[总诀]膀胱胞室与肝经,时辈犹知此数层。独于瘕气和寒疝,此意从来少识人。
小腹满痛,由于小便不通者,膀胱之水结也。宜加味五苓散。
白芍(三钱) 白术(三钱) 云苓(三钱) 猪苓(三钱) 泽泻(三钱) 杏仁(三钱) 桂枝(二
钱)
歌曰∶小腹疼时便溺穷,膀胱水结二苓攻。
术和桂泽心阳导,芍杏还从肝肺通。
小腹满痛,小便仍然通利者,胞宫之血结也。宜加减桃仁汤(重者加大黄)。
桃仁(一钱) 蒲黄(三钱) 赤芍(二钱) 白芍(二钱) 灵脂(三钱) 郁金(一钱) 归尾(三
钱) 木香(一钱) 香附(三钱) 黄芩(二钱) 甘草(一钱) 川芎(八分)
歌曰∶疼居少腹便犹通,归郁灵桃蒲草攻。
二芍木香香附子,芎芩或与大黄同。
小腹绞痛,绕脐上下难忍者,下焦之寒疝也。宜乌头羊肉汤。
当归(三钱) 生姜(三钱) 羊肉(四两) 乌头(二钱炮)
歌曰∶绕脐疼痛下焦寒,羊肉乌头姜共餐。
更有当归宜合用,须知四药总温肝。
(伯未按∶感寒腹痛,用食盐川椒炒热,熨脐四周。)
小腹旁痛,以及软肋俱痛者,厥阴血不和也。宜当归四逆汤。
当归(三钱) 桂枝(二钱) 细辛(五分) 白芍(二钱) 木通(一钱) 生地(二钱) 云苓
(二钱) 香附(二钱) 灵脂(二钱) 甘草(一钱) 橘叶(三钱) 艾叶(二钱) 川芎(一钱)
台乌药(二钱)
歌曰∶小腹疼连软胁旁,归辛桂芍地通尝。
芎灵香附台乌草,橘叶云苓艾煮汤。
小腹疼痛,得屁腹鸣乃快者,小肠气不和也,宜普明橘核丸。
楂核(二钱) 荔枝(三钱) 吴萸(一钱) 橘核(三钱) 香附(三钱) 小茴(一钱) 楝子(三
钱)
歌曰∶腹鸣得屁痛方轻,楂荔吴萸橘核呈。
香附小茴和楝子,小肠疼痛此方平。
小腹疼痛,由于淋 血虚者,胞宫瘀与热也。宜下瘀清热汤。
黄柏(二钱) 黄芩(三钱) 白芍(二钱) 赤芍(二钱) 桃仁(三钱) 牛膝(一钱) 丹
皮(三钱) 茜草(一钱) 归尾(三钱) 生地(三钱) 甘草(一钱)
歌曰∶小腹疼因血结胞,柏芩二芍并甘梢。
桃仁牛膝丹和茜,归地浓煎煮作胶。
【总诀】
膀胱、胞宫(子宫)与肝经,时下的医生尚且知晓这些层次。唯独对于瘕气(腹中结块之气)和寒疝(因寒邪引起的腹痛),这种医理向来很少有人能深刻理解。
小腹胀满疼痛,由于小便不通畅导致的,是膀胱的水液凝结阻滞。适宜使用加味五苓散。
白芍(三钱) 白术(三钱) 云茯苓(三钱) 猪苓(三钱) 泽泻(三钱) 杏仁(三钱) 桂枝(二钱)
歌诀说:小腹胀痛时小便排尽困难,用猪苓和茯苓攻逐膀胱水结。
白术配合桂枝、泽泻以引导心阳,白芍和杏仁则分别通达肝肺之气。
小腹胀满疼痛,但小便仍然通利的,是胞宫的瘀血凝结。适宜使用加减桃仁汤(病情重的加大黄)。
桃仁(一钱) 蒲黄(三钱) 赤芍(二钱) 白芍(二钱) 五灵脂(三钱) 郁金(一钱) 当归尾(三钱) 木香(一钱) 香附(三钱) 黄芩(二钱) 甘草(一钱) 川芎(八分)
歌诀说:疼痛位于少腹但大便小便仍通畅,用当归、郁金、五灵脂、桃仁、蒲黄和甘草来攻逐瘀血。
两种芍药、木香、香附子,川芎和黄芩有时与大黄一同使用。
小腹绞痛,环绕脐部上下剧烈难以忍受的,是下焦的寒疝。适宜使用乌头羊肉汤。
当归(三钱) 生姜(三钱) 羊肉(四两) 乌头(二钱,炮制过)
歌诀说:绕脐疼痛是由于下焦受寒,羊肉、乌头和生姜共同食用。
更有当归适宜合用,要知道这四味药总体都是温养肝脏的。
(伯安按语:感受寒邪导致腹痛,可用食盐和川椒炒热,熨烫脐部周围。)
小腹两侧疼痛,以及胁肋部都疼痛的,是厥阴肝经的血行不和。适宜使用当归四逆汤。
当归(三钱) 桂枝(二钱) 细辛(五分) 白芍(二钱) 木通(一钱) 生地黄(二钱) 云茯苓(二钱) 香附(二钱) 五灵脂(二钱) 甘草(一钱) 橘叶(三钱) 艾叶(二钱) 川芎(一钱) 台乌药(二钱)
歌诀说:小腹疼痛牵连到软肋旁,用当归、细辛、桂枝、白芍、生地和木通来尝试治疗。
川芎、五灵脂、香附、台乌药和甘草,加上橘叶、云茯苓和艾叶煮成汤剂。
小腹疼痛,放屁后腹部鸣响感到舒缓的,是小肠气机不和。适宜使用普明橘核丸。
山楂核(二钱) 荔枝核(三钱) 吴茱萸(一钱) 橘核(三钱) 香附(三钱) 小茴香(一钱) 川楝子(三钱)
歌诀说:腹部鸣响并放屁后疼痛才减轻,山楂核、荔枝核、吴茱萸和橘核显现功效。
香附、小茴香和川楝子配合,此方能平息小肠疼痛。
小腹疼痛,由于淋证(排尿不适)兼有血虚的,是胞宫有瘀血与热邪。适宜使用下瘀清热汤。
黄柏(二钱) 黄芩(三钱) 白芍(二钱) 赤芍(二钱) 桃仁(三钱) 牛膝(一钱) 牡丹皮(三钱) 茜草(一钱) 当归尾(三钱) 生地黄(三钱) 甘草(一钱)
歌诀说:小腹疼痛是因为血结于胞宫,黄柏、黄芩、两种芍药和甘草梢并用。
桃仁、牛膝、牡丹皮和茜草,当归和生地黄浓煎煮成胶状服用。
[General Verse]
The Bladder, the Uterus (Bao Gong), and the Liver Meridian are layers that contemporary physicians still understand. However, regarding Zha Qi (abdominal masses caused by qi stagnation) and Han Shan (cold hernia characterized by abdominal pain), few people have historically grasped this meaning.
Fullness and pain in the lower abdomen due to difficulty in urination is caused by the condensation of water in the Bladder. Jia Wei Wu Ling San (Modified Five-Ingredient Powder with Poria) is indicated.
Bai Shao (3 qian) Bai Zhu (3 qian) Yun Ling (3 qian) Zhu Ling (3 qian) Ze Xie (3 qian) Xing Ren (3 qian) Gui Zhi (2 qian)
Song says: When there is pain in the lower abdomen and urine output is exhausted, Zhu Ling and Fu Ling attack the water condensation in the Bladder.
Bai Zhu harmonizes with Gui Zhi and Ze Xie to guide Heart Yang, while Bai Shao and Xing Ren facilitate communication with the Liver and Lungs.
Fullness and pain in the lower abdomen where urination remains normal is caused by blood stasis condensing in the the Uterus (Bao Gong). Jia Jian Tao Ren Tang (Modified Peach Kernel Decoction) is indicated (add Da Huang for severe cases).
Tao Ren (1 qian) Pu Huang (3 qian) Chi Shao (2 qian) Bai Shao (2 qian) Ling Zhi (3 qian) Yu Jin (1 qian) Gui Wei (3 qian) Mu Xiang (1 qian) Xiang Fu (3 qian) Huang Qin (2 qian) Gan Cao (1 qian) Chuan Xiong (8 fen)
Song says: Pain located in the Shaoyang/abdomen with unobstructed bowel and bladder movements is attacked by Gui, Yu, Ling, Tao, Pu, and Cao.
Two types of Shao, Mu Xiang, and Xiang Fu Zi; Chuan Xiong and Huang Qin may be used together with Da Huang.
Cramping pain in the lower abdomen, unbearable as it wraps around the umbilicus up and down, is Han Shan of the Lower Jiao. Wu Tou Yang Rou Tang (Aconite and Mutton Decoction) is indicated.
Dang Gui (3 qian) Sheng Jiang (3 qian) Yang Rou (4 liang) Wu Tou (2 qian, processed)
Song says: Periumbilical pain stems from Cold in the Lower Jiao; Yang Rou, Wu Tou, and Sheng Jiang are consumed together.
Dang Gui is suitably combined; know that these four herbs collectively warm the Liver.
(Ber An's Note: For abdominal pain caused by cold invasion, stir-fry Yan Yan (salt) and Chuan Jiao until hot, then apply as a compress around the navel.)
Pain on both sides of the lower abdomen, along with pain in the hypochondrium, indicates disharmony of blood in the Jueyin Meridian. Dang Gui Si Ni Tang (Angelica Sinensis Four Reversal Decoction) is indicated.
Dang Gui (3 qian) Gui Zhi (2 qian) Xi Xin (5 fen) Bai Shao (2 qian) Mu Tong (1 qian) Sheng Di (2 qian) Yun Ling (2 qian) Xiang Fu (2 qian) Ling Zhi (2 qian) Gan Cao (1 qian) Ju Ye (3 qian) Ai Ye (2 qian) Chuan Xiong (1 qian) Tai Wu Yao (2 qian)
Song says: Lower abdominal pain extending to the soft hypochondriac region; try Dang Gui, Xi Xin, Gui Zhi, Bai Shao, Sheng Di, and Mu Tong.
Chuan Xiong, Ling Zhi, Xiang Fu, Tai Wu, and Gan Cao; boil with Ju Ye, Yun Ling, and Ai Ye to make a decoction.
Lower abdominal pain that feels relieved after passing gas and hearing borborygmus indicates disharmony of Xiao Chang Qi (Small Intestine Qi). Pu Ming Ju He Wan (Pu Ming Tangerine Seed Pill) is indicated.
Zha He (2 qian) Li Zhi (3 qian) Wu Yu (1 qian) Ju He (3 qian) Xiang Fu (3 qian) Xiao Hui (1 qian) Lian Zi (3 qian)
Song says: Pain lightens only when borborygmus occurs and gas is passed; Zha, Li, Wu Yu, and Ju He present their efficacy.
Xiang Fu, Xiao Hui, and Lian Zi harmonize; this formula calms Small Intestine pain.
Lower abdominal pain due to Lin Syndrome (dysuria) accompanied by Blood deficiency indicates Blood stasis and Heat in the the Uterus (Bao Gong). Xia Yu Qing Re Tang (Descend Stasis and Clear Heat Decoction) is indicated.
Huang Bo (2 qian) Huang Qin (3 qian) Bai Shao (2 qian) Chi Shao (2 qian) Tao Ren (3 qian) Niu Xi (1 qian) Dan Pi (3 qian) Qian Cao (1 qian) Gui Wei (3 qian) Sheng Di (3 qian) Gan Cao (1 qian)
Song says: Lower abdominal pain arises from Blood binding in the Bao Gong; Huang Bo, Huang Qin, two Shaos, and Gan Cao tip are used together.
Tao Ren, Niu Xi, Dan Pi, and Qian Cao; Gui and Sheng Di are decocted thickly into a gelatinous consistency.