【纲】仲景曰。少阴病。咳而下利。谵语者。被火劫故也。小便必难。以强发少阴汗也。
【目】鳌按。上咳下利。津液丧亡之故。
【纲】仲景曰。少阴病。二三日不已。至四五日。腹痛。小便不利。四肢沉重疼痛。自下利者。
此为有水气。其人或咳。或小便利。或下利。呕者。真武汤主之。
【目】朱肱曰。有少阴症咳嗽。真武汤、四逆散、猪苓汤也。大抵热在上焦。其人必饮水。水
停心下。则肺为之浮。肺主于咳。水气乘之。故咳而微喘。真武加五味子、干姜。大抵伤寒水气。
皆因饮水过多。古人治水气而咳者。病在阳。小青龙汤。病在阴。真武汤。古今录验。橘皮汤治咳
佳。
【纲】仲景曰。少阴病。下利。六七日。咳而呕。渴。心烦。不得眠者。猪苓汤主之。
【目】寇宗 曰。又咳呕。又烦渴。非肾水不升之故而何。
【纲】仲景曰。少阴病。四逆。泄利下重。其人或咳。或悸。或小便不利。或腹中痛者。四逆
散主之。
【目】朱肱曰。四逆散加五味子、干姜。
【纲】仲景曰。太阳病。发汗。汗出不解。其人仍发热。心下悸。头眩。身 动。振振欲擗地
者。真武汤主之。
【目】鳌按。仍发热而心下悸。坎阳外亡。而肾水凌心也。以其为肾水凌心之故。故亦列少阴
款中。
【纲领】张仲景说：少阴病（少阴经受邪所致的病证），出现咳嗽并伴有腹泻，如果还有胡言乱语的症状，这是因为被火疗强行劫夺津液所致。小便必然困难，因为强行发汗导致少阴经的汗液外泄。
【附注】沈金鳌按语：上面的咳嗽和下面的腹泻，是因为津液丧失殆尽的缘故。
【纲领】张仲景说：少阴病，经过两三天没有好转，到了四五天，出现腹痛、小便不利、四肢沉重疼痛、自发性腹泻的症状。这是体内有水气停留。其中有的人可能咳嗽，有的人小便通利，有的人腹泻，有的人呕吐，应当用真武汤（温阳利水方剂）主治。
【附注】朱肱说：有少阴病症状表现为咳嗽的，可用真武汤、四逆散（疏肝理脾方剂）、猪苓汤（利水清热方剂）。大抵热邪在上焦的人，必定想喝水。水饮停滞在心下（胃脘部），肺脏因此受迫而上浮。肺主司咳嗽，水气侵犯肺脏，所以咳嗽且伴有轻微气喘。在真武汤中加入五味子（收敛固涩药）、干姜（温中散寒药）。大抵伤寒病中的水气，大多是因为饮水过多引起。古人治疗因水气引起的咳嗽，若病在阳分，用小青龙汤（解表散寒、温肺化饮方剂）；若病在阴分，用真武汤。《古今录验》记载，橘皮汤治疗咳嗽效果很好。
【纲领】张仲景说：少阴病，腹泻，经过六七天，出现咳嗽、呕吐、口渴、心烦、无法入睡的症状，应当用猪苓汤主治。
【附注】寇宗奭说：又有咳嗽、呕吐，又有烦躁、口渴，这难道不是肾水不能上升的缘故吗？
【纲领】张仲景说：少阴病，出现四肢厥冷、泄泻且肛门重坠感。其中有的人可能咳嗽，有的人可能心悸（心中悸动不安），有的人小便不利，有的人腹部疼痛，应当用四逆散主治。
【纲领】张仲景说：太阳病（太阳经受邪所致的病证），经过发汗治疗后，汗出后病仍未解除，病人仍然发热，心下悸动，头晕目眩，身体肌肉跳动，震颤不稳想要倒在地上，应当用真武汤主治。
【附注】沈金鳌按语：仍然发热且心下悸动，是坎中之阳（肾阳）向外亡失，导致肾水凌犯心脏。正因为是肾水凌心的缘故，所以也将其列在少阴病的条目中。
[General Principle] Zhang Zhongjing stated: In Shaoyin disease (a syndrome caused by pathogenic invasion of the Shaoyin meridians), if coughing is accompanied by diarrhea, and the patient also exhibits delirium (confused speech due to heat or phlegm misting the mind), this is caused by fire therapy forcibly depleting body fluids. Urination will inevitably become difficult because excessive sweating was forced upon the Shaoyin channel.
[Commentary] Shen Jin'ao noted: The aforementioned cough and subsequent diarrhea are due to the exhaustion of body fluids (Jinye).
[General Principle] Zhang Zhongjing stated: In Shaoyin disease, if it persists for two to three days without improvement, progressing to four or five days, symptoms such as abdominal pain, difficulty in urination, heaviness and pain in the four limbs, and spontaneous diarrhea occur. This indicates the presence of retained water qi (pathogenic fluid accumulation). Among these patients, some may have coughing, some may have normal urination, some may have diarrhea, and some may have vomiting. These cases should be treated with Zhenwu Tang (True Warrior Decoction).
[Commentary] Zhu Gong stated: For Shaoyin syndrome presenting with cough, one may use Zhenwu Tang, Sini San (Frigid Extremities Powder), or Zhuling Tang (Polyporus Decoction). Generally, when heat is located in the Upper Jiao (Upper Burner), the patient will desire drinking water. If water stagnates below the heart (epigastrium), the Lung is affected and floats upward. Since the Lung governs coughing, the invasion of water qi causes coughing with slight wheezing. Adding Wuweizi (Schisandra Fruit) and Ganjiang (Dried Ginger) to Zhenwu Tang is effective. Generally, water qi in cold damage diseases often results from excessive water intake. In ancient times, for treating cough caused by water qi, if the pathology was in the Yang aspect, Xiao Qinglong Tang (Minor Blue Dragon Decoction) was used; if in the Yin aspect, Zhenwu Tang was used. The *Gujin Luyan* records that Chupi Tang (Tangerine Peel Decoction) is excellent for treating cough.
[General Principle] Zhang Zhongjing stated: In Shaoyin disease, after six or seven days of diarrhea, if the patient presents with cough, vomiting, thirst, irritability, and insomnia, Zhuling Tang should be administered.
[Commentary] Kou Zongshi stated: With the presence of cough and vomiting, along with irritability and thirst, could this not be attributed to the failure of Kidney Water to ascend?
[General Principle] Zhang Zhongjing stated: In Shaoyin disease, if there are cold extremities (Sini), diarrhea with a sensation of heaviness in the rectum, and among these patients, some may have coughing, some palpitations (heart palpitations), some difficulty in urination, and some abdominal pain, Sini San should be used.
[Commentary] Zhu Gong stated: Add Wuweizi and Ganjiang to Sini San.
[General Principle] Zhang Zhongjing stated: In Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang meridians), after perspiration therapy, if the sweat does not resolve the condition, and the patient still has fever, palpitations below the heart, dizziness, muscle twitching, and tremors making them feel as though they are about to fall to the ground, Zhenwu Tang should be administered.
[Commentary] Shen Jin'ao noted: The persistence of fever combined with palpitations below the heart indicates the loss of Kan Yang (Kidney Yang) to the exterior, leading to Kidney Water flooding over the Heart. Because this is due to Kidney Water flooding the Heart, it is also categorized under Shaoyin conditions.