（此方本治上焦热甚。气中之血药也。今借用之。以治少阴渴逆之证。）
山栀子仁（一两） 连翘 黄芩 薄荷（各一两半） 大黄（半两）
上为粗末。每服一两。水二盏。同竹叶七片。煎至一盏。去滓。入蜜少许。食后服。
琥按上主疗云。少阴渴逆。肾热也。然至舌挛。言语不正。昏冒。咽痛。虽为肾热。实则阴不纳阳。阳热已极。
逆而上行。上干于心矣。脉微者。乃阴气微而将尽也。此为脉中无神。故不可用下药。以大泄其热。止须用凉膈散。又
去硝以清肺。盖金为水母。肺清。则肾经之热。亦随之而解矣。此读仲景书。而神于通变。不执死方者欤。
又云。少阴心惊悸。邪热入阴。肾水乘心。是以心悸。是水犯火也。不当治水与火。治在于木。故仲景用四逆散调
之。（此即甘草枳实柴胡芍药四味药也。方已见前。）
琥按上主疗云。治木者。乃肾热极。反调其肝。实则泻其子也。又仲景于四逆散方后云。悸者。加桂枝五分。兹
则专主悸。而不加桂。可见用药之法。不可执也。
（琥）按仲景治少阴病。用大承气汤者。共三证。一则口燥咽干。一则自利纯青水。心下痛。口干燥。一则腹胀不
大便。乃火土过极。水将涸矣。故用大承气汤泻土。即所以救水。土为水之贼也。然病患之脉。必两尺沉数。有力者。
宜下之。无力者。不宜下也。宜滋阴泻热。玄黄膏主之。
(This prescription was originally intended to treat excessive heat in the Upper Jiao (Upper Burner). It belongs to herbs that regulate blood within the Qi level. It is now borrowed to treat the syndrome of thirst and rebellious Qi in Shaoyin disease.)
Gardeniae Fructus (1 liang) / Gardenia jasminoides fruit
Forsythiae Fructum (1.5 liang each) / Forsythia suspensa fruit
Scutellariae Radix (1.5 liang each) / Scutellaria baicalensis root
Menthae Haplocalycis Herba (1.5 liang each) / Mentha haplocalyx herb
Rhei Radix et Rhizoma (0.5 liang) / Rheum palmatum root and rhizome
Grind the above ingredients into a coarse powder. Take 1 liang per dose, add two cups of water, boil together with seven leaves of Bambusa vulgaris var. striata (Zhuye), reduce to one cup, strain, add a small amount of honey, and take after meals.
Wang Hu notes: The aforementioned indications mention "Shaoyin thirst and rebellious Qi," which indicates Kidney heat. However, when it progresses to tongue retraction, slurred speech, mental confusion, and sore throat, although the root is Kidney heat, it is actually due to Yin failing to contain Yang, causing extreme Yang heat to rebel and ascend, disturbing the Heart. If the pulse is faint, it signifies that Yin Qi is depleted and nearing exhaustion; this indicates a lack of Shen (Spirit) in the pulse. Therefore, purgative drugs should not be used to vigorously drain the heat. Instead, Liangge San (Cooling the Mediator Powder) should be used, with Mangxiao (Mirabilite) removed to clear Lung heat. Since Metal (Lung) is the mother of Water (Kidney), clearing the Lung will cause the heat in the Kidney meridian to resolve accordingly. This demonstrates profound flexibility in studying Zhang Zhongjing's works, avoiding rigid adherence to fixed prescriptions.
It is also stated: In Shaoyin disease, if there is palpitations and fright, it is because pathogenic heat has entered the Yin level, and Kidney Water overacts on the Heart Fire, causing palpitations; this is Water invading Fire. In such cases, one should not directly treat Water or Fire, but rather treat Wood (Liver). Thus, Zhang Zhongjing uses Sini San (Four Reversal Powder) to harmonize. (This formula consists of four herbs: Glycyrrhizae Radix et Rhizoma, Ziziphi Spinosae Semen, Bupleuri Radix, and Paeoniae Radix Alba. The formula was presented earlier.)
Wang Hu notes: The aforementioned indication mentions "treating Wood," meaning that when Kidney heat is extreme, the Liver is regulated instead. This actually applies the principle of "draining the son when excess." Furthermore, in the post-prescription notes for Sini San, Zhang Zhongjing states: "If there are palpitations, add Guizhi (Cinnamon Twig) 5 fen." Here, since palpitations are the primary symptom, Guizhi is not added. This shows that the method of prescribing should not be rigidly adhered to.
(Wang Hu) notes: Zhang Zhongjing uses Dachengqi Tang (Major Order the Qi Decoction) to treat Shaoyin disease in three specific syndromes. One is dry mouth and throat; another is spontaneous diarrhea of pure green water with epigastric pain and dry mouth; the third is abdominal distension and constipation. These conditions represent extreme Fire and Earth elements, leading to the depletion of fluids/water. Therefore, Dachengqi Tang is used to purge the Earth (Spleen/Stomach), which is essentially a method to save the Water (Kidney). Earth is the controlling element (thief) of Water. However, the patient's pulse must be deep, rapid, and forceful at both Chi positions (cun-kou pulse diagnosis) to indicate suitability for purgation; if the pulse is weak, purgation is contraindicated. Instead, methods to nourish Yin and drain heat should be employed, with Xuanhuang Gao (Black-Yellow Paste) as the primary treatment.