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。）
少阴病的典型表现是：脉象微细，精神萎靡只想睡觉。（这是因为卫气在清醒时运行于阳经，睡眠时运行于阴经。病邪必从足少阴肾经开始侵袭，所以少阴病患者会出现只想睡觉的症状。）
如果患少阴病，刚发病时就出现发热且脉象沉的，应当用麻黄附子细辛汤治疗。（该方剂的具体内容见“发热”章节。）
如果患少阴病，过了两三天，出现上述情况但无明显症状（指没有呕吐、腹泻、四肢厥冷等症状），应用麻黄附子甘草汤轻微发汗。（所谓“无症”，是指没有吐、利、厥等严重症状。）
【方剂】麻黄附子甘草汤
组成：麻黄、炙甘草（各二两）、附子（一枚，炮制，去皮，切片）
用法：将药物切碎，每次服用五钱，加水煎煮后温服。通常需要服用二三剂，以身体微微出汗为痊愈标准。
如果患少阴病，过了一两天，口中感觉正常（不苦不燥），但背部怕冷的，应当进行艾灸，并用附子汤治疗。
【方剂】附子汤
组成：附子（半枚）、茯苓（七钱半）、人参（半两）、白术（一两）、芍药（七钱半）
用法：将药物切碎，每次服用五钱，加水煎煮后温服，每日三次。
如果患少阴病两三天，出现口干燥、咽喉干的，应用大承气汤紧急攻下。（方论见“口燥咽干”章节。）如果伴有咽痛的，用甘草汤；服药后未愈的，用桔梗汤。（方论见“咽痛”章节。）
如果患少阴病，过了两三天以上，心中烦躁，无法入睡的，应用黄连阿胶汤治疗。（该方剂的具体内容见“不得卧”章节。）
如果患少阴病两三天到四五天，出现腹部胀满，小便不利，或者大便带脓血的，应用桃花汤治疗。（方论见“下利”章节。）
如果出现四肢沉重疼痛并伴有腹泻的，应用真武汤治疗。（方论见“下利”章节。）
如果患少阴病六七天，出现腹部胀满且不大便的，应紧急攻下，适宜用大承气汤。（该方剂见“潮热”章节。）如果少阴病腹泻持续六七天，转变为咳嗽、呕吐，口渴，心烦无法安眠的，应用猪苓汤治疗。
如果少阴病患者脉象微细沉，只想睡觉，出汗且不烦躁，自己想吐，到了五六天出现自发性腹泻，再次出现烦躁无法入睡的，预后不良，属死证。少阴病六七天，呼吸浅表急促（息高）的，属死证。少阴病患者脉象紧，到了七八天出现自发性腹泻，脉象由紧突然变为微弱并出现四肢厥冷，但手足反而转温的，这是病情将要解除的征兆。（相关论述见“下利”章节。）少阴病到了八九天，全身及手足都发热的，是因为热邪在膀胱，必然会导致便血。
（以下条文均伴有“但欲寐”症状，方论分别见对应章节）：
口燥咽干，只想睡觉。（方论见“口燥”。）
想吐却吐不出来，只想睡觉。（方论见“吐”。）
呕吐腹泻，只想睡觉。（方论见“吐出”。）
腹泻，只想睡觉。（方论见“下利”。）
如果少阴病患者，只有四肢厥冷而无汗，医生强行发汗，必然会扰动血液出血，不知道血液会从哪个通道流出，有的从口鼻出，有的从眼睛出，这称为“下厥上竭”，属于难治之症。
少阴病患者，出现四肢厥逆，怕冷且身体蜷缩，脉搏摸不到，不烦躁但出现躁动的，属死证。
少阴病患者，怕冷身体蜷缩且腹泻，手足冰冷的，不可治愈。
少阴病患者，出现四肢厥逆，其中有的人伴有咳嗽、心悸，或者小便不利，或者腹中疼痛，或者腹泻伴有肛门重坠感的，适宜用四逆散治疗。
【方剂】四逆散
组成：炙甘草、枳实、柴胡、芍药（各等分）
用法：研成细末，每日分次连渣服用一方寸匕，每日三次。如果咳嗽的，加五味子、干姜各五分，同时主治腹泻。如果心悸的，加桂枝五分。如果小便不利的，加茯苓五分。如果腹中冷痛的，加附子一枚，炮裂。如果腹泻伴有肛门重坠感的，先用水五升煮薤白三升，去渣，将散药三方寸匕放入汤中，煮取一升半，分两次温服。
少阴病患者，手足冰冷，如果腹泻后伴有肛门重坠感的，此条适用四逆散加薤白汤。如果腹泻导致脉搏消失或无脉的，应用通脉四逆汤、白通加猪胆汁汤。（方论见“下利”章节。）如果身体骨节疼痛，脉象沉的，适宜用附子汤。少阴病患者，脉象沉的，应紧急温阳，适宜用四逆汤。（该方剂见“下利”章节。）少阴病患者，身体疼痛，手足寒冷，骨节疼痛，脉象沉的，应用附子汤治疗。少阴病患者，脉象沉且发热的，适宜用前文提到的麻黄附子细辛汤。
少阴病想要解除的时间，是从子时到寅时这段时间。
少阴病患者，怕冷且身体蜷缩，但时常感到烦躁，想要脱去衣被的，可以治愈。
少阴病患者，腹泻停止但出现头晕，时常感到头目昏蒙的，属死证。
少阴中风，脉象寸部微、尺部浮的，是病情即将痊愈的表现。
少阴病患者，脉象细沉数，说明病位在里，不可使用发汗法。
少阴病患者，脉象微弱的，不可发汗，因为阳气已亡失的缘故。
阳气已经虚弱，尺部脉象弱而涩的，不可再用攻下法。
太阳病，过了十天以上，脉象浮细，嗜睡想躺着的，说明表邪已解。如果胸满胁痛的，用小柴胡汤。如果脉象仅见浮象的，用麻黄汤。（相关论述见“鼻干”章节。）
脉浮、出汗多、嗜睡，如果身体沉重、呼吸打鼾的，是风温病。（方论见“风温”章节。）如果闭眼时就盗汗出的，是三阳合病。（方论见“盗汗”章节。）
狐惑病，患者沉默寡言想睡觉，但眼睛睁不开不想闭合，不想吃东西，厌恶食物气味，面色时而发红、时而发黑、时而发白，声音嘶哑的，用甘草泻心汤。咽喉干燥的，用苦参汤熏洗。如果有肛虫侵蚀肛门的，用雄黄熏蒸。脉数身无热，眼睛红赤且瞳仁发黑的，用当归赤小豆散。（均见“狐惑”条目。）
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.)