周汉卿治永康人腹疾，伛偻行，卿解衣视之，气冲起腹间者二，其大如臂，刺其一砉然鸣，又刺其一亦如
之，加以按摩疾遂愈。（《明史》。）
薛立斋治一妇人，小腹胀满，小水不利，或胸乳作痛，或胁肋作胀，或气逆心吻。薛以为肝火而血滞伤脾，
用四物、柴胡、青皮、延胡索、木香而愈。
一妇人久患腹痛，去瘀血方止，已而腹大痛，诸药不纳。薛以脾胃之气虚寒，用参、术、炮姜，丸如黍，
每日数粒，津咽下，后以二味浓煎，渐呷而愈。
通府赵孟威云∶其妹小腹痛，服附子理中汤，附子服过八十余粒。此乃沉寒痼冷之甚，不多有者。又壬午
仲冬，金台一男子患腹痛，误服干姜理中丸，实时口鼻出血，烦躁发狂，入井而死。（二条俱见薛公案。）
龚子才治一妇人，脐腹疼痛，不省人事，只一剂立止。人不知者，云是心气痛，误矣。方用白芍药、五灵
脂、木通去皮，三味等分，每服五钱，水醋各半，煎至七分，去渣温服。（此瘕痛也。）
李北川仲夏患腹痛吐泻，两手足扪之则热，按之则冷。（外假热，内真寒之证。）其脉轻诊则浮大，重诊则
微细。（外假热，内真寒之脉。）此阴寒之证也，急服附子理中汤，不应，仍服至四剂而愈。
汪石山治大坑方细形瘦，年三十余，忽病腹痛，磊块起落如波浪然，昼轻夜重。（病在血分可知。）医用木香磨服，
及服六君子汤，皆不验。诊其脉浮缓弦小，重按似涩，曰∶此血病也，前药作气治谬矣。彼谓血则有形，发时
有块磊痛，减则消而无迹，非气而何？（此难亦不可少。）盖不知有形者，血积也，无形者，血滞也。滞视积略轻耳，
安得作气论邪？若然，则前药胡为不验？遂用四物汤加三棱、蓬术、乳香、没药，服之其痛遂脱然。（《本传》。）
孙文垣治严印老长媳患腹痛，有小块累累然，腹觉冷甚，两寸关皆滑数，两尺沉微。此脾气弱而饮食不消，
又当秋令湿淫之候，不利亦泻，宜预防之。与白术、苍术、茯苓、甘草、白蔻仁、木香、半夏、陈皮、泽泻煎
服，其夜果泻一度，次早又泻一度，小腹仍痛且里急后重。盖其禀赋素虚，当补中兼消兼利。白芍药三钱，桂
心一钱，甘草、人参、茯苓、泽泻、陈皮、白术各八分，升麻、葛根各六分，服后脉皆软弱不滑，累块亦消。
改以人参、黄 、白芍各二钱，炙甘草、陈皮、泽泻、葛根、柴胡、茯苓各一钱，调理而安。
张道南内人以饮食忤于气，因腹痛，不饮食五日矣，两寸关弦尺滑。孙曰∶此上焦气虚，下有郁滞。以姜
黄、青皮为君，山楂、槟榔、当归、杏仁、乌药、枳壳为臣，柴胡、木香为佐，吴萸为使，（此症气虚轻而郁滞重，
故治法如此。否则，未通其郁，先伤其气。可，若何即调理善后之方，亦仍以通郁滞为重。不然，用小建中汤何
尝有此等加减法耶？）服后，气稍顺。然后用葱二斤，煎汤浴洗腰腹，即将熟葱擦摩，使气通透。（郁滞外治法。）
洗毕即安卧少顷，其夜大便通，先下皆黑硬结块，后皆清水。此积滞行而正气虚也，以建中汤加山楂、茯苓、泽泻、
柴胡、香附、姜连，调理而痊。
李士材治一妇人，郁怒之余，胸腹胀痛，先服消痰顺气化食之剂不效，更以人参补之亦不效。诊之，六脉
弦而数。此内有郁热，为寒凉饮食壅之而痛，用黄连三钱，栀子一钱五分，橘红、白豆蔻各二钱，钩藤、木香
各八分，官桂二钱，加姜汁半钟，三剂痛止，四剂复加干姜、人参而霍然。
焦太史当脐切痛，作食气疗之无效。李诊之曰∶当脐者，少阴肾之部位也。况脉沉而弱，与气食何干？非
徒无益，反害真元。以八味丸料煎饮，不十日而痊。
胡京卿少腹作痛，连于两胁，服疏肝之剂，一月以来，日甚一日。李诊之，左关尺俱沉迟，治以理中汤加吴茱萸。
柴屿青治广抚讳苏昌，将赴沈阳京兆任时，伊芳嫂腹疼吐酸，日夜转侧呼号。已治木，求一诊以决之。其
脉微紧，受寒所致，并非危症，何用惊惶若此？苏云∶昨服药稍定。以方就政，并属定方。柴见前方系附子
理中汤，颇合是症，遂不另立。
王海藏治姬提领，因疾服凉剂，数日遂病脐腹下大痛，几至于死，与姜、附等剂虽稍苏，痛不已。随于本
方内倍白芍，服之愈。（《纲目》。）
陆肖愚治尤少溪，年近六十，性急多怒，因食冷粽四枚，遂患腹痛，并胁亦痛。医用平胃散加枳实、黄连
不效。彼亦知其家润字丸方，以五钱分三服，令一日内服之，大便已泻，而痛乃未止。谓通则不痛，今通而仍
痛，药力浅而积未尽也。再以五钱，令一日服之，大便数十行皆清水，而痛反增剧，号叫不已，饮食不进，面
色青紫，势危极。陆脉之，弦细沉弱，右关弦而有力，曰∶虚中有实，消则元气即脱，补则腹痛尚剧。因用理
中汤料五钱，配枳实五钱，一日二剂，始下坚积缶许，是夜痛大减。明日减枳实之半，又二剂而腹痛全愈。第
胁间尚微痛，去枳实加青皮、吴茱萸，数剂而痊。后以调气养荣汤理之。
张三锡治一人，腹痛而泻，口干，面时赤，乃食积也，与木香槟榔丸，一服去硬物愈。
一酒客每日腹痛泻黄沫，知积热也，投芩、连、浓朴、炒栀子、木通、泽泻、赤苓，二剂少可。复以酒蒸
大黄为丸，酒下二钱，凡三服，遂不发。
一妇人小腹块痛，医作阴治，投热剂不应。又有作燥矢治者，硝黄润肠丸等药，屡用不减。询之，七日前
作寒起遂腹痛。左三部皆弦小无力，右寸关俱弦滑，必起于外感内伤。挟气下早，故食滞不下，每疼则下黄水，
止作无时。下伤气液，故作渴。遂以炒白芍药、茯苓保脾，木香、青皮疏气，炒山楂清块中之火，当归润燥，
陈皮、甘草和中。小水不利，加泽泻、升麻、车前，二剂黄水虽少，痛块不减。用葱豉熨法，复投二剂，二便
大去而安。
陈良甫治家提干内人，病心腹胀痛，众投木香、槟榔、大腹、白芍、姜、桂之类，病益甚。诊之，六脉弦
紧而和，不似病脉，但诊之两手如火，以此知其热也。众问治法。曰∶大凡心腹刺痛，不可便作虚冷治之。或
曰∶非冷而何？热即生风，冷即生气是也。曰∶不然，《难经》云虚则痒，实则痛。又仲景曰∶腹痛者，桂枝
加芍药汤；痛甚者，桂枝加大黄汤。家云∶荆布素来质弱。曰∶有可辨处，遇痛时使一婢按之，若痛止是虚寒
症也。若按之转甚，手不可近，叫唤异常，日此实热无可疑者，当用大柴胡汤治之。众皆不许，乃与责状而投
之，八服愈。（《良方》。）
朱丹溪治一妇，上腹大痛，连及两肋，以香附末汤调而安。
罗谦甫治副使覃郎中，年四十九岁，至正丙寅春病脐腹冷痛，完谷不化，足 寒而逆，皮肤不仁，精神困
弱。诊其脉沉细而微，遂投以大热甘辛之剂，及灸气海百壮，三里二穴各三七壮，阳辅各二七壮。三日后，以
葱熨灸，疮皆不发。复灸前穴，根据前壮数，亦不发。十日后，疮亦更不作脓，疮口皆干。癸丑岁，予随朝承应，
冬屯于卓多地面，学针于窦子声先生。因论穴，窦曰∶凡用针者，气不至而不效，灸之亦不发。大抵本气空虚，
不能作脓，失其所养故也。（雄按∶此是名言，更加不慎，邪气加之，病必不退。）异日因语针科呼教授，亦以
为然。戊辰春，副使除益州府判，到任未几，时患风疾，半身麻木，自汗恶风，妄喜笑，又多健忘，语言微涩，
医以续命汤复发其汗，津液重渴，其症愈甚。因求医，还家日久，神气昏愦，形容羸瘦，饮食无味，便溺遗矢，
扶而后起。屡易医药，皆不能效。因思《内经》云∶阳气者，若天与日，失其所则折寿而不彰。今因此病，而知
子声先生之言矣。或曰∶副使肥甘足于口，轻暖足于体，使令足于前，所言无不如意，君言失其所养何也？予曰∶
汝言所以养之，正所以害之。务快于心，精神耗散，血气空虚，因致此疾。《灵枢》云∶人年十岁，五脏始定，
血气始通，其气在下，故好走；二十岁，血气始盛，肌肉方长，故好趋；三十岁，五脏大定，肌肉坚，血气盛
满，故好步；四十岁，五脏六腑、十二经脉，皆大盛以平定，腠理始疏，华容颓落，发颇斑白，平盛不摇，
故好坐；五十岁，肝气始衰，肝叶始薄，胆汁始减，目始不明；六十岁，心气始衰，苦忧悲，血气懈惰，故
好卧；七十岁，脾气始衰，皮肤已枯，八十岁，肺气衰，魂魄散离，故言善误；九十岁，肾气焦，脏枯经脉空
虚；百岁，五脏俱虚，神气皆去，形骸独居而终矣。盖精神有限，嗜欲无穷，轻丧性命，一失难复，其覃氏之谓欤。
朱丹溪治一人，痛当脐，绵绵不已，脉弦伏无力，因作挟阴治，理中加肉桂八分，附子三分，煎冷服，随愈。
薛立斋治罗给事，小腹急痛，大便欲去不去。此脾肾气虚而下陷也，用补中益气送八味丸，二剂而愈。此
等症候，因利药致损元气，肢体肿胀而死者，不可枚举。
副郎李孟卿，常患腹痛，每治以补中益汤加山栀即愈。一日，因怒腹痛，脉弦紧，以前汤吞左金丸二十粒而愈。
一妇人心腹痛，诸药不应，用炒黑山栀、桔梗治之而愈。
傅青主治，一妇，妒恶夫有所昵，忽患腹痛，辗转地上不可忍。其夫求治，先生令持敝瓦釜置妇床前，捣千
杵，服之立止。此移易性情之法，不问药饵。张子和之后，此术不传久矣。（刘绍文《九畴古文》。）
一妇人少腹痛，百药不效。一医用杉木节、童便煎服，下血而愈。（《医学纲目》。）
汪 庵尝病腹中啾唧，经两月，有友人见招，饮以芦稷烧酒，一醉而积 畅然。（芦稷最能和中，煎汤温服，
治霍乱如神。）
《华佗传》有人病腹中半切痛，十余日中，须眉堕落。佗曰∶是脾半腐，可刳腹养活也。使饮药令卧，（或即
麻沸散也。）破腹就视，脾果半腐坏。以刀断之，刮去恶肉，以膏敷之，饮之以药，百日平复。（雄按∶此事果实，
法亦不传，似可不选。）
赵从先治保义郎顿公，苦冷疾，时方盛暑，俾就屋开三天窗，于日光下射处，使顿仰卧，操艾遍铺腹上，
约数斤，移时日光透脐腹不可忍，俄而腹中雷鸣下泻，口鼻间皆浓艾气乃止。明日复为之，如是一月，疾良已。
乃令满百二十日，宿 如洗，壮健如少年时。赵曰∶此孙真人秘诀也。世人但知灼艾，而不知点穴，又不审虚
实，徒受痛楚，损耗气力。日者太阳真火，艾既遍腹，徐徐照射，入腹之功极大，五六七月最佳。若秋冬间当
以浓艾铺腹，蒙以棉衣，以熨斗盛炭火慢熨之，以闻浓艾气为度，亦其次也。
缪仲淳治高存之长郎患腹痛。问曰∶按之痛更甚否？曰∶按之则痛缓。曰∶此虚症也。即以人参等药饮之，
数剂不愈，但药入口则痛止。其痛每以卯时发，得药即安。至午痛复发，又进再煎而安。近晚再发，又进三剂
而安睡，则不复发矣。如是者月余，存之疑之，更他医药则痛愈甚，药入痛不止矣。以是服缪方不疑，一年后
渐愈，服药六百剂全瘳。（雄按∶治法已善，而六百剂始瘳者，方未尽善也。）人参三钱，白芍三钱，甘草一钱，
麦冬三钱，当归二钱，橘红一钱五分，木瓜一钱。又重定方加萸肉二钱，黄柏一钱五分，鳖甲二钱，枸杞三钱。
又以饮食少，时恶心，去当归、黄柏，加牛膝三钱，秦艽一钱五分，枣仁三钱，石斛二钱，延胡索一钱。（《广笔记》。）
包海亭夫人患腹痛连少腹，上连心，日夜靡间，百药不效。诊其脉两寸关俱伏，独两尺实大，按之愈甚。
询知其起于暴怒，风木郁于地中。投以芎 （上）、柴胡（中）、升麻（下），下咽嗳气数十声，痛立已，
已而作喘。曰∶是升之大骤也。以四磨汤与之遂平。（同上。）
蒋仲芳治吴氏母，年六十余，患腹痛，日泻四五行，已三四年，遍治不效。诊之，两尺沉紧，曰∶内有沉
积也。用熟大黄三钱，入本病药中，煎服一帖而痛如失。（沈抄本。）
示吉曰∶毛方来忽患真寒症，腹痛自汗，四肢厥冷，诸医束手，予用回阳汤急救而痊。吴石虹曰∶症暂愈，
后必下脓血则危矣。数日后，果下痢如鱼脑，全无臭气，投参、附不应。忽思三物桃花汤，仲景法也，为丸与
之，三四服愈。（沈效兄抄本。）
徐灵胎曰∶腹痛久者，必有积滞，必用消积丸药，以渐除之。但用煎方，不足以愈久病也。
Zhou Hanqing treated a patient from Yongkang suffering from abdominal disease. The patient walked with a stooped back. Zhou Hanqing undressed the patient to examine him and observed two instances of Qi rushing up in the abdomen, with swellings as large as an arm. He needled one swelling, which made a "hua" sound; he then needled the other swelling in the same manner. Following this, he applied massage, and the disease was immediately cured. (From *History of Ming*)
Xue Lizhai treated a woman with distension and fullness in the lower abdomen, difficulty in urination, occasional pain in the chest and breasts, distension in the hypochondrium, and rebellious Qi causing pain in the heart region. Xue diagnosed it as Liver Fire causing Blood stasis and damaging the Spleen. He used Si Wu Tang (Four Substances Decoction), Chai Hu (Bupleuri Radix), Qing Pi (Aurantii Fructus Immaturus), Yan Hu Suo (Corydalis Rhizoma), and Mu Xiang (Aucklandiae Radix), resulting in a cure.
Another woman had suffered from abdominal pain for a long time. The pain ceased only after taking a formula to expel Blood stasis. Shortly thereafter, she experienced severe abdominal pain, and all medicines were rejected by her stomach. Xue Lizhai determined that the Qi of the Spleen and Stomach was deficient and cold. He used Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Pao Jiang (Prepared Zingiberis Rhizoma), formed into pills the size of millet seeds. She swallowed a few pills daily with saliva. Later, she took a strong decoction of these two herbs and slowly sipped it until she recovered.
Zhao Mengwei, Commissioner of Communications, stated: His younger sister suffered from lower abdominal pain and took Fu Zi Li Zhong Tang (Aconite Root and Magnolia Bark Decoction to Regulate the Middle), consuming over eighty Fu Zi (Aconiti Lateralis Radix Praeparata) pills. This was a case of extreme deep cold and entrenched chill, which is rare. Additionally, in the mid-winter of the Renwu year, a man in Jintai suffered from abdominal pain and mistakenly took Gan Jiang Li Zhong Wan (Dried Ginger Pill to Regulate the Middle). Immediately, he bled from his mouth and nose, became irritable and mad, and jumped into a well to his death. (Both cases are found in Master Xue's medical records.)
Gong Zicai treated a woman with pain around the umbilicus and abdomen, who lost consciousness. One dose of medicine stopped the pain immediately. Those unaware of the condition called it Heart Qi Pain, which was incorrect. The prescription consisted of Bai Shao Yao (Paeoniae Radix Alba), Wu Ling Zhi (Trogopteri Dung), and Mu Tong (Akebiae Caulis) with the skin removed, in equal parts. Each dose was five qian, decocted in half water and half vinegar until reduced to seven-tenths, strained, and taken warm. (This was pain caused by a mass/jia.)
Li Beichuan suffered from abdominal pain with vomiting and diarrhea in mid-summer. His hands felt hot to the touch but cold upon pressure. (This is a syndrome of external false heat and internal true cold.) His pulse was floating and large when lightly palpated, but faint and fine when heavily pressed. (This is the pulse of external false heat and internal true cold.) This is a Yin-Cold syndrome. He urgently took Fu Zi Li Zhong Tang, but there was no response. He continued taking it until the fourth dose, after which he recovered.
Wang Shishan treated Fang Xi from Dakeng, who was thin and frail, in his thirties. He suddenly developed abdominal pain with hard masses rising and falling like waves, lighter during the day and heavier at night. (It can be known that the disease is in the Blood level.) Doctors used ground Mu Xiang (Aucklandiae Radix) and Liu Jun Zi Tang (Six Gentlemen Decoction), neither of which worked. His pulse was floating, slow, wiry, and small, and seemed choppy upon heavy pressure. Wang said: This is a Blood disease. The previous medications treated it as a Qi disorder, which was wrong. The patient argued that since Blood is substantial, and masses appear with pain during attacks and disappear without a trace when subsiding, how could it not be a Qi issue? (This doubt is also necessary to address.) However, they did not know that substantial forms indicate Blood accumulation (Ji), while insubstantial forms indicate Blood stagnation (Zhi). Stagnation is slightly milder than accumulation. How can it be discussed as a Qi disorder? If so, why did the previous medicines fail? Thus, he used Si Wu Tang (Four Substances Decoction) added with San Leng (Curcumae Rhizoma), Peng Ze (Curcumae Longae Rhizoma), Ru Xiang (Olibanum), and Mo Yao (Myrrha). After taking it, the pain was completely relieved. (From *Biography*)
Sun Wenyuan treated the eldest daughter-in-law of Yan Yinlao, who suffered from abdominal pain with small, clustered masses, feeling very cold in the abdomen. Both Cun and Guan pulses on both sides were slippery and rapid, while both Chi pulses were deep and faint. This indicated weak Spleen Qi leading to indigestion. It was also the season of autumn dampness, where lack of bowel movement or diarrhea should be prevented. He prescribed Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cang Zhu (Atractylodis Rhizoma), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Kou Ren (Amomi Fructus Rotundus), Mu Xiang (Aucklandiae Radix), Ban Xia (Pinelliae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), and Ze Xie (Alismatis Rhizoma) decocted and taken orally. That night, she had one bowel movement, and another the next morning. However, lower abdominal pain persisted with tenesmus. Given her constitution was inherently deficient, treatment should combine tonification with resolution and draining. He used Bai Shao Yao (Paeoniae Radix Alba) 3 qian, Gui Xin (Cinnamomi Cortex) 1 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), and Bai Zhu (Atractylodis Macrocephalae Rhizoma) each 8 fen, Sheng Ma (Cimicifugae Rhizoma) and Ge Gen (Puerariae Lobatae Radix) each 6 fen. After taking this, the pulses became weak and non-slippery, and the masses disappeared. The prescription was changed to Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), and Bai Shao Yao (Paeoniae Radix Alba) each 2 qian, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Ze Xie (Alismatis Rhizoma), Ge Gen (Puerariae Lobatae Radix), Chai Hu (Bupleuri Radix), and Fu Ling (Poria) each 1 qian. She was regulated and stabilized.
The wife of Zhang Daonan suffered from abdominal pain due to food clashing with Qi, unable to eat for five days. Her Cun and Guan pulses were wiry, and her Chi pulse was slippery. Sun said: This is deficiency of Qi in the Upper Jiao and stagnation below. He used Jiang Huang (Curcumae Longae Rhizoma) and Qing Pi (Aurantii Frizctus Immaturus) as Sovereign herbs, Shan Zha (Crataegi Fructus), Bing Lang (Arecae Semen), Dang Gui (Angelicae Sinensis Radix), Xing Ren (Armeniacae Semen Amarum), Wu Yao (Linderae Radix), and Zhi Ke (Aurantii Fructus) as Minister herbs, Chai Hu (Bupleuri Radix) and Mu Xiang (Aucklandiae Radix) as Assistant herbs, and Wu Yu (Evodiae Fructus) as Guide herb. (In this case, Qi deficiency was mild while stagnation was severe, hence this treatment method. Otherwise, unblocking stagnation before protecting Qi would harm the Qi. As for post-treatment regulation, the focus remains on unblocking stagnation. Otherwise, why would Xiao Jian Zhong Tang have such modifications?) After taking it, Qi smoothed slightly. Then, he used two jin of scallions, decocted the soup to bathe the waist and abdomen, and rubbed the area with cooked scallions to make the Qi penetrate. (External treatment for stagnation.) After bathing, she lay down quietly for a moment. That night, her bowels moved, first passing black, hard, clotted matter, followed by clear water. This indicated the expulsion of accumulated stagnation and deficiency of righteous Qi. He used Jian Zhong Tang (Minor Construct the Middle Decoction) added with Shan Zha (Crataegi Fructus), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Chai Hu (Bupleuri Radix), Xiang Fu (Cyperī Rhizoma), and Jiang Lian (Ginger-processed Coptidis Rhizoma) to regulate and cure her.
Li Shicai treated a woman who, after depression and anger, suffered from chest and abdominal distension and pain. First, she took medicines to resolve phlegm, smooth Qi, and digest food, which failed. Then, she took Ren Shen (Ginseng Radix) for tonification, which also failed. Palpation revealed wiry and rapid pulses in all six positions. This indicated internal stagnant heat obstructed by cold-dietary intake. He used Huang Lian (Coptidis Rhizoma) 3 qian, Zhi Zi (Gardeniae Fructus) 1.5 qian, Ju Hong (Citri Reticulatae Pericarpium) and Bai Dou Kou (Amomi Fructus Rotundus) each 2 qian, Gou Teng (Uncariae Ramulus cum Uncis) and Mu Xiang (Aucklandiae Radix) each 8 fen, Guan Gui (Cinnamomi Cortex) 2 qian, plus half a zhong of fresh ginger juice. After three doses, the pain stopped. On the fourth dose, Gan Jiang (Zingiberis Rhizoma) and Ren Shen (Ginseng Radix) were added, leading to a complete recovery.
Grand Historian Jiao suffered from cutting pain at the umbilicus, treated as food-Qi disorder without effect. Li Shicai palpated and said: The umbilical region corresponds to the Shaoyin Kidney channel. Moreover, the pulse is deep and weak; what does this have to do with Qi or food? Not only is it ineffective, but it also harms the True Yuan. He used Ba Wei Wan (Eight-Ingredient Pill) material decocted and drunk. Within ten days, he recovered.
Imperial Censor Hu suffered from lower abdominal pain radiating to both hypochondria. He took Liver-soothing medicines for a month, worsening daily. Li Shicai palpated and found both Left Guan and Chi pulses deep and slow. He treated with Li Zhong Tang (Regulate the Middle Decoction) added with Wu Zhu Yu (Evodiae Fructus).
Chai Yuqing treated Governor-General Su Chang, who was about to take office in Shenyang Jingzhao. His sister-in-law suffered from abdominal pain and acid regurgitation, turning side to side and crying out day and night. Treatment had begun, and he sought a diagnosis for decision-making. Her pulse was faint and tight, caused by Cold invasion, not a critical condition, yet she was extremely panicked. Su said: I took medicine yesterday and felt slightly better. He reviewed the previous prescription and asked for a final order. Chai saw that the previous prescription was Fu Zi Li Zhong Tang (Aconite Root and Magnolia Bark Decoction to Regulate the Middle), which fit the symptoms well, so he did not create a new one.
Wang Haizang treated Commander Ji, who, due to illness, took cooling agents. Several days later, he suffered severe pain in the lower abdomen and umbilicus, nearly dying. Although given Ginger and Aconite agents, he slightly revived but pain persisted. Wang doubled the amount of Bai Shao Yao (Paeoniae Radix Alba) in the original formula. After taking it, he recovered. (From *Bencao Gangmu*)
Lu Xiaoyu treated You Shaoxi, nearly sixty years old, impatient and prone to anger. After eating four cold zongzi (sticky rice dumplings), he developed abdominal pain extending to the hypochondrium. Doctors used Ping Wei San (Peace the Stomach Powder) added with Zhi Shi (Aurantii Fructus) and Huang Lian (Coptidis Rhizoma) without effect. He knew of the family's Run Zi Wan (Moistening Pill) formula, took five qian divided into three doses within one day. Bowels moved, but pain persisted. Lu said: "If unblocked, there is no pain." Now, although unblocked, pain remains; the medicinal force is shallow, and the accumulation is not fully cleared. He took another five qian in one day. Bowels moved dozens of times with clear water, but pain intensified, with incessant crying, loss of appetite, cyanotic face, and critical condition. Lu palpated the pulse: wiry, fine, deep, and weak; Right Guan was wiry and forceful. He said: Deficiency with excess. Resolving will cause Yuan Qi collapse; tonifying will worsen pain. Therefore, he used Li Zhong Tang (Regulate the Middle Decoction) material 5 qian combined with Zhi Shi (Aurantii Fructus) 5 qian, two doses per day. Only then did he pass hard accumulation about the volume of a jar. That night, pain greatly decreased. The next day, Zhi Shi was halved, and after two more doses, abdominal pain completely resolved. There was still slight pain in the hypochondrium, so Zhi Shi was removed, and Qing Pi (Aurantii Fructus Immaturus) and Wu Zhu Yu (Evodiae Fructus) were added. After several doses, he recovered. Later, Tiao Qi Yang Rong Tang (Regulate Qi and Nourish Blood Decoction) was used for regulation.
Zhang Sanxi treated a man with abdominal pain and diarrhea, dry mouth, and intermittent facial redness, diagnosing it as Food Accumulation. He gave Mu Xiang Bing Lang Wan (Aucklandia and Areca Pill). One dose expelled hard matter, and he recovered.
A wine drinker suffered daily abdominal pain and yellow frothy diarrhea, indicating accumulated heat. He was given Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Chao Zhi Zi (Fried Gardeniae Fructus), Mu Tong (Akebiae Caulis), Ze Xie (Alismatis Rhizoma), and Chi Fu Ling (Red Poria). After two doses, he improved slightly. Then, Da Huang (Rhei Radix et Rhizoma) steamed with wine was made into pills, taken with wine, two qian per dose, three times total, preventing recurrence.
A woman had painful masses in the lower abdomen. Doctors treated it as a Yin syndrome with heating agents without effect. Others treated it as dry stool with Xiao Huang Run Chang Wan (Minor Cathartic Moistening Intestine Pill), repeatedly without reduction. Inquiry revealed abdominal pain started seven days ago due to Cold. Left three positions were wiry, small, and powerless; Right Cun and Guan were wiry and slippery. It must stem from external contraction and internal injury, complicated by premature downward movement of Qi, causing food stagnation. Each pain episode resulted in yellow water discharge, stopping unpredictably. Lower injury to Qi and fluids caused thirst. He used Chao Bai Shao Yao (Fried Paeoniae Radix Alba) and Fu Ling (Poria) to protect the Spleen, Mu Xiang (Aucklandiae Radix) and Qing Pi (Aurantii Fructus Immaturus) to soothe Qi, Chao Shan Zha (Fried Crataegi Fructus) to clear fire in the mass, Dang Gui (Angelicae Sinensis Radix) to moisten dryness, Chen Pi (Citri Reticulatae Pericarpium) and Gan Cao (Glycyrrhizae Radix et Rhizoma) to harmonize the middle. For difficult urination, Ze Xie (Alismatis Rhizoma), Sheng Ma (Cimicifugae Rhizoma), and Che Qian Zi (Plantaginis Semen) were added. After two doses, yellow water decreased, but the painful mass remained. A Cong Chi Ironing Method (Scallion and Fermented Soybean Ironing) was used, followed by two more doses. With significant improvement in urination and defecation, she was safe.
Chen Liangfu treated the wife of Family Ti Gan, suffering from heart and abdominal distension and pain. Everyone administered Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Da Fu Pi (Arecae Pericarpium), Bai Shao Yao (Paeoniae Radix Alba), Ginger, and Cinnamon. The condition worsened. Palpation revealed wiry, tight, and harmonious pulses in all six positions, unlike typical pathological pulses, but both hands felt like fire, indicating Heat. When asked for treatment, he said: Generally, stabbing pain in the heart and abdomen should not be immediately treated as deficiency-cold. Someone asked: If not cold, what is it? Heat generates Wind, Cold generates Qi. He replied: Incorrect. *Nan Jing* states: Deficiency causes itching, Excess causes pain. Also, Zhang Zhongjing said: For abdominal pain, use Gui Zhi Jia Shao Yao Tang (Cinnamon Twig Decoction Added with Peony); for severe pain, use Gui Zhi Jia Da Huang Tang (Cinnamon Twig Decoction Added with Rhubarb). I say: Jing Bu has always been physically weak. He added: There is a way to distinguish. When pain occurs, have a maid press the area. If pain stops, it is deficiency-cold. If pressing increases pain, making the hand unbearable and causing abnormal screaming, it is undoubtedly Excess-Heat. Use Da Chai Hu Tang (Major Bupleurum Decoction). Everyone disagreed, so he had them sign a waiver before administering the medicine. After eight doses, she recovered. (From *Liang Fang*)
Zhu Danxi treated a woman with severe upper abdominal pain radiating to both ribs. She was calmed by taking Xiang Fu (Cyperī Rhizoma) powder mixed with water.
Luo Qianfu treated Vice Commissioner Tan Langzhong, aged forty-nine. In the spring of Bingyin year, he suffered from cold pain in the umbilical and abdominal region, undigested food in stool, cold and inverted feet, numb skin, and mental fatigue. Palpation revealed deep, fine, and faint pulses. He administered large-hot, sweet, and acrid agents and moxa-ed Qi Hai (CV6) 100 cones, Zu San Li (ST36) 21 cones on each side, and Yang Fu (GB38) 14 cones on each side. Three days later, he used Scallion Moxibustion; the sores did not develop. Re-moxa-ing the previous acupoints according to the previous cone counts also did not develop sores. Ten days later, the sores did not suppurate and dried up. In the Gui Chou year, I attended the court in winter at Zhuoduo. I learned acupuncture from Master Dou Zisheng. Discussing acupoints, Dou said: In acupuncture, if Qi does not arrive, there is no effect; moxibustion will not develop sores either. Generally, if Original Qi is empty, it cannot generate pus because it lacks nourishment. (Xu Zhongke notes: This is a profound statement. If not careful, pathogenic factors will invade, and the disease will not recede.) Another day, discussing with Professor Hu of the Acupuncture Department, he agreed. In the spring of Wuchen year, the Vice Commissioner was appointed Judge of Yizhou Prefecture. Shortly after taking office, he frequently suffered from Wind disease: hemiparesthesia, spontaneous sweating, aversion to wind, manic laughter, forgetfulness, and slurred speech. Doctors used Xu Ming Tang (Life-Sustaining Decoction) to induce sweating again, severely depleting body fluids and increasing thirst, worsening symptoms. Seeking medical help, he returned home long ago, with confused spirit, emaciated appearance, loss of taste, incontinence, and needing support to stand. Many medicines failed. He recalled *Nei Jing*: "Yang Qi is like the sky and the sun; if it loses its function, lifespan is shortened and brilliance is obscured." Because of this illness, I understood Master Zisheng's words. Someone said: The Vice Commissioner has ample rich food, warm clothing, and servants, getting everything he wants. Why do you say he lacks nourishment? I said: What you call nourishment is actually harming him. Pursuing immediate gratification dissipates Spirit, empties Blood and Qi, leading to this disease. *Ling Shu* states: At age ten, Five Viscera begin to stabilize, Blood and Qi begin to flow, Qi is in the lower part, so he likes to run; at twenty, Blood and Qi flourish, muscles grow, so he likes to walk briskly; at thirty, Five Viscera are firmly established, muscles are firm, Blood and Qi are full, so he likes to walk steadily; at forty, Five Viscera, Six Bowels, and Twelve Channels are in great prosperity and stable, pores become loose, complexion declines, hair grays, stability is reached, so he likes to sit; at fifty, Liver Qi begins to decline, Liver lobes thin, bile decreases, vision dims; at sixty, Heart Qi begins to decline, sorrow and grief increase, Blood and Qi slacken, so he likes to lie down; at seventy, Spleen Qi begins to decline, skin withers; at eighty, Lung Qi declines, Soul and Ethereal Soul scatter, so speech is error-prone; at ninety, Kidney Qi dries up, viscera wither, channels empty; at one hundred, Five Viscera are all deficient, Spirit departs, only the corpse remains. Spirit is limited, desires are infinite. Lightly losing life is hard to recover. This describes Mr. Tan.
Zhu Danxi treated a man with continuous pain at the umbilicus, pulse wiry, hidden, and powerless. He treated it as "Clasping Yin," using Li Zhong Tang (Regulate the Middle Decoction) added with Rou Gui (Cinnamomi Cortex) 8 fen and Fu Zi (Aconiti Lateralis Radix Praeparata) 3 fen, taken cold. He recovered immediately.
Xue Lizhai treated Luo Jishi with urgent lower abdominal pain and incomplete defecation. This was deficiency of Spleen and Kidney Qi with sinking. He used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to deliver Ba Wei Wan (Eight-Ingredient Pill). After two doses, he recovered. Such syndromes, caused by purgatives damaging Yuan Qi, leading to limb swelling and death, are countless.
Vice Director Li Mengqing often suffered from abdominal pain, recovering each time with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shan Zhi Zi (Gardeniae Fructus). One day, due to anger, he had abdominal pain with a wiry and tight pulse. He took twenty Zuo Jin Wan (Left Metal Pills) with the previous decoction and recovered.
A woman suffered from heart and abdominal pain, unresponsive to various medicines. She was cured by Chao Hei Shan Zhi Zi (Charred Black Gardeniae Fructus) and Jie Geng (Platycodonis Radix).
Fu Qingzhu treated a woman who, jealous of her husband's affection for others, suddenly suffered from unbearable abdominal pain, rolling on the floor. Her husband sought treatment. The Master ordered a broken clay pot placed before her bed, pounded a thousand times, and consumed. The pain stopped immediately. This is a method of altering temperament, independent of herbal medicine. Since Zhang Zihe, this technique has been lost for a long time. (Liu Shaowen *Jiu Chou Gu Wen*)
A woman suffered from lower abdominal pain, unresponsive to hundreds of medicines. A doctor used Shan Mu Jie (Taxodium Segment) and Tong Bian (Child's Urine) decocted and taken. She passed blood and recovered. (From *Yi Xue Gang Mu*)
Wang Ang once suffered from gurgling in the abdomen for two months. A friend invited him and served Lu Ji Shao Jiu (Sorghum Spirits). After getting drunk, the accumulation cleared smoothly. (Lu Ji best harmonizes the middle; decocted and taken warm, it is miraculous for treating Huoluan.)
*Huotuo Zhuan* records a person suffering from half-cutting abdominal pain for over ten days, with eyebrows and beard falling out. Huo Tuo said: This is half-rotten spleen. It can be kept alive by opening the abdomen. He gave medicine to make him sleep (perhaps Ma Fei San), opened the abdomen, and indeed found half-rotten spleen. He cut it with a knife, scraped away foul flesh, applied ointment, and gave medicine. After one hundred days, he recovered. (Xu Zhongke notes: This event is factual, and the method is not lost, so it might not need selection.)
Zhao Congxian treated Bao Yi Lang Dun Gong, suffering from chronic cold disease. It was mid-summer. He had him open three skylights in the house, lie supine under direct sunlight, and cover his abdomen with several jin of mugwort. After a while, the sunlight penetrating the umbilicus and abdomen became unbearable. Soon, rumbling sounds occurred in the abdomen with diarrhea, and thick mugwort scent filled the mouth and nose before stopping. He repeated this the next day for a month, and the disease largely resolved. He instructed him to continue for 120 days. Old ailments were washed away, and he became robust as a youth. Zhao said: This is the secret of Sun Simiao. People only know burning moxibustion, not point-pointing, and do not assess deficiency/excess, suffering pain and depleting Qi. Recently, the True Fire of the Sun, with mugwort covering the abdomen and slowly irradiating, has great efficacy entering the abdomen. July, May, and June are best. In autumn and winter, spread thick mugwort on the abdomen, cover with cotton clothes, and slowly iron with charcoal-filled irons until the thick mugwort scent is detected. This is the secondary method.
Miao Zhongchun treated the eldest son of Gao Cunzhi for abdominal pain. He asked: Does pressing worsen the pain? Answer: Pressing relieves the pain. He said: This is a deficiency syndrome. He immediately gave Ren Shen (Ginseng Radix) and other herbs. After several doses, it did not cure, but pain stopped as soon as medicine entered the mouth. The pain occurred every Mao hour (5-7 AM), resolving with medicine. At Wu hour (11 AM-1 PM), pain recurred, resolving with the second decoction. In the evening, it recurred again, resolving with the third dose and allowing sleep, after which it did not recur. This lasted over a month. Cunzhi doubted him; changing medicines worsened pain, while Miao's medicine stopped it. Trusting Miao's prescription, he gradually recovered after one year, taking 600 doses for complete cure. (Xu Zhongke notes: The treatment method was good, but taking 600 doses suggests the formula was not optimal.) Ren Shen 3 qian, Bai Shao Yao 3 qian, Gan Cao 1 qian, Mai Dong 3 qian, Dang Gui 2 qian, Ju Hong 1.5 qian, Mu Gua 1 qian. Revised formula added Yu Rou 2 qian, Huang Bo 1.5 qian, Bie Jia 2 qian, Gou Qi 3 qian. Due to poor appetite and nausea, Dang Gui and Huang Bo were removed, adding Niu Xi 3 qian, Qin Jiao 1.5 qian, Zao Ren 3 qian, Shi Hu 2 qian, Yan Hu Suo 1 qian. (From *Guang Bi Ji*)
Lady Bao Haiting suffered from abdominal pain radiating to the lower abdomen and heart, day and night, unresponsive to hundreds of medicines. Palpation revealed both Cun and Guan pulses hidden, while Chi pulses were solid and large, worsening with pressure. Inquiry revealed onset after sudden anger, with Wind-Wood stagnating in the earth. He administered Xiong Qiong (Chuan Xiong Rhizoma), Chai Hu (Bupleuri Radix), and Sheng Ma (Cimicifugae Rhizoma). After swallowing, he belched dozens of times, and pain stopped immediately, followed by asthma. He said: This is too abrupt ascending. He gave Si Mo Tang (Four Knocks Decoction), which settled it. (Ibid.)
Jiang Zhongfang treated Mother Wu, over sixty, suffering from abdominal pain and diarrhea four to five times daily for three to four years, unresponsive to treatments. Palpation revealed deep and tight Chi pulses. He said: Internal accumulation. He used Shu Da Huang (Prepared Rhubarb) 3 qian added to the disease-specific medicine. One dose eliminated the pain. (Shen Copy)
Shi Ji said: Mao Fanglai suddenly suffered from True Cold syndrome: abdominal pain, spontaneous sweating, cold limbs. Doctors were helpless. I used Hui Yang Tang (Restore the Yang Decoction) for emergency rescue, and he recovered. Wu Shihong said: Symptoms temporarily resolved, but pus and blood in stool would follow, leading to danger. Days later, he indeed had dysentery like fish brain, odorless. Ren Shen and Fu Zi were ineffective. Suddenly recalling San Wu Tao Hua Tang (Three-Ingredient Peach Blossom Decoction), Zhang Zhongjing's method, made into pills. After three to four doses, he recovered. (Shen Xiaoxiong Copy)
Xu Lingtai said: Chronic abdominal pain must have accumulation. Must use Xiao Ji Wan (Resolve Accumulation Pills) to gradually remove it. Using decoctions alone is insufficient to cure chronic disease.