四帖，加甘草下之，痛呕虽减，食犹未进；遂与小柴胡汤去黄芩、人参，加芍药、陈皮、黄连、生甘草二十帖
而愈。
白云许先生，始因饮食作痰成脾疼，后累因触冒风雪，腿骨作疼，众皆以脾疼、骨疼为寒，杂进黄牙 丹
等药杂治。十余年间，艾灸数万计，或似有效，及至病再作，反觉加重。至五十一岁时，又冒雪乘船而病愈加，
至坐则不能起，扶起亦不能行，两胯骨不能开合。若脾疼作时，则两胯骨痛处似觉稍轻；若饮食甘美，脾疼不
作，则胯骨重痛增。诸老袖手，计无所出。予谓此初因中脘有食积痰，杂以胃寒湿抑遏经络，血气津液不行，
痰饮注入骨节，往来如潮，其涌而上则为脾疼，降而下则为胯痛，非涌泄之法不足以治之。时七月二十四日，
遂以甘遂末一钱，入猪腰子内煨与食之，连泻七行，至次日两足便能行步。至八月初三日，呕吐大作，不能起
床，颗粒不食，但时烦躁，气弱不能言语，诸老皆归罪于七月之泻，而又知累年热补之误，皆不敢用药。予尝
记《金匮》云∶病患无寒热，而短气不足以息者，此实也。其病多年郁结，一旦以刀圭之剂泄之，徒动猖狂之
势，他未有制御之药，所以如此。仍以吐剂达其上焦，以次第治及中、下二焦。于初三日，用瓜蒂吐不透；初
六日，用栀子又吐不透；初九日，用附子尖三枚和浆水与之，始得大吐，其呕哕终止。前后所吐，共得膏痰沫
液一大水桶。初十日，遂以朴硝、滑石、黄芩、石膏、连翘等凉药， 咀一斤，蒸煎浓汁，放井水中极冷冻饮料之。
十一月十二日、十三日、十四日，每日食上件药一斤；十五日，腹微满，大小便皆秘闷。予欲用大承气下之，
诸老皆以为不可。十六日，六脉皆歇至。予诊其脉，独歇至卯酉二时，其余时刻平匀如旧。予曰卯酉为手、足
阴阳之应，此大肠与胃有积滞不行所致，当速泻之。争论不已。至十八日，遂作紫雪半斤。十九日早，紫雪成，
每用一匙头，以新汲井水化下，至二十日天未明，已服紫雪五两，神思稍安，腹满亦减。遂收起紫雪不与。二
十一日，大为小便闭作痛所苦，遂饮以萝卜子汁半茶钟，随手痛止，小便立通。二十二日，小腹满痛，不可扪摸，
神思不佳，遂以大黄、牵牛作丸，服至三百丸。至二十三日巳时，下大便，并通如烂鱼肠三碗许，臭恶可畏。
是日神思稍安，诊其脉不歇至矣。二十四日，腹大绞痛，殆不能胜者约一时许，腰胯沉重且坠，两时不出声，
不能言，泻下秽物如 油条者一尺余，肚中如烧，片时方定。至二十五日，神思渐安，夜间得睡。二十六日，渐能
出声言语。自初二日至此，并颗粒不曾入口，语言并不出声。至二十七日，方啜半盏稀粥者四次，似有生意。至
次月初四日方平安。其脉自呕吐至病安日，皆是平常弦大之脉，唯有中间数日歇至少异耳。至次年四月复行倒
仓法，方步履如初。
肠痈亦腹痛，但小便数似淋，脉滑数为异耳。（治法见肠痈本门。）
〔《肘》〕治小腹俱胀痛，短气欲死，或已绝。用乌梅二七枚，水五升，煮一沸，内大钱二七枚，煮取二
升半，强人可顿服；瘦人可分之再服。
〔海〕当归丸 治三阴受邪，于心、脐、少三腹疼痛，气风等症。
四物汤（各半两） 防风 独活 全蝎（各五分） 续断（一两） 苦楝 玄胡（各七钱） 木香 丁香（各二钱
半） 茴香（一两，炒）
上为细末，酒糊丸，桐子大。空心温酒下三五十丸，大效。
四物苦楝汤
四物汤（四两） 玄胡索 苦楝（各一两）
〔云〕治腹中搅痛不可忍。
玄胡索 当归 白芍 川芎 干姜（各等分）
上为末。每服三钱，温酒调下。
又法 治证同前。
玄胡索 桂心（各半两） 当归（一两）
上为细末，热酒调下。
失笑散 治心腹痛欲死，百药不效，服此顿愈，（方见心痛。）
〔《经》〕治脾寒气发歇痛不可忍者。茱萸一两，桃仁一两和炒，令茱萸焦黑后，去茱萸，取桃仁，去皮
尖研细，葱白三茎煨熟，以酒浸，温分三服。
腹痛，脉滑者，痰；脉弦者，食。
清痰多作腹痛。
台芎 苍术 香附 白芷
上为末，生姜自然汁调入，热汤服之。
温中丸 治食积肚痛。
白术 香附（童便浸） 针砂（各四两，醋浸，炒红） 山楂肉 神曲（各八两） 苦参（一两）
川芎（半两，春用夏去） 吴茱萸（半两，汤浸。冬用春去之） 苍术（米泔浸一宿，二两五钱）
上为末，醋调曲糊为丸，如桐子大。一方，去山楂、神曲、川芎，加半夏、青皮、黄连。
〔世〕苍术丸 治失饥伤饱，肚痛不食。
苍术（炒） 橘红（等分，为末）
上生姜汁打、炒，神曲糊丸，如桐子大。每七十丸，米饮下。
〔丹〕酒积腹疼痛。用三棱、蓬莪术、香附、官桂、苍术、浓朴、陈皮、甘草、茯苓、木香、槟榔治之。
杨淳三哥，年六十，食积痰作痛在心头，或在腹胁，脉皆弦涩，食甚少，大便秘实，此湿积也，宜生血、
行气、进食、磨积、补虚。
白术 炒曲 半夏（各一钱半） 郁李仁 归身尾 芍药 陈皮（各五钱） 山楂（五钱） 川芎（三钱）
人参（二钱） 柴胡（二钱） 红花（五分） 桃仁（三个）
细末粥丸。一日三次，食前白汤下四五十丸。
〔罗〕七气汤 治虚冷上气，及寒气、怒气、思气、喜气、忧气、愁气，内结积聚，坚牢如杯，心腹绞痛，不
能饮食，时发时止，发即欲死，此药主之。
半夏（汤洗，五两） 人参（去芦） 甘草（炙） 肉桂（各一两）
上为粗末，入半夏令匀。每服二钱，水一大盏，生姜三片，煎七分，去渣稍热服，食前。
腹痛有作止者，有块耕起往来者，吐清水者，皆是虫痛。治法见心痛。
井窈渠吴孺人，年近四十，得腹隐痛，常以火烧砖瓦熨之，面与胸襟间，恶火之热气。发时少烦，食亦减，
六脉和，皆微弦，最苦夜间不得睡，但世上凶恶之事，并忧苦境像皆上念，时作恶泣，说离别，嘱付后事。
如此者一年，众作心痛治之。自觉气自下冲上，虽久病，人却不瘦。予曰∶此肝受病，遂与防风通圣散吐之。
时尚春寒，于通圣中加桂，入姜汁调之，日三四次，至初夏稍热，与当归龙胆丸、枳术丸，一月而愈。
运气 腹痛有二∶
一曰土盛攻肾而痛。经云∶岁土太过，雨湿流行，肾水受邪，民病腹痛清厥，意不乐是也。
二曰火郁之发痛。经云∶火郁之发，民病腹中暴痛是也。
〔世〕盐炒热，用布裹，熨痛处，神效。
〔丹〕搅肠沙。用台芎为末，每一钱许，入生姜自然汁半盏，热汤内调服。又方，樟木煎汤大吐之，或
用白矾末一钱，清汤调服探吐之，或盐汤探吐之亦可。
〔世〕治发沙，面青肚疼，昏倒不省人事。急以鼠屎一合，研为细末，滚汤调令通口澄清服之，一服而安，
神效。宜预收下。
刺灸 腹痛有四法∶
其一取脾胃。经云∶邪在脾胃，阳气不足，阴气有余，则寒中肠鸣腹痛，皆调于三里。又云∶足太阴之别，
名曰公孙，去本节之后一寸，实则腹中切痛取之所别也。又云∶腹痛刺脐左右动脉，已刺按之立已；不己，刺
气冲，已刺，按之立已是也。
其二取大肠。经云∶大肠病者，肠中切痛而鸣濯濯，感于寒即泄，当脐而痛，取巨虚、上廉是也。
其三取督脉。经云∶肾虚则胸中痛，大腹小腹痛，清厥，意不乐，取其经少阴、太阳血者是也。
其四取任脉。经曰∶任脉之别，名曰尾翳，下鸠尾，散于腹，实则腹皮痛，取之所别也。
〔世〕治绞肠沙症，手足厥冷，腹痛不可忍者，以手蘸温水，于病者膝湾内拍打，有紫黑处，以针刺去恶
血即愈。
〔《玉》〕腹痛，并治气块∶内关 支沟 照海
〔《撮》〕气痛，并治积痛，食不化∶气海（一寸半，灸五十壮。） 中脘（二寸半，灸十壮。） 隐白（二分，泻之，
灸七壮。）
〔桑〕又法∶巨阙 足三间
〔怪穴〕腹痛肠鸣∶气冲（在气海旁各一寸半，针入二寸半，灸五十壮。）
〔世〕脐腹痛∶阴陵泉 太冲 三里 支沟 不已，取下穴∶中脘 关元天枢 绕脐痛∶公孙 三阴交 阴谷
〔东〕胃脘暴痛，脐中坚痛∶石门 商丘 阴谷 大肠俞 膈俞
〔《甲》〕腹中尽疼，外陵主之。大肠寒中，（《千金》作“寒疝”）大便干，腹中切痛者，肓输主之。绕脐痛，
抢心，膝寒，注利，腹结主之。
〔仲〕夫瘦人绕脐痛，必有风冷，谷气不行，而反下之，其气必冲。不冲者，心下则痞也。
〔《脉》〕若腹痛，脉反浮大而长者死。（虫痛，脉浮大无妨。）
心腹痛，痛不得息，脉细小迟者生；坚大疾者死。（有积，脉坚大无妨。）
共服用四帖药，加入甘草以攻下实邪，虽然疼痛和呕吐有所减轻，但食欲仍未恢复；于是给予小柴胡汤（和解少阳的方剂），去掉黄芩、人参，加入芍药、陈皮、黄连、生甘草，连服二十帖后痊愈。
白云许先生，起初因为饮食不当导致痰湿内生，引发脾脏区域的疼痛，后来多次因冒犯风雪寒气，导致腿部骨骼疼痛。大家都认为脾疼和骨疼属于寒证，混杂服用黄牙丹等药物进行治疗。十多年来，艾灸次数数以万计，有时似乎有效，但等到病情复发时，反而觉得加重了。到了五十一岁时，又冒着雪乘船，病情更加严重，以至于坐着无法站起，扶起来也无法行走，两胯骨不能开合。如果脾脏区域疼痛发作时，两胯骨的疼痛处似乎稍微减轻；如果饮食甘美可口，脾脏区域不痛，那么胯骨的重痛就会增加。各位老医生束手无策，想不出办法。我认为这起初是因为中脘部位有食积和痰饮，夹杂胃寒湿气郁遏经络，导致气血津液运行不畅，痰饮注入骨节之间，往来如潮水般涌动，向上涌发则表现为脾脏区域疼痛，向下沉降则表现为胯部疼痛，不用涌吐泄下的方法不足以治疗。当时是七月二十四日，于是用甘遂末一钱，放入猪腰子内煨熟给他吃，连续腹泻七次，到第二天双脚就能行走了。到了八月初三日，呕吐大作，无法起床，颗粒食物不进，只是时常烦躁，气弱不能说话，各位老医生都归咎于七月的那次泻下，而又知道多年误用热补药的错误，都不敢再用药。我曾记得《金匮要略》中说：病人没有恶寒发热，但短气不足以呼吸的，这是实证。他的病多年郁结，一旦用少量药物泄之，只会触动猖狂的病势，而没有其他药物来制约它，所以会这样。仍然用催吐的方法通达上焦，按次序治疗中、下二焦。在初三日，用瓜蒂催吐未能彻底；初六日，用栀子催吐也未能彻底；初九日，用附子尖三枚配合浆水给他服用，才得到剧烈呕吐，呕逆声停止。前后所吐出的，共有一大桶膏状痰沫液体。初十日，于是用朴硝、滑石、黄芩、石膏、连翘等凉性药物，切碎一斤，蒸煎成浓汁，放在井水中极冷冻后饮用。十一月十二日、十三日、十四日，每天食用上述药物一斤；十五日，腹部轻微胀满，大小便都闭塞不通。我想用大承气汤（峻下热结的方剂）攻下，各位老医生都认为不可以。十六日，六脉皆出现歇止现象。我诊察他的脉搏，只有卯时和酉时两个时辰出现歇止，其余时刻平稳均匀如旧。我说卯酉对应手足阴阳经气，这是大肠与胃有积滞不行所致，应当迅速泻下。争论不休。到了十八日，于是制作紫雪（清热开窍的方剂）半斤。十九日早晨，紫雪制成，每次用一匙头，用新汲取的井水化开服用，到二十日天未亮时，已服用紫雪五两，神志稍安，腹胀也减轻。于是收起紫雪不再给服。二十一日，因小便闭阻疼痛非常痛苦，于是饮用萝卜子汁半茶钟，随即疼痛停止，小便立刻通畅。二十二日，小腹满痛，不可触摸，神志不佳，于是用大黄、牵牛子做成丸药，服用至三百丸。到二十三日巳时，排出大便，并通出如烂鱼肠状约三碗多，气味臭恶可怕。这一天神志稍安，诊察脉搏不再歇止。二十四日，腹部剧烈绞痛，几乎难以忍受，持续约一个时辰，腰胯沉重且下坠，两个时辰说不出话，不能言语，泻下秽物如油条状一尺多长，肚中如火烧，片刻后才安定。到二十五日，神志逐渐安宁，夜间能入睡。二十六日，渐渐能出声说话。从初二日到此时，一直颗粒食物未曾入口，语言也不出声。到二十七日，才喝四次半盏稀粥，似乎有了生机。到次月初四日才平安无事。其脉象从呕吐到病愈期间，都是平常弦大的脉象，唯有中间几天略有歇止不同。到次年四月再次进行倒仓法（一种通过大量进食肉类以清理肠胃的治疗方法），才能步履如初。
肠痈（肠道化脓性炎症）也是腹痛，但小便频数似淋证，脉象滑数是其不同之处。（治法见肠痈本门。）
〔《肘后备急方》〕治疗小腹部俱胀痛，短气欲死，或已断气。用乌梅十四枚，水五升，煮至沸腾一次，放入大铜钱十四枚，煮取二升半，体质强壮者可一次性服下；瘦弱者可分为两次服用。
〔海藏〕当归丸 治疗三阴经受邪，在心、脐、少腹三个部位疼痛，以及气风等症状。
四物汤（各半两） 防风 独活 全蝎（各五分） 续断（一两） 苦楝皮 玄胡索（各七钱） 木香 丁香（各二钱半） 茴香（一两，炒）
以上研为细末，酒糊为丸，如梧桐子大。空腹时用温酒送服三五十丸，效果显著。
〔云岐子〕治疗腹中搅痛不可忍受。
以上研为末。每服三钱，温酒调下。
又一种方法 治疗症状同前。
以上研为细末，热酒调下。
失笑散 治疗心腹疼痛欲死，百药无效，服用此药立即痊愈。（方剂见心痛门。）
〔《内经》〕治疗脾寒气发作时疼痛不可忍受。吴茱萸一两，桃仁一两一起炒，令吴茱萸焦黑后，去掉吴茱萸，取桃仁，去皮尖研细，葱白三茎煨熟，用酒浸泡，分三次温服。
以上研为末，生姜自然汁调入，热汤服之。
白术 香附（童便浸） 针砂（各四两，醋浸，炒红） 山楂肉 神曲（各八两） 苦参（一两）
川芎（半两，春用夏去） 吴茱萸（半两，汤浸。冬用春去之） 苍术（米泔浸一宿，二两五钱）
以上研为末，醋调曲糊为丸，如梧桐子大。另一方，去掉山楂、神曲、川芎，加半夏、青皮、黄连。
〔世医〕苍术丸 治疗饥饱失常，肚痛不食。
以上用生姜汁打、炒，神曲糊为丸，如梧桐子大。每服七十丸，米饮送下。
〔丹溪〕酒积引起的腹疼痛。用三棱、蓬莪术、香附、官桂、苍术、浓朴、陈皮、甘草、茯苓、木香、槟榔治疗。
杨淳三哥，六十岁，食积痰浊作痛在心头，或在腹胁，脉皆弦涩，吃得很少，大便秘结坚实，这是湿积，宜用生血、行气、进食、磨积、补虚的方法。
白术 炒曲 半夏（各一钱半） 郁李仁 归身尾 芍药 陈皮（各五钱） 山楂（五钱） 川芎（三钱）
研为细末，粥为丸。一日三次，食前用白开水送服四五十丸。
〔罗谦甫〕七气汤 治疗虚冷上气，以及寒气、怒气、思气、喜气、忧气、愁气，内结积聚，坚牢如杯，心腹绞痛，不能饮食，时发时止，发作即欲死，此药主治。
半夏（汤洗，五两） 人参（去芦） 甘草（炙） 肉桂（各一两）
以上为粗末，入半夏令匀。每服二钱，水一大盏，生姜三片，煎至七分，去渣稍热服，食前。
腹痛有发作停止的，有块状物耕起往来的，吐清水的，都是虫痛。治法见心痛门。
井窈渠吴孺人，年近四十，得腹部隐痛，常用火烧砖瓦熨烫患处，面部与胸襟间厌恶火的热气。发作时稍微烦躁，食欲也减少，六脉平和，皆微弦，最苦恼夜间不能睡觉，只要世上凶恶之事，并忧苦境像都上心头，时常哭泣，说离别，嘱托后事。如此一年，众人当作心痛治疗。自觉气自下冲上，虽久病，人却不消瘦。我说：这是肝脏受病，于是给予防风通圣散（表里双解的方剂）催吐。当时尚是春寒，在通圣散中加入桂枝，入姜汁调服，日三四次，到初夏稍热时，给予当归龙胆丸、枳术丸（健脾消食的方剂），一个月而愈。
一是土盛攻肾而痛。经文说：岁土太过，雨湿流行，肾水受邪，百姓生病腹痛清厥，心情不乐，就是这种情况。
二是火郁之发痛。经文说：火郁之发，百姓生病腹中暴痛，就是这种情况。
〔世医〕盐炒热，用布包裹，熨烫疼痛处，神效。
〔丹溪〕搅肠沙。用台芎为末，每一钱许，入生姜自然汁半盏，热汤内调服。又一方，樟木煎汤大吐之，或用白矾末一钱，清汤调服探吐之，或用盐汤探吐之亦可。
〔世医〕治疗发沙症，面青肚疼，昏倒不省人事。急以鼠屎一合，研为细末，滚汤调令通口澄清服之，一服而安，神效。宜预收下。
其一取脾胃。经文说：邪在脾胃，阳气不足，阴气有余，则寒中肠鸣腹痛，皆调于三里。又说：足太阴之别，名曰公孙，去本节之后一寸，实则腹中切痛取之所别也。又说：腹痛刺脐左右动脉，已刺按之立已；不已，刺气冲，已刺，按之立已是也。
其二取大肠。经文说：大肠病者，肠中切痛而鸣濯濯，感于寒即泄，当脐而痛，取巨虚、上廉是也。
其三取督脉。经文说：肾虚则胸中痛，大腹小腹痛，清厥，意不乐，取其经少阴、太阳血者是也。
其四取任脉。经文说：任脉之别，名曰尾翳，下鸠尾，散于腹，实则腹皮痛，取之所别也。
〔世医〕治疗绞肠沙症，手足厥冷，腹痛不可忍者，以手蘸温水，于病者膝湾内拍打，有紫黑处，以针刺去恶血即愈。
〔《撮要》〕气痛，并治积痛，食不化：气海（一寸半，灸五十壮。） 中脘（二寸半，灸十壮。） 隐白（二分，泻之，灸七壮。）
〔怪穴〕腹痛肠鸣：气冲（在气海旁各一寸半，针入二寸半，灸五十壮。）
〔世医〕脐腹痛：阴陵泉 太冲 三里 支沟 不已，取下穴：中脘 关元天枢 绕脐痛：公孙 三阴交 阴谷
〔《甲乙经》〕腹中尽疼，外陵主之。大肠寒中，（《千金》作“寒疝”）大便干，腹中切痛者，肓输主之。绕脐痛，抢心，膝寒，注利，腹结主之。
〔仲景〕夫瘦人绕脐痛，必有风冷，谷气不行，而反下之，其气必冲。不冲者，心下则痞也。
Four doses were taken, with Licorice Root (Gancao) added to purge the excess. Although pain and vomiting decreased, food intake had not yet resumed; therefore, Xiao Chai Hu Tang (Minor Bupleurum Decoction) was administered with Scutellaria Root (Huangqin) and Ginseng Root (Renshen) removed, and Paeonia Root (Shaoyao), Tangerine Peel (Chenpi), Coptis Rhizome (Huanglian), and Raw Licorice Root (Sheng Gancao) added. After twenty doses, the patient recovered.
Mr. Xu from Baiyun initially developed phlegm due to improper diet, leading to pain in the spleen region. Later, repeated exposure to wind and cold snow caused pain in the leg bones. Everyone considered the spleen pain and bone pain as cold syndromes, administering various medicines such as Huangya Dan indiscriminately. Over ten years, tens of thousands of moxibustion sessions were performed. Although there seemed to be some effect, when the disease recurred, it felt worse. At age fifty-one, after traveling by boat in the snow, the condition worsened further. He could not rise from sitting, nor walk even when supported, and his hip joints could not open or close. When the spleen-region pain occurred, the pain in the hip joints seemed slightly relieved; when the diet was palatable and the spleen-region pain did not occur, the heavy pain in the hips increased. The senior physicians were at a loss. I stated that this originated from food retention and phlegm in the Zhongwan area, complicated by stomach cold-dampness obstructing the meridians, causing stagnation of Qi, blood, and body fluids. Phlegm-fluids injected into the bone joints, surging like tides; surging upward manifested as spleen-region pain, sinking downward manifested as hip pain. Only emetic and purgative methods could treat this. On July 24th, one qian of Kansui Root (Gansui) powder was placed inside a pig kidney, roasted, and fed to him. After seven bowel movements, he could walk the next day. On August 3rd, severe vomiting occurred, preventing him from getting out of bed. He ate nothing but was irritable, weak in Qi, and unable to speak. The seniors blamed the purgation in July and recognized the error of years of hot tonification, so they dared not prescribe medicine. I recalled the *Jin Gui Yao Lue* stating: "If a patient has no chills or fever but suffers from shortness of breath and inability to take deep breaths, this is an excess syndrome." His disease had been stagnant for years; suddenly purging with a small dose of medicine only stirred up the rampant pathogenic factor without other medicines to control it, hence the situation. An emetic was used to clear the Upper Jiao, followed by sequential treatment of the Middle and Lower Jiao. On the 3rd, using Melon Seed (Gua Di) failed to induce thorough vomiting; on the 6th, using Gardenia Fruit (Zhizi) also failed; on the 9th, three Aconite Tips (Fuzi Jian) mixed with fermented rice water induced massive vomiting, stopping the hiccups. In total, a large bucket of paste-like phlegm and fluid was vomited. On the 10th, a decoction of Mirabilite (Puxiao), Talcum (Huashi), Scutellaria Root (Huangqin), Gypsum (Shigao), and Forsythia Fruit (Lianqiao) totaling one jin was steamed and boiled into a thick liquid, chilled in well water, and drunk. From November 12th to 14th, one jin of this medicine was consumed daily. On the 15th, mild abdominal fullness occurred, and both urination and defecation were blocked. I intended to use Da Cheng Qi Tang (Major Order the Qi Decoction) to purge, but the seniors disagreed. On the 16th, all six pulses showed intermittent pauses. Upon palpation, pauses occurred only during Mao and You hours, while other times were normal. I explained that Mao and You correspond to the hand and foot Yin-Yang meridians; this was due to stagnation in the Large Intestine and Stomach, requiring rapid purgation. After much debate, on the 18th, half a jin of Zi Xue (Purple Snow Powder) was prepared. On the morning of the 19th, it was ready. One spoonful was dissolved in fresh well water and taken. By the early morning of the 20th, five liang had been taken, mental clarity improved, and abdominal distension reduced. The Zi Xue was then withheld. On the 21st, severe urinary retention and pain plagued him. Radish Seed (Luobozi) juice was given, immediately relieving pain and restoring urination. On the 22nd, lower abdominal fullness and pain were intolerable to touch, and mental state was poor. Rhubarb Root (Dahuang) and Morning Glory Seed (Qianniuzi) pills were taken, totaling three hundred pills. At Si hour on the 23rd, stool was passed, along with approximately three bowls of foul-smelling, rotten-fish-intestine-like material. Mental state improved, and pulses normalized. On the 24th, severe colicky abdominal pain lasted about one shichen, accompanied by heavy, dragging sensations in the waist and hips. For two shichen, he could not speak. Foul matter resembling fried dough sticks over one chi long was expelled. The abdomen felt burning until calm. By the 25th, mental state gradually stabilized, and sleep was achieved at night. On the 26th, speech resumed. From the 2nd to the 27th, no food was ingested, and no sound was made. On the 27th, four half-cups of thin porridge were consumed, indicating signs of life. Peace was restored by the 4th of the next month. Throughout the illness, except for a few days of pulse pauses, the pulse remained normally wiry and large. In April of the following year, Dao Cang Fa (Inverting the Warehouse Method) was performed again, restoring normal gait.
Intestinal abscess (Chang Yong) is also abdominal pain, distinguished by frequent urination resembling strangury and a slippery-rapid pulse. (Treatment see Intestinal Abscess section.)
[*Zhou Hou Bei Ji Fang*] Treats lower abdominal distension and pain, shortness of breath nearing death, or apparent cessation of breathing. Use fourteen Wumei (Mume Fruit), boil in five sheng of water for one boil, add fourteen large copper coins, boil to obtain two and a half sheng. Robust patients may take it at once; frail patients should divide it into two doses.
*[Haizang]* Danggui Wan treats pathogens affecting the Three Yin meridians, causing pain in the heart, umbilicus, and lower abdomen, and symptoms like Qi-Wind.
Siwu Tang (each half liang) Fangfeng, Duhuo, Quanxie (each 5 fen), Xuduan (1 liang), Kulian, Yuanhusuo (each 7 qian), Muxiang, Dingxiang (each 2.5 qian), Huixiang (1 liang, stir-fried).
Grind into fine powder, make pills with wine paste, size of wutong seeds. Take 30-50 pills with warm wine on an empty stomach. Highly effective.
Siwu Kulian Tang
Siwu Tang (4 liang), Yuanhusuo, Kulian (each 1 liang).
*[Yunqi Zi]* Treats unbearable twisting abdominal pain.
Yuanhusuo, Danggui, Baishao, Chuanxiong, Ganjiang (equal parts).
Grind into powder. Take 3 qian each time, mixed with warm wine.
Another method: Same indications.
Yuanhusuo, Guixin (each half liang), Danggui (1 liang).
Grind into fine powder, mix with hot wine.
Shixiao San treats fatal heart and abdominal pain unresponsive to other medicines; takes effect immediately. (Formula see Heart Pain section.)
*[Neijing]* Treats unbearable spasmodic pain due to Spleen-Cold. Zhyuyu (1 liang), Taoren (1 liang) stir-fried together until Zhyuyu is charred black. Remove Zhyuyu, take Taoren, remove skin and tips, grind finely. Simmer three stalks of Congbai (White Onion Stem), soak in wine, take in three warm doses.
Abdominal pain with a slippery pulse indicates Phlegm; with a wiry pulse indicates Food Retention.
Clearing Phlegm often causes abdominal pain.
Taixiong, Cangzhu, Xiangfu, Baizhi.
Grind into powder, mix with fresh Ginger Juice, take with hot water.
Wenzhong Wan treats abdominal pain due to Food Retention.
Baizhu, Xiangfu (soaked in child's urine), Zhensha (each 4 liang, soaked in vinegar, stir-fried red), Shanzharen, Shenqu (each 8 liang), Kushen (1 liang).
Chuanxiong (half liang, use in spring, remove in summer), Wuzhuyu (half liang, soaked in water. Use in winter, remove in spring), Cangzhu (soaked in rice wash overnight, 2.5 liang).
Grind into powder, mix with vinegar and Shenqu paste to make pills, size of wutong seeds. Another formula removes Shanzharen, Shenqu, Chuanxiong, adding Banxia, Qingpi, Huanglian.
*[World Physicians]* Cangzhu Wan treats irregular eating habits, abdominal pain, and anorexia.
Cangzhu (stir-fried), Juhong (equal parts, powder).
Mix with Ginger Juice, stir-fry, make pills with Shenqu paste, size of wutong seeds. Take 70 pills with rice drink.
*[Danxi]* Abdominal pain due to Wine Accumulation. Treat with Sanleng, Peng'ezhu, Xiangfu, Guanzi, Cangzhu, Houpo, Chenpi, Gancao, Fuling, Muxiang, Binglang.
Yang Chun's third brother, aged sixty, suffered pain in the heart center or hypochondrium due to Food Retention and Phlegm. Pulses were wiry and choppy, appetite was low, stools were dry and hard. This is Dampness Accumulation. Treatment should involve generating blood, moving Qi, promoting digestion, grinding accumulation, and tonifying deficiency.
Baizhu, Chaoqu, Banxia (each 1.5 qian), Yuliren, Dangshenwei, Shaoyao, Chenpi (each 5 qian), Shanzharen (5 qian), Chuanxiong (3 qian).
Renshen (2 qian), Chaihu (2 qian), Honghua (5 fen), Taoren (3 kernels).
Grind into fine powder, make pills with congee. Take 40-50 pills before meals with plain water, three times daily.
*[Luo Qianfu]* Qi Qi Tang treats deficiency-cold rising Qi, and internal knotting of Cold Qi, Anger Qi, Thought Qi, Joy Qi, Worry Qi, and Sorrow Qi. It forms accumulations hard as cups, causing severe heart and abdominal pain, inability to eat, intermittent attacks nearly fatal. This medicine treats it.
Banxia (washed in hot water, 5 liang), Renshen (remove rhizome), Gancao (roasted), Rougui (each 1 liang).
Grind into coarse powder, mix evenly with Banxia. Take 2 qian each time with one large cup of water, three slices of Ginger, decoct to 70%, strain, drink slightly warm before meals.
Abdominal pain that comes and goes, with masses moving back and forth, or vomiting clear fluid, are all Worm Pain. Treatment see Heart Pain section.
Wurunren of Jingyaoqu, near forty years old, suffered dull abdominal pain. She frequently used heated bricks/tiles to moxa the area but disliked the heat on her face and chest. Attacks caused slight irritability and reduced appetite. Six pulses were harmonious but slightly wiry. She suffered most from insomnia, constantly thinking of tragic events and sorrowful scenes, weeping, talking of parting, and arranging affairs. This lasted a year. Others treated it as Heart Pain. She felt Qi rushing up from below. Despite chronic illness, she was not emaciated. I said: This is Liver pathology. Prescribed Fangfeng Tongsheng San to induce vomiting. As it was still cold in spring, Guizhi was added to Tongsheng San, mixed with Ginger Juice, taken 3-4 times daily. By early summer, when it warmed up, Danggui Longdan Wan and Zhi Zhu Wan were given. Recovery in one month.
Physiologic Factors (Yunqi): Two types of abdominal pain:
First, Earth Excess attacking Kidney causing pain. The Classic states: "When Earth Qi is excessive, rain and dampness prevail, Kidney Water is attacked, people suffer abdominal pain, cold extremities, and lack of joy." This refers to that.
Second, Fire Stagnation causing pain. The Classic states: "When Fire Stagnation erupts, people suffer sudden abdominal pain." This refers to that.
*[World Physicians]* Stir-fry salt until hot, wrap in cloth, apply to painful area. Divine efficacy.
*[Danxi]* Jiaochang Sha. Use Taixiong powder, approx. 1 qian, mixed with half cup fresh Ginger Juice, taken with hot water. Another method: Decoct Camphor Wood, induce massive vomiting. Or use 1 qian Baijian powder mixed with clear water to provoke vomiting. Or use salt water to provoke vomiting.
*[World Physicians]* Treats Fa Sha: blue face, abdominal pain, unconsciousness. Immediately grind one he of Rat Dropping into fine powder, mix with boiling water, clarify, and drink. One dose brings peace. Divine efficacy. Keep in reserve.
Acupuncture and Moxibustion: Four methods for abdominal pain:
First, select Spleen and Stomach meridians. The Classic states: "Pathogen in Spleen/Stomach, Yang deficiency, Yin excess, leads to cold entering intestines, borborygmus, and abdominal pain. All regulated via Zusanli." Also: "The collateral of Foot Taiyin is named Gongsun, one cun distal to the root of the metatarsal. If excess, sharp abdominal pain, treat its collateral." Also: "For abdominal pain, puncture arterial points left and right of umbilicus; press immediately stops pain. If not, puncture Qichong; press immediately stops pain."
Second, select Large Intestine. The Classic states: "Large Intestine disease involves sharp intestinal pain and borborygmus, diarrhea upon cold exposure, pain at umbilicus. Treat Shangjuxu and Xiajuxu."
Third, select Du Meridian. The Classic states: "Kidney deficiency causes chest pain, upper/lower abdominal pain, cold extremities, lack of joy. Treat Blood aspects of Shaoyin and Taiyang meridians."
Fourth, select Ren Meridian. The Classic states: "The collateral of Ren Meridian is named Wei Yi, descending from Jiweil, dispersing in the abdomen. If excess, abdominal wall pain, treat its collateral."
*[World Physicians]* Treats Jiaochang Sha with cold limbs and unbearable abdominal pain: Dip hand in warm water, slap the popliteal fossa of the patient. If purple-black spots appear, prick to release bad blood. Cure.
*[Yujizhenzang Lun]* Abdominal pain, treating Qi masses: Neiguan, Zhigou, Zhaohai.
*[Cuoyao]* Qi pain, treating accumulation pain, indigestion: Qihai (1.5 cun, moxa 50 cones), Zhongwan (2.5 cun, moxa 10 cones), Yinbai (2 fen, reduce, moxa 7 cones).
*[Sang]* Another method: Juque, Zu Sanjian.
*[Strange Acupoints]* Abdominal pain with borborygmus: Qichong (1.5 cun lateral to Qihai, needle 2.5 cun, moxa 50 cones).
*[World Physicians]* Umbilical abdominal pain: Yinlingquan, Taichong, Zusanli, Zhigou. If ineffective, lower points: Zhongwan, Guanyuan, Tianshu. Periumbilical pain: Gongsun, Sanyinjiao, Yinggu.
*[Dongyuan]* Sudden epigastric pain, firm pain at umbilicus: Shimen, Shangqiu, Yinggu, Dachangshu, Geshu.
*[Jiayingjing]* General abdominal pain: Wailing governs. Cold invading Large Intestine (*Qianjin* calls it "Cold Colic"), dry stool, sharp abdominal pain: Huangshu governs. Periumbilical pain, seizing heart, cold knees, profuse diarrhea: Fujie governs.
*[Zhongjing]* Thin persons with periumbilical pain must have Wind-Cold, causing grain Qi stagnation. If purged wrongly, Qi will surge upward. If it does not surge, Epigastric Fullness (Pi) will result.
*[Maijing]* If abdominal pain presents with floating, large, and long pulse, death ensues. (Note: For Worm Pain, floating-large pulse is acceptable.)
Heart/Abdominal pain where pain prevents relief, with fine, small, slow pulse indicates survival; firm, large, rapid pulse indicates death. (Note: With accumulation, firm-large pulse is acceptable.)