喻嘉言治陆子坚，从来无病，因外感之余，益以饥饱内伤，遂至胸膈不快，胃中隐隐作痛，有时得食则已，
有时得食转加，大便甚艰，小水不畅，右关之脉，乍弦乍迟，不得调适，有似痼疾。用药得当，驱之无难；若
岁久日增，必为大患。人身胃中之脉，从头而走于足者也。胃中之气，一从小肠而达于膀胱，一从小肠而达于
大肠者也。夫下行之气，浊气也。以失调之故，而令浊气乱于胸中，干其清道，因是窒塞不舒。其始本于病时
胃中津液为邪火所烁，至今津液未充，火势内蕴，易于上燎，所以得食以压其火则安。然邪火炽则正气消，若食
饮稍过，则气不能运转其食而痛亦增，是火不除则气不复，气不复则胃中清浊混乱，不肯下行，而痛终不免也。
（论症洞如观火）病属胃之下脘，而所以然之故，全在胃之中脘。盖中者，上下四旁之枢机。中脘之气，旺盛有余，
必驱下脘之气入于大小肠，从前后二阴而出。惟其不足，所以反受下脘之浊气而桡括也。夫至人之息以踵，呼
之于根，吸之于蒂者也。以浊气上干之故，吸入之气艰于归根。且以痛之故，而令周身之气，凝滞不行，亦非
细故也。为订降火生津下气止痛一方，以为常用之药。尚有进者，在先收摄肾气，不使外出，然后浊气之源清，
而膀胱得吸引上中二焦之气以下行，想明哲之所务矣。
喻君实有发前人所未发之本领，独欠于峻养肝肾一着。然此案末行，已 乎得之矣。
张子和治一将军，病心痛不可忍。张曰∶此非心痛也，乃胃脘当心痛也。（二语为此症点睛，然予更有一
转语曰∶非胃脘痛也，乃肝木上乘于胃也。）《内经》曰∶岁木太过，风气流行，民病胃脘当心而痛。（风木为
病，非肝而何？）乃与神 丸一百余粒，病不减。或问曰∶此胃脘有寒也，宜温补？将军数知张明了，复求
药，乃复与神 丸二百余粒，作一服，大下六七行，立愈矣。（治法则非今人所宜。）
一妇病数年不愈，一医用人言半分，茶末一分，白汤调下，吐瘀血一块而愈。（李楼奇方，若非神手，
未许轻用。）
王执中久患心脾疼，服醒脾药反胀。用蓬莪，面裹煨熟，研末，以水与酒煎服立愈。盖此药能破气中之血
也。（《本草纲目》、王执中《资生经》。）
一妇人年三十，病心气痛，用小红花为末，热酒服二钱立效。又法，男用酒水各半煎，女用醋水各半煎。
（摘元方本《本草纲目》。）
李时珍治荆穆王妃胡氏，因食荞麦面着怒，病胃脘当心痛，不可忍。医用吐下行气化滞诸药，皆入口即吐，
不能奏功，大便三日不通。因思《雷公炮炙论》云∶心痛欲死，速觅延胡。乃以延胡索末三钱，温酒调下，即
纳饮食，少顷大便行三五次，积滞俱下，胃脘心痛豁然遂止。
友人言，于武昌见一老僧患胃脘痛，痛发濒死，其徒亦患之。师死遗命必剖视吾心，务去其疾。果于心间
得细骨一条，长七八寸，形如簪，其徒以插瓶中，供师前，已数年矣。有贵客来寓庵中，偶杀鹅喉未断，其童
取瓶中骨挑鹅喉，凡染鹅血处即化矣。徒因悟此理，饮鹅血数日，胃疾竟除。
薛立斋治一妇人，久患心痛，饮食少思，诸药到口即吐。薛以为脾土虚弱，用白术一味，同黄土炒去土，
每服一两，以米泔煎浓，徐服少许，数日后自能大饮，用三斤余而安。（雄按∶脾弱何至作痛？此盖停饮为患
也。蔡按∶停饮之说诚然，此与许学士神术丸意同。但饮之微者可用，若饮已盛，则反益其痛，以术能闭气也。
黄锦芳论之甚详，宜参观之。）
上舍陈履学长子室，素怯弱，产后患疔疮，年余不愈，因执丧旬月，每欲眩仆。一日感气，忽患心脾高肿
作疼，手不可按，而呕吐不止，六脉微细。或见其形实，误诸痛不可补气，乃用青皮、木香、五味、吴茱萸等
药愈甚。继复患疟，且堕胎。又投理气行血之药，病虽去，元气转脱，（病家无识，举世皆然。）再投参、
补剂不应矣。六脉如丝欲绝，迎薛至，诊之曰∶形虽实而虚极，反用理气之剂，损其真气故也。连投参、 、
归、芍、术、附、姜、桂，二剂，间用八味丸，五日寝食渐甘，六脉全复。此症若心脾疼痛时，即服此等药，
疟亦不作矣。
龚子才治一人，心胃刺痛，手足稍冷，出汗，指甲青，百药不效。以当归二钱，煎汤，用水磨沉香、木香、
乌药、枳壳，调服乃止。
一教谕年五十一，因酒食过饱，胃脘作痛，每食后，其气自两肩下及胸次至胃口，痛不可忍，令人将手重
按痛处，移时忽响动一声，痛遂止。如是八年，肌瘦如柴。诊之，六脉微数，气口稍大有力。以神 丸一服下
之，其痛如失，后以参苓白术散调理复元。
程沙随在泰兴时，有一乳娘，因食冷肉，心脾胀痛不忍。钱受之以陈茱萸五六十丸，水一盏，煎取汁去渣，
入官局平胃散三钱，再煎热服，一服痛止，再服无他。云高宗尝以此赐近臣、愈疾甚多，真奇方也。（《槎庵小乘》。）
孙文垣治张二尹近川，始以内伤外感，服发散消导多剂，致胃脘当心而痛。诊之，六脉皆弦而弱，法当
补而敛之。白芍五钱，炙甘草三钱，桂枝一钱五分，香附一钱，大枣三枚，饴糖一合，（小建中加香附。）
煎服，一剂而瘳。
族弟应章胃脘当心而痛，手不可近，疑有瘀血使然。延胡索、五灵脂、丹皮、滑石、川芎、当归、甘草、
桃仁、桔梗、香附，临服加韭菜汁一小酒杯，其夜痛止则睡，饮食亦进。惟大便下坠，逼迫不安，此瘀血已动，
欲下行也。前剂去韭汁，一帖全安。
吴鹤洲如夫人，病胃脘痛。医者认为虫者，认为火者，又有认为痰、为气、为食、为虚、为寒者，百治不
效。孙诊之，两手大而无力，皆六至。曰∶肝脾相胜之症耳。（胃脘何以云脾？）以白芍为君，恶热而痛加黄
柏，此法则万全矣。白芍四钱，一半生一半炒，伐肝补脾为君；甘草二钱，一半炙一半生，缓肝养脾为臣；
山楂为佐；黑山栀、五灵脂各一钱，止痛为使。三帖而愈。
吴仰元患胃脘痛则彻于背，以手重按之少止，痛时冷汗如雨，脉涩。孙曰∶此气虚而痛也。（脉涩乃血
虚，此独言气虚。）以小建中汤加御米壳而愈。（仍是肝病。）
李士材治宋敬夫，心腹大痛，伛偻不能抑，自服行气和血药罔效。其脉左滑而急，其气不能以息，偶一咳，
攒眉欲绝，为疝无疑。以生姜饮粥，用小茴香、川楝子、青木香、吴茱萸、木通、延胡索、归身、青皮，一服
而痛减，五日而安。（《医通》。）
李长蘅吴门舟次，忽发胃脘痛，用顺气化食之药勿效。李诊之曰∶脉沉而迟，客寒犯胃也。以参苏饮加草
豆蔻三钱，煎熟，加生姜自然汁半碗，一服而减，两服而痊。
一人将应试，八月初五心口痛甚，致不能饮食。李诊之，寸口涩而软。与大剂归脾汤加人参三钱，官桂一
钱。彼云痛而骤补，实所不敢，得毋与场期碍乎？李曰∶第能信而服之，可以无碍。若投破气之药，其碍也必
矣。遂服之不超时而痛减，更进一剂，连饮独参汤，场事获竣。
高鼓峰治一妇人胃痛，勺水不入，寒热往来。或从火治，用芩、连、栀、柏，或从寒治，用姜、桂、茱
萸，辗转月余，形体羸瘦，六脉弦数，几于毙矣。高曰∶此肝痛也，非胃脘也。其病起于郁结生火，阴血受伤，
肝肾枯干，燥迫成痛，（色欲之人，尤多此病。）医复投以苦寒辛热之剂，胃脘重伤，其能瘳乎？急以滋肾生肝
饮与之，一昼夜尽三大剂，五鼓熟寐，次日痛定。再用加味归脾汤加麦冬、五味，十余剂而愈。
按∶此病外间多用四磨、五香、六郁、逍遥，新病亦效，久服则杀人矣。又用肉桂亦效，以木得桂而枯
也。屡发屡服，则肝血燥竭，少壮者多成劳，衰弱者多发厥而死，不可不知。
吕东庄治吴维师内，患胃脘痛，叫号几绝，体中忽热忽寒，止觉有气逆左胁而上，呕吐酸水，饮食俱出。
或疑停滞，或疑感邪，或疑寒凝，或疑痰积。脉之弦数，重按则濡，盖火郁肝血燥耳。与以当归、白芍、地黄、
柴胡、枣仁、山药、山萸、丹皮、山栀、茯苓、泽泻顿安。惟胃口犹觉稍劣，用加味归脾及滋肝补肾丸而愈。
高吕二案，持论略同，而俱用滋水生肝饮。子早年亦尝用此，却不甚应，乃自创一方，名一贯煎，用北
沙参、麦冬、地黄、当归、杞子、川楝，六味出入加减，投之应如桴鼓。口苦燥者，加酒连尤捷。可统治
胁痛、吞酸、吐酸、疝瘕一切肝病。
薛立斋治一妇人，心腹作痛，久而不愈，此肝火伤脾气也。用炒山栀一两，生姜五片，煎服而痛止。更以
二陈加山栀、桔梗，乃不发。
孙文垣治周芦汀乃眷，患胃脘痛，呕吐不食者四月，昼夜号呼不绝，脉则两手俱滑数。（故作实治。）
曰∶当以清热为先。乃先与末子药二钱，令服之，不一饭顷，痛止而睡，家人色喜。曰∶未也，此火暂息
也。其中痰积
甚固，不乘时下之，势必再作。因与总管丸三钱，服下腹中微痛。再服二钱，又睡至天明乃寤，腹痛亦止，大
便下痰积甚多。次日以二陈汤加枳实、姜黄、香附、山栀、黄连与之，服后胃痛全止。惟小腹略胀，盖痰积未
尽也。再与总管丸三钱，天明又行一次，痰之下如前，胃脘之痛遂不发。
薛立斋治陈湖陆小材母，久患心腹疼痛，每作必胸满呕吐，手足俱冷，面赤唇麻，咽干舌燥，寒热不时，
月余竟夕不安，其脉洪大。众以痰火治之，屡止屡作。迨乙巳春，发烦而甚，仍用前药反剧。此寒凉损真之故，
内真寒而外假热也。且脉息洪弦而有怪状，乃脾气亏损，肝木乘之而然。当温补胃气，遂用补中益气汤加半夏、
茯苓、吴茱萸、木香，一服熟寐彻晓，洪脉顿敛，怪脉顿除，诸症释然。
陆养愚治陆前川，素患肠风便燥，冬天喜食盆柿，致胃脘当心而痛。医以温中下气药，疗其心痛，痛未减
而肠红如注；以寒凉润燥之剂，疗其血，便未通而心痛如刺。脉之，上部沉弱而迟，下部洪滑而数，此胃中冷
而肠中热也。大肠属金，原喜清而恶热，喜润而恶燥，况素有肠风燥急之症，因心痛而投以辛温香燥之剂，能
不剧乎？脾胃原喜温而恶寒，湿润之品，能不甚乎？今大便不行已数日矣，乃用润字丸三钱，以沉香三分衣其
外，浓煎姜汤，送下二钱。半日许又送一钱，至夜半大便行，极坚，而不甚痛，血减平日十六七。少顷又便一
次，微痛而血亦少。清晨又便溏一次，微见血而竟不痛矣。惟心痛未舒，与脏连丸，亦用沉香为衣，姜汤送下，
以清下焦之热而润其燥。又以附子理中料为散，饴糖拌吞之，使恋膈而不速下，不终剂而两症并痊矣。
王肯堂治韩敬堂，患胸膈痛，脉洪大而涩，用山栀、赤芍、通草、麦芽、香附、归、芎，煎加姜汁、竹沥、
韭汁、童便之类，饮之而止。一日劳倦忍饥，痛大发，亟邀王至，入房。问曰∶晨起痛甚不能待公，服家兄药，
下咽如刀割，其痛不可忍，此何意也？曰∶得非二陈、平胃、紫苏之属乎？曰∶然。曰∶是则何怪乎其增病也。
夫劳饿而发，饱逸而止，如其虚也。饮以十全大补汤，一剂而胸痛止。
张三锡治一妇，苦胃脘痛，每发辄大吐，多方不应，以盐汤探吐，出积痰碗许，痛良已。后常作恶心，知
胃中有痰也。以橘、半、枳实加木香、川芎、白螺壳、南星、海粉、神曲，糊为丸，白汤下钱半，未及一半，
病去如脱。
一老妪急胃痛，已六日，诸辛燥药历试无验。诊得左关弦急，而右寸更甚。其痛一来即不可当，少选方定，
口干面时赤，知肝气有余而成火也。乃以越鞠加吴茱萸、炒黄连、姜汁、炒栀子，二剂顿愈。
一妇胃脘痛，凡一月，右关寸俱弦而滑，乃饮食不节所致。投滚痰丸一服，下痰及宿食三碗许。节食数日，
调理而愈。
一妪胃痛久，诸药不应。六脉微小，按之痛稍定，知中气虚而火郁为患也。投理中汤，一服随愈。
一中年人因郁悒，心下作痛，一块不移，日渐羸瘦，与桃仁承气汤一服，下黑物并痰碗许，永不再发。
一人中脘大痛，脉弦而滑，右为甚，乃食郁也。二陈、平胃加山楂、草豆蔻、木香、砂仁，一服顿愈。
一人中脘至小腹痛不可忍，已十三日，香燥历试，且不得卧，卧则痛顶胸上，每痛急则脉不见。询之，因
入房后过食肉食而致，遂以为阴症，而投姜、附。因思其饮食自倍，中气损矣。况在房室之后、宜宿物不能运
化，又加燥剂太多，消耗津液，致成燥矢郁滞不通，所以不得卧而痛也。古云∶胃不和则卧不安。遂以枳实导
滞丸三钱，去黑矢碗许，小腹痛减矣。又与黄连、枳实、栝蒌、麦芽、浓朴、山楂、莱菔子，二服痛复移于小腹。
乃更与润肠丸二服，更衣痛除。第软倦不支，投补中益气汤，调理半月而愈。
王叔权曰∶荆妇旧侍疾，累日不食，因得心脾痛。发则攻心腹，后心痛亦应之，至不可忍，则与儿女别。
以药饮之，疼反甚。若灸，则遍身不胜灸矣。不免令儿女各以火针微刺之，不拘心腹，须臾痛定，即欲起矣。
神哉！
喻嘉言治疗陆子坚，此人向来没有疾病，因为外感病后，又加上饥饱不均造成的内伤，导致胸膈部不适，胃中隐隐作痛。有时进食后疼痛缓解，有时进食后疼痛反而加重，大便非常困难，小便不畅利。右关脉时而弦紧时而迟缓，无法调和适应，看起来像是顽固的旧疾。用药得当，驱除病邪并不难；如果拖延日久，病情日益加重，必定成为大患。人体胃中的经脉，是从头部走向足部的。胃中的气，一部分从小肠通达膀胱，另一部分从小肠通达大肠。向下运行的气，属于浊气。由于失调的原因，导致浊气在胸中混乱，干扰了清阳之道，因此出现窒塞不舒的感觉。这起初是因为生病时胃中的津液被邪火灼烧，至今津液尚未恢复充盈，火势在内蕴结，容易向上燎烧，所以进食可以压制火势从而感到安宁。然而邪火炽盛则正气消减，如果饮食稍有过量，气就不能推动食物运转，疼痛也会增加，这是火不消除则气不能恢复，气不恢复则胃中清浊之气混乱，不肯向下运行，而疼痛终究不可避免。（对病机的分析透彻如观火焰）病症部位在胃的下脘，但之所以如此的原因，全在于胃的中脘。盖“中”是上下四方的枢纽。中脘之气旺盛有余，必然驱使下脘之气进入大小肠，从前阴和后阴排出。正因为中脘之气不足，所以反而受到下脘浊气的牵制和束缚。至于得道之人呼吸直达脚跟，呼气源于根本，吸气源于蒂固（丹田）。由于浊气上干的原因，吸入的气难以归根。而且因为疼痛的缘故，导致周身之气凝滞不行，这也不是小事。为此制定了一个降火、生津、下气、止痛的方子，作为常用药物。还有更进一步的说法，在于先收敛肾气，不让其外泄，然后浊气的源头得以澄清，而膀胱能够吸引上焦和中焦的气下行，想必明智者所致力于此。
喻君确实有发掘前人未曾发现的才能，唯独欠缺峻补肝肾这一着。然而此案末尾的处理，已经接近这个理法了。
张子和治疗一位将军，心痛剧烈无法忍受。张子和说：这不是心痛，而是胃脘痛，位置正当心口。（这两句话点出了此症的关键，但我还有一句转折语说：不是胃脘痛，而是肝木上乘于胃。）《内经》说：岁木太过，风气流行，百姓发病表现为胃脘当心而痛。（风木致病，除了肝还能是什么？）于是给予神保丸一百多粒，病未减轻。有人问：这是胃脘有寒，应该温补吗？将军多次知晓张子和医术高明，再次求药，张子和又给予神保丸二百多粒，一次性服下，大泻六七次，立刻痊愈了。（这种治法不是今人所能轻易效仿的。）
一位妇女患病数年不愈，一位医生用人参粉半钱，茶末一分，用白开水调服，吐出瘀血一块而痊愈。（李楼奇方，如果不是神医之手，不敢轻易使用。）
王执中长期患心脾疼，服用醒脾药反而腹胀。使用蓬莪术，用面粉包裹煨熟，研成粉末，用水和酒煎服，立刻痊愈。因为此药能破除气中的血瘀。（《本草纲目》、王执中《资生经》。）
一位三十岁的妇人，患心气痛，用小红花研末，热酒送服二钱，立刻见效。另一种方法，男性用酒和水各半煎煮，女性用醋和水各半煎煮。（摘录自元方，本于《本草纲目》。）
李时珍治疗荆穆王妃胡氏，因为吃荞麦面时发怒，导致胃脘当心而痛，无法忍受。医生使用催吐、下行、行气、化滞等药物，都入口即吐，不能奏效，大便三天不通。李时珍想到《雷公炮炙论》说：心痛欲死，速觅延胡索。于是用延胡索末三钱，温酒调服，随即能进食，不久大便行了三五次，积滞全部排出，胃脘心痛豁然停止。
朋友说，在武昌见到一位老僧患胃脘痛，发作时濒死，他的徒弟也患有此病。师父死后留下遗命一定要剖开查看心脏，务必去除这个疾病。果然在心脏间得到一根细骨，长七八寸，形状像簪子，徒弟把它插在瓶中，供奉在师父灵前，已经有几年了。有位贵客住在庵中，偶然杀鹅，喉咙没断，徒弟取瓶中的骨头挑鹅喉，凡是沾染鹅血的地方就融化了。徒弟因此领悟了这个道理，喝了几天的鹅血，胃病竟然消除了。
薛立斋治疗一位妇女，长期患心痛，饮食减少思虑，各种药物入口即吐。薛立斋认为是脾土虚弱，只用白术一味，同黄土炒后去掉黄土，每次服用一两，用米泔水浓煎，慢慢服用少许，几天后自然能大量饮水，用了三斤多而安愈。（徐灵胎按：脾弱怎么会引起疼痛？这大概是停饮为患。蔡忠按：停饮的说法确实正确，这与许学士的神术丸意思相同。但饮邪轻微者可用，如果饮邪已经很盛，则反而增加疼痛，因为白术能闭气。黄锦芳对此论述得很详细，应当参考。）
上舍陈履学的长子之妻，素来怯弱，产后患疔疮，一年多不愈，因为守丧一个月，常常想要晕倒。一天感受气邪，忽然患心脾高肿作痛，手不能按压，而且呕吐不止，六脉微细。有人见她形体壮实，误以为诸痛不可补气，于是使用青皮、木香、五味子、吴茱萸等药，病情反而加重。接着又患疟疾，并且堕胎。又投用理气行血的药物，病虽然去了，元气却更加脱失，（病家无见识，举世皆然。）再投人参、黄芪等补剂也不见效。六脉如丝几乎要断绝，迎接薛立斋前来，诊察后说：形体虽然壮实但虚极，反而使用理气药剂，损伤了真气。连续投用参、芪、归、芍、术、附、姜、桂，两剂，间或用八味丸，五天寝食逐渐香甜，六脉完全恢复。此症如果在心脾疼痛时，就服用这些药，疟疾也不会发作了。
龚子才治疗一人，心胃刺痛，手足稍微发冷，出汗，指甲发青，百药无效。用当归二钱，煎汤，用水磨沉香、木香、乌药、枳壳，调服，疼痛才停止。
一位教谕五十一岁，因为酒食过饱，胃脘作痛，每次进食后，气从两肩下到胸次到胃口，痛不可忍，让人用手重按痛处，过了一会儿突然响动一声，疼痛就停止了。这样持续八年，肌肉消瘦如柴。诊察发现，六脉微数，气口稍大有力。用神保丸一服下之，疼痛消失，后来用参苓白术散调理恢复元气。
程沙随在泰兴时，有一位乳母，因为吃冷肉，心脾胀痛难忍。钱受之用陈皮、吴茱萸五六十丸，水一盏，煎取汁去渣，加入官局平胃散三钱，再煎热服，一服疼痛停止，再服无其他反应。据说宋高宗曾经将此方赐给近臣，治愈疾病很多，真是奇方啊。（《槎庵小乘》。）
孙文垣治疗张二尹近川，开始因为内伤外感，服用发散消导药多剂，导致胃脘当心而痛。诊察发现，六脉皆弦而弱，法当补而敛之。白芍五钱，炙甘草三钱，桂枝一钱五分，香附一钱，大枣三枚，饴糖一合，（小建中汤加香附。）煎服，一剂而痊愈。
族弟应章胃脘当心而痛，手不能靠近，怀疑有瘀血所致。延胡索、五灵脂、丹皮、滑石、川芎、当归、甘草、桃仁、桔梗、香附，临服加韭菜汁一小酒杯，当晚疼痛停止就能睡觉，饮食也进。只是大便下坠，逼迫不安，这是瘀血已动，欲下行。前方去掉韭汁，一帖全安。
吴鹤洲的小妾，患胃脘痛。医生有的认为是虫，有的认为是火，又有认为是痰、气、食、虚、寒的，百治无效。孙文垣诊察，两手脉大而无力，都是六至（每息六至）。说：这是肝脾相胜的症状罢了。（胃脘痛为什么说是脾？）以白芍为君药，恶热而痛加黄柏，此法则万全。白芍四钱，一半生一半炒，伐肝补脾为君；甘草二钱，一半炙一半生，缓肝养脾为臣；山楂为佐；黑山栀、五灵脂各一钱，止痛为使。三帖而愈。
吴仰元患胃脘痛则放射到背部，用手重按稍止，痛时冷汗如雨，脉涩。孙文垣说：这是气虚而痛。（脉涩通常是血虚，这里独言气虚。）用小建中汤加御米壳而愈。（仍然是肝病。）
李士材治疗宋敬夫，心腹大痛，弯腰不能伸直，自己服用行气和血药无效。其脉左滑而急，气息不能顺畅，偶尔咳嗽，皱眉欲绝，无疑是疝气。用生姜饮粥，用小茴香、川楝子、青木香、吴茱萸、木通、延胡索、归身、青皮，一服疼痛减轻，五日安愈。（《医通》。）
李长蘅在吴门舟次，忽然发作胃脘痛，用顺气化食药无效。李士材诊察说：脉沉而迟，是客寒犯胃。用参苏饮加草豆蔻三钱，煎熟，加生姜自然汁半碗，一服减轻，两服痊愈。
一个人将要参加科举考试，八月初五心口痛甚，导致不能饮食。李士材诊察，寸口涩而软。给予大剂归脾汤加人参三钱，官桂一钱。那人说：痛而骤补，实在不敢，恐怕会影响考场日期吧？李士材说：只要相信并服用，就不会有影响。如果投用破气药，那一定会妨碍。于是服用不到一个时辰疼痛减轻，再进一剂，连饮独参汤，考试顺利完成。
高鼓峰治疗一位妇人胃痛，勺水不入，寒热往来。有的从火治，用黄芩、黄连、栀子、黄柏，有的从寒治，用生姜、肉桂、吴茱萸，辗转月余，形体羸瘦，六脉弦数，几乎毙命。高鼓峰说：这是肝痛，不是胃脘痛。其病起于郁结生火，阴血受伤，肝肾枯干，燥迫成痛，（好色之人，尤其多此病。）医生又投以苦寒辛热之剂，胃脘重伤，怎么能痊愈呢？急用滋肾生肝饮与之，一昼夜喝完三大剂，五更熟睡，第二天疼痛安定。再用加味归脾汤加麦冬、五味子，十余剂而愈。
按：此病外面多用四磨、五香、六郁、逍遥散，新病也有效，久服则杀人矣。又用肉桂也有效，因为木得桂而枯也。屡发屡服，则肝血燥竭，少壮者多成劳损，衰弱者多发厥而死，不可不知。
吕东庄治疗吴维师的妻子，患胃脘痛，叫喊号哭几乎断气，身体忽热忽寒，只觉有气逆左胁而上，呕吐酸水，饮食俱出。有人怀疑停滞，有人怀疑感邪，有人怀疑寒凝，有人怀疑痰积。脉象弦数，重按则濡，这是火郁肝血燥。给予当归、白芍、地黄、柴胡、枣仁、山药、山萸肉、丹皮、山栀、茯苓、泽泻，顿然安愈。只是胃口还觉得稍差，用加味归脾及滋肝补肾丸而愈。
高鼓峰和吕东庄两个案例，持论大致相同，且都用滋水生肝饮。我早年也曾使用此方，却不怎么见效，于是自创一方，名一贯煎，用北沙参、麦冬、地黄、当归、杞子、川楝子，六味出入加减，投之应验如击鼓。口苦燥者，加酒炒黄连尤其快捷。可统治胁痛、吞酸、吐酸、疝瘕一切肝病。
薛立斋治疗一位妇女，心腹作痛，久而不愈，这是肝火伤脾气。用炒山栀一两，生姜五片，煎服而痛止。再以二陈汤加山栀、桔梗，就不再发作。
孙文垣治疗周芦汀的妻子，患胃脘痛，呕吐不食四个月，昼夜号呼不绝，脉则两手俱滑数。（故意当作实证治疗。）说：应当以清热为先。于是先给末子药二钱，令其服用，不一顿饭功夫，疼痛停止而睡觉，家人很高兴。说：还没完，这是火暂时平息。其中痰积很牢固，不趁现在攻下，势必再发作。于是给予总管丸三钱，服下腹中微痛。再服二钱，又睡到天亮才醒，腹痛也停止，大便排出很多痰积。次日用二陈汤加枳实、姜黄、香附、山栀、黄连与之，服后胃痛全止。只是小腹略胀，盖痰积未尽。再与总管丸三钱，天明又行一次，痰之下如前，胃脘之痛遂不再发作。
薛立斋治疗陈湖陆小材的母亲，长期患心腹疼痛，每次发作必胸满呕吐，手足俱冷，面赤唇麻，咽干舌燥，寒热不时，月余竟夕不安，其脉洪大。众人以痰火治之，屡止屡作。等到乙巳年春，发作烦躁而严重，仍用前药反而加剧。这是寒凉损伤真气的缘故，内真寒而外假热。且脉息洪弦而有怪状，乃脾气亏损，肝木乘之而然。当温补胃气，遂用补中益气汤加半夏、茯苓、吴茱萸、木香，一服熟睡直到天亮，洪脉顿敛，怪脉顿除，诸症释然。
陆养愚治疗陆前川，素患肠风便燥，冬天喜欢吃盆柿，导致胃脘当心而痛。医生用温中下气药，治疗其心痛，痛未减而肠红如注；用寒凉润燥之剂，治疗其血，便未通而心痛如刺。诊脉，上部沉弱而迟，下部洪滑而数，这是胃中冷而肠中热。大肠属金，原喜清而恶热，喜润而恶燥，何况素有肠风燥急之症，因心痛而投以辛温香燥之剂，能不严重吗？脾胃原喜温而恶寒，湿润之品，能不严重吗？如今大便不行已数日，乃用润字丸三钱，以沉香三分包其外，浓煎姜汤，送下二钱。半日许又送一钱，至夜半大便行，极坚，而不甚痛，血减平日十六七。少顷又便一次，微痛而血亦少。清晨又便溏一次，微见血而竟不痛矣。惟心痛未舒，与脏连丸，也用沉香为衣，姜汤送下，以清下焦之热而润其燥。又以附子理中料为散，饴糖拌吞之，使恋膈而不速下，不终剂而两症并痊矣。
王肯堂治疗韩敬堂，患胸膈痛，脉洪大而涩，用山栀、赤芍、通草、麦芽、香附、归、芎，煎加姜汁、竹沥、韭汁、童便之类，饮之而止。一日劳倦忍饥，痛大发，亟邀王肯堂至，入房。问曰：晨起痛甚不能待公，服家兄药，下咽如刀割，其痛不可忍，此何意也？曰：得非二陈、平胃、紫苏之属乎？曰：然。曰：是则何怪乎其增病也。夫劳饿而发，饱逸而止，如其虚也。饮以十全大补汤，一剂而胸痛止。
张三锡治疗一妇，苦胃脘痛，每发辄大吐，多方不应，以盐汤探吐，出积痰碗许，痛良已。后常作恶心，知胃中有痰也。以橘、半、枳实加木香、川芎、白螺壳、南星、海粉、神曲，糊为丸，白汤下钱半，未及一半，病去如脱。
一老妪急胃痛，已六日，诸辛燥药历试无验。诊得左关弦急，而右寸更甚。其痛一来即不可当，少选方定，口干面时赤，知肝气有余而成火也。乃以越鞠加吴茱萸、炒黄连、姜汁、炒栀子，二剂顿愈。
一妇胃脘痛，凡一月，右关寸俱弦而滑，乃饮食不节所致。投滚痰丸一服，下痰及宿食三碗许。节食数日，调理而愈。
一妪胃痛久，诸药不应。六脉微小，按之痛稍定，知中气虚而火郁为患也。投理中汤，一服随愈。
一中年人因郁悒，心下作痛，一块不移，日渐羸瘦，与桃仁承气汤一服，下黑物并痰碗许，永不再发。
一人中脘大痛，脉弦而滑，右为甚，乃食郁也。二陈、平胃加山楂、草豆蔻、木香、砂仁，一服顿愈。
一人中脘至小腹痛不可忍，已十三日，香燥历试，且不得卧，卧则痛顶胸上，每痛急则脉不见。询之，因入房后过食肉食而致，遂以为阴症，而投姜、附。因思其饮食自倍，中气损矣。况在房室之后、宜宿物不能运化，又加燥剂太多，消耗津液，致成燥矢郁滞不通，所以不得卧而痛也。古云：胃不和则卧不安。遂以枳实导滞丸三钱，去黑矢碗许，小腹痛减矣。又与黄连、枳实、栝蒌、麦芽、浓朴、山楂、莱菔子，二服痛复移于小腹。乃更与润肠丸二服，更衣痛除。第软倦不支，投补中益气汤，调理半月而愈。
王叔权说：我的妻子过去侍奉疾病，多日不食，因而得心脾痛。发作时攻冲心腹，后来心痛也相应而至，到了不可忍受的地步，就要跟儿女告别。喂药喝，疼痛反而加重。如果艾灸，则全身承受不了艾灸。不免让儿女各自用火针微刺，不拘心腹，一会儿疼痛安定，就想起来了。神奇啊！
Yu Jiayan treated Lu Zijian, who had never been ill before. Due to residual effects of an external contraction compounded by internal injury from irregular eating (hunger and fullness), he developed discomfort in the chest and diaphragm, with a dull pain in the stomach. Sometimes eating relieved the pain, sometimes it aggravated it. Stool was very difficult to pass, and urination was obstructed. The pulse at the right Guan position was alternately wiry (Xian) and slow (Chi), unable to harmonize, resembling a chronic disease. If medicated correctly, dispelling the pathogen would be easy; however, if left for years and increasing daily, it would surely become a major affliction. The meridian of the stomach in the human body runs from the head down to the feet. Qi in the stomach reaches the bladder via the small intestine, and also reaches the large intestine via the small intestine. The qi that descends is turbid qi. Due to disharmony, this turbid qi becomes chaotic in the chest, interfering with the clear pathways, resulting in obstruction and discomfort. Initially, during the illness, the fluids (Jin Ye) in the stomach were scorched by evil fire. To this day, the fluids have not replenished, and the fire smolders internally, prone to flaring upward. Thus, eating suppresses the fire, bringing relief. However, when evil fire is rampant, righteous qi diminishes. If food intake is slightly excessive, qi cannot move the food, and pain increases. This means if fire is not removed, qi will not recover; if qi does not recover, clear and turbid qi in the stomach will mix chaotically, refusing to descend, and pain will inevitably persist. (The analysis of symptoms is as clear as watching fire.) The pathology belongs to the lower Wan (lower part) of the stomach, but the reason lies entirely in the middle Wan (middle part). "Middle" is the pivot of the upper, lower, and four directions. If qi in the middle Wan is abundant, it must drive the qi of the lower Wan into the large and small intestines, exiting through the anterior and posterior orifices. Precisely because it is insufficient, it is instead constrained by the turbid qi of the lower Wan. As for perfected individuals, their breath reaches the heels; exhalation originates from the root, inhalation from the tip (Dantian). Due to turbid qi ascending and interfering, inhaled qi struggles to return to its root. Moreover, due to pain, the qi of the whole body stagnates and fails to circulate, which is no minor matter. Therefore, a prescription to descend fire, generate fluids, direct qi downward, and relieve pain was formulated for common use. Furthermore, one must first gather and secure Kidney Qi, preventing it from escaping externally. Then, the source of turbid qi is cleared, and the Bladder can attract the qi of the Upper and Middle Jiao to descend. This is what the wise strive for.
Master Yu indeed possesses the ability to uncover what predecessors had not revealed, lacking only the step of vigorously nourishing the Liver and Kidneys. However, the handling at the end of this case already approaches this principle.
Zhang Zihe treated a General suffering from unbearable heart pain. Zhang said: This is not heart pain, but stomach-ache located at the heart region. (These two words pinpoint the symptom, but I add a twist: It is not stomach-ache, but Liver Wood overacting on the Stomach.) The *Nei Jing* states: When Wood Qi is excessive in a year, wind patterns prevail, and people suffer from stomach-ache at the heart region. (Wind-Wood pathology, how could it not be the Liver?) He administered over one hundred pills of Shenbao Wan, but the illness did not subside. Someone asked: Is there cold in the stomach-ache? Should we warm and tonify? The General, knowing Zhang's medical acumen, sought medicine again. Zhang gave another two hundred plus pills of Shenbao Wan, taken in one dose. After severe diarrhea six or seven times, he recovered immediately. (This treatment method is not suitable for modern practitioners to imitate lightly.)
A woman suffered for several years without recovery. A physician used half a qian of Ren Shen powder and one fen of tea leaves, mixed with hot water. She vomited a piece of blood stasis and was cured. (Li Lou's Strange Prescriptions; unless one is a divine hand, do not use lightly.)
Wang Zhizhong suffered from heart-spleen pain for a long time. Taking spleen-awakening medicines caused distension. He used Peng E Zhu (Curcuma zedoaria Rhizome), wrapped in flour and roasted, ground into powder, decocted with water and wine, and was cured immediately. This medicine breaks blood stasis within Qi. (*Ben Cao Gang Mu*, Wang Zhizhong's *Zi Sheng Jing*.)
A thirty-year-old woman suffered from heart-Qi pain. Using Hong Hua (Carthamus tinctorius Flower) powder taken with hot wine (2 qian) brought immediate effect. Another method: men decoct with half wine and half water; women with half vinegar and half water. (Extracted from Yuan Fang, based on *Ben Cao Gang Mu*.)
Li Shizhen treated Hu Shi, Consort of Prince Jingmu. Anger while eating buckwheat noodles caused stomach-ache at the heart region, unbearable. Physicians used emetics, purgatives, Qi-moving, and stagnation-resolving drugs, all vomited upon entry, ineffective. Stool had not passed for three days. Li thought of the *Lei Gong Pao Zhi Lun*: "For heart pain wanting death, quickly seek Yan Hu Suo." He used 3 qian of Yan Hu Suo powder, mixed with warm wine. Immediately after, she could eat. Soon, stool passed three or five times, accumulated stagnation discharged, and stomach-ache ceased abruptly.
A friend said that in Wuchang, he saw an old monk suffering from stomach-ache, so severe it felt like dying. His disciple also suffered from it. Before dying, the master ordered his heart to be dissected to remove the disease. Indeed, a thin bone, 7-8 cun long, shaped like a hairpin, was found near the heart. The disciple kept it in a vase, offering it before his master's spirit tablet for years. When a noble guest stayed at the temple and killed a goose (throat not severed), the disciple took the bone to probe the goose's throat. Wherever goose blood touched the bone, it dissolved. The disciple realized this principle, drank goose blood for several days, and his stomach disease was cured.
Xue Lizhai treated a woman with long-term heart pain, poor appetite, and vomiting of all medicines. Xue diagnosed Spleen Earth deficiency. He used only Bai Zhu (Atractylodis Macrocephalae Rhizoma), stir-fried with yellow earth, removing the earth. Each dose was 1 liang, decocted strongly with rice wash water, taken slowly in small amounts. After several days, she could drink heavily. Using over 3 jin, she recovered. (Xu Lingtai notes: How can Spleen weakness cause pain? This is likely fluid retention. Cai Zhong agrees: Fluid retention theory is correct, similar to Xu Xueshi's Shenzhu Wan. But for mild fluid retention, it works; if fluid retention is severe, it worsens pain because Bai Zhu closes Qi. Huang Jinfang discusses this in detail, refer to it.)
The eldest son of Shangshe Chen Lvxue's wife was naturally weak. Postpartum, she developed a ding sore (carbuncle) lasting over a year. During a month of mourning, she often felt dizzy and about to faint. One day, affected by Qi, she suddenly developed swelling and pain in the heart and spleen regions, intolerable to touch, with incessant vomiting. The six pulses were minute and fine. Seeing her robust appearance, some mistakenly believed pain should not be treated with tonification, using Qing Pi, Mu Xiang, Wu Wei Zi, Wu Zhu Yu, etc., which worsened the condition. Subsequently, she contracted malaria and miscarried. Further administration of Qi-regulating and blood-moving drugs resolved the illness but depleted Yuan Qi further. (Patients lack understanding; the world is alike.) Re-administration of Ren Shen and Huang Qi tonics failed. Pulses were thread-like, nearly absent. Xue was invited. Diagnosis: Appearance is robust but deficiency is extreme; previous Qi-regulating agents damaged true Qi. Continuous doses of Ren Shen, Huang Qi, Dang Gui, Bai Shao, Bai Zhu, Fu Zi, Sheng Jiang, Gui Zhi for two doses, interspersed with Bawei Wan. Within five days, sleep and appetite improved, pulses fully restored. If these medicines were taken during heart-spleen pain, malaria would not have occurred.
Gong Zicai treated a man with stabbing pain in the heart and stomach, slightly cold hands and feet, sweating, cyanotic nails. All medicines failed. Using 2 qian of Dang Gui decocted in water, mixed with Chen Xiang, Mu Xiang, Wu Yao, and Zhi Ke ground in water, the pain stopped.
A Jiaoyu (educational official), aged 51, suffered stomach-ache after overeating alcohol and food. After each meal, Qi descended from both shoulders to the chest and stomach, causing unbearable pain. Pressing hard on the painful area with hands, followed by a sudden sound, relieved the pain. This persisted for eight years, leaving him emaciated. Pulses were minute and rapid, Qi Kou slightly large and forceful. One dose of Shenbao Wan eliminated the pain. Later, Shenling Baizhu San regulated and restored health.
When Cheng Shasui was in Taixing, a wet nurse suffered unbearable heart-spleen distending pain after eating cold meat. Qian Shouyi used 50-60 pills of Chen Zhu Yu (aged Evodia fruit), decocted in one cup of water, strained, then added 3 qian of Pingwei San from the Imperial Pharmacy, reheated and taken. One dose stopped the pain; a second dose had no adverse effects. It is said Emperor Gaozong once bestowed this on close ministers, curing many illnesses. Truly a strange prescription. (*Cha An Xiao Cheng*.)
Sun Wen yuan treated Zhang Er Yin Jin Chuan. Initially suffering from internal injury and external contraction, multiple doses of dispersing and digesting medicines led to stomach-ache at the heart region. Pulses were wiry and weak throughout. The method should be tonifying and astringing. Bai Shao 5 qian, Zhi Gan Cao 3 qian, Gui Zhi 1.5 qian, Xiang Fu 1 qian, Da Zao 3 pieces, Yi Tang 1 he. (Xiao Jian Zhong Tang plus Xiang Fu.) Decocted and taken. Cured in one dose.
My clan brother Ying Zhang suffered stomach-ache at the heart region, intolerable to touch. Suspected blood stasis. Yan Hu Suo, Wu Ling Zhi, Dan Pi, Hua Shi, Chuan Xiong, Dang Gui, Gan Cao, Tao Ren, Jie Geng, Xiang Fu. Add one small glass of Le Jiu Zhi (Chinese chive juice) before taking. Pain stopped that night, allowing sleep and food intake. Only defecation urgency remained, indicating moving stasis descending. Remove chive juice from formula. One dose brought complete peace.
Wu Hezhou's concubine suffered stomach-ache. Physicians attributed it to worms, fire, phlegm, Qi, food, deficiency, or cold. Hundred treatments failed. Sun diagnosed: Both hands' pulses were large but powerless, six beats per respiration. He said: This is Liver-Spleen overcoming syndrome. (Why mention Spleen for stomach-ache?) Use Bai Shao as Sovereign. For heat-intolerance pain, add Huang Bo. This rule is perfect. Bai Shao 4 qian (half raw, half stir-fried) to subdue Liver and tonify Spleen as Sovereign; Gan Cao 2 qian (half honey-roasted, half raw) to soothe Liver and nourish Spleen as Minister; Shan Zha as Assistant; Hei Shan Zhi and Wu Ling Zhi 1 qian each as Envoy for pain relief. Cured in three doses.
Wu Yangyuan suffered stomach-ache radiating to the back, relieved slightly by hard pressure, sweating cold sweat like rain during pain, pulse choppy. Sun said: This is Qi deficiency causing pain. (Choppy pulse usually indicates Blood deficiency, here specifically Qi deficiency.) Cured with Xiao Jian Zhong Tang plus Yu Mi Ke (Poppy Shell). (Still Liver disease.)
Li Shicai treated Song Jingfu with severe heart-abdominal pain, bent over unable to straighten. Self-administered Qi-moving and blood-invigorating medicines with no effect. Pulse left slippery and urgent. Breath short. Coughing caused extreme frowning. Undoubtedly Hernia (Shan). Fed ginger-infused porridge. Used Xiao Hui Xiang, Chuan Lian Zi, Qing Mu Xiang, Wu Zhu Yu, Mu Tong, Yan Hu Suo, Dang Gui, Qing Pi. One dose reduced pain; recovered in five days. (*Yi Tong*.)
Li Changheng, at a boat stop in Wumen, suddenly developed stomach-ache. Smooth Qi and digest food medicines failed. Li diagnosed: Pulse deep and slow, invading cold attacking the Stomach. Used Shen Su Yin plus 3 qian Cao Dou Kou. Decocted, add half bowl fresh Ginger Juice. One dose reduced pain; two doses cured.
A man about to take exams suffered severe heart pain on August 5th, unable to eat. Li diagnosed: Cun Kou pulse slippery and soft. Prescribed large dose of Gui Pi Tang plus 3 qian Ren Shen, 1 qian Guan Gui. Patient feared sudden tonification during pain might affect the exam. Li said: Trust and take it, no harm. If using Qi-breaking drugs, harm is certain. Taken within an hour, pain reduced. Another dose, followed by Du Shen Tang, completed the exam successfully.
Gao Gugeng treated a woman with stomach-ache, unable to swallow water, alternating chills and fever. Treated as Fire with Huang Qin, Huang Lian, Zhi Zi, Huang Bo; or as Cold with Sheng Jiang, Rou Gui, Wu Zhu Yu. Over a month, emaciated, pulses wiry and rapid, near death. Gao said: This is Liver pain, not stomach-ache. Caused by depression generating fire, damaging Yin Blood, drying Liver and Kidneys, dryness forcing pain. (Those indulging in sex are prone to this.) Doctors used bitter-cold and pungent-hot agents, severely injuring the Stomach. How could it heal? Urgently administer Zi Sheng Gan Yin. Finish three large doses in one day and night. Deep sleep at dawn, pain settled next day. Then Jia Wei Gui Pi Tang plus Mai Dong, Wu Wei Zi. Over ten doses, cured.
Note: Outside practitioners often use Si Mo, Wu Xiang, Liu Yu, Xiao Yao San. Effective for new diseases, but long-term use kills. Rou Gui is also effective because Wood withers with Gui. Frequent recurrence and use lead to Liver Blood dryness. Youthful/strong become consumptive; weak develop syncope and die. Must know this.
Lv Dongzhuang treated Wu Weishi's wife. Stomach-ache, screaming nearly died. Body fluctuating hot/cold. Qi reversing up left hypochondrium, vomiting sour water, food/drink expelled. Suspected stagnation, pathogen, cold coagulation, or phlegm accumulation. Pulse wiry-rapid, soft on heavy pressure. Fire depression, Liver Blood dryness. Given Dang Gui, Bai Shao, Di Huang, Chai Hu, Suan Zao Ren, Shan Yao, Shan Yu Rou, Dan Pi, Shan Zhi, Fu Ling, Ze Xie. Instantly calm. Appetite slightly low, treated with Jia Wei Gui Pi and Zi Gan Bu Shen Wan. Cured.
Cases by Gao and Lv share similar theories, both using Zi Shui Sheng Gan Yin. I used this early on with little effect, so I created my own formula, Yi Guan Jian, using Bei Sha Shen, Mai Dong, Di Huang, Dang Gui, Qi Zi, Chuan Lian. Six herbs adjusted flexibly, effective as drumbeat. Bitter taste and dryness: add Jiu Lian (wine-fried Coptis) for best results. Treats hypochondriac pain, acid regurgitation, hernia masses—all Liver diseases.
Xue Lizhai treated a woman with heart-abdominal pain, chronic. Liver Fire injuring Spleen Qi. Stir-fried Zhi Zi 1 liang, Sheng Jiang 5 slices. Decocted and taken. Pain stopped. Followed by Er Chen Tang plus Zhi Zi, Jie Geng. No recurrence.
Sun Wen yuan treated Zhou Lutings wife. Stomach-ache, vomiting, anorexia for four months. Day and night screaming. Pulses slippery-rapid in both hands. (Treated as excess.) Said: Clear heat first. Gave 2 qian of powdered medicine. In less than a meal time, pain stopped, slept. Family happy. Said: Not yet. Fire temporarily suppressed. Phlegm-stagnation is solid. Must purge now or it returns. Gave Zong Guan Wan 3 qian. Mild abdominal pain after taking. Another 2 qian, slept until dawn, pain stopped, passed much phlegm-stagnation in stool. Next day, Er Chen Tang plus Zhi Shi, Jiang Huang, Xiang Fu, Shan Zhi, Huang Lian. Stomach-ache completely stopped. Lower abdomen slightly distended, phlegm-stagnation not exhausted. Another 3 qian Zong Guan Wan. Passed more phlegm at dawn. Stomach-ache did not recur.
Xue Lizhai treated Mother of Lu Xiaocai from Chen Lake. Long-term heart-abdominal pain. Each attack: chest fullness, vomiting, cold limbs, red face, numb lips, dry throat/mouth, intermittent chills/fever, restless nights for a month. Pulse large and forceful. Treated as Phlegm-Fire, repeatedly stopped and returned. In spring of Yisi year, severe irritability, previous medicines worsened it. Cause: Cold-cooling damaged True Qi, Internal True Cold, External False Heat. Pulse large-wiry with abnormal features. Spleen Qi deficiency, Liver Wood overacting. Warm and tonify Stomach Qi. Use Bu Zhong Yi Qi Tang plus Ban Xia, Fu Ling, Wu Zhu Yu, Mu Xiang. One dose, slept till dawn, large pulse retracted, abnormal pulse gone, symptoms resolved.
Lu Yangyu treated Lu Qianchuan. Prone to intestinal wind and dry stool. Winter liked eating persimmons, causing stomach-ache at heart region. Doctors used warming/lowering Qi meds for heart pain; pain didn't decrease, intestinal bleeding increased. Used cooling/moistening meds for blood; stool didn't pass, stabbing pain continued. Pulse: Upper deep-weak-slow, Lower large-slippery-rapid. Cold in Stomach, Heat in Intestines. Large Intestine is Metal, likes clarity, hates heat; likes moisture, hates dryness. With pre-existing intestinal wind/dryness, using pungent-warm-drying meds for pain exacerbated it. Spleen/Stomach likes warmth, hates cold; moistening meds... (text cuts off slightly in logic but implies imbalance). Stool blocked for days. Used Run Zi Wan 3 qian, coated with Chen Xiang 3 fen, sent down with strong Ginger Soup 2 qian. Half day later, another 1 qian. Midnight, stool passed, very hard, little pain, bleeding reduced significantly. Shortly after, another stool, slight pain, less blood. Morning, loose stool, trace blood, no pain. Heart pain not relieved. Given Zang Lian Wan, coated with Chen Xiang, Ginger Soup. Clears Lower Jiao heat, moistens dryness. Also Fu Zi Li Zhong San mixed with Yi Tang, swallowed to linger in chest, not fast acting. Without finishing course, both ailments healed.
Wang Kentang treated Han Jingtang. Chest-diaphragm pain, pulse large-forceful-choppy. Used Zhi Zi, Chi Shao, Tong Cao, Mai Ya, Xiang Fu, Dang Gui, Chuan Xiong. Decocted with Ginger Juice, Zhu Li, Jiu Zhi, Tong Bian. Pain stopped. One day, fatigue and hunger triggered severe pain. Wang invited urgently. Patient: Morning pain unbearable, couldn't wait for you. Took brother's medicine, swallowing felt like knife cutting, unbearable. Why? Wang: Was it Er Chen, Ping Wei, Zi Su? Patient: Yes. Wang: No wonder it worsened. Pain triggered by labor/hunger, relieved by fullness/rest indicates deficiency. Drink Shi Quan Da Bu Tang. One dose, chest pain stopped.
Zhang Sanxi treated a woman suffering stomach-ache, vomiting heavily each episode. Many methods failed. Used salt water to induce vomiting, expelled bowl of accumulated phlegm. Pain largely resolved. Later frequent nausea, indicating phlegm in stomach. Ju Hong, Ban Xia, Zhi Shi plus Mu Xiang, Chuan Xiong, Bai Luo Ke, Nan Xing, Hai Fen, Shen Qu. Paste-made pills, taken with hot water 1.5 qian. Less than half dose, disease departed like shedding skin.
Old woman with acute stomach-ache for six days. Various pungent-drying medicines failed. Left Guan pulse wiry-urgent, Right Cun even worse. Pain overwhelming upon onset, subsides after a while. Dry mouth, occasional red face. Liver Qi excess transforming into Fire. Yue Ju San plus Wu Zhu Yu, Chao Huang Lian, Ginger Juice, Chao Zhi Zi. Two doses, instantly cured.
Woman with stomach-ache for one month. Right Guan/Cun wiry-slipping. Caused by irregular diet. One dose of Gun Tan Wan passed three bowls of phlegm and retained food. Diet control for days, regulated, cured.
Old woman with chronic stomach-ache, medicines failed. Six pulses minute-small. Pressure relieves pain slightly. Middle Qi deficiency with depressed Fire. Li Zhong Tang. One dose, cured.
Middle-aged man, depressed, pain below heart, fixed mass, wasting away. Tao Ren Cheng Qi Tang. One dose, passed black matter and phlegm. Never recurred.
Man with severe Zhong Wan pain, pulse wiry-slipping, Right worse. Food stagnation. Er Chen, Ping Wei plus Shan Zha, Cao Dou Kou, Mu Xiang, Sha Ren. One dose, instantly cured.
Man with pain from Zhong Wan to lower abdomen, unbearable, 13 days. Pungent-drying tried, cannot lie down. Lying down pushes pain to chest. Pulse disappears during acute pain. History: Excessive meat consumption after intercourse. Diagnosed as Yin syndrome, given Sheng Jiang, Fu Zi. Thought: Double food intake damages Middle Qi. After intercourse, undigested food accumulates. Too many drying agents consumed fluids, forming dry feces/stagnation. Hence inability to lie down and pain. Ancient saying: Stomach disharmony leads to restless sleep. Zhi Shi Dao Zhi Wan 3 qian. Passed bowl of black feces, lower abdominal pain reduced. Then Huang Lian, Zhi Shi, Gua Lou, Mai Ya, Hou Po, Shan Zha, Lai Fu Zi. Two doses, pain moved to lower abdomen. Then Run Chang Wan two doses, bowel movement, pain removed. Weak and exhausted. Bu Zhong Yi Qi Tang. Regulated for half month, cured.
Wang Shuquan said: My wife previously cared for the sick, fasting for days, developed heart-spleen pain. Attacks attacked heart/abdomen, then heart pain followed, unbearable, preparing to say goodbye to children. Medicines worsened pain. Moxibustion unbearable. Had children prick with fire needles lightly, anywhere on heart/abdomen. Pain settled instantly, wanted to get up. Divine!