、良姜；气虚，加参、术；血虚，加当归；大虚厥逆，加姜、附；肝火，加青黛、青皮、
黄连；痰饮，加白螺壳、滑石、南星；食积，加砂仁、香附；瘀血，加韭汁、桔梗；虫痛
，加苦楝根，或木香、槟榔；急痛，加胡椒，略用斑蝥炒过；痛不可忍，加细茶、乳香，或
石。凡痛攻走腰背，发厥呕吐，诸药不效
者，加苍
术、川芎、山栀，探吐积痰碗许乃愈。
劫痛丸丹可入唇。
寒者，九痛丸、却痛散；热者，散痛丸、通灵散；有积，神保丸；瘀血，单干漆
丸；通用手拈散、如意丹、神圣代针散。
腹痛（附腹中窄狭）
腹痛大小分阴阳，
大腹痛，多食积外邪；脐腹痛，多积热痰火；小腹痛，多瘀血及痰与溺涩；脐下
卒大痛，人中黑者，中恶客忤，不治。阴证，满腹牵痛，自利或呕，喜按少食，绵绵不减，
宜温之。阳证，腹中觉热，甚则大便闭涩，胀满怕按，时痛时止，宜下之。
寒痛绵绵热不常；
旧以虚痛喜按，实痛怕按，但寒热邪有浅深，不可太泥。经谓∶寒气入经，客于
卫分，则血涩急痛，按之热则止；寒气客于荣分，则气郁满痛，甚怕按；寒气客肠胃募原，
血络急引皮痛，按之则气血散而痛止；寒气客侠脊背俞之脉，则深按之不能及也；寒气客关
元，则气逆喘；寒气客厥阴脉络，则胁肋与小腹或阴股引痛；寒气客小肠募原之间，则血气
凝聚成积；寒气客小肠不聚，则腹痛而泄；寒气客胃，则腹痛而呕；寒气客五脏，则痛死复
生。治伤寒腹痛，详三卷。寻常外感冒寒证卒痛，吐利俱酸，喜热物熨者，五积散加
吴萸、木瓜、煨葱，或藿香正气散加木香少许；风证，桂枝汤加芍药，或胃风汤加木香；
暑证，香薷散加生姜、陈壁土、红蓼、木瓜，或五苓散；湿证，除湿汤，或香苏散加苍术
、枳壳。积热，时痛时止，痛处亦热，手不可近，便闭喜冷，宜四顺清凉饮、大承气汤、三
黄丸；老人，麻子仁丸。
食积有形便后减，
食积郁结，肠胃作痛，得大便后则减者，宜平胃散加消导药，或保和丸、枳术丸
、红丸子调之，或木香槟榔丸、大黄备急丸、神保丸、如意丹下之。又有食填胸满，心胃作
痛者，宜大吐之。
湿痰溺涩火鸣肠。
湿痰阻滞气道，必小便不利，或二便俱不利，宜芎术散。如清痰留滞胸腹作声
者，控涎丹、小胃丹。痰火痛，乃火欲升，水欲降，相击肠鸣者，二陈汤加芩、连、山栀；
如怒火攻冲，痛无定处、定时者，更加香附、芍药、青皮。又有粪结肠鸣作痛，不大便者，
大黄备急丸之类通之。如脏寒冷结肠鸣者，宜分三阴，以温药治之
。
虫痛吐水定能食，
虫痛，肚大青筋，往来绞痛，痛定能食，发作有时，不比诸痛停聚不散，乌梅丸
、化虫丸。
七情气痛痞胸膛；
七情痛，心胸痞闷，或攻注胁背。虚者，七气汤、木香匀气散、
木香化滞汤；实
者，三和散、分心气饮。
中虚全不思饮食，
中虚脾弱，隐隐冷痛，全不思食者，人参养胃汤加肉桂、吴萸、木香。素气虚挟
痰者，六君子汤加苍术。
瘀血痛必着一方。
瘀血，痛有常外，或忧思逆郁，跌扑伤瘀，或妇人经来、产后恶瘀不尽而凝，四
物汤去地黄，加桃仁、大黄、红花。又血虚郁火，燥结阻气不运而痛者，四物汤倍芍药，加
炒干姜。凡痛多属血涩，通用芍药甘草汤为主，恶寒而痛属脾肾，加肉桂；恶热而痛属脾胃
，加黄芩。脉缓伤水，加桂枝；脉涩伤血，加当归；脉迟伤寒，加干姜；脐下痛，加熟地。
惟气分诸痛，不宜芍药酸收，宜木香、槟榔、青皮、陈皮、香附辛散之。劫痛，手拈散。
初起虚温实宜荡，
虚宜辛温消散，烧脾散、蟠葱散、丁香脾积丸。果系沉寒痼冷，小腹下痛者，酒
煮当归丸。经曰∶结者散之是也。实宜辛寒推荡，经曰∶通因通用，痛随利减是也。方与积
热痛同。
久则升消理胃房；
腹属坤，久病宜和脾胃。如脉弦急，木克土也，小建中汤加当归，取芍药味酸，
于土中泻木为君；如脉沉细，水侮土也，理中汤，取干姜辛热，于土中泻水为君；如脉缓，
腹痛自利，米谷不化，平胃散加肉桂、吴萸，取苍术苦辛，泻湿土为君。胃气下陷者，加
升麻、柴胡、苍术以升之；有积者，加山楂、麦芽、枳实、黄连、木香以消之。上热下寒，
升降失常，腹痛呕吐者，黄连汤主之。疝痛引睾丸，痢痛拘急，积聚痛有形可按，肠痈痛，
脐生疮，小便如淋、脉芤，痧证痛甚，呕吐、脉沉，治见各条。
腹中窄狭性偏躁，无非痰火善为殃。
腹中自觉窄狭，神昏性躁，乃湿痰浊气攻于心脾，以致升降失常，肥人多湿痰，
宜二陈汤加苍术燥湿，香附行气；瘦人多火，宜二陈汤加黄连清热，苍术流湿；心神不敛者
，俱加远志、麦门冬、酸枣仁。血气虚者，六君子汤加芎、归养血流湿，自然平复。
良姜；气虚者，加人参、白术；血虚者，加当归；大虚且出现四肢厥冷逆乱者，加干姜、附子；肝火旺者，加青黛、青皮、黄连；痰饮内停者，加白螺壳、滑石、天南星；食积停滞者，加砂仁、香附；瘀血阻滞者，加韭菜汁、桔梗；虫痛者，加苦楝根，或木香、槟榔；急痛者，加胡椒，略用炒过的斑蝥；疼痛难以忍受者，加细茶、乳香，或石（此处原文似有缺字，通常指石膏或特定矿物药，依原文保留“石”）；凡是疼痛攻窜至腰背部，伴有发厥呕吐，服用各种药物无效者，加苍术、川芎、山栀，通过探吐排出约一碗的积痰即可痊愈。劫痛丸丹可含于唇边。
寒性疼痛，用九痛丸、却痛散；热性疼痛，用散痛丸、通灵散；有积滞者，用神保丸；瘀血所致者，单用干漆丸；通用方剂用手拈散、如意丹、神圣代针散。
腹痛（附腹中窄狭感）
腹痛大小分阴阳：大腹痛，多因饮食积滞和外邪侵袭；脐周腹痛，多因积热、痰火；小腹痛，多因瘀血以及痰饮和小便涩滞；脐下突然剧烈疼痛，人中部位发黑者，为中恶客忤，属不治之症。阴证表现为满腹牵引作痛，自发性腹泻或呕吐，喜欢按压且食欲减退，疼痛绵绵不绝，宜用温法治疗。阳证表现为腹部感觉发热，严重则大便闭塞不通，胀满且怕按压，疼痛时作时止，宜用下法治疗。
寒痛绵绵而热象不常现；
以往认为虚痛喜欢按压，实痛害怕按压，但寒热邪气有深浅之分，不可过于拘泥。《内经》说：寒气侵入经脉，客居于卫分，则血液涩滞引起急痛，按压后产生热量则疼痛停止；寒气客居于荣分，则气机郁结导致胀满疼痛，甚至害怕按压；寒气客居于肠胃募原，血络紧急牵引皮肤疼痛，按压则气血疏散而疼痛停止；寒气客居于夹脊背俞的脉络，则深按无法触及病所；寒气客居关元穴处，则气逆喘息；寒气客居于厥阴脉络，则胁肋与小腹或大腿内侧牵引疼痛；寒气客居于小肠募原之间，则血气凝聚形成积块；寒气客居小肠使其不能聚敛，则腹痛而泄泻；寒气客居胃腑，则腹痛而呕吐；寒气客居五脏，则疼痛剧烈至昏死复生。治疗伤寒引起的腹痛，详见第三卷。寻常外感风寒证突发疼痛，呕吐和腹泻均带有酸味，喜欢用热物熨烫者，用五积散加吴茱萸、木瓜，或藿香正气散加少许木香；风证，用桂枝汤加芍药，或胃风汤加木香；暑证，用香薷散加生姜、陈壁土、红蓼、木瓜，或五苓散；湿证，用除湿汤，或香苏散加苍术、枳壳。积热证，时痛时止，疼痛部位也发热，手不可靠近，大便闭塞喜冷，宜用四顺清凉饮、大承气汤、三黄丸；老年人，用麻子仁丸。
食积有形，大便通畅后疼痛减轻；
食积郁结，肠胃作痛，得大便后则减轻者，宜用平胃散加消导药，或保和丸、枳术丸、红丸子调理，或用木香槟榔丸、大黄备急丸、神保丸、如意丹攻下。又有食物填塞胸膈胀满，心胃作痛者，宜用催吐法。
湿痰阻滞致小便涩滞，火邪鸣响于肠间。
湿痰阻滞气道，必然小便不利，或二便都不利，宜用芎术散。如清痰留滞胸腹发出声响者，用控涎丹、小胃丹。痰火痛，是火欲上升，水欲下降，相互撞击导致肠鸣者，用二陈汤加黄芩、黄连、山栀；如怒火攻冲，疼痛无固定位置和时间的，再加香附、芍药、青皮。又有粪便结肠鸣作痛，不大便者，用大黄备急丸之类通利。如脏寒冷结肠鸣者，宜分辨三阴经，用温药治疗。
虫痛吐水，定能进食；
虫痛，肚子大且有青筋暴露，往来绞痛，疼痛停止时能进食，发作有定时，不像其他疼痛那样停聚不散，用乌梅丸、化虫丸。
七情气痛痞塞胸膛；
七情所致疼痛，心胸痞闷，或攻注胁背。虚证，用七气汤、木香匀气散、木香化滞汤；实证，用三和散、分心气饮。
中焦虚弱完全不想饮食；
中焦虚弱脾弱，隐隐冷痛，完全不想吃东西者，用人参养胃汤加肉桂、吴茱萸、木香。素来气虚兼挟痰湿者，用六君子汤加苍术。
瘀血疼痛必定固定在一处。
瘀血疼痛，部位固定，或因忧思逆郁，跌扑损伤瘀血，或妇女经期、产后恶露不尽而凝结，用四物汤去地黄，加桃仁、大黄、红花。又血虚郁火，燥结阻碍气机运行而疼痛者，用四物汤倍用芍药，加炒干姜。凡是疼痛多属于血涩，通用芍药甘草汤为主方，恶寒而痛属脾肾，加肉桂；恶热而痛属脾胃，加黄芩。脉缓伤水，加桂枝；脉涩伤血，加当归；脉迟伤寒，加干姜；脐下痛，加熟地。只有气分诸痛，不宜用芍药的酸收，宜用木香、槟榔、青皮、陈皮、香附辛散之。劫痛，用手拈散。
初起虚证宜温，实证宜荡涤；
虚证宜用辛温消散，烧脾散、蟠葱散、丁香脾积丸。果真是沉寒痼冷，小腹下部疼痛者，用酒煮当归丸。《内经》说：结者散之。实证宜用辛寒推荡，《内经》说：通因通用，痛随利减。方剂与积热痛相同。
久病则升提消导，调理脾胃；
腹部属坤土，久病宜调和脾胃。如脉弦急，是木克土，用小建中汤加当归，取芍药味酸，在土中泻木为君药；如脉沉细，是水侮土，用理中汤，取干姜辛热，在土中泻水为君药；如脉缓，腹痛自利，米谷不化，用平胃散加肉桂、吴茱萸，取苍术苦辛，泻湿土为君药。胃气下陷者，加升麻、柴胡、苍术以升提；有积滞者，加山楂、麦芽、枳实、黄连、木香以消导。上热下寒，升降失常，腹痛呕吐者，用黄连汤主治。疝痛牵引睾丸，痢疾疼痛拘急，积聚疼痛有形可按，肠痈疼痛，脐部生疮，小便如淋、脉芤，痧证疼痛剧烈，呕吐、脉沉，治法见各条目。
腹中窄狭性质偏急躁，无非是痰火善于作殃。
腹中自觉窄狭，神志昏蒙性情急躁，是湿痰浊气攻于心脾，导致升降失常，肥人多湿痰，宜用二陈汤加苍术燥湿，香附行气；瘦人多火，宜用二陈汤加黄连清热，苍术流湿；心神不收敛者，都加远志、麦门冬、酸枣仁。血气虚者，用六君子汤加川芎、当归养血活血祛湿，自然平复。
Rhizoma Zingiberis (Shengjiang, 生姜) [Note: Context implies Rhizoma Alpiniae Officinarum/Liangjiang based on text "Liangjiang"]; for Qi deficiency, add Ginseng Radix et Rhizoma (Renshen, 人参) and Atractylodis Macrocephalae Rhizoma (Baizhu, 白术); for Blood deficiency, add Angelicae Sinensis Radix (Danggui, 当归); for severe deficiency with cold extremities and reversal, add Zingiberis Rhizoma (Shengjiang, 生姜) and Aconiti Lateralis Radix Praeparata (Fuzi, 附子); for Liver Fire, add Indigo Naturalis (Qingdai, 青黛), Tangerini Pericarpium Viride (Qingpi, 青皮), and Coptidis Rhizoma (Huanglian, 黄连); for Phlegm-Fluid retention, add Concha Vivipari (Bailuoke, 白螺壳), Talcum (Huashi, 滑石), and Pinelliae Rhizoma Preparatum (Nanxing, 南星); for Food Stagnation, add Amomi Fructus Rotundus (Sharen, 砂仁) and Cyperi Rhizoma (Xiangfu, 香附); for Blood Stasis, add Juice of Allii Tuberosi (Jiuji, 韭汁) and Platycodonis Radix (Jiegeng, 桔梗); for Worm Pain, add Radix Meliae Toosendan (Kulian Gen, 苦楝根), or Cyperi Rhizoma (Muxiang, 木香) and Arecae Semen (Binglang, 槟榔); for acute pain, add Piperis Fructus (Hujiao, 胡椒), used slightly with processed Mylabris (Banmao, 斑蝥); for unbearable pain, add Fine Tea (Xicha, 细茶) and Olibanum (Ruxiang, 乳香), or Shi (Stone, 石); for pain radiating to the lower back accompanied by fainting and vomiting, unresponsive to other medicines, add Atractylodis Rhizoma (Cangzhu, 苍术), Ligustici Chuanxiong Rhizoma (Chuanxiong, 川芎), and Gardeniae Fructus (Shanzhi, 山栀), induce vomiting to expel about one bowl of accumulated phlegm for recovery. Jietong Wan/Dan can be held in the lips.
For Cold patterns, use Jiutong Wan (Nine-Pain Pill) andquetong San (Pain-Relieving Powder); for Heat patterns, use Santong Wan (Pain-Scattering Pill) and Tongling San (Spirit-Connecting Powder); for accumulation, use Shenbao Wan (Divine Protection Pill); for Blood Stasis, use Ganqi Wan (Dry Lacquer Pill) alone; commonly used formulas include Shou Niansan (Hand-Picking Powder), Ruyi Dan (As-Desired Pill), and Shensheng Daizhen San (Divine Needle-Replacement Powder).
Abdominal Pain (with a sensation of narrowness in the abdomen)
Abdominal pain is differentiated into Yin and Yang based on location: Greater abdominal pain is mostly due to Food Stagnation and external pathogens; periumbilical pain is mostly due to accumulated Heat, Phlegm, and Fire; lesser abdominal pain is mostly due to Blood Stasis, Phlegm, and difficult urination; sudden severe pain below the umbilicus with blackening of the philtrum indicates Zhong'e (Evil Invasion) or Ke Wu (Guest Hostility), which is untreatable. Yin patterns manifest as full abdominal pulling pain, spontaneous diarrhea or vomiting, preference for pressure and reduced appetite, with continuous mild pain, suitable for warming treatment. Yang patterns manifest as a feeling of heat in the abdomen, severe cases with constipation, distension, aversion to pressure, and intermittent pain, suitable for purgative treatment.
Cold pain is continuous with infrequent Heat;
Traditionally, it was believed that Deficiency pain prefers pressure while Excess pain fears pressure, but Cold and Heat pathogens have varying depths, so one should not be too rigid. The Classic states: When Cold Qi enters the meridians and lodges in the Wei (Defensive) level, blood becomes stagnant causing acute pain, which stops when pressure generates heat; when Cold Qi lodges in the Ying (Nutritive) level, Qi stagnation causes distending pain, often fearing pressure; when Cold Qi lodges in the Mu Yuan (Diaphragmatic Origin) of the stomach and intestines, blood vessels contract pulling the skin, causing pain that stops when pressed as Qi and Blood disperse; when Cold Qi lodges in the meridians along the spine and Back-Shu points, deep pressing cannot reach the disease site; when Cold Qi lodges at Guanyuan (CV4), Qi rebels causing wheezing; when Cold Qi lodges in the Jueyin meridians, the hypochondrium, lower abdomen, or inner thigh may experience pulling pain; when Cold Qi lodges between the Mu Yuan of the Small Intestine, Qi and Blood condense forming masses; when Cold Qi lodges in the Small Intestine preventing its gathering function, abdominal pain and diarrhea occur; when Cold Qi lodges in the Stomach, abdominal pain and vomiting occur; when Cold Qi lodges in the Five Zang Organs, pain is severe enough to cause death followed by revival. For treating abdominal pain caused by Shanghan (Cold Damage), see Volume 3. For common external Cold invasion with sudden pain, sour vomiting and diarrhea, and preference for hot compresses, use Wujie San (Five Accumulations Powder) with Evodiae Fructus (Wuyu, 吴茱萸) and Papaveris Semen (Mugua, 木瓜), or Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) with a small amount of Aucklandiae Radix (Muxiang, 木香); for Wind patterns, use Guizhi Tang (Cinnamon Twig Decoction) with Paeoniae Radix Alba (Shaoyao, 芍药), or Weifeng Tang (Stomach Wind Decoction) with Muxiang; for Summerheat patterns, use Xiangru San (Elsholtzia Powder) with Zingiberis Rhizoma Recens (Shengjiang, 生姜), Chen Bitu (Old Wall Soil), Polygoni Multiflori Vine (Hongliao, 红蓼), and Mugua, or Wuling San (Five-Ling Powder); for Dampness patterns, use Chushi Tang (Dampness-Removing Decoction) or Xiangsu San (Aucklandia and Perilla Powder) with Cangzhu and Aurantii Fructus (Zhike, 枳壳). For Accumulated Heat patterns, intermittent pain with heat at the painful site, intolerance to touch, constipation, and preference for cold, use Sishun Qingliang Yin (Four-Obedient Cooling Drink), Dachengqi Tang (Major Order the Qi Decoction), or Sanhuang Wan (Three-Yellow Pill); for the elderly, use Maziren Wan (Hemp Seed Pill).
Food Stagnation has tangible form and pain reduces after defecation;
For pain caused by Food Stagnation and intestinal blockage that reduces after defecation, use Pingwei San (Calm the Stomach Powder) with digestive herbs, or Baohe Wan (Preserve Harmony Pill), Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill), or Hongwanzi (Red Pill) for regulation, or purge with Muxiang Binglang Wan (Aucklandia and Areca Pill), Dahuang Beiji Wan (Rhubarb Emergency Pill), Shenbao Wan, or Ruyi Dan. For food filling the chest causing fullness and heart/stomach pain, induce vomiting.
Damp-Phlegm obstruction leads to difficult urination, Fire resonates in the intestines.
When Damp-Phlegm obstructs the Qi pathway, urination is necessarily difficult, or both urine and stool are difficult, use Xiongzhu San (Peony and Atractylodes Powder). For clear Phlegm滞留 in the chest and abdomen making sounds, use Kongxian Dan (Saliva-Controlling Pill) or Xiaowei Dan (Small Stomach Pill). Phlegm-Fire pain, where Fire desires to rise and Water desires to descend, striking each other causing borborygmus, use Erchen Tang (Two-Aged Decoction) with Scutellariae Radix (Huangqin, 黄芩), Huanglian, and Shanzhi; if Angry Fire attacks with pain having no fixed location or time, add Xiangfu, Shaoyao, and Qingpi. For fecal impaction with borborygmus and pain without defecation, use Dahuang Beiji Wan to unblock. For Cold-Damp causing intestinal borborygmus, differentiate the Three Yin channels and treat with warming medicines.
Worm pain involves vomiting water, yet the patient can eat;
Worm pain presents with a large abdomen and visible blue veins, colicky pain moving around, ability to eat when pain subsides, and regular episodes, unlike other pains that remain stationary. Use Wumei Wan (Mume Pill) or Huachong Wan (Worm-Transforming Pill).
Seven Emotions Qi pain causes chest fullness;
Pain from Seven Emotions manifests as chest stuffiness or radiation to the hypochondrium and back. For Deficiency, use Qiqi Tang (Seven-Qi Decoction), Muxiang Yunqi San (Aucklandia Regulating Qi Powder), or Muxiang Huazhi Tang (Aucklandia Resolving Stagnation Decoction); for Excess, use Sanhe San (Three-Harmonies Powder) or Fenxin Qi Yin (Separate Heart Qi Drink).
Middle Jiao deficiency leads to complete loss of appetite;
For Middle Jiao deficiency and Spleen weakness with dull cold pain and no desire to eat, use Renshen Yangwei Tang (Ginseng Nourishing Stomach Decoction) with Rougui (Cinnamon Bark), Wuyu, and Muxiang. For those with chronic Qi deficiency and Phlegm, use Liujunzi Tang (Six-Gentlemen Decoction) with Cangzhu.
Blood Stasis pain is always localized.
Blood Stasis pain is fixed in location, or due to worry/thought rebellion/depression, trauma, or women's menstrual/postpartum lochia remaining and coagulating. Use Siwu Tang (Four-Materials Decoction) removing Rehmanniae Radix (Dihuang, 地黄), adding Persicae Semen (Taoren, 桃仁), Dahuang, and Carthami Flos (Honghua, 红花). For Blood Deficiency with constrained Fire, dryness/blockage hindering Qi movement causing pain, use Siwu Tang doubling Shaoyao, adding fried Shengjiang. Generally, pain belongs to Blood stagnation; commonly use Shaoyao Gancao Tang (Peony and Licorice Decoction) as the main formula. Pain with aversion to Cold belongs to Spleen/Kidney, add Rougui; pain with aversion to Heat belongs to Stomach/Spleen, add Huangqin. Slow pulse indicates Water injury, add Guizhi; choppy pulse indicates Blood injury, add Danggui; delayed pulse indicates Cold Damage, add Ganjiang (Dried Ginger); pain below the umbilicus, add Shudi (Prepared Rehmannia). For Qi-level pains, avoid Shaoyao's astringency; use Muxiang, Binglang, Qingpi, Chenpi, and Xiangfu for dispersing. For seizing pain, use Shou Niansan.
Early stage: Deficiency requires warming dispersion, Excess requires purging;
Deficiency requires acrid-warm dispersion: Shaopi San (Spleen-Burning Powder), Pancong San (Scallion-Coiling Powder), Dingxiang Pi Ji Wan (Clove Spleen-Accumulation Pill). If truly Deep-Cold and Chronic-Cold with lower abdominal pain, use Jiuzhu Dangui Wan (Wine-Boiled Angelica Pill). The Classic says: Disperse what is knotted. Excess requires acrid-cold pushing/purging: The Classic says: Treat obstruction with unblocking methods; pain decreases with relief. Formulas are the same as for Accumulated Heat pain.
Long-standing illness requires ascending and eliminating, regulating the Stomach and Intestines;
The abdomen belongs to Kun (Earth); long-term illness requires harmonizing Spleen and Stomach. If the pulse is wiry and urgent, Wood overacts on Earth; use Xiaojianzhong Tang (Minor Construct the Middle Decoction) with Danggui, using Shaoyao's sour taste to drain Wood within Earth as the sovereign herb; if the pulse is deep and fine, Water insults Earth; use Lizhong Tang (Regulate the Middle Decoction), using Ganjiang's acrid-hot nature to drain Water within Earth as the sovereign herb; if the pulse is slow, with abdominal pain, spontaneous diarrhea, and undigested food, use Pingwei San with Rougui and Wuyu, using Cangzhu's bitter-acrid nature to drain Damp-Earth as the sovereign herb. For sinking Stomach Qi, add Shengma, Chaihu, and Cangzhu to ascend; for accumulation, add Hawthorn Fruit (Shanzha, 山楂), Maltae Fructus (Maiya, 麦芽), Zhi Shi (Immature Bitter Orange), Huanglian, and Muxiang to eliminate. For Upper Heat and Lower Cold with abnormal ascending/descending, abdominal pain, and vomiting, use Huanglian Tang (Coptis Decoction). Hernia pain radiating to the testicles, dysentery pain with spasms, mass pain palpable, intestinal abscess pain, umbilical sores, stranguria-like urination with a hollow pulse, severe Sha syndrome pain, vomiting with a deep pulse—treatments are detailed in respective sections.
Narrowness in the abdomen indicates irritability, caused by Phlegm-Fire misfortune.
A subjective sensation of abdominal narrowness with mental confusion and irritability is caused by Damp-Phlegm and turbid Qi attacking the Heart and Spleen, leading to abnormal ascending/descending. Fat people tend to have Damp-Phlegm; use Erchen Tang with Cangzhu to dry Dampness and Xiangfu to move Qi. Thin people tend to have Fire; use Erchen Tang with Huanglian to clear Heat and Cangzhu to flow Dampness. For unconverged Heart Spirit, add Yuanzhi (Polygalae Radix), Maidong (Ophiopogonis Radix), and Suanzaoren (Ziziphus Seed). For Qi and Blood deficiency, use Liujunzi Tang with Chuanxiong and Danggui to nourish Blood and flow Dampness, leading to natural recovery.