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Abdominal fullness refers to the sensation of distension in the abdomen. The Spleen belongs to the Central Earth element; therefore, abdominal fullness mostly pertains to Taiyin disease (Disease of the Taiyin channel/syndrome). Treatment should distinguish between deficiency and excess patterns. The Classics state: Abdominal fullness that does not diminish indicates an interior excess pattern, which requires purgation. Abdominal fullness that fluctuates and diminishes intermittently indicates an interior deficiency pattern, which requires warming. However, although abdominal fullness is an interior syndrome, there are differences in depth. The Classics state: If the exterior has been resolved but internal stagnation remains, unless it is a severe fullness, purgation should not be used hastily. This indicates that the pathogenic factor has not fully entered the Fu organs. If there is severe fullness and excess, with hard and dry feces, even if the number of days since onset is small, purgation should be employed. This indicates that the pathogenic factor has entered the Fu organs. If Yang pathogenic factors sink inward causing abdominal distension, symptoms such as dry mouth and throat will occur. If Yin cold pathogens enter the interior causing abdominal distension, symptoms such as vomiting, diarrhea, and cold extremities will occur. Another view holds: Abdominal distension results from righteous Qi deficiency and pathogenic excess, disharmony of Yin and Yang, and mixing of clear and turbid Qi; using Jiegeng Banxia Tang (Platycodon and Pinellia Decoction) is most beneficial.

Shaofu fullness (distension of the lower abdomen) refers to fullness below the umbilicus. If there is fullness in the chest, it is caused by pathogenic factors rather than tangible objects. Now, if there is fullness in the Shaofu region, it is due to tangible objects rather than mere pathogenic factors. If there is fullness in the abdomen, it implies the formation of dry urine. The Classics state: Clear Yang emerges from the upper orifices, while Turbid Yin exits through the lower orifices. When what should exit fails to do so, accumulation leads to fullness. Thus, fullness in the upper part is due to Qi stagnation, while fullness in the lower part is due to tangible objects. These tangible objects refer to urine and blood. If urination is smooth, it is a Blood Stasis syndrome. If urination is difficult, it is a Urinary Retention syndrome. Therefore, treatments for expelling blood stasis and promoting diuresis should be distinguished into two approaches.

Abdominal pain occurs because pathogenic factors enter the interior and contend with Righteous Qi. The Classics state: All pains are generally excess patterns. It also states: Pain decreases with the unblocking of bowels and bladder. This refers to excess patterns. If pain is caused by deficiency, how can it be treated uniformly? Generally, pain that worsens upon pressure or rubbing indicates an excess pattern. Pain that alleviates upon pressure or rubbing indicates a deficiency pattern. Intermittent pain indicates a deficiency pattern. Continuous pain without relief indicates an excess pattern. If Yang heat pathogens transmit to the interior, making the interior Qi excessive, resulting in abdominal pain and hard stools, it is an excess pattern. If Yin cold pathogens enter the interior, causing cold stagnation in the interior, resulting in abdominal pain and diarrhea, it is a deficiency pattern. A slippery and large pulse with strength indicates an excess pattern. A wiry and thin pulse without strength indicates a deficiency pattern. Furthermore, treatment should differentiate based on the Da Fu (large abdomen/epigastrium), Xiao Fu (small abdomen), and Shaofu (lower abdomen). Pain in the Da Fu, i.e., epigastric pain, is due to Cold pathogens and food retention, pertaining to Taiyin. Pain in the Xiao Fu, i.e., periumbilical pain, is due to Heat pathogens and dry feces, pertaining to Shaoyin. Pain in the Shaofu, i.e., pain in the area below the umbilicus at the Dantian acupoint, is due to Blood stasis accumulating heat, pertaining to Jueyin. If Yang heat pathogens transmit to the interior causing intermittent abdominal pain, harmonizing formulas with pungent-warm properties should be used, such as Xiaojianzhong Tang (Minor Construct the Middle Decoction). If Yin cold pathogens enter the interior causing abdominal pain, where pain is ceaseless and there is a frequent urge to defecate, warming formulas with hot properties should be used, such as Fuzi Lizhong Tang (Aconite and Ginseng Decoction for Regulating the Middle). If there are dry feces, delirious speech, constipation, abdominal fullness, and pain, purgative medicines should be used, such as Chengqi Tang (Gut-Clearing Decoction).