少腹隶于厥阴。厥阴者肝也。为阴中之至阴。中寒一症。少腹绞痛。唇青囊缩。非桂、附、吴茱
萸不为功。肝乃藏血之脏。凡闪挫跌扑。有所损伤凝结者。少用必胀满而疼。小便利。大便黑。
非桃仁、泽兰、红花不为效。木曰曲直。曲直作酸。肝火下流。小便频数。少腹拘急。或时作疼。
非山栀、钩藤、芍药不为取。然而少腹之中。膀胱为之州都。故小便不利而胀者。当利其小便。
小便自利而胀者。当治其血。二症又迥不同也。要之足三阴经太阴居上。则理中焦。少阴厥阴居
下。则补下焦。大抵虚寒者十之七。实热者十之三也。女人患此尤多。余每以桃仁、茱萸。一取
其破血。一取其同气。而调经恒效。盖有所凝滞而然也。临症者辨之。
一厥阴中寒。少腹绞痛。烦躁厥逆。或呕。用仲景吴茱萸汤。
一闪挫作痛。用柴胡、钩藤、当归、丹皮、茯苓、甘草、延胡索之类。若困卷甚。四物汤加
白术、茯苓、牛膝、钩藤、柴胡、杜仲。
一小腹蓄血。小便自利。大便色黑。桃仁承气汤。如元气弱者。去硝、黄。减甘草。加生地、
泽兰、红花、丹皮。
一色欲过度而痛。六味汤加杜仲、柴胡。脉迟弱者加肉桂。
一湿热渗注。少腹内痛。小便淋沥者。用龙胆泻肝汤。
一冲疝气逆上攻。少腹左痛。用木香、川芎、山栀、吴茱萸、枳实、青皮、小茴香、广皮。
一膀胱气不化。小便不利而痛。五苓散加减。
一大便秘结。少腹胀满而痛。在伤寒脉实。用承气汤。老人血虚而秘。或病久元气弱者。用
滋养阴血。如麻仁、桃仁、杏仁、郁李仁之类。虚甚。六味汤加杜仲、牛膝、苁蓉、锁阳。
一元气下陷。小腹重堕。多服补中益气汤。
一男妇奔豚气块。用地黄膏子丸。
吴茱萸汤
吴茱萸（汤泡七次） 生姜 人参（各一钱）
枣一枚。水煎。或入桂、附。
桃仁承气汤
桃仁（十个） 肉桂 甘草（各一钱） 大黄（二钱半）
水煎。去渣。入芒硝一钱五分。热服。
龙胆泻肝汤
龙胆草（酒炒） 柴胡 车前子（焙研） 泽泻（各一钱） 木通 生地黄 归尾 黄芩 生甘草 山栀（各五分）
水煎。
The lower abdomen belongs to the Foot-Jueyin Liver Meridian. Jueyin refers to the Liver. It is the most extreme aspect of Yin. In the syndrome of Cold invading the interior, characterized by severe colicky pain in the lower abdomen, cyanosis of the lips, and retraction of the scrotum, only Guizhi Tang (Cinnamon Twig Decoction), Fuzi (Prepared Aconite Root), and Wuzhuyu (Evodia Fruit) can achieve efficacy. The Liver is the zang-organ that stores Blood. Whenever there is injury and coagulation due to sprains, falls, or blows, if not adequately treated, it inevitably leads to distension and pain. When urination is free and stool is black, only Taoren (Peach Seed), Zelan (Lycopus Herba), and Honghua (Carthamus Flower) can be effective. Wood is characterized by bending and straightening; bending and straightening generate Sourness. When Liver Fire flows downward, it causes frequent urination, tension in the lower abdomen, and intermittent pain; only Shanzhi (Gardenia Fruit), Gouteng (Uncaria Rhynchophylla), and Shaoyao (Peony Root) can take effect. However, within the lower abdomen, the Bladder serves as the "State Capital" (Zhou Du, storing urine). Therefore, when there is distension due to difficult urination, one should promote diuresis; when there is distension with free urination, one should treat the Blood. These two syndromes are distinctly different. In summary, among the Three Yin Meridians of the Foot, Taiyin is superior and regulates the Middle Jiao; Shaoyin and Jueyin are inferior and tonify the Lower Jiao. Generally, deficiency-cold accounts for seven-tenths, while excess-heat accounts for three-tenths. Women suffer from this condition particularly often. I commonly use Taoren (Peach Seed) and Wuzhuyu (Evodia Fruit); the former breaks Blood, and the latter shares the same Qi affinity, making them consistently effective for regulating menstruation. This is likely due to the presence of stagnation. Clinicians must distinguish between these cases carefully.
First, for Jueyin Cold invading the interior, causing severe colicky pain in the lower abdomen, irritability, cold limbs, or vomiting, use Zhongjing's Wuzhuyu Tang (Evodia Decoction).
Second, for pain caused by sprains or trauma, use herbs such as Chaihu (Bupleurum Root), Gouteng (Uncaria Rhynchophylla), Danggui (Angelica Sinensis), Danpi (Moutan Cortex), Fuling (Poria), Gancao (Licorice Root), and Yanhusuo (Corydalis Rhizome). If the patient is severely fatigued and curled up, use Siwu Tang (Four Substances Decoction) modified with Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Niuxi (Achyranthes Root), Gouteng (Uncaria Rhynchophylla), Chaihu (Bupleurum Root), and Duzhong (Eucommia Bark).
Third, for Blood accumulation in the lower abdomen, with free urination and black stool, use Taoren Chengqi Tang (Peach Kernel Da Huang Decoction). For patients with weak Yuan Qi (Primal Qi), remove Xiaoshi (Magnesium Sulfate) and Dahuang (Rhubarb Root), reduce the dosage of Gancao (Licorice Root), and add Shengdi (Rehmannia Root), Zelan (Lycopus Herba), Honghua (Carthamus Flower), and Danpi (Moutan Cortex).
Fourth, for pain due to excessive sexual activity, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) modified with Duzhong (Eucommia Bark) and Chaihu (Bupleurum Root). Add Rougui (Cinnamon Bark) if the pulse is slow and weak.
Fifth, for Damp-Heat infiltrating, causing internal pain in the lower abdomen and dribbling urination, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction).
Sixth, for Chong Hernia with Qi counter-attacking upwards, causing pain on the left side of the lower abdomen, use Muxiang (Aucklandiae Radix), Chuanxiong (Ligusticum Chuanxiong Rhizome), Shanzhi (Gardenia Fruit), Wuzhuyu (Evodia Fruit), Zhishi (Immature Bitter Orange), Qingpi (Green Tangerine Peel), Xiaohuixiang (Fennel Fruit), and Guangpi (Tangerine Peel).
Seventh, for failure of Bladder Qi transformation, causing difficult and painful urination, use Wuling San (Five-Ingredient Powder with Poria) modified.
Eighth, for constipation with fullness and pain in the lower abdomen: if the pulse is excess in the context of Shanghan (Cold Damage), use Chengqi Tang (Da Huang Decoction variants). For elderly people with Blood deficiency leading to constipation, or those with prolonged illness and weak Yuan Qi (Primal Qi), use herbs to nourish Yin and Blood, such as Mahuang Ren (Hemp Seed), Taoren (Peach Seed), Xingren (Apricot Seed), and Yuliren (Bush Cherry Pit). For severe deficiency, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) modified with Duzhong (Eucommia Bark), Niuxi (Achyranthes Root), Rongrong (Cistanche Stem), and Suoyang (Cynomorium Herb).
Ninth, for sinking of Yuan Qi (Primal Qi), causing a heavy sensation and prolapse of the lower abdomen, administer Buchong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) frequently.
Tenth, for Ben Tun (Running Piglet) Qi masses in men and women, use Dihuang Gaozi Wan (Rehmannia Paste Pill).
Wuzhuyu Tang (Evodia Decoction)
Wuzhuyu (Evodia Fruit, soaked in hot water seven times), Shengjiang (Fresh Ginger), Renshen (Ginseng Root) (each 1 qian),
One Jujube date. Decoct in water. Can also be taken with Guizhi (Cinnamon Twig) or Fuzi (Prepared Aconite Root).
Taoren Chengqi Tang (Peach Kernel Da Huang Decoction)
Taoren (Peach Seed) (10 seeds), Rougui (Cinnamon Bark), Gancao (Licorice Root) (each 1 qian), Dahuang (Rhubarb Root) (2.5 qian).
Decoct in water, strain, add Mangxiao (Mirabilite/Natrii Sulfas) 1.5 qian, and take hot.
Longdan Xiegan Tang (Gentian Liver-Draining Decoction)
Longdancao (Gentiana Root, stir-fried with wine), Chaihu (Bupleurum Root), Cheqianzi (Plantago Seed, roasted and ground), Zexie (Alisma Rhizome) (each 1 qian), Mutong (Akebia Caulis), Shengdi Huang (Rehmannia Root), Guiwei (Angelica Sinensis Tail), Huangqin (Scutellaria Root), Sheng Gancao (Raw Licorice Root), Shanzhi (Gardenia Fruit) (each 0.5 qian).
Decoct in water.