Chapter 10, Stomach pain, fullness, Shan, Hosting-food

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 腹满寒疝宿食病脉证并治第十

Chapter 10, Stomach pain, fullness, Shan, Hosting-food, their symptoms, pulse and treatment


趺阳脉微弦,法当腹满,不满者必便难,两胠疼痛,此虚寒从下上也,当以温药服之。

If the Fuyang pulse is slight string, the person should have bloating and fullness in the abdomen. If no fullness in the abdomen, he must have constipation, pain in the side of upper abdomen. This is due to the weakness and cold from the Lower Jao Cavity (the Liver system). Use warm herbs to solve the problem.[1]

腹满时减,复如故,此为寒,当与温药。(厚朴生姜甘草半夏人参汤主之)

If the person feels fullness in the abdomen, and the fullness comes and goes, it is a Cold condition in the abdomen, use warm herb therapy (use Houpo Shenjiang Gancao Banxia Renshen Tang). [2]


厚朴生姜甘草半夏人参
汤方

Houpo Shenjiang Gancao Banxia Renshen Tang


厚朴
半斤,生姜半斤,半夏半斤,人参一两,甘草(炙)三两

Houpo 125 gram, fresh ginger 125 gram, Banxia 125 gram, Renshen 15 gram, Gancao (processed) 45 gram.


右五味,以水一斗,煮取三升,去滓,温服一升,日三服。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 750 ml left. Collect the tea. Drink one third of the tea each time, three times a day.


腹满不减,减不足言,当须下之,宜大承气汤。

If the person have had the warm herbal therapy, the abdomen fullness feeling does not reduce, or reduce very little, use bowel-cleansing therapy, use Da Chengqi Tang.


大承气汤方(见前痉病中)

Da Chengqi Tang (see the formula in the Jing disease)


病者腹满,按之不痛为虚,痛者为实,可下之。舌黄未下者,下之黄自去。

If the person has fullness in the abdomen, and if he feels pain when press his abdomen, the condition belongs to a Fullness condition; if he has no pain when press, the condition belongs to a Weakness condition. For the Fullness condition, use bowel-cleansing therapy. If he has yellow tongue covering, the color will disappear after the bowel cleansing.

病者痿黄,燥而不渴,胃中寒实[3]而利不止者,死。

If the person looks withered and yellow skin color, feels dry mouth but not thirsty, it belongs to Cold-Fullness condition. In such condition, if the person has continuous diarrhea, he is to die.[4]

夫瘦人,绕脐痛,必有风冷,谷气不行,而反下之,其气必冲,不冲者,心下则痞。

For skinny person, if he has pain around the naval, he has Wind and Cold in the stomach. The Guqi in the body does not move properly in the abdomen. If a bowel-cleansing therapy is used, the Xieqi will come to push up, if it does not push up, will stay in the abdomen to cause fullness condition. [5]


寸口脉弦者,肋下拘急而痛,其人啬啬恶寒也。

 For above person, if his pulse is string on the Chun position, he will has spasm or pain on the side of the upper abdomen. He feels chilly. (This is a condition needing warm herbal therapy).


夫中寒家,喜欠,其人清涕出,发热色和者,善嚏。

For person who is easy to be attacked by Cold Xieqi, tends to have yawn and have clear running nose[6]. If he has fever but the face color does not change, he will also tend to sneeze.


中寒,其人下利,以里虚也,欲嚏不能,此人肚中寒。(一云痛)

When attacked by Cold, the person has diarrhea. This is because a weakness condition inside of the body. If he has a willing to sneeze but can not sneeze, the Cold is in the abdomen. [7]

 
腹中寒气雷鸣切痛,胸逆满,呕吐,附子粳米汤主之。

If the person has Cold in the abdomen, has strong noise due to intestine movement, has cutting pain in stomach, feels fullness in chest, has nausea, use Fuzi Genmi Tang.
 

附子梗米汤方

附子(炮)一枚,半夏  半升,甘草  一两,大枣  十枚,粳米  半升

Fuzi 25 gram, Banxia 65 gram, Gancao 15 gram, Chinese date 10 badges, Genmi 65 gram.  

右五味,以水八升,煮米熟汤成,去滓,温服一升,日三服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until the Genmi is eatable. Remove the reside. Collect the herbal tea. Drink one third of the tea each time, three times a day.


心胸中大寒痛,呕不能饮食,腹中寒,上冲,皮起出见有头足,上下痛不可触近,大建中汤主之。

When the person has strong Cold in the chest, he feels nausea and hard to eat, feels cold in abdomen, feels air pushing up feeling. In the abdomen, it can be seen a rise of the skin, as seems has a head and feet there. Due to the pain in the abdomen, the person refuses to allow the touch on his abdomen. In this case, use Da Jianzhong Tang.

大建中汤方

Da Jianzhong Tang


蜀椒(去汗)二合,干姜  四两,人参  二两

Shujiao 10 gram, Ganjiang 60 gram, Renshen 30 gram.


右三味,以水四升,煮取二升,去滓,内胶饴一升,微火煎取一升半,分温再服,如一爨顷,可饮粥二升,后更服,当一日食糜温覆之。

Add the Shujiao and Renshen and 1000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 500 ml herbal tea left. Remove the residue, add the Jiaoyi 250 ml, keep in mild boiling until the total volume is about 300 ml. Drink one third of the tea when the tea is warm. After about 30 min, eat rise soup 500 ml. After about 3 to 4 hours, drink the second one third of the tea. Always eat the rice soup and cover the body to warm.
       

寒气厥逆,赤丸主之。

If the Cold is strong and causes Jue condition (cold hands and feet, the cold develops reverse up towards the body stem), use Chiyuan Tang.

 【按】此条之文、之方,必有简脱,难以为后世法,不释。



茯苓 
四两,半夏(洗)四两(一方用桂,)乌头(炮)二两,细辛  一两

Fuling 60 gram, Banxia (washed) 60 gram, Wutou (processed) 30 gram, Xixin 15 gram.


右四味,末之,真朱为色炼丸,丸如麻子大,先食,酒饮下三丸,日再夜一服。不知稍增之,以知为度。

Prepare the herbs into pills as 0.5 cm in diameter. Eat three pills after food, with the help of wine for swallow. Eat once more in the day time and once at night. If the person feels no slight dizzy or slight cloud in the mind after taking the pills, increase the number of the pill each time until he feels such healing effect.


(
)痛而闭者,厚朴三物汤主之。

If the person has pain in the stomach and has no bowel movement, use Houpo Sanwu Tang[8].


厚朴
三物汤方

Houpo Sanqu Tang


厚朴 
八两,大黄  四两,枳实  五枚

Houpo 125 gram, Dahuang 60 gram, Zhishi 5 badges


右三味,以水一斗二升,先煮二味,取五升,内大黄,煮取三升,温服一升,以利为度。

Add the Houpo and Zhishi and 3000 ml water in a herbal pot. Bring to boil and keep in mild boiling until there is about 1250 ml herbal tea left. Add the Dahuang in. Continue to boiling until there is about 750 ml left. Collect the tea. Drink one third of the tea each time, three times a day, until there is bowel movement.


其脉数而紧,乃弦,状如弓弦,按之不移。脉弦数者,脉紧大而迟者,必心下坚, 当下其寒。脉大而紧者,阳中有阴,可下之。

If the pulse is tight, big and slow, the person must have hardness feeling (hardness also when touch) on the upper abdomen. This is due to Cold in the stomach. For the pulse of big and tight, it means there is Yin within the Yang. Big pulse means Yang Fullness, and tight pulse suggests Yin Fullness, so that a bowel-cleansing therapy can be used.  


(
)下满痛,发热,其脉紧弦,此寒也,宜温药下之,以大黄附子汤。

If the person feels fullness and pain in the side of upper abdomen and his pulse is tight and string, it is a Cold condition. Use warm therapy with Dahuang Fuzi Tang


 大黄附子
汤方

Dahuang Fuzi Tang


大黄 
三两,附子(炮)三枚,细辛  二两

Dahuang 45 gram, Fuzi (processed) 3 badges, Xixin 30 gram


右三味,以水五升,煮取二升,分温三服,若强人煮取二升半,分温三服,服后如人行四、五里,进一服。

Add the herbs and 1250 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 500 ml herbal tea left. Collect the tea. Drink one third of the tea each time, three times a day. For person with strong body ship, collect 600 ml herbal tea, separate it into four parts. Drink one fourth of the tea each time for three time with 2 to 3 hours interval. After about 1 hour, drink the last part.


病腹满,发热,十日脉浮而数,饮食如故,厚朴七物汤主之。

If the person has fullness in the abdomen and has fever, such condition lasts up to ten days with floating and frequent pulse, normal appetite, use Houpo Qiwu Tang.


厚朴
七物汤方

Houpo Qiwu Tang


厚朴 
半斤,甘草  三两,大黄  二两,大枣  十枚,枳实  五枚,桂枝  二两,生姜  五两

Houpo 125 gram, Gancao 45 gram, Dahuang 30 gram, Chinese date 10 badges, Zhishi 5 badges, Guizhi 30 gram, fresh ginger 78 gram.


右七味,以水一斗,煮取四升,温服八合,日三服。呕者加半夏五合。下利去大黄
寒多者,加生姜至半斤。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep it in mild boiling until there is about 1000 ml herbal tea left. Drink 200 ml of the tea each time, three times a day. If there is nausea, add Banxia 65 gram; whit diarrhea, remove Dahuang; with more cold, add the fresh ginger to 125 gram.


按之心下满痛者,「有潮热」,  此为实也,当下之,宜大柴胡汤。

If the person has fullness and pain on his upper stomach upon pressing, (and he has wave-hot), the condition belongs to Fullness, should use depletion therapy, use Da Chaihu Tang

 
 
柴胡汤方

Da Chaihu Tang


柴胡 
半斤,黄芩  三两,芍药  三两,半夏(洗)半斤,枳实(炙)四枚,大黄  二两,  大枣  十二枚,生姜  五两

Chaihu 125 gram, Huangqin 45 gram, Shaoyao 45 gram, Banxia (wash) 125 gram, Zhishi (processed) 4 badges, Dahuang 30 gram, Chinese date 12 badges, fresh ginger 78 gram.


右八味,以水一斗二升,煮取六升,去滓再煎,温服一升,日三服。

Add the herbs and 3000 ml water into a herbal pot. Bring to boil and keep it in mild boiling until there is about 1500 ml herbal tea left. Remove the residue and continue to boiling until there is 750 ml herbal tea left. Drink 250 ml of the tea each time, three times a day. 


腹痛,脉弦而紧,弦则卫气不行,即恶寒,紧则不欲食,邪正相抟,即为寒疝。绕脐痛苦,发则自汗出,手足厥冷,其脉沉紧者,大乌头煎主之。

If the person has pain in the abdomen, pulse is string and tight, the string pulse suggests the Weiqi does not move properly, e.g. the person feels chilly; the tight pulse means loss of appetite. All of these cause Cold Shan[9]. The person feels pain around the naval, and has sweat and feels cold in the hands and feet when the pain comes. In such Cold Shan disease, use Da Wutou Jian.


乌头煎方

Wutou Jian


乌头(熬,去皮,不咀)大者五枚

Wutou (processed, remove peel), big size, 5 badges.


右以水三升,煮取一升,去滓,内蜜二升,煎令水气尽,取二升,强人服七合,弱人服五合,不差明日更服,不可一日再服。

Add the herb and 750 ml water into herbal pot. Bring to boil and keep in mild boiling until there is 250 ml left. Remove the residue, add 500 ml honey in, continue to boiling until there is no water vapor comes. Collect 500 ml. For person with strong body ship, drink 175 ml; for person with skinny body shape, drink 125 ml. If the symptom does not improve, repeat the drinking next day, not the same day any more.


寒疝,腹中痛,及痛里急者,(其脉沉紧者,)  当归生姜羊肉汤主之。

For person with the Cold Shan disease has pain in stomach and he feels need to go to washroom for bowel movement when feels pain, and if the pulse is deep and tight, use Danggui Shenjiang Yangrou Tang.

当归生姜羊肉汤方

Danggui Shenjiang Yangrou Tang


当归 
三两,生姜  五两,羊肉  一斤

Danggui 45 gram, fresh ginger 78 gram, lamb 250 gram.


右三味,以水八升,煮取三升,温服七合,日三服。若寒多者,加生姜成一斤。痛多而呕者,加橘皮二两,白术一两。加生姜者,亦加水五升,煮取三升二合,服之。

Add the herb and 2000 ml water into herbal pot. Bring to boil and keep in mild boiling until there is 750 ml left. Drink one third of the tea each time, three times a day. If there is more Cold, add fresh ginger to 250 gram; if there is more pain and nausea, add orange peel 30 gram and Baishu 15 gram. When the fresh ginger is added, the water used should be 1250 ml more and cook to collect 800 ml tea.


寒疝,腹中痛,逆冷,手足不仁,若身疼痛,灸刺、诸药不能治,抵当乌头桂枝汤主之。

Cold Shan disease, the person feels pain in the abdomen, feels cold in hands and feet, numb in hands and feet. If he also feels pain in the body and acupuncture, moxibustion and herbal therapy, all fail to solve the problem, try Wutou Guizhi Tang.


乌头桂枝汤方

Wutou Guizhi Tang


乌头五枚

Wutou 5 badges.


右一味,以蜜二斤,煎减半,去滓,以桂枝汤五合解之,令得一升,初服二合不知,即服三合;又不知,复加至五合。其知者如醉状,得吐者为中病。

Add the Wutou and honey 500 ml. Bring to boil until there is about 150 ml honey left in the pot. Remove the herb residue, add 125 ml in and mix it well. Drink 50 ml of the mixture, hoping the person has healing feeling.[10] If no such healing feeling, drink another 75 ml. If sill no such feeling, drink another 125 ml. If the person has vomiting, it suggests the herb starts to work.


问曰:人病有宿食,何以别之?师曰:寸口脉浮而大,按之反涩,尺中亦大而涩,故知有宿食,大承气汤主之。

Asked: how do we know if a person has hosting food in the abdomen?[11] Master: if the pulse is floating and big in the Chun position, but it is harsh when pressed deep; the pulse is big and harsh on the Chi position, all indicating the hosting-food condition in the abdomen. Use Da Chengqi Tang.

 脉数而滑者,实也,此有宿食,下之愈,宜大承气汤。

If the pulse is frequent and slippery, it is a Fullness condition, indicating a food-hosting condition.
Use bowel-cleansing therapy with Da Chengqi Tang.

下利不欲食者,有宿食也,当下之,宜大承气汤。

If a person has diarrhea but no appetite, it indicates a food-hosting condition, use bowel-cleansing therapy with Da Chengqi Tang. [12]


宿食在上脘,当吐之,宜瓜蒂散。

If the hosting-food is accumulated in the upper abdomen (Shangyuan), vomiting therapy should be used. Use Guadi San.[13]

瓜蒂散方

Guadi San


瓜蒂
(熬黄)一分,   赤小豆(煮)一分

Guadi (process to yellow color) 4 gram, Chixiaodou 4 gram.


右二味,杵为散,以香鼓七合煮取汁,和散一钱匕温服之,不吐者少加之,以快吐为度而止。亡血及虚者,不可与之。

Grind the herbs into powder. Cook Xiangchi 140 gram in water. Drink 1.5 gram of the powder with the Xiangchi juice. If the person has vomit, stop to drink more powder. If not, add more powder each time. This therapy should not be used in person with bleeding and with weakness condition.


脉紧如转索无常者,有宿食也。

If the pulse is tight and turns and twists as a string, it indicates the hosting-food condition.


脉紧,头痛风寒,腹中有宿食不化也。(一云寸口脉紧)

If the pulse is tight, the person feels Cold-invasion headache, it indicates the presence of hosting-food condition.



[1] Fuyang pulse refers to the pulse in front of the feet. String pulse here suggests the overwhelming of the Liver over the Spleen to cause fullness in the abdomen. If no fullness, the disease in the Liver system remains to its own meridian system, so the person feels pain in the side of the upper abdomen.

[2] If the person feels both fullness and hard bowel movement, it is a condition of Spleen Fullness condition. If he has only fullness but no hard stool, it is a Spleen weakness condition.

[3] In original version, it is Cold-Fullness condition in the chest.

[4] Withered condition with yellow color on skin suggests Spleen disease. If the person feels dry in mouth and thirsty, the condition belongs to Fire; if he does not feel thirsty, the condition belongs to Cold. The Cold condition is accompanied with the diarrhea, suggesting the depletion of the Spleen Qi, so he is to die.

[5] Skinny person is weak in the stomach and is easy to be attacked by Wind and Cold. The Wind and Cold influences the normal Guqi metabolism in the stomach to cause the pain around the naval. It seems a inside Fullness condition, but actually a Weakness-Cold condition. Warm herb therapy should be used. If not so, but a bowel-cleansing therapy is used, the food is out of the body, but not the Wind and Cold. The body becomes more weak so the Xieqi is relatively more strong, to move up. If the Xieqi does not push up, it will remain in the abdomen to cause a fullness condition.

[6] Yawn and clear running nose: Yang deficiency in the Chest.

[7] Last paragraph tells the symptoms for Cold in chest. This paragraph tells that for Cold in the abdomen.

[8] If the person feels fullness and pain in the stomach, has diarrhea, use Lizhong Tang to warm the abdomen. If the person feels fullness and pain in the stomach, has no

[9] Shan disease: the hernia condition in western medicine is similar to the Shan disease here.

[10] Healing feeling: the person feels cloudy mind as in drunken.

[11] Hosting food condition: the food stays in the abdomen without digestion.

[12] If the person has acute diarrhea and dislikes to eat anything, it is due to a wrong food eating. If he has chronic diarrhea without appetite, it is a Spleen deficiency, in which the Spleen system does not work to digest the food; if he has acute diarrhea, and has no appetite, this condition suggests the presence of a hosting-food in the abdomen, so the Da Chengqi Tang should be considered. Note: the feeling of dislike-food (people refuse to eat for worry the discomfort from eating) is different from “have no appetite”(people can still eat).

[13] The abdomen is separated into three parts: the upper part (Shangyuan), the middle part (Zhongyuan) and the lower part (Xiayuan). If the hosting-food stays in the upper part, use vomiting therapy; in the middle part, use either vomiting or bowel-cleansing therapy; in the lower part, only use the bowel-cleansing therapy.