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[Symptoms of Sha Distension Abdominal Pain] Sudden onset of distending pain in the chest and abdomen, coldness of the hands and feet, cyanosis of the fingernails, unbearable pain, absence of vomiting or diarrhea, or presence of vomiting or diarrhea, exacerbation of pain upon pressure. Commonly known as "Intestinal Cramping Sha," this constitutes the syndrome of Sha Distension Abdominal Pain (Sha Zheng Fu Tong).

[Etiology of Sha Distension Abdominal Pain] Whether in coastal regions or amidst mountain mists, or due to pathogenic factors of Wind-Wood, or excessive Dryness-Metal, all manner of abnormal Qi invading the intestines and stomach can generate Sha Toxin, leading to abdominal pain.

[Pulse Diagnosis of Sha Distension Abdominal Pain] The pulse is mostly large and forceful, or presents with rapid (Cu) or knotted (Jie) characteristics. When pain is extreme, the pulse may exhibit intermittent pauses.

[Treatment of Sha Distension Abdominal Pain] If the ten fingers are cyanotic and cold, puncture the fingertips to release blood. If there is an urge to vomit but inability to do so, induce vomiting using salt water solution. For pain radiating to the hypochondrium, puncture Qimen (LR14). This practice is referred to by some as "Releasing Sha." In cases accompanied by aversion to cold and fever with a floating and large pulse, utilize Baidu San (Decoction for Resolving Toxicity).
Qiang Du Baidu San (Qiang Huo and Du Huo Decoction for Resolving Toxicity)
Ingredients: Radix Notopterygii (Qiang Huo), Radix Angelicae Dahuricae et Saposhnikoviae (Du Huo), Radix Bupleuri (Chai Hu), Caulis Peucedani (Qian Hu), Flos Platycodonis (Jie Geng), Radix Saposhnikoviae (Fang Feng), Herba Schizonepetae (Jing Jie), Pericarpium Citri Reticulatae (Guang Pi), Radix Glycyrrhizae (Gan Cao), Radix Chuanxiong (Chuan Xiong).
Note by Zhen: The above five items all pertain to abdominal pain caused by external contraction; hence, they are listed separately at the beginning.

[Symptoms of Heat Accumulation Abdominal Pain] Fever of the body and abdomen, restlessness, insomnia, intermittent pain, sweating during pain episodes, vocalization during pain, or an immediate urge for dysentery after a bout of pain, with cessation of pain upon defecation. This constitutes the syndrome of Heat Accumulation Abdominal Pain (Re Ji Fu Tong).

[Etiology of Heat Accumulation Abdominal Pain] Accumulation of internal heat from rich foods and alcohol, or hyperactivity of Heart and Liver Fire causing internal scorching, or overeating leading to food stagnation and subsequent fever. All these scenarios result in the syndrome of Heat Accumulation Abdominal Pain.

[Pulse Diagnosis of Heat Accumulation Abdominal Pain] A slippery and rapid pulse at the Right Guan position indicates Heat Accumulation in the Intestines and Stomach. A wiry and urgent pulse at the Left Guan position indicates Fire in the Liver and Gallbladder. When Heat Accumulation lies latent internally, the pulse may appear deep and hidden; upon prolonged pressing, the pulsation feels vigorous and distinct.

[Treatment of Heat Accumulation Abdominal Pain] For those consuming rich and greasy foods, utilize Zhike Chuanlian Tang (Zhi Guo and Coptis Decoction). For pain with urge for dysentery, slight relief after defecation, and recurrence shortly after, select Chengqi Tang (Downbearing Decoction). For accumulation caused by wine and heat, utilize Zhilian Pingwei San (Gardenia and Coptis Powder for Calming the Stomach), adding Zhi Guo and Ge Gen. For fever due to food stagnation, utilize Baohe Wan (Preserve Harmony Pill), adding Zhi Guo and Lian. For a flooding and rapid pulse at the Right Guan position, use Qingwei Tang (Clear Stomach Decoction). For a flooding and rapid pulse at the Left Guan position, use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver).

Zhike Chuanlian Tang (Zhi Guo and Coptis Decoction)
Ingredients: Fructus Aurantii (Zhi Ke), Rhizoma Coptidis (Chuan Lian Huang).
Add Semen Amomi Rotundum powder if there is fullness and oppression in the chest. Add Herba Aristolochiae Manshuriensis (Mutong) and Talcum (Huashi) if urination is difficult. Add Radix Rhei Palmati (Dahuang) and Natrii Sulfas (Xuanming Fen) if stool is constipated.

Chengqi Tang (Downbearing Decoction)
Ingredients: Radix Rhei Palmati (Dahuang), Fructus Aurantii (Zhi Ke), Cortex Magnoliae Officinalis (Nong Po), Natrii Sulfas (Mang Xiao).

Zhilian Pingwei San (Gardenia and Coptis Powder for Calming the Stomach)
Ingredients: Cortex Magnoliae Officinalis (Nong Po), Pericarpium Citri Reticulatae (Chen Pi), Radix Glycyrrhizae (Gan Cao), Fructus Gardeniae (Shan Zhi), Radix Puerariae Lobatae (Ge Gen), Prepared Rhizoma Atractylodis Macrocephalae (Shu Cang Zhu), Rhizoma Coptidis (Chuan Lian), Fructus Aurantii (Zhi Ke).
Add Mutong and Huashi for red urine. Add Dahuang and Mang Xiao for constipation. Add Amomi Fructus Rotundus (Sharen) and Cardamomi Albi Fructus (Baikou Ren) for chest fullness. [Text fragment regarding yellow eyes and gallbladder color omitted as incomplete].

Baohe Wan (Preserve Harmony Pill)
Ingredients: Fructus Crataegi (Shanzha), Massa Medicata Fermentata (Shenqu), Rhizoma Pinelliae Preparatum (Banxia), Polyporus (Baifuling), Semen Raphani (Laifuzi), Pericarpium Citri Reticulatae (Chen Pi), Flos Forsythiae (Lianqiao).
Add Rhizoma Coptidis (Chuanlian) for severe accumulated heat. Add Zhi Ke and Nong Po for chest fullness.

Qingwei Tang (Clear Stomach Decoction)
Ingredients: Rhizoma Cimicifugae (Shengma), Fructus Gardeniae (Shanzhi), Radix Glycyrrhizae (Gancao), Cortex Moutan (Danpi), Rhizoma Coptidis (Chuanhuanglian).

Longdan Xiegan Tang (Gentian Decoction to Drain the Liver)
Ingredients: Radix Bupleuri (Chaihu), Radix Scutellariae (Huangqin), Fructus Gardeniae (Shanzhi), Rhizoma Anemarrhenae (Zhimu), Radix Asparagi (Tian Dong), Radix Ophiopogonis (Maidong), Herba Gentianae (Dancao), Radix Ginseng (Renshen), Radix Glycyrrhizae (Gancao), Rhizoma Coptidis (Chuanhuanglian).