医书言腹痛者，中脘属太阴，脐腹属少阴，小腹属厥阴。此指各经所隶而言，然不可执
一而
论。凡伤食腹有燥屎者，往往当脐腹痛不可按，或欲以手擦而移动之，则痛似稍缓。（凡验
伤食，舌苔、舌根色黄而浊。）仲景《伤寒论》有云∶病患不大便五六日，绕脐痛烦躁，发
作有时。可以为证。
今人所谓心痛、胃痛、胁痛，无非肝气为患，此有虚实之分，大率实者十之二，虚者十
之八
。余表兄周士熙，弱冠得肝病胃痛，医用疏肝之药即止，后痛屡发，服其药即止，而病发转
甚，成婚后数月，痛又大发，医仍用香附、豆蔻、枳壳等药，遂加剧而卒。盖此症初起，即
宜用高鼓峰滋水清肝饮，魏玉璜一贯煎之类，稍加疏肝之味，如鳖血炒柴胡、四制香附之类
，俾肾水涵濡肝木，肝气得舒，肝火渐熄而痛自平。若专用疏泄，则肝阴愈耗，病安得痊？
余尝治钮 村学博福厘之室人肝痛，脉虚，得食稍缓，用北沙参、石斛、归须、白芍、木瓜
、甘草、云苓、鳖血炒柴胡、橘红，二剂痛止，后用逍遥散加参、归、石斛、木瓜，调理而
愈。
赵养葵《医贯》，徐灵胎砭之是矣，然观其治木郁之法，先用逍遥散，继用六味地黄汤
加柴
胡、芍药以滋肾水，俾水能生木，此实开高鼓峰清水滋肝饮之法门。（六味加归身、白芍、
柴胡、山栀、大枣以治肝胃等证，血少者加味逍遥散加生地。）再传而魏玉璜之治胁痛用一
贯煎，（沙参、麦冬、生地、归身、枸杞、川楝子，口苦燥者加酒连），叶天士之治脘痛用石
决明、阿胶、生地、枸杞子、茯苓、石斛、白粳米等以养胃汁，则又化而裁之。法益详备，
学人不可忘所自来也。
魏玉璜曰∶带浊之病，多由肝火炽盛，上蒸胃而乘肺，肺主气，气弱不能散布为津液，反
因火
性迫速而下输膀胱之州都，本从气化，又肝主疏泄，反禀其令而行，遂至淫淫不绝。使但属
胃家湿热，无肝火为难，则上为痰而下为泻耳。叶天士曰∶肝主疏泄，侮所不胜，故亦下利
。余尝治下利，但平肝而得效。（余尝遵此法治素有肝痛病而下利、脉弦者，果获效。）是则
肝之主病甚多，司命者不可不察也。
何西池曰∶百病皆生于郁，与凡病皆属火，及风为百病之长，三句总只一理。盖郁未有
不
病火者也，火未有不由郁者也。第郁而不舒，则皆肝木之病矣。此又可为肝病多之一证。
医书中关于腹痛的论述指出，中脘部位的疼痛归属于太阴经，脐腹部位的疼痛归属于少阴经，小腹部位的疼痛归属于厥阴经。这是从各经络所属范围来划分的，然而不能拘泥于这一种说法而一概而论。凡是饮食停滞、腹部有燥结粪便的患者，往往会在肚脐周围出现剧烈疼痛且拒绝按压，或者想要用手擦拭并移动位置，这样疼痛似乎会稍微缓解。（凡检验是否为伤食，可见舌苔及舌根颜色黄而浑浊。）张仲景在《伤寒论》中曾说：病人五六天不大便，绕脐疼痛、烦躁不安，发作有定时。这可以作为佐证。
如今人们所说的心痛、胃痛、胁痛，无非都是肝气为患，这其中又有虚证和实证的区分，大体上实证占十分之二，虚证占十分之八。我的表兄周士熙，二十岁时患上肝病引起的胃痛，医生使用疏肝的药物后疼痛即止，后来疼痛多次复发，服用同样的药物也能暂时缓解，但病情发作时反而更加严重。结婚几个月后，疼痛再次剧烈发作，医生仍然使用香附、豆蔻、枳壳等药物，结果病情加剧导致死亡。大概这种病症在初起时，就应当使用高鼓峰的滋水清肝饮、魏玉璜的一贯煎之类的方剂，稍加一些疏肝的药物，如用鳖血炒制的柴胡、经过四制处理的香附等，使肾水能够滋养肝木，肝气得以舒展，肝火逐渐熄灭，疼痛自然平息。如果专门使用疏泄的方法，那么肝阴会更加耗损，疾病怎么能痊愈呢？我曾经治疗钮村学博福厘的妻子肝痛，脉象虚弱，进食后疼痛稍缓，使用了北沙参、石斛、当归须、白芍、木瓜、甘草、云苓、鳖血炒柴胡、橘红，两剂药后疼痛停止，之后用逍遥散加入人参、当归、石斛、木瓜进行调理而痊愈。
赵养葵的《医贯》，被徐灵胎批评是正确的，然而观察他治疗木郁（肝气郁结）的方法，先用逍遥散，继用六味地黄汤加入柴胡、芍药以滋补肾水，使水能生木，这实际上开启了高鼓峰滋水清肝饮的治疗法门。（六味地黄汤加入当归身、白芍、柴胡、山栀、大枣来治疗肝胃等证候，血少的患者使用加味逍遥散加入生地。）再传到魏玉璜治疗胁痛使用一贯煎（北沙参、麦冬、生地、当归身、枸杞、川楝子，口苦干燥者加酒黄连），叶天士治疗脘痛使用石决明、阿胶、生地、枸杞子、茯苓、石斛、白粳米等来养胃汁，则是进一步变化裁减而成。治疗方法日益详细完备，学习的人不可忘记其源头。
魏玉璜说：带下浊液的病症，多由肝火炽盛，向上熏蒸胃腑并侵犯肺脏，肺主气，气弱不能散布化为津液，反而因为火的性质迫促迅速而下输到膀胱的州都（指膀胱），本应从气化功能运行，但又受肝主疏泄的命令影响而行事，于是导致淋漓不断。如果只是属于胃家湿热，没有肝火的干扰，那就只是上面产生痰涎下面发生腹泻罢了。叶天士说：肝主疏泄，克制所不胜（脾土），所以也会引起下利。我曾经治疗下利，只要平抑肝气就能见效。（我曾遵循此法治疗素有肝痛病且伴有下利、脉弦的患者，果然获得疗效。）这说明肝脏所致的主病非常多，掌握生命救治的人不可不仔细考察。
何西池说：百病皆生于郁，以及凡病皆属火，还有风为百病之长，这三句话总归只有一个道理。大概郁结没有不转化为火的，火也没有不是由郁结产生的。只是郁结而不舒畅，那就都是肝木的病了。这又可以为肝病多的一个证明。
Medical texts state that pain in the epigastrium (Zhongwan area) belongs to the Taiyin meridian, pain around the umbilicus and abdomen belongs to the Shaoyin meridian, and pain in the lower abdomen belongs to the Jueyin meridian. This refers to the domains of each meridian; however, one cannot rigidly adhere to this classification. In cases of food stagnation with dry feces in the abdomen, there is often severe pain around the umbilicus that cannot be pressed, or the patient desires to rub and move the area, which may slightly relieve the pain. (To verify food stagnation, the tongue coating and root color are yellow and turbid.) Zhang Zhongjing stated in *Shanghan Lun* (Treatise on Cold Damage): "When a patient has not had a bowel movement for five or six days, experiences periumbilical pain, irritability, and periodic attacks," which serves as evidence.
What people today call heart pain, stomach pain, and hypochondriac pain are none other than disorders caused by Liver Qi. These can be divided into deficiency and excess patterns, with excess accounting for two-tenths and deficiency for eight-tenths. My cousin, Zhou Shixi, developed Liver disease-induced stomach pain at age twenty. Physicians used Liver-soothing medicines which stopped the pain initially. Later, the pain recurred frequently; although taking these medicines provided temporary relief, the condition worsened upon recurrence. Several months after marriage, the pain flared up severely again. The physician still used herbs such as Cyperi Rhizoma (Xiangfu), Amomi Fructus (Dudou), and Aurantii Fructus Pericarpium (Zhiqiao), leading to exacerbation and death. Generally, for this condition from its onset, formulas like Gao Gufeng's Zishui Qinggan Yin (Nourishing Water to Clear Liver Fire Decoction) or Wei Yuhuang's Yiguan Jian (One Glance Decoction) should be used, slightly augmented with Liver-soothing agents such as Bupleuri Radix (Chaihu) stir-fried with turtle blood, or processed Cyperi Rhizoma (Xiangfu). This allows Kidney water to nourish Liver wood, enabling Liver Qi to relax, Liver fire to subside, and pain to cease. If only draining methods are used, Liver Yin will be further depleted, and how can the disease recover? I once treated the wife of Fu Li, a scholar from Niu Village, for Liver pain. Her pulse was deficient, and pain eased slightly after eating. I prescribed Glehniae Radix (Beishashen), Dendrobii Caulis (Shihu), Paeoniae Radix Rubra (Guixu), Paeoniae Radix Alba (Baishao), Chaenomelis Fructus (Mugua), Glycyrrhizae Radix et Rhizoma (Gancao), Poria (Yunling), Bupleuri Radix (Chaihu) stir-fried with turtle blood, and Citri Reticulatae Pericarpium (Juhong). After two doses, the pain ceased. Subsequently, she recovered after regulation with Xiaoyao San (Free and Easy Wanderer Powder) added with Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), Dendrobii Caulis (Shihu), and Chaenomelis Fructus (Mugua).
Zhao Yangkui's *Yi Guan* (Medical Canon) was correctly criticized by Xu Lingtai. However, observing his method for treating Wood Stagnation (Liver Qi Stagnation), he first used Xiaoyao San, followed by Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Chaihu and Baishao to nourish Kidney water, allowing water to generate wood. This essentially opened the methodology for Gao Gufeng's Zishui Qinggan Yin. (Liuwei Dihuang Wan added with Dangguishen, Baishao, Chaihu, Gardeniae Fructus (Shanzhi), and Jujubae Fructus (Dazao) treats Liver-Stomach syndromes; for blood deficiency, Jiawei Xiaoyao San added with Shengdi is used.) This evolved into Wei Yuhuang's use of Yiguan Jian for hypochondriac pain (Glehniae Radix, Ophiopogonis Tuber (Maidong), Rehmanniae Radix Preparata (Shengdi), Angelicae Sinensis Radix (Guishen), Lycii Fructus (Gouqi), Toosendan Fructus (Chuanlianzi); add Huanglian prepared with wine if bitter taste and dryness exist), and Ye Tianshi's treatment of epigastric pain using Concha Heterodonis (Shijueming), Ecorum Gelatinum (Ejiao), Rehmanniae Radix Preparata (Shengdi), Lycii Fructus (Gouqi), Poria (Fuling), Dendrobii Caulis (Shihu), and Oryza Sativa (Bajingmi) to nourish stomach fluids. The methods became increasingly detailed and complete; students must not forget their origins.
Wei Yuhuang said: Diseases involving turbid leukorrhea are mostly due to blazing Liver Fire steaming upward to affect the Stomach and invading the Lung. The Lung governs Qi; when Qi is weak, it cannot disperse to form body fluids. Instead, driven by the rapid nature of Fire, it flows downward to the Bladder (Zhou Du). Originally governed by Qi transformation, it is also influenced by the Liver's command of dispersion and excretion, resulting in continuous dripping. If it were merely Damp-Heat in the Stomach without Liver Fire, it would manifest as phlegm above and diarrhea below. Ye Tianshi said: The Liver governs dispersion and excretion and overacts on what it cannot overcome (Spleen/Earth), thus causing diarrhea. I have treated diarrhea successfully by simply calming the Liver. (I once followed this method to treat patients with chronic Liver pain accompanied by diarrhea and a wiry pulse, achieving effective results.) Thus, the diseases originating from the Liver are numerous; practitioners must carefully examine them.
He Xichi said: All diseases arise from stagnation; all diseases belong to Fire; and Wind is the chief of all diseases. These three statements share the same principle. Stagnation inevitably transforms into Fire, and Fire invariably arises from stagnation. When stagnation fails to diffuse, it becomes a disorder of Liver Wood. This serves as another proof that Liver diseases are common.