卫气寤则行阳。寐则行阴。故寐为足少阴病。若欲寐。无表里症。身和脉小。是已
解也。风温症亦欲寐。多眠。则有脉浮发热汗出。身重鼻息鼾鸣之异。
属热邪。有实热宜承气。有虚热宜养阴。
邵评∶口燥咽干。属热邪。但热有虚实。治宜分别。
少阴之脉。上贯肝膈。循喉咙。系舌本。故咽痛独列少阴篇内。少阴咽痛。属热者。
有半夏散及汤。又甘草汤。桔梗汤。此散火也。属寒者。有桂枝干姜汤。治汗多亡阳也。有通脉四逆汤。
治阴盛格阳也。（参准绳）
邵评∶咽痛热症。是虚火上升。寒症有亡阳格阳二症。
金鉴云。咽痛一症。寒热皆有。肿痛为热症。仲景有甘桔、半夏、苦酒、猪肤等汤调治。
不肿而痛为寒症。宜四逆汤加桔梗主治也。
邵评∶咽痛寒热俱有。肿者为热。不肿为寒。治当分别。
有寒热之分。热者寸口脉数。发热烦渴。渴欲饮水。水入即吐者。宜五苓散。食入口
即吐者。宜二陈汤加姜汁炒连和之。
邵评∶吐症寒热均有。此条热吐。又有水逆痰热格拒二症。
寒者口不渴而吐。理中去白术加生姜。（参准绳）
邵评∶此治寒吐之正法。亦可加石莲、丁香。
金鉴云。口不渴。厥而吐属寒。宜理中、吴萸辈。渴而得食即吐属火。实热。黄连解毒汤。虚热干
姜黄芩黄连汤。渴而饮。饮而吐。吐而复渴。属水逆。五苓散。
邵评∶吐症不渴为寒。渴为热。热有虚实之分。
卫气清醒时运行于阳分，睡眠时运行于阴分。因此，嗜睡属于足少阴病（足少阴肾经受邪所致的病证）。如果患者想睡觉，但没有表证或里证的表现，身体调和，脉象细小，这是病情即将解除的征兆。风温病也会出现嗜睡、多眠的情况，但不同的是，风温病会有脉浮、发热、出汗、身体沉重、鼻息鼾鸣等症状。
这属于热邪致病。如果有实热，适宜用承气汤类方剂；如果有虚热，适宜用养阴的方法。
邵评：口燥咽干，属于热邪致病。但热邪有虚实之分，治疗应当分别对待。
足少阴经脉，向上贯穿肝和膈，沿着喉咙，连接舌根。因此，咽痛单独列在少阴篇中。少阴病引起的咽痛，属于热证的，有半夏散及汤，还有甘草汤、桔梗汤，这些是用来疏散火邪的。属于寒证的，有桂枝干姜汤，用于治疗汗出过多导致亡阳的病症；有通脉四逆汤，用于治疗阴盛格阳的病症。（参考《医学准绳》）
邵评：咽痛的热证，是虚火上升所致。寒证有亡阳和格阳两种病症。
《医宗金鉴》说，咽痛这一症状，寒证和热证都有。肿痛的是热证，张仲景有用甘桔汤、半夏散、苦酒汤、猪肤汤等方剂调治。不肿而痛的是寒证，适宜用四逆汤加桔梗主治。
邵评：咽痛既有寒证也有热证，肿的为热证，不肿的为寒证，治疗应当分别对待。
呕吐有寒证和热证的区别。热证表现为寸口脉搏数，发热，心烦口渴，想喝水，但水喝进去就吐出来的，适宜用五苓散。食物吃进去就吐出来的，适宜用二陈汤加姜汁和炒黄连调和。
邵评：呕吐症状寒证和热证都有。这条讲的是热吐，又分为水逆症和痰热格拒症两种情况。
寒证表现为口不渴而呕吐，适宜用理中汤去掉白术加生姜。（参考《医学准绳》）
邵评：这是治疗寒吐的正法。也可以加石莲子、丁香。
《医宗金鉴》说，口不渴，四肢厥冷而呕吐属于寒证，适宜用理中汤、吴茱萸汤之类。口渴且进食后立即呕吐属于火邪，实热用黄连解毒汤，虚热用干姜黄芩黄连汤。口渴想喝水，喝了就吐，吐了又觉得渴，属于水逆症，用五苓散。
邵评：呕吐症状中，不渴的为寒证，渴的为热证。热证又有虚实之分。
When the Wei Qi (Defensive Qi) is awake, it circulates in the Yang aspects; when asleep, it circulates in the Yin aspects. Therefore, somnolence (excessive sleepiness) belongs to Shaoyin disease (disease of the Foot-Shaoyin Kidney channel). If a patient desires to sleep but presents no exterior or interior symptoms, with a harmonious body condition and a small pulse, this indicates that the pathogen is resolving. Wind-warmth syndrome also manifests as somnolence and excessive sleep, but differs by presenting with a floating pulse, fever, sweating, heaviness of the body, and snoring breath.
This belongs to heat pathogen. If there is excess heat, Chengqi Tang (Gut-Purging Decoction) is appropriate; if there is deficiency heat, nourishing Yin is appropriate.
Shao’s Commentary: Dry mouth and throat belong to heat pathogen. However, heat has excess and deficiency types, so treatment must be distinguished accordingly.
The Shaoyin meridian ascends through the liver and diaphragm, follows the throat, and connects to the root of the tongue. Therefore, sore throat is listed exclusively in the Shaoyin chapter. For sore throat due to Shaoyin disease: those belonging to heat patterns include Banxia San Ji Tang (Pinellia Powder and Decoction), Gancao Tang (Licorice Decoction), and Jiegeng Tang (Platycodon Decoction), which are used to disperse fire. Those belonging to cold patterns include Guizhi Ganjiang Tang (Cinnamon Twig and Dried Ginger Decoction), used for treating yang collapse due to excessive sweating; and Tongmai Sini Tang (Pulse-Reviving Four Reversals Decoction), used for treating yin excess repelling yang. (Refer to *Yixue Zhunsheng*)
Shao’s Commentary: Heat-type sore throat is caused by rising deficient fire. Cold-type sore throat involves two conditions: yang collapse and yin repelling yang.
*Yizong Jinjian* states that sore throat can be either cold or heat. Swelling and pain indicate heat pattern; Zhang Zhongjing treated these with Ganjie Tang (Licorice and Platycodon Decoction), Banxia San (Pinellia Powder), Kujiu Tang (Bitter Wine Decoction), and Zhufu Tang (Pig Skin Decoction). Pain without swelling indicates cold pattern, best treated with Sini Tang (Four Reversals Decoction) plus Jiegeng (Platycodon).
Shao’s Commentary: Sore throat occurs in both cold and heat patterns; swelling indicates heat, lack of swelling indicates cold. Treatment must be distinguished.
Vomiting distinguishes between cold and heat. Heat patterns present with a rapid pulse at the Cunkou (radial artery position), fever, irritability, thirst, desire to drink water, yet vomiting immediately after drinking; Wuling San (Five-Ingredient Powder with Poria) is appropriate. Vomiting immediately after eating suggests using Erchen Tang (Two-Aged Decoction) added with ginger juice and stir-fried Huanglian (Coptis Rhizome) to harmonize.
Shao’s Commentary: Vomiting occurs in both cold and heat patterns. This section discusses heat vomiting, further divided into Shuini (Water-Reversal) syndrome and Tanre Geju (Phlegm-Heat Repulsion) syndrome.
Cold patterns present with vomiting without thirst; Lizhong Tang (Middle-Warming Decoction) with Baizhu (Atractylodes Rhizome) removed and fresh ginger added is appropriate. (Refer to *Yixue Zhunsheng*)
Shao’s Commentary: This is the standard method for treating cold vomiting. Shelian (Stone Lotus Seed) and Dingxiang (Clove) may also be added.
*Yizong Jinjian* states: Lack of thirst, cold limbs, and vomiting indicate cold pattern, suitable for Lizhong Tang or Wuyu (Evodia) formulas. Thirst with immediate vomiting after eating indicates fire/heat; excess heat is treated with Huanglian Jiedu Tang (Coptis Detoxification Decoction), while deficiency heat is treated with Ganjiang Huangqin Huanglian Tang (Dried Ginger, Scutellaria, and Coptis Decoction). Thirst with desire to drink, vomiting after drinking, and recurring thirst indicates Shuini (Water-Reversal) syndrome, treated with Wuling San.
Shao’s Commentary: In vomiting, lack of thirst indicates cold, while thirst indicates heat. Heat patterns further distinguish between excess and deficiency.