草豆蔻 诃子肉(各一两) 桂心 苦梗 浓朴(各三分) 甘草(一分) 川芎 当
归干姜 槟榔(各半两)
上为粗末,每服四钱。水一盏,煎七分,去滓热服,食前。
治妇人脏腑虚冷、宿冷,气攻两胁胀痛,坐卧不安。
子 延胡索 桃仁 桂心 琥珀 当归(各一分) 赤芍药 木香 没药(各半两)
上为末,每服二钱,温酒调下,无时候。
治妇人荣卫不和,心腹刺痛,胸膈胀满,不进饮食。(饶武传方)
紫金皮 苍术 石菖蒲(各一两) 香附子(二两) 人参(半两) 木香(三钱)
上为末,米糊和丸如梧桐子大,每服三十丸,食后,姜汤下。
治久积风壅。疏利滞气,空胸膈,止刺痛。
木香 青皮(去白) 大黄(炮) 槟榔(各一两) 黑牵牛(二两,半生半炒)
上为末,炼蜜丸如梧子大,温水下三十丸。
邓安人年五十,忽然气痛,投神保丸愈。不一、二日再痛,再服神保丸六、七十粒。大
腑不通,其疾转甚。亦有要用沉香、木香、姜、桂等药,而未敢投。痛甚则筑心、筑背、筑
定两胁,似有两柴十字插定心胁,叫声彻天。召仆诊之,六脉沉伏,乍来乍去。众问仆诊脉
吉凶何如?答曰∶夫九痛之脉不可准也,但以证辨用药。观其人质肥伟,问其大腑数日不通
,仆曰实痛也。其腹、心胀,但以人按之痛甚,手不可向迩,此大实也。经云∶大满大实者
,可下之。用气针丸五、六百粒,是夜即愈。
又己未在金陵,有家提干上之下巽内人,病心腹胀痛。众医投木香、沉香、槟榔、大腹
、芍药、姜、桂之类,病益甚。召仆诊之,六脉弦紧而和,不似病脉。但诊之时两手如火,
以此知其实痛也。众问如何治疗?仆曰∶大凡心腹刺痛,不可便作虚冷治疗。有两医答曰∶
非冷而何?热即生风,冷生气是也。仆曰不然。《难经》云∶虚则痒,实则痛。又仲景云∶
腹痛者,桂枝加芍药汤;痛甚者,桂枝加大黄汤。家提干云∶荆布素来质弱。仆曰∶有可辨
处,遇痛时使一婢按之,若痛止,是虚寒证也。若按之转甚,手不可近,此实痛也。即令一
婢按之,手不可近,叫唤异常。仆曰∶此实热无可疑者,当用大柴胡汤治之。众皆不许,仆
责状而投之,八服愈。
论胁肋疼痛,服木通散(亦可治男子,出《明理方》)。心下、胁肋、少腹疼痛,皆素有
积寒,而温暖汤散亦可主治。甚者以温药下之。心下与小腹痛,诸书并有效方;而胁肋下痛
,鲜获治法,此散可以主之。
草豆蔻、诃子肉(各一两),桂心、桔梗、厚朴(各三分),甘草(一分),川芎、当归、干姜、槟榔(各半两)。
以上药材捣成粗末,每次服用四钱。加水一盏,煎至七分,滤去药渣,趁热服用,饭前服。
延胡索、桃仁、桂心、琥珀、当归(各一分),赤芍药、木香、没药(各半两)。
以上药材研为细末,每次服用二钱,用温酒调服,不拘时候。
治疗妇人营卫不和,心腹刺痛,胸膈胀满,不思饮食。(饶武传方)
紫金皮、苍术、石菖蒲(各一两),香附子(二两),人参(半两),木香(三钱)。
以上药材研为细末,用米糊和丸,如梧桐子大小,每次服用三十丸,饭后,姜汤送下。
木香、青皮(去白)、大黄(炮制)、槟榔(各一两),黑牵牛(二两,半生半炒)。
以上药材研为细末,炼蜜为丸,如梧桐子大小,温水送服三十丸。
邓安人五十岁时,忽然发生气痛,服用神保丸后痊愈。过了一两天再次疼痛,又服用神保丸六七十粒。大便不通,病情反而加重。也有想用沉香、木香、姜、桂等药物,但不敢投用。疼痛剧烈时,感觉像有东西撞击心脏、背部,固定撞击两胁,好像有两根柴火十字交叉插定心胁,叫声震天。请我诊治,六脉沉伏,忽来忽去。众人问我诊脉吉凶如何?我回答说:九种痛证的脉象不可作为唯一标准,应当根据证候辨别用药。观察其人形体肥壮伟岸,询问其大便数日不通,我说这是实痛。其腹部、心脏胀满,只要用手按压就疼痛加剧,手不能靠近,这是大实证。经书说:大满大实者,可以用泻下法。于是使用气针丸五六百粒,当天晚上即痊愈。
又在己未年在金陵,有家提干的妾室,患有心腹胀痛。众医生投用木香、沉香、槟榔、大腹皮、芍药、姜、桂之类药物,病情更加严重。请我诊治,六脉弦紧而和缓,不像病脉。但在诊脉时两手如火烫,因此知道这是实痛。众人问如何治疗?我说:大凡心腹刺痛,不可以立即当作虚寒治疗。有两个医生回答说:不是冷是什么?热则生风,冷则生气,就是这个道理。我说不对。《难经》说:虚则痒,实则痛。另外张仲景说:腹痛者,用桂枝加芍药汤;疼痛剧烈的,用桂枝加大黄汤。家提干说:荆布素来体质虚弱。我说:有可以辨别的地方,遇到疼痛时让一个婢女按压患处,如果疼痛停止,是虚寒证。如果按压后疼痛更甚,手不能靠近,这是实痛。随即令一婢女按压,手不能靠近,叫唤异常。我说:这是实热无疑,应当用大柴胡汤治疗。众人都不允许,我让他们写下保证书后投药,服用八剂后痊愈。
论及胁肋疼痛,服用木通散(也可以治疗男子,出自《明理方》)。心下、胁肋、少腹疼痛,都是素有积寒,温暖汤散也可以主治。严重的用温药泻下。心下与小腹痛,各种书籍都有有效方剂;而胁肋下痛,很少获得治疗方法,这个散剂可以作为主治。
Grass Cardamom Seed (Caodoukou), Pericarpium Arecae Catechu (Hezi Rou) (each 1 liang), Cassia Twig (Guixin), Platycodon Root (Kujie), Magnolia Bark (Nongpu) (each 3 qian), Licorice Root (Gancao) (1 qian), Szechwan Lovage Rhizome (Chuanxiong), Angelica Sinensis Radix (Danggui), Dried Ginger (Ganjiang), Areca Seed (Binglang) (each 0.5 liang).
The above herbs are crushed into coarse powder. Each dose is 4 qian. Add one zhan of water, decoct until seven-tenths remains, remove the dregs, and take hot before meals.
Treats deficiency-cold in the Zang-Fu organs and lingering cold qi in women, where qi attacks both hypochondriac regions causing distension and pain, leading to restlessness in sitting or lying down.
Corydalis Rhizome (Yanhusuo), Peach Kernel (Taoren), Cassia Twig (Guixin), Amber (Hupo), Angelica Sinensis Radix (Danggui) (each 1 qian), Red Peony Root (Chishao), Aucklandia Root (Muxiang), Myrrh (Moyao) (each 0.5 liang).
The above herbs are ground into fine powder. Each dose is 2 qian, taken with warm wine, at any time.
Treats disharmony of Ying and Wei in women, stabbing pain in the heart and abdomen, fullness and distension in the chest and diaphragm, and loss of appetite. (Prescription passed down by Rao Wu)
Phellodendron Bark (Zijinpi), Atractylodes Rhizome (Cangzhu), Acorus Tatarinowii Rhizome (Shichangpu) (each 1 liang), Cyperus Rhizome (Xiangfuzi) (2 liang), Ginseng Radix (Renshen) (0.5 liang), Aucklandia Root (Muxiang) (3 qian).
The above herbs are ground into fine powder, mixed with rice paste to form pills the size of Sophora seeds. Each dose is 30 pills, taken after meals with ginger soup.
Treats long-standing accumulation of wind-phlegm obstruction. It disperses stagnant qi, clears the chest and diaphragm, and stops stabbing pain.
Aucklandia Root (Muxiang), Green Tangerine Peel (Qingpi) (white part removed), Prepared Rhubarb (Dahuang) (prepared), Areca Seed (Binglang) (each 1 liang), Black Morning Glory Seed (Heiqianniu) (2 liang, half raw, half stir-fried).
The above herbs are ground into fine powder, mixed with refined honey to form pills the size of Sophora seeds. Take 30 pills with warm water.
Lady Deng An, aged fifty, suddenly suffered from Qi pain. After taking Shenbao Wan, she recovered. One or two days later, the pain recurred, and she took another 60-70 pills of Shenbao Wan. Her bowels were blocked, and her condition worsened. There were those who wished to use Agarwood (Chenxiang), Aucklandia Root (Muxiang), Ginger (Jiang), and Cassia Twig (Guizi), but dared not administer them. When the pain was severe, it felt as if something was striking the heart, back, and fixed on both hypochondriac regions, like two firewood sticks crossing and pinning the heart and hypochondrium, with cries reaching the sky. I was summoned to diagnose. The six pulses were deep and hidden, appearing and disappearing intermittently. Everyone asked me about the auspiciousness or inauspiciousness of the pulse. I replied: The pulses for the nine types of pain cannot be relied upon solely; medication should be determined by syndrome differentiation. Observing that her physique was fat and robust, and asking that her bowels had not moved for several days, I said this is excess pain. Her abdomen and heart were distended, and pressing caused severe pain, making the hand unable to approach; this is a great excess syndrome. The Classics state: For great fullness and excess, purgation can be used. Thus, I administered 500-600 pills of Qizhen Wan, and she recovered that very night.
Later, in the year Jiwu in Jinling, the concubine of a Family Ti Gan suffered from heart and abdominal distension and pain. Various physicians administered herbs such as Aucklandia Root (Muxiang), Agarwood (Chenxiang), Areca Seed (Binglang), Betel Nut (Dafu), Peony Root (Shaoyao), Ginger (Jiang), and Cassia Twig (Guizi), but the illness worsened. I was summoned to diagnose. The six pulses were wiry, tight, yet harmonious, not resembling a diseased pulse. However, during diagnosis, both hands felt like fire, indicating excess pain. Everyone asked how to treat it. I said: Generally, stabbing pain in the heart and abdomen should not immediately be treated as deficiency-cold. Two doctors replied: If not cold, then what? Heat generates wind, and cold generates Qi, which is the case here. I said otherwise. The Nan Jing states: Deficiency causes itching, excess causes pain. Furthermore, Zhang Zhongjing stated: For abdominal pain, use Guizhi Jia Shaoyao Tang; for severe pain, use Guizhi Jia Dahuang Tang. The Family Ti Gan said: Jing Bu has always had a weak constitution. I said: There are points for differentiation. When pain occurs, have a maid press the area. If the pain stops, it is a deficiency-cold syndrome. If pressing exacerbates the pain and the hand cannot approach, it is excess pain. Immediately, a maid pressed the area; the hand could not approach, and she cried out abnormally. I said: This is undoubtedly excess-heat. Da Chai Hu Tang should be used. Everyone disagreed. I had them sign a guarantee and administered the medicine. After eight doses, she recovered.
Regarding hypochondriac pain, take Mutong San (also effective for men, from Ming Li Fang). Pain in the epigastrium, hypochondrium, and lower abdomen is due to long-standing accumulated cold, which can also be primarily treated with warming decoctions and powders. Severe cases are treated with warming purgatives. For epigastric and lower abdominal pain, various books contain effective prescriptions; however, for pain under the hypochondrium, treatment methods are rarely obtained. This powder can serve as the primary treatment.