脐下为少腹。夫胸中满。心下满。皆气也。腹满。多有燥矢也。少腹满。溺与血之分
也。邪结下焦。津液不通。则溺蓄。血气不行。则血结。皆为胀满而痛也。若小便利者。
为蓄血。宜桃仁承气汤。小便不利者。为水蓄膀胱。宜五苓散。二症俱是热邪。若四
肢厥冷。小便清白。而小腹满痛者。为冷结膀胱。宜当归四逆。加吴萸生姜汤治之。（合参准绳金鉴）
邵评∶少腹满。有寒热二因。邪热入于膀胱。又有血蓄水蓄之不同。最宜细辨。
舌卷囊缩者死。热极而缩者。承气。寒极而缩者。四逆吴茱萸。
邵评∶合虚实寒热二因。治法最精。
按六经主病。仲景非专为伤寒立言。如厥阴所述气冲吐蛔等症。乃厥阴风木
自病。不拘伤寒杂症。但见呕逆吐蛔者。即是肝邪犯胃。宜兼厥阴而治。要知六
淫伤寒兼带厥阴者。可治。若从三阳传至厥阴。则热极生风。九窍将闭。所形皆
败症矣。今将厥阴本病治法列于下。勿以伤寒传经目之可也。
凡遇伤寒热病。症见干呕渴饮。胸膈满闷。格食不下。或两胁抽痛。舌苔黄黑。或兼
吐蛔。此即症兼厥阴。肝邪犯胃而然也。宜用桂枝、芍药、川连、干姜、茯苓、半夏、黄芩
之类主之。吐蛔加椒梅。寒热似疟加柴胡。引出少阳。（肝邪犯胃）
凡伤寒暑湿之症。有呕吐青绿黑臭之水。或黄黑浊饮。或兼吐蛔。此邪已犯厥阴。
因胃中空虚。肝风乘虚袭胃。所吐之物。乃胃底肠中之阴浊。被肝风翻腾。遂至逆
涌而上出于口。俗名胃底翻是也。治宜泄厥阴以安阳明。如桂枝、白芍、川连、吴茱
萸、半夏、茯苓、椒梅之类。以泄厥阴。次用人参、代赭、茯苓、半夏、干姜、川连、乌梅之类。
以安胃镇逆。若其人阳明虚馁。不禁酸苦。又当安胃为主。微兼泄肝。宜人参、姜、连、
吴萸、白芍、茯苓、半夏、乌梅、代赭之类主之。（肝风内袭）
若身热。耳聋。口渴。胸腹板实。入暮谵语。呕逆吐蛔。舌苔黄中带灰黑。此湿热之邪。
结于厥阴之界。病势最险。宜川连、枳实、半夏、茯苓、菖蒲、乌梅、姜汁之类治之。（湿温干厥阴）
若邪从三阳经传入。即在太阴。已多危候。再入少阴。生者少。死者多矣。至传厥阴。
内风已盛。九窍热极将闭。无庸议治。
邵评∶阳邪传至厥阴。入里极深。厥阴内寄相火。邪热与相火两相蒸灼。伤阴最速。阴液消耗。
邪热陷闭。故症多不治。
凡见面青目白。面黄目青。面白目紫。筋急直视。角弓反张。舌焦耳聋。皆厥阴将败
形色。舌卷囊缩。鸦口嘬嘴。昏不知人。醒作睡声。跷足喉直。撮空视。跃跃欲起。脉硬如弦。
此皆厥阴死证。（阳邪传入厥阴死证）
脐下部位称为少腹。胸中胀满、心下（胃脘部）胀满，多属于气机阻滞所致。腹部胀满，大多是因为有燥结的粪便。少腹胀满，则需分辨是尿液蓄积还是瘀血凝结。邪气结聚于下焦，导致津液运行不畅，就会造成尿液蓄积；气血运行受阻，就会形成瘀血凝结。这两种情况都会引起胀满和疼痛。如果小便通畅，属于蓄血证，适宜使用桃仁承气汤。如果小便不利，属于水湿蓄积在膀胱，适宜使用五苓散。这两种病症都是由热邪引起的。如果出现四肢厥冷、小便颜色清亮且白，同时伴有小腹胀痛，这属于冷结膀胱证，适宜使用当归四逆汤加吴茱萸、生姜进行治疗。（参考《医宗金鉴》等书）
邵评：少腹胀满，有寒证和热证两种病因。邪热侵入膀胱，又有蓄血和蓄水之不同，最应当仔细辨别。
舌头卷缩、阴囊收缩者，预后不良，主死。因热极导致的收缩，用承气汤类治疗；因寒极导致的收缩，用四逆汤加吴茱萸治疗。
按六经主治疾病的规律，张仲景并非专门为伤寒立论。例如厥阴篇所述的气上冲心、吐蛔等症状，乃是厥阴风木之气自病，不拘泥于伤寒或杂病，只要见到呕吐、逆气、吐蛔的症状，就是肝邪侵犯胃腑，应当兼治厥阴。要知道，六淫之邪与伤寒兼带厥阴病的，是可以治疗的；若病邪从三阳经传入厥阴，则热极生风，九窍即将闭塞，所呈现的都是败症。现将厥阴本病的治法列在下面，不要将其仅仅视为伤寒传经之病。
凡是遇到伤寒热病，症状表现为干呕、口渴想喝水、胸膈部胀满闷塞、食物格拒不下，或者两胁抽痛，舌苔黄黑，或者兼有吐蛔，这就是症状兼涉厥阴，由肝邪侵犯胃腑所致。适宜使用桂枝、芍药、黄连、干姜、茯苓、半夏、黄芩等药物为主方。吐蛔者加花椒、乌梅；寒热往来似疟疾者加柴胡，以引出病邪至少阳经。（肝邪犯胃）
凡是伤寒暑湿之症，出现呕吐青、绿、黑且气味臭秽的水液，或者黄黑色的浑浊饮水，或者兼有吐蛔，这是邪气已经侵犯厥阴。因为胃中空虚，肝风乘虚侵袭胃腑，所呕吐之物，乃是胃底和肠中的阴浊之气，被肝风翻腾，于是逆涌而上出于口。俗名“胃底翻”。治疗应当泄降厥阴以安抚阳明，如使用桂枝、白芍、黄连、吴茱萸、半夏、茯苓、花椒、乌梅之类以泄降厥阴；其次用人参、代赭石、茯苓、半夏、干姜、黄连、乌梅之类以安抚胃气、镇降逆气。如果其人阳明胃气虚弱，不能耐受酸苦之味，又应当以安抚胃气为主，微微兼以疏泄肝气，适宜使用人参、干姜、黄连、吴茱萸、白芍、茯苓、半夏、乌梅、代赭石等药物为主方。（肝风内袭）
如果身体发热、耳聋、口渴、胸腹部板硬坚实，入夜出现谵语、呕吐逆气、吐蛔，舌苔黄中带灰黑色，这是湿热之邪结聚于厥阴经的界限，病势最为险恶，适宜使用黄连、枳实、半夏、茯苓、石菖蒲、乌梅、姜汁等药物进行治疗。（湿温干犯厥阴）
如果邪气从三阳经传入，即便是在太阴经阶段，也已经多有危重征候；再传入少阴经，存活者少，死亡者多；等到传入厥阴经，体内风邪已经旺盛，九窍热极即将闭塞，无需讨论治疗了。
邵评：阳邪传入厥阴，入里极深。厥阴内寄相火，邪热与相火相互蒸灼，损伤阴液的速度最快。阴液消耗殆尽，邪热陷闭，所以症状大多无法治愈。
凡是见到面色青而眼白、面色黄而眼青、面色白而眼紫、筋脉拘急直视、角弓反张、舌焦耳聋，这些都是厥阴经将败露出的形色特征。舌头卷缩、阴囊收缩、口角歪斜（鸦口嘬嘴）、神志昏迷不知人事、清醒时发出睡梦中的声音、足跷伸、喉头僵硬、撮空理线、跃跃欲起、脉象坚硬如弦，这些都是厥阴经的死证。（阳邪传入厥阴的死证）
The area below the umbilicus is called the Shaoyang abdomen (lower abdomen). Fullness in the chest and fullness below the heart (epigastrium) are both due to Qi stagnation. Abdominal fullness mostly involves dry fecal matter. Shaoyang abdominal fullness distinguishes between urine retention and blood stasis. When pathogenic factors knot in the Lower Jiao, body fluids fail to circulate, leading to urine accumulation; when Qi and Blood fail to move, blood stasis forms. Both conditions result in distension, fullness, and pain. If urination is smooth, it indicates Blood Accumulation (Xuexu), for which Taoren Chengqi Tang (Peach Kernel Decoction to Order the Qi) is appropriate. If urination is difficult, it indicates Water Accumulation in the Bladder, for which Wuling San (Five-Ingredient Powder with Poria) is appropriate. Both syndromes are caused by Heat pathogens. However, if there is coldness of the four limbs, clear and white urine, accompanied by lower abdominal fullness and pain, this indicates Cold Knotting in the Bladder, treated with Danggui Sini Tang (Angelica Sinensis Decoction to Restore Extremities) added with Zhuyu (Evodiae Fructus) and Shengjiang (Zingiberis Rhizoma Recens). (Referenced from *Yizong Jinjian* etc.)
Shao's Commentary: Shaoyang abdominal fullness has two etiologies: Cold and Heat. When Heat pathogens enter the Bladder, there is a distinction between Blood Accumulation and Water Accumulation; careful differentiation is essential.
Tongue retraction and testicular contraction indicate a fatal prognosis. Retraction caused by extreme Heat is treated with Chengqi Decoctions; retraction caused by extreme Cold is treated with Sini Tang added with Zhuyu (Evodiae Fructus).
Shao's Commentary: Integrating the etiologies of Deficiency/Excess and Cold/Heat, the treatment methods are most refined.
According to the diseases governed by the Six Channels, Zhang Zhongjing did not speak solely regarding Shanghan (Cold Damage). For instance, symptoms such as Qi rushing upward and vomiting roundworms described in the Jueyin chapter refer to self-disease of the Jueyin Wind-Wood qi, applicable regardless of whether it is Shanghan or miscellaneous diseases. Whenever vomiting, counterflow Qi, or vomiting roundworms are seen, it indicates Liver Pathogen invading the Stomach, and should be treated by addressing the Jueyin channel. It must be understood that when the Six Exogenous Pathogens and Shanghan involve the Jueyin, they are treatable. However, if the pathogen transmits from the Three Yang channels to the Jueyin, extreme Heat generates Wind, the Nine Orifices are about to close, and all manifestations are signs of collapse. The treatment methods for the primary disease of Jueyin are listed below; do not regard them merely as transmission stages of Shanghan.
Whenever encountering Shanghan heat diseases presenting with dry retching, thirst with desire to drink, oppression and stuffiness in the chest and diaphragm, food rejection unable to go down, or drawing pain in both hypochondria, yellow or black tongue coating, or accompanied by vomiting roundworms, this indicates syndrome involvement of Jueyin due to Liver Pathogen invading the Stomach. It is appropriate to use Guizhi (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix Alba), Chuanlian (Coptidis Rhizoma), Ganjiang (Zingiberis Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma), Huangqin (Scutellariae Radix) as the main formula. Add Jiaojiao (Semen Zanthoxyli) and Wu Mei (Mume Fructus) for vomiting roundworms; add Chaihu (Bupleuri Radix) for alternating chills and fever resembling malaria, to guide the pathogen out to the Shaoyang channel. (Liver Pathogen Invading Stomach)
In cases of Shanghan with Summerheat-Dampness, where there is vomiting of green, blue-black, foul-smelling water, or yellow-black turbid fluid, or accompanied by vomiting roundworms, this indicates the pathogen has invaded Jueyin. Because the Stomach is empty, Liver Wind attacks the Stomach vacuously. The vomited material is the Yin turbidity from the bottom of the stomach and intestines, churned up by Liver Wind, surging counterflow upwards out of the mouth. This is colloquially known as "Stomach Bottom Reversal." Treatment should vent Jueyin to calm Yangming, using Guizhi (Cinnamomi Ramulus), Baishao (Paeoniae Radix Alba), Chuanlian (Coptidis Rhizoma), Zhuyu (Evodiae Fructus), Banxia (Pinelliae Rhizoma), Fuling (Poria), Jiaojiao (Semen Zanthoxyli), Wu Mei (Mume Fructus) to vent Jueyin. Subsequently, use Renshen (Ginseng Radix et Rhizoma), Daizhe (Haematitum), Fuling (Poria), Banxia (Pinelliae Rhizoma), Ganjiang (Zingiberis Rhizoma), Chuanlian (Coptidis Rhizoma), Wu Mei (Mume Fructus) to calm the Stomach and suppress counterflow. If the patient has deficient Yangming Stomach Qi and cannot tolerate sour and bitter flavors, the primary focus should be calming the Stomach, slightly combining with venting the Liver. Use Renshen (Ginseng Radix et Rhizoma), Jiang (Zingiberis Rhizoma), Lian (Coptidis Rhizoma), Zhuyu (Evodiae Fructus), Baishao (Paeoniae Radix Alba), Fuling (Poria), Banxia (Pinelliae Rhizoma), Wu Mei (Mume Fructus), Daizhe (Haematitum) as the main formula. (Internal Invasion of Liver Wind)
If there is body heat, deafness, thirst, board-like hardness of the chest and abdomen, delirium at night, vomiting, counterflow Qi, vomiting roundworms, and a tongue coating yellow with gray-black tinge, this indicates Damp-Heat pathogen knotting at the boundary of Jueyin. The disease progression is extremely dangerous. Treat with Chuanlian (Coptidis Rhizoma), Zhishi (Aurantii Fructus Immaturus), Banxia (Pinelliae Rhizoma), Fuling (Poria), Changpu (Acori Tatarinowii Rhizoma), Wu Mei (Mume Fructus), Jiangzhi (Zingiberis汁) etc. (Damp-Warmth Invading Jueyin)
If the pathogen transmits from the Three Yang channels, even if it reaches Taiyin, there are already many critical signs. Entering Shaoyin, few survive, many die. Upon reaching Jueyin, internal Wind is already vigorous, the Nine Orifices are extremely hot and about to close; discussion of treatment is unnecessary.
Shao's Commentary: Yang pathogens transmitting to Jueyin penetrate deeply into the interior. Jueyin houses Ministerial Fire internally; pathogenic Heat and Ministerial Fire steam each other, damaging Yin rapidly. As Yin fluids are consumed and pathogenic Heat collapses inward, symptoms are mostly untreatable.
Manifestations such as cyanotic complexion with white eyes, yellow complexion with green-tinted eyes, pale complexion with purple eyes, tendon tension with staring gaze, opisthotonos, scorched tongue with deafness, are all color and form indicators of impending Jueyin collapse. Tongue retraction, testicular contraction, crooked mouth corners, unconsciousness, somniloquy upon waking, dorsiflexion of feet with stiff throat, grasping at empty air, restlessness with desire to rise, pulse hard like a bowstring—all these are fatal signs of Jueyin. (Fatal Signs of Yang Pathogen Transmitting to Jueyin)