寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Abdomen

Bok

한글 복  ·  Pinyin Fu

Where the pain is and what it answers to — the belly divided into three grounds, the six causes of a pain there, and the one question that sorts them: does pressing make it better or worse

腹

A chapter about pain in the belly, organized by where and why. The abdomen divides into three grounds and each has its channel: the great abdomen above the navel is the greater yin, the navel region the lesser yin, the lower abdomen the reverting yin — and Dongwon names a formula for each before any cause is known. Then six causes: cold, heat, dead blood, food, phlegm and worms, each with its own sign. Cold pain is unbroken and does not let up; heat pain comes and goes; blood pain stays in one place and worsens under the hand; food pain eases once the bowel moves; worm pain starts and stops without pattern and brings up clear froth. The chapter's single most useful line is the one that cuts across all of them — press the belly, and if the pain worsens it is repletion, and if it eases it is vacuity — with the Jasaeng's refinement that a light press hurting and a firm press easing means qi, while a firm press hurting on something hard means an accumulation. There is a farmer who slept out drunk one night and had a stabbing pain for years after, a chemical hand-warmer of damp iron filings that can be recharged ten times, and at the end the rule that a bad abdominal pain is opened rather than soothed: the pain lessens as the bowel does.

3.1 The Measurements of the Abdomen 腹圍度數

3.1.1
Source원문

𩩲骬以下至天樞, 長八寸. 天樞二穴, 正當臍兩傍各二寸. 天樞以下至橫骨, 長六寸半. 橫骨長六寸半. 《靈樞》

Translation영역
From the xiphoid down to Cheonchu is eight chon. The two Cheonchu points lie exactly two chon to either side of the navel. From Cheonchu down to the pubic bone is six and a half chon; the pubic bone is six and a half chon across.

Yeongchu 靈樞

3.2 The Abdomen Has a Greater and a Lesser 腹有大小

3.2.1
Source원문

臍之上曰大腹, 臍之下曰小腹.

Translation영역
Above the navel is called the great abdomen; below the navel, the lesser abdomen.

Donguibogam · Bok

3.2.2
Source원문

小腹, 謂臍下兩傍髖骨內也. 《內經註》

Translation영역
The lesser abdomen means below the navel, inside the hip bones on either side.

Naegyeong-ju 內經註

3.2.3
Source원문

脾胃主中州, 大腹小腹是其候也. 《類聚》

Translation영역
The spleen and stomach govern the central region, and the great and lesser abdomen are where they are read.

Yuchwi 類聚

3.3 Abdominal Pain Has Its Divisions 腹痛有部分

3.3.1
Source원문

大腹屬太陰, 臍腹屬少陰, 小腹屬厥陰. 《入門》

Translation영역
The great abdomen belongs to the greater yin, the navel region to the lesser yin, the lesser abdomen to the reverting yin.
Clinical note임상 주석
Three bands of belly and three channels, from the ribs to the pubis. It is the chapter's first move and a good one: before asking why a belly hurts, ask where.

Immun 入門

3.3.2
Source원문

腹痛有部分. 中脘痛, 太陰也, 理中湯方見寒門ㆍ加味小建中湯ㆍ草豆蔲丸方見胸部之類主之. 臍腹痛, 少陰也, 四逆湯ㆍ薑附湯或五積散三方幷見寒門加吳茱萸主之. 小腹痛, 厥陰也, 當歸四逆湯方見寒門加吳茱萸主之. 《東垣》

Translation영역
Abdominal pain has its divisions. Pain at the middle cavity is the greater yin: Regulate the Centre Decoction formula in the Cold Damage chapter, Supplemented Minor Fortify the Centre Decoction and Round Cardamom Pill formula in the Chest chapter and their kind govern it. Pain of the navel region is the lesser yin: Counterflow Cold Decoction, Ginger and Aconite Decoction, or Five Accumulations Powder all three in the Cold Damage chapter with evodia added govern it. Pain of the lesser abdomen is the reverting yin: Angelica Counterflow Cold Decoction formula in the Cold Damage chapter with evodia added governs it.

Dongwon 東垣

3.3.3
Source원문

大腹痛, 多食積外邪. 臍腹痛, 多積熱痰火. 小腹痛, 多瘀血及痰與尿澁. 《入門》

Translation영역
Pain of the great abdomen is mostly food accumulation and an outside evil; pain of the navel region mostly accumulated heat and phlegm fire; pain of the lesser abdomen mostly static blood, or phlegm, or rough urination.

Immun 入門

3.3.4
Source원문

從心下至小腹皆硬滿而痛者, 是邪實也, 須以大陷胸湯方見寒門下之. 若小腹硬滿而痛, 小便利則是蓄血之證, 小便不利則尿澁之證也. 《正傳》

Translation영역
Where from below the heart down to the lesser abdomen all is hard, full and painful, the evil is replete and Major Sinking into the Chest Decoction formula in the Cold Damage chapter should purge it. Where the lesser abdomen is hard, full and painful, if the urine passes freely it is blood amassment; if the urine does not pass, it is a rough-urination pattern.
Clinical note임상 주석
One question separates two diseases with the same belly: a hard, tender lower abdomen with normal urination is blood, with retention it is the bladder. The Urine chapter's 1.7.6 teaches the same test from the other side.

Jeongjeon 正傳

3.4 The Pulse 脉法

3.4.1
Source원문

尺脉弦則腹痛. 《醫鑑》

Translation영역
Where the cubit pulse is stringlike there is abdominal pain.

Uigam 醫鑑

3.4.2
Source원문

脉細小緊急, 腹中刺痛. 陰弦則腹痛. 弦急小腹痛. 尺脉緊, 臍下痛. 尺脉伏或實, 小腹痛. 《脉經》

Translation영역
A pulse fine, small, tight and urgent means stabbing pain within the abdomen. A stringlike yin pulse means abdominal pain. Stringlike and urgent means lesser abdominal pain. A tight cubit pulse means pain below the navel. A hidden or replete cubit pulse means lesser abdominal pain.

Maekgyeong 脉經

3.4.3
Source원문

心腹痛不得息, 脉細小遲者生, 堅大疾者死. 腹痛脉反浮大而長者死. 《脉經》

Translation영역
In pain of heart and abdomen that gives no rest, a pulse fine, small and slow means life; firm, large and swift means death. In abdominal pain, a pulse that is instead floating, large and long means death.
Clinical note임상 주석
The reverse of the Urine chapter's rule. There a strong pulse in a blocked bladder was good; here a large swift pulse in a belly that will not stop hurting is the bad sign — the body answering a pain it cannot contain.

Maekgyeong 脉經

3.4.4
Source원문

心腹痛, 脉沈細宜, 浮大弦長, 命必殂. 《脉訣》

Translation영역
In pain of heart and abdomen a sunken fine pulse is fitting; floating, large, stringlike and long, and the life must end.

Maekgyeol 脉訣

3.5 Abdominal Pain Has Six Causes 腹痛有六

3.5.1
Source원문

有寒, 有熱, 有死血, 有食積, 有痰飮, 有蟲.

Translation영역
There is cold, heat, dead blood, food accumulation, phlegm rheum, and worms.

Donguibogam · Bok

3.5.2
Source원문

氣血痰水食積風冷諸證之痛, 每每停聚而不散. 惟蟲痛則乍作乍止, 來去無定, 又有嘔吐淸沫之爲可驗焉. 《直指》

Translation영역
The pains of qi, blood, phlegm, water, food accumulation and wind cold all gather and stay and do not scatter. Only worm pain starts and stops by turns, coming and going without fixed rule, and there is vomiting of clear froth besides, by which it may be confirmed.
Clinical note임상 주석
乍作乍止, 來去無定 — coming and going with no rule. The Worms chapter's 14.6 gave the same two signs, the intermittent pain and the clear froth, and both are right: ascaris colic is episodic and brings up clear fluid.

Jikji 直指

3.5.1 Cold Abdominal Pain 寒腹痛

3.5.1.1
Source원문

寒氣客於脉外則脉寒, 脉寒則縮踡, 縮踡則脉絀急, 絀急則外引小絡, 故卒然而痛. 因重中於寒, 則痛久矣. 《內經》

Translation영역
Where cold qi lodges outside the vessels the vessels are cold; cold, they shrink and curl; shrunk and curled, the vessels are drawn taut; drawn taut, they pull outward on the small networks, and so there is sudden pain. Where the cold is taken in a second time, the pain lasts long.

Naegyeong 內經

3.5.1.2
Source원문

寒氣客於背兪, 其兪注于心, 故相引而痛. 《內經》

Translation영역
Where cold qi lodges at the back transport points, those transport points pour into the heart, and so they draw on each other and there is pain.

Naegyeong 內經

3.5.1.3
Source원문

寒氣客於厥陰之脉, 則血澁脉急, 故脇肋與小腹相引痛矣. 《內經》

Translation영역
Where cold qi lodges in the reverting yin channel, the blood runs rough and the vessels tighten, and so the flank and ribs and the lesser abdomen draw on each other with pain.

Naegyeong 內經

3.5.1.4
Source원문

寒氣客於五藏, 厥逆上泄, 陰氣竭, 陽氣未入, 故卒然痛死不知人. 氣復反則生矣. 《內經》

Translation영역
Where cold qi lodges in the five viscera, it counterflows and discharges upward; the yin qi is exhausted and the yang qi has not yet entered, and so there is sudden pain and one faints as if dead and knows no one. When the qi returns, one lives.
Clinical note임상 주석
卒然痛死不知人 — sudden pain and a faint like death. Syncope from severe visceral pain, and the Suwen's account of why it passes: the qi comes back. It is what a vasovagal faint does.

Naegyeong 內經

3.5.1.5
Source원문

綿綿痛而無增減者, 寒痛也. 《丹心》

Translation영역
A pain that goes on unbroken without increase or decrease is cold pain.

Dansim 丹心

3.5.1.6
Source원문

寒痛, 宜厚朴溫中湯ㆍ桂香散ㆍ溫胃湯方見胸部ㆍ沈香磨脾散ㆍ酒煮當歸丸方見婦人ㆍ代灸塗臍膏方見臍部ㆍ玉抱肚. 冒寒卒痛, 五積散方見寒門加吳茱萸ㆍ葱白. 《入門》

Translation영역
For cold pain: Magnolia Bark Warm the Centre Decoction, Cinnamon and Aromatics Powder, Warm the Stomach Decoction formula in the Chest chapter, Aloeswood Grind the Spleen Powder, Wine-Boiled Angelica Pill formula in the Women chapter, Moxa-Substitute Navel Paste formula in the Navel chapter and Jade Belly-Warmer. For sudden pain from braving the cold, Five Accumulations Powder formula in the Cold Damage chapter with evodia and scallion white added.

Immun 入門

3.5.2 Heat Abdominal Pain 熱腹痛

3.5.2.1
Source원문

熱氣留於小腸, 小腸中痛, 癉熱焦渴則堅乾不得出, 故痛而閉不通矣. 《內經》

Translation영역
Where hot qi stays in the small intestine there is pain within it; with pure heat and parching thirst the stool hardens and dries and cannot come out, and so there is pain and blockage.

Naegyeong 內經

3.5.2.2
Source원문

時痛時止者, 熱也. 《丹心》

Translation영역
A pain that comes at times and stops at times is heat.

Dansim 丹心

3.5.2.3
Source원문

腹中常覺有熱而暴痛暴止, 此爲積熱, 宜調胃承氣湯方見寒門下之. 《正傳》

Translation영역
Where the abdomen constantly feels hot and the pain breaks out and stops abruptly, this is accumulated heat, and Regulate the Stomach and Order the Qi Decoction formula in the Cold Damage chapter should purge it.

Jeongjeon 正傳

3.5.2.4
Source원문

積熱腹痛, 時作時止, 痛處亦熱, 手不可近, 便閉喜冷, 宜調胃承氣湯ㆍ四順淸凉飮方見火門. 《入門》

Translation영역
In abdominal pain from accumulated heat, it comes and goes, the painful place is hot and the hand cannot come near it, the stool is bound and cold things are liked: Regulate the Stomach and Order the Qi Decoction and Four Obediences Cooling Drink formula in the Fire chapter are appropriate.
Clinical note임상 주석
手不可近 — the hand cannot come near. Guarding: the patient will not let the belly be touched, and the chapter takes it as the mark of a hot, replete pain that must be opened rather than warmed.

Immun 入門

3.5.2.5
Source원문

熱痛, 宜黃芩芍藥湯方見大便.

Translation영역
For heat pain, Scutellaria and Peony Decoction formula in the Stool chapter is appropriate.

Donguibogam · Bok

3.5.3 Abdominal Pain from Dead Blood 死血腹痛

3.5.3.1
Source원문

瘀血腹痛有常處, 或跌撲傷損, 或婦人經來産後惡瘀未盡下而凝. 四物湯方見血門去地黃, 加桃仁ㆍ大黃ㆍ紅花. 《入門》

Translation영역
Abdominal pain from static blood has a fixed place; it comes either from a fall or a blow, or in a woman from menstruation or childbirth where the foul stasis has not all come down and has congealed. Four Substances Decoction formula in the Blood chapter with the rehmannia removed and peach kernel, rhubarb and safflower added.

Immun 入門

3.5.3.2
Source원문

其痛有常處而不移動者, 是死血也. 《丹心》

Translation영역
A pain that has a fixed place and does not move is dead blood.

Dansim 丹心

3.5.3.3
Source원문

如打撲墜墮而腹痛, 乃是瘀血, 宜桃仁承氣湯方見寒門加當歸ㆍ蘇木ㆍ紅花, 入童便幷酒煎服下之. 《丹心》

Translation영역
Where abdominal pain follows a blow or a fall, it is static blood: Peach Kernel Order the Qi Decoction formula in the Cold Damage chapter with angelica, sappan and safflower added, decocted with child's urine and wine and taken to purge it.

Dansim 丹心

3.5.3.4
Source원문

血痛, 宜失笑散方見婦人ㆍ消瘀飮ㆍ萬靈散.

Translation영역
For blood pain, Sudden Smile Powder formula in the Women chapter, Disperse Stasis Drink and Ten Thousand Spirits Powder are appropriate.

Donguibogam · Bok

3.5.4 Abdominal Pain from Food Accumulation 食積腹痛

3.5.4.1
Source원문

脉弦者, 食積痛, 宜溫散之. 《丹心》

Translation영역
Where the pulse is stringlike it is food accumulation pain, and it should be warmed and dispersed.

Dansim 丹心

3.5.4.2
Source원문

在上者多屬食, 食能作痛, 宜溫散之, 如乾薑(炒)ㆍ蒼朮ㆍ川芎ㆍ白芷ㆍ香附ㆍ薑汁之類. 不可妄用峻利藥攻下. 盖食得寒則凝, 得熱則化, 更兼行氣快氣藥助之, 無不愈者. 《丹心》

Translation영역
What lies above mostly belongs to food, and food can make pain; it should be warmed and dispersed with such things as dried ginger (stir-fried), atractylodes lancea, chuanxiong, angelica dahurica, cyperus and ginger juice. Harsh purging medicines must not be used recklessly to attack downward. Food meeting cold congeals and meeting heat transforms; add medicines that move and quicken the qi to help, and there is none that does not heal.
Clinical note임상 주석
食得寒則凝, 得熱則化 — food meeting cold congeals, meeting heat transforms. Danxi's argument against purging a food pain: warm it and it moves itself. The rule is a plain observation about fat in a cold pan.

Dansim 丹心

3.5.4.3
Source원문

痛甚欲大便, 利後痛減者, 是食積也. 《丹心》

Translation영역
Where the pain is severe and one wants the bowel to move, and the pain lessens after it does, it is food accumulation.

Dansim 丹心

3.5.4.4
Source원문

食積痛, 平胃散方見內傷加山査ㆍ神麴ㆍ麥芽ㆍ縮砂ㆍ靑皮, 或加味二陳湯方見痰飮調之, 木香檳榔丸或利氣丸下之. 《入門》

Translation영역
For food accumulation pain, Level the Stomach Powder formula in the Internal Damage chapter with crataegus, medicated leaven, barley sprout, amomum and green tangerine peel added, or Supplemented Two Matured Ingredients Decoction formula in the Phlegm chapter to regulate it; and Costus and Areca Pill or Free the Qi Pill to purge it.

Immun 入門

3.5.4.5
Source원문

食物塡塞心胸作痛, 宜吐之, 用瓜蔕散方見吐門ㆍ薑鹽湯. 《入門》

Translation영역
Where food fills and blocks the heart and chest and makes pain, it should be ejected: use Melon Pedicel Powder formula in the Ejection chapter or ginger and salt decoction.

Immun 入門

3.5.4.6
Source원문

食積腹痛, 宜服丁香脾積丸. 《丹心》

Translation영역
For abdominal pain from food accumulation, Clove Spleen Accumulation Pill should be taken.

Dansim 丹心

3.5.5 Abdominal Pain from Phlegm Rheum 痰飮腹痛

3.5.5.1
Source원문

凡腹痛脉滑者是痰, 宜導痰解鬱. 《丹心》

Translation영역
Where in abdominal pain the pulse is slippery it is phlegm, and the phlegm should be guided out and the depression resolved.

Dansim 丹心

3.5.5.2
Source원문

淸痰多作腹痛, 川芎ㆍ蒼朮ㆍ香附ㆍ白芷爲末, 薑汁和湯點服. 《丹心》

Translation영역
Clear phlegm often makes abdominal pain: powder chuanxiong, atractylodes lancea, cyperus and angelica dahurica, and take stirred into hot water with ginger juice.

Dansim 丹心

3.5.5.3
Source원문

痰痛者必小便不利. 又云, 痛則小便不利者, 痰也. 《丹心》

Translation영역
In phlegm pain the urine will surely not pass freely. It is also said: where there is pain and the urine does not pass freely, it is phlegm.

Dansim 丹心

3.5.5.4
Source원문

濕痰阻滯氣道而作痛, 宜芎朮散. 淸痰作痛, 胸腹有聲, 宜控涎丹方見痰飮. 《入門》

Translation영역
Where damp phlegm obstructs the qi road and makes pain, Chuanxiong and Atractylodes Powder is appropriate. Where clear phlegm makes pain with a sound in chest and abdomen, Control the Drool Elixir formula in the Phlegm chapter is appropriate.

Immun 入門

3.5.5.5
Source원문

或曰痰豈能作痛. 殊不知氣鬱則痰聚, 痰聚則碍氣道, 不得運行, 故作痛. 宜芎夏湯方見痰飮ㆍ四合湯.

Translation영역
Some say: how can phlegm make pain? They fail to see that where the qi is depressed the phlegm gathers, and where the phlegm gathers it obstructs the qi road so that it cannot move, and so there is pain. Chuanxiong and Pinellia Decoction formula in the Phlegm chapter and Four Combined Decoction are appropriate.
Clinical note임상 주석
The Bogam answering an objection it expects. Phlegm does not hurt; the stalled qi behind it does — which is why every phlegm formula in the chapter carries qi movers as well.

Donguibogam · Bok

3.5.6 Abdominal Pain from Worms 蟲腹痛

3.5.6.1
Source원문

詳見蟲門.

Translation영역
Treated in detail in the Worms chapter.

Donguibogam · Bok

3.6 Abdominal Pain Has Vacuity and Repletion 腹痛有虛實

3.6.1
Source원문

凡腹痛, 按之痛者爲實, 按之不痛爲虛. 《醫鑑》

Translation영역
In abdominal pain, where pressing makes it pain it is repletion; where pressing does not make it pain it is vacuity.
Clinical note임상 주석
The chapter's most useful sentence and the one a practitioner uses first. Press the belly: worse under the hand is something to be moved, better under the hand is something to be fed.

Uigam 醫鑑

3.6.2
Source원문

腹痛按之痛, 重按却不痛者, 此是氣痛, 乃虛寒證也. 若重按愈痛而堅者, 有積也. 《資生》

Translation영역
Where the abdomen pains on pressing but on firm pressing does not pain, this is qi pain and a vacuity cold pattern. If firm pressing makes it pain the more and there is hardness, there is an accumulation.
Clinical note임상 주석
A refinement worth having: light touch hurting and deep pressure easing is qi, while deep pressure hurting on something firm is a mass. It is close to how rebound and guarding are still distinguished from a tender but soft belly.

Jasaenggyeong 資生經

3.6.3
Source원문

腹痛時, 有積者按之痛愈甚, 無積者按之不痛. 《易老》

Translation영역
In abdominal pain, where there is an accumulation pressing makes it far worse; where there is none, pressing gives no pain.

Yeokro 易老

3.6.4
Source원문

凡腹痛大便利, 或用手重按之不痛者, 爲虛爲寒, 宜加味小建中湯方見胸部ㆍ加桂理中湯方見寒門之類. 其或大便堅, 或用手按之痛甚, 手不可近者, 爲實爲熱, 宜大柴胡湯ㆍ調胃承氣湯幷見寒門之類. 《入門》

Translation영역
Where in abdominal pain the stool is loose, or firm pressure with the hand gives no pain, it is vacuity and cold: Supplemented Minor Fortify the Centre Decoction formula in the Chest chapter and Regulate the Centre Decoction with cinnamon added formula in the Cold Damage chapter and their kind. Where the stool is bound, or pressing with the hand makes it pain severely so that the hand cannot come near, it is repletion and heat: Major Bupleurum Decoction and Regulate the Stomach and Order the Qi Decoction both in the Cold Damage chapter and their kind.

Immun 入門

3.6.5
Source원문

腎虛則胸中痛, 大腹小腹痛, 淸厥, 意不樂. 《內經》

Translation영역
Where the kidney is vacuous there is pain within the chest, pain of the great and lesser abdomen, cold reversal of the limbs, and no gladness of mind.

Naegyeong 內經

3.6.6
Source원문

寒氣客於經脉之中, 與炅氣相薄則脉滿, 滿則痛而不可按也. 《內經》

Translation영역
Where cold qi lodges within the channels and presses against the hot qi, the vessels fill; filled, they pain and cannot be pressed.

Naegyeong 內經

3.6.7
Source원문

寒氣客於俠脊之脉, 則深按之不能及, 故按之無益也. 《內經》

Translation영역
Where cold qi lodges in the vessels flanking the spine, even deep pressure cannot reach it, and so pressing is of no use.

Naegyeong 內經

3.6.8
Source원문

壯實與初病宜下, 宜備急丸方見救急之類. 虛弱與久病宜和, 宜建中湯方見虛勞之類. 《入門》

Translation영역
The robust and the newly ill should be purged: Prepare for Urgency Pill formula in the Emergencies chapter and its kind. The weak and the long ill should be harmonized: Fortify the Centre Decoction formula in the Vacuity Taxation chapter and its kind.

Immun 入門

3.7 Abdominal Pain from Accumulated Cold 積冷腹痛

3.7.1
Source원문

有一田夫, 醉飽露宿一枕天明, 自此脾疼攻刺, 百藥罔功, 淹淹數載. 後遇至人, 授以和劑抽刀散, 溫酒調下數服頓愈. 則知風露之根入胃, 良薑ㆍ菖蒲爲能散其邪, 巴ㆍ猫借氣爲能伐其根也. 故有如是之驗焉. 《直指》

Translation영역
A farmer, drunk and full, slept out in the open on a single pillow until daybreak, and from then on had a stabbing spleen pain that a hundred medicines did not touch, and he dragged on for several years. Later he met a perfected man who gave him Drawn Blade Powder, and taking it a few times stirred into warm wine he was cured at once. From this one knows that the root of the wind and dew had entered the stomach: galangal and acorus can scatter the evil, and croton and blister beetle, borrowing their force, can cut down its root — hence such an effect.
Clinical note임상 주석
One night in the open, and years of pain dated from it. The Bogam keeps this kind of case because the history is the diagnosis: a patient who can name the night their pain began is telling you what caused it.

Jikji 直指

3.8 Abdominal Pain with Vomiting and Diarrhoea 腹痛嘔泄

3.8.1
Source원문

寒氣客於腸胃, 厥逆上出, 故痛而嘔也. 《內經》

Translation영역
Where cold qi lodges in the intestines and stomach and counterflows upward, there is pain and vomiting.

Naegyeong 內經

3.8.2
Source원문

寒氣客於小腸, 小腸不得成聚, 故後泄腹痛矣. 《內經》

Translation영역
Where cold qi lodges in the small intestine, the small intestine cannot gather what it holds, and so there is diarrhoea and abdominal pain.

Naegyeong 內經

3.8.3
Source원문

太陰傳少陰, 腹痛甚者, 當變下利不止. 《東垣》

Translation영역
Where the greater yin passes to the lesser yin and the abdominal pain is severe, it will turn into diarrhoea that does not stop.

Dongwon 東垣

3.8.4
Source원문

腹痛作嘔, 欲利大便, 諸藥皆吐, 惟蘇感元方見胸部用薑湯呑下最妙. 《直指》

Translation영역
Where there is abdominal pain with retching and a wish for the bowel to move, and every medicine is vomited back, only Perilla and Storax Pill formula in the Chest chapter swallowed with ginger decoction is best.
Clinical note임상 주석
諸藥皆吐 — every medicine comes back up. A pill swallowed whole with warm ginger is the one route left when nothing will stay down, and the chapter keeps it for exactly that.

Jikji 直指

3.8.5
Source원문

腹痛嘔泄, 宜理中湯ㆍ治中湯幷見寒門.

Translation영역
For abdominal pain with vomiting and diarrhoea, Regulate the Centre Decoction and Order the Centre Decoction both in the Cold Damage chapter are appropriate.

Donguibogam · Bok

3.8.6
Source원문

上熱下寒, 腹痛嘔吐, 宜黃連湯. 《入門》

Translation영역
For heat above and cold below with abdominal pain and vomiting, Coptis Decoction is appropriate.

Immun 入門

3.8.7
Source원문

腹痛欲嘔吐者, 上熱下寒也. 以陽不得降而胸熱欲嘔, 陰不得升而下寒腹痛, 是升降失常也. 《河間》

Translation영역
Abdominal pain with a wish to vomit is heat above and cold below: the yang cannot descend and so the chest is hot and one wants to vomit, the yin cannot ascend and so below is cold and the abdomen pains — this is ascent and descent gone out of order.

Hagan 河間

3.9 A Cramped Feeling in the Abdomen 腹中窄狹

3.9.1
Source원문

乃濕痰濁氣攻於心脾二藏, 升降失常, 以致自覺腹中窄狹.

Translation영역
It is damp phlegm and turbid qi attacking the two viscera of heart and spleen, so that ascent and descent go out of order and one feels the abdomen cramped within.
Clinical note임상 주석
自覺腹中窄狹 — the patient feels the belly narrow inside. A sensation with nothing to find on examination, and the chapter treats it as a real complaint rather than dismissing it.

Donguibogam · Bok

3.9.2
Source원문

肥人乃濕痰流灌藏府, 宜二陳湯加蒼朮ㆍ香附. 瘦人乃濕熱熏蒸藏府, 宜二陳湯加黃連ㆍ蒼朮. 神昏性躁, 心神不斂者, 二陳湯加遠志ㆍ麥門冬ㆍ酸棗仁. 血氣虛者, 宜以六君子湯方見痰飮加芎歸養血流濕, 自然平復. 《入門》

Translation영역
In the stout it is damp phlegm flooding the viscera and bowels: Two Matured Ingredients Decoction with atractylodes lancea and cyperus added. In the thin it is damp heat steaming the viscera and bowels: Two Matured Ingredients Decoction with coptis and atractylodes lancea added. Where the spirit is clouded and the nature restless and the heart-spirit not gathered: Two Matured Ingredients Decoction with polygala, ophiopogon and jujube kernel added. Where blood and qi are vacuous: Six Gentlemen Decoction formula in the Phlegm chapter with chuanxiong and angelica added to nourish the blood and move the damp, and it settles of itself.

Immun 入門

3.9.3
Source원문

腹中窄狹, 須用蒼朮. 《丹心》

Translation영역
For a cramped feeling in the abdomen, atractylodes lancea must be used.

Dansim 丹心

3.10 The Skin of the Abdomen Numb or Painful 腹皮麻痺或痛

3.10.1
Source원문

腹皮麻痺不仁, 多煮葱白吃之, 自愈. 《綱目》

Translation영역
Where the skin of the abdomen is numb and without feeling, boil plenty of scallion white and eat it, and it heals of itself.

Gangmok 綱目

3.10.2
Source원문

肚皮痛者, 由腎虛不能行水, 加之酒麪無度, 酒與水交聚於腹中, 而麪毒復纏滯其氣, 是以水滲於肚皮而作痛矣. 以錢氏宣風散方見小兒用蜜水煎嚥下神保元方見氣門, 候其大便流利後, 以靑木香元方見氣門一分, 安腎元方見虛勞倍之, 用二陳湯煎水空心嚥下. 脾腎氣復, 自然向安. 《直指》

Translation영역
Pain in the skin of the belly comes of the kidney being vacuous and unable to move water, with wine and wheat food taken without measure besides; wine and water gather together in the abdomen and the toxin of the wheat food further binds and stagnates the qi, so that water seeps into the abdominal skin and makes pain. Use Qian's Diffuse the Wind Powder formula in the Children chapter decocted in honey water to swallow Spirit Protecting Pill formula in the Qi chapter; when the bowel has moved freely, take one part of Green Costus Pill formula in the Qi chapter with twice as much Quiet the Kidney Pill formula in the Vacuity Taxation chapter, swallowed on an empty stomach with a decoction of Two Matured Ingredients Decoction. When the spleen and kidney qi return, it settles of itself.

Jikji 直指

3.11 Rumbling in the Abdomen 腹中鳴

3.11.1
Source원문

腹中鳴者, 病本於胃也. 《內經》

Translation영역
Where the abdomen rumbles, the disease is rooted in the stomach.

Naegyeong 內經

3.11.2
Source원문

脾氣虛則腹滿腸鳴. 《內經》

Translation영역
Where the spleen qi is vacuous the abdomen is full and the intestines rumble.

Naegyeong 內經

3.11.3
Source원문

中氣不足, 腸爲之苦鳴. 《靈樞》

Translation영역
Where the centre qi is insufficient, the intestines rumble bitterly for it.

Yeongchu 靈樞

3.11.4
Source원문

腹中水鳴, 乃火擊動其水也, 二陳湯方見痰飮加芩ㆍ連ㆍ梔子. 《丹心》

Translation영역
Water rumbling in the abdomen is fire striking and stirring the water: Two Matured Ingredients Decoction formula in the Phlegm chapter with scutellaria, coptis and gardenia added.

Dansim 丹心

3.11.5
Source원문

腸鳴者, 火欲升, 水欲降, 相擊而鳴. 《丹心》

Translation영역
Intestinal rumbling is fire wanting to rise and water wanting to fall, striking each other and sounding.
Clinical note임상 주석
Fire rising and water falling and meeting on the way. It is a physical image rather than a doctrine — the sound of gas moving through fluid — and Danxi treats it by cooling.

Dansim 丹心

3.11.6
Source원문

亦有藏寒有水而鳴者, 宜五積散方見寒門或理中湯方見寒門加吳茱萸ㆍ赤茯苓. 《丹心》

Translation영역
There are also those whose viscera are cold and hold water and so rumble: Five Accumulations Powder formula in the Cold Damage chapter, or Regulate the Centre Decoction formula in the Cold Damage chapter with evodia and red poria added.

Dansim 丹心

3.12 The Pattern of Welling Water 涌水證

3.12.1
Source원문

內經曰, 肺移寒於腎爲涌水. 涌水者, 按之腹不堅, 水氣客於大腸, 疾行則鳴濯濯, 如囊裹漿水之病也. 宜葶藶丸. 《宣明》

Translation영역
The Neijing says: where the lung moves cold to the kidney it becomes welling water. In welling water the abdomen is not hard to the press; the water qi lodges in the large intestine, and on walking fast it sloshes — the disease is like a bag holding liquid. Lepidium Pill is appropriate.
Clinical note임상 주석
如囊裹漿水 — like a bag with liquid in it, sloshing when the patient walks fast. A soft belly with a fluid thrill, and the walking test is one a physician could do in the consulting room.

Seonmyeong 宣明

3.13 The Various Patterns of Abdominal Pain 腹痛諸證

3.13.1
Source원문

疝氣腹痛ㆍ痢疾腹痛ㆍ積聚腹痛ㆍ霍亂腹痛ㆍ腸癰腹痛, 幷見諸門. 《入門》

Translation영역
Abdominal pain of mounting qi, of dysentery, of accumulations, of sudden turmoil, and of intestinal welling-abscess are each in their own chapters.
Clinical note임상 주석
Five abdominal pains sent elsewhere, and the list is worth reading as a differential: a hernia, dysentery, a mass, cholera and an abscess. Between them and the chapter's own six causes, little is left out.

Immun 入門

3.14 Abdominal Pain Should Be Freed 腹痛宜通利

3.14.1
Source원문

凡腹痛大抵宜通, 塞則爲痛. 凡痛甚, 須通利藏府乃愈. 隨冷熱用巴豆ㆍ大黃ㆍ牽牛, 最爲要法. 《得效》

Translation영역
Abdominal pain should in general be freed, for blockage is what makes pain. Wherever the pain is severe, the viscera and bowels must be freed for it to heal; using croton, rhubarb or morning-glory seed according to cold or heat is the most essential method.

Deukhyo 得效

3.14.2
Source원문

初得時元氣未虛, 必推蕩之, 此通因通用之法也. 《丹心》

Translation영역
When it is newly got and the origin qi is not yet vacuous, it must be pushed and washed out — this is the method of using freeing for what is already free.

Dansim 丹心

3.14.3
Source원문

實痛宜辛寒推蕩. 經曰, 通因通用. 又曰, 痛隨利減, 是也. 《入門》

Translation영역
A repletion pain should be pushed and washed out with the acrid and cold. The classic says: use freeing for what is free. It also says: the pain lessens as the bowel opens — such is the case.
Clinical note임상 주석
痛隨利減 — the pain lessens as the bowel opens. Four graphs, and they carry the chapter's therapeutics. The caution is 3.6's: this is for the robust and the newly ill, not for a weak belly that eases under the hand.

Immun 入門

3.14.4
Source원문

宜用備急丸方見救急ㆍ利氣丸方見上.

Translation영역
Prepare for Urgency Pill formula in the Emergencies chapter and Free the Qi Pill formula above should be used.

Donguibogam · Bok

3.15 The General Treatment of Abdominal Pain 腹痛通治

3.15.1
Source원문

凡腹痛必用溫散. 此是鬱結不行, 阻氣不運, 故痛也. 《丹心》

Translation영역
Abdominal pain must always be warmed and dispersed: it is depression bound and not moving, the qi obstructed and not circulating, and so there is pain.

Dansim 丹心

3.15.2
Source원문

凡腹痛多屬血澁, 通用芍藥甘草湯. 治四時腹痛, 脉弦傷氣加黃芩, 脉洪傷金倍芍藥, 脉緩傷水加桂枝, 脉澁傷血加當歸, 脉遲傷火加乾薑, 臍下痛加熟地黃. 《入門》

Translation영역
Abdominal pain mostly belongs to the blood running rough, and Peony and Licorice Decoction is used generally. It treats abdominal pain in all four seasons: where the pulse is stringlike and the qi damaged add scutellaria; surging and metal damaged, double the peony; moderate and water damaged, add cinnamon twig; rough and blood damaged, add angelica; slow and fire damaged, add dried ginger; for pain below the navel add cooked rehmannia.
Clinical note임상 주석
One base formula and six modifications read off the pulse. Peony and licorice is two medicinals — sour and sweet together to relax a cramp — and it remains the tradition's answer to a spasm anywhere in the body.

Immun 入門

3.15.3
Source원문

雜病腹痛, 通用四物苦練湯ㆍ酒煮當歸丸方見胞門ㆍ開鬱導氣湯.

Translation영역
For abdominal pain in miscellaneous diseases, Four Substances and Toosendan Decoction, Wine-Boiled Angelica Pill formula in the Uterus chapter and Open Depression and Guide the Qi Decoction are used generally.

Donguibogam · Bok

3.15.4
Source원문

稼穡作甘, 甘者己也. 曲直作酸, 酸者甲也. 甲己化土, 此仲景妙法也. 酸以收之, 甘以緩之. 《東垣》

Translation영역
Sowing and reaping make sweetness, and the sweet is the earth stem; bending and straightening make sourness, and the sour is the wood stem. Wood and earth together transform into earth — this is Zhongjing's subtle method. The sour gathers it in and the sweet relaxes it.
Clinical note임상 주석
Dongwon explaining Peony and Licorice Decoction through the stems: sour and sweet paired make earth, which is the middle, which is where the pain is. The cosmology is elaborate and the clinical point is simple — sour to gather, sweet to loosen.

Dongwon 東垣

3.16 Ominous Signs in Abdominal Pain 腹痛凶證

3.16.1
Source원문

太陰連小腹痛甚, 自利不止者, 難治. 《入門》

Translation영역
Where the greater yin pain reaches to the lesser abdomen and is severe, with diarrhoea that does not stop, it is hard to treat.

Immun 入門

3.16.2
Source원문

鼻頭色靑, 腹中痛, 舌冷者死. 《靈樞》

Translation영역
Where the tip of the nose is green, the abdomen pains and the tongue is cold — death.

Yeongchu 靈樞

3.16.3
Source원문

臍下忽大痛, 人中黑色者, 多死. 《丹心》

Translation영역
Where there is sudden severe pain below the navel and the philtrum is black, death is common.
Clinical note임상 주석
Sudden agonizing lower abdominal pain with a dusky face. A ruptured viscus or a twisted bowel presents exactly so, and the tradition's verdict — 多死, death is common — was accurate until surgery could answer it.

Dansim 丹心

3.17 Simple Medicinals 單方

3.17.1
Source원문

凡十四種.

Translation영역
Fourteen kinds in all.

Donguibogam · Bok

3.17.2
Source원문

鹽 腹脹痛痞悶欲死, 極醎鹽湯頓服一二椀, 吐下卽定. 《本草》

Translation영역
Salt (鹽): For the abdomen distended and painful with glomus and oppression bringing one near death: take one or two bowls of very strong brine at one draught, and when it is vomited up and passed down the trouble settles at once.
Clinical note임상 주석
Strong brine drunk in that quantity empties the stomach upward and the bowel downward, so the entry does what it says. The picture it treats — the abdomen distended and painful to the point of death — is a bowel obstruction as often as it is indigestion, and giving an emetic into an obstructed abdomen is dangerous: the vomiting is already the symptom, and what is needed is a nasogastric tube and a surgeon.

Boncho 本草

3.17.3
Source원문

竈中熱灰 治心腹冷痛. 和醋熨之, 冷則易. 《本草》

Translation영역
Hot ash from the stove (竈中熱灰): Treats cold pain of the heart and abdomen. Mix it with vinegar and iron the part with it, changing it when it goes cold.

Boncho 本草

3.17.4
Source원문

磁石 鐵氣入腹作痛. 以磁石杵爲末, 鋪簟席睡其上. 再以磁石煎湯, 調小調氣散服之, 效.

Translation영역
Magnetite (磁石): Where iron qi has entered the abdomen and causes pain. Pound magnetite to a powder, spread it on the sleeping mat and have the patient lie on it. Then decoct magnetite and take Soiogi-san 小調氣散 stirred into the liquid — effective.
Clinical note임상 주석
鐵氣入腹 is iron swallowed — a nail or a needle — and the method is to draw it out with a magnet, the patient lying on a bed of magnetite powder. The physics is right and the distance is not: no magnet outside the body will move a foreign object through the bowel wall. Swallowed sharp metal needs endoscopy or watching; blunt metal usually passes.

Donguibogam · Bok

3.17.5
Source원문

芍藥 治腹中㽲痛, 以此爲君, 甘草爲佐, 煎服之. ○能治血虛腹痛, 氣分諸痛不宜用也. 《丹心》

Translation영역
Peony (芍藥): Treats griping pain within the abdomen; take this as sovereign with licorice as assistant, decoct and take. ○ It is able to treat abdominal pain from blood vacuity; for the various pains of the qi division it should not be used.
Clinical note임상 주석
Peony with licorice is 芍藥甘草湯, two drugs, and it is still the reflex prescription for abdominal cramp and for cramp anywhere. The caution is the prescribing: for a pain in the blood, not for a pain in the qi — which is to say for a sustained cramping spasm rather than a shifting, distending, belching pain.

Dansim 丹心

3.17.6
Source원문

乾薑 治脾冷腹痛嘔吐. 炒薑 三錢ㆍ甘草 灸 半錢, 右剉, 棗 一枚, 同煎服. 或爲末和飮服. 《直指》

Translation영역
Dried ginger (乾薑): Treats a cold spleen with abdominal pain and vomiting. Parched ginger 3 don and roasted licorice half a don, cut up together with one jujube, decocted and taken. Or powdered and taken mixed in a drink.

Jikji 直指

3.17.7
Source원문

艾葉 心腹惡氣作痛. 擣取汁飮之. 乾則濃煎服之. 《本草》

Translation영역
Mugwort leaf (艾葉): For malign qi in the heart and abdomen causing pain. Pound it and drink the juice. If it is dried, decoct it strongly and take.

Boncho 本草

3.17.8
Source원문

桔梗 主腹中滿痛. 剉取濃煎服之. 《本草》

Translation영역
Platycodon (桔梗): Governs fullness and pain within the abdomen. Cut it up, decoct it strongly and take.

Boncho 本草

3.17.9
Source원문

丁香 止腹中冷痛. 剉取水煎服, 或爲末點湯服. 《本草》

Translation영역
Clove (丁香): Stops cold pain within the abdomen. Cut it up, decoct it in water and take, or powder it and take it infused.

Boncho 本草

3.17.10
Source원문

吳茱萸 主腹痛不可忍. 水煎服之. 《本草》

Translation영역
Evodia (吳茱萸): Governs abdominal pain beyond bearing. Decoct it in water and take.

Boncho 本草

3.17.11
Source원문

厚朴 主腹痛脹滿雷鳴. 薑製, 水煎服, 或爲末薑湯點服. 《本草》

Translation영역
Magnolia bark (厚朴): Governs abdominal pain with distension, fullness and thunderous rumbling. Process it with ginger, decoct it in water and take, or powder it and take it infused in ginger decoction.
Clinical note임상 주석
雷鳴, thunderous rumbling, is borborygmi loud enough to hear across a room, and with distension and pain it is the picture of gas and fluid moving through a narrowed or hyperactive bowel. Magnolia bark is the corpus's chief drug for a distended abdomen and is the one that distinguishes 脹 from 滿, the distension one can see from the fullness one only feels.

Boncho 本草

3.17.12
Source원문

桂皮 治腹內冷痛不可忍. 煎服末服幷良. 秋冬腹痛非桂不能止. 《湯液》

Translation영역
Cinnamon bark (桂皮): Treats cold pain within the abdomen beyond bearing. Decocted or powdered, both are good. For abdominal pain in autumn and winter, nothing but cinnamon can stop it.
Clinical note임상 주석
秋冬腹痛非桂不能止 — abdominal pain in autumn and winter cannot be stopped without cinnamon. The season is part of the diagnosis, which is unusual even in this literature, and the reasoning is that cold weather produces cold pain and cold pain needs a hot drug.

Tangaek 湯液

3.17.13
Source원문

川椒 主腹內冷痛. 取四十九粒, 漿水浸一宿, 令口合, 空心以井水呑下. 《本草》

Translation영역
Sichuan pepper (川椒): Governs cold pain within the abdomen. Take forty-nine corns, steep them a night in fermented millet water until the husks close, and swallow them down with well water on an empty stomach.
Clinical note임상 주석
令口合, until the husks close — soaking makes the split pepper husks swell shut, and the corpus specifies it because a closed husk is held to keep the drug's power in until it reaches the abdomen. It is a delayed-release instruction, reached by observation of what soaking does to the husk.

Boncho 本草

3.17.14
Source원문

葱白 主腹冷痛. 濃煎湯飮之. 又細切和鹽炒熱熨之良. 《俗方》

Translation영역
Scallion white (葱白): Governs cold pain of the abdomen. Decoct it strongly and drink the liquid. Or cut it fine, parch it hot with salt and iron the part with it — good.

Sokbang 俗方

3.17.15
Source원문

狗肉 治脾胃冷弱ㆍ腹中刺痛. 肥狗肉半斤, 以椒ㆍ薑ㆍ鹽ㆍ醬煮粥喫, 良. 《本草》

Translation영역
Dog meat (狗肉): Treats a spleen and stomach cold and weak with stabbing pain within the abdomen. Fat dog meat, half a geun, boiled into a gruel with pepper, ginger, salt and soy and eaten — good.

Boncho 本草

3.18 Acupuncture and Moxibustion 鍼灸法

3.18.1
Source원문

腹痛, 取內關ㆍ支溝ㆍ照海ㆍ巨闕ㆍ足三里. 《綱目》

Translation영역
For abdominal pain, take Naegwan (內關, PC6), Jigu (支溝, TE6), Johae (照海, KI6), Geogwol (巨闕, CV14) and Jok-samni (足三里, ST36).

Gangmok 綱目

3.18.2
Source원문

臍腹痛, 取陰陵泉ㆍ太衝ㆍ足三里ㆍ支溝ㆍ中脘ㆍ關元ㆍ天樞ㆍ公孫ㆍ三陰交ㆍ陰谷.

Translation영역
For pain of the navel region, take Eumneungcheon (陰陵泉, SP9), Taechung (太衝, LR3), Jok-samni, Jigu, Jungwan (中脘, CV12), Gwanwon (關元, CV4), Cheonchu (天樞, ST25), Gongson (公孫, SP4), Samumgyo (三陰交, SP6) and Eumgok (陰谷, KI10).

Gangmok 綱目

3.18.3
Source원문

腹中切痛, 取公孫. 《靈樞》

Translation영역
For cutting pain within the abdomen, take Gongson.
Clinical note임상 주석
Gongson on the arch of the foot — the spleen channel's connecting point and the opening point of the penetrating vessel. It is the one point the Lingshu names alone for a belly pain, and it is still the first needled for one.

Yeongchu 靈樞

3.18.4
Source원문

臍中痛溏泄, 灸神闕卽效.

Translation영역
For pain at the navel with loose diarrhoea, moxa Singwol (神闕, CV8) and it answers at once.

Donguibogam · Bok

3.18.5
Source원문

積痛, 取氣海ㆍ中脘ㆍ隱白. 《綱目》

Translation영역
For accumulation pain, take Gihae (氣海, CV6), Jungwan and Eunbaek (隱白, SP1).

Gangmok 綱目

3.18.6
Source원문

臍腹痛甚, 灸獨陰, 神效. 《得效》

Translation영역
For severe pain of the navel region, moxa Dogeum (獨陰) — divinely effective.

Deukhyo 得效

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Outer Form, Volume 3, Abdomen chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.