中焦脂膜团聚之处，脾居其中，斯为太阴，前已言之。而下焦
脂膜团聚之处，肾居其中，故名少阴。少阴之府在肾，少阴之经
即团聚之脂膜也。为其与中焦团聚之处相连，是以外感之传递，可由太阴而传入少阴也。
《伤寒论》原文∶少阴之为病，脉微细，但欲寐也。
少阴之病，有凉有热。说者谓，若自太阴传来，是阳明、少阳之邪顺序传入少阴则为热证，若外感之
邪直中真阴则为寒证者。而愚临证实验以来，知少阴病之凉者原非直中，乃自太阳传来为表里之相传，亦为
腑脏之相传（膀胱），因太阳之府相连之脂膜，原与包肾之脂膜相通也。其间有直中者，或因少阴骤虚之时，
饮食寒凉而得，此不过百中之一二，其治法原当另商也。至少阴病之热者，非必自传经而来，多由伏气化热
入少阴也。所谓伏气者，因其素受外寒甚轻，不能即病，其所受之寒气伏于三焦脂膜之中，阻塞气化之升
降而化热（气化因阻塞而生热伏气即可与之相合而化热），恒因少阴之虚损，伏气即乘虚而窜入少阴，此
乃少阴之热病初得即宜用凉药者也。
至无论其病之或凉或热而脉皆微细者，诚以脉之跳动发于心，而脉之所以跳动有力者，又关于肾。
心肾者，水火之根源也，心肾之气相济，则身中之气化自然壮旺，心肾之气若相离，身中之气化遽形衰惫。
少阴有病者，其肾气为外邪遏抑不能上升以济心，是以无论病之为凉为热，其脉象皆微细无力也。其但欲
寐者，因心肾之气不交，身中之气化衰惫，精神必然倦懒，是以常常闭目以静自休息。又因肾气不能上达
以吸引心阳下潜，是以虽闭目休息不能成寐，而为但欲寐之状也。
《伤寒论》原文∶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。
张拱端曰∶少阳为阳枢，少阴为阴枢。少阴欲吐不吐者，以
少阴有水复有火，水火之气循环上下不利，故欲吐不吐也。少阳喜呕者，以内外之气由焦膜中行，焦膜
不利则气难于出入，是以逆于胃而为呕，呕则气少畅，故喜呕，此少阴欲吐、少阳喜呕之所以然也。又太阴、
少阴俱有自利证，少阴自利而渴，从少阴本热之化也。太阴自利不渴，从太阴本湿之化也。若治少阴上焦口渴
之实热，罔顾及下焦下利之虚寒，则下利不止矣。故凡对于水火分病，则当用寒热之药分治之。对于水火合
病，无妨用寒热之药合治之。本论用方有纯于寒有纯于热，复有寒热并用者，即此理也。
──本节未列治法，张氏谓上有实热下有虚寒，宜用寒热之药函问∶师答曰∶宜用生地一两，生杭
芍五钱，附子二钱，干姜二钱，细辛一钱，计五味，不宜用石膏。 高××注
《伤寒论》原文∶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。
少阴之中有水有火，肾左右两枚水也，肾系命门所生之相火，少阴中之火也。外寒自太阳透入少阴，与少
阴中之水气相并，以阻遏其元阳，是以脉现紧象，紧者寒也，乃阴盛阳衰逼阳不得宣布之象也。迨阳气蓄之
既久，至七、八日又重值太阳、阳明主气之候，命门之火因蓄极而暴发，遂迫阴寒自下利外出，脉之紧
者亦暴微。盖脉紧原阳为阴迫，致现弦而有力之象，至暴微是由紧而变为和缓，未必甚微，与紧相较则见
其微矣。且其手足反温，此为元阳已回之兆无疑，治少阴中之寒病者，原以保护其元阳为主，此时或有心
烦之病，实因相火暴发，偶有浮越于上者，此益足征元阳之来复也，是以知其必愈也。
陈修园曰∶此言少阴得阳热之气而解也。余自行医以来，每遇将死之证，必以大药救之，忽而发烦下利，
病家怨而更医，医家亦诋前医之误，以搔不着疼痒之药居功，余反因热肠受谤，甚矣名医之不可为也。
愚年少时，初阅《伤寒论浅注》至此，疑修园之言，似近自为掩饰。迨医学研究既久，又加以临证实验，
乃知修园之言诚不诬也。后又见常德张拱端所着《伤寒论会参》，亦谓修园之言诚然，且谓余治一人，
服药后下利苦烦，又喜哈哈，似癫非癫，数时病愈，亦与此节烦利自愈一例也。而愚则谓，若遇少阴阴寒险
证，欲用药以回其阳时，不妨预告病家，阳回之后恒现下利心烦之象，自能免病家之生疑也。
子××按∶数年前余在里处，曾治一少阴寒证，服药后下利发烦而愈。一九三三年腊月，在津又治阎××
少阴寒证，服茴香、干姜等药久不愈，乃询方于余，俾单服生硫黄如枣大，食前服，每日三次，至五六
日忽下利日二三次，骇而问余。余曰∶此寒结得硫黄之热而开，《伤寒论》所谓虽烦下利必自愈者是也。后数
日利果止，其病亦愈。
《伤寒论》原文∶少阴病下利，若利自止，恶寒而蜷卧，手足温者，可治。
张拱端曰∶以上三节，俱少阴阴寒之病，前两节手足温，第三节自烦欲去衣被，均为阳回之候，均
为自愈、可治之证。可见治少阴伤寒以阳为主，不特阴证见阳脉者生，即阴病见阳证亦为易愈。论中恶寒而
蜷之蜷字，足供阴寒在内之考察，何也？大凡阴寒之病，俱有屈曲身体之形，其屈曲之理，实关系于督、任
二脉，盖以督统诸阳行于背脊，任统诸阴行于胸腹，阴寒在内屈曲身体者，伸背之阳以抑阴也，阳热在
内直腰张胸者，伸腹之阴以济阳也。如天气热人必张胸，天气寒人必拘急，观其伸阳以自救，则蜷之属于阴
寒其理可得矣。故阳盛则作痉，阴盛则蜷卧，理所必然也。至于自烦欲去衣被，是阴得阳化故为可治。
张氏论督任相助之理，以释本节中之蜷卧颇为精细，而愚于张氏所论之外，则更别有会心也。推
坎离相济，阴阳互根之理，人之心肾相交，即能生热（心肾相交能补助元阳故能生热），而心肾之相交每在呼
气外出之时也。盖当呼气外出之时，其心必然下降，其肾必然上升（此可默自体验），此际之一升一降
而心肾交矣。是乃呼吸间自然之利益，以为人身热力之补助也（试观睡时恒畏冷，以人睡着则呼吸慢，热力即
顿形不足，是明征也）。人之畏冷身蜷卧者，是其心肾欲相交以生热也（此中有无思无虑自然而然之天机）。
至于病热，其身恒后挺，是心肾欲相远，防其相交以助热也。
《伤寒论》原文∶少阴病吐利，手足不逆冷，反发热者不死，脉不至者，灸少阴七壮。
陈修园谓∶宜灸太 二穴。张拱端谓，亦可灸复溜二穴。而愚则谓，若先灸太 二穴，脉仍不应，可再
灸复溜二穴，灸时宜两腿一时同灸。太 二穴，在足内踝后五分，跟骨上动脉中，复溜二穴，
在内踝上二寸，大骨后侧陷中，此与太 同为少阴生脉之源。
中焦脂膜聚集的地方，脾脏位于其中，这就是太阴经，前面已经讲过。而下焦脂膜聚集的地方，肾脏位于其中，所以称为少阴经。少阴的腑在肾，少阴的经就是那团聚的脂膜。因为它与中焦脂膜聚集处相连，所以外感病的传变，可以由太阴传入少阴。
《伤寒论》原文：少阴病的主要表现是脉象微细，只想睡觉（精神萎靡）。
少阴的病，有寒证也有热证。评论者认为，如果是从太阴传来，那是阳明、少阳的邪气顺序传入少阴，属于热证；如果是外感邪气直接侵犯真阴，则属于寒证。但我临证实践以来，知道少阴病的寒证原本不是直中，而是从太阳传来，这是表里相传，也是腑脏相传（膀胱），因为太阳之腑相连的脂膜，本来就和包绕肾脏的脂膜相通。其中有直中的情况，往往是因为少阴突然虚弱时，饮食寒凉所致，这不过是一百例中的一二例，其治法应当另外商讨。至于少阴病的热证，不一定非要由传经而来，多是由伏气化热进入少阴。所谓伏气，是因为平时感受的外寒很轻，不能立即发病，所受寒气潜伏在三焦脂膜之中，阻塞了气化的升降从而化热（气化因阻塞而生热，伏气即可与之相合而化热），常常因为少阴虚损，伏气便乘虚窜入少阴，这正是少阴热病初起就适宜用凉药治疗的原因。
至于无论病情是寒是热，脉象都微细，确实是因为脉搏跳动发源于心，而脉搏跳动有力与否，又关系到肾。心和肾，是水火的根源。心肾之气相互济助，人体内的气化自然壮旺；如果心肾之气分离，人体内的气化就会迅速衰惫。患少阴病的人，肾气被外邪遏抑，不能上升以济助心，所以无论病是寒是热，脉象都微细无力。那些只想睡觉的症状，是因为心肾之气不交，体内气化衰惫，精神必然倦怠懒惰，所以常常闭目静养休息。又因为肾气不能上达以吸引心阳下潜，所以虽然闭目休息也不能入睡，呈现出只想睡觉的状态。
《伤寒论》原文：少阴病，想吐却吐不出来，心烦只想睡觉，五、六天后出现自利且口渴的，属于少阴病。因为虚所以引水自救，如果小便颜色白的，少阴病的症状就完全具备了。小便白是因为下焦虚寒，不能制约水液，所以使小便颜色发白。
张拱端说：少阳是阳枢，少阴是阴枢。少阴想吐却吐不出来，是因为少阴既有水又有火，水火之气循环上下不利，所以想吐却吐不出来。少阳喜欢呕吐，是因为内外之气通过三焦膜原运行，膜原不利则气难以出入，于是逆于胃而发生呕吐，呕吐后气稍微通畅，所以喜欢呕吐，这就是少阴欲吐和少阳喜呕的原因。另外，太阴和少阴都有自利的症状，少阴自利且口渴，是从少阴本热的变化而来；太阴自利且不渴，是从太阴本湿的变化而来。如果治疗少阴上焦口渴的实热，而不顾及下焦下利的虚寒，那么下利就不会停止。所以对于水火分病，应当用寒热药物分别治疗；对于水火合病，不妨用寒热药物合并治疗。本论所用的方剂，有纯用寒药的，有纯用热药的，还有寒热并用的，就是这个道理。
——本节未列出治法，张氏认为上有实热下有虚寒，宜用寒热药物。函问：老师回答说：宜用地黄一两，生杭芍五钱，附子二钱，干姜二钱，细辛一钱，共五味药，不宜用石膏。高××注
《伤寒论》原文：少阴病脉紧，到了七、八天出现自下利，脉象突然变得微弱，手足反而温暖，脉紧反而消失的，是快要痊愈的迹象。虽然有心烦和下利，必定自愈。
少阴中有水有火，肾脏左右两枚属水，肾系命门所生的相火，是少阴中的火。外寒从太阳透入少阴，与少阴中的水气相并，以阻遏元阳，所以脉现紧象，紧代表寒，这是阴盛阳衰逼迫阳气不得宣通的景象。等到阳气蓄积已久，到了七、八日又正值太阳、阳明主气的时节，命门之火因蓄极而暴发，于是迫使阴寒通过下利外出，脉象的紧也随之暴微。大概脉紧原本是阳为阴迫，导致呈现弦而有力的景象，到暴微是由紧变为和缓，未必非常微弱，与紧相比就显得微了。而且手足反而温暖，这是元阳已回返的征兆无疑。治疗少阴中的寒病，原本以保护元阳为主，此时或许会有心烦的病状，实在是因为相火暴发，偶尔浮越于上，这更足以证明元阳的来复，所以知道它必定痊愈。
陈修园说：这是说少阴得到阳热之气而解。我自从行医以来，每遇到将死的证候，必用大药救治，忽然出现发烦下利，病人家属抱怨并更换医生，医生也诋毁前医的错误，用不着痛痒的药来居功，我却反因热心肠受诽谤，可见名医是不好当的。我年轻时，初次阅读《伤寒论浅注》到这里，怀疑修园的话，似乎接近于自我掩饰。等到医学研究既久，又加上临证实验，才知道修园的话确实没有欺骗人。后来又见到常德张拱端所著的《伤寒论会参》，也说修园的话确实正确，并且说我治一个人，服药后下利苦烦，又喜欢哈哈大笑，似癫非癫，几个时辰病愈，也与这一节“烦利自愈”的例子一样。而我则认为，如果遇到少阴阴寒险证，想要用药回阳时，不妨预告病人家属，阳回之后常会出现下利心烦的现象，自然能避免病人家属产生疑虑。
子××按：几年前我在故里，曾治一个少阴寒证，服药后下利发烦而愈。一九三三年腊月，在天津又治阎××少阴寒证，服用茴香、干姜等药很久不好，于是向我求方，让他单服生硫黄如枣大小，饭前服，每日三次，到了五、六天忽然每天下利二三次，惊恐地问我。我说：这是寒结得硫黄的热气而开，《伤寒论》所谓“虽烦下利必自愈”的情况。后来几天利果然停止，他的病也好了。
《伤寒论》原文：少阴病下利，如果利自止，恶寒而蜷卧，手足温暖的，可以治疗。
张拱端说：以上三节，都是少阴阴寒的病，前两节手足温，第三节自己心烦想去掉衣被，都是阳气回复的征候，都是自愈、可治的证候。可见治疗少阴伤寒以阳为主，不仅阴证见阳脉者生，就是阴病见阳证也为易愈。论中恶寒而蜷的“蜷”字，足以供考察阴寒在内之理，为什么呢？大凡阴寒的病，都有屈曲身体的形态，其屈曲的道理，实在关系到督、任二脉，因为督脉统率诸阳行于背脊，任脉统率诸阴行于胸腹，阴寒在内屈曲身体，是伸展背部的阳以抑制阴；阳热在内直腰张胸，是伸展腹部的阴以济助阳。如天气热人一定张开胸膛，天气寒冷人一定拘急蜷缩，观察他伸展阳以自救，那么蜷缩属于阴寒的道理就可以明白了。所以阳盛则发生痉病，阴盛则蜷卧，是理所当然的。至于自己心烦想去掉衣被，是阴得到阳的化解所以可治。
张氏论述督任相助的道理，来解释本节中的蜷卧颇为精细，而我对张氏所论之外，更有独到的体会。推究坎离相济、阴阳互根的道理，人的心肾相交，就能生热（心肾相交能补助元阳所以能生热），而心肾的相交往往在呼气外出之时。大概在呼气外出之时，心必然下降，肾必然上升（这可以默默自我体验），此刻的一升一降而心肾交合了。这是呼吸间自然的利益，用来作为人身热力的补助（试看睡觉时常常怕冷，因为人睡着则呼吸慢，热力就顿时显得不足，这是明显的证据）。人怕冷身体蜷卧，是其心肾想要相交以生热（这其中有无思无虑自然而然的天机）。至于患热病的人，身体常常向后挺，是心肾想要远离，防止其相交以助热。
《伤寒论》原文：少阴病吐利，手足不逆冷，反而发热的不死，脉不至的，灸少阴穴七壮。
陈修园说：宜灸太溪穴。张拱端说，也可灸复溜穴。而我则认为，如果先灸太溪穴，脉仍不应，可以再灸复溜穴，灸时宜双腿同时灸。太溪穴，在足内踝后五分，跟骨上动脉中；复溜穴，在内踝上二寸，大骨后侧陷中，这与太溪同为少阴生脉之源。
The area where the fatty membranes of the Middle Jiao gather is where the Spleen resides; this is the Taiyin (Taiyang Meridian), as stated previously. The area where the fatty membranes of the Lower Jiao gather is where the Kidney resides, hence it is named Shaoyin (Lesser Yin Meridian). The Fu organ of Shaoyin is the Kidney, and the meridian of Shaoyin is the gathered fatty membrane itself. Because it connects with the gathering place of the Middle Jiao fatty membranes, external pathogenic factors can transmit from Taiyin to Shaoyin.
Original text from *Shanghan Lun*: "Shaoyin disease manifests as a faint and fine pulse, and a desire only to sleep."
Shaoyin diseases can be either cold or hot. Commentators state that if transmitted from Taiyin, it is the pathogen from Yangming and Shaoyang transmitting sequentially to Shaoyin, constituting a heat syndrome; whereas if an external pathogen directly strikes the True Yin, it constitutes a cold syndrome. However, through my clinical practice, I have come to know that the cold nature of Shaoyin disease is originally not direct strike, but transmission from Taiyang, representing a transmission between exterior and interior, and also between Fu organs (the Bladder), because the fatty membrane connected to the Fu organ of Taiyang naturally communicates with the fatty membrane enveloping the Kidney. Cases of direct strike occur when the Shaoyin suddenly becomes deficient, often due to consuming cold food and drink; these account for only one or two in a hundred, and their treatment methods should be discussed separately. As for the heat nature of Shaoyin disease, it does not necessarily come via meridian transmission; rather, it mostly arises from latent pathogenic qi transforming into heat and entering Shaoyin. What is called latent pathogenic qi refers to cases where external cold acquired previously was mild and did not cause immediate illness; the acquired cold qi lies latent within the Sanjiao fatty membranes, obstructing the ascending and descending of Qi transformation, thereby generating heat (Qi transformation generates heat due to obstruction, and latent qi combines with it to transform into heat). This often occurs when Shaoyin is deficient, allowing latent qi to take advantage of the deficiency and invade Shaoyin. This is precisely why cooling medicines should be used early in the onset of Shaoyin heat diseases.
Regarding the fact that regardless of whether the disease is cold or hot, the pulse is always faint and fine: this is indeed because the pulsation originates in the Heart, while the strength of the pulsation relates to the Kidney. The Heart and Kidney are the roots of Water and Fire. When the Qi of the Heart and Kidney mutually assist each other, the Qi transformation within the body naturally becomes robust; if the Qi of the Heart and Kidney separates, the Qi transformation within the body rapidly becomes exhausted. In patients with Shaoyin disease, the Kidney Qi is suppressed by external pathogens and cannot ascend to assist the Heart; therefore, regardless of whether the disease is cold or hot, the pulse image is faint, fine, and weak. The symptom of "desire only to sleep" occurs because the Qi of the Heart and Kidney do not intersect, leading to exhaustion of bodily Qi transformation and inevitable mental fatigue and laziness, causing the patient to frequently close their eyes to rest quietly. Furthermore, because Kidney Qi cannot reach the upper body to attract Heart Yang to descend, even though they close their eyes to rest, they cannot fall asleep, presenting the state of "desire only to sleep."
Original text from *Shanghan Lun*: "In Shaoyin disease, if there is a desire to vomit but no vomiting, irritability, and a desire only to sleep, and after five or six days spontaneous diarrhea accompanied by thirst occurs, it belongs to Shaoyin. Due to deficiency, the patient draws water to save themselves. If the urine is white, the signs of Shaoyin disease are complete. Urine is white because of deficiency-cold in the Lower Jiao, which fails to control water, thus causing the color to be white."
Zhang Gongduan said: "Shaoyang is the pivot of Yang, and Shaoyin is the pivot of Yin. In Shaoyin, the desire to vomit without vomiting occurs because Shaoyin contains both Water and Fire; the improper circulation of Water and Fire Qi up and down leads to this desire to vomit without actual vomiting. Shaoyang prefers vomiting because internal and external Qi travel through the Sanjiao membranes; when these membranes are obstructed, Qi finds it difficult to enter or exit, reversing into the Stomach and causing vomiting. After vomiting, Qi becomes slightly unobstructed, hence the preference for vomiting. This explains the difference between Shaoyin's desire to vomit and Shaoyang's preference for vomiting. Additionally, both Taiyin and Shaoyin present with spontaneous diarrhea. Shaoyin spontaneous diarrhea with thirst stems from the transformation of Shaoyin's inherent heat; Taiyin spontaneous diarrhea without thirst stems from the transformation of Taiyin's inherent dampness. If treating the excess heat of thirst in the Upper Jiao of Shaoyin without attending to the deficiency-cold of diarrhea in the Lower Jiao, the diarrhea will persist. Therefore, for diseases where Water and Fire are separated, one should use cold and hot medicines separately. For diseases where Water and Fire combine, it is acceptable to use cold and hot medicines together. The formulas in this treatise include those purely cold, purely hot, and those combining cold and hot, illustrating this principle."
—This section does not list treatment methods. Zhang believed that with excess heat above and deficiency-cold below, cold and hot medicines should be used. Inquiry: The Master replied: Use Sheng Di Huang (Rehmanniae Radix) 1 liang, Sheng Hang Shao (Paeoniae Radix Alba) 5 qian, Fu Zi (Aconiti Lateralis Radix Praeparata) 2 qian, Gan Jiang (Zingiberis Rhizoma) 2 qian, Xi Xin (Asari Radix et Rhizoma) 1 qian, totaling five flavors. Do not use Shi Gao (Gypsum Fibrosum). Note by Gao XX.
Original text from *Shanghan Lun*: "In Shaoyin disease, if the pulse is tight, and upon reaching the seventh or eighth day, spontaneous diarrhea occurs, the pulse suddenly becomes faint, the hands and feet become warm, and the tightness of the pulse disappears, this indicates impending resolution. Although there is irritability and diarrhea, it will surely heal on its own."
Shaoyin contains both Water and Fire. The two kidneys represent Water; the Ministerial Fire generated by the Mingmen (Gate of Life) associated with the Kidneys represents the Fire in Shaoyin. External cold penetrating from Taiyang into Shaoyin merges with the Water Qi in Shaoyin, obstructing the Yuan Yang (Primordial Yang), resulting in a tight pulse. Tightness indicates Cold; it is a manifestation of Yin excess and Yang deficiency forcing Yang unable to distribute freely. When Yang Qi has accumulated for a long time, reaching the seventh or eighth day coincides with the ruling Qi periods of Taiyang and Yangming. The Fire of Mingmen, having accumulated excessively, erupts, forcing Yin Cold outward through diarrhea, and the previously tight pulse suddenly becomes faint. Originally, the tight pulse was caused by Yang being oppressed by Yin, presenting as wiry and forceful. The sudden faintness represents a change from tight to relaxed and moderate; it may not be extremely faint, but appears faint compared to the previous tightness. Moreover, the reversal of warmth in the hands and feet is undoubtedly a sign that Yuan Yang has returned. Treating cold diseases in Shaoyin primarily focuses on protecting Yuan Yang. At this time, irritability may occur, actually due to the eruption of Ministerial Fire occasionally floating upward. This further confirms the recovery of Yuan Yang, hence knowing it will surely heal.
Chen Xiuyuan said: "This describes Shaoyin resolving by obtaining Yang-heat Qi. Since I began practicing medicine, whenever I encountered critical conditions nearing death, I would invariably use potent medicines to rescue them. Suddenly, the patient would develop irritability and diarrhea. The family would complain and change doctors, and the new doctor would criticize the previous physician's errors, taking credit with ineffective remedies. I, however, suffered slander due to my earnest concern. It is truly difficult to be a renowned physician. When I was young and first read *Shanghan Lun Qian Zhu* (Annotated Brief Commentary on Shanghan Lun) to this point, I suspected Chen Xiuyuan's words were merely self-exoneration. Only after years of medical study and clinical experimentation did I realize his words were indeed truthful. Later, I saw Zhang Gongduan of Changde's *Shanghan Lun Hui Can*, which also affirmed Chen's words. He mentioned that I treated a patient who, after taking medicine, experienced painful diarrhea and irritability, followed by laughter resembling mania but not quite, recovering after several hours. This aligns with the principle of 'irritability and diarrhea healing spontaneously.' I believe that when encountering critical Shaoyin Yin-Cold syndromes and intending to use medicine to restore Yang, one should inform the family beforehand that following Yang restoration, symptoms of diarrhea and irritability often appear, thereby preventing suspicion."
Note by Zi XX: Several years ago, while in my hometown, I treated a Shaoyin cold syndrome. After medication, the patient experienced diarrhea and irritability before recovering. In December 1933, in Tianjin, I treated Yan XX for a Shaoyin cold syndrome. After prolonged treatment with Huixiang (Foeniculi Fructus), Gan Jiang, etc., without success, he sought my prescription. I advised him to take raw Liu Huang (Sulfur) the size of a jujube alone, taken before meals, three times daily. On the fifth or sixth day, he suddenly had diarrhea two or three times a day. Terrified, he asked me. I said: "This is the cold accumulation opening due to the heat of Liu Huang, exactly as described in *Shanghan Lun*: 'Although there is irritability and diarrhea, it will surely heal.' A few days later, the diarrhea stopped, and his illness healed."
Original text from *Shanghan Lun*: "In Shaoyin disease with diarrhea, if the diarrhea stops spontaneously, and the patient feels aversion to cold and curls up to lie down, but the hands and feet are warm, the condition is treatable."
Zhang Gongduan said: "The above three sections all describe Shaoyin Yin-Cold diseases. In the first two sections, the hands and feet are warm; in the third, the patient feels irritable and desires to remove clothing and blankets. All are signs of Yang recovery, indicating spontaneous healing or treatability. This shows that treating Shaoyin Cold Damage prioritizes Yang. Not only does seeing Yang pulse in Yin syndromes indicate life, but seeing Yang symptoms in Yin diseases also indicates ease of cure. The character 'Quan' (curling up) in the phrase 'aversion to cold and curling up' suffices to investigate the presence of internal Yin-Cold. Why? Generally, Yin-Cold diseases manifest with a curled body posture. The rationale relates to the Du Mai (Governor Vessel) and Ren Mai (Conception Vessel). The Du Mai governs all Yang meridians running along the back, while the Ren Mai governs all Yin meridians running along the chest and abdomen. Curling up in internal Yin-Cold involves extending the back's Yang to suppress Yin; extending the waist and chest in internal Yang-Heat involves extending the abdomen's Yin to assist Yang. Just as people spread their chests in hot weather and contract in cold weather, observing the extension of Yang for self-rescue reveals that curling up belongs to Yin-Cold. Thus, Yang excess leads to spasms, and Yin excess leads to curling up, which is logical. Regarding spontaneous irritability and desire to remove clothing/blankets, this indicates Yin is transformed by Yang, making it treatable."
Zhang's discussion on the mutual assistance of Du and Ren meridians to explain curling up in this section is quite detailed. Beyond Zhang's discussion, I have another insight. Inferring the principle of Kan-Li mutual assistance and Yin-Yang interdependence: when the Heart and Kidney intersect in humans, heat is generated (Heart-Kidney intersection supplements Yuan Yang, thus generating heat). This intersection often occurs during exhalation. During exhalation, the Heart necessarily descends, and the Kidney necessarily ascends (this can be verified through silent self-experience). This simultaneous ascent and descent achieves Heart-Kidney intersection. This is a natural benefit of respiration, assisting bodily heat generation (observe that people often feel cold when sleeping because breathing slows down, and heat generation instantly becomes insufficient; this is clear evidence). When people fear cold and curl up, it is their Heart and Kidney attempting to intersect to generate heat (a natural mechanism beyond conscious thought). Conversely, in heat diseases, the body often arches backward, indicating the Heart and Kidney wish to stay apart to prevent intersection from aiding heat.
Original text from *Shanghan Lun*: "In Shaoyin disease with vomiting and diarrhea, if the hands and feet are not cold, but instead feverish, the patient will not die. If the pulse is absent, moxa should be applied to Shaoyin points seven moxibustions."
Chen Xiuyuan stated: "One should moxa Taixi (KI3)." Zhang Gongduan stated: "One may also moxa Fuliou (KI7)." I, however, believe that if after moxa-ing Taixi the pulse still does not respond, one can then moxa Fuliou. During moxa application, both legs should be treated simultaneously. Taixi is located five fen behind the medial malleolus, in the artery above the calcaneus. Fuliou is located two cun above the medial malleolus, in the depression posterior to the large bone. These two points, like Taixi, are the sources of generating pulse in Shaoyin.