脉弦 伤气 加芍药
脉洪 伤金 加黄芩 加枣
脉缓 伤水 加桂枝 生姜
脉涩 伤血 加当归
脉迟 伤火 加干姜
〔丹〕妇人痢后,血少腹痛。
白芍药(二钱) 归身尾(一钱半) 陈皮(二钱) 川芎(五分)
调服六一散。
〔仲〕痛而秘者,浓朴三物汤主之。
浓朴(一两) 大黄(四两) 枳实(五个)
上三味,以水一斗二升,先煮二味,取五升,内大黄,煮取二升,温服一升,以利为度。
〔丹〕一男子,年十八岁,自小面带微黄,五月间腹大痛,医者与小建中汤加丁香两帖,不效。加呕吐清
汁,又与十八味丁沉透膈汤两帖,食全不进,痛无休止,卧不能起。如此五六日,又与阿魏丸百余粒,至夜发
躁不得睡,口却不渴。予脉之,左三部沉弦而数,关部尤甚;右三部沉滑而数实,痛处不可按。遂与大柴胡汤
脉象弦,提示气机受损,加用芍药。
脉象洪大,提示金(肺)受损,加用黄芩、大枣。
脉象缓,提示水(肾)受损,加用桂枝、生姜。
脉象涩,提示血受损,加用当归。
脉象迟,提示火受损,加用干姜。
〔朱丹溪〕妇女痢疾之后,因血虚导致腹痛。
白芍药(二钱) 当归身尾(一钱半) 陈皮(二钱) 川芎(五分)
配合六一散调服。
〔张仲景〕腹痛且大便闭塞不通的,用厚朴三物汤主治。
厚朴(一两) 大黄(四两) 枳实(五个)
以上三味药,用水一斗二升,先煮前两种药(厚朴、枳实),取五升药液,加入大黄,再煮取二升药液,温服一升,以大便通利为度。
〔朱丹溪〕一名男子,十八岁,从小面色微黄,五月间腹部剧烈疼痛,医生给予小建中汤加丁香服用两帖,无效。随后出现呕吐清汁症状,又给予十八味丁沉透膈汤服用两帖,饮食完全无法进入,疼痛没有停止,卧床不能起身。如此持续五六天,又服用阿魏丸一百多粒,到了夜晚烦躁不安无法入睡,口却不渴。我诊察其脉象,左手三部脉沉弦而数,关部尤为明显;右手三部脉沉滑而数实,疼痛部位不可按压。于是给予大柴胡汤
The pulse is wiry (Xian), indicating Qi injury; add Shaoyao (Paeoniae Radix).
The pulse is surging (Hong), indicating Metal (Lung) injury; add Huangqin (Scutellariae Radix) and Zao (Jujubae Fructus).
The pulse is slow/relaxed (Huan), indicating Water (Kidney) injury; add Guizhi (Cinnamomi Ramulus) and Shengjiang (Zingiberis Rhizoma Recens).
The pulse is choppy (Se), indicating Blood injury; add Danggui (Angelicae Sinensis Radix).
The pulse is delayed (Chi), indicating Fire injury; add Ganjiang (Zingiberis Rhizoma).
[Zhu Danxi] After dysentery, women suffer from abdominal pain due to blood deficiency.
Baishao Yao (White Peony Root, 2 qian)
Guishenwei (Radix Angelicae Sinensis, body and tail, 1.5 qian)
Chenpi (Citri Reticulatae Pericarpium, 2 qian)
Chuanxiong (Ligustici Chuanxiong Rhizoma, 0.5 qian)
Take with Liuyi San (Six-to-One Powder).
[Zhang Zhongjing] For abdominal pain accompanied by constipation, Houpo Sanwu Tang (Magnolia Bark Three-Ingredient Decoction) is the primary treatment.
Houpo (Magnoliae Officinalis Cortex, 1 liang)
Dahuang (Rhei Radix et Rhizoma, 4 liang)
Zhishi (Aurantii Fructus Immaturus, 5 pieces)
These three ingredients: use one dou two sheng of water. First decoct the first two ingredients (Houpo and Zhishi) to obtain five sheng of liquid. Add Dahuang, and decoct again to obtain two sheng of liquid. Take one sheng warm; stop when bowel movement is achieved.
[Zhu Danxi] A male patient, eighteen years old, had a slightly yellow complexion since childhood. In May, he suffered severe abdominal pain. The physician prescribed Xiao Jianzhong Tang (Minor Construct the Middle Decoction) with Dingxiang (Caryophylli Flos) for two doses, but it was ineffective. Subsequently, vomiting of clear fluid occurred. Another two doses of Shibawei Dingshen Touge Tang (Eighteen-Ingredient Clove and Agarwood Diaphragm-Penetrating Decoction) were given, resulting in complete inability to ingest food, unceasing pain, and an inability to rise from bed. This persisted for five or six days. Then, over one hundred pills of Awei Wan (Ferula Pill) were administered. At night, he became restless and unable to sleep, yet his mouth was not thirsty. Upon palpation, the left Cun, Guan, and Chi positions were deep, wiry, and rapid, especially at the Guan position; the right positions were deep, slippery, rapid, and excess/full. The painful area was intolerable to pressure. Therefore, Da Chaihu Tang (Major Bupleurum Decoction) was administered.