【纲】仲景曰。少阴脉沉细。手足冷。或时烦躁。作渴。欲漱水不欲咽者。宜四逆汤。
【目】吴绶曰。本条之外。又有下利。厥逆无脉。干呕烦渴。欲漱水不欲咽者。白通加猪胆汁
人尿主之。又有厥阴蛔厥。体寒烦躁吐蛔。口燥舌干。但欲凉水浸舌及唇。时不可离者。理中汤加
乌梅。大抵阴症发躁烦渴不能饮水。或有勉强饮下。良久复吐。或饮水而呕。或哕逆者。皆内寒也。
盖无根失守之火。游于咽嗌之间。假作燥渴。则不能饮。或有能饮不吐。复欲饮者。热也。
（附不能言）
【纲】仲景曰。病患脉阴阳俱紧。反汗出者。亡阳也。此属少阴。法当咽痛。而复吐利。
【目】朱肱曰。脉沉迟。手足厥冷。或吐利而咽中痛。此少阴症也。病源云。此为下部脉都不
至。阴阳隔绝。邪客于足少阴之络。毒瓦斯上冲。故咽喉不利。或痛而生疮也。伤寒脉阴阳俱紧。如本条
云云。此候汗下熏熨俱不可。汗出者。 本粉传之。咽喉痛者。甘草汤、桔梗汤、猪肤汤、通脉四
逆去芍加桔梗汤、麻黄升麻汤。选用。又有伏气之病。谓非时暴寒中人。伏气于少阴经。始不觉病。
旬月乃发。脉微弱。法先咽痛似伤寒。非喉痹之病。次必利。始用半夏桂枝汤。次四逆散。此病
只一二日便瘥。古方谓之肾伤寒也。
戴原礼曰。亦有初得病。头痛发热。无阳毒少阴诸症。而咽自痛者。此因感冒后。顿用浓衣被
堆壅。或用蛮法。服姜汤热酒即卧。遂成上壅。或先有壅热。欲取凉快。致为外邪所袭。既有风寒。
又有热壅。宜参苏饮。倍桔梗。加木香五分。或消风百解散。或五积散、败毒散各半帖。名交加
散。
闵芝庆曰。此寒邪在少阴本脏而非经病也。当咽痛而又吐利。利为少阴本症。吐而咽痛。则孤
阳欲飞脱于上矣。急救欲亡之阳。真武四逆附子等汤。可选用也。
【纲】仲景曰。少阴病。下利清谷。里寒外热。手足厥逆。脉微欲绝。身反不恶寒。其人面色
赤。或腹痛。或干呕。或咽痛。或利止。脉不出者。通脉四逆汤主之。
【目】王肯堂曰。太阳阳明咽痛各一症。悉属热也。太阳治以半夏散。阳明治以四逆散加桔梗。
少阴咽痛有六症。热症四。寒症二。热者治以猪肤汤、甘草汤、桔梗汤、苦酒汤、半夏散。寒者
治以桂枝干姜汤、真武汤、四逆汤。厥阴咽痛一症。亦热也。治以桔梗汤。咽痛皆属热。何独少阴
二症寒耶。其一以汗多亡阳。故用干姜、附子以复阳温经。其一以阴盛格阳。故用通脉四逆以散阴
通阳。
【纲】仲景曰。伤寒六七日。大下后。寸脉沉而迟。手足厥冷。下部脉不至。咽喉不利。吐脓
血。泄利不止者。为难治。
【目】王肯堂曰。此宜麻黄升麻汤。
柯琴曰。此为下厥上绝。阴阳离决之候。故咽痛不利。为水谷之道绝也。
【纲】仲景曰。少阴病。下利咽痛。胸满心烦者。猪肤汤主之。
【目】张元素曰。或云。六经皆不言咽痛。惟少阴有咽痛咽伤。何也。夫少阴咽痛。乃经络所
系。盖少阴脉循喉咙。系舌本。故有咽伤痛之患。内经曰。少阴所生病者。咽肿上气。干嗌及痛。
此经脉所系。邪气循行而致然也。
方中行曰。猪肤。本草不载。但猪属亥。宜入少阴。肤乃外皮。宜能解外。其性则凉。固能退
热。邪散而热退。烦满可除也。白蜜润燥以利咽。痛可愈也。白粉益土以胜水。利可止也。意者义
取于此乎。
魏荔彤曰。此申解少阴传经热耶。上下充满之症。立法以滋阴散热为义。盖少阴之邪。上冲为
咽痛。为心烦。热之性升也。为便血。为便脓。阴之性降也。又有上下充周。热邪弥漫者。如下利。
犹之阴之降也。咽痛胸满心烦。犹之热之升也。无非邪在少阴。既内耗其真。复交乱三焦使之然
也。法用猪肤。猪亥水。肾蓄也。其肤主太阳。能入肾滋阴。兼透表散邪之用。佐蜜甘寒。上炎之
焰熄。白粉淡渗。下利之路分。一剂而三善备焉。盖肾脏原无散法。散药又必用辛温。今热邪在内。
非散不可。辛温又不可。因另出此法。以甘寒之味。佐原属肾经之物。带太阳表性者。入其中以
导之出。肤乃肉外皮中之薄脂。浮而外发之性也。亦如石膏以辛凉为发散之义也。
【纲】仲景曰。少阴病。二三日咽痛者。可与甘草汤。不瘥者。与桔梗汤。少阴病。咽中痛。
半夏散及汤主之。
【目】苏颂曰。咽痛而无下利心烦胸满等症。但甘以缓之足矣。不瘥者。配以桔梗。辛以散之
也。其热微。故用轻剂。
魏荔彤曰。少阴之邪。惟其缘木而升。所以于其传也。必传厥阴。亦升降之理也。太阴降而
少阴。少阴升而厥阴。三阴中之升降也。比之三阳之表里亦然。盖气之行也。无论病气与正气。皆以往复
屈伸为义也。
鳌按。下条之症。比上条较重。故非甘草桔梗。甘缓辛开。轻清之物可治。必用半夏之苦。开
而兼泄。桂枝之辛。升散其热。甘草之缓。缓其炎焰。其义如此。喻氏谓半夏涤饮。桂枝散邪。犹
非的义。盖本方用桂枝半夏。并非发汗解肌之谓也。
【纲】仲景曰。少阴病。咽中伤生疮。不能语言。声不出者。苦酒汤主之。
【目】吴绶曰。少阴脉疾。可下。脉沉。附子汤加知、柏、五味子、麦冬、花粉。若虚热。病
后烦热不解者。竹叶石膏汤去半夏加花粉。凡汗吐下后。口燥咽干。此津液衰少。肾水不升。虚火
上炎也。生津益气汤。脉沉微。足冷舌燥。难治。其少阴有急下以救肾水之例。若虚人水竭火燥不
可下者。以补中益气汤。倍人参。加麦冬、五味、花粉、知、柏。以滋水也。
赵嗣真曰。活人谓脾脏有热。则津液枯少。故口燥咽干。然非独脾脏有热。脾主太阴。太阴腹
满而咽干。此可言脾热。特一症耳。余皆非也。如白虎加人参汤。口舌干燥者。表里俱热也。口苦
咽干者。少阳经热。或阳明中风也。口燥咽干。急下之。自利清水。色纯青。心下痛。口干燥者。
少阴经热也。咽干烦躁吐逆者。误汗。津液少。而欲作阳明内热者也。如上数症。岂亦脾脏有热哉。
鳌按。伤者。痛久而伤也。火灼则疮生。邪热壅于胸膈之上。故不能语言。声出于喉。咽病则
喉亦病。肺金为邪火所制。故声不出。其症较重于咽中痛。皆治之迟误也。半夏开散。鸡子清凉润。
故必治以本汤。甘草汤、桔梗汤、半夏散及汤、苦酒汤数方。皆为少阴热邪在经。上冲为咽痛而
立之法也。
【纲】仲景曰。少阴病。得之二三日。口燥咽干者。急下之。宜大承气汤。少阴病。自利清水。
色纯青。心下必痛。口干燥者。急下之。宜大承气汤。
【目】成无己曰。伤寒传经五六日。邪传少阴。则口燥舌干而渴。为邪渐深也。今少阴病得之二
三日。邪未深入之时。
便作口燥咽干者。是邪热已甚。肾水干也。急与大承气。以全肾也。正经自病。其邪深入。宜急下
之。若燥则死。肾水干燥之故也。
张元素曰。承气汤。阳明当下之症宜用。少阴亦用。何也。盖胃为水谷之海。主养四旁。四旁
有病。皆能传入胃。胃土燥则肾水干。以二三日则口燥咽干。是热之深。传之远也。故曰。急下之
以全肾水。夫土实则水清。谓水谷不相混。故自利清水。而口干燥。此胃土实热致然也。下利色青。
青者肝也。乃肝邪传肾。缘肾之经脉。从肺出络心。注胸中。由是而心下痛。故急下以去实热。
逐肾邪。其六七日腹胀不大便。以入腑之邪壅甚。胃土胜。则肾涸。故急下以逐胃热。滋肾水。盖
阳明与少阴。皆有急下之条。然而症虽不同。其入腑之理则一。是以皆用大承气也。
王肯堂曰。按舌干轻。咽干重者。盖咽舌虽皆通于少阴之络。而舌又为心之苗也。伤寒喜阳而
恶阴。故舌干轻。
喻昌曰。热邪传入少阴。逼迫津水。注为自利。质清而无渣滓相杂。色青而无黄赤相间。可见
阳邪炎威之极。反与阴邪无异。但阳邪传自上焦。其人心下必痛。口必干燥。设系阴邪。必心下满
而不痛。口中和而不燥。必无此枯槁之象。故宜急下以救其阴也。
[Outline] Zhang Zhongjing stated: In Shaoyin disease, the pulse is deep and fine, the hands and feet are cold, there is occasional irritability, thirst with a desire to rinse the mouth but not swallow (Shuishu Buyan), Si Ni Tang (Four Counterflow Decoction) is indicated.
[Commentary] Wu Shou stated: In addition to the above clause, there are cases presenting with diarrhea, cold extremities without a pulse, dry heaving, irritability, thirst with a desire to rinse the mouth but not swallow; these should be treated with Bai Tong Jia Zhu Dan Jiang Ren Nao Tang (Bai Tong Decoction plus Pig Bile and Human Urine). There are also cases of Jueyin disease with Hui Jue (Roundworm Syncope), characterized by cold body, irritability, vomiting roundworms, dry mouth and tongue, with a strong desire to immerse the tongue and lips in cool water continuously; these should be treated with Li Zhong Tang (Regulate the Middle Decoction) plus Wumei (Mume Fruit). Generally, in Yin syndromes, if restlessness and irritability with thirst prevent drinking, or if drinking is forced but vomited after some time, or if drinking leads to vomiting or hiccups, these are all due to internal cold. This is because rootless fire, having lost its foundation, wanders between the throat and pharynx, feigning dryness and thirst, thus preventing drinking. If one can drink without vomiting and desires more, it is a Heat syndrome.
(Attachment: Inability to speak)
[Outline] Zhang Zhongjing stated: When a patient's pulse is tight in all positions (Yin Yang Ju Jin), yet sweating occurs, this indicates Loss of Yang (Wang Yang). This belongs to Shaoyin disease. By protocol, it should present with sore throat, accompanied by vomiting and diarrhea.
[Commentary] Zhu Gong stated: A deep and slow pulse with cold extremities, or vomiting and diarrhea with throat pain, constitutes Shaoyin disease. The *Pathogenesis* states: This occurs when pulses at the lower part are absent, indicating separation of Yin and Yang. Pathogenic factors invade the collaterals of the Foot-Shaoyin meridian, and toxic qi rushes upward, causing throat obstruction, pain, or even sores. In Taiyang Cold Damage, if the pulse is tight in all positions as described, neither sweating, purging, fumigation, nor moxibustion熨 (ironing/warming) methods should be used. If sweating occurs, it is a transmission from the original formula. For sore throat, Gan Cao Tang (Licorice Decoction), Jie Geng Tang (Platycodon Decoction), Zhu Fu Tang (Pig Skin Decoction), Tong Mai Si Ni Qu Shao Yao Jia Jie Geng Tang (Tongmai Sini Decoction removing Peony and adding Platycodon), or Ma Huang Sheng Ma Tang (Ephedra and Cypertrachis Decoction) may be selected. There is also "Fu Qi" disease (Latent Pathogen Disease), caused by sudden cold at an improper season invading the body, where latent pathogens hide in the Shaoyin meridian. Initially asymptomatic, it manifests after a month with a weak pulse. Protocol dictates initial sore throat resembling Cold Damage, but distinct from Hou Bi (Throat Bi). Subsequently, diarrhea must occur. Treatment begins with Ban Xia Gui Zhi Tang (Pinellia and Cinnamon Twig Decoction), followed by Si Ni San (Four Counterflow Powder). This disease resolves within one or two days; ancient texts call it Shen Shang Han (Kidney Cold Damage).
Dai Yuanli stated: There are cases where, upon onset, there is headache and fever, without Yang toxicity or other Shaoyin symptoms, yet the throat hurts spontaneously. This results from wearing thick clothes and blankets immediately after a cold, or using harsh methods such as drinking ginger soup and hot wine before sleeping, leading to upper congestion. Or, if there was pre-existing heat congestion and one sought cooling, inviting external pathogens, resulting in both Wind-Cold and Heat congestion. Can Su Yin (Ginseng and Perilla Drink) with doubled Jie Geng (Platycodon) and 5 fen Mu Xiang (Aucklandia) is suitable. Alternatively, Xiao Feng Bai Jie San (Eliminate Wind Hundred-Release Powder), or half doses of Wu Ji San (Five Accumulations Powder) and Bai Du San (Hundred Toxin Release Powder), named Jiao Jia San (Intersecting Release Powder).
Min Zhiqing stated: This is Cold pathogen affecting the Shaoyin organ proper rather than the meridian. It presents with sore throat and diarrhea; diarrhea is a primary Shaoyin symptom. Vomiting with sore throat indicates solitary Yang attempting to fly off upwards. One must urgently rescue the perishing Yang. Zhen Wu Tang (True Warrior Decoction), Si Ni Tang, and Fu Zi Tang (Aconite Decoction) are selectable.
[Outline] Zhang Zhongjing stated: In Shaoyin disease, with diarrhea of undigested food, interior cold with exterior heat, cold extremities, a faint pulse nearly imperceptible, the body is paradoxically not aversive to cold, the person has a red complexion, and possibly abdominal pain, dry heaving, sore throat, or cessation of diarrhea with no palpable pulse, Tong Mai Si Ni Tang (Tongmai Sini Decoction) is the primary treatment.
[Commentary] Wang Kentang stated: Sore throat in Taiyang and Yangming diseases, each having one presentation, belongs to Heat. Taiyang is treated with Ban Xia San (Pinellia Powder); Yangming with Si Ni San plus Jie Geng. Shaoyin sore throat has six presentations: four Heat types and two Cold types. Heat types are treated with Zhu Fu Tang, Gan Cao Tang, Jie Geng Tang, Ku Jiu Tang (Bitter Wine Decoction), and Ban Xia San. Cold types are treated with Gui Zhi Gan Jiang Tang (Cinnamon Twig and Dried Ginger Decoction), Zhen Wu Tang, and Si Ni Tang. Jueyin sore throat is one presentation, also Heat, treated with Jie Geng Tang. Since sore throat generally belongs to Heat, why are there two Cold types in Shaoyin? One type involves excessive sweating leading to Yang loss, hence Gan Jiang (Dried Ginger) and Fu Zi (Aconite) are used to restore Yang and warm the meridians. The other involves Yin excess repelling Yang, hence Tong Mai Si Ni Tang is used to scatter Yin and unblock Yang.
[Outline] Zhang Zhongjing stated: After six or seven days of Cold Damage, following severe purging, if the Cun (inch) pulse is deep and slow, extremities are cold, pulses at the lower part are absent, throat is obstructed, pus and blood are expectorated, and diarrhea persists uncontrollably, this is difficult to treat.
[Commentary] Wang Kentang stated: This situation is suitable for Ma Huang Sheng Ma Tang.
Ke Qin stated: This represents "Lower Jue and Upper Absolute," a state of separation of Yin and Yang. Thus, sore throat and obstruction occur because the pathway for food and fluids is severed.
[Outline] Zhang Zhongjing stated: In Shaoyin disease, with diarrhea, sore throat, chest fullness, and irritability, Zhu Fu Tang (Pig Skin Decoction) is the primary treatment.
[Commentary] Zhang Yuansu stated: Some ask why the Six Meridians do not mention sore throat, except for Shaoyin which has sore and injured throat. Shaoyin sore throat is related to the meridians. The Shaoyin meridian circulates along the throat and connects to the root of the tongue, hence suffering from throat pain. The *Neijing* states: Diseases generated by Shaoyin include throat swelling, Qi rushing upward, dry throat, and pain. This is due to meridian connections and pathogenic factors circulating along them.
Fang Zhongxing stated: Zhu Fu (Pig Skin) is not recorded in Materia Medica. However, Pig corresponds to Hai (Water), suitable for entering Shaoyin. Skin is the outer layer, suitable for resolving exterior conditions. Its nature is cool, capable of reducing heat. As pathogens disperse and heat recedes, irritability and fullness are eliminated. Bai Mi (White Honey) moistens dryness to benefit the throat, curing pain. Bai Fen (Rice Flour) tonifies Earth to control Water, stopping diarrhea. Perhaps the meaning lies here.
Wei Litong stated: Is this explaining the transmission heat of Shaoyin? Symptoms of fullness above and below are addressed by laws establishing Yin-nourishing and Heat-dispersing principles. Shaoyin pathogens rush upward causing sore throat and irritability, reflecting the ascending nature of Heat. They cause bloody stool or pus in stool, reflecting the descending nature of Yin. There are also cases of fullness throughout above and below with diffuse Heat, such as diarrhea (descending like Yin), while sore throat, chest fullness, and irritability ascend like Heat. This is merely pathogens in Shaoyin consuming True Yin internally and disturbing the Triple Burner. The method uses Zhu Fu. Pig is Hai Water, stored in Kidney. Its skin governs Taiyang, enters Kidney to nourish Yin, and penetrates the exterior to scatter pathogens. Assisted by sweet-cold Honey, it extinguishes flaming Fire. White powder (rice flour) is light and penetrating, diverting the path of diarrhea. One dose achieves three benefits. Kidneys originally have no dispersing method, and dispersing drugs must be Acrid-Warm. Now Heat is internal, requiring dispersal, but Acrid-Warm is contraindicated. Hence this method is devised: using Sweet-Cold flavors assisted by Kidney-related substances carrying Taiyang exterior properties to guide them out. Skin is thin fat under the skin, possessing floating and outward-expanding properties. Similar to Shi Gao (Gypsum) using Acrid-Cool for dispersal.
[Outline] Zhang Zhongjing stated: In Shaoyin disease, if sore throat appears on the second or third day, Gan Cao Tang (Licorice Decoction) may be given. If not cured, give Jie Geng Tang (Platycodon Decoction). In Shaoyin disease, with throat pain, Ban Xia San Ji Tang (Pinellia Powder and Decoction) is the primary treatment.
[Commentary] Su Song stated: If sore throat occurs without diarrhea, irritability, or chest fullness, soothing with Sweet flavor is sufficient. If not cured, add Jie Geng to disperse with Acrid flavor. Since Heat is mild, light agents are used.
Wei Litong stated: Shaoyin pathogens, rising along the Wood meridian, must transmit to Jueyin during progression, following the principle of ascent and descent. Taiyin descends to Shaoyin; Shaoyin ascends to Jueyin. This is the ascent and descent among the Three Yin meridians. Similarly, this applies to the Exterior-Interior relationship of the Three Yang meridians. The movement of Qi, whether pathological or healthy, follows the principle of recurrence and flexion-extension.
Shen Jin'ao noted: The symptoms in the next clause are heavier than the previous one. Therefore, they cannot be treated with light, clear agents like Gan Cao and Jie Geng which soothe and open. Instead, the bitterness of Ban Xia is needed to open and drain, the acridity of Gui Zhi to ascend and scatter Heat, and the soothing nature of Gan Cao to calm inflammation. This is the rationale. Yu Chang claimed Ban Xia clears phlegm-fluids and Gui Zhi scatters pathogens, which is not the precise meaning. The use of Gui Zhi and Ban Xia in this formula does not refer to inducing sweating or releasing the muscle layer.
[Outline] Zhang Zhongjing stated: In Shaoyin disease, if the throat is injured and sores form, preventing speech and voice production, Ku Jiu Tang (Bitter Wine Decoction) is the primary treatment.
[Commentary] Wu Shou stated: If Shaoyin pulse is rapid, purging may be used. If deep, use Fu Zi Tang plus Zhi Mu, Huang Bo, Wu Wei Zi, Mai Dong, and Hua Fen. If it is Deficient Heat with persistent irritability after illness, use Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) removing Ban Xia and adding Hua Fen. After sweating, vomiting, or purging, if dry mouth and throat occur due to fluid depletion and failing Kidney Water rising with Deficient Fire flaming upward, use Sheng Jin Yi Qi Tang. If pulse is deep and faint with cold feet and dry tongue, it is difficult to treat. Shaoyin disease has examples of urgent purging to save Kidney Water. For deficient patients with exhausted Water and Dry Fire who cannot be purged, use Bu Zhong Yi Qi Tang with doubled Ren Shen, plus Mai Dong, Wu Wei Zi, Hua Fen, Zhi Mu, and Huang Bo to nourish Water.
Zhao Sizhen stated: *Huoren Shu* says Heat in the Spleen causes fluid depletion, leading to dry mouth and throat. However, it is not only Spleen Heat. Spleen governs Taiyin; Taiyin presents with abdominal fullness and dry throat, which can be called Spleen Heat, but this is just one symptom. Others are incorrect. For example, in Bai Hu Jia Ren Shen Tang, dry mouth and tongue indicate Heat in both Interior and Exterior. Bitter taste and dry throat indicate Shaoyang Heat or Yangming Wind Strike. Urgent purging is required for dry mouth/throat with pure green watery diarrhea, epigastric pain, and dry mouth, indicating Shaoyang Heat. Irritability, vomiting, and dry throat after mistaken sweating indicate fluid depletion and impending Yangming Internal Heat. Do these not imply Spleen Heat?
Shen Jin'ao noted: "Injury" refers to damage from prolonged pain. Fire burning generates sores. Pathogenic Heat congests above the chest and diaphragm, preventing speech. Voice originates from the larynx; throat disease affects the larynx. Lung Metal is constrained by Evil Fire, hence voice is lost. This condition is heavier than simple throat pain, usually due to delayed treatment. Ban Xia opens and disperses; egg white is cool and moistening. Hence this decoction is necessary. Gan Cao Tang, Jie Geng Tang, Ban Xia San Ji Tang, and Ku Jiu Tang are all methods established for Shaoyin Heat pathogens in the meridian rushing upward to cause sore throat.
[Outline] Zhang Zhongjing stated: In Shaoyin disease, if dry mouth and throat appear on the second or third day, urgent purging is required, preferably Da Cheng Qi Tang (Major Order the Qi Decoction). In Shaoyin disease, if there is spontaneous watery diarrhea with pure green color,必 (must) epigastric pain, and dry mouth, urgent purging is required, preferably Da Cheng Qi Tang.
[Commentary] Cheng Wuji stated: In Cold Damage transmission, around the fifth or sixth day, when pathogens enter Shaoyin, dry mouth, tongue, and thirst indicate deepening pathogens. Now, in Shaoyin disease, if dry mouth and throat appear within two or three days, before pathogens deeply penetrate, it means Pathogenic Heat is severe and Kidney Water is dried. Urgently administer Da Cheng Qi Tang to preserve Kidney Water. Primary disease with deep pathogens requires urgent purging. If dryness prevails, death ensues due to Kidney Water exhaustion.
Zhang Yuansu stated: Cheng Qi Tang is indicated for Yangming diseases requiring purging. Why is it used in Shaoyin? Stomach is the Sea of Water and Grain, nourishing the surroundings. Illness in surroundings transmits to Stomach. Dry Stomach Earth dries Kidney Water. Dry mouth and throat within two or three days indicate deep Heat and distant transmission. Thus, urgent purging preserves Kidney Water. Solid Earth clarifies Water, meaning water and grain do not mix, causing watery diarrhea and dry mouth. This is due to Stomach Earth Excess Heat. Green diarrhea indicates Liver Wood (Green belongs to Liver); Liver Pathogens transmit to Kidney. Kidney meridian exits Lung, connects Heart, enters Chest, causing epigastric pain. Urgent purging removes Excess Heat and drives out Kidney pathogens. Abdominal distension and constipation on the seventh day indicate severe pathogen congestion in the Fu organs. Overpowering Stomach Earth dries Kidney, necessitating urgent purging to drive Stomach Heat and nourish Kidney Water. Both Yangming and Shaoyin have urgent purging clauses. Although symptoms differ, the principle of entering Fu organs is identical, hence Da Cheng Qi Tang is used in both.
Wang Kentang stated: Tongue dryness is mild; throat dryness is severe. Although throat and tongue connect to Shaoyin collaterals, the tongue is the sprout of the Heart. Cold Damage favors Yang and dislikes Yin, hence tongue dryness is milder.
Yu Chang stated: When Heat pathogens enter Shaoyin, they force fluids into spontaneous diarrhea. The substance is clear without dregs, color is green without yellow or red, showing extreme Yang Heat power, resembling Yin pathogens. But Yang pathogens transmit from the Upper Jiao, causing epigastric pain and dry mouth. If Yin pathogens, there would be fullness without pain, and a neutral, non-dry mouth, lacking this withered appearance. Thus, urgent purging is needed to save Yin fluids.