邪气入里，与正气相搏，则为腹痛。盖阳邪传里而痛者，其痛不常，当以辛温之剂和之。阴寒
在内而痛者，则痛无休时，欲作利也，当以热剂温之。有燥屎宿食为痛者，则烦而不大便，腹满而
痛也，则后用下。经曰∶诸痛为实，痛随利减。此皆为里证，而所治各不同矣，又当随证施治。
伤寒四五日，腹中痛，若转气不趣小腹者，此欲自利也，四逆汤。
少阴腹痛、四逆，或咳或悸，或小便不利，或泻利下重，并四逆散。
下利清谷，脉微欲绝，通脉四逆汤；腹痛，小便不利，真武汤。
胸中热，胃中有邪气，腹痛，欲呕吐者，黄连汤。
大便实痛者，关脉实，腹满不大便，桂枝加大黄汤、大小承气汤选用之。
小腹满者，脐下满是也。若胸满，心下满，腹满，皆为邪气而非物。今小腹满，
皆为有物而非气。小便利者，则为蓄血之形。小便不利者，乃是溺涩之证。渗利之剂，宜分两途。
经曰∶病患素有痞气，连在脐旁，痛引小腹，入阴筋者，名脏结也，死。
太阳病不解，热结膀胱，其人如狂，小便急结，桃仁承气汤。
太阳病六七日，表证在，脉微沉，不结胸，发狂，小腹硬满，小便自利，抵当汤。
太阳病，目黄，脉沉结，小腹硬，小便不利者，五苓散。
阴阳易，小腹痛，烧 散。
病者手足厥冷，真武汤；不结胸，小腹满，按之痛者，此冷结在膀胱关元，宜灸关元穴。
邪气侵入体内，与正气相互搏结，就会引发腹痛。如果是阳邪传入里部而导致的疼痛，其疼痛发作不规律，应当用辛温性质的方剂来调和。如果是阴寒之气停留在体内而导致的疼痛，则疼痛持续不停，即将出现腹泻症状，应当用热性方剂进行温补。如果有燥屎或积食导致疼痛，患者会感到烦躁且大便不通，腹部胀满并疼痛，此时应随后使用泻下法。医经中说：各种疼痛多属于实证，疼痛随着二便通畅而减轻。这些都属于里证，但治疗方法各不相同，因此应当根据具体证候灵活施治。
伤寒病经过四五日，腹中疼痛，如果听到肠鸣气转但未急迫地趋向小腹的，这是即将自行腹泻的征兆，适用四逆汤。
少阴病出现腹痛、四肢厥冷，或者伴有咳嗽、心悸，或者小便不利，或者腹泻伴肛门重坠感，均适用四逆散。
腹泻排出未消化的食物，脉搏微弱几乎摸不到，适用通脉四逆汤；腹痛且小便不利，适用真武汤。
大便干结疼痛，关脉实大，腹部胀满且不大便的，可选用桂枝加大黄汤或大、小承气汤。
所谓“小腹满”，是指脐下部位胀满。如果是胸部胀满、心下部胀满、全腹部胀满，这些都是由邪气引起而非有形实邪。如今的小腹胀满，都是由有形实邪引起而非单纯的气滞。如果小便通畅，则是蓄血证的征象。如果小便不利，则是尿涩不畅的证候。使用渗湿利水的药物，应当分为两种情况处理。医经中说：病人素来有痞块，连在脐旁，疼痛牵引至小腹，甚至进入阴筋的，称为脏结，预后不良，属死证。
太阳病未解，热邪结聚于膀胱，患者神志如狂，小便急迫结滞，适用桃仁承气汤。
太阳病经过六七日，表证仍在，脉象微沉，没有形成结胸，但出现发狂、小腹硬满、小便自利的症状，适用抵当汤。
When pathogenic factors enter the interior and contend with healthy qi, abdominal pain occurs. If the pain is caused by yang pathogens transmitting to the interior, the pain is intermittent, and it should be harmonized with acrid-warm formulas. If the pain is caused by yin-cold residing in the interior, the pain is continuous without relief, and diarrhea is impending; it should be warmed with hot formulas. If the pain is caused by dry stool or retained food, the patient will feel vexed, have no bowel movement, and experience abdominal fullness and pain; purgation should be applied subsequently. The Classics state: "All pains are excess patterns; pain decreases with the discharge of feces or urine." These all belong to interior patterns, yet their treatments differ; therefore, treatment must be adapted to the specific syndrome.
In Shaoyin disease (Disease of the Lesser Yin), if there is abdominal pain accompanied by cold limbs, or cough, palpitations, difficulty in urination, or diarrhea with a sensation of rectal heaviness, Sini San (Four Counterflow Powder) is indicated.
If there is diarrhea with undigested food and the pulse is faint and nearly imperceptible, Tongmai Sini Tang (Decoction to Restore the Pulse and Reanimate the Extremities) is indicated. If there is abdominal pain and difficulty in urination, Zhenwu Tang (True Warrior Decoction) is indicated.
If there is heat in the chest, pathogenic factors in the stomach, abdominal pain, and a desire to vomit, Huanglian Tang (Coptis Decoction) is indicated.
If the stool is hard and painful, the Guan pulse (Radial artery at the cun position) is excess, and there is abdominal fullness with constipation, Guizhi Ji Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb) or Dachengqi Tang (Major Order the Qi Decoction) / Xiaochengqi Tang (Minor Order the Qi Decoction) may be selected.
"Small abdominal fullness" refers to fullness below the umbilicus. Fullness in the chest, epigastrium, or general abdomen is usually due to pathogenic factors rather than tangible masses. However, small abdominal fullness is typically due to tangible masses rather than mere qi stagnation. If urination is free, it indicates blood retention (Blood Stasis). If urination is difficult, it indicates damp-heat obstructing the bladder. Diuretic and draining agents should be differentiated accordingly. The Classics state: "If a patient has had痞 (Pi - mass/blockage) since ancient times, connected to the side of the umbilicus, with pain radiating to the small abdomen and entering the genitalia, this is called Zang Jie (Organ Knotting), which is fatal."
If Taiyang disease (Disease of the Greater Yang) does not resolve, and heat binds in the Bladder, the patient may exhibit manic behavior, urgent and binding urinary symptoms; Taoren Chengqi Tang (Peach Kernel Order the Qi Decoction) is indicated.
If Taiyang disease persists for six or seven days, with exterior symptoms remaining, a faint and sinking pulse, no Jie Xiong (Chest Binding), but with mania, hardness and fullness of the small abdomen, and free urination, Didang Tang (Defeat the Accumulation Decoction) is indicated.
If Taiyang disease presents with yellow eyes, a sinking and knotted pulse, hardness of the small abdomen, and difficulty in urination, Wuling San (Five-Ingredient Powder with Poria) is indicated.
In Yin-Yang Yi (Exchange of Yin and Yang), if there is small abdominal pain, Shao Kun San (Burned Undergarment Powder) is indicated.
If the patient's hands and feet are cold, Zhenwu Tang (True Warrior Decoction) is indicated. If there is no Jie Xiong, but there is fullness of the small abdomen that is painful upon pressure, this indicates cold binding in the Bladder and Guanyuan (CV-4) area; moxibustion on Guanyuan (CV-4) is appropriate.