四逆汤原方加人参一两。煎服法同。
恶寒脉微而复利，利止亡血也。按∶亡阴即为亡血，不必真脱血也。成无己注引《金匮玉函》曰∶水
竭则无血。谓∶利止则津液内竭。四逆加人参汤主之。加参以生津液。
甘草（二两，炙） 干姜（三两，强人四两） 附子（大者一枚，生用去皮破八片） 上三味，以水三升，煮取一
升二合，去渣，分温再服，其脉即出者愈。
面色赤者，加葱九茎；腹中痛者，去葱加芍药二两；呕者，加生姜二两；咽痛者，去芍药加桔梗一
两；利止脉不出者，去桔梗加人参二两。补益津液。病皆与方相应者，乃服之。
少阴病，下利清谷，里寒外热，寒逼阳于外。手足厥逆，外症。脉微欲绝，内症 身反不恶寒，寒邪
已入里。其人面色赤，阳越。或腹痛；或干呕；或咽痛；阳升。或利止、脉不出者，通脉四逆汤主之。其脉即
出者愈。诸症或阳或阴，乃闭塞不通之故，用辛温通阳之品以治之。其兼症不同，详加减法。
下利清谷，里寒外热，汗出而厥者，汗出而厥，阳有立亡之象。通脉四逆汤主之。
通脉四逆原方加猪胆汁半合。煎如前法，煎成纳猪胆汁，温服，其脉即出。猪胆汁苦滑之极，引药直达下焦。
吐已下断，利止也。汗出而厥，四肢拘急不解，脉微欲绝者，通脉四逆加猪胆汁汤主之。
Si Ni Tang (Frigid Extremities Decoction) original formula plus Ren Shen (Ginseng Radix et Rhizoma) one liang. The decoction and administration methods are the same.
Aversion to cold, faint pulse, accompanied by diarrhea; if the diarrhea stops, it indicates the depletion of Yin fluids and blood. Note: Depletion of Yin is equivalent to depletion of blood; it does not necessarily imply actual hemorrhage. Cheng Wuji's commentary cites *Jin Gui Yu Han* stating: "When water dries up, there is no blood." This means that when diarrhea stops, internal body fluids are exhausted. Si Ni Jia Ren Shen Tang (Frigid Extremities Decoction with Ginseng) should be used as the principal treatment. Ginseng is added to generate body fluids.
Gan Cao (Licorice Root, two liang, honey-fried), Gan Jiang (Dried Ginger, three liang, four liang for robust individuals), Fu Zi (Aconite Lateral Root, one large piece, raw, skin removed, broken into eight pieces). These three ingredients are boiled in three sheng of water until one sheng er he remains. Strain the dregs, divide into two doses, and take warm. If the pulse emerges, the patient will recover.
If the complexion is red, add nine stalks of Cong Bai (Allii Fistulosi Bulbus); if there is abdominal pain, remove Cong Bai and add Bai Shao (White Peony Root, two liang); if there is vomiting, add Sheng Jiang (Fresh Ginger, two liang); if there is a sore throat, remove Bai Shao and add Jie Geng (Platycodon Root, one liang); if diarrhea stops but the pulse does not emerge, remove Jie Geng and add Ren Shen (Ginseng Radix et Rhizoma, two liang) to tonify and benefit body fluids. Administer only when the symptoms correspond precisely to the formula indications.
Sha Yin Bing (Lesser Yin Disease) presenting with diarrhea of undigested food, interior cold with exterior false heat (cold forcing Yang outward), cold extremities (exterior symptom), faint pulse nearly imperceptible (interior symptom), yet the body feels no aversion to cold (indicating pathogenic cold has entered the interior), and the person has a red complexion (Yang floating upward). Alternatively, abdominal pain; or dry retching; or sore throat (Yang rising); or cessation of diarrhea with non-palpable pulse. Tong Mai Si Ni Tang (Pulse-Reviving Frigid Extremities Decoction) should be used as the principal treatment. If the pulse emerges, the patient will recover. Whether symptoms manifest as Yang or Yin patterns, they result from blockage and obstruction. Treat with acrid-warm herbs that unblock and warm Yang. For varying accompanying symptoms, refer to the modification rules.
Diarrhea of undigested food, interior cold with exterior false heat, sweating with cold extremities. Sweating with cold extremities indicates an imminent collapse of Yang. Tong Mai Si Ni Tang (Pulse-Reviving Frigid Extremities Decoction) should be used as the principal treatment.
Tong Mai Si Ni Tang (Pulse-Reviving Frigid Extremities Decoction) original formula plus Zhu Dan Zhi (Porcine Bile, half he). Decoct as previously described; after decoction, add Porcine Bile. Take warm. If the pulse emerges, recovery occurs. Porcine Bile is extremely bitter and slippery, guiding the medicinal action directly to the Lower Jiao.
After vomiting has ceased and diarrhea has stopped, if there is sweating with cold extremities, persistent tetanic contraction of the four limbs, and a faint pulse nearly imperceptible, Tong Mai Si Ni Jia Zhu Dan Zhi Tang (Pulse-Reviving Frigid Extremities Decoction with Porcine Bile) should be used as the principal treatment.