经云∶阳气者，精则养神，柔则养筋。发汗多，津液枯少，阳气大虚，筋肉失养，故惕
惕而跳， 然而动也。急宜温经益阳。真武汤主之。
治伤寒发汗后，筋惕肉 ，并治中寒下利，里有水气而发咳，或呕吐腹痛
水煎服。
若咳者，加五味子十粒，干姜一钱五分；若小便利，去茯苓；若下利，去芍药；若呕者
去附子，加生姜一倍。
心忪也，惕惕然跳动也。有气虚者，有汗下过多，损津液者，有水气者，当按兼症施治
可也。
小便不利，有数种。因汗下而小便不利者，津液不足也。黄胆热病，小便不利者，郁热
内蓄也。风湿相搏，与夫阳明中风而小便不利者，寒气所乘也。更有气虚而小便不利者，宜
详辨之。
伤寒遗溺，乃危急之候。下焦虚寒，不能摄水，多致遗溺，理中、四逆辈主之。然三阳
合病，每兼此症，有用白虎汤者，此热甚而阴挺失职也。大抵热甚神昏者可治，虚寒逆冷为
难治也。若杂症遗尿，多属气虚，参、 、归、术主之。
即KT 也，气自脐下直冲胸也。或谓咳逆即呃逆，非也，咳逆为咳嗽，与呃逆有何干
涉？大法伤寒当下失下，胃火上冲而呃者，其证燥渴内热，大便闭结，大柴胡汤下之。便不
结，泻心汤主之。三阴中寒，胃气欲绝而呃者，其证厥冷恶寒，下利清谷，附子理中汤，合
丁香散温之。呃止则吉，不止则凶也。
《黄帝内经》说：阳气，如果精纯则能滋养精神，柔和则能滋养筋脉。发汗过多，导致津液干枯减少，阳气严重虚弱，筋肉失去滋养，所以出现肌肉跳动、抽搐的现象。应当立即温通经脉、补益阳气。用真武汤（True Warrior Decoction）主治。
真武汤用于治疗伤寒发汗后出现的筋惕肉瞤（肌肉跳动），并治疗中寒引起的下利（腹泻），以及体内有水气导致的咳嗽或呕吐腹痛。水煎服用。
如果伴有咳嗽，加五味子十粒，干姜一钱五分；如果小便通畅，去掉茯苓；如果伴有腹泻，去掉芍药；如果伴有呕吐，去掉附子，加倍生姜用量。
发汗过多，导致患者双手交叉护住心前区，心中悸动不安，喜欢按压缓解的，用桂枝甘草汤（Cinnamon Twig and Licorice Decoction）主治。
“心忪”是指心中惊恐不安，“惕惕然”是指心跳剧烈的样子。这种情况有的属于气虚，有的是因为发汗或攻下过多损伤了津液，有的是因为有水气，应当根据兼夹症状进行治疗即可。
小便不利有好几种情况。因为发汗或攻下导致小便不利的，是津液不足所致。黄疸热病导致小便不利的，是郁热内蕴蓄积所致。风湿相搏，以及阳明中风导致小便不利的，是寒气侵袭所致。还有因气虚导致小便不利的，应当仔细辨别。
伤寒病中出现遗尿（睡中或清醒时小便失禁），这是危急的症状。由于下焦虚寒，不能固摄尿液，多导致遗尿，用理中汤（Regulate the Middle Decoction）、四逆汤（Four Reversal Decoction）等方剂主治。然而三阳合病（太阳、阳明、少阳三经同时受邪），常兼有此症，有用白虎汤（Tiger Powder Decoction）治疗的，这是因为热势极盛而阴气失职所致。大抵来说，热盛神昏者尚可治疗，虚寒厥冷者难以治疗。如果是杂病中的遗尿，多属于气虚，用人参、黄芪、当归、白术等药材主治。
呃逆（打嗝）就是此症，指气从脐下直冲胸部的现象。有人说咳逆就是呃逆，这是不对的，咳逆指的是咳嗽，与呃逆有什么关系呢？一般大法认为，伤寒病应当攻下而未攻下，胃火上冲导致的呃逆，其证候表现为燥渴、内热、大便闭结，用大柴胡汤（Major Bupleurum Decoction）攻下治疗。如果大便不结，用泻心汤（Drain the Epigastrium Decoction）主治。三阴经受寒，胃气将绝导致的呃逆，其证候表现为四肢厥冷、恶寒、下利清谷（腹泻完谷不化），用附子理中汤（Aconite Regulate the Middle Decoction）合丁香散（Clove Powder）温中治疗。呃逆停止则吉利，不停止则凶险。
The *Yellow Emperor's Inner Canon* states: "Yang qi, when pure, nourishes the spirit; when soft, it nourishes the sinews." Excessive sweating leads to withered and scanty body fluids, causing severe deficiency of yang qi. As a result, the muscles and sinews lose their nourishment, leading to twitching and jumping sensations (muscle fasciculations). Immediate treatment should focus on warming the meridians and benefiting yang qi. Zhenwu Tang (True Warrior Decoction) is the primary prescription.
Zhenwu Tang is indicated for muscle fasciculations following excessive sweating in Shanghan (Cold Damage) syndrome, as well as for diarrhea caused by middle-jiao cold, cough or vomiting accompanied by abdominal pain due to water retention within, and other related symptoms. It is prepared by decocting in water.
If cough is present, add ten grains of Wuweizi (Schisandrae Fructus) and 1.5 qian of Ganjiang (Zingiberis Rhizoma); if urination is smooth, remove Fuling (Poria); if diarrhea is present, remove Shaoyao (Paeoniae Radix Alba); if vomiting occurs, remove Fuzi (Aconiti Lateralis Radix Praeparata) and double the amount of Shengjiang (Zingiberis Rhizoma Recens).
When excessive sweating causes the patient to cover the heart area with both hands, experiencing palpitations that are relieved by pressure, Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) is the primary prescription.
"Xin Song" refers to a feeling of fright or unease in the heart, while "Ti Ti Ran" describes the sensation of violent heartbeat. This condition may arise from qi deficiency, damage to body fluids due to excessive sweating or purging, or the presence of water qi. Treatment should be administered according to the accompanying symptoms.
There are several types of difficult urination. When difficult urination results from sweating or purging, it is due to insufficient body fluids. In cases of jaundice and heat disease where urination is difficult, it is due to stagnant heat accumulating internally. When wind-dampness combats each other, or in Yangming wind-stroke cases where urination is difficult, it is due to the invasion of cold qi. Furthermore, difficult urination caused by qi deficiency requires careful differentiation.
Enuresis (involuntary urination) in Shanghan syndrome is a critical sign. Due to deficiency-cold in the lower jiao, the inability to control water leads frequently to enuresis. Lizhong Tang (Regulate the Middle Decoction) and Sini Tang (Four Reversal Decoction) are primarily used. However, in San Yang He Bing (combined disease of the three yang meridians), this symptom often accompanies the condition; Baihu Tang (Tiger Powder Decoction) may be used when the heat is extreme and yin function fails. Generally speaking, cases with extreme heat and confusion of the spirit are treatable, whereas those with deficiency-cold and cold reversal are difficult to treat. For enuresis arising from miscellaneous diseases, it mostly belongs to qi deficiency, treated with herbs such as Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma).
E Ni (hiccups) refers to the phenomenon where qi rushes directly from below the navel to the chest. Some claim that Ke Ni (cough-reversal) is synonymous with E Ni, which is incorrect; Ke Ni refers to coughing, which has no relation to hiccups. According to general principles, in Shanghan syndrome, if purgation was indicated but not performed, stomach fire rushing upward causes hiccups. The symptoms include dryness, thirst, internal heat, and constipation. Daxiehu Tang (Major Bupleurum Decoction) is used to purge. If the stool is not hard, Xiexin Tang (Drain the Epigastrium Decoction) is the primary prescription. In cold affecting the three yin meridians, where stomach qi is about to exhaust, hiccups occur with symptoms of cold extremities, aversion to cold, and diarrhea with undigested food. Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) combined with Dingxiang San (Clove Powder) is used to warm the interior. If the hiccups stop, the prognosis is good; if they persist, the prognosis is poor.