（邪传于里与正气搏则为腹痛太阳经无腹痛症少阳经有胸胁痛而无腹痛阳明经腹
满而痛此为里实三阴下利清谷而腹痛者此为里寒太阴腹痛当分虚实肠鸣泄泻而痛者也便秘按之
转痛者实也）
伤寒阴脉涩阴脉弦。当腹中急痛。（先与小建中汤不 瘥者与小柴胡汤）胸中有热。胃中
有邪。腹痛呕吐。（黄连汤）往来寒热。胸胁满。烦呕腹痛（小柴胡汤）阳明病不大便五六日绕脐痛。
烦躁。此有燥屎。（大承气汤）大下后。六七日不大便。烦而腹痛。有宿食也。（大承气汤）发
汗
重自利。此有水气。（真武汤）少阴病。下利清谷。里寒外热。厥逆脉微。反不恶寒。面赤腹
痛。（通脉四逆汤）少阴病。四逆。或咳或悸。或小便不利。腹痛泄利。（四逆散）少阴病。腹
痛。便脓血。（桃花汤）厥阴四五日腹痛。若转气下趋少腹者欲下利也。（四逆汤）。
按腹痛。有虚。有实。有寒。有热。有食。有血当详辨之。可按可揉而软者。虚也。不
可揉按而硬者。实也。身无大热。口中不渴。喜饮热汤者。寒也。身热口渴。喜饮凉水者。热也
。噫气恶食。气口脉实者。食也。痛有定处。而不动移。或胁。或小腹硬满。小便利。大便
黑者。血也。大抵脉大而有力者。可凉可下。脉沉而无力者。宜补宜温。更以症参之。百不
失一矣。
（病邪传入体内，与正气相互搏结，就会形成腹痛。太阳经没有腹痛的症状；少阳经有胸胁痛，但没有腹痛；阳明经腹部胀满且疼痛，这属于里实证；三阴经出现下利清谷并伴有腹痛的，这属于里寒证。太阴腹痛应当区分虚实：肠鸣泄泻而痛的，是虚证；便秘、按压时疼痛加剧的，是实证。）
伤寒病中，脉象涩或弦，应当感到腹中拘急疼痛。（先给予小建中汤治疗，若无效，再给予小柴胡汤治疗。）胸中有热，胃中有邪气，导致腹痛呕吐。（使用黄连汤）寒热往来，胸胁部胀满，心烦欲呕且腹痛。（使用小柴胡汤）阳明病，五六天不大便，绕脐疼痛，烦躁不安，这是有燥屎内结。（使用大承气汤）经过剧烈攻下后，六七天又不大便，烦躁且腹痛，这是有宿食停滞。（使用大承气汤）发汗过度导致自利不止，这是有水气停留。（使用真武汤）少阴病，下利清谷，里寒外热，四肢厥冷，脉微细，反而不恶寒，面色发红，腹痛。（使用通脉四逆汤）少阴病，四肢厥逆，或者咳嗽或者心悸，或者小便不利，腹痛泄利。（使用四逆散）少阴病，腹痛，大便带脓血。（使用桃花汤）厥阴病，四五天后腹痛，如果感觉气向下趋向小腹，这是将要发生下利的征兆。（使用四逆汤）。
按察腹痛，有虚证，有实证，有寒证，有热证，有食积，有瘀血，应当详细辨别。可以按压揉摸且腹部柔软的，是虚证；不可揉按且腹部坚硬的，是实证。身体没有大热，口中不渴，喜欢喝热汤的，是寒证；身体发热口渴，喜欢喝凉水的，是热证。嗳气厌恶食物，人迎脉或寸口脉实的，是食积。疼痛部位固定不移，或者胁部、小腹硬满，小便通畅，大便黑色的，是瘀血。大致而言，脉象大而有力的，可以用清热或攻下的方法；脉象沉而无力的，宜用补益或温里的方法。再结合症状参详判断，就不会有失误了。
(When pathogenic factors transmit to the interior and contend with healthy qi, abdominal pain results. The Taiyang channel does not present with abdominal pain; the Shaoyang channel presents with hypochondriac pain but no abdominal pain; the Yangming channel presents with abdominal fullness and pain, which indicates an Interior Excess syndrome; when the Three Yin channels present with diarrhea of undigested food accompanied by abdominal pain, this indicates an Interior Cold syndrome. Abdominal pain in the Taiyin channel must be differentiated into deficiency and excess: pain accompanied by borborygmus and diarrhea is a deficiency pattern; constipation with pain exacerbated by palpation is an excess pattern.)
In cold damage diseases, if the pulse is choppy or wiry, there should be acute tension and pain in the abdomen. (First administer Xiaojianzhong Tang [Minor Construct the Middle Decoction]; if ineffective, then administer Xiao Chaihu Tang [Minor Bupleurum Decoction].) Heat in the chest and pathogenic factors in the stomach lead to abdominal pain and vomiting. (Use Huanglian Tang [Coptis Decoction]). Alternating chills and fever, hypochondriac fullness, irritability, vomiting, and abdominal pain. (Use Xiao Chaihu Tang [Minor Bupleurum Decoction]). In Yangming disease, five to six days without stool, periumbilical pain, and restlessness indicate the presence of dry fecal impaction. (Use Dachengqi Tang [Major Order the Qi Decoction]). After severe purgation, if there is no stool for six or seven days, accompanied by irritability and abdominal pain, this indicates retained food stagnation. (Use Dachengqi Tang [Major Order the Qi Decoction]). Excessive sweating leading to spontaneous diarrhea indicates the presence of fluid retention. (Use Zhenwu Tang [True Warrior Decoction]). In Shaoyin disease, diarrhea of undigested food, interior cold with exterior heat, cold limbs, faint pulse, paradoxically no aversion to cold, flushed face, and abdominal pain. (Use Tongmai Sini Tang [Unblock the Pulse Sini Decoction]). In Shaoyin disease, cold limbs, possibly cough or palpitations, possibly difficulty urinating, abdominal pain, and diarrhea. (Use Sini San [Sini Powder]). In Shaoyin disease, abdominal pain and pus-blood in the stool. (Use Taohua Tang [Peach Flower Decoction]). In Jueyin disease, after four or five days, abdominal pain; if one feels gas moving downward toward the lower abdomen, diarrhea is impending. (Use Sini Tang [Sini Decoction]).
Palpation of abdominal pain reveals deficiency, excess, cold, heat, food stagnation, and blood stasis, which must be carefully distinguished. If the abdomen is soft and tolerates pressure and kneading, it is deficiency. If it is hard and cannot tolerate pressure or kneading, it is excess. If there is no significant fever, no thirst in the mouth, and a preference for hot drinks, it is cold. If there is fever and thirst, with a preference for cold water, it is heat. If there is belching, aversion to food, and an excess pulse at the cunkou (radial artery), it is food stagnation. If the pain is fixed in location and does not move, or if the hypochondrium or lower abdomen is hard and full, with free urination and black stools, it is blood stasis. Generally, if the pulse is large and forceful, cooling or purging methods may be used; if the pulse is deep and weak, tonifying or warming methods are appropriate. By correlating these findings with symptoms, errors will be rare.