伤寒何事不得眠。汗过胃中干燥烦。（仲景云。太阳病发汗。若大汗出。胃中干。燥烦不得眠。其人欲饮水。当稍饮
之。荣卫和则愈矣。）或因吐下虚烦致。（仲景云。发汗吐下后。虚烦不得眠。若剧者。必反复颠倒。心中懊 。栀子豉
汤主之。）或因大热语言颠。（阳毒热病。皆不得眠。）小便不利正发渴。心烦少气苦孜煎。忽若水停心下满。但与猪苓可
保全。（仲景云。胃中干燥。不得眠者。猪苓汤。）伤寒瘥后热尚在。阴未复时阳使然。（病源云。卫气昼行于阳。夜行于
阴。阴主夜。夜主卧。谓阳气尽。阴气盛。则目瞑矣。今热气未散。与诸阳并。所以阳独盛。阴偏虚。虽复病后仍不得
眠者。阴气未复于本。故也。外台有肘后乌梅汤。）
胃中干则无小便。慎勿利之强使然。（病源云。伤寒发汗后。而汗出不止。津液少。胃中干。小肠有伏热。故小便不
通也。故不可强利之。）下焦有热不通泄。量病浮沉用药宣。（下焦有热者。可宣导之也。）咳而有水青龙候。（仲景云。
伤寒表不解。心下有水气。干呕发热而咳。或小便不利。小腹满或喘者。小青龙汤主之。）项强无汗桂枝痊。（仲景云。
服桂枝汤。或下之。仍头项强痛。翕翕发热。无汗。心下满。胀痛。小便不利者。桂枝去桂加茯苓白术汤。）大抵中湿发
黄者。先利小盒饭使快。（大抵中湿发黄。先利小便使快。仲景云。中湿之为候。其人小便不利。大便反快。但当利其小
便。仲景论风湿证云。若被下者。小便不利。又云。伤寒身色如金黄。如橘子色。小便利。腹微满者。茵陈蒿汤主之。）
阳明汗多津液无。却以小便利为戒。（仲景云。阳明病。汗出多而渴者。不可与猪苓汤。以汗多。胃中燥猪苓复利其小便
也。）阳若凑之阴分（去声。）虚。小便难出热中居。（素问云。阴虚者。阳必凑之。阳入阴分。则膀胱热。而小便难。）
漏风不止桂加附。（仲景云。太阳病发汗。遂漏风不止。恶风。小便难。四肢急。桂枝加附子汤主之。）阳明风中小柴胡。
Why does insomnia occur in Shaoyang diseases? Excessive sweating leads to dryness in the Stomach and restlessness. (Zhang Zhongjing stated: In Taiyang disease, after administering diaphoresis, if profuse sweating occurs, it causes dryness in the Stomach, leading to irritability and inability to sleep. The patient desires water; one should provide small amounts of water frequently. Once Ying and Wei Qi harmonize, the condition will resolve.) It may also result from deficiency-heat causing vexation due to improper use of emesis or purgation. (Zhang Zhongjing stated: After diaphoresis, emesis, or purgation, deficiency-vexation leads to insomnia. If severe, the patient tosses and turns with a feeling of stifling discomfort in the chest; Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.) It may also stem from high fever disturbing the mind, causing delirious speech. (Yang Du heat diseases typically involve insomnia.)
When urination is difficult accompanied by thirst, vexation, and shortness of breath causing suffering. If sudden fluid retention in the Heart region causes fullness, Zhu Ling Tang (Polyporus Decoction) can ensure recovery. (Zhang Zhongjing stated: For insomnia caused by Stomach dryness, Zhu Ling Tang is used.) After the resolution of Cold Damage, residual heat remains; this is due to Yang Qi prevailing while Yin has not yet recovered. (The *Bing Yuan* states: Wei Qi travels through the Yang meridians during the day and Yin meridians at night. Yin governs the night and sleep. When Yang Qi exhausts and Yin Qi abounds, the eyes close for sleep. Now, since heat has not dispersed and merges with Yang Qi, Yang becomes excessive while Yin is deficient. Thus, even post-illness, insomnia persists because Yin has not returned to its root. The *Wai Tai Mi Yao* cites Wu Mei Tang (Black Plum Decoction) from *Zhou Hou Bei Ji Fang*.)
Dryness in the Stomach results in scanty urine; do not forcibly promote diuresis. (The *Bing Yuan* states: After sweating for Cold Damage, if sweating continues incessantly, body fluids decrease, Stomach dryness ensues, and latent heat exists in the Small Intestine, causing urinary obstruction. Therefore, forced diuresis is contraindicated.) Heat in the Lower Jiao causing obstruction requires medication based on the floating or sinking nature of the disease to guide and unblock. (For heat in the Lower Jiao, guiding and unblocking methods are applicable.) Coughing with internal fluid retention indicates Xiao Qing Long Tang (Minor Blue Dragon Decoction). (Zhang Zhongjing stated: In Cold Damage where the exterior syndrome is unresolved, with fluid accumulation in the epigastrium, presenting as dry heaves, fever, and cough, or additionally urinary difficulty, lower abdominal fullness, or wheezing, Xiao Qing Long Tang is indicated.) Neck stiffness without sweat indicates Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractodes Decoction). (Zhang Zhongjing stated: After taking Gui Zhi Tang or undergoing purgation, if headache, neck stiffness, mild fever, absence of sweat, epigastric fullness, distending pain, and urinary difficulty persist, Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang is indicated.) Generally, for jaundice caused by dampness, first promote diuresis to clear the pathways. (Generally, for jaundice due to dampness, diuresis should be promoted first. Zhang Zhongjing stated: The manifestation of dampness involves urinary difficulty but loose stools; only diuresis should be employed. Regarding wind-dampness, Zhang Zhongjing noted: If mistakenly purged, urinary difficulty ensues. Also, in Cold Damage, if the body color resembles jaundice like an orange peel, with free urination and slight abdominal fullness, Yin Chen Hao Tang (Artemisiae Scopariae Decoction) is indicated.) In Yangming disease, excessive sweating depletes fluids; thus, promoting diuresis is contraindicated. (Zhang Zhongjing stated: In Yangming disease, with profuse sweating and thirst, Zhu Ling Tang must not be given, as profuse sweating already causes Stomach dryness, and Zhu Ling Tang would further drain fluids via diuresis.) If Yang Qi invades the Yin aspect (pronounced 'qù shēng'), Yin deficiency allows Yang intrusion, making urination difficult with heat residing within. (The *Su Wen* states: In Yin deficiency, Yang inevitably crowds in. When Yang enters the Yin aspect, the Bladder becomes heated, causing dysuria.) Profuse sweating leakage with continuous perspiration is treated with Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Decoction plus Prepared Aconite Root). (Zhang Zhongjing stated: In Taiyang disease, after diaphoresis, if sweating leaks continuously, accompanied by aversion to wind, dysuria, and tetany of the four limbs, Gui Zhi Jia Fu Zi Tang is indicated.) Yangming Wind Strike is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction).