娄全善先生云∶痘腹痛多是热毒为患，当临症消息之。又云∶痘出腹痛，或身痛脉洪数者，用解毒凉药加芍药、甘
草。窃谓前症若痘未出而发热烦躁，或作渴饮冷，大便坚实，此热毒壅滞也，用疏利之药。若痘已出而不热躁，不饮
冷，大便不实，此元气虚弱也，用白术散之类补之。若嗳腐吞酸，大便秽臭，乳食停滞也，用保和丸消之。凡腹痛作渴
饮冷，手足并热者，属实热；作渴饮汤，手足并冷者，属虚寒。虚寒者，当温补脾胃；虚弱者，当调补脾胃。
一小儿善食作渴，腹痛便秘，痘痕赤色，先用加味四物汤而愈。后仍痛恶食，此脾胃受伤，用白术散而痊。
一小儿痘将靥，腹胀发热面赤，午后益甚，按其腹不痛，余谓脾虚，用五味异功散而痊。
一小儿出痘腹痛，大便似利，寒热往来，余以为脾气虚，用白术散而痊。
一小儿出痘，腹痛作渴，饮食如常，光泽红活，此胃经实热，先用泻黄散，一剂顿安，又用白木散而痊。
一小儿痘后，腹痛作渴，饮冷便秘，用清凉饮末五分顿安。后腹痛吐泻发搐，用白术散加钩藤钩而愈。
一小儿出痘腹痛，嗳腐吞酸，此饮食停滞，先用保和丸二服，续用五味异功散而痛止，又用托里散而靥。
人参理中汤 治脾胃虚寒，胸膈痞满，或心腹疼痛，痰逆呕吐少气；或霍乱吐利，手足厥冷，不喜饮水。
（加附子名附子理中汤）
人参 白术 干姜（炮。各等分） 甘草（炒，减半）
上每服三钱，水煎。或研末，白汤调下。
一味异功散 治小儿诸般钓症，角弓反张，胸膈脐凸，以透明没药为末，姜汤调下。
桔梗枳壳汤 治气壅痞结，腹胁疼痛。
桔梗 枳壳（炒。各二两） 甘草（炙，半两）
上每服二三钱，姜水煎。
七味白术散 治肚腹作痛，和胃气，生津液。若脾胃气虚，作渴饮汤，或因吐泻，津液亏损，烦渴引饮；或脾
胃气虚，腹胀泻渴，弄舌流涎，手足指冷，并宜服之，以温补脾气，化生津液。（方见发热属阴阳）
保和丸 治饮食停滞腹痛，或恶寒发热，不可多服。
神曲（炒） 山楂 半夏 茯苓 陈皮（各一两） 连翘 萝卜子（各五钱）
上为末，粥饭丸，小豆丸。每服二三十丸，白汤送下，化服亦可。加白术，名大安丸。
六君子汤 治脾胃气虚，肚腹作痛，或吐泻不食；或肺虚痰喘，气促恶寒；或肝虚惊搐，眩晕自汗诸症，并宜
服。即四君子汤，加陈皮、半夏。（方见不靥闷乱）
泻黄散（方见痘泻渴）
五味异功散（方见寒战切牙）
圣济犀角地黄汤（方见顶陷心烦）
托里散（方见痘痈）
四物汤（方见痘疮出迟）
清凉饮（方见痘大便不通）
娄全善先生说：痘疹引起的腹痛，大多是由热毒致病，应当根据具体症状仔细辨证。他又说：痘疹发出后出现腹痛，或者身体疼痛、脉象洪大而数的，使用解毒凉血药并加入芍药、甘草。
我认为上述病症中，如果痘疹尚未发出而发热烦躁，或者口渴想喝冷水，大便干结坚硬，这是热毒壅滞所致，应使用疏泄通利的药物。如果痘疹已经发出而不发热躁动，不想喝冷水，大便稀溏不成形，这是元气虚弱所致，应使用白术散之类的方剂进行补益。如果出现嗳气有腐臭味、吞酸，大便气味秽臭，这是乳食停滞所致，应使用保和丸来消食导滞。凡是腹痛且口渴想喝冷水，手足都发热的，属于实热证；口渴想喝热水，手足都发冷的，属于虚寒证。虚寒证，应当温补脾胃；元气虚弱证，应当调理补益脾胃。
有一个小孩食欲好但易口渴，腹痛便秘，痘痕颜色赤红，先用加味四物汤治疗而痊愈。后来仍然疼痛、厌恶进食，这是脾胃受伤，用白术散治疗而康复。
有一个小孩痘疹即将结痂，腹胀发热面赤，午后加重，按压腹部不痛，我认为是脾虚，用五味异功散治疗而康复。
有一个小孩出痘疹腹痛，大便像腹泻一样，寒热往来，我认为是脾气虚，用白术散治疗而康复。
有一个小孩出痘疹，腹痛且口渴，饮食如常，痘色光泽红活，这是胃经实热，先用泻黄散，一剂药后顿时安宁，又用白术散治疗而康复。（注：原文“白木散”疑为“白术散”之误，此处依语境及常见用法译为白术散，若严格对应原文则为“白木散”，但在中医古籍校勘中通常指代白术散，鉴于任务要求忠实原文，此处保留“白木散”或根据上下文逻辑修正。考虑到前文多次提及白术散治脾虚，且“白木”非标准方名，极大概率为“白术”之误。但为了严格遵守“不增添内容”原则，我将翻译为“白木散”，并在括号内备注可能为白术散，或者直接译为白术散以符合医学常识。鉴于指令要求“准确、流畅”，且前文已有白术散，此处推测为笔误。为稳妥起见，译为“白术散（原文作白木散）”或直接译为白术散。在此选择最合理的医学解释：白术散。） *修正：为了严格遵循“不遗漏、不增添”，我将直译“白木散”，但通常在现代白话文中会指出其意。此处直接译为“白术散”更符合“通俗易懂”的要求，因为“白木散”在中医里极少见，多为传抄错误。* -> 决定译为：白术散。
有一个小孩痘疹之后，腹痛且口渴，喝冷水、大便干结，用清凉饮粉末五分顿服即安。后来腹痛、呕吐腹泻并发搐搦，用白术散加钩藤钩治疗而痊愈。
有一个小孩出痘疹腹痛，嗳气有腐臭味、吞酸，这是饮食停滞，先用保和丸服用两次，接着用五味异功散使疼痛停止，又用托里散使痘疹结痂。
人参理中汤：治疗脾胃虚寒，胸膈痞闷胀满，或者心腹疼痛，痰逆呕吐、少气乏力；或者霍乱吐泻，手足厥冷，不喜欢喝水。
（加入附子称为附子理中汤）
人参、白术、干姜（炮制。各等分）、甘草（炒，减半量）。
以上每服三钱，用水煎煮。或者研成粉末，用白开水调服。
一味异功散：治疗小儿各种疳积症状，角弓反张，胸膈肚脐凸起，用透明的没药研末，姜汤调服。
桔梗枳壳汤：治疗气机壅塞痞结，腹胁部疼痛。
桔梗、枳壳（炒。各二两）、甘草（炙，半两）。
以上每服二三钱，用姜水煎煮。
七味白术散：治疗肚腹作痛，调和胃气，生津液。如果脾胃气虚，口渴想喝热水，或者因为呕吐腹泻，津液亏损，烦渴引饮；或者脾胃气虚，腹胀、腹泻、口渴，弄舌流涎，手足指头冷，都适宜服用，以温补脾气，化生津液。（方剂详见发热属阴阳章节）
保和丸：治疗饮食停滞引起的腹痛，或者恶寒发热，不可多服。
神曲（炒）、山楂、半夏、茯苓、陈皮（各一两）、连翘、萝卜子（各五钱）。
以上研成粉末，用粥饭或豆丸作为粘合剂制成丸药。每次服用二三十丸，用白开水送下，也可以化开服用。加入白术，称为大安丸。
六君子汤：治疗脾胃气虚，肚腹作痛，或者吐泻不食；或者肺虚痰喘，气促恶寒；或者肝虚惊搐，眩晕自汗等各种症状，都适宜服用。即四君子汤，加上陈皮、半夏。（方剂详见不靥闷乱章节）
泻黄散（方剂详见痘泻渴章节）
五味异功散（方剂详见寒战切牙章节）
圣济犀角地黄汤（方剂详见顶陷心烦章节）
托里散（方剂详见痘痈章节）
四物汤（方剂详见痘疮出迟章节）
清凉饮（方剂详见痘大便不通章节）
Mr. Lou Quanshan stated: Abdominal pain caused by smallpox is mostly due to heat-toxin pathogenesis; one should carefully assess the symptoms clinically. He further stated: If abdominal pain occurs after the eruption of smallpox, accompanied by body pain and a flooding, rapid pulse, use cooling and detoxifying herbs with added Paeoniae Radix (Shaoyao) and Glycyrrhizae Radix et Rhizoma (Gancao).
I believe that in the aforementioned conditions, if fever and restlessness occur before the eruption of smallpox, or if there is thirst with a desire to drink cold water and hard, dry stools, this indicates stagnation of heat-toxin; one should use herbs that promote drainage and purgation. If the smallpox has erupted but there is no fever or restlessness, no desire for cold drinks, and loose stools, this indicates deficiency of primordial qi; one should use formulas such as Baizhu San (Atractylodes Macrocephala Powder) to tonify. If belching with a rotten smell, acid regurgitation, and foul-smelling stools occur, this indicates retention of milk and food; one should use Baohe Wan (Harmonize the Stomach Pill) to resolve stagnation. Whenever abdominal pain is accompanied by thirst with a desire for cold drinks and hot hands and feet, it belongs to excess-heat; when thirst is accompanied by a desire for warm drinks and cold hands and feet, it belongs to deficiency-cold. For deficiency-cold, one should warm and tonify the Spleen and Stomach; for qi deficiency, one should regulate and tonify the Spleen and Stomach.
A child who had a good appetite but was prone to thirst, suffering from abdominal pain and constipation, with red smallpox scars, was cured using Jiawei Siwu Tang (Modified Four Substances Decoction). Later, pain and anorexia recurred, indicating injury to the Spleen and Stomach; he recovered after taking Baizhu San (Atractylodes Macrocephala Powder).
A child whose smallpox was about to crust over presented with abdominal distension, fever, and facial redness, worsening in the afternoon. Palpation of the abdomen revealed no pain; I diagnosed Spleen deficiency and treated him with Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder), resulting in recovery.
A child with smallpox-induced abdominal pain, stool resembling diarrhea, and alternating chills and fever was diagnosed with Spleen qi deficiency; treatment with Baizhu San (Atractylodes Macrocephala Powder) led to recovery.
A child with smallpox presented with abdominal pain and thirst, normal diet, and bright, vibrant red smallpox lesions. This was diagnosed as excess-heat in the Stomach meridian. Initial treatment with Xiehuang San (Drain Yellow Powder) brought immediate relief after one dose, followed by recovery with Baizhu San (Atractylodes Macrocephala Powder). *(Note: Original text says "Baimu San", likely a typo for Baizhu San)*.
After a child's smallpox episode, abdominal pain and thirst with cold water intake and constipation occurred. Five fen of Qingliang Yin (Cooling Drink) powder provided immediate relief. Subsequently, abdominal pain, vomiting, diarrhea, and convulsions developed; treatment with Baizhu San (Atractylodes Macrocephala Powder) plus Uncaria rhynchophylla (Gouteng) resulted in cure.
A child with smallpox-induced abdominal pain, belching with a rotten smell, and acid regurgitation was diagnosed with food stagnation. Two doses of Baohe Wan (Harmonize the Stomach Pill) were administered first, followed by Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) to stop the pain, and Tuoli San (Support the Interior Powder) to facilitate crusting.
**Renshen Lizhong Tang (Ginseng and Atractylodes Decoction to Regulate the Middle)**: Treats deficiency-cold of the Spleen and Stomach, chest and diaphragm fullness and obstruction, or heart and abdominal pain, phlegm reversal with vomiting and shortness of breath; or cholera-like vomiting and diarrhea, cold extremities, and aversion to drinking water.
*(Adding Fuzi (Prepared Aconite Root) makes it Fuzi Lizhong Tang)*
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Zingiberis Rhizoma - processed), equal parts each; Gancao (Licorice Root - stir-fried), half the amount.
Take three qian per dose, decoct in water. Alternatively, grind into powder and take with warm water.
**Yiwei Yigong San (Single-Ingredient Extraordinary Efficacy Powder)**: Treats various pediatric malnutrition syndromes, opisthotonos, convexity of the chest, diaphragm, and umbilicus. Make transparent Mayyao (Myrrha) into powder and take with ginger water.
**Jiegeng Zhike Tang (Platycodon and Aurantium Decoction)**: Treats qi stagnation and obstruction, abdominal and hypochondriac pain.
Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus - stir-fried), two liang each; Gancao (Licorice Root - honey-fried), half a liang.
Take two to three qian per dose, decoct in ginger water.
**Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder)**: Treats abdominal pain, harmonizes Stomach qi, and generates body fluids. If Spleen and Stomach qi deficiency causes thirst with a desire for warm drinks, or if fluid depletion due to vomiting and diarrhea causes irritability and intense thirst; or if Spleen and Stomach qi deficiency causes abdominal distension, diarrhea, thirst, tongue protrusion, drooling, and cold fingertips, this formula is suitable to warm and tonify Spleen qi and transform fluids. (See Fever: Yin and Yang chapter for the formula details).
**Baohe Wan (Harmonize the Stomach Pill)**: Treats abdominal pain due to food stagnation, or aversion to cold with fever. Do not take in large quantities.
Shenqu (Massa Medicata Fermentata - stir-fried), Shanzha (Crataegi Fructus), Banxia (Pinelliae Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), one liang each; Lianqiao (Forsythiae Fructus), Luobozhi (Brassicae Semen), five qian each.
Grind into powder, make pills using congee or bean paste. Take 20–30 pills per dose with warm water, or dissolve and take. Adding Baizhu (Atractylodis Macrocephalae Rhizoma) creates Da'an Wan (Great Peace Pill).
**Liujunzi Tang (Six Gentlemen Decoction)**: Treats Spleen and Stomach qi deficiency causing abdominal pain, vomiting/diarrhea and anorexia; Lung deficiency with phlegm-wheezing, shortness of breath, and aversion to cold; Liver deficiency with convulsions, vertigo, and spontaneous sweating. All these conditions are suitable for this formula. It is Sijunzi Tang (Four Gentlemen Decoction) plus Chenpi (Citri Reticulatae Pericarpium) and Banxia (Pinelliae Rhizoma). (See Non-crusted Restlessness chapter for the formula details).
Xiehuang San (Drain Yellow Powder) (See Smallpox Diarrhea and Thirst chapter).
Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) (See Chills and Teeth Grinding chapter).
Shengji Xijiao Dihuang Tang (Sangji Rhinoceros Horn and Rehmannia Decoction) (See Sunken Crown and Heart Distress chapter).
Tuoli San (Support the Interior Powder) (See Smallpox Carbuncle chapter).
Siwu Tang (Four Substances Decoction) (See Delayed Smallpox Eruption chapter).
Qingliang Yin (Cooling Drink) (See Smallpox Constipation chapter).