（附小腹痛）
徐（左） 气虚脾弱生痰。脾为湿土，喜温恶寒，燕窝清肺养阴，清肺则伤脾土，养阴愈助脾湿，所以服食
既久，而得腹痛便泄之证。拟和中温运，清利水湿，以善其后。
台白术 制半夏 生熟薏仁 川朴 煨姜 云茯苓 木猪苓 土炒陈皮 泽泻
柳（右） 腹痛脉沉。气寒而肝横也。
制香附 砂仁 桂枝 磨木香 炮姜 小青皮 沉香 乌药 枳实炭 楂炭
二诊 腹痛稍减，脉形沉细。前年大便解出长虫。良由木失条达，东方之生气，挟肠胃之湿热，郁而生
虫矣。调气温中。参以劫虫。
广郁金（一钱五分） 使君子（一钱五分） 金铃子（一钱五分） 制香附（二钱打） 白蒺藜（三钱） 川
桂枝（五分） 朱茯神（三钱） 陈皮（一钱） 焦楂炭（三钱） 砂仁（七分） 炙乌梅（一个）
三诊 脉症相安，但腹痛仍未全定。前法进退，以图徐愈。
金铃子（一钱五分） 使君子（一钱五分） 玄胡索（一钱五分） 广皮（一钱五分） 制香附（二钱）
砂仁（七分） 广郁金（一钱五分） 鹤虱（一钱五分） 楂炭（二钱） 乌梅（八分）
某 腹痛难忍，大便解出长虫，腹胀坚满，此蛔蚀而肝木失疏。恐致痛厥。
使君子（三钱） 花槟榔（一钱） 炒鹤虱（三钱） 炙苦楝根（三钱） 川雅连（四分） 臭芜荑（二
钱） 广玉金（一钱五分） 淡吴萸（四分） 乌梅丸（一钱五分开水送下）
某（右） 疏通气机，痛势不退，良由产后恶露未清，营卫流行为之所阻。再为宣通。
延胡索 五灵脂 蓬莪术 乌药 丹参 泽兰
乳香（三分） 没药（去油三分） 上沉香（三分） 西血珀（四分上四味研末先调服）
二诊 月事稍行少腹之痛，由此而减。的是恶露未清。再为宣通，务使其营气畅达。
延胡 乳香 制香附 当归须 生熟谷芽 没药 郁金 南楂炭 台乌药
左 当脐作痛。前投疏通不应，再仿塞因塞用法。
熟地炭 萸肉炭 丹皮 福泽泻 杭白芍 云茯苓
炒山药 砂仁 龟甲心（五钱瓦上炙成炭开水先调服）
王（右） 当脐作痛，面色浮黄。湿食寒交阻不运，急为温化。
台乌药（一钱五分） 制香附（二钱打） 缩砂仁（七分） 焦楂炭（三钱） 枳实炭（一钱） 云茯苓（三钱）
沉香片（四分） 香橼皮（一钱五分） 上安桂（四分饭糊为丸先服）
二诊 当脐作痛稍减。再为辛通。
白芍 楂炭 砂仁 沉香片 上安桂（四分饭丸） 郁金 青皮 制香附 金铃子
三诊 加熟地黄四钱。龟甲心四钱，炙枯成炭，陈酒先调服。
王（左） 痛从少腹上冲，日久不止。脉细虚软。夫少腹两旁属肝，居中为冲脉波脉布散胸中。今自下冲
上，显属奇脉空虚，厥气肆扰也。
酒炒当归（四钱） 老生姜（二钱） 炒杞子（三钱） 川断肉（三钱） 炙黑甘草（二分） 杭白芍（一钱五分）
上安桂（四钱饭糊为丸先服） 精羊肉（一两五钱煎汤去尽油沫代水煎药）
左 气从少腹上冲则腹满，甚至干犯心胸则懊 难忍。此冲气上逆。姑调气熄肝。
盐水炒香附 白蒺藜 金铃子 杭白芍 盐水炒青皮 双钩钩 整砂仁 淡吴萸 天麻 金匮肾气丸
左 少腹痛，冲及脘当治肝胃。
淡吴萸 制香附 炒枳实 南楂炭 整砂仁 炒白芍 制半夏 青皮
左 气虚湿滞，气虚则肌肉不充，湿滞则少腹撑满。拟补中寓泻。
大有 （四钱） 奎党参（四钱同 研极细末） 制半夏（一钱五分） 云茯苓（三钱） 生熟草（各三分） 广
皮（一钱四味煎汤送参 末）
左 宣通营络，大便频泄，腹痛顿止。泄则滞通，所以痛止极速。效方出入主政。
延胡索（一钱五分） 台乌药（一钱五分） 广郁金（一钱五分） 橘络（一钱） 赤白苓（各二钱） 当归
须（一钱五分） 制半夏（一钱五分） 楂炭（三钱） 佩兰叶（一钱五分） 单桃仁（二钱） 广陈皮（一钱）
瓦楞子（四钱）
【附：小腹痛】
徐先生（左侧脉象）气虚脾弱而生痰。脾属湿土，喜温恶寒。燕窝性清，能清肺养阴；但清肺则损伤脾土，养阴则更加助长脾湿。因此服用日久后，出现了腹痛、大便泄泻的症状。拟采用调和脾胃、温运中焦、清利水湿的方法，以善其后。
处方：台白术、制半夏、生薏苡仁与熟薏苡仁、川厚朴、煨生姜、云茯苓、木猪苓、土炒陈皮、泽泻。
柳女士（右侧脉象）腹痛，脉象沉。这是寒气内盛且肝气横逆所致。
处方：制香附、砂仁、桂枝、磨木香、炮姜、小青皮、沉香、乌药、枳实炭、山楂炭。
二诊：腹痛稍减，脉象呈沉细之象。前年曾排出过蛔虫。这主要是因为肝木失于条达，肝之生气挟带肠胃中的湿热，郁结而生虫。治宜调气温中，兼用杀虫之法。
处方：广郁金（一钱五分）、使君子（一钱五分）、金铃子（一钱五分）、制香附（二钱，捣碎）、白蒺藜（三钱）、川桂枝（五分）、朱茯神（三钱）、陈皮（一钱）、焦山楂炭（三钱）、砂仁（七分）、炙乌梅（一个）。
三诊：脉症平稳，但腹痛仍未完全消除。在前法基础上进退调整，以求缓慢痊愈。
处方：金铃子（一钱五分）、使君子（一钱五分）、玄胡索（一钱五分）、广陈皮（一钱五分）、制香附（二钱）、砂仁（七分）、广郁金（一钱五分）、鹤虱（一钱五分）、山楂炭（二钱）、乌梅（八分）。
某患者：腹痛剧烈难忍，大便排出蛔虫，腹胀坚硬满闷，此为蛔虫蚀扰且肝木失于疏泄。恐怕会导致痛厥。
处方：使君子（三钱）、花槟榔（一钱）、炒鹤虱（三钱）、炙苦楝根皮（三钱）、川雅连（四分）、臭芜荑（二钱）、广玉金（即郁金，一钱五分）、淡吴茱萸（四分）、乌梅丸（一钱五分，开水送服）。
某患者（右侧脉象）疏通气机后，疼痛未退，这主要是由于产后恶露未净，阻碍了营卫之气的正常运行。再次予以宣通调理。
处方：延胡索、五灵脂、蓬莪术、乌药、丹参、泽兰。
另配散剂：乳香（三分）、没药（去油三分）、上沉香（三分）、西血珀（四分）。以上四味研成细末，先调服。
二诊：月经稍行，少腹疼痛由此减轻。确是恶露未清所致。继续宣通，务必使营气畅达。
处方：延胡索、乳香、制香附、当归须、生谷芽与熟谷芽、没药、郁金、南山楂炭、台乌药。
左姓患者：肚脐周围作痛。此前投用疏通之法无效，再仿照“塞因塞用”（以补开塞）的治法。
处方：熟地黄炭、山茱萸炭、牡丹皮、福泽泻、杭白芍、云茯苓、炒山药、砂仁、龟甲心（五钱，在瓦上炙成炭，开水先调服）。
王女士（右侧脉象）肚脐周围作痛，面色浮黄。这是湿邪、食积与寒气交阻，导致运化失常，急需温阳化湿。
处方：台乌药（一钱五分）、制香附（二钱，捣碎）、缩砂仁（七分）、焦山楂炭（三钱）、枳实炭（一钱）、云茯苓（三钱）、沉香片（四分）、香橼皮（一钱五分）、上安桂（肉桂的一种，四分，用饭糊为丸，先服）。
二诊：肚脐周围作痛稍减。再次予以辛温通散。
处方：白芍、山楂炭、砂仁、沉香片、上安桂（四分，饭丸）、郁金、青皮、制香附、金铃子。
王先生（左侧脉象）疼痛从少腹向上冲逆，日久不止。脉象细弱虚软。少腹两旁属于肝经，居中部位为冲脉和任脉布散之处，波及胸中。如今疼痛自下向上冲逆，明显属于奇经八脉空虚，厥逆之气肆意扰乱。
处方：酒炒当归（四钱）、老生姜（二钱）、炒枸杞子（三钱）、川续断肉（三钱）、炙黑甘草（二分）、杭白芍（一钱五分）、上安桂（四钱，饭糊为丸，先服）、精羊肉（一两五钱，煎汤去尽油沫，代替水来煎药）。
左姓患者：气从少腹上冲则腹部胀满，甚至干犯心胸则心中烦闷懊恼难以忍受。这是冲气上逆。暂且调气熄风平肝。
处方：盐水炒香附、白蒺藜、金铃子、杭白芍、盐水炒青皮、双钩藤（钩藤）、整砂仁、淡吴茱萸、天麻、金匮肾气丸。
左姓患者：少腹痛，牵连至胃脘部，当治肝胃。
处方：淡吴茱萸、制香附、炒枳实、南山楂炭、整砂仁、炒白芍、制半夏、青皮。
左姓患者：气虚湿滞。气虚则肌肉不充实，湿滞则少腹撑满。拟采用补益中寓以泻浊的治法。
处方：大蓟（此处原文“大有”疑为笔误或特定称呼，结合语境及常见配伍，若指补气药可能为党参/人参之误，但依原文提取实体，暂录为“大有”，注：中医古籍中“大有”非标准药材名，极大概率为“大腹皮”或“党参”之误写，此处严格按原文提取）（四钱）、奎党参（四钱，与大蓟同研极细末）、制半夏（一钱五分）、云茯苓（三钱）、生甘草与熟甘草（各三分）、广陈皮（一钱）。以上四味煎汤，送服参和大蓟的细末。
左姓患者：宣通营络，大便频繁泄泻，腹痛顿时停止。泄泻则积滞通畅，所以疼痛停止得极快。效方出入变化为主政。
处方：延胡索（一钱五分）、台乌药（一钱五分）、广郁金（一钱五分）、橘络（一钱）、赤茯苓与白茯苓（各二钱）、当归须（一钱五分）、制半夏（一钱五分）、山楂炭（三钱）、佩兰叶（一钱五分）、单桃仁（二钱）、广陈皮（一钱）、瓦楞子（四钱）。
[Appendix: Lower Abdominal Pain]
Patient Xu (Left pulse): Qi deficiency and spleen weakness generate phlegm. The Spleen belongs to damp earth, favoring warmth and disliking cold. Swallow's nest clears the Lungs and nourishes Yin; however, clearing the Lungs damages Spleen Earth, and nourishing Yin further assists Spleen Dampness. Therefore, after prolonged consumption, symptoms of abdominal pain and loose stools appeared. The proposed treatment is to harmonize the middle, warm and transport, clear and drain Damp-Heat/Water-Dampness, to conclude the treatment.
Prescription: Taizhu Zhu (Atractylodis Rhizoma), Zhi Banxia (Pinelliae Rhizoma Preparatum), Sheng Shu Yiren (Coicis Semen Raw and Prepared), Chuan Pu (Magnoliae Officinalis Cortex), Wei Jiang (Prepared Ginger), Yun Fuling (Poria), Mu Zhuling (Polyporus), Tu Chao Chenpi (Citri Reticulatae Pericarpium Soil-fried), Ze Xie (Alismatis Rhizoma).
Patient Liu (Right pulse): Abdominal pain with a deep pulse. This is due to internal Cold and Liver Qi stagnation/horizontal invasion.
Prescription: Zhi Xiangfu (Cyperi Rhizoma Preparatum), Sha Ren (Amomi Fructus), Guizhi (Cinnamomi Ramulus), Mo Muxiang (Aucklandiae Radix Ground), Pao Jiang (Prepared Ginger), Xiao Qingpi (Citri Reticulatae Pericarpium Viride), Chenxiang (Aquilariae Lignum Resinatum), Wuyao (Linderae Radix), Zhishi Tan (Aurantii Fructus Immaturus Charred), Zha Tan (Crataegi Fructus Charred).
Second Visit: Abdominal pain slightly reduced, pulse is deep and fine. Last year, long worms were passed in stool. This is likely due to the Liver Wood failing to maintain free flow; the vital energy of the Liver, carrying Damp-Heat from the intestines and stomach, became stagnant and generated worms. Treatment should regulate Qi and warm the middle, combined with antiparasitic methods.
Prescription: Guang Yujin (Curcumae Radix) (1.5 qian), Shijunzi (Quisqualis Fructus) (1.5 qian), Jinlingzi (Meliae Fructus) (1.5 qian), Zhi Xiangfu (Cyperi Rhizoma Preparatum) (2 qian, crushed), Bai Jili (Tribuli Fructus) (3 qian), Chuan Guizhi (Cinnamomi Ramulus) (0.5 qian), Zhu Fushen (Poria with Hostwood) (3 qian), Chenpi (Citri Reticulatae Pericarpium) (1 qian), Jiao Zha Tan (Crataegi Fructus Charred) (3 qian), Sha Ren (Amomi Fructus) (0.7 qian), Zhi Wumei (Mume Fructus Prepared) (1 piece).
Third Visit: Pulse and symptoms are stable, but abdominal pain has not completely resolved. Adjust the previous prescription slightly to aim for gradual recovery.
Prescription: Jinlingzi (Meliae Fructus) (1.5 qian), Shijunzi (Quisqualis Fructus) (1.5 qian), Yanhusuo (Corydalis Rhizoma) (1.5 qian), Guang Pi (Citri Reticulatae Pericarpium) (1.5 qian), Zhi Xiangfu (Cyperi Rhizoma Preparatum) (2 qian), Sha Ren (Amomi Fructus) (0.7 qian), Guang Yujin (Curcumae Radix) (1.5 qian), Lesi (Carthami Semen) (1.5 qian), Zha Tan (Crataegi Fructus Charred) (2 qian), Wumei (Mume Fructus) (0.8 qian).
Patient [Name Omitted]: Severe unbearable abdominal pain, passage of long worms in stool, abdominal distension with hardness and fullness. This is caused by worm erosion and Liver Wood failing to disperse. Fear of leading to pain-induced syncope (Tong Jue).
Prescription: Shijunzi (Quisqualis Fructus) (3 qian), Hua Binglang (Arecae Semen) (1 qian), Chao Lesi (Carthami Semen Stir-fried) (3 qian), Zhi Kulgen (Toosendan Radicis Cortex Preparatum) (3 qian), Chuan Yalian (Coptidis Rhizoma) (0.4 qian), Chou Wuyi (Euodiae Fructus) (2 qian), Guang Yujin (Curcumae Radix) (1.5 qian), Dan Wuyu (Evodiae Fructus) (0.4 qian), Wu Mei Wan (Mume Pill) (1.5 qian, taken with boiling water).
Patient [Name Omitted] (Right pulse): After unblocking Qi mechanism, pain did not recede. This is mainly because postpartum lochia was not cleared, obstructing the circulation of Ying and Wei Qi. Re-prescribe for dispersion and unblocking.
Prescription: Yanhusuo (Corydalis Rhizoma), Wulingzhi (Trogopterori Faeces), Peng Ezhu (Curcumae Longae Rhizoma), Wuyao (Linderae Radix), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Zelan (Lycopus Japonicus Herba).
Powder preparation: Rushi (Bisutis) (3 fen), Moyao (Myrrha) (3 fen, oil removed), Shang Chenxiang (Aquilariae Lignum Resinatum Superior) (3 fen), Xi Xuepo (Succinum Occidentale) (4 fen). Grind the above four into powder, take first mixed with liquid.
Second Visit: Menstruation slightly flowed, lower abdominal pain decreased thereby. Indeed, lochia was not cleared. Continue dispersion and unblocking, ensuring Ying Qi flows freely.
Prescription: Yanhu (Corydalis Rhizoma), Rushi (Bisutis), Zhi Xiangfu (Cyperi Rhizoma Preparatum), Danggui Xu (Angelicae Sinensis Radix Tomentum), Sheng Shu Guya (Oryzae Fructus Germinatus Raw and Prepared), Moyao (Myrrha), Yujin (Curcumae Radix), Nan Zha Tan (Crataegi Fructus Charred), Tai Wuyao (Linderae Radix).
Patient Zuo: Pain at the umbilicus. Previous unblocking treatment was ineffective. Again imitate the method of "treating obstruction with obstruction" (using tonification to relieve blockage).
Prescription: Shudi Tan (Rehmanniae Radix Preparatum Charred), Yurou Corni (Corni Fructus Charred), Danpi (Moutan Cortex), Fu Zexie (Alismatis Rhizoma), Hang Baishao (Paeoniae Radix Alba), Yun Fuling (Poria), Chao Shanyao (Dioscoreae Rhizoma Stir-fried), Sha Ren (Amomi Fructus), Guijia Xin (Testudinis Carapax et Plastrum Heart) (5 qian, roasted on tile until charred, taken first mixed with boiling water).
Patient Wang (Right pulse): Pain at the umbilicus, complexion floating and yellow. Dampness, food stagnation, and Cold obstruct each other, failing to transform. Urgently treat with warming and resolving.
Prescription: Tai Wuyao (Linderae Radix) (1.5 qian), Zhi Xiangfu (Cyperi Rhizoma Preparatum) (2 qian, crushed), Suo Sha Ren (Amomi Fructus) (0.7 qian), Jiao Zha Tan (Crataegi Fructus Charred) (3 qian), Zhishi Tan (Aurantii Fructus Immaturus Charred) (1 qian), Yun Fuling (Poria) (3 qian), Chenxiang Pian (Aquilariae Lignum Resinatum Slice) (0.4 qian), Xiangyuan Pi (Citri Reticulatae Pericarpium Citri Grandis Exocarpium) (1.5 qian), Shang Angui (Cinnamomi Cortex Superior) (0.4 qian, made into pills with rice paste, take first).
Second Visit: Pain at the umbilicus slightly reduced. Again apply acrid unblocking.
Prescription: Baishao (Paeoniae Radix Alba), Zha Tan (Crataegi Fructus Charred), Sha Ren (Amomi Fructus), Chenxiang Pian (Aquilariae Lignum Resinatum Slice), Shang Angui (Cinnamomi Cortex Superior) (0.4 qian, rice pill), Yujin (Curcumae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Zhi Xiangfu (Cyperi Rhizoma Preparatum), Jinlingzi (Meliae Fructus).
Third Visit: Add Shudi Huang (Rehmanniae Radix Preparatum) 4 qian, Guijia Xin (Testudinis Carapax et Plastrum Heart) 4 qian, roasted until charred, taken first mixed with aged wine.
Patient Wang (Left pulse): Pain rushes upward from the lower abdomen, lasting for a long time without stopping. Pulse is thin, weak, and soft. The sides of the lower abdomen belong to the Liver; the center is where the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) distribute to the chest. Now rushing upward from below, it clearly indicates emptiness of the extraordinary vessels, with rebellious Qi causing disturbance.
Prescription: Jiu Chao Danggui (Angelicae Sinensis Radix Wine-fried) (4 qian), Lao Shengjiang (Zingiberis Rhizoma Recens) (2 qian), Chao Qizi (Lycii Fructus Stir-fried) (3 qian), Chuan Duany Rou (Dioscoreae Hypoglaucae Caulis) (3 qian), Zhei Hei Gancao (Glycyrrhizae Radix et Rhizoma Prepared Blackened) (0.2 qian), Hang Baishao (Paeoniae Radix Alba) (1.5 qian), Shang Angui (Cinnamomi Cortex Superior) (4 qian, made into pills with rice paste, take first), Jing Yangrou (Ovis/Capis Carnea) (1.5 liang, decocted, skim off all oil foam, use as water to decoct herbs).
Patient Zuo: Qi rushing upward from the lower abdomen causes abdominal fullness; if it invades the heart and chest, it causes unbearable restlessness and oppression. This is Chong Qi rebelling upward. Temporarily regulate Qi and extinguish Liver wind.
Prescription: Yanshui Chao Xiangfu (Cyperi Rhizoma Salt-water stir-fried), Bai Jili (Tribuli Fructus), Jinlingzi (Meliae Fructus), Hang Baishao (Paeoniae Radix Alba), Yanshui Chao Qingpi (Citri Reticulatae Pericarpium Viride Salt-water stir-fried), Shuang Gougou (Uncariae Ramulus cum Uncis), Zheng Sha Ren (Amomi Fructus), Dan Wuyu (Evodiae Fructus), Tianma (Gastrodiae Rhizoma), Jin Kui Shen Qi Wan (Kidney Qi Pill from Golden Cabinet).
Patient Zuo: Lower abdominal pain radiating to the epigastrium. Treat Liver and Stomach.
Prescription: Dan Wuyu (Evodiae Fructus), Zhi Xiangfu (Cyperi Rhizoma Preparatum), Chao Zhishi (Aurantii Fructus Immaturus Stir-fried), Nan Zha Tan (Crataegi Fructus Charred), Zheng Sha Ren (Amomi Fructus), Chao Baishao (Paeoniae Radix Alba Stir-fried), Zhi Banxia (Pinelliae Rhizoma Preparatum), Qingpi (Citri Reticulatae Pericarpium Viride).
Patient Zuo: Qi deficiency with Damp stagnation. Qi deficiency means muscles are not filled; Damp stagnation causes lower abdominal distension and fullness. Propose tonifying while containing purging.
Prescription: Dayou (Note: Likely a typo or local term, possibly referring to a specific herb or part thereof, extracted as is) (4 qian), Kui Dangshen (Codonopsis Radix Kweichowensis) (4 qian, ground together with Dayou into very fine powder), Zhi Banxia (Pinelliae Rhizoma Preparatum) (1.5 qian), Yun Fuling (Poria) (3 qian), Sheng Sheng Cao (Glycyrrhizae Radix et Rhizoma Raw and Prepared) (3 fen each), Guang Pi (Citri Reticulatae Pericarpium) (1 qian). Decoct the above four ingredients, take the soup to deliver the powder of Dangshen and Dayou.
Patient Zuo: Unblocking Ying collaterals. Frequent loose stools, abdominal pain stopped instantly. Diarrhea unblocks stagnation, hence pain stops rapidly. Modify effective formulas as main strategy.
Prescription: Yanhusuo (Corydalis Rhizoma) (1.5 qian), Tai Wuyao (Linderae Radix) (1.5 qian), Guang Yujin (Curcumae Radix) (1.5 qian), Jieluo (Citri Reticulatae Pericarpium Retinervium) (1 qian), Chi Bai Ling (Poria Rosea and Alba) (2 qian each), Danggui Xu (Angelicae Sinensis Radix Tomentum) (1.5 qian), Zhi Banxia (Pinelliae Rhizoma Preparatum) (1.5 qian), Zha Tan (Crataegi Fructus Charred) (3 qian), Peilan Ye (Eupatorii Herba) (1.5 qian), Dan Taoren (Persicae Semen) (2 qian), Guang Chenpi (Citri Reticulatae Pericarpium) (1 qian), Walengzi (Arcae Concha) (4 qian).