〔娄〕痘腹痛，多是痘毒，当临证消息。〔万〕《内经》腹痛皆属于寒，惟有一证为热，疮疹腹痛，皆属毒
热也。诀云∶发热肚中痛， 疮腹内攻，发多防不透，发少更防痈。是已。或有兼食积者。〔翁〕痘疹腹痛者，
由毒郁于三阴，脐以上属太阴，当脐属少阴，小腹属厥阴，须分别之。腹胀者，毒聚于肠胃也，治法俱当升
发解利痘毒，兼分利小便，使毒瓦斯上下分消，则痛与胀自止，故曰∶痛随利减，胀以利消。俗医以浓朴行滞气而
不知升发解利，非其治矣。亦有乳食停滞不消化而腹胀者，当以升发解利药中，加消食之剂，所伤之物，当审其寒热。
又有数日大便者，大便行而痛胀自止，亦未可骤用硝黄也。
定痛散 伤寒肚痛，及冷气痛。
神曲 香附（各一钱） 山楂（二钱） 良姜 当归 甘草（各五分）
上，用姜三片，枣二枚，水煎服。手足逆冷，加大附子二分。
桂枝芍药汤 治腹痛。
桂枝 炙甘草（各一钱） 白芍药（酒炒，二钱）
生姜三片，枣二枚，水煎服。
黄连汤 治热毒在胃腹痛，时或欲吐。此药能升降阴阳。
黄连 炙甘草 干姜 桂枝（各二钱） 半夏 人参（各八分）
枣二枚，水煎服。
一味异功散 治小儿诸般钓证，角弓反张，胸膈脐凸，以透明没药为末，姜汤调下。
《绍定论》云∶病有似是而非，若同而异者。盖肢体厥冷而腹痛者，此毒瓦斯在里也，若不审谛，必作极冷治之，
反与热药，为害愈深。未冷极者不问有无寒热，肢冷腹痛，必大便自利，蜷卧恶寒，今身热肢冷，腹痛大便不通，
乃热毒在里，热甚则发厥，仲景所谓热深厥亦深也。伏热深而疮疹不出者，宜以蝉蜕末水煎服之，已
出者亦可服，毒瓦斯得泄，则四肢温暖，腹痛自止矣。前人论腹痛有虚实，肠鸣自利而腹痛者为虚痛，是冷也。腹
满而不大便者为实痛，是热也。今腹中痛而不大便、又身热，耳尖冷，脚冷，为疮疹证明矣。又有疮疹始发，腹中
有宿块而痛者，医不能辨，误作食积下之，多夭横矣。〔薛〕前证，痘未出而发热烦躁，或作渴饮冷，大便坚实，此
热毒壅滞也，用疏利之药。
〔万〕凡发热腹中便痛者，此毒瓦斯内攻也，急宜发表疏里，桂枝大黄汤主之。亦有外邪与毒相并，致未尽出而腹疼
胀满者，宜参苏饮去参、苓、加缩砂、陈皮，温而出之。若原无腹痛发热，二三日后大便不通而痛者，此燥屎与毒相并
而痛也，三黄丸（热）、七物升麻丸（初热）、宣风散（痘发热）择而用之。有谵妄狂乱者，三乙承气汤主之（便秘）。
原无腹痛，或因饮冷水而痛者，此冷痛也，理中汤（吐利）加桂心。或因多食而痛者，此食积痛也，微则木香大安丸
（伤食），甚则备急丸（伤食），丁香脾积丸（伤食）、原物汤下。原无腹痛，自利后痛者，此虚痛也，黄 建中汤
加木香、青皮。发热自利，又腹痛者，此亦毒也，黄芩汤（吐利）加木香、青皮，或化毒汤主之。如疮乍出乍隐，此
伏也，七物升麻丸。疮出尽者，
再以紫草饮（出不快）大发之。疮不出者，勿治。〔张〕痘未出，有先作腹疼或腹中有块者，乃腹中先出也，不可投疏利
之药，以戕贼胃气，但与和平匀气兼发散药，如升麻汤、参苏饮之类。
蝉蜕一物汤
用蝉蜕二十一个，洗去泥，为末，水一盏，慢火煎至半盏，去滓，量儿大小温
服之。如觉疮疹已出，便根据前服三五次，不是疮疹，亦无害。小儿疮疹欲发出，加甘草一钱五分，煎一盏，旋旋
与服，累效。小儿伏所蕴积热毒，蝉蜕味咸寒可以制，况有暴感风作热，客于表者，蝉蜕亦治，风毒充于皮肤，
瘙痒不止，惊痫夜啼，癫疾，寒热惊悸，皆宜服之。
桂枝大黄汤
桂枝 白芍药（各二钱半） 甘草（五分） 大黄（一钱半）
上锉碎。加生姜一片，水一盏半，煎至一盏，去滓温服，食前。
桂枝芍药汤
桂枝 白芍药 防风 黄 （炙） 甘草（各等分）
上锉细。加枣子二枚，水一盏，煎七分，去滓温服。
黄 建中汤
黄 人参 桂枝 白芍药 甘草（各等分）
上锉细。加生姜三片，枣二枚，水一盏，煎五分，去滓温服。
化毒汤
肉桂（五分） 白芍药 甘草（各一钱） 青皮 木香 枳壳（各七分） 山楂肉 连翘（各五分）
上锉细。水一盏，煎七分，去滓温服，不拘时。
（汪）一女伤寒，但腹痛甚，日夜啼哭，手足厥冷，渐至危殆。此时天时痘灾，
吾疑或者痘症，遂取生猪血，急用脑麝和灌，一服得睡，须臾痘出而安，若非此方，则夭横矣。
〔万〕痘已出而腹痛，亦是毒在里未曾出透，亦宜桂枝大黄汤。起发不透腹痛者，陷伏也，亦宜三乙承气汤（便
秘）及宣风散（痘发热）。〔薛〕痘已出，而不热躁，不饮冷，大便不实，此元气虚弱也，用白术散之类补之。
〔张〕出不快而腹痛者，活血散（即一味白芍药，见出不快）以姜汤调下。若毒瓦斯弥蔓，阳毒入胃，便血日夜无度，
腹痛啼哭者，牛黄散主之。又有一等将成内溃之证而腹痛者，当预防之，七日前内溃，盖因风寒所中，腠理固密，阴
阳二分，壅塞不通，其毒内攻，脏腑之间毒火炮炽，以致胃烂溃而成脓，口舌皆白，是其验也。此证极为惨毒，识者
知痘毒未出之时，或有风寒阻隔，气粗热甚，身必战动，腹吐急疼者，是欲成内溃也，急以和解汤、升麻汤（初热）逐
散寒邪，开泄腠理，纵毒而出，庶无此证，若证已成，而治之亦无及矣。
牛黄散 治疮疹阳毒入胃，便血日夜无度，腹痛啼哭。
牛黄（一分） 郁金（一两）
上为细末。每服半钱，以浆水半盏，煎至三分，和滓温服。量儿大小以此增减，日二服。
和解汤 三日前后用。
升麻 芍药 葛根 人参 川芎 甘草 防风 羌活（各四分）
上，用水一钟半，生姜三片，煎至五分，温服。
〔丹〕吴店子出痘疮腹痛。
丁香（二枚） 官桂 芍药（各一钱） 白术 当归（各五分）
上，作一帖服。
如身不甚热，或时发寒，或呕吐，六脉虚细，四肢逆冷而腹痛者，陈氏木香散主之（痘泻利）。腹痛面青，
而手足冷者，脾胃虚寒证也，宜益黄、理中辈主之。理中汤加白芍药、桂。
上三条，以温药治寒痛例。作渴饮汤，手足并冷者，宜之。
〔娄〕尝治痘始出腹痛，或身痛，脉洪数者，解表凉药加芍药、甘草渐安。
按∶解表凉药，即升麻汤、连翘升麻汤、双解散之类，加者倍而用之也。
上一条，以凉药治热痛例。作渴饮冷，手足并热者，宜之。
如疮已出，至收靥时原无腹痛，忽然作痛，此必有饮食也，消息审问，曾因饮冷水者，五苓散主之，或用黄 建中
汤加白术、干姜、人参。曾伤食者，问伤何食，丁香脾积丸主之，用原物汤送下。〔张〕伤食腹痛，不可用巴豆、
大黄辈，只宜平胃助气之剂，如平胃散、小异功散、橘皮汤（吐逆）皆可。〔薛〕嗳腐吞酸，大便秽臭，
乳食停滞也，用保和丸消之（伤食）。
若靥后伤食，食蒸发搐而呕吐腹痛者，治法见惊搐条。靥后热多，大便实，粪黑，腹痛者，蓄血也，犀角地黄
汤主之。
如发热时心腹绞痛，烦闷叫呼，或疮陷伏，胀满疼痛，喘促者，此毒恶之气，攻刺肠胃，燔灼脏腑，必不可治。
【娄全善】痘疮腹痛，大多是由于痘毒所致，应当根据临床具体情况进行分析判断。【万全】《内经》认为腹痛多属于寒证，只有一个证候属于热证；而痘疹引起的腹痛，都属于毒热。诀云：“发热且肚中痛，是疮毒内攻，发疹多要防止透发不畅，发疹少更要防止酿成痈肿。”这是正确的。有的患者兼有食积。【翁氏】痘疹腹痛，是因为毒气郁结在三阴经：脐以上属太阴脾经，当脐部属少阴肾经，小腹属厥阴肝经，必须加以区分。腹胀，则是毒气聚集在肠胃所致，治疗方法都应当采用升发、解利痘毒的方法，兼用分利小便之法，使毒气上下分消，那么疼痛和胀满自然停止，所以说：“疼痛随着通利而减轻，胀满随着通利而消除。”世俗医生只知道用厚朴来行滞气，却不懂得升发解利，这不是正确的治法。也有因乳食停滞不消化而导致腹胀的，应当在升发解利的药物中加入消食的药物，所伤的食物，应当辨别其寒热性质。又有数日不大便的，大便通畅后疼痛和胀满自然停止，也不可骤然使用芒硝、大黄等泻下药。
定痛散 治疗伤寒引起的肚痛，以及冷气痛。
神曲、香附（各一钱）、山楂（二钱）、良姜、当归、甘草（各五分）。
上药，用生姜三片，大枣二枚，加水煎服。若手足逆冷，加大附子二分。
桂枝芍药汤 治疗腹痛。
桂枝、炙甘草（各一钱）、白芍药（酒炒，二钱）。
生姜三片，大枣二枚，加水煎服。
黄连汤 治疗热毒在胃引起的腹痛，有时想呕吐。此药能升降阴阳。
黄连、炙甘草、干姜、桂枝（各二钱）、半夏、人参（各八分）。
大枣二枚，加水煎服。
一味异功散 治疗小儿各种惊风证，角弓反张，胸膈及脐部凸起，以透明没药研为末，姜汤调服。
《绍定论》说：疾病有似是而非、看似相同实则不同的情况。肢体厥冷且腹痛的，这是毒气在里，如果不仔细审察，必定当作极寒证治疗，反而给予热药，危害更深。尚未冷至极点的，无论有无寒热表现，只要肢冷腹痛，必然大便自利，蜷缩卧倒，恶寒；如今身热肢冷，腹痛大便不通，这是热毒在里，热甚则发厥，正如仲景所说“热深厥亦深”。伏热深重而疮疹不出者，宜用蝉蜕末水煎服，已出的也可服用，毒气得泄，则四肢温暖，腹痛自止。前人论述腹痛有虚实之分，肠鸣自利而腹痛的是虚痛，属于寒证。腹满而不大便的是实痛，属于热证。如今腹中痛而不大便，又身热，耳尖冷，脚冷，这是疮疹的明证。又有疮疹刚发出，腹中有宿块而痛的，医生不能辨别，误作食积而下之，大多导致夭折横死。【薛己】前证，痘未出而发热烦躁，或口渴饮冷，大便坚实，这是热毒壅滞，用疏利之药。
【万全】凡发热且腹中便痛的，这是毒气内攻，急宜发表疏里，主方用桂枝大黄汤。也有外邪与毒相并，导致未尽出而腹疼胀满的，宜用参苏饮去掉人参、茯苓，加缩砂、陈皮，温服以透出毒邪。如果原本无腹痛发热，二三日后大便不通而痛的，这是燥屎与毒相并而痛，可选用三黄丸（热证）、七物升麻丸（初热证）、宣风散（痘发热）择而用之。有谵妄狂乱的，主方用三乙承气汤（便秘）。原本无腹痛，或因饮冷水而痛的，这是冷痛，用理中汤（吐利证）加桂心。或因多食而痛的，这是食积痛，轻则用木香大安丸（伤食），重则用备急丸（伤食）、丁香脾积丸（伤食），用原物汤送下。原本无腹痛，自利后痛的，这是虚痛，用黄芪建中汤加木香、青皮。发热自利，又腹痛的，这也是毒邪，用黄芩汤（吐利证）加木香、青皮，或用化毒汤主之。如疮乍出乍隐，这是毒伏在内，用七物升麻丸。疮出尽的，再用紫草饮（出不快）大发之。疮不出者，不要治疗。【张氏】痘未出，有先作腹疼或腹中有块的，这是腹中先出痘，不可投用疏利之药，以免戕害胃气，只给与和平匀气兼发散药，如升麻汤、参苏饮之类。
蝉蜕一物汤
用蝉蜕二十一个，洗去泥土，研为末，用水一盏，慢火煎至半盏，去渣，根据患儿大小温服。如果觉得疮疹已出，便按前述方法服三五次，如果不是疮疹，也无害处。小儿疮疹欲发出，加甘草一钱五分，煎至一盏，慢慢喂服，屡见疗效。小儿伏热蕴积热毒，蝉蜕味咸寒可以制约，况且有暴感风邪作热，客于体表的，蝉蜕也能治疗，风毒充于皮肤，瘙痒不止，惊痫夜啼，癫疾，寒热惊悸，都适宜服用。
桂枝大黄汤
桂枝、白芍药（各二钱半）、甘草（五分）、大黄（一钱半）。
上药锉碎。加生姜一片，水一盏半，煎至一盏，去渣温服，饭前。
桂枝芍药汤
桂枝、白芍药、防风、黄芪（炙）、甘草（各等分）。
上药锉细。加枣子二枚，水一盏，煎至七分，去渣温服。
黄芪建中汤
黄芪、人参、桂枝、白芍药、甘草（各等分）。
上药锉细。加生姜三片，大枣二枚，水一盏，煎至五分，去渣温服。
化毒汤
肉桂（五分）、白芍药、甘草（各一钱）、青皮、木香、枳壳（各七分）、山楂肉、连翘（各五分）。
上药锉细。水一盏，煎七分，去渣温服，不拘时候。
（汪某）一女患伤寒，但腹痛剧烈，日夜啼哭，手足厥冷，逐渐危殆。此时正值天时痘灾，我怀疑或许是痘症，于是取生猪血，急用脑麝调和灌服，一服后得睡，片刻后痘出而安，若非此方，则夭折横死了。
【万全】痘已出而腹痛，也是毒在里未曾出透，也宜用桂枝大黄汤。起发不透而腹痛的，是陷伏证，也宜用三乙承气汤（便秘）及宣风散（痘发热）。【薛己】痘已出，但不热躁，不饮冷，大便不实，这是元气虚弱，用白术散之类补之。
【张氏】出不快而腹痛的，用活血散（即一味白芍药，见出不快条）以姜汤调下。若毒气弥漫，阳毒入胃，便血日夜无度，腹痛啼哭的，主方用牛黄散。又有一类将成内溃之证而腹痛的，应当预防，七日内内溃，大概因风寒所中，腠理固密，阴阳二分，壅塞不通，其毒内攻，脏腑之间毒火炮炽，以致胃烂溃而成脓，口舌皆白，是其征验。此证极为惨毒，识者知道痘毒未出之时，或有风寒阻隔，气粗热甚，身必战动，腹吐急疼的，是欲成内溃，急以和解汤、升麻汤（初热）逐散寒邪，开泄腠理，纵毒而出，庶无此证，若证已成，而治之亦无及矣。
牛黄散 治疗疮疹阳毒入胃，便血日夜无度，腹痛啼哭。
牛黄（一分）、郁金（一两）。
上为细末。每服半钱，以浆水半盏，煎至三分，和滓温服。量儿大小以此增减，日二服。
和解汤 三日前后用。
升麻、芍药、葛根、人参、川芎、甘草、防风、羌活（各四分）。
上药，用水一钟半，生姜三片，煎至五分，温服。
【丹溪】吴店子出痘疮腹痛。
丁香（二枚）、官桂、芍药（各一钱）、白术、当归（各五分）。
上，作一帖服。
如身不甚热，或时发寒，或呕吐，六脉虚细，四肢逆冷而腹痛的，陈氏木香散主之（痘泻利）。腹痛面青，而手足冷的，是脾胃虚寒证，宜益黄散、理中汤辈主之。理中汤加白芍药、桂。
上三条，是以温药治寒痛的例子。作渴饮汤，手足并冷的，适宜用。
【娄全善】曾治痘始出腹痛，或身痛，脉洪数的，用解表凉药加芍药、甘草渐安。
按：解表凉药，即升麻汤、连翘升麻汤、双解散之类，加者倍而用之也。
上一条，是以凉药治热痛的例子。作渴饮冷，手足并热的，适宜用。
如疮已出，至收靥时原本无腹痛，忽然作痛，这必有饮食因素，仔细审问，曾因饮冷水的，五苓散主之，或用黄芪建中汤加白术、干姜、人参。曾伤食的，问伤何食，丁香脾积丸主之，用原物汤送下。【张氏】伤食腹痛，不可用巴豆、大黄辈，只宜平胃助气之剂，如平胃散、小异功散、橘皮汤（吐逆）皆可。【薛己】嗳腐吞酸，大便秽臭，是乳食停滞，用保和丸消之（伤食）。
[Lou] Abdominal pain in smallpox is mostly due to the smallpox toxin; clinical judgment should be exercised. [Wan] According to the *Neijing*, abdominal pain generally belongs to cold, with only one pattern belonging to heat. However, abdominal pain caused by rash diseases (exanthems) all belongs to toxic heat. The aphorism states: "Fever accompanied by abdominal pain indicates internal attack by the rash toxin; if the eruption is profuse, prevent incomplete penetration; if sparse, fear abscess formation." This is correct. Some cases are complicated by food stagnation. [Weng] Abdominal pain in smallpox/rash arises from toxin stagnation in the Three Yin channels: above the umbilicus belongs to Taiyin (Spleen), at the umbilicus belongs to Shaoyin (Kidney), and the lower abdomen belongs to Jueyin (Liver); these must be distinguished. Abdominal distension results from toxin accumulation in the intestines and stomach. The treatment method for both should involve raising and venting to resolve the smallpox toxin, combined with promoting urination to allow the toxin to dissipate upward and downward. Thus it is said: "Pain diminishes with purgation/urination, distension resolves with drainage." Vulgar physicians know only to use Houpo (Magnolia Bark) to move stagnant Qi but fail to understand raising and venting to resolve toxins; this is incorrect treatment. There are also cases of abdominal distension due to milk or food stagnation and indigestion; in such cases, digestive-resolving agents should be added to the raising-and-venting formulas. The ingested food must be assessed for cold or heat nature. In cases of constipation for several days, once bowel movements resume, pain and distension cease naturally; sudden use of Xiaoshi (Mangosteen Pericarp/Xia Kuding Cha? Context implies Cathartics like Mangxiao/Magnolia Fructus contextually often grouped with Dahuang, here likely referring to harsh cathartics like Mangxiao) and Dahuang (Rhubarb) should be avoided.
Dingtong San (Definitive Pain Powder) treats abdominal pain from Cold Damage (Shanghan) and cold qi pain.
Shenqu (Massa Medicata Fermentata), Xiangfu (Cyperus Rhizome) (each 1 qian), Shanzha (Crataegus Fruit) (2 qian), Liangjiang (Alpinia Officinarum Rhizome), Danggui (Angelica Sinensis Root), Gancao (Licorice Root) (each 5 fen).
Decoct with 3 slices of Shengjiang (Fresh Ginger) and 2 dates (Zao) in water. If extremities are cold, add Fuzi (Aconite Lateral Root) 2 fen.
Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction) treats abdominal pain.
Guizhi (Cinnamon Twig), Zhigancao (Honey-fried Licorice Root) (each 1 qian), Baishaoyao (White Peony Root) (wine-fried, 2 qian).
Decoct with 3 slices of Shengjiang (Fresh Ginger) and 2 dates (Zao) in water.
Huanglian Tang (Coptis Decoction) treats abdominal pain caused by heat toxin in the stomach, sometimes accompanied by nausea/vomiting. This formula regulates the ascending and descending of Yin and Yang.
Huanglian (Coptis Rhizome), Zhigancao (Honey-fried Licorice Root), Ganjiang (Dried Ginger), Guizhi (Cinnamon Twig) (each 2 qian), Banxia (Pinellia Tuber), Renshen (Ginseng Root) (each 8 fen).
Decoct with 2 dates (Zao) in water.
Yiwei Yigong San (Single-Ingredient Yi Gong Powder) treats various types of convulsions in children, including opisthotonos and protrusion of the chest/diaphragm and umbilicus. Use transparent Moyao (Myrrh) as powder, taken with Ginger Water.
*Shaoding Lun* states: Diseases may appear similar yet differ essentially. Limb coldness with abdominal pain indicates toxin in the interior. Without careful examination, treating this as extreme cold and administering hot herbs will deepen the harm. If not extremely cold, regardless of presence of cold/heat signs, limb coldness with abdominal pain implies spontaneous diarrhea, curling up, and aversion to cold. However, current symptoms of fever, limb coldness, abdominal pain, and constipation indicate heat toxin in the interior. Extreme heat causes jue (cold limbs), as Zhongjing stated: "The deeper the heat, the deeper the jue." For latent deep heat preventing rash eruption, decoct Chanui (Cicada Slough) powder in water and administer; it can also be used after eruption. Once the toxin is released, limbs warm and abdominal pain stops. Predecessors discussed deficiency and excess in abdominal pain: borborygmus with spontaneous diarrhea and abdominal pain is deficiency pain (cold). Abdominal fullness with constipation is excess pain (heat). Current symptoms of abdominal pain, constipation, fever, cold ear tips, and cold feet clearly indicate rash disease. Another case involves a pre-existing mass in the abdomen causing pain when the rash first appears; misdiagnosis as food stagnation and purging often leads to premature death. [Xue] In the preceding condition, fever and irritability before eruption, thirst for cold drinks, and firm stool indicate heat toxin obstruction; use draining/resolving medicines.
[Wan] Fever with immediate abdominal pain indicates internal attack by toxin; urgently release the exterior and drain the interior using Guizhi Dahuang Tang (Cinnamon Twig and Rhubarb Decoction). If external pathogen combines with toxin, preventing complete eruption and causing abdominal pain/distension, use Shenqi Yin (Ginseng Qi Drink) removing Renshen (Ginseng) and Fuling (Poria), adding Suansha (Amomum Fruit) and Chenpi (Tangerine Peel), administered warm to vent the toxin. If there was originally no abdominal pain/fever, but constipation and pain arise after 2-3 days, this is dry feces combining with toxin; choose among Sanhuang Wan (Three Yellows Pill - Heat), Qi Wu Shengma Wan (Seven-Ingredient Cimicifuga Pill - Initial Heat), or Xuanfeng San (Dispel Wind Powder - Smallpox Fever) as appropriate. For delirium and mania, use Sanyi Chengqi Tang (Three-Yi Da-Cheng-Qi Decoction) for constipation. Originally no abdominal pain, but pain after drinking cold water indicates cold pain; use Lizhong Tang (Regulate the Middle Decoction) + Guixin (Cinnamon Bark). Pain after overeating indicates food stagnation pain; mild cases use Muxiang Da'an Wan (Costus Great Peace Pill), severe cases use Beiji Wan (Emergency Pill) or Dingxiang Pi Ji Wan (Clove Spleen Accumulation Pill), taken with the soup of the ingested substance. Originally no abdominal pain, but pain after spontaneous diarrhea indicates deficiency pain; use Huangqi Jianzhong Tang (Astragalus Build-the-Middle Decoction) + Muxiang (Costus Root), Qingpi (Green Tangerine Peel). Fever with spontaneous diarrhea plus abdominal pain indicates toxin; use Huangqin Tang (Scutellaria Decoction) + Muxiang, Qingpi, or Huadu Tang (Resolve Toxin Decoction). If eruptions appear and disappear, this is latent toxin; use Qi Wu Shengma Wan. If eruptions are complete, use Zicao Yin (Arnebia Drink) to vigorously promote eruption. If eruptions do not appear, do not treat. [Zhang] Before smallpox eruption, abdominal pain or masses indicate early eruption in the abdomen; do not use draining medicines to damage Stomach Qi. Use harmonizing Qi and dispersing formulas like Shengma Tang (Cimicifuga Decoction) or Shenqi Yin.
Chanui Yi Wu Tang (Single-Ingredient Cicada Slough Decoction)
Use 21 Chanui (Cicada Slough), wash off mud, powder. Decoct in 1 sheng of water over slow fire until half remains. Strain and take warm according to age. If eruptions have appeared, continue taking 3-5 times; even if not rash, it is harmless. For children whose rashes desire to erupt, add Gancao (Licorice) 1.5 qian, decoct to 1 sheng, feed slowly. Highly effective. Chanui is salty and cold, capable of restraining latent heat/toxin accumulation in children. It also treats wind-heat attacking the exterior, skin itching from wind-toxin, convulsions, night crying, epilepsy, chills/fever, and palpitations.
Guizhi Dahuang Tang (Cinnamon Twig and Rhubarb Decoction)
Guizhi (Cinnamon Twig), Baishaoyao (White Peony Root) (each 2.5 qian), Gancao (Licorice Root) (5 fen), Dahuang (Rhubarb Root) (1.5 qian).
Chop coarsely. Add 1 slice of Shengjiang (Fresh Ginger), 1.5 sheng of water, decoct to 1 sheng. Strain and take warm before meals.
Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction)
Guizhi (Cinnamon Twig), Baishaoyao (White Peony Root), Fangfeng (Saposhnikovia Root), Huangqi (Astragalus Root) (fried), Gancao (Licorice Root) (equal parts).
Chop finely. Add 2 dates, 1 sheng of water, decoct to 0.7 sheng. Strain and take warm.
Huangqi Jianzhong Tang (Astragalus Build-the-Middle Decoction)
Huangqi (Astragalus Root), Renshen (Ginseng Root), Guizhi (Cinnamon Twig), Baishaoyao (White Peony Root), Gancao (Licorice Root) (equal parts).
Chop finely. Add 3 slices of Shengjiang (Fresh Ginger), 2 dates, 1 sheng of water, decoct to 0.5 sheng. Strain and take warm.
Huadu Tang (Resolve Toxin Decoction)
Rougui (Cinnamon Bark) (5 fen), Baishaoyao (White Peony Root), Gancao (Licorice Root) (each 1 qian), Qingpi (Green Tangerine Peel), Muxiang (Costus Root), Zhike (Bitter Orange Fruit) (each 7 fen), Shanzha Rou (Crataegus Flesh), Lianqiao (Forsythia Fruit) (each 5 fen).
Chop finely. Decoct in 1 sheng of water to 0.7 sheng. Strain and take warm, anytime.
(Wang) A girl with Cold Damage had severe abdominal pain, crying day and night, cold limbs, approaching critical state. During a smallpox epidemic, I suspected smallpox. I took raw pig blood, mixed with Naozhang (Camphor and Musk), and forced it down. One dose led to sleep, followed by eruption and recovery. Without this, she would have died prematurely.
[Wan] Abdominal pain after smallpox eruption indicates toxin still in the interior not fully vented; Guizhi Dahuang Tang is also suitable. Failure to rise/develop with abdominal pain indicates sinking/latent toxin; use Sanyi Chengqi Tang (for constipation) and Xuanfeng San (for smallpox fever). [Xue] After eruption, if there is no fever/restlessness, no desire for cold drinks, and loose stools, this is Yuanqi (Primordial Qi) deficiency; tonify with Baizhu San (Atractylodes Powder).
[Zhang] Slow eruption with abdominal pain: use Huoxue San (Blood Invigorating Powder, i.e., single ingredient Baishaoyao) taken with Ginger Water. If toxin spreads, Yang toxin enters the Stomach, causing continuous bloody stools day and night with abdominal pain and crying, use Niuhuang San (Calculus Bovis Powder). Another type involves impending internal ulceration with abdominal pain; prevention is key. Internal ulceration within 7 days is often due to Wind-Cold blocking the pores, causing stagnation of Yin/Yang, leading to internal attack of toxin, fiery inflammation in organs, rotting of the Stomach forming pus, and white coating on mouth/tongue. This is extremely severe. Those who understand know that before eruption, if Wind-Cold blocks, causing rough breathing, high fever, trembling, and acute abdominal/vomiting pain, it signals impending internal ulceration. Urgently use Hejie Tang (Harmonize Decoction) or Shengma Tang (Initial Heat) to disperse cold, open pores, and vent toxin. If the condition develops, treatment is futile.
Niuhuang San (Calculus Bovis Powder) treats Yang toxin entering Stomach from rash, continuous bloody stools, abdominal pain, and crying.
Niuhuang (Calculus Bovis) (1 fen), Yujin (Curcuma Radix) (1 liang).
Powder finely. Take 0.5 qian per dose, decoct in 0.5 sheng of Jiangshui (Fermented Rice Water) to 0.3 sheng. Take warm with dregs. Adjust dosage by age. Twice daily.
Hejie Tang (Harmonize Decoction) Used 3 days before or after.
Shengma (Cimicifuga Rhizome), Shaoyao (Peony Root), Gegen (Pueraria Root), Renshen (Ginseng Root), Chuanxiong (Ligusticum Rhizome), Gancao (Licorice Root), Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome) (each 4 fen).
Decoct in 1.5 zhong of water with 3 slices of Shengjiang (Fresh Ginger) to 0.5 sheng. Take warm.
[Dandan/Wu Dianzi] Smallpox eruption with abdominal pain.
Dingxiang (Clove) (2 pieces), Guanyuan Gui (Official Cinnamon), Shaoyao (Peony Root) (each 1 qian), Baizhu (Atractylodes Macrocephala Rhizome), Danggui (Angelica Sinensis Root) (each 5 fen).
Take as one dose.
If body heat is not high, occasional chills, vomiting, empty/fine pulse, cold limbs with abdominal pain, use Chen's Muxiang San (Costus Powder) (for smallpox diarrhea). Abdominal pain with blue face and cold hands/feet indicates Spleen/Stomach deficiency-cold; use Yihuang San (Yellow Regulating Powder) or Lizhong Tang (Regulate the Middle Decoction). Lizhong Tang + Baishaoyao, Gui (Cinnamon).
These three items illustrate treating cold pain with warm herbs. Indicated for thirst for hot drinks and cold limbs.
[Lou] I treated smallpox initial eruption with abdominal or body pain and surging-rapid pulse using exterior-releasing cooling herbs + Shaoyao, Gancao, resulting in gradual improvement.
Note: Exterior-releasing cooling herbs refer to Shengma Tang, Lianqiao Shengma Tang, Shuangjie San, etc., with doubled dosage of added ingredients.
This item illustrates treating heat pain with cooling herbs. Indicated for thirst for cold drinks and hot limbs.
If eruptions have reached the crusting stage and suddenly develop abdominal pain (previously absent), dietary factors are likely. Investigate carefully. If caused by cold water, use Wuling San (Five-Ingredient Powder with Poria) or Huangqi Jianzhong Tang + Baizhu, Ganjiang, Renshen. If caused by food injury, identify the food; use Dingxiang Pi Ji Wan taken with the soup of the ingested substance. [Zhang] For food-stagnation abdominal pain, do not use Badou (Croton Seed) or Dahuang (Rhubarb); use gentle Qi-moving formulas like Pingwei San (Peace the Stomach Powder), Xiao Yigong San (Minor Yi Gong Powder), or Jupi Tang (Tangerine Peel Decoction). [Xue] Belching with sour regurgitation and foul stool indicates milk/food stagnation; use Baohe Wan (Preserve Harmony Pill).
After crusting, if food stagnation triggers wind stirring and convulsions with vomiting/abdominal pain, see the Convulsions section. After crusting, if heat is prominent, stool is hard/black, and abdominal pain exists, this is Blood Stasis; use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction).
If during fever there is heart/abdominal colic, restlessness, shouting, or sunken/latent eruptions with distension/pain and panting, this is malignant toxic qi attacking intestines/stomach and burning organs; this is incurable.