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Abdominal pain arises from the struggle between pathogenic factors and healthy qi. If the pain is caused by yang pathogens transmitting inward, the pain is intermittent; it should be harmonized with acrid-warm formulas, such as Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). If abdominal pain is due to internal yin-cold, the pain is unceasing and often accompanied by a desire for diarrhea; it should be warmed with hot agents, such as Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction). If pain is caused by dry stool or retained food, there will be restlessness, constipation, abdominal fullness, hardness, and painful tenderness; Da Cheng Qi Tang (Major Order the Qi Decoction) should be used to purge. In Sha Yin disease (Disease of the Lesser Yin), if there is diarrhea with undigested food, a pulse that is faint and nearly imperceptible, and abdominal pain, Tong Mai Si Ni Tang (Pulse-Regulating Four Reversals Decoction) is indicated; if accompanied by difficulty in urination, Zhen Wu Tang (True Warrior Decoction) is indicated. For excess-type pain with a solid Guan pulse (Radial position), Gui Zhi Da Huang Tang (Cinnamon Twig and Rhubarb Decoction) is used. The Classic states, "All pains are considered excess," thus the principle that pain decreases with bowel movement applies.

Fullness in the lower abdomen refers to distension below the umbilicus. Fullness in the chest, epigastrium, or general abdomen is usually due to pathogenic stagnation rather than tangible accumulation. However, fullness specifically in the lower abdomen indicates tangible accumulation rather than mere qi stagnation. If urination is free, this presents as blood retention (Blood Stasis). If urination is difficult, it is a syndrome of urinary obstruction. The use of diuretic and damp-draining agents must distinguish between these two pathways. If Tai Yang disease (Disease of the Greater Yang) is unresolved, heat binds to the Bladder, causing mental agitation resembling madness, urgent lower abdominal fullness, and binding pain, Tao Ren Cheng Qi Tang (Peach Kernel Order the Qi Decoction) is used; recovery occurs when black material (blood clots) is expelled. In Tai Yin disease (Disease of the Greater Yin) with jaundice, deep pulse, lower abdominal fullness, and difficult urination, Wu Ling San (Five Ingredient Powder with Poria) is used to promote urination; recovery is marked by clear urine. If a patient has a chronic mass connected to the side of the umbilicus, with pain radiating to the genitalia, it is named Zang Jie (Visceral Binding), which is fatal.

"Ou" (vomiting with sound) involves both sound and matter being ejected simultaneously. "Tu" (spitting/vomiting without sound) involves matter being ejected suddenly without sound. Vomiting only sound without matter is called Gan Ou (dry heaving). Comparing severity, Ou is more severe than Tu. Generally, when exterior pathogens transmit inward, causing rebellious qi in the interior, vomiting occurs. Typically, when pathogens are at the half-exterior half-interior level, vomiting is common; similarly, vomiting due to interior heat is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Thus, the Classic states: "If there is much vomiting, even if Yang Ming symptoms exist, one must not purge; purging would be contraindicated." If vomiting occurs in a combined Tai Yang and Shao Yang disease (Disease of the Lesser Yang), Huang Qin Jia Ban Xia Tang (Scutellaria Added Pinellia Decoction) is used. In combined Tai Yang and Yang Ming disease, spontaneous diarrhea is expected; if there is no diarrhea but vomiting occurs, Ge Gen Jia Ban Xia Tang (Kudzu Added Pinellia Decoction) is used. For fever and vomiting involving the three Yang meridians, Xiao Chai Hu Tang is generally used. Vomiting followed by thirst indicates the condition is resolving; hydration should be provided. Thirst followed by vomiting indicates water retention in the epigastrium; Chi Fu Ling Tang (Red Poria Decoction) is used. For Yang Ming syndrome presenting with fever, sweating, irritability, epigastric hardness, diarrhea, and vomiting, Da Chai Hu Tang (Major Bupleurum Decoction) is indicated. For cold stomach with deep-slow pulse, anorexia, and free urination, Ban Xia Li Zhong Tang (Pinellia Regulate the Middle Decoction) added with ginger juice is used. If diarrhea is accompanied by cold extremities (Jue Ni), it is difficult to treat due to extreme deficiency-cold.