人有腹痛欲死，手按之而更甚，此乃火痛也。但火痛不同，有胃火，有脾火，有大小肠
火，有膀胱火，有肾火，不可不辨也。胃火者，必汗而渴，口中臭；脾火痛者，必走来走去
，无一定之处也；大肠火者，大便必闭结，而肛门必干燥后重；小肠火者，小便必闭涩如淋
；膀胱火者，小便闭涩而若急；肾火者，则强阳不倒，口不渴而面赤，水窍涩痛是也。既知
火症分明，然后因症以治之，自然不瘥。然而各立一方，未免过于纷纭。我有一方，可以共治有火之腹痛，方名
导火汤∶
玄参（一两） 生地（五钱） 车前子（三钱） 甘草（一钱） 泽泻（二钱）
水煎服。连服二剂而诸痛皆可愈也。
夫火之有余，水之不足也。玄参、生地滋其阴，而阳火自降，况又益之车前、泽泻之滑
利，甘草之调和，尤能导火解氛，化有事为无事。倘知为胃火而加石膏，知为脾火而加知母
，知为大肠火而加地榆，小肠火而加黄连，知为膀胱火而加滑石，知为肾火而加黄柏，尤效
之极也。
人有终日腹痛，手按之而宽快，饮冷则痛剧，此寒痛也。不必分别脏腑，皆命门火衰，
而寒邪留之也。盖命门为一身之主，命门寒而五脏七腑皆寒矣，故只宜温其命门之火为主。
然命门之火不可独补，必须治兼脾胃。火土相合，而变化出焉。然又不可止治其土，盖土之
仇者，肝木也，命门助土而肝木乘之，则脾胃之气，仍为肝制而不能发生，必须制肝，使木
不克土，而后以火生之，则脾胃之寒邪既去，而阳气升腾，浊阴销亡于乌有，土木无战克之
忧，而肠腹享安宁之乐矣。方用制
肝益火汤∶
白芍（三钱） 白术（五钱） 茯苓（三钱） 甘草（一钱） 肉桂（一钱） 肉豆蔻（一枚） 半夏（一钱） 人
参
水煎服。一剂而痛减半，再剂而痛尽除也。
方中虽六君子加减，无非助其脾胃之阳气。然加入白芍，则能平肝木之气矣。又有肉桂
以温命门之火，则火自生土，而肉豆蔻复自暖其脾胃，则寒邪不战而自走也。
此症亦可用消寒饮∶
白术 人参（各五钱） 肉桂 肉豆蔻 甘草（各一钱）
水煎服。一剂即止。
人有腹痛，得食则减，遇饥则甚，面黄体瘦，日加困顿者，此腹内生虫也（虫生于腹，
。夫虫之生也，必有其故，或因饥食难化之物
，渴饮寒冷之汤，以致久变为虫者有之。若阴阳之气旺，虫即生而亦随灭，安能久据于腹而
作巢窟哉。惟其阴阳之气衰，不能运化于一身，而虫乃生而不死矣。其初食物，后将饮血而
不可止，及至饮血而腹痛之病作。然则治法，乌可单杀虫，而不培其阴阳之气血乎。方用卫
生汤∶
人参（三钱） 白术（五钱） 白薇（一钱） 甘草（一钱） 榧子（十枚，切片） 槟榔（一钱） 使君子（十
个，
去壳） 干葛（一钱）
水煎服。一剂而腹转痛，二剂而腹痛除矣。
此服药后而腹痛者，拂虫之意，切戒饮茶水，一饮茶水，止可杀虫之半，而不能尽杀
之也。故禁食半日，则虫尽化为水，从大小便而出。方中用人参、白术为君，以升其阳气。
阳升而虫不能自安，必头向上而觅食，所佐者尽是杀虫之药，虫何能久存哉。倘一饮茶水，
则虫得水而反可死中求活矣，虽临时安贴，久则虫多而痛如故也。
此症用逐虫丹颇效。
白薇 茯苓（各三钱） 雷丸 甘草 槟榔（各一钱） 黄连（五分） 使君子（十个） 乌梅（一个）
水煎服。三剂全愈。
人有腹痛至急，两胁亦觉胀满，口苦作呕，吞酸欲泻，而又不可得，此乃气痛也。用寒
药治之不效，热药亦不效，用补药亦不效。盖肝木气郁，下克脾土，土畏木克，而阳气不敢
升腾，因之下行而无可舒泄，复转行于上而作呕，彼此牵掣而痛无已时也。治法必须疏肝气
之滞，而又升腾脾胃之阳气，则土不畏木之侵凌，而痛自止也。方用
逍遥散加减最妙。
柴胡（一钱） 白芍（五钱） 白术（一钱） 甘草（一钱） 茯苓（三钱） 陈皮（一钱） 当归（二钱） 神
曲（一钱）
水煎服。二剂而痛止矣。
盖逍遥散解郁，而此痛又须缓图，不必更用重剂，再服四剂而奏功全矣。
此症用苍白甘草汤亦妙。
苍术（五钱） 白芍（一两） 甘草（一钱）
水煎服。二剂愈。
人有多食生冷燔炙之物，或难化之品，存于腹内作痛，手按之而痛甚者，此食积于肠，
闭结而不得出，有燥屎之故也。法宜逐积化滞，非下之不可
。然而下多亡阴，不可不防。夫人能食者，阳旺也，能食而不能化
者，阴衰也。使阳旺之人，何物不能消化，焉有停住大肠
之理，必阴血不能润于大肠，阳火焚烁而作祟，遂致大肠熬干，留食结为燥屎而不下矣。及
至燥屎不下，则阴阳不通，变成腹痛之楚。治宜于滋阴之中，而佐以祛逐之味，则阴不伤而
食又下也。方宜用逐秽丹∶
当归尾（五钱） 大黄（三钱） 甘草（一钱） 枳实（一钱） 丹皮（三钱）
水煎服。一剂而燥屎下，腹痛顿除，不必用二剂也。
此方用大黄、枳实以逐秽，加入当归、丹皮以补血生阴，攻补兼施，复何患于亡阴哉。
此症用利腹汤亦甚效。
大黄（三钱） 当归（五钱） 枳壳 山楂 麦芽 浓朴 甘草（各一钱） 桃仁（十粒）
水煎服。一剂即通，腹亦不痛矣。
人有腹痛，从右手指冷起，渐上至头，如冷水浇灌，由上而下，而腹乃大痛，既而遍身
大热，热退则痛止，或食或不食，或过于食而皆痛也。初则一年一发，久则一月一发，发久
则旬日一发也。用四物汤加解郁之药不应，用四君子汤加消积之药又不应，用二陈汤加消痰
破气和中之药复不应，人以为有瘀血存焉，谁知是阳气大虚乎。盖四肢为诸阳之末，而头乃
诸阳之会，阳虚恶寒，阴虚恶热，阳虚而阴来乘之，则发寒，阴虚而阳往乘之，则发热。今
指冷而上至于头，明是阳不能敌阴，以失其健运而痛乃大作。痛作而热者，寒极变热也。及
其寒热两停，阴阳俱衰，两不相斗，故热止而痛亦止也。治法单补其阳，阳旺而阴自衰，况
阳旺则气自旺，气旺则血自生，气血两旺，而阴阳又何致争战而作痛哉。方用独参汤∶
人参（一两） 加陈皮（八分） 甘草（一钱）
水煎服。数剂而痛轻，十剂而痛止矣。
夫独参汤乃补气之药也。仲景夫子曰∶血虚气弱，以人参补之。故用之而止痛也。或曰
四君子汤亦补气之剂，何以用之而不效?盖四君子有白术、茯苓以分人参之权，不若独参汤
之功专而力大。况前此兼用消积破气之药，是为诛伐无过，用人参止可救失耳，何能成功哉
此症用阴阳和合汤亦效。
白术（五钱） 人参（二钱） 甘草（一钱） 柴胡（一钱） 白芍（五钱） 枳壳（五分）
水煎服。二剂全愈。
A person suffers from severe abdominal pain, as if dying, and pressing on the abdomen with the hand exacerbates the pain; this is Fire Pain. However, Fire Pain varies: there is Stomach Fire, Spleen Fire, Large Intestine Fire, Small Intestine Fire, Bladder Fire, and Kidney Fire, which must be distinguished. Stomach Fire abdominal pain is necessarily accompanied by sweating and thirst, and a foul odor in the mouth; Spleen Fire abdominal pain necessarily presents with wandering pain without a fixed location; Large Intestine Fire abdominal pain necessarily involves constipation and dryness with a sensation of heaviness at the anus; Small Intestine Fire abdominal pain necessarily involves dysuria resembling strangury; Bladder Fire abdominal pain involves dysuria with a sense of urgency; Kidney Fire abdominal pain presents with persistent erection (priapism), no thirst but a red face, and painful, difficult urination. Once the Fire syndrome is clearly identified, treating according to the symptoms will naturally lead to recovery. However, establishing a separate formula for each case is overly complicated. I have one formula that can treat abdominal pain caused by Fire collectively, named Dao Huo Tang (Guide Fire Decoction):
Xuan Shen (Scrophulariae Radix, 1 liang) Sheng Di (Rehmanniae Radix Recens, 5 qian) Che Qian Zi (Plantaginis Semen, 3 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Ze Xie (Alismatis Rhizoma, 2 qian)
Decoct in water and take orally. After two doses, all pains can be cured.
Excess Fire results from insufficient Water. Xuan Shen and Sheng Di nourish Yin, causing Yang Fire to descend naturally; moreover, adding the slippery and draining properties of Che Qian Zi and Ze Xie, along with the harmonizing effect of Gan Cao, especially guides Fire to dissipate, transforming pathology into health. If it is known to be Stomach Fire, add Shi Gao (Gypsum Fibrosum); if Spleen Fire, add Zhi Mu (Anemarrhenae Rhizoma); if Large Intestine Fire, add Di Yu (Sanguisorbae Radix); if Small Intestine Fire, add Huang Lian (Coptidis Rhizoma); if Bladder Fire, add Hua Shi (Talcum); if Kidney Fire, add Huang Bo (Phellodendri Cortex). This yields extreme efficacy.
A person suffers from abdominal pain throughout the day, feels relief upon pressing, and experiences intensified pain after drinking cold water; this is Cold Pain. There is no need to distinguish the specific organs involved; it is due to Ming Men Fire Decline (Fire of the Gate of Life), allowing Cold Evil to remain. Since Ming Men is the master of the body, if Ming Men is cold, the Five Viscera and Six Bowels are all cold. Therefore, treatment should primarily focus on warming the Fire of Ming Men. However, the Fire of Ming Men cannot be tonified alone; it must be treated concurrently with the Spleen and Stomach. Fire and Earth combine to generate transformation. Yet, one cannot treat only Earth, for the enemy of Earth is Liver Wood. When Ming Men assists Earth, if Liver Wood takes advantage to overcome it, the Qi of the Spleen and Stomach remains constrained by Liver Wood and cannot arise. One must restrain Liver Wood so that Wood does not overcome Earth, then use Fire to generate Earth. In this way, once the Cold Evil of the Spleen and Stomach is removed and Yang Qi ascends, turbid Yin vanishes, eliminating the worry of conflict between Wood and Earth, allowing the intestines and abdomen to enjoy peace. Use Zhi Gan Yi Huo Tang (Restrain Liver and Benefit Fire Decoction):
Bai Shao (Paeoniae Radix Alba, 3 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian) Fu Ling (Poria, 3 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Rou Gui (Cinnamomi Cortex, 1 qian) Rou Dou Kou (Myristicae Semen, 1 piece) Ban Xia (Pinelliae Tuber, 1 qian) Ren Shen (Ginseng Radix et Rhizoma)
Decoct in water and take orally. After one dose, pain reduces by half; after another dose, pain is completely eliminated.
Although this formula is a modification of Liu Jun Zi Tang (Six Gentlemen Decoction), its purpose is merely to assist the Yang Qi of the Spleen and Stomach. The addition of Bai Shao pacifies the Qi of Liver Wood. Furthermore, Rou Gui warms the Fire of Ming Men, generating Fire to produce Earth, while Rou Dou Kou warms the Spleen and Stomach, causing Cold Evil to retreat without struggle.
This syndrome can also be treated with Xiao Han Yin (Eliminate Cold Drink):
Bai Zhu (Atractylodis Macrocephalae Rhizoma) Ren Shen (Ginseng Radix et Rhizoma) (each 5 qian) Rou Gui (Cinnamomi Cortex) Rou Dou Kou (Myristicae Semen) Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1 qian)
Decoct in water and take orally. One dose stops the pain.
A person suffers from abdominal pain that decreases after eating and worsens when hungry, with a sallow complexion, emaciation, and increasing fatigue daily; this is caused by worms in the abdomen. Worms arise due to specific causes, such as consuming indigestible food or drinking cold liquids, leading to long-term transformation into worms. If Yin and Yang Qi are vigorous, any worms generated will perish immediately and cannot establish nests in the abdomen. Only when Yin and Yang Qi decline, failing to transform and transport throughout the body, do worms survive. Initially, they consume food, but later consume blood uncontrollably, triggering abdominal pain. Thus, how can treatment merely kill worms without cultivating Yin and Yang Qi? Use Wei Sheng Tang (Protect Life Decoction):
Ren Shen (Ginseng Radix et Rhizoma, 3 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian) Bai Wei (Cynanchi Atrati Radix, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Fei Zi (Torreya Seed, 10 pieces, sliced) Bing Lang (Arecae Semen, 1 qian) Shi Jun Zi (Quisqualis Fructus, 10 pieces, shelled) Gan Ge (Puerariae Radix, 1 qian)
Decoct in water and take orally. After one dose, the abdomen turns painful (indicating worm agitation); after two doses, abdominal pain ceases.
Abdominal pain after taking medicine indicates the intent to expel worms. Strictly avoid drinking tea; drinking tea kills only half the worms, not all. Fasting for half a day allows worms to turn into water and exit via stool and urine. Ren Shen and Bai Zhu serve as Sovereign herbs to raise Yang Qi. As Yang rises, worms become uneasy and move upward seeking food, where the assisting vermifuge herbs act. How can worms survive? If tea is drunk, worms gain water and may survive despite adversity; though temporarily relieved, worms multiply and pain returns.
This syndrome responds well to Zhu Chong Dan (Expel Worms Pill):
Bai Wei (Cynanchi Atrati Radix) Fu Ling (Poria) (each 3 qian) Lei Wan (Omphalia's Conk, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Bing Lang (Arecae Semen, 1 qian) Huang Lian (Coptidis Rhizoma, 5 fen) Shi Jun Zi (Quisqualis Fructus, 10 pieces) Wu Mei (Mume Fructus, 1 piece)
Decoct in water and take orally. Three doses result in full recovery.
A person suffers from urgent abdominal pain, distension in both hypochondria, bitter taste, nausea, acid regurgitation, and an urge to defecate that cannot be satisfied; this is Qi Pain. Cold herbs are ineffective, hot herbs are ineffective, and tonics are ineffective. This is due to Liver Wood Qi Stagnation overcoming Spleen Earth downward. Earth fears Wood's control, so Yang Qi dares not ascend, instead descending without release, then reversing upward causing nausea. Mutual pulling results in ceaseless pain. Treatment must soothe Liver Qi stagnation and ascend Spleen-Stomach Yang Qi. Then Earth will not fear Wood's invasion, and pain stops. Modifying Xiao Yao San (Free and Easy Wanderer Powder) is best.
Chai Hu (Bupleuri Radix, 1 qian) Bai Shao (Paeoniae Radix Alba, 5 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Fu Ling (Poria, 3 qian) Chen Pi (Citri Reticulatae Pericarpium, 1 qian) Dang Gui (Angelicae Sinensis Radix, 2 qian) Shen Qu (Massa Medicata Fermentata, 1 qian)
Decoct in water and take orally. Pain stops after two doses.
Xiao Yao San resolves depression, and this pain requires gradual treatment; heavy dosage is unnecessary. Four more doses complete the cure.
This syndrome also responds excellently to Cang Bai Gan Cao Tang (Cang Zhu, Bai Zhu, and Licorice Decoction):
Cang Zhu (Atractylodis Rhizoma, 5 qian) Bai Shao (Paeoniae Radix Alba, 1 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian)
Decoct in water and take orally. Cured in two doses.
A person consumes excessive raw, cold, roasted, or hard-to-digest foods, causing abdominal pain exacerbated by pressure; this is Food Accumulation in the intestines, blocked and unable to exit, resulting in dry feces. The method should be to purge accumulation and resolve stagnation, requiring purgation. However, excessive purgation damages Yin, which must be guarded against. Ability to eat indicates vigorous Yang; inability to digest indicates declining Yin. If Yang is vigorous, what food cannot be digested? Why would food stay in the Large Intestine? It must be that Yin Blood fails to moisten the Large Intestine, and Yang Fire scorches it, drying the intestine and forming dry feces that cannot pass. When dry feces do not pass, Yin and Yang communication is blocked, causing abdominal pain. Treatment should moisten Yin while assisting expulsion, preserving Yin while moving food. Use Zhu Hui Dan (Expel Filth Pill):
Dang Gui Wei (Angelicae Sinensis Radix Caulis, 5 qian) Da Huang (Rhei Radix et Rhizoma, 3 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Zhi Shi (Aurantii Fructus Immaturus, 1 qian) Dan Pi (Moutan Cortex, 3 qian)
Decoct in water and take orally. Dry feces pass after one dose, and abdominal pain instantly disappears; a second dose is unnecessary.
This formula uses Da Huang and Zhi Shi to purge filth, adding Dang Gui and Dan Pi to nourish Blood and generate Yin. Attacking and tonifying are combined; why worry about damaging Yin?
This syndrome also responds very well to Li Fu Tang (Benefit Abdomen Decoction):
Da Huang (Rhei Radix et Rhizoma, 3 qian) Dang Gui (Angelicae Sinensis Radix, 5 qian) Zhi Ke (Aurantii Fructus, 1 qian) Shan Zha (Crataegi Fructus, 1 qian) Mai Ya (Hordei Fructus Germinatus, 1 qian) Hou Po (Magnoliae Officinalis Cortex, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Tao Ren (Persicae Semen, 10 grains)
Decoct in water and take orally. Passage occurs after one dose, and abdominal pain ceases.
A person suffers from abdominal pain starting with coldness in the right fingers, ascending to the head like cold water pouring, descending below, followed by severe abdominal pain, then general body heat; pain stops when heat subsides. Whether eating or fasting, or overeating, pain occurs. Initially occurring once a year, progressing to once a month, then once every ten days. Si Wu Tang (Four Substances Decoction) with depressant herbs failed; Si Jun Zi Tang (Four Gentlemen Decoction) with digestive herbs failed; Er Chen Tang (Two Aged Herbs Decoction) with phlegm-resolving and Qi-moving herbs failed. People assume blood stasis exists, but who knows it is severe Yang Deficiency? Limbs are the extremities of Yang, and the head is the meeting place of Yang. Yang deficiency fears cold; Yin deficiency fears heat. When Yang is deficient and Yin invades, cold manifests; when Yin is deficient and Yang invades, heat manifests. Now, cold fingers ascending to the head clearly show Yang cannot resist Yin, losing vigorous movement, causing severe pain. Heat during pain is extreme cold transforming into heat. When cold and heat balance, and Yin and Yang both decline without fighting, heat stops and pain stops. Treatment should solely tonify Yang. When Yang is vigorous, Yin naturally declines. Moreover, vigorous Yang generates Qi, and vigorous Qi generates Blood. With abundant Qi and Blood, Yin and Yang will not fight and cause pain. Use Du Shen Tang (Single Ginseng Decoction):
Ren Shen (Ginseng Radix et Rhizoma, 1 liang) plus Chen Pi (Citri Reticulatae Pericarpium, 8 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian)
Decoct in water and take orally. Pain lightens after several doses; pain stops after ten doses.
Du Shen Tang is a Qi-tonifying herb. Zhang Zhongjing said: "For Blood deficiency and Qi weakness, tonify with Ren Shen." Hence it stops pain. Some ask: Si Jun Zi Tang is also a Qi tonic; why was it ineffective? Because Si Jun Zi Tang contains Bai Zhu and Fu Ling, which disperse the power of Ren Shen, unlike Du Shen Tang which has focused efficacy and great strength. Furthermore, previous treatments included digestive and Qi-breaking herbs, which attacked the innocent; using Ren Shen could only remedy errors, not achieve success.
This syndrome also responds well to Yin Yang He He Tang (Yin and Yang Harmony Decoction):
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian) Ren Shen (Ginseng Radix et Rhizoma, 2 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Chai Hu (Bupleuri Radix, 1 qian) Bai Shao (Paeoniae Radix Alba, 5 qian) Zhi Ke (Aurantii Fructus, 5 fen)
Decoct in water and take orally. Cured in two doses.