【气虚腹痛之症】面色痿黄，言语轻微，饮食减少，时时腹痛，劳动则甚，按之稍减，
此气虚腹痛之症也。
【气虚腹痛之因】或久病汗下，久泻伤元，劳形气散，饥饿损伤，或急于奔走，或勉强
行房，气道虚损，则腹为之痛矣。
【气虚腹痛之脉】多见微弱，或见空大，或见细涩，元气虚惫，脉反动急。
【气虚腹痛之治】气怯神倦，脉见微细，四君子汤。遇劳痛甚，脉大无力，补中益气汤
。饮食减少，香砂六君子汤。
四君子汤
人参 白术 茯苓 甘草
补中益气汤 治气血两亏，元气下陷之症。
人参 白术 当归 黄 陈皮 柴胡 甘草 升麻
加茯神、枣仁，又合归脾汤。
香砂六君子汤
人参 白术 陈皮 白茯苓 熟半夏 藿香 砂仁 炙甘草
【肠痈腹痛之症】缩脚皱眉，小便如淋，痛有肿处，手不可按，夜来每发寒热，或绕脐
生疮，或腹皮紧急，肌肤甲错，或时时出汗，此肠痈腹痛之症也。
【肠痈腹痛之因】或膏粱浓味，蕴积肠胃，或劳动跌扑，损伤气血，或六淫之邪内伏，
或恼怒郁结，气血凝聚，或偶有他病，误用温热补塞之药，亦能成痈。
【肠痈腹痛之脉】多见滑数。脉小而数，将有脓也。洪大而数，已有脓也。脉迟而小，
未有脓也。脉迟而涩，内蓄血也。
【肠痈腹痛之治】脉小数，将有脓者，四圣散。脉洪而数，已有脓者，薏苡仁汤排之。
内蓄血者，桃仁承气汤。
四圣散
栝蒌（一个） 甘草（四钱） 没药（二钱） 乳香（一钱五分）
研末酒调服。
薏苡仁汤
排脓散 上二方，见蓄血。
桃仁承气汤 见血滞腹痛。
凡作痛于内，即防内痈。以其外不现形，最能误人。今以肠痈列入腹痛门，则咳嗽胸痛
之肺痈，胁痛寒热之肝胆疽，能食胃痛夜间寒热之胃痈，腰痛之腰注，推之身痛寒热未发之
流注，腿痛内溃之附骨痈，皆有下手真诀矣。
[Symptoms of Abdominal Pain due to Qi Deficiency] The complexion is sallow and withered, speech is faint, appetite is reduced, abdominal pain occurs frequently, worsens upon exertion, and is slightly relieved by pressure. This constitutes the symptoms of abdominal pain due to Qi deficiency.
[Etiology of Abdominal Pain due to Qi Deficiency] It may result from excessive sweating or purgation during prolonged illness, chronic diarrhea damaging the Yuan Qi (Primordial Qi), physical overexertion causing Qi dispersion, injury due to hunger, hurried running, or forced sexual intercourse. When the Qi pathways become deficient and damaged, abdominal pain ensues.
[Pulse of Abdominal Pain due to Qi Deficiency] The pulse is predominantly weak and thready (Wei Mai), or appears empty and large (Kong Da Mai), or fine and choppy (Xi Se Mai). If the Yuan Qi is extremely exhausted, the pulse may beat rapidly despite the deficiency.
[Treatment of Abdominal Pain due to Qi Deficiency] If there is timidity of Qi and mental fatigue with a fine and weak pulse, use Si Jun Zi Tang (Four Gentlemen Decoction). If pain intensifies upon exertion with a large but forceless pulse, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If appetite is reduced, use Xiang Sha Liu Jun Zi Tang (Atractylodes Macrocephala and Amomum Six Gentlemen Decoction).
Si Jun Zi Tang (Four Gentlemen Decoction)
Ren Shen (Ginseng Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Fu Ling (Poria) Gan Cao (Licorice Root)
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) Treats conditions of dual deficiency of Qi and Blood, with sinking of Yuan Qi.
Ren Shen (Ginseng Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Dang Gui (Angelicae Sinensis Radix) Huang Qi (Astragali Radix) Chen Pi (Citri Reticulatae Pericarpium) Chai Hu (Bupleuri Radix) Gan Cao (Licorice Root) Sheng Ma (Cimicifugae Rhizoma)
Add Fu Shen (Poria with Hostwood) and Zao Ren (Ziziphi Spinosae Semen), combined with Gui Pi Tang (Restore the Spleen Decoction).
Xiang Sha Liu Jun Zi Tang (Atractylodes Macrocephala and Amomum Six Gentlemen Decoction)
Ren Shen (Ginseng Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Chen Pi (Citri Reticulatae Pericarpium) Bai Fu Ling (Poria) Shu Ban Xia (Pinelliae Rhizoma Praeparatum) Huo Xiang (Agastaches Herba) Sha Ren (Amomi Fructus) Zhi Gan Cao (Honey-fried Licorice Root)
[Symptoms of Intestinal Abscess Abdominal Pain] The patient curls up their legs and frowns, urination resembles strangury (Lin Syndrome), painful areas are swollen and cannot be touched, chills and fever occur nightly, sores may appear around the umbilicus, the abdominal skin feels tight, the skin is rough like fish scales (Jia Cuo), or there is frequent sweating. These are the symptoms of abdominal pain caused by intestinal abscess (Chang Yong).
[Etiology of Intestinal Abscess Abdominal Pain] It may result from the accumulation of rich and greasy foods in the intestines and stomach, injury to Qi and Blood from labor or falls, internal retention of pathogenic factors from the Six Excesses (Liu Yin), Qi stagnation and Blood coagulation due to anger and depression, or the misapplication of warm, tonifying, and astringent medicines for other diseases, which can also lead to abscess formation.
[Pulse of Intestinal Abscess Abdominal Pain] The pulse is predominantly slippery and rapid (Hua Shuo Mai). A small and rapid pulse indicates impending suppuration. A surging, large, and rapid pulse indicates existing suppuration. A slow and small pulse indicates no suppuration yet. A slow and choppy pulse indicates internal blood stasis.
[Treatment of Intestinal Abscess Abdominal Pain] For a small and rapid pulse indicating impending suppuration, use Si Sheng San (Four Sages Powder). For a surging and rapid pulse indicating existing suppuration, use Yi Yi Ren Tang (Coix Seed Decoction) to drain pus. For internal blood stasis, use Tao Ren Cheng Qi Tang (Peach Kernel Modifying the Bowels Decoction).
Si Sheng San (Four Sages Powder)
Gua Lou (Trichosanthis Fructus) - one piece
Gan Cao (Licorice Root) - 4 qian
Mo Yao (Myrrha) - 2 qian
Ru Xiang (Olibanum) - 1.5 qian
Grind into powder and take mixed with wine.
Yi Yi Ren Tang (Coix Seed Decoction)
Pai Nong San (Drain Pus Powder) See "Blood Stasis" section for the above two formulas.
Tao Ren Cheng Qi Tang (Peach Kernel Modifying the Bowels Decoction) See "Abdominal Pain due to Blood Stasis" section.
Whenever pain occurs internally, one must guard against the formation of internal abscesses. Because they do not manifest externally, they are most prone to misleading diagnosis. By classifying intestinal abscess under the category of abdominal pain, the diagnostic principles for lung abscess presenting with cough and chest pain, liver and gallbladder jaundice presenting with hypochondriac pain and chills/fever, gastric abscess presenting with good appetite, stomach pain, and night chills/fever, lumbar injection (Yao Zhu) presenting with lower back pain, flowing injection (Liu Zhu) presenting with body pain and unmanifested chills/fever, and osteomyelitis (Fu Gu Yong) presenting with leg pain and internal ulceration, can all be deduced and applied.