少阴病吐利，手足厥冷，烦躁欲死者，吴茱萸汤主之。
少阴病吐利，烦躁、四逆者死。四逆者，四肢厥冷，兼臂胫而言。此云手足，是指指掌而言，四肢之阳犹
在。岐伯曰∶“四末阴阳之会，气之大路也。四街者，气之经络也。络绝则经通，四末解则气从合。”故用吴
茱萸汤以温之，吐利止而烦躁除。阴邪入于合者，更得从阳而出乎井矣。
干呕，吐涎沫，头痛者，吴茱萸汤主之；不头痛者，半夏
干姜汤主之。
呕而无物，胃虚可知矣；吐惟涎沫，胃寒可知矣，头痛者，阳气不足，阴寒得以乘之也。吴茱萸汤温中益气，
升阳散寒，呕、痛尽除矣。干呕、吐涎是二证，不是并见。
食谷欲呕者，属阳明也，吴茱萸汤主之。得汤反剧者，属上焦也。
胃热则消谷善饥，胃寒则水谷不纳。食谷欲呕，固是胃寒；服汤反剧者，以痰饮在上焦为患，呕尽自愈，
非谓不宜服也。此与阳明不大便，服柴胡汤胃气因和者不同。
吴茱萸汤∶
吴茱萸（一升，汤洗七次） 人参（三两） 生姜（六两） 大枣（十二枚）
水七升，煮取二升，温服七合、日三服。
吴萸温中散寒，则吐利可除；人参安神定志，则烦躁可止；姜、枣调和营卫，则手足自温、头痛自瘳矣。
少阴病下利脉微者，与白通汤。利不止，厥逆、无脉、干呕烦者，白通加猪胆汁汤主之。服汤后脉暴出者
死，微续者生。
下利脉微，是下焦虚寒不能制水故也。与白通汤以通其阳，补虚却寒而制水。服之利仍不止，更厥逆，反
无脉，是阴盛格阳也。如干呕而烦，是阳欲通而不得通也。猪者水畜，属少阴也；胆者甲木，从少阳也。法当取
猪胆汁之苦寒为反佐，加入白通汤中，从阴引阳，则阴盛格阳者，当成水火既济矣。脉暴出者，孤阳独行也，故
死∶微续者，少阳初生也，故生。
白通汤∶
葱白（四茎） 干姜（一两） 附子（一枚，去皮生用）
上三味，以水三升，煮取一升，去滓，分温再服。
白通加猪胆汁汤∶
本方加人尿（五合），猪胆汁（一合）。
和合相得，分温再服。无猪胆汁亦可服。
葱辛温而茎白，通肺以行营卫阴阳，故能散邪而通阳气。率领姜、附，入阳明而止利，入少阴而生脉也。
附子生用，亦取其勇气耳。论中不及人尿，而方后反云无猪胆汁亦可服者，以人尿咸寒，直达下焦，亦能止烦
除呕矣。
下利，手足逆冷、无脉者，灸之不温，若脉不还，反微喘者死。
下利后，脉绝、手足厥冷， 时脉还、手足温者生，脉不还者死。
此不呕不烦，不须反佐而服白通，外灸少阴及丹田、气海，或可救于万一。
少阴病出现呕吐和下利，手足冰冷，烦躁得快要死去时，用吴茱萸汤主治。
少阴病出现呕吐和下利，伴有烦躁、四肢厥冷（四逆）的，预后不良，主死。“四逆”是指四肢厥冷，包括手臂和小腿而言。此处说“手足”，是指手指和手掌而言，说明四肢的阳气尚存。岐伯说：“四肢末端是阴阳经气交会的地方，也是气血运行的主要通道。四街是经气汇聚的路径。如果络脉闭塞则经气通畅受阻，四肢末端温暖则经气得以汇合。”因此使用吴茱萸汤来温补，呕吐下利停止后，烦躁症状也会消除。阴寒邪气侵入合穴深处，现在借助阳气从井穴向外透达。
干呕，吐出涎沫，头痛的，用吴茱萸汤主治；如果不头痛的，用半夏干姜汤主治。
只干呕而没有食物吐出，可知胃气虚弱；只吐涎沫，可知胃中寒冷；伴有头痛，是因为阳气不足，阴寒之邪乘虚侵袭所致。吴茱萸汤能温中益气，升发阳气并驱散寒邪，干呕和头痛都能消除。干呕和吐涎沫是两个不同的证候，并不是同时出现的。
进食后想要呕吐的，属于阳明病范畴，用吴茱萸汤主治；如果服药后病情反而加重，说明病位在上焦。
胃热则会消谷善饥，胃寒则水谷无法受纳。进食后想呕吐，确实是胃寒的表现；但服药后反而加剧，是因为痰饮停留在上焦造成危害，呕吐之后自然痊愈，并不是说不应该服用此药。这与阳明病不大便，服用小柴胡汤后胃气调和的情况不同。
吴茱萸汤方：
吴茱萸（一升，用热水清洗七次） 人参（三两） 生姜（六两） 大枣（十二枚）
用水七升，煮取二升药液，每次温服七合，每日服用三次。
吴茱萸能温中散寒，则呕吐下利可除；人参能安神定志，则烦躁可止；生姜和大枣能调和营卫，则手足自然温暖，头痛自然痊愈。
少阴病出现下利，脉象微弱的，给予白通汤治疗。如果下利不止，出现四肢厥冷、无脉、干呕且心烦的，用白通加猪胆汁汤主治。服药后脉搏突然暴出的，主死；脉搏逐渐微弱续接的，主生。
下利而脉微，这是下焦虚寒不能制约水液所致。给予白通汤以通达阳气，补虚祛寒从而制约水液。服药后下利仍然不止，反而出现四肢厥冷、无脉，这是阴寒极盛格拒阳气于外。如出现干呕和心烦，说明阳气想要通达却无法通达。猪是水畜，归属于少阴肾；胆属甲木，归属于少阳肝。治法应当取猪胆汁的苦寒之性作为反佐，加入白通汤中，从阴引阳，这样阴盛格阳的局面，就能达成水火既济的状态。脉搏突然暴出的，是孤阳独行，所以主死；脉搏微弱逐渐恢复的，是少阳初生之气，所以主生。
白通汤方：
葱白（四茎） 干姜（一两） 附子（一枚，去皮生用）
以上三味药，用水三升，煮取一升药液，去渣，分两次温服。
白通加猪胆汁汤方：
本方加入人尿（五合），猪胆汁（一合）。
混合均匀，分两次温服。如果没有猪胆汁也可以服用。
葱辛温而茎色白，能通肺气以运行营卫阴阳，所以能散邪气并通达阳气。率领干姜、附子，进入阳明经以止利，进入少阴经以生脉。附子生用，也是取其勇猛通行之力。原文中未提及人尿，但方后注却说没有猪胆汁也可以服用，是因为人尿咸寒，直达下焦，也能止烦除呕。
出现下利，手足逆冷、无脉的，施灸后仍不温暖，如果脉搏不恢复，反而出现轻微喘息的，主死。
Shaoyin disease presenting with vomiting and diarrhea, cold extremities, and severe restlessness bordering on death is primarily treated with Wuzhuyu Tang (Evodia Decoction).
Shaoyin disease presenting with vomiting, diarrhea, restlessness, and Si Ni (Four Reversals/Cold Extremities) indicates a fatal prognosis. "Si Ni" refers to coldness of the four limbs, encompassing both arms and legs. The text here specifies "hands and feet," referring specifically to fingers and palms, indicating that Yang Qi in the limbs is still present. Qibo stated: "The four extremities are the meeting points of Yin and Yang, and major pathways for Qi. The Si Jie (Four Streets) are the meridians where Qi converges. If collaterals are blocked, meridian flow is obstructed; if the four extremities are warm, Qi harmonizes." Therefore, Wuzhuyu Tang is used to warm the interior; once vomiting and diarrhea cease, restlessness is resolved. The Yin pathogenic factor, having entered the He-Sea points, now exits from the Jing-Well points via Yang Qi.
For dry retching, expulsion of saliva/phlegm, and headache, Wuzhuyu Tang is indicated. If there is no headache, Banxia Ganjiang Tang (Pinellia and Dried Ginger Decoction) is indicated.
Dry retching without expulsion of food indicates deficiency of Stomach Qi. Expulsion of only saliva/phlegm indicates Cold in the Stomach. Headache occurs because insufficient Yang Qi allows Yin-Cold to invade. Wuzhuyu Tang warms the middle and supplements Qi, raises Yang and disperses Cold, thereby resolving dry retching and pain. Dry retching and expulsion of saliva are two distinct syndromes and do not necessarily occur simultaneously.
Desire to vomit after eating belongs to the Yangming stage; Wuzhuyu Tang is indicated. If symptoms worsen after taking the decoction, the pathology resides in the Upper Jiao (Upper Burner).
Heat in the Stomach leads to rapid digestion and hunger; Cold in the Stomach prevents the reception of water and grain. Desire to vomit after eating confirms Stomach Cold. However, worsening after medication indicates that Phlegm-Fluid retention in the Upper Jiao is the issue; vomiting will resolve the condition naturally. This does not mean the decoction should not be taken. This differs from Yangming constipation where Chaihu Tang (Bupleurum Decoction) harmonizes Stomach Qi.
Wuzhuyu Tang Formula:
Evodiae Fructus (Wuzhuyu) (1 sheng, rinsed seven times with hot water)
Ginseng Radix et Rhizoma (Renshen) (3 liang)
Zingiberis Rhizoma Recens (Shengjiang) (6 liang)
Jujubae Fructus (Dazao) (12 pieces)
Boil in 7 sheng of water to obtain 2 sheng of liquid. Take 7 ge warm, three times daily.
Evodiae Fructus warms the middle and disperses Cold, resolving vomiting and diarrhea; Ginseng calms the Spirit and stabilizes the Will, stopping restlessness; Zingiberis Rhizoma Recens and Jujubae Fructus harmonize Ying and Wei (Nutritive and Defensive Qi), warming the extremities and curing headache.
Shaoyin disease with diarrhea and a faint pulse is treated with Baitong Tang (White Passage Decoction). If diarrhea persists, accompanied by cold extremities, absence of pulse, dry retching, and vexation, Baitong Jia Zhudanji Dan Tang (Baitong Decoction plus Pig Bile and Human Urine) is indicated. If the pulse suddenly emerges violently after ingestion, death ensues; if the pulse gradually returns weakly, survival is possible.
Diarrhea with a faint pulse indicates deficiency-cold in the Lower Jiao failing to control fluids. Baitong Tong Yang (passes Yang), tonifies deficiency, dispels Cold, and controls fluids. If diarrhea persists after administration, progressing to cold extremities and absent pulse, this indicates Extreme Yin repelling Yang. Dry retching and vexation indicate Yang attempting to penetrate but being blocked. Pig is a Water animal, associated with Shaoyin Kidney; Gallbladder is Jia Wood, associated with Shaoyang Liver. The treatment utilizes the bitter-cold nature of Pig Bile as a counter-agent (Fan Zuo), added to Baitong Tang, drawing Yang from Yin. Thus, the state of Extreme Yin repelling Yang transforms into the intersection of Water and Fire. A sudden violent pulse indicates solitary Yang moving alone, leading to death; a gradual, weak return of the pulse indicates the initial birth of Shaoyang Qi, leading to survival.
Baitong Tang Formula:
Allii Tuberosi Bulbus (Congbai) (4 stems)
Zingiberis Rhizoma (Ganjiang) (1 liang)
Aconiti Lateralis Radix Praeparata (Fuzi) (1 piece, peeled and raw)
Decoct these three ingredients in 3 sheng of water to obtain 1 sheng. Strain and take warm in two divided doses.
Baitong Jia Zhudanji Dan Tang Formula:
Add to the base formula: Human Urine (Ren Niao) (5 he), Pig Bile (Zhudanji Dan) (1 he).
Mix well and take warm in two divided doses. If Pig Bile is unavailable, it may be omitted.
Allii Tuberosi Bulbus is acrid-warm and white-stemmed; it unblocks Lung Qi to circulate Ying and Wei, dispersing pathogens and unblocking Yang Qi. It leads Zingiberis Rhizoma and Aconiti Lateralis Radix Praeparata into the Yangming channel to stop diarrhea and into the Shaoyin channel to generate pulse. Raw Aconiti Lateralis Radix Praeparata is used for its vigorous penetrating power. Although the main text does not mention Human Urine, the post-script states Pig Bile can be omitted because Human Urine is salty-cold, reaches the Lower Jiao directly, and also stops vexation and retching.
In cases of diarrhea with cold extremities and absent pulse, if moxibustion fails to warm the body and the pulse does not return, but slight panting appears, death ensues.
After diarrhea, if the pulse vanishes and extremities are cold, but the pulse occasionally returns and extremities become warm, survival is possible; if the pulse does not return, death ensues.
Since there is no vomiting or vexation, a counter-agent is not needed; administer Baitong Tang directly. External moxibustion on Shaoyin channels, as well as the Dantian and Qihai acupoints, may offer a slim chance of rescue.