【纲】仲景曰。尺寸脉微缓者。厥阴受病也。当六七日发。其症少腹烦满。而囊缩。
病者手足厥逆。言我不结胸。小腹满。按之痛者。此冷结在膀胱关元也。胁下素有痞。连在脐
旁。痛引少腹。入阴筋者。名脏结。死。
【目】王肯堂曰。少腹。下焦所治。当膀胱上口。主分别清浊。冷结在膀胱。或用真武汤。
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。溺与血耳。邪结下焦。则津液不通。血气不行。或溺或血。留滞而腹胀也。若小便利者。蓄血
之症。小便不利者。溺涩症也。俱是热病。惟冷结膀胱。少腹满一症。为寒病。有手足厥冷可辨。
【纲】仲景曰。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。宜桃仁承气汤。
【目】成无己曰。如狂者。热在下焦。必与血相搏。若不蓄。为热迫之。则血自下。下则热随血
出而自愈。不下则血为热搏。蓄积于下。而少腹急结。乃可攻之。以下热散血。内经曰。从外之内
而盛于内者。先治其外。后调其内。此之谓也。
【纲要】张仲景说：寸口和尺部的脉搏呈现微缓之象，这是厥阴经受邪所致。通常在发病后的第六或第七天发作。其症状表现为少腹部烦闷胀满，以及阴囊收缩。
如果患者手足逆冷，并诉说“我没有结胸证”，但小腹胀满，按压时感到疼痛，这是寒气凝结在膀胱的关元穴部位。
如果胁下素有痞块，延伸至脐旁，疼痛牵引至少腹并进入阴筋（阴茎），这种病症称为“脏结”，预后不良，会导致死亡。
【目论】王肯堂说：少腹是下焦所管辖的区域，位于膀胱上口，主要功能是分别清浊之气。若寒气凝结在膀胱，可以使用真武汤治疗。
胸部胀满、心下部胀满，都是气机阻滞所致；腹部胀满，大多是因为有燥屎内结；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；身体下半部分，与地之阴气相应。清阳之气出于上窍，浊阴之气出于下窍。因此，在上部的胀满是气滞，在下部的胀满是有形之物。所谓有形之物，不过是溺液（尿液）和血液罢了。
邪气结聚于下焦，导致津液不通畅，气血运行受阻，从而造成溺液或血液留滞，引起腹胀。
如果小便通畅，则是蓄血的症状；如果小便不利，则是溺涩（尿潴留）的症状。这两种情况都属于热病。只有寒气凝结在膀胱引起的少腹胀满这一症状，属于寒病，可以通过手足厥冷来辨别。
【纲要】张仲景说：太阳病未能解除，热邪结聚在膀胱。患者会出现神志狂乱如狂的状态。如果瘀血自行排出，病情就会痊愈。
如果表证仍未解除，尚不可使用攻下法。应当先解表。待表证解除后，如果仅剩下少腹急迫结痛的症状，才可以进行攻下治疗。适宜使用桃仁承气汤。
【目论】成无己说：“如狂”的症状，是因为热邪在下焦，必然与血液相互搏结。如果瘀血没有蓄积，只是受热邪逼迫，血液就会自行排出。血液排出后，热邪随之而散，疾病自愈。
如果血液不排出，就会被热邪搏结，蓄积在下焦，导致少腹急迫结痛，此时才可以进行攻下治疗，以泻下热邪、消散瘀血。
《内经》说：“病邪从外部侵入内部并在内部盛行的，应先治疗外部，后调理内部。”说的就是这个道理。
[General Principles] Zhang Zhongjing stated: When the pulse at both the Cun (inch) and Chi (cubit) positions appears slightly slow and mild, it indicates that the Jueyin meridian is affected. This condition typically manifests on the sixth or seventh day of onset. The symptoms include a sense of vexation and fullness in the lower abdomen, along with retraction of the scrotum.
If the patient experiences cold extremities and states, "I do not have chest binding (Jie Xiong)," yet presents with fullness in the lower abdomen and pain upon palpation, this indicates cold binding at the Guanyuan point of the Bladder.
If there has long been a mass (Pi) under the hypochondrium extending to the side of the umbilicus, with pain radiating to the lower abdomen and entering the genitalia (penis), this disease is named Zang Jie (Organ Binding). It carries a fatal prognosis.
[Commentary] Wang Kentang stated: The lower abdomen is governed by the Lower Jiao, located at the upper opening of the Bladder, and its primary function is to separate the clear from the turbid. If cold binds in the Bladder, Zhenwu Tang may be used.
Fullness in the chest and below the heart is due to Qi stagnation. Fullness in the abdomen is mostly caused by dry feces. Fullness in the lower abdomen is caused by the accumulation of tangible matter. Generally, the upper half of the body corresponds to the Yang of Heaven, while the lower half corresponds to the Yin of Earth. Clear Yang emerges from the upper orifices, and turbid Yin exits through the lower orifices. Therefore, fullness in the upper part is due to Qi, whereas fullness in the lower part is due to tangible matter. Such tangible matter consists merely of urine and blood.
When pathogenic factors bind in the Lower Jiao, body fluids become obstructed, and Qi and Blood fail to circulate. Consequently, either urine or blood remains stagnant, leading to abdominal distension. If urination is unobstructed, it is a symptom of Blood Accumulation (Xu Xue); if urination is difficult, it is a symptom of Urinary Retention (Niao Se). Both are classified as Heat diseases. Only the symptom of lower abdominal fullness caused by Cold binding in the Bladder belongs to Cold diseases, which can be distinguished by cold extremities.
[General Principles] Zhang Zhongjing stated: If the Taiyang disease is not resolved, heat binds in the Bladder. The patient will exhibit a manic state resembling madness (Ru Kuang). If blood discharges spontaneously, the disease will heal. If the exterior syndrome is not yet resolved, attack methods should not be employed yet. One must first resolve the exterior. Once the exterior is resolved, if only urgent binding and pain in the lower abdomen remain, then an attack method can be used. Tao Ren Cheng Qi Tang is appropriate.
[Commentary] Cheng Wuji stated: The symptom of "resembling madness" occurs because heat in the Lower Jiao necessarily contends with blood. If blood does not accumulate but is merely forced by heat, it will discharge spontaneously. Upon discharge, the heat dissipates with the blood, and the disease heals. If the blood does not discharge, it is contended by heat and accumulates in the lower part, causing urgent binding in the lower abdomen; only then can an attack method be used to purge heat and dissipate blood.
The Neijing states: "When pathogens enter from the exterior into the interior and become prevalent within, treat the exterior first, then regulate the interior." This refers to such cases.