（此方本治上焦热甚。气中之血药也。今借用之。以治少阴渴逆之证。）
山栀子仁（一两） 连翘 黄芩 薄荷（各一两半） 大黄（半两）
上为粗末。每服一两。水二盏。同竹叶七片。煎至一盏。去滓。入蜜少许。食后服。
琥按上主疗云。少阴渴逆。肾热也。然至舌挛。言语不正。昏冒。咽痛。虽为肾热。实则阴不纳阳。阳热已极。
逆而上行。上干于心矣。脉微者。乃阴气微而将尽也。此为脉中无神。故不可用下药。以大泄其热。止须用凉膈散。又
去硝以清肺。盖金为水母。肺清。则肾经之热。亦随之而解矣。此读仲景书。而神于通变。不执死方者欤。
又云。少阴心惊悸。邪热入阴。肾水乘心。是以心悸。是水犯火也。不当治水与火。治在于木。故仲景用四逆散调
之。（此即甘草枳实柴胡芍药四味药也。方已见前。）
琥按上主疗云。治木者。乃肾热极。反调其肝。实则泻其子也。又仲景于四逆散方后云。悸者。加桂枝五分。兹
则专主悸。而不加桂。可见用药之法。不可执也。
（琥）按仲景治少阴病。用大承气汤者。共三证。一则口燥咽干。一则自利纯青水。心下痛。口干燥。一则腹胀不
大便。乃火土过极。水将涸矣。故用大承气汤泻土。即所以救水。土为水之贼也。然病患之脉。必两尺沉数。有力者。
宜下之。无力者。不宜下也。宜滋阴泻热。玄黄膏主之。
（此方原本用于治疗上焦热邪极盛的情况。它属于调理气分中的血分药物。现在借用它来治疗少阴病中口渴且气逆的证候。）
山栀子仁（一两） 连翘 黄芩 薄荷（各一两半） 大黄（半两）
将上述药材捣成粗末。每次服用一两，加水二盏，同竹叶七片一起煎煮至一盏，滤去药渣，加入少许蜂蜜，饭后服用。
王琥按：上述主治功效提到“少阴渴逆”，这是肾热的表现。然而发展到舌体卷缩、言语不清、神志昏蒙、咽喉疼痛，虽然根源在于肾热，但实际上是阴气不能收纳阳气，导致阳热极度亢盛，逆乱而上行，上扰于心。如果脉象微弱，说明阴气衰微且即将耗尽，这是脉中无神的表现，因此不可使用泻下药来大力泄除热邪。只需使用凉膈散，并去掉芒硝以清肃肺热。因为金（肺）是水（肾）之母，肺气清肃，则肾经的热邪也会随之解除。这真是研读仲景书籍后，能够灵活变通而不拘泥于固定方剂的高明之处啊。
又说：少阴病出现心惊悸，是因为邪热侵入阴分，肾水凌犯心火，所以导致心悸，这是水气侵犯火气的表现。此时不应当直接治疗水或火，而应该从木（肝）论治，所以仲景使用四逆散来调和。（这就是由甘草、枳实、柴胡、芍药四味药组成的方子，该方在前面已经见过。）
王琥按：上述主治功效提到“治木”，意思是肾热极盛时，反而调理肝脏，这实际上是运用“实则泻其子”的治疗原则。另外，仲景在四逆散的方后注中说：“若有心悸者，加桂枝五分。”这里专门针对心悸，却没有加桂枝，可见用药之法不可拘执死板。
（王琥）按：仲景治疗少阴病，使用大承气汤的情况共有三种证候。一种是口燥咽干；一种是自利纯青色稀水，心下疼痛，口干燥；一种是腹胀且不大便。这些情况属于火土之气过极，津液水湿即将枯竭。因此使用大承气汤泻除脾土之实，这也就是救肾水的方法。土是水的贼邪（克制者）。但是患者的脉象必须是两尺部沉数且有力，才适宜用下法；如果脉无力，则不宜用下法，应当采用滋阴泻热的方法，玄黄膏为主治方。
(This prescription was originally intended to treat excessive heat in the Upper Jiao (Upper Burner). It belongs to herbs that regulate blood within the Qi level. It is now borrowed to treat the syndrome of thirst and rebellious Qi in Shaoyin disease.)
Gardeniae Fructus (1 liang) / Gardenia jasminoides fruit
Forsythiae Fructum (1.5 liang each) / Forsythia suspensa fruit
Scutellariae Radix (1.5 liang each) / Scutellaria baicalensis root
Menthae Haplocalycis Herba (1.5 liang each) / Mentha haplocalyx herb
Rhei Radix et Rhizoma (0.5 liang) / Rheum palmatum root and rhizome
Grind the above ingredients into a coarse powder. Take 1 liang per dose, add two cups of water, boil together with seven leaves of Bambusa vulgaris var. striata (Zhuye), reduce to one cup, strain, add a small amount of honey, and take after meals.
Wang Hu notes: The aforementioned indications mention "Shaoyin thirst and rebellious Qi," which indicates Kidney heat. However, when it progresses to tongue retraction, slurred speech, mental confusion, and sore throat, although the root is Kidney heat, it is actually due to Yin failing to contain Yang, causing extreme Yang heat to rebel and ascend, disturbing the Heart. If the pulse is faint, it signifies that Yin Qi is depleted and nearing exhaustion; this indicates a lack of Shen (Spirit) in the pulse. Therefore, purgative drugs should not be used to vigorously drain the heat. Instead, Liangge San (Cooling the Mediator Powder) should be used, with Mangxiao (Mirabilite) removed to clear Lung heat. Since Metal (Lung) is the mother of Water (Kidney), clearing the Lung will cause the heat in the Kidney meridian to resolve accordingly. This demonstrates profound flexibility in studying Zhang Zhongjing's works, avoiding rigid adherence to fixed prescriptions.
It is also stated: In Shaoyin disease, if there is palpitations and fright, it is because pathogenic heat has entered the Yin level, and Kidney Water overacts on the Heart Fire, causing palpitations; this is Water invading Fire. In such cases, one should not directly treat Water or Fire, but rather treat Wood (Liver). Thus, Zhang Zhongjing uses Sini San (Four Reversal Powder) to harmonize. (This formula consists of four herbs: Glycyrrhizae Radix et Rhizoma, Ziziphi Spinosae Semen, Bupleuri Radix, and Paeoniae Radix Alba. The formula was presented earlier.)
Wang Hu notes: The aforementioned indication mentions "treating Wood," meaning that when Kidney heat is extreme, the Liver is regulated instead. This actually applies the principle of "draining the son when excess." Furthermore, in the post-prescription notes for Sini San, Zhang Zhongjing states: "If there are palpitations, add Guizhi (Cinnamon Twig) 5 fen." Here, since palpitations are the primary symptom, Guizhi is not added. This shows that the method of prescribing should not be rigidly adhered to.
(Wang Hu) notes: Zhang Zhongjing uses Dachengqi Tang (Major Order the Qi Decoction) to treat Shaoyin disease in three specific syndromes. One is dry mouth and throat; another is spontaneous diarrhea of pure green water with epigastric pain and dry mouth; the third is abdominal distension and constipation. These conditions represent extreme Fire and Earth elements, leading to the depletion of fluids/water. Therefore, Dachengqi Tang is used to purge the Earth (Spleen/Stomach), which is essentially a method to save the Water (Kidney). Earth is the controlling element (thief) of Water. However, the patient's pulse must be deep, rapid, and forceful at both Chi positions (cun-kou pulse diagnosis) to indicate suitability for purgation; if the pulse is weak, purgation is contraindicated. Instead, methods to nourish Yin and drain heat should be employed, with Xuanhuang Gao (Black-Yellow Paste) as the primary treatment.