有实、有虚、寒、气滞、死血、积、热、风、湿痰、清痰、惊痰。脉滑者痰,弦者食痹
、疮、痧、疝。
发汗 大抵风寒与湿痰在表之里作痛,宜汗之。
温 寒入中脘痛,理中。少腹小腹,四逆,厥阴,当归四逆汤、吴茱。
熨 寒在内急痛,宜灰包熨之。
逐热 有湿热作痢者,宜导气汤下之。湿热怫郁,痛随利减。
针 大抵实痛宜刺泻之,太冲、三阴交、太白、太渊、太陵。
消积 脾积丸。见泻例中。
下食 食积停滞,与内消脾积,看冷热物下之。
通利 坠肭疮疝之类。皆宜下之。有悬饮为痛,当下之,见痰例中。
软 诸痛未可用参术,盖补气则气痛转甚。虚者须咸以 之。
灸 邪客经络,药不能及者,宜灸气海穴、关元穴、中脘穴。
外接法 治阴毒。
牡蛎(烧) 不灰木(烧) 良姜(炒) 川乌(炮) 白芍(各一钱) 麝(少许)
上为细末,每服一钱。男病用女唾津调,涂外肾。女病用男唾调,涂两乳。
摩按 风寒湿宜按摩之,或用油线绞括夺命、委中等处。俗谓之括痧。
逐血 有积血奔豚,皆以活血通经药逐之。
补 伤寒腹痛,脐下筑动者,理中丸加人参主之。
消郁导痰 清痰多作腹痛,用茗、芎、仙术、香附、白芷、姜汁入汤调服。
托疮 有疮在肺或肠痈,脉来数而实。
腹痛的病因包括实证、虚证、寒邪、气机阻滞、瘀血(死血)、积滞、热邪、风邪、湿痰、清稀之痰、惊悸所致之痰。脉象滑利主痰饮,弦脉主食痹、疮疡、痧症、疝气。
发汗法:大抵风寒与湿痰在表及半表半里部位引起的疼痛,适宜采用发汗法治疗。
温法:寒邪侵入中脘引起疼痛,使用理中汤;少腹和小腹疼痛,涉及厥阴经者,使用四逆汤或当归四逆汤、吴茱萸等。
逐热法:有湿热导致痢疾者,适宜用导气汤攻下。湿热郁结,疼痛随通利而减轻。
针刺法:大抵实痛适宜针刺泻法,选取太冲、三阴交、太白、太渊、太陵穴。
通利法:坠肭疮、疝气之类,都适宜攻下。有悬饮引起疼痛的,应当攻下,参见痰饮案例中。
软坚法:各种疼痛未可用人参、白术,因为补气会使气滞疼痛加剧。虚证必须用咸味药来软坚散结。
灸法:邪气客于经络,药物难以到达之处,适宜灸气海穴、关元穴、中脘穴。
外接法:治疗阴毒。
牡蛎(烧制) 不灰木(烧制) 良姜(炒制) 川乌(炮制) 白芍(各一钱) 麝香(少许)
以上研为细末,每次服用一钱。男病用女唾津液调匀,涂敷外肾。女病用男唾调匀,涂敷两乳。
摩按法:风寒湿适宜按摩,或用油线绞括夺命、委中等处。俗称为括痧。
The etiology of abdominal pain includes excess patterns, deficiency patterns, cold pathogenic factors, qi stagnation, dead blood (stasis), accumulation, heat pathogenic factors, wind pathogenic factors, damp-phlegm, clear phlegm, and phlegm caused by fright. A slippery pulse indicates phlegm; a wiry pulse indicates food-bi, sores, sha syndrome, or hernia.
Diaphoresis: Generally, pain caused by wind-cold and damp-phlegm located in the exterior or half-exterior/half-interior regions is suitable for treatment via diaphoresis.
Warming: When cold enters the Zhongwan region causing pain, Lizhong Tang is used. For pain in the lower abdomen and hypogastrium involving the Jueyin channel, Sini Tang, Danggui Sini Tang, or Wuzhuyu are used.
Moxibustion/Hot Compress: For acute pain caused by internal cold, hot compresses with ash bags are suitable.
Clearing Heat: In cases where damp-heat causes dysentery, Daoqi Tang is suitable for purgation. When damp-heat is constrained, pain decreases following purgation.
Acupuncture: Generally, excess pain is suitable for needle insertion with draining techniques, selecting Taichong (LR3), Sanyinjiao (SP6), Taibai (SP3), Taiyuan (LU9), and Tailing (PC4).
Eliminating Accumulation: Use Piji Wan. See examples under diarrhea.
Purgation for Food: For food stagnation, combined with internal elimination of spleen accumulation, use purgatives according to cold or heat properties.
Unblocking and Purging: Conditions such as zhena sores and hernia are all suitable for purgation. Pain caused by xuan-yin (suspended fluid) should be treated with purgation; see examples under phlegm.
Softening Hardness: Ginseng and Atractylodes macrocephala should not be used for various pains initially, as tonifying qi may exacerbate qi-stagnation pain. Deficiency patterns require salty substances to soften hardness.
Moxibustion: When pathogens lodge in the meridians where herbs cannot reach, moxibustion on Qihai (CV6), Guanyuan (CV4), and Zhongwan (CV12) is suitable.
External Application Method: Used to treat Yin Du (Yin Toxin).
Oyster Shell (calcined), Ashless Wood (calcined), Galangal (stir-fried), Sichuan Aconite Root (processed), White Peony Root (each 1 qian), Musk (a small amount).
Grind into fine powder. Take 1 qian per dose. For male patients, mix with female saliva and apply externally to the external genitalia. For female patients, mix with male saliva and apply to both breasts.
Massage and Pressing: Wind-cold-dampness is suitable for massage, or using oil-thread squeezing at points like Duoming and Weizhong. Commonly known as Gua Sha (scraping).
Expelling Blood: Cases of accumulated blood and Ben Tun (rushing pig) are expelled using blood-invigorating and meridian-unblocking herbs.
Tonification: For abdominal pain due to Shanghan (Cold Damage) with throbbing below the umbilicus, Lizhong Wan plus Ren Shen is indicated.
Resolving Stagnation and Guiding out Phlegm: Clear phlegm often causes abdominal pain. Use tea, Chuanxiong Rhizome, Atractylodes lancea, Cyperi Rhizoma, Angelicae Dahuricae Radix, and ginger juice mixed in decoction for oral administration.
Supporting Sores: When there are sores in the lungs or intestinal abscesses, the pulse is rapid and excess.