脐下为少腹。夫胸中满。心下满。皆气也。腹满。多有燥矢也。少腹满。溺与血之分
也。邪结下焦。津液不通。则溺蓄。血气不行。则血结。皆为胀满而痛也。若小便利者。
为蓄血。宜桃仁承气汤。小便不利者。为水蓄膀胱。宜五苓散。二症俱是热邪。若四
肢厥冷。小便清白。而小腹满痛者。为冷结膀胱。宜当归四逆。加吴萸生姜汤治之。（合参准绳金鉴）
邵评∶少腹满。有寒热二因。邪热入于膀胱。又有血蓄水蓄之不同。最宜细辨。
舌卷囊缩者死。热极而缩者。承气。寒极而缩者。四逆吴茱萸。
邵评∶合虚实寒热二因。治法最精。
按六经主病。仲景非专为伤寒立言。如厥阴所述气冲吐蛔等症。乃厥阴风木
自病。不拘伤寒杂症。但见呕逆吐蛔者。即是肝邪犯胃。宜兼厥阴而治。要知六
淫伤寒兼带厥阴者。可治。若从三阳传至厥阴。则热极生风。九窍将闭。所形皆
败症矣。今将厥阴本病治法列于下。勿以伤寒传经目之可也。
凡遇伤寒热病。症见干呕渴饮。胸膈满闷。格食不下。或两胁抽痛。舌苔黄黑。或兼
吐蛔。此即症兼厥阴。肝邪犯胃而然也。宜用桂枝、芍药、川连、干姜、茯苓、半夏、黄芩
之类主之。吐蛔加椒梅。寒热似疟加柴胡。引出少阳。（肝邪犯胃）
凡伤寒暑湿之症。有呕吐青绿黑臭之水。或黄黑浊饮。或兼吐蛔。此邪已犯厥阴。
因胃中空虚。肝风乘虚袭胃。所吐之物。乃胃底肠中之阴浊。被肝风翻腾。遂至逆
涌而上出于口。俗名胃底翻是也。治宜泄厥阴以安阳明。如桂枝、白芍、川连、吴茱
萸、半夏、茯苓、椒梅之类。以泄厥阴。次用人参、代赭、茯苓、半夏、干姜、川连、乌梅之类。
以安胃镇逆。若其人阳明虚馁。不禁酸苦。又当安胃为主。微兼泄肝。宜人参、姜、连、
吴萸、白芍、茯苓、半夏、乌梅、代赭之类主之。（肝风内袭）
若身热。耳聋。口渴。胸腹板实。入暮谵语。呕逆吐蛔。舌苔黄中带灰黑。此湿热之邪。
结于厥阴之界。病势最险。宜川连、枳实、半夏、茯苓、菖蒲、乌梅、姜汁之类治之。（湿温干厥阴）
若邪从三阳经传入。即在太阴。已多危候。再入少阴。生者少。死者多矣。至传厥阴。
内风已盛。九窍热极将闭。无庸议治。
邵评∶阳邪传至厥阴。入里极深。厥阴内寄相火。邪热与相火两相蒸灼。伤阴最速。阴液消耗。
邪热陷闭。故症多不治。
凡见面青目白。面黄目青。面白目紫。筋急直视。角弓反张。舌焦耳聋。皆厥阴将败
形色。舌卷囊缩。鸦口嘬嘴。昏不知人。醒作睡声。跷足喉直。撮空视。跃跃欲起。脉硬如弦。
此皆厥阴死证。（阳邪传入厥阴死证）
The area below the umbilicus is called the Shaoyang abdomen (lower abdomen). Fullness in the chest and fullness below the heart (epigastrium) are both due to Qi stagnation. Abdominal fullness mostly involves dry fecal matter. Shaoyang abdominal fullness distinguishes between urine retention and blood stasis. When pathogenic factors knot in the Lower Jiao, body fluids fail to circulate, leading to urine accumulation; when Qi and Blood fail to move, blood stasis forms. Both conditions result in distension, fullness, and pain. If urination is smooth, it indicates Blood Accumulation (Xuexu), for which Taoren Chengqi Tang (Peach Kernel Decoction to Order the Qi) is appropriate. If urination is difficult, it indicates Water Accumulation in the Bladder, for which Wuling San (Five-Ingredient Powder with Poria) is appropriate. Both syndromes are caused by Heat pathogens. However, if there is coldness of the four limbs, clear and white urine, accompanied by lower abdominal fullness and pain, this indicates Cold Knotting in the Bladder, treated with Danggui Sini Tang (Angelica Sinensis Decoction to Restore Extremities) added with Zhuyu (Evodiae Fructus) and Shengjiang (Zingiberis Rhizoma Recens). (Referenced from *Yizong Jinjian* etc.)
Shao's Commentary: Shaoyang abdominal fullness has two etiologies: Cold and Heat. When Heat pathogens enter the Bladder, there is a distinction between Blood Accumulation and Water Accumulation; careful differentiation is essential.
Tongue retraction and testicular contraction indicate a fatal prognosis. Retraction caused by extreme Heat is treated with Chengqi Decoctions; retraction caused by extreme Cold is treated with Sini Tang added with Zhuyu (Evodiae Fructus).
Shao's Commentary: Integrating the etiologies of Deficiency/Excess and Cold/Heat, the treatment methods are most refined.
According to the diseases governed by the Six Channels, Zhang Zhongjing did not speak solely regarding Shanghan (Cold Damage). For instance, symptoms such as Qi rushing upward and vomiting roundworms described in the Jueyin chapter refer to self-disease of the Jueyin Wind-Wood qi, applicable regardless of whether it is Shanghan or miscellaneous diseases. Whenever vomiting, counterflow Qi, or vomiting roundworms are seen, it indicates Liver Pathogen invading the Stomach, and should be treated by addressing the Jueyin channel. It must be understood that when the Six Exogenous Pathogens and Shanghan involve the Jueyin, they are treatable. However, if the pathogen transmits from the Three Yang channels to the Jueyin, extreme Heat generates Wind, the Nine Orifices are about to close, and all manifestations are signs of collapse. The treatment methods for the primary disease of Jueyin are listed below; do not regard them merely as transmission stages of Shanghan.
Whenever encountering Shanghan heat diseases presenting with dry retching, thirst with desire to drink, oppression and stuffiness in the chest and diaphragm, food rejection unable to go down, or drawing pain in both hypochondria, yellow or black tongue coating, or accompanied by vomiting roundworms, this indicates syndrome involvement of Jueyin due to Liver Pathogen invading the Stomach. It is appropriate to use Guizhi (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix Alba), Chuanlian (Coptidis Rhizoma), Ganjiang (Zingiberis Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma), Huangqin (Scutellariae Radix) as the main formula. Add Jiaojiao (Semen Zanthoxyli) and Wu Mei (Mume Fructus) for vomiting roundworms; add Chaihu (Bupleuri Radix) for alternating chills and fever resembling malaria, to guide the pathogen out to the Shaoyang channel. (Liver Pathogen Invading Stomach)
In cases of Shanghan with Summerheat-Dampness, where there is vomiting of green, blue-black, foul-smelling water, or yellow-black turbid fluid, or accompanied by vomiting roundworms, this indicates the pathogen has invaded Jueyin. Because the Stomach is empty, Liver Wind attacks the Stomach vacuously. The vomited material is the Yin turbidity from the bottom of the stomach and intestines, churned up by Liver Wind, surging counterflow upwards out of the mouth. This is colloquially known as "Stomach Bottom Reversal." Treatment should vent Jueyin to calm Yangming, using Guizhi (Cinnamomi Ramulus), Baishao (Paeoniae Radix Alba), Chuanlian (Coptidis Rhizoma), Zhuyu (Evodiae Fructus), Banxia (Pinelliae Rhizoma), Fuling (Poria), Jiaojiao (Semen Zanthoxyli), Wu Mei (Mume Fructus) to vent Jueyin. Subsequently, use Renshen (Ginseng Radix et Rhizoma), Daizhe (Haematitum), Fuling (Poria), Banxia (Pinelliae Rhizoma), Ganjiang (Zingiberis Rhizoma), Chuanlian (Coptidis Rhizoma), Wu Mei (Mume Fructus) to calm the Stomach and suppress counterflow. If the patient has deficient Yangming Stomach Qi and cannot tolerate sour and bitter flavors, the primary focus should be calming the Stomach, slightly combining with venting the Liver. Use Renshen (Ginseng Radix et Rhizoma), Jiang (Zingiberis Rhizoma), Lian (Coptidis Rhizoma), Zhuyu (Evodiae Fructus), Baishao (Paeoniae Radix Alba), Fuling (Poria), Banxia (Pinelliae Rhizoma), Wu Mei (Mume Fructus), Daizhe (Haematitum) as the main formula. (Internal Invasion of Liver Wind)
If there is body heat, deafness, thirst, board-like hardness of the chest and abdomen, delirium at night, vomiting, counterflow Qi, vomiting roundworms, and a tongue coating yellow with gray-black tinge, this indicates Damp-Heat pathogen knotting at the boundary of Jueyin. The disease progression is extremely dangerous. Treat with Chuanlian (Coptidis Rhizoma), Zhishi (Aurantii Fructus Immaturus), Banxia (Pinelliae Rhizoma), Fuling (Poria), Changpu (Acori Tatarinowii Rhizoma), Wu Mei (Mume Fructus), Jiangzhi (Zingiberis汁) etc. (Damp-Warmth Invading Jueyin)
If the pathogen transmits from the Three Yang channels, even if it reaches Taiyin, there are already many critical signs. Entering Shaoyin, few survive, many die. Upon reaching Jueyin, internal Wind is already vigorous, the Nine Orifices are extremely hot and about to close; discussion of treatment is unnecessary.
Shao's Commentary: Yang pathogens transmitting to Jueyin penetrate deeply into the interior. Jueyin houses Ministerial Fire internally; pathogenic Heat and Ministerial Fire steam each other, damaging Yin rapidly. As Yin fluids are consumed and pathogenic Heat collapses inward, symptoms are mostly untreatable.
Manifestations such as cyanotic complexion with white eyes, yellow complexion with green-tinted eyes, pale complexion with purple eyes, tendon tension with staring gaze, opisthotonos, scorched tongue with deafness, are all color and form indicators of impending Jueyin collapse. Tongue retraction, testicular contraction, crooked mouth corners, unconsciousness, somniloquy upon waking, dorsiflexion of feet with stiff throat, grasping at empty air, restlessness with desire to rise, pulse hard like a bowstring—all these are fatal signs of Jueyin. (Fatal Signs of Yang Pathogen Transmitting to Jueyin)