（少腹急）
脐下为少腹夫胸中满心下满皆气也腹满者多有燥屎也少腹满者有物聚也盖身半以上同天之阳身半以下同地之阴清
阳出上窍浊阴出下窍故在上满者气也在下满者物也物者溺与血尔邪结下焦则津液不通血气不行或溺或血流滞而胀满也
若小便利者蓄血之证小便不利溺涩证也俱是热病惟冷结膀胱少腹满一证为寒病有手足厥冷为可辩
太阳伤寒表不解干呕发热而咳或小便不利少腹满者小青龙去麻黄加茯苓汤主之（详咳）太阳病六七日表证仍在脉微
而沉反不结胸其人发狂者以热在下焦少腹当硬满小便自利者下血乃愈所以然者以太阳随经瘀热在里故也抵当汤主之（成
太阳经也膀胱府也此太阳瘀热随经入腑者也六七日者邪气传里之时也脉微而沉邪气在里之脉也表证仍在者则邪气犹浅
当结于胸中若不结于胸中其人发狂者热结在膀胱也经曰热结膀胱其人如狂此发狂则热又深也少腹硬满小便不利者为无
血也小便自利者血证谛也与抵当汤以下蓄血）伤寒有热少腹满应小便不利今反利者为有血也当下之不可余药宜抵当丸
（成 伤寒有热少腹满是蓄血于下焦若热蓄津液不通则小便不利其热不蓄津液而蓄血不行小便自利者乃为蓄血当与桃
仁承气汤抵当汤下之然此无身黄屎黑又无喜忘发狂是未至于甚故不可与其余驶峻之药也可与抵当丸小可下之也）太阳病
身黄脉沉结少腹硬小便不利者为无血也小便自利其人如狂者血证谛也抵当汤主之（身黄脉沉结少腹硬小便不利者胃热发
黄也可与茵陈汤身黄脉沉结少腹硬小便自利其人如狂者非胃中瘀热为热结下焦而为蓄血也与抵当汤以下蓄血）太阳病重
发汗而复下之不大便五六日舌上燥而渴日晡所小有潮热从心下至少腹硬满而痛不可近者大陷胸汤主之（活人曰昼夜谵语
喜忘少腹满小便不利男子为瘀血妇人为热入血室抵当汤）
厥阴 尺寸脉微缓者厥阴受病也当六七日发其证少腹烦满而囊缩病者手足厥冷言我不结胸小腹满按之痛者此冷结
在膀胱关元也（小腹下焦所治当膀胱上口主分别清浊或用真武汤）胁下素有痞连在脐旁痛引少腹入阴筋者名脏结死或云
此有动气犯汗吐下者死
少腹急 太阳病不解热结膀胱其人如狂血自下下者愈其外不解者尚未可攻当先解外外解已但少腹急结者乃可攻之宜
桃核承气汤（下血抵当汤解表桂枝汤太阳膀胱经也太阳经邪热不解随经入腑为热结膀胱其人如狂者为未至于狂但不宁尔
经曰其人如狂者以热在下焦太阳多热热在膀胱必与血相搏若血不为蓄为热迫之则血自下血下则热随血出而愈若血不下
者则血为热搏蓄积于下而少腹急结乃可攻之与桃核承气汤下热散血内经曰从外之内而盛于内者先治其外后调其内此之
谓也）身重少气少腹里急或引阴中拘挛热上冲胸为阴阳易病（治见本门）
（少腹急）
脐下部位称为少腹。胸中胀满和心下胀满，多由气机阻滞引起；腹部胀满，大多是因为有燥屎内结；少腹（小腹）胀满，则是有形之物积聚所致。大概而言，身体上半部分与天之阳气相应，下半部分与地之阴气相应。清气出于上窍，浊阴出于下窍。因此，在上部的胀满是气滞，在下部的胀满是有形实邪。所谓有形之物，就是溺液（尿液）和血液罢了。邪气结聚于下焦，导致津液运行不通，血气不能畅行，或者溺液、血液停滞不畅，从而产生胀满。
如果小便通畅，这是蓄血证；如果小便不利，这是溺涩证。这两种情况都属于热病，只有“冷结膀胱”导致的少腹满这一种证候属于寒病，可以通过手足厥冷来辨别。
太阳伤寒，表证未解，出现干呕、发热且咳嗽，或者小便不利、少腹满的，主治方为小青龙汤去麻黄加茯苓汤（关于咳嗽的详细论述见前文）。
太阳病经过六七日，表证依然存在，脉象微而沉，反而没有形成结胸证，其人出现发狂的症状，这是因为热邪结聚在下焦。如果少腹部坚硬胀满，且小便自利（正常），则是瘀血下行才能痊愈。之所以这样，是因为太阳经的邪热随经脉入里，瘀热蕴结在体内。主治方为抵当汤。（成无己注：太阳经与膀胱腑相表里，这是太阳经的瘀热随经传入膀胱腑的缘故。六七日，是邪气传变入里的时间。脉微而沉，是邪气在里的脉象。表证仍在，说明邪气尚浅，本应结于胸中；若不结于胸中，而其人发狂，说明热结在膀胱。《内经》说：“热结膀胱，其人如狂。”这里说发狂，说明热邪更深。少腹硬满且小便不利的，是无血证；小便自利的，才是血证的确据。用抵当汤来攻下蓄血。）
伤寒伴有发热，少腹满，应当小便不利，现在反而小便通利，这是有瘀血的表现，应当攻下，不可使用其他药物，适宜用抵当丸。（成无己注：伤寒发热、少腹满，是蓄血于下焦。如果热邪蓄积导致津液不通，则小便不利；如果热邪不蓄积津液而是蓄积血液导致血行不行，则小便自利，这才是蓄血证。应当用桃仁承气汤或抵当汤攻下。然而此证没有身黄、大便黑，也没有健忘、发狂等症状，说明病情尚未达到严重程度，所以不可给予其余峻猛的药物。可以给予抵当丸，轻微攻下即可。）
太阳病，身体发黄，脉象沉而结，少腹坚硬，如果小便不利，这是无血证；如果小便自利，其人出现如狂的症状，这是血证的确据，主治方为抵当汤。（身体发黄、脉沉结、少腹硬、小便不利，是胃热发黄，可用茵陈汤。身体发黄、脉沉结、少腹硬、小便自利、其人如狂，这不是胃中的瘀热，而是热邪结聚于下焦形成的蓄血证，用抵当汤来攻下蓄血。）
太阳病，重发汗后又误用泻下法，导致五六天不大便，舌上干燥且口渴，傍晚时分略有潮热，从心下直到少腹坚硬胀满且疼痛，手不可接近的，主治方为大陷胸汤。（《活人书》曰：昼夜谵语、喜忘、少腹满、小便不利，男子为瘀血，女子为热入血室，均用抵当汤。）
厥阴病：寸口和尺口的脉象微缓，是厥阴经受邪。应当在发病后六七日出现其证候：少腹烦闷胀满且睾丸收缩。患者手足厥冷，说我不结胸，但小腹满，按压时疼痛，这是冷结在膀胱关元穴部位。（小腹属下焦所治，位于膀胱上口，主分别清浊。可用真武汤治疗。）胁下素有痞块，牵连到脐旁，疼痛牵引少腹并进入阴筋，名叫脏结，属死证。也有人说，如果有动气，误用汗、吐、下法，也会致死。
少腹急：太阳病不解，热邪结聚于膀胱，其人出现如狂的症状，如果瘀血能自行排出，病就会好。如果表证仍未解除，暂时不可攻下，应当先解表。待表证解除后，仅剩下少腹急结的，才可以攻下，适宜用桃核承气汤。（攻下瘀血用抵当汤，解表用桂枝汤。太阳经与膀胱腑相表里。太阳经的邪热不解，随经传入腑，成为热结膀胱。其人如狂，说明热邪尚未至于完全发狂，只是心神不宁而已。《内经》说：“其人如狂”，是因为热在下焦。太阳经多热，热在膀胱必与血相搏。如果血不被蓄积，被热邪逼迫则会自行排出；血排出后，热邪随血而出，病即痊愈。如果血不排出，则血被热邪搏结蓄积于下焦，导致少腹急结，这时才可以攻下，给予桃核承气汤以清热散血。《内经》说：“病邪从外侵入内部并在内部盛行的，先治其外部，后调理其内部。”说的就是这个道理。）
身体沉重、气短、少腹里急，或者牵引阴部拘挛、热气上冲胸部，这叫阴阳易病（治疗方法见本门其他章节）。
(Shao Fu Ji - Urgency and Fullness of the Lower Abdomen)
The area below the umbilicus is called Shao Fu (Lower Abdomen). Fullness in the chest and fullness below the heart are mostly due to Qi stagnation; abdominal fullness is mostly caused by the accumulation of dry feces; fullness in the lower abdomen is caused by the accumulation of tangible pathogens. Generally speaking, the upper half of the body corresponds to the Yang Qi of Heaven, and the lower half corresponds to the Yin Qi 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, while fullness in the lower part is due to tangible pathogens. These tangible pathogens are essentially urine and blood. When pathogenic factors knot in the Lower Jiao (Lower Burner), the flow of Body Fluids is obstructed, and Qi and Blood fail to circulate freely. Whether it is urine or blood that stagnates, it leads to distension and fullness.
If urination is unobstructed, this indicates Blood Accumulation (Xu Xue); if urination is difficult, this 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 (Greater Yang) Cold Damage, 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 used (see previous sections for details on cough).
In 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 mania, it is because Heat has knotted in the Lower Jiao. If the lower abdomen is hard and full, and urination is normal, the release of blood will lead to recovery. This is because the Heat of the Tai Yang channel has followed the meridian into the interior, where Stagnant Heat resides. Di Dang Tang (Di Dang Decoction) should be primarily administered. (Cheng Wuji notes: Tai Yang Channel and Bladder Fu Organ are interior-exteriorly related; this is Stagnant Heat of Tai Yang following the channel into the Bladder Fu. 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 mania, the Heat has knotted in the Bladder. The Classic states: "Heat knotted in the Bladder, the person appears manic." Here, actual mania indicates deeper Heat. If the lower abdomen is hard and full with difficult urination, it is not a Blood syndrome; if urination is free, it is definitely a Blood syndrome. Use Di Dang Tang to purge the accumulated blood.)
In Cold Damage with fever and lower abdominal fullness, urination should be difficult. If it is now free, it indicates the presence of Blood stasis. It must be purged; other medicines are not suitable. Di Dang Wan (Di Dang Pill) is appropriate. (Cheng Wuji notes: Fever and lower abdominal fullness in Cold Damage indicate Blood accumulation in the Lower Jiao. If Heat accumulates and obstructs Body Fluids, urination is difficult. If Heat does not accumulate in Body Fluids but causes Blood stasis, urination remains free, which confirms Blood accumulation. One should use Tao Ren Cheng Qi Tang or Di Dang Tang to purge. However, since there is no yellowing of the skin, black stool, amnesia, or mania, the condition is not severe. Thus, harsh purgatives should not be used. Di Dang Wan, a milder formula, should be given for slight purging.)
In Tai Yang disease, if the body is yellow, the pulse is deep and knotted, and the lower abdomen is hard, but urination is difficult, it is not a Blood syndrome. If urination is free and the person appears manic, it is definitely a Blood syndrome. Di Dang Tang should be primarily administered. (Body yellowing, deep and knotted pulse, hard lower abdomen, and difficult urination indicate Stomach Heat causing jaundice; Yin Chen Tang may be used. Body yellowing, deep and knotted pulse, hard lower abdomen, free urination, and mania indicate not Stomach Heat but Heat knotted in the Lower Jiao causing Blood accumulation; use Di Dang Tang to purge the accumulated blood.)
In Tai Yang disease, if excessive sweating is followed by erroneous purgation, leading to constipation for five or six days, dry tongue with thirst, slight tidal fever in the late afternoon, and hardness, fullness, and pain from the epigastrium down to the lower abdomen such that the area cannot be touched, Da Xian Xiong Tang (Major Sinking into the Chest Decoction) should be primarily administered. (Huo Ren Shu states: Day and night delirium, forgetfulness, lower abdominal fullness, and difficult urination indicate Blood stasis in men and Heat entering the Blood Chamber in women; both are treated with Di Dang Tang.)
Jue Yin Disease: If the Cun (Inch) and Chi (Cubit) pulses are faint and slow, it indicates Jue Yin disease. After six or seven days, its manifestations include irritability and fullness in the lower abdomen and retraction of the scrotum. The patient has cold extremities and claims there is no chest binding, but the lower abdomen is full and painful 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 opening of the Bladder, responsible for separating the clear from the turbid. Zhen Wu Tang may be used.) If there is a pre-existing Pi Mass (subcutaneous mass) under the hypochondrium extending to the side of the umbilicus, with pain radiating to the lower abdomen and into the Yin sinews, it is called Zang Jie (Zang Binding) and is fatal. Some say that if there is Dong Qi (moving Qi) and one erroneously uses sweating, vomiting, or purging methods, it is also fatal.
Shao Fu Ji (Urgency of Lower Abdomen): In Tai Yang disease that has not resolved, if Heat knots in the Bladder and the person appears manic, if the blood discharges spontaneously, the disease will heal. If the exterior syndrome is not yet resolved, attack is contraindicated; one must first resolve the exterior. Once the exterior is resolved, if only urgency and binding in the lower abdomen remain, attack may proceed. Tao He Cheng Qi Tang (Tao He Decoction to Order the Qi) is appropriate. (To purge blood, use Di Dang Tang; to resolve the exterior, use Gui Zhi Tang. Tai Yang Channel and Bladder Fu are interior-exteriorly related. Unresolved Heat in the Tai Yang channel follows the meridian into the Fu organ, becoming Heat knotted in the Bladder. "Appearing manic" means the Heat has not reached full mania but causes restlessness. The Classic states: "Appearing manic" because Heat is in the Lower Jiao. Tai Yang channels are prone to Heat; Heat in the Bladder must contend with Blood. If Blood is not accumulated but forced by Heat, it discharges spontaneously; once discharged, Heat exits with the Blood, and the disease heals. If Blood does not discharge, it is contended and accumulated by Heat in the lower part, causing urgency and binding in the lower abdomen. At this point, attack is permissible. Give Tao He Cheng Qi Tang to clear Heat and dissipate Blood. The Inner Classic states: "When pathogenic factors enter from the exterior and become prevalent in the interior, treat the exterior first, then regulate the interior." This refers to this principle.)
Heavy body, shortness of breath, urgency in the lower abdomen, or contraction drawing into the genitalia, with Heat rushing up to the chest, is called Yin Yang Yi Disease (Treatment seen in this section).