【歌】寒痛绵绵无减增，时疼时止热为根。血瘀痛处无移动，食积便通便见轻。实者不能将手近，痛时
能按作虚论。湿痰痛者溲便秘，体认其形见病情。
【论】夫寒痛者，常痛而无增减也，成无己云∶阴寒为邪，则腹痛而吐利。热痛者，时作时止，《原病》
式云∶热郁于内，而腹满坚结痛，勿以为寒。死血痛者，每痛不移其处，成无己云∶邪气聚于下焦，津液不得
通，气血不得行，或溺或血，留滞于下，是生胀硬，小便不利也。食积痛者，利后即痛减。湿痰痛者，凡痛，
大、小便俱不利，丹溪云∶清痰多作腹痛，脉滑，痰因气滞而聚凝，其道路不得通故也。肠痈痛者，身甲错，
小便如淋，腹皮急，按之濡，如肿状，脉芤数也。积聚腹痛者，腹中原有积，左、右、上、下当积而痛也。寒
疝入腹痛者，少腹痛引睾丸。阴毒痛者，四肢厥逆，痛甚，咽喉不利，或心下胀满结燥，虚汗狂言，面色俱青，
阴积于下，阳消于上。实痛者，腹坚不可按。虚痛者，虽痛不胀满，手可按。若此霄壤不侔，可一药而尽之乎？
谨按∶腹痛，为脾家受病，盖脾或受有形而痛者，或受无形而痛者。若暴伤饮食，则胃脘先痛而后入腹。暴触怒
气，则两胁先痛而后入腹。血积上焦，脾火熏蒸，则痛从腹而上于胸臆。血积下部，胃气下行，则痛从腹而入
于少腹。伤于寒者，寒于痛，得热则缓。伤于饥者，饥即痛，得食即止。吞酸腹痛，为痰郁中焦，复伤饮食。
面黄腹痛，为宿食不消，蛔虫攻咬。气虚腹痛，腹必虚豁，呼吸短浅。血虚腹痛者，痛如芒刺，牵引不宁。医
者当审其因以处治，大要以甘温为上，惟伤酒作痛者，方可凉剂，而必佐之以甘温也。
【脉】沉弦细动，皆是痛证。心痛在寸，腹痛在关，下部在尺，脉象显然。
热痛
胸中有热，胃中有邪，腹痛欲呕，黄连汤。腹痛脉洪，热也，黄芩芍药汤。寒邪变热，传里腹痛，便秘而
厥，四逆散。腹满时痛，桂枝加大黄汤。腹痛便秘，脉实大者，大承气汤。（方见伤食。）
黄连汤
治热邪腹痛。
黄连（三钱，炒） 甘草（三钱，炙） 干姜（三钱） 桂枝（三钱） 人参（二钱） 半夏（半两，姜制）
每七钱，枣煎服。
黄芩芍药汤
黄芩（炒，二钱） 芍药（炒，一钱半） 甘草（一钱）
煎服。
四逆散
阳邪传里腹痛。
甘草（炙，一两） 枳壳（炒，一两） 芍药（炒，一两） 柴胡（一两）
末之，每服二钱，白汤调下。
桂枝加大黄汤
治太阴腹满时痛。
桂枝（一钱） 芍药（炒，一钱） 甘草（一钱） 大黄（二钱）
姜、枣煎，入饧一合，微烊服。
寒痛
伤寒下利腹痛，四逆汤。（方见中寒。）腹痛厥冷欲死者，霹雳散。腹痛下利，四肢沉重，真武汤或理
中汤。（方见中寒。）
霹雳散
治中寒腹痛。
附子（一枚，炮）
入真腊茶一大盏，同研匀，更分二剂，水二钟，煎八分，入熟白蜜一匙，凉服。
真武汤
治少阴腹痛。
茯苓（一钱五分） 芍药（炒，一钱半） 生姜（七片） 附子（炮，二钱）
水二大盏，煎至一盏，冷服。
痰痛 食积痛
清痰多作腹痛，台芎、苍术、木香、白芷、香附末之，姜汤调服。肥人腹痛，乃气虚湿痰也，二术、半
夏、陈皮、芍药之类。饮食过伤腹痛，保和丸、木香槟榔丸。（二方俱见伤食。）虚人饮食伤，腹时痛，六君
子汤加曲 。（方见脾胃。）
虚痛
素弱人，全不思食，腹冷痛，养胃汤加肉桂、茱萸、木香，或小建中汤，（方见脾胃。）或理中汤。
（方见中寒。）腹痛欲以手按，按之痛止者属虚，参、术、姜、桂之类。血虚腹痛，须用白芍药之酸补以和之，
或四物汤加焦炒干姜，炒芍药倍用。（方见血证。）
实痛
凡痛胀满，手不可按，大实也，大承气汤。（方见伤食。）初得腹痛，元气未虚，宜推荡之，此通因通用，
痛随利减也，桂枝加大黄汤，（方见前热腹痛条下。）或木香槟榔丸。（方见伤食。）
血痛
因跌扑瘀血，腹痛脉芤，桃仁承气汤加苏木、红花。（方见血证。）女人经闭，血积滞，腹中痛，玉烛
散，（即大承气汤对四物汤，二方一见伤食，一见血证。）或失笑散，（方见女科恶露条下。）或通经散。
通经散
活血定痛。
陈皮（一两） 甘遂（一两，煨） 当归尾（一两五钱） 川芎（一两） 红花（一两，酒洗） 桃
仁（一百个，去皮、尖）
上锉，每服七钱，水二钟，酒一钟，煎至八分，空心服。
积聚痛
腹中上、下、左、右有积聚，当积而痛，三圣膏，或木香槟榔丸、保和丸，（二方俱见伤食。）丁香脾
积丸。食积痞块作痛，阿魏丸。
三圣膏
未化锻石半斤，为细末，瓦器中炒令淡红色，提出火，候热稍减，次下大黄末一两，微炒，又提出，
候温，下桂心末半两，略炒，入陈米醋熬，搅成黑膏，浓纸摊贴患处，其痛自减，块渐消矣。
丁香脾积丸
丁香（半两） 木香（半两） 巴豆（去心膜油，半两） 良姜（醋煎，半两） 蓬莪术（三两）
京三棱（三两） 皂荚（三条，去皮弦子） 青皮（一两）
末之，入百草霜三钱糊丸，麻子大，每服十丸，空心时白沸汤下。
阿魏丸
治肉积腹痛。
连翘（半两，去壳） 山楂（一两，去核） 阿魏（一两） 黄连（六钱）
末之，用阿魏醋煮作糊，丸如梧桐子大，每服五、六十丸，清晨白滚汤送下。
肠痈痛
肠痈痛者，腹大痛，身甲错，小便如淋，脉芤，或攒脐有疮。积冷，以附子温之。积热，以大黄下之。脓
大出，以参、 补之。
阴毒痛
阴毒厥逆腹痛，阴寒欲绝，脉沉，爪甲、手指、唇、面青黑者，回肠丹或真武汤，方见前寒腹痛。急灸关
元、气海各五、七十壮。
回阳丹
阴毒厥冷腹痛。
牡蛎（烧，一钱） 良姜（炒，一钱） 不灰木（烧，一钱） 川乌（泡，一钱） 白芍药（一钱）
麝香（少许）
末之，每用一钱。男用女津调，涂外肾；女用男津调，涂两乳。
痧证痛（附疝痛）
忽然腹中大痛，呕吐脉沉，痧证也，正气散加香附、砂仁。（方见霍乱。）手足厥冷，举体转筋，理
中汤。（方见中寒。）少腹引睾丸痛，疝气入腹中痛，脉沉弦，补肾汤。余详疝证本条。
补肾汤
治疝气入腹痛。
人参（一钱，去芦） 白茯苓（一钱） 黄 （一钱，蜜炙） 附子（炮，一钱半） 白术（炒，一
钱） 沉香（一钱二分） 木瓜（一钱二分） 羌活（去芦，八分） 川芎（七分） 紫苏（八分） 甘
草（炙，六分）
上锉，一剂，姜三片，枣二枚，水二盏，煎八分，空心服。
【歌诀】寒性腹痛表现为绵绵不断的隐痛，且疼痛程度没有明显的增减变化；时疼时止的腹痛，其根本原因多在于热邪。血瘀导致的腹痛，痛点位置固定不移；食积引起的腹痛，在排便后疼痛会减轻。实证腹痛的特点是腹部坚硬，患者拒绝按压，若疼痛时反而喜欢按压，则应判断为虚证。湿痰引起的腹痛，常伴有小便和大便不通畅，通过观察患者的体态特征可以识别病情。
【论述】所谓寒性腹痛，通常是持续疼痛且无剧烈波动。成无己曾说：阴寒之邪侵袭人体，会导致腹痛并伴随呕吐和腹泻。热性腹痛，表现为发作有时、停止有时，《原病式》中说：热邪郁结于体内，导致腹部胀满、坚硬结聚而疼痛，不要将其误认为是寒证。死血（瘀血）引起的腹痛，每次疼痛的位置都不移动。成无己说：邪气聚集在下焦，津液无法通畅运行，气血不能流通，或者导致小便或大便异常，停滞在下部，从而产生胀硬感，小便不利。食积引起的腹痛，在泻下之后疼痛就会缓解。湿痰引起的腹痛，凡是这种疼痛，大、小便都不通畅。丹溪说：清稀的痰饮多引起腹痛，脉象滑利，这是因为痰因气机阻滞而凝聚，导致通道不畅的缘故。肠痈引起的腹痛，表现为皮肤粗糙如鳞甲交错，小便像淋证一样频急，腹皮紧张但按之柔软，看起来像肿胀的样子，脉象芤数。积聚引起的腹痛，是因为腹中原先就有积块，疼痛发生在积块所在的左、右、上、下部位。寒疝入腹引起的腹痛，表现为少腹疼痛牵引至睾丸。阴毒引起的腹痛，表现为四肢厥冷逆乱，疼痛剧烈，咽喉不适，或者心下部胀满干燥结滞，出虚汗、胡言乱语，面色发青，这是阴寒积聚于下部，阳气消损于上部所致。实证腹痛，腹部坚硬不可按压。虚证腹痛，虽然疼痛但腹部不胀满，手可以按压。如果这两者相差悬殊，怎么能用一种药方来治疗所有情况呢？
谨按：腹痛，是脾脏受病所致。因为脾脏要么受到有形之邪致病，要么受到无形之邪致病。如果是突然饮食受伤，那么胃脘部先痛，然后疼痛传入腹部。如果是突然触怒生气，那么两胁部先痛，然后疼痛传入腹部。血液积聚在上焦，脾火熏蒸，那么疼痛从腹部向上蔓延至胸膈。血液积聚在下部，胃气下行，那么疼痛从腹部进入少腹。受寒邪伤害的，寒冷导致疼痛，得到温热则缓解。受饥饿伤害的，饥饿时即痛，进食后疼痛停止。吞酸伴腹痛，是由于痰浊郁结在中焦，又加上饮食受伤。面色发黄伴腹痛，是由于宿食不消化，蛔虫攻咬所致。气虚引起的腹痛，腹部必然感觉空虚豁落，呼吸短浅。血虚引起的腹痛，疼痛如芒刺扎入，牵引不安。医生应当审察病因进行治疗，大体原则以甘温药物为上策，只有因饮酒过量导致疼痛的，才可以使用凉剂，但也必须佐以甘温药物。
【脉诊】沉脉、弦脉、细脉、动脉，都是痛证的脉象。心痛体现在寸口脉，腹痛体现在关部脉，下部疼痛体现在尺部脉，脉象表现非常明显。
热性腹痛
胸中有热，胃中有邪气，腹痛想呕吐，用黄连汤。腹痛脉象洪大，属于热证，用黄芩芍药汤。寒邪转化为热邪，传入里部导致腹痛，便秘且四肢厥冷，用四逆散。腹部胀满且时痛时止，用桂枝加大黄汤。腹痛伴便秘，脉象实大的，用大承气汤。（方剂见伤食条下。）
黄连汤
治疗热邪引起的腹痛。
黄连（三钱，炒制） 甘草（三钱，炙制） 干姜（三钱） 桂枝（三钱） 人参（二钱） 半夏（半两，姜汁制）
每服七钱，用大枣煎汤送服。
黄芩芍药汤
黄芩（炒制，二钱） 芍药（炒制，一钱半） 甘草（一钱）
煎汤服用。
四逆散
治疗阳邪传入里部引起的腹痛。
甘草（炙制，一两） 枳壳（炒制，一两） 芍药（炒制，一两） 柴胡（一两）
研成粉末，每服二钱，用白开水调下。
桂枝加大黄汤
治疗太阴病腹部胀满时痛。
桂枝（一钱） 芍药（炒制，一钱） 甘草（一钱） 大黄（二钱）
加生姜、大枣煎煮，加入饴糖一合，微火融化后服用。
寒性腹痛
伤寒导致下利腹痛，用四逆汤。（方剂见中寒条下。）腹痛四肢厥冷欲死者，用霹雳散。腹痛下利，四肢沉重，用真武汤或理中汤。（方剂见中寒条下。）
霹雳散
治疗中寒引起的腹痛。
附子（一枚，炮制）
放入真腊茶一大盏，一同研磨均匀，再分为两剂，用水二钟，煎至八分，加入熟白蜜一匙，凉服。
真武汤
治疗少阴病腹痛。
茯苓（一钱五分） 芍药（炒制，一钱半） 生姜（七片） 附子（炮制，二钱）
用水两大盏，煎至一盏，冷服。
痰饮与食积引起的腹痛
清稀的痰饮多引起腹痛，可用台芎、苍术、木香、白芷、香附研末，用姜汤调服。肥胖之人腹痛，是气虚湿痰所致，可用二术（白术、苍术）、半夏、陈皮、芍药等药。饮食过度损伤引起的腹痛，用保和丸、木香槟榔丸。（两个方剂均见伤食条下。）体虚之人饮食受伤，腹部时常疼痛，用六君子汤加神曲。（方剂见脾胃条下。）
虚性腹痛
平素体弱的人，完全不想吃东西，腹部冷痛，用养胃汤加肉桂、吴茱萸、木香，或小建中汤，（方剂见脾胃条下。）或理中汤。（方剂见中寒条下。）腹痛想要用手按压，按压后疼痛停止的属于虚证，用人参、白术、干姜、肉桂等药。血虚引起的腹痛，必须用白芍药的酸味来补益调和，或用四物汤加焦炒干姜，加倍使用炒芍药。（方剂见血证条下。）
实性腹痛
凡是胀痛，手不可按压，是大实证，用大承气汤。（方剂见伤食条下。）刚得腹痛，元气尚未虚弱，适宜推荡积滞，这是“通因通用”的方法，疼痛会随着大便通畅而减轻，可用桂枝加大黄汤，（方剂见前热腹痛条下。）或木香槟榔丸。（方剂见伤食条下。）
血瘀引起的腹痛
因跌打损伤导致瘀血，腹痛脉芤，用桃仁承气汤加苏木、红花。（方剂见血证条下。）妇女经闭，血液积聚停滞，腹中疼痛，用玉烛散，（即大承气汤与四物汤合方，两个方剂一见伤食，一见血证。）或失笑散，（方剂见女科恶露条下。）或通经散。
通经散
活血定痛。
陈皮（一两） 甘遂（一两，煨制） 当归尾（一两五钱） 川芎（一两） 红花（一两，酒洗） 桃仁（一百个，去皮、尖）
以上药材切碎，每服七钱，用水二钟，酒一钟，煎至八分，空腹服用。
积聚引起的腹痛
腹部上、下、左、右有积聚，当积块处疼痛，用三圣膏，或木香槟榔丸、保和丸，（两个方剂均见伤食条下。）丁香脾积丸。食积痞块作痛，用阿魏丸。
三圣膏
未锻烧过的锻石半斤，研为细末，在瓦器中炒至淡红色，取出离火，待热度稍减，再加入大黄末一两，微炒，再次取出，待温度降低，加入桂心末半两，略炒，加入陈米醋熬制，搅拌成黑膏状，用厚纸摊开贴敷患处，疼痛自然减轻，肿块逐渐消散。
丁香脾积丸
丁香（半两） 木香（半两） 巴豆（去心膜油，半两） 良姜（醋煎，半两） 蓬莪术（三两）
京三棱（三两） 皂荚（三条，去皮弦子） 青皮（一两）
研为粉末，加入百草霜三钱，用糊制作成梧桐子大小的丸药，每服十丸，空腹时用白开水送下。
阿魏丸
治疗肉积引起的腹痛。
连翘（半两，去壳） 山楂（一两，去核） 阿魏（一两） 黄连（六钱）
研为粉末，用阿魏醋煮成糊状，制成梧桐子大小的丸药，每服五六十丸，清晨用白开水送下。
肠痈引起的腹痛
肠痈疼痛，表现为腹部大痛，身体皮肤粗糙如鳞甲交错，小便像淋证一样，脉象芤，或者肚脐周围有疮疡。若是积冷，用附子温之；若是积热，用大黄下之；脓液大量排出后，用人参、黄芪补之。
阴毒引起的腹痛
阴毒导致厥逆腹痛，阴寒欲绝，脉象沉，指甲、手指、嘴唇、面色青黑的，用回阳丹或真武汤，方剂见前寒腹痛条下。紧急灸关元、气海穴各五七十壮。
回阳丹
治疗阴毒厥冷腹痛。
牡蛎（烧制，一钱） 良姜（炒制，一钱） 不灰木（烧制，一钱） 川乌（泡制，一钱） 白芍药（一钱）
麝香（少许）
研为粉末，每用一钱。男性用女性唾液调匀，涂在外肾；女性用男性唾液调匀，涂在两乳。
痧证疼痛（附疝痛）
忽然腹部大痛，呕吐，脉沉，是痧证，用正气散加香附、砂仁。（方剂见霍乱条下。）手足厥冷，全身转筋，用理中汤。（方剂见中寒条下。）少腹牵引睾丸疼痛，疝气入腹中痛，脉沉弦，用补肾汤。其余详情见疝证本条。
补肾汤
治疗疝气入腹引起的腹痛。
人参（一钱，去芦头） 白茯苓（一钱） 黄芪（一钱，蜜炙） 附子（炮制，一钱半） 白术（炒制，一钱） 沉香（一钱二分） 木瓜（一钱二分） 羌活（去芦头，八分） 川芎（七分） 紫苏（八分） 甘草（炙制，六分）
以上药材切碎，一剂药，加生姜三片，大枣二枚，水两盏，煎至八分，空腹服用。
[Verse] Cold-type abdominal pain presents as a continuous, lingering ache without significant fluctuation in intensity. Abdominal pain that comes and goes is often rooted in heat. Pain caused by blood stasis remains fixed in one location. Pain due to food stagnation alleviates after defecation. In excess-type abdominal pain, the abdomen is hard and patients refuse pressure; if pressing relieves the pain, it should be diagnosed as deficiency. Pain from damp-phlegm is accompanied by constipation of both urine and stool, and can be identified by observing the patient's physique.
[Dissertation] Cold-type abdominal pain is typically persistent without severe fluctuations. Cheng Wuji stated: "When Yin-cold pathogenic factors invade, abdominal pain occurs accompanied by vomiting and diarrhea." Heat-type abdominal pain manifests intermittently. The *Yuan Bing Shi* states: "Heat constrained internally causes abdominal fullness, hardness, and pain; do not mistake this for cold." Pain from stagnant blood (blood stasis) does not shift location. Cheng Wuji said: "Pathogenic factors gather in the Lower Jiao, preventing the free flow of body fluids and Qi-blood. This may lead to urinary or fecal abnormalities, stagnation in the lower region, resulting in distension and hardness, and difficult urination." Pain from food stagnation alleviates after purging. Pain from damp-phlegm involves obstruction of both urination and defecation. Danxi stated: "Clear phlegm often causes abdominal pain with a slippery pulse; this is because phlegm condenses due to Qi stagnation, blocking the pathways." Intestinal abscess pain presents with rough, scaly skin (like fish scales), frequent urgent urination resembling strangury, tense abdominal wall that feels soft upon palpation (suggesting swelling), and a cun-kou pulse that is hollow and rapid. Accumulation-induced abdominal pain arises from pre-existing masses within the abdomen, with pain occurring at the site of the mass (left, right, upper, or lower). Cold hernia entering the abdomen causes pain in the Shaoyang region radiating to the testicles. Yin-toxin pain presents with cold extremities, severe pain, throat discomfort, epigastric fullness and dryness, spontaneous sweating, delirium, and a bluish complexion. This indicates Yin-cold accumulating below and Yang Qi declining above. Excess-type abdominal pain features a hard abdomen that cannot be pressed. Deficiency-type abdominal pain involves pain without fullness, allowing for gentle pressure. Given the vast difference between these two conditions, how can a single formula treat all cases?
Note: Abdominal pain is primarily a disorder of the Spleen. The Spleen may be affected by tangible pathogens or intangible pathogens. If injured suddenly by diet, pain starts in the Stomach region before spreading to the abdomen. If provoked suddenly by anger, pain starts in the hypochondrium before spreading to the abdomen. Blood accumulation in the Upper Jiao, steamed by Spleen fire, causes pain to radiate from the abdomen upward to the chest. Blood accumulation in the lower part, combined with descending Stomach Qi, causes pain to move from the abdomen into the lower abdomen. Cold injury causes pain that worsens with cold and alleviates with warmth. Hunger causes pain that stops upon eating. Acid regurgitation with abdominal pain results from phlegm-dampness constrained in the Middle Jiao compounded by dietary injury. Yellowish complexion with abdominal pain indicates undigested food and roundworm attack. Qi-deficiency abdominal pain presents with a feeling of emptiness in the abdomen and shortness of breath. Blood-deficiency abdominal pain feels like needle pricks with restless pulling sensations. Physicians must examine the cause for treatment. Generally, sweet-warm herbs are preferred. Only in cases of alcohol-induced pain are cooling formulas used, but they must still be supplemented with sweet-warm herbs.
[Pulse Diagnosis] Deep, wiry, fine, and moving pulses are all indicative of pain syndromes. Heart pain is reflected in the Cun position, abdominal pain in the Guan position, and lower body pain in the Chi position; the pulse signs are clear.
Heat-Type Abdominal Pain
Heat in the chest and pathogenic factors in the stomach, causing abdominal pain and nausea, are treated with Huanglian Tang (Coptis Decoction). Abdominal pain with a surging pulse indicates heat, treated with Huangqin Shaoyao Tang (Scutellaria and Peony Decoction). Cold transforming into heat and transmitting inward causing abdominal pain, constipation, and cold limbs, are treated with Sini San (Four Counterflow Powder). Abdominal fullness with intermittent pain is treated with Guizhi Jiadahuang Tang (Cinnamon Twig Decoction plus Rhubarb). Abdominal pain with constipation and a large, excess pulse is treated with Dachengqi Tang (Major Order the Qi Decoction). (See Food Stagnation section for formulas.)
Huanglian Tang (Coptis Decoction)
Treats abdominal pain caused by heat pathogens.
Huanglian (Coptidis Rhizoma, 3 qian, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian, honey-fried), Ganjiang (Zingiberis Rhizoma, 3 qian), Guizhi (Cinnamomi Ramulus, 3 qian), Renshen (Ginseng Radix, 2 qian), Banxia (Pinelliae Tuber, half liang, ginger-processed).
Take 7 qian per dose, decoct with dates, and take orally.
Huangqin Shaoyao Tang (Scutellaria and Peony Decoction)
Huangqin (Scutellariae Radix, 2 qian, stir-fried), Shaoyao (Paeoniae Radix Alba, 1.5 qian, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian).
Decoct and take orally.
Sini San (Four Counterflow Powder)
Treats abdominal pain caused by Yang pathogens transmitting inward.
Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried), Zhike (Aurantii Fructus Immaturus, 1 liang, stir-fried), Shaoyao (Paeoniae Radix Alba, 1 liang, stir-fried), Chaihu (Bupleuri Radix, 1 liang).
Grind into powder, take 2 qian per dose, mixed with warm water.
Guizhi Jiadahuang Tang (Cinnamon Twig Decoction plus Rhubarb)
Treats Taiyin syndrome with abdominal fullness and intermittent pain.
Guizhi (Cinnamomi Ramulus, 1 qian), Shaoyao (Paeoniae Radix Alba, 1 qian, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian), Dahuang (Rhei Radix et Rhizoma, 2 qian).
Decoct with ginger and dates, add Yi (Maltose, 1 he), melt slightly, and take.
Cold-Type Abdominal Pain
Shaoyin syndrome with diarrhea and abdominal pain is treated with Sini Tang (Frigid Extremities Decoction). (See Cold Invasion section.) Severe abdominal pain with cold limbs approaching death is treated with Pili San (Thunderbolt Powder). Abdominal pain with diarrhea and heavy limbs is treated with Zhenwu Tang (True Warrior Decoction) or Lizhong Tang (Regulate the Middle Decoction). (See Cold Invasion section.)
Pili San (Thunderbolt Powder)
Treats abdominal pain from cold invasion.
Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, processed).
Grind together with Zhenla Tea (one large cup), divide into two doses, decoct with two zhong of water until eight parts remain, add one spoonful of white honey, and take cool.
Zhenwu Tang (True Warrior Decoction)
Treats Shaoyin syndrome abdominal pain.
Fuling (Poria, 1.5 qian), Shaoyao (Paeoniae Radix Alba, 1.5 qian, stir-fried), Shengjiang (Zingiberis Rhizoma Recens, 7 slices), Fuzi (Aconiti Lateralis Radix Praeparata, 2 qian, processed).
Decoct with two large cups of water until one cup remains, and take cool.
Phlegm and Food Stagnation Abdominal Pain
Clear phlegm often causes abdominal pain; use Taixiong (Chuanxiong Rhizome), Cangzhu (Atractylodis Rhizoma), Muxiang (Aucklandiae Radix), Baizhi (Angelicae Dahuricae Radix), Xiangfu (Cyperi Rhizoma) ground into powder, taken with ginger tea. Fat individuals with abdominal pain suffer from Qi deficiency and damp-phlegm; use Er Zhu (Atractylodis Rhizoma and Atractylodis Macrocephalae Rhizoma), Banxia (Pinelliae Tuber), Chenpi (Citri Reticulatae Pericarpium), Shaoyao (Paeoniae Radix Alba), etc. Pain from overeating is treated with Baohe Wan (Harmonize the Stomach Pill) or Muxiang Binglang Wan (Aucklandia and Areca Seed Pill). (See Food Stagnation section.) Weak individuals with dietary injury and intermittent abdominal pain are treated with Liujunzi Tang (Six Gentlemen Decoction) plus Shenqu (Medicated Leaven). (See Spleen and Stomach section.)
Deficiency-Type Abdominal Pain
Frail individuals who lose appetite and have cold abdominal pain are treated with Yangwei Tang (Nourish the Stomach Decoction) plus Rougui (Cinnamomi Cortex), Zhuyu (Evodiae Fructus), Muxiang (Aucklandiae Radix), or Xiaojianzhong Tang (Minor Construct the Middle Decoction). (See Spleen and Stomach section.) Or Lizhong Tang (Regulate the Middle Decoction). (See Cold Invasion section.) Abdominal pain relieved by pressure indicates deficiency; use Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Jiang (Zingiberis Rhizoma), Guizhi (Cinnamomi Ramulus), etc. Blood-deficiency abdominal pain requires Sour-tonifying Shaoyao (Paeoniae Radix Alba) to harmonize, or Siwu Tang (Four Substances Decoction) plus charred Ganjiang (Zingiberis Rhizoma), with doubled charred Shaoyao. (See Blood Syndromes section.)
Excess-Type Abdominal Pain
Distending pain that cannot tolerate pressure indicates severe excess; treat with Dachengqi Tang (Major Order the Qi Decoction). (See Food Stagnation section.) For recent onset of abdominal pain where Yuan Qi is not yet depleted, purgation is appropriate. This is "treating obstruction with unblocking methods," where pain decreases with bowel movement. Use Guizhi Jiadahuang Tang (Cinnamon Twig Decoction plus Rhubarb) or Muxiang Binglang Wan (Aucklandia and Areca Seed Pill). (See preceding Heat Abdominal Pain section and Food Stagnation section.)
Blood Stasis Abdominal Pain
Abdominal pain with a hollow pulse due to traumatic blood stasis is treated with Tao Ren Chengqi Tang (Apricot Kernel Order the Qi Decoction) plus Sumu (Daemonorops Spine) and Honghua (Carthami Flos). (See Blood Syndromes section.) Women with amenorrhea, blood stasis, and abdominal pain are treated with Yuzhu San (Jade Candle Powder), which combines Dachengqi Tang (Major Order the Qi Decoction) and Siwu Tang (Four Substances Decoction). Or Shixiao San (Pain Relieved Powder). Or Tongjing San (Unblock Menstruation Powder).
Tongjing San (Unblock Menstruation Powder)
Invigorates blood and relieves pain.
Chenpi (Citri Reticulatae Pericarpium, 1 liang), Gansui (Kansui Radix, 1 liang, roasted), Dangguiwei (Angelicae Sinensis Radix, 1.5 liang), Chuanxiong (Chuanxiong Rhizome, 1 liang), Honghua (Carthami Flos, 1 liang, wine-washed), Taoren (Persicae Semen, 100 pieces, peeled and de-husked).
Cut into pieces, take 7 qian per dose, decoct with two zhong of water and one zhong of wine until eight parts remain, and take on an empty stomach.
Accumulation Abdominal Pain
For accumulations located up, down, left, or right in the abdomen causing pain at the site of the mass, use Sansheng Gao (Three Saints Plaster) or Muxiang Binglang Wan (Aucklandia and Areca Seed Pill), Baohe Wan (Harmonize the Stomach Pill), or Dingxiang Pi Ji Wan (Clove Spleen Accumulation Pill). For pain from food stagnation masses, use Awei Wan (Ferula Pill).
Sansheng Gao (Three Saints Plaster)
Half jin of uncalcined Dushi (Calcined Lime), ground fine, stir-fried in a clay vessel until pale red, remove from fire, wait for slight cooling, add 1 liang of Dahuang (Rhei Radix et Rhizoma) powder, stir-fry lightly, remove again, wait for cooling, add 0.5 liang of Guixin (Cinnamomi Cortex) powder, stir-fry slightly, boil with aged rice vinegar, stir into a black paste. Apply thick paper soaked in this paste to the affected area; pain will subside and masses will gradually dissipate.
Dingxiang Pi Ji Wan (Clove Spleen Accumulation Pill)
Dingxiang (Caryophylli Flos, 0.5 liang), Muxiang (Aucklandiae Radix, 0.5 liang), Badou (Crotonis Fructus, de-heart, membrane, and oil removed, 0.5 liang), Liangjiang (Alpiniae Officinarum Rhizoma, vinegar-boiled, 0.5 liang), Peng'ezhu (Curcumae Longae Rhizoma, 3 liang), Jing Sanleng (Sparganii Rhizoma, 3 liang), Zaojiao (Gleditsiae Fructus, three strips, de-skin and de-seed), Qingpi (Citri Reticulatae Pericarpium Viride, 1 liang).
Grind into powder, mix with 3 qian of Baicaoshuang (Carbonized Bamboo Dust) and paste to form pills the size of hemp seeds. Take 10 pills per dose on an empty stomach with boiling water.
Awei Wan (Ferula Pill)
Treats abdominal pain from meat accumulation.
Lianqiao (Forsythiae Fructus, 0.5 liang, de-shelled), Shanzha (Crataegi Fructus, 1 liang, de-pitted), Awei (Ferulae Resina, 1 liang), Huanglian (Coptidis Rhizoma, 6 qian).
Grind into powder, use Awei boiled in vinegar as paste to form pills the size of wutong seeds. Take 50-60 pills per dose in the morning with plain hot water.
Intestinal Abscess Abdominal Pain
Intestinal abscess pain presents with severe abdominal pain, rough scaly skin, strangury-like urination, hollow pulse, or sores around the umbilicus. For accumulated cold, use Fuzi (Aconiti Lateralis Radix Praeparata) to warm; for accumulated heat, use Dahuang (Rhei Radix et Rhizoma) to purge. When pus discharges significantly, tonify with Renshen (Ginseng Radix) and Huangqi (Astragali Radix).
Yin Toxin Abdominal Pain
Yin toxin causing cold extremities, abdominal pain, extreme Yin cold, deep pulse, and blue-black nails, fingers, lips, and face is treated with Huiyang Dan (Return Yang Pill) or Zhenwu Tang (True Warrior Decoction). (See preceding Cold Abdominal Pain section.) Urgently moxa Guanyuan (CV4) and Qihai (CV6) points, 50-70 moxa cones each.
Huiyang Dan (Return Yang Pill)
Treats Yin toxin cold extremities and abdominal pain.
Muli (Concha Ostreae, calcined, 1 qian), Liangjiang (Alpiniae Officinarum Rhizoma, stir-fried, 1 qian), Buhui Mu (Asbestus, calcined, 1 qian), Chuanwu (Aconiti Radix, soaked, 1 qian), Baishaoyao (Paeoniae Radix Alba, 1 qian), Shexiang (Moschus, a small amount).
Grind into powder, use 1 qian per dose. For men, mix with female saliva and apply to external genitalia; for women, mix with male saliva and apply to breasts.
Sha Syndrome Pain (Including Hernia Pain)
Sudden severe abdominal pain, vomiting, and deep pulse indicate Sha Syndrome; treat with Zhengqi San (Righteous Qi Powder) plus Xiangfu (Cyperi Rhizoma) and Sharen (Amomi Fructus Rotundus). (See Cholera Section.) Cold extremities and whole-body muscle spasms are treated with Lizhong Tang (Regulate the Middle Decoction). (See Cold Invasion Section.) Lower abdomen pain radiating to testicles, hernia entering the abdomen with deep-wiry pulse, is treated with Bushen Tang (Tonify Kidney Decoction). See Hernia Syndrome section for details.
Bushen Tang (Tonify Kidney Decoction)
Treats hernia pain entering the abdomen.
Renshen (Ginseng Radix, 1 qian, de-rhizome), Fuling (Poria, 1 qian), Huangqi (Astragali Radix, 1 qian, honey-fried), Fuzi (Aconiti Lateralis Radix Praeparata, 1.5 qian, processed), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian, stir-fried), Chenxiang (Aquilariae Lignum Resinatum, 1.2 qian), Mugua (Chaenomelis Fructus, 1.2 qian), Qianghuo (Notopterygii Rhizoma et Radix, de-rhizome, 0.8 qian), Chuanxiong (Chuanxiong Rhizome, 0.7 qian), Zisu (Perillae Folium, 0.8 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.6 qian, honey-fried).
Cut into pieces, one dose with 3 slices of ginger and 2 dates, decoct with two cups of water until eight parts remain, and take on an empty stomach.