【纲】仲景曰。少阴病。咳而下利。谵语者。被火劫故也。小便必难。以强发少阴汗也。
【目】鳌按。上咳下利。津液丧亡之故。
【纲】仲景曰。少阴病。二三日不已。至四五日。腹痛。小便不利。四肢沉重疼痛。自下利者。
此为有水气。其人或咳。或小便利。或下利。呕者。真武汤主之。
【目】朱肱曰。有少阴症咳嗽。真武汤、四逆散、猪苓汤也。大抵热在上焦。其人必饮水。水
停心下。则肺为之浮。肺主于咳。水气乘之。故咳而微喘。真武加五味子、干姜。大抵伤寒水气。
皆因饮水过多。古人治水气而咳者。病在阳。小青龙汤。病在阴。真武汤。古今录验。橘皮汤治咳
佳。
【纲】仲景曰。少阴病。下利。六七日。咳而呕。渴。心烦。不得眠者。猪苓汤主之。
【目】寇宗 曰。又咳呕。又烦渴。非肾水不升之故而何。
【纲】仲景曰。少阴病。四逆。泄利下重。其人或咳。或悸。或小便不利。或腹中痛者。四逆
散主之。
【目】朱肱曰。四逆散加五味子、干姜。
【纲】仲景曰。太阳病。发汗。汗出不解。其人仍发热。心下悸。头眩。身 动。振振欲擗地
者。真武汤主之。
【目】鳌按。仍发热而心下悸。坎阳外亡。而肾水凌心也。以其为肾水凌心之故。故亦列少阴
款中。
[General Principle] Zhang Zhongjing stated: In Shaoyin disease (a syndrome caused by pathogenic invasion of the Shaoyin meridians), if coughing is accompanied by diarrhea, and the patient also exhibits delirium (confused speech due to heat or phlegm misting the mind), this is caused by fire therapy forcibly depleting body fluids. Urination will inevitably become difficult because excessive sweating was forced upon the Shaoyin channel.
[Commentary] Shen Jin'ao noted: The aforementioned cough and subsequent diarrhea are due to the exhaustion of body fluids (Jinye).
[General Principle] Zhang Zhongjing stated: In Shaoyin disease, if it persists for two to three days without improvement, progressing to four or five days, symptoms such as abdominal pain, difficulty in urination, heaviness and pain in the four limbs, and spontaneous diarrhea occur. This indicates the presence of retained water qi (pathogenic fluid accumulation). Among these patients, some may have coughing, some may have normal urination, some may have diarrhea, and some may have vomiting. These cases should be treated with Zhenwu Tang (True Warrior Decoction).
[Commentary] Zhu Gong stated: For Shaoyin syndrome presenting with cough, one may use Zhenwu Tang, Sini San (Frigid Extremities Powder), or Zhuling Tang (Polyporus Decoction). Generally, when heat is located in the Upper Jiao (Upper Burner), the patient will desire drinking water. If water stagnates below the heart (epigastrium), the Lung is affected and floats upward. Since the Lung governs coughing, the invasion of water qi causes coughing with slight wheezing. Adding Wuweizi (Schisandra Fruit) and Ganjiang (Dried Ginger) to Zhenwu Tang is effective. Generally, water qi in cold damage diseases often results from excessive water intake. In ancient times, for treating cough caused by water qi, if the pathology was in the Yang aspect, Xiao Qinglong Tang (Minor Blue Dragon Decoction) was used; if in the Yin aspect, Zhenwu Tang was used. The *Gujin Luyan* records that Chupi Tang (Tangerine Peel Decoction) is excellent for treating cough.
[General Principle] Zhang Zhongjing stated: In Shaoyin disease, after six or seven days of diarrhea, if the patient presents with cough, vomiting, thirst, irritability, and insomnia, Zhuling Tang should be administered.
[Commentary] Kou Zongshi stated: With the presence of cough and vomiting, along with irritability and thirst, could this not be attributed to the failure of Kidney Water to ascend?
[General Principle] Zhang Zhongjing stated: In Shaoyin disease, if there are cold extremities (Sini), diarrhea with a sensation of heaviness in the rectum, and among these patients, some may have coughing, some palpitations (heart palpitations), some difficulty in urination, and some abdominal pain, Sini San should be used.
[Commentary] Zhu Gong stated: Add Wuweizi and Ganjiang to Sini San.
[General Principle] Zhang Zhongjing stated: In Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang meridians), after perspiration therapy, if the sweat does not resolve the condition, and the patient still has fever, palpitations below the heart, dizziness, muscle twitching, and tremors making them feel as though they are about to fall to the ground, Zhenwu Tang should be administered.
[Commentary] Shen Jin'ao noted: The persistence of fever combined with palpitations below the heart indicates the loss of Kan Yang (Kidney Yang) to the exterior, leading to Kidney Water flooding over the Heart. Because this is due to Kidney Water flooding the Heart, it is also categorized under Shaoyin conditions.