腹满时痛不足证，腹满大痛有余名。误下邪陷太阴里，汗热便硬转阳明。
【注】腹满时痛为不足，桂枝加芍药汤，不愈，用理中汤。腹满大痛为有余，桂枝加
大黄汤。此皆误下邪陷太阴之里证也。若潮热自汗，大便硬，则为太阴之邪转属阳明也，
宜大承气汤。
中寒吐食不能食，不渴而厥吐寒虚，得食吐渴火为逆，饮吐相因水病居。
【注】中寒吐食，谓中寒吐食不能食也。凡不渴而厥吐，是寒虚吐也，宜理中、吴茱
萸辈。凡渴而得食即吐，是火吐也，热实宜黄连解毒汤。热虚宜干姜黄连黄芩汤，或竹
叶石膏汤。渴而饮，饮而吐，吐而复渴，水逆病也，宜五苓散。
热利尿红渴粘秽，寒利澄清小便白，理中不应宜固涩，仍然不应利之瘥。
【注】自利不渴者，属太阴寒也。下利欲饮水者，以有热故也。此以渴辨寒热也。小
便黄赤，秽气稠粘者，皆热利也。小便清白，澄彻清谷，皆寒利也。热利有表证，轻者升
麻葛根汤，重者葛根汤汗之。有里证者，量以三承气汤下之。无表里证，轻者宜黄芩汤，
重者宜葛根黄连黄芩汤清之。寒利宜理中汤温而补之。若服理中汤不应者，此属下焦滑
脱，宜赤石脂禹余粮汤固涩。仍然不应，此为清浊不分，水走大肠，宜五苓散或猪苓汤
利之，可瘥也。
腹部胀满且时有疼痛，属于正气不足的证候；腹部胀满且剧烈疼痛，属于邪气有余的证候。误用攻下法导致邪气内陷于太阴脾经之里，若出现汗出、发热、大便干硬，则病势转属阳明经。
【注】腹部胀满且时有疼痛属于不足证，可用桂枝加芍药汤治疗；若无效，改用理中汤。腹部胀满且剧烈疼痛属于有余证，可用桂枝加大黄汤治疗。这些都属于误用攻下法导致邪气内陷于太阴里的证候。如果出现潮热、自汗、大便干硬，则是太阴病的邪气转属阳明经，适宜使用大承气汤。
感受寒邪导致呕吐食物且不能进食，口不渴且四肢厥冷、呕吐清稀，属于虚寒证；进食后呕吐且口渴，属于火逆证；饮水即吐、水饮与呕吐互为因果，属于水饮病。
【注】“中寒吐食”是指感受寒邪导致呕吐食物且不能进食。凡是口不渴且四肢厥冷、呕吐的，是寒性虚证呕吐，适宜使用理中汤或吴茱萸汤等方剂。凡是口渴且进食后立即呕吐的，是火性呕吐，热实证适宜使用黄连解毒汤；热虚证适宜使用干姜黄连黄芩人参汤，或竹叶石膏汤。口渴想喝水，喝了又吐，吐了又觉得口渴，这是水逆病，适宜使用五苓散。
热利表现为小便短赤、口渴、排泄物粘滞秽臭；寒利表现为排泄物澄清、小便清白。服用理中汤无效时宜用固涩法，若仍无效则宜用通利法以痊愈。
【注】自发性腹泻且口不渴的，属于太阴寒证。腹泻且想喝水的，是因为体内有热。这是通过是否口渴来辨别寒热的方法。小便黄赤、气味秽浊稠粘的，都是热利。小便清白、清澈见底、完谷不化的，都是寒利。热利伴有表证的，轻症用升麻葛根汤，重症用葛根汤发汗解表。伴有里证的，酌情使用三承气汤攻下。既无表证也无里证的，轻症适宜用黄芩汤，重症适宜用葛根黄芩黄连汤清热。寒利适宜用理中汤温补。如果服用理中汤无效，这属于下焦滑脱不禁，适宜用赤石脂禹余粮汤固涩止泻。如果仍然无效，这是因为清浊不分，水液走注大肠，适宜用五苓散或猪苓汤通利小便，可以痊愈。
Abdominal fullness with intermittent pain indicates a deficiency syndrome; abdominal fullness with severe pain indicates an excess syndrome. Incorrect use of purgatives causes pathogenic factors to sink into the interior of the Taiyin (Taiyin Spleen) channel. If sweating, fever, and hard stool appear, the disease shifts to the Yangming (Yangming Stomach/Large Intestine) channel.
[Note] Abdominal fullness with intermittent pain is a deficiency pattern, treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Peony Root). If ineffective, Lizhong Tang (Regulate the Middle Decoction) is used. Abdominal fullness with severe pain is an excess pattern, treated with Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rheum Rhizome). These are all patterns where pathogenic factors have sunk into the interior of the Taiyin due to incorrect purgation. If tidal fever, spontaneous sweating, and hard stool occur, it means the pathogen from Taiyin has transferred to Yangming, and Dachengqi Tang (Major Order the Qi Decoction) is indicated.
Cold invasion causing vomiting of food and inability to eat, without thirst but with cold extremities and vomiting of clear fluids, indicates a deficiency-cold pattern. Vomiting after eating accompanied by thirst indicates fire reversal. Vomiting immediately after drinking water, where fluid retention and vomiting cause each other, indicates a fluid-retention disease.
[Note] "Cold invasion causing vomiting of food" refers to vomiting food and inability to eat due to cold invasion. Cases without thirst, with cold extremities and vomiting, are cold-deficiency vomiting, treated with Lizhong Tang or Wuzhuyu Tang (Evodia Fruit Decoction), etc. Cases with thirst and immediate vomiting after eating are fire vomiting; heat-excess is treated with Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity); heat-deficiency is treated with Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction) or Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Thirst leading to drinking, drinking leading to vomiting, and vomiting leading back to thirst constitutes Water Reversal Disease, treated with Wuling San (Five-Ingredient Powder with Poria).
Heat-dysentery presents with red scanty urine, thirst, and sticky, foul-smelling excrement; cold-dysentery presents with clear excrement and white/clear urine. If Lizhong Tang is ineffective, astringent methods should be used; if still ineffective, draining methods should be used for recovery.
[Note] Spontaneous diarrhea without thirst belongs to Taiyin cold. Diarrhea with desire to drink water is due to heat. This distinguishes cold from heat based on thirst. Yellow-red urine with foul odor and sticky consistency indicates heat-dysentery. Clear-white urine, clear vision, and undigested food in stool indicate cold-dysentery. Heat-dysentery with exterior symptoms: mild cases use Shengma Gegen Tang (Kudzu Root and Cimicifuga Decoction), severe cases use Gegen Tang (Kudzu Root Decoction) to induce sweating. With interior symptoms, one of the Chengqi Decoctions (San Chengqi Tang) is used appropriately for purging. Without exterior or interior symptoms: mild cases use Huangqin Tang (Scutellaria Decoction), severe cases use Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction) to clear heat. Cold-dysentery is treated with Lizhong Tang to warm and tonify. If Lizhong Tang is ineffective, this indicates slipping and uncontrolled descent of the Lower Jiao, treated with Chishizhi Yuyuliang Tang (Red Halloysite and Hematite Decoction) to astringe. If still ineffective, this indicates failure to separate clear from turbid, with water flowing into the Large Intestine, treated with Wuling San or Zhu Ling Tang (Polyporus Decoction) to promote urination, which leads to recovery.