（邪传于里与正气搏则为腹痛太阳经无腹痛症少阳经有胸胁痛而无腹痛阳明经腹
满而痛此为里实三阴下利清谷而腹痛者此为里寒太阴腹痛当分虚实肠鸣泄泻而痛者也便秘按之
转痛者实也）
伤寒阴脉涩阴脉弦。当腹中急痛。（先与小建中汤不 瘥者与小柴胡汤）胸中有热。胃中
有邪。腹痛呕吐。（黄连汤）往来寒热。胸胁满。烦呕腹痛（小柴胡汤）阳明病不大便五六日绕脐痛。
烦躁。此有燥屎。（大承气汤）大下后。六七日不大便。烦而腹痛。有宿食也。（大承气汤）发
汗
重自利。此有水气。（真武汤）少阴病。下利清谷。里寒外热。厥逆脉微。反不恶寒。面赤腹
痛。（通脉四逆汤）少阴病。四逆。或咳或悸。或小便不利。腹痛泄利。（四逆散）少阴病。腹
痛。便脓血。（桃花汤）厥阴四五日腹痛。若转气下趋少腹者欲下利也。（四逆汤）。
按腹痛。有虚。有实。有寒。有热。有食。有血当详辨之。可按可揉而软者。虚也。不
可揉按而硬者。实也。身无大热。口中不渴。喜饮热汤者。寒也。身热口渴。喜饮凉水者。热也
。噫气恶食。气口脉实者。食也。痛有定处。而不动移。或胁。或小腹硬满。小便利。大便
黑者。血也。大抵脉大而有力者。可凉可下。脉沉而无力者。宜补宜温。更以症参之。百不
失一矣。
(When pathogenic factors transmit to the interior and contend with healthy qi, abdominal pain results. The Taiyang channel does not present with abdominal pain; the Shaoyang channel presents with hypochondriac pain but no abdominal pain; the Yangming channel presents with abdominal fullness and pain, which indicates an Interior Excess syndrome; when the Three Yin channels present with diarrhea of undigested food accompanied by abdominal pain, this indicates an Interior Cold syndrome. Abdominal pain in the Taiyin channel must be differentiated into deficiency and excess: pain accompanied by borborygmus and diarrhea is a deficiency pattern; constipation with pain exacerbated by palpation is an excess pattern.)
In cold damage diseases, if the pulse is choppy or wiry, there should be acute tension and pain in the abdomen. (First administer Xiaojianzhong Tang [Minor Construct the Middle Decoction]; if ineffective, then administer Xiao Chaihu Tang [Minor Bupleurum Decoction].) Heat in the chest and pathogenic factors in the stomach lead to abdominal pain and vomiting. (Use Huanglian Tang [Coptis Decoction]). Alternating chills and fever, hypochondriac fullness, irritability, vomiting, and abdominal pain. (Use Xiao Chaihu Tang [Minor Bupleurum Decoction]). In Yangming disease, five to six days without stool, periumbilical pain, and restlessness indicate the presence of dry fecal impaction. (Use Dachengqi Tang [Major Order the Qi Decoction]). After severe purgation, if there is no stool for six or seven days, accompanied by irritability and abdominal pain, this indicates retained food stagnation. (Use Dachengqi Tang [Major Order the Qi Decoction]). Excessive sweating leading to spontaneous diarrhea indicates the presence of fluid retention. (Use Zhenwu Tang [True Warrior Decoction]). In Shaoyin disease, diarrhea of undigested food, interior cold with exterior heat, cold limbs, faint pulse, paradoxically no aversion to cold, flushed face, and abdominal pain. (Use Tongmai Sini Tang [Unblock the Pulse Sini Decoction]). In Shaoyin disease, cold limbs, possibly cough or palpitations, possibly difficulty urinating, abdominal pain, and diarrhea. (Use Sini San [Sini Powder]). In Shaoyin disease, abdominal pain and pus-blood in the stool. (Use Taohua Tang [Peach Flower Decoction]). In Jueyin disease, after four or five days, abdominal pain; if one feels gas moving downward toward the lower abdomen, diarrhea is impending. (Use Sini Tang [Sini Decoction]).
Palpation of abdominal pain reveals deficiency, excess, cold, heat, food stagnation, and blood stasis, which must be carefully distinguished. If the abdomen is soft and tolerates pressure and kneading, it is deficiency. If it is hard and cannot tolerate pressure or kneading, it is excess. If there is no significant fever, no thirst in the mouth, and a preference for hot drinks, it is cold. If there is fever and thirst, with a preference for cold water, it is heat. If there is belching, aversion to food, and an excess pulse at the cunkou (radial artery), it is food stagnation. If the pain is fixed in location and does not move, or if the hypochondrium or lower abdomen is hard and full, with free urination and black stools, it is blood stasis. Generally, if the pulse is large and forceful, cooling or purging methods may be used; if the pulse is deep and weak, tonifying or warming methods are appropriate. By correlating these findings with symptoms, errors will be rare.