尺寸俱沉细者，太阴受病也。当四五日发，其经布胃中，络于嗌，故腹满而嗌干，宜大承气汤
下之。（方在可下证中。）
太阴之为病，腹满而吐，食不下，自利益甚，时腹自痛，若下之，必胸下结硬。自利不渴者，
属太阴，其脏有寒故也。（当温之，以四逆辈。）
伤寒三日，太阳脉弱，至四日，太阴脉大。（脉大而胸满多痰者，宜吐之；无此证者，宜汗之。）
伤寒脉浮缓，（亦大之类。）手足自温者，系在太阴，小便不利者，必发黄；（五苓散加茵陈主之。）
若小便自利者，不能发黄，至七八日，虽暴烦下利日十余行，必自止，以脾家实，腐秽当去故也，
橘皮汤主之。
五苓茵陈汤
以茵陈浓煎，汤调五苓散二钱服之，日三四，黄从小便下，以小便清为度。
橘皮汤
橘皮（一两） 生姜（二两）
细锉，水一升半，煎七合去滓，分二服，稍热呷，未瘥再作服。
本太阳病，医反下之，因尔腹满时痛者，属太阴也，桂枝芍药汤主之。
桂枝（一两半） 芍药（三两） 甘草（一两） 大枣（六枚） 生姜（一两半）
咀，以水三升，煮取一升半，去滓，每温一盏，日三服。（注云∶小建中汤不用饴糖，故芍
药为君，止痛复利邪故也。）
尺寸俱沉者，少阴受病也。当五六日发，以其经贯肾，络于肺，系舌本，故口燥舌干而渴，大
承气汤下之。（方在可下证中。）
少阴之为病，脉微细，欲寐也。
少阴中风，阳微阴浮，为欲愈也。
凡少阴病四逆者，宜温之。
少阴病，始得之，反发热，脉沉者，麻黄细辛附子汤主之。
麻黄（二两） 细辛（二两） 附子（一枚）
咀，以水三升，先煮麻黄十数沸，去上沫，内诸药，煮取一升，去滓。每温一盏，日三服。
少阴病，得之二三日，麻黄附子甘草汤微汗，以二三日无阳证，故微发汗也。（谓初得病
二三日，常见少阴证，无阳者，须发小汗也。）
麻黄（二两） 甘草（二两） 附子（一枚）
咀，以水三升，先煮麻黄十数沸，去上沫，内诸药，煮取一升半，去滓，每温一盏，日三服。
庞曰∶少阴病脉沉，不知何沉也，且沉紧发汗则动经，沉数为病在里，不可发汗。详此脉或沉
而濡，或沉而微，是表中寒而里不消，脉应里而发热在表，故以小辛之药，温散而微微取汗也。
少阴病，吐利，手足不逆冷，发热者不死；脉不至者，灸少阴七壮。（太溪穴在内踝后跟骨上
动脉陷中。言发热者，谓其身发热也。）
少阴病，吐利，烦躁四逆者，死。（烦躁者，内烦躁也。与茱萸汤证，宜细审其生死也。）
少阴病，恶寒而倦（居员切。）时时自烦，不欲浓衣，宜大柴胡汤。（方在可下证中。）
少阴病四逆，恶寒而自倦，脉不至而吐利，烦躁者，死。（重详定此。）
少阴病下利，利止而眩，时自冒者，死。（此合是少阳冒昧汗 出，脉匀小浮者生。少阴无眩
冒之证。）
少阴病六七日，息高者，死。
少阴病，脉微细沉，但欲卧，汗出不烦，自欲吐，至五六日自利，复烦躁，不得卧寐者，死。
少阴病，得之二三日以上，心中烦，不得卧者，黄连阿胶汤主之。
黄连（一两） 黄芩（一分） 芍药（一分） 鸡子黄（半枚） 阿胶（炙，三分，为末）
以水二升，先煮三物，取一升，去滓，内阿胶烊尽，小冷，内鸡子黄，搅令相得，温温一盏，
日三四服。
少阴病，下利清水，色纯清，心下必痛，口干燥者，大承气汤下之。（方在可下证中。）
少阴病，吐利，手足厥冷，烦躁欲死者，茱萸汤主之。
茱萸（一两半，汤洗三遍） 人参（三分） 生姜（一两半） 大枣（三个）
以水三升半，煮取一升半，去滓。每温一盏，日三服。
少阴病，咽痛者，桔梗甘草汤主之。
桔梗（半两） 甘草（一两）
细锉，水一升，煎半升，去滓，作三服，细呷之。
又半夏散亦主之。
半夏（汤洗七遍） 桂枝（去皮） 甘草（炙）
上各等分，各别捣筛已，合治之。每服三钱，水一盏半，煎至八分，温冷少少咽之。
少阴病，下利清谷，里寒外热，手足厥逆，脉微欲绝，身反不恶寒，其人面赤，
或腹痛，或干呕，或咽痛，或利止脉不出者，通脉四逆汤主之。
甘草（一两） 附子（大者半个，强人加半个。） 干姜（三分，强人加一两半）
细锉，水三升，煎至一升，去滓，每温服一盏，日三四服。未瘥，急更作一剂，不可作煮散。
其脉续续出者愈，暴出者死。面赤者，加连须葱四茎，去青；腹痛，去葱加芍药一两；呕者加生姜
一两；咽痛者去芍药加桔梗半两；利止脉不出者，去桔梗加人参半两。病与方皆相应者，乃与服之。
少阴病，下利六七日，咳而呕渴，心烦不得眠者，宜猪苓汤。
猪苓 茯苓 泽泻 滑石 阿胶（各半两）
咀，以水二升，先煮四物取一升，去滓，内阿胶末烊尽，每温一盏服。
少阴病，下利咽痛，胸满心烦，猪肤汤主之。
猪肤（半斤）
以水五升，煮取二升半，去滓，加白蜜半升，白粉二合半，熬香和令相得，每温服一盏，日三
四服。
少阴病，四逆，其人或咳，或悸，或小便不利，或腹中痛，或泄利下重者，四逆
散主之。
甘草 枳实 柴胡 芍药（各五分）
捣筛为细末，白饮和服方寸匕，日三服。咳者加五味子、干姜（炮），各二分半，并主下利；
悸者，加桂二分半；小便不利者，加赤茯苓二分半；腹痛者，加附子一个，炮，去皮脐；泄利下重
者，先以水三升，薤白一升半，煮取二升，去滓，以散方寸匕，用薤白汤一盏，煎八分，日三四服。
When the pulse at the cun, guan, and chi positions is both deep (Chen) and fine (Xi), it indicates that the Taiyin meridian is affected. This typically manifests on the fourth or fifth day of onset. Since the Taiyin meridian spreads through the stomach and connects to the throat, symptoms include abdominal fullness and dryness of the throat. The appropriate treatment is Dachengqi Tang (Major Order the Qi Decoction) to purge downward. (The formula is detailed in the section on "Indications for Purging".)
Taiyin disease is characterized by abdominal fullness and vomiting, inability to eat, worsening spontaneous diarrhea, and occasional spontaneous abdominal pain. If purgatives are incorrectly used, it will inevitably lead to hardness and binding below the chest. Spontaneous diarrhea without thirst belongs to Taiyin, caused by cold in the zang organs. (Treatment should involve warming methods, using formulas such as Sini Tang.)
In Shanghan (Cold Damage) disease, on the third day, the Shaoyang pulse becomes weak; by the fourth day, the Taiyin pulse becomes large. (If the pulse is large accompanied by chest fullness and profuse phlegm, emesis is indicated; if these symptoms are absent, diaphoresis is indicated.)
In Shanghan disease, if the pulse is floating and slow (also a variation of a large pulse) and the hands and feet are naturally warm, the disease is associated with Taiyin. If urination is difficult, jaundice will certainly develop; (Wuling San plus Yinchen should be administered.) If urination is free, jaundice will not develop. By the seventh or eighth day, although there may be sudden irritability and frequent diarrhea (more than ten times a day), the diarrhea will stop spontaneously because the spleen's qi is restored (Shijia Shi) and the putrid filth is being expelled. Jupi Tang should be administered.
Wuling Yichen Tang
Decoct Yinchen (Artemisiae Scopariae Herba) thickly to make a decoction, mix with two qian of Wuling San, and take three to four times daily. Continue until the urine clears, indicating the resolution of jaundice via urination.
Jupi Tang
Jupi (Citri Reticulatae Pericarpium, 1 liang) Shengjiang (Zingiberis Rhizoma Recens, 2 liang)
Finely chop, add one sheng and half of water, decoct to seven he, remove dregs, and divide into two doses. Sip while slightly warm. If not cured, prepare another dose.
Originally suffering from Taiyang disease, if the physician erroneously uses purgation, leading to abdominal fullness and intermittent pain, this belongs to Taiyin. Guizhi Shaoyao Tang should be administered.
Guizhi (Cinnamomi Ramulus, 1.5 liang) Shaoyao (Paeoniae Radix Alba, 3 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang) Dazao (Ziziphi Jujubae Fructus, 6 pieces) Shengjiang (Zingiberis Rhizoma Recens, 1.5 liang)
Chop, add three sheng of water, decoct to obtain one sheng and half, remove dregs, and take one wan warm, three times daily. (Note: Xiao Jianzhong Tang does not use Yitang, so Shaoyao serves as the sovereign herb to relieve pain and expel pathogens.)
When the pulse at all three positions is deep, it indicates that the Shaoyin meridian is affected. This typically manifests on the fifth or sixth day. Since the Shaoyin meridian passes through the kidney, connects to the lung, and ties to the root of the tongue, symptoms include dry mouth, dry tongue, and thirst. Dachengqi Tang should be used to purge downward. (The formula is detailed in the section on "Indications for Purging".)
Shaoyin disease is characterized by a faint and fine pulse and a desire to sleep.
Shaoyin disease with wind-strike, where the yang pulse is faint and the yin pulse is floating, indicates impending recovery.
For any Shaoyin disease presenting with SiNi (cold extremities), warming methods should be employed.
In Shaoyin disease, if upon initial onset there is fever despite a deep pulse, Mahuang Xixin Fuzi Tang should be administered.
Mahuang (Ephedrae Herba, 2 liang) Xixin (Asari Radix et Rhizoma, 2 liang) Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece)
Chop, add three sheng of water, first boil Mahuang for several boils, skim off the foam, add other herbs, decoct to obtain one sheng, remove dregs, and take one wan warm, three times daily.
In Shaoyin disease, after two or three days, Mahuang Fuzi Gancao Tang should be used to induce slight sweating. This is because there are no Yang syndrome manifestations after two or three days, requiring mild diaphoresis. (This means that in the first two or three days, when Shaoyin symptoms are common and Yang signs are absent, mild sweating is necessary.)
Mahuang (Ephedrae Herba, 2 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang) Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece)
Chop, add three sheng of water, first boil Mahuang for several boils, skim off the foam, add other herbs, decoct to obtain one sheng and half, remove dregs, and take one wan warm, three times daily.
Pang Anshi stated: Regarding the deep pulse in Shaoyin disease, one must determine the specific quality. A deep-tight pulse contraindicates diaphoresis as it disturbs the meridians; a deep-rapid pulse indicates interior pathology, also contraindicating diaphoresis. Careful examination reveals the pulse may be deep and soggy or deep and faint. This indicates exterior cold with unresolved interior conditions, where the pulse reflects interior involvement but fever is present at the exterior. Therefore, acrid-warm herbs are used to disperse cold and induce slight sweating.
In Shaoyin disease, if there is vomiting and diarrhea, but the hands and feet are not cold, and there is fever, the prognosis is good (not fatal). If the pulse is imperceptible, moxa should be applied to the Shaoyin point (Taixi) seven moxibustion cones. (Taixi is located in the depression anterior to the medial malleolus and posterior to the tibialis posterior artery. "Fever" here refers to body heat.)
In Shaoyin disease, if there is vomiting, diarrhea, restlessness, and cold extremities, the prognosis is poor (fatal). (Restlessness here refers to internal agitation. This must be carefully distinguished from Zhuyu Tang patterns to assess prognosis.)
In Shaoyin disease, if there is aversion to cold, fatigue, periodic internal irritability, and a dislike for heavy clothing, Da Chaihu Tang should be used. (The formula is detailed in the section on "Indications for Purging".)
In Shaoyin disease, if there are cold extremities, aversion to cold, fatigue, an imperceptible pulse, vomiting, diarrhea, and restlessness, the prognosis is poor (fatal). (This situation requires careful re-evaluation.)
In Shaoyin disease, if diarrhea stops but is followed by vertigo and periodic syncope/dizziness, the prognosis is poor (fatal). (Vertigo and sweating with a small, floating, even pulse are characteristic of Shaoyang disease and indicate survival. Shaoyin disease does not typically present with vertigo or syncope.)
In Shaoyin disease, if after six or seven days the breathing is shallow and rapid (Xi Gao), the prognosis is poor (fatal).
In Shaoyin disease, if the pulse is faint, fine, and deep, the patient desires to sleep, sweats without irritability, feels like vomiting, and then develops spontaneous diarrhea, further irritability, and insomnia by the fifth or sixth day, the prognosis is poor (fatal).
In Shaoyin disease, if after two or more days there is mental restlessness and inability to sleep, Huanglian Ejiao Tang should be administered.
Huanglian (Coptidis Rhizoma, 1 liang) Huangqin (Scutellariae Radix, 1 fen) Shaoyao (Paeoniae Radix Alba, 1 fen) Jizihuang (Gallic Ovipsum, half a piece) Ejiao (Colla Corii Asini, 3 fen, calcined and powdered)
Add two sheng of water, decoct the first three herbs to obtain one sheng, remove dregs, dissolve Ejiao completely, let cool slightly, add the egg yolk, stir well, and take one wan warm, three to four times daily.
In Shaoyin disease, if there is diarrhea of clear watery stool, pure clear color, pain in the epigastrium, and dry mouth, Dachengqi Tang should be used to purge downward. (The formula is detailed in the section on "Indications for Purging".)
In Shaoyin disease, if there is vomiting, diarrhea, cold extremities, and severe restlessness, Zhuyu Tang should be administered.
Zhuyu (Euodiae Fructus, 1.5 liang, washed three times with hot water) Renshen (Ginseng Radix, 3 fen) Shengjiang (Zingiberis Rhizoma Recens, 1.5 liang) Dazao (Ziziphi Jujubae Fructus, 3 pieces)
Add three sheng and half of water, decoct to obtain one sheng and half, remove dregs, and take one wan warm, three times daily.
In Shaoyin disease, if there is sore throat, Jiegeng Gancao Tang should be administered.
Jiegeng (Platycodonis Radix, 0.5 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang)
Finely chop, add one sheng of water, decoct to half a sheng, remove dregs, divide into three doses, and sip slowly.
Additionally, Banxia San can also be used.
Banxia (Pinelliae Rhizoma, washed seven times with hot water) Guizhi (Cinnamomi Ramulus, peeled) Gancao (Glycyrrhizae Radix et Rhizoma, calcined)
Equal parts of each, separately pounded and sifted, then mixed. Take three qian per dose, decoct with one sheng and half of water to eight fen, and swallow slowly at a comfortable temperature.
In Shaoyin disease, if there is diarrhea with undigested food, interior cold with exterior heat, cold extremities, a faint pulse nearly imperceptible, aversion to cold is absent, the face is red, or there is abdominal pain, dry retching, sore throat, or cessation of diarrhea with non-detectable pulse, Tongmai Sini Tang should be administered.
Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang) Fuzi (Aconiti Lateralis Radix Praeparata, half of a large piece, add half for robust individuals) Ganjiang (Zingiberis Rhizoma, 3 fen, add 1.5 liang for robust individuals)
Finely chop, add three sheng of water, decoct to one sheng, remove dregs, and take one wan warm, three to four times daily. If not improved, immediately prepare another dose; do not use as a boiled powder. Recovery is indicated by a continuous pulse emergence; sudden emergence indicates death. For facial redness, add four stalks of Congbai (Allii Fistulosi Bulbus) with roots, removing green parts; for abdominal pain, remove Congbai and add Shaoyao (1 liang); for vomiting, add Shengjiang (1 liang); for sore throat, remove Shaoyao and add Jiegeng (0.5 liang); for cessation of diarrhea with non-detectable pulse, remove Jiegeng and add Renshen (0.5 liang). Administer only when the syndrome and formula correspond accurately.
In Shaoyin disease, if after six or seven days of diarrhea there is cough, vomiting, thirst, mental restlessness, and insomnia, Zhuling Tang should be used.
Zhuling (Polyporus, 0.5 liang) Fuling (Poria, 0.5 liang) Zexie (Alismatis Rhizoma, 0.5 liang) Huashi (Talcum, 0.5 liang) Ejiao (Colla Corii Asini, 0.5 liang)
Chop, add two sheng of water, decoct the first four herbs to obtain one sheng, remove dregs, dissolve Ejiao powder completely, and take one wan warm.
In Shaoyin disease, if there is diarrhea, sore throat, chest fullness, and mental restlessness, Zhufu Tang should be administered.
Zhufu (Porcis Cutis, 0.5 jin)
Add five sheng of water, decoct to obtain two sheng and half, remove dregs, add Baimi (White Honey, 0.5 sheng) and Baifen (Rice Flour, 2.5 he), cook until fragrant and mixed well, and take one wan warm, three to four times daily.
In Shaoyin disease, if there are cold extremities, and optionally cough, palpitations, difficult urination, abdominal pain, or a sensation of heaviness in defecation, Sini San should be administered.
Gancao (Glycyrrhizae Radix et Rhizoma) Zhishi (Aurantii Fructus Immaturus) Chaihu (Bupleuri Radix) Shaoyao (Paeoniae Radix Alba) (each 5 fen)
Pound and sift into fine powder, mix with rice water, and take one fangcun bi per dose, three times daily. For cough, add Wuweizi (Schisandrae Fructus) and Ganjiang (Zingiberis Rhizoma, processed), each 2.5 fen, which also treats diarrhea; for palpitations, add Guizhi (Cinnamomi Ramulus) 2.5 fen; for difficult urination, add Chifuling (Polyporus with Red Core) 2.5 fen; for abdominal pain, add Fuzi (Aconiti Lateralis Radix Praeparata) one piece, processed, peeled; for heaviness in defecation, first decoct Xiebai (Allii Macrostemonis Bulbus, 1.5 sheng) in three sheng of water to obtain two sheng, remove dregs, mix with one fangcun bi of the powder, decoct with one wan of the Xiebai soup to eight fen, and take three to four times daily.