（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都是气机阻滞所致，腹部胀满大多是因为有燥屎内结，而少腹胀满则是有形之物积聚。大概身体上半部分与天之阳气相应，下半部分与地之阴气相应，清阳之气出于上窍，浊阴之气出于下窍。所以上部的胀满是气滞，下部的胀满是物积。所谓“物”，就是溺液（尿液）和血液罢了。邪气结聚在下焦，导致津液不通、血气运行不畅，或者是溺液停滞，或者是血液停滞，从而引起胀满。如果小便通畅，则是蓄血证；如果小便不利，则是溺涩证。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情况属于寒病，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（详见咳嗽条）。
太阳病经过六七天，表证仍在，脉象微而沉，反而不形成结胸证，其人发狂的，是因为热邪结聚在下焦。如果少腹部硬满，小便自利的，通过泻下瘀血才能痊愈。之所以这样，是因为太阳经的邪热随经入里，瘀热在体内。主治方为抵当汤。（成无己注：太阳经与膀胱腑相表里，这是太阳瘀热随经传入腑脏的情况。六七天是邪气传里的时间。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，其人发狂，说明热结在膀胱。经文说“热结膀胱，其人如狂”，现在发狂，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，才是血证的确凿证据。用抵当汤来攻下蓄血。）
伤寒发热，少腹满，应当小便不利，现在反而小便通利的，是有瘀血，应当攻下，不可用其他药物，宜用抵当丸。（成无己注：伤寒发热、少腹满是下焦蓄血。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蓄积血液，导致血行不行，则小便自利，这才是蓄血。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，也没有喜忘、发狂等症状，说明病情尚未严重，所以不能用其余峻猛的药物，可以用抵当丸轻微攻下。）
太阳病，身黄，脉沉结，少腹硬，小便不利的，是无血证；小便自利，其人如狂的，是血证的确凿证据，主治方为抵当汤。（身黄、脉沉结、少腹硬、小便不利，是胃热发黄，可用茵陈汤。身黄、脉沉结、少腹硬、小便自利、其人如狂，不是胃中瘀热，而是热结下焦形成的蓄血，用抵当汤攻下蓄血。）
太阳病，重发汗又误用下法，导致五六天不大便，舌上干燥且口渴，傍晚时分有轻微潮热，从心下直到少腹硬满且疼痛拒按的，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：寸关尺脉微缓的，是厥阴经受病。应当在六七天时出现其证候：少腹烦闷胀满且睾丸收缩。病人手足厥冷，说自己不结胸，小腹满，按压疼痛的，这是冷结在膀胱关元穴。（小腹属下焦管辖，位于膀胱上口，主分别清浊，可用真武汤治疗。）胁下素有痞块，连及脐旁，疼痛牵引少腹进入阴筋的，名叫脏结，属死证；也有人说，如果有动气，误用汗、吐、下法的，也是死证。
少腹急：太阳病不解，热邪结聚膀胱，其人如狂，如果瘀血自行排出，病就会好。如果表证未解，还不可以攻下，应当先解表。表解之后，仅见少腹急结的，才可以攻下，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。太阳经邪热不解，随经传入腑脏，形成热结膀胱。其人如狂，说明还未达到真正发狂的程度，只是心神不宁。经文说“其人如狂”，是因为热在下焦。太阳多热，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，血下则热随血出而愈。如果血不下，则血被热邪搏结蓄积于下，导致少腹急结，此时才可攻下，给予桃核承气汤以清热散血。《内经》说：“病邪从外侵入内部并盛于内的，先治其外部，后调理其内部”，说的就是这个道理。）身体沉重、少气、少腹里急，或者牵引阴中拘挛、热气上冲胸部的，是阴阳易病（治法见本门）。
(Shao Fu Ji - Urgency and Fullness in the Lower Abdomen)
The area below the umbilicus is called Shao Fu (Lower Abdomen). Fullness in the chest and fullness below the heart are caused by Qi stagnation. Abdominal fullness is mostly due to the accumulation of dry stool, whereas fullness in the lower abdomen is due to the accumulation of tangible matter. Generally, the upper half of the body corresponds to the Yang of Heaven, and the lower half corresponds to the Yin 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 stagnation, while fullness in the lower part is due to tangible matter accumulation. The so-called "matter" refers to urine and blood. When pathogenic factors knot in the Lower Jiao (Lower Burner), fluid metabolism is obstructed, and Qi and Blood circulation is impeded. This leads to either urinary retention or blood stasis, resulting in distension and fullness. If urination is unobstructed, it indicates Blood Accumulation (Xu Xue); if urination is difficult, it 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 Shang Han (Cold Damage to the Tai Yang Channel), 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 administered (see details under Cough).
In Tai Yang Bing (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 madness, it is because heat has knotted in the Lower Jiao. If the lower abdomen is hard and full, and urination is spontaneous, purging the blood will lead to recovery. This is because the heat from the Tai Yang channel has followed the meridian into the interior, where stasis-heat resides. Di Dang Tang (Di Dang Decoction) should be administered. (Cheng Wuji notes: Tai Yang Channel and Bladder Fu Organ are externally and internally related; this is a case of Tai Yang stasis-heat entering the Fu organ via the channel. 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 madness, the heat has knotted in the Bladder. The Classic states: "Heat knotting in the Bladder causes the person to appear mad." The current state of actual madness indicates deeper heat. If the lower abdomen is hard and full with difficult urination, it is not a blood syndrome; if urination is spontaneous, it is definitive evidence of a blood syndrome. Use Di Dang Tang to purge the accumulated blood.)
In Shang Han (Cold Damage) with fever and lower abdominal fullness, urination should be difficult. If it is now unobstructed, it indicates blood stasis. It should be purged; other medicines are not suitable, and Di Dang Wan (Di Dang Pill) should be used. (Cheng Wuji notes: Fever and lower abdominal fullness in Shang Han indicate blood accumulation in the Lower Jiao. If heat accumulates and obstructs fluids, urination is difficult. If heat does not accumulate fluids but causes blood stasis, urination remains spontaneous, which confirms blood accumulation. One should use Tao Ren Cheng Qi Tang (Tao Ren Cathartic Decoction) or Di Dang Tang to purge. However, this case lacks yellowing of the skin, black stools, forgetfulness, or madness, indicating the condition is not severe. Therefore, harsh purgatives should not be used; instead, the mild purgative effect of Di Dang Wan is appropriate.)
In Tai Yang Bing, if there is jaundice, a deep and knotted pulse, hardness in the lower abdomen, and difficult urination, it is not a blood syndrome. If urination is spontaneous and the patient appears mad, it is definitive evidence of a blood syndrome, treated with Di Dang Tang. (Jaundice, deep/knotted pulse, lower abdominal hardness, and difficult urination indicate Stomach Heat Jaundice, treatable with Yin Chen Tang. Jaundice, deep/knotted pulse, lower abdominal hardness, spontaneous urination, and appearing mad indicate not Stomach Heat Stasis, but Heat Knotting in the Lower Jiao forming Blood Accumulation, treated with Di Dang Tang to purge the accumulated blood.)
In Tai Yang Bing, if excessive sweating is followed by mistaken purgation, leading to constipation for five or six days, dry tongue with thirst, slight afternoon tidal fever, and hardness/fullness/pain from the epigastrium down to the lower abdomen that cannot be touched, Da Xian Xiong Tang (Major Sinking Chest Decoction) should be administered. (The *Ren Jian Shu* states: Delirium day and night, forgetfulness, lower abdominal fullness, and difficult urination indicate Blood Stasis in men and Heat Entering the Blood Chamber in women, both treated with Di Dang Tang.)
Jue Yin Disease: A faint and slow pulse at all three positions indicates Jue Yin disease. Around the sixth or seventh day, symptoms such as irritability and fullness in the lower abdomen and retraction of the scrotum may appear. If the patient has cold extremities, claims there is no chest binding, has lower abdominal fullness, and pain 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 bladder opening, responsible for separating clear from turbid. Zhen Wu Tang (True Warrior Decoction) may be used.) If there is a pre-existing mass under the ribs extending to the side of the umbilicus, with pain radiating to the lower abdomen and into the genital tendons, it is named Zang Jie (Organ Binding), which is fatal. Some say that if there is moving Qi and one mistakenly uses sweating, vomiting, or purging methods, it is also fatal.
Shao Fu Ji (Urgency in Lower Abdomen): In Tai Yang Bing, if unresolved, heat knots in the Bladder, causing the patient to appear mad. If blood discharges spontaneously, the disease resolves. If the exterior syndrome is unresolved, attack is contraindicated; resolve the exterior first. Once the exterior is resolved, if only urgency and knotting in the lower abdomen remain, attack may proceed using Tao He Cheng Qi Tang (Peach Pit Cathartic Decoction). (To purge blood, use Di Dang Tang; to resolve the exterior, use Gui Zhi Tang. Tai Yang Channel and Bladder Fu Organ are related. Unresolved heat in the Tai Yang channel follows the meridian into the Fu organ, causing Heat Knotting in the Bladder. Appearing mad indicates the condition has not reached true madness but is merely restlessness. The Classic states: "Appearing mad" occurs because heat is in the Lower Jiao. Tai Yang is prone to heat; heat in the Bladder must contend with blood. If blood is not accumulated but forced by heat, it discharges spontaneously; as blood leaves, heat exits with it, and the disease resolves. If blood does not discharge, it is contended and accumulated by heat in the lower region, causing urgency and knotting in the lower abdomen. At this point, attack is permissible. Administer Tao He Cheng Qi Tang to clear heat and dissipate blood. The *Nei Jing* states: "When pathogenic factors enter from the exterior and become abundant in the interior, treat the exterior first, then regulate the interior." This principle applies here.) Body heaviness, shortness of breath, urgency in the lower abdomen, possibly drawing into spasms in the genitalia, and heat rushing up to the chest constitute the Yi Chang Bing (Yin-Yang Exchange Disease) (Treatment see relevant section).