猪肤（一斤）
上一味。以水一斗。煮取五升。去滓。加白蜜一升。白粉五合。熬香。和令相得。温分六服。
成注云。猪。水畜也。其气先入肾。少阴客热。以猪肤解之。加白蜜以润燥除烦。白粉以益气断利。琥按上汤。
治少阴客热。虚燥下利之药也。猪肤甘寒。白蜜。甘凉。白粉甘平。三物皆能清热润燥补虚。热清则烦满除。燥润则咽
痛解。虚补则利自止矣。
或问下利一候。乃水来侮土。今者少阴经有热邪。当是湿热利。何为而云。有燥热也。余答云。下利既多。则亡阴
致虚而津液去。故燥咽痛心胸烦满。此是燥热之征无疑。
少阴病二三日。咽痛者。可与甘草汤。不瘥者。与桔梗汤。（此条少阴病。亦阳邪入于阴经之证。经中客热。故咽痛。
用甘草汤者。甘以发其热。缓其痛也。服汤后不瘥者。与桔梗汤。即于甘草汤内加桔梗。以开提其邪。邪散。则少阴之
气自和矣。）
甘草（二两）
上一味。以水三升。煮取一升半。去滓。温服七合。日二服。
桔梗（一两） 甘草（二两）
上二味。以水三升。煮取一升半。去滓分温再服。（成注云。桔梗辛温以散寒。甘草甘平以除热。甘梗相合。以调寒
热。或问仲景于甘桔二汤证。无所谓寒热者。成注云。甘梗相合。以调寒热。何也。余答云。少阴为寒水之藏。今者热
客其经。故成注又云。寒热相搏。则为咽痛。乃热邪与经中之寒气相搏。故宜用甘梗相合以调和之也。）
武陵陈亮斯云。咽痛既属热邪。何不兼用寒凉之味。不知少阴病真藏气寒。得热证。犹为易治。若纯寒。则已滨
于死。故虽属热证。不敢轻用寒凉。以其热非极热。而骤用寒凉。势必变极寒之证。其去死不远矣。此猪肤汤治热痛热
利。亦止用粉蜜。猪肤不用苦寒。兢兢防正气之虚寒而热证之易变为寒证。同一意耳。学人不可不识此意。
少阴病。咽中伤生疮不能语言。声不出者。苦酒汤主之。（此条少阴病。亦系阳邪所传入者。邪热客于经络。甚至咽
伤生疮。比之上条咽痛。则更剧矣。不能语言声不出者。以少阴之脉。入肺循喉咙肺属金。主声金空则鸣。肺受热邪所
实故喉咙为之窒塞也。或问仲景言咽痛。咽以咽物。于喉何。与而云。语声不出邪。余答云。喉与咽相附。仲景言少阴
病热咽痛。而喉咙即在其中。）
猪肤（一斤）
以上一味药。用水一斗。煮至剩余五升。滤去药渣。加入白蜜一升、米粉五合。熬至香气溢出。混合均匀。分六次温服。
成无己注解说：猪是水畜。其气首先入肾。少阴经受客热侵袭，用猪肤来解除它。加入白蜜以润燥除烦。加入米粉以益气止利。我按语认为上述汤剂是治疗少阴经受客热、虚燥导致下利的药物。猪肤甘寒，白蜜甘凉，米粉甘平。这三味药都能清热润燥补虚。热清则烦闷消除，燥润则咽痛缓解，虚补则下利自然停止。
有人问：下利这一证候，通常是水邪侮土所致。如今少阴经有热邪，应当是湿热利，为什么说是有燥热呢？我回答说：下利次数过多，会导致亡阴致虚而津液耗损，所以出现咽痛、心胸烦满。这是燥热的征象无疑。
少阴病二三日，出现咽痛的，可以给予甘草汤；如果未痊愈的，给予桔梗汤。（此条少阴病，也是阳邪侵入阴经的证候。经中有客热，所以咽痛。使用甘草汤，是因为甘味能发散热邪、缓解疼痛。服用汤药后若未痊愈，给予桔梗汤，即在甘草汤中加入桔梗，以宣提邪气。邪气散去，少阴之气自然调和。）
甘草（二两）
以上一味药。用水三升。煮至剩余一升半。滤去药渣。温服七合。每日两次。
以上两味药。用水三升。煮至剩余一升半。滤去药渣。分两次温服。（成无己注解说：桔梗辛温以散寒，甘草甘平以除热。甘味与桔梗相合，以调和寒热。有人问张仲景在甘草汤和桔梗汤的证候中，并未提及寒热，成注却说甘梗相合以调寒热，为什么呢？我回答说：少阴是寒水之脏，如今热邪客居其经，所以成注又说寒热相搏，就会导致咽痛。乃是热邪与经中的寒气相搏结，所以适宜用甘味与桔梗相合来调和它。）
武陵人陈亮斯说：咽痛既然属于热邪，为什么不兼用寒凉的药物？不知道少阴病的真脏气本寒，得了热证，还算是容易治疗的。如果是纯寒证，就已经接近死亡了。所以即使是热证，也不敢轻易使用寒凉药物，因为这里的热并非极热，如果骤然使用寒凉，势必转变为极寒证，离死就不远了。这个猪肤汤治疗热痛和下利，也只使用粉和蜜，猪肤也不用苦寒之品，是小心翼翼地防止正气虚寒以及热证容易转变为寒证。用意是一样的。学习中医的人不可不认识到这一点。
少阴病，咽喉受伤生疮，不能说话，声音发不出来的，用苦酒汤主治。（此条少阴病，也是阳邪传入所致。邪热客居经络，甚至咽喉受伤生疮，比上一条的咽痛更为严重。不能说话、声音发不出来，是因为少阴经脉入肺并循行喉咙。肺属金，主声音，金空则鸣。肺受热邪壅实，所以喉咙为之窒塞。有人问张仲景说咽痛，咽是用来吞咽食物的，与喉有什么关系，却说不出声呢？我回答说：喉与咽相连附，张仲景所说的少阴病热邪导致的咽痛，其中就包含了喉咙的病机。）
Zhu Fu (Cortex Sus Scrofa Domesticus, one jin)
Take the above single ingredient. Boil in ten dou of water until five sheng remain. Strain the dregs. Add one sheng of white honey and five he of white powder (rice flour). Cook until fragrant. Mix well. Divide into six doses and take warm.
Cheng Wuji's commentary states: Pigs are aquatic animals. Their qi enters the Kidney first. Shaoyin (Lesser Yin) exogenous heat is resolved by Zhu Fu. White honey is added to moisten dryness and remove irritability. White powder is added to boost Qi and stop diarrhea. My analysis notes that the above decoction is a medicine for treating Shaoyin exogenous heat with deficiency-dryness leading to diarrhea. Zhu Fu is sweet and cold; white honey is sweet and cool; white powder is sweet and neutral. All three ingredients can clear heat, moisten dryness, and tonify deficiency. When heat is cleared, irritability and fullness are removed; when dryness is moistened, sore throat is relieved; when deficiency is tonified, diarrhea stops naturally.
A question arises: Diarrhea is usually caused by Water insulting Earth. Now, if there is pathogenic heat in the Shaoyin channel, it should be damp-heat diarrhea. Why is it said to be dry-heat? I answer: Since diarrhea occurs frequently, Yin is lost leading to deficiency and body fluids are depleted. Thus, sore throat, chest irritability, and fullness occur. This is undoubtedly a sign of dry-heat.
In Shaoyin disease, after two or three days, if there is a sore throat, Gancao Tang (Licorice Decoction) may be given. If not cured, Jiegeng Tang (Platycodon Decoction) is administered. (This case of Shaoyin disease is also a syndrome where Yang pathogen enters the Yin channel. Exogenous heat in the channel causes sore throat. Gancao Tang is used because its sweet nature disperses heat and alleviates pain. If not cured after taking the decoction, Jiegeng Tang is given, which adds Jiegeng to Gancao Tang to lift and disperse the pathogen. Once the pathogen scatters, the Qi of Shaoyin harmonizes itself.)
Gancao (Radix Glycyrrhizae Preparata, two liang)
Take the above single ingredient. Boil in three sheng of water until one and a half sheng remain. Strain the dregs. Take seven he warm. Twice daily.
Jiegeng (Radix Platycodonis, one liang); Gancao (Radix Glycyrrhizae Preparata, two liang)
Take the above two ingredients. Boil in three sheng of water until one and a half sheng remain. Strain the dregs. Divide into two doses and take warm. (Cheng Wuji's commentary states: Jiegeng is pungent and warm to disperse cold; Gancao is sweet and neutral to clear heat. The combination of sweet and Jiegeng harmonizes cold and heat. A question asks: Zhang Zhongjing does not mention cold and heat in the syndromes for Gancao Tang and Jiegeng Tang. Cheng's commentary says they harmonize cold and heat. Why? I answer: Shaoyin is the storehouse of cold-water. Now, heat lodges in its channel. Cheng's commentary further states that the struggle between cold and heat leads to sore throat. It is the pathogenic heat struggling with the cold qi in the channel. Therefore, it is appropriate to use the combination of sweet flavor and Jiegeng to harmonize them.)
Chen Liangsi from Wuling says: Since sore throat belongs to pathogenic heat, why not simultaneously use cold-cooling herbs? One must not realize that the true organ qi of Shaoyin is cold. Getting a heat syndrome is relatively easy to treat. If it were pure cold, death would be imminent. Therefore, even if it is a heat syndrome, one dares not lightly use cold-cooling herbs. Because the heat here is not extreme, suddenly using cold-cooling herbs will inevitably transform it into an extreme cold syndrome, bringing one close to death. This Zhu Fu Tang treats heat-pain and heat-diarrhea, yet only uses powder and honey. Zhu Fu is not bitter-cold. It carefully guards against the deficiency-cold of healthy Qi and the tendency of heat syndromes to transform into cold syndromes. The intention is the same. Students of medicine must recognize this principle.
In Shaoyin disease, if the throat is injured and sores form, preventing speech and voice production, Kujiu Tang (Bitter Wine Decoction) is the primary treatment. (This case of Shaoyin disease is also caused by the transmission of Yang pathogens. Pathogenic heat lodges in the meridians, causing throat injury and sores, which is more severe than the previous sore throat. Inability to speak and produce voice occurs because the Shaoyin meridian enters the Lung and follows the throat. The Lung belongs to Metal and governs voice; empty metal rings. When the Lung is filled with pathogenic heat, the throat becomes obstructed. A question asks: Zhang Zhongjing mentions sore throat, but the throat is for swallowing food. What does it have to do with the larynx, yet it says voice cannot be produced? I answer: The larynx and pharynx are adjacent. When Zhang Zhongjing speaks of heat-induced sore throat in Shaoyin disease, the pathology of the larynx is included within it.)