治少阴病始得之，发热，脉沉，无里证者。
麻黄（一两） 附子（一枚，炮） 细辛（二两）
上三味，以水一斗，先煮麻黄，减二升，去沫，纳药，取三升，去滓。温服一升，日三
服。
热微者，以甘草易细辛，微发汗。
柯韵伯曰∶少阴主里，应无表证。病发于阴，应有内热。今始受寒邪，即便发热，而里
无热，似乎太阳，而属之少阴者，以头不痛而但欲寐也。盖少阴为太阳之雌，大言阴与阳，
小言
便露
里雌雄
肾气独沉，故身虽热而脉则沉也。所
表反热，便于表剂中加附子，以豫固
阴邪始得以内侵，孤阳因之以外越耳！
（且开且固，本方妙义如此。）夫发热、无汗，太阳之表不得不开；沉为在里，少阴之
枢又不
阳之微阳
病及表，
甘草易细
下后，复发汗，昼日烦躁不得眠，夜而安静，不呕，不渴，无表证，脉沉微，身无大热
者，
干姜（一两） 附子（一枚，去皮破八片，生用）
上二味，以水三升，顿服。
发汗，若下之，病仍不解，烦躁者，茯苓四逆汤主之。
茯苓（六两）人参（一两） 甘草（二两，炙） 干姜（一两半） 附子（一枚，去
皮，生用）上五味，以水五升，煮三升，温服七合，日三服。
柯韵伯曰∶二条皆太阳坏病，转属少阴者也。凡太阳病而妄汗、妄下者，其变证或仍在
太阳
属少
阳
少阴则
少阴
属
表证之解不解，为之详辨，则阴阳之差多差少，不致混淆，而用方命剂，无纤毫之失也。夫
先汗后下，于法为顺，而表仍不解，是妄下亡阴，阴阳俱虚而烦躁也，制茯苓四逆固阴以收
阳；先下后汗，于治为逆，而表证反解，内不呕渴，似乎阴阳自和，而实妄汗亡阳，所以
虚阳扰于阳分，昼则烦躁不得安，阳虚不得入于阴，故脉沉微而夜静，是真阳将脱而烦躁也，
用干姜、附子固阳以配阴。（方议妙极！）同一烦躁，所用之方不同如此。姜、附者，阳中阳
气化，不假根苗而成，能补先天无形之气，安虚阳外脱之烦，故以为君；人参能回元气于无
何有之乡，通血脉于细微欲绝之际，故以为佐。是方以人参佐茯苓，补下焦之元气；以干姜
而缓急自别，用方之神乎！（急缓二议，开后学心胸。）
治疗少阴病初起，出现发热、脉沉，且没有里证的情况。
麻黄（一两） 附子（一枚，炮制） 细辛（二两）
以上三味药，用水一斗，先煮麻黄，减少二升水量，撇去浮沫，加入其他药物，煎取三升药液，滤去药渣。每次温服一升，每日服用三次。
如果热象轻微，用甘草替换细辛，以微微发汗。
柯韵伯说：少阴主里，本应没有表证。病发于阴经，应有内热。如今刚受寒邪，就立即发热，而里没有热象，看似太阳病，却归属于少阴的原因，是因为头不痛且只想睡觉。大概少阴是太阳的配偶（对应关系），大而言之涉及阴阳，小而言之显露出里的雌雄关系。肾气独自下沉，所以身体虽然发热但脉象却沉。表证反而发热，便于在解表剂中加入附子，预先固护阳气，防止阴邪得以向内侵袭，孤阳因此向外越脱！（既发散又固护，本方的精妙义理就在于此。）发热、无汗，太阳之表不得不开泄；沉脉表示病在里，少阴的枢机又不通。
经过攻下后，又发汗，白天烦躁不能入睡，夜间安静，不呕吐，不口渴，没有表证，脉象沉微，身体没有大热的情况，
干姜（一两） 附子（一枚，去皮破成八片，生用）
以上两味药，用水三升，一次性服用。
发汗，或者攻下之后，病仍未解除，出现烦躁症状的，用茯苓四逆汤主治。
茯苓（六两）人参（一两） 甘草（二两，炙烤） 干姜（一两半） 附子（一枚，去皮，生用）以上五味药，用水五升，煎煮至三升，每次温服七合，每日服用三次。
柯韵伯说：这两条条文都是太阳病的坏病，转属到少阴的。凡是太阳病而误用汗法、误用下法的，其变证有的仍在太阳，有的转属少阴。对于表证是否解除，进行详细辨别，那么阴阳的偏差多或少，就不会混淆，从而使用方剂和确定剂量，就没有丝毫失误。先汗后下，从治法来说是顺应的，但表证仍不解，这是误下导致亡阴，阴阳都虚弱而出现烦躁，制作茯苓四逆汤来固护阴气以收敛阳气；先下后汗，从治疗来说是逆乱的，但表证反而解除，内部不呕不渴，看似阴阳自我调和，实际上是误汗导致亡阳，所以虚阳扰动在阳分，白天烦躁不得安宁，阳气虚弱不能进入阴分，所以脉象沉微而夜间安静，这是真阳即将脱失而出现的烦躁，用干姜、附子固护阳气以配合阴气。（方论精妙至极！）同样是烦躁，所使用的方剂却如此不同。干姜、附子，属于阳中的阳，气化作用，不借助根苗而成，能补益先天无形之气，安定虚阳外脱的烦躁，所以作为君药；人参能在元气极度虚弱时挽回元气，在血脉细微欲绝之际疏通血脉，所以作为佐药。这个方子用人参辅助茯苓，补益下焦的元气；用干姜……（此处原文似有缺漏或排版错误，按文意理解为配伍意义），急缓两种议论，开阔了后学者的心胸。
To treat Shaoyin disease at its onset, presenting with fever, deep pulse, and absence of interior syndromes.
Mahuang (Ephedrae Herba, one liang) Fuzi (Aconiti Lateralis Radix Praeparata, one piece, processed) Xixin (Asari Radix et Rhizoma, two liang)
Take the above three herbs, add ten dou of water, first decoct Mahuang until the volume reduces by two dou, skim off the foam, then add the remaining herbs, decoct to obtain three sheng of liquid, strain. Take one sheng warm, three times a day.
If the heat is mild, replace Xixin with Gancao (Glycyrrhizae Radix et Rhizoma) to induce slight sweating.
Ke Yunbo stated: Shaoyin governs the interior and should not present exterior syndromes. Diseases originating from Yin should have internal heat. Now, upon just receiving cold pathogen, fever occurs immediately, yet there is no heat in the interior. It resembles Taiyang disease but is attributed to Shaoyin because there is no headache and only drowsiness. Generally, Shaoyin corresponds to Taiyang as its counterpart; speaking broadly involves Yin and Yang, speaking specifically reveals the yin-yang relationship within the interior. The Kidney Qi sinks alone, thus although the body is hot, the pulse is deep. The exterior manifests heat, so it is convenient to add Fuzi to exterior-releasing formulas to pre-emptively secure the Yang, preventing Yin pathogens from invading inward, and preventing isolated Yang from floating outward! (Both releasing and securing, this is the profound meaning of this formula.) Fever and anhidrosis require opening the Taiyang exterior; a deep pulse indicates pathology in the interior, and the Shaoyin pivot is obstructed.
After purgation followed by sweating, if the patient experiences restlessness during the day preventing sleep, but remains quiet at night, without vomiting or thirst, no exterior syndrome, with a deep and faint pulse, and no significant heat on the body:
Ganjiang (Zingiberis Rhizoma, one liang) Fuzi (Aconiti Lateralis Radix, one piece, peeled, broken into eight slices, raw)
Take the above two herbs, add three sheng of water, take all at once.
If after sweating or purgation the disease persists and restlessness occurs, Lingjue Sini Tang (Poria Decoction for Reversing Collapse) is the primary treatment.
Fuling (Poria, six liang) Renshen (Ginseng Radix, one liang) Gancao (Glycyrrhizae Radix et Rhizoma, two liang, honey-fried) Ganjiang (Zingiberis Rhizoma, one and a half liang) Fuzi (Aconiti Lateralis Radix, one piece, peeled, raw)
Take the above five herbs, add five sheng of water, decoct to three sheng, take seven ge warm, three times a day.
Ke Yunbo stated: Both these clauses describe complications of Taiyang disease that have transferred to Shaoyin. Whenever Taiyang disease is treated with improper sweating or purgation, the resulting changes may remain in Taiyang or transfer to Shaoyin. By carefully distinguishing whether the exterior syndrome has resolved or not, one can differentiate between greater or lesser deviations of Yin and Yang, avoiding confusion, thereby ensuring that the selection of formulas and dosages are flawless. First sweating then purging is methodologically consistent, yet if the exterior remains unresolved, it indicates improper purgation leading to loss of Yin, with both Yin and Yang deficient causing restlessness; Lingjue Sini Tang is formulated to secure Yin and gather Yang. First purging then sweating is therapeutically adverse, yet if the exterior syndrome resolves and internally there is no vomiting or thirst, it seems like self-harmonization of Yin and Yang, but actually represents improper sweating leading to loss of Yang. Thus, deficient Yang disturbs the Yang aspect, causing daytime restlessness and inability to settle; Yang deficiency prevents entry into Yin, hence the deep faint pulse and nighttime quietness; this is true Yang about to collapse causing restlessness. Ganjiang and Fuzi are used to secure Yang and coordinate with Yin. (The discussion of the formula is extremely profound!) Although both present with restlessness, the formulas used differ significantly. Ganjiang and Fuzi belong to Yang within Yang; their qi transformation does not rely on roots or shoots, but can tonify the formless primordial Qi, calming the restlessness of external-floating deficient Yang, thus serving as the Sovereign herb; Renshen can restore Yuan Qi where it is nearly exhausted and unblock blood vessels when they are minute and near cessation, thus serving as the Assistant. This formula uses Renshen to assist Fuling in tonifying the primordial Qi of the Lower Jiao; [text implies further coordination]... (These discussions on urgency and moderation broaden the minds of future scholars.)