（脾为胃行津液热则枯）
脾中有热胃干枯。口燥咽干津液无。宜用白虎加参治。少阳口苦小柴胡。咽干慎不可发
汗。发汗无津气愈虚。少阴火威水欲涸。口苦却宜承气需。
伤寒吐下仍不解。大便不利寒热在。循衣摸床殊不安。独语犹如见鬼怪。微喘直视不识
人。谵语狂言不可骇。大承服后脉强生。忽若清兮死难待。
伤寒烦躁症如何。阳明经与少阴科。阳明脉长大便秘。伤寒之候太阳多。阴盛阳虚亦烦
躁。
少阴之症勿会讹。汗之而烦医者误。病解而烦气不和。更有虚烦宜竹叶。根据方调治莫蹉跎。
卫气循环不暂停。昼则行阳夜在阴。卫独留阳阳跷盛。阳盛阴虚夜不宁。卫若留阴阴跷
满。
阴满阳虚昼却宁。暮谵昼了阴虚症。昼燥阳虚夜气清。须要调胃各归分。二气和谐可渐平。
多眠思症病形殊。风温狐惑及柴胡。更有少阴当慎别。须知四者病何如。风温身热当自
汗。小柴胁满项强拘。少阴自利但欲寐。狐惑多眠非一途。
伤寒何事不得眠。汗过胃中干燥烦。或因吐下虚烦致。或因大热语言颠。小便不利
正发
渴。心烦少气苦忧煎。若其水停心下满。但与猪苓可保痊。伤寒瘥后热还在。阴来复时阳使
然。
胃中干则无小便。慎勿利之强使然。下焦有热不通泄。量病时须泄与宣。咳而有水青龙
候。
项强无汗桂枝痊。大抵中遇发黄者。先利小盒饭使快。阳明汗多津液无。却以小便利为戒。
阳若凑之阴分虚。小便难出热邪拘。伤风不止桂加附。阳明风中小柴胡。
（脾脏为胃输送津液，若脾中有热则导致干枯）
脾脏内部有热邪，导致胃中津液干枯。出现口燥、咽干，体内津液匮乏。适宜使用白虎加人参汤进行治疗。若是少阳病出现口苦，适用小柴胡汤。咽干症状务必谨慎，不可使用发汗法。因为发汗会耗伤津液，使正气更加虚弱。若是少阴病火邪旺盛，肾水即将枯竭，出现口苦等症状，却适宜使用承气汤类方剂来通腑泄热。
伤寒经过催吐或攻下治疗后，病情仍未解除。出现大便不通利，伴有寒热往来。患者出现循衣摸床（手指无意识地抓摸衣物和床沿），极度不安。独自说话，仿佛看到了鬼怪。轻微气喘，两眼直视，不能识别亲人。说胡话、狂言乱语，不必惊慌。服用大承气汤后，如果脉象变得强劲有力，说明正气尚存，有望恢复；但如果突然变得清冷微弱，则是死证，难以挽救。
伤寒出现的烦躁症状该如何辨析？主要涉及阳明经与少阴经。阳明病的特征是脉象长大、大便便秘，这是伤寒的典型候象，但太阳病也较多见。若是阴盛阳虚导致的烦躁，属于少阴病症，切勿误诊。若误用发汗法会导致烦躁加重，这是医者的失误。若是病邪已解但仍有烦躁，是气机不和所致。另外还有虚烦证，适宜使用竹叶石膏汤等方剂，根据具体情况进行调治，不要延误时机。
卫气在体内循环不停止。白天运行于阳分，夜晚运行于阴分。如果卫气单独停留在阳分，导致阳跷脉盛，就会出现阳盛阴虚，夜间无法安宁。如果卫气若停留在阴分，导致阴跷脉满，就会出现阴满阳虚，白天反而安宁。傍晚说胡话、白天清醒，是阴虚的症状；白天烦躁、晚上气息平稳，是阳虚的症状。必须调理胃气，使阴阳各归其位。二气和谐，病情才能逐渐平复。
嗜睡多眠的症状表现各不相同。风温病、狐惑病以及少阳柴胡证都可能出现。还有少阴病应当谨慎辨别。需要知道这四种病症的区别。风温病表现为身体发热，自然出汗。少阳病表现为胁肋胀满、项部僵硬拘急。少阴病表现为自发性腹泻，只想睡觉。狐惑病的多眠并非单一途径所致。
伤寒为何会出现不得失眠的情况？发汗过度导致胃中干燥而烦躁。或者是因为催吐、攻下导致虚烦。或者是因为高热导致言语颠倒错乱。小便不利且正在发生口渴，心烦、少气，痛苦忧虑煎熬。如果是水饮停聚在心下导致胀满，只需用猪苓汤即可保证痊愈。伤寒病愈之后余热未清，是阴气来复时阳气抗争的表现。
胃中干燥就会导致没有小便。千万不要强行利尿，那样做是不对的。如果是下焦有热导致排泄不通，需要根据病情时间长短来决定是泄热还是宣通。咳嗽且体内有水饮停滞的，适用小青龙汤。项部僵硬、无汗的，适用桂枝汤治愈。大抵上遇到发黄的患者，先通过利小便使湿热排出顺畅。阳明病汗出过多导致津液枯竭，却以小便利为禁忌。如果阳气凑集于阴分导致阴虚，小便难出，是热邪拘束所致。伤风不止的，适用桂枝加附子汤。阳明中风证的，适用小柴胡汤。
(Spleen transports fluids to the Stomach; heat in the Spleen leads to dryness)
Heat within the Spleen causes dryness and withering of the Stomach. There is dryness in the mouth and throat, and a lack of body fluids (Jinye). It is appropriate to use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) for treatment. If Shaoyang disease presents with a bitter taste in the mouth, Xiaochaihu Tang (Minor Bupleurum Decoction) is applicable. For symptoms of dry throat, sweating methods must be used with caution. Sweating consumes fluids and further weakens Qi. In Shaoyin disease, if Fire pathogen is vigorous and Kidney Water is about to dry up, presenting with bitter taste, Chengqi Tang formulas (Gut-Draining Decoctions) are appropriate to purge heat through the bowels.
After vomiting or purging treatments for Shanghan (Cold Damage), the condition remains unresolved. There is difficulty in bowel movement, accompanied by alternating chills and fever. The patient exhibits "circular clothing and bed-grabbing" (unconscious grasping movements), showing extreme restlessness. They speak alone, as if seeing ghosts. There is slight panting, fixed gaze, and inability to recognize people. Delirious speech and wild talk should not cause alarm. After administering Dachengqi Tang (Major Gut-Draining Decoction), if the pulse becomes strong, it indicates remaining righteous Qi and potential recovery; however, if the pulse suddenly becomes faint and cold, it is a fatal sign that is difficult to save.
How to differentiate irritability and restlessness in Shanghan? It mainly involves the Yangming Meridian and Shaoyin Meridian. Yangming disease is characterized by a large and long pulse and constipation, which is a typical sign of Shanghan, though Taiyang disease also frequently presents this. Irritability caused by Yin excess and Yang deficiency belongs to Shaoyin syndrome and must not be misdiagnosed. Misusing sweating methods will worsen irritability, which is a medical error. If irritability persists after the pathogen has resolved, it is due to disharmony of Qi. Additionally, for deficiency irritability, Zhuyeqi Tang (Bamboo Leaf Decoction) or similar formulas are appropriate. Treatment should be adjusted according to the specific situation without delay.
Wei Qi (Defensive Qi) circulates continuously without pause. During the day, it moves through the Yang aspects; at night, it resides in the Yin aspects. If Wei Qi stays exclusively in the Yang aspect, causing the Yang Qiao vessel to become full, Yang excess and Yin deficiency occur, leading to insomnia at night. If Wei Qi stays in the Yin aspect, causing the Yin Qiao vessel to become full, Yin excess and Yang deficiency occur, leading to calmness during the day. Delirium at dusk and clarity during the day indicate Yin deficiency; irritability during the day and calmness at night indicate Yang deficiency. One must regulate the Stomach Qi so that Yin and Yang return to their respective places. When the two Qi harmonize, the condition can gradually subside.
The manifestations of hypersomnia vary significantly. Fengwen (Wind-Warmth), Huhuo (Huhuo Disease), and Chaihu syndromes may all present this. Shaoyin disease must also be carefully distinguished. One must understand the differences among these four conditions. Fengwen presents with fever and spontaneous sweating. Shaoyang disease presents with hypochondriac fullness and neck stiffness/contracture. Shaoyin disease presents with spontaneous diarrhea and a desire to sleep. Hypersomnia in Huhuo disease follows different pathways.
Why does insomnia occur in Shanghan? Excessive sweating leads to dryness in the Stomach and irritability. It may also result from deficiency irritability caused by vomiting or purging. Or it may result from high fever causing confused speech. Difficulty in urination accompanied by thirst, irritability, shortness of Qi, and distressful anxiety. If water retention causes fullness under the heart, Zhu Ling Tang (Polyporus Decoction) alone can ensure recovery. After Shanghan resolves, lingering heat occurs when Yin returns and Yang struggles.
Dryness in the Stomach leads to absence of urine. Do not forcibly induce diuresis, as this is incorrect. If heat in the Lower Jiao causes obstruction of excretion, one must judge based on the duration of the illness whether to purge heat or promote circulation. Cough with water retention indicates Xiao Qinglong Tang (Minor Green Dragon Decoction). Neck stiffness with no sweat indicates Guizhi Tang (Cinnamon Twig Decoction). Generally, for patients with jaundice, first promote urination to facilitate the smooth discharge of damp-heat. In Yangming disease, excessive sweating depletes fluids; thus, promoting urination is contraindicated. If Yang gathers in the Yin aspect causing Yin deficiency, difficulty in urination results from heat pathogen constraint. For persistent wind-strike, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite) is used. For Yangming wind-strike, Xiaochaihu Tang is used.