自利不渴者。属太阴。以其藏有寒故也。当温之宜。（四逆辈。）此条虽不言脉。当知沉迟
而弱。
仲景（理中汤丸）。暨易老（人参黄 汤）。量其轻重。或温或热。人之强弱虚实。所可宜者。
选而用之。
答曰有经云。本太阳证。医反下之。因尔腹满时痛者太阴也。（桂枝芍药汤）主之。大实痛
者。（桂枝加大黄汤。）易老云。此非本有是证。以其错下脾传于胃。故误下传。
太阴中风四肢烦疼。阳微阴涩而长者。欲愈。表少里和脉长者。为阳渐生也。此一证。
太阴便从外感太阴病欲解时。从亥至丑上也。
太阴之为病。腹满而吐。食不下。自利益甚。时腹自痛。若下之。则胸下结硬。太阴为
病脉
手足自温者。系在太阴。小便自利者。则不发黄。日久利益甚必自止者。便硬。乃入府传阳
中脘痛。太阴也。（理中）（建中）（黄 汤）类。主之。
脐腹痛。少阴也。（四逆）（真武）（附子汤）类。主之。
少腹痛。小腹痛。厥阴也。重则正阳（回阳丹）之类。轻则（当归四逆汤）。
太阴传少阴痛甚者。当变下利不止。
杂证而痛。（四物苦楝汤）（酒煮当归丸）。增损（当归丸）之类。
夏肌热恶热。脉洪疾。手太阴足阳明主之。（黄芩芍药汤）。
秋肌热恶寒。脉沉疾足少阴足太阴主之（桂枝芍药汤）。
腹痛 腹痛者。（芍药甘草汤）主之。
\r图\ps11a3.bmp\r
腹不满者加枣。若满者不加。脾虚满者。黄 汤。芍药停湿。
中满者。分食甘二药。用甘引至满所脾实。
平胃散。苍术泄湿。小便不利者利之。
大便秘 实痞 浓朴 枳实 大便利 虚痞 芍药 陈皮
伤食满者。伤厥阴。是以腹胀满者。皆属木。
腹部胀满，咽喉干燥。手足自然温暖。自行腹泻且不口渴。时常出现腹痛。寸脉和尺脉都呈现沉细之象。
自行腹泻且不口渴的，属于太阴病。这是因为脏腑内有寒邪所致。应当采用温法治疗，适宜使用四逆汤类方剂。这一条虽然未提及脉象，但应当知道脉象是沉迟而弱的。
张仲景（李中梓注：此处指《伤寒论》中的理中汤丸）。以及易老（王好古尊称其师罗天益为易老，或指罗氏方）的人参黄耆汤。根据病情的轻重，或者用温法，或者用热法，结合患者体质的强弱虚实，选择适宜的方法使用。
回答说：有经文记载，原本是太阳病证，医生反而使用了攻下法，因此导致腹部胀满、时常腹痛的，这是太阴病。由桂枝加芍药汤主治。如果疼痛剧烈且伴有实邪阻滞的，由桂枝加大黄汤主治。易老说：这并不是原本就有的证候，而是因为错误地使用了攻下法，导致病邪从脾传入胃，所以误下后传变。
太阴中风，四肢烦扰疼痛。若脉象微弱、涩滞而长，预示将要痊愈。表证轻微、里气调和，脉象长，说明阳气逐渐恢复。这一个证候，太阴病解除的时间，是从亥时到丑时。
太阴病的典型症状是：腹部胀满并呕吐，饮食难以下咽，自行腹泻日益严重，时常腹部自痛。如果使用攻下法，会导致胸膈下方结聚硬满。太阴病的手足自然温暖的，病位系在太阴。小便自利的，就不会发黄。日久腹泻严重必然停止的，是大便变硬，这是传入腑证，传变为阳证。
中脘穴处疼痛，属于太阴病。由理中汤、建中汤、黄耆汤之类主治。
脐部周围疼痛，属于少阴病。由四逆汤、真武汤、附子汤之类主治。
小腹疼痛，小腹痛，属于厥阴病。重症用正阳回阳丹之类。轻症用当归四逆汤。
杂病引起的疼痛，由四物苦楝汤、酒煮当归丸，增减当归丸之类主治。
夏季肌肤发热、恶热，脉象洪大疾速，由手太阴肺经和足阳明胃经主治。由黄芩芍药汤主治。
秋季肌肤发热、恶寒，脉象沉疾，由足少阴肾经和足太阴脾经主治。由桂枝芍药汤主治。
[图片]
腹部不胀满的，加红枣。如果胀满的，不加红枣。脾虚导致的胀满，用黄耆汤。芍药能停湿。
中焦胀满的，分消食积和甘味药物。用甘味药引导至胀满之处，脾实则胀满消。
Abdominal fullness and dry throat. The hands and feet are naturally warm. Spontaneous diarrhea without thirst. Occasional abdominal pain. Both the cun (inch) and chi (foot) pulses are deep and fine.
Taiyin disease. If the pulse is floating, sweating therapy may be applied. Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
Spontaneous diarrhea without thirst belongs to Taiyin. This is because there is cold in the zang organs. Warming therapy should be used; Sini Tang (Frigid Extremities Decoction) or similar formulas are appropriate. Although this clause does not mention the pulse, one should know that it would be deep, slow, and weak.
Zhang Zhongjing's Lizhong Tang Wan (Ginseng and Ginger Pill) and Yi Lao's Renshen Huangqi Tang (Ginseng and Astragalus Decoction). Depending on the severity of the condition, either warming or heating methods are used, selected according to the patient's strength, deficiency, and excess.
The answer states: There is a classic text saying, "Originally a Taiyang syndrome, but the physician incorrectly used purgation, resulting in abdominal fullness and occasional pain; this is Taiyin." It is treated with Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction). For severe pain with excess, Guizhi Jia Dahuang Tang (Cinnamon Twig plus Rhubarb Decoction) is used. Yi Lao said: "This is not the original syndrome. It occurred because incorrect purgation caused the pathogen to transmit from the Spleen to the Stomach."
Taiyin wind-stroke causes vexing pain in the four limbs. If the yang pulse is micro and the yin pulse is choppy yet long, recovery is desired. A slight exterior and harmonious interior with a long pulse indicates the gradual generation of yang. Regarding the resolution time for Taiyin disease, it occurs from Hai hour to Chou hour.
The defining characteristics of Taiyin disease are abdominal fullness with vomiting, inability to eat, worsening spontaneous diarrhea, and occasional spontaneous abdominal pain. If purged, there will be hardness and binding below the chest. In Taiyin disease, if the hands and feet are naturally warm, the disease is located in Taiyin. If urination is normal, jaundice will not develop. If prolonged diarrhea eventually stops, the stool becomes hard, indicating transmission to the fu organs and transformation into yang.
Pain at the Zhongwan point (CV12) belongs to Taiyin. Treated with Lizhong Tang (Regulate the Middle Decoction), Jianzhong Tang (Establish the Middle Decoction), or Huangqi Tang (Astragalus Decoction) categories.
Pain around the umbilicus belongs to Shaoyin. Treated with Sini Tang (Frigid Extremities Decoction), Zhenwu Tang (True Warrior Decoction), or Fuzi Tang (Aconite Decoction) categories.
Pain in the lower abdomen or small abdomen belongs to Jueyin. For severe cases, Zhengyang Huiyang Dan (Correct Yang Return Yang Pill) is used. For mild cases, Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities) is used.
When Taiyin transmits to Shaoyin with severe pain, it may transform into incessant diarrhea.
For miscellaneous disorders causing pain, Siwu Koushen Tang (Four Substances and Melia Decoction) or Jiuzhu Danggui Wan (Wine-Boiled Angelica Pill), modifications of Danggui Wan (Angelica Pill), are used.
In summer, skin heat with aversion to heat and a surging, rapid pulse involves the Hand-Taiyin Lung meridian and Foot-Yangming Stomach meridian. Treated with Huangqin Shaoyao Tang (Scutellaria and Peony Decoction).
In autumn, skin heat with aversion to cold and a deep, rapid pulse involves the Foot-Shaoyin Kidney meridian and Foot-Taiyin Spleen meridian. Treated with Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction).
Abdominal pain. Treated with Shaoyao Gancao Tang (Peony and Licorice Decoction).
[Image]
If the abdomen is not full, add Jujube. If full, do not add Jujube. For Spleen deficiency causing fullness, use Huangqi Tang (Astragalus Decoction). Shaoyao (Peony) retains dampness.
For middle jiao fullness, separate food stagnation and sweet herbs. Use sweet herbs to guide the treatment to the site of fullness; when the Spleen is solid, fullness resolves.
Pingwei San (Peace the Stomach Powder). Cangzhu (Atractylodis Rhizoma) drains dampness. For difficult urination, promote diuresis.
Constipation with excess bloating uses Houpo (Magnoliae Officinalis Cortex) and Zhishi (Immature Bitter Orange). Normal bowel movement with deficiency bloating uses Shaoyao (Paeoniae Radix Alba) and Chenpi (Citri Reticulatae Pericarpium).
Food stagnation causing fullness injures Jueyin Liver Wood. Therefore, abdominal distension and fullness all belong to Wood (Liver) qi stagnation.