腹痛者，缘邪气与正气相搏，则为腹痛。如阳邪传里而痛者，其痛不常，当以辛温之剂和之，
小建中汤。阴寒在内而腹痛者，则痛无休时，尝欲作利也，以热剂
温之，附子理中汤。有燥屎宿食而痛者，则烦而不大便，腹满而硬痛也，大承气下之。少阴下利清
谷，脉欲绝，腹痛者，通脉四逆汤；兼小便不利者，真武汤。实痛而关脉实者，桂枝大黄汤。经云
诸痛为实，则痛随利减之法也。
小腹满者，脐下满也。若胸满，心下满，腹中满，皆为邪气而非物。今小腹满，则为有物而非
气。若小便利者，则为蓄血之形。小便不利，此乃溺涩之证。渗利之剂，宜分两途。太阳病不解，
热结膀胱，其人如狂，小腹急满结痛者，桃仁承气汤，下尽黑物则愈。太阴身黄，脉沉，小腹满，
小水不利者，五苓散利之，小便清白为愈。病患素有痞气，连在脐旁，痛引入阴筋者，名脏结，死
也。
呕者，声物俱有而旋出。吐者，无声有物而顿出。有声无物，为干呕也。较之轻重，则呕甚于
吐矣。盖表邪传里，里气上逆，则为呕也。大抵邪在半表半里，则
多呕，及里热而呕者，俱用小柴胡汤。故经云∶呕多，虽有阳明证，不可攻，攻之为逆。若太阳少
阳合病而呕者，黄芩加半夏汤。太阳阳明合病，当自利，若不利而呕者，葛根半夏汤。三阳发热而
呕，俱用小柴胡汤。先呕后渴，此为欲解，当与水解。先渴后呕，为水停心下，赤茯苓汤。若阳明
证，发热汗出，心烦痞硬，下利呕吐，大柴胡汤。若胃冷，脉沉迟，不食，小便利者，半夏理中汤
加姜汁。利而见厥逆者，难治，以其虚寒之甚也。
腹痛，是由于邪气与正气相互搏结所致。如果是阳邪传入体内引起的疼痛，其痛势时作时止，应当用辛温性质的方剂调和，如小建中汤。如果是阴寒之邪内盛导致的腹痛，则疼痛持续不停，常伴有想要腹泻的症状，应用热性药剂温散寒邪，如附子理中汤。如果有燥屎或积食停滞而致痛，则表现为心烦、大便不通、腹部胀满且硬痛，需用大承气汤攻下。少阴病出现下利清谷（完谷不化）、脉象微弱欲绝并伴有腹痛的，用通脉四逆汤；如果兼有小便不利的，用真武汤。实证疼痛且关脉有力的，用桂枝大黄汤。《内经》说“各种疼痛多属实证”，因此疼痛随大便通畅而减轻是治疗法则之一。
小腹满，是指脐下部位胀满。如果是胸部胀满、心下部胀满、全腹胀满，这些都是由邪气阻滞而非有形实邪积聚所致。如今小腹满，则是有形实邪积聚而非单纯的气滞。如果小便通畅，则是蓄血证的表现。如果小便不利，这是溺涩（排尿不畅）的证候。使用渗湿利水的方法，需要区分这两种情况加以处理。太阳病未解，热邪结于膀胱，患者神志如狂，小腹急迫胀满且有结聚疼痛感的，用桃仁承气汤攻下，直到排出黑色瘀血块即可痊愈。太阴病身黄、脉沉、小腹满、小便不利的，用五苓散利水，直到小便颜色清白才算痊愈。病人素有痞气，连及脐旁，疼痛牵引至阴筋的，称为脏结，属于死证。
呕，是指声音和食物同时发出并随即吐出。吐，是指没有声音但有食物突然吐出。只有声音而没有食物吐出，称为干呕。比较轻重程度，呕比吐更严重。大致而言，表邪传入体内，导致里气上逆，就会发生呕吐。一般来说，邪气在半表半里之间，多伴有呕吐；以及里热引起的呕吐，都可用小柴胡汤治疗。所以经书说：“呕吐频繁者，即使有阳明病的症状，也不可攻下，否则就是误治。”如果是太阳病与少阳病合病而出现呕吐的，用黄芩加半夏汤。太阳病与阳明病合病，本应自下利，如果不下利反而呕吐的，用葛根加半夏汤。三阳经发热并伴有呕吐的，都用小柴胡汤。先呕吐后口渴，这是病情将要解除的迹象，应当给予水分补充。先口渴后呕吐，是水饮停聚在心下所致，用赤茯苓汤治疗。如果是阳明病证，出现发热、汗出、心烦、痞硬、下利、呕吐等症状的，用大柴胡汤。如果是胃寒，脉象沉迟，不能进食，但小便通畅的，用半夏理中汤加姜汁。如果下利并出现四肢厥冷的，难以治疗，因为这是极度虚寒的表现。
Abdominal pain arises from the struggle between pathogenic factors and healthy qi. If the pain is caused by yang pathogens transmitting inward, the pain is intermittent; it should be harmonized with acrid-warm formulas, such as Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). If abdominal pain is due to internal yin-cold, the pain is unceasing and often accompanied by a desire for diarrhea; it should be warmed with hot agents, such as Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction). If pain is caused by dry stool or retained food, there will be restlessness, constipation, abdominal fullness, hardness, and painful tenderness; Da Cheng Qi Tang (Major Order the Qi Decoction) should be used to purge. In Sha Yin disease (Disease of the Lesser Yin), if there is diarrhea with undigested food, a pulse that is faint and nearly imperceptible, and abdominal pain, Tong Mai Si Ni Tang (Pulse-Regulating Four Reversals Decoction) is indicated; if accompanied by difficulty in urination, Zhen Wu Tang (True Warrior Decoction) is indicated. For excess-type pain with a solid Guan pulse (Radial position), Gui Zhi Da Huang Tang (Cinnamon Twig and Rhubarb Decoction) is used. The Classic states, "All pains are considered excess," thus the principle that pain decreases with bowel movement applies.
Fullness in the lower abdomen refers to distension below the umbilicus. Fullness in the chest, epigastrium, or general abdomen is usually due to pathogenic stagnation rather than tangible accumulation. However, fullness specifically in the lower abdomen indicates tangible accumulation rather than mere qi stagnation. If urination is free, this presents as blood retention (Blood Stasis). If urination is difficult, it is a syndrome of urinary obstruction. The use of diuretic and damp-draining agents must distinguish between these two pathways. If Tai Yang disease (Disease of the Greater Yang) is unresolved, heat binds to the Bladder, causing mental agitation resembling madness, urgent lower abdominal fullness, and binding pain, Tao Ren Cheng Qi Tang (Peach Kernel Order the Qi Decoction) is used; recovery occurs when black material (blood clots) is expelled. In Tai Yin disease (Disease of the Greater Yin) with jaundice, deep pulse, lower abdominal fullness, and difficult urination, Wu Ling San (Five Ingredient Powder with Poria) is used to promote urination; recovery is marked by clear urine. If a patient has a chronic mass connected to the side of the umbilicus, with pain radiating to the genitalia, it is named Zang Jie (Visceral Binding), which is fatal.
"Ou" (vomiting with sound) involves both sound and matter being ejected simultaneously. "Tu" (spitting/vomiting without sound) involves matter being ejected suddenly without sound. Vomiting only sound without matter is called Gan Ou (dry heaving). Comparing severity, Ou is more severe than Tu. Generally, when exterior pathogens transmit inward, causing rebellious qi in the interior, vomiting occurs. Typically, when pathogens are at the half-exterior half-interior level, vomiting is common; similarly, vomiting due to interior heat is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Thus, the Classic states: "If there is much vomiting, even if Yang Ming symptoms exist, one must not purge; purging would be contraindicated." If vomiting occurs in a combined Tai Yang and Shao Yang disease (Disease of the Lesser Yang), Huang Qin Jia Ban Xia Tang (Scutellaria Added Pinellia Decoction) is used. In combined Tai Yang and Yang Ming disease, spontaneous diarrhea is expected; if there is no diarrhea but vomiting occurs, Ge Gen Jia Ban Xia Tang (Kudzu Added Pinellia Decoction) is used. For fever and vomiting involving the three Yang meridians, Xiao Chai Hu Tang is generally used. Vomiting followed by thirst indicates the condition is resolving; hydration should be provided. Thirst followed by vomiting indicates water retention in the epigastrium; Chi Fu Ling Tang (Red Poria Decoction) is used. For Yang Ming syndrome presenting with fever, sweating, irritability, epigastric hardness, diarrhea, and vomiting, Da Chai Hu Tang (Major Bupleurum Decoction) is indicated. For cold stomach with deep-slow pulse, anorexia, and free urination, Ban Xia Li Zhong Tang (Pinellia Regulate the Middle Decoction) added with ginger juice is used. If diarrhea is accompanied by cold extremities (Jue Ni), it is difficult to treat due to extreme deficiency-cold.