(Shao Fu Ji - Urgency and Fullness of the Lower Abdomen)
The area below the umbilicus is called Shao Fu (Lower Abdomen). Fullness in the chest and fullness below the heart are mostly due to Qi stagnation; abdominal fullness is mostly caused by the accumulation of dry feces; fullness in the lower abdomen is caused by the accumulation of tangible pathogens. Generally speaking, the upper half of the body corresponds to the Yang Qi of Heaven, and the lower half corresponds to the Yin Qi 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, while fullness in the lower part is due to tangible pathogens. These tangible pathogens are essentially urine and blood. When pathogenic factors knot in the Lower Jiao (Lower Burner), the flow of Body Fluids is obstructed, and Qi and Blood fail to circulate freely. Whether it is urine or blood that stagnates, it leads to distension and fullness.

If urination is unobstructed, this indicates Blood Accumulation (Xu Xue); if urination is difficult, this 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 (Greater Yang) Cold Damage, 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 used (see previous sections for details on cough).

In 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 mania, it is because Heat has knotted in the Lower Jiao. If the lower abdomen is hard and full, and urination is normal, the release of blood will lead to recovery. This is because the Heat of the Tai Yang channel has followed the meridian into the interior, where Stagnant Heat resides. Di Dang Tang (Di Dang Decoction) should be primarily administered. (Cheng Wuji notes: Tai Yang Channel and Bladder Fu Organ are interior-exteriorly related; this is Stagnant Heat of Tai Yang following the channel into the Bladder Fu. 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 mania, the Heat has knotted in the Bladder. The Classic states: "Heat knotted in the Bladder, the person appears manic." Here, actual mania indicates deeper Heat. If the lower abdomen is hard and full with difficult urination, it is not a Blood syndrome; if urination is free, it is definitely a Blood syndrome. Use Di Dang Tang to purge the accumulated blood.)

In Cold Damage with fever and lower abdominal fullness, urination should be difficult. If it is now free, it indicates the presence of Blood stasis. It must be purged; other medicines are not suitable. Di Dang Wan (Di Dang Pill) is appropriate. (Cheng Wuji notes: Fever and lower abdominal fullness in Cold Damage indicate Blood accumulation in the Lower Jiao. If Heat accumulates and obstructs Body Fluids, urination is difficult. If Heat does not accumulate in Body Fluids but causes Blood stasis, urination remains free, which confirms Blood accumulation. One should use Tao Ren Cheng Qi Tang or Di Dang Tang to purge. However, since there is no yellowing of the skin, black stool, amnesia, or mania, the condition is not severe. Thus, harsh purgatives should not be used. Di Dang Wan, a milder formula, should be given for slight purging.)

In Tai Yang disease, if the body is yellow, the pulse is deep and knotted, and the lower abdomen is hard, but urination is difficult, it is not a Blood syndrome. If urination is free and the person appears manic, it is definitely a Blood syndrome. Di Dang Tang should be primarily administered. (Body yellowing, deep and knotted pulse, hard lower abdomen, and difficult urination indicate Stomach Heat causing jaundice; Yin Chen Tang may be used. Body yellowing, deep and knotted pulse, hard lower abdomen, free urination, and mania indicate not Stomach Heat but Heat knotted in the Lower Jiao causing Blood accumulation; use Di Dang Tang to purge the accumulated blood.)

In Tai Yang disease, if excessive sweating is followed by erroneous purgation, leading to constipation for five or six days, dry tongue with thirst, slight tidal fever in the late afternoon, and hardness, fullness, and pain from the epigastrium down to the lower abdomen such that the area cannot be touched, Da Xian Xiong Tang (Major Sinking into the Chest Decoction) should be primarily administered. (Huo Ren Shu states: Day and night delirium, forgetfulness, lower abdominal fullness, and difficult urination indicate Blood stasis in men and Heat entering the Blood Chamber in women; both are treated with Di Dang Tang.)

Jue Yin Disease: If the Cun (Inch) and Chi (Cubit) pulses are faint and slow, it indicates Jue Yin disease. After six or seven days, its manifestations include irritability and fullness in the lower abdomen and retraction of the scrotum. The patient has cold extremities and claims there is no chest binding, but the lower abdomen is full and painful 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 opening of the Bladder, responsible for separating the clear from the turbid. Zhen Wu Tang may be used.) If there is a pre-existing Pi Mass (subcutaneous mass) under the hypochondrium extending to the side of the umbilicus, with pain radiating to the lower abdomen and into the Yin sinews, it is called Zang Jie (Zang Binding) and is fatal. Some say that if there is Dong Qi (moving Qi) and one erroneously uses sweating, vomiting, or purging methods, it is also fatal.

Shao Fu Ji (Urgency of Lower Abdomen): In Tai Yang disease that has not resolved, if Heat knots in the Bladder and the person appears manic, if the blood discharges spontaneously, the disease will heal. If the exterior syndrome is not yet resolved, attack is contraindicated; one must first resolve the exterior. Once the exterior is resolved, if only urgency and binding in the lower abdomen remain, attack may proceed. Tao He Cheng Qi Tang (Tao He Decoction to Order the Qi) is appropriate. (To purge blood, use Di Dang Tang; to resolve the exterior, use Gui Zhi Tang. Tai Yang Channel and Bladder Fu are interior-exteriorly related. Unresolved Heat in the Tai Yang channel follows the meridian into the Fu organ, becoming Heat knotted in the Bladder. "Appearing manic" means the Heat has not reached full mania but causes restlessness. The Classic states: "Appearing manic" because Heat is in the Lower Jiao. Tai Yang channels are prone to Heat; Heat in the Bladder must contend with Blood. If Blood is not accumulated but forced by Heat, it discharges spontaneously; once discharged, Heat exits with the Blood, and the disease heals. If Blood does not discharge, it is contended and accumulated by Heat in the lower part, causing urgency and binding in the lower abdomen. At this point, attack is permissible. Give Tao He Cheng Qi Tang to clear Heat and dissipate Blood. The Inner Classic states: "When pathogenic factors enter from the exterior and become prevalent in the interior, treat the exterior first, then regulate the interior." This refers to this principle.)

Heavy body, shortness of breath, urgency in the lower abdomen, or contraction drawing into the genitalia, with Heat rushing up to the chest, is called Yin Yang Yi Disease (Treatment seen in this section).