1．趺阳脉微弦，法当腹满，不满者必便难，两 疼痛，此虚寒从下上也，当以温药服之。
2．病者腹满，按之不痛为虚，痛者为实，可下之。舌黄未下者，下之黄自去。
3．腹满时减，复如故，此为寒，当与温药。
4．病者痿黄，躁而不渴，胸中寒实而利不止者，死。
5．寸口脉弦者，即胁下拘急而痛，其人啬啬恶寒也。
6．夫中寒家，喜欠，其人清涕出，发热色和者，善嚏。
7．中寒其人下利，以里虚也，欲嚏不能，此人肚中寒。
8．夫瘦人绕脐痛，必有风冷，谷气不行，
而反下之，其气必冲；不冲者，心下则痞。
9．病腹满，发热十日，脉浮而数，饮食如故，浓朴七物汤主之。
浓朴七物汤方
浓朴（半斤） 甘草 大黄（各三两） 大枣（十枚） 枳实（五枚） 桂枝（二两） 生姜（五两）
上七味，以水一斗，煮取四升，温服八合，日三服。呕者加半夏五合，下利去大黄，寒多者加生姜至半斤。
10．腹中寒气，雷鸣切痛，胸胁逆满，呕吐，附子粳米汤主之。
附子粳米汤方
附子（一枚，炮） 半夏（半升） 甘草（一两） 大枣（十枚） 粳米（半升）
上五味，以水八升，煮米熟汤成，去滓，温服一升，日三服。
11．痛而闭者，浓朴三物汤主之。
浓朴三物汤方
浓朴（八两） 大黄（四两） 枳实（五枚）
上三味，以水一斗二升，先煮二味，取五升，纳大黄，煮取三升，温服一升，以利为度。
12．按之心下满痛者，此为实也，当下之，宜大柴胡汤。
大柴胡汤方
柴胡（半斤） 黄芩（三两） 芍药（三两） 半夏（半升，洗） 枳实（四枚，炙） 大黄（二两） 大
枣（十二枚） 生姜（五两）
上八味，以水一斗二升，煮取六升，去滓，再煎，温服一升，日三服。
13．腹满不减，减不足言，当须下之，宜大承气汤。
大承气汤方（见前痉病中。）
14．心胸中大寒痛，呕不能饮食，腹中寒，上冲皮起，出见有头足，上下痛而不可触近，大建中汤主之。
大建中汤方
蜀椒（二合，去汗） 干姜（四两） 人参（二两）
上三味，以水四升，煮取二升，去滓，纳胶饴一升，微火煎取一升半，分温再服，如一炊顷，可饮
粥二升后更服，当一日食糜，温复之。
15．胁下偏痛，发热，其脉紧弦，此寒也，宜温药下之，以大黄附子汤。
大黄附子汤方
大黄（三两） 附子（三枚，炮） 细辛（二两）
上三味，以水五升，煮取二升，分温三服，若强人煮取二升半，分温三服，服后如人行四五里，进一服。
16．寒气厥逆，赤丸主之。
赤丸方
茯苓（四两） 半夏（四两，洗，一方用桂） 乌头（二两，炮） 细辛（一两，《千金》作人参。）
上四味，末之，纳真朱为色，炼蜜丸如麻子大，先食酒饮下三丸，日再夜一服，不知，稍增之，以知为度。
17．腹痛，脉弦而紧，弦则卫气不行，即恶寒，紧则不欲食，邪正相搏，即为寒疝。寒疝绕脐痛，若发则白
津出，手足厥冷，其脉沉紧者，大乌头煎主之。
乌头煎方
乌头（大者五枚，熬去皮，不 咀）
上以水三升，煮取一升，去滓，纳蜜二升，煎令水气尽，取二升，强人服七合，弱人服五合。不瘥，明日更
服，不可一日再服。
18．寒疝腹中痛，及胁痛里急者，当归生姜羊肉汤主之。
当归生姜羊肉汤方
当归（三两） 生姜（五两） 羊肉（一斤）
上三味，以水八升，煮取三升，温服七合，日三服，若寒多者，加生姜成一斤；痛多而呕者，加桔皮二两，
白术一两。加生姜者，亦加水五升，煮取三升二合，服之。
19．寒疝腹中痛，逆冷，手足不仁，若身疼痛，灸刺、诸药不能治，抵当乌头桂枝汤主之。
乌头桂枝汤方
乌头
上一味，以蜜二斤，煎减半，去滓，以桂枝汤五合解之，令得一升后，初服二合，不知，即服三合，又不
知，复加至五合。其知者如醉状，得吐者为中病。
桂枝汤方
桂枝（三两，去皮） 芍药（三两） 甘草（二两，炙） 生姜（三两） 大枣（十二枚）
上五味， ，以水七升，微火煮取三升，去滓。
20．其脉数而紧，乃弦，状如弓弦，按之不移。脉数弦者，当下其寒。脉紧大而迟者，必心下坚。脉大而紧
者，阳中有阴，可下之。
附方
《外台》乌头汤 治寒疝腹中绞痛，贱风入攻五脏，拘急不得转侧，发作有时，使人阴缩，手足厥逆。
方见上。
《外台》柴胡桂枝汤方 治心腹卒中痛者。
柴胡（四两） 黄芩 人参 芍药 桂枝 生姜（各一两半） 甘草（一两） 半夏（二合半） 大枣（六
枚）
上九味，以水六升，煮取三升，温服一升，日三服。
《外台》走马汤 治中恶心痛腹胀，大便不通。
巴豆（二枚，去皮心熬） 杏仁（二枚）
上二味，以绵缠槌令碎，热汤二合，捻取白汁，饮之当下，老小量之。通治飞尸鬼击病。
21．问曰∶人病有宿食，何以别之？师曰∶寸口脉浮而大，按之反涩，尺中亦微而涩，故知有宿食，大承气
汤主之。
22．脉数而滑者，实也，此有宿食，下之愈，宜大承气汤。
23．下利不欲食者，有宿食也，当下之，宜大承气汤。大承气汤方（见前痉病中。）
24．宿食在上脘，当吐之，宜瓜蒂散。
瓜蒂散方
瓜蒂（一分，熬黄） 赤小豆（一分，煮）
上二味，杵为散，以香豉七合煮取汁，和散一钱匕，温服之，不吐者，少加之，以快吐为度而止。亡血及虚
者，不可与之。
25．脉紧如转索无常者，有宿食也。
26．脉紧，头痛风寒，腹中有宿食不化也。（一云∶寸口脉紧。）
1. The Yueyang pulse (foot dorsalis pedis artery, reflecting the condition of the spleen and stomach) is faint and wiry. According to medical principles, abdominal fullness should occur; if there is no fullness, there must be difficulty in defecation and pain in both hypochondriac regions. This is caused by deficiency-cold ascending from below. It should be treated with warm herbs.
2. In patients with abdominal fullness, tenderness upon palpation indicates excess syndrome, while non-tenderness indicates deficiency syndrome. Purging methods may be used. If the tongue coating is yellow and purging has not yet been applied, the yellow coating will disappear after purging.
3. Abdominal fullness that decreases intermittently but returns to its original state indicates cold syndrome. Warm herbs should be administered.
4. Patients with sallow complexion, restlessness without thirst, cold-evil excess accumulation in the chest, and unremitting diarrhea are in a critical condition (death prognosis).
5. A wiry pulse at the Cun Kou position (radial artery at the wrist, reflecting systemic conditions) leads to spasm and pain in the lower hypochondriac region, accompanied by aversion to cold.
6. Individuals suffering from cold invasion often yawn excessively and have clear nasal discharge. If they have fever but normal facial color, they are prone to sneezing.
7. Cold invasion causing diarrhea indicates deficiency in the interior. The inability to sneeze despite the urge suggests cold in the abdomen.
8. Thin individuals experiencing periumbilical pain likely suffer from wind-cold invasion obstructing the movement of grain qi. If purging is incorrectly applied, Qi will rebel upward; if it does not rebel, epigastric stuffiness (Pi syndrome) will form.
9. For abdominal fullness with fever for ten days, floating and rapid pulse, and normal appetite, Nongpu Qiwu Tang (Magnolia Bark Seven-Ingredient Decoction) is indicated.
Nongpu Qiwu Tang Formula:
Houpo (Magnoliae Officinalis Cortex, half jin), Gancao (Licorice Radix et Rhizoma), Dahuang (Rhei Radix et Rhizoma) [each three liang], Dazao (Jujubae Fructus, ten pieces), Zhishi (Aurantii Fructus Immaturus, five pieces), Guizhi (Cinnamomi Ramulus, two liang), Shengjiang (Zingiberis Rhizoma Recens, five liang).
Process these seven ingredients with one dou of water, decoct to obtain four sheng of liquid. Take eight ge of warm decoction three times daily. Add Banxia (Pinelliae Rhizoma, five ge) for vomiting; remove Dahuang for diarrhea; increase Shengjiang to half jin for severe cold.
10. For abdominal coldness with borborygmus like thunder, cutting pain, rebellious Qi causing chest and hypochondriac fullness, and vomiting, Fuzi Jimi Tang (Aconite and Rice Decoction) is indicated.
Fuzi Jimi Tang Formula:
Fuzi (Aconiti Lateralis Radix Praeparata, one piece, processed), Banxia (Pinelliae Rhizoma, half sheng), Gancao (Licorice Radix et Rhizoma, one liang), Dazao (Jujubae Fructus, ten pieces), Jingmi (Oryza Sativa, half sheng).
Process these five ingredients with eight sheng of water, decoct until the rice is cooked and the soup is ready. Strain and take one sheng of warm decoction three times daily.
11. For abdominal pain with constipation, Nongpu Sanwu Tang (Magnolia Bark Three-Ingredient Decoction) is indicated.
Nongpu Sanwu Tang Formula:
Houpo (Magnoliae Officinalis Cortex, eight liang), Dahuang (Rhei Radix et Rhizoma, four liang), Zhishi (Aurantii Fructus Immaturus, five pieces).
Process these three ingredients with one dou two sheng of water. First decoct Houpo and Zhishi to obtain five sheng. Add Dahuang and decoct to obtain three sheng. Take one sheng of warm decoction; stop when bowel movement occurs.
12. Fullness and pain in the epigastrium upon palpation indicate excess syndrome. Purging is required; Da Chaihu Tang (Major Bupleurum Decoction) is suitable.
Da Chaihu Tang Formula:
Chaihu (Bupleuri Radix, half jin), Huangqin (Scutellariae Radix, three liang), Shaoyao (Paeoniae Radix Alba, three liang), Banxia (Pinelliae Rhizoma, half sheng, washed), Zhishi (Aurantii Fructus Immaturus, four pieces, roasted), Dahuang (Rhei Radix et Rhizoma, two liang), Dazao (Jujubae Fructus, twelve pieces), Shengjiang (Zingiberis Rhizoma Recens, five liang).
Process these eight ingredients with one dou two sheng of water, decoct to obtain six sheng. Strain and decoct again. Take one sheng of warm decoction three times daily.
13. Abdominal fullness that persists without relief, or where any reduction is negligible, requires purging. Da Chengqi Tang (Major Order the Qi Decoction) is suitable.
Da Chengqi Tang Formula (See earlier chapter on Spasms).
14. For severe cold pain in the heart and chest, vomiting preventing food intake, abdominal coldness with Qi rushing up to the skin surface appearing as lumps with heads and feet, and extreme tenderness making touch unbearable, Da Jianzhong Tang (Major Construct the Middle Decoction) is indicated.
Da Jianzhong Tang Formula:
Shujiao (Szechwan Pepper Fruit, two he, sweat removed/dried), Ganjiang (Zingiberis Rhizoma, four liang), Renshen (Ginseng Radix, two liang).
Process these three ingredients with four sheng of water, decoct to obtain two sheng. Strain and add Jiaoyi (Malt Sugar, one sheng). Simmer over low heat to obtain one and a half sheng. Divide into two warm doses. About the time of one meal, drink two sheng of porridge, then take the remaining dose. Consume only porridge for the day and keep warm.
15. Unilateral hypochondriac pain with fever and a tight, wiry pulse indicates cold syndrome. Warm purgatives are suitable; Dahuang Fuzi Tang (Rhubarb and Aconite Decoction) is indicated.
Dahuang Fuzi Tang Formula:
Dahuang (Rhei Radix et Rhizoma, three liang), Fuzi (Aconiti Lateralis Radix Praeparata, three pieces, processed), Xixin (Asari Radix et Rhizoma, two liang).
Process these three ingredients with five sheng of water, decoct to obtain two sheng. Divide into three warm doses. For robust individuals, decoct to obtain two and a half sheng, divide into three doses. After taking the medicine, wait the time it takes to walk four or five li before administering the next dose.
16. For cold-induced reversal coldness (Jue Ni), Chi Wan (Red Pill) is indicated.
Chi Wan Formula:
Fuling (Poria, four liang), Banxia (Pinelliae Rhizoma, four liang, washed; another version uses Guizhi), Wutou (Aconiti Radix, two liang, processed), Xixin (Asari Radix et Rhizoma, one liang; Qianjin Fang uses Renshen).
Process these four ingredients into powder. Add real cinnabar for color. Form pills with refined honey the size of hemp seeds. Take three pills with wine before meals. Take twice during the day and once at night. If ineffective, slightly increase the dose until therapeutic effect is achieved.
17. Abdominal pain with wiry and tight pulses: Wiry indicates impaired Wei Qi flow leading to aversion to cold; tight indicates anorexia. The struggle between pathogenic evil and righteous Qi forms Han Shan (Cold Hernia). Han Shan presents with periumbilical pain, sweating of white fluid upon attack, cold extremities, and deep, tight pulse. Da Wutou Jian (Major Aconite Decoction) is indicated.
Wutou Jian Formula:
Wutou (Aconiti Radix, five large pieces, roasted, skin removed, not chopped).
Decoct this single ingredient in three sheng of water to obtain one sheng. Strain and add two sheng of honey. Boil until the water vapor is gone to obtain two sheng. Robust individuals take seven ge; weak individuals take five ge. If not cured, administer again the next day. Do not administer more than once a day.
18. For Han Shan (Cold Hernia) with abdominal pain, hypochondriac pain, and internal urgency, Danggui Shengjiang Yangrou Tang (Angelica Sinensis, Ginger, and Mutton Decoction) is indicated.
Danggui Shengjiang Yangrou Tang Formula:
Danggui (Angelicae Sinensis Radix, three liang), Shengjiang (Zingiberis Rhizoma Recens, five liang), Yangrou (Mutton, one jin).
Process these three ingredients with eight sheng of water, decoct to obtain three sheng. Take seven ge of warm decoction three times daily. Increase Shengjiang to one jin for severe cold; add Chenpi (Citri Reticulatae Pericarpium, two liang) and Baizhu (Atractylodis Macrocephalae Rhizoma, one liang) for severe pain with vomiting. If adding Shengjiang, add five sheng of water, decoct to obtain three sheng two ge, and take.
19. For Han Shan (Cold Hernia) with abdominal pain, cold limbs, numbness in hands and feet, body pain, which cannot be cured by moxibustion, acupuncture, or other medicines, Didang Wutou Guizhi Tang (Aconite and Cinnamon Twig Decoction) is indicated.
Wutou Guizhi Tang Formula:
Wutou (Aconiti Radix).
Decoct this single ingredient in two jin of honey until reduced by half. Strain and dissolve in five he of Guizhi Tang (Cinnamon Twig Decoction) to obtain one sheng. Initial dose is two ge; if no effect, take three ge; if still no effect, increase to five ge. A sensation like drunkenness or vomiting indicates the medicine has taken effect.
Guizhi Tang Formula:
Guizhi (Cinnamomi Ramulus, three liang, skin removed), Shaoyao (Paeoniae Radix Alba, three liang), Gancao (Licorice Radix et Rhizoma, two liang, roasted), Shengjiang (Zingiberis Rhizoma Recens, three liang), Dazao (Jujubae Fructus, twelve pieces).
Process these five ingredients with seven sheng of water, simmer to obtain three sheng. Strain.
20. A pulse that is rapid and tight becomes wiry, feeling like a bowstring that does not move under pressure. Rapid and wiry pulses indicate cold that should be purged. Tight, large, and slow pulses indicate hardness in the epigastrium. Large and tight pulses indicate Yin within Yang, which can be purged.
Attached Formulas:
Wutou Tang from "Waitai Miyao": Treats cold hernia with severe abdominal colic, invading wind attacking the five zang organs, stiffness preventing turning, periodic attacks, penile retraction, and cold extremities. See formula above.
Chaihu Guizhi Tang from "Waitai Miyao": Treats sudden pain in the heart and abdomen.
Chaihu (Bupleuri Radix, four liang), Huangqin (Scutellariae Radix, one and a half liang), Renshen (Ginseng Radix, one and a half liang), Shaoyao (Paeoniae Radix Alba, one and a half liang), Guizhi (Cinnamomi Ramulus, one and a half liang), Shengjiang (Zingiberis Rhizoma Recens, one and a half liang), Gancao (Licorice Radix et Rhizoma, one liang), Banxia (Pinelliae Rhizoma, two and a half he), Dazao (Jujubae Fructus, six pieces).
Process these nine ingredients with six sheng of water, decoct to obtain three sheng. Take one sheng of warm decoction three times daily.
Zouma Tang from "Waitai Miyao": Treats sudden heart pain and abdominal distension with constipation.
Badou (Crotonis Fructus, two pieces, skin and heart removed, roasted), Xingren (Armeniacae Semen Amarum, two pieces).
Process these two ingredients by wrapping in silk and crushing. Add two he of hot water, squeeze out the white juice, and drink. It induces purging. Dosage varies for elderly and children. Also treats Feishi Guiji diseases.
21. Question: How to distinguish Su Shi (retained food)? Master says: If the Cun Kou pulse is floating and large, but rough upon pressure, and the Chi pulse is also faint and rough, retained food is confirmed. Da Chengqi Tang (Major Order the Qi Decoction) is indicated.
22. A rapid and slippery pulse indicates excess syndrome due to retained food. Purging will cure it. Da Chengqi Tang (Major Order the Qi Decoction) is suitable.
23. Diarrhea with loss of appetite indicates retained food. Purging is required. Da Chengqi Tang (Major Order the Qi Decoction) is suitable. Da Chengqi Tang Formula (See earlier chapter on Spasms).
24. Retained food in the upper jiao (upper burner/stomach outlet) should be expelled via vomiting. Guiti San (Melon Seed Powder) is indicated.
Guiti San Formula:
Guiti (Thlapsidis Herba, one part, roasted yellow), Chixiaodou (Vigna angularis, one part, boiled).
Process these two ingredients into powder. Boil Xiangchi (Fermented Soybean, seven he) to obtain juice. Mix with one qianbi of powder. Take warm. If vomiting does not occur, slightly increase the dose. Stop when vigorous vomiting occurs. Contraindicated in blood loss and deficiency syndromes.
25. A tight pulse resembling a turning rope indicates retained food.
26. Tight pulse with headache and wind-cold indicates retained food in the abdomen that is not digesting. (Another version states: Cun Kou pulse is tight.)