裴（氏） 脉数。按之涩。腹痛呕吐。恐痧秽格拒。宜宣通气分。（上中二焦气阻）
白蔻仁 桔梗 黑山栀 香豉 半夏 广皮白
某（四十） 腰痛腹痛。得冷愈甚。（阳气不通）
桂枝木 茯苓 蕲艾 生香附 青皮 炒小茴
吴（五三） 当脐微痛。手按则止。此络空冷乘。阳气久虚之质。自述戒酒谷增。不可因痛。再以破泄真
气。
茯苓 生姜（煨） 熟术 肉桂
俞（十九） 腹痛六七年。每发必周身寒凛。吐涎沫而痛止。此诸气郁痹。得涌则宣之象。法当升
阳散郁。（郁伤脾阳）
半夏 草果 金铃子 延胡 浓朴 生姜 苏梗
程 秽浊阻遏中焦。气机不宣。腹痛脘痹。当用芳香逐秽。兼以疏泄。（秽浊阻气）
藿香 浓朴 杏仁 莱菔子 半夏 广皮白
郑 脉沉微。腹痛欲大便。阴浊内凝。乃阳气积衰。通阳必以辛热。（阴浊内阻腑阳不通）
生白术 吴萸 良姜 川熟附 茯苓 小茴
某 腑阳不通。腹痛。用禹余粮丸。暖下通消。二便通。胀缓。腹仄。此无形之气未振。宜疏补醒中。
生白术 浓朴 广皮 半夏 茯苓 生益智 姜汁
某 气结。腹痛食少。寒热。（肝气郁） 逍遥散去术加郁金香附。
某（氏） 肝郁。腹痛有形。经不调。（肝郁血滞）
香附 川芎 当归 肉桂 五灵脂 木香
吴萸 炒白芍
毕 小便自利。大便黑色。当脐腹痛。十五年渐发日甚。脉来沉而结涩。此郁勃伤及肝脾之络。
致血败瘀留。劳役动怒。宿 乃发。目今冬深闭藏。忌用攻下。议以辛通润血。所谓通则不痛
矣。（郁伤肝脾络血凝瘀）
桃仁 桂枝木 穿山甲 老韭白 煎送阿魏丸一钱。
徐（四十） 疹发五六年。形体畏寒。病发身不大热。每大便。腹痛里急。此皆气血凝滞。当以郁病推求。
当归 酒制大黄 枳实 桂枝 炙草 白芍
某 劳力伤气。浮肿。食入腹痛。姑用戊己调中。（劳伤中阳）
白芍（二钱） 炙草（五分） 当归（炒焦一钱半） 生益智（七分研） 广皮（一钱） 煨姜（一钱）
枣肉（三钱） 河水煎。
袁（四五） 当脐腹痛。发于冬季。春深渐愈。病发嗳气。过饥劳动亦发。宜温通营分主治。（营分虚寒）
当归 炙草 肉桂 茯苓 炮姜 南枣
华 腹痛三年。时发时止。面色明亮。是饮邪。亦酒湿酿成。因怒左胁有形。痛绕腹中。及胸背诸
俞。乃络空。饮气逆攻入络。食辛热痛止复痛。盖怒则郁折肝用。惟气辛辣可解。论药必首推气味。（郁怒饮气入络）
粗桂枝木（一钱） 天南星（姜汁浸炮黑一钱半） 生左牡蛎（五钱打碎） 真橘核（炒香打一钱半）
川楝子肉（一钱） 李根东行皮（一钱）
某 长夏腹胀减食。微痛。是暑伤在气分。东垣每调和脾胃。疏泄肝木。最属近理。若守中之补。
及腻滞血药皆左。（暑伤中气）
人参 广皮 白芍 茯苓 谷芽 生益智仁
腹处乎中。痛因非一。须知其无形及有形之为患。而主治之机宜。已先得其要矣。所谓无
形为患者。如寒凝火郁。气阻营虚。及夏秋暑湿痧秽之类是也。所谓有形为患者。如蓄血
食滞 瘕蛔蛲内疝。及平素偏好成积之类是也。审其痛势之高下。辨其色脉之衰旺。细
究其因确从何起。大都在脏者以肝脾肾为主。在腑者以肠胃为先。夫脏有贼克之情。
非比腑病而以通为用也。此通字。勿执攻下之谓。古之建中汤。理中汤。三物浓朴汤。及浓
朴温中汤。各具至理。考先生用古。若通阳而泄浊者。如吴茱萸汤。及四逆汤法。清火而泄
郁者。如左金丸。及金铃散法。开通气分者。如四七汤及五磨饮法。宣攻营络者。如穿山甲
桃仁归须韭根之剂。及下瘀血汤法。缓而和者。如芍甘汤加减。及甘麦大枣汤法。柔而通
者。如苁蓉柏子肉桂当归之剂。及复脉加减法。至于食滞消之。蝤扰安之。 瘕理之。内疝
平之。痧秽之候。以芳香解之。偏积之类。究其原而治之。是皆先生化裁之法也。若夫疡科
内痈。妇科四症。兼患是病者。更于各门兼参其法而用之。则无遗蕴矣。（邵新甫）
徐评 腹痛久者必有积滞。必用消积丸药以渐除之。煎方恐不足以愈久病也。案中用丸散。
绝妙。
裴姓患者，脉象数，重按感觉涩滞。出现腹痛、呕吐症状，担心是痧秽之气格拒于内。适宜宣通气分。（上中二焦气机阻滞）
白蔻仁 桔梗 黑山栀 香豉 半夏 广皮白
某患者（四十岁），腰痛且腹痛，遇冷则疼痛加剧。（阳气不通）
桂枝木 茯苓 蕲艾 生香附 青皮 炒小茴
吴姓患者（五十三岁），肚脐周围轻微疼痛，用手按压则疼痛停止。这是络脉空虚，寒邪乘虚而入。患者体质阳气久虚，自述戒除酒谷后症状增加，不可因为疼痛，就再用破气泄气的药物，以免进一步损伤真气。
茯苓 生姜（煨） 熟术 肉桂
俞姓患者（十九岁），腹痛已有六七年，每次发作必定全身发冷颤抖，吐出涎沫后疼痛才停止。这是诸气郁结痹阻，得涌吐则气机宣散的征象。治法应当升阳散郁。（郁结损伤脾阳）
半夏 草果 金铃子 延胡 浓朴 生姜 苏梗
程姓患者，秽浊之气阻遏中焦，气机不宣畅，导致腹痛、胃脘部痹阻。当用芳香药物驱逐秽浊，兼以疏泄。（秽浊阻滞气机）
藿香 浓朴 杏仁 莱菔子 半夏 广皮白
郑姓患者，脉象沉微，腹痛且有便意。这是阴浊之气内凝，乃阳气积渐衰微所致，通阳必须使用辛热药物。（阴浊内阻，腑阳不通）
生白术 吴萸 良姜 川熟附 茯苓 小茴
某患者，腑阳不通，腹痛。使用禹余粮丸，温暖下焦，通利消散。二便通畅后，腹胀缓解，腹部变软。这是无形之气未振奋，适宜疏理补益，醒脾和中。
生白术 浓朴 广皮 半夏 茯苓 生益智 姜汁
某患者，气结，腹痛，食少，伴有寒热感。（肝气郁结）逍遥散去白术，加郁金香和香附。
某姓患者，肝气郁结，腹痛且有形质积聚，月经不调。（肝郁血滞）
香附 川芎 当归 肉桂 五灵脂 木香
吴萸 炒白芍
毕姓患者，小便自利，大便黑色，肚脐周围腹痛，十五年逐渐发作且日益加重。脉象沉而结涩。这是郁勃之气损伤了肝脾的络脉，导致血败瘀留。因劳役或动怒，宿疾乃发。如今正值深冬闭藏之时，忌用攻下之法。议定以辛温通络、润血之法治疗，所谓通则不痛。（郁结损伤肝脾络脉，血凝成瘀）
桃仁 桂枝木 穿山甲 老韭白 煎送阿魏丸一钱。
徐姓患者（四十岁），出疹五年六年，形体畏寒，发病时身体不大热。每次大便时，腹痛且有里急后重感。这都是气血凝滞所致，应当从郁病角度推求病因。
当归 酒制大黄 枳实 桂枝 炙草 白芍
某患者，劳力伤气，浮肿，进食后腹痛。暂用戊己调中法。（劳伤中阳）
白芍（二钱） 炙草（五分） 当归（炒焦一钱半） 生益智（七分研） 广皮（一钱） 煨姜（一钱）
枣肉（三钱） 河水煎。
袁姓患者（四十五六岁），肚脐周围腹痛，发于冬季，春深时节逐渐痊愈。发病时有嗳气，过饥或劳动也会诱发。适宜温通营分主治。（营分虚寒）
当归 炙草 肉桂 茯苓 炮姜 南枣
华姓患者，腹痛三年，时发时止，面色明亮，这是饮邪，也是由酒湿酿成。因愤怒导致左胁有有形之块，疼痛环绕腹中，及胸背各俞穴部位，这是络脉空虚，饮气逆攻入络脉。食用辛辣热物后疼痛停止但随即复发。盖因愤怒则郁折肝之用，只有气味辛辣的药物可以解郁。论药必首推气味。（郁怒致饮气入络）
粗桂枝木（一钱） 天南星（姜汁浸炮黑一钱半） 生左牡蛎（五钱打碎） 真橘核（炒香打一钱半）
川楝子肉（一钱） 李根东行皮（一钱）
某患者，长夏季节腹胀减轻食欲减退，轻微疼痛，这是暑邪伤在气分。东垣先生常调和脾胃，疏泄肝木，最为合理。若守中焦之补法，以及腻滞的血药都是错误的。（暑伤中气）
人参 广皮 白芍 茯苓 谷芽 生益智仁
腹部处于人体中部，疼痛原因不一。须知其有无形和有形两种致病因素，从而掌握主治的关键，已先得其要领。所谓无形为患者，如寒凝、火郁、气阻、营虚，以及夏秋季节的暑湿、痧秽之类。所谓有形为患者，如蓄血、食滞、瘕聚、蛔虫、蛲虫、内疝，以及平素偏好食物形成的积块之类。审察疼痛势态的高下，辨别面色脉象的盛衰，仔细探究病因确切从何而起。大都在脏者以肝、脾、肾为主；在腑者以肠胃为先。脏腑之间有相克的关系，不像腑病那样以通为用。这个“通”字，不要固执地理解为攻下。古人的建中汤、理中汤、三物浓朴汤，以及浓朴温中汤，各具至理。考察叶先生运用古方，如通阳而泄浊者，如吴茱萸汤，及四逆汤法；清火而泄郁者，如左金丸，及金铃散法；开通气分者，如四七汤及五磨饮法；宣通营络者，如穿山甲、桃仁、归须、韭根之剂，及下瘀血汤法；缓而和者，如芍甘汤加减，及甘麦大枣汤法；柔而通者，如苁蓉、柏子肉、肉桂、当归之剂，及复脉加减法。至于食滞则消导之，蛔扰则安蛔之，瘕聚则理散之，内疝则平复之，痧秽之候，以芳香解之，偏积之类，究其原而治之。这些都是先生化裁运用的方法。若夫外科的内痈，妇科的四症，兼患此病者，更在各门类中参考其法而用之，则无遗漏蕴涵矣。（邵新甫评）
Patient Pei, the pulse is rapid (Shu Mai). Upon deep pressure, it feels choppy (Se Mai). Symptoms include abdominal pain and vomiting. There is concern about obstruction by Sha Hui (sand-dust filth/toxic pathogens). The appropriate treatment is to promote the circulation of Qi in the Qi level (Qi Fen). (Obstruction of Qi in the Upper and Middle Jiao)
Amomum Fruit (Bai Kou Ren), Platycodon Root (Jie Geng), Gardenia Fruit (Hei Shan Zhi), Fermented Soybean (Xiang Chi), Pinellia Tuber (Ban Xia), Tangerine Peel (Guang Pi Bai)
Patient Mou (40 years old), lower back pain and abdominal pain, worsened by cold exposure. (Obstruction of Yang Qi)
Cinnamon Twig (Gui Zhi Mu), Poria (Fu Ling), Mugwort Leaf (Qi Ai), Cyperus Rhizome (Sheng Xiang Fu), Green Tangerine Peel (Qing Pi), Fennel Seed (Chao Xiao Hui)
Patient Wu (53 years old), slight pain around the umbilicus, relieved by manual pressure. This indicates cold invading due to emptiness in the collaterals. The constitution has been deficient in Yang Qi for a long time. The patient reports that symptoms increased after abstaining from alcohol and grains. One must not use Qi-breaking or purgative drugs merely because of pain, so as not to further damage True Qi.
Poria (Fu Ling), Ginger (Sheng Jiang, baked), Prepared Atractylodes Macrocephala Rhizome (Shu Zhu), Cinnamon Bark (Rou Gui)
Patient Yu (19 years old), abdominal pain for six or seven years. Each episode is accompanied by whole-body chills, and pain stops only after spitting out saliva/phlegm. This is a manifestation of Qi stagnation and bi-syndrome, where inducing vomiting leads to dispersion. The method should be to raise Yang and scatter depression. (Depression injuring Spleen Yang)
Pinellia Tuber (Ban Xia), Areca Seed (Cao Guo), Sichuan Chinaberry Seed (Jin Ling Zi), Corydalis Rhizome (Yan Hu), Magnolia Bark (Nong Po), Ginger (Sheng Jiang), Perilla Stem (Su Geng)
Patient Cheng, turbid filth obstructs the Middle Jiao, Qi mechanism is not free. Abdominal pain and epigastric bi-syndrome occur. Aromatic herbs to expel filth should be used, combined with dispersing and draining methods. (Filth obstructing Qi)
Agastache Herb (Huo Xiang), Magnolia Bark (Nong Po), Apricot Seed (Xing Ren), Radish Seed (Lai Fu Zi), Pinellia Tuber (Ban Xia), Tangerine Peel (Guang Pi Bai)
Patient Zheng, pulse is deep and faint (Chen Wei). Abdominal pain with urge to defecate. Yin turbidity coagulates internally, indicating accumulated decline of Yang Qi. To unblock Yang, acrid-hot herbs are necessary. (Internal obstruction of Yin turbidity, blocking Fu organ Yang)
Raw Atractylodes Rhizome (Sheng Bai Zhu), Evodia Fruit (Wu Yu), Galangal Rhizome (Liang Jiang), Prepared Aconite Lateral Root (Chuan Shu Fu), Poria (Fu Ling), Fennel Seed (Xiao Hui)
Patient Mou, Fu organ Yang is not unblocked, causing abdominal pain. Use Yuyuli Wan (Hematitum Pill) to warm the lower part and promote diffusion. After bowel movements and urination become smooth, distension eases, and the abdomen becomes soft. This indicates that formless Qi has not yet revitalized; thus, dispersing, tonifying, and awakening the middle Jiao is appropriate.
Raw Atractylodes Rhizome (Sheng Bai Zhu), Magnolia Bark (Nong Po), Tangerine Peel (Guang Pi), Pinellia Tuber (Ban Xia), Poria (Fu Ling), Alpinia Oxyphylla Fruit (Sheng Yi Zhi), Ginger Juice (Jiang Zhi)
Patient Mou, Qi knotting, abdominal pain, reduced appetite, alternating chills and fever. (Liver Qi Stagnation) Xiaoyao San without Atractylodes, plus Curcuma Longa Rhizome (Yu Jin), Cyperus Rhizome (Xiang Fu).
Patient Mou (female), Liver Qi stagnation, abdominal pain with palpable mass, irregular menstruation. (Liver Stagnation and Blood Stasis)
Cyperus Rhizome (Xiang Fu), Ligusticum Rhizome (Chuan Xiong), Angelica Sinensis Root (Dang Gui), Cinnamon Bark (Rou Gui), Trogopterus Dung (Wu Ling Zhi), Costus Root (Mu Xiang)
Evodia Fruit (Wu Yu), Stir-fried White Peony Root (Chao Bai Shao)
Patient Bi, urination is normal, stool is black, abdominal pain around the umbilicus. Gradually worsening over fifteen years. Pulse is deep, knotted, and choppy. This indicates that stagnant Qi has injured the collaterals of the Liver and Spleen, leading to blood degeneration and stasis retention. Labor and anger trigger the recurrence. Given the deep winter season of storage, purgatives are contraindicated. It is proposed to use acrid-warm herbs to unblock and moisten blood, following the principle "if there is free flow, there is no pain." (Stagnation injuring Liver-Spleen collateral blood, congealing into stasis)
Peach Kernel (Tao Ren), Cinnamon Twig (Gui Zhi Mu), Pangolin Scales (Chuan Shan Jia), Leek White (Lao Jiu Bai), taken with decoction of one qian of Asafoetida Pill (Wei Ai Wan).
Patient Xu (40 years old), rash for five or six years, aversion to cold in the body. During episodes, body temperature is not high. Every time defecating, there is abdominal pain and tenesmus. All these are due to Qi and Blood stagnation; they should be sought through the lens of depression diseases.
Angelica Sinensis Root (Dang Gui), Rhubarb prepared with wine (Jiu Zhi Da Huang), Immature Bitter Orange (Zhi Shi), Cinnamon Twig (Gui Zhi), Honey-fried Licorice Root (Zhi Cao), White Peony Root (Bai Shao)
Patient Mou, labor injures Qi, edema occurs, abdominal pain after eating. Temporarily use Weiji Tiaozhong method. (Labor injuring Middle Yang)
White Peony Root (2 qian), Honey-fried Licorice Root (0.5 qian), Angelica Sinensis Root stir-fried until charred (1.5 qian), Alpinia Oxyphylla Fruit ground (0.7 fen), Tangerine Peel (1 qian), Baked Ginger (1 qian)
Jujube flesh (3 qian), decocted in river water.
Patient Yuan (45-46 years old), abdominal pain around the umbilicus, occurring in winter, gradually improving in late spring. Episodes are accompanied by belching, triggered by hunger or labor. Treatment should focus on warming and unblocking the Ying (Nutrient) level. (Deficient Cold in Ying Level)
Angelica Sinensis Root (Dang Gui), Honey-fried Licorice Root (Zhi Cao), Cinnamon Bark (Rou Gui), Poria (Fu Ling), Roasted Ginger (Pao Jiang), Southern Jujube (Nan Zao)
Patient Hua, abdominal pain for three years, intermittent. Complexion is bright. This is Yin fluid pathogen, also brewed from alcohol dampness. Anger causes a palpable mass in the left hypochondrium, pain winding around the abdomen and affecting various Shu points on the chest and back. This indicates empty collaterals, where Yin fluid Qi attacks upward into the collaterals. Pain stops after consuming spicy-hot foods but recurs. Anger fractures Liver function; only acrid-spicy aromatics can resolve this. In discussing herbs, aroma and taste are paramount. (Depression and anger causing Yin fluid Qi to enter collaterals)
Coarse Cinnamon Twig (1 qian), Arisaema Rhizome soaked in ginger juice and stir-fried until black (1.5 qian), Raw Left Oyster Shell crushed (5 qian), Real Mandarin Nut stir-fried until fragrant and crushed (1.5 qian)
Sichuan Chinaberry Flesh (1 qian), Li Tree Bark from the east side (1 qian)
Patient Mou, during midsummer, abdominal distension decreases and appetite reduces, with slight pain. This is Summerheat injuring the Qi level. Dongyuan often harmonizes the Spleen and Stomach and disperses Liver Wood, which is very reasonable. Tonifying the Middle with cloying blood-invigorating herbs is incorrect. (Summerheat injuring Middle Qi)
Ginseng Root (Ren Shen), Tangerine Peel (Guang Pi), White Peony Root (Bai Shao), Poria (Fu Ling), Rice Sprout (Gu Ya), Alpinia Oxyphylla Fruit (Sheng Yi Zhi Ren)
The abdomen resides in the center. Pain arises from various causes. One must understand the distinction between formless and pathogenic factors to grasp the key principles of treatment. Formless pathogens include Cold coagulation, Fire depression, Qi obstruction, Ying deficiency, and Summer-Dampness or Sha Filth in summer and autumn. Formless pathogens refer to conditions like Cold coagulation, Fire depression, Qi obstruction, Ying deficiency, and seasonal pathogens such as Summer-Dampness and Sha Filth. Formful pathogens include Blood accumulation, Food stagnation, Masses (Jia), Roundworms, Pinworms, Internal Hernia, and accumulations formed by habitual dietary preferences. Examine the height and depth of the pain, distinguish the vigor or decline of complexion and pulse, and carefully investigate the exact origin of the cause. Generally, Zang organ disorders focus on the Liver, Spleen, and Kidney; Fu organ disorders prioritize the Intestines and Stomach. Zang organs have mutual restraining relationships, unlike Fu organs which utilize "unblocking" as their primary function. The term "unblocking" (Tong) should not be rigidly interpreted as purgation. Ancient formulas such as Jianzhong Tang, Lizhong Tang, Sanwu Nongpo Tang, and Nongpo Wenzhong Tang each possess profound logic. Examining Mr. Ye's application of ancient formulas: to unblock Yang and drain turbidity, he used Wuzhuyu Tang and Sini Tang methods; to clear fire and drain depression, Zuojin Wan and Jinling San methods; to open the Qi level, Siqi Tang and Wumo Yin methods; to disseminate Ying and collaterals, formulas containing Pangolin Scales, Peach Kernel, Angelica Tail, and Leek Root, along with Xiayuxue Tang methods; to be gentle and harmonizing, Shaogan Tang modifications and Ganmai Dazao Tang methods; to be soft and unblocking, formulas containing Cistanche, Biota Seed, Cinnamon, and Angelica, along with Fumai Tang modifications. For food stagnation, he used digestion-promoting methods; for roundworm disturbance, he used calming methods; for masses, he used resolving methods; for internal hernia, he used pacifying methods; for Sha Filth, he used aromatic resolution; for fixed accumulations, he treated based on the root cause. These are all Mr. Ye's methods of modification. If dealing with internal abscesses in surgery or the four syndromes in gynecology, referring to these methods across categories ensures no omission. (Commentary by Shao Xinpu)
Xu's Commentary: Chronic abdominal pain must involve stagnation/accumulation. Accumulation-expelling pills should be used to gradually eliminate them. Decoctions may not suffice for chronic diseases. The use of pills and powders in the cases is exquisite.