少阴之为病，脉微细，但欲寐。（卫气寤则行阳，寐则行阴而寐也。必从足少阴始，故少阴病但欲寐。）
少阴病，始得之，反发热脉沉者，麻黄附子细辛汤主之。（方见发热。）
少阴病，得之二三日，麻黄附子甘草汤微发汗，以二三日无症，故微发汗也。（无症谓无吐利厥症。）
麻黄附子甘草汤
麻黄 甘草（炙。各二两） 附子（一枚，炮，去皮，切）
上 咀，每服五钱，水煎温服，须二三服，以身汗为度。
少阴病，得之一二日，口中和，其背恶寒者，当灸之，附子汤主之。
附子（半枚） 茯苓（七钱半） 人参（半两） 白术（一两） 芍药（七钱半）
上 咀，每服五钱，水煎温服，日三。
少阴二三日，口燥咽干者，大承气汤急下之。（方论见口燥咽干。）若咽痛者，甘草汤；不瘥者，桔梗汤。（方论见咽
痛。）
少阴病，得之二三日以上，心中烦，不得卧，黄连阿胶汤主之。（方见不得卧。）
少阴病二三日至四五日，腹满，小便不利，若便脓血者，桃花汤主之。（方论见下利。）
若四肢重痛下利者，真武汤主之。（方论见下利。）
少阴病六七日，腹胀不大便者，急下之，宜大承气汤。方见潮热。少阴病下利至六七日，变咳而呕，渴，心烦
不得眠者，猪苓汤主之。
少阴病，脉微细沉，但欲卧，汗出不烦，自欲吐，至五六日自利，复烦躁不得寤寐者死。少阴病六七日，
息高者死。少阴病脉紧，至七八日自利，脉紧变暴微厥，手足反温者，欲解也。（论见下利。）少阴病八九日，
一身手足尽热者，以热在膀胱，必便血也。口燥咽干，但欲寐。（方论见口燥。）欲吐不吐，但欲寐。（方论见吐。）
吐利但欲寐。（方论见吐出。）下利但欲寐。（方论见下利。）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。少阴病，四逆，恶寒而身蜷，脉不至，不烦而
躁者死。少阴病，恶寒身蜷而利，手足逆冷者，不可治。少阴病，四逆，其人或咳悸，或小便不利，或腹
中痛，或泄利下重者，宜四逆散
甘草（炙） 枳实 柴胡 芍药（各等分）
上为细末，日饮和渣服方寸匕，日三服。如咳者加五味子、干姜各五分，并主下利。悸者，加桂枝五分。
小便不利者，加茯苓五分。腹中冷痛者，加附子一枚，炮令坼。泄利下重者，先以水五升煮薤白三升，去渣，
以散三方寸匕纳汤中，煮取一升半，分温再服。
少阴病，手足逆冷，其人若下利后重者，此条四逆散加薤白汤。若下利脉绝及无脉者，通脉四逆汤、白通
加猪胆汁汤。（方论见下利。）若身体骨节痛，脉沉者，宜附子汤。少阴病，脉沉者，急温之，宜四逆汤。
（方见下利。）少阴病，身体痛，手足寒，骨节痛，脉沉者，附子汤主之。少阴病脉沉发热者，宜前条麻黄
附子细辛汤。少阴病欲
解时，从子至寅上。少阴病，恶寒而蜷，时自烦，欲去衣被者可治。少阴病，下利止而头眩，时时自冒者死。
少阴中风，脉阳微阴浮者，为欲愈。少阴病，脉细沉数，病为在里，不可发汗。少阴病，脉微不可发汗，亡阳
故也。阳已虚，尺部弱涩者，不可复下之。
太阳病，十日已去，脉浮细嗜卧者，外已解也。胸满胁痛者，小柴胡汤。脉但浮者，麻黄汤。（论见鼻干。）
脉浮汗出多眠，若身重息鼾者，风温。（方论见风温。）若合目则盗汗出者，三阳合病。（方论见盗汗。）
狐惑病，默默欲眠，目不得闭，不欲饮食，恶闻食臭，其面目乍赤乍黑乍白，其声嗄者，甘草泻心汤。咽
干者，苦参汤。其肛虫蚀，雄黄熏之。其脉数无热，目赤皆黑者，当归赤小豆散。（并见狐惑条。）
Shaoyin disease is characterized by a faint and fine pulse, and a desire to sleep (Wei Qi circulates in the Yang meridians when awake and in the Yin meridians during sleep. The pathogen must start from the Foot Shaoyin Kidney meridian; therefore, patients with Shaoyin disease exhibit a desire to sleep).
If Shaoyin disease presents with fever and a deep pulse upon its initial onset, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) should be administered. (See "Fever" for formula details.)
If Shaoyin disease persists for two or three days without severe symptoms (specifically vomiting, diarrhea, or cold limbs), Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) should be used to induce mild sweating. ("No symptoms" refers to the absence of severe signs like vomiting, diarrhea, or cold limbs.)
[Formula] Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction)
Ingredients: Mahuang (Ephedrae Herba), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) [each 2 liang], Fuzi (Prepared Aconiti Lateralis Radix) [1 piece, processed, skin removed, sliced].
Usage: Crush the ingredients. Take 5 qian per dose, decoct with water, and take warm. Usually requires 2-3 doses; stop when slight perspiration occurs.
If Shaoyin disease appears after one or two days, with a normal sensation in the mouth but aversion to cold on the back, moxibustion should be applied, followed by Fuzi Tang (Aconite Decoction).
[Formula] Fuzi Tang (Aconite Decoction)
Ingredients: Fuzi (Prepared Aconiti Lateralis Radix) [half a piece], Fuling (Poria), Renshen (Ginseng Radix) [0.5 liang], Baizhu (Atractylodis Macrocephalae Rhizoma) [1 liang], Shaoyao (Paeoniae Radix) [0.75 qian].
Usage: Crush the ingredients. Take 5 qian per dose, decoct with water, and take warm, three times daily.
If Shaoyin disease lasts for two or three days and presents with dry mouth and throat, Dachengqi Tang (Major Order the Qi Decoction) should be used urgently to purge. (See "Dry Mouth and Throat" for theory.) If accompanied by sore throat, Gancao Tang (Licorice Decoction) is used; if ineffective, Jiegeng Tang (Platycodon Decoction) is used. (See "Sore Throat" for theory.)
If Shaoyin disease persists for more than two or three days and presents with vexation in the heart and inability to sleep, Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) should be administered. (See "Inability to Sleep" for formula details.)
If Shaoyin disease lasts from two or three days to four or five days and presents with abdominal fullness, difficulty in urination, or pus and blood in the stool, Taohua Tang (Peach Seed Decoction) should be used. (See "Diarrhea" for theory.)
If there is heaviness and pain in the four limbs accompanied by diarrhea, Zhenwu Tang (True Warrior Decoction) should be used. (See "Diarrhea" for theory.)
If Shaoyin disease lasts six or seven days and presents with abdominal fullness and constipation, urgent purging is required, preferably with Dachengqi Tang (Major Order the Qi Decoction). (See "Tidal Fever" for formula.) If Shaoyin disease involves diarrhea persisting for six or seven days, transforming into cough, vomiting, thirst, and vexation preventing sleep, Zhuling Tang (Polyporus Decoction) should be used.
If a Shaoyin patient has a faint, fine, and deep pulse, desires to sleep, sweats without vexation, and feels an urge to vomit, and by the fifth or sixth day develops spontaneous diarrhea followed by restlessness and inability to sleep, the prognosis is fatal. If Shaoyin disease lasts six or seven days and breathing becomes shallow and rapid (Xi Gao), it is fatal. If Shaoyin disease presents with a tight pulse, and by the seventh or eighth day spontaneous diarrhea occurs, the pulse changes from tight to suddenly weak with cold limbs, but the hands and feet become warm, this indicates the disease is resolving. (See "Diarrhea" for discussion.) If Shaoyin disease lasts eight or nine days and the whole body and hands/feet become hot, the heat is in the Bladder, and hematochezia will likely occur.
(These conditions are all accompanied by "desire to sleep"; see respective sections for theories):
Dry mouth and throat with desire to sleep. (See "Dry Mouth".)
Urge to vomit without actual vomiting, with desire to sleep. (See "Vomiting".)
Vomiting and diarrhea with desire to sleep. (See "Vomiting/Diarrhea".)
Diarrhea with desire to sleep. (See "Diarrhea".)
If a Shaoyin patient has cold limbs without sweat, and the physician forcibly induces sweating, it will disturb the blood causing hemorrhage. The bleeding may come from the mouth/nose or eyes. This is called "Lower Cold and Upper Exhaustion" (Xia Jue Shang Jie) and is difficult to treat.
If Shaoyin disease presents with cold limbs, aversion to cold, curled posture, absent pulse, and restlessness without vexation, it is fatal.
If Shaoyin disease presents with aversion to cold, curled posture, diarrhea, and cold extremities, it is incurable.
If Shaoyin disease presents with cold limbs, and the patient additionally experiences cough, palpitations, dysuria, abdominal pain, or tenesmus during diarrhea, Sini San (Four Counterflow Powder) is appropriate.
[Formula] Sini San (Four Counterflow Powder)
Ingredients: Zhi Gancao (Prepared Licorice), Zhishi (Immature Bitter Orange), Chaihu (Bupleuri Radix), Shaoyao (Paeoniae Radix) [equal parts].
Usage: Grind into fine powder. Take one cun bi (measure) mixed with liquid, three times daily. For cough, add Wuweizi (Schisandrae Fructus) and Ganjiang (Zingiberis Rhizoma) [0.5 fen each], also treating diarrhea. For palpitations, add Guizhi (Cinnamomi Ramulus) [0.5 fen]. For dysuria, add Fuling (Poria) [0.5 fen]. For cold abdominal pain, add Fuzi (Processed Aconite) [1 piece, cracked]. For tenesmus, boil Xiebai (Allii Macrostemonis Bulbus) in water, strain, add the powder, boil, and take warm in two doses.
If Shaoyin disease presents with cold limbs and tenesmus after diarrhea, use Sini San plus Xiebai. If diarrhea leads to absent pulse, use Tongmai Sini Tang (Pulse-Returning Four Counterflow Decoction) or Baitong Jia Zhu Dan Tang (White Through Decoction plus Pig Bile). (See "Diarrhea" for theory.) If body and joint pain with a deep pulse occur, use Fuzi Tang. If Shaoyin disease presents with a deep pulse, urgent warming is needed, using Sini Tang (Four Counterflow Decoction). (See "Diarrhea" for formula.) If Shaoyin disease presents with body pain, cold extremities, joint pain, and deep pulse, use Fuzi Tang. If Shaoyin disease presents with deep pulse and fever, use Mahuang Fuzi Xixin Tang (as mentioned previously).
Shaoyin disease tends to resolve between Zi (23:00-01:00) and Yin (03:00-05:00).
If Shaoyin disease presents with aversion to cold, curled posture, but occasional vexation and desire to remove covers, it is treatable.
If Shaoyin disease diarrhea stops but dizziness and frequent vertigo occur, it is fatal.
Shaoyin Wind Strike with a superficial-fine and deep-floating pulse indicates impending recovery.
Shaoyin disease with fine, deep, and rapid pulse indicates interior pathology; sweating methods are contraindicated.
Shaoyin disease with a faint pulse prohibits sweating due to Yang exhaustion.
If Yang is deficient and the Chi position pulse is weak and choppy, purgative methods are contraindicated.
Taiyang disease lasting over ten days, with a floating-fine pulse and lethargy, indicates the exterior pathogen has resolved. If chest fullness and hypochondriac pain occur, Xiaochaihu Tang (Minor Bupleurum Decoction) is used. If only floating pulse remains, Mahuang Tang (Ephedra Decoction) is used. (See "Nasal Dryness" for discussion.)
Floating pulse with profuse sweating, lethargy, heavy body, and snoring indicates Feng Wen (Wind-Warmth). (See "Wind-Warmth" for theory.) Closing eyes leading to night sweats indicates Taiyang-Shaoyang-Yangming Combined Disease. (See "Night Sweats" for theory.)
Huhe Disease (Chancroid/Ulceration) presenting with silence, desire to sleep but inability to close eyes, anorexia, aversion to food odor, fluctuating facial color (red/black/white), and hoarse voice is treated with Gancao Xiexin Tang (Licorice and Pinellia Decoction to Drain the Epigastrium). For dry throat, Kushen Tang (Sophora Decoction) is used externally. For anal worm erosion, Xionghuang fumigation is used. For rapid pulse without fever, red eyes, and dark pupils, Danggui Chixiaodou San (Angelica and Adzuki Bean Powder) is used. (See "Huhe" entry.)