成无己云∶阴寒为邪者，则腹满而吐，食不下，自利益甚，腹中痛，太阴证也。发汗不解，
医反下之，因而腹满时痛者，属太阳也，桂枝加芍药汤主之。大实痛者，桂枝加大黄汤主之。
东垣曰∶腹中诸痛皆因劳役过甚，咳食失节，中气不足，寒气乘虚而入客之，故卒然而作大痛，
经言得炅则止。炅者以热治寒，治之正也。然腹痛有部分，脏位有高下，治之者宜分之。
《原病式》曰∶热郁于内而腹满坚结痛者，不可言为寒也。故丹溪云∶积热死血、食积湿痰
皆能作腹痛，宜于各类求治之。戴氏曰∶绵绵腹痛而无增减者，寒也。时作时止者，热也。痛
有常处不走移者，死血也。痛甚欲大便，利后痛减者，食积也。大抵痛而小便不利，或得辛辣
热汤则暂止者，痰也。痛定则能食，时作时止，或肚大、青筋肿聚，往来无有休止，涎出呕吐清
水者，虫也。
成无己云∶邪气聚于下焦，则津液不得通，血气不得行，或溺，或血留滞于下，是以胀
满而硬痛也。若
从心下至少腹硬满而痛，小便利者则是蓄血之证，小便不利者则是溺涩之证。
《脉经》曰∶脉细小紧急，病速进，在腹中刺痛。阴弦则腹痛。弦急小腹痛。尺脉紧，
脐下痛。尺脉伏，小腹痛，有症疝。尺脉实，小腹痛，当利之。腹痛，脉反浮大而长者死。
心腹痛不得息，脉细小迟者生，脉大而疾者死。伤寒，脉阳涩阴微，腹中急痛，里有虚寒。
成无己说：如果是阴寒之邪致病，就会出现腹部胀满且呕吐，饮食难进，腹泻日益严重，腹中疼痛，这是太阴病的证候。如果发汗后病未解，医生反而使用攻下法，导致腹部胀满、时而疼痛的，属于太阳病范畴，用桂枝加芍药汤主治。如果腹部胀满疼痛剧烈且伴有实邪的，用桂枝加大黄汤主治。
李东垣说：腹中的各种疼痛，大多是因为过度劳累、饮食不节制，导致中气不足，寒气乘虚侵入体内客居，所以突然发生剧烈疼痛。经书说“得到温热则疼痛停止”。“炅”（jiǒng，热）的意思是用热法治疗寒证，这是正确的治法。然而腹痛有具体的部位，脏腑位置有高有低，治疗时应当加以区分。
《原病式》说：热气郁结在内部而导致腹部胀满、坚硬结聚且疼痛的，不能说是寒证。所以朱丹溪说：积热、瘀血、食积、湿痰都能引起腹痛，应当在各类病因中寻求治疗方法。戴氏说：绵绵不断的腹痛且没有增减变化的，是寒证；时作时止的，是热证；疼痛位置固定不移的，是瘀血；疼痛剧烈想大便，排便后疼痛减轻的，是食积。大抵而言，疼痛且小便不利，或者喝辛辣热汤后暂时缓解的，是痰饮；疼痛缓解后能进食，时作时止，或者肚子大、青筋肿胀聚集，往来不停止，流涎并呕吐清水的，是虫证。
成无己说：邪气聚集在下焦，就会导致津液不通畅，气血运行受阻，或者出现小便异常，或者血液停滞在下焦，因此产生胀满且硬痛的症状。如果从心窝部一直到小腹部都坚硬胀满且疼痛，但小便通畅的，这是蓄血证的证候；小便不利的，则是小便涩滞证的证候。
《脉经》说：脉象细小紧急，病情发展迅速，表现为腹中刺痛。脉象阴部弦紧则腹痛。脉象弦急则小腹痛。尺脉紧，脐下疼痛。尺脉伏，小腹痛，或有症疝。尺脉实，小腹痛，应当通利二便。腹痛，脉象反而浮大而长的，预后不良（死证）。心腹痛导致呼吸不畅，脉象细小迟缓的，预后良好（生证）；脉象大而疾速的，预后不良（死证）。伤寒病，脉象阳部涩、阴部微，腹中拘急疼痛，说明里有虚寒。
Cheng Wuji stated: When Yin-cold pathogenic factors act as the cause, symptoms such as abdominal fullness and vomiting, inability to eat or drink, worsening spontaneous diarrhea, and abdominal pain occur; this is a Taiyin syndrome (Taiyin disease). If sweating fails to resolve the condition, and the physician erroneously applies purgation, resulting in abdominal fullness and intermittent pain, it belongs to the Taiyang syndrome (Taiyang disease), which should be treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Paeonia Root). For cases of severe fullness and pain due to excess, Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rheum Palmatum) is indicated.
Li Dongyuan stated: Various pains in the abdomen are generally caused by excessive labor, irregular diet, deficiency of Middle Qi (Spleen and Stomach Qi), allowing Cold pathogenic factors to invade and lodge due to deficiency, thus causing sudden severe pain. The classics state that "pain ceases upon obtaining heat." "Jiong" (heat) implies treating cold with heat, which is the correct approach. However, abdominal pain has specific locations, and the viscera are situated at different levels; therefore, treatment must differentiate according to these factors.
The *Yuan Bing Shi* (Original Treatise on Disease Mechanisms) states: When heat is depressed internally, leading to abdominal fullness, hardness, condensation, and pain, it cannot be classified as a cold syndrome. Therefore, Zhu Danxi said: Accumulated heat, dead blood (stasis), food retention, and damp-phlegm can all cause abdominal pain; one should seek treatment based on the specific category of the cause. Dai Shi said: Continuous abdominal pain without fluctuation indicates cold; intermittent pain indicates heat; pain fixed in one place without migration indicates blood stasis; severe pain with an urge to defecate, where pain decreases after defecation, indicates food retention. Generally speaking, pain accompanied by difficulty in urination, or temporary relief after consuming spicy hot liquids, indicates phlegm-dampness; pain that subsides allowing for eating, intermittent occurrence, distended abdomen with swollen blue veins, continuous recurrence, salivation, and vomiting of clear fluid indicate parasitic worms.
Cheng Wuji stated: When pathogenic factors gather in the Lower Jiao (Lower Burner), body fluids fail to circulate freely, and Qi and Blood stagnate. This may manifest as urinary abnormalities or blood stasis in the lower region, resulting in fullness, hardness, and pain. If hardness, fullness, and pain extend from the epigastrium down to the hypogastrium, but urination is free, it is a syndrome of Blood Stasis (accumulation of blood); if urination is difficult, it is a syndrome of Urinary Difficulty (dysuria).
The *Mai Jing* (Pulse Classic) states: A pulse that is fine, small, and urgent indicates rapid progression of disease and stabbing pain in the abdomen. A wiry pulse in the Yin position indicates abdominal pain. A wiry and urgent pulse indicates lower abdominal pain. A tight pulse at the Chi position (cun-chi pulse at the wrist corresponding to the kidneys/lower abdomen) indicates pain below the navel. A hidden pulse at the Chi position indicates lower abdominal pain, possibly associated with hernia or masses. A solid pulse at the Chi position indicates lower abdominal pain, requiring purgation or unblocking. In abdominal pain, if the pulse is unexpectedly floating, large, and long, the prognosis is fatal. In heart and abdominal pain causing breathlessness, a fine, small, and slow pulse indicates survival; a large and rapid pulse indicates death. In Shanghan (Cold Damage), if the Yang pulse is choppy and the Yin pulse is minute, with acute abdominal pain, it indicates interior deficiency-cold.