仁斋云腹痛之因邪正交攻与脏气相击而作也挟热痛者以面赤或壮热四肢烦手心热见之挟
冷也
以面色或白或青见之冷甚而证变则黑黯黑唇口爪甲皆青矣热证四顺清凉饮加青皮枳壳冷证指
迷七气汤加辣桂调苏合香丸若乃邪正交争冷热不调加青皮木香为妙钱氏曰小儿积痛口中气温
面黄白目无睛光或白睛多及多睡畏食或大便酸臭者当磨积宜消积丸甚者白饼子下之后和胃虫
痛面 白心腹痛口中沫及清水出发痛时安虫散主之小儿本怯者多此病积痛食积虚痛大同小异
惟虫痛口淡而沫出
七气汤 治七气所伤痰涎结聚心刺痛不能饮乳食
半夏(一两泡) 人参 桂心(各二钱) 甘草(一钱炙)
上锉散每服二钱姜五片枣一枚同煎食前服
指迷七气汤 治阴阳不升降气道壅滞作疼
青皮(炒) 陈皮 桔梗(炒) 蓬术(煨) 肉桂(去皮) 藿香 益智子(各一两) 香附子
(一两半) 甘草 半夏(各七钱半泡)
上锉散每服二钱水一盏姜五片枣一枚煎服
桔梗枳壳汤 治诸气痞结满闷腹腰疼痛
桔梗(各一两炒) 枳壳(炒) 甘草(炙半两)
上锉散每服三钱姜三片水一钟煎
芍药甘草汤 治腹痛小便不通及治出疹肚疼
芍药(一两) 甘草(二钱半)
上锉散白水煎
四顺清凉饮
治小儿血脉壅实脏腑生热颊赤多渴五心烦躁睡不宁四肢惊掣及因乳哺不时寒温失度令儿
血气不
顺肠胃不调或湿吐连滞欲成伏热或壮热不饮欲发惊痫又治风热结核头面疮疖目赤咽痛余毒一
切壅滞并宜服之
芍药 当归 甘草 大黄(各半分)
上锉散三岁儿服一钱水半盏煎服冒风邪加去节麻黄中风体强眼上视加独活热泻加木香煨
大黄
仁斋说,腹痛的成因是邪气与正气相互交攻,以及脏腑之气相互搏击而产生的。伴有热象的疼痛,表现为面色发红,或者高热、四肢烦躁、手心发热;伴有寒象的疼痛,表现为面色发白或发青。如果寒气极重且证候发生转变,则面色变为黑黯,嘴唇、口唇、指甲都呈现青色。对于热证,使用四顺清凉饮加青皮、枳壳;对于寒证,使用指迷七气汤加辣桂(肉桂),并调服苏合香丸。如果是邪正交争、冷热不调的情况,加入青皮、木香效果更佳。钱乙说,小儿因积滞引起的疼痛,口中气息温热,面色黄白,眼神无光彩,或者眼白部分较多,嗜睡,厌恶进食,或者大便有酸臭味,应当消导积滞,适宜用消积丸;病情严重的,用白饼子攻下,之后调和胃气。因虫扰引起的疼痛,表现为面色苍白,心腹疼痛,口中流出泡沫及清水,发作时宜用安虫散主治。小儿体质本怯弱者多患此病。积滞痛、食积痛、虚痛大同小异,只有虫痛表现为口淡而流涎沫。
七气汤:治疗因七情之气所伤,导致痰涎结聚,心部刺痛,不能饮食乳食。
药材:半夏(一两,炮制)、人参、桂心(各二钱)、甘草(一钱,炙)。
用法:以上药物锉成散剂,每次服用二钱,加生姜五片、大枣一枚,同煎,饭前服用。
指迷七气汤:治疗阴阳之气不升降,气道壅滞导致的疼痛。
药材:青皮(炒)、陈皮、桔梗(炒)、蓬术(煨)、肉桂(去皮)、藿香、益智子(各一两)、香附子(一两半)、甘草、半夏(各七钱半,炮制)。
用法:以上药物锉成散剂,每次服用二钱,加水一盏、生姜五片、大枣一枚,煎服。
桔梗枳壳汤:治疗各种气机痞塞结聚,胸满闷胀,腹部及腰部疼痛。
药材:桔梗(各一两,炒)、枳壳(炒)、甘草(炙,半两)。
用法:以上药物锉成散剂,每次服用三钱,加生姜三片、水一钟,煎服。
芍药甘草汤:治疗腹痛、小便不通,以及治疗出疹子时的肚子疼。
药材:芍药(一两)、甘草(二钱半)。
用法:以上药物锉成散剂,用白水煎服。
四顺清凉饮:
治疗小儿血脉壅实,脏腑生热,脸颊红赤,口渴,五心烦躁,睡眠不安,四肢惊厥抽搐,以及因喂养不当、寒温失度导致小儿血气不顺、肠胃不调,或者湿吐连绵不断欲成伏热,或者高热不饮、欲发惊痫。又治疗风热结核、头面疮疖、目赤咽痛等余毒,一切壅滞之症均适宜服用。
药材:芍药、当归、甘草、大黄(各半分)。
用法:以上药物锉成散剂,三岁小儿服用一钱,加水半盏煎服。若冒风邪,加去节麻黄;中风身体强直、眼睛上视,加独活;热泻,加木香、煨大黄。
Ren Zhai stated that the cause of abdominal pain lies in the mutual conflict between pathogenic factors and healthy qi, as well as the striking interaction among zang-fu organs. Pain accompanied by heat manifests with a red face, or high fever, restlessness of the four limbs, and heat in the palms. Pain accompanied by cold manifests with a pale or bluish complexion. If the cold is severe and the syndrome transforms, the complexion becomes dark black, and the lips, mouth, and nails turn blue. For heat syndromes, Six-Shun Qingliang Yin (Six-Shun Cooling Drink) added with Qingpi (Green Tangerine Peel) and Zhike (Bitter Orange) is used; for cold syndromes, Zhimi Qiqi Tang (Pointing-to-Confusion Seven-Qi Decoction) added with Lagui (Spicy Cinnamon Twig) is used, along with Suhe Xiang Wan (Styrax Pill). In cases where pathogenic and healthy qi contend, and cold and heat are unbalanced, adding Qingpi (Green Tangerine Peel) and Muxiang (Aucklandia Root) is excellent. Qian Yi stated that abdominal pain due to food accumulation in children presents with warm breath from the mouth, yellowish-white complexion, dull eyes, excessive whites of the eyes, lethargy, aversion to eating, or sour-smelling stool. One should reduce accumulation, preferably using Xiaoji Wan (Accumulation-Reducing Pill); for severe cases, Baixiazi (White Pills) is used to purge, followed by harmonizing the stomach. Abdominal pain caused by intestinal parasites presents with a pale face, heart and abdominal pain, and the discharge of foam and clear fluid from the mouth during attacks; Anchong San (Parasite-Calming Powder) is the primary treatment. Children with inherently timid constitutions are prone to this disease. Accumulation pain, food-stagnation pain, and deficiency pain are largely similar, whereas parasitic pain is characterized by a bland taste and the discharge of saliva.
Qiqi Tang (Seven-Qi Decoction): Treats injury caused by the seven emotions, leading to the accumulation of phlegm-fluids and stabbing pain in the heart region, preventing the intake of milk and food.
Ingredients: Banxia (Pinelliae Rhizoma, 1 liang, processed), Renshen (Ginseng Radix et Rhizoma), Guixin (Cinnamomi Cortex, each 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian, honey-fried).
Usage: The above ingredients are cut into pieces and made into a powder. Take 2 qian per dose, decoct with 5 slices of Shengjiang (Zingiberis Rhizoma Recens) and 1 Zao (Jujubae Fructus), and take before meals.
Zhimi Qiqi Tang (Pointing-to-Confusion Seven-Qi Decoction): Treats pain caused by the failure of yin and yang qi to ascend and descend, resulting in stagnation of the qi pathway.
Ingredients: Qingpi (Aurantii Fructus Viridis, stir-fried), Chenpi (Aurantii Fructus Pericarpium), Jiegeng (Platycodonis Radix, stir-fried), Pengzhu (Curcumae Radix, baked), Rougui (Cinnamomi Cortex, bark removed), Huoxiang (Agastaches Herba), Yizhiren (Alpiniae Oxyphyllae Semen, each 1 liang), Xiangfu (Cyperi Rhizoma, 1.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma), Banxia (Pinelliae Rhizoma, each 7.5 qian, processed).
Usage: The above ingredients are cut into pieces and made into a powder. Take 2 qian per dose, decoct with 1 zhan of water, 5 slices of Shengjiang (Zingiberis Rhizoma Recens), and 1 Zao (Jujubae Fructus).
Jiegeng Zhike Tang (Platycodon and Bitter Orange Decoction): Treats various forms of qi obstruction and knotting, chest fullness and oppression, and abdominal and lumbar pain.
Ingredients: Jiegeng (Platycodonis Radix, each 1 liang, stir-fried), Zhike (Aurantii Fructus, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang).
Usage: The above ingredients are cut into pieces and made into a powder. Take 3 qian per dose, decoct with 3 slices of Shengjiang (Zingiberis Rhizoma Recens) and 1 zhong of water.
Shaoyao Gancao Tang (Peony and Licorice Decoction): Treats abdominal pain and dysuria, and also treats abdominal pain during the eruption of rashes.
Ingredients: Shaoyao (Paeoniae Radix Alba, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 2.5 qian).
Usage: The above ingredients are cut into pieces and decocted in plain water.
Six-Shun Qingliang Yin (Six-Shun Cooling Drink):
Treats children with congested blood vessels and excess heat in the zang-fu organs, presenting with red cheeks, excessive thirst, vexation and heat in the five centers, restless sleep, and convulsions of the four limbs. It also treats conditions caused by improper feeding and loss of thermal balance, leading to disharmony of blood and qi, gastrointestinal dysfunction, persistent damp vomiting tending toward latent heat, high fever with refusal to drink, and impending convulsive epilepsy. It further treats wind-heat nodules, sores and boils on the head and face, red eyes, sore throat, and other residual toxins, suitable for all types of congestion and stagnation.
Ingredients: Shaoyao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Dahuang (Rhei Radix et Rhizoma, each 0.5 fen).
Usage: The above ingredients are cut into pieces and made into a powder. A three-year-old child takes 1 qian, decocted in half a zhan of water. If exposed to wind-cold, add Mahuang (Ephedrae Herba) with nodes removed; if suffering from wind-stroke with body stiffness and upward-gazing eyes, add Duhuo (Angelicae Pubescentis Radix); if experiencing hot diarrhea, add Muxiang (Aucklandiae Radix) and Dahuang (Rhei Radix et Rhizoma) baked.