（附∶绞肠沙）
帝曰∶愿闻人之五脏卒痛，何气使然？岐伯对曰∶经脉流行不止，环周不休。寒气入经而稽
迟，泣而不行。客于脉外则血少；客于脉中则气不通，故卒然而痛。夫腹痛之证，多因劳役过甚
，饮食失节，中气不足，寒气乘虚而客之，故卒然而作大痛。经曰∶得炅则止。炅者，以热治寒
，治之正也。然腹痛有部分，脏位有高下，感受不同，为病非一。故痛有九种，曰寒、热、食、
血、湿、痰、虫、虚、实是也。凡痛绵绵无减增，以热手暖气按之，饮热姜汤之类得暂止，脉沉
迟者，虚寒也。时痛时止，腹满坚实，按之愈痛，口渴，大便秘结，脉洪数者，实热也。痛甚欲
大便，利后痛减，脉沉实者，食积也。痛有常处而不动移，从心下至腹，遍满而痛，若小便不利
，宜通小便。若小便利者，属蓄血，脉涩者，瘀血或死血也。居处卑湿，多饮停蓄为涎，肥人气
虚，脾湿生痰，小便不利，或得辛辣热汤少可，脉濡滑
者，湿痰也。痛定能食，时作时止，面白唇红，或肚上青筋肿聚，往来无休止，呕吐清水，脉乍
大乍小者，虫也。（脉宜沉细，忌浮大）。
主方 苍术 香附 抚芎 茯苓 白芍（各一钱） 陈皮 浓朴 神曲 半夏 枳实（各
七分） 甘草（三分） 上生姜三片，水煎服。
寒痛加良姜、干姜（炮）、肉桂、藿香、木香、砂仁、吴萸、浓朴；不止加玄胡、茴香，甚者加
乳香、没药各五分，研细，调入服。寒极手足冷加附子，去良姜、吴萸，甚则用理中汤之类（方
见寒门）。热痛加栀子（炒）、滑石、黄连（炒）、白芍（煨）；不止加玄胡，甚者加木香、砂
仁、茴香、乳香从治。食痛加浓朴、山楂、麦芽、木香、砂仁、官桂、干姜。湿痛，小便不利加
猪苓、泽泻。痰痛加南星。痛甚防干霍乱，戒米汤，一口即死。
活血汤 治瘀血作痛。
乌药 赤芍药 当归尾 桃仁 牡丹皮 玄胡（各一钱） 枳壳（一钱） 抚芎 红花 官
桂木香（各五分） 加姜煎服。
桂枝大黄汤 治腹满痛，躁渴。经曰∶痛随利减，胀以利宽。
白芍（六钱） 桂枝 生姜（各三钱） 甘草（二钱） 大黄（一钱）姜、枣煎服。
芍甘汤 治诸腹痛效。
白芍（三钱） 甘草（一钱）
上加生姜五片，水煎服。热痛加黄芩。
草蔻汤 治脐腹虚寒疼痛。
泽泻（一钱） 木香（三分） 神曲（四分） 半夏（制） 枳实（麸炒） 草豆蔻 黄
益智仁 甘草（炙，各五分） 青皮 陈皮（各六分） 川归 茯苓（各七分）
上咀，加生姜三片，黑枣一枚，水煎服。
浓朴温中汤 治胃虚腹满疼痛。
浓朴（姜制） 陈皮（各一钱） 茯苓 草豆蔻 木香 甘草（各五分） 干姜（三分）
上咀，水盏半，姜五片，煎八分，不拘时热服。
黄芩芍药汤 治腹痛脉洪大，口渴因火者。
黄芩 芍药 甘草（等分） 上锉，加生姜水煎服。
温经汤 治虚寒腹痛。
良姜 香附 陈皮 浓朴 当归 茴香 益智 砂仁 木香 官桂 玄胡（等分）水煎服。
槟梅汤 治虫痛
槟榔 枳实 香附 木香 砂仁 浓朴 干姜 肉桂 川楝子 楝根皮（等分） 甘草（减
半） 川椒（二十粒） 乌梅（二个）
上姜一片，水煎服。未止加黄连。
承气汤 （方见伤寒）加槟榔、木香，治实热痛。
简便方 （治诸腹痛） 小麦秆烧灰、去火毒，将麻布包，煮汁服，立止。
又方 白砂糖一两，酒三碗煮服。
又 菖蒲根二寸（捶碎） 吴萸同煎热服。
又 官桂一两，水二碗，煎八分服。未止再服，无桂用生姜。
又 木瓜三片，桑叶七片，大枣三枚，水煎服。或胡椒二十一粒擂，热酒服。川椒亦可。
又方（热痛） 栀子十四枚，豆豉七合，水二大腕，先煮豆豉至碗半，绞去渣，纳栀子煎至
八分去渣，分二服。或明矾末淡汤泡服。
（附注：绞肠痧）
黄帝问道：我想听听人的五脏突然疼痛，是什么气导致的？岐伯回答说：经脉中的气血运行不止，循环周身没有休止。寒气侵入经脉后，运行就会迟缓、凝滞而不通畅。如果寒气客居在脉外，就会导致血液亏少；如果寒气客居在脉中，就会导致气机阻滞不通，所以会突然发生疼痛。大凡腹痛这种病证，多是因为过度劳累，饮食不节制，导致中气不足，寒气乘虚侵袭人体，所以突然发作剧烈疼痛。医经说：得到温热就会停止。所谓“炅”（热），就是用热法来治疗寒证，这是正确的治疗方法。然而腹痛有部位之分，脏腑位置有高有低，感受的邪气不同，所患的疾病也不止一种。所以疼痛有九种类型，分别是寒痛、热痛、食积痛、血瘀痛、湿痛、痰痛、虫痛、虚痛、实痛。凡是疼痛绵绵不断，没有增减变化，用手掌温暖按压后舒服，喝热姜汤等能暂时缓解，脉象沉迟的，属于虚寒痛。有时痛有时止，腹部胀满坚实，按压时疼痛加剧，口渴，大便秘结，脉象洪数的，属于实热痛。疼痛剧烈想要大便，排便后疼痛减轻，脉象沉实的，属于食积痛。疼痛部位固定不移，从心窝下延伸到腹部，遍满而痛，如果小便不利，应当通利小便。如果小便利的，属于蓄血证，脉象涩的，是瘀血或死血所致。居住在低洼潮湿的地方，经常饮用停蓄的水液化为涎沫，肥胖之人气虚，脾湿生痰，小便不利，或者喝辛辣热汤稍有好转，脉象濡滑的，属于湿痰痛。疼痛停止后能进食，疼痛时作时止，面色白嘴唇红，或者肚子上青筋肿聚，往来不停止，呕吐清水，脉象忽大忽小的，属于虫痛。（脉象宜沉细，忌浮大）。
主方：苍术、香附、抚芎（川芎）、茯苓、白芍（各一钱），陈皮、浓朴（厚朴）、神曲、半夏、枳实（各七分），甘草（三分）。上药加生姜三片，水煎服。
寒痛加良姜、干姜（炮制）、肉桂、藿香、木香、砂仁、吴茱萸、浓朴；疼痛不止加玄胡索、茴香，严重的加乳香、没药各五分，研成细末，调入药液中服用。寒极导致手足冰冷的加附子，去掉良姜、吴茱萸，严重的用理中汤之类（方剂见寒门章节）。热痛加栀子（炒）、滑石、黄连（炒）、白芍（煨制）；疼痛不止加玄胡索，严重的加木香、砂仁、茴香、乳香进行反佐治疗。食积痛加浓朴、山楂、麦芽、木香、砂仁、官桂、干姜。湿痛，小便不利加猪苓、泽泻。痰痛加天南星。疼痛剧烈防止发生干霍乱，禁止喝米汤，一口即死。
活血汤：治疗瘀血引起的疼痛。
乌药、赤芍药、当归尾、桃仁、牡丹皮、玄胡索（各一钱），枳壳（一钱），抚芎、红花、官桂、木香（各五分）。加生姜煎服。
桂枝大黄汤：治疗腹部胀满疼痛，烦躁口渴。医经说：疼痛随着排泄而减轻，胀满随着通利而缓解。
白芍（六钱），桂枝、生姜（各三钱），甘草（二钱），大黄（一钱）。加姜、枣煎服。
芍甘汤：治疗各种腹痛有效。
白芍（三钱），甘草（一钱）。
上加生姜五片，水煎服。热痛加黄芩。
草蔻汤：治疗脐腹虚寒疼痛。
泽泻（一钱），木香（三分），神曲（四分），半夏（制），枳实（麸炒），草豆蔻，黄精，益智仁，甘草（炙，各五分），青皮，陈皮（各六分），川当归，茯苓（各七分）。
上药切碎，加生姜三片，黑枣一枚，水煎服。
浓朴温中汤：治疗胃虚腹部胀满疼痛。
浓朴（姜制），陈皮（各一钱），茯苓，草豆蔻，木香，甘草（各五分），干姜（三分）。
上药切碎，用水一盏半，生姜五片，煎至八分，不拘时候热服。
黄芩芍药汤：治疗腹痛脉象洪大，因火邪导致口渴者。
黄芩、芍药、甘草（等分）。上药锉碎，加生姜水煎服。
温经汤：治疗虚寒腹痛。
良姜、香附、陈皮、浓朴、当归、茴香、益智、砂仁、木香、官桂、玄胡索（等分）。水煎服。
槟梅汤：治疗虫痛。
槟榔、枳实、香附、木香、砂仁、浓朴、干姜、肉桂、川楝子、楝根皮（等分），甘草（减半），川椒（二十粒），乌梅（二个）。
上药加生姜一片，水煎服。疼痛未止加黄连。
简便方（治疗各种腹痛）：小麦秆烧成灰，去除火毒，用麻布包裹，煮汁服用，立即停止。
又一方：白砂糖一两，酒三碗，煮后服用。
又一方：菖蒲根二寸（捶碎），与吴茱萸同煎热服。
又一方：官桂一两，水二碗，煎至八分服用。疼痛未止再服，若无官桂可用生姜代替。
又一方：木瓜三片，桑叶七片，大枣三枚，水煎服。或者将胡椒二十一粒研磨，用热酒送服。川椒也可以。
又一方（治疗热痛）：栀子十四枚，豆豉七合，水两大碗，先煮豆豉至一碗半，过滤去渣，放入栀子煎至八分，去渣，分两次服用。或者用明矾末，淡汤泡服。
(Note: Jiaochang Sha [Intestinal Colic])
The Yellow Emperor asked: I wish to hear about the sudden pain of the five zang organs in humans; what qi causes this? Qibo replied: The flow of qi and blood in the meridians never ceases, circulating around the body without rest. When cold pathogen enters the meridians, its flow becomes sluggish, stagnant, and obstructed. If it lodges outside the vessels, blood volume decreases; if it lodges inside the vessels, qi mechanism becomes blocked, thus causing sudden pain. Generally, abdominal pain is often caused by excessive labor, irregular diet, deficiency of middle jiao qi, allowing cold pathogen to invade when the defense is weak, resulting in sudden severe pain. The classics state: "Obtaining heat stops it." "Jiong" (heat) refers to treating cold with heat, which is the correct method. However, abdominal pain has specific locations, zang-fu positions vary in height and depth, and the pathogens contracted differ, so the diseases are not uniform. Therefore, there are nine types of pain: cold, heat, food stagnation, blood stasis, dampness, phlegm, parasites, deficiency, and excess.
Pain that is continuous without increase or decrease, relieved by warm hand pressure or drinking hot ginger soup, with a deep and slow pulse, indicates deficiency-cold pain. Pain that comes and goes, accompanied by abdominal fullness and firmness, worsened by pressure, thirst, constipation, and a flooding and rapid pulse, indicates excess-heat pain. Severe pain with an urge to defecate, relief after defecation, and a deep and solid pulse indicates food stagnation pain. Pain fixed in one place, moving from the epigastrium down to the abdomen, with generalized fullness and pain; if urination is difficult, promote urination. If urination is normal, it belongs to blood retention; a choppy pulse indicates blood stasis or dead blood. Living in low, damp places, frequently drinking stagnant water transforming into saliva/phlegm, obesity with qi deficiency, spleen dampness generating phlegm, difficulty in urination, or slight improvement after spicy hot drinks, with a soggy and slippery pulse, indicates damp-phlegm pain. Pain subsides allowing eating, pain comes and goes, pale face with red lips, or swelling of green veins on the abdomen, unceasing episodes, vomiting clear fluid, with a pulse that suddenly becomes large or small, indicates parasite pain. (The pulse should be deep and fine, avoiding floating and large).
Main Formula: Cangzhu (Atractylodis Rhizoma), Xiangfu (Cyperi Rhizoma), Fuxiong (Ligusticum Chuanxiong Rhizoma), Fuling (Poria), Baishao (Paeoniae Radix Alba) (each 1 qian); Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex), Shenqu (Massa Medicata Fermentata), Banxia (Pinelliae Rhizoma), Zhishi (Aurantii Fructus Immaturus) (each 0.7 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.3 qian). Add three slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water and take orally.
For cold pain, add Liangjiang (Alpiniae Katsumadai Rhizoma), Ganjiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), Huoxiang (Agastaches Herba), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Wuyu (Evodiae Fructus), Houpo; if pain persists, add Yanyan (Corydalis Rhizoma), Huixiang (Foeniculi Fructus); for severe cases, add Rushi (Olibanum) and Moyao (Myrrha) each 0.5 qian, grind into fine powder, mix into the decoction. For extreme cold causing cold hands and feet, add Fuzi (Aconiti Lateralis Radix Praeparata), remove Liangjiang and Wuyu; for severe cases, use Lizhong Tang (Regulate the Middle Decoction) (see Cold section). For heat pain, add Zhizi (Gardeniae Fructus, stir-baked), Huashi (Talcum), Huanglian (Coptidis Rhizoma, stir-baked), Baishao (Paeoniae Radix Alba, baked); if pain persists, add Yanyan; for severe cases, add Muxiang, Sharen, Huixiang, Rushi for counter-treatment. For food pain, add Houpo, Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), Muxiang, Sharen, Guanzi (Cinnamomi Ramulus), Ganjiang. For damp pain with difficult urination, add Zhuling (Polyporus), Zexie (Alismatis Rhizoma). For phlegm pain, add Nanting (Arisaematis Rhizoma). Severe pain may prevent Dry Huoluan; avoid rice soup, as one sip can be fatal.
Huoxue Tang (Invigorate Blood Decoction): Treats pain caused by blood stasis.
Wuyao (Linderae Radix), Chishaoyao (Paeoniae Radix Rubra), Dangguiwei (Angelicae Sinensis Radix caudex), Taoren (Persicae Semen), Mudanpi (Moutan Cortex), Yanyan (Corydalis Rhizoma) (each 1 qian); Zhiqiao (Aurantii Fructus), Fuxiong, Honghua (Carthami Flos), Guanzi, Muxiang (each 0.5 qian). Add Shengjiang, decoct and take orally.
Guizhi Dahuang Tang (Cinnamon Twig and Rhubarb Decoction): Treats abdominal fullness and pain, irritability, and thirst. The classics state: "Pain decreases with discharge, distension alleviates with purgation."
Baishao (6 qian), Guizhi (Cinnamomi Ramulus), Shengjiang (each 3 qian), Gancao (2 qian), Dahuang (Rhei Radix et Rhizoma) (1 qian). Add Shengjiang and Zao (Jujubae Fructus), decoct and take orally.
Shaogan Tang (Peony and Licorice Decoction): Effective for various abdominal pains.
Baishao (3 qian), Gancao (1 qian).
Add five slices of Shengjiang, decoct in water and take orally. For heat pain, add Huangqin (Scutellariae Radix).
Caokou Tang (Cardamom Decoction): Treats deficiency-cold pain in the umbilical and abdominal regions.
Zexie (1 qian), Muxiang (0.3 qian), Shenqu (0.4 qian), Banxia (processed), Zhishi (bran-fried), Caodoukou (Cardamomi Fructus), Huangjing (Polygonati Rhizoma), Yizhiren (Yici Fructus), Gancao (roasted, each 0.5 qian), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (each 0.6 qian), Chuangui (Angelicae Sinensis Radix), Fuling (each 0.7 qian).
Grind the herbs, add three slices of Shengjiang and one black Zao, decoct in water and take orally.
Houpo Wenzhong Tang (Magnolia Bark Decoction to Warm the Middle): Treats stomach deficiency with abdominal fullness and pain.
Houpo (ginger-processed), Chenpi (each 1 qian), Fuling, Caodoukou, Muxiang, Gancao (each 0.5 qian), Ganjiang (0.3 qian).
Grind the herbs, add one and a half bowls of water and five slices of Shengjiang, decoct until eight parts remain, take hot at any time.
Huangqin Shaoyao Tang (Scutellaria and Peony Decoction): Treats abdominal pain with flooding-large pulse and thirst caused by fire.
Huangqin, Shaoyao, Gancao (equal parts). Grind the herbs, add Shengjiang, decoct in water and take orally.
Wenjing Tang (Warm the Meridians Decoction): Treats deficiency-cold abdominal pain.
Liangjiang, Xiangfu, Chenpi, Houpo, Danggui, Huixiang, Yizhi, Sharen, Muxiang, Guanzi, Yanyan (equal parts). Decoct in water and take orally.
Binmei Tang (Areca and Mume Decoction): Treats parasite pain.
Binglang (Arecae Semen), Zhishi, Xiangfu, Muxiang, Sharen, Houpo, Ganjiang, Rougui, Chuanlianzi (Toosendan Fructus), Lian Genpi (Meliae Radicis Cortex) (equal parts), Gancao (half dose), Chuanjiao (Sichuan Pepper) (20 grains), Wumei (Mume Fructus) (two pieces).
Add one slice of Shengjiang, decoct in water and take orally. If pain does not stop, add Huanglian.
Chengqi Tang (See Cold Damage section) plus Binglang and Muxiang: Treats excess-heat pain.
Simple Prescription (Treats all abdominal pains): Burn wheat stalks to ash, remove fire toxicity, wrap in hemp cloth, boil in water to make juice, take orally for immediate cessation.
Another prescription: 1 liang of white sugar, boiled in three bowls of wine, take orally.
Another prescription: 2 cun of Changpu root (crushed), decoct with Wuyu and take hot.
Another prescription: 1 liang of Guanzi, two bowls of water, decoct until eight parts remain, take orally. If pain persists, take again; if no Guanzi, use Shengjiang.
Another prescription: Three slices of Mugua (Chaenomelis Fructus), seven leaves of Sangye (Mori Folium), three dates (Dazao), decoct in water and take orally. Or grind 21 grains of Huajiao (Zanthoxyli Pericarpium), take with hot wine. Chuanjiao is also acceptable.
Another prescription (for heat pain): Fourteen Zhizi, seven he of Douchi (Sojae Semen Preparatum), two large bowls of water. First boil Douchi until half a bowl remains, strain and discard dregs, add Zhizi, decoct until eight parts remain, strain, divide into two doses. Or dissolve Mingfan (Alumen) powder in light broth and take orally.