〔《活》〕若饮食不节，寒中阴经，胸膈不快，腹满闭塞，唇青，手足冷，脉沉细。少情绪，或腹痛，
急作理中汤加青皮，每服一二剂，胸即快矣。枳实理中丸、五积散尤妙。腹胀满者，宜桔梗半夏汤。
桔梗半夏汤 治伤寒心腹痞满，时发疼痛。
桔梗（微炒） 半夏（姜制） 橘红（各一两）
上 咀，每服四钱，生姜三片，水煎服。
〔海〕少阴症，小便遗沥，大便遗失，其人病六七日，静重如山，目不视，体如冰，腹胀满，与物
则咽，不与则不求，其脉沉细而微疾，按之有力，宜急下之，与大承气汤。
腹满而痛，吐利者，属太阴，宜四逆汤。（论见腹满太阴条。）
若兼头痛发热身痛者，属霍乱。霍乱腹痛不渴者，理中丸加人参。（论见吐利。）
病腹中满痛者，此为实也，宜大承气汤下之。病患不大便五六日，绕脐烦疼，发作有时者，有燥粪，故使
不大便也。发汗不解，腹满痛者，急下之，宜大承气汤。大下后，六七日不大便，烦不解，腹满痛者，
此有燥屎也。所以然者，本有宿食故也，宜大承气汤。汗下后不大便而渴，日晡潮热，从心下至小腹硬满而
痛者，宜大陷胸汤。（方论见结胸。）
少阴病，腹满下利，若小便不利，四肢重痛者，真武汤；便脓血者，桃花汤；若下利清谷，手足厥逆，脉
微欲绝者，通脉四逆汤去葱白加芍药。
少阴病，腹痛，若四肢逆而不温者，四逆散加附子。（方论见欲寐。）若手足厥冷，脉微欲绝者，通
脉四逆加芍药汤。（方论见下利。）
伤寒，胸中有热，胃中有邪气，腹中痛欲呕吐者，宜黄连汤
甘草（炙） 黄连 干姜（各三分） 大枣（三枚） 半夏（半两） 人参 桂枝（各三分）
上 咀，水煎服，分二服。
往来寒热，胸胁满，心烦喜呕而腹痛者，小柴胡去黄芩加芍药汤。（方见往来寒热条。）
伤寒阳脉涩，阴脉弦，当腹中急痛者，先与小建中汤。不瘥者，再与小柴胡汤。
小建中汤
桂枝（一两半） 甘草（炙，一两） 芍药（三两） 生姜（一两半） 大枣（六枚） 胶饴（八两）
上 咀，每服五钱，生姜三片，同煎至八分，去渣，下胶饴两匙许，再煎化服。（东垣云∶芍药
味酸，于土中泻木为君。饴糖、甘草甘温补脾养胃为臣。水挟木势亦来侮土，故脉弦而腹痛。肉桂
大辛热佐芍药以退寒水，姜、枣甘辛温发散阳气行于经络皮毛为使，故建中之名始于此焉。）
伤寒四五日，腹中痛，若转矢气及少腹满者，此欲自利也。
〔《活》〕如果是饮食不节制，寒气侵入阴经，导致胸膈部不适，腹部胀满闭塞，嘴唇发青，手脚冰凉，脉象沉细。情绪低落，或者出现腹痛，应当紧急服用理中汤加青皮，每次服用一两剂，胸部就会感到舒畅。枳实理中丸、五积散效果尤其好。如果是腹部胀满，适宜服用桔梗半夏汤。
桔梗半夏汤 治疗伤寒引起的心腹痞塞胀满，时常发作疼痛。
桔梗（微炒） 半夏（姜制） 橘红（各一两）
以上药材切碎，每次服用四钱，生姜三片，加水煎煮后服用。
〔海〕少阴病证，小便淋漓不尽，大便失禁，病人患病六七天，身体安静沉重如坐山石，眼睛看不见东西，身体像冰一样冷，腹部胀满，给食物就吞咽，不给也不寻求，脉象沉细且微弱快速，重按有力，应当紧急攻下，给予大承气汤。
腹部胀满且疼痛，伴有呕吐腹泻的，属于太阴病，适宜服用四逆汤。（相关论述见“腹满太阴”条。）
如果兼有头痛、发热、身体疼痛的，属于霍乱。霍乱腹痛且不口渴的，用理中丸加人参。（相关论述见“吐利”条。）
病在腹部胀满疼痛的，这是实证，适宜用大承气汤攻下。病人五六天不大便，脐周烦躁疼痛，定时发作的，是有燥屎，所以导致不大便。发汗后病不解，腹部胀满疼痛的，紧急攻下，适宜用大承气汤。大泻之后，六七天不大便，烦躁不解除，腹部胀满疼痛的，这是有燥屎。之所以这样，是因为原本就有宿食，适宜用大承气汤。发汗或攻下后不大便且口渴，下午申时潮热，从心窝到小腹硬满而疼痛的，适宜用大陷胸汤。（方剂论述见“结胸”条。）
少阴病，腹部胀满腹泻，如果小便不利，四肢沉重疼痛的，用真武汤；大便带脓血的，用桃花汤；如果腹泻排出未消化的食物，手脚冰冷，脉象微弱几乎摸不到的，用通脉四逆汤去掉葱白加芍药。
少阴病，腹痛，如果四肢逆冷且不温暖的，用四逆散加附子。（相关论述见“欲寐”条。）如果手脚厥冷，脉象微弱几乎摸不到的，用通脉四逆加芍药汤。（相关论述见“下利”条。）
伤寒，胸中有热，胃中有邪气，腹部疼痛想要呕吐的，适宜用黄连汤。
甘草（炙） 黄连 干姜（各三分） 大枣（三枚） 半夏（半两） 人参 桂枝（各三分）
以上药材切碎，加水煎煮服用，分两次服。
寒热往来，胸胁胀满，心烦喜欢呕吐且腹痛的，用小柴胡汤去掉黄芩加芍药汤。（方剂见“往来寒热”条。）
伤寒，阳脉涩，阴脉弦，应当腹部拘急疼痛的，先给予小建中汤。如果不痊愈，再给予小柴胡汤。
小建中汤
桂枝（一两半） 甘草（炙，一两） 芍药（三两） 生姜（一两半） 大枣（六枚） 胶饴（八两）
以上药材切碎，每次服用五钱，生姜三片，共同煎煮至八分，去渣，加入约两匙胶饴，再次煎化后服用。（李东垣说：芍药味酸，在土中泻木为君药。饴糖、甘草甘温补脾养胃为臣药。水挟带木势也会来侮土，所以脉弦而腹痛。肉桂大辛大热佐助芍药以退寒水，姜、枣甘辛温发散阳气行于经络皮毛为使药，所以建立中气的名称始于此处焉。）
伤寒四五日，腹部疼痛，如果转矢气及少腹胀满的，这是将要自行腹泻。
[From *Huo*] If diet is irregular, cold invades the Yin meridians, causing discomfort in the chest and diaphragm, abdominal distension and blockage, cyanosis of the lips, cold hands and feet, and a deep, fine pulse. With low mood or abdominal pain, urgently administer Lizhong Tang (Regulate the Middle Decoction) with Qingpi (Green Tangerine Peel). Take one to two doses per administration; the chest will feel relieved immediately. Zhishi Lizhong Wan (Immature Bitter Orange Regulate the Middle Pill) and Wuji San (Five Accumulations Powder) are especially excellent. For abdominal distension and fullness, Jiegeng Banxia Tang (Platycodon and Pinellia Decoction) is appropriate.
Jiegeng Banxia Tang treats heart and abdominal stuffiness and fullness caused by Shanghan (Cold Damage), with intermittent pain.
Jiegeng (Platycodonis Radix, lightly stir-fried) Banxia (Pinelliae Rhizoma, prepared with ginger) Juhong (Exocarpium Citri Reticulatae, each 1 liang)
Chop the above ingredients. Take 4 qian per dose, with 3 slices of Shengjiang (Fresh Ginger), decocted in water and taken orally.
[From *Hai*] Shaoyin syndrome (Syndrome of the Lesser Yin), with dribbling urination and fecal incontinence. The patient has been ill for six or seven days, quiet and heavy as if sitting on a mountain, unable to see, body cold as ice, abdominal distension and fullness. Swallows when offered food, does not seek it when not offered. The pulse is deep, fine, weak, and rapid, but forceful upon pressure. Urgent purgation is indicated; administer Dachengqi Tang (Major Order the Qi Decoction).
Abdominal distension with pain, accompanied by vomiting and diarrhea, belongs to Taiyin syndrome (Syndrome of the Greater Yin); Sini Tang (Frigid Extremities Decoction) is appropriate. (See discussion under "Abdominal Fullness - Taiyin" section.)
If accompanied by headache, fever, and body pain, it belongs to Huoluan (Cholera-like disorder). For Huoluan with abdominal pain and no thirst, Lizhong Wan (Regulate the Middle Pill) with Renshen (Ginseng Root) is used. (See discussion under "Vomiting and Diarrhea" section.)
Disease presenting with abdominal fullness and pain indicates excess; Dachengqi Tang (Major Order the Qi Decoction) should be used to purge. If the patient has not had a bowel movement for five or six days, experiences irritability and pain around the umbilicus, occurring at specific times, this is due to dry stool, hence the constipation. If sweating fails to resolve the condition and abdominal distension and pain persist, urgent purgation is required; Dachengqi Tang (Major Order the Qi Decoction) is appropriate. After severe purgation, if there is no bowel movement for six or seven days, irritability persists, and abdominal distension and pain occur, this indicates dry feces. This is because there was originally retained food; Dachengqi Tang (Major Order the Qi Decoction) is appropriate. After sweating or purging, if there is constipation accompanied by thirst, afternoon tidal fever, and hardness/fullness with pain from the epigastrium to the lower abdomen, Daxiexiong Tang (Major Chest-Expelling Decoction) is appropriate. (See discussion under "Chest Binding" section.)
Shaoyin disease (Lesser Yin disease) with abdominal distension and diarrhea: if urine is difficult and limbs are heavy and painful, Zhenwu Tang (True Warrior Decoction) is used; if pus and blood are passed in stool, Taohua Tang (Peach Blossom Decoction) is used; if diarrhea involves undigested food, limbs are cold, and the pulse is faint and nearly imperceptible, Tongmai Sini Tang (Pulse-Restoring Frigid Extremities Decoction) without Congbai (Scallion White) plus Shaoyao (Peony Root) is used.
Shaoyin disease with abdominal pain: if limbs are cold and not warm, Sini San (Frigid Extremities Powder) plus Fuzi (Aconite Lateral Root) is used. (See discussion under "Desire to Sleep" section.) If hands and feet are cold and the pulse is faint and nearly imperceptible, Tongmai Sini Jia Shaoyao Tang (Pulse-Restoring Frigid Extremities Decoction plus Peony Root) is used. (See discussion under "Diarrhea" section.)
Shanghan (Cold Damage), with heat in the chest and pathogenic qi in the stomach, abdominal pain, and desire to vomit; Huanglian Tang (Coptis Decoction) is appropriate.
Gancao (Licorice Root, honey-fried) Huanglian (Coptidis Rhizoma) Ganjiang (Dried Ginger) (each 3 fen) Dazao (Jujube Fruit, 3 pieces) Banxia (Pinelliae Rhizoma, 0.5 liang) Renshen (Ginseng Root) Guizhi (Cinnamon Twig) (each 3 fen)
Chop the above ingredients, decoct in water, and take orally, divided into two doses.
Alternating chills and fever, chest and hypochondriac fullness, irritability, frequent vomiting, and abdominal pain; Xiaochaihu Tang (Minor Bupleurum Decoction) without Huangqin (Scutellaria Root) plus Shaoyao (Peony Root) is used. (See formula under "Alternating Chills and Fever" section.)
Shanghan (Cold Damage), with a choppy Yang pulse and a string-taut Yin pulse, indicating acute abdominal pain; first administer Xiao Jianzhong Tang (Minor Construct the Middle Decoction). If not cured, administer Xiaochaihu Tang (Minor Bupleurum Decoction) again.
Xiao Jianzhong Tang (Minor Construct the Middle Decoction)
Guizhi (Cinnamon Twig, 1.5 liang) Gancao (Licorice Root, honey-fried, 1 liang) Shaoyao (Peony Root, 3 liang) Shengjiang (Fresh Ginger, 1.5 liang) Dazao (Jujube Fruit, 6 pieces) Jiyi (Maltose, 8 liang)
Chop the above ingredients. Take 5 qian per dose, with 3 slices of Shengjiang (Fresh Ginger), decoct together until reduced to 80%, strain, add about two spoons of Jiyi (Maltose), re-decoct until dissolved, and take orally. (Li Dongyuan stated: Shaoyao (Peony Root) is sour; it drains Wood within Earth and serves as the Sovereign herb. Yitang (Maltose) and Gancao (Licorice Root) are sweet and warm, tonifying Spleen and nourishing Stomach, serving as the Minister herbs. Water, aided by Wood's momentum, also attacks Earth, hence the string-taut pulse and abdominal pain. Rougui (Cinnamon Bark), being greatly pungent and hot, assists Shaoyao (Peony Root) to dispel Cold Water. Jiang (Ginger) and Zao (Jujube) are sweet, pungent, and warm, dispersing Yang Qi to move through meridians, collaterals, skin, and hair, serving as the Envoy herbs. Thus, the name 'Constructing the Middle' originates here.)
Shanghan (Cold Damage) for four or five days, with abdominal pain, flatus, and lower abdominal fullness; this indicates impending spontaneous diarrhea.