A Brief Analysis of the Treatment Patterns for “Abdominal Pain” in Women According to the Golden Cabinet Essentials

The three chapters on women’s diseases in the Golden Cabinet Essential Prescriptions established the rudiments of diagnosing and treating “abdominal pain in women.” Based on the principles of “obstruction causes pain” and “inadequate nourishment causes pain,” this study examines the pathomechanisms underlying relevant passages concerning women’s abdominal pain. It analyzes the properties, frequencies, and special preparation methods of 11 formulas and 25 herbs mentioned. Findings reveal that Zhang Zhongjing’s diagnosis and treatment of women’s abdominal pain consistently revolved around these two principles, while also distinguishing between blood stasis, heat accumulation, blood deficiency, and yang deficiency for flexible differentiation. Therapeutic approaches adeptly targeted the pathogenesis through methods such as promoting blood circulation to remove stasis, clearing heat accumulation, and nourishing blood. “Pain arises from deficiency of nourishment.” He also flexibly differentiated patterns such as blood stasis, heat accumulation, blood deficiency, and yang deficiency. Therapeutically, he adeptly targeted the underlying mechanisms, employing methods like promoting blood circulation to remove stasis, clearing heat to resolve accumulation, nourishing blood to replenish deficiency, and warming yang to dispel cold to achieve pain relief. His formula selection embodied principles such as “preserving existing functions while eliminating pathogens,” “combining tonification with drainage to strengthen the body and expel pathogens,” “concurrently using cold and warm herbs to clear heat and warm the body,” “utilizing food-medicine duality to nourish through flavor,” “balancing qi and blood while protecting the spleen and stomach,” and “enhancing the efficacy of blood-activating agents with wine.” The herbs predominantly exhibit warm, neutral, sweet, and bitter properties, frequently employing peony root and angelica root. Emphasis is placed on qi and blood-nourishing herbs, with skillful integration of cold and warm herbs. The decoction method prioritizes warm administration, enhanced by the addition of wine to amplify therapeutic efficacy.