【纲】仲景曰。少阳之为病。口苦咽干目眩也。
【目】成无己曰。咽干口燥舌涩。俱为热症。但有微甚耳。惟太阳中寒桂枝附子汤症。由误汗
咽干。作甘草干姜汤。以复其阳者。随其逆治坏病者也。非治其本寒也。然咽干之由。由汗下后而
得者。有不由汗下而得者。其间治法。或和解。或微汗。或急下。或微下。当察兼有之症。而施轻
重之治。然其为热。则一也。盖经谓咽喉干燥。亦不可汗。以其多有里症故也。实无寒病。善治者。
尤宜互参渴门。乃获全功焉。
王肯堂曰。凡伤寒头眩者。莫不因汗吐下。虚其上焦元气之所致。眩者。目无常主。头眩者。
俗谓头旋眼花是也。眩冒者。昏冒是也。少阳口苦咽干目眩者。少阳居表里之间。以表邪渐入于里。
表中阳虚。故目眩也。太阳少阳并病或眩者。责其虚也。伤寒有起则头眩与眩冒者。皆汗吐下后
所致。是知其阳虚也。故针经曰。上虚则眩。下虚则厥。眩虽为虚。又阳明中风。但头眩不恶寒者。
此又风主眩也。凡此皆水逆候。及其诸逆发汗。剧者言乱目眩。则死矣。
治少阳目眩。小柴胡汤加天麻、川芎。
张兼善曰。凡口唇焦干为脾热。焦而红者吉。焦而黑者凶。唇口俱赤肿者。热甚也。唇口俱青
黑者。冷极也。口中苦者。胆热也。口中甜者。脾热也。口燥咽干者。肾热也。舌干口燥而欲饮水
者。阳明热也。口噤难言者。痉风也。凡上唇有疮为狐。虫蚀其脏。下唇有疮为惑。虫蚀其肛。若
唇青舌卷。唇吻反青。环口黧黑。口张气直。口如鱼口。及口唇颤摇不止。气出不返。皆不治也。
柯琴曰。此为少阳病之提纲也。口咽目三者。不可谓表。不可谓里。是表之入里。里之出表处。
所谓半表里也。
三症为少阳经病机。兼风寒杂病而言。但见一症即是。不必悉具。
【纲】仲景曰。少阳中风。两耳无所闻。目赤。胸中满而烦者。不可吐下。吐下则悸而惊。
【目】魏荔彤曰。凡伤寒。原兼伤风而言。风寒之邪。从类而投太阳营卫。在肌肤之表而已。
感之者浅。故曰伤。所以日久不治。渐入渐深。有经尽而解者。有过经而传者。皆有一定之道路。
此伤寒所以有传经。无传经则非伤寒病矣。若夫中风中寒。则直突而来。并无次第。然风必中于三
阳之少阳。寒必中于三阴之少阴。仍是各从其类。又寓从少不从老之理。其邪较太阳营卫之伤甚深
且速。故曰中。所以卒遇即病。有立尽者。此与伤寒传经之病大不同也。
【纲】张仲景说：少阳病的主要症状是口苦、咽喉干燥和头晕目眩。
【目】成无己说：咽喉干燥、口中燥渴、舌苔干涩，都属于热证，只是有轻微与严重的区别罢了。只有太阳中寒证服用桂枝附子汤时，因误用发汗法导致咽干，此时应使用甘草干姜汤来恢复阳气，这是针对因误治而变坏的病症进行随证施治的方法，并非治疗原本的根本寒邪。然而，咽干的原因，有的是因为发汗或泻下之后出现的，也有不是因发汗或泻下引起的。其中的治疗方法，有的采用和解法，有的采用微发汗法，有的采用急下法，有的采用轻下法，应当观察伴随的其他症状，从而施加轻重不同的治疗。虽然其本质都是热证，但这一点是一致的。正如经典所说，咽喉干燥者，也不可用发汗法，因为其中多伴有里证。确实没有寒邪病的患者，善于治病的人，尤其应当参考关于口渴的章节，才能取得全面的治疗效果。
王肯堂说：凡是伤寒出现头晕目眩的，没有不是因为发汗、催吐或泻下，导致上焦元气虚损而引起的。“眩”是指眼睛不能正常聚焦，“头眩”是俗称的头昏眼花。“眩冒”是指头昏且意识模糊。少阳病的口苦、咽干、目眩，是因为少阳位于表里之间，表邪逐渐向里传入，导致体表阳气虚弱，所以出现头晕目眩。太阳病与少阳病合并出现并伴有眩晕的，责任在于正气虚弱。伤寒中有起身时头晕目眩或头昏意识模糊的，都是由于发汗、催吐或泻下后造成的，由此可知这是阳气虚弱。所以《针经》说：上部虚弱则眩晕，下部虚弱则四肢厥冷。眩晕虽然属于虚证，但也有阳明中风，仅表现为头晕且不恶寒的情况，这又是风邪主导致的眩晕。凡此种种，都属于水气逆上的候象。以及各种逆证误用发汗后，病情严重者会出现言语错乱、头晕目眩，这就死亡了。
张兼善说：凡是口唇焦干是脾热的表现，焦而发红的是吉兆，焦而发黑的是凶兆。嘴唇和口部都红肿的，是热邪极盛。嘴唇和口部都青黑的，是寒邪极盛。口中发苦，是胆热。口中发甜，是脾热。口燥咽干，是肾热。舌头干、口中燥且想喝水的，是阳明热。牙关紧闭难以说话的，是痉病或风病。凡是上唇生疮称为“狐”，是虫蚀内脏；下唇生疮称为“惑”，是虫蚀肛门。如果出现嘴唇青紫、舌头卷缩，嘴唇周围反现青色，口周颜色黧黑，嘴巴张开气息直出，口形像鱼嘴，以及口唇颤抖不止，气息呼出不返，这些都是无法治疗的死症。
柯琴说：这是少阳病的提纲证。口、咽、目这三个部位的症状，不能说是在表，也不能说是在里，这是由表入里、由里出表的过渡地带，也就是所谓的“半表半里”。这三种症状反映了少阳经的病机，兼及风寒等杂病而言，只要见到其中一个症状即可诊断，不必全部具备。
【纲】张仲景说：少阳中风，两耳听不见声音，眼睛发红，胸中胀满且心烦，不可使用催吐或泻下的方法。如果误用吐下法，会导致心悸和惊恐。
【目】魏荔彤说：凡是伤寒，原本就兼带伤风而言。风寒之邪，按照同类相投的原则侵袭太阳经的营卫之气，仅在肌肤表层而已。感受较浅，所以称为“伤”。因此日久不治疗，病邪会逐渐深入，有的传遍一经而解，有的越过一经而传变，都有固定的传变路径。这就是伤寒之所以有“传经”之说，如果没有传经过程，那就不是伤寒病了。至于中风和中寒，则是突然袭击而来，并没有固定的次第顺序。然而，风邪必定侵犯三阳经中的少阳经，寒邪必定侵犯三阴经中的少阴经，这仍然是各从其类的道理，又蕴含了“从少不从老”的原理。这种邪气比太阳营卫受邪更深更速，所以称为“中”。因此突然遭遇就会立即发病，有的甚至立刻致死。这与伤寒通过传经途径产生的疾病大不相同。
[Outline] Zhang Zhongjing stated: The defining symptoms of Shaoyang disease are bitter taste in the mouth, dryness of the throat, and vertigo (dizziness).
[Mu] Cheng Wuji stated: Dryness of the throat, thirst in the mouth, and a dry tongue are all manifestations of Heat syndromes, differing only in severity. Only in cases of Taiyang Cold injury treated with Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction), where misapplied sweating leads to dryness of the throat, should Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) be used to restore Yang Qi. This is treating the complicated disease resulting from mismanagement according to the deviation, not treating the original fundamental Cold. However, the causes of dry throat include those arising after sweating or purging, and those not arising from these methods. The treatment methods involved may include harmonizing, mild sweating, urgent purging, or mild purging. One must observe accompanying symptoms to apply treatments of appropriate intensity. Although the underlying nature is Heat, this remains consistent. As the classics state, those with dry throat should not be subjected to sweating, as interior syndromes are often present. For patients truly lacking Cold pathogenic factors, skilled practitioners should cross-reference chapters on thirst to achieve comprehensive success.
Wang Kentang stated: In all cases of Shanghan (Cold Damage) presenting with vertigo, it is invariably caused by prior sweating, emesis, or purging, which has depleted the Yuan Qi (Primordial Qi) of the Upper Jiao (Upper Burner). "Xuan" refers to the inability of the eyes to focus steadily; "Tou Xuan" is the common term for dizziness and blurred vision. "Xuan Mao" refers to dizziness accompanied by confusion. In Shaoyang disease, characterized by bitter taste, dry throat, and vertigo, Shaoyang resides between the exterior and interior. As exterior pathogens gradually move inward, deficiency of Yang Qi at the exterior level results in vertigo. When Taiyang and Shaoyang diseases occur simultaneously with vertigo, the root cause is deficiency. In Shanghan, dizziness upon rising or severe dizziness/confusion are all caused by post-sweating, post-emetic, or post-purging states, indicating Yang deficiency. Thus, the *Zhen Jing* (Classic of Acupuncture) states: Deficiency above leads to vertigo; deficiency below leads to cold extremities. Although vertigo is generally a sign of deficiency, there are cases of Yangming Wind strike presenting solely with vertigo and no aversion to cold; this indicates that Wind is the primary cause of vertigo. All such scenarios belong to the pattern of Water Counterflow. If various counterflow conditions are mistakenly treated with sweating, severe cases will result in disordered speech and vertigo, leading to death.
To treat vertigo caused by Shaoyang disease, use Xiaochaihu Tang (Minor Bupleurum Decoction) supplemented with Tianma (Gastrodia Rhizome) and Chuanxiong (Ligusticum Rhizome).
Zhang Jianshan stated: Scorched and dry lips indicate Spleen Heat; if scorched but red, it is auspicious; if scorched and black, it is ominous. Redness and swelling of both lips and mouth indicate extreme Heat. Cyanosis and blackness of both lips and mouth indicate extreme Cold. Bitter taste in the mouth indicates Gallbladder Heat. Sweet taste in the mouth indicates Spleen Heat. Dry mouth and throat indicate Kidney Heat. Dry tongue, oral dryness, and desire to drink water indicate Yangming Heat. Trismus (lockjaw) and difficulty speaking indicate Spasm or Wind disease. Sores on the upper lip are termed "Hu" (Fox), indicating parasites eroding the internal organs; sores on the lower lip are termed "Huo" (Confusion), indicating parasites eroding the anus. If the lips are cyanotic and the tongue is curled, if the corners of the mouth turn cyanotic, if the area around the mouth is dark/black, if the mouth is open with straight airflow, if the mouth resembles a fish's mouth, or if the lips tremble continuously with breath failing to return, these are all untreatable conditions.
Ke Qin stated: This is the outline syndrome of Shaoyang disease. The symptoms involving the mouth, throat, and eyes cannot be classified strictly as Exterior or Interior; they represent the transition from Exterior to Interior and from Interior to Exterior, known as the Half-Exterior Half-Interior stage. These three symptoms reflect the pathogenesis of the Shaoyang meridian, applicable to wind-cold and miscellaneous diseases. The presence of any one symptom is sufficient for diagnosis; it is not necessary for all to be present.
[Outline] Zhang Zhongjing stated: In Shaoyang Wind strike, the patient experiences bilateral hearing loss, redness of the eyes, fullness in the chest, and irritability. Emesis and purging methods must not be used. Misapplication of emesis or purging will lead to palpitations and fright.
[Mu] Wei Litong stated: Shanghan inherently includes aspects of Wind strike. Wind-Cold pathogens, following the principle of similarity, invade the Ying and Wei (Nutritive and Defensive) Qi of the Taiyang meridian, remaining only at the surface of the skin and muscles. The invasion is shallow, hence termed "Shang" (Injury). Therefore, if left untreated for a long time, the pathogen gradually deepens. It may resolve after traversing one meridian or transmit after passing through one meridian, following a fixed pathway. This is why Shanghan involves "meridian transmission"; without transmission, it would not be considered Shanghan disease. In contrast, Zhongfeng (Wind Strike) and Zhonghan (Cold Strike) arrive suddenly without sequential order. However, Wind pathogens inevitably strike the Shaoyang meridian among the Three Yang meridians, and Cold pathogens inevitably strike the Shaoyin meridian among the Three Yin meridians, adhering to the principle of affinity. This also embodies the logic of "following the young rather than the old." These pathogens are deeper and faster than those affecting Taiyang Ying and Wei, hence termed "Zhong" (Strike). Consequently, illness occurs immediately upon exposure, sometimes leading to instant death. This differs significantly from Shanghan diseases transmitted via meridians.