〔曾〕 瘕痛,乃积久所致,由荣卫俱虚,外则感受风寒,内则过伤乳食,停滞既久,不能克化,故
邪并于阴为 ,阴则专静,凝而不移,邪并于阳为瘕,假物象
形,动而不息。若久而不治,亦成脾疳积,或两胁间有块如石,按之则痛,不按则轻。或面黄肌瘦,肚硬
而胀及有青筋,昼凉夜热,蒸潮无时,乳食减少,爱吃泥土。或大便酿泻,痛则身冷如冰。法当调脾养胃,用醒
脾散(慢惊)参苓白术散(不乳食)。磨积理疳,用化癖丸(癖)三棱散(宿食)木香莪术丸(宿食)。治酿泻,
没石子丸(泻)、沉香槟榔丸(癖积)。然此积滞之疾,非七剂可疗,必须次第调理,则日久自然平复。
〔曾〕始则腹内一小长块,其硬如臂,从腰缠转,或左或右,良久痛甚,则见于皮下,不妨乳食。其证先因
有疾表解未尽,遽尔下之太过,气虚寒搏,郁结而成。法宜益气理虚,用参苓白术散(不乳食)、沉香槟榔丸(癖)、
木香莪术丸(宿食)为治,或间投白芍药汤(疝)加人参、茯苓,水姜煎服。
癖痛治法详癖门
按∶ 瘕 癖四证,大同小异,治法亦无大分别,似不必琐琐作名,亦可也。
吊肾偏坠痛证治在阴肿门
寒疝痛证治在疝门
芍药甘草汤 治出疹肚疼腹满,小便不通。
芍药(一两) 甘草(二钱半)
上锉散。白水煎服。
《圣惠》人参散 治小儿卒吐下,腹痛不止。
人参(去芦头) 当归(锉,微炒。各半两) 甘草(炙,微赤,锉) 干姜(炮裂,锉) 黄 (锉。
各一分) 细辛(一分)
上件药捣,粗罗为散。每服一钱,以水一小盏,煎至五分,去滓稍热服,量儿大小,以意加减。频服。
〔钱乙〕附方和中散 和胃气,止吐泻,定烦渴,治腹痛,思食。
人参(去芦) 白茯苓 白术 甘草(锉,炒) 干葛(锉) 黄 白扁豆(炒) 藿香叶(各等分)
上为细末。每服三钱,水一盏,干枣二个去核,姜五片,煎至八分,食前温服。
〔曾氏〕瘕痛,是由于病邪积聚日久所致。这是因为营卫之气都虚弱,对外则感受风寒之邪,对内则乳食过度损伤,停滞时间长久,不能消化,所以邪气并入阴分形成“”,阴气主静,凝结而不移动;邪气并入阳分形成“瘕”,假借物象成形,动而不停息。如果时间久了不治疗,也会变成脾疳积,或者在两胁之间出现像石头一样的硬块,按压时疼痛,不按则感觉轻微。或者面色发黄、肌肉消瘦,肚子坚硬且胀大,还有青色筋脉显露,白天凉爽晚上发热,定时或不定时地蒸热,吃奶和食物减少,爱吃泥土。或者大便稀溏泄泻,疼痛时身体冷得像冰一样。治疗方法应当调理脾胃,使用醒脾散(适用于慢惊风)、参苓白术散(适用于不吃奶食)。消除积滞、理治疳积,使用化癖丸(适用于癖积)、三棱散(适用于宿食)、木香莪术丸(适用于宿食)。治疗稀溏泄泻,使用没石子丸(适用于泻)、沉香槟榔丸(适用于癖积)。然而这种积滞的疾病,不是七剂药就能治愈的,必须按次序调理,时间久了自然就会平复痊愈。
〔曾氏〕起初是腹内有一小块长形的肿块,硬度像手臂一样,从腰部缠绕转动,有时在左边有时在右边,过了很久疼痛加剧,则在皮下显现,但不妨碍吃奶和进食。这个病症起初是因为有疾病表证未解尽,就匆忙使用下法太过,导致气虚寒邪搏结,郁结而成。治疗方法适宜益气理虚,使用参苓白术散(适用于不吃奶食)、沉香槟榔丸(适用于癖)、木香莪术丸(适用于宿食)来治疗,或者间歇投服白芍药汤(适用于疝)加入人参、茯苓,用水、生姜煎服。
癖痛的治疗方法详见癖门。
按语:、瘕、癖四种证候,大同小异,治疗方法也没有大的分别,似乎不必琐碎地设立名称,也可以这样处理。
吊肾偏坠痛证治详见阴肿门。
寒疝痛证治详见疝门。
芍药甘草汤 治疗出疹子时的肚疼、腹部胀满、小便不通。
芍药(一两) 甘草(二钱半)
以上药材切碎成散剂。用白水煎服。
《圣惠方》人参散 治疗小儿突然呕吐腹泻,腹痛不止。
人参(去掉芦头) 当归(切碎,微炒。各半两) 甘草(炙烤,微红,切碎) 干姜(炮制裂开,切碎) 黄(切碎。各一分) 细辛(一分)
以上药材捣碎,粗筛为散剂。每次服用一钱,用水一小盏,煎至五分,去渣滓稍热服用,根据孩子的大小,酌情加减。频繁服用。
〔钱乙〕附方和中散 调和胃气,止吐泻,定烦渴,治疗腹痛,增进食欲。
人参(去掉芦头) 白茯苓 白术 甘草(切碎,炒) 干葛(切碎) 黄 白扁豆(炒) 藿香叶(各等分)
以上制成细末。每次服用三钱,用水一盏,干枣两个去核,生姜五片,煎至八分,饭前温服。
[Zeng] Jia tong (pain associated with abdominal masses) is caused by the accumulation of pathogenic factors over a long period. This results from the deficiency of both Ying (Nutritive Qi) and Wei (Defensive Qi). Externally, it involves contraction of Wind-Cold; internally, it stems from excessive damage to milk and food intake. After prolonged stagnation, digestion fails, causing pathogens to merge into the Yin aspect, forming "Yi" (a fixed mass), where Yin energy is static, leading to coagulation without movement; or merge into the Yang aspect, forming "Jia" (a mobile mass), which takes shape resembling objects and moves incessantly. If left untreated for a long time, it may develop into Pi Gan Ji (Spleen-related malnutrition and accumulation), or present as stone-like hard lumps between the two hypochondria, painful upon pressure but mild when untouched. Symptoms may include sallow complexion, emaciation, a hard and distended abdomen with visible cyanotic veins, coolness during the day and fever at night, irregular tidal fever, reduced appetite for milk and food, pica (craving for dirt), or loose stools. During pain episodes, the body may feel cold as ice. The treatment principle should be to regulate the Spleen and nourish the Stomach, using Xingpi San (Awakening the Spleen Powder) for Slow Convulsion, or Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) for anorexia. To resolve accumulations and treat Gan Ji, use Huapi Wan (Eliminating Accumulation Pill) for Pi (accumulated dampness/phlegm), Sanleng San (Sparganium Powder) for retained food, or Muxiang Ezhu Wan (Costus and Curcuma Pill) for retained food. For loose stools, use Meishi Zi Wan (Terminalia Chebula Pill) for diarrhea, or Chenxiang Binglang Wan (Aquilaria and Areca Nut Pill) for Pi accumulation. However, such accumulation diseases cannot be cured in seven doses; sequential regulation is required, and recovery will occur naturally over time.
[Zeng] Initially, there is a small, elongated lump inside the abdomen, hard as an arm, winding around from the waist, shifting left or right. After a while, pain intensifies, becoming visible subcutaneously, yet not interfering with feeding. This condition arises because the exterior syndrome was not fully resolved, and purgatives were used excessively, leading to Qi deficiency, Cold stagnation, and郁结 (depression and knotting). The treatment should focus on tonifying Qi and regulating deficiency, using Shenling Baizhu San (for anorexia), Chenxiang Binglang Wan (for Pi), or Muxiang Ezhu Wan (for retained food). Alternatively, administer Shaoyao Tang (Peony Decoction) intermittently for Shan (hernia), adding Renshen (Ginseng) and Fuling (Poria), decocted with water and fresh ginger.
For detailed treatment of Pi Tong (pain due to Pi), refer to the Pi section.
Commentary: Yi, Jia, and Pi syndromes are largely similar with minor differences, and their treatments are not significantly distinct. It may be unnecessary to create separate names for them.
Diao Shen Pian Zhui Tong (testicular hernia with descent and pain) is treated in the Yin Zhong (Genital Swelling) section.
Han Shan (Cold Hernia) pain treatment is detailed in the Shan (Hernia) section.
Shaoyao Gancao Tang (Peony and Licorice Decoction) treats abdominal pain and distension, and urinary retention accompanying exanthema.
Baishao (Radix Paeoniae Alba) (1 liang) Gancao (Radix Glycyrrhizae) (2 qian 5 fen).
Crush into coarse powder. Decoct in plain water and take orally.
*Shenghui Fang* Renshen San (Ginseng Powder) treats sudden vomiting and diarrhea in infants with persistent abdominal pain.
Renshen (Ginseng Root, remove rhizome) Danggui (Radix Angelicae Sinensis, crush, stir-fry lightly) [each 0.5 liang] Gancao (Licorice Root, honey-fried, slightly reddened, crush) Ganjiang (Dried Ginger, processed until cracked, crush) Huangqi (Astragalus Root, crush) [each 1 fen] Xixin (Asarum Root, 1 fen).
Grind the above herbs into a coarse powder. Take 1 qian per dose, add one small cup of water, boil down to half a cup, strain, and drink while slightly warm. Adjust dosage according to the child's age and condition. Administer frequently.
[Qian Yi] Supplementary Formula Hezhong San (Harmonizing the Middle Powder) harmonizes Stomach Qi, stops vomiting and diarrhea, relieves irritability and thirst, treats abdominal pain, and promotes appetite.
Renshen (Ginseng Root, remove rhizome) Baifuling (Poria with Hostwood) Baizhu (Atractylodes Macrocephala Rhizome) Gancao (Licorice Root, crush, stir-fry) Gegen (Kudzu Root, crush) Huangqi (Astragalus Root) Baibidou (White Lablab Bean, stir-fry) Huoxiangye (Patchouli Leaf) [equal parts].
Grind into fine powder. Take 3 qian per dose, add one cup of water, two dried dates (pitted), and five slices of fresh ginger. Boil down to 0.8 cups. Take warm before meals.