（见痉病。） 治腹满不减。减不足言。当下之。
以上三方。虽缓急不同。而攻泄则一。所谓中满泻之于内也。伤寒论浅注已解。毋庸再
赘。
治心胸中大寒痛。呕不能饮食。腹中满。上冲皮起。出见有头足。上下痛而不可
此汤主之。
蜀椒（二合。炒去汗。） 干姜（四两。） 人参（二两。）
上二味。以水四升。煮取二升。去滓。内胶饴一升。微火煎取二升。分温再服。如一炊
顷可
歌曰 痛呕食艰属大寒。腹冲头足触之难。（腑脏经络皆寒所痹。痛甚手不可近也。）干
姜四两椒二合。参二饴升食粥安。
受业林礼丰按。胸为阳气出入之位。师云心胸中大寒者。胸中之阳不宣。阴寒之气从下
而上
出见
腹之
可
椒性纯阳下达。镇阴邪之逆。助干姜以振中土之阳。服后一炊顷饮粥者。亦温养中焦之气以
行药力也。
治胁下偏痛。脉紧弦。此寒也。以温药下之。宜此汤。
大黄（三两。） 附子（三枚。） 细辛（二两。）
上三味。以水五升。煮取二升。分温三服。若强人。煮取二升半。分温三服。服后
行四五里。进一服。
歌曰 胁下偏疼脉紧弦。若非温下恐迁延。大黄三两三枚附。二两细辛可补天。
尤在泾云。阴寒成聚。非温不能已其寒。非下不能去其结。故曰阴寒聚结。宜急以温药
下之
（此方见痉病篇。）治疗腹部胀满持续不缓解，即使偶有减轻也微不足道。应当采用攻下法。
以上三个方剂，虽然病情缓急不同，但攻逐泄下的原则是一致的。这就是所谓“中焦满闷需从内部泻除”的道理。《伤寒论浅注》中已有解释，此处不再赘述。
治疗心胸部位剧烈寒冷疼痛，呕吐无法进食，腹部胀满，气向上冲撞皮肤，突起如头足状，上下疼痛且手不可触碰。此汤主治。
以上三味药，用水四升，煮取二升药液，去渣，加入胶饴一升，用微火煎取二升，分两次温服。如果服药后一顿饭的工夫，可以喝粥以助药力。
歌诀曰：痛呕食艰属大寒，腹冲头足触之难。（腑脏经络皆寒所痹，痛甚手不可近也。）干姜四两椒二合，参二饴升食粥安。
受业林礼丰按语：胸是阳气出入的部位，老师说心胸中大寒，是因为胸中阳气不宣通，阴寒之气从下而上逆。
治疗胁下偏侧疼痛，脉象紧弦，这是寒邪所致，应用温性药物攻下，适宜用此汤。
以上三味药，用水五升，煮取二升药液，分三次温服。如果是体质强壮的人，煮取二升半，分三次温服。服药后行走四五里路，再服用一次。
歌诀曰：胁下偏疼脉紧弦，若非温下恐迁延。大黄三两三枚附，二两细辛可补天。
尤在泾说：阴寒凝聚成实，不用温药不能消除其寒，不用下药不能去除其结滞。所以说阴寒聚结，应当急切地用温药攻下。
(See the chapter on Spasm.) Treats abdominal fullness that does not decrease, or decreases insignificantly. Purging should be employed.
Although the above three formulas differ in urgency, their principle of purging and draining is identical. This is what is meant by "fullness in the middle must be drained from within." The *Shanghan Lun Qian Zhu* (Light Commentary on the Treatise on Cold Damage) has already explained this; no further elaboration is necessary here.
Treats severe cold pain in the chest and heart region, vomiting with inability to eat, abdominal fullness, qi rushing upward causing the skin to bulge out like heads and feet, and pain throughout the upper and lower body that cannot be touched. This formula governs these symptoms.
Shu Jiao (Fructus Zanthoxyli, two he, stir-fried to remove moisture) Gan Jiang (Radix Zingiberis Recens, four liang) Ren Shen (Radix Ginseng, two liang)
Take the above three herbs, add four sheng of water, decoct to obtain two sheng of liquid, remove the dregs, add one sheng of Glucinum (Jiao Yi), and simmer over a gentle fire to obtain two sheng. Divide into two warm doses. If, after the time it takes to cook a meal, [the patient can tolerate food], porridge may be consumed.
Song says: Pain, vomiting, and difficulty eating belong to severe cold; the abdomen rushes upward with bulges like heads and feet, difficult to touch. (The fu organs, zang organs, meridians, and collaterals are all obstructed by cold, causing severe pain where the hands cannot approach.) Gan Jiang four liang, Shu Jiao two he, Ren Shen two [liang], Jiao Yi one sheng, consume porridge for peace.
Disciple Lin Lifeng notes: The chest is the position where yang qi enters and exits. The Master said that severe cold in the chest and heart indicates that the yang qi in the chest is not unblocked, and yin-cold qi reverses upward from below.
Treats unilateral pain in the hypochondrium, with a tight and wiry pulse. This is cold; use warming purgatives. This formula is appropriate.
Da Huang (Radix et Rhizoma Rhei, three liang) Fu Zi (Lateral Radix Aconiti Preparata, three pieces) Xi Xin (Herba Asari, two liang)
Take the above three herbs, add five sheng of water, decoct to obtain two sheng of liquid. Divide into three warm doses. For robust individuals, decoct to obtain two and a half sheng, divide into three warm doses. After taking the medicine, walk for four or five li, then take another dose.
Song says: Unilateral pain in the hypochondrium with a tight and wiry pulse; if not treated with warming purgation, it may linger. Da Huang three [liang], Fu Zi three [pieces], Xi Xin two liang can supplement heaven.
You Zaijing stated: When yin-cold condenses into accumulation, only warming can dispel the cold, and only purging can remove the stagnation. Therefore, it is said that when yin-cold accumulates and knots, it should be urgently treated with warming purgatives.