伤寒何事不得眠。汗过胃中干燥烦。（仲景云。太阳病发汗。若大汗出。胃中干。燥烦不得眠。其人欲饮水。当稍饮
之。荣卫和则愈矣。）或因吐下虚烦致。（仲景云。发汗吐下后。虚烦不得眠。若剧者。必反复颠倒。心中懊 。栀子豉
汤主之。）或因大热语言颠。（阳毒热病。皆不得眠。）小便不利正发渴。心烦少气苦孜煎。忽若水停心下满。但与猪苓可
保全。（仲景云。胃中干燥。不得眠者。猪苓汤。）伤寒瘥后热尚在。阴未复时阳使然。（病源云。卫气昼行于阳。夜行于
阴。阴主夜。夜主卧。谓阳气尽。阴气盛。则目瞑矣。今热气未散。与诸阳并。所以阳独盛。阴偏虚。虽复病后仍不得
眠者。阴气未复于本。故也。外台有肘后乌梅汤。）
胃中干则无小便。慎勿利之强使然。（病源云。伤寒发汗后。而汗出不止。津液少。胃中干。小肠有伏热。故小便不
通也。故不可强利之。）下焦有热不通泄。量病浮沉用药宣。（下焦有热者。可宣导之也。）咳而有水青龙候。（仲景云。
伤寒表不解。心下有水气。干呕发热而咳。或小便不利。小腹满或喘者。小青龙汤主之。）项强无汗桂枝痊。（仲景云。
服桂枝汤。或下之。仍头项强痛。翕翕发热。无汗。心下满。胀痛。小便不利者。桂枝去桂加茯苓白术汤。）大抵中湿发
黄者。先利小盒饭使快。（大抵中湿发黄。先利小便使快。仲景云。中湿之为候。其人小便不利。大便反快。但当利其小
便。仲景论风湿证云。若被下者。小便不利。又云。伤寒身色如金黄。如橘子色。小便利。腹微满者。茵陈蒿汤主之。）
阳明汗多津液无。却以小便利为戒。（仲景云。阳明病。汗出多而渴者。不可与猪苓汤。以汗多。胃中燥猪苓复利其小便
也。）阳若凑之阴分（去声。）虚。小便难出热中居。（素问云。阴虚者。阳必凑之。阳入阴分。则膀胱热。而小便难。）
漏风不止桂加附。（仲景云。太阳病发汗。遂漏风不止。恶风。小便难。四肢急。桂枝加附子汤主之。）阳明风中小柴胡。
伤寒病中为何会出现无法入睡的情况？发汗过度导致胃中干燥、烦躁不安。（张仲景说：太阳病经过发汗治疗，如果大汗淋漓，会导致胃中津液干涸，出现燥热烦躁、无法入睡的症状。此时病人想喝水，应当少量多次给予饮水，待营卫调和即可痊愈。）也有因为误用吐法或下法导致虚烦而难以入睡的。（张仲景说：在发汗、催吐或泻下之后，因正气受损产生虚烦，导致无法入睡；如果病情严重，患者会翻来覆去，心中郁闷不舒，应使用栀子豉汤主治。）也有因为大热之邪扰乱心神导致胡言乱语的。（阳毒热病，通常都伴有失眠症状。）
小便不利且正发渴，心烦气短痛苦煎熬。忽然发现水饮停聚在心下导致胀满，只需使用猪苓汤便可保全健康。（张仲景说：胃中干燥导致无法入睡的，适用猪苓汤。）伤寒病愈后余热尚存，阴气尚未恢复时阳气偏亢所致。（《病源》说：卫气白天行于阳分，夜晚行于阴分。阴主夜间，夜间主睡眠。当阳气尽、阴气盛时，人就会闭目入睡。如今热气未散，与诸阳之气相并，导致阳气独盛，阴气偏虚，所以即使病后仍然无法入睡，这是因为阴气未能恢复到本源状态。《外台秘要》中有引用《肘后备急方》的乌梅汤。）
胃中干燥则没有小便，切勿强行利尿使其通利。（《病源》说：伤寒发汗后，汗出不止，津液减少，胃中干燥，小肠有伏热，所以小便不通。因此不可强行利尿。）下焦有热导致不通泄，需根据病情的浮沉轻重来用药宣导。（下焦有热的情况，可以采用宣导的方法治疗。）咳嗽且体内有水饮的是小青龙汤证候。（张仲景说：伤寒表证未解，心下有痰饮水气，出现干呕、发热而咳，或者小便不利、小腹满或气喘的，用小青龙汤主治。）项背强直无汗的是桂枝加茯苓白术汤证候。（张仲景说：服用桂枝汤，或者经过攻下治疗后，仍然头项强痛，翕翕发热，无汗，心下满闷胀痛，小便不利的，用桂枝去桂加茯苓白术汤主治。）大致上中湿导致发黄的患者，先通过利小便使水道通畅。（大体上中湿发黄，应先利小便使其通畅。张仲景说：中湿的表现是，病人小便不利，大便反而快利，只应当利其小便。张仲景论述风湿证时说：如果被误用下法，会导致小便不利。又说：伤寒身体颜色如黄疸，像橘子色，小便利，腹部微满的，用茵陈蒿汤主治。）阳明病汗多导致津液枯竭，却以小便利为禁忌。（张仲景说：阳明病，出汗多且口渴的，不可给予猪苓汤，因为汗多导致胃中干燥，猪苓汤会进一步利其小便。）若阳气凑集于阴分（去声），阴虚则小便难出，热邪居其中。（《素问》说：阴虚者，阳气必凑集之。阳气进入阴分，则膀胱受热，导致小便困难。）漏风不止可用桂枝加附子汤。（张仲景说：太阳病发汗后，遂致汗漏不止，恶风，小便难，四肢拘急，用桂枝加附子汤主治。）阳明中风证候用小柴胡汤。
Why does insomnia occur in Shaoyang diseases? Excessive sweating leads to dryness in the Stomach and restlessness. (Zhang Zhongjing stated: In Taiyang disease, after administering diaphoresis, if profuse sweating occurs, it causes dryness in the Stomach, leading to irritability and inability to sleep. The patient desires water; one should provide small amounts of water frequently. Once Ying and Wei Qi harmonize, the condition will resolve.) It may also result from deficiency-heat causing vexation due to improper use of emesis or purgation. (Zhang Zhongjing stated: After diaphoresis, emesis, or purgation, deficiency-vexation leads to insomnia. If severe, the patient tosses and turns with a feeling of stifling discomfort in the chest; Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.) It may also stem from high fever disturbing the mind, causing delirious speech. (Yang Du heat diseases typically involve insomnia.)
When urination is difficult accompanied by thirst, vexation, and shortness of breath causing suffering. If sudden fluid retention in the Heart region causes fullness, Zhu Ling Tang (Polyporus Decoction) can ensure recovery. (Zhang Zhongjing stated: For insomnia caused by Stomach dryness, Zhu Ling Tang is used.) After the resolution of Cold Damage, residual heat remains; this is due to Yang Qi prevailing while Yin has not yet recovered. (The *Bing Yuan* states: Wei Qi travels through the Yang meridians during the day and Yin meridians at night. Yin governs the night and sleep. When Yang Qi exhausts and Yin Qi abounds, the eyes close for sleep. Now, since heat has not dispersed and merges with Yang Qi, Yang becomes excessive while Yin is deficient. Thus, even post-illness, insomnia persists because Yin has not returned to its root. The *Wai Tai Mi Yao* cites Wu Mei Tang (Black Plum Decoction) from *Zhou Hou Bei Ji Fang*.)
Dryness in the Stomach results in scanty urine; do not forcibly promote diuresis. (The *Bing Yuan* states: After sweating for Cold Damage, if sweating continues incessantly, body fluids decrease, Stomach dryness ensues, and latent heat exists in the Small Intestine, causing urinary obstruction. Therefore, forced diuresis is contraindicated.) Heat in the Lower Jiao causing obstruction requires medication based on the floating or sinking nature of the disease to guide and unblock. (For heat in the Lower Jiao, guiding and unblocking methods are applicable.) Coughing with internal fluid retention indicates Xiao Qing Long Tang (Minor Blue Dragon Decoction). (Zhang Zhongjing stated: In Cold Damage where the exterior syndrome is unresolved, with fluid accumulation in the epigastrium, presenting as dry heaves, fever, and cough, or additionally urinary difficulty, lower abdominal fullness, or wheezing, Xiao Qing Long Tang is indicated.) Neck stiffness without sweat indicates Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractodes Decoction). (Zhang Zhongjing stated: After taking Gui Zhi Tang or undergoing purgation, if headache, neck stiffness, mild fever, absence of sweat, epigastric fullness, distending pain, and urinary difficulty persist, Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang is indicated.) Generally, for jaundice caused by dampness, first promote diuresis to clear the pathways. (Generally, for jaundice due to dampness, diuresis should be promoted first. Zhang Zhongjing stated: The manifestation of dampness involves urinary difficulty but loose stools; only diuresis should be employed. Regarding wind-dampness, Zhang Zhongjing noted: If mistakenly purged, urinary difficulty ensues. Also, in Cold Damage, if the body color resembles jaundice like an orange peel, with free urination and slight abdominal fullness, Yin Chen Hao Tang (Artemisiae Scopariae Decoction) is indicated.) In Yangming disease, excessive sweating depletes fluids; thus, promoting diuresis is contraindicated. (Zhang Zhongjing stated: In Yangming disease, with profuse sweating and thirst, Zhu Ling Tang must not be given, as profuse sweating already causes Stomach dryness, and Zhu Ling Tang would further drain fluids via diuresis.) If Yang Qi invades the Yin aspect (pronounced 'qù shēng'), Yin deficiency allows Yang intrusion, making urination difficult with heat residing within. (The *Su Wen* states: In Yin deficiency, Yang inevitably crowds in. When Yang enters the Yin aspect, the Bladder becomes heated, causing dysuria.) Profuse sweating leakage with continuous perspiration is treated with Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Decoction plus Prepared Aconite Root). (Zhang Zhongjing stated: In Taiyang disease, after diaphoresis, if sweating leaks continuously, accompanied by aversion to wind, dysuria, and tetany of the four limbs, Gui Zhi Jia Fu Zi Tang is indicated.) Yangming Wind Strike is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction).