腹中上下诸痛，寒热虚实，皆能致之。温清消补，及发表攻里诸法，皆所以止痛，故止
痛无定方也。今因《医学真传》部位分析清楚，亦是认证之快捷方式，故全录之。噫！《金匮》
诸法，何等精详，十载研穷，致讥迂阔。今亦穷而知返也。然古圣贤章程，终不敢废，编中
所录，虽曰从时，亦从纯而不从拜乎上之道也。
心为君主而藏神，不可以痛。今云心痛，乃心包之络，不能旁通于脉故也。（心痛有论有
方，今因全录高士宗此论，存之以备参考。《种福堂良方》有丹参一两、檀香、砂仁各一钱煎服。）
心脉之上，则为胸膈。胸膈痛乃上焦失职，不能如雾霭之溉，则胸痹而痛。薤白、蒌仁
、贝母、豆蔻之药，可以开胸痹以止痛。
两乳之间，则为膺胸。膺胸痛者，乃肝血内虚，气不充于期门，致冲任之血，不能从膺
胸而散则痛。当归、白芍、红花、银花、续断、木香之药，可和气血而止痛。
有中脘作痛，手不可近者。夫手不可近，乃内外不和，外则寒气凝于皮毛，内则垢浊停
于中脘，当审其体之虚实而施治。莫若以灯草当痛处，爆十余点，则寒结去而内外通，便不
痛矣。
有中脘之下，当阳明胃土之间，时痛时止者，乃中土虚而胃气不和。若行血消泄之剂服
之过多，便宜温补。但以手重按之，则痛稍平，此中土内虚，虚而且寒之明验也。（宜香砂理
中汤。）
乳下两旁，胸骨尽处痛者，乃上下阴阳不和，少阳枢转不利也。伤寒病中每多此痛，当
助其枢转，和其气血，上下通调则愈矣。（宜小柴胡汤加味。）
大腹痛者，乃太阴脾土之部。痛在内而缓，坤土虚寒也。痛兼内外而急，脾络不通也。
盖脾之大络，名曰大包。从经隧而外出于络脉。今脾络滞而不行，则内外皆痛。《太阳篇》
云∶伤寒阳脉涩，阴脉弦，法当腹中急痛，先与小建中汤。不瘥者，与小柴胡汤，此先补
益于内，而后枢转于外也。
脐旁左右痛者，乃冲脉病。冲脉当脐左右，若为寒气所凝，其冲脉之血，不能上行外达
，则当脐左右而痛。当用血分之药，使胞中之血通达肌表，若用气药无裨也。（当归四逆汤加
吴茱萸、生姜。）
脐下痛者，乃少阴水脏。太阳水府，不得阳热之气以施化，致阴寒凝结而痛。少阴虚寒
，当用附子、肉桂以温之。太阳水府虚寒，亦当用附子、桂枝以温之。盖太阳与少阴，相为
表里，互为中见者也。（亦有火逼膀胱不通而痛者。）
小腹两旁，谓之少腹。少腹痛者，乃厥阴肝脏之部，又为胞中之血海。盖胞中之水，主
于少阴，而胞中之血，主于厥阴也。痛者，厥阴肝气，不合胞中之血而上行也。肝脏不虚者，
当疏通以使之上。肝脏虚者，当补益以助其下。盖厥阴不从标本，从中见少阳之气，使厥阴
上合乎少阳，则不痛矣。
两旁季胁痛者，肝气虚也。（宜暖肝煎。）两胁之上痛者，少阳之气不和也。（宜小柴胡去参
枣加牡蛎、青皮之类。景岳云∶肾虚羸弱之人多胸胁间隐隐作痛，此肝肾精虚不能化气，
气虚不能生血而然，凡人之气血，犹源泉也，盛则疏通，少则壅滞。使不知培补气血但以
行滞通经则愈行愈虚鲜不殆矣。）又高士宗云∶所痛之部，有气血阴阳之不同，若概以行
气消导为治，漫云通则不痛。夫通则不痛，理也。但通之之法，各有不同。调气以和血，调
血以和气，通也。下逆者使之上行，中结者使之旁达，亦通也。虚者助之使通，寒者温之
使通，无非通之之法也。若必以下泄为通，则妄矣。
腹部上下各种疼痛，无论是寒证、热证、虚证还是实证，都能导致。温法、清法、消法、补法，以及解表攻里等各种治法，都是用来止痛的，所以止痛没有固定的方剂。现在因为《医学真传》对病位分析得很清楚，这也是辨证确诊的快捷方式，所以全文抄录下来。唉！《金匮要略》中的各种方法，何等精详，我钻研了十年，反而被讥笑为迂腐不切实际。如今我也在穷究之后知道回头了。然而古代圣贤的法度章程，终究不敢废弃，编中所收录的内容，虽然说是顺应时宜，也是遵循崇尚纯正而不盲目崇上的道理。
心是君主之官而藏神，是不应该发生疼痛的。现在所说的“心痛”，其实是心包络（保护心脏的外围组织）的络脉，不能旁通于经脉的缘故。（关于心痛有专门的论述和方剂，现在因为要完整收录高士宗的这篇论述，保存下来以备参考。《种福堂良方》中有丹参一两、檀香、砂仁各一钱煎服的方法。）心脉之上，就是胸膈部位。胸膈疼痛是由于上焦功能失职，不能像雾露一样灌溉全身，从而导致胸痹（胸部闷痛不适的病证）而痛。薤白、瓜蒌仁、贝母、豆蔻等药物，可以开通胸痹从而止痛。
两乳之间，称为膺胸。膺胸痛，是因为肝血内部亏虚，气不能充养期门穴（肝经募穴），导致冲脉和任脉的血，不能从膺胸部位疏散，从而产生疼痛。当归、白芍、红花、金银花、续断、木香等药物，可以调和气血从而止痛。
有中脘穴部位作痛，手不能触碰的。所谓手不能触碰，是内外不和的表现，外部则是寒气凝结在皮毛，内部则是污浊之物停滞在中脘，应当审察体质的虚实来施治。不如用灯草在疼痛处爆灸十余点，那么寒结去除而内外通畅，疼痛就会停止。
在中脘之下，正当阳明胃土的部位，时而疼痛时而停止的，是中土虚弱而胃气不和。如果服用行血消导的药物过多，就适宜用温补法。只要用手重按疼痛处，疼痛稍微缓解，这是中土内部虚弱，且虚而兼寒的明显证据。（适宜用香砂理中汤。）
乳房下两旁，胸骨尽头处疼痛的，是上下阴阳不和，少阳枢机运转不利的表现。伤寒病中经常多有这种疼痛，应当帮助其枢机运转，调和气血，上下通畅调理就能痊愈。（适宜用小柴胡汤加味。）
大腹疼痛的，是太阴脾土所属的部位。疼痛在内且舒缓的，是坤土（脾）虚寒。疼痛涉及内外且急迫的，是脾络不通畅。大概脾的大络，名叫大包。从经脉隧道向外出于络脉。现在脾络滞涩而不运行，则内外都疼痛。《太阳篇》说：伤寒病中阳脉涩，阴脉弦，按照法度应当腹中急痛，先给予小建中汤。如果不愈，再给予小柴胡汤，这是先在内部补益，然后在外部枢转的道理。
脐旁左右疼痛的，是冲脉病变。冲脉正当脐部左右，如果被寒气凝滞，冲脉的血，不能上行外达，就会在脐部左右疼痛。应当使用入血分的药物，使胞宫中的血液通达肌表，如果使用理气药就没有益处。（适宜用当归四逆汤加吴茱萸、生姜。）
脐下疼痛的，是少阴水脏（肾）。太阳水府（膀胱），得不到阳热之气来施行气化，导致阴寒凝结而疼痛。少阴虚寒，应当用附子、肉桂来温补。太阳水府虚寒，也应当用附子、桂枝来温补。大概太阳与少阴，互为表里，互为中见之气。（也有因火邪逼迫膀胱不通而导致疼痛的情况。）
小腹两旁，称为少腹。少腹痛，是厥阴肝脏所属的部位，又是胞宫中的血海。大概胞宫中的水液，主司于少阴，而胞宫中的血液，主司于厥阴。疼痛的原因，是厥阴肝气，不与胞宫中的血液一起上行。肝脏不虚的，应当疏通使其上行。肝脏虚的，应当补益以助其下行。大概厥阴不从标本，而从从中见少阳之气，使厥阴上合于少阳，就不会疼痛了。
两旁季胁疼痛的，是肝气虚。（适宜用暖肝煎。）两胁上部疼痛的，是少阳之气不和。（适宜用小柴胡汤去掉人参、大枣，加入牡蛎、青皮之类。张景岳说：肾虚羸弱的人多表现为胸胁间隐隐作痛，这是肝肾精虚不能化气，气虚不能生血所致。凡人的气血，就像源泉一样，旺盛则疏通，稀少则壅滞。如果不知道培补气血，只是用行滞通经的方法，则越治越虚，很少有不危险的。）另外高士宗说：疼痛的部位，有气血阴阳的不同，如果一概用行气消导的方法来治疗，漫无边际地说通则不痛。所谓通则不痛，是常理。但是通的法则，各有不同。调气来和血，调血来和气，这就是通。下逆的使其上行，中结的使其旁达，这也是通。虚的辅助它使其通，寒的用温法使其通，无非都是通的方法。如果一定把泻下当作通，那就荒谬了。
Various pains in the upper and lower abdomen, whether caused by Cold (Han), Heat (Re), Deficiency (Xu), or Excess (Shi), can all result in pain. Warming (Wen), Clearing (Qing), Resolving (Xiao), and Tonifying (Bu) methods, as well as various techniques such as releasing the exterior (Biao) and purging the interior (Li), are all employed to alleviate pain; therefore, there is no fixed formula for stopping pain. Now, because *Yixue Zhenzhuan* (The True Transmission of Medicine) analyzes the locations clearly, it serves as a quick method for syndrome differentiation and diagnosis; thus, I record it in full. Alas! The methods in *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) are so exquisite and detailed. After ten years of study, I was ridiculed for being pedantic and impractical. Today, having exhausted my efforts, I know to return to the right path. Nevertheless, I dare not abandon the principles of the ancient sages. Although the content recorded in this compilation claims to follow contemporary trends, it adheres to the principle of valuing purity over blind conformity to authority.
The Heart is the Sovereign and stores the Shen (Spirit); it should not experience pain. What is now referred to as "Heart Pain" is actually due to the Luo-connecting vessels of the Pericardium (the protective outer layer of the heart) failing to communicate laterally with the meridians. (There are specific discussions and formulas for Heart Pain. Here, we fully record Gao Shizong's discussion on this topic for reference. *Zhongfutang Liangfang* (Good Prescriptions from Zhongfu Hall) contains a prescription of Dan Shen (Salvia miltiorrhiza Root) 1 liang, Tan Xiang (Sandalwood Wood) 1 qian, and Sha Ren (Amomum fruit) 1 qian, decocted and taken orally.) Above the Heart meridian lies the chest and diaphragm. Pain in the chest and diaphragm results from the dysfunction of the Upper Jiao (Upper Burner), which fails to irrigate the body like mist and dew, leading to Chest Bi (obstruction syndrome characterized by chest stuffiness and pain). Herbs such as Xie Bai (Allium macrostemon Bulb), Gua Lou Ren (Trichosanthes seed), Bei Mu (Fritillaria bulb), and Dou Kou (Cardamom fruit) can open up Chest Bi and alleviate pain.
Between the two breasts is the Ying-chest area. Pain in the Ying-chest arises from internal deficiency of Liver Blood, where Qi fails to nourish the Qimen acupoint (Front-Mu point of the Liver), causing the blood of the Chong and Ren vessels to fail to disperse from the Ying-chest, resulting in pain. Herbs such as Dang Gui (Angelica sinensis Root), Bai Shao (White Peony Root), Hong Hua (Carthamus flower), Yin Hua (Honeysuckle Flower), Xu Duan (Dipsacus root), and Mu Xiang (Aucklandia root) can harmonize Qi and Blood to stop pain.
When there is pain at the Zhongwan acupoint that cannot be touched by hand: The inability to touch indicates disharmony between the interior and exterior. Externally, Cold Qi condenses in the skin and hair; internally, turbid matter stagnates at Zhongwan. One must examine the constitution for Deficiency or Excess before treating. It is advisable to use Deng Cao (Juncus effusus pith) to cauterize the painful spot about ten times; this will dispel the Cold congealation, restore communication between the interior and exterior, and relieve the pain.
Below Zhongwan, in the region corresponding to the Yangming Stomach Earth, intermittent pain indicates deficiency of the Central Earth and disharmony of Stomach Qi. If too many herbs for moving Blood and resolving accumulation have been taken, warming and tonifying methods are appropriate. If heavy pressure alleviates the pain slightly, this is clear evidence of internal deficiency of the Central Earth, combined with cold. (Xiang Sha Li Zhong Tang (Atractylodes Macrocephala and Amomum Decoction for Regulating the Middle) is suitable.)
Pain at the ends of the sternum below the breasts indicates disharmony between the upper and lower Yin and Yang, and unfavorable rotation of the Shaoyang pivot. This type of pain is common in Shanghan (Cold Damage) diseases. Treatment should assist the pivot mechanism, harmonize Qi and Blood, and ensure smooth regulation between the upper and lower, leading to recovery. (Xiao Chai Hu Tang (Minor Bupleurum Decoction) with modifications is suitable.)
Pain in the large abdomen belongs to the Taiyin Spleen Earth region. Pain that is internal and slow/dull indicates deficiency-cold of Kun Earth (Spleen). Pain that involves both interior and exterior and is urgent/tight indicates obstruction of the Spleen Luo-vessels. The great Luo-vessel of the Spleen is named Da Bao (Great Wrap). It emerges from the meridians outward into the Luo-vessels. When Spleen Luo-vessels are stagnant and non-functional, both interior and exterior areas hurt. The *Taiyang Pian* (Chapter on Taiyang) states: In Shanghan disease, if the Yang pulse is choppy and the Yin pulse is wiry, according to the rules, there should be urgent abdominal pain. First administer Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). If not cured, then administer Xiao Chai Hu Tang. This illustrates first tonifying internally, then rotating externally.
Pain to the left and right of the umbilicus indicates pathology of the Chong vessel. The Chong vessel runs alongside the umbilicus. If congealed by Cold Qi, the blood of the Chong vessel cannot ascend or reach the exterior, causing pain around the umbilicus. Herbs entering the Blood level should be used to make the blood of the Baozhong (Uterus/Abdominal Center) reach the muscle surface; using Qi-moving herbs would be of little benefit. (Dang Gui Si Ni Tang (Angelica Four Reversals Decoction) with added Wu Zhu Yu (Evodia fruit) and Sheng Jiang (Fresh Ginger) is suitable.)
Pain below the umbilicus involves the Shaoyin Water Organ (Kidney). The Taiyin Water Mansion (Bladder) fails to receive Yang-heat Qi to perform transformation, leading to pain from Yin-Cold congealation. For Shaoyin deficiency-cold, Fu Zi (Aconite lateral root) and Rou Gui (Cinnamon bark) should be used to warm. For Taiyin Water Mansion deficiency-cold, Fu Zi and Gui Zhi (Cinnamon twig) should also be used to warm. The Taiyin and Shaoyin are exterior-interior pairs and mutually reveal each other's nature. (There are also cases of pain due to Fire forcing Bladder obstruction.)
The sides of the small abdomen are called Shaofu (Lesser Abdomen). Pain in the Shaofu belongs to the Jueyin Liver region and is also the Sea of Blood of the Baozhong. The water of the Baozhong is governed by Shaoyin, while the blood of the Baozhong is governed by Jueyin. Pain occurs because Jueyin Liver Qi does not ascend together with the blood of the Baozhong. If the Liver is not deficient, unblocking and dredging should be used to facilitate ascent. If the Liver is deficient, tonification should be used to support descent. Jueyin does not follow the standard or reverse aspects but follows its intermediate Shaoyang Qi; when Jueyin harmonizes upward with Shaoyang, pain ceases.
Pain in the hypochondriac regions on both sides indicates Liver Qi deficiency. (Nuan Gan Jian (Warming the Liver Decoction) is suitable.) Pain in the upper part of both hypochondria indicates disharmony of Shaoyang Qi. (Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Ren (Ginseng) and Zao (Jujube) removed, plus Mu Li (Oyster shell) and Qing Pi (Tangerine peel) is suitable. Zhang Jingyue stated: People with Kidney deficiency and emaciation often experience dull pain in the chest and hypochondrium. This is due to deficiency of Essence and Qi of the Liver and Kidney failing to transform Qi, and Qi deficiency failing to generate Blood. Human Qi and Blood are like a spring source; when abundant, they flow smoothly; when scarce, they stagnate. If one does not nourish and tonify Qi and Blood, but only uses methods to move stagnation and unblock collaterals, the condition will worsen with treatment, leading to danger.) Furthermore, Gao Shizong said: Different parts of pain involve different Qi, Blood, Yin, and Yang. If one generally treats with Qi-moving and digestion-resolving methods, claiming broadly that "unblocked means no pain," this is simplistic. While "unblocked means no pain" is a general principle, the methods of "unblocking" vary. Harmonizing Qi to regulate Blood, and regulating Blood to harmonize Qi, constitutes unblocking. Directing downward-rebellious Qi upward, and dispersing central knots laterally, also constitutes unblocking. Assisting the deficient to achieve flow, and warming the cold to achieve flow—these are all methods of unblocking. To equate unblocking solely with purgation/downward-draining is absurd.