黄连四两 黄芩二两 芍药二两 鸡子黄二枚 阿胶三两
右五味，以水六升，先煮三物，取二升，去滓，内胶烊尽，小冷，纳鸡子黄，搅令相
得，温服七合，日三服。
【集解】
柯琴曰：此少阴之泻心汤也，凡泻心必藉连、芩，而导引有阴阳之别。病在三阳，胃
中不和，而心下痞□者，虚则加参、甘补之，实则加大黄下之。病在少阴，而心中烦
不得卧者，既不得用参甘以助阳，亦不得用大黄以伤胃也。故用芩、连以直折心火，
用阿胶以补肾阴；鸡子黄佐芩、连，于泻心中补心血；芍药佐阿胶，于补阴中敛阴气
。斯则心肾交合，水升火降，是以扶阴泻阳之方，而变为滋阴和阳之剂也。是则少阴
之火，各归其部，心中之烦不得眠可除矣。经曰：阴平阳秘，精神乃治。斯方之谓欤
！
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少阴病，下利咽痛，胸满心烦，猪肤汤主之。
【注】
身温腹满下利，太阴证也；身寒欲寐下利，少阴证也。身热不眠咽痛，热邪也；身寒
欲寐咽痛，寒邪也。今身寒欲寐，下利咽痛，与胸满心烦之证并见，是少阴热邪也。
少阴之脉，循喉咙，其支者，从肺出络心注胸中，是以少阴之热邪上逆，则所过之处
无不病也。以猪肤汤主之，解少阴上焦之热，兼止下焦之利也。
【集注】
喻昌曰：下利咽痛，胸满心烦，此少阴热邪充斥上下中间，无所不到，寒下之药，不
可用矣，故立猪肤汤一法也。盖阳微者，用附子温经；阴竭者，用猪肤润燥，温经润
燥中，同具散邪之义也。
黄连四两，黄芩二两，芍药二两，鸡蛋黄两个，阿胶三两。
以上五味药，用水六升，先煎煮前三味药（黄连、黄芩、芍药），取药液二升，滤去药渣，加入阿胶使其完全溶化，待药液稍凉后，加入鸡蛋黄，搅拌均匀，每次温服七合，每日服用三次。
【集解】
柯琴说：这是少阴经的泻心汤。凡是治疗“泻心”证，必须借助黄连、黄芩，但引导药力的方法有阴阳的区别。病在三阳经，胃中不和，导致心下痞塞者，虚证则加人参、甘草以补益，实证则加大黄以攻下。病在少阴经，出现心中烦躁、不能安卧的症状时，既不能用参、甘来助长阳气，也不能用大黄来损伤胃气。因此使用黄芩、黄连来直折心火，使用阿胶来补肾阴；鸡蛋黄辅助黄芩、黄连，在清泻心火的同时补养心血；芍药辅助阿胶，在滋补阴液的同时收敛阴气。这样使得心肾相交，肾水上升，心火下降，从而将扶阴泻阳的方剂，转变为滋阴和阳的药剂。这样少阴经的火邪各归其位，心中烦躁不得睡眠的症状即可消除。《内经》说：“阴气平和，阳气固秘，精神才能正常。”说的就是这个方剂吧！
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少阴病，出现腹泻、咽喉疼痛、胸部胀满、心烦意乱的症状，用猪肤汤主治。
【注】
身体温暖、腹部胀满、腹泻，是太阴病的证候；身体发冷、想睡觉、腹泻，是少阴病的证候。身体发热、失眠、咽喉疼痛，是热邪所致；身体发冷、想睡觉、咽喉疼痛，是寒邪所致。现在身体发冷、想睡觉，同时伴有腹泻、咽喉疼痛，以及胸部胀满、心烦意乱的证候并见，这是少阴经的热邪。少阴经脉，沿着喉咙，其分支从肺出来，联络心脏，注入胸中，所以少阴经的热邪上逆，经过的地方没有不生病的。用猪肤汤来主治，可以解除少阴上焦的热邪，兼能止住下焦的腹泻。
【集注】
喻昌说：腹泻、咽喉疼痛、胸部胀满、心烦意乱，这是少阴热邪充斥于上、下、中间，无处不到，此时寒凉攻下的药物已不可使用，所以创立了猪肤汤这一治法。大概阳气微弱者，用附子温通经脉；阴液枯竭者，用猪肤滋润燥热，在温通经脉和滋润燥热的过程中，都包含了疏散邪气的意义。
Coptidis Rhizoma (Huanglian) 4 liang, Scutellariae Radix (Huangqin) 2 liang, Paeoniae Radix Alba (Shaoyao) 2 liang, two egg yolks, and Asini Corii Colla (Ejiao) 3 liang.
The above five ingredients are boiled with six sheng of water. First, decoct the first three ingredients (Coptidis Rhizoma, Scutellariae Radix, and Paeoniae Radix Alba) to obtain two sheng of liquid. Strain out the dregs, add Asini Corii Colla until completely dissolved, allow the mixture to cool slightly, then add the egg yolks and stir well to mix. Take seven he of the warm decoction per dose, three times a day.
[Ji Jie - Collected Commentary]
Ke Qin stated: This is the Xiexin Tang (Draining Epigastrium Decoction) for Shaoyin disease. Whenever treating "Xiexin" patterns, Coptidis Rhizoma and Scutellariae Radix are essential, but the method of guiding the medicinal action differs between yin and yang. When the pathogen is in the Yangming or Taiyang stages, accompanied by disharmony in the stomach and fullness/stuffiness below the heart, deficiency patterns require supplementation with Ginseng Radix et Rhizoma (Renshen) and Glycyrrhizae Radix et Rhizoma (Gancao), while excess patterns require purgation with Rhei Radix et Rhizoma (Dahuang). In Shaoyin disease, characterized by vexation in the heart and inability to sleep, neither Renshen nor Gancao should be used as they might aid yang excessively, nor should Dahuang be used as it might damage the stomach qi. Therefore, Scutellariae Radix and Coptidis Rhizoma are used to directly subdue heart fire; Asini Corii Colla is used to tonify kidney yin; Egg Yolk assists Scutellariae Radix and Coptidis Rhizoma to nourish heart blood while draining heart fire; Paeoniae Radix Alba assists Asini Corii Colla to consolidate yin while nourishing yin. This facilitates the interaction between heart and kidney, allowing kidney water to ascend and heart fire to descend, transforming a formula that supports yin and drains yang into one that nourishes yin and harmonizes yang. Thus, the fire of Shaoyin returns to its proper place, and the vexation and insomnia in the heart are eliminated. The Classic states: "When yin is peaceful and yang is secure, spirit and mind are regulated." This describes this formula!
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In Shaoyin disease, presenting with diarrhea, sore throat, chest fullness, and mental restlessness/vexation, Zhufu Tang (Pig Skin Decoction) is the primary treatment.
[Note]
Warm body, abdominal fullness, and diarrhea indicate a Taiyin syndrome pattern; cold body, desire to sleep, and diarrhea indicate a Shaoyin syndrome pattern. Fever, insomnia, and sore throat indicate heat pathogenic factors; cold body, desire to sleep, and sore throat indicate cold pathogenic factors. Currently, the symptoms of cold body and desire to sleep coexist with diarrhea, sore throat, chest fullness, and mental restlessness. This indicates a heat pathogenic factor in the Shaoyin channel. The Shaoyin meridian runs along the throat; its branch emerges from the lung, connects with the heart, and enters the chest. Therefore, when heat pathogens in the Shaoyin channel rebel upward, all areas traversed by the meridian become diseased. Zhufu Tang is used to resolve heat in the upper jiao of Shaoyin and simultaneously stop diarrhea in the lower jiao.
[Ji Zhu - Collected Annotations]
Yu Chang stated: Diarrhea, sore throat, chest fullness, and mental restlessness indicate that Shaoyin heat pathogens are pervasive throughout the upper, lower, and middle regions, leaving no area unaffected. Cold-purgative medications are contraindicated; thus, the method of Zhufu Tang was established. Generally, for deficient yang, Fuzi (Prepared Aconite Lateral Root) is used to warm the meridians; for exhausted yin, Pig Skin (Zhu Fu) is used to moisten dryness. Both warming the meridians and moistening dryness contain the principle of dispersing pathogens.