Areca Nut Pill).

This section addresses pain caused by moving roundworms, characterized by spitting clear saliva, occasional vomiting of worms, and unbearable pain. The disease results from early consumption of rich, sweet, greasy, and fishy foods, causing Stomach cold and worm agitation. The vomited worms may be alive or dead. In young children, severe pain of this type can lead to danger. First, administer Lizhong Tang (Regulate the Middle Decoction) with Wumei (Mume Fruit) to warm the Stomach and prevent rebellion, followed by Shijunzi Wan (Quince Seed Pill). In older children presenting with a sallow-white complexion tinged with yellow, increased meat consumption, emaciation, and intermittent abdominal pain, blood flukes or roundworms may be aggregating within. Treat with Ersheng Wan (Two Sages Pill) to purge them.

Additionally, extreme cold or heat affecting the Stomach can cause worm agitation, resulting in slight pain or no pain, followed by sudden vomiting. The treatment priority should be to calm the worms; treating only the worms without protecting the Stomach Qi is inadvisable. For agitation due to cold, use Lizhong Tang with Wumei decocted in water. For agitation due to heat, use Wuling San (Five-Ingredient Polyporus Powder) with Wumei, decocted with water and fresh ginger.

Ji Tong (Accumulation Pain) presents as dull abdominal pain, yellow complexion, and anorexia. In older children, acid regurgitation and flatulence occur. First treat the accumulation, then regulate the Spleen and Stomach; the pain will cease naturally. Differentiate between excess and deficiency. Harmonizing treatment methods are detailed in the Treatise on Food Accumulation.

Pi Tong (Favoritism/Mass Pain) refers to Yi, Jia, and Pi. These four conditions are largely similar with minor differences, collectively termed Ji Ju (Accumulations and Masses). See the Treatise on Accumulations and Masses for details.

Zang Han Tong (Visceral Cold Pain) is attached to the Treatise on Fetal Cold.

Pan Chang Nei Diao Tong (Coiling Intestine Internal Torsion Pain) is discussed in the Treatise on Night Crying.

Diao Shen Pian Zhui Tong (Hanging Kidney Unilateral Hernia Pain) requires regulating the Kidney and harmonizing Qi; see the Treatise on Scrotal Swelling.

Han Shan Tong (Cold Hernia Pain) is detailed in the Treatise on Hernia.

[Attached Formulas]
Baishaoyao Tang (White Peony Decoction): Shaoyao (Paeoniae Radix), Zexie (Alisma Rhizoma), Bo Gui (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma).
Wumei San (Mume Powder): Gouteng (Uncariae Ramulus cum Uncis), Ruxiang (Olibanum), Yuanhu (Corydalis Rhizoma), Moyao (Myrrha), Wumei Rou (Fructus Mume), Fugan (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle).
Xingpi San (Awaken Spleen Powder): Renshen (Ginseng Radix), Sharen (Amomi Fructus), Huangqin (Scutellariae Radix), Huoxiang (Agastaches Herba), Baizhu (Atractylodis Macrocephalae Rhizoma), Dingxiang (Caryophylli Flos), Nanxing (Arisaomatis Rhizoma Preparatum), Gancao (Glycyrrhizae Radix et Rhizoma).
Huapi Wan (Eliminate Mass Pill): See Treatise on Accumulations.
Moshizi Wan (Myrobalan Pill): Moyao (Myrrha), Chishizhi (Halloysit Rubra), Hezi (Terminaliae Chebulae Fructus).
Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder): See Treatise on Cholera-like Disease.
Chenxiang Binglang Wan (Aquilaria and Areca Nut Pill): Chenxiang (Aquilariae Lignum Resinatum), Binglang (Arecae Semen), Muxiang (Aucklandiae Radix), Dingxiang (Caryophylli Flos), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Shenqu (Massae Fermentatae Medicatae), Nongpo (Magnoliae Officinalis Cortex), Cangzhu (Atractylodis Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus), Yizhi (Alpiniae Oxyphyllae Fructus), Zhike (Aurantii Fructus Immaturus), Liangjiang (Alpiniae Katsumadai Rhizoma), Xiangfu (Cyperi Rhizoma), Guya (Hordei Fructus Germinatus), Shijunzi (Quisqualis Fructus).
Lizhong Tang (Regulate the Middle Decoction): See Treatise on Convulsions.
Shijunzi Wan (Quince Seed Pill): Binglang (Arecae Semen), Dahuang (Rhei Radix et Rhizoma), Shijunzi (Quisqualis Fructus), Suan Shiliu Pi (Granati Pericarpium).
Ersheng Wan (Two Sages Pill): Binglang (Arecae Semen, 1 liang), Badou (Crotonis Fructus, 15 grains, remove shell, membrane, and heart, slightly press out oil). Pound Badou with Binglang using a wooden mortar to make pills the size of mung beans. After worms are expelled, drink thin rice gruel for comfort. Alternatively, Heiqiu (Strychni Semen) may be used.
Wuling San (Five-Ingredient Polyporus Powder): See Treatise on Convulsions.