【暑湿腹痛之症】热令当权,忽尔腹中作痛,肠中作响,痛泻交作,此暑湿霍乱之类
【暑湿腹痛之因】夏令暑湿之邪,与肠胃水谷互相混乱,暑热不得发越,食气不得运化
,而诸腹作痛之症成矣。
【暑湿腹痛之脉】伤暑脉虚,腹痛脉大。虚大弦数,暑热之痛。滑大而数,暑食所伤。
痛极郁遏,脉反沉伏。
【暑湿腹痛之治】脉洪大者,黄连香薷散。脉弦数者,清热胜湿汤。痛一阵,泻一阵,
平胃散煎汤,调六一散。寒热脉伏,或寒热脉浮大,皆宜发表,败毒散。大便结,浓朴三物汤
。腹痛呕吐,藿香正气散。
黄连香薷散
川黄连 香薷 白扁豆 浓朴
呕吐加藿香。胸前饱闷加枳壳。小便不利加六一散、木通汤。大便结加大黄。恶寒身热
加羌活、防风。
清热胜湿汤
黄柏 黄连 泽泻 苍术 浓朴 白茯苓 陈皮 甘草
平胃散
浓朴 陈皮 甘草 熟苍术
六一散
滑石 甘草
败毒散
羌活 独活 川芎 荆芥 防风 前胡 柴胡 桔梗 陈皮 甘草
浓朴三物汤
浓朴 枳实 大黄
藿香正气散
浓朴 陈皮 苍术 甘草 半夏 藿香
【燥火腹痛之症】满腹刺痛,攻注胁肋,口渴身热,烦躁不寐,小便黄赤,不吐不泻,
此燥火腹痛之症也。
【燥火腹痛之因】或令值燥热,或燥金司政,燥气伤人,肠胃干涸,不得流利,不通则
痛,此燥火腹痛也。
【燥火腹痛之脉】多见躁疾,躁则为燥,疾则为热,躁疾兼见,则为燥热。
【燥火腹痛之治】脉数应下者,芍药黄连汤。攻刺胁肋者,柴胡清肝饮。目黄便赤,痛
连小腹
,合本事凉膈散。
芍药黄连汤
当归 川连 大黄 甘草 赤芍药
失气者倍大黄。
柴胡清肝饮 治肝胆有热。
柴胡 青皮 枳壳 山栀 木通 钩藤 苏梗 黄芩 知母 甘草
龙胆泻肝汤
黄芩 山栀 知母 天冬 麦冬 龙胆草 黄连 柴胡 人参 甘草
葛根石膏汤
干葛 石膏 知母 粳米
木通汤 见前。
益元散 即六一散。
四顺饮
当归 大黄 白芍药 怀生地
《本事》凉膈散
芍药 连翘 薄荷 大黄 桔梗 山栀仁 葛根
【暑湿腹痛的症状】正值炎热季节,突然腹部疼痛,肠鸣音亢进,腹痛与腹泻交替出现,这属于暑湿霍乱一类的病证。
【暑湿腹痛的病因】夏季的暑湿邪气,与肠胃中的水谷相互混杂,导致暑热无法发散透达,食物之气无法运化,从而形成各种腹痛症状。
【暑湿腹痛的脉象】伤暑的脉象多虚,腹痛的脉象多大。若脉象虚大、弦数,为暑热引起的疼痛;若脉象滑大且数,为暑邪兼食积所伤;若疼痛极度剧烈导致气机郁遏,脉象反而呈现沉伏之象。
【暑湿腹痛的治疗】脉象洪大的,用黄连香薷散(Coptis and Mosla Decoction)。脉象弦数的,用清热胜湿汤(Clear Heat and Overcome Dampness Decoction)。若痛一阵、泻一阵,用平胃散煎汤,调和六一散(Six-One Powder)。若见寒热往来且脉象沉伏,或寒热往来且脉象浮大,均宜采用解表法,使用败毒散(Decoction to Defeat Toxins)。若大便干结,用浓朴三物汤(Magnolia Bark and Rhubarb Three-Ingredient Decoction)。若腹痛伴呕吐,用藿香正气散(Patchouli and Bupleurum Decoction)。
黄连香薷散
川黄连(Coptidis Rhizoma)、香薷(Moslae Herba)、白扁豆(Dolichoris Semen)、浓朴(Magnoliae Officinalis Cortex)
若呕吐,加藿香(Agastachis Herba)。若胸膈饱闷,加枳壳(Aurantii Fructus)。若小便不利,加六一散、木通汤(Akebiae Caulis Decoction)。若大便干结,加大黄(Rhei Radix et Rhizoma)。若恶寒身热,加羌活(Notopterygii Rhizoma et Radix)、防风(Saposhnikoviae Radix)。
清热胜湿汤
黄柏(Phellodendri Cortex)、黄连(Coptidis Rhizoma)、泽泻(Alismatis Rhizoma)、苍术(Atractylodis Rhizoma)、浓朴(Magnoliae Officinalis Cortex)、白茯苓(Poria)、陈皮(Citri Reticulatae Pericarpium)、甘草(Glycyrrhizae Radix et Rhizoma)
平胃散
浓朴(Magnoliae Officinalis Cortex)、陈皮(Citri Reticulatae Pericarpium)、甘草(Glycyrrhizae Radix et Rhizoma)、熟苍术(Prepared Atractylodis Rhizoma)
六一散
滑石(Talcum)、甘草(Glycyrrhizae Radix et Rhizoma)
败毒散
羌活(Notopterygii Rhizoma et Radix)、独活(Angelicae Pubescentis Radix)、川芎(Chuanxiong Rhizoma)、荆芥(Schizonepetae Herba)、防风(Saposhnikoviae Radix)、前胡(Peucedani Radix)、柴胡(Bupleuri Radix)、桔梗(Platycodonis Radix)、陈皮(Citri Reticulatae Pericarpium)、甘草(Glycyrrhizae Radix et Rhizoma)
浓朴三物汤
浓朴(Magnoliae Officinalis Cortex)、枳实(Aurantii Fructus Immaturus)、大黄(Rhei Radix et Rhizoma)
藿香正气散
浓朴(Magnoliae Officinalis Cortex)、陈皮(Citri Reticulatae Pericarpium)、苍术(Atractylodis Rhizoma)、甘草(Glycyrrhizae Radix et Rhizoma)、半夏(Pinelliae Tuber)、藿香(Agastachis Herba)
【燥火腹痛的症状】全腹刺痛,疼痛放射至胁肋部,口渴,身体发热,烦躁不安,失眠,小便黄赤,不呕吐也不腹泻,这是燥火腹痛的症状。
【燥火腹痛的病因】或是正值燥热季节,或是燥金之气主令,燥气伤人,导致肠胃干枯涸竭,气机不得流利通畅,“不通则痛”,这就是燥火腹痛。
【燥火腹痛的脉象】多见躁疾之脉,“躁”代表燥,“疾”代表热,躁疾脉象同时出现,即为燥热之证。
【燥火腹痛的治疗】脉数且应当用下法的,用芍药黄连汤(Peony and Coptis Decoction)。疼痛攻刺胁肋部的,用柴胡清肝饮(Bupleurum Liver-Clearing Infusion)。若目黄、便赤,疼痛牵连小腹,合用《本事方》凉膈散(Cool the Diaphragm Powder from Ben Shi Fang)。
芍药黄连汤
当归(Angelicae Sinensis Radix)、川连(Coptidis Rhizoma)、大黄(Rhei Radix et Rhizoma)、甘草(Glycyrrhizae Radix et Rhizoma)、赤芍药(Paeoniae Radix Rubra)
若有矢气(放屁),加倍使用大黄。
柴胡清肝饮 治疗肝胆有热。
柴胡(Bupleuri Radix)、青皮(Citri Reticulatae Pericarpium Viride)、枳壳(Aurantii Fructus)、山栀(Gardeniae Fructus)、木通(Akebiae Caulis)、钩藤(Uncariae Ramulus cum Uncis)、苏梗(Perillae Caulis)、黄芩(Scutellariae Radix)、知母(Anemarrhenae Rhizoma)、甘草(Glycyrrhizae Radix et Rhizoma)
龙胆泻肝汤
黄芩(Scutellariae Radix)、山栀(Gardeniae Fructus)、知母(Anemarrhenae Rhizoma)、天冬(Asparagi Radix)、麦冬(Ophiopogonis Tuber)、龙胆草(Gentianae Radix)、黄连(Coptidis Rhizoma)、柴胡(Bupleuri Radix)、人参(Ginseng Radix)、甘草(Glycyrrhizae Radix et Rhizoma)
葛根石膏汤
干葛(Puerariae Lobatae Radix)、石膏(Gypsum Fibrosum)、知母(Anemarrhenae Rhizoma)、粳米(Oryza Sativa)
木通汤 见前文。
四顺饮
当归(Angelicae Sinensis Radix)、大黄(Rhei Radix et Rhizoma)、白芍药(Paeoniae Radix Alba)、怀生地(Rehmanniae Radix Preparata)
《本事》凉膈散
芍药(Paeoniae Radix)、连翘(Forsythiae Fructus)、薄荷(Menthae Haplocalycis Herba)、大黄(Rhei Radix et Rhizoma)、桔梗(Platycodonis Radix)、山栀仁(Gardeniae Fructus)、葛根(Puerariae Lobatae Radix)
[Symptoms of Summerheat-Dampness Abdominal Pain] During the hot season, sudden abdominal pain occurs, accompanied by hyperactive bowel sounds (borborygmus), alternating episodes of abdominal pain and diarrhea. This belongs to the category of summerheat-dampness cholera-like disorders.
[Etiology of Summerheat-Dampness Abdominal Pain] The pathogenic factors of summerheat and dampness in summer mix with food and fluids in the stomach and intestines. The summerheat cannot be dispersed and vented, and the qi of food fails to transform and transport, resulting in various types of abdominal pain.
[Pulse Patterns of Summerheat-Dampness Abdominal Pain] The pulse pattern of summerheat injury is typically deficient (Xu). The pulse pattern of abdominal pain is typically large (Da). If the pulse is deficient, large, wiry (Xian), and rapid (Shu), it indicates pain due to summerheat. If the pulse is slippery (Hua), large, and rapid, it indicates injury by summerheat combined with food retention. If the pain is extremely severe causing qi stagnation and obstruction, the pulse may paradoxically appear deep (Chen) and hidden (Fu).
[Treatment of Summerheat-Dampness Abdominal Pain] For a flooding (Hong) and large pulse, use Huanglian Xiangru San (Coptis and Mosla Decoction). For a wiry and rapid pulse, use Qingre Shengshi Tang (Clear Heat and Overcome Dampness Decoction). For alternating episodes of pain and diarrhea, decoct Pingwei San (Pingwei Powder) and mix with Liuyi San (Six-One Powder). For alternating chills and fever with a deep-hidden pulse, or alternating chills and fever with a floating-large pulse, exterior-releasing methods should be employed using Baidu San (Decoction to Defeat Toxins). For constipation, use Nongpu Sanyu Tang (Magnolia Bark and Rhubarb Three-Ingredient Decoction). For abdominal pain with vomiting, use Huoxiang Zhengqi San (Patchouli and Bupleurum Decoction).
Huanglian Xiangru San
Chuan Huanglian (Coptidis Rhizoma), Xiangru (Moslae Herba), Bai Biandou (Dolichoris Semen), Nongpu (Magnoliae Officinalis Cortex)
For vomiting, add Huoxiang (Agastachis Herba). For chest fullness and oppression, add Zhike (Aurantii Fructus). For difficult urination, add Liuyi San and Mutong Tang (Akebiae Caulis Decoction). For constipation, add Dahuang (Rhei Radix et Rhizoma). For aversion to cold and fever, add Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix).
Qingre Shengshi Tang
Huangbai (Phellodendri Cortex), Huanglian (Coptidis Rhizoma), Zexie (Alismatis Rhizoma), Cangzhu (Atractylodis Rhizoma), Nongpu (Magnoliae Officinalis Cortex), Bai Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma)
Pingwei San
Nongpu (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Shu Cangzhu (Prepared Atractylodis Rhizoma)
Liuyi San
Huashi (Talcum), Gancao (Glycyrrhizae Radix et Rhizoma)
Baidu San
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chuanxiong (Chuanxiong Rhizoma), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Qianhu (Peucedani Radix), Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma)
Nongpu Sanyu Tang
Nongpu (Magnoliae Officinalis Cortex), Zhishi (Aurantii Fructus Immaturus), Dahuang (Rhei Radix et Rhizoma)
Huoxiang Zhengqi San
Nongpu (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Banxia (Pinelliae Tuber), Huoxiang (Agastachis Herba)
[Symptoms of Dryness-Fire Abdominal Pain] Stabbing pain throughout the abdomen radiating to the hypochondrium, thirst, fever, irritability, insomnia, yellow-red urine, without vomiting or diarrhea. These are the symptoms of dryness-fire abdominal pain.
[Etiology of Dryness-Fire Abdominal Pain] Either occurring during a dry-hot season, or when the metal element associated with dryness governs the climate, dryness pathogenic factors injure the body, causing dryness and depletion of the stomach and intestines. Qi and blood fail to flow smoothly; "lack of free flow causes pain," which constitutes dryness-fire abdominal pain.
[Pulse Patterns of Dryness-Fire Abdominal Pain] Typically presents as a restless (Zao) and rapid (Ji) pulse. "Restless" indicates dryness, and "rapid" indicates heat. The simultaneous presence of these qualities indicates dryness-heat.
[Treatment of Dryness-Fire Abdominal Pain] For a rapid pulse indicating the need for purgation, use Shaoyao Huanglian Tang (Peony and Coptis Decoction). For stabbing pain attacking the hypochondrium, use Chaihu Qinggan Yin (Bupleurum Liver-Clearing Infusion). For yellow eyes and red urine, with pain extending to the lower abdomen, combine with Liangge San (Cool the Diaphragm Powder) from *Ben Shi Fang*.
Shaoyao Huanglian Tang
Danggui (Angelicae Sinensis Radix), Chuan Lian (Coptidis Rhizoma), Dahuang (Rhei Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Chi Shaoyao (Paeoniae Radix Rubra)
If flatus occurs, double the dosage of Dahuang.
Chaihu Qinggan Yin Treats heat in the liver and gallbladder.
Chaihu (Bupleuri Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Zhike (Aurantii Fructus), Shanzhi (Gardeniae Fructus), Mutong (Akebiae Caulis), Gouteng (Uncariae Ramulus cum Uncis), Sugeng (Perillae Caulis), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma)
Longdan Xiegan Tang
Huangqin (Scutellariae Radix), Shanzhi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), Tiandong (Asparagi Radix), Maidong (Ophiopogonis Tuber), Longdancao (Gentianae Radix), Huanglian (Coptidis Rhizoma), Chaihu (Bupleuri Radix), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma)
Gegen Shigao Tang
Gan Ge (Puerariae Lobatae Radix), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Jingmi (Oryza Sativa)
Mutong Tang See previous section.
Yiyuan San Is identical to Liuyi San.
Sishun Yin
Danggui (Angelicae Sinensis Radix), Dahuang (Rhei Radix et Rhizoma), Baishaoyao (Paeoniae Radix Alba), Huaishengdi (Rehmanniae Radix Preparata)
*Ben Shi* Liangge San
Shaoyao (Paeoniae Radix), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Dahuang (Rhei Radix et Rhizoma), Jiegeng (Platycodonis Radix), Shanzhiren (Gardeniae Fructus), Gegen (Puerariae Lobatae Radix)