大城王××，年五十岁，少腹冷疼，久服药不愈。
病因 自幼在家惯睡火炕，后在津栖处寒凉，饮食又多不慎，遂得此证。
证候 其少腹时觉下坠，眠时须以暖水袋熨脐下，不然则疼不能寐。若屡服热药，上焦即觉
烦躁，已历二年不愈。脉象沉弦，左右皆然，至数稍迟。
诊断 即其两尺沉弦凉而且坠论之，知其肠中当有冷积，此宜用温通之药下之。
处方 与以自制通彻丸（系用牵牛头末和水为丸如秫米粒大）三钱，俾于清晨空心服下。
效果 阅三点钟，腹中疼似加剧，须臾下如绿豆糊所熬凉粉者若干。疼坠脱然全愈，亦不觉凉。
继为开温通化滞之方，俾再服数剂以善其后。
天津李××，年二十五岁，于仲春得腹结作疼证。
病因 偶因恼怒触动肝气，遂即饮食停肠中，结而不下作疼。
证候 食结肠中，时时切疼，二十余日大便不通。始犹少进饮食，继则食不能进，饮水一口亦
吐出。延医服药，无论何药下咽亦皆吐出，其脉左右皆微弱，犹幸至数照常，按之犹有根柢，知犹可救。
疗法 治此等证，必止呕之药与开结之药并用，方能直达病所，又必须内外兼治，则久停之结庶可下行。
处方 用硝菔通结汤，送服生赭石细末，汤分三次服下（每五十分钟服一次），共送服赭石末两半，外
又用葱白四斤切丝，醋炒至极热，将热布包熨患处，凉则易之。又俾用净萸肉二两，煮
汤一盅，结开下后饮之，以防虚脱。
效果 自晚八点钟服，至夜半时将药服完，炒葱外熨，至翌日早八点钟下燥粪二十枚，后继以溏
便。知其下净，遂将萸肉汤饮下，安然全愈。若虚甚者，结开欲大便时，宜先将萸肉汤服下。
大城县的王某某，五十岁，小腹部寒冷疼痛，长期服药未能痊愈。
病因：自幼在家习惯睡火炕，后来在天津居住时受寒凉侵袭，加上饮食又多不谨慎，因此得了这个病证。
证候：他的下腹部时常感觉下坠，睡觉时必须用暖水袋熨烫脐下部位，否则疼痛导致无法入睡。如果多次服用热性药物，上焦就会感到烦躁，此病已持续两年未愈。脉象沉弦，左右手都一样，脉搏次数稍慢。
诊断：根据他两尺脉沉弦、感觉凉且伴有下坠感来判断，知道他的肠中应当有冷积，这适宜使用温通性质的药物来攻下。
处方：给予自制通彻丸（由牵牛子头末和水制成如秫米大小的药丸）三钱，嘱咐他在清晨空腹服用。
效果：过了三个小时，腹中疼痛似乎加剧，不久后排出了一些像绿豆糊熬制的凉粉状物质。疼痛和下坠感突然完全痊愈，也不觉得凉了。随后又为他开具温通化滞的方剂，让他再服用几剂以巩固疗效。
天津的李某某，二十五岁，在仲春时节患上腹结作疼的病证。
病因：偶然因为恼怒触动肝气，随即导致饮食停滞在肠中，凝结而不下行引起疼痛。
证候：食物凝结在肠中，时时剧烈疼痛，二十多天大便不通。起初还能少量进食，后来则完全不能进食，喝一口水也会吐出来。请医生服药，无论什么药咽下去都会吐出，他的左右脉都微弱，幸好脉搏次数正常，按之仍有根基，知道还可以救治。
疗法：治疗这类病证，必须将止呕药物与开结药物并用，才能直达病所，而且必须内外兼治，这样久停的结滞才可能下行。
处方：使用硝菔通结汤，送服生赭石细末，汤剂分三次服用（每五十分钟服一次），共送服赭石末一两半，另外又用葱白四斤切丝，用醋炒至极热，用热布包裹熨烫患处，凉了则更换。又让他用净山茱萸二两，煮成一盅汤，待结开便下后饮用，以防虚脱。
效果：从晚上八点钟开始服药，到半夜时分将药服完，同时用炒葱外熨，到第二天早上八点钟排出了二十枚干硬粪便，随后是稀便。知道他排干净了，于是将山茱萸汤饮下，安然痊愈。如果虚损严重的，在结开想要大便时，宜先服用山茱萸汤。
Wang XX from Dacheng County, aged 50, suffered from cold pain in the lower abdomen and had not recovered despite long-term medication.
Etiology: Since childhood, he was accustomed to sleeping on a heated brick bed (huokang). Later, while residing in Tianjin, he was exposed to cold and dampness, and his diet was often careless, leading to this condition.
Symptoms: He frequently felt a bearing-down sensation in the lower abdomen. During sleep, he required a hot water bottle to apply heat to the area below the umbilicus; otherwise, the pain prevented him from sleeping. If he repeatedly took hot-natured medicines, he would feel irritability in the upper jiao (upper burner). This condition had persisted for two years without cure. The pulse was deep and wiry (Chen Xian) on both sides, with a slightly slow rate.
Diagnosis: Based on the deep, wiry, cold, and bearing-down quality of the pulses at the Chi position (cun-kou method), it is known that there should be cold accumulation in the intestines. It is appropriate to use warm and unblocking agents to purge the accumulation.
Prescription: Administered self-made Tongche Wan (Pill of Unimpeded Penetration), made from the coarse powder of Semen Sisymbrii Iridae (Qianniu Zi Tou Mo) mixed with water into pills the size of Sorghum grains (Shumi), three qian. Instructed to take it on an empty stomach in the early morning.
Effect: After three hours, abdominal pain seemed to intensify. Shortly thereafter, he passed some material resembling cool jelly boiled from mung bean paste. The pain and bearing-down sensation disappeared completely, and he no longer felt cold. Subsequently, a prescription for warming, unblocking, and resolving stagnation was prescribed for him to take a few more doses to consolidate the recovery.
Li XX from Tianjin, aged 25, developed abdominal knotting and pain in mid-spring.
Etiology: Accidental anger stirred up Liver Qi (Gan Qi), causing food to stagnate in the intestines, condense, and fail to descend, resulting in pain.
Symptoms: Food stagnated in the intestines, causing frequent sharp pain. Bowel movements were obstructed for over twenty days. Initially, he could eat small amounts, but later he could not eat at all; even drinking one mouthful of water caused vomiting. Medical treatment was sought, but regardless of the medicine taken, it was vomited immediately. The pulse was weak and faint (Wei Ruo) on both sides, fortunately with a normal rate and root upon palpation, indicating that the case was still salvageable.
Therapeutic Method: Treating such conditions requires combining anti-emetic herbs with agents that resolve stagnation to reach the disease site directly. Furthermore, internal and external treatments must be combined so that long-standing stagnation can descend.
Prescription: Used Xiaofu Tongjie Decoction (Radish and Natrii Sulfas Decoction to Resolve Knots), administered with fine powder of raw Hematitum (Sheng Zhe Shi). The decoction was taken in three doses (one dose every fifty minutes), totaling one tael and half of Zhe Shi powder. Externally, four jin of scallion white (Cong Bai) were cut into shreds, stir-fried with vinegar until extremely hot, wrapped in hot cloth, and applied to the affected area, replacing it when it cooled. Additionally, he was instructed to boil two liang of clean Cornus Officinalis Fructus (Yurou) in enough water to make one cup of soup, which he should drink after the knot resolved and stool passed, to prevent collapse due to deficiency.
Effect: Starting at 8 PM, the medicine was finished by midnight, accompanied by external application of the fried scallions. By 8 AM the next day, he passed twenty hard fecal pellets, followed by loose stools. Knowing that the bowels were cleared, he drank the Yurou soup and recovered peacefully. In cases of severe deficiency, if the knot resolves and defecation is imminent, it is advisable to drink the Yurou soup first.