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(Shao Fu Ji - Urgency and Fullness in the Lower Abdomen)
The area below the umbilicus is called Shao Fu (Lower Abdomen). Fullness in the chest and fullness below the heart are caused by Qi stagnation. Abdominal fullness is mostly due to the accumulation of dry stool, whereas fullness in the lower abdomen is due to the accumulation of tangible matter. Generally, the upper half of the body corresponds to the Yang of Heaven, and the lower half corresponds to the Yin of Earth. Clear Yang emerges from the upper orifices, and turbid Yin exits from the lower orifices. Therefore, fullness in the upper part is due to Qi stagnation, while fullness in the lower part is due to tangible matter accumulation. The so-called "matter" refers to urine and blood. When pathogenic factors knot in the Lower Jiao (Lower Burner), fluid metabolism is obstructed, and Qi and Blood circulation is impeded. This leads to either urinary retention or blood stasis, resulting in distension and fullness. If urination is unobstructed, it indicates Blood Accumulation (Xu Xue); if urination is difficult, it indicates Urinary Retention (Niao Se). Both conditions belong to Heat diseases. Only the condition of Cold Knotting in the Bladder causing lower abdominal fullness belongs to Cold diseases, which can be distinguished by cold extremities.

In Tai Yang Shang Han (Cold Damage to the Tai Yang Channel), if the exterior syndrome is unresolved, accompanied by dry heaving, fever, and cough, or with difficulty in urination and lower abdominal fullness, Xiao Qing Long Tang (Minor Blue Dragon Decoction) with Mahuang (Ephedrae Herba) removed and Fuling (Poria) added should be administered (see details under Cough).

In Tai Yang Bing (Tai Yang Disease), after six or seven days, if the exterior syndrome persists, the pulse is faint and deep, yet there is no formation of Jie Xiong (Chest Binding), and the patient exhibits madness, it is because heat has knotted in the Lower Jiao. If the lower abdomen is hard and full, and urination is spontaneous, purging the blood will lead to recovery. This is because the heat from the Tai Yang channel has followed the meridian into the interior, where stasis-heat resides. Di Dang Tang (Di Dang Decoction) should be administered. (Cheng Wuji notes: Tai Yang Channel and Bladder Fu Organ are externally and internally related; this is a case of Tai Yang stasis-heat entering the Fu organ via the channel. Six or seven days is the time when pathogenic factors transmit inward. A faint and deep pulse indicates pathogenic factors in the interior. The persistence of exterior symptoms suggests the pathogen is still shallow and should have knotted in the chest; since it did not knot in the chest but caused madness, the heat has knotted in the Bladder. The Classic states: "Heat knotting in the Bladder causes the person to appear mad." The current state of actual madness indicates deeper heat. If the lower abdomen is hard and full with difficult urination, it is not a blood syndrome; if urination is spontaneous, it is definitive evidence of a blood syndrome. Use Di Dang Tang to purge the accumulated blood.)

In Shang Han (Cold Damage) with fever and lower abdominal fullness, urination should be difficult. If it is now unobstructed, it indicates blood stasis. It should be purged; other medicines are not suitable, and Di Dang Wan (Di Dang Pill) should be used. (Cheng Wuji notes: Fever and lower abdominal fullness in Shang Han indicate blood accumulation in the Lower Jiao. If heat accumulates and obstructs fluids, urination is difficult. If heat does not accumulate fluids but causes blood stasis, urination remains spontaneous, which confirms blood accumulation. One should use Tao Ren Cheng Qi Tang (Tao Ren Cathartic Decoction) or Di Dang Tang to purge. However, this case lacks yellowing of the skin, black stools, forgetfulness, or madness, indicating the condition is not severe. Therefore, harsh purgatives should not be used; instead, the mild purgative effect of Di Dang Wan is appropriate.)

In Tai Yang Bing, if there is jaundice, a deep and knotted pulse, hardness in the lower abdomen, and difficult urination, it is not a blood syndrome. If urination is spontaneous and the patient appears mad, it is definitive evidence of a blood syndrome, treated with Di Dang Tang. (Jaundice, deep/knotted pulse, lower abdominal hardness, and difficult urination indicate Stomach Heat Jaundice, treatable with Yin Chen Tang. Jaundice, deep/knotted pulse, lower abdominal hardness, spontaneous urination, and appearing mad indicate not Stomach Heat Stasis, but Heat Knotting in the Lower Jiao forming Blood Accumulation, treated with Di Dang Tang to purge the accumulated blood.)

In Tai Yang Bing, if excessive sweating is followed by mistaken purgation, leading to constipation for five or six days, dry tongue with thirst, slight afternoon tidal fever, and hardness/fullness/pain from the epigastrium down to the lower abdomen that cannot be touched, Da Xian Xiong Tang (Major Sinking Chest Decoction) should be administered. (The *Ren Jian Shu* states: Delirium day and night, forgetfulness, lower abdominal fullness, and difficult urination indicate Blood Stasis in men and Heat Entering the Blood Chamber in women, both treated with Di Dang Tang.)

Jue Yin Disease: A faint and slow pulse at all three positions indicates Jue Yin disease. Around the sixth or seventh day, symptoms such as irritability and fullness in the lower abdomen and retraction of the scrotum may appear. If the patient has cold extremities, claims there is no chest binding, has lower abdominal fullness, and pain upon pressure, this is Cold Knotting in the Bladder at the Guan Yuan acupoint. (The lower abdomen is governed by the Lower Jiao, located above the bladder opening, responsible for separating clear from turbid. Zhen Wu Tang (True Warrior Decoction) may be used.) If there is a pre-existing mass under the ribs extending to the side of the umbilicus, with pain radiating to the lower abdomen and into the genital tendons, it is named Zang Jie (Organ Binding), which is fatal. Some say that if there is moving Qi and one mistakenly uses sweating, vomiting, or purging methods, it is also fatal.

Shao Fu Ji (Urgency in Lower Abdomen): In Tai Yang Bing, if unresolved, heat knots in the Bladder, causing the patient to appear mad. If blood discharges spontaneously, the disease resolves. If the exterior syndrome is unresolved, attack is contraindicated; resolve the exterior first. Once the exterior is resolved, if only urgency and knotting in the lower abdomen remain, attack may proceed using Tao He Cheng Qi Tang (Peach Pit Cathartic Decoction). (To purge blood, use Di Dang Tang; to resolve the exterior, use Gui Zhi Tang. Tai Yang Channel and Bladder Fu Organ are related. Unresolved heat in the Tai Yang channel follows the meridian into the Fu organ, causing Heat Knotting in the Bladder. Appearing mad indicates the condition has not reached true madness but is merely restlessness. The Classic states: "Appearing mad" occurs because heat is in the Lower Jiao. Tai Yang is prone to heat; heat in the Bladder must contend with blood. If blood is not accumulated but forced by heat, it discharges spontaneously; as blood leaves, heat exits with it, and the disease resolves. If blood does not discharge, it is contended and accumulated by heat in the lower region, causing urgency and knotting in the lower abdomen. At this point, attack is permissible. Administer Tao He Cheng Qi Tang to clear heat and dissipate blood. The *Nei Jing* states: "When pathogenic factors enter from the exterior and become abundant in the interior, treat the exterior first, then regulate the interior." This principle applies here.) Body heaviness, shortness of breath, urgency in the lower abdomen, possibly drawing into spasms in the genitalia, and heat rushing up to the chest constitute the Yi Chang Bing (Yin-Yang Exchange Disease) (Treatment see relevant section).