但欲寐，大家想一想，实际上能不能寐呢？不能寐！所以，但欲寐的实际情况是，一天到晚都想睡，可是却不能入寐。不能寐，就应该是寤的状态，觉醒的状态，可是因为他昏昏欲寐，却又不能很好的寤。因此，但欲寐，实际上是寐也不能，寤也不能，寐寤皆不能。若以易卦言之，则是明夷与晋皆不能。为什么不能？就是调节上述开合、调节太厥二阴的少阴枢出了问题。因此，在少阴病的提纲条文里讨论“但欲寐”，就正好反映了少阴主枢的特性。另者，寤寐的问题亦可以从心肾的角度来谈。寤是一个什么状态呢？是阳气开放，日出于地的状态，因此，这个状态应该是心所主。寐呢？寐是阳气收藏日入于地的状态，因此，这个状态理应由肾来主。所以，寤寐的问题无非又是一个心肾的问题。现在病人出现“但欲寐”，很想睡但又不能睡，寤寐皆不能，精神萎靡不振。这样的状态标志着心肾都不行了，心肾都有虚衰的趋势。如果在疾病的过程中，突然出现“但欲寐”及前面所讲的“脉微细”，这就是疾病转入危重的一个信号。所以，少阴病的这两个提纲证，于少阴病的危重性而言，是很具代表性的。3.少阴病形少阴病 281条的提纲非常简单，也许大家还有不理解的地方，所以，仲景在接下来的 282 条补充云：“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，少阴病形悉俱。小便白者，以下焦虚有寒，不能制水，故令色白也。”以下仅就本条所论，对提纲条文作两点补充。（1）但欲寐而心烦对于 282条的内容，我们只要稍加留意，就能发现一个问题。在《伤寒论》中，心烦一证总是跟什么联系在一起呢？总是跟不眠连在一起。如 61 条：“昼日烦躁不得眠”，71条：“胃中干，烦躁不得眠”，76 条：“虚烦不得眠”，303 条：“心中烦，不得卧”，319条：“心烦不得眠者”，等等。心烦为什么老是跟失眠连在一起呢？这说明两者之间是很有关联的。两者之间甚至有一个因果的关系。而在少阴篇的 282条里，却一反常规，心烦反而与“但欲寐”连在一起。为什么呢？我想这样一个反常必定有它反常的原因。这就有必要对烦及其与但欲寐的关系作一番讨论。① 何为烦烦是什么东西呢？烦是心不能定静，是一种内心的感觉，所以，往往称为心烦。心烦是内在的不静，外在并不表现出什么。而一旦内在的不静及于外在，外在亦不静，这种情况就称为烦躁。烦是心神的不安定，是心神的扰乱。为什么会烦呢？从造字来看，烦的形符是火，右边是页。页是什么意思呢？首也，头也。所以，《说文》将烦释为“热头痛”。为什么呢？因为烦就是火加在头上。因此，烦的造字及《说文》的释义是很直观的。当然，在这里我们不一定将烦作热头痛讲，可是它必定与烦的这样一个结构有关联。因为页为头为上，所以，烦就必定与火在上、火浮于上的因素有关联。火在上为烦，在易卦中哪些是火在上的卦呢？我们刚刚讨论过的晋就是一个火在上的卦。晋为寤，明夷为寐，故晋亦不寐也。为什么烦总与不眠相连呢？从烦之造字及易之晋象便十分清楚了。② 归根曰静火浮越在上则容易起烦，所以，火要归根。为什么中医要强调心肾相交呢？心肾相交的目的是什么？就是要肾水来济心火，心火不浮越在上，火便归根了。这是一个方面。而从我们上面讨论的明夷卦可知，要使火不浮越，要使火归根，太阴脾土的作用同样是十分重要的。火浮越则烦，火不浮越，火归根了则不烦，不烦曰静。由此烦静，我们又一次见到了水土合德的意义。《老子·十六章》云：“夫物芸芸，各复归其根。归根曰静，静曰复命，复命曰常，知常曰明。不知常，妄作凶。”所以，归根是很重要的，静是很重要的。考察我们人类，芸芸众生，怎么才叫归根？怎么才叫复命？归根曰静。以一天的 24小时而言，什么时候是静呢？当然是睡眠的时候。所以，人的睡眼其实就是一种归根，一种静，而静了则能复命。因此，我们每天都有一次复命的机会。否则，我们的生命怎么延续呢？对这样一个复命的机会，大家都应该很好地把握。2000年 11月 8号的《参考消息》，有一篇题为“睡眠不足寿命短”的文章。其文曰“最新研究显示，睡眠不足对健康的威胁与不良饮食习惯和缺乏锻炼对健康的威胁一样严重。睡眠不足，或者在正确的睡眠时间没有得到充分睡眠，都可能严重危害你的健康。”该文以猴子为例，在很多正常的睡眠时间里不让它们睡觉，结果猴子的健康状况急剧恶化，并很快死去。当然，上述研究对中医而言，并没有什么新处。我们在前面谈阴阳的工作机制时就知道，睡眠实际上是人体阳气得到收藏，得到蓄养的过程。睡眠虽不像吃饭那样直接地给机体补充给养，但，相比之下，也许它比吃饭更重要。吃饭要是吃得快一点的，几分钟就解决了，可是睡眠却不能在几分钟里解决，它必须有充足的时间。如上所言，人的睡眠实际上就是一种复命，恢复生命的活力。因此，没有这个复命不行，生命就难以延续。为什么“睡眠不足寿命短”呢？原因就在这里。这一点，中医这样认为，现代医学亦这样认为。由于睡眠的时候，阳气收藏了，到阴分去了，到根上去了。因此，睡眠实际就是阳归根的过程。提高睡眠的质量，也就是担高归根的质量。归根好，复命自然就好。如此不但生命的质量会提高，寿命也会延长。《内经》云：“阳气者，静则神藏，躁则消亡。”因此，复命的过程也就是神藏的过程。道云：复命曰常，知常日明。而医云：神藏则主明，主明则下安，以此养生则寿。故知道者医者，其揆一也。③ 睡眠为大归根，吸纳为小归根睡眠是归根，而且是大归根。有大就有小，什么是小归根呢？就是呼吸过程中的吸纳。呼吸是一个非常玄妙的过程，而这个过程说到底就是一个阴阳。呼吸是我们活着的每个人每时每刻都在进行的大事，当年阿难尊者请教世尊释迦牟尼，生死是一个什么概念呢？世尊回答：生死是呼吸间的事。故若能将这样一个生死大事置于阴阳中来讨论。我想对于阴阳的把握也就真正落到了实处。我们说呼吸的过程就是阴阳的过程，其中呼出这个过程为阳，而吸纳这个过程为阴。阴属体，阳属用。如果我们吸纳得很深，则呼出就必定很长，反过来，要是有很长的呼出，那就必须要很深的吸入。这便很好地体现了阴阳体用相生的关系，也很好地体现了“阳生阴长，阳杀阴藏”的这样一个主导过程。呼出为阳，阳者言释放也，言功用也；吸纳为阴，阴者言收藏也，蓄积也。练过武功的人就应该很清楚，我们发大力往往是在什么时候呢？都是在呼出的时候，而在吸纳的时候是发不出大力的。可是在发大力前，往往都需一口很深的吸纳。即便不练武功，就是我们平常使大劲，也都是这样的情况。因此，以呼吸言阴阳，言体用是非常深刻的。道家与瑜伽的修炼都非常讲究呼吸，如《庄子》中就专门提出一个“踵息”的概念。踵就是脚跟，是人体最下的地方，所以，踵息实际上就是指的很深的呼吸。而这样很深长的呼吸，道家又有一个术语，叫“息息归根”。这个功夫做好了，基础也就打牢了，脚跟也就站稳了。因此，道家的筑基，主要就是锻炼这个呼吸。锻炼呼吸还有什么好处呢？因为锻炼呼吸就要“息息归根”，所以，锻炼呼吸其实也就是锻炼归根。而“归根曰静”，因此，这样一个很深长的呼吸是很能够帮助我们入静的。大家可以思考一个相反的例子，在你跑动的时候，在你躁扰的时候，在你烦乱的时候，这个时候的呼吸深不深长呢？这个时候的呼吸绝对不深长，都很浅表。从这个事例，你也就知道深呼吸是很有助于安静的。如果晚上不能很好睡眠的人，在睡前不妨试着双腿相盘，做一会儿深呼吸，做一会儿归根的锻炼，这会很有益于你的入睡。深呼吸看上去是归根，是静，是保这个体。可是体厚则必定用强，所以，静之后就有复命。复命是什么呢？复命其实就是讲用的过程。因此，深呼吸不但是练体，连用也得到增强。是体用双修，阴阳双修的一个好方法。古云：大道不繁。做一个深呼吸繁不繁呢？当然不繁？可是在这不繁之中却有大道存焉。奉劝诸君，切莫小视之！在民间，对人的寿命还有另外一个很形象的称呼，就是“气数”。如果说你的气数未尽，那说明你还可以活上一段时间。如果是气数已尽了，那就意味着寿命即将终结。气数是什么呢？其实很简单，就是讲的人呼吸的次数。一个人一生中的呼吸次数有一个相对的量，当然每个人的相对量是不同的，而这个相对量就构成了“气数”这个概念。这有点像一个电器开关，我们到五金公司买一个电器开关，在开关的说明书里，它会告诉你这个开头可以正常使用的开关次数，比如说是三万次。那么，在三万次的使用期限内，如果开关坏了，那厂家会负责保修。如果超过了三万次，那开关的使用寿限就到期了，这时若再发生故障，厂家就没有责任了。通过上述事例，我们现在来做一道算术题，我们把人的平均寿命定为七十二岁。若将人的正常呼吸数，按每分钟十五次计算，那么，每天的呼吸次数为二万一千六百次，一年若按三百六十天计算，则每年的呼吸次数为七百七十七万六千次。将这个年呼吸数再乘以七十二，就得到五亿五千九百八十七万二千次。这就是人一辈子的平均呼吸次数，就是一个人的气数。既然人的气数是这样一个概念，它有一个相对一定的范围，那这里就大有文章可做了。试想我们若将单位时间里的呼吸次数增加一倍，也就是三十次。那我们上述气数的使用期限就缩短到了三十六年。为什么从事剧烈体育运动，比如足球运动的运动员，其寿命普遍低于人均寿命呢？原因就在这里。而反过来，我们若能像《庄子》讲的那样，息息都归根，将这个呼吸的次数降到每分钟七次、八次，甚至更少，那上述气数的使用期限不就大大地延长了吗。尽管不会成倍地延长，可是在一定程度上延长寿命却是毫无疑问的。要不然，道家何以敢言“我命在我不在天”呢？踵息为小归根，归根曰静，静则不烦也。不烦则得寐得眠。能寐能眠又为大归根，大归根则得大静，静曰复命。故此一过程，实为小静引大静也。诚如佛祖所云，生死乃呼吸间之事。既然生死是呼吸间的事，那么，把握生死何以不从呼吸开始呢？谚云：“君若识得呼吸事，生死海中任游行。”信不诬也。④ 烦则不当欲寐上面我们讲到，烦就是火不归根，就是火气上浮。而火气浮越了，烦了，就应该“不寐”，而不是“欲寐”。所以，前面讲的绝大多数条文，都是把烦与不眠连在一起。烦为因，不眠为果。而在这里，心烦却与“但欲寐”连在一起。说明这是很反常的现象，不是一般的毛病。这个“心烦，但欲寐”既不是一般的困倦，亦不是一般的失眠。以心烦者，真阳亡失而上越也；但欲寐者，心火虚衰，神明昏暗也。故而它是心肾将衰的一个信号，是少阴病很重要的一个特点。用这个特点，就可以将它与上述的一般情况区别开来。（2）渴而小便色白《伤寒论》中有许多讨论渴的条文，在我们以往的印象中，渴多是伤津了，什么伤津呢？当然是热伤津。所以，连带地就会出现小便黄，小便短赤。可是在上述的 282条里，口渴却不是小便黄，而是小便色白。也就是又口渴小便又清长。为什么呢？“以下焦虚有寒，不能制水，故令色白也。”所以，这也是一个反常的现象，也是少阴病的一个特色。现在让我们回过头来看前面的几篇，太阳篇里有没有讲口渴的？有。五苓散证就是讲口渴。如 71 条云：“若脉浮，小便不利，微热消渴者，五苓散主之。”所以，太阳病的口渴兼小便不利，兼脉浮。阳明有没有渴？更有渴。白虎汤证，白虎加人参汤证就有口渴。而且这个渴很厉害，要饮水数升，小便也一定短黄。少阳病里也有口渴，一个是小柴胡汤的加减里有治口渴的；另外，就是 147条的柴胡桂枝干姜汤证也有口渴，这个口渴也兼有小便不利。以上三阳病都有口渴，但各有各的兼证，各有各的机理。到了三阴病，情况就不同了。所以，到太阴篇的时候就专门有一条条文谈到这个问题，如 277条云：“自利不渴者，属太阴。”而到少阴病又开始讲口渴，故 282条云：“五六日自利而渴者，属少阴也。”这就明确地与太阴病的自利区分开来了。到了厥阴病，口渴更是成了它提纲条文的首证。因此，综观六经，只有太阴这一篇没有口渴，惟其不渴，这又成为太阴病的一个很大的特点。现在临床上的很多医生，见到口渴就是花粉、麦冬一类的养阴生津药，这行不行呢？显然不行！如果这个渴是在阳明，那用养阴生津还算对证。如果是少阴的渴，你也用养阴生津，那就死定了。这是我们从少阴口渴引出的一些问题，由这些问题，大家会不会有所感受呢？我想应该有所感受。少阴病提纲就讨论到这里。三、少阴病时相少阴病时相，即为少阴篇 291条：“少阴病欲解时，从子至寅上。”所讨论的内容。子至寅就是子丑寅。
但想睡觉，大家想一想，实际上能不能睡着呢？不能睡着！所以，“但欲寐”的实际情况是，一天到晚都想睡，可是却无法入睡。无法入睡，就应该是觉醒的状态，可是因为他昏昏沉沉想睡，却又不能很好地保持清醒。因此，“但欲寐”，实际上是既不能睡，也不能醒，睡和醒都无法做到。如果用《易经》卦象来说，就是“明夷”（光明受损）与“晋”（晋升、日出）两种状态都不能实现。为什么不能实现呢？就是因为调节上述开合、调节太阴和厥阴二经的少阴枢机出了问题。因此，在少阴病的提纲条文里讨论“但欲寐”，正好反映了少阴主司枢机的特性。另外，寤（觉醒）和寐（睡眠）的问题也可以从心和肾的角度来谈。寤是一种什么状态呢？是阳气开放，像太阳从地面升起的状态，因此，这个状态应该由心所主宰。寐呢？寐是阳气收藏，像太阳落入地下的状态，因此，这个状态理应由肾来主宰。所以，寤寐的问题无非又是一个心和肾的问题。现在病人出现“但欲寐”，很想睡但又不能睡，睡和醒都做不到，精神萎靡不振。这样的状态标志着心和肾都不行了，心和肾都有虚衰的趋势。如果在疾病的过程中，突然出现“但欲寐”以及前面所讲的“脉微细”，这就是疾病转入危重的一个信号。所以，少阴病的这两个提纲证，对于少阴病的危重性而言，是很具代表性的。
3. 少阴病的表现
少阴病第281条的提纲非常简单，也许大家还有不理解的地方，所以，张仲景在接下来的第282条补充说：“少阴病，想吐又吐不出来，心烦，但想睡觉。过了五六天，出现自发性腹泻且口渴的，属于少阴病。因为虚，所以想喝水自救，如果小便颜色发白的，少阴病的症状就全部具备了。小便发白，是因为下焦虚寒，不能制约水液，所以导致小便颜色发白。”以下仅就本条所论，对提纲条文作两点补充。
（1）但欲寐而心烦
对于第282条的内容，我们只要稍加留意，就能发现一个问题。在《伤寒论》中，心烦这一症状总是跟什么联系在一起呢？总是跟失眠连在一起。如第61条：“白天烦躁不得眠”，第71条：“胃中干，烦躁不得眠”，第76条：“虚烦不得眠”，第303条：“心中烦，不得卧”，第319条：“心烦不得眠者”，等等。心烦为什么老是跟失眠连在一起呢？这说明两者之间是很有关联的。两者之间甚至有一个因果关系。而在少阴篇的第282条里，却一反常规，心烦反而与“但欲寐”连在一起。为什么呢？我想这样一个反常必定有它反常的原因。这就有必要对“烦”及其与“但欲寐”的关系作一番讨论。
① 何为烦
“烦”是什么东西呢？“烦”是心不能定静，是一种内心的感觉，所以，往往称为心烦。心烦是内在的不静，外在并不表现出什么。而一旦内在的不静波及到外在，外在也不静，这种情况就称为烦躁。“烦”是心神的不安定，是心神的扰乱。为什么会烦呢？从造字来看，“烦”的形符是“火”，右边是“页”。“页”是什么意思呢？首也，头也。所以，《说文解字》将“烦”解释为“热头痛”。为什么呢？因为“烦”就是火加在头上。因此，“烦”的造字及《说文解字》的释义是很直观的。当然，在这里我们不一定将“烦”作热头痛讲，可是它必定与“烦”的这样一个结构有关联。因为“页”为头为上，所以，“烦”就必定与火在上、火浮于上的因素有关联。火在上为烦，在易卦中哪些是火在上的卦呢？我们刚刚讨论过的“晋”就是一个火在上的卦。“晋”为寤（觉醒），“明夷”为寐（睡眠），故“晋”亦不寐也（指晋卦虽为觉醒之象，但在病理状态下可能表现为失眠）。为什么“烦”总与不眠相连呢？从“烦”之造字及易之“晋”象便十分清楚了。
② 归根曰静
火浮越在上则容易起烦，所以，火要归根。为什么中医要强调心肾相交呢？心肾相交的目的是什么？就是要肾水来济心火，使心火不浮越在上，火便归根了。这是一个方面。而从我们上面讨论的“明夷”卦可知，要使火不浮越，要使火归根，太阴脾土的作用同样是十分重要的。火浮越则烦，火不浮越，火归根了则不烦，不烦曰静。由此烦静，我们又一次见到了水土合德的意义。《老子·十六章》云：“夫物芸芸，各复归其根。归根曰静，静曰复命，复命曰常，知常曰明。不知常，妄作凶。”所以，归根是很重要的，静是很重要的。考察我们人类，芸芸众生，怎么才叫归根？怎么才叫复命？归根曰静。以一天的24小时而言，什么时候是静呢？当然是睡眠的时候。所以，人的睡眠其实就是一种归根，一种静，而静了则能复命（恢复生命活力）。因此，我们每天都有一次复命的机会。否则，我们的生命怎么延续呢？对这样一个复命的机会，大家都应该很好地把握。2000年11月8号的《参考消息》，有一篇题为“睡眠不足寿命短”的文章。其文曰“最新研究显示，睡眠不足对健康的威胁与不良饮食习惯和缺乏锻炼对健康的威胁一样严重。睡眠不足，或者在正确的睡眠时间没有得到充分睡眠，都可能严重危害你的健康。”该文以猴子为例，在很多正常的睡眠时间里不让它们睡觉，结果猴子的健康状况急剧恶化，并很快死去。当然，上述研究对中医而言，并没有什么新处。我们在前面谈阴阳的工作机制时就知道，睡眠实际上是人体阳气得到收藏，得到蓄养的过程。睡眠虽不像吃饭那样直接地给机体补充给养，但，相比之下，也许它比吃饭更重要。吃饭要是吃得快一点的，几分钟就解决了，可是睡眠却不能在几分钟里解决，它必须有充足的时间。如上所言，人的睡眠实际上就是一种复命，恢复生命的活力。因此，没有这个复命不行，生命就难以延续。为什么“睡眠不足寿命短”呢？原因就在这里。这一点，中医这样认为，现代医学亦这样认为。由于睡眠的时候，阳气收藏了，到阴分去了，到根上去了。因此，睡眠实际就是阳归根的过程。提高睡眠的质量，也就是担高归根的质量。归根好，复命自然就好。如此不但生命的质量会提高，寿命也会延长。《内经》云：“阳气者，静则神藏，躁则消亡。”因此，复命的过程也就是神藏的过程。道云：复命曰常，知常日明。而医云：神藏则主明，主明则下安，以此养生则寿。故知道者医者，其揆一也（道理是一致的）。
③ 睡眠为大归根，吸纳为小归根
睡眠是归根，而且是大归根。有大就有小，什么是小归根呢？就是呼吸过程中的吸纳。呼吸是一个非常玄妙的过程，而这个过程说到底就是一个阴阳。呼吸是我们活着的每个人每时每刻都在进行的大事，当年阿难尊者请教世尊释迦牟尼，生死是一个什么概念呢？世尊回答：生死是呼吸间的事。故若能将这样一个生死大事置于阴阳中来讨论。我想对于阴阳的把握也就真正落到了实处。我们说呼吸的过程就是阴阳的过程，其中呼出这个过程为阳，而吸纳这个过程为阴。阴属体，阳属用。如果我们吸纳得很深，则呼出就必定很长，反过来，要是有很长的呼出，那就必须要很深的吸入。这便很好地体现了阴阳体用相生的关系，也很好地体现了“阳生阴长，阳杀阴藏”的这样一个主导过程。呼出为阳，阳者言释放也，言功用也；吸纳为阴，阴者言收藏也，蓄积也。练过武功的人就应该很清楚，我们发大力往往是在什么时候呢？都是在呼出的时候，而在吸纳的时候是发不出大力的。可是在发大力前，往往都需一口很深的吸纳。即便不练武功，就是我们平常使大劲，也都是这样的情况。因此，以呼吸言阴阳，言体用是非常深刻的。道家与瑜伽的修炼都非常讲究呼吸，如《庄子》中就专门提出一个“踵息”的概念。“踵”就是脚跟，是人体最下的地方，所以，“踵息”实际上就是指的很深的呼吸。而这样很深长的呼吸，道家又有一个术语，叫“息息归根”。这个功夫做好了，基础也就打牢了，脚跟也就站稳了。因此，道家的筑基，主要就是锻炼这个呼吸。锻炼呼吸还有什么好处呢？因为锻炼呼吸就要“息息归根”，所以，锻炼呼吸其实也就是锻炼归根。而“归根曰静”，因此，这样一个很深长的呼吸是很能够帮助我们入静的。大家可以思考一个相反的例子，在你跑动的时候，在你躁扰的时候，在你烦乱的时候，这个时候的呼吸深不深长呢？这个时候的呼吸绝对不深长，都很浅表。从这个事例，你也就知道深呼吸是很有助于安静的。如果晚上不能很好睡眠的人，在睡前不妨试着双腿相盘，做一会儿深呼吸，做一会儿归根的锻炼，这会很有益于你的入睡。深呼吸看上去是归根，是静，是保这个体。可是体厚则必定用强，所以，静之后就有复命。复命是什么呢？复命其实就是讲用的过程。因此，深呼吸不但是练体，连用也得到增强。是体用双修，阴阳双修的一个好方法。古云：大道不繁。做一个深呼吸繁不繁呢？当然不繁？可是在这不繁之中却有大道存焉。奉劝诸君，切莫小视之！在民间，对人的寿命还有另外一个很形象的称呼，就是“气数”。如果说你的气数未尽，那说明你还可以活上一段时间。如果是气数已尽了，那就意味着寿命即将终结。气数是什么呢？其实很简单，就是讲的人呼吸的次数。一个人一生中的呼吸次数有一个相对的量，当然每个人的相对量是不同的，而这个相对量就构成了“气数”这个概念。这有点像一个电器开关，我们到五金公司买一个电器开关，在开关的说明书里，它会告诉你这个开头可以正常使用的开关次数，比如说是三万次。那么，在三万次的使用期限内，如果开关坏了，那厂家会负责保修。如果超过了三万次，那开关的使用寿限就到期了，这时若再发生故障，厂家就没有责任了。通过上述事例，我们现在来做一道算术题，我们把人的平均寿命定为七十二岁。若将人的正常呼吸数，按每分钟十五次计算，那么，每天的呼吸次数为二万一千六百次，一年若按三百六十天计算，则每年的呼吸次数为七百七十七万六千次。将这个年呼吸数再乘以七十二，就得到五亿五千九百八十七万二千次。这就是人一辈子的平均呼吸次数，就是一个人的气数。既然人的气数是这样一个概念，它有一个相对一定的范围，那这里就大有文章可做了。试想我们若将单位时间里的呼吸次数增加一倍，也就是三十次。那我们上述气数的使用期限就缩短到了三十六年。为什么从事剧烈体育运动，比如足球运动的运动员，其寿命普遍低于人均寿命呢？原因就在这里。而反过来，我们若能像《庄子》讲的那样，息息都归根，将这个呼吸的次数降到每分钟七次、八次，甚至更少，那上述气数的使用期限不就大大地延长了吗。尽管不会成倍地延长，可是在一定程度上延长寿命却是毫无疑问的。要不然，道家何以敢言“我命在我不在天”呢？踵息为小归根，归根曰静，静则不烦也。不烦则得寐得眠。能寐能眠又为大归根，大归根则得大静，静曰复命。故此一过程，实为小静引大静也。诚如佛祖所云，生死乃呼吸间之事。既然生死是呼吸间的事，那么，把握生死何以不从呼吸开始呢？谚云：“君若识得呼吸事，生死海中任游行。”信不诬也。
④ 烦则不当欲寐
上面我们讲到，烦就是火不归根，就是火气上浮。而火气浮越了，烦了，就应该“不寐”，而不是“欲寐”。所以，前面讲的绝大多数条文，都是把烦与不眠连在一起。烦为因，不眠为果。而在这里，心烦却与“但欲寐”连在一起。说明这是很反常的现象，不是一般的毛病。这个“心烦，但欲寐”既不是一般的困倦，亦不是一般的失眠。以心烦者，真阳亡失而上越也；但欲寐者，心火虚衰，神明昏暗也。故而它是心肾将衰的一个信号，是少阴病很重要的一个特点。用这个特点，就可以将它与上述的一般情况区别开来。
（2）渴而小便色白
《伤寒论》中有许多讨论渴的条文，在我们以往的印象中，渴多是伤津了，什么伤津呢？当然是热伤津。所以，连带地就会出现小便黄，小便短赤。可是在上述的第282条里，口渴却不是小便黄，而是小便色白。也就是又口渴小便又清长。为什么呢？“以下焦虚有寒，不能制水，故令色白也。”所以，这也是一个反常的现象，也是少阴病的一个特色。现在让我们回过头来看前面的几篇，太阳篇里有没有讲口渴的？有。五苓散证就是讲口渴。如第71条云：“若脉浮，小便不利，微热消渴者，五苓散主之。”所以，太阳病的口渴兼小便不利，兼脉浮。阳明有没有渴？更有渴。白虎汤证，白虎加人参汤证就有口渴。而且这个渴很厉害，要饮水数升，小便也一定短黄。少阳病里也有口渴，一个是小柴胡汤的加减里有治口渴的；另外，就是第147条的柴胡桂枝干姜汤证也有口渴，这个口渴也兼有小便不利。以上三阳病都有口渴，但各有各的兼证，各有各的机理。到了三阴病，情况就不同了。所以，到太阴篇的时候就专门有一条条文谈到这个问题，如第277条云：“自利不渴者，属太阴。”而到少阴病又开始讲口渴，故第282条云：“五六日自利而渴者，属少阴也。”这就明确地与太阴病的自利区分开来了。到了厥阴病，口渴更是成了它提纲条文的首证。因此，综观六经，只有太阴这一篇没有口渴，惟其不渴，这又成为太阴病的一个很大的特点。现在临床上的很多医生，见到口渴就是花粉、麦冬一类的养阴生津药，这行不行呢？显然不行！如果这个渴是在阳明，那用养阴生津还算对证。如果是少阴的渴，你也用养阴生津，那就死定了。这是我们从少阴口渴引出的一些问题，由这些问题，大家会不会有所感受呢？我想应该有所感受。少阴病提纲就讨论到这里。
三、少阴病时相
少阴病时相，即为少阴篇第291条：“少阴病欲解时，从子至寅上。”所讨论的内容。子至寅就是子丑寅。
"Dan Yu Mei" (desire to sleep but unable to do so): Everyone, think about it, can one actually fall asleep? No! Therefore, the actual situation of "Dan Yu Mei" is that one wants to sleep all day long, yet cannot enter sleep. Since one cannot sleep, it should be a state of Wu (Waking/Awakening), but because he is drowsy and desires sleep, he cannot maintain a good waking state. Thus, "Dan Yu Mei" actually means neither sleeping nor waking; both states are inaccessible. If we refer to I Ching hexagrams, it implies that neither Ming Yi (Hexagram 36: Darkening of the Light) nor Jin (Hexagram 35: Progress) can be achieved. Why? Because the Shao Yin pivot (Shao Yin Pivot Mechanism), which regulates the opening and closing and the Tai Yin and Jue Yin meridians, has malfunctioned. Therefore, discussing "Dan Yu Mei" in the outline clause of Shao Yin disease accurately reflects the characteristic of Shao Yin governing the pivot mechanism. Furthermore, the issue of Waking and Sleeping can also be discussed from the perspective of Heart and Kidney. What kind of state is Waking? It is a state where Yang Qi opens up, resembling the sun rising from the earth; thus, this state should be governed by the Heart. And Sleeping? Sleeping is a state where Yang Qi stores inward, resembling the sun setting into the earth; thus, this state should theoretically be governed by the Kidney. Hence, the issue of Waking and Sleeping is essentially an issue of Heart and Kidney. Now, the patient presents with "Dan Yu Mei," wanting to sleep but unable to, unable to achieve either state, with listless spirit. Such a state indicates that both Heart and Kidney are failing, showing a trend of deficiency and decline in both. If during the course of the disease, "Dan Yu Mei" appears suddenly along with the previously mentioned "pulse Wei Xi" (Fine and Weak Pulse), this is a signal that the disease has turned critical. Therefore, these two outline signs of Shao Yin disease are highly representative of its critical nature.
3. Manifestations of Shao Yin Disease
The outline for Shao Yin disease in Clause 281 is very simple, and perhaps there are parts that remain unclear. Therefore, Zhang Zhongjing supplements in the following Clause 282: "In Shao Yin disease, if there is a desire to vomit but nothing comes out, irritability (Fan Xin), and Dan Yu Mei; after five or six days, spontaneous diarrhea accompanied by thirst belongs to Shao Yin. Due to deficiency, the patient seeks water to save themselves. If the urine is white, the manifestations of Shao Yin disease are complete. White urine occurs because of deficiency-cold in the Lower Jiao, which fails to control water metabolism, resulting in white color." Based on this clause, we will make two supplementary points regarding the outline clause.
(1) Dan Yu Mei accompanied by Irritability
Regarding the content of Clause 282, if we pay slight attention, we can discover an issue. In Shang Han Lun, the symptom of Fan Xin (Irritability/Restlessness) is always associated with what? It is always linked with insomnia. For example, Clause 61: "Irritable during the day, unable to sleep"; Clause 71: "Dryness in the stomach, irritable and unable to sleep"; Clause 76: "Empty irritability, unable to sleep"; Clause 303: "Irritation in the heart, unable to lie down"; Clause 319: "Those with irritability and inability to sleep," etc. Why is Fan Xin always linked with insomnia? This shows a close association between the two, even a causal relationship. However, in Clause 282 of the Shao Yin chapter, contrary to convention, Fan Xin is linked with "Dan Yu Mei." Why? I believe such an anomaly must have its reasons. It is necessary to discuss "Fan" (Irritability) and its relationship with "Dan Yu Mei."
① What is Fan?
What is "Fan"? "Fan" refers to the mind's inability to settle and remain quiet, an internal sensation, hence often called Fan Xin (Heart Irritability). Fan Xin is internal unrest, without external manifestation. Once internal unrest extends externally, causing external restlessness, this condition is called Fan Zao (Irritability and Restlessness). "Fan" is the instability of Shen Spirit (Spirit/Mind), the disturbance of the heart-mind. Why does one feel "Fan"? Etymologically, the radical of "Fan" is Huo (Fire), and the right side is Ye (Head). What does "Ye" mean? It means head. Thus, Shuo Wen Jie Zi defines "Fan" as "heat-induced headache." Why? Because "Fan" is fire added to the head. Therefore, the etymology and definition in Shuo Wen Jie Zi are quite intuitive. Although we may not strictly interpret "Fan" as heat-induced headache here, it must be related to this structure. Since "Ye" represents the head and the upper part, "Fan" must be associated with factors of fire being above or floating upward. Fire above causes Fan. Which I Ching hexagrams feature fire above? The hexagram Jin (Progress), which we just discussed, is a hexagram with fire above. Jin represents Waking, while Ming Yi represents Sleeping; thus, Jin also relates to non-sleep (insomnia). Why is Fan always linked with non-sleep? This is clear from the etymology of "Fan" and the imagery of the Jin hexagram.
② Returning to the Root is Called Quiet
When fire floats upward, it easily causes Fan; therefore, fire must return to its root. Why does Traditional Chinese Medicine emphasize the interaction between Heart and Kidney? What is the purpose of Heart-Kidney interaction? It is for Kidney Water to cool Heart Fire, preventing Heart Fire from floating upward, allowing the fire to return to its root. This is one aspect. From our discussion of the Ming Yi hexagram, we know that to prevent fire from floating and to help it return to the root, the role of Tai Yin Spleen Earth is equally important. Floating fire causes Fan; rooted fire does not cause Fan, and absence of Fan is called Jing (Quiet/Stillness). Through this distinction between Fan and Jing, we again see the significance of the harmony of Water and Earth. Laozi, Chapter 16, states: "All things flourish, each returns to its root. Returning to the root is called Quiet; Quiet is called returning to destiny (Fu Ming); returning to destiny is called Constant; knowing the Constant is called Illumination. Not knowing the Constant leads to reckless action and misfortune." Thus, returning to the root is crucial, and stillness is crucial. Considering humanity, how does one return to the root? How does one return to destiny? Returning to the root is called Quiet. In terms of a 24-hour day, when is it quiet? Naturally, during sleep. Therefore, human sleep is essentially a form of returning to the root, a state of stillness, and through stillness, one can restore vitality (Fu Ming). Thus, we have a chance to restore vitality every day. Otherwise, how would life continue? We should all seize this opportunity well. On November 8, 2000, Reference News published an article titled "Sleep Deprivation Shortens Lifespan." It stated, "Latest research shows that sleep deprivation poses a threat to health as serious as poor diet and lack of exercise. Sleep deprivation, or insufficient sleep during correct hours, can severely harm your health." Using monkeys as an example, when prevented from sleeping during normal periods, their health deteriorated rapidly, leading to quick death. Of course, this research offers no novelty to TCM. As discussed earlier regarding the working mechanism of Yin and Yang, sleep is actually the process of Yang Qi being stored and nourished. Although sleep does not directly replenish nutrients like eating, comparatively, it might be more important. Eating can be done quickly in minutes, but sleep cannot be resolved in minutes; it requires sufficient time. As mentioned, human sleep is essentially Fu Ming, restoring life vitality. Without this restoration, life cannot continue. Why does "sleep deprivation shorten lifespan"? The reason lies here. TCM holds this view, and modern medicine agrees. During sleep, Yang Qi is stored, moving to the Yin aspect, to the root. Therefore, sleep is actually the process of Yang returning to the root. Improving sleep quality is improving the quality of returning to the root. Good rooting naturally leads to good restoration of vitality. This not only improves the quality of life but also extends lifespan. Nei Jing states: "Yang Qi, when quiet, hides the Spirit; when restless, the Spirit perishes." Thus, the process of restoring vitality is also the process of hiding the Spirit. Dao says: Returning to destiny is Constant; knowing the Constant is Illumination. Medicine says: When the Spirit is hidden, the Master (Heart) is clear; when the Master is clear, the lower parts are peaceful; using this for health preservation leads to longevity. Thus, those who understand Dao and Medicine share the same principle.
③ Sleep is Great Rooting, Inhalation is Small Rooting
Sleep is rooting, specifically great rooting. Where there is great, there is small. What is small rooting? It is inhalation in the breathing process. Breathing is a profound process, fundamentally a matter of Yin and Yang. Breathing is a major event occurring every moment for everyone alive. When Ananda asked the Buddha Shakyamuni about the concept of life and death, the Buddha replied: Life and death are matters within the breath. Therefore, discussing this major issue of life and death within the framework of Yin and Yang brings true understanding of Yin and Yang into practice. We say the breathing process is a process of Yin and Yang; exhalation is Yang, and inhalation is Yin. Yin belongs to Substance (Ti), Yang belongs to Function (Yong). If inhalation is deep, exhalation must be long; conversely, long exhalation requires deep inhalation. This well embodies the mutual generation of Yin-Yang Substance and Function, and the dominant process of "Yang generates Yin, Yang kills/stores Yin." Exhalation is Yang, representing release and function; inhalation is Yin, representing storage and accumulation. Those who practice martial arts know clearly: when do we exert great force? Usually during exhalation; during inhalation, great force cannot be exerted. However, before exerting great force, a deep inhalation is usually required. Even without martial arts training, when exerting great effort in daily life, the situation is the same. Thus, discussing Yin and Yang, Substance and Function via breathing is profound. Both Daoist and Yoga practices emphasize breathing. Zhuangzi specifically proposes the concept of "Zhong Xi" (Heel Breathing). "Zhong" means heel, the lowest part of the body; thus, "Zhong Xi" refers to very deep breathing. Daoists have another term for such deep, long breathing: "Xi Xi Gui Gen" (Breath by Breath Returning to the Root). Mastering this skill solidifies the foundation and stabilizes the stance. Therefore, Daoist foundation building mainly involves exercising breathing. What other benefits does breathing exercise offer? Since breathing exercise requires "breath by breath returning to the root," exercising breathing is essentially exercising rooting. And "returning to the root is called quiet," thus such deep, long breathing helps us enter stillness. Consider the opposite example: when running, agitated, or troubled, is the breathing deep and long? At such times, breathing is definitely not deep or long; it is superficial. From this, you can see that deep breathing aids tranquility. If one suffers from poor sleep at night, trying sitting cross-legged and practicing deep breathing before bed, engaging in rooting exercises, will greatly benefit falling asleep. Deep breathing appears to be rooting, quiet, preserving Substance. But thick substance inevitably strengthens function; thus, after stillness comes restoration of vitality (Fu Ming). What is Fu Ming? Fu Ming actually refers to the process of Function. Therefore, deep breathing not only trains Substance but also enhances Function. It is a good method for cultivating both Substance and Function, Yin and Yang. Ancient saying: The Great Dao is not complex. Is a deep breath complex? Certainly not? Yet within this simplicity lies the Great Dao. I advise everyone not to underestimate it! In folklore, lifespan is vividly referred to as "Qi Shu" (Lifespan/Qi Count). If your Qi Shu is not exhausted, you can live for some time. If Qi Shu is exhausted, lifespan is ending. What is Qi Shu? Simply put, it refers to the number of breaths a person takes. There is a relative limit to the total breaths in a lifetime, varying per individual, constituting the concept of "Qi Shu." It is like an electrical switch bought at a hardware store; the manual states a usage limit, e.g., 30,000 switches. Within this limit, if it breaks, the manufacturer repairs it. Beyond 30,000, the lifespan expires, and the manufacturer is no longer responsible. Using this analogy, let's do a calculation. Assuming average lifespan is 72 years. Normal respiration rate is 15 times per minute. Daily breaths: 21,600. Annual breaths (360 days/year): 7,776,000. Multiplying annual breaths by 72 gives 559,872,000. This is the average total breaths in a lifetime, i.e., a person's Qi Shu. Since Qi Shu has a relatively fixed range, much can be done here. Imagine doubling the breaths per unit time to 30 times. Our Qi Shu duration would shrink to 36 years. Why do athletes in intense sports like soccer generally have lifespans below average? Here lies the reason. Conversely, if we follow Zhuangzi's teaching, ensuring every breath returns to the root, reducing respiration to 7-8 times per minute or less, wouldn't the Qi Shu duration extend significantly? Although not necessarily doubled, extending lifespan to a certain extent is undeniable. Otherwise, why would Daoists dare claim "My fate is in my hands, not in Heaven"? Zhong Xi is small rooting; returning to the root is quiet; quiet means no Fan. No Fan leads to sleep. Ability to sleep is great rooting; great rooting leads to great stillness; stillness is Fu Ming. Thus, this process is small stillness leading to great stillness. As the Buddha said, life and death are matters of breath. Since life and death are in the breath, why not start mastering them through breathing? Proverb: "If you understand the matter of breath, you can roam freely in the sea of life and death." Truly not false.
④ Fan Should Not Accompany Desire to Sleep
We mentioned above that Fan is fire not returning to the root, i.e., fire qi floating upward. When fire qi floats and causes Fan, one should experience "non-sleep" (insomnia), not "desire to sleep." Therefore, most clauses previously discussed link Fan with insomnia. Fan is the cause; insomnia is the effect. Here, however, Fan Xin is linked with "Dan Yu Mei." This indicates an abnormal phenomenon, not a common ailment. This combination of "Fan Xin, Dan Yu Mei" is neither ordinary fatigue nor ordinary insomnia. Regarding Fan Xin: it signifies loss of True Yang and its upward floating. Regarding Dan Yu Mei: it signifies deficiency-decline of Heart Fire and dimming of Shen Spirit. Thus, it is a signal of impending Heart-Kidney decline and a significant characteristic of Shao Yin disease. Using this characteristic, it can be distinguished from the general situations mentioned above.
(2) Thirst with White Urine
Shang Han Lun contains many clauses discussing thirst. In our past impression, thirst is mostly due to fluid injury, specifically heat injuring fluids. Consequently, yellow, scanty urine often accompanies it. However, in Clause 282, thirst is accompanied by white urine, i.e., thirst with clear, profuse urine. Why? "Because of deficiency-cold in the Lower Jiao, failing to control water, causing white color." Thus, this is also an abnormal phenomenon and a characteristic of Shao Yin disease. Looking back at previous chapters, did Tai Yang chapter discuss thirst? Yes. Wu Ling San syndrome discusses thirst. Clause 71 states: "If pulse is floating, urination is difficult, slight fever, and excessive thirst, Wu Ling San governs." Thus, Tai Yang disease thirst is accompanied by difficult urination and floating pulse. Does Yang Ming have thirst? Yes, even more so. Bai Hu Tang syndrome and Bai Hu Jia Ren Shen Tang syndrome involve thirst. This thirst is severe, requiring drinking several liters, and urine is definitely short and yellow. Shao Yang disease also has thirst; one instance is in modifications of Xiao Chai Hu Tang; another is Clause 147, Chai Hu Gui Zhi Gan Jiang Tang syndrome, where thirst is accompanied by difficult urination. All three Yang diseases have thirst, but each has different accompanying symptoms and mechanisms. Moving to Yin diseases, the situation differs. Thus, in Tai Yin chapter, there is a specific clause addressing this: Clause 277 states: "Spontaneous diarrhea without thirst belongs to Tai Yin." But in Shao Yin disease, thirst reappears; Clause 282 states: "After five or six days, spontaneous diarrhea with thirst belongs to Shao Yin." This clearly distinguishes it from Tai Yin spontaneous diarrhea. In Jue Yin disease, thirst becomes the primary sign in the outline clause. Therefore, reviewing the Six Stages, only Tai Yin lacks thirst; its absence of thirst is a major characteristic of Tai Yin disease. Many clinicians today, seeing thirst, immediately use Yin-nourishing and fluid-generating herbs like Hua Fen (Trichosanthes Root) and Mai Dong (Ophiopogon Tuber). Is this acceptable? Obviously not! If the thirst is in Yang Ming, using Yin-nourishing herbs is appropriate. But if the thirst is in Shao Yin and you use Yin-nourishing herbs, it will be fatal. These are issues raised by Shao Yin thirst. I hope these issues provoke some reflection. Discussion of Shao Yin disease outline concludes here.
III. Timing of Shao Yin Disease Resolution
The timing of Shao Yin disease resolution refers to Clause 291 in the Shao Yin chapter: "Shao Yin disease resolves from Zi to Yin hours." This discusses the content. Zi to Yin corresponds to Zi, Chou, and Yin hours.