少阴病。脉细沉数。病为在里。不可发汗。
少阴与太阳为表里。而少阴亦自有表里。经病为在表。脏病为在里也。浮沉而身发热。为病在
表。脉细沉数。身不发热。为病在里。病在表者可发汗。如麻黄附子细辛汤之例是也。病在里而汗
之。是竭其阴而动其血也。故曰不可发汗。
少阴病。脉微。不可发汗。亡阳故也。阳已虚。尺脉弱涩者。复不可下之。
少阴虽为阴脏。而元阳寓焉。故其病有亡阳亡阴之异。脉微者为亡阳。脉弱涩者为亡阴。发汗
则伤阳。
故脉微者。不可发汗。下则伤阴。故阳已虚而尺脉弱涩者。非特不可发汗。亦复不可下之也。
少阴病。但厥无汗而强发之。必动其血。未知从何道出。或从口鼻。或从目出。是名下厥上竭
。为难治。
少阴中寒。但厥无汗。邪方内淫而气不外达。非可得汗愈者而强发之。则汗必不出。而血反自
动。或口鼻。或目。随其所攻之道而外出也。盖发汗之药。其气上行。而性多 悍。不得于气。则去
而之血。必尽其性而后止耳。然既脏虚邪入。以致下厥而复迫血妄动。以致上竭。上下交征。而血
气之存者无几矣。尚何以御邪而却疾耶。故曰难治。
少阴病。咳而下利谵语者。被火气劫故也。小便必难。以强责少阴汗也。
少阴之邪上逆而咳。下注而利矣。而又复谵语。此非少阴本病。乃被火气劫夺津液所致。火劫
即温针灼艾之属。少阴不当发汗。而强以火劫之。不特竭其肾阴。亦并耗其胃液。胃干则谵语。肾
燥则小便难也。
Shaoyin disease. The pulse is fine, deep, and rapid, indicating the pathology is in the interior; sweating therapy is contraindicated.
Shaoyin and Taiyang are exterior-interior counterparts, yet Shaoyin itself has its own exterior and interior aspects: meridian diseases are considered exterior, while zang organ diseases are considered interior. If the pulse is floating or deep accompanied by fever, the disease is in the exterior. If the pulse is fine, deep, and rapid without fever, the disease is in the interior. For diseases in the exterior, sweating may be employed, as exemplified by Mahuang Fuzi Xixin Tang (Ephedra, Aconite and Asarum Decoction). However, applying sweating to a disease located in the interior depletes Yin fluids and agitates blood; therefore, sweating is contraindicated.
Shaoyin disease. The pulse is faint; sweating is contraindicated due to the risk of Yang Qi Exhaustion. If Yang Qi is already deficient and the Chi pulse (pulse at the distal position on both wrists) is weak and choppy, purgation is also contraindicated.
Although Shaoyin is a Yin Zang, it harbors Original Yang Qi. Consequently, its pathologies may involve either Yang Qi Exhaustion or Yin Fluid Exhaustion. A faint pulse indicates Yang Qi Exhaustion, while a weak and choppy pulse indicates Yin Fluid Exhaustion. Sweating damages Yang Qi; thus, those with a faint pulse should not undergo sweating. Purgation damages Yin fluids; therefore, when Yang Qi is already deficient and the Chi pulse is weak and choppy, not only is sweating contraindicated, but purgation is also prohibited.
In Shaoyin disease, if there is cold extremities (Jue) without sweat, forcing sweating will inevitably disturb blood. It is uncertain from which orifice the blood will emerge; it may come from the mouth and nose, or from the eyes. This condition is termed "Lower Jue and Upper Exhaustion" and is difficult to treat.
When Shaoyin is invaded by cold, presenting with cold extremities and absence of sweat, the pathogenic factor is invading inward while healthy Qi fails to reach the exterior. This is not a condition curable by sweating. Forcing sweating will fail to produce sweat but will instead cause blood to move recklessly, exiting through the mouth, nose, or eyes depending on the site of attack. Generally, diaphoretic herbs have ascending properties and are often harsh and vigorous. When Qi flow is obstructed, the pathogenic influence shifts to the blood vessels, exhausting the blood before subsiding. Since the Zang organs are already deficient and pathogens have entered, causing lower cold extremities, and forced movement of blood causes upper exhaustion, both upper and lower are simultaneously depleted. With little Qi and Blood remaining, how can the body resist pathogens and cure the disease? Hence, it is described as difficult to treat.
In Shaoyin disease, coughing accompanied by diarrhea and Delirium results from Fire Therapy Complications. Urination will certainly be difficult because sweating was forcibly extracted from Shaoyin.
When Shaoyin pathogens rebel upward, coughing occurs; when they sink downward, diarrhea ensues. The appearance of Delirium here is not intrinsic to Shaoyin disease but results from the depletion of Jin-Ye (Body Fluids) by fire methods. "Fire therapy" refers to techniques such as warm needle moxibustion or burning mugwort. Shaoyin disease does not warrant sweating; forcibly inducing sweat via fire methods not only depletes Kidney Yin but also consumes Stomach fluids. Dryness of the Stomach leads to Delirium, while dryness of the Kidney leads to difficulty in urination.