邓安人年五十，忽然气痛，投神保丸，愈不一二日再痛，再服神保丸六七十粒，大便不通，其痰转甚。亦
有要用沉香、木香、姜、桂等药而未敢投。痛甚则筑心筑背筑走两胁，似有两柴十字插定心胁，叫声彻天。召
良甫诊之，六脉沉伏，乍来乍去。众问诊脉吉凶何如。答曰∶凡九痛之脉，不可准也。但以症辨同药，观其人
质肥伟，问其便数日不通，曰∶实痛也。其腹必胀，但以人按之痛甚，手不可近，此大实也。经曰，大满大实
者，可下之。用替针丸五六百粒，是夜即愈。（《医说续编》。）
罗谦甫治赵运使夫人，年五十八岁，于至元甲戌三月中，病脐腹冷疼，相引胁下痛不可忍，反复闷乱，不
得安卧，以当归四逆汤主之，灸中庭穴。（同上。）
朱丹溪治一妇，气自小腹丹田冲上，遂吐清水，火气上逆，由丹田虚寒故也。用白术二两，白豆蔻五钱为
末，早饭后以白汤送下。白术补脾，豆蔻温肺，此药服之则金水相生，其病自愈。若在男子纯阴无阳，则为不
治之症矣。（按∶既是丹田虚寒，何以纯用脾药？所云金水相生之义亦未的，二药不过补脾扶气而已。）
陈三农治一人怒气感寒，小腹有块，气逆上行，喘息不安。众用散气降气药益甚。曰∶此因汗下过多，伤
其胃气，胃气虚为冲脉所逆，并胁下少阳脉二道而反行，病多厥逆。以调中益气汤加炒黄柏、炒青皮，一剂而愈。
一老人大怒，气自脐下上攻，两胁作痛，喘息不卧，此动少阳之火也。两胁肝胆部分，怒气伤肝，而动龙
雷之火，故逆上作痛耳。用伏龙肝煎汤下左金丸愈。（按∶补脾泻肝兼寓降逆，制方何其简妙。）
一贵人患气从小腹上攻，胸胁头项遍身急胀而痛，诸治罔效。曰∶此督脉为病也。经曰∶督脉为病，令人
逆气而里急。以四物加炒黑黄柏、醋炒青皮，一剂而愈。
朱丹溪治郑仲游，年二十三，膈有一点相引痛，吸气皮觉急。滑石、枳壳炒各一两，桃仁、黄连炒各半两，
炙甘草二钱，为末。每服一钱半，以萝卜自然汁研，煎熟饮之，一日三五次。（作污血治。）
郑仲本，年二十七，因吃热补药，又妄自学吐纳，以致气乱血热，嗽血消瘦，遂与行倒仓法。今嗽血消瘦
已除，因吃炒豆米，膈间有一点气梗痛，似有一条丝垂映在腰，小腹亦痛，大率偏在左边，此肝部有恶血行未
尽也。滑石，枳壳一两，柴胡，黄连五分，桃仁二两，黄丹三钱，生甘草二钱，红花一钱，服法同前。
缪仲淳治高存之婿浦生，气上逆，每饭下一二口辄嗳气数十口，再饭再嗳，食顷三四作。曰∶此气不归元，
中焦不运也，每剂须人参二钱。不信，服快气药愈甚。逾二三月，曰∶今须参四钱矣。不信。又逾二三月，曰∶
今须六钱矣。不信，又逾月饮食不下，每呕冷气如团而出，上下气不属。分必死，存之坐其家，迫令服缪药。
首服不动，再煎不动，然亦不如他汤药辄呕也。服三剂，忽心口下如爆一声，上则嗳气，下则小遗无 ，上下
洞然，即索粥顿食三四碗，不上逆矣。服五六剂减参二钱，嗳逆复作，仍用六钱而安。一月后方减参二钱，服
半年全愈。人参六钱，麦冬三钱，五味二钱，橘红一钱，砂仁一钱，白芍二钱，沉香五分，益智仁一钱五分，
山萸肉三钱，苏子二钱，枇杷叶三大片，水煎，临服加沉香汁十五匙，逆水芦根汁一大盏。又十倍为末，山药
糊为丸，空心白汤吞。（《广笔记》。）
梁溪一妇人，喉间如一物，上下作梗，前后板痛，服仲淳方二十剂愈。降香、通草、苏子、橘红、枇杷叶、
人参、炙草、石菖蒲、麦冬、甘菊、白芍、远志、白豆仁、木瓜、石斛，加芦根汁一钟同煎八分，入姜汁二匙。（同上。）
邓安人五十岁时，突然发生气痛，服用神保丸后，不到一两天疼痛复发，再次服用神保丸六七十粒，导致大便不通，痰湿症状反而加重。当时也有想用沉香、木香、生姜、肉桂等药物却不敢使用的情况。疼痛剧烈时，感觉心脏、背部及两侧胁肋部像被两根交叉的柴火棍插定一样，叫声震天。邀请良甫诊治，发现六脉沉伏，忽隐忽现。众人询问脉象吉凶如何。良甫回答说：凡是九种痛证的脉象，都不能作为准确判断依据。仅凭症状辨别用药，观察患者体质肥壮，询问得知数日未排便，说：这是实痛。腹部必然胀满，但用手按压时疼痛剧烈，手不能靠近，这是大实证。《内经》说，大满大实者，可以用攻下法。于是使用替针丸五六百粒，当晚即痊愈。（出自《医说续编》。）
罗谦甫治疗赵运使夫人，五十八岁，在至元甲戌年三月间，患病表现为脐腹冷痛，牵引胁下疼痛难以忍受，反复烦闷扰乱，无法安卧，用当归四逆汤主治，并灸中庭穴。（同上。）
朱丹溪治疗一位妇女，气从小腹丹田处向上冲逆，随即吐出清水，这是火气上逆，原因是丹田虚寒所致。使用白术二两、白豆蔻五钱研为末，早饭后用白开水送服。白术补脾，豆蔻温肺，服用此药则金水相生，疾病自然痊愈。如果是男子纯阴无阳，则是难治之症。（按语：既然是丹田虚寒，为何纯用健脾药？所谓金水相生的道理也不确切，这两味药不过是补脾扶气罢了。）
陈三农治疗一人，因愤怒感受寒邪，小腹有肿块，气逆上行，喘息不安。众人使用散气降气的药物反而加重病情。陈三农说：这是因为发汗和攻下过多，损伤了胃气，胃气虚弱导致冲脉之气上逆，并与胁下少阳脉两道反向运行，病症多为厥逆。用调中益气汤加炒黄柏、炒青皮，一剂即愈。
一位老人大怒，气从脐下向上攻冲，两胁作痛，喘息不能平卧，这是动用了少阳之火。两胁是肝胆部位，怒气伤肝，触动龙雷之火，所以气逆上行而作痛。用伏龙肝煎汤送服左金丸治愈。（按语：补脾泻肝兼寓降逆之意，制方何其简洁巧妙。）
一位贵人患气从小腹上攻，胸胁头项及全身急胀疼痛，各种治疗无效。陈三农说：这是督脉发病。《内经》说：督脉发病，使人气逆且里急。用四物汤加炒黑黄柏、醋炒青皮，一剂即愈。
朱丹溪治疗郑仲游，二十三岁，膈部有一点牵引性疼痛，吸气时皮肤感觉紧绷。用滑石、枳壳（炒）各一两，桃仁、黄连（炒）各半两，炙甘草二钱，研为末。每次服用一钱半，用萝卜自然汁研磨，煎熟后饮用，一日三到五次。（按瘀血治疗。）
郑仲本，二十七岁，因为吃热性补药，又妄自学习吐纳导引，导致气乱血热，咳嗽吐血、身体消瘦，于是采用倒仓法治疗。如今咳嗽吐血、身体消瘦的症状已消除，但因吃了炒豆子，膈间有一点气梗疼痛，好像有一条丝线垂映在腰部，小腹也痛，大体偏向左侧，这是肝部有恶血未尽。用滑石、枳壳一两，柴胡、黄连五分，桃仁二两，黄丹三钱，生甘草二钱，红花一钱，服用方法同前。
缪仲淳治疗高存之的女婿浦生，气上逆，每吃下一两口饭就打几十口嗳气，再吃饭再打嗳气，一顿饭的时间里发作三四次。缪仲淳说：这是气不归元，中焦不运化，每剂药必须用人参二钱。患者不信，服用快气药反而更重。过了两三个月，缪仲淳说：现在需要人参四钱了。患者仍不信。又过了两三个月，缪仲淳说：现在需要六钱了。患者仍不信，又过一个月饮食不下，每呕吐冷气如团块而出，上下之气不相连接，分必死无疑。高存之坐在他家，强迫他服用缪仲淳的药。第一次煎煮不动，第二次煎煮也不动，但也不像其他汤药那样引起呕吐。服用三剂后，忽然心口下方像爆炸一声，上面打嗳气，下面小便失禁，上下通畅，立刻索要粥喝，一顿吃了三四碗，不再上逆。服用五六剂后减少人参二钱，嗳逆又发作，仍用六钱才安定。一个月后才减少人参二钱，服用半年完全痊愈。处方：人参六钱，麦冬三钱，五味子二钱，橘红一钱，砂仁一钱，白芍二钱，沉香五分，益智仁一钱五分，山萸肉三钱，苏子二钱，枇杷叶三大片，水煎，临服加沉香汁十五匙，逆水芦根汁一大盏。又将上述药材十倍量研为末，山药糊为丸，空腹用白开水吞服。（出自《广笔记》。）
梁溪一位妇人，喉间感觉像有一物，上下梗阻，前后板痛，服用缪仲淳的方剂二十剂后痊愈。处方：降香、通草、苏子、橘红、枇杷叶、人参、炙甘草、石菖蒲、麦冬、甘菊、白芍、远志、白豆仁、木瓜、石斛，加芦根汁一钟同煎至八分，加入姜汁二匙。（同上。）
Lady Deng, aged fifty, suddenly suffered from Qi pain. After taking Shenbao Wan (Divine Preservation Pill), the pain recurred within one or two days. She took another sixty to seventy pills of Shenbao Wan, which resulted in constipation and worsened her phlegm symptoms. At that time, there were those who wished to use drugs such as Chenxiang (Aquilaria Lignum), Muxiang (Aucklandiae Radix), Shengjiang (Zingiberis Rhizoma Recens), and Rongui (Cinnamomi Cortex) but dared not administer them. When the pain was severe, she felt as if two crossed firewood sticks were piercing her heart, back, and bilateral hypochondrium, with cries reaching the sky. Liangfu was summoned for diagnosis. The six pulses were deep and hidden, appearing intermittently. Everyone asked about the auspiciousness or inauspiciousness of the pulse. Liangfu replied: "The pulses of the nine types of pain are not reliable indicators. We must differentiate treatment based on symptoms. Observing that the patient has a robust and plump constitution, and asking revealed several days of constipation, I conclude this is Excess Pain. Her abdomen must be distended, and pressing it causes severe pain that repels the hand; this indicates a Great Excess Syndrome. The Classic states: 'In cases of great fullness and excess, purgation may be used.' Therefore, we use Tizhen Wan (Substitute Needle Pill), five to six hundred pills, and she recovered that very night." (From *Yishuo Xubian*.)
Luo Qianfu treated the wife of Transport Commissioner Zhao, aged fifty-eight. In the third month of the Ji Xu year of the Zhiyuan era, she suffered from cold pain in the umbilical and abdominal region, radiating to the hypochondrium with unbearable pain, accompanied by recurrent restlessness and inability to lie down comfortably. He prescribed Danggui Sini Tang (Angelica Sinensis Decoction for Cold Extremities) and moxa-needled the Zhongting (CV 15) acupoint. (Ibid.)
Zhu Danxi treated a woman whose Qi rushed upward from the Dantian (Sea of Qi) in the lower abdomen, followed by vomiting of clear fluid. This was due to Fire Qi rebelling upward, caused by deficiency-cold in the Dantian. He used Baizhu (Atractylodis Macrocephalae Rhizoma), two liang, and Baidoukou (Cardamomi Fructus), five qian, ground into powder. It was taken after breakfast with warm water. Baizhu tonifies the Spleen, and Baidoukou warms the Lung. Taking this medicine promotes the mutual generation of Metal and Water, and the disease would heal spontaneously. If this occurred in a man with pure Yin and no Yang, it would be an incurable condition. (Commentary: Since it is Dantian deficiency-cold, why use only Spleen-tonifying herbs? The theory of Metal-Water mutual generation is also imprecise; these two herbs merely tonify the Spleen and support Qi.)
Chen Sansan treated a man who contracted cold due to anger. There was a mass in his lower abdomen, Qi rebelled upward causing panting and discomfort. Others used Qi-scattering and Qi-descending medicines, which exacerbated the condition. Chen said: "This is because excessive sweating and purging damaged Stomach Qi. Deficient Stomach Qi allows the Chong Mai (Penetrating Vessel) to rebel, running counter to the Shaoyang channels under the hypochondrium, leading to Jue Ni (reversal cold/convulsion)." He prescribed Tiaozhong Yiqi Tang (Regulate Middle and Boost Qi Decoction) with fried Huangbai (Phellodendri Cortex) and fried Qingpi (Citri Reticulatae Pericarpium Viride), resulting in recovery after one dose.
An elderly man, enraged, felt Qi attacking upward from below the navel, causing pain in both hypochondria, panting, and inability to lie flat. This stirred the Fire of Shaoyang. The hypochondria belong to the Liver and Gallbladder; anger injures the Liver, stirring the Dragon and Thunder Fire, causing rebellious Qi and pain. He used Fulonggan (Dragon's House Earth) decoction to wash down Zuojin Wan (Left Metal Pill), achieving cure. (Commentary: Tonifying Spleen, draining Liver, and containing descending action; how concise and exquisite the prescription.)
A nobleman suffered from Qi attacking upward from the lower abdomen, causing acute distension and pain throughout the chest, hypochondria, head, neck, and body. Various treatments failed. Chen said: "This is a disease of the Du Mai (Governing Vessel). The Classic states: 'Disease of the Du Mai causes rebellious Qi and internal urgency.'" He used Siwu Tang (Four Substances Decoction) with fried-black Huangbai and vinegar-fried Qingpi, curing him in one dose.
Zhu Danxi treated Zheng Zhongyou, aged twenty-three, who had a localized pulling pain in the diaphragm, with skin tightness upon inhalation. He used Huashi (Talcum), fried Zhike (Aurantii Fructus), each one liang; Taoren (Persicae Semen), fried Huanglian (Coptidis Rhizoma), each half liang; and Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), two qian, ground into powder. Each dose was one and a half qian, ground with natural radish juice, decocted until cooked, and drunk three to five times a day. (Treated as Blood Stasis.)
Zheng Zhongben, aged twenty-seven, consumed hot tonic medicines and recklessly practiced Tu Na (breathing exercises), leading to chaotic Qi and hot Blood, coughing blood, and emaciation. He underwent Dao Cang Fa (Stomach Purging Method). Although the coughing blood and emaciation resolved, eating fried beans caused a sensation of Qi blockage and pain in the diaphragm, resembling a thread hanging to the waist, with lower abdominal pain, predominantly on the left side. This indicated incomplete elimination of evil Blood in the Liver region. He used Huashi, Zhike (one liang); Chaihu (Bupleuri Radix), Huanglian (five fen); Taoren (two liang); Huangdan (Minii Oxidum Rubrum, three qian); Sheng Gancao (two qian); Honghua (Carthami Flos, one qian). Administration method same as before.
Miu Zhongchun treated Pu Sheng, son-in-law of Gao Cunzhi, who suffered from rebellious Qi. After swallowing one or two mouthfuls of food, he belched dozens of times. Repeated eating led to repeated belching, occurring three or four times per meal. Miu said: "This is Qi failing to return to its origin, with failure of Middle Jiao transportation. Each dose requires Ren Shen (Ginseng Radix), two qian." The patient did not believe this and took Qi-moving medicines, worsening the condition. After two or three months, Miu said: "Now you need four qian of Ren Shen." The patient still refused. After another two or three months, Miu said: "Now you need six qian." Still refusing, after another month, he could not eat or drink, vomiting cold Qi in clumps, with upper and lower Qi disconnected. Death was certain. Gao Cunzhi sat at his home, forcing him to take Miu's medicine. The first decoction did not move, the second did not move, but unlike other decoctions, it did not cause vomiting. After three doses, suddenly there was a sound like an explosion below the heart; above, he belched; below, he urinated involuntarily. Upper and lower pathways became clear. He immediately asked for porridge and ate three or four bowls without rebellion. After five or six doses, reducing Ren Shen by two qian caused the belching and rebellion to recur; returning to six qian brought peace. Only after one month was Ren Shen reduced by two qian. After half a year, full recovery was achieved. Prescription: Ren Shen (six qian), Maidong (Ophiopogonis Radix, three qian), Wuweizi (Schisandrae Fructus, two qian), Juhong (Citri Reticulatae Pericarpium, one qian), Sharen (Amomi Fructus, one qian), Baishao (Paeoniae Radix Alba, two qian), Chenxiang (Aquilaria Lignum, five fen), Yizhiren (Alpiniae Oxyphyllae Fructus, one qian and five fen), Shanzhuyu (Corni Fructus, three qian), Suzi (Perillae Fructus, two qian), Pipaye (Eriobotryae Folium, three large slices). Decoct in water, add Chenxiang juice (fifteen spoons) and Nishui Lugenzhi (Reed Rhizome Juice from reverse-flowing water, one large cup) just before drinking. For long-term maintenance, ten times the amount was ground into powder, formed into pills with Yam paste, and swallowed with warm water on an empty stomach. (From *Guang Biji*.)
A woman from Liangxi felt a lump in her throat obstructing up and down, with rigid pain front and back. She was cured after twenty doses of Miu Zhongchun's formula. Prescription: Jiangxiang (Daemonorops Draconis Resina), Tongcao (Tetrapanacis Medulla), Suzi, Juhong, Pipaye, Ren Shen, Zhi Gancao, Shichangpu (Acori Tatarinowii Rhizoma), Maidong, Ganju (Chrysanthemi Flos), Baishao, Yuanzhi (Polygalae Radix), Baidouren (Arecae Semen), Mugua (Chaenomelis Fructus), Shihu (Dendrobii Caulis), plus Lugenzhi (Reed Rhizome Juice, one bell) decocted together to eight-tenths volume, adding Ginger Juice (two spoons). (Ibid.)