《病源》疝者,痛也,此由阴气积于内,寒气结搏而不散,腑脏虚弱,风冷邪气相击,
则腹痛里急,故云寒疝腹痛也。(出第二十卷中)
《广济》疗丈夫虚劳,寒疝腹痛,并主产后方。
生干地黄(三两) 甘草(炙二两) 茯苓(二两) 人参(二两) 当归(二两) 大
枣(十四
枚) 白羊肉(去脂三斤)
上七味,切,以水三斗,先煮羊肉取一斗,去羊肉,纳诸药,煮取五升,纳葱白一把,
煮取四升,绞去滓,分温五服,服别相去如人行十二三里后药消,进少食,食消服药。忌芜
荑、海藻、菘菜、酢物,余无忌。(出第四卷中)
仲景《伤寒论》,寒疝绕脐苦痛,若发则白汗出,手足厥寒,若脉沉弦者。二物大乌头
煎主之方。
大乌头(十五枚) 白蜜(二斤)
上药以水三升,煮乌头取二升,去乌头,纳蜜煎令水气尽,得二升,强人服七合,弱人
五合,一服不瘥,明日更服,日止一服,不可再也。忌猪肉、冷水。(《千金》同)
又寒疝腹满逆冷,手足不仁,若一身尽痛,灸刺、诸药所不能治者。抵当乌头桂枝汤主
之方。
秋乌头(实中大者十枚) 白蜜(二斤一方一斤) 桂心(四两)
上三味,先以蜜微火煎乌头减半,去乌头,别一处,以水二升半,煮桂,取一升,去滓
,以桂汁和前蜜合煎之,得一升许,初服二合,不知更服,至三合又不复知,更加至五合,
其知如醉状,得吐者,为中病也。忌猪肉、冷水、生葱等。(《范汪方》同)
桂心(三两) 芍药(三两) 甘草(二两炙) 生姜(三两切) 大枣(十二枚)
上五味,切,以水七升,煮取三升,去滓,取五合,和前乌头蜜,令得一升余,并同前
法服。(仲景《伤寒论》、《千金》同)
又疗寒疝腹中痛,引胁痛及腹里急者。当归生姜羊肉汤主之方。
当归(三两) 生姜(五两) 肥羊肉(一斤去脂)
上三味,切,以水一斗合煮取三升,去滓,温服七合,日三,痛即当止。若寒多者,加
生姜,足前成一斤;若痛多而呕者,加橘皮二两、术一两,合前物煮取三升。加生姜者,亦
加水五升,煮取三升二合,服之依前。(《经心录》、《范汪》同,无忌)
又疗寒疝腹中痛者。柴胡桂枝汤方。
柴胡(四两) 大枣(六枚) 黄芩(一两半) 人参(一两半) 甘草(一两炙) 半
夏(二合
半) 桂心 生姜(各一两半) 芍药(一两半)
上九味,以水八升,煮取三升,去滓,温服一升,日三服。又云,人参汤作如桂枝法,
加半夏、柴胡、黄芩,复如柴胡汤法。今着人参作半剂。忌海藻、菘菜、羊肉、饧、生葱。
(并出第十五卷中)
《短剧》寒疝气,腹中虚痛,及诸胁痛,里急。当归生姜等四味主之方。
当归 生姜 芍药(各三两) 羊肉(三斤)
上药,切,以水一斗二升,煮肉烂熟,出肉,纳诸药,煎取三升,分温服七合,日三,
数有效。(《古今录验》、《经心录》、《范汪》同,出第一卷中)
《集验》疗寒疝气来往,冲心腹痛。桂心汤方。
桂心(四两) 生姜(三两) 吴茱萸(二两)
上三味,切,以酒一大升,煎至三合,去滓,分温三服,如人行六七里一服。忌生葱。
又疗寒疝下牵少腹痛。附子丸方。
附子(二两炮) 桃仁(三两去皮、尖) 蒺藜子(一升去角、尖,熬)
上三味,捣筛末,蜜和丸梧子大。空腹酒下十丸,渐加至十五丸及二十丸,日再服。忌
生菜、热面、炙肉、笋、蒜、猪、鱼。(出第六卷中)
又疗积年腹内宿结疝冷气,及诸癖症等。香豉丸方。
香美烂豉曝干,微熬,令香即止 小芥子去土石,微熬,令赤即止(各一升)
上二味,捣筛,蜜和丸梧子大。空腹酒服二十丸,渐加至三十丸,日二服。初服半剂以
来,腹中微绞痛,勿怪之,是此药攻病之候。
又疗疝瘕冷气方
采鼠李子日干,九蒸九曝,酒浸。服三合,日两服。渐加至三服,能下血及碎肉积滞物
《古今录验》楚王瓜子丸 疗心腹寒疝,胸胁支满,食饮不化,寒中腹痛,及呕痢风痉
,颈项强急,不得俯仰方。
桂心(五分) 茱萸(三两) 白薇(一分) 干姜(四分) 乌头(二分炮) 蜀椒
(五分汗)
上九味,末之,合蜜和为丸如梧子。先食服一丸,日三。不知,稍稍增之,以腹中温、
身中 为度。忌生葱、猪肉、冷水。(方中无瓜子,未详方名,《范汪》等同,出第八卷
中)
《诸病源候论》记载:疝,就是疼痛的意思。这是由于阴气积聚在体内,寒气凝结搏结而不能消散,加上脏腑虚弱,风冷邪气相互冲击,从而导致腹部疼痛、里急后重,所以称为寒疝腹痛。(出自第二十卷中)
《广济方》治疗男子虚劳引起的寒疝腹痛,同时也主治产后相关的方剂。
生干地黄(三两) 甘草(炙制二两) 茯苓(二两) 人参(二两) 当归(二两) 大枣(十四枚) 白羊肉(去除脂肪三斤)
以上七味药,切碎,用水三斗,先煮羊肉取汁一斗,去掉羊肉,放入其他药物,煎煮取汁五升,加入一把葱白,再煎煮取汁四升,过滤去渣,分五次温服。每次服药间隔时间相当于人行走十二三里路的时间,待药力消退后进食少量食物,待食物消化后再服药。忌食芜荑、海藻、菘菜(白菜)、醋制品,其余无禁忌。(出自第四卷中)
张仲景《伤寒论》中提到:寒疝绕脐剧烈疼痛,发作时出冷汗,手足厥冷,如果脉象沉弦的,用二物大乌头煎主治。
大乌头(十五枚) 白蜜(二斤)
以上药物用水三升,煮乌头取汁二升,去掉乌头,加入蜂蜜煎熬至水分蒸发尽,得到二升药液。体质强壮的人服用七合,体质虚弱的人服用五合。如果一次服用后病未愈,第二天继续服用,每天只服一次,不可再次加量。忌食猪肉、冷水。(与《千金方》相同)
另外,对于寒疝导致腹部胀满、四肢逆冷、手足麻木不仁,或者全身疼痛,针灸和各种药物都无法治疗的,用抵当乌头桂枝汤主治。
秋乌头(个头饱满坚实的十枚) 白蜜(二斤,一方用一斤) 桂心(四两)
以上三味药,先用蜂蜜在微火上煎煮乌头至减半,去掉乌头,放在别处备用。另取容器,用水二升半,煮桂心取汁一升,过滤去渣,将桂汁与前文备用的蜂蜜混合再煎,得到约一升药液。初次服用二合,若无感觉则增加剂量,服至三合仍无感觉,则进一步增加至五合。服药后出现如醉酒般的状态,或者发生呕吐的,说明达到了治疗效果(中病)。忌食猪肉、冷水、生葱等。(与《范汪方》相同)
桂心(三两) 芍药(三两) 甘草(炙制二两) 生姜(三两,切碎) 大枣(十二枚)
以上五味药,切碎,用水七升,煎煮取汁三升,过滤去渣,取五合药汁,与前文制备好的乌头蜜混合,使总量达到一升多,按照前面的方法服用。(与仲景《伤寒论》、《千金方》相同)
另外,治疗寒疝引起的腹中疼痛,牵引胁肋部疼痛及腹部内部拘急的,用当归生姜羊肉汤主治。
当归(三两) 生姜(五两) 肥羊肉(一斤,去除脂肪)
以上三味药,切碎,用水一斗合煮取汁三升,过滤去渣,温服七合,每日三次,疼痛应当停止。如果寒气较重者,增加生姜用量,使其总量达到一斤;如果疼痛剧烈且伴有呕吐者,增加橘皮二两、白术一两,与其他药物一起煎煮取汁三升。若增加了生姜,也需增加水五升,煎煮取汁三升二合,服用方法同前。(与《经心录》、《范汪方》相同,无特殊禁忌)
另外,治疗寒疝腹中疼痛的,用柴胡桂枝汤方。
柴胡(四两) 大枣(六枚) 黄芩(一两半) 人参(一两半) 甘草(炙制一两) 半夏(二合半) 桂心 生姜(各一两半) 芍药(一两半)
以上九味药,用水八升,煎煮取汁三升,过滤去渣,温服一升,每日三次服用。另有说法称,用人参汤作为基础,按照桂枝汤的方法,加入半夏、柴胡、黄芩,又如同柴胡汤的方法。现在记录的是使用人参制成半剂量的方子。忌食海藻、菘菜、羊肉、饴糖、生葱。(均出自第十五卷中)
《短剧方》治疗寒疝气,腹中虚痛,以及各类胁痛、里急后重。用当归生姜等四味药主治。
当归 生姜 芍药(各三两) 羊肉(三斤)
以上药物,切碎,用水一斗二升,煮肉至烂熟,取出羊肉,放入其他药物,煎煮取汁三升,分次温服七合,每日三次,多次服用有效。(与《古今录验方》、《经心录》、《范汪方》相同,出自第一卷中)
《集验方》治疗寒疝气往来冲撞心脏引起腹痛。用桂心汤方。
桂心(四两) 生姜(三两) 吴茱萸(二两)
以上三味药,切碎,用酒一大升,煎煮至三合,过滤去渣,分三次温服,相当于人行走六七里的时间服用一次。忌食生葱。
另外,治疗寒疝向下牵引少腹疼痛的,用附子丸方。
附子(二两,炮制) 桃仁(三两,去皮、尖) 蒺藜子(一升,去角、尖,炒制)
以上三味药,捣碎过筛成粉末,用蜂蜜和丸,大小如梧桐子。空腹时用酒送服十丸,逐渐增加至十五丸及二十丸,每日服用两次。忌食生菜、热面、烤肉、笋、蒜、猪肉、鱼肉。(出自第六卷中)
另外,治疗多年腹内宿结的疝冷气,以及各类癖积症等的,用香豉丸方。
香美腐烂豆豉晒干,轻微炒制,闻到香味即止 小芥子去除土石,轻微炒制,炒至变红即止(各一升)
以上两味药,捣碎过筛,用蜂蜜和丸,大小如梧桐子。空腹时用酒送服二十丸,逐渐增加至三十丸,每日服用两次。刚开始服用半剂以来,腹中出现轻微绞痛,不要奇怪,这是此药攻逐病邪的反应。
另外,治疗疝瘕冷气的方子
采集鼠李子日晒干燥,经过九次蒸制和九次曝晒,用酒浸泡。服用三合,每日两次。逐渐增加至三次,能够排出瘀血及碎裂的肉积滞物。
《古今录验方》楚王瓜子丸 治疗心腹寒疝,胸胁支撑胀满,饮食不消化,寒邪入中引起腹痛,以及呕吐、痢疾、风痉,颈项强直紧急,不能俯仰的方子。
桂心(五分) 茱萸(三两) 白薇(一分) 干姜(四分) 乌头(二分,炮制) 蜀椒(五分,出汗处理)
以上九味药,研成粉末,混合蜂蜜和丸,大小如梧桐子。饭前服用一丸,每日三次。若无效果,逐渐增加剂量,以腹部温暖、身体舒适为度。忌食生葱、猪肉、冷水。(方名中虽提及瓜子,但方中无瓜子,不详为何名,《范汪方》等同,出自第八卷中)
According to *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases): "Shan" refers to pain. This condition arises from the accumulation of Yin Qi within the body, where Cold Qi condenses and binds without dispersing. Combined with the weakness of the Fu and Zang organs, Wind-Cold pathogenic factors strike each other, resulting in abdominal pain and a sensation of urgency in the interior. Hence, it is called Cold Shan Abdominal Pain. (From Volume 20)
*Guangji Fang* treats deficiency exhaustion in men accompanied by Cold Shan abdominal pain, and also serves as a primary formula for postpartum conditions.
Sheng Gan Di Huang (Prepared Rehmannia Root, 3 liang), Gan Cao (Licorice Root, roasted, 2 liang), Fu Ling (Poria, 2 liang), Ren Shen (Ginseng, 2 liang), Dang Gui (Angelica Sinensis, 2 liang), Da Zao (Jujube, 14 pieces), Bai Yang Rou (White Goat Meat, fat removed, 3 jin).
Cut the seven ingredients. Boil in 3 dou of water; first decoct the goat meat until one dou remains. Remove the meat, add the remaining herbs, and decoct until five sheng remain. Add one bunch of Cong Bai (Scallion White), decoct until four sheng remain, strain, and divide into five warm doses. Administer each dose at intervals equivalent to walking twelve or thirteen li. Take a small amount of food after the medicinal effect subsides, and take medicine again after digestion. Avoid Wu Yi (Chrysanthemum seed), Hai Zao (Sargassum), Song Cai (Chinese Cabbage), and vinegar products. No other restrictions apply. (From Volume 4)
In Zhang Zhongjing's *Shanghan Lun*: For Cold Shan causing severe pain around the umbilicus, with cold sweat, cold extremities upon onset, and a deep, string-like pulse, treat with Er Wu Da Wu Tou Jian (Two-Ingredient Large Aconite Decoction).
Da Wu Tou (Large Aconite Root, 15 pieces), Bai Mi (White Honey, 2 jin).
Boil the Aconite in three sheng of water until two sheng remain. Remove the Aconite, add the honey, and boil until the water evaporates, yielding two sheng. Strong individuals take seven ge; weak individuals take five ge. If not cured after one dose, administer again the next day. Limit to one dose per day; do not exceed this. Avoid pork and cold water. (Same as *Qianjin Fang*)
Furthermore, for Cold Shan presenting with abdominal fullness, cold limbs, numbness in hands and feet, or generalized body pain that cannot be treated by acupuncture or other medicines, use Di Dang Wu Tou Gui Zhi Tang (Di Dang Aconite and Cinnamon Twig Decoction).
Qiu Wu Tou (Autumn Aconite, plump ones, 10 pieces), Bai Mi (White Honey, 2 jin; one version uses 1 jin), Gui Xin (Cinnamon Heart, 4 liang).
First, gently boil the Aconite in honey over low heat until reduced by half. Remove the Aconite and set aside. In a separate vessel, boil Gui Xin in two and a half sheng of water until one sheng remains. Strain and mix the Gui Xin juice with the reserved honey, boiling until approximately one sheng remains. Initial dose: two ge. If no effect, increase to three ge. If still no effect, increase to five ge. A sensation resembling drunkenness or vomiting indicates the disease is being addressed (Zhong Bing). Avoid pork, cold water, and raw scallions. (Same as *Fan Wang Fang*)
Gui Xin (Cinnamon Heart, 3 liang), Shao Yao (Peony Root, 3 liang), Gan Cao (Licorice Root, roasted, 2 liang), Sheng Jiang (Fresh Ginger, cut, 3 liang), Da Zao (Jujube, 12 pieces).
Cut the five ingredients. Boil in seven sheng of water until three sheng remain. Strain, take five ge of the liquid, and mix with the previously prepared Aconite-Honey mixture to obtain slightly more than one sheng. Administer according to the previous method. (Same as Zhang Zhongjing's *Shanghan Lun* and *Qianjin Fang*)
Furthermore, for Cold Shan causing abdominal pain radiating to the hypochondrium and internal tension, use Dang Gui Sheng Jiang Yang Rou Tang (Angelica, Ginger, and Mutton Decoction).
Dang Gui (Angelica Sinensis, 3 liang), Sheng Jiang (Fresh Ginger, 5 liang), Fei Yang Rou (Fatty Mutton, fat removed, 1 jin).
Cut the three ingredients. Boil in ten dou of water until three sheng remain. Strain, take seven ge warm, three times daily. Pain should cease. If Cold is predominant, increase Sheng Jiang to total one jin. If pain is severe with vomiting, add Ju Pi (Tangerine Peel, 2 liang) and Zhu (Atractylodes, 1 liang), decoct together to yield three sheng. If Sheng Jiang is increased, add five sheng of water and boil to yield three sheng two ge. Administration follows the prior method. (Same as *Jing Xin Lu* and *Fan Wang Fang*, no restrictions)
Furthermore, for Cold Shan abdominal pain, use Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction).
Chai Hu (Bupleurum, 4 liang), Da Zao (Jujube, 6 pieces), Huang Qin (Scutellaria, 1.5 liang), Ren Shen (Ginseng, 1.5 liang), Gan Cao (Licorice Root, roasted, 1 liang), Ban Xia (Pinellia, 2.5 he), Gui Xin (Cinnamon Heart), Sheng Jiang (Fresh Ginger, each 1.5 liang), Shao Yao (Peony Root, 1.5 liang).
Boil the nine ingredients in eight sheng of water until three sheng remain. Strain, take one sheng warm, three times daily. Another version states: Use Ren Shen Tang as a base, follow Gui Zhi Tang method, add Ban Xia, Chai Hu, and Huang Qin, following Chai Hu Tang method. The current record uses half-dose Ren Shen. Avoid Hai Zao (Sargassum), Song Cai (Chinese Cabbage), Yang Rou (Mutton), Yi Tang (Malt Sugar), and raw scallions. (All from Volume 15)
*Duan Ju Fang* treats Cold Shan Qi with empty pain in the abdomen, hypochondriac pain, and internal urgency. Treat with Dang Gui, Sheng Jiang, and other four ingredients.
Dang Gui (Angelica Sinensis), Sheng Jiang (Fresh Ginger), Shao Yao (Peony Root, each 3 liang), Yang Rou (Mutton, 3 jin).
Cut the ingredients. Boil mutton in twelve dou of water until tender. Remove meat, add herbs, decoct to three sheng. Divide into warm doses of seven ge, three times daily. Repeated administration is effective. (Same as *Gu Jin Lu Yan*, *Jing Xin Lu*, *Fan Wang Fang*, from Volume 1)
*Ji Yan Fang* treats Cold Shan Qi coming and going, striking the heart with abdominal pain. Use Gui Xin Tang (Cinnamon Heart Decoction).
Gui Xin (Cinnamon Heart, 4 liang), Sheng Jiang (Fresh Ginger, 3 liang), Wu Zhu Yu (Evodia, 2 liang).
Cut the three ingredients. Decoct in one da sheng of wine until three ge remain. Strain, divide into three warm doses. Administer at intervals equivalent to walking six or seven li. Avoid raw scallions.
Furthermore, for Cold Shan pulling pain in the lower abdomen, use Fu Zi Wan (Aconite Pill).
Fu Zi (Prepared Aconite Child Root, roasted, 2 liang), Tao Ren (Peach Seed, peeled and slit tips, 3 liang), Ji Li Zi (Tribulus Fruit, thorns and tips removed, roasted, 1 sheng).
Grind to powder, mix with honey to form pills the size of wu tou seeds. Take ten pills with wine on an empty stomach, gradually increasing to fifteen and then twenty pills, twice daily. Avoid raw vegetables, hot noodles, roasted meat, bamboo shoots, garlic, pork, and fish. (From Volume 6)
Furthermore, for chronic internal accumulation of Cold Qi in Shan and various Pi masses, use Xiang Chi Wan (Fermented Soybean Pill).
Xiang Mei Lan Chi (Fine Fermented Black Bean, dried), Xiao Jie Zi (Small Mustard Seed, cleaned, roasted until red), each 1 sheng.
Grind to powder, mix with honey to form pills the size of wu tou seeds. Take twenty pills with wine on an empty stomach, gradually increasing to thirty pills, twice daily. Mild cramping pain in the abdomen during initial half-dose administration is expected; this is the drug attacking the disease.
Furthermore, a formula for Shan Jia Cold Qi:
Harvest Shu Li Zi (Mouse Plum), dry in sun, steam nine times and sun-dry nine times, soak in wine. Take three ge, twice daily. Gradually increase to three doses. It can expel blood stasis and fragmented meat accumulations.
*Gu Jin Lu Yan Fang* Chu Wang Gua Zi Wan (Chu King Melon Seed Pill) treats Heart-Abdomen Cold Shan, chest and hypochondriac distension, indigestion, Cold entering the middle causing abdominal pain, vomiting, dysentery, wind spasms, stiff neck unable to bend or look up.
Gui Xin (Cinnamon Heart, 5 fen), Zhu Yu (Evodia, 3 liang), Bai Wei (Cynanchum Root, 1 fen), Gan Jiang (Dried Ginger, 4 fen), Wu Tou (Aconite, roasted, 2 fen), Shu Jiao (Sichuan Pepper, sweating processed, 5 fen).
Grind nine ingredients to powder, mix with honey to form pills the size of wu tou seeds. Take one pill before meals, three times daily. If ineffective, gradually increase dosage until warmth in the abdomen and comfort in the body are achieved. Avoid raw scallions, pork, and cold water. (The name mentions melon seeds, but none are in the formula; reason unknown. Same as *Fan Wang Fang*, from Volume 8)