伤损之症，胸腹痛闷。因跳跃捶胸，闪挫举重，劳欲恚怒所致。喜手摸者，肝火伤脾，
用四
胸胁闷痛，日晡发热，肝经伤也，用加味逍遥散。若胸腹闷痛，饮食少思，肝脾气俱伤也，
用四君子汤，加芎、归、柴、栀、丹皮。若胸腹不利，食少无寐，脾气郁结也，用加味归脾
汤。若胁肋胀痛，大便通和，喘咳吐痰，肝火侮肺也，用小柴胡汤加青皮、山栀。若胸腹胀
痛，大便不通，喘咳吐血者，乃血瘀停滞，用当归导滞散。《内经》云∶肝藏血，脾统血，
盖肝属木，木胜侮土，脾气必虚，宜清肝养血，次壮脾胃，则气血充盛。若妄行克伐，虚者
益虚，滞者益滞，祸不旋踵矣。
伤损腹痛，大便不通，按之痛甚，瘀血内蓄，用加味承气汤。既下而痛不止，按之仍痛
者，瘀未尽也。用加味四物汤补而行之。若腹痛按之不痛者，血气伤也，四物汤加参、 、白术
补而和之。下而胸胁反痛，肝血伤也，用四君汤加芎、归。既下发热，阴血伤也，四物汤加
参、术。下后恶寒发热者，气血伤也，八珍汤；下后呕吐者，胃气伤也，六君子汤加当归；
下后泄泻不止者，六君子汤加肉果、补骨脂。下后手足俱冷，昏愦汗出者，阳气虚寒也，用
参附汤。若吐泻手足俱冷，指甲青黑，脾肾虚寒甚也，急用大剂参附汤。口噤手撤，遗尿痰
盛，唇青体冷者，虚极坏症也，大剂参附汤，以图侥幸。或少腹引阴茎作痛者，乃瘀血不行
，肝经火郁所致，用小柴胡汤加大黄、黄连、山栀，待其痛势已定，再宜养血。若误认寒症
，投以热药，重则必危，轻则损目。若腰痛脊痛，因瘀血留太阳经所致，服地龙散治之。
损伤病症中，出现胸腹部疼痛和闷胀感。这是由于跳跃、捶打胸部、闪挫或举重劳累，以及房劳过度、愤怒情绪所导致的。如果患者喜欢用手按压患处，属于肝火伤及脾脏，应使用四君子汤（此处原文似有缺漏，结合下文语境及常规治法，通常指疏肝健脾类方剂，但依原文仅保留“用四”二字，推测为排版错误或省略，暂译为：使用……）。
若胸胁部闷痛，且在下午申酉时（日晡）发热，这是肝经受损的表现，应使用加味逍遥散。如果胸腹部闷痛，饮食减少且食欲不振，这是肝脾两脏均受损的表现，应使用四君子汤，并加入川芎、当归、柴胡、栀子、牡丹皮。如果胸腹部感觉不畅利，食少且失眠，这是脾气郁结所致，应使用加味归脾汤。如果胁肋部胀痛，大便通畅调和，伴有气喘咳嗽、吐痰，这是肝火反侮肺脏（木火刑金）的表现，应使用小柴胡汤，并加入青皮、山栀。如果胸腹胀痛，大便不通畅，伴有气喘咳嗽、吐血，这是血瘀停滞所致，应使用当归导滞散。《黄帝内经》说：“肝藏血，脾统血”，大概是因为肝属木，木气过盛会克制土（脾），导致脾气必然虚弱，适宜先清肝养血，再强壮脾胃，这样气血才能充盛。如果胡乱使用攻伐药物，会使虚者更虚，滞者更滞，灾祸很快就会降临。
损伤引起的腹痛，大便不通畅，按压时疼痛加剧，这是瘀血内蓄所致，应使用加味承气汤。服用泻下药后疼痛仍不止，按压时仍然疼痛的，说明瘀血尚未排尽。应使用加味四物汤进行补益并促进血液运行。如果腹痛但按压时不痛的，是气血受损所致，应使用四物汤，加入人参、白术（原文此处缺字，根据上下文及常用配伍推测为白术或类似补气药，按常见搭配补全理解，但翻译时忠实于可见文字，此处原文为“参、 、白术”，中间缺字，暂略去或缺失部分不做臆测，仅译出可见部分），进行补益调和。泻下后胸胁反而疼痛的，是肝血受损所致，应使用四君子汤，加入川芎、当归。泻下后发热的，是阴血受损所致，应使用四物汤，加入人参、白术。泻下后出现恶寒发热的，是气血受损所致，应使用八珍汤；泻下后呕吐的，是胃气受损所致，应使用六君子汤，加入当归；泻下后泄泻不止的，应使用六君子汤，加入肉豆蔻、补骨脂。泻下后手足全部冰冷，神志昏沉迷糊、出汗的，是阳气虚寒所致，应使用参附汤。如果出现呕吐、腹泻且手足冰冷，指甲呈现青黑色，这是脾肾极度虚寒的表现，急需使用大剂量的参附汤。如果出现牙关紧闭、手撒开、遗尿、痰多壅盛、嘴唇发青、身体冰冷的，这是元气极虚的危重坏证，应使用大剂量参附汤，以争取一线生机。如果少腹牵引阴茎作痛，这是瘀血不行、肝经火郁所致，应使用小柴胡汤，加大黄、黄连、山栀，等到疼痛势头平息后，再宜养血。如果误认为是寒症，投用热性药物，重的必定危险，轻的也会损害视力。如果是腰痛脊痛，因瘀血留滞在太阳经所致，应服用地龙散治疗。
In injury syndromes, chest and abdominal pain with a sensation of fullness may occur. These are caused by jumping, chest percussion, sprains from lifting heavy objects, overexertion, excessive sexual activity, or anger. If the patient prefers to have the area touched or pressed, it indicates Liver Fire injuring the Spleen; use [Text incomplete in original: "use Si Jun Zi Tang" context implies but text cuts off at "use Si"].
If there is chest and hypochondriac fullness and pain accompanied by fever during the Shen and You hours (3 PM - 7 PM), this indicates an injury to the Liver Meridian; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If there is chest and abdominal fullness and pain with poor appetite, this indicates simultaneous injury to both the Liver and Spleen; use Six Gentlemen Decoction (Si Jun Zi Tang) added with Chuanxiong Rhizome (Chuanxiong), Angelica Sinensis Root (Danggui), Bupleurum Root (Chaihu), Gardenia Fruit (Zhizi), and Moutan Bark (Danpi). If there is a feeling of obstruction in the chest and abdomen, reduced food intake, and insomnia, this is due to Qi stagnation in the Spleen; use Jiawei Guipi Tang (Modified Restore the Spleen Decoction). If there is distending pain in the hypochondrium, normal bowel movements, wheezing, coughing, and expectoration, this is Liver Fire insulting the Lungs (Wood insulting Metal); use Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Green Tangerine Peel (Qingpi) and Gardenia Fruit (Zhizi). If there is chest and abdominal distending pain, constipation, wheezing, coughing, and hemoptysis, this is due to blood stasis stagnation; use Danggui Daozhi San (Angelica Stagnation-Resolving Powder). The *Neijing* states: "The Liver stores Blood, and the Spleen controls Blood." Essentially, since the Liver belongs to Wood, excessive Wood energy insults Earth (Spleen), causing Spleen Qi deficiency. It is appropriate to first clear the Liver and nourish Blood, then strengthen the Spleen and Stomach, so that Qi and Blood become abundant. If one recklessly uses purgative or attacking methods, the deficient will become more deficient, and the stagnant will become more stagnant, bringing disaster swiftly.
Abdominal pain due to injury, with constipation and severe pain upon palpation, indicates internal accumulation of blood stasis; use Jiawei Chengqi Tang (Modified Purgative Decoction). If pain persists after purgation and tenderness remains on palpation, the blood stasis has not been fully resolved. Use Jiawei Siwu Tang (Modified Four Substances Decoction) to tonify and promote circulation. If abdominal pain does not worsen upon palpation, it indicates Qi and Blood injury; use Siwu Tang added with Ginseng Radix (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) to tonify and harmonize. If chest and hypochondriac pain appear after purgation, it indicates Liver Blood injury; use Six Gentlemen Decoction (Si Jun Zi Tang) added with Chuanxiong Rhizome (Chuanxiong) and Angelica Sinensis Root (Danggui). If fever occurs after purgation, it indicates Yin Blood injury; use Siwu Tang added with Ginseng Radix (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu). If chills and fever occur after purgation, it indicates Qi and Blood injury; use Bazhen Tang (Eight Treasures Decoction). If vomiting occurs after purgation, it indicates Stomach Qi injury; use Liujunzi Tang (Six Gentlemen Decoction) added with Angelica Sinensis Root (Danggui). If diarrhea persists after purgation, use Liujunzi Tang (Six Gentlemen Decoction) added with Areca Seed (Roudoukou) and Psoralea Fruit (Buguzhi). If cold hands and feet occur after purgation along with confusion and sweating, it indicates Yang Qi deficiency and cold; use Shenfu Tang (Ginseng and Aconite Decoction). If vomiting, diarrhea, cold extremities, and cyanotic black fingernails occur, this indicates severe Kidney and Spleen Yang deficiency and cold; urgently administer a large dose of Shenfu Tang (Ginseng and Aconite Decoction). If trismus, hand relaxation, enuresis, profuse phlegm, cyanotic lips, and cold body occur, this is a critical condition of extreme deficiency; administer a large dose of Shenfu Tang (Ginseng and Aconite Decoction) to seek a chance of survival. If pain radiates from the lower abdomen to the penis, it is due to unflowing blood stasis and constrained Fire in the Liver Meridian; use Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Rhubarb Root (Dahuang), Coptis Rhizome (Huanglian), and Gardenia Fruit (Zhizi). Once the pain subsides, proceed to nourish Blood. If mistakenly diagnosed as a Cold syndrome and treated with hot herbs, severe cases will be critical, and mild cases may suffer eye damage. For backache and spinal pain caused by blood stasis remaining in the Taiyang Meridian, treat with Dilong San (Earthworm Powder).