少阴之为病，脉微细，但欲寐也。
少阴为病，脉微细，为邪气传里深也。卫气行于阳则寤，行于阴则寐。邪传少阴，则气行于阴而不行于
阳，故但欲寐。
少阴病，欲吐不吐，心烦，但欲寐，五六日，自利而渴者，属少阴也，虚故引水自救。若小便色白者，
少阴病形悉具。小便白者，以下焦虚有寒，不能制水，故令色白也。
欲吐不吐，心烦者，表邪传里也。若腹满痛，则属太阴；此但欲寐，则知属少阴。五六日，邪传少阴
之时。自利不渴者，寒在中焦，属太阴；此自利而渴，为寒在下焦，属少阴。肾虚水燥，渴欲引水自救。下
焦虚寒，不能制水，小便色白也。经曰∶下利欲饮水者，以有热故也。此下利虽渴，然以小便色白，明
非里热，不可不察。
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。
脉阴阳俱紧，为少阴伤寒，法当无汗；反汗出者，阳虚不固也，故云亡阳。以无阳阴独，是属少阴。《
内经》曰∶邪客少阴之络，令人嗌痛，不可内食。少阴寒甚，是当咽痛而复吐利。
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。
咳而下利，里寒而亡津液也，反以火劫，强责少阴汗者，津液内竭，加火气烦之，故谵语、小便难也。
少阴病，脉细沉数，病为在里，不可发汗。
少阴病，始得之，反发热脉沉者，为邪在经，可与麻黄附子细辛汤发汗。此少阴病，脉细沉数，为
病在里，故不可发汗。
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。
脉微为亡阳表虚，不可发汗；脉弱涩为亡阳里虚，复不可下。
少阴病脉紧，至七八日，自下利，脉暴微，手足反温，脉紧反去者，为欲解也，虽烦下利，必自愈。
少阴病，脉紧者，寒甚也。至七八日传经尽，欲解之时，自下利，脉暴微者，寒气得泄也。若阴
寒胜正，阳虚而泄者，则手足厥，而脉紧不去；今手足反温，脉紧反去，知阳气复，寒气去，
故为欲解。下利烦躁者逆；此正胜邪微，虽烦下利，必自止。
少阴病，下利，若利自止，恶寒而蜷卧，手足温者，可治。
少阴病下利，恶寒，蜷卧，寒极而阴胜也；利自止，手足温者，里和阳气得复，故为可治。
少阴病，恶寒而蜷，时自烦，欲去衣被者可治。
恶寒而蜷，阴寒甚也；时时自烦，欲去衣被，为阳气得复，故云可治。
少阴中风，脉阳微阴浮者，为欲愈。
少阴中风，阳脉当浮，而阳脉微者，表邪缓也；阴脉当沉，而阴脉浮者，里气和也。阳中有阴，阴
中有阳，阴阳调和，故为欲愈。
少阴病欲解时，从子至寅上。
阳生于子。子为一阳，丑为二阳，寅为三阳，少阴解于此者，阴得阳则解也。
少阴病，吐利，手足不逆冷，反发热者，不死。脉不至（赵本注∶“一作足”）者，灸少阴七壮。
经曰∶少阴病，吐利躁烦四逆者，死；吐利，手足不厥冷者，则阳气不衰，虽反发热，不死。脉
不至者，吐利，暴虚也，灸少阴七壮，以通其脉。
少阴病，八九日，一身手足尽热者，以热在膀胱，
必便血也。
膀胱，太阳也。少阴太阳为表里。少阴病至八九日，寒邪变热，复传太阳。太阳为诸阳主气，热在太阳，
故一身手足尽热；太阳经多血少气，为热所乘，则血散下行，必便血也。
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，（赵本有“者”字）
是名下厥上竭，为难治。
但厥无汗，热行于里也，而强发汗，虚其经络，热乘经虚，迫血妄行，从虚而出，或从口鼻，或从目出。诸
厥者，皆属于下，但厥为下厥，血亡于上为上竭，伤气损血，邪甚正虚，故为难治。
少阴病，恶寒身蜷而利，手足逆冷者，不治。
《针经》曰∶多热者易已，多寒者难已。此内外寒极，纯阴无阳，故云不治。
少阴病，吐利，躁烦，四逆者死。
吐利者，寒甚于里；四逆者，寒甚于表。躁烦则阳气欲绝，是知死矣。
少阴病，下利止而头眩，时时自冒者死。
下利止，则水谷竭，眩冒则阳气脱，故死。
少阴病，四逆恶寒而身蜷，脉不至；不烦而躁者，死。（赵本注∶“一作吐利而躁逆者死”）
四逆恶寒而身蜷，则寒甚。脉不至则真气绝。烦，热也；躁，乱也。若愤躁之躁，从烦至躁，为热来有渐
则犹可；不烦而躁，是气欲脱而争也，譬犹灯将减而暴明，其能久乎。
少阴病，六七日，息高者，死。
肾为生气之源，呼吸之门。少阴病六七日不愈而息高者，
生气断绝也。
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，不得卧寐者，死。
阴气方盛，至五六日传经尽，阳气得复则愈；反更自利，烦躁，不得卧寐，则正气弱，阳不能复，病胜脏，故死。
少阴病，始得之，反发热，脉沉者，麻黄附子细辛（赵本作“细辛附子”）汤主之。
少阴病，当无热，恶寒；反发热者，邪在表也。虽脉沉，以始得，则邪气未深，亦当温剂发汗以散之。
麻黄附子细辛（赵本作“细辛附子”）汤方∶
麻黄（二两，去节。甘热） 细辛（二两。辛热） 附子（一枚，炮，去皮，破八片。辛热）
《内经》曰∶寒淫于内，治以甘热，佐以苦辛，以辛润之。麻黄之甘，以解少阴之寒；细辛、附子之
辛，以温少阴之经。
上三味，以水一斗，先煮麻黄，减二升，去上沫，内（赵本医统本并有“诸”字）药，煮取三升，去
滓，温服一升，日三服。
少阴病，得之二三日，麻黄附子甘草汤微发汗。以二三日无里（赵本医统本并无“里”字）证，故发微汗也。
二三日，邪未深也。既无吐利厥逆诸里证，则可与麻黄附子甘草汤，微汗以散之。
麻黄附子甘草汤方∶
麻黄（二两，去节） 甘草（二两，炙） 附子（一枚，炮，去皮。赵本有“破八片”三字）
麻黄、甘草之甘，以散表寒；附子之辛，以温寒（医统本作“经”）气。
上三味，以水七升，先煮麻黄一两沸，去上沫，内诸药，煮取三升，去滓，温服一升，日三服。
少阴病，得之二三日以上，心中烦，不得卧，黄连阿胶汤主之。
《脉经》曰∶风伤阳，寒伤阴。少阴受病，则得之于寒，二三日以上，寒极变热之时，热烦于内，心
中烦，不得卧也。与黄连阿胶汤，扶阴散热。
黄连阿胶汤方∶
黄连（四两。苦寒） 黄芩（一。赵本作二，两。苦寒） 芍药（二两。酸平） 鸡子黄（二枚。甘温）
阿胶（三两。赵本注∶一云三挺。甘温）
阳有余，以苦除之，黄芩、黄连之苦，以除热；阴不足，以甘补之，鸡黄、阿胶之甘，以补血；酸，收
也，泄也，芍药之酸，收阴气而泄邪热。
上五味，以水五（赵本作“六”）升，先煮三物，取二升，去滓，内胶烊尽，小冷，内鸡子黄，搅令
相得，温服七合，日三服。
少阴病，得之一二日，口中和，其背恶寒者，当灸之，附子汤主之。
少阴客热，则口燥舌干而渴。口中和者，不苦不燥，是无热也。背为阳，背恶寒者，阳气弱，阴气胜也。
经曰∶无热恶寒者，发于阴也。灸之，助阳消阴；与附子汤，温经散寒。
附子汤方∶
附子（二枚。赵本有“炮”字。破八片，去皮。辛热） 茯苓（三两。甘平） 人参（二两。甘温）
白术（四两。甘温） 芍药（三两。酸平）
辛以散之，附子之辛以散寒；甘以缓之，茯苓、人参、白术之甘以补阳；酸以收之，芍药之酸以扶阴。
所以然者，偏阴偏阳则为病，火欲实，水当平之，不欲偏胜也。
上五味，以水八升，煮取三升，去滓，温服一升，日三服。
少阴病，身体痛，手足寒，骨节痛，脉沉者，附子汤主之。
少阴肾水而主骨节，身体疼痛，肢冷，脉沉者，寒成（医统本作“盛”）于阴也。身疼骨痛，若脉浮，
手足热，则可发汗；此手足寒，脉沉，故当与附子汤温经。
少阴病，下利便脓血者，桃花汤主之。
阳病下利便脓血者，协热也；少阴病下利便脓血者，下焦不约而里寒也。与桃花汤，固下散寒。
桃花汤方∶
赤石脂（一斤，一半全用，一半筛末。甘温） 干姜（一两。辛热） 粳米（一斤。赵本医统本
并作升。甘平）
涩可去脱，赤石脂之涩，以固肠胃；辛以散之，干姜之辛，以散里寒；粳米之甘以补正气。
上三味，以水七升，煮米令熟，去滓，温服七合，内赤石脂末，方寸匕，日三服。若一服愈，余勿服。
少阴病，二三日至四五日，腹痛，小便不利，下利不止便脓血者，桃花汤主之。
二三日以至四五日，寒邪入里深也。腹痛者，里寒也；小便不利者，水谷不别也；下利不止便脓血者，
肠胃虚弱下焦不固也。与桃花汤，固肠止利也。
少阴病，下痢（赵本医统本并作“利”）便脓血者，可刺。
下焦血气留聚，腐化则为脓血。刺之，以利下焦，宣通血气。
少阴病，吐利，手足厥（赵本作“逆”）冷，烦躁欲死者，吴茱萸汤主之。（赵本有“吴茱萸汤方”详见卷五）
吐利手足厥冷，则阴寒气甚；烦躁欲死者，阳气内争。与吴茱萸汤，助阳散寒。
少阴病，下痢，（赵本医统本并作“利”）咽痛，胸满心烦者，（赵本无“者”字）猪肤汤主之。
少阴之脉，从肾上贯肝膈，入肺中，则循喉咙；其支别者，从肺出，络心注胸中。邪自阳经传于少阴，
阴虚客热，下利，咽痛、胸满、心烦也，与猪肤汤，调阴散热。
猪肤汤方∶
猪肤（一斤。味甘寒）
猪，水畜也，其气先入肾。少阴客热，是以猪肤解之。加白蜜以润躁除烦，白粉以益气断利。
上一味，以水一斗，煮取五升，去滓，加白蜜一升，白粉五合，熬香，和（赵本医统本并有“令”字）
相得，温分六服。
少阴病，二三日咽痛者，可与甘草汤；不瘥者，（赵本无“者”字）与桔梗汤。
阳邪传于少阴，邪热为咽痛，服甘草汤则瘥；若寒热相搏为咽痛者，服甘草汤，若不瘥，与桔梗汤，以
和少阴之气。
甘草汤方∶
甘草（二两）
上一味，以水三升，煮取一升半，去滓，温服七合，日二服。
桔梗汤方∶
桔梗（一两，医统本有“味”字。辛甘，微温） 甘草（二两，医统本有“味”字。甘平）
桔梗辛温以散寒，甘草味甘平以除热，甘梗相合，以调寒热。
上二味，以水三升，煮取一升，去滓，分温（赵本作“温分”）再服。
少阴病，咽中伤生疮，不能语言，声不出者，苦酒汤主之。
热伤于络，则经络干燥，使咽中伤，生疮，不能言语，声不出者，与苦酒汤，以解络热，愈咽疮。
苦酒汤方∶
半夏（洗，破，如枣核大，赵本无“大”字，十四枚。辛温） 鸡子（一枚，去黄，内上苦酒着鸡子壳中。甘微寒）
辛以散之，半夏之辛，以发声音；（医统本作“音声”）甘以缓之，
鸡子之甘，以缓咽痛；酸以收之，苦酒之酸，以敛咽疮。
上二味，内半夏，着苦酒中，以鸡子壳，置刀 （赵本作“环”）中，安火上，令三沸，去滓，少少含咽之。不
瘥，更作三剂。
少阴病咽中痛，半夏散及汤主之。
甘草汤，主少阴客热咽痛；桔梗汤，主少阴寒热相搏咽痛；
半夏散及汤，主少阴客寒咽痛也。
半夏散及汤方∶
半夏（洗。辛温） 桂枝（去皮。辛热） 甘草（炙。甘平。以上各等分）
《内经》曰∶寒淫所胜，平以辛热，佐以甘苦。半夏、桂枝之辛，以散经寒；甘草之甘，以缓正气。
以上三味，（赵本作“右三味等分”）各别捣筛已，合治之，白饮和，服方寸匕，日三服。若不能散
服者，以水一升，煎七沸，内散两方寸匕，更煎（赵本作“煮”）三沸，下火令小
冷，少少咽之。（赵本有“半夏有毒，不当散服”二句）
少阴病，下利，白通汤主之。
少阴主水。少阴客寒，不能制水，故自利也。白通汤温里散寒。
白通汤方∶
葱白（四茎。辛温） 干姜（一两。辛热） 附子（一枚，生用。赵本无“用”字，去皮，破八片。辛热）
《内经》曰∶肾苦燥，急食辛以润之。葱白之辛，以通阳气；姜附之辛，以散阴寒。
上三味，以水三升，煮取一升，去滓，分温再服。
少阴病，下利脉微者，与白通汤；利不止，厥逆无脉，干呕烦者，白通加猪胆汁汤主之。服汤脉暴出者
死，微续者生。
少阴病，下利，脉微，为寒极阴胜，与白通汤复阳散寒。服汤利不止，厥逆无脉，干呕烦者，寒气太甚，
内为格拒，阳气逆乱也，与白通汤加猪胆汁汤以和之。《内经》曰∶逆而从之，从而逆之。又曰∶逆者正治，
从者反治。此之谓也。服汤脉暴出者，正气因发泄而脱也，故死；脉微续者，阳气渐复也，故生。
白通加猪胆汁（赵本医统本并有“汤”字）方∶
葱白（四茎） 干姜（一两） 附子（一枚，生，去皮，破八片） 人尿（五合。咸寒） 猪胆汁（一合。苦寒）
《内经》曰∶若调寒热之逆，冷热必行，则热物冷服，下嗌
Shao Yin disease is characterized by a faint and fine pulse, and a desire to sleep.
A faint and fine pulse in Shao Yin disease indicates that the pathogenic factor has transmitted deeply into the interior. When Wei Qi (Defensive Qi) circulates in the Yang aspects, one is awake; when it circulates in the Yin aspects, one sleeps. When the pathogen transmits to Shao Yin, Qi circulates in Yin but not in Yang, hence the patient desires to sleep.
In Shao Yin disease, if there is a desire to vomit but nothing comes up, irritability, and a desire to sleep, and after five or six days, spontaneous diarrhea with thirst occurs, this belongs to Shao Yin. Due to deficiency, the body draws water to自救 (self-rescue). If the urine is clear and white, the manifestations of Shao Yin disease are fully present. Clear and white urine indicates deficiency-cold in the Lower Jiao (Lower Burner), which fails to control water metabolism, thus causing the urine to be white.
Desire to vomit without vomiting and irritability indicate that exterior pathogens have transmitted to the interior. If accompanied by abdominal fullness and pain, it belongs to Tai Yin; here, only the desire to sleep indicates it belongs to Shao Yin. Five or six days mark the time when pathogens transmit to Shao Yin. Spontaneous diarrhea without thirst indicates cold in the Middle Jiao, belonging to Tai Yin; spontaneous diarrhea with thirst indicates cold in the Lower Jiao, belonging to Shao Yin. Kidney deficiency leads to dryness of fluids, causing thirst and a desire to drink water for self-rescue. Lower Jiao deficiency-cold fails to control water, resulting in white urine. The Classics state: "Diarrhea with desire to drink water is due to heat." Although there is thirst here, the white urine clearly indicates it is not an interior-heat syndrome; this must be carefully observed.
If the pulse is tight in both Yin and Yang positions, yet sweating occurs, this is loss of Yang Qi, belonging to Shao Yin. According to the rules, sore throat should occur, accompanied by vomiting and diarrhea.
A tight pulse in both Yin and Yang positions indicates Shao Yin Cold Damage, where sweating should not normally occur. Sweating indicates Yang deficiency failing to secure the exterior, hence termed "loss of Yang." With Yang absent and Yin alone prevailing, it belongs to Shao Yin. The *Nei Jing* states: "When pathogens lodge in the collaterals of Shao Yin, they cause sore throat and inability to swallow food." Severe cold in Shao Yin leads to sore throat, vomiting, and diarrhea.
In Shao Yin disease, coughing with diarrhea and delirium results from being coerced by fire therapy to sweat. Urination will certainly be difficult because excessive effort was made to induce sweating in Shao Yin disease.
Coughing with diarrhea indicates interior cold and loss of body fluids. Using fire therapy to forcibly induce sweating in Shao Yin depletes internal fluids. Added to the harassing effect of fire heat, this causes delirium and difficulty urinating.
In Shao Yin disease, a thin, deep, and rapid pulse indicates the disease is in the interior; sweating methods are contraindicated.
At the onset of Shao Yin disease, fever with a deep pulse indicates the pathogen is in the meridians; Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) can be used to induce sweating. However, in this case, a thin, deep, and rapid pulse indicates the disease is in the interior, so sweating is contraindicated.
In Shao Yin disease, a faint pulse contraindicates sweating, as it would lead to loss of Yang. If Yang is already deficient and the Chi (Cun Kou) pulse is weak and choppy, purgation is also contraindicated.
A faint pulse indicates loss of Yang and exterior deficiency, precluding sweating; a weak and choppy pulse indicates loss of Yang and interior deficiency, precluding purgation.
In Shao Yin disease with a tight pulse, if after seven or eight days, spontaneous diarrhea occurs, the pulse suddenly becomes faint, the hands and feet become warm, and the tightness of the pulse disappears, this indicates the disease is resolving. Although there is irritability and diarrhea, it will heal spontaneously.
A tight pulse in Shao Yin indicates severe cold. After seven or eight days, when the transmission cycle completes and resolution approaches, spontaneous diarrhea and a suddenly faint pulse indicate the dispersion of cold pathogens. If Yin-cold overwhelms the healthy Qi and Yang deficiency causes leakage, the hands and feet would be cold and the pulse tight; now, since the hands and feet are warm and the pulse tightness has disappeared, we know Yang Qi has recovered and cold has departed, indicating resolution. Diarrhea with irritability is a adverse sign; here, healthy Qi prevails over weak pathogens, so despite irritability and diarrhea, it will stop on its own.
In Shao Yin disease with diarrhea, if the diarrhea stops spontaneously, and although there is aversion to cold and curling up, the hands and feet are warm, the condition is treatable.
Diarrhea, aversion to cold, and curling up in Shao Yin indicate extreme cold and Yin predominance. Spontaneous cessation of diarrhea and warmth of the hands and feet indicate harmony in the interior and recovery of Yang Qi, making it treatable.
In Shao Yin disease, aversion to cold, curling up, occasional spontaneous irritability, and a desire to remove clothing/blankets indicate a treatable condition.
Aversion to cold and curling up indicate severe Yin-cold. Occasional irritability and desire to remove coverings indicate recovery of Yang Qi, hence treatable.
In Shao Yin wind-stroke, a superficial pulse that is faint and a deep pulse that is floating indicates impending recovery.
In Shao Yin wind-stroke, the superficial pulse should be floating; a faint superficial pulse indicates the easing of exterior pathogens. The deep pulse should be sunken; a floating deep pulse indicates harmony of interior Qi. Yang contains Yin, and Yin contains Yang; their harmony indicates recovery.
The time for resolution of Shao Yin disease is from Zi hour to Yin hour.
Yang Qi arises at Zi hour. Zi represents the first Yang, Chou the second Yang, and Yin the third Yang. Shao Yin resolves at this time because Yin is resolved through the assistance of Yang.
In Shao Yin disease with vomiting and diarrhea, if the hands and feet are not cold and there is fever, death is not inevitable. If the pulse is absent (Zhao edition notes: alternatively "feet"), moxa should be applied to Shao Yin points seven times.
The Classics state: "In Shao Yin disease, vomiting, diarrhea, restlessness, and cold limbs indicate death; however, if vomiting and diarrhea occur without cold limbs, Yang Qi is not exhausted, and even with fever, death does not ensue." An absent pulse here results from sudden deficiency due to vomiting and diarrhea; applying moxa to Shao Yin points seven times helps restore the pulse.
In Shao Yin disease, if after eight or nine days, the whole body and hands and feet become hot, it is because heat resides in the Bladder, and hematochezia (blood in stool) or hematuria will likely occur.
The Bladder corresponds to the Tai Yang channel. Shao Yin and Tai Yang are exterior-interior partners. By the eighth or ninth day of Shao Yin disease, cold pathogens transform into heat and transmit back to Tai Yang. Tai Yang governs all Yang channels; heat in Tai Yang causes heat throughout the body and extremities. Since Tai Yang channels are abundant in blood but deficient in Qi, heat invasion causes blood to scatter and flow downward, leading to bleeding via the lower orifices.
In Shao Yin disease, if there is only cold limbs without sweating, and forced sweating is attempted, blood will be disturbed. It is unknown from which orifice it will emerge—perhaps from the mouth and nose, or from the eyes. This is called "Lower Cold and Upper Exhaustion," a difficult-to-treat condition.
Cold limbs without sweating indicate heat moving inward. Forced sweating empties the meridians; heat exploits this deficiency, forcing blood to move recklessly and exit through weak points, such as the mouth, nose, or eyes. All types of Jue (cold limbs) belong to the lower part; cold limbs alone constitute "Lower Cold," while blood loss from above constitutes "Upper Exhaustion." Injury to Qi and Blood, with strong pathogens and weak healthy Qi, makes this difficult to treat.
In Shao Yin disease, aversion to cold, curling up, diarrhea, and cold limbs indicate an untreatable condition.
The *Zhen Jing* states: "Those with much heat recover easily; those with much cold recover with difficulty." Here, there is extreme internal and external cold, pure Yin without Yang, hence untreatable.
In Shao Yin disease, vomiting, diarrhea, restlessness, and cold limbs indicate death.
Vomiting and diarrhea indicate severe interior cold; cold limbs indicate severe exterior cold. Restlessness indicates the exhaustion of Yang Qi, signaling death.
In Shao Yin disease, if diarrhea stops but dizziness and frequent sensations of blackout occur, death is inevitable.
Cessation of diarrhea indicates exhaustion of water and grain essence; dizziness and blackouts indicate depletion of Yang Qi, leading to death.
In Shao Yin disease, cold limbs, aversion to cold, curling up, and an absent pulse; if there is no irritability but only restlessness/agitation, death is inevitable. (Zhao edition note: alternatively "vomiting, diarrhea, restlessness, and cold limbs indicate death").
Cold limbs, aversion to cold, and curling up indicate severe cold. An absent pulse indicates extinction of True Qi. "Fan" (irritability) relates to heat; "Zao" (restlessness/agitation) relates to disorder. If agitation follows irritability, heat is gradually increasing, which may still be treatable; however, agitation without prior irritability indicates Qi attempting to escape and struggle, like a lamp flickering brightly just before going out. How long can it last?
In Shao Yin disease, if after six or seven days, respiration becomes high and shallow, death is inevitable.
The Kidney is the source of vital Qi and the gate of respiration. In Shao Yin disease, if after six or seven days respiration becomes high, it indicates the severance of vital Qi.
In Shao Yin disease, with a faint, fine, and deep pulse, a desire to sleep, sweating without irritability, and a desire to vomit; if by the fifth or sixth day, spontaneous diarrhea occurs, followed by irritability and inability to lie down or sleep, death is inevitable.
When Yin Qi is dominant, by the fifth or sixth day, if Yang Qi recovers upon completion of transmission, healing occurs. However, if spontaneous diarrhea, irritability, and insomnia occur instead, it indicates weak healthy Qi and failure of Yang recovery; the disease overcomes the Zang organs, leading to death.
At the onset of Shao Yin disease, if there is fever with a deep pulse, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) is indicated.
Shao Yin disease typically presents without fever and with aversion to cold. Fever indicates the pathogen is in the exterior. Although the pulse is deep, since the disease is recent, the pathogen has not penetrated deeply; warming agents inducing mild sweating should be used to disperse it.
Mahuang Fuzi Xixin Tang Formula:
Mahuang (Ephedrae Herba, 2 liang, remove nodes. Sweet, Hot)
Xixin (Asari Radix et Rhizoma, 2 liang. Pungent, Hot)
Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, processed, peel removed, broken into 8 pieces. Pungent, Hot)
The *Nei Jing* states: "For cold invading the interior, treat with sweet-hot herbs, assisted by bitter-pungent ones, using pungency to moisten." The sweetness of Mahuang dispels Shao Yin cold; the pungency of Xixin and Fuzi warms the Shao Yin meridians.
Take the three ingredients, add 1 dou of water, boil Mahuang first until reduced by 2 sheng, skim off the foam, add remaining herbs, boil to obtain 3 sheng, strain, and take 1 sheng warm, three times daily.
For Shao Yin disease lasting two to three days, Mahuang Fuzu Gancao Tang (Ephedra, Aconite, and Licorice Decoction) induces mild sweating. Since there are no interior syndromes after two to three days, mild sweating is appropriate.
After two to three days, the pathogen is not deep. Without interior symptoms like vomiting, diarrhea, or cold limbs, Mahuang Fuzi Gancao Tang can be given to induce mild sweating and disperse the pathogen.
Mahuang Fuzi Gancao Tang Formula:
Mahuang (Ephedrae Herba, 2 liang, remove nodes)
Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried)
Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, processed, peel removed. Zhao edition adds "broken into 8 pieces")
The sweetness of Mahuang and Gancao disperses exterior cold; the pungency of Fuzi warms the cold Qi.
Take the three ingredients, add 7 sheng of water, boil Mahuang for one boiling, skim foam, add other herbs, boil to obtain 3 sheng, strain, and take 1 sheng warm, three times daily.
For Shao Yin disease lasting more than two to three days, with mental restlessness and inability to lie down, Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) is indicated.
The *Mai Jing* states: "Wind injures Yang, Cold injures Yin." Shao Yin disease results from cold. After two to three days, cold reaches extremity and transforms into heat. Heat harasses internally, causing mental restlessness and insomnia. Huanglian Ejiao Tang nourishes Yin and dissipates heat.
Huanglian Ejiao Tang Formula:
Huanglian (Coptidis Rhizoma, 4 liang. Bitter, Cold)
Huangqin (Scutellariae Radix, 1 liang. Zhao edition says 2 liang. Bitter, Cold)
Shaoyao (Paeoniae Radix Alba, 2 liang. Sour, Neutral)
Jizihuang (Ovi Ovum Vitellus, 2 pieces. Sweet, Warm)
Ejiao (Asini Corii Colla, 3 liang. Zhao edition note: alternatively 3 strips. Sweet, Warm)
Excess Yang is cleared with bitterness; the bitterness of Huangqin and Huanglian clears heat. Insufficient Yin is tonified with sweetness; the sweetness of Jizihuang and Ejiao nourishes blood. Sourness collects and drains; the sourness of Shaoyao collects Yin Qi and drains pathogenic heat.
Take the five ingredients, add 5 sheng of water (Zhao edition says 6 sheng), boil the first three to obtain 2 sheng, strain, dissolve Ejiao, cool slightly, add Jizihuang, mix well, take 7 he warm, three times daily.
For Shao Yin disease lasting one to two days, with a neutral taste in the mouth and aversion to cold on the back, moxibustion should be applied, and Fuzi Tang (Aconite Decoction) is indicated.
External heat in Shao Yin causes dry mouth and tongue with thirst. A neutral mouth indicates no bitterness or dryness, implying no heat. The back is Yang; aversion to cold on the back indicates weak Yang and prevailing Yin. The Classics state: "Aversion to cold without fever originates in Yin." Moxibustion assists Yang and dispels Yin; Fuzi Tang warms the meridians and dispels cold.
Fuzi Tang Formula:
Fuzi (Aconiti Lateralis Radix Praeparata, 2 pieces. Zhao edition has "processed". Broken into 8 pieces, peel removed. Pungent, Hot)
Fuling (Poria, 3 liang. Sweet, Neutral)
Renshen (Ginseng Radix, 2 liang. Sweet, Warm)
Baizhu (Atractylodis Macrocephalae Rhizoma, 4 liang. Sweet, Warm)
Shaoyao (Paeoniae Radix Alba, 3 liang. Sour, Neutral)
Pungency disperses; Fuzi's pungency dispels cold. Sweetness moderates; the sweetness of Fuling, Renshen, and Baizhu tonifies Yang. Sourness collects; Shaoyao's sourness supports Yin.
This is necessary because deviation toward Yin or Yang causes disease. If Fire wants to be substantial, Water must balance it, preventing excess.
Take the five ingredients, add 8 sheng of water, boil to obtain 3 sheng, strain, and take 1 sheng warm, three times daily.
For Shao Yin disease with body pain, cold hands and feet, bone joint pain, and a deep pulse, Fuzi Tang is indicated.
Shao Yin Kidney Water governs bones and joints. Body pain, cold limbs, and deep pulse indicate cold flourishing in Yin. If the pulse were floating and hands/feet warm, sweating could be used; here, cold limbs and deep pulse require Fuzi Tang to warm the meridians.
For Shao Yin disease with diarrhea and pus-blood in stool, Taohua Tang (Peach Kernel Decoction) is indicated.
In Yang diseases, diarrhea with pus-blood is associated with heat; in Shao Yin disease, it results from Lower Jiao failure to constrain and interior cold. Taohua Tang secures the lower orifice and dispels cold.
Taohua Tang Formula:
Chishizhi (Halloysit Rubrum, 1 jin, half used whole, half powdered. Sweet, Warm)
Ganjiang (Zingiberis Rhizoma, 1 liang. Pungent, Hot)
Jingmi (Oryza Sativa, 1 jin. Zhao/YiTong editions say 1 sheng. Sweet, Neutral)
Astringents treat collapse; Chishizhi's astringency secures the intestines and stomach. Pungency disperses; Ganjiang's pungency dispels interior cold. Jingmi's sweetness tonifies healthy Qi.
Take the three ingredients, add 7 sheng of water, cook rice until soft, strain, take 7 he warm, add 1 cun-bi of Chishizhi powder, three times daily. If cured after one dose, do not take the remainder.
For Shao Yin disease lasting two to four or five days, with abdominal pain, difficult urination, persistent diarrhea with pus-blood, Taohua Tang is indicated.
Two to four or five days indicate deep penetration of cold pathogens. Abdominal pain indicates interior cold; difficult urination indicates separation of water and grain; persistent diarrhea with pus-blood indicates weak intestines/stomach and insecure Lower Jiao. Taohua Tang secures the intestines and stops diarrhea.
For Shao Yin disease with diarrhea and pus-blood, acupuncture may be used.
Stagnation and accumulation of Qi and blood in the Lower Jiao rot and transform into pus-blood. Acupuncture promotes drainage of the Lower Jiao and unblocks Qi and blood.
For Shao Yin disease with vomiting, diarrhea, cold limbs, and severe irritability approaching death, Wuzhuyu Tang (Evodia Decoction) is indicated. (Zhao edition has "Wuzhuyu Tang Formula", see Volume 5).
Vomiting, diarrhea, and cold limbs indicate severe Yin-cold; severe irritability indicates internal struggle of Yang Qi. Wuzhuyu Tang assists Yang and dispels cold.
For Shao Yin disease with diarrhea, sore throat, chest fullness, and mental restlessness, Zhufu Tang (Pig Skin Decoction) is indicated.
The Shao Yin meridian ascends from the Kidney, passes through the Liver and Diaphragm, enters the Lung, and follows the throat. Its branch emerges from the Lung, connects to the Heart, and pours into the Chest. Pathogens transmitting from Yang meridians to Shao Yin cause Yin deficiency with guest heat, leading to diarrhea, sore throat, chest fullness, and irritability. Zhufu Tang harmonizes Yin and dissipates heat.
Zhufu Tang Formula:
Zhufu (Porcis Cutis, 1 jin. Sweet, Cold)
Pigs are water animals; their Qi enters the Kidney first. For Shao Yin guest heat, Pig Skin resolves it. Add White Honey to moisten and relieve irritability, and White Flour (rice flour) to boost Qi and stop diarrhea.
Take the single ingredient, add 1 dou of water, boil to obtain 5 sheng, strain, add 1 sheng of White Honey and 5 he of White Flour, stir-fry until fragrant, mix well, divide into six doses, take warm.
For Shao Yin disease with sore throat after two to three days, Gancao Tang (Licorice Decoction) may be given; if ineffective, Jiegeng Tang (Platycodon Decoction) is administered.
Yang pathogens transmitting to Shao Yin cause heat-induced sore throat; Gancao Tang heals this. If sore throat is caused by cold-heat conflict and Gancao Tang is ineffective, Jiegeng Tang harmonizes Shao Yin Qi.
Gancao Tang Formula:
Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang)
Take the single ingredient, add 3 sheng of water, boil to obtain 1.5 sheng, strain, take 7 he warm, twice daily.
Jiegeng Tang Formula:
Jiegeng (Platycodonis Radix, 1 liang. YiTong edition adds "flavor". Pungent, Sweet, Slightly Warm)
Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang. YiTong edition adds "flavor". Sweet, Neutral)
Jiegeng's pungent-warmth disperses cold; Gancao's sweet-neutral nature clears heat. Together, they harmonize cold and heat.
Take the two ingredients, add 3 sheng of water, boil to obtain 1 sheng, strain, divide into two warm doses.
For Shao Yin disease with sores in the throat, inability to speak, and voice loss, Kujiu Tang (Bitter Wine Decoction) is indicated.
Heat injuring collaterals causes dryness, leading to throat injury and sores, speech impairment, and voice loss. Kujiu Tang resolves collateral heat and heals throat sores.
Kujiu Tang Formula:
Banxia (Pinelliae Rhizoma, washed, broken, size of jujube pit, 14 pieces. Zhao edition omits "size of jujube pit". Pungent, Warm)
Jizi (Gallicolum Ovipem, 1 piece, remove yolk, place Bitter Wine in shell. Sweet, Slightly Cold)
Pungency disperses; Banxia's pungency restores voice. Sweetness moderates; Jizi's sweetness relieves sore throat. Sourness collects; Kujiu's (vinegar) sourness contracts throat sores.
Place Banxia in Kujiu within the eggshell, set in a knife ring over fire, boil three times, strain, and gargle/swallow small amounts frequently. If not cured, prepare three more doses.
For Shao Yin disease with sore throat, Banxia San Ji Tang (Pinellia Powder and Decoction) is indicated.
Gancao Tang treats Shao Yin guest-heat sore throat; Jiegeng Tang treats Shao Yin cold-heat conflict sore throat; Banxia San Ji Tang treats Shao Yin guest-cold sore throat.
Banxia San Ji Tang Formula:
Banxia (Pinelliae Rhizoma, washed. Pungent, Warm)
Guizhi (Cinnamomi Ramulus, peeled. Pungent, Hot)
Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried. Sweet, Neutral. Equal parts)
The *Nei Jing* states: "For overwhelming cold, use pungent-hot to level, assisted by sweet-bitter." Banxia and Guizhi's pungency disperses meridian cold; Gancao's sweetness moderates healthy Qi.
Take the three ingredients (Zhao edition: "Right three ingredients equal parts"), grind and sieve separately, mix, combine with Bai Yin (rice gruel), take 1 cun-bi, three times daily. If powder cannot be taken, boil 1 sheng of water for seven boils, add two cun-bi of powder, boil three more times, let cool slightly, and gargle/swallow small amounts frequently. (Zhao edition adds: "Banxia is toxic, not suitable for powder administration").
For Shao Yin disease with diarrhea, Baitong Tang (White Pass Decoction) is indicated.
Shao Yin governs Water. Guest cold in Shao Yin fails to control water, causing spontaneous diarrhea. Baitong Tang warms the interior and dispels cold.
Baitong Tang Formula:
Congbai (Allii Fistulosi Bulbus, 4 stems. Pungent, Warm)
Ganjiang (Zingiberis Rhizoma, 1 liang. Pungent, Hot)
Fuzi (Aconiti Lateralis Radix, raw, 1 piece. Zhao edition omits "use". Peel removed, broken into 8 pieces. Pungent, Hot)
The *Nei Jing* states: "Kidney dislikes dryness; urgently eat pungent to moisten." Congbai's pungency unblocks Yang Qi; Ginger and Aconite's pungency disperses Yin cold.
Take the three ingredients, add 3 sheng of water, boil to obtain 1 sheng, strain, divide into two warm doses.
For Shao Yin disease with diarrhea and faint pulse, give Baitong Tang; if diarrhea persists, cold limbs, absent pulse, dry retching, and irritability occur, Baitong Tang plus Pig Gallbladder Bile is indicated. If the pulse suddenly surges after taking the decoction, death ensues; if the pulse slowly returns, life is preserved.
Faint pulse with diarrhea indicates extreme cold and Yin predominance; Baitong Tang restores Yang and dispels cold. Persistence of diarrhea, cold limbs, absent pulse, dry retching, and irritability after dosing indicate excessive cold causing internal rejection and chaotic Yang Qi. Baitong Tang plus Pig Gallbladder Bile harmonizes this. The *Nei Jing* states: "Follow the reverse, reverse the follow." Also: "Reverse is standard treatment, Follow is counter-treatment." This refers to such cases. A sudden surge of pulse indicates healthy Qi escaping and collapsing, leading to death; a gradual return indicates Yang recovery, leading to survival.
Baitong Tang plus Pig Gallbladder Bile Formula:
Congbai (Allii Fistulosi Bulbus, 4 stems)
Ganjiang (Zingiberis Rhizoma, 1 liang)
Fuzi (Aconiti Lateralis Radix, raw, peeled, broken into 8 pieces)
Ren Niao (Hominis Urina, 5 he. Salty, Cold)
Zhu Dan (Suis Fel, 1 he. Bitter, Cold)
The *Nei Jing* states: "To regulate the reversal of cold and heat, cold and hot must proceed together; therefore, hot medicine is taken cold..."