少年素有 癖，忽然少腹胀疼。屡次服药，多系开气行气之品，或不效，或效而复发。脉象无力。以
愚意见度之，不宜再用开气行气之药。近在奉天有治腹疼二案，详录于下，以备参考。
一为门生张××，少腹素有寒积，因饮食失慎，肠结，大便不下，少腹胀疼，两日饮食不进。用蓖麻
油下之，便行三次而疼胀如故。又投以温暖下焦之剂，服后亦不觉热，而疼胀如故。细诊其脉，沉而无力。
询之，微觉短气。疑系胸中大气下陷，先用柴胡二钱煎汤试服，疼胀少瘥。遂用生箭 一两，当归、党参各三
钱，升麻、柴胡、桔梗各钱半，煎服一剂，疼胀全消，气息亦顺，惟觉口中发干。又即原方去升麻、党参，加
知母三钱，连服数剂全愈。
一为奉天史姓学生，少腹疼痛颇剧，脉左右皆沉而无力。疑为气血凝滞，治以当归、丹参、乳香、没
药各三钱，莱菔子二钱，煎服后疼益甚，且觉短气。再诊其脉，愈形沉弱。遂改用升陷汤一剂而愈。此亦大
气下陷，迫挤少腹作疼，是以破其气则疼益甚，升举其气则疼自愈也。
若疑因有 癖作疼，愚曾经验一善化 癖之法。忆在籍时，有人问下焦虚寒治法，俾日服鹿角胶三钱，
取其温而且补也。后月余晤面，言服药甚效，而兼获意外之效∶少腹素有积聚甚硬，
前竟忘言，因连服鹿角胶已尽消。盖鹿角胶具温补之性，而又善通血脉，林屋山人阳和汤用之以消硬疽，
是以有效也。又尝阅喻氏《寓意草》，载有袁聚东痞块危证治验，亦宜参观。
少年素来患有癥癖（腹内结块），突然感到少腹部胀满疼痛。多次服药，大多属于行气、破气的药物，要么无效，要么见效后复发。脉象无力。依愚者之见，不适宜再使用行气破气的药物。最近在奉天有两例治疗腹痛的案例，详细记录如下，供参考。
一例是门生张某某，少腹部素来有寒性积滞，因为饮食不慎，导致肠道闭塞，大便不通，少腹胀痛，两天没有进食。用蓖麻油通便，排便三次后，胀痛依旧。又给予温补下焦的药剂，服用后也不觉得热，但胀痛依旧。仔细诊察其脉象，沉而无力。询问病情，感觉轻微的气短。怀疑是胸中大气下陷，先用柴胡二钱煎汤试服，胀痛稍有好转。于是用生黄芪一两，当归、党参各三钱，升麻、柴胡、桔梗各一钱半，煎服一剂，胀痛完全消除，气息也顺畅了，只是觉得口中发干。随即在原方中去掉升麻、党参，加入知母三钱，连续服用几剂后痊愈。
另一例是奉天姓史的学生，少腹疼痛非常剧烈，左右脉象都沉而无力。怀疑是气血凝滞，治疗使用当归、丹参、乳香、没药各三钱，莱菔子二钱，煎服后疼痛反而加剧，并且感觉气短。再次诊察脉象，更加沉弱。于是改用升陷汤一剂而痊愈。这也是因为大气下陷，压迫少腹导致疼痛，所以破除气机则疼痛加剧，升举气机则疼痛自愈。
如果怀疑是因为有癥癖作痛，我曾经验过一种善化癥癖的方法。回忆在家乡时，有人询问下焦虚寒的治疗方法，让他每天服用鹿角胶三钱，取其既能温阳又能补益的特性。后来一个多月见面，他说服药很有效，而且获得了意外的效果：少腹部素来有非常坚硬的积聚物，之前竟然忘了提及，因为连续服用鹿角胶已经全部消散。大概鹿角胶具有温补的性质，而又善于疏通血脉，林屋山人所用的阳和汤用它来消除硬疽，所以有效。又曾阅读喻嘉言的《寓意草》，其中记载了袁聚东痞块危重证候的治疗验证，也宜参考。
The patient, a young man, had long suffered from *zheng* masses (abdominal masses), and suddenly experienced distension and pain in the lower abdomen. He had taken medicine several times, mostly consisting of Qi-moving and Qi-breaking herbs, but either with no effect or with recurrence after temporary relief. The pulse was weak. In my opinion, it is not appropriate to continue using Qi-moving and Qi-breaking medicines. Recently, there were two cases of abdominal pain treated in Fengtian, recorded in detail below for reference.
One case involved my student, Zhang XX. He had long had cold accumulation in the lower abdomen. Due to dietary indiscretion, his intestines became obstructed, stool did not pass, and he suffered from lower abdominal distension and pain, unable to eat for two days. Castor oil was used to promote defecation; after three bowel movements, the distension and pain remained unchanged. A decoction warming the Lower Jiao was then administered, but even after taking it, he felt no warmth, and the distension and pain persisted. Upon careful examination of the pulse, it was deep and weak. Inquiry revealed slight shortness of breath. I suspected sinking of the Great Qi in the chest. I first tried administering Chai Hu (Bupleuri Radix) 2 qian decocted in water as a test dose, which resulted in slight improvement of the distension and pain. Subsequently, I prescribed Sheng Huang Qi (Astragali Radix) 1 liang, Dang Gui (Angelicae Sinensis Radix) and Dang Shen (Codonopsis Radix) each 3 qian, Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) each 1.5 qian, and Jie Geng (Platycodonis Radix) 1.5 qian. After one dose decocted and taken, the distension and pain completely disappeared, and breathing became smooth, although he felt dryness in the mouth. Immediately thereafter, Sheng Ma and Dang Shen were removed from the original formula, and Zhi Mu (Anemarrhenae Rhizoma) 3 qian was added. After taking this modified formula for several doses, he fully recovered.
Another case involved a student surnamed Shi from Fengtian. His lower abdominal pain was quite severe, and both left and right pulses were deep and weak. I suspected Qi and Blood stagnation and treated him with Dang Gui (Angelicae Sinensis Radix), Dan Shen (Salviae Miltiorrhizae Radix), Ru Xiang (Olibanum), Mo Yao (Myrrha), each 3 qian, and Lai Fu Zi (Radish Seed) 2 qian. After taking the decoction, the pain worsened, and he felt shortness of breath. Re-examination of the pulse showed it to be even more deep and weak. I then switched to Sheng Xian Tang (Ascending the Sinking Decoction), one dose, and he recovered. This was also due to the sinking of the Great Qi, which pressed upon the lower abdomen causing pain; thus, breaking the Qi aggravated the pain, while lifting the Qi cured it.
If one suspects the pain is caused by *zheng* masses, I have experience with a method to effectively resolve such masses. Recalling when I was at home, someone asked about the treatment for deficiency-cold of the Lower Jiao. I advised him to take Lu Jiao Jiao (Deer-Horn Glue) 3 qian daily, taking advantage of its warming and tonifying properties. Over a month later, we met again, and he said the medication was very effective, yielding an unexpected benefit: he had long had hard accumulations in the lower abdomen, which he had previously forgotten to mention, but they had completely dissipated due to continuous intake of Lu Jiao Jiao. It seems Lu Jiao Jiao possesses warming and tonifying nature, and is also good at unblocking blood vessels. Linwu Shanren used it in Yang He Tang (Yang-Harmonizing Decoction) to eliminate hard abscesses, hence its efficacy. I also once read Yu Jiayan's *Yi Yi Cao* (Meaningful Grass), which records a critical case of Pi Kuai (obstructive mass) involving Yuan Judong and its successful treatment; this should also be consulted.